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Current concepts

Peter Michael Prodinger, Norbert Harrasser, Christian Scheele, Carolin Knebel, Gernot Hertel, Christian Suren, Rüdiger von Eisenhart-Rothe
In addition to their outstanding significance in the field of tumor orthopaedics, megaprostheses are becoming increasingly important for revision arthroplasty. Despite their wide application, the reported complication and failure rates remain high. The analysis of failure mechanisms roughly allows a breakdown into mechanical and non-mechanical causes; soft-tissue failure, loosening and periprosthetic infection play outstanding roles. Each type of failure can be associated to a specific prosthetic component: To avoid soft tissue failure, muscular connection to the prosthesis is essential; to avoid loosening, the anchoring technique on the stem is crucial; to prevent infection, the surface condition or possibly the coating of the prosthesis seem to play major roles...
December 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Paolo Vercellini, Paola Viganò, Giussy Barbara, Laura Buggio, Edgardo Somigliana
Elagolix, an orally active non-peptidic GnRH antagonist, has been approved by the Food and Drug Administration for the management of moderate to severe pain associated with endometriosis. As the degree of ovarian suppression obtained with elagolix is dose-dependent, pain relief may be achieved by modulating the level of hypo-oestrogenism while limiting side effects. Elagolix may thus be considered a novelty in terms of its endocrine and pharmacological properties but not for its impact on the pathogenic mechanisms of endometriosis, as the target of this new drug is, yet again, alteration of the hormonal milieu...
December 14, 2018: Human Reproduction
Veronika Rajecka, Tomas Skalicky, Stepanka Vanacova
RNA modifications are being recognized as an essential factor in gene expression regulation. They play essential roles in germ line development, differentiation and disease. In eukaryotic mRNAs, N6 -adenosine methylation (m6 A) is the most prevalent internal chemical modification identified to date. The m6 A pathway involves factors called writers, readers and erasers. m6 A thus offers an interesting concept of dynamic reversible modification with implications in fine-tuning the cellular metabolism. In mammals, FTO and ALKBH5 have been initially identified as m6 A erasers...
December 11, 2018: Biochimica et biophysica acta. Gene regulatory mechanisms
Pragyi Shrestha, Bart van de Sluis, Robin P F Dullaart, Jacob van den Born
Chronic kidney disease (CKD) is a global health problem with a profound impact on quality of life. Cardiovascular disease is established as a major cause of morbidity and mortality in patients with CKD. Dyslipidemia is frequently observed in CKD patients, suggesting a causal relation between dyslipidemia and cardiovascular disease in CKD patients. Currently, lipid-lowering drugs such as statins, are the primary choice for lipid lowering therapy in high-risk populations. Despite many studies showing CVD risk reduction with statins, CVD still remains the leading cause of the death in CKD...
December 11, 2018: Cellular Signalling
Margherita Malanchini, Laura E Engelhardt, Andrew D Grotzinger, K Paige Harden, Elliot M Tucker-Drob
Self-regulation describes the ability to control both behaviors and internal states against a backdrop of conflicting or distracting situations, drives, or impulses. In the cognitive psychology tradition, individual differences in self-regulation are commonly measured with performance-based tests of executive functioning, whereas in the personality psychology tradition, individual differences in self-regulation are typically assessed with report-based measures of impulse control, sustained motivation, and perseverance...
December 13, 2018: Journal of Personality and Social Psychology
Liping Yu, Silin Sa, Ling Wang, Keely Dulmage, Neha Bhagwat, Stephanie S Yee, Moen Sen, Charles H Pletcher, Jonni S Moore, Suraj Saksena, Eric P Dixon, Erica L Carpenter
Circulating tumor cells (CTCs) carry valuable biological information. While enumeration of CTCs in peripheral blood is an FDA-approved prognostic indicator of survival in metastatic prostate and other cancers, analysis of CTC phenotypic and genomic markers is needed to identify cancer origin and elucidate pathways that can guide therapeutic selection for personalized medicine. Given the emergence of single-cell mRNA sequencing technologies, a method is needed to isolate CTCs with high sensitivity and specificity as well as compatibility with downstream genomic analysis...
December 2018: Cytometry. Part A: the Journal of the International Society for Analytical Cytology
G Plotino, N M Grande, M Mercade
Photodynamic therapy (PDT) is a treatment modality that was initiated in 1900; however, it was not until the last decade that PDT regained attention again for its several favourable features during the treatment of microbial infections in Endodontics. Recently, several papers advocated its use for root canal treatment. The concept of photodynamic inactivation requires microbial exposure to either exogenous or endogenous photosensitizer molecules, followed by visible light energy, typically wavelengths in the red/near infrared region that cause the excitation of the photosensitizers resulting in the production of singlet oxygen and other reactive oxygen species that react with intracellular components and consequently produce cell inactivation and death...
December 12, 2018: International Endodontic Journal
Stephanie Tierney, Roberta Bivins, Kate Seers
Compassion in healthcare has received significant attention recently, on an international scale, with concern raised about its absence during clinical interactions. As a concept, compassionate care has been linked to nursing. We examined historical discourse on this topic, to understand and situate current debates on compassionate care as a hallmark of high-quality services. Documents we looked at illustrated how responsibility for delivering compassionate care cannot be consigned to individual nurses. Health professionals must have the right environmental circumstances to be able to provide and engage in compassionate interactions with patients and their relatives...
December 11, 2018: Nursing Inquiry
Simone Albisinni, Fouad Aoun, Romain Diamand, Walid Al-Hajj Obeid, Francesco Porpiglia, Thierry Roumeguere, Cosimo De Nunzio
INTRODUCTION: Cytreductive prostatectomy is an experimental surgical approach to metastatic prostate cancer (mPCa), with the scope of improving local symptoms and potentially ameliorate oncologic outcomes. Aim of the current systematic review is to analyze available evidence to support this approach and explore published data a future trial on cytoreductive prostatectomy. EVIDENCE ACQUISITION: A systematic review was conducted searching all relevant studies published in PubMed, EMBASE, Cochrane Library, CINAHL, Google Scholar and Ovid database until August 1, 2018...
December 14, 2018: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Beenish Nafees, Zenia M Størling, Charlotte Hindsberger, Andrew Lloyd
BACKGROUND: Leakage is a major concern for people who use a stoma, but people's experience and its impact is not well understood. This study aimed to establish a definition of leakage through clinical and user input. This information was used to develop and validate a new measurement tool to understand the impact of leakage for people using a stoma appliance, in the UK, US, France, and Denmark. METHODS: Participants were recruited from a panel of users, hosted by Coloplast, that includes people who currently use Coloplast products...
December 14, 2018: Health and Quality of Life Outcomes
Sharon Yeung, Amy Bombay, Chad Walker, Jeff Denis, Debbie Martin, Paul Sylvestre, Heather Castleden
BACKGROUND: Including content on Indigenous health in medical school curricula has become a widely-acknowledged prerequisite to reducing the health disparities experienced by Indigenous peoples in Canada. However, little is known about what levels of awareness and interest medical students have about Indigenous peoples when they enter medical school. Additionally, it is unclear whether current Indigenous health curricula ultimately improve students' beliefs and behaviours. METHODS: A total of 129 students completed a 43-item questionnaire that was sent to three cohorts of first-year medical students (in 2013, 2014, 2015) at one undergraduate medical school in Canada...
December 14, 2018: BMC Medical Education
Nadine Sannino, Julie Biga, Thierry Kurth, Elise Picon
The policy designed to address social inequalities in health (SIH) currently does not integrate the specificities of self-employed persons, who nevertheless occupy an intermediate position in the mortality gradient observed since the 1990s. Qualitative analysis of the care pathway of precarious people, financed by the French Directorate of health care services (DGOS), despite its limitations, highlights the difficulties encountered by self-employed persons in the use of the health system in its present state and shows the poor perception of these difficulties, due to the limitations of the available evaluation tools of individual precarity, the representations of professional and institutional actors, or the absence of response in the field of social solidarity...
September 6, 2018: Santé Publique: Revue Multidisciplinaire Pour la Recherche et L'action
Dennis A Revicki, Sara Lavoie, Rebecca M Speck, Jorge Puelles, Braden Kuo, Michael Camilleri, Cristina Almansa, Henry P Parkman
BACKGROUND: The American Neurogastroenterology and Motility Society Gastroparesis Cardinal Symptom Index-Daily Diary (ANMS GCSI-DD) was developed to meet Food and Drug Administration (FDA) recommendations for patient-reported outcome (PRO) endpoints in gastroparesis studies, including therapeutic trials. The current version of the ANMS GCSI-DD contains five items pertaining to nausea, early satiety, post-prandial fullness, upper abdominal pain, and vomiting. The specific aims of this study were to determine if the appropriate symptoms are included in the ANMS GCSI-DD and to assess the content validity in patients with idiopathic (IG) and diabetic gastroparesis (DG)...
December 13, 2018: Journal of patient-reported outcomes
Kevin R Gagne, M Ryan McDevitt, Darren L Hitt
This study focused on the development of a chemical micropropulsion system suitable for primary propulsion and/or attitude control for a nanosatellite. Due to the limitations and expense of current micropropulsion technologies, few nanosatellites with propulsion have been launched to date; however, the availability of such a propulsion system would allow for new nanosatellite mission concepts, such as deep space exploration, maneuvering in low gravity environments and formation flying. This work describes the design of "dual mode" monopropellant/bipropellant microthruster prototype that employs a novel homogeneous catalysis scheme...
2018: Aerospace
Cristina Benito-Villalvilla, Irene Soria, José Luis Subiza, Oscar Palomares
Allergen-specific immunotherapy (AIT) is the single disease-modifying treatment for allergy. Clinical trials show AIT to be safe and effective for many patients; however, it still faces problems related to efficacy, safety, long treatment duration and low patient adherence. There has been intensive research to develop alternative strategies, including novel administration routes, adjuvants or hypoallergenic molecules. Promising results are reported for some of them, but clinical progress is still moderate...
2018: Allergo Journal International
Federica Ruggieri, Luuk M van Langen, Derek T Logan, Björn Walse, Per Berglund
Dynamic kinetic resolution (DKR) reactions in which a stereoselective enzyme and a racemization step are coupled in one pot would represent powerful tools for the production of enantiopure amines through enantioconvergence of racemates. The exploitation of DKR strategies is currently hampered by the lack of effective, enzyme-compatible and scalable racemization strategies for amines. In the present work, the proof of concept of a fully biocatalytic method for amine racemization is presented. Both enantiomers of the model compound 1-methyl-3-phenylpropylamine could be racemized in water and at room temperature using a couple of wild-type, non-proprietary, enantiocomplementary amine transaminases and a minimum amount of pyruvate/alanine as a co-substrate couple...
November 7, 2018: ChemCatChem
Thomas Elmqvist, José Siri, Erik Andersson, Pippin Anderson, Xuemei Bai, Pranab Kishore Das, Tatu Gatere, Andrew Gonzalez, Julie Goodness, Steven N Handel, Ellika Hermansson Török, Jessica Kavonic, Jakub Kronenberg, Elisabet Lindgren, David Maddox, Raymond Maher, Cheikh Mbow, Timon McPhearson, Joe Mulligan, Guy Nordenson, Meggan Spires, Ulrika Stenkula, Kazuhiko Takeuchi, Coleen Vogel
Cities are currently experiencing serious, multifaceted impacts from global environmental change, especially climate change, and the degree to which they will need to cope with and adapt to such challenges will continue to increase. A complex systems approach inspired by evolutionary theory can inform strategies for policies and interventions to deal with growing urban vulnerabilities. Such an approach would guide the design of new (and redesign of existing) urban structures, while promoting innovative integration of grey, green and blue infrastructure in service of environmental and health objectives...
2018: Sustainability science
Magnus Bengtsson, Eva Alfredsson, Maurie Cohen, Sylvia Lorek, Patrick Schroeder
The United Nations formulated the sustainable development goals (SDGs) in 2015 as a comprehensive global policy framework for addressing the most pressing social and environmental challenges currently facing humanity. In this paper, we analyse SDG 12, which aims to "ensure sustainable consumption and production patterns." Despite long-standing political recognition of this objective, and ample scientific evidence both on its importance and on the efficacy of various ways of promoting it, the SDGs do not provide clear goals or effective guidance on how to accomplish this urgently needed transformation...
2018: Sustainability science
Katherine E Liu
Despite the productivity of basic cancer research, cancer continues to be a health burden to society because this research has not yielded corresponding clinical applications. Many proposed solutions to this dilemma have revolved around implementing organizational and policy changes related to cancer research. Here I argue for a different solution: a new conceptualization of causation in cancer. Neither the standard molecular biomarker approaches nor evolutionary biology approaches to cancer fully capture its complex causal dynamics, even when considered jointly...
2018: Biological Theory
Gilles Rg Monif
For more than a decade, the therapeutic focus for Crohn's disease has remained fixed at temporary arrestment of symptomology. The Centers for Disease Control and Prevention (CDC) lists Crohn's disease as a disease entity without current cure. Biologics in combination with antibiotics can frequently achieve remissions. Without ongoing drug administration, these remissions tend to be of limited duration. Conceptual advancements in understanding the pathogenesis of Crohn's disease have identified treatment approaches, the focus of which goes beyond temporary remission...
2018: Clinical Medicine Insights. Gastroenterology
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