The Journal of Physiology, EarlyView.
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Τετάρτη 23 Μαΐου 2018
The bigger they are the harder they fall: size‐dependent vulnerability of motor neurons in amyotrophic lateral sclerosis
Therapeutic potential to reduce brain injury in growth restricted newborns
The Journal of Physiology, EarlyView.
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Age‐related changes in late I‐waves influence motor cortex plasticity induction in older adults
The Journal of Physiology, EarlyView.
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Genomic Variation Among and Within Six Juglans Species
Genomic analysis in Juglans (walnuts) is expected to transform the breeding and agricultural production of both nuts and lumber. To that end, we report here the determination of reference sequences for six additional relatives of Juglans regia: Juglans sigillata (also from section Dioscaryon), Juglans nigra, Juglans microcarpa, Juglans hindsii (from section Rhysocaryon), Juglans cathayensis (from section Cardiocaryon), and the closely related Pterocarya stenoptera. While these are 'draft' genomes, ranging in size between 640Mbp and 990Mbp, their contiguities and accuracies can support powerful annotations of genomic variation that are often the foundation of new avenues of research and breeding. We annotated nucleotide divergence and synteny by creating complete pairwise alignments of each reference genome to the remaining six. In addition, we have re-sequenced a sample of accessions from four Juglans species (including regia). The variation discovered in these surveys comprises a critical resource for experimentation and breeding, as well as a solid complementary annotation. To demonstrate the potential of these resources the structural and sequence variation in and around the polyphenol oxidase loci, PPO1 and PPO2 were investigated. As reported for other seed crops variation in this gene is implicated in the domestication of walnuts. The apparently Juglandaceae specific PPO1 duplicate shows accelerated divergence and an excess of amino acid replacement on the lineage leading to accessions of the domesticated nut crop species, Juglans regia and sigillata.
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Atrioventricular canal defect and genetic syndromes: The unifying role of sonic hedgehog
Clinical Genetics, EarlyView.
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Mutational analysis of CCM1, CCM2 and CCM3 in a Han Chinese cohort with multiple cerebral cavernous malformations in Taiwan
Clinical Genetics, EarlyView.
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Clinical and molecular insights into Glanzmann's thrombasthenia in China
Clinical Genetics, EarlyView.
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Confirmation of SLC5A7‐related distal hereditary motor neuropathy 7 in a family outside Wales
Clinical Genetics, EarlyView.
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Clinical, molecular genetics and therapeutic aspects of syndromic obesity
Clinical Genetics, EarlyView.
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Developmental disorders with intellectual disability driven by chromatin dysregulation: Clinical overlaps and molecular mechanisms
Clinical Genetics, EarlyView.
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Neuroimmune modulation of cardiorespiratory responses to acute severe hypoxia
Experimental Physiology, EarlyView.
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Functional high‐intensity training: A HIT to improve insulin sensitivity in type 2 diabetes
Experimental Physiology, EarlyView.
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Purinergic receptor stimulation induces calcium oscillations and smooth muscle contraction in small pulmonary veins
The Journal of Physiology, EarlyView.
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Maternal undernutrition in late gestation increases IGF2 signalling molecules and collagen deposition in the right ventricle of the fetal sheep heart
The Journal of Physiology, EarlyView.
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β1 subunit stabilises sodium channel Nav1.7 against mechanical stress
The Journal of Physiology, EarlyView.
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Cardiac progenitor cell ion currents: revealing a little more on the lesser known
The Journal of Physiology, EarlyView.
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Sympathoexcitation following intermittent hypoxia in rat is mediated by circulating angiotensin II acting at the carotid body and subfornical organ
The Journal of Physiology, EarlyView.
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Smoke‐induced neuromuscular junction degeneration precedes the fibre type shift and atrophy in chronic obstructive pulmonary disease
The Journal of Physiology, EarlyView.
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Central and peripheral chemoreceptors in sudden infant death syndrome
The Journal of Physiology, EarlyView.
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Reply from L. P. Cid, T. J. Jentsch and F. V. Sepúlveda: intestinal electrolyte and fluid secretion – a model in trouble?
The Journal of Physiology, EarlyView.
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Carotid body activity – are we eating our way into the ventilatory pathway?
The Journal of Physiology, EarlyView.
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Synaptic depression induced by postsynaptic cAMP production in the Drosophila mushroom body calyx
The Journal of Physiology, EarlyView.
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When muscle doesn't ‘Rac’ it up, adipose tissue ‘AKTs’
The Journal of Physiology, EarlyView.
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“Twin” Biliary Trees in a Patient With Heterotaxy Syndrome
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Multivariate Model for the Prediction of Severity of Acute Pancreatitis in Children
This study aimed to develop a severity prediction system for pediatric patients with acute pancreatitis (AP) based on clinical and laboratory parameters recorded at disease onset. A retrospective cohort study including 130 patients with AP, aged 0 to 18 years, was conducted. Correlations between severe AP (SAP) and clinical and laboratory data were established. Parameters with a significant statistical correlation (P ≤ 0.05) were incorporated in logistic regression models, and receiver operating characteristic curves were generated. The best-performance cutoff points were calculated to propose a severity prediction score, for which sensitivity and specificity were determined. Thirty-eight cases (29.2%) were consistent with SAP. A value of ≥1 point yielded a sensitivity of 81.5% and specificity of 64.1% for SAP prediction, when using a score including blood urea nitrogen ≥12.5 mg/dL (1 point) or hemoglobinfrom Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2IYBMES
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Factors Influencing Time-to-diagnosis of Biliary Atresia
Objectives: Diagnosing biliary atresia (BA) quickly is critical, because earlier treatment correlates with delayed or reduced need for liver transplantation. However, diagnosing BA quickly is also difficult, with infants usually treated after 60 days of life. In this study, we aim to accelerate BA diagnosis and treatment, by better understanding factors influencing the diagnostic timeline. Methods: Infants born between 2007 and 2014 and diagnosed with BA at our institution were included (n = 65). Two periods were examined retrospectively: P1, the time from birth to specialist referral, and P2, the time from specialist referral to treatment. How sociodemographic factors associate with P1 and P2 were analyzed with Kaplan-Meier curves and Cox proportional hazard models. In addition, to better characterize P2, laboratory results and early tissue histology were studied. Results: P1 associated with race/ethnicity, with shorter times in non-Hispanic white infants compared to non-Hispanic black and Hispanic infants (P = 0.007 and P = 0.004, respectively). P2 associated with referral age, with shorter times in infants referred after 30, 45, or 60 days of life (P from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2KRAxVw
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Compliance With Fecal Calprotectin Testing in Pediatric Patients With Inflammatory Bowel Disease
Fecal calprotectin (FC) is a highly sensitive biomarker for inflammatory bowel diseases (IBDs). Utilization of this assay has been steadily increasing. Adherence levels for FC have, however, yet to be examined in the pediatric IBD setting. We analyzed 100 consecutive patients diagnosed with IBD between 2014 and 2015 at Texas Children's Hospital. Fifty-six percent of patients were men and median age at diagnosis was 13.7 years. Following diagnosis of IBD, 84 patients had a minimum of 1 FC requested, and 95.2% of these patients completed the test at least once. An average of 2 FCs per patient was ordered each year, and the overall compliance was 76.6%. Patients who completed the initial testing with a minimum of 3 consecutive tests were more likely to remain compliant than those who failed to perform the first lab (P from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2LozGfK
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Medium-term Outcome of Laparoscopic Kasai Portoenterostomy for Biliary Atresia With 49 Cases
Objective: The aim of this study was to evaluate the mid-term results of laparoscopic Kasai portoenterostomy (LKPE) for biliary atresia (BA) at our hospital. Methods: From May 2009 to May 2012, the charts of infants with BA who underwent LKPE were reviewed retrospectively. The clearance of jaundice (CJ) as well as 3-year, and 5-year survival with native liver (SNL) rates were analyzed and compared with those after open Kasai portoenterostomy (OKPE). Results: Forty-nine patients with BA who underwent LKPE were assigned to group A, and 40 patients with BA who underwent OKPE were assigned to group B. All patients in both groups had type III non-syndromic BA, and the LKPE and OKPE procedures were performed by 2 different surgical teams at our hospital. After median follow-up periods of 77 months in group A and 79 months in group B, the CJ and 3- and 5-year SNL rates were 61.2%, 55.1%, and 36.7% in group A, and 45.0%, 37.5%, and 25.0% in group B, respectively. The difference of CJ between group A and group B was not significant. The Kaplan-Meier method analysis showed that the difference in SNL between group A and group B was not significant either. Conclusions: LKPE for patients with BA was a technically feasible and alternative procedure to OKPE. The 3- and 5-year SNL rates after LKPE were not different compared to those after OKPE.from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2GJGW2l
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Reversal of Intestinal Failure in Children With Tufting Enteropathy Supported With Parenteral Nutrition at Home
Objectives: The aim of the study was to review long-term outcome of intestinal epithelial dysplasia (IED)/tufting enteropathy (TE) patients treated with parenteral nutrition (PN) at home managed by an intestinal failure (IF) rehabilitation service. Methods: Infants presenting from 1986 to 2010 with IF, and TE histology were retrospectively reviewed for up to 30 years. Data collected included outcome, presentation, nutrition (parenteral/enteral), country of residence, race, EpCAM gene, growth, bone age, and occupation. Results: Thirteen patients (6 boys) in Malta and the UK with TE histology were established on home PN. Survival was 100% for UK children and 92% overall (1 death aged 13 months). Six patients (50% of the surviving 12) weaned off PN. Overall PN requirements reduced with increasing age and 25 years. Two of 12 cases weaned from PN by 10 years, 1 of 8 by 15 years, 3 of 7 by 20 years, and 3 of 4 or 75% >25 years. Seven Maltese patients homozygous for the same EPCAM gene abnormality had a similar outcome to the other cases. Weight, height, bone mineralization, bone age, and insulin-like growth factor-1 (IGF-1) levels were low, but improved with age. Patients achieved educational levels of parents and were employed. Conclusions: IED cases should have >92% chance of long-term survival and >50% chance of enteral autonomy by/in early adult life and 75% by 25 years. Even if PN dependent s/he can gain employment. Patients with IED managed on PN at home by an IF rehabilitation service should avoid intestinal transplant.from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2J3iSfW
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Autoimmune Hepatitis in Children and Adolescents: Effect on Quality of Life
Objectives: The aim of this study was to evaluate the effect of autoimmune hepatitis (AIH) on the quality of life of children and adolescents and to identify which variables effect health-related quality of life (HRQoL). Methods: The Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) was used to evaluate HRQoL. In addition, a questionnaire was applied which included signs, symptoms, and use of medications. Results: A total of 43 patients (mean age, 15.0 ± 3.9 years; 65.1% girls; 90.7% with type 1 AIH) was evaluated. Advanced liver disease was present in 30.2%, and 18.6% had sclerosing cholangitis. Treatment was effective in 93.1% of patients. The lowest HRQoL scores were associated with the school (67.7), emotional (68.2), and psychosocial (75.5) domains. Compared with healthy children, patients presented lower scores on the total, psychosocial, emotional, and school domains (P from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2KRwTL7
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Plasma Exchange in Hypertriglyceridemic Pancreatitis in Children
No abstract available
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Clinical and Imaging Predictors of Surgical Splenorenal Shunt Dysfunction in Pediatric Patients
Purpose: Few established criteria exist to prompt angiographic evaluation and intervention for surgically created splenorenal shunts (SRS). Clinical and Doppler ultrasound (DUS) imaging predictors of shunt dysfunction were evaluated in this retrospective study. Materials and Methods: Consecutive patients undergoing SRS angiography over a 10-year period were retrospectively identified. Preangiography platelet count and DUS measurements of spleen diameter, maximum splenic vein velocity, and maximum shunt velocity were assessed and compared to findings at subsequent catheter angiography. Results: Twenty-six SRS angiograms were performed in 16 patients. Two of the 26 procedures were excluded from analysis due to insufficient baseline preangiography clinical and DUS data. In the remaining 24 cases, significant stenosis/occlusion was confirmed at angiography in 20, whereas wide patency was seen in 4. For the 20 cases of angiographically confirmed significant stenosis/occlusion, when compared to baseline post-SRS creation to immediate preangiography evaluation there was a greater decrease in platelet count (−51.8% vs −19.4%), a greater increase in spleen diameter (+13.4% vs +3.7%), a greater increase in maximum shunt velocity (+74.7% vs +59.7%), and a greater decrease in splenic vein velocity (−25.0% vs −18.5%). Conclusion: Clinical evidence of splenic sequestration and DUS finding of increased maximum shunt velocity correlate with angiographic findings of SRS dysfunction and could be used to help predict the need for shunt intervention.from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2KRAhWy
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Celiac Disease by the Age of 13 Years Is Not Associated With Probiotics Administration in Infancy
Probiotics are theoretically promising in primary prevention of celiac disease (CD), but research evidence on the topic is scarce. We used the data and material of a clinical double-blind randomized placebo-controlled trial on primary allergy prevention (n = 1223) to investigate in an exploratory study whether administration of a mix of pro- and prebiotics during late pregnancy and first 6 months of life was associated with prevalence of CD during 13-year follow-up. Children who fulfilled diagnostic criteria for CD (n = 11) and subjects with a serum sample available for analyzing CD antibodies (n = 867) were included. CD or elevated tissue transglutaminase IgA antibodies were not associated with probiotics or placebo. Nor were there any associations with the mode of delivery, the duration of exclusive or total breast-feeding, or respiratory infections during the first 2 years of life. Allergic diseases or sensitization by the age of 2 or 5 years were not clearly associated with the development of CD.from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2IZOPpv
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Psychological Factors and Outcomes in the Surgical Treatment of Pediatric Patients With Median Arcuate Ligament Syndrome
Objective: Median arcuate ligament syndrome (MALS) is a frequently overlooked cause of chronic abdominal pain (CAP), and results in many symptoms that mimic other gastrointestinal conditions that result in CAP. A small, but growing body of literature indicates that surgery improves quality of life (QOL) in patients with MALS. The purpose of the current study was to examine the psychological characteristics of pediatric patients with MALS to determine their prevalence and impact on surgical outcomes. Methods: Thirty-two pediatric patients completed psychological assessments before surgery, and 6 months postsurgical intervention. Descriptive analyses and t tests were conducted to characterize the sample and compare psychosocial and QOL items. To explore possible associations between coping and ultimate changes in QOL, exploratory multiple regressions were conducted. Results: Comorbid psychological conditions were common, occurring in about half the sample before and after surgery. Current pain significantly improved, as well as patient and parent-reported QOL constructs (Ps from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2KPZxwi
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Digested Early Preterm Human Milk Suppresses Tumor Necrosis Factor–induced Inflammation and Cytotoxicity in Intestinal Epithelial Cells
Objectives: The aim of this study was to determine the effect of digested whole human milk (HM; first sample available after birth from mothers of premature infants) on inflammation, oxidative stress, and cytotoxicity in Caco-2 human intestinal epithelial cells stimulated with lipopolysaccharides or tumor necrosis factor (TNF) to mimic the potential in vivo insults facing the premature infant's gastrointestinal tract. Methods: Fully differentiated Caco-2 cells were exposed to digested HM (n = 10; samples from 10 different individuals) before stimulation with lipopolysaccharides, TNF, or no stimulation overnight. Inflammation was determined by production of interleukin-8, oxidative stress by levels of F2-isoprostane, and cytotoxicity by released lactate dehydrogenase. Results: HM significantly suppressed interleukin-8 production and cytotoxicity in TNF-stimulated cells, while also suppressing cell death under baseline conditions. Individual HM samples differed widely in their ability to modulate cellular responses. Conclusions: Results from this study provide evidence that digested HM can reduce both an exaggerated inflammatory response and intestinal damage that contribute to the pathogenesis of necrotizing enterocolitis.from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2J3L2aN
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Gastrointestinal Symptoms in Children and Adolescents With Neurofibromatosis Type 1
Objectives: Neurofibromatosis type 1 (NF1) is a complex genetic disorder characterized by symptoms of the skin and nervous system. A previous study indicated that constipation is common in children with NF1. The aim of the present study was to investigate the phenotype and prevalence of gastrointestinal (GI) symptoms in a population of 4 to 17-year-olds with NF1 compared with their unaffected siblings. Methods: GI symptoms were assessed with a web-based, parent or self-administered, validated, Rome III diagnostic questionnaire. Participants were recruited from 1 of 2 Danish National Centers of Expertise for NF1. Logistic regression was used to estimate the prevalence of functional dyspepsia, irritable bowel syndrome (IBS), and constipation in each group and the groups were compared using odds ratio (OR). Results: We compared 102 NF1 patients (median age 10.3 years) and 46 of their unaffected siblings (median age 10 years). The overall likelihood of having GI symptoms usually attributed to either functional dyspepsia, IBS, or constipation was 30.4% in patients versus 10.9% in siblings, OR 3.58 (95% confidence interval 1.30 to 9.79). The prevalence of constipation was 22.5% in patients and 4.3% in siblings, OR 6.41 (95% confidence interval 1.45 to 28.24). The use of laxatives was 16% (n = 16) in patients and 2% (n = 1) in siblings. Conclusions: Overall, GI symptoms attributed to functional dyspepsia, IBS or constipation are more common in 4 to 17-year-olds with NF1 when compared with their unaffected siblings. The high prevalence indicates that GI dysfunction in NF1 is not functional but may be part of the underlying NF1 disorder.from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2KPFKNq
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The Health Care Transition of Youth With Liver Disease Into the Adult Health System: Position Paper From ESPGHAN and EASL
Background: Medical advances have dramatically improved the long-term prognosis of children and adolescents with once-fatal hepatobiliary diseases. However, there is no generally accepted optimal pathway of care for the transition from paediatric care to the adult health system. Aim: The purpose of this position paper is to propose a transition process for young people with paediatric onset hepatobiliary diseases from child-centred to adult-centred healthcare services. Methods: Seventeen ESPGHAN/EASL physicians from 13 countries (Austria, Belgium, France, Germany, Hungary, Italy, the Netherlands, Norway, Poland, Spain, Sweden, Switzerland, and United Kingdom) formulated and answered questions after examining the currently published literature on transition from childhood to adulthood. PubMed and Google Scholar were systematically searched between 1980 and January 2018. Quality of evidence was assessed by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) system. Expert opinions were used to support recommendations whenever the evidence was graded weak. All authors voted on each recommendation, using the nominal voting technique. Results: We reviewed the literature regarding the optimal timing for the initiation of the transition process and the transfer of the patient to adult services, principal documents, transition multi-professional team components, main barriers, and goals of the general transition process. A transition plan based on available evidence was agreed focusing on the individual young people's readiness and on coordinated teamwork, with transition monitoring continuing until the first year of adult services. We further agreed on selected features of transitioning processes inherent to the most frequent paediatric-onset hepatobiliary diseases. The discussion highlights specific clinical issues that will probably present to adult gastrointestinal specialists and that should be considered, according to published evidence, in the long-term tracking of patients. Conclusions: Transfer of medical care of individuals with paediatric onset hepatobiliary chronic diseases to adult facilities is a complex task requiring multiple involvements of patients and both paediatric and adult care providers.from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2Ls7WHd
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Clinical Presentation and Outcomes of Diagnostic Endoscopy in Newly Presenting Children With Gastrointestinal Symptoms
Objectives: Paediatric endoscopy is an important diagnostic tool; however, there is little published data to guide clinicians in selecting patients for endoscopy. This study aimed to evaluate a single centre's experience of newly presenting children focusing on presenting symptoms, investigations, and diagnostic yield. Methods: Clinical factors and endoscopic plus histological findings over a 6-month period were assessed. Only first diagnostic endoscopies were included. All biopsies were reviewed in a weekly histopathology multidisciplinary team meeting with a final agreed outcome. Abnormal histology was used as the criterion standard for reporting abnormality. Results: A total of 218 endoscopies were reviewed in 164 children. Approximately 65% were histologically normal (49% of children had macroscopically and histologically normal findings). Macroscopic and histological abnormalities (respectively) were 44% and 28% of oesophagogastroduodenoscopy (OGD) patients, 25% and 25% of colonoscopy alone, and 53% and 53% of those undergoing both OGD and colonoscopy (OGD&Col). For OGD-only patients, excluding those with raised anti-tissue transglutaminase antibodies, vomiting led to the highest rate of abnormal histology (22%). For colonoscopy-only and OGD&Col patients, per rectum bleeding led to the highest rates of abnormal histology (14% and 29%, respectively), after excluding those with laboratory abnormalities (anaemia and raised erythrocyte sedimentation rate) suggestive of inflammatory bowel disease. Conclusions: This study showed that half of all first diagnostic endoscopies in our unit had neither macroscopic nor histological abnormalities. There was discrepancy between macroscopic abnormalities and histological findings in OGD. Prospective studies are needed to develop guidelines in appropriately predicting abnormality and selecting patients for endoscopy.from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2GL5l7M
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Proteomics and Gastrointestinal Dynamic Models: 2 Possible Allies
No abstract available
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Non-invasive Assessment of Significant Dehydration in Infants Using the Inferior Vena Cava to Aortic Ratio: Is it Useful?
Objectives: The aim of the study was to assess the accuracy of the inferior vena cava to aorta (IVC/Ao) diameter ratio for predicting significant dehydration in infants relative to their percentage weight change and the clinical diagnosis by a physician. Methods: A prospective observational study was performed on 200 infants presented with acute diarrhea and clinical evidence of significant dehydration whose treatment required intravenous (IV) fluids as determined by the attending physician at the pediatric emergency department of Tanta University Hospital. Weight was recorded at admission before IV fluid treatment and at hospital discharge. The percentage of dehydration was determined using the following formula: (discharge weight − admission weight)/discharge weight × 100%. Patients with a percentage weight change of 5% were considered significantly dehydrated. The IVC/Ao diameter ratio was measured for all patients before IV fluid rehydration and again at discharge. Results: Only 134 out of 200 dehydrated infants were found to be significantly dehydrated using the gold standard, percentage weight change. Receiver operating characteristics (ROC) curve analysis of the prehydration IVC/Ao ratio showed a sensitivity of 82%, a specificity of 91%, and an accuracy of 87% for predicting significant dehydration in infants at a cut-off point of less than 0.75. In contrast, physician clinical diagnosis showed a sensitivity of 70%, a specificity of 63%, and an accuracy of 73%. Conclusions: The IVC/Ao diameter ratio can be used as a reliable predictor for diagnosing significant dehydration in infants.from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2KQ5qJA
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Province-wide Biliary Atresia Home Screening Program in British Columbia: Evaluation of First 2 Years
Background and Objectives: Biliary atresia (BA), a rare newborn liver disease, is the leading cause of liver-related death in children. Early disease recognition and timely surgical Kasai hepatoportoenterostomy (KP) offers long-term survival without liver transplant. Universal BA screening in Taiwan using infant stool color cards (ISCCs) has proven effectiveness. We report our experience with infant stool color card (ISCC) BA screening in a province-wide program in British Columbia (BC). The objective of this study is to assess program performance and cost from launch April 1, 2014 to March 31, 2016. Methods: ISCCs distributed to families upon maternity ward discharge. Parents were instructed to monitor their infant's stool color for 1 month and contacted the screening center with concerns. The number of live births, ISCC distribution, BA cases, and costs were recorded. Cases with Program screen success had both acholic stool recognition (ISCC screen success) and timely referral for BA. Results: All 126 maternity units received ISCCs. Of 87,583 live births there were 6 BA cases. Of the 5 cases with ISCC Screen Success 3 had Program Screen Success. The median KP age in the program screen success and failure groups was 49 (42–52) and 116 (49–184) days, respectively. Program sensitivity was 50%, specificity 99%, positive predictive value 4%, and negative predictive value 99%. A random sample of 1054 charts at BC Children's Hospital found an ISCC distribution rate of 94%. After a phase-in period, the annual program cost was $30,033.82, and the ISCC cost per birth was $0.68. Conclusions: The screening program has high specificity and distribution with low cost. Successful program case identification had earlier age at KP. Program modifications aim to improve sensitivity. Longer-term studies will determine program impact on health outcomes.from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2J4VG0U
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Preoperative Evaluation Is Not Predictive of Transpyloric Feeding Conversion in Gastrostomy-dependent Pediatric Patients
Objectives: Limited literature exists as to whether preoperative gastrostomy (GT) evaluation may predict which patients will go onto require gastrojejunostomy (GJ) tube feeding. The goal of this study was to compare the preoperative evaluations between patients maintained on GT feeds versus patients who required conversion to GJ feeds. Methods: We identified patients at Boston Children's Hospital who underwent GT tube placement and required GJ feeding between 2006 and 2012. GT patients were matched according to age, neurologic, and cardiac status with GJ-converted patients. Preoperative characteristics, rates of total hospitalizations, and respiratory-related admissions were reviewed. Results: A total of 79 GJ patients (median interquartile range (IQR): age 15 (4.3, 55.7) months; weight 8.8 (4.6, 14.5) kg) were matched with 79 GT patients (median (IQR): age 14.6 (4.7, 55.7) months; weight 8.5 (5, 13.6) kg). Median time from GT to GJ conversion was 8 (IQR 3, 16) months. Both groups had similar rates of successful preoperative nasogastric feeding trials (GT (84.5%) versus GJ (83.1%), P = 1.0), upper gastrointestinal series (GT (89.1%) versus GJ (93.2%), P = 0.73), abnormal videofluoroscopic swallow studies (GT (53.8%) versus GJ (62.2%), P = 0.4), and completion of gastric emptying studies (GT (10.1%) versus GJ (5.1%), P = 0.22). No differences were seen in preoperative hospitalization rates (P = 0.25), respiratory admissions (P = 0.36), although GJ patients had a mean reduction in the number of hospitalization of −1.5 ± 0.5 days, P from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2KMtbm8
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Prevalence of Anti-tissue Transglutaminase Antibodies and Celiac Disease in Children With Inflammatory Bowel Disease
Objectives: Celiac disease can occur in children with inflammatory bowel disease (IBD) and poses a diagnostic challenge. We evaluated the presence of anti-tissue transglutaminase (tTG) antibodies and celiac disease among children with IBD. Methods: In a retrospective chart review, we assessed the prevalence of tTG antibodies and celiac disease and compared with a control group of children with gastrointestinal symptoms without IBD. Results: Study population included 130 children with IBD and 257 in the control group. Abnormal tTG levels were found in 6 and 20 patients, respectively (4.6% vs 7.8%, P = 0.24). One patient with IBD and 12 in the control group had celiac disease (0.8% vs 4.7%, P = 0.07). Conclusions: False-positive tTG can occur in children with IBD. The prevalence of celiac disease is not increased in children with IBD compared with non-IBD children with gastrointestinal symptoms and is similar to that in the general population.from Gastroenterology via xlomafota13 on Inoreader https://ift.tt/2J3L0Qd
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EEG oscillations during caress‐like affective haptic elicitation
Psychophysiology, EarlyView.
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Individual differences in decisiveness: ERP correlates of response inhibition and error monitoring
Psychophysiology, EarlyView.
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Reliability and validity of the Karaduman Chewing Performance Scale in paediatric neuromuscular diseases: A system for classification of chewing disorders
Journal of Oral Rehabilitation, EarlyView.
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Laparoscopic radical nephrectomy for a right renal tumor with renal vein tumor thrombus in a patient with situs inversus totalis
Asian Journal of Endoscopic Surgery, EarlyView.
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Inguinoscrotal hernia containing the urinary bladder successfully repaired using laparoscopic transabdominal preperitoneal repair technique: A case report
Asian Journal of Endoscopic Surgery, EarlyView.
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Combination of endoscopic submucosal dissection and transanal minimally invasive surgery for the resection of early rectal cancer with fibrosis after prior partial excision
Asian Journal of Endoscopic Surgery, EarlyView.
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The Feasibility of Blood Flow Restriction Exercise in Incomplete Spinal Cord Injured Patients
Blood flow restriction (BFR) exercise, which has already shown promise in the able-bodied population, may be a novel method for improving muscle function in the incomplete spinal cord injury (iSCI) population. However, the feasibility and tolerance for BFR exercise in this population is unknown.
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Relative Adrenal Insufficiency in Cirrhotic Patients with Ascites (Hepatoadrenal Syndrome)
Relative adrenal insufficiency (RAI) has been reported in critically ill patients with cirrhosis. We evaluated the prevalence of RAI and its relationship to clinical course in non-septic cirrhosis patients with ascites.
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Surgical treatment of early onset idiopathic scoliosis in the United States: A trend analysis of 15 years (1997-2012)
Early onset scoliosis is a challenging problem that is defined as a curvature of the spine of more than 10 degrees identified in a child less than 10 years. Early onset idiopathic scoliosis (EOIS) can cause substantial morbidity and may require surgical intervention.
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Crestline to deliver $4.5 million in specialized ambulances to the Department of National Defence
Saskatoon, SK, Canada — Crestline Coach, a global leader in ambulance and specialty vehicle manufacturing and a Canadian supplier of small to mid-sized buses, secured a contract with the Department of National Defence to manufacture specialized ambulances for Canadian Armed Forces military bases, situated coast to coast. The contract is valued at $4.5 million, excluding options. With its rugged ...
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Celebrating EMS Week 2018
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Celebrating EMS Week 2018
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Prevalence of CTX-M-Type Extended-Spectrum β-Lactamase-Producing Escherichia coli B2-O25-ST131 H30R Among Residents in Nonacute Care Facilities in Japan
Microbial Drug Resistance, Ahead of Print.
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When will every EMT wear a body camera?
An EMT's attack of a restrained patient is a reminder for all leaders to discuss response to provocations and consider body-worn cameras to capture the EMS point-of-view
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Effect of telerehabilitation on mobility in people after hip surgery: a pilot feasibility study
The goal of this study was to evaluate the effects of telerehabilitation on mobility in people following hip surgery. This feasibility pilot randomized controlled trial included a sample of 40 participants, with 22 male and 18 female patients and mean age (SD) of 67.5 (7.8) years following a surgical intervention. Participants were equally divided and randomly assigned to a telerehabilitation or control intervention group (6 weeks, 3 sessions/week). Telerehabilitation was based on video clips of common rehabilitation exercises focusing on the lower limbs. The control group received an exercise booklet. Both groups participated in physical therapy sessions, twice a week. Outcome measures included the Timed Up and Go test, 2-min walk test, 10-m walk test, sit to stand test, walking speed, and mean step length. Measurements were completed at baseline, at termination of the intervention, and at a 4-week follow-up examination. Improvements in both groups were demonstrated in all outcome measures in the postintervention evaluation. Improvements in the telerehabilitation group were greater in five of six tests compared with those achieved by the controls. The telerehabilitation group showed greater improvements in the 2-min walking test (86.1%) and walking speed (65.6%). During follow-up, the telerehabilitation group continued to improve in all outcome measures in contrast to the control group, who showed no changes in five of the six outcome measures. Telerehabilitation, a complementary treatment to standard physical therapy, generates a positive effect on mobility in people following hip surgery. Correspondence to Alon Kalron, PT, PhD, Department of Physical Therapy, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel Tel: +972 99 512 726; fax: +972 036 409 223; e-mail: alonkalr@post.tau.ac.il Received March 4, 2018 Accepted May 3, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Ketamine and electroconvulsive therapy: so happy together?
Purpose of review Anesthetics, such as thiopental, methohexital, propofol and ketamine have been used to induce unconsciousness for electroconvulsive therapy (ECT), each with its advantages and disadvantages. Only until recently was it discovered that ketamine may have inherent antidepressant effects. We reviewed the side effect profile of ketamine and examined the literature for whether or not ketamine augments the antidepressant effects of ECT. Recent findings Systematic reviews and meta-analyses of randomized controlled trials of the potential benefits of adding ketamine to ECT treatment have generated varied conclusions. Currently there is a lack of clear evidence that ketamine with ECT is more efficacious than ECT alone. Summary Large, multicenter randomized controlled trials are needed to further investigate the potential advantages of adding ketamine to ECT for patients with severe or refractory depression. The addition of ketamine to ECT treatment may have some early beneficial effect in patients with acute depressive disorders. Most likely, ECT itself is responsible for lasting remission from severe depression. Ketamine's side effect profile may be undesirable in certain patient populations, and so the risks and benefits of the addition of this drug to ECT treatment must be weighed. Correspondence to Kathryn Cobb, MD, N2198 UNC Hospitals, CB# 7010, Chapel Hill, NC 27599-7010, USA. Tel: +1 919 966 5136; e-mail: kathryn_cobb@med.unc.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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When will every EMT wear a body camera?
An EMT's attack of a restrained patient is a reminder for all leaders to discuss response to provocations and consider body-worn cameras to capture the EMS point-of-view
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Dear new EMT or paramedic: It's OK to ask for help
In EMS, most providers learn their most important lessons by doing; here are three lessons learned that you should never forget – no matter how long you've been in EMS
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Video: Celebrating EMS Week 2018
Departments are marking the occasion by enhancing their training skills, teaching lifesaving lessons and reminding providers to always have their partner's back
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NERVE STIMULATION ENHANCES TASK-ORIENTED TRAINING FOR MODERATE-TO-SEVERE HEMIPARESIS 3-12 MONTHS AFTER STROKE: A RANDOMIZED TRIAL
Objective Determine whether somatosensory stimulation affects outcomes of motor training for moderate-to-severe upper extremity hemiparesis less than 12 months post-stroke. Design 55 adults participated in 18 intervention sessions pairing 2 hours of active (n=33) or sham (n=22) somatosensory stimulation with 4 hours of intensive task-oriented motor training. Wolf Motor Function Test, Action Research Arm Test, Fugl-Meyer Assessment, and Stroke Impact Scale were administered at baseline, post-intervention, and 1- and 4-month follow-up. Results Statistically significant between-groups differences favored the active condition on Wolf Motor Function Test at post (p=0.04) and Action Research Arm Test at post (p=0.02), 1-month (p=0.01), and 4-month (p=0.01) but favored the sham condition on Stroke Impact Scale at 1-month (p=0.03). There were no significant between-groups differences on Fugl-Meyer Assessment. Conclusion Somatosensory stimulation can improve objective outcomes of motor training for moderate-to-severe hemiparesis less than 12 months after stroke, although the magnitude of between-groups differences in this study needs to be determined if they are clinically relevant. Future studies should investigate the intervention's impact on disability and functional recovery for this population as well as neurophysiological mechanisms underlying intervention effects. Corresponding author: Lumy Sawaki, MD, PhD, University of Kentucky Department of Physical Medicine and Rehabilitation at Cardinal Hill Hospital, 2050 Versailles Road, Lexington, KY 40504 (lsawa2@uky.edu; phone 859/323-6226; fax 859/323-1123) Disclosures: This study was funded by the National Institutes of Health R01 NIH HD056002, ARRA Administrative Supplement, and the Cardinal Hill Rehabilitation Hospital Endowed Chair in Stroke and Spinal Cord Injury Rehabilitation (0705129700). There are no financial benefits to the authors. Results of this study were first presented in poster form at the 2015 Conference of the American Society of Neurorehabilitation. There are no conflicts of interest related to this research or this manuscript. The clinical trial registration number with clinicaltrials.gov is NCT03124186. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Effectiveness of Physiotherapy Interventions on Spasticity in People with Multiple Sclerosis. A Systematic Review and Meta-Analysis
Objective To examine the effectiveness of physiotherapy (PT) interventions on spasticity in people with multiple sclerosis (PwMS). Design A systematic search was performed using PRISMA guidance. Studies evaluate the effect of PT interventions on spasticity were included. PwMS, spasticity, disability and PT interventions characteristics were extracted in included studies. Level of evidence was synthesized by GRADE approach. Meta-analyses were performed by calculating Hedges g at 95% confidence interval. Results A total of 29 studies were included in the review, and 25 in the meta-analyses. The included PT interventions were exercise therapy, electrical stimulation, radial shock wave therapy, vibration, and standing. The review and meta-analyses showed different evidences of benefits and non-benefits for PT interventions on some spasticity outcomes. The best quality evidences were for beneficial effects of exercise therapy especially robot gait training, and outpatient exercise programs on self-perceived spasticity and muscle tone respectively. The review results were positive regarding the acute effects, follow-up measurements, safety, progressive MS, and non-ambulatory PwMS. The included articles were heterogeneous and badly reported in PT interventions and PwMS characteristics. Conclusion PT interventions can be safe and beneficial option for spasticity in PwMS. No firm conclusion can be drawn on overall spasticity. Further researches in different spasticity aspects are needed. Corresponding Author: Mohammad Etoom PT, PhD, Physical Therapy Department, Al-Isra University, Amman-Jordan, Email: mohammed.etoom2016@gmail.com Financial support and conflict of interest: None The manuscript has not been previously presented in any scientific meeting or publication. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Functional Outcome of Elderly Hip Fracture Patients is not Affected By Pre-Fracture Dementia
Objective The aim of the study was to examine whether a diagnosis of pre-fracture Dementia (PFD) affects functional outcome at discharge from a geriatric rehabilitation setting. Design A total of 211 consecutive elderly hip fracture patients were evaluated retrospectively. We used the Functional Independence Measure (FIM) and analyzed data by t-test, chi square-test and multiple linear regression analysis. Results Patients with PFD were older (P = 0.001), presented with lower Mini-Mental State Examination (MMSE) scores (P
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Celebrating EMS Week 2018
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The impact of ankle–foot orthoses on toe clearance strategy in hemiparetic gait: a cross-sectional study
Ankle–foot orthoses (AFOs) are frequently used to improve gait stability, toe clearance, and gait efficiency in individuals with hemiparesis. During the swing phase, AFOs enhance lower limb advancement by faci...
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Is Mental Illness a Risk Factor for Hospital Readmission?
Abstract
People with mental illnesses (MI) receive suboptimal care for medical comorbidities and their high risk for readmission may be addressed by adequate medication management and follow-up care. We examined the association between MI, medication changes, and post-discharge outpatient visits with 30-day readmission in 40,048 Medicare beneficiaries hospitalized for acute myocardial infarction, heart failure or pneumonia. Beneficiaries with MI were more likely to be readmitted than those without MI (14 vs. 11%). Probability of readmission was 13 and 12% when medications were dropped or added, respectively, versus 11% when no change was made. Probability of readmission also increased with outpatient visits.
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How DahlgrenDecon is the fastest, most effective decontamination solution
DahlgrenDecon can neutralize fentanyl in about five minutes and is the most effective decontamination for other drugs, chemical and biological agents as well as toxic industrial chemicals and materials
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Celebrating EMS Week 2018
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Perioperative Hyperchloremia and its Association With Postoperative Acute Kidney Injury After Craniotomy for Primary Brain Tumor Resection: A Retrospective, Observational Study
Background: Hyperchloremia is known to influence postoperative outcomes and may result in postoperative acute kidney injury (AKI). This study sought to investigate whether hyperchloremia was associated with postoperative AKI in patients who underwent surgery for primary brain tumor resection. Materials and Methods: This is a retrospective, observational study of patients who underwent craniotomy for primary brain tumor resection at a single tertiary care hospital between January 2005 and October 2017. Maximum levels of serum chloride (mmol/L) measured on postoperative days (PODs) 0 to 3 and increase in serum chloride (mmol/L), (maximum serum chloride−baseline serum chloride before surgery) were measured. We examined whether perioperative hyperchloremia was associated with postoperative AKI during PODs 0 to 3. Univariate and multivariate logistic regression analyses were used in this study. Results: A total of 726 patients were included in the analysis; of these, 39 (5.4%) were diagnosed with postoperative AKI during PODs 0 to 3. The risk of postoperative AKI was associated with maximum chloride levels (odds ratio, 1.10; 95% confidence interval, 1.02-1.19; P=0.015) and with an increase in serum chloride levels during PODs 0 to 3 (odds ratio, 1.11; 95% confidence interval, 1.04-1.19; P=0.004). Conclusions: Our study shows that perioperative hyperchloremia during PODs 0 to 3 was associated with an increased risk of postoperative AKI during this period after craniotomy for primary brain tumor resection. The authors have no funding or conflicts of interest to disclose. Address correspondence to: Sang-Hwan Do, MD, PhD, Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, 166, Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 13620, South Korea (e-mail: shdo@snu.ac.kr). Received January 31, 2018 Accepted April 19, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved
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De novo FBXO11 mutations are associated with intellectual disability and behavioural anomalies
Abstract
Intellectual disability (ID) has an estimated prevalence of 1.5–2%. In most affected individuals, its genetic basis remains unclear. Whole exome sequencing (WES) studies have identified a multitude of novel causative gene defects and have shown that a large proportion of sporadic ID cases results from de novo mutations. Here, we present two unrelated individuals with similar clinical features and deleterious de novo variants in FBXO11 detected by WES. Individual 1, a 14-year-old boy, has mild ID as well as mild microcephaly, corrected cleft lip and alveolus, hyperkinetic disorder, mild brain atrophy and minor facial dysmorphism. WES detected a heterozygous de novo 1 bp insertion in the splice donor site of exon 3. Individual 2, a 3-year-old boy, showed ID and pre- and postnatal growth retardation, postnatal mild microcephaly, hyperkinetic and restless behaviour, as well as mild dysmorphism. WES detected a heterozygous de novo frameshift mutation. While ten individuals with ID and de novo variants in FBXO11 have been reported as part of larger studies, only one of the reports has some additional clinical data. Interestingly, the latter individual carries the identical mutation as our individual 2 and also displays ID, intrauterine growth retardation, microcephaly, behavioural anomalies, and dysmorphisms. Thus, we confirm deleterious de novo mutations in FBXO11 as a cause of ID and start the delineation of the associated clinical picture which may also comprise postnatal microcephaly or borderline small head size and behavioural anomalies.
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Ultrasound-guided single injection versus continuous sciatic nerve blockade on pain management and mobilisation after total knee arthroplasty (CoSinUS trial): A randomised, triple-blinded controlled trial
BACKGROUND Combining continuous femoral nerve blockade with single injection sciatic nerve blockade is standard peripheral nerve block practice for total knee arthroplasty (TKA) during the first 24 postoperative hours. OBJECTIVES To assess the analgesic benefits and mobilisation capability of continuous sciatic blockade in conjunction with continuous femoral nerve blockade for 72 h after arthroplasty. DESIGN Randomised, triple-blinded controlled trial. SETTING Single-Centre, German University Hospital. PATIENTS In total, 50 patients receiving continuous femoral nerve blockade (5 ml h−1 ropivacaine 0.2%) for TKA under general anaesthesia. INTERVENTIONS Patients were randomised to receive a sciatic nerve catheter with an initial dose of 10 ml ropivacaine 0.2% followed by either continuous double-blinded application of 5 ml h−1 ropivacaine 0.2% (CO) or 5 ml h−1 saline infusion (SIN). MAIN OUTCOME Measures primary endpoint: cumulative morphine consumption until 48 h postoperatively. Further endpoints included morphine consumption, pain scores, mobilisation, dynamometry until postoperative day 3. RESULTS Median [25th to 75th percentiles] cumulative morphine consumption at postoperative day 2 differed significantly between groups (CO 15 mg [11 to 25] versus SIN, 43 mg [27 to 67.5, P
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Ambulance designed to transport premature newborns unveiled
Oishei Children's Hospital, Kaleida Health and AMR teamed up to design an ambulance to transport premature newborns in honor of EMS Week
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Cleveland Clinic-Postural Stability Index Norms for the Balance Error Scoring System
Introduction Despite the widespread utilization of the Balance Error Scoring System (BESS) in the evaluation of concussion, it has been criticized for its error-based scoring that is susceptible to floor and ceiling effects and substantial inter-rater variability. A biomechanical outcome, Cleveland Clinic-Postural Stability Index (CC-PSI), has been developed as an alternative to subjective BESS scoring. The CC-PSI utilizes inertial sensor data within a mobile device to provide an objective measure of postural sway during the BESS. This project aimed to determine the effect of age and sex on the CC-PSI and report normative values for healthy, active children, adolescents, and young adults. Methods A cross sectional sample of 6,762 student-athletes completed BESS testing. Participants were stratified according to three age groups for each sex. Groups included: youth (age 5-13): males (n=360), females (n=246), high school (age 14-18): males (n=3743), females (n=1673), and college (age 19-23): males (n=497), females (n=243). Percentile rankings were determined for each participant to characterize movement of center of mass in the medial-lateral, anterior-posterior and trunk rotation directions relative to the entire cohort during the BESS stances. Results Overall, postural stability was worse in youth compared to high school and collegiate athletes. Specifically, the CC-PSI was significantly worse in youth male athletes compared to high school and collegiate male athletes (p
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Estimating heritability without genetic testing
Estimating heritability without genetic testing
Estimating heritability without genetic testing, Published online: 23 May 2018; doi:10.1038/s41576-018-0021-2
A new study reports the use of electronic health records as a resource for studying the heritability of traits.
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Towards a complete map of the human long non-coding RNA transcriptome
Towards a complete map of the human long non-coding RNA transcriptome
Towards a complete map of the human long non-coding RNA transcriptome, Published online: 23 May 2018; doi:10.1038/s41576-018-0017-y
Virtually all studies depend on annotations, maps of the genome that catalogue gene loci and the sequences of their transcripts. This Review discusses the state of currently available long non-coding RNA annotations and the impact of emerging technologies such as long-read sequencing.
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Transanal minimally invasive surgery as a treatment option for a completely occluded anastomosis after low anterior resection: A new approach to severe anastomotic stenosis
Asian Journal of Endoscopic Surgery, EarlyView.
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Intermittent versus constant aerobic exercise in middle-aged males: acute effects on arterial stiffness and factors influencing the changes
Abstract
Purpose
Both constant and intermittent acute aerobic exercises have been found to decrease arterial stiffness. However, direct comparisons of these two types of exercise are sparse. It is not known which type of exercise has the greatest effect.
Methods
We evaluated the haemodynamic responses in 15 males (age 48.5 ± 1.3 years; BMI 27.5 ± 0.8 kg m−2) following acute constant (CE) and intermittent cycling exercise (IE). Duration and heart rate were matched during both exercises (131.8 ± 3.2 bpm for CE and 132.0 ± 3.1 bpm for IE). Central and peripheral arterial stiffness was assessed through pulse wave velocity (PWV). Plasma concentrations of nitric oxide (NO), atrial natriuretic peptide (ANP), blood lactate, noradrenaline, and adrenaline were measured before and after each exercise.
Results
Central (+ 1.8 ± 7.4 and − 6.5 ± 6.8% for CE and IE) and upper limb PWV (+ 2.7 ± 6.2 and − 8 ± 4.6% for CE and IE) were not significantly altered although a small decrease (small effect size) was observed after IE. However, lower limb PWV significantly decreased after exercises (− 7.3 ± 5.7 and − 15.9 ± 4% after CE and IE), with a larger effect after IE.
Conclusions
Greater decrease in lower limb PWV occurred after IE despite greater heart rate. This may be due to the higher blood levels of lactate during IE, while NO, ANP, noradrenaline, and adrenaline levels remained not statistically different from CE. These results underlined the importance of lactate in triggering the post-exercise vascular response to exercise, as well as its regional characteristic.
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A novel submucosal injection solution for endoscopic resection of large colorectal lesions: A randomized, double-blind trial
Gastrointestinal Endoscopy
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Effectiveness and safety of total laparoscopic distal gastrectomy vs laparoscopy-assisted distal gastrectomy for gastric cancer: A retrospective cohort study
The American Journal of Surgery
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Effects of nutritional prehabilitation, with and without exercise, on outcomes of patients who undergo colorectal surgery: a systematic review and meta-analysis
Gastroenterology
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Association between pancreatic fat and incidence of metabolic syndrome: A 5?year Japanese cohort study
Journal of Gastroenterology and Hepatology
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Evaluation of the impact of a rotavirus vaccine program on pediatric acute gastroenteritis hospitalizations: Estimating the overall effect attributable to the program as a whole, and as a per-unit change in rotavirus vaccine coverage
American Journal of Epidemiology
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Normal on-treatment ALT during antiviral treatment is associated with a lower risk of hepatic events in patients with chronic hepatitis B
Journal of Hepatology
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Similar subclinical enthesitis in celiac and inflammatory bowel diseases by ultrasound suggests a gut enthesis axis independent of spondyloarthropathy spectrum
Rheumatology
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Safety and efficacy of leukocytapheresis in elderly patients with ulcerative colitis: The impact in steroid?free elderly patients
Journal of Gastroenterology and Hepatology
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Real-world virological efficacy and safety of elbasvir and grazoprevir in patients with chronic hepatitis C virus genotype 1 infection in Japan
Journal of Gastroenterology
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A systematic review of the effectiveness of psychological treatments for IBS in gastroenterology settings: Promising but in need of further study
Digestive Diseases and Sciences
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Robotic vs laparoscopic minimally invasive surgery for rectal cancer: A systematic review and meta-analysis of randomized controlled trials
Annals of Surgery
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Double-blind, placebo-controlled study with alginate suspension for laryngopharyngeal reflux disease
The Laryngoscope
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Who is studied in de novo fear conditioning paradigms? An examination of demographic and stimulus characteristics predicting fear learning
Publication date: Available online 22 May 2018
Source:International Journal of Psychophysiology
Author(s): M. Alexandra Kredlow, Scott P. Orr, Michael W. Otto
A common challenge in fear conditioning studies is that a relatively large proportion of individuals fail to acquire a differential conditioned skin conductance response (SCR). Researchers have identified demographic factors associated with poorer fear learning and explored the use of different fear conditioning paradigms across various populations. However, few studies have strategically aimed to enhance acquisition by manipulating the unconditioned stimulus (UCS). In the current manuscript, we examined whether demographic factors predicted failure to condition (n = 274) and explored whether modifications to the UCS enhanced fear learning (n = 143). Results indicated that race, but not age, education, or gender, predicted failure to condition. Stepwise logistic regression demonstrated that race was the most influential of these predictors; African Americans were less likely to acquire a conditioned SCR, compared to non-African Americans. Also, use of a compound UCS (i.e., electric shock combined with a scream noise) led to nearly double the rate of acquisition of a conditioned SCR. Hence, use of a compound UCS may provide a way to reduce the number of excluded individuals in studies of fear-conditioned SCR and thereby improve the representativeness of research samples.
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