bluuebunny/crossref_metadata_2025 huggingface dataset:
Reductions in Perceived Injustice are Associated With Reductions in Disability and Depressive Symptoms After Total Knee Arthroplasty
Authors: Yakobov Esther , Scott Whitney , Stanish William D. , Tanzer Michael , Dunbar Michael , Richardson Glen , Sullivan Michael J.L.
Published: September 2017

Introduction:

Perceptions of injustice have been associated with problematic recovery outcomes in individuals with a wide range of debilitating pain conditions. It has been suggested that, in patients with chronic pain, perceptions of injustice might arise in response to experiences characterized by illness-related pain severity, depressive symptoms, and disability. If symptoms severity and disability are important contributors to perceived injustice (PI), it follows that interventions that yield reductions in symptom severity and disability should also contribute to reductions in perceptions of injustice. The present study examined the relative contributions of postsurgical reductions in pain severity, depressive symptoms, and disability to the prediction of reductions in perceptions of injustice.

Methods:

The study sample consisted of 110 individuals (69 women and 41 men) with osteoarthritis of the knee scheduled for total knee arthroplasty (TKA). Patients completed measures of perceived injustice, depressive symptoms, pain, and disability at their presurgical evaluation, and at 1-year follow-up.

Results:

The results revealed that reductions in depressive symptoms and disability, but not pain severity, were correlated with reductions in perceived injustice. Regression analyses revealed that reductions in disability and reductions in depressive symptoms contributed modest but significant unique variance to the prediction of postsurgical reductions in perceived injustice.

Discussion:

The present findings are consistent with current conceptualizations of injustice appraisals that propose a central role for symptom severity and disability as determinants of perceptions of injustice in patients with persistent pain. The results suggest that the inclusion of psychosocial interventions that target depressive symptoms and perceived injustice might augment the impact of rehabilitation programs made available for individuals recovering from TKA.
Risk Factors for Low Back Pain in Childhood and Adolescence
Authors: Calvo-Muñoz Inmaculada , Kovacs Francisco M. , Roqué Marta , Gago Fernández Inés , Seco Calvo Jesús
Published: September 2017

Objectives:

To identify factors associated with low back pain (LBP) in children and adolescents.

Materials and Methods:

A systematic review was conducted (Prospero CRD42016038186). Observational studies analyzing LBP risk factors among participants aged between 9 and 16 were searched for in 13 electronic databases and 8 specialized journals until March 31, 2016, with no language restrictions. In addition, references in the identified studies were manually tracked. All identified studies that included ≥50 participants aged 9 to 16, were reviewed. Their methodological quality was assessed by 2 reviewers separately, using validated tools, which scored, from worst to best, 0 to 100 for cross-sectional and 0 to 12 for cohort studies. A sensitivity analysis only included studies that had adjusted for confounders, had ≥500 participants, and had a methodological score of ≥50%.

Results:

A total of 5142 citations were screened and 61 studies, including 137,877 participants from 5 continents, were reviewed. Their mean (range) methodological scores were 74.56 (50 to 100) for cross-sectional studies and 7.36 (5 to 9) for cohort studies. The studies had assessed 35 demographic, clinical, biological, family, psychological, ergonomic, and lifestyle risk factors. The mean (range) prevalence of LBP ranged between 15.25% (3.20 to 57.00) for point prevalence and 38.98% (11.60 to 85.56) for lifetime prevalence. Results on the association between LBP and risk factors were inconsistent. In the sensitivity analysis, “older age” and “participation in competitive sports” showed a consistent association with LBP.

Discussion:

Future studies should focus on muscle characteristics, the relationship between body and backpack weights, duration of carrying the backpack, characteristics of sport practice, and which are the factors associated with specifically chronic pain.
Current insights in obstetric antiphospholipid syndrome
Authors: Schreiber Karen , Radin Massimo , Sciascia Savino
Published: September 2017

Purpose of review

Antiphospholipid syndrome (APS) is defined as the association of thrombotic events and/or obstetric morbidity in patients persistently positive for antiphospholipid antibodies (aPL). In this review, we will highlight the most important clinical presentations of APS with a focus on the obstetric morbidity, the current management strategies and the outlook for the future.

Recent findings

The use of aspirin and heparin has improved the pregnancy outcome in obstetric APS and approximately 70% of pregnant women with APS have a successful pregnancy outcome. Unfortunately, the current standard of care does not prevent all pregnancy complications as the current treatment fails in 20–30% of APS pregnancies. This therefore highlights the need for alternative treatments to improve obstetrical outcome. Other treatment options are currently explored and retrospective studies show that pravastatin for example is beneficial in women with aPL-related early preeclampsia. Moreover, the immunmodulator hydroxychloroquine may play a beneficial role in the prevention of aPL-related pregnancy complications.

APS is among the most frequent acquired risk factors for a treatable cause of recurrent pregnancy loss and increases the risk of conditions associated with ischaemic placental dysfunction, such as fetal growth restriction, preeclampsia, premature birth and intrauterine death. Current treatment is mainly based on aspirin and heparin. Studies to inform on alternative treatment options are urgently needed.
Contraception in US servicewomen: emerging knowledge, considerations, and needs
Authors: Harrington Lauren A. , Shaw Kate A. , Shaw Jonathan G.
Published: September 2017

Purpose of review

We describe current literature regarding contraceptive use among women serving in the military. We explore the state of contraceptive use by female servicewomen, gaps in knowledge, special considerations, and evidence of unmet needs.

Recent findings

Recent data on US servicewomen show that overall rates of contraceptive use remain low. Data highlight disparities and suggest barriers to contraceptive uptake persist, with contraceptive use being lower around the time of deployment. Methods that do not require daily use or prescription refills, such as long-acting reversible contraception (LARC) – intrauterine devices and contraceptive implants – may be distinctly well suited for service and deployment. Two contemporary studies document growing popularity of LARC methods among female members of the military, possibly driven by a surge in contraceptive implant use. Nonetheless, LARC appears to remain underutilized.

Despite no-cost provision, the importance of preventing unplanned pregnancy, and the potential benefits of cycle control during service, emerging data about the US military suggest barriers to and underutilization of contraception, particularly LARC. Research is needed to explore preferences and tailor contraceptive counseling to servicewomen. Existing and future work can inform efforts to standardize military provider training and ensure all servicewomen are appropriately counseled and have timely access to any method they may choose.
Assessment of Aesthetic Results of 100 Patients Who Underwent Rhinoplasty—Rhinoplasty Outcome Evaluation
Authors: Kotzampasakis Dimitrios , Mantalos Panagiotis , Kotzampasakis Stylianos , Danias Nikolaos , Nikolopoulos Thomas
Published: September 2017

Background:

To assess the long-term aesthetic results of rhinoplasty and predict the final outcome.

Methods:

The sample was composed of 100 patients (34 men and 66 women) between 23 and 57 years old (mean, 34.8) operated on exclusively for aesthetic reasons. The time elapsed from the operation ranged from 3 to 13 years with a mean of 6.8 years. The study used Rhinoplasty Outcome Evaluation questionnaire, a simple, reliable, validated, and widely used inventory.

Results:

The vast majority of patients (93%) were satisfied postoperatively with scores > 50% (67 patients had scores > 80%). Only 7 patients had scores less than 50%. The mean score was 82.4 ± 1.7% with a median of 87%. In addition, it seems that the results of the operation remain high through time with a small decline along age groups and years elapsed. Women were found more satisfied than men (P = 0.03).

Conclusions:

The study concludes that the results of aesthetic rhinoplasty, if performed by skilled and experienced surgeons, are very satisfying and stable throughout time.
Employee organizational commitment and hospital performance
Authors: Baird Kevin M. , Tung Amy , Yu Yanjie
Published: September 2017

Background:

There is widespread evidence of the purported benefits of employee organizational commitment (EOC) and its impact on both individual and organizational performance. This study contributes to this literature by providing a unique insight into this relationship, focusing on the interrelationship between EOC with hospital performance and the role of the provision of adequate facilities in eliciting EOC.

Purpose:

The aim of this study was to introduce and empirically examine a new theoretical model in which it is argued that the performance of hospitals with regard to the provision of adequate facilities (medical facilities, support facilities, and staff resources) influences the level of EOC, which in turn influences hospital performance with regard to patient care and operational effectiveness.

Methodology/Approach:

To examine the interrelationships between the provision of adequate facilities, EOC, and hospital performance, the study utilizes a survey of hospital managers.

Results:

The findings support the theoretical model, with the provision of support facilities and staff resources positively indirectly associated with both patient care and operational effectiveness through their impact on EOC.

Conclusion:

The findings highlight the importance of providing adequate facilities and EOC within hospitals and suggest that CEOs and general managers should try to enhance the provision of such resources in an attempt to elicit EOC within their hospitals.

Practice Implications:

The findings suggest that managers should try to enhance their provision of adequate facilities in order to elicit EOC and enhance hospital performance. With regard to medical facilities, they should consider and incorporate the latest technology and up-to-date equipment. They should also provide adequate staff resources, including appropriate numbers of beds, nurses, and doctors, to prevent “fatigue” (West, 2001, p. 41) and provide adequate support facilities.
Minor Salivary Gland Transplantation for Severe Dry Eyes
Authors: Wakamatsu Tais Hitomi , Sant'Anna Ana Estela Besteti Pires Ponce , Cristovam Priscila Cardoso , Alves Venâncio Avancini Ferreira , Wakamatsu Alda , Gomes José Alvaro Pereira
Published: September 2017

Dry eye is a multifactorial disease comprising a wide spectrum of ocular surface alterations and symptoms of discomfort. In most patients with aqueous-deficient dry eye, pharmaceutical tear substitutes are used to control symptoms and prevent ocular surface damage. However, in severe dry eye conditions caused by cicatricial disorders, such as Stevens–Johnson syndrome and ocular cicatricial mucous membrane pemphigoid, noninvasive treatments are insufficient, and patients are at risk of developing complications that can lead to blindness. The use of salivary glands as a source of lubrication to treat severe cases of dry eye has been proposed by different authors. The first reports proposed parotid or submandibular gland duct transplantation into the conjunctival fornix. However, complications limited the functional outcomes. Minor salivary gland autotransplantation together with labial mucosa has been used as a complex graft to the conjunctival fornix in severe dry eye with a good outcome. Our group demonstrated significant improvements in best-corrected visual acuity, Schirmer I test score, corneal transparency, and neovascularization after using this technique. A symptoms questionnaire applied to these patients revealed improvements in foreign body sensation, photophobia, and pain. Similar to tears, saliva has a complex final composition comprising electrolytes, immunoglobulins, proteins, enzymes, and mucins. We demonstrated the viability of minor salivary glands transplanted into the fornix of patients with dry eye by performing immunohistochemistry on graft biopsies with antibodies against lactoferrin, lysozyme, MUC1, and MUC16. The findings revealed the presence of functional salivary gland units, indicating local production of proteins, enzymes, and mucins.
Lamina Cribrosa Thickness in Patients With Keratoconus
Authors: Akkaya Serkan , Küçük Bekir
Published: September 2017

Purpose:

To evaluate the thickness and depth of lamina cribrosa (LC) in the optic nerve head region of the eyes in patients with nonglaucomatous keratoconus and to compare the thickness and depth with those of age-matched controls.

Methods:

This was a cross-sectional, observational study comprising 45 patients with keratoconus and 56 healthy subjects. Analysis of LC imaging was performed using spectral domain optical coherence tomography. Data collected included spherical equivalent, central corneal thickness, axial length, intraocular pressure, and keratometry.

Results:

Eyes with keratoconus had significantly thinner LC (174.9 ± 11.4 vs. 249.1 ± 4.9 μm, P < 0.001) compared with control group eyes. There was no statistically significant difference in the depth of LC between the keratoconus and control groups (P = 0.3). Multivariable analysis, controlled for age and sex, showed that the thickness of LC significantly correlated with central corneal thickness (P < 0.001). This association persisted (P < 0.001) after controlling for intraocular pressure in addition to age and sex. There was no significant correlation with other factors, including the spherical equivalent (P = 0.93) and keratometry (P = 0.46).

Conclusions:

The results of this study showed that optical coherence tomography measurement of LC revealed thinner LC for patients with keratoconus compared with healthy controls. The structural properties of the cornea may be related to the optic nerve.
Probe-based Confocal Laser Endomicroscopy in Metastatic Pulmonary Calcification
Authors: Vasilev Igor , Mamenko Igor , Tabanakova Irina , Vikulova Irina , Shevel Vera , Ushkov Alexey , Novickaya Tatiana , Archakova Ludmila , Sokolovich Eugene , Yablonskii Piotr
Published: September 2017

We report a case of metastatic pulmonary calcification in a patient with chronic renal failure on hemodialysis and secondary hyperparathyroidism. The diagnosis was made by using a probe-based confocal endomicroscopy which showed specific structures in the lung tissue and was proven by a transbronchial lung biopsy. To the best of our knowledge, this is the first reported case of the confocal endomicroscopy findings in a patient with metastatic pulmonary calcification.
The regulation and importance of monocyte chemoattractant protein-1
Authors: Bianconi Vanessa , Sahebkar Amirhossein , Atkin Stephen L. , Pirro Matteo
Published: September 2017

Purpose of review

Monocyte chemoattractant protein (MCP)-1, a chemokine regulating monocyte chemotaxis and T-lymphocyte differentiation by binding to the CC chemokine receptor 2 (CCR2), plays a crucial role in the pathogenesis of inflammatory diseases, atherosclerosis and cancer. This review summarizes the current knowledge on the regulation and importance of the MCP-1/CCR2 axis, focusing on the therapeutic potential of its inhibition.

Recent findings

Differential modulation of MCP-1 and CCR2 lead to downstream activation pathways, pathogenetic to differing disease conditions characterized by dysregulated monocyte/macrophage tissue recruitment. Pharmacological targeting of the MCP-1/CCR2 axis has led to selective MCP-1/CCR2 antagonists that have now entered phase I/II clinical trials for the treatment of inflammatory diseases, atherosclerosis and cancer. The pleiotropic nonselective MCP-1/CCR2 inhibition by current pharmacological agents is thought to contribute to their anti-inflammatory and antiatherosclerotic effects that is also seen for nutraceutical compounds such as curcumin.

MCP-1 has a critical role in regulating chemotaxis both in health and disease, with increasing interest in its pharmacological inhibition. However, the therapeutic efficacy and safety of targeting the MCP-1/CCR2 axis is still in evolution.
Clinical genetics of craniosynostosis
Authors: Wilkie Andrew O.M. , Johnson David , Wall Steven A.
Published: September 2017

Purpose of review

When providing accurate clinical diagnosis and genetic counseling in craniosynostosis, the challenge is heightened by knowledge that etiology in any individual case may be entirely genetic, entirely environmental, or anything in between. This review will scope out how recent genetic discoveries from next-generation sequencing have impacted on the clinical genetic evaluation of craniosynostosis.

Recent findings

Survey of a 13-year birth cohort of patients treated at a single craniofacial unit demonstrates that a genetic cause of craniosynostosis can be identified in one quarter of cases. The substantial contributions of mutations in two genes, TCF12 and ERF, is confirmed. Important recent discoveries are mutations of CDC45 and SMO in specific craniosynostosis syndromes, and of SMAD6 in nonsyndromic midline synostosis. The added value of exome or whole genome sequencing in the diagnosis of difficult cases is highlighted.

Strategies to optimize clinical genetic diagnostic pathways by combining both targeted and next-generation sequencing are discussed. In addition to improved genetic counseling, recent discoveries spotlight the important roles of signaling through the bone morphogenetic protein and hedgehog pathways in cranial suture biogenesis, as well as a key requirement for adequate cell division in suture maintenance.
Engendered Responses to, and Interventions for, Shame in Dissociative Disorders
Authors: Dorahy Martin J. , Gorgas Julia , Seager Lenaire , Middleton Warwick
Published: September 2017

This study examined shame and responses to it in adult dissociative disorder (DD; n = 24) and comparison psychiatric (n = 14) samples. To investigate how helpful different therapeutic responses are after shame disclosures in therapy, participants heard two vignettes from “mock” patients disclosing a) shame and b) surprise. Participants rated the helpfulness of five potential responses. Interventions covered withdrawing from the affect (withdrawal focused) to feeling it (feeling focused), with other interventions on cognitions (cognitive focused), management strategies (management focused), and previous experiences (history focused). The DD sample reported higher characterological and bodily shame, and more shame avoidance and withdrawal. There was no difference across groups for intervention ratings. For shame, interventions focused on feelings, cognitions, or previous shame experiences were deemed most helpful, but this was qualified by experiencing dissociation while hearing the script, where the history intervention was reported less helpful. Exposure to shame while monitoring dissociation should accompany therapy for DDs.
Motor Imagery Training After Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Guerra Zaqueline Fernandes , Lucchetti Alessandra L. G. , Lucchetti Giancarlo
Published: September 2017

Background and Purpose:

A number of studies have suggested that imagery training (motor imagery [MI]) has value for improving motor function in persons with neurologic conditions. We performed a systematic review and meta-analysis to assess the available literature related to efficacy of MI in the recovery of individuals after stroke.

Methods:

We searched the following databases: PubMed, Web of Knowledge, Scopus, Cochrane, and PEDro. Two reviewers independently selected clinical trials that investigated the effect of MI on outcomes commonly investigated in studies of stroke recovery. Quality and risk of bias of each study were assessed.

Results:

Of the 1156 articles found, 32 articles were included. There was a high heterogeneity of protocols among studies. Most studies showed benefits of MI, albeit with a large proportion of low-quality studies. The meta-analysis of all studies, regardless of quality, revealed significant differences on overall analysis for outcomes related to balance, lower limb/gait, and upper limb. However, when only high-quality studies were included, no significant difference was found. On subgroup analyses, MI was associated with balance gains on the Functional Reach Test and improved performance on the Timed Up and Go, gait speed, Action Research Arm Test, and the Fugl-Meyer Upper Limb subscale.

Discussion and Conclusions:

Our review reported a high heterogeneity in methodological quality of the studies and conflicting results. More high-quality studies and greater standardization of interventions are needed to determine the value of MI for persons with stroke.

Video Abstract available for more insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A188).
Prospective Side by Side Comparison of Outcomes and Complications With a Simple Versus Intensive Anticoagulation Monitoring Strategy in Pediatric Extracorporeal Life Support Patients*
Authors: Yu Jane S. , Barbaro Ryan P. , Granoski Donald A. , Bauman Mary E. , Massicotte M. Patricia , Lequier Laurance L. , Annich Gail M. , Ryerson Lindsay M.
Published: September 2017

Objectives:

A continuous infusion of unfractionated heparin is the most common anticoagulant used for pediatric patients on extracorporeal life support. The objective of this study was to compare extracorporeal life support complications and outcomes between two large-volume pediatric extracorporeal life support centers that use different anticoagulation strategies.

Design:

Prospective, observational cohort study.

Setting:

The University of Michigan used simple anticoagulation monitoring, whereas the University of Alberta used an intensive anticoagulation monitoring strategy.

Patients:

Pediatric patients on extracorporeal life support.

Interventions:

None.

Measurements and Main Results:

The primary outcome measure was major bleeding per extracorporeal life support run defined as bleeding that was retroperitoneal, pulmonary, or involved the CNS; bleeding greater than 20 mL/kg over 24 hours; or bleeding that required surgical intervention. Secondary outcomes measured were patient thrombosis per run, circuit thrombosis per run, and survival to hospital discharge per patient. Eighty-eight patients (95 runs) less than 18 years old were enrolled at the two centers over 2 years. The two centers enrolled different extracorporeal life support populations; University of Alberta enrolled more postcardiac surgical patients (74% vs 47%; p = 0.005). The indication for extracorporeal life support support also varied by center (p = 0.04). The two centers used similar proportions of VA extracorporeal life support (p = 0.3). Median (interquartile range) unfractionated heparin doses were similar between University of Michigan and University of Alberta, 30 (21–34) U/kg/hr and 26 (22–31) U/kg/hr, p value equals to 0.3, respectively. Median (interquartile range) antifactor Xa was lower in the University of Michigan cohort (0.23 [0.19–0.28] vs 0.41 [0.36–0.46] U/mL; p < 0.001). There was no significant difference in major bleeding (15% University of Michigan vs 21% University of Alberta; p = 0.6) or in patient thromboses (18% University of Michigan vs 13% University of Alberta; p = 0.5). There was no significant difference in survival to hospital discharge (University of Michigan 63% vs University of Alberta 73%; p = 0.1).

Conclusions:

Although this prospective cohort study compared different pediatric extracorporeal life support populations, the results did not identify a significant difference in outcomes between simple and intensive anticoagulation monitoring strategies.
Co-occurrence of posttraumatic stress symptoms, pain, and disability 12 months after traumatic injury
Authors: Giummarra Melita J. , Casey Sara L. , Devlin Anna , Ioannou Liane J. , Gibson Stephen J. , Georgiou-Karistianis Nellie , Jennings Paul A. , Cameron Peter A. , Ponsford Jennie
Published: September 2017

Introduction:

Chronic pain is common after traumatic injury and frequently co-occurs with posttraumatic stress disorder (PTSD) and PTSD symptoms (PTSS).

Objectives:

This study sought to understand the association between probable PTSD, PTSS, and pain.

Methods:

Four hundred thirty-three participants were recruited from the Victorian Orthopaedic Trauma Outcomes Registry and Victorian State Trauma Registry and completed outcome measures. Participants were predominantly male (n = 324, 74.8%) and aged 17-75 years at the time of their injury (M = 44.83 years, SD = 14.16). Participants completed the Posttraumatic Stress Disorder Checklist, Brief Pain Inventory, Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire, Tampa Scale of Kinesiophobia, EQ-5D-3L and Roland-Morris Disability Questionnaire 12 months after hospitalization for traumatic injury. Data were linked with injury and hospital admission data from the trauma registries.

Results:

Those who reported having current problems with pain were 3 times more likely to have probable PTSD than those without pain. Canonical correlation showed that pain outcomes (pain severity, interference, catastrophizing, kinesiophobia, self-efficacy, and disability) were associated with all PTSSs, but especially symptoms of cognition and affect, hyperarousal, and avoidance. Posttraumatic stress disorder symptoms, on the contrary, were predominantly associated with high catastrophizing and low self-efficacy. When controlling for demographics, pain and injury severity, depression, and self-efficacy explained the greatest proportion of the total relationship between PTSS and pain-related disability.

Conclusion:

Persons with both PTSS and chronic pain after injury may need tailored interventions to overcome fear-related beliefs and to increase their perception that they can engage in everyday activities, despite their pain.
Face Graft Scaffold Production in a Rat Model
Authors: Duisit Jérôme , Amiel Hadrien , Orlando Giuseppe , Dedriche Adeline , Behets Catherine , Gianello Pierre , Lengelé Benoît
Published: September 2017

Background:

As a route toward face bioengineering, the authors previously reported the production of a complete scaffold by perfusion-decellularization of a porcine ear subunit graft and partial recellularization. To extend the scaffold to the whole face and to down-scale it, they applied their findings to a rodent hemifacial graft model.

Methods:

After the animals were killed, seven full-thickness rat hemiface grafts were harvested with the common carotid artery and the external jugular vein as a pedicle, and cannulated. Grafts were decellularized by a detergent-based protocol: either by perfusion through the common carotid artery, or by mechanical agitation. After decellularization, samples were analyzed for DNA quantification and histology by hematoxylin and eosin, Masson trichrome, Sirius red, or Safranin O staining. Vascular tree patency was assessed by microangiographic computed tomography after contrast injection. Cell-friendly extracellular matrix was assessed by seeding of human adipose-derived stem cells and vital staining after 7 days of culture.

Results:

Decellularization was effective in both groups, with a cell clearance at all levels, with the exception of cartilage areas in the agitation-treated groups. Microscopic assessment found a well-preserved extracellular matrix in both groups. Vascular contrast was found in all regions of the scaffolds. After the animals were killed, seeded cells were found viable and well distributed on all scaffolds.

Conclusions:

The authors successfully decellularized face grafts in a rodent model, with a preserved vascular tree. Perfusion-decellularization led to better and faster results compared with mechanical agitation but is not mandatory in this model. The rat face is an interesting scaffold model for further recellularization studies, in the final goal of human face bioengineering.
Biological Properties and Therapeutic Value of Cryopreserved Fat Tissue
Authors: Mashiko Takanobu , Wu Szu-Hsien , Kanayama Koji , Asahi Rintaro , Shirado Takako , Mori Masanori , Sunaga Ataru , Sarukawa Shunji , Uda Hirokazu , Yoshimura Kotaro
Published: September 2017

Background:

Fat grafting frequently requires multiple treatments and thus repeated liposuction to achieve treatment goals. The purpose of this study was to evaluate whether cryopreservation of adipose tissue may facilitate future fat grafting.

Methods:

Lipoaspirates were harvested from six women and preserved using two cryopreservation methods: (1) simple cooling to −80°C (cryo-1); or (2) programmed cooling to −196°C (cryo-2). Fresh fat, cryo-1 fat, and cryo-2 fat were analyzed both in vitro and in vivo.

Results:

Immunohistochemistry of both types of cryopreserved adipose tissue revealed that most adipocytes were necrotic. The cell number and viability of stromal vascular fraction cells were significantly decreased in cryo-1 fat (1.7 × 105 cells, 42.6 percent viable) and cryo-2 fat (2.0 × 105 cells, 55.4 percent viable), compared with fresh fat (3.9 × 105 cells, 90.6 percent viable). Although adipose-derived stem cells were cultured successfully from all fats, functional adipose-derived stem cells from cryopreserved fats were much fewer, with comparable multilineage differentiating capacity. In vivo studies using human fat grafted into immunocompromised mice revealed that, 3 months after transplantation, all of the cryopreserved fats maintained their volume to some extent; however, the cryopreserved fats were mostly filled with dead tissue and produced significantly lower engraftment scores than fresh fat.

Conclusions:

Most adipocytes were killed in the process of cryopreservation and thawing. Adipose-derived stem cells were isolated from cryopreserved fat, but the number of functional adipose-derived stem cells was very limited in both cryopreservation methods. After grafting, cryopreserved fat was retained as dead and fibrous tissue, suggesting a risk of clinical complications such as oil cysts.
Screening for DSM-5 Somatic Symptom Disorder: Diagnostic Accuracy of Self-Report Measures Within a Population Sample
Authors: Laferton Johannes A.C. , Stenzel Nikola M. , Rief Winfried , Klaus Kristina , Brähler Elmar , Mewes Ricarda
Published: September 2017

Objective

The new DSM-5 somatic symptom disorder was introduced to improve the diagnosis of persons experiencing what used to be called somatoform disorders. So far, it is unclear whether existing self-report measures are useful to detect the new somatic symptom disorder. This study investigates the diagnostic accuracy of three self-report questionnaires that measure somatic complaints (15 item Patient Health Questionnaire [PHQ-15]) and psychological features (7-item Whiteley Index [WI-7]; Scale for Assessing Illness Behavior [SAIB]), in detecting somatic symptom disorder.

Methods

A nationally representative general population survey was performed resulting in 250 participants (minimum age = 14 years. 12.8% participation rate). Assessment took place at baseline and 12-month follow-up. Individual and combined diagnostic accuracy of the PHQ-15, WI-7, and SAIB in detecting somatic symptom disorder was evaluated using the area under the curve (AUC) of a receiver operating characteristic.

Results

Diagnostic accuracy was adequate to good for each individual questionnaire (PHQ-15: AUC = 0.79, p < .001, 95% confidence interval [CI] = 0.73–0.85; WI-7: AUC = 0.76, p < .001, 95% CI = 0.69–0.83; SAIB: AUC = 0.77, p < .001, 95% CI = 0.71–0.83). Combining the PHQ-15 and the WI-7 slightly improved diagnostic accuracy (AUC = 0.82, p < .001, 95% CI = 0.77–0.88), as did the combination of all three questionnaires (AUC = 0.85, p < .001, 95% CI = 0.79–0.90).

Conclusions

The PHQ-15, WI-7, and SAIB are useful screening instruments to detect persons at risk for somatic symptom disorder, and a combination of these three instruments slightly improves diagnostic accuracy. Their use in routine care will lead to improved detection rates.
What, where and why: exploring fluorodeoxyglucose-PET's ability to localise and differentiate infection from cancer
Authors: Douglas Abby , Lau Eddie , Thursky Karin , Slavin Monica
Published: September 2017

Purpose of review

To review the utility of FDG-PET imaging in detecting the cause of fever and infection in patients with cancer.

Recent findings

FDG-PET has been shown to have high sensitivity and accuracy for causes of neutropenic fever, leading to higher diagnostic certainty in this group. Recent advances in pathogen-specific labelling in PET to identify Aspergillus spp. and Yersinia spp. infections in mice, as well as differentiating between Gram-positive, Gram-negative and mycobacterial infections are promising.

Patients with cancer are vulnerable to infection and fever, and the causes of these are frequently unclear using conventional diagnostic methods leading to high morbidity and mortality, length of stay and costs of care. FDG-PET/CT, with its unique complementary functional and anatomical information as well as its whole-body imaging capability, has demonstrated use in detecting occult infection in immunocompromised patients, including invasive fungal and occult bacterial infections, as well as defining extent of infection. By demonstrating disease resolution following treatment and allowing earlier cessation of therapy, FDG-PET acts as a key tool for antimicrobial and antifungal stewardship. Limitations include at times poor differentiation between infection, malignancy and sterile inflammation, however, exciting new technologies specific to infectious pathogens may help alleviate that issue. Further prospective randomised research is needed to explore these benefits in a nonbiased fashion.
Evaluation of the Changes in the Quality of Life in Patients Undergoing Orthognathic Surgery: A Multicenter Study
Authors: Emadian Razvadi Elham Sadat , Soheilifar Sepideh , Esmaeelinejad Mohammad , Naghdi Navid
Published: September 2017

Orthognathic surgery can affect patients’ quality of life. The aim of the present study was to assess changes in quality of life during combined orthodontics-surgery treatment and effect of orthodontist-surgeon teamwork on final patient's satisfaction. Twenty-six orthognathic patients who were referred to oral and maxillofacial department of 3 hospitals in Tehran were included in the study. Orthognathic quality of life questionnaire (OQLQ) was given to patients 1 week before, 4 weeks and 4 months after surgery. Two self-designed forms were used for evaluating mood and comfort of patients 1 week before surgery and 4 days after surgery. Self-designed forms were given to the orthodontists and the maxillofacial surgeons to assess quality of teamwork and difficulty of the procedure. Twenty-four patients (15 females and 9 males) with the mean age of 22.62 ± 3.57 completed the study. Quality of life increased from 1 week before surgery to 4 months after surgery (P < 0.013) and the difference was statistically significant between OQLQ score at 1 week before surgery and that of 4 months postoperative. Esthetic and social domain showed significant changes during the studied period. Orthognathic quality of life questionnaire at 4 months postoperative was correlated with surgery difficulty and duration. It can be concluded that orthognathic surgery can improve quality of life, especially in esthetic and social aspects.
Treatment of Zenker’s Diverticulum With Endoscopic Stapled Esophago-divertisculostomy (ESD): Analysis of Long-term Outcome
Authors: Mazza Michele , Bergamini Alberto N. , Parise Paolo , Cossu Andrea , Adamenko Olga , Elmore Ugo , Rosati Riccardo
Published: September 2017

Background:

Endoscopic Zenker diverticulum (ZD) treatment has become quite common because of the low complication rates, reduced procedure time, and shorter hospital stay. Many endoscopic treatments are available including the endoscopic stapled esophago-diverticulostomy (ESD). Many data regarding ESD are available on the short-term outcomes, but few on the long-term ones.

Materials and Methods:

From March 1998 to July 2016, 126 patients with ZD were candidate for ESD. Since 2009, 2 stay sutures were routinely positioned at the lateral edges of the septum using Medtronic Endostitch 10 mm suturing device. Demographic and perioperative data, symptoms, and surgical outcomes were recorded. Long-term ESD results were analyzed. An extra-analysis on the surgical outcome was performed comparing patients treated with or without stay sutures.

Results:

In total, 117 patients successfully underwent ESD. The mean age was 69.9 years with a male predominance. Intraoperative complications occurred in 6.8% of cases. Only 2.6% of the patients reported postoperative complications. For the long-term analysis, we were able to contact 92 patients for a mean period follow-up of 65.3 months. At 6-month outpatient visit 77.68% of patients were completely asymptomatic. In total, 22.3% of the patients needed an extratreatment due to incomplete section of the septum, reaching a success rate of 95.5%. The long-term resolution rate remained high (91.3%). The use of stay sutures did not statistically influence the operative time (22.8 vs. 26.7 min, P=0.070), nor intraoperative and postoperative complication rate, but a statistically significant higher complete resolution rate of symptoms with a single session of ESD was observed respect those treated without (87.3% vs. 65.3%, respectively).

Conclusions:

ESD is a safe and effective treatment of ZD and it can control symptoms even in a long-term follow-up. In our experience, the use of stay sutures placed with Endostitch increases short and long-term results reducing the need for further treatments.
Revisiting the concept of amyotrophic lateral sclerosis as a multisystems disorder of limited phenotypic expression
Authors: Strong Michael J.
Published: September 2017

Purpose of review

The current review will examine the contemporary evidence that amyotrophic lateral sclerosis (ALS) is a syndrome in which the unifying feature is a progressive loss of upper and lower motor neuron function.

Recent findings

Although ALS is traditionally viewed as a neurodegenerative disorder affecting the motor neurons, there is considerable phenotypic heterogeneity and widespread involvement of the central nervous system. A broad range of both causative and disease modifying genetic variants are associated with both sporadic and familial forms of ALS. A significant proportion of ALS patients have an associated frontotemporal dysfunction which can be a harbinger of a significantly shorter survival and for which there is increasing evidence of a fundamental disruption of tau metabolism in those affected individuals. Although the traditional neuropathology of the degenerating motor neurons in ALS is that of neuronal cytoplasmic inclusions composed neuronal intermediate filaments, the presence of neuronal cytoplasmic inclusions composed of RNA binding proteins suggests a key role for RNA dysmetabolism in the pathogenesis of ALS.

ALS is a complex multisystem neurodegenerative syndrome with marked heterogeneity at not only the level of clinical expression, but also etiologically.
Primary central nervous system lymphoma: time for diagnostic biomarkers and biotherapies?
Authors: Royer-Perron Louis , Hoang-Xuan Khê , Alentorn Agusti
Published: September 2017

Purpose of review

Primary central nervous system lymphoma (PCNSL) is a rare cancer with a somber prognosis in older patients, which it affects predominantly. Only in recent years have molecular alterations characterizing PCNSL been thoroughly described. This opens possibilities for the use of targeted therapies. Developments in imaging and biomarkers have also great potential to help clinicians faced with diagnostic and prognostic uncertainties.

Recent findings

Several biomarkers for PCNSL, such as different microRNAs, which could be tested in cerebrospinal fluid and vitreous fluid, and IL-10, which has been shown to have excellent sensitivity and specificity in the cerebrospinal fluid, have emerged in the last years. Methotrexate-based regimens remain the gold standard first-line treatment, with recent studies looking at the best adjunctive molecules to methotrexate, including rituximab, and at the role of autologous stem cell transplantation. As mutations leading to the activation of nuclear factor-kappa-B signaling are found in most PCNSLs, with mutations of MYD88 and CD79B particularly, ibrutinib is studied as molecule of great interest and encouraging results have been found in pilot studies. There is also great interest in the immunomodulatory drugs (lenalidomide) and immunotherapy (anti-programmed cell death 1/programmed cell death 1 ligand 1).

Identification of molecular genetic and cytokine changes in tumor and liquid biopsies will have an increasing role in the diagnostic and follow-up of PCNSL but also in the treatment and management of the disease
Selective and mechanistic sources of recurrent rearrangements across the cancer genome
Authors: Wala Jeremiah A , Shapira Ofer , Li Yilong , Craft David , Schumacher Steven E , Imielinski Marcin , Haber James E , Roberts Nicola D , Yao Xiaotong , Stewart Chip , Zhang Cheng-Zhong , Tubio Jose , Ju Young Seok , Campbell Peter J , Weischenfeldt Joachim , Beroukhim Rameen ,   on behalf of the PCAWG-Structural Variation Working Group and the PCAWG Network.
Published: September 2017

Cancer cells can acquire profound alterations to the structure of their genomes, including rearrangements that fuse distant DNA breakpoints. We analyze the distribution of somatic rearrangements across the cancer genome, using whole-genome sequencing data from 2,693 tumor-normal pairs. We observe substantial variation in the density of rearrangement breakpoints, with enrichment in open chromatin and sites with high densities of repetitive elements. After accounting for these patterns, we identify significantly recurrent breakpoints (SRBs) at 52 loci, including novel SRBs nearBRD4andAKR1C3. Taking into account both loci fused by a rearrangement, we observe different signatures resembling either single breaks followed by strand invasion or two separate breaks that become joined. Accounting for these signatures, we identify 90 pairs of loci that are significantly recurrently juxtaposed (SRJs). SRJs are primarily tumor-type specific and tend to involve genes with tissue-specific expression. SRJs were frequently associated with disruption of topology-associated domains, juxtaposition of enhancer elements, and increased expression of neighboring genes. Lastly, we find that the power to detect SRJs decreases for short rearrangements, and that reliable detection of all driver SRJs will require whole-genome sequencing data from an order of magnitude more cancer samples than currently available.
Single-molecule DNA unzipping reveals asymmetric modulation of a transcription factor by its binding site sequence and context
Authors: Rudnizky Sergei , Khamis Hadeel , Malik Omri , Squires Allison , Meller Amit , Melamed Philippa , Kaplan Ariel
Published: September 2017

Most functional transcription factor (TF) binding sites deviate from their “consensus” recognition motif, although their sites and flanking sequences are often conserved across species. Here, we used single-molecule DNA unzipping with optical tweezers to study how Egr-1, a TF harbouring 3 zinc fingers (ZF1,ZF2 and ZF3), is modulated by the sequence and context of its functional sites in the Lhb gene promoter. We find that both the core 9 base pairs bound to Egr-1 in each of the sites, and the base pairs flanking them, modulate the affinity and structure of the protein-DNA complex. The effect of the flanking sequences is asymmetric, with a stronger effect for the sequence flanking ZF3. Characterization of the dissociation time of Egr-1 revealed that a local, mechanical perturbation of the interactions of ZF3 destabilizes the complex more effectively than a perturbation of the ZF1 interactions. Our results reveal a novel role for ZF3 in the interaction of Egr-1 with other proteins and the DNA, providing insight on the regulation of Lhb and other genes by Egr-1. Moreover, our findings reveal the potential of small changes in DNA sequence to alter transcriptional regulation, and may shed light on the organization of regulatory elements at promoters.
xenoGI: reconstructing the history of genomic island insertions in clades of closely related bacteria
Authors: Bush Eliot C , Clark Anne E , DeRanek Carissa A , Eng Alexander , Forman Juliet , Heath Kevin , Lee Alexander B , Stoebel Daniel M , Wang Zunyan , Wilber Matthew , Wu Helen
Published: September 2017

Background

Genomic islands play an important role in microbial genome evolution, providing a mechanism for strains to adapt to new ecological conditions. A variety of computational methods, both genome-composition based and comparative have been developed to identify them. Some of these methods are explicitly designed to work in single strains, while others make use of multiple strains. In general, existing methods do not identify islands in the context of the phylogeny in which they evolved. Even multiple strain approaches are best suited to identifying genomic islands that are present in one strain but absent in others. They do not automatically recognize islands which are shared between some strains in the clade or determine the branch on which these islands inserted within the phylogenetic tree.

Results

We have developed a software package, xenoGI, that identifies genomic islands and maps their origin within a clade of closely related bacteria, determining which branch they inserted on. It takes as input a set of sequenced genomes and a tree specifying their phylogenetic relationships. Making heavy use of synteny information, the package builds gene families in a species-tree-aware way, and then attempts to combine into islands those families whose members are adjacent and whose most recent common ancestor is shared. The package provides a variety of text-based analysis functions, as well as the ability to export genomic islands into formats suitable for viewing in a genome browser. We demonstrate the capabilities of the package with several examples from enteric bacteria, including an examination of the evolution of the acid fitness island in the genus Escherichia. In addition we use output from simulations and a set of known genomic islands from the literature to show that xenoGI can accurately identify genomic islands and place them on a phylogenetic tree.

Conclusions

xenoGI is an effective tool for studying the history of genomic island insertions in a clade of microbes. It identifies genomic islands, and determines which branch they inserted on within the phylogenetic tree for the clade. Such information is valuable because it helps us understand the adaptive path that has produced living species. Given the large and growing number of sequenced microbial genomes, this sort of analysis will become increasingly useful in the future.