bluuebunny/crossref_metadata_2025 huggingface dataset:
Interval Cancers in a Population-Based Screening Program for Colorectal Cancer in Catalonia, Spain
Authors: Garcia M. , Domènech X. , Vidal C. , Torné E. , Milà N. , Binefa G. , Benito L. , Moreno V.
Published: February 2015

Objective. To analyze interval cancers among participants in a screening program for colorectal cancer (CRC) during four screening rounds.Methods. The study population consisted of participants of a fecal occult blood test-based screening program from February 2000 to September 2010, with a 30-month follow-up (n= 30,480). We used hospital administration data to identify CRC. An interval cancer was defined as an invasive cancer diagnosed within 30 months of a negative screening result and before the next recommended examination. Gender, age, stage, and site distribution of interval cancers were compared with those in the screen-detected group.Results. Within the study period, 97 tumors were screen-detected and 74 tumors were diagnosed after a negative screening. In addition, 17 CRC (18.3%) were found after an inconclusive result and 2 cases were diagnosed within the surveillance interval (2.1%). There was an increase of interval cancers over the four rounds (from 32.4% to 46.0%). When compared with screen-detected cancers, interval cancers were found predominantly in the rectum (OR: 3.66; 95% CI: 1.51–8.88) and at more advanced stages (P=0.025).Conclusion. There are large numbers of cancer that are not detected through fecal occult blood test-based screening. The low sensitivity should be emphasized to ensure that individuals with symptoms are not falsely reassured.
Orostachys japonicusInhibits Expression of the TLR4, NOD2, iNOS, and COX-2 Genes in LPS-Stimulated Human PMA-Differentiated THP-1 Cells by Inhibiting NF-κB and MAPK Activation
Authors: Yoon Yeo-Kwang , Woo Hong-Jung , Kim Youngchul
Published: February 2015

Orostachys japonicusis traditionally used as an inflammatory agent. In this report, we investigated the effects ofO. japonicusextract on the expression of genes encoding pathogen-recognition receptors (TLR2, TLR4, NOD1, and NOD2) and proinflammatory factors (iNOS, COX-2, and cytokines) in LPS-stimulated PMA-differentiated THP-1 cells and the NF-κB and MAPK pathways.O. japonicusinduced toxicity at high concentrations but had no effect at concentrations lower than 25 μg/mL.O. japonicusinhibited LPS-induced TLR4 and NOD2 mRNA levels, suppressed LPS-induced iNOS and COX-2 transcription and translocation, and downregulated LPS-induced proinflammatory cytokine (IL-1β, IL-6, IL-8, and TNF-α) mRNA levels. In addition,O. japonicusinhibited LPS-induced NF-κB activation and IκBαdegradation and suppressed LPS-induced JNK, p38 MAPK, and ERK phosphorylation. Overall, our results demonstrate that the anti-inflammatory effects ofO. japonicusare mediated by suppression of NF-κB and MAPK signaling, resulting in reduced TLR4, NOD2, iNOS, and COX-2 expression and inhibition of inflammatory cytokine expression.
A Case of Cardiac Metastasis from Uterine Cervical Carcinoma
Authors: Okamoto Kazuhiro , Kusumoto Tomoyuki , Seki Noriko , Nakamura Keiichiro , Hiramatsu Yuji
Published: February 2015

Cases of cardiac metastasis from uterine cervical carcinoma are rare. While they are occasionally found on autopsy, antemortem recognition is extremely rare. We confirmed a case of cardiac metastasis from cervical carcinoma antemortem, because we observed a decrease in platelet count during the course of treatment. The patient was a 27-year-old woman diagnosed with stage Ib1 uterine cervical carcinoma. Radical hysterectomy with pelvic lymphadenectomy was performed. Para-aortic lymph node metastasis was detected on positron emission tomography/computed tomography (PET-CT). Adjuvant chemotherapy was started, and most of the metastatic lesions disappeared. Pelvic lymph node recurrence was suspected on PET-CT during continued chemotherapy; therefore, treatment was shifted to radiation therapy. Tumor shrinkage was recognized, and the initial therapy was completed. A noticeable decrease in platelet count was recognized seven months after treatment. Multidetector CT was performed, and an intracardiac tumor was detected. The patient did not desire any further treatment. She died three weeks after the intracardiac tumor was confirmed. Few previous autopsy studies have reported cardiac metastasis from cervical carcinoma. Thus, it is necessary to consider the possibility of cardiac metastasis for patients diagnosed with terminal cervical carcinoma.
Early Laparoscopic Cholecystectomy with Continuous Pressurized Irrigation and Dissection in Acute Cholecystitis
Authors: Ozsan I. , Yoldas O. , Karabuga T. , Yıldırım U. M. , Cetin H. Y. , Alpdoğan O. , Aydin U.
Published: February 2015

Background. The aim of this study was to evaluate the preliminary results of a new dissection technique in acute cholecystitis.Material and Method. One hundred and forty-nine consecutive patients with acute cholecystitis were operated on with continuous pressurized irrigation and dissection technique. The diagnosis of acute cholecystitis was based on clinical, laboratory, and radiological evidences. Age, gender, time from symptom onset to hospital admission, operative risk according to the American Society of Anesthesiologists (ASA) score, white blood cell count, C-reactive protein test levels, positive findings of radiologic evaluation of the patients, operation time, perioperative complications, mortality, and conversion to open surgery were prospectively recorded.Results. Of the 149 patients, 87 (58,4%) were female and 62 (41,6%) were male. The mean age was46.3±6.7years. The median time from symptom onset to hospital admission 3.2 days (range, 1–6). There were no major complications such as bile leak, common bile duct injury or bleeding. Subhepatic liquid collection occurred in 3 of the patients which was managed by percutaneous drainage. Conversion to open surgery was required in four (2,69%) patients. There was no mortality in the study group.Conclusion. Laparoscopic cholecystectomy with continuous pressurized irrigation and dissection technique in acute cholecystitis seems to be an effective and reliable procedure with low complication and conversion rates.
Application of Acupoints and Meridians for the Treatment of Primary Dysmenorrhea: A Data Mining-Based Literature Study
Authors: Yu Siyi , Yang Jie , Yang Mingxiao , Gao Yan , Chen Jiao , Ren Yulan , Zhang Leixiao , Chen Liang , Liang Fanrong , Hu Youping
Published: February 2015

Background.Dysmenorrhea is a common problem for which acupuncture provides effective analgesia. Although acupoint selection affects the effectiveness of acupuncture, the basic rules of acupoint selection are little understood. This study aims to investigate the principles of acupoint selection and characteristics of acupoints used for primary dysmenorrhea.Methods.PubMed, China National Knowledge Infrastructure, and Chinese Biomedical Database were searched for clinical trials published in English or Chinese from January 1978 to April 2014 evaluating the effect of acupuncture on primary dysmenorrhea, with or without methods of randomization and/or control. Three authors extracted information and two reviewers inputted information on titles, journals, interventions, main acupoints, and outcomes using the self-established Data Excavation Platform of Acupoint Specificity for data mining.Results. Sanyinjiao(SP06),Guanyuan(CV04), andQihai(CV06) were used most frequently. The most frequently used meridians were Conception Vessel, Spleen Meridian of FootTaiyin, and Bladder Meridian of FootTaiyang. 67.24% of acupoints used were specific acupoints. Acupoints on lower limbs were most frequently used.Conclusion.Data mining is a feasible approach to identify the characteristics of acupoint selection. Our study indicated that modern acupuncture treatment for primary dysmenorrhea is based on selection of specific acupoints according to traditional acupuncture theory.
Chin Necrosis as a Consequence of Prone Positioning in the Intensive Care Unit
Authors: Bunker Daniel Lee John , Thomson Michael
Published: February 2015

Pressure necrosis of the skin is a rarely reported avoidable complication of prone positioning that can be minimised by active collaboration between care teams. We report a case of pressure necrosis of the chin after prone ventilation in the intensive care setting. Such injuries pose a risk of infection, possible need for surgical intervention, and increased costs to the health care system. Pressure necrosis injuries should be diligently guarded against by the careful selection of support devices, frequent turning, and rigorous skin care to minimise extended external compression, particularly on the face and bony prominences.
Subacute Sclerosing Panencephalitis in a Child with Recurrent Febrile Seizures
Authors: Kartal Ayşe , Çıtak Kurt Ayşegül Neşe , Hirfanoğlu Tuğba , Aydın Kürşad , Serdaroğlu Ayşe
Published: February 2015

Subacute sclerosing panencephalitis (SSPE) is a devastating disease of the central nervous system (CNS) caused by persistent mutant measles virus infection. The diagnosis of SSPE is based on characteristic clinical and EEG findings and demonstration of elevated antibody titres against measles in cerebrospinal fluid. Subacute sclerosing panencephalitis can have atypical clinical features at the onset. Herein, we report an unusual case of subacute sclerosing panencephalitis in a child with recurrent febrile seizures. The disease progressed with an appearance of myoclonic jerks, periodic high amplitude generalized complexes on EEG, and elevated titers of measles antibodies in cerebrospinal fluid leading to the final diagnosis of subacute sclerosing panencephalitis.
Asphaltene Formation Damage Stimulation by Ultrasound: An Analytical Approach Using Bundle of Tubes Modeling
Authors: Rabbani Arash , Ghazanfari Mohammad Hossein , Amani Mahmood
Published: February 2015

This study presents a novel approach for bundle of tubes modeling of permeability impairment due to asphaltene-induced formation damage attenuated by ultrasound which has been rarely attended in the available literature. Model uses the changes of asphaltene particle size distribution (APSD) as a function of time due to ultrasound radiation, while considering surface deposition and pore throat plugging mechanisms. The proposed model predicts the experimental data of permeability reduction during coinjection of solvent and asphaltenic oil into core with reasonable agreement. Viscosity variation due to sonication of crude oil is used to determine the fluid mobility applied in the model. The results of modeling indicate that the fluid samples exposed to ultrasound may cause much less asphaltene-induced damage inside the porous medium. Sensitivity analysis of the model parameters showed that there is an optimum time period during which the best stimulation efficiency is observed. The results of this work can be helpful to better understand the role of ultrasound prohibition in dynamic behavior of asphaltene deposition in porous media. Furthermore, the present model could be potentially utilized for modeling of other time-dependent particle induced damages.
Stability Results for an Age-Structured SIS Epidemic Model with Vector Population
Authors: Liu He-Long , Yu Jing-Yuan , Zhu Guang-Tian
Published: February 2015

We formulate an age-structured SIS epidemic model with periodic parameters, which includes host population and vector population. The host population is described by two partial differential equations, and the vector population is described by a single ordinary differential equation. The existence problem for endemic periodic solutions is reduced to a fixed point problem of a nonlinear integral operator acting on locally integrable periodic functions. We obtain that if the spectral radius of the Fréchet derivative of the fixed point operator at zero is greater than one, there exists a unique endemic periodic solution, and we investigate the global attractiveness of disease-free steady state of the normalized system.
A Critical Evaluation of Carotid Duplex Scanning in the Diagnosis of Significant Carotid Artery Occlusive Disease
Authors: Henry Jon C. , Kiser Dennis , Satiani Bhagwan
Published: February 2015

Carotid duplex (CD) scanning is the primary method of evaluating patients suspected of having extracranial carotid occlusive disease. It is incumbent on vascular laboratories (VL) to have internally validated criteria confirming overall accuracy, specificity (SP), sensitivity (SS), negative predictive value (NPV), and positive predictive value (PPV). Receiver operating characteristic (ROC) curves allow further analysis to update existing criteria. We correlated 127 internal carotid arteries studied by carotid duplex scanning and confirmatory modalities, which showed a SP of 83.3%, SS of 97.9%, NPV of 92.5%, PPV of 95%, and overall accuracy of 94.5% for >50% internal carotid artery stenosis. For >70% stenosis, SP was 88.8%, SS was 96.1%, NPV was 93.6%, PPV was 92.5%, and overall accuracy was 92.9%. ROC curves for the peak systolic velocities were used; for detecting a 50–69% stenosis range a sensitivity of 88%, specificity of 93%, NPV of 73%, and PPV of 97% were found. For detecting a 70–99% stenosis a sensitivity of 95%, specificity of 90%, NPV of 93%, and a PPV of 93% were found. All vascular laboratories must have a vigorous quality assurance program and must validate their own internal criteria or the recently promulgated consensus criteria for grading the severity of carotid stenosis by carotid duplex examination.
Feasible Time Evolution Model That Predicts Breakdown in Thin SiO2Films within Unstressed Interval after Constant-Current Stress
Authors: Omura Yasuhisa
Published: February 2015

This paper proposes a poststress time evolution model for sub-10-nm thick SiO2films for degradation prediction and the extraction of trap-related parameters. The model is based on the understanding that the degradation in thin SiO2films continues within the unstressed interval. The phenomenon is captured by an analytical expression that indicates that the time evolution of SiO2film degradation roughly consists of two stages and that the degradation is more likely to occur if water molecules are present. It is demonstrated that the simple analytical model successfully reproduces measured results. It is also suggested that the degradation process considered here is related to oxygen diffusion in the resistive transition process.
Galactic Cosmic Ray Variability at Two Neutron Monitors: Relation to Kp Index
Authors: Okpala Kingsley Chukwudi
Published: February 2015

The average characteristics of year-to-year variability of Galactic cosmic ray (GCR) flux measured in one mid-latitude neutron monitor stations (Newark) and high latitude station (Apatity) have been studied under different planetary disturbance (Kp) conditions. The year-to-year variability which oscillates in response to solar cycle was analyzed using Fourier technique and the amplitude of variation was obtained using data for 1980–2005. There is a noticeable trend in the difference between the amplitudes of the year-to-year variation of the two stations. The difference is highest during low Kp conditions and lowest during high Kp condition. There is generally lesser association of GCR with solar wind (SW) flow pressure and density as the Kp index increases. Similar feature is observed with the interplanetary magnetic field IMF (total). These observations have important implications for our present understanding of the effect of solar activity to variability in GCR flux.
Influence of Sampling Site on Uterine Artery Doppler Indices at 11-13+6 Weeks Gestation
Authors: Ridding Gus , Schluter Philip J. , Hyett Jon A. , McLennan Andrew C.
Published: February 2015

Introduction: Uterine artery pulsatility index (PI) is a key variable in the first trimester screening for pre-eclampsia. The aims of the study were to examine the effect of sampling the uterine arteries at a site distal to the level of the internal os, and to determine a lower limit of peak systolic velocity (PSV) to establish an auditable standard. Material and Methods: PI and PSV measurements were performed at 11-13+6 weeks' gestation at two sites: at the level of the internal os and 3 cm distal to the internal os. Comparative analyses utilised the Student's paired t-test. A 90% reference interval of transformed PSV measurements at the internal os was generated by polynomial regression. Results: There was a significant reduction in both the PI (14.9%) and the PSV (17.4%) when measured at the distal site compared to the level of the internal os (both p < 0.001). The best estimated 5th centile for uterine artery PSV at 11-13+6 weeks was 60.9 cm/s. Conclusion: PI measurements performed distal to the internal os are significantly lower and will result in inaccurate pre-eclampsia risk assessment. PSV measurements below 60 cm/s are likely to indicate an incorrect sampling site. Development of auditable measurement standards is important to ensure accuracy of prospective pre-eclampsia screening.
In utero Exposure to Cigarette Smoking, Environmental Tobacco Smoke and Reproductive Hormones in US Girls Approaching Puberty
Authors: Gollenberg Audra L. , Addo O. Yaw , Zhang Zhiwei , Hediger Mary L. , Himes John H. , Lee Peter A.
Published: February 2015

Background/Aims: Evidence is unclear whether prenatal smoking affects age at menarche and pubertal development, and its impact upon hormones has not been well studied. We aim to identify potential pathways through which prenatal smoking and environmental tobacco smoke (ETS) affect reproductive hormones in girls approaching puberty. Methods: We examined the association between prenatal smoking, current ETS and luteinizing hormone (LH) and inhibin B (InB) in 6- to 11-year-old girls in the 3rd National Health and Nutrition Examination Survey, 1988-1994. Parents/guardians completed interviewer-assisted questionnaires on health and demographics at the time of physical examination. Residual blood samples were analyzed for reproductive hormones in 2008. Results: Of 660 girls, 19 and 39% were exposed to prenatal smoke and current ETS, respectively. Accounting for multiple pathways in structural equation models, prenatally exposed girls had significantly lower LH (β = -0.205 log-mIU/ml, p < 0.0001) and InB (β = -0.162, log-pg/ml, p < 0.0001). Prenatal smoking also influenced LH positively and InB negatively indirectly through BMI-for-age. ETS was positively associated with LH, but not with InB. Conclusion: Exposure to maternal smoking may disrupt reproductive development manifesting in altered hormone levels near puberty.
A Telephone- and Text Message-Based Telemedicine Concept for Patients with Mental Health Disorders: Results of a Randomized Controlled Trial
Authors: van den Berg Neeltje , Grabe Hans-Jörgen , Baumeister Sebastian E. , Freyberger Harald J. , Hoffmann Wolfgang
Published: February 2015

Background: A telemedicine care concept based on telephone contacts and individualized text messages was developed for patients with mental disorders to continue treatment after therapy in a psychiatric day hospital. The primary objective of this study was to evaluate the effectiveness of the telemedicine interventions. Methods: The study had a 3-armed, randomized design with 2 intervention arms (intervention 1: telephone contacts; intervention 2: telephone contacts and short text messages; both took place over a period of 6 months and in addition to usual care), and a control group with usual care. Primary outcomes were 18-item Brief Symptom Inventory (BSI-18) scores for anxiety, depression and somatization. All participants were recruited from psychiatric day hospitals. The study was registered in the German Clinical Trials Register (DRKS00000662). Results: 113 participants were analyzed 6 months after starting the intervention. The average BSI-18 anxiety score after 6 months was -2.04 points lower in intervention group 2 than in the control group (p value: 0.042). The difference in BSI depression score between these two groups was marginally significant (p value: 0.1), with an average treatment effect of -1.73. In an exploratory sensitivity analysis restricted to the 75% of patients with the highest symptom scores at baseline, intervention group 1 yielded a significant effect for anxiety and depression compared to the control group (p = 0.036 and 0.046, respectively). Conclusions: Telemedicine provides a novel option in psychiatric ambulatory care with statistically significant effects on anxiety. A positive tendency was observed for depression, especially in cases with higher symptom load at baseline.
Regulation of Appetite, Satiation, and Body Weight by Enteroendocrine Cells. Part 2: Therapeutic Potential of Enteroendocrine Cells in the Treatment of Obesity
Authors: Posovszky Carsten , Wabitsch Martin
Published: February 2015

Obesity is an epidemic and medical issue. Investigating the pathways regulating appetite, food intake, and body weight is crucial to find strategies for the prevention and treatment of obesity. In the context of therapeutic strategies, we focus here on the potential of enteroendocrine cells (EECs) and their secreted hormones in the regulation of body weight. We review the role of the enteroendocrine system during weight loss after lifestyle intervention or after bariatric surgery. We discuss the therapeutic potential of EECs and their hormones as targets for new treatment strategies. In fact, targeting nutrient receptors of EECs with a nutritional approach, pharmaceutical agents or prebiotics delivered to the lumen may provide a promising new approach.
Effects of Pioglitazone or Exercise in Older Adults with Mild Cognitive Impairment and Insulin Resistance: A Pilot Study
Authors: Hildreth Kerry L. , Van Pelt Rachael E. , Moreau Kerrie L. , Grigsby Jim , Hoth Karin F. , Pelak Victoria , Anderson C. Alan , Parnes Bennett , Kittelson John , Wolfe Pamela , Nakamura Tammie , Linnebur Sunny A. , Trujillo Jennifer M. , Aquilante Christina L. , Schwartz Robert S.
Published: February 2015

Aims: To examine the effects of pioglitazone or endurance exercise training on cognitive function in older adults with mild cognitive impairment (MCI) and insulin resistance. Methods: Seventy-eight adults (mean age ± SD: 65 ± 7 years) with central obesity and MCI were randomized to 6 months of endurance exercise, pioglitazone or control. Results: Sixty-six participants completed the study. Exercise training did not significantly increase peak oxygen uptake compared to control (p = 0.12). Compared to control, insulin resistance improved in the pioglitazone group (p = 0.002) but not in the exercise group (p = 0.25). There was no measureable effect of pioglitazone or exercise on cognitive performance compared to control. Conclusion: In this pilot study, pioglitazone improved insulin resistance but not cognitive performance in older adults with MCI and insulin resistance.
White Adipose Tissue Depot-Specific Activity of Lipogenic Enzymes in Response to Fasting and Refeeding in Young and Old Rats
Authors: Wronska Agata , Lawniczak Aleksandra , Wierzbicki Piotr M. , Goyke Elzbieta , Sledzinski Tomasz , Kmiec Zbigniew
Published: February 2015

Background: Although the heterogeneity of white adipose tissue (WAT) in different anatomical sites is a well-known phenomenon, there are scarce data on aging-associated metabolic alterations in various WAT depots. Objective: We used the model of fasting and refeeding to analyze the effect of aging on the activity of key lipogenic enzymes in retroperitoneal (rWAT), epididymal (eWAT), and subcutaneous (sWAT) adipose tissue depots. Methods: 5- and 24-month-old male Wistar rats were fasted for 48 h or were fasted for 2 days and subsequently refed for 2 or 4 days. Control animals had ad libitum access to chow. Samples obtained from three WAT deposits were analyzed for the enzymatic activities of ATP citrate lyase (ACL), fatty acid synthase (FAS), and glucose-6-phosphate dehydrogenase (G6PD). Concentrations of lipids and proteins were measured in the blood serum. Results: Fasting for 2 days decreased the concentration of free fatty acids only in the young rats. The basal activities of ACL and FAS were lower in eWAT than in rWAT and sWAT of the young rats. In the young rats, fasting did not change ACL and FAS activities in any of the studied depots. Refeeding increased these activities more quickly in rWAT than in eWAT, while in sWAT no induction was observed. ACL and FAS activities were manifold lower in all WAT depots of the old than in those of the young rats. In the old animals fasting had no effect on ACL activity in any depot and decreased FAS activity only in sWAT. After 4 days of refeeding, FAS activity increased in rWAT and sWAT, but no change in ACL activity occurred. G6PD activity in the young rats was lower by 40% in eWAT than in rWAT. The induction of the enzyme by refeeding occurred faster in rWAT than in eWAT, while in sWAT no change in G6PD activity was observed. G6PD activity did not change with aging. Fasting of the old rats decreased G6PD activity in rWAT and sWAT. Refeeding failed to induce the enzyme in these depots, whereas in eWAT G6PD activity increased by 76% after 4 days of refeeding. Conclusion: Fasting and refeeding revealed WAT depot-specific, age-related changes of the activities of lipogenic enzymes.
Aging, Cognitive Load, Dementia and Hearing Loss
Authors: Martini Alessandro , Castiglione Alessandro , Bovo Roberto , Vallesi Antonino , Gabelli Carlo
Published: February 2015

Sensorineural systems play a crucial role in the diagnosis, treatment and management of several neurological disorders. The function of the eye and ear represents a unique window for testing various conditions in cognitive decline or dementia. Touch and smell have also been found to be strongly involved in neurodegenerative conditions, and their decline has been significantly associated with the progression of the disease; hence, the idea that restoring sensory function in cognitively impaired adults might enable a significant improvement in their cognitive status, reducing the worldwide incidence and prevalence of dementia. Not all sensorineural ‘windows' can benefit equally from the same procedures; however, hearing and vision can certainly gain the most from dependable therapeutic and other diagnostic options. The ear, including the vestibular system, deserves an honored place among the sensory organs in this context due mainly to the sophisticated electrical devices available that have amply demonstrated their effectiveness in treating hearing loss. Restoring an individual's hearing can reduce the cognitive ‘load', i.e. the neural activity needed to understand/recognize the spoken word - an activity that becomes more demanding if the brain is obliged to recruit different neural populations to achieve the same performance, as happens in older adults with sensory impairments. The sensory interfaces may also facilitate the early diagnosis of conditions characterized by a lengthy preclinical phase, as well as enabling noninvasive, follow-up procedures to assess the outcome of rehabilitation measures and distinguish physiological brain aging from neurodegenerative disorders. The present study is a brief literature review on the issues and prospects relating to the unique relationship between hearing and cognitive decline, with a general introduction to the main topics before focusing on rehabilitation training with hearing aids and cochlear implants to combat cognitive decline.
Hearing Loss and Dementia in the Aging Population
Authors: Peracino Andrea
Published: February 2015

For some years, policy makers and medical scientists have both begun to focus more on chronic noncommunicable diseases. It is well known that cardio-cerebrovascular disease, tumors, diabetes, and chronic obstructive pulmonary disease (COPD), are considered areas of major interest in many scientific projects and health programs. The economic impact of cardio-cerebrovascular disease in EU alone is more than EUR 200 billion, while tumors have an impact of EUR 150 billion. The direct and indirect cost of brain disorders exceeds EUR 700 billion a year. Among the brain disorders, the devastating impact of dementia on affected individuals and the burden imposed on their families and society has made prevention and treatment of dementia a public health priority. Interventions that could merely delay the onset of dementia by 1 year would result in a more than 10% decrease in the global prevalence of dementia in 2050. Unfortunately, there are no known interventions that currently have such effectiveness. The manifestations of age-related hearing loss in many older adults are subtle and, thus, hearing loss is often perceived as an unfortunate but inconsequential part of aging. Researchers report that hearing loss seems to speed up age-related cognitive decline. Researchers suggest that treating hearing loss more aggressively could help delay cognitive decline and dementia. Furthermore, there is an increasing interest in better understanding the pathophysiologic correlations between hearing loss and dementia. Hearing loss in older adults, in fact, is associated independently with poorer cognitive functioning, incident dementia, and falls. Further research investigating the basis of this connection as well as the pathomechanism of the two diseases will further our ability to treat dementia.
Improvement of Telephone Communication in Elderly Cochlear Implant Patients
Authors: Di Nardo Walter , Anzivino Roberta , Gambini Gloria , De Corso Eugenio , Paludetti Gaetano
Published: February 2015

Introduction: Elderly patients demonstrate more difficulty in telephone communication than in direct conversation. This deterioration in comprehension is due most likely to the narrowing of frequency range of transmission (300-3,400 Hz) and the lack of specific maps in the sound processor to accommodate the reduced information. Aims: The goal of this study was to create a new ‘telephone map' specific for phone use and to verify its effectiveness even in elderly patients. Methods: Twenty cochlear implant (CI) adult patients divided into two age groups (under 60 and over 60 years) were included in the study. All patients were assessed with a word recognition test presented via recorded, conventional telephone-transmitted voice signal while using their everyday map (SB-map) and while using the experimental map (T-map). The latter was created by lowering the current level to the minimum value for electrodes representing frequencies outside the range of the telephone signal without changing the frequency bands assigned to them. Results: In experimental listening conditions, the average recognition score using the SB-map was 65.5% in patients under 60 and 36.5% in patients over 60, while using the T-map it was 73.5 and 41.5%, respectively. This difference between the two maps was statistically significant in both groups (p ˂ 0.05) and was confirmed by subjective assessment. After 3 months of training provided to the over 60 CI group, subjects showed further improvement. Discussion: The increase in comprehension skills by phone-transmitted speech with the T-map is objective and immediate in both groups of patients and proves to be improved further after training. The results demonstrate that it is possible to reduce the background noise and improve the ability to comprehend the phone message through changes to some map parameters. Conclusions: In light of the results obtained, we believe that our experimental map, applicable to all types of implants, currently represents a simple and effective solution to improve telephone communication in patients with CI.
The Impact of Growth Hormone Therapy on Adult Height in Noonan Syndrome: A Systematic Review
Authors: Giacomozzi Claudio , Deodati Annalisa , Shaikh Mohamad Guftar , Ahmed Syed Faisal , Cianfarani Stefano
Published: February 2015

Background: Recombinant human growth hormone (rhGH) is being used to promote linear growth in short children with Noonan syndrome. However, its efficacy is still controversial. Aims: To systematically determine the impact of rhGH therapy on adult height in children with Noonan syndrome. Methods: We searched the Cochrane Central Register of Controlled Trials, ISI Web of Science, MEDLINE, and the bibliographic references from all retrieved articles published until April 2014. Studies reporting adult/near-adult height in children with Noonan syndrome treated with rhGH or reporting at least a 3-year follow-up were analysed. Quality and strength of recommendation were assessed according to the Endocrine Society criteria. Results: No controlled trials reporting adult height were available. Five studies were identified reporting adult height or near adult height. Data comparison showed inter-individual variability in the response to rhGH, mean height gain standard deviation score ranging between 0.6 and 1.4 according to national standards, and between 0.6 and 2 according to Noonan standards. Significant biases affected all the studies. Conclusions: High-quality controlled trials on the impact of rhGH therapy on adult height are lacking, and the robustness of available data is not sufficient to recommend such therapy in children with Noonan syndrome.
An Intervention Study of Individual, apoE Genotype-Based Dietary and Physical-Activity Advice: Impact on Health Behavior
Authors: Hietaranta-Luoma Hanna-Leena , Tahvonen Raija , Iso-Touru Terhi , Puolijoki Hannu , Hopia Anu
Published: February 2015

Aim: To assess the behavioral effects of receiving personal genetic information, using apoE genotypes as a tool for promoting lifestyle changes. apoE was chosen because it has a significant impact on lipid metabolism and cholesterol absorption, both factors in cardiovascular disease. Methods: This study was a 1-year intervention study of healthy adults aged 20-67 years (n = 107). Their behavioral changes were measured by diet (e.g., fat quality, as well as consumption of vegetables, berries, fruits, and fatty and sugary foods), alcohol consumption, and exercise. Health and taste attitudes were assessed with the Health and Taste Attitude Scales (HTAS). The measurements were performed 4 times: at baseline (T0), as well as 10 weeks (T1), 6 months (T2), and 12 months after baseline (T3). These behavioral effects were assessed for three groups: a high-risk (Ɛ4+; n = 16), a low-risk (Ɛ4-; n = 35), and a control group (n = 56). Results: Personal genetic information affected health behavior. Dietary fat quality improved more in the Ɛ4+ group than in the Ɛ4- and control groups after personal, genotype-based health advice. This change differed significantly between the Ɛ4+ and the control group (p < 0.05), but only for a short time. Conclusion: Personal genetic information, based on apoE, may affect dietary fat quality. More research is required to determine how to utilize genotype-based health information and how to efficiently achieve long-term changes in the prevention of lifestyle-related diseases.
Real-World Outcome Analysis of Continuously and Intermittently Treated Patients with Moderate to Severe Psoriasis after Switching to a Biologic Agent
Authors: Hjalte Frida , Steen Carlsson Katarina , Schmitt-Egenolf Marcus
Published: February 2015

Background: Clinical studies of continuous versus intermittent biologic therapy for moderate to severe psoriasis demonstrate improved efficacy with continuous treatment. Objective: To analyse Swedish real-world data of continuously and intermittently treated biologic-naïve patients after switching to a biologic agent. Methods: This is an observational study based on PsoReg, the Swedish registry for systemic psoriasis treatment. Outcome effects in biologic-naïve patients who switched to a biologic agent (n = 351) were analysed in groups of continuous, intermittent and terminated treatment. Results: Intermittently treated patients (n = 50) reported higher Psoriasis Area and Severity Index and Dermatology Life Quality Index values after switching than patients with continuous (n = 260) or terminated treatment (n = 41). Study Limitations: The reason for intermittent treatment was not recorded. The intermittently treated patients may be a heterogeneous group and a limitation is that it cannot be determined whether less than continuous use was offered to handle negative aspects. Conclusion: Patients with continuous biologic treatment tend to achieve better outcomes compared to intermittently treated patients.
Increased L-Ornithine Production in Corynebacterium glutamicum by Overexpression of a Gene Encoding a Putative Aminotransferase
Authors: Kim Dai-Joong , Hwang Gui-Hye , Um Ji-Na , Cho Jae-Yong
Published: February 2015

Overexpression of the NCgl0462 open reading frame, encoding a class II aminotransferase, was studied in conjunction with other enzymes in L-ornithine biosynthesis in an L-ornithine-producing strain. Expression of the wild-type NCgl0462 open reading frame, which displayed aminotransferase activity, was amplified by placing it under the control of the glyceraldehyde 3-phosphate dehydrogenase gene promoter in the pEK0 plasmid and in the genome. L-Ornithine production in Corynebacteriumglutamicum SJC8260 harboring plasmid and the genomic NCgl0462 open reading frame was increased by 8.8 and 21.6%, respectively. In addition, the combined overexpression of the NCgl0462 open reading frame within the genome along with the mutated L-ornithine biosynthesis genes (argCJBD) placed in the pEK0 plasmid in C. glutamicum SJC8260 resulted in significant improvement in L-ornithine production (12.48 g/l for combined overexpression compared with 8.42 g/l for the control). These results suggest that overexpression of the aminotransferase-encoding NCgl0462 open reading frame plays an unequivocal role in the L-ornithine biosynthetic pathway, with overlapping substrate specificity in C. glutamicum.
The Effect of Different Doses of Isotretinoin on Pituitary Hormones
Authors: Karadag Ayse Serap , Takci Zennure , Ertugrul Derun Taner , Bilgili Serap Gunes , Balahoroglu Ragip , Takir Mumtaz
Published: February 2015

Background: There are a limited number of studies investigating the side effects and effectiveness of various doses of isotretinoin (ISO). We have previously shown that high-dose ISO affects pituitary hormones. Objectives: To our knowledge, there is no study in the literature looking into the effects of various doses of ISO on pituitary hormones. We searched pituitary hormones in three groups of different doses in acne patients. Methods: We included 105 acne vulgaris patients from two different centers. We divided the patients into three groups; the first group received 0.5-1 mg/kg/day, the second 0.2-0.5 mg/kg/day and the third intermittent 0.5-1 mg/kg/day (only 1 week in 1 month) ISO treatment. Blood samples were collected for biochemistry and hormone analysis, before the treatment and after 3 months. Results: After 3 months of treatment with ISO, luteinizing hormone (LH) (p < 0.001), prolactin (p < 0.001), total testosterone (p < 0.001), adrenocorticotropic hormone (ACTH) (p < 0.001), cortisol (p < 0.001), insulin-like growth factor-binding protein 3 (p < 0.001), insulin-like growth factor 1 (IGF-1) (p = 0.002), growth hormone (GH) (p = 0.002) and free T3 (fT3) (p < 0.001) levels had decreased significantly. Furthermore, we split data into three different groups. Among the patients receiving intermittent-dose ISO, LH, ACTH, IGF-1, GH and fT3 measurements lost significance. Most of the significant measurements observed in the whole group were also significant among the patients receiving high-dose ISO. Additionally, dehydroepiandrosterone sulfate (p = 0.003) levels increased, and free T4 levels decreased significantly. Conclusions: ISO affects pituitary hormones at all of these three doses. The differences in pituitary hormones are more pronounced in high-dose treatment. The weakest effect was observed in the intermittent-dose group. Choosing lower doses of ISO may decrease side effects, however the effectiveness of the treatment may also be diminished. ISO, by affecting the PPARγ/RXR system, may affecting hormone systems. These changes in various hormone systems may be related to the effectiveness of ISO.
Dexamethasone Implant (Ozurdex) in a Case with Unilateral Simultaneous Central Retinal Vein and Branch Retinal Artery Occlusion
Authors: Ozturk Taylan , Takes Omer , Saatci A. Osman
Published: February 2015

Simultaneous branch retinal artery and vein occlusion is a rare condition that may cause severe visual loss, and its treatment is often unrewarding. Herein, we report a case with simultaneous central retinal vein and branch retinal artery occlusion; it was successfully treated with a single dexamethasone intravitreal implant. The affected eye attained a visual acuity level of 20/25 from the visual acuity of hand motions at presentation with a residual, but relatively diminished, altitudinal scotoma during a follow-up period of 6 months.
Sebaceous Carcinoma of the Parotid Gland: A Case Report
Authors: Takada Yohei , Kawamoto Kohei , Baba Susumu , Takada Tomoko , Inoue Toshiya , Tomoda Koichi
Published: February 2015

Background: Primary sebaceous carcinoma of the parotid gland is extremely rare, and because of its rarity, clinicopathological characteristics and histogenesis are not fully understood. Methods: Here, we report a patient who presented with a left infra-auricular painless mass. We present the histological features and discuss possible optimal treatments based on previous literature. Results: The mass was suspected to be a myoepithelial tumor or possibly a pleomorphic adenoma. Initially, the mass was resected with preservation of the facial nerve, but this caused facial palsy. Because the histological examination showed a sebaceous carcinoma and a part of the mass could be remaining on the facial nerve, additional surgery was performed, and the facial nerve was reconstructed with cervical nerve. Follow-up after 7 months showed no sign of recurrence of metastasis. Conclusion: We encountered a rare sebaceous carcinoma of the parotid gland. Additional surgery was performed because preoperative diagnosis was difficult.
Aprendizado de adultos
Authors: Iglesias Alessandro Giraldes , Pazin-Filho Antonio
Published: February 2015

Gradativamente, o aprendizado de adultos tem se diferenciado da pedagogia. Isso começou com a psicologia cognitiva e atualmente já se dispõe de evidências de neuroimagem que justifiquem essas diferenças e permitam o melhor conhecimento do processo de aprendizagem e memória para embasar o desenvolvimento de novas técnicas de ensino.
Aprendizado baseado em problemas
Authors: Borges Marcos de Carvalho , Chachá Silvana Gama Florencio , Quintana Silvana Maria , Freitas Luiz Carlos Conti de , Rodrigues Maria de Lourdes Veronese
Published: February 2015

A Aprendizagem Baseada em Problemas (ABP), introduzida no ensino de Ciências da Saúde na McMaster University, Canadá, em 1969, é uma proposta pedagógica que consiste no ensino centrado no estudante e baseado na solução de problemas, reais ou simulados. Os alunos, para solucionar esse problema, recorrem aos conhecimentos prévios, discutem, estudam, adquirem e integram os novos conhecimentos. Essa integração, aliada à aplicação prática, facilita a retenção do conhecimento. Portanto, a ABP valoriza, além do conteúdo a ser aprendido, a forma como ocorre o aprendizado, reforçando o papel ativo do aluno neste processo, permitindo que ele aprenda como aprender. A ABP oferece diversas vantagens, como o desenvolvimento da autonomia, a interdisciplinaridade, a indissociabilidade entre teoria e prática, o desenvolvimento do raciocínio crítico e de habilidades de comunicação, e a educação permanente. Porém, para a sua utilização são necessários investimentos em recursos humanos e materiais, além de um programa de capacitação de professores e alunos bem estruturado, que devem sempre ser considerados antes de sua implementação.
Avaliação formativa e feedback como ferramenta de aprendizado na formação de profissionais da saúde
Authors: Borges Marcos C. , Miranda Carlos H. , Santana Rodrigo C. , Bollela Valdes R.
Published: February 2015

As diferentes formas de avaliação são elementos centrais do processo de ensino-aprendizagem de qualquer programa educacional, e devem ser bem planejadas e implementadas em todas as propostas curriculares, especialmente na formação de profissionais na área da saúde. Uma avaliação do estudante adequada e de qualidade guarda estreita relação com a competência e capacitação do profissional que será entregue à sociedade. Neste contexto, a avaliação formativa e a capacitação dos professores para prover feedback efetivo, frequente, e de qualidade são fundamentais na formação dos futuros profissionais da saúde. Este artigo faz uma revisão sobre avaliação formativa, feedback e debriefing.
Canais Iônicos na Epilepsia
Authors: Silva Alysson S. da , Souza Iara L. L. de , Silva Bagnólia A. da
Published: February 2015

Dados da Organização Mundial da Saúde apontaram uma prevalência mundial de epilepsia por volta de 50 milhões de pessoas. A crise epiléptica é um período de excitação síncrona anormal de uma população de neurônios. O balanço entre sistemas de controle que impedem uma descarga de potencial de ação excessiva nos neurônios e outros sistemas que facilitam a excitação mantém o bom funcionamento do sistema nervoso. Este trabalho teve como objetivo compilar informações sobre o envolvimento das canalopatias no processo fisiopatológico das crises epilépticas. Foi realizada uma revisão de literatura, através de pesquisas bibliográficas utilizando os bancos de dados Medline/PubMed, Scielo, Scirus, Wiley Online Library e Science Direct. Para tal finalidade, os descritores utilizados foram: epilepsia, crises epilépticas, canais iônicos, canalopatias e epidemiologia, em idiomas português e inglês. As investigações genéticas fizeram com que algumas síndromes epilépticas fossem consideradas canalopatias e, por conseguinte, aumentaram o entendimento da fisiopatologia dos transtonos convulsivos. Dada à incapacidade de cura dos fármacos disponíveis atualmente, o grande desafio para as pesquisas científicas é a descoberta de um tratamento capaz de prevenir ou reverter a epilepsia.
Tratamento cirúrgico da Incontinência Urinária de Esforço com o minisling OPHIRA – um estudo piloto
Authors: Marra Joana Espagiari , Mendes Guilherme P. , Moroni Rafael M. , Magnani Pedro S. , Rodrigues Heitor L. P. , Reis Francisco Jose Candido dos , Brito Luiz Gustavo O.
Published: February 2015

Desenho do estudo: Transversal. Objetivos: Avaliar a eficácia do minisling Ophyra ™ em mulheres com incontinência urinária de esforço (IUE). Métodos: Estudo prospectivo, observacional, que abrangeu 13 pacientes que realizaram cirurgia de minisling entre 2010 e 2011. As seguintes variáveis foram analisadas: idade, taxa subjetiva de sucesso (cura e /ou melhora), complicações cirúrgicas imediatas e tardias. Os parâmetros de qualidade de vida (King’s Health Questionnaire - KHQ) foram analisados antes e depois de um ano de cirurgia. Resultados: Treze (3/13) por cento das mulheres recidivaram a IUE, com 87,5% de sucesso subjetivo depois de um ano de seguimento. Depois de 12 meses de seguimento, as mulheres foram consideradas subjetivamente curadas em todos os domínios dos questionários de qualidade de vida KHQ, exceto por relações pessoais e domínio de sono/energia. Quatro pacientes tiveram sintomas irritativos depois da cirurgia e duas pacientes com retenção urinária crônica. Conclusão: O minisling Ophira foi efetivo para melhorar a IUE e promover melhor qualidade de vida em mulheres com IUE. Maior amostragem é necessária para posteriormente comparar essas pacientes com mulheres que foram submetidas a técnicas retropúbicas clássicas.