The Scientific World Journal
The Process of Separating Bovine Serum Albumin Using Hydroxyapatite and Active Babassu Coal (Orbignya martiana)
Márcia Regina Ribeiro Alves, Abraham Damian Giraldo Zuñiga, Rita De Cássia Superbi Sousa, And Carmelita Zacchi Scolforo · Tuesday, June 07, 2016, 14:47
Bovine serum albumin is one of the major serum proteins; it plays an important role as a result of its functional and nutritional properties which have bioactive peptides. Adsorption method was used to separate protein, which involves hydroxyapatite, synthetic hydroxyapatite, and active babassu coal. Initially, characterization was carried out using the zeta potential of the adsorbents. Kinetic pseudo-first- and pseudo-second-order models were applied. For isotherms, equilibrium data studies were carried out using the Langmuir and Freundlich models, in addition to determining the efficiency of adsorptive process. The results of the zeta potential showed loads ranging from +6.9 to −42.8 mV. The kinetic data were better represented in the pseudo-second-order model with chemisorption characteristics. The adsorption capacity of the adsorbents decreased as pH increased, indicating that the electrostatic bonds and some functional groups of active babassu coal contributed to the reduction of adsorption, especially oxygen linked to carbon atoms. The value of pH 4.0 showed the best results of adsorption, being obtained as the maximum adsorption capacity () and yield (%) (where mg g−1 and 74.2%; 68.26 mg g−1 and 68.6%; and 36.18 mg g−1, 37.4%) of hydroxyapatite, synthetic hydroxyapatite, and active babassu coal, respectively.
Tags: Internal Medicine
Journal of Internal Medicine
HIV infection and bone disease
J. Compston · Tuesday, June 07, 2016, 7:06
Abstract
The success of antiretroviral therapy in treating HIV infection has greatly prolonged life expectancy in affected individuals, transforming the disease into a chronic condition. A number of HIV-associated non-AIDS comorbidities have emerged in the ageing HIV-infected population, including osteoporosis and increased risk of fracture. The pathogenesis of fracture is multifactorial with contributions from both traditional and HIV-specific risk factors. Significant bone loss occurs on initiation of antiretroviral therapy but stabilizes on long-term therapy. Fracture risk assessment should be performed in HIV-infected individuals and bone mineral density measured when indicated. Lifestyle measures to optimize bone health should be advised and, in individuals at high risk of fracture, treatment with bisphosphonates considered.
Tags: Internal Medicine
Annals of Internal Medicine Online First
Control of an Outbreak of Middle East Respiratory Syndrome in a Tertiary Hospital in Korea
Park G, Ko J, Peck K, Et Al. · Tuesday, June 07, 2016, 1:57
Background:
In 2015, a large outbreak of Middle East respiratory syndrome (MERS) occurred in the Republic of Korea. Half of the cases were associated with a tertiary care university hospital. Objective:
To document the outbreak and successful control measures. Design:
Descriptive study. Setting:
A 1950-bed tertiary care university hospital. Patients:
92 patients with laboratory-confirmed MERS and 9793 exposed persons. Measurements:
Description of the outbreak, including a timeline, and evaluation of the effectiveness of the control measures. Results:
During the outbreak, 92 laboratory-confirmed MERS cases were associated with a large tertiary care hospital, 82 of which originated from unprotected exposure to 1 secondary patient. Contact tracing and monitoring exposed patients and assigned health care workers were at the core of the control measures in the outbreak. Nontargeted screening measures, including body temperature screening among employees and visitors at hospital gates, monitoring patients for MERS-related symptoms, chest radiographic screening, and employee symptom monitoring, did not detect additional patients with MERS without existing transmission links. All in-hospital transmissions originated from 3 patients with MERS who also had pneumonia and productive cough. Limitations:
This was a retrospective single-center study. Statistical analysis could not be done. Because this MERS outbreak originated from a superspreader, effective control measures could differ in endemic areas or in other settings. Conclusion:
Control strategies for MERS outbreaks should focus on tracing contacts of persons with epidemiologic links. Adjusting levels of quarantine and personal protective equipment according to the assumed infectivity of each patient with MERS may be appropriate. Primary Funding Source:
Samsung Biomedical Research Institute.
Tags: Internal Medicine
Annals of Internal Medicine Online First
Suicide Rates and Methods in Active Duty Military Personnel, 2005 to 2011 A Cohort Study
Anglemyer A, Miller Ml, Buttrey S, Et Al. · Tuesday, June 07, 2016, 1:57
Background:
Suicide prevention programs have become ubiquitous among military units; identifying temporal trends and nonclinical factors associated with the chosen suicide methods may help improve suicide prevention strategies. Objective:
To calculate suicide rates of active duty military personnel and identify those who are at risk for firearm-specific suicide. Design:
Retrospective cohort study. Setting:
Military units in the United States. Patients:
All active duty enlisted U.S. military personnel from 2005 to 2011. Measurements:
Suicide rates per 100 000 were calculated for each branch. Adjusted odds ratios for firearm-specific suicide were calculated with 95% CIs. Results:
1455 military personnel committed suicide from 2005 to 2011. From 2006 to 2011, the rates were highest among army personnel (19.13 to 29.44 cases per 100 000). Among suicides with a known cause of death, 62% were attributed to firearms. The results of this study also suggest that among army personnel or marines who committed suicide, those with infantry or special operations job classifications were more likely than those in noninfantry positions to use a firearm. Limitations:
Results are generalizable only to enlisted personnel and reflect only stateside suicides. Data regarding previous psychiatric illness, deployment history, and firearms ownership were lacking. Conclusion:
These results may help inform policymakers and advisors about differences in risks of suicide and violent suicide among the armed services and may help guide efforts to prevent self-harm within the military. Primary Funding Source:
None.
Tags: Internal Medicine
Annals of Internal Medicine Online First
Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement A Systematic Review and Meta-analysis
Gargiulo G, Sannino A, Capodanno D, Et Al. · Tuesday, June 07, 2016, 1:57
Purpose:
To compare clinical outcomes, including early (≤30-day) and midterm (≤1-year) mortality, in adults with severe aortic stenosis undergoing either transapical aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). Data Sources:
MEDLINE, Cochrane, and Scopus databases (without language restrictions) from April 2002 to 5 April 2016; multiple registries and Web sites; scientific meeting presentations. Study Selection:
Five randomized trials and 31 observational matched studies comparing mortality outcomes after TAVI or SAVR. Data Extraction:
Two investigators independently extracted study data and rated risk of bias. Data Synthesis:
A total of 16 638 patients were analyzed. Overall, there was no statistically significant difference between TAVI and SAVR in early (odds ratio [OR], 1.01 [95% CI, 0.81 to 1.26]) or midterm (OR, 0.96 [CI, 0.81 to 1.14]) all-cause mortality. Analyses restricted to trials (early: OR, 0.80 [CI, 0.51 to 1.25]; midterm: OR, 0.90 [CI, 0.64 to 1.26]) were inconclusive, with wide CIs, whereas analyses of matched studies were similar to the overall results. Transfemoral TAVI provided mortality benefits over SAVR in trials. Analyses restricted to studies of patients at low to intermediate risk showed statistically nonsignificant reductions in early (OR, 0.67 [CI, 0.42 to 1.07]) and midterm (OR, 0.91 [CI, 0.67 to 1.23]) mortality with TAVI. Incidence of periprocedural myocardial infarction, major bleeding, acute kidney injury, and new-onset atrial fibrillation was lower with TAVI, but risk for pacemaker implantation, vascular complications, and paravalvular leak increased. Overall, there was a statistically nonsignificant increased risk in long-term (2- to 5-year) all-cause mortality with TAVI (OR, 1.28 [CI, 0.97 to 1.69]), whereas long-term mortality outcomes in patients at low to intermediate risk were inconclusive, with wide CIs (OR, 1.06 [CI, 0.59 to 1.91]). Limitation:
The number of trials was limited, and study designs and patient characteristics were heterogeneous. Conclusion:
Compared with SAVR, TAVI may have similar or better early and midterm outcomes for adults with aortic stenosis, including those at low to intermediate risk. Primary Funding Source:
None.
Tags: Internal Medicine
Annals of Internal Medicine Online First
Using Bayesian Adaptive Trial Designs for Comparative Effectiveness Research: A Virtual Trial Execution
Luce Br, Connor Jt, Broglio Kr, Et Al. · Tuesday, June 07, 2016, 1:57
Background:
Bayesian and adaptive clinical trial designs offer the potential for more efficient processes that result in lower sample sizes and shorter trial durations than traditional designs. Objective:
To explore the use and potential benefits of Bayesian adaptive clinical trial designs in comparative effectiveness research. Design:
Virtual execution of ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) as if it had been done according to a Bayesian adaptive trial design. Setting:
Comparative effectiveness trial of antihypertensive medications. Patients:
Patient data sampled from the more than 42 000 patients enrolled in ALLHAT with publicly available data. Measurements:
Number of patients randomly assigned between groups, trial duration, observed numbers of events, and overall trial results and conclusions. Results:
The Bayesian adaptive approach and original design yielded similar overall trial conclusions. The Bayesian adaptive trial randomly assigned more patients to the better-performing group and would probably have ended slightly earlier. Limitations:
This virtual trial execution required limited resampling of ALLHAT patients for inclusion in RE-ADAPT (REsearch in ADAptive methods for Pragmatic Trials). Involvement of a data monitoring committee and other trial logistics were not considered. Conclusion:
In a comparative effectiveness research trial, Bayesian adaptive trial designs are a feasible approach and potentially generate earlier results and allocate more patients to better-performing groups.
Tags: Internal Medicine
Annals of Internal Medicine Online First
Hearing Health Care: Review of a Report From the National Academies of Sciences, Engineering, and Medicine
Blazer Dg. · Tuesday, June 07, 2016, 1:57
Hearing loss affects about 30 million persons in the United States. This public health burden is especially important because, although interventions work for many people, the unmet need for hearing health care has been estimated at between 67% and 86%. The National Academies of Sciences, Engineering, and Medicine (of which the former Institute of Medicine is now part) recently released a report on hearing health care for adults. This commentary summarizes findings and recommendations from that report that are particularly relevant for physicians.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Isolation and Expansion of Mesenchymal Stem/Stromal Cells Derived from Human Placenta Tissue
Monday, June 06, 2016, 22:14
Herein we describe methods for the dissection of fetal and maternal tissues from human term placenta, followed by isolation and expansion of mesenchymal stem/stromal cells (MSC) from these tissues.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
A Protocol for Collecting and Constructing Soil Core Lysimeters
Monday, June 06, 2016, 22:14
A detailed method for extraction and assembly of intact soil core lysimeters and their use for study of leachate and associated loss of nutrients from surface applied poultry litter is demonstrated.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Loss- and Gain-of-function Approach to Investigate Early Cell Fate Determinants in Preimplantation Mouse Embryos
Monday, June 06, 2016, 20:14
The goal of this protocol is to describe a loss- and gain-of function method that is applicable to identify neogenin as a stage-specific receptor that leads to trophectoderm and inner cell mass differentiation in preimplantation mouse embryos.
Tags: Internal Medicine
The Scientific World Journal
Association between Reactive Attachment Disorder/Disinhibited Social Engagement Disorder and Emerging Personality Disorder: A Feasibility Study
Khadija Mirza, Gracia Mwimba, Rachel Pritchett, And Claire Davidson · Monday, June 06, 2016, 14:47
A systematic review of reactive attachment disorder (RAD)/disinhibited social engagement disorder (DSED) in adolescence highlighted that young people with the disorder had indiscriminate friendliness with difficulties in establishing and maintaining stable relationships. Most reported experiences of rejection. We were struck by similarities between the above and features of emergence of personality disorders (EPD). This feasibility study aimed to determine best ways of recruiting and retaining vulnerable young people and the proportion of participants with RAD/DSED who might have emerging borderline personality disorder (EBPD). Participants were referred to the study by their treating clinicians from local mental health teams. Results showed strong association between RAD/DSED and EBPD. Participant characteristics showed high levels of out of home placements, early termination of school careers, suicide attempts, quasipsychotic symptoms, and multiagency involvements. They experienced the project as an opportunity to talk about relationships and reported that they would like more of this in usual clinical contacts. They all agreed to be contacted for future studies. Previous studies have shown that early detection and treatment of emergent personality traits can alter trajectory. Future research will continue to explore these trajectories, explore detection of vulnerability factors, and evaluate interventions.
Tags: Internal Medicine
NEJM : Research
Extending Aromatase-Inhibitor Adjuvant Therapy to 10 Years
Monday, June 06, 2016, 4:02
The risk of recurrence of hormone-receptor–positive early breast cancer continues indefinitely. Long-term reduction in the risk of recurrence has been achieved with the antiestrogen agent tamoxifen, aromatase inhibitors, or a combination of the two. These treatments are administered in a variety…
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Recording Mouse Ultrasonic Vocalizations to Evaluate Social Communication
Sunday, June 05, 2016, 22:11
Mouse ultrasonic vocalizations are used as proxies to model the genetic bases of vocal communication deficits in mouse models for neuropsychiatric disorders. The present protocol describes three experimental contexts that reliably elicit ultrasonic vocalizations from pups (throughout development) and adult mice (same-sex interactions, male-estrus female interactions).
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Errors as a Means of Reducing Impulsive Food Choice
Sunday, June 05, 2016, 22:11
Giving in to temptation of tasty food may result in long-term overweight problems. This protocol describes how to reduce imprudent preference for edible commodities during hypothetical intertemporal choices in women by associating them with errors.
Tags: Internal Medicine
The Scientific World Journal
The Challenges of Nursing Students in the Clinical Learning Environment: A Qualitative Study
Nahid Jamshidi, Zahra Molazem, Farkhondeh Sharif, Camellia Torabizadeh, And Majid Najafi Kalyani · Sunday, June 05, 2016, 14:46
Background/Aim. Clinical learning is a main part of nursing education. Students’ exposure to clinical learning environment is one of the most important factors affecting the teaching-learning process in clinical settings. Identifying challenges of nursing students in the clinical learning environment could improve training and enhance the quality of its planning and promotion of the students. We aimed to explore Iranian nursing students’ challenges in the clinical learning environment. Materials and Methods. This is a qualitative study using the content analysis approach. The participants consisted of seventeen nursing students and three nursing instructors. The participants were selected through purposive sampling method and attended semistructured interviews and focus groups. Results. Three themes emerged after data analysis, including ineffective communications, inadequate readiness, and emotional reactions. Conclusion. Nursing students in Iran are faced with many challenges in the clinical learning environment. All challenges identified in this study affected the students’ learning in clinical setting. Therefore, we recommend that the instructors prepare students with a specific focus on their communication and psychological needs.
Tags: Internal Medicine
The Scientific World Journal
Recent Trends and Techniques in Computing Information Intelligence
Venkatesh Jaganathan, Balasubramanie Palanisamy, And Mariofanna Milanova ·Sunday, June 05, 2016, 14:46
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
A Rapid Strategy for the Isolation of New Faustoviruses from Environmental Samples Using Vermamoeba vermiformis
Saturday, June 04, 2016, 23:08
We describe here the latest advances in viral isolation for the characterization of new genotypes of Faustovirus, a new asfarvirus-related lineage of giant viruses. This protocol can be applied to the high throughput isolation of viruses, especially giant viruses infecting amoeba.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
RNA Purification from Intracellularly Grown Listeria monocytogenes in Macrophage Cells
Saturday, June 04, 2016, 21:08
Here we describe a method for bacterial RNA isolation from Listeria monocytogenes bacteria growing inside murine macrophages. This technique can be used with other intracellular pathogens and mammalian host cells.
Tags: Internal Medicine
ScienceDirect Publication: Medical Hypotheses
CTC immune escape mediated by PD-L1
Saturday, June 04, 2016, 12:12
Publication date: August 2016
Source:Medical Hypotheses, Volume 93
Author(s): Xuefei Wang, Qiang Sun, Qiaofei Liu, Changjun Wang, Ru Yao, Yimin Wang
Breast cancer is the most common malignant tumor in women around the world. Most breast cancer-related deaths are from CTC (circulating tumor cells) metastasis. CTC is associated with the breast cancer patients’ prognosis. But recently, circulating clusters were found and its metastasis and tumor formation ability is 23–50 times as CTC. However, its mechanism has not been clarified. These days, researchers have successfully completed CTC cluster separation, CTC cell culture, and PD-L1 was found to be related with histological grading of tumor. Meanwhile, the high expression of PD-L1 in CTC surface has also been reported. Since PD-L1 can mediate Treg to play the role of immunosuppression, we propose that CTC with positive PD-L1 is easier to connect PD-L1, immune cells (Treg regulatory T cells, MDSC bone marrow inhibitory cells) and CK cytokines etc. On one hand, Treg cells can protect CTC from being attacked by the immune system through the immunosuppression, on the other hand, they can weaken CTL killing ability and trigger more MDSC. Finally, CTC formed the metastatic lesion.
Tags: Internal Medicine
ScienceDirect Publication: Medical Hypotheses
The potential synergism by combining external counterpulsation with intermittent theta burst stimulation in post-stroke motor function recovery
Saturday, June 04, 2016, 12:12
Publication date: August 2016
Source:Medical Hypotheses, Volume 93
Author(s): Weijia He, Suk-yin Stephanie Au-Yeung, Margaret Mak, Thomas Wai Hong Leung, Howan Leung, Lawrence Ka Sing Wong
Upper limb weakness and incoordination is a common disability following ischemic stroke. Previous studies have showed that the single application of external counterpulsation (ECP) and intermittent theta burst stimulation (iTBS) can effectively enhance the cortical motor excitability and facilitate recovery. However, it remains uncertain if sequential application of these therapies would further augment the recovery. We hypothesize a synergistic effect of ECP followed by iTBS to upper limb function may happen through improvements in both cerebral perfusion and neuron excitability.
Tags: Internal Medicine
ScienceDirect Publication: Medical Hypotheses
Adipose-derived stem cells: A novel source of parathyroid cells for treatment of hypoparathyroidism
Saturday, June 04, 2016, 12:12
Publication date: August 2016
Source:Medical Hypotheses, Volume 93
Author(s): Yue Zhao, Bin Luo
Hypoparathyroidism is characterized by decreased function of the parathyroid glands with underproduction of parathyroid hormone (PTH), which can lead to low levels of calcium in the blood, often causing cramping and twitching of muscles or tetany, and several other symptoms. Severe hypocalcemia is a life-threatening condition. At present, both medical and surgical treatments are offered to improve the blood calcium, but they are not a cure. Adipose-derived stem cells (ADSCs), derived from the adipose tissue, are confirmed to be multipotent with adipogenic, chondrogenic, neurogenic, myogenic and osteogenic capabilities. Our hypothesis is that human ADSCs in culture can be differentiated into parathyroid cells, and used to reconstitute function.
Tags: Internal Medicine
Clinical Ophthalmology
Changing indications and techniques for corneal transplantations at a tertiary referral center in Turkey, from 1995 to 2014
Saturday, June 04, 2016, 11:17
Tags: Internal Medicine
Clinical Ophthalmology
The association of sleep quality with dry eye disease: the Osaka study
Saturday, June 04, 2016, 11:17
Tags: Internal Medicine
Journal of Human Evolution
Membrane–plate transition in leaves as an influence on dietary selectivity and tooth form
Saturday, June 04, 2016, 5:09
Publication date: Available online 3 June 2016
Source:Journal of Human Evolution
Author(s): Mauricio G. Talebi, Enrico A. Sala, Barbara Carvalho, Giovanna M. Villani, Peter W. Lucas, Adam van Casteren
Primates need accurate sensory signals about food quality to forage efficiently. Current evidence suggests that they target leaf foods based on color at long-range, reinforcing this with post-ingestive sensations relating to leaf toughness evoked during chewing. Selection against tough leaves effectively selects against high fiber content, which in turn gives a greater opportunity of acquiring protein. Here we consider a novel intermediate mechanical factor that could aid a folivore: leaves may transform mechanically from membranes (sheets that cannot maintain their shape under gravitational loads and thus ‘flop’) early on in development into plates (that can maintain their shape) as they mature. This transformation can be detected visually. Mechanical tests on two species of leaf eaten by southern muriqui monkeys (Brachyteles arachnoides) in Southern Atlantic Forest, Brazil, support a membrane-to-plate shift in turgid leaves during their development. A measure of this mechanical transition, termed lambda (λ), was found to correlate with both leaf color and toughness, thus supporting a potential role in leaf selection. Muriquis appear to select membranous leaves, but they also eat leaves that are plate-like. We attribute this to the degree of cresting of their molar teeth. A dietary choice restricted to membranous leaves might typify the type of ‘fallback’ leaf that even frugivorous primates will target because membranes of low toughness are relatively easily chewed. This may be relevant to the diets of hominins because these lack the bladed postcanine teeth seen in mammals with a specialized folivorous diet. We suggest that mammals with such dental adaptations can consume tougher leaf ‘plates’ than others.
Tags: Internal Medicine
Latest Results for Maternal and Child Health Journal
Erratum to: Moderate and Vigorous Intensity Exercise During Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes
Saturday, June 04, 2016, 2:52
Tags: Internal Medicine
The Kaohsiung Journal of Medical Sciences
The effects of tadalafil and pentoxifylline on apoptosis and nitric oxide synthase in liver ischemia/reperfusion injury
Friday, June 03, 2016, 23:50
Publication date: Available online 2 June 2016
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Sibel Bektas, Kemal Karakaya, Murat Can, Burak Bahadir, Berrak Guven, Nilsen Erdogan, Sukru Oguz Ozdamar
The aim of this study was to investigate the effects of tadalafil (TDF) and pentoxifylline (PTX) on hepatic apoptosis and the expressions of endothelial and inducible nitric oxide synthases (eNOS and iNOS) after liver ischemia/reperfusion (IR). Forty Wistar albino rats were randomly divided into five groups (n =8) as follows: sham group; IR group with ischemia/reperfusion alone; low-dose and high-dose TDF groups received 2.5 mg/kg and 10 mg/kg TDF, respectively; and PTX group received 40 mg/kg PTX. Blood was collected for the analysis of serum alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, uric acid, malondialdehyde (MDA), and total antioxidant capacity (TAC). MDA and TAC also were measured in liver tissue. Histopathological examination was performed to assess the severity of hepatic injury. Apoptosis was evaluated using the apoptosis protease-activating factor 1 (APAF-1) antibody; the expressions of eNOS and iNOS were also assessed by immunohistochemistry in all groups. Serum alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transferase, uric acid, MDA, and TAC, tissue MDA and TAC levels, hepatic injury, and score for extent and for intensity of eNOS, iNOS, and apoptosis protease-activating factor 1 were significantly different in TDF and PTX groups compared to the IR group. High dose-TDF and PTX have the best protective effect on IR-induced liver tissue damage. This study showed that TDF and PTX supplementation may be helpful in preventing free oxygen radical damage, lipid peroxidation, hepatocyte necrosis, and apoptosis in liver IR injury and minimizing liver damage.
Tags: Internal Medicine
The Kaohsiung Journal of Medical Sciences
Can the neutrophil-to-lymphocyte ratio be used to predict recurrence and progression of non-muscle-invasive bladder cancer?
Friday, June 03, 2016, 23:50
Publication date: Available online 2 June 2016
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Sebahattin Albayrak, Kursad Zengin, Serhat Tanik, Muhittin Atar, Serhat Haluk Unal, M. Abdurrahim Imamoglu, Mesut Gurdal
The aim of our study was to evaluate whether neutrophil-to-lymphocyte ratio (NLR) is a predictor of disease progression and recurrence in patients with primary non-muscle-invasive bladder cancer (NMIBC). This was a prospective study of 86 patients with newly diagnosed NMIBC. The patients were classified by the number of points assigned by the European Organization for Research and Treatment of Cancer risk tables. The correlation between progression score, recurrence score, age, mean platelet volume, red blood cell distribution width and NLR was assessed statistically. The same parameters were compared between the risk groups. A significant difference in NLR and age values was observed between recurrence and progression risk score groups. The relationships between NLR and recurrence and progression risk scores were no longer significant after correcting for the statistical effect of age on scores. Age was significantly different between groups after adjusting for NLR. Our study revealed that NLR and age were associated with patient age and bladder tumor progression and recurrence risk scores. After correcting for age, the significant relationship with NLR was lost, in contrast to some previous studies. We recommend that patient age should be corrected to avoid misleading results in NLR studies.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Recording Temperature-induced Neuronal Activity through Monitoring Calcium Changes in the Olfactory Bulb of Xenopus laevis
Friday, June 03, 2016, 23:05
Here we describe a protocol for measuring and analyzing temperature responses in the olfactory bulb of Xenopus laevis. Olfactory receptor neurons and mitral cells are differentially stained, after which calcium changes are recorded, reflecting a sensitivity of some neural networks in the bulb to temperature drops induced at the nose.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Epigenetic Regulation of Cardiac Differentiation of Embryonic Stem Cells and Tissues
Friday, June 03, 2016, 22:05
A fine tuning regulation of gene transcription underlies embryonic cell fate decision. Herein, we describe chromatin immunoprecipitation assays used to investigate epigenetic regulation of both cardiac differentiation of stem cells and cardiac development of mouse embryos.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Mechanism of Regulation of Adipocyte Numbers in Adult Organisms Through Differentiation and Apoptosis Homeostasis
Friday, June 03, 2016, 21:05
Adipose tissue (AT) can influence whole body homeostasis, therefore understanding the molecular mechanisms of adipocyte differentiation and function is of importance. We provide a protocol for gaining new insights into these processes by analyzing adipocyte homeostasis, differentiation and hypoxia exposure as a model for induced adipocyte apoptosis.
Tags: Internal Medicine
SpringerPlus – Latest Articles
Differentiation of the Chinese minority medicinal plant genus Berchemia spp. by evaluating three candidate barcodes
Li-cheng Guo, Ming-ming Zhao, Wei Sun, Hong-li Teng, Bi-sheng Huang And Xiang-pei Zhao · Friday, June 03, 2016, 15:51
The genus Berchemia comprises important Chinese plants with considerable medicinal value; however, these plants are often misidentified in the herbal medicinal market. To differentiate the various morphotypes of
Tags: Internal Medicine
Clinical Ophthalmology
Optical bench performance of a novel trifocal intraocular lens compared with a multifocal intraocular lens
Friday, June 03, 2016, 15:17
Tags: Internal Medicine
Journal of Human Evolution
Cranial anatomy of Paleogene Micromomyidae and implications for early primate evolution
Friday, June 03, 2016, 5:07
Publication date: July 2016
Source:Journal of Human Evolution, Volume 96
Author(s): Jonathan I. Bloch, Stephen G.B. Chester, Mary T. Silcox
Paleogene micromomyids are small (∼10–40 g) euarchontan mammals with primate-like molars and postcrania suggestive of committed claw-climbing positional behaviors, similar to those of the extant arboreal treeshrew, Ptilocercus. Based primarily on evidence derived from dental and postcranial morphology, micromomyids have alternately been allied with plesiadapiforms, Dermoptera (colugos), or Primatomorpha (Primates + Dermoptera) within Euarchonta. Partial crania described here of Paleocene Dryomomys szalayi and Eocene Tinimomys graybulliensis from the Clarks Fork Basin of Wyoming are the first known for the family Micromomyidae. The cranium of D. szalayi exhibits a distinct, small groove near the lateral extreme of the promontorium, just medial to the fenestra vestibuli, the size of which suggests that the internal carotid artery was non-functional, as has been inferred for paromomyid and plesiadapid plesiadapiforms, but not for Eocene euprimates, carpolestids, and microsyopids. On the other hand, D. szalayi is similar to fossil euprimates and plesiadapoids in having a bullar morphology consistent with an origin that is at least partially petrosal, unlike that of paromomyids and microsyopids, although this interpretation will always be tentative in fossils that lack exhaustive ontogenetic data. Micromomyids differ from all other known plesiadapiforms in having an inflated cochlear part of the bony labyrinth and a highly pneumatized squamosal and mastoid region with associated septa. Cladistic analyses that include new cranial data, regardless of how bullar composition is coded in plesiadapiforms, fail to support either Primatomorpha or a close relationship between micromomyids and dermopterans, instead suggesting that micromomyids are among the most primitive known primates.
Tags: Internal Medicine
The Kaohsiung Journal of Medical Sciences
Correlating blood levels of 8-hydroxydeoxyguanosine to hOGG1 genotypes and the incidence of ischemic cardiomyopathy
Thursday, June 02, 2016, 23:49
Publication date: Available online 2 June 2016
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Yu Jin, Chun-Guang Qiu, Qiang-Sun Zheng, Shi-Fang Ding, Qi-Jun Jiang
We measured the serum levels of 8-hydroxydeoxyguanosine (8-OHdG) and investigated whether these levels correlate with incidence of ischemic cardiomyopathy (ICM), and whether these levels correlate with underlying oxidative stress in patients with ICM. Polymerase chain reaction-restriction fragment length polymorphism analysis was performed to assess the prevalence of the Ser/Cys polymorphism in the human 8-oxoguanine glycosylase (hOGG1) gene. We analyzed the samples from 246 ICM cases (the ICM group) and another 246 age- and sex-matched volunteers with normal coronary artery function (the control group). Levels of 8-OHdG in participants’ blood samples were 6.7 ± 1.7 and 3.0 ± 0.8 in the ICM and control groups, respectively (p < 0.05). Although there were no differences in allele frequency (p = 0.140), significant differences were present in the genotype distributions (p = 0.002). The Cys/Cys genotype correlated strongly with the risk of developing ICM (odds ratio, 2.2; 95% confidence interval, 1.4–3.3). Treating the Ser/Ser and Ser/Cys genotypes as members of the same group increased the predicted ICM risk for patients carrying the Cys/Cys genotype (odds ratio, 1.9; 95% confidence interval, 1.2–2.9). The serum level of 8-OHdG in the ICM group was higher than that in the control group (p < 0.05) and significantly increased in those carrying the Cys/Cys genotype (8.7 ± 1.7 for the Cys/Cys group, and 4.5 ± 0.8 for the Ser/Ser+Ser/Cys group; p < 0.05). Patients carrying the Cys/Cys genotype had a significantly increased risk of developing ICM. Serum levels of 8-OHdG were significantly increased in patients with ICM.
Tags: Internal Medicine
The Kaohsiung Journal of Medical Sciences
Effect of day/night administration of three different inhalational anesthetics on melatonin levels in rats
Thursday, June 02, 2016, 23:49
Publication date: Available online 2 June 2016
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Elvan Ocmen, Hale Aksu Erdost, Leyla S. Duru, Pinar Akan, Dilek Cimrin, Ali N. Gokmen
The nocturnal peak of melatonin can be altered after anesthesia and surgery. We aimed to examine the melatonin levels during the day and night after anesthesia with three commonly used inhalational anesthetics. Forty-eight male Wistar albino rats were randomized into eight groups. Rats were administered anesthesia between 7:00 am and 1:00 pm (day groups) or 7:00 pm and 1:00 am (night groups) for 6 hours. At the end of the anesthesia, blood samples were collected for assessing melatonin levels. Mean values of melatonin levels after 6 hours of anesthesia during daytime were 43.17±12.95 for control, 59.79±27.83 for isoflurane, 50.75±34.28 for sevoflurane and 212.20±49.56 pg/mL for desflurane groups. The night groups’ mean melatonin levels were 136.12±33.20 for control, 139.85±56.29 for isoflurane, 117.48±82.39 for sevoflurane and 128.70±44.63 pg/mL for desflurane groups. Desflurane anesthesia between 7:00 am and 1:00 pm significantly increased melatonin levels (p <0.001). Sevoflurane and desflurane anesthesia between 7:00 pm and 1:00 am decreased the melatonin levels but there were no significant differences (p =0.904 and p >0.99, respectively). Isoflurane anesthesia did not significantly change melatonin levels during day or night (p =0.718 and p >0.99, respectively). Our results demonstrate that during daytime desflurane anesthesia can alter melatonin levels. Altered melatonin rhythm following inhalational anesthesia can be related to sleep disorders observed after anesthesia.
Tags: Internal Medicine
The Kaohsiung Journal of Medical Sciences
Current status and future perspective of laparoscopic surgery in hepatobiliary disease
Thursday, June 02, 2016, 23:49
Publication date: Available online 1 June 2016
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Sae Byeol Choi, Sang Yong Choi
Recent advances in minimally invasive surgery include laparoscopic and robotic surgery. These surgical techniques have changed the paradigm of surgical treatment for hepatobiliary diseases. Minimally invasive surgery has the advantages of minimal wound extension for cosmetic effect, early postoperative recovery, and few postoperative complications in patients. For laparoscopic liver resection, the indications have been expanded and oncological outcome was proven to be similar with open surgery in the malignant disease. Laparoscopic cholecystectomy is a classical operation for benign gallbladder diseases and the effort to decrease the surgical wound resulted to perform single incision laparoscopic cholecystectomy. For choledochal cyst, laparoscopic surgery is applied gradually despite of the difficulties associated with anastomosis, and robotic surgery for hepatobiliary disease is also performed for more minimally invasive surgery; however, while admitting the advantage of robotic surgery, robotic technology should be improved for development of more convenient and cheaper instrument and continuous efforts to enhance surgical technique to overcome long operation is necessary. In this review, the status and future perspectives of minimally invasive surgery for hepatobiliary diseases are summarized and discussed.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Expression and Purification of Virus-like Particles for Vaccination
Thursday, June 02, 2016, 23:03
Here, we present a protocol for synthesizing virus-like particles using either baculovirus or mammalian expression systems, and ultracentrifugation purification. This highly customizable approach is used to identify viral antigens as vaccine targets in a safe and flexible manner.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
TRUE Gene Silencing: Screening of a Heptamer-type Small Guide RNA Library for Potential Cancer Therapeutic Agents
Thursday, June 02, 2016, 22:02
Here we present a protocol for screening of a heptamer-type sgRNA library for potential therapeutic drugs against blood cancers.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Circumscribed Capsular Infarct Modeling Using a Photothrombotic Technique
Thursday, June 02, 2016, 21:02
This manuscript describes a modeling technique of capsular infarct. Here we utilized a modified photothrombotic technique with low intensity of light after pre-surgery target mapping. Using this technique, we created a circumscribed capsular infarct model with persistent motor impairment.
Tags: Internal Medicine
NEJM : Research
Zika Virus Infection with Prolonged Maternal Viremia and Fetal Brain Abnormalities
Thursday, June 02, 2016, 16:00
Zika virus (ZIKV), a mosquito-borne flavivirus and member of the Flaviviridae family, was originally isolated from a sentinel primate in Uganda in 1947. ZIKV was associated with mild febrile disease and maculopapular rash in tropical Africa and some areas of Southeast Asia. Since 2007, ZIKV has…
Tags: Internal Medicine
NEJM : Research
A Program to Prevent Catheter-Associated Urinary Tract Infection in Acute Care
Thursday, June 02, 2016, 16:00
Catheter-associated urinary tract infection (UTI) is a common device-associated infection in the United States and one of the most common health care–associated infections worldwide. Up to 69% of catheter-associated UTIs are considered to be avoidable, provided that recommended infection…
Tags: Internal Medicine
Clinical Ophthalmology
The acute phase of inflammatory response involved in the wound-healing process after excimer laser treatment
Thursday, June 02, 2016, 15:16
Tags: Internal Medicine
Clinical Ophthalmology
Valved versus nonvalved cannula small-gauge pars plana vitrectomy for repair of retinal detachments with Grade C proliferative vitreoretinopathy
Thursday, June 02, 2016, 15:16
Tags: Internal Medicine
The New England Journal of Medicine: Search Results in Images in Clinical Medicine
Intrafacial Synkinesis
Thursday, June 02, 2016, 14:00
A 52-year-old man was admitted to the hospital with weakness that had progressed over a period of several weeks. Cranial-nerve examination revealed involuntary unilateral ptosis that coincided with voluntary contraction of the lower facial muscles, a form of synkinesis known as the Marin-Amat…
Tags: Internal Medicine
The New England Journal of Medicine: Search Results in Images in Clinical Medicine
Gastrointestinal Complication of Granulomatosis with Polyangiitis
Thursday, June 02, 2016, 14:00
A 48-year-old man who was known to have granulomatosis with polyangiitis was admitted to the hospital for evaluation of an elevated blood creatinine level of 9.5 mg per deciliter (840 μmol per liter; normal range in men, 0.5 to 1.2 mg per deciliter [40 to 110 μmol per liter]). Urinalysis was…
Tags: Internal Medicine
ScienceDirect Publication: Medical Hypotheses
Anthropogenic and temporal components in a complex trigger of type 1 diabetes suggest the active participation of antipyretics
Thursday, June 02, 2016, 12:11
Publication date: August 2016
Source:Medical Hypotheses, Volume 93
Author(s): Darijus Veteikis
Tremendous efforts in research without a conclusion on the cause of type 1 diabetes allow the presumption that there is still a blind spot in the development of T1D that is not covered by current hypotheses. The review of geographical knowledge suggests that there is a well-expressed anthropogenic element within the complex environmental trigger of T1D. On the other hand, the initiation of T1D’s directed autoimmunity is temporally related to the organism’s immune response, induced by entero-viruses, most expectedly. Consequently, the searched for anthropogenic environmental factor is a player temporally linked to enteroviral infections. This paper discusses the participation of antipyretic medicines, and especially paracetamol, with a whole century’s history of growing sales and popularity, including indirect influence through phenacetin during the first half of the 20th century. As proposed by several independent studies, the use of pharmaceuticals to reduce fever may counteract with the protective features of the immune system and create favourable conditions for a virus to spread within the organism and damage specific tissue. A preliminary comparison of paracetamol sales with the incidence of T1D data in Lithuania and the other countries in the North-eastern Baltic region supports this hypothesis.
Tags: Internal Medicine
ScienceDirect Publication: Medical Hypotheses
A systemic evolutionary approach to cancer: Hepatocarcinogenesis as a paradigm
Thursday, June 02, 2016, 12:11
Publication date: August 2016
Source:Medical Hypotheses, Volume 93
Author(s): Antonio Mazzocca, Giovanni Ferraro, Giovanni Misciagna, Brian I. Carr
The systemic evolutionary theory of cancer pathogenesis posits that cancer is generated by the de-emergence of the eukaryotic cell system and by the re-emergence of its archaea (genetic material and cytoplasm) and prokaryotic (mitochondria) subsystems with an uncoordinated behavior. This decreased coordination can be caused by a change in the organization of the eukaryote environment (mainly chronic inflammation), damage to mitochondrial DNA and/or to its membrane composition by many agents (e.g. viruses, chemicals, hydrogenated fatty acids in foods) or damage to nuclear DNA that controls mitochondrial energy production or metabolic pathways, including glycolysis. Here, we postulate that the two subsystems (the evolutionarily inherited archaea and the prokaryote) in a eukaryotic differentiated cell are well integrated, and produce the amount of clean energy that is constantly required to maintain the differentiated status. Conversely, when protracted injuries impair cell or tissue organization, the amount of energy necessary to maintain cell differentiation can be restricted, and this may cause gradual de-differentiation of the eukaryotic cell over time. In cirrhotic liver, for example, this process can be favored by reduced oxygen availability to the organ due to an altered vasculature and the fibrotic barrier caused by the disease. Thus, hepatocarcinogenesis is an ideal example to support our hypothesis. When cancer arises, the pre-eukaryote subsystems become predominant, as shown by the metabolic alterations of cancer cells (anaerobic glycolysis and glutamine utilization), and by their capacity for proliferation and invasion, resembling the primitive symbiotic components of the eukaryotic cell.
Tags: Internal Medicine
Journal of Internal Medicine
C-peptide antioxidant adaptive pathways in β cells and diabetes
P. Luppi, P. Drain · Thursday, June 02, 2016, 11:02
Abstract
In this review, we present findings that support autocrine cell protection by C-peptide in the context of clinical studies of type 1 diabetes (T1D), which universally measure C-peptide serum levels as a surrogate for β cell functional mass. Over the last decade, evidence has accumulated that supports models in which C-peptide, cosecreted with insulin by pancreatic β cells, acts on peripheral targets including the vascular endothelium to reduce oxidative stress and apoptosis subsequent to exposure to diabetic insults. In parallel, as assays have become more sensitive, C-peptide has been detected in the circulation of most subjects with T1D where higher C-peptide levels are associated with fewer and slower development of diabetic microvascular complications, consistent with antioxidant protection by C-peptide. Clinical trials investigating C-peptide-replacement therapy effects have demonstrated amelioration of T1D nephropathy and neuropathy. Recently, the antioxidant action of C-peptide was extended to the β cells secreting it, that is an autocrine mechanism. Autocrine protection has major implications for the treatment of diabetes because the more C-peptide secreted, the more protection provided to the same β cells resulting in a slower decay in β cell functional mass over the time course of disease. Why β cells evolved to cosecrete an antioxidant C-peptide hormone together with the glycaemia-lowering insulin hormone is explored in the context of proposed evolutionary advantages of physiologically transient oxidative stress and insulin resistance as an adaptation for survival through times of fuel scarcity. The importance of recognizing autocrine C-peptide protection of functional β cell mass in observational clinical studies, and its therapeutic implications in interventional C-peptide-replacement studies, will be discussed.
Tags: Internal Medicine
Clinical Medicine Insights: Case Reports
Double Trouble in a Patient with Coronary Ectasia, Bradycardia with Angina: Epiphenomenal or Mechanistic Association
Vanessa Rameh · Thursday, June 02, 2016, 3:13
Coronary artery ectasia is a rare angiographical finding, and it accounts for less than 5% of all coronary angiograms. We report a case of a 55-year-old male patient who presented with fatigue and exertional chest pain. Paraclinical tests revealed cardiac ischemia and sinus node dysfunction, as well as coronary artery ectasia without significant coronary stenosis. Factors involved in cardiac ischemia in this context comprise slow flow, poor collateral circulation, microcirculatory dysfunction, lack of adequate exertional coronary vasodilatation, and endothelial dysfunction. Moreover, poor collaterals with rudimentary sinus node artery may explain sinus node dysfunction. Discussion is made in light of the relevant medical literature.
Tags: Internal Medicine
The Kaohsiung Journal of Medical Sciences
Impaired olfactory function in patients with polycystic ovary syndrome
Wednesday, June 01, 2016, 23:48
Publication date: Available online 1 June 2016
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Sezen Bozkurt Koseoglu, Sabri Koseoglu, Ruya Deveer, Serhan Derin, Mehmet Kececioglu, Murat Sahan
Polycystic ovary syndrome (PCOS) is an endocrine disorder which affects 6.6% of women of child-bearing age. Although olfactory dysfunction is frequent in the population and it negatively affects quality of life, neither physicians or patients consider this important. This case-control study included 30 patients diagnosed with PCOS, and 25 healthy age-matched controls. Sniffin’ sticks tests (BurghartGmbH, Wedel, Germany) were used to analyze olfactory functions, and the Beck Depression Inventory was used to evaluate depressive symptoms. The total odor score was significantly lower in the PCOS group compared to the control group (p <0.005). The Beck depression score was higher in the PCOS group (p <0.005). There was a negative correlation between the total odor score and the Beck Depression Score. Patients with PCOS have impaired olfactory function. This might be related to depressive disorders that are also observed in those patients.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Correlative Light and Electron Microscopy to Study Microglial Interactions with β-Amyloid Plaques
Wednesday, June 01, 2016, 23:00
This article describes a protocol for visualizing amyloid Aβ plaques in Alzheimer’s disease mouse models using methoxy-X04, which crosses the blood-brain barrier and selectively binds to β-pleated sheets found in dense core Aβ plaques. It allows pre-screening of plaque-containing tissue sections prior to immunostaining and processing for electron microscopy.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Experimental Methodology for Estimation of Local Heat Fluxes and Burning Rates in Steady Laminar Boundary Layer Diffusion Flames
Wednesday, June 01, 2016, 21:59
We describe the use of micro-thermocouples to estimate local temperature gradients in steady laminar boundary layer diffusion flames. By extension of the Reynolds Analogy, local temperature gradients can be further used to estimate the local mass burning rates and heat fluxes in such flames with high accuracy.
Tags: Internal Medicine
JoVE: Journal of Visualized Experiments
Functionalization of Single-walled Carbon Nanotubes with Thermo-reversible Block Copolymers and Characterization by Small-angle Neutron Scattering
Wednesday, June 01, 2016, 20:59
A method for the functionalization of carbon nanotubes with structure-tunable polymeric encapsulation layers and structural characterization using small-angle neutron scattering is presented.
Tags: Internal Medicine
SpringerPlus – Latest Articles
A protocol of homozygous haploid callus induction from endosperm of Taxus chinensis Rehd. var. mairei
Yan-lin Li, San-wen Huang, Jia-yin Zhang, Feng-jiao Bu, Tao Lin, Zhong-hua Zhang And Xing-yao Xiong · Wednesday, June 01, 2016, 15:48
Obtainment and characterization of the novel endosperm callus of Taxus chinensis Rehd. var. mairei are valuable for haploid breeding, genome, and functional genome in Taxus. Callus was obtained by hydropriming wi…
Tags: Internal Medicine
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