No abstract available
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Τετάρτη 14 Μαρτίου 2018
Response to the Letter to the Editor on ‘The effectiveness of technology-supported exercise therapy for low back pain: A systematic review.’
No abstract available
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Soil uranium concentration at Ranger Uranium Mine Land Application Areas drives changes in the bacterial community
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Saqib Mumtaz, Claire Streten, David L. Parry, Keith A. McGuinness, Ping Lu, Karen S. Gibb
Soil microorganisms may respond to metal stress by a shift in the microbial community from metal sensitive to metal resistant microorganisms. We assessed the bacterial community from low (2–20 mg kg−1), medium (200–400 mg kg−1), high (500–900 mg kg−1) and very high (>900 mg kg−1) uranium soils at Ranger Uranium Mine in northern Australia through pyrosequencing. Proteobacteria (28.85%) was the most abundant phylum at these sites, followed by Actinobacteria (9.31%), Acidobacteria (7.33%), Verrucomicrobia (2.11%), Firmicutes (2.02%), Chloroflexi (1.11%), Cyanobacteria (0.93%), Planctomycetes (0.82%), Bacteroidetes (0.46%) and Candidate_division_WS3 (Latescibacteria) (0.21%). However, 46.79% of bacteria were unclassified. Bacteria at low U soils differed from soils with elevated uranium. Bacterial OTUs closely related to Kitasatospora spp., Sphingobacteria spp. and Rhodobium spp. were only present at higher uranium concentrations and the bacterial community also changed with seasonal and temporal changes in soil uranium and physicochemical variables. This study using next generation sequencing in association with environmental variables at a uranium mine has laid a foundation for further studies of soil-microbe-metal interactions which may be useful for developing sustainable management and rehabilitation strategies. Furthermore, bacterial species associated with higher uranium may serve as useful indicators of uranium contamination in the wet-dry tropics.
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Percutaneous Dilatational Tracheostomy Using Tube Exchanger
We describe a modified technique for percutaneous dilatational tracheostomy using a 15F tube exchanger or Eschmann catheter. A retrospective review of 1180 procedures using this modified technique demonstrated it to be effective with a failure rate of only 0.25% (3 patients). Moreover, it provides an additional safeguard with the ability to rapidly reintroduce the endotracheal tube into the trachea guided by the exchange catheter in the event of accidental extubation during the procedure. This technique needs no additional special devices or equipment (eg, a bronchoscope). However, a prospective study is needed to better define its complication rate. Accepted for publication January 22, 2018. Funding: None. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Ohad Ronen, MD, Department of Otolaryngology, Head and Neck Surgery, Galilee Medical Center, POB 21, Nahariya 2210001, Israel. Address e-mail to ohadr@gmc.gov.il. © 2018 International Anesthesia Research Society
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Perioperative Cardiac Arrest: Focus on Local Anesthetic Systemic Toxicity (LAST) Erratum
No abstract available
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Burnout in American Anesthetists, Comparison With a French Cohort
No abstract available
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Intrathecal Drug Delivery Systems for Refractory Pancreatic Cancer Pain: Observational Follow-Up Study Over an 11-Year Period in a Comprehensive Cancer Center
BACKGROUND: Pancreatic cancer is the fourth leading cause of cancer-related death in Europe and the United States. Studies have demonstrated that patients with pancreatic cancer have a high prevalence of pain, with rates varying from 47% to 82%. Analgesia using intrathecal drug delivery systems (IDDS) has been poorly studied specifically in this population. METHODS: The IDDS for pancreatic cancer pain was a follow-up observational study designed to evaluate 11-year results of IDDS for refractory pancreatic cancer pain at the Institut de Cancérologie de L'Ouest, Paul Papin in France. Patients were followed from March 2006 to April 2017. Patients were selected for IDDS based on multidisciplinary meeting discussion. All IDDS-treated patients were prescribed a combined intrathecal analgesics regimen through a catheter placed according to painful metameric level. Postimplant assessment of pain was determined using a numerical rating scale (NRS). Patients were followed via day-hospital visits and telephone calls at least monthly until death. Pain scores were compared using the Wilcoxon signed rank test. Overall survival (OS) was estimated using the Kaplan–Meier method and compared between groups by log rank tests. RESULTS: Ninety-three patients received IDDS, and total therapy duration accounts for 10,300 IDDS days. Implanted patients suffered from severe pain before implantation (median presurgical NRS, 8 [interquartile range, 7–9]) despite a median 360 mg (260–600) oral morphine equivalent daily dose. Median OS in the whole cohort after intrathecal treatment start was 82 days (95% confidence interval, 59–95). Median OS after surgery for implantable pump was 91 days (83–111) and for external pump 27 days (20–49; P
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In Response
No abstract available
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Anesthesia for Percutaneous Pulmonary Valve Implantation: A Case Series
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center. METHODS: The study consisted of a chart review of patients who underwent TPVR at Toronto General Hospital between 2006 and 2015. Information about preoperative assessment, intraoperative anesthetic management, and intra- and postprocedural complications was collected. Two types of percutaneous valves have been used for a conduit or valve size between 16 and 28 mm. These procedures are done via the femoral, jugular, or subclavian vein under general anesthesia. RESULTS: Seventy-nine adults (17–68 years of age) who underwent elective TPVR procedures were included. General anesthesia was used in all cases. Defibrillation was necessary in 1 case, and bradycardia was spontaneously resolved in another 1. Eighty-five percent were successfully extubated at the end of the procedure. Five patients required intraoperative inotropic support. Three patients presented self-resolved hemoptysis. Mechanical ventilation for >24 hours was necessary in 3 cases, 2 of which also required concomitant inotropic support. Four failed deployments and 1 case of persistent conduit stenosis were reported. Three patients required reintubation. All patients were discharged home. CONCLUSIONS: Patients undergoing TPVR represent a complex and heterogeneous population. General anesthesia with endotracheal intubation is preferred. Setup for urgent lung isolation and cardiac defibrillation should be considered. Postoperative monitoring and intensive care setting are required. Anesthesiologists with cardiac anesthesia training are probably better suited to manage these patients. Accepted for publication January 22, 2018. Funding: None. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Massimiliano Meineri, MD, Department of Anesthesia and Pain Management, Toronto General Hospital, 200 Elizabeth St, EN3-400, Toronto, ON M5G 2C4, Canada. Address e-mail to massimiliano.meineri@uhn.ca. © 2018 International Anesthesia Research Society
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Spontaneous regression of colorectal liver metastasis
Abstract
A 72-year-old woman with advanced ascending colon cancer and an intraductal papillary mucinous neoplasm (IPMN) of the pancreatic head was treated by right hemicolectomy (RHC) and pylorus-preserving pancreaticoduodenectomy (PpPD). Adjuvant chemotherapy was not administered. Multimodal examinations at 5 months after surgery detected a solitary metastatic liver tumor derived from cancer of the ascending colon. Liver resection proceeded at 7 months after the first surgery. A pathological study of a surgical specimen of the liver identified a necrotic nodule that did not contain viable tumor cells. However, an immunohistological study of the hepatic mass indicated metastasis derived from cancer of the ascending colon. These findings were consistent with total necrosis of a liver metastasis of colorectal cancer. The mechanism of spontaneous regression of tumors remains unexplained. In our case, pancreaticoduodenectomy was performed at the same time as right hemicolectomy, which involved a risk of continuous biliary infection after biliary tract reconstruction. A host immune response to chronic biliary tract infection might have been involved in the spontaneous regression of liver metastasis. Spontaneous regression of colorectal liver metastasis is rare, and the mechanism remains unknown. This needs to be investigated in more tissues from patients who have experienced this phenomenon.
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Mupirocin at Subinhibitory Concentrations Induces Biofilm Formation in Staphylococcus aureus
Microbial Drug Resistance, Ahead of Print.
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Porin Deficiency in Carbapenem-Resistant Enterobacter aerogenes Strains
Microbial Drug Resistance, Ahead of Print.
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Evaluation of Different Screening Methodologies for the Detection of Methicillin-Resistant Staphylococcus aureus from Environmental Surfaces: Swabs, Gauzes, and Polywipes
Microbial Drug Resistance, Ahead of Print.
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Antimicrobial Susceptibility Patterns of Brachyspira Species Isolated in Taiwan
Microbial Drug Resistance, Ahead of Print.
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Molecular Mechanisms of Colistin Resistance Among Pandrug-Resistant Isolates of Acinetobacter baumannii with High Case-Fatality Rate in Intensive Care Unit Patients
Microbial Drug Resistance, Ahead of Print.
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Plasmid-Mediated Quinolone Resistance in Gram-Negative Pathogens Isolated from Cancer Patients in Egypt
Microbial Drug Resistance, Ahead of Print.
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A Flow Cytometry-Based Phenotypic Screen To Identify Novel Endocytic Factors in Saccharomyces cerevisiae
Endocytosis is a fundamental process for internalizing material from the plasma membrane, including many transmembrane proteins that are selectively internalized depending on environmental conditions. In most cells, the main route of entry is clathrin-mediated endocytosis (CME), a process that involves the coordinated activity of over 60 proteins; however, there are likely as-yet unidentified proteins involved in cargo selection and/or regulation of endocytosis. We performed a mutagenic screen to identify novel endocytic genes in Saccharomyces cerevisiae expressing the methionine permease Mup1 tagged with pHluorin (pHl), a pH-sensitive GFP variant whose fluorescence is quenched upon delivery to the acidic vacuole lumen. We used fluorescence-activated cell sorting to isolate mutagenized cells with elevated fluorescence, resulting from failure to traffic Mup1-pHl cargo to the vacuole, and further assessed subcellular localization of Mup1-pHl to characterize the endocytic defects in 256 mutants. A subset of mutant strains was classified as having general endocytic defects based on mislocalization of additional cargo proteins. Within this group, we identified mutations in four genes encoding proteins with known roles in endocytosis: the endocytic coat components SLA2, SLA1, and EDE1, and the ARP3 gene, whose product is involved in nucleating actin filaments to form branched networks. All four mutants demonstrated aberrant dynamics of the endocytic machinery at sites of CME; moreover, the arp3R346H mutation showed reduced actin nucleation activity in vitro. Finally, whole genome sequencing of two general endocytic mutants identified mutations in conserved genes not previously implicated in endocytosis, KRE33 and IQG1, demonstrating that our screening approach can be used to identify new components involved in endocytosis.
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Rapid Multiplex Small DNA Sequencing on the MinION Nanopore Sequencing Platform
Real-time sequencing of short DNA reads has a wide variety of clinical and research applications including screening for mutations, target sequences and aneuploidy. We recently demonstrated that MinION, a nanopore-based DNA sequencing device the size of a USB drive, could be used for short-read DNA sequencing. In this study, an ultra-rapid multiplex library preparation and sequencing method for the MinION is presented and applied to accurately test normal diploid and aneuploidy samples' genomic DNA in under three hours, including library preparation and sequencing. This novel method shows great promise as a clinical diagnostic test for applications requiring rapid short-read DNA sequencing.
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The local cytokine and growth factor response to rhBMP-2 after spinal fusion
The systemic response regarding cytokine expression after application of recombinant human Bone Morphogenetic Protein-2 (rhBMP-2) in a rat spinal fusion model has recently been defined1, but the local response has not. Defining the local cytokine and growth factor response at the fusion site will help explain the roles of these molecules in the fusion process, as well as that of rhBMP-2. Our hypothesis is that application of rhBMP-2 to the fusion site will alter the local levels of cytokines and growth factors throughout the fusion process, in a manner that is different than the systemic response given the tissue-specific effects of rhBMP-2.
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Application of morphometrics as a predictor for survival in female patients with breast cancer spinal metastasis, a retrospective cohort study
The current standard of care for prediction of survival of cancer staging is based on TNM staging. However, for patients with spinal metastasis, who all have identical stage IV disease, identifying accurate prognostic markers of survival would allow better treatment stratification between more aggressive treatment strategies or palliation. Analytic morphometrics enables physicians to quantify patient frailty by measuring lean muscle mass. Morphometrics also predicts survival in patients with lung cancer metastases to the spine.
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Amantadine Induced Corneal Edema in a Pediatric Neuro-Oncology Patient: A Case Report
Amantadine is commonly prescribed as a neurostimulant in patients with brain injuries. This is a case of a 14 year-old male with a history of brain tumor that developed corneal edema after initiation of amantadine, a rare but documented side effect of this medication. After discontinuation of amantadine, the corneal edema resolved within two months, but endothelial cells density remained low.
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Frailty in a Post-Acute Care Population: A Scoping Review
Frailty is a complex and growing phenomenon facing healthcare providers throughout the continuum of care. Frailty is not well understood in post-acute care (PAC) settings. The purpose of this scoping review was to summarize current evidence of frailty impact on outcomes and frailty mitigation initiatives in PAC. Three major publication databases were searched from January 2000-June 2017 that identified 18 articles specifically addressing frailty in PAC. Three themes were identified: scales used to measure frailty; factors that led to an adverse outcome or diagnosis of frailty; and interventions to address frailty in PAC.
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Myocardial Infarction Injury in Patients with Chronic Lung Disease Entering Pulmonary Rehabilitation: Frequency and Association with Heart Rate Parameters
Myocardial infarction (MI) remains under-recognized in chronic lung disease (CLD) patients. Rehabilitation health professionals need accessible clinical measurements to identify the presence of prior MI in order to determine appropriate training prescription.
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Sex Differences in Common Sports Injuries
Common sports injuries include bone stress injuries (BSI), anterior cruciate ligament injuries (ACL), and concussions. Less commonly recognized are the specific sex differences in epidemiology, risk factors, and outcomes of these conditions by sex. An understanding of these factors can improve their clinical management, from prescribing appropriate prehabilitation to guiding post injury rehabilitation and return to play. This narrative review summarizes the sex differences in the diagnosis and management of BSI, ACL injuries, and concussions.
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Rhythmic Neck Muscle Spasms and Upper Limb Muscle Myoclonic Jerks as an Unusual Initial Presentation of Posttraumatic Cervicothoracic Syringomyelia: A Case Report
Posttraumatic syringomyelia with an initial presentation of involuntary movement is rare. We describe a 25-year-old patient who sustained complete traumatic spinal cord injury at the thoracic level and presented with rhythmic neck muscle spasms and upper limb muscle myoclonic jerks 1 month after trauma. Magnetic resonance imaging revealed syrinx formation between C3 and T1. Lumbar-peritoneal shunt and decompression were performed. The symptoms completely disappeared after surgery. This report highlights that rhythmic neck muscle spasms and upper limb muscle myoclonic jerks can be the initial and only manifestations of syringomyelia.
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Characteristics and outcomes of children with conversion disorder admitted to a single inpatient rehabilitation unit, a retrospective study
Conversion disorder (CD) can lead to impaired functioning. Few studies present demographic and outcome data for pediatric patients. Many have had success with rehabilitation, however further details are not known.
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Pharmacological Treatment for Depression at Injury is associated with Fewer Clinician Visits for Persistent Symptoms after Mild Traumatic Brain Injury: A Medical Record Review Study
Depression and traumatic brain injury (TBI) substantially contribute to the United States healthcare burden. Depression is a known risk factor for prolonged recovery after TBI. However, the effect of depression treatment on health care utilization has yet to be studied.
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Functional Outcomes of an Interdisciplinary Outpatient Rehabilitation Program for Patients with Malignant Brain Tumors
Malignant brain tumors cause significant impairments in function due to nature of the disease. Patients with malignant brain tumors can make functional gains equivalent to those with stroke and traumatic brain injury in the inpatient rehabilitation setting. However, the efficacy of outpatient rehabilitation in this population has received little study.
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Hepatic Resection vs. Transarterial Chemoembolization for Hepatocellular Carcinoma beyond the Milan Criteria with Portal Hypertension
To assess the value of hepatic resection by comparing it with transarterial chemoembolization for hepatocellular carcinoma beyond the Milan criteria with clinically relevant portal hypertension.
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MYOGENIC OXIDATIVE IMBALANCE INTERFERES WITH ANTRAL MOTILITY IN OBESE SUBJECTS
Obesity is characterized by a systemic low-grade chronic inflammatory oxidative condition that affects vascular and cardiac smooth muscle relaxation. In human antrum, relaxation is mediated by Vasoactive Intestinal Peptide (VIP) through cAMP and cGMP signalling pathways. A genome-wide association study has demonstrated an association between VIP and obesity.
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Adalimumab treatment of anti-TNF-naïve patients with ulcerative colitis: deep remission and response factors
Adalimumab is the second tumour necrosis factor antagonist (anti-TNF) adopted for the treatment of ulcerative colitis. Clinical data from naïve patients are scarce.
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MYOGENIC OXIDATIVE IMBALANCE INTERFERES WITH ANTRAL MOTILITY IN OBESE SUBJECTS
Obesity is characterized by a systemic low-grade chronic inflammatory oxidative condition that affects vascular and cardiac smooth muscle relaxation. In human antrum, relaxation is mediated by Vasoactive Intestinal Peptide (VIP) through cAMP and cGMP signalling pathways. A genome-wide association study has demonstrated an association between VIP and obesity.
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Hepatic Resection vs. Transarterial Chemoembolization for Hepatocellular Carcinoma beyond the Milan Criteria with Portal Hypertension
To assess the value of hepatic resection by comparing it with transarterial chemoembolization for hepatocellular carcinoma beyond the Milan criteria with clinically relevant portal hypertension.
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Adalimumab treatment of anti-TNF-naïve patients with ulcerative colitis: deep remission and response factors
Adalimumab is the second tumour necrosis factor antagonist (anti-TNF) adopted for the treatment of ulcerative colitis. Clinical data from naïve patients are scarce.
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Emergency Reporting releases Buyer’s Guide to help Fire and EMS leaders choose the right records management solution
Choosing the right Fire and EMS records management software can be a daunting task. This objective new Buyer's Guide tells you exactly what to look for.
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Online mapping of EMG signals into kinematics by autoencoding
In this paper, we propose a nonlinear minimally supervised method based on autoencoding (AEN) of EMG for myocontrol. The proposed method was tested against the state-of-the-art (SOA) control scheme using a Fit...
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Variables influencing wearable sensor outcome estimates in individuals with stroke and incomplete spinal cord injury: a pilot investigation validating two research grade sensors
Monitoring physical activity and leveraging wearable sensor technologies to facilitate active living in individuals with neurological impairment has been shown to yield benefits in terms of health and quality ...
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Development of VariLeg, an exoskeleton with variable stiffness actuation: first results and user evaluation from the CYBATHLON 2016
Powered exoskeletons are a promising approach to restore the ability to walk after spinal cord injury (SCI). However, current exoskeletons remain limited in their walking speed and ability to support tasks of ...
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Adaptation and post-adaptation effects of haptic forces on locomotion in healthy young adults
Developing rehabilitation strategies to improve functional walking and postural control in patients is a priority for rehabilitation clinicians and researchers alike. One possible strategy is the use of sensor...
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tester - zztest-2
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Staff Nurse – Vitalink - New Hanover Regional EMS
Staff Nurse – Vitalink The Staff RN provides high quality patient care and safe medical transport to sick and injured patients in all age groups. Essential Responsibilities: Collaborates with team and initiates care plan based on patient assessment and significant other input/data. Continuously reviews and revises plan as needed per patient's condition. Maintains thorough patient care documentation ...
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Critical Care Transport Paramedic – Vitalink - New Hanover Regional EMS
Critical Care Transport Paramedic – Vitalink Essential Responsibilities: Provides high quality patient care and safe medical transport to sick and injured patients in all age groups Uses an interdisciplinary model to work with the Airlink/Vitalink Staff Nurse and other appropriate medical personnel to establish and prioritize a plan of care consistent with approved treatment protocols, policies ...
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EMS1 Job List Test - Internet Explorer - Praetorian Digital
Testing Functionality
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EMS1 Job List Test - Firefox - Praetorian Digital
Testing Functionality
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EMS1 Job List Test - Chrome - Praetorian Digital
testing functionality
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EMS1 Job List Test - Chrome - PoliceOne.com
Enter Job Description Here Bullets are here here Numerical outline are here here already set to separate in paragraph format
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An explanation for sudden death in epilepsy (SUDEP)
Abstract
This review traces the examination of autonomic, cardiovascular, and respiratory derangements associated with seizure activity in the clinical and preclinical literature generally, and in the author's animal model specifically, and concludes with the author's views on the potential mechanisms for sudden death in epilepsy (SUDEP). An animal model that employs kainic acid-induced seizures on a background of urethane anesthesia has permitted unprecedented access to the behavior of autonomic, cardiovascular, and respiratory systems during seizure activity. The result is a detailed description of the major causes of death and how this animal model can be used to develop and test preventative and interventional strategies. A critical translational step was taken when the rat data were shown to directly parallel data from definite SUDEP cases in the clinical literature. The reasons why ventricular fibrillation as a cause of death is so rarely reported and tools for verifying that seizure-associated laryngospasm can induce obstructive apnea as a cause of death are discussed in detail. Many details of the specific kinetics of activation of brainstem neurons serving autonomic and respiratory function remain to be elucidated, but the boundary conditions described in this review provide an excellent framework for more focused studies. A number of studies conducted in animal models of seizure activity and in epilepsy patients have contributed information on the autonomic, cardiovascular, and respiratory consequences of seizure activity spreading through hypothalamus and brainstem to the periphery. The result is detailed information on the systemic impact of seizure spread and the development of an understanding of the essential mechanistic features of sudden unexpected death in epilepsy (SUDEP). This review summarizes translation of data obtained from animal models to biomarkers that are useful in evaluating data from epilepsy patients.
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Hypoxia-induced lowered executive function depends on arterial oxygen desaturation
Abstract
Although it has been traditionally thought that decreasing SpO2 with ascent to high altitudes not only induces acute mountain sickness but also can decrease executive function, the relationship between decreased SpO2 levels and hypoxia-induced lowered executive function is still unclear. Here we aimed to clarify whether hypoxia-induced lowered executive function was associated with arterial oxygen desaturation, using 21 participants performing the color–word Stroop task under normoxic and three hypoxic conditions (FIO2 = 0.165, 0.135, 0.105; corresponding to altitudes of 2000, 3500, and 5000 m, respectively). Stroop interference significantly increased under severe hypoxic condition (FIO2 = 0.105) compared with the other conditions. Moreover, there was a negative correlation between Stroop interference and SpO2. In conclusion, acute exposure to severe hypoxic condition decreased executive function and this negative effect was associated with decreased SpO2. We initially implicated an arterial oxygen desaturation as a potential physiological factor resulting in hypoxia-induced lowered executive function.
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Basicranium and face: Assessing the impact of morphological integration on primate evolution
Source:Journal of Human Evolution, Volume 118
Author(s): Dimitri Neaux, Gabriele Sansalone, Justin A. Ledogar, Sarah Heins Ledogar, Theodora H.Y. Luk, Stephen Wroe
The basicranium and facial skeleton are two integrated structures displaying great morphological diversity across primates. Previous studies focusing on limited taxonomic samples have demonstrated that morphological integration has a significant impact on the evolution of these structures. However, this influence is still poorly understood. A more complete understanding of craniofacial integration across primates has important implications for functional hypotheses of primate evolution. In the present study, we analyzed a large sample of primate species to assess how integration affects the relationship between basicranial and facial evolutionary pathways across the order. First, we quantified integration and modularity between basicranium and face using phylogenetically-informed partial least squares analyses. Then, we defined the influence of morphological integration between these structures on rates of evolution, using a time-calibrated phylogenetic tree, and on disparity through time, comparing the morphological disparity across the tree with that expected under a pure Brownian process. Finally, we assessed the correlation between the basicranium and face, and three factors purported to have an important role in shaping these structures during evolution: endocranial volume, positional behavior (i.e., locomotion and posture), and diet. Our findings show that the face and basicranium, despite being highly integrated, display significantly different evolutionary rates. However, our results demonstrate that morphological integration impacted shape disparity through time. We also found that endocranial volume and positional behavior are important drivers of cranial shape evolution, partly affected by morphological integration.
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Tracheal expression of Osiris gene family in Drosophila
Source:Gene Expression Patterns
Author(s): Aaron Scholl, Yuyang Yang, Patrick McBride, Kelly Irwin, Lan Jiang
The Drosophila trachea is a premier genetic system to investigate the fundamental mechanisms of tubular organ formation. Development of the trachea consists of the well understood early branch specification and migration processes, and the less clear later branch maturation process including the apical membrane expansion, cytoskeleton rearrangement, luminal matrix clearance, and air-filling. We identified seven members of the Osiris (Osi) gene family with obvious tracheal expression in trachea. In addition, HA-tagged Osi proteins are highly concentrated in vesicle-like structures at and near the apical membrane. Osi proteins are predicted to contain endocytic signals and transmembrane domains. The localization of Osi proteins is consistent with these predictions. Interestingly, the Drosophila tracheal tube maturation process also occurs at the apical membrane. Taken together, the localization of Osi proteins suggest that these proteins are likely involved in tube maturation through vesicular trafficking or interacting with other apical membrane proteins.
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Astacin gene family of metalloproteinases in planarians: Structural organization and tissue distribution
Source:Gene Expression Patterns
Author(s): Maria Emilia Isolani, Renata Batistoni, Chiara Ippolito, Anna Maria Bianucci, Silvia Marracci, Leonardo Rossi
Planarian flatworms possess extraordinary regenerative capability and body plasticity, which rely on a composite population of stem cells, the neoblasts. Despite impressive advances have been recently achieved in the knowledge of neoblast biology, few is still known about factors that are released by differentiated tissues and influence the neoblast fate. Extracellular matrix (ECM) is a fundamental component of the stem cell niche and its remodeling affects stem cell fate. Here we provide the characterization of the astacin gene family of metalloproteinases in planarians, good candidate enzymes for generating dynamicity in the ECM. Ten and eighteen astacin isoforms were identified in the planarian species Schmidtea mediterranea and Dugesia japonica, respectively. Besides the already characterized Smedolloid, in Schmidtea mediterranea are present eight astacins with a minimal structure (a signal peptide, an activation domain and a Zn-binding catalytic domain), that are colocalized in large cells organized in a peculiar, not yet morphologically characterized, two-ring-shaped structure located in the middle of the body. A single astacin, characterized by a ShK toxin domain in its C-terminal region, has been found to be produced in gastrodermal cells.
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ND child care staff now required to undergo CPR, AED training
The state is also mandating that all child care employees undergo training for Sudden Infant Death Syndrome before working with children
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Immunohistochemical Assessment of CD30+ Lymphocytes in the Intestinal Mucosa Facilitates Diagnosis of Pediatric Ulcerative Colitis
Abstract
Background
Diagnosis of pediatric inflammatory bowel diseases (IBD) remains challenging. We aimed at the value of immunohistochemical assessment of CD30+ lymphocytes in the intestinal mucosa in differential diagnosis between pediatric Crohn's disease (CD) and ulcerative colitis (UC) and its utility as a predictor of future differentiation in patients with IBD unclassified (IBDU).
Methods
Seventy-four treatment naive pediatric patients with IBD (33 CD, 30 UC and 11 IBDU) were enrolled into the study. Biopsy samples from six different regions (terminal ileum, cecum, ascending colon, transverse colon, descending colon and rectum) were immunohistochemically stained with anti-CD30 antibody, and the number of positive cells per one high power field was quantified.
Results
Significant differences between CD and UC were found when compared total counts of CD30+ cells in median numbers, mean values and maximal numbers and also for separate counts in terminal ileum, transverse colon, descending colon and rectum. The most profound difference between CD and UC was shown for total median values of CD30+ cells and for the values in rectal localization. The difference was independent on the intensity of inflammation. A cutoff value of 2.5 CD30+ cells with sensitivity 83% and specificity 90% was found for the rectum. There was no difference between patients with CD and IBDU, but a marked difference between UC and IBDU patients was revealed.
Conclusion
Histopathological assessment of biopsy with rectal CD30+ count is reliable and simple method that could help in differential diagnosis among IBD subtypes in children with IBD.
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Impact of regular physical activity on adipocytokines and cardiovascular characteristics in spinal cord injured subjects
Publication date: Available online 13 March 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Roberto Schreiber, Cristiane M. Souza, Layde R. Paim, Guilherme de Rossi, José R. Matos-Souza, Anselmo de A. Costa e Silva, Fernando R. Faria, Eliza R. Azevedo, Karina C. Alonso, Andrei C. Sposito, Alberto Cliquet, José I. Gorla, Wilson Nadruz
ObjectiveTo investigate the relationship of carotid intima-media thickness (IMT) and cardiac structure and function with adipocytokines in sedentary (S-SCI) and physically-active (PA-SCI) subjects with spinal cord injury (SCI).DesignCross-sectional observational study.SettingAcademic medical center.ParticipantsForty-one SCI men (16 S-SCI and 25 PA-SCI) with chronic (>1y) SCI were evaluated. S-SCI subjects did not perform labor that required physical effort, recreational physical activity or sports, while PA-SCI subjects included competing athletes that were regularly performing adapted sports.InterventionsNot applicable.Main Outcome MeasuresClinical, laboratory, carotid ultrasonography and echocardiography analysis. Plasma leptin, adiponectin and plasminogen activating inhibitor-1 (PAI-1) were determined.ResultsPA-SCI subjects had similar levels of adipocytokines, but lower carotid IMT and carotid IMT/diameter, and better left ventricular diastolic function than S-SCI participants. Bivariate analysis showed that adiponectin was inversely correlated with triglycerides (r=-0.85, p<0.001), low-density-lipoprotein cholesterol (r=-0.57, p<0.05) and carotid IMT/diameter (r=-0.56, p<0.05) in S-SCI, but not in PA-SCI participants. Additionally, leptin/adiponectin ratio showed a direct correlation with triglycerides (r=0.84, p<0.001) and low-density-lipoprotein cholesterol (r=0.53, p<0.05) in S-SCI, but not in PA-SCI individuals. By contrast, the studied adipocytokines did not correlate with cardiac structure and function in PA-SCI and S-SCI participants.ConclusionsLower adiponectin levels and higher leptin/adiponectin ratio are related to adverse vascular and/or metabolic characteristics in SCI individuals. This relationship, however, appears to be mitigated by regular physical activity.
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Medical genetics: Towards precision medicine
Source:Journal of Genetics and Genomics, Volume 45, Issue 2
Author(s): Peng Jin
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The importance of specific rehabilitation for an obese patient with idiopathic intracranial hypertension: a case report
Idiopathic intracranial hypertension (IIH) is associated with obesity, and weight loss is important to reduce intracranial pressure and improve visual function. A 38-year-old woman with IIH followed an extreme diet, which resulted in 30% weight loss (BMI moved from 34.9 to 24.6). Weight loss resulted in a significant reduction of papilloedema, normalization of intracranial pressure and improvement in headache pattern, but also induced a state of initial malnutrition, relevant depression and disability. She was discharged with the indication to start a controlled diet and improve physical activity: clinical situation get back to stability, with the patient loosing further weight (BMI=21.8) through a balanced diet and moderate physical exercise. Obese patients with IIH should be offered a comprehensive treatment approach consisting of diet and nutritional support, psychological counselling, indication to increase physical activity and, when appropriate, a specific rehabilitation programme. Correspondence to Alberto Raggi, PsyD, PhD, Neurology, Public Health and Disability Unit, Neurological Institute C. Besta IRCCS Foundation, Via Celoria 11, 20133 Milan, Italy Tel: +39 02 2394 3105/+39 02 2394 2521; fax: +39 02 2394 2442; e-mail: alberto.raggi@istituto-besta.it Received January 19, 2018 Accepted February 13, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Post-mortem analysis of suicide victims shows ABCB1 haplotype 1236T–2677T–3435T as a candidate predisposing factor behind adverse drug reactions in females
Background Genetic variation in efflux transporter, permeability glycoprotein (P-gp), has recently been associated with completed violent suicides and also violent suicide attempts. As depression is known to be a risk factor for suicide and many antidepressants are P-gp substrates, it has been speculated that inadequate antidepressant treatment response or adverse side effects could be involved. Objectives The aim of this study was to investigate whether there is an association between the P-gp coding ABCB1 gene and completed suicides in citalopram users. Also, the effect of sex and suicide method used (violent vs. non-violent) was evaluated. Materials and methods All cases included in the study population, 349 completed suicide victims and 284 controls, were shown to be positive for antidepressant citalopram in a post-mortem toxicological drug screen. ABCB1 1236C>T, 2677G>T/A and 3435C>T polymorphisms were determined by TaqMan genotyping assays. Haplotypes were constructed from genotype data using the PHASE software. The association between the manner of death and the ABCB1 haplotype was tested with logistic regression analysis. Results No statistically significant differences were observed in the ABCB1 allele or genotype frequencies between the suicide and control groups. However, the ABCB1 1236T–2677T–3435T haplotype was associated with completed suicides of female citalopram users (odds ratio: 2.23; 95% confidence interval: 1.22–4.07; P=0.009). After stratification by the method used for suicide, the association emerged in fatal intoxications (odds ratio: 2.51; 95% confidence interval: 1.29–4.87; P=0.007). In other groups, no statistically significant associations were observed. Conclusion Our results suggest that female citalopram users with ABCB1 1236T–2677T–3435T are more vulnerable to adverse effects of the drugs as this haplotype was enriched in non-violent suicides of female citalopram users. Even though the biological mechanism behind this observation is unknown, the results provide another example of the importance of sex-based segregation in pharmacogenetics studies.from Genetics via xlomafota13 on Inoreader http://ift.tt/2tLAB5v
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Effects and Dose–Response Relationships of Motor Imagery Practice on Strength Development in Healthy Adult Populations: a Systematic Review and Meta-analysis
Abstract
Background
Motor imagery (MI), a mental simulation of a movement without overt muscle contraction, has been largely used to improve general motor tasks. However, the effects of MI practice on maximal voluntary strength (MVS) remain equivocal.
Objectives
The aims of this meta-analysis were to (1) estimate whether MI practice intervention can meaningfully improve MVS in healthy adults; (2) compare the effects of MI practice on MVS with its combination with physical practice (MI-C), and with physical practice (PP) training alone; and (3) investigate the dose–response relationships of MI practice.
Data Sources and Study Eligibility
Seven electronic databases were searched up to April 2017. Initially 717 studies were identified; however, after evaluation of the study characteristics, data from 13 articles involving 370 participants were extracted. The meta-analysis was completed on MVS as the primary parameter. In addition, parameters associated with training volume, training intensity, and time spent training were used to investigate dose–response relationships.
Results
MI practice moderately improved MVS. When compared to conventional PP, effects were of small benefit in favour of PP. MI-C when compared to PP showed unclear effects. MI practice produced moderate effects in both upper and lower extremities on MVS. The cortical representation area of the involved muscles did not modify the effects. Meta-regression analysis revealed that (a) a training period of 4 weeks, (b) a frequency of three times per week, (c) two to three sets per single session, (d) 25 repetitions per single set, and (e) single session duration of 15 min were associated with enhanced improvements in muscle strength following MI practice. Similar dose–response relationships were observed following MI and PP.
Conclusions
The present meta-analysis demonstrates that compared to a no-exercise control group of healthy adults, MI practice increases MVS, but less than PP. These findings suggest that MI practice could be considered as a substitute or additional training tool to preserve muscle function when athletes are not exposed to maximal training intensities.
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Toll-like receptor 4 deficient mice do not develop remifentanil-induced mechanical hyperalgesia: An experimental randomised animal study
BACKGROUND Drugs with antagonistic actions on the Toll-like receptor 4 (Tlr4), such as naloxone at ultra low doses, have been used to inhibit opioid-induced hyperalgesia in rodents suggesting the involvement of this receptor and pathway on opioid-induced hyperalgesia. OBJECTIVE The aim of this study was to determine whether mice without the Tlr4 gene (Tlr4−/−) would not develop remifentanil-induced hyperalgesia. DESIGN An experimental randomised animal study. SETTING Experimental Unit, Complutense University of Madrid, Madrid, Spain. ANIMALS Twelve adult female wild-type mice and 12 adult Tlr4−/− mice. INTERVENTIONS Under sevoflurane anaesthesia, a 1-h, constant rate subcutaneous infusion of remifentanil (4 μg kg−1 min−1) or 0.9% saline. MAIN OUTCOME MEASURES Mechanical nociceptive thresholds were evaluated using a von Frey hair test before (baseline) and on days 5, 6 and 7 after treatment. Hyperalgesia was considered to be a decrease in the mechanical nociceptive threshold. Changes in mechanical nociceptive thresholds in the different groups were compared with one-sided paired t tests. RESULTS Baseline mechanical nociceptive thresholds were similar in all groups (2.2 ± 0.1 g). Remifentanil produced a 24% decrease in mechanical nociceptive thresholds in the wild-type mice (1.7 ± 0.0 g, averaged over 3 days, P = 0.00021), whereas the nociceptive thresholds were not changed in Tlr4−/− mice (2.2 ± 0.1 g, P = 0.857) or in mice receiving 0.9% saline (Tlr4−/−, 2.2 ± 0.1 g, P = 0.807; wild-type, 2.2 ± 0.1 g, P = 0.962). CONCLUSION Tlr4 receptor involvement is suggested in the development of remifentanil-induced hyperalgesia in mice. TRIAL REGISTRATION CEA-UCM 107/2012). Correspondence to Ignacio A. Gómez de Segura, Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Avda. Puerta de Hierro, 28040 Madrid, Spain Tel: +34 913 943 858; fax: +34 913 943 808; e-mail: iagsegura@vet.ucm.es © 2018 European Society of Anaesthesiology
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Prediction of bilateral cerebral oxygen desaturations from a single sensor in adult cardiac surgery: A prospective observational study
BACKGROUND Monitoring regional cerebral oxygen saturation (rcSO2) with near-infrared spectroscopy is increasingly being performed in patients scheduled for cardiac surgery. It is sometimes difficult to monitor both frontal lobes due to anatomical or space compromises. However, it remains unclarified whether the use of only one lateral or medial probe can provide adequate bilateral monitoring. OBJECTIVE To evaluate the efficacy of using a single lateral or medial probe to detect substantial desaturations on both sides. DESIGN A prospective observational study. SETTING Tertiary university teaching hospital. PATIENTS Seventeen adult patients undergoing elective cardiac surgery monitored with three near-infrared spectroscopy probes (two lateral and one medial) using an INVOS 5100C monitor. INTERVENTIONS The value of rcSO2 was registered up to 19 times during each procedure. Substantial desaturation was defined as an absolute rcSO2 value of 50% or less or a decrease of more than 20% compared with basal values on spontaneous ventilation with 21% oxygen. MAIN OUTCOME MEASURES The agreement between the three probes using the Bland–Altman method for repeated measures, and the grade of concordant and discordant results between probes by means of contingency tables and the κ coefficient. RESULTS We obtained 244 records per probe. Greater agreement was observed between the two lateral probes (mean of the differences between recordings was -0.9 ± 5.5 points); mean difference between left and medial, and right and medial probes was 2.4 ± 7.3 and 3.3 ± 6.7, respectively. The rate of discordant results between the two lateral probes was 5.7% [κ coefficient of 0.6 [95% confidence interval (95% CI) 0.4 to 0.8)], and between the left and medial, and right and medial of 8.2 and 7.4%, with κ coefficients of 0.57 (95% CI 0.38 to 0.76) and 0.5 (95% CI 0.29 to 0.71), respectively. CONCLUSION In cardiac surgery patients in whom there is difficulty in accommodating two rcSO2 probes, a single lateral probe can effectively measure bilateral rcSO2 in specific scenarios. Correspondence to Manuel de la Matta, Department of Anaesthesia, Hospital General, Hospital Universitario Virgen del Rocío, Avda Manuel Siurot s/n, Sevilla 41013, Spain. E-mail: mdlmattam@hotmail.com © 2018 European Society of Anaesthesiology
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Prolonged Effects of Elevated 17β-Estradiol on Physical Activity after Orchidectomy
ABSTRACTThe biological mechanisms regulating physical activity patterns appear to be linked to the sex hormones. Elucidation of these regulatory mechanisms may enhance individual physical activity patterns producing positive gains in health.PURPOSEThe purpose of this study was to evaluate the prolonged effects of estrogen on wheel running distance, duration, and speed in orchidectomized mice.METHODSThe physical activity patterns of 9-week old C57BL/6j male mice (n=28) were observed. Wheel running distance, duration, and speed were assessed under physiological conditions for seven days. Next, physical activity patterns were evaluated following bilateral orchidectomy (n=14) or sham orchidectomy (n=14) for an additional seven days. Orchidectomized mice were provided estrogen containing capsules for three additional weeks; control mice were provided estrogen-free capsules. Wheel running distance, duration, and speed were analyzed by three two-way (treatment group x phase of study) analysis of variance tests.RESULTSWheel running speed was unaffected by sex hormone status. Distance (mean±SD: 6.74±2.13 km at baseline) decreased significantly after orchidectomy (2.27±1.55 km) and remained low following initial estrogen treatment (3.04±1.05 km). Prolonged estrogen exposure sustained a significant elevation of daily distance (4.47±1.87 km). Prolonged estrogen exposure recovered and significantly sustained wheel running duration (baseline: 248±60 min; post-orchidectomy: 102±53 min; prolonged exposure: 170±63 min).CONCLUSIONSWheel running behavior was reduced significantly following orchidectomy and remained low following initial treatment with estrogens, but recovered to near control levels after two weeks of exposure to estrogens. The estrogenic mechanism regulating wheel running behavior in male mice appears to induce an extensive, but slow acting biological mechanism. Understanding the biological drive behind this mechanism may aid in developing useful therapeutic strategies to combat health issues related to physical inactivity. The biological mechanisms regulating physical activity patterns appear to be linked to the sex hormones. Elucidation of these regulatory mechanisms may enhance individual physical activity patterns producing positive gains in health. PURPOSE The purpose of this study was to evaluate the prolonged effects of estrogen on wheel running distance, duration, and speed in orchidectomized mice. METHODS The physical activity patterns of 9-week old C57BL/6j male mice (n=28) were observed. Wheel running distance, duration, and speed were assessed under physiological conditions for seven days. Next, physical activity patterns were evaluated following bilateral orchidectomy (n=14) or sham orchidectomy (n=14) for an additional seven days. Orchidectomized mice were provided estrogen containing capsules for three additional weeks; control mice were provided estrogen-free capsules. Wheel running distance, duration, and speed were analyzed by three two-way (treatment group x phase of study) analysis of variance tests. RESULTS Wheel running speed was unaffected by sex hormone status. Distance (mean±SD: 6.74±2.13 km at baseline) decreased significantly after orchidectomy (2.27±1.55 km) and remained low following initial estrogen treatment (3.04±1.05 km). Prolonged estrogen exposure sustained a significant elevation of daily distance (4.47±1.87 km). Prolonged estrogen exposure recovered and significantly sustained wheel running duration (baseline: 248±60 min; post-orchidectomy: 102±53 min; prolonged exposure: 170±63 min). CONCLUSIONS Wheel running behavior was reduced significantly following orchidectomy and remained low following initial treatment with estrogens, but recovered to near control levels after two weeks of exposure to estrogens. The estrogenic mechanism regulating wheel running behavior in male mice appears to induce an extensive, but slow acting biological mechanism. Understanding the biological drive behind this mechanism may aid in developing useful therapeutic strategies to combat health issues related to physical inactivity. *MRA BEC, BMD, BRF, MJH, JCL, HGS, and TPS contributed equally to this study CORRESPONDING AUTHOR: Robert S. Bowen, 100 Alumni Drive, Truett McConnell University, Cleveland, GA 30528, Tele: 706-865-2134 ext 6400. E-mail: rbowen@truett.edu Research monies for this project were provided through the Pilgram Marpeck School of STEM at Truett McConnell University. The results of this study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. The results of the present study do not constitute endorsement by ACSM. DISCLOSURES: The authors have nothing to disclose. Accepted for Publication: 22 February 2018 © 2018 American College of Sports Medicine
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Intravenous Iron Does Not Augment the Haemoglobin Mass Response to Simulated Hypoxia
ABSTRACTPURPOSEIron is integral for erythropoietic adaptation to hypoxia, yet the importance of supplementary iron compared to existing stores is poorly understood. The aim of the present study was to compare the magnitude of the haemoglobin mass (Hbmass) response to altitude in athletes supplemented with intravenous (IV), oral or placebo iron supplementation.METHODSThirty-four, non-anaemic, endurance-trained athletes completed 3 weeks of simulated altitude (3000 m, 14h.d−1), receiving either 2-3 bolus iron injections (ferric carboxymaltose), daily oral iron supplementation (ferrous sulphate) or a placebo, commencing 2 weeks prior to and throughout altitude exposure. Hbmass and markers of iron regulation were assessed at baseline (day -14), immediately prior to (day 0), weekly during (days 8, 15), and immediately, 1, 3 and 6 weeks after the completion of altitude exposure (days 22, 28, 42 and 63).RESULTSHbmass significantly increased following altitude in IV (Mean%, [90% CI]: 3.7%, [2.8, 4.7]) and oral (3.2%, [2.2, 4.2]), and remained elevated at 7 days post-altitude in oral (2.9%, [1.5, 4.3]) and 21 days post in IV (3.0%, [1.5, 4.6]). Hbmass was not significantly higher than baseline at any time point in placebo.CONCLUSIONIron supplementation appears necessary for optimal erythropoietic adaptation to altitude exposure. Intravenous iron supplementation during three weeks of simulated LHTL altitude training offered no additional benefit in terms of the magnitude of the erythropoietic response for non-anaemic endurance athletes compared to oral supplementation. PURPOSE Iron is integral for erythropoietic adaptation to hypoxia, yet the importance of supplementary iron compared to existing stores is poorly understood. The aim of the present study was to compare the magnitude of the haemoglobin mass (Hbmass) response to altitude in athletes supplemented with intravenous (IV), oral or placebo iron supplementation. METHODS Thirty-four, non-anaemic, endurance-trained athletes completed 3 weeks of simulated altitude (3000 m, 14h.d−1), receiving either 2-3 bolus iron injections (ferric carboxymaltose), daily oral iron supplementation (ferrous sulphate) or a placebo, commencing 2 weeks prior to and throughout altitude exposure. Hbmass and markers of iron regulation were assessed at baseline (day -14), immediately prior to (day 0), weekly during (days 8, 15), and immediately, 1, 3 and 6 weeks after the completion of altitude exposure (days 22, 28, 42 and 63). RESULTS Hbmass significantly increased following altitude in IV (Mean%, [90% CI]: 3.7%, [2.8, 4.7]) and oral (3.2%, [2.2, 4.2]), and remained elevated at 7 days post-altitude in oral (2.9%, [1.5, 4.3]) and 21 days post in IV (3.0%, [1.5, 4.6]). Hbmass was not significantly higher than baseline at any time point in placebo. CONCLUSION Iron supplementation appears necessary for optimal erythropoietic adaptation to altitude exposure. Intravenous iron supplementation during three weeks of simulated LHTL altitude training offered no additional benefit in terms of the magnitude of the erythropoietic response for non-anaemic endurance athletes compared to oral supplementation. Address for correspondence: Laura A. Garvican-Lewis, Physiology, Australian Institute of Sport, Leverrier Crescent, Bruce, ACT, 2616, Australia. Email: laura.lewis@ausport.gov.au; Tel: +61 2 6214 1145, Fax: +61 6214 1904 The authors declare no conflicts of interest. Funding for this study was received from a Partnership for Clean Competition Research Grant (cleancompetition.org). The results of the present study do not constitute endorsement by ACSM. The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. Accepted for Publication: 7 March 2018 © 2018 American College of Sports Medicine
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Genetic Determinants for Leisure-Time Physical Activity
ABSTRACTPurposeLeisure-time physical activity (LTPA) is a well-established modifiable lifestyle determinant for multiple cardio-metabolic outcomes. However, current understanding of the genetic architecture that may determine LTPA remains very limited. Therefore, we aimed to examine the role of genetic factors in affecting LTPA, which has yet to be investigated comprehensively and in-depth.MethodsWe conducted a genome-wide analysis using 1000 Genomes Project imputed data from the Women's Health Initiative (n=11,865), the Jackson Heart Study (n=3,015) and the Framingham Heart Study (n=7,339). A series of secondary analyses, including candidate gene analysis, sequence kernel association tests, pathway analysis, functional annotation and expression quantitative trait loci analysis, were performed to follow up on the primary findings.ResultsEthnicity-specific genetic signals were investigated respectively for African Americans (AA) and European Americans (EA). Two variants, rs116550874 (meta-analysis: P = 1.63 × 10–7) and rs3792874 (meta-analysis: P = 8.33 × 10–7), were associated with LTPA in AA; rs28524846 (meta-analysis: P = 1.30 × 10–6) was identified for EA. We also replicated four previously reported loci (GABRG3, CYP19A1, PAPSS2 and CASR; P for lead SNPs
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The Impact of Universal Health Care Programmes on Improving ‘Realized Access’ to Care for Depression in Chile
Abstract
Universal health care programmes have the potential to reduce treatment gaps. We explored the potential impact of an equity-oriented universal health care programme on access to care for depression, hypertension and diabetes using data from two nationally representative health surveys in Chile. The likelihood a depressed individual had accessed health care appears to have increased significantly after the programme was introduced whereas those for hypertension and diabetes remained unchanged. Depressed women seem to have benefited mostly from the programme. Universal health care programmes for depression could substantially increase coverage and reduce inequities in access to health care in middle-income countries.
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Editorial Board
Source:International Journal of Psychophysiology, Volume 126
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Material Hardship and Mental Health Symptoms Among a Predominantly Low Income Sample of Pregnant Women Seeking Prenatal Care
Abstract
Introduction Although poverty is an established correlate of poorer mental health for pregnant women, limited research has examined the mental health effects of material hardship (i.e., difficulties meeting basic needs such as for food, transportation, or stable housing) during pregnancy. Methods The current research examined rates of material hardship among pregnant women seeking prenatal care and the relationships of both income and material hardship with depression and anxiety during pregnancy. Pregnant women (N = 892) responded to self-report measures of mental health symptoms, annual household income, and current material hardship in the waiting areas of community-based obstetrics/gynecology practices serving primarily financially disadvantaged patients. Results About 56% of the sample reported some form of material hardship. About 19% of the sample reported elevated depression, and 17% reported elevated anxiety. Both depression and anxiety were uniquely associated with lower income and greater material hardship, even after controlling for age, race/ethnicity, relationship status, and number of children in the home. Furthermore, material hardship partially mediated the effect of income on mental health symptoms. Discussion The physical, emotional, and social effects of deprivation of basic daily needs may contribute to pregnant women's experiences of mental health symptoms. These results converge with the broader literature focused on the social determinants of physical and mental health. When symptoms of depression and anxiety reflect distress related to material hardship, addressing unmet social needs may be more effective than mental health treatment.
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Guillain–Barré syndrome: rare extra-intestinal manifestation of hepatitis B
Abstract
Extrahepatic syndromes are uncommon manifestations of acute and chronic hepatitis B. The pathogenesis likely involves an aberrant immunologic response to extrahepatic viral proteins. Antiviral therapy reduces the availability of these viral protein antigens and thus halts immune activation. Approximately 1% of all cases of acute inflammatory demyelinating polyneuropathy are associated with hepatitis B. Guillain–Barre syndrome (GBS) is a remarkably clinically diverse disorder with distinctive variants characterised by an immune-mediated attack to components of the peripheral nervous system. In this report, we present a rare case of GBS with chronic hepatitis B that resolved with antiviral and intravenous immunoglobulin therapy.
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