Friday, 30 March 2018

All NewsConsumerProNew DrugsPipelineClinical TrialsFDA Alerts Researchers Making Inroads Against Ovarian Cancer


Ovarian malignancy can be difficult to beat, especially in the event that it returns after starting treatment, yet new research offers a hint of something better over the horizon. One investigation found that another focused on "immunotherapy" to treat ovarian tumor that has returned looked encouraging in a little, early trial. Then, a moment group of specialists found what has all the earmarks of being a marker for patients who will improve the situation after treatment by and large. "These examinations are energizing, yet early," said Dr. Eva Chalas, chief of the Center for Cancer Care at NYU Winthrop Hospital in Mineola, N.Y. She added that it regarded see examine on ovarian tumor, since "minimal expenditure is spent on this malignancy that is frequently deadly." 

Chalas wasn't engaged with either contemplate. The main examination included 29 ladies who had ovarian tumor that had returned. The patients were treated with an ovarian tumor antibody called Vigil. The antibody - otherwise called focused on immunotherapy - is made to treat every lady's malignancy independently by utilizing cells collected from the lady's own tumor. "Ovarian growth is such a troublesome illness since it's an alternate infection starting with one individual then onto the next. Along these lines, we made an immunization particular to every specific disease. It works for that patient's tumor," clarified consider creator Dr. Rodney Rocconi. He is head of gynecologic oncology at the University of South Alabama-Mitchell Cancer Institute. 

Rocconi said the way toward making the antibody takes about seven days. He didn't have data on the cost to create the antibody. The immunization - given as month to month infusions - works by boosting the invulnerable framework's reaction to the growth. It likewise stops tumor cells' capacity to take on the appearance of ordinary cells to the invulnerable framework. "We're trusting this approach will enable us to be significantly more particular from patient to understanding, and our reaction rates have been shockingly great," he said. Twenty out of the 29 ladies accomplished three-year survival. The middle general survival was somewhat over 41 months, as indicated by the report. The treatment was exceptionally all around endured. The most widely recognized protests were identified with infusion site issues. One lady revealed huge weariness.

Wednesday, 28 March 2018

Correlation Between Body Weight and Total Body Fat Composition in Adults in A Community in Ghana

Body composition is the amount of fat versus lean muscle tissue in the human body expressed as a percentage of a person’s total weight. Body weight alone is not a clear indicator of good health because it does not distinguish how much comes from fat and lean body mass. Thus body composition can be referred as the relative sizes of the four basic body compartments that make up the total body: lean body mass, fat, water and bone. The division of body composition into the fourcompartment model is based on metabolic activity, energy demand and comparative size. The body weight can be defined as the sum of bone, muscle, organs, body fluids and adipose tissue. Some or all of these components are subject to normal change as a reflection of growth, reproductive status, variation in exercise levels and effects of aging. It has been argued that water, which makes up 60% to 65% of the body weight is the most variable component, because ones state of hydration can induce fluctuations of several pounds. Muscle and skeletal mass adjust to some extent to support the changing burden of adipose tissue. However, true weight loss and excessive weight gain are associated primarily with a change in the size of the fat depots. Both cross-sectional and longitudinal studies have shown that with advancing age people tend to become more obese -their amount of visceral fat tends to increase and their skeletal muscle mass declines. There seems to be some correlation between one body weight and body fat composition. 

This was a cross-sectional study and constituted 108 males (54%) and 92 females (46%) adults between 30 to 60 years. WHO Step-wise questionnaires were used to gather all data. This took into account the background of respondents which included occupation, ethnicity and income level. The lifestyle variables also included physical activities with corresponding duration for a particular activity. The subjects composed of males and females without any observable medical or surgical disorders in a suburb of Greater Accra Region in Ghana. Parameters indicating body weight and body fat composition and their correlation were determined. Hence, the main thrust of this research was to find out the strength of correlation between body weight and body fat composition in adults from the ages 30 to 60 years. The study was conducted in a densely populated suburb of Accra the capital city of Ghana. 

Weight was determined using standard weighing scale ensuring that subjects were in minimal clothing. The respondents were prompted to stand upright with their heads in an erect position and the barefoot on the foot pads of the scale. Readings were recorded to the nearest 1kg. Height measurement was taken using microtoise where the subject stood upright with their arms at their sides, feet together and with the maximum occipital prominence of the head, their shoulders, calves, heels and the buttocks touching the vertical wall. The head was steadied such that the Frankfort plane (the lower border of the orbit of the eye aligned horizontally with the external auditory meatus of the ear) was perpendicular to the vertical wall. The measurement was then taken from the crown of the head to the heel of the feet. Measurements were recorded to the nearest 0.1cm. Measurements of body weights and heights of respondents were used in calculating the BMI= kg / m2 .  

Tuesday, 27 March 2018

Aging Can Be Tough to Swallow


It's felt that one-fourth of U.S. grown-ups will build up a gulping issue eventually. Be that as it may, analysts trust knowledge from another examination may help prompt enhanced treatment. Their investigation took a gander at the progressions that happen in your capacity to swallow as you age. The Johns Hopkins University group trusts the discoveries will enable restoration specialists to configuration practices that could help forestall gulping issue in danger more seasoned grown-ups, said Dr. Alba Azola, a Hopkins inhabitant in physical solution and restoration. 

The investigation included 31 grown-ups, ages 62 to 91, with no gulping issues, and 33 solid youthful grown-ups, ages 18 to 28. The two gatherings experienced a X-beam video test that uncovered the mechanics of their gulping. The test indicated to what extent the windpipe was shut off amid a swallow, to what extent it took to close the aviation route, and how sustenance was kept from getting into the lungs. In the more seasoned grown-ups, the swallow began later. This implied the nourishment was getting to the throat later, and it took more time for the beginning of activities to keep sustenance from getting into the aviation route, the scientists said in a college news discharge. 

That puts more established grown-ups at higher danger of nourishment getting into their lungs, which expands the danger of aspration pneumonia a condition that can prompt demise, the agents brought up. While more typical among more seasoned grown-ups, gulping issues can influence more youthful grown-ups, as well. About portion of patients determined to have dysphagia pass on inside one year of determination, as per Azola's group. Medicines incorporate rehabilitative treatment, for example, gulping practices that incorporate quality preparing. The discoveries were introduced as of late at the yearly gathering of the Dysphagia Research Society, in Baltimore. Research discharged at gatherings is by and large viewed as preparatory until distributed in a companion checked on therapeutic diary.

Friday, 23 March 2018

L-carnitine Partially Improves Metabolic Syndrome Symptoms but does not Reverse Perturbed Sperm Function or Infertility in High Fat Diet-Induced Obese Mice


In recent years, adverse effects of obesity on female reproduction and male fertility have received significant attention. In this study, we investigated infertility improvements following L-Carnitine treatment using a high-fat diet (HFD)-induced obesity mouse model. Five-week-old male mice were divided into a control diet (CTD) group, a HFD group, and a HFD with L-Carnitine supplementation (HFD+C) group that received L-Carnitine-supplemented water and a HFD. At 30 weeks of age, mating tests with female mice were conducted to investigate reproductive ability. Dissection was then performed to analyse organ weights, blood glucose and lipid levels, and sperm motility. HFD mice displayed increased body, liver, and visceral fat weights and blood glucose, blood lipid, and liver lipid levels compared with those of CTD mice. In addition, sperm motility was decreased, and female mouse pregnancies could not be confirmed. HFD+C mice displayed significantly decreased body, liver, and visceral fat mass and blood and liver lipid concentrations compared with those of HFD mice. Though fertility was observed in one out of five mice, no significant improvement in sperm motility or fertility was observed. These results suggest that L-Carnitine administration does not reverse male infertility in diet induced obesity but partially improves metabolic syndrome symptoms.

It is currently estimated that one out of every six married couples in Japan have undergone infertility treatment and testing, indicating that this is a social problem. Infertility is defined by the World Health Organization as “inability to achieve pregnancy after 12 months of unprotected sexual intercourse”. According to the National Fertility Survey of birth trends conducted by the National Association of Population and Social Security Research in 2002, 12.1% of Japanese married couples had experienced infertility testing and treatment. This figure increased to 18.2% in the 2015 Survey. Research has demonstrated that 41% of infertility cases can be traced to problems with the woman, 24% to problems with the man, 24% to problems with both partners, and 11% unknown. This indicates that nearly half of infertility cases can be traced to problems with the man. Biological disorders that cause infertility in women include fallopian tube disorders, anovulation, and cervical disorders and in men include hypo spermatogenesis, seminal duct obstruction, accessory organ disorders, and sexual dysfunction. Other factors related to infertility include lifestyle-related causes, such as alcoholic beverage consumption, smoking, stress, obesity, and excessive dieting. In Japan, obesity is defined as a body mass index (BMI) of 25 kg/m2 and above. According to the international standard established by the World Health Organization, a BMI of 25 kg/m2 and above is considered “overweight,” while a BMI of 30 kg/m2 and above is considered “obese”. Obesity is caused by energy intake habitually exceeding energy consumption. Currently, 2.1 billion people, or 29% of the world’s population, are overweight or obese, indicating that this is a global problem. In Japan, although the percentage of obese adult women is on the decline, the percentage of obese adult men increased to 29.5% in 2015 from 20.4% in 1987. 

When the data for people of reproductive age were examined by age group, 26.6% of men in their twenties, 30.3% of men in their thirties, and 36.5% of men in their forties were either overweight are obese. Studies investigating the correlation between obesity in women and infertility reported that obesity caused declines in fertility rate and made women more susceptible to menstrual disorders. Furthermore, these studies revealed that overweight women had lower ongoing pregnancy rates than women at their ideal weight. Investigation of the correlation between obesity in men and infertility revealed that obese men have fewer sperm, lower sperm motility, and a higher percentage of sperm with DNA fragmentation. The majority of these studies were clinical studies conducted in humans.

Thursday, 22 March 2018

Climate Change Will Bring Hotter Summers to U.S.


Prepare for outrageous warmth. Analysts caution that environmental change will soon trigger more serious summers over the United States. Warmth waves - the main source of climate related passings in the United States - have expanded in number and seriousness in late decades. The new investigation of warmth wave designs predicts that is going to escalate. Outrageous summer warm is relied upon to appear in the western U.S. - including California and the Southwest - as right on time as 2020, as per the new report. 

By 2030, human-caused environmental change will likewise cause warm waves in the Great Lakes locale. Outrageous warmth waves are normal in the Northern and Southern Plains by 2050 to 2070. "These are the years that the human commitments to environmental change will progress toward becoming as critical as characteristic fluctuation in causing heat waves," said think about lead creator Hosmay Lopez. Lopez is a meteorologist at the University of Miami's Cooperative Institute for Marine and Atmospheric Studies. 

Local contrasts in air course, precipitation and green spaces influence when human-caused environmental change rises as the primary driver of extraordinary warmth, the scientists said. In any case, Lopez included a college news discharge: "Without human impact, half of the outrageous warmth waves anticipated to happen amid this century wouldn't occur." Environmental change is being driven by human-created carbon dioxide and different discharges into the air, the specialists said. The investigation was distributed online March 19 in the diary Nature Climate Change. Lopez and his partners utilized atmosphere models and recorded atmosphere information from 1900 to 2010 to anticipate future summer warm examples. They characterized outrageous warmth waves as at least three days of record-high temperatures. The investigation creators said understanding what's driving outrageous temperatures is a basic advance in discovering approaches to manage them.

Wednesday, 21 March 2018

HIV’s Unsolicited Flirtation with the African Woman: A Review of the Present Status


The human immune deficiency virus (HIV) first reared its head in the early eighties when young homosexual men (MSM) curiously began presenting with features suggestive of Pneumocyitis carinni Pneumonia (PCP) now jirovechi (PJP) and Kaposi sarcoma. These presentations were occurring mostly in healthcare centers located in the USA especially in New York and California. It was in 1982 the first cases were scientifically described. Later the virus was isolated from one of these patients with lymphadenopathy and identified in the laboratory by Gallo and colleagues. This eventually identified the HIV as the cause of AIDs. However it might be mentioned for historical purposes that as far back as the early 1900s the Simian immunodeficiency (SIV) virus the ‘relative’ of HIV that resides harmlessly in monkeys and Apes were first transmitted to the human race where they evolved into pathological species and eventually renamed HIV. 

In 1980 a male from San Fransisco the first case of AIDS recognized at the time was reported to the center for Disease control (CDC). Later that same year this first case, ‘patient zero’ was identified as Gaetan Dugas a Kaposi sarcoma patient that was 1 Received Date: 12 Jan 2016 Accepted Date: 22 Jan 2016 Published Date: 26 Jan 2016 KEYWORDS: HIV; AIDS; Female Condoms; Culture Education Copyright © 2016 Mabayoje VO Citation: Mabayoje VO. (2016). HIV’s Unsolicited Flirtation with the African Woman: A Review of the Present Status. M J HIV. 1(1): 002. Introduction: Human immune deficiency virus (HIV) is a virus that has plagued both men and women since the onset of the pandemic in the early eighties. However over time it as became evident that the virus through various means has a predilection for the female sex. Aim: The aim of this paper is to highlight this problem, consider the various causes and offer suggestions as to how the problems may be overcome. Materials and Methods: Review of existing literature, personal and similar published work emphasizing and supporting the subject. Dext top referencing. Results and Conclusion: Various studies have repeatedly confirmed that the female sex is significantly more vulnerable without a doubt to HIV infection than the male sex. There has to be a more active and aggressive approach designed towards reducing the higher incidence of HIV among the female sex. This may include increased societal awareness and education and reduction in cultural practices that predispose them to HIV ABSTRACT HIV positive, a flight attendant known to frequent many bath houses and was subsequently linked to many of the cases at the time. Gaetan Dugas is thought to have introduced HIV from Canada in to the United States (transcontinental transmission) and has often been compared to Typhoid Mary (Mary Mallon) responsible for the typhoid epidemic of the early 1990s in New York City. 

Presently the number of those living with HIV world wide is 36.9 million, however 70% of them reside in Sub-Saharan Africa [5, 6]. Of this 70% the majority are females. HIV not only affects the health of individuals, it impacts households, communities, and the development and economic growth of nations. Many of the countries hardest hit by HIV also suffer from other infectious diseases, food insecurity, and other serious problems. In most studies carried out on the prevalence and incidence of HIV it has been found consistently that females are more frequently infected than males. This cannot be over emphasized. Studies carried out in our institution correspond with studies carried out elsewhere in Africa in this respect. For example in studies carried out in our center based in sub-saharan Africa and published recently it was noted that females were much more infected than males. One such study revealed that 68.92% of the total infected study population were females and this was found to be statistically significantly higher than males (p=0<0.005). Another study showed that 73.8% of the study population were females [7, 8]. African females could also be two to six times more infected with HIV than men. Even though the vast majority of new HIV infections in sub-Saharan Africa occur in adults over the age of 25, HIV disproportionately affects young women. More than 4 in 10 new infections among women are in young women aged 15-24. 15-19 year olds are particularly at risk equating to higher HIV prevalence rates when they are older. For example, in Mozambique, HIV prevalence is 7% among 15-19 year olds but rises to 15% for 25 years olds. Likewise, in Lesotho, HIV prevalence rises from 4% among 15-19 year olds to 24% among 20-24 year olds. A review of 45 studies across sub-Saharan Africa found that relationships between young women and older men are common and associated with unsafe sexual behaviour and low condom use, which heightens their risk of HIV infection. This has been established in similar environs to ours repeatedly as mentioned earlier, since the introduction of highly active antiretroviral drugs in 1996 there has been a dramatic increase in the quality and length of life of infected individuals. However it is unfortunate that females that contribute significantly to the development of nations through the nurturing of both men and women from birth do not appear to be receiving the optimal benefits from HAART due to their increased susceptibility to HIV infection. Several reasons have been proposed for this disparity in HIV infection among males and females. This becomes ironical when in the same breath it is said men have more ‘risky’ sexual habits than women yet women are more infected.  

Tuesday, 20 March 2018

HIV-Associated Generalized Papular Mucinosis and Neurosyphilis

The association of cutaneous mucinosis with other conditions is frequent. While the rare coexistence of papular mucinosis with HIV infection has already been documented, any relation of the disease to syphilitic infection has not been proved yet. We present on a patient with generalized papular mucinosis, HIV infection and neurosyphilis.

Cutaneous mucinoses are characterized by excessive dermal deposition of acid glycosaminoglycans. Dubreuilh was the first to describe lichen myxoedematosus in 1906, and it was in 1953 when Montgomery and Underwood classified the various clinical forms. Association of cutaneous mucinoses with other conditions, such as paraproteinemia, diabetes mellitus, thyroid dysfunction, hepatitis C and HIV-infection, was found frequently. No definite reference about relation to syphilis infection has been published yet. Etiologic factors of dermal mucin deposition have not been clarified, it is assumed that abnormal activation of mucinproducing dermal fibroblasts by autoantibodies, paraproteins and cytokines, or defective pathways of mucin degradation could be involved. Here we present an uncommon form of papular mucinosis (PM) associated with HIV infection and neurosyphilis.

A 30-year-old, otherwise healthy man presented with widespread skin symptoms of about 12 month’s duration without any subjective complaints. Widespread 3-5 mm, skin coloured papules suggested scleromyxoedema. Skin biopsy revealed alcian blue and PAS positive mucin deposition in the papillary dermis, perivascular and perifollicular inflammatory infiltrate and discrete epidermal vacuolization. Laboratory examination showed elevated liver enzymes and polyclonal hypergammaglobulinaemia, ANA antibodies were negative. The patient refused the offered thorough examination. After a few months he was hospitalised at an ophthalmologic department because of bilateral visual impairment. Panuveitis was diagnosed on the basis of abnormal perimetry and funduscopy findings. TPPA, TP-ELISA and RPR tests were positive, the latter in 1/512 dilution. Anti-HIV ELISA was reactive. On admission the patient showed widespread indurated, skincoloured papules 2-5 mm in diameter, diffuse alopecia, bilat eral inguinal and submandibular lymphadenopathy and he complained of dizziness and headache. No genital symptoms were present.

Monday, 19 March 2018

Abortion Services Vary Widely Across the U.S.


The report from The National Academies of Sciences, Engineering, and Medicine found that while lawful premature births in the United States are viewed as protected, numerous states have decides that cutoff a lady's entrance to a sheltered and viable fetus removal. As indicated by the advisory group that drafted the report, states can confine premature birth access by denying qualified suppliers from playing out the methods, misleading ladies of the dangers included, or requiring medicinally superfluous administrations and postponing care. As plot in the report, a few cases of these guidelines include: compulsory holding up periods; pre-premature birth ultrasound; a different advising visit; and constraining fetus removal suppliers to give ladies composed or verbal data proposing that premature birth builds a lady's danger of bosom disease or psychological maladjustment, in spite of the way that there is no logical confirmation to help that claim. he greater part of premature births can be given securely in office-based settings, and 95 percent of premature births performed in 2014 in the United States happened in facilities and other office-based settings, as indicated by the board of trustees that composed the report. 

What's more, there is no confirmation that specialists who perform premature births require healing facility benefits to guarantee a sheltered result for the patient. All things considered, there has been a drop in the quantity of fetus removal centers the nation over, the report found. In 2014, there were 17 percent less fetus removal facilities in the United States than in 2011, and 39 percent of ladies of regenerative age lived in a region without a premature birth supplier, the report noted. In 2017, 25 states had five or less premature birth centers, and five states had just a single fetus removal facility. Around 17 percent of ladies need to movement in excess of 50 miles to have a premature birth, the report found. Most premature births in the United States are performed ahead of schedule in pregnancy, the report expressed. In 2014, 90 percent of premature births happened by 12 weeks of incubation. 

Genuine difficulties from premature birth are uncommon, and the most abnormal amounts of wellbeing and quality are accomplished when a fetus removal is executed as right on time in pregnancy as could be expected under the circumstances, the report creators said. The board of trustees likewise assessed the long haul wellbeing impacts of fetus removal and reasoned that it doesn't build the danger of barrenness, hypertension amid pregnancy, preterm birth, bosom disease or psychological wellness issue, for example, gloom, uneasiness or post-horrendous pressure issue. There appeared to be a relationship between exceptionally preterm birth and the quantity of earlier premature births. For instance, an expanded danger of extremely preterm birth of a first-conceived kid was related with having at least two yearning premature births, which is a sort of surgical methodology.

Saturday, 17 March 2018

Initial Response to Therapy with Fulvestrant and Cyclin-Dependent Kinase 4/6 Inhibitor in a Male with Stage IV Breast Cancer


Male breast cancer (MaBC) accounts for less than 1% of breast cancers (BC). Based on the low incidence of MaBC, information from randomized clinical trials is not available. Therefore, the same guidelines for palliative endocrine therapy in women with advanced BC are generally followed for men. Endocrine therapy (ET) represents the first line of treatment for male patients with stage IV disease in the absence of a visceral crisis. However, resistance to ET in hormone receptor positive advanced breast cancer is common, and given sufficient time, most patients are faced with disease progression. In this report we describe the case of a male that experienced systemic recurrence of BC following adjuvant therapy for locally advanced disease. First line endocrine treatment was combined with a cyclin-dependent kinase 4/6 inhibitor, leading to a dramatic radiographic and clinical response.

Male breast cancer (MaBC) accounts for less than 1% of breast cancers (BC). In the United States, males were expected to account for only 2600 of the estimated 249,260 cases of breast cancer during 2016 projections. The worldwide variation of MaBC resembles that of BC in women, with higher rates in North America and Europe and lower rates in Asia. Although the epidemiologic literature on female breast cancer (FBC) is extensive, little is known about the etiology of MaBC; it appears to be associated with marital status, previous breast and testicular pathology, gynecomastia and liver diseases. Due to its rarity, information from randomized clinical trials is not available. Men tend to be diagnosed with locally advanced or metastatic disease more frequently than women; more than 40% of patients have stage III or IV disease at diagnosis.They also have a proportionately higher mortality, although outcomes for male and female patients with breast cancer are similar when survival is adjusted for age at diagnosis and stage of disease. The association between estrogen levels and breast cancer in men is of interest because estrogen-related risk factors have been strongly implicated in the etiology of FBC. Obesity has been implicated in the etiology of MaBC due to higher circulating estrogen levels and has consistently been associated with an increased risk of MaBC. Men with a mutation in the BRCA2 gene have an increased risk of breast cancer with a lifetime risk of about 6 in 100. BRCA1 mutations can also cause breast cancer in men, but the risk is lower - about 1 in 100. Histologically, the majority of breast cancers in men are infiltrating ductal carcinomas, but the entire spectrum of histological variants of breast cancer has been seen. Papillary and lobular carcinoma are seen in less than 2% of the cases. About 80% of MaBC are hormone receptor positive (HR+), 15% overexpress human epidermal growth factor receptor 2 (HER2), and 4% are triple negative (estrogen receptor (ER), progesterone receptor (PR), and HER2/neu negative). 

In terms of gene expression profile, recent studies by Johansson and colleagues have revealed two subgroups: luminal M1 and luminal M2. These subgroups demonstrated differences in tumor biological features and outcome, and differed from the intrinsic subgroups described in FBC. Luminal M2 tumors were characterized by high expression of immune response genes and genes associated with ER signaling. On the other hand, luminal M1 tumors, despite being ER positive (ER+) by immunohistochemistry, showed a lower correlation to genes associated with ER signaling and displayed a more aggressive phenotype and worse prognosis. Since gene expression is typically related to protein expression, examination of the differences between MaBC and FBC were studied at the hormone receptor (HR) immunohistochemical level in a large series of 514 matched cases. Strikingly, hierarchical clustering in FBC revealed ERα clustered together with PR, while in MBC, ERα clustered with the androgen receptor (AR) suggesting a clinically actionable difference between genders in HR biology. Although MaBC is typically considered ERα driven, there are distinct molecular features found in MaBC, which could be used as targets for currently available or yet undeveloped therapies. 

Friday, 16 March 2018

Current Practice Patterns After Carpal Tunnel Release. A Survey of Clinical Practice Trends Across the World


Since Phalen popularized the diagnosis and treatment of carpal tunnel syndrome (CTS) in the 1950s  there has been continued debate over the optimal management of the condition regarding conservative treatment, surgical approach, and post-surgical intervention. The goal of postoperative rehabilitation is to speed up and en hance symptom resolution and restore functional recovery following surgery. Although the evidence base for rehabilitation for hand conditions has grown throughout the last decade, evidence and guidelines for the use of specific interventions after CTR (carpal tunnel release) are limited. 

Studies suggest postsurgical treatment intervention should combine different methods of scar treatment and numerous strategies  for controlling edema as well as passive, assisted and active mobilization, strengthening, and functional exercises and the gradual progression of activities. However, no clinical practice guidelines exist regarding the optimal post-surgical approach. None of the studies that addressed the effectiveness of the variety of interventions have been described with high quality evidence. Literature provides us with an overview of the effectiveness of various rehabilitation treatments to optimize results following CTR compared with no treatment, placebo, or another non-surgical intervention. No evidence-based practice survey has been performed to assess the current practice patterns around the globe after carpal tunnel release. The aims of this research study was to assess the practice patterns around the globe after carpal tunnel release interventions.

In order to assess the current practice patterns of physical and occupational therapies regarding interventions after CTR, an internet-based survey was designed to address the study aims outlined above using the Google database online electronic survey program. A total of 78 occupational and physical therapists were contacted between September and December 2017 through social networks. Therapists were invited to participate voluntary on the survey and were directed to a Web site link containing the electronic survey. No incentives were provided to participants.

Thursday, 15 March 2018

Noise-Induced Hearing Loss and Tinnitus in Milit ary Personnel


Hearing loss is the most common form of sensory impairment in humans, affecting 5.3% worldwide population. Hearing is critical to the performance of military personnel and is integral to the rapid and accurate processing of speech information. Noise-induced hearing loss represents a severe impairment that reduces military effectiveness, safety, and quality of life. Military personnel work in high-noise environments, yet the Department of Defense cannot predict who is susceptible to noise-induced hearing loss and tinnitus. Of those exposed to noise, 80% may also suffer from chronic tinnitus. Despite its prevalence, there are no means to objectively measure the severity of tinnitus in those individuals. 

A fundamental understanding of the underlying mechanisms of tinnitus and its relation to noise-induced hearing loss is critical. Such an understanding may provide insight to who is at risk for each condition, allow aggressive hearing protection measures in those individuals most at risk, and create areas for treatment for those already suffering from the conditions. The current review addresses the scope of the problems of noise-induced hearing loss and tinnitus for the military, discuss the noise environments in which military personnel operate, and describe recent pharmacotherapy trials. Some recent breakthroughs in noise-induced hearing loss research are discussed along with some challenges and directions for future research on hearing loss and tinnitus.

The mammalian cochlea is the sensory organ capable of perceiving sound over a range of pressure, and discriminating both infrasonic and ultrasonic frequencies in different species. The organ of Corti is located in the cochlea of the inner ear and is responsible for the detection of sound. This organ harbours the auditory sensory epithelium, which, in humans, contains approximately 16,000 hair cells that are patterned into three rows of outer hair cells (OHCs) and one row of inner hair cells (IHCs). The cell bodies of hair cells form specialized adhesive contacts with supporting cells that adhere at their basolateral surfaces to the basilar membrane, an extracellular matrix assembly with a different molecular composition from the tectorial membrane. 

Wednesday, 14 March 2018

The Past and Future of Endodontic Treatments: Where and How we are Going?

Following a pulp exposure, gradual alterations dues to the carious decay were detected in the dental pulp. Small necrotic foci exhibiting limited necrosis were noticeable, and they were growing slowly or rapidly. A sequence of treatment of the infected pulp leads endodontic therapy. Elimination of the infection and the protection of a decontaminated tooth, free from future microbial invasion, implicate the removal of nerve, blood vessels, cell remnants and fibers containing connective tissue. They contribute to direct the shaping, orientation, and enlargement of the root canal, while cleaning of the roots. This is completed by the filling of decontaminated canals with a stable material. Since more than one century, root canal treatments provide good results in the context of endodontic therapies. It was clearly shown that as a consequence of endodontic therapy, pulp healing and regeneration were stimulated inside the root canal. This possibility was linked to the survival of some pulp cells, despite severe pulp alterations. Inflammatory and immune reactions combine with pulp destruction. The pulp contains cells reacting positively to the carious attack. Inflammatory cells have been characterized. They include dendritic cells, histiocytes/macrophages, T lymphocytes and latent stem cells (progenitors), involved in the stem cells self-renewal. 

Anti-inflammatory agents include also a series of mediators such as steroids, interleukin-I receptor antagonist, solid tumor necrosis factor (TNF) receptor, IL-10, nitric oxide (NO), heme oxygenase-1 and regulatory Tlymphocytes (Tregs). They play a crucial role by limiting tissue damages. Programmed cell death involves necrosis, apoptosis, nemosis, pyroptosis and autophagy. Proteases are also associated to such processes. They implicate caspases, calpains, cathepsins and transglutaminases. Obviously, reparative dentinogenesis is associated to the expression of class II MHC markers located at the surface of macrophages. These cell markers are involved in the recovery of the wounded root canal, a prerequisite for pulp rescue, leading ultimately to pulp regeneration. Embryonic stem cells (ECSs) and induced pluripotent cell lines (IPs) provide different tools with a potential for regeneration. However, their phenotype is unstable and the initial phenotype is ultimately restored. In adult teeth, there are a small number of stem cells compared with the total of pulp fibroblasts or pulpoblasts, according to Baume analysis. 

After isolation, expansion, and characterization of the multipotent human mesenchymal stem cells, 5 to 7 days after the initial plating, committed progenitor cells display a restricted potential. Evaluated by Pittenger et al. as being about 0.001 to 0.01% of the grand total of cells, the subset of undifferentiated cells represents in the dental pulp as little as 1% of the total cell population according to Sloan and Waddington. Side population (SP) cells in human deciduous dental pulp were evaluated to be 2% of the total cells. According to Kenmotsu et al. approximately 0.40% of the pulp cells may be stem cells or side population when they are found in young rats, whereas only 0.11% is found in old rats. 

Tuesday, 13 March 2018

Diplopia as the Sole Symptom of Lyme Borreliosis

Lyme Borreliosis (LB) is the most common human tick-borne disease in the Northern Hemisphere. The illness usually begins with erythema migrans, followed by neurologic or cardiac abnormalities and finally arthritis. Ocular complications have been reported, including conjunctivitis, keratitis, uveitis, oculomotor palsies, papilloedema and others, but they have been rarely described in literature as unique clinical feature of disease. Herein, the case of a 53-year-old Caucasian woman with diplopia as the sole symptom of LB. No other systemic symptoms were detected, leading to an initial misdiagnosis. Undergoing to detailed investigation, our patient actually had serology positive for Borreliosis. Two months after antibiotic and orthoptic treatment, diplopia definitively disappeared. These results confirm the theory that an appropriate drug therapy associated with an effective orthoptic rehabilitation has made possible a quick restoration of binocular vision, achieving a good quality of life. This case demonstrates the importance of considering LB as part of the differential diagnosis of patients with isolated cranial nerve palsies, stressing the importance of the orthoptic intervention. 

Lyme Borreliosis (LB) is the most frequently infectious multi system disorder worldwide. The prevalence of LB is estimated to be 20-100 cases per 100,000 persons in the United States and 100-155 cases per 100,000 persons in Europe. The disease is transmitted following exposure to a tick bite carrying the spirochete Borrelia Burgdorferi. It typically begins with an erythematous rash (erythema migrans), but patients can develop also cardiac anomalies (4- 8%), neurologic compromise (11%) and arthritis (45-60%). Literature also reports common ocular manifestation, such as conjunctivitis, keratitis, uveitis, oculomotor palsies, papilloedema, papillitis, accompanied by ophthalmological symptoms among pain, visual impairment, photophobia, myodesopsia, diplopia and lack of accommodation. LB diagnosis is highly likely based upon appropriate serology and clinical manifestations. Symptoms generally disappear with antibiotic treatment that generally lasts less than 4 weeks, although the length of therapy could vary according to disease course. Ocular LB is probably underdiagnosed due to a difficult serologic diagnosis, as well as its various and soft ophthalmological symptoms. This case presents a 53-year-old Caucasian woman affected by an isolated paralytic strabismus originally caused by LB. The clinical findings, limitated to diplopia, have lead to a late diagnosis since an isolated abducens nerve palsy does not represent a specific features of Borreliosis. 

Monday, 12 March 2018

Magnetic Heart Pump Cuts Risk of Blood Clots, Stroke in Study


Another heart pump cuts the danger of blood clusters and stroke in patients with heart failure,research subsidized by the gadget producer appears. The investigation included 366 patients who got either Abbott Inc's. HeartMate 3 remaining ventricular help gadget or the HeartMate II. Two years subsequent to getting the gadgets, 151 of the 190 patients (79.5 percent) who got the HeartMate 3 had not endured a crippling stroke or required a moment activity to supplant or evacuate the gadget. That contrasted and 106 of the 176 patients (60 percent) with the HeartMate II. 

Just three individuals with the HeartMate 3 required another task, contrasted and 30 HeartMate II patients. None of the HeartMate 3 patients required re-activity because of blood clumps in the pump, the discoveries appeared. Rates of death and handicapping strokes in the two gatherings were comparable, however the general stroke rate was bring down among HeartMate 3 patients. The two gatherings had comparative rates of draining and contamination, the analysts found. The investigation was to be exhibited Sunday by Dr. Mandeep Mehra at the American College of Cardiology yearly gathering, in Orlando, Fla. It was additionally distributed online at the same time in the New England Journal of Medicine. 

Mehra is official chief of the Center for Advanced Heart Failure/Cardiomyopathy at Brigham and Women's Hospital in Boston. "This is a crucial report in the field of cutting edge heart disappointment," he said. "Left ventricular help gadgets have been being developed for a long time and there have been changes in their innovation, however a few difficulties exist, including issues of blood clumps shaping in these gadgets, requiring gadget substitution," Mehra said in a doctor's facility news discharge. As indicated by the report, the HeartMate 3 has a few plan changes intended to lessen the danger of entanglements.

Friday, 9 March 2018

Use of the Endo Retract II © in laparoscopic Colon Surgery


We describe the use of the Endo Retract II © to perform the separation of the small bowel loops in laparoscopic colonic surgery. The idea is to introduce an open compress into the area occupied by the small intestine in such a way that, resting the separator upon it, we can manoeuvre as if it were a hand, thus allowing us to separate the intestinal package and freeing the area of the mesocolon for intervention. 

Thursday, 8 March 2018

Age Assessment in Forensic Cases: Anthropological, Odontological and Biochemical Methods for Age Estimation in the Dead

One of the main goals of forensic science is determining the age of an individual to perform the biological profile. This is important in criminal cases and mass disaster scenarios, where the skeletons are often incomplete, which makes difficult their identification. The knowledge and application of anthropological methods and new biochemical approaches is essential to correct age determination, leading to the identification of an individual. Forensic anthropology and odontology methods estimate age through the macroscopic changes in bones and teeth due to growth and development in subadult individuals, and degenerative changes in adults. When growth has ceased, age estimation in adults is basically based on the degenerative changes of bone and teeth, and is generally less precise than in subadults. Due to the accuracy of the age estimate decreases as the age of the individual increases, other methods have been developed for estimating the age of the adult individual based on changes at the biochemical level due to the physiological process of aging. Biochemical methods are accurate, however, they have some limitations, so its use in combination with anthropological methods can be very useful for accurately estimating age.

Traditionally, forensic anthropology and odontology methods estimate age through the macroscopic changes in bones and teeth due to growth and development in subadult individuals, and degenerative changes in adults. Selection of methods to be employed in age estimation depends upon the materials available for examination, their condition and the age category of the individual. According to the age group to which the individual belongs, different methods of age estimation can be used. In this way, dental development could be used in fetal individuals the presence of ossification nuclei or long bones development. In the case of children, dental development can be used the presence of ossification centers and the fusion of the epiphyses and development of hand and wrist bones. Dental development has been demonstrated to reflect chronological age more accurately than osteological development. 

Dental development appears to be under stronger genetic control, while osteological development is more influenced by environmental factors such as biomechanics, physiological stress and nutrition. So that, in cases of age estimation of inmature individuals (fetal, neonatal, infant, child and adolescent) a special attention on dental age estimation methods should be considered. In adolescents and young adults the most relevant age indicators are the development of the third molar development of hand and wrist bones spheno-occipital fusion (Scheuer and Black, 2000; Madeline and Elster, 1995), and fusion of the sternal end of the clavicle It is advisable to use as many indicators as possible, to obtain better results.  

Wednesday, 7 March 2018

A Simple Voice Training Method by Emphasizing Abdominal Respiration and Refractory Laryngeal Granulomas

It has been suggested that doctors should perform voice therapy in cooperation with speech therapists. However, speech therapists have not fully spread in Japan. Therefore, we designed “a simple method of voice training by emphasizing the importance of abdominal respiration” and relying on only a single doctor to administer this voice training. Voice therapy is the first choice for vocal fold nodules in Japan. Previously, we reported the improvement of 9 cases with vocal fold nodules using this method.

Some hospitals reported high rates of postoperative recurrence, therefore, proton pump inhibitor (PPI ) treatment have been the first choice for laryngeal granulomas. However, some cases do not improve by PPI alone. In this study, our voice training was employed for refractory laryngeal granuloma cases that were resistant to PPI (including postoperative recurrent cases ). In Japan, evaluation of the effectiveness of voice therapy is widely done using the grade rough breathy asthenic strained scale (GRBAS scale). The GRBAS scale is considered the gold standard for psychoacoustic voice evaluation in Japan, and is a subjective rather than objective evaluation. Therefore, we tried to make our evaluation as objective and clear as possible. The grade of the effectiveness of our training was evaluated by changing the laryngeal diseases.

At our hospital otorhinolaryngology out-patient clinic, voice therapy was performed from April 2011 to June 2017 using the simple method of voice training by stressing the importance of using abdominal respiration. All patients (29) received an explanation about surgical and pharmacological treatments, as well as our voice training method, and chose our method of voice training. Finally, All 29 cases with laryngeal granulomas had not improved by PPI treatment for 8 weeks. Four cases with postoperative recurrence did not improve by PPI treatment. All cases were treated by our method of voice training alone, using no other therapy (e.g., silent therapy, medicine, operation) during the voice training period. 

Tuesday, 6 March 2018

More U.S. Kids Landing in ICU From Opioids


A developing number of U.S. kids are winding up in the emergency unit overdosing on solution painkillers or different opioids, another examination finds. Specialists found that in the vicinity of 2004 and 2015, the quantity of youngsters and teenagers admitted to a pediatric emergency unit an opioid overdose almost multiplied. That included adolescents who'd mishandled the medications, and youthful youngsters who'd incidentally gotten hold of them. "These affirmations are completely preventable," said lead specialist Dr. Jason Kane, of the University of Chicago Comer Children's Hospital. "These children shouldn't be there." 

The discoveries, revealed online March 5 in the diary Pediatrics, offer the most recent take a gander at the U.S. opioid pandemic. Conversely, the examination found, just 12 percent of kids hospitalized for any reason must be admitted to the ICU. After some time, ICU affirmations for opioids ascended: from 367 children for the years 2004-2007, to 643 in the vicinity of 2012 and 2015. Most were adolescents, however around 33% were youngsters more youthful than 6 - who might have unintentionally gotten their hands on somebody's prescription, Kane said. Near 2 percent of kids who overdosed at last kicked the bucket. The discoveries feature another lamentable side of the country's opioid scourge emergency, Kane stated: "Very nearly 2 percent of these children kicked the bucket of a totally preventable sickness." 

An expected 2.4 million Americans have an opioid utilize clutter, as indicated by government gauges. That incorporates manhandle of remedy painkillers, for example, Vicodin and oxycontin, and also illicit medications like heroin. Be that as it may, while the emphasis is ordinarily on grown-ups, kids have turned into "the second flood of casualties," Kane said. One late examination found that a developing number of kids and young people are appearing in crisis rooms subject to opioids. In 2013, approximately 135 children for each day were trying positive for opioid reliance in the country's ERs, as per the investigation. 

The new examination took a gander at pediatric emergency unit confirmations, which would catch the most genuine overdose cases. A few children arrived there in respiratory misery, needing a ventilator, Kane said. Others required pharmaceuticals to raise their circulatory strain from hazardously low levels. The discoveries depend on records from 31 U.S. kids' doctor's facilities. In the vicinity of 2004 and 2015, there were in excess of 3,600 kids and young people admitted to the doctor's facility for an opioid overdose - and 43 percent of them must be taken the ICU.

Monday, 5 March 2018

Experiences of the Families of Cancer Patients Receiving Chemotherapy

The cancer is the second cause of death in the world; in 2015, almost one of the six deaths stemmed from this illness, also it is foreseen that the number of new cases increases 70 % in the next 20 years. Chemotherapy is one of the treatments used to fight cancer disease. This treatment causes numerous side effects that most patients experience once arrived at his home and that are shared with relatives who suffer indirectly, especially those who have assumed the role of primary caregivers. Some common side effects from chemotherapy are fatigue, nausea, vomiting, hair loss, pain etc. There have been numerous studies on the experiences of cancer patients in chemotherapy treatment although there are few who analyze this situation and face closest to sick relatives. Cancer is a chronic disease that involves many changes in the life of the individual and has an impact not only for the affected, but also for your environment. Often throughout the process a whole problems associated with the disease develop anxiety disorders or depression, high levels of suffering, somatic discomfort and even psychosocial impairment. 

Even when the patient who receives the physical consequences of this disease and its treatment, psychosocial consequences affect the entire family. Programs of palliative care are started that whose target is to provide quality of life to the patient with an illness portencialmente mortal as it is the cancer and the family that takes care of it; as he recognizes the WHO in the 67th World Assembly of the Health in 2014 “the palliative care constitutes an exposition that allows to improve the quality of life of the patients (adults and children) and its relatives when they confront the problems inherent in a potentially mortal illness, exposition that materializes in the prevention and the mitigation of the suffering by means of the precocious detection and the correct evaluation and therapy of the pain and other problems, be already this of physical, psychosocial order or spiritual.

The family usually provides the patient the main support, but at the same time supports a high level of physical and especially emotional overload. Some studies show that the prevalence of emotional disorders (mainly anxiety and depression) is practically the same in relatives of patients than in those affected, reaching patients considered “second order”. Not all are suitable coping mechanisms so emotional disturbances are frequent and adopting health habits sometimes harmful to combat stress.

Friday, 2 March 2018

Complications of subclavian Vein Catheterization and Their Management in the ICU


The subclavian approach remains the most commonly used blind approach for subclavian vein catheterization (SVC). Its advantages include consistent landmarks, increased patient comfort, and lower potential for infection or arterial injury compared with other sites of access. However, the list associated with this procedure is quite long. Thus, we describe here the case of three patients in whom serious but preventable SVC complications occurred in an intensive care unit (ICU). We emphasize the role of proper management for minimizing the negative consequences associated with SVC.

Subclavian vein catheterization (SVC) is a technique used worldwide millions of times each year for the management of perioperative fluids or the administration of chemotherapy, total parenteral nutrition, or long-term antibiotics. This procedure is often a successful and uncomplicated. However, reported complication rates range from 0.3 to 12 %, according to the experience of the physician and the definition of complications. Potential complications include failure to locate or cannulate the vein, puncture of the subclavian artery, misplacement of the catheter (placement of the catheter tip in the contralateral subclavian vein or in either jugular vein), pneumothorax, mediastinal hematoma, haemothorax, and injury to adjacent nerves. Except for the physician’s experience, the risk factors for complications and failures of subclavian-vein catheterization are poorly understood. Here, we present our gained experience from more than one hundred SVCs performed in one month in our 14-bed ICU, reporting the case of complications that occurred during the attempts to cannulate the subclavian vein of three patients who were admitted to our intensive care unit (ICU) and we discuss the management of such complications. 

A 52-year-old overweight patient was admitted in the ICU with acute respiratory failure, exacerbated by his chronic obstructive pulmonary disease. He was placed under mechanical ventilation and on the sixth day of his hospitalization a subclavian catheter was placed on the right side to measure central venous pressure. Chest X-rays after cannulation showed right pneumothorax and subcutaneous emphysema. The catheter was removed, and thoracentesis was performed. The patient continuously improved his condition and was released from the ICU on the 15th day of his hospitalization. 

Thursday, 1 March 2018

Apple Body Shape Can Raise Women's Heart Attack Risk


Abundance tummy weight - a supposed apple shape - raises a lady's hazard for heart assault considerably more than general stoutness, scientists report. While weight brings heart assault hazard up in both genders, ladies with greater midriffs and abdomen to-hip proportions have more prominent chances for a heart assault than men who have a comparable apple-formed body, a substantial British investigation finds. 

"Our discoveries demonstrate that taking a gander at how fat tissue is dispersed in the body - particularly in ladies - can give us more understanding into the danger of heart assault than general measures of heftiness, for example, weight record," said lead analyst Sanne Peters. Weight record (BMI) is a regularly utilized estimation in light of tallness and weight. 

Having a pear-molded body - a littler abdomen with abundance weight for the most part around the hips - isn't thought to raise heart assault hazard to a similar degree. As of now, no restorative treatment centers around abundance paunch fat, said Peters, an exploration individual in the study of disease transmission at the University of Oxford's George Institute for Global Health. 

Be that as it may, "more concentrated screening for the danger of cardiovascular ailment and diabetes among those with an apple shape may avoid coronary illness, particularly in ladies," Peters said. As indicated by the World Health Organization, 40 percent of ladies worldwide are overweight and 15 percent are hefty. Weight builds the hazard for heart assault, the main source of death around the world, the scientists noted. Weight additionally raises your chances for stroke, hypertension, diabetes and a few growths. 

For the new examination, Peters and associates gathered information on about 500,000 grown-ups in the United Kingdom, matured 40 to 69, and tailed them for a long time. The examiners found that midriff to-hip proportion and midsection periphery, individually, were 15 percent and 7 percent all the more unequivocally fixing to heart assault chance in ladies than men. Likewise, contrasted and BMI, midsection to-hip proportion was a 18 percent more grounded indicator of heart assault in ladies and a 6 percent more grounded indicator of heart assault in men, the discoveries appeared.