Thursday, 28 September 2017

The Basal, Peak and Maximum Heart Rate Determinants of the Cardiac Patients Who Underwent Dobutamine Stress Echocardiography

It is too hard to determine the individual heart rate changes even by an experienced heart specialist. Practically, there are many determinants for a heart rate to slow down, or speed up, or vary inexplicably. The determinants are not well-known in the heart disease literature. The maximum, peak and basal heart rates are generally used values in clinical medicine and physiology. Generally, the percentage of peak, or maximum, or a fixed percentage of heart rate is used to prescribe the intensity of exercise, or medicine in both the rehabilitation programs and the disease prevention. It is known that a delayed heart rate recovery during the first and second minute after acute exercise is an independent predictor of overall mortality. The peak, or maximum, or basal heart rate is widely used as a criterion for achieving peak exertion in the determination of maximal aerobic capacity. 

Recently, some longitudinal and cross-sectional studies have pointed that aerobic endurance training accelerates heart rate recovery after exercise in healthy subjects. In many clinical settings, exercise testing is not used if subjects attain an arbitrary percentage of their age-predicted maximal heart rate . In earlier research articles, mainly metaanalysis and regression analysis have been used to identify the determinants of heart rates, assuming the response variance is constant. Note that the three heart rates basal, peak and maximum are positive and heterogeneous. For a positive response variable, the variance may be non-constant, due to variance-to-mean relationship. Such data set should be analysed using joint Log-normal and gamma models. The current data sets (basal, peak and maximum) are positive, their variances are non-constant, distributions are non-normal, and the previous statistical methodologies are inappropriate. In addition, best of our knowledge, there is little study of heart rates for the DSE data. These issues have motivated us to locate the heart rate (basal, peak and maximum) determinants of the DSE data set. 

The present report aims to examine the following hypotheses. What are the determinants of the basal, or peak, or maximum heart rate of the DSE data set? What are the associations of the determinants with the basal, or peak, or maximum heart rate? What are the effects of the determinants on the basal, or peak, or maximum heart rate? Answer of these hypotheses are little known in the cardiology literature. These issues are addressed in the current report.Some continuous positive responses such as basal, peak, and maximum heart rates have non-normal error distributions. The class of generalized linear models is used for analysing such data. In practice, the gamma and the log-normal distributions are often used in modelling positive data. For some positive response variables, it is often observed that there exists a variance-to-mean relationship, consequently the response variance may be non-constant.

Wednesday, 27 September 2017

Prevalence and Causes of Visual Impairment among Patients in Juaben Hospital Eye Clinic, Ghana

Visual impairment (VI) is a global health problem which affects all aspects of life. It presents educational, occupational and social challenges, with the affected persons being at risk of behavioral, psychological, and poor social integration. It does not only have significant effects on the lives of those affected but it also presents a large social and economic cost to the country. The World Health Organization (WHO) defines visual impairment (VI) as presenting visual acuity (PVA) that is worse than 6/18, but better and equal to 3/60 or a corresponding visual field (VF) loss of less than 20 degrees around the central fixation in the better eye with presenting optical correction if any. Blindness is defined as PVA of worse than 3/60, or a corresponding VF loss of less than 10 degrees around the central fixation in the better eye with presenting optical correction if any.

 Previously, estimates of VI were based on corrected vision, but in order to assess the magnitude of VI caused by uncorrected refractive errors (URE), estimates need to be based on presenting visual acuity. The estimated number of people visually impaired in the world is 285 million, of whom 39 million are blind. Age and gender affect VI and it has been reported that prevalence increases with age and women have a significantly higher risk of developing VI than men in every region of the world. It is estimated that globally, up to 75% of all blindness is avoidable (either preventable or treatable). Without intervention, the number of blind people might reach 76 million by 2020 because of a number of factors, primarily the rapid aging of populations in most countries. 

The principal causes of VI globally are uncorrected refractive errors (URE) and cataracts, 43% and 33 % respectively. Other causes are glaucoma, 2%, age related macular degeneration (ARMD), diabetic retinopathy, trachoma and corneal opacities, all about 1%. A large proportion of causes, 18%, are undetermined. The causes of blindness are cataract, 51%, glaucoma, 8%, ARMD, 5%, childhood blindness and corneal opacities, 4%, uncorrected refractive errors and trachoma, 3%, and diabetic retinopathy 1%, the other causes are 21%. There is inadequate data on the prevalence rate of VI and blindness in Ghana.The paucity of reliable information on this contributes to problems in designing and evaluating eye care services in Ghana. The purpose of this study is to provide useful information on the prevalence and causes of VI and blindness and their relationship with age and gender among patients who reported at the Juaben Hospital Eye Clinic.

Monday, 25 September 2017

Interpretation and Diplomacy Aspects of Authority and Mental Care in Imaging Reports

Whereas the creativity and intellectual power of the radiologist are measured against his / her written report, the value of the message will not only be judged by the precision of the medical statement. The same result can be attributed to different words. Numerous common and accidental factors exert influence on the decision on what is said and what is not said, how it is assessed and what is ignored. The less certain a diagnosis is and the less favourable its possible consequences are, the more subtleties and periphrases are to be expected within the report. The decision on the nature and the volume of the written report will not only be taken by the time of recording, but is likewise prepared by the knowledge of the patient`s history and symptoms, the personal relationship to him / her as well as by a set of conditions throughout the inspection of the images. The intuition that accompanies the information transfer in imaging diagnostics does not only explain the differences in volume and depth of diagnosis and differential diagnosis, but also the range of diagnostic and therapeutic recommendations.

The analytical performance aligned with the records of diagnostic imaging is often referred to as interpretation. However, this term describes only incompletely the enquiry that comes about by stages. It suggests to the reader that the radiologist reads a finished product like the philologist a poem or the musician a score. But the radiograph is an object, the production and quality of which is essentially influenced and the properties of which can be modified by the analyst. In addition, the examiner is determined by a series of conditions, that are more or less foreseeable, that are perceived more or less intentionally and that unfold more or less strong effects. What will finally be expressed in the record and in which words the message will be clothed, is initiated in the approaches and the surroundings of the study. Thus, the authority of the radiologist on the choice of words is challenged in each particular case one more time. The comparative reading of medical imaging reports shows, to what extent the willingness and the ability to take notice of the various challenges differ.

The broad range of the information transfer has two fundamental consequences. Firstly, it exercises an influence on the response and reaction of the recipient to the presented result. Regardless of whether the diagnostic statement is correct or only more or less appropriate, the feedback that it evokes with the questioner is shaped by the choice of words. Secondly, it controls the degree of satisfaction of the recipient with the diagnostic performance and his readiness to continue the cooperation with the radiologist on the same or another scale. Both effects are more pronounced in outpatient than in inpatient imaging diagnostics. Therefore, a change between the two modi operandi will unveil these effects especially well, indeed in both directions. 

Friday, 22 September 2017

Multiple Thromboembolic Stroke and Myocardial Infarction in a Young Male in the Setting of Amphetamine Use


Amphetamines are first line treatment for Attention-Deficit Hyperactivity Disorder (ADHD). Known to have serious cardiovascular adverse effects such as MI, Stroke, and sudden death specially if used in high doses or long term. ADHD patients are predisposed to have concomitant substance use disorder. Substances like cocaine and marijuana increase risk of cardiovascular events. By knowing these, clinicians must be cautious in prescribing CNS stimulant agents. Precise personal, medical, drugs and medication history needs to be obtained before and during treatment. Herein, we present a young male with ADHD treated with amphetamines and concomitant marijuana use who presented with multiple thromboembolic stroke and acute myocardial infarction.

Many studies have revealed high-doses and long-term use of amphetamines associated with numerous adverse effects, especially serious cardiovascular events and sudden death. Multiple cases have reported atrial filtration and acute myocardial infarction in recreational amphetamine abusers. Other psychiatric illnesses such as mood disorders (38%), anxiety (47%) and poor impulse control (20%) are also found among adults with ADHD resulting in a higher likelihood of leading an unhealthy lifestyle (i.e obesity, smoking, substance abuse, etc) and subsequently cardiovascular events. Studies have revealed that 15% of ADHD patients have concomitant substance use disorders. Substances like cocaine and marijuana increase risk of cardiovascular events. World Health Organization (WHO) recently reported that chronic use of cocaine may be associated with myocardial infarction and stroke.

Gerhard et al study reported that 80% of adult patients with ADHD with evidence of ≥ 1 preexisting cardiovascular diseases were treated with CNS stimulants. Despite knowledge of preexisting cardiovascular disease (10.5%) in ADHD patients, no significant reduction in stimulants prescription has been observed.A 37-year-old man presented to the emergency department with left facial droop and left sided weakness which started 45 minutes prior to admission. All history was obtained from his wife because he was intubated upon arrival to emergency ward. He was diagnosed with ADHD at age 13 and was prescribed amphetamine-based medication up until he graduated from college. Amphetamine was re-started by his primary care physician one year ago due to the patient`s lack of concentration at his new job. He was taking Adderall XR 25 mg daily. According to his wife he was in his normal state of health until afternoon of admission day when he suddenly developed left facial droop and left sided weakness. He did not have reported chest pain, nausea or diaphoresis. 

Thursday, 21 September 2017

The Elderly with Pressure Ulcer in Household: What has Dealing with Nutrients and Immunonutrients Shown?

The objective of this study was to research the use of nutrients and immunonutrients in household nutritional therapy for elderly patients with pressure ulcer (PU). Methods: A literature review of scientific articles indexed in databases: Scielo, Pubmed/Medline, Lilacs/Bireme Latindex, Elsevier and DOAJ, in Portuguese, English and Spanish, with emphasis in the last 10 years. Results: Six types of hyperproteic dietary supplement were identified, enriched with special nutrients such as zinc, selenium, vitamin A, C, E, arginine and omega-3 fatty acid, used in PU patients. The enriched formulas may increase the immune cells proliferation, reduce oxidative stress, decrease inflammation and optimize healing. Conclusion: The home nutrition therapy and nutrients are essential tools to treat and prevent nutritional deficiencies and possible complications, and reintegrate the elderly into his/her family nucleus, favoring comfort and quality of life.

The representation of the elderly in the world population is estimated at approximately 10% (705 millions). In 2050, according to demographic projections, the number of people aged 60 and older, will be almost two billions. The aging fragility associated with morbid conditions such as changes in mobility, neurological and mental status, bowel functions and nutritional status are characteristics of a prone population to the formation, recurrence and complication for pressure ulcers (PU). The PUs are a worldwide problem and are described as localized lesions of the skin and/or underlying tissue, usually over a prominent bone, caused by pressure, friction or shearing, or even by combining these factors. In addition to worsen the quality of life of hospitalized patients, PU increases the length of stay and cost of treatment. In this context, home care emerges as a strategy able to offer greater possibility of comfort and proximity to family, to reduce readmissions, the risk of infection, the hospital stay for treatment and rehabilitation and the costs of care.

Simultaneously with the emergence of home care, wide and multidisciplinary care model, Home Nutrition Therapy (HNT) materialized as a genre of growing expansion to the present day. The HNT began to stand out in the 1980s and since then is a greater tendency to proceed with hospital care at home. The aim of this study was to review the literature on the use of nutrients and immunonutrients used in household nutritional therapy for elderly patients with pressure ulcer.This study consists of a literature review on the topic, using indexed scientific articles in: Scielo, Pubmed/Medline, Lilacs/ Bireme Latindex, Elsevier and DOAJ - Directory of Open Access Journals, in Portuguese, English and Spanish, with emphasis on the last 10 years, using the following descriptors: home care, nutritional therapy, elderly, pressure ulcer.

Wednesday, 20 September 2017

Dietary Tradition, Nutritional Theories and Science


Since the inception of life, nutrition has dictated the growth and survival of our species. Almost all of the body processes, from meager to vital, have a strong dependence on the diet. The nutritional status serves as an outlook on the past, present, and future of one’s health. The presence of health does not only mean the absence of disease or infirmity, rather, it is a quality of life emphasizing physical, mental and social well-being. In other words, nutrition, both in terms of amount and the kind, serves to act as the cornerstone of optimum health and the cutting edge for disease prevention.

Since ancient times, philosophers and researchers have deemed nutrition as one of the fundamental components of life. Therefore, it is no surprise that all the universal medical science concepts included nutrition as one of their integral components. The ancient theory of nutrition dates back to the time of Aristotle and Galen. They considered nutrition as a vital part of health, disease, performance, and healing. The power in each part of the body is believed to be dependent on the blood flowing to that part. The blood is formed by the nutrients absorbed from the consumed foods. This nutrition and human physiology theory in ancient Europe is mirrored by the concepts described in an ancient Chinese medicine text, Huangdi Neijing (Yellow Emperor’s Classic of Medicine) - a Chinese counterpart of the Hippocratic Corpus. According to the Greek, Roman, and Chinese classical literature, the diet should consist largely of cereal grains, legumes, fruits, honey, fish, and milk. Foods like meat, wine, and confectionary should be consumed in moderation. It is intriguing how those ancient doctors and philosophers were able to predict a gross dietary map without having a clear understanding of how the human body works.

The modern theory of nutrition has taken one step ahead. Starting with a series of discoveries of vitamins and minerals between 1910 and 1930, nutritional science has evolved alongside modern food production methods. Although serious malnourishment problems still exist in parts of the world such as Africa and South East Asia, food distribution improved following WWII in many countries. Prior to the 1940s, nutrition-related diseases resulted primarily from undernourishment i.e., lack of variety, inadequate calories or a combination of both. 

Increasingly, nutrition and lifestyle related conditions such as obesity, heart disease, diabetes, and metabolic syndrome have become prevalent in many modern cities and countries. Now, foods are not just considered a source of energy for survival, instead it is an experience for instant pleasure and gratification. According to researchers, the modern food industry has learned the weaknesses in our fundamental biology. For instance, the human body has a natural liking for sweetness and fatty foods. This weakness has been exploited by the mass production of sweetened beverages and excessively processed food items. Similarly, the human fatty food preference has been fueled by the easy accessibility to fast foods on every block. This convenience for instant gratification has fostered changes in our body composition, an increase of obesity, and deterioration of overall health. Obesity is growing into a global pandemic and is considered one of the most urgent health care issues today 

Tuesday, 19 September 2017

FDA Approves Solosec


Symbiomix Therapeutics today declared the U.S. Nourishment and Drug Administration (FDA) has endorsed Solosec (secnidazole) 2g oral granules for the treatment of bacterial vaginosis (BV) in grown-up ladies. Solosec is a strong, people to come, 5-nitroimidazole anti-toxin with upgraded pharmacokinetic properties that empower conveyance in a solitary dosage that has been appeared to be useful and all around endured. Solosec is the first and final single-measurement oral treatment for BV, the most well-known gynecologic contamination in the U.S. "The FDA's endorsement of this first-of-its-kind treatment is an essential turning point for Symbiomix and above all, a large number of ladies experiencing BV," said David L. Stern, CEO of Symbiomix. "The endorsement of Solosec speaks to a basic minute in our endeavors to convey creative meds to the ladies' wellbeing market. Solosec is the main new oral anti-microbial to treat BV in over 10 years and will give ladies another treatment choice. We anticipate making this treatment accessible to patients in the primary quarter of 2018." 

BV is the most common gynecologic contamination in the U.S., influencing 21 million ladies ages 14 to 49 every year. [2] The most usually endorsed oral BV treatment regimen requires twice-a-day dosing for seven days. Adherence with the present driving treatment for the treatment of BV has been appeared to be just roughly 50 percent. On the off chance that left untreated, BV can expand the danger of contracting sexually transmitted sicknesses, including chlamydia, gonorrhea, herpes, trichomaniasis and HIV, and can likewise build the danger of pre-term birth and low birth weight. "The endorsement of Solosec at long last gives ladies the choice of a solitary, all around endured, oral measurement treatment for BV, a typical disease which can have numerous wellbeing outcomes," said Paul Nyirjesy, MD, Professor of Obstetrics and Gynecology at Drexel University College of Medicine in Philadelphia, PA and an examiner in the Solosec clinical trials. "A solitary measurements regimen may enhance adherence and the probability of an effective cure." 

More than 50 percent of ladies treated for BV include a repeat inside a year, altogether affecting work profitability and personal satisfaction. [3] In late investigations, 60 percent of intermittent sufferers detailed a negative effect on work participation, work execution and efficiency, and 95 percent announced an extreme limitation in hint accomplice relations. "One of every three ladies have been influenced by BV, affecting their personal satisfaction and potential for genuine wellbeing dangers," said Beth Battaglino, RN, President and CEO of HealthyWomen, the main autonomous, not-for-profit wellbeing data hotspot for ladies. "We are energized that surprisingly, both incessant and rare BV grown-up ladies sufferers will now have a solitary measurements treatment choice." The FDA endorsement was bolstered by an extensive arrangement of studies, incorporating two urgent trials in BV and an open name security contemplate, which discovered viability for single-measurement secnidazole 2g. All treatment-new unfavorable occasions were gentle or direct in force; no genuine unfriendly occasions were accounted for, and no patients ceased treatment because of antagonistic occasions.

Friday, 15 September 2017

Evolution of Subtypes of the Human Immunodeficiency Virus Type 1 in Kinshasa over the Last 30 years: Documentary Review from 1985 to 2015


More than 30 years after its official declaration, the infection by the Human Immunodeficiency Virus (HIV) remains a major public health problem in Kinshasa and even for the entire Democratic Republic of Congo (DRC). The prevalence of the HIV epidemic in Kinshasa was of 1.6% according to the reports of the Demographic Health Survey (DHS) in 2014. It has remained more or less stable below 5% since the beginning of this century for the country. HIV, which is a Lentivirus of the Retroviridae family, has a diversity that is equal to the complexity of its treatment. This virus is divided into 2 types (HIV-1 and HIV-2), each of which is divided into different groups, subtypes and recombinant forms. In the DRC, in Kinshasa in particular, the HIV epidemic is dominated by the group M of Type 1. This group M comprises several subtypes and Circulating Recombinant Forms (CRFs) as well as Unknown Recombinant Forms (URFs) which stayed very dynamically in Kinshasa. Since 1985, with the first phylogenetic study on the population of Kinshasa, the distribution of strains circulating in the city has changed considerably; it is in constant evolution.

Some subtypes have  been confirmed over time while others gradually disappear due to pressure and different selections. The objective of this review was to expose the specificities of the HIV epidemic in Kinshasa, in terms of the evolution of different variants of HIV over time.Various publications and abstract papers presented at a conference focusing on the identification of the different variants of HIV Type 1 in Kinshasa, in the Democratic Republic of Congo (DRC), were the subject of this review. The search for these published works on the various variants of HIV Type 1 was done on the internet from the following websites: (i) MEDLINE / PubMed; (ii) POPLINE electronic database of published documents; (iii) Public access data on conference papers; (iv) Scientific report published on the Internet; (v) Google Scholar; (vi) Cochrane Library. This online research was based on the following key words: “HIV, subtype, Kinshasa”, “genotype, HIV, Kinshasa” and “HIV strains in Kinshasa”.

virus is divided into 2 types (HIV-1 and HIV-2), each of which is divided into different groups, subtypes and recombinant forms. In the DRC, in Kinshasa in particular, the HIV epidemic is dominated by the group M of Type 1. This group M comprises several subtypes and Circulating Recombinant Forms (CRFs) as well as Unknown Recombinant Forms (URFs) which stayed very dynamically in Kinshasa. Since 1985, with the first phylogenetic study on the population of Kinshasa, the distribution of strains circulating in the city has changed considerably; it is in constant evolution. Some subtypes have population, the measurement methods and the objectives were considered in the evaluation of the articles. Reading the various articles made it possible to exclude articles that did not directly concern the HIV-1 strains circulating in Kinshasa. Pediatric studies, studies on migrant populations as well as studies without original data were not retained for this review. 

Thursday, 14 September 2017

Using Immune Cells for Transport of Therapeutics to Brain Tumors


Glioblastoma (GBM) is the most common and aggressive form of primary brain tumor. Currently, no curative therapies are available for GMB. Merely palliative treatments only prolong survival 12-14 months after diagnosis. One of the greatest obstacles to GBM therapy is the blood-brain barrier (BBB) that severely limits the brain penetration of more than 95% of all promising therapeutics. However, classes of immune cells (monocytes and macrophages), as well as stem cells have an extraordinary ability to cross the BBB due to enhanced margination and extravasation. These immune cells can be genetically modified to express diagnostic markers or secreted therapeutic molecules directed against death receptors on GBM cells. Furthermore, exosomes released from immune cells can be loaded with cytotoxic agents and utilized for the drug transport across the BBB. Capitalizing on the powerful tumor-focused homing of immune cells, this approach directly addresses the critical deficiencies in traversing the BBB and tumor-specific accumulation plaguing current anti-GBM therapies. Noteworthy, beside the treatment of primary brain tumor, eradication of brain metastasis may also be addressed by means of cells-mediated drug delivery. In this review, we discuss new drug delivery systems that utilize living cells for drug carriage to the brain tumors.

The use of living cells for active targeted drug delivery to brain tumors is a new concept that has a potential to open different therapeutic avenues within the central nervous system (CNS). The current standard of care for glioblastoma multiforme (GBM) is surgery and chemo-radiation therapy, yet this approach is grossly inadequate and patient mortality remains high universally. Cell-based therapy is an innovative approach that is not only a departure from traditional systemic or forced-infusion drug delivery, but also alters kinetics to provide prolonged and focused drug delivery to tumors. Using inflammatory response cells enables targeted drug transport and prolonged circulation times, along with reductions in cell and tissue toxicities. In addition, these cells are capable of cell-to-cell transmission of their cargo that improves therapeutic outcomes. Noteworthy, a proper differentiation of drug carriers into particular subtypes may further boost the therapeutic efficiency of cell-based drug formulations.

To achieve anti-tumor efficacy, immune cells should be loaded with therapeutics. However, drug loading in cell-carriers is often low, drugs must be efficiently unloaded at the tumor, and drugs must not affect the survival or migration of the carrier. This has created a bottleneck for cell-based cancer therapy. To this end, protein-based therapies that are the ideal drug for cell-mediate delivery to GBM have been recently developed. Thus cell-based carriers “armed” with the targeted anti-cancer proteins could represent a novel and highly effective therapy for GBM. Another approach is based on using exosomes, released from immune cells. These nano-sized naturally occurred extracellular vesicles can be loaded with cytotoxic drugs and then used for drug transport to the brain tumors. Reflective of their origin, these nanocarriers can cross the blood-brain barrier (BBB) and target cancer cells in the brain. Such systems for drug carriage and targeted release represent a novel strategy that can be applied to a spectrum of human disorders. 

Wednesday, 13 September 2017

Insights into Dermatological Applications and Cutaneous Toxicities of Bleomycin

Bleomycin is a chemotherapeutic agent used for treatment of many types of tumors including lymphomas, testicular cancer and breast cancer. Its cytotoxic effect may be attributed to its interaction with O2 and Fe2+ leading to scission of DNA. Its systemic application may be associated with serious pulmonary fibrosis. It may be used by intralesional injection for management of keloids, hypertrophic scars, cutaneous warts, hemangiomas, cutaneous malignancies, cutaneous leishmaniasis and condyloma accuminata. However, its use may lead to significant dermatologic toxicities including scratch dermatitis, Raynaud’s phenomenon, hyperpigmentation, fibrosis, gangrene, neutrophilic eccrine hidradenitis, alopecia areata, oedema and nail changes.

The bleomycins are DNA-cleaving antibiotics that were discovered as fermentation products of Streptococcus verticillus. The drug currently employed clinically is a mixture of the two copper-chelating peptides, bleomycins A2 and B2. Bleomycins have attracted interest because of their significant antitumor activity against squamous carcinoma of the cervix, lymphomas and testicular tumors. They are minimally myelo- and immunosuppressive but cause unusual cutaneous side effects and pulmonary fibrosis. Because their toxicities do not overlap with those of other drugs and because of their unique mechanism of action, bleomycins maintain an important role in combination chemotherapy.

Although bleomycin has a number of interesting biochemical properties, its cytotoxic action results from their ability to cause oxidative damage to the deoxyribose of thymidylate and other nucleotides leading to single- and double-stranded breaks in DNA. Studies in vitro indicate that bleomycin causes accumulation of cells in the G2 phase of the cell cycle and many of these cells display chromosomal aberrations including chromatid breaks, gaps and fragments, as well as translocations. Bleomycin causes scission of DNA by interacting with O2 and Fe2+ (Figure 1). In the presence of O2 and a reducing agent, such as dithiothreitol, the metal-drug complex becomes activated and functions as a ferrous oxidase, transferring electrons from Fe2+ to molecular oxygen to produce activated species of oxygen. Metallobleomycin complexes can be activated by reaction with the flavin enzyme, NADPH-cytochrome P450 reductase. Bleomycin binds to DNA through its amino-terminal peptide and the activated complex generates free radicals that are responsible for scission of the deoxyribose backbone of the DNA chain. Bleomycin is degraded by a specific hydrolase found in various normal tissues. However, hydrolase activity is low in skin and lung, perhaps contributing to the toxicity at these sites. 

Monday, 11 September 2017

Brown-Bagging It? Think Outside the Box


At noon, it's anything but difficult to fall into a trench. To energize this late morning dinner for your children or yourself, take some dark colored stowing tips from an enrolled dietitian. Keep things fascinating through variety, said Samantha Coogan, a teacher at the University of Nevada, Las Vegas. A solid lunch can be tasty and moderate, she said. Here are some of her proposals. In case you're a parent, endeavor to include another organic product or vegetable every week for your kid to attempt. 

Think past the store. You may spare cash by purchasing new products of the soil at dollar stores and rebate markets, Coogan said. Pack more than lunch. Understudies frequently get eager amid long classes. It's keen to prepare both your lunch and enough snacks to get you as the day progressed, Coogan said. Watch those natural marks. You may expect that "natural" deliver is 100 percent natural, yet publicists can escape with utilizing that name on items that are not as much as half natural, Coogan said. Be mindful so as to ensure you're not paying more without getting a full natural item to appear for it. 

Try not to accept sans gluten is better for you. Without gluten items aren't really sound, Coogan said. They're made for individuals whose bodies experience considerable difficulties handling gluten proteins in wheat, she said. Watch the sugar to stay away from the evening blahs. "To remain ready and gainful amid the second 50% of your day, keep away from additional sugar," Coogan said. "Regardless of whether darker stowing it or requesting out, limit the pop, treats and different desserts. The more noteworthy the handled sugar allow, the harder the evening crash." Fruit matched with a protein or fat like nutty spread will prop you up without the requirement for a caffeine help, she said.

Friday, 8 September 2017

Anatomical Modifications for Bipedal Locomotion in Modern Humans: A Mini Review


Several attributes are especial for primates, some of these are even more unique in humans. These may not be limited to; energy-saving bipedal posture and locomotion, complex manual skills and tool making abilities, social and cultural organisation, augmented cranial capacity, a more developed frontal lobe, and language proficiency. From a Darwinian point of view, erect posture was achieved to free the hands for tool-making. However, more recent theories suggested that bipedal locomotion was related to environmental factors which led to the advent of distinctive and remarkable anatomical features for a form of locomotion that is more energy-economic than quadrupedal locomotion. The purpose of this mini-review is to elaborate on the critical biomechanical and anatomical adaptations in modern human which enabled an energy-efficient form of bipedalism; this form of locomotion is never seen in other species including primates. These anatomic features and adaptations include; adjustments to the general body architectural plan, in addition to cranial and postcranial modifications. The latter is debated to be the most critical for a stable and fuel-efficient upright walking, other anatomic adaptation were parallel and complimentary. The most significant of these anatomical changes took place post-cranially at the level of the pelvis. Some of these changes can be found in Australopithecus afarensis dating back to 3.6 million years ago.

Several features are unique to humans including; an efficient bipedal or upright walking, stable supine posture, an augmented cranial capacity and a complex frontal lobe, ability to speak and interpret speech, complex tool-making abilities, an elaborate social structure. Cultural anthropologists and physical anthropologists consider that all these features contributed eventually to the development of a real culture, rather than a primitive culture (proto-culture) as seen in several primates species including chimpanzees. It is estimated that the earliest of these traits to be established was the upright posture (bipedalism) in Australopithecine; including Lucy’s specie (Australopithecus afarensis).

Numerous anatomic adaptations materialised independently across time; these changes exist cranially and post-cranially, principally serving the purpose of high energy efficiency. Compared to apes and quadrupeds, humans spend much less en ergy in bipedal locomotion. Humans have also acquired longer lower limbs to serve the propulsive function during walking. Besides, humans have less body weight (BW) above the waist (68% of total BW in genus Homo vs. 82% in Apes). Additionally, the line of gravity passes behind the ears and slightly anterior to the spine, and anterior to the knees. Bipedalism appears to be unique and more advanced in humans, and particularly in genus Homo, than in all others primates. Musculoskeletal and anatomical adaptations can be specifically categorised into; general (1), post-cranial (2), and cranial (3). The changes started to be perfected in Australopithecus afarensis at approximately 3.6 million years; it has been extensively studied via the Laetoli footprints discovered by Mary Leaky in 1978 near Olduvai gorge in Tanzania. On the other that hominids adaptations, particularly pelvic redesigning, were far different for example that of Oreopithecus bambolii.

Thursday, 7 September 2017

Patients who Die Within Emergency Department: A Descriptive Study

 A total of 355 patients who died within the ED were included in study. Their mean age was 57.8 ± 20.5 years (range: 0–114 years), and 53.8% were male. The most common primary complaint was chest pain. Of the patients, most (65.1%) died of cardiac diseases, followed by diseases of the respiratory system (13.5%), and cerebrovascular diseases (4.5%). The most frequent cause of ED deaths was acute myocardial infarction (MI) (n = 202, 56.6%). The highest mortality rate occurred in patients aged at least 50 years (n = 314, 88.5%). In the three distinct groups of patients aged at least 50 years, the highest mortality rate was observed in those aged 75 years and over (n = 156, 44%). Deaths caused by cardiac diseases were the most prevalent in the patients aged 71-80 years, while deaths caused by diseases of the respiratory and cerebrovascular systems were the most prevalent in the patients aged 81-114 years. A total of 58.8% of the patients had at least one chronic disease in their medical history. Recording of the major complaint was incomplete in 70.4% of patients. Conclusions: The highest mortality rate occurred in patients aged at least 50 years, and reached a maximum in those aged 75 years and over. The majority of the deaths within the ED were due to cardiovascular system diseases, and the most common diagnosis was acute MI. Deaths in the ED can be very traumatic for physicians, our study reinforces that the most common causes of death are in line with national statistics.

The characteristics of patients who die are an outcome that can be used to improve knowledge of a service. Deaths in the emergency department (ED) have unique characteristics, and a description of deaths in the ED could be used to assess trends within individual institutions. With an increasing number of patient admissions, the ED can become crowded and chaotic, and deaths are stressful situations that commonly occur in the routine work of an emergency physician. The high frequency of ED deaths necessitates that ED physicians prepare themselves for the issues surrounding death, and mortality statistics are important in the description of an ED [2]. Published studies describing patients who have died within the ED are scarce. This, and the fact that the ED patient databases cannot be fully developed, constitutes a great obstacle in determining ED requirements, and in revealing patient profiles. The present study aimed to investigate the demographic and etiologic characteristics of the patients who died in one particular ED.

This retrospective, cross-sectional study was conducted in patients who died in the ED of Adiyaman University Training and Research Hospital between 01 January 2013 and 31 December 2015. It is a single center serving Adiyaman city, which is located in the west of the Southeastern Anatolia region of Turkey. There is no admission for pediatric patients in the Adiyaman University Training and Research Hospital ED, except for those requiring surgery. The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was approved by the Medical Ethics Committee (number: 1-11/2016). It was verified according to the checklist for observational studies in Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and registered to Clinicaltrials ( ID: NCT03138707). 

Wednesday, 6 September 2017

Could the Zika Virus Help Battle a Deadly Brain Cancer?


Zika infection is notable for causing annihilating mind surrenders in embryos. In any case, imagine a scenario in which researchers could utilize that capacity to accomplish something great. Specialists report that they figure they may have the capacity to outfit the infection's fascination in creating mind cells - rather than grown-up cerebrum cells - as a potential treatment for a savage sort of cerebrum growth. In lab and creature tests, researchers from Washington University School of Medicine in St. Louis and the University of California, San Diego, demonstrated - that the infection could target and obliterate undifferentiated organisms that drive the development of a destructive and basic kind of mind tumor, known as a glioblastoma. "Our examination is an initial move towards the advancement of sheltered and successful strains of Zika infection that could end up plainly vital instruments in neuro-oncology and the treatment of glioblastoma," said contemplate co-pioneer Michael Diamond, from Washington University School of Medicine, in St. Louis. "Be that as it may, general wellbeing concerns should be tended to through pre-clinical testing and assessments of the strains' capacity to spread or return to more destructive structures," he said. 

The exploration is in the beginning times, and tests that look encouraging in creature inquire about don't generally turn out also in people. The discoveries were distributed Sept. 5 in The Journal of Experimental Medicine. The vast majority with a gliobastoma kick the bucket inside two years of being analyzed, scientists said. The undifferentiated organisms that fuel these tumors are hard to execute on the grounds that they can stay away from the resistant framework's regular barriers. These creating cells are likewise impervious to existing medicines, for example, chemotherapy and radiation. Regardless of the possibility that the tumor is effectively expelled, these undifferentiated cells must be decimated to keep new tumors from developing, the investigation creators clarified. "It is so disappointing to regard a patient as forcefully as we probably am aware how, just to see his or her tumor repeat a couple of months after the fact," examine pioneer Milan Chheda, from Washington University School of Medicine, said in a diary news discharge. 

"We pondered whether nature could give a weapon to focus on the cells in all likelihood in charge of this arrival," Chheda said. Zika infection disturbs mental health in babies, focusing on mind stem and begetter cells. Be that as it may, the infection doesn't have such annihilating consequences for grown-up brains, the scientists clarified. "We guessed that the inclination of Zika infection for [developing cells in the brain] could be utilized against glioblastoma foundational microorganisms," said Diamond. Zika infection distinguished, contaminated and demolished patient-inferred glioblastoma foundational microorganisms contrasted and other glioblastoma cell sorts or ordinary mind cells. Specialists likewise found that an altered strain of Zika infection hindered tumor development among mice with forceful cerebrum tumors, significantly expanding their lives. Next, researchers tried a less hurtful, normally happening mutant strain of Zika that is more touchy to the body's resistant reaction. This debilitated strain of the infection was as yet ready to explicitly target and execute glioblastoma undifferentiated organisms.

Monday, 4 September 2017

Anticancer Potential of EDTA: A Preliminary in Vitro Study

To determine the potential anticancer activity of ethylenediaminetetraacetic acid (EDTA), six cancer cell lines of human origin (U937, C-32, HeLa, HSC-2, Molt-4, and U87-MG) were treated with different concentrations of EDTA, and then assayed for cell viability. The melanoma C-32 cell line, which was found to be moderately sensitive to EDTA, was then compared to normal melanocytes, on the other hand, a relatively resistant cell line Molt-4 was then chosen for further investigation to determine the role of calcium-chelating activity of EDTA against the cells. The result showed that the cell lines had different levels of sensitivity to EDTA; and, that melanoma cells are more sensitive compared to melanocytes. Comparison of EDTA toxicity to that of a known calcium-selective chelator, BAPTA, also showed marked differences in toxicity profiles, which may suggest that the calcium chelating ability of EDTA may not be a major player in its toxicity against the cancer cells. Further study should be done to investigate how such anticancer effects work in vivo; and also, if EDTA can be utilized as an enhancer of other anticancer therapies, such as chemotherapy, radiotherapy and hyperthermia.

Ethylenediaminetetraacetic acid (EDTA) is a known metal chelating agent that is clinically being used to treat heavy metal poisoning, such as mercury or lead poisoning; and also, to remove excess iron in blood. In the body, EDTA is eliminated in the kidneys, which is clinically being utilized to determine the glomerular filtration rate in children. With EDTA’s iron chelation ability, it is being proposed that EDTA could be used as an additive in an agent that protects skin from radiation such as antiphotoaging products. EDTA has also been shown as a potent inhibitor of matrix metalloproteinases and an important component in the design of drug. carrying liposomes. While a study also found that EDTA could be a useful and well-tolerated adjuvant for enhancing intratumoral effects of cisplatin chemotherapy, other studies found it to affect subcellular expression of clusterin protein in human colon adenocarcinoma COLO 205 cell line. EDTA may also inhibit the effect of bleomycin and was shown to prevent bleomycin nucleasic activity, a process important for bleomycin’s ability to induce cancer cell apoptosis. EDTA may also prevent iron from the iron-doxorubicin complex that produces damaging reactive oxygen species. In these studies where EDTA counters the effects of anticancer drugs, it may serve as an adjunctive therapy in preventing unwanted effects in the event of accidental extravasation injury during the administration of anticancer drugs. This in vitro preliminary study aims to investigate the potential of EDTA as an anticancer agent or as a potential enhancer of anticancer therapy.

Six cancer cell lines, all of human origin, were used in the study. The human cell line used were the: myelolymphocytic (U937), melanoma (C-32), epithelial adenocarcinoma (HeLa), squamous (HSC-2), T lymphoblastic leukemia (Molt-4), and glioblastoma (U87-MG) cell lines. The cells were cultured in ISSN: 2474-6797 ABSTRACT To determine the potential anticancer activity of ethylenediaminetetraacetic acid (EDTA), six cancer cell lines of human origin (U937, C-32, HeLa, HSC-2, Molt-4, and U87-MG) were treated with different concentrations of EDTA, and then assayed for cell viability. The melanoma C-32 cell line, which was found to be moderately sensitive to EDTA, was then compared to normal melanocytes, on the other hand, a relatively resistant cell line Molt-4 was then chosen for further investigation to determine the role of calcium-chelating activity of EDTA against the cells. The result showed that the cell lines had different levels of sensitivity to EDTA; and, that melanoma cells are more sensitive compared to melanocytes. Comparison of EDTA toxicity to that of a known calcium-selective chelator, BAPTA, also showed marked differences in toxicity profiles, which may suggest that the calcium chelating ability of EDTA may not be a major player in its toxicity against the cancer cells. Further study should be done to investigate how such anticancer effects work in vivo; and also, if EDTA can be utilized as an enhancer of other anticancer therapies, such as chemotherapy, radiotherapy and hyperthermia. Citation: Feril LB Jr, Ogawa K, Watanabe A, Ogawa R, et al. (2017). Anticancer Potential of EDTA: A Preliminary in Vitro Study. M J Canc. 2 2(1): 009. minimum essential medium (MEM) with Earle’s salts and Lglutamine supplemented with 1% essential amino acids and 10% fetal bovine serum (Gibco, Invitrogen Corporation, Groningen, The Netherlands) under humidified air and 5% CO2

Friday, 1 September 2017

Eating Feeds 'Feel Good' Hormones in the Brain


Eating prompts the cerebrum to discharge "can rest easy" hormones, known as endorphins, another examination appears. Scientists found the direction of these normally happening opioids, which can deliver a feeling of joy or rapture, may enable the body to know when it's fulfilled. On the other side, indulging related with the overstimulation of this framework may add to obesity,the specialists noted. For the investigation, Finnish scientists, drove by Lauri Nummenmaa from Turku PET Center, examined the brains of 10 male volunteers utilizing positron outflow tomography (PET). The members were told to quick overnight and were infused with a radioactive compound, which ties to opioid receptors in the mind. 

Utilizing the PET sweeps, the researchers measured the radioactivity in the men's brains after they broke their quick and ate a pizza. The sweeps were rehashed after the volunteers expended a less mouth-watering fluid dinner that contained an indistinguishable measure of calories from the pizza. The examiners found that the two dinners set off a noteworthy arrival of endogenous opioids in the cerebrum. Notwithstanding, just the pizza prompted an outstanding increment in lovely sentiments, the specialists said. 

The nutritious drink provoked the mind to discharge more endorphins. However, this feast didn't deliver sentiments of delight. This proposes opioid discharge in the mind related with eating is free of the joy related with eating. The examination creators said their discoveries could enable researchers to pick up a superior comprehension of the indicators of dependence and dietary problems, and in the long run prompt new medicines for heftiness.