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pubmed_590_22052 | Goals for the management of osteoarthritis (OA) emphasize pain relief, reduction of inflammation, and improvement in functioning. Among pharmacological pain management interventions, nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently recommended as the most effective treatment option for OA. However, the use of traditional oral NSAIDs is associated with risk of serious adverse events involving the gastrointestinal, cardiovascular, and renal systems. Topical NSAIDs are an alternative with well-established tolerability and efficacy in the treatment of OA of the knee or hand. While the management of OA pain is evolving toward the more widespread use of topical NSAIDs, some OA management guidelines have yet to incorporate these agents in their recommendations. This review examines the efficacy and tolerability of topical NSAIDs, their current placement in OA management guidelines, and their potential role in enabling pain specialists to provide individualized care for their patients with OA. | 10.2147/JPR.S45321 |
pubmed_833_7892 | EDI is expected to be the dominant form of business communication between organisations moving to the Electronic Commerce era of 2000. The healthcare sector is already using EDI in the hospital supply function as well as in the clinical area and the reimbursement process. In this paper, we examine the use of EDI in the healthcare administration sector and move specifically its application to the Medical Devices Vigilance System. At a first place, the potential of this approach is examined, after an initial brief presentation of the EDI concept and its application in healthcare. This presentation is followed by an overall description of the EDI prototype system, which was developed in the context of the EUROMEDIES Concerted Action, in order to facilitate the requirements definition phase. | pubmed_833_7892 |
pubmed_994_20117 | UNLABELLED
Multi-motivational theories of human relatedness state that different motivational systems with an evolutionary basis modulate interpersonal relationships. The reliable assessment of their dynamics may usefully inform the understanding of the therapeutic relationship. The coding system of the Assessing Interpersonal Motivation in Transcripts (AIMIT) allows to identify in the clinical the activity of five main interpersonal motivational systems (IMSs): attachment (care-seeking), caregiving, ranking, sexuality and peer cooperation. To assess whether the criteria currently used to score the AIMIT are consistently correlated with the conceptual formulation of the interpersonal multi-motivational theory, two different studies were designed. Study 1: Content validity as assessed by highly qualified independent raters. Study 2: Content validity as assessed by unqualified raters. Results of study 1 show that out of the total 60 AIMIT verbal criteria, 52 (86.7%) met the required minimum degree of correspondence. The average semantic correspondence scores between these items and the related IMSs were quite good (overall mean: 3.74, standard deviation: 0.61). In study 2, a group of 20 naïve raters had to identify each prevalent motivation (IMS) in a random sequence of 1000 utterances drawn from therapy sessions. Cohen's Kappa coefficient was calculated for each rater with reference to each IMS and then calculated the average Kappa for all raters for each IMS. All average Kappa values were satisfactory (>0.60) and ranged between 0.63 (ranking system) and 0.83 (sexuality system). Data confirmed the overall soundness of AIMIT's theoretical-applicative approach. Results are discussed, corroborating the hypothesis that the AIMIT possesses the required criteria for content validity. Copyright © 2015 John Wiley & Sons, Ltd.
KEY PRACTITIONER MESSAGE
Assessing Interpersonal Motivations in psychotherapy transcripts as a useful tool to better understand links between motivational systems and intersubjectivity. A step forward in the knowledge of evolutionary cognitivism and a contribution to the bio-psycho-social model of human relatedness and interpersonal neurobiology. | 10.1002/cpp.1960 |
pubmed_295_13924 | PURPOSE
To present a novel technique, minimal gas vitrectomy with scleral buckle (MGV-SB), as a means of potentially minimizing retinal displacement compared to standard vitrectomy or vitrectomy/scleral buckle for select cases.
METHODS
A patient with a right macula off retinal detachment and retinal breaks at 7 o'clock and 10 o'clock underwent a 23-gauge pars plana vitrectomy, localization and cryopexy of the breaks along with an inferior temporal segmental scleral buckle. No air-fluid exchange was performed. Suturing of sclerotomies, anterior chamber paracentesis of 0.3 ml and intravitreal injection of 0.6 mL pure sulfur hexafluoride were then performed. The patient was advised to perform the steamroller maneuver with initial face down positioning for 6 hours.
RESULTS
The patient achieved retinal reattachment and post-operative wide-field fundus autofluorescence imaging demonstrated a high integrity retinal attachment (HIRA) with no retinal displacement.
CONCLUSION
The MGV-SB technique has the potential to minimize retinal displacement in cases with inferior break(s) by using a small volume expansile gas tamponade and localized scleral buckle compared to standard vitrectomy or vitrectomy/scleral buckle with a full gas fill. | 10.1097/ICB.0000000000001174 |
pubmed_463_18375 | PURPOSE
We evaluated the long-term natural history of renal function after radical cystectomy with urinary diversion and determined factors associated with decreased renal function.
MATERIALS AND METHODS
We reviewed the records of 1,631 patients who underwent radical cystectomy between 1980 and 2006. The estimated glomerular filtration rate was calculated preoperatively and at various intervals after surgery. A renal function decrease was defined as a greater than 10 ml per minute/1.73 m(2) reduction in the estimated glomerular filtration rate. Multivariate analysis was done to evaluate the association of clinicopathological features, incontinent vs continent diversion type and postoperative complications with decreased renal function.
RESULTS
A total of 1,241 patients (76%) underwent incontinent diversion and 390 (24%) underwent continent diversion. Median followup after radical cystectomy in patients alive at last followup was 10.5 years (IQR 7.1, 15.3). The median preoperative estimated glomerular filtration rate was higher in the continent diversion cohort (67 vs 59 ml per minute/1.73 m(2), p <0.0001). This difference was maintained until 7 years postoperatively, after which no difference was noted in renal function by diversion type. By 10 years after radical cystectomy the risk of a renal function decrease was similar for incontinent and continent diversion (71% and 74%, respectively, p = 0.13). On multivariate analysis risk factors associated with decreased renal function included age (HR 1.03, p <0.0001), preoperative estimated glomerular filtration rate (HR 1.05, p <0.0001), chronic hypertension (HR 1.2, p = 0.01), postoperative hydronephrosis (HR 1.2, p = 0.03), pyelonephritis (HR 1.3, p = 0.01) and ureteroenteric stricture (HR 1.6, p <0.0001).
CONCLUSIONS
Decreased renal function is noted in most patients during long-term followup after radical cystectomy. Postoperative hydronephrosis, pyelonephritis and ureteroenteric stricture represent potentially modifiable factors associated with a decrease. Choice of urinary diversion was not independently associated with decreased renal function. | pubmed_463_18375 |
pubmed_98_17069 | Thermal injury repair is a complex process during which the maintenance of the proliferation and migration of human skin fibroblasts (HSFs) exert a crucial role. MicroRNAs have been proven to exert an essential function in repairing skin burns. This study delves into the regulatory effects of miR-24-3p on the migration and proliferation of HSFs that have sustained a thermal injury, thereby, providing deeper insight into thermal injury repair pathogenesis. The PPAR-β protein expression level progressively increased in a time-dependent manner on the 12th, 24th and 48th hour following the thermal injury of the HSFs. The knockdown of PPAR-β markedly suppressed the proliferation of and migration of HSF. Following thermal injury, the knockdown also promoted the inflammatory cytokine IL-6, TNF-α, PTGS-2 and P65 expression. PPAR-β contrastingly exhibited an opposite trend. A targeted relationship between PPAR-β and miR-24-3p was predicted and verified. miR-24-3p inhibited thermal injured HSF proliferation and migration and facilitated inflammatory cytokine expression through the regulation of PPAR-β. p65 directly targeted the transcriptional precursor of miR-24 and promoted miR-24 expression. A negative correlation between miR-24-3p expression level and PPAR-β expression level in rats' burnt dermal tissues was observed. Our findings reveal that miR-24-3p is conducive to rehabilitating the denatured dermis, which may be beneficial in providing effective therapy of skin burns. | 10.1111/exd.14517 |
pubmed_203_8764 | The combination of artesunate and mefloquine is currently one of the most effective treatments for multidrug-resistant Plasmodium falciparum malaria. Simultaneous, rather than sequential treatment with the two drugs, would allow better patient compliance. We therefore evaluated three-day treatment with artesunate combined with either 2 or 3 days of mefloquine co-administered once a day with artesunate. The study was an open, randomized trial for acute, uncomplicated falciparum malaria and was conducted at the Bangkok Hospital for Tropical Diseases. One hundred and twenty adult patients were randomized to two treatment groups. Group 1 patients received 4 mg/kg/day of artesunate for 3 days and 3 daily doses of 8.0 mg/kg/day mefloquine given with artesunate. Group 2 patients received the same dose of artesunate and the same total dose of mefloquine (25 mg/kg). However, the mefloquine was given as 15 mg/kg on the first day and 10 mg/kg/ on the second day, again with artesunate. The baseline demographic and clinical characteristics of the patients in the two groups were similar. The cure rates for the 3-day and 2-day mefloquine regimens were 100% and 99%, respectively. There were no significant differences in either median fever clearance times (group 1=32 hours; group 2=33 hours) or mean parasite clearance times (group 1=42.3 hours; group 2=43.3 hours). Both regimens were well tolerated and there were no significant differences in the incidence of adverse effects. Nausea or vomiting occurred in 3.8% of patients in both groups and transient dizziness occurred in 4% of group 1 and 9% of group 2 patients. These results suggest that a 3-day regimen of mefloquine administered with artesunate is effective and well tolerated. This practical regimen could improve patient compliance. | pubmed_203_8764 |
pubmed_667_8125 | We evaluated the accuracy of cardiac output estimations by three transthoracic echocardiographic techniques in critically ill subjects. This study was a prospective comparison study carried out in a general intensive care unit of a teaching hospital. The subjects had a broad range of diagnoses including pulmonary embolus, cardiogenic shock, septic shock, Legionnaire's disease and perioperative myocardial infarction. All patients requiring pulmonary artery catheterization underwent echocardiographic cardiac assessment with comparison of findings to those obtained by thermodilution techniques. Nineteen studies on eighteen patients were performed, with cardiac output calculated by the two-chamber Simpson's, four-chamber Simpson's, and left ventricular outflow tract (LVOT) Doppler methods. Acceptable data was obtained in those patients without mitral regurgitation. There was good correlation between the thermodilution technique and Simpson's two-chamber method (r = 0.91), but less so with the Simpson's four-chamber method (r = 0.77). All studies were included in the LVOT Doppler method with a good correlation (r = 0.94). A plot of differences between methods using the Bland and Altman statistical method indicated that only the LVOT Doppler method demonstrated acceptable agreement with a mean of 0.2 litres/minute, standard deviation of 0.82 litres/minute and 95% limits of agreement of -1.5 to +1.9 litres/minute. We concluded that the LVOT Doppler method was the only one which demonstrated acceptable agreement between the thermodilution method and echocardiographic techniques in all critically ill patients studied. | 10.1177/0310057X9702500307 |
pubmed_936_19116 | INTRODUCTION
Covid-19 has highlighted the need to understand the long-term impact of epidemics on health systems. There is extensive evidence that the Ebola epidemic of 2014-16 dramatically reduced coverage of key reproductive, maternal, newborn, child and adolescent health (RMNCAH) indicators during the period of acute crisis in Sierra Leone. However, less is known about the longer lasting effects, and whether patients continue to be deterred from seeking care either through fear or cost some years after the end of the epidemic METHODS: We analysed nationally representative household surveys from before (2011) and after (2018) the Ebola epidemic to estimate the coverage of 11 indicators of access to RMNCAH, and affordability of care. We used a differences-in-differences analysis, exploiting the variation in epidemic intensity across chiefdoms, to identify the effect of epidemic intensity on access and affordability outcomes, with propensity score weighting to adjust for differences in underlying characteristics between chiefdoms.
RESULTS
13537 households were included across both datasets. Epidemic intensity was associated with a significant stalling in progress (-12.2 percentage points, 95% CI: 23.2 to -1.3, p = 0.029) in the proportion of births attended by a skilled provider. Epidemic intensity did not have a significant impact on any other indicator.
CONCLUSION
While there is evidence that chiefdoms which experienced worse Ebola outbreaks had poorer coverage of attendance of skilled providers at birth than would have otherwise been expected, more broadly the intensity of the epidemic did not impact on most indicators. This suggests the measures to restore both staffing and trust were effective in supporting the health system to recover from Ebola. | 10.1016/j.socscimed.2022.114995 |
pubmed_646_15887 | Crystallographic information on dental hard tissue is helpful in evaluating whether incipient caries that has received preventative treatments is resistant to subsequent attack. The aim here was to analyse crystallographically by means of high-resolution electron microscopy (HREM) demineralized human enamel that had been laser-irradiated or remineralized. Electron-microscopic observation identified a distinct layer at a depth of 100 nm in the demineralized and laser-irradiated enamel. The crystallinity in the shallower area was inferior to that in the deeper area. Comparison of the HREM findings from the deeper area with the data provided by the Joint Committee on Powdered Diffraction Standards revealed that the mineral in the demineralized and laser-irradiated enamel was either alpha- or beta-tricalcium phosphate, while that in the remineralized enamel was thought to be tetracalcium diphosphate monoxide. | 10.1016/s0003-9969(00)00034-0 |
pubmed_498_13153 | AIM
To investigate the ability of the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III), scores to predict later Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), performances in a cohort of children born extremely preterm.
METHODS
323 children, born <27 gestational weeks, were tested with the Bayley-III at corrected age 2.5 years and with the WISC-IV at 6.5 years. Regression analyses investigated the association between Bayley-III scores and WISC-IV full-scale intelligence quotient (IQ). The ability of Bayley-III Cognitive Index scores to predict low IQ was evaluated using receiver operating characteristic curves.
RESULTS
Bayley-III Cognitive Index scores and IQ had a moderately positive correlation and accounted for 38% of the IQ variance. Using a Bayley-III cut-off score of 70, the sensitivity to detect children with IQ<70 was 18%, and false positive rate was 7%. A Bayley-III cut-off score of 85 corresponded to sensitivity and false positive rates of 44% and 7%, respectively.
CONCLUSIONS
Results emphasise the relative importance of Bayley-III Cognitive Index scores as predictors of IQ. An 85 score cut-off for suspecting subnormal IQ is supported. A less conservative threshold would increase identification of true cases yet increase the risk of wrongly diagnosing children. | 10.1111/apa.16037 |
pubmed_756_8545 | INTRODUCTION
The influence of season at diagnosis on cancer survival has been an intriguing issue for many years. Most studies have shown a possible correlation in between the seasonality and some cancer type survival. With short expected survival, lung cancer is an arena that still is in need of new prognostic factors and models. We aimed to investigate the effect of season of diagnosis on 3 months, 1 and 2 years survival rates and overall survival of non small cell lung cancer patients.
MATERIALS AND METHODS
The files of non small cell lung cancer patients that were stages IIIB and IV at diagnosis were reviewed retrospectively. According to diagnosis date, the patients were grouped into 4 season groups, autumn, winter, spring and summer.
RESULTS
A total of 279 advanced non small cell lung cancer patients' files were reviewed. Median overall survival was 15 months in the entire population. Overall 3 months, 1 and 2 years survival rates were 91.0%, 58.2% and 31.2% respectively. The season of diagnosis was significantly correlated with 3 months survival rates, being diagnosed in spring being associated with better survival . Also the season was significantly correlated with T stage of the disease. For 1 and 2 years survival rates and overall survival, the season of diagnosis was not significantly correlated. There was no correlation detected between season and overall survivals according to histological subtypes of non small cell lung cancer.
CONCLUSION
As a new finding in advanced non small cell lung cancer patients, it can be concluded that being diagnosed in spring can be a favorable prognostic factor for short term survival. | 10.7314/apjcp.2013.14.7.4325 |
pubmed_374_8665 | BACKGROUND
Hepatotoxicity and visual symptoms are common adverse effects (AEs) of voriconazole therapy.
OBJECTIVE
To retrospectively evaluate the effects of treatment modification based on therapeutic drug monitoring on AEs in patients undergoing voriconazole therapy.
METHODS
The target voriconazole trough concentration (Cmin ) was 1-5 µg/mL. Receiver operating characteristic curves were used to determine Cmin cut-offs for AEs.
RESULTS
A total of 401 patients were included. Among 108 patients with high initial Cmin , voriconazole was discontinued in 32 and the dose was reduced in 71. Among 44 patients with low initial Cmin , voriconazole was discontinued in 4 and the dose was increased in 19. Hepatotoxicity occurred in 6.0% of patients, after a median of 10 days. Visual symptoms were evident in 9.5% of patients after a median of 4 days. Initial Cmin was significantly associated with visual symptoms but not hepatotoxicity, which suggested the effect of treatment modification on hepatotoxicity. However, both hepatotoxicity and visual symptoms were significantly correlated with Cmin at the onset of AEs, and the Cmin cut-offs were 3.5 μg/mL for hepatotoxicity and 4.2 μg/mL for visual symptoms. Voriconazole was discontinued after the occurrence of AEs in 62.5% of patients with hepatotoxicity but only 26.3% of patients with visual symptoms. With dose adjustment, treatment was completed in 8/9 patients with hepatotoxicity and 27/28 patients with visual symptoms.
CONCLUSIONS
A significant preventive effect was demonstrated on hepatotoxicity, but not on visual symptoms because of earlier occurrence. With treatment modification after the occurrence of AEs, most patients completed therapy. | 10.1111/myc.13129 |
pubmed_1119_16985 | Apolipoprotein E-epsilon 4 (APOE4, gene; apoE4, protein) is a susceptibility gene or risk factor for Alzheimer's disease. The genetic relevance of APOE4 has been widely confirmed. The APOE gene is not a disease locus, with specific mutations causing Alzheimer disease. Allelic variations at the APOE locus affect the rate of disease progression. The association of specific inherited APOE alleles with age of onset distributions describes biological effects based on genotype. The inheritance of polymorphic genes with single amino acid differences between apoE4 and apoE3 (and between apoE3 and apoE2) at the protein level is associated with differences in the mean age of disease onset spanning almost two decades. The isoform-specific metabolism of apoE resulting in a faster rate of disease expression can now be studied with the expectation that genetically relevant processes are being investigated. There is now an opportunity to develop theories directed at the genetically relevant apoE metabolism that can significantly delay disease expression. | pubmed_1119_16985 |
pubmed_1018_13179 | PURPOSE
A new ensemble-averaging (EA) approach was developed with the goal of investigating central hemodynamics by transthoracic impedance cardiography during maximal arm cranking. This EA procedure of the first time derivative of impedance changes (dZ/dt) over several cardiac cycles differs from previously reported techniques with respect to cycle selection strategy, according to fixed criteria, and processing methods.
METHODS
First, the primary elements of the Kubicek stroke volume (SV) formula, as determined by EA, were compared with the values determined by the standard hand-processing (HP) method over a large range of cardiac outputs.
RESULTS
Results showed a very high reliability for ventricular ejection time (r = 0.996), (dZ/dt)min (r = 0.995), SV (r = 0.977), and heart rate (r = 0.999). Second, the EA procedure was applied to six subjects performing a continuous, multistage arm cranking test to volitional fatigue. The present technique allowed for an effective filtering of movement and breathing artifacts of the original signal. Thus, interpretation of the dZ/dt wave form was convenient, even at maximal arm cranking power outputs up to 120 W. Stroke volume ranged from 63.83 to 127.18 mL.beat-1, showing no significant variations with oxygen consumption. Cardiac output increased linearly with oxygen uptake, reaching a mean maximal value of 16 L.min-1.
CONCLUSION
The present procedure opens a new field of application to impedance cardiography, permitting to measure cardiac output during maximal arm cranking exercise. | 10.1097/00005768-199808000-00022 |
pubmed_17_11813 | Leptospirosis is one of the most widespread zoonotic diseases in the world. Infection may range from sub clinical infection to death of the patient. It may also occur endemically in tropical countries, showing seasonal incidences following heavy rainfall. As the diagnosis is difficult due to vague clinical symptoms, laboratory investigations are essential for the confirmation of the disease. This study was undertaken to correlate the clinical findings, occupation and behavioural pattern in seropositive cases of Leptospirosis. A total of 733 patients suspected of Leptospirosis were tested for specific IgM ELISA and clinical findings, occupation and behavioural pattern were noted. | pubmed_17_11813 |
pubmed_550_7176 | BACKGROUND
The aim of this study was to evaluate the appropriateness of prescription of non-invasive cardiological tests (exercise stress test, echocardiography, Holter monitoring and vascular echography), consecutively performed in our outpatient laboratory during 4 weeks.
METHODS
We collected the following data: the appropriateness of prescription (according to the Italian Federation of Cardiology guidelines); test indications; the prescribing physician (cardiologist/non-cardiologist); type of prescription (elective/urgent); clinical utility (useful/useless) and result (normal/abnormal) of each test.
RESULTS
We evaluated 960 prescriptions (320 exercise tests; 282 echocardiograms; 158 Holter tests; 200 vascular echographies). Test indications were appropriate (class I) in 37%, doubtfully appropriate (class II) in 39% and inappropriate (class III) in 24% of the cases. The appropriateness was slightly better for vascular echography and echocardiography (class I: 44% and 43%, respectively), markedly worse for exercise test (class I: 27%). The tests were considered useful in 46% and abnormal in 39% of the cases. Cardiologist-prescribed exams resulted more often appropriate (class I: 53 vs 30%; class II: 41 vs 38%; class III: 6 vs. 32%; p = 0.0001), more often useful (74 vs. 34%; p = 0.0001) and more frequently abnormal (43 vs. 37%; p = 0.05), when compared to non-cardiologist-prescribed exams. No differences in appropriateness, utility and test result have been detected between elective and urgent exams. Exercise test, echocardiogram and Holter monitoring resulted more often appropriate and useful when prescribed by cardiologists.
CONCLUSIONS
This study confirms that only one third of prescriptions for non-invasive cardiological tests are appropriate. Cardiologist-prescribed exams are more often appropriate, useful and abnormal. | pubmed_550_7176 |
pubmed_1028_8605 | The frequency of haemoglobin types in several major breeds of cattle in northern Austrailia was determined. In all Boss taurus cattle examined only the three common bovine haemoglobin types (AA, AB, BB) were found. F2 Africander cross-breeds showed only AA patterns. The frequency of haemoglobin B was significantly higher in Bos indicus type cattle than in Bos taurus breeds. In the pure breed Banteng cattle (Bos banteng) three genotypes (BB, CB, CC) were present. The eleven buffaloes types each showed two haemoglobins (A1 and A2) in proporotions of 71 to 29 respectively. | pubmed_1028_8605 |
pubmed_1039_15589 | The discriminatory power of ten factors has been explored in relation to the presence or absence of muscular rigidity in patients with Huntington's disease. The sex and neurological sign of an affected parent were the only two significant determinants of rigidity or choreoathetosis in offspring. It was shown, using the Mantel-Haenszel method of adjusting for confounding variables that the risk of a patient displaying rigidity (and thereby having a graver prognosis) is five times as great for those with rigid parents as it is for those with non-rigid parents. Additionally, the risk of a patient displaying rigidity is more than three times as great for those with affected fathers as it is for those with affected mothers. Some implications of these findings are discussed. | 10.1136/jmg.17.2.112 |
pubmed_132_14848 | Nrdp1 is a RING finger ubiquitin E3 ligase that interacts with Parkin, and promotes the degradation of Parkin, a causative protein for early onset Autosomal Recessive Juvenile Parkinsonism (AR-JP). To investigate if Nrdp1 plays a role in the pathogenesis of Parkinson's disease, we generated transgenic Drosophila that expressed Drosophila Nrdp1 (dNrdp1) and dNrdp1(D56V), an aspartic acid to valine mutant at residue 56 that disrupts its ring finger domain, resulting in impaired capacity to degrade its substrate ErbB3. Our data show that a pan-neuronal expression of transgenic dNrdp1 but not dNrdp1(D56V) mutant leads to the loss of dopaminergic neurons in brains, resulting in reduction of dopamine production. These flies also manifested decreased flight ability. Co-expression of human Parkin (hParkin) provides protection against toxicity induced by over-expression of dNrdp1, reversing the effects of dNrdp1 on death of dopaminergic neurons, reduction of dopamine production, and decreased flight ability. Taken together, we conclude that Nrdp1 plays a role in neurodegeneration and could be potentially targeted as a therapeutic strategy for Parkinson's disease. | 10.1016/j.bbrc.2011.10.104 |
pubmed_1061_3921 | PURPOSE OF REVIEW
The microbiota in mammalian hosts can affect maturation and function of the immune system and has been associated with health and disease. We will review new findings on how this dynamic environmental factor impacts alloimmunity and therapy in transplant hosts.
RECENT FINDINGS
The microbiota changes after transplantation and immunosuppressive therapy. New data indicate that different microbial community structures have distinct impact on graft outcome, from promoting, to inhibiting or being neutral to transplant survival. In addition, we will address reciprocal interactions between the microbiota and immunosuppressive drugs, as well as the suitability of the microbiota as a predictive biomarker and its utility as adjunct therapy in transplantation.
SUMMARY
Advances in microbiome sequencing and wider availability of gnotobiotic facilities are enabling mechanistic investigations into the commensal communities and pathways that modulate allograft outcome, responsiveness to immunosuppression and side effects of drugs. A better understanding of the functions of the microbiota may help mitigate drug toxicity, predict drug dosage and dampen alloimmunity in transplant patients. | 10.1097/MOT.0000000000000702 |
pubmed_153_11943 | AIM
The aim of this study was to analyze clinical findings and treatment outcomes of patients with endoscopic retrograde cholangiopancreatography complications.
BACKGROUND
Endoscopic retrograde cholangiopancreatography has become a very common procedure for the evaluation and treatment of biliary and pancreatic diseases.
PATIENTS AND METHODS
A retrospective review of 2447 endoscopic retrograde cholangiopancreatography procedures and their complications since Apr 2006 till Dec 2010 was conducted to identify their incidence, optimal management, and clinical outcomes.
RESULTS
2447 endoscopic retrograde cholangiopancreatography procedures were performed. Overall, complications developed in 168 (6.9%) cases: perforation in 10 (0.4%), hemorrhage in 4 (0.16%) and mild to severe pancreatitis in 154 (6.3%). The patients mean age was 66± 6 yrs with females/ males of 1432(58.5%)/ 1015(41.5%). Abdominal pain, nausea, leukocytosis and hyperamylasemia were most common findings in these patients. Surgery was performed for 6 patients (0.24%). The most hospital station was 20 days: surgical group 7±2 days, pancreatitis 11± 4 days and average 6 days for others.
CONCLUSION
Endoscopic retrograde cholangiopancreatography remains the endoscopic procedure that carries a high risk for morbidity and or mortality. The majority of events are of mild-to-moderate severity and when surgery should be done, it depends upon the clinicopathological condition and we don't advise pyloric exclusion, gastrojejunostomy and duodenal diversion for these patients. | pubmed_153_11943 |
pubmed_348_12174 | We present a compact mid-infrared laser spectrometer for trace-gas monitoring. Difference frequency generation in periodically poled LiNbO(3) is used as laser source, yielding a tuning range 3.2-3.7mum at a linewidth of 154 MHz. The relatively high average power of 3 to 5 mW favors detection with a small resonant photoacoustic gas cell. Measurements of methane yield a detection limit in the low parts in 10(6) by volume concentration range. | 10.1364/ol.26.001609 |
pubmed_20_9261 | OBJECTIVE
To compare knee kinematics and kinetics during walking in patients with posttraumatic versus nontraumatic medial compartment knee osteoarthritis (OA).
METHODS
Participants with medial compartment knee OA were classified as nontraumatic (n = 122) or posttraumatic (n = 93) based on evidence of previous anterior cruciate ligament tear, confirmed arthroscopically. Kellgren/Lawrence severity scores and mechanical axis angle (MAA) were determined from radiographs. Knee flexion and adduction angles and external moments were calculated from gait analysis using a 3-dimensional optical motion capture system and force plate. Peak values were identified and principal component (PC) analysis determined waveform characteristics (PC scores). Linear regression models examined whether the OA group (posttraumatic or nontraumatic) predicted peak values and PC scores after controlling for age, gait speed, and severity. Models were repeated with and without controlling for MAA.
RESULTS
The knee OA group was a significant predictor of peak knee adduction angles (P = 0.04) and moments (P = 0.05). Similarly, it was a significant predictor for some knee adduction angle (P = 0.02 to 0.64) and moment (P = 0.02 to 0.25) PC scores. The nontraumatic OA group had higher adduction angles and moments. There were no significant relationships between OA group and knee flexion angles and moments. After controlling for MAA, only one significant relationship remained between knee adduction moment shape characteristics and OA group.
CONCLUSION
Frontal plane knee kinematics and kinetics during walking differ between patients with posttraumatic versus nontraumatic medial compartment knee OA, with posttraumatic OA showing relatively decreased adduction. | 10.1002/acr.22822 |
pubmed_952_11363 | We studied two adult patients with fulminating, necrotizing vaso-occlusive retinitis, and documented the progressive course of retinal necrosis, vitreoretinal interface contraction, and consequent retinal detachment. The systemic criteria for Behçet's disease were present in one patient, and partially fulfilled in the second. | 10.1016/0002-9394(77)90854-6 |
pubmed_660_4516 | The nutritional requirements of high-producing dairy cows increase rapidly in the weeks postpartum due to elevated milk production, and most cows enter a state of negative energy balance (NEB). Cows in this condition may preferentially divert nutrients away from reproduction, thereby experiencing a period of anovulatory anestrus, delayed ovulation of large follicles, and impaired fertility. To better understand the changes occurring in these large follicles as a function of time postpartum, granulosa cells from preovulatory follicles were collected at different times after calving: 30 days, 60 days, 90 days, and 120 days from a minimum of six animals at each time point. Three subjects for each period were selected for the analysis of the transcriptome, which was performed using a global bovine oligoarray microarray to identify differences in gene expression and cellular functions that occur in the follicular microenvironment during the progressive recovery from NEB in dairy cows. The time point 120 days was chosen as a reference period, as cows are then fully recovered from NEB. Data clustering indicated that the most different period from 120 days was 60 days with several 100 genes deregulated at that time. The principal cellular functions affected were cell proliferation, which was reduced, and deregulation of steroidogenesis, indicating immaturity of the follicles from the 60-day period relative to 120 days. One of the most interesting downregulated pathways was p38 mitogen-activated protein kinase, which is sensitive to the amount of retinoic acid or vitamin A, suggesting a possible treatment to improve postpartum fertility. | pubmed_660_4516 |
pubmed_690_14104 | A central issue in clinical radiobiological research is the prediction of responses to different radiation qualities. The choice of cell survival and dose-response model greatly influences the results. In this context the relationship between theory and model is emphasized. Generally, the interpretations of experimental data depend on the model. Cell survival models are systematized with respect to their relations to radiobiological theories of cell kill. The growing knowledge of biological, physical, and chemical mechanisms is reflected in the formulation of new models. The present overview shows that recent modelling has been more oriented towards the stochastic fluctuations connected to radiation energy deposition. This implies that the traditional cell survival models ought to be complemented by models of stochastic energy deposition processes and repair processes at the intracellular level. | 10.3109/02841869209088286 |
pubmed_713_10130 | BACKGROUND
Intussusception occurs when a segment of the bowel (the intussusceptum) telescopes into an adjacent segment (the intussuscipiens). Adult intussusception occurs rarely and often requires surgical resection for its treatment. We describe the case of an adult patient with extremely rare cecorectal intussusception treated using a novel combined transabdominal and trans-anal approach, which has not yet been reported in the literature.
CASE PRESENTATION
A 71-year-old woman was transferred to our hospital for the treatment of upper abdominal pain. Physical examination, laboratory tests, and imaging inspections showed strangulated bowel obstruction induced by intussusception associated with the intra-rectal mass. We performed an emergency operation and treated the intussusception using a combined transabdominal and trans-anal approach. The intraoperative findings revealed bloody ascites and a potentially malignant tumor that had moved toward the anal side from peritoneal reflection. The tumor served as the lead point in the cecum with mobile cecum. After reducing the intussusception using the combined procedure, we removed the ileocecal portion. The intraoperative and histopathological findings suggested that cecum cancer with mobile cecum had caused the cecorectal intussusception. The patient had an uneventful postoperative course, except for postoperative pulmonary pneumonia.
CONCLUSION
To the best of our knowledge, this is the first reported case of adult cecorectal intussusception due to cecum cancer with mobile cecum successfully treated using the combined transabdominal and trans-anal approach. This combined procedure may be useful in treating the intussusception where the lead point is distal from the peritoneal reflection. | 10.1186/s40792-021-01180-0 |
pubmed_1076_19653 | Balance between effector T cells (Teff) and regulatory T cells (Treg) appears to be very crucial for effective anti-tumor immunotherapy. The therapeutic efficacies of enhancement of Teff and suppression of Treg were compared between two murine hepatoma cell lines of a similar origin, MH129 and MH134. Enhancement of Teff was achieved by infection of tumor cells with adenovirus expressing glucocorticoid-induced tumor necrosis factor receptor-related protein (GITR), and suppression of Treg, by depletion of CD4+CD25+ naturally occurring Treg by administration of anti-CD25 monoclonal antibody (PC61) or low-dose cyclophosphamide. Our data show that MH129 cells were susceptible to Treg depletion but resistant to GITR expression, and vice versa for MH134 cells. Thus, in MH129 cells, injection of PC61 prior to or after tumor cell inoculation completely or partially, respectively, eradicated tumor growth. Low-dose cyclophosphamide administered after tumor cell inoculation also delayed tumor growth. However, GITR expression either in vitro or in vivo exhibited little effect. In contrast, in MH134 cells, PC61 induced partial tumor growth delay only when injected prior to tumor cell inoculation, and low-dose cyclophosphamide showed no effect, but GITR, particularly when administered in vitro, inhibited tumor growth. An additive effect of PC61 and GITR was observed only in MH134 cells. The ratios of peripheral CD4+CD25+ to CD4+ T cells remained unaltered during the experimental course in both tumor models. From these results we speculate that this different sensitivity may be due to a difference in relative induction levels of Teff versus Treg, not due to different immunogenicity or different kinetics of peripheral Treg, between the two tumor models. Future studies identifying antigen(s) or epitope(s) specific for Teff and Treg in these tumor cell lines are necessary as analysis of the immune response to such antigen(s) or epitope(s) may in general help predict the relative efficacy of different immunotherapies against distinct tumors. | pubmed_1076_19653 |
pubmed_810_270 | Regulation of proteins across the cell cycle is a basic process in cell biology. It has been difficult to study this globally in human cells due to lack of methods to accurately follow protein levels and localizations over time. Estimates based on global mRNA measurements suggest that only a few percent of human genes have cell-cycle dependent mRNA levels. Here, we used dynamic proteomics to study the cell-cycle dependence of proteins. We used 495 clones of a human cell line, each with a different protein tagged fluorescently at its endogenous locus. Protein level and localization was quantified in individual cells over 24h of growth using time-lapse microscopy. Instead of standard chemical or mechanical methods for cell synchronization, we employed in-silico synchronization to place protein levels and localization on a time axis between two cell divisions. This non-perturbative synchronization approach, together with the high accuracy of the measurements, allowed a sensitive assay of cell-cycle dependence. We further developed a computational approach that uses texture features to evaluate changes in protein localizations. We find that 40% of the proteins showed cell cycle dependence, of which 11% showed changes in protein level and 35% in localization. This suggests that a broader range of cell-cycle dependent proteins exists in human cells than was previously appreciated. Most of the cell-cycle dependent proteins exhibit changes in cellular localization. Such changes can be a useful tool in the regulation of the cell-cycle being fast and efficient. | 10.1371/journal.pone.0048722 |
pubmed_177_7083 | OBJECTIVE
The Cancer Care Index (CCI), a single metric that sums the number of undesirable patient events in a given time frame (either preventable harm events or missed opportunities to provide optimal care), resulted in a 42% improvement in performance. Our objective was to test the index concept in other service lines to determine whether similar performance improvement occurred.
STUDY DESIGN
Care indices were developed and introduced in 3 additional service lines: Nephrology (Chronic Kidney Disease Care Index; CKDCI), Pulmonology (Lung Transplantation Care Index; LTCI), and Otolaryngology (Tracheostomy Care Index; TCI). After reaching agreement on specific harms to be avoided and elements of optimal care that should be reliably delivered, these items were compiled into indices that were updated monthly. Reports included each element individually and the total for all elements. Baseline performance was calculated retrospectively for the previous year.
RESULTS
Significant improvement in performance occurred in each program following implementation of the clinical indices. The CKDCI was decreased by 63.2% (P < .001), the LTCI was decreased by 89.5% (P < .001), and the TCI was decreased by 53.0% (P < .001). Surveyed staff indicated satisfaction with use of the metric.
CONCLUSIONS
Clinical indices are useful for evaluating and managing the overall reliability of a program's ability to deliver optimal care, and are associated with improved clinical performance and satisfaction by service line staff when incorporated into a program's operation. | 10.1016/j.jpeds.2017.09.073 |
pubmed_457_9236 | 1-O-acylceramide is a new class of epidermal cer-amide (Cer) found in humans and mice. Here, we report an ESI linear ion-trap (LIT) multiple-stage MS (MSn) approach with high resolution toward structural characterization of this lipid family isolated from mice. Molecular species desorbed as the [M + H]+ ions were subjected to LIT MS2 to yield predominately the [M + H - H2O]+ ions, followed by MS3 to cleave the 1-O-acyl residue to yield the [M + H - H2O - (1-O-FA)]+ ions. The structures of the N-acyl chain and long-chain base (LCB) of the molecule were determined by MS4 on [M + H - H2O - (1-O-FA)]+ ions that yielded multiple sets of specific ions. Using this approach, isomers varied in the 1-O-acyl (from 14:0- to 30:0-O-acyl) and N-acyl chains (from 14:0- to 34:1-N-acyl) with 18:1-sphingosine as the major LCB were found for the entire family. Minor isomers consisting of 16:1-, 17:1-, 18:2-, and 19:1-sphingosine LCBs with odd fatty acyl chain or with monounsaturated N- or O-fatty acyl substituents were also identified. An estimation of more than 700 1-O-acylceramide species, largely isobaric isomers, are present, underscoring the complexity of this Cer family. | 10.1194/jlr.D071647 |
pubmed_688_2173 | The rate of positive tuberculin skin tests for Latino children was examined to help define high risk groups. We reviewed 330 charts of subjects, 18 years of age or younger, with one or more tuberculin (5 tuberculin units, purified protein derivative) skin test readings in a 5-year period. Overall 9% of United States-born and 53% of foreign-born Latinos had positive tuberculin tests (P less than 0.01). Repeat applications identified 35 converters and a greater proportion of United States-born Latinos were in this group (P less than 0.05). Radiographic changes on chest films consistent with active tuberculous disease were found in four of the foreign-born converters. The calculated tuberculin conversion rate of these Latinos is 15 to 30 times that of the United States general population. Unsuspected transmission of tuberculosis may be one possible explanation. We recommend that: clinicians should perform routine tuberculin skin tests in healthy Latino children whether born in the United States or in a foreign country; and active screening for tuberculosis of Latino immigrants by local health departments be conducted with appropriate funding support. | 10.1097/00006454-198509000-00007 |
pubmed_1014_4364 | BACKGROUND
Asthma is one of the most common chronic diseases in the world, and previous studies have reported low levels of control. Recent developments in the availability and use of online sources of information about asthma might add to patients' knowledge and help improve control.
AIMS
To investigate whether asthma control has improved by assessing levels of symptoms, exacerbations and Global Initiative for Asthma-defined control in a real-life population of patients who use the Internet and social media, as well as evaluate patient perception of control and attitudes to asthma.
METHODS
Online surveys were conducted among 8,000 patients with asthma (aged 18-50 years, ≥2 prescriptions in the previous 2 years, use of social media) from 11 European countries.
RESULTS
Levels of asthma control were low: 45% of respondents had uncontrolled asthma. Acute exacerbations were common: 44% of respondents reported having used oral steroids for asthma in the previous 12 months, 24% had visited an emergency department and 12% had been hospitalised. More than 80% of respondents (overall, and among those with a history of exacerbations) considered their asthma to be controlled. Of those who had an exacerbation requiring oral steroids, 75% regarded their asthma as not serious.
CONCLUSIONS
Asthma control in Europe remains poor; symptoms and exacerbations are common. Many patients regard their asthma as controlled and not serious despite experiencing symptoms and exacerbations. There is a need to assess patients' control, risk and inhaler technique, and to ensure that patients are prescribed, and take, appropriate treatments. | 10.1038/npjpcrm.2014.9 |
pubmed_528_4310 | INTRODUCTION
Dynamic exercise therapy as defined by the American College of Sports Medicine for healthy individuals is of unclear relevance to patients with rheumatoid arthritis (RA). No recommendations on this issue are available. Few studies have evaluated the optimal program, frequency, or target population; furthermore, there is no consensus about the best assessment tools for monitoring clinical, functional, and structural parameters during dynamic exercise therapy in patients with RA.
METHODS
We conducted an extensive review of the literature published between 1964 and 2005. We identified nine randomized controlled studies that provided a high level of proof regarding the effects of dynamic exercise therapy in RA patients older than 18 years of age.
RESULTS
Dynamic exercise programs improve aerobic capacity and muscle strength in patients with RA. Their effects on functional capacity are unclear, and many sources of bias influenced the study results. The clinical and laboratory safety profiles were good. The structural impact of dynamic exercise remains to be determined. | 10.1016/j.jbspin.2007.04.015 |
pubmed_805_11724 | Seventeen patients with relapsing remitting multiple sclerosis (MS) and mild physical disability had neuropsychological testing, magnetic resonance imaging (MRI) and single photon emission computerised tomography (SPECT) using technetium 99m (99mTc) hexamethyl-propyleneamine oxime (HMPAO). Performance in verbal fluency, naming and memory testing appeared to be impaired in MS patients compared with 17 age-sex and education matched normal controls. Weighted periventricular and confluent lesion scores and the width of the third ventricle, proved to be the most sensitive MRI measures in differentiating more cognitively impaired patients from those who were relatively unimpaired. Ratios of regional to whole brain activity, measured by SPECT, showed significant reduction in the frontal lobes and in the left temporal lobe of MS patients. A relationship was found between left temporal abnormality in 99mTc-HMPAO uptake and deficit in verbal fluency and verbal memory. Finally, asymmetrical lobar activity indicated a predominant left rather than right temporo-parietal involvement. | 10.1136/jnnp.54.2.110 |
pubmed_559_9274 | We present a real-time PCR approach for the identification and subtyping of HLA-DR4 alleles. The technique, which uses sequence-specific primers and probes in conjunction with real-time PCR for the detection and differentiation of target alleles, is rapid, involves minimal hands-on time, and is inexpensive compared to existing methods. Further, there is no post-PCR handling, so the risk of contamination is avoided. We have validated the assay using 44 blinded and 56 unblinded samples, which were identified with 100% accuracy, sensitivity, and specificity. We demonstrate the applicability of this assay as an alternative approach to traditional HLA typing methods. | 10.1016/j.jim.2006.09.003 |
pubmed_213_20668 | Morphological features of four tumours of the spinal cord in two strains of rats (BDIX/Han and Han:SPRD) are described. Histological classification as ependymoma, glioblastoma (multiforme), astrocytoma and oligodendroglioma was made. | 10.1016/0021-9975(89)90133-3 |
pubmed_932_18369 | Recent advances in our understanding of the biology of muscle, and how anabolic and catabolic stimuli interact to control muscle mass and function, have led to new interest in the pharmacological treatment of muscle wasting. Loss of muscle occurs as a consequence of several chronic diseases (cachexia) as well as normal aging (sarcopenia). Although many negative regulators [Atrogin-1, muscle ring finger-1, nuclear factor-kappaB (NF-κB), myostatin, etc.] have been proposed to enhance protein degradation during both sarcopenia and cachexia, the adaptation of mediators markedly differs among these conditions. Sarcopenic and cachectic muscles have been demonstrated to be abundant in myostatin- and apoptosis-linked molecules. The ubiquitin-proteasome system (UPS) is activated during many different types of cachexia (cancer cachexia, cardiac heart failure, chronic obstructive pulmonary disease), but not many mediators of the UPS change during sarcopenia. NF-κB signaling is activated in cachectic, but not in sarcopenic, muscle. Some studies have indicated a change of autophagic signaling during both sarcopenia and cachexia, but the adaptation remains to be elucidated. This review provides an overview of the adaptive changes in negative regulators of muscle mass in both sarcopenia and cachexia. | 10.1007/s13539-011-0052-4 |
pubmed_1011_5946 | The appearance and disapperance of total radioactivity in plasma and cerebrospinal fluid (CSF) were studied after a single intravenous injection of tritium-labelled cyclic adenosine 3', 5'-monophosphate (cAMP) into rabbits and cats. The radioactivity was rapidly cleared both from plasma and relatively stable when compared to plasma cAMP level. Exogenous cAMP in plasma does not seen to distribute into CSF by a simple diffusion. | pubmed_1011_5946 |
pubmed_56_3866 | BACKGROUND
Bonding brackets to dental surfaces restored with composites are increasing. No studies to date have assessed the efficacy of laser irradiation in roughening of composite and the resulted shear bond strength (SBS) of the bonded bracket. We assessed, for the 1(st) time, the efficacy of two laser beams compared with conventional methods.
MATERIALS AND METHODS
Sixty-five discs of light-cured composite resin were stored in deionized distilled water for 7 days. They were divided into five groups of 12 plus a group of five for scanning electron microscopy (SEM): Bur-abrasion followed by phosphoric acid etching (bur-PA), hydrofluoric acid conditioning (HF), sandblasting, 3 W and 2 W erbium-doped yttrium aluminum garnet laser irradiation for 12 s. After bracket bonding, specimens were water-stored (24 h) and thermocycled (500 cycles), respectively. SBS was tested at 0.5 mm/min crosshead speed. The adhesive remnant index (ARI) was scored under ×10 magnification. SEM was carried out as well. Data were analyzed using analysis of variance (ANOVA), Kruskal-Wallis, Tukey, Dunn, one-sample t-test/Wilcoxon tests, and Weibull analysis (α =0.05).
RESULTS
The SBS values (megapascal) were bur-PA (11.07 ± 1.95), HF (19.70 ± 1.91), sandblasting (7.75 ± 1.10), laser 2 W (15.38 ± 1.38), and laser 3 W (20.74 ± 1.73) (compared to SBS = 6, all P = 0.000). These differed significantly (ANOVA P = 0.000) except HF versus 3 W laser (Tukey P > 0.05). ARI scores differed significantly (Kruskal-Wallis P = 0.000), with sandblasting and 2 W lasers having scores inclined to the higher end (safest debonding). Weibull analysis implied successful clinical outcome for all groups, except for sandblasting with borderline results.
CONCLUSION
Considering its high efficacy and the lack of adverse effects bound with other methods, the 3 W laser irradiation is recommended for clinical usage. | 10.4103/2278-0203.176654 |
pubmed_179_4629 | Kugel's artery is defined as a rare anatomical variant of the coronary artery vascular bed consisting of an anastomotic connection between branches of the right coronary artery (RCA) and/or left circumflex artery (LCX). Kugel's artery has been reported to have an incidence of 6% in the general population. The presence of this anastomotic communication may play a pathophysiological role in a patient with a right dominant coronary circulation and an underlying coronary artery disease (CAD) affecting the right coronary system. Understanding the existence and significance of Kugel's artery and the anastomotic network cannot be overemphasized. The presence of an anomalous vascular connection bypassing an area of epicardial vessel occlusion may be a lifesaving pathophysiological finding that maintains myocardial perfusion and viability. Herein, we present a case with multivessel occlusion myocardial infarction found to have anomalous vascular anastomosis between the proximal RCA and distal segment of the same artery. | 10.7759/cureus.17039 |
pubmed_162_25014 | Precise tunability of electronic properties of two-dimensional (2D) nanomaterials is a key goal of current research in this field of materials science. Chemical modification of layered transition metal dichalcogenides leads to the creation of heterostructures of low-dimensional variants of these materials. In particular, the effect of oxygen-containing plasma treatment on molybdenum disulfide (MoS2) has long been thought to be detrimental to the electrical performance of the material. We show that the mobility and conductivity of MoS2 can be precisely controlled and improved by systematic exposure to oxygen/argon plasma and characterize the material using advanced spectroscopy and microscopy. Through complementary theoretical modeling, which confirms conductivity enhancement, we infer the role of a transient 2D substoichiometric phase of molybdenum trioxide (2D-MoO ) in modulating the electronic behavior of the material. Deduction of the beneficial role of MoO will serve to open the field to new approaches with regard to the tunability of 2D semiconductors by their low-dimensional oxides in nano-modified heterostructures. | 10.1126/sciadv.aao5031 |
pubmed_905_14706 | The potential of deuterated pharmaceuticals is being widely demonstrated. Here we describe the first trideuteromethylation under radical reaction conditions using deuterated dimethyl sulfoxide as a reagent for the synthesis of labelled heterocycles and trideuteromethylated compounds. A broad scope of the developed method for the synthesis of various scaffolds was demonstrated. | 10.1039/c6cc07196a |
pubmed_949_5107 | BACKGROUND
Institutional variation in the quality of medical care may be evaluated by examining process measures, such as use of diagnostic procedures or treatment modalities, or outcome measures, such as mortality. We undertook this study to examine variations in both process and outcome of care for patients with HIV-related Pneumocystis carinii pneumonia (PCP) at two geographically diverse, HIV-experienced, public municipal hospitals.
DESIGN
Retrospective review of hospitalized patients diagnosed as having PCP cared for at two municipal hospitals from 1988 to 1990. At hospital A, charts of all patients diagnosed as having PCP were abstracted (n=209); at hospital B, a random sample of 15% were abstracted (=136).
RESULTS
Among all hospitalized patients diagnosed as having PCP, the frequency of making a definitive diagnosis of PCP (as opposed to treating empirically) differed markedly at the two hospitals (85% in hospital A vs 26% in hospital B; p<0.001), as did the use of intensive care (18% vs 3%; p<0.001) and "do-not-resuscitate" orders (39% vs 14%; p<0.001), although the timing of starting anti-Pneumocystis medications (89% vs 88% within the first 2 hospital days) and the use of corticosteroids (21% vs 23%) were similar. Despite differences in the process of care, survival rates were similar at the two institutions (75% vs 76%; p=0.8) and remained similar when logistic regression was used to control for demographic variables and severity of illness (odds ratio for survival, hospital B vs A, 1.2 [95% confidence interval, 0.7, 2.0]). The 95% confidence intervals (0.7, 2.0), however, were consistent with a considerable (and clinically significant) disparity in survival (from 30% lower to a twofold higher odds of survival). Sample size calculations showed that a sample of 10 cases in each hospital would be required to detect the observed difference in definitive diagnosis rates (85% vs 26%), but 722 cases in each hospital would be required to detect a relevant difference in mortality.
CONCLUSIONS
The process of care for hospitalized patients with PCP in these two institutions differed considerably, but the survival rates were not significantly different, even after adjusting for confounding factors. While sample sizes available at the individual institutions were sufficient for evaluation of the process of care, they did not provide the power necessary to evaluate outcomes. Comparisons of outcomes such as mortality between individual hospitals may not have the statistical power to exclude important differences. | 10.1378/chest.112.2.398 |
pubmed_67_12076 | Background
Historically marginalized youth are at risk for daily substance use. Daily use may be associated with social and environmental factors.
Methods
In March 2018, we surveyed primarily Latino adolescents ages 14-18 who lived on the US-Mexico border and assessed associations between daily substance use, neighborhood stress, border community and immigration stress, and family support.
Results
Of 443 surveyed adolescents, 41 (9%) reported daily use. Those who used daily were more likely to be older, identify as male, and reported lower social support and higher neighborhood and border community stress compared to those who did not use daily. Perceived neighborhood stress (OR = 1.95, 95% CI 1.37-2.80) and border community and immigration stress (OR = 1.55, 95% CI 1.12-2.02) were associated with increased odds of daily substance use.
Discussion
Latino adolescents who live near the US-Mexico border experience unique socioenvironmental stress which is associated with daily substance use. | 10.1177/00220426211046593 |
pubmed_1099_222 | The gas-phase acidity of 3,3-dimethylcyclopropene (1) has been measured by bracketing and equilibrium techniques. Consistent with simple hybridization arguments, our value (deltaH degrees (acid) = 382.7 +/- 1.3 kcal mol(-)(1)) is indistinguishable from that for methylacetylene (i.e., deltadeltaH degrees (acid)(1 - CH(3)Ctbd1;CH) = 1.6 +/- 2.5 kcal mol(-)(1)). The electron affinity of 3,3-dimethylcyclopropenyl radical (1r) was also determined (EA = 37.6 +/- 3.5 kcal mol(-)(1)), and these quantities were combined in a thermodynamic cycle to afford the homolytic C-H bond dissociation energy. To our surprise, the latter quantity (107 +/- 4 kcal mol(-)(1)) is the same as that for methane, which cannot be explained in terms of the s-character in the C-H bonds. An orbital explanation (delocalization) is proposed to account for the extra stability of 1r. All of the results are supplemented with G3 and B3LYP computations, and both approaches are in good accord with the experimental values. We also note that for simple hydrocarbons which give localized carbanions upon deprotonation there is an apparent linear correlation between any two of the following three quantities: deltaH degrees (acid), BDE, and EA. This observation could be of considerable value in many diverse areas of chemistry. | 10.1021/ja035725s |
pubmed_202_8756 | A comparative study of thermo-acid stable proteinase inhibitor from rabbit serum and commercial drug contrykal was made on rats and in vitro experiments. Both inhibitors in equal doses effectively suppress proteolytic activity during initiation of lung inflammation. It was shown that the thermo-acid stable inhibitor possesses higher than contrykal, antielastase activity. A high effect of the acid stable inhibitors in the treatment of lung disease is suggested. | pubmed_202_8756 |
pubmed_587_9590 | OBJECTIVE
Experiences with psychoeducational groups have been extensively reported for schizophrenic patients and their families. For patients with affective disorders, however, only a few publications exist. We describe results and conclusions for clinical practice with a type of psychoeducational group that addresses family members of in-patients treated at a specialized depression ward. The group sessions are every other week and we try to take up the questions asked by the attenders in order to concentrate on their personal needs.
METHODS
Protocols of 40 group sessions over 18 months were analysed concerning attendance figures, degree of relatedness to the patient, main topics and questions, and emotional condition of the participants.
RESULTS
The 40 group sessions were attended by 400 participants (mean = 10; median = 9). About 50 % of them were spouses. For the other family members, there was a clear association between female patients and female attenders. Main question was how to deal with the patient, at present and after discharge. With regard to the emotional state, 23 % were under strain themselves, 7 % were skeptical and 23 % could be described as relieved.
CONCLUSIONS
This kind of group reaches a considerable number of family members, who in general highly appreciate these sessions. The therapeutic team also benefits from enlarging their knowledge by including the relatives' perspective. Therefore, the effort for preparing and holding the group session seems to be justified and rewarding. To our opinion, good attendance figures can be reached by personal invitation of the relatives and by being flexible and oriented towards their needs. | 10.1055/s-2002-25101 |
pubmed_788_9917 | Two cyclolanostane-type saponins, astragalosides I and II, were first identified by TLC-MS/MS in the ethyl acetate extract of the roots of Astragalus membranaceus Bge var. mongholicus (Bge.) Hsiao without chemical reference substances. They were then isolated by high-speed counter-current chromatography with a two-step two-phase solvent system of ethyl acetate-2-propanol-water (5:1:5, 50:1:50, v/v/v). The quantities of astragalosides I and II isolated from 1 g of the crude extract were 30.2 mg and 16.5 mg, respectively. Their purities were found to be over 95% by HPLC-ELSD analysis. Their chemical structures were confirmed by 1H and 13C nuclear magnetic resonance analysis. | 10.1002/jssc.200600264 |
pubmed_932_18687 | Statins are recognized as the principal and most effective class of drugs for reducing serum cholesterol levels and, therefore, significantly reducing cardiovascular events and mortality. Statins may have a wide range of beneficial biological effects in addition to lipid lowering, a phenomenon commonly termed a 'pleiotropic effect'. However, the dose-dependency of these effects remains unclear. The present study evaluated whether atorvastatin, a potent statin, ameliorates the serum markers of pleiotropic effects, with a focus on dose-dependency. The pleiotropic effects of treatment with atorvastatin 5 mg/day and 10 mg/day for six months each in 15 patients with primary hypercholesterolemia were assessed in a prospective, randomized, open-label, crossover, single-centre study. Atorvastatin treatment dose-dependently decreased a serum marker of oxidative stress as well as the serum low-density lipoprotein cholesterol level. However, serum markers of inflammation and fibrinolysis decreased independently of dose. In conclusion, the dose-dependency of atorvastatin's pleiotropic effects differs among individual biological effects. | 10.1055/s-0031-1278256 |
pubmed_788_14322 | An internal pilot design uses interim sample size analysis, without interim data analysis, to adjust the final number of observations. The approach helps to choose a sample size sufficiently large (to achieve the statistical power desired), but not too large (which would waste money and time). We report on recent research in cerebral vascular tortuosity (curvature in three dimensions) which would benefit greatly from internal pilots due to uncertainty in the parameters of the covariance matrix used for study planning. Unfortunately, observations correlated across the four regions of the brain and small sample sizes preclude using existing methods. However, as in a wide range of medical imaging studies, tortuosity data have no missing or mistimed data, a factorial within-subject design, the same between-subject design for all responses, and a Gaussian distribution with compound symmetry. For such restricted models, we extend exact, small sample univariate methods for internal pilots to linear mixed models with any between-subject design (not just two groups). Planning a new tortuosity study illustrates how the new methods help to avoid sample sizes that are too small or too large while still controlling the type I error rate. | 10.1002/sim.2840 |
pubmed_89_18438 | The use of highly efficient methods and natural raw materials in syntheses of new biologically active substances addresses the current challenges in this area: ensuring the highest possible efficacy at low concentrations and reducing negative environmental impact. In the present study, we applied this strategy to obtain a new group of ionic liquids containing the indole-3-acetate anion, which is a well-known plant growth hormone, and a cation derived from a cinchona alkaloid - quinine or quinidine. A comparison of the derivatization kinetics of both alkaloids was also carried out, and the use of a quaternary quinidine derivative as a source of biologically active ionic liquids is described here for the first time. The structures of the obtained compounds were fully confirmed based on spectral methods. According to analyses of the effects of the obtained compounds on the growth and development of lettuce plants (Lactuca sativa L.), the ionic liquids obtained with indole-3-acetate anions exhibited activity at a concentration of 0.5 mg dm-3, and the length of the alkyl substituent in the alkaloid-derived cation or the chirality of this cation is crucial in determining the biological activity of the compound. In the cases of several salts containing the 1-alkylquininium cation, we recorded significant, beneficial changes in micronutrient content, which directly translated into plant nutritional value, while no signs of phytotoxicity were observed. Analyses of relevant physicochemical properties (e.g., with differential scanning calorimetry, thermogravimetric analysis and solubility analysis) as well as microbial toxicity tests were also performed to evaluate the environmental impacts of the products. The promising results of our study indicate significant potential for application of these new ionic liquids derived from cinchona alkaloids. | 10.1039/d1ra04805h |
pubmed_855_13213 | Like other technical advances in medicine, the initial phase of rejection of off-pump revascularization has given way to its acceptance with some limitations. Today's main concern is whether the technique can be safely applied to access all coronary arteries, specially the postero-lateral vessels of the heart. We believe that off-pump CABG has proven to be an excellent alternative to the standard revascularization techniques avoiding the risks and complications of cardiopulmonary bypass (CPB). It can be applied to any case with minimal incidence of conversions thus avoiding the complications of CPB. In this debate we describe our technique, discuss our experience with complete myocardial revascularization, and suggest that the CPB machine should be a readily available tool for more complex cases rather than the current concept that it is an indispensable element for myocardial revascularization. | 10.1016/s0300-8932(00)75097-4 |
pubmed_361_1483 | A surface probability method was used to select a decapeptide homologous to residues 993 to 1002 of the peplomer protein E2 of murine hepatitis virus strain JHM, a neurotropic coronavirus. This sequence of amino acids corresponded to a minor peak on a hydrophilicity plot. Immunization of mice with the chemically synthesized peptide coupled to keyhole limpet hemocyanin elicited high levels of neutralizing antibody and protected against lethal virus challenge. Protection correlated with a critical level of antipeptide antibody, which could be reached after a single inoculation. These results suggest that an appropriate antibody response to a highly restricted, surface-exposed domain of this viral protein is critical in determining the outcome of infection of the central nervous system. This sequence is located in the C-terminal fifth of the E2 peplomers, between two predicted coiled-coil structures. | 10.1128/JVI.62.8.3032-3036.1988 |
pubmed_345_24172 | BACKGROUND
Temsirolimus, a selective inhibitor of the mammalian target of rapamycin, has demonstrated clinical benefit versus investigator's choice (INV) of therapy in patients with relapsed/refractory mantle cell lymphoma (MCL).
METHODS
This post hoc study retrospectively assigned simplified Mantle Cell Lymphoma International Prognostic Index (MIPI) scores (ie, secondary MIPI) based on parameters at the time of randomization in patients with MCL (N = 162) who received temsirolimus 175 mg once weekly for 3 weeks followed by once-weekly 75 mg or 25 mg or the INV of active therapy. Outcomes were analyzed according to the low-, intermediate- or high-risk category.
RESULTS
Patient distribution by MIPI risk category was 31%, 39%, and 30% in the low-, intermediate-, and high-risk groups, respectively. Among patients in all categories, objective response rate (complete response + partial response) was higher in patients in the temsirolimus 175/75-mg group versus the INV group, respectively: 42% versus 0% (low-risk); 33% versus 5% (intermediate-risk); 10% versus 0% (high-risk). Median progression-free survival was significantly longer with temsirolimus 175/75 mg versus INV, respectively, in patients with intermediate (4.3 vs 1.9 months; P = 0.035) or high (4.5 vs 1.6 months; P = 0.0025) risk, and a trend toward improvement was observed in patients with low risk (5.3 vs 2.6 months; P = 0.091). Improvement in median overall survival was observed with temsirolimus 175/75 mg versus INV in low-risk patients (18.0 vs 10.5 months, respectively; P = 0.069).
CONCLUSIONS
This analysis suggests that, compared with INV, temsirolimus demonstrated benefit in all MIPI risk categories in patients with MCL. In all treatment groups, patients with high secondary MIPI scores at baseline faced a dismal prognosis.
TRIAL REGISTRATION
ClinicalTrials.gov NCT00117598. | 10.1186/s40164-015-0006-1 |
pubmed_982_5246 | Microemulsion electrokinetic chromatography (MEEKC) using 1-butyl-3-methylimidazolium tetrafluoroborate (BMIM-BF4) ionic liquid (IL) as additive was developed for the analysis of baicalin, wogonin and baicalein in Scutellariae radix and its preparation. After conducting a series of optimizations, baseline separation was obtained for the analytes within 5min under the optimum conditions (sodium dodecyl sulfate (SDS) 0.88% (m/v) ethyl acetate 0.8% (v/v) butan-1-ol 0.2% (v/v) and the buffer composition were 25% acetonitrile (v/v), 7.5 mM BMIM-BF4 and 10 mM NaH2PO4, pH 8.2, applied voltage 17.5 kV and detection at 254 nm), the method has been successfully applied to the determination and quantification of the analytes in the extracts of S. radix (cooked), S. radix (raw) and Qingfeiyihuowan which was the preparation including S. radix. | 10.1016/j.chroma.2006.08.016 |
pubmed_556_18006 | PURPOSE
The purpose of this study was to evaluate the safety and feasibility of transarterial fiducial marker implantation for CyberKnife radiotherapy to treat locally advanced pancreatic cancer.
MATERIALS AND METHODS
Fifteen pancreatic cancer patients were enrolled for transarterial marker implantation. Embolization platinum coils were implanted as a fiducial marker within 20 mm of the cancer edge, and preferably within 3 mm. The technical success of the implantation was defined as implantation of at least one fiducial marker within 20 mm of the target tumor. Irradiation was performed using the CyberKnife system.
RESULTS
For 14 of 15 patients, transarterial implantation was successfully performed, and for 13 of 14 patients, the tracking marker was implanted within 3 mm of the cancer. Tracking instability was observed in two patients, but irradiation was accomplished in all 14 patients. No major complications caused by the implantation procedure were observed. The median overall survival after irradiation was 13.8 months, and the 1- and 2-years survival rates were 62.9% and 32.3%, respectively.
CONCLUSION
Transarterial fiducial marker implantation for pancreatic cancer can be safely performed for tracking, and it will be a valuable alternative approach to percutaneous fiducial marker implantation. | 10.1007/s11604-020-01040-1 |
pubmed_929_18646 | BACKGROUND
Blood pressure (BP) and body mass index (BMI) trends during childhood and adolescence are complex, making context-specific projections necessary to inform prevention and presage changes.
OBJECTIVE
This study aimed to project BP and BMI in Hong Kong Chinese children and adolescents from 2015 to 2024 based on trends in BP and BMI observed from 1996/99 to 2014.
METHODS
We decomposed recent trends into sex-specific contributions of age, period and cohort using age-period-cohort linear regression with Bayesian inference and autoregressive priors based on BP in children and adolescents aged 9-18 years from 1999 to 2014 and BMI in those aged 6-18 years from 1996 to 2014. We then used the resultant models to project BP and BMI from 2015 to 2024.
RESULTS
During the study period, systolic BP decreased from 1999 to 2004/5 before gradually increasing to 2014 during childhood (for boys: from 104.6 to 101.9 and then to 103.4 mmHg) and during adolescence. Similar patterns were observed for diastolic BP. BMI generally increased from 1996 to 2009 before falling to 2014 during childhood (e.g. for boys: from 17.2 to 18.0 and then to 17.1 kg/m2). From 2015 onwards, systolic BP was projected to increase in girls, but remain stable in boys. For both sexes, diastolic BP was projected to increase, whereas BMI was projected to decrease to 2024.
CONCLUSIONS
In this economically developed Chinese setting, future trends in BP and BMI in children and adolescents are predicted to be divergent, consistent with prior discordant trends in BP and BMI. | 10.1186/s12887-020-1928-2 |
pubmed_547_15377 | AIMS
To evaluate whether determination of the central retinal artery and vein collapse pressure correlate with systemic blood pressure measurements, using a new Goldmann contact lens associated ophthalmodynamometric device
METHODS
The prospective clinical study included 92 eyes of 92 patients presenting with cataract or refractive problems (n = 40; control study group) or with retinal and orbital pathologies (n = 52). With topical anaesthesia, a Goldmann contact lens fitted with a pressure sensor in its holding ring was placed onto the cornea. Pressure was asserted onto the globe by pressing the contact lens, and the pressure value at the time when the central retinal artery and vein started pulsating were noted as central retinal artery and vein collapse pressure. Additionally, the brachial arterial blood pressure was measured.
RESULTS
In the control study group, central retinal artery collapse pressure was highly significantly correlated with diastolic blood pressure (correlation coefficient r = 0.77; p<0.001) and systolic blood pressure (r = 0.35; p = 0.03). Central retinal vein collapse pressure was statistically independent of diastolic blood pressure (p = 0.11). In eyes with retinal or orbital diseases, the correlation coefficients were lower than in the control study group. In eyes with retinal arterial occlusions, central retinal vessel collapse pressure measurements were not correlated with arterial blood pressure measurements.
CONCLUSIONS
Depending on coexisting retinal or orbital diseases, ophthalmodynamometric estimation of the central retinal artery collapse pressure, performed during a routine Goldmann contact lens ophthalmoscopy, correlates with systemic blood pressure measurements. | 10.1136/bjo.2003.030650 |
pubmed_548_10901 | OBJECTIVE
To verify the regulatory effects of acupuncture on exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) at stable phase.
METHODS
Thirty cases of COPD were randomly divided into a treatment group (16 cases) and a placebo group (14 cases). Based on specified aerobic exercise, acupuncture was applied in the treatment group and placebo acupuncture was used in the placebo group. The acupoints included Danzhong (CV 17), Rugen (ST 18), Guanyuan (CV 4), Zhongwan (CV 12), Tianshu (ST 25) and so on. The needle did not penetrate into the skin for the placebo group. The treatment was required for 2 to 3 times per week for totally 5 weeks. The indices of exercise tolerance, including 6-min walking distance (6-MWD), exercise time, maximum oxygen uptake (VO2max) forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC), maximum ventilatory volume (MVV), St. George respiratory questionnaire (SGRQ) were observed in two groups before and after treatment.
RESULTS
(1) Exercise tolerance: the differences of 6-MWD and exercise time were statistically significant between groups, which were more superior in the treatment group (both P<0.01); the VO2max was significantly increased after treatment in the treatment group (P<0.05), but there was no difference between two groups (P>0.05). (2) Pulmonary ventilation function: the differences of FEV1%, FEV1/FVC and MVV% were statistically significant between groups, which were more superior in the treatment group (P<0.05, P<0.01); (3) SGRQ: the SGRQ was significantly improved after treatment in the treatment group (P<0.05), but there was no difference between two groups (P>0.05).
CONCLUSION
The acupuncture could improve the exercise tolerance in patients with chronic obstructive pulmonary disease at stable phase, and shorten the onset time of aerobic exercise. Besides, acupuncture combined with aerobic exercise could effectively improve the pulmonary function. | pubmed_548_10901 |
pubmed_38_24115 | BACKGROUND & AIMS
Inherited mutations in the BRCA2 tumor suppressor have been associated with an increased risk of pancreatic cancer. To establish the contribution of Brca2 to pancreatic cancer we developed a mouse model of pancreas-specific Brca2 inactivation. Because BRCA2-inactivating mutations cause defects in repair of DNA double-strand breaks that result in chromosomal instability, we evaluated whether Brca2 inactivation induced instability in pancreatic tissue from these mice and whether associated pancreatic tumors were hypersensitive to DNA damaging agents.
METHODS
We developed mouse models that combined pancreas-specific Kras activation and Trp53 deletion with Brca2 inactivation. Development of pancreatic cancer was assessed; tumors and nonmalignant tissues were analyzed for chromosomal instability and apoptosis. Cancer cell lines were evaluated for sensitivity to DNA damaging agents.
RESULTS
In the presence of disrupted Trp53, Brca2 inactivation promoted the development of premalignant lesions and pancreatic tumors that reflected the histology of human disease. Cancer cell lines derived from these tumors were hypersensitive to specific DNA damaging agents. In contrast, in the presence of KrasG12D, Brca2 inactivation promoted chromosomal instability and apoptosis and unexpectedly inhibited growth of premalignant lesions and tumors.
CONCLUSIONS
Trp53 signaling must be modified before inactivation of the Brca2 wild-type allele, irrespective of Kras status, for Brca2-deficient cells to form tumors. | 10.1053/j.gastro.2010.12.039 |
pubmed_1108_6884 | How sensitive is morphogenesis to the mechanical properties of embryos? To estimate an upper bound on the sensitivity of early morphogenetic movements to tissue mechanical properties, we assessed natural variability in the apparent stiffness among gastrula-stage Xenopus laevis embryos. We adapted micro-aspiration methods to make repeated, nondestructive measurements of apparent tissue stiffness in whole embryos. Stiffness varied by close to a factor of 2 among embryos within a single clutch. Variation between clutches was of similar magnitude. On the other hand, the direction of change in stiffness over the course of gastrulation was the same in all embryos and in all clutches. Neither pH nor salinity--two environmental factors we predicted could affect variability in nature--affected tissue stiffness. Our results indicate that gastrulation in X. laevis is robust to at least twofold variation in tissue stiffness. | 10.1002/dvdy.21809 |
pubmed_720_22712 | We present a theoretical and experimental study of guided-mode resonant (GMR) spectral filters made of III-V semiconductors and operating in the long-wave infrared (LWIR) wavelength range. In the scope of the colorization of infrared photodetectors, we used materials fully compatible with the epitaxial growth of Type 2 super lattice LWIR photodetectors: heavily n-doped InAsSb for the grating and GaSb for the waveguide of the GMR resonator. | 10.1364/OL.44.003090 |
pubmed_547_13128 | OBJECTIVE
The response of patients with dystonia to pallidal procedures is not well understood. In this study, we assessed the postoperative outcome of patients with primary and secondary dystonia undergoing pallidotomy or pallidal deep brain stimulation.
METHODS
Fifteen patients with dystonia had pallidal surgery (lesions or deep brain stimulation). These included nine patients with primary dystonia (generalized and cervical dystonias) and six with secondary dystonia (generalized, segmental, and hemidystonias). There were nine male patients and six female patients. The mean age at onset was 21 years for primary dystonia and 18 years for secondary dystonia. The primary outcome measure was a Global Outcome Scale score for dystonia at 6 months after surgery. Other outcome measures were the Burke-Fahn-Marsden Dystonia Rating Scale and Toronto Western Spasmodic Torticollis Rating Scale scores.
RESULTS
The mean Global Outcome Scale score at 6 months for patients with primary dystonia was 3 (improvement in both movement disorder and function). In contrast, patients with secondary dystonia had a mean score of 0.83 (mild or no improvement in movement disorder with no functional improvement). All patients with primary dystonia had normal brains by magnetic resonance imaging, whereas five of six patients with secondary dystonia had basal ganglia abnormalities on their magnetic resonance imaging scans.
CONCLUSION
This study indicates that primary dystonia responds much better than secondary dystonia to pallidal procedures. We could not distinguish a difference in efficacy between pallidotomy and pallidal deep brain stimulation. The presence of basal ganglia abnormalities on the preoperative magnetic resonance imaging scan is an indicator of a lesser response to pallidal interventions for dystonia. | 10.1227/01.neu.0000108643.94730.21 |
pubmed_575_17863 | Numerous abiotic stressors including heavy metal stresses, specifically cadmium (Cd) stress in agricultural bio-system hinder the plant adequate growth. The present study was aimed to reveal the protective role of silicon (Si) application with two levels and to recognize the optimum level of Si for wheat plants grown hydroponically under three different levels of Cd toxicities. In methodology, we used nine treatments with three levels of Si (0, 1, and 3 mmol L-1; Na2SiO3) against three levels of Cd (0, 50, 200 μmol L-1; CdCl2) with three biological replicates. The results of our study demonstrated that Si incorporation with the advantage of 3 mmol L-1 in cultured media with Cd50 and Cd200 demolished the toxic effects of Cd on the leaves of wheat plants by increasing plant dry biomass by 88% and 262%, leaf area by 48% and 57%, total chlorophyll contents by 120% and 74%, catalase (CAT) activity by 92% and 110%, superoxide dismutase (SOD) activity by 62% and 78%, peroxidase (POD) activity by 66% and 40%, ascorbic acid (AsA) contents by 33% and 34%, glutathione (GHS) contents by 39% and 30% and reduced MDA contents by 56% and 50%, H2O2 contents by 61% and 66%, and EL contents by 56% and 47% as parallel to Cd corresponding levels. In addition, Si incorporation with the advantage of 3 mmol L-1 significantly increased relative water contents (RWC) to maintain the cell turgor pressure and protect the plant from wilting and cells flaccid and enhanced membrane stability index (MSI) to protect the plant from logging under damaging effects of Cd toxicities. Based on the present findings, Si can be considered a quasi-essential element that enhanced wheat tolerance against Cd toxicity by limiting uptake, accumulation, and translocation of Cd and through regulating antioxidative defense mechanisms. | 10.1016/j.plaphy.2021.05.038 |
pubmed_573_11435 | BACKGROUND
Pelvic exenteration is a potentially curative treatment for locally advanced primary or recurrent rectal cancer.
OBJECTIVE
This systematic review examines the current evidence regarding clinical and oncological outcomes in patients with locally advanced primary and recurrent rectal cancer who undergo pelvic exenteration.
DATA SOURCES
A literature search of PubMed, Medline, and the Cochrane library was undertaken, and studies published in the English language from January 2000 to August 2012 were identified.
STUDY SELECTION
Prospective and retrospective studies that report outcomes of pelvic exenteration for primary advanced and locally recurrent rectal cancer with or without subgroup evaluation were included for examination.
MAIN OUTCOME MEASURES
Oncological outcomes included 5-year survival, median survival, and local recurrence rates. Clinical outcomes included complication rates and perioperative mortality rates.
RESULTS
A total of 23 studies with 1049 patients were reviewed. The complication rates ranged from 37% to 100% (median, 57%) and the perioperative mortality rate ranged from 0% to 25% (median, 2.2%). The rate of local recurrence ranged from 4.8% to 61% (median, 22%). The median survival for primary advanced rectal cancers was 14 to 93 months (median, 35.5 months) and 8 to 38 months (median, 24 months) for locally recurrent rectal cancer.
LIMITATIONS
Our review was limited by the small sample sizes from single-institutional studies reporting outcomes over long periods of time with heterogeneity in both the disease and treatments reported.
CONCLUSIONS
Although the human costs and risks are significant, the potentially favorable survival outcomes make this acceptable in the absence of other effective treatment modalities that would otherwise result in debilitating symptoms that afflict patients who have advanced pelvic malignancy. | 10.1097/DCR.0b013e31827a7868 |
pubmed_191_21137 | Habitat characteristics that affect transmission and degradation of acoustical signals should influence strongly the evolution of bird songs. In this study propagation properties of songs of five antbird species were measured in a rainforest in southern Venezuela. The investigated species (Myrmothera campanisona, Thamnophilus aethiops, Thamnophilus amazonicus, Myrmotherula axillaris, and Herpsilochmus dorsimaculatus) use different song post heights at all levels of the rainforest. Because there is a height-specific pattern in degradation, it is hypothesized that their songs are adapted to species-specific transmission paths. To test this assumption, transmission parameters (excess attenuation, signal-to-noise ratio, and blur ratio) were measured for the songs at five different heights and at three different distances. In three of the five species, the results indicate a strong influence of environmental conditions on the design of the vocalizations. Degradation was minimized by the concentration of the signal to a narrower frequency range, the usage of lower frequencies, or a slower time structure for the songs near the ground. The results are discussed in relation to acoustical models of sound propagation and physiology, and it is suggested that height-dependent degradation within a forest is an important selection pressure for transmissibility in avian communication. | 10.1121/1.1420385 |
pubmed_196_14068 | The gray wolf (Canis lupus) is making a comeback in many habitats in central Europe, where it has been once extirpated. Although densities are still low to moderate, this comeback already raises management concerns. In Anatolia, the gray wolf is one of the most common predator species occupying almost all kind of habitats. Although its numbers were reduced in some parts of the country, it has never been extirpated and lived in sympatry with humans. In this study we investigated, for the first time, the winter diet of wolves in north-west Anatolia, where a multispecies wild ungulate community occurs in sympatry with high density livestock. We selected two geographically close but different habitats (steppe and forest) with different wild prey availabilities and compositions. In both areas ungulate contribution to winter diet biomass was more than 90%. Wolf pack size (four to eight wolves) were higher in the study area where livestock numbers and human disturbance were lower and wild prey were more available. In both study areas, wild boar (Sus scrofa) was the main and most preferred food item (Chesson's α = 0.7 - 0.9) and it occurred at higher density where wolf pack size was smaller. We could not find a high preference (Chesson's α = 0.3) and high winter predation pressure on the reintroduced Anatolian wild sheep (Ovis gmelinii anatolica) population that occurs in the study area covered by steppe vegetation. Contribution of livestock and food categories other than wild ungulates to wolf diet stayed low. Wolves can help mitigate human-wildlife conflict regulating wild boar numbers, the most common conflict-causing ungulate species in Anatolia. Instead of managing wolf numbers in human dominated landscapes, we recommend reintroduction of wild ungulates to the areas where they became locally extinct and replaced by livestock. | 10.7717/peerj.7446 |
pubmed_754_5581 | Infections and chronic liver injury are common causes of morbidity and mortality in alcoholics, and both of these may be related to an altered immune response. This study describes a guinea pig model of chronic ethanolism designed to selectively study the cellular immune system in a setting free from the malnutrition, socioeconomic deprivation, and severe underlying hepatic dysfunction seen in human disease. Animals were given 2.5 g/kg/day of ethanol as a 15% solution in 0.9% NaCl or isocaloric-dextrose-saline control solution intraperitoneally in 2 divided doses for 5 weeks. At 2 weeks, the mean serum ethanol level 1 hr after treatment was 20.4 mM (range 8.9-30.6) while the mean serum acetaldehyde level was 55.1 microM (range 17.0-111). At 5 weeks the serum levels for ethanol and acetaldehyde were 20.1 mM (13.3-32.9) and 41.5 microM (2.4-87.6), respectively. Weight gain was persistent throughout the study and did not differ significantly between ethanol and control groups. After 5 weeks of treatment, lymphocyte response to the mitogens, phytohemagglutinin, and concanavalin A was significantly decreased in the ethanol treated group (p less than 0.05). Response to the specific antigen, picrylated human serum albumin, T & B cell per cent and number, skin test reactivity, peripheral white blood cell count, total lymphocyte count, and migration inhibitory factor production were not significantly altered by 5 weeks of ethanol treatment. Therefore, in a controlled animal model of chronic ethanolism, we observed a significant depression of lymphocyte blastogenic response which may, in part, explain the increased propensity to infection by intracellular pathogens seen in alcoholics. | pubmed_754_5581 |
pubmed_353_4954 | Diagnosis of infectious diseases in birds using direct assays such as conventional ELISA or immunofluorescence require antibody directed to IgG of each avian species. In this study, we tested binding of human C1q to different antigen-antibody complexes of two avian species in a sandwich immunofluorescent complement fixation test (S-ICFT). The reaction was as follows: virus (in cells) + decomplemented avian serum + human-C1q + goat anti-human-C1q + fluorescein isothiocyanate rabbit anti-goat-IgG. Positive and negative chicken (order Galliformes) sera against chicken anaemia virus (CAV) and sera against avian pox virus as well as positive and negative sera against chicken pox virus raised in a milvago chimango (order Falconiformes) were used. Positive sera of either avian species demonstrated clear fluorescent staining of infected cells while negative sera did not show any reaction. This demonstrated that both chicken and milvago chimango antibodies were able to bind human C1q. Since both avian species tested belonged to different orders, we believe that antibodies of other avian species will also bind human Clq allowing serological surveys in feral birds through S-ICFT. | 10.1080/03079459608419129 |
pubmed_1117_6244 | The pH-dependence of efflux of salicylate and p-hydroxybenzoic acid (PHB) from human red cells indicates that the un-ionized species penetrates the membrane. No effect of the anion channel blocker 4,4'-diisothiocyano-2,2'-disulphonic stilbene was observed. The temperature-dependence of efflux suggests that the energy barrier to transport of salicylate and PHB is the transfer of the acids from water into the membrane, rather than transport through the membrane interior. Intracellular binding of both acids was found to be pH-dependent. | 10.1111/j.2042-7158.1987.tb06264.x |
pubmed_83_13182 | Using first-principles calculations we predict that the layered-perovskite metal Bi5Mn5O17 is a ferromagnet, ferroelectric, and ferrotoroid which may realize the long sought-after goal of a room-temperature ferromagnetic single-phase multiferroic with large, strongly coupled, primary-order polarization and magnetization. Bi5Mn5O17 has two nearly energy-degenerate ground states with mutually orthogonal vector order parameters (polarization, magnetization, ferrotoroidicity), which can be rotated globally by switching between ground states. Giant cross-coupling magnetoelectric and magnetotoroidic effects, as well as optical non-reciprocity, are thus expected. Importantly, Bi5Mn5O17 should be thermodynamically stable in O-rich growth conditions, and hence experimentally accessible. | 10.1038/s41467-020-18664-6 |
pubmed_180_17001 | AIMS
Genetic polymorphisms of alcohol dehydrogenase-1B (ADH1B, rs1229984) and aldehyde dehydrogenase-2 (ALDH2, rs671) affect ethanol (EtOH) metabolism and susceptibility to alcoholism.
METHODS
We evaluated associations between ADH1B/ALDH2 genotypes and the blood EtOH levels of 805 Japanese alcoholic men in the morning after they had drunk within the previous 34 h.
RESULTS
Age-adjusted usual alcohol consumption did not differ according to ADH1B/ALDH2 genotypes. Higher blood EtOH levels persisted for longer periods in the ADH1B*1/*1 carriers (n = 246) than in the ADH1B*2 carriers (n = 559). Blood EtOH levels did not differ by ALDH2 genotype. The blood EtOH levels ≥ 0.3 mg/ml (criterion for drunk driving in Japanese law) were observed (40% vs. 14-17%, P < 0.0001) in a higher proportion of the ADH1B*1/*1 carriers than of the ADH1B*2 carriers after a 12.1-to-18-h interval since the last drink. Multivariate analyses showed that the EtOH levels heightened by 0.500 mg/ml in the presence of ADH1B*1*1 and by 0.248 mg/ml in the presence of cirrhosis, and lowered by 0.120 mg/ml per 10-year age increase, by 0.087 mg/ml per 10-kg body-weight increase and by 0.673 mg/ml per 10-h interval since the last drink. The odds ratio (95% confidence interval) for an EtOH level ≥ 0.3 mg/ml was 3.44 (2.34-5.04) in the presence of ADH1B*1/*1, 2.01 (1.28-3.14) in the presence of cirrhosis, 0.59 (0.49-0.71) per 10-year age increase, 0.80 (0.68-0.95) per 10-kg body-weight increase and 0.10 (0.07-0.15) per 10-h interval since the last drink.
CONCLUSION
The longer-than-expected EtOH lingering in the blood of the ADH1B*1/*1 alcoholics may exacerbate alcohol-related problems, including drunk driving. | 10.1093/alcalc/agt136 |
pubmed_2_16851 | Kaolinite/iron oxide magnetic composites (kaolinite/MCs) were used as adsorbent for the removal of Cd(II) from aqueous solutions. The influences of pH, ionic strength, solid/liquid ratio and temperature on Cd(II) sorption on kaolinite/MCs were evaluated. The results showed that the removal of Cd(II) on kaolinite/MCs was strongly dependent on pH and ionic strength. An optimal kaolinite/MCs concentration mass per volume for removal of Cd(II) from aqueous solutions was 1.4 g L(-1). The Langmuir and Freundlich models were used to simulate sorption isotherms of Cd(II) at three different temperatures of 293, 313 and 333 K. The sorption of Cd(II) on kaolinite/MCs increased with increasing temperature, and thermodynamic parameters (standard entropy change, enthalpy change and Gibbs free energy change) illustrated that this sorption process was spontaneous and endothermic. The sorption behaviors of Cd(II) were mainly dependent on surface properties of kaolinite/MCs and solution chemistry conditions. The sorption capacity of Cd(II) on kaolinite/MCs was lower than that on kaolinite, because iron oxide particles decreased surface charge of kaolinite leading to less sorption capacity. Due to high magnetism, kaolinite/MCs could be easily separated with an external magnetic field. Kaolinite/MCs could therefore be used as potential adsorbent for preconcentration and immobilization of Cd(II) ions from large volumes of aqueous solutions. | 10.2166/wst.2013.012 |
pubmed_379_13463 | The usefulness was tested of the biological insecticides containing B. thuringiensis available in the market in the eradication of cockroaches. Thuridan was the most effective out of the tested insecticides in reducing the number of the insects. Its higher activity in relation to Thuricide was evident at all tested concentrations. Males were more sensitive than females. On the other hand, no significant response of cockroaches to M-one preparation was noted, since the per cent of dying insects was only slightly higher than in the control group. | pubmed_379_13463 |
pubmed_259_5101 | Mannose-binding lectin (MBL) is a serum complement factor playing a dominant role in first-line defense. When MBL binds to specific sugar moieties on microorganisms, the lectin complement pathway (LCP) is activated. Changes in the mbl gene and promotor may result in MBL with less activity, predisposing the individual to recurrent infections. Using a functional MBL assay, we investigated at what concentration different microbes activated MBL. Less than 1 colony-forming unit (CFU) of Neisseria meningitidis groups B and C still activated MBL, which may be ascribed to filterable blebs. Nocardia farcinica and Legionella pneumophila activated MBL well, which raises new questions about host susceptibility. In contrast to other research, Pseudomonas aeruginosa activated the LCP potently. | 10.1016/S0928-8244(03)00032-4 |
pubmed_245_7764 | Two kinds of cnida predominate in the tentacles of the acontiate sea anemones: spirocysts and microbasic mastigophore nematocysts. These cnidae discharge in response to appropriate mechanical and chemical stimulation. In this paper, we calculate the strengths of attachment between the tentacle and the capsules (= "tentacle adherence") of discharged spirocysts and mastigophores by measuring adhesive force and by determining the numbers of spirocysts and mastigophores discharged onto targets under conditions where the attachment of everted cnida tubules to the target (= "cnida adhesion") exceeds tentacle adherence. Under these conditions, the average contribution of individual cnidae to adhesive force is called the intrinsic adherence. The intrinsic adherence is a measure of the average frictional force required to dislodge the capsule of individual discharged cnidae from the tentacle. The intrinsic adherence of discharged mastigophores varies inversely, from 0.45 to 0.15 mgf (4.41 to 1.47 μN), with the number of discharged mastigophores. The larger values characterize mastigophores discharged by mechanically triggering nonchemosensitized tentacles, whereas the lower values characterize the intrinsic adherence of mastigophores discharged from chemosensitized tentacles. In contrast, the intrinsic adherence of discharged spirocysts is very low to insignificant. Thus, by comparison to mastigophores, spirocysts contribute little, if any, to adhesive force, and, by inference, do not directly secure captured prey to the tentacle. Our measurements indicate that penetrable prey are primarily secured to the tentacle by discharged mastigophores and by the inherent stickiness of the tentacle surface. | 10.2307/1542681 |
pubmed_999_21003 | Enabled by electron donor-acceptor complexes, a novel visible-light-induced α-amino C-H bond arylation protocol, without a photoredox catalyst, has been disclosed. The protocol does not require any transition metal, oxidant, or exclusion of oxygen or moisture. A direct irradiation of the mixture of tertiary amines and benzonitriles with visible light in N,N-diethylethanamide in the presence of Cs2CO3 afforded α-arylated amines in good to excellent yields. | 10.1021/acs.orglett.1c00984 |
pubmed_392_19587 | INTRODUCTION
Disparities in health-related quality of life (HRQOL) have been inadequately studied in patients with glomerular disease. The aim of this study was to identify relationships between race/ethnicity, socioeconomic status, disease severity, and HRQOL in an ethnically and racially diverse cohort of patients with glomerular disease.
METHODS
Cure Glomerulonephropathy (CureGN) is a multinational cohort study of patients with biopsy-proven glomerular disease. Associations between race/ethnicity and HRQOL were determined by the following: 1. Missed school or work due to kidney disease; 2. Responses to Patient Reported Outcomes Measurement Information System (PROMIS) questionnaires. We adjusted for demographics, socioeconomic status, and disease characteristics using multivariable logistic and linear regression.
RESULTS
Black and Hispanic participants had worse socioeconomic status and more severe glomerular disease than White or Asian participants. Black adults missed work or school most frequently due to kidney disease (30% versus 16-23% in the other three groups, p=0.04), and had the worst self-reported global physical health (median score 44.1 versus 48.0-48.2, p<0.001) and fatigue (53.8 versus 48.5-51.1, p=0.002), compared to other racial/ethnic groups. However, these findings were not statistically significant with adjustment for socioeconomic status and disease severity, both of which were strongly associated with HRQOL in adults. Among children, disease severity but not race/ethnicity or socioeconomic status were associated with HRQOL.
CONCLUSIONS
Among patients with glomerular disease enrolled in CureGN, the worse HRQOL reported by Black adults was attributable to lower socioeconomic status and more severe glomerular disease. No racial/ethnic differences in HRQOL were observed in children. | 10.1159/000516832 |
pubmed_699_18802 | The L-threonine aldolase from Leishmania major was engineered to improve its diastereoselectivity by a CAST/ISM strategy, providing insights into the relationship between the physico-chemical properties of the substrate access path and diastereoselectivity. The steric hindrance, hydrophobic interaction and π-π interaction cooperated to improve the diastereoselectivity of the enzyme, with a diastereomeric excess (de) value reaching 96.3% from 26.8%. | 10.1039/d2cc02644a |
pubmed_390_12668 | For the purpose of evaluating the tissue blood flow reducing effect on lower esophagus and cardiac portion of the stomach after transabdominal mucosal transection operation for esophageal varices, 28 adult mongrel dogs were used and divided into (A) 18 as the control (B) 10 caused to have portal hypertension for present study. Closed-couple thermoelectrode flow meter was used to measure the tissue blood flow at lower esophagus and cardiac portion of the stomach following this procedures (1) ligating short gastric vessels, (2) ligating left gastric vessels, (3) transecting only the mucosal tube of the esophagus, (4) completely transecting of the esophagus. The following results were obtained. Effect on lower esophagus: transecting only the mucosal tube of the esophagus reduced 36.0 +/- 11.0% of the tissue blood flow and ligating short gastric vessels or left gastric vessels also reviewed a rather large effect. Effect on cardiac portion of the stomach: ligating the short gastric vessels reduced 2.5 +/- 3.0% of the tissue blood flow, while ligating of the left gastric vessels reduced more effectively 13.6 +/- 6.5%. | pubmed_390_12668 |
pubmed_1070_7325 | Patterning of the Arabidopsis thaliana gynoecium is dependent on the localization and concentration of the plant hormone auxin and it has been previously reported that STYLISH1 (STY1) activates transcription of the auxin biosynthesis gene YUCCA4 (YUC4) and affects gynoecium development. Here, the relationship between auxin, STY1 and other regulators of gynoecium development was examined. Exogenous auxin in droplets of lanolin paste were applied to young gynoecia; auxin biosynthesis rate was measured and STY1 overexpression or chemically mediated polar auxin transport (PAT) inhibition were induced in various mutants. The style phenotype of sty1-1sty2-1 mutants was restored by exogenous application of auxin, and STY1 over-activation resulted in an elevated auxin biosynthesis rate. Both over-activation of STY1 and inhibition of PAT restored the stylar defects of several unrelated mutants, but with regard to gynoecium apical-basal patterning the mutants responded differently to inhibition of PAT. These results suggest that reduced auxin concentrations cause the sty1-1 sty2-1 phenotype, that STY1 induces auxin biosynthesis, that elevated apical auxin concentrations can compensate for the loss of several style-promoting factors, and that auxin may act downstream of, or in parallel with these during style development but is dependent on their action in apical-basal patterning. | 10.1111/j.1469-8137.2008.02625.x |
pubmed_794_12983 | Heliomicrobium modesticaldum has been used as a model organism for the Heliobacteria, the only phototrophic family in the Firmicutes. It is a moderately thermophilic anoxygenic phototrophic bacterium that is capable of fermentative growth in the dark. The genetic manipulation of H. modesticaldum is still in its infancy. Methods to introduce genes through the use of exogenous plasmids and to delete genes from the chromosome through the use of the native CRISPR/Cas system have been developed in the last several years. To expand our genetic toolkit, it was necessary to control gene expression. In this study, we analyzed constitutive and inducible promoters developed for clostridia for their use in H. modesticaldum and further tested two reporters, adhB and lacZ, as indicators of promoter strength. Alcohol dehydrogenase (AdhB) was unsuitable as a reporter in this species due to high endogenous activity and/or low activity of the reporter, but a thermostable LacZ worked well as a reporter. A set of constitutive promoters previously reported to work in Clostridium thermocellum was found to be reliable for controlling the expression of the lacZ reporter gene in H. modesticaldum at a range of activities spanning an order of magnitude. An anhydrotetracycline-inducible promoter was created by inserting tetO operators into a strong constitutive promoter, but it was not fully repressible. The implementation of a xylose-inducible promoter resulted in complete repression of β-gal in the absence of xylose, and reliable expression tunable through the concentration of xylose added to the culture. | 10.3390/microorganisms10050876 |
pubmed_39_3835 | The Wolff-Parkinson-White syndrome is a usually benign heart disease with accessory pathways. Circling excitations arise between atria and ventricles which can lead to cardiac arrhythmias. Cases of sudden cardiac death are rare (0.2 %). Risk factors for sudden cardiac death in patients with WPW syndrome are old age, several accessory pathways, male sex and previous syncopes. A 16-year-old girl was found lying dead in her bed. The evening before, she didn't feel well and complained about abdominal pain. The girl had known epilepsy and Wolff- Parkinson-White syndrome. The macroscopic and histological findings are presented and discussed with reference to the pertinent literature. | pubmed_39_3835 |
pubmed_713_22241 | PURPOSE
Urinary retention (UR) is common in older patients. The aim of this observational cohort study was to measure the prevalence of UR in patients aged ≥ 75 years on admission to an acute geriatric hospitalisation unit and to determine which at risk group would benefit from screening.
METHODS
Post-void residual volumes (PVR) were measured within 3 days of admission with an ultrasound bladder scan. Uni- and multivariable analysis were used to determine risk factors associated with PVR ≥ 150 and ≥ 300 millilitres.
RESULTS
Ninety-four patients, mean age 84.6 years, were included. The male/female ratio was 0.7. Patients with PVR ≥ 150 (29.8%) had more urological comorbidities, symptoms of overflow incontinence, voiding difficulties, subtotal voiding, faecal impaction, urinary tract infection (UTI) and were more frequently referred because of urinary symptoms. Patients with PVR ≥ 300 lived less at home, had more urological comorbidities, dysuria, voiding difficulties, subtotal voiding, constipation, faecal impaction, UTI, detrusor relaxants, and were more frequently referred because of urinary symptoms. Voiding difficulties and referral because of urinary symptoms were independently associated with PVR ≥ 150. Not living at home, reporting subtotal voiding, constipation, and referral because of urinary symptoms were independently associated with PVR ≥ 300.
CONCLUSION
Screening for UR on admission to an acute geriatric hospitalisation unit is most indicated in patients with urinary and defaecation problems. However, because the prevalence was high, because UR was also observed in patients without these problems, and history taking may be difficult, the threshold for PVR measurement in acutely ill geriatric patients should be low.
TRIAL REGISTRATION
Clinicaltrials.gov NTC04715971, January 19, 2021 (retrospectively registered). | 10.1007/s41999-021-00495-3 |
pubmed_459_6433 | Rectal prolapse is best treated by intra-abdominal or perineal procedures that either resect the redundant rectosigmoid colon or fix the rectum within the pelvis. We have found the Thiersch procedure to be adequate treatment in patients who are high risk or who have only mild to moderate prolapse of the rectum. Over the past 20 years, we have treated 15 patients with a modified Thiersch procedure, using a knitted Dacron vascular graft to encircle the anus. One patient required a second Thiersch procedure after failure of a Ripstein procedure that followed failure of a Thiersch procedure done with wire. A second Thiersch procedure was required in two patients after suture breakage, and in one patient after removal of an infected graft. Two other patients had graft infections necessitating removal of the Dacron graft; one patient had a perianal infection that was treated without removing the graft. Continence was achieved in six of nine patients previously incontinent, and maintained in the six patients who had been continent before operation. Prolapse was corrected in 13 of the 15 patients. Although the Thiersch procedure is not applicable to all patients with rectal prolapse, it can be used successfully when performed properly. | pubmed_459_6433 |
pubmed_909_23423 | UNLABELLED
INTRODUCTION
Rural residence is associated with increased peritoneal dialysis (PD) utilization. The influence of travel distance on rates of home dialysis utilization has not been examined in the United States. The purpose of this study was to determine whether travel distances to the closest home and in-center hemodialysis (IHD) facilities are a barrier to home dialysis. ♢
METHODS
This was a retrospective cohort study of patients aged ≥ 18 years initiating dialysis between 2005 and 2011. Unadjusted PD and home hemodialysis (HHD) rates were compared by travel distances to both the closest home dialysis and closest IHD facilities. Adjusted PD and HHD utilization rates were examined using multivariable logistic regression models. ♢
RESULTS
There were 98,608 patients in the adjusted analyses. 55.5% of the dialysis facilities offered home dialysis. IHD, PD and HHD patients traveled median distances of 5.4, 3.5 and 6.6 miles respectively to their initial dialysis facilities. Unadjusted analyses showed an increase in PD rates and decrease in HHD rates with increased travel distances. Adjusted odds of PD and HHD were 1.6 and 1.2 respectively for a ten mile increase in distance to the closest home dialysis facility, while for distances to the closest IHD facility the odds ratios for both PD and HHD were 0.7 (all p < 0.01). ♢
CONCLUSIONS
In metropolitan areas, PD and HHD generally increased with increased travel distance to the closest home dialysis facility and decreased with greater distance to an IHD facility. Examination of travel distances to PD and HHD facilities separately may provide further insight on specific barriers to these modalities which can serve as targets for future studies examining expansion of home dialysis utilization. | 10.3747/pdi.2012.00234 |
pubmed_526_22165 | A new type of mesostructured hybrid organic-inorganic film has been synthesised by evaporation-induced self-assembly using 3-glycidoxypropyltrimethoxysilane as the precursor and a tri-block copolymer, Pluronic F127, as the template. The chemistry has been tuned to form bridged polysilsesquioxanes that self-organise into ordered lamellar structures. Controlled aging under highly basic conditions, which has been monitored by Raman and infrared spectroscopy, has been used to obtain the layered ordered hybrid structures in the precursor sol. The pH of the sol has been adjusted to form the micelles that act as templates during solvent evaporation. The self-assembly of the system has been studied in situ by small and wide angle X-ray scattering using a synchrotron light source, which has confirmed both the formation of hybrid layered structures and the long-range organization of the mesophase in the hybrid films. The present approach allows ordering the hybrid film on two different length scales; at the end of film processing, hybrid crystals are incorporated into the pore walls and the micelles are arranged within the films with long range order. | 10.1039/c5cp00433k |
pubmed_889_23472 | BACKGROUND
Many novel drug delivery systems have been extensively studied to exploit the full therapeutic potential of SN38, which is one of the most potent antitumor analogs of camptothecins (CPTs), whose clinical application is seriously hindered by poor water solubility, low plasmatic stability, and severe toxicity, but results are always unsatisfactory.
METHODS
In this study, combining the advantages of prodrug and nanotechnology, a lipophilic prodrug of SN38, SN38-PA, was developed by conjugating palmitic acid to SN38 via ester bond at C10 position, and then the lipophilic prodrug was encapsulated into a long-circulating liposomal carrier by film dispersion method.
RESULTS
The SN38-PA liposomes were characterized as follows: an average particle size of 80.13 nm, an average zeta potential of -33.53 mv, and the entrapment efficiency of 99%. Compared with CPT-11, SN38-PA liposome was more stable in close lactone form, more efficient in conversion rate to SN38, and more potent in cytotoxicity against tumor cells. Pharmacokinetic study showed that SN38-PA liposome had significantly enhanced plasma half-life (t1/2) value of SN38 and increased area under the curve (AUC) of SN38, which was 7.5-fold higher than that of CPT-11. Biodistribution study showed that SN38-PA liposome had more active metabolite SN38 in each tissue. Finally, the pharmacodynamic study showed that SN38-PA liposome had higher antitumor effect with the antitumor inhibition rate of 1.61 times than that of CPT-11.
CONCLUSION
These encouraging data merit further investigation on this novel SN38-PA liposome. | 10.2147/IJN.S187906 |
pubmed_82_20988 | In this study we approach the issue preoperatory orientation which we understand to be a vital practice in the field of Nursing also allowing the identification of same features at clients perception regarding the information achieved before operation. It is also suitable to recognize the failure of this procedure in the daily work at surgical units which upsets us with the absence of a guideline for preparing patients to surgical acts. Facing this need, we have decided to deeply investigate this issue to achieve the dimension, the description and analyzing the trajectory follow-up started in the first contact with the phenomenological approach. Thus, we make use of our patient operatory phase through his talk according to MARTINS & BICUDO's reference. So, this research aims at presenting the knowledge feature achieved through patients talk, its meaning and repercussion onto the individual plane as well as identifying what should alone improve it. That is the way phenomenological method questions the need of a preoperatory orientation which links us to theme dimension. In our experience of guiding patients to cope with their surgical intervention, we open a space that allows us to intervene under the perspective of conducting patients to recognize their existential dimension of experiencing an operation. | 10.1590/s0034-71671997000100004 |
pubmed_633_1617 | The mechanisms that regulate mitochondrial inheritance are not yet clear, even though it is 100 years since the first description of non-Mendelian genetics. Here, we quantified the copy numbers of mitochondrial DNA (mtDNA) in the gametic cells of angiosperm species. We demonstrate that each egg cell from Arabidopsis thaliana, Antirrhinum majus, and Nicotiana tabacum possesses 59.0, 42.7, and 73.0 copies of mtDNA on average, respectively. These values are equivalent to those in Arabidopsis mesophyll cells, at 61.7 copies per cell. On the other hand, sperm or generative cells from Arabidopsis, A. majus, and N. tabacum possess minor amounts of mtDNA, at 0.083, 0.47, and 1 copy on average, respectively. We further reveal a 50-fold degradation of mtDNA during pollen development in A. majus. In contrast, markedly high levels of mtDNA are found in the male gametic cells of Cucumis melo and Pelargonium zonale (1296.3 and 256.7 copies, respectively). Our results provide direct evidence for mitochondrial genomic insufficiency in the eggs and somatic cells and indicate that a male gamete of an angiosperm may possess mtDNA at concentrations as high as 21-fold (C. melo) or as low as 0.1% (Arabidopsis) of the levels in somatic cells. These observations reveal the existence of a strong regulatory system for the male gametic mtDNA levels in angiosperms with regard to mitochondrial inheritance. | 10.1105/tpc.109.071902 |
pubmed_278_6813 | A growing body of evidence suggests Chronic Lower Back Pain (CLBP) is associated with cognitive dysfunction. Little is known, however, about the extent of cognitive impairment in CLBP. The present study explored the cognitive profile of people with CLBP and sought to determine the extent of Mild Cognitive Impairment (MCI) according to the DSM-V and the Movement Disorders Society criteria for MCI. Thirty-one participants with CLBP and 27 age and gender matched healthy controls completed a full neuropsychological battery, consisting of two tasks for each of the five cognitive domains (Executive Function, Attention/Working Memory, Memory, Language, and Visuospatial). Participants with CLBP performed worse, compared to controls, on measures of Attention/Working Memory, Memory, Language, and Visuospatial performance. Cognitive performance in CLBP was also compared to equivalent normative data to determine cognitive impairment. Sixteen CLBP participants were impaired on at least one cognitive measure, with 5 participants meeting criteria for MCI. MCI was not associated with pain-related experience, or psychological health. The present study supports and extends previous findings that CLBP is associated with cognitive dysfunction and some people with CLBP meet criteria for MCI. These findings support that rehabilitation in people with CLBP requires a multidisciplinary approach. | 10.1016/j.bandc.2021.105737 |
pubmed_778_24165 | This study was designed to clarify the mechanisms of the hypocholesterolemic action of Spirulina platensis concentrate (SPC) and identify the novel hypocholesterolemic protein derived from SPC. We investigated the effects of casein or SPC on the solubility of cholesterol, taurocholate binding capacity in vitro, cholesterol absorption in Caco-2 cells, and cholesterol metabolism in rats for 10 d. We also evaluated the effects of SPC, C-phycocyanin (PHY), and PHY residue on cholesterol metabolism in rats fed a high-cholesterol diet for 5 d, and SPC or SPC-acetone extract for 10 d. SPC had a significantly greater bile acid-binding capacity than casein in vitro. Micellar cholesterol solubility and cholesterol uptake by Caco-2 cells was significantly lower in the presence of SPC compared with casein. Fecal excretion of cholesterol and bile acids was significantly greater in rats fed the SPC-supplemented diet than in those fed the casein control diet. Serum and liver cholesterol concentrations were significantly lower in rats fed SPC than in those fed casein. Thus, the hypocholesterolemic action of SPC may involve the inhibition of both jejunal cholesterol absorption and ileal bile acid reabsorption. Although no studies to date have found a hypocholesterolemic protein among the algal proteins, we report here the discovery of a hypocholesterolemic effect in the novel protein C-phycocyanin. This study provides the first direct evidence that PHY, a novel hypocholesterolemic protein derived from Spirulina platensis, can powerfully influence serum cholesterol concentrations and impart a stronger hypocholesterolemic activity than SPC in animals. | 10.1093/jn/135.10.2425 |
pubmed_862_19827 | RATIONALE AND OBJECTIVES
Low back pain (LBP) is a common condition with frequent health care visits and work disability. Quality improvement efforts in primary care focused on guidelines adherence, provider selection and education, and feedback on appropriateness of care. Such efforts can only succeed if a health care provider is in charge of care over a substantial period. This study was conducted to provide insights about actual patterns of provider involvement in LBP care and implications for quality evaluation.
METHODS
Established primary care patients with occupational LBP and health care covered by a workers' compensation insurer were selected. Primary care physician (PCP) involvement was examined relative to overall health care utilization. Four methods of classifying PCP involvement were used to assess the association between PCP involvement and health care and work disability outcomes over a 2-year follow-up period.
RESULTS
Primary care physician was rarely the sole provider during episodes of occupational LBP. PCP was the initial non-emergency room provider in 55% of cases, and was the most prevalent provider during at least one episode of care in 45% of cases. Different methods of classification led to different conclusions about the association between PCP involvement and work disability or number of health care visits. Multiple providers were involved throughout the clinical course of the small number of cases that accounted for most of the health care visits and work disability; in these cases, the role of PCP in care was difficult to determine.
CONCLUSIONS
Administrative data alone are adequate for provider comparisons only in relatively simple cases. Provider comparisons based on initial treating provider likely overstate the importance of early care, particularly in more complex cases. For LBP, quality improvement models based on PCP-directed interventions or reinforcing guideline adherence may not impact outcomes. A patient-centred model may be necessary to achieve outcome improvements. | 10.1111/j.1365-2753.2007.00890.x |
pubmed_1073_2301 | The Caenorhabditis elegans gene rec-1 was the first genetic locus identified in metazoa to affect the distribution of meiotic crossovers along the chromosome. We report that rec-1 encodes a distant paralog of HIM-5, which was discovered by whole-genome sequencing and confirmed by multiple genome-edited alleles. REC-1 is phosphorylated by cyclin-dependent kinase (CDK) in vitro, and mutation of the CDK consensus sites in REC-1 compromises meiotic crossover distribution in vivo. Unexpectedly, rec-1; him-5 double mutants are synthetic-lethal due to a defect in meiotic double-strand break formation. Thus, we uncovered an unexpected robustness to meiotic DSB formation and crossover positioning that is executed by HIM-5 and REC-1 and regulated by phosphorylation. | 10.1101/gad.266056.115 |
pubmed_976_15212 | We present the first reported case of disseminated cytomegalovirus (CMV) in association with prednisone therapy in bullous pemphigoid (BP). A 66-year-old black male patient was admitted to our hospital presenting cutaneous pruritic lesions represented by tense blisters, with serous content on the arms, abdomen and legs. Laboratory findings confirmed the diagnosis of BP. After two weeks of prednisone therapy, the patient developed prolonged fever, which was caused by CMV disseminated disease, with prompt clinical recovery after ganciclovir administration. | 10.1111/j.1346-8138.2003.tb00396.x |
pubmed_367_4822 | Clinical diagnosis of subcortical infarction, chiefly lacunar stroke, has been considered important for arriving at the most rational stroke diagnosis and treatment strategy. This review focuses on the lacunar hypothesis and potential inaccuracy of clinical diagnosis and computed tomography in subcortical stroke. Modern magnetic resonance imaging techniques have increased sensitivity and specificity for subcortical infarcts and may help in determining the pathogenesis in individual patients. Full investigation is now favored for all stroke patients regardless of the clinical diagnosis. Acute stroke and secondary prevention treatments are discussed in reference to a diagnosis of subcortical infarction. | 10.1586/14737175.3.5.703 |
pubmed_494_1732 | BACKGROUND
Intra-articular injection of hyaluronic acid (HA) is a well-documented treatment for knee osteoarthritis (OA). One of the multifactorial mechanisms is that exogenous HA can stimulate endogenous HA production. HA can regulate the growth and function of chondrocytes by binding to CD44 receptors on the chondrocytes. Synovitis is often found in patients with rheumatoid arthritis (RA) and is supposed to result from CD44 activity. The aim of this study was to investigate the effect of intra-articular injection of HA in patients with RA combined with knee OA.
METHODS
Twenty RA patients with OA knees were enrolled; 11 patients were placed into a stage II group and 9 into a stage III group, in accordance with the Kellgren-Lawrence classification of knee OA. All patients received intra-articular injection of HA (ARTZ) once a week for 5 weeks, and were evaluated with the WOMAC index (including the pain, stiffness and physical function subscales) at baseline, week 5 and week 9. The Friedman test and Wilcoxon signed rank test with Bonferroni correction method were used for statistical analysis.
RESULTS
The effect of intra-articular injection of HA was significant at week 5 (p < 0.0167) and persisted to week 9 (p < 0.0167). This therapy was equally efficacious with stage II and stage III patients, with no difference between the 2 groups.
CONCLUSION
Intra-articular injection of HA was beneficial in patients with RA combined with knee OA. | 10.1016/S1726-4901(08)70092-3 |
pubmed_617_2848 | BACKGROUND
In most cases bacterial infections of orbital and periorbital structures constitute inflammatory processes transmitted from the paranasal sinus system. The anatomical continuity of the paranasal sinuses to the orbit and also to the brain is the main reason for the occurrence of serious or even life-threatening complications.
MATERIAL AND METHODS
Under consideration of the literature and selected clinical cases, the pathogenesis, diagnostic standards and therapy strategies are discussed with respect to the stage of the disease and the clinical course.
CONCLUSIONS
Inflammatory periorbital and orbital complications require immediate otorhinolaryngological diagnosis and therapy and therefore, interdisciplinary cooperation with ophthalmologists and radiologists is indispensable. In particular the infrequent, but still seriously life-threatening processes associated with a 5-10% fatality rate must be diagnosed and treated as early as possible. In these cases the inclusion of neurosurgery and intensive care into a complex treatment management is necessary in order to prevent severe progression with endocrinal complications or even fatal outcome. | 10.1007/s00106-009-2045-6 |
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