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Pubmed
Journal: The Medical journal of Malaysia
April/22/2016
Pubmed
Journal: The Medical journal of Malaysia
April/22/2016
Abstract

Melioidosis is an infection caused by Gram negative bacterium Burkholderia pseudomallei leading to abscesses in lungs, liver, spleen, musculoskeletal system, prostate and sepsis. We present a rare case of purulent pericardial effusion caused by melioidosis with concomitant pneumonia and splenic abscesses. The patient underwent pericardiocentesis and successfully recovered from cardiogenic and septic shock.

Pubmed
Journal: The Medical journal of Malaysia
April/22/2016
Pubmed
Journal: The Medical journal of Malaysia
April/22/2016
Abstract

BACKGROUND

Ventricular tachycardia (VT) storm is an uncommon but life-threatening condition. We describe the incidence, causes and management of VT storm among patients admitted to the coronary care unit of a large tertiary hospital.

METHODS

Between 1 November 2009 and 30 April 2010, 198 patients were admitted to the coronary care unit and 7 (3.5%) presented with VT storm. A retrospective review of their records was conducted. The mean follow-up period was 268 (196 to 345) days.

RESULTS

The mean age was 67 years and 4 patients were male. One patient had a previous myocardial infarction. All had abnormal left ventricular ejection fraction, median of 30%. Acute myocardial infarction (4 patients) was the most common trigger, followed by decompensated heart failure (1), systemic inflammatory response syndrome on a background of non-ischemic dilated cardiomyopathy (1) and bradycardia-induced polymorphic VT (1). Three patients had polymorphic VT and the rest had monomorphic VT. Intravenous amiodarone, lignocaine, overdrive pacing and intra-aortic balloon pump counterpulsation were useful in arrhythmia control. Three patients underwent coronary revascularization, 3 patients received implantable cardioverter-defibrillators, 1 had a permanent cardiac pacemaker, 1 died during the acute episode. Five out of the 6 survivors were prescribed oral beta-blockers upon discharge. On follow-up, none of the patients had a recurrence of the tachyarrhythmia.

CONCLUSIONS

Acute myocardial infarction was the main trigger of VT storm in our patients. Intravenous amiodarone, lignocaine, overdrive pacing and intra-aortic balloon pump counterpulsation were useful at suppressing VT storm.

Pubmed
Journal: The Medical journal of Malaysia
April/22/2016
Abstract

BACKGROUND

Stomach and esophageal cancers are both deadly and difficult to diagnose early. Stomach cancer is the second most common cancer in Asia. Both these are one of the most common causes of cancer related death in the world.

OBJECTIVE

To determine the mean time delay from appearance of the symptoms to the endoscope procedure [OGDS] and rationalized the reason for this delay in diagnosis.

METHODS

This is a cross sectional study of stomach and esophageal cancer data from Jan 2004- July 2008. All patients' records of histologically confirmed stomach or esophageal cancers during the study period were reviewed.

RESULTS

Total of 112 consecutive patients with stomach and esophageal cancer were analysed. 86 cases of stomach and 26 cases of esophageal cancer were reviewed. The average age for stomach and esophageal cancers are 60.8 years and 58.4 years respectively. The mean duration from the first appearance of cancer symptoms to endoscope procedure was 32.4 weeks for stomach cancer patient and 16.7 weeks for esophageal cancer patients. The reasons for the delays are due to 1) self-medication, 2) Empirical treatment for dyspepsia using antacid and H2 antagonist, 3) Delay in endoscope procedure for high risk patients.

CONCLUSIONS

Reducing the delay in endoscope procedure may lead to early detection of cancer and thereby may improve the prognosis of these patients.

Pubmed
Journal: Australian health review : a publication of the Australian Hospital Association
April/22/2016
Abstract

Little is known of difficulties in accessing health care for recently arrived paediatric refugees in Australia. We reviewed routinely collected data for all 199 East African children attending a hospital Immigrant Health Clinic for the first time over a 16 month period. Although 63% of parents reported medical consultations since arrival, 77% of this group reported outstanding, unaddressed health problems. Availability of interpreters and information on health services were the main factors hindering access to care. These data have informed future service planning at the Clinic. Ongoing data collection is key to maintaining a responsive, targeted service for a continually changing population.

Pubmed
Journal: Xi bao yu fen zi mian yi xue za zhi = Chinese journal of cellular and molecular immunology
April/22/2016
Abstract

OBJECTIVE

To explore the role of continuous high-volume renal replacement therapy(HV-CRRT) in serum TNF-alpha removal.

METHODS

13 panceatitis patients complicated with acute renal failure were treated by continuous venovenous hemofiltration (CVVH), and they were divided into two groups according to the substitution rate during CVVH. The substitution rate of group I (8 cases) was 2 L/h, the that of group II(5 cases) was 4 L/h. 1ml blood samples were taken from the post-filter at 0,1,2,3,6 and 24 h after CRRT, respectively. The TNF-alpha level produced from endotoxin-induced periphral blood mononuclear cells (PBMCs) was detected by ELISA. Ultrafiltrate samples were co-incubated with donor's whole blood containing ET so as to detect suppression activity of ultrafiltrate.

RESULTS

Production of TNF-alpha by ET-induced PBMCs was significantly suppressed in group I and II. During CVVH treatment, suppressed ET-induced TNF-alpha production increased variously in the first 3 h, and then decreased gradually. In contrast, the increased levels of ET-induced TNF-alpha production in group II were higher than that in group I, and maintained a higher level until 24 h after CVVH therapy. The ultrafiltrate from group I had no suppressing activity, but the ultrafiltrate from group II suppressed ET-induced TNF-alpha production, the suppression rate was (15+/-6)%.

CONCLUSIONS

HV-CRRT is more effective than standard CRRT in removal of inflammatory mediators. The mediators are removed mainly by filter membrane adsorption, and maybe partly by convection. Therefore, HV-CRRT with large-pore filter membranes is an effective way in removal of inflammatory mediators.

Pubmed
Journal: Xi bao yu fen zi mian yi xue za zhi = Chinese journal of cellular and molecular immunology
April/22/2016
Abstract

OBJECTIVE

To study the function of newly cloned NF-kappaB-activating gene (NAP2) and its mechanism. METHEDS: Activation of NF-kappaB and IL-12 promoters as well as modulation of IL-12 synthesis by NAP2 in macrophages were observed by NF-kappaB and IL-12 luciferase reporter assay and intracellular IL-12 staining.

RESULTS

NAP2 could activate NF-kappaB and IL-12 promoter. But IkappaBalphaDN could inhibit their activation. In addition, NAP2 could induce IL-12 expression in macrophage cell line J774.

CONCLUSIONS

NAP2 as a newly cloned NF-kappaB activating gene can activate IL-12 promoter and induce IL-12 expression in macrophages. The data suggest that NAP2 regulates the expression of IL-12 most likely through its modulation of NF-kappaB transcription factor.

Pubmed
Journal: Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi
April/22/2016
Abstract

OBJECTIVE

To investigate the expression of mDia1 (mammalian diaphanous 1)in platelet and the role of mDia1 or phosphatidylinositol 3-kinase (PI3K) in the process of thrombin-induced platelet aggregation.

METHODS

The extent of platelet aggregation was measured by a platelet aggregation system and the expression of mDia1 and its relation with F-actin in quiescent, spreading or aggregated platelets by Western blot.

RESULTS

There was no significant difference in mDia1 expression level between quiescent and activated platelets. mDia1 moved from a Triton-X100-soluble cytosolic fraction to insoluble cytoskeleton fraction after thrombin induced platelets aggregation. Anti-mDia1 antibody could inhibit this aggregation. PI3K inhibitor Wortmannin or Ly294002 inhibited the thrombin induced platelet aggregation and the above mentioned mDia1 translocation.

CONCLUSIONS

PI3-kinase mediates the thrombin-induced platelet aggregation through mDia1 pathway.

Pubmed
Journal: Studies in health technology and informatics
April/22/2016
Abstract

Recent approaches to the study of identity in online contexts underline how people on the Internet have multiple identities and are at risk of identity fragmentation. Subjectivities are context-specific, negotiated with other people and actualized in Self Presentations. The aim of this study is to investigate how social media users deal with choices regarding their Self Presentation and how different profiles of the same person relate to one other. Thirty-six users with accounts on two blog-hosting services and one social network website answered an online structured interview and elaborated on the different choices of Self Presentation for each service. Content Results show users accurately and consciously choose the way they present their Self according to their aims, actual and potential readership, and the technical possibilities of the media. Answers also show that people online are conscious of the multiple presentations they enact, and they feel an underlining sense of unity and coherence, which may be traced back to the concept of Self.

Pubmed
Journal: Progress in molecular and subcellular biology
April/22/2016
Abstract

Crustaceans have hard cuticle with layered structure, which is composed mainly of chitin, proteins, and calcium carbonate. Crustaceans grow by shedding the old cuticle and replacing it with a new one. Decalcification in the cuticle during the pre-molt stage and concomitant calcification in the stomach to form gastroliths observed in some crustacean species are triggered by the molting hormone. Various proteins and peptides have been identified from calcified cuticle and gastroliths, and their functions have been examined in terms of calcification and interaction with chitin. Acidic nature of matrix proteins is important for recruitment of calcium ions and interaction with calcium carbonate. Examination of the relationship between amino acid sequence containing acidic amino acid residues and calcification inhibitory activity revealed that the potency did not depend on the sequence but on the number of acidic amino acid residues. Calcium carbonate in the calcified tissues of crustaceans is amorphous in many cases. Crustaceans take a strategy to induce and maintain amorphous calcium carbonate by using low-molecular-weight phosphorus compounds.

Pubmed
Journal: L' Orthodontie francaise
April/22/2016
Abstract

BACKGROUND

The term "primary failure of eruption" (PFE) refers to the complete or partial failure of a primary non-ankylosed tooth to erupt due to a disturbance of the eruption mechanism. Up to now, the molecular basis for this failure was unknown.

METHODS

Four families were studied in whom at least two members were affected by non-syndromic PFE as part of a clinical and molecular genetics study. Radiological diagnostics (OPTs) were carried out in all patients and their unaffected relatives (control group). The genetic analysis included a genomewide linkage analysis followed by direct DNA sequencing of positional candidate genes.

RESULTS

Starting from the index patients, we were able to reconstruct pedigrees over two and/or three generations in the families that indicated an autosomal-dominant mode of inheritance of non-syndromic PFE. Fifteen patients were diagnosed with PFE. Gender distribution was nearly equal (7 female, 8 male). Molecular genetic analysis of the PTHR1 gene revealed three distinct heterozygous mutations (c.1050-3C>G; c.543 + 1G>A; c.463G>T). Unaffected persons exhibited no mutations.

CONCLUSIONS

Knowledge of the genetic causes of non-syndromic PFE can now be used for the differential diagnosis of eruption failure. It permits affected family members to be identified early and may lead to new treatment possibilities in the long term. The genetically-verified diagnosis of "primary failure of eruption" can protect patients and orthodontists from years of futile treatment, because orthodontic treatment alone does not lead to success. Moreover, it has a negative influence on unaffected teeth and areas of the jaw.

Pubmed
Journal: Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation
April/22/2016
Abstract

The diagnostic of protein-energy wasting should be done using a tool that can predict clinically important outcomes, besides identifying malnutrition. This study investigated which nutritional composed scoring systems best predicts all-cause mortality in maintenance hemodialysis patients.

Cohort study that included prevalent patients undergoing hemodialysis for at least 1 month. To assess nutritional status, Subjective Global Assessment (SGA), Malnutrition-Inflammation Score (MIS), and diagnostic criteria for protein-energy wasting proposed by the International Society of Renal Nutrition and Metabolism (ISRNM) were used. Patients were assessed in the moment of inclusion in the study (between July 2012 and December 2012) and followed prospectively to verify the occurrence of deaths.

A total of 163 patients were included, 54.6% were male, and mean age was 58.4 ± 15.5 years. During the follow-up period (15.5 ± 5.4 months), 29 patients died and 16 underwent kidney transplant. Kaplan-Meier survival curves and Cox proportional hazard analysis adjusted for age, gender, dialysis vintage, diabetes, and serum urea showed that SGA and MIS were predictors of all-cause mortality.

Of the 3 investigated scoring systems, SGA and MIS predict mortality in a period of 15.5 ± 5.4 months of follow-up.

Pubmed
Journal: The European respiratory journal
May/18/2016
Abstract

Cystic fibrosis airways are frequently colonised with fungi. However, the interaction of these fungi with immune cells and the clinical relevance in cystic fibrosis lung disease are incompletely understood.We characterised granulocytes in airway fluids and peripheral blood from cystic fibrosis patients with and without fungal colonisation, non-cystic fibrosis disease controls and healthy control subjects cross-sectionally and longitudinally and correlated these findings with lung function parameters.Cystic fibrosis patients with chronic fungal colonisation by Aspergillus fumigatus were characterised by an accumulation of a distinct granulocyte subset, expressing the HIV coreceptor CXCR4. Percentages of airway CXCR4(+) granulocytes correlated with lung disease severity in patients with cystic fibrosis.These studies demonstrate that chronic fungal colonisation with A. fumigatus in cystic fibrosis patients is associated with CXCR4(+) airway granulocytes, which may serve as a potential biomarker and therapeutic target in fungal cystic fibrosis lung disease.

Pubmed
Journal: The European respiratory journal
May/18/2016
Pubmed
Journal: International journal of mycobacteriology
May/18/2016
Abstract

BACKGROUND

Health care workers (HCW) in low and middle income countries are at high risk of nosocomial tuberculosis infection. Periodic screening of health workers for both TB disease and infection can play a critical role in TB infection control. Occupational health programs that implement serial tuberculin skin testing (TST) are advised to use a two-step baseline TST. This helps to ensure that boosting of waned immune response is not mistaken as new TB infection (i.e. conversion). However, there are no data on safety of the two-step TST in the Indian context where HCWs are repeatedly exposed.

METHODS

Nursing students were recruited from 2007 to 2009 at the Christian Medical College and Hospital, Vellore, India. Consenting nursing students were screened with a baseline two-step TST at the time of recruitment. From 2007 to 2008 adverse events were recorded when reported during the TST reading (Cohort A). Nurses recruited in the final study year (2009) answered an investigator administered questionnaire assessing all likely side-effects Cohort B). This information was extracted from the case report forms and analysed.

RESULTS

Between 2007 and 09, 800 trainees consented to participate in the annual TB screening study and 779 did not have a past history of TB or recall a positive TST and were selected to administer TST. Of these, 755 returned for reading the result and had complete data and were included for the final analysis - 623 subjects in (cohort A) and 132 in (cohort B). These were included for the final analysis. In cohort A only 1.3% reported adverse events. In cohort B, as per the investigator administered questionnaire; 25% reported minor side effects. Itching and local pain were the most common side effects encountered. There were no major adverse events reported. In particular, the adverse events were similar in the second step of the test and not more severe.

CONCLUSIONS

Screening of HCWs with two-step TST for LTBI is simple and safe, and hence suitable for wide scale implementation in high-burden settings such as India.

Pubmed
Journal: Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)
May/18/2016
Abstract

OBJECTIVE

To describe the onset pattern, frequency, and severity of the signs and symptoms of the prodrome of the first hypomanic/manic episode and first depressive episode of bipolar disorder (BD) and to investigate the influence of a history of childhood maltreatment on the expression of prodromal symptoms.

METHODS

Using a semi-structured interview, the Bipolar Prodrome Symptom Scale-Retrospective (BPSS-R), information regarding prodromal symptoms was assessed from patients with a DSM-IV diagnosis of BD. History of childhood maltreatment was evaluated using the Childhood Trauma Questionnaire (CTQ).

RESULTS

Forty-three individuals with stable BD were included. On average, the prodrome of mania lasted 35.8 ± 68.7 months and was predominantly subacute or insidious, with rare acute presentations. The prodrome of depression lasted 16.6 ± 23.3 months and was also predominantly subacute or insidious, with few acute presentations. The prodromal symptoms most frequently reported prior to the first hypomanic or manic episode were mood lability, depressive mood, and impatience. A history of childhood abuse and neglect was reported by 81.4% of participants. Presence of childhood maltreatment was positively associated with prodromal symptoms, including social withdrawal, decreased functioning, and anhedonia.

CONCLUSIONS

This study provides evidence of a long-lasting, symptomatic prodrome prior to first hypomanic/manic and depressive episode in BD and suggests that a history of childhood maltreatment influences the manifestations of this prodrome.

Pubmed
Journal: Journal of theoretical biology
May/18/2016
Abstract

Individual migration plays a crucial role in evolutionary dynamics of population on networks. In this paper, we generalize the networked ultimatum game by diluting population structures as well as endowing individuals with migration ability, and investigate evolutionary dynamics of fairness on graphs with migration in the ultimatum game. We first revisit the impact of node degree on the evolution of fairness. Interestingly, numerical simulations reveal that there exists an optimal value of node degree resulting in the maximal offer level of populations. Then we explore the effects of dilution and migration on the evolution of fairness, and find that both the dilution of population structures and the endowment of migration ability to individuals would lead to the drop of offer level, while the rise of acceptance level of populations. Notably, natural selection even favors the evolution of self-incompatible strategies, when either vacancy rate or migration rate exceeds a critical threshold. To confirm our simulation results, we also propose an analytical method to study the evolutionary dynamics of fairness on graphs with migration. This method can be applied to explore any games governed by pairwise interactions in finite populations.

Pubmed
Journal: Research on aging
May/18/2016
Abstract

So far, limited research has been carried out to better understand the interplay between the emotions, the use of emotion regulation strategies, and the well-being of professional caregivers of People with Dementia (PwD). This pilot study (N = 43 professional caregivers) aimed to (1) describe the type and frequency of emotions experienced at work; (2) analyze the associations between experienced emotions, emotion regulation strategies, and well-being; and (3) test whether the use of specific emotion regulation strategies moderates the relationship between experienced emotions and emotional exhaustion. In the challenging context of professionally caring for PwD, results suggest that (1) caregivers experience positive emotions more frequently than negative emotions; (2) caregivers using relatively inappropriate regulation strategies are more likely to experience negative emotions, less likely to experience positive emotions, and have poorer physical and mental health; and (3) expressive suppression significantly moderates the relationship between positive experienced emotions and emotional exhaustion.

Pubmed
Journal: Clinical oral investigations
May/18/2016
Abstract

OBJECTIVE

This study seeks to assess and compare immunohistochemical characteristics of regenerated and pristine bone areas following surgical therapy of advanced peri-implantitis.

METHODS

At ligature-induced peri-implantitis defects, the intrabony component was filled with a natural bone mineral (NBM), and the supracrestal component was treated by either an equine bone block (EB) or implantoplasty. NBM and EB were soak-loaded with rhBMP-2 or sterile saline. Membrane (i.e., native collagen) protected sites were submerged for 12 weeks. Osteocalcin (OC) and transglutaminase 2 (TG2; angiogenesis) antigen reactivity was assessed within the augmented-(AA) and pristine bone (PB) areas at non-exposed sites (n = 39 defects).

RESULTS

In all groups investigated, mean OC (AA, 0.5 ± 0.4 to 1.9 ± 2.9 %/PB, 1.7 ± 2.6 to 3.5 ± 6.5 %) and TG2 (AA, 0.6 ± 0.5 to 1.3 ± 1.5 %/PB, 0.5 ± 0.5 to 1.6 ± 1.9 %) values within AA did not significantly differ from those values assessed within PB (P > 0.05, respectively).

CONCLUSIONS

AA formed in different treatment groups may not be considered as qualitatively (i.e., OC and TG2) compromised bone.

Pubmed
Journal: The Journal of hand surgery
May/18/2016
Abstract

OBJECTIVE

To investigate the length changes in proper collateral ligament (PCL) and accessory collateral ligament (ACL) during flexion of the proximal interphalangeal (PIP) joint in vivo and how portions of the PCL and ACL stabilize the PIP joint.

METHODS

We obtained computed tomography scans of the index, middle, and ring fingers of one hand from 6 volunteers at 0°, 30°, 60°, 90°, and full flexion of the PIP joint. Radial and ulnar PCL and ACL were measured and analyzed with computer modeling.

RESULTS

The data showed that during flexion the average length of the dorsal portion of the radial and ulnar PCL increased significantly and reached a maximum at 90°. The volar portion of the radial and ulnar PCL and the distal portion of the radial and ulnar ACL shortened continuously from extension to full flexion.

CONCLUSIONS

The proximal and middle portions of each ACL are nearly isometric, the dorsal portion of each PCL becomes taut only in flexion, and the volar portion of PCL and the distal portion of ACL become taut only in extension. The current findings indicate that the dorsal portion of PCL is the most stabilizing structure during flexion of the PIP joint, and that the volar portion of PCL and the distal portion of ACL provide the crucial lateral stability to the joint at extension.

CONCLUSIONS

The results may provide information relevant to the ligaments of PIP joint reconstruction and rehabilitation.

Pubmed
Journal: Seminars in cardiothoracic and vascular anesthesia
May/18/2016
Abstract

The significant decline in mortality among children and adolescents with congenital heart disease (CHD) is associated with an increasing prevalence of CHD in adults, particularly those with moderate to severe defects. As a significant percentage of adolescents and young adults are lost to follow-up in the transition from pediatric to adult care, they may present for elective procedures with substantial CHD-associated morbidity. In addition to the specific cardiac defect, the procedures performed, and the current pathophysiological status, several factors should be considered when managing the adult with CHD. These include the type of setting (adult vs pediatric institution); surgeon (pediatric vs adult cardiac surgeon); coexisting diseases associated with CHD, such as coronary artery disease, hepatic dysfunction, renal dysfunction, cerebrovascular accidents, myopathy, and coagulation disorders; acquired diseases of aging; pregnancy; and psychosocial functioning. The current status of the management of common and important congenital cardiac defects is also described.

Pubmed
Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
May/18/2016
Abstract

OBJECTIVE

The aim of this study was to evaluate the impact of mean platelet volume (MPV) on the intracoronary thrombus burden and short-term mortality in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).

BACKGROUND

Platelets play a crucial role in the pathophysiology of coronary artery disease. MPV has been reported to be an indicator of platelet reactivity.

METHODS

A total of 649 consecutive STEMI patients who underwent primary PCI between January 2008 and December 2013 were enrolled and divided into two groups based on the thrombus burden: the large thrombus burden (LTB) group and the small thrombus burden (STB) group. The primary endpoint was all-cause mortality at 30 days.

RESULTS

The LTB group had significantly higher admission MPV compared with the STB group (10.77 ± 1.22 vs. 9.95 ± 1.03, P < 0.001). The cumulative 30-day all-cause mortality rate was significantly higher in the groups with high MPV and LTB (9.8% vs. 2.5%, P < 0.001, 8.6% vs. 4.1%, P = 0.036, respectively). In a receiver operating characteristics analysis, MPV ≥ 10.2 predicted LTB with 73.5% sensitivity and 68.9% specificity. Multivariate logistic regression analysis demonstrated MPV was an independent predictor of large intracoronary thrombus burden (OR 1.794, 95% CI 1.533 to 2.100, P < 0.001) and 30-day all-cause mortality (HR 1.408, 95% CI 1.040 to 1.906, P = 0.027).

CONCLUSIONS

Increased MPV at admission is an independent predictor of large intracoronary thrombus burden and short-term mortality. It may be a useful biomarker for risk stratification in patients with STEMI undergoing primary PCI. © 2015 Wiley Periodicals, Inc.

Pubmed
Journal: Angewandte Chemie (International ed. in English)
May/18/2016
Abstract

The electric conductivity-dependence of the number of electrons transferred during the oxygen reduction reaction is presented. Intensive properties, such as the number of electrons transferred, are difficult to be considered conductivity-dependent. Four different perovskite oxide catalysts of different conductivities were investigated with varying carbon contents. More conductive environments surrounding active sites, achieved by more conductive catalysts (providing internal electric pathways) or higher carbon content (providing external electric pathways), resulted in higher number of electrons transferred toward more complete 4e reduction of oxygen, and also changed the rate-determining steps from two-step 2e process to a single-step 1e process. Experimental evidence of the conductivity dependency was described by a microscopic ohmic polarization model based on effective potential localized nearby the active sites.

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