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pubmed_776_20108
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Acute respiratory failure is usually managed by means of mechanical ventilation via an endotracheal tube or tracheostomy, when conservative treatment fails. Invasive mechanical ventilation is associated with several complications. The recent development of non-invasive methods of ventilation, has led to an attempt to avoid the complications of invasive mechanical ventilation during episodes of acute respiratory failure, ensuring at the same time a similar degree of efficacy. Both intermittent negative pressure ventilation and positive pressure ventilation by face or nasal mask have recently been used for this purpose. Negative pressure ventilation by means of iron lung, cuirass or poncho-wrap ventilators, has never been used in place of endotracheal intubation, and studies of this kind of ventilation are inconclusive: as a consequence, there is, at the moment, no indication for the generalized use of negative pressure ventilation in acute respiratory failure. Intermittent positive pressure ventilation by facial or nasal masks, has recently been used in the treatment of respiratory failure in place of endotracheal intubation. The results are promising, but remain controversial. It may be attempted in selected patients with obstructive respiratory disorders, but the procedure is very time-consuming for nurses.
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pubmed_776_20108
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pubmed_855_13499
|
Proregions of papain-like cysteine proteases are potent and often highly selective inhibitors of their parental enzymes. The molecular basis of their selectivity is poorly understood. For two closely related members of the cathepsin L-like subfamily we established strong selectivity differences. The propeptide of cathepsin S was observed to inhibit cathepsin L with a K(i) of 0.08 nM, yet cathepsin L propeptide inhibited cathepsin S only poorly. To identify the respective structural correlates we engineered chimeric propeptides and compared their inhibitory specificity with the wild-types. Specificity resided in the N-terminal part, strongly suggesting that the backbone of the prodomain was the underlying structure.
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10.1016/s0014-5793(00)01281-3
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pubmed_922_16328
|
BACKGROUND
Development of high-performance serum biomarkers will likely improve treatment outcomes of patients with gastric cancer (GC). We previously identified the candidate serum markers, anosmin 1 (ANOS1), dihydropyrimidinase-like 3 (DPYSL3), and melanoma-associated antigen D2 (MAGE-D2) and evaluated their clinical significance through a single-center retrospective analysis. Here we conducted a prospective multicenter observational study aimed at validating the diagnostic performance of these potential markers.
METHODS
We analyzed serum levels before and after surgery of the three potential biomarkers in patients with GC and healthy volunteers. Quantification of serum and GC tissue levels was performed using an ELISA.
RESULTS
Area under the curve (AUC) values that discriminated patients with GC from healthy controls were - 0.7058, 0.6188, and 0.5031 for ANOS1, DPYSL3, and MAGED2, respectively. The sensitivity and specificity of the ANOS1 assay were 0.36 and 0.85, respectively. The AUC value of ANOS1 that discriminated patients with stage I GC from healthy controls was 0.7131. Serum ANOS1 levels were significantly elevated in patients with stage I GC compared with those of healthy controls (median 1179 ng/ml and 461 ng/ml, respectively, P < 0.0001) and decreased after resection of primary GC lesions (P < 0.0001). The combination of serum ANOS1 and DPYSL3 levels increased the AUC value that discriminated patients with GC from healthy controls. Serum levels of ANOS1 did not significantly correlate with those of carcinoembryonic antigen, carbohydrate antigen 19-9, or other markers of inflammation.
CONCLUSIONS
Serum levels of ANOS1 may serve as a useful diagnostic tool for managing GC.
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10.1007/s10120-019-00995-z
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pubmed_1135_4285
|
After the development and mass commercialization of antibiotics, pathogenic and environmental bacteria have developed resistance to antibiotics since the last century, so that the infection caused by antibiotic-resistant organisms (AROs) could be considered an emerging infection. As a result, its control should be prioritized as a threat to all nations, regardless of territory and economic situation. Increased surveillance in the United States, Europe and East Asia has illustrated the rapid spread leading to an increasing burden of infections caused by AROs. However, the information available in countries of continued development in Latin America is limited. This review describes recent information on AROs surveillance studies in Latin America as well as common sources of AROs and possible strategies for their control.
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pubmed_1135_4285
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pubmed_372_21155
|
OBJECTIVES
Emergency Medicine Service (EMS) providers play a pivotal role in early identification and initiation of treatment for stroke. The objective of this study is to characterize nationwide EMS practices for suspected stroke and assess for gender-based differences in compliance with American Stroke Association (ASA) guidelines.
MATERIALS AND METHODS
Using the 2019-2020 National Emergency Medical Services Information System (NEMSIS) Datasets, we identified encounters with an EMS designated primary impression of stroke. We characterized patient characteristics and EMS practices and assessed compliance with eight metrics for "guideline-concordant" care. Multivariable logistic regression modeled the association between gender and the primary outcome (guideline-concordant care), adjusted for age, EMS level of service, EMS geographical region, region type (i.e. urban or rural), and year.
RESULTS
Of 693,177 encounters with a primary impression of stroke, overall compliance with each performance metric ranged from 18% (providing supplemental oxygen when the pulse oximetry is less than 94%) to 76% (less than 90sec from incoming call to EMS dispatch). 2,382 (0.39%) encounters were fully guideline-concordant. Women were significantly less likely than men to receive guideline-concordant care (adjusted OR 0.82, 95% CI 0.75-0.89; 0.36% women, 0.43% men with guideline-concordant care).
CONCLUSIONS
A minority of patients received prehospital stroke care that was documented to be compliant with ASA guidelines. Women were less likely to receive fully guideline-compliant care compared to men, after controlling for confounders, although the difference was small and of uncertain climical importance. Further studies are needed to evaluate the underlying reasons for this disparity, its impact on patient outcomes, and to identify potential targeted interventions to improve prehospital stroke care.
|
10.1016/j.jstrokecerebrovasdis.2021.106278
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pubmed_488_4536
|
This paper presents sequential histological, histochemical and biochemical changes in rat caput epididymis after a single 100 mg/kg oral dose of alpha chlorohydrin. Desquamation of caput epithelium occurs as early as two days after drug treatment. The caput epididymis is blocked because of accumulation of testicular fluid containing exfoliated immature testicular cells and caput epithelium. There was no effect of drug on motility and morphology of spermatozoa examined from different segments of epididymis and vas deferens. Marked decrease in acid and alkaline phosphatases, nucleic acids and proteins have been registered after drug treatment. On the contrary increase in SDH, cholesterol and glycogen was observed after drug treatment. Decrease in phospholipids in initial stages has also been observed.
|
10.1016/s0014-4908(76)80029-4
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pubmed_443_23273
|
The aim of the study was to evaluate the soluble form of intercellular adhesion molecule 1 (sICAM-1), a ligand of LFA-1, in the serum of patients with spondylarthropathies (SpA) and to look for a correlation with several inflammatory parameters. sICAM-1 levels were measured by ELISA in 25 SpA patients, 20 healthy controls and 20 patients with rheumatoid arthritis (RA). Results showed that sICAM-1 levels were increased (but not significantly) in SpA patients compared with controls; high levels (> 400 ng/ml) where found in 28% of SpA patients but in none of the RA or control groups. In SpA, correlations were found between sICAM-1 and erythrocyte sedimentation rate, C-reactive protein and interleukin 6, but not with tumour necrosis factor alapha or IgA. These correlations were absent in RA. In conclusion, these results suggest that sICAM-1 levels in SpA may reflect the acute phase of inflammation.
|
10.1007/BF01451047
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pubmed_1134_11293
|
Vibrio vulnificus produces siderophores, lowmolecular- weight iron-chelating compounds, to obtain iron under conditions of iron deprivation. To identify genes associated with the biosynthesis of siderophore in V. vulnificus MO6-24/ O, we screened clones with mini-Tn5 random insertions for those showing decreased production of siderophore. Among 6,000 clones screened, nine such clones were selected. These clones contain the transposon inserted in VV2_0830 (GenBank accession number) that is a homolog of a nonribosomal peptide synthetase (NRPS). There is an another NRPS module, VV2_0831, 49-bp upstream to VV2_0830. We named these two genes vvs (Vibrio vulnificus siderophore synthetase) A and B, respectively. Mutation of either vvsA or vvsB showed a decreased production of siderophore. The expression of an NRPS-lux fusion was negatively modulated by the presence of iron, and the regulation was dependent on Fur (ferric uptake regulator). However, the expression of the NRPS genes was still not fully derepressed in the iron-rich condition, even in fur-null mutant cells, suggesting that some other unknown factors are involved in the regulation of the genes. We also demonstrated that the NRPS genes are important for virulence of the pathogen in a mice model.
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pubmed_1134_11293
|
pubmed_1040_15576
|
Serotonin immunoreactive material was localized to rat enterochromaffin cells (EC cells) at the subcellular level using antibodies to serotonin (5-HT) raised in rabbits. Ultrathin sections from paraformaldehyde fixed plastic embedded tissues were directly labelled with the 5-HT antiserum, using the protein A-gold technique to visualize the immunoreaction. The 5-HT immunoreactivity (5-HT-IR) in the rat gastrointestinal mucosa was exclusively localized to epithelial EC cells with a low background over other epithelial non-enterochromaffin cells. Quantitative evaluation of the immunoreaction revealed that most of the 5-HT-IR in the cytoplasm of EC cells (60%) was located over the dense cores of the secretory granules. However, a significant part of the cytoplasmic 5-HT-IR (40%) was located outside the dense cores of the secretory granules which suggests that different forms of 5-HT storage may exist.
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10.1007/BF00494064
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pubmed_41_7438
|
The aim of this qualitative study was to gain a deeper understanding of patient perceptions of wearing implant-retained overdentures with ball-shaped or cylindrical attachment systems. Twenty-two wearers of implant-supported overdentures participated in this qualitative study based on a randomized crossover clinical trial that aimed to compare a cylindrical attachment and a ball attachment. In phase I of the study, group A experienced ball attachments (n = 11) and group B Locator attachments (n = 11) for 1 year. Afterward, in phase II, the attachments were changed; group A received Locator attachments and group B received ball attachments. One week after the attachment's replacement, semistructured individual interviews were conducted. All interviews were audiotaped and transcribed. The analysis was guided by thematic content analysis. Most of the patients from both groups preferred the attachment they received in phase II, regardless the type. A major theme raised by the participants to justify their preference between the attachment types was prosthesis retention/stability, sometimes considered as a positive and other times as a negative factor. Other themes were also explored: oral function, pain, hygiene, previous experiences, confidence on the dentist's work, and esthetic. Aspects related to the retention/stability of the overdentures are the main concerns associated with the perceptions of most patients treated with implant overdentures regardless of the type of attachment. Adequate retention level should be identified and adjusted on an individual basis and maintained overtime as possible. Therefore, follow-up appointments should be planned for readjustment of the attachment's retention. Overretention should be avoided.
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10.1563/aaid-joi-D-17-00166
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pubmed_1057_3905
|
Optimal QuEChERS (quick, easy, cheap, effective, rugged and safe) conditions with good accuracy, repeatability and precision were established to rapidly extract the European Union (EU) priority polycyclic aromatic hydrocarbons (PAHs) from various food matrices (Category: Poultry and Meat, Fish and seafood, Grains, Soy beans and products, Root vegetables and Coffee). The QuEChERS conditions combined with the established high performance liquid chromatography-fluorescence detection conditions were used to rapidly determine the PAHs in 19 popular cooked foods in Taiwan and their corresponding original materials. These conditions also meet the EU and Taiwan Food and Drug Administration specifications. Charcoal grilled, gas stove grilled and smoked foods had higher PAHs contents, while fried and electric oven-baked/baked foods had lower PAHs contents. In addition to the effects of cooking methods, the contamination of original materials by PAHs in the environment should also have an important impact on the contents of PAHs in these cooked foods.
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10.1016/j.foodchem.2020.127471
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pubmed_876_7685
|
In the field of reference materials, long-term stability is of highest importance. Particularly for biological matrices, any kind of deterioration must be avoided during shelf-life. In the production precautions are taken to prevent these, but possible alterations caused by intensive drying have been underestimated until today. This presentation discusses several mechanisms of deterioration related to water activity and water content. Comparison of the results for water and moisture for six reference materials and their water sorption isotherms serve as a base to discuss the importance of accurate dry mass corrections for certified values. It is shown that the method chosen for dry mass correction influences certified contents significantly and a method description must be given. Furthermore, it is confirmed that for biological matrices optimal ranges of water activity and water content exist, where hygroscopicity is low without significant danger of product deterioration. Additionally, handling is facilitated in the optimised ranges.
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10.1007/s002160000696
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pubmed_157_9073
|
PURPOSE
Simple decompression of the ulnar nerve has outcomes similar to anterior transposition for cubital tunnel syndrome; however, there is no consensus on the proper technique for patients with an unstable ulnar nerve. We hypothesized that 1) simple decompression or anterior ulnar nerve transposition, depending on nerve stability, would be effective for cubital tunnel syndrome and that 2) there would be determining factors of the clinical outcome at two years.
MATERIALS AND METHODS
Forty-one patients with cubital tunnel syndrome underwent simple decompression (n=30) or anterior transposition (n=11) according to an assessment of intra-operative ulnar nerve stability. Clinical outcome was assessed using grip and pinch strength, two-point discrimination, the mean of the disabilities of arm, shoulder, and hand (DASH) survey, and the modified Bishop Scale.
RESULTS
Preoperatively, two patients were rated as mild, another 20 as moderate, and the remaining 19 as severe according to the Dellon Scale. At 2 years after operation, mean grip/pinch strength increased significantly from 19.4/3.2 kg to 31.1/4.1 kg, respectively. Two-point discrimination improved from 6.0 mm to 3.2 mm. The DASH score improved from 31.0 to 14.5. All but one patient scored good or excellent according to the modified Bishop Scale. Correlations were found between the DASH score at two years and age, pre-operative grip strength, and two-point discrimination.
CONCLUSION
An ulnar nerve stability-based approach to surgery selection for cubital tunnel syndrome was effective based on 2-year follow-up data. Older age, worse preoperative grip strength, and worse two-point discrimination were associated with worse outcomes at 2 years.
|
10.3349/ymj.2016.57.2.455
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pubmed_345_2517
|
OBJECTIVE
To determine the proportion of euthyroid women attending a fertility practice who develop hypothyroidism in very early pregnancy (gestational hypothyroidism [GHT]), and to examine the association of GHT with exogenous gonadotropin treatment.
DESIGN
Retrospective cohort study.
SETTING
A private reproductive medicine practice.
PATIENT(S)
All healthy women (N = 94) with infertility or recurrent pregnancy loss, TSH level <2.5 mIU/L, negative thyroid peroxidase antibodies at initial evaluation, and not taking thyroid medication, who conceived during an 18-month period.
INTERVENTION(S)
Usual fertility care; 30 women who had received exogenous gonadotropins.
MAIN OUTCOME MEASURE(S)
Serum TSH level at the time of pregnancy detection.
RESULT(S)
Gestational hypothyroidism (TSH ≥ 2.5 mIU/L) developed in 23 of 94 women (24%). The mean increase in serum TSH level from initial evaluation to early pregnancy was 0.45 ± 0.08 [SE] mIU/L. There was a trend toward the association of GHT with use of exogenous gonadotropins. Gestational hypothyroidism was positively associated with initial prepregnancy TSH level.
CONCLUSION(S)
Euthyroid women may develop mild hypothyroidism in early pregnancy, especially after exogenous gonadotropin treatment. Appropriate vigilance will allow for timely levothyroxine treatment.
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pubmed_345_2517
|
pubmed_999_23809
|
Therapeutic gene silencing by RNA interference relies on the safe and efficient in vivo delivery of small interfering RNAs (siRNAs). Polyethylenimines are among the most studied cationic polymers for gene delivery. For several reasons including superior tolerability, small linear PEIs would be preferable over branched PEIs, but they show poor siRNA complexation. Their chemical modification for siRNA formulation has not been extensively explored so far. We generated a set of small linear PEIs bearing tyrosine modifications (LPxY), leading to substantially enhanced siRNA delivery and knockdown efficacy in vitro in various cell lines, including hard-to-transfect cells. The tyrosine-modified linear 10 kDa PEI (LP10Y) is particularly powerful, associated with favorable physicochemical properties and very high biocompatibility. Systemically administered LP10Y/siRNA complexes reveal antitumor effects in mouse xenograft and patient-derived xenograft (PDX) models, and their direct application into the brain achieves therapeutic inhibition of orthotopic glioma xenografts. LP10Y is particularly interesting for therapeutic siRNA delivery.
|
10.1016/j.nano.2021.102403
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pubmed_534_13060
|
Most of the procedures for antimony determination require time-consuming sample preparation (e.g. liquid-liquid extraction with organic solvents), which are harmful to the environment. Because of the high antimony toxicity, a rapid, sensitive and greener procedure for its determination becomes necessary. The goal of this work was to develop an analytical procedure exploiting for the first time the cloud point extraction on a lab-in-syringe flow system aiming at the spectrophotometric determination of antimony. The procedure was based on formation of an ion-pair between the antimony-iodide complex and H(+) followed by extraction with Triton X-114. The factorial design showed that the concentrations of ascorbic acid, H2SO4 and Triton X-114, as well as second and third order interactions were significant at the 95% confidence level. A Box-Behnken design was applied to obtain the response surfaces and to identify the critical values. System is robust at the 95% confidence level. A linear response was observed from 5 to 50 µg L(-1), described by the equation A=0.137+0.050C(Sb) (r=0.998). The detection limit (99.7% confidence level), the coefficient of variation (n=5; 15 µg L(-1)) and the sampling rate was estimated at 1.8 µg L(-1), 1.6% and 16 h(-1), respectively. The procedure allows quantification of antimony in the concentrations established by environmental legislation (6 µg L(-1)) and it was successfully applied to the determination of antimony in freshwater samples and antileishmanial drugs, yielding results in agreement with those obtained by HGFAAS at the 95% confidence level.
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pubmed_534_13060
|
pubmed_272_21602
|
We hypothesised that the derived physiological variables V2 and V4 (velocity to achieve a blood lactate concentration of 2 and 4 mmol/l, respectively), HR2 and HR4 (the corresponding heart rate) and V200 (the velocity for a heart rate of 200 beats/min) would improve with training state and age, in French Trotters. A total of 194 French Trotters from one training establishment were followed for 6 years and 1105 standardised field exercise tests performed on a sand training track. The horses were divided into 6 age groups (from 1 to > or = 6 years) and 4 training groups (beginning, endurance training, sprint training, racing). A 2-way analysis of variance was performed to evaluate the effects of age, training and the interaction of age and training on these physiological variables with the level of statistical significance set at 5%. The results showed that there was a significant influence of age on HR4, V2, V4 and V200, with these variables increasing with age. Also, there was a significant influence of training and both age and training on V2, V4 and V200, with these variables increasing with training and age. These results, obtained in a longitudinal study in a reproducible field environment, are consistent with previous laboratory-based experimental studies. We conclude that objective indices of fitness obtained on the training track can be useful in the commercial training environment.
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10.2746/042516402776181141
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pubmed_631_24672
|
We describe the occurrence of cerebral hyperperfusion syndrome (CHS) in a case of long-standing carotid-jugular fistula (CJF) treated by endovascular reconstruction of the carotid artery. A 43-year-old male with a high-flow CJF between the internal carotid artery (ICA) and internal jugular vein underwent endovascular reconstruction of the carotid artery using a stent graft. After treatment, the patient developed CHS. The patient succumbed to a large intracranial bleed in the left external capsule and parietal lobe on the fifth postoperative day. CHS following endovascular reconstruction of carotid artery is rare. We present the first reported case of CHS following endovascular reconstruction of ICA. A review of literature for patients treated by endovascular rerouting of blood flow to the cerebral parenchyma associated with hyperperfusion syndrome has been performed.
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10.1007/s00270-014-0837-x
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pubmed_229_1761
|
BACKGROUND
The radiographic anatomy of the cervical spine in children is complex and can be difficult to interpret. The present study was undertaken to document radiographically the growth and development of the cervical spine in a prospective, longitudinal manner and to establish standard radiographic measurements on the basis of findings in patients who were followed serially from the age of three months until skeletal maturity.
METHODS
The radiographic resources of the Cleveland Study of Normal Growth and Development (Bolton-Brush Collection, Cleveland, Ohio) were reviewed. From this large database, we identified fifty boys and forty-six girls who had a sufficient number of radiographs of the cervical spine for inclusion in our study. With use of a computerized image analyzer, the growth and development of the atlantodens interval, the diameter of the spinal canal, the Torg ratio, the height and width of the second through fifth cervical vertebral bodies, the height of the dens, and the ossification of the first cervical vertebra were assessed on serial radiographs made from the age of three months until skeletal maturity.
RESULTS
Serial measurements of the atlantodens interval, the anteroposterior diameter of the cervical canal, the height and anteroposterior width of the cervical vertebral bodies, and the height of the dens, made in normal, healthy children from the age of three months to fifteen years, are presented in tabular and graphic forms. The median Torg ratio was 1.47 for both males and females primarily, and it reached values of 1.06 for males and 1.10 for females by maturity. The anterior arch of the first cervical vertebra had ossified in 33% of the children by the age of three months and in 81% of the children by the age of one year. Closure of the synchondroses was completed in all children by the age of three years.
CONCLUSIONS
The measurements presented in the current study are important because they are the first, as far as we know, to document the radiographic parameters of the cervical spine in children who were followed longitudinally from before the age of three years through the course of growth and development until skeletal maturity.
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10.2106/00004623-200108000-00011
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pubmed_579_12668
|
STUDY DESIGN
Retrospective analysis of kinetic magnetic resonance images (kMRI).
OBJECTIVE
To analyse the kinematics of cervical spine inpatients without significant spondylosis and to understand the normal movement of the cervical spine as reference for future comparison.
SUMMARY OF BACKGROUND DATA
Although some studies have been conducted to describe the normal mobility of the cervical spine, prior studies did not establish a relationship between the kinematics of cervical spine and disc degeneration. Only a few studies of the kinematics of the non-degenerated cervical spine have been reported; however, they focused on single level and not all the levels of cervical spine.
METHODS
468 symptomatic patients underwent upright cervical kMRI, and cervical disc degeneration was evaluated with a new grading system. This grading system consists of four grades (0-III), and the cervical spines with grade 0 and grade I discs were included in this study. Finally, 61 symptomatic patients were studied 34 male and 27 female with an average age of 41.9 years. kMRI was used to define the normal mobility of the cervical spine by calculating the translation motion, angular variation and percentage angular contribution to the total cervical spine.
RESULTS
The translation motion of the cervical spine at each level was 0.85 ± 1.22 mm at C2/3, 1.05 ± 1.19 mm at C3/4, 0.63 ± 1.19 mm at C4/5, 0.57 ± 0.91 mm at C5/6, 0.16 ± 0.86 mm at C6/7 and -0.11 ± 0.81 at C7/T1. In general, the translation motion decreased from proximal segment to distal segment. The angular variation of the cervical spine at each level was 5.58 ± 3.86° at C2/3, 8.26 ± 4.81° at C3/4, 9.11 ± 4.87° at C4/5, 10.05 ± 5.26° at C5/6, 8.31 ± 4.30° at C6/7 and 4.87 ± 3.28° at C7/T1. The angular variation at C2/3 and C7/T1 was significantly lower compared to other levels (P < 0.05). The contribution of each cervical level to the total angular mobility of cervical spine was the greatest at C5/6 (21.68 ± 10.31%) and least at C7/T1 (11.11 ± 7.60%) (P < 0.05).
CONCLUSION
This study demonstrates the normal cervical segmental mobility for the entire cervical spine using kMRI. These results will be helpful to understand the normal mobility of the cervical spine and for understanding the relationship between kinematics of the cervical spine and disc degeneration for future comparisons.
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10.1007/s00586-015-4101-0
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pubmed_201_24992
|
Elastin, the principle protein component of the elastic fiber, is a critical extracellular matrix (ECM) component of the arterial wall providing structural resilience and biological signaling essential in vascular morphogenesis and maintenance of mechanical homeostasis. Pathogenesis of many cardiovascular diseases have been associated with alterations of elastin. As a long-lived ECM protein that is deposited and organized before adulthood, elastic fibers can suffer from cumulative effects of biochemical exposure encountered during aging and/or disease, which greatly compromise their mechanical function. This review article covers findings from recent studies of the mechanical and structural contribution of elastin to vascular function, and the effects of biochemical degradation. Results from diverse experimental methods including tissue-level mechanical characterization, fiber-level nonlinear optical imaging, piezoelectric force microscopy, and nuclear magnetic resonance are reviewed. The intriguing coupled bio-chemo-electro-mechanical behavior of elastin calls for a multi-scale and multi-physical understanding of ECM mechanics and mechanobiology in vascular remodeling.
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10.1088/1361-6463/aa5c55
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pubmed_1025_16764
|
BACKGROUND
The Comprehensive Geriatric Assessment (CGA) included the physical, psychic and social environment. The purpose was to describe the use of CGA in primary care.
METHODS
A descriptive transversal study was carried out. "Timed-up-and-go"; Barthel index and the Lawton and Brody scales were used. The minimental state examination and the Yesavage scale were used for the mental performance. The Gijon instrument was used for the social and family environmental evaluation.
RESULTS
Average age was 64 years. In 83% the caretaker was a direct relative, and 65% were hospitalized within the last year. The 84% had multiple pathology, 93% poly-pharmacy, 71% overweight or obesity, 68% visual deficit, 35% hearing deficiency, 68% were prone to falls; 86% had some degree of dependency on daily life activities; 38% had a mild deterioration of the cognitive state and 27% moderate; 37% suffers mild depression and 17% a established depression and 35% had a social-family risk. Among physicians 72% knew the CGA concept, 72% preferred not to perform it due to lack of time and 67% point out fo not having the tools for it.
CONCLUSIONS
The studied population showed some grade of bio-psycho-social deterioration and the lack use of CGA.
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pubmed_1025_16764
|
pubmed_798_18540
|
OBJECTIVES
The aim of our study was to identify individual factors that may predict which subset of prostate cancer patients is more likely to experience emotional distress.
DESIGN AND METHODS
Prostate cancer survivors identified through the Icelandic Cancer Registry (N=184), completed questionnaires measuring emotional distress, dispositional emotional expressivity and social constraints.
RESULTS
A significant positive relationship was observed between perceived social constraints and distress (e.g. anxiety, depression, and intrusive thoughts), but only among prostate cancer survivors with higher levels of dispositional emotional expressivity.
CONCLUSIONS
The results of our study suggest that it might be important to assess individual differences as well as social environmental factors in the treatment of distress among prostate cancer survivors.
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10.1348/135910709X426148
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pubmed_623_15276
|
The first total synthesis of (±)-cereoanhydride has been achieved under the inspiration of its biosynthetic hypothesis. The tricyclic skeleton of trypethelone, the proposed biosynthetic precursor of cereoanhydride, was constructed by an interesting ring expansion of cyclobutenone in one step in which the introduced acetyl group is pivotal to avoid the following aerial oxidation. On the basis of X-ray crystallographic analysis, the structure of cereoanhydride is reassigned to a spiroketal structure 2, which should be formed through an isomerization of the originally proposed structure 1.
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10.1021/acs.orglett.6b02424
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pubmed_537_11689
|
The literature on panic disorder and depression illustrates the expense of not identifying and correctly treating behavioral disorders, including increased medical utilization, lost productivity, exacerbated comorbid conditions, and other indirect costs that exceed by at least three-fold the cost of treatment. This article discusses health care reform focused on person-based, rather than employer-based, health insurance: patient incentives to practice responsible utilization review; incentives for primary care physicians to identify and treat behavioral disorders; and facilitation of collaboration between primary care physicians and mental health consultants.
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pubmed_537_11689
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pubmed_146_18535
|
Liver fibrosis is a serious health issue for many liver patients and is currently diagnosed using liver biopsy. The erroneous nature of this technique urges the search for better, noninvasive alternatives. In this regard, proteomics has been described as a useful biomarker discovery tool and has become increasingly applied in the study of liver fibrosis. Experimental and clinical studies have already provided deeper insights in the molecular pathways of liver fibrosis and even confirmed previous findings. Recent advances in proteomic strategies and tools enable multiple fractionation, multiple protein identifications and parallel analyses of multiple samples. Despite its increasing popularity, proteomics still faces certain pitfalls concerning preanalytical variability, protein coverage and statistic reliability. Proteomics is still evolving, but will undoubtedly contribute to a better understanding of the basics of the pathology and certainly offer opportunities in liver fibrosis diagnostics and therapeutics.
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10.1097/MEG.0b013e3282f4de92
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pubmed_93_1657
|
An early-stage version of the simulation package 'ELSES' (extra-large-scale electronic structure calculation) is developed for simulating the electronic structure and dynamics of large systems, particularly nanometer-scale and ten-nanometer-scale systems (see www.elses.jp). Input and output files are written in the extensible markup language (XML) style for general users. Related pre-/post-simulation tools are also available. A practical workflow and an example are described. A test calculation for the GaAs bulk system is shown, to demonstrate that the present code can handle systems with more than one atom species. Several future aspects are also discussed.
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10.1088/0953-8984/21/6/064233
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pubmed_936_21516
|
Insulin receptor (INSR) is a key protein in the INSR signaling pathway and plays a critical role in biological processes, especially in the regulation of glucose homeostasis. Many metabolic diseases are often accompanied by abnormal INSR signaling. However, the specific effector mechanisms regulating insulin resistance and the distribution patterns of INSR during cell membrane activation remain unclear. Here, we investigated the changes in the distribution of INSR during activation using super-resolution imaging. By observing the connection between INSR activation and its distribution, we found that insulin resistance inhibits its receptor clustering. More importantly, we found that INSR has a highly co-localized relationship with the skeletal protein βII-spectrin. Specific knockout of βII-spectrin inhibited the interaction of INSR with GLUT4 and affected the normal metabolism of glucose. Our work elucidates the effects of insulin activation and insulin resistance on INSR distribution and reveals a potential relationship between INSR and cytoskeleton at the single molecule level, which promotes a deeper understanding of the roles associated with insulin signaling and insulin resistance.
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10.1039/d2nr01051h
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pubmed_567_11806
|
OBJECTIVE
Meta-analysis (MA) is the application of quantitative techniques for the purposes of summarizing data from individual studies. This type of review has many advantages over traditional reviews. However, different investigators performing MAs on the same data set have reached different conclusions. These reliability problems have been attributed to differences in the quality of the implemented meta-analytic procedures. We, therefore, examined the chronic pain treatment meta-analytic literature for MA procedure quality and for the consistency of conclusions. DESIGN, SETTING, PARTICIPANTS, OUTCOME MEASURES: Chronic pain treatment MAs were isolated according to inclusion/exclusion criteria. Data from these MAs were abstracted into structured tables. Table format reflected eight meta-analytic procedures identified previously as being important to MA implementation quality. These were: adequacy of retrieval, publication bias, inclusion/exclusion criteria, abstraction of data, quality, homogeneity/heterogeneity, independence, and statistical versus clinical interpretation. Each meta-analytic procedure was then independently rated by two raters. Rating results were then analyzed by procedure for each individual MA for percentage scores out of 100%, and mean scores. For MAs addressing the same topic area (pain facility treatment, antidepressant treatment, manipulation treatment) direction of effect size was noted. Mean effect sizes were calculated for these subgroups.
RESULTS
Sixteen chronic pain treatment MAs fulfilled inclusion/exclusion criteria. Mean procedure ratings indicated that four procedures may not be implemented adequately. These were publication bias, abstraction of data, quality, and homogeneity/heterogeneity. There was wide MA implementation score variability, with 37.5% scoring less than 50%. The effect sizes of the MA subgroups demonstrated replicate nonvariability.
CONCLUSIONS
Some meta-analytic procedures could be interpreted to be implemented inadequately in some chronic pain treatment MAs. There is wide variability between individual chronic pain treatment MAs on adequacy of implementation of these procedures. However, the effect sizes of the different MA subgroups demonstrated consistency. This finding indicates that for these MA subgroups, MA results are consistent between authors. In addition, chronic pain MAs, as compared with other groups of MAs, appear to address some of the procedures in a more adequate fashion. Future chronic pain MAs should concentrate on improving the quality of their methods with particular emphasis on the above four procedures. Because of potential validity problems with these results, these data cannot and should not be used to make administrative decisions about previous MAs.
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10.1097/00002508-200003000-00011
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pubmed_371_16576
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This paper describes the development of a price index for hospital equipment. Based on 10 years of hospital capital acquisition data from a large teaching hospital, equipment acquisitions were categorized and weights derived for each category. Using national producer price indexes for each of these categories, a national hospital equipment index was derived for 1981 to 1991. Forecasts for 1991 and 1992 were then made. The resulting index indicated that price movements of our hospital capital equipment index were very similar to the Implicit Gross Domestic Product Deflator, an index that measures price changes for the nation's Gross Domestic Product. However, because of the relative importance of several categories of equipment (scientific instruments, computers), more widespread data on hospital equipment expenditure patterns would be desirable in order to validate these results.
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pubmed_371_16576
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pubmed_158_12253
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A subset of Hodgkin's disease (HD) patients have detectable Epstein-Barr virus (EBV) genomes in the malignant Reed-Sternberg (R-S) cells. R-S cells express only a limited set of latent EBV proteins, but only LMP1 and LMP2 can potentially elicit a CD8+ cytotoxic T-lymphocyte (CTL) response. We have evaluated if either of these proteins could be used as targets for specific adoptive T-cell therapy for EBV-positive (EBV+) HD. The success of this strategy requires that R-S cells are susceptible to lysis by CD8+ CTL, and that CTL specific for LMP1 and LMP2 can be detected and potentially amplified in HD patients. Antigen presentation and CTL sensitivity was evaluated with an in vitro maintained, phenotypically representative R-S cell line, HDLM-2. The R-S cells were able to process and present viral proteins, and to be efficiently lysed by specific CTL in a Class I-restricted manner. Since CTL responses to LMP1 and LMP2 do not represent the dominant responses to EBV, we examined if CTL clones specific for these proteins could be isolated despite the presence of weak or nondetectable responses in polyclonal T-cell lines. LMP-specific clones were generated from individuals either by cloning from the polyclonal EBV-reactive T-cell lines or by direct stimulation of peripheral blood mononuclear cells (PBMC) with cells expressing LMP1 or LMP2 as the only EBV protein. Our ability to isolate CTL specific for LMP proteins from individuals with HD and the sensitivity of R-S cells for CTL-mediated lysis suggest that the pursuit of specific adoptive immunotherapy represents a viable strategy for the subset of HD patients with EBV+ tumors.
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pubmed_158_12253
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pubmed_697_21668
|
Tacrolimus is a widely used macrolide immunosuppressant in transplant surgery, with mild and major neurologic side effects. A 21-year-old woman had undergone preemptive transplantation of a kidney from her mother. On the 1st postoperative day, the patient had headache, nausea, vomiting, and agitation. Magnetic resonance imaging (MRI) of the brain showed hyperintensity and a lesion in the right mesial temporal lobe. After we switched from tacrolimus to cyclosporine, the symptoms regressed. Persistence of the lesion, confirmed by repeated MRI, required that the patient be operated on. Pathologic examination showed the gangliocytoma, a rare brain tumor. Our case shows that preexisting brain lesions may cause tacrolimus-induced neurotoxicity in the early postoperative period.
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10.1016/j.transproceed.2016.09.004
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pubmed_804_9131
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Scleral cyst is an unusual, rare clinical condition. Most of the cases reported have described the cyst to occur at the limbus, with or without involvement of the cornea. Posterior scleral cysts have seldom been reported in literature. This case report describes a postequatorial scleral cyst that may mimic a choroidal melanoma. Certain clinical features and swept-source optical coherence tomography are useful for elucidating the location of intraocular lesions anatomically, as well as distinguishing their structural characteristics. [Ophthalmic Surg Lasers Imaging Retina. 2018;49:209-211.].
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10.3928/23258160-20180221-10
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pubmed_347_15627
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R2 retrotransposable elements exclusively insert into the tandemly repeated rRNA genes, the rDNA loci, of their animal hosts. R2 elements form stable long-term associations with their host, in which all individuals in a population contain many potentially active copies, but only a fraction of these individuals show active R2 retrotransposition. Previous studies have found that R2 RNA transcripts are processed from a 28S co-transcript and that the likelihood of R2-inserted units being transcribed is dependent upon their distribution within the rDNA locus. Here we analyze the rDNA locus and R2 elements from nearly 100 R2-active and R2-inactive individuals from natural populations of Drosophila simulans. Along with previous findings concerning the structure and expression of the rDNA loci, these data were incorporated into computer simulations to model the crossover events that give rise to the concerted evolution of the rRNA genes. The simulations that best reproduce the population data assume that only about 40 rDNA units out of the over 200 total units are actively transcribed and that these transcribed units are clustered in a single region of the locus. In the model, the host establishes this transcription domain at each generation in the region with the fewest R2 insertions. Only if the host cannot avoid R2 insertions within this 40-unit domain are R2 elements active in that generation. The simulations also require that most crossover events in the locus occur in the transcription domain in order to explain the empirical observation that R2 elements are seldom duplicated by crossover events. Thus the key to the long-term stability of R2 elements is the stochastic nature of the crossover events within the rDNA locus, and the inevitable expansions and contractions that introduce and remove R2-inserted units from the transcriptionally active domain.
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10.1371/journal.pgen.1003179
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pubmed_1052_3503
|
Shortly following an occlusion of an epicardial coronary artery, changes in the surface electrocardiogram (ECG) can be detected. Initially, T waves in leads with their positive poles facing the ischemic zone become positive, tall and symmetrical. Later, ST segment elevation (STE) becomes apparent. If ischemia continues, changes in the terminal portion of the QRS may also be detected. The changes in the terminal portion of the QRS are believed to be caused by prolongation of the electrical conduction in the ischemic zone and reflect severe ischemia due to lack of protection by preconditioning or collateral circulation. Several groups have shown that patients with the QRS changes of grade 3 ischemia have higher mortality, higher incidence of reinfarction and heart failure than patients presenting with only the T and ST changes of grade 2 ischemia, despite equal success in recanalizing the epicardial coronary artery by either thrombolytic therapy or primary percutaneous coronary intervention. Grade 3 ischemia is associated with more rapid progression of necrosis and larger final infarct size. Further studies are needed to better understand the underlying mechanisms that determine the severity of ischemia and how we should use this method based on the standard 12 lead ECG to implement clinical therapeutic decisions.
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pubmed_1052_3503
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pubmed_73_6034
|
The statistical 1NN method is an elegant way to derive the composition of small B-enriched clusters in a random AB solid solution from 3D atomic fields. An extension of this method is proposed that includes the contribution of interface region and provides an estimate of the core composition of clusters. This model is applied to boron-implanted silicon containing boron-enriched clusters. A comparison with the previous model is performed. This new approach gives relevant information, i.e. the core composition of clusters and the cluster-matrix interface width.
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10.1111/j.1365-2818.2009.03359.x
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pubmed_160_12184
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Sweet cream butter oil was analyzed to identify new volatile compounds that may contribute to its flavor, with an emphasis on lactones. The volatile part of butter oil was obtained by using short-path distillation. As some previously unknown lactones were detected in this first extract, it was fractionated further. The fatty acids were removed, and the extract was fractionated by flash chromatography. Three lactonic fractions possessing a creamy, buttery, and fatty character were investigated in depth by gas chromatography (GC) and mass spectrometry (MS) (EI and CI) and high-resolution GC-time-of-flight MS. Many lactones were identified by their mass fragmentation and by comparison with reference materials synthesized during this work. Six γ-lactones, five δ-lactones, and one ε-lactone were identified for the first time in butter oil, seven of them for the first time in a natural product. The possible contribution of these new lactones to the aroma of butter oil is briefly discussed.
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10.1021/jf201380u
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pubmed_1090_13728
|
The tablet formulation of diltiazem has been available for the treatment of angina pectoris but has not been comprehensively evaluated in hypertension. This study's aim was to evaluate the efficacy, dose-response characteristics, and duration of action of tablet (prompt-release) diltiazem in mild to moderate hypertension. Three placebo-controlled trials were designed. The first (trial #1) evaluated the dose response of 120, 240, and 360 mg/day (q12h regimen) of diltiazem in parallel fixed-dose fashion using hourly blood pressures. The second (trial #2) evaluated a q12h titration from 240 to 360 mg/day, which could be switched to q8h. The third (trial #3) evaluated a q8h titration from 180 to 270 to 360 mg/day, followed by conversion to a q12h regimen. The goal was a supine diastolic blood pressure of less than 90 mmHg and 10 mmHg less than baseline. With doses of diltiazem increasing from 120 to 240 to 360 mg/day, there was a progressive decrease in the average mean arterial pressure, describing a dose response with 120 mg/day as the ineffective dose. The peak effect for each dose regimen was found at 6 hours, with significant reductions lasting over 10 hours in the 240 mg/day and 360 mg/day groups. Peak plasma concentrations occurred at 3 hours. The residual effect at the trough of the 240 mg/day and 360 mg/day doses was 48% and 53% of the peak effect, respectively. When titration was carried out on a q8h regimen, both systolic and diastolic blood pressures were significantly decreased. When the regimen was switched from q8h to q12h, the effect was not maintained.(ABSTRACT TRUNCATED AT 250 WORDS)
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10.1007/BF01856504
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pubmed_1018_21871
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OBJECTIVES
The effect of tamoxifen on cyclic mastalgia and on chemoprophylaxis against breast cancer is little known, mainly due to the difficulties in studying the normal human gland. We proposed to evaluate the mitotic index and the nuclear volume of the lobule of women medicated with tamoxifen only during the luteal phase of the menstrual cycle in order to observe the effect of tamoxifen on the normal human mammary gland.
METHODS
Twenty-four premenopausal women with fibroadenoma diagnosed via biopsy were studied. The phase of the cycle was determined by the date of menstruation and serum progesterone level in the luteal phase (> or = 3 ng/ml). The patients admitted to the study and were given written informed consent to participate in the investigation, which was previously approved of by the hospital Ethics Committee. Patients were divided at random into two groups: Group I consisted of 12 untreated women (control) and Group II consisted of 12 patients treated with 20 mg/day tamoxifen for 10 consecutive days beginning on the 13th day of the menstrual cycle. In both groups, the patients were submitted to biopsies of the nodule and of a 1-cm3 fragment of adjacent mammary parenchyma between the 23rd and 26th day of the cycle. The mitotic index (number of mitoses/1000 nuclei counted) and mean nuclear volume (mean of 10 nuclear volumes for each case) were measured.
RESULTS
No mitosis was observed in Group II. There was a reduction in the mean nuclear volume in Group II (Mann-Whitney test).
CONCLUSIONS
Tamoxifen, when administered only during the luteal phase of the menstrual cycle, significantly reduces the nuclear volume and mitotic activity of the epithelium. This data demonstrates an antagonistic action of tamoxifen on estrogen even when administered for short periods of time.
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10.1016/s0020-7292(98)00050-2
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pubmed_408_10096
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Successful application of the technique of transbronchoscopic endobronchial occlusion of a persistent bronchopleural fistula requires an accurate determination of the segmental location of the air leak. This was achieved by injections of small boluses of Xe-133 into a number of segmental bronchi through a fiber-optic bronchoscope. Following the instillation of Xe-133 into the segmental bronchus leading to the fistula, there was a marked increase in radioactivity in the intercostal drainage tube.
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pubmed_408_10096
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pubmed_1034_25307
|
BACKGROUND
The effect of warfarin on the risk of cardiovascular (CV) disease is unknown among chronic hemodialysis patients with atrial fibrillation (HD-AF).
METHODS
Population-based propensity score and prescription time-distribution matched cohort study including 6719 HD-AF patients with CHA2DS2-VASc score ≥ 2 were divided into warfarin users and nonusers and followed-up for CV events and death.
RESULTS
Warfarin treatment in HD-AF patients with AF preceding HD was associated with higher risks of developing congestive heart failure [hazard ratio (HR)=1.82, 95% confidence interval (CI)=1.29-2.58, p<0.01], peripheral artery occlusive disease (HR=3.42, 95% CI=1.86-6.31, p<0.01), and aortic valve stenosis (HR=3.20, 95% CI=1.02-9.98, p<0.05). Warfarin users were not associated with risks of ischemic or hemorrhagic stroke and all-cause mortality as compared to nonusers.
CONCLUSION
Warfarin may be associated with vascular calcification, increasing the risks of congestive heart failure and peripheral artery occlusive disease among HD-AF patients.
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10.1016/j.jcma.2016.10.012
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pubmed_24_13904
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The morphologies of films spin coated from dilute block copolymer solution onto a mica substrate were studied by atomic force microscopy (AFM). Variables of interest were the polymer concentration, solvent, heating temperature, aging, and ultrasonic effect. It is shown that the solution concentration is the predominant factor in determining the shape of the aggregates displayed from spheres and rods to irregular patches with increasing concentration. The solubility parameter of the solvent plays an important role in modifying the distribution and the size of clusters at the surface. The structures of the aggregates at the surface are metastable, which could evolve with temperature from rodlike aggregates into regular stripes when annealed at a temperature higher than the order-disorder transition temperature of SEBS, whereas those in solution could evolve with aging and ultrasonic treatment into a more stable network structure.
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10.1021/la051293i
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pubmed_841_3624
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Female circumcision is widespread in Egypt. Research suggests that the practice persists because of a belief that circumcision will moderate female sexuality, that it will assure a girl's marriagability, and that it is sanctioned by Islam. Using data from a nationally representative survey of adolescents, this paper investigates the prevalence and social correlates of circumcision among girls aged 10-19, the circumstances surrounding the procedure, and the attitudes of adolescents towards it. While the vast majority of adolescents are circumcised, a life table analysis indicates that girls today are at least 10 percentage points less likely to undergo female circumcision than were their mothers. Circumcision may have begun to decline prior to the time when the current cohort of girls were at risk; however, the data hint at a temporal association between the decline and the 1994 International Conference on Population and Development (ICPD) in Cairo, a time when the campaign against circumcision gained momentum. Over half of circumcised girls reported that the procedure was performed by a physician or nurse rather than a traditional practitioner. This represents a substantial increase over rates of "medicalized" circumcision found among earlier cohorts of Egyptian women. Even among circumcised girls, support for the practice is by no means universal, with 14 percent saying they think the procedure is unnecessary and a further 28 percent expressing ambivalence. A multivariate analysis indicates that girls who have been or are currently in school, who live in urban governorates, and who are older are more likely to believe that circumcision is not obligatory. When the analysis includes boys as well as uncircumcised girls, a large gender gap emerges, with boys considerably more supportive of the practice than are their female counterparts.
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10.1016/s0277-9536(01)00020-x
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pubmed_288_8551
|
In spite of being dispensable, O-antigens are believed to facilitate various cellular processes and alter antibiotic sensitivities. Escherichia coli K-12 (CS109) strains are lacking in O-antigens and are reported to be sensitive to antibiotics. To our surprise, E. coli 2443 (expressing O8-antigen) manifested two- to fourfold higher sensitivities toward penicillin and its derivatives than strain CS109. However, sensitivities toward other structurally unrelated antibiotics remained unchanged. To understand the rationale behind such observations, we replaced the rfb locus of strain 2443 with that of E. coli K-12. The beta-lactam sensitivities of 2443 cells with replaced rfb locus appeared to be identical to those for CS109. Therefore, it is quite reasonable to hypothesize the possible involvement of O8-antigen in beta-lactam sensitization.
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10.1111/j.1574-6968.2008.01104.x
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pubmed_224_9955
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During meiotic prophase I the nucleolus of the mouse oocyte assumes a reticulate structure of 'nucleolonema' type. This change coincides with the appearance of several secondary fibrillar centres. The number of these centres at diplotene (97-113), largely exceeds that of nucleolar organizers (4c DNA = 20 NORs). The quantitative analysis of autoradiographs after hybridization in situ with 3H-uridine labelled rRNA, enabled us to demonstrate that the multiplication of the fibrillar centres in mouse oocyte nucleolus during meiotic prophase I is not the result of an amplification of the rDNA. The number of silver grains in pachytene and diplotene nuclei was twice that counted for somatic cell and oogonium nuclei (2c DNA).
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10.1016/0040-8166(83)90040-x
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pubmed_687_23329
|
This study presents the application of metabolomics to evaluate changes in the rumen metabolites of beef cattle fed with three different diet types: forage-rich, mixed and concentrate-rich. Rumen fluid samples were analysed by 1H-NMR spectroscopy and the resulting spectra were used to characterise and compare metabolomic profiles between diet types and assess the potential for NMR metabolite signals to be used as proxies of methane emissions (CH4 in g/kg DMI). The dataset available consisted of 128 measurements taken from 4 experiments with CH4 measurements taken in respiration chambers. Predictive modelling of CH4 was conducted by partial least squares (PLS) regression, fitting calibration models either using metabolite signals only as predictors or using metabolite signals as well as other diet and animal covariates (DMI, ME, weight, BW0.75, DMI/BW0.75). Cross-validated R2 were 0.57 and 0.70 for the two models respectively. The cattle offered the concentrate-rich diet showed increases in alanine, valerate, propionate, glucose, tyrosine, proline and isoleucine. Lower methane yield was associated with the concentrate-rich diet (p < 0.001). The results provided new insight into the relationship between rumen metabolites, CH4 production and diets, as well as showing that metabolites alone have an acceptable association with the variation in CH4 production from beef cattle.
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10.1038/s41598-020-62485-y
|
pubmed_49_12362
|
In a group of 269 untreated hypertensive patients the effect of a single oral dose of captopril (25 mg) on blood pressure was studied for 90-120 minutes. The systolic blood pressure decreased by more than 20% in 9.5% and by more than 30% in 1.1% of the patients. In 22.6% the diastolic blood pressure decreased by more than 20%; in 4.5% it fell more than 30%. The calculated mean arterial pressure (MAP) was reduced by more than 20% in 12.3% of the patients and by more than 30% in 3%. Three patients showed transient neurological deficits. Factors related to a strong blood pressure drop were: renal artery disease and resistant hypertension. However, a potentially dangerous fall in blood pressure, i.e. an acute fall of MAP of over 30%, was also observed in the absence of these risk factors. Therefore not all patients at risk can be identified in advance, and treatment with ACE-inhibitors has to be started under well-controlled circumstances especially in elderly patients.
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pubmed_49_12362
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pubmed_702_22362
|
PURPOSE
Pulmonary rehabilitation (PR) programs have been shown to improve functional status, exercise performance, and quality of life (QOL) and decrease perception of exertion in individuals with chronic obstructive pulmonary disease. The purpose of this study was to identify the dose effect of PR on the outcome variables of activity level, perceived exertion, and physical and mental QOL.
METHODS
The study used a retrospective explanatory design. The sample (N = 104) included records of individuals diagnosed with chronic bronchitis and emphysema who attended a PR program from 2000 to 2005 at a Midwest inner-city, academic medical center. Participants attended rehabilitation sessions 2 to 3 days per week for approximately 90 minutes each day; maximum duration of the program was 3 months (24 sessions). The PR dose was calculated by multiplying the number of PR sessions with the number of weeks attended.
RESULTS
There were 32 men and 72 women, with a mean age of 59.9 years +/- 10.2 years. All patients were retired or unemployed, and 99% used oxygen during exercise. A higher PR dose was significantly related to improvement in activity level measured by maximum metabolic equivalent (MET) level achieved. A nonsignificant but minimally clinically important difference was found on the Medical Outcomes Study Short-Form 36 (SF-36) outcomes of mental and physical QOL.
CONCLUSIONS
The findings of the current study support a significant relationship between PR dose and activity level (maximum MET level achieved). Physical and mental QOL improved clinically after PR. Optimal program outcomes were related to greater patient participation in supervised PR.
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10.1097/HCR.0b013e3181a814fa
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pubmed_113_11709
|
Fibroblasts are important cells for the support of homeostatic tissue function. In inflammatory diseases such as rheumatoid arthritis and inflammatory bowel disease, fibroblasts take on different roles (a) as inflammatory cells themselves and (b) in recruiting leukocytes, driving angiogenesis, and enabling chronic inflammation in tissues. Recent advances in single-cell profiling techniques have transformed the ability to examine fibroblast states and populations in inflamed tissues, providing evidence of previously underappreciated heterogeneity and disease-associated fibroblast populations. These studies challenge the preconceived notion that fibroblasts are homogeneous and provide new insights into the role of fibroblasts in inflammatory pathology. In addition, new molecular insights into the mechanisms of fibroblast activation reveal powerful cell-intrinsic amplification loops that synergize with primary fibroblast stimuli to result in striking responses. In this Review, we focus on recent developments in our understanding of fibroblast heterogeneity and fibroblast pathology across tissues and diseases in rheumatoid arthritis and inflammatory bowel diseases. We highlight new approaches to, and applications of, single-cell profiling techniques and what they teach us about fibroblast biology. Finally, we address how these insights could lead to the development of novel therapeutic approaches to targeting fibroblasts in disease.
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pubmed_113_11709
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pubmed_369_3667
|
BACKGROUND
Since January 2004 hospitals have the opportunity to establish an ambulatory health-care centre (Medizinisches Versorgungszentrum - MVZ) as a result of the introduction of the Health-care Modernisation Act (Gesetz zur Modernisierung der gesetzlichen Krankenversicherung - GMG). After about a half-year preparatory phase, the UKE, in September 2004, began operation of the "Ambulanzzentrum des UKE GmbH" (a limited liability company) as the first MVZ at a university hospital in Germany. We report here on the establishment of the MVZ and the experience made.
MATERIALS AND METHODS
In the initial phase, only the medical fields of radiation therapy and nuclear medicine were represented. Both disciplines, especially radiation therapy, were existentially threatened by the extensive loss of ambulatory patients. The central motive for the establishment of the ambulatory health-care centre was to secure the survival of both disciplines and to preserve existing jobs. After it was put into operation, the referrals from practice-based colleagues to both radiation therapy and nuclear medicine increased quickly. The positive developments caused other departments of the UKE to express their interest in supplementing their outpatient activities with facilities in the MVZ.
RESULTS
Over the following years, the ambulance centre grew steadily. Now 24 departments are represented in the MVZ, and the centre has a total of 49 positions for physicians contracted by and registered within the German public health insurance system. The number of salaried doctors has risen to 85, although many of these only work part time in the MVZ. Also more than 83 non-medical staff members were hired over the years. These were mostly physiotherapists, radiographers, and medical assistants. With the growing number of departments in the MVZ, the number of treated cases grew steadily. Currently approximately 20 000 cases are treated in each quarter of a year.
CONCLUSIONS
The experience made while establishing an ambulatory health-care centre is very positive. Better cross-sectoral medicine, support of referring practice-based colleagues, content of centre-physicians and a strengthening of research and teaching summarise the experience of the last 7 years accurately. The outpatient centre of UKE GmbH will strive to continue to expand its range of medical services into other medical fields whenever it makes sense.
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10.1055/s-0031-1283883
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pubmed_827_13900
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Spiral computer tomography (CT) has become a widely accepted clinical tool in the diagnosis of acute pulmonary embolism. The accuracy of computed tomography in diagnosing pulmonary embolism has increased over the past 10 years, parallel to technological improvements. However, as with most imaging techniques, interpretative pitfalls may occur for a variety of reasons. These include technical problems caused by respiratory motion artifact, improper bolus timing, streak artifact, and patient body habitus. In addition, misinterpretation of normal bronchovascular anatomy may lead to an erroneous diagnosis. This article discusses the various diagnostic pitfalls and methods to minimize and overcome them.
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10.1016/j.cpradiol.2003.11.001
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pubmed_615_4808
|
BACKGROUND
Central neurocytomas (CNs) are infrequent intraventricular tumors with features of neuronal differentiation that affect young adults and have an excellent prognosis after total resection. The main differential intraoperative diagnoses are oligodendrogliomas, ependymomas and non-Hodgkin's lymphomas; therefore, an accurate and precise intraoperative diagnosis is essential, making the cytologic features the hallmark for cytopathologists, surgical pathologists and neurosurgeons alike. Seven previous reports have described 18 cases of CNs and have addressed the cytodiagnostic criteria during intraoperative assessment in the English medical literature.
CASES
Three patients (23 years old/male, 29 years old/female and 28 years old/male) were evaluated during intraoperative assessment as CNs. They showed intraventricular tumors that measured 6.5, 3.5 and 6.6 cm, respectively. The cytologic features common in these cases were: (1) monotonous or isomorphic round cells, (2) small nuclei with stippled or granular chromatin, and (3) acellular fibrillary areas or neuropil (islands). Other cytologic features often encountered were: rosette-like structures, micronucleoli, perinuclear haloes, well-formed capillary-sized vessels and calcifications.
CONCLUSION
Differential diagnosis of CNs can be a diagnostic challenge. The integration of radiologic imaging and touch preparations taking into account specific cytologic features and frozen sections is necessary for an optimal intraoperative assessment.
|
10.1159/000350893
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pubmed_393_6415
|
We investigated the influence of a PSMF on body weight, body composition, blood lipids, physical working capacity, and nitrogen balance in obese HLP patients. During 4 weeks, 12 patients were treated by PSMF (approximately 340 kcal/d) under health resort conditions. At the same time, they daily exercised on a bicycle with an intensity of 80% of their physical working capacity estimated by an exercise load. The therapeutic regimen induced a significant weight loss (10.1 kg in the mean). Evidently, the patients diminished their body fat only as could be shown by estimations of total body water. Triglycerides, total cholesterol, and LDL-cholesterol also decreased significantly, while HDL-cholesterol remained unchanged. In spite of the weight reduction, the physical working capacity significantly increased from 57.8 to 93.2 kgm. Measurements of total nitrogen excretion with urine gave evidence of the protein saving effect of the therapy. Thus, PSMF--representing an effective therapeutic procedure--can be recommended to be used in obese HLP patients, proceeded that contraindications have been taken into consideration carefully.
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pubmed_393_6415
|
pubmed_192_2443
|
An unresolved issue regarding working memory (WM) processes relates to whether domain-general attentional resources are required to form and store bound representations. Recent evidence suggests that visual WM performance during tasks that require binding of face-scene pairs is disrupted by concurrent divided attention to a greater degree than when needing to remember only faces or scenes (Peterson & Naveh-Benjamin, 2017). These findings contrast with associative long-term memory (LTM) studies, which have found no differential impact of divided attention on associative relative to item memory (Naveh-Benjamin, Guez, & Marom, 2003). In the current study, a verbal WM change detection paradigm, incorporating methods typical of LTM paradigms as well, was leveraged to examine memory for items and item-item bindings, for unrelated word pairs sampled with and without replacement across trials within distinct experimental blocks. In Experiment 1, WM performance was measured under within-domain verbal interference. In Experiment 2, a cross-domain auditory interference task was used to parametrically vary concurrent load. Whereas the results of Experiment 1 revealed that within-domain interference was sufficient to elicit a binding deficit by disrupting verbal rehearsal, in Experiment 2, parametric variation of a cross-domain interference task revealed a divided attention-related binding deficit that increased in magnitude with increased task difficulty. In both experiments, an item-item binding deficit was observed, in comparison with item memory, regardless of whether word pairs were sampled with or without replacement. These findings reveal a dissociable influence of within-domain and cross-domain interference tasks on item-item binding processes in verbal WM. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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10.1037/xlm0000698
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pubmed_304_12109
|
OBJECTIVE
To evaluate patient characteristics and satisfaction in an outpatient service at a university hospital, aiming at obtaining subsidies for standardization of a quality assessment program.
METHOD
Patient-representative sample was selected. It consisted of users of the Ophthalmology Outpatient Service at the Hospital das Clínicas, Universidade Estadual de Campinas (UNICAMP). A structured questionnaire was applied through interview, including the following variables: personal characteristics (gender, age, literacy, job), type of appointment (new patient, follow-up), waiting time for the first appointment, opinion regarding ease of access to the hospital, assistance at the front desk, time spent in the waiting room on the appointed day, quality of care, degree of satisfaction with the consultation and general evaluation of the assistance.
RESULTS
The sample was characterized by patients with low literacy and socioeconomic level; 21.7% had a steady income. The majority of them think that it is easy to obtain an appointment. According to patients, the mean waiting time for the appointment was 94.6 minutes and 45.3% of them received no orientation after the appointment. Final evaluation of the quality of assistance was positive and patients were satisfied with the provided assistance.
CONCLUSION
Although a high level of satisfaction regarding the provided service was observed, when the various factors that can affect patient satisfaction are considered, users reported limitations as concerns quality. Evaluation allowed a better knowledge about the provided service in a university hospital and pointed to the possibility of implantation of quality assessment routines.
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10.1590/s0004-27492006000500021
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pubmed_977_7450
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The release of cytokines and chemokines such as IL-1β, IL-2, IL-6, IL-7, IL-10, TNF-α, IFN-γ, CCL2, CCL3, and CXCL10 is increased in critically ill patients with COVID-19. Excessive cytokine release during COVID-19 is related to increased morbidity and mortality. Several mechanisms are put forward for cytokine release syndrome during COVID-19. Here we have mentioned novel pathways. SARS-CoV-2 increases angiotensin II levels by rendering ACE2 nonfunctional. Angiotensin II causes cytokine release via AT1 and AT2 receptors. Moreover, angiotensin II potently stimulates the Na+/H+ exchanger (NHE). It is a pump found in the membranes of many cells that pumps Na+ inward and H+ outward. NHE has nine isoforms. NHE1 is the most common isoform found in endothelial cells and many cells. NHE is involved in keeping the intracellular pH within physiological limits. When the intracellular pH is acidic, NHE is activated, bringing the intracellular pH to physiological levels, ending its activity. Sustained NHE activity is highly pathological and causes many problems. Prolonged NHE activation in COVID-19 may cause a decrease in intracellular pH through H+ ion accumulation in the extracellular area and subsequent redox reactions. The activation reduces the intracellular K+ concentration and leads to Na+ and Ca2+ overload. Increased ROS can cause intense cytokine release by stimulating NF-κB and NLRP3 inflammasomes. Cytokines also cause overstimulation of NHE. As the intracellular pH decreases, SARS-CoV-2 rapidly infects new cells, increasing the viral load. This vicious circle increases morbidity and mortality in patients with COVID-19. On the other hand, SARS-CoV-2 interaction with NHE3 in intestinal tissue is different from other tissues. SARS-CoV-2 can trigger CRS via NHE3 inhibition by disrupting the intestinal microbiota. This review aimed to help develop new treatment models against SARS-CoV-2- induced CRS by revealing the possible effects of SARS-CoV-2 on the NHE.
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10.2174/1381612828666220713121741
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pubmed_251_12869
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A case of intraventricular arachnoid cyst in an elderly man is reported. A 63-year-old man developed a progressive gait disturbance over a five-year period. CT scan showed a large cyst in the left lateral ventricle which was negative to contrast enhancement. CT cisternography revealed gradual accumulation and more than 48 hours retention of contrast medium in the cyst. The patient underwent left frontal craniotomy, and the cyst wall was partially resected for histopathological examination. Although limit microscopic examination could not establish a diagnosis, arachnoid cyst was diagnosed by electron microscopic findings. Biochemical analysis did not detect any difference between cyst fluid and CSF obtained during surgery. It is suggested that a ball-valve mechanism caused progressive enlargement of the cyst and gradual development of symptoms in this elderly patient.
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10.1007/BF02188793
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pubmed_611_8674
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The accessory navicular bone is one of the most symptomatic bones of the foot. Although it has been reported to be present in various members of the same family, there is a lack of knowledge about its inheritance in the literature. We examined three families and suggest that it has an autosomal dominant trait with incomplete penetrance.
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10.1007/s004020000143
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pubmed_517_1394
|
OBJECTIVE
The influence of body mass index (BMI) as a risk factor for isolated off-pump coronary artery bypass (OPCAB) surgery is unknown. We postulated that BMI ≥ 30 kg/m(2) would adversely affect outcomes following OPCAB at our institution.
METHODS
From 2002 to 2009, we selected 742 patients (primary, N = 709 [95.6%], re-operative, N = 33 [4.45%]) who underwent isolated OPCAB for analysis. Patients were stratified into groups by BMI: non-obese (BMI < 30 kg/m(2) ) and obese (BMI ≥ 30 kg/m(2)). Preoperative risk, operative characteristics, and postoperative outcomes were analyzed. Risk-adjusted models evaluated the occurrence of any complication and mortality.
RESULTS
Overall crude mortality was 1.5% (11/742). When compared to non-obese (26.12 ± 2.72 kg/m(2)) recipients, the obese (35.81 ± 5.69 kg/m(2)) comprised younger patients (62.46 ± 9.96 years, p < 0.001). Number of diseased vessels, Left ventricular ejection fraction, and baseline renal function was equivalent across groups. Diabetes (53.24%) and hypertension (90.59%) were more prevalent among obese patients (p < 0.001, respectively). Internal mammary artery utilization (p = 0.47), endoscopic vein harvest (p = 0.74), and intra-aortic balloon pump use (p = 0.58) were similar between groups. Interestingly, postoperative blood product requirement was lower in obese versus non-obese recipients (47.35% vs. 56.72%, p < 0.01). Furthermore, intensive care unit stay (p = 0.93), mortality (p = 0.56), and discharge to home (p = 0.09) remained equivalent between groups. Importantly, multivariable logistic regression did not identify BMI ≥ 30 kg/m(2) as an independent predictor of any complication (p = 0.21) or mortality (p = 0.74).
CONCLUSIONS
Obesity does not influence operative characteristics or effect outcomes after OPCAB. BMI ≥ 30 kg/m(2) should not be considered a prohibitive risk factor in isolated off-pump coronary revascularization.
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10.1111/j.1540-8191.2011.01312.x
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pubmed_435_16714
|
Neurological disorders secondary to vitamin B12 deficiency are polymorphic and diverse. There have been very few studies conducted in the Moroccan as well as in the African population. This study aims to describe the clinical, paraclinical, evolutionary features of neurological manifestations in patients with vitamin B12 deficiency within the Department of Neurology at the Moulay Ismail Military Hospital, Meknes over a period of 18 years (1999-2017). The study involved 06 women and 23 men, with an average age of 57 years. The mean time between symptom onset and diagnosis was 3 months. Neurological manifestation was indicative of vitamin B12 deficiency in 100% of cases. The average hemoglobin level was 10 g/dl, the mean corpuscular volume was 115 fl. Medullary megaloblastosis and atrophic gastritis were found in 95% and 90% of cases respectively. Regular electromyography (EMG), electroencephalography (EEG) and visual evoked potentials (VEP) showed subclinical peripheral and optic neuropathies. In 20 cases they were caused by Biermer's anemia. All the patients received parenteral Vitamin B12 with good outcome. These results demonstrate the importance of early diagnosis in patients with a potentially serious neuropsychiatric condition as well as of rapid substitution treatment which is the only therapeutic option to secure a good outcome.
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10.11604/pamj.2019.32.108.17609
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pubmed_554_25322
|
BACKGROUND
Access to integrated services for individuals with co-occurring substance use and mental health disorders is a long-standing public health issue. Receiving integrated treatment services are both more effective and preferred by patients and families versus parallel or fragmented care. National policy statements and expert consensus guidelines underscore the benefits of integrated treatment. Despite decades of awareness, adequate treatment for individuals with co-occurring substance use and mental health disorders occurs infrequently. The underlying disease burden associated with alcohol, illicit and prescription drug problems, as well as mental health disorders, such as depression, posttraumatic stress disorder and schizophrenia, is substantial.
METHODS
This cluster randomized controlled trial (RCT) is designed to determine if the multi-component Network for the Improvement of Addiction Treatment (NIATx) strategies are effective in implementing integrated services for persons with co-occurring substance use and mental health disorders. In this study, 50 behavioral health programs in Washington State will be recruited and then randomized into one of two intervention arms: 1) NIATx implementation strategies, including coaching and learning sessions over a 12-month intervention period to implement changes targeting integrated treatment services; or 2) wait-list control. Primary outcome measures include: 1) fidelity - a standardized organizational assessment of integrated services (Dual Diagnosis in Addiction Treatment [DDCAT] Index); and 2) penetration - proportion of patients screened and diagnosed with co-occurring disorders, proportion of eligible patients receiving substance use and mental health services, and psychotropic or substance use disorder medications. Barriers and facilitators, as determinants of implementation outcomes, will be assessed using the Consolidated Framework for Implementation Research (CFIR) Index. Fidelity to and participation in NIATx strategies will be assessed utilizing the NIATx Fidelity Scale and Stages of Implementation Completion (SIC).
DISCUSSION
This study addresses an issue of substantial public health significance: the gap in access to an evidence-based practice for integrated treatment for individuals with co-occurring mental health and substance use disorders. The study utilizes rigorous and reproducible quantitative approaches to measuring implementation determinants and strategies, and may address a longstanding gap in the quality of care for persons with co-occurring disorders.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03007940 . Registered 02 January 2017 - Retrospectively Registered.
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10.1186/s12913-018-3241-4
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pubmed_305_21493
|
PURPOSE
Previous studies did not specifically assess the influence of proximal femoral angle (PFA) on sagittal balance in high-grade spondylolisthesis (HGS). In addition, the relationship between PFA and quality of life (QOL) remains unknown. This study determines if increased PFA is associated with decreased QOL and sagittal balance in lumbosacral HGS.
METHODS
This retrospective case-control study was performed on a cohort of 56 normal subjects and 42 patients with HGS. Initially, PFA was measured twice by 3 raters in a random subset of 30 subjects (15 normal and 15 HGS) to determine the intrarater and interrater reliability of the measurement technique. PFA was then measured for all subjects. For the 42 patients with HGS, QOL was assessed from the SRS-22 questionnaire, in addition to the evaluation of the spino-pelvic balance.
RESULTS
The intrarater and interrater intraclass correlation coefficients for the measurement of PFA were, respectively, 0.951 and 0.958, suggesting excellent reliability. PFA was significantly higher in HGS patients (8.3° ± 6.7°; range - 5° to 24°) when compared to normal subjects (3.0° ± 3.1°; range - 6° to 10°). The PFA in HGS was 5.6° ± 5.6° (range - 5° to 18°), 8.9° ± 6.7° (range - 2° to 24°), and 14.0° ± 6.0° (range 7°-23°) in type 4 (balanced pelvis), type 5 (unbalanced pelvis/balanced spine), and type 6 (unbalanced pelvis and spine) subjects, respectively. There were, respectively, 23.5% (4/17), 26.3% (5/19), and 83.3% (5/6) of HGS patients with abnormal PFA ≥ 10° in type 4, type 5, and type 6 subgroups. Increased PFA in HGS patients was related with deteriorating self-image, pain, function and total SRS-22 score, as well as with increasing pelvic tilt and decreasing sacral slope.
CONCLUSION
A PFA ≥ 10° is proposed as a criterion to define abnormal PFA. PFA was increased in HGS and increased along with deteriorating sagittal balance and QOL. PFA is a clinically relevant parameter of sagittal balance, and can be useful in the evaluation and management of patients with HGS.
|
10.1007/s00586-018-5506-3
|
pubmed_856_16844
|
Mobile devices now rival desktop computers as the most popular devices for web surfing and E-commerce. As screen sizes of mobile devices continue to get larger, operating smartphones with a single-hand becomes increasingly difficult. Automatic operating hand detection would enable E-commerce applications to adapt their interfaces to better suit their user's handedness interaction requirements. This paper addresses the problem of identifying the operative hand by avoiding the use of mobile sensors that may pose a problem in terms of battery consumption or distortion due to different calibrations, improving the accuracy of user categorization through an evaluation of different classification strategies. A supervised classifier based on machine learning was constructed to label the operating hand as left or right. The classifier uses features extracted from touch traces such as scrolls and button clicks on a data-set of 174 users. The approach proposed by this paper is not platform-specific and does not rely on access to gyroscopes or accelerometers, widening its applicability to any device with a touchscreen.
|
10.7717/peerj-cs.487
|
pubmed_791_13567
|
Cronobacter sakazakii is an opportunistic foodborne pathogen associated with necrotizing enterocolitis, bacteremia, and meningitis in infants. A comparative proteomic study of C. sakazakii ATCC BAA-894 (CS WT) and a fliF::Tn5 mutant was performed, including the ability of both strains to adhere to and invade N1E-115 cells. To achieve this goal, a nonmotile C. sakazakii ATCC BAA-894 fliF::Tn5 (CS fliF::Tn5) strain was generated using an EZ-Tn5 <KAN-2>Tnp Transposome kit. Analysis of differential protein expression showed that 81.49% (361/443) of the proteins were expressed in both strains, 8.35% (37/443) were exclusively expressed in the CS WT strain, and 10.16% (45/443) were exclusively expressed in the CS fliF::Tn5 strain. The main exclusively expressed proteins in the CS WT strain were classified into the "cell motility" and "signal transduction mechanisms" subcategories. The proteins exclusively expressed in the CS fliF::Tn5 strain were classified into the following subcategories: "intracellular trafficking, secretion, and vesicular transport", "replication, recombination, and repair", "nucleotide transport and metabolism", "carbohydrate transport and metabolism", "coenzyme transport and metabolism", and "lipid transport and metabolism". Expression of the Cpa protein was detected in both strains, but Cpa was more abundant in the CS WT strain than in the CS fliF::Tn5 strain. A significant increase (p = 0.0001) in adherence to N1E-115 cells was observed in the nonmotile CS fliF::Tn5 strain (31.3 × 106 CFU/mL) compared to the CS WT strain (14.5 × 106 CFU/mL). Additionally, the CS WT strain showed a 0.17% invasion frequency in N1E-115 cells, which was significantly higher (p = 0.01) than that of the nonmotile CS fliF::Tn5 strain. In conclusion, the proteins involved in the motility were mainly identified by proteomic analysis in the CS WT strain compared to the CS fliF::Tn5 strain. Our data indicate that flagella are required to promote the invasion of N1E-115 cells and that the absence of flagella significantly increases the adherence to N1E-115 cells.
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10.1016/j.micpath.2020.104595
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pubmed_877_25319
|
We present a multiloop flow equation for the four-point vertex in the functional renormalization group (FRG) framework. The multiloop flow consists of successive one-loop calculations and sums up all parquet diagrams to arbitrary order. This provides substantial improvement of FRG computations for the four-point vertex and, consequently, the self-energy. Using the x-ray-edge singularity as an example, we show that solving the multiloop FRG flow is equivalent to solving the (first-order) parquet equations and illustrate this with numerical results.
|
10.1103/PhysRevLett.120.057403
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pubmed_752_683
|
The debate over using the word accident has encouraged some groups to adopt the word crash, while other groups retain using accident. This article addresses the inconsistent and interchangeable use of the terms accident and crash. This conceptual analysis used a Critical Review Method, with Critical Theory as the theoretical framework. A literature search was conducted in MEDLINE and CINAHL for articles published through 2011. An extensive review of literature was followed by purposive sampling of articles published in 2011 across countries, disciplines, and contexts. Forty-seven articles were read in entirety, resulting in 2 themes for accident: intent and injury. Seven articles were critically analyzed for intent, injury, and underrepresented margins of society (5 articles using the term accident, 1 article using crash and accident interchangeably, and 1 using only crash). There was congruency on injury across all 7 articles. Results were mixed for intent and the incorporation of marginalized people. Although there is evidence that the use of the word accident should be maintained when the event could not have reasonably been prevented, the theoretical framework highlights this will likely perpetuate the conceptual confusion. The recommendation is to (1) identify the mechanism of injury, (2) identify event as intentional versus nonintentional, and (3) identify event as preventable versus nonpreventable.
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10.1097/JTN.0000000000000167
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pubmed_314_19837
|
Connexin 43(Cx43) and E-cadherin are concurrently expressed in many tumors and were ever classified as tumor suppressors in primary tumors (PT), whereas recent studies showed that these two proteins played specific roles in tumor metastasis. The aim of our study is to determine the expression of Cx43 and E-cadherin in primary gastric tumors (PTs) and matched metastatic lymph nodes (MLNs) and to explore the clinical and pathological implications of expression of these proteins. Immunohistochemical assay was conducted to detect the expression of Cx43 and E-cadherin in PTs and MLNs, and the clinical and pathological implications were analyzed by statistical methods. In PTs, the expression of Cx43 and E-cadherin was significantly reduced, compared to adjacent normal tissues (P < 0.01). The expression of Cx43 and E-cadherin was significantly increased in MLNs compared with PTs (P < 0.01 and P < 0.01, for Cx43 and E-cadherin, respectively), and some Cx43 and E-cadherin-negative PTs developed Cx43 and E-cadherin-positive MLNs. Furthermore, reduced expression of both Cx43 and E-cadherin significantly correlated with poor differentiation, advanced TNM stage, and lymph note metastasis of gastric cancers. Cx43 and E-cadherin expression significantly correlated with each other. We concluded that concurrent reduction in Cx43 and E-cadherin may contribute to the occurrence of gastric cancer. However, concurrent increased expression of Cx43 and E-cadherin may contribute to the efficient metastasis of gastric cancer to the lymph nodes.
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10.1007/s12032-010-9492-5
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pubmed_1051_9856
|
We propose and experimentally demonstrate an on-chip switchable polarization beam splitter (PBS) using silicon waveguides. To the best of our knowledge, it is the first demonstration of an on-chip PBS that is not only able to split polarization beams but can be tuned to allow these beams to switch the output paths. The design of the switchable PBS is based on a directional coupler. Measurements show extinction ratios of >12 dB in both the initial state and the switched state, which is realized by heating the device up to 57°C. By adding switching ability to an on-chip PBS, this work is expected to benefit quantum technology, communications, microwave photonics, etc.
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10.1364/OL.451486
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pubmed_327_15776
|
Preexisting malignancy is considered a relative contraindication to orthotopic liver transplantation (OLT) because of the risk of tumor recurrence. The purpose of this study is to assess the outcome of OLT in patients with a preexistent malignant state. Of 1,097 OLTs performed between 1989 and 1999 at King's College Hospital (London, UK), 18 patients had a pretransplantation malignant state, including 6 cases of myeloproliferative disorder (MPD) presenting as Budd-Chiari syndrome. Those patients with solid-organ malignancies had their tumor detected at an early stage and underwent curative treatment before or during OLT. Patients were followed up for a median of 71 months (range, 1 to 119 months) post-OLT, and the rates of rejection and malignancy were compared with those of transplant recipients without preexisting malignancy during the same period. One patient had a recurrence of his primary malignancy (non-Hodgkin's lymphoma) after 27 months, whereas another patient developed a de novo posttransplant lymphoproliferative disorder after 57 months. One patient with MPD developed acute leukemia 72 months after OLT. In comparison, of 1,079 OLTs performed in patients without preexisting malignancy during the same period, there were 34 cases of de novo malignancies. The rate of rejection in patients with and without preexisting malignancy was similar. Successful medium-term outcome after OLT can be achieved in carefully selected patients with preexisting malignancy providing the malignancy is amenable to curative treatment before or at OLT. Primary MPDs responsible for Budd-Chiari syndrome should not be considered a contraindication to OLT.
|
10.1053/jlts.2001.20788
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pubmed_98_8127
|
CONTEXT
Ethanol ablation (EA) is considered an alternative to surgery for metastatic lymph nodes from papillary thyroid carcinoma (PTC) in selected patients.
OBJECTIVE
The aim of this study was to evaluate the long-term efficacy and safety of this treatment.
DESIGN AND SETTING
Adult patients with PTC who had received EA in lymph node metastasis at a tertiary referral center, and were included in a published study from 2011, were invited to participate in this follow-up study.
METHODS
Radiologic and medical history were reviewed. Ultrasound examination of the neck was performed by radiologists, and clinical examination was performed by an endocrine surgeon. Response was reported according to predefined criteria for satisfactory EA treatment. Adverse events associated with EA were evaluated. Cause of death was reported for deceased patients.
RESULTS
From the 2011 study, 51 of 63 patients were included. Forty-four patients were reexamined (67/109 lesions) and 7 patients were deceased. Median follow-up time from primary surgery was 14.5 years. Median follow-up from the latest performed EA in the 2011 study was 11.3 years. Local control was permanently achieved in most patients (80%). Recurrence within an ablated node was registered in 13 metastases in 10 patients. Seven of these patients also had recurrent disease elsewhere in the neck. No major side effects were reported.
CONCLUSION
EA is a minimally invasive procedure with a low risk of complications. Our data suggest that EA is a safe and efficient treatment, providing excellent results for a large group of patients in the long term.
|
10.1210/clinem/dgab907
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pubmed_580_6215
|
OBJECTIVE
To examine current issues in the management of people with type 2 diabetes, focusing on the need for early recognition, aggressive multifactorial therapy, and a systems approach to treatment in order to reduce the development and progression of the serious and costly complications of this disease.
SUMMARY
Affecting more than 6% of the population in the United States, type 2 diabetes and its complications have become a serious public health concern that exerts a substantial toll on the individuals affected, the entire health care system, and the economy, including employers. Clinical data suggest that early intervention can diminish the risk for developing diabetes in high-risk individuals with prediabetes. Further, improved glycemic control in individuals with diabetes substantially lowers the risk for microvascular complications, and evidence is increasing that it can also decrease macrovascular complications. To maintain long-term glycemic control and reductions in diabetes-related complications, people with diabetes require lifestyle measures, and many will also require combinations of antidiabetic medications and, often, additional treatments for coexisting hypertension and dyslipidemia. Unfortunately, the majority of individuals with type 2 diabetes have not achieved the optimal glucose, blood pressure, or lipid levels recommended by national guidelines. A more aggressive multifactorial approach to treatment is required to improve treatment outcomes for the increasing numbers of people with type 2 diabetes. The comprehensive team approach needed should include early recognition of at-risk individuals, use of risk-specific therapies, regular patient education, and consistent follow-up.
CONCLUSIONS
Despite a prevalence that has reached epidemic proportions, type 2 diabetes remains underdiagnosed and suboptimally controlled. A more aggressive multifactorial approach to treatment is required to improve treatment outcomes.
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pubmed_580_6215
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pubmed_235_16762
|
BACKGROUND
Medial meniscus (MM) tears are associated with both acute and chronic anterior cruciate ligament (ACL) insufficiency and can lead to degenerative changes in the knee. ACL reconstruction (ACLR) combined with the meniscal repair was reported to result in decreased anterior knee joint laxity with evidence of improved patient-reported outcomes in the long term. However, a subtle tear of the MM posterior segment, also known as a ramp lesion, is difficult to detect on conventional magnetic resonance imaging (MRI) and is frequently missed in ACL-deficient knees. However, there are few studies about the associations between bone geometry and ramp lesion of the MM. This study aimed to compare sagittal medial tibial slope (MTS), medial tibial plateau depth (MTPD), and coronal tibial slope (CTS) between ACL-injured knees with and without ramp lesion of the MM. We hypothesised that patients with ramp lesion of the MM and a concomitant ACL injury have a steeper MTS and shallower MTPD than those without ramp lesion of the MM.
METHODS
Twenty-seven patients who underwent ACLR (group A), and 15 patients with combined MM repair (group AM) were included in the study. Anterior tibial translation (ATT) was measured under general anaesthesia just before surgery using a knee arthrometer. MRI was performed in the 10°-knee-flexed position. The MTS and MTPD were measured on sagittal view, and the CTS was measured on coronal view. These parameters were compared between the groups. Differences in MRI measurements or patient demographics between the groups were evaluated using the Mann-Whitney U test.
RESULTS
No significant difference was observed in demographic data and post-operative side-to-side difference in ATT between both groups. Pre-operative ATT was significantly higher in group AM than in group A (P < 0.05), whereas post-operative ATT was similar in both groups. Further, Pre-operative ATT was significantly higher in patients with MTS ≥5.0° than in those with MTS <5.0° (P < 0.05). In groups A and AM, the MTS were 3.6° ± 1.8° and 6.2° ± 2.9°, the MTPD were 2.0 ± 0.5 mm and 2.1 ± 0.6 mm, and the CTS were 2.5° ± 1.8° and 2.4° ± 1.6°, respectively. Patients in group AM had a significantly steeper MTS compared to those in group A (P < 0.01), whereas MTPD and CTS were nearly the same in both groups. When the MTS cut-off value was set at 5.0°, the sensitivity and specificity for ACL injury with concomitant ramp lesion of the MM were 0.73 and 0.76, respectively.
CONCLUSION
A steep posterior slope of the medial tibial plateau is a risk factor for ramp lesion of the MM associated with an ACL injury. Especially in patients with MTS ≥5.0°, an occult MM ramp lesion should be strongly suspected, and surgeons should prepare for MM repair in combination with ACLR.
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10.1016/j.asmart.2021.01.005
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pubmed_1014_1942
|
The study measured effects of Sit 'N' Fit Chair Yoga on pain and physical and psychological functioning. A quasi-experimental research design included a yoga intervention group and an attention control group. There was greater improvement in depression and life satisfaction in the yoga group than in the control group.
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10.1097/HNP.0000000000000034
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pubmed_377_12023
|
Heavy metal pollution caused by traffic activities is increasingly becoming a great threat to urban environmental quality and human health. In this paper, soils of Kerman urban and suburban areas were collected to assess the potential effects of traffic and other vehicle-related pollution by heavy metal accumulation in soils. Eighty-six samples were collected along streets and from residential and rural sectors, as well as vehicle-related workshops from depth of 0-5 and 15-20 cm and analyzed by flame atomic absorption spectrometry (FAAS) for heavy metals (Cd, Cr, Cu, Pb, Sn and Zn), as well as major elements (Al, Ca, Fe and Mn). Several hot-spot areas were identified in the composite geochemical maps produced based on Geographical Information System (GIS) technology. The majority of the hot-spot areas were identified to be vehicle-related workshops, fuel stations and road junctions. The most polluted hot-spot in the study area was located in soils close to a car battery processing workshop in the southwestern part of Kerman city, with concentrations of Cd (0.32 mg/kg), Cr (169 mg/kg), Cu (250 mg/kg), Pb (5,780 mg/kg), Sn (27.2 mg/kg) and Zn (178 mg/kg) of 1, 8.5, 8.3, 230, 13.5 and 3 times more than the relevant mean concentrations in natural soils, respectively. Traffic pollution has resulted in significant accumulation of heavy metals in soils and sediments, and that level of accumulation varied remarkably among elements. Based on X-ray diffraction analysis, most parts of soils and sediments of the Kerman basement consist of calcite and clay minerals. Abundance of clay minerals and medium to alkaline pH causes low mobility of heavy metals in soils of Kerman.
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10.1007/s10653-010-9372-0
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pubmed_893_19221
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Decompression times reported in previous studies suggest that thoroughly brittle fragmentation is unlikely in actual explosive volcanic eruptions. What occurs in practice is brittle-like fragmentation, which is defined as the solid-like fracture of a material whose bulk rheological properties are close to those of a fluid. Through laboratory experiments and numerical simulation, the link between the inhomogeneous structure of bubbles and the development of cracks that may lead to brittle-like fragmentation was clearly demonstrated here. A rapid decompression test was conducted to simulate the fragmentation of a specimen whose pore morphology was revealed by X-ray microtomography. The dynamic response during decompression was observed by high-speed photography. Large variation was observed in the responses of the specimens even among specimens with equal bulk rheological properties. The stress fields of the specimens under decompression computed by finite element analysis shows that the presence of satellite bubbles beneath a large bubble induced the stress concentration. On the basis of the obtained results, a new mechanism for brittle-like fragmentation is proposed. In the proposed scenario, the second nucleation of bubbles near the fragmentation surface is an essential process for the advancement of fragmentation in an upward magma flow in a volcanic conduit.
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10.1038/s41598-017-16941-x
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pubmed_158_16934
|
OBJECTIVES
This study analyzed the impact of eight common chronic medical conditions on functional, social, and affective domains of health-related quality of life among community-based Dutch elderly (n = 5279).
METHODS
Health-related quality of life was measured with six domains of the MOS Short-Form General Health Survey. The impact of the selected chronic conditions on health-related quality of life was analyzed by means of Student's t tests, analyses of variance, and multiple regression analyses.
RESULTS
Compared with other domains of health-related quality of life, mental health was the least affected by chronic medical conditions. Back problems and rheumatoid arthritis/other joint complaints accounted for relatively high proportions of the variance in health-related quality of life (from 35.5% to 68.3%), except for health perceptions (22.6%), indicating that health-related quality of life is most affected by these two conditions.
CONCLUSIONS
Subjective well-being is by far the domain least affected by chronic medical conditions, while physical functioning and health perceptions are most affected. Back problems and rheumatoid arthritis/other joint complaints affect health-related quality of life strongly.
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10.2105/ajph.87.1.38
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pubmed_1129_11269
|
BACKGROUND
Percutaneous coronary intervention (PCI) are increasingly used in daily clinical practice in elderly patients with acute coronary syndrome (ACS) despite limited evidence. The purpose of this study was to assess the impact of PCI on short and long term survivals in a large cohort of elderly patients with ACS from a "real world".
METHODS
We enrolled 491 patients aged ≥70 years admitted to our institution with ACS from 2006 to 2012. Effect of PCI on short and long term survival was evaluated in both overall and a propensity score-matched cohort.
RESULTS
The mean age of the overall cohort is 83 ± 6 years. Among them, 285 were treated with PCI, whereas 206 were not. Patients treated with PCI were younger (82 ± 5 vs. 85 ± 6), more males (67% vs. 46%), with lower heart rate (77 ± 22 vs. 84 ± 21), higher eGFR (58 ± 20 vs. 47 ± 23), and less with heart failure (29% vs. 15%) (all p < 0.001). In both overall and propensity-matched population, improved survival was associated with PCI-treatment at 1 and 3 years (p < 0.001 for all comparisons). Furthermore, by using multivariate Cox proportional-hazards regression model following factors were identified as independent predictors of 3-year all-cause mortality: age (HR 1.08, 95% CI 1.00-1.16), heart rate (HR 1.02, 95% CI 1.01-1.03), eGFR (HR 3.07, 95% CI 1.63-5.77), malignancy (HR 2.03, 95% CI 1.27-4.57), prior CABG (HR 2.033, 95% CI 1.27-4.57), medication with statin (HR 0.40, 95% CI 0.19-0.86) in PCI group, whereas age (HR 1.08, 95% CI 1.03-1.13), heart rate (HR 1.01, 95% CI 1.01-1.02), hypertension (HR 1.87, 95% CI 1.01-3.49) and using of ACEI/ARB (HR 0.46, 95% CI 0.28-0.76) in non-PCI group.
CONCLUSIONS
In elderly ACS patients, PCI-treatment was associated with improved 1 and 3-year survival and PCI-treated patients had different prognostic profile compared to those without PCI treatment.
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10.1186/s12877-018-0818-z
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pubmed_381_3774
|
There has been little research on childhood lead exposure pathways since the 1990s. New data from Michigan in 2017-2021 for 429 children in 345 homes included lead in blood, paint, dust, soil, water, and other housing, demographic, and behavioral metrics. Fifty-three percent of these children had blood lead (BPb) ≥5 μg/dL. A repeated measures pathway model that accounted for multiple children in the same home was constructed using weighted least squares mean estimation and included variance-covariance model multiple imputation. Results showed that children's BPb was directly predicted by lead in settled floor house dust, child's age, season, and mouthing behavior and indirectly predicted by window sill and trough dust lead (DPb), bare soil lead (SPb), proportion of floors with carpets, and exterior building deteriorations. Paint lead (PPb) was also an indirect predictor of BPb through the soil and settled dust pathways. Water lead (WPb), water consumption and other lead sources/pathways were not significant predictors of BPb in this cohort. Although risk factors for individual children are highly variable and worthy of investigation to pinpoint their exposures, this study shows that the main direct and indirect pathways of lead exposure for most children in older housing remain paint and the contaminated dust and soil it generates. Pathway analyses in other jurisdictions using current data should be performed to confirm these results. This study suggests both DPb and BPb in high-risk homes may have declined since the 1990s and that lead in dust, soil, and paint all should be measured to predict risk and target remediation. Because most homes still have not been assessed for lead hazards and remediated, too many children remain at needless risk.
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10.1016/j.envres.2022.114204
|
pubmed_934_22315
|
Cerebral ischemic events remain a major problem in patients undergoing cardiac and thoracic aortic surgery. Efforts to improve outcomes have been made in many aspects which include cerebral monitoring. New technology is making it possible to shed a light to the brain, which historically used to be a black box during general anesthesia in the operating room. Cerebral brain monitoring methods include cerebral oxymetry using near infrared spectroscopy, trans cranial Doppler, Jugular venous oxygen saturation, bispectral index, temporal artery pressure monitoring. Cerebral oxymetry probably is the most commonly used method among these based on its simplicity and reproducibility. Though it is easy to obtain numbers from cerebral oxymetry, it is important to understand the principle and the limitations to interpret the results, properly.
|
pubmed_934_22315
|
pubmed_303_7079
|
Eleven corneal specimens from nine patients with Salzmann's nodular degeneration of the cornea, together with all available clinical information, were collected for this study. The specimens were examined by light and electron microscopy. An antecedent keratitis was diagnosed by history and microscopic findings in every case. The corneal epithelium showed degenerative changes, its thickness varied, and in nodular areas it often consisted of only a single layer of flattened epithelial cells by light microscopy. Bowman's membrane was missing over the nodules, and in this zone there was excessive secretion of a basement membrane-like material. Hyaline degeneration of collagen, cellular debris, and electron-dense hyaline deposits were seen in the collagen of the nodules. The number of fibrocytes in the nodules varied from many that were active to a few that were degenerating. External irritation because of poor epithelial protection was interpreted as a causative factor, although other tissue repair mechanisms may also have played a role.
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10.1016/0002-9394(75)90074-4
|
pubmed_453_3574
|
PURPOSE
To determine the effect of a fresh corneal wound or a healed corneal scar on the immunodiffusion of immunoglobulins into the cornea.
METHODS
F344 rats were immunized with human serum albumin (HSA) 1 week before an autologous rotational keratoplasty of the right cornea or 1 year after an autograft was performed. One group of rats also was treated with gentamicin-dexamethasone ointment in the grafted eye for 1 week after transplantation to reduce the postsurgical inflammatory signs. A serum sample was drawn every week and booster injections with HSA were given after 2 and 3 weeks. At various times after immunization, groups of rats were killed, blood and aqueous humor samples were taken, and the corneas of both eyes were removed. The corneas were divided into the graft or a 3-mm central button and the peripheral rim and weighed. The anti-HSA titer was determined in serum, aqueous humor, and both parts of the corneas.
RESULTS
Up to 5 weeks after transplantation, the grafted cornea contained more anti-HSA immunoglobulins than did the control eye. One year postgrafting, no difference was seen. In the first weeks after keratoplasty, influx of anti-HSA from the peripheral into the central cornea was, however, neither obstructed nor enhanced.
CONCLUSIONS
Surgical trauma in itself causes increased influx of anti-HSA immunoglobulins into the cornea. Within the cornea, a wound or a scar does not appear to be a barrier for centripetal immunoglobulin diffusion.
|
pubmed_453_3574
|
pubmed_405_2033
|
INTRODUCTION
Gaucher disease is an autosomal recessive systemic condition, and the most common of the lysosomal storage disorders. It is characterized by lipid accumulation in certain cells and organs, particularly macrophages, which appear on light microscopy as 'Gaucher cells' or vacuolated lipid-laden reticuloendothelial cells. Long bone involvement is common in Gaucher disease, whereas craniofacial bone involvement is extremely rare. Reports confirming the diagnoses of Gaucher disease involving craniofacial bones by histopathologic evidence are even rarer.
CASE PRESENTATION
A 46-year-old Caucasian Ashkenazi Jewish woman with Gaucher disease presented with jawbone pain and lytic radiographic lesions of her mandible. Surgical biopsy of a mandibular lesion revealed Gaucher cells infiltrating the mandible, which correlated with radiographic and clinical findings, supporting a diagnosis of Gaucher disease with jawbone involvement.
CONCLUSIONS
Lysosomal storage diseases can have head and neck manifestations, and bone involvement in Gaucher disease is common. Therefore, careful consideration of signs and symptoms and medical history, with a thorough review of systems, is important when evaluating patients with lysosomal storage disorders to rule out head and neck involvement of disease. Biopsy may be warranted in some cases for more definitive diagnosis of painful jawbone lesions and to rule out other odontogenic and non-odontogenic conditions in the differential diagnosis.
|
10.1186/1752-1947-8-360
|
pubmed_959_7178
|
PURPOSE
Remodeling of the extracellular matrix (ECM) by matrix metalloproteinases (MMPs) plays a pivotal role for microglia in developing retina. We tested whether integrin-dependent microgliosis mediates ketamine-induced neuronal apoptosis in the developing rat retina.
METHODS
We performed immunofluorescence assays to investigate the role of integrin receptors expressed in the microglia in ketamine-induced neuronal apoptosis. Quantitative reverse transcription polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA) were used to investigate the protein and mRNA levels of cytokines (TNF-α, IL-1β) and/or chemokines (CCL2, CXCL6, CXCL10, and CXCL12). Experiments were performed using whole-mount retinas dissected from P7 Sprague-Dawley rats.
RESULTS
Integrin receptors expressed in microglia were upregulated in ketamine-induced neuronal apoptosis in the early developing rat retina. Downregulating integrin receptors with RGD peptide ameliorated ketamine-induced microgliosis through: 1) ameliorating the change in microglia morphology from immature ramified microglia to an amoeboid state; 2) decreasing the number of microglia and intensity of activated microglia in the retinal ganglion cell layer (GCL); and 3) decreasing cytokine (TNF-α and IL-1β) and chemokine (CCL2, CXCL10) levels in the retinal tissue. Inhibition of activated microglia with minocycline or the blockade of cytokines (TNF-α and IL-1β) with a receptor antagonist (RA) attenuated neuronal apoptosis after exposure to ketamine.
CONCLUSIONS
The upregulation of integrin β1 receptors in the microglia acts as a signaling molecule, triggering microgliosis to aggravate ketamine-induced neuronal apoptosis via the release of TNF-α and IL-1β in the early developing rat retina.
|
10.1016/j.expneurol.2021.113659
|
pubmed_396_18028
|
Narcotized rats with crush syndrome develop severe syndrome of increased blood viscosity. A strict correlation was found between changes in blood viscosity at different shear rates and total peripheral vascular resistance. The severity of central hemodynamic and hemorheological disturbances was different in rats with different reaction of total peripheral vascular resistance to injury accompanied by shock.
|
10.1023/a:1002827230305
|
pubmed_923_9831
|
This article deals with the limitations of infant behavioral audiometry, which have led us to seek objective methods of audiometry for determining hearing sensitivity in infants. It describes efforts to add objectivity to (or reduce the subjectivity of) behavioral methods of infant audiometry. Several aspects of visual reinforcement audiometry (VRA), including the head turn response, the use of control trials, and adherence to the principles of operant conditioning, serve to reduce the subjectivity inherent in behavior observation audiometry. In addition, computer control of VRA procedures can relieve the examiner of potentially subjective decision-making during the course of evaluation and can facilitate testing with sophisticated algorithms that could not be done manually by a single examiner. Computer simulations to determine the best VRA test parameters are described.
|
10.1097/00003446-199302000-00007
|
pubmed_145_3850
|
The following morphological findings can lead to false negative results in steroid hormone receptor concentration tests: Tumour-free mammary tissue besides carcinoma tissue in the biochemically analysed specimen. Focal necroses of the tumour tissue. After exclusion of these findings, more than 80% of the tumours are positive for oestrogen receptors and more than 50% are positive for progesterone receptors in the cytosol. The histological type of tumour has no significant influence on the receptor status, with the exception of the medullary carcinoma of the breast. The semi-quantitatively determined tumour cell content of the invasive ductal carcinoma of the breast does not exercise any influence on the qualitative and quantitative receptor status. This means that tumours which are rich in cells largely consist of cells without receptors which do not respond to endocrine therapy.
|
10.1055/s-2008-1036662
|
pubmed_476_14574
|
Previously it has been shown that fetal alcohol exposure increases the stress response partly due to lowering stress regulatory proopiomelanocortin (Pomc) gene expression in the hypothalamus via epigenetic mechanisms for multiple generations in mixed-breed rats. In this study we assess the induction of heritable epigenetic changes of Pomc-related variants by fetal alcohol exposure in isogenic Fischer 344 rats. Using transgenerational breeding models and fetal alcohol exposure procedures, we determined changes in hypothalamic Pomc gene expression and its methylation levels, plasma corticosterone hormone response to restraint stress, and anxiety-like behaviors using elevated plus maze tests in fetal alcohol-exposed offspring for multiple generations in isogenic Fischer rats. Fetal alcohol-exposed male and female rat offspring showed significant deficits in POMC neuronal functions with increased Pomc gene methylation and reduced expression. These changes in POMC neuronal functions were associated with increased plasma corticosterone response to restraint stress and increased anxiety-like behavior. These effects of fetal alcohol exposure persisted in the F1, F2, and F3 progeny of the male germline but not of the female germline. These data suggest that fetal alcohol exposure induces heritable changes in Pomc-related variants involving stress hyperresponsiveness and anxiety-like behaviors which perpetuate into subsequent generations through the male germline via epigenetic modifications.
|
10.1371/journal.pone.0263340
|
pubmed_261_4207
|
Primary stability of artificial acetabular cups, used for total hip arthroplasty, is required for the subsequent osteointegration and good long-term clinical results of the implant. Although closed-cell polymer foams represent an adequate bone substitute in experimental studies investigating primary stability, correct numerical modelling of this material depends on the parameter selection. Material parameters necessary for crushable foam plasticity behaviour were originated from numerical simulations matched with experimental tests of the polymethacrylimide raw material. Experimental primary stability tests of acetabular press-fit cups consisting of static shell assembly with consecutively pull-out and lever-out testing were subsequently simulated using finite element analysis. Identified and optimised parameters allowed the accurate numerical reproduction of the raw material tests. Correlation between experimental tests and the numerical simulation of primary implant stability depended on the value of interference fit. However, the validated material model provides the opportunity for subsequent parametric numerical studies.
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10.1080/10255842.2011.561012
|
pubmed_402_17830
|
1. We investigated whether insulin-like growth factor-1 (IGF-1), an endogenous potent activator of skeletal muscle proliferation and differentiation, enhances L-type Ca2+ channel gene expression resulting in increased functional voltage sensors in single skeletal muscle cells. 2. Charge movement and inward Ca2+ current were recorded in primary cultured rat myoballs using the whole-cell configuration of the patch-clamp technique. Ca2+ current and maximum charge movement (Qmax) were potentiated in cells treated with IGF-1 without significant changes in their voltage dependence. Peak Ca2+ current in control and IGF-1-treated cells was -7.8 +/- 0.44 and -10. 5 +/- 0.37 pA pF-1, respectively (P < 0.01), whilst Qmax was 12.9 +/- 0.4 and 22.0 +/- 0.3 nC microF-1, respectively (P < 0.01). 3. The number of L-type Ca2+ channels was found to increase in the same preparation. The maximum binding capacity (Bmax) of the high-affinity radioligand [3H]PN200-110 in control and IGF-1-treated cells was 1.21 +/- 0.25 and 3.15 +/- 0.5 pmol (mg protein)-1, respectively (P < 0.01). No significant change in the dissociation constant for [3H]PN200-110 was found. 4. Antisense RNA amplification showed a significant increase in the level of mRNA encoding the L-type Ca2+ channel alpha1-subunit in IGF-1-treated cells. 5. This study demonstrates that IGF-1 regulates charge movement and the level of L-type Ca2+ channel alpha1-subunits through activation of gene expression in skeletal muscle cells.
|
10.1111/j.1469-7793.1999.0331v.x
|
pubmed_163_5485
|
BACKGROUND & AIMS
Among the large population of patients with non-alcoholic fatty liver disease (NAFLD), identifying those with fibrotic non-alcoholic steatohepatitis (Fibro-NASH) is a clinical priority, as these patients are at the highest risk of disease progression and will benefit most from pharmacologic treatment. MRI-based proton density fat fraction (MRI-PDFF) and MR elastography (MRE) can risk-stratify patients with NAFLD by assessing steatosis and fibrosis, respectively. We developed a highly specific MRI-based score to identify patients with Fibro-NASH.
METHODS
This analysis included derivation (n = 103) and validation (n = 244) cohorts of patients who underwent MRI, liver biopsy, transient elastography, and laboratory testing for NAFLD from 2016-2020 in 2 tertiary care centers. To identify Fibro-NASH, a formula was developed based on MRI-PDFF, MRE, and a third variable with highest balanced accuracy per logistic regression. The MRI-aspartate aminotransferase (MAST) score was created and compared to NAFLD fibrosis (NFS), Fibrosis-4 (FIB-4), and FibroScan-aspartate aminotransferase (FAST) scores.
RESULTS
The MAST score demonstrated high performance and discrimination in the validation cohort (AUC 0.93; 95% CI 0.88-0.97). In the validation cohorts, the 90% specificity cut-off of 0.242 corresponded to a sensitivity of 75.0%, positive predictive value (PPV) of 50.0% and negative predictive value (NPV) of 96.5%, whereas the 90% sensitivity cut-off of 0.165 corresponded to a specificity of 72.2%, PPV of 29.4%, and NPV of 98.1%. Compared to NFS and FIB-4, MAST resulted in fewer patients having indeterminate scores and an overall higher AUC. Compared to FAST, MAST exhibited a higher AUC and overall better discrimination.
CONCLUSION
The MAST score is an accurate, MRI-serum-based score that outperforms previous scores in non-invasively identifying patients at higher risk of Fibro-NASH.
LAY SUMMARY
Identifying patients with non-alcoholic steatohepatitis and significant fibrosis - who need treatment and are at risk of clinical liver-related outcomes - is a clinical priority. We developed a more accurate score using MRI-based technologies and a laboratory blood test (aspartate aminotransferase) that outperforms previous non-invasive scores for the identification of patients at higher risk of liver disease progression.
|
10.1016/j.jhep.2021.11.012
|
pubmed_541_11238
|
Hematopoietic stem cells have an impressive regenerative potential, strikingly illustrated in transplantation experiments using limited number of cells. In mice, serial transplantation experiments suggest that individual hematopoietic cells are capable of extensive self-renewal and that any possible limitations in the replicative potential of individual hematopoietic stem cells are not affecting normal blood cell formation. The situation with human hematopoietic stem cells is less clear. Unlike the situation in the mouse, the telomere length in nucleated human blood cells shows a remarkable decline with age. Furthermore, even partial telomerase deficiency in humans typically results in marrow failure, whereas complete lack of telomerase is tolerated up to several generations in the mouse. The decline in telomere length in human leukocytes with age follows a cubic function and is much higher in lymphocytes than in granulocytes. This finding suggests that, under normal circumstances, telomere loss is more likely to compromise the function of lymphocytes than the function of hematopoietic stem cells. To reconcile differences in telomere biology between man and mice, it has been proposed that telomere shortening evolved as a tumor suppressor mechanism in long-lived species that may not exist in shorter-lived mammals. According to this model, telomeres in human cells are intimately involved in signaling cell cycle progression and cell division. Most likely, a minimum number of telomere repeats is required at each telomere to prevent activation of a "telomere checkpoint" and allow cell cycle progression. Telomere length measurements appear useful to distinguish between depletion and exhaustion of hematopoietic stem cells as a cause of marrow failure.
|
10.1111/j.1749-6632.2003.tb03231.x
|
pubmed_826_15283
|
Three rhesus macaques (Macaca mulatta) were challenged with Mycobacterium tuberculosis (Mtb), Erdman strain, as part of studies to investigate lesion development at early time points in tuberculosis (TB) and to assess computed tomography (CT) as a method of monitoring disease progression in vivo. Animals were challenged with either a high, mid or low dose of aerosolized Mtb. The low-dose animal was killed humanely at 24 days post challenge (dpc) and the remaining animals at 25 dpc. Abnormalities in clinical parameters were observed in all animals, but clinical signs relating to respiratory disease were not seen. Pulmonary changes consistent with TB infection were detected by CT at 21 dpc and magnetic resonance imaging (MRI) post mortem. Pulmonary nodule counts obtained from both imaging techniques were directly proportional to the challenge dose and correlated with gross and microscopical lesion counts. On gross and microscopical examination, lesions of similar size and morphology were observed in the lungs of all three animals, with the majority containing necrotic foci. Concomitant gross and microscopical, granulomatous lesions were observed in the tracheobronchial lymph nodes of all animals together with evidence of systemic spread. These findings further contribute to our understanding and knowledge of early lesion formation in the lungs of non-human primates.
|
pubmed_826_15283
|
pubmed_57_6675
|
Spectroscopic Optical Coherence Tomography (S-OCT) extracts depth resolved spectra that are inherently available from OCT signals. The back scattered spectra contain useful functional information regarding the sample, since the light is altered by wavelength dependent absorption and scattering caused by chromophores and structures of the sample. Two aspects dominate the performance of S-OCT: (1) the spectral analysis processing method used to obtain the spatially-resolved spectroscopic information and (2) the metrics used to visualize and interpret relevant sample features. In this work, we focus on the second aspect, where we will compare established and novel metrics for S-OCT. These concepts include the adaptation of methods known from multispectral imaging and modern signal processing approaches such as pattern recognition. To compare the performance of the metrics in a quantitative manner, we use phantoms with microsphere scatterers of different sizes that are below the system's resolution and therefore cannot be differentiated using intensity based OCT images. We show that the analysis of the spectral features can clearly separate areas with different scattering properties in multi-layer phantoms. Finally, we demonstrate the performance of our approach for contrast enhancement in bovine articular cartilage.
|
10.1364/BOE.4.002945
|
pubmed_114_12879
|
This report deals with the results of post-mortem sonographic examination of the spleen of 36 patients. The goal of the study was to gain direct information on the precision of the sonographic organometric method we use. It becomes evident that - depending on the position of the spleen in the dome of the diaphragm - the real length of the organ is underestimated when it is measured as the direct line between the two poles. For this reason the length should be taken as the (curved) median line obtained when performing a longitudinal section of the spleen at sonography. Under these conditions there is a good correlation of the sonographic and anatomic data obtained by autopsy. The mean deviation is maximally 7 mm. For the approximate calculation of the organ weight from the sonographically obtained data the simple ellipsoid formula is sufficient. In order to obtain a normogram for sonographic weight estimation a larger statistical sample is necessary.
|
10.1055/s-2007-1012077
|
pubmed_1000_21098
|
In reconstruction of cartilage defects, autogenous transplantation is known as a reliable and experienced method. Although a clinical application has not been reported until now, tissue engineering permits in vitro production of autogenous cartilage transplants. Nevertheless, in both methods the cartilage is exposed to individually varying resorptive mechanisms. Among other methods for in vivo tissue protection, the encapsulation with a semipermeable polyelectrolytecomplex membrane could guarantee sufficient protection against resorptive influences. Human septal cartilage was encapsulated (group 1) with polyelectrolytecomplex membranes and subcutaneously implanted on the back of thymusaplastic nude mice. Cartilage implants without encapsulation (group 2) were used as control. Scanning electron microscopy and histochemical investigations were performed 1, 4, 8, 12 and 16 weeks after implantation. Group 1 showed no signs of resorption and chronic inflammation at all. In contrast, group 2 presented, correlating to the time of implanta-tion, increasing signs of cell death and fibrotic transformation, representing an increased activity of resorption. In conclusion, tissue encapsulation with a polyelectrolytecomplex membrane could ensure a sufficient protection of human cartilage transplants from resorptive influences. For the plastic-reconstructive surgeon the desired result becomes more calculable.
|
10.1007/s001060050018
|
pubmed_639_47
|
OBJECTIVES
To examine how postoperative pain control after robotic thoracoscopic surgery varies with liposomal bupivacaine (LipoB) versus 0.5% bupivacaine/1:200,000 epinephrine (Bupi/Epi) intercostal nerve blocks within the context of an enhanced recovery after thoracic surgery (ERATS) protocol.
DESIGN
A retrospective analysis of a prospectively maintained database of patients undergoing robotic thoracoscopic procedures between September 1, 2018 and October 31, 2019 was conducted.
SETTING
University of Miami, single-institutional.
PARTICIPANTS
Patients.
INTERVENTIONS
Two hundred fifty-two patients had either LipoB intercostal nerve blocks (n = 129) or Bupi/Epi intercostal nerve blocks (n = 123) when undergoing robotic thoracic surgery.
MEASUREMENTS AND MAIN RESULTS
Comparative analysis of patient-reported pain levels, in-hospital and post-discharge opioid requirements, 90-day operative complications, length of hospital stay, and hospital costs was performed. Data were stratified to either anatomic lung resection or pulmonary wedge resection/mediastinal-pleural procedures. Bupi/Epi patients reported significantly more acute postoperative pain than LipoB patients, which correlated with higher in-hospital and post-discharge opioid requirements. There were no differences in postoperative complications, length of hospital stay, or hospital costs between the two groups.
CONCLUSIONS
As part of an ERATS protocol, infiltration of intercostal spaces and surgical wounds with LipoB for robotic thoracoscopic procedures afforded better postoperative subjective pain control and decreased opioid requirements without an increase in hospital costs as compared with use of Bupi/Epi.
|
10.1053/j.jvca.2021.02.065
|
pubmed_225_16226
|
The effect of diazepam (0.3, 1.0, and 3.0 mg/kg) on the acquisition and retention of place learning was evaluated. The analysis of escape latencies indicates that 1.0 and 3.0 mg/kg diazepam significantly impaired the retention of spatial information. When a free swim trial was carried out only control animals showed spatial bias to the target quadrant. The absence of spatial bias in the group that received 0.3 mg/kg suggests that the amnesic effect of diazepam can be seen at doses similar to or even lower than the anxiolytic ones, and that the GABA/benzodiazepine receptor complex is highly sensitive to the cognitive impairment induced by diazepam in spatial tasks.
|
10.1016/0163-1047(91)80133-y
|
pubmed_491_13888
|
Recent epidemiological studies have reported a positive association between levels of ambient particulate matter (PM) and daily morbidity and mortality due to respiratory or cardiovascular causes; however, toxicological evidence supporting these findings is limited. The present study compared cardiac and thermoregulatory responses to intratracheal instillations of residual oil fly ash (ROFA) in normal and cardiopulmonary-compromised male Sprague-Dawley rats. Animals (n = 64) were implanted with radiotelemetry transmitters capable of continuously monitoring heart rate, core body temperature, and electrocardiographic waveforms. Comparisons of ROFA toxicity were conducted between (1) healthy rats and rats with cardiopulmonary stress or disease, including (2) rats exposed to an ambient temperature of 10° C, (3) rats preexposed to ozone to induce pulmonary inflammation, and (4) rats pretreated with monocrotaline (MCT) to induce pulmonary hypertension and vasculitis. Animals from each regimen were instilled with 1 of 4 doses of ROFA (0, 0.25, 1.0, 2.5 mg), and telemetry data were acquired for 96 h following ROFA instillation. Dose-related hypothermia and bradycardia were observed in healthy animals following exposure to ROFA; the magnitude and duration of these responses were potentiated in all compromised models. Delayed hypothermic and bradycardic responses occurred in healthy animals receiving 2.5 mg ROFA up to 48 h following instillation. These delayed responses were exacerbated in the MCT-and 10°C-exposure models, but attenuated in the 03-preexposed group. Additional observed effects of ROFA included induction of cardiac arrhythmias and increased mortality. These results demonstrate a distinct cardiac component to ROFA toxicity that agrees with epidemiological findings of PM-related excess cardiovascular mortality. Furthermore, the dose-related hypothermia and bradycardia observed in rodents from this study may confound the interpretation of results from similar air pollution toxicology studies.
|
10.1080/08958378.2000.11463196
|
pubmed_755_4605
|
Eleven endometrial biopsies, taken from six Turner's syndrome patients receiving hormone replacement therapy prior to treatment by oocyte donation and embryo transfer, were assessed by freeze fracture followed by electron microscopy for epithelial tight junctions. Nine of the eleven biopsies had no discernible tight junctions; the other two biopsies had reduced and disorganized junctional structures. Two patients subsequently became pregnant following embryo transfer. It is concluded that compromised epithelial integrity does not prevent embryo implantation in the human, an observation that is consistent with a barrier role for the epithelium except at times when appropriately conditioned with oestrogen and progesterone to induce receptivity for implantation.
|
10.1093/oxfordjournals.humrep.a137754
|
pubmed_556_12191
|
High altitude (HA) conditions induce several physiological and molecular changes, prevalent in individuals who are unexposed to this environment. Individuals exposed towards HA hypoxia yields physiological and molecular orchestration to maintain adequate tissue oxygen delivery and supply at altitude. This study aimed to understand the temporal changes at altitude of 4,111m. Physiological parameters and transcriptome study was conducted at high altitude day 3, 7, 14 and 21. We observed changes in differentially expressed gene (DEG) at high altitude time points along with altered BP, HR, SpO2, mPAP. Physiological changes and unsupervised learning of DEG's discloses high altitude day 3 as distinct time point. Gene enrichment analysis of ontologies and pathways indicate cellular dynamics and immune response involvement in early day exposure and later stable response. Major clustering of genes involved in cellular dynamics deployed into broad categories: cell-cell interaction, blood signaling, coagulation system, and cellular process. Our data reveals genes and pathways perturbed for conditions like vascular remodeling, cellular homeostasis. In this study we found the nodal point of the gene interactive network and candidate gene controlling many cellular interactive pathways VIM, CORO1A, CD37, STMN1, RHOC, PDE7B, NELL1, NRP1 and TAGLN and the most significant among them i.e. VIM gene was identified as top hub gene. This study suggests a unique physiological and molecular perturbation likely to play a critical role in high altitude associated pathophysiological condition during early exposure compared to later time points.
|
10.1371/journal.pone.0238117
|
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