bluuebunny/crossref_metadata_2025 huggingface dataset:
Mucin Expression in Colorectal Cancer (CRC)
Authors: Niv Yaron , Rokkas Theodore
Published: May 2018

Background:

A body of evidence has suggested that mucins play an important role in adhesion, invasion, and cancer metastasis. However, this evidence is scarce and sometimes confusing.

Objective:

We performed a systematic review and meta-analysis of available studies to better define the role of mucins in the behavior of colorectal cancer (CRC).

Methods:

Medical literature was searched through November 30, 2017, using suitable keywords. Pooled estimates, that is, odd ratios (ORs), were obtained using fixed or random-effects models, as appropriate. Heterogeneity between studies was evaluated with the Cochran Q test and I
2 values, whereas the likelihood of publication bias was assessed by constructing funnel plots. Their symmetry was estimated by the Begg and Mazumdar adjusted rank correlation test and by the Egger regression test.

Results:

A total of 2234 CRC patients were included in 12 studies, eligible for meta-analysis. There was a significant difference concerning total mucin expression between CRC patients and controls [pooled ORs (95% confidence interval)=8.156 (2.624-25.354), test for overall effect Z=3.627, P<0.0001]. There was no significant publication bias. This significant difference was constricting to MUC1. In addition, there was a significance concerning MUC1 overexpression according to the stage of CRC, that is advanced stage versus localized disease [ORs (95% confidence interval)=2.724 (1.211-6.127), Z= 2.423, P=0.015], as opposed to MUC2 and MUC4.

Conclusions:

MUC1 is overexpressed in CRC tissue comparing with healthy mucosa, and may have a role in the neoplastic transformation and metastatic process. MUC2 has probably no role in carcinogenesis.
New Approach in Acne Therapy
Authors: Deidda Francesca , Amoruso Angela , Nicola Stefania , Graziano Teresa , Pane Marco , Mogna Luca
Published: May 2018

Goals:

The aim of this research was to assess the antibacterial activity of Lactobacillus salivarius LS03 (DSM 22776) against Propionibacterium acnes and its anti-inflammatory properties by inhibiting P. acnes-induced interleukin-8 (IL-8) release.

Background:

Acne is the most common skin disease, causing significant psychosocial problems for those afflicted. Currently available agents for acne treatment, such as oral antibiotics, have limited use. Thus, development of novel agents to treat this disease is needed. In the generation of inflammatory lesions, proliferation of P. acnes in the obstructed follicles is critical. The administration of beneficial microorganisms represents a promising approach for treating several skin alterations and can have many favorable effects.

Study:

For the inhibition assay, P. acnes was spread on Propionibacter Isolation Agar Base plates, and LS03-soaked disks were placed directly on the agar surface. Peripheral blood mononuclear cells, isolated from healthy volunteers, were preincubated with phytohemagglutinin 1 μg/mL for 1 hour and stimulated with the probiotic strains for 24 hours to simulate an in vitro IL-8 release model. The IL-8 concentration in the supernatants was analyzed in duplicate using ELISA Kit.

Results:

L. salivarius LS03 exerted a significant inhibitory capacity against the target pathogen strain. This antagonistic activity was primarily ascribable to the feature of LS03 strain of secreting active bacteriocins against P. acnes. Concerning the IL-8 analysis, 3 different L. salivarius strains were able to inhibit the release of this chemokine by 10% to 25%.

Conclusions:

L. salivarius LS03 probiotic strain could be an alternative treatment to antibiotic/anti-inflammatory therapy in subjects presenting acne vulgaris.
Effectiveness of Probiotics in Children With Functional Abdominal Pain Disorders and Functional Constipation
Authors: Wegh Carrie A.M. , Benninga Marc A. , Tabbers Merit M.
Published: May 2018

Objective:

The objective of this study was to investigate the effect of probiotics on functional abdominal pain disorders (FAPD) and functional constipation (FC).

Methods:

A systematic review was conducted, searching PubMed and Cochrane databases from inception to January 2018 for randomized controlled trials (RCTs) investigating the efficacy of probiotics in children aged 4 to 18 years with FAPD or children aged 0 to 18 years with FC.

Results:

A total of 657 citations were identified. Finally, 11 RCTs for FAPD and 6 RCTs for FC were included. Some evidence exists for Lactobacillus rhamnosus GG (n=3) in reducing frequency and intensity of abdominal pain in children with irritable bowel syndrome. There is no evidence to recommend L. reuteri DSM 17938 (n=5), a mix of Bifidobacterium infantis, Bifidobacterium breve and Bifidobacterium longum (n=1), Bifidobacterium lactis (n=1) or VSL#3 (n=1) for children with FAPD. No evidence exists to support the use of Lactobacillus casei rhamnosus LCR35 (n=1), B. lactis DN173 010 (n=1), B. longum (n=1), L. reuteri DSM 17938 (n=1), a mix of B. infantis, B. breve and B. longum (n=1), or Protexin mix (n=1) for children with FC. In general, studies had an unclear or high risk of bias.

Conclusions:

Insufficient evidence exists for the use of probiotics in FAPD and FC, only L. rhamnosus GG seems to reduce frequency and intensity of abdominal pain but only in children with irritable bowel syndrome. A better understanding of differences in gut microbiota in health and disease might lead to better probiotic strategies to treat disease.
Gut Microbiota, Probiotics, and Sport
Authors: Pane Marco , Amoruso Angela , Deidda Francesca , Graziano Teresa , Allesina Serena , Mogna Luca
Published: May 2018

Human beings harbor clusters of bacteria in different parts of the body, such as the surface or the deep layers of the skin, the mouth, the lungs, the intestine, the vagina, and all the surfaces exposed to the outer world. The majority of microbes resides in the gut, have a weighty influence on human physiology and nutrition and are vital for human life. There is growing evidence showing that the gut microbiota plays important roles in the maturation of the immune system and the protection against some infectious agents. In addition, there are several well-known effects of exercise on gut physiology. Exercise volume and intensity have been shown to exert an influence on gastrointestinal health status. An estimated 20% to 60% of athletes suffer from stress caused by excessive exercise and inadequate recovery. Supplementing the diet with prebiotics and/or probiotics able to improve the metabolic, immune, and barrier function can be a therapy for athletes. A recent study showed the effects of coadministration of 2 probiotic strains (Bifidobacterium breve BR03 and Streptococcus thermophilus FP4) on measures of skeletal muscle performance, damage, tension, and inflammation following a bout of strenuous exercise. Probiotic supplementation likely enhanced isometric average peak torque production from 24 to 72 hours into the recovery period following exercise. The active formulation also moderately increased resting arm angle at 24 and 48 hours following exercise. In conclusion, selected beneficial bacteria could positively affect athletes undergoing periods of intense training and may assist in the performance recovery.
Characterizing Abdominal Pain in Patients With Gastroparesis Into Neuropathic and Nociceptive Components
Authors: Jehangir Asad , Abdallah Rany T. , Parkman Henry P.
Published: May 2018

Introduction:

The cause of abdominal pain (AP) in gastroparesis (Gp) is often not known; hence, its treatment can be challenging. Preoccupation with or increased attention (hypervigilance) to pain is associated with perceived pain severity and psychosocial disability. The aims of this study were to (1) characterize AP in Gp patients into neuropathic and nociceptive pain components; (2) assess these patients for hypervigilance to pain.

Materials and Methods:

Gp patients with AP as an important symptom, seen from June 2017 to November 2017 were given validated questionnaires to characterize their AP. Carnett’s sign (worsened AP/tenderness on head/shoulder lift and/or leg lift) was assessed on examination.

Results:

Of 32 patients (87% females), 20 had idiopathic Gp, and 9 had diabetic Gp. AP severity using Patient Assessment of Gastrointestinal Symptoms averaged 4.3±0.2 (standard error of mean) for upper AP and 2.3±0.3 for lower AP. AP was typically located in epigastrium (53.1%), and described as sharp (75%). Eleven patients (35.5%) met criteria for neuropathic pain on Neuropathic Pain Questionnaire. Twenty patients (62.5%) had positive Carnett’s sign suggesting somatic pain. Fifteen patients (48.4%) were hypervigilant to pain on Pain Vigilance and Awareness Questionnaire.

Conclusions:

Of Gp patients with AP, over one third have a neuropathic component to their pain whereas nearly two thirds have characteristics of somatic pain. Almost half of the Gp patients with AP are hypervigilant to pain. Determining the underlying cause of AP and hypervigilance to pain in Gp patients may assist in devising appropriate treatment strategies.
Gamma-Delta T Lymphocytes in the Diagnostic Approach of Coeliac Disease
Authors: Nijeboer Petula , van Gils Tom , Reijm Martine , Ooijevaar Rogier , Lissenberg-Witte Birgit I. , Bontkes Hetty J. , Mulder Chris J.J. , Bouma Gerd
Published: May 2018

Goals:

To validate cut-off values of CD3+ T-cell receptor gamma-delta chain (TCRγδ+) intraepithelial lymphocyte (IEL) in the (differential) diagnosis of celiac disease (CD).

Background:

CD is characterized by an increase in gamma-delta IEL (CD3+TCRγδ+ IEL).

Study:

Percentages were determined by flow cytometric analysis of IELs from small bowel biopsies in 213 CD and 13 potential CD (PCD) patients and in total 112 controls. A cut-off value for percentages of CD3+TCRγδ+ IEL to differentiate active CD and controls was obtained from a receiver operating characteristic curve and implemented in controls and PCD patients.

Results:

Percentage of CD3+TCRγδ+ IEL was significantly increased in the majority of CD patients, irrespective of the presence of villous atrophy. A cut-off value of 14% for CD3+TCRγδ+ IEL resulted in 66.3% sensitivity and 96.6% specificity for CD diagnosis (area under the curve, 88.6%).

Conclusions:

A percentage of ≥14% CD3+TCRγδ+ IEL has a high specificity for CD diagnosis and can be of diagnostic help in cases where diagnosis is not straightforward.
Use of Probiotics in the Prevention of Nosocomial Infections
Authors: Trivić Ivana , Hojsak Iva
Published: May 2018

Nosocomial, hospital-acquired or health care–associated infections occur worldwide, affecting both developed and developing countries. This results in a prolonged hospital stay, increased antimicrobial resistance, increased mortality rate, and significant financial burden on the health care system. Routine preventive measures have led to the decrease in infection spreading; however, it cannot successfully prevent all of them, making a place for the development of new strategies, including probiotics. The aim of this review was to summarize available evidence of the role of probiotics in the prevention of nosocomial infections in children. Currently there is enough evidence showing that Lactobacillus rhamnosus GG administrated in a dose of at least 109 colony-forming units per day during the hospital stay can significantly reduce a risk for nosocomial diarrhea at regular pediatric ward. For other indications including the risk of respiratory tract infections at regular pediatric ward or risk of nosocomial infections at intensive care units we do not have enough evidence to give a recommendation. Therefore, additional research is needed to increase our knowledge and possibly further improve clinical practice.
Precision Surgery for Obesity
Authors: Dong Zhiyong , Shariful Islam Sheikh Mohammed , Simms-Walker Enan , Wang Cunchuan
Published: May 2018

Precision medicine is targeted towards improving the effectiveness of treatment, reducing the side effects of drugs and reducing medical costs. The application of precision surgery for obesity is a new concept that involves 2 stages: the first stage is to attain a precise obesity surgery, and the second stage is to achieve individualized obese gene therapy. In this article, we discuss the value of precision surgery for obesity, its stages and its future application to improve obesity surgery. Due to recent advancements in medical technologies, genetics, surgical and clinical research; precision surgery for obesity will lead the future of obesity surgery.
Transcription factors FOXO in the regulation of homeostatic hematopoiesis
Authors: Menon Vijay , Ghaffari Saghi
Published: May 2018

Purpose of review

Work in the past decade has revealed key functions of the evolutionary conserved transcription factors Forkhead box O (FOXO) in the maintenance of homeostatic hematopoiesis. Here the diverse array of FOXO functions in normal and diseased hematopoietic stem and progenitor cells is reviewed and the main findings in the past decade are highlighted. Future work should reveal FOXO-regulated networks whose alterations contribute to hematological disorders.

Recent findings

Recent studies have identified unanticipated FOXO functions in hematopoiesis including in hematopoietic stem and progenitor cells (HSPC), erythroid cells, and immune cells. These findings suggest FOXO3 is critical for the regulation of mitochondrial and metabolic processes in hematopoietic stem cells, the balanced lineage determination, the T and B homeostasis, and terminal erythroblast maturation and red blood cell production. In aggregate these findings highlight the context-dependent function of FOXO in hematopoietic cells. Recent findings also question the nature of FOXO's contribution to heme malignancies as well as the mechanisms underlying FOXO's regulation in HSPC.

FOXO are safeguards of homeostatic hematopoiesis. FOXO networks and their regulators and coactivators in HSPC are greatly complex and less well described. Identifications and characterizations of these FOXO networks in disease are likely to uncover disease-promoting mechanisms.
An update on PCOS in adolescents
Authors: Fitzgerald Shannon , DiVasta Amy , Gooding Holly
Published: May 2018

Purpose of review

Polycystic ovarian syndrome (PCOS) is a common endocrinopathy which can be difficult to treat in adolescents. Fortunately, early identification and treatment can help mitigate some of the metabolic complications. In this review, we reflect on recent literature regarding PCOS diagnosis, associated complications, and treatment options.

Recent findings

Although there are three well known criteria to diagnose PCOS, they can be difficult to translate to adolescence. Newer diagnostic tools under study include anti-Mullerian hormone and revised ultrasound criteria. More is known about the many complications associated with PCOS, and new treatment options are on the horizon.

PCOS frequently will present during adolescence. These young women may already have symptoms of metabolic comorbidities. Providers caring for these patients must be aware of the many related complications and common treatment options. Newer diagnostic techniques and treatment options are under active study in adults, and may soon be translated to adolescence. A comprehensive approach allows treatment of patients’ concerns, and also prevention of metabolic complications.
Breastfeeding: uncovering barriers and offering solutions
Authors: Sayres Stephanie , Visentin Lisa
Published: May 2018

Purpose of review

The Centers for Disease Control and Prevention and the American Academy of Pediatrics recommend exclusive breastfeeding for 6 months after an infant is born. Although the recommendations are well known, mothers face barriers that make breastfeeding difficult. This article reviews the recent literature on barriers to breastfeeding as well as strategies for pediatricians to use to help women overcome them.

Recent findings

The mode of delivery, mother's socioeconomic status, return to work, and prenatal breastfeeding education have been reported as factors that influence breastfeeding. Family-centered models for breastfeeding, peer support groups, and technology have been studied as potential ways to help women meet their breastfeeding goals.

Pediatricians are the first providers to care for babies after hospital discharge and are likely the first doctors that mothers see after childbirth. These early visits create opportunities for pediatricians to learn about the barriers that their patients face and open the doors to addressing these barriers.
Effects of gait training with auditory feedback on walking and balancing ability in adults after hemiplegic stroke: a preliminary, randomized, controlled study
Authors: Cha Yong-Jun , Kim Jung-Doo , Choi Yu-Ran , Kim Nan-Hyang , Son Sung-Min
Published: May 2018

The aim of this study was to identify a gait training type that better improves the walking and balancing abilities of adult patients with chronic hemiplegic stroke. Single-blinded, randomized, controlled, comparative preliminary study was carried out. Patients were recruited from the inpatient unit of a Rehabilitation Hospital. Thirty-one patients who had experienced hemiplegic stroke were randomly assigned to three groups: the heel group (gait training by active weight bearing on the paretic heel with auditory feedback), the forefoot group (gait training with auditory feedback from paretic metatarsals), and the control group (general gait intervention). All patients performed 30 min of comprehensive rehabilitation therapy followed by an additional 20 min of gait intervention with or without auditory feedback three times a week for 6 weeks. Significant improvements in walking and balancing variables were observed after gait training in all three groups (P<0.05). However, significantly larger gains were identified in the heel group than in the control group (center of loading path length, −29.4 vs. −11.4%, d=−1.0; center of loading path velocity, −35.8 vs. −19.6%, d=−1.4). In addition, significantly larger gains were observed in the forefoot group than in the control group (functional gait assessment, +42.6 vs. +20.1%, d=1.3; center of loading path length, −37.2 vs. −11.4%, d=−1.8; center of loading path velocity, −36.0 vs. −19.6%, d=−1.3). Auditory feedback during active weight bearing on paretic feet appears to more effectively improve the walking and balancing abilities of hemiplegic stroke patients than general gait training.
The Efficacy of Regional Anesthesia Techniques to Control Postoperative Pain After Total Knee Arthroplasty
Authors: Otten Cecilia , Dunn Karen S.
Published: May 2018

BACKGROUND:

Choosing the most effective type of anesthesia for controlling postoperative pain is paramount for improving patient outcomes and patient satisfaction. Most often, the type of anesthesia selected is dependent on the duration and type of surgical procedure and anesthesiologist/surgeon preference. Using a combination of regional anesthesia techniques, however, remains the cornerstone of multimodal analgesia for postoperative pain management after total knee arthroplasty.

PURPOSE:

The purpose of this study was to determine what regional anesthesia techniques and/or combinations of regional anesthesia techniques provided the best postoperative pain control in patients who had undergone a total knee arthroplasty.

METHODS:

Retrospective chart review.

RESULTS:

Patients who received a single-shot regional anesthetic reported significantly more postoperative opiate consumption and requested pain medication significantly sooner than patients who received multimodal techniques of regional analgesia.

CONCLUSION:

This study found support for the use of multimodal analgesia techniques for optimum postoperative pain management after total knee arthroplasty.
“I Can't Poop”
Authors: Turkoski† Beatrice B.
Published: May 2018

One of the challenging side effects of many medications is constipation. When knowledgeable nurses who teach patients about their medications include information about the possibility of constipation, they can then educate patients about how to prevent, reduce, or treat medication-related constipation. Discussion in the following article addresses examples of drugs that have the potential for constipation, why constipation may occur with these medications, and how to safely prevent or reduce medication-induced constipation.
Suspecting Hyperferritinemic Sepsis in Iron-Deficient Population: Do We Need a Lower Plasma Ferritin Threshold?*
Authors: Ghosh Swarup , Baranwal Arun K. , Bhatia Prateek , Nallasamy Karthi
Published: May 2018

Objectives:

Hyperferritinemia is being suggested to identify patients with sepsis-induced macrophage activation syndrome for early intervention. However, data among iron-deficient children are scarce. This study was planned to explore the biological behavior of plasma ferritin in children from communities with a high frequency of iron deficiency with septic shock and its association with the outcome.

Design:

Prospective observational study.

Setting:

Tertiary care teaching hospital in a low-middle income economy of South Asia.

Patients or Subjects:

Patients (6 mo to 12 yr) (n = 42) with septic shock and their healthy siblings as controls (n = 36). Patients/controls with blood transfusion/iron supplement during last 6 months or with any chronic disease were excluded.

Interventions:

None.

Measurements and Main Results:

Ferritin was measured in patients at enrollment and then at 1 month of hospital discharge while they were not on iron supplementation and in controls as indicative of baseline level. Patients’ median age was 30 months (13.5–87 mo), 31% were malnourished, majority (86%) had anemia, and two thirds had microcytic hypochromic red cells. Ferritin at admission was 763 ng/mL (480–1,820 ng/mL) in nonsurvivors, whereas 415 ng/mL (262–852 ng/mL) in survivors (p = 0.11). Pediatric Logistic Organ Dysfunction score and C-reactive protein correlated positively with plasma ferritin (p = 0.03 and p = 0.01, respectively) at enrollment. Elevated ferritin of greater than 500 ng/mL (relative risk, 2.48; 95% CI, 0.95–6.43) and greater than 1,000 ng/mL (relative risk, 1.94; 95% CI, 0.94–4.02) were associated with higher mortality but not independently. Among survivors, the 1-month follow-up ferritin fell significantly to 97 ng/mL (16–118 ng/mL) (p = 0.001). However, it was still significantly higher than that in sibling controls (19 ng/mL [10–54 ng/mL]) (p = 0.003).

Conclusions:

Ferritin rises significantly in septic shock patients despite iron deficiency and seems to correlate with the severity of inflammation and organ dysfunction. Even a lower threshold (of 500 or 1,000 ng/mL) could predict higher mortality. It may suggest the need for redefining the plasma ferritin threshold for suspecting hyperferritinemic sepsis and sepsis-induced macrophage activation syndrome in these patients. Larger studies with frequent ferritin measurements are desirable to validate these initial observations.
Organizational Supports for Research Evidence Use in State Public Health Agencies: A Latent Class Analysis
Authors: Hu Hengrui , Allen Peg , Yan Yan , Reis Rodrigo S. , Jacob Rebekah R. , Brownson Ross C.
Published: May 2018

Objective:

Use of research evidence in public health decision making can be affected by organizational supports. Study objectives are to identify patterns of organizational supports and explore associations with research evidence use for job tasks among public health practitioners.

Design:

In this longitudinal study, we used latent class analysis to identify organizational support patterns, followed by mixed logistic regression analysis to quantify associations with research evidence use.

Setting:

The setting included 12 state public health department chronic disease prevention units and their external partnering organizations involved in chronic disease prevention.

Participants:

Chronic disease prevention staff from 12 US state public health departments and partnering organizations completed self-report surveys at 2 time points, in 2014 and 2016 (N = 872).

Main Outcome Measures:

Latent class analysis was employed to identify subgroups of survey participants with distinct patterns of perceived organizational supports. Two classify-analyze approaches (maximum probability assignment and multiple pseudo-class draws) were used in 2017 to investigate the association between latent class membership and research evidence use.

Results:

The optimal model identified 4 latent classes, labeled as “unsupportive workplace,” “low agency leadership support,” “high agency leadership support,” and “supportive workplace.” With maximum probability assignment, participants in “high agency leadership support” (odds ratio = 2.08; 95% CI, 1.35-3.23) and “supportive workplace” (odds ratio = 1.74; 95% CI, 1.10-2.74) were more likely to use research evidence in job tasks than “unsupportive workplace.” The multiple pseudo-class draws produced comparable results with odds ratio = 2.09 (95% CI, 1.31-3.30) for “high agency leadership support” and odds ratio = 1.74 (95% CI, 1.07-2.82) for “supportive workplace.”

Conclusions:

Findings suggest that leadership support may be a crucial element of organizational supports to encourage research evidence use. Organizational supports such as supervisory expectations, access to evidence, and participatory decision making may need leadership support as well to improve research evidence use in public health job tasks.
Case Reports and Consent for Publishing in Rheumatology Journals
Authors: Pineda Carlos , Sandoval Hugo
Published: May 2018

Case reports have a long-standing tradition in the current rheumatology literature. We aimed to present the main points of view regarding the importance, meaning, and barriers of consent for publishing under the comprehensive protection of patients' rights within this genre. We encourage Latin American editors and authors of rheumatology journals to adopt the best ethical practices in the field, avoiding security and legal liabilities from a regional perspective.
The Profile of Serum Transferrin Isoforms in Rheumatoid Arthritis
Authors: Gudowska Monika , Gruszewska Ewa , Wrona Alicja , Gindzienska-Sieskiewicz Ewa , Domyslawska Izabela , Lipartowska-Klimuk Karina , Cylwik Bogdan , Sierakowski Stanislaw , Chrostek Lech
Published: May 2018

Introduction

Transferrin, a microheterogeneous iron-transporting N-glycoprotein, is an optimal model for the analysis of the glycosylation profile in rheumatoid arthritis (RA). The aim of this study was to assess the transferrin isoforms profile in RA patients at the time of diagnosis and then look into their associations with disease activity.

Methods

Serum samples were collected from 48 patients with RA. The patients were males (6) and females (42) (age range: 33–85 years). Control group consisted of 30 healthy volunteers. Transferrin isoforms were analysed by capillary electrophoresis on MINICAP electrophoretic system.

Results

There was a significant decrease in the relative concentrations of trisialo- (mean ± SD; 2.130 ± 1.112) and pentasialotransferrin (13.562 ± 3.088), and significant increase in tetrasialotransferrin (83.640 ± 3.165) in RA patients when compared to the control group (3.615 ± 1.156; 76.840 ± 5.621; 18.610 ± 6.027, respectively) (U Mann–Whitney test: p < 0.001 for all comparisons). There were no significant changes in the disialotransferrin concentrations in RA patients. Trisialotransferrin concentration correlated with RA activity expressed as DAS 28 in RA patients (p < 0.001). The low trisialotransferrin concentration was also associated with high platelet count and high ESR (p < 0.001 for both). Disialo-, tetrasialo- and pentasialotransferrin concentrations did not correlate with DAS 28.

Conclusions

In patients with RA the serum profile of transferrin isoforms is altered. We predict that the levels of trisialylated isoforms of transferrin will serve as a useful biochemical marker of the RA activity.
Clinical Profile of Levamisole-Adulterated Cocaine-Induced Vasculitis/Vasculopathy
Authors: Muñoz-Vahos Carlos Horacio , Herrera-Uribe Sebastián , Arbeláez-Cortés Álvaro , Jaramillo-Arroyave Daniel , González-Naranjo Luis Alonso , Vásquez-Duque Gloria , Restrepo-Escobar Mauricio , Correa-Londoño Luis Alfonso , Arias-Restrepo Luis Fernando , Vanegas-García Adriana Lucía
Published: May 2018

Objectives

The aims of this study were to describe clinical and laboratory manifestations of patients with levamisole-adulterated cocaine-induced vasculitis/vasculopathy and to propose a skin classification according to the distribution and severity of lesions.

Methods

We report the characteristics of 30 patients admitted with levamisole-adulterated cocaine-induced vasculitis/vasculopathy in 4 high-complexity institutions in Colombia, from December 2010 to May 2017. We compare our findings with the main published series.

Results

Median age was 31 years (interquartile range, 27–38 years) with a male-to-female ratio of 5:1. Eighty-three percent of the patients had retiform purpura affecting the limbs, buttocks, face, or abdomen; 73% had ear necrosis, 50% cutaneous ulcers, 17% genital necrosis, 13% oral ulcers, and 10% digital necrosis. Cutaneous involvement was classified according to the frequency of the compromised corporal area, and purpuric lesions were stratified in 4 grades of severity. Anti–neutrophil cytoplasmic autoantibodies were positive in 85% of the cases, lupus anticoagulant in 73%, and antinuclear autoantibodies in 57%; rheumatoid factor was negative in all cases. We found nephritis in 17 cases (57%). Prednisolone was used in most of the patients (70%), with other immunosuppressive agents being used in a lower percentage. Improvement was observed in 93% of the patients, but symptoms recurred in 40%, attributed to relapses in consumption. End-stage chronic renal disease developed in 10% of the cases, and 1 patient died.

Conclusions

Because of rising cocaine consumption and levamisole adulteration frequency, levamisole-adulterated cocaine-induced vasculitis/vasculopathy is becoming more common. Detailed characterization of skin involvement coupled with multiple antibody positivity is essential for a diagnosis. Renal involvement is frequent, clinically and histologically heterogeneous, and potentially serious.
Nailfold Videocapillaroscopy Changes Are Associated With the Presence and Severity of Systemic Sclerosis–Related Interstitial Lung Disease
Authors: Caetano Joana , Paula Filipe S. , Amaral Marta , Oliveira Susana , Alves José D.
Published: May 2018

Objective

The aim of this study was to evaluate the association of nailfold videocapillaroscopy (NVC) changes and the presence and severity of interstitial lung disease (ILD) in systemic sclerosis.

Methods

This was a cross-sectional analysis of 48 systemic sclerosis patients (21 patients with ILD). The NVC characteristics considered were capillary organization, capillary loss (CL), avascular areas, enlarged and giant capillaries, hemorrhages, abnormally shaped capillaries, edema, and intermittent flux.

We analyzed the association between NVC findings and (1) presence and extension of ILD and (2) percent predicted of forced vital capacity (FVC) and the carbon monoxide diffusing capacity (DLCO).

Results

Capillary loss and avascular areas showed a significant association with the presence of ILD (odds ratio, 18.57; 95% confidence interval [CI], 2.17–158.72 [p = 0.008]; and odds ratio, 4.64; 95% CI, 1.35–15.91 [p = 0.015], respectively). Receiver operating characteristic (ROC) curve analysis confirmed the association between CL and ILD (area under the ROC curve, 90.1%; 95% CI, 81.8–91.4). Avascular areas and CL were associated with a worse pulmonary function (FVC −18.1% [p = 0.034], DLCO −14.0% [p = 0.013]; and FVC −15.3% [p = 0.086], DLCO −12.3% [p = 0.049], respectively). No association was found between other NVC findings and ILD or lung function.

Conclusions

Capillary loss and avascular area showed a significant association with the presence of ILD, supported by ROC curve analysis. These results may reinforce a prognostic role for NVC and a physiopathology mechanism for ILD based on vascular damage.
Sociodemographic Factors Affecting the Disease Acceptance and the Quality of Life in Patients With Parkinson's Disease: A Preliminary Study
Authors: Rosińczuk Joanna , Pytel Aleksandra , Kołtuniuk Aleksandra
Published: May 2018

Purpose

Parkinson’s disease (PD) significantly affects functioning of patients, thereby lowering their quality of life. The aim of this study was to evaluate the influence of sociodemographic variables on illness acceptance and quality of life in patients with idiopathic PD.

Design

This is a cross-sectional research study.

Methods

The study was conducted with 50 patients with PD. The diagnostic survey method was applied for the purposes of this study with the use of the Parkinson's Disease Questionnaire, the Acceptance of Illness Scale, and a study-specific demographic questionnaire that included questions about sociodemographic data. Multivariable logistic regression was derived to define independent predictors of quality of life.

Findings

Men assessed quality of life in the bodily discomfort domain as significantly worse than women (p = .0214). Age negatively and significantly affected the assessment of quality of life in particular domains. Professionally active respondents significantly more often accepted their disease than others (p = .0070).

Conclusions and Clinical Relevance

Being professionally active, living in urban areas, and having higher education and higher financial status increase subjective assessment of quality of life in patients with PD. Knowing the impact of sociodemographic variables on quality of life allows rehabilitation nurses to plan nursing and rehabilitation activities more effectively and in line with the capacity of a patient and caregivers.
The Therapeutic Relationship: Enhancing Referrals
Authors: Coyle Mary Kathleen
Published: May 2018

Purpose

This article focuses on the ways rehabilitation nurses use the therapeutic relationship to lessen barriers some veterans experience when a referral to mental health treatment is recommended.

Design

Veterans presenting with posttraumatic stress symptoms are discussed, and possible interventions within the therapeutic relationship are proposed.

Method

Veterans’ perception of mental health stigma, building a collaborative therapeutic relationship, recommending a referral and assessments of stress responses, posttraumatic stress symptoms, suicide risk, and intervention strategies are proposed.

Findings

When changes in functioning and suicidality occur in veterans with posttraumatic stress disorder symptoms, it is important to screen and engage veterans at risk.

Conclusions and Clinical Relevance

When veterans in the rehabilitation process present with a need for mental health referral, barriers to treatment may include the stigma of mental health treatment. Rehabilitation nurses using the therapeutic relationship act as change agents to assist veterans in overcoming these barriers to treatment. The therapeutic relationship provides nurses with a foundation to provide opportunities for veterans to be supported and to seek treatment.
BASIC Training: A Pilot Study of Balance/Strengthening Exercises in Heart Failure
Authors: McGuire Rita , Honaker Julie , Pozehl Bunny , Hertzog Melody
Published: May 2018

Purpose

The aim of this pilot study was to evaluate the effect of a multicomponent balance and resistance training intervention on physical function, balance, and falls in older (≥65 years) community-dwelling heart failure (HF) patients.

Design

Randomized, two-group repeated-measures experimental design.

Methods

The intervention involved once weekly supervised group sessions with home sessions encouraged twice weekly. Focus groups held pre/post intervention. Outcome variables included measures of physical function, balance confidence, and falling risk.

Findings

In a sample size of 33, the Dynamic Gait Index change from baseline to 12 weeks was significantly different in the groups (p = .029). The number of reported falls declined from 0.92 to 0.54 per participant.

Conclusions

A supervised group session intervention can increase mobility and gait and reduce fall rate for HF patients.

Clinical Relevance

This study was designed to improve lower extremity strength, balance, and falls in elderly HF patients, thus reducing costs and improving quality of life for this population.
The Influence of 3D in Single-port Laparoscopy Surgery: An Experimental Study
Authors: Vilaça Jaime , Leite Mariana , Correia-Pinto Jorge , Högemann Gerrit , Costa Patrício , Leão Pedro
Published: May 2018

The aim of this experimental study was to analyze the effect of 3-dimensional (3D) imaging in laparoendoscopic single-site surgery. End points were time, errors, and preference. Twenty-six participants were enrolled in the study, and these were divided into Beginners and Experts, in exercises either with a 2-dimensional or a 3D system. The 4 phantom exercises were chosen from the E-BLUS—European Training in Basic Laparoscopic Urological Skills from the American Fundamentals of Laparoscopic Surgery (FLS) system. A postexercise questionnaire was delivered. Statistical analyses using SPSS 22.0 for Windows yielded a 1-way analysis of variance. There was a significant positive impact of 3D imaging on experts’ performance: faster exercise completion with fewer errors. The majority reported improved performance with the 3D system (86%, Beginners; 100%, Experts). 3D systems for laparoscopy would likely increase experts’ performance for laparoendoscopic single-site surgery and improve comfort during difficult procedures.
Early Results of Laparoscopic Sleeve Gastrectomy With Loop Bipartition
Authors: Arslan Ergin , Sipahi Mesut , Banli Oktay
Published: May 2018

Purpose:

We evaluated early results of this new procedure of transit loop bipartition with sleeve gastrectomy (TLB-SG), making a comparison with transit bipartition with sleeve gastrectomy.

Materials and Methods:

Between January 2017 and September 2017, 22 patients have undergone transit bipartition with sleeve gastrectomy or TLB-SG surgery in our clinic. Patients’ body mass index, excess body mass index loss, and HOMA-IR were calculated before and after the surgical operation. The values of c-peptide, HgA1C, insulin, blood sugar, albumin, Hg, urea, creatinine, calcium, total cholesterol, 25-hydroxy vitamin D, and vitamin B12 were evaluated retrospectively.

Results:

Vitamin and mineral deficiency, malnutrition, and anemia were not observed in both groups during the follow-up process. The operation time was shorter in the TLB-SG operation. Both groups were found to be effective at the expected level in terms of weight loss, diabetes remission, and improvement.

Conclusions:

TLB-SG is a more effective and simpler method, becoming a candidate for being the most frequently performed surgical operation, in the field of metabolic surgery.
Two Biliary Cannulation Techniques for ERCP in Patients With Intradiverticular Papilla: A Retrospective Review
Authors: Huang Long , Yu Qing-sheng , Sun Kun
Published: May 2018

Purpose:

To compare the effectiveness and complications of the different cannulation techniques for bile duct stones removal in patients with intradiverticular papilla.

Materials and Methods:

The records of 472 patients with common bile duct (CBD) stones who underwent endoscopic retrograde cholangiopancreatography (ERCP) procedures for bile duct stones removal from January 2014 to December 2016 were retrospectively reviewed. A total of 42 patients with CBD stones were included in the study and data of included patients were collected retrospectively. The outcomes and complications of ERCP procedures were compared.

Results:

Of 42 ERCP procedures included in the study, patients were divided into Two-devices-in-one-channel group (n=20) and Endoclip group (n=22). The success rate of CBD cannulation at first attempt in Two-devices-in-one-channel and Endoclip groups was 85.0% (17/20) and 54.5% (12/22), respectively (P<0.05). The average time it took to cannulation in Endoclip group was much longer than that in Two-devices-in-one-channel Group (17.55±2.06 vs. 10.6±2.75 min, P<0.05). Overall complications occurred in 3 cases of Two-devices-in-one-channel group and in 4 cases of Endoclip group, respectively (15.0% vs. 18.2%, P>0.05). There was no statistically significant difference between groups regarding the complications.

Conclusions:

Two-devices-in-one-channel and Endoclip techniques are both safe and effective for bile duct cannulation in patients with intradiverticular papilla.
Neuroimaging in epilepsy
Authors: Sidhu Meneka Kaur , Duncan John S. , Sander Josemir W.
Published: May 2018

Purpose of review

Epilepsy neuroimaging is important for detecting the seizure onset zone, predicting and preventing deficits from surgery and illuminating mechanisms of epileptogenesis. An aspiration is to integrate imaging and genetic biomarkers to enable personalized epilepsy treatments.

Recent findings

The ability to detect lesions, particularly focal cortical dysplasia and hippocampal sclerosis, is increased using ultra high-field imaging and postprocessing techniques such as automated volumetry, T2 relaxometry, voxel-based morphometry and surface-based techniques. Statistical analysis of PET and single photon emission computer tomography (STATISCOM) are superior to qualitative analysis alone in identifying focal abnormalities in MRI-negative patients. These methods have also been used to study mechanisms of epileptogenesis and pharmacoresistance.

Recent language fMRI studies aim to localize, and also lateralize language functions. Memory fMRI has been recommended to lateralize mnemonic function and predict outcome after surgery in temporal lobe epilepsy.

Combinations of structural, functional and post-processing methods have been used in multimodal and machine learning models to improve the identification of the seizure onset zone and increase understanding of mechanisms underlying structural and functional aberrations in epilepsy.
Interactions between Viperin, IRAK1 andTRAF6 couple innate immune signaling to antiviral ribonucleotide synthesis
Authors: Dumbrepatil Arti B. , Ghosh Soumi , Patel Ayesha M. , Zegalia Kelcie A. , Malec Paige A. , Hoff J. Damon , Kennedy Robert T. , G Marsh E. Neil.
Published: May 2018

Viperin is a radical S-adenosylmethionine (SAM) enzyme that plays a multifaceted role in the cellular antiviral response. Viperin was recently shown to catalyze the SAM-dependent formation of 3′-deoxy-3′,4′-didehydro-CTP (ddhCTP), which inhibits some viral RNA polymerases. Viperin is also implicated in regulating K63-linked poly-ubiquitination of interleukin-1 receptor-associated kinase-1 (IRAK1) by the E3 ubiquitin ligase TNF Receptor-Associated Factor 6 (TRAF6) as part of the Toll-like receptor-7 and 9 (TLR7/9) innate immune signaling pathways. We show that IRAK1 and TRAF6 activate viperin to efficiently catalyze the radical-mediated dehydration of CTP to ddhCTP. Furthermore, poly-ubiquitination of IRAK1 requires the association of viperin with IRAK1 and TRAF6. Poly-ubiquitination appears dependent on structural changes induced by SAM binding to viperin but doesnotrequire catalytically active viperin. The synergistic activation of viperin and IRAK1 provides a mechanism that couples innate immune signaling with the production of the antiviral nucleotide ddhCTP.
Merging in-solution X-ray and neutron scattering data allows fine structural analysis of membrane-protein detergent complexes
Authors: Dias-Mirandela Gaetan , Tamburrino Giulia , Ivanović Miloš T , Strnad Felix M , Byron Olwyn , Rasmussen Tim , Hoskisson Paul A , Hub Jochen S , Zachariae Ulrich , Gabel Frank , Javelle Arnaud
Published: May 2018

In-solution small angle X-ray and neutron scattering (SAXS/SANS) have become popular methods to characterize the structure of membrane proteins, solubilized by either detergents or nanodiscs. SANS studies of protein-detergent complexes usually require deuterium-labelled proteins or detergents, which in turn often lead to problems in their expression or purification. Here, we report an approach whose novelty is the combined analysis of SAXS and SANS data from an unlabeled membrane protein complex in solution in two complementary ways. Firstly, an explicit atomic analysis, including both protein and detergent molecules, using the program WAXSiS which has been adapted to predict SANS data. Secondly, the use of MONSA which allows to discriminate between detergent head- and tail-groups in an ab initio approach. Our approach is readily applicable to any detergent-solubilized protein and provides more detailed structural information on protein-detergent complexes from unlabeled samples than SAXS or SANS alone.
Emergence of a node-like population within an in vitro derived Neural Mesodermal Progenitors (NMPs) population
Authors: Edri Shlomit , Hayward Penelope , Jawaid Wajid , Arias Alfonso Martinez
Published: May 2018

The mammalian embryos Caudal Lateral Epiblast (CLE) harbours bipotent progenitors, called Neural Mesodermal Progenitors (NMPs), that contribute to the spinal cord and the paraxial mesoderm throughout axial elongation. Here we performed a single cell analysis of different in vitro NMPs populations produced either from embryonic stem cells (ESCs) or epiblast stem cells (EpiSCs) and compared them to E8.25 CLE mouse embryos. In our analysis of this region our findings challenge the notion that NMPs should coexpressSox2andT. We built a Support Vector Machine (SVM) based on the embryo CLE and use it as a classification model to analyse the in vitro NMP-like populations. We showed that ESCs derived NMPs are heterogeneous and contain few NMP-like cells, whereas EpiSCs derived NMPs, produce a high proportion of cells with the embryo NMP signature. Importantly, we found that the population from which the Epi-NMPs are derived in culture, contains a nodelike population, which is responsible for maintaining the expression ofTin vitro. These results mimic the events in vivo and suggest a sequence of events for the NMPs emergence.
Fragment-based screening identifies inhibitors of the ATPase activity and of hexamer formation of Cagα from the Helicobacter pylori type IV secretion system
Authors: Arya Tarun , Oudouhou Flore , Casu Bastien , Bessette Benoit , Sygusch Jurgen , Baron Christian
Published: May 2018

Type IV secretion systems are membrane-bound multiprotein complexes that mediate the translocation of macromolecules across the bacterial cell envelope. In Helicobacter pylori a type IV secretion system is encoded by the cag pathogenicity island that encodes 27 Cag proteins and most of these are essential for bacterial virulence. We here present our work on the identification and characterization of inhibitors of Cagα, a hexameric ATPase and member of the family of VirB11-like proteins that is essential for translocation of the CagA cytotoxin into mammalian cells. We conducted fragment-based screening using a differential scanning fluorimetry assay and identified 16 molecules that stabilize the protein during thermal denaturation suggesting that they bind Cagα. Several of these molecules affect binding of ADP and four of them inhibit the ATPase enzyme activity of Cagα. Analysis of enzyme kinetics suggests that their mode of action is non-competitive, suggesting that they do not bind to the ATPase active site. Cross-linking analysis suggests that the active molecules change the conformation of the protein and gel filtration and transmission electron microscopy show that molecule 1G2 dissociates the Cagα hexamer. Analysis by X-ray crystallography reveals that molecule 1G2 binds at the interface between Cagα subunits. Addition of the molecule 1G2 inhibits the induction of interleukin-8 production in gastric cancer cells after co-incubation with H. pylori suggesting that it inhibits Cagα in vivo. Our results reveal a novel mechanism for the inhibition of the ATPase activity of VirB11-like proteins and the identified molecules have potential for the development into antivirulence drugs.