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Carlijn C M Welten, Maarten W J Koeter, Tamar D Wohlfarth, Jitschak G Storosum, Wim van den Brink, Christine C Gispen-de Wied, Hubert G M Leufkens, Damiaan A J P Denys
OBJECTIVE: To investigate whether early nonresponse to antipsychotic treatment of acute mania predicts treatment failure and, if so, to establish the best definition or criterion of an early nonresponse. DATA SOURCES: Short-term efficacy studies assessing antipsychotics that were submitted to the Dutch Medicines Evaluation Board during an 11-year period as part of the marketing authorization application for the indication of acute manic episode of bipolar disorder...
September 2016: Journal of Clinical Psychiatry
Richard J Cassidy, Yuan Liu, Kirtesh Patel, Jim Zhong, Conor E Steuer, David A Kooby, Maria C Russell, Theresa W Gillespie, Jerome C Landry
BACKGROUND: Stage II and III rectal cancers have been effectively treated with neoadjuvant chemoradiotherapy (NCRT) followed by definitive resection. Advancements in surgical technique and systemic therapy have prompted investigation of neoadjuvant multiagent chemotherapy (NMAC) regimens with the elimination of radiation (RT). The objective of the current study was to investigate factors that predict for the use of NCRT versus NMAC and compare outcomes using the National Cancer Data Base (NCDB) for select stage II and III rectal cancers...
October 25, 2016: Cancer
Kit D Longden
Color is famous for not existing in the external world: our brains create the perception of color from the spatial and temporal patterns of the wavelength and intensity of light. For an intangible quality, we have detailed knowledge of its origins and consequences. Much is known about the organization and evolution of the first phases of color processing, the filtering of light in the eye and processing in the retina, and about the final phases, the roles of color in behavior and natural selection. To understand how color processing in the central brain has evolved, we need well-defined pathways or circuitry where we can gauge how color contributes to the computations involved in specific behaviors...
October 24, 2016: Current Biology: CB
Jessica A Zagory, Jamie Golden, Kathleen Holoyda, Natalie Demeter, Nam X Nguyen
The optimal management of pilonidal disease in the pediatric population is still debated. We conducted a retrospective review of patients 21 years old and younger who underwent surgical management for pilonidal disease between 2009 and 2013 at a single pediatric institution. Sixty patients (41.7% male) were included in the analysis, with a mean age of 15.0 years (range, 13-20). Twelve (20%) had a prior drainage procedure for pilonidal abscess before the definitive operative treatment. After excision to the presacral fascia, 36 (60%) had primary closure, 17 (28...
October 2016: American Surgeon
Megan Johnson, Kenji Inaba, Saskya Byerly, Erika Falsgraf, Lydia Lam, Elizabeth Benjamin, Aaron Strumwasser, Jean-Stephane David, Demetrios Demetriades
Intraosseous (IO) needle placement is an alternative for patients with difficult venous access. The purpose of this retrospective study was to examine indications and outcomes associated with IO use at a Level 1 trauma center (January 2008-May 2015). Data points included demographics, time to insertion, intravenous (IV) access points, indications, infusions, hospital and intensive care unit length of stay, and mortality. Of 68 patients with IO insertion analyzed (63.2% blunt trauma, 29.4% penetrating trauma, and 7...
October 2016: American Surgeon
Alejandro Garbino, Derek M Nusbaum, Daniel M Buckland, Anil S Menon, Jonathan B Clark, Erik L Antonsen
The Stratex Project is a high altitude balloon flight that culminated in a freefall from 41,422 m (135,890 ft), breaking the record for the highest freefall to date. Crew recovery operations required an innovative approach due to the unique nature of the event as well as the equipment involved. The parachutist donned a custom space suit similar to a NASA Extravehicular Mobility Unit (EMU), with life support system mounted to the front and a parachute on the back. This space suit had a metal structure around the torso, which, in conjunction with the parachute and life support assembly, created a significant barrier to extraction from the suit in the event of a medical emergency...
2016: Aerospace Medicine and Human Performance
Jeffery S Babischkin, Graham W Aberdeen, Gerald J Pepe, Eugene D Albrecht
We have shown that fetal adrenal fetal zone (FZ) volume and serum dehydroepiandrosterone sulfate (DHAS) levels were increased, whereas definitive and transitional zone (DZ/TZ) volume was unaltered, in baboons in which estrogen levels were suppressed by administration of the aromatase inhibitor letrozole. The interaction of the melanocortin 2 receptor (MC2R) with its accessory protein (MRAP) is essential for trafficking MC2R to the adrenal cell surface for binding to ACTH. The present study determined whether the estrogen-dependent regulation of fetal adrenocortical development is mediated by ACTH and/or expression/interaction of MC2R and MRAP...
October 25, 2016: Endocrinology
David T Huang, Derek C Angus, Marc Moss, B Taylor Thompson, Niall D Ferguson, Adit Ginde, Michelle Ng Gong, Stephanie Gundel, Douglas L Hayden, R Duncan Hite, Peter C Hou, Catherine L Hough, Theodore J Iwashyna, Kathleen D Liu, Daniel S Talmor, Donald M Yealy
The Reevaluation Of Systemic Early neuromuscular blockade trial (ROSE) is a multicenter randomized trial designed to assess the efficacy and safety of early neuromuscular blockade in patients with moderate to severe acute respiratory distress syndrome. This document provides background for interpretation of the trial results, and highlights unique design approaches that may inform future trials of acute illness. We describe the process by which ROSE was chosen as the inaugural trial of the multidisciplinary Prevention and Early Treatment of Acute Lung Injury (PETAL) Network, provide the trial methodology using the Consolidated Standards of Reporting Trials (CONSORT) framework, and discuss key design challenges and their resolution...
October 25, 2016: Annals of the American Thoracic Society
Richard D Scheffe, Madeleine Strum, James Thurman, Sharon B Phillips, Alison Eyth, Steve Fudge, Mark Morris, Ted Palma, Richard Cook
A hybrid air quality model has been developed and applied to estimate annual concentrations of 40 hazardous air pollutants (HAPs) across the continental United States (CONUS) to support the 2011 calendar year National Air Toxics Assessment (NATA). By combining a chemical transport model (CTM) with a Gaussian dispersion model, both reactive and non-reactive HAPs are accommodated across local to regional spatial scales, through a multiplicative technique designed to improve mass conservation relative to previous additive methods...
October 25, 2016: Environmental Science & Technology
Małgorzata Stępień, Katarzyna Piwowarow, Mirosław P Czarkowski
OBJECTIVE: The aim of the study was to assess the epidemiological situation of hepatitis B in Poland in 2014 in comparison with the previous years. MATERIAL AND METHODS: The evaluation of the epidemiological situation was carried out on a basis of analysis of data from case-based reports on acute hepatitis B registered by sanitary and epidemiological stations, aggregate data derived from annual bulletins “Infectious diseases and poisonings in Poland”, data from annual bulletin “Vaccinations in Poland” and data on locally registered HBsAg carriers...
2016: Przegla̧d Epidemiologiczny
Monika Roberta Korczyńska, Justyna Rogalska
BACKGROUND: Vaccination against mumps from 2003 is mandatory in Poland and given as two dose scheme with MMR vaccine (mumps, measles, and rubella). Earlier this vaccination was only recommended. Despite observed decline in mumps incidence for over a decade which is a result of conducted vaccinations, mumps is still a common disease among the children. AIM: To assess epidemiological situation of mumps in Poland in 2014, including vaccination coverage in Polish population, in comparison to previous years...
2016: Przegla̧d Epidemiologiczny
Trevor P E Williams, Scott Shaw, Adam Porter, Larry Berkwitt
OBJECTIVE: To review information regarding etiology, pathophysiology, and treatment options for aortic thrombotic disease in dogs. ETIOLOGY: Diseases resulting in hypercoagulable states can cause thrombus formation in the distal aorta, and account for the majority of cases of aortic thrombosis (ATh) in dogs, although a substantial number of cases have no identifiable underlying cause. Aortic thromboembolism (ATE) also occurs but appears to be much less frequently documented...
October 25, 2016: Journal of Veterinary Emergency and Critical Care
Alison Kitson, Erik Elgaard Sorenson
We are experiencing unprecedented change in our health systems. The growing ageing and co-morbid profile of health service users creates a range of challenges around how health systems construct more integrated processes to support recovery to health and provide care. While there is an emphasis upon prevention and screening, the trend will continue to be around providing care and support for individuals, families and communities for chronic and life-style induced diseases. The emphasis will therefore be on the need for evidence-based care as much as evidence-based medicine (or cure)...
October 25, 2016: Journal of Clinical Nursing
Katharina Wimmer, Thorsten Rosenbaum, Ludwine Messiaen
Constitutional mismatch repair (MMR) deficiency (CMMRD) is a rare childhood cancer susceptibility syndrome resulting from biallelic germline loss-of-function mutations in one of the MMR genes. Individuals with CMMRD have a high risk to develop a broad spectrum of malignancies and frequently display features reminiscent of neurofibromatosis type 1 (NF1). Evaluation of the clinical findings of genetically proven CMMRD patients shows that not only multiple café-au-lait macules but any of the diagnostic features of NF1 may be present in a CMMRD patient...
October 25, 2016: Clinical Genetics
Hugo A Loáiciga
Methods for calculating the safe yield are evaluated in this paper using a high-quality and long historical data set of groundwater recharge, discharge, extraction, and precipitation in a karst aquifer. Consideration is given to the role that climatic variability has on the determination of a climatically representative period with which to evaluate the safe yield. The methods employed to estimate the safe yield are consistent with its definition as a long-term average extraction rate that avoids adverse impacts on groundwater...
October 25, 2016: Ground Water
Harcharan K Rooprai, Andrew J Martin, Andrew King, Usha D Appadu, Huw Jones, Richard P Selway, Richard W Gullan, Geoffrey J Pilkington
MMPs (matrix metalloproteinases), ADAMs (a disintegrin and metalloproteinase) and TIMPs (tissue inhibitors of metalloproteinases) are implicated in invasion and angiogenesis: both are tissue remodeling processes involving regulated proteolysis of the extracellular matrix, growth factors and their receptors. The expression of these three groups and their correlations with clinical behaviour has been reported in gliomas but a similar comprehensive study in meningiomas is lacking. In this study, we aimed to evaluate the patterns of expression of 23 MMPs, 4 TIMPs, 8 ADAMs, selective growth factors and their receptors in 17 benign meningiomas using a quantitative real-time polymerase chain reaction (qPCR)...
October 18, 2016: International Journal of Oncology
Han-Shi Zeng, Wei-Xia Lin, Shu-Tao Zhao, Zhan-Hui Zhang, Heng-Wen Yang, Feng-Ping Chen, Yuan-Zong Song, Zhi-Nan Yin
Neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) is an autosomal recessive disorder resulting from biallelic mutations of the SLC25A13 gene. Due to the lack of well‑recognized clinical or biochemical diagnostic criteria, the definitive diagnosis of this disease relies on the genetic analysis of SLC25A13 at present. As novel large deletion/insertion mutations of the SLC25A13 gene are difficult to detect using routine DNA analytic approaches, the timely diagnosis of patients with these types of mutations remains a challenge...
October 21, 2016: Molecular Medicine Reports
Xiang-Yang Fang, Zhe Chen, Guo-Bin Miao, Lin Zhang
β-adrenergic receptors (β-ARs) and anti-β1-AR autoantibodies play important roles in heart failure. This study was designed to investigate the expression of β1- and β2-ARs in the lungs, and their relevance to the corresponding autoantibodies in an aged rat model of heart failure. In addition, we investigated the association between anti-β-AR autoantibody and soluble Fas (sFas) and soluble Fas ligand (sFasL). Aged male Wistar rats were divided into the sham-operated control group and the heart failure group...
October 24, 2016: International Journal of Molecular Medicine
Paul R Lewis, Jayraan Badiee, Michael J Sise, Richard Y Calvo, Jason B Brill, James D Wallace, Steven R Shackford, Casey E Dunne, Vishal Bansal, C Beth Sise
BACKGROUND: The American College of Surgeons Committee on Trauma devised process audit filters to identify opportunities for improvement (OFI), prevent adverse outcomes, and improve quality. Delay to the operating room for primary trauma laparotomy is a process audit filter that has not been definitively associated with improved outcomes. We sought to evaluate the effectiveness of delay to the operating room of greater than 2 hours (DOR) to independently identify an adverse outcome or an OFI at our Level I trauma center...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Christine M Leeper, Matthew D Neal, Christine McKenna, Jason Sperry, Barbara A Gaines
BACKGROUND: Abnormalities in fibrinolysis are common and associated with increased mortality in injured adults. While hyperfibrinolysis (HF) and fibrinolysis shutdown (SD) are potential prognostic indicators and treatment targets in adults, these derangements are not well-described in a pediatric trauma cohort. METHODS: Prospective analysis of highest level trauma activations age 0-18 presenting to our academic center between 6/1/2015-7/31/2016 with admission rapid thromboelastogram (TEG)...
October 25, 2016: Journal of Trauma and Acute Care Surgery
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