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Ivan R Da Silva, Joao A Gomes, Ari Wachsman, Gabriel Rodriguez de Freitas, Jose Javier Provencio
BACKGROUND: It is not well understood whether age impacts transcranial Doppler (TCD) mean flow velocities (MFVs) in patients with aneurysmal subarachnoid hemorrhage (SAH) with or without delayed cerebral ischemia (DCI). The aim of our study was to analyze the behavior of TCD MFV during the first 7 days after SAH in patients of different ages and correlate them with the occurrence of DCI. METHODS: This study is a databank analysis of patients with SAH admitted between 2010 and 2012 in a single center...
October 21, 2016: European Neurology
Riikka S K Takala, Riku Kiviranta, Klaus T Olkkola, Tero Vahlberg, Dan Laukka, Anna Kotkansalo, Melissa Rahi, Matti Sankinen, Jussi Posti, Ari Katila, Jaakko Rinne
PURPOSE: The aim was to assess anterior pituitary hormone levels during the acute phase of aneurysmal subarachnoid hemorrhage (aSAH) and analyze the possible association with the clinical condition and outcome. MATERIAL AND METHODS: Forty patients with aSAH whose aneurysm was secured by endovascular coiling were enrolled. Basal secretions of cortisol, testosterone, luteinizing hormone (LH), prolactin (PRL), and sex hormone binding globulin (SHBG) levels were measured up to 14 days after the incident...
October 18, 2016: Endocrine Research
T V K Herregods, A J P M Smout, J L S Ooi, D Sifrim, A J Bredenoord
BACKGROUND: With the advent of high-resolution manometry (HRM), a new diagnosis, jackhammer esophagus, was introduced. Little is known about this rare condition, and the relationship between symptoms and hypercontractility is not always straightforward. The aim of our study was to describe a large cohort of patients with jackhammer esophagus and to investigate whether manometric findings are associated with the presence of symptoms. METHODS: All patients from 06, 2014 until 12, 2015 seen at two tertiary centers with at least one hypercontractile swallow (distal contractile integral [DCI] >8000 mm Hg/s/cm) on HRM were analyzed...
October 17, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Charles L Francoeur, Stephan A Mayer
For patients who survive the initial bleeding event of a ruptured brain aneurysm, delayed cerebral ischemia (DCI) is one of the most important causes of mortality and poor neurological outcome. New insights in the last decade have led to an important paradigm shift in the understanding of DCI pathogenesis. Large-vessel cerebral vasospasm has been challenged as the sole causal mechanism; new hypotheses now focus on the early brain injury, microcirculatory dysfunction, impaired autoregulation, and spreading depolarization...
October 14, 2016: Critical Care: the Official Journal of the Critical Care Forum
Kai I Cheang, Sakita N Sistrun, Kelley S Morel, John E Nestler
Background. A deficiency of D-chiro-inositol-inositolphosphoglycan mediator (DCI-IPG) may contribute to insulin resistance in polycystic ovary syndrome (PCOS). Whether the relationship between impaired DCI-IPG release and insulin resistance is specific to PCOS rather than obesity is unknown. We assessed insulin-released DCI-IPG and its relationship to insulin sensitivity at baseline and after weight loss in obese women with and without PCOS. Methods. Obese PCOS (n = 16) and normal (n = 15) women underwent 8 weeks of a hypocaloric diet...
2016: International Journal of Endocrinology
Ivan Rocha Ferreira Da Silva, Joao Antonio Gomes, Ari Wachsman, Gabriel Rodriguez de Freitas, Jose Javier Provencio
PURPOSE: Aneurysmal subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality, but currently no single clinical method or ancillary test can reliably predict which subset of patients will develop delayed cerebral ischemia (DCI). The aim of this study was to find hematologic derangements and clinical factors present during the first 7 days after bleeding that could help identify patients at risk for development of DCI. MATERIALS AND METHODS: Databank analysis of patients with SAH admitted between 2010 and 2012 in a single center...
September 22, 2016: Journal of Critical Care
Abdulrahman Aldakkan, Alireza Mansouri, Blessing N R Jaja, Naif M Alotaibi, R Loch Macdonald
BACKGROUND: Risk of delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH) patients with asymptomatic angiographic vasospasm on admission is unclear in the literature. The goal of this study is to identify predictors of clinical DCI in this group of patients. METHOD: ology: An exploratory subgroup analysis was conducted in the Subarachnoid Hemorrhage International Trialists (SAHIT) data repository to identify predictors of clinical DCI in good-grade aSAH patients (World Federation of Neurological Surgeons (WFNS) grade I and II) with angiographic vasospasm on admission...
October 4, 2016: World Neurosurgery
Alessandro D Genazzani
Studies over the last decade have demonstrated that some polycystic ovary syndrome (PCOS) patients have abnormal insulin sensitivity (insulin resistance), independently from being overweight or obese. This induces the risk of developing type 2 diabetes in such PCOS patients. The use of insulin sensitizers (i.e. metformin), reduces such metabolic, and most hormonal, impairments. As metformin often induces side effects, new integrative strategies have been proposed to treat insulin resistance, such as the use of inositols...
September 16, 2016: Reproductive Biomedicine Online
Giovanna Muscogiuri, Stefano Palomba, Antonio Simone Laganà, Francesco Orio
A growing body of research is currently focused on the role of inositol isomers and in particular myo-inositol (MYO-INS) and D-chiroinositol (DCI) in the treatment of insulin resistance states. Both isomers have been shown to exert insulin-mimetic action and to lower postprandial glucose. Further, insulin resistance-related diseases were associated to derangements in inositol metabolism. Thus, the aim of this review is to provide current evidence on the potential benefits of inositol isomers (MYO-INS and DCI) in the treatment of disease associated to insulin resistance such as polycystic ovary syndrome (PCOS), gestational diabetes, and metabolic syndrome...
2016: International Journal of Endocrinology
L Huang, M Pimentel, A Rezaie
BACKGROUND: Jackhammer esophagus (JE) is a rare esophageal motility disorder defined in the Chicago Classification of Esophageal Motility by presence of excessively high distal contractile integral (DCI) on high-resolution manometry (HRM), with unknown natural manometric course. We examined the development of achalasia over time in patients with JE. METHODS: Through a retrospective longitudinal design, patients with Jackhammer contractions who had more than one HRM between 2005 and 2015 were identified...
September 23, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Hidenori Suzuki, Masato Shiba, Yoshinari Nakatsuka, Fumi Nakano, Hirofumi Nishikawa
Recent investigations have shown that many factors may cause delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH). To find new potential contributors to DCI, this retrospective study compared gas data in the cerebrospinal fluid (CSF) between patients with and without DCI. The subjects were 61 consecutive patients with SAH classified as Fisher group III on admission computed tomography scans, whose aneurysms were obliterated by clipping or coiling within 24 h post-SAH. Thirty-three patients were treated with CSF drainage...
September 14, 2016: Translational Stroke Research
Bolanle Akinsola, John Cheng, April Zmitrovich, Naghma Khan, Shabnam Jain
BACKGROUND: Effective communication between physician and patient is essential to optimize care after discharge from the emergency department (ED). Written discharge care instructions (DCI) complement verbal instructions and have been shown to improve communication and patient management. In 2012, Centers for Medicare and Medicaid Services proposed a quality measure (OP-19) that assesses compliance with key elements considered essential for high-quality written DCI. OBJECTIVE: To evaluate the impact of a QI intervention on improving quality of written DCI in a pediatric emergency department (PED)...
September 9, 2016: Pediatric Emergency Care
Sandro Sacchi, Federica Marinaro, Debora Tondelli, Jessica Lui, Susanna Xella, Tiziana Marsella, Daniela Tagliasacchi, Cindy Argento, Alessandra Tirelli, Simone Giulini, Antonio La Marca
BACKGROUND: d-chiroinositol (DCI) is a inositolphosphoglycan (IPG) involved in several cellular functions that control the glucose metabolism. DCI functions as second messenger in the insulin signaling pathway and it is considered an insulin sensitizer since deficiency in tissue availability of DCI were shown to cause insulin resistance (IR). Polycystic ovary syndrome (PCOS) is a pathological condition that is often accompanied with insulin resistance. DCI can positively affects several aspect of PCOS etiology decreasing the total and free testosterone, lowering blood pressure, improving the glucose metabolism and increasing the ovulation frequency...
2016: Reproductive Biology and Endocrinology: RB&E
Antonio Simone Laganà, Paola Rossetti, Massimo Buscema, Sandro La Vignera, Rosita Angela Condorelli, Giuseppe Gullo, Roberta Granese, Onofrio Triolo
Polycystic ovary syndrome (PCOS) is characterized by chronical anovulation and hyperandrogenism which may be present in a different degree of severity. Insulin-resistance and hyperinsulinemia are the main physiopathological basis of this syndrome and the failure of inositol-mediated signaling may concur to them. Myo (MI) and D-chiro-inositol (DCI), the most studied inositol isoforms, are classified as insulin sensitizers. In form of glycans, DCI-phosphoglycan and MI-phosphoglycan control key enzymes were involved in glucose and lipid metabolism...
2016: International Journal of Endocrinology
Hirokazu Sadahiro, Satoshi Shirao, Hiroshi Yoneda, Hideyuki Ishihara, Takayuki Oku, Akinori Inamura, Akiko Yamane, Kazutaka Sugimoto, Yuichi Fujiyama, Michiyasu Suzuki
BACKGROUND AND OBJECTIVE: Despite intensive therapy, vasospasm remains a major cause of delayed cerebral ischemia (DCI) in worsening patient outcome after aneurysmal subarachnoid hemorrhage (aSAH). Transcranial Doppler (TCD) and transcranial color-coded duplex sonography (TCCS) are noninvasive modalities that can be used to assess vasospasm. However, high flow velocity does not always reflect DCI. The purpose of this study was to investigate the utility of TCD/TCCS in decreasing permanent neurological deficits...
October 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Dror Ofir, Yoav Yanir, Michael Mullokandov, Ben Aviner, Yehuda Arieli
"Yo-yo" diving may place divers at a greater risk of neurologic decompression illness (DCI). Using a rat model, we previously demonstrated that "yo-yo" diving has a protective effect against DCI. In the current study, we evaluated the risk of neurologic DCI following "yo-yo" dives in a pig model. Pigs were divided into four groups. The Control group (A) made a square dive, without excursions to the surface ("peeps"). Group B performed 2 "peeps", Group C performed 4 "peeps", and Group D did not dive at all. All dives were conducted on air to 5 atmospheres absolute, for 30 min bottom time...
August 18, 2016: Journal of Applied Physiology
Katarzyna Rerych, Józef Kurek, Ewa Klimacka-Nawrot, Barbara Błońska-Fajfrowska, Antoni Stadnicki
Background/Aims: The study was aimed to evaluate pre and postfundoplication profile of esophagogastric junction (EGJ) and esophageal peristalsis by high-resolution manometry (HRM) in patients with gastroesophageal reflux disease (GERD). Methods: HRM was performed in 25 patients with GERD before (pre-ops) and after (post-ops) laparoscopic Nissen fundoplication. The study involved capturing HRM data for 10 consecutive swallows of 10 mL water boluses in upright position...
August 17, 2016: Journal of Neurogastroenterology and Motility
Ran Arieli, Soliman Khatib, Jacob Vaya
Most severe cases of decompression illness (DCI) are caused by vascular bubbles. We showed that there are active hydrophobic spots (AHS) on the luminal aspect of ovine blood vessels where bubbles are produced after decompression. It has been suggested that AHS may be composed of lung surfactant. Dipalmitoylphosphatidylcholine (DPPC) is the main component of lung surfactants. Blood samples and four blood vessels, the aorta, superior vena cava, pulmonary vein and pulmonary artery, were obtained from 11 slaughtered sheep...
August 11, 2016: Journal of Applied Physiology
P Mylonas, D C Attrill, A D Walmsley
Aims To evaluate the quality of clinical record keeping and determine quality of denture cleanliness; record baseline denture cleanliness for 60 patients; introduce denture hygiene instruction (DHI); and then re-assess the patients for improvement and enhanced record keeping.Methods Analysis of patients' denture hygiene instruction record keeping (n = 60) was undertaken retrospectively. The Denture Cleanliness Index (DCI) was utilised to assess denture cleanliness (best score 0, worst score 4). Baseline DCI scores were taken and individual DHI was delivered...
August 12, 2016: British Dental Journal
Elena Benelli, Scilla Del Ghianda, Caterina Di Cosmo, Massimo Tonacchera
Introduction. We evaluated the effects of a therapy that combines myo-inositol (MI) and D-chiro-inositol (DCI) in young overweight women affected by polycystic ovary syndrome (PCOS), characterized by oligo- or anovulation and hyperandrogenism, correlated to insulin resistance. Methods. We enrolled 46 patients affected by PCOS and, randomly, we assigned them to two groups, A and B, treated, respectively, with the association of MI plus DCI, in a 40 : 1 ratio, or with placebo (folic acid) for six months. Thus, we analyzed pretreatment and posttreatment FSH, LH, 17-beta-Estradiol, Sex Hormone Binding Globulin, androstenedione, free testosterone, dehydroepiandrosterone sulphate, HOMA index, and fasting glucose and insulin...
2016: International Journal of Endocrinology
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