Unilateral vs. Bilateral Lower Extremity Motor Deficit Following Complex Adult Spinal Deformity Surgery: Is there a Difference in Recovery Up to 2 Year F/U?

Scoli-RISK-1 is a multicenter prospective cohort designed to study neurologic outcomes following complex adult spinal deformity (ASD). The effect of unilateral versus bilateral postoperative motor deficits on the likelihood of long term recovery has not been previously studied in this population.

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Acknowledgement of Reviewers

Scientific progress depends on the generosity of reviewers who assist editors by sharing their time and expertise in the peer review process. Deborah Carr, editor of the Journal of Gerontology: Social Sciences, wishes to thank the following persons for their assistance in reviewing at least one manuscript during 2017.

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Acknowledgement of Reviewers

Scientific progress depends on the generosity of reviewers who assist editors by sharing their time and expertise in the peer review process. Derek Isaacowitz, PhD, editor of the Journal of Gerontology: Psychological Sciences, wishes to thank the following persons for their assistance in reviewing at least one manuscript during 2017.

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Functions of the COPII gene paralogs SEC23A and SEC23B are interchangeable in vivo [Genetics]

Approximately one-third of the mammalian proteome is transported from the endoplasmic reticulum-to-Golgi via COPII-coated vesicles. SEC23, a core component of coat protein-complex II (COPII), is encoded by two paralogous genes in vertebrates (Sec23a and Sec23b). In humans, SEC23B deficiency results in congenital dyserythropoietic anemia type-II (CDAII), while SEC23A deficiency results...

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Warsaw breakage syndrome DDX11 helicase acts jointly with RAD17 in the repair of bulky lesions and replication through abasic sites [Genetics]

Warsaw breakage syndrome, a developmental disorder caused by mutations in the DDX11/ChlR1 helicase, shows cellular features of genome instability similar to Fanconi anemia (FA). Here we report that DDX11-deficient avian DT40 cells exhibit interstrand crosslink (ICL)-induced chromatid breakage, with DDX11 functioning as backup for the FA pathway in regard to...

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Editorial Board

Publication date: July–September 2018

Source: Mutation Research/Reviews in Mutation Research, Volume 777

Author(s):

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Designing robot-assisted neurorehabilitation strategies for people with both HIV and stroke

There is increasing evidence that HIV is an independent risk factor for stroke, resulting in an emerging population of people living with both HIV and stroke all over the world. However, neurorehabilitation st...

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NJ students stress need for stricter CPR requirements

A student-run nonprofit is pushing for a law that requires minors provide proof of CPR training before sitting for a driver's license test

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A case of early colorectal cancer with rectal varices treated with endoscopic variceal ligation

Abstract

Rectal varices are ectopic varices that occur in patients with portal hypertension and cause abrupt gastrointestinal bleeding. Endoscopic variceal ligation is a minimally invasive treatment used for patients with bleeding from rectal varices. Endoscopic treatment of colorectal tumors accompanied by rectal varices has been rarely reported. It is very important to control bleeding during treatment. The patient was a 76-year-old man who had a chief complaint of bloody stools. A flat-elevated-type neoplastic lesion measuring about 20 mm was found above the rectal varices. After performing endoscopic variceal ligation for rectal varices around the lesion, the lesion was resected en bloc by endoscopic submucosal dissection. Bleeding was controlled during the procedure; the patient was discharged 7 days after the endoscopic treatment, and there was no postoperative bleeding. Colonoscopy performed 90 days after the procedure showed scar formation in the wound area and no remnant lesion. The implementation of preoperative endoscopic variceal ligation enabled us to control bleeding during endoscopic treatment in a case of early colorectal cancer accompanied by rectal varices.

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Correctional EMT/Paramedic - NatCore Healthcare

NatCore Healthcare is a company dedicated to providing exceptional medical care to incarcerated persons. The employee listed above currently works in a position that provides skilled medical care for incarcerated offenders in a clinic, or specialized cell house setting for acute care, chronic support and emergency interventions. **JOB DUTIES:** · Provides physical care and treatments, administers medications ...

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Cover Image

Journal of Oral Rehabilitation, Volume 45, Issue 9, Page i-i, September 2018.


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Issue Information

Journal of Oral Rehabilitation, Volume 45, Issue 9, Page ii-iv, September 2018.


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Validation of water-fat MRI and proton MRS in assessment of hepatic fat and the heterogeneous distribution of hepatic fat and iron in subjects with non-alcoholic fatty liver disease

European Journal of Radiology

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Fidaxomicin for the treatment of Clostridium difficile infection (CDI) in at-risk patients with inflammatory bowel disease, fulminant CDI, renal impairment or hepatic impairment: A retrospective study of routine clinical use (ANEMONE)

European Journal of Clinical Microbiology & Infectious Diseases

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Mental Health Status and Service Assessment for Adult Syrian Refugees Resettled in Metropolitan Atlanta: A Cross-Sectional Survey

Abstract

Because little is known about the mental health status of Syrian refugees in the United States, we conducted a survey among a convenience sample of those resettled in Atlanta between March 2011 and 2017. Though home visits, we delivered a questionnaire including standardized instruments (HSCL25 and PTSD-8) to assess symptoms of anxiety, depression and Posttraumatic Stress Disorder. We found high rates of anxiety (60%), depression (44%) and Posttraumatic Stress Disorder (84%) symptoms; however, only 20% of participants had seen a mental health professional. Reported reasons for not seeking professional help were lack of transportation and access to information. Findings of this survey indicate the high burden of mental health symptoms and the need for services to the study population. A longitudinal study with a larger sample size would improve the understanding of mental health needs and resilience factors of Syrian refugees resettled in the US.

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Effectiveness and safety of vedolizumab for maintenance treatment in inflammatory bowel disease- The Israeli real world experience

Digestive and Liver Diseases

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Continuous hemofiltration improves the prognosis of bacterial sepsis complicated by liver dysfunction in children

BMC Pediatrics

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Identification of pathways and genes associated with cerebral palsy

Abstract

Cerebral palsy (CP) is a non-progressive neurological disease, of which susceptibility is linked to genetic and environmental risk factors. More and more studies have shown that CP might be caused by multiple genetic factors, similar to other neurodevelopmental disorders. Due to the high genetic heterogeneity of CP, we focused on investigating related molecular pathways. Ten children with CP were collected for whole-exome sequencing by next-generation sequencing (NGS) technology. Customized processes were used to identify potential pathogenic pathways and variants. Three pathways (axon guidance, transmission across chemical synapses, protein–protein interactions at synapses) with twenty-three genes were identified to be highly correlated with CP. This study showed that the three pathways associated with CP might be the molecular mechanism of pathogenesis. These findings could provide useful clues for developing pathway-based pharmacotherapies. Further studies are required to confirm potential roles for these pathways in the pathogenesis of CP.

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Anti‐Müllerian hormone levels in patients with turner syndrome: Relation to karyotype, spontaneous puberty, and replacement therapy

American Journal of Medical Genetics Part A, EarlyView.


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Prominent and elongated coccyx, a new manifestation of KBG syndrome associated with novel mutation in ANKRD11

American Journal of Medical Genetics Part A, EarlyView.


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A comprehensive clinical and genetic study in 127 patients with ID in Kinshasa, DR Congo

American Journal of Medical Genetics Part A, EarlyView.


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Features of Feingold syndrome 1 dominate in subjects with 2p deletions including MYCN

American Journal of Medical Genetics Part A, EarlyView.


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Genetic regulatory pathways of split hand‐foot malformation

Clinical Genetics, Volume 0, Issue ja, -Not available-.


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Novel compound heterozygous ABCC2 variants in patients with Dubin‐Johnson syndrome and intrahepatic cholestasis of pregnancy

Clinical Genetics, EarlyView.


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Influence of food texture on energy metabolism and adiposity in male rats

Experimental Physiology, EarlyView.


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Comparison of ischemia/reperfusion‐induced acute kidney injury by clamping renal arteries, veins, or pedicles in anaesthetised rats

Experimental Physiology, Volume 0, Issue ja, -Not available-.


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Muscle and tendon lengthening behaviour of the medial gastrocnemius during ankle joint rotation in children with cerebral palsy

Experimental Physiology, Volume 0, Issue ja, -Not available-.


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Reduced mitochondrial reactive oxygen species production in peripheral nerves of mice fed a ketogenic diet

Experimental Physiology, EarlyView.


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Two months sodium nitrate supplementation alleviates testicular injury in streptozotocin‐induced diabetic male rats

Experimental Physiology, Volume 0, Issue ja, -Not available-.


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The importance of exercise intensity, volume, and metabolic signaling events in the induction of mitochondrial biogenesis

The Journal of Physiology, Volume 0, Issue ja, -Not available-.


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Legacy of excess: consequences of maternal obesity for the adult offspring

The Journal of Physiology, Volume 0, Issue ja, -Not available-.


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A cellular mechanism of muscle memory facilitates mitochondrial remodelling following resistance training

The Journal of Physiology, EarlyView.


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“The application of stable‐isotope tracers to study human musculoskeletal protein turnover: a tale of bag filling and bag enlargement.”

The Journal of Physiology, Volume 0, Issue ja, -Not available-.


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Fatigue‐related group III/IV muscle afferent feedback facilitates intracortical inhibition during locomotor exercise

The Journal of Physiology, Volume 0, Issue ja, -Not available-.


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Age‐dependent effects to sympathetic responsiveness in cardiac action potential conduction and calcium handling

The Journal of Physiology, Volume 0, Issue ja, -Not available-.


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Sensors and signals: The role of ROS in hypoxic pulmonary vasoconstriction

The Journal of Physiology, Volume 0, Issue ja, -Not available-.


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Short‐term feeding of a ketogenic diet induces more severe hepatic insulin resistance than a obesogenic high‐fat diet

The Journal of Physiology, EarlyView.


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Emerging views of how changes in blood pressure influence cerebral blood flow

The Journal of Physiology, Volume 0, Issue ja, -Not available-.


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Two mutations at different positions in the CNBH domain of the hERG channel accelerate deactivation and impair the interaction with the EAG domain

The Journal of Physiology, Volume 0, Issue ja, -Not available-.


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Deep continuous theta burst stimulation of the operculo‐insular cortex selectively affects Aδ‐fiber heat pain

The Journal of Physiology, Volume 0, Issue ja, -Not available-.


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Developing a Barriers Scale in the Context of Travel: TRIP – Travel Restrictions Influencing Participation

Publication date: Available online 14 August 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): Shu Cole, Dubravka Svetina, Gale Whiteneck

Abstract

Objective

To develop an environmental barriers scale (TRIP) in the context of travel for people living with SCI.

Design

A mixed-method approach where in the qualitative phase, items were developed and written based on results of interviewers with different stakeholder groups and in the quantitative phase, survey data were collected to examine the psychometric properties of the scale.

Setting

Home, work and community settings.

Participants

People living with SCI, caregivers/family members, therapists, travel professionals.

Interventions

None.

Main Outcome Measures

A 19-item TRIP scale that measures the travel barriers encountered by people with SCI.

Results

Results from 83 semi-structured in-depth interviews with four stakeholder groups guided the writing of items in the TRIP scale. Seven cognitive interviews and an expert panel conducted reviews for content validity of the scale, and 19 items were included in the quantitative assessment of the scale. A total of 250 patients enrolled in the Rocky Mountain Regional Spinal Injury System was systematically selected to report their experience with each travel barrier. Item-response theory based Rasch analysis revealed that TRIP has acceptable psychometric properties.

Conclusions

The 19-item TRIP scale demonstrates promising psychometric properties for the scale to be used in clinical settings to quickly identify environmental barriers individuals with SCI encounter when traveling. It has the potential to assist with developing interventions that will improve the travel experience of individuals with SCI or to assist with strategies to overcome travel barriers.

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Cortisol response to awakening in prepubertal children and adults: Magnitude and variability

Psychophysiology, EarlyView.


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Task‐free auditory EEG paradigm for probing multiple levels of speech processing in the brain

Psychophysiology, EarlyView.


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Victims of war—Psychoendocrine evidence for the impact of traumatic stress on psychological well‐being of adolescents growing up during the Israeli–Palestinian conflict

Psychophysiology, EarlyView.


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N2pc reflects two modes for coding the number of visual targets

Psychophysiology, EarlyView.


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Reducing saccadic artifacts and confounds in brain imaging studies through experimental design

Psychophysiology, EarlyView.


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Depressive symptoms and error‐related brain activity in CPS‐referred children

Psychophysiology, EarlyView.


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Prior Diagnosis of Barrett’s Esophagus Is Infrequent, but Associated with Improved Esophageal Adenocarcinoma Survival

Abstract

Background

Efforts to reduce mortality from esophageal adenocarcinoma (EA) have focused on screening and surveillance of Barrett's esophagus (BE).

Aims

We sought to determine the frequency of prior diagnosis of BE in patients with EA and to evaluate the impact of a prior BE diagnosis on mortality in EA patients.

Methods

This was a retrospective cohort study of patients diagnosed with EA in the VA during 2002–2016. We compared the distributions of EA stage and receipt of treatment between EA patients with and without a prior BE diagnosis and used Cox proportional hazards models to compare mortality risk (all-cause and cancer specific) unadjusted and adjusted for stage and treatment to assess their impact on any survival differences.

Results

Among 8564 EA patients, only 4.9% had a prior BE diagnosis. The proportion with prior BE diagnosis increased from 3.2% in EA patients diagnosed during 2005–2007 to 7.0% in those diagnosed during 2014–2016. EA patients with a prior BE diagnosis were more likely to have stage 1 disease and receive any treatment. A prior BE diagnosis was associated with lower all-cause mortality risk (hazard ratio [HR] unadjusted for stage, 0.69; 95% CI, 0.61–0.80), which was largely explained by the earlier stage of EA at the time of diagnosis (HR adjusted for stage, 0.87; 95% CI, 0.75–0.99). There was no evidence of lead time bias or length time bias.

Conclusions

Prior diagnosis of BE was associated with better survival, largely due to earlier EA stage at diagnosis.

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Survival Disparities by Race and Ethnicity in Early Esophageal Cancer

Abstract

Background

Survival outcome disparities among esophageal cancer patients exist, but are not fully understood.

Aims

We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database to determine whether survival differences among racial/ethnic patient populations persist after adjusting for demographic and clinical characteristics.

Methods

Our study included T1-3N0M0 adenocarcinoma and squamous cell cancer patients diagnosed between 2003 and 2011. We compared survival among two racial/ethnic patient subgroups using Cox proportional hazards methods, adjusting for age, sex, histology, marital status, socioeconomics, SEER region, comorbidities, T stage, tumor location, diagnosis year, and treatment received.

Results

Among 2025 patients, 87.9% were White and 12.1% were Nonwhite. Median survival was 18.7 months for Whites vs 13.8 months for Nonwhites (p = 0.01). In the unadjusted model, Nonwhite patients had higher risk of mortality (HR = 1.29, 95% CI 1.11–1.49, p < 0.0001) when compared to White patients; however, in the Cox regression adjusted model there was no significant difference (HR = 0.94, 95% CI 0.80–1.10, p = 0.44). Surgery, chemotherapy, younger age, lower T stage, and lower Charlson comorbidity score were significant predictors in the full adjusted model.

Conclusions

Differences in mortality risk by race/ethnicity appear to be largely explained by additional factors. In particular, associations were seen in surgery and T stage. Further research is needed to understand potential mechanisms underlying the differences and to better target patients who can benefit from treatment options.

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Hamstring stiffness pattern during contraction in healthy individuals: analysis by ultrasound-based shear wave elastography

Abstract

Purpose

To assess the stiffness of hamstring muscles during isometric contractions in healthy individuals, using ultrasound-based shear wave elastography to (1) determine the intra- and inter-day assessment repeatability, (2) characterize the stiffness of semitendinosus (ST) and biceps femoris long head (BFlh) along the contraction intensity, and (3) characterize stiffness distribution among the hamstring muscles and inter-limb symmetry.

Methods

Two experiments were conducted. In experiment I (n = 12), the intra-day repeatability in assessing the BFlh and ST stiffness were determined at intensities between 10–60% of maximal voluntary isometric contraction (MVIC) in a single session. In experiment II (n = 11), the stiffness of the hamstring muscles of both thighs was assessed at 20% of MVIC in the first session; and retested (for one randomly chosen thigh) in a second session. Isometric contraction of knee flexors was performed with the knee flexed at 30° and with the hip in a neutral position.

Results

Moderate-to-very-high intra- and inter-day repeatability was found (ICC = 0.69–0.93). The BFlh/ST stiffness ratio increased with contraction intensity. At 20% of MVIC, the ST showed the highest stiffness among the hamstring muscles (p < 0.02), with no differences between the remaining hamstring muscles (p > 0.474). No differences were found between limbs (p = 0.12).

Conclusions

The stiffness distribution among the hamstring muscles during submaximal isometric contractions is heterogeneous, but symmetric between limbs, and changes depending on the contraction intensity. Shear wave elastography is a reliable tool to assess the stiffness of hamstring muscles during contraction.

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A resected case of gallbladder metastasis with symptoms of acute cholecystitis in multiple metastatic ductal carcinoma of the breast

Abstract

Gallbladder metastasis from breast cancer, especially from ductal carcinoma, is rare. Herein, we report a rare case of gallbladder metastasis from ductal carcinoma of the breast that was diagnosed after laparoscopic cholecystectomy (LC) for acute cholecystitis. A 78-year-old woman presented with right upper abdominal tenderness and positive Murphy's sign during chemotherapy for advanced multiple metastases of the breast cancer. Abdominal ultrasonography and computed tomography showed a slightly thickened gallbladder wall and two calculi. After a diagnosis of acute calculous cholecystitis was established, LC was performed. Pathological examination revealed poorly differentiated adenocarcinoma infiltrating the submucosal and subserosal layer over the entire gallbladder, and a lymph node metastasis in the gallbladder neck. Immunohistochemical examination revealed that the tumor cells tested positive for estrogen receptor and negative for progesterone receptor, which was consistent with primary breast cancer. The patient was uneventfully discharged without abdominal pain 7 days later. Although she subsequently underwent several chemotherapies, she died 16 months later. In conclusion, gallbladder metastasis should be considered in patients with multiple metastatic breast cancer who present with signs or symptoms of cholecystitis. Moreover, LC should be considered to relieve the symptoms of cholecystitis for improved prognosis, even in a patient with multiple metastases.

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Development and validation of a web-based questionnaire to identify environmental risk factors for inflammatory bowel disease: the Groningen IBD Environmental Questionnaire (GIEQ)

Abstract

Background

In the complex etiology of inflammatory bowel disease (IBD), the exposome is a major contributor. Though many environmental exposures have been identified, quality of evidence varies greatly and overall evidence for the exposome is inconclusive. A universal, precise, and reproducible measurement tool is needed to study the exposome in IBD.

Methods

We built the web-based Groningen IBD Environmental Questionnaire (GIEQ), an extensive and structured questionnaire measuring potentially involved environmental exposures, consisting of 848 items, subdivided into 15 categories. For validation, 76 IBD patients completed the GIEQ twice (2-month interval). Cohen's kappa and correlation coefficients were used to compare both fills. Internal consistency was evaluated using Cronbach's alpha tests. Proportional bias was examined using Bland–Altman plots.

Results

In general, we obtained a mean kappa coefficient of 0.78 (standard deviation 0.17) for categorical questions and a mean intraclass correlation coefficient of 0.88 (0.15) for numeric questions. Cronbach's alpha ranged from 0.64 to 1.0 with a mean of 0.79 (0.14). Bland–Altman plots showed proportional bias only for current physical activity score.

Conclusions

The GIEQ is a reliable measurement tool to study the exposome in IBD, enabling consistent measurement of an extended number of environmental factors and their interactions. Use of the GIEQ across IBD cohorts will lead to more standardized, generalizable, and comparable results. Also, the GIEQ can be used for calculation of an exposome risk score, applicable for secondary prevention by identifying high-risk patients as well as to analyze interactions between the exposome and other aspects of IBD etiology.

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A Simple Pre-endoscopy Score for Predicting Risk of Malignancy in Patients with Dyspepsia: A 5-Year Prospective Study

Abstract

Background

The guidelines for performing endoscopy in dyspeptic patients based on clinical parameters alone have shown variable performance, and there is a need for better prediction tools.

Aim

We aimed to prospectively develop and validate a simple clinical-cum-laboratory test-based scoring model to identify dyspeptic patients with high risk of upper gastrointestinal malignancy (UGIM).

Methods

Adult patients with dyspeptic symptoms were prospectively recruited over 5 years. Clinical details including alarm features were recorded, and blood tests for hemoglobin and albumin were done before endoscopy. The presence of UGIM was the primary outcome. Risk factors for UGIM were assessed, and based on the OR of significant factors, a predictive scoring model was constructed. ROC curve was plotted to identify optimal cutoff score. The model was validated using bootstrapping technique.

Results

The study included 2324 patients (41.9 ± 12.8 years; 33.4% females). UGIM was noted in 6.8% patients. The final model had following five positive predictors for UGIM—age > 40 years (OR 3.3, score 1); albumin ≤ 3.5 g% (OR 3.4, score 1); Hb ≤ 11 g% (OR 3.3, score 1); alarm features (OR 5.98, score 2); recent onset of symptoms (OR 8.7, score 3). ROC curve had an impressive AUC of 0.9 (0.88–0.93), and a score of 2 had 92.5% sensitivity in predicting UGIM. Validation by bootstrapping showed zero bias, which further strengthened our model.

Conclusion

This simple clinical-cum-laboratory test-based model performed very well in identifying dyspeptic patients at risk of UGIM. This can serve as a useful decision-making tool for referral for endoscopy.

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Food Insecurity and the Double Burden of Malnutrition of Indigenous Refugee Épera Siapidara

Abstract

The goal of this paper is to assess food and nutritional security status of an indigenous population who migrated from Colombia to Ecuador. We collected data about the perception of food insecurity, anthropometric and food intake (n = 104). An analysis multivariate (Generalized Linear Model) we used to know the adequacy to the Dietary Reference Intake (DRI). All the households were food insecure, stunting affected 45.1% of children and adolescents and the 60% were overweight or obese women. Significant differences were observed by gender for energy, lipid, carbohydrate, fiber, and iron (p < 0.001). No age group meets the DRI for fiber, calcium and potassium (except in children 24–59 months) and iron. There was a deficiency in vitamins A, D, folic acid and thiamine. The Epera Siapidara people in Ecuador experience acute food insecurity and a double burden of malnutrition, which may seriously affect their health and general progress.

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