bluuebunny/crossref_metadata_2025_split huggingface dataset:
Salivary dysfunction caused by medication usage
Authors: Einhorn O.M. , Georgiou K. , Tompa A. 
Published: July 2020

AbstractA considerable number of patients arriving in dental offices are being treated with ongoing medication for a variety of chronic diseases. As a result, dentists must be familiar with the potential side effects these therapeutic agents may have on the tissues of the oral cavity, and in particular on the salivary gland. Salivary gland function may be altered by a wide range of medications, leading to effects such as xerostomia, hyposalivation, hypersalivation or even swelling of the glands. These disorders can cause a variety of other health complications. This review will focus on the most common groups of drugs responsible for salivary gland dysfunction, including psychoactive drugs, antidepressants, antipsychotics, antihypertensives, and antihistamines.
Growth factors in pulmonary arterial hypertension: Focus on preserving right ventricular function
Authors: Csósza G. , Karlócai K. , Losonczy G. , Müller V. , Lázár Z. 
Published: July 2020

AbstractPulmonary arterial hypertension (PAH) is a rare and progressive disease, characterized by increased vascular resistance leading to right ventricle (RV) failure. The extent of right ventricular dysfunction crucially influences disease prognosis; however, currently no therapies have specific cardioprotective effects. Besides discussing the pathophysiology of right ventricular adaptation in PAH, this review focuses on the roles of growth factors (GFs) in disease pathomechanism. We also summarize the involvement of GFs in the preservation of cardiomyocyte function, to evaluate their potential as cardioprotective biomarkers and novel therapeutic targets in PAH.
Prenatal urban traffic noise exposure impairs spatial learning and memory and reduces glucocorticoid receptor expression in the hippocampus of male rat offspring
Authors: Sajjadi F.S. , Aghighi F. , Vahidinia Z. , Azami-Tameh A. , Salami M. , Talaei S.A. 
Published: July 2020

AbstractIntroductionExposure to noise stress during early life may permanently affect the structure and function of the central nervous system. The aim of this study was to evaluate the effects of prenatal exposure to urban traffic noise on the spatial learning and memory of the rats' offspring and the expression of glucocorticoid receptors (GRs) in their hippocampi.MethodsThree g\roups of pregnant rats were exposed to recorded urban traffic noise for 1, 2 or 4 h/day during the last week of pregnancy. At the age of 45 days, their male offspring were introduced to the Morris water maze (MWM) for assessment of spatial learning and memory. The corticosterone levels were measured in the offspring's sera by radioimmunoassay, and the relative expression of glucocorticoid and mineralocorticoid receptors (MRs) in their hippocampi was evaluated via RT-PCR.ResultsFacing urban traffic noise for 2 and 4 h/day during the third trimester of pregnancy caused the offspring to spend more time and to travel a larger distance than the controls to find the target platform. Analogously, these two groups were inferior to their control counterparts in the probe test. Also, prenatal noise stress elevated the corticosterone concentration in the sera of the rats' offspring and dose-dependently decreased the relative expression of the mRNA of both GRs and MRs in their hippocampi.ConclusionsUrban traffic noise exposure during the last trimester of pregnancy impairs spatial learning and memory of rat offspring and reduces GRs and MRs gene expression in the hippocampus.
T cell responses to an HLA-A2-restricted adipophilin peptide correlate with BMI in patients with atherosclerosis
Authors: Kalantar K. , Farzaneh Z. , Eshkevar Vakili M. , Karimi M.H. , Asadi M. , Khosropanah S. , Doroudchi M. 
Published: July 2020

AbstractIntroductionAtherosclerosis is an inflammatory disease causing a vast array of cardiovascular diseases. Adipophilin has been reported to be highly expressed in atherosclerotic lesions. This study investigated the possible existence of auto-reactive T cells against an HLA-A02-restricted adipophilin-derived peptide as well as peptides from Epstein-barr virus (EBV), Cytomegalovirus (CMV) and influenza (Flu) virus in patients with atherosclerosis.MethodsHLA-A02 expression on peripheral blood mononuclear cells (PBMCs) was examined by flow cytometry. PBMCs from HLA-A02 individuals were stimulated with adipophilin, CMV, EBV, and Flu peptides at a concentration of 10 µM. Interferon (IFN)-γ production was evaluated in the culture supernatant using a commercial ELISA test.ResultsThe levels of IFN-γ production against an HLA-A02-restricted adipophilin peptide and peptides from CMV, EBV, and Flu revealed no statistically significant differences between patients and healthy controls. However, we found a positive correlation between IFN-γ production against adipophilin and Body mass index (BMI) of patients (R = 0.8, P = 0.003), whereas no significant correlation was found in healthy controls (R = −0.267, P = 0.378). No correlation between BMI and IFN-γ production against CMV, EBV, or Flu peptides was found.DiscussionAtherosclerotic patients with higher BMIs might have greater numbers of T cells against adipophilin that is highly expressed in atherosclerotic plaques. Therefore, autoimmune reactions may have a greater role in the development of atherosclerosis in individuals with higher BMI.
Combined therapies with exercise, ozone and mesenchymal stem cells improve the expression of HIF1 and SOX9 in the cartilage tissue of rats with knee osteoarthritis
Authors: Asadi Sara , Farzanegi Parvin , Azarbayjani Mohammad Ali 
Published: July 2020

AbstractPurposeKnee osteoarthritis (OA) is a common type of degenerative joint disease which decreases the quality of life. Sex-determining region Y box 9 (SOX9) and hypoxia-inducible factor-1 (HIF1) are considered as the key regulators of OA. We investigated the effect of combined therapies with mesenchymal stem cells (MSCs), ozone (O3) and exercise training on SOX9 and HIF1 expression in the cartilage of rats with knee OA.MethodsKnee OA was induced by surgical method. OA rats were divided into model, MSCs, ozone, exercise, MSCs + ozone, MSCs + exercise, ozone + exercise and MSCs + ozone + exercise groups. Rats in the MSCs group received intraarticular injection of 1 × 106 cells/kg. Rats in the ozone group received O3 at the concentration of 20 μg/mL, once weekly for 3 weeks. Rats in the exercise group were trained on rodent treadmill three times per week. 48 hours after the programs, cartilage tissues were isolated and the expression of SOX9 and HIF1 was determined using Real-Time PCR.ResultsSignificant differences were found in the expression of SOX9 and HIF1 between groups (P < 0.0001). Although combined therapies with exercise, MSCs and O3 significantly increased the expression of SOX9 and HIF1 in the cartilage tissue of rats with knee OA, combination of exercise with O3 was significantly more effective compared to the other combined therapies (P < 0.001).ConclusionsCombined therapy with exercise, MSCs and O3 significantly increased the expression of SOX9 and HIF1 genes in the cartilage of rats with knee OA; however, exercise + O3 was significantly more effective.
The gastroprotective effect of obestatin on indomethacin-induced acute ulcer is mediated by a vagovagal mechanism
Authors: Şen Leyla Semiha , Özdemir Kumral Zarife Nigar , Memi Gülsün , Ercan Feriha , Yeğen Berrak C. , Yeğen Cumhur 
Published: July 2020

AbstractIn order to investigate the role of the vagus nerve in the possible gastroprotective effect of obestatin on the indomethacin-induced acute oxidative gastric injury, Sprague-Dawley rats of both sexes were injected subcutaneously with indomethacin (25 mg/kg, 5% NaHCO3) followed by obestatin (10, 30 or 100 μg/kg). In other sets of rats, surgical vagotomy (Vx) or selective degeneration of vagal afferent fibers by perivagal capsaicin was performed before the injections of indomethacin or indomethacin + obestatin (30 μg/kg). Gastric serosal blood flow was measured, and 4 h after ulcer induction gastric tissue samples were taken for histological and biochemical assays. Obestatin reduced the severity of indomethacin-induced acute ulcer via the reversal of reactive hyperemia, by inhibiting ulcer-induced neutrophil infiltration and lipid peroxidation along with the replenishment of glutathione (GSH) stores, whereas Vx abolished the inhibitory effect of obestatin on blood flow and lipid peroxidation, and worsened the severity of ulcer. On the other hand, serosal blood flow was even amplified by the selective denervation of the capsaicin-sensitive vagal afferent fibers, but obestatin-induced reduction in ulcer severity was not altered. In conclusion, the gastroprotective effect of obestatin on indomethacin-induced ulcer appears to involve the activation of the vagovagal pathway.
The role of age in post-cardiac arrest therapy in an elderly patient population
Authors: Kovács E. , Pilecky D. , Szakál-Tóth Z. , Fekete-Győr A. , Gyarmathy V.A. , Gellér L. , Hauser B. , Gál J. , Merkely B. , Zima E. 
Published: July 2020

AbstractAimWe investigated the effect of age on post-cardiac arrest treatment outcomes in an elderly population, based on a local database and a systemic review of the literature.MethodsData were collected retrospectively from medical charts and reports. Sixty-one comatose patients, cooled to 32–34 °C for 24 h, were categorized into three groups: younger group (≤65 years), older group (66–75 years), and very old group (>75 years). Circumstances of cardiopulmonary resuscitation (CPR), patients' characteristics, post-resuscitation treatment, hemodynamic monitoring, neurologic outcome and survival were compared across age groups. Kruskal-Wallis test, Chi-square test and binary logistic regression (BLR) were applied. In addition, a literature search of PubMed/Medline database was performed to provide a background.ResultsAge was significantly associated with having a cardiac arrest on a monitor and a history of hypertension. No association was found between age and survival or neurologic outcome. Age did not affect hemodynamic parameter changes during target temperature management (TTM), except mean arterial pressure (MAP). Need of catecholamine administration was the highest among very old patients. During the literature review, seven papers were identified. Most studies had a retrospective design and investigated interventions and outcome, but lacked unified age categorization. All studies reported worse survival in the elderly, although old survivors showed a favorable neurologic outcome in most of the cases.ConclusionThere is no evidence to support the limitation of post-cardiac arrest therapy in the aging population. Furthermore, additional prospective studies are needed to investigate the characteristics and outcome of post-cardiac arrest therapy in this patient group.
Aspirin protects human coronary artery endothelial cells by inducing autophagy
Authors: Chen J. , Wang L. , Liu W.H. , Shi J. , Zhong Y. , Liu S.J. , Liu S.M. 
Published: July 2020

AbstractAlthough the use of aspirin has substantially reduced the risks of cardiovascular events and death, its potential mechanisms have not been fully elucidated. In a previous study, we found that aspirin triggers cellular autophagy. In the present study, we aimed to determine the protective effects of aspirin on human coronary artery endothelial cells (HCAECs) and explore its underlying mechanisms. HCAECs were treated with oxidized low-density lipoprotein (ox-LDL), angiotensin II (Ang-II), or high glucose (HG) with or without aspirin stimulation. The expression levels of endothelial nitric oxide (NO) synthase (eNOS), p-eNOS, LC3, p62, phosphor-nuclear factor kappa B (p-NF-κB), p-p38 mitogen-activated protein kinase (p-p38 MAPK), and Beclin-1 were detected via immunoblotting analysis. Concentrations of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured via ELISA. NO levels were determined using the Griess reagent. Autophagic flux was tracked by tandem mRFP-GFP-tagged LC3. Results showed that aspirin increased eNOS level and reduced injury to the endothelial cells (ECs) caused by ox-LDL, Ang-II, and HG treatment in a dose-dependent manner. Aspirin also increased the LC3II/LC3I ratio, decreased p62 expression, and enhanced autophagic flux (autophagosome and autolysosome puncta) in the HCAECs. p-NF-κB and p-p38 mitogen-activated protein kinase inhibition, sVCAM-1 and sICAM-1 secretion, and eNOS activity promotion by aspirin treatment were found to be dependent on Beclin-1. These results suggested that aspirin can protect ECs from ox-LDL-, Ang-II-, and HG-induced injury by activating autophagy in a Beclin-1-dependent manner.
A comparative study of perinatal outcome in primary caesarean in multiparous women to that in nulliparous women
Authors: Kokate Surabhi , Kokate Abhishek 
Published: July 2020

Background: To compare indication, incidence, complication, fetal and maternal morbidity and mortality in primary caesarean section in multiparous women and nulliparous women. Objective of this study was to compare perinatal outcome of caesarean section in multiparous women to that in nulliparous women.Methods: It is a prospective observational study conducted in a tertiary care centre during April 2017 to April 2018. All patients who delivered vaginally and abdominally were noted during study period. All patients undergoing primary caesarean section were noted. Their indication, incidence and complication throughout stay were noted. Statistics were calculated separately for multiparous women and primiparous women. Statistical analysis was done using chi square test.Results: Total 150 primary caesarean section in primiparous women and 100 primary caesarean section in multiparous women were done. Fetal distress and meconium stained amniotic fluid forms the most common indication in study. Birth weight of babies was more in multiparous women. Need of blood and blood products was more in multiparous women compared to nulliparous women. Complications like postpartum fever and wound gape was more in multiparous women.Conclusions: In the study population significant difference was seen between the indication and complication between multiparous and nulliparous women.
Changing trends in the indication of caesarean delivery in multigravida- experience from a referral center in Eastern India: a prospective study
Authors: Sebastian Nikhil , Pradhan Anup , Lucksom Pesona Grace 
Published: July 2020

Background: Caesarean delivery is one of the commonly performed surgical procedures in obstetrics in today's practice. The objective of this study was to estimate the overall incidence and indications of primary caesarean delivery among multiparous women and to study the immediate maternal and perinatal outcome.Methods: It was a prospective observational study done in Sikkim Manipal Institute of Medical Science, Sikkim, India. It included all pregnant women after 28 weeks of gestation who had normal vaginal delivery in previous pregnancy but underwent caesarean delivery during current pregnancy (n=120) from January 2016 to December 2016. Authors collected data using a pro forma. Relevant history including demographic details, relevant clinical, laboratory and radiological examination, indication for caesarean delivery, details of delivery and neonate, and duration of hospital stay were noted. Data was described using descriptive data like mean and percentages.Results: Out of 1646 deliveries conducted, 49% were by caesarean section. It included 7.29% primary caesarean delivery in multigravida. Majority of women (27%) were in the age group 25-29. Maternal request was the commonest indication for caesarean delivery (21.66%). Atonic PPH was the commonest intraoperative complication (2.5%). Surgical site infection was the commonest post-operative morbidity (3.33%). There were 51 perinatal morbidity and 2 perinatal mortality. There was no maternal mortality.Conclusions: Caesarean section rates in this study was higher than WHO recommendation (15% versus 49.69%). This shift in trend can be attributed to higher number of maternal request for caesarean delivery which can be avoided by good analgesic facility and good counselling.
Colposcopy in evaluation of suspected cervical cancer: a prospective, observational study
Authors: Desai Ashwini Sudhir , Panchbudhe Shruti 
Published: July 2020

Background: Cervical cancer is the fourth most frequent cancer in women according to World Health Organization. In India the incidence is approximately 1 in 53 compared with 1 in 100 women in more developed regions of the world. Cervical cancer is eminently preventable by early detection using various screening tests like Pap smear, colposcopy, HPV testing. In this study we aim to evaluate the use of colposcopy in early detection of cervical cancer and also assess risk factors for the same. Primary objective was to study the correlation between colposcopic findings and histopathological analysis with a secondary objective to assess risk factors for development of cervical neoplasia.Methods: The study was carried over a period of 2 years (October 2016 to October 2018) with a sample size of 60 in the department of obstetrics and gynecology at tertiary care centre. Participants who fit the inclusion criteria were included in the study after taking a written and informed consent. The colposcopy findings were correlated with the histopathological findings of the cervical biopsy that was undertaken.Results: Colposcopy impression had sensitivity of 93.8% in predicting the histopathology, specificity was 77.3%, positive predictive value was 60%, negative predictive value was 9% and the diagnostic accuracy was 81.7%. On analyzing the risk factors, it was found that the odds of malignant histopathology were 0.55 times decreasing with each unit increase in age (at first intercourse) (p value<0.05).Conclusions: Colposcopy gives immediate and accurate results and its value as a diagnostic test is undisputable. The sensitivity of colposcopy is high and hence in high risk population or remote places where women do not turn for regular screening tests, colposcopy can be used primarily as the screening test.
The efficacy of alpha-lipoic acid and/or gabapentin on the oxidant-antioxidant system in patients with diabetic polyneuropathy
Authors: Komurcu Hatice Ferhan , Baran Pervin , Erel Ozcan , Anlar Omer 
Published: July 2020

Background: Diabetic peripheral sensorimotor polyneuropathy is the most common complication seen in patients with diabetes mellitus (DM). Oxidant system plays a crucial role in its physiopathology. We investigated the changes in the serum levels of total antioxidant status (TAS), total oxidant status (TOS), paraoxonase-1 (PON1) and oxidative stress index (OSI) to evaluate the antioxidant efficacy of alpha lipoic acid (ALA) and/or gabapentin in patients with diabetic polyneuropathy (DPN).Methods: Sixty-three type 2 DM patients with diabetic polyneuropathy (DPN) were enrolled in the study. Patients with DPN were divided into four groups in terms of their treatment: Group 1 consisted of treatment-naive patients; patients treated with ALA, gabapentin or combination of ALA and gabapentin comprised groups 2, 3, and 4, respectively. The patients received the medications for at least six weeks. Serum levels of TAS, TOS, PON1 and OSI were analyzed.Results: No significant difference was observed between the groups according to the oxidative stress parameters studied.Conclusions: The use of ALA and/or gabapentin in patients with DPN did not significantly affect the oxidative stress parameters, including TAS, TOS, PON1, and OSI.
Tourniquet application in snake bite: are we aware?
Authors: Gargi Gaveshna , Saini Amit 
Published: July 2020

Background: To assess the use of tourniquets as mentioned in National Snake Bite Management Protocol among peripheral health care providers.Methods: This was a prospective cross-sectional study conducted in a tertiary care institute between June 2016 to June 2017. A total of 36 patients of snake bite referred from peripheral health facility were enrolled in the study and were evaluated for : date and time of bite, site of bite, weather snake was seen, type of envenomation, first aid given in Govt facility/alternative practitioner, tourniquet applied/not applied, anti snake venom given/not given as first aid and outcome.Results: The mean age of the study population was 39 years (17.38) range 18 years to 75 years. 18 patients were male and 18 were female. 30 (83.3%) patients had site of bite over the extremities’. The venom was hemotoxic in 12 (33.3%) patients and neurotoxic 21 (58.3%). 30 (83.3%) patients received first aid in the Government health facility manned by qualified in healthcare practitioner and 6 (16.7%) were treated by traditional healers. 29 (80.6%) patients had a tight tourniquet tied to the site of the bite when seen in emergency department of institute. None of the patients had their limbs splinted. 31 (86.1%) patients had received anti snake venom (ASV) at the peripheral health facility. The mortality rate was 5.6% with only 2 deaths.Conclusions: The majority of peripheral health care providers both qualified and unqualified use tourniquets in patients suffering with snake bite. The peripheral health care providers are not aware of importance of limb splinting and immobilisation. Though the rate of instilling ASV is good, the health care providers in the peripheral institutes should be made aware of recommendations of national snake bite management protocol with regard to use of tourniquets and limb splitting in snake bite patients.
Kodamaea Ohmeri: a rare fungus causing a severe case of necrotizing fasciitis
Authors: Jimenez Mercy , Seltzer Emily S. , Shakil Javeria , Louis Martine 
Published: July 2020

Necrotizing soft tissue infection, NSTI, involves the soft tissue characterized by rapid spread of infection and consequent cell necrosis. NSTI, in particular necrotizing fasciitis (NF), is a significant disease burden in the US with an annual mortality of 4.8 per 1,000,000 person years. Here we describe a rare fungal pathogen, Kodamaea Ohmeri, as a cause of NF in a diabetic but otherwise healthy male patient. In the past K. Ohmeri has been described in children, immunocompromised individuals, and in cases with IV catheters and prolonged use of IV antibiotics. A febrile and hypotensive male (LRINEC score of 6) presented after sustaining abrasions of his right lower extremity. He was initially started on broad-spectrum antibiotics and underwent surgical exploration. During the following weeks, the patient developed sepsis and endured a total of four debridement. Wound cultures resulted K. Ohmeri with sensitivity to miconazole and voriconazole. Anti-fungal, silver dressings and wound vacuum, were utilized to assist in treatment and tissue granulation. To our knowledge, this is the first case describing Kodamea ohmeri as a causative agent of NF. K. Ohmeri should be on the radar of the health care providers taking care of patients with NF, especially in the context of intermittent bouts of sepsis and prolonged hospital course. Our case illustrates the fact that prompt identification, addition of fungal cultures and appropriate surgical treatment are crucial to improve patient outcomes.
“This above all: to thine own self be true…” the effects of the COVID-19 pandemic on surgical residency training and education
Authors: Dockter Andrew Grayson , Angelos George C. 
Published: July 2020

COVID-19 has drastically affected the current surgical training paradigm. Fellows anticipate a 10-25% decrease in procedural volumes for this year because of the pandemic. With a reduction in elective cases, surgical programs have transitioned to resident coverage cutbacks and/or reassigning trainees to non-surgical wards to assist with pandemic relief.