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Gower EW, West SK, Harding JC, Cassard SD, Munoz BE, Othman MS, Kello AB, Merbs SL.
JAMA Ophthalmol. 2013 Mar ;131(3):294-301.
PMID: 23494035
To determine whether a new surgical clamp reduces unfavorable postoperative outcomes.
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Clarkson TB, Meléndez GC, Appt SE.
Menopause. 2013 Mar ;20(3):342-53.
PMID: 23435033
This work aims to review preclinical/clinical cardiovascular studies that led to randomized trials of the risks and benefits of postmenopausal hormone therapy (HT), the pathobiological basis for the timing hypothesis, and subset analyses of randomized trials that tend to support the timing hypothesis; to elaborate experimental data that might inform the results of recent trials; and to summarize evidence regarding how early is early enough for the initiation of HT.
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Clarkson TB, Ethun KF, Chen H, Golden D, Floyd E, Appt SE.
Menopause. 2013 Mar ;20(3):274-81.
PMID: 23435024
The objectives of this study were to evaluate the effects of bazedoxifene acetate (BZA), a new selective estrogen receptor modulator, on coronary and peripheral artery atheroscleroses and to determine if it would antagonize the atheroprotective effects of conjugated equine estrogens (CEE) on a monkey model.
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Pirkle JL, Freedman BI.
Minerva Urol Nefrol. 2013 Mar ;65(1):37-50.
PMID: 23538309
The relationship between hypertension and chronic kidney disease (CKD) has long been the subject of controversy. The pathogenetic mechanisms of nephropathy in non-diabetic individuals with hypertension, as well as optimal hypertension treatment targets in populations with nephropathy remain important clinical concerns. This manuscript reviews breakthroughs in molecular genetics that have clarified the complex relationship between hypertension and kidney disease, answering the question of which factor comes first. An overview of the potential roles that hyperuricemia plays in the pathogenesis of hypertension and CKD and current blood pressure treatment guidelines in populations with CKD are discussed. The ongoing National Institutes of Health-sponsored Systolic Blood Pressure Intervention Trial (SPRINT) is underway to help answer these important questions. Enrollment of 9250 hypertensive SPRINT participants will be completed in 2013; important results on ideal blood pressure control targets for reducing nephropathy progression, cardiovascular disease end-points, and preserving cognitive function are expected. As such, many of the controversial aspects of hypertension management will likely be clarified in the near future.
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Sarwal A, Walker FO, Cartwright MS.
Muscle Nerve. 2013 Mar ;47(3):319-29.
PMID: 23382111
Neuromuscular clinicians are often asked to evaluate the diaphragm for diagnostic and prognostic purposes. Traditionally, this evaluation is accomplished through history, physical exam, fluoroscopic sniff test, nerve conduction studies, and electromyography (EMG). Nerve conduction studies and EMG in this setting are challenging, uncomfortable, and can cause serious complications, such as pneumothorax. Neuromuscular ultrasound has emerged as a non-invasive technique that can be used in the structural and functional assessment of the diaphragm. In this study we review different techniques for assessing the diaphragm using neuromuscular ultrasound and the application of these techniques to enhance diagnosis and prognosis by neuromuscular clinicians.
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Rauck R, Deer T, Rosen S, Padda G, Barsa J, Dunbar E, Dwarakanath G.
Neuromodulation. 2013 Mar-Apr;16(2):163-7.
PMID: 23057877
The Prometra® Programmable Pump System (Flowonix Medical, Inc., Mt. Olive, NJ, USA) is designed for continuous intrathecal administration of morphine sulfate to treat chronic intractable pain. As a follow-up to a previous report on acute six-month data, this study evaluated the efficacy of treatment at one year and the accuracy of drug delivery throughout the study (average of 2.5 years, range 0-3.6 years).
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Lu YC, Untaroiu CD.
Proc Inst Mech Eng H. 2013 Mar ;227(3):293-301.
PMID: 23662345
To investigate the possible changes in material properties of cadaveric abdominal organs due to the preservation methods, the indentation data obtained from porcine abdominal organs (kidney, liver, and spleen) preserved by cooling and freezing are analyzed statistically in this study. Indentation tests were first conducted on fresh specimens. One half of the specimens of each organ were then frozen (preserved at - 12 degrees C), and the other half of the specimens were cooled (preserved at 4 degrees C). All preserved specimens were retested after 20 days. Force and displacement data recorded during indentation were analyzed using a quasi-linear viscoelastic model. The results show that both cooling and freezing storage increased the kidney stiffness. In contrast, both storage methods decreased the stiffness of the spleen specimens. While cooling increased the liver stiffness, no significant changes of the instantaneous elastic response were observed in the liver specimens preserved by freezing. The liver and spleen's reduced relaxation responses and the liver's instantaneous elastic response were significantly different when comparing between cooling and freezing effects after 20 days of preservation. This study showed that both cooling and freezing storage methods significantly changed the material properties of abdominal organs, especially the instantaneous elastic response. More research is needed in investigating the effect of preservation on failure properties and mechanical properties under large deformation.
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Blackham AU, Northrup SA, Willingham M, D'Agostino RB, Lyles DS, Stewart JH.
Surgery. 2013 Mar ;153(3):333-43.
PMID: 23102637
Vesicular stomatitis virus (VSV) is a novel, anti-cancer therapy that targets cancer cells selectively with defective antiviral responses; however, not all malignant cells are sensitive to the oncolytic effects of VSV. Herein, we have explored the mechanistic determinants of mutant M protein VSV (M51R-VSV) susceptibility in malignant melanoma cells.
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Smith WK, Berry ZC.
Tree Physiol. 2013 Mar ;33(3):233-7.
PMID: 23438468
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Arcury TA, Grzywacz JG, Sidebottom J, Wiggins MF.
Am J Ind Med. 2013 Feb 28. [Epub ahead of print]
PMID: 23450742
BACKGROUND: Manual labor in the Agriculture, Forestry, and Fishing (AgFF) Sector is provided primarily by immigrant workers. Limited information is available that documents the demographic characteristics of these manual workers, the occupational illnesses, injuries and fatalities they experience; or the risk factors to which they are exposed. METHODS: A working conference of experts on occupational health in the AgFF Sector was held to address information limitations. This paper provides an overview of the conference. Other reports address organization of work, health outcomes, healthcare access, and safety policy. CONTENTS: This report addresses how best to define the population and the AgFF Sector, occupational exposures for the sector, data limitations, characteristics of immigrant workers, reasons for concern for immigrant workers in the AgFF Sector, regulations, a conceptual model for occupational health, and directions for research and intervention. Am. J. Ind. Med. © 2013 Wiley Periodicals, Inc.
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Quandt SA, Kucera KL, Haynes C, Klein BG, Langley R, Agnew M, Levin JL, Howard T, Nussbaum MA.
Am J Ind Med. 2013 Feb 28. [Epub ahead of print]
PMID: 23450720
BACKGROUND: Workers in the Agriculture, Forestry, and Fisheries (AgFF) sector experience exposures directly related to the work itself, as well as the physical environment in which the work occurs. Health outcomes vary from immediate to delayed, and from acute to chronic. METHODS: We reviewed existing literature on the health outcomes of work in the AgFF sector and identified areas where further research is needed to understand the impact of these exposures on immigrant Latino workers in the southeastern US. RESULTS: Outcomes related to specific body systems (e.g., musculoskeletal, respiratory) as well as particular exposure sources (e.g., pesticides, noise) were reviewed. The most extensive evidence exists for agriculture, with a particular focus on chemical exposures. Little research in the southeastern US has examined health outcomes of exposures of immigrant workers in forestry or fisheries. CONCLUSION: As the AgFF labor force includes a growing number of Latino immigrants, more research is needed to characterize a broad range of exposures and health outcomes experienced by this population, particularly in forestry and fisheries. Am. J. Ind. Med. © 2013 Wiley Periodicals, Inc.
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Young L, Kemper KJ.
J Altern Complement Med. 2013 Feb 28. [Epub ahead of print]
PMID: 23448120
Abstract Objectives: Although pediatric patients with chronic pain often turn to complementary therapies, little is known about patients who seek academic integrative pediatric care. Design: The study design comprised abstraction of intake forms and physician records from new patients whose primary concern was pain. Setting/location: The study setting was an academic pediatric clinic between January 2010 and December 2011. Subjects: Of the 110 new patients, 49 (45%) had a primary concern about headache (20), abdominal pain (18), or musculoskeletal pain (11). Results: The average age was 13±4 years, and 37% were male. Patients reported an average pain level of 6±3 on a 10-point scale, and most reported more than one kind of pain; parents had an average of 7±3 health concerns per child, including fatigue (47%), mood or anxiety (45%), constipation/diarrhea (41%), and/or sleep problems (35%). Most patients (57%) were referred by specialists; 71% were taking prescription medications; and 53% were taking one or more dietary supplements at intake. Of those tested, most (61%) had suboptimal vitamin D levels. All families wanted additional counseling about diet (76%), exercise (66%), sleep (58%), and/or stress management (81%). In addition to encouraging continued medical care (100%) and referral to other medical specialists (16%), frequent advice included continuing or initiating dietary supplements such as vitamins/minerals (80%), omega-3 fatty acids (67%), and probiotics (31%). Stress-reducing recommendations included biofeedback (33%), gratitude journals (16%), and yoga/t'ai chi (8%). Other referrals included acupuncture (24%) and massage (20%). Discussion: Patients who have chronic pain and who present to an integrative clinic frequently have complex conditions and care. They are interested in promoting a healthy lifestyle, reducing stress, and using selected complementary therapies. Conclusion: Patients with chronic pain who seek integrative care may benefit from the kind of coordinated, integrated, comprehensive care provided in a medical home.
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Liu J, Argenta L, Morykwas M, Wagner WD.
J Biomater Appl. 2013 Feb 28. [Epub ahead of print]
PMID: 23449680
Single nanofibers with chemical and functional properties consistent with artery extracellular matrix nanofibers were produced by electrospinning. Using weight ratios to mimic artery extracellular matrix, five materials were tested: (1) Collagen type I, (2) Collagen type I + Collagen type III, (3) Collagen type I + poly (diol citrate), (4) Collagen type I + Collagen type III + poly (diol citrate), and (5) Collagen type I + poly (diol citrate) + Decorin + Aggrecan. Fiber sizes for all materials ranged from 50 nm to 600 nm and random fiber mats had pore sizes from 21 to 40 = m(2) and porosities of 72-84%. Human embryonic palatal mesenchymal cells fibroblasts adhered to all fibers and proliferated over a 7-day study period. Mechanical properties of single fibers were investigated using a combined atomic force/optical microscope. Materials containing poly (diol citrate) showed elasticity increased 3.2 fold greater than composites without poly (diol citrate). Maximum stress was within functional range in comparison to decellularized artery extracellular matrix fibers. By incorporating poly (diol citrate) and proteoglycan along with collagen, a viscoelastic nanofibrous material was produced for use in tissues such as artery where viscoelasticity and tensile strength are required.
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Yang Q, Ayers K, Chen Y, Helderman J, Welch CD, O'Shea TM.
J Pediatr. 2013 Feb 28. [Epub ahead of print]
PMID: 23453547
OBJECTIVE: To test the hypothesis that in the premature infant with an enterostomy, early enteral supplementation with Microlipid (fat supplement) and fish oil increases enteral fat absorption and decreases the requirement for Intralipid (intravenous fat emulsion). STUDY DESIGN: Premature infants (<2 months old) with an enterostomy after surgical treatment for necrotizing enterocolitis or spontaneous intestinal perforation and tolerating enteral feeding at 20 mL/kg/day were randomized to usual care (control 18 infants) or early supplementing enteral fat and fish oil (treatment 18 infants). Intravenous fat emulsion was decreased as enteral fat intake was increased. Daily weight, ostomy output, and nutrition data were recorded. Weekly 24-hour ostomy effluent was collected until bowel reanastomosis, and fecal fat, fecal liquid, and dry feces were measured. Fat absorption (g/kg/d) was calculated by subtracting fecal fat from dietary fat. The fecal liquid and dry feces were reported as mg/g wet stool. Date were analyzed by using ANOVA and mixed-effects model. RESULTS: The interval from initial postoperative feeding to bowel reanastomosis varied from 2 to 10 weeks. The treatment group received more dietary fat and less intravenous fat emulsion and had higher enteral fat absorption, less fecal liquid, and drier feces than the control group. These effects were greater among infants with a high ostomy compared with those with a low ostomy. Enteral fat intake was significantly correlated with fat absorption. CONCLUSION: Early enteral fat supplement and fish oil increases fat absorption and decreases the requirement for intravenous fat emulsion. This approach could be used to promote bowel adaptation and reduce the use of intravenous fat emulsion in the premature infant with an enterostomy.
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Andersson KE, Martin N, Nitti V.
J Urol. 2013 Feb 28. [Epub ahead of print]
PMID: 23458471
BACKGROUND AND PURPOSE: Bladder effects of isoprenaline and selective β1- and β2-adrenoceptor (AR) agonists reported in early studies suggested that bladder β-ARs are "atypical". Since there is a lack of alternatives to antimuscarinics in the treatment of overactive bladder (OAB) symptoms, there has been an intensive search for new drug targets. The discovery of the β3-AR with high expression in the bladder, suggested that this receptor, mediating detrusor relaxation, could be a target for treatment of patients with OAB symptoms. METHODS: An overview of published literature on β-ARs and bladder (MEDLINE) was performed. The US Food and Drug Administration web site, clinicaltrials.gov, and controlled-trials.com online trial registries were searched for English-language articles containing the terms β3-ARs and β3-AR agonists. In addition, abstracts from recent international scientific meetings were searched for randomised controlled trials (RCTs) on β3-AR agonists. RESULTS: Stimulation of β3-ARs relaxes detrusor smooth muscle, decreases afferent signaling from the bladder, improves bladder compliance on filling, and increases bladder capacity. RCTs show that the selective β3-AR agonist, mirabegron, for which most information is available and which is approved in Japan, USA, and Europe, reduces the number of micturitions and incontinence episodes in a 24-h period compared with placebo. The most common adverse effects recorded are dry mouth (placebo level) and gastrointestinal disturbances rated as mild to moderate. Small rises in mean heart rate (1 beat /minute) and blood pressure (1 mm Hg) have been demonstrated in OAB patients. CONCLUSIONS: Available information suggests that β3-AR agonists may be a promising alternative to antimuscarinics in the treatment of OAB. However, further clinical experiences outside clinical trials, and information on the long-term use in terms of efficacy, safety, and tolerability are warranted to optimally characterize the position of β3-AR agonists in the treatment algorithm for OAB.
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Marchant B, Sheele JM.
J Emerg Med. 2013 Feb 27. [Epub ahead of print]
PMID: 23453428
BACKGROUND: Pneumocephalus is rare, mostly arising as a complication of surgery, trauma, infection, or neoplasm. OBJECTIVE: Our aim was to briefly discuss the etiology and Emergency Department evaluation of patients with pneumocephalus. CASE REPORT: We present a case of a spontaneous esophageal-arachnoid fistula in a patient with stage IV non-small cell carcinoma leading to spontaneous pneumocephalus with resulting meningitis and death. CONCLUSIONS: Although usually asymptomatic, pneumocephalus can lead to tension pneumocephalus, a potentially fatal condition, or septic meningitis, if it is the result of infection from gas-producing bacteria.
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Choi JS, Kim EY, Kim MJ, Khan FA, Giegengack M, D'Agostino R, Criswell T, Khang G, Soker S.
Cell Transplant. 2013 Feb 26. [Epub ahead of print]
PMID: 23461892
Corneal transplantation is a common transplant procedure used to improve visual acuity by replacing the opaque or distorted host tissue with clear healthy donor tissue. However, its clinical utility is limited due to a lack of donor supply of high quality corneas. Bioengineered neo-corneas, created using an expandable population of human donor-derived corneal endothelial cells (HCECs), could address this shortage. Thus, the objective of this study was to evaluate HCEC sourcing with various isolation methods, including enzymatic digestion, culture medium components, and adhesive proteins. HCECs were obtained from corneas obtained from various aged donors after endothelial keratoplasty. Under a dissection microscope, the Descemet's membrane, including the attached corneal endothelium was stripped from the stroma and the cells were isolated and expanded by explant culture or by enzymatic digestion with enzymes such as collagenase II, dispase, or trypsin. In order to improve the initial cell attachment, tissue culture plates were coated with collagen IV, fibronectin, or fibronectin-collagen combination coating mix (FNC) before cell plating. We were able to successfully HCECs from 32% (86/269) of donor corneas. Donor age and isolation method influenced the characteristics of the resulting in vitro HCEC culture. Under all conditions tested, FNC-coated plates showed higher quality cultures than the other coatings tested. These results suggested that donor age and HCEC isolation methodology are the two factors that most directly affect the quality of the resulting HCEC culture in vitro. These factors should guide the methodological development for the clinical expansion of HCECs for the generation of bioengineered neo-corneas.
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Ravish ME, Krowchuk DP, Zapadka M, Shetty AK.
J Emerg Med. 2013 Feb 26. [Epub ahead of print]
PMID: 23485263
BACKGROUND: Rocky Mountain spotted fever (RMSF) is a well-described, potentially lethal, tick-borne zoonotic infection and has very effective therapy. However, the diagnosis might not be made early enough, often leading to worse outcomes. OBJECTIVE: Our aim was to discuss the diagnostic dilemmas facing the physician when evaluating patients with suspected RMSF. METHODS: We report a case of RMSF in a 6-year-old girl who presented to our hospital with a 7-day history of fever, headache, and a petechial rash. After blood cultures were obtained, the patient was treated empirically with doxycycline, vancomycin, and ceftriaxone. During the next 24 h, her clinical status worsened, with acute onset of altered mental status, posturing, and fixed and dilated pupils. A computed tomography scan of the brain demonstrated diffuse cerebral edema with evidence of tonsillar herniation. She died 24 h after admission. A serum specimen tested positive for immunoglobulin G to Rickettsia rickettsii at a titer of 128 dilutions, confirming recent infection. CONCLUSIONS: We present this case to raise awareness of RMSF in patients who present with a nonspecific febrile illness in tick-endemic areas in the United States. Early diagnosis and treatment with doxycycline before day 5 of illness is essential and can prevent morbidity and mortality.
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Manny T, Krane LS, Hemal AK.
J Endourol. 2013 Feb 26. [Epub ahead of print]
PMID: 23442199
INTRODUCTION: Indocyanine Green (ICG) is emerging as a potential adjunct to robotic partial nephrectomy by its ability to aide in the real-time identification of renal vasculature, renal masses, and the renal mass-parenchymal margin. The fluorescence patterns of renal masses have not been adequately described according to histology and it remains unknown if fluorescence pattern can reliably predict histology or malignancy. We therefore describe the ICG fluorescence pattern of our first 100 robotic partial nephrectomies and correlate with histology. METHODS: We reviewed our prospective robotic partial nephrectomy database and categorized fluoresce pattern as isofluoresent (same as surrounding parenchyma), hypofluorescent (less than surrounding parenchyma, but with uptake), or afluorescent (no visable uptake of dye). Descriptive statistics were applied. RESULTS: All 14 cystic lesions were afluorescent, and comprised 9 malignant and 5 benign masses. Eighty-six lesions were solid, of which 3 were isofluorescent including two clear cell and one translocation tumor. The remaining 83 solid lesions were hypoflurescent and included 65 malignant and 18 benign lesions. Clear cell was the most common histology of which 96% were hypofluorescent and 4% isofluorescent. In determining malignant vs. benign lesions, hypofluorescence had a positive predictive value of 87%, negative predictive value of 52%, sensitivity of 84% and specificity of 57%. CONCLUSIONS: A three grade classification of renal mass ICG fluorescence pattern is correlated with some histologic findings, but unable to reliably predict malignant versus benign lesions.
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Schirillo JA.
Psychon Bull Rev. 2013 Feb 23. [Epub ahead of print]
PMID: 23435628
In studies of lightness and color constancy, the terms lightness and brightness refer to the qualia corresponding to perceived surface reflectance and perceived luminance, respectively. However, what has rarely been considered is the fact that the volume of space containing surfaces appears neither empty, void, nor black, but filled with light. Helmholtz (1866/1962) came closest to describing this phenomenon when discussing inferred illumination, but previous theoretical treatments have fallen short by restricting their considerations to the surfaces of objects. The present work is among the first to explore how we infer the light present in empty space. It concludes with several research examples supporting the theory that humans can infer the differential levels and chromaticities of illumination in three-dimensional space.
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