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https://www.readbyqxmd.com/read/28445807/rewiring-brain-circuits-to-block-cataplexy-in-murine-models-of-narcolepsy
#1
REVIEW
Meng Liu, Carlos Blanco-Centurion, Priyattam J Shiromani
Narcolepsy was first identified almost 130 years ago, but it was only 15 years ago that it was identified as a neurodegenerative disease linked to a loss of orexin neurons in the brain. It is unclear what causes the orexin neurons to die, but our strategy has been to place the gene for orexin into surrogate neurons in the validated mouse models of narcolepsy, and test whether it can block narcolepsy symptoms, such as cataplexy. In both the orexin knockout and the orexin-ataxin-3 mouse models of narcolepsy we have found that cataplexy can be blocked if the surrogate neurons are part of the circuit responsible for cataplexy...
April 23, 2017: Current Opinion in Neurobiology
https://www.readbyqxmd.com/read/28442955/no-preemptive-analgesic-effect-of-preoperative-ketorolac-administration-following-total-abdominal-hysterectomy-a-randomized-study
#2
Beatriz Nistal-Nuño
BACKGROUND: Experimental models using short-duration noxious stimuli have led to the concept of preemptive analgesia. Ketorolac, a nonsteroidal anti-inflammatory drug, has been shown to have a postoperative narcotic-sparing effect when given preoperatively and alternatively to not have this effect. This study was undertaken to determine whether a single intravenous (IV) dose of ketorolac would result in decreased postoperative pain and narcotic requirements. METHODS: In a double-blind, randomized controlled trial, 48 women undergoing abdominal hysterectomy were studied...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28438721/clinical-profile-and-mutation-spectrum-of-long-qt-syndrome-in-saudi-arabia-the-impact-of-consanguinity
#3
Zuhair N Al-Hassnan, Majid Al-Fayyadh, Bander Al-Ghamdi, Azam Shafquat, Yaseen Mallawi, Faten Al-Hadeq, Sahar Tulbah, Zarghuna Ma Shinwari, Abdulrahman Almesned, Ali Alakhfash, Fadel Al Fadly, Ahmed S Hersi, Abdullah Alhayani, Amal Al-Hashem, Dia Arafah, Nduna Dzimiri, Brian Meyer, Monther Rababh, Waleed Al-Manea
BACKGROUND: Congenital long QT syndrome (LQTS) is an inherited potentially fatal arrhythmogenic disorder. At least 16 genes have been implicated in LQTS; the yield of genetic analysis of 3 genes (KCNQ1, KCNH2, and SCN5A) is about 70% with KCNQ1 mutations accounting for ∼50% of positive cases. LQTS is mostly inherited in an autosomal dominant pattern. Systemic analysis of LQTS has not been previously conducted in a population with a high degree of consanguinity. OBJECTIVES: We aim to describe the clinical and molecular profiles of LQTS in the highly consanguineous Saudi population...
April 21, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28432714/high-human-cytomegalovirus-dnaemia-early-post-transplantation-associates-with-irreversible-and-progressive-loss-of-renal-function
#4
Wouter T Lollinga, Lilli Rurenga-Gard, Willem van Doesum, Rik van Bergen, Arjan Diepstra, Judith M Vonk, Annelies Riezebos-Brilman, Hgm Niesters, Willem J van Son, Jacob van den Born, Jan-Stephan Sanders
BACKGROUND: Transplant recipients are prone to viral infections, which could affect renal transplantation outcome. Our aim was to assess the effects of early human cytomegalovirus (CMV) DNAemia on transplant renal function. METHODS: 264 (age 50.9±13.5; male 55%) Renal transplantation recipients undergoing preemptive anti-CMV therapy were retrospectively categorized based on early (<3 months post-Tx) CMV peak viral load (PVL); PVL≤536, PVL536-6310 or PVL>6310 International Units/ml (IU/ml)...
April 22, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28426304/a-significant-and-quiet-threat-to-public-health-in-the-united-states-state-preemption
#5
Jennifer L Pomeranz, Mark Pertschuk
State and local governments traditionally protect the health and safety of their populations more strenuously than does the federal government. Preemption, when a higher level of government restricts or withdraws the authority of a lower level of government to act on a particular issue, was historically used as a point of negotiation in the legislative process. More recently, however, 3 new preemption-related issues have emerged that have direct implications for public health. First, multiple industries are working on a 50-state strategy to enact state laws preempting local regulation...
April 20, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28422925/dynamics-of-b-cell-recovery-following-kidney-bone-marrow-transplant-recipients
#6
Baoshan Gao, Yiming Gu, Chunshu Rong, Carolina Moore, Fabrice Porcheray, Waichi Wong, Frederic Preffer, Susan L Saidman, Yaowen Fu, Benedict Cosimi, David H Sachs, Tatsuo Kawai, Megan Sykes, Emmanuel Zorn
BACKGROUND: Previous studies identified B cell gene signatures and predominance of specific B cell subsets as a marker of operational tolerance following kidney transplantation. These findings suggested a role for B cells in the establishment or maintenance of tolerance. Here we analyzed B cell recovery in 4 subjects, 3 of whom achieved tolerance after combined kidney/bone marrow transplantation. METHODS: Peripheral B cell subsets were examined longitudinally by flow cytometry...
April 19, 2017: Transplantation
https://www.readbyqxmd.com/read/28418577/prospective-assessment-of-sleep-quality-before-and-after-primary-total-joint-replacement
#7
Blaine T Manning, Sean M Kearns, Daniel D Bohl, Tori Edmiston, Scott M Sporer, Brett R Levine
Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods. The survey included the Epworth Sleepiness Scale, current sleeping habits, and patient perspectives of sleep quality and duration...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28417267/preemptive-warfarin-dose-reduction-after-initiation-of-sulfamethoxazole-trimethoprim-or-metronidazole
#8
Anna Powers, Erin B Loesch, Anthony Weiland, Nicole Fioravanti, David Lucius
To evaluate the utility of a preemptive warfarin dose reduction at the time of initiation of either sulfamethoxazole-trimethoprim or metronidazole, a retrospective chart review of patients who received an outpatient prescription for warfarin and either sulfamethoxazole-trimethoprim and/or metronidazole from July 1, 2011 to July 1, 2015 was conducted. Clinical outcomes compared Veterans who had a warfarin dose reduction and those who did not within 120 h (5 days) of antibiotic initiation. The primary outcome compared the pre-and post-antibiotic International Normalized Ratio (INR) of patients in the intervention group (warfarin dose reduction) with those in the control group (no intervention)...
April 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28416042/earthquakes-fuel-crisis-power-outages-and-health-care-in-nepal-implications-for-the-future
#9
Bipin Adhikari, Shiva Raj Mishra, Sujan Babu Marahatta, Nils Kaehler, Kumar Paudel, Janak Adhikari, Shristi Raut
Earthquakes are a major natural calamity with pervasive effects on human life and nature. Similar effects are mimicked by man-made disasters such as fuel crises and power outages in developing countries. Natural and man-made disasters can cause intangible human suffering and often leave scars of lifelong psychosocial damage. Lessons from these disasters are frequently not implemented. The main objective of this study was to review the effects of the 2015 earthquakes, fuel crisis, and power outages on the health services of Nepal and formulate recommendations for the future...
April 18, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28413792/epedimiologic-clinical-profile-and-factors-affecting-the-outcome-in-febrile-neutropenia
#10
Kalpathi Krishnamani, Linga Vijay Gandhi, Gundeti Sadashivudu, Digumarti Raghunadharao
BACKGROUND: Febrile neutropenia (FN) is common in cancer patients particularly hematologic malignancies due to intensive cytotoxic chemotherapy. It is an important cause of morbidity, mortality and treatment delays. The risk is greater in patients with ANC < 500/ mm3 and increases dramatically in those with ANC < 100/ mm3 and duration of neutropenia more than 1 week. AIMS AND OBJECTIVES: The purpose of this study was to evaluate the incidence, demographic characteristics, clinical profile, mortality, outcome and factors affecting the outcome in patients with febrile neutropenia (FN) admitted at our Center between January 2011 and November 2012...
January 2017: South Asian Journal of Cancer
https://www.readbyqxmd.com/read/28413514/effect-of-pre-emptive-analgesia-by-continuous-femoral-nerve-block-on-early-postoperative-cognitive-function-following-total-knee-arthroplasty-in-elderly-patients
#11
Li-Qin Deng, Lei-Na Hou, Feng-Xiang Song, Han-Yue Zhu, Hai-Ying Zhao, Gang Chen, Jing-Jing Li
To the best of our knowledge, the effect of pre-emptively blocking pain transmission on acute postoperative cognitive dysfunction (POCD) has not yet been assessed. Therefore, the present study aimed to investigate the effect of pre-emptive analgesia via a continuous femoral nerve block (CFNB) on postoperative pain and early cognitive function following total knee arthroplasty (TKA) surgery in elderly patients. CFNB was performed prior to TKA surgery in the pre-emptive analgesia group (n=30) and following TKA surgery in the control group (n=30)...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28403084/the-comparative-preemptive-analgesic-efficacy-of-addition-of-vitamin-b-complex-to-gabapentin-versus-gabapentin-alone-in-women-undergoing-cesarean-section-under-spinal-anesthesia-a-prospective-randomized-double-blind-study
#12
Marzieh Beigom Khezri, Nahid Nasseh, Ghodratollah Soltanian
BACKGROUND: Development of new multimodal analgesic regimens have led to substantial improvement in postoperative pain relief. We designed this study to compare the effect of combined vitamin B complex-gabapentin versus gabapentin alone on postoperative pain in women undergoing cesarean section under spinal anesthesia. METHODS: One hundred twenty-eight women who underwent cesarean section under spinal anesthesia were randomized to receive orally 300 mg gabapentin (group G) or 300 mg of gabapentin plus 2 vitamin B complex (group GB) tablets 30 minutes before surgery...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28398598/pharmacogenomics-based-point-of-care-clinical-decision-support-significantly-alters-drug-prescribing
#13
Peter H O'Donnell, Nisha Wadhwa, Keith Danahey, Brittany A Borden, Sang Mee Lee, Julianne P Hall, Catherine Klammer, Sheena Hussain, Mark Siegler, Matthew J Sorrentino, Andrew M Davis, Yasmin A Sacro, Rita Nanda, Tamar S Polonsky, Jay L Koyner, Deborah L Burnet, Kristen Lipstreuer, David T Rubin, Cathleen Mulcahy, Mary E Strek, William Harper, Adam S Cifu, Blase Polite, Linda Patrick-Miller, Kiang-Teck J Yeo, Edward K Y Leung, Samuel L Volchenboum, Russ B Altman, Olufunmilayo I Olopade, Walter M Stadler, David O Meltzer, Mark J Ratain
Changes in behavior are necessary to apply genomic discoveries to practice. We prospectively studied medication changes made by providers representing eight different medicine specialty clinics whose patients had submitted to preemptive pharmacogenomic genotyping. An institutional clinical decision support (CDS) system provided pharmacogenomic results using traffic light alerts: green/genomically favorable, yellow/genomic caution, red/high risk. The influence of pharmacogenomic alerts on prescribing behaviors was the primary endpoint...
April 11, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28396108/augmented-nurse-care-management-in-ckd-stages-4-to-5-a%C3%A2-randomized-trial
#14
Steven Fishbane, Sofia Agoritsas, Alessandro Bellucci, Candice Halinski, Hitesh H Shah, Vipul Sakhiya, Leah Balsam
BACKGROUND: Outcomes for patients with late-stage chronic kidney disease (CKD) in the United States are suboptimal. There is poor education and preparation for end-stage kidney disease, as well as a high rate of hospitalization in this group of patients. STUDY DESIGN: A randomized, parallel-group, 2-arm, controlled trial. SETTING & PARTICIPANTS: The study was conducted at 3 sites: a clinic of an academic medical center, a public hospital academic clinic, and a community-based private practice...
April 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28394329/a-stemness-related-zeb1-msrb3-axis-governs-cellular-pliancy-and-breast-cancer-genome-stability
#15
Anne-Pierre Morel, Christophe Ginestier, Roxane M Pommier, Olivier Cabaud, Emmanuelle Ruiz, Julien Wicinski, Mojgan Devouassoux-Shisheboran, Valérie Combaret, Pascal Finetti, Christelle Chassot, Christiane Pinatel, Frédérique Fauvet, Pierre Saintigny, Emilie Thomas, Caroline Moyret-Lalle, Joël Lachuer, Emmanuelle Despras, Jean-Luc Jauffret, François Bertucci, Jérôme Guitton, Anne Wierinckx, Qing Wang, Nina Radosevic-Robin, Frédérique Penault-Llorca, David G Cox, Frédéric Hollande, Stéphane Ansieau, Julie Caramel, Daniel Birnbaum, Arnaud M Vigneron, Agnès Tissier, Emmanuelle Charafe-Jauffret, Alain Puisieux
Chromosomal instability (CIN), a feature of most adult neoplasms from their early stages onward, is a driver of tumorigenesis. However, several malignancy subtypes, including some triple-negative breast cancers, display a paucity of genomic aberrations, thus suggesting that tumor development may occur in the absence of CIN. Here we show that the differentiation status of normal human mammary epithelial cells dictates cell behavior after an oncogenic event and predetermines the genetic routes toward malignancy...
April 10, 2017: Nature Medicine
https://www.readbyqxmd.com/read/28393786/prosthesis-patient-mismatch-what-cardiac-anesthesiologists-need-to-know
#16
REVIEW
Kathirvel Subramaniam, Soheyla Nazarnia
Prosthesis-patient Mismatch (PPM) is not uncommon with an incidence reported up to 70% after aortic valve (AV) replacement. Severe forms of PPM are less common (up to 20%); PPM can lead to increased short- and long-term morbidity and mortality. It is important to discriminate PPM from other forms of prosthetic valve dysfunction. Sometimes, prosthetic valve degenerative disease may coexist with PPM. Echocardiography plays an important role in the prevention and diagnosis of PPM. Preemptive strategies to prevent PPM include insertion of newer generation prosthetic valves with better hemodynamic characteristics, stentless prosthesis, aortic root enlargement to insert a larger prosthesis, aortic homograft, and transcutaneous AV implantation...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28376233/a-call-for-fertility-preservation-coverage-for-breast-cancer-patients-the-cost-of-consistency
#17
Jessica R Walter, Shuai Xu, Teresa K Woodruff
In 1998, the passage of the Women's Health and Cancer Rights Act required insurance health plans nationwide covering breast cancer treatments to also reimburse for subsequent breast reconstructive surgery and prostheses. In response to low utilization of breast reconstructive services, particularly among racial minorities, plastic surgery interest groups successfully advocated for the passage of the Breast Cancer Patient Education Act, which provides a timely opportunity to reconsider patient accessibility to other equally important quality of life issues for cancer survivors...
May 1, 2017: Journal of the National Cancer Institute
https://www.readbyqxmd.com/read/28372652/dose-ranging-effects-of-pregabalin-on-pain-in-patients-undergoing-laparoscopic-hysterectomy-a-randomized-double-blinded-placebo-controlled-clinical-trial
#18
Zahra Asgari, Safoura Rouholamin, Masoomeh Nataj, Mahdi Sepidarkish, Reihaneh Hosseini, Maryam Razavi
OBJECTIVE: The study aimed to investigate the preemptive analgesia efficacy of different concentrations (75, 150 and 300mg) of preemptive pregabalin for the postoperative pain management after laparoscopic hysterectomy. DESIGN: Prospective, randomized, placebo-controlled, double-blind study. SETTING: The Gynecology and Obstetrics Center of Arash Hospital, Tehran, Iran, from October 2013 to November 2014. PATIENTS: A total of 96 women with American Association of Anesthesiologist (ASA) physical status I and II underwent elective laparoscopic hysterectomy surgery...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28371158/the-effect-of-gabapentin-on-delayed-discharge-from-the-postanesthesia-care-unit-a-retrospective-analysis
#19
Naveed T Siddiqui, Amir Yousefzadeh, Maaz Yousuf, Dileep Kumar, Farah K Choudhry, Zeev Friedman
BACKGROUND: Enhanced recovery after surgery programs have incorporated gabapentin as part of a multimodal analgesia protocol. The preemptive use of gabapentin was found to be beneficial due to its opioid-sparing effect. However, excessive sedation and delayed discharge from postanesthesia recovery units are of concern. The aim of this study was to investigate whether preoperative gabapentin increased the length of stay in the recovery unit. METHODS: This retrospective cross-sectional study was carried out over a period of 2 months in the postanesthesia care unit (PACU) of a tertiary care hospital in Canada...
March 30, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28358727/salvage-islet-auto-transplantation-after-relaparatomy
#20
Gianpaolo Balzano, Rita Nano, Paola Maffi, Alessia Mercalli, Raffaelli Melzi, Francesca Aleotti, Francesca Gavazzi, Cesare Berra, Francesco De Cobelli, Massimo Venturini, Paola Magistretti, Marina Scavini, Giovanni Capretti, Alessandro Del Maschio, Antonio Secchi, Alessandro Zerbi, Massimo Falconi, Lorenzo Piemonti
BACKGROUND: To assess feasibility, safety and metabolic outcome of islet auto transplantation (IAT) in patients undergoing completion pancreatectomy because of sepsis or bleeding following pancreatic surgery. METHODS: From November 2008 to October 2016, 22 patients were candidates to salvage IAT during emergency relaparotomy because of postpancreatectomy sepsis (n=11) or bleeding (n=11). Feasibility, efficacy, and safety of salvage IAT were compared to those documented in a cohort of 36 patients who were candidate to simultaneous IAT during nonemergency preemptive completion pancreatectomy through the pancreaticoduodenectomy...
March 29, 2017: Transplantation
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