Σάββατο, 22 Σεπτεμβρίου 2018

The P300 component decreases in a bimodal oddball task in individuals with depression: An event-related potentials study

Event-related potentials (ERPs) are electroencephalogram (EEG) indexes that allow for non-invasive recordings of cerebral activity with a temporal resolution on the order of milliseconds (Boutros et al., 2011). Such recordings may also allow for further identification of the relationship between neural activity and stimulus processing, each of which may be abnormal in individuals with psychiatric disorders (Charney and Nestler, 2008). Many studies have attempted to identify distinct ERP properties of specific cognitive functions or processes, most frequently reporting on the P300 component (Hansenne,2006).

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EUS-guided versus percutaneous biliary access in patients with obstructive jaundice due to gastric cancer

Gastric cancer is sometimes complicated by obstructive jaundice. However, ERCP may be challenging in patients who have advanced gastric cancer, or recurrent gastric cancer after surgical resection that is complicated by obstructive jaundice. In such cases, percutaneous transhepatic biliary drainage (PTBD) is considered. Recently, EUS-guided biliary drainage (EUS-BD) has been developed. We conducted a retrospective study to compare the efficacy of EUS-BD and PTBD in patients with obstructive jaundice due to gastric cancer.

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SpyGlass rescue treatment of common bile duct impacted foreign bodies



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Immune inflammation indicators and ALBI score to predict liver cancer in HCV-patients treated with direct-acting antivirals

Unexpectedly high occurrence or recurrence rate of hepatocellular carcinoma (HCC) has been observed in patients with chronic hepatitis C receiving direct-acting antivirals (DAAs) therapy.

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EUS-guided versus percutaneous biliary access in patients with obstructive jaundice due to gastric cancer

Gastric cancer is sometimes complicated by obstructive jaundice. However, ERCP may be challenging in patients who have advanced gastric cancer, or recurrent gastric cancer after surgical resection that is complicated by obstructive jaundice. In such cases, percutaneous transhepatic biliary drainage (PTBD) is considered. Recently, EUS-guided biliary drainage (EUS-BD) has been developed. We conducted a retrospective study to compare the efficacy of EUS-BD and PTBD in patients with obstructive jaundice due to gastric cancer.

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SpyGlass rescue treatment of common bile duct impacted foreign bodies



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Immune inflammation indicators and ALBI score to predict liver cancer in HCV-patients treated with direct-acting antivirals

Unexpectedly high occurrence or recurrence rate of hepatocellular carcinoma (HCC) has been observed in patients with chronic hepatitis C receiving direct-acting antivirals (DAAs) therapy.

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Progress in characterizing the linkage between Fusobacterium nucleatum and gastrointestinal cancer

Abstract

Microbiome research is a rapidly advancing field in human cancers. Fusobacterium nucleatum is an oral bacterium, indigenous to the human oral cavity, that plays a role in periodontal disease. Recent studies have found that F. nucleatum can promote gastrointestinal tumor progression and affect the prognosis of the disease. In addition, F. nucleatum may contribute to the chemo-resistance of gastrointestinal cancers. This review summarizes recent progress in the pathogenesis of F. nucleatum and its impact on gastrointestinal cancer.



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Cushing response-based warning system for intensive care of brain-injured patients

Publication date: Available online 21 September 2018

Source: Clinical Neurophysiology

Author(s): Yi-Hsin Tsai, Jie-Ying Lin, Yi-You Huang, Jau-Min Wong

Abstract
Objective

Cushing response (CR) is categorized. Wavelet transform (WT) and decision tree (DT) are utilized to analyze physiological signals from neurocritical patients. A warning model is built for recognition of CR, real-time evaluation of intracranial condition and prediction of neurological outcome.

Methods

Physiological signals of neurocritical patients are preprocessed by WT and compressed by linear regression. An algorithm labels each segment as pathological, physiological, negative or uncertain CR. The DT identifies CR. Continuous data input to the established DT predicts condition at that moment and following outcome.

Results

From 33 neurocritical patients, 422,524 sets of physiological signals were collected. The cross-validation scores of DT ranged from 0.562 to 0.579 with averaged accuracy rate 60.6% (3.5% to 98.1%). The model correctly predicted the outcome of the training group, 87.9% in accuracy. The ratios of pathological CR were 9.3 ± 16.6%, 74.2 ± 29.7% and 99.7 ± 0.3% in patients of good, coma and death groups, respectively. The prediction accuracy for a test set of 103 patients reached 81.6%.

Conclusions

Cushing response categorization helps in identifying critical conditions and predicting outcome.

Significance

A novel concept of four categories of Cushing response is proposed to represent broader ranges of intracranial change.



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Little effort with big effect – implementing the new IFCN 2017 recommendations on standard EEGs

Publication date: Available online 21 September 2018

Source: Clinical Neurophysiology

Author(s): Markus Gschwind, Pieter van Mierlo, Stephan Rüegg



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Network characteristics in benign epilepsy with centro-temporal spikes patients indicating defective connectivity during spindle sleep: a partial directed coherence study of EEG signals

Publication date: Available online 21 September 2018

Source: Clinical Neurophysiology

Author(s): Giulia Varotto, Silvana Franceschetti, Davide Caputo, Elisa Visani, Laura Canafoglia, Elena Freri, Francesca Ragona, Giuliano Avanzini, Ferruccio Panzica

Abstract
Objective

to investigate the changes in EEG connectivity in children with the typical presentation of benign epilepsy with centro-temporal spikes (BECTS).

Methods

We compared awake and spindle-sleep EEG recordings obtained by a standard electrode array in patients with lateralised (10 Right, 9 Left-BECTS) or bilateral spikes (10 MF-BECTS) and in 17 age-matched controls. We analysed EEG activity using partial directed coherence, an estimator of connectivity based on the multivariate autoregressive models and calculated in- and out-degrees, strength, clustering coefficient and betweenness centrality.

Results

In comparison with the controls, the awake EEG recordings of the patients with lateralised BECTS showed a minimal increase in out-degrees on F4 and F3. The greater differences, found during sleep, included significant reductions in both in- and out-degrees and strength in all of the patient groups, but in T4 or T3 showing increased out-degrees and strength in Right and Left-BECTS. Betweenness centrality was significantly reduced on C3 and C4 in the patients with MF-BECTS.

Conclusions

Our observations suggest that the main finding in BECTS patients is widely reduced local connectivity.

Significance

The network changes in BECTS can be interpreted as a permissive condition occurring in a developmental window that predisposes to seizure generation during spindle-sleep.



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Respiratory sinus arrhythmia and adaptive emotion regulation as predictors of nonsuicidal self-injury in young adults

Publication date: Available online 21 September 2018

Source: International Journal of Psychophysiology

Author(s): Andrew R. Fox, Lauren E. Hammond, Amy H. Mezulis

Abstract

Research suggests that both respiratory sinus arrhythmia (RSA) and emotion regulation are related to maladaptive outcomes. However, little is known about how these factors jointly contribute to nonsuicidal self-injury (NSSI). We examined how resting RSA and RSA withdrawal to stress predicted NSSI among young adults, and whether adaptive emotion regulation strategies moderated this effect. We examined this relation in a sample of 70 young adults (Mage = 19.25, SDage= 0.92, 94% female), 35 with a recent history of NSSI and 35 who had never engaged in NSSI. Participants completed a baseline questionnaire and lab visit where physiological responses to a social stressor were collected. Results indicated that resting RSA did not predict recent NSSI engagement. However, greater RSA withdrawal to social stress significantly predicted recent NSSI (β = 1.35 [0.57], Wald χ2 = 5.52 p = 0.02). Further, problem-solving moderated the relation between RSA withdrawal and recent NSSI such that individuals with greater levels of RSA withdrawal were significantly more likely to engage in NSSI if they also reported low problem-solving (β = −1.44 [0.64], Wald χ2 = 5.16, p = 0.02). In contrast, the effect of greater RSA withdrawal on NSSI was buffered by high problem-solving. Cognitive reappraisal did not moderate the relation between RSA withdrawal and NSSI. These findings suggest that problem-solving may be an important moderator in the relation between physiological reactivity and NSSI. Interventions should help clients with poor self-regulation develop adaptive problem-solving strategies.



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The Burden of Traumatic Spinal Cord Injury in the United States: Disability-Adjusted Life Years

Publication date: Available online 21 September 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): O. Trent Hall, Ryan P. McGrath, Mark D. Peterson, Edmund H. Chadd, Michael J. DeVivo, Allen W. Heinemann, Claire Z. Kalpakjian

Abstract
Objective

To quantify the burden of traumatic spinal cord injury (SCI) as defined by non-fatal health loss and premature mortality among a large sample of participants over a 44-year period, and estimate the national burden of SCI in the United States (U.S.) for the year 2010.

Design

Longitudinal.

Setting

National SCI Model Systems and Shriners Hospitals.

Participants

Individuals were categorized by neurologic level of injury as cervical (N=28,178) or thoracic and below (N=23,048).

Main Outcome Measures

The burden of SCI was calculated in years lost due to premature mortality (YLL), years lived with disability (YLD) and disability-adjusted life years (DALY).

Results

For those with cervical level injuries, the overall YLLs and YLDs were 253,745 and 445,709, respectively, for an estimated total of 699,454 DALYs. For those with thoracic and below level injuries, the overall YLLs and YLDs were 153,885 and 213,160, respectively, for an estimated total of 367,045 DALYs. Proportionally-adjusted DALYs attributable to SCI in 2010 were 445,911.

Conclusions

SCIs accounted for over 1 million years of healthy life lost in a national sample over a 44-year span. We estimated that 445,911 DALYs resulted from SCIs in the U.S. in 2010 alone, placing the national burden of SCIs above other impactful conditions such as Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome. Future investigations may employ DALYs to monitor trends in SCI burden in response to innovations in SCI care and identify subgroups of persons with SCIs for whom tailored interventions might improve DALYs.



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A case of unique endoscopic findings of intestinal endometriosis exposed to the mucosa: aggregation of papillary protruded bulges from the submucosal elevation of the rectum

Abstract

Intestinal endometriosis exposed to the mucosa is relatively rare. Therefore, its endoscopic findings with pit pattern and magnifying endoscopy with narrow-band imaging and clinicopathological features of intestinal endometriosis exposed to the mucosa have not been well documented until now. A 44-year-old woman was suspected to have gastrointestinal bleeding by positive fecal occult blood test. Colonoscopy revealed a hemicircular submucosal tumor whose surface was covered with easy-bleeding papillary bulges in the rectum. Pit pattern analysis and magnifying endoscopy with narrow-band imaging revealed straight microvessels among the straight pits arranged in a radial manner, and the avascular area with no pit pattern of the top of the bulge. These findings were different from those of polyps or cancer. Biopsy specimens from the protruded lesions were diagnosed as rectal mucosal endometriosis by hematoxylin–eosin staining and immunohistochemical examination. Surgical resection was suggested to the patient, but the patient did not favor surgical treatment. After the diagnosis dienogest treatment started and successfully relieved her abdominal pain. Malignant transformation of the endometriotic lesion has not arisen to this date.



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Factors Associated with Community-Partnered School Behavioral Health Clinicians’ Adoption and Implementation of Evidence-Based Practices

Abstract

Community-partnered school behavioral health (CP-SBH) is a model whereby schools partner with local community agencies to deliver services. This mixed-methods study examined 80 CP-SBH clinicians' adoption and implementation of evidence-based practice (EBP) approaches following mandated training. Forty-four clinicians were randomly assigned to one of two training conditions for a modular common elements approach to EBPs; 36 clinicians were preselected for training in a non-modular EBP. EBP knowledge improved for all training conditions at 8-month follow-up and practice element familiarity improved for modular approach training conditions, but the modular condition including ongoing consultation did not yield better results. Qualitative interviews (N = 17) highlighted multi-level influences of the CP-SBH service system and individual clinician characteristics on adoption and implementation.



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Identification novel LQT syndrome-associated variants in Polish population and genotype-phenotype correlations in eight families

Abstract

Congenital long QT syndrome (LQTS) is a primary cardiac channelopathy. Genetic testing has not only diagnostic but also prognostic and therapeutic implications. At present, 15 genes have been associated with the disease, with most mutations located in 3 major LQTS-susceptibility genes. During a routine genetic screening for KCNQ1, KCNH2 and SCN5A genes in index cases with LQTS, seven novel variants in KCNH2 and SCN5A genes were found. Genotype-phenotype correlations were analysed in these patients and their families. An open reading frame and splice site analysis of the exons was conducted using next-generation sequencing. In novel variants, phenotypes of carriers and their affected relatives were analysed. In 39 unrelated patients, 40 pathogenic/putative pathogenic mutations were found. Thirty-three of them, predominantly missense, were reported previously: 11 were in the KCNQ, 17 in the KCNH2 and 5 in the SCN5A gene. Seven novel missense variants were found in eight families. Among them, four variants were in typical for LQTS location. Two variants in the KCNH2 gene (p.D803Y and p.D46F) and one in the SCN5A gene (G1391R) were in amino acid (AA) position which up to present has not been reported in LQTS. Phenotype analysis showed the life-threatening course of the disease in index cases with a history of sudden cardiac death in six families. Mutation carriers presented with ECG abnormalities and some of them received beta-blocker therapy. We report three novel variants (KCNQ1 p.46, KCNH2 p.D803Y, SCN5A p.G1391R) which have never been reported for this AA location in LQTS; the phenotype-genotype correlation suggests their pathogenicity.



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Flutter sensitivity in FM bats. Part I: delay modulation

Abstract

Echolocating bats measure target distance by the time delay between call and echo. Target movement such as the flutter of insect wings induces delay modulations. Perception of delay modulations has been studied extensively in bats, but only concerning how well bats discriminate flutter frequencies, never with regard to flutter magnitude. We used an auditory virtual reality approach to generate changes in echo delay that were independent of call repetition rate, mimicking fluttering insect wings. We show that in the frequency-modulating (FM) bat Phyllostomus discolor, the sensitivity for modulations in echo delay depends on the rate of the modulation, with bats being most sensitive at modulation rates below 20 Hz and above 50 Hz. The very short duration of their calls compels FM bats to evaluate slow modulations (< about 100 Hz) across entire echo sequences. This makes them susceptible to interference between their own call repetition rate and the modulation rate. We propose that this phenomenon constitutes an echo-acoustic wagon-wheel effect. We further demonstrate how at high modulation rates, flutter sensitivity could be rescued by using spectral and temporal cues introduced by Doppler distortions. Thus, Doppler distortions may play a crucial role in flutter sensitivity in the hundreds of FM species worldwide.



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UBC‐Nepal expedition: peripheral fatigue recovers faster in Sherpa than Lowlanders at high‐altitude

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


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And the beat goes on

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


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Commissural communication allows mouse intergeniculate leaflet and ventral lateral geniculate neurons to encode interocular differences in irradiance

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


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Cleft palate and hypopituitarism in a patient with Noonan‐like syndrome with loose anagen hair‐1

American Journal of Medical Genetics Part A, EarlyView.


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Use of nutritional devices in Cornelia de Lange syndrome: Data from a large Italian cohort

American Journal of Medical Genetics Part A, EarlyView.


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Novel de novo pathogenic variant in the ODC1 gene in a girl with developmental delay, alopecia, and dysmorphic features

American Journal of Medical Genetics Part A, EarlyView.


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Risk of Down syndrome birth: Consanguineous marriage is associated with maternal meiosis‐II nondisjunction at younger age and without any detectable recombination error

American Journal of Medical Genetics Part A, EarlyView.


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Motor Control Training Compared to Transcutaneous Electrical Nerve Stimulation in Patients with Disc Herniation with Associated Radiculopathy: A Randomized Controlled Trial

Objective To compare the effectiveness of motor control training(MCT)and transcutaneous electrical nerve stimulation (TENS) in relieving pain, reducing functional disability, and improving transversus abdominis (TrA) activation in patients with lumbar disc herniation(LDH) with associated radiculopathy. Design Randomized controlled trial. Methods Forty patients diagnosed with LDH were randomly divided into two groups: motor control training group (MCTG; n=20) and TENS group(TG; n=20). Interventions The MCTG and TG attended 60-minsessions twice a week for 8 weeks, totaling to 16 sessions. Main outcome measures Pain, functional disability, and TrA activation capacity. Results Differences between both groups were observed after 8 weeks, favoring the MCTG. MCT was more effective than TENS in relieving pain (mean difference=3.3 points, 95% confidence interval [CI] 2.12–4.48), reducing functional disability (mean difference=8.4 points, 95% CI 5.44–11.36), improving the quality of pain (mean difference=17 points, 95% CI 7.93–26.07), sensory quality of pain (mean difference=10.3 points, 95% CI5.55–15.05), and TrA activation (mean difference=1.5 points, 95% CI0.90–2.10). Conclusions The results suggest that MCT is more effective than TENS with respect to relieving pain, reducing functional disability, and improving TrA activation in patients with LDH. Registration number NCT01640431 clinicaltrials.gov Corresponding Author: Bianca Callegari – Laboratory of Human Motricity Studies, Institute of Health Sciences, Federal University of Pará, Belém (PA), Brazil. Phone: (+55 91) 982210054 E-mail: callegaribi@uol.com.br FUNDING This study received public financial support from the: State of São Paulo Research Foundation (FAPESP), and there is not conflict of interest in the work. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Customized 3D-Printed Prosthetic Devices for Wounded Warriors

No abstract available

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Treatment of NASH with Gastric Bypass

Abstract

Purpose of Review

Nonalcoholic steatohepatitis (NASH) is a spectrum of nonalcoholic fatty liver disease (NAFLD). It is defined as the presence of fatty liver along with inflammation and hepatocyte injury. To date, weight loss achieved via lifestyle intervention remains the mainstay of NASH treatment. However, given the known benefit of weight loss on NASH and the known effect of bariatric surgery on weight loss, several studies have explored the potential role of bariatric surgery on the treatment of NASH.

Recent Findings

This review article summarizes the evidence on the effect of Roux-en-Y gastric bypass (RYGB), a common bariatric surgery, on NASH therapy. Specifically, studies show that RYGB is associated with an improvement of all NASH histologic features at 1 year.

Summary

Compared to adjustable gastric band, RYGB appears to be superior at treating NASH. Randomized controlled trials and long-term studies are underway to better clarify the role of these procedures specifically for NASH therapy.



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Indications for Helicobacter pylori Eradication: Do We Need to Consider to Screen and Treat Asymptomatic Children?

No abstract available

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Analysis of Healthcare Institutional Costs of Pediatric Home Parenteral Nutrition Central Line Infections

imageBackground: Although previous literature suggests home parenteral nutrition (HPN)–dependent children experience frequent complications like community-acquired central line-associated bloodstream infections (CLABSI), few studies have characterized the cost. Objective: The aim of this study was to evaluate institutional cost of community-acquired CLABSI in pediatric patients with HPN. Methods: This is a single-center retrospective review of institutional costs for patients with HPN with community-acquired CLABSI at a tertiary care children's hospital. Inclusion was age 18 years or less between October 2011 and April 2016. Exclusions were death during hospitalization and readmission within 2 days of discharge. Patient-level factors were compared between high-cost group and all others using Welch 2-sample t test and analysis of variance. Multivariable logistic regression was used to determine predictors of higher cost. Results: There were 176 CLABSI admissions among 68 patients during the study period (median 2 hospitalizations per patients). The mean cost and length of stay per hospital admission are $28,375 (2015 US dollars) and 8 days, and both were associated with intensive care unit admission (ICU), central venous catheter removal, private insurance, and age

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Electronic Medical Records Enable Precision Medicine Approaches for Celiac Disease

No abstract available

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Academic Stress May Contribute to the Onset of Pediatric Inflammatory Bowel Diseases

imageIt is currently unclear whether seasonality affects the onset of inflammatory bowel diseases (IBDs: Crohn disease and ulcerative colitis) in children. Here, we examined the records of pediatric patients with IBD diagnosed between 2009 and 2015 in a discovery cohort of 169 cases and a validation cohort of 122 subjects, where the month of symptoms onset could be determined. No seasonal patterns could be identified in respect to conception, birth, and disease onset. An annual rhythm of symptomatic onset, however, correlating with academic semesters was identified. IBD symptoms in the discovery cohort presented significantly more (P = 0.0218) during 5 months including the initiation (August, September, January) and the termination of academic semesters (December, May) compared to any other 5 months of the year. This observation was validated in the independent cohort (P 

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The Use of Bioimpedance in Pediatric Health, Nutrition, and Disease

No abstract available

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