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- miR-146a-5p acts as a negative regulator of TGF-β ...
- α-Asarone suppresses the proliferation and migrati...
- miR-290 contributes to the low abundance of cyclin...
- Detection of cytological changes in oral mucosa am...
- Fermentation induced changes in volatile component...
- A rounded opacity silhouetting the left heart bord...
- Transient hemiparaesthesias and dysarthria
- MHC I presentation of Toxoplasma gondii immunodomi...
- Satellite glial cells in human trigeminal ganglia ...
- Antiviral activity of nordihydroguaiaretic acid an...
- Real-Life Assessment of the Safety and Effectivene...
- Efficacy and pharmacokinetics of the combination o...
- Toxic Electrophiles Induce Expression of the Multi...
- Safety, Pharmacokinetics and_Antiviral Activity of...
- ERG11 gene mutations and MDR1 up-regulation confer...
- Reduced vancomycin susceptibility of methicillin-s...
- Genetic Characterization of Broad Host-range IncQ ...
- Efficacy of a Binuclear Cyclopalladated Compound T...
- Colistin resistance in carbapenem-resistant Klebsi...
- Controlled release of plectasin NZ2114 from a hybr...
- Pharmacokinetics of Levofloxacin in Multidrug- and...
- In Vitro Cross-Resistance Profiles of Rilpivirine,...
- Sensitivity of White and Opaque Candida albicans t...
- MCR-1 and OXA-48 in vivo acquisition in KPC-produc...
- Mitral valve vegetation diagnosed with oesophageal...
- Double hit lymphoma presenting as haemophagocytic ...
- Mitral Stenosis
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- Anaemia and respiratory failure in a child: can it...
- A rare case of thrombotic microangiopathy triggere...
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- The Effect of Immunosuppression on Airway Integrity.
- A RODENT MODEL OF CARDIAC DONATION AFTER CIRCULATO...
- Combined heart lung transplantation: an updated re...
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- Tablet e-Logbooks: Four Thousand Clinical Cases an...
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- CRISPR/Cas9-mediated somatic and germline gene cor...
- In older men with low testosterone levels and age-...
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- The Clearing
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- Botulinum Toxin for Burning Mouth Syndrome
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- Patient-Centered Medical Homes and Adherence to Ch...
- Development of a Research Agenda to Identify Evide...
- Guideline: Insufficient evidence exists on screeni...
- Physicians, Patients, and Firearms: The Courts Say...
- Review: After coronary DES, ≤ 6 mo and 1 y of dual...
- What We Do (and Don't) Know About the Health Effec...
- Review: Strategies to improve provider adoption an...
- The Development and Performance of After-Hours Pri...
- Annals for Hospitalists - 16 May 2017
- The True Effect of Mass Shootings on Americans
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- Acute Pancreatitis: How Soon Should We Feed Patients?
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Αναζήτηση αυτού του ιστολογίου
Δευτέρα 15 Μαΐου 2017
miR-146a-5p acts as a negative regulator of TGF-β signaling in skeletal muscle after acute contusion
http://ift.tt/2qmAdHf
α-Asarone suppresses the proliferation and migration of ASMCs through targeting the lncRNA-PVT1/miR-203a/E2F3 signal pathway in RSV-infected rats
http://ift.tt/2rkO1zg
miR-290 contributes to the low abundance of cyclin D1 protein in mouse embryonic stem cells
http://ift.tt/2qmCu4Z
Detection of cytological changes in oral mucosa among users of smokeless tobacco (shamma) in the KSA
Background and aim
Smokeless tobacco (ST) use is a major cause of cytological changes in the oral mucosa. ST products, such as shamma, which is prevalent in southern Saudi Arabia, raise concerns about the adverse health effects among its users. We evaluated the cytological changes in the oral mucosa of users and nonusers of shamma in the city of Najran, using Papanicolaou staining.
Materials and methods
We designed questionnaires and consent forms for this study that were administered to a total of 397 participants, comprising 250 nonusers of shamma (controls) and 147 shamma users (cases). Buccal cell smears were collected from all participants, fixed, and Papanicolaou stained. Photomicrographs were taken of all stained smears, and samples were subsequently diagnosed.
Results
Various cytological changes were detected among both cases and controls: atypia (2.0%, 1.2%, respectively), keratinisation (0.7%, 0%, respectively), inflammation (13.6%, 10.8%, respectively), and infection (4.1%, 3.6%, respectively).
Conclusion
The results showed higher percentages of cytological changes among shamma users compared with nonusers; however, the differences were not statistically significant. Habitual use of other substances in the control group could be a confounding factor given this geographic region and the cytological changes we detected in both cases and controls.
http://ift.tt/2pEQmbD
Fermentation induced changes in volatile components of African oil bean (Pentaclethra macrophylla Benth) seeds
Abstract
Fermented African oil bean (Pentaclethra macrophylla Benth) seed also referred to as "Ugba" is a known delicacy, mainly consumed by Africans. Human migration has also led to the introduction of this delicacy into most European and American countries. This study shows the changes in volatile components of African oil bean (P. macrophylla Benth) seed at different stages of fermentation. A quantity of 0.3 kg each of dehulled and sliced raw sample and cooked unfermented sample were separately ground, while 2 and 4 days fermented samples obtained by inoculating 0.6 kg of cooked, sliced and washed sample with 0.5 g of 4 days fermented seed was divided into two of 0.3 kg each and ground at the second and fourth day of fermentation. GC-MS analyses of the volatile components showed 9,12-Octadecadienoic acid (Z,Z)- and its esters as highest in raw seed, with total percentage concentration of 96.301, while 9-Octadecenoic acid, methyl ester, (E)- was highest in cooked unfermented seed, with percentage concentration 55.204. Phenol, 2-methoxy-3-(2-propenyl)- and its esters were the highest observed in cooked 2 days fermented seed, with total percentage concentration of 50.596, while 9-Octadecenoic acid (Z)-, methyl ester was highest in cooked 4 days fermented seed with percentage concentration of 67.788. Aside from softening the delicacy, a 4 days chance fermentation of cooked P. macrophylla Benth seed also reduces the eight component lipids present in the cooked unfermented seed to a more nutriceutical three component lipids (Hexadecanoic acid methyl ester, 9-Octadecenoic acid (Z)-methyl ester and Methyl stearate).
This study shows the changes in volatile components of African oil bean (P. macrophylla Benth) seed at different stages of fermentation.
http://ift.tt/2pEU851
A rounded opacity silhouetting the left heart border and hilum
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Transient hemiparaesthesias and dysarthria
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
MHC I presentation of Toxoplasma gondii immunodominant antigen does not require Sec 22b and is regulated by antigen orientation at the vacuole membrane
The intracellular Toxoplasma gondii parasite replicates within a parasitophorous vacuole (PV). T. gondii secretes proteins that remain soluble in the PV space, are inserted into PV membranes or are exported beyond the PV boundary. In addition to supporting T. gondii growth, these proteins can be processed and presented by MHC I for CD8+ T-cell recognition. Yet it is unclear whether membrane binding influences the processing pathways employed and if topology of membrane antigens impacts their MHC I presentation. Here we report that the MHC I pathways of soluble and membrane-bound antigens differ in their requirement for host ER recruitment. In contrast to the soluble SAG1-OVA model antigen, we find that presentation of the membrane-bound GRA6 is independent from the SNARE Sec 22b, a key molecule for transfer of host endoplasmic reticulum components onto the PV. Using parasites modified to secrete a transmembrane antigen with opposite orientations, we further show that MHC I presentation is highly favored when the C-terminal epitope is exposed to the host cell cytosol, which corresponds to GRA6 natural orientation. Our data suggest that the biochemical properties of antigens released by intracellular pathogens critically guide their processing pathway and are valuable parameters to consider for vaccination strategies.
This article is protected by copyright. All rights reserved
http://ift.tt/2pEyihY
Satellite glial cells in human trigeminal ganglia have a broad expression of functional Toll-like receptors
Toll-like receptors (TLRs) orchestrate immune responses to a wide variety of danger- and pathogen-associated molecular patterns. Compared to the central nervous system (CNS), expression profile and function of TLRs in the human peripheral nervous system (PNS) are ill-defined. We analyzed TLR expression of satellite glial cells (SGCs) and microglia, glial cells predominantly involved in local immune responses in ganglia of the human PNS and normal-appearing white matter (NAWM) of the CNS, respectively. Ex vivo flow cytometry analysis of cell suspensions obtained from human cadaveric trigeminal ganglia (TG) and NAWM showed that both SGCs and microglia expressed TLR1–5, TLR7 and TLR9, although expression levels varied between these cell types. Immunohistochemistry confirmed expression of TLR1–TLR4 and TLR9 by SGCs in situ. Stimulation of TG- and NAWM-derived cell suspensions with ligands of TLR1–TLR6, but not TLR7 and TLR9, induced interleukin 6 (IL-6) secretion. We identified CD45LOWCD14POS SGCs and microglia, but not CD45HIGH leukocytes and CD45NEG cells as the main source of IL-6 and tumor necrosis factor α upon stimulation with TLR3 and TLR5 ligands. In conclusion, human TG-resident SGCs express a broad panel of functional TLRs, suggesting their role in initiating and orchestrating inflammation to pathogens in human sensory ganglia.
This article is protected by copyright. All rights reserved
http://ift.tt/2qq68o0
Antiviral activity of nordihydroguaiaretic acid and its derivative tetra-O-methyl nordihydroguaiaretic acid against West Nile virus and Zika virus [PublishAheadOfPrint]
Flaviviruses are positive strand RNA viruses distributed all over the world that infect millions of people every year, and for which no specific antiviral agents have been approved. These viruses include the mosquito-borne West Nile virus (WNV) responsible for outbreaks of meningitis and encephalitis. Considering that nordihydroguaiaretic acid (NDGA) has been previously shown to inhibit the multiplication of the related dengue virus and hepatitis C virus, we have evaluated the effect of NDGA, and its methylated derivative tetra-O-methyl nordihydroguaiaretic (M4N), on the infection of WNV. Both compounds inhibited the infection of WNV likely by impairing viral replication. Since flavivirus multiplication is highly dependent on host cell lipid metabolism, the antiviral effect of NDGA has been previously related to its ability to disturb the lipid metabolism probably by interfering with the sterol regulatory element binding proteins (SREBP) pathway. Remarkably, we observed that other structurally unrelated inhibitors of the SREBP pathway, such as PF-429242 and Fatostatin, also reduced WNV multiplication, supporting that the SREBP pathway could constitute a druggable target suitable for antiviral intervention against flavivirus infection. Moreover, treatment with NDGA, M4N, PF-429242, and Fatostatin also inhibited the multiplication of the mosquito-borne flavivirus Zika virus (ZIKV), which has been recently associated with birth defects (microcephaly) and neurological disorders. Our results point to SREBP inhibitors such as NDGA and M4N as potential candidates for further antiviral development against medically relevant flaviviruses.
http://ift.tt/2rkMRUZ
Real-Life Assessment of the Safety and Effectiveness of the New Tablet and Intravenous Formulations of Posaconazole in the Prophylaxis of Invasive Fungal Infections: Analysis of 343 courses [PublishAheadOfPrint]
Background: Posaconazole is the preferred mold-active azole for prophylaxis against invasive fungal infection (IFI) in patients with hematologic malignancy (HM). Delayed release tablet and intravenous formulations of posaconazole have recently become available, but clinical data are limited. We sought to examine the real-world pharmacokinetics and prophylactic effectiveness of the new formulations of posaconazole given as prophylaxis in patients with HM.
Methods: A retrospective cohort of all consecutive adult inpatients with HM who received ≥3 days of posaconazole as tablet or intravenous from 12/1/2013-12/31/2015 for primary IFI prophylaxis at MD Anderson Cancer center. Clinical information were collected and correlated with low posaconazole serum levels (<700ng/mL). Rates of invasive fungal infections as well as safety events were assessed.
Results: 1,321 courses of posaconazole were administered at MD Anderson Cancer Center during the study time period, with 343 patient courses assessed for prophylactic safety and effectiveness. Seventy-nine patient (23%) courses had posaconazole serum levels available for interpretation. Acute myelogenous leukemia was the primary malignancy (62%) with 20% of all patients having previously received a stem cell transplant. Median posaconazole level was 1,380ng/ml (IQR 864-1860). A low posaconazole level (< 700ng/mL) was observed in 14 (18%) of patients. Proven or probable breakthrough IFI occurred in 8 patients (2%), 6 of whom had posaconazole TDM performed, all with levels above 700ng/mL. Overall, 19% of patients experienced grade 3/4 liver injury, primarily manifesting as hyperbilirubinemia and correlated with a serum level >1,830.
Conclusions: Although hepatotoxicity in a small percentage of patients is of concern, posaconazole tablets appeared to be generally safe and effective. As all breakthrough IFI in whom TDM was performed occurred in patients with levels >700ng/mL and a PCZ level >1,830ng/mL correlated with grade 3/4 liver toxicity, further studies are needed to assess the role of therapeutic drug monitoring.
http://ift.tt/2rlfPUL
Efficacy and pharmacokinetics of the combination of OP0595 and cefepime in a mouse model of pneumonia caused by ESBL-producing Klebsiella pneumoniae [PublishAheadOfPrint]
Background: OP0595 (RG6080) is a novel diazobicyclooctane that inhibits class A and C serine beta-lactamases. Although the combination of OP0595 and cefepime (FEP) showed good in vitro activity against extended spectrum beta-lactamase (ESBL)-producing pathogens, the effect of the combination therapy against severe infections, such as pneumonia or bacteraemia, remains unknown in vivo.
Objectives: In this study, we investigated the efficacy and pharmacokinetics of the combination therapy of OP0595 and FEP in a mouse model of pneumonia caused by Klebsiella pneumoniae harbouring SHV and CTX-M-9-type ESBLs.
Methods: The infected BALB/c mice were intraperitoneally administered saline (control), 100 mg/kg of FEP, 20 mg/kg of OP0595, or both FEP and OP0595, twice a day.
Results: The minimum inhibitory concentration (MIC) of FEP against the bacteria was 8 mg/L and markedly improved to 0.06 mg/L with the addition of 0.5 mg/mL of OP0595. In the survival study, the combination of FEP and OP0595 significantly improved the survival rate compared to that reported with either OP0595 or FEP alone (P < 0.001). The number of bacteria in the lungs and blood significantly decreased in the combination therapy group compared to that reported for the monotherapy groups (P < 0.001). In addition, the in vivo effect depended on the dose of FEP. However, pharmacokinetic analysis revealed that the percentage of time above MIC remained constant when increasing the dose of FEP in combination with 20 mg/kg of OP0595.
Conclusions: The results of our study demonstrated the in vivo effectiveness of the combination of OP0595 and FEP.
http://ift.tt/2qLvFLt
Toxic Electrophiles Induce Expression of the Multi-Drug Efflux Pump MexEF-OprN in Pseudomonas aeruginosa Through a Novel Transcriptional Regulator, CmrA [PublishAheadOfPrint]
The multidrug efflux system MexEF-OprN is produced at low levels in wild-type strains of Pseudomonas aeruginosa. However, mutational alteration of gene mexS results in constitutive overexpression of the pump along with an increased resistance of the bacterium to chloramphenicol, fluoroquinolones and trimethoprim. In this study, analysis of in vitro selected chloramphenicol-resistant clones of strain PA14 led to the identification of a new class of mutants (called nfxC2) exhibiting alterations in a so far uncharacterized gene, PA14_38040 (homolog of PA2047 in strain PAO1). This gene is predicted to encode an AraC-like transcriptional regulator, and was called CmrA (for Chloramphenicol resistance Activator). In nfxC2 mutants, the mutated CmrA increases its proper gene expression and upregulates operon mexEF-oprN through MexS and MexT, resulting in a multidrug resistance phenotype without significant loss in bacterial virulence. Transcriptomic experiments demonstrated that CmrA positively regulates a small set of 11 genes, including PA14_38020 (homolog of PA2048) which is required for the MexS/T-dependent activation of mexEF-oprN. PA2048 codes for a protein sharing conserved domains with quinol monooxygenase YgiN from Escherichia coli. Interestingly, exposure of strain PA14 to toxic electrophilic molecules (glyoxal, methylglyoxal, cinnamaldehyde) strongly activates the CmrA pathway, upregulates MexEF-OprN and thus increases the resistance of P. aeruginosa to the pump substrates. A picture emerges in which MexEF-OprN is central in the response of the pathogen to stresses affecting intracellular redox homeostasis.
http://ift.tt/2qLvDTR
Safety, Pharmacokinetics and_Antiviral Activity of a Novel HIV Antiviral, ABX464, in Treatment- Naïve HIV Infected Subjects: a Phase II Randomized, Controlled Study [PublishAheadOfPrint]
We investigated the safety and anti-viral effects of an anti-HIV compound (ABX464) with a unique mechanism of viral replication inhibition. This was a randomized, double blind, placebo controlled, dose- ranging study in treatment naïve HIV infected patients. Participants were assigned to eight groups; each group included 8 subjects receiving either the study compound, ABX464 (n=6) or corresponding placebo (n=2), according to a randomization code. The first dose administered was 25 mg, given once or 3 times a day over a 2 to 3-week period. Ascending doses up to 150 mg were delivered after review of the safety data. The primary objective of the study was to assess safety and tolerability of ABX464 after repeated oral administrations in subjects infected by HIV. Sixty-six (66) subjects were enrolled and were randomized. Sixty-three (63) subjects completed the study according to the study protocol. Twenty-one (21) AEs were reported by 7 subjects out of 16 (44%) who received placebo and 158 AEs were reported by 39 subjects out of 50 (78%) who received the study drug. In the ABX464 treatment group, all of these adverse events were mild to moderate. No subjects discontinued treatment due to drug related AE's. Administration of ABX464 up to 150 mg, once a day was safe and well tolerated in HIV infected subjects. An efficacy signal with respect to reduction of viral load by ABX464 was detected, mainly in subjects treated at the highest dose. Further studies will be required to demonstrate anti-viral effects in HIV- infected subjects in combination with other anti-retroviral therapies.
http://ift.tt/2rkXpU9
ERG11 gene mutations and MDR1 up-regulation confer pan-azole-resistance in Candida tropicalis causing disseminated candidiasis while on posaconazole prophylaxis in an acute lymphoblastic leukemia patient [PublishAheadOfPrint]
In this study, we presented a rare case of fatal breakthrough Candida tropicalis in a patient with acute lymphoblastic leukemia (ALL) while on posaconazole prophylaxis. And then we explored the mechanisms underlying azole resistance by focusing on enhanced efflux pumps and changes in the azole target enzyme Erg11p, which was encoded by the ERG11 gene. Our study demonstrates that Y132C substitution of Erg11p combined with MDR1 overexpression may be the pan-azole-resistance mechanisms in Candida tropicalis.
http://ift.tt/2qLrTSm
Reduced vancomycin susceptibility of methicillin-susceptible Staphylococcus aureus: no significant impact on mortality but increase in complicated infection [PublishAheadOfPrint]
Methicillin-susceptible Staphylococcus aureus (MSSA) bloodstream infections (BSIs) often lead to severe complications despite the availability of effective antibiotics. It remains unclear whether elevated vancomycin MICs are associated with worse outcomes.
We conducted a 2-year retrospective cohort study (n=252) of patients with MSSA BSIs at a tertiary care hospital. We defined reduced vancomycin susceptibility (RVS) as a Microscan MIC of 2 mg/L. All strains were genotyped (spa) and assessed for agr functionality. Multivariable logistic regression models were used to examine the impact of RVS phenotype and strain genotype on 30-day all-cause mortality and complicated bacteremia (metastatic spread, endovascular infection, or duration ≥3 days).
One third of patients (84/252) were infected with RVS isolates. RVS Infections were more frequently associated with metastatic or embolic sites of infection (36% vs. 17%, p<0.001), and endovascular infection (26% vs. 12%, p=0.004). They occurred more often in patients with fewer underlying comorbidities (CCI≥3: 73% vs. 88%, p=0.002). Genotyping identified 127 spa-types and 14 Spa-clonal complexes (Spa-CCs). Spa-CC002 and Spa-CC008 were more likely to exhibit the RVS phenotype versus other Spa-CCs (OR=2.2, p<0.01). The RVS phenotype was not significantly associated with 30-day mortality, however was associated with complicated bacteremia (aOR 2.35 [1.26, 4.37], p = 0.007) in adjusted analyses.
The association of RVS strains with complicated infection and fewer underlying comorbidities suggests the phenotype as a potential marker of strain virulence in MSSA BSIs. The RVS phenotype itself was not a significant predictor of mortality in this patient cohort. Further studies are necessary to explore this host-pathogen relationship.
http://ift.tt/2rkMU37
Genetic Characterization of Broad Host-range IncQ Plasmids Harboring blaVEB-18 in Vibrio spp. [PublishAheadOfPrint]
Dissemination of genetic elements encoding VEB type β-lactamases among Gram-negative bacteria has become a public health concern worldwide (1, 2)....
http://ift.tt/2qLMlCq
Efficacy of a Binuclear Cyclopalladated Compound Therapy for cutaneous leishmaniasis in the murine model of infection with Leishmania amazonensis and its inhibitory effect on Topoisomerase 1B [PublishAheadOfPrint]
Leishmaniasis is a disease found throughout the (sub)tropical parts of the world caused by protozoan parasites of the Leishmania genus. Despite the numerous problems associated with existing treatments, pharmaceutical companies continue to neglect the development of better ones. The high toxicity of current drugs combined with emerging resistance makes the discovery of new therapeutic alternatives urgent. Here we report the evaluation of a binuclear cyclopalladated complex containing Pd(II) and N,N' -dimethylbenzylamine (Hdmba) against Leishmania amazonensis. The compound [Pd(dmba)(μ-N3)]2 (CP2) inhibits promastigote growth (IC50 = 13.2 ± 0.7 μM) and decreases the proliferation of intracellular amastigotes in in vitro incubated macrophages (IC50 = 10.2 ± 2.2 μM) without a cytotoxic effect when tested against peritoneal macrophages (CC50 = 506.0 ± 10.7 μM). Additionally, CP2 was also active against T. cruzi intracellular amastigotes (IC50 = 2.3 ± 0.5 μM, Selective Index = 225), an indication of its potential for use in Chagas disease therapy. In vivo assays using L. amazonensis-infected BALB/c showed an 80% reduction in parasite load when compared to infected and non-treated animals. Also, compared to amphotericin B treatment, CP2 did not show any side effects, which was corroborated by the analysis of plasma levels of different hepatic and renal biomarkers. Furthermore, CP2 was able to inhibit Leishmania donovani topoisomerase 1B (Ldtopo1B), a potentially important target in this parasite.
http://ift.tt/2qLMiXg
Colistin resistance in carbapenem-resistant Klebsiella pneumoniae mediated by chromosomal integration of plasmid DNA [PublishAheadOfPrint]
Here we describe the spread of colistin resistance in clinical isolates of carbapenem-resistant-K. pneumoniae in Medellín, Colombia. Among 32 isolates collected between 2012 and 2014, 24 showed genetic alterations in mgrB. Nineteen isolates belonged to ST512 (or its SLV) and harbored a novel 8.1-Kb hsdMSR insertion, indicating a clonal expansion of the resistant strain. The insertion region showed 100% identity to several plasmids, suggesting the colistin resistance is mediated by chromosomal integration of plasmid DNA.
http://ift.tt/2rkFKfn
Controlled release of plectasin NZ2114 from a hybrid silicone-hydrogel material for inhibition of Staphylococcus aureus biofilm [PublishAheadOfPrint]
Staphylococcus aureus is a major human pathogen in catheter-related infections. Modifying catheter material with interpenetrating polymer networks is a novel material technology that allows for impregnation with drugs and subsequent controlled release. Here we evaluated the potential for combining this system with plectasin derivate NZ2114, in an attempt to design an S. aureus biofilm-resistant catheter. The material demonstrated promising anti-biofilm properties, also against methicillin-resistant S. aureus, thus suggesting a novel application of this antimicrobial peptide.
http://ift.tt/2qLLm5p
Pharmacokinetics of Levofloxacin in Multidrug- and Extensively Drug-Resistant Tuberculosis patients [PublishAheadOfPrint]
Pharmacodynamics are important in treatment of especially multidrug- and extensively resistant tuberculosis (M/XDR-TB). The free area under the concentration time curve in relation to minimal inhibitory concentration (fAUC/MIC) is the most relevant pharmacokinetic (PK)-pharmacodynamic (PD) parameter to predict the efficacy of levofloxacin (LFX). The objective of our study was to assess LFX PK variability in M/XDR-TB patients and its potential consequence for fAUC/MIC ratios. Patients with pulmonary M/XDR-TB received LFX as part of treatment regimen at a dose of 15 mg/kg once daily. Blood samples obtained at steady state before- and 1, 2, 3, 4, 7, and 12 hrs after drug administration were measured by validated a liquid chromatography-tandem mass spectrometry. MIC values of LFX were determined by the agar dilution method on Middlebrook 7H10 and the MGIT960 system. Twenty patients with a mean age of 31 (IQR; 27-35) years were enrolled in this study. The median AUC0-24h was 98.8 mg/h/L (IQR; 84.8-159.6). The MIC median value for LFX was 0,5 mg/L with a range of 0.25 to 2.0 mg/L and the median fAUC0-24/MIC ratio was 109.5 (IQR; 48.5-399.4). In four of the 20 patients the value was below the target value of ≥100. When a MIC of 0.25, 0.5, 1.0 and 2.0 mg/L were applicable, 19, 18, 3 and no patients, respectively, had a fAUC/MIC ratio that exceeded 100. We observed a large variability in AUC. A fAUC0-24/MIC of ≥ 100 was only observed in case MIC values for LFX were 0.25-0.5 mg/L. Dosages exceeding 15mg/kg should be considered for target attainment if exposures are assumed to be safe.
http://ift.tt/2rkYbRb
In Vitro Cross-Resistance Profiles of Rilpivirine, Dapivirine and MIV-150: NNRTI Microbicides in Clinical Development for the Prevention of HIV-1 Infection [PublishAheadOfPrint]
Rilpivirine, dapivirine (DPV) and MIV-150 are in development as microbicides. It is not known whether they will block infection of circulating NNRTI-resistant HIV-1 variants. Here, we demonstrate that the activity of DPV and MIV-150 are compromised by many resistant viruses containing single or double substitutions. High DPV genital tract concentrations from DPV-ring use may block replication of resistant viruses. However, MIV-150 genital tract concentrations may be insufficient to inhibit many resistant viruses, including those harboring K103N or Y181C.
http://ift.tt/2rkVY8g
Sensitivity of White and Opaque Candida albicans to Antifungal Drugs [PublishAheadOfPrint]
White and opaque cells of Candida albicans have the same genome but differ in gene expression patterns, metabolic profiles, and host niche preferences. We tested whether these differences (which include the differential expression of drug transporters) resulted in different sensitivities to 27 antifungal agents. The analysis was performed in two different strain backgrounds; although there was strain-to-strain variation, only terbinafine hydrochloride and caspofungin showed consistent, two-fold differences between white and opaque cells across both strains.
http://ift.tt/2qLyImG
MCR-1 and OXA-48 in vivo acquisition in KPC-producing Escherichia coli after colistin treatment. [PublishAheadOfPrint]
The spread of mcr-1-encoding plasmids into carbapenem-resistant Enterobacteriaceae raises concerns about the emergence of untreatable bacteria. We report the acquisition of mcr-1 in a carbapenem- resistant E. coli after a 3-week course of colistin in a patient repatriated to France from Portugal. Whole-genome sequencing revealed that the KPC-producing E. coli strain acquired two plasmids, an IncL OXA-48-encoding plasmid and an IncX4 mcr-1-encoding plasmid. This is the first report of mcr-1 in carbapenemase-encoding bacteria in France.
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Mitral valve vegetation diagnosed with oesophageal ultrasound with bronchoscope (EUS-B)
Oesophageal ultrasound with bronchoscope (EUS-B) is designed to evaluate mediastinal structures. We describe a case of a 78-year-old woman who presented with altered mental status for 2 weeks. CT head revealed a subacute infarct in the right middle cerebral artery distribution. She was also found to have a lung mass on chest imaging. EUS-B-guided fine needle aspiration demonstrated the presence of adenocarcinoma in station 7 lymph node and in the mass. Immunohistochemistry confirmed it to be a lung primary as the Thyroid Transcription Factor-1 (TTF-1) was strongly positive. During the procedure, the cardiac valves were evaluated, and a mitral valve vegetation was noted. Formal echocardiography confirmed the presence of the vegetation. During hospital stay, the patient developed fever. Her blood cultures grew oxacillin-resistant Staphylococcus aureus. She was subsequently treated for infective endocarditis. We suggest that the use of EUS-B to routinely scan adjacent structures during a procedure may help obtain additional clinical information that may be critical to patient management.
http://ift.tt/2qLpFCu
Double hit lymphoma presenting as haemophagocytic lymphohistiocytosis
Description
A 67-year-old woman with history of severe rheumatoid arthritis and use of multiple biologics including infliximab, tocilizumab and abatacept presented with fever of 39.1°C and severe pancytopenia (white blood cell count (WBC)=1.0x109/L, absolute neutrophil count (ANC)=0.55x109/L, haemoglobin=8.7 g/dL, platelets=46x109/L). As part of the pancytopenia evaluation, imaging (CT of the chest, abdomen and pelvis) showed diffuse lymphadenopathy. Further evaluation revealed an elevated ferritin (8564 ng/mL), hypofibrinogenaemia (fibrinogen=95 mg/dL), elevated triglycerides (399 mg/dL) and a soluble interleukin 2 receptor level of 41 167 units/mL, satisfying diagnostic criteria for haemophagocytic lymphohistiocytosis (HLH). A subsequent bone marrow biopsy also revealed morphological evidence of haemophagocytosis (figure 1A), in addition to a population of very large and atypical mononuclear cells with markedly irregular, folded nuclear contours, prominent nucleoli and moderate amounts of cytoplasm (figure 1B,C). A similar large cell infiltrate was identified in the left axillary lymph node, causing complete effacement of nodal architecture (figure...
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Mitral Stenosis
Description
A previously healthy 29-year-old Mexican woman presented to an emergency department with transient hemiparaesthesias and dysarthria. There was no evidence of stroke on cross-sectional imaging of the head, and she was discharged without a clear diagnosis. Two days later, she returned with acute abdominal pain. Abdominal imaging revealed complete occlusion of the right renal artery, prompting emergency embolectomy. Following the procedure, she developed acute haemoptysis, dyspnoea and hypoxaemia. Chest imaging demonstrated evidence of pulmonary venous hypertension. Cardiac auscultation revealed an opening snap followed by a diastolic murmur with presystolic accentuation. These sounds were better appreciated in combination with phonocardiography, a technique supplanted by echocardiography in the 1970s1 that visualised heart sounds (video 1). An echocardiogram confirmed the presence of mitral stenosis (MS), unifying the syndrome of embolic phenomena, haemoptysis and pulmonary hypertension. She underwent successful mitral valve replacement and has since returned to normal...
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Uncommon presentation of adult-form scimitar syndrome associated with single left pulmonary vein in a pregnant woman
Scimitar syndrome is the constellation of malformations including an abnormal venous drainage of the right lung into the inferior vena cava, associated with the right lung and systemic supply to the right lung. The anomalous vein looks like the curved, Turkish sword (scimitar), hence the name.
The adult form of scimitar syndrome is rare, and it is usually an incidental diagnosis based on the characteristic finding on radiological imaging since the patients are usually asymptomatic or with minimal symptoms.
Our patient presented with a rare presentation of scimitar syndrome, which is tachyarrhythmia (sinus tachycardia, with episodes of supraventricular tachycardia). The diagnosis of scimitar syndrome was made based on the typical radiological finding of the anomalous venous drainage on CT angiography. Our patient does not have the full spectrum of the scimitar syndrome; therefore, she did not suffer from the usual complication (pulmonary hypertension). She was treated with ablation without surgical intervention.
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Anaemia and respiratory failure in a child: can it be idiopathic pulmonary haemosiderosis?
We present an 8-year-old male child admitted with cough and high-grade fever for 7 days and respiratory difficulty for 2 days. There was a history of blood transfusion at 2 years of age during a respiratory illness. The child was anaemic, tachycardic, tachypnoeic and hypoxic at presentation. Chest examination revealed equal air entry with fine crackles bilaterally. Blood reports were suggestive of anaemia (haemoglobin 6.5 g/dL), leucocytosis and high C reactive protein levels. Chest radiograph revealed bilateral air space opacities involving diffuse lung fields, right more than left. Relevant microbiological workup was negative. Based on the clinical scenario and investigations, a provisional diagnosis of pulmonary haemosiderosis was kept. The patient was started on intravenous pulse methylprednisolone. Fibre-optic bronchoscopy was done following recovery from the acute event. Bronchoalveolar lavage demonstrated a significant number of haemosiderin-laden macrophages confirming pulmonary haemosiderosis.
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A rare case of thrombotic microangiopathy triggered by acute pancreatitis
Thrombotic microangiopathy (TMA) occurring after acute pancreatitis is rarely described. Without prompt intervention, TMA can be, and often is, lethal, so prompt recognition is important. Here, we present a case of a 61-year-old woman with a history of alcohol misuse who presented with epigastric pain, nausea and vomiting after binge drinking. Elevated serum lipase and imaging were suggestive of acute-on-chronic pancreatitis. Although the patient's symptoms of acute pancreatitis subsided, her anaemia, thrombocytopenia and acute kidney injury worsened. A peripheral blood smear revealed schistocytes, prompting suspicion for TMA. Therapeutic plasma exchange (TPE) was promptly initiated and she completed 10 TPE sessions that improved her anaemia and serum creatinine and resolved the thrombocytopenia. Since TPE was effective and the ADAMTS13 assay revealed 55% activity in the absence of anti-ADAMTS13 IgG prior to initiation of therapy, a confident diagnosis of TMA caused by acute pancreatitis was made. There was no evidence of relapse 2 years later.
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Novel use of combination of electromyography and ultrasound to guide quadratus lumborum block after open appendicectomy
The quadratus lumborum (QL) block facilitates the administration of anaesthesia to the anterior abdominal wall. The use of ultrasound (US) improves the accuracy of the QL block and reduces the risk of adverse events. Electromyography (EMG) in combination with US for muscle plane blocks has not been described previously. We postulated that the addition of EMG-guided needle positioning might assist the execution of this block. This case report describes the first use of combined needle EMG and US to carry out a QL block performed for postoperative analgesia following an open appendicectomy.
http://ift.tt/2pQKM16
Pericardial incidentaloma: benign pericardial cyst
Description
A 73-year-old woman with hypertension and atrial fibrillation presented with head and neck injury after mechanical fall. During workup, chest X-ray anteroposterior view (figure 1) revealed a rounded opacity silhouetting the left heart border and hilum. Subsequent contrast-enhanced CT of the chest showed single, 6.4 cm, rounded, well-defined, thin-walled, non-enhanced, low attenuated (–20 and 20 Hounsfield Unit) and homogenous cyst-like structure at the left mediastinum connected to pericardial recesses and not attached to adjacent structures (figure 2A–C). Transthoracic echocardiogram ruled out left ventricular aneurysm, aortic aneurysm, solid tumour and outflow tracts obstruction. Although bronchogenic cyst, oesophageal duplication cyst, thymic tumour and mediastinal lymphoma were considered as possible differentials, radiological features such as CT appearance, homogenous attenuation, unrelated to the underlying structures favoured pericardial cyst. Since patient was asymptomatic, patient and family member were unwilling to undergo surgical removal and pathological confirmation. Follow-up with non-enhanced CT of...
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Herbal Medicine Treatment for Children with Autism Spectrum Disorder: A Systematic Review
Objective. To summarize and evaluate the efficacy and safety of herbal medicines used for the treatment of autism spectrum disorder (ASD) in children. Methods. Thirteen electronic databases were searched from their inception to November 2016. Randomized controlled trials (RCTs) that assessed the efficacy of herbal medicines alone or in combination with other Traditional Chinese Medicine treatments for ASD in children were included. The Cochrane Risk of Bias Tool was used and other data analyses were performed using RevMan (Version 5.3). Results. Ten RCTs involving 567 patients with ASD were included for qualitative synthesis. In conjunction with conventional therapy, herbal medicines significantly improved the Childhood Autism Rating Scale (CARS) score, but the results of effects on total effective rate (TER) were different between the included studies. The use of herbal medicines with integrative therapy improved the CARS score and TER. In the studies that documented adverse events, no serious events were associated with herbal medicines. Conclusions. The efficacy of herbal medicines for the treatment of ASD appears to be encouraging but was inconclusive owing to low methodological quality, herbal medicine diversity, and small sample size of the examined studies.
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Yokenella regensburgei Septicemia in a Chinese Farmer Immunosuppressed by HIV: A Case Report and Literature Review
Yokenella regensburgei is a member in the family Enterobacteriaceae and a few cases have been reported in immunocompromised hosts. Herein, we described a case of septicemia in a human immunodeficiency virus (HIV) infected patient in South West China, which is the first reported case of Y. regensburgei infection in HIV-infected populations. We then reviewed the literature on all the reported cases of Y. regensburgei infection worldwide and presented some common features of them. Our case report and literature review will help increase the knowledge of the bacterium Y. regensburgei and its clinical implications.
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Improving the temperature characteristics and catalytic efficiency of a mesophilic xylanase from Aspergillus oryzae, AoXyn11A, by iterative mutagenesis based on in silico design
To improve the temperature characteristics and catalytic efficiency of a glycoside hydrolase family (GHF) 11 xylanase from Aspergillus oryzae (AoXyn11A), its variants were predicted based on in silico design. Fir...
http://ift.tt/2rkhzNs
Application of response surface methodology for optimization of medium components for the production of secondary metabolites by Streptomyces diastatochromogenes KX852460
A bioactive strain Streptomyces diastatochromogenes KX852460 was selected for the production of secondary metabolites to control the target spot disease on tobacco leaves, caused by the Rhizoctonia solani AG-3. P...
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The novel intracellular protein CREG inhibits hepatic steatosis, obesity and insulin resistance
Abstract
Cellular repressor of E1A-stimulated genes (CREG), a novel cellular glycoprotein, has been identified as a suppressor of various cardiovascular diseases (CVDs) because of its capacity to reduce hyperplasia, maintain vascular homeostasis, and promote endothelial restoration. However, the effects and mechanism of CREG in metabolic disorder and hepatic steatosis remain unknown. Here, we report that hepatocyte-specific CREG deletion dramatically exacerbates high fat diet (HFD) and leptin deficiency-induced (ob/ob) adverse effects such as obesity, hepatic steatosis and metabolic disorders, whereas a beneficial effect is conferred by CREG overexpression. Additional experiments demonstrated that JNK1 but not JNK2 is largely responsible for the protective effect of CREG on the above mentioned pathologies. Notably, JNK1 inhibition strongly prevents the adverse effects of CREG deletion on steatosis and related metabolic disorders. Mechanistically, CREG directly interacts with apoptosis signal-regulating kinase1 (ASK1) and inhibits its phosphorylation, thereby blocking the downstream MKK4/7-JNK1 signaling pathway and leading to significantly alleviated obesity, insulin resistance and hepatic steatosis. Importantly, dramatically reduced CREG expression and hyper-activated JNK1 signaling was observed in the livers of NAFLD patients, thus suggesting that CREG might be a promising therapeutic target for NAFLD and related metabolic diseases. Conclusion: The results of our study provide the first evidence that CREG is a robust suppressor of hepatic steatosis and metabolic disorders through its direct interaction with ASK1 and the resultant inactivation of ASK1-JNK1 signaling. This study offers new insights into NAFLD pathogenesis and its complicated pathologies, such as obesity and insulin resistance, and paves the way for disease treatment through targeting CREG. This article is protected by copyright. All rights reserved.
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Nicotinic acid phosphoribosyltransferase regulates cancer cell metabolism, susceptibility to NAMPT inhibitors and DNA repair
In the last decade, substantial efforts have been made to identify NAD+ biosynthesis inhibitors, specifically against nicotinamide phosphoribosyltransferase (NAMPT), as preclinical studies indicate their potential efficacy as cancer drugs. However, the clinical activity of NAMPT inhibitors has proven limited, suggesting that alternative NAD+ production routes exploited by tumors confer resistance. Here we show the gene encoding nicotinic acid phosphoribosyltransferase (NAPRT), a second NAD+ producing enzyme, is amplified and overexpressed in a subset of common types of cancer, including ovarian cancer, where NAPRT expression correlates with a BRCAness gene expression signature. Both NAPRT and NAMPT increased intracellular NAD+ levels. NAPRT silencing reduced energy status, protein synthesis, and cell size in ovarian and pancreatic cancer cells. NAPRT silencing sensitized cells to NAMPT inhibitors both in vitro and in vivo; similar results were obtained with the NAPRT inhibitor 2-hydroxynicotinic acid. Reducing NAPRT levels in a BRCA2-deficient cancer cell line exacerbated DNA damage in response to chemotherapeutics. In conclusion, NAPRT-dependent NAD+ biosynthesis contributes to cell metabolism and to the DNA repair process in a subset of tumors. This knowledge could be used to increase the efficacy of NAMPT inhibitors and chemotherapy.
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Metformin improves the glucose and lipid metabolism via influencing the level of serum total bile acids in rats with streptozotocin-induced type 2 diabetes mellitus
OBJECTIVE: To study the effects of metformin on streptozotocin-induced type 2 diabetes mellitus (T2DM) in rats.
MATERIALS AND METHODS: Wistar male rats were divided into two groups: standard diet (SD, n = 20) group and high-fat diet (HFD, n = 80) group. Twenty rats in HFD group were randomly treated with metformin (EI group). After 6 weeks, among rats in HFD group, 20 rats were intraperitoneally injected with citrate buffered saline (IR group), 20 rats treated with metformin per day for 4 weeks (LI group), and 20 rats were given nothing (DM group). Rats in SD group were injected with citrate buffered saline as normal control (NC) group. Moreover, streptozotocin (STZ) was used for inducing diabetes. The metabolic parameters, such as body weight, fasting blood glucose (FBG), fasting insulin concentration (FINS), total cholesterol (TC), total triglycerides (TG), low-density lipoprotein cholesterol (LDLC) and total bile acid (TBA) were measured.
RESULTS: Compared with SD group, the levels of body weight, FBG, TC, LDLC, TBA and FINS and AUC (glucose) were significantly higher in HFD group. After administration of metformin, the levels of FBG, TG, TC, LDLC and TBA in DM and LI group were higher than NC group. Besides, the FBG, TG, TC, TBA and LDLC levels in EI group were higher than DM group.
CONCLUSIONS: Metformin may help to improve the glucose and lipid metabolism by influencing the level of serum total bile acids. A combination of HFD and metformin could be effective in the treatment of rats with T2DM.
L'articolo Metformin improves the glucose and lipid metabolism via influencing the level of serum total bile acids in rats with streptozotocin-induced type 2 diabetes mellitus sembra essere il primo su European Review.
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MAIT cells and MR1-antigen recognition
Andrew N Keller | Alexandra J Corbett | Jacinta M Wubben | James McCluskey | Jamie Rossjohn
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Unusual antigen presentation offers new insight into HIV vaccine design
Andrew J McMichael | Louis J Picker
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miR-138 suppressed the progression of osteoarthritis mainly through targeting p65
OBJECTIVE: MicroRNAs are reported to play key roles in regulating the main risk factors for osteoarthritis (OA) chondrogenesis. In the current study, we focused on miR-138, which has never been explored in OA.
PATIENTS AND METHODS: The expression of miR-138 and p65 was explored in the cartilage tissues of OA patients and compared with those of normal controls. We then explored the effects of miR-138 on NF-κB signaling activation in both human OA chondrocytes and chondrogenic SW1353 cells in the presence of 10 nM TNFα. The protein levels of p65, COX-2 and IL6 were determined using Western blot analysis. To validate the target gene of miR-138, a dual luciferase reporter assay was performed.
RESULTS: The level of miR-138 was markedly reduced in the OA cartilage tissues compared with those of normal controls. Real-time PCR analysis demonstrated that the level of miR-138 decreased after TNFα treatment for 3, 6, and 12 h in the normal chondrocytes and OA chondrocytes. Furthermore, overexpression of miR-138 suppressed the protein levels of p65, COX-2 and IL6 in human OA chondrocytes and chondrogenic SW1353 cells. A dual luciferase reporter assay demonstrated that miR-138 significantly suppressed the relative luciferase activity of pmirGLO-p65-3'UTR. More importantly, treatment with TNFα significantly enhanced the protein levels of p65, COX-2 and IL6. However, overexpression of miR-138 could partially abolish such effects.
CONCLUSIONS: We demonstrated that reduced miR-138 expression enhanced the destruction of the cartilage tissues among OA patients, mainly through targeting p65.
L'articolo miR-138 suppressed the progression of osteoarthritis mainly through targeting p65 sembra essere il primo su European Review.
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Computational fluid dynamics study of intra-arterial chemotherapy for oral cancer
Intra-arterial chemotherapy (IAC) for oral cancer can deliver a higher concentration of anticancer agent into a tumor-feeding artery than intravenous systemic chemotherapy. However, distribution of anticancer ...
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Inertial measurement systems for segments and joints kinematics assessment: towards an understanding of the variations in sensors accuracy
Joints kinematics assessment based on inertial measurement systems, which include attitude and heading reference system (AHRS), are quickly gaining in popularity for research and clinical applications. The var...
http://ift.tt/2pQFFxX
Reply
We thank Dr Bachynski for her thoughtful letter. She states that our data "suggest the importance of examining how broader social contexts may influence this apparent disconnect between what a physician would do for his or her own child and what he or she recommends for patients." Bachynski suggests that "one probable key factor is race." We did not ask physicians for the racial/ethnic makeup of their practice, so we cannot speculate about whether patient race/ethnicity influences physician counseling practices, as has been found in other studies.
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The Effect of Immunosuppression on Airway Integrity.
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A RODENT MODEL OF CARDIAC DONATION AFTER CIRCULATORY DEATH AND NOVEL BIOMARKERS OF CARDIAC VIABILITY DURING EX VIVO HEART PERFUSION.
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Combined heart lung transplantation: an updated review of the current literature.
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Autonomic Nervous System Pretransplant Malfunction is a Powerful Predictor of Survival after Allogeneic Hematopoietic Cell Transplantation.
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(P076) Sequential Boost Compared With Simultaneous Integrated Boosts for HPV Positive Oropharyngeal Cancer Patients
We hypothesized that sequential boost plans (SEQ) may reduce acute toxicity while maintaining excellent control and survival rates for patients with Human Papilloma Virus (HPV) associated squamous cell carcinomas of the oropharynx.
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Preoperative Low-Dose Aspirin Exposure and Outcomes After Emergency Neurosurgery for Traumatic Intracranial Hemorrhage in Elderly Patients.
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Tablet e-Logbooks: Four Thousand Clinical Cases and Complications e-Logged by 14 Nondoctor Anesthesia Providers in Nepal.
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Structural Behavior of the Endothelial Glycocalyx Is Associated With Pathophysiologic Status in Septic Mice: An Integrated Approach to Analyzing the Behavior and Function of the Glycocalyx Using Both Electron and Fluorescence Intravital Microscopy.
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Red Blood Cell Transfusion and Surgical Site Infection After Colon Resection Surgery: A Cohort Study.
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Stroke Volume Variation and Pulse Pressure Variation Are Not Useful for Predicting Fluid Responsiveness in Thoracic Surgery.
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A Structured Transfer of Care Process Reduces Perioperative Complications in Cardiac Surgery Patients.
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Trends in Perioperative Practice and Resource Utilization in Patients With Obstructive Sleep Apnea Undergoing Joint Arthroplasty.
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Remote Ischemic Preconditioning Decreases Oxidative Lung Damage After Pulmonary Lobectomy: A Single-Center Randomized, Double-Blind, Controlled Trial.
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The Labor Analgesia Requirements in Nulliparous Women Randomized to Epidural Catheter Placement in a High or Low Intervertebral Space.
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Somatic mosaicism with reversion to normality of a mutated transthyretin allele related to a familial amyloidotic polyneuropathy
Abstract
Familial amyloidotic polyneuropathy (FAP) is a progressive neuropathy, with onset in adulthood and high mortality. It is related to an altered transthyretin (TTR) plasma protein, mainly produced by the liver and responsible for amyloid deposit in the peripheral nervous system. SNPs in the TTR gene were associated with FAP, and the G>C substitution (NM_000371.3:c.325G>C) in the 109th codon (GAG vs CAG; NP_362.1:p.E109Q) was previously described in Sicily (Italy). Here, we report on a Sicilian family with several patients affected by FAP related to the E109Q mutation, which displayed a somatic mosaicism with the reversion to normality of the c.325G>C mutation. After exclusion of isodisomy and allele deletion, this event seems to be due to a rare, post-zygotic interallelic gene conversion with the wild-type allele serving as a donor. Further investigations will be necessary to better understand the molecular basis of this phenomenon, and could help determine if this can be induced in a targeted manner in the context of natural gene therapy to treat TTR-related FAP patients, as previously proposed for other diseases. Moreover, our results confirm the need to perform DNA-based diagnostic tests with at least a second tissue when a suspected germline mutation in a candidate gene is not identified in the first tissue.
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CRISPR/Cas9-mediated somatic and germline gene correction to restore hemostasis in hemophilia B mice
Abstract
Hemophilia B (HB) is an X-linked disorder caused by defects of F9 encoded coagulation factor IX, which is an ideal model for gene therapy. Most existing HB gene therapies are based on viral mediated gene supplementation, which could increase immunoreaction. In this study, CRISPR/Cas9 system was used for gene correction in an F9 mutant HB mouse model in both adult mice (in vivo) and in germline cells (ex vivo). In vivo, naked Cas9-sgRNA plasmid and donor DNA were delivered to HB mice livers to recover the mutation via hydrodynamic tail vein (HTV) injection. 62.5% of the HTV-treated mice showed a detectable gene correction (>1%) in the F9 alleles of hepatocytes, which was sufficient to remit the coagulation deficiency. Ex vivo, three different forms of Cas9 were microinjected into germline cells of HB mice to investigate their efficiency and safety in gene correction. Cas9 protein showed higher gene recovery rates, less embryo toxicity, and lower mosaic repair percentage, making it more suitable for germline gene therapy. Our study strongly supports that CRISPR/Cas9-mediated genome editing is feasible in gene therapy of genetic disorders.
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Handgun Acquisitions in California After Two Mass Shootings
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Development of the SaFETy Score: A Clinical Screening Tool for Predicting Future Firearm Violence Risk
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Rapid Rule-out of Acute Myocardial Infarction With a Single High-Sensitivity Cardiac Troponin T Measurement Below the Limit of Detection A Collaborative Meta-analysis
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Clinical Trials of Therapeutics for the Prevention of Congenital Zika Virus Disease: Challenges and Potential Solutions
Zika virus (ZIKV) infection in pregnancy is associated with adverse fetal outcomes, such as microcephaly and other congenital malformations. No therapeutic options are available to pregnant women with ZIKV infection to prevent these effects. Drug trials in pregnancy raise several scientific, ethical, and logistic challenges, which are compounded further in ZIKV because of limited knowledge of the disease pathophysiology and a product development pipeline in its infancy. We evaluate the major challenges in choosing therapeutics to prevent congenital ZIKV disease and conducting clinical trials of these treatments, with a focus on preventing congenital central nervous system malformations. These challenges must be characterized and planned for now so that clinical trials can progress expediently and effectively in the future.
http://ift.tt/2nfZq4o
Health and Public Policy to Facilitate Effective Prevention and Treatment of Substance Use Disorders Involving Illicit and Prescription Drugs: An American College of Physicians Position Paper
Substance use disorders involving illicit and prescription drugs are a serious public health issue. In the United States, millions of individuals need treatment for substance use disorders but few receive it. The rising number of drug overdose deaths and the changing legal status of marijuana pose new challenges. In this position paper, the American College of Physicians maintains that substance use disorder is a treatable chronic medical condition and offers recommendations on expanding treatment options, the legal status of marijuana, addressing the opioid epidemic, insurance coverage of substance use disorders treatment, education and workforce, and public health interventions.
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Development of a Research Agenda to Identify Evidence-Based Strategies to Improve Physician Wellness and Reduce Burnout
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Physicians, Patients, and Firearms: The Courts Say “Yes”
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What We Do (and Don't) Know About the Health Effects of Cannabis and Whether Marijuana Is Medicine
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The Development and Performance of After-Hours Primary Care in the Netherlands A Narrative Review
In many Western countries, hospital emergency departments are overcrowded, leading to the desire to strengthen primary care, particularly after hours. To achieve this goal, an increasing number of Western nations are reorganizing their after-hours primary care systems into large-scale primary care physician (PCP) cooperatives. This article provides an overview of the organization, performance, and development of PCP cooperatives in the Netherlands. The Dutch after-hours primary care system might offer opportunities for other countries facing problems with after-hours care and inappropriate emergency department visits.During the past several years, the number of contacts with Dutch PCP cooperatives has increased to 245 contacts per 1000 citizens per year. Many contacts (45%) are nonurgent, and about half occur as part of a series of primary care contacts. Low accessibility and availability of daytime primary care are related to greater use of after-hours primary care. To prevent unnecessary attendance at the cooperatives, physicians advocate copayment, a stricter triage system, and a larger role for telephone doctors.More than half of the PCP cooperatives in the Netherlands have integrated with hospital emergency departments, forming "emergency care access points." This collaboration has decreased emergency department use by 13% to 22%, and treatment of self-referrals by PCP cooperatives in emergency care access points is safe and cost-effective. Direct access to diagnostic facilities may optimize efficiency even more. Other recent developments include access to electronic health records of daytime primary care practices, task substitution from physicians to nurses, and the launch of a 2-year training program for PCPs to become experts in emergency care.
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The True Effect of Mass Shootings on Americans
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Membrane Fusion Stalks and Lipid Rafts: A Love-Hate Relationship
Coarse-grained molecular dynamics simulations are applied to explore the experimentally observed ability of the liquid-ordered (lo)/liquid-disordered (ld) phase boundary to facilitate viral membrane fusion. Surprisingly, a formed fusion stalk can be both attracted (i.e., stalkophilic) and repelled (i.e., stalkophobic) by the lo/ld phase boundary. The phase boundary becomes stalkophilic if the lo phase constituents have the larger negative spontaneous curvature. In such a case, location of the highly curved stalk near the less-ordered and thus (relatively) softer boundary region becomes energetically favorable.
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Acute Pancreatitis: How Soon Should We Feed Patients?
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Missed Opportunities for Measles, Mumps, Rubella Vaccination Among Departing U.S. Adult Travelers Receiving Pretravel Health Consultations
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Prevalence of Elevated Cardiovascular Risks in Young Adults A Cross-sectional Analysis of National Health and Nutrition Examination Surveys
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Early Versus Delayed Feeding in Patients With Acute Pancreatitis A Systematic Review
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Cholesterol Evaluation in Young Adults: Absence of Clinical Trial Evidence Is Not a Reason to Delay Screening
http://ift.tt/2pOYXoa
MACRA: Big Fix or Big Problem?
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Why Aren't International Travelers Vaccinated for Measles?
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Sites of colonization in hospitalized patients with infections caused by extended-spectrum beta-lactamase organisms: a prospective cohort study
The objective of this study was to determine whether patients infected with extended-spectrum beta-lactamase (ESBL)-producing organisms are colonized at multiple body sites.
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The threat of antimicrobial resistance in developing countries: causes and control strategies
The causes of antimicrobial resistance (AMR) in developing countries are complex and may be rooted in practices of health care professionals and patients' behavior towards the use of antimicrobials as well as ...
http://ift.tt/2riS7ru
Determinants of felt demand for dengue vaccines in the North Caribbean region of Colombia
The increasing burden associated with dengue in Latin America makes it essential to understand the community's interest in acquiring vaccines, as an input to plan its introduction in endemic regions. The objec...
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Mindfulness-based stress reduction in Parkinson’s disease: a systematic review
Mindfulness based stress reduction (MBSR) is increasingly being used to improve outcomes such as stress and depression in a range of long-term conditions (LTCs). While systematic reviews on MBSR have taken pla...
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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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heory of COVID-19 pathogenesis Publication date: November 2020Source: Medical Hypotheses, Volume 144Author(s): Yuichiro J. Suzuki ScienceD...
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