Philosophical Transactions of the Royal Society ATheme issue 'Nonlinear dynamics of delay systems' organised and edited by Andreas Otto, Wolfram Just and Günter RadonsVol. 377, No. 2153, (September 2019) The above issue is now available online at:https://royalsocietypublishing.org/toc/rsta/2019/377/2153?ai=aqlb&ui=cbwb&af=HClick the links below to view the abstract for each article, or click the link above to view all Just Released articles for this journal.INTRODUCTIONIntroduction: Nonlinear... Cannabis versus combination chemotherapy; n = 1 trial in Hodgkin's lymphomaImplementation of day of surgery admission for rectal cancer surgery in Ireland following a national centralisation programmeAbstractBackgroundCentralisation of rectal cancer surgery has altered the delivery of colorectal cancer care in Ireland. This has resulted in an increased demand for elective surgical beds in designated centres.AimThis study aimed to assess if day of surgery admission (DOSA), in conjunction with implementation... International Forum of Allergy & RhinologyVolume 9, Issue S32019 Report: Skull Base SurgeryPages: S125-S370July 2019Publication of this special issue is made possible by support from KARL STORZ Endoscopy‐America, Inc.Issue InformationIssue InformationPages: S125-S126 | First Published: 22 July 2019Original ArticlesInternational consensus statement on endoscopic skull‐base surgery: executive summaryEric W. Wang MD, Paul A. Gardner MD, Adam M. Zanation MDPages: S127-S144 | First Published: 08 April... Biologics in psoriasis: Indian experienceShrichand G Parasramani, Jisha PillaiIndian Journal of Drugs in Dermatology 2019 5(1):1-5Janus Kinase Inhibitors in DermatologyAditya Kumar BubnaIndian Journal of Drugs in Dermatology 2019 5(1):6-13Janus kinase (JAK) inhibitors are a new addition in the armamentarium of drugs in the treatment of autoimmune dermatoses. They have proven to be valuable in treating a variety of inflammatory dermatoses with lesser side effects compared to their biological counterparts.... Anthropometric study of the frontal sinus on plain radiographs in Delta State University Teaching HospitalEnaohwo Taniyohwo Mamerhi, Okoro Oghenerieborue GodswillJournal of Experimental and Clinical Anatomy 2018 17(2):49-52INTRODUCTION: The paranasal sinuses are air-filled spaces located within the bones of the skull and face. The different anatomical dimensions of paranasal sinuses can be obtained from plain radiograph and computed tomography images. Determining the possible significant variation... Eating disorders and disordered eating behaviors in males: a challenging topicThe behavioral and affective profile of inpatient adolescent girls with restrictive anorexia nervosaAbstractBackgroundA better understanding of the individual difficulties reported by adolescents presenting with anorexia nervosa seems like an interesting avenue to refine our understanding of their psychological functioning.ObjectiveThis study aimed to: (1) describe the behavioral and affective profile of difficulties of... Ethical, Policy, and Practice Implications of Nurses' Experiences With Assisted Death: A SynthesisThe conceptualization of assisted death as an act performed by physicians has resulted in a lack of attention to nurses' roles and experiences with the processes that surround an assisted death. In this article, we synthesize evidence from 6 articles focusing on the experiences of 55 nurses from Canada, Belgium, and the Netherlands, with relevant ethical and policy implications derived from the literature.... Effect of Gestational Age on Maternofetal Vascular Function Following Single Maternal Engineered Nanoparticle ExposureAbstractNormal pregnancy outcome is accomplished, in part, by rapid and expansive physiological adaptations to the systemic circulation, the extent of which is specific to gestational day (GD) and anatomical location. Pregnancy-related hemodynamic changes in uterine placental blood flow stimulate compensatory vascular signaling and remodeling that begins early and continues throughout... Evidence for efficacy of parent-based interventions on parental characteristicsHome-based parent training for school-aged children with attention-deficit/hyperactivity disorder and behavior problems with remaining impairing disruptive behaviors after routine treatment: a randomized controlled trialAbstractThe objective is to investigate the effectiveness of home-based behavioral parent training for school-aged children with attention-deficit/hyperactivity disorder (ADHD) and behavior problems with... Discrimination between arterial and venous bowel ischemia by computer-assisted analysis of the fluorescent signalIn the original version, Ines Gockel was omitted as a coauthor. The complete author listing is corrected here.Correction to: Safety of orogastric tubes in foregut and bariatric surgeryThe article "Safety of orogastric tubes in foregut and bariatric surgery," written by Kulvir Nandra and Richard Ing, was originally published Online First without Open Access. After publication in volume... Pre-exposure prophylaxis differentially alters circulating and mucosal immune cell activation in HSV-2 seropositive womenObjective: Oral tenofovir-based pre-exposure prophylaxis (PrEP) is an important tool for prevention of new HIV infections, which also reduces subclinical HSV-2 shedding and symptomatic lesions in HIV-negative, HSV-2-seropositive individuals. However, the impact of PrEP on mucosal immunity has not been examined in detail. Design: Here we evaluate paired genital tissue and systemic... Comment on "Glabella impending skin necrosis: a case report"Correction to: Current trends in operative treatment of carpometacarpal osteoarthritis: a survey of European hand surgeonsThe entries in Tables 1, 2 and 3 were captured as N = 433,439 instead of N = 439.Breast augmentation with Aquafilling: complications and radiologic features of two casesAbstractBreast augmentation with various injectable materials has been performed for decades. Aquafilling was developed in 2005 as soft tissue filler... Correction to: Piezo proteins: incidence and abundance in the enteric nervous system. Is there a link with mechanosensitivity?The Authors regret forgetting in the original version of this article to mention that this work was also supported by the US National Institute of Health (NIH) (1OT2OD024899-01).Correction to: "Comparative repair capacity of knee osteochondral defects using regenerated silk fiber scaffolds and fibrin glue with/without autologous chondrocyes during 36 weeks in rabbit modelThe... Clinical, Radiographic, and Ultrasound Findings between Simple and Complicated Baker's CystsPurpose To compare the clinical, radiographic, and ultrasound findings between simple and complicated Baker's cysts (BCs). Methods Forty-seven knees with BCs in 45 patients with knee pain were identified from a chart review. BCs were classified as simple or complicated according to ultrasound findings. Clinical data, including duration of knee pain, visual analogue scale score, Kellgren-Lawrence grade, ultrasound... Cypermethrin triggers apoptosis, depletes granulosa cells, and induces endometrium thinning in female ratsNovita Eka Kusuma Wardani, Respatiningrum Respatiningrum, Anis Nur Laili, Dwi Yuni Nur Hidayati, Setyawati Soeharto, Hidayat SujutiAsian Pacific Journal of Reproduction 2019 8(4):141-147Objective: To analyze the effects of subchronic Cypermethrin on the ovary and endometrium as well as the involvement of apoptosis in the toxicity of cypermethrin. Methods: A total of 32 female Wistar rats were... About our paper "Intradural spinal cord arteriovenous shunts in the pediatric population: natural history, endovascular management and follow-up"André Léri (1875–1930 AD) and his legacy to neuroscienceA singular association of migraine with brainstem aura and Alice in Wonderland syndromeAbstractBackgroundIn this work, we describe an association of brainstem headache with aura (BHA) and Alice in Wonderland syndrome (AIWS) in a 17-year-old male, suffering from crises of vertigo, weakness, dysarthria,... National Medical Commission Bill, 2019 – Good intent but unmet expectationsSantosh G HonavarIndian Journal of Ophthalmology 2019 67(8):1259-1260Cutting corners, or simplifying technology to reach more patients; using the body as its own incubator for epithelial regenerationVirender S Sangwan, Nidhi Gupta, Aastha Singh, Sheila MacNeilIndian Journal of Ophthalmology 2019 67(8):1261-1263Unilateral enophthalmosGrace L Su, Sara E Lally, Carol L ShieldsIndian Journal of Ophthalmology 2019 67(8):1264-1264Simple... Correction to: Biochar efficiency in copper removal from Haplic soilsThe articles listed above were initially published with incorrect copyright information.Handling different types of environmental monitoring fraud in multiple waysAbstractEnvironmental monitoring fraud has become a serious issue all over the world, in both developed and developing countries. A very different and more pernicious type of fraud was exposed in China. This is the first time that government officials but not enterprise... Correction to: Debiasing versus knowledge retrieval checklists to reduce diagnostic error in ECG interpretationDue to an unfortunate turn of events, Fig. 3 was omitted from the original publication.Coming and goingSociological analysis of the medical field: using Bourdieu to understand the processes preceding medical doctors' specialty choice and the influence of perceived status and other forms of symbolic capital on their choicesAbstractSeveral studies have demonstrated that medical students and... Correction to: Cognitive penetration and the cognition–perception interfaceOn page 3653, there is a mistake in the explanation of the Cornsweet illusion. In fact, the explanation is that the panel perceived as darker is facing towards the light source—in the case of this figure the light is coming from the right.Vindicating methodological triangulationAbstractSocial scientists use many different methods, and there are often substantial disagreements about which method is appropriate for a given research... The NLRP3 inflammasome as pharmacological targetNLRP3 is a cytosolic receptor member of the nucleotide-binding and oligomerization domain NOD-like receptor (NLR) family that surveys the intracellular environment for the presence of infection, pathogens, and metabolic alarms. While the surveillance activity of NLRP3 is required to protect the host from several pathogens, uncontrolled activity can be detrimental to the host. Pharmacological and genetic strategies limiting NLRP3 inflammasome activation... Use of a Versatile Buccinator Myomucosal Flap in the Palatal DefectHyalinizing Clear Cell Carcinoma of the MaxillaAbstractHyalinizing clear cell carcinoma (HCCC) is a rare low-grade salivary gland tumor with distinctive clear cell morphology, accounting for < 1% of all salivary gland tumors. In the majority of cases, the tumor originates typically from the minor salivary glands in the oral cavity. A total of 155 cases of HCCCs from head and neck region have been reported in the literature until... Biologically Inspired Parent Selection in Genetic AlgorithmsAbstractIn this paper we suggest a new rule for parent selection in genetic algorithms inspired by natural evolutionary processes. The new rule is simple to implement in any genetic or hybrid genetic algorithm. We also review some biological principles that inspire genetic algorithms and their extensions. The new rule is tested on the planar p-median problem, also termed the location–allocation problem or the multi-source Weber problem,... The role of gabapentinoids in acute and chronic pain after surgeryPurpose of review Gabapentinoid use has increased substantially in the past several years after initial promising data with regard to acute perioperative pain control. The purpose of this review is to critically appraise the evidence for the use of gabapentinoids for acute pain management and its impact on the development of chronic pain after surgery. Recent findings Recent meta-analyses have revealed that prior data likely have overestimated... https://www.sciencedirect.com/journal/american-journal-of-otolaryngology,Commentary on bacterial cellulose graft versus fat graft in closure of tympanic membrane perforationZhengcai LouIn Press, Accepted Manuscript, Available online 22 July 2019Purchase PDFselect article The profound oral cavity cancer burden in the United States Commonwealth of the Northern Mariana Islands: A global health opportunityResearch articleAbstract onlyThe profound oral cavity cancer burden in the United States Commonwealth... Insect sting allergy: new guidelines from the European and USA consensus groups: algorithms and recommendationsPurpose of review Guidelines on insect sting allergy and venom immunotherapy (VIT) have been updated. This review describes the evolution of these guidelines and their similarities and differences. Recent findings The US and European guidelines show the evolution of guideline development in the grading of recommendations and the transparency of the evaluation of evidence. The US and European... Fibroblast growth factor 23 and phosphate homeostasisPurpose of review The current review highlights recent advances in the area of renal tubular phosphate transport and its regulation by fibroblast growth factor 23 (FGF23), a potent regulator of phosphate homeostasis. Recent findings Recent studies demonstrate that FGF23 binds to both membrane and soluble form of α-klotho to activate FGF receptor signaling pathways. Parathyroid hormone and FGF23 equivalently decrease sodium-dependent phosphate cotransport... Anomalous origins of the coronary arteries: current knowledge and future perspectivesPurpose of review The purpose of this review is to survey the contemporary literature surrounding congenital anomalies of origin of the coronary arteries and to identify remaining gaps in knowledge. Recent findings In recent years, lineage tracing analyses and mechanistic studies in model organisms have enhanced our understanding of the normal embryologic development of the coronary arteries, and how disruption of... Maximizing the benefits of cholesterol-lowering drugsPurpose of review Drugs to lower LDL-C levels are very widely used. In this brief review, I will use selected recent studies to delineate several important principles that provide a rationale for how to maximize the benefits of using LDL-C lowering drugs to reduce cardiovascular disease. The focus will be on using statins, ezetimibe, and PCSK9 monoclonal antibodies as recent studies have predominantly utilized these agents. Recent findings The... Ceftazidime, carbapenems, or piperacillin-tazobactam as single definitive therapy for Pseudomonas aeruginosa bloodstream infection - a multi-site retrospective study Tanya Babich; Pontus Naucler; John Karlsson Valik ; Christian G Giske; Natividad Benito ... Middle fossa approach for spontaneous cerebrospinal fluid fistula and encephalocelesPurpose of review The aim of this article is to describe the middle fossa craniotomy (MFC) approach for the repair of cerebrospinal (CSF) fistula and encephaloceles. Recent findings The MFC approach has a greater than 93% success rate for managing CSF fistula and encephaloceles located along the tegmen tympani and tegmen mastoideum. Posterior fossa defects cannot be managed by an MFC approach. Multilayer repair with... Medical Test for Tax Reasons,Published on Jul 22, 2019US tax agency says 23andMe's genetic health test can be claimed as a medical expense for tax purposes, the Wall Street Journal reports. Read more >Act Proposed to Combat InterferencePublished on Jul 22, 2019Two Democratic lawmakers argue at USA Today that independent science is under attack by the Trump Administration. Read more >Little More Regulation WantedPublished on Jul 22, 2019The Guardian reports that some UK physicians are calling... Cancer Biotherapy and Radiopharmaceuticals,FREE ACCESS to the TOP READ Papers of this year to date through August 5, 2019.Read Now:[ Open Access ]An IL-15 Superagonist, ALT-803, Enhances Antibody-Dependent Cell-Mediated Cytotoxicity Elicited by the Monoclonal Antibody NEO-201 Against Human Carcinoma CellsMassimo Fantini, Justin M. David, Hing C. Wong, Christina M. Annunziata, Philip M. Arlen, and Kwong Y. Tsang Read NowCombined Detection of HER2, Ki67, and GSTP1 Genes on the Diagnosis and Prognosis... Massive Intramedullary Hemorrhage After Subarachnoid Hemorrhage in Patient with Vertebrovertebral.. · Save5 mins ago · Publication date: September 2019 Source: World Neurosurgery, Volume 129 Author(s): Tomoo Inoue, Toshiki Endo, Kenichi Sato, Ramazan Fesli, Yoshikazu Ogawa, Mik.. Read More → Magic, Monsters, and Make-Believe Heroes: How Myth and Religion Shape Fantasy Culture. By Douglas E. Cowan Chris Klassen Does programmed intermittent epidural bolus improve childbirth conditions of nulliparous women compared with patient-controlled epidural analgesia?: A multicentre, prospective, controlled, randomised, triple-blind studyBACKGROUND Epidural analgesia may change the mechanics of childbirth. These changes are related to the concentration of the local anaesthetic used epidurally but probably also to its mode of delivery into the epidural space. OBJECTIVE To determine whether the administration of programmed... Updates in opioid and nonopioid treatment for chronic breathlessnessPurpose of review Chronic breathlessness is a troublesome symptom experienced by people with advanced malignant and nonmalignant disease. Disease-directed therapies are often insufficient in the management of chronic breathlessness. Therefore, pharmacological and nonpharmacological breathlessness-specific interventions should be considered for select patients. Recent findings There is some evidence to support the use of low-dose... "Jesus Saved an Ex-Con": Political Activism and Redemption after Incarceration, by EDWARD OROZCO FLORES Jack Delehanty The Use of a Venous Catheter as a Stent for Treatment of Acquired Punctal and Canalicular StenosisPurpose: The aim of this study was to describe a simple technique to insert a venous catheter as a stent for the treatment of acquired punctal and canalicular stenosis. Methods: We performed this technique using a central venous catheter as a stent for the treatment of acquired punctal and canalicular stenosis. Results: The results show the easy availability of the material used for the intervention,...
Role of integrin β1 as a biomarker of stemness in head and neck squamous cell carcinomaPublication date: September 2019Source: Oral Oncology, Volume 96Author(s): Jung Hwa Moon, Young Soo Rho, Sang Hyuk Lee, Bon Seok Koo, Hyun Joo Lee, Sung Im Do, Jae Hoon Cho, Young Gyu Eun, Min Woo Park, Hyang Ae Shin, Young Chang LimAbstractObjectivesSignaling between cancer stem cells (CSC) and their extracellular matrix has a crucial role in CSC progression and maintenance. However, mediators of this signaling... Measuring Dynamic CT Perfusion Based on Time-Resolved Quantitative DECT Iodine Maps: Comparison to Conventional Perfusion at 80 kVp for Pancreatic CarcinomaObjectives Using dual-energy computed tomography (DECT) for quantifying iodine content after injection of contrast agent could provide a quantitative basis for dynamic computed tomography (CT) perfusion measurements by means of established mathematical models of contrast agent kinetics, thus improving results by combining the strength of both... Experimental DermatologyAccepted ArticlesAccepted, unedited articles published online and citable. The final edited and typeset Version of Record will appear in the future.2‐deoxy D‐glucose treatment does not elicit a hair growth response in alopecia areataJohn P. Sundberg, Kathleen A. Silva, Victoria E. Kennedy, John J. Wilson, Nicholas E. Gott, Beth A. Sundberg, Derry C. RoopenianFirst Published: 19 July 2019In situ antioxidant activity of a dermo‐cosmetic product: a randomized‐controlled clinical... Medic Mindset Podcast: Thinking about headache ,By The Medic Mindset PodcastWhen does a chief complaint of a headache mean something more sinister is occurring in your prehospital medicine patient? When a Video Laryngoscope Blade Isn't Enough,A video laryngoscope may not always work if a patient has a cervical spine injury, limited mouth opening or upper airway obstruction. The versatile and portable C-MAC video stylet is your Plan B.Redefine your limits Aspirin enhances trophoblast invasion and represses soluble fms-like tyrosine kinase 1 production: a putative mechanism for preventing preeclampsiaObjective: Recent studies suggested that prophylactic aspirin prior to 16 weeks of gestation in high-risk patients may reduce the risk of developing preeclampsia; however, the exact mechanism of aspirin's effect on the pathophysiology of preeclampsia is not clear. This study was designed to investigate the effect of aspirin on trophoblast cell function... The role of school in the management of children with epilepsyAminu Taura Abdullahi, Umar Abdullahi Taura, Zubaida Ladan FaroukJournal of Health Research and Reviews 2019 6(2):37-41Worldwide, epilepsy affects about 0.7% of children of school age. It is associated with educational difficulties in addition to psychological, social, and other comorbidities. It is important for children with medical conditions such as epilepsy to receive education. The trend is to provide this at mainstream schools.... Modified Minerva Cervical Thoracic Orthosis for Postoperative Management of Cricotracheal Resection,Timothy N. Baerg, BS, Jennifer F. Ha, MBBS, Megan Christ, MSPO, Glenn E. Green, MDhttps://doi.org/10.1177/0145561319859348 | First Published July 11, 2019AbstractHide PreviewThe worst complication of cricotracheal resection (CTR) is anastomotic dehiscence, and to limit it, postoperative management at Michigan Medicine included the use of a modified Minerva cervical-thoracic orthosis (MMCTO). To date,... Lymphangiomatous Polyp Arising From the Palatine TonsilHyun Jin Min, MD, PhD, Kyung Soo Kim, MD, PhDhttps://doi.org/10.1177/0145561319863367 | Laryngeal Synovial Sarcoma: A Systematic Review of the Last 40 Years of Reported CasesGregory Shein, MBBS, Gurfateh Sandhu, MBBS, Alison Potter, MBBS (Hons), Christine Loo, MBBS (Hons), FRCPA, PhD, Ian Jacobson, MB BCh, FRACS, Antoinette Anazodo, MBBS, MSC, FRACPhttps://doi.org/10.1177/0145561319850697 | First Published July 16, 2019AbstractHide PreviewPrimary laryngeal synovial sarcoma is an extremely rare tumor predominantly affecting young adults. There are currently no well-defined guidelines... Epithelial Squamous Metaplasia and Dysplasia in Inflammatory Nasal Polyps: An Observational StudyAleksandar Perić, MD, PhD, Marko Stoiljkov, MD, Danijela Đokić, MD, Biserka Vukomanović Đurđević, MD, PhDhttps://doi.org/10.1177/0145561319862207 | First Published July 16, 2019AbstractHide PreviewNasal polyposis (NP) is characterized by polypoid outgrowths of chronically inflamed respiratory mucosa. The presence of squamous metaplasia and dysplasia on the mucosal surface of nasal polyps (NPs) represents... Long-term Effects of Conservative Management of Vestibular Schwannoma on Dizziness, Balance, and Caloric Function,Kathrin Skorpa Nilsen, MD, Morten Lund-Johansen, MD, PhD, Stein Helge Glad Nordahl, MD, PhD, Monica Finnkirk, BSc, Frederik Kragerud Goplen, MD, PhDhttps://doi.org/10.1177/0194599819860831 | First Published July 16, 2019AbstractHide PreviewObjectivesTo study the development of dizziness, caloric function, and postural sway during long-term observation of untreated vestibular schwannoma... Otolaryngology–Head and Neck Surgery View onlineOnlineFirst AlertOriginal ResearchLong-term Effects of Conservative Management of Vestibular Schwannoma on Dizziness, Balance, and Caloric FunctionKathrin Skorpa Nilsen, Morten Lund-Johansen, Stein Helge Glad Nordahl, Monica Finnkirk, Frederik Kragerud GoplenOtolaryngology–Head and Neck SurgeryJul 16, 2019 | OnlineFirstOriginal ResearchDoes Surgical Volume and Complexity Affect Cost and Mortality in Otolaryngology–Head and Neck Surgery?Andrew J. Redmann,... Diagnosing the Onset of MenopauseNanette Santoro, MD1; Joshua Johnson, PhD1Author Affiliations Article Information1Department of Obstetrics and Gynecology, University of Colorado, AuroraJAMA. Published online July 22, 2019. doi:10.1001/jama.2019.6250multimedia icon MultimediaClinical Review Audio(15:38)Diagnosing MenopauseA50-year-old woman with a fibroid uterus and heavy menses presents with 4 months of amenorrhea. She would like to know when she will become menopausal because she wishes to avoid... Ear, Nose & Throat Journal ,View onlineOnlineFirst AlertResearch ArticleEpithelial Squamous Metaplasia and Dysplasia in Inflammatory Nasal Polyps: An Observational StudyAleksandar Perić, Marko Stoiljkov, Danijela Đokić, Biserka Vukomanović ĐurđevićEar, Nose & Throat JournalJul 16, 2019 | OnlineFirstOtherAcute Bilateral Peritonsillar AbscessesWilliam L. Valentino, David Lafferty, Alyssa TerkEar, Nose & Throat JournalJul 16, 2019 | OnlineFirstCase ReportLaryngeal Synovial Sarcoma: A Systematic... Antimotility Agents For The Treatment Of Acute Non-Infectious Diarrhea In Critically Ill Patients: A Practice Management Guideline From The Eastern Association For The Surgery Of TraumaBackground Acute non-infectious diarrhea is a common phenomenon in ICU patients. Multiple treatments are suggested but the most effective management is unknown. A working group of the Eastern Association for the Surgery of Trauma (EAST), aimed to evaluate the effectiveness of loperamide, diphenoxylate/atropine, and... Distribution and relative abundance of three protist genera within the Zootermopsis nevadensis nuttingi hindgutAbstractThe termite Zootermopsis nevadensis nuttingi, which inhabits coastal forests of the western United States, plays an important ecological role in the breakdown and digestion of wood. Vital to this role are symbiotic protists residing in the termite's hindgut. Five protist genera of varying size and morphology make up this gut community, but very little is known about their spatial... Correction to: Spectrum of diagnostic errors in cervical spine trauma imaging and their clinical significanceThe published version of this article unfortunately contained a mistake. Author given and family name Alessandrino Francesco was incorrectly interchanged. The correct presentation is given above. The original article has been corrected.Core curriculum illustration: supination-external rotation trimalleolar fractureAbstractThis is the 37th installment of a series that will highlight one case... Sexual Functioning in Hyperprolactinemic Patients Treated With Cabergoline or BromocriptineBackground: Elevated prolactin levels were found to be associated with impaired sexuality. Study Question: The aim of the study was to compare the impact of bromocriptine and cabergoline on sexual functioning in both genders. Study Design: The study enrolled 39 young women and 18 young men receiving bromocriptine treatment. In 19 women and 8 men, because of poor tolerance, bromocriptine was replaced with cabergoline,... Could the extreme conformality achieved with proton therapy in paranasal sinuses cancers accidentally results in a high rate of leptomeningeal progression?Ester Orlandi MD Nicola A. Iacovelli MD Anna Cavallo PhD Carlo Resteghini MD Lorenza Gandola MD Lisa Licitra MD Paolo Bossi MDFirst published: 17 July 2019 https://doi.org/10.1002/hed.25848
Temporomandibular disorder in head and neck cancer patients undergoing radiotherapy: Clinical findings and patient‐reported symptomsNina Pauli MD, PhD Christina Mejersjö LDS, PhD Bodil Fagerberg‐Mohlin DDS Caterina Finizia MDFirst published: 16 July 2019 https://doi.org/10.1002/hed.25878Funding information: Cancerfonden; Göteborgs Läkaresällskap; Stiftelsen Assar Gabrielssons FondRead the full textePDFPDFTOOLS SHAREAbstractBackgroundThe aim of this study was to investigate how common temporomandibular... Prognosis of nasopharyngeal carcinoma with insufficient radical dose to the primary site in the intensity‐modulated radiotherapy eraTianzhu Lu MD Xingyun Xie MD Qiaojuan Guo MD Shenghua Zhan MD Cheng Lin MD Shaojun Lin MD Yu Zhang MD Jingfeng Zong MD Jianji Pan MDFirst published: 16 July 2019 https://doi.org/10.1002/hed.25865Tianzhu Lu and Xingyun Xie contributed equally to this study.Funding information: Fujian Provincial Natural Science Foundation of China, Grant/Award Number: 2018J01275... Interventions to Prevent Perinatal Depression: Evidence Report and Systematic Review for the US Preventive Services Task Force(Abstracted from JAMA 2019;321(6):588–601) Perinatal depression is a common condition that was estimated in 2012 to affect more than 180,000 new mothers (11.5%) annually in the United States and that can have serious impact on mother and infant well-being. Numerous interventions have been proposed to prevent perinatal depression, but there is no commonly agreed-on prevention... Recurrence factors in pediatric ameloblastoma: Clinical features and a new classification systemRong Yang DDS Yu Tang BDS Xu Zhang DDS Zheqi Liu BDS Sandhya Gokavarapu MDS Chengzhong Lin DDS Zhenhu Ren MD, PhD Yongmei Zhou MD, PhD Wei Cao MD, PhD Tong Ji MD, PhDFirst published: 19 July 2019 https://doi.org/10.1002/hed.25867Rong Yang, Yu Tang, Xu Zhang contributed equally to this work.Funding information: National Natural Science Foundation of China, Grant/Award Numbers: 81671009, 81672745;... Head & NeckEarly ViewOnline Version of Record before inclusion in an issueRecurrence factors in pediatric ameloblastoma: Clinical features and a new classification systemRong Yang DDS, Yu Tang BDS, Xu Zhang DDS, Zheqi Liu BDS, Sandhya Gokavarapu MDS, Chengzhong Lin DDS, Zhenhu Ren MD, PhD, Yongmei Zhou MD, PhD, Wei Cao MD, PhD, Tong Ji MD, PhDVersion of Record online: 19 July 2019Could the extreme conformality achieved with proton therapy in paranasal sinuses cancers accidentally results in a... Production of non-mosaic genome edited porcine embryos by injection of CRISPR/Cas9 into germinal vesicle oocytesPublication date: Available online 20 July 2019Source: Journal of Genetics and GenomicsAuthor(s): Xiaohu Su, Wei Chen, Qingqing Cai, Puping Liang, Yaosheng Chen, Peiqing Cong, Junjiu HuangAbstract:Genetically modified pigs represent a great promise for generating models of human diseases and producing new breeds. Generation of genetically edited pigs using somatic cell nuclear transfer... Reversible tactile hypoesthesia associated with myofascial trigger points: a pilot study on prevalence and clinical implicationsIntroduction: Tactile hypoesthesia observed in patients with myofascial pain syndrome (MPS) is sometimes reversible when pain is relieved by trigger point injections (TPIs). We aimed to investigate the prevalence of such reversible hypoesthesia during TPI therapy and topographical relations between areas of tactile hypoesthesia and myofascial trigger points (MTrP) in patients... Density of Macrophages Immunostained With Anti-Iba1 Antibody in the Vestibular Endorgans After Cochlear Implantation in the HumanHypothesis: Cochlear implantation may result in an increase in the density of macrophages in vestibular endorgans in the human. Background: Vestibular symptoms are a common complication of cochlear implantation. In a previous study, we demonstrated histological evidence of a foreign-body response caused by silicon and platinum in the human cochlea following cochlear implantation.... Hearing Preservation With the Use of Flex20 and Flex24 Electrodes in Patients With Partial DeafnessObjective: To evaluate the impact of electrode length on hearing preservation (HP) in Partial Deafness Treatment–Electrical Complement (PDT-EC) subjects. Study Design: Retrospective case review. Setting: Tertiary referral center. Patients: Twenty-three PDT-EC patients (with preoperative air-conduction thresholds ≤30 dB up to 500 Hz) were divided into two groups: Flex20 electrode (Med-EL GmbH, Innsbruck,... Evaluation of the Effect of Diclofenac Sodium and 5-Fluourasil in a 3D Cholesteatoma Cell Culture ModelIntroduction: Middle ear cholesteatoma is a benign disease with invasive and destructive clinical behaviors. It increases the rate of both chronic otitis media complications and revision surgeries. The most effective treatment of middle ear cholesteatoma is surgical excision, and there is no medical treatment for this disease. Exploring new medical treatment options may help to create treatment... Speech Perception Growth Patterns in Prelingual Deaf Children With Bilateral Sequential Cochlear ImplantationObjective: To evaluate speech perception following the first (CI-1) and second (CI-2) cochlear implantation (CI) in children with sequential bilateral CI. Study Design: Retrospective. Patients: Seventy children with follow-up for 60 months post CI-1 and 36 months post CI-2. Main Outcome Measures: Word recognition score (WRS) was the main outcome. WRSs were compared by age at CI operation (group... The Influence of Metabolic Syndrome on the Prognosis of Idiopathic Sudden Sensorineural Hearing LossObjectives: We aimed to verify the hypothesis that metabolic syndrome (MetS) and its components affect the prognosis of idiopathic sudden sensorineural hearing loss (ISNNHL). Study Design: A retrospective cohort study. Setting: Tertiary otology referral center. Patients: We divided patients who were diagnosed with ISSNHL between January 2015 and January 2018 into a MetS group and a Non-MetS group according... Density of Macrophages Immunostained With Anti-Iba1 Antibody in the Vestibular Endorgans After Cochlear Implantation in the HumanHypothesis: Cochlear implantation may result in an increase in the density of macrophages in vestibular endorgans in the human. Background: Vestibular symptoms are a common complication of cochlear implantation. In a previous study, we demonstrated histological evidence of a foreign-body response caused by silicon and platinum in the human cochlea following cochlear implantation.... Incidence and Risk of Various Disorders of the External Ear in Patients With Hearing Aids Treated in ENT Practices in GermanyObjective: The aim of the study was to investigate the relationship between the presence of a hearing aid (HA) and the occurrence of various disorders of the external ear, using data from ear, nose, and throat (ENT) practices in Germany from a nationwide, representative practice database. Methods: In the period between 2012 and 2016, the incidences of disorders of the external... Vestibular Schwannoma Tumor Size Is Associated With Acute Vestibular Symptoms After Gamma Knife TherapyObjective: To assess how pretreatment vestibular schwannoma (VS) tumor characteristics are associated with vestibular symptoms after gamma knife (GK) surgery. Study Design: Retrospective chart review of patients undergoing GK treatment for VS at our institution from 2005 to 2018. Setting: Academic tertiary referral center. Patients: Patients receiving primary GK surgery for vestibular schwannomas... Changes in epidermal morphology associated with dandruff,J. E. Pople, R. K. Bhogal, A. E. Moore, G. JenkinsVersion of Record online: 16 July 2019Dandruff is a common scalp condition and this study demonstrates that there are significant changes in epidermal morphology in this condition. The epidermis is thicker, more convoluted and has deeper rete ridges. We show an increase in proliferating keratinocytes in dandruff skin, a novel finding suggesting the epidermis is in a hyper‐proliferative state. Does gender influence cardiovascular remodeling in C57BL/6J mice fed a high‐fat, high‐sucrose and high‐salt diet?Debora Cristina Pereira‐Silva Rayane Paula Machado‐Silva Camila Castro‐Pinheiro Caroline Fernandes‐SantosFirst published: 19 July 2019 https://doi.org/10.1111/iep.12318Funding information:This study was supported by a grant from the Brazilian agency FAPERJ (E‐26/210.525/2014).SECTIONSPDFTOOLS SHARESummaryAnimal models are widely used to study the physiopathology of human diseases. However,... Effects of beta‐hydroxy‐beta‐methylbutyrate supplementation on skeletal muscle in healthy and cirrhotic ratsMilan Holeček Melita VodeničarovováFirst published: 18 July 2019 https://doi.org/10.1111/iep.12322Funding information:This work was supported by the programme PROGRES Q40/02Read the full textePDFPDFTOOLS SHARESummaryBeta‐hydroxy‐beta‐methylbutyrate (HMB) is a leucine metabolite with protein anabolic effects. We examined the effects of an HMB‐enriched diet in healthy rats and rats with liver... International Journal of Cosmetic ScienceAccepted ArticlesAccepted, unedited articles published online and citable. The final edited and typeset Version of Record will appear in the future.Facial skin mapping: from single point bio‐instrumental evaluation to continuous visualization of skin hydration, barrier function, skin surface pH, and sebum in different ethnic skin typesRainer Voegeli, Jordan Gierschendorf, Beverley Summers, Anthony V. RawlingsFirst Published: 20 July 2019Engineering optimisation... Identification of Patients With Heart Failure From Test Bolus of Computed Tomography Angiography in Patients Undergoing Preoperative Evaluation for Transcatheter Aortic Valve ReplacementPurpose: Identify a measurable parameter from test bolus of computed tomography angiography that can differentiate aortic stenosis patients with normal systolic function from those with heart failure and reduced ejection fraction (HFrEF). Materials and Methods: This retrospective study included patients (undergoing...
A single‐institution retrospective evaluation of Mohs incision angles and histopathologic specimen quality,Sherry H. Yu MD Suzanne M. Olbricht MD Jeffrey B. Tiger MDFirst published: 17 July 2019 https://doi.org/10.1111/ijd.14591Funding: None.Conflicts of interest: None.Read the full textePDFPDFTOOLS SHAREAbstractBackgroundTraditionally, Mohs layers are excised using a beveled incision to facilitate tissue flattening for tangential sectioning. Some surgeons perform non‐beveled incisions; however,... Relationship between oral and gut microbiota in elderly people,Megumi Iwauchi, Ayako Horigome, Kentaro Ishikawa, Aya Mikuni, Manabu Nakano, Jin‐zhong Xiao, Toshitaka Odamaki, Shouji HironakaVersion of Record online: 15 July 2019 Recent studies have shown that oral bacteria might induce systemic inflammation through alteration of gut microbiota. We investigated the relationship between oral and gut microbiota and evaluated the transition of oral bacteria to the gastrointestinal tract. Unweighted UniFrac... The utility of ECMO, not just after but also during Liver TransplantationNo abstract availableImpact of a Mobile Health Intervention on Long-Term Nonadherence After Lung Transplantation: Follow-up After a Randomized Controlled TrialBackground: In a randomized controlled trial (RCT), lung transplant recipients (LTRs) using a mobile health intervention, Pocket Personal Assistant for Tracking Health (Pocket PATH), showed better adherence to the medical regimen than LTRs receiving usual care during the...
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Philosophical Transactions of the Royal Society ATheme issue 'Nonlinear dynamics of delay systems' organised and edited by Andreas Otto, Wolfram Just and Günter Radons Vol. 377, No. 2153, (September 2019) The above issue is now available online at:https://royalsocietypublishing.org/toc/rsta/2019/377/2153?ai=aqlb&ui=cbwb&af=HClick the links below to view the abstract for each article, or click the link above to view all Just Released articles for this journal. INTRODUCTIONARTICLES| Research articles: Fokker–Planck representations of non-Markov Langevin equations: application to delayed systems | Luca Giuggioli  and Zohar Neu | Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences, Vol. 377, No. 2153, September 2019
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Cannabis versus combination chemotherapy; n = 1 trial in Hodgkin's lymphoma
| Implementation of day of surgery admission for rectal cancer surgery in Ireland following a national centralisation programme
AbstractBackgroundCentralisation of rectal cancer surgery has altered the delivery of colorectal cancer care in Ireland. This has resulted in an increased demand for elective surgical beds in designated centres. AimThis study aimed to assess if day of surgery admission (DOSA), in conjunction with implementation of a coordinated enhanced recovery pathway can reduce length of stay following elective rectal cancer resection. MethodsThis is a retrospective review from a single institution. Our prospectively maintained Dendrite® Database was interrogated. Three time points were analysed across a 7-year period (2011, 2012, 2016). The first predates the introduction of a dedicated DOSA programme, the next was directly thereafter, and the final was 5-years post-implementation. These dates coincide with the centralisation of rectal cancer surgery to this centre. Outcomes included unadjusted length of stay and rates of DOSA pre-and post-implementation of the programme. ResultsThe introduction of a DOSA pathway resulted in a fivefold increase in day of surgery admissions and a related 3-day reduction in average length of stay within a single year of implementation. This further improved in 2016, showing an almost 83% increase (15.90–98.50%) in day of surgery admission and a reduction in average length of stay from 16.4 to 12.4 days when compared to 2011. ConclusionsDespite an increase in caseload of 54%, an estimated 272 bed days were saved. This demonstrated that DOSA is sustainable and highly effective in tackling the increased inpatient bed demands associated with the growing requirement for elective surgery.
| Transmission electron microscopy and histological analysis of the peridural membrane
AbstractIntroductionWhile first described in 1904, the characterisation of the peridural membrane, which is frequently encountered, yet usually unnoticed, during lumbar decompression surgery, remains inconclusive. This relatively little known membrane is continuous with the posterior longitudinal ligament and lines the epidural space. In this study, we are comparing the membrane and ligamentum flavum from patients to analyse the variations of the histological and ultrastructural compositions. Materials and methodsWe took samples of the membrane and ligamentum flavum from five separate patients who were undergoing lumbar spine decompression surgery for herniated discs which were then analysed with transmission electron microscopy and stained with H&E (morphology), trichrome (collagen content), and Verhoeff-Van Gieson (elastin content). ResultsUpon analysis of the peridural membrane, we observed tightly packed collagen fibres, interspaced with elastin fibres and very few fibroblasts. While the ligamentum flavum showed a significantly higher elastin to collagen ratio and looser arrangement of collagen fibres with a larger extracellular matrix. The peridural membrane was similar in appearance and constituent parts to the dura mater. ConclusionThe peridural membrane is a distinctive and important membrane in the spinal canal, and given its high collagen to elastin ratio and it tightly packed nature, we conclude that it forms a protective layer around the spinal cord which may help in minimising the compressive nature of intervertebral disc herniation.
| The purpose of ward rounds
AbstractWard rounds are a highly important forum for collaborative medical reasoning. Despite being prevalent for over a century, they are under-researched. In particular, no clear and comprehensive statement of the purpose of ward rounds exists in the literature. This letter provides such a statement. Having the purpose of ward rounds clearly described helps to provide a foundation for evaluating the effectiveness of rounds and suggesting ways in which rounds can be improved.
| Migration to aphakia and contact lens treatment is the trend in the management of unilateral congenital cataract in Britain and Ireland
AbstractBackgroundThe Infant Aphakia Treatment Study (IATS) compared the treatment of unilateral cataract in infants aged 1–6 months with primary intraocular lens (IOL) implantation vs aphakia with contact lens (CL) correction. AimsThis study aims to assess the current trends in the treatment of unilateral congenital cataract in infants less than 6 months at surgery in the UK and Ireland. MethodsAn anonymous survey was emailed to the 200 members of the BIPOSA mailing list with 14 questions to assess treatment choice (primary intraocular lens (IOL) vs aphakia with contact lens (CL)), reasons for this choice, and assessment of local CL services. ResultsThere were 56 respondents, 39 of whom completed the entire survey. Aphakia with CL was the treatment choice for 74.4% of respondents. A quarter (25.6%) of respondents said they were performing primary IOL implantation prior to the publication of the Infant Aphakia Treatment Study (IATS), but now choose aphakia with CL. Amongst the 20.5% (n = 8) of respondents who chose primary IOL implantation, 5 attributed their choice to "inadequate CL service". The majority (84.6%) of respondents rated their infant CL service as either "good" or "very good". ConclusionAphakia with CL rehabilitation was the most common approach to the treatment of unilateral congenital cataract in infants less than 6 months in this study. The results of the IATS appear to have influenced a change in practice from primary IOL implantation to aphakia and CL visual rehabilitation in approximately one quarter of those surveyed.
| Parental awareness of newborn bloodspot screening in Ireland
AbstractBackgroundThere is little known regarding how familiar parents are with the newborn bloodspot screening (NBS) test or how well parents of a child with a screen-detected condition understand that condition initially. AimThe study aim was to examine parental NBS awareness and conditions screened. MethodsTwo studies were conducted: [1] Parents of children with cystic fibrosis (CF) detected via NBS and subsequently, diagnosed (n = 124) completed a telephone questionnaire regarding information they received at the time of NBS. [2] A cross-sectional study of women (n = 662 (58%) antenatal; n = 480 (42%) postnatal) attending three large maternity hospitals completed a questionnaire addressing NBS awareness. ResultsMothers incorrectly identified diabetes/asthma (35% postnatal; 70% antenatal) and sickle cell disease (26%) as conditions on NBS in Ireland. Phenylketonuria was correctly identified by 48/26%, CF by 82/64%, and congenital hypothyroidism by 35/13% postnatal and antenatal women respectively. Of parents of children screen-detected and subsequently, diagnosed with CF, only half (n = 63; 51%) reported awareness at the time of NBS that CF was included. These results should be used to improve the information provided to expectant mothers and to inform health professionals' initial discussions with parents about their child's diagnosis, building on parents' pre-existing knowledge.
| Dialysis independence following single-agent daratumumab in refractory myeloma with renal failure
| Critical biochemistry values and patient safety in primary care
| The inclusion health awareness month at University College Hospital Galway (UCHG)
| An investigation into nature and extent of errors within the Irish Vital Statistics mortality database
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Publication of this special issue is made possible by support from KARL STORZ Endoscopy‐America, Inc. Issue Information Original Articles ICAR: endoscopic skull‐base surgeryEric W. Wang MD, Adam M. Zanation MD, Paul A. Gardner MD, Theodore H. Schwartz MD, Jean Anderson Eloy MD, Nithin D. Adappa MD, Martin Bettag MD, PhD, Benjamin S. Bleier MD, Paolo Cappabianca MD, Ricardo L. Carrau MD, Roy R. Casiano MD, Luigi M. Cavallo MD, PhD, Charles S. Ebert MD, MPH Jr, Ivan H. El‐Sayed MD, James J. Evans MD, Juan C. Fernandez‐Miranda MD, Adam J. Folbe MD, MS, Sebastien Froelich MD, PhD, Fred Gentili MD, MSc, Richard J. Harvey MD, Peter H. Hwang MD, John A. Jane MD Jr, Daniel F. Kelly MD, David Kennedy MD, Engelbert Knosp MD, Devyani Lal MD, John Y.K. Lee MD, MSCE, James K. Liu MD, Valerie J. Lund MD, James N. Palmer MD, Daniel M. Prevedello MD, Rodney J. Schlosser MD, Raj Sindwani MD, C. Arturo Solares MD, Abtin Tabaee MD, Charles Teo MBBS, Parthasarathy D. Thirumala MD, Brian D. Thorp MD, Eduardo de Arnaldo Silva Vellutini MD, PhD, Ian Witterick MD, MSc, Bradford A. Woodworth MD, Peter‐John Wormald MD, Carl H. Snyderman MD, MBAPages: S145-S365 | First Published: 22 July 2019 Index INDEXPages: S366-S370 | First Published: 22 July 2019
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Biologics in psoriasis: Indian experience
Shrichand G Parasramani, Jisha Pillai
Indian Journal of Drugs in Dermatology 2019 5(1):1-5
| Janus Kinase Inhibitors in Dermatology
Aditya Kumar Bubna
Indian Journal of Drugs in Dermatology 2019 5(1):6-13
Janus kinase (JAK) inhibitors are a new addition in the armamentarium of drugs in the treatment of autoimmune dermatoses. They have proven to be valuable in treating a variety of inflammatory dermatoses with lesser side effects compared to their biological counterparts. This review throws light on JAK inhibitors and their role in dermatologic diseases.
| Real-life efficacy and safety of secukinumab: A single-center, retrospective observational study with 52-week follow-up
Shekhar Neema, S Radhakrishnan, Sehdev Singh, Biju Vasudevan, Manas Chatterjee
Indian Journal of Drugs in Dermatology 2019 5(1):14-18
Background: Secukinumab is a fully human monoclonal antibody against interleukin-17. Phase III trials have shown encouraging results in chronic plaque psoriasis. The real-life data for safety and efficacy of secukinumab are limited. Methodology: This was a retrospective, single-center, observational study conducted in a tertiary care center of East India between January 2016 and December 2017. Patients with chronic plaque psoriasis who were initiated on injection secukinumab during the study period and completed 52 weeks of observation period were included in the study. Analysis was performed using SPSS version 25. Results: Twenty patients were recruited in the study. Mean age of the patients was 46 years and mean duration of disease was 11 years. Eleven (55%) patients were biologic experienced and Nine (45%) patients were biologic naïve. Mean Psoriasis Area and Severity Index (PASI) score at baseline was 17.05 (±6.7). Fifteen (75%) patients achieved PASI75 at 4 weeks. Seventeen (85%) patients achieved PASI75, 13 (65%) achieved PASI90, and 10 (50%) patients achieved PASI100 at 12 weeks. Eighteen (90%), 10 (50%), and 7 (35%) patients maintained PASI75, PASI90, and PASI100 response, respectively, at the end of 52 weeks. Adverse effects were seen in 6 (30%) patients over 52 weeks. Drug discontinuation was required because of severe exacerbation of eczema and recalcitrant vulvovaginal candidiasis in one patient each. Conclusion: Secukinumab is an effective drug for the management of chronic plaque psoriasis even in patients who have previously been treated with systemic drugs and other biologics; however, adverse effects are more common as compared to what trial data suggest. Limitations of Study: Small sample size and retrospective study design are main limitations of the study. Strength of Study: This is first real-life data with 52 weeks follow up from India.
| A comparative study between topical adapalene (0.1%) versus a combination of topical adapalene (0.1%) and intense pulsed light therapy in the treatment of inflammatory and noninflammatory facial acne vulgaris: A split-face randomized controlled trial
Shah Karan, Jadhav Vikrant, Gugle Anil
Indian Journal of Drugs in Dermatology 2019 5(1):19-25
Introduction: Acne vulgaris is a common dermatological disorder encountered in dermatology practice. Various treatment modalities are available for acne. Lasers and light-based therapies are also gaining popularity with good clinical results. The choice of treatment depends on the type and severity of acne. Aims:(1) To evaluate the efficacy and safety of topical adapalene (0.1%) gel in facial acne vulgaris. (2) To evaluate the efficacy and safety of topical adapalene (0.1%) gel in combination with intense pulsed light (IPL) in facial acne vulgaris. (3) To compare the above results. Materials and Methods: A total of 50 patients with facial acne were included. IPL device equipped with an acne treatment filter emitting light between 430 and 1200 nm was used. Adapalene 0.1% in gel form was used. One side of the face was treated with plain adapalene gel and another side with a combination of daily application of adapalene, with fortnightly exposure of IPL. A total of four sittings of IPL at the interval of 15 days were given. Final evaluation was done 2 weeks after the last session of IPL. Results: On adapalene + IPL-treated side, statistically significant reduction in comedones started from the 2nd visit,P < 0.05. On the 6th visit, there was statistically significant difference in mean comedones (P < 0.05) between two sides. After the study (9 weeks), the mean reduction in inflammatory lesion was 69.98% for adapalene-treated side and 79.92% for combination therapy. Conclusion: IPL therapy with 430–1200 nm wavelength filter is an effective adjuvant therapy when used with adapalene 0.1 gel. It gives an additional benefit in the treatment of acne. We can avoid systemic antibiotics and retinoids using adapalene and IPL combination in mild-to-moderate acne.
| Oral ranitidine: A promising novel therapeutic option in molluscum contagiosum in children
Pooja Agarwal, Bhushan Madke, Priyanka Bodar
Indian Journal of Drugs in Dermatology 2019 5(1):26-29
Background: Molluscum contagiosum(MC) is one of the most common cutaneous viral infection observed in children. Though, it is benign and self-limiting, treatment is often sought for cosmetic reasons. Existing invasive therapeutic modalities are generally not well tolerated in children because of pain and risk of scarring. Immunomodulatory potential of cimetidine is well established. We thus extrapolated the same to ranitidine and conducted this study. Aim: To assess the efficacy of oral ranitidine in treatment of molluscum contagiosum in immunocompetent children. Methods: A multicentre longitudinal study was conducted in the dermatology departments of tertiary care hospitals in Ahmedabad and Wardha, India over a period of 4 months. 24 children with MC were included. Oral ranitidine was started in dose of 5 mg/kg/day in two divided doses for 8 weeks. Follow up was done very 15 days and changes in number and size of lesions were noted. Results: Mean age of patients was 5.08 years. 19 patients completed the study. 15 patients had improvement in the lesions at the end of 8 weeks while 4 patients did not show any improvement. Complete clearance was seen in 14 patients(73.6%) and 1 patient had decrease in size of the lesions without change in the number. Mean duration of complete clearance of lesion was 6.5 weeks. Conclusion: Oral ranitidine may be considered as a safe and effective alternative therapeutic option in widespread MC in immunocompetent children where invasive painful procedures are less desirable.
| Successful Treatment of Pyogenic Granuloma with Sclerotherapy
Neelima Bansal, Vasudha A Belgaumkar, Ravindranth B Chavan, Bhavana Ravindra Doshi
Indian Journal of Drugs in Dermatology 2019 5(1):30-33
Pyogenic granuloma (PG) is a common benign vascular proliferation that usually occurs on the skin and mucosa. Various treatment options exist in literature with no clear consensus. Our objective was to evaluate the efficacy and safety of sclerotherapy (sodium tetradecyl sulfate [STS]) in PG. This case series included 15 patients of PG, treated with intralesional injection of the STS (3%, 30 mg/ml) solution. All patients showed complete resolution of PG, without any major complication or recurrence during a 6-month follow-up period.
| Sorafenib-Induced Cutaneous Toxicities: Four Different Presentations
Pooja Bains, Saurabh Sharma
Indian Journal of Drugs in Dermatology 2019 5(1):34-37
Sorafenib is a multikinase inhibitor which is used in the treatment of hepatocellular carcinoma and renal cell carcinoma. The cutaneous toxicities due to sorafenib can affect the daily activities of patients, resulting in interruption or dose modification of therapy. We report four cases of adverse cutaneous effects of sorafenib along with their management. The cases represent the wide spectrum of sorafenib cutaneous toxicities from mild to severe.
| Thalidomide-induced leukocytoclastic vasculitis in leprosy
Vasudha Abhijit Belgaumkar, Pallavi Prataprao Patil, Ravindranath Brahmadeo Chavan, Prernaa R Suryataley
Indian Journal of Drugs in Dermatology 2019 5(1):38-41
Thalidomide has become the gold standard for the treatment of erythema nodosum leprosum (ENL) within a few decades of its serendipitous discovery for this condition. It has also demonstrated efficacy in dermatoses such as recalcitrant oral aphthae, prurigo nodularis, and pyoderma gangrenosum. Despite a good safety profile, thalidomide is known to cause side effects such as sedation, constipation, peripheral neuropathy, and thromboembolism. Although rare and anecdotal, adverse cutaneous drug reactions (ACDRs) have been reported. Both thalidomide and its newer analogs have been implicated for maculopapular, urticaria-angioedema, Steven–Johnson-like, toxic epidermal necrolysis, and acneiform eruptions. Only a few cases of leukocytoclastic vasculitis (LCV) occurring in patients of multiple myeloma on this drug have been described till date. However, this unusual presentation of ACDR due to thalidomide in leprosy has not been hitherto documented. Herein, we describe a patient of lepromatous leprosy with ENL who developed thalidomide-induced LCV and discuss myriad aspects such as immunopathogenesis with emphasis on the possible role of various cytokines such as interleukin (IL)-2, IL-6, IL-12, and tumor necrosis factor-alpha.
| "PRIDE" Complex: A Report of Two Cases
Shashank Krishna Agrawal, Bhagyashree Babanrao Supekar, Vaishali Wankhade, Rajesh Pratap Singh
Indian Journal of Drugs in Dermatology 2019 5(1):42-45
Epidermal growth factor receptor inhibitors are currently widely used for the treatment of nonsmall cell lung cancer and head-and-neck malignancy. These are associated with constellation of cutaneous reactions termed as PRIDE complex which comprises papulopustules and/or paronychia, regulatory abnormalities of hair growth, itching, and dryness. We report two cases of PRIDE complex, diagnosed clinically and histopathologically in patients of nonsmall cell carcinoma of the lung being treated with erlotinib and gefitinib.
| Drug-induced Henoch-Schonlein purpura with severe gastrointestinal involvement
Nibedita Dixit, Chinmoy Raj, Debasmita Behera, Maitreyee Panda
Indian Journal of Drugs in Dermatology 2019 5(1):46-48
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Anthropometric study of the frontal sinus on plain radiographs in Delta State University Teaching Hospital
Enaohwo Taniyohwo Mamerhi, Okoro Oghenerieborue Godswill
Journal of Experimental and Clinical Anatomy 2018 17(2):49-52
INTRODUCTION: The paranasal sinuses are air-filled spaces located within the bones of the skull and face. The different anatomical dimensions of paranasal sinuses can be obtained from plain radiograph and computed tomography images. Determining the possible significant variation of the right and frontal sinuses of males and females is essential for clinical purpose. PURPOSE OF THE STUDY: The purpose of this study, therefore, was to measure the anthropometric length and width of the frontal sinus on plain radiograph in different age groups and to determine the possible variations in males and females. MATERIALS AND METHODS: This descriptive cross-sectional study adopted the simple random sampling technique. The study population comprised 200 individuals (100 males and 100 females). RESULTS: Frontal sinus length and width were measured using the inelastic plastic ruler (in centimeter) and recorded on a data sheet pro forma. The mean total frontal sinus length and frontal sinus width across the entire population for both the right and left sides as regards males and females were given as (4.42 ± 4.79 cm, 3.85 ± 4.24 cm, 4.05 ± 4.44 cm, 3.57 ± 3.93 cm) and (3.64 ± 4.01 cm, 3.29 ± 3.46 cm, 3.23 ± 3.57 cm, 2.83 ± 3.13 cm), respectively. The Student's t-test statistics between the right and left sides in each of the studied parameters were highly statistically significant (P = 0.000). CONCLUSION: The frontal sinus is a constant structure in human beings, but shape and dimensions may vary among individuals; thus, the dimorphic nature of the left frontal sinus dimensions has implications for human identification.
| A simple and sensitive immunoassay method for the detection of low-molecular-weight proteins and neuropeptides
Abayomi Ajayi, Boonsirm Withyachumnarnkul
Journal of Experimental and Clinical Anatomy 2018 17(2):53-55
BACKGROUND: Low-molecular-weight proteins and peptides perform numerous regulatory roles in biological systems and could be useful as biomarkers. Hence, qualitative and quantitative measurement of peptide levels has become increasingly important. AIM: This present study was aimed at developing a simple and sensitive dot immunoblot assay (DIA) by modifying existing protocols. MATERIALS AND METHODS: Using polyclonal antibody generated against FMRFamide peptide, at a dilution ratio of 1:10,000 in buffer, as a primary antibody, alkaline phosphatase-conjugated goat anti-rabbit antibody as secondary antibody and nitro blue tetrazolium/5-bromo-4-chloro-3-indolyl phosphate development system, peptides were dotted on 0.2μm nitrocellulose membrane in volumes of 1μl, 0.5μl and 0.2μl. RESULTS: Results show immunoreactivity of FMRFamide antibody to small quantities of dotted neuropeptide as low as 0.2ng and 33.4pM. CONCLUSION: This indicates that this protocol is sensitive with the additional advantage of simplicity, speed, small sample volume, low cost, and production of nonhazardous waste. This DIA protocol could be useful in resource-poor settings and laboratories with low budgets.
| Risk of foot complications in diabetes mellitus; how much do the diabetes mellitus patients in Enugu know?
Wilfred Okwudili Okenwa, Anthony Jude Edeh
Journal of Experimental and Clinical Anatomy 2018 17(2):56-59
BACKGROUND: Diabetes Mellitus is a disease that has multisystem effects and complications are known to develop in several organs after some years. Diabetic foot problems are largely preventable and both care givers and the diabetic patient must place high priority on prevention through education. Health providers in developing countries are inadequate, overworked and do not have enough time to spend on health education of their patients. AIM: This study was carried out to evaluate the level of awareness of diabetes mellitus patients of complications of the disease seen in the foot in order to plan and execute effective health education programme to reduce complications. MATERIALS AND METHODS: This prospective study was carried out in the medical outpatient clinic of ESUT teaching Hospital Enugu from January to July 2015 using pretested structured questionnaire. RESULTS: 283 patients were sampled but only 260 supplied data for analysis. In the study, 150(57.7%) were females and 110(42.3%) were males. Age of the participants ranged from 32years to 88years, with mean age 0f 60.2years. Majority of the participants 258(99.2%) had been educated on common foot complications seen in diabetes mellitus. Only 70(27%) of the respondents could recognise loss of sensation in the foot as a sign of foot complication. CONCLUSION: Diabetic foot complication is still high in our diabetics and represents failure of preventive measures, requiring change of modality. Better education of diabetics must be emphasised in addition to any other attempt to curtail the problem.
| Subchronic dichlorvos-induced Cardiotoxicity in Wistar rats: Mitigative efficacy of Nigella sativa oil
Aminu Imam, Maryam Oluwatobi Busari, Misturat Yetunde Adana, Musa Iyiola Ajibola, Abdulmumin Ibrahim, Fatimoh Ajoke Sulaimon, Moyosore Salihu Ajao
Journal of Experimental and Clinical Anatomy 2018 17(2):60-65
BACKGROUND: Accidental poisoning from indiscriminate use of organophosphates have become endemic in recent decades, most especially in developing nations, coupled with the limitations of the availability of satisfactory antidotes. AIM OF THE STUDY: Thus, we investigated the cardioprotective efficacy of Nigella sativa oil (NSO) following dichlorvos dichlorvos (DDVP)-induced cardiotoxicity in Wistar rats. MATERIALS AND METHODS: A total of 24 Wistar rats were randomly divided into four groups (n = 6); the control was administered sunflower oil (1 ml/kg), DDVP (8.8 mg/kg) to the experimental Group I, whereas DDVP + NSO (8.8 mg/kg +1 ml/kg) and NSO (1 ml/kg) was administered orally to the experimental Groups II and III, respectively. The animals were euthanized; blood was transcardially collected from the right atrium, centrifuged, and plasma extracted to analyze levels of total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol (LDL-C). While cardiac muscle tissue was collected from the left heart, processed and stained for general architecture (hematoxylin and eosin) and elastic morphology (orcein). RESULTS: DDVP significantly (P ≤ 0.05) increased the plasma levels of TC, LDL, atherogenic and atherosclerotic indices (TC/HDL-C and LDL-C/HDL-C ratios), but this was prevented by co-administration with NSO. Histological investigations showed that DDVP resulted in the pathological appearance of cardiac tissues, such as the lack of striations, myocardial hemorrhage, and necrosis-like features. CONCLUSION: It can be concluded that NSO was able to attenuate DDVP-induced cardiotoxicity.
| Presence of GFSKLYFamide-like neuropeptide in the nervous tissue of Holothuria scabra: Immunohistochemical evidence
Abayomi Ajayi, Boonsirm Withyachumnarnkul
Journal of Experimental and Clinical Anatomy 2018 17(2):66-69
BACKGROUND: Physiological activities in animals and other biological systems are often regulated by neuropeptides. GFSKLYFamide neuropeptide, an echinoderm SALMFamide, was first isolated from the sea cucumber, Holothuria glaberrima, an echinoderm, in 1992 (Díaz-Miranda et al., 1992). Since this discovery, there have been unresolved questions regarding the interphyletic and intraphyletic distribution of GFSKLYFamide neuropeptide. AIM: The study was done in an attempt to answer these questions. MATERIALS AND METHODS: An immunohistochemical study was conducted on the radial nerve cord of Holothuria scabra utilizing an antibody specifically raised against GFSKLYFamide. RESULTS: Results show strong and widespread localization of GFSKLYFamide immunoreactivity, including the ectoneural and hyponeural regions of the radial nerve cord. CONCLUSION: This, to the best of our knowledge, is the fi rst report that provides evidence for the presence of GFSKLYFamide-like neuropeptide in the nervous tissue of this species.
| Topographic anatomy of the neurovascular bundle at the tarsal tunnel and its applied significance
Nehal Mohamed Nabil, Nesrine Al Homosani, Dalia Biram
Journal of Experimental and Clinical Anatomy 2018 17(2):70-75
BACKGROUND: There are different surgical procedures and treatment modalities dealing with medial ankle region such as placement of percutaneous pins in the calcaneus, decompression in tarsal tunnel syndrome, and nerve block. This requires detailed anatomical knowledge about the neurovascular bundle to avoid iatrogenic injury. AIM OF THE WORK: To study the topography of nerves and vessels at the tarsal tunnel in relation to surface anatomical landmarks. MATERIALS AND METHODS: The medial calcaneal region of 20 lower limbs of formalin preserved specimens was dissected. The neurovascular structures were identified within a quadrangle named ABCD, formed by four palpable bony landmarks, respectively: inferior tip of medial malleolus, posterior superior tip of calcaneal tuberosity, posteroinferior aspect of medial calcaneus, and tuberosity of navicular bone. A regression analysis was done to correlate the lengths of the four imaginary lines connecting the four bony landmarks with the location of the neurovascular structures. RESULTS: The posterior tibial artery was located medial to the tibial nerve in 50% of cases. The bifurcation of the artery was found to be proximal to that of the nerve in only one case. The number of the medial calcaneal nerves (MCNs) varied from 1 to 3 branches; the most common was one branch (50%). In two cases, there was high origin of the MCN at a distance of 15.4 and 23.5 cm proximal to the ankle region. CONCLUSION: The location of the neurovascular bundle at the tarsal tunnel could be predicted by measuring the distances between the anatomical bony landmarks.
| Bilateral "quadriceps gastrocnemius" and termination of small saphenous vein outside the popliteal fossa in a cadaver
Dawit Habte Woldeyes, Abebe Muche Moges
Journal of Experimental and Clinical Anatomy 2018 17(2):76-78
The gastrocnemius muscle located on the posterior compartment of the leg, has two heads. Muscular variations presumably seriously compromise parts of the muscular, vascular, nervous, and skeletal and/or organ systems. The main causes of gastrocnemius muscle variation may be due to an error of embryologic developmental timing or persistence of an embryologic condition. On the other hand, variations in the origin, course, and termination of the superficial veins of the lower limb are common. However, variations of the short saphenous are rarely reported. Knowledge on the anatomical variations of structures has clinical significance to surgeons, radiologists who interpret plain and computerized imaging.
| Successful antibiotic therapy in early prosthetic valve endocarditis with large vegetation
Erick Hoetama, Bambang Budi Siswanto, Rarsari Soerarso, Nani Hersunarti
Journal of Experimental and Clinical Anatomy 2018 17(2):79-81
Prosthetic valve endocarditis (PVE) is a fearful complication of cardiac valve replacement surgery. Compared with the late presentation, early PVE is associated with higher rates of morbidity and mortality. Despite significant improvement in our understanding regarding the treatment of native valve endocarditis, the optimal treatment for PVE is still a matter of debate. There is still no clear agreement whether to choose surgery or medication as the best therapeutic option for PVE patient. Furthermore, the timing of surgery for PVE has not yet been defined.
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Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity
Eating disorders and disordered eating behaviors in males: a challenging topic
| The behavioral and affective profile of inpatient adolescent girls with restrictive anorexia nervosa
AbstractBackgroundA better understanding of the individual difficulties reported by adolescents presenting with anorexia nervosa seems like an interesting avenue to refine our understanding of their psychological functioning. ObjectiveThis study aimed to: (1) describe the behavioral and affective profile of difficulties of inpatient adolescent girls presenting a restricting type of anorexia (ANR); and (2) investigate the presence of a relationship between behavioral and affective problems and severity of the disorder. MethodsThe sample consisted of 52 inpatient adolescent girls presenting an ANR. The youth self report assessed the behavioral and emotional profile of difficulties of participants while the Eating Disorder Risk Composite of the Eating Disorder Inventory measured the symptomatology of the disorder. A ratio between body mass index at admission and at the end of the treatment served as an indicator of weight gain. ResultsThe sample presented an internalized profile of problems. Individual differences were found and three profiles of difficulties were present in the sample: normative, pure internalizing and mixed (clinical on the internalizing and externalizing clusters). ConclusionThis study provides information on the heterogeneity of this specific population otherwise quite similar and demonstrates how severity of the disorder can be associated with a wide range of other behavioral and affective difficulties. Level of evidenceLevel V, cross-sectional descriptive study.
| Selflessness as a predictor of remission from an eating disorder: 1–4 year outcomes from an adolescent day-care unit
AbstractObjectiveTo assess the potential role of selflessness in predicting remission from an eating disorder (ED) following discharge from an adolescent day-care unit. MethodParticipants were 95 female patients (aged 13–19 years) with an ED diagnosis across the spectrum admitted to an adolescent day-care unit for EDs between 2008 and 2012. Forty-one of these participants completed the follow-up assessment, between 12 and 46 months following discharge. No significant differences were found in Time 1 variables between patients who participated in Time 2 and those who did not. At both time points, ED and psychiatric comorbidity diagnoses were made using standard structured interviews. Patients were also administered the Beck Depression Inventory (BDI), the State-Trait Anxiety Inventory (STAI), The Eating Attitude Test (EAT-26), The Eating Disorder Inventory (EDI-2) and the Selflessness Scale (SS)*. ResultsOnly baseline Selflessness Scale was significant in predicting the continuous variable of ED symptomatology level in follow-up. When dividing EDI total score into its subscales at baseline, one of those, maturity fears, was found, together with the SS, significant in the prediction. In predicting remission (this time as a dichotomized variable) in follow-up, only the SS, maturity fears, EDI total, and EAT-26, at baseline, predicted remission at follow-up, but the strength of selflessness was the greatest. ConclusionsPsychological features are not the main target of the important search for predictors of remission from ED. The findings of the present study add the psychological feature of selflessness to this search. Psychotherapy can be enriched by identifying psychological features such as selflessness as one of its foci. The present findings might also renew interest in maturity fears as an additional focus in psychotherapy. Level of evidenceLevel III, cohort study.
| The association between Food and Alcohol Disturbance (FAD), race, and ethnic identity belonging
AbstractPurposeA growing body of literature has established that food and alcohol disturbance (FAD: decreasing one's caloric intake in preparation for alcohol consumption) is a specific health risk that endangers health and wellbeing. Recent research on trends in FAD has revealed ethno-racial disparities. A sociological analysis is helpful to center race and examine the role of ethnic identity in reproducing health disparities. The current study is guided by theories of socialization into ideal body types by race. MethodsStudy uses data from a cross-sectional survey conducted among college students. The sample includes White and Black American college students, ages 18–25, and uses ordinal logistic regression to test for the impact of race and ethnic identity on engagement in FAD using the Compensatory Eating and Behaviors in Response to Alcohol Consumption Scale (CEBRACS). ResultsFAD prevalence was lower among Black Americans than among White Americans in the sample. Results from ordered logistic regression models indicate that stronger ethnic ties reduce likelihood of FAD among Black Americans but have the opposite effect among White Americans. This modification effect provides evidence that ethnic identity belonging protects against FAD for Black Americans but acts as a risk factor for FAD among White Americans. ConclusionsFindings shed light on the documented racial disparities in FAD and weight control behavior more broadly. Ethnic identity modifies the relationship between race and FAD in our sample. Level of evidenceLevel V, cross-sectional descriptive study
| Characteristics of patients in an eating disorder sample who dropped out: 2-year follow-up
AbstractObjectiveThis manuscript explores the characteristics of individuals diagnosed with an eating disorder who dropped out of treatment, compared with those who completed it. MethodThe participants were 196 patients diagnosed with eating disorders (according to DSM-IV-TR criteria) who consecutively began treatment for the first time in an eating disorders unit. They were assessed at baseline with a set of questionnaires evaluating eating habits, temperament, and general psychopathology. During the follow-up period, patients who dropped out were re-assessed via a telephone interview. ResultsIn the course of a 2-year follow-up, a total of 80 (40.8%) patients were labeled as dropouts, and 116 (59.2%) remaining subjects were considered completers. High TCI scores in the character dimensions of Disorderliness (NS4) (p < .01) and total Novelty Seeking (NST), along with low scores in Dependency (RD4), were significantly associated with dropout in the course of 2 years. Once the results were submitted to logistic regression analysis, dropout only remained associated with high scores in Disorderliness (NS4) and, inversely, with an initial Anorexia Nervosa (AN) diagnosis (p < .05). Reasons for dropout stated by the patients included logistic difficulties, subjective improvement of their condition, and lack of motivation. DiscussionClinicians should handle the first therapeutic intervention with particular care in order to enhance their understanding of clients and their ability to rapidly identify those who are at risk of dropping out of treatment. Level of evidenceLevel III: Cohort Study.
| Food craving predicts the consumption of highly palatable food but not bland food
AbstractThe impact of obesity on physical and psychological health is well recognized in the literature with, among others, evidence of alterations in cognition. Indeed, obese populations are characterized by lower executive functions as well as an enhanced food craving. However, the relationship between executive functions and food craving remains unexplored. Moreover, these two variables have also been shown to predict food intake, but studies in the context of obesity are lacking. Thus, this study had two objectives: (1) determining if executive functions and food craving are linked, and (2) examining the predictors of highly palatable food intake and bland food intake. First, it was hypothesized that executive functions would be negatively associated with food craving. Second, it was expected that food craving would predict positively highly palatable food intake but not bland food intake. Third, it was predicted that executive functions would predict negatively highly palatable food intake and positively bland food intake. 48 participants (34 females) with BMIs ranging from 17.9 to 46.4 took part in two experimental sessions. First, executive functions were assessed using the delayed discounting task (impulsivity towards food and money) and the color–word interference test (CWIT; inhibition/flexibility). Second, a cue-induced food craving protocol, with images as well as real food, was administered followed by an ad libitum food intake protocol including both highly palatable and bland food. The inhibition/flexibility condition of the CWIT was significantly and negatively correlated with food craving following induction. Highly palatable food intake was significantly predicted by food craving following induction, but bland food intake was not. This study reveals an association between lower inhibition/flexibility and susceptibility to food craving induction that is of great importance in obesogenic environments. Moreover, this study confirmed the link between food craving and food intake, and showed for the first time a specific contribution of food craving to highly palatable food intake but not to bland food intake, highlighting its potential influence in obesity. This work leads to future research questions regarding the possible benefits of cognitive remediation interventions, as well as interventions aiming at reducing food craving, in weight loss programs. Level of evidenceLevel IV, quasi-experimental study.
| Gender differences in relations between alcohol-related compensatory behavior and eating pathology
AbstractPurposeConcerns about caloric intake associated with alcohol use (e.g., fear of weight gain) are positively associated with compensatory eating behaviors (e.g., caloric restriction, self-induced vomiting), a phenomenon that has been identified across gender. Specific motivations for compensatory behaviors differ; some relate to eating disorder (ED) pathology (e.g., shape and weight concerns), and others to alcohol (e.g., enhancing effects). Research examining motivations for alcohol-related compensatory behaviors in men is limited to date. The current study sought to assess how specific types of alcohol-related compensatory behaviors and their association with ED pathology present differently by gender. MethodsUndergraduates (N = 530, 48% female) completed the Compensatory Eating Behaviors in Response to Alcohol Consumption Scale (CEBRACS), Eating Disorders Diagnostic Scale (EDDS), and reported height, weight, and frequency and quantity of alcohol consumption. Data were examined using linear regression, and relations between CEBRACS behaviors and eating pathology were compared across gender. ResultsFactors that were positively associated with EDDS scores for both men and women included alcohol-related dietary restraint, and exercise. For women, but not men, alcohol-related bulimic behavior also contributed to elevations in EDDS scores. ConclusionsFindings indicate that specific types of alcohol-related compensatory eating behaviors (i.e., dietary restraint and exercise) are positively related to ED pathology for both male and female participants. In contrast, bulimic behaviors' association with ED pathology is gender specific. Understanding gender differences in alcohol-related compensatory behaviors and ED risk may inform gender-specific intervention targets. Level of evidenceCross-sectional descriptive study, Level V.
| Testing virtual reality-based cue-exposure software: Which cue-elicited responses best discriminate between patients with eating disorders and healthy controls?
AbstractPurposeVirtual reality (VR) technologies have been proposed as a new tool able to improve on in vivo exposure in patients with eating disorders. This study assessed the validity of a VR-based software for cue exposure therapy (CET) in people with bulimia nervosa (BN) and binge eating disorder (BED). MethodsFifty eight outpatients (33 BN and 25 BED) and 135 healthy participants were exposed to 10 craved virtual foods and a neutral cue in four experimental virtual environments (kitchen, dining room, bedroom, and cafeteria). After exposure to each VR scenario, food craving and anxiety were assessed. The frequency/severity of episodes of uncontrollable overeating was also assessed and body mass index was measured prior to the exposure. ResultsIn both groups, craving and anxiety responses when exposed to the food-related virtual environments were significantly higher than in the neutral-cue virtual environment. However, craving and anxiety levels were higher in the clinical group. Furthermore, cue-elicited anxiety was better at discriminating between clinical and healthy groups than cue-elicited craving. ConclusionsThis study provides evidence of the ability of food-related VR environments to provoke food craving and anxiety responses in BN and BED patients and highlights the need to consider both responses during treatment. The results support the use of VR-CET in the treatment of eating disorder patients characterized by binge-eating and people with high bulimic symptoms.
| Eating disorder symptoms and the 2 × 2 model of perfectionism: mixed perfectionism is the most maladaptive combination
AbstractPurposeThe 2 × 2 model of perfectionism (Gaudreau and Thompson in Personal Individ Diff 48:532–537, 2010) represents an important addition to the perfectionism literature, but so far has not been studied in relation with disordered eating. MethodUsing the 2 × 2 model as analytic framework, this study examined responses from a convenience sample of 716 participants aged 19–68 years (71% female) investigating how self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP) predicted individual differences in eating disorder symptoms, additionally controlling for body mass index, gender, and age. ResultsResults showed a significant SOP × SPP interaction indicating that the combination of high SOP and high SPP—called "mixed perfectionism"—was associated with the highest levels of eating disorder symptoms. ConclusionsThe findings demonstrate the utility of the 2 × 2 model of perfectionism as an analytic framework for examining perfectionism and disordered eating. Moreover, they suggest that mixed perfectionism is the most maladaptive form of perfectionism when it comes to disordered eating, such that having high levels of SPP combined with high levels of SOP represents the most maladaptive combination of perfectionism in terms of risk of eating disorder. Level of evidenceLevel V, cross-sectional descriptive study.
| Baseline motives for eating palatable food: racial differences and preliminary utility in predicting weight loss
AbstractPurposeBehavioral predictors of weight-loss program (WLP) outcomes are needed and important because they can be modified. Eating calorie-dense palatable foods (PFs) outside of hunger contributes to obesity. This study assessed if habitual motives to consume PFs could predict weight-loss outcomes. MethodsN = 171 Black and N = 141 White adults in a reduced-calorie program completed the Palatable Eating Motives Scale (PEMS). Body weight and body mass index (BMI) lost after 3 and 6 months were analyzed controlling for initial BMI and demographics. Greater PEMS motive scores meant more frequent habitual intake of PFs for that motive. ResultsWhites vs. Blacks had higher scores on most of the PEMS motives: Social, Coping, and Reward Enhancement. In Whites at 3 months, greater Reward Enhancement scores and initial BMI predicted more BMI loss (p < 0.05). At 6 months, greater Reward Enhancement and lower Conformity scores predicted more weight (p < 0.05) and BMI loss (Conformity: p < 0.05; Reward Enhancement: p = 0.05). PEMS motives did not predict outcomes for Blacks. ConclusionThe results provide preliminary evidence for the PEMS to predict WLP outcomes. White patients who eat PFs primarily for their rewarding properties and less to conform should fare better in Lifestyle programs while group or family-based interventions may be more efficacious when conformity is the main motive. Lower motive scores among Blacks suggest that eating PFs outside of hunger may go unrecognized or underreported and warrants further investigation. The findings highlight the motive-based heterogeneity of obesity and how it may be used to predict outcomes and customize interventions to improve WLP outcomes. Level of evidenceLevel IV, multiple time series.
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Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
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Ethical, Policy, and Practice Implications of Nurses' Experiences With Assisted Death: A Synthesis
The conceptualization of assisted death as an act performed by physicians has resulted in a lack of attention to nurses' roles and experiences with the processes that surround an assisted death. In this article, we synthesize evidence from 6 articles focusing on the experiences of 55 nurses from Canada, Belgium, and the Netherlands, with relevant ethical and policy implications derived from the literature. Nurses have a central role in negotiating inquiries about assisted death and in providing wraparound care for patients, families, and other health care providers. This role is impactful for nurses and requires significant personal and professional moral work. Correspondence: Barbara Pesut, PhD, RN, University of British Columbia, Okanagan, 1147 Research Rd, ARTS 3rd Floor, Kelowna, BC V1V 1V7, Canada (Barb.pesut@ubc.ca). This work received funding from the Canadian Institutes of Health Research (201610PJT-376065). Dr Pesut is supported, in part, by the Canada Research Chairs Program. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
| Letter to the Editor
No abstract available
| Letter to the Editor
No abstract available
| Reconceptualizing the Electronic Health Record for a New Decade: A Caring Technology?
Since the 2009 publication by Petrovskaya et al on, "Dilemmas, Tetralemmas, Reimagining the Electronic Health Record," and passage of the Health Information Technology for Economic Clinical Health (HITECH) Act, 96% of hospitals and 78% of providers have implemented the electronic health record. While many positive outcomes such as guidelines-based clinical decision support and patient portals have been realized, we explore recent issues in addition to those continuing problems identified by Petrovskaya et al that threaten patient safety and integrity of the profession. To address these challenges, we integrate polarity thinking with the tetralemma model discussed by Petrovskaya et al and propose application of a virtue ethics framework focused on cultivation of technomoral wisdom. Correspondence: Catherine Robichaux, PhD, RN, 2541 Gramercy Park Dr, Flower Mound, TX 75028 (robichaux@uthscsa.edu). The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
| Clinical Information Needs: A Concept Analysis
Health care organizations have invested resources to implement and upgrade information systems capable of collecting large quantities of data. Recent technology developments have created a renewed interest in studying clinician information needs. However, a common definition and analysis of the concept clinical information needs have not been provided. Walker and Avant's method was used to perform a concept analysis. Following a review of relevant literature, a clinical information need was defined as a conscious expression, which can be verbal or nonverbal, of a desire for knowledge to answer clinical questions in the course of decision making to deliver patient care. Correspondence: Cara S. Schlegel, MS, RN, The University of Texas at Austin, School of Nursing, 1710 Red River St, Austin, TX 78701 (cara.schlegel@utexas.edu). The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
| Reducing 30-Day Readmissions Through Nursing Science: An Application of Transitions Theory With Best Practice Guidelines
The Transition Management Model was developed by and for nurse care coordinators at an Independent Health Network to reduce Medicare and Medicaid 30-day readmission rates. Preimplementation assessment revealed the need for a nursing science framework to effectively reduce 30-day readmissions. The model was developed through thoughtful integration of transitions theory with best practice guidelines set forth by Project BOOST. Initial results of the Transition Management Model produced a decline in readmission rates by 11%. The Transition Management Model initiative can serve as an exemplar for the integration of transitions theory to best practice guidelines to effectively reduce 30-day readmissions. Correspondence: Bridget Stixrood, MSN, RN, CNL, 220 Tacoma Ave S, Apt 402, Tacoma, WA 98402 (bridgetstixrood@gmail.com). The author has disclosed that she has no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
| Analyzing Patients' Complaints: Awakening of the Ethic of Belonging
Nursing ethics are fundamental principles to nursing practice. The purpose of this study is to analyze patients' complaints filed against nurses from a nursing ethics perspective. This is a qualitative study. The data source is the patients' complaints filed in a university-affiliated hospital in China. The complaints are categorized into 4 themes: uncompassionate attitudes, unprofessional communication, disrespect of patient rights, and unsatisfactory quality of nursing care. The ethic of belonging reflects nurse-patient relations. Patients expect to be treated with dignity. This study sends out a call for nurse leaders and educators to reevaluate the practice and education of the nursing professional identity. Correspondence: Holly Wei, PhD, RN, Graduate Nurse Leadership, College of Nursing, East Carolina University, Greenville, NC 27834 (weih16@ecu.edu). The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. We would like to acknowledge the reviewers for their constructive feedback to improve the quality of this article. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
| Toward a System Theory of Stress, Resilience, and Reintegration
Military to civilian reintegration is a complex, multidimensional phenomenon warranting holistic perspectives. Complex phenomena require theory to understand and interpret relationships among concepts. Despite the need for theory-driven research, recent nursing reports often lack a theoretical structure. We extracted relevant concepts from the Neuman's Systems Model (stressors, environment, and person) and the Transactional Model of Stress and Coping (primary and secondary appraisal, coping, and adaptation) to form a Conceptual-Theoretical-Empirical model. Exemplar empirical instruments are presented, along with their conceptual and theoretical dimensions. An integrated System Theory of Stress, Resilience, and Reintegration is presented with its utility demonstrated through a research application. Correspondence: Anna G. Etchin, PhD, RN, Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, 150 S Huntington Ave (182 JP), Jamaica Plain, MA 02130 (Anna.Etchin@va.gov). The first author sincerely thanks Dr Clifford for the Clifford Scholarship in the name of his late wife, Joyce Clifford. Dr Etchin was supported by a Veterans Affairs OAA Polytrauma fellowship, Jonas Veterans Healthcare Scholar grant 2016-2018, and Sigma grant 2018. This material is the result of work supported with resources and the use of facilities at the VA Boston Healthcare System. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs of the United States government. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
| Intersectionality and Critical Realism: A Philosophical Framework for Advancing Nursing Leadership
This article presents intersectionality theory with critical realism as a philosophical framework for studying nursing leadership. In response to gaps in the current leadership literature, the aim is to develop an approach that addresses how the multiple social positions nurses hold can create an intersecting matrix of oppression that impacts on their opportunities to develop as leaders. The result is a theoretical foundation, which can inform the methodological framework of future studies. Providing evidence by which a reader can judge the merits of a chosen methodology, it sets the case for integrating intersectionality with critical realism for studying nursing leadership. Correspondence: Cathleen Aspinall, MSc, RN, School of Nursing, University of Auckland, 85 Park Rd, Grafton, Auckland, New Zealand (c.aspinall@auckland.ac.nz). The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
| Analysis and Evaluation of Conceptual Model for Health-Related Quality of Life Employing Fawcett and DeSanto-Madeya's Critique Framework
Health-related quality of life is increasingly used as a predictor in nursing research and practice because its multidimensional constructs encompass the holistic spectrum of care. This article comprehensively analyzes and evaluates the conceptual model of health-related quality of life of Ferrans and colleagues using Fawcett and Desanto-Madeya's 2013 framework. The model encompasses all relevant concepts and propositions in its theoretical foundation while maintaining consistency with the nursing metaparadigm. Also, the model has comprehensive content, appropriate context, and social and theoretical significance. To maximize the model's empirical and pragmatic adequacy, researchers should carefully define the variables associated with each concept. Correspondence: Min Kyeong Jang, PhD, KOAPN, RN, Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, 845 S. Damen Ave, MC 802, Chicago, IL 60612 (mjang21@uic.edu). The authors are grateful to Dr Carol Ferrans of the University of Illinois at Chicago for making herself available to answer questions about her Conceptual Model for Health-Related Quality of Life. This study was funded in part by the National Institute of Nursing Research of the National Institutes of Health (K24NR015340), the Sigma Alpha Lambda Chapter, and the PhD Research Award from the University of Illinois at Chicago, College of Nursing. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.
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Effect of Gestational Age on Maternofetal Vascular Function Following Single Maternal Engineered Nanoparticle Exposure
AbstractNormal pregnancy outcome is accomplished, in part, by rapid and expansive physiological adaptations to the systemic circulation, the extent of which is specific to gestational day (GD) and anatomical location. Pregnancy-related hemodynamic changes in uterine placental blood flow stimulate compensatory vascular signaling and remodeling that begins early and continues throughout gestation. Exposure of the maternal environment to engineered nanomaterials (ENM) during pregnancy has been shown to impact health of the dam, fetus, and adult offspring; however, the consequences of specific temporal (gestational age) and spatial (vascular location) considerations are largely undetermined. We exposed pregnant Sprague–Dawley rats to nano-TiO2 aerosols at three critical periods of fetal development (GD 4, 12, and 17) to identify vascular perturbations associated with ENM exposure at these developmental milestones. Vascular reactivity of the maternal thoracic aorta, the uterine artery, the umbilical vein, and the fetal thoracic aorta were evaluated using wire myography on GD 20. While impairments were noted at each level of the maternofetal vascular tree and at each exposure day, our results indicate the greatest effects may be identified within the fetal vasculature (umbilical vein and fetal aorta), wherein effects of a single maternal inhalational exposure to nano-TiO2 on GD 4 modified responses to cholinergic, NO, and α-adrenergic signaling.
| Acute and Subacute Effects of Low Versus High Doses of Standardized Panax ginseng Extract on the Heart: An Experimental Study
AbstractPanax ginseng is commonly used in Chinese medicine and Western herbal preparations. However, it has also been recently noted to be associated with some cardiac pathologies-including cardiogenic shock due to acute anterior myocardial infarction, trans-ischemic attack, and stent thrombosis. This study was aimed to elucidate acute and subacute effects of the low and high doses of standardized Panax ginseng extract (sPGe) on cardiac functions. Rats were randomly assigned to control group, acute low-dose group (ALD), subacute low-dose group (SALD), acute high-dose group (AHD), and subacute high-dose group (SAHD). The cardiac effects of sPGe were evaluated using hemodynamic, biochemical, echocardiographic, genetic, and immunohistopathologic parameters. Mean blood pressures were significantly lower in all sPGe-treated groups compared with the control group. Troponin I and myoglobin levels were increased in the SALD, AHD, and SAHD groups. Mitral E-wave velocity was reduced after sPGe administration in all the groups. Acidophilic cytoplasm and pyknotic nucleus in myocardial fibers were observed in AHD and SAHD groups. Cu/Zn-SOD1 gene expressions were significantly higher in the sPGe-treated groups whereas caveolin 1 and VEGF-A gene expressions were not changed. According to our results, sPGe may have a potential effect to cause cardiac damage including diastolic dysfunction, heart failure with preserved ejection fraction, and reduction of blood pressure depending on the dose and duration of usage. Healthcare professionals must be aware of adverse reactions stemming from the supplementation use, particularly with cardiac symptoms.
| Ischemic Preconditioning Efficacy Following Anabolic Steroid Usage: A Clear Difference Between Sedentary and Exercise-Trained Rat Hearts
AbstractPrevious studies show that anabolic steroids impair innate cardioprotective mechanisms. Here, we investigated the effect of supraphysiological doses of nandrolone on ischemic preconditioning (IPC) as a potent cardioprotective tool against ischemia reperfusion (IR) injury in rat hearts. Male Wistar rats in two experimental settings of sedentary and exercise-trained (60 min/day swimming, 5 days/week, for 8 weeks) were either pretreated with intramuscular injections of arachis oil (Arach, n = 16) as vehicle or nandrolone decanoate (ND, n = 8), 10 mg/kg/week, for 8 weeks. At the end, the hearts were excised and perfused in a Langendorff system. Then, the vehicle-treated hearts subdivided into the IR (30 min of LAD coronary artery occlusion and 120 min reperfusion, n = 8) and IPC (three cycles of 3-min ischemia and 3-min reperfusion before test ischemia, n = 8) groups and nandrolone-treated hearts served as ND + IPC (nandrolone pretreatment before IR and IPC protocols, n = 8) group. Post-ischemic cardiac function and infarct size were assessed. Reperfusion arrhythmias were analyzed using a standard scoring system. In sedentary hearts, ND slightly increased heart-to-body weight ratio and increased baseline cardiac contractile function. In trained hearts, ND markedly increased heart-to-body weight ratio which was also associated with enhanced baseline cardiac function. ND pretreatment enhanced protective effects of IPC in sedentary group; however, abolished these effects in exercise-trained group. The arrhythmia score was not significantly different between nandrolone-treated groups vs. respective preconditioned groups. Our findings show that ND impairs IPC-induced cardioprotection in exercise-trained rat hearts. Cardiac hypertrophy seems to play a crucial role in this response.
| SSeCKS/Gravin/AKAP12 Inhibits PKCζ-Mediated Reduction of ERK5 Transactivation to Prevent Endotoxin-Induced Vascular dysfunction
AbstractSSeCKS/Gravin/AKAP12 is a protein kinase C (PKC) substrate that inhibits the activity of PKC through binding with it. SSeCKS is expressed in vascular endothelial cells (ECs). The atypical PKC isoform ζ (PKCζ) is a pathologic mediator of endothelial dysfunction. However, the functional significance of SSeCKS/PKCζ dimerization in the vascular endothelium remains poorly understood. Given this background, we investigated the effects of SSeCKS on endothelial dysfunction and elucidated the possible mechanism involved. Vascular endothelial dysfunction and inflammatory changes were induced by treatment with bacterial endotoxin lipopolysaccharide (LPS, a vascular endothelial toxicity inducer). LPS can increase the level of SSeCKS. However, we also found that depletion of SSeCKS aggravated the LPS-induced vascular endothelial dysfunction, upregulated pro-inflammatory proteins and phosphorylation level of PKCζ, increased ROS formation, decreased extracellular-signal-regulated kinase 5 (ERK5) transcriptional activity, and reduced eNOS expression. Further examination revealed that depletion of SSeCKS increased PKCζ/ERK5 dimerization. These findings provide preliminary evidence that the expression of SSeCKS induced by LPS, as a negative feedback mechanism, has the potential to improve endothelium-dependent relaxation in vascular disease conditions by inhibiting PKCζ-mediated reduction of ERK5 transactivation.
| Linoleic Acid Metabolite DiHOME Decreases Post-ischemic Cardiac Recovery in Murine Hearts
AbstractCardiac ischemia/reperfusion injury is associated with the formation and action of lipid mediators derived from polyunsaturated fatty acids. Among them, linoleic acid (LA) is metabolized to epoxyoctadecanoic acids (EpOMEs) by cytochrome P450 (CYP) epoxygenases and further to dihydroxyoctadecanoic acids (DiHOMEs) by soluble epoxide hydrolase (sEH). We hypothesized that EpOMEs and/or DiHOMEs may affect cardiac post-ischemic recovery and addressed this question using isolated murine hearts in a Langendorff system. Hearts from C57Bl6 mice were exposed to 12,13-EpOME, 12,13-DiHOME, or vehicle (phosphate buffered sodium; PBS). Effects on basal cardiac function and functional recovery during reperfusion following 20 min of ischemia were investigated. Electrocardiogram (ECG), left ventricular (LV) pressure and coronary flow (CF) were continuously measured. Ischemia reperfusion experiments were repeated after administration of the sEH-inhibitor 12-(3-adamantan-1-yl-ureido)dodecanoic acid (AUDA). At a concentration of 100 nM, both EpOME and DiHOME decreased post-ischemic functional recovery in murine hearts. There was no effect on basal cardiac parameters. The detrimental effects seen with EpOME, but not DiHOME, were averted by sEH inhibition (AUDA). Our results indicate that LA-derived mediators EpOME/DiHOME may play an important role in cardiac ischemic events. Inhibition of sEH could provide a novel treatment option to prevent detrimental DiHOME effects in acute cardiac ischemia.
| Carnitine Supplementation Attenuates Sunitinib-Induced Inhibition of AMP-Activated Protein Kinase Downstream Signals in Cardiac Tissues
AbstractThis study has been initiated to investigate whether sunitinib (SUN) alters the expression of key genes engaged in mitochondrial transport and oxidation of long chain fatty acids (LCFA), and if so, whether these alterations should be viewed as a mechanism of SUN-induced cardiotoxicity, and to explore the molecular mechanisms whereby carnitine supplementation could attenuate SUN-induced cardiotoxicity. Adult male Wister albino rats were assigned to one of the four treatment groups: Rats in group 1 received no treatment but free access to tap water for 28 days. Rats in group 2 received l-carnitine (200 mg/kg/day) in drinking water for 28 days. Rats in group 3 received SUN (25 mg/kg/day) in drinking water for 28 days. Rats in group 4 received the same doses of l-carnitine and SUN in drinking water for 28 days. Treatment with SUN significantly increased heart weight, cardiac index, and cardiotoxicity enzymatic indices, as well as severe histopathological changes. Moreover, SUN significantly decreased level of adenosine monophosphate-activated protein kinase (AMPKα2), total carnitine, adenosine triphosphate (ATP) and carnitine palmitoyltransferase I (CPT I) expression and significantly increased acetyl-CoA carboxylase-2 (ACC2) expression and malonyl-CoA level in cardiac tissues. Interestingly, carnitine supplementation resulted in a complete reversal of all the biochemical, gene expression and histopathological changes-induced by SUN to the control values. In conclusion, data from this study suggest that SUN inhibits AMPK downstream signaling with the consequent inhibition of mitochondrial transport of LCFA and energy production in cardiac tissues. Carnitine supplementation attenuates SUN-induced cardiotoxicity.
| Measurement of J–T peak c along with QT-Interval Prolongation May Increase the Assay Sensitivity and Specificity for Predicting the Onset of Drug-Induced Torsade de Pointes: Experimental Evidences Based on Proarrhythmia Model Animals
Abstractdl-Sotalol which can block both K+ channel and ß-adrenoceptor has been shown to prolong the J–Tpeakc of electrocardiogram in beagle dogs but tended to shorten it in microminipigs, although the drug prolonged the QT interval in both animals under physiologically maintained experimental condition. In order to estimate how the changes in the J–Tpeakc in the normal hearts would be reflected in the pathologic hearts, we compared proarrhythmic effects of dl-sotalol by using proarrhythmia models of beagle dogs and microminipigs, of which atrioventricular node had been ablated > 2 months and 8–9 weeks before, respectively (n = 4 for each species). dl-Sotalol in an oral dose of 10 mg/kg induced torsade de pointes in three out of four beagle dogs, which degenerated into ventricular fibrillation. In microminipigs, the same dose did not trigger torsade de pointes at all, whereas intermittent ventricular pauses were observed in each animal after the drug treatment. These results indicate that assessment of the J–Tpeakc along with the QT-interval prolongation in healthy subjects may provide reliable information of risk prediction for patients susceptible to the drug-induced torsade de pointes.
| Micheliolide Protects Against Doxorubicin-Induced Cardiotoxicity in Mice by Regulating PI3K/Akt/NF-kB Signaling Pathway
AbstractMicheliolide (MCL) is a naturally derived anti-inflammatory agent. In the present investigation, we examined the protective potential of MCL against doxorubicin (DOX)-induced cardiotoxicity in mice. Mice were injected with a single 15-mg/kg intraperitoneal dose of DOX at day 1 and the study groups received daily 12.5, 25, and 50 mg/kg doses of MCL for 7 days. Cardiac histopathology, cardiac function, serum markers of cardiac injury, and tissue markers of inflammation, and oxidative stress were examined. MCL decreased serum levels of creatinine kinase MB (CK-MB) and cardiac troponin I (cTnI) levels, ameliorated cardiac tissue architecture, and improved cardiac stroke volume. Apart from reducing the activities of NF-kB p65 subunit, MCL attenuated the cardiac levels of PI3K, phosphorylated (p)-Akt, p-Bad, and caspase-3 levels and simultaneously elevated p-PTEN levels. While the gene expressions of tumor necrosis factor alpha (TNF-α) and interleukin 1 beta (IL-1β) were decreased, the tissue activities of superoxide dismutase (SOD) as well as gene expressions of heme oxygenase-1 (HO-1) and NAD(P)H quinone dehydrogenase-1 (NQO1) were increased after treatment with MCL. Furthermore, tissue levels of malondialdehyde (MDA) were also decreased. Collectively, these findings point to the protective effects of MCL against DOX-induced cardiotoxicity by regulating PI3K/Akt/NF-kB signaling pathway in mice.
| Diagnostic Value of Parameters Related to White Blood Cell Counts for Troponin I Elevation in CO Poisoning
AbstractTo assess myocardial injury related to acute carbon monoxide (CO) poisoning, serial troponin I is measured in patients not presenting with troponin I elevation. This retrospective study investigated whether parameters related to white blood cell (WBC) counts (total and differential WBC counts, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio) improved predictive accuracy for troponin I elevation (> 0.04 ng/ml) in patients not presenting with evidence of myocardial injury. Serial parameters, troponin I values, and clinical courses were collected in 241 patients. Troponin I was elevated in 33 (13.7%) patients after hospitalization. The median lag times to troponin I elevation in patients with undetectable and detectable troponin I (0.015 ng/ml ≤ troponin I ≤ 0.04 ng/ml) at presentation were 5.9 h and 3.0 h, respectively. Patients with troponin I elevation after presentation had higher total WBC and neutrophil counts and NLRs and a lower lymphocyte count during the first 4 h after presentation than patients without troponin I elevation during hospitalization. Total WBC count, neutrophil count, and log NLR at presentation were selected as independent predictive factors for troponin I elevation after presentation. However, only the neutrophil count and log NLR at presentation improved the predictive accuracy in combination with clinical parameters compared with that achieved with a predictive model including only clinical parameters. The optimal cut-off neutrophil count and NLR were 5.21 × 103 /uL and 4.02, respectively. The total neutrophil count and NLR, which are widely available and inexpensive parameters obtained in the emergency department (ED), are promising screening tools for predicting the risk of troponin I elevation in patients without evidence of myocardial injury-related acute CO poisoning at presentation.
| Fulminant Vascular and Cardiac Toxicity Associated with Tyrosine Kinase Inhibitor Sorafenib
AbstractThe use of vascular endothelial growth factor inhibitors such as sorafenib is limited by a risk of severe cardiovascular toxicity. A 28-year-old man with acute myeloid leukemia treated with prednisone, tacrolimus, and sorafenib following stem cell transplantation presented with severe bilateral lower extremity claudication. The patient was discharged against medical advice prior to finalizing a cardiovascular evaluation, but returned 1 week later with signs suggestive of septic shock. Laboratory tests revealed troponin I of 12.63 ng/mL, BNP of 1690 pg/mL, and negative infectious workup. Electrocardiogram showed sinus tachycardia and new pathologic Q waves in the anterior leads. Coronary angiography revealed severe multivessel coronary artery disease. Peripheral angiography revealed severely diseased left anterior and posterior tibial arteries, tibioperoneal trunk, and peroneal artery, and subtotal occlusion of the right posterior tibial artery. Multiple coronary and peripheral drug-eluting stents were implanted. An intra-aortic balloon pump was placed. Cardiac magnetic resonance imaging revealed chronic left ventricular infarction with some viability, 17% ejection fraction, and left ventricular mural thrombi. The patient opted for medical management. Persistent symptoms 9 months later led to repeat angiography, showing total occlusion of the second obtuse marginal artery due to in-stent restenosis with proximal stent fracture, and chronic total occlusion of the right internal iliac artery extending to the pudendal branch. Cardiac positron emission tomography/computed tomography viability study demonstrated viable myocardium, deeming revascularization appropriate. Symptom resolution was obtained with no recurrences. Sorafenib-associated vasculopathy may follow a fulminant course. Multimodality cardiovascular imaging is essential for optimal management.
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Evidence for efficacy of parent-based interventions on parental characteristics
| Home-based parent training for school-aged children with attention-deficit/hyperactivity disorder and behavior problems with remaining impairing disruptive behaviors after routine treatment: a randomized controlled trial
AbstractThe objective is to investigate the effectiveness of home-based behavioral parent training for school-aged children with attention-deficit/hyperactivity disorder (ADHD) and behavior problems with remaining impairing disruptive behaviors after routinely offered treatments in clinical practice. In a randomized controlled study including 73 referred children with ADHD and impairing disruptive symptoms after routine clinical pharmacotherapy and/or clinic-based parent training had been tried or, at least, offered, home-based behavioral parent training (n = 26) was compared to a waiting list (n = 23) and a care-as-usual home-based treatment (n = 24). It was unknown to families which of the home-based treatments that they received. Using mixed models for repeated measures, we examined the effectiveness on the primary outcome measure of children's severity of disruptive behaviors and on a number of secondary outcome measures [the degree to which parents experienced the disruptive behaviors as troublesome, ADHD symptoms, oppositional-defiant disorder (ODD) symptoms, and internalizing problems]. Compared to the waiting list, children receiving home-based parent training improved significantly more regarding severity of disruptive behaviors (ES = 0.75), ADHD symptoms (ES = 0.89), ODD symptoms (ES = 0.65), and internalizing problems (ES = 0.60). Compared to care-as-usual, home-based parent training was more effective in reducing disruptive behaviors (ES = 0.57), ADHD symptoms (ES = 0.89), and ODD symptoms (ES = 0.88). Significantly more reduction of children's internalizing problems was not found. In conclusion, children with ADHD and residual behavioral problems after routine treatment may benefit from home-based behavioral parent training.
| Binge drinking during pregnancy and psychosis-like experiences in the child at age 11
AbstractIncreased frequency of psychosis-like experiences (PLEs) has been previously reported in children born to mothers with high general levels of alcohol intake during pregnancy. The aim of this study was to examine whether the risk of PLEs was likewise elevated in children prenatally exposed to binge drinking. Participants were 44,326 children and their mothers enrolled in the Danish National Birth Cohort from 1996–2002. Information on maternal binge drinking was collected twice in pregnancy by telephone interview and PLEs in the children were ascertained in a Web-based questionnaire at age 11. Analyses were carried out using weighted multinomial logistic regression models. Maternal binge drinking was relatively common among the participating women (27%). The adjusted relative risk ratio (RRR) for reporting one definite PLE symptom was 1.04 (95% confidence interval (CI) 0.95–1.13) and 1.06 (95% CI 0.95–1.20) for two or more symptoms in children exposed compared to unexposed to binge drinking during pregnancy. Furthermore, no association was found when addressing frequency and timing of binge drinking, nor for various levels of average alcohol consumption. When sub-dividing PLEs into specific types of experiences however, a slightly, although non-significant, increased risk was observed for one specific delusional idea, receiving messages from radio/TV, following prenatal exposure to binge drinking. Our results provide no evidence of an association between maternal binge drinking, nor average alcohol consumption in pregnancy, and overall occurrence of PLEs in the offspring. However, our results indicated that binge drinking might be related to a specific PLE.
| Correction to: Long-term mental health in unaccompanied refugee minors: pre- and post-flight predictors
In the original publication, the Table 1 was published.
| Maternal serum C-reactive protein (CRP) and offspring attention deficit hyperactivity disorder (ADHD)
AbstractExposure to infection and inflammation during the fetal period are associated with offspring neuropsychiatric disorders. Few previous studies have examined this association with ADHD with mixed findings. This study aims to examine the association between early gestational maternal C-reactive protein (CRP), prospectively assayed in stored maternal sera and the risk of ADHD in offspring. This study is based on the Finnish Prenatal studies of ADHD (FIPS-ADHD) with a nested case–control design. It includes all singleton-born children in Finland between January 1, 1998 and December 31, 1999 and diagnosed with ADHD. A total of 1079 cases and equal number of controls were matched on date of birth, sex and place of birth. Maternal CRP levels were assessed using a latex immunoassay from archived maternal serum specimens, collected during the first and early second trimester of pregnancy. Elevated maternal CRP when analyzed as a continuous variable was not associated with offspring ADHD (OR 1.05, 95% CI 0.96–1.15). No significant associations were seen in the highest quintile of CRP (OR 1.18, 95% CI 0.88–1.58). The results were similar in both sexes as well as among ADHD cases with or without comorbid ASD or conduct disorder. In this first study examining CRP, a biomarker for inflammation, during early pregnancy in relation to offspring ADHD, we report no significant associations. The lack of any association, when considered with positive findings seen in ASD and schizophrenia, and negative findings in bipolar disorder suggests different pathways linking maternal immune activation and development of various neuropsychiatric disorders.
| Post-traumatic stress disorder, emotional and behavioral difficulties in children and adolescents 2 years after the 2012 earthquake in Italy: an epidemiological cross-sectional study
AbstractDespite the occurrence of several earthquakes, only a few studies were conducted in Italy on the psychological impact in children and adolescents, with data mostly collected within one year after the disaster. This cross-sectional study aimed at exploring the prevalence of both post-traumatic stress disorder (PTSD) and emotional/behavioral difficulties, as well as at identifying their main predictors, among youths 2 years after the earthquake that hit Northern Italy in 2012. 682 children and adolescents (9–14 years) living in two districts (earthquake zone vs control zone) were administered an exposure questionnaire, the UCLA PTSD-Index for DSM-IV, and the Strengths and Difficulties Questionnaire (SDQ) and 1162 parents were assessed through the Symptom Checklist-90 (SCL-90). The prevalence of a likely PTSD in the earthquake zone was 1.9% (4.4% near the epicenter) and the total PTSD score in the affected area was significantly higher than in the control zone. 14.9% of youths living in the earthquake zone had a borderline/abnormal SDQ total difficulties score and 87.5% of youth with a likely PTSD also had a SDQ total score in the borderline/abnormal range. Regression analysis showed that the number of lifetime traumatic events (e.g., death of a relative) was the best predictor of children/adolescents psychological difficulties 2 years after the earthquake, followed by severity of exposure (personal injuries and losses) and parental psychopathology. Despite some limitations, this study highlights that youths may exhibit PTSD symptoms years after disasters, often in comorbidity with behavioral/emotional difficulties, stressing the need for long-term surveillance and interventions in exposed populations.
| Parent–youth conflict as a predictor of depression in adulthood: a 15-year follow-up of a community-based cohort
AbstractExperiencing conflictual relations with one's parents while growing up has been linked to onset, recurrence, and worse treatment outcome of adolescent depression. While this suggests that significant problems in the parent–youth relationship make depressive disorders more relentless, it is not clear whether this effect lasts into adulthood. Our aim was to examine if major and minor conflict with parents while growing up predicts depression in adulthood in youth with and without a history of depression. We utilized data from the Uppsala Longitudinal Adolescent Depression Study. This community-based cohort was assessed with structured diagnostic interviews both at age 16–17 and at follow-up 15 years later. The analyses included 382 individuals (227 with a history of child or adolescent depression; 155 peers without such a history). Binary logistic regression was used, adjusting for sex, disruptive behavior disorders, and additional family-related adversities. Among individuals with adolescent depression, major conflict with parents was strongly associated with adult depression (adjusted OR 2.28, 95% CI 1.07–4.87). While major conflict with parents was rare among non-depressed controls, a non-significant association of similar magnitude was still observed. Minor conflict, on the other hand, was not significantly associated with adult depression. Overall, conflict with parents did not predict adult anxiety disorders, substance use, suicidal behavior, somatoform disorders, or psychotic disorders. In conclusion, major parent–youth conflict during upbringing seems to be linked with an increased risk of depression in adulthood. These findings underscore the need to consider contextual/familial factors in the prevention and clinical management of early-life depression.
| Negative impact of maternal antenatal depressive symptoms on neonate's behavioral characteristics
AbstractPrenatal maternal depression is associated with developmental disorders in offspring. However, the specific effects of the intensity of prenatal depressive symptoms on infant behavior remain poorly explored. The aim of this work is to explore the links between early neonatal behavior and maternal prenatal depressive symptoms, independently from maternal pre- and postnatal anxiety and early postnatal maternal depressive symptoms. Five hundred and ninety-eight women and their newborns from the MATQUID cohort were prospectively evaluated during the 8th month of pregnancy (T1) and at day 3 postpartum (T2). We analyzed the independent associations between neonates' behavior (Neonatal Behavioral Assessment Scale—NBAS) at T2 and the intensity of maternal prenatal depressive symptoms (CES-D), taking into account confounding factors including depressive symptoms at T2 and anxiety (T1 and T2). The presence of a major depressive episode (MDE) based on MINI at T1 was also studied, independently. Our results show a significant negative correlation between prenatal CES-D scores and NBAS scores on "habituation" (p = 0.0001), "orientation" (p = 0.015), "motor system" (p < 0.0001), "autonomic stability" (p < 0.0001) dimensions, independently of other variables, including pre/postnatal anxiety and postnatal depressive symptoms. A prenatal MDE was independently associated with lower scores on the "orientation" dimension (p = 0.005). This study reports a specific effect of prenatal depressive symptoms on newborn's behavior. These results highlight the crucial necessity for antenatal screening and adjusted treatments of maternal depressive symptoms and not only of MDE. Particular attention must be paid to infants of mothers presenting prenatal depressive symptoms to provide them with early developmental care when necessary.
| Perspectives on clinical guidelines for severe behavioural problems in children across Europe: a qualitative study with mental health clinicians
AbstractClinical guidelines for severe behavioural problems (SBPs) in children have recently been developed in several European countries. However, questions emerged regarding their applicability to practice. Our study aimed to provide a first European insight into guidelines' fitness-for-purpose by exploring mental health clinicians' familiarity with, use and perceived value of guidelines for SBPs in children. Participants included 161 clinicians, primarily psychiatrists, from 24 countries. Clinicians completed a semi-structured qualitative questionnaire on existing SBPs guidelines and development of new guidelines where not available. Clinicians' responses were mapped against academic experts' perceptions on SBPs guidelines highlighted in a previous study (Gatej et al. in Eur Psychiatry 57:1–9, 2019). Under half of the clinicians reported being unaware of guidelines. Of these, 37.6% represented countries where guidelines were available according to experts. The remaining half of clinicians who were aware of guidelines on average reported being moderately familiar with their content, perceiving them as moderately useful and using them some of the time. Additionally, 60.8% clinicians agreed that SBPs guidelines need to be developed, as these would create a shared scientific knowledge base and common practice. Guideline improvements included taking a multifactorial approach, creating specific case recommendations, and dissemination efforts. The modest familiarity with and use of guidelines amongst practitioners may highlight guidelines poor fitness-for-purpose, or, alternatively, an underlying confusion around the meaning and purpose of guidelines. Moving forward, efforts should be directed at disseminating clearer definitions of guidelines, addressing existing challenges, and unifying efforts to further develop and audit application of international guidelines for SBPs.
| Understanding anhedonia: a qualitative study exploring loss of interest and pleasure in adolescent depression
AbstractAnhedonia (or loss of interest and pleasure) is a core symptom of depression and may predict poor treatment outcome. However, little is known about the subjective experience of anhedonia, and it is rarely targeted in psychological treatment for depression. The aim of this study is to examine how young people experience anhedonia in the context of depression. Semi-structured interviews were conducted with 34 adolescents with a primary diagnosis of depression (N = 12) or elevated depressive symptoms (N = 22). Thematic analysis was used to identify important aspects of adolescents' experiences. Four main themes were identified: (1) experiencing a loss of joy and a flattening of emotion; (2) struggling with motivation and active engagement; (3) losing a sense of connection and belonging; and (4) questioning sense of self, purpose, and the bigger picture. The results challenge the framing of anhedonia as simply the loss of interest and pleasure. Adolescents reported a range of experiences that mapped closely onto the cluster of negative symptoms associated with schizophrenia and were similar to the sense of 'apathy' characteristic in Parkinson's disease. This highlights the potential benefit of taking a trans-diagnostic approach to understanding and treating reward deficits associated with mental health problems.
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