Ergonomics in endoscopic sinus surgery.

Ergonomics in endoscopic sinus surgery.

Curr Opin Otolaryngol Head Neck Surg. 2018 Dec 03;:

Authors: Ramakrishnan VR

Abstract
PURPOSE OF REVIEW: Awareness of ergonomics is growing into surgical specialties including otolaryngology. Most otolaryngologists experience occupational physical discomfort, and daily incorporation of standard ergonomic principles may alleviate some of this pain.
RECENT FINDINGS: Further demonstration of surgery-related physical discomfort has been documented based on surveys of general otolaryngologists and subspecialty rhinologists. One study utilized surface electromyography to document physical findings directly associated with the endoscopic sinus surgery procedure. However, relatively little work has been published on interventions to relieve task-related pain and body discomfort in rhinology.
SUMMARY: Surgeon fatigue and bodily injury is a surprisingly frequent occurrence and is more likely to occur in procedures that are mentally challenging, prolonged, and require the surgeon to operate in a fixed position. Endoscopic sinus and skull base surgeons appear particularly susceptible to task-related physical discomfort, and incorporation of ergonomic principles should be a priority.

PMID: 30516549 [PubMed - as supplied by publisher]

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Ergonomics in endoscopic sinus surgery.

Ergonomics in endoscopic sinus surgery.

Curr Opin Otolaryngol Head Neck Surg. 2018 Dec 03;:

Authors: Ramakrishnan VR

Abstract
PURPOSE OF REVIEW: Awareness of ergonomics is growing into surgical specialties including otolaryngology. Most otolaryngologists experience occupational physical discomfort, and daily incorporation of standard ergonomic principles may alleviate some of this pain.
RECENT FINDINGS: Further demonstration of surgery-related physical discomfort has been documented based on surveys of general otolaryngologists and subspecialty rhinologists. One study utilized surface electromyography to document physical findings directly associated with the endoscopic sinus surgery procedure. However, relatively little work has been published on interventions to relieve task-related pain and body discomfort in rhinology.
SUMMARY: Surgeon fatigue and bodily injury is a surprisingly frequent occurrence and is more likely to occur in procedures that are mentally challenging, prolonged, and require the surgeon to operate in a fixed position. Endoscopic sinus and skull base surgeons appear particularly susceptible to task-related physical discomfort, and incorporation of ergonomic principles should be a priority.

PMID: 30516549 [PubMed - as supplied by publisher]

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Economic Analysis of a Three-Arm RCT Exploring the Delivery of Intensive, Prophylactic Swallowing Therapy to Patients with Head and Neck Cancer During (Chemo)Radiotherapy.

Economic Analysis of a Three-Arm RCT Exploring the Delivery of Intensive, Prophylactic Swallowing Therapy to Patients with Head and Neck Cancer During (Chemo)Radiotherapy.

Dysphagia. 2018 Dec 04;:

Authors: Wall LR, Kularatna S, Ward EC, Cartmill B, Hill AJ, Isenring E, Byrnes J, Porceddu SV

Abstract
Research advocates for the use of intensive, prophylactic swallowing therapy to help reduce the severity of dysphagia in patients receiving (chemo)radiotherapy ([C]RT) for head/neck cancer (HNC). Unfortunately, the intensity of this therapy, coupled with growing patient numbers and limited clinical resources, provides challenges to many international cancer facilities. Telepractice has been proposed as a potential method to provide patients with greater support in home-practice, whilst minimising burden to the health service. This study investigated the clinical and patient-attributable costs of delivering an intensive, prophylactic swallowing therapy protocol via a new telepractice application "SwallowIT" as compared to clinician-directed FTF therapy and independent patient self-directed therapy. Patients (n = 79) with oropharyngeal HNC receiving definitive (C)RT were randomised to receive therapy via a: clinician-directed (n = 26), patient-directed (n = 27), or SwallowIT-assisted (n = 26) model of care. Data pertaining to health service costs (service time, consumables, therapy resources), patient-attributable costs (travel and wages) and patient-reported health-related quality of life (QoL) (AQoL-6D) were collected. SwallowIT provided a cost-efficient model of care when compared to the clinician-directed model, with significant cost savings to both the health service and to HNC consumers (total saving of $1901.10 AUD per patient; p < 0.001). The SwallowIT model also proved more cost-effective than the patient-directed model, yielding clinically significantly superior QoL at the end of (C)RT, for comparable costs. Overall, when compared to the alternate methods of service-delivery, SwallowIT provided a financially viable and cost-effective method for the delivery of intensive, prophylactic swallowing therapy to patients with HNC during (C)RT.

PMID: 30515560 [PubMed - as supplied by publisher]

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The dangers of sublethal carvacrol exposure: increases in virulence of Bacillus cereus during endophthalmitis.

The dangers of sublethal carvacrol exposure: increases in virulence of Bacillus cereus during endophthalmitis.

Int J Biochem Mol Biol. 2018;9(2):11-21

Authors: Rajabli N, Williamson L, Nimmer PS, Kelly-Worden M, Bange JS, Ho Y, McKillip JL

Abstract
Bacillus cereus can cause endophthalmitis through secretion of virulence factors, including hemolysin BL (Hbl) and nonhemolytic entertoxin (Nhe). Carvacrol is an extract from oregano oil, with potential for curtailing B. cereus endophthalmitis, due to antimicrobial and anti-inflammatory qualities. However, sublethal levels of carvacrol increases B. cereus virulence. The goal of this study was to investigate the increase in B. cereus virulence potential in response stress induced by a subinhibitory concentration (SIC) of carvacrol. Enterotoxin production and tissue damage were examined during ocular infections in vitro and in vivo. We hypothesized that the SIC of carvacrol would significantly increase toxin production in B. cereus without progressing systemically. RT-PCR determined SIC carvacrol-treated B. cereus had significantly higher hblC and nheA mRNA expression levels than controls in vitro. ELISA and RPLA analysis revealed a 46.8% and 50% increase in NheA and HblC toxin levels, respectively, in SIC-treated cultures. Caenorhabditis elegans-fed SIC carvacrol-treated B. cereus had a significantly higher mean mortality rate than nematodes fed untreated B. cereus. Significantly higher TNF-α levels were observed in SIC carvacrol-treated B. cereus mice compared to other treatment groups except for mice infected with B. cereus alone. Significantly higher IL-6 levels were also found in SIC-B. cereus mice. Histological analysis using Rose-Bengal and DAPI determined that the eyes of mice infected with SIC carvacrol-treated B. cereus had significantly more damage than eyes treated with B. cereus alone. The SIC of carvacrol increased B. cereus virulence in vitro and in vivo, with a mild systemic infection noted.

PMID: 30515347 [PubMed]

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Correlation of clinical parameters with imaging findings to confirm the diagnosis of fat embolism syndrome.

Correlation of clinical parameters with imaging findings to confirm the diagnosis of fat embolism syndrome.

Int J Burns Trauma. 2018;8(5):135-144

Authors: Shaikh N, Mahmood Z, Ghuori SI, Chanda A, Ganaw A, Zeeshan Q, Ehfeda M, Mohamed Belkhair AO, Zubair M, Kazi ST, Momin U

Abstract
BACKGROUND: Fat embolism syndrome (FES) is a multi-organ dysfunction caused by the fat emboli. The diagnostic of FES remains a challenge for clinicians. The clinical criteria including those of Gurd's and Wilson's although universally used for its diagnosis are not specific. Different methods of imaging are increasingly performed in the patients with presumed FES. The objective of this study is to determine whether there is a correlation between the clinical parameters and the imaging findings in confirming the FES diagnosis.
METHODS: Patients admitted with FES were identified from the surgical intensive unit registry and enrolled in this study. Patient's demographic data, admission diagnosis, associated injuries, comorbid conditions, time to deteriorate, surgical duration, clinical manifestations, imaging findings and outcome were recorded. Data was entered into the SPSS program and required tests were applied for comparisons with a p value <0.05 considered as significant.
RESULTS: A total of 81 patients were enrolled in this study. Majority of patients (51/63%) were young male and without comorbidity (58/71.6%). About a half of the patients (49.4%) underwent intramedullary nailing for long bone fracture. Respiratory insufficiencies occurred in 98% patients and of them 11.1% had diffuse alveolar hemorrhage. Neurological deterioration was seen in 70% of the patients while the petechial skin rash was rare (2.5%). All patients had an abnormal chest x-ray but chest computerized tomography scan (CT) showed patchy alveolar opacities in 49 (60.5%) of them. Cerebral edema was a common finding in the CT brain while the brain magnetic resonance imaging (MRI) revealed a typical star field appearance in 28.4% of the patients. There was a significant correlation (P<0.05) between the major and minor clinical criteria components and abnormal imaging findings.
CONCLUSIONS: The FES is common in young males with long bone fractures. Respiratory distress and neurological deterioration were common presentations. We suggest that the all patients with suspected FES by clinical criteria should have imaging studies to confirm the diagnosis.

PMID: 30515352 [PubMed]

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Rapid tissue viability evaluation using methemoglobin as a biomarker in burns.

Rapid tissue viability evaluation using methemoglobin as a biomarker in burns.

Int J Burns Trauma. 2018;8(5):126-134

Authors: Leung G, Duta D, Perry J, Leonardi L, Fish J, Cross K

Abstract
Burns are a frequent cause of traumatic injury, accounting for an average of 1,230 visits to the emergency department every day in the United States. While many of these injuries will heal spontaneously, nearly 1 in 10 are severe enough to require hospitalization or transfer to a specialized burn center. The early surgical management of a severe burn is critical to patient outcome, but few tools exist for triaging viable and non-viable tissue at early time-points post-injury. Without a validated outcome measure, even experienced burn surgeons diagnose tissue viability with an accuracy of only 50-70%, with significant consequences for patient morbidity, mortality and cost to the healthcare system. In this work, we have developed a non-invasive device that uses near-infrared spectroscopy to rapidly assess traumatic burns at the bedside. We report that near-infrared spectroscopy can detect methemoglobin non-invasively, and that this molecule increases in burned tissue immediately following injury in both a porcine model and in humans. Methemoglobin levels are highest in non-viable tissue, and correlate with tissue viability as early as 24 hours post-burn. Methemoglobin is the first reported objective outcome measure for use in the management of traumatic burn injury.

PMID: 30515351 [PubMed]

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An experimental rat model of hilar splenic vessel ligation versus splenectomy for spleen trauma.

An experimental rat model of hilar splenic vessel ligation versus splenectomy for spleen trauma.

Int J Burns Trauma. 2018;8(5):117-125

Authors: Mehrvarz S, Shahabi S, Mohammadi Mofrad R, Sheikhbahaei E, Moslehi M

Abstract
BACKGROUND: The most prevalent method of treating splenic injury is by splenectomy. This method is followed by postoperative complications. Therefore, less invasive procedures such as splenic angioembolization are introduced. This technique needs appropriate training, a high-tech setting and could be followed by complications. Thus, not all surgeons agree to do this procedure. Splenic hilar ligation of main vessels is a non-invasive procedure which has similarities to a splenectomy with unknown results.
OBJECTIVES: We aim to evaluate and compare splenectomy and hilar ligation.
METHODS: Thirty rats were divided into splenectomy and splenic hilar ligation groups. An identical grade 3-spleen injury was performed on all rats. After 6 weeks blood samples were obtained and hematologic and immunologic aspects were measured in their serum. Giemsa stained peripheral blood smears were obtained from the ligation group.
RESULTS: Comparing the above-mentioned variables before and after the surgery in each groups showed statistical significance in all aspects except IgM, C4 and platelets levels in ligation group (P value: 0.213, 0.059 and 0.649 respectively). Analysis revealed significant deference in postoperative WBC, IgM and C4 levels between splenectomy and ligation group (P value: < 0.001, < 0.001 and 0.026 respectively).
CONCLUSION: Splenic hilar ligation of main vessels is an easy way of treating splenic injury in hemodynamically stable patients with less postoperative complications. Therefore, it can be performed by all surgeons in all kind of medical centers. Spleen remains viable and continues its role although some aspects of its function become interrupted.

PMID: 30515350 [PubMed]

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Unusual pattern of partial failure of preexpanded free parascapular flap for neck reconstruction.

Unusual pattern of partial failure of preexpanded free parascapular flap for neck reconstruction.

Int J Burns Trauma. 2018;8(5):114-116

Authors: Romansky RK, Sharkov EV, Komitski SH

Abstract
The present article focuses on a relatively rare condition of a partial necrosis of free microvascular flap in a patient with severe postburn contracture of the neck region, subjected to reconstructive microsurgery. Reconstructive microsurgical staged procedure was undertaken to correct the scar contracture and restore the aesthetic unit. Substantial partial flap necrosis, requiring secondary surgery, was observed in the early postoperative period. Surprisingly only the distal 1/3 of the skin island of the parascapular flap survived. Final reconstruction of the neck reconstruction was accomplished by means of full thickness skin graft over the area of partially necrotic flap. Good final result was achieved. Overall treatment course is discussed in the light of the current trends.

PMID: 30515349 [PubMed]

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Application of animated cartoons in reducing the pain of dressing changes in children with burn injuries.

Application of animated cartoons in reducing the pain of dressing changes in children with burn injuries.

Int J Burns Trauma. 2018;8(5):106-113

Authors: Feng Z, Tang Q, Lin J, He Q, Peng C

Abstract
BACKGROUND: Nonpharmacological management remains one of the central pain interventional therapies in the burn unit. VR and other distraction treatments for adults have achieved great advantages in pain relief.
METHODS: A within-subject study was conducted to evaluate 54 participants aged from 3 to 7. In the control group, a standard analgesic, ibuprofen, was used over the period of dressing change, whereas animated cartoons were played simultaneously in the intervention-group condition. We adopted the Wong-Baker faces pain rating scale, COMFORT scale, FLACC scale and POCIS to assess the pain rating 5 min before, during and 5 min after dressing changes, respectively.
RESULTS: Compared with the control group, FLACC scale and POCIS scores in the intervention group were not significantly different (P>0.05) throughout the observation period; outcomes measured using the Wong-Baker faces pain rating scale and COMFORT scale 5 min before and during dressing changes were also not different between the groups (P>0.05). Nevertheless, 5 min after that period, subjects in the intervention group had reduced pain behavior according to scores on the Wong-Baker faces pain rating scale (control-group scores: 7.231±0.403; intervention-group scores: 6.026±0.501, P<0.05) and COMFORT scale (control-group scores: 21.602±1.316; intervention-group scores: 19.040±1.204, P<0.05).
CONCLUSION: This study supports that watching animated cartoons appears to be a practical way to ease the pain behavior of children in the burn unit after replacing wound dressings, although its effectiveness remains insufficient before and during the dressing change procedure.
SIGNIFICANCE: Conducting a thorough study and exploring the efficacy of animated cartoons in reducing the pain of dressing changes for pediatric patients may surely result in practical value, especially in developing countries.

PMID: 30515348 [PubMed]

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"Folia Neuropathol"[jour]; +19 new citations

19 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Folia Neuropathol"[jour]

These pubmed results were generated on 2018/12/06

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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"Continuum (Minneap Minn)"[jour]; +21 new citations

21 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Continuum (Minneap Minn)"[jour]

These pubmed results were generated on 2018/12/06

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Role of adenylyl cyclase activator in controlling experimental diabetic nephropathy in rats.

Role of adenylyl cyclase activator in controlling experimental diabetic nephropathy in rats.

Int J Physiol Pathophysiol Pharmacol. 2018;10(5):144-153

Authors: Singh L, Rana S, Mehan S

Abstract
The present study aimed to investigate the role of adenylyl cyclase activator in preventing diabetic nephropathy in rats. Renal function parameters, renal hypertrophy, lipid profile, markers of oxidative stress and free radical scavenging activities were assessed. Histopathology was performed to confirm Streptozotocin induced renal morphological changes in diabetic rats. Male Wistar rats were used in the present study to reduce the effect of estrogen. Rats were subjected to high fat diet (HFD) for two weeks followed by low dose of Streptozotocin (STZ) [35 mg/kg, i.p.] to develop experimental diabetic nephropathy in eight weeks. Two weeks treatment with low dose of Forskolin (10 mg/kg) reduced the level of diabetic nephropathy markers but results observed were not significant. Whereas, Forskolin intermediate dose (20 mg/kg) and high dose (30 mg/kg) treated rats significantly attenuated diabetes induced elevated renal function parameters and endogenous antioxidants enzymatic activities. High dose of Forskolin was found to be more effective in attenuating the renal structural and functional abnormalities. Forskolin prevented renal structural and functional abnormalities in diabetic rats. Histopathological evaluation revealed that Forskolin (20 mg/kg and 30 mg/kg) treated diabetic rats demonstrated reduced vacuolar degeneration of tubules and glomerulosclerosis. In the present study, Glibenclamide (0.6 mg/kg) and Atorvastatin (0.5 mg/kg) were used as standard drugs. Our results demonstrated synergistic effects, when high dose of Forskolin was co-administered with standard drugs. In conclusion, treatment with adenylyl cyclase activator, Forskolin in diabetic rats reduced the elevated serum glucose level, biomarkers of renal morphological dysfunction, renal hypertrophy, dyslipidaemia, oxidative stress and improved renal structure, function and enhanced level of endogenous antioxidants. Forskolin has a potential to prevent nephropathy without showing any effect on body weight in diabetic rats.

PMID: 30515257 [PubMed]

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Regional Node Distribution in Papillary Thyroid Cancer with Microscopic Metastasis.

Regional Node Distribution in Papillary Thyroid Cancer with Microscopic Metastasis.

J Thyroid Res. 2018;2018:1718284

Authors: Hurtado-López LM, Ordoñez-Rueda A, Zaldivar-Ramírez FR, Basurto-Kuba E

Abstract
Background: Optimal neck lymphadenectomy in patients with papillary thyroid cancer (PTC) and microscopic lymph node metastasis needs to be defined in order to aid surgeons in their decision about the best way to proceed in these cases.
Methods: Patients who underwent total thyroidectomy and lymphadenectomy at levels IIa to VI were divided into two groups: Group 1 (G1) with macroscopic metastasis detected before surgery and Group 2 (G2) with microscopic metastasis detected in sentinel node during surgery. Odds ratio (OR) was computed for age, sex, tumor size, multicentricity, capsular invasion, vascular/lymphatic permeation, and nodes with metastasis.
Results: Primary tumor size was (G1 versus G2, respectively) 3.8 cm versus 1.98 cm (P<0.001); only lymphatic permeation was correlated to an increase in metastasis in lymph nodes 65.4% versus 25% (OR=5.6, p<0.001); metastatic frequency by region was IIa 18.5% versus 1.5%, III 24.3% versus 9.9%, IV 17.4% versus 18.1%, and VI 25.9% versus 71,2%. Metastasis to level V was found only in G1.
Conclusion: Selective lymphadenectomy at levels III, IV, and VI is optimal for PTC patients without preoperative evidence of lymph node disease, but who present with lymph node microscopic metastasis in an intraoperative assessment.

PMID: 30515289 [PubMed]

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Ergonomics in endoscopic sinus surgery.

Ergonomics in endoscopic sinus surgery.

Curr Opin Otolaryngol Head Neck Surg. 2018 Dec 03;:

Authors: Ramakrishnan VR

Abstract
PURPOSE OF REVIEW: Awareness of ergonomics is growing into surgical specialties including otolaryngology. Most otolaryngologists experience occupational physical discomfort, and daily incorporation of standard ergonomic principles may alleviate some of this pain.
RECENT FINDINGS: Further demonstration of surgery-related physical discomfort has been documented based on surveys of general otolaryngologists and subspecialty rhinologists. One study utilized surface electromyography to document physical findings directly associated with the endoscopic sinus surgery procedure. However, relatively little work has been published on interventions to relieve task-related pain and body discomfort in rhinology.
SUMMARY: Surgeon fatigue and bodily injury is a surprisingly frequent occurrence and is more likely to occur in procedures that are mentally challenging, prolonged, and require the surgeon to operate in a fixed position. Endoscopic sinus and skull base surgeons appear particularly susceptible to task-related physical discomfort, and incorporation of ergonomic principles should be a priority.

PMID: 30516549 [PubMed - as supplied by publisher]

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Study on the association between vitamin D receptor gene fokI (T/C) polymorphisms and the susceptibility to type 2 diabetic kidney disease of Han nationality in south of China.

Study on the association between vitamin D receptor gene fokI (T/C) polymorphisms and the susceptibility to type 2 diabetic kidney disease of Han nationality in south of China.

Int J Mol Epidemiol Genet. 2018;9(5):55-63

Authors: Dong X, Yang D, Han R, Yang W, Pang W, Song D, Shi R

Abstract
AIMS: To investigate the distribution of vitamin D receptor fokI gene polymorphism in Yunnan Han population, and to explore the relationship between SNP of fokI and type 2 diabetic kidney disease.
METHODS: We included 276 individuals of Han population of Yunnan in this study: 91 type 2 diabetes patients without kidney disease (DM group), their duration of diabetes is more than 10 years, 89 type 2 diabetes patients with diabetic kidney disease (DKD group), their duration of diabetes is less than 10 years and 96 healthy controls (NC group). We compared the concentration of 25 hydroxy vitamin D in different groups and used taqman probe to detect the genotype and allele of fokI, then analysed the relationship between the polymorphisms of fokI and the susceptibility of diabetic kidney disease.
RESULTS: (1) NC group had a significantly higher plasma concentrations of 25 (OH) D than DKD group and DM group (P < 0.01); (2) 25 (OH) D and age, BMI, HbA1c, TG showed a weak negative correlation (P < 0.01); (3) Genotype of fokI showed no differences in DM group and DKD group, same as in DM group and NC group; FF genotype in DKD group is relatively lower than NC group (P < 0.05), and there is no difference in Ff and ff genotype (P > 0.05); In DKD group, f allele was 53.4%, higher than DM group (RR = 1.46, P < 0.05); (4) Logistic regression analysis showed that ff genotype may be a susceptible factor for DKD (P = 0.04, OR = 2.37).
CONCLUSION: FokI Ff genotype accounted for a larger proportion of the Han population in Yunnan, and ff genotype may be a susceptible factor for DKD in Yunnan Han population.

PMID: 30515259 [PubMed]

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MBL2 rs7095891 G > A polymorphism was associated with an increased risk of tuberculosis in the Chinese Uygur population.

MBL2 rs7095891 G > A polymorphism was associated with an increased risk of tuberculosis in the Chinese Uygur population.

Int J Mol Epidemiol Genet. 2018;9(5):64-70

Authors: Li X, Cao X, El-Ashram S, Zhang W, Lu L, Wang X, Chen C, Wu J

Abstract
INTRODUCTION: Tuberculosis (TB) is a foremost infectious disease in most parts of the world. Globally, tuberculosis is the second-leading cause of infectious diseases. This has become a significant world-wide social and public health issue, and one of the major diseases in China. In addition to environmental risk factors, genetic factors may play an important role in the development of tuberculosis.
METHODS: We conducted a case-control study to evaluate the genetic effects of functional single nucleotide polymorphisms (SNPs): MBL2 rs1800450 C > T, MBL2 rs7095891 G > A and MBL2 rs7096206 C > G, and their influences on the development of tuberculosis. A total of 231 tuberculosis cases and 240 controls were included in this study. Genotypes were determined using a custom-designed 48-Plex SNPscanTM kit.
RESULTS: The MBL2 rs7095891 G > A polymorphism was associated with an increased risk of TB. However, there were no significant links with the other two SNPs. In any subgroup, there was no relvant risk of TB associated with MBL2 rs7095891 G > A polymorphism.
CONCLUSION: These findings suggest that functional polymorphism MBL2 rs7095891 G > A may be positively correlated with susceptibility to tuberculosis. These findings may be somewhat limited by sample size. A further study with more focus on different regions, ethnic groups and larger sample sizes is therefore suggested.

PMID: 30515260 [PubMed]

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Centromere-associated protein E expresses a novel mRNA isoform in acute lymphoblastic leukemia.

Centromere-associated protein E expresses a novel mRNA isoform in acute lymphoblastic leukemia.

Int J Mol Epidemiol Genet. 2018;9(5):43-54

Authors: Jiménez-Ávila CE, Villegas-Ruíz V, Zapata-Tarres M, Rubio-Portillo AE, Pérez López EI, Zenteno JC, Juárez-Méndez S

Abstract
The alternative splicing plays an important role to generate protein diversity. Recent studies have shown alterations in alternative splicing, resulting in loss, gain or changes of functions in the resulting protein. Specific products of alternative splicing are known to contribute in cancer-related mechanisms, such as angiogenesis, migration, adhesion and cell proliferation, among others. We using high-density microarrays reported a CENP-E as a one of significant transcript expressed and potentially is alternatively spliced in cancer. We focus in validate alternative splicing of CENP-E transcript using RT-PCR and sequencing in different cancer cell lines. We performed RT-PCR using specific primers designed to delimit the non-reported alternative splicing in CENP-E transcript. Our results showed the co-expression of the variant one and two of CENP-E in all cell lines evaluated. We detected more expression of variant one than two. Moreover, we identify an alternative 5'splice site of CENP-E in the exon 38 and was observed in RoVa cell line. Additionally, we characterized alternative skipping from exon 20 (NAT-CENP-E), these alternative splicing was observed in all cell lines evaluated except RoVa. Finally, we corroborate alternative mRNA splicing in leukemia patients using quantitative RT-PCR, in 71.8% of the patients NAT-CENP-E is downregulated and 28.2% is overexpressed.

PMID: 30515258 [PubMed]

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Ergonomics in endoscopic sinus surgery.

Ergonomics in endoscopic sinus surgery.

Curr Opin Otolaryngol Head Neck Surg. 2018 Dec 03;:

Authors: Ramakrishnan VR

Abstract
PURPOSE OF REVIEW: Awareness of ergonomics is growing into surgical specialties including otolaryngology. Most otolaryngologists experience occupational physical discomfort, and daily incorporation of standard ergonomic principles may alleviate some of this pain.
RECENT FINDINGS: Further demonstration of surgery-related physical discomfort has been documented based on surveys of general otolaryngologists and subspecialty rhinologists. One study utilized surface electromyography to document physical findings directly associated with the endoscopic sinus surgery procedure. However, relatively little work has been published on interventions to relieve task-related pain and body discomfort in rhinology.
SUMMARY: Surgeon fatigue and bodily injury is a surprisingly frequent occurrence and is more likely to occur in procedures that are mentally challenging, prolonged, and require the surgeon to operate in a fixed position. Endoscopic sinus and skull base surgeons appear particularly susceptible to task-related physical discomfort, and incorporation of ergonomic principles should be a priority.

PMID: 30516549 [PubMed - as supplied by publisher]

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Balancing opioid analgesia with the risk of nonmedical opioid use in patients with cancer.

Balancing opioid analgesia with the risk of nonmedical opioid use in patients with cancer.

Nat Rev Clin Oncol. 2018 Dec 04;:

Authors: Arthur J, Bruera E

Abstract
The current opioid crisis has brought renewed attention and scrutiny to opioid prescriptions. When patients receiving opioid therapy for pain engage in nonmedical opioid use (NMOU) or diversion, untoward consequences can occur. New evidence suggests that patients with cancer might be at a higher risk of NMOU than was previously thought, but clinical evidence still supports the use of opioid analgesics as the gold standard to treat cancer-related pain, creating a dilemma in patient management. Clinicians are encouraged to adopt a universal precautions approach to patients with cancer receiving opioids, which includes screening all patients; discussing the risks, benefits, adverse effects and alternatives of opioid therapy; and providing education on safe use, storage and disposal. Use of urine drug tests, prescription drug monitoring programmes and close observation of behaviours related to opioid use help to ensure treatment adherence, detect NMOU and support therapeutic decision-making. These measures can optimize the risk-benefit ratio while supporting safe opioid use. In this Review, we examine the role of opioids in cancer pain, the risk of substance use disorder and methods to achieve the right balance between the two in order to ensure safe opioid use.

PMID: 30514978 [PubMed - as supplied by publisher]

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A framework for the development of effective anti-metastatic agents.

A framework for the development of effective anti-metastatic agents.

Nat Rev Clin Oncol. 2018 Dec 04;:

Authors: Anderson RL, Balasas T, Callaghan J, Coombes RC, Evans J, Hall JA, Kinrade S, Jones D, Jones PS, Jones R, Marshall JF, Panico MB, Shaw JA, Steeg PS, Sullivan M, Tong W, Westwell AD, Ritchie JWA, Cancer Research UK and Cancer Therapeutics CRC Australia Metastasis Working Group

Abstract
Most cancer-related deaths are a result of metastasis, and thus the importance of this process as a target of therapy cannot be understated. By asking 'how can we effectively treat cancer?', we do not capture the complexity of a disease encompassing >200 different cancer types - many consisting of multiple subtypes - with considerable intratumoural heterogeneity, which can result in variable responses to a specific therapy. Moreover, we have much less information on the pathophysiological characteristics of metastases than is available for the primary tumour. Most disseminated tumour cells that arrive in distant tissues, surrounded by unfamiliar cells and a foreign microenvironment, are likely to die; however, those that survive can generate metastatic tumours with a markedly different biology from that of the primary tumour. To treat metastasis effectively, we must inhibit fundamental metastatic processes and develop specific preclinical and clinical strategies that do not rely on primary tumour responses. To address this crucial issue, Cancer Research UK and Cancer Therapeutics CRC Australia formed a Metastasis Working Group with representatives from not-for-profit, academic, government, industry and regulatory bodies in order to develop recommendations on how to tackle the challenges associated with treating (micro)metastatic disease. Herein, we describe the challenges identified as well as the proposed approaches for discovering and developing anticancer agents designed specifically to prevent or delay the metastatic outgrowth of cancer.

PMID: 30514977 [PubMed - as supplied by publisher]

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Results of a surgical cricothyrotomy workshop with a pig trachea model.

Results of a surgical cricothyrotomy workshop with a pig trachea model.

Rev Esp Anestesiol Reanim. 2018 Dec 01;:

Authors: Añez Simón C, Serrano Gonzalvo V, Carrillo Luna LH, Farré Nebot V, Holgado Pascual CM, grupo de investigación ANESTARRACO (IISPV)

Abstract
BACKGROUND: The latest Difficult Airway Society (DAS) guidelines recommend that all anaesthesiologists should to be trained in the performing of a surgical cricothyrotomy (CtQ). The aim of this study was to analyse the learning results of a CtQ workshop by assessing the success rate and time to perform CtQ on a porcine tracheal model.
MATERIAL AND METHODS: A workshop was designed in which each student completed a questionnaire with demographic data and theoretical knowledge about surgical approaches of airway. During the following hour, a review was presented theoretical aspects of CtQ. The model was shown and a CtQ was performed using a classical technique. Afterwards, in groups of 3-4 students with an instructor, each one of the students performed 6 CtQ. A record was made on whether the ventilation was correct, the time to perform CtQ, and the ease of performing the CtQ by the students and instructors. Finally, students completed a questionnaire on the theoretical aspects. Students and instructors performed a workshop debriefing. A statistical analysis was performed, considering a P-value <0.05 as statistically significant.
RESULTS: A total of 8 workshop sessions were held with a total of 91 students. At first attempt, 86% of students performed a CtQ with successful ventilation, and 92% at the sixth attempt (P<.0001). Time taken was 163 [107-211] seconds at first attempt, and 70 [55-85] seconds at the sixth (P<.0001). At the end of workshop, students had improved their theoretical knowledge (P<.0001) and perception of the ease of the technique.
CONCLUSION: Workshop performance improved theoretical knowledge and competence in surgical cricothyrotomy.

PMID: 30514575 [PubMed - as supplied by publisher]

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"Plast Reconstr Surg"[jour]; +21 new citations

21 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Plast Reconstr Surg"[jour]

These pubmed results were generated on 2018/12/06

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

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Does metformin usage improve survival in head and neck squamous cell carcinoma? A population-based study.

Does metformin usage improve survival in head and neck squamous cell carcinoma? A population-based study.

J Otolaryngol Head Neck Surg. 2018 Dec 04;47(1):74

Authors: Quimby AE, Lebo NL, Griffiths R, Hall S, Dimitroulakos J, Johnson-Obaseki S

Abstract
BACKGROUND: We sought to expand upon preliminary data suggesting that metformin confers a survival benefit to patients with head and neck squamous cell carcinoma (HNSCC).
METHODS: A large-scale retrospective cohort study of all patients in Ontario diagnosed with squamous cancer of the larynx, hypopharynx, and nasopharynx between Dec 1st 2007 to Dec 1st 2012 was undertaken. The Institute for Clinical and Evaluative Sciences was accessed to obtain patient demographic, treatment and outcome information. We included patients on metformin at the time of diagnosis. Kaplan Meier methods and Cox Regression models were used.
RESULTS: Patients taking metformin at the time of diagnosis had a higher comorbid status but were otherwise similar to patients without metformin usage. Using multivariate analysis, neither overall survival nor disease specific survival was improved in patients on metformin (OS: HR 1.123, p = .338; DSS: HR 1.048, p = .792).
CONCLUSIONS: No survival advantage was observed in patients with HNSCC taking metformin at the time of diagnosis.

PMID: 30514404 [PubMed - in process]

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Shared decision-making within goal-setting in rehabilitation: a mixed-methods study.

Shared decision-making within goal-setting in rehabilitation: a mixed-methods study.

Clin Rehabil. 2018 Dec 04;:269215518815251

Authors: Rose A, Rosewilliam S, Soundy A

Abstract
OBJECTIVES:: To assess the extent of shared decision-making within goal-setting meetings and explore patient-reported factors that influenced their participation to shared decision-making about their goals.
DESIGN:: A two-phase explanatory sequential mixed-methods study, using questionnaires and interviews.
SETTING:: A rehabilitation centre and patients' homes.
SUBJECTS:: Frail elderly patients.
MAIN MEASURES:: Quantitative data were collected after every patient's goal-setting meeting using the Multifocal Approach to Sharing in Shared Decision Making (MAPPIN'SDM) questionnaire that assesses competencies relevant to shared decision-making. Shared decision-making was rated by an observer, patients and staff and compared. Qualitative data were collected through semi-structured interviews.
RESULTS:: A total of 24 rehabilitation team members and 40 patients (mean age: 83 years) participated. All study participants felt that competency 7a (the language used by staff made sense to the patient) was observed in all meetings. Patients reported that for 22 of the meetings competency 4a, the advantages and disadvantages of rehabilitation, was not discussed. Games-Howell tests for direction of differences between groups showed significant difference ( P = 0.001) between patients and staff in whether patients' problems were discussed. Nine patients' interviews suggested that motivation, self-confidence, family support, preparing themselves, getting information about goal-setting and rehabilitation options could enable them to participate in shared decision-making. They suggested that staff should communicate clearly and demonstrate that they are listening to patients but without a paternalistic approach.
CONCLUSION:: Staff exhibited most shared decision-making competencies at a good level. However, patients highlighted problems with information sharing and felt staff might not be listening to them. Research and practice should explore tools to address these shortfalls.

PMID: 30514111 [PubMed - as supplied by publisher]

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A study of the description of exercise programs evaluated in randomized controlled trials involving people with fibromyalgia using different reporting tools, and validity of the tools related to pain relief.

A study of the description of exercise programs evaluated in randomized controlled trials involving people with fibromyalgia using different reporting tools, and validity of the tools related to pain relief.

Clin Rehabil. 2018 Dec 05;:269215518815931

Authors: Jo D, Del Bel MJ, McEwen D, O'Neil J, Mac Kiddie OS, Álvarez-Gallardo IC, Brosseau L

Abstract
RATIONALE:: Exercise programs for the management of fibromyalgia are well recognized as being effective. However, the incomplete descriptions of exercise programs make replication and implementation difficult. Also, existing reporting tools have not been validated in relation to pain relief as well as with each other.
OBJECTIVES:: This study aimed to evaluate the description of exercise programs in randomized control trials for the management of fibromyalgia using different assessment tools, and the correlations of each tool in relation to effectiveness of pain relief of fibromyalgia, and the correlations between each tool.
METHOD/RESULTS:: Through a consensus made by two different pairs of reviewers and an arbitrator, the mean total scores for the exercise programs were reported: 10.61/19 for Consensus on Exercise Reporting Template; 4.17/12 for Template for Intervention Description and Replication; 7.05/12 for the Consensus on Therapeutic Exercise Training; and 2.50/4 (aerobic) and 2.36/5 (flexibility and resistance) for the 2016 American College of Sports Medicine guidelines. This demonstrates generally low reporting scores (less than 60% out of the total number of items were reported). Overall, low correlations (Cohen's kappa value, ranging from -0.47 (poor) to 0.313 (fair)) were found between all tools and pain relief. Good to excellent correlations (0.680-0.908) among the reporting tools were shown.
CONCLUSION:: Incomplete descriptions of exercise programs were consistently shown among the randomized clinical trials assessed in this study. The overall weak correlations demonstrated that the reporting tools have the limited ability to determine whether exercise programs were or were not effective for pain relief among individuals with fibromyalgia.

PMID: 30516064 [PubMed - as supplied by publisher]

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A qualitative study exploring therapists' experiences of implementing a complex intervention promoting meaningful activity for residents in care homes.

A qualitative study exploring therapists' experiences of implementing a complex intervention promoting meaningful activity for residents in care homes.

Clin Rehabil. 2018 Dec 04;:269215518815233

Authors: Smith R, Wood J, Jones F, Turner S, Hurley M

Abstract
OBJECTIVES:: To explore the experiences of occupational therapists and physiotherapists and to reveal any factors that can facilitate delivering a complex care home intervention promoting meaningful activity.
DESIGN:: Qualitative interview study using data from three focus groups conducted longitudinally post intervention implementation. Data were analysed thematically.
SETTING:: Three residential care homes in South London, UK.
SUBJECTS:: All therapists involved in the implementation of the intervention: three occupational therapists and three physiotherapists.
RESULTS:: Three interconnected themes emerged from the analysis: (1) developing trusting relationships, (2) empowering staff and (3) remaining flexible. Therapists described how successfully implementing a complex care home intervention was dependant on developing trusting relationships with care staff. This enabled the therapists to empower care staff to take ownership of the intervention and help embed it in care home culture, facilitating long-term change. The therapists described how remaining flexible in their approach helped keep care staff engaged for the duration of implementation.
CONCLUSION:: This study has revealed several important factors that can help facilitate therapists delivering complex interventions in care homes.

PMID: 30514110 [PubMed - as supplied by publisher]

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Varicella-zoster virus clades circulating in Spain over two decades.

Varicella-zoster virus clades circulating in Spain over two decades.

J Clin Virol. 2018 Nov 28;110:17-21

Authors: González I, Molina-Ortega A, Pérez-Romero P, Echevarría JE, He L, Tarragó D

Abstract
BACKGROUND: Despite childhood universal VZV immunization was introduced in 2015, there are no data on VZV clade distribution in Spain.
OBJECTIVES: To characterize the varicella-zoster virus strains circulating in Spain between 1997 and 2016.
STUDY DESIGN: In this retrospective study, we determined the VZV clades in 294 patients with different pathologies (mainly encephalitis, zoster and varicella) by sequencing three fragments within ORF 22, ORF 21 and ORF 50 and, subsequently analyzing 7 relevant SNPs.
RESULTS: Among these 294 patients, 132(44.9%) patients were infected by clade 1, 42(14.3%) patients by clade 3, 19(6.5%) by clade 5, 29(9.9%) by clade VI and 3(1%) by clade 4. Four patients (1.4%) were infected by clade 2 vOKA strains, who received one dose of live-attenuated varicella vaccine. Putative recombinant clade 1/3 was identified in 6 cases (2.0%). Results obtained from partial sequences were assigned to clade 1 or 3 in 56(19%) patients and clade 5 or VI in 3(1.0%) patients. In the multivariate analysis, encephalitis was independently associated with clades 1 and 3 and age >14y.o. (P = 0.035 and P = 0.021, respectively). Additionally, Madrid had significant fewer cases of encephalitis compared with the rest of regions analyzed (P = 0.001).
CONCLUSIONS: Higher prevalence of clades 1 and 3 and their relation with encephalitis and age >14y.o. suggest earlier introduction of this clades in Spain. Putative interclade 1 and 3 recombinants are circulating in patients with encephalitis, herpes zoster and varicella. Several cases were related to vOKA vaccination but vaccine strains do not seem to circulate in the general population.

PMID: 30517902 [PubMed - as supplied by publisher]

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The effect of group exercises on balance, mobility, and depressive symptoms in older adults with mild cognitive impairment: a randomized controlled trial.

The effect of group exercises on balance, mobility, and depressive symptoms in older adults with mild cognitive impairment: a randomized controlled trial.

Clin Rehabil. 2018 Dec 04;:269215518815218

Authors: Langoni CDS, Resende TL, Barcellos AB, Cecchele B, da Rosa JN, Knob MS, Silva TDN, Diogo TS, da Silva IG, Schwanke CHA

Abstract
OBJECTIVE:: To determine the effects of group exercises on balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment.
DESIGN:: Single blinded, randomized, matched pairs clinical trial.
SETTING:: Four primary healthcare units.
SUBJECTS:: Fifty-two sedentary subjects with mild cognitive impairment were paired (age, sex, body mass index, and Addenbrooke's Cognitive Examination Revised score), tested, and then randomized into an intervention group ( n = 26) and a control group ( n = 26).
INTERVENTION:: The intervention group performed strength (ankle weights, elastic bands, and dumbbells) and aerobic exercises (walking) in their communities' public spaces, twice a week (60 minutes each), during 24 weeks. The control group maintained its usual routine.
MAIN MEASURES:: Balance (Berg Balance Scale (BBS)), mobility (Timed Up and Go Test (TUG)), and depressive symptoms (Geriatric Depression Scale-15) were assessed before and after the intervention.
RESULTS:: Before the intervention, the two groups did not differ statistically. After, the intervention group showed significant improvement ( P < 0.05) in balance (before: 53 ± 3; after: 55.1 ± 1.1 points), mobility (before: 10.7 ± 2.9 seconds; after: 8.3 ± 2 seconds), and depressive symptoms (median punctuation (interquartile range) before: 4 (1.8-6); after: 2.5 (1-4)). The control group presented a significant increase in their depressive symptoms (median before: 3.5 (2-7.3); after: 4 (2-5.3)), while their balance and mobility showed no significant modification. Small effect sizes were observed in the intervention group and control group depressive symptoms, as well as in the control group's mobility and balance. Large effect sizes were observed the intervention group's mobility and balance.
CONCLUSION:: Group exercises improved balance, mobility, and depressive symptoms in community-dwelling older adults with mild cognitive impairment.

PMID: 30514115 [PubMed - as supplied by publisher]

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High-intensity interval training in people with Parkinson's disease: a randomized, controlled feasibility trial.

High-intensity interval training in people with Parkinson's disease: a randomized, controlled feasibility trial.

Clin Rehabil. 2018 Dec 04;:269215518815221

Authors: Harvey M, Weston KL, Gray WK, O'Callaghan A, Oates LL, Davidson R, Walker RW

Abstract
OBJECTIVES:: To investigate whether people with Parkinson's disease can exercise at a high-intensity across a 12-week intervention and to assess the impact of the intervention on cardiorespiratory fitness.
DESIGN:: This is a randomized, controlled, feasibility study with waiting list control. Assessors were blinded to group allocation.
SETTING:: The intervention took place at an exercise centre and assessments at a district general hospital.
SUBJECTS:: This study included 20 people with idiopathic Parkinson's disease.
INTERVENTION:: A total of 36 exercise sessions over 12 weeks, with each session lasting ~45 minutes, were conducted.
MAIN MEASURES:: The main measures were maximal heart rates achieved during exercise, recruitment rate, attendance, drop-out, change in peak oxygen consumption, cardiac output, cognitive function and quality of life. The study was considered technically feasible if participants achieved ⩾85% of maximal heart rate during exercise.
RESULTS:: There were 12 male and 8 female participants; they had a mean age of 68.5 years (standard deviation 6.825). Two participants were of Hoehn and Yahr stage I, 11 stage II and 7 stage III. In all, 17 participants completed the intervention. The median (interquartile range) proportion of repetitions delivered across the intervention which met our high-intensity criterion was 80% (67% to 84%). Mean peak heart rate was 88.8% of maximal. Peak oxygen consumption increased by 2.8 mL kg-1 min-1 in the intervention group and 1.5 mL kg-1 min-1 in the control group after 12 weeks of exercise. We estimate that a fully powered randomized controlled trial would require 30 participants per group.
CONCLUSION:: High-intensity interval exercise is feasible in people with Parkinson's disease. Improvements in cardiorespiratory function are promising.

PMID: 30514114 [PubMed - as supplied by publisher]

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Short-term effects of neuromuscular electrical stimulation and ultrasound therapies on muscle architecture and functional capacity in knee osteoarthritis: a randomized study.

Short-term effects of neuromuscular electrical stimulation and ultrasound therapies on muscle architecture and functional capacity in knee osteoarthritis: a randomized study.

Clin Rehabil. 2018 Dec 04;:269215518817807

Authors: Devrimsel G, Metin Y, Serdaroglu Beyazal M

Abstract
OBJECTIVE:: To determine the effects of ultrasound therapy and neuromuscular electrical stimulation (NMES) application on the muscle architecture and functional capacity in patients with knee osteoarthritis.
DESIGN:: A randomized study.
SUBJECTS:: A total of 60 patients with knee osteoarthritis.
INTERVENTIONS:: Participants were randomized into one of the following two intervention groups, five days a week, for three weeks: the combination of NMES application, hot pack, and exercise therapy was applied to the NMES group. The combination of therapeutic ultrasound, hot pack and exercise therapy was applied to the ultrasound therapy group.
MAIN MEASURES:: Subjects were evaluated for pain and functional capacity with the use of the visual analog pain scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and 15 meter walking test. The muscle architecture (muscle thickness, pennation angle and fascicle length) was assessed from vastus lateralis and quadriceps femoris muscles bilaterally by ultrasonography.
RESULTS:: Two groups presented significant improvements in all outcome measures before and after treatment ( P < 0.01). There were significant improvements in VAS rest pain ( P < 0.05), VAS activity pain ( P < 0.05), WOMAC pain ( P < 0.05), WOMAC stiffness score ( P < 0.05), and WOMAC physical function ( P < 0.05) for the ultrasound therapy group in comparison to the NMES group. NMES group exhibited more increases in the muscle thickness and fascicle length values when compared to ultrasound therapy group ( P < 0.05).
CONCLUSION:: Ultrasound therapy appears to be an effective treatment in reducing pain and improving functional capacity. NMES application has more effects on the muscle architecture.

PMID: 30514113 [PubMed - as supplied by publisher]

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Understanding physical activity behavior in patients with bladder cancer before and after radical cystectomy: a qualitative interview study.

Understanding physical activity behavior in patients with bladder cancer before and after radical cystectomy: a qualitative interview study.

Clin Rehabil. 2018 Dec 04;:269215518815531

Authors: Rammant E, Fonteyne V, Decaestecker K, Bultijnck R, Deforche B, Pieters R, Ost P, Verhaeghe S, Van Hecke A

Abstract
OBJECTIVE:: To explore the determinants of physical activity in patients with bladder cancer before and after radical cystectomy.
DESIGN:: A qualitative research design using semi-structured face-to-face interviews.
SETTING AND SUBJECTS:: A total of 30 interviews were conducted with people diagnosed with bladder cancer and treated with radical cystectomy at Ghent University Hospital.
MAIN MEASURES:: The interviews were audiotaped and transcribed verbatim. Framework analysis with constant comparison between and within interviews was applied until final topics were derived from interpreting the data.
RESULTS:: Physical activity behavior in patients with bladder cancer is determined multifactorial with condition-related (e.g. urinary symptoms, comorbidities), therapy-related (e.g. fatigue, diarrhea), patient-related (e.g. outcome expectations, coping skills, definitions of physical activity), social/economic-related (e.g. social support, attractive environment) and health system-related (e.g. physicians' advice, information) factors.
CONCLUSION:: The results of this study can guide the development of theory-based behavior change interventions to increase physical activity in bladder cancer patients.

PMID: 30514109 [PubMed - as supplied by publisher]

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Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study.

Web-based physiotherapy for people affected by multiple sclerosis: a single blind, randomized controlled feasibility study.

Clin Rehabil. 2018 Dec 04;:269215518817080

Authors: Paul L, Renfrew L, Freeman J, Murray H, Weller B, Mattison P, McConnachie A, Heggie R, Wu O, Coulter EH

Abstract
OBJECTIVE:: To examine the feasibility of a trial to evaluate web-based physiotherapy compared to a standard home exercise programme in people with multiple sclerosis.
DESIGN:: Multi-centre, randomized controlled, feasibility study.
SETTING:: Three multiple sclerosis out-patient centres.
PARTICIPANTS:: A total of 90 people with multiple sclerosis (Expanded Disability Status Scale 4-6.5).
INTERVENTIONS:: Participants were randomized to a six-month individualized, home exercise programme delivered via web-based physiotherapy ( n = 45; intervention) or a sheet of exercises ( n = 45; active comparator).
OUTCOME MEASURES:: Outcome measures (0, three, six and nine months) included adherence, two-minute walk test, 25 foot walk, Berg Balance Scale, physical activity and healthcare resource use. Interviews were undertaken with 24 participants and 3 physiotherapists.
RESULTS:: Almost 25% of people approached agreed to take part. No intervention-related adverse events were recorded. Adherence was 40%-63% and 53%-71% in the intervention and comparator groups. There was no difference in the two-minute walk test between groups at baseline (Intervention-80.4(33.91)m, Comparator-70.6(31.20)m) and no change over time (at six-month Intervention-81.6(32.75)m, Comparator-74.8(36.16)m. There were no significant changes over time in other outcome measures except the EuroQol-5 Dimension at six months which decreased in the active comparator group. For a difference of 8(17.4)m in two-minute walk test between groups, 76 participants/group would be required (80% power, P > 0.05) for a future randomized controlled trial.
CONCLUSION:: No changes were found in the majority of outcome measures over time. This study was acceptable and feasible by participants and physiotherapists. An adequately powered study needs 160 participants.

PMID: 30514108 [PubMed - as supplied by publisher]

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Homozygous missense mutation L673P in adenylate kinase 7 (AK7) leads to primary male infertility and multiple morphological anomalies of the flagella but not to primary ciliary dyskinesia.

Homozygous missense mutation L673P in adenylate kinase 7 (AK7) leads to primary male infertility and multiple morphological anomalies of the flagella but not to primary ciliary dyskinesia.

Hum Mol Genet. 2018 Dec 05;:

Authors: Lorès P, Coutton C, Khouri EE, Stouvenel L, Givelet M, Thomas L, Rode B, Schmitt A, Louis B, Sakheli Z, Chaudhry M, Fernandez-Gonzales A, Mitsialis A, Dacheux D, Wolf JP, Papon JF, Gacon G, Escudier E, Arnoult C, Bonhivers M, Savinov SN, Amselem S, Ray PF, Dulioust E, Touré A

PMID: 30517620 [PubMed - as supplied by publisher]

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Identification and partial characterization of a novel serpin from Eudiplozoon nipponicum (Monogenea, Polyopisthocotylea).

Identification and partial characterization of a novel serpin from Eudiplozoon nipponicum (Monogenea, Polyopisthocotylea).

Parasite. 2018;25:61

Authors: Roudnický P, Vorel J, Ilgová J, Benovics M, Norek A, Jedličková L, Mikeš L, Potěšil D, Zdráhal Z, Dvořák J, Gelnar M, Kašný M

Abstract
BACKGROUND: Serpins are a superfamily of serine peptidase inhibitors that participate in the regulation of many physiological and cell peptidase-mediated processes in all organisms (e.g. in blood clotting, complement activation, fibrinolysis, inflammation, and programmed cell death). It was postulated that in the blood-feeding members of the monogenean family Diplozoidae, serpins could play an important role in the prevention of thrombus formation, activation of complement, inflammation in the host, and/or in the endogenous regulation of protein degradation.
RESULTS: In silico analysis showed that the DNA and primary protein structures of serpin from Eudiplozoon nipponicum (EnSerp1) are similar to other members of the serpin superfamily. The inhibitory potential of EnSerp1 on four physiologically-relevant serine peptidases (trypsin, factor Xa, kallikrein, and plasmin) was demonstrated and its presence in the worm's excretory-secretory products (ESPs) was confirmed.
CONCLUSION: EnSerp1 influences the activity of peptidases that play a role in blood coagulation, fibrinolysis, and complement activation. This inhibitory potential, together with the serpin's presence in ESPs, suggests that it is likely involved in host-parasite interactions and could be one of the molecules involved in the control of feeding and prevention of inflammatory responses.

PMID: 30516130 [PubMed - in process]

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Treatment of canine sarcoptic mange with afoxolaner (NexGard®) and afoxolaner plus milbemycin oxime (NexGard Spectra®) chewable tablets: efficacy under field conditions in Portugal and Germany.

Treatment of canine sarcoptic mange with afoxolaner (NexGard®) and afoxolaner plus milbemycin oxime (NexGard Spectra®) chewable tablets: efficacy under field conditions in Portugal and Germany.

Parasite. 2018;25:63

Authors: Hampel V, Knaus M, Schäfer J, Beugnet F, Rehbein S

Abstract
The efficacy of NexGard® and NexGard Spectra® against sarcoptic mange in dogs was evaluated in a clinical field study. Skin scrapings from dogs presenting signs suggestive of sarcoptic mange were examined to confirm infestation. A total of 106 dogs were screened at eight sites in Portugal and Germany. In all, 80 dogs that had demonstrated ≥5 live Sarcoptes mites in five skin scrapings were enrolled, scored for specific clinical signs (pruritus; papules and crusts; alopecia), and allocated at random to receive either NexGard® or NexGard Spectra® twice, one month apart per label instructions. To determine efficacy, live Sarcoptes mites in five skin scrapings per dog were counted, and clinical signs were scored one month and two months after first treatment and compared to pre-treatment (baseline) values. Based on compliance, 65 dogs were determined to be evaluable cases at the end of the study. The efficacy, in terms of reduction of geometric mean live Sarcoptes mite counts, was 98.9% and 99.7% for NexGard®-treated (n = 38) and 99.6% and 100% for NexGard Spectra®-treated dogs (n = 27) at one month and two months after treatment initiation (p < 0.001, both treatments). Both treatments resulted in a significant improvement in pruritus, papules and crusts, and alopecia one month and two months after treatment initiation (p = 0.0001, both treatments). In conclusion, this field study confirms that both NexGard® and NexGard Spectra® administered twice one month apart provide an effective and safe treatment against sarcoptic mange in dogs.

PMID: 30516132 [PubMed - in process]

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Recombinant α- and β-tubulin from Echinococcus granulosus: expression, purification and polymerization.

Recombinant α- and β-tubulin from Echinococcus granulosus: expression, purification and polymerization.

Parasite. 2018;25:62

Authors: Liu C, Yao J, Yin J, Xue J, Zhang H

Abstract
Echinococcosis, which causes a high disease burden and is of great public health significance, is caused by the larval stage of Echinococcus species. It has been suggested that tubulin is the target of benzimidazoles, the only drugs for the treatment of echinococcosis. This study evaluated the characteristics of tubulins from Echinococcus granulosus. The full-length cDNAs of E. granulosus α- and β-tubulin isoforms were cloned by reverse transcription PCR from protoscolex RNA. Then, these two tubulin isoforms (α9 and β4) were recombinantly expressed as insoluble inclusion bodies in Escherichia coli. Nickel affinity chromatography was used to purify and refold the contents of these inclusion bodies as active proteins. The polymerization of tubulins was monitored by UV spectrophotometry (A350) and confirmed by confocal microscopy and transmission electron microscopy (TEM). Nucleotide sequence analysis revealed that E. granulosus 1356 bp α9-tubulin and 1332 bp β4-tubulin encode corresponding proteins of 451 and 443 amino acids. The average yields of α9- and β4-tubulin were 2.0-3.0 mg/L and 3.5-5.0 mg/L of culture, respectively. Moreover, recombinant α9- and β4-tubulin were capable of polymerizing into microtubule-like structures under appropriate conditions in vitro. These recombinant tubulins could be helpful for screening anti-Echinococcus compounds targeting the tubulins of E. granulosus.

PMID: 30516131 [PubMed - in process]

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A National Bowel Cancer Screening Programme using FIT: Achievements and challenges.

A National Bowel Cancer Screening Programme using FIT: Achievements and challenges.

Cancer Prev Res (Phila). 2018 Dec 04;:

Authors: O'Donoghue DP, Sheahan K, MacMathuna P, Stephens RB, Fenlon H, Morrin M, Mooney J, Fahy L, Mooney T, Smith A

Abstract
Colorectal Cancer (CRC) accounts for 11% of all cancer deaths in Ireland. With the aim of diagnosing these cancers at an earlier stage, and detecting pre-malignant lesions, the National Screening Service offered a Faecal Immunochemical Test (FIT) to all individuals aged 60-69. All individuals in the age range were contacted by post and invited to participate in the programme. Those with a positive FIT result were offered a colonoscopy in an internationally accredited unit. From an eligible population of 488,628, 196,238 individuals participated giving an uptake of 40.2%. Commencing at a FIT threshold of 20µg Hg/g faeces, the positivity rate was 8.6% which overwhelmed colonoscopy capacity and thus the threshold was increased to 45µg resulting in an overall 5% positivity rate. 520 individuals had cancer detected, (68.3% stage I or II) of which 104 were removed endoscopically (pT1s). Adenomas were present in 54.2% of all colonoscopies, 17.4% deemed high risk. Despite a lower uptake, males were twice as likely to have CRCs as females and had a 59% increased rate of high risk adenomas diagnosed. Challenges facing the programme include increasing participation, especially amongst males, and increasing colonoscopy capacity. The ability to alter the sensitivity of FIT to match colonoscopy capacity is a valuable option for such a programme as it ensures that the maximum public health benefit can be achieved within available resources.

PMID: 30514807 [PubMed - as supplied by publisher]

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"Plast Reconstr Surg"[jour]; +21 new citations

21 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Plast Reconstr Surg"[jour]

These pubmed results were generated on 2018/12/06

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UBTF Mutation Causes Complex Phenotype of Neurodegeneration and Severe Epilepsy in Childhood.

UBTF Mutation Causes Complex Phenotype of Neurodegeneration and Severe Epilepsy in Childhood.

Neuropediatrics. 2018 Dec 05;:

Authors: Sedláčková L, Laššuthová P, Štěrbová K, Haberlová J, Vyhnálková E, Neupauerová J, Staněk D, Šedivá M, Kršek P, Seeman P

Abstract
INTRODUCTION:  Neurodegenerative diseases of childhood present with progressive decline in cognitive, social, and motor function and are frequently associated with seizures in different stages of the disease. Here we report a patient with severe progressive neurodegeneration with drug-resistant epilepsy of unknown etiology from the age of 2 years.
METHODS AND RESULTS:  Using whole exome sequencing, we found heterozygous missense de novo variant c.628G > A (p.Glu210Lys) in the UBTF gene. This variant was recently described as de novo in 11 patients with similar neurodegeneration characterized by developmental decline initially confined to motor development followed by language regression, appearance of an extrapyramidal movement disorder, and leading to severe intellectual disability. In 3 of the 11 patients described so far, seizures were also present.
CONCLUSIONS:  Our report expands the complex phenotype of neurodegeneration associated with the c.628G > A variant in the UBTF gene and helps to clarify the relation between this one single recurrent pathogenic variant described in this gene to date and its phenotype. The UBTF gene should be considered a novel candidate gene in neurodegeneration with or without epilepsy.

PMID: 30517966 [PubMed - as supplied by publisher]

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Differences in video head impulse test gains from right versus left or outward versus inward head impulses.

Differences in video head impulse test gains from right versus left or outward versus inward head impulses.

Laryngoscope. 2018 Dec 04;:

Authors: Park JW, Kim TS, Cha EH, Kang BC, Park HJ

Abstract
OBJECTIVE: To investigate the effect of the right/left and outward/inward head impulses on video head impulse test (vHIT) gains.
METHODS: Video head impulse test gains were calculated by recording the right eye movements with an infrared camera in a cohort of 24 healthy subjects (26-39 years old, 30 ± 9 years old). We compared the vHIT gains in four different situations in which the right and left lateral semicircular canals (LSCC) were stimulated through outward or inward head impulses.
RESULTS: The vHIT gains from stimulating the right LSCC were significantly larger than those stimulating the left LSCC, regardless of whether the head impulse was outward or inward (1.06 ± 0.1 by right outward vs. 0.98 ± 0.08 by left outward, P = 0.003; 1.02 ± 0.1 by right inward vs. 0.92 ± 0.07 by left inward, P < 0.0001). The mean difference in vHIT gain between stimulating the right or left LSCC was 0.09. The gains from outward vHITs were significantly larger than those from the inward tests, regardless of the LSCC side stimulated (1.06 ± 0.1 from right outward vs. 1.02 ± 0.1 from right inward, both stimulating the right LSCC, P = 0.013; 0.98 ± 0.08 from left outward vs. 0.92 ± 0.07 from left inward, both stimulating the left LSCC, P = 0.001). The mean difference in the vHIT gains between the outward and inward tests was 0.05.
CONCLUSION: The right/left vHIT gain difference (0.09) is higher than the outward/inward vHIT gain difference (0.05). These are independently significant differences when using a vHIT system, which records movements in the right eye. An understanding of these differences may be helpful when interpreting vHIT results.
LEVEL OF EVIDENCE: 4. Laryngoscope, 2018.

PMID: 30515834 [PubMed - as supplied by publisher]

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Is acupuncture effective in reducing overall symptomatology in chronic rhinosinusitis?

Is acupuncture effective in reducing overall symptomatology in chronic rhinosinusitis?

Laryngoscope. 2018 Dec 04;:

Authors: Jin AJ, Chin CJ

PMID: 30515831 [PubMed - as supplied by publisher]

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Ertapenem - a potent treatment for clinical and quality of life improvement in patients with hidradenitis suppurativa- Reply.

Ertapenem - a potent treatment for clinical and quality of life improvement in patients with hidradenitis suppurativa- Reply.

Int J Dermatol. 2018 Dec 04;:

Authors: Lyons AB, Parks-Miller A, Zubair R, Hamzavi IH

PMID: 30515760 [PubMed - as supplied by publisher]

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[The Mini-Audio-Test (MAT) - a screening method on hearing impairment to be used by general practitioners and specialized physicians].

[The Mini-Audio-Test (MAT) - a screening method on hearing impairment to be used by general practitioners and specialized physicians].

Laryngorhinootologie. 2018 Dec 05;:

Authors: Löhler J, Lehmann M, Segler V, Volkenstein S, Battmer RD, Ernst A, Gräbner F, Schlattmann P, Schönweiler R, Wollenberg B, Dazert S

Abstract
BACKGROUND: In Germany, about 15 million people are suffering from hearing loss (HL), whereas only 16 % are using hearing aids. Untreated hearing loss may lead to severe complications (e. g. social isolation, depression, progress of dementia). An early and widespread screening, beginning at the age of 50, is meant to improve this shortage in medical care. By this study, the Mini-Audio-Test (MAT), a six-question and three-step answers containing questionnaire on subjective HL, should be verified on a normal collective of subjects (sensitivity (Se), specificity (Sp), positive predictive value (Ppv)).
METHODS: 943 subjects (older 50 years) without any history of ear disease answered the MAT and received pure-tone audiometry. The Se, Sp, and Pv to detect a relevant HL with the MAT for the age-group < 60 years (AG1) and ≥ 60 years (AG2) were determined.
RESULTS: The Se for AG1 was 0.66, the Sp 0.61, the Ppv 0.60, for AG2 the Se was 0.47, the Sp 0.80, the Ppv 0,89.
CONCLUSION: Following our results, the MAT is recommended as a general screening-tool for HL in patients over 50 years of age for general practitioners. Hereby, severe secondary diseases (loss of cognitive power, risk of fall, depression, dementia) could be influenced positively.

PMID: 30517967 [PubMed - as supplied by publisher]

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Use of bovine pericardium for the treatment of anterior iatrogenic glottic web.

Use of bovine pericardium for the treatment of anterior iatrogenic glottic web.

Laryngoscope. 2018 Dec 04;:

Authors: Zapater E, Oishi N, Arribas M, Hernández R, López I, Basterra J

PMID: 30515833 [PubMed - as supplied by publisher]

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Thick nails, plantar keratoderma, follicular hyperkeratosis, and leukokeratosis associated with a novel mutation in KRT6A gene.

Thick nails, plantar keratoderma, follicular hyperkeratosis, and leukokeratosis associated with a novel mutation in KRT6A gene.

Int J Dermatol. 2018 Dec 04;:

Authors: Tous-Romero F, Vico-Alonso C, Calleja-Algarra A, Sánchez-Calvín MT, Palencia-Pérez S

PMID: 30515758 [PubMed - as supplied by publisher]

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Notch dysregulation and HS: let's talk about Numb.

Notch dysregulation and HS: let's talk about Numb.

Br J Dermatol. 2018 Dec 04;:

Authors: Marasca C, Scala E, Di Caprio R, Raimondo A, Cacciapuoti S, Balato A, Fabbrocini G

Abstract
We read with great interest the article by J. W. Frew regarding Notch Dysregulation as an Epiphenomenon in Inflammatory Skin Diseases.1 The paper pointed out some controversies among Notch activity and keratinocyte proliferation as well as maturation in Hidradenitis Suppurativa (HS), Psoriasis, Atopic Dermatitis and Lichen Planus. Because of a recognized involvement of Notch in HS, but at the same time still not clear, we also explored other components of the same signalling. This article is protected by copyright. All rights reserved.

PMID: 30515753 [PubMed - as supplied by publisher]

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Incidence of Traumatic Brain Injury in the U.S. Military, 2010-2014.

Incidence of Traumatic Brain Injury in the U.S. Military, 2010-2014.

Mil Med. 2018 Dec 04;:

Authors: Agimi Y, Regasa LE, Stout KC

Abstract
Introduction: Traumatic brain injury (TBI) is a significant health issue that affects U.S. military service members (SM) at home and in combat deployments. We estimated the TBI incidence rate in the deployed and non-deployed setting between 2010 and 2014 and identified subgroups with elevated rates for prevention efforts.
Methods: Retrospective population-based study of all active duty U.S. military SM that sustained a first active duty TBI diagnosis between January 2010 and December 2014 collected and analyzed in 2017. Using Armed Forces Health Surveillance Branch data we calculated the Mantel-Haenszel (MH) standardized TBI incidence rate in the deployed and non-deployed setting, adjusting for service and demographic factors.
Results: From 2010 to 2014, the MH standardized incidence rate for deployed SMs was 3,265 TBIs per 100 thousand p-yrs (95% CI: 3,222-3,307) and 1,705.2 (95% CI: 1,694.0-1,716.5) for non-deployed SMs. The youngest deployed male Army soldiers, those ages 17-24, especially White and Hispanic soldiers, had the highest TBI incidence rate (IR) of 5,748.7 (95% CI: 5,585.8-5,916.4) and 5,010.3 (95% CI: 4,647.5-5,401.4), respectively. The IR for all branches was 1,972.6 (95% CI: 1,959.5-1,985.7) and 724.0 (95% CI: 714.9-733.0) for Reserve/Guard Service members.
Conclusions: Across all years, Marines and Army Soldiers experience the highest rates of injury with deployed SMs having elevated IRs of TBI. The TBI IR among deployed SMs was 91% higher than among those in the non-deployed setting, due to continued exposures to combat. Deployed Reserve/Guard component SMs seem to have an above average rate, a finding with implications for training and prevention.

PMID: 30517721 [PubMed - as supplied by publisher]

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Uncertain diagnosis and prognosis in advanced melanoma: A qualitative study of the experiences of bereaved carers in a time of immune and targeted therapies.

Uncertain diagnosis and prognosis in advanced melanoma: A qualitative study of the experiences of bereaved carers in a time of immune and targeted therapies.

Br J Dermatol. 2018 Dec 04;:

Authors: Fox JA, Langbecker D, Rosenberg J, Ekberg S

Abstract
BACKGROUND: Recent advances in advanced melanoma therapies are associated with improved survival for some patients. How patients with diagnoses of advanced disease and their carers experience this expanding treatment paradigm, however, is not well understood.
OBJECTIVES: We explored bereaved carers' accounts of the trajectory of advanced melanoma involving treatment by immune or targeted therapies to build an understanding of their experiences of care relating to diagnosis and prognosis.
METHODS: A qualitative exploratory design, using methods drawn from grounded theory was adopted. Analyses drew on in-depth interviews with 20 bereaved carers from three metropolitan melanoma treatment centres in Australia. A flexible interview guide and a structured approach of concurrent data collection and analysis were applied.
RESULTS: Carers described qualities of the experience including the shock of diagnosis after a sometimes-innocuous presentation with vague symptoms. They reported an unclear prognosis with complexity arising from interplay between an uncertain disease trajectory and often ambiguous expectations of outcomes of emerging immune and targeted therapies. Uncertainty dominated carers' experiences, increasing the complexity of care planning.
CONCLUSIONS: Effective communication of an advanced melanoma diagnosis and prognosis is critical. Recognition of the uncertainty inherent in the benefit of immune and targeted therapies in a constructive manner may facilitate more timely and effective care planning conversations between patients, carers and medical specialists. This article is protected by copyright. All rights reserved.

PMID: 30515757 [PubMed - as supplied by publisher]

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The illusion of conventional histological resection margin control.

The illusion of conventional histological resection margin control.

Br J Dermatol. 2018 Dec 04;:

Authors: van Delft LCJ, Nelemans PJ, van Loo E, Abdul Hamid M, Kelleners-Smeets NWJ

Abstract
An advantage of surgical treatment for basal cell carcinoma (BCC) over other therapeutic options is the possibility of histological margin control. The general understanding is that only 1-2% of the actual margins are checked histologically using the 'bread loaf' or step sectioning technique for conventional excision specimens, but the percentage of resection margins that are microscopically evaluated have not actually been quantified to date. [1, 2] This study's objective was to calculate the mean percentage of resection margins of BCC excision specimens that is histologically evaluated. This article is protected by copyright. All rights reserved.

PMID: 30515776 [PubMed - as supplied by publisher]

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"Clin Nucl Med"[jour]; +29 new citations

29 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Clin Nucl Med"[jour]

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Dementia care model: Promoting personhood through co-production.

Dementia care model: Promoting personhood through co-production.

Arch Gerontol Geriatr. 2018 Nov 16;81:59-73

Authors: Bosco A, Schneider J, Coleston-Shields DM, Orrell M

Abstract
BACKGROUND: Despite robust evidence on its effectiveness, current approaches that aspire to person-centred care (PCC) frequently locate people with dementia as passive recipients rather than as active agents in the care process. We define active involvement in care as 'co-production'. In order to investigate co-production, we set out to review the evidence concerning personhood and dignity in dementia care.
METHOD: We adopted a meta-ethnographic approach to synthesise the predominantly- qualitative literature on personhood and dignity in dementia care using EMBASE, PsycINFO, and ASSIA databases. We also included relevant policy documents. Members of Patient and Public Involvement (PPI) group were consulted throughout.
RESULTS: A total of 14 empirical studies were subjected to content analysis. Three themes were identified: dignity and personhood, coping with dementia, and barriers to dignity in care. The findings suggest that positive strategies and coping mechanisms are associated with superior outcomes in relation to: sense of self, dignity and quality of care. The 22 policy documents yielded six themes pertaining to co-production: the part played by the person with dementia, family, environment, behaviour, governance and law, and health care partnership.
CONCLUSION: Personhood in dementia care is enhanced through co-production, by actively participating in social, civic and political life. This is promoted through behavioural changes at the micro and macro levels of society, including providers of care being trained in co-producing care and policy makers creating opportunities with, rather than for people with dementia.

PMID: 30517898 [PubMed - as supplied by publisher]

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Simulation Training for Operational Medicine Providers (STOMP): Impact of a Comprehensive Skills-Based Curriculum for Military General Medical Officers.

Simulation Training for Operational Medicine Providers (STOMP): Impact of a Comprehensive Skills-Based Curriculum for Military General Medical Officers.

Mil Med. 2018 Dec 04;:

Authors: Spooner MT, Alex JE, Greer JA, Delorey DR, Kiser RA, Petersen C, Polk T, Gunzelman K

Abstract
Introduction: A standardized training curriculum designed for general medical officers (GMO) titled Simulation Training for Operational Medicine Providers (STOMP) was recently developed to educate and improve GMOs' procedural skills through directed feedback prior to assuming duties in an operational environment. This study aimed to determine the impact this novel curriculum had on GMOs'confidence levels in 21 core privileges covering eight different subspecialties while stationed at Naval Medical Center Portsmouth (NMCP).
Materials and Methods: A cohort study from 2015 to 2017 was designed to address our specific aim to examine if the implementation of the STOMP curriculum increased GMOs' confidence levels. Fifty-seven participants enrolled in the study. The GMO case group completed the STOMP curriculum (n = 22), while the control or GMO self-study group (n = 35) did not complete the curriculum. Six months after starting clinical practice at NMCP, both groups completed an online survey that assessed their confidence level in performing each core privilege using a 5-point Likert scale. Scores were analyzed using a Wilcoxon Mann-Whitney test. Research data were derived from an approved Naval Medical Center, Portsmouth, Virginia IRB, protocol number: NMCP.2016.0010.
Results: Participants demonstrated a statistically significant increase in self-rated confidence scores (p < 0.05) in nine core privilege skills: punch biopsy, shave biopsy, excisional biopsy, removal of otic foreign body, removal of nasal foreign body, removal of ocular foreign body, tonometry, incision and drainage of a thrombosed hemorrhoid, and reduction of simple closed fractures and dislocations.
Conclusions: These findings suggest that a novel and recently developed standardized simulation training curriculum entitled STOMP improves the confidence levels of early career physicians' in several primary care procedural skills and is an ideal adjunct to traditional lecture-based teaching prior to independent practice in a primary care environment.

PMID: 30517692 [PubMed - as supplied by publisher]

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Self-targeted knockdown of CD44 improves cisplatin sensitivity of chemoresistant non-small cell lung cancer cells.

Self-targeted knockdown of CD44 improves cisplatin sensitivity of chemoresistant non-small cell lung cancer cells.

Cancer Chemother Pharmacol. 2018 Dec 04;:

Authors: Quan YH, Lim JY, Choi BH, Choi Y, Choi YH, Park JH, Kim HK

Abstract
BACKGROUND: Chemoresistance remains a major challenge for effective chemotherapy of non-small-cell lung carcinoma (NSCLC). CD44 expression is related to the susceptibility of various cancer cell types to anticancer drugs. Here, we systematically investigated the CD44-dependent chemoresistance of NSCLC cells and developed a liposomal siRNA delivery system to overcome this chemoresistance by the self-targeted downregulation of CD44.
METHODS: We confirmed the relationship between the expression of CD44 and the chemosensitivity of NSCLC cells using flow cytometry and MTT assay. We then generated and characterized cisplatin-resistant cell lines and compared the expression of CD44 in resistant cells to that in parental cells using western blotting. To evaluate whether the chemosensitivity of resistant cells depends on CD44 expression, we performed CD44 knockdown using CD44 siRNA and detected the chemosensitivity of these cells. Additionally, we prepared hyaluronic acid (HA)-coated liposomes as a targeted delivery system to selectively deliver CD44-specific siRNA to chemoresistant NSCLC cells and observed whether the chemosensitivity of these cells was improved.
RESULTS: We found that CD44 expression is inversely proportional to the degree of cellular response to cisplatin chemotherapy and that CD44 is overexpressed in chemoresistant NSCLC cells. By performing CD44 knockdown using siRNA, we reconfirmed that the chemosensitivity of resistant cells depends on CD44 expression. We also observed that HA-liposome-mediated siRNA delivery prior to cisplatin chemotherapy significantly reduced CD44 expression and enhanced cisplatin sensitivity in chemoresistant NSCLC cells.
CONCLUSIONS: These results suggest that self-targeted downregulation of chemoresistance-associated cell surface proteins during chemotherapy is an effective therapeutic strategy for overcoming the chemoresistance of NSCLC cells.

PMID: 30515553 [PubMed - as supplied by publisher]

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Response to the Letter by Weisman et al on: Twenty Thousand Needles Under the Sea: Trigger Point Dry Needling Aboard an Israeli Navy Submarine. A Case Report.

Response to the Letter by Weisman et al on: Twenty Thousand Needles Under the Sea: Trigger Point Dry Needling Aboard an Israeli Navy Submarine. A Case Report.

Mil Med. 2018 Dec 04;:

Authors: Ronel D, Gabbay O, Esterson A, Brand R, Vulfsons S

PMID: 30517683 [PubMed - as supplied by publisher]

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Inertial Sensor-Based Assessment of Central Sensory Integration for Balance After Mild Traumatic Brain Injury: Corrigendum.

Inertial Sensor-Based Assessment of Central Sensory Integration for Balance After Mild Traumatic Brain Injury: Corrigendum.

Mil Med. 2018 Dec 04;:

Authors:

PMID: 30517673 [PubMed - as supplied by publisher]

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A Cluster of Exertional Rhabdomyolysis Cases in an ROTC Program Engaged in an Extreme Exercise Program: Corrigendum.

A Cluster of Exertional Rhabdomyolysis Cases in an ROTC Program Engaged in an Extreme Exercise Program: Corrigendum.

Mil Med. 2018 Dec 04;:

Authors:

PMID: 30517717 [PubMed - as supplied by publisher]

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Return to Duty Following Open Reduction and Internal Fixation of Unstable Ankle Fractures in the Active Duty Population.

Return to Duty Following Open Reduction and Internal Fixation of Unstable Ankle Fractures in the Active Duty Population.

Mil Med. 2018 Dec 04;:

Authors: Johnson JD, Chachula LA, Bickley RJ, Anderson CD, Ryan PM

Abstract
Introduction: Literature on functional outcomes after ankle surgery is for the most part limited to return to sport studies. The purpose of this study was to determine occupational and functional outcomes following operative treatment of unstable ankle fractures in the active duty military population.
Materials and Methods: All ankle fractures treated with open reduction internal fixation at a single institution from 2013 to 2015 were reviewed. Inclusion criteria included active duty personnel with a single-sided injury requiring operative management. All patients had a minimum of 6 months follow-up. Forty-seven records were reviewed with 43 patients fitting these criteria. Patients were predominantly male (91%) with an average age of 26 years at the time of fracture. Functional outcomes were evaluated using AOFAS and SANE scores. Occupational outcomes were determined in reference to a service member's ability to return to full duty.
Results: Of the 43 subjects, 81% (n = 35) returned to active duty. Of the eight individuals who did not return to active duty, six were medically boarded out of the military. Looking at demographic, surgical, and functional variables, only the SANE and AFAOS scores functional outcomes showed a significant correlation with individual return to duty. Individuals who reported less pain and increased functional outcomes had increased return to duty rates.
Conclusion: This study sought to determine predictors for return to duty within an active duty military population after ORIF of unstable ankle fractures. Given the paucity of military literature on this subject, the end goal was to provide realistic recovery expectations for both injured service members and their command teams. Overall, 81% of patients were able to return to active duty following operative treatment of unstable ankle fractures. There were no associations found between age, gender, military rank, or fracture patterns and return to duty.

PMID: 30517675 [PubMed - as supplied by publisher]

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Omitting the lower neck and sparing the glottic larynx in node-negative nasopharyngeal carcinoma was safe and feasible, and improved patient-reported voice outcomes.

Omitting the lower neck and sparing the glottic larynx in node-negative nasopharyngeal carcinoma was safe and feasible, and improved patient-reported voice outcomes.

Clin Transl Oncol. 2018 Dec 04;:

Authors: Xiao F, Dou S, Li Y, Qian W, Liang F, Kong L, Wang X, Wu K, Hu C, Zhu G

Abstract
BACKGROUND: Worsening voice and speech quality was frequently reported in head-and-neck patients after radiotherapy to the neck; omitting the lower neck and sparing the glottic larynx in node-negative nasopharyngeal carcinoma (NPC) patients might be safe and feasible, and improve voice and speech outcomes.
METHODS: From January 2009 to January 2013, 71 patients were analyzed. All patients received bilateral neck irradiation. Upper group (UG) patients spared the glottic larynx while lower group (LG) patients did not. Voice and speech quality were evaluated at two time-points (T1 and T2) using the Communication Domain of the Head and Neck Quality of Life (HNQOL) instrument and the Speech question of the University of Washington Quality of Life instrument.
RESULTS: At a median follow-up time of 32 months (T1),71.6% of patients reported worsened voice and speech quality. UG patients resulted in significant decreases in glottic larynx dose. With a median follow-up time of 71 months (T2), no patients experienced out-of-field nodal recurrence;there was no difference in the 5-year overall survival and nodal recurrence-free survival between two groups (P = 0.235 and 0.750, respectively). At T1, in patients who without concurrent chemotherapy (CCT), UG patients showed significantly better patient-reported voice quality, (P = 0.022). UG patients without CCT also showed higher scores in the HNQOL communication domain and pain domain (P = 0.012 and P = 0.019).
CONCLUSIONS: For node-negative NPC patients, omitting the lower neck and sparing the glottic larynx was safe and feasible, and better voice outcomes were achieved in patients without CCT. Further prospective longitudinal studies to investigate whether this approach would be beneficial to node-negative patients are warranted.

PMID: 30515646 [PubMed - as supplied by publisher]

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