Cyclic peptide RD808 reduces myocardial injury induced by β 1 -adrenoreceptor autoantibodies

Abstract

Autoantibodies against the second extracellular loop of β₁-adrenergic receptor (β₁-AA) have been shown to be involved in the development of cardiovascular diseases. Recently, there has been considerable interest in strategies to remove these autoantibodies, particularly therapeutic peptides to neutralize β₁-AA. Researchers are investigating the roles of cyclic peptides that mimic the structure of relevant epitopes on the β₁-AR-EC_II in a number of immune-mediated diseases. Here, we used a cyclic peptide, namely, RD808, to neutralize β₁-AA, consequently alleviating β₁-AA-induced myocardial injury. We investigated the protective effects of RD808 on the myocardium both in vitro and in vivo. RD808 was found to increase the survival rate of cardiomyocytes; furthermore, it decreased myocardial necrosis and apoptosis and improved the cardiac function of BalB/c mice in a β₁-AA transfer model. In vitro and in vivo experiments showed that myocardial autophagy was increased in the presence of RD808, which might contribute to its cardioprotective effects. Our findings indicate that RD808 reduced myocardial injury induced by β₁-AA.

https://ift.tt/2RXJwbj

Genome analysis and -omics approaches provide new insights into the biodegradation potential of Rhodococcus

Abstract

The past few years observed a breakthrough of genome sequences of bacteria of Rhodococcus genus with significant biodegradation abilities. Invaluable knowledge from genome data and their functional analysis can be applied to develop and design strategies for attenuating damages caused by hydrocarbon contamination. With the advent of high-throughput -omic technologies, it is currently possible to utilize the functional properties of diverse catabolic genes, analyze an entire system at the level of molecule (DNA, RNA, protein, and metabolite), simultaneously predict and construct catabolic degradation pathways. In this review, the genes involved in the biodegradation of hydrocarbons and several emerging plasticizer compounds in Rhodococcus strains are described in detail (aliphatic, aromatics, PAH, phthalate, polyethylene, and polyisoprene). The metabolic biodegradation networks predicted from omics-derived data along with the catabolic enzymes exploited in diverse biotechnological and bioremediation applications are characterized.

https://ift.tt/2QW3y98

The effect of hyperosmolality application time on production, quality, and biopotency of monoclonal antibodies produced in CHO cell fed-batch and perfusion cultures

Abstract

Hyperosmolality has been commonly investigated due to its effects on the production and quality characteristics of monoclonal antibodies (mAbs) produced in CHO cell fed-batch cultures. However, the application of hyperosmolality at different times and its effect on biopotency have seldom been researched, especially in perfusion culture. In our study, different degrees of hyperosmolality induced by sodium chloride were investigated in anti-IgE rCHO cell fed-batch cultures and anti-CD52 rCHO cell perfusion cultures during the initial and stable phases. The results showed that the initial hyperosmolality group (IHG) in fed-batch and early phase of perfusion cultures exhibited significant suppression of the viable cell density yet an enhancement in specific productivity, whereas the stable hyperosmolality group (SHG) achieved higher mAb production in both fed-batch and perfusion cultures. Additionally, the SHG produced less aggregates and acidic charge variants than IHG in fed-batch culture, which differed from perfusion cultures. However, the contents of non-glycosylation heavy chain (NGHC) and man5 were higher in SHG than in IHG in fed-batch cultures at plus 60 and 120 mOsm/kg, which was similar to perfusion cultures. Furthermore, the biopotency in the IHG was higher than in the SHG at plus 60 and 120 mOsm/kg in fed-batch cultures, which is similar to complement-dependent cytotoxicity (CDC) efficacy in perfusion cultures. The biopotency of all group was acceptable, except FI3. Thus, the study shows that hyperosmolality at a certain level could be beneficial for both mAb production, quality and biopotency, which could play an important role in process development for commercial production.

https://ift.tt/2UHPjDQ

Characterization of airborne particle release from nanotechnology-enabled clothing products

Abstract

This study investigated airborne particle release from 17 nanotechnology-enabled clothing items, including 10 items that were advertised as containing silver nanoparticles and 1 item with silver materials. Clothing wear was simulated using an abrader, where the rotating clothing samples came in contact with felt abrader wheels, and size distribution and concentration of the released particles were measured using a scanning mobility particle sizer and aerodynamic particle sizer. Through the use of inductively coupled plasma mass spectrometry, silver was detected in all 11 products advertised as containing silver, and its concentration varied from approximately 1 ppm to ~ 1.5 × 10⁵ ppm depending on the product. Nano-sized particles, as well as larger agglomerates, were released from all investigated products with concentrations as high as ~ 2 × 10⁴ particles/cm³; the concentration and size distribution varied substantially from product to product, and silver-based clothing tended to release smaller and higher number concentrations of particles than products where fibers were formulated using nanotechnology. Examination of the released particles using TEM confirmed the presence of manufactured nanoparticles; airborne sample analysis using SEM/EDS showed that the released particles contained Ag as well as other metals. This study can be valuable for the risk assessment of nanotechnology-based consumer goods, especially clothing containing silver.

https://ift.tt/2UI9l1b

Thrombotic microangiopathy in a patient with eosinophilic granulomatosis with polyangiitis: case-based review

Abstract

The correct diagnosis, classification and therapeutic management of thrombotic microangiopathies (TMA) continue to be a challenge for the clinician. We report a rare case of eosinophilic granulomatosis with polyangiitis (EGPA) as a trigger for complement-mediated TMA in a 57-year-old man who was successfully treated with corticoids, cyclophosphamide and therapeutic plasma exchange. Additionally, we review few other cases reported in the literature and the pathophysiological pathway of association between TMA and EGPA. We found that the mutual relationships between the inflammation triggered by vasculitis, the exacerbated complement activation, together with hypereosinophilia and endothelial damage seem to be the key in explaining the connection between both entities. We suggest that an understanding of the multi-causal nature of TMAs is crucial for the correct diagnosis and treatment of these patients.

https://ift.tt/2QyG2zB

Photoplethysmographic characterization of vascular tone mediated changes in arterial pressure: an observational study

Abstract

To determine whether a classification based on the contour of the photoplethysmography signal (PPGc) can detect changes in systolic arterial blood pressure (SAP) and vascular tone. Episodes of normotension (SAP 90–140 mmHg), hypertension (SAP > 140 mmHg) and hypotension (SAP < 90 mmHg) were analyzed in 15 cardiac surgery patients. SAP and two surrogates of the vascular tone, systemic vascular resistance (SVR) and vascular compliance (Cvasc = stroke volume/pulse pressure) were compared with PPGc. Changes in PPG amplitude (foot-to-peak distance) and dicrotic notch position were used to define 6 classes taking class III as a normal vascular tone with a notch placed between 20 and 50% of the PPG amplitude. Class I-to-II represented vasoconstriction with notch placed > 50% in a small PPG, while class IV-to-VI described vasodilation with a notch placed < 20% in a tall PPG wave. 190 datasets were analyzed including 61 episodes of hypertension [SAP = 159 (151–170) mmHg (median 1st–3rd quartiles)], 84 of normotension, SAP = 124 (113–131) mmHg and 45 of hypotension SAP = 85(80–87) mmHg. SAP were well correlated with SVR (r = 0.78, p < 0.0001) and Cvasc (r = 0.84, p < 0.0001). The PPG-based classification correlated well with SAP (r = − 0.90, p < 0.0001), SVR (r = − 0.72, p < 0.0001) and Cvasc (r = 0.82, p < 0.0001). The PPGc misclassified 7 out of the 190 episodes, presenting good accuracy (98.4% and 97.8%), sensitivity (100% and 94.9%) and specificity (97.9% and 99.2%) for detecting episodes of hypotension and hypertension, respectively. Changes in arterial pressure and vascular tone were closely related to the proposed classification based on PPG waveform.

Clinical Trial Registration NTC02854852.

https://ift.tt/2S25Xwl

Thrombotic microangiopathy in a patient with eosinophilic granulomatosis with polyangiitis: case-based review

Abstract

The correct diagnosis, classification and therapeutic management of thrombotic microangiopathies (TMA) continue to be a challenge for the clinician. We report a rare case of eosinophilic granulomatosis with polyangiitis (EGPA) as a trigger for complement-mediated TMA in a 57-year-old man who was successfully treated with corticoids, cyclophosphamide and therapeutic plasma exchange. Additionally, we review few other cases reported in the literature and the pathophysiological pathway of association between TMA and EGPA. We found that the mutual relationships between the inflammation triggered by vasculitis, the exacerbated complement activation, together with hypereosinophilia and endothelial damage seem to be the key in explaining the connection between both entities. We suggest that an understanding of the multi-causal nature of TMAs is crucial for the correct diagnosis and treatment of these patients.

https://ift.tt/2QyG2zB

Resveratrol Protects Against Renal Damage via Attenuation of Inflammation and Oxidative Stress in High-Fat-Diet-Induced Obese Mice

Abstract

Oxidative stress and inflammation play an important role in the chronic kidney disease associated with obesity. Resveratrol (RSV) has been reported to exhibit a wide range of biological activities including antioxidant and anti-inflammatory properties. The objective of the present study was to investigate the effects of RSV on renal inflammation and oxidative stress in obese mice induced by high-fat diet. Male C57BL/6 mice were induced to have nephropathy associated obesity by high-fat diet for 12 weeks. After 8 weeks of feeding, oral supplementation with 100 mg RSV/kg body weight/day was applied with the high-fat-diet feeding for another 4 weeks. The results showed that RSV treatment protected against renal damage induced by high-fat diet, as evidenced by the decreased serum creatinine and urea nitrogen levels, alleviation of glomerular damage, and tubular vacuolization. In addition, RSV enhanced the antioxidant enzyme activity; improved the expression of genes related to inflammation; and decreased the malondialdehyde, tumor necrosis factor-α, and interleukin-6 concentrations in the kidney of high-fat-diet mice. In conclusion, RSV could alleviate renal damage in obese mice induced by high-fat diet via suppressing inflammation and oxidative stress.

https://ift.tt/2SPKcj4

Selective Activation of Cannabinoid Receptor 2 Attenuates Myocardial Infarction via Suppressing NLRP3 Inflammasome

Abstract

The administration of cannabinoid receptor 2 (CB2R) agonist has been reported to produce a cardioprotective effect against the pathogenesis and progression of myocardial infarction (MI). Here in this study, we investigated the specific mechanism related to inflammatory suppression. JWH-133 was used for the activation of CB2R. MI mice models and cardiomyocytes under oxygen-glucose deprivation (OGD) challenge were used for the in vivo and in vitro studies, respectively. Detection of cardiac infarct size and levels of myocardial enzymes as well as echocardiographic examination were applied to assess MI severity and cardiac function. Cell viability and lactate dehydrogenase (LDH) release were detected in vitro. Real-time-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA) were used to detect the levels of proinflammatory cytokines. Western blot was used for the analysis of the NOD-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome activation. We found that the administration of CB2R agonist attenuated the severity of MI through reducing infarct size ratio and levels of myocardial enzymes and improved cardiac function in ejection fraction (EF), fractional shortening (FS), left ventricular end-systolic diameter (LVESD), and left ventricular end-diastolic diameter (LVEDD) in MI mice. JWH-133 also produced a cardioprotective effect in murine primary cardiomyocytes by improving cell viability and LDH release. JWH-133 largely reduced the production and secretion of proinflammatory cytokines, which was significantly attenuated by AM630. HU308 showed the same effects as JWH-133. Taken together, we demonstrated for the first time the cardioprotective effect of CB2R agonist and its NLRP3 inflammasome-related mechanism in MI.

https://ift.tt/2QPFSDl

Cranioplasties following craniectomies in children—a multicenter, retrospective cohort study

Abstract

Objective

Complications following pediatric cranioplasty after craniectomy with either autologous bone flaps or cranial implants are reported to be common, particularly bone flap resorption. However, only sparse data are available regarding cranioplasty strategies, complications, and outcomes. This manuscript describes a Canadian-Dutch multicenter pediatric cohort study with autografts and cranial implant cranioplasties following craniectomies for a variety of indications.

Methods

The study included all children (< 18 years) who underwent craniectomy and subsequent cranioplasty surgeries from 2008 to 2014 (with a minimum of 1-year follow-up) at four academic hospitals with a dedicated pediatric neurosurgical service. Data were collected regarding initial diagnosis, age, time interval between craniectomy and cranioplasty, bone flap storage method, type of cranioplasty for initial procedure (and redo if applicable), and the postoperative outcome including surgical site infection, wound breakdowns, bone flap resorption, and inadequate fit/disfigurement.

Results

Sixty-four patients (46 males, average age 9.7 ± 5.5 years) were eligible for inclusion, with mean follow-up of 82.3 ± 31.2 months after craniectomy. Forty cranioplasties (62.5%) used autologous bone re-implant, 23 (57.5%) of which showed resorption. On average, resorption was documented at 434 days (range 62–2796 days) after reimplantation. In 20 cases, a revision cranioplasty was needed. In 24 of the post-craniectomy cases (37.5%), a cranial implant was used with one of ten different implant types. Implant loosening prompted a complete revision cranioplasty in 2 cases (8.3%). Cranial implants were associated with low morbidity and lower reoperation dates compared to the autologous cranioplasties.

Conclusion

The most prominent finding in this multicenter cohort study was that bone flap resorption in children remains a common and widespread problem following craniectomy. Cranioplasty strategies varied between centers and evolved over time within centers. Cranial implants were associated with low morbidity and low reoperation rates. Still, longer term and prospective multicenter cohort studies are needed to optimize cranioplasty strategies in children after craniectomies.

https://ift.tt/2CeqU1C

Development and validation of a simple LC-MS/MS method for the simultaneous quantitative determination of trimethylamine-N-oxide and branched chain amino acids in human serum

Abstract

Serum branched chain amino acids and trimethylamine-N-oxide are monitored as potential indicators of diabetes and cardiovascular health respectively. A rapid method for their simultaneous determination using liquid chromatography and tandem mass spectrometry is described here. Branched chain amino acids and trimethylamine-N-oxide were quantified based on their specific MS/MS fragments using a selected reaction monitoring approach. A number of columns were tested for their ability to separate the analytes. A C18-PFP column separated the analytes in just 4 minutes, and resulted in excellent peak shape and retention time repeatability, and was therefore chosen as the optimal column. A second column, the Intrada Amino Acid column, was chosen for comparison and validation experiments as it provided an orthogonal separation mechanism. The intra-day and inter-day precision and accuracy were less than 12% for trimethylamine-N-oxide and less than 6% for the branched chain amino acids. Recoveries, where serum was spiked with three different concentrations of the analytes, ranged from 97 to 113%. The LODs and LOQs for trimethylamine-N-oxide were 1 and 6 ng/mL, for leucine and isoleucine were 4 and 8 ng/mL, and for valine were 5 and 15 ng/mL, respectively. The C18-PFP column method was validated using the Intrada Amino Acid column method and percentage agreement for all four analytes was within 10%. Sample preparation was minimal, and use of labelled internal standards accounted for matrix effects. The method was successfully applied to human plasma samples.

Graphical abstract

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https://ift.tt/2QvkVy2

A novel switchable fluorescent sensor for facile and highly sensitive detection of alkaline phosphatase activity in a water environment with gold/silver nanoclusters

Abstract

A novel fluorescent sensor based on bovine serum albumin stabilized gold/silver nanoclusters (BSA-Au/Ag NCs) was developed for sensitive and facile detection of alkaline phosphatase (ALP) activity. For this fluorescent sensor, ascorbic acid 2-phosphate (AAP) was decomposed into ascorbic acid (AA) and phosphate by catalysis with ALP. The initial red fluorescence of the BSA-Au/Ag NCs was effectively quenched by KMnO₄ and then the fluorescence was recovered by addition of AA. The mechanism of interaction between BSA-Au/Ag NCs and KMnO₄ and AA was studied with use of the fluorescence lifetime and UV-vis absorption spectra. The results indicated that the oxidation/reduction modulated by KMnO₄/AA led to surface structure destruction/restoration of the BSA-Au/Ag NCs, resulting in fluorescence quenching/recovery. The proposed fluorescence-based method based on a dark background was used to detect ALP and had excellent sensitivity, with a detection limit of 0.00076 U/L. Moreover, the method was applied to the determination of added analytes, with satisfactory recoveries (97.0–105.0 %). In a simulated eutrophic water body, this method successfully detected ALP in actual water samples and could monitor the dynamic changes of ALP activity through visual observation. More importantly, the proposed fluorescent sensor not only has the advantages of simple operation and high sensitivity but has also been successfully used on filter paper to establish a rapid and visual test paper for ALP.

https://ift.tt/2S1ZvW9

Colistin and polymyxin B for treatment of nosocomial infections in intensive care unit patients: pharmacoeconomic analysis

Abstract

Background The emergence and rapid spread of multidrug-resistant gram-negative bacteria related to nosocomial infections is a growing worldwide problem, and polymyxins have become important due to the lack of new antibiotics. Objectives To evaluate the outcomes and pharmacoeconomic impact of using colistin and polymyxin B to treat nosocomial infections. Setting Neurosurgical, cardiovascular, or transplantation intensive care unit (ICU) at the Clinical Hospital of the University of Campinas (São Paulo, Brazil). Method A retrospective cohort study was conduct in patients in the ICU. The renal function was determined daily during treatment by measuring the serum creatinine. A cost minimization analysis was performed to compare the relative costs of treatment with colistin and polymyxin B. Main outcomes measure The outcomes were 30-day mortality and frequency and onset of nephrotoxicity after beginning treatment. Results Fifty-one patients treated with colistin and 51 with polymyxin B were included. 30-day mortality was observed in 25.49% and 33.33% of patients treated with colistin and polymyxin B, respectively; Nephrotoxicity was observed in 43.14% and 54.90% of patients in colistin and polymyxin B groups, respectively; and onset time of nephrotoxicity was 9.86 ± 13.22 days for colistin and 10.68 ± 9.93 days for polymyxin B group. Colistin treatment had a lower cost per patient compared to the cost for polymyxin B treatment (USD $13,389.37 vs. USD $13,639.16, respectively). Conclusion We found no difference between 30-day mortality and nephrotoxicity between groups; however, colistin proved to be the best option from a pharmacoeconomic point of view.

https://ift.tt/2CdUdRZ

Impact of medication therapy management on pharmacotherapy safety in an intensive care unit

Abstract

Background Drug-related problems are mostly preventable or predictable circumstances that may impact on health outcomes. Clinical pharmacy activities such as medication therapy management can identify and solve these problems, with potential to improve medication safety and effectiveness. Objective To evaluate ability of medication therapy management service to detect drug-related problems and prevent adverse drug events. This study also aimed to assess the risk factors for drugrelated problem occurrence. Setting Medical intensive care unit of a public tertiary hospital in Brazil. Methods Patients were evaluated by a clinical pharmacist, who provided medication therapy management service. Detected drug-related problems were categorized according to the Pharmaceutical Care Network Europe methodology and analyzed in multinomial regression to identify risk factors. Main outcome measure Potential risk factors for drug-related problem occurrence. Results The proposed medication therapy management service allowed detection of 170 drug-related problems that had potential to reach patients causing harm and other 50 unavoidable adverse events. Drug-related problems identified were more often associated with antibacterial use, caused by improper combinations or inadequate drug dosage. These problems required interventions that were accepted by the multidisciplinary team, resulting in more than 85% adherence and total problem solving. Main risk factors identified were previous diagnosis of kidney injury (OR = 8.38), use of midazolam (OR = 7.96), furosemide (OR = 5.87) and vancomycin (OR = 4.82). Conclusion Medication therapy management proved to be an effective method not only for drug-related problem detection, but also for adverse drug event prevention, contributing to improve patient safety.

https://ift.tt/2LgDss1

Identification of the gene encoding the TATA box-binding protein-associated factor 1 (TAF1) and its putative role in the heat shock response in the protozoan parasite Entamoeba histolytica

Abstract

Transcription factor IID (TFIID) is a cornerstone in the transcription initiation in eukaryotes. It is composed of TBP and approximately 14 different subunits named TBP-associated factors (TAFs). TFIID has a key role in transcription of many genes involved in cell proliferation, cell growth, cell cycle, cell cycle checkpoint, and various other processes as well. Entamoeba histolytica, the protozoan parasite responsible for human amoebiasis, represents a major global health concern. Our research group has previously reported the genes coding the TATA box-binding protein (EhTBP) and TBP-related factor 1 (EhTRF1), which displayed different mRNA levels in trophozoites under different stress conditions. In this work, we identified the TBP-associated factor 1 (Ehtaf1) gene in the E. histolytica genome, which possess a well-conserved DUF domain and a Bromo domain located in the middle and C-terminus of the protein, respectively. The EhTAF1-DUF domain tertiary structure is similar to the corresponding HsTAF1 DUF domain. RT-qPCR experiments with RNA isolated from trophozoites harvested at different time points of the growth curve and under different stress conditions revealed that the Ehtaf1 gene was found slightly upregulated in the death phase of growth curve, but under heat shock stress, it was found upregulated 10 times, suggesting that Ehtaf1 might have an important role in the heat shock stress response. We also found that EhTAF1 is expressed in the nucleus and cytoplasm at 37 °C, but under heat shock stress, it is overexpressed in both the nucleus and cytoplasm, and partially colocalized with EhHSP70 in cytoplasm.

https://ift.tt/2EjyzNw

In Schizophrenia, Increased Plasma IgM/IgA Responses to Gut Commensal Bacteria Are Associated with Negative Symptoms, Neurocognitive Impairments, and the Deficit Phenotype

Abstract

Increased gut permeability (leaky gut) with increased translocation of Gram-negative bacteria plays a role in the gut-brain axis through effects on systemic immune-inflammatory processes. Deficit schizophrenia is characterized by an immune-inflammatory response combined with a deficit in natural IgM antibodies to oxidative-specific epitopes (OSEs), which are a first-line defense against bacterial infections. This study measured plasma IgA/IgM responses to 5 Gram-negative bacteria in association with IgM responses to malondialdehyde (MDA) and azelaic acid in 80 schizophrenia patients (40 with the deficit syndrome and 40 without) and in 38 healthy controls. Deficit schizophrenia was characterized by significantly increased IgA responses to Hafnei alvei, Pseudomonas aeruginosa, Morganella morganii, and Klebsiella pneumoniae as compared with non-deficit schizophrenia. The presence of deficit schizophrenia was highly predicted by increased IgA responses to Pseudomonas putida and IgM responses to all five Gram-negative bacteria and lowered natural IgM to MDA and azelaic acid with a bootstrap area under the receiver operating characteristic curve of 0.960 (2000 random curves). A large proportion of the variance (41.5%) in the negative subscale score of the Positive and Negative Syndrome Scale was explained by the regression on IgA responses to K. pneumoniae and IgM responses to the five enterobacteria coupled with lowered IgM antibodies to azelaic acid. There were significant associations between IgA levels to Gram-negative bacteria and Mini-Mental State Examination, Boston naming test, Verbal Fluency, and Word List Memory test scores. These findings provide further evidence that deficit schizophrenia is a distinct phenotype of schizophrenia, which is characterized by an increased impact of Gram-negative commensal bacteria coupled with a deficit in natural IgM, pointing to aberrations in B1 cells. It is concluded that increased bacterial translocation and deficits in the compensatory immune-regulatory system (CIRS) may drive negative symptoms and neurocognitive impairments, which are hallmarks of deficit schizophrenia.

https://ift.tt/2S7FcXr

Thymosin beta 4-Induced Autophagy Increases Cholinergic Signaling in PrP (106–126)-Treated HT22 Cells

Abstract

Prion protein peptide (PrP) has been associated with neurotoxicity in brain cells and progression of prion diseases due to spongiform degeneration and accumulation of the infectious scrapie prion protein (PrP^Sc). Autophagy has been shown to provide protective functions for neurodegenerative diseases, including prion disease. Thymosin beta 4 (Tβ₄) plays a key role in the nervous system, providing a neuronal growth effect that includes motility, neurite outgrowth, and proliferation. However, the effect of Tβ₄ on autophagy in prion disease has not been investigated. In this study, we investigated the neuroprotective effects of Tβ₄, an activator of autophagy, in cholinergic signaling activation in PrP (106–126)-treated HT22 cells. We found that Tβ₄-induced autophagy markers, LC3A/B and Beclin1, were protective against PrP-induced neurotoxicity. Interestingly, a balance between autophagy markers and autophagy pathway factors (AKT, p-AKT, mTOR, and p-mTOR) was maintained by Tβ₄ competitively against each protein factors reacted to PrP (106–126). The cholinergic signaling markers ChTp and AChE, which play an important role in the brain, were maintained by Tβ₄ competitively against each protein factors reacted to PrP (106–126). However, these results were reversed by 3-MA, an autophagy inhibitor. Taken together, our results indicate that Tβ₄ has cholinergic signaling activities through the induction of autophagy. Thus, Tβ₄ may be to a potential therapeutic agent for preventing neurodegenerative diseases.

https://ift.tt/2QCz4K4

Positive influence of simvastatin used as adjuvant agent for cavity lining

Abstract

Objectives

To assess the biological, antimicrobial, and mechanical effects of the treatment of deep dentin with simvastatin (SV) before application of a glass-ionomer cement (GIC).

Materials and methods

Dentin discs were adapted to artificial pulp chambers and SV (2.5 or 1.0 mg/mL) was applied to the occlusal surface, either previously conditioned or not with EDTA (±EDTA). The extracts (culture medium + SV that diffused through dentin) was obtained and then applied to cultured odontoblast-like MDPC-23 cells. Cell viability, alkaline phosphatase (ALP) activity, and mineralization nodule (MN) deposition were evaluated. Untreated discs were used as control. The antibacterial activity of SV (2.5 or 1.0 mg/mL) against Streptococcus mutans and Lactobacillus acidophilus, as well as the bond strength of GIC to dentin in the presence of SV 2.5 mg/mL (±EDTA) were also assessed. The data were analyzed by ANOVA/Tukey tests (α = 5%).

Results

EDTA + SV 2.5 mg/mL significantly enhanced the ALP activity and MN deposition in comparison with the control, without changing in the cell viability (p < 0.05). The association EDTA + SV 2.5 mg/mL + GIC determined the highest ALP and MN values (p < 0.05). SV presented intense antimicrobial activity, and the EDTA dentin conditioning followed by SV application increased bond strength values compared with SV treatment alone (p < 0.05).

Conclusion

SV presents antimicrobial activity and diffuses across conditioned dentin to biostimulate odontoblast-like pulp cells.

Clinical significance

The use of SV as adjuvant agent for indirect pulp capping may biostimulate pulp cells thus preserving vitality and function of the pulp-dentin complex.

https://ift.tt/2S0AYAI

In vitro characterization of hepatic toxicity of Alternaria toxins

Abstract

Alternaria mycotoxins are secondary fungal metabolites which can contaminate food and feed. They are produced by Alternaria species with alternariol (AOH), alternariol monomethyl ether (AME), tenuazonic acid (TeA), and tentoxin (TEN) as the main representatives for Alternaria mycotoxins in food. Once passing the intestinal barrier, Alternaria toxins can reach the liver to exert yet uncharacterized molecular effects. Therefore, hepatic in vitro systems were used to examine selected Alternaria mycotoxins for their induction of metabolism-dependent cytotoxicity, phosphorylation of the histone H2AX as a surrogate marker for DNA double-strand breaks, and relevant marker genes for hepatotoxicity. Analysis of cell viability as well as the induction of H2AX phosphorylation in the hepatocarcinoma cell line HepG2 revealed a detoxification of 100 μmol/l AME and AOH by pre-treatment with S9 liver homogenate as shown by a decrease in cytotoxicity and H2AX histone phosphorylation to levels observed in control cells. Concentrations up to 100 μmol/l TeA and TEN did not induce H2AX phosphorylation whether metabolized or not. In the metabolically competent human hepatoma cell line HepaRG, no cytotoxicity of Alternaria toxins occurred even at high concentrations up to 100 μmol/l, which indicates a low cytotoxic potential. Induction of gene expression associated with liver toxicity was analyzed by quantitative real-time PCR using a specific hepatotoxicity PCR array in HepaRG cells: here, an evidence was found that 50 μmol/l of AOH, AME, TeA, and TEN might be associated with hepatotoxic effects, necrosis, and the development of diseases like cholestasis and phospholipidosis.

https://ift.tt/2QWDfzu

Response to “Reproductive Function Abnormalities and Bariatric Surgery: is a Matter of Time?”

https://ift.tt/2zZDD6B

Complex gastric surgery in Germany—is centralization beneficial? Observational study using national hospital discharge data

Abstract

Purpose

This observational study explored the association between hospital volume and short-term outcome following gastric resections for non-bariatric indication, aiming to contribute to the discussion on centralization of complex visceral surgery in Germany.

Methods

Based on complete national hospital discharge data from 2010 to 2015, the association between hospital volume and in-hospital mortality was evaluated according to volume quintiles and volume deciles. Case-mix differences regarding surgical indication, age, sex, and comorbidities were considered for risk adjustment. In addition, rates of major complications and failure to rescue were analyzed across hospital volume categories.

Results

Inpatient episodes (72,528) with gastric resection were analyzed. Risk-adjusted mortality in patients treated in very low volume hospitals (median volume of 5 surgeries per year) was higher (12.0% [95% CI 11.4 to 12.5]) compared to those treated in very high volume hospitals (50 surgeries per year; 10.6% [10.0 to 11.1]). Failure to rescue patients with complications was 28.1% [27.0 to 29.3] in very low volume hospitals and 22.7% [21.6 to 23.8] in very high volume hospitals. Differences were similar within the subgroup of patients operated for gastric cancer.

Conclusions

Treatment in very high volume hospitals is associated with a lower in-hospital mortality compared to treatment in very low volume hospitals. This effect seems to be determined by the ability to rescue patients who experience complications. As the observed benefit is only related to very high volumes, the results do not clearly indicate that centralization may improve short-term results substantially, unless a very high degree of centralization would be achieved. Possibly, further research focusing on other outcome measures, such as clinical processes or long-term results, might lead to divergent conclusions.

https://ift.tt/2rAC9v1

Correction to: ZNF143 is a regulator of chromatin loop

There are some errors in Fig. 1. First, owing to a production error, the sub-figure labels a, b, and c were absent in the online version, and the proportion number 55.1% together with its bracket for cell type HelaS3 were messy in Fig. 1a.

https://ift.tt/2S6Ruzi

Recent Advances on Relationship Between Inorganic Phosphate and Pathologic Calcification: Is Calcification After Breast Augmentation with Fat Grafting Correlated with Locally Increased Concentration of Inorganic Phosphate?

Abstract

Background

Pathologic calcification has frequently occurred after breast augmentation with fat grafting as well as other conditions such as breast cancer, trauma, myocardial infarction, arteriosclerosis and even after reduction mammoplasty. Inorganic phosphate, correlated with fat metabolism, is an important factor that induces pathologic calcification such as vascular calcification.

Methods

A literature search was conducted using PubMed with the keywords: calcification, inorganic phosphate, fat. Studies related to the process of pathologic calcification, correlation between inorganic phosphate and pathologic calcification, between inorganic phosphate and fat metabolism in pathologic calcification were collected.

Results

Various mechanisms were referred to in pathologic calcification among which inorganic phosphate played an important role. Inorganic phosphate could be liberated, under the effect of various enzymes, in the process of fat metabolism. The authors hypothesized that a large-scale necrotizing zone, which could occur in fat grafting with large amounts per cannula, might provide a high-phosphate environment which might contribute to differentiation of surrounding cells such as stem cells or regenerated vessel cells into osteoblast-like cells that induce pathologic calcification.

Conclusion

Inorganic phosphate, which was correlated with fat metabolism, played a significant role in pathologic calcification. We firstly hypothesize that calcification after fat grafting may be related to locally increasing concentrations of phosphate in a necrotizing zone. Further research should be conducted to verify this hypothesis.

Level of Evidence V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

https://ift.tt/2QypFTs

The Use of Platelet-Rich Plasma in Aesthetic and Regenerative Medicine: A Comprehensive Review

Abstract

Introduction

In recent years, platelet-rich plasma (PRP) has emerged as a promising autologous biological treatment modality for the use in aesthetic and regenerative medicine. PRP is a high concentration of platelets derived from whole blood which is isolated by centrifugation to separate and concentrate platelet-containing plasma from red blood cells. PRP comprises hundreds of bioactive proteins, including growth factors, peptides, and cytokines that stimulate healing of skin and soft tissues. Attractive features of PRP are the extended release of various growth and differentiation factors from activated platelets, tissue regenerative, and healing capabilities, as well as the lack of problems associated with immunogenicity. Because of the unique biological features of this whole blood-derived biological agent, multiple clinical uses for PRP exist for aesthetic and regenerative medicine.

Evidence Acquisitions

A comprehensive review of the literature regarding the use of platelet-rich plasma in aesthetic and regenerative medicine was performed.

Evidence Synthesis

Therapeutic applications of PRP including several methods for its clinical deployment in conditions related to aesthetic and regenerative medicine including wound healing, skin and facial rejuvenation, hair restoration, hand rejuvenation, breast augmentation, and musculoskeletal regeneration were reviewed.

Conclusion

PRP treatment has shown itself as a bright future for a safe and efficient cosmetic intervention. However, more studies are needed to better our understanding of limitations and benefits in clinical phases associated with the aesthetic use of PRP.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Effectiveness of 2% Articaine as an anesthetic agent in children: randomized controlled trial

Abstract

Aim

The aim of this study was to compare the effectiveness of 2% articaine and 2% lignocaine in achieving adequate anesthesia in children between the age group of 6–13 years using inferior alveolar nerve block.

Methods

A triple blinded randomized controlled trial was conducted in 180 participants (90 patients- 2% articaine, 90 patients-2% lignocaine). Effectiveness of the anesthetic agent was determined at 3 points determined by subjective evaluation of pain using pain scales (FPS-R). Paired sample t-test and chi square test were performed for statistical significance.

Result

Anesthetic success for 2% articaine were 64.4%, 42.2% and 81.8% respectively. The anesthetic success of 2% lignocaine was 66.7%, 48.9% and 85.7% at point one, point two and point three respectively (p > 0.05).

Conclusion

This study concludes that 2% articaine in 1:2,00,000 did not demonstrate superior clinical effectiveness in comparison to 2% lignocaine.

Clinical significance

Lignocaine has always been considered the gold standard. With its unique chemical structure and increased potency, Articaine has been gaining popularity. Its efficacy in 2% concentration had not been compared to 2% lignocaine. 2% articaine did not show clinical superiority but its comparable effectiveness with lignocaine can encourage further research in using articaine in reduced concentrations to improve effectiveness.

https://ift.tt/2zYR9aw

Radiologic types of Mycobacterium xenopi pulmonary disease: different patients with similar short-term outcomes

Abstract

Mycobacterium xenopi pulmonary disease (Mxe-PD) is common among nontuberculous mycobacterial infections in Europe and Canada. Associations between radiological pattern and clinical features and outcomes are inadequately studied in Mxe-PD. We sought to investigate clinical characteristics and outcomes according to the dominant radiological pattern among patients with Mxe-PD. We retrospectively studied patients with Mxe-PD seen in our clinic, categorizing their predominant CT pattern as nodular bronchiectasis, fibrocavitary, or unclassifiable, and compared clinical characteristics, treatment, and outcomes between radiologic groups. Of 94 patients with Mxe-PD, CT patterns comprised nodular bronchiectasis (40/94, 42.6%), fibrocavitary (37/94, 39.4%), and unclassifiable (17/94, 18.1%). Compared with fibrocavitation, patients with nodular bronchiectasis were female dominant, less often had COPD, less often had AFB smear-positive sputum, and more frequently had co-isolation of Pseudomonas. Patients with nodular bronchiectasis were less often treated (65% versus 91.9%) and when treated, they received fewer anti-mycobacterial drugs (on average 3 versus 4). Outcomes did not differ significantly by radiological pattern. Nodular bronchiectasis was common among Mxe-PD patients in our clinic. Compared with fibrocavitary disease, patients with nodular bronchiectasis had features suggestive of milder disease and were less often treated. Among treated patients, outcomes did not differ by radiologic pattern.

https://ift.tt/2QtS5hD

Patient 3D body pose estimation from pressure imaging

Abstract

Purpose

In-bed motion monitoring has become of great interest for a variety of clinical applications. Image-based approaches could be seen as a natural non-intrusive approach for this purpose; however, video devices require special challenging settings for a clinical environment. We propose to estimate the patient's posture from pressure sensors' data mapped to images.

Methods

We introduce a deep learning method to retrieve human poses from pressure sensors data. In addition, we present a second approach that is based on a hashing content-retrieval approach.

Results

Our results show good performance with both presented methods even in poses where the subject has minimal contact with the sensors. Moreover, we show that deep learning approaches could be used in this medical application despite the limited amount of available training data. Our ConvNet approach provides an overall posture even when the patient has less contact with the mattress surface. In addition, we show that both methods could be used in real-time patient monitoring.

Conclusions

We have provided two methods to successfully perform real-time in-bed patient pose estimation, which is robust to different sizes of patient and activities. Furthermore, it can provide an overall posture even when the patient has less contact with the mattress surface.

https://ift.tt/2RWl7Db

The Gaze Stabilization Test Following Concussion.

Related Articles

The Gaze Stabilization Test Following Concussion.

J Am Acad Audiol. 2018 Nov 29;:

Authors: Dunlap PM, Mucha A, Smithnosky D, Whitney SL, Furman JM, Collins MW, Kontos AP, Sparto PJ

Abstract
BACKGROUND: Concussion can cause vestibular dysfunction and oculomotor abnormalities which can lead to dizziness and protracted recovery time. There are few clinically useful, functional measures of the vestibulo-ocular reflex (VOR) post-concussion.
PURPOSE: The purpose of this study was to examine the gaze stabilization test (GST) in those referred for vestibular physical therapy following concussion, to determine the association between GST and other measures of recovery following concussion, and to examine the effect of demographic variables on GST performance.
RESEARCH DESIGN: Retrospective chart review.
STUDY SAMPLE: One hundred fifty-eight individuals who sustained a concussion and were referred to vestibular physical therapy.
DATA COLLECTION AND ANALYSIS: Horizontal and vertical GST scores (HGST and VGST), neurocognitive testing results, and demographic data were extracted retrospectively from the patient health record. Correlations between GST velocity and neurocognitive test results and between GST and patient-reported outcomes were examined. Differences in GST performance among patient subgroups were examined using one-way analysis of variance.
RESULTS: Subjects included individuals aged 12 to 43 years (mean = 20, standard deviation [SD] = 7), with most having sport-related concussion (67%). The mean time from injury to GST was 215 days (SD = 241) and the mean time from physical therapy evaluation to GST was 48 days (SD = 54). HGST and VGST had a weak positive correlation to the Activities-Specific Balance Confidence Scale (r = 0.20, r = 0.21) and weak negative correlation to the Dizziness Handicap Inventory (r = -0.18, r = -0.22). HGST had a weak positive correlation to the visual motor processing speed domain of the immediate post-concussion assessment and cognitive test (r = 0.20). Male patients achieved significantly higher velocities than female patients on HGST and VGST (p = 0.02, p = 0.01).
CONCLUSIONS: The present study details the use of GST in patients with concussion and demonstrates an association with common outcome measures in vestibular rehabilitation. Results indicate that patients who achieved higher velocities on GST perceived lower handicap due to dizziness and had higher confidence in their balance. GST may be a relevant test of VOR in this population, as it is a more functional test of the VOR required for sports. Future work is needed to further evaluate the role of GST in concussion management.

PMID: 30541656 [PubMed - as supplied by publisher]

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Communication between Audiologist, Patient, and Patient's Family Members during Initial Audiology Consultation and Rehabilitation Planning Sessions: A Descriptive Review.

Related Articles

Communication between Audiologist, Patient, and Patient's Family Members during Initial Audiology Consultation and Rehabilitation Planning Sessions: A Descriptive Review.

J Am Acad Audiol. 2018 Nov 29;:

Authors: Manchaiah V, Bellon-Harn ML, Dockens AL, Azios JH, Harn WE

Abstract
BACKGROUND: Communication during clinical consultations is an important factor that facilitates decision-making by patients and family members. For clinicians, these interactions are opportunities to build rapport and to facilitate appropriate decision-making.
PURPOSE: This article presents the literature review of studies focusing on communication between audiologist, patients, and their family members during initial audiology consultations and rehabilitation planning sessions.
RESEARCH DESIGN: A literature review was conducted.
STUDY SAMPLE: The review included eight empirical studies.
DATA COLLECTION AND ANALYSIS: A systematic search of the CINAHL Complete, MEDLINE, and PsychInfo databases was used to identify relevant articles for review. Quality of the included studies was assessed using the Rating of Qualitative Research (RQR) scale.
RESULTS: The average consultation length was 57.4 min (ranged 27.3-111 min), in which the mean length of case history discussion was 8.8 min (ranged 1.7-22.6 min) and the mean length of diagnosis and management planning was 29 min (ranged 2.2-78.5 min). Utterances spoken by audiologists were greater (about 51%) than patients (37%), whereas family members spoke the fewest utterances (12%) during interactions. Patients raised concerns (typically psychological in nature with negative emotional stance) about hearing aids in half of the appointments where hearing aids were recommended as the rehabilitation option. However, audiologists missed opportunities to build relationships as these concerns of patients were not typically addressed. Also, audiologists' language was associated with hearing aid uptake (i.e., patients were less likely to uptake hearing aids when audiologists used complex language).
CONCLUSIONS: The review highlights that audiologists dominate the conversation during audiology consultations and rehabilitation planning sessions. Audiologists did not take advantage of the opportunity to develop patient-centered communication and shared decision-making. Implications of these findings to both clinical practice and to audiology education and training are discussed.

PMID: 30541658 [PubMed - as supplied by publisher]

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Application of Wireless Contralateral Routing of Signal Technology in Unilateral Cochlear Implant Users with Bilateral Profound Hearing Loss.

Related Articles

Application of Wireless Contralateral Routing of Signal Technology in Unilateral Cochlear Implant Users with Bilateral Profound Hearing Loss.

J Am Acad Audiol. 2018 Nov 29;:

Authors: Snapp HA, Hoffer ME, Spahr A, Rajguru S

Abstract
PURPOSE: The aim of the study was to determine if contralateral routing of signal (CROS) technology results in improved hearing outcomes in unilateral cochlear implant (CI) patients and provides similar gains in speech perception in noise to traditional monaural listeners (MLs).
RESEARCH DESIGN: The study is a prospective, within-subject repeated-measures experiment.
STUDY SAMPLE: Adult, English-speaking patients with bilateral severe-profound sensorineural hearing loss using an Advanced Bionics CI (n = 12) in one ear were enrolled for the study.
INTERVENTION: Hearing performance in the monaural listening condition (CI only) was compared with the CROS-aided (unilateral CI + CROS) condition. Participants were tested for speech-in-noise performance using the Bamford-Kowal-Bench Speech-in-Noise™ test materials in the speech front/noise front (0 degrees/0 degrees azimuth), speech front/noise back (0 degrees/180 degrees azimuth), speech deaf ear/noise monaural ear (90 degrees/270 degrees azimuth), and speech monaural ear/noise deaf ear (90 degrees/270 degrees azimuth) configurations. Localization error was assessed using three custom stimuli consisting of 1/3 octave narrowband noises centered at 500 and 4000 Hz and a broadband speech stimulus. Localization stimuli were presented at random in the front hemifield by 19 speakers spatially separated by 10 degrees. Outcomes were compared with a previously described group of traditional MLs in the CROS-aided condition (normal hearing ear + CROS).
DATA COLLECTION AND ANALYSIS: All participants were tested acutely with no adaptation to the CROS device. Statistical analyses were performed using Wilcoxon signed rank tests for nonparametric data and paired sample. Statistical significance was set to p < 0.00625 after Bonferroni adjustment for eight tests.
RESULTS: Significant benefit was observed from unaided to the CI + CROS-aided condition for listening in noise across most listening conditions with the greatest benefit observed in the speech deaf ear/noise monaural ear (90 degrees/270 degrees azimuth) condition (p < 0.0005). When compared with traditional MLs, no significant difference in decibel gain from the unaided to CROS-aided conditions was observed between participant groups. There was no improvement in localization ability in the CROS-aided condition for either participant group and no significant difference in performance between traditional MLs and unilateral CI listeners.
CONCLUSIONS: These findings support that unilateral CI users are capable of achieving similar gains in speech perception to that of traditional MLs with wireless CROS. These results indicate that the use of wireless CROS stimulation in unilateral CI recipients provides increased benefit and an additional rehabilitative option for this population when bilateral implantation is not possible. The results suggest that noninvasive CROS solutions can successfully rehabilitate certain monaural listening deficits, provide improved hearing outcomes, and expand the reach of treatment in this population.

PMID: 30541657 [PubMed - as supplied by publisher]

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Communication between Audiologist, Patient, and Patient's Family Members during Initial Audiology Consultation and Rehabilitation Planning Sessions: A Descriptive Review.

Related Articles

Communication between Audiologist, Patient, and Patient's Family Members during Initial Audiology Consultation and Rehabilitation Planning Sessions: A Descriptive Review.

J Am Acad Audiol. 2018 Nov 29;:

Authors: Manchaiah V, Bellon-Harn ML, Dockens AL, Azios JH, Harn WE

Abstract
BACKGROUND: Communication during clinical consultations is an important factor that facilitates decision-making by patients and family members. For clinicians, these interactions are opportunities to build rapport and to facilitate appropriate decision-making.
PURPOSE: This article presents the literature review of studies focusing on communication between audiologist, patients, and their family members during initial audiology consultations and rehabilitation planning sessions.
RESEARCH DESIGN: A literature review was conducted.
STUDY SAMPLE: The review included eight empirical studies.
DATA COLLECTION AND ANALYSIS: A systematic search of the CINAHL Complete, MEDLINE, and PsychInfo databases was used to identify relevant articles for review. Quality of the included studies was assessed using the Rating of Qualitative Research (RQR) scale.
RESULTS: The average consultation length was 57.4 min (ranged 27.3-111 min), in which the mean length of case history discussion was 8.8 min (ranged 1.7-22.6 min) and the mean length of diagnosis and management planning was 29 min (ranged 2.2-78.5 min). Utterances spoken by audiologists were greater (about 51%) than patients (37%), whereas family members spoke the fewest utterances (12%) during interactions. Patients raised concerns (typically psychological in nature with negative emotional stance) about hearing aids in half of the appointments where hearing aids were recommended as the rehabilitation option. However, audiologists missed opportunities to build relationships as these concerns of patients were not typically addressed. Also, audiologists' language was associated with hearing aid uptake (i.e., patients were less likely to uptake hearing aids when audiologists used complex language).
CONCLUSIONS: The review highlights that audiologists dominate the conversation during audiology consultations and rehabilitation planning sessions. Audiologists did not take advantage of the opportunity to develop patient-centered communication and shared decision-making. Implications of these findings to both clinical practice and to audiology education and training are discussed.

PMID: 30541658 [PubMed - as supplied by publisher]

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Application of Wireless Contralateral Routing of Signal Technology in Unilateral Cochlear Implant Users with Bilateral Profound Hearing Loss.

Related Articles

Application of Wireless Contralateral Routing of Signal Technology in Unilateral Cochlear Implant Users with Bilateral Profound Hearing Loss.

J Am Acad Audiol. 2018 Nov 29;:

Authors: Snapp HA, Hoffer ME, Spahr A, Rajguru S

Abstract
PURPOSE: The aim of the study was to determine if contralateral routing of signal (CROS) technology results in improved hearing outcomes in unilateral cochlear implant (CI) patients and provides similar gains in speech perception in noise to traditional monaural listeners (MLs).
RESEARCH DESIGN: The study is a prospective, within-subject repeated-measures experiment.
STUDY SAMPLE: Adult, English-speaking patients with bilateral severe-profound sensorineural hearing loss using an Advanced Bionics CI (n = 12) in one ear were enrolled for the study.
INTERVENTION: Hearing performance in the monaural listening condition (CI only) was compared with the CROS-aided (unilateral CI + CROS) condition. Participants were tested for speech-in-noise performance using the Bamford-Kowal-Bench Speech-in-Noise™ test materials in the speech front/noise front (0 degrees/0 degrees azimuth), speech front/noise back (0 degrees/180 degrees azimuth), speech deaf ear/noise monaural ear (90 degrees/270 degrees azimuth), and speech monaural ear/noise deaf ear (90 degrees/270 degrees azimuth) configurations. Localization error was assessed using three custom stimuli consisting of 1/3 octave narrowband noises centered at 500 and 4000 Hz and a broadband speech stimulus. Localization stimuli were presented at random in the front hemifield by 19 speakers spatially separated by 10 degrees. Outcomes were compared with a previously described group of traditional MLs in the CROS-aided condition (normal hearing ear + CROS).
DATA COLLECTION AND ANALYSIS: All participants were tested acutely with no adaptation to the CROS device. Statistical analyses were performed using Wilcoxon signed rank tests for nonparametric data and paired sample. Statistical significance was set to p < 0.00625 after Bonferroni adjustment for eight tests.
RESULTS: Significant benefit was observed from unaided to the CI + CROS-aided condition for listening in noise across most listening conditions with the greatest benefit observed in the speech deaf ear/noise monaural ear (90 degrees/270 degrees azimuth) condition (p < 0.0005). When compared with traditional MLs, no significant difference in decibel gain from the unaided to CROS-aided conditions was observed between participant groups. There was no improvement in localization ability in the CROS-aided condition for either participant group and no significant difference in performance between traditional MLs and unilateral CI listeners.
CONCLUSIONS: These findings support that unilateral CI users are capable of achieving similar gains in speech perception to that of traditional MLs with wireless CROS. These results indicate that the use of wireless CROS stimulation in unilateral CI recipients provides increased benefit and an additional rehabilitative option for this population when bilateral implantation is not possible. The results suggest that noninvasive CROS solutions can successfully rehabilitate certain monaural listening deficits, provide improved hearing outcomes, and expand the reach of treatment in this population.

PMID: 30541657 [PubMed - as supplied by publisher]

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via IFTTT

The Gaze Stabilization Test Following Concussion.

Related Articles

The Gaze Stabilization Test Following Concussion.

J Am Acad Audiol. 2018 Nov 29;:

Authors: Dunlap PM, Mucha A, Smithnosky D, Whitney SL, Furman JM, Collins MW, Kontos AP, Sparto PJ

Abstract
BACKGROUND: Concussion can cause vestibular dysfunction and oculomotor abnormalities which can lead to dizziness and protracted recovery time. There are few clinically useful, functional measures of the vestibulo-ocular reflex (VOR) post-concussion.
PURPOSE: The purpose of this study was to examine the gaze stabilization test (GST) in those referred for vestibular physical therapy following concussion, to determine the association between GST and other measures of recovery following concussion, and to examine the effect of demographic variables on GST performance.
RESEARCH DESIGN: Retrospective chart review.
STUDY SAMPLE: One hundred fifty-eight individuals who sustained a concussion and were referred to vestibular physical therapy.
DATA COLLECTION AND ANALYSIS: Horizontal and vertical GST scores (HGST and VGST), neurocognitive testing results, and demographic data were extracted retrospectively from the patient health record. Correlations between GST velocity and neurocognitive test results and between GST and patient-reported outcomes were examined. Differences in GST performance among patient subgroups were examined using one-way analysis of variance.
RESULTS: Subjects included individuals aged 12 to 43 years (mean = 20, standard deviation [SD] = 7), with most having sport-related concussion (67%). The mean time from injury to GST was 215 days (SD = 241) and the mean time from physical therapy evaluation to GST was 48 days (SD = 54). HGST and VGST had a weak positive correlation to the Activities-Specific Balance Confidence Scale (r = 0.20, r = 0.21) and weak negative correlation to the Dizziness Handicap Inventory (r = -0.18, r = -0.22). HGST had a weak positive correlation to the visual motor processing speed domain of the immediate post-concussion assessment and cognitive test (r = 0.20). Male patients achieved significantly higher velocities than female patients on HGST and VGST (p = 0.02, p = 0.01).
CONCLUSIONS: The present study details the use of GST in patients with concussion and demonstrates an association with common outcome measures in vestibular rehabilitation. Results indicate that patients who achieved higher velocities on GST perceived lower handicap due to dizziness and had higher confidence in their balance. GST may be a relevant test of VOR in this population, as it is a more functional test of the VOR required for sports. Future work is needed to further evaluate the role of GST in concussion management.

PMID: 30541656 [PubMed - as supplied by publisher]

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via IFTTT

Communication between Audiologist, Patient, and Patient's Family Members during Initial Audiology Consultation and Rehabilitation Planning Sessions: A Descriptive Review.

Related Articles

Communication between Audiologist, Patient, and Patient's Family Members during Initial Audiology Consultation and Rehabilitation Planning Sessions: A Descriptive Review.

J Am Acad Audiol. 2018 Nov 29;:

Authors: Manchaiah V, Bellon-Harn ML, Dockens AL, Azios JH, Harn WE

Abstract
BACKGROUND: Communication during clinical consultations is an important factor that facilitates decision-making by patients and family members. For clinicians, these interactions are opportunities to build rapport and to facilitate appropriate decision-making.
PURPOSE: This article presents the literature review of studies focusing on communication between audiologist, patients, and their family members during initial audiology consultations and rehabilitation planning sessions.
RESEARCH DESIGN: A literature review was conducted.
STUDY SAMPLE: The review included eight empirical studies.
DATA COLLECTION AND ANALYSIS: A systematic search of the CINAHL Complete, MEDLINE, and PsychInfo databases was used to identify relevant articles for review. Quality of the included studies was assessed using the Rating of Qualitative Research (RQR) scale.
RESULTS: The average consultation length was 57.4 min (ranged 27.3-111 min), in which the mean length of case history discussion was 8.8 min (ranged 1.7-22.6 min) and the mean length of diagnosis and management planning was 29 min (ranged 2.2-78.5 min). Utterances spoken by audiologists were greater (about 51%) than patients (37%), whereas family members spoke the fewest utterances (12%) during interactions. Patients raised concerns (typically psychological in nature with negative emotional stance) about hearing aids in half of the appointments where hearing aids were recommended as the rehabilitation option. However, audiologists missed opportunities to build relationships as these concerns of patients were not typically addressed. Also, audiologists' language was associated with hearing aid uptake (i.e., patients were less likely to uptake hearing aids when audiologists used complex language).
CONCLUSIONS: The review highlights that audiologists dominate the conversation during audiology consultations and rehabilitation planning sessions. Audiologists did not take advantage of the opportunity to develop patient-centered communication and shared decision-making. Implications of these findings to both clinical practice and to audiology education and training are discussed.

PMID: 30541658 [PubMed - as supplied by publisher]

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via IFTTT

Application of Wireless Contralateral Routing of Signal Technology in Unilateral Cochlear Implant Users with Bilateral Profound Hearing Loss.

Related Articles

Application of Wireless Contralateral Routing of Signal Technology in Unilateral Cochlear Implant Users with Bilateral Profound Hearing Loss.

J Am Acad Audiol. 2018 Nov 29;:

Authors: Snapp HA, Hoffer ME, Spahr A, Rajguru S

Abstract
PURPOSE: The aim of the study was to determine if contralateral routing of signal (CROS) technology results in improved hearing outcomes in unilateral cochlear implant (CI) patients and provides similar gains in speech perception in noise to traditional monaural listeners (MLs).
RESEARCH DESIGN: The study is a prospective, within-subject repeated-measures experiment.
STUDY SAMPLE: Adult, English-speaking patients with bilateral severe-profound sensorineural hearing loss using an Advanced Bionics CI (n = 12) in one ear were enrolled for the study.
INTERVENTION: Hearing performance in the monaural listening condition (CI only) was compared with the CROS-aided (unilateral CI + CROS) condition. Participants were tested for speech-in-noise performance using the Bamford-Kowal-Bench Speech-in-Noise™ test materials in the speech front/noise front (0 degrees/0 degrees azimuth), speech front/noise back (0 degrees/180 degrees azimuth), speech deaf ear/noise monaural ear (90 degrees/270 degrees azimuth), and speech monaural ear/noise deaf ear (90 degrees/270 degrees azimuth) configurations. Localization error was assessed using three custom stimuli consisting of 1/3 octave narrowband noises centered at 500 and 4000 Hz and a broadband speech stimulus. Localization stimuli were presented at random in the front hemifield by 19 speakers spatially separated by 10 degrees. Outcomes were compared with a previously described group of traditional MLs in the CROS-aided condition (normal hearing ear + CROS).
DATA COLLECTION AND ANALYSIS: All participants were tested acutely with no adaptation to the CROS device. Statistical analyses were performed using Wilcoxon signed rank tests for nonparametric data and paired sample. Statistical significance was set to p < 0.00625 after Bonferroni adjustment for eight tests.
RESULTS: Significant benefit was observed from unaided to the CI + CROS-aided condition for listening in noise across most listening conditions with the greatest benefit observed in the speech deaf ear/noise monaural ear (90 degrees/270 degrees azimuth) condition (p < 0.0005). When compared with traditional MLs, no significant difference in decibel gain from the unaided to CROS-aided conditions was observed between participant groups. There was no improvement in localization ability in the CROS-aided condition for either participant group and no significant difference in performance between traditional MLs and unilateral CI listeners.
CONCLUSIONS: These findings support that unilateral CI users are capable of achieving similar gains in speech perception to that of traditional MLs with wireless CROS. These results indicate that the use of wireless CROS stimulation in unilateral CI recipients provides increased benefit and an additional rehabilitative option for this population when bilateral implantation is not possible. The results suggest that noninvasive CROS solutions can successfully rehabilitate certain monaural listening deficits, provide improved hearing outcomes, and expand the reach of treatment in this population.

PMID: 30541657 [PubMed - as supplied by publisher]

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via IFTTT

The Gaze Stabilization Test Following Concussion.

Related Articles

The Gaze Stabilization Test Following Concussion.

J Am Acad Audiol. 2018 Nov 29;:

Authors: Dunlap PM, Mucha A, Smithnosky D, Whitney SL, Furman JM, Collins MW, Kontos AP, Sparto PJ

Abstract
BACKGROUND: Concussion can cause vestibular dysfunction and oculomotor abnormalities which can lead to dizziness and protracted recovery time. There are few clinically useful, functional measures of the vestibulo-ocular reflex (VOR) post-concussion.
PURPOSE: The purpose of this study was to examine the gaze stabilization test (GST) in those referred for vestibular physical therapy following concussion, to determine the association between GST and other measures of recovery following concussion, and to examine the effect of demographic variables on GST performance.
RESEARCH DESIGN: Retrospective chart review.
STUDY SAMPLE: One hundred fifty-eight individuals who sustained a concussion and were referred to vestibular physical therapy.
DATA COLLECTION AND ANALYSIS: Horizontal and vertical GST scores (HGST and VGST), neurocognitive testing results, and demographic data were extracted retrospectively from the patient health record. Correlations between GST velocity and neurocognitive test results and between GST and patient-reported outcomes were examined. Differences in GST performance among patient subgroups were examined using one-way analysis of variance.
RESULTS: Subjects included individuals aged 12 to 43 years (mean = 20, standard deviation [SD] = 7), with most having sport-related concussion (67%). The mean time from injury to GST was 215 days (SD = 241) and the mean time from physical therapy evaluation to GST was 48 days (SD = 54). HGST and VGST had a weak positive correlation to the Activities-Specific Balance Confidence Scale (r = 0.20, r = 0.21) and weak negative correlation to the Dizziness Handicap Inventory (r = -0.18, r = -0.22). HGST had a weak positive correlation to the visual motor processing speed domain of the immediate post-concussion assessment and cognitive test (r = 0.20). Male patients achieved significantly higher velocities than female patients on HGST and VGST (p = 0.02, p = 0.01).
CONCLUSIONS: The present study details the use of GST in patients with concussion and demonstrates an association with common outcome measures in vestibular rehabilitation. Results indicate that patients who achieved higher velocities on GST perceived lower handicap due to dizziness and had higher confidence in their balance. GST may be a relevant test of VOR in this population, as it is a more functional test of the VOR required for sports. Future work is needed to further evaluate the role of GST in concussion management.

PMID: 30541656 [PubMed - as supplied by publisher]

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Why could the coffee crop endure climate change and global warming to a greater extent than previously estimated?

Abstract

Coffee, one of the most heavily globally traded agricultural commodities, has been categorized as a highly sensitive plant species to progressive climatic change. Here, we summarize recent insights on the coffee plant's physiological performance at elevated atmospheric carbon dioxide concentration [CO₂]. We specifically (i) provide new data of crop yields obtained under free-air CO₂ enrichment conditions, (ii) discuss predictions on the future of the coffee crop as based on rising temperature and (iii) emphasize the role of [CO₂] as a key player for mitigating harmful effects of supra-optimal temperatures on coffee physiology and bean quality. We conclude that the effects of global warming on the climatic suitability of coffee may be lower than previously assumed. We highlight perspectives and priorities for further research to improve our understanding on how the coffee plant will respond to present and progressive climate change.

https://ift.tt/2Gem9sM

Combined effects of pumped-storage operation and climate change on thermal structure and water quality

Abstract

The assessment of ecological impacts of pumped-storage (PS) hydropower plants on the two connected water bodies is usually based on present climatic conditions. However, significant changes in climate must be expected during their long concession periods. We, therefore, investigate the combined effects of climate change and PS operations on water temperature and quality, as well as extent and duration of stratification and ice cover, using a site in Switzerland. For this purpose, a coupled two-dimensional hydrodynamic and water quality model for the two connected water bodies is run with 150 years long synthetic stochastic meteorological forcing for both current and future climate conditions under two PS and two reference scenarios. The results show relevant synergistic and antagonistic effects of PS operations and climate change. For example, hypolimnion temperatures in September are projected to increase by < 0.6 °C in a near-natural reference scenario and by ~ 2.5 °C in an extended PS scenario. Ice cover, which occurs every year under near-natural conditions in the current climate, would almost completely vanish with extended PS operation in the future climate. Conversely, the expected negative impacts of climate change on hypolimnetic dissolved oxygen concentrations are partially counteracted by extended PS operations. We, therefore, recommend considering future climate conditions for the environmental impact assessment in the planning of new or the recommissioning of existing PS hydropower plants.

https://ift.tt/2ryDO4g

The evaluation of the sense of hearing in patients with carotid artery stenosis within the extracranial segments.

Related Articles

The evaluation of the sense of hearing in patients with carotid artery stenosis within the extracranial segments.

Acta Neurol Belg. 2018 Dec 12;:

Authors: Dorobisz K, Dorobisz T, Janczak D, Krecicki T

Abstract
Stenosis of arteries that supplies blood to the brain is one of the main causes of ischemic stroke which is the third most common cause of deaths in Europe. Atherosclerosis of carotid and vertebral arteries is responsible for 20% of the ischemic stroke cases. Stenosis may be either asymptomatic or manifested with typical neurological symptoms including motor and sensory disturbances as well as disturbances in vision and speech. However, discrete non-specific symptoms of ischemia, including headaches and vertigo, tinnitus and hearing loss, are also quite common. These symptoms may be indicative of a clinically significant stenosis of carotid and vertebral arteries, particularly within the internal carotid artery region, as well as of a risk of ischemic stroke. To date, research reports were unable to provide exact explanation of correlations between impaired hearing and the stenosis of carotid and vertebral arteries. Despite this, numerous articles list these symptoms as one of the first non-specific symptoms of this disorder. The ischemic mechanism within the inner ear region may lead to early symptoms of atherosclerosis of large vessels. However, no evidence of relationship and no explanation could be provided with this regard. The objective of the study was to assess the effect of carotid and vertebral artery stenosis on the function of the hearing and equilibrium organ on the basis of diagnostic audiological examinations including pure-tone threshold audiometry, impedance audiometry, otoacoustic emission tests and brainstem auditory evoked potential tests. The study was conducted in 63 patients (32 males, 31 females) aged 45-75 years, presenting with carotid and vertebral artery stenosis and treated at the Vascular Surgery Clinic of the University Clinical Hospital in Wrocław. Patients were stratified into two subgroups according to their age (45-60 years, 61-75 years). Patients were also divided into subgroups according to the stenotic arteries and to the symptomatic/asymptomatic status of the disorder. All patients were homogeneous in terms of the degree of artery stenosis. The control group consisted of 32 healthy persons (14 males, 18 females) aged 48-75 years. Patients qualified to the control group reported no history of middle or inner ear disorders, disturbed hearing, vertigo and balance disorders, as well as cardiovascular diseases; they also presented with unremarkable ultrasound scans of the arteries. All patients were subjected to precise audiological examinations. Prior to being qualified for the study, patients were subjected to the assessment of arteries by means of Doppler ultrasonography. The hearing organ function was assessed by means of pure-tone threshold audiometry, impedance audiometry, otoacoustic emission tests and brainstem auditory evoked potential tests. Reduction of the flow through the carotid arteries causes problems in the organ of hearing; abnormalities are reported especially in tone threshold audiometry, examinations of the stapedius muscle reflexes and brainstem auditory evoked potentials, which prove the presence of receptive cochlear-extracochlear hearing damage. Disturbances of the organ of hearing have similar severity in stenosis of the internal carotid artery and vertebral artery. Abnormalities found in audiologic examinations in patients with carotid artery stenosis are not always explicitly clinically expressed in patients with hearing loss; we should consider diagnostics for carotid artery stenosis.

PMID: 30542965 [PubMed - as supplied by publisher]

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Cochrane corner: platinum-induced hearing loss after treatment for childhood cancer.

Related Articles

Cochrane corner: platinum-induced hearing loss after treatment for childhood cancer.

Int J Audiol. 2018 Dec 13;:1-4

Authors: Brennan-Jones CG, McMahen C, Van Dalen EC

Abstract
This Cochrane Corner features the review entitled "Platinum-induced hearing loss after treatment for childhood cancer" published in 2016. In their review, van As et al. identified 13 cohort studies including 2837 participants with a hearing test after treatment with a platinum-based therapy for different types of childhood cancers. All studies had problems related to quality of the evidence. The reported frequency of hearing loss varied between 1.7% and 90.1% for studies that included a definition of hearing loss; none of the studies provided data on tinnitus. Only two studies evaluated possible risk factors. One study found a higher risk of hearing loss in people treated with the combination of cisplatin plus carboplatin compared to treatment with cisplatin only and for exposure to aminoglycosides. The other found that age at treatment (lower risk in older children) and single maximum cisplatin dose (higher risk with an increasing dose) were significant predictors for hearing loss, while gender was not. This systematic review shows that children treated with platinum analogues are at risk of developing hearing loss, but the exact prevalence and risk factors remain unclear.

PMID: 30545270 [PubMed - as supplied by publisher]

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Circulating Immune Complexes and Heat Shock Protein 70 in the Sera of Patients with Sudden Sensorineural Hearing Loss.

Related Articles

Circulating Immune Complexes and Heat Shock Protein 70 in the Sera of Patients with Sudden Sensorineural Hearing Loss.

J Int Adv Otol. 2018 Dec 12;:

Authors: Osińska KP, Gołda R, Osiński S, Kaźmierczak H, Krumrych W, Marzec M, Przybylski G

Abstract
OBJECTIVES: The aim of this paper is to analyze and assess the usefulness of heat shock protein 70 (Hsp70) and circulating immune complexes (CIC) in patients with sudden sensorineural hearing loss (SSHL) in a tertiary care hospital in a research university (2014-2017).
MATERIALS AND METHODS: Patients were interviewed about the history of diseases; underwent an ear, nose, and throat (ENT) examination; a hearing test; and were analyzed for the presence of CIC and Hsp70 protein. A simple dot blot method was designed for the purpose of identification of Hsp70 bound to CIC and free Hsp70.
RESULTS: In 59.4% of patients with idiopathic SSHL, elevated levels of immune complexes were observed. Compared with healthy subjects, a significant difference was noted (p=0.00016). Positive reactions to the presence of free Hsp70 protein were noted in the sera of 48.4% of patients. In the control group, free Hsp70 was observed in 8% of patients (p=0.0000034). Hsp70 bound to CIC was detected in the sera of 62.5% of patients; and in healthy cases, in 12% (p<0.0001).
CONCLUSION: In the sera of persons with SSHL, there are elevated levels of CIC and Hsp70. After the application of the innovative method for determining the occurrence of Hsp70 bound to CIC, it was stated that its presence is greater than that of free Hsp70, commonly detected by means of the Western-blot method. The dot blot method applied in the present study increases the Hsp70 identification and by the same token increases the probability of detection of autoimmunological background of SSHL.

PMID: 30541735 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader https://ift.tt/2QBViMg

Cochrane corner: platinum-induced hearing loss after treatment for childhood cancer.

Related Articles

Cochrane corner: platinum-induced hearing loss after treatment for childhood cancer.

Int J Audiol. 2018 Dec 13;:1-4

Authors: Brennan-Jones CG, McMahen C, Van Dalen EC

Abstract
This Cochrane Corner features the review entitled "Platinum-induced hearing loss after treatment for childhood cancer" published in 2016. In their review, van As et al. identified 13 cohort studies including 2837 participants with a hearing test after treatment with a platinum-based therapy for different types of childhood cancers. All studies had problems related to quality of the evidence. The reported frequency of hearing loss varied between 1.7% and 90.1% for studies that included a definition of hearing loss; none of the studies provided data on tinnitus. Only two studies evaluated possible risk factors. One study found a higher risk of hearing loss in people treated with the combination of cisplatin plus carboplatin compared to treatment with cisplatin only and for exposure to aminoglycosides. The other found that age at treatment (lower risk in older children) and single maximum cisplatin dose (higher risk with an increasing dose) were significant predictors for hearing loss, while gender was not. This systematic review shows that children treated with platinum analogues are at risk of developing hearing loss, but the exact prevalence and risk factors remain unclear.

PMID: 30545270 [PubMed - as supplied by publisher]

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via IFTTT

The evaluation of the sense of hearing in patients with carotid artery stenosis within the extracranial segments.

Related Articles

The evaluation of the sense of hearing in patients with carotid artery stenosis within the extracranial segments.

Acta Neurol Belg. 2018 Dec 12;:

Authors: Dorobisz K, Dorobisz T, Janczak D, Krecicki T

Abstract
Stenosis of arteries that supplies blood to the brain is one of the main causes of ischemic stroke which is the third most common cause of deaths in Europe. Atherosclerosis of carotid and vertebral arteries is responsible for 20% of the ischemic stroke cases. Stenosis may be either asymptomatic or manifested with typical neurological symptoms including motor and sensory disturbances as well as disturbances in vision and speech. However, discrete non-specific symptoms of ischemia, including headaches and vertigo, tinnitus and hearing loss, are also quite common. These symptoms may be indicative of a clinically significant stenosis of carotid and vertebral arteries, particularly within the internal carotid artery region, as well as of a risk of ischemic stroke. To date, research reports were unable to provide exact explanation of correlations between impaired hearing and the stenosis of carotid and vertebral arteries. Despite this, numerous articles list these symptoms as one of the first non-specific symptoms of this disorder. The ischemic mechanism within the inner ear region may lead to early symptoms of atherosclerosis of large vessels. However, no evidence of relationship and no explanation could be provided with this regard. The objective of the study was to assess the effect of carotid and vertebral artery stenosis on the function of the hearing and equilibrium organ on the basis of diagnostic audiological examinations including pure-tone threshold audiometry, impedance audiometry, otoacoustic emission tests and brainstem auditory evoked potential tests. The study was conducted in 63 patients (32 males, 31 females) aged 45-75 years, presenting with carotid and vertebral artery stenosis and treated at the Vascular Surgery Clinic of the University Clinical Hospital in Wrocław. Patients were stratified into two subgroups according to their age (45-60 years, 61-75 years). Patients were also divided into subgroups according to the stenotic arteries and to the symptomatic/asymptomatic status of the disorder. All patients were homogeneous in terms of the degree of artery stenosis. The control group consisted of 32 healthy persons (14 males, 18 females) aged 48-75 years. Patients qualified to the control group reported no history of middle or inner ear disorders, disturbed hearing, vertigo and balance disorders, as well as cardiovascular diseases; they also presented with unremarkable ultrasound scans of the arteries. All patients were subjected to precise audiological examinations. Prior to being qualified for the study, patients were subjected to the assessment of arteries by means of Doppler ultrasonography. The hearing organ function was assessed by means of pure-tone threshold audiometry, impedance audiometry, otoacoustic emission tests and brainstem auditory evoked potential tests. Reduction of the flow through the carotid arteries causes problems in the organ of hearing; abnormalities are reported especially in tone threshold audiometry, examinations of the stapedius muscle reflexes and brainstem auditory evoked potentials, which prove the presence of receptive cochlear-extracochlear hearing damage. Disturbances of the organ of hearing have similar severity in stenosis of the internal carotid artery and vertebral artery. Abnormalities found in audiologic examinations in patients with carotid artery stenosis are not always explicitly clinically expressed in patients with hearing loss; we should consider diagnostics for carotid artery stenosis.

PMID: 30542965 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader https://ift.tt/2S1ERVZ
via IFTTT

Circulating Immune Complexes and Heat Shock Protein 70 in the Sera of Patients with Sudden Sensorineural Hearing Loss.

Related Articles

Circulating Immune Complexes and Heat Shock Protein 70 in the Sera of Patients with Sudden Sensorineural Hearing Loss.

J Int Adv Otol. 2018 Dec 12;:

Authors: Osińska KP, Gołda R, Osiński S, Kaźmierczak H, Krumrych W, Marzec M, Przybylski G

Abstract
OBJECTIVES: The aim of this paper is to analyze and assess the usefulness of heat shock protein 70 (Hsp70) and circulating immune complexes (CIC) in patients with sudden sensorineural hearing loss (SSHL) in a tertiary care hospital in a research university (2014-2017).
MATERIALS AND METHODS: Patients were interviewed about the history of diseases; underwent an ear, nose, and throat (ENT) examination; a hearing test; and were analyzed for the presence of CIC and Hsp70 protein. A simple dot blot method was designed for the purpose of identification of Hsp70 bound to CIC and free Hsp70.
RESULTS: In 59.4% of patients with idiopathic SSHL, elevated levels of immune complexes were observed. Compared with healthy subjects, a significant difference was noted (p=0.00016). Positive reactions to the presence of free Hsp70 protein were noted in the sera of 48.4% of patients. In the control group, free Hsp70 was observed in 8% of patients (p=0.0000034). Hsp70 bound to CIC was detected in the sera of 62.5% of patients; and in healthy cases, in 12% (p<0.0001).
CONCLUSION: In the sera of persons with SSHL, there are elevated levels of CIC and Hsp70. After the application of the innovative method for determining the occurrence of Hsp70 bound to CIC, it was stated that its presence is greater than that of free Hsp70, commonly detected by means of the Western-blot method. The dot blot method applied in the present study increases the Hsp70 identification and by the same token increases the probability of detection of autoimmunological background of SSHL.

PMID: 30541735 [PubMed - as supplied by publisher]

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via IFTTT

Flow-Mediated Drug Transport from Drug-Eluting Stents is Negligible: Numerical and In-vitro Investigations

Abstract

Prior numerical studies have shown that the blood flow patterns surrounding drug-eluting stents can enhance drug uptake in stented arteries. However, these studies employed steady-state simulations, wherein flow and drug transport parameters remained constant with respect to time. In the present study, numerical simulations and in-vitro experiments were performed to determine whether luminal blood flow patterns can truly enhance drug uptake in stented arteries. Unlike the aforementioned studies, the time-varying depletion of drug within the stent coating was modelled and the simulation results were validated qualitatively with the in-vitro experiments. The simulations showed that the non-Newtonian properties of blood, its complex near-wall behavior, and the pulsatility of its flow all affect drug uptake only modestly. Furthermore, flow-mediated drug transport was found to be negligible due to the rapid rate at which drug depletes at the stent coating surfaces that are exposed to arterial blood flow. For fluid dynamicists, these results show that steady-state simulations must be avoided when modelling drug transport in stented arteries. For device designers, these results may be used to optimize the shape of drug-eluting stent struts and coatings to improve stent efficacy.

https://ift.tt/2SLlQaj

High Speed Pneumatic Stepper Motor for MRI Applications

Abstract

Presented in this paper is an exploration into the efficacy of a plastic, four-cylinder piston pneumatic motor designed for driving medical instruments inside magnetic resonance imaging (MRI) systems. Because of the increasing use of MRI for diagnostic and interventional purposes and the benefits that could be realized by operating with real-time MR image guidance, there exists a significant need for MRI compliant surgical devices. Some type of actuation mechanism is necessary to drive such devices. The motor can be controlled to operate in a "step" type motion by using pneumatic valves to sequentially apply air pressure to push the piston surfaces, meaning the motor is metal-free and does not use electricity. The stepwise nature of this piston stepper motor is ideal for the accurate, controlled movements required for MRI-guided interventions. The motor was geared down by a gearbox to increase torque. Performance indices determined include output torque and achievable rotational velocity with respect to factors such as air pressure and load conditions. The stepper motor achieved speeds of approximately 2000 rpm, and maximum output torques of approximately 19 N mm. The motor represents a high speed pneumatic stepper motor design capable of actuating devices in MR environments without affecting image quality.

https://ift.tt/2QR5v6E

Strongyloides stercoralis infection in imported and local dogs in Switzerland: from clinics to molecular genetics

Abstract

Strongyloides stercoralis is a worldwide-distributed intestinal nematode affecting mainly humans and dogs. Canine strongyloidosis is generally characterised by diarrhoea, malabsorption and bronchopneumonia, and may be fatal in cases of impaired immunity. In recent years, molecular and epidemiological studies suggested that host-adapted populations of S. stercoralis with different zoonotic potential may exist. Clinical and subclinical cases of S. stercoralis infection have been increasingly diagnosed in imported (France, Belgium, Bulgaria) and locally born dogs in Switzerland, showing that this parasite is currently circulating in Europe. Three of these clinical cases will be described here. All three dogs presented severe disease, characterised by harsh diarrhoea, dehydration, vomiting, respiratory and/or neurologic signs, and needed intensive care and hospitalisation. One of these dogs was related to a Swiss breeding kennel, in which the infection was subsequently diagnosed in several other dogs. Faeces were analysed by three coproscopical methods including (i) the Baermann technique, which consistently identified the typical S. stercoralis first-stage larvae in both clinical and subclinical infections, (ii) the sedimentation-zinc chloride flotation and (iii) sodium acetate—acetic acid—formalin concentration (SAFC) methods, which allowed the additional identification of parasitic females and/or eggs in two of the clinical cases. Interestingly, S. stercoralis isolated from all three independent clinical cases exhibited an identical genetic background on the nuclear 18S rDNA (fragment involving hypervariable regions I and IV) and the mitochondrial cytochrome oxidase subunit I (cox1) loci, similar to that of zoonotic isolates from other geographical regions, and not to that of dog-adapted variants. Due to the clinical relevance and zoonotic potential of this parasite, the awareness of both diagnosticians and clinicians is strongly required.

https://ift.tt/2EkaOEY

Cochrane corner: platinum-induced hearing loss after treatment for childhood cancer.

Related Articles

Cochrane corner: platinum-induced hearing loss after treatment for childhood cancer.

Int J Audiol. 2018 Dec 13;:1-4

Authors: Brennan-Jones CG, McMahen C, Van Dalen EC

Abstract
This Cochrane Corner features the review entitled "Platinum-induced hearing loss after treatment for childhood cancer" published in 2016. In their review, van As et al. identified 13 cohort studies including 2837 participants with a hearing test after treatment with a platinum-based therapy for different types of childhood cancers. All studies had problems related to quality of the evidence. The reported frequency of hearing loss varied between 1.7% and 90.1% for studies that included a definition of hearing loss; none of the studies provided data on tinnitus. Only two studies evaluated possible risk factors. One study found a higher risk of hearing loss in people treated with the combination of cisplatin plus carboplatin compared to treatment with cisplatin only and for exposure to aminoglycosides. The other found that age at treatment (lower risk in older children) and single maximum cisplatin dose (higher risk with an increasing dose) were significant predictors for hearing loss, while gender was not. This systematic review shows that children treated with platinum analogues are at risk of developing hearing loss, but the exact prevalence and risk factors remain unclear.

PMID: 30545270 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader https://ift.tt/2PC4laA
via IFTTT

The evaluation of the sense of hearing in patients with carotid artery stenosis within the extracranial segments.

Related Articles

The evaluation of the sense of hearing in patients with carotid artery stenosis within the extracranial segments.

Acta Neurol Belg. 2018 Dec 12;:

Authors: Dorobisz K, Dorobisz T, Janczak D, Krecicki T

Abstract
Stenosis of arteries that supplies blood to the brain is one of the main causes of ischemic stroke which is the third most common cause of deaths in Europe. Atherosclerosis of carotid and vertebral arteries is responsible for 20% of the ischemic stroke cases. Stenosis may be either asymptomatic or manifested with typical neurological symptoms including motor and sensory disturbances as well as disturbances in vision and speech. However, discrete non-specific symptoms of ischemia, including headaches and vertigo, tinnitus and hearing loss, are also quite common. These symptoms may be indicative of a clinically significant stenosis of carotid and vertebral arteries, particularly within the internal carotid artery region, as well as of a risk of ischemic stroke. To date, research reports were unable to provide exact explanation of correlations between impaired hearing and the stenosis of carotid and vertebral arteries. Despite this, numerous articles list these symptoms as one of the first non-specific symptoms of this disorder. The ischemic mechanism within the inner ear region may lead to early symptoms of atherosclerosis of large vessels. However, no evidence of relationship and no explanation could be provided with this regard. The objective of the study was to assess the effect of carotid and vertebral artery stenosis on the function of the hearing and equilibrium organ on the basis of diagnostic audiological examinations including pure-tone threshold audiometry, impedance audiometry, otoacoustic emission tests and brainstem auditory evoked potential tests. The study was conducted in 63 patients (32 males, 31 females) aged 45-75 years, presenting with carotid and vertebral artery stenosis and treated at the Vascular Surgery Clinic of the University Clinical Hospital in Wrocław. Patients were stratified into two subgroups according to their age (45-60 years, 61-75 years). Patients were also divided into subgroups according to the stenotic arteries and to the symptomatic/asymptomatic status of the disorder. All patients were homogeneous in terms of the degree of artery stenosis. The control group consisted of 32 healthy persons (14 males, 18 females) aged 48-75 years. Patients qualified to the control group reported no history of middle or inner ear disorders, disturbed hearing, vertigo and balance disorders, as well as cardiovascular diseases; they also presented with unremarkable ultrasound scans of the arteries. All patients were subjected to precise audiological examinations. Prior to being qualified for the study, patients were subjected to the assessment of arteries by means of Doppler ultrasonography. The hearing organ function was assessed by means of pure-tone threshold audiometry, impedance audiometry, otoacoustic emission tests and brainstem auditory evoked potential tests. Reduction of the flow through the carotid arteries causes problems in the organ of hearing; abnormalities are reported especially in tone threshold audiometry, examinations of the stapedius muscle reflexes and brainstem auditory evoked potentials, which prove the presence of receptive cochlear-extracochlear hearing damage. Disturbances of the organ of hearing have similar severity in stenosis of the internal carotid artery and vertebral artery. Abnormalities found in audiologic examinations in patients with carotid artery stenosis are not always explicitly clinically expressed in patients with hearing loss; we should consider diagnostics for carotid artery stenosis.

PMID: 30542965 [PubMed - as supplied by publisher]

from #Audiology via ola Kala on Inoreader https://ift.tt/2S1ERVZ
via IFTTT