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Peter Flüchter
Suicidality is a complex process with social, individual and medical aspects. Almost every doctor - regardless of discipline - must at some point treat and care for people in suicidal crises. It is important then, to assess the situation correctly and to recognize an acute suicidal risk. Below you will read what to look for and how you can help the patient the best in that difficult situation.
March 2018: Deutsche Medizinische Wochenschrift
Gesine Meyer, Klaus Badenhoop
An adrenal crisis (Addisonian crisis) is an acute life-threatening complication of adrenal insufficiency. It occurs when hydrocortisone demand is not met by supplementation in the context of an infection - often gastrointestinal, fever, trauma, acute psychological or physical stress. Symptoms of weakness, nausea, muscle/joint pain and drowsiness may develop out of robust health within few hours. If overlooked, treated too late, with insufficient dose or route of application, there exists a considerable risk of mortality...
March 2018: Deutsche Medizinische Wochenschrift
Jozef Kováčik, Sławomir Dresler, Petr Babula
Short-term (24 h) responses of Cladonia arbuscula subsp. mitis (formerly known as Cladina and this name is used to distinguish the tested species) and Cladonia furcata to nickel (Ni2+ ) excess (10 or 100 μM) were compared. Cladonia accumulated more Ni at higher Ni dose (1.717 mg total Ni/g DW), K amount was unaffected and Ca amount decreased in Cladina only. Fluorescence microscopy detection of total/general ROS and hydrogen peroxide showed Ni-stimulated increase in both species being more pronounced in Cladonia and in mycobiont partner mainly...
March 6, 2018: Plant Physiology and Biochemistry: PPB
Eloi Parladé, Andrea Hom-Diaz, Paqui Blánquez, Maira Martínez-Alonso, Teresa Vicent, Nuria Gaju
The use of microalgal consortia for urban wastewater treatment is an increasing trend, as it allows simultaneous nutrient removal and biomass production. Emerging contaminants proposed for the list of priority substances such as the hormone 17β-estradiol are commonly found in urban wastewater, and their removal using algal monocultures has been accomplished. Due to the inherent potential of algae-based systems, this study aimed to assess the capability of native photobioreactor biomass to remove 17β-estradiol under indoor and outdoor conditions...
March 3, 2018: Water Research
Pavel Šauer, Alžběta Stará, Oksana Golovko, Olga Valentová, Adam Bořík, Roman Grabic, Hana Kocour Kroupová
Vast numbers of xenobiotics are known still to be present in treated municipal wastewater treatment plant (WWTP) effluents. Some of these possess endocrine-disrupting potency and pose risks for exposed aquatic animals. We searched for 17 potential environmental contaminants having affinity to the progesterone receptor. Relative potency values of these progesterone receptor-active chemicals were obtained. On the basis of relative potencies and measured environmental concentrations, the contribution of progestins to measured progestagenic activities was evaluated...
March 2, 2018: Water Research
Taylor McLinden, Erica E M Moodie, Anne-Marie Hamelin, Sam Harper, Carmine Rossi, Sharon L Walmsley, Sean B Rourke, Curtis Cooper, Marina B Klein, Joseph Cox
BACKGROUND: Severe food insecurity (FI) is common among individuals living with HIV-hepatitis C virus (HCV) co-infection. We hypothesize that the injection of opioids is partly responsible for the association between injection drug use and severe FI. Therefore, this analysis examines whether methadone maintenance treatment for opioid dependence is associated with a lower risk of severe FI. METHODS: We used biannual data from the Canadian Co-infection Cohort (N = 608, 2012-2015)...
February 20, 2018: Drug and Alcohol Dependence
M Murali, P Athif, P Suganthi, A Sadiq Bukhari, H E Syed Mohamed, H Basu, R K Singhal
In the present study, freshwater fish Oreochromis mossambicus were exposed to sub lethal concentrations (120, 150 and 180 ppm) of Aluminium oxide nanoparticles (Al2 O3 NPs) for 96 h. Histological abnormalities were not observed in the organs of control fishes whereas severe damages and extensive architectural loss was found in the brain, gill, intestine, kidney and muscle tissues of treated fishes with more pronounced effects in 180 ppm. The results showed that the acute exposure to Al2 O3 NPs altered the histoarchitecture in various fish tissues...
March 5, 2018: Environmental Toxicology and Pharmacology
Alzbeta Bujnakova Mlynarcikova, Sona Scsukova
In the present study, we aimed to examine effects of different concentrations of the endocrine disruptor Bisphenol A (BPA; 1 nM, 1 μM, 100 μM) and the flavonoid fisetin (1, 10, 25, 50 μM), individually and in combinations, on steroidogenic function of porcine ovarian granulosa cells (GCs) represented by progesterone production. We confirmed that BPA inhibited progesterone production by GCs at the highest concentration. Fisetin reduced gonadotropin-stimulated progesterone synthesis dose-dependently, and in this manner, fisetin impaired progesterone production when added to BPA-treated GCs...
March 2, 2018: Environmental Toxicology and Pharmacology
Fraser Magee, Michael Bailey, David V Pilcher, Johan Mårtensson, Rinaldo Bellomo
PURPOSE: To investigate the relationship between dysglycemia and hospital mortality in patients with and without a preadmission diagnosis of insulin treated diabetes mellitus (ITDM). MATERIALS AND METHODS: An observational multicentre cohort study using the ANZICS-APD database on adult patients admitted to ICU with sepsis between January 1st 2006 and December 31st 2015. Four domains of dysglycemia were investigated (highest, mean and lowest blood glucose levels and glycemic variability: the absolute difference between the highest and lowest level)...
March 3, 2018: Journal of Critical Care
Rodrigo de Abreu Domingos, Fabiana Valéria da Fonseca
The oil refinery industry seeks solutions to reduce its water uptake and consumption by encouraging the reuse of internal streams and wastewater from treatment systems. After conventional treatment the petroleum refinery wastewater still contains a considerable quantity of recalcitrant organics and the adsorption on activated carbon is currently used in Brazilian refineries, although it is still expensive due to the difficulty of its regeneration. This study evaluated the use of adsorbent and ion exchange resins for the removal of organic matter from refinery wastewater after conventional treatment in order to verify its feasibility, applying successive resin regenerations and comparing the results with those obtained for activated carbon process...
March 12, 2018: Journal of Environmental Management
Saurabh Sudha Dhiman, Namita Shrestha, Aditi David, Neha Basotra, Glenn R Johnson, Bhupinder S Chadha, Venkataramana Gadhamshetty, Rajesh K Sani
Residual solid and liquid streams from the one-pot CRUDE (Conversion of Raw and Untreated Disposal into Ethanol) process were treated with two separate biochemical routes for renewable energy transformation. The solid residual stream was subjected to thermophilic anaerobic digestion (TAD), which produced 95 ± 7 L methane kg-1 volatile solid with an overall energy efficiency of 12.9 ± 1.7%. A methanotroph, Methyloferula sp., was deployed for oxidation of mixed TAD biogas into methanol. The residual liquid stream from CRUDE process was used in a Microbial Fuel Cell (MFC) to produce electricity...
March 12, 2018: Bioresource Technology
Vesa M Olkkonen, Juha Sinisalo, Matti Jauhiainen
Remarkably good results have been achieved in the treatment of atherosclerotic cardiovascular diseases (CVD) by using statin, ezetimibe, antihypertensive, antithrombotic, and PCSK9 inhibitor therapies and their proper combinations. However, despite this success, the remaining CVD risk is still high. To target this residual risk and to treat patients who are statin-intolerant or have an exceptionally high CVD risk for instance due to familial hypercholesterolemia (FH), new therapies are intensively sought. One pathway of drug development is targeting the circulating triglyceride-rich lipoproteins (TRL) and their lipolytic remnants, which, according to the current view, confer a major CVD risk...
March 8, 2018: Atherosclerosis
Lingling Gan, Xuemei Zhang, Xiuyu Xu, Wenchun Xu, Chang Lu, Jin Cui, Hong Wang
<i>spd1672</i>, a novel <i>Streptococcus pneumoniae</i> (<i>S. pn</i>) gene induced in vivo, has been identified to contribute to the virulence of <i>S. pn</i>; however, the role of <i>spd1672</i> during host innate immune reaction against<i> S. pn</i> infection is unknown. In the present study, mice were infected with wild type D39 and mutant D39Δspd1672 strains. Compared to the D39-infected mice, reduced bacterial load and attenuated inflammatory response were observed in the D39Δ<i>spd1672</i>-treated mice...
March 15, 2018: Canadian Journal of Microbiology
Taner Arabaci, Mevlut Albayrak
BACKGROUND: The aim of this study to evaluate the contributions of titanium-prepared platelet-rich fibrin (T-PRF) combined with open flap debridement (OFD) on biological markers in gingival crevicular fluid (GCF)and periodontal outcomes. METHODS: Twenty-nine participants with chronic periodontitis were treated either with autologous T-PRF+OFD or OFD alone. GCF growth factor levels and relative receptor activator nuclear factor kappa-B/osteoprotegerin (RANKL/OPG) ratio at baseline and 2, 4, and 6 weeks postoperatively were analyzed, and clinical parameters such as probing depth (PD), relative attachment level (RAL) and gingival margin level (GML) at baseline and 9 months after surgery were compared...
March 2018: Journal of Periodontology
Tanya Moutray, Jennifer R Evans, Noemi Lois, David J Armstrong, Tunde Peto, Augusto Azuara-Blanco
BACKGROUND: Diabetic retinopathy (DR) is a chronic progressive disease of the retinal microvasculature associated with prolonged hyperglycaemia. Proliferative DR (PDR) is a sight-threatening complication of DR and is characterised by the development of abnormal new vessels in the retina, optic nerve head or anterior segment of the eye. Argon laser photocoagulation has been the gold standard for the treatment of PDR for many years, using regimens evaluated by the Early Treatment of Diabetic Retinopathy Study (ETDRS)...
March 15, 2018: Cochrane Database of Systematic Reviews
Carol Kelly, James D Chalmers, Iain Crossingham, Nicola Relph, Lambert M Felix, David J Evans, Stephen J Milan, Sally Spencer
BACKGROUND: Bronchiectasis is a chronic respiratory disease characterised by abnormal and irreversible dilatation and distortion of the smaller airways. Bacterial colonisation of the damaged airways leads to chronic cough and sputum production, often with breathlessness and further structural damage to the airways. Long-term macrolide antibiotic therapy may suppress bacterial infection and reduce inflammation, leading to fewer exacerbations, fewer symptoms, improved lung function, and improved quality of life...
March 15, 2018: Cochrane Database of Systematic Reviews
Claire M Lawlor, Charles A Riley, John M Carter, Kimsey H Rodriguez
Importance: The 1996 Tonsillectomy and Adenoidectomy Inpatient Guidelines of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) Pediatric Otolaryngology Committee recommended that children younger than 3 years be admitted following tonsillectomy. Recommendations for hospital observation were not included as a key action statement in the 2011 AAO-HNS Clinical Practice Guidelines for Tonsillectomy in Children. Objective: To examine the association between posttonsillectomy complication rate and the age and weight of the child at the time of surgery...
March 15, 2018: JAMA Otolaryngology—Head & Neck Surgery
Sang Min Yoon, Baek-Yeol Ryoo, So Jung Lee, Jong Hoon Kim, Ji Hoon Shin, Ji Hyun An, Han Chu Lee, Young-Suk Lim
Importance: Patients with hepatocellular carcinoma showing macroscopic vascular invasion have a poor prognosis. Sorafenib is the sole treatment option for these patients, with unsatisfactory response and survival benefit. Combined treatment with transarterial chemoembolization (TACE) plus external beam radiotherapy (RT) has shown promising results for these patients in observational studies. Objective: To evaluate the efficacy and safety of TACE plus RT compared with sorafenib for patients with hepatocellular carcinoma and macroscopic vascular invasion...
March 15, 2018: JAMA Oncology
Charles S Fuchs, Toshihiko Doi, Raymond W Jang, Kei Muro, Taroh Satoh, Manuela Machado, Weijing Sun, Shadia I Jalal, Manish A Shah, Jean-Phillipe Metges, Marcelo Garrido, Talia Golan, Mario Mandala, Zev A Wainberg, Daniel V Catenacci, Atsushi Ohtsu, Kohei Shitara, Ravit Geva, Jonathan Bleeker, Andrew H Ko, Geoffrey Ku, Philip Philip, Peter C Enzinger, Yung-Jue Bang, Diane Levitan, Jiangdian Wang, Minori Rosales, Rita P Dalal, Harry H Yoon
Importance: Therapeutic options are needed for patients with advanced gastric cancer whose disease has progressed after 2 or more lines of therapy. Objective: To evaluate the safety and efficacy of pembrolizumab in a cohort of patients with previously treated gastric or gastroesophageal junction cancer. Design, Setting, and Participants: In the phase 2, global, open-label, single-arm, multicohort KEYNOTE-059 study, 259 patients in 16 countries were enrolled in a cohort between March 2, 2015, and May 26, 2016...
March 15, 2018: JAMA Oncology
Laurits J Holm, Martin Haupt-Jorgensen, Jesper Larsen, Jano D Giacobini, Mesut Bilgin, Karsten Buschard
Sphingolipids are a diverse group of lipids with important roles in beta-cell biology regulating insulin folding and controlling apoptosis. Sphingolipid biosynthesis begins with the condensation of L-serine and palmitoyl-CoA. Here we tested the effect of L-serine supplementation on autoimmune diabetes development and blood glucose homeostasis in female NOD mice. We found that continuous supplementation of L-serine reduces diabetes incidence and insulitis score. In addition, L-serine treated mice had an improved glucose tolerance test, reduced HOMA-IR, and reduced blood glucose levels...
2018: PloS One
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