Balamugesh Thangakunam
Lung India 2015 32(6):641-643
Closed pleural biopsy used to be a popular method of evaluation of pleural effusion. With the advent of thoracoscopy, this valuable method is being neglected. Studies have shown that closed pleural biopsy especially done with image guidance has high yield and low complication rate as compared to thoracoscopy. Given the ease of the procedure and the less cost involved, imaged guided closed pleural biopsy should be considered as the initial diagnostic step in undiagnosed pleural biopsy especially in developing countries with high prevalence of tuberculosis.
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Δευτέρα 26 Οκτωβρίου 2015
Cost-effectiveness of noninvasive ventilation for chronic obstructive pulmonary disease-related respiratory failure in Indian hospitals without ICU facilities
Shraddha P Patel, Margarita E Pena, Charlene Irvin Babcock
Lung India 2015 32(6):549-556
Introduction: The majority of Indian hospitals do not provide intensive care unit (ICU) care or ward-based noninvasive positive pressure ventilation (NIV). Because no mechanical ventilation or NIV is available in these hospitals, the majority of patients suffering from respiratory failure die. Objective: To perform a cost-effective analysis of two strategies (ward-based NIV with concurrent standard treatment vs standard treatment alone) in chronic obstructive pulmonary disease (COPD) respiratory failure patients treated in Indian hospitals without ICU care. Materials and Methods: A decision-analytical model was created to compare the cost-effectiveness for the two strategies. Estimates from the literature were used for parameters in the model. Future costs were discounted at 3%. All costs were reported in USD (2012). One-way, two-way, and probabilistic sensitivity analysis were performed. The time horizon was lifetime and perspective was societal. Results: The NIV strategy resulted in 17.7% more survival and was slightly more costly (increased cost of $101 (USD 2012) but resulted in increased quality-adjusted life-years (QALYs) (1.67 QALY). The cost-effectiveness (2012 USD)/QALY in the standard and NIV groups was $78/QALY ($535.02/6.82) and $75/QALY ($636.33/8.49), respectively. Incremental cost-effectiveness ratio (ICER) was only $61 USD/QALY. This was substantially lower than the gross domestic product (GDP) per capita for India (1489 USD), suggesting the NIV strategy was very cost effective. Using a 5% discount rate resulted in only minimally different results. Probabilistic analysis suggests that NIV strategy was preferred 100% of the time when willingness to pay was >$250 2012 USD. Conclusion: Ward-based NIV treatment is cost-effective in India, and may increase survival of patients with COPD respiratory failure when ICU is not available.
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Lung India 2015 32(6):549-556
Introduction: The majority of Indian hospitals do not provide intensive care unit (ICU) care or ward-based noninvasive positive pressure ventilation (NIV). Because no mechanical ventilation or NIV is available in these hospitals, the majority of patients suffering from respiratory failure die. Objective: To perform a cost-effective analysis of two strategies (ward-based NIV with concurrent standard treatment vs standard treatment alone) in chronic obstructive pulmonary disease (COPD) respiratory failure patients treated in Indian hospitals without ICU care. Materials and Methods: A decision-analytical model was created to compare the cost-effectiveness for the two strategies. Estimates from the literature were used for parameters in the model. Future costs were discounted at 3%. All costs were reported in USD (2012). One-way, two-way, and probabilistic sensitivity analysis were performed. The time horizon was lifetime and perspective was societal. Results: The NIV strategy resulted in 17.7% more survival and was slightly more costly (increased cost of $101 (USD 2012) but resulted in increased quality-adjusted life-years (QALYs) (1.67 QALY). The cost-effectiveness (2012 USD)/QALY in the standard and NIV groups was $78/QALY ($535.02/6.82) and $75/QALY ($636.33/8.49), respectively. Incremental cost-effectiveness ratio (ICER) was only $61 USD/QALY. This was substantially lower than the gross domestic product (GDP) per capita for India (1489 USD), suggesting the NIV strategy was very cost effective. Using a 5% discount rate resulted in only minimally different results. Probabilistic analysis suggests that NIV strategy was preferred 100% of the time when willingness to pay was >$250 2012 USD. Conclusion: Ward-based NIV treatment is cost-effective in India, and may increase survival of patients with COPD respiratory failure when ICU is not available.
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Pathogenesis of bilateral chylothorax after injury of thoracic duct during central venous catheterization
Animesh Ray
Lung India 2015 32(6):673-675
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Lung India 2015 32(6):673-675
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The incidence of recurrence of tuberculosis and its related factors in smear-positive pulmonary tuberculosis patients in Iran: A retrospective cohort study
Mahmood Moosazadeh, Abbas Bahrampour, Mahshid Nasehi, Narges Khanjani
Lung India 2015 32(6):557-560
Background and Aim: Studying the recurrence of smear-positive pulmonary tuberculosis (TB) is a convenient way to evaluate the effectiveness of TB control programs and identify vulnerable patients. In the present study, the rate of recurrence of TB and its predictors were determined in Iran. Materials and Methods: This study was a retrospective cohort. Eligible people were patients with smear-positive TB who were diagnosed from 2002 to 2011. The end of the follow-up time was December 2013. The number of people who entered the cohort was 1,271 subjects. In order to determine the predictors of recurrence, multivariate logistic regression was used. Analysis was done using SPSS 20. Results: The recurrence incidence was 8.3% and in 85.9% of these patients, it occurred in the time interval of 1-5 years after successful treatment. The recurrence rate was not significantly related to gender, age group, and diabetes. But it was significantly higher in patients whose sputum smear grading before treatment was 2 + or more, patients with positive sputum smear at the end of the second month of the treatment, patients who had completed treatment, and patients who were smokers (P < 0.05). Conclusions: Our study showed that a considerable percentage of smear-positive pulmonary TB patients experience recurrence and that some patients are at a higher risk of recurrence.
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Lung India 2015 32(6):557-560
Background and Aim: Studying the recurrence of smear-positive pulmonary tuberculosis (TB) is a convenient way to evaluate the effectiveness of TB control programs and identify vulnerable patients. In the present study, the rate of recurrence of TB and its predictors were determined in Iran. Materials and Methods: This study was a retrospective cohort. Eligible people were patients with smear-positive TB who were diagnosed from 2002 to 2011. The end of the follow-up time was December 2013. The number of people who entered the cohort was 1,271 subjects. In order to determine the predictors of recurrence, multivariate logistic regression was used. Analysis was done using SPSS 20. Results: The recurrence incidence was 8.3% and in 85.9% of these patients, it occurred in the time interval of 1-5 years after successful treatment. The recurrence rate was not significantly related to gender, age group, and diabetes. But it was significantly higher in patients whose sputum smear grading before treatment was 2 + or more, patients with positive sputum smear at the end of the second month of the treatment, patients who had completed treatment, and patients who were smokers (P < 0.05). Conclusions: Our study showed that a considerable percentage of smear-positive pulmonary TB patients experience recurrence and that some patients are at a higher risk of recurrence.
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A 35-year old woman with productive cough and breathlessness
Umasankar Kalai, Vijay Hadda, Karan Madan, Sudheer Arava, Firdaus Ali, Neetu Jain, Anant Mohan
Lung India 2015 32(6):651-654
A 35-year-old lady was seen in the outpatient clinic owing to fever, cough with mucopurulent expectoration, and breathlessness for the duration of 1 month. She had history of similar episodes treated with antibiotics four times during last 2 years. There was no history of recurrent sinusitis, diarrhea, and skin or soft tissue infection. She had no history of diabetes mellitus or steroid intake. She denied any history of facial trauma or dental infection in the past. There was no history of tuberculosis in her or in the family. Radiograph and CT scan of the chest revealed right upper lobe consolidation. Flexible fibreoptic bronchoscopy revealed multiple nodules at opening of right upper lobe bronchus. This clinicopathological conference describes the details of differential diagnoses, difficulties in achieving the final diagnosis and management of such patient.
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Lung India 2015 32(6):651-654
A 35-year-old lady was seen in the outpatient clinic owing to fever, cough with mucopurulent expectoration, and breathlessness for the duration of 1 month. She had history of similar episodes treated with antibiotics four times during last 2 years. There was no history of recurrent sinusitis, diarrhea, and skin or soft tissue infection. She had no history of diabetes mellitus or steroid intake. She denied any history of facial trauma or dental infection in the past. There was no history of tuberculosis in her or in the family. Radiograph and CT scan of the chest revealed right upper lobe consolidation. Flexible fibreoptic bronchoscopy revealed multiple nodules at opening of right upper lobe bronchus. This clinicopathological conference describes the details of differential diagnoses, difficulties in achieving the final diagnosis and management of such patient.
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Prevalence and outcome of epidermal growth factor receptor mutations in non-squamous non-small cell lung cancer patients
Rajesh Kota, Sadashivudu Gundeti, Muralidhar Gullipalli, Vijay Gandhi Linga, Lakshmi Srinivas Maddali, Raghunadharao Digumarti
Lung India 2015 32(6):561-565
Background: Epidermal growth factor receptor (EGFR) mutation analysis has become an important part of the initial workup of non-squamous non-small cell lung cancer (NS-NSCLC) patients as it is now recognized both as a prognostic and predictive marker to therapy with EGFR tyrosine kinase inhibitors (TKI). Aim: In this retrospective study conducted at a University hospital, we evaluated the prevalence of EGFR mutations in patients with NS-NSCLC, clinico-pathological correlation and outcome to treatment with EGFR TKIs. Materials and Methods: Case records of 147 patients of NS-NSCLC in whom EGFR mutation status was tested were screened. EGFR mutation analysis was done using DNA sequencing by real time polymerase chain reaction method from tissue and cell blocks prepared from core biopsy, fine needle aspiration cytology and pleural fluid specimens. Results: EGFR mutations were seen in 30.6% of the 111 evaluable specimens, with a significantly higher rate in females (44% vs 19.6% P = 0.0072) as compared to men and non-smokers (41% vs 12% P = 0.0013) as against smokers. Most common mutations were observed in exons 19 (71%) and 21 (25%). The estimated median progression free survival for patients with and without mutations when treated with upfront TKIs was 12 months and 3 months respectively and the estimated median overall survival for patients with and without mutations was 20 and 9 months respectively. Conclusion: This study from India, further establishes the importance of upfront EGFR mutation testing in all NS-NSCLC patients, not only to prognosticate, but also to identify that subset of patients who could benefit from EGFR TKI therapy, early in the course of their disease.
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Lung India 2015 32(6):561-565
Background: Epidermal growth factor receptor (EGFR) mutation analysis has become an important part of the initial workup of non-squamous non-small cell lung cancer (NS-NSCLC) patients as it is now recognized both as a prognostic and predictive marker to therapy with EGFR tyrosine kinase inhibitors (TKI). Aim: In this retrospective study conducted at a University hospital, we evaluated the prevalence of EGFR mutations in patients with NS-NSCLC, clinico-pathological correlation and outcome to treatment with EGFR TKIs. Materials and Methods: Case records of 147 patients of NS-NSCLC in whom EGFR mutation status was tested were screened. EGFR mutation analysis was done using DNA sequencing by real time polymerase chain reaction method from tissue and cell blocks prepared from core biopsy, fine needle aspiration cytology and pleural fluid specimens. Results: EGFR mutations were seen in 30.6% of the 111 evaluable specimens, with a significantly higher rate in females (44% vs 19.6% P = 0.0072) as compared to men and non-smokers (41% vs 12% P = 0.0013) as against smokers. Most common mutations were observed in exons 19 (71%) and 21 (25%). The estimated median progression free survival for patients with and without mutations when treated with upfront TKIs was 12 months and 3 months respectively and the estimated median overall survival for patients with and without mutations was 20 and 9 months respectively. Conclusion: This study from India, further establishes the importance of upfront EGFR mutation testing in all NS-NSCLC patients, not only to prognosticate, but also to identify that subset of patients who could benefit from EGFR TKI therapy, early in the course of their disease.
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Chronic cough: An Indian perspective
Shoaib Faruqi, Woo-Jung Song
Lung India 2015 32(6):668-669
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Lung India 2015 32(6):668-669
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Unusual lesions of the mediastinum
Fatima Shamsuddin, Urmila N Khadilkar, Debarshi Saha
Lung India 2015 32(6):566-571
Objectives: To study unusual lesions in the mediastinum, which do not originate from the thymus, lymph nodes, neural tissues or germ cells, and tissues that normally engender pathologic lesions in the mediastinum. Materials and Methods: Of the 65 cases seen, 12 unusual lesion were encountered in a 5½ year period from 2006 to 2011. Results: Two cases of nodular colloid goiter and one each of the mediastinal cyst, undifferentiated carcinoma, and Langerhans cell histiocytosis (LCH) affected the anterosuperior mediastinum. In the middle mediastinum, one case each of the mesothelioma, malignant gastrointestinal stromal tumor (GIST), squamous cell carcinoma (SCC), solitary fibrous tumor (SFT), and pleomorphic sarcoma (PS) was seen. One case of meningeal melanocytoma (Mme) and primary pleural liposarcoma (PL) involved the posterior mediastinum. Persistent disease was seen in LCH after 2 years. Of all the cases with malignant lesions, only the patient with SCC was alive after 1 year. Conclusion: The cases of primary and SCC, LCH, melanocytoma, liposarcoma and PS, and GIST are unexpected and very rarely have paradigms in the mediastinum. Radiologic impression and knowledge of the compartment where these lesions arose from hardly assisted in arriving at a definitive opinion as the lesions were not typical of this location. A high index of suspicion and the immunohistochemical profile facilitated the final diagnosis.
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Lung India 2015 32(6):566-571
Objectives: To study unusual lesions in the mediastinum, which do not originate from the thymus, lymph nodes, neural tissues or germ cells, and tissues that normally engender pathologic lesions in the mediastinum. Materials and Methods: Of the 65 cases seen, 12 unusual lesion were encountered in a 5½ year period from 2006 to 2011. Results: Two cases of nodular colloid goiter and one each of the mediastinal cyst, undifferentiated carcinoma, and Langerhans cell histiocytosis (LCH) affected the anterosuperior mediastinum. In the middle mediastinum, one case each of the mesothelioma, malignant gastrointestinal stromal tumor (GIST), squamous cell carcinoma (SCC), solitary fibrous tumor (SFT), and pleomorphic sarcoma (PS) was seen. One case of meningeal melanocytoma (Mme) and primary pleural liposarcoma (PL) involved the posterior mediastinum. Persistent disease was seen in LCH after 2 years. Of all the cases with malignant lesions, only the patient with SCC was alive after 1 year. Conclusion: The cases of primary and SCC, LCH, melanocytoma, liposarcoma and PS, and GIST are unexpected and very rarely have paradigms in the mediastinum. Radiologic impression and knowledge of the compartment where these lesions arose from hardly assisted in arriving at a definitive opinion as the lesions were not typical of this location. A high index of suspicion and the immunohistochemical profile facilitated the final diagnosis.
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Clinicopathological profile and course of malignant pleural effusion in a tertiary care teaching hospital in western Uttar Pradesh with special reference to lung cancer
Anurag Agrawal, Rajiv Tandon, Lalit Singh, Aakanksha Chawla
Lung India 2015 32(6):678-679
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Lung India 2015 32(6):678-679
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Burden of obstructive lung disease study in Tehran: Prevalence and risk factors of chronic obstructive pulmonary disease
Hooman Sharifi, Mohammad Reza Masjedi, Habib Emami, Mostafa Ghanei, Alireza Eslaminejad, Golnar Radmand, Sonia Buist
Lung India 2015 32(6):572-577
Background: Chronic obstructive pulmonary disease (COPD) was ranked the sixth-most common cause of death worldwide in 1990, but now it is the third-most common cause. The goal of the present study was to assess the prevalence and determine the causes and risk factors of COPD in Tehran. Materials and Methods: This study followed a stratified cluster sampling strategy with proportional allocation within strata. The target population was all non-institutionalized inhabitants, aged 18 to 40 in one group and over 40 in another who resided in Tehran in 2013. The core questionnaire was developed from pre-existing validated questionnaires that had already been used in multi-national studies. The single most important outcome measure obtained as part of this protocol was spirometry before and after the administration of 200 mg (two puffs) of salbutamol. Results: The most commonly reported respiratory symptoms were: sputum production in 291 patients (16.2%) [95% confidence interval (CI): 14.5-17.9%], chronic cough in 171 (9.5%) (95% CI: 8.2-10.9%), wheezing in 377 (21.0%) (95%CI: 19.1-22.9%) and dyspnea in 388 patients (21.6%) (95% CI: 19.7-23.5%). The overall COPD prevalence defined by the post-bronchodilator spirometric functional criteria was 9.2%. This value in men (10.1%) was higher than in women (8.5%); the prevalence was significantly higher in subjects aged over 55 years (P ≤ 0.002). The prevalence of COPD was strongly dependent on smoking status, especially in ex-smokers, and increased considerably with age. 69% of patients with COPD were non-smoker. Conclusion: The high prevalence of verified COPD, a great deal of which was undiagnosed before by a physician, highlights the necessity of raising awareness of this disease among health professionals, and use of spirometry in the primary care setting. A future cross-sectional and prospective cohort study should be performed to explore all risk factors and their impact on decline in lung function and worsening of respiratory symptoms especially in non-smokers.
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Lung India 2015 32(6):572-577
Background: Chronic obstructive pulmonary disease (COPD) was ranked the sixth-most common cause of death worldwide in 1990, but now it is the third-most common cause. The goal of the present study was to assess the prevalence and determine the causes and risk factors of COPD in Tehran. Materials and Methods: This study followed a stratified cluster sampling strategy with proportional allocation within strata. The target population was all non-institutionalized inhabitants, aged 18 to 40 in one group and over 40 in another who resided in Tehran in 2013. The core questionnaire was developed from pre-existing validated questionnaires that had already been used in multi-national studies. The single most important outcome measure obtained as part of this protocol was spirometry before and after the administration of 200 mg (two puffs) of salbutamol. Results: The most commonly reported respiratory symptoms were: sputum production in 291 patients (16.2%) [95% confidence interval (CI): 14.5-17.9%], chronic cough in 171 (9.5%) (95% CI: 8.2-10.9%), wheezing in 377 (21.0%) (95%CI: 19.1-22.9%) and dyspnea in 388 patients (21.6%) (95% CI: 19.7-23.5%). The overall COPD prevalence defined by the post-bronchodilator spirometric functional criteria was 9.2%. This value in men (10.1%) was higher than in women (8.5%); the prevalence was significantly higher in subjects aged over 55 years (P ≤ 0.002). The prevalence of COPD was strongly dependent on smoking status, especially in ex-smokers, and increased considerably with age. 69% of patients with COPD were non-smoker. Conclusion: The high prevalence of verified COPD, a great deal of which was undiagnosed before by a physician, highlights the necessity of raising awareness of this disease among health professionals, and use of spirometry in the primary care setting. A future cross-sectional and prospective cohort study should be performed to explore all risk factors and their impact on decline in lung function and worsening of respiratory symptoms especially in non-smokers.
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Round atelectasis
Chandan Kakkar, Prakashini Koteshwara, Rajagopal Kadavigere
Lung India 2015 32(6):646-647
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Lung India 2015 32(6):646-647
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Impact of overlap syndrome on severity of acute exacerbation of chronic obstructive pulmonary disease
Dipti Gothi, Shiv Sagar Gupta, Nishith Kumar, Kartik Sood
Lung India 2015 32(6):578-583
Background: The severity of exacerbation in chronic obstructive pulmonary disease (COPD) due to the overlap of obstructive sleep apnea syndrome (OSAS) is not known. Aims: To find out the 1) severity of acute exacerbation of COPD (AECOPD) in patients with overlap syndrome compared to only COPD, 2) prevalence of overlap syndrome in AECOPD, and 3) clinical characteristics of COPD compared to overlap syndrome. Materials and Methods: Fifty-one patients admitted with AECOPD were classified into; Mild exacerbation: Normal arterial blood gases (ABG) treated with antibiotics, Moderate: Normal ABG treated with parenteral corticosteroids, Severe: Type 1 respiratory failure, Very severe: Type 2 respiratory failure with normal pH and Life-threatening: Type 2 respiratory failure with pH <7.35. They were evaluated for OSAS with full polysomnography after the exacerbation subsided and analysed depending on presence or absence of overlap syndrome. Results: The majority of only COPD cases (26/38) had mild and moderate exacerbations whereas majority of overlap patients (9/13) had severe, very severe and life-threatening exacerbations (statistically significant, P = 0.021). Of 51 patients, 13 had OSAS i.e. the prevalence of overlap in AECOPD was 25.5%. The mean BMI in only COPD and overlap syndrome was 20.70 ± 8.03 kg/m2 and 31.82 ± 5.80 kg/m2 (P < 0.001), respectively. Metabolic syndrome was recorded in 2/36 (5.3%) patients in only COPD and 6/13 (46.2%) patients in overlap (P < 0.001). Conclusion: Overlap syndromes are more likely have respiratory failure compared to only COPD during AECOPD. AECOPD have a high prevalence of OSAS. Overlap syndrome have significantly higher likelihood of obesity and metabolic syndrome compared to only COPD.
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Lung India 2015 32(6):578-583
Background: The severity of exacerbation in chronic obstructive pulmonary disease (COPD) due to the overlap of obstructive sleep apnea syndrome (OSAS) is not known. Aims: To find out the 1) severity of acute exacerbation of COPD (AECOPD) in patients with overlap syndrome compared to only COPD, 2) prevalence of overlap syndrome in AECOPD, and 3) clinical characteristics of COPD compared to overlap syndrome. Materials and Methods: Fifty-one patients admitted with AECOPD were classified into; Mild exacerbation: Normal arterial blood gases (ABG) treated with antibiotics, Moderate: Normal ABG treated with parenteral corticosteroids, Severe: Type 1 respiratory failure, Very severe: Type 2 respiratory failure with normal pH and Life-threatening: Type 2 respiratory failure with pH <7.35. They were evaluated for OSAS with full polysomnography after the exacerbation subsided and analysed depending on presence or absence of overlap syndrome. Results: The majority of only COPD cases (26/38) had mild and moderate exacerbations whereas majority of overlap patients (9/13) had severe, very severe and life-threatening exacerbations (statistically significant, P = 0.021). Of 51 patients, 13 had OSAS i.e. the prevalence of overlap in AECOPD was 25.5%. The mean BMI in only COPD and overlap syndrome was 20.70 ± 8.03 kg/m2 and 31.82 ± 5.80 kg/m2 (P < 0.001), respectively. Metabolic syndrome was recorded in 2/36 (5.3%) patients in only COPD and 6/13 (46.2%) patients in overlap (P < 0.001). Conclusion: Overlap syndromes are more likely have respiratory failure compared to only COPD during AECOPD. AECOPD have a high prevalence of OSAS. Overlap syndrome have significantly higher likelihood of obesity and metabolic syndrome compared to only COPD.
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Nocardia farcinica as a causative agent of lung abscess
Manoj Meena, Ramakant Dixit, Sabarigirivasan Harish, Govind Narayan Srivastava, Lalit Prashant Meena
Lung India 2015 32(6):657-659
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Lung India 2015 32(6):657-659
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The correlation of symptoms, pulmonary function tests and exercise testing with high-resolution computed tomography in patients with idiopathic interstitial pneumonia in a tertiary care hospital in South India
Barney Thomas Jesudason Isaac, Balamugesh Thangakunam, Rekha A Cherian, Devasahayam Jesudas Christopher
Lung India 2015 32(6):584-588
Context: For the follow-up of patients with idiopathic interstitial pneumonias (IIP), it is unclear which parameters of pulmonary function tests (PFT) and exercise testing would correlate best with high-resolution computed tomography (HRCT).Aim: To find out the correlation of symptom scores, PFTs and exercise testing with HRCT scoring in patients diagnosed as idiopathic interstitial pneumonia. Settings and Design: Cross-sectional study done in pulmonary medicine outpatients department of a tertiary care hospital in South India. Materials and Methods: Consecutive patients who were diagnosed as IIP by a standard algorithm were included into the study. Cough and dyspnea were graded for severity and duration. Pulmonary function tests and exercise testing parameters were noted. HRCT was scored based on an alveolar score, an interstitial score and a total score. The HRCT was correlated with each of the clinical and physiologic parameters. Pearson's/Spearman's correlation coefficient was used for the correlation of symptoms and parameters of ABG, PFT and 6MWT with the HRCT scores. Results: A total of 94 patients were included in the study. Cough and dyspnea severity (r = 0.336 and 0.299), FVC (r = −0.48), TLC (r = −0.439) and DLCO and distance saturation product (DSP) (r = −0.368) and lowest saturation (r = −0.324) had significant correlation with total HRCT score. Among these, DLCO, particularly DLCO corrected % of predicted, correlated best with HRCT score (r = −0.721).Conclusion: Symptoms, PFT and exercise testing had good correlation with HRCT. DLCO corrected % of predicted correlated best with HRCT.
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Lung India 2015 32(6):584-588
Context: For the follow-up of patients with idiopathic interstitial pneumonias (IIP), it is unclear which parameters of pulmonary function tests (PFT) and exercise testing would correlate best with high-resolution computed tomography (HRCT).Aim: To find out the correlation of symptom scores, PFTs and exercise testing with HRCT scoring in patients diagnosed as idiopathic interstitial pneumonia. Settings and Design: Cross-sectional study done in pulmonary medicine outpatients department of a tertiary care hospital in South India. Materials and Methods: Consecutive patients who were diagnosed as IIP by a standard algorithm were included into the study. Cough and dyspnea were graded for severity and duration. Pulmonary function tests and exercise testing parameters were noted. HRCT was scored based on an alveolar score, an interstitial score and a total score. The HRCT was correlated with each of the clinical and physiologic parameters. Pearson's/Spearman's correlation coefficient was used for the correlation of symptoms and parameters of ABG, PFT and 6MWT with the HRCT scores. Results: A total of 94 patients were included in the study. Cough and dyspnea severity (r = 0.336 and 0.299), FVC (r = −0.48), TLC (r = −0.439) and DLCO and distance saturation product (DSP) (r = −0.368) and lowest saturation (r = −0.324) had significant correlation with total HRCT score. Among these, DLCO, particularly DLCO corrected % of predicted, correlated best with HRCT score (r = −0.721).Conclusion: Symptoms, PFT and exercise testing had good correlation with HRCT. DLCO corrected % of predicted correlated best with HRCT.
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Mediastinal hamartoma - A rare presentation
Jayaprakash Balakrishnan, Deepu Maniyan, Nileena Nayak, Anila Kunjulekshmi Amma Raveendran Nair
Lung India 2015 32(6):665-666
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Lung India 2015 32(6):665-666
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Increased metabolic activity of neutrophils in patients with chronic obstructive pulmonary disease
Ashwin Vaidyanathan, Komaladevi Sampath Damodar
Lung India 2015 32(6):589-592
Aims: To compare the metabolic activity of peripheral neutrophils in patients diagnosed with chronic obstructive pulmonary disease (COPD) with that of healthy, nonsmoking volunteers. Materials and Methods: Venous blood samples were taken from patients diagnosed with COPD as well as from healthy nonsmokers. Each sample was subjected to the nitro blue tetrazolium (NBT) test in which neutrophils exhibiting elevated metabolic activity were detected by light microscopy. The test was repeated after stimulation with Escherichia coli (E. coli) endotoxin with fresh samples. Neutrophils showing dye uptake were then counted in each case. Results: We found that the mean numbers of activated neutrophils without and with the addition of endotoxin were 19% and 23%, respectively, in the control group and 56% and 62%, respectively, in the test group. Two-sample t-test statistic revealed that there was a significant (P < 0.01) increase in neutrophilic metabolic activity in patients with COPD as compared to that in healthy volunteers. This significance remained even after stimulation using E. coli endotoxin. Conclusion: The results hint at a potentially relevant pathogenic mechanism in COPD related to the metabolic activity of neutrophils. By exhibiting enhanced metabolic activity, neutrophils in the COPD patients are more likely to be involved in damaging lung tissues.
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Lung India 2015 32(6):589-592
Aims: To compare the metabolic activity of peripheral neutrophils in patients diagnosed with chronic obstructive pulmonary disease (COPD) with that of healthy, nonsmoking volunteers. Materials and Methods: Venous blood samples were taken from patients diagnosed with COPD as well as from healthy nonsmokers. Each sample was subjected to the nitro blue tetrazolium (NBT) test in which neutrophils exhibiting elevated metabolic activity were detected by light microscopy. The test was repeated after stimulation with Escherichia coli (E. coli) endotoxin with fresh samples. Neutrophils showing dye uptake were then counted in each case. Results: We found that the mean numbers of activated neutrophils without and with the addition of endotoxin were 19% and 23%, respectively, in the control group and 56% and 62%, respectively, in the test group. Two-sample t-test statistic revealed that there was a significant (P < 0.01) increase in neutrophilic metabolic activity in patients with COPD as compared to that in healthy volunteers. This significance remained even after stimulation using E. coli endotoxin. Conclusion: The results hint at a potentially relevant pathogenic mechanism in COPD related to the metabolic activity of neutrophils. By exhibiting enhanced metabolic activity, neutrophils in the COPD patients are more likely to be involved in damaging lung tissues.
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Limitations of CBA study: Controlled before after study
Anjali Mahajan
Lung India 2015 32(6):670-671
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Lung India 2015 32(6):670-671
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Hemophagocytic lymphohistiocytosis: An unusual complication in disseminated Mycobacterium tuberculosis
Somanath Padhi, Kandasamy Ravichandran, Jayaprakash Sahoo, Renu G'Boy Varghese, Aneesh Basheer
Lung India 2015 32(6):593-601
Background: Hemophagocytic lymphohistiocytosis (HLH) is an uncommon, potentially fatal, hyperinflammatory syndrome that may rarely complicate the clinical course of disseminated Mycobacterium tuberculosis (MTB). The clinical course of tuberculosis-associated HLH (TB-HLH) has been reported to be unpredictable. Materials and Methods: Here we describe the clinicopathological features, laboratory parameters, management, and outcome data of a patient who satisfied the 2004 diagnostic criteria for HLH secondary to disseminated MTB; we also do a systematic review of the international literature on TB-HLH. The literature review (January 1975–March 2014) found that HLH complicated the clinical course of 63 tuberculosis patients (41 males, 22 females, mean age = 45 ± 23.5 years) with a high mortality rate of 49% (31/63 died). The mean serum ferritin level (n = 44/63) was 5963 ng/mL (range 500–38,539 ng/mL); and a higher proportion (54.2%) of patients had pancytopenia at presentation. On univariate analysis (n = 53/63), age >30 years [hazard ratio (HR): 2.79, 95% confidence interval (CI):1.03–7.56, P = 0.03], presence of comorbidities (HR 4.59, CI: 1.08–19.52, P = 0.04), marked hemophagocytosis in bone marrow (HR: 2.65, CI: 1.16–6.05, P = 0.02), and nonusage/delayed usage of antitubercular therapy (ATT) (HR: 3.44, CI: 1.51–7.87, P = 0.003) were associated with decreased survival, though none of these parameters attained statistical significance (P > 0.05) in multivariate analysis. Usage of corticosteroids and/or immunomodulator drugs (HR 1.00, CI: 0.66–3.22, P = 0.35) did not alter the outcome in these patients. Conclusion: HLH should be considered as a differential diagnosis in patients with tuberculosis who present with cytopenias, organomegaly, and coagulopathy. Strong clinical suspicion and early usage of ATT might be useful in reducing the morbidity and mortality. The utility of immunosuppressive/immunomodulator therapy lacks general concensus among treating physicians, and warrants further studies.
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Lung India 2015 32(6):593-601
Background: Hemophagocytic lymphohistiocytosis (HLH) is an uncommon, potentially fatal, hyperinflammatory syndrome that may rarely complicate the clinical course of disseminated Mycobacterium tuberculosis (MTB). The clinical course of tuberculosis-associated HLH (TB-HLH) has been reported to be unpredictable. Materials and Methods: Here we describe the clinicopathological features, laboratory parameters, management, and outcome data of a patient who satisfied the 2004 diagnostic criteria for HLH secondary to disseminated MTB; we also do a systematic review of the international literature on TB-HLH. The literature review (January 1975–March 2014) found that HLH complicated the clinical course of 63 tuberculosis patients (41 males, 22 females, mean age = 45 ± 23.5 years) with a high mortality rate of 49% (31/63 died). The mean serum ferritin level (n = 44/63) was 5963 ng/mL (range 500–38,539 ng/mL); and a higher proportion (54.2%) of patients had pancytopenia at presentation. On univariate analysis (n = 53/63), age >30 years [hazard ratio (HR): 2.79, 95% confidence interval (CI):1.03–7.56, P = 0.03], presence of comorbidities (HR 4.59, CI: 1.08–19.52, P = 0.04), marked hemophagocytosis in bone marrow (HR: 2.65, CI: 1.16–6.05, P = 0.02), and nonusage/delayed usage of antitubercular therapy (ATT) (HR: 3.44, CI: 1.51–7.87, P = 0.003) were associated with decreased survival, though none of these parameters attained statistical significance (P > 0.05) in multivariate analysis. Usage of corticosteroids and/or immunomodulator drugs (HR 1.00, CI: 0.66–3.22, P = 0.35) did not alter the outcome in these patients. Conclusion: HLH should be considered as a differential diagnosis in patients with tuberculosis who present with cytopenias, organomegaly, and coagulopathy. Strong clinical suspicion and early usage of ATT might be useful in reducing the morbidity and mortality. The utility of immunosuppressive/immunomodulator therapy lacks general concensus among treating physicians, and warrants further studies.
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Viruses, Vol. 7, Pages 5610-5618: Entry of Oncolytic Herpes Simplex Virus into Human Squamous Cell Carcinoma Cells by Ultrasound
Low-intensity ultrasound is a useful method to introduce materials into cells due to the transient formation of micropores, called sonoporations, on the cell membrane. Whether oncolytic herpes simplex virus type 1 (HSV-1) can be introduced into oral squamous cell carcinoma (SCC) cells through membrane pores remains undetermined. Human SCC cell line SAS and oncolytic HSV-1 RH2, which was deficient in the 134.5 gene and fusogenic, were used. Cells were exposed to ultrasound in the presence or absence of microbubbles. The increase of virus entry was estimated by plaque numbers. Viral infection was hardly established without the adsorption step, but plaque number was increased by the exposure of HSV-1-inoculated cells to ultrasound. Plaque number was also increased even if SAS cells were exposed to ultrasound and inoculated with RH2 without the adsorption step. This effect was abolished when the interval from ultrasound exposure to virus inoculation was prolonged. Scanning electron microscopy revealed depressed spots on the cell surface after exposure to ultrasound. These results suggest that oncolytic HSV-1 RH2 can be introduced into SAS cells through ultrasound-mediated pores of the cell membrane that are resealed after an interval.
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Viruses, Vol. 7, Pages 5609: Addendum: Kong, M.Y.; Whitley, R.J.; Peng, N.; Oster, R.; Schoeb, T.R.; Sullender, W.; Ambalavanan, N.; Clancy, J.P.; Gaggar, A.; Blalock J.E. Matrix Metalloproteinase-9 Mediates RSV Infection in Vitro and in Vivo. Viruses 2015, 30, 7, 4230–4253
The authors wish to make the following addition to their paper [1]. [...]
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Water, Vol. 7, Pages 5849-5875: Water Discharge and Sediment Load Changes in China: Change Patterns, Causes, and Implications
In this research, monthly hydrological and daily meteorological data were collected across China for the period 1956–2012. Modified Mann–Kendall tests, double mass curve analysis, and correlation statistics were performed to identify the long-term trends and interrelation of the hydrometeorological variables and to examine the influencing factors of streamflow and sediment. The results are as follows: (1) In the last 60 years, the streamflow in northern China has shown different decreasing trends. For the southern rivers, the streamflow presented severe fluctuations, but the declining trend was insignificant. For the streamflow in western China, an increasing trend was shown. (2) In the northern rivers, the streamflow was jointly controlled by the East Asian monsoon and westerlies. In the southern rivers, the runoff was mainly influenced by the Tibet–Qinghai monsoon, the South Asian monsoon, and westerlies. (3) Sediment loads in the LCRB (Lancang River Basin) and YZRB (Yarlung Zangbo River Basin) did not present significant change trends, although other rivers showed different degrees of gradual reduction, particularly in the 2000s. (4) Underlying surface and precipitation changes jointly influenced the streamflow in eastern rivers. The water consumption for industrial and residential purposes, soil and water conservation engineering, hydraulic engineering, and underlying surface changes induced by other factors were the main causes of streamflow and sediment reduction.
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Polymers, Vol. 7, Pages 2146-2164: Effect of the Network Structure and Programming Temperature on the Shape-Memory Response of Thiol-Epoxy “Click” Systems
This paper presents a new methodology to develop "thiol-epoxy" shape-memory polymers (SMPs) with enhanced mechanical properties in a simple and efficient manner via "click" chemistry by using thermal latent initiators. The shape-memory response (SMR), defined by the mechanical capabilities of the SMP (high ultimate strength and strain), the shape-fixation and the recovery of the original shape (shape-recovery), was analyzed on thiol-epoxy systems by varying the network structure and programming temperature. The glass transition temperature (Tg) and crosslinking density were modified using 3- or 4- functional thiol curing agents and different amounts of a rigid triglycidyl isocyanurate compound. The relationship between the thermo-mechanical properties, network structure and the SMR was evidenced by means of qualitative and quantitative analysis. The influence of the programming temperature (Tprog) on the SMR was also analyzed in detail. The results demonstrate the possibility of tailoring SMPs with enhanced mechanical capabilities and excellent SMR, and intend to provide a better insight into the relationship between the network structure properties, programming temperature and the SMR of unconstrained (stress-free) systems; thus, making it easier to decide between different SMP and to define the operative parameters in the useful life.
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Nanomaterials, Vol. 5, Pages 1766-1781: Control of Partial Coalescence of Self-Assembled Metal Nano-Particles across Lyotropic Liquid Crystals Templates towards Long Range Meso-Porous Metal Frameworks Design
The formation of purely metallic meso-porous metal thin films by partial interface coalescence of self-assembled metal nano-particles across aqueous solutions of Pluronics triblock lyotropic liquid crystals is demonstrated for the first time. Small angle X-ray scattering was used to study the influence of the thin film composition and processing conditions on the ordered structures. The structural characteristics of the meso-structures formed demonstrated to primarily rely on the lyotropic liquid crystal properties while the nature of the metal nano-particles used as well as the their diameters were found to affect the ordered structure formation. The impact of the annealing temperature on the nano-particle coalescence and efficiency at removing the templating lyotropic liquid crystals was also analysed. It is demonstrated that the lyotropic liquid crystal is rendered slightly less thermally stable, upon mixing with metal nano-particles and that low annealing temperatures are sufficient to form purely metallic frameworks with average pore size distributions smaller than 500 nm and porosity around 45% with potential application in sensing, catalysis, nanoscale heat exchange, and molecular separation.
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Materials, Vol. 8, Pages 7191-7198: Effects of Electrodes on the Switching Behavior of Strontium Titanate Nickelate Resistive Random Access Memory
Strontium titanate nickelate (STN) thin films on indium tin oxide (ITO)/glass substrate were synthesized using the sol-gel method for resistive random access memory (RRAM) applications. Aluminum (Al), titanium (Ti), tungsten (W), gold (Au) and platinum (Pt) were used as top electrodes in the STN-based RRAM to probe the switching behavior. The bipolar resistive switching behavior of the set and reset voltages is in opposite bias in the Al/STN/ITO and Pt/STN/ITO RRAMs, which can be partly ascribed to the different work functions of top electrodes in the ITO. Analyses of the fitting results and temperature-dependent performances showed that the Al/STN/ITO switching was mainly attributed to the absorption/release of oxygen-based functional groups, whereas the Pt/STN/ITO switching can be associated with the diffusion of metal electrode ions. The Al/STN/ITO RRAM demonstrated a high resistance ratio of >106 between the high-resistance state (HRS) and the low-resistance state (LRS), as well as a retention ability of >105 s. Furthermore, the Pt/STN/ITO RRAM displayed a HRS/LRS resistance ratio of >103 and a retention ability of >105 s.
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Microorganisms, Vol. 3, Pages 746-758: Carbon-Starvation Induces Cross-Resistance to Thermal, Acid, and Oxidative Stress in Serratia marcescens
The broad host-range pathogen Serratia marcescens survives in diverse host and non-host environments, often enduring conditions in which the concentration of essential nutrients is growth-limiting. In such environments, carbon and energy source starvation (carbon-starvation) is one of the most common forms of stress encountered by S. marcescens. Related members of the family Enterobacteriaceae are known to undergo substantial changes in gene expression and physiology in response to the specific stress of carbon-starvation, enabling non-spore-forming cells to survive periods of prolonged starvation and exposure to other forms of stress (i.e., starvation-induced cross-resistance). To determine if carbon-starvation also results in elevated levels of cross-resistance in S. marcescens, both log-phase and carbon-starved cultures, depleted of glucose before the onset of high cell-density stationary-phase, were grown in minimal media at either 30 °C or 37 °C and were then challenged for resistance to high temperature (50 °C), low pH (pH 2.8), and oxidative stress (15 mM H2O2). In general, carbon-starved cells exhibited a higher level of resistance to thermal stress, acid stress, and oxidative stress compared to log-phase cells. The extent of carbon-starvation-induced cross-resistance was dependent on incubation temperature and on the particular strain of S. marcescens. In addition, strain- and temperature-dependent variations in long-term starvation survival were also observed. The enhanced stress-resistance of starved S. marcescens cells could be an important factor in their survival and persistence in many non-host environments and within certain host microenvironments where the availability of carbon sources is suboptimal for growth.
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IJGI, Vol. 4, Pages 2267-2291: Cloud-Based Geospatial 3D Image Spaces—A Powerful Urban Model for the Smart City
In this paper, we introduce the concept and an implementation of geospatial 3D image spaces as new type of native urban models. 3D image spaces are based on collections of georeferenced RGB-D imagery. This imagery is typically acquired using multi-view stereo mobile mapping systems capturing dense sequences of street level imagery. Ideally, image depth information is derived using dense image matching. This delivers a very dense depth representation and ensures the spatial and temporal coherence of radiometric and depth data. This results in a high-definition WYSIWYG ("what you see is what you get") urban model, which is intuitive to interpret and easy to interact with, and which provides powerful augmentation and 3D measuring capabilities. Furthermore, we present a scalable cloud-based framework for generating 3D image spaces of entire cities or states and a client architecture for their web-based exploitation. The model and the framework strongly support the smart city notion of efficiently connecting the urban environment and its processes with experts and citizens alike. In the paper we particularly investigate quality aspects of the urban model, namely the obtainable georeferencing accuracy and the quality of the depth map extraction. We show that our image-based georeferencing approach is capable of improving the original direct georeferencing accuracy by an order of magnitude and that the presented new multi-image matching approach is capable of providing high accuracies along with a significantly improved completeness of the depth maps.
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Viruses, Vol. 7, Pages 5603-5608: Special Issue: Honey Bee Viruses
Pollination of flowering plants is an important ecosystem service provided by wild insect pollinators and managed honey bees. Hence, losses and declines of pollinating insect species threaten human food security and are of major concern not only for apiculture or agriculture but for human society in general. Honey bee colony losses and bumblebee declines have attracted intensive research interest over the last decade and although the problem is far from being solved we now know that viruses are among the key players of many of these bee losses and bumblebee declines. With this special issue on bee viruses we, therefore, aimed to collect high quality original papers reflecting the current state of bee virus research. To this end, we focused on newly discovered viruses (Lake Sinai viruses, bee macula-like virus), or a so far neglected virus species (Apis mellifera filamentous virus), and cutting edge technologies (mass spectrometry, RNAi approach) applied in the field.
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Musculoskeletal manifestations of diabetes mellitus
The prevalence of Type 1 and Type 2 diabetes are increasing significantly worldwide. Whilst vascular complications of diabetes are well recognized, and account for principle mortality and morbidity from the condition, musculoskeletal manifestations of diabetes are common and whilst not life threatening, are an important cause of morbidity, pain and disability. Joints affected by diabetes include peripheral joints and the axial skeleton. Charcot neuroarthropathy is an important cause of deformity and amputation associated with peripheral neuropathy. A number of fibrosing conditions of the hands and shoulder are recognized, including carpal tunnel syndrome, adhesive capsulitis, tenosynovitis and limited joint mobility. People with diabetes are more prone to gout and osteoporosis. Management of these conditions requires early recognition and close liaison between diabetes and rheumatology specialists.
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An international study of the quality of national-level guidelines on driving with medical illness
Background: Medical illnesses are associated with a modest increase in crash risk, although many individuals with acute or chronic conditions may remain safe to drive, or pose only temporary risks. Despite the extensive use of national guidelines about driving with medical illness, the quality of these guidelines has not been formally appraised.
Aim: To systematically evaluate the quality of selected national guidelines about driving with medical illness.
Design: A literature search of bibliographic databases and Internet resources was conducted to identify the guidelines, each of which was formally appraised.
Methods: Eighteen physicians or researchers from Canada, Australia, Ireland, USA and UK appraised nine national guidelines, applying the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.
Results: Relative strengths were found in AGREE II scores for the domains of scope and purpose, stakeholder involvement and clarity of presentation. However, all guidelines were given low ratings on rigour of development, applicability and documentation of editorial independence. Overall quality ratings ranged from 2.25 to 5.00 out of 7.00, with modifications recommended for 7 of the guidelines. Intra-class coefficients demonstrated fair to excellent appraiser agreement (0.57–0.79).
Conclusions: This study represents the first systematic evaluation of national-level guidelines for determining medical fitness to drive. There is substantive variability in the quality of these guidelines, and rigour of development was a relative weakness. There is a need for rigorous, empirically derived guidance for physicians and licensing authorities when assessing driving in the medically ill.
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Sarcoidosis and lymphoma: a comparative study
Aim: To assess the clinical features and outcome of lymphoma when associated with sarcoidosis and to determine whether this association gives lymphoma a better prognosis.
Design: Multicentre retrospective cohort study.
Methods: Retrospective chart review.
Results: Twenty-one patients were included (9 males, 12 females). Median age at sarcoidosis diagnosis was 48 years (range: 24–68 years). In 14 cases, lymphoma occurred within a previously known sarcoidosis. Five patients received a concomitant diagnosis of sarcoidosis and lymphoma, whereas lymphoma preceded sarcoidosis in two patients. Three patients were diagnosed with Hodgkin's lymphoma and 18 patients with non-Hodgkin's lymphoma (diffuse large B-cell lymphoma (DLBCL) (n = 11), follicular lymphoma (n = 2), chronic lymphocytic leukemia/small lymphocytic lymphoma (n = 2), anaplastic large cell lymphoma ALK + (n = 1), angioimmunoblastic T-cell lymphoma (n = 1) and T-cell prolymphocytic leukemia (n = 1)). Thirteen patients were alive and in complete remission. Median age at the time of diagnosis of sarcoidosis was lower in patients with concomitant lymphoma compared with patients with sarcoidosis preceding lymphoma (34 years vs. 51 years, P = 0.01). Patients presenting with DLBCL associated with sarcoidosis were compared with DLBCL without sarcoidosis. No statistical difference was found in the risk of death or progression between the two groups (P = 0.685).
Conclusions: We report here the largest series of lymphoma associated sarcoidosis patients. As opposed to previous studies, we observed a predominance of patients with DLBCL. Our study confirms the concept of the sarcoidosis-lymphoma syndrome. Large B-cell lymphoma does not have a better prognosis when associated with sarcoidosis.
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Renin-angiotensin system inhibitors linked to anemia: a systematic review and meta-analysis
Background: The objective of this meta-analysis was to evaluate the risk of anemia in patients who received renin-angiotensin system (RAS) inhibitors.
Methods: A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through November, 2014. Studies that reported relative risks, odd ratios or hazard ratios comparing the anemia risk in patients who received angiotensin-converting-enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) vs. those who did not were included. We performed the prespecified sensitivity analysis including only only studies with confounder adjusted analysis. Pooled risk ratios (RRs) and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method.
Results: Seven studies (2 cohort and 5 cross-sectional studies) with 29 061 patients were included in the analysis to assess the risk of anemia and the RAS inhibitors use. The pooled RR of anemia in patients receiving ACEIs was 1.56 (95% CI, 1.40–1.73, I2 = 17%). When meta-analysis was limited only to studies with confounder adjusted analysis, the pooled RR of anemia in patients using ACEIs was 1.57 (95% CI, 1.43–1.73, I2 = 0%) The pooled RR of anemia in patients receiving ARBs was 1.60 (95% CI, 1.27–2.00, I2 = 39%). The meta-analysis of studies with confounder adjusted analysis demonstrated the pooled RR of anemia in patients using ARBs of 1.59 (95% CI, 1.38–1.83, I2 = 0%).
Conclusions: Our meta-analysis demonstrates an association between anemia and the use of RAS inhibitors. Hematological parameters should be monitored in patients treated with RAS inhibitors.
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High risk factors of atrial fibrillation in type 2 diabetes: results from the Chinese Kailuan study
Background: The pathophysiological mechanisms for atrial fibrillation (AF) vulnerability in diabetic patients are largely unclear.
Aim: To investigate the high risk factors of AF in Chinese Kailuan diabetes.
Design: A retrospective review of AF in Chinese Kailuan diabetes.
Methods: Research and statistic analysis on the clinical data of 9050 diabetic patients from Kailuan Coal Mine Group Corporation who participated in a health survey from July 2006 to October 2007.
Results: Sixty diabetic patients (50 males and 10 females) were diagnosed with AF during the health checkup, with a prevalence of 0.66% (0.67% in males and 0.62% in females). Univariate analysis showed that patients with AF were older and had higher levels of serum uric acid (UA), pulse pressure, serum c-reactive protein and anti-hypertensive medication usage, but lower levels of fasting blood glucose and triglycerides (TG). Multivariate analysis indicated that older age (OR = 1.09; 95% CI: 1.06–1.12), increased UA (OR = 1.01; 95% CI: 1.00–1.01) and decreased TG (OR = 0.71; 95% CI: 0.55–0.92) were independent predictive factors of AF after adjusting for other variables. After gender stratification, age and UA remained as independent predictive factors of AF in both male and female patients. However, TG had an independent inverse association with AF in male patients only.
Conclusions: Age and UA are independent predictive factors of AF in both male and female diabetic patients. TG is inversely correlated with AF in male diabetic patients only.
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Non-small cell lung cancer in young adults: presentation and survival in the English National Lung Cancer Audit
Background: Non-small cell lung cancer (NSCLC) in young adults is a rare but devastating illness with significant socioeconomic implications, and studies of this patient subgroup are limited.
Aim: This study employed the National Lung Cancer Audit to compare the clinical features and survival of young adults with NSCLC with the older age groups.
Design: A retrospective cohort review using a validated national audit dataset.
Methods: Data were analysed for the period between 1 January 2004 and 31 December 2011. Young adults were defined as between 18 and 39 years, and all others were divided into decade age groups, up to the 80 years and above group. We performed logistic and Cox regression analyses to assess clinical outcomes.
Results: Of a total of 1 46 422 patients, 651 (0.5%) were young adults, of whom a higher proportion had adenocarcinoma (48%) than in any other age group. Stage distribution of NSCLC was similar across the age groups and 71% of young patients had stage IIIb/IV. Performance status (PS) was 0–1 for 85%. Young adults were more likely to have surgery and chemotherapy compared with the older age groups and had better overall and post-operative survival. The proportion with adenocarcinoma, better PS and that receiving surgery or chemotherapy diminished progressively with advancing decade age groups.
Conclusion: In our cohort of young adults with NSCLC, the majority had good PS despite the same late-stage disease as older patients. They were more likely to have treatment and survive longer than older patients.
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Cancers, Vol. 7, Pages 2147-2168: The Interactions of Obesity, Inflammation and Insulin Resistance in Breast Cancer
Obese postmenopausal women have an increased breast cancer risk, the principal mechanism for which is elevated estrogen production by adipose tissue; also, regardless of menstrual status and tumor estrogen dependence, obesity is associated with biologically aggressive breast cancers. Type 2 diabetes has a complex relationship with breast cancer risk and outcome; coexisting obesity may be a major factor, but insulin itself induces adipose aromatase activity and estrogen production and also directly stimulates breast cancer cell growth and invasion. Adipose tissue inflammation occurs frequently in obesity and type 2 diabetes, and proinflammatory cytokines and prostaglandin E2 produced by cyclooxygenase-2 in the associated infiltrating macrophages also induce elevated aromatase expression. In animal models, the same proinflammatory mediators, and the chemokine monocyte chemoattractant protein-1, also stimulate tumor cell proliferation and invasion directly and promote tumor-related angiogenesis. We postulate that chronic adipose tissue inflammation, rather than body mass index-defined obesity per se, is associated with an increased risk of type 2 diabetes and postmenopausal estrogen-dependent breast cancer. Also, notably before the menopause, obesity and type 2 diabetes, or perhaps the associated inflammation, promote estrogen-independent, notably triple-negative, breast cancer development, invasion and metastasis by mechanisms that may involve macrophage-secreted cytokines, adipokines and insulin.
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Biosensors, Vol. 5, Pages 647-663: Biocompatible Hydrogels for Microarray Cell Printing and Encapsulation
Conventional drug screening processes are a time-consuming and expensive endeavor, but highly rewarding when they are successful. To identify promising lead compounds, millions of compounds are traditionally screened against therapeutic targets on human cells grown on the surface of 96-wells. These two-dimensional (2D) cell monolayers are physiologically irrelevant, thus, often providing false-positive or false-negative results, when compared to cells grown in three-dimensional (3D) structures such as hydrogel droplets. However, 3D cell culture systems are not easily amenable to high-throughput screening (HTS), thus inherently low throughput, and requiring relatively large volume for cell-based assays. In addition, it is difficult to control cellular microenvironments and hard to obtain reliable cell images due to focus position and transparency issues. To overcome these problems, miniaturized 3D cell cultures in hydrogels were developed via cell printing techniques where cell spots in hydrogels can be arrayed on the surface of glass slides or plastic chips by microarray spotters and cultured in growth media to form cells encapsulated 3D droplets for various cell-based assays. These approaches can dramatically reduce assay volume, provide accurate control over cellular microenvironments, and allow us to obtain clear 3D cell images for high-content imaging (HCI). In this review, several hydrogels that are compatible to microarray printing robots are discussed for miniaturized 3D cell cultures.
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Beverages, Vol. 1, Pages 273-291: Packaging Attributes of Antioxidant-Rich Instant Coffee and Their Influence on the Purchase Intent
The present study aimed to identify the most important packaging attributes for purchasing a product not currently on the Brazilian market: antioxidant-rich instant coffee, a blend of roasted coffee and green coffee. Five package types of the same brand of instant antioxidant-rich coffee marketed in different countries were evaluated through a focus group. The attributes' glass shape, glass lid color and label, information and brand were selected for the quantitative study. The purchase intent for the packaging images was evaluated with conjoint analysis. In general, an increased purchase intent was verified for more modern packages and browner labels that indicated roasted coffee. The consumers preferred the image of green and roasted coffee beans next to the cup of coffee and valued information about the product's differentiation (the origin, type, quantity and functions of antioxidants) that was presented in the form of explanatory charts on the back of the packaging.
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Applied Sciences, Vol. 5, Pages 942-954: Fabrication and Simulation of Self-Focusing Field Emission X-ray Tubes
A self-focusing field emission (FE) X-ray tube with a large-area cathode design was simulated and fabricated. The designed X-ray tube had a cylindrically symmetric geometry; the diameter of the cathode and the anode was 15 mm, and the cathode-anode distance was 20 mm. Owing to the unique cup-shaped design of the cathode, the electron beam emitted from the large-area cathode was focused onto the anode without using magnetic lenses or extra biased electrodes. Carbon nanocoils, which were grown on the bottom of the circular cup-shaped cathode, were used as electron emitters because of their excellent FE properties. A simulation of the electron trajectories for various cup heights revealed that the optimal focal spot size (0.1 mm) was obtained at a cup height of 5 mm when a voltage of 50 kV was applied. To verify this result, an X-ray tube was fabricated and tested. An X-ray photograph of the tested tooth and electric circuits showed good resolution and X-ray intensity. The large cathode area effectively reduces the current density and thereby improves the lifetime of the cathode.
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Actuators, Vol. 4, Pages 237-254: Ionic Polymer Microactuator Activated by Photoresponsive Organic Proton Pumps
An ionic polymer microactuator driven by an organic photoelectric proton pump transducer is described in this paper. The light responsive transducer is fabricated by using molecular self-assembly to immobilize oriented bacteriorhodopsin purple membrane (PM) patches on a bio-functionalized porous anodic alumina (PAA) substrate. When exposed to visible light, the PM proton pumps produce a unidirectional flow of ions through the structure's nano-pores and alter the pH of the working solution in a microfluidic device. The change in pH is sufficient to generate an osmotic pressure difference across a hydroxyethyl methacrylate-acrylic acid (HEMA-AA) actuator shell and induce volume expansion or contraction. Experiments show that the transducer can generate an ionic gradient of 2.5 μM and ionic potential of 25 mV, producing a pH increase of 0.42 in the working solution. The ΔpH is sufficient to increase the volume of the HEMA-AA microactuator by 80%. The volumetric transformation of the hydrogel can be used as a valve to close a fluid transport micro-channel or apply minute force to a mechanically flexible microcantilever beam.
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Metals, Vol. 5, Pages 1984-1996: Microstructures and Wear Performance of PTAW Deposited Ni-Based Coatings with Spherical Tungsten Carbide
The Ni-based coatings with different content of spherical tungsten carbide were deposited by plasma transfer arc welding (PTAW) method on 304 austenitic stainless steel sheets in this study. The microstructure and wear property of spherical tungsten carbide particle reinforced composite coatings were investigated by means of optical microscope, scanning electron microscope (SEM), X-ray diffraction (XRD), electron probe microanalysis (EPMA) and sliding wear test. It is shown that the fraction of spherical tungsten carbides has an important influence on microstructure of Ni-based overlay. The Ni40 overlay consists of γ-Ni dendrites with interdendritic Ni-based eutectics, borides and carbides improving the wear resistance. In the case of composite coatings with different content of tungsten carbide, many new phases are observed, such as Ni2W4C and NiW. In addition, there are a large number of irregular structures in composite coatings, such as acicular structure and irregular stripe organization. The results of sliding wear test indicate that the mass loss of coatings is influenced by the content of tungsten carbide. The mass loss decreases with the increase of tungsten carbide fraction. At high load, the abrasive resistance of composite coating with 60 wt. % tungsten carbide is improved about 50-fold compared to that of Ni40 overlay.
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Chemosensors, Vol. 3, Pages 253-273: New Nanomaterials and Luminescent Optical Sensors for Detection of Hydrogen Peroxide
Accurate methods that can continuously detect low concentrations of hydrogen peroxide (H2O2) have a huge application potential in biological, pharmaceutical, clinical and environmental analysis. Luminescent probes and nanomaterials are used for fabrication of sensors for H2O2 that can be applied for these purposes. In contrast to previous reviews focusing on the chemical design of molecular probes for H2O2, this mini-review highlights the latest luminescent nanoparticular materials and new luminescent optical sensors for H2O2 in terms of the nanomaterial composition and luminescent receptor used in the sensors. The nanomaterial section is subdivided into schemes based on gold nanoparticles, polymeric nanoparticles with embedded enzymes, probes showing aggregation-induced emission enhancement, quantum dots, lanthanide-based nanoparticles and carbon based nanomaterials, respectively. Moreover, the sensors are ordered according to the type of luminescent receptor used within the sensor membranes. Among them are lanthanide complexes, metal-ligand complexes, oxidic nanoparticles and organic dyes. Further, the optical sensors are confined to those that are capable to monitor the concentration of H2O2 in a sample over time or are reusable. Optical sensors responding to gaseous H2O2 are not covered. All nanomaterials and sensors are characterized with respect to the analytical reaction towards H2O2, limit of detection (LOD), analytical range, electrolyte, pH and response time/incubation time. Applications to real samples are given. Finally, we assess the suitability of the nanomaterials to be used in membrane-based sensors and discuss future trends and perspectives of these sensors in biomedical research.
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Oxidative DNA damage in mouse sperm chromosomes: Size matters
Publication date: Available online 25 October 2015
Source:Free Radical Biology and Medicine
Author(s): Ayhan Kocer, Joelle Henry-Berger, Anais Noblanc, Alexandre Champroux, Romain Pogorelcnik, Rachel Guiton, Laurent Janny, Hanae Pons-Rejraji, Fabrice Saez, Graham D. Johnson, Stephen A. Krawetz, Juan G. Alvarez, R. John Aitken, Joël R. Drevet
Normal embryo and fetal development as well as the health of the progeny are mostly dependent on gamete nuclear integrity. In the present study, in order to characterize more precisely oxidative DNA damage in mouse sperm we used two mouse models that display high levels of sperm oxidative DNA damage, a common alteration encountered both in in vivo and in vitro reproduction. Immunoprecipitation of oxidized sperm DNA coupled to deep sequencing showed that mouse chromosomes may be largely affected by oxidative alterations. We show that the vulnerability of chromosomes to oxidative attack inversely correlated with their size and was not linked to their GC richness. It was neither correlated with the chromosome content in persisting nucleosomes nor associated with methylated sequences. A strong correlation was found between oxidized sequences and sequences rich in short interspersed repeat elements (SINEs). Chromosome position in the sperm nucleus as revealed by fluorescent in situ hybridization appears to be a confounder. These data map for the first time fragile mouse sperm chromosomal regions when facing oxidative damage that may challenge the repair mechanisms of the oocyte post-fertilization.
Graphical abstract
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Medicine,New Articles,October 26th,2015
Biological Evidence Management for DNA Analysis in Cases of Sexual Assault
Biological evidence with forensic interest may be found in several cases of assault, being particularly relevant if sexually related. Sexual assault cases are characterized by low rates of disclosure, reporting, prosecution, and conviction. Biological evidence is sometimes the only way to prove the occurrence of sexual contact and to identify the perpetrator. The major focus of this review is to propose practical approaches and guidelines to help health, forensic, and law enforcement professionals to deal with biological evidence for DNA analysis. Attention should be devoted to av... περισσότερα »
Function analysis of rs9589207 polymorphism in miR-92a in gastric cancer
Abstract MiR-92a was identified as an essential oncogene by promoting the cell proliferation through FBXW7 in gastric cancer (GC). The function of the single nucleotide polymorphism (SNP) located in the mature region of miR-92a (rs9589207) has not been investigated. We found that rs9589207 in miR-92a was involved in the occurrence of GC by acting as a tumor protective factor and was highly associated with tumor size in GC patients instead of tumor number or metastasis in 554 GC patients and 531 cancer-free controls. Besides, the AA genotype in miR-92a could attenuate the promoting... περισσότερα »
Inoculation of paperboard mill sludge versus mixed culture bacteria for hydrogen production from paperboard mill wastewater
Abstract A comparative evaluation of paperboard mill sludge (PMS) versus mixed culture bacteria (MCB) as inoculum for hydrogen production from paperboard mill wastewater (PMW) was investigated. The experiments were conducted at different initial cultivation pHs, inoculums to substrate ratios (ISRs gVS/gCOD), and hydraulic retention times (HRTs). The peak hydrogen yield (HY) of 5.29 ± 0.16 and 1.22 ± 0.11 mmol/gCODinitial was occurred at pH = 5 for MCB and PMS, respectively. At pH of 5, the HY and COD removal achieved the highest values of 2.26 ± 0.14 mmol/gCODinitial and 86 ± 1.6 %... περισσότερα »
Uptake of polybrominated diphenyl ethers by carrot and lettuce crops grown in compost-amended soils
Abstract The uptake of polybrominated diphenyl ethers (PBDEs) by carrot and lettuce was investigated. Degradation of PBDEs in soil in the absence of the plants was discarded. Different carrot (*Nantesa* and *Chantenay*) and lettuce (*Batavia Golden Spring* and *Summer Queen*) varieties were grown in fortified or contaminated compost-amended soil mixtures under greenhouse conditions. After plant harvesting, roots (core and peel) and leaves were analyzed separately for carrot, while for lettuce, leaves and hearts were analyzed together. The corresponding bioconcentration factors (BCF...περισσότερα »
Quinolone co-resistance in ESBL- or AmpC-producing Escherichia coli from an Indian urban aquatic environment and their public health implications
Abstract Quinolone and β-lactam antibiotics constitute major mainstay of treatment against infections caused by pathogenic *Escherichia coli*. Presence of *E. coli* strains expressing co-resistance to both these antibiotic classes in urban aquatic environments which are consistently being used for various anthropogenic activities represents a serious public health concern. From a heterogeneous collection of 61 *E. coli* strains isolated from the river Yamuna traversing through the National Capital Territory of Delhi (India), those harboring *bla* CTX-M-15 (*n* = 10) or *bla* CMY-42... περισσότερα »
Viruses, Vol. 7, Pages 5571-5586: Nucleobase but not Sugar Fidelity is Maintained in the Sabin I RNA-Dependent RNA Polymerase
The Sabin I poliovirus live, attenuated vaccine strain encodes for four amino acid changes (i.e., D53N, Y73H, K250E, and T362I) in the RNA-dependent RNA polymerase (RdRp). We have previously shown that the T362I substitution leads to a lower fidelity RdRp, and viruses encoding this variant are attenuated in a mouse model of poliovirus. Given these results, it was surprising that the nucleotide incorporation rate and nucleobase fidelity of the Sabin I RdRp is similar to that of wild-type enzyme, although the Sabin I RdRp is less selective against nucleotides with modified sugar gro... περισσότερα »
Viruses, Vol. 7, Pages 5553-5570: Vector-Enabled Metagenomic (VEM) Surveys Using Whiteflies (Aleyrodidae) Reveal Novel Begomovirus Species in the New and OldWorlds
Whitefly-transmitted viruses belonging to the genus Begomovirus (family Geminiviridae) represent a substantial threat to agricultural food production. The rapid evolutionary potential of these single-stranded DNA viruses combined with the polyphagous feeding behavior of their whitefly vector (Bemisia tabaci) can lead to the emergence of damaging viral strains. Therefore, it is crucial to characterize begomoviruses circulating in different regions and crops globally. This study utilized vector-enabled metagenomics (VEM) coupled with high-throughput sequencing to survey begomoviruse... περισσότερα »
Future Internet, Vol. 7, Pages 393-404: Embedding an Identity-Based Short Signature as a Digital Watermark
Digital watermarking aims at protecting multimedia content by hiding into it some data that can be used for such purposes as, for example, intellectual property protection or integrity control. Sometimes, the owner of an image would prefer to not transmit, publish, or hand to a cloud service the original image, but rather an encrypted version of it. Encrypted images allow for less embedding room with respect to their unencrypted counterparts, as there is less spatial correlation to leverage upon. An architecture for embedding as payload the digital signature of an encrypted image,... περισσότερα »
Salutary Effects of Cepharanthine against Skeletal Muscle and Kidney Injuries following Limb Ischemia/Reperfusion
Limb ischemia/reperfusion (I/R) causes oxidation and inflammation and subsequently induces muscle and kidney injuries. Cepharanthine, a natural plant alkaloid, possesses anti-inflammatory and antioxidative properties. We elucidated the salutary effects of cepharanthine against muscle and kidney injuries following limb I/R. Adult male rats were randomized to receive I/R or I/R plus cepharanthine. I/R was achieved by applying tourniquet high around each thigh for 3 hours followed by reperfusion for 24 hours. Cepharanthine (10 mg/kg, intraperitoneal) was injected immediately before r... περισσότερα »
Association between Albuminuria and Different Body Constitution in Type 2 Diabetes Patients: Taichung Diabetic Body Constitution Study
Objective. Albuminuria in type 2 diabetes mellitus (T2DM) patients increases the risk of diabetic nephropathy, the leading cause of end-stage renal disease worldwide. Because albuminuria is modifiable, identifying relevant risk factors could facilitate prevention and/or management. This cross-sectional study investigated whether body constitution (BC) independently predicts albuminuria. Method. Patients with T2DM () received urinalysis, a blood test, and diabetic retinopathy examination. Albuminuria was defined by an elevated urinary albumin/creatinine ratio (≥30 μg/mg). BC type (... περισσότερα »
Gastrodin Reduces Blood Pressure by Intervening with RAAS and PPARγ in SHRs
Gastrodin is a bioactive compound extracted from traditional Chinese medicine, Gastrodia elata Bl. It has a definite effect on reducing blood pressure in hypertensive patients. However, the mechanisms of gastrodin in lowering blood pressure still remain unclear. In this study, 4 weeks of administration of gastrodin (100 mg/kg/d intraperitoneally injected) decreased the systolic blood pressure (SBP) in spontaneously hypertensive rats (SHRs) ( versus , ). Among SHRs receiving gastrodin treatment, angiotensin II (Ang II) and aldosterone (ALD) in serum were significantly decreased ( v... περισσότερα »
Plant-Derived Compounds Targeting Pancreatic Beta Cells for the Treatment of Diabetes
Diabetes is a global health problem and a national economic burden. Although several antidiabetic drugs are available, the need for novel therapeutic agents with improved efficacy and few side effects remains. Drugs derived from natural compounds are more attractive than synthetic drugs because of their diversity and minimal side effects. This review summarizes the most relevant effects of various plant-derived natural compounds on the functionality of pancreatic beta cells. Published data suggest that natural compounds directly enhance insulin secretion, prevent pancreatic beta c...περισσότερα »
The Role of Circulating Tight Junction Proteins in Evaluating Blood Brain Barrier Disruption following Intracranial Hemorrhage
Brain injury after intracranial hemorrhage (ICH) results in significant morbidity and mortality. Blood brain barrier (BBB) disruption is a hallmark of ICH-induced brain injury; however, data mirroring BBB disruption in human ICH are scarce. The aim of this study was to assess the significance of circulating biomarkers in evaluating BBB disruption after ICH. Twenty-two patients with ICH were recruited in this study. Concentrations of the tight junction proteins (TJs) Claudin-5 (CLDN5), Occludin (OCLN), and zonula occludens 1 (ZO-1) and vascular endothelial growth factor (VEGF) and ... περισσότερα »
Melodic Contour Training and Its Effect on Speech in Noise, Consonant Discrimination, and Prosody Perception for Cochlear Implant Recipients.
Related Articles *Melodic Contour Training and Its Effect on Speech in Noise, Consonant Discrimination, and Prosody Perception for Cochlear Implant Recipients.* Behav Neurol. 2015;2015:352869 Authors: Lo CY, McMahon CM, Looi V, Thompson WF Abstract Cochlear implant (CI) recipients generally have good perception of speech in quiet environments but difficulty perceiving speech in noisy conditions, reduced sensitivity to speech prosody, and difficulty appreciating music. Auditory training has been proposed as a method of improving speech perception for CI recipients, and recent effo...περισσότερα »
Videofluoroscopic Predictors of Penetration-Aspiration in Parkinson's Disease Patients.
Related Articles *Videofluoroscopic Predictors of Penetration-Aspiration in Parkinson's Disease Patients.* Dysphagia. 2015 Oct 22; Authors: Argolo N, Sampaio M, Pinho P, Melo A, Nóbrega AC Abstract Parkinson's disease (PD) patients show a high prevalence of swallowing disorders and tracheal aspiration of food. The videofluoroscopic study of swallowing (VFSS) allows clinicians to visualize the visuoperceptual and temporal parameters associated with swallowing disorders in an attempt to predict aspiration risk. However, this subject remains understudied in PD populations. Our aim ... περισσότερα »
Auditory Middle Latency Response and Phonological Awareness in Students with Learning Disabilities.
Related Articles *Auditory Middle Latency Response and Phonological Awareness in Students with Learning Disabilities.* Int Arch Otorhinolaryngol. 2015 Oct;19(4):325-30 Authors: Romero AC, Funayama CA, Capellini SA, Frizzo AC Abstract Introduction Behavioral tests of auditory processing have been applied in schools and highlight the association between phonological awareness abilities and auditory processing, confirming that low performance on phonological awareness tests may be due to low performance on auditory processing tests. Objective To characterize the auditory middle late...περισσότερα »
Aspects of Oral Language, Speech, and Written Language in Subjects with Temporal Lobe Epilepsy of Difficult Control.
Related Articles *Aspects of Oral Language, Speech, and Written Language in Subjects with Temporal Lobe Epilepsy of Difficult Control.* Int Arch Otorhinolaryngol. 2015 Oct;19(4):302-8 Authors: Berberian AP, Hopker C, Mazzarotto I, Cunha J, Guarinello AC, Massi G, Crippa A Abstract Introduction About 50 million people have epilepsy and 30% of them have epilepsy that does not respond to properly conducted drug treatment. Objective Verify the incidence of language disorders in oral language, speech, and written language of subjects with difficult to control temporal lobe epilepsy (... περισσότερα »
Orofacial Praxis Abilities in Children with Speech Disorders.
Related Articles *Orofacial Praxis Abilities in Children with Speech Disorders.* Int Arch Otorhinolaryngol. 2015 Oct;19(4):286-92 Authors: Bertagnolli AP, Gubiani MB, Ceron M, Keske-Soares M Abstract Introduction Phonological development occurs in a gradual manner until the age of 7 years. The phonological system is constructed in a similar way for all children, despite presenting some variations in terms of age, paths taken, or repair strategies used. Objective To compare the orofacial praxis abilities of children with typical phonological development (DFT), children with phonet...περισσότερα »
SMAD4 Defect Causes Auditory Neuropathy Via Specialized Disruption of Cochlear Ribbon Synapses in Mice.
Related Articles *SMAD4 Defect Causes Auditory Neuropathy Via Specialized Disruption of Cochlear Ribbon Synapses in Mice.* Mol Neurobiol. 2015 Oct 21; Authors: Liu K, Ji F, Yang G, Hou Z, Sun J, Wang X, Guo W, Sun W, Yang W, Yang X, Yang S Abstract More than 100 genes have been associated with deafness. However, SMAD4 is rarely considered a contributor to deafness in humans, except for its well-defined role in cell differentiation and regeneration. Here, we report that a SMAD4 defect in mice can cause auditory neuropathy, which was defined as a mysterious hearing and speech perc...περισσότερα »
Case report: an unexpected link between partial deletion of the SHANK3 gene and Heller's dementia infantilis, a rare subtype of autism spectrum disorder.
Related Articles *Case report: an unexpected link between partial deletion of the SHANK3 gene and Heller's dementia infantilis, a rare subtype of autism spectrum disorder.* BMC Psychiatry. 2015;15(1):256 Authors: Philippe A, Craus Y, Rio M, Bahi-Buisson N, Boddaert N, Malan V, Bonnefont JP, Robel L Abstract BACKGROUND: Deletions and mutations involving the SHANK3 gene lead to a nonspecific clinical presentation with moderate to profound intellectual disability, severely delayed or absent speech, and autism spectrum disorders (ASD). Better knowledge of the clinical spectrum of SH... περισσότερα »
Literacy transforms speech production.
[image: http:--http://ift.tt/1M8vfzn] [image: http:--http://ift.tt/1Fkw4zC] Related Articles *Literacy transforms speech production.* Front Psychol. 2015;6:1458 Authors: Saletta M PMID: 26483721 [PubMed] from Language and Communication Disorders via ola Kala on Inoreader http://ift.tt/1LWfTAt via IFTTT
Suggested Minimum Data Set for Speech Therapy Centers Affiliated to Tabriz University of Medical Sciences.
[image: http:--http://ift.tt/1Fkw4zC] Related Articles *Suggested Minimum Data Set for Speech Therapy Centers Affiliated to Tabriz University of Medical Sciences.* Acta Inform Med. 2015 Aug;23(4):243-7 Authors: Damanabi S, Abdolnejad S, Karimi G Abstract BACKGROUND: The minimum data considered as a conceptual framework, based on the achievement of effectiveness indicators and it ensures to access of precise and clear health data. The aims of the present study were identified and proposed a data element set of speech therapy centers affiliated with Tabriz University of Medical Sci...περισσότερα »
The Effects of a Voice Education Program on VHI Scores of Elementary School Teachers.
[image: http:--linkinghub.elsevier.com-ihub-imag] Related Articles *The Effects of a Voice Education Program on VHI Scores of Elementary School Teachers.* J Voice. 2015 Oct 16; Authors: Faham M, Ahmadi A, Drinnan M, Saadatmand N, Fatahi E, Jalalipour M Abstract INTRODUCTION: Teachers seem to be vulnerable to voice disorders because of excessive use of their voice. The purpose of this study was to investigate the effects of a voice education program on the Vocal Handicap Index (VHI) scores of elementary school teachers in the Persian education system. METHOD: This was a semi-experi...περισσότερα »
Long-latency auditory evoked potentials with verbal and nonverbal stimuli.
[image: http:--linkinghub.elsevier.com-ihub-imag] [image: http:--http://ift.tt/1Nv6Vcu] Related Articles *Long-latency auditory evoked potentials with verbal and nonverbal stimuli.* Braz J Otorhinolaryngol. 2015 Sep 7; Authors: Oppitz SJ, Didoné DD, da Silva DD, Gois M, Folgearini J, Ferreira GC, Garcia MV Abstract INTRODUCTION: Long-latency auditory evoked potentials represent the cortical activity related to attention, memory, and auditory discrimination skills. Acoustic signal processing occurs differently between verbal and nonverbal stimuli, influencing the latency and ampli... περισσότερα »
Quality of statistical reporting in developmental disability journals.
[image: http:--pt.wkhealth.com-pt-pt-core-templa] Related Articles *Quality of statistical reporting in developmental disability journals.* Int J Rehabil Res. 2015 Oct 16; Authors: Namasivayam AK, Yan T, Wong WY, van Lieshout P Abstract Null hypothesis significance testing (NHST) dominates quantitative data analysis, but its use is controversial and has been heavily criticized. The American Psychological Association has advocated the reporting of effect sizes (ES), confidence intervals (CIs), and statistical power analysis to complement NHST results to provide a more comprehensive... περισσότερα »
Prolonged auditory brainstem responses in infants with autism.
[image: http:--media.wiley.com-assets-2250-98-Wi] [image: http:--media.wiley.com-assets-2250-98-Wi] Related Articles *Prolonged auditory brainstem responses in infants with autism.* Autism Res. 2015 Oct 19; Authors: Miron O, Ari-Even Roth D, Gabis LV, Henkin Y, Shefer S, Dinstein I, Geva R Abstract Numerous studies have attempted to identify early physiological abnormalities in infants and toddlers who later develop autism spectrum disorder (ASD). One potential measure of early neurophysiology is the auditory brainstem response (ABR), which has been reported to exhibit prolonged...περισσότερα »
Risk factors for the recurrence of post-semicircular canal benign paroxysmal positional vertigo after canalith repositioning.
[image: http:--production.springer.de-OnlineReso] Related Articles *Risk factors for the recurrence of post-semicircular canal benign paroxysmal positional vertigo after canalith repositioning.* J Neurol. 2015 Oct 17; Authors: Su P, Liu YC, Lin HC Abstract This retrospective study was conducted to determine the relationship between variable factors and the recurrence rate of post-semicircular canal benign paroxysmal positional vertigo (PSC-BPPV) after canalith repositioning procedure (CRP). Patients with PSC-BPPV were diagnosed by history and the presence of a positive Dix-Hallpi... περισσότερα »
An essential role for UBE2A/HR6A in learning and memory and mGLUR-dependent long-term depression.
Related Articles *An essential role for UBE2A/HR6A in learning and memory and mGLUR-dependent long-term depression.* Hum Mol Genet. 2015 Oct 16; Authors: Bruinsma CF, Savelberg SM, Kool MJ, Jolfaei MA, van Woerden GM, Baarends WM, Elgersma Y Abstract UBE2A deficiency syndrome (also known as X-linked intellectual disability type Nascimento) is an intellectual disability syndrome characterized by prominent dysmorphic features, impaired speech and often epilepsy. The syndrome is caused by Xq24 deletions encompassing the UBE2A (HR6A) gene or by intragenic UBE2A mutations. UBE2A enco... περισσότερα »
Early electrophysiological markers of atypical language processing in prematurely born infants.
[image: http:--linkinghub.elsevier.com-ihub-imag] Related Articles *Early electrophysiological markers of atypical language processing in prematurely born infants.* Neuropsychologia. 2015 Oct 14; Authors: Paquette N, Vannasing P, Tremblay J, Lefebvre F, Roy MS, McKerral M, Lepore F, Lassonde M, Gallagher A Abstract Because nervous system development may be affected by prematurity, many prematurely born children present language or cognitive disorders at school age. The goal of this study is to investigate whether these impairments can be identified early in life using electrophys... περισσότερα »
The Effect of Experience on Response Time When Judging Synthesized Voice Quality.
[image: http:--linkinghub.elsevier.com-ihub-imag] Related Articles *The Effect of Experience on Response Time When Judging Synthesized Voice Quality.* J Voice. 2015 Oct 13; Authors: Kisenwether JS, Prosek RA Abstract OBJECTIVES/HYPOTHESIS: The purpose of this study was to determine the effect of level and type of experience on response time and the number of replays needed when judging voice quality. STUDY DESIGN: This was a within-subjects group design. METHODS: Speech-language pathologists, singing voice teachers, speech-language pathology graduate students with and without expe... περισσότερα »
Infections Associated With Tunnelled Indwelling Pleural Catheters in Patients Undergoing Chemotherapy
[image: image]Background: Malignant pleural effusions are common complications of advanced malignancies and are associated with significant morbidity and reduced survival. Tunnelled indwelling pleural catheters (TIPCs) are implantable devices used for palliation of symptomatic malignant pleural effusions. Although complication rates are overall low, their use in the setting of concurrent chemotherapy has not been carefully reviewed. We report our experience with infectious complications directly attributable to TIPCs (pleural or local soft tissue infections) in those patients rec... περισσότερα »
Unilateral hyperhidrosis and hypothermia – symptoms of an intrathoracic tumour
A 34-year old man presented at the Department of Dermato-allergology, Herlev and Gentofte Hospital with unilateral hyperhidrosis localized to the right axilla through approximately 10 years without progression of symptoms. The patient often experienced that his right hand was colder than the left, especially during bouts of hyperhidrosis. The symptoms usually arose in stressful situations. The patient had no sensory symptoms (pain and light touch of upper extremitieswere assessed) and no medical history of other diseases including lung disease or neurological disease. This articl...περισσότερα »
Identification of invasive fungal diseases in immunocompromised patients by combining an Aspergillus specific PCR with a multifungal DNA-microarray from primary clinical samples
Summary The increasing incidence of invasive fungal diseases (IFD), most of all invasive aspergillosis (IA) in immunocompromised patients emphasises the need to improve the diagnostic tools for detection of fungal pathogens. We investigated the diagnostic performance of a multifungal DNA-microarray detecting 15 different fungi [*Aspergillus, Candida, Fusarium, Mucor, Rhizopus, Scedosporium* and *Trichosporon* species (spp.)] in addition to an *Aspergillus* specific polymerase chain reaction (PCR) assay. Biopsies, bronchoalveolar lavage and peripheral blood samples of 133 immunocom... περισσότερα »
Acroosteolysis presenting with brachyonychia following exposure to cold
Abstract Background A vast number of conditions ranging from simple trauma to hereditary and collagen vascular disease had been described in association with acroosteolysis. Objective To demonstrate that severe cold exposure not mounting to frostbite may be associated with acroosteolysis. Methods A 16–year-old girl with acroosteolysis presenting with brachyonychia was fully investigated for possible cause of her nail and bone deformity. Results Lab investigations including Parathormone levels, Anti Scl 70, ANA, Anti-CCP and RF levels were all normal. X-ray imaging revealed res... περισσότερα »
Successful treatment of PASH syndrome with infliximab, cyclosporine and dapsone
Abstract Background The group of autoinflammatory syndromes associated with Pyoderma gangrenosum, Acne, and Suppurative Hidradenitis are poorly defined and difficult to control with currently available treatment modalities. Objectives We describe a patient with PASH syndrome and report about the successful multimodal treatment with infliximab, cyclosporine, and dapsone. Methods A review of the available literature to date about this group of autoinflammatory diseases was performed. We performed genetic analysis for PSTPIP1 mutations associated with PAPA syndrome. Results A 22-... περισσότερα »
Chondrocutaneous helix rim advancement flap: two classical and two new modifications for very large defects of the ear
Abstract Background The plastic reconstruction of the ear after microscopically controlled tumor surgery is a particular challenge. The chondrocutaneous helix rim advancement flap (CHRAF) is perfectly suited for the repair of different defects of the helix and even defects beyond. Objective Here, we describe two known and two new modifications of the CHRAF that enlarge the scope of application in tumor surgery of the ear. Methods We demonstrate the different techniques and practical application of the repair and evaluate the benefits and limitations. Results The CHRAF and its ... περισσότερα »
Non-ablative fractional photothermolysis in treatment of idiopathic guttate hypomelanosis
Abstract Background Idiopathic guttate hypomelanosis (IGH) is a common pigmentary disorder affecting a large number of individuals. Many patients seek medical attention due to aesthetic concern. However, no standard treatment is available. Objectives To evaluate the efficacy and side-effects of non-ablative fractional photothermolysis (FP) as a treatment of IGH. Materials and methods A total of 120 lesions from 30 patients with IGH were treated. In each patient, two lesions on the extremities were assigned to treatment group, while lesions from the other side served as control.... περισσότερα »
Gait & Posture
- Recovery of gait after quadriceps muscle fatigue2015-10-26 10:28:39 AM Publication date: Available online 25 October 2015 *Source:*Gait & Posture Author(s): Fabio Augusto Barbieri, Stephannie Spiandor Beretta, Vinicius A.I. Pereira, Lucas Simieli, Diego Orcioli-Silva, Paulo Cezar Rocha dos Santos, Jaap H. van Dieën, Lilian Teresa Bucken Gobbi The aim of this study was to investigate the effect of recovery time after quadriceps muscle fatigue on gait in young adults. Forty young adults (20 to 40 years old) performed three 8-m gait trials at pref... περισσότερα »
The α7-nicotinic acetylcholine receptor mediates the sensitivity of gastric cancer cells to taxanes
Abstract Gastric cancer is difficult to cure because most patients are diagnosed at an advanced disease stage. Systemic chemotherapy remains an important therapy for gastric cancer, but both progression-free survival and disease-free survival associated with various combination regimens are limited because of refractoriness and chemoresistance. Accumulating evidence has revealed that the homomeric α7-nicotinic acetylcholine receptor (A7-nAChR) promotes human gastric cancer by driving cancer cell proliferation, migration, and metastasis. Therefore, A7-nAChR may serve as a potential... περισσότερα »
Upregulation of long non-coding RNA TUG1 correlates with poor prognosis and disease status in osteosarcoma
Abstract The pathogenesis of osteosarcoma involves complex genetic and epigenetic factors. This study was to explore the impact and clinical relevance of long non-coding RNA (lncRNA), Taurine up-regulated gene 1 (TUG1) on patients with osteosarcoma. Seventy-six osteosarcoma tissues and matched adjacent normal tissues were included for analysis. The plasma samples were obtained from 29 patients with osteosarcoma at pre-operation and post-operation, 42 at newly diagnosed, 18 who experienced disease progression or relapse, 45 post-treatment, 36 patients with benign bone tumor, and 20... περισσότερα »
Long-term outcomes of concurrent chemoradiotherapy versus radiotherapy alone in stage II nasopharyngeal carcinoma treated with IMRT: a retrospective study
Abstract This study aimed to evaluate the efficacy of concurrent chemoradiotherapy (CCRT) for stage II nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiation therapy (IMRT). A total of 249 patients were retrospectively reviewed. All patients were treated with IMRT. One hundred forty-three patients treated with CCRT and 106 patients treated with IMRT alone. With a median follow-up of 59.4 months, adding concurrent chemotherapy did not statistically significantly improve the 5-year overall survival (OS) (89.7 % vs 99.0 %, *p* = 0.278), locoregional relapse...περισσότερα »
Benefits and risks of antihypertensive medications in the elderly
Abstract Hypertension is highly prevalent in older age and accounts for a large proportion of cardiovascular (CV) morbidity and mortality worldwide. Isolated systolic hypertension is more common in the elderly than younger adults and associated with poor outcomes such as cerebrovascular disease and acute coronary events. International guidelines are inconsistent in providing recommendations on optimal blood pressure targets in hypertensive elderly patients as a result of the limited evidence in this population. Evidence from clinical trials supports the use of antihypertensive drug... περισσότερα »
Fish oil supplementation does not lower C-reactive protein or interleukin-6 levels in healthy adults
Abstract Background The n-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) may prevent a range of chronic conditions through anti-inflammatory actions. However, as clinical trials using these fatty acids for primary prevention are yet unavailable, their putative role in disease prevention rests, in part, on evidence of anti-inflammatory actions in healthy individuals. Objective To investigate in a double-blind, placebo-controlled clinical trial whether supplementation with a moderate dose of EPA+DHA reduces common biomarkers of chronic, sy... περισσότερα »
T Lymphocyte Plasticity in Autoimmunity and Cancer
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Journal of Oral Rehabilitation
- Clinical importance of median mandibular flexure in oral rehabilitation: a reviewK. Sivaraman, A. Chopra, S. B. Venkatesh, 2015-10-26 10:25:17 AM Summary The mandible has a property to flex inwards around the mandibular symphysis with change in shape and decrease in mandibular arch width during opening and protrusion of the mandible. The mandibular deformation may range from a few micrometres to more than 1 mm. The movement occurs because of the contraction of lateral pterygoid muscles that pulls mandibular condyles medially and causes a sagittal mov... περισσότερα »
Unilateral hyperhidrosis and hypothermia – symptoms of an intrathoracic tumour
A 34-year old man presented at the Department of Dermato-allergology, Herlev and Gentofte Hospital with unilateral hyperhidrosis localized to the right axilla through approximately 10 years without progression of symptoms. The patient often experienced that his right hand was colder than the left, especially during bouts of hyperhidrosis. The symptoms usually arose in stressful situations. The patient had no sensory symptoms (pain and light touch of upper extremitieswere assessed) and no medical history of other diseases including lung disease or neurological disease. This articl... περισσότερα »
Inconclusive role of human papillomavirus infection in breast cancer
Abstract Background Epidemiological studies have examined the association between human papillomavirus (HPV) and breast cancer, but the findings are inconclusive. This study aimed to detect the prevalence of HPV in breast cancer tissue in patients from northeastern China and define the association between HPV and breast cancer using meta-analysis. Methods Polymerase chain reaction (PCR) was used to test cutaneous or mucosal HPV DNA sequence in 77 breast cancer samples and 77 corresponding adjacent normal tissues. The prevalence of HPV in breast cancer was estimated by pooling dat...περισσότερα »
A randomised, phase IIa exploratory trial to assess the safety and preliminary efficacy of LEO 43204 in patients with actinic keratosis
Abstract Background LEO 43204 is a novel ingenol derivative in development for the treatment of actinic keratosis. Objectives To compare safety and preliminary efficacy of three doses of LEO 43204 with ingenol mebutate in actinic keratoses (AKs). Methods Patients with at least three visible, discrete, non-keratotic AKs on four separate selected treatment areas on the forearms received LEO 43204 gel (0.025%, 0.05% and 0.075%) and ingenol mebutate 0.05% gel, by investigator-blinded randomised allocation, for 2 consecutive days. Patients were assessed at 8 weeks. Primary outcomes ... περισσότερα »
A new approach for pre-surgical margin assessment of basal cell carcinoma by reflectance confocal microscopy
Abstract Background Surgical excision represents the elective treatment for BCC. Several non invasive approaches have been proposed for in vivo determination of tumor margin, in order to achieve a radical removal. Objectives We proposed a new approach for lateral margin detection in BCCs through the combination of dermoscopy and Reflectance Confocal Microscopy (RCM). Methods Ten patients with lesions clinically suggestive of non-pigmented BCCs with ill-defined margins were enrolled. All BCCs were first dermoscopically evaluated and the ill-defined margins were marked with a supe...περισσότερα »
Surface air plasma induced cell death and cytokines release of human keratinocytes in the context of psoriasis
Abstract Background Cold atmospheric plasma(CAP) have shown promises for wound healing though little is understood of underpinning mechanisms. Little has been reported so far of their potential treatment of immune-mediated diseases such as psoriasis. Objectives To study CAP-induced cell death and in cytokine release of human keratinocytes as a first assessment of possible CAP use for psoriasis. Methods Using a CAP generator free of energetic ions, we observed its effects on keratinocytes in morphology, cell viability and apoptosis, intracellular and mitochondrial ROS, lysosomal...περισσότερα »
Retrospective study of changes in pharyngeal airway space and position of hyoid bone after mandibular setback surgery by cephalometric analysis
Abstract Background The posterior movement of mandible was known as the main cause of the changes in the pharyngeal airway space (PAS) and the postoperative obstructive sleep apnea (OSA). The purpose of this study was to know the changes of PAS and position of hyoid bone. Methods Lateral cephalographies of 13 patients who had undergone sagittal split ramus osteotomy (SSRO) setback surgery were taken preoperatively (T1), postoperatively within 2 months (T2), and follow-up after 6 months or more (T3). On the basis of F-H plane, diameters of nasopharynx, oropharynx, and hypopharynx ... περισσότερα »
Guidelines for quantification of noise-induced hearing loss in a medicolegal context
Abstract Objectives Guidelines published in 2000 by the authors are widely used by medical and legal professionals in the UK for diagnosis of noise-induced hearing loss (NIHL) in a medicolegal context. However, they cannot be used for quantification of the noise-induced hearing loss, which is required in most cases. This requirement is addressed. Design A method is developed here to quantify NIHL, thereby overcoming this shortcoming. Setting Assessment of NIHL in medicolegal cases. Participants A consecutive series of 124 cases of NIHL is used for evaluation. Main outcome m... περισσότερα »
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Αλέξανδρος Γ. Σφακιανάκης Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,0030693260717...
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Alimentary Pharmacology &Therapeutics, EarlyView. https://ift.tt/2qECBIJ
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heory of COVID-19 pathogenesis Publication date: November 2020Source: Medical Hypotheses, Volume 144Author(s): Yuichiro J. Suzuki ScienceD...
