Clinical effects of transobturator tape procedure with porcine small intestine submucosa for female stress urinary incontinence

Publication date: Available online 7 April 2016
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Chiu-Lin Wang, Ching-Ju Shen, Kun-Ling Lin, Cheng-Yu Long
The aim of this study was to evaluate the efficacy of the transobturator tape (TOT) procedure using porcine small intestine submucosa (SIS) for the treatment of female stress urinary incontinence (SUI). Forty-two consecutive patients with SUI who underwent the TOT procedure with porcine SIS were enrolled. The surgical outcomes, and data of urodynamic study and a questionnaire prior to and after surgery were collected and analyzed retrospectively. SUI was reported subjectively cured in 34 of the 42 patients (81.0%) 1 year after surgery, and declined to the rate of 66.7% at 5 years postoperatively. The subjective symptoms of frequency and nocturia also improved significantly (p < 0.01). Graft-versus-host disease (GVHD) developed in four patients, but without major complications. Despite the bladder volume at first desire to void increased significantly after surgery (p < 0.01), the remaining urodynamic parameters did not differ in a significant manner. In conclusion, the long-term cure rate of the TOT procedure with SIS is lower than with synthetic materials, but with relatively lower morbidity.



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Association of REL polymorphisms and outcome of patients with septic shock

cRel, a subunit of NF-κB, is implicated in the inflammatory response observed in autoimmune disease. Hence, knocked-out mice for cRel had a significantly higher mortality, providing new and important functions...

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A Mercy Salute to Siblings

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Brad Haller

Sisters Jane Fleer and Helen Ballmann
at Mercy Hospital Washington.

Did you know nearly 80 percent of Americans have either a brother or sister? Among the 40,000 co-workers at Mercy, you don't have to look far to find a stong sibling bond on National Siblings Day (April 10).

In Washington, Missouri, sisters Helen Ballmann and Jane Fleer have dedicated decades to Mercy.

"I'm going on 42 years here," said Helen, a radiology technologist. "The last 35 of them, my younger sister Jane has also been part of my work family!"

Helen and Jane weren't the first of their siblings to launch careers in health care. Now retired, older sister Lorraine worked within the walls of the hospital known today as Mercy Hospital Washington.

"She started the ball rolling, eventually becoming a radiology tech," said Helen. "Jane and I later followed in her footsteps in imaging."

And believe it or not, a fourth sister works for Mercy Hospital St. Louis as – you guessed it – an x-ray technician.

"We love what we do and we work so well together," said Helen. "We have four more sisters, but they don't work in health care. We're a great team, regardless!"

 

 

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Endothelin-1 Plasma Levels and Acute Mountain Sickness

High Altitude Medicine & Biology , Vol. 0, No. 0.


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The Effects of Cognitive Training for Elderly: Results from My Mind Project

Rejuvenation Research , Vol. 0, No. 0.


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Buyang Huanwu Decoction Vigorously Rescues PC12 Cells Against 6-OHDA-Induced Neurotoxicity via Akt/GSK3β Pathway Based on Serum Pharmacology Methodology

Rejuvenation Research , Vol. 0, No. 0.


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Impacts of experimentally induced and clinically acquired quinolone resistance on the membrane and intracellular subproteomes of Salmonella Typhimurium DT104B

Publication date: Available online 8 April 2016
Source:Journal of Proteomics
Author(s): Susana Correia, Michel Hébraud, Ingrid Chafsey, Christophe Chambon, Didier Viala, Carmen Torres, María de Toro, José L. Capelo, Patrícia Poeta, Gilberto Igrejas
Antimicrobial resistance is a growing public health threat worldwide that is still far from a complete understanding. Salmonella Typhimurium DT104 multiresistant strains with additional quinolone resistance are highly adaptive and have been responsible for global outbreaks and high mortality. In order to give new insights about the resistance mechanisms involved, the developed work aimed to point out subproteome changes between a DT104B clinical strain (Se20) that acquired quinolone resistance after patient treatment and an in vitro induced clonally related highly-resistant mutant (Se6-M). The intracellular subproteomes were compared by a 2-DE/LC–MS/MS approach and a total of 50 unique proteins were identified (32 more abundant in Se20 and 18 more abundant in Se6-M). The membrane subproteomes were analysed by a shotgun LC–MS/MS approach, where 7 differentially abundant proteins were identified (5 more abundant in Se6-M and 2 more abundant in Se20). Several proteins known to be directly related to quinolone resistance mechanisms (AAC(6′)-Ib-cr4, OmpC, OmpD, OmpX, etc.) and MipA, recently reported as novel antibiotic resistance-related protein, were identified. Other proteins (Fur, SodA, SucB, AtpD/AtpG, OmpC, GltI, CheM/CheB, etc.) reflecting the metabolic re-adjustments occurred in each strain in order to acquire quinolone resistance were also identified. Moreover, proteins involved in lipopolysaccharide biosynthesis (RfbF, RfbG, GmhA) and export (LptA) were detected, supporting the importance of exploring these proteins as targets for the development of new antimicrobial agents. In conclusion, this study provides new insights into the mechanisms involved in the acquisition of antibiotic resistance, which can be highly valuable for the development of improved therapeutic strategies.Biological significanceThis comparative proteomic study revealed a large number of differentially regulated proteins involved in antibiotic resistance which can be of great value to drug discovery, research and development programmes.

Graphical abstract

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Microenvironmental Effect of 2′-O-(1-Pyrenylmethyl)uridine Modified Fluorescent Oligonucleotide Probes on Sensitive and Selective Detection of Target RNA

Analytical Chemistry

DOI: 10.1021/acs.analchem.6b00227

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Dopant-Assisted Positive Photoionization Ion Mobility Spectrometry Coupled with Time-Resolved Thermal Desorption for On-Site Detection of Triacetone Triperoxide and Hexamethylene Trioxide Diamine in Complex Matrices

Analytical Chemistry

DOI: 10.1021/acs.analchem.5b04830

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From organophosphate poisoning to diabetes mellitus: the incretin effect

Publication date: Available online 7 April 2016
Source:Medical Hypotheses
Author(s): D. Rathish, S.B. Agampodi, M.A.C.S. Jayasumana, S.H. Siribaddana
Organophosphate (OP) poisoning induced disruption of glucose homeostasis is well established. OP poisoning leads to accumulation of acetylcholine (ACh) due to the inhibition of acetylcholinesterases (AChE). On the other hand the incidence of type 2 diabetes mellitus (T2DM) is shown to rise along with the use of pesticides in Southeast Asia. Attenuation of the 'incretin effect' is seen in T2DM. This effect is regulated by a complex loop of mechanism involving ACh driven muscarinic receptors. We hypothesize that OP poisoning leads to disruption of glucose homeostasis by attenuation of the incretin effect. Inhibition of the Glucagon Like Peptide-1 (GLP-1) secretion is our main focus of interest. Positive finding of the hypothesis will open possibility of using incretin based treatment modalities to treat or prevent acute OP induced disruption of glucose homeostasis.



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Chronic Kidney Disease of Uncertain Etiology in Sri Lanka: Are Leptospirosis and Hantaviral infection likely causes?

Publication date: Available online 8 April 2016
Source:Medical Hypotheses
Author(s): Chandika Damesh Gamage, Yomani Dilukshi Sarathkumara
Chronic kidney disease of uncertain etiology (CKDu) has been a severe burden and a public health crisis in Sri Lanka over the past two decades. Many studies have established hypotheses to identify potential risk factors although causative agents, risk factors and etiology of this disease are still uncertain. Several studies have postulated that fungal and bacterial nephrotoxins are a possible etiological factor; however, the precise link between hypothesized risk factors and the pathogenesis of chronic kidney disease has yet to be proven in prior studies.Leptospirosis and Hantavirus infections are important zoonotic diseases that are naturally maintained and transmitted via infected rodent populations and which present similar clinical and epidemiological features. Both infections are known to be a cause of acute kidney damage that can proceed into chronic renal failure. Several studies have reported presence of both infections in Sri Lanka. Therefore, we hypothesized that pathogenic Leptospira or Hantavirus are possible causative agents of acute kidney damage which eventually progresses to chronic kidney disease in Sri Lanka.The proposed hypothesis will be evaluated by means of an observational study design. Past infection will be assessed by a cross-sectional study to detect the presence of IgG antibodies with further confirmatory testing among chronic kidney disease patients and individuals from the community in selected endemic areas compared to low prevalence areas. Identification of possible risk factors for these infections will be followed by a case-control study and causality will be further determined with a cohort study.If the current hypothesis is true, affected communities will be subjected for medical interventions related to the disease for patient management while considering supportive therapies. Furthermore and possibly enhance their preventive and control measures to improve vector control to decrease the risk of infection.



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ACOS syndrome: single disease entity or not? Could exhaled nitric oxide be a useful biomarker for the differentiation of ACOS, asthma and COPD?

Publication date: Available online 8 April 2016
Source:Medical Hypotheses
Author(s): Theodoros Karampitsakos, Konstantinos I. Gourgoulianis
Asthma and chronic obstructive pulmonary disease (COPD) represent two major public health problems. However, there is a significant proportion of patients with a mixed asthma-COPD phenotype. This condition is defined as Asthma-COPD overlap syndrome (ACOS). Since there are no internationally accepted criteria for the diagnosis of that syndrome, its management remains difficult. Given the fact that patients with ACOS have an increased risk of exacerbation and hospitalization, there is a pressing need for a more targeted approach and better management. We propose that Fractional exhaled nitric oxide (FeNO), a marker of eosinophilic inflammation, could help clinicians differentiate ACOS from asthma and COPD. We evaluate this hypothesis, using data derived from the existing literature.



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Virtual implantation and patient-specific simulation for optimization of outcomes in ventricular assist device recipients

Publication date: Available online 7 April 2016
Source:Medical Hypotheses
Author(s): Amedeo Anselmi, Sophie Collin, Pascal Haigron, Jean-Philippe Verhoye, Erwan Flecher
BackgroundLeft Ventricular Assist Devices (LVAD) are increasingly used for long-term mechanical circulatory support and are effective in improving survival and quality-of-life of patient with advanced heart failure. Nonetheless, they are associated with significant early and late morbidity rates (including pump thrombosis, thromboembolic events, and pump dysfunction). These complications are at least partially associated with suboptimal pump positioning. Currently, we are missing tools to further improve the positioning of LVAD devices in a patient-specific fashionMethods and evaluation of the hypothesisWe hypothesized that the analysis of the implanted device in patients presenting selected LVAD-related complications through segmentation and three-dimensional reconstruction of CT scans may provide patient-specific information into mechanical factors contributing to pump dysfunction and thromboembolic events, with potential to guide preventive interventions against development of new complications. We also hypothesized that preoperative virtual implantation and computer-assisted surgery in candidates to LVAD implantation may help in the customization of device positioning, with potential to minimize severe complications. The hypothesis was evaluated in a multidisciplinary fashion (cardiac surgeons, biomedical engineers and biomedical images processing experts). CT scans of 14 LVAD recipients were reconstructed through semi-automatic segmentation (including the whole heart, the implanted device and the chest wall). A coordinate system was built to quantify the coaxiality of the LVAD apical cannula with the mitral annulus. Patients were stratified into Group 1 (presenting complications such as thromboembolic events, pump dysfunction or thrombosis) and Group 2 (no complications). Group 1 patients presented significantly greater average rotation of the apical cannula towards the interventricular septum (p=0.015), although no difference was observed in terms of average rotation towards the anterior or posterior left ventricular wall.ConclusionsSeveral patient-specific factors (including left ventricular morphology and chest wall conflict with the device after wound closure) may influence the effectiveness and safety of LVAD therapy, but they are difficultly managed through the current implantation techniques. We suggest that the clinical results of LVAD treatment can be improved through preoperative virtual implantation and computer-assisted surgery (in order to guide device selection, exact site of left ventricular wall coring site). Given these preliminary results, we are examining larger patient datasets in order to further test the hypothesis. Dedicated tools for virtual implantation are currently under development.



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A stable epoxide as a potential endogenous estrogen metabolite: Possible significance in breast cancer?

Publication date: Available online 8 April 2016
Source:Medical Hypotheses
Author(s): James I. Raeside
Epoxides as reactive intermediates of estrogen metabolism have been considered to be potential precursors of the 2- and 4-hydroxy, catechol estrogens and even to be mutagenic/carcinogenic agents themselves. The labile nature of the intermediates has made proof of their existence difficult in natural biological conditions. In our studies on estrogen metabolism in vitro, in various tissues from several laboratory and domestic species, there was chromatographic evidence of formation of a stable estrogen metabolite that could be seen after incubation with radiolabeled estrone, but not with unlabeled substrate. Investigation with acid treatment of the metabolite yielded material detected as 6-hydroxy-estrone—suggesting the presence of an additional oxygen atom in the molecule. An identification of the "unknown compound" has not yet been made but, with this evidence, the properties revealed so far can best be met by assuming the presence of 5, 6-epoxy-estrone. The recent favorable reports on the role of 5α, 6α-epoxy-cholesterol in breast cancer has led to the hypothesis that the formation of a similar, stable epoxide of an estrogen could potentially be a compound of interest. If a metabolic pathway from estrone to 6-hydroxy-estrone through a stable epoxide has indeed been observed, it would suggest that identifying and screening for the enzymes responsible for its production, as opposed to those generating the catecholestrogens, could provide valuable information in relation to breast cancer. The balance in production of estrogen epoxides could be a key factor in determining normal health or risk of tumor development.



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Tyrosinase, could it be a missing link in ochronosis in alkaptonuria?

Publication date: Available online 8 April 2016
Source:Medical Hypotheses
Author(s): Adam M Taylor, Vishnu Kammath, Aaron Bleakley
The hypothesis that is proposed is that tyrosinase, an enzyme widely found within the human body is implicated in the ochronosis that occurs in alkaptonuria; an autosomal recessive condition first used by Archibald Garrod to describe the theory of "Inborn Errors of Metabolism." The disease results from the absence of a single enzyme in the liver that breaks down homogentisic acid; this molecule becomes systemically elevated in sufferers. The condition is characterised by a clinical triad of symptoms; homogentisic aciduria from birth, ochronosis (darkening) of collagenous tissues (from ∼30years of age) and ochronotic osteoarthropathy in weight bearing joints due to long term ochronosis in them (from ∼40years of age). Tyrosinase, a polyphenol oxidase has been shown in many species to contribute to the darkening of tissues in many organisms; including humans in the production of melanin. Tyrosinase under the right conditions shows alterations in its substrate specificity and may contribute to the darkening seen in AKU where it moves away from polymerising tyrosine but also homogentisic acid, the causative molecule in alkaptonuria, that is present in excess.



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Hepatitis B Viral Infection of Hepatic Progenitor Cells. Resolving Unresolved Questions?

Publication date: Available online 8 April 2016
Source:Medical Hypotheses
Author(s): G.Y. Minuk, Y. Baruch
Accumulated data to date do not entirely explain the; propensity of the hepatitis B virus (HBV) to cause chronic infections in newborns; failure of antiviral agents to resolve infections or precise mechanism whereby HBV causes hepatocellular carcinoma (HCC). Based on the increased numbers of hepatic stem/progenitor cells (HPCs) present within the neonatal liver, the refractoriness of these cells to the effects of interferons and xenobiotics and their ability to undergo malignant transformation, we hypothesize that HBV infection of HPCs could explain these and perhaps other clinical features of chronic HBV.



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Title of the manuscript: Atypical symptoms in patients with cervical spondylosis might be the result of stimulation on the dura mater and spinal cord

Publication date: Available online 7 April 2016
Source:Medical Hypotheses
Author(s): Aikeremujiang Muheremu, Yuqing Sun
Patients with cervical spondylosis often present with some atypical symptoms such as vertigo, headache, palpitation, nausea, abdominal discomfort, tinnitus and blurred vision and hypomnesia. Although there are a few hypotheses about the etiology of those symptoms, none of them have provided evidence convincing enough to explain the clinical, pathological and anatomic manifestation of those symptoms. One of the more acceptable explanations is that those symptoms are the results of stimulation of the sympathetic nerves in the posterior longitudinal ligament. The clinical fact that dissection of the posterior longitudinal ligament significantly alleviates the severity of those symptoms seems like an evidence for the validity of this hypothesis. However, recent clinical studies showed that laminoplasty, which has no effect on the posterior longitudinal ligament, can achieve the similar effect. In this paper, we hypothesize that stimulation of the dura mater and spinal cord might be the cause of atypical symptoms in patients with cervical spondylosis



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“Foreplay, a selected strategy that might be able to increase fertility rates”

Publication date: Available online 7 April 2016
Source:Medical Hypotheses
Author(s): Juan José Segura-Sampedro




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A multipronged, nutritional-based strategy for managing Alzheimer’s disease

Publication date: Available online 8 April 2016
Source:Medical Hypotheses
Author(s): J. Leslie Glick, Philip A. McMillan
A nutritional-based strategy has been proposed in order to improve cognitive performance of Alzheimer's disease (AD) patients. The strategy requires daily dietary supplementation with magnesium (Mg), folic acid, and vitamins B6 and B12, daily consumption of silicic acid-rich mineral water in order to lower the body burden of Al, and several plasma exchange procedures in order to replace Aβ-bound albumin with fresh albumin. Evidence suggests that the deteriorating cognitive performance associated with AD may be improved by supplementation with either Mg alone or with the combination of the above three B vitamins (B vitamin combo), or by drinking silicic acid-rich mineral water, or by undergoing plasma exchange. However, for the following reasons the combination of all four therapeutic approaches may have a synergistic effect on improving cognitive performance of AD patients.1. Various studies suggest that AD represents a form of diabetes of the brain, otherwise known as Type 3 diabetes. Proper functioning of carbohydrate metabolism requires both Mg and the B vitamin combo.2. High levels of homocysteine associated with gray matter atrophy found in AD patients can be lowered by the B vitamin combo, which has also been found to prevent loss of intracellular Mg induced by homocysteine.3. Consumption of silicic acid-rich mineral water not only removes Al, but lowering the body burden of Al enables more Mg to access the brain and regulate neurochemical processes that would otherwise be disrupted by Al.4. As a result of plasma exchange, fresh albumin, not bound to the amyloid-β (Aβ) peptide that is associated with AD and which binds extensively to albumin, replaces Aβ-bound albumin. Compared to Aβ-bound albumin, the fresh albumin has an increased affinity for Mg, thereby facilitating the distribution of Mg across the blood-brain barrier (BBB) and into brain tissue.



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The Future of Neonatal BCG

Publication date: Available online 8 April 2016
Source:Medical Hypotheses
Author(s): Michel R Odent
We hypothesise that neonatal BCG (Bacillus Calmette-Guérin) might be used to adapt to a new phase in the history of human births.Among most mammals, the placenta is not effective at transferring antibodies to the fetus: antibodies are transferred immediately after birth via the colostrum. Among humans (and other mammals with hemochorial placentas) the transplacental transfer of antibodies (namely IgG) is effective. In humans, fetal concentrations of IgG sub-classes approximate to maternal concentrations at 38 weeks and continue to increase thereafter. These facts explain inter-species differences regarding the basic needs of neonates. Among most mammals, the early colostrum is, strictly speaking, vital. Among humans, the main questions are about the bacteriological environment in the birthing place and how familiar it is to the mother.Today, most human beings are born in unfamiliar bacteriological environments characterized by a low microbial diversity. The effects of clinical environments may be amplified by the use of antibiotics and birth by caesarean, i.e. by-passing the bacteriologically rich perineal zone.There is already an accumulation of data confirming that the maturation of a balanced Th1/Th2 immune response is affected by the mode of delivery. There is also an accumulation of epidemiological studies detecting risk factors in the perinatal period for health conditions such as type 1 diabetes (and other autoimmune diseases), atopy, autism and obesity.In such a context there are reasons to plan randomized controlled trials with long term follow-up of the effects of BCG given immediately after birth, as a modulator of Th-1/Th-2 responses. A follow-up period in the region of 6 to 10 years would be long enough to evaluate the prevalence of several nosologically well defined diseases. These studies would be ethically acceptable, since BCG is the only infancy vaccine that has been evaluated through randomised controlled trials with long term follow-up. Furthermore, whatever the standard of living of the populations and the research protocols, concordant results suggest that BCG has positive non-specific long term effects on health.Meanwhile, some simple adaptive practices are possible, such as, after a caesarean section, wrapping the neonate in clothes recently worn by the mother and, occasionally, putting the neonate in the arms of a person who is cohabiting with the mother.



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