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pubmed_421_16377
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INTRODUCTION
Matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) are considered important mediators of the periapical immune response to infection. This study aimed to clarify the putative relationship between MMPs and TIMPs by elucidating the activity of MMP-1, MMP-2, MMP-8, MMP-9, TIMP-1, and TIMP-2 in the temporal development of apical periodontitis (AP) in mice.
METHODS
AP was induced in the lower first molars of 30 male Kunming mice. The animals were randomly killed at 0, 7, 14, 28, 60, and 90 days after pulp exposure. The jaws were removed and subjected to quantitative real-time reverse transcription polymerase chain reaction, enzyme-linked immunosorbent assay, and immunohistochemical analysis.
RESULTS
The MMP-1, MMP-2, MMP-8, MMP-9, TIMP-1, and TIMP-2 messenger RNA and protein expression levels increased with periapical inflammation progression (P < .05). The MMP-1, MMP-2, MMP-9, TIMP-1, and TIMP-2 messenger RNA and protein expression levels increased during the acute and chronic stages of periapical lesions, with less MMP-2 and MMP-9 expression levels at the chronic stage (P < .05). The MMP-8 expression increased at the chronic stage of inflammation (P < .05) but not at the acute stage. Immunostained MMP-2 and TIMP-1 were observed in all experimental periods.
CONCLUSIONS
MMP-1, MMP-2, MMP-8, MMP-9, TIMP-1, and TIMP-2 were expressed in all periapical samples with varying levels between them. MMP expression could be related to TIMP expression in the temporal development of AP.
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10.1016/j.joen.2021.04.005
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pubmed_744_1051
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OBJECTIVE
To assess the diagnostic performance of a commercially available computer-aided diagnosis (CAD) system for automatic detection of pulmonary nodules with multi-row detector CT scans compared to single and double reading by radiologists.
MATERIALS AND METHODS
A CAD system for automatic nodule detection (Siemens LungCare NEV VB10) was applied to four-detector row low-dose CT (LDCT) performed on nine patients with pulmonary metastases and compared to the findings of three radiologists. A standard-dose CT (SDCT) was acquired simultaneously and used for establishing the reference data base. The study design was approved by the Institutional Review Board and the appropriate German authorities. The reference data base consisted of 457 nodules (mean size 3.9 +/- 3.1 mm) and was established by fusion of the sets of nodules detected by three radiologists independently reading LDCT and SDCT and by CAD. An independent radiologist used thin slices to eliminate false positive findings from the reference base.
RESULTS
An average sensitivity of 54 % (range 51 % to 55 %) was observed for single reading by one radiologist. CAD demonstrated a similar sensitivity of 55 %. Double reading by two radiologists increased the sensitivity to an average of 67 % (range 67 % to 68 %). The difference to single reading was significant (p < 0.001). CAD as second opinion after single reading increased the sensitivity to 79 % (range 77 % to 81 %), which proved to be significantly better than double reading (p < 0.001). CAD produced more false positive results (7.2 %) than human readers but it was acceptable in clinical routine.
CONCLUSION
Double reading with CAD as second reader offered a significantly increased sensitivity compared to conventional double reading. Thus, CAD is a valuable tool for the detection of pulmonary nodules and should be used as second opinion.
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10.1055/s-2004-813251
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pubmed_804_19657
|
OBJECTIVES
Voice is produced by the vibration of the vocal folds expressed by its fundamental frequency (Hz), whereas the formants (F) are fundamental frequency multiples, indicating amplification zones of the vowels in the vocal tract. We have shown that lifetime isolated growth hormone deficiency (IGHD) causes high pitch voice, with higher values of most formant frequencies, maintaining a prepuberal acoustic prediction. The objectives of this work were to verify the effects of the therapy with a semi-occluded vocal tract (SOVTT) and choir training on voice in these subjects with IGHD. We speculated that acoustic vocal parameters can be improved by SOVTT or choir training.
STUDY DESIGN
This is a prospective longitudinal study without control group.
METHODS
Acoustic analysis of isolated vowels was performed in 17 adults with IGHD before and after SOVTT (pre-SOVTT and post-SOVTT) and after choir training (post training), in a 30-day period.
RESULTS
The first formant was higher in post training compared with the pre-SOVTT (P = 0.009). The second formant was higher in post-SOVTT than in pre-SOVTT (P = 0.045). There was a trend of reduction in shimmer in post-choir training in comparison with pre-SOVTT (P = 0.051), and a reduction in post-choir training in comparison with post-SOVTT (P = 0.047).
CONCLUSIONS
SOVTT was relevant to the second formant, whereas choir training improved first formant and shimmer. Therefore, this speech therapy approach was able to improve acoustic parameters of the voice of individuals with congenital, untreated IGHD. This seems particularly important in a scenario in which few patients are submitted to growth hormone replacement therapy.
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10.1016/j.jvoice.2018.02.018
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pubmed_1015_2921
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8-Anilinonaphthalene-1-sulfonate (ANS) complexes with phytochrome, exhibiting a higher affinity for the Pfr form of phytochrome than for the Pr form. ANS fluorescence is enhanced by the additional binding of ANS to Pfr upon transformation of phytochrome from Pr to Pfr. The specific site of ANS binding appears to be the hydrophobic surface area of the protein, which becomes at least partially exposed in the Pfr form. An exposed, hydrophobic surface area in the Pfr phytochrome has been confirmed by the effects of ANS on the phototransformation of phytochrome. ANS accelerates the Pr leads to Pfr phototransformation, and it inhibits Pfr leads to Pr photoreversion and dark reversion. These effects are interpretable in terms of competitive binding of ANS to the chromophore binding site. Binding of ANS results in a drastic bleaching of the chromophore's absorption bands at 660 and 730 nm, particularly of the latter. This can be attributed to the exposed chromophore, which tends to resume a cyclic conformation with concomitant blue shift and hypochromism of the Qy bands. Sodium dithionite counteracts the inhibitory effects of ANS on the dark reversion of Pfr to Pr, and its effect on the biphasic kinetics of the reversion has been discussed in terms of the Pfr model proposed.
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10.1021/bi00512a036
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pubmed_915_19844
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Cisplatin resistance is a vital obstacle for the prognosis of ovarian cancer. However, the mechanism of cisplatin resistance is still unknown. This research was performed to explore the role of Nrf2 (nuclear factor, erythroid 2 like 2) and CD99 (CD99 molecule) in cisplatin resistance in ovarian cancer. QRT-PCR and Western blot were used to detect the expression of CD99 in ovarian cancer cells and tissues with different cisplatin sensitivities. Cell viability was analyzed by the Cell Counting Kit-8 (CCK8). The relationship of Nrf2 and CD99 was assessed by dual-luciferase reporter gene assay and chromatin immunoprecipitation (ChIP). Bioinformatics analysis was performed to search for the downstream gene of CD99. In this study, it was revealed that CD99 was highly expressed in cisplatin-resistant ovarian cancer cells and tissues, while lower CD99 expression was found in cisplatin-sensitive ovarian cancer cells and tissues. In addition, the overexpression of CD99 resulted in cisplatin resistance; on the other hand, knockdown of CD99 sensitized ovarian cancer to cisplatin. Furthermore, survival analysis indicated that overall survival (OS) and progression-free survival (PFS) of patients with higher CD99 expression were shorter than those with lower CD99 expression. It was also found that when Nrf2 was upregulated in cisplatin-sensitive ovarian cells, CD99 expression and cell viability increased after cisplatin treatment. Knockdown of CD99 could reverse cisplatin resistance induced by Nrf2. Conversely, when Nrf2 was knocked down in cisplatin-resistant ovarian cancer cells, CD99 expression and cell viability with cisplatin treatment decreased, while simultaneously upregulating CD99 reactivated cisplatin resistance in ovarian cancer cells. The dual-luciferase reporter gene assay and ChIP analysis suggested CD99 was a downstream gene of Nrf2, and Nrf2 positively regulated the expression of CD99 at the transcriptional level. In conclusion, Nrf2 induced cisplatin resistance in ovarian cancer cells by promoting CD99 expression. Targeted CD99 might be an effective way to reverse cisplatin resistance in ovarian cancer.
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10.1016/j.bbrc.2019.08.113
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pubmed_766_1853
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In the past 10 years, 15 children with bilateral optic nerve hypoplasia have been studied at the Royal Alexandra Hospital for Children. There were 5 boys and 10 girls. Nine were first-born and they presented at a mean age of 5 months (range: 4 days to 25 months). Five presented with suspected blindness and 7 with abnormal eye movements (nystagmus or less commonly squint). The other 3 presented because of fits or developmental delay. Eight showed evidence of neural damage--microcephaly, seizures and/or abnormalities of tone. Four appeared to be of normal or near normal intelligence, 6 were mildly retarded and 5 severely so. Two patients had already died, one suddenly. Six of the 7 cases investigated in detail had evidence of hypothalamic pituitary dysfunction. Another one had a minimal hypothalamic abnormality. Four were severely growth retarded and 2 were receiving growth hormone replacement. Two males had micropenis and a girl had precocious puberty with partial diabetes insipidus. Neuroradiological investigations showed an absent septum pellucidum in only 5 cases. Five patients had other major CNS malformations. Five patients had normal CT scans; 3 of these 5 appeared of normal intelligence and all 5 had normal neurological examinations. Bilateral optic nerve hypoplasia is frequently associated with serious brain and endocrine abnormalities.
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pubmed_766_1853
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pubmed_486_5446
|
Life experiences at early ages, such as physical activity in childhood and adolescence, can result in long-lasting brain effects able to reduce future risk of brain disorders and to enhance lifelong brain functions. However, how early physical exercise promotes these effects remains unclear. A possible hypothesis is that physical exercise increases the expression of neurotrophic factors and stimulates neuronal growth, resulting in a neural reserve to be used at later ages. Basing our study on this hypothesis, we evaluated the absolute number and morphology of neuronal cells, as well as the expression of growth, proliferation and survival proteins (BDNF, Akt, mTOR, p70S6K, ERK and CREB) in the cerebral cortex and hippocampal formation throughout of a sedentary period of rats who were physically active during youth. To do this, male Wistar rats were submitted to an aerobic exercise protocol from the 21st to the 60th postnatal days (P21-P60), and evaluated at 0 (P60), 30 (P90) and 60 (P120) days after the last exercise session. Results showed that juvenile exercise increased, and maintained elevated, the number of cortical and hippocampal neuronal cells and dendritic arborization, when evaluated at the above post-exercise ages. Hippocampal BDNF levels and cortical mTOR expression were found to be increased at P60, but were restored to control levels at P90 and P120. Overall, these findings indicate that, despite the short-term effects on growth and survival proteins, early exercise induces long-lasting morphological changes in cortical and hippocampal neurons even during a sedentary period of rats.
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10.1038/s41598-019-50218-9
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pubmed_464_20429
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A 74-year-old female with lung cancer underwent thoracoscopic right upper lobectomy. The patient was diagnosed chylothorax due to the milky drain effusion on postoperative day 1 (POD 1). Despite fasting management, chylothorax was not improved. Lymphangiography by inguinal lymph node puncture was performed on POD 4. The amount of drainage decreased on POD 6 and disappered by following pleurodesis. Early lymphangiography is recommended prior to surgical treatment for patients with chyle leakages who are unlikely to be cured by conservative treatment alone.
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pubmed_464_20429
|
pubmed_1124_1553
|
BACKGROUND
The use of endosseous dental implants to replace natural teeth lost to trauma, dental caries, or periodontal disease has become a predictable form of prosthetic treatment since gaining popularity in the early 1980s. While numerous clinical studies have focused on the survival of implants, few address the survival of different prosthesis designs.
METHODS
Beginning in 1991, 882 prostheses supported by more than 2,900 implants (687 patients) were placed by the Department of Veterans Affairs Dental Implant Clinical Research Group (DICRG). These prostheses were divided into five research strata based on arch location. The recommended design for each stratum was: bar-supported overdenture (maxillary completely edentulous); screw-retained hybrid denture (mandibular completely edentulous); screw-retained fixed partial denture (mandibular and maxillary posterior partially edentulous); and cemented single crown (maxillary anterior single tooth). Alternative overdenture designs were utilized in the edentulous arches when the recommended prosthesis could not be fabricated. Prosthesis success rates for the research strata were calculated for an observation time of up to 36 months following prosthesis placement.
RESULTS
Success rates for the maxillary edentulous stratum ranged from 94.6% for the bar-retained overdenture supported by five to six fixtures to 81.8% for the cap-retained overdenture. The mandibular edentulous strata produced success rates of 98.1% for the fixed hybrid prosthesis to 91.7% for the cap-retained prosthesis. Success rates for maxillary and mandibular posterior fixed partial dentures were 94.3% and 92.6%, respectively, while the maxillary anterior single-tooth prosthesis yielded a success rate of 98.1% for the 36-month observation period.
CONCLUSIONS
The recommended prosthesis designs investigated in this study proved to be reliable, with encouraging success rates for an observation period of 36 months following placement.
|
10.1902/annals.2000.5.1.101
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pubmed_723_1191
|
This article describes a case of using intravenous sufentanil in treatment of ultherapy to achieve satisfactory analgesic effect. Further rearchis need to find a convenient, safe and practical method to solve the problem of pain caused by ultherapy treatment.
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10.1111/jocd.13236
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pubmed_50_8609
|
INTRODUCTION
There have been conflicting data regarding the relationship between sepsis-bundle adherence and mortality. Moreover, little is known about how this relationship may be moderated by the anatomic source of infection or the location of sepsis declaration.
METHODS
This was a multi-center, retrospective, observational study of adult patients with a hospital discharge diagnosis of severe sepsis or septic shock. The study included patients who presented to one of three Los Angeles County Department of Health Services (DHS) full-service hospitals January 2012 to December 2014. The primary outcome of interest was the association between sepsis-bundle adherence and in-hospital mortality. Secondary outcome measures included in-hospital mortality by source of infection, and the location of sepsis declaration.
RESULTS
Among the 4,582 patients identified with sepsis, overall mortality was lower among those who received bundle-adherent care compared to those who did not (17.9% vs. 20.4%; p=0.035). Seventy-five percent (n=3,459) of patients first met sepsis criteria in the ED, 9.6% (n=444) in the intensive care unit (ICU) and 14.8% (n=678) on the ward. Bundle adherence was associated with lower mortality for those declaring in the ICU (23.0% adherent [95% confidence interval{CI} {16.8-30.5}] vs. 31.4% non-adherent [95% CI {26.4-37.0}]; p=0.063), but not for those declaring in the ED (17.2% adherent [95% CI {15.8-18.7}] vs. 15.1% non-adherent [95% CI {13.0-17.5}]; p=0.133) or on the ward (24.8% adherent [95% CI {18.6-32.4}] vs. 24.4% non-adherent [95% CI {20.9-28.3}]; p=0.908). Pneumonia was the most common source of sepsis (32.6%), and patients with pneumonia had the highest mortality of all other subsets receiving bundle non-adherent care (28.9%; 95% CI [25.3-32.9]). Although overall mortality was lower among those who received bundle-adherent care compared to those who did not, when divided into subgroups by suspected source of infection, a statistically significant mortality benefit to bundle-adherent sepsis care was only seen in patients with pneumonia.
CONCLUSION
In a large public healthcare system, adherence with severe sepsis/septic shock management bundles was found to be associated with improved survival. Bundle adherence seems to be most beneficial for patients with pneumonia. The overall improved survival in patients who received bundle-adherent care was driven by patients declaring in the ICU. Adherence was not associated with lower mortality in the large subset of patients who declared in the ED, nor in the smaller subset of patients who declared in the ward.
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10.5811/westjem.2018.7.37651
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pubmed_337_17097
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Given periodic outbreaks of fatal human infections caused by coronaviruses, development of an optimal coronavirus vaccine platform capable of rapid production is an ongoing priority. This chapter describes the use of an insect cell expression system for rapid production of a recombinant vaccine against severe acute respiratory syndrome coronavirus (SARS). Detailed methods are presented for expression, purification, and release testing of SARS recombinant spike protein antigen, followed by adjuvant formulation and animal testing. The methods herein described for rapid development of a highly protective SARS vaccine are equally suited to rapid development of vaccines against other fatal human coronavirus infections, e.g., the MERS coronavirus.
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10.1007/978-1-4939-3387-7_14
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pubmed_242_14217
|
Rare haplotypes may tag rare causal variants of common diseases; hence, detection of such rare haplotypes may also contribute to our understanding of complex disease etiology. Because rare haplotypes frequently result from common single-nucleotide polymorphisms (SNPs), focusing on rare haplotypes is much more economical compared with using rare single-nucleotide variants (SNVs) from sequencing, as SNPs are available and 'free' from already amassed genome-wide studies. Further, associated haplotypes may shed light on the underlying disease causal mechanism, a feat unmatched by SNV-based collapsing methods. In recent years, data mining approaches have been adapted to detect rare haplotype association. However, as they rely on an assumed underlying disease model and require the specification of a null haplotype, results can be erroneous if such assumptions are violated. In this paper, we present a haplotype association method based on Kullback-Leibler divergence (hapKL) for case-control samples. The idea is to compare haplotype frequencies for the cases versus the controls by computing symmetrical divergence measures. An important property of such measures is that both the frequencies and logarithms of the frequencies contribute in parallel, thus balancing the contributions from rare and common, and accommodating both deleterious and protective, haplotypes. A simulation study under various scenarios shows that hapKL has well-controlled type I error rates and good power compared with existing data mining methods. Application of hapKL to age-related macular degeneration (AMD) shows a strong association of the complement factor H (CFH) gene with AMD, identifying several individual rare haplotypes with strong signals.
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10.1038/ejhg.2015.25
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pubmed_1033_13958
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We examined the cis- vs. trans-splicing status of the mitochondrial group II intron nad1i728 in 439 species (427 genera) of land plants, using both Southern hybridization results (for 416 species) and intron sequence data from the literature. A total of 164 species (157 genera), all angiosperms, was found to have a trans-spliced form of the intron. Using a multigene land plant phylogeny, we infer that the intron underwent a transition from cis to trans splicing 15 times among the sampled angiosperms. In 10 cases, the intron was fractured between its 5' end and the intron-encoded matR gene, while in the other 5 cases the fracture occurred between matR and the 3' end of the intron. The 15 intron fractures took place at different time depths during the evolution of angiosperms, with those in Nymphaeales, Austrobaileyales, Chloranthaceae, and eumonocots occurring early in angiosperm evolution and those in Syringodium filiforme, Hydrocharis morsus- ranae, Najas, and Erodium relatively recently. The trans-splicing events uncovered in Austrobaileyales, eumonocots, Polygonales, Caryophyllales, Sapindales, and core Rosales reinforce the naturalness of these major clades of angiosperms, some of which have been identified solely on the basis of recent DNA sequence analyses.
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10.1007/s00239-004-2606-y
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pubmed_437_3909
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Toll-like receptors (TLRs) and nucleotide-binding oligomerization domain receptors (NLRs) are families of pattern recognition receptors that, together with inflammasomes, sense and respond to highly conserved pathogen motifs and endogenous molecules released upon cell damage or stress. Evidence suggests that TLRs, NLRs and the NACHT, LRR and PYD domains-containing protein 3 (NLRP3) inflammasome have important roles in kidney diseases through regulation of inflammatory and tissue-repair responses to infection and injury. In this Review, we discuss the pathological mechanisms that are related to TLRs, NLRs and NLRP3 in various kidney diseases. In general, these receptors are protective in the host defence against urinary tract infection, but can sustain and self-perpetuate tissue damage in sterile inflammatory and immune-mediated kidney diseases. TLRs, NLRs and NLRP3, therefore, have become promising drug targets to enable specific modulation of kidney inflammation and suppression of immunopathology in kidney disease.
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10.1038/nrneph.2014.91
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pubmed_595_4014
|
BACKGROUND
Proteinuria is a common manifestation of renal disease which is a significant cause of morbidity in patients with sickle cell disease (SCD).
OBJECTIVE
To evaluate and compare cystatin C, beta(2)-microglobulin, and creatinine as markers of renal disease in relation to the degree of proteinuria and other complications of SCD.
METHODS
24 h urine collections were used for estimation of urine protein and creatinine clearance in 59 patients with SCD. Results were correlated with plasma cystatin C, beta(2)-microglobulin, creatinine, glomerular filtration rate (GFR; derived from plasma creatinine by Cockcroft-Gault, MDRD formulae, and calculated cystatin C clearance), and clinical and haematological variables.
RESULTS
Comparing the different methods of GFR, the proportion of patients with hyperfiltration (GFR >140 ml/min) were 30.5% (MDRD), 44.1% (Cockcroft-Gault), and 10.2 % (calculated cystatin C clearance). Cystatin C was the most consistent marker of hyperfiltration. The endogenous markers of GFR showed an increasing trend with increasing proteinuria, but haematological variables were not correlated with cystatin C, beta(2)-microglobulin, or plasma creatinine. Urine protein excretion was correlated with age (r = 0.33) and significant proteinuria was present in 13.6% of patients. Patients with proteinuria had lower haemoglobin concentration (p = 0.027) than those without proteinuria but HbF was not related to the degree of proteinuria or to markers of GFR.
CONCLUSIONS
Markers of GFR show variable ability to identify hyperfiltration in patients with SCD, but cystatin C is the best endogenous marker. Proteinuria is associated with age, haemoglobin, and abnormalities of GFR. Routine screening is recommended to allow for early detection and intervention.
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10.1136/jcp.2005.026799
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pubmed_64_15477
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(1) Background: Sub-Saharan African migrants residing in high-income countries are more affected by cardiovascular diseases (CVDs) and associated risk factors than host populations for unclear reasons. The aim was to explore the associations of religion and religious affiliations with CVD risk among Ghanaian non-migrants and migrants in Europe. (2) Methods: The 10-year CVD risk was estimated using pooled cohort equations for 3004 participants from the cross-sectional Research on Obesity and Diabetes among African Migrants (RODAM) study. Logistic regression analyses were conducted to assess associations between religion and elevated CVD risk (score ≥ 7.5) with adjustment for covariates. (3) Results: Religious men in Europe had a lower 10-year CVD risk compared with non-religious men (adjusted OR 0.51; 95% confidence interval 0.30-0.85), specifically men affiliated with Seventh-Day Adventism (0.24; 0.11-0.53) followed by other affiliations (0.32; 0.11-0.94) and Roman Catholicism (0.42; 0.21-0.86). The opposite was found in Ghana, with religious women having higher odds for elevated 10-year CVD risk (1.53; 1.02-2.30) compared with their non-religious counterparts, specifically women affiliated with Reformed Christianity (1.73; 1.03-2.90) and other denominations (2.81; 1.20-6.54). Associations were not significant for men in Ghana and women in Europe. Adjustments for social support, stress, and health behaviors did not meaningfully alter the associations. (4) Conclusions: Christian religious Ghanaian men living in Europe seem to have lower CVD risk compared with their non-religious counterparts, while Christian religious women in Ghana appear to have increased CVD risk. Further unravelling the contributing factors and the differences between sex and environmental settings is needed.
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10.3390/ijerph18052451
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pubmed_1107_9652
|
During purification of fungal deoxyribonuclease (DNase) from Syncephalastrum racemosum, a protein which was functionally unknown and persistently existed in the DNase-containing fractions through chromatography over DEAE-cellulose, hydroxylapatite, and phenyl-Sepharose was identified. The protein was finally separated from DNase after affinity chromatography on a cibacron blue-Sepharose column and purified to apparent homogeneity after gel chromatography on a Superdex 200 HR column. Ten tryptic peptides of this protein were isolated and sequenced. Searching in the sequence data bank with the aid of the computer program PC/Gene, we found that this protein was highly homologous to aspartic proteinases, such as pepsin and rhizopuspepsin. Because of its fungal origin and because the protein indeed showed catalytic cleavage on peptide bonds of bovine serum albumin, RNase, and carbonic anhydrase, we termed this protein syncephapepsin. The molecular weight of syncephapepsin is 38,000 daltons, based on gel filtration and sodium dodecyl sulfate-polyacrylamide electrophoresis.
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10.1006/abbi.1996.0434
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pubmed_913_7213
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Two cases of Prinzmetal's variant angina are presented in which coronary spasm was documented by electrocardiographic evidence obtained in the coronary care unit during provocative testing with ergonovine maleate after the arteriographic demonstration of anatomically normal coronary arteries. The rationale and risks of provocative testing for spasm in patients with chest pain and anatomically normal coronary arteries are reviewed. The advantages of performing provocative testing in the coronary care unit after arteriography rather than in the catheterization laboratory during coronary arteriography are discussed.
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10.1016/0002-9149(77)90081-9
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pubmed_283_12759
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The Chedoke-McMaster Attitudes towards Children with Handicaps Scale (CATCH) has been developed to measure the attitudes of children toward peers with disabilities. The present study aims to evaluate the factorial validity of the CATCH in a sample of 2396 students in 7th grade, including 179 students with disabilities and 2217 typically developing students. Each classroom included at least one student with a disability. The structure of the scale, as proposed by the developers, was tested and its stability was evaluated across gender, disability status, awareness of the disability status of classmates and having a classmate with a disability as a friend. Confirmatory factor analysis did not support the originally proposed subscale structure. Instead of the three proposed subscales, a single subscale including seven items was found. Strict factorial invariance was obtained across gender, disability status, awareness of the disability status of classmates and being friends with a classmate with a disability. Implications of these findings will be discussed.
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pubmed_283_12759
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pubmed_861_25529
|
BACKGROUND
Respiratory function would be impaired during general anesthesia period. Researchers devoted their energies to finding effective strategies for protecting respiratory function. Low tidal volume, positive end-expiratory pressure (PEEP), and lung recruitment maneuvers (LRMs) were recommended for patients under mechanical ventilation. However, based on the current evidence, there was no consensus on whether LRMs should be routinely used for anesthetized patients with healthy lungs, and the benefits of them remained to be determined.
MATERIALS AND METHODS
To evaluate the benefits of LRMs on patients undergoing surgery with general anesthesia, we searched relevant studies in PubMed, EMBASE, Ovid Medline and the Cochrane Library up to June 30, 2018. The primary outcome was postoperative pulmonary complications (PPCs).
RESULTS
Twelve trials involving 2756 anesthetized patients were included. The results of our study showed a significant benefit of LRMs for reducing the incidence of PPCs (RR = 0.67; 95%CI, 0.49 to 0.90; P<0.05; Chi2 = 32.94, p for heterogeneity = 0.0005, I2 = 67%). After subgroup analyses, we found LRMs combining with lung protective ventilation strategy and sustained recruitment maneuvers were associated with reducing the occurrence of PPCs. The results also revealed that the use of LRMs improved PaO2/FiO2 in non-obese patients, but with extremely high heterogeneity (I2 = 95%).
CONCLUSION
According to the findings from contemporary meta-analysis, LRMs combining with lung protective ventilation strategy may have an association with decreasing in the incidence of PPCs and improvement of oxygenation on non-obese patients. However, the conclusions must be interpreted cautiously as the outcome may be influenced dramatically due to varied LRMs and ventilation patterns.
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10.1371/journal.pone.0217405
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pubmed_570_20764
|
Water-dispersible polypyrrole nanospheres with diameters of less than 100 nm were synthesized in high yield without any templates, surfactants, or functional dopants by the introduction of 2,4-diaminodiphenylamine as an initiator into a reaction mixture of pyrrole monomer, oxidant, and acid. The initiator plays a critical role in tailoring the nanostructures of polypyrrole. 2,4-Diaminodiphenylamine interacts with acid to form cations, which combine with various anions to self-assemble resulting in different size nanomicelles. These nanomicelles, stabilized by initiator molecules, act as templates to encapsulate pyrrole and oxidant leading to the formation of nanospheres during polymerization. When smaller acids are used, smaller diameter sphere-like polypyrrole nanostructures are obtained. The as-synthesized polypyrrole nanospheres can then be used to fabricate highly conducting nitrogen-doped carbon nanospheres with controllable sizes of 50-220 nm with monodispersities up to 95% after pyrolysis. The size of the carbon nanospheres decreases by 20-30 nm due to carbonization when compared to the original polymer nanospheres. The molecular structures, morphologies, and electrical properties along with the formation mechanism of the polypyrrole and carbon nanospheres are discussed.
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10.1021/nn101378p
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pubmed_940_14495
|
BACKGROUND/AIMS
Immunological mechanisms are involved in many adverse drug reactions. In certain forms of drug-induced hepatitis, patients have been reported to express specific autoantibodies to hepatic drug-metabolising enzymes. The alcohol deterrent disulfiram is associated with a low frequency of severe liver toxicity, including hepatitis, but the mechanism of the toxicity is unknown. We investigated whether autoantibodies to cytochrome P450 enzymes were expressed in the serum of a 28-year-old male patient, who developed hepatitis after 7 weeks of disulfiram treatment and in whom possible causes of hepatitis other than disulfiram had been ruled out.
METHODS
Patient serum IgG reactivity was analysed by immunoblotting or ELISA against test antigens consisting of recombinant/purified human or rat liver P450 enzymes, or isolated rat liver microsomes.
RESULTS
A significant serum reactivity was found in immunoblotting against human cytochromes P450 1A2 and rat P450 3A1, using serum dilutions of up to 1:900 and 1:2400, respectively. In contrast, the reactivity against cytochromes P450 2E1, 2C9, 2D6, 3A4, and rat liver P450 reductase was either very low or undetectable. ELISA reactivity was low in general, indicating that the P450 epitopes were not surface exposed. Immunoblotting of rat liver microsomes revealed that autoantibodies recognised one major polypeptide corresponding to P450 3A. Autoantibody titres remained stable for at least 6 months after acute hepatitis. A similar reactivity was not found in any of ten control sera.
CONCLUSIONS
The expression of autoantibodies directed against specific cytochromes P450 in a case of disulfiram hepatitis suggests that immunological mechanisms are involved in this adverse drug reaction, and that these P450 proteins should be evaluated as possible diagnostic test antigens in disulfiram hepatotoxicity.
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10.1016/s0168-8278(98)80264-x
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pubmed_368_15293
|
OBJECTIVE
To examine key aspects of neurologists' and psychiatrists' views and approaches regarding prenatal genetic testing (GT) and preimplantation genetic diagnosis (PGD).
STUDY DESIGN
We surveyed attitudes and practices among 163 neurologists and 372 psychiatrists.
RESULTS
A total of 24.9% of neurologists and 31.9% of psychiatrists had discussed prenatal GT with patients, but 95.3% did not feel comfortable discussing PGD; only 2.9% discussed it, and only 1.8% had patients ask about PGD. Most would refer for PGD for Huntington's disease and Tay-Sachs disease, fewer for cystic fibrosis, and fewer still for autism, Alzheimer's disease, or gender selection for family balancing; in each of these cases, psychiatrists' percentages were higher than those of neurologists. Providers who would refer for PGD for Huntington's disease, cystic fibrosis, or gender selection differed from others in proportions of patients with insurance and were more likely to have undergone a GT themselves and be concerned about discrimination.
CONCLUSION
These data, the first to examine how neurologists and psychiatrists view PGD, suggest that they do not feel comfortable discussing PGD but have strong views about its use. Potential PGD use is associated with concerns about discrimination and less experience with GT. These data highlight the need for enhancing education about these technologies among various providers.
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pubmed_368_15293
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pubmed_740_25140
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Therapy is predicated on the need for clients to share intimate details about their lives, including their cultural values, attitudes, and beliefs. Previous studies have found that clients conceal certain aspects of their lives including, but not limited to their symptoms and their feelings about the therapy process. To date, there has not been an investigation focused on whether clients conceal aspects of their cultural identities, whether some therapists are more likely to have clients conceal aspects of their cultural identities, and if cultural concealment is associated with therapy outcomes. The present study attempted to do so utilizing the caseloads of 37 therapists who treated a total of 233 clients in a university counseling center setting. Client data were collected at the end of treatment utilizing the Patient's Estimate of Improvement (PEI; Hatcher & Barends, 1996), a measure that assesses client change on domains including general functioning, symptom related distress, intimate and social relationships, work or school, feelings about oneself, behavior, control of life, and tolerance for and ability to share painful feelings. Cultural concealment was assessed via 5 items regarding the amount and circumstances under which clients withheld cultural identity based information in therapy. Results indicated that within therapists' caseloads, client's ratings of cultural concealment were negatively associated with therapy outcomes. Additionally, therapists whose clients rated more cultural concealment on average had clients with worse therapy outcomes. Lastly, there was a significant contextual effect indicating that within and between therapist cultural concealment were statistically different from one another. (PsycINFO Database Record
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10.1037/cou0000246
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pubmed_146_10368
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BACKGROUND AND PURPOSE
We investigated the impact of percutaneous renal procedures on estimated glomerular filtration rate (GFR) of patients with chronic kidney disease (CKD).
PATIENTS AND METHODS
The GFRs of adult patients were calculated using the Modification of Diet in Renal Disease formula, and the patients were staged according to the Kidney Disease Outcome Quality Initiative CKD classification system. The study included 185 patients with preoperative GFR values less than 60 mL/min/1.73 m(2). The impact of percutaneous nephrolithotomy (PCNL) on GFR was analyzed by comparing the preoperative GFR with the GFR before discharge and at postoperative month 3.
RESULTS
Patients with CKD had a significant increase in the GFR after the procedure. In postoperative month 3, the mean GFR was more than 60 mL/min/1.73 m(2) in 25% of the patients with CKD and less than 60 mL/min/1.73 m(2) in 75%. While all patients with stage 5 CKD improved to better stages, some other patients' conditions declined to stage 5 from better stages at the end of postoperative month 3. No patient needed dialysis. The presence of urinary tract infections tended to affect GFR negatively.
CONCLUSION
Estimated GFR, as a better indicator of renal function, is significantly affected by the PCNL procedure. While significant improvement was observed in late-stage patients with CKD, unexpected deterioration could occur in patients at earlier stages.
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10.1089/end.2007.0435
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pubmed_456_11839
|
BACKGROUND
Common resistant-to-therapy warts pose a challenge to both clinicians and patients. Among many destructive and immunotherapeutic options, no single, fully effective treatment has been suggested yet. Many investigations, including those using intralesional antigen administrations, have demonstrated that cellular immunity plays a major role in the clearance of human papilloma virus (HPV) infection. The aim of the present study was to evaluate the effects of the intralesional injection of the measles-mumps-rubella (MMR) vaccine into resistant-to- treatment palmoplantar warts and its complications.
METHODS
In this single-blind, randomized, controlled clinical trial, 60 cases with resistant-to-therapy palmoplantar warts referring to the Dermatology Clinic of Bou-Ali Sina Hospital of Sari between June 2015 and 2016 were randomly assigned to 2 equal groups: the MMR Group received intralesional MMR and the Placebo Group was given saline injection. The injections were administered at 2-week intervals until complete clearance was achieved or for a maximum of 5 injections (<5 injections at 2-week intervals). The study protocol was registered in the Iranian Registry of Randomised Clinical Trials (ID: IRCT2016101027636N3), and the statistical analyses were performed using SPSS, version 17.0. The χ2 test and the F-test were used as appropriate, and a P value less than 0.05 was considered statistically significant.
RESULTS
Complete clearance was observed in 65.2% (14⁄23) of the patients presenting with resistant-to-therapy palmoplantar warts in the MMR Group and 23.85% (5/21) in the Placebo Group (P=0.021). Recurrence was not observed in any of the completely cured patients at 6 months' follow-up.
CONCLUSION
Intralesional immunotherapy with the MMR vaccine may result in a desirable therapeutic response and can be used as an effective and safe treatment option for palmoplantar warts, particularly persistent ones. Trial Registration Number: IRCT2016101027636N3.
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pubmed_456_11839
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pubmed_1007_2585
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Near infrared spectroscopy (NIR) and skin impedance (IMP) spectroscopy are two methods suggested for diagnoses of diseases inducing adverse effects in skin. The reproducibility of these methods and their potential value in non-invasive diagnostics were investigated. Measurements were performed in vivo on healthy skin at five anatomic body sites on eight young women. partial least squares discriminant analysis showed that both methods were useful for classification of the skin characteristics at the sites. Inter-individually the NIR model gave 100% correct classification while the IMP model provided 92%. Intra-individually the NIR model gave 88% correct classification whereas the IMP model did not provide any useful classification. The correct classification was increased to 93% when both datasets were combined, which demonstrates the value of adding information. Partial least squares discriminant analysis gave 72% correct predictions of skin sites while the combined model slightly improved to 73%.
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10.1007/s11517-008-0343-x
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pubmed_300_17276
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New blood vessel growth via angiogenesis is a fundamental process in both physiological and pathological conditions. Physiological angiogenesis is critical during embryogenesis and placental development, whereas pathological angiogenesis plays an important role in the progression of many diseases, most notably tumor growth. Tumor angiogenesis is well accepted to be regulated by a balance of proangiogenic and antiangiogenic factors produced both by tumor cells and surrounding stromal cells. For many years, investigation of antiangiogenic therapies for cancer has focused on the proangiogenic cytokine, vascular endothelial growth factor; its receptors; or downstream signaling pathways. However, more recently with the identification of endogenous angiogenesis inhibitors, studies have turned toward understanding the role of endogenous antiangiogenic proteins in preventing disease progression. Clinical clues have suggested that specific populations may have dysregulated angiogenesis due to differential expression of endogenous angiogenesis regulators. For example, individuals with Down syndrome may possess a systemic antiangiogenic state with a significantly decreased incidence of angiogenesis-dependent diseases. Our work suggests that endogenous angiogenesis inhibitors may be the master regulators controlling progression of angiogenesis-dependent diseases such as vascular anomalies and cancer. The molecular regulation of angiogenesis is not yet fully understood; however, the Down syndrome population may give us insights toward novel therapies for controlling angiogenesis in disease.
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10.1097/scs.0b013e3181927f47
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pubmed_1118_20229
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DNA long-term stability and integrity is of importance for applications in DNA based bio-dosimetry, data-storage, pharmaceutical quality-control, donor insemination and DNA based functional nanomaterials. Standard protocols for these applications involve repeated freeze-thaw cycles of the DNA, which can cause detrimental damage to the nucleobases, as well as the sugar-phosphate backbone and therefore the whole molecule. Throughout the literature three hypotheses can be found about the underlying mechanisms occurring during freeze-thaw cycles. It is hypothesized that DNA single-strand breaks during freezing can be induced by mechanical stress leading to shearing of the DNA molecule, by acidic pH causing damage through depurination and beta elimination or by the presence of metal ions catalyzing oxidative damage via reactive oxygen species (ROS). Here we test these hypotheses under well defined conditions with plasmid DNA pUC19 in high-purity buffer (1xPBS) at physiological salt and pH 7.4 conditions, under pH 6 and in the presence of metal ions in combination with the radical scavengers DMSO and Ectoine. The results show for the 2686 bp long plasmid DNA, that neither mechanical stress, nor pH 6 lead to degradation during repeated freeze-thaw cycles. In contrast, the presence of metal ions (Fe2+ ) leads to degradation of DNA via the production of radical species.
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10.1002/cbic.202200391
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pubmed_458_22452
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Recent research has clarified a number of important questions concerning adverse effects of cannabis on health. A causal role of acute cannabis intoxication in motor vehicle and other accidents has now been shown by the presence of measurable levels of Delta(9)-tetrahydrocannabinol (THC) in the blood of injured drivers in the absence of alcohol or other drugs, by surveys of driving under the influence of cannabis, and by significantly higher accident culpability risk of drivers using cannabis. Chronic inflammatory and precancerous changes in the airways have been demonstrated in cannabis smokers, and the most recent case-control study shows an increased risk of airways cancer that is proportional to the amount of cannabis use. Several different studies indicate that the epidemiological link between cannabis use and schizophrenia probably represents a causal role of cannabis in precipitating the onset or relapse of schizophrenia. A weaker but significant link between cannabis and depression has been found in various cohort studies, but the nature of the link is not yet clear. A large body of evidence now demonstrates that cannabis dependence, both behavioral and physical, does occur in about 7-10% of regular users, and that early onset of use, and especially of weekly or daily use, is a strong predictor of future dependence. Cognitive impairments of various types are readily demonstrable during acute cannabis intoxication, but there is no suitable evidence yet available to permit a decision as to whether long-lasting or permanent functional losses can result from chronic heavy use in adults. However, a small but growing body of evidence indicates subtle but apparently permanent effects on memory, information processing, and executive functions, in the offspring of women who used cannabis during pregnancy. In total, the evidence indicates that regular heavy use of cannabis carries significant risks for the individual user and for the health care system.
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10.1016/j.pnpbp.2004.05.027
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pubmed_135_14995
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We present a position- and time-dependent optical force theory for optomechanics of dispersive 3D photonic materials and devices. The theory applies to media including material interfaces, waveguides, and general photonic crystal structures. The theory enables calculation of the dynamical state of the coupled field-material system and the interference of this state with other excitations of the material, such as surface acoustic waves or phonons. As an example, we present computer simulations of energy and momentum flows through a silicon crystal with anti-reflective structured interfaces. Using commercially available simulation tools, the theory can be applied to analyze optical forces in complex photonic materials and devices.
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10.1364/OE.458252
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pubmed_100_3909
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A sonochemical method has been used to prepare negative electrode materials containing intermetallic nanoparticles and polyacrylonitrile (PAN). The ultrasound irradiation is applied to achieve small particle size. After annealing at 490 °C under Ar-flow, the polymer PAN is partially carbonized and the metallic nanoparticles are surrounded by a carbonaceous matrix. The main metallic phase is CoSn(2). The carbonaceous coating and the surface oxides have been explored by using XPS. The resulting CoSn(2)-carbonaceous phase electrode (CoSn(2)@C) shows improved electrochemical behavior (ca. 450 mAh/g after 50 cycles) in comparison with previous reports on pure crystalline CoSn(2). The reaction between CoSn(2)@C and Li has been studied by using XRD and (119)Sn Mössbauer spectroscopy. The formation of large grains of crystalline Li(x)Sn phases after the first discharge is discarded. The small particle size which is achieved by using ultrasonication and the carbonaceous matrix contribute to maintain the Co-Sn interactions during the electrochemical cycling. The aggregation of the nanosized metallic particles upon electrochemical cycling can be suppressed by the carbonaceous matrix (pyrolytic PAN).
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10.1016/j.ultsonch.2011.06.014
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pubmed_443_15223
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PURPOSE
The purpose of this paper is to review the relevance of keratocyte programmed cell death (apoptosis) in response to epithelial injury to corneal wound healing following refractive surgery and the pathogenesis of corneal diseases such as keratoconus.
METHODS
The TUNEL assay (to detect DNA fragmentation in situ) DNA laddering assay, and transmission electron microscopy have been used to detect apoptosis in human and animal corneas and cultured corneal cells. Molecular and cell biologic techniques have been used to study the cytokine-receptor systems that are involved in modulating apoptosis in the cornea.
RESULTS
Keratocyte apoptosis, mediated through the release of cytokines such as soluble Fas ligand and interleukin-1 from the injured epithelium, occurs following refractive surgical procedures like photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). Keratocytes that die in the anterior stroma following PRK or along the lamellar cut following LASIK are replenished in 2 to 4 days by proliferation and migration. The replenishing cells are activated myofibroblastic keratocytes that produce collagen, hyaluronic acid, growth factors modulating epithelial healing, and other components of the wound healing response. Keratocyte apoptosis can be inhibited by transepithelial PRK (probably by photodisruption of the apoptotic cytokines in the epithelium) or pharmacologic agents.
CONCLUSIONS
Keratocyte apoptosis may be an initiator of the wound healing response in the cornea. Control of this response has the potential to regulate wound healing in the cornea in response to PRK or LASIK. Recent evidence suggests that keratocyte apoptosis mediated by chronic epithelial injury could have a role in the pathogenesis of keratoconus.
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pubmed_443_15223
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pubmed_33_19615
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The interaction between one polychlorobiphenyl (3,3',4,4',-tetrachlorobiphenyl, coded PCB77) and the four DNA nucleic acid-base is studied by means of quantum mechanics calculations in stacked conformations. It is shown that even if the intermolecular dispersion energy is the largest component of the total interaction energy, some other contributions play a non negligible role. In particular the electrostatic dipole-dipole interaction and the charge transfer from the nucleobase to the PCB are responsible for the relative orientation of the monomers in the complexes. In addition, the charge transfer tends to flatten the PCB, which could therefore intercalate more easily between DNA base pairs. From these seminal results, we predict that PCB could intercalate completely between two base pairs, preferably between Guanine:Cytosine pairs.
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10.1007/s00894-012-1580-3
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pubmed_52_7298
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Improper positioning of the endotracheal tube during intubation poses a serious health risk to patients. In one prospective study of 219 critically ill patients, 14% required endotracheal tube repositioning after intubation [Brunel et al. Chest 1989; 96: 1043-1045] While a variety of techniques are used to confirm proper tube placement, a chest X-ray is usually employed for definitive verification. Radio frequency identification (RFID) technology, in which an RFID reader emits and receives a signal from an RFID tag, may be useful in evaluating endotracheal tube position. RFID technology has already been approved for use in humans as a safe and effective tool in a variety of applications. The use of handheld RFID detectors and RFID tag-labeled endotracheal tubes could allow for easy and accurate bedside monitoring of endotracheal tube position, once initial proper placement is confirmed.
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10.1007/s10877-007-9069-9
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pubmed_0_16167
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PURPOSE
This study aims to investigate the association between social support variables and healthy lifestyle for asthma management among early adolescents (ages 9-14 years).
DESIGN AND METHODS
Questionnaires were completed by 86 parent-adolescent dyads.
RESULTS
Healthy lifestyle was associated with social support variables. The association with peer acceptance was stronger among adolescents who received less asthma-specific support from peers. Age was negatively associated with healthy lifestyle, but the association was attenuated after adjustment for asthma-specific peer support.
PRACTICE IMPLICATIONS
The findings of this study suggest recognizing the developmental change of social support during early adolescence.
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10.1111/j.1744-6155.2010.00247.x
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pubmed_293_1136
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Surface plasmon resonance (SPR) biosensing strategies have drawn substantial attention due to their advantages of label free, real time, and high performance, but complicated modification procedures and strict reaction conditions of amplification tags associated with current SPR biosensors hinder their potential utilizations. Herein, an in situ prepared AgNPs-based SPR biosensor for MicroRNA (miRNA) sensitive detection was developed based on hybridization chain reaction (HCR) without the biomodification on amplification tags. The target miRNA initiated the HCR of the hairpin probes to generate long double strand DNA (dsDNA) chains that were immobilized on SPR disk. Thus, with Ag+ intercalating into dsDNA chains, large numbers of AgNPs generated after NaBH4 reduction, resulting in the significantly elevated SPR angle. Further, the SPR angle is positively proportional to target miRNA concentrations. As a result, the in situ generated AgNPs-based SPR biosensor realized exceptional let-7a detection with linear range of 0.001-0.1 pM and detection limit (LOD) of 0.35 fM, lower than that of other SPR biosensors that used modifiable amplification tags. Featured with the modification-free characteristic and excellent performance, the proposed strategy provides new way for ultrasensitive detection of miRNA, and allows to detect other biomarkers by simply verifying the target responsive substances, and thus has a great potential for health and early disease diagnosis.
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10.1016/j.bios.2019.05.006
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pubmed_1013_26852
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The rapid development of Internet of Things (IoT) applications calls for light-weight IoT sensor nodes with both low-power consumption and excellent task execution efficiency. However, in the existing system framework, designers must make trade-offs between these two. In this paper, we propose an "edge-to-end integration" design paradigm, Butterfly, which assists sensor nodes to perform sensing tasks more efficiently with lower power consumption through their (high-performance) network infrastructures (i.e., a gateway). On the one hand, to optimize the power consumption, Butterfly offloads the energy-intensive computational tasks from the nodes to the gateway with only microwatt-level power budget, thereby eliminating the power-consuming Microcontroller (MCU) from the node. On the other hand, we address three issues facing the optimization of task execution efficiency. To start with, we buffer the frequently used instructions and data to minimize the volume of data transmitted on the downlink. Furthermore, based on our investigation on typical sensing data structures, we present a novel last-bit transmission and packaging mechanism to reduce the data amount on the uplink. Finally, we design a task prediction mechanism on the gateway to support efficient scheduling of concurrent tasks on multiple MCU-free Butterfly nodes. The experiment results show that Butterfly can speed up the task rate by 4.91 times and reduce the power consumption of each node by 94.3%, compared to the benchmarks. In addition, Butterfly nodes have natural security advantages (e.g., anti-capture) as they offload the control function with all application information up to the gateway.
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10.3390/s22083082
|
pubmed_118_24757
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Opioids are the cornerstone for the treatment of acute pain in small animal patients. This is primarily because of their remarkable safety profile, high efficacy, and benefit of reversibility. There have been some significant advances in our knowledge on opioid pharmacology and clinical usage in companion animal medicine. This review discusses the progression of opioid use in small animal practice providing current misconceptions and controversies in light of routes of administration. Potential targets for research and drug development and novel therapies are discussed in addition to the concepts of glial cell modulators, individual variability, and opioid tolerance and hyperalgesia. The future brings an interesting perspective with the application of pharmacogenetics and individualized pain management in canine and feline practice.
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10.1111/jvp.12377
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pubmed_279_3633
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To determine if cytomegalovirus (CMV) DNA could be detected in the cerebrospinal fluid (CSF) of infants with congenital infection with CMV, polymerase chain reaction (PCR) was done on CSF samples from 13 infants (10 with confirmed, 1 with possible, and 2 with asymptomatic congenital CMV infection) and on CSF samples from 100 control patients with alternative diagnoses. By use of two sets of primers that targeted different areas of the CMV genome, CMV DNA was amplified in the CSF of 6 of 10 symptomatic infants, 0 of 3 infants with asymptomatic CMV infection or possible congenital CMV disease, and 2 control patients (one primer set only). A positive CSF PCR result at birth correlated with a poor neurodevelopmental outcome (P = .048; two-tailed Fisher's exact test).
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10.1093/infdis/169.6.1334
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pubmed_587_10814
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Office chairs have often been designed to promote a single 'correct' rather rigid and upright posture, yet it is acknowledged that allowing changes in posture is good ergonomics practice. The present study investigated office worker's preferences for a standard shaped typist's chair (ST) and a prototype multi-posture (PMP) office chair designed to allow its users a variety of sitting positions. Forty-two (22 male and 20 female) telesales personnel (12), clerical staff (12) and researchers (18) used ST or PMP in their workplace for the first week of a 2-week study (with an even number in each work area). The PMP chair was introduced to participants with a brief lecture on how to use it and with an information booklet. Following this, each participant completed a chair comfort questionnaire. In the second week, participants swapped chairs and again completed the chair comfort questionnaire. At the end of the second week participants were also asked to complete a separate questionnaire about the usability of the information booklet that accompanied the PMP chair. Statistically significant differences in subject's rating of the two chairs were observed in 7 out of 19 questions. On a 100 mm scale, the ST chair was rated as having a greater mean overall acceptability, desirability and suitability for body build than the PMP chair. Participants also claimed to achieve better posture in the ST chair, that they tipped forward less and were more satisfied with its width. Although the participants generally preferred the ST chair, the PMP chair received more favourable ratings among the researchers who were quite mobile in their work, and in whom there was a trend for less neck, shoulder and upper back discomfort. More participants reported an overall preference for the PMP chair. The findings suggest that a more aesthetically acceptable PMP chair should be developed, peoples' reasons for preferring a more traditionally designed chair should be explored, and that the effect of postural stability education on personal preconceptions should be examined to obtain an optimal combination of healthy sitting habits, comfort and aesthetic qualities in an office chair.
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10.1080/00140130110120042
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pubmed_889_16908
|
Essentials Thromboprophylaxis after lower limb injury is often based on complex risk stratification. Our systematic review identified variables predicting venous thromboembolism (VTE) in this group. Age and injury type were commonly reported to increase the odds of VTE (odds ratio 1.5-3.48). We found limited evidence to support the use of other risk factors within prediction models. SUMMARY: Background Patients immobilized after lower limb injury are at risk of venous thromboembolism (VTE). There is international variation in the use of thromboprophylaxis for such patients. Risk-based strategies have been adopted to aid decision making in many settings. The accuracy of these strategies is unclear. Objectives A systematic review was undertaken to identify all individual patient-identifiable risk factors linked to any VTE outcome following lower limb immobilization. Methods Several electronic databases were searched from inception to May 2017. Any studies that included a measurement of VTE as a patient outcome in adults requiring temporary immobilization (e.g. leg cast or brace in an ambulatory setting) for an isolated lower limb injury and reported risk factor variables were included. Descriptive statistics and thematic analysis were used to synthesize the evidence. Results Our database search returned 4771 citations, of which 15 studies reporting outcome data on 80 678 patients were eligible for analysis. Risk-factor associations were reported through regression analyses, non-parametric tests and descriptive statistics. All studies were assessed as at moderate or serious risk of bias using the ROBINS-I risk of bias tool. Advancing age and injury type were the only individual risk factors demonstrating a reproducible association with increased symptomatic and/or asymptomatic VTE rates. Several risk factors currently used in scoring tools did not appear to be robustly evaluated for subsequent association with VTE within these studies. Conclusions Clinicians should be aware of the limited evidence to support individual risk factors in guiding thromboprophylaxis use for this patient cohort.
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10.1111/jth.14367
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pubmed_520_11478
|
INTRODUCTION
The insertion of gluteal silicone implants by intramuscular technique leads patients to develop gluteus maximus muscle atrophy. The objective of the present study was to correlate the muscular atrophy of the gluteus maximus proportional to the volume of the silicone implants used. The secondary objectives were to assess volumetry of the gluteus maximus muscle in the late follow-up, positioning of the implants and to verify association between volumetric muscle recovery and practice of physical exercise.
METHODS
This is a prospective study. The sample was composed of 22 patients who were operated and followed up on an outpatient basis and through gluteus computed tomography in 3 different moments: pre-operative, 12-month post-operative and late post-operative (≥ 96 months).
RESULTS
Computed Tomography 3D reconstruction and volumetric analysis showed a median atrophy of 6.68% of the gluteus maximus muscle volume in 12 months and 7.47% in the late post-operative period. The correlation between relative volume of the implant and atrophy percentage of the gluteus maximus didn't present statistically significant results. There was an association between the practice of physical exercise and volumetry recovery of the gluteus maximus. No patient presented gluteal implant rotation.
CONCLUSION
There isn't correlation between proportional volume of implants and atrophy percentage of gluteus maximus muscle, when using implants up to 400cm3. The gluteus maximus muscle presents atrophy in the late follow-up of augmentation gluteoplasty with implants surgery. There is recovery of muscle volumetry on the patients that practice physical activities. Intramuscular plane implants demonstrated stability in their long-term positioning.
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10.1097/PRS.0000000000009792
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pubmed_304_5212
|
The enzyme UDP-galactose-4-epimerase (GAL10) catalyzes a key step in galactose metabolism converting UDP-galactose to UDP-glucose which then can get metabolized through glycolysis and TCA cycle thus allowing the cell to use galactose as a carbon and energy source. As in many fungi, a functional homolog of GAL10 exists in Candida albicans. The domainal organization of the homologs from Saccharomyces cerevisiae and C. albicans show high degree of homology having both mutarotase and an epimerase domain. The former is responsible for the conversion of beta-d-galactose to alpha-d-galactose and the latter for epimerization of UDP-galactose to UDP-glucose. Absence of C. albicans GAL10 (CaGAL10) affects cell-wall organization, oxidative stress response, biofilm formation and filamentation. Cagal10 mutant cells tend to flocculate extensively as compared to the wild-type cells. The excessive filamentation in this mutant is reflected in its irregular and wrinkled colony morphology. Cagal10 strain is more susceptible to oxidative stress when tested in presence of H2O2. While the S. cerevisiae GAL10 (ScGAL10), essential for survival in the presence of galactose, has not been reported to have defects in the absence of galactose, the C. albicans homolog shows these phenotypes during growth in the absence of galactose. Thus a functional CaGal10 is required not only for galactose metabolism but also for normal hyphal morphogenesis, colony morphology, maintenance of cell-wall integrity and for resistance to oxidative stress even in the absence of galactose.
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10.1016/j.fgb.2006.11.006
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pubmed_1041_18833
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Lower extremity surgical procedures in patients with Werner's syndrome are uncommon, and for this reason they are rarely reported in the literature. In this report, we present the case of a 39-year-old man with a history of Werner's syndrome, and a malunited right hallux varus and first ray insufficiency after previous bunionectomy performed 4 years earlier. Further reconstructive surgery involved forefoot osteotomy and arthrodesis with internal fixation, and the patient ultimately healed the soft tissues and bones, despite delayed wound healing.
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10.1053/j.jfas.2011.02.011
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pubmed_978_347
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We investigated whether a low-dose infusion of ATP-MgCl2 could affect the functional status of the ductus arteriosus during hypoxia-induced pulmonary vasoconstriction. Three-day-old piglets were made hypoxic by ventilation with a mixture containing 10% oxygen, 4% CO2, and balance nitrogen. Serial infusions of ATP-MgCl2 at 0.1, 0.5, and 1.0 mg/kg/min were compared with preinfusion hypoxia baselines. The functional status of the ductus arteriosus was determined by change in transit time of a bolus of iced saline between thermistor probes in the pulmonary artery and aorta. The method was validated using a Blalock-Taussing shunt (subclavian to pulmonary artery) in 3-week-old piglets instrumented in a similar manner. In these three-day-old piglets, hypoxia alone produced a significant elevation in pulmonary artery pressure and reduction in PO2. All dose rates of ATP-MgCl2 produced a significant decrease in mean pulmonary artery pressure. Systemic pressure was significantly decreased only during the 1.0-mg/kg/min infusion. Transit times of a bolus of iced saline during the validation were definitive for characterizing a situation of "shunt open" or "shunt closed." Infusion of ATP-MgCl2 produced no change in the status of the ductus arteriosus in 45 (94%) of the determinations. In only three cases was the effect of ATP-MgCl2 sufficient to result in a functional change in the status of the ductus arteriosus. Pre- and postductal pulmonary artery PO2 were not altered during ATP-MgCl2 infusion, thus corroborating the transit time determinations. From these results, we conclude that an infusion of ATP-MgCl2 does not alter the functional status of the ductus arteriosus.
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10.1016/s0022-3468(89)80712-2
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pubmed_572_16790
|
Background and objectives T-cell activation may be one of the pathogenic mechanisms of systemic lupus erythematosus (SLE). After repeated antigenic stimulation, T-cells undergo different modifications, leading to the differentiation into effector memory T-cells (CCR7-CD45RA-) and terminally differentiated effector memory (TDEM) T-cells (CCR7-CD45RA+). Similarly, down-modulation of CD28 may lead to the expansion of the CD28- T-cells, a subpopulation with peculiar effector activities. The aim of this study was the characterization of T-cell phenotype in a cohort of patients with SLE according to disease activity and damage index. Materials and methods Phenotypic analysis of peripheral blood T lymphocytes of 51 SLE patients and 21 healthy controls was done by flow-cytometry. SLE disease activity was evaluated by SLE Disease Activity Index-2000 (SLEDAI-2K) and damage by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index (SDI). The variations between different groups were evaluated by Mann-Whitney test. Bonferroni correction was applied to adjust for multiple comparisons ( padj). Spearman rank test was used to evaluate the correlations between quantitative variables. Results CD4+ lymphopenia was found among SLE patients. Patients showed a trend for a higher percentage of TDEM among the CD4+ T-cell subpopulation in comparison with healthy controls ( p = .04). SLE patients were divided into two groups according to disease activity: patients with SLEDAI-2K ≥ 6 ( n = 13) had a higher percentage of circulating CD4+ T-cells with CD28- phenotype ( padj = .005) as well as those with an effector memory ( padj = .004) and TDEM ( padj = .002) phenotype and a trend of decrease of regulatory T-cells (TREGs) ( p = .02), in comparison with patients with low disease activity ( n = 38). Patients with damage (SDI ≥ 1) tended to show an expansion of TDEM among CD4+ T-cells as compared with patients with no damage ( p = .01). In SLE patients an inverse correlation was found between the percentages of TREGs and those of TDEM ( p < .01) or CD4 + CD28- ( p < .01) T-cells. Conclusions CD4+ T-cell subpopulations displaying phenotype characteristics of effector lymphocytes are proportionally expanded in patients with active SLE and a higher damage index. These findings may suggest a role of effector T-cells in the pathogenesis of the disease and in the mechanisms of damage in SLE.
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10.1177/0961203317722848
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pubmed_804_7776
|
Previous studies have demonstrated that 3'-hydroxy-5,6,7,4'-tetramethoxyflavone (TMF) content in Orthosiphon stamineus fractions correlate with its vasorelaxation activity. Even with the availability of previous studies, there is still very little information on the vasorelaxation effect of TMF, and few scientific studies have been carried out. Therefore, the present study was designed to investigate the vasorelaxation activity and mechanism of action of the TMF. The vasorelaxation activity and the underlying mechanisms of TMF were evaluated on thoracic aortic rings isolated from Sprague Dawley rats. TMF caused the relaxation of aortic rings with endothelium pre-contracted with phenylephrine. However, the vasorelaxant effect of TMF was significantly decreased in PE-primed endothelium-denuded and potassium chloride-primed endothelium-intact aortic rings. In the presence of Nω-nitro-L-arginine methyl ester, methylene blue, 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one, indomethacin, tetraethylammonium, 4-aminopyridine, barium chloride, atropine and propranolol, the relaxation stimulated by TMF was significantly reduced. TMF was also found to reduce Ca2+ release from sarcoplasmic reticulum (via IP3R) and block calcium channels (VOCC). The present study demonstrates the vasorelaxant effect of TMF involves NO/sGC/cGMP and prostacyclin pathways, calcium and potassium channels and muscarinic and beta-adrenergic receptors.
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10.1007/s00210-018-1481-9
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pubmed_223_24943
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BACKGROUND
Malaria is a major travel medicine issue. Retrospective confirmation of a malaria episode diagnosed in an endemic area can have relevant implications in transfusional medicine in Europe, where blood donors are excluded from donation on the basis of positive malaria serology. However, there is scarce evidence on the dynamics of anti-malarial antibodies after a first malaria episode in non-immune individuals. The first aim of this study was to describe the dynamics of anti-malarial antibodies in a first malaria episode in non-immune travellers. Secondary objectives were to assess the sensitivity of serology for a retrospective diagnosis in non-immune travellers diagnosed while abroad and to discuss the implications in transfusional medicine.
METHODS
Retrospective analysis of the results of an indirect fluorescence antibody test (IFAT) for malaria available for patients with a first malaria episode by Plasmodium falciparum and admitted at the IRCCS Sacro Cuore Don Calabria hospital in a 14-year period. The antibody titres were collected at baseline and during further follow up visits. Epidemiological, demographic and laboratory test results (including full blood count and malaria parasite density) were anonymously recorded in a study specific electronic Case Report Form created with OpenClinica software. Statistical analysis was performed with SAS software version 9.4.
RESULTS
Thirty-six patients were included. Among them, all but two were Europeans (one African and one American). Median length of fever before diagnosis was 2 days (IQR 1-3). Thirty-five patients had seroconversion between day 1 and day 4 from admission, and the titre showed a sharply rising titre, often to a very high level in a few days. Only a single patient remained negative in the first 5 days from admission, after which he was no more tested. Six patients were followed up for at least 2 months, and they all showed a decline in IFAT titre, tending to seroreversion (confirmed in one patient with the longest follow up, almost 4 years).
CONCLUSIONS
Serology demonstrated reliable for retrospective diagnosis in non-immune travellers. The decline in the anti-malarial titre might be included in the screening algorithms of blood donors, but further studies are needed.
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10.1186/s12936-020-03300-x
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pubmed_920_3243
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BACKGROUND
Diabetes mellitus (DM) is the leading cause of end-stage renal disease and 50% of dialysis patients are insulin-treated.
AIM
to search for unexplained hypoglycemia (HYPO).
METHODS
identify a possible cause of HYPO due to altered insulin absorption.
RESULTS
insulin injected into subcutaneous lipo-hypertrophy (LH) nodules leads to unpredictable HYPOS.
CONCLUSION
looking for LH systematically and training patients to the best injection technique are new challenges for nephrologists to reduce HYPO and emergency hospitalization rates, thus sparing healthcare resources and improving the quality of life of insulin-treated dialysis patients.
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10.1016/j.dsx.2021.05.018
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pubmed_132_23593
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The objective of the present work was to evaluate the effect of hydraulic retention time (HRT) on hydrolysis and acidogenesis for the pretreatment processes: acid phase digestion (APD) and autothermal thermophilic aerobic digestion (ATAD) using blended municipal sludge. The effect of the different pretreatment steps on mesophilic anaerobic digestion (MAD) was evaluated in terms of methane yield, keeping the operating conditions of the MAD the same for all systems. Best operating conditions for both APD and ATAD were observed for 2.5 d HRT with high total volatile fatty acids (tVFA), and the highest methane yield observed for MAD. No significant difference was observed between the two processes in terms of overall volatile solids (VS) reduction with same total HRT. The autothermal process produced heat of 14,300 J/g VS removed from hydrolytic and acetogenic reactions without compromising overall methane yields when the HRT was 2.5 d or lower and the total O2 used was 0.10 m3 O2/g VS added or lower. However, the process needs the input of oxygen and engineering analysis should balance these differences when considering the relative merits of the two pretreatment processes. This is the first study of its kind directly comparing these two viable pretreatment processes with the same sludge.
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10.2166/wst.2011.729
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pubmed_456_8561
|
The purpose of this study was to compare the: 1) RVUs; 2) lengths-of-surgery; 3) RVU per minute between revision hip (THA) and knee (TKA) arthroplasties; and 4) perform an annualized surgeon cost analysis. Using the ACS-NSQIP from 2008 to 2015, 8081 revision TKAs, 7233 THAs were compared. Revision THA had greater mean RVUs (30.27 vs. 27.10 RVUs, p < 0.001), operative times (152 vs. 149 min, p < 0.001), and RVU/minute (0.3 vs. 0.2 RVUs per minute, p < 0.001). Cost analysis yielded and annual $89,922.73 difference. Revision THA, therefore, is reimbursed at a significantly higher "hourly rate," when compared to revision TKA.
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10.1016/j.jor.2018.12.010
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pubmed_518_10468
|
The current therapy of insulin-dependent (Type 1) diabetes mellitus is based on the lifelong application of exogenous insulin. Since the destruction of insulin-producing pancreatic islets is considered to be responsible for disease development, the transplantation of healthy islets could turn out to be the curative therapy of the disease. Unfortunately, numerous problems seem to be associated with the transplantation of islets of human origin. Therefore, xenotransplantation (the transplantation of organs/tissues of animal origin) could turn out to be an effective alternative treatment protocol. Some human trials have already been performed. In this brief review the author attempts to make a synopsis of the present perspectives and problems of islet xenotransplantation.
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pubmed_518_10468
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pubmed_215_15415
|
Passage of E. coli RNA polymerase through an intrinsic transcription terminator, which encodes an RNA hairpin followed by a stretch of uridine residues, results in quick dissociation of the elongation complex. We show that folding of the hairpin disrupts the three upstream base pairs of the 8 bp RNA:DNA hybrid, a major stability determinant in the complex. Shortening the weak rU:dA hybrid from 8 nt to 5 nt causes dissociation of the complex. During termination, the hairpin does not directly compete for base pairing with the 8 bp hybrid. Thus, melting of the hybrid seems to result from spatial restrictions in RNA polymerase that couple the hairpin formation with the disruption of the hybrid immediately downstream from the stem. Our results suggest that a similar mechanism disrupts elongation complexes of yeast RNA polymerase II in vitro.
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10.1016/s1097-2765(02)00738-4
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pubmed_948_20092
|
A 68-year old woman suffering from Sjögren's syndrome for the last 30 years took sulphasalazine (SSP) for severe signs and symptoms at the joints. Soon after the start of this medication she developed progressive cough and shortness of breath. After two years she was referred for evaluation of a hemoptysis and a reddish skin lesion. The chest radiograph showed wide spread interstitial infiltrates in the lower lobes and some fibrotic changes. FVC was slightly reduced, DLCO markedly reduced. There was a high percentage of eosinophils in the bronchoalveolar lavage (55.2%). Transbronchial lung biopsy and skin biopsy demonstrated epitheloid granulomata. SSP was discontinued. After a short period of prednisone treatment the patient's condition improved considerably. After two months of followup neither pulmonary infiltrates nor any skin lesions were found. History and the clinical course after discontinuation of SSP indicate the relation of these infiltrates to SSP treatment. The previously published case reports of SSP-related lung disorders are reviewed. Three of these case reports included bronchoalveolar lavage. Our data suggest that patients with SSP related pulmonary infiltrates may have a marked increase of eosinophils in the bronchoalveolar lavage fluid.
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pubmed_948_20092
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pubmed_890_12216
|
OBJECTIVE
The aim of this study is to evaluate the demographic characteristics of critically ill patients and to determine intensive care unit (ICU) mortality and its predictors.
METHODS
This study was undertaken in the Istanbul Medeniyet University Göztepe Training and Research Hospital Medical ICU. Between May 2012 and January 2013, 111 patients (53 female, 58 male; mean age, 73.79±14.73, mean length of ICU length stay, 9.1±10.7; prevalence of geriatric patients, 77.5%) were admitted to the ICU. The common indications for ICU admission, prevalence of mechanical ventilation support, hematological and biochemical parameters and their effects on mortality were assessed.
RESULTS
The common indications for ICU admission were hemodynamic instability (48.6%), respiratory failure (27.9%) and sepsis (15.3%). Hypertension (46.8%) was the most common comorbidity. Prevalance rates of heart failure and diabetes mellitus were 32.4% and 25.2% respectively. Mortality rate was 52.3% in all patients. Approximately 80% of all deaths was observed within the first fifteen-day. In additon, mortality rate (85.7%) was prominent within patients in need of the mechanical ventilation support. Mechanical ventilation requirement, increased ferritin and vitamin B12 levels were independent risk factors for mortality in critically ill patients (p<0.01, for all).
CONCLUSION
Mortality rate was higher in medical ICU. Herein, increased prevalence of geriatric population, concomitant comorbidities and mechanical ventilation requirements may play role.
|
10.14744/nci.2015.79188
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pubmed_714_19000
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It has been reported that polycystic ovary syndrome (PCOS) is very frequently associated with obesity, insulin resistance and hyperinsulinemia. However, metabolic disorders may lead to suppression of reproductive hormone secretion during undernutrition and in obesity. Some neuropeptides, such as neuropeptide Y (NPY) and galanin, modulate the control of appetite and play an important role in the mechanism of luteinizing hormone-releasing hormone (LHRH) secretion. NPY and galanin regulate appetite via both central and peripheral mechanisms. The interaction between central and peripheral signals for the control of food intake is due to leptin. Leptin can modulate the activity of NPY and other peptides in the hypothalamus that are known to affect eating behavior. In order to evaluate the relationship between NPY, galanin and leptin, 28 women with PCOS, 32 obese women (non-PCOS) and 19 lean healthy women (control group) were investigated. Obese women with PCOS were divided into two groups: PCOS (A) overweight (body mass index, BMI 26-30 kg/m2), and PCOS (B) obese (BMI 31-40 kg/m2). Plasma NPY, galanin and leptin concentrations were measured by radioimmunoassay. Plasma leptin levels in obese women with PCOS (groups A and B) were significantly higher than those in the control group (p < 0.05, p < 0.05, respectively). A significant positive correlation between plasma leptin and BMI in women with PCOS was found (r = 0.427, p < 0.01). A positive correlation was demonstrated between leptin and testosterone in PCOS (r = 0.461, p < 0.01). Plasma galanin concentrations in PCOS were higher than in the control group but the differences were not significant. Plasma NPY levels were significantly elevated in both non-obese (normal) and obese women with PCOS (group A) (p < 0.01, p < 0.005, respectively). However, in obese non-PCOS women plasma NPY levels gradually increased with increase in BMI. No significant correlations were found between galanin, NPY and percentage change in response of LH to LHRH, as well as between NPY and insulin, and galanin and testosterone. Plasma insulin concentrations in women with PCOS (group B) were significantly higher than in the control group (p < 0.001). Increased plasma NPY levels are found in both obese and non-obese women with PCOS. The increase in NPY is independent of the increase in BMI. In obese women with PCOS, plasma leptin is increased compared with control lean women. Serum insulin concentration is increased in obese women with PCOS. A positive correlation exists between leptin and BMI as well as between leptin and testosterone in women with PCOS. These results may suggest that the feedback system in the interaction between leptin and NPY is disturbed in PCOS.
|
10.3109/09513599909167578
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pubmed_937_13550
|
Reduced retinyl ester synthesis has been associated with several forms of cancer; we therefore proposed studying melanoma development from the perspective of this biochemical pathway. Cultures of human melanoma cells with fibroblastoid morphology showed negligible retinyl ester synthesis; in sharp contrast, those with epithelioid morphology were capable of retinol esterification. Further, isolated proliferating epidermal melanocytes (HFSC/2) esterified retinol, whereas proliferating normal skin fibroblasts (F:CCD-1121.Sk) did not. A primary site cutaneous melanoma and its metastatic match (both of epithelioid morphology) were capable of retinol esterification, while a matched fibroblastoid tumor pair did not synthesize retinyl esters; nevertheless, LRAT (lecithin:retinol acyltransferase) protein was found in microsomal fractions from all four tumors. A mutation screen in the LRAT coding region and adjacent intronic sequences revealed several novel mutations in these melanomas as well as in HFSC/2 and F:CCD-1121.Sk cells: a single nucleotide polymorphism in exon 1(37A-->G), a silent mutation in exon 2a (188 A-->G/186 G-->A), and an insertion in the 5'UTR (9-10insC). CRBP-1 basal expression was present in the HFSC/2, and in both sets of matched tumor pairs; however, steady-state levels in the fibroblastoid melanoma pair were one-third that found in the epithelioid matched tumor pair. Co-culture of human primary site epithelioid melanoma with proliferating normal human skin fibroblasts abrogated retinol esterification within 96 h and increased the expression of the active form of TGFbeta-1 by 2.4-fold. A concomitant 3.2-fold downregulation of CRBP-1 expression took place. This is the first study to (1) demonstrate an association between retinyl ester synthesis and cutaneous melanoma morphological phenotypes; (2) suggest the existence of a soluble, diffusible inhibitor of the retinol esterification pathway; (3) report the ability of the isolated, proliferating human epidermal melanocyte to esterify retinol; and (4) provide evidence of DNA variants in the coding region of LRAT.
|
10.1093/carcin/23.11.1821
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pubmed_416_13690
|
BACKGROUND
Optimal treatment of primary negative symptoms is important because their presence is associated with poor outcome.
AIMS
To systematically review all studies dealing with the efficacy of pharmacological agents on primary negative symptoms.
METHOD
A comprehensive search of the relevant literature was undertaken using electronic database, reference lists and personal contact.
RESULTS
There is a lack of standardized research designs. Amisulpride is the most extensively studied drug with respect to efficacy against primary negative symptoms. At low doses it demonstrates a consistent, modest effect compared to placebo, though not to conventional antipsychotics and has yet to be tested against other atypicals. Evidence from multiple studies that used simple statistical analyses and inclusion criteria for patients with primary negative symptoms does not support a direct effect for clozapine. Path-analysis studies support the direct effects of risperidone, olanzapine, sertindole and aripiprazole, however, different statistical analyses of the same risperidone study produced conflicting results and the direct effects of olanzapine were not confirmed in selected patients with primary negative symptoms. There are no studies supporting the use of ziprasidone or quetiapine. The effects of typical antipsychotics on primary negative symptoms are inconclusive and likely to depend on drug dosages. Selective serotonin reuptake inhibitors (SSRIs), mirtazepine and NMDA agonists show early promise but require further study. Novel agents such as selegiline, naltrexone, dehydroepiandrosterone, galantamine, Ginkgo, nitric oxide, L-deprenyl and pergolide show positive effects on general negative symptoms but remain untested against primary negative symptoms.
CONCLUSIONS
Further studies using standardized selective inclusion criteria and controlling for chronicity are needed. Research guidelines are discussed.
|
10.1016/j.schres.2006.07.002
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pubmed_750_21997
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Two missing syntypes of the Japanese subterranean amphipod Procrangonyx japonicus (Uéno, 1930), the type species of Procrangonyx Schellenberg, 1934, were rediscovered in the collections of the Kyoto University Museum. The morphology of uropod 3, which has been considered the principal diagnostic character of the genus, is redescribed on the basis of one of the syntypes, and the nomenclatural history of the generic names Procrangonyx and Eocrangonyx Schellenberg, 1937 (corrected from 1936) for some Far-Eastern subterranean amphipod species is reviewed. Owing to confusion between the terms "type fixation" and "type designation"-the latter being just one means of accomplishing the former-the view that Procrangonyx is unavailable and invalid has prevailed in recent literature. Procrangonyx was indeed proposed after 1930 with no type species "designation", but under Articles 67.2.1 and 68.3 of the International Code of Zoological Nomenclature, Eucrangonyx japonicus Uéno, 1930 was "fixed" as its type species by monotypy in the original publication. Since a diagnosis of the genus was also provided in the same work, Procrangonyx is available under Article 13.3 of the Code. However, because endopodal segmentation of uropod 3 proves to be variable in P. japonicus, doubt is thrown on the taxonomic distinctness of Procrangonyx vis à vis Pseudocrangonyx Akatsuka Komai, 1922. Additionally, the publication dates of Allocrangonyx Schellenberg, 1937 and Niphargus foreli speziae Schellenberg, 1937 are corrected from 1936.
|
10.11646/zootaxa.4532.1.4
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pubmed_1140_15925
|
Chronic constant hypoxia (CCH), such as in pulmonary diseases or high altitude, and chronic intermittent hypoxia (CIH), such as in sleep apnea, can lead to major changes in the heart. Molecular mechanisms underlying these cardiac alterations are not well understood. We hypothesized that changes in gene expression could help to delineate such mechanisms. The current study used a neonatal mouse model in CCH or CIH combined with cDNA microarrays to determine changes in gene expression in the CCH or CIH mouse heart. Both CCH and CIH induced substantial alterations in gene expression. In addition, a robust right ventricular hypertrophy and cardiac enlargement was found in CCH- but not in CIH-treated mouse heart. On one hand, upregulation in RNA and protein levels of eukaryotic translation initiation factor-2alpha and -4E (eIF-2alpha and eIF-4E) was found in CCH, whereas eIF-4E was downregulated in 1- and 2-wk CIH, suggesting that eIF-4E is likely to play an important role in the cardiac hypertrophy observed in CCH-treated mice. On the other hand, the specific downregulation of heart development-related genes (e.g., notch gene homolog-1, MAD homolog-4) and the upregulation of proteolysis genes (e.g., calpain-5) in the CIH heart can explain the lack of hypertrophy in CIH. Interestingly, apoptosis was enhanced in CCH but not CIH, and this was correlated with an upregulation of proapoptotic genes and downregulation of anti-apoptotic genes in CCH. In summary, our results indicate that 1) the pattern of gene response to CCH is different from that of CIH in mouse heart, and 2) the identified expression differences in certain gene groups are helpful in dissecting mechanisms responsible for phenotypes observed.
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10.1152/physiolgenomics.00217.2004
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pubmed_244_13815
|
OBJECTIVE. This series of patients presented to the emergency department (ED) with abdominal pain, without the respiratory symptoms typical of coronavirus disease (COVID-19), and the abdominal radiologist was the first to suggest COVID-19 infection because of findings in the lung bases on CT of the abdomen. CONCLUSION. COVID-19 infection can present primarily with abdominal symptoms, and the abdominal radiologist must suggest the diagnosis when evaluating the lung bases for typical findings.
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10.2214/AJR.20.23232
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pubmed_550_4769
|
OBJECTIVES
We aimed to determine adherence, virological, and immunological outcomes one year after starting a first combination antiretroviral therapy (ART) regimen.
DESIGN
Observational; synthesis of administrative, laboratory, and pharmacy data. Antiretroviral regimens were divided into efavirenz, nevirapine, boosted protease inhibitor (PI), and single PI categories. Propensity scores were used to control for confounding by treatment assignment. Adherence was estimated from pharmacy refill records.
SETTING
Veterans Affairs Healthcare System, all sites.
PARTICIPANTS
HIV-infected individuals starting combination ART with a low likelihood of previous antiretroviral exposure.
INTERVENTIONS
None.
OUTCOMES
The proportion of antiretroviral prescriptions filled as prescribed, a change in log HIV-RNA, the proportion with log HIV-RNA viral suppression, a change in CD4 cell count.
RESULTS
A total of 6394 individuals unlikely to have previous antiretroviral exposure started combination ART between 1996 and 2004, and were eligible for analysis. Adherence overall was low (63% of prescriptions filled as prescribed), and adherence with efavirenz (67%) and nevirapine (65%) regimens was significantly greater than adherence with boosted PI (59%) or single PI (61%) regimens (P < 0.001). Efavirenz regimens were more likely to suppress HIV-RNA at one year (74%) compared with nevirapine (62%), boosted PI (63%), or single PI (53%) regimens (all P < 0.001), and this superiority was maintained when analyses were adjusted for baseline clinical characteristics and propensity for treatment assignment. Efavirenz also yielded more favorable immunological outcomes.
CONCLUSION
HIV-infected individuals initiating their first combination ART using an efavirenz-based regimen had improved virological and immunological outcomes and greater adherence levels.
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10.1097/QAD.0b013e3281532b31
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pubmed_73_3900
|
The aim of the present study is to investigate the correlation between microbial activity, i.e., biological stability measured by aerobic (OD(20) test) and anaerobic tests (ABP test), and odour emissions of organic fraction of municipal solid waste during anaerobic digestion in a full-scale treatment plant considering the three stages of the process (input, digested and post-digested waste). The results obtained indicated that the stabilization of the treated material reduces the odour impact measured by the olfactometric approach. Successive application of gas chromatography mass spectrometry (GC-MS) and electronic nose (EN) allowed the characterization of the different groups of volatile organic compounds (VOCs) responsible of odour impacts determining, also, their concentration. Principal component and partial least squares analyses applied to the EN and GC-MS data sets gave good regression for the OD(20) vs the EN and OD(20) vs the GC-MS data. Therefore, OD(20) reduction could be used as an odour depletion indicator.
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10.1016/j.biortech.2010.04.098
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pubmed_174_11952
|
We developed a program for a pocket computer (Sharp PC-1500) enabling conversion to and optimizing of meal-related insulin injection regimens. The dosage of regular insulin injected at meal times by a penshaped device (Novo Pen) was calculated in dependence of the carbohydrate content of the ingested meal, daytime, difference of actual and target blood glucose, 4 daily glucose levels of the last 2 or 4 days and physical activity. Long-acting insulin was proposed in dependence of morning blood levels of the preceding days. The response to elevated levels was additionally determined by night values. All quantifications were based on equivalent factors reflecting relations between insulin need and blood glucose changes and carbohydrate intake, respectively. This permits a so-called "quantified adaptation", where all these factors are individually defined and steadily actualized by the computer according to the data processed during adaptation. In a controlled cross-over study 12 type 1 diabetics were treated with conventional therapy (CT = 2-3 injections daily) and computer-assisted meal-related insulin therapy (CAMIT = 3-4 injections daily), each for a 6 weeks period. Although the number of meals was reduced from 6-7 to 3-5 and carbohydrate intake was allowed to vary from day to day, parameters of metabolic control were significantly improved by CAMIT compared to CT: mean blood glucose decreased from 9.10 +/- 2.96 to 6.22 +/- 0.65 mmol/l with CAMIT and only from 8.86 +/- 1.83 to 6.91 +/- 0.90 mmol/l with CT (p less than 0.05) and HbA1 from 10.2 +/- 1.5 to 8.6 +/- 0.8% with CAMIT and only from 9.8 +/- 1.3 to 9.1 +/- 1.0% with CT.(ABSTRACT TRUNCATED AT 250 WORDS)
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pubmed_174_11952
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pubmed_97_13551
|
Current evidence indicates that only complete or partial intact spleen can protect the organism against pneumococcal sepsis. What is not clear is the amount of minimal splenic tissue needed to protect the organism against such infection. This study has been carried out on 20 dogs which underwent partial or total splenectomy with stapler. Animals were divided into 8 groups according to the quantity of the remnant splenic tissue: 0% (4 dogs); 5% (4); 15% (1); 25% (1); 35% (2); 50% (2); 75% (2); 100% (4), and were followed up for 6 and 12 months. No mortality or bleeding was registered. Results showed a splenic regeneration, histologically demonstrated as an increased number of germinal follicles, in 12 out of 16 dogs, more evident in the animals sacrificed at one year. In conclusion, even a small amount (5%) of splenic tissue preserved with its blood supply can regenerate and acquire with time enough immunological function to protect the organism against post-splenectomy sepsis.
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pubmed_97_13551
|
pubmed_540_15882
|
Introduction
Chronic Heart Failure (CHF) involves a complex regimen of daily self-care behaviors: pharmacological therapy, symptom monitoring and lifestyle modifications. Patients with CHF may have a reduced health related quality of life (HRQoL) due to various physical and emotional symptoms. HRQoL may be improved through the use of self-care interventions.
Purpose
To assess the level of self-care and quality of life among men with chronic heart failure.
Methods
The study was conducted among 80 men diagnosed with CHF (mean age 58 years). The study was cross-sectional. A self-administered questionnaire and analysis of medical records were used to collect baseline sociodemographic and clinical data. Self-care was assessed using the standardized European Heart Failure Self-care Behavior Scale- EHFScBS-9 and quality of life was assessed using the World Health Organization Quality of Life Bref.
Results
The Patients in NYHA class II constituted the vast majority (71.25%), mean LVEF in the study group was 43.5%, and mean disease duration was 3 years. The most common comorbidities were ischemic heart disease (72.5%), hypertension (70%) and diabetes mellitus (60%). The most commonly reported non-pharmacological treatments for NS were fluid restriction (45%), moderate physical activity (42.50%) and daily weight control (41.25%). The EHFSc-9 questionnaire score averaged 50.31 points out of 100 possible (SD = 26.52). The mean score regarding perception of QoL was 2.78 points (SD = 0.91), and 40% of patients indicating poor perception of QoL. The mean score for self-rated Analysis of the results of the individual domains of the WHOQoL BREF questionnaire showed that patients rated their QoL best in the environmental domain (M = 13.28; SD = 3.11), then in the social domain (M = 12.81; SD = 2.71), and in the psychological domain (M = 12.8; SD = 3.2). In contrast, QoL in the physical domain was rated the lowest (M = 10.44; SD = 2.85). There was no significant correlation between quality of life and self-care (p > 0.05).
Conclusions
Men with CHF have unsatisfactory self-care outcomes and low quality of life scores and are dissatisfied with their health. Strategies to improve selfcare and quality of life in this group are indicated.
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10.3389/fpubh.2022.942305
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pubmed_159_12194
|
INTRODUCTION
This study aimed to examine the views of children and adolescents with significant coordination difficulties, and their parents, regarding factors they considered had most supported and hindered the development of their self-esteem (SE).
METHODS
A survey was sent to members of the Dyspraxia Support Group of New Zealand asking participants to prioritise the three factors that had most positively and negatively influenced the development of the young person's SE. Quantitative content analysis was utilised to summarise responses in order to describe main influences.
RESULTS
Both groups rated love and support from family as an important factor that had promoted SE. Young people placed more emphasis than parents on friendship and rewarding activities. Parents emphasised the importance of a supportive school environment and the benefits of "diagnosis." Both groups frequently rated aspects directly related to coordination difficulties and bullying as negative influences on SE.
CONCLUSION
The results provide information for young people with coordination difficulties, their parents, and occupational therapists regarding useful strategies for developing healthy SE. Occupational therapists have a critical role in the assessment of children and adolescents with coordination difficulties which leads to better understanding of the young person by others. Additionally, task-oriented treatment approaches are indicated and are likely to lead to increased rates of participation of young people in rewarding activities, including with friends. Further research is required to determine whether these occupational therapy interventions promote increases in SE.
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10.1111/1440-1630.12663
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pubmed_477_3727
|
Stuttering is not usually considered genetic, although it has long been known to be familial. Data collected on 2035 relatives of 397 unrelated adult stutterers confirm and quantify the strong familial concentration. Our analytic approach to these family data, one that does not require specification of a genetic hypothesis, shows that stuttering among relatives occurs in a pattern indicating vertical transmission of a susceptibility to stuttering with sex-modified expression. Although simple Mendelian hypotheses are not sufficient to explain the observed pattern of stuttering in families, more complex genetic models can explain the pattern. In the past, such evidence has been considered sufficient, because it does not preclude the possibility of cultural transmission. However, certain cultural transmission hypotheses previously proposed for stuttering are excluded by these data. The findings in this study support a growing opinion among speech pathologists that most stuttering is a genetically inherited neurologic disorder.
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10.1073/pnas.78.1.606
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pubmed_682_18761
|
The mixture of finely ground blast furnace slag (BFS), basic oxygen furnace (BOF) steel slag (SS), and flue gas desulfurisation (FGD) gypsum could be used as cement to solidify heavy metals. In this study, these cementitious materials were combined with high-arsenic-containing tailings to form cemented backfill material (CBM). The results indicated that the optimal design of CBM was that of specimen CBM2 which showed good early strength (10.09 MPa) at a curing age of 3 days containing 60% BF slag, 30% SS, and 10% gypsum. And the arsenic leaching concentration of CBM2 at a curing age of 7 days and 28 days were both less than the limits specified in standards for drinking water quality (Chinese Standard GB 5749-2006). The predominant hydration products of CBM2 contained rod-like ettringite and amorphous C-S-H gel both of which promote arsenic solidification.
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10.1016/j.chemosphere.2019.02.030
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pubmed_889_602
|
A 1-year, 8-month-old Rhodesian Ridgeback was presented with obtundation, ambulatory tetraparesis, and myoclonus. Initial clinical findings included ionized hypercalcemia with an apparent marked increase in parathyroid hormone, thrombocytopenia, and nonregenerative anemia. Low numbers of circulating atypical cells were noted on blood film evaluation. Brain magnetic resonance imaging identified an extra-axial contrast enhancing subtentorial lesion, and cerebrospinal fluid (CSF) analysis documented a marked atypical lymphocytic pleocytosis. Flow cytometry performed on the CSF demonstrated expression of only CD45, CD90, and MHC class II, with Pax5 positivity on subsequent immunohistochemistry. The final diagnosis was of B-cell lymphoblastic lymphoma or acute leukemia, given the distribution of disease and the presence of significant bone marrow infiltration alongside an aggressive clinical course. The unusual immunophenotype of the neoplastic cells and hypercalcemia presented antemortem diagnostic challenges, highlighting the need for a multidisciplinary approach and caution in the interpretation of clinical abnormalities in cases with multiple comorbidities.
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10.1111/jvim.15398
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pubmed_164_7478
|
BACKGROUND
White matter hyperintensities (WMH) lesions on T2/FLAIR brain MRI are frequently seen in healthy elderly people. Whether these radiological lesions correspond to irreversible histological changes is still a matter of debate. We report the radiologic-histopathologic concordance between T2/FLAIR WMHs and neuropathologically confirmed demyelination in the periventricular, perivascular and deep white matter (WM) areas.
RESULTS
Inter-rater reliability was substantial-almost perfect between neuropathologists (kappa 0.71 - 0.79) and fair-moderate between radiologists (kappa 0.34 - 0.42). Discriminating low versus high lesion scores, radiologic compared to neuropathologic evaluation had sensitivity / specificity of 0.83 / 0.47 for periventricular and 0.44 / 0.88 for deep white matter lesions. T2/FLAIR WMHs overestimate neuropathologically confirmed demyelination in the periventricular (p < 0.001) areas but underestimates it in the deep WM (0 < 0.05). In a subset of 14 cases with prominent perivascular WMH, no corresponding demyelination was found in 12 cases.
CONCLUSIONS
MRI T2/FLAIR overestimates periventricular and perivascular lesions compared to histopathologically confirmed demyelination. The relatively high concentration of interstitial water in the periventricular / perivascular regions due to increasing blood-brain-barrier permeability and plasma leakage in brain aging may evoke T2/FLAIR WMH despite relatively mild demyelination.
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10.1186/2051-5960-1-14
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pubmed_660_13293
|
The induction of drug-metabolising enzymes is being increasingly recognised for its clinical importance in drug research and development. In the present study, we used a pregnane X receptor (PXR)-mediated reporter gene assay to evaluate the activating effects of various food, herb, and horticultural plant constituents on the PXR and a UGT1A1 reporter gene DNA construct. The results showed that of 102 naturally occurring constituents tested, 50 activated the PXR signaling pathway and induced expression of the UGT1A1-reporter gene DNA construct. Eleven constituents strongly induced gene expression (a response of >70% compared to that associated with rifampicin), and were further evaluated in in vitro experiments to confirm the induction of UGT1A1 mRNA and protein expression. The results suggest that foods and herbs containing these constituents should be consumed with caution to avoid undesirable drug-drug interactions with co-administered drugs that are substrates for UGT1A1.
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pubmed_660_13293
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pubmed_383_17831
|
OBJECTIVES
The present study aimed to investigate the dentists' knowledge of the risks from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and how it will impact their practice.
MATERIALS AND METHODS
An ad hoc self-administered anonymous questionnaire was submitted to Italian dentists.
STATISTICAL ANALYSIS
Differences in rates were calculated using the chi-square test. The level of significance was set at p < 0.05.
RESULTS
A total of 849 dentists fully completed the survey. Eighty-eight per cent of Italian dentists are worried about the health of their families, with no difference in high-risk (red zone) and low-risk (orange zone) regions. About 86% of professionals report some income loss and 94% fear a drop in patients after the quarantine phase, with the dentists working the red zone claiming a greater economic loss and fearing a reduced practice after the end of the lockdown.
DISCUSSION
A large majority of the Italian dentists appears to be aware of the need for changes in their dental practices by planning specific sterilization processes between appointments, testing patients for SARS-CoV-2 serology, asking patients not to be accompanied, and reducing the number of visits per day.
CONCLUSION
The survey expresses the serious concern of the dentists for the pandemic's effects on their profession.
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10.1055/s-0040-1721910
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pubmed_452_20621
|
The conserved kinetochore-associated NDC80 complex (composed of Hec1/Ndc80, Nuf2, Spc24, and Spc25) has well-documented roles in mitosis including 1) connecting mitotic chromosomes to spindle microtubules to establish force-transducing kinetochore-microtubule attachments and 2) regulating the binding strength between kinetochores and microtubules such that correct attachments are stabilized and erroneous attachments are released. Although the NDC80 complex plays a central role in forming and regulating attachments to microtubules, additional factors support these processes as well, including the spindle and kinetochore-associated (Ska) complex. Multiple lines of evidence suggest that Ska complexes strengthen attachments by increasing the ability of NDC80 complexes to bind microtubules, especially to depolymerizing microtubule plus ends, but how this is accomplished remains unclear. Using cell-based and in vitro assays, we demonstrate that the Hec1 tail domain is dispensable for Ska complex recruitment to kinetochores and for generation of kinetochore-microtubule attachments in human cells. We further demonstrate that Hec1 tail phosphorylation regulates kinetochore-microtubule attachment stability independently of the Ska complex. Finally, we map the location of the Ska complex in cells to a region near the coiled-coil domain of the NDC80 complex and demonstrate that this region is required for Ska complex recruitment to the NDC80 complex--microtubule interface.
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10.1091/mbc.E20-05-0286
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pubmed_598_18742
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Niche partitioning through foraging is a mechanism likely involved in facilitating the coexistence of ecologically similar and co-occurring animal species by separating their use of resources. Yet, this mechanism is not well understood in flying insectivorous animals. This is particularly true of bats, where many ecologically similar or cryptic species coexist. The detailed analysis of the foraging niche in sympatric, cryptic sibling species provides an excellent framework to disentangle the role of specific niche factors likely involved in facilitating coexistence. We used DNA metabarcoding to determine the prey species consumed by a population of sympatric sibling Rhinolophus euryale and Rhinolophus mehelyi whose use of habitat in both sympatric and allopatric ranges has been well established through radio tracking. Although some subtle dietary differences exist in prey species composition, the diet of both bats greatly overlapped (Ojk = 0.83) due to the consumption of the same common and widespread moths. Those dietary differences we did detect might be related to divergences in prey availabilities among foraging habitats, which prior radio tracking on the same population showed are differentially used and selected when both species co-occur. This minor dietary segregation in sympatry may be the result of foraging on the same prey-types and could contribute to reduce potential competitive interactions (e.g., for prey, acoustic space). Our results highlight the need to evaluate the spatial niche dimension in mediating the co-occurrence of similar insectivorous bat species, a niche factor likely involved in processes of bat species coexistence.
|
10.1111/mec.14508
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pubmed_806_24473
|
The contributions of intrinsic (passive) and extrinsic (active) properties of the human trunk, in terms of the simultaneous actions about the hip and spinal joints, to the control of sagittal and coronal seated balance were examined. Able-bodied (ABD) and spinal-cord-injured (SCI) volunteers sat on a moving platform which underwent small amplitude perturbations in the anterior-posterior (AP) and medial-lateral (ML) directions while changes to trunk orientation were measured. A linear parametric model that related platform movement to trunk angle was fit to the experimental data by identifying model parameters in the time domain. The results showed that spinal cord injury leads to a systematic reduction in the extrinsic characteristics, while most of the intrinsic characteristics were rarely affected. In both SCI and ABD individuals, passive characteristics alone were not enough to maintain seated balance. Passive stiffness in the ML direction was almost 3 times that in the AP direction, making more extrinsic mechanisms necessary for balance in the latter direction. Proportional and derivative terms of the extrinsic model made the largest contribution to the overall output from the active system, implying that a simple proportional plus derivative (PD) controller structure will suffice for restoring seated balance after spinal cord injury.
|
10.1123/jab.2013-0307
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pubmed_852_22815
|
BACKGROUNDS
A pancreatic fistula (PF) is the most relevant complication after a pancreaticoduodenectomy (PD). This retrospective multicentric study attempts to elucidate the risk factors and complications of a PF in a large cohort of patients undergoing a PD for ductal adenocarcinoma.
METHODS
Using a survey tool, clinical data of 1325 patients undergoing a PD for ductal adenocarcinoma at 37 institutions, between January 2004 and December 2009, were collected. Peri-operative risk factors associated with PF and its association with morbidity and mortality were assessed. Morbidity and PF were graded according to the ISGPF (International Study group for pancreatic fistula) definition and the Dindo-Clavien classification.
RESULTS
Overall PF, mortality, morbidity and relaparotomy rates were 14.3%, 3.8%, 54.4% and 11.7%, respectively. PF occurred more frequently after a pancreaticojejunostomy (PJ) compared with a pancreaticogastrostomy (PG) (16.8% vs. 10.4%; P = 0.0012). Independent risk factors for PF by multivariate analysis were absence of pre-operative diabetes (P = 0.0014), PJ reconstruction (P = 0.0035), soft pancreatic parenchyma (P < 0.0001) and low-volume centre (P = 0.0286). Clinically relevant PF (grade B and C) and severe complications (Dindo-Clavien grade IIIB, IV, V) were significantly more frequent after PJ than PG (71.6% vs. 28.3%; P = 0.030 and 24.8% vs. 19.1%; P = 0.015, respectively). Overall mortality and relaparotomy rates were similar after PG and PJ.
CONCLUSIONS
A soft pancreatic parenchyma, the absence of pre-operative diabetes, PJ and low-volume centre are independent risk factors for PF after PD for ductal adenocarcinoma. A significantly higher incidence and clinical severity of PF are associated with PJ.
|
10.1111/hpb.12063
|
pubmed_642_21510
|
OBJECTIVE
Ultrasound-guided fine-needle aspiration biopsy (US-FNAB) is a safe and effective method of screening malignant thyroid nodules such as papillary thyroid carcinoma. However, not much data are available regarding the diagnostic efficacy of US-FNAB for papillary thyroid microcarcinoma (≤10 mm in diameter). We aim to compare the diagnostic efficacy of US-FNAB on thyroid nodules between two groups divided by a diameter of 10 mm by correlating the cytological results of US-FNAB with the histopathologic diagnoses in selected patients.
PATIENTS AND METHODS
Eight hundred twenty-two thyroid nodules (Group A: diameter ≤10 mm, n=620; Group B: diameter >10 mm, n=202) from 797 patients treated between March 2014 and June 2017 were retrospectively evaluated. Only nodules with Thyroid Imaging Reporting and Data System (TIRADS) categories 4-6 were enrolled and sampled by US-FNAB, followed by surgical resection.
RESULTS
According to The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) diagnostic categories, 94 thyroid nodules were classified as I, III and IV, and were excluded from the analysis. The resultant 728 thyroid nodules from 721 patients were analyzed. The malignant tendency (TBSRTC V and VI) rates on US-FNAB were 88.2% and 84.6% (P=0.202) in Group A and Group B, respectively, and the malignant rates were 89.5% and 86.9% (P=0.330), respectively, on histopathology. There was a high concordance between cytology and histopathology diagnoses (kappa value =0.797), and no statistical difference in terms of US-FNAB accuracy was found between the two groups (P=0.533).
CONCLUSION
For thyroid nodules of TIRADS category 4-6, the diagnostic efficacy of US-FNAB is similar for thyroid nodules either smaller or greater than 10 mm in their maximum diameter.
|
10.2147/CMAR.S189358
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pubmed_236_3751
|
Mouse embryonic stem (ES) cells were transfected with a plasmid composed of an E. coli lacZ gene fused to 1.8 kb of rat neuron-specific enolase (NSE) promoter sequences. While this reporter construct had been shown previously to function exclusively in postmitotic neurons and neuro-endocrine cells of transgenic mice, stably transfected ES cell clones unexpectedly displayed beta-galactosidase (beta-Gal) activity in the undifferentiated state. This transcriptional activity of the heterologous NSE promoter was confirmed by the identification of endogenous NSE mRNA in undifferentiated ES cells, mouse morulae and blastocysts. NSE protein, however, could not be found in undifferentiated ES cells. Interestingly, in ES cells which were cultured for 7 days under differentiation conditions in vitro, beta-Gal activity decreased to basal levels consistent with the parallel down-regulation of endogenous NSE mRNA. In contrast, prolonged culture of ES cells under differentiation conditions led to the reappearance of NSE mRNA and beta-Gal activity after 17 days. Significant increases in beta-Gal activity were also observed in ES cells which were cultured either on dishes coated with attachment factors such as laminin and gelatin or in the presence of nerve growth factor (NGF). These results suggest that i) transcriptional control mechanisms regulating neuronal gene expression are present at early developmental stages in the mouse and ii) ES cells provide a useful in vitro model system for the analysis of developmentally regulated cellular and molecular events coupled to neuron-specific enolase promoter activity.
|
pubmed_236_3751
|
pubmed_174_14413
|
The naturally occurring, nonradioactive, stable isotopes, 2H, 15N, 18O, and in particular, 13C, are valuable tracers in studies of pediatric nutrition and gastroenterology. Techniques using these isotopes have been developed for the measurement of digestion, absorption, utilization, and excretion of nutrients in premature and term infants, as well as in young children. Compounds labeled with 13C enable quantitative measurements of nutrient oxidation rates and percent nutrient malabsorption. Illustrations of these applications are presented in studies of simple and complex carbohydrate metabolism, of medium- and long-chain triglyceride absorption and malabsorption, and of bile salt conservation and loss in the neonate. Modular protocols for the determination of nutrient absorption, oxidation, and loss now can be applied in longitudinal studies which involve comparisons of diet or which monitor recovery following malnutrition or disease. Instrumentation to be available in the future will simplify isotope ratio determinations and create ready access to the methodologies described.
|
10.1097/00005176-198502000-00004
|
pubmed_953_4927
|
BACKGROUND
The possibility of impaired antioxidant status and so increased oxidative damage in periodontal disease is being conjectured. The present randomized controlled study was carried out with the objective of analyzing the activity of superoxide dismutase enzyme and thiol antioxidants in gingival crevicular fluid (GCF) and saliva as indicators of response to periodontal therapy.
MATERIALS AND METHODS
SUBJECTS WERE SCREENED AND RANDOMLY DIVIDED INTO THREE GROUPS: 23 periodontally healthy controls, 24 with gingivitis, and 23 with periodontitis. Based on the clinical attachment levels, the periodontitis group was further divided into subgroups, including mild, moderate, and severe periodontitis. GCF and saliva samples were collected for estimation of superoxide dismutase and thiol antioxidant concentrations at baseline and 15 days after nonsurgical treatment. Intragroup comparisons were statistically analyzed using repeated measures analysis of covariance (P value <0.05).
RESULTS
Superoxide dismutase was present in greater quantities in the GCF compartment (100.32±3.67 U/0.5 mL) than in saliva (39.99±3.52 U/0.5 mL), with elevated levels in mild and moderate subgroups as compared with severe periodontitis. Thiol concentrations were comparable in these media, 14.43±1.57 micromol /L in GCF and 15.09±2.26 micromol/L in saliva. Following treatment, superoxide dismutase and thiol antioxidant concentrations significantly improved in all the patient groups.
CONCLUSION
The reduction of the inflammatory response following therapy resulted in improved antioxidant profiles in both the GCF and salivary compartments.
|
pubmed_953_4927
|
pubmed_1051_11224
|
Dysregulation of the balance between pro-inflammatory and anti-inflammatory macrophages has a key function in the pathogenesis of Duchenne muscular dystrophy (DMD), a fatal genetic disease. We postulate that an evolutionarily ancient protective mechanism against infection, known as trained immunity, drives pathological inflammation in DMD. Here we show that bone marrow-derived macrophages from a murine model of DMD (mdx) exhibit cardinal features of trained immunity, consisting of transcriptional hyperresponsiveness associated with metabolic and epigenetic remodeling. The hyperresponsive phenotype is transmissible by bone marrow transplantation to previously healthy mice and persists for up to 11 weeks post-transplant. Mechanistically, training is induced by muscle extract in vitro. The functional and epigenetic changes in bone marrow-derived macrophages from dystrophic mice are TLR4-dependent. Adoptive transfer experiments further support the TLR4-dependence of trained macrophages homing to damaged muscles from the bone marrow. Collectively, this suggests that a TLR4-regulated, memory-like capacity of innate immunity induced at the level of the bone marrow promotes dysregulated inflammation in DMD.
|
10.1038/s41467-022-28531-1
|
pubmed_732_20657
|
Twenty-six species of anemonefish of the genera Amphiprion and monospecific Premnas, use only 10 species of anemones as hosts in the wild (Families: Actiniidae, Stichodactylidae and Thalassianthidae). Of these 10 anemone species some are used by multiple species of anemonefish while others have only a single anemonefish symbiont. Past studies have explored the different patterns of usage between anemonefish species and anemone species; however the evolution of this relationship remains unknown and has been little studied over the past decade. Here we reopen the case, comparing the toxicity of crude venoms obtained from anemones that host anemonefish as a way to investigate why some anemone species are used as a host more than others. Specifically, for each anemone species we investigated acute toxicity using Artemia francisca (LC50), haemolytic toxicity using ovine erythrocytes (EC50) and neurotoxicity using shore crabs (Ozius truncatus). We found that haemolytic and neurotoxic activity varied among host anemone species. Generally anemone species that displayed greater haemolytic activity also displayed high neurotoxic activity and tend to be more toxic on average as indicated by acute lethality analysis. An overall venom toxicity ranking for each anemone species was compared with the number of anemonefish species that are known to associate with each anemone species in the wild. Interestingly, anemones with intermediate toxicity had the highest number of anemonefish associates, whereas anemones with either very low or very high toxicity had the fewest anemonefish associates. These data demonstrate that variation in toxicity among host anemone species may be important in the establishment and maintenance of anemonefish anemone symbiosis.
|
10.1371/journal.pone.0098449
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pubmed_674_6288
|
This study aimed to investigate the mechanism underlying the neuroprotective effect of hemin in oxygen-glucose deprivation (OGD)-treated neurons. OGD-treated SH-SY5Y cells (human neuroblastoma cells) were used in the study. The cellular viability of SH-SY5Y cells was assessed by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and the cell apoptosis rate was determined by flow cytometry analysis with Annexin V-fluorescein isothiocyanate and propidium iodide staining with or without hemin pretreatment. Cell viability and apoptotic activation were detected after hemin administration combined with neuroglobin (Nqb), thioredoxin-1, peroxiredoxin-2, or heme oxygenase-1 siRNA transient transfection. The release of cytochrome c from mitochondria and the interaction between Ngb and cytochrome c were examined with hemin pretreatment. Hemin had a neuroprotective effect in OGD-treated SH-SY5Y cells, which was mainly mediated by the upregulation of Ngb. Moreover, the release of cytochrome c from mitochondria was inhibited by hemin-induced Ngb expression through facilitating the interaction of Ngb with cytochrome c in mitochondria. The present findings provided new insights into the neuroprotective mechanisms of hemin. It was concluded that low-dose hemin pretreatment had a neuroprotective effect in OGD-treated SH-SY5Y cells, through inhibiting cell apoptosis. The neuroprotective effects of hemin following hypoxic-ischemic neuronal damage were mainly mediated by Ngb. One underlying mechanism was hemin-induced overexpression of mitochondrial Ngb, which inhibited endogenous apoptosis via the association with cytochrome c.
|
10.1007/s11064-017-2230-z
|
pubmed_125_5523
|
Carcinoembryonic antigen-related cell adhesion (CEACAM) molecules belong to a family of membrane glycoproteins that mediate intercellular interactions influencing cellular growth, immune cell activation, apoptosis, and tumor suppression. Several family members (CEACAM1, CEACAM5, and CEACAM6) are highly expressed in cancers, and they share a conserved N-terminal domain that serves as an attractive target for cancer immunotherapy. A multi-epitope vaccine candidate against this conserved domain has been developed using immunoinformatics tools. Specifically, several epitopes predicted to interact with MHC class I and II molecules were linked together with appropriate linkers. The tertiary structure of the vaccine is generated by homology and ab initio modeling. Molecular docking of epitopes to MHC structures have revealed that the lowest energy conformations are the epitopes bound to the antigen-binding groove of the MHC molecules. Subsequent molecular dynamics simulation has confirmed the stability of the binding conformations in solution. The predicted vaccine has relatively high antigenicity and low allergenicity, suggesting that it is an ideal candidate for further refinement and development.Communicated by Ramaswamy H. Sarma.
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10.1080/07391102.2020.1797539
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pubmed_950_15155
|
BACKGROUND
Bone marrow smear and biopsy are the main methods for the diagnosis of multiple myeloma (MM), bone marrow infiltration, and metastasis in lymphoma and cancer. However, several factors, including the focal growth of tumor cells, inappropriate puncture sites, and hemodilution of bone marrow aspirates, lower the rate of target cell detection. To solve this problem, we developed a novel method-bone marrow particle enrichment analysis-and here, we describe this procedure and its use in the diagnosis of a rare case of MM.
METHODS
An 88-year-old man with primary gastric gamma delta T-cell lymphoma (γδTCL) was found to have anemia. As the cause of anemia could not be determined, hemodilution was suspected, warranting the re-examination of the bone marrow aspirate. Re-puncture could not be performed because of the patient's age and unwillingness to undergo this procedure. Hence, we used a novel approach to enrich bone marrow particles and isolate marrow cells, and subsequently performed morphological and flow cytometric analysis.
RESULTS
Examinations performed after bone marrow particle enrichment revealed the presence of myeloma cells, and the patient was diagnosed with primary gastric γδTCL accompanied by MM.
CONCLUSIONS
Bone marrow particle enrichment analysis may be applied to overcome the problems caused by hemodilution of bone marrow aspirates and to improve the rate of tumor cell detection. The application of this method for the diagnosis of hematological disorders should be explored further.
|
10.1002/jcla.23372
|
pubmed_214_15057
|
Background
Ureteral ectopy is a congenital anomaly, affecting young dogs, predominantly bitches. The main complication of the disease is urinary incontinence, which leads to low life quality for both animals and their owners. However, only two less invasive surgical management options are reported. Laser ablation is quite popular, while monopolar electrocautery use is very rare.
Case Description
A 3-month and 1-week-old, 1.7 kg female Poodle was admitted to the Vetamicus clinic with severe urinary incontinence and moisture-associated dermatitis. After diagnosing intramural ectopy type during computed tomography scan and video cystoscopy, a search for surgical management options began. We proceeded with the monopolar cauterization technique, where a semirigid Karl Storz monopolar coagulating ball electrode is used to cut a mucous membrane partition between the ureter and urinary bladder. No complications occurred during or after the surgery. Ureter successfully healed and full continence was achieved together with sporadically using phenylpropanolamine syrup.
Conclusion
The present case indicates that monopolar electrocautery use in intramural ectopy type management and possibly other urinary tract pathologies might be strongly beneficial.
|
10.5455/OVJ.2022.v12.i2.4
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pubmed_1092_1470
|
A new diamond-based variable spring-mass model has been proposed in this study. It can realize the deformation simulation for different organs by changing the length of the springs, spring coefficient and initial angle. The virtual spring joined in the model is used to provide constraint and to avoid hyperelastic phenomenon when excessive force appears. It is also used for the calculation of force feedback in the deformation process. With the deformation force feedback algorithm, we calculated the deformation area of each layer through screening effective particles, and contacted the deformation area with the force. This simplified the force feedback algorithm of traditional spring-particle model. The deformation simulation was realized by the PHANTOM haptic interaction devices based on this model. The experimental results showed that the model had the advantage of simple structure and of being easy to implement. The deformation force feedback algorithm reduces the number of the deformation calculation, improves the real-time deformation and has a more realistic deformation effect.
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pubmed_1092_1470
|
pubmed_313_9782
|
Meno's paradox-which asks 'how will you know it is the thing you didn't know?'-appears in Plato's dialogue of the same name. This article suggests that a similar question arises in some supportive relationships. Attention to this question clarifies one condition necessary to justify making a best interests decisions against someone's will: the decided-for person must be unable to recognise that they have failed to recognise a need. From this condition, two duties are derived: a duty to ensure that someone cannot recognise that they have failed to recognise a need before making a decision against their will; and a duty to provide consensual support to those who have had decisions made against their will, in order to help them to avoid such second-order failures of recognition in the future. The article assesses the Mental Capacity Act 2005 against each of these duties. For each duty, it finds that the Act allows compliance, but does not robustly require it.
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10.1093/medlaw/fww026
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pubmed_117_16662
|
OBJECTIVES
Transjugular intrahepatic portosystemic shunt (TIPS) is an effective intervention for portal hypertensive complications. Little is known about the ability of spleen stiffness (SS) for predicting the survival of cirrhotic patients undergoing TIPS. This study is to evaluate the influence of SS detected by point shear wave elastography (pSWE) in predicting survival after TIPS.
METHODS
This retrospective cohort study screened consecutive patients who underwent TIPS and reliable pSWE measurement between October 2014 and September 2017 from our prospectively maintained database. SS values were measured before TIPS. The primary endpoint was the overall survival after TIPS. The Cox regression analysis model was used for univariate and multivariate analyses. A receiver operating characteristic (ROC) curve analysis was performed to calculate the sensitivity, specificity, and positive and negative predictive values.
RESULTS
A total of 89 patients were involved in the final analysis. 24 patients (27.0%) died during a median follow-up time of 31 m. Multivariable Cox regression analysis confirmed that higher SS value (P < 0.001), LS value (P = 0.008), diameter of shunt (P = 0.001), and older age (P < 0.001) were independent prognostic factors of survival after TIPS. The risk of death rose 57.440-fold for each SS unit (m/s) increase. SS was also correlated with liver failure after TIPS. ROC analysis showed that the best SS cutoff value was 3.60 m/s for predicting survival, with a sensitivity of 54.2% and specificity of 90.8%.
CONCLUSIONS
The SS value determined by pSWE in cirrhotic patients was an independent predictive factor for survival after TIPS.
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10.1155/2020/3860390
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pubmed_840_20238
|
Ectopia cordis is a pathology in which the heart is complete or partially outside of the thoracic cavity. It represents a challenge for the diagnosis and handling because of its high perinatal mortality. We present the first case of thoracic ectopia cordis with prenatal diagnostic (27th week), its multidisciplinary handling at Hospital de Ginecopediatria núm. 71 of the Centro Medico Nacional Adolfo Ruiz Cortines, IMSS, in Veracruz, Mexico. We communicate the case of a 24 year-old woman referred by her correspondent medical unit with the diagnosis of 23.6 weeks pregnancy with suspicion of heart malformation by ultrasound. The pregnancy was followed-up until the 38th week, when it was programmed a caesarean section. The newborn had ectopia cordis, which was treated at the moment of birth. In this article, we present pictures of the heart defect as well as its evolution. The up-to-date bibliography is revised about the medical profile and treatment. The handling of the ectopia cordis includes an appropriate prenatal diagnosis through echocardiograph, a multidisciplinary perinatal team, to program the caesarean operation, aseptic handling of the newborn, immediate correction of the wall defect with skin torn piece without trying to correct the costal grill, specific hemodynamic cares, to reprogramme a correction of associated defects.
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pubmed_840_20238
|
pubmed_900_4400
|
Novel heterocyclic thyromimetics are presented carrying carboxy-substituted benzofurans or sulfur containing heterocycles, as replacements for the amino acid side chain of T3. Potent agonists were identified in both series. SAR trends are examined and found to be mostly consistent with previously published thyromimetics. The lack of isoform selectivity demonstrated with isoform-selective transient THR transfection assays has been confirmed by corresponding in vivo studies.
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10.1016/j.bmcl.2007.04.085
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pubmed_738_11970
|
Cotton bollworm (Helicoverpa armigera) is the major insect herbivore of cotton plants. As its larvae feed and grow on cotton, H. armigera can likely tolerate gossypol, the main defense metabolite produced by cotton plants, through detoxification and sequestration mechanisms. Recent reports have shown that various P450 monooxygenases and UDP-glycosyltransferases in H. armigera are involved in gossypol detoxification, while the roles of ABC transporters, another gene family widely associated with metabolite detoxification, remain to be elucidated. Here, we show that ingestion of gossypol-infused artificial diet and cotton leaves significantly induced the expression of HaABCB6 in H. armigera larvae. Knockdown and knockout of HaABCB6 increased sensitivity of H. armigera larvae to gossypol. Moreover, HaABCB6-GFP fusion protein was localized on lysosomes in Hi5 cells and its overexpression significantly enhanced gossypol tolerance in vitro. These experimental results strongly support that HaABCB6 plays an important role in gossypol detoxification by H. armigera.
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10.1016/j.ibmb.2020.103387
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pubmed_774_25808
|
This paper investigates feedback pinning control of synchronization behaviors aroused by epidemic spread on complex networks. Based on the quenched mean field theory, epidemic control synchronization models with the inhibition of contact behavior are constructed, combined with the epidemic transmission system and the adaptive dynamical network carrying active controllers. By the properties of convex functions and the Gerschgorin theorem, the epidemic threshold of the model is obtained, and the global stability of disease-free equilibrium is analyzed. For individual's infected situation, when an epidemic disease spreads, two types of feedback control strategies depending on the diseases' information are designed: the first one only adds controllers to infected individuals, and the other adds controllers to both infected and susceptible ones. By using the Lyapunov stability theory, under designed controllers, some criteria that guarantee the epidemic controlled synchronization system achieving behavior synchronization are also derived. Several numerical simulations are performed to show the effectiveness of our theoretical results. As far as we know, this is the first work to address the controlled behavioral synchronization induced by epidemic spread under the pinning feedback mechanism. It is hopeful that we may have deeper insights into the essence between the disease's spread and collective behavior under active control in complex dynamical networks.
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10.1063/1.5047653
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pubmed_643_21322
|
Renal cell carcinoma (RCC) is the most common malignant disease of the kidneys in adults. Patients with metastatic RCC have an unusually poor prognosis and exhibit resistance to all current therapies. Therefore, it is necessary to explore novel molecules involved in the progression of RCC and to identify effective therapeutic targets. Hepatocyte nuclear factor‑4α (HNF‑4α) serves an important role in hepatocyte differentiation and is involved in the progression of liver cancer; however, the functional role of HNF‑4α has not been well established in RCC. The present study reported that HNF‑4α expression was markedly downregulated in RCC tissue samples compared with in normal controls by immunohistochemistry and RNA‑sequencing analysis. Statistical analysis demonstrated that HNF‑4α downregulation was significantly associated with tumor stage, recurrence, metastasis and poor prognosis in patients with RCC. Furthermore, wound‑healing and Transwell assays revealed that downregulation of HNF‑4α promoted cell migration and invasion by transcriptionally regulating E‑cadherin in RCC. Finally, a positive correlation was revealed between HNF‑4α expression and E‑cadherin expression, and patients with low E‑cadherin expression also had a poor prognosis. These findings may provide novel insights into the biological effects of HNF‑4α and lay the foundation for the discovery of molecular therapeutic targets in RCC.
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10.3892/or.2019.7214
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pubmed_714_20311
|
BACKGROUND
Standards for good practice in clinical risk management issued by the Clinical Negligence Scheme for Trusts indicate that "appropriate information is provided to patients on the risks and benefits of proposed treatment, and of the alternatives available before a signature on a consent form is sought".
AIMS
To investigate the practicability and patient acceptability of a postal information and consent booklet for patients undergoing outpatient gastroscopy.
METHODS
Information about gastroscopy procedure, personalised appointment details, and a carbonised consent form were compiled into a single booklet. This was mailed to patients well in advance of their endoscopic procedure. Patient satisfaction for this new process was assessed by questionnaire.
RESULTS
275 patients received a patient information booklet. Of these, 150 (54.5%) returned the consent form by post when they confirmed their attendance; 141 (94%) had signed the form, and the other nine requested further information. Of the remaining 125 booklets sent out, 115 (92%) forms were brought back on the day of the investigation having been previously signed. The remaining 10 (8%) required further information before signing the form. An audit of 168 patients was used to test reaction to the booklet and the idea of filling in the form before coming to hospital; 155 patients (92. 2%) reported the information given in the booklet to be "very useful", and all reported it to be "clear and understandable".
CONCLUSION
A specifically designed patient information booklet with integral consent form is accepted by patients, and improves the level of understanding prior to the investigation being carried out.
|
10.1136/gut.46.1.37
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pubmed_99_13720
|
The ability to assess prognosis in patients with serious ventricular arrhythmias treated with antiarrhythmic drugs by the degree of complexity on the 24-hour ambulatory electrocardiogram was evaluated in 59 survivors of ventricular tachycardia (VT) and ventricular fibrillation. After conventional therapy had failed, patients were treated with investigational drugs until symptomatic VT was abolished. A Holter monitor recording, obtained once the therapeutic regimen was established, was graded for the presence or absence of asymptomatic VT. Fifty-two patients were asymptomatic at discharge and were followed for 700 days. Of 44 patients followed for 1 year, none had recurrent syncope or died if asymptomatic VT was absent at 1 month (p less than 0.002). After 700 days, 27 patients (82%) without asymptomatic VT at 1 month were doing well, compared with 11 patients (58%) with asymptomatic VT at 1 month (p less than 0.002). In patients at risk for sudden cardiac arrest, early abolition of asymptomatic VT on ambulatory monitoring can be used to predict a good long-term clinical response.
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10.1016/0002-9149(84)90309-6
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pubmed_17_6851
|
PURPOSE
The purpose of this study was to determine patient function and satisfaction prospectively after bilateral simultaneous open carpal tunnel release (CTR).
METHODS
Twenty patients (40 CTR) completed a questionnaire regarding postoperative activities of daily living (ADL), return to work, procedure satisfaction (visual analog scale), and willingness to have the surgery again.
RESULTS
The average patient age was 43 years (range, 23-73 y). The hardest task was opening a jar; the easiest task was using the bathroom. Other tasks on the list in descending order of difficulty included driving, household chores, carrying groceries, buttoning, bathing, cooking, writing, dressing, shopping, holding a book, eating, computer use, and holding a phone. Average return to work was 2.6 weeks (range, 3 d-6 wk). Average satisfaction with the surgery was 9.6 of 10 (range, 8-10); 20 of 20 patients (100%) would have the bilateral simultaneous surgery again.
CONCLUSIONS
These data are useful for patient education and decision making when considering surgery in patients with bilateral carpal tunnel syndrome, and show that bilateral simultaneous open CTR is a feasible and useful procedure.
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10.1016/s0363-5023(03)00257-0
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