bluuebunny/crossref_metadata_2025 huggingface dataset:
Terbinafine: broad new spectrum of indications in several subcutaneous and systemic and parasitic diseases
Authors: Pérez A.
Published: December 2017

Immunocompromised patients are at risk of contracting serious fungal infections. The emergence of acquired resistance to azole treatment by opportunistic fungal organisms is increasing and poses a major therapeutic challenge. Treatment of some deep cutaneous and subcutaneous mycoses remains unresolved, relapses are frequent, lack of tolerability of the antifungal drugs becomes an obstacle, and, unfortunately, surgery is, in some cases, the last option. The development of allylamine antifungals, of which terbinafine is the most effective to date, may help to resolve this situation.

In vitro, terbinafine is highly active against a broad spectrum of pathogenic fungi. Clinical studies have shown that terbinafine is effective in the treatment of both cutaneous and lymphocutaneous sporotrichosis, and in several patterns of disseminated and refractory aspergillosis. Patients with chromoblastomycosis, and other mycoses (phaeohyphomycosis, maduromycosis, and mucormycosis) have also been successfully treated with terbinafine. Old World cutaneous leishmaniasis, a parasitic disease, has also been treated with terbinafine.

These results suggest that the therapeutic potential of terbinafine extends well beyond its currently licensed applications to include a range of serious and life‐threatening subcutaneous and systemic mycoses.
Efficacy and tolerability of treatment with mirabegron compared with solifenacin in the management of overactive bladder syndrome: A retrospective analysis
Authors: Schiavi Michele C. , Faiano Pierangelo , D'Oria Ottavia , Zullo Marzio A. , Muzii Ludovico , Benedetti Panici Pierluigi
Published: December 2017

Aim

The aim of this study was to compare the efficacy and tolerability of solifenacin and mirabegron in patients with overactive bladder (OAB) syndrome.

Methods

We carried out a retrospective analysis in 342 women affected by OAB syndrome; 168 were treated with solifenacin 5 mg/daily and 174 with mirabegron 50 mg/daily. A clinical evaluation, 3‐day voiding diary, and urodynamic testing was performed. Patients completed the Overactive Bladder Questionnaire – Short Form, the King's Health Questionnaire, and the Patient Global Impression of Improvement questionnaire. The adverse effects were evaluated. The two groups were compared at baseline and at 12 weeks.

Results

After 12 weeks, a significant reduction in the mean number/24 h of voids and urgent micturition episodes/24 h was observed in both groups. Detrusor overactivity decreased from 58.3% to 13.1% in the solifenacin group and from 58% to 11% in the mirabegron group. Twenty (12%) and 18 (10.7%) patients taking solifenacin reported constipation and dry mouth, respectively, versus four (2.3%) and five (2.9%) patients taking mirabegron, respectively, but there was no difference between the groups in the change in vital signs. The Overactive Bladder Questionnaire – Short Form and King's Health Questionnaire scores did not demonstrate significant differences and the abandonment rates in the solifenacin and mirabegron groups were 25.5% and 20%, respectively.

Conclusion

Solifenacin and mirabegron showed the same efficacy in the treatment of OAB but solifenacin had more adverse effects.
The effect of the interdialytic interval on cognitive function in patients on haemodialysis
Authors: Henry Shayna L. , Jamner Larry D. , Choi Sarah E. , Pahl Madeleine V.
Published: December 2017

Background

Cognitive deficits are common among individuals on haemodialysis (HD). The degree of dysfunction may shift over the course of the interdialytic interval.

Objectives

To use ecological momentary assessment (EMA) to examine the relationship between the length of the interdialytic interval and reports of cognitive dysfunction.

Design

A quantitative study whereby each patient's cognitive functioning was measured during both short and long interdialytic intervals.

Participants

Adults maintained on HD (Female n = 15, Male n = 11; MAge = 42.7 ± 15.8 years) were drawn from a standalone HD unit within a large university medical centre.

Measurements

Tests of baseline neurocognitive functioning were undertaken (Mini‐Mental Status Examination, Digit Span, California Verbal Learning Test, Benton Visual Retention Test, Trail‐Making Test) and smartphone‐based electronic diary reports of cognitive impairment were made around six times each day for one week.

Results

Cognitive function and aptitude in this sample, although low, did not reflect clinically‐significant impairment, with a mean Mini‐Mental Status Exam score of 25.7 ± 3.0. Diary reports of cognitive impairment were also minimal, with an overall mean rating of .22 out of 5. Contrary to expectations, cognitive impairment was significantly greater on the one‐day interdialytic days than on Day 2 of the two‐day interdialytic interval (β = .094, p = .017).

Conclusions

Although cognitive impairment appears to be mild in stable, young patients with end stage renal disease, volumetric disruptions caused by HD may exacerbate such dysfunction.
Malassezia furfur colonization of neonates in an intensive care unit
Authors: Ahtonen P. , Lehtonen O.-P. , Kero P. , Tunnela E. , Havu V.
Published: December 2017

We studied Malassezia furfur colonization of neonates in the neonatal intensive care unit (NICU) and found that the rate was astonishingly high as compared to the previous studies. In very low birth weight ( < 1 000 g) infants we recorded a colonization rate of 80%, and 4% in infants with a birth weight greater than 2 000 g. Under 10 day's hospitalization the rate was 11%, and it was 70% after 20 days spent in the unit. Among the infants with the birth weight less than 1 700 g, antibiotic therapy was recorded as a significant risk factor for colonization. In the infants with a greater birth weight, the colonization rate was independent from the risk factors studied. M. furfur colonization could not be linked with occurrence of any symptoms of signs recorded and colonization by M. furfur was so common in NICU that the predictive value of surveillance cultures is Poor.
Clotrimazole and bifonazole in the topical treatment of Candida keratitis in rabbits
Authors: Behrens-Baumann W. , Klinge B. , Uter W.
Published: December 2017

Using a reproducible model of Candida albicans keratitis in rabbits we studied the effect of topical clotrimazole and bifonazole. Candida albicans DSM 70010 (2.5 × 105cells) was injected into the corneal stroma of both eyes of 28 rabbits. All eyes developed a corneal ulcer. Fourtye‐ight hours after inoculation the animals were divided into four groups: I (14 eyes) receiving 10 × clotrimazole 1% drops and subsequently removing the epithelium; II (14 eyes) receiving only clotrimazole drops; III (8 eyes) receiving 6 × bifonazole 1% drops and IV (19 eyes) serving as control (0.9% NaCI, castor oil, untreated), 6 eyes of this group were also debrided. A further 6 rabbits were used respectively to judge if the drugs penetrated into the cornea and aqueous humor. There was a significant difference between the clotrimazole group with debridement (I) and the bifonazole group (III) compared with the control group (IV) concerning hypopyon and complications (descemetocele, corneal perforation). Clotrimazole penetrated into the cornea and after debridement into the aqueous humor. Bifonazole could not be identified in the cornea or aqueous humor.
Comparison of oral fluconazole and amphotericin B in the prophylaxis of fungal infection in neutropenic patients treated for acute leukemia
Authors: Finke R.
Published: December 2017

40 Patienten mit akuter Leukose im Alter von 16–71 Jahren, 13 Frauen und 27 Männer, mit chemotherapeutisch induzierter Neutropenie bekamen entweder 50 mg Fluconazol oder 800 mg Amphotericin B täglich oral als Prophylaxe gegen Pilzinfektionen. Zur mykologischen Überwachung wurden Nasen‐ und Genitalabstriche, Gurgelwasser, Urin, Stuhl und Blutserum vor Therapiebeginn und wöchentlich einmal während der Neutropeniephase ( < 109Granulozyten/l) pro Patient gewonnen. Die quantitativeBestimmung der Sproßpilzkonzentration im Stuhl ergab, daß Amphotericin B nur bei einem Drittel der Patienten zu einer Hefereduktion im Darm führte, bei einem weiteren Drittel der Patienten jedoch eine intestinale Hefevermehrung nicht zu verhindern vermochte. Darüber hinaus erwies sich die quantitative Bestimmung der Hefebesiedlung in Oropharynx, Genitale, Blut und Stuhl nicht als verläßlicher Bewertungsparameter für die Wirt‐Erreger‐Beziehungen während der Neutropenie. Die Mykoserologie dagegen spiegelte die Candidose‐Episoden gut wider. Die 19 Patienten mit Fluconazol‐Be‐handlung zeigten nur geringe Candida‐Antikörper‐Anstiege. Bei den 21 Amphotericin B‐behandelten Patienten wurden vier Candidämien gefunden: Zwei durch den Hämagglutinationstest (HAT) und Immunfluoreszenztest (IFT), eine durch den IFT und eine durch den Ramco‐Antigennachweis allein. Nur bei einem dieser Patienten wurden Candida‐Zellen mit dem Urin ausgeschieden. Aus den Ergebnissen wird geschlossen, daß die Mykoserologie für solche Studien unabdingbar ist und daß Fluconazol während der induzierten Neutropeniephase einen besseren Schutz vor Candidose als Amphotericin B oral bietet.
Laboratory diagnosis of deep‐seated candidosis
Authors: Müller J.
Published: December 2017

Die Arbeit gibt eine Übersicht über die derzeit praktizierten labordiagnostischen Verfahren der Candida‐Isolierung und ‐Differenzierung sowie der Candidose‐Serologie. Zu den Schwierigkeiten der pathognomonischen Bewertung der Laborparameter wird Stellung genommen.
Influence of Serum on in Vitro Digestion of Paracoccidioides brasiliensis by Neutrophils
Authors: Goihman-Yahr M. , Bastardo de Albornoz María C. , Istúriz G. , Viloria Nora , Saavedra de Borges Nelly , Carrasquero Mercedes , Avila-Millán E. , Guilarte A. , Pereira J. , de Gómez María H. , San Martín Blanca , de Román Ana , Villanueva E.
Published: December 2017

Serum from patients with paracoccidioidomycosis (PARA) did not block digestive abilities of neutrophils (PMNs) from healthy individuals against Paracoccidioides brasiliensis. Conversely, serum from healthy donors did not enhance digestive capacities of PMNs from patients with PARA vis á vis the causative organism. We conclude that the specific digestive defect present in PMNs from patients with PARA is not mediated by serum factors.
Pathogenicity of Streptomyces griseus for Laboratory Mice
Authors: Unaogu I. C. , Gugnani H. C.
Published: December 2017

Streptomyces griseus, an aerobic actinomycete usually regarded as a saprophyte, was found to be virulent for laboratory mice both by intraperitoneal and intravenous routes of inoculation, the latter route producing a more progressive and disseminating infection. Suspension in mucin resulted in higher mortality and more extensive lesions, often leading to membranous adhesions of some visceral organs. The lesions appeared as nodules containing granules of Str. griseus. The pathogenicity of Str. griseus is compared with that of Str. somaliensis from published reports.
Treatment of Onychomycosis with a Bifonazole‐Urea Combination
Authors: Hardjoko F. S. , Widyanto S. , Singgih I. , Susilo J.
Published: December 2017

A clinical trial has been conducted to assess the efficacy of 1 % bifonazole and 40 % urea ointment for 2 weeks followed by 1 % bifonazole cream for one month in the topical treatment of onychomycosis. Thinning and total avulsion of the nails occurred in 97 % of 30 patients with candidal onychomycosis and regrowth of a normal appearing nail was found in 92 % of 26 patients. Failure rate was 4 % and recurrence rate was 12 % in 26 patients. Results of the treatment was followed up for 12 weeks. Side effects were negligible.
Sporotrichosis in the metropolitan area of Cusco, Peru, and in its region
Authors: Cuadros R. G. , Vidotto V. , Bruatto M.
Published: December 2017

Eight cases of sporotrichosis originating from the metropolitan area of Cusco, Peru, and its region are described, including the circumstances of infection and the isolation of Sporothrix schenckii from the lesions. This finding classifies this particular area with high altitude, low temperature and dry weather as an endemic zone of interest in the epidemiological and ecological study of Andean sporotrichosis. Among the eight cases observed, five were of the fixed cutaneous type and three were lymphocutaneous. Six patients were male and two female. Two paediatric cases were also observed. Therapy with potassium iodide was very satisfactory, whereas poor results were obtained with ketoconazole.
Pathogenicity determinants of Candida
Authors: Ghannoum M. A. , Abu-Elteen K. H.
Published: December 2017

The incidence of infections due to Candida albicans and other related species has increased in recent years. A number of factors have contributed to this, e.g. the use of a wide range of potent antibacterial and immunosuppressive therapeutic agents and the increased incidence of immune‐deficiency diseases such as AIDS. Pathogenicity determinants which confer virulence on C. albicans, and other Candida species to a lesser extent, have been reviewed. These include factors related to species and strains, adherence, dimorphism, toxin and enzyme production and cell surface composition. This review clearly shows that C. albicans virulence is a function of a multiplicity of factors working jointly to overcome the host defences. A lack or debility in any of these parameters will reflect negatively on its infectivity and make it difficult for Candida to establish itself, particularly in a healthy individual.
A case of cutaneous mucormycosis in Shanghai, China
Authors: Wang J.-J. , Satoh H. , Takahashi H. , Hasegawa A.
Published: December 2017

A 34‐year‐old female farmer suffered from localized cutaneous mucormycosis for 17 years. At the first admission, the lesion was a dull red plaque, about 7 x 9 cm in size with ulcerations, surrounded by some nodules on the dorsum of her right hand. General examination did not reveal abnormal findings except the skin lesion. Direct examination of skin scrapings in 10 % KOH revealed broad, sparsely septate, branching hyphae. Histopathology showed many intradermal granulomata and microabscesses as well as mycelial elements comprising broad, distorted, ribbon‐like strands. Some of them were phagocytized by multi‐nucleated giant cells. Cultures revealed rapidly growing yellow colonies on Sabouraud dextrose agar medium at 25°C. Sporangiophores branched in sympodia and the sporangia were globose, 35–60 μm in diameter. Their walls were deliquescent, but some of them were rather persistent. Columellae were mostly globose, 12–17 μm in diameter, up to 35 μm with collars. Sporangiospores were mainly ellipsoidal, 1.5–2.5 x 3–5 μm in size, but sometimes highly variable in size and shape. The maximum growth temperature of the isolate was 37°C. The pathogenic organism isolated was tentatively identified as Mucor lusitanicus, which, as far as we know, has not been reported as a causative agent of cutaneous mucormycosis.
Persistence of Cryptococcus neoformans in seminal fluid and urine under itraconazole treatment. The urogenital tract (prostate) as a niche for Cryptococcus neoformans
Authors: Staib F. , Seibold M. , L'age M.
Published: December 2017

The open questions of the persistence of Cryptococcus neoformans in the urogenital tract under antimycotic treatment can be examined under optimal mycological‐diagnostic conditions only. The example of a case of cryptococcosis in an AIDS patient diagnosed and treated with itraconazole in the early secondary stage of cryptococcosis is used to discuss the problems of the persistence of Cr. neoformans involvement in the urogenital tract (prostate). Data from a ten‐week follow‐up study are presented and discussed. The observations made have shown that itraconazole is effective in all regions of the body, with the exception of the urogenital tract. In addition to clinical examinations, cases treated with itraconazole should be finally subjected to cultural examination of prostatic secretion and/or seminal fluid, to exclude the possible presence of a symptomfree involvement of the prostate by Cr. neoformans.
Comparison of enzyme immunoassay and immunodiffusion for the detection of canine blastomycosis
Authors: Seawell B. W. , Scalarone G. M.
Published: December 2017

Two Blastomyces dermatitidis commercial immunodiffusion antigens, Meridian Diagnostics and Nolan‐Scott Laboratories, and two B. dermatitidis yeast phase lysate antigens, T‐58 and K‐Le, prepared in our laboratory were utilized in an enzyme‐linked immunosorbent assay (ELISA) for the detection of antibodies in 61 serum specimens from dogs with blastomycosis. All antigens used in the ELISA were diluted to 50 ng of protein ml−1. Immunodiffusion (ID) tests were also performed on the sera using a Nolan‐Scott ID antigen. Greater reactivity, based on the ELISA index value, was evidenced with the two yeast phase lysate antigens over the two commercial reagents in the ELISA. In addition the sensitivity of the ELISA with the T‐58, K‐Le and Meridian antigens was considerably greater than that of the ID test. The Nolan‐Scott antigen, however, was able to detect more positive specimens when used in the ID procedure than in the ELISA. Therefore encouraging results were obtained with respect to the continued development and optimization of the ELISA using B. dermatitidis cell lysate antigens for the diagnosis of blastomycosis.
Polymerase chain reaction‐mediated genotyping of Hortaea werneckii, causative agent of tinea nigra
Authors: Uijthof J. M. J. , de Cock A. W. A. M. , de Hoog G. S. , Quint W. G. V. , van Belkum A.
Published: December 2017

The black yeast Hortaea werneckii is known to be a causative agent of human tinea nigra but is also found in the environment. Strains from dissimilar sources were studied by polymerase chain reaction fingerprinting of nuclear DNA, using primers annealing to repetitive and random sequences. The seven groups found correspond to those known from restriction fragment length polymorphism (RFLP) studies of the mitochondrial DNA of the same strains. Two main groups contained strains from human as well as from non‐human sources. The human strains did not cluster, but were randomly distributed over several populations. It was concluded that these strains are not pathogenic. The factor common to both niches is a relatively high salt concentration.
Structural alterations in Candida albicans by caffeine and caffeine salts
Authors: Mittag Hannelore
Published: December 2017

Cytological alterations of Candida albicans following exposure to subinhibitory concentrations of caffeine and caffeine salts were examined by light and transmission electron microscopy (TEM). The effect was different from that induced by ketoconazole. Caffeine and especially caffeine salts caused an increase in unusual modes of proliferation with signs of multiple budding in Candida albicans. Structurally, such yeast cells present some resemblance to Paracoccidioides brasiliensis.
Association between Malassezia furfur colonization and seborrhoeic dermatitis in AIDS patients
Authors: Ross Sabine , Richardson M. D. , Graybill J. R.
Published: December 2017

A total of 180 HIV‐positive patients were assessed for seborrhoeic dermatitis (SD) and colonization with Malassezia species. Diseased skin of patients with seborrhoeic dermatitis were sampled selectively for Malassezia. In patients without SD, uninvolved skin was sampled. The prevalence of SD was 19%. Of the 34 SD patients, 16 were positive for Malassezia. Of the 146 patients without SD, only 27 were culture positive for Malassezia. Analysis of the largest HIV‐positive patient population studied thus far yielded only a weak correlation between SD and Malassezia colonization.
Antifungal activity of some 2,2′:5′,2″‐tertiophene derivatives
Authors: Mares D. , Romagnoli C. , Rossi R. , Carpita A. , Ciofalo M. , Bruni A.
Published: December 2017

The dermatophyte Microsporum cookei Ajello was treated with nine new natural and synthetic 2,2′: 5′,2″‐terthiophenes to determine their possible antifungal activity. In the dark the thiophenes were inactive, while when photoactivated with UV‐A they induced a remarkable reduction in the growth rate of the fungus. The only exception was (E)‐N‐(2‐methylpropyl)‐3‐(2,2′: 5′,2″‐terthien‐5‐yl)‐propenamide, which was not fungistatic even at the highest dose tested (24 μm). The more active compounds were 31‐methoxy‐2,2′: 5′,2″‐terthiophene and 3′‐methylthio‐2,2′ : 5′,2″‐terthiophene, whose activity seems to be related to the presence of a substituent in the 3′ position of the central ring of thiophenes. Transmission electron microscopic observations demonstrated the photoactive nature of the synthetic molecules to be similar to that of α‐terthienyl, a natural thiophene present in some Asteraceae. The dark treatment caused only the accumulation of the compound in vacuoles, without other evident alterations. After UV‐A irradiation the activated thiophene causes severe modifications to the endomembrane system, probably via oxygen‐dependent mechanism.
Reducing starbursts in highly aberrated eyes with pupil miosis
Authors: Xu Renfeng , Kollbaum Pete , Thibos Larry , Lopez‐Gil Norberto , Bradley Arthur
Published: December 2017

Purpose

To test the hypothesis that marginal ray deviations determine perceived starburst sizes, and to explore different strategies for decreasing starburst size in highly aberrated eyes.

Methods

Perceived size of starburst images and visual acuities were measured psychophysically for eyes with varying levels of spherical aberration, pupil sizes, and defocus. Computationally, we use a polychromatic eye model including the typical levels of higher order aberrations (HOAs) for keratoconic and post‐LASIK eyes to quantify the image quality (the visually weighted Strehl ratio derived from the optical transfer function, VSOTF) with different pupil sizes at both photopic and mesopic light levels.

Results

For distance corrected post‐LASIK and keratoconic eyes with a night‐time pupil (e.g., 7 mm), the starburst diameter is about 1.5 degrees (1 degree for normal presbyopic eyes), which can be reduced to ≤0.25 degrees with pupil sizes ≤3 mm. Starburst size is predicted from the magnitude of the longitudinal spherical aberration. Refracting the eye to focus the pupil margin also removed starbursts, but, unlike small pupils, significantly degraded visual acuity. Reducing pupil diameter to 3 mm improved image quality for these highly aberrated eyes by about 2.7 ×  to 1.7 ×  relative to the natural pupils when light levels were varied from 0.1 to 1000 cd m−2, respectively.

Conclusion

Subjects with highly aberrated eyes observed larger starbursts around bright lights at night predictable by the deviated marginal rays. These were effectively attenuated by reducing pupil diameters to ≤3 mm, which did not cause a drop in visual acuity or modelled image quality even at mesopic light levels.
Simulation of a central scotoma using contact lenses with an opaque centre
Authors: Almutleb Essam S. , Bradley Arthur , Jedlicka Jason , Hassan Shirin E.
Published: December 2017

Purpose

This study evaluated the feasibility of using soft contact lenses (CLs) with an opaque centre to induce absolute central scotomas that move with the eye. We examined the geometrical optics prediction that scotoma size will vary with the size of the CL's opaque centre and with ocular pupil size. We also tested the hypothesis that high environmental light levels will ensure that the ocular pupil will remain small enough, even with opaque centre CLs, to generate absolute scotomas representative of those experienced by patients with age‐related macular disease.

Methods

Using an Octopus 900 Perimeter ( www.Haag-Streit.com), kinetic visual fields (VFs) were measured in five normally‐sighted subjects using a V4e Goldmann target with CLs that had central opaque areas with diameters of 2.8, 3.0, and 3.2 mm. To control pupil size, VFs were measured with background perimeter bowl luminances of 10, 585, and 1155 cd m−2. Subjects attempted to (i) fixate the bowl centre; and (ii) place the scotoma edge at the bowl fixation target (eccentric viewing).

Results

As predicted, there was a direct relationship between scotoma size and both luminance level and diameter of the opacity. Mean scotoma diameters were 0°, 17.6° and 22°, for the low, medium and high bowl luminances, respectively. Scotoma size was determined primarily by the difference between the diameters of CL opacity and the entrance pupil of the eye and the axial separation between them, and between‐subject differences in pupil diameters contributed most to the between‐subject variability in scotoma diameter at each light level (SD: 6.01°). Scotoma displacement during eccentric fixation confirmed the gaze‐contingent characteristics of this experimental model.

Conclusion

It is possible to induce a gaze‐contingent absolute scotoma and hence mimic central vision loss using centrally‐opaque CLs provided that the CL opacity is larger than the entrance pupil of the eye. This simulation tool will, therefore, be ineffective at low environmental light levels (as shown previously) if the entrance pupil of the eye is larger than the CL opacity.
Double standards? How historical and political aspiration levels guide managerial performance information use
Authors: Holm Jakob Majlund
Published: December 2017

Performance evaluations are a vital part of how public managers react to performance information. Yet, we know little about the way evaluations unfold and the reactions they produce. This article examines the idea that historical and political aspiration levels guide evaluations by labelling performance results as either a failure or success. Thus, the same result could lead to different evaluations and reactions depending on the aspiration level. The study also tests the idea that a negativity bias characterizes managers' reactions to political performance feedback. A survey experiment among a sample of principals in Danish public schools is used to examine these hypotheses. The results show that aspiration levels change principals' interpretation and reaction to otherwise identical performance results, but primarily in situations with positive historical and political feedback. Conflicting feedback from two aspiration levels makes principals rely mostly on the signals from the historical aspiration level.
Real‐time elastosonography of lipomatous vs. malignant subcutaneous neoplasms in dogs: Preliminary results
Authors: Longo Maurizio , Bavcar Spela , Handel Ian , Smith Sionagh , Liuti Tiziana
Published: December 2017

Real‐time elastography is a recently introduced ultrasound technique allowing the investigation of elastic properties of tissues. A diagnostic accuracy study was conducted to test the performance of this technique in the assessment of subcutaneous lesions in dogs. Fifty‐two dogs were prospectively included in the preliminary study (34 malignant and 18 benign lesions). B‐mode ultrasound was performed assessing the shape, margins, heterogeneity, and echotexture of the lesions. On elastosonography, assessment of the percentage of softness/hardness was recorded. A qualitative assessment was performed according to the Tsukuba elasticity score with a 1–5 score, representing the increased percentage of high stiffness areas. Results were compared with cytology/histopathology of the lesions. Receiver Operating Curves of the overall diagnostic sensitivity and specificity were obtained. Fisher's exact test and Pearsons's Chi‐squared test estimated the relationship between the B‐mode appearance of the lesions and final diagnosis. A hardness cutoff of 50.25% was identified between lesions, with malignant neoplasms having higher percentages. A 100% specificity and 89% sensitivity for correctly detecting the nature of the lesion on elastosonography was established. Qualitative assessment of the Tsukuba elasticity score established 1.5 as the cutoff between elastograms of lipomatous and malignant lesions, with 100% sensitivity and 61% specificity in differentiating them. Real‐time elastosonography is a novel, noninvasive, and accurate technique for differentiating malignant from benign lipomatous lesions in dogs. This method could be considered as a complementary tool with additional diagnostic value for routine invasive procedures, such as fine needle aspirates.
A Practical Measurement of Parkinson's Patients Gait Using Simple Walker-Based Motion Sensing and Data Analysis
Authors: Aharonson Vered , Schlesinger Ilana , McDonald Andre M. , Dubowsky Steven , Korczyn Amos D.
Published: December 2017

We present personal aid for mobility and monitoring (PAMM II), an instrumented walker for Parkinson's disease (PD) patients' gait monitoring. The objective of the walker is to aid in the diagnosis and monitoring of PD progression as well as the effects of clinical treatment and rehabilitation. In contrast to existing devices, the walker is a low-cost solution that is simple to operate and maintain, requiring no adjustments, special usage instructions, or infrastructure. This preliminary study reports on the efficiency, reliability, and accuracy of PAMM II when used to evaluate 22 PD patients and 20 control individuals. All subjects walked two prescribed paths while pushing the walker, and their kinematic motion signals were automatically collected by the walker. Feature derivation from the walker's signals was followed by combinations of two classical feature selection methods and two learning algorithms, with the objective of discriminating PD patients from control subjects. Sensitivity and specificity scores of 91% and 95% were achieved for the first walking protocol, whereas discrimination over the second walking protocol produced sensitivity and specificity scores of 96% and 100%. These preliminary results provide insight as to the usefulness of PAMM II and its data processing algorithms for the assessment of PD patients' condition.
Neuropsychiatric performance and treatment of hepatitis C with direct-acting antivirals: a prospective study
Authors: Volpato Sofia , Montagnese Sara , Zanetto Alberto , Turco Matteo , De Rui Michele , Ferrarese Alberto , Amodio Piero , Germani Giacomo , Senzolo Marco , Gambato Martina , Russo Francesco Paolo , Burra Patrizia
Published: December 2017

Background

Since direct-acting antivirals (DAAs) have been approved for the treatment of hepatitis C virus (HCV) infection, a small series of patients with new-onset neuropsychiatric alterations have been referred to us. We therefore set out to study neuropsychiatric function in relation to DAAs prospectively.

Methods

Ten patients with cirrhosis and 12 post-liver transplant (post-LT) patients were enrolled. All underwent wake electroencephalography (EEG) and a neuropsychological evaluation (paper and pencil battery, simple/choice reaction times, working memory task) at baseline, at the end of treatment with DAAs and after 6 months. At the same time points, full blood count, liver/kidney function tests, quantitative HCV RNA, ammonia and immunosuppressant drug levels were obtained, as appropriate.

Results

Patients with cirrhosis were significantly older than post-LT patients (65±12 vs 55±7 years; P<0.05). Neuropsychological performance and wake EEG were comparable in the two groups at baseline. At the end of a course of treatment with DAAs, a significant slowing in choice reaction times and in the EEG (increased relative delta power) was observed in patients with cirrhosis, which resolved after 6 months. In contrast, no significant changes over time were observed in the neuropsychiatric performance of post-LT patients. No significant associations were observed between neuropsychiatric performance and stand-alone/combined laboratory variables.

Conclusion

Some degree of neuropsychiatric impairment was observed in relation to treatment with DAAs in patients with cirrhosis, but not in post-LT patients, suggesting that the former may be sensitive to mild DAA neurotoxicity.
Risk of autism spectrum disorder in offspring following paternal use of selective serotonin reuptake inhibitors before conception: a population-based cohort study
Authors: Yang Fen , Chen Jianping , Miao Mao-Hua , Yuan Wei , Li Lin , Liang Hong , Ehrenstein Vera , Li Jiong
Published: December 2017

Objective

The present study aimed to examine the association between paternal selective serotonin reuptake inhibitor (SSRI) use before conception and the risk of autism spectrum disorder (ASD) in offspring.

Design

A population-based cohort study.

Methods

We conducted a cohort study of 669 922 children born from 1998 to 2008, with follow-up throughout 2013. Based on Danish national registers, we linked information on paternal use of SSRIs, ASD diagnosed in children and a range of potential confounders. The children whose fathers used SSRIs during the last 3 months prior to conception were identified as the exposed. Cox regression model was used to estimate the HR for ASD in children.

Results

Compared with unexposed children, the exposed had a 1.62-fold higher risk of ASD (95% CI 1.33 to 1.96) and the risk attenuated after adjusting for potential confounders, especially fathers’ psychiatric conditions (HR=1.43, 95% CI 1.18 to 1.74). When extending the exposure window to 1 year before conception, the increased risk persisted in children of fathers using SSRIs only from the last year until the last 3 months prior to conception (HR=1.54, 95% CI 1.21 to 1.94) but not in children of fathers using SSRIs only during the last 3 months prior to conception (HR=1.17, 95% CI 0.75 to 1.82). We also performed stratified analyses according to paternal history of affective disorders and observed no increased ASD risk among children whose father had affective disorders. Besides, the sibling analysis showed that the ASD risk did not increase among exposed children compared with their unexposed siblings.

Conclusions

The mildly increased risk of ASD in the offspring associated with paternal SSRI use before conception may be attributable to paternal underlying psychiatric indications related to SSRI use or other unmeasured confounding factors.
New-onset arrhythmias following transcatheter aortic valve implantation: a systematic review and meta-analysis
Authors: Siontis George C M , Praz Fabien , Lanz Jonas , Vollenbroich René , Roten Laurent , Stortecky Stefan , Räber Lorenz , Windecker Stephan , Pilgrim Thomas
Published: December 2017

Objective

To evaluate the prevalence and clinical impact of new-onset arrhythmias in patients following transcatheter aortic valve implantation (TAVI).

Method

We systematically identified studies reporting new-onset arrhythmias after TAVI other than atrioventricular conduction disturbances. We summarised monitoring strategies, type and prevalence of arrhythmias and estimated their effect on risk of death or cerebrovascular events by using random-effects meta-analysis. The study is registered withInternational prospective register of systematic reviews (PROSPERO) (CRD42017058053).

Results

Sixty-five studies (43 506 patients) reported new-onset arrhythmias following TAVI. The method of arrhythmia detection was specified only in 31 studies (48%). New-onset atrial fibrillation (NOAF) (2641 patients), bradyarrhythmias (182 patients), supraventricular arrhythmias (29 patients), ventricular arrhythmias (28 patients) and non-specified major arrhythmias (855 patients) were reported. In most studies (52 out of 65), new-onset arrhythmia detection was limited to the first month following TAVI. The most frequently documented arrhythmia was NOAF with trend of increasing summary prevalence of 11%, 14%, 14% and 25% during inhospital, 30-day, 1-year and 2-year follow-ups, respectively (P for trend=0.011). Summary prevalence estimates of NOAF at 30-day follow-up differ significantly between studies of prospective and retrospective design (8% and 21%, respectively, P=0.002). New episodes of bradyarrhythmias were documented with a summary crude prevalence of 4% at 1-year follow-up. NOAF increased the risk of death (relative risk 1.61, 95% CI 1.35 to 1.98, I2=47%) and cerebrovascular events (1.79, 95% CI 1.24 to 2.64, I2=0%). No study commented on therapeutic modifications following the detection of new-onset arrhythmias.

Conclusions

Systematic identification of new-onset arrhythmias following TAVI may have considerable impact on subsequent therapeutic management and long-term prognosis in this patient population.
Assessment of human placenta as an ex-vivo vascular model for testing of liquid embolic agent injections with adjunctive techniques
Authors: Okada Hideo , Chung Joonho , Heiferman Daniel M , Lopes Demetrius K
Published: December 2017

Purpose

This project sought to test the utility of post-delivery human placenta (HP) as a vascular model for liquid embolic agent (LEA) simulation, along with adjunctive techniques.

Materials and methods

Twelve LEA injections were performed under fluoroscopy in HP with two reflux control methods: dual lumen ‘mini’ balloon-catheter (n=9); and injection after proximal nBCA plug formation through a second microcatheter (‘pressure cooker’) (n=3). Measured outcomes included liquid embolic agent (LEA) advancement and reflux. Reflux was categorized into three grades: grade 0=no reflux; grade 1=occlusion of side branches without reflux beyond the balloon or plug; and grade 2=reflux beyond the balloon or plug.

Results

Simulation success was greater when a balloon was used rather than with a nBCA plug (89% vs 33%, P=0.054). In eight successful balloon-assisted injections, the reflux grades were: 50% grade 0; 12.5% grade 1; and 37.5% grade 2. The one successful nBCA plug injection had grade 2 reflux. All grade 2 balloon injections occurred when the balloon was positioned across a vessel bifurcation.

Conclusions

HP provides excellent simulation for liquid embolic agents with a dual lumen balloon catheter.
Stimulation of rat oxyntic gland mucosal growth by epidermal growth factor
Authors: Johnson L. R. , Guthrie P. D.
Published: December 2017

Epidermal growth factor (EGF) inhibits gastric acid secretion, but its effects on the growth of gut mucosa have not been examined. Fasted male rats were given six injections of EGF (10 micrograms/kg) over a 48-h period. The animals were killed and the incorporation of [3H]thymidine into various tissues was examined and compared to rats treated with NaCl, pentagastrin, and EGF plus secretin. EGF and pentagastrin significantly increased DNA synthesis of the oxyntic gland mucosa. Pentagastrin, but not EGF, stimulated DNA synthesis of duodenal and colonic mucosa as well. Neither peptide altered skin DNA synthesis. Secretin inhibited the effects of pentagastrin but not EGF. Chronic administration of EGF (5 days) caused significant increases in oxyntic gland mucosal DNA, RNA, and protein content. These results not only demonstrate that EGF is a trophic agent for the oxyntic gland mucosa but lend further support to the hypothesis that acid secretion and mitogenesis are the result of two separate mechanisms.
Alteration of myoelectric activity of small intestine by invasive Escherichia coli
Authors: Burns T. W. , Mathias J. R. , Martin J. L. , Carlson G. M. , Shields R. P.
Published: December 2017

Invasive strains of Escherichia coli (4608-58 and TD 213 CL) altered myoelectric activity of the small intestine in New Zealand White rabbits. The altered myoelectric activity had two distinct complex patterns. The first was defined as repetitive bursts of action potentials (RBAPs) that occurred predominantly in infected ligated ileal loops. The RBAP activity is characterized by action potential discharge activity greater than 1.5 s in duration and occurring on three or more successive slow waves on the same electrode recording site. These bursts of action potentials often migrated to adjacent electrode sites. The second complex pattern, defined as the migrating action potential complex (MAPC), occurred predominantly in the uninfected small intestine orad to the ligated ileal loop. The MAPC consists of action potential discharge activity of 2.5 s or longer that propagates aborally over at least two consecutive electrode sites. These studies demonstrated an altered myoelectric pattern, the RBAP, characteristic of invasion within the infected ligated loop. The MAPC, characteristic of noninvasion, was noted in the uninfected proximal small intestine.
Intravenous indomethacin and aspirin reduce basal gastric mucosal blood flow in dogs
Authors: Kauffman G. L. , Aures D. , Grossman M. I.
Published: December 2017

The effect of two known inhibitors of prostaglandin synthesis, indomethacin and aspirin, on blood flow was studied in six Heidenhain pouch and three antral pouch dogs. The unstimulated gastric mucosa was bathed with 0.15 M HCl and clearance of [14C]-aminopyrine was used as an index of changes in mucosal blood flow. [14C]aminopyrine clearance was measured during three 15-min predrug periods and five 15 min-postdrug periods. Either indomethacin (10 mg . kg-1), aspirin (100 mg . kg-1), or 0.15 M NaCl were given intravenously as a bolus. Indomethacin reduced mucosal blood flow in the Heidenhain pouch 52% (P less than 0.05) and in the antral pouch 52% (P less than 0.05). Aspirin reduced Heidenhain pouch mucosal blood flow 31% (P less than 0.05). Indomethacin caused no significant change in electrical potential difference or in net flux of H+ or Na+ in Heidenhain pouches. Indomethacin (10 mg . kg-1 iv) produced no change in mean arterial pressure. We conclude that indomethacin and aspirin reduce unstimulated gastric mucosal blood flow, suggesting that endogenous prostaglandin may contribute to its maintenance.
Mucosal gastrin receptor. III. Regulation by gastrin
Authors: Takeuchi K. , Speir G. R. , Johnson L. R.
Published: December 2017

Specific binding of 125I-labeled gastrin to rat gastric mucosal membranes was found to vary with serum gastrin levels. The dissociation equilibrium constants were not significantly different between receptor preparations. However, the binding capacities of the membrane preparations were directly correlated with serum gastrin levels. Fasting, feeding a liquid diet, and antrectomy significantly decreased serum gastrin and the concentrations of the gastrin receptor. Treatment of fasted and liquid-fed animals with pentagastrin prevented the decrease in receptors. Vagotomy increased both binding capacity and serum gastrin levels. These data indicate that gastrin stimulates the production of its own receptor. The upregulation of the gastrin receptor was evident if the binding capacity was expressed per milligram of protein, per microgram of DNA, or per amount of 125I-labeled choleragen bound to the same membrane preparation. This indicates that the biological response to gastrin is controlled in part by the regulation of the number of gastrin receptors present and that gastrin plays a role in this regulatory process.
Active secretion of hypoxanthine and xanthine by guinea pig jejunum in vitro
Authors: Kolassa N. , Schutzenberger W. G. , Wiener H. , Turnheim K.
Published: December 2017

Isolated epithelium of guinea pig jejunum secretes hypoxanthine and xanthine by a transport process that is capable of uphill transport and dependent on metabolic energy supply. Unidirectional influx of hypoxanthine across both the luminal and the contraluminal cell membrane appears to be saturable; influx across the contraluminal membrane is inhibited by 2,4-dinitrophenol (DNP). Efflux across the luminal membrane is diminished by DNP; efflux across the contraluminal membrane is increased by DNP. This evidence suggests the existence of a mediated transport system both in the luminal and the contraluminal cell membrane. Additionally, intracellular metabolism of hypoxanthine seems to regulate transepithelial permeation: increased hypoxanthine salvage by the phosphoribosyltransferase reduces the rate of secretion. However, the incorporation of hypoxanthine into the nucleotides is limited when the hypoxanthine is added to the luminal side of the epithelium, and the permeation rate in the absorptive direction is not markedly influenced by the rate of hypoxanthine salvage. These findings are a further example of the functional orientation of the jejunal epithelial cells with respect to enzymic activity and transepithelial transport properties.
Probes of parietal cell function
Authors: Berglindh T. , Dibona D. R. , Ito S. , Sachs G.
Published: December 2017

The site of acid secretion in the gastric mucosa has been inferred, but never proven. Using differential interference-contrast (Nomarski) microscopy an expansion of intracellular vacuoles was observed in the parietal cells of living rabbit gastric glands following histamine stimulation. A similar vacuolization occurring only in part of a parietal cell population could be induced by high concentrations of accumulated weak base, aminopyrine, in the absence of secretagogue. In high-K+ medium, 10(-3) M aminopyrine induced massive vacuolization in all parietal cells, consistent with the strong effect of high K+ in stimulating aminopyrine uptake by isolated glands. Electron micrographs showed that the apparent vacuoles correspond to the secretory canaliculi in various stages of swelling. Acridine orange, a fluorescent dye which is distributed across natural membranes as a function of a pH gradient and binds in a multimolecular fashion (stacking) to negative sites, was accumulated by gastric glands as a function of acid secretion. Visualization of such glands by fluorescence or a combination of Nomarski and fluorescence microscopy showed a red fluorescence in the expanding secretory canaliculi that was in sharp contrast to the green fluorescence in the rest of the cell. From these data it is concluded that the site of acid secretion is indeed the secretory canaliculus of the parietal cell. It is also possible that the formation of secretory canaliculi may be induced osmotically and that the peripheral "parietal" position and triangular shape of the parietal cell is necessary to allow expansion and oriented apical flow of HCl.
Effects of infection and endotoxin on rat hepatic RNA production and distribution
Authors: Thompson W. L. , Wannemacher R. W.
Published: December 2017

Rat liver was quantitatively subfractionated into free ribosomal, bound ribosomal, nuclear, and soluble fractions to determine the effects of infection and endotoxin treatment on hepatic RNA production and distribution. A 4-h pulse label of [14C]orotic acid was used to monitor newly transcribed RNA; distribution was determined by measuring RNA content at various times after infection or endotoxin treatment. A significant increase in the rate of RNA synthesis was seen by 12 h and continued through 20 h in response to Streptococcus pneumoniae infection. During the peak hours of the RNA response, redistribution of RNA into the bound ribosomal fraction takes place at the expense of the free ribosomes. However, in Salmonella typhimurium and its endotoxin, more involvement of the free ribosoma fraction during the early stages of the infection was apparent. These data suggest that the hepatic RNA response takes place in two stages, an early "endotoxin" response, resulting in redistribution of cytoplasmic RNA into free ribosomes, and a later "infection" response, involving the mobilization of the bound ribosomes.