An enhanced recovery after surgery pathway: LOS reduction, rapid discharge and minimal complications after anterior cervical spine surgery

xlomafota.13 shared this article with you from Inoreader An enhanced recovery after surgery pathway: LOS reduction, rapid discharge and minimal complications after anterior cervical spine surgery Via Latest Results for BMC Musculoskeletal Disorders Abstract Background Enhance recovery after surgery (ERAS) is a new and promising paradigm for spine surgery. The purpose of this study is to investigate the effectiveness and safety of a multimodal and evidence-based ERAS pathway to the patients undergoing anterior cervical discectomy and fusion (ACDF). Methods The patients treated with the ACDF-ERAS pathway were compared with a historical cohort of patients who underwent ACDF before ERAS pathway implementation. Primary outcome was length of stay (LOS). Secondary outcomes included cost, MacNab grading, complication rates and 90-day readmission and reoperation. And perioperative factors and postoperative complications were reviewed. Results The ERAS protocol was composed of 21 components. More patients undergoing multi-level surgery (n ≥ 3) were included in the ERAS group. The ERAS group showed a shorter LOS and a lower cost than the conventional group. The postoperative satisfaction of patients in ERAS group was better than that in conventional group. In addition, the rate of overall complications was significantly higher in the conventional group than that in the ERAS group. There were no significant differences in operative time, postoperative drainage, or 90-day readmission and reoperation. Conclusions The ACDF-tailored ERAS pathway can reduce LOS, cost and postoperative complications, and improve patient satisfaction without increasing 90-day readmission and reoperation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

ECG Signal Quality Assessments of a Small Bipolar Single-Lead Wearable Patch Sensor

xlomafota.13 shared this article with you from Inoreader ECG Signal Quality Assessments of a Small Bipolar Single-Lead Wearable Patch Sensor Via Latest Results for Cardiovascular Engineering and Technology Abstract Purpose There is an increasing clinical interest in the adoption of small single-lead wearable ECG sensors for continuous cardiac monitoring. The purpose of this work is to assess ECG signal quality of such devices compared to gold standard 12-lead ECG. Methods The ECG signal from a 1-lead patch was systematically compared to the 12-lead ECG device in thirty subjects to establish its diagnostic accuracy in terms of clinically relevant signal morphology, wave representation, fiducial markers and interval and wave duration. One minute ECG segments with good signal quality was selected for analysis and the features of ECG were manually annotated for comparative assessment. Results The patch showed closest similarity based on correlation and normalized root-mean-square error to the standard ECG leads I, II, \({\text {V}_3}\) and \({\text {V}_4}\) . P-wave and QRS complexes in the patch showed sensitivity (Se) and positive predictive value (PPV) of at least 99.8% compared to lead II. T-wave representation showed Se and PPV of at least 99.9% compared to lead \({\text {V}_3}\) and \({\text {V}_4}\) . Mean errors for onset and offset of the ECG waves, wave durations, and ECG intervals were within 2 samples based on 125Hz patch ECG sampling frequency. Conclusion This study demonstrates the diagnostic capability with similar morphological representation and reasonable timing accuracy of ECG signal from a patch sensor compared to 12-lead ECG. The advantages and limitations of small bipolar single-lead wearable patch sensor compared to 12-lead ECG are discussed in the context of relevant differences in ECG signal for clinical applications. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Actively targeted delivery of SN38 by ultrafine iron oxide nanoparticle for treating pancreatic cancer

xlomafota.13 shared this article with you from Inoreader Actively targeted delivery of SN38 by ultrafine iron oxide nanoparticle for treating pancreatic cancer Via Latest Results for Investigational New Drugs Abstract Pancreatic cancer remains one of the most lethal cancers largely due to the inefficient delivery of therapeutics. Nanomaterials have been extensively investigated as drug delivery platforms, showing improved drug pharmacodynamics and pharmacokinetics. However, their applications in pancreatic cancer have not yet been successful due to limited tumor delivery caused by dense tumor stroma and distorted tumor vasculatures. Meanwhile, smaller-sized nanomaterials have shown improved tumor delivery and retention in various tumors, including pancreatic tumors, suggesting their potential in enhancing drug delivery. An ultrafine iron oxide nanoparticle (uIONP) was used to encapsulate 7-ethyl-10-hydroxyl camptothecin (SN38), the water-insoluble active metabolite of pancreatic cancer chemotherapy drug irinotecan. Insulin-like growth factor 1 (IGF-1) was conjugated to uIONP as a ligand for targeting pancreatic cancer cells overexpressing IGF-1 receptor (IGF1R). The SN38 loadi ng and release profile were characterized. The pancreatic cancer cell targeting using IGF1-uIONP/SN38 and subsequently induced cell apoptosis were also investigated. IGF1-uIONP/SN38 demonstrated a stable drug loading in physiological pH with the loading efficiency of 68.2 ± 3.5% (SN38/Fe, wt%) and < 7% release for 24 h. In tumor-interstitial- and lysosomal-mimicking pH (6.5 and 5.5), 52.2 and 91.3% of encapsulated SN38 were released over 24 h. The IGF1-uIONP/SN38 exhibited specific receptor-mediated cell targeting and cytotoxicity Ato MiaPaCa-2 and Panc02 pancreatic cancer cells with IC50 of 11.8 ± 2.3 and 20.8 ± 3.5 nM, respectively, but not to HEK293 human embryonic kidney cells. IGF1-uIONP significantly improved the targeted SN38 delivery to pancreatic cancer cells, holding the potential for in vivo theranostic applications. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Synthetic fused sRNA for the simultaneous repression of multiple genes

xlomafota.13 shared this article with you from Inoreader Synthetic fused sRNA for the simultaneous repression of multiple genes Via Latest Results for Applied Microbiology and Biotechnology Abstract Efficient control over multiple gene expression still presents a major challenge. Synthetic sRNA enables targeted gene expression control in trans without directly modifying the chromosome, but its use to simultaneously target multiple genes can often cause cell growth defects because of the need for additional energy for transcription and lowering of their repression efficiency by limiting the amount of Hfq protein. To address these limitations, we present fusion sRNA (fsRNA) that simultaneously regulates the translation of multiple genes efficiently. It is constructed by linking the mRNA-binding modules for multiple targeted genes in one sRNA scaffold via one-pot generation using overlap extension PCR. The repression capacity of fsRNA was demonstrated by the construction of sRNAs to target four endogenous genes: caiF, hybG, ytfR and minD in Escherichia coli. Their cross-reactivity and the effect on cell growth were a lso investigated. As practical applications, we applied fsRNA to violacein- and protocatechuic acid–producing strains, resulting in increases of 13% violacein and 81% protocatechuic acid, respectively. The developed fsRNA-mediated multiple gene expression regulation system thus enables rapid and efficient development of optimised cell factories for valuable chemicals without cell growth defects and limiting cellular resources. Key points • Synthetic fusion sRNA (fsRNA)–based system was constructed for the repression of multiple target genes. • fsRNA repressed multiple genes by only expressing a single sRNA while minimising the cellular burden. • The application of fsRNA showed the increased production titers of violacein (13%) and protocatechuic acid (81%). View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Protective effects of interleukin-22 on oxalate-induced crystalline renal injury via alleviating mitochondrial damage and inflammatory response

xlomafota.13 shared this article with you from Inoreader Protective effects of interleukin-22 on oxalate-induced crystalline renal injury via alleviating mitochondrial damage and inflammatory response Via Latest Results for Applied Microbiology and Biotechnology Abstract Oxalate-induced crystalline kidney injury is one of the most common types of crystalline nephropathy. Unfortunately, there is no effective treatment to reduce the deposition of calcium oxalate crystals and alleviate kidney damage. Thus, proactive therapeutic is urgently needed to alleviate the suffering it causes to patient. Here, we investigated whether IL-22 exerted nephroprotective effects to sodium oxalate-mediated kidney damage and its potential mechanism. Crystalline kidney injury models were developed in vitro and in vivo that was often observed in clinic. We provided evidence that IL-22 could effectively decrease the accumulation of ROS and mitochondrial damage in cell and animal models and reduce the death of TECs. Moreover, IL-22 decreased the expression of the NLRP3 inflammasome and mature IL-1β in renal tissue induced by sodium oxalate. Further studies confirmed that IL-22 could play an anti-inflammatory role by reducing the levels of cytokines suc h as IL-1β, IL-18, and TNF-α in serum. In conclusion, our study confirmed that IL-22 has protective effects on sodium oxalate-induced crystalline kidney injury by reducing the production of ROS, protecting mitochondrial membrane potential, and inhibiting the inflammatory response. Therefore, IL-22 may play a potential preventive role in sodium oxalate-induced acute renal injury. Key points • IL-22 could reduce sodium oxalate-mediated cytotoxicity and ameliorate renal injury. • IL-22 could alleviate oxidative stress and mitochondrial dysfunction induced by sodium oxalate. • IL-22 could inhibit inflammatory response of renal injury caused by sodium oxalate. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Increased migratory activity and cartilage regeneration by superficial-zone chondrocytes in enzymatically treated cartilage explants

xlomafota.13 shared this article with you from Inoreader Increased migratory activity and cartilage regeneration by superficial-zone chondrocytes in enzymatically treated cartilage explants Via Latest Results for BMC Musculoskeletal Disorders Abstract Background Limited chondrocyte migration and impaired cartilage-to-cartilage healing is a barrier in cartilage regenerative therapy. Collagenase treatment and delivery of a chemotactic agent may play a positive role in chondrocyte repopulation at the site of cartilage damage. This study evaluated chondrocyte migratory activity after enzymatic treatment in cultured cartilage explant. Differential effects of platelet-derived growth factor (PDGF) dimeric isoforms on the migratory activity were investigated to define major chemotactic factors for cartilage. Methods Full-thickness cartilage (4-mm3 blocks) were harvested from porcine femoral condyles and subjected to explant culture. After 15 min or 60 min of actinase and collagenase treatments, chondrocyte migration and infiltration into a 0.5-mm cartilage gap was investigated. Cell morphology and lubricin, keratan sulfate, and chondroitin 4 sulfate expression in superficial- and deep-zone chondrocytes were assessed. The chemotactic activities of PDGF-AA, −AB, and -BB were measured in each zone of chondrocytes, using a modified Boyden chamber assay. The protein and mRNA expression and histological localization of PDGF-β were analyzed by western blot analysis, real-time reverse transcription polymerase chain reaction (RT-PCR), and immunohistochemistry, and results in each cartilage zone were compared. Results Superficial-zone chondrocytes had higher migratory activity than deep-zone chondrocytes and actively bridged the cartilage gap, while metachromatic staining by toluidine blue and immunoreactivities of keratan sulfate and chondroitin 4 sulfate were detected around the cells migrating from the superficial zone. These superficial-zone cells with weak immunoreactivity for lubricin tended to enter the cartilage gap and possessed higher migratory activity, while the deep-zone chondrocytes remained in the lacuna and exhibited less migratory activity. Among PDGF isoforms, PDGF-AB maximized the degree of chemotactic activity of superficial zone chondrocytes. Increased expression of PDGF receptor-β was associated with higher migratory activity of the superficial-zone chondrocytes. Conclusions In enzymatically treated cartilage explant culture, chondrocyte migration and infiltration into the cartilage gap was higher in the superficial zone than in the deep zone. Preferential expression of PDGF receptor-β combined with the PDGF-AB dimeric isoform may explain the increased migratory activity of the superficial-zone chondrocytes. Cells migrating from superficial zone may contribute to cartilage regeneration. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients

xlomafota.13 shared this article with you from Inoreader The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients Via Latest Results for BMC Musculoskeletal Disorders Abstract Background Several interventions are established for treating patellofemoral instability in adults. Fewer exist for pediatric patients without damaging the epiphysis. The Ali Krogius (AK) method is currently still being used. Most studies are not current and report varying results in small patient population. The aim of this study is to determine the long-term results of the AK method. Methods In this monocentric, retrospective study design, 33 knees in 33 patients who received the AK procedure for recurrent patellar dislocation were assessed. The average age was 20.8 years (range 6–40). The following functional scores were assessed: Kujala Score, Lysholm Score and Tegner Score. Subgroup analysis was done for patients ≤16 years of age. Available preoperative imaging was assessed for known risk factors. Results After an average follow-up of 7.8 years (Range 59–145 months), a total of 8 (24%) knees suffered a redislocation postoperatively. Seven of the eight dislocations occurred in patients ≤ 16 years of age. One knee (3%) was revised due to persistent pain. The median score was 86 points for the Kujala score and 90 for the Lysholm score. The median in the Tegner score was level 6. Clinically, the patellar glide was lateralized in 7 knees (21%) and an apprehension sign was triggered in 8 knees (24%). Conclusions Including the present study, the existing literature indicates a redislocation rate between 24 and 41% following AK. It should thus be regarded as obsolete even though it protects the epiphysis. Surgical interventions such as medial patellofemoral ligament reconstruction with femoral drilling distal to the epiphysis should be preferred. Trial registration Retrospectively registered: S-302/2016. Level of evidence III View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The time course of different neuromuscular adaptations to short-term downhill running training and their specific relationships with strength gains

xlomafota.13 shared this article with you from Inoreader The time course of different neuromuscular adaptations to short-term downhill running training and their specific relationships with strength gains Via Latest Results for European Journal of Applied Physiology Abstract Purpose Due to its eccentric nature, downhill running (DR) training has been suggested to promote strength gains through neuromuscular adaptations. However, it is unknown whether short-term chronic DR can elicit such adaptations. Methods Twelve untrained, young, healthy adults (5 women, 7 men) took part in 4 weeks' DR, comprising 10 sessions, with running speed equivalent to 60–65% maximal oxygen uptake ( \(\dot{V}\) O2max, assessed at weeks 0 and 4). Isometric and isokinetic knee-extensor maximal voluntary torque (MVT), vastus lateralis (VL) muscle morphology/architecture (anatomical cross-sectional area, ACSA; physiological CSA, PCSA; volume; fascicle length, Lf; pennation angle, PA) and neuromuscular activation (VL EMG) were assessed at weeks 0, 2 and 4. Results MVT increased by 9.7–15.2% after 4 weeks (p < 0.01). VL EMG during isometric MVT increased by 35.6 ± 46.1% after 4 weeks (p < 0.05) and correlated with changes in isometric MVT after 2 weeks (r = 0.86, p = 0.001). VL ACSA (+2.9 ± 2.7% and +7.1 ± 3.5%) and volume (+2.5 ± 2.5% and +6.6 ± 3.2%) increased after 2 and 4 weeks, respectively (p < 0.05). PCSA (+3.8 ± 3.3%), PA (+5.8 ± 3.8%) and Lf (+2.7 ± 2.2%) increased after 4 weeks (p < 0.01). Changes in VL volume (r = 0.67, p = 0.03) and PCSA (r = 0.71, p = 0.01) correlated with changes in concentric MVT from 2 to 4 weeks. \(\dot{V}\) O2max (49.4 ± 6.2 vs. 49.7 ± 6.3 mL·kg−1·min−1) did not change after 4 weeks (p = 0.73). Conclusion Just 4 weeks' moderate-intensity DR promoted neuromuscular adaptations in young, healthy adults, typically observed after high-intensity eccentric resistance training. Neural adaptations appeared to contribute to most of the strength gains at 2 and 4 weeks, while muscle hypertrophy seemed to contribute to MVT changes from 2 to 4 weeks only. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Enhancement of radiation response of breast cancer cells through the incorporation of Bi2S3 nanorods

xlomafota.13 shared this article with you from Inoreader Enhancement of radiation response of breast cancer cells through the incorporation of Bi2S3 nanorods Via Latest Results for Journal of Nanoparticle Research Abstract The aim of this work was to develop nanomaterials that can be used as sensitizers in radiotherapy treatment. The synthesis of bismuth sulfide (Bi2S3) particles with nanometer size by the hot injection method was studied as well as their behavior when coated with a biocompatible agent. The hot injection method allowed us to synthesize Bi2S3 nanorods measuring in average 4.2 ± 1.4 nm in width and 27.5 ± 16.3 nm in length. Moreover, to improve their biocompatibility, these nanorods were coated with polyvinylpyrrolidone with the purpose of studying the behavior of nanorods in the bloodstream. The results indicated that the suspensions were more stable when the media had protein components which may facilitate the blood circulation of the particles. The toxicity of the nanorods and their radiosensitization potential were evaluated and determined in breast cancer cells (MCF7). These results show that the synthesized nanorods did not evidence cytotoxicity up to a concentration of 2500 μg/mL, over 72 h of incubation. On the other hand, the sensitivity of MCF7 cells with and without nanorods in the culture medium, afterward irradiating them with a dose of 2 Gy 60Co gamma radiation source, showed a 38% increase in cell death when compared to cells that were only irradiated. Our results show that Bi2S3 nanorods are very promising as anticancer agents improving the efficiency of radiotherapy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gastric duplication cyst: a challenging EUS differential diagnosis between subepithelial gastric lesion and exophytic pancreatic cystic neoplasm—a case report and a literature review

xlomafota.13 shared this article with you from Inoreader Gastric duplication cyst: a challenging EUS differential diagnosis between subepithelial gastric lesion and exophytic pancreatic cystic neoplasm—a case report and a literature review Via Latest Results for Clinical Journal of Gastroenterology Abstract Gastric duplication cysts are rare congenital malformation with a potential neoplastic progression and they may represent a challenge in differential diagnosis with exophytic pancreatic cyst neoplasm. We describe a case of a 38-year old man, complaining of recurrent epigastric pain due to a large abdominal mass, referred to our Hospital for EUS evaluation. Differential diagnosis was between gastric duplication cyst and exophytic pancreatic cyst because of FNA pointed out amylase 1280 UI/L and CEA 593.33 ng/mL. Despite antibiotic prophylaxis, an overinfection of the lesion occurred after the FNA, likely due to the technical failure to drain the cyst completely. Afterwards, the patient was referred to surgery and the pathologist confirmed the diagnosis of gastric duplication cyst. In this setting, EUS procedure has gained a leading play, complementary to traditional imaging tests, although its role has been not yet standardized in the reported literature. Here , we describe and discuss our demanding case, and we propose an algorithm to simplify and standardize the diagnostic workup. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Protective Performance of Helmets and Goggles in Mitigating Brain Biomechanical Response to Primary Blast Exposure

xlomafota.13 shared this article with you from Inoreader Protective Performance of Helmets and Goggles in Mitigating Brain Biomechanical Response to Primary Blast Exposure Via Latest Results for Annals of Biomedical Engineering Abstract The current combat helmets are primarily designed to mitigate blunt impacts and ballistic loadings. Their protection against primary blast wave is not well studied. In this paper, we comprehensively assessed the protective capabilities of the advanced combat helmet and goggles against blast waves with different intensity and directions. Using a high-fidelity human head model, we compared the intracranial pressure (ICP), cerebrospinal fluid (CSF) cavitation, and brain strain and strain rate predicted from bare head, helmet-head and helmet-goggles-head simulations. The helmet was found to be effective in mitigating the positive ICP (24–57%) and strain rate (5–34%) in all blast scenarios. Goggles were found to be effective in mitigating the positive ICP in frontal (6–16%) and lateral (5–7%) blast exposures. However, the helmet and goggles had minimal effects on mitigating CSF cavitation and even increased brain strain. Further investigation showed that weari ng a helmet leads to higher risk of cavitation. In addition, their presence increased the head kinetic energy, leading to larger strains in the brain. Our findings can improve our understanding of the protective effects of helmets and goggles and guide the design of helmet pads to mitigate brain responses to blast. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.