bluuebunny/crossref_metadata_2025 huggingface dataset:
A unusual case of multifocal pyogenic abscess formation following ERCP procedure
Authors: Merei Fahed , Shapiro Galina , Abu Shakra Ibrahim , Bickel Amitai , Ganam Samer , Bez Maxim , Kakiashvili Eli
Published: May 2020

Background

Endoscopic retrograde cholangiopancreatography (ERCP) is essential for managing biliary and pancreatic disorders. Infection is the most morbid complication of ERCP and among the most common causes of ERCP-related death.

Case presentation

A 69-year-old man presented with right upper quadrant abdominal pain, obstructive jaundice and abnormal liver function tests. Ultrasound revealed cholelithiasis without bile duct dilation. After receiving intravenous antibiotics for acute cholecystitis, the patient was discharged. Two weeks later, an endoscopic ultrasound demonstrated gallstones and CBD dilation of up to 6.4 mm with 2 filling defects. An ERCP was performed with a papillotomy and stone extraction. Twenty-four hours post-ERCP the patient developed a fever, chills, bilirubinemia and elevated liver function tests. Ascending cholangitis was empirically treated using Ceftriaxone and Metronidazole. However, the patient remained febrile, with a diffusely tender abdomen and elevated inflammatory markers. A CT revealed a very small hypodense lesion in the seventh liver segment. Extended-spectrum beta-lactamase positive Klebsiella Pneumonia and Enterococcus Hirae were identified, and the antibiotics were switched to Imipenem and Cilastatin. The hypodense lesion in the liver increased to 1.85 cm and a new hypodense lesion was seen in the right psoas. At day 10 post-ERCP, the patient started having low back pain and difficulty walking. MRI revealed L4-L5 discitis with a large epidural abscess, spanning L1-S1 and compressing the spinal cord. Decompressive laminectomy of L5 was done and Klebsiella pneumonia was identified. Due to continued drainage from the wound, high fever, we performed a total body CT which revealed increased liver and iliopsoas abscess. Decompressive laminectomy was expanded to include L2-L4 and multiple irrigations were done. Gentamycin and Vancomycin containing polymethylmethacrylate beads were implanted locally and drainage catheters were placed before wound closure. Multidisciplinary panel discussion was performed, and it was decided to continue with a non invasive approach .

Conclusions

Early recognition of complications and individualized therapy by a multi-disciplined team is important for managing post-ERCP septic complications. Particular attention should be given to adequate coverage by empiric antibiotics.
Burkitt’s lymphoma of the prostate presenting as acute urinary retention: a case report
Authors: Derigs Marcus , Pehl Anika , Riera-Knorrenschild Jorge , Hofmann Rainer , Hegele Axel
Published: May 2020

Background

Non-Hodgkin lymphomas, which include Burkitt’s lymphoma, affect the prostate in only 0.1% of cases. They most commonly present as painless lymphadenopathy elsewhere in the body and can cause abdominal or thoracic pain and systemic symptoms such as fever, weight loss and night sweats. Here we report a rare case of sporadic Burkitt’s lymphoma of the prostate whose initial clinical presentation was acute urinary retention.

Case presentation

A 28-year-old Caucasian male presented repeatedly with urinary retention. First, he was misdiagnosed with alcohol-induced urinary retention and later with benign prostatic hyperplasia. After the appearance of new symptoms, including hematuria and hydronephrosis, endoscopic and radiographic evaluation was performed. Transurethral biopsy of the prostate secured the diagnosis of Burkitt’s lymphoma. The symptoms receded under chemotherapy and complete remission of the disease was established.

Conclusion

This case report brings lymphomas into focus as a differential diagnosis for urinary retention in young males. Early use of extensive diagnostic measures is advised in patients with urinary retention for uncertain reasons to make prompt diagnosis and start appropriate treatment early.
The effect of legislation on the treatment practices and role of naturopaths in South Africa
Authors: Ericksen-Pereira Wendy , Roman Nicolette V. , Swart Rina
Published: May 2020

Background

In South Africa naturopaths have been practising for over half a century. Over this period, changes in legislation have resulted in different levels of training and registration processes - which has impacted on the profession in various ways. This paper explores the effect of legislation on the treatment practices and role of naturopaths in South Africa.

Methods

This was a qualitative study which used an exploratory approach. Participants were sampled from the list of naturopaths registered with the Allied Health Professions Council of South Africa (AHPCSA). A set of 15 open-ended survey questions were emailed to 59 naturopaths. Twenty one naturopaths participated: 13 responded via email and eight were interviewed. Responses were coded and thematically analysed.

Results

It was found that despite differences in training and years of practice experience, four core treatment practices of diet therapy, lifestyle medicine, supplementation and physical therapies were common to all participants with the older, more experienced naturopaths using a wider range of treatment practices. There is a shared common vision of wanting the profession to have greater participation in the public healthcare system. This research has found that legislation influences the treatment practices and role played by naturopaths in South Africa. The findings of this paper acknowledges the limiting impact of state legislation on naturopathic and other complementary medicine professions.

Conclusion

Naturopathy has to operate within the legislative framework and this appears to be one of the key factors which has contributed to the lack of growth of naturopathy in South Africa. Findings thus highlight the need for new legislation to reflect the changes in society to ensure that the emergent healthcare needs of the population are met.
Patients’ and tutors’ evaluations of medicine students’ consultations in general practice/family medicine in Coimbra
Authors: Santiago Luiz Miguel , Silva Inês , Simões José Augusto
Published: May 2020

Background

Undergraduate teaching of General Practice/Family Medicine (GP/FM) must ensure students acquire the necessary competencies and skills to perform an adequate GP/FM consultation with adequate annotations (the SOAP model) and classifications. So aimed to study and to correlate students’ evaluation by tutors and patients in specific consultations in the formal practical evaluation of GP/FM Curricular Unit of the Integrated Masters on Medicine at the Faculty of Medicine of the University of Coimbra (IMM-FMUC) in the academic years of 2017–2018 and 2018–2019.

Methods

Observational study of the 2017–2018 and 2018–2019 academic years of the assessment grids for tutor’s evaluation of SOAP performance and fluency in consultation and for patient’s evaluation of the student ‘performance, in the convenience sample of those who chose to be so evaluated.

Results

We studied a population of 435 (67,7%) out of a universe of 646 students, 125 (28,7%) males, ns by sex and academic year who performed this evaluation. In a mark up to 20 from tutors, difference was found for Plan (P) mark, higher in 2018–2019 (18,38 ± 2,18vs18,54 ± 2,11, p = 0,005) of the SOAP methodology evaluation. Patients’ evaluation was not different 19,34 ± 1,70vs19,35 ± 1,40, p = 0,091. A positive significant correlation was found between tutors and patients marks (ρ = 0,278; p < 0,001), as well as between tutor mark and final mark (ρ = 0,958; p < 0,001) and patient and final marks (ρ = 0,465; p < 0,001). Final marks were not different in both years, 18,61 ± 1,38vs18,78 ± 1,15, p = 0,158.

Conclusions

This innovative model of evaluation of student’s performance in medical appointment, showed a significant positive moderate correlation between patients’ and tutors’ marks in the setting of GP/FM at the IMM-FMUC, and was not different between years. Yearly evaluation must be continued.
ReNaApp: increasing the long-term effects of oncological rehabilitation through an application after medical rehabilitation (ReNaApp): a quasi-randomized longitudinal study of prospective design
Authors: Rutsch Mercedes , Jochems Nicole , Schrader Andreas , Brandes Iris , Weier Lisa , Deck Ruth
Published: May 2020

Background

Breast cancer is the most common malignant disease in women. Compared with other cancer types, breast cancer has a higher survival rate. The majority of breast cancer patients are overstrained to implement cancer-specific recommendations relating to changes in health behaviour. Numerous epidemiological studies have shown a positive correlation between physical activity and quality of life as well as the course of disease during and after breast cancer treatment. However, many patients have difficulties integrating physical activity into their everyday lives due to cancer symptoms. To develop physical activity into a daily routine, an aftercare programme for breast cancer patients will be developed. In particular, the programme is structured in terms of the validated concept “Neues Credo”. The basic concept is converted into a mobile application.

Methods

The study sample includesn = 740 rehabilitants (370 for the intervention group and for the control group) from five different rehab clinics in Northern Germany. The evaluation is as follows: a) Quasi-randomized, prospective longitudinal study (sequential study design). The intervention group receives a mobile application after rehabilitation, and the control group receives treatment as usual. The study evaluation is carried out through a questionnaire at three stages (at the beginning of the rehabilitation, at the end of the rehabilitation, and after 12 months). b) Qualitative analysis of interviews and focus groups in terms of feasibility and acceptance. c) Formative evaluation of the app.

Discussion

Above all, the aftercare programme ReNaApp increases the long-term effects of oncological rehabilitation. By documenting physical activity in ReNaApp, rehabilitants become more motivated to engage in physical activity in their everyday lives. Currently, there is no scientifically evaluated app for breast cancer patients in the German language. Thus, ReNaApp ensures an aftercare treatment for breast cancer patients with high-quality performance regardless of their place of residence. By adopting a participatory approach and a user-centred design, ReNaApp corresponds to the demands of the rehabilitants.

Trial registration

German Register of Clinical Trials, www.drks.de.

Identifier:DRKS00019017; Registered: November 7th, 2019.

Date and version identifier: April 17th 2020; vesion 2.
A single-center, retrospective study of COVID-19 features in children: a descriptive investigation
Authors: Ma Huijing , Hu Jiani , Tian Jie , Zhou Xi , Li Hui , Laws Maxwell Thomas , Wesemann Luke David , Zhu Baiqi , Chen Wei , Ramos Rafael , Xia Jun , Shao Jianbo
Published: May 2020

Background

Compared to adults, there are relatively few studies on COVID-19 infection in children, and even less focusing on the unique features of COVID-19 in children in terms of laboratory findings, locations of computerized tomography (CT) lesions, and the role of CT in evaluating clinical recovery. The objective of this study is to report the results from patients at Wuhan Children’s Hospital, located within the initial center of the outbreak.

Methods

Clinical, imaging, and laboratory data of 76 children were collected retrospectively and analyzed with the Fisher exact test and Cox regression statistical methods.

Results

Among 50 children with a positive COVID-19 real-time reverse-transcriptase polymerase chain reaction (PCR), five had negative PCR results initially but showed positive results in subsequent tests. Eight (16%) patients had lymphopenia, seven (14%) with thrombocytopenia, four (8%) with lymphocytosis, two (4%) with thrombocytosis, ten (20%) with elevated C-reactive protein, four (8%) with hemoglobin above, and six (12%) with below standard reference values. Seven (14%) of the 50 had no radiologic evidence of disease on chest CT. For the 43 patients who had abnormal CT findings, in addition to previously reported patterns of ground-glass opacity (67%), local patchy shadowing (37%), local bilateral patchy shadowing (21%), and lesion location of lower lobes (65%), other CT features include that an overwhelming number of pediatric patients had lesions in the subpleural area (95%) and 22 of the 28 lower lobe lesions were in the posterior segment (78%). Lesions in most of the 15 patients (67%) who received chest CT at discharge were not completely absorbed, and 26% of these pediatric patients had CT lesions that were either unchanged or worse.

Conclusions

There were a few differences between COVID-19 children and COVID-19 adults in terms of laboratory findings and CT characteristics. CT is a powerful tool to detect and characterize COVID-19 pneumonia but has little utility in evaluating clinical recovery for children. These results oppose current COVID-19 hospital discharge criteria in China, as one requirement is that pulmonary imaging must show significant lesion absorption prior to discharge. These differences between pediatric and adult cases of COVID-19 may necessitate pediatric-specific discharge criteria.
Differences in airway microbiome and metabolome of single lung transplant recipients
Authors: Sharma Nirmal S. , Vestal Grant , Wille Keith , Patel Kapil N. , Cheng Feng , Tipparaju Srinivas , Tousif Sultan , Banday Mudassir M. , Xu Xin , Wilson Landon , Nair Viswam S. , Morrow Casey , Hayes Don , Seyfang Andreas , Barnes Stephen , Deshane Jessy S. , Gaggar Amit
Published: May 2020

Background

Recent studies suggest that alterations in lung microbiome are associated with occurrence of chronic lung diseases and transplant rejection. To investigate the host-microbiome interactions, we characterized the airway microbiome and metabolome of the allograft (transplanted lung) and native lung of single lung transplant recipients.

Methods

BAL was collected from the allograft and native lungs of SLTs and healthy controls. 16S rRNA microbiome analysis was performed on BAL bacterial pellets and supernatant used for metabolome, cytokines and acetylated proline-glycine-proline (Ac-PGP) measurement by liquid chromatography-high-resolution mass spectrometry.

Results

In our cohort, the allograft airway microbiome was distinct with a significantly higher bacterial burden and relative abundance of genera Acinetobacter & Pseudomonas. Likewise, the expression of the pro-inflammatory cytokine VEGF and the neutrophil chemoattractant matrikine Ac-PGP in the allograft was significantly higher. Airway metabolome distinguished the native lung from the allografts and an increased concentration of sphingosine-like metabolites that negatively correlated with abundance of bacteria from phyla Proteobacteria.

Conclusions

Allograft lungs have a distinct microbiome signature, a higher bacterial biomass and an increased Ac-PGP compared to the native lungs in SLTs compared to the native lungs in SLTs. Airway metabolome distinguishes the allografts from native lungs and is associated with distinct microbial communities, suggesting a functional relationship between the local microbiome and metabolome.
Saliva exosomes-derived UBE2O mRNA promotes angiogenesis in cutaneous wounds by targeting SMAD6
Authors: Mi Bobin , Chen Lang , Xiong Yuan , Yan Chenchen , Xue Hang , Panayi Adriana C. , Liu Jing , Hu Liangcong , Hu Yiqiang , Cao Faqi , Sun Yun , Zhou Wu , Liu Guohui
Published: May 2020

Background

Enhancing angiogenesis is critical for accelerating wound healing. Application of different types of exosomes (Exos) to promote angiogenesis represents a novel strategy for enhanced wound repair. Saliva is known to accelerate wound healing, but the underlying mechanisms remain unclear.

Results

Our results have demonstrated that saliva-derived exosomes (saliva-Exos) induce human umbilical vein endothelial cells (HUVEC) proliferation, migration, and angiogenesis in vitro, and promote cutaneous wound healing in vivo. Further experiments documented that Ubiquitin-conjugating enzyme E2O (UBE2O) is one of the main mRNAs of saliva-Exos, and activation of UBE2O has effects similar to those of saliva-Exos, both in vitro and in vivo. Mechanistically, UBE2O decreases the level of SMAD family member 6 (SMAD6), thereby activating bone morphogenetic protein 2 (BMP2), which, in turn, induces angiogenesis.

Conclusions

The present work suggests that administration of saliva-Exos and UBE2O represents a promising strategy for enhancing wound healing through promotion of angiogenesis.
Changes in mortality and years of life lost due to lung cancer in Poland, 2000–2016
Authors: Pikala Małgorzata , Burzyńska Monika , Maniecka-Bryła Irena
Published: May 2020

Background

The aim of the study was to evaluate trends of mortality and the number of years of life lost due to lung cancer in Poland, in the period 2000–2016.

Methods

The study material was 375,151 death certificates of all inhabitants of Poland who died in the period 2000–2016 due to lung cancer. In order to calculate the number of years of life lost, the authors used indices: SEYLLp (Standard Expected Years of Life Lost per living person), SEYLLd (per deaths), APC (Annual Percentage Change) and AAPC (Average Annual Percentage Change).

Results

The standardized death rate (SDR) due to lung cancer decreased in the analyzed period from 74.5 to 68.3 per 100,000 population (AAPC = −0.6%). The most rapid decrease was noted in the years 2008–2011 (APC = –2.2%). With regards to males, SDR decreased from 148.8 to 114.5 (AAPC = –1.7%), whereas in females, it increased from 25.7 to 37.6 (AAPC = 2.3%). The SEYLLp index, calculated per 100,000 inhabitants, increased from 1189.9 in the year 2000 to 1250.5 in the year 2016. The trend and pace of changes fluctuated. In 2000–2008, the SEYLLp index was increasing at a pace of 0.7%. This growth was followed by a decrease at a pace of −1.2%, noted in 2008–2011. After the year 2011, the indices started to grow at an annual pace of 0.4%. AAPC in the whole study period was 0.3%. Increased mortality in females was responsible for the increase in the number of lost years of life. SEYLLp values in this sex group increased from 464.8 in the year 2000 to 774.7 in the year 2016 (APC = 3.3%).With regards to males, SEYLLp values, calculated for 100,000 male population, decreased in the analyzed period from 1961.1 to 1758.3.

Conclusions

Lung cancer still poses a serious epidemiological problem in Poland and the number of years of life lost due to this cause reflects social and economic implications of premature lung cancer-related mortality. There is a great need to educate, particularly women, and show effective ways of quitting smoking.
Is HDL cholesterol protective in patients with type 2 diabetes? A retrospective population-based cohort study
Authors: Fanni Giovanni , Rosato Rosalba , Gentile Luigi , Anselmino Matteo , Frea Simone , Ponzo Valentina , Pellegrini Marianna , Broglio Fabio , Pivari Francesca , De Ferrari Gaetano Maria , Ghigo Ezio , Bo Simona
Published: May 2020

Background

The protective role of high HDL cholesterol levels against cardiovascular diseases has been recently questioned. Limited data are available on this specific topic in patients with type 2 diabetes mellitus (T2DM). We aimed to evaluate the association of HDL cholesterol concentrations with all-cause and cause-specific mortality in a historical cohort of T2DM patients with 14 years of follow-up.

Methods

This is a retrospective population-based cohort study involving 2113 T2DM patients attending the Diabetic Clinic of Asti. Survival analyses were performed to assess hazard ratios for overall and specific-cause mortality by HDL cholesterol tertiles, using the middle HDL cholesterol tertile as a reference.

Results

The mean age was 66 ± 11 years; 51.4% of patients had low HDL-cholesterol levels. After a 14-year follow-up, 973/2112 patients had died (46.1%). The HDL cholesterol tertile cut-off points were 37.5 and 47.5 mg/dL (males) and 41.5 and 52.0 mg/dL (females). No associations between lower and upper HDL cholesterol tertiles respectively and all-cause (HR = 1.12; 95% CI 0.96–1.32; HR = 1.11; 0.95–1.30), cardiovascular (HR = 0.97; 0.77–1.23; HR = 0.94; 0.75–1.18) or cancer (HR = 0.92; 0.67–1.25; HR = 0.89; 0.66–1.21) mortality were found. A significantly increased risk for infectious disease death was found both in the lower (HR = 2.62; 1.44–4.74) and the upper HDL-cholesterol tertiles (HR = 2.05; 1.09–3.85) when compared to the reference. Individuals in the upper tertile showed an increased risk for mortality due to diabetes-related causes (HR = 1.87; 1.10–3.15).

Conclusions

Our results corroborate the hypothesis that HDL cholesterol levels are nonprotective in T2DM patients. The U-shaped association between HDL-cholesterol levels and mortality associated with infectious diseases should be verified by further studies.
Interleukin-9 regulates macrophage activation in the progressive multiple sclerosis brain
Authors: Donninelli Gloria , Saraf-Sinik Inbar , Mazziotti Valentina , Capone Alessia , Grasso Maria Grazia , Battistini Luca , Reynolds Richard , Magliozzi Roberta , Volpe Elisabetta
Published: May 2020

Background

Multiple sclerosis (MS) is an immune-mediated, chronic inflammatory, and demyelinating disease of the central nervous system (CNS). Several cytokines are thought to be involved in the regulation of MS pathogenesis. We recently identified interleukin (IL)-9 as a cytokine reducing inflammation and protecting from neurodegeneration in relapsing–remitting MS patients. However, the expression of IL-9 in CNS, and the mechanisms underlying the effect of IL-9 on CNS infiltrating immune cells have never been investigated.

Methods

To address this question, we first analyzed the expression levels of IL-9 in post-mortem cerebrospinal fluid of MS patients and the in situ expression of IL-9 in post-mortem MS brain samples by immunohistochemistry. A complementary investigation focused on identifying which immune cells express IL-9 receptor (IL-9R) by flow cytometry, western blot, and immunohistochemistry. Finally, we explored the effect of IL-9 on IL-9-responsive cells, analyzing the induced signaling pathways and functional properties.

Results

We found that macrophages, microglia, and CD4 T lymphocytes were the cells expressing the highest levels of IL-9 in the MS brain. Of the immune cells circulating in the blood, monocytes/macrophages were the most responsive to IL-9. We validated the expression of IL-9R by macrophages/microglia in post-mortem brain sections of MS patients. IL-9 induced activation of signal transducer and activator of transcription (STAT)1, STAT3, and STAT5 and reduced the expression of activation markers, such as CD45, CD14, CD68, and CD11b in inflammatory macrophages stimulated in vitro with lipopolysaccharide and interferon (IFN)-γ. Similarly, in situ the number of activated CD68+macrophages was significantly reduced in areas with high levels of IL-9. Moreover, in the same conditions, IL-9 increased the secretion of the anti-inflammatory cytokine, transforming growth factor (TGF)-β.

Conclusions

These results reveal a new cytokine expressed in the CNS, with a role in the context of MS. We have demonstrated that IL-9 and its receptor are both expressed in CNS. Moreover, we found that IL-9 decreases the activation state and promotes the anti-inflammatory properties of human macrophages. This mechanism may contribute to the beneficial effects of IL-9 that are observed in MS, and may be therapeutically potentiated by modulating IL-9 expression in MS.
Embryonic microglia influence developing hypothalamic glial populations
Authors: Marsters Candace M. , Nesan Dinushan , Far Rena , Klenin Natalia , Pittman Quentin J. , Kurrasch Deborah M.
Published: May 2020

Background

Although historically microglia were thought to be immature in the fetal brain, evidence of purposeful interactions between these immune cells and nearby neural progenitors is becoming established. Here, we examined the influence of embryonic microglia on gliogenesis within the developing tuberal hypothalamus, a region later important for energy balance, reproduction, and thermoregulation.

Methods

We used immunohistochemistry to quantify the location and numbers of glial cells in the embryonic brain (E13.5–E17.5), as well as a pharmacological approach (i.e., PLX5622) to knock down fetal microglia. We also conducted cytokine and chemokine analyses on embryonic brains in the presence or absence of microglia, and a neurosphere assay to test the effects of the altered cytokines on hypothalamic progenitor behaviors.

Results

We identified a subpopulation of activated microglia that congregated adjacent to the third ventricle alongside embryonic Olig2+ neural progenitor cells (NPCs) that are destined to give rise to oligodendrocyte and astrocyte populations. In the absence of microglia, we observed an increase in Olig2+ glial progenitor cells that remained at the ventricle by E17.5 and a concomitant decrease of these Olig2+ cells in the mantle zone, indicative of a delay in migration of these precursor cells. A further examination of maturing oligodendrocytes in the hypothalamic grey and white matter area in the absence of microglia revealed migrating oligodendrocyte progenitor cells (OPCs) within the grey matter at E17.5, a time point when OPCs begin to slow their migration. Finally, quantification of cytokine and chemokine signaling in ex vivo E15.5 hypothalamic cultures +/− microglia revealed decreases in the protein levels of several cytokines in the absence of microglia. We assayed the influence of two downregulated cytokines (CCL2 and CXCL10) on neurosphere-forming capacity and lineage commitment of hypothalamic NPCs in culture and showed an increase in NPC proliferation as well as neuronal and oligodendrocyte differentiation.

Conclusion

These data demonstrate that microglia influence gliogenesis in the developing tuberal hypothalamus.
Immunomodulatory and anti-oxidative effect of the direct TRPV1 receptor agonist capsaicin on Schwann cells
Authors: Grüter Thomas , Blusch Alina , Motte Jeremias , Sgodzai Melissa , Bachir Hussein , Klimas Rafael , Ambrosius Björn , Gold Ralf , Ellrichmann Gisa , Pitarokoili Kalliopi
Published: May 2020

Background

Only few studies describe the impact of nutritive factors on chronic inflammatory demyelinating polyneuropathy (CIDP), an inflammatory disease of the peripheral nervous system. The active component of chili pepper, capsaicin, is the direct agonist of the transient receptor potential channel vanilloid subfamily member 1. Its anti-inflammatory effect in the animal model experimental autoimmune neuritis (EAN) has been previously demonstrated.

Methods

In the present study, we describe the anti-inflammatory and anti-oxidative influence of capsaicin on Schwann cells (SCs) in an in vitro setting. Hereby, we analyze the effect of capsaicin on Schwann cells’ gene expression pattern, major histocompatibility complex class II (MHC-II) presentation, and H2O2-induced oxidative stress. Furthermore, the effect of capsaicin on myelination was examined in a SC-dorsal root ganglia (DRG) coculture by myelin basic protein staining. Finally, in order to investigate the isolated effect of capsaicin on SCs in EAN pathology, we transplant naïve and capsaicin pre-treated SCs intrathecally in EAN immunized rats and analyzed clinical presentation, electrophysiological parameters, and cytokine expression in the sciatic nerve.

Results

In SC monoculture, incubation with capsaicin significantly reduces interferon gamma-induced MHC-II production as well as toll-like receptor 4 and intercellular adhesion molecule 1 mRNA expression. Calcitonin gene-related peptide mRNA production is significantly upregulated after capsaicin treatment. Capsaicin reduces H2O2-induced oxidative stress in SC in a preventive, but not therapeutic setting. In a SC-DRG coculture, capsaicin does not affect myelination rate. After intrathecal transplantation of naïve and capsaicin pre-treated SCs in EAN-immunized rats, naïve, but not capsaicin pre-treated intrathecal SCs, ameliorated EAN pathology in rats.

Conclusions

In conclusion, we were able to demonstrate a direct immunomodulatory and anti-oxidative effect of capsaicin in a SC culture by reduced antigen presentation and expression of an anti-inflammatory profile. Furthermore, capsaicin increases the resistance of SCs against oxidative stress. A primary effect of capsaicin on myelination was not proven. These results are in concordance with previous data showing an anti-inflammatory effect of capsaicin, which might be highly relevant for CIDP patients.
Global Health – emergence, hegemonic trends and biomedical reductionism
Authors: Holst Jens
Published: May 2020

Background

Global Health has increasingly gained international visibility and prominence. First and foremost, the spread of cross-border infectious disease arouses a great deal of media and public interest, just as it drives research priorities of faculty and academic programmes. At the same time, Global Health has become a major area of philanthropic action. Despite the importance it has acquired over the last two decades, the complex collective term “Global Health” still lacks a uniform use today.

Objectives

The objective of this paper is to present the existing definitions of Global Health, and analyse their meaning and implications. The paper emphasises that the term “Global Health” goes beyond the territorial meaning of “global”, connects local and global, and refers to an explicitly political concept. Global Health regards health as a rights-based, universal good; it takes into account social inequalities, power asymmetries, the uneven distribution of resources and governance challenges. Thus, it represents the necessary continuance of Public Health in the face of diverse and ubiquitous global challenges. A growing number of international players, however, focus on public-private partnerships and privatisation and tend to promote biomedical reductionism through predominantly technological solutions. Moreover, the predominant Global Health concept reflects the inherited hegemony of the Global North. It takes insufficient account of the global burden of disease, which is mainly characterised by non-communicable conditions, and the underlying social determinants of health.

Conclusions

Beyond resilience and epidemiological preparedness for preventing cross-border disease threats, Global Health must focus on the social, economic and political determinants of health. Biomedical and technocratic reductionism might be justified in times of acute health crises but entails the risk of selective access to health care. Consistent health-in-all policies are required for ensuring Health for All and sustainably reducing health inequalities within and among countries. Global Health must first and foremost pursue the enforcement of the universal right to health and contribute to overcoming global hegemony.
Local and scientific knowledge in the school context: characterization and content of published works
Authors: Sotero Maria Carolina , Alves Ângelo Giuseppe Chaves , Arandas Janaina Kelli Gomes , Medeiros Maria Franco Trindade
Published: May 2020

Background

Bridging the gap between local and scientific knowledge can have useful implications in the teaching-learning process because it can create environments conducive to the valorization of sociocultural diversity in schools. The present review aims to analyze the profile and contributions of scientific publications dealing with articulations between local and scientific knowledge in basic formal education.

Method

Combined searches of 14 terms related to ethnoscience and 20 terms of education were conducted in English, Portuguese, and Spanish using the databases ofWeb of Science,Scopus,Science Direct, andScielo. The recovered works were filtered, organized in a spreadsheet, and analyzed for publication characteristics (year, author, periodicals, countries of origin of the authors, and countries surveyed) and contents of the studies (epistemological bases, techniques of application, and record of the articulation of local and scientific knowledge).

Results

The research field that establishes these articulations is growing, with 81% of the works being written in the English language. A total of 494 researchers were recorded. The USA, South Africa, Brazil, Canada, and Australia were the countries of origin of the first author for the majority (64%) of the works considered. Multiculturalism, Vygotskian theory of learning, postcolonial theory, constructivism, critical pedagogy, and the argumentation theory were the main theoretical bases of half of the recovered works in which some explicit theoretical orientation could be found. Teacher training and interviews stood out as important tools in the application and record of links between local and scientific knowledge, respectively.

Conclusions

Interdisciplinary approaches were common in the conception and application of pedagogical activities reported in the recovered works. Articulations between local and scientific knowledge are effective for culturally-sensitive scientific education, especially (but not exclusively) in schools directly related to traditional communities. There was a tendency to emphasize the teacher as a fundamental agent in the search for education that establishes these articulations. The authors of the analyzed works frequently indicated a need for greater proximity of the community to school spaces.
Transcatheter rectal arterial chemoembolization with oxaliplatin plus S-1 concurrent chemoradiotherapy can improve the pathological remission rate in locally advanced rectal cancer: a comparative study
Authors: Yang Bo , Shan Jinlu , Feng Yan , Dai Nan , Li Mengxia , Chen Chuan , He Shengyong , Wang Ge , Xiao Hualiang , Li Chunxue , Wang Dong
Published: May 2020

Background

To explore the efficacy and safety of Transcatheter rectal arterial chemoembolization with oxaliplatin and S-1 concurrent chemoradiotherapy as neoadjuvant therapy for locally advanced rectal cancer.

Methods

This s a prospective, monocentric, non-randomized clinical study, a total of 95 patients were enrolled and assigned to two groups: an investigational group (n = 50) receiving transcatheter rectal arterial chemoembolization (TRACE) with oxaliplatin and preoperative radiotherapy plus S-1 concurrent chemotherapy (NATRACE-CRT), followed by surgery, a control group (n = 45) receiving standard fluorouracil-based combined modality treatment, consisting of preoperative radiotherapy plus capecitabine based chemotherapy (NA-CRT), followed by surgery. The primary endpoint was postoperative pathological regression rate which evaluated by tumor regression grade (TRG) according to the 7th edition of the American Joint Committee on Cancer (AJCC) standard, and the secondary endpoints included objective response rate (ORR) and toxicity, as well as surgical complications, and postoperative tumor downstaging.

Results

Compared with NA-CRT group (17.78% (95% confidence interval (CI): 6.2–29.4)), the TRG0 was 30% (95% CI 16.8–43.2) in the NATRACE-CRT group (P = 0.231). The TRG0 + 1 rate was 60% (95% CI: 45.9–74.1) and 33.33% (95% CI: 19–47.7) in NATRACE-CRT group and NA-CRT group, respectively (P = 0.013). The ORR of the NATRACE-CRT group was 84% and that of the NA-CRT group was 66.67% (p = 0.058). Incidence of preoperative toxic side effects and surgical complications was similar between the two groups.

Conclusion

TRACE with oxaliplatin plus concurrent S-1 chemoradiotherapy as a neoadjuvant therapy provided better pathological remission rate versus standard treatment with a similar safety profile.

Trial registration

NCT03601156.
Prognostic impact of the “Sekhar grading system for cranial Chordomas” in patients treated with pencil beam scanning proton therapy: an institutional analysis
Authors: Hottinger Anna-Lena , Bojaxhiu Beat , Ahlhelm Frank , Walser Marc , Bachtiary Barbara , Zepter Stefan , Lomax Tony , Pica Alessia , Weber Damien C.
Published: May 2020

Background

Skull base chordomas are rare and heterogeneously behaving tumors. Though still classified as benign they can grow rapidly, are locally aggressive, and have the potential to metastasize. To adapt the treatment to the specific needs of patients at higher risk of recurrence, a pre-proton therapy prognostic grading system would be useful. The aim of this retrospective analysis is to assess prognostic factors and the “Sekhar Grading System for Cranial Chordomas” (SGSCC) by evaluating the larger cohort of patients treated at our institution as to determine its reproducibility and ultimately to ensure more risk adapted local treatments for these challenging tumors.

Methods

We analyzed 142 patients treated for skull base chordomas between 2004 and 2016. We focused the analysis on the 5 criteria proposed for the SGSCC (tumor size, number of anatomic regions and vessels involved, intradural invasion, as well as recurrence after prior treatment) and classified our patients according to their score (based on the above mentioned criteria) into three prognostic groups, low-risk, intermediate-risk and high-risk. The three groups were then analyzed in regards of local control, local recurrence-free survival and overall survival.

Results

The median follow up was 52 months (range, 3–152). We observed 34 (24%) patients with a local recurrence, resulting in a local control of 75% at 5 years. Overall survival was 83% at 5 years, 12 (9%) patients had died due to local progression. When split into the three prognostic groups according to the SGSCC the observed local control was 90, 72 and 64% (p = 0.07) in the low-, intermediate- and high-risk group, respectively. A similar correlation was observed for local recurrence-free survival with 93, 89 and 66% (p = 0.05) and for overall survival with 89, 83 and 76% (p = 0.65) for the same prognostic groups.

Conclusions

After splitting our patient cohort into the three SGSCC risk groups, we found a trend towards better outcome for those patients with lower as opposed to higher scores. These results suggest that this prognostic grading system published by Sekhar et al. could be integrated in the management decision-tree for patients with skull base chordoma.
Effect of continuous nursing interventions on valve noise-related anxiety and quality of life in patients who underwent mechanical mitral valve replacement
Authors: Chen Qiu-Yu , Xu Ning , Huang Shu-Ting , Lin Ze-Wei , Cao Hua , Chen Liang-Wan , Chen Qiang
Published: May 2020

Objective

The purpose of this study was to evaluate the effect of continuous nursing interventions on valve noise-related anxiety in patients undergoing mechanical mitral valve replacement (MVR) and to analyze its impact on patient quality of life.

Methods

Ninety patients who underwent mechanical MVR were divided into two groups. All patients in group A received routine nursing care. In addition to this intervention, an assigned nurse periodically provided patients in group B with continuous nursing interventions and ongoing health consultations during a 1-year follow-up. A hospital anxiety and depression (HAD) scale, a customized questionnaire and a Short Form Health Status 36 (SF-36) score questionnaire were used as the research tools.

Results

The postoperative HAD scores were better in group B than in group A, but the differences in most of the data were not statistically significant between the groups, except for HA sections 0–7 and 11–21. Based on the customized questionnaire, the subjective disturbance level was significantly lower in group B than in group A (the results of Q1 and Q4 were statistically significant). With regard to the SF-36 scores, group B was superior to group A in general health, emotional function and mental health, while the other dimensions had no significant difference.

Conclusions

Compared with routine care, patients who received continuous care intervention after mechanical MVR had fewer anxiety symptoms and better quality of life.
Recent advances on innate immune pathways related to host–parasite cross-talk in cystic and alveolar echinococcosis
Authors: Bakhtiar Nayer Mehdizad , Spotin Adel , Mahami-Oskouei Mahmoud , Ahmadpour Ehsan , Rostami Ali
Published: May 2020

Cystic echinococcosis (CE) and alveolar echinococcosis (AE) are life-threatening parasitic infections worldwide caused by Echinococcus granulosus (sensu lato) and E. multilocularis, respectively. Very little is known about the factors affecting innate susceptibility and resistance to infection with Echinococcus spp. Although benzimidazolic drugs against CE and AE have definitively improved the treatment of these cestodes; however, the lack of successful control campaigns, including the EG95 vaccine, at a continental level indicates the importance of generating novel therapies. This review represents an update on the latest developments in the regulatory functions of innate immune pathways such as apoptosis, toll-like receptors (TLRs), and inflammasomes against CE and AE. We suggest that apoptosis can reciprocally play a bi-functional role among the host-Echinococcus metabolite relationships in suppressive and survival mechanisms of CE. Based on the available information, further studies are needed to determine whether the orchestrated in silico strategy for designing inhibitors and interfering RNA against anti-apoptotic proteins and TLRs would be effective to improve new treatments as well as therapeutic vaccines against the E. granulosus and E. multilocularis.
Molecular identification of Sarcocystis lutrae (Apicomplexa: Sarcocystidae) from the raccoon dog, Nyctereutes procyonoides, and the common raccoon, Procyon lotor, in the Czech Republic
Authors: Máca Ondřej
Published: May 2020

Background

Apicomplexan parasites of the genus Sarcocystis have an obligate two-host life-cycle and comprise about 200 species, which infect different cold- and warm-blooded hosts, including humans. Recently, morphological and molecular studies of sarcocysts in broadly spread carnivore hosts have been on the rise. The description of muscular tissues infection by Sarcocystis in the raccoon dog and the common raccoon from the Czech Republic is herein presented.

Methods

During January-August 2019, 15 raccoon dogs and 1 common raccoon were examined from 5 districts (Česká Lípa, Liberec, Mladá Boleslav, Trutnov and Ústí nad Labem) of the Czech Republic. Muscle parts (diaphragm, forearm, hind-limb, tongue and heart) were examined in wet preparations under compression by light microscopy. After finding Sarcocystis sp., morphological characteristics and molecular analyses of 18S rRNA, 28S rRNA, ITS1 and cox1 loci were used to identify the species.

Results

Sarcocysts were detected and identified in 1 out of 15 raccoon dogs and in the single common raccoon. Preferential infection sites were diaphragm and tongue, followed by forearm and hind limb. To our knowledge, this is the first identification of microscopic sarcocysts by multi-locus genetic analysis from both host species. Molecular analyses revealed 100% similarity at 18S rRNA, 28S rRNA, and cox1 genes with S. lutrae for both hosts and 98–100% identity at the ITS1 region of the isolate from the common raccoon.

Conclusions

Both widely distributed non-indigenous wild carnivores represent new intermediate host records for S. lutrae and the first report of this parasite in a member of the family Procyonidae, but still with an unknown natural definitive host. Molecular data revealed that this parasite species appears more closely related to the Sarcocystis spp. using raptorial birds as definitive hosts. Therefore, further studies aimed at its identification, including the complete life-cycle, remain necessary.
Field-based evaluation of novaluron EC10 insect growth regulator, a chitin synthesis inhibitor against dengue vector breeding in leaf axils of pineapple plantations in Gampaha District, Sri Lanka
Authors: Gunathilaka Nayana , Ranathunga Tharaka , Hettiarachchi Dakshina , Udayanga Lahiru , Abeyewickreme Wimaladharma
Published: May 2020

Background

Insect growth regulators (IGRs) are considered a novel group of insecticides to control mosquitoes. Novaluron is an IGR with benzoylphenyl urea insecticide, which inhibits chitin synthesis in insects and can reduce insect population density; it is also known to have a high margin of safety for mammals.

Methods

The effective minimum concentration of novaluron formulation EC10 was tested. Six pineapple plantations [control (n = 3) and test (n = 3)] were selected from Meerigama Medical Officer of Health area in Gampaha District, Sri Lanka. Fifteen plots (10 × 10 m) were demarcated in each site with a 200 m distance apart. Leaf axils of 450 pineapple plants (30 plants × 15 plots) were screened for immature stages of Aedes mosquitoes weekly for 12 weeks. The required concentration (20 ppm) of novaluron was sprayed onto the selected pineapple plants (n = 1350) individually in 3 selected test sites for 5–10 s. The reduction in the vector population was interpreted as the percentage of reduction in immature stages of Aedes mosquitoes.

Results

The 100% mortality of the Ae. aegypti larvae within 24 h was observed at 20 ppm (0.05 ml of novaluron 100 g/l in 250 ml of water) as the minimum dose. Variation in the number of Aedes larvae present in the control and intervention sites was found to be significantly different throughout the entire observational period (χ2 = 128.29, df = 11, P < 0.001). The total elimination of Aedes larvae continued for up to 2 weeks and a 50% reduction was observed until the 8th week.

Conclusions

The present study emphasizes that novaluron (10% EC) can be used as an effective larvicide at the treatment dose of 20 ppm. The residual effect of the IGR lasted for 12 weeks with a functional efficacy of 8 weeks. The 100% reduction of larval breeding was observed up to the 2nd week after application and the percentage reduction of immature stages remained > 50% until the 8th week. The lowest reduction (34.2%) was observed at 12 weeks after the initial treatment. Therefore, re-treatment may be recommended based on the reduction in the efficacy of the IGR.