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Monish M Maharaj, Kevin Phan, Soumya Hariswamy, Prashanth J Rao
BACKGROUND: Surfers myelopathy can be a rapidly devastating disease and little is known surrounding the pathophysiology of the condition. Although the classical pattern of illness has been well reported, it has never been observed in a non-surfing setting. METHODS: A 51-year-old demolition worker presented with acute non-traumatic myelopathy. Clinical examination revealed sensory loss to the level of L2. T2-MRI and MRI-DWI revealed a hyperintense signal suggestive of an ischaemic event...
September 2016: J Spine Surg
Rae Woong Park
Big data indicates the large and ever-increasing volumes of data adhere to the following 4Vs: volume (ever-increasing amount), velocity (quickly generated), variety (many different types), veracity (from trustable sources). The last decade has seen huge advances in the amount of data we routinely generate and collect in pretty much everything we do, as well as our ability to use technology to analyze and understand it. The routine operation of modern health care systems also produces an abundance of electronically stored data on an ongoing basis as a byproduct of clinical practice...
September 2016: Journal of Hypertension
Clive Rosendorff
Many guidelines for the management of hypertension have recommended that the goal of antihypertensive treatment in the elderly (usually specified as 80 years or above) should be less than 150/90 mmHg. SPRINT included subjects 50 years or above, and a substantial proportion of subjects 75 years and older. These are individuals at high risk for adverse cardiovascular events because of high prevalence of hypertension and atherosclerotic disease. The less stringent BP goals have been based on a percieved danger of lowering BP to levels that threaten vital organ pefusion (myocardium, brain, kidney)...
September 2016: Journal of Hypertension
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
Miguel Pinto, Vítor Borges, Minia Antelo, Miguel Pinheiro, Alexandra Nunes, Jacinta Azevedo, Maria José Borrego, Joana Mendonça, Dina Carpinteiro, Luís Vieira, João Paulo Gomes
Insights into the genomic adaptive traits of Treponema pallidum, the causative bacterium of syphilis, have long been hampered due to the absence of in vitro culture models and the constraints associated with its propagation in rabbits. Here, we have bypassed the culture bottleneck by means of a targeted strategy never applied to uncultivable bacterial human pathogens to directly capture whole-genome T. pallidum data in the context of human infection. This strategy has unveiled a scenario of discreet T. pallidum interstrain single-nucleotide-polymorphism-based microevolution, contrasting with a rampant within-patient genetic heterogeneity mainly targeting multiple phase-variable loci and a major antigen-coding gene (tprK)...
October 17, 2016: Nature Microbiology
Yusuf Haydar Ertekin, Burkay Yakar, Hülya Ertekin, Ayşegül Uludağ, Murat Tekin
BACKGROUND: Drugs represent one of the etiologic causes of acute rhabdomyolysis (AR) with drug-induced rhabdomyolysis most commonly associated with HMG-CoA reductase inhibitors. AR etiology can also result from the use of diclofenac, a non-steroidal anti-inflammatory drug, and omeprazole, a proton pump inhibitor. Cases of AR triggered by pantoprazole have never before been reported, although it has been observed that its inclusion in multiple drug therapies can result in muscle events...
December 2015: Drug Saf Case Rep
Yong Yang, Hua Gu, Xiaofeng Yu, Li Zhan, Jiancai Chen, Yun Luo, Yunyi Zhang, Yanjun Zhang, Yiyu Lu, Jianmin Jiang, Lingling Mei
Emetic toxin producing Bacillus cereus (emetic B. cereus) is the third member of B. cereus group whose toxins are encoded by megaplasmids, beside anthrax and insecticidal toxins of B. anthracis and B. thuringiensis respectively. 18 emetic isolates collected from food poisoning events, clinical and non-random food samples in Zhejiang province of China, were analyzed by plasmid screening, pulse field gel electrophoresis (PFGE), multi-locus sequence typing (MLST), as well as toxic gene identification to investigate their genotypic diversity...
October 14, 2016: FEMS Microbiology Letters
Georges Daccache, Edouard Caspersen, Michel Pegoix, Kelly Monthé-Sagan, Ludovic Berger, Dominique Fletcher, Jean-Luc Hanouz
BACKGROUND: The intraoperative modulation of opioids continues to be based on clinical signs. This may result in adverse events such as sympathetic reactivity or opioid induced hyperalgesia. Recently, the Analgesia/Nociception Index (ANI), a non-invasive 0-100 index derived from heart rate variability analysis, has been proposed for nociception assessment. However, the ability of the ANI to adequately guide intraoperative opioid administration has never been demonstrated. We designed a prospective study to evaluate the ability of the ANI to guide remifentanil administration in vascular surgery...
October 12, 2016: Anaesthesia, Critical Care & Pain Medicine
Chao-Ming Tseng, Wei-Chih Liao, Chi-Yang Chang, Ching-Tai Lee, Cheng-Hao Tseng, Yao-Chun Hsu, Jaw-Town Lin
BACKGROUND: Pancreatic safety remains a concern for diabetic patients using incretin-based medications. We aimed to determine if there was an association between incretin-based therapy and an increased risk for acute pancreatitis and pancreatic cancer in patients with type 2 diabetes mellitus (DM). METHODS: This retrospective population-based cohort study analyzed data from the Taiwan National Health Insurance Research Database. A total of 13 171 eligible type 2 DM patients who had received incretin-based treatment for a minimum of two months were matched 1:1 for age, gender, diabetes complications severity index, and inception date with DM patients who never used this pharmacotherapy...
October 7, 2016: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Paul A Lehur, Anne S Didnée, Jean-Luc Faucheron, Guillaume Meurette, Philippe Zerbib, Laurent Siproudhis, Béatrice Vinson-Bonnet, Anne Dubois, Christine Casa, Jean-Benoit Hardouin, Isabelle Durand-Zaleski
OBJECTIVE: To compare Doppler-guided hemorrhoidal artery ligation (DGHAL) with circular stapled hemorrhoidopexy (SH) in the treatment of grade II/III hemorrhoidal disease (HD). BACKGROUND: DGHAL is a treatment option for symptomatic HD; existing studies report limited risk and satisfactory outcomes. DGHAL has never before been compared with SH in a large-scale multi-institutional randomized clinical trial. METHODS: Three hundred ninety-three grade II/III HD patients recruited in 22 centers from 2010 to 2013 were randomized to DGHAL (n = 197) or SH (n = 196)...
November 2016: Annals of Surgery
Jiwon Sarah Park, Jennifer H Kuo, J Nilas Young, Michael S Wong
BACKGROUND: Rigid sternal fixation (RSF) has been shown to reduce sternal wound complications in high-risk patients. However, the higher initial cost continues to deter its use. This study evaluates the cost of caring for high-risk sternotomy patients who underwent RSF compared with those who underwent sternal closure with a modified wire technique (MWT). METHODS: A retrospective single institution review of high-risk patients who underwent MWT (n = 45) and RSF (n = 30) for primary sternal closure from 2006 to 2009 was conducted...
October 6, 2016: Annals of Plastic Surgery
Amanda J Ampt, Vijay Roach, Christine L Roberts
OBJECTIVES: To compare the characteristics of women who have undergone vulvoplasty with those of other women of reproductive age; to quantify short term adverse events and complications; to determine any association between vulvoplasty and subsequent outcomes for women giving birth. DESIGN, SETTING AND PARTICIPANTS: A population-based record linkage study, analysing New South Wales Admitted Patient Data Collection and NSW Perinatal Data Collection data. The characteristics of all women who had vulvoplasties in NSW hospitals during 2001-2013 were compared with those of all women of reproductive age...
October 17, 2016: Medical Journal of Australia
Reshmi Srinath, Rebecca F Gottesman, Sherita Hill Golden, Kathryn A Carson, Adrian Dobs
BACKGROUND AND PURPOSE: Epidemiological studies in men suggest a relationship between endogenous testosterone and ischemic vascular events. We hypothesized that low testosterone is independently associated with ischemic stroke and ischemic brain changes. METHODS: In 1558 male participants (mean [SD] age, 63.1 [5.6] years; body mass index, 28.2 [4.3] kg/m(2)) from visit 4 (1996-1998) of the ARIC study (Atherosclerosis Risk in Communities) without cardiovascular disease, stroke, and previous testosterone therapy, we measured plasma total testosterone by liquid chromatography mass spectrometry using morning samples and divided levels into tertiles (median [25th-75th percentile], 377...
October 11, 2016: Stroke; a Journal of Cerebral Circulation
Tao Liu, Gang Wang, Huangheng Tao, Zhonghua Yang, Yongzhi Wang, Zhe Meng, Rui Cao, Yu Xiao, Xinghuan Wang, Jiajie Zhou
BACKGROUND: Renal cell carcinoma (RCC) is one of the tumors most refractory to chemotherapy to date. Therefore, novel therapeutic agents are urgently needed for this disease. Capsaicin (CPS), a natural active ingredient of green and red peppers, and a ligand of transient receptor potential vanilloid type 1 (TRPV1), has been showed potential in suppression of tumorigenesis of several cancers. Nonetheless, the anti-cancer activity of CPS has never been studied in human RCC. METHODS: CCK8 analysis, LDH release activity and ROS generation analysis, flow cytometry analysis, and nuclear staining test were performed to test the influence of CPS in cultured cells in vitro, meanwhile western blot was done to uncover the precise molecular mechanisms...
October 12, 2016: BMC Cancer
Wei-Te Wu, Su-Shan Tsai, Yu-Jen Lin, Ming-Hsiu Lin, Trong-Neng Wu, Tung-Sheng Shih, Saou-Hsing Liou
BACKGROUND: Professional drivers' work under conditions predisposes them for development of sleep-disordered breathing (SDB) and cardiovascular disease (CVD). However, the effect of SDB on CVD risk among professional drivers has never been investigated. A cohort study was used to evaluate the effectiveness of overnight pulse oximeter as a sleep apnea screening tool to assess the 8-year risk of CVD events. METHODS: The Taiwan Bus Driver Cohort Study (TBDCS) recruited 1014 professional drivers in Taiwan since 2005...
September 29, 2016: International Journal of Cardiology
Frederik Clauson-Kaas, Carmel Ramwell, Hans Chr B Hansen, Bjarne W Strobel
The bracken fern (Pteridium spp.) densely populates both open and woodland vegetation types around the globe. Bracken is toxic to livestock when consumed, and a group of potent illudane-type carcinogens have been identified, of which the compound ptaquiloside (PTA) is the most abundant. The highly water soluble PTA has been shown to be leachable from bracken fronds, and present in the soil and water below bracken stands. This has raised concerns over whether the compound might pose a risk to drinking water sources...
September 26, 2016: Water Research
Harold Sungani, Benjamin P Ngatunga, Stephan Koblmüller, Tuuli Mäkinen, Paul H Skelton, Martin J Genner
It has been proposed that the fish faunas of African rivers assemble through multiple colonisation events, while lake faunas form additionally through intralacustine speciation. While this pattern has been established for many lineages, most notably cichlids, there are opportunities to further investigate the concept using phylogenies of congeneric endemic species within ancient lake catchments. The Lake Malawi catchment contains three river-spawning cyprinids of the genus Opsaridium, two of which are endemic...
September 30, 2016: Molecular Phylogenetics and Evolution
Yu-Chu Shen, Jesse M Cunha, Thomas V Williams
BACKGROUND: US military suicides have increased substantially over the past decade and currently account for almost 20% of all military deaths. We investigated the associations of a comprehensive set of time-varying risk factors with suicides among current and former military service members. METHODS: We did a retrospective multivariate analysis of all US military personnel between 2001 and 2011 (n=110 035 573 person-quarter-years, representing 3 795 823 service members)...
September 30, 2016: Lancet Psychiatry
Jaymin Upadhyay, Julia Granitzka, Thomas Bauermann, Ulf Baumgärtner, Markus Breimhorst, Rolf-Detlef Treede, Frank Birklein
Being able to remember physically and emotionally painful events in one's own past may shape behavior, and can create an aversion to a variety of situations. Pain imagination is a related process that may include recall of past experiences, in addition to production of sensory and emotional percepts without external stimuli. This study aimed to understand 1) the central nervous system processes that underlie pain imagination, 2) the retrieval of pain memories, and 3) to compare the latter with visual object memory...
2016: Journal of Pain Research
Amy E Vinson, David Zurakowski, Gail I Randel, Kathy D Schlecht
STUDY OBJECTIVE: The prevalence of anesthesiology department wellness programs is unknown. A database of wellness programs is needed as a resource for departments attempting to respond to the Accreditation Council for Graduate Medical Education Anesthesiology Milestones Project. The purpose of this study was to survey academic anesthesiology chairs on wellness issues, characterize initiatives, and establish wellness contacts for a Wellness Initiative Database (WID). DESIGN: An Internet-based survey instrument was distributed to academic anesthesiology department chairs in the United States...
November 2016: Journal of Clinical Anesthesia
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