Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00306932607174

Κυριακή 17 Σεπτεμβρίου 2017

Damage Identification of a Derrick Steel Structure Based on the HHT Marginal Spectrum Amplitude Curvature Difference

For the damage identification of derrick steel structures, traditional methods often require high-order vibration information of structures to identify damage accurately. However, the high-order vibration information of structures is difficult to acquire. Based on the technology of signal feature extraction, only using the low-order vibration information, taking the right front leg as an example, we analyzed the selection of HHT marginal spectrum amplitude and the calculation process of its curvature in practical application, designed the damage conditions of a derrick steel structure, used the index and intrinsic mode function (IMF) instantaneous energy curvature method to perform the damage simulation calculation and comparison, and verified the effect of identifying the damage location in a noisy environment. The results show that the index can accurately determine the location of the damage element and weak damage element and can be used to qualitatively analyze the damage degree of the element; under the impact load, the noise hardly affects the identification of the damage location. Finally, this method was applied to the ZJ70 derrick steel structure laboratory model and compared with the IMF instantaneous energy curvature method. We verified the feasibility of this method in the damage location simulation experiment.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wn7VAI
via IFTTT

Cardiovascular Protective Effects of Salvianic Acid A on db/db Mice with Elevated Homocysteine Level

The onsets of left ventricular hypertrophy (LVH) and endothelial dysfunction (ED) in diabetics, especially in those with elevated homocysteine (Hcy), precede the development of cardiovascular (CV) events. Salvianic acid A (SAA) is a renowned Traditional Chinese Medicine (TCM) that has been applied in the treatment of cardiovascular disease for many decades. In this study, we aimed (1) to investigate the CV protective effects of SAA on ameliorating LVH and ED in db/db mice with elevated blood Hcy level and (2) to decipher whether the observed CV protective effects of SAA are associated with Hcy metabolism by modulating the methylation potential and redox status in the liver of the db/db mice with elevated blood Hcy level. Our results found that the administration of SAA could significantly slow down the build-up of left ventricular mass and ameliorate ED. Immunological assay analysis on the mouse liver tissue also indicated that SAA treatment on db/db mice with elevated Hcy was associated with reduced methylation potential but improved redox status. In conclusion, we revealed that SAA has the potential to protect against the hyperglycemia- and hyperhomocysteinemia-induced oxidative stress on diabetic mice via modulation in Hcy metabolism.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2ygHPwm
via IFTTT

Guanxintai Exerts Protective Effects on Ischemic Cardiomyocytes by Mitigating Oxidative Stress

Oxidative stress participates in numerous myocardial pathophysiological processes and is considered a therapeutic target for myocardial ischemia and heart failure. Guanxintai (GXT), a traditional Chinese medicine, is commonly used to treat cardiovascular disease on account of its numerous beneficial physiological activities, such as dilating coronary arteries, inhibiting platelet aggregation, and reducing the serum lipid content. However, the antioxidative properties of GXT and potential underlying mechanisms remain to be established. In the present study, we investigated the protective effects of GXT on ischemic cardiomyocytes and the associated antioxidative mechanisms, both in vivo and in vitro. Notably, GXT treatment reduced the degree of cardiomyocyte injury, myocardial apoptosis, and fibrosis and partially improved cardiac function after myocardial infarction. Furthermore, GXT suppressed the level of ROS as well as expression of NADPH oxidase (NOX) and phospho-p38 mitogen-activated protein kinase (MAPK) proteins. Our results collectively suggest that the protective effects of GXT on ischemic cardiomyocytes are exerted through its antioxidative activity of NOX inhibition.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wlO0lp
via IFTTT

Women Living with HIV over Age of 65: Cervical Cancer Screening in a Unique and Growing Population

Objective. Women living with HIV are at increased risk of human papillomavirus (HPV) infection, which can lead to cervical cancer. New guidelines recommend indefinite screening. The objective of this study is to describe cervical cancer screening practices and colposcopy results in a cohort of women living with HIV over age of 65 who were followed before the new guidelines. Comorbidities, sexually transmitted infections (STIs), and other risk factors were evaluated. Methods. We conducted a retrospective chart review on 75 women aged 65 or older living with HIV with at least one Pap smear. Results. The mean age of the cohort was 66.5 and at HIV diagnosis was 56. The majority of women were immunocompetent. 80% had serial Pap smears. Of these, 86% of 238 were negative or ASCUS. No women progressed to HSIL. 92% of colposcopies had negative or CIN I results. Three women were treated successfully for high-grade dysplasia. More than half of women had other STIs. 72% were screened for HPV; 50% were positive. Conclusion. The majority of women had negative and low-grade Pap smears. Questions remain regarding the utility of continued Pap screening and the added value of HPV testing in this unique population of older women living with HIV.

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2yhCp4k
via IFTTT

Mechanisms of MAGUK-mediated cellular junctional complex organization.

Mechanisms of MAGUK-mediated cellular junctional complex organization.

Curr Opin Struct Biol. 2017 Sep 13;48:6-15

Authors: Ye F, Zeng M, Zhang M

Abstract
Membrane-associated guanylate kinases (MAGUKs) are a family of scaffold proteins that are enriched in cellular junctions and essential for tissue development and homeostasis. Mutations of MAGUKs are linked to many human diseases including cancers, psychiatric disorders, and intellectual disabilities. MAGUKs share a common PDZ-SH3-GK tandem domain organization at the C-terminal end. In this review, we summarize the mechanistic basis governing target recognition and regulations of this binding by the PDZ-SH3-GK tandem of various MAGUKs. We also discuss recent discoveries showing unique folding features of MAGUK PDZ-SH3-GK tandems that facilitate ligand-induced oligomerization of MAGUKs and phase transition of MAGUK-assembled synaptic signaling complexes.

PMID: 28917202 [PubMed - as supplied by publisher]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wlIEqn
via IFTTT

Reconstruction of atmospheric trace metals pollution in Southwest China using sediments from a large and deep alpine lake: Historical trends, sources and sediment focusing.

Reconstruction of atmospheric trace metals pollution in Southwest China using sediments from a large and deep alpine lake: Historical trends, sources and sediment focusing.

Sci Total Environ. 2017 Sep 13;613-614:331-341

Authors: Lin Q, Liu E, Zhang E, Nath B, Shen J, Yuan H, Wang R

Abstract
Atmospheric pollution, one of the leading environmental problems in South and East Asia, and its impact on the terrestrial environmental quality remain poorly understood particularly in alpine areas where both historical and present-day mining and smelting operations might leave an imprint. Here, we reconstructed atmospheric trace metals pollution during the past century using core sediments from a large and deep alpine lake in Southwest China. The implication of in lake and/or in watershed sediment focusing in pollution quantification is discussed by analyzing 15 sediment cores. Factor analysis and enrichment factor indicated Cd, Pb and Sb as the typical pollutants. Distinct peaks of Pb and Sb pollution were observed around the 1920s, but little Pb pollution was detected in recent decades, different from other studies in similar regions. Cadmium pollution was observed until the mid-1980s synchronized with Sb. The distinctive variations in atmospheric trace metal pollution process in Southwest China highlight the regional and sub-regional sources of metal pollutants, which should be primarily attributed to non-ferrous metal smelting emissions. Both natural and anthropogenic metals showed wide concentration ranges though exhibited similar temporal trends in the 15 cores. Spatial variations of anthropogenic metals were influenced by the in-watershed pollutants remobilization, whereas, natural metals were regulated by the detrital materials in the sub-basin. In-lake sediment focusing had little influence on the spatial distributions of all metals, different from the traditional sediment focusing pattern observed in small lakes. Anthropogenic Cd accumulation in sediments ranged from 1.5 to 10.1mgm(-2) in a specific core with an average of 6.5mgm(-2) for the entire lake, highlighting that a reliable whole-lake pollutant budget requires an analysis of multiple cores. Our study suggests that the management of aquatic ecosystem health should take the remobilization of in-watershed stored pollutants into consideration especially under increasing human perturbation.

PMID: 28917172 [PubMed - as supplied by publisher]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2ygIhL0
via IFTTT

Ambient air pollution and daily hospital admissions for mental disorders in Shanghai, China.

Ambient air pollution and daily hospital admissions for mental disorders in Shanghai, China.

Sci Total Environ. 2017 Sep 13;613-614:324-330

Authors: Chen C, Liu C, Chen R, Wang W, Li W, Kan H, Fu C

Abstract
Few studies have investigated the associations between ambient air pollution and mental disorders (MDs), especially in developing countries. We conducted a time-series study to explore the associations between six criteria air pollutants and daily hospital admissions for MDs in Shanghai, China, from 2013 to 2015. The MDs data were derived from the Shanghai Health Insurance System. We used over-dispersed, generalized additive models to estimate the associations after controlling for time trend, weather conditions, day of the week, and holidays. In addition, we evaluated the effect of modification by age, sex, and season. A total of 39,143 cases of hospital admissions for MDs were identified during the study period. A 10-μg/m(3) increase in 2-day, moving-average concentration of inhalable particulate matter, sulfur dioxide (SO2), and carbon monoxide was significantly associated with increments of 1.27% [95% confidence interval (CI): 0.28%, 2.26%], 6.88% (95% CI, 2.75%, 11.00%), and 0.16% (95% CI: 0.02%, 0.30%) in daily hospital admissions for MDs, respectively. We observed positive but insignificant associations of fine particulate matter, nitrogen dioxide and ozone. The estimated association of SO2 was relatively robust to the adjustment of simultaneous exposure to other pollutants. We found generally stronger associations of air pollutants with MDs in warm seasons than in cool seasons. There were no significant differences in the associations between different sex and age groups. This study suggested that short-term exposure to air pollution, especially to sulfur dioxide, was associated with increased risk of hospital admissions for MDs in Shanghai, China.

PMID: 28917171 [PubMed - as supplied by publisher]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wmwjCo
via IFTTT

Health-related quality of life and its determinants in patients with metastatic renal cell carcinoma.

Health-related quality of life and its determinants in patients with metastatic renal cell carcinoma.

Qual Life Res. 2017 Sep 15;:

Authors: de Groot S, Redekop WK, Versteegh MM, Sleijfer S, Oosterwijk E, Kiemeney LALM, Uyl-de Groot CA

Abstract
PURPOSE: Based on improvements of progression-free survival (PFS), new agents for metastatic renal cell carcinoma (mRCC) have been approved. It is assumed that one of the benefits is a delay in health-related quality of life (HRQoL) deterioration as a result of a delay in progression of disease. However, little data are available supporting this relationship. This study aims to provide insight into the most important determinants of HRQoL (including progression of disease) of patients with mRCC.
METHODS: A patient registry (PERCEPTION) was created to evaluate treatment of patients with (m)RCC in the Netherlands. HRQoL was measured, using the EORTC QLQ-C30 and EQ-5D-5L, every 3 months in the first year of participation in the study, and every 6 months in the second year. Participation started as soon as possible following a diagnosis of (m)RCC. Random effects models were used to study associations between HRQoL and patient and disease characteristics, symptoms and treatment.
RESULTS: Eighty-seven patients with mRCC completed 304 questionnaires. The average EORTC QLQ-C30 global health status was 69 (SD, 19) before progression and 61 (SD, 22) after progression of disease. Similarly, the average EQ-5D utility was 0.75 (SD, 0.19) before progression and 0.66 (SD, 0.30) after progression of disease. The presence of fatigue, pain, dyspnoea, and the application of radiotherapy were associated with significantly lower EQ-5D utilities.
CONCLUSIONS: Key drivers for reduced HRQoL in mRCC are disease symptoms. Since symptoms increase with progression of disease, targeted therapies that increase PFS are expected to postpone reductions in HRQoL in mRCC.

PMID: 28917029 [PubMed - as supplied by publisher]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2x9VyVK
via IFTTT

Air-electron stream interactions during magnetic resonance IGRT : Skin irradiation outside the treatment field during accelerated partial breast irradiation.

Air-electron stream interactions during magnetic resonance IGRT : Skin irradiation outside the treatment field during accelerated partial breast irradiation.

Strahlenther Onkol. 2017 Sep 15;:

Authors: Park JM, Shin KH, Kim JI, Park SY, Jeon SH, Choi N, Kim JH, Wu HG

Abstract
PURPOSE: To investigate and to prevent irradiation outside the treatment field caused by an electron stream in the air generated by the magnetic field during magnetic resonance image-guided accelerated partial breast irradiation (APBI).
MATERIALS AND METHODS: In all, 20 patients who received APBI with a magnetic resonance image-guided radiation therapy (MR-IGRT) system were prospectively studied. The prescription dose was 38.5 Gy in 10 fractions of 3.85 Gy and delivered with a tri-cobalt system (the ViewRay system). For each patient, primary plans were delivered for the first five fractions and modified plans with different gantry angles from those of the primary plan (in-treatment plans) were delivered for the remaining five fractions to reduce the skin dose. A 1 cm thick bolus was placed in front of the patient's jaw, ipsilateral shoulder, and arm to shield them from the electron stream. Radiochromic EBT3 films were attached to the front (towards the breast) and back (towards the head) of the bolus during treatment. Correlations between the measured values and the tumor locations, treatment times, and tumor sizes were investigated.
RESULTS: For a single fraction delivery, the average areas of the measured isodoses of 14% (0.54 Gy), 12% (0.46 Gy), and 10% (0.39 Gy) at the front of the boluses were as large as 3, 10.4, and 21.4 cm(2), respectively, whereas no significant dose could be measured at the back of the boluses. Statistically significant but weak correlations were observed between the measured values and the treatment times.
CONCLUSION: During radiotherapy for breast cancer with an MR-IGRT system, the patient must be shielded from electron streams in the air generated by the interaction of the magnetic field with the beams of the three-cobalt treatment unit to avoid unwanted irradiation of the skin outside the treatment field.

PMID: 28916952 [PubMed - as supplied by publisher]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wmdUp7
via IFTTT

Interactions Between Genetics, Lifestyle, and Environmental Factors for Healthcare.

Interactions Between Genetics, Lifestyle, and Environmental Factors for Healthcare.

Adv Exp Med Biol. 2017;1005:167-191

Authors: Lin Y, Chen J, Shen B

Abstract
The occurrence and progression of diseases are strongly associated with a combination of genetic, lifestyle, and environmental factors. Understanding the interplay between genetic and nongenetic components provides deep insights into disease pathogenesis and promotes personalized strategies for people healthcare. Recently, the paradigm of systems medicine, which integrates biomedical data and knowledge at multidimensional levels, is considered to be an optimal way for disease management and clinical decision-making in the era of precision medicine. In this chapter, epigenetic-mediated genetics-lifestyle-environment interactions within specific diseases and different ethnic groups are systematically discussed, and data sources, computational models, and translational platforms for systems medicine research are sequentially presented. Moreover, feasible suggestions on precision healthcare and healthy longevity are kindly proposed based on the comprehensive review of current studies.

PMID: 28916933 [PubMed - in process]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xIniDR
via IFTTT

Informatics for Nutritional Genetics and Genomics.

Informatics for Nutritional Genetics and Genomics.

Adv Exp Med Biol. 2017;1005:143-166

Authors: Gao Y, Chen J

Abstract
While traditional nutrition science is focusing on nourishing population, modern nutrition is aiming at benefiting individual people. The goal of modern nutritional research is to promote health, prevent diseases, and improve performance. With the development of modern technologies like bioinformatics, metabolomics, and molecular genetics, this goal is becoming more attainable. In this chapter, we will discuss the new concepts and technologies especially in informatics and molecular genetics and genomics, and how they have been implemented to change the nutrition science and lead to the emergence of new branches like nutrigenomics, nutrigenetics, and nutritional metabolomics.

PMID: 28916932 [PubMed - in process]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xI6NYi
via IFTTT

Tongue Image Analysis and Its Mobile App Development for Health Diagnosis.

Tongue Image Analysis and Its Mobile App Development for Health Diagnosis.

Adv Exp Med Biol. 2017;1005:99-121

Authors: Kanawong R, Obafemi-Ajayi T, Liu D, Zhang M, Xu D, Duan Y

Abstract
Computer-aided diagnosis provides a medical procedure that assists physicians in interpretation of medical images. This work focuses on computer-aided tongue image analysis specifically, based on Traditional Chinese Medicine (TCM). Tongue diagnosis is an important component of TCM. Computerized tongue diagnosis can aid medical practitioners in capturing quantitative features to improve reliability and consistency of diagnosis. Recently, researchers have started to develop computer-aided tongue analysis algorithms based on new advancement in digital photogrammetry, image analysis, and pattern recognition technologies. In this chapter, we will describe our recent work on tongue image analysis as well as a mobile app that we developed based on this technology.

PMID: 28916930 [PubMed - in process]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2xI6IUu
via IFTTT

Newborn Screening in the Era of Precision Medicine.

Newborn Screening in the Era of Precision Medicine.

Adv Exp Med Biol. 2017;1005:47-61

Authors: Yang L, Chen J, Shen B

Abstract
As newborn screening success stories gained general confirmation during the past 50 years, scientists quickly discovered diagnostic tests for a host of genetic disorders that could be treated at birth. Outstanding progress in sequencing technologies over the last two decades has made it possible to comprehensively profile newborn screening (NBS) and identify clinically relevant genomic alterations. With the rapid developments in whole-genome sequencing (WGS) and whole-exome sequencing (WES) recently, we can detect newborns at the genomic level and be able to direct the appropriate diagnosis to the different individuals at the appropriate time, which is also encompassed in the concept of precision medicine. Besides, we can develop novel interventions directed at the molecular characteristics of genetic diseases in newborns. The implementation of genomics in NBS programs would provide an effective premise for the identification of the majority of genetic aberrations and primarily help in accurate guidance in treatment and better prediction. However, there are some debate correlated with the widespread application of genome sequencing in NBS due to some major concerns such as clinical analysis, result interpretation, storage of sequencing data, and communication of clinically relevant mutations to pediatricians and parents, along with the ethical, legal, and social implications (so-called ELSI). This review is focused on these critical issues and concerns about the expanding role of genomics in NBS for precision medicine. If WGS or WES is to be incorporated into NBS practice, considerations about these challenges should be carefully regarded and tackled properly to adapt the requirement of genome sequencing in the era of precision medicine.

PMID: 28916928 [PubMed - in process]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2h8KCno
via IFTTT

High C-reactive protein levels are associated with depressive symptoms in schizophrenia.

High C-reactive protein levels are associated with depressive symptoms in schizophrenia.

J Affect Disord. 2017 Sep 08;225:671-675

Authors: Faugere M, Micoulaud-Franchi JA, Faget-Agius C, Lançon C, Cermolacce M, Richieri R

Abstract
BACKGROUND: Depressive symptoms are frequently associated with schizophrenia symptoms. C - Reactive protein (CRP), a marker of chronic inflammation, had been found elevated in patients with schizophrenia and in patients with depressive symptoms. However, the association between CRP level and depressive symptoms has been poorly investigated in patients with schizophrenia. The only study conducted found an association between high CRP levels and antidepressant consumption, but not with depressive symptoms investigated with the Calgary Depression Rating Scale for Schizophrenia (CDSS).
OBJECTIVES: The aim of this study was to evaluate CRP levels and depressive symptoms in patients with schizophrenia, and to determine whether high CRP levels are associated with depressive symptoms and/or antidepressant consumption, independently of potential confounding factors, especially tobacco-smoking and metabolic syndrome.
METHODS: Three hundred and seven patients with schizophrenia were enrolled in this study (mean age = 35.74 years, 69.1% male gender). Depressive symptoms was investigated with the CDSS. Patients were classified in two groups: normal CRP level (≤ 3.0mg/L) and high CRP level (> 3.0mg/L). Current medication was recorded.
RESULTS: 124 subjects (40.4%) were classified in the high CRP level group. After adjusting for confounding factors, these patients were found to have higher CDSS scores than those with normal CRP levels in multivariate analyses (p = 0.035, OR = 1.067, 95% CI = 1.004-1.132). No significant association between CRP levels and antidepressants consumption was found.
LIMITATIONS: The size sample is relatively small. The cut-off point for high cardiovascular risk was used to define the two groups. CRP was the sole marker of inflammation in this study and was collected at only one time point. The design of this study is cross-sectional and there are no conclusions about the directionality of the association between depression and inflammation in schizophrenia.
CONCLUSION: This study found an association between high rates of CRP levels and depressive symptoms in patients with schizophrenia, but no association with antidepressant consumption. Further studies are needed to investigate the impact of inflammation in schizophrenia.

PMID: 28917193 [PubMed - as supplied by publisher]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2yh9gGu
via IFTTT

Physiological Ripples (± 100 Hz) in Spike-Free Scalp EEGs of Children With and Without Epilepsy.

Physiological Ripples (± 100 Hz) in Spike-Free Scalp EEGs of Children With and Without Epilepsy.

Brain Topogr. 2017 Sep 15;:

Authors: Mooij AH, Raijmann RCMA, Jansen FE, Braun KPJ, Zijlmans M

Abstract
Pathological high frequency oscillations (HFOs, >80 Hz) are considered new biomarkers for epilepsy. They have mostly been recorded invasively, but pathological ripples (80-250 Hz) can also be found in scalp EEGs with frequent epileptiform spikes. Physiological HFOs also exist. They have been recorded invasively in hippocampus and neocortex. There are no reports of spontaneously occurring physiological HFOs recorded with scalp EEG. We aimed to study ripples in spike-free scalp EEGs. We included 23 children (6 with, 17 without epilepsy) who had an EEG without interictal epileptiform spikes recorded during sleep. We differentiated true ripples from spurious ripples such as filtering effects of sharp artifacts and high frequency components of muscle artifacts by viewing ripples simultaneously in bipolar and average montage and double-checking the unfiltered signal. We calculated mean frequency, duration and root mean square amplitude of the ripples, and studied their shape and distribution. We found ripples in EEGs of 20 out of 23 children (4 with, 16 without epilepsy). Ripples had a regular shape and occurred mostly on central and midline channels. Mean frequency was 102 Hz, mean duration 70 ms, mean root mean square amplitude 0.95 µV. Ripples occurring in normal EEGs of children without epilepsy were considered physiological; the similarity in appearance suggested that the ripples occurring in normal EEGs of children with epilepsy were also physiological. The finding that it is possible to study physiological neocortical ripples in scalp EEG paves the way for investigating their occurrence during brain development and their relation with cognitive functioning.

PMID: 28917017 [PubMed - as supplied by publisher]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wlHSti
via IFTTT

Higher physical activity and lower pain levels before surgery predict non-improvement of knee pain 1 year after TKA.

Higher physical activity and lower pain levels before surgery predict non-improvement of knee pain 1 year after TKA.

Knee Surg Sports Traumatol Arthrosc. 2017 Sep 15;:

Authors: Kornilov N, Lindberg MF, Gay C, Saraev A, Kuliaba T, Rosseland LA, Lerdal A

Abstract
PURPOSE: The purpose of this study was to describe patterns of pain during the first year following total knee arthroplasty (TKA) and evaluate pre- and postoperative factors associated with pain and patient satisfaction at 1 year. It was hypothesized that more severe preoperative pain would be associated with more residual pain and lower patient satisfaction 1 year after surgery.
METHODS: A longitudinal cohort study was performed with repeated measures of pain (0-10 numeric rating scale) and evaluation of other self-reported symptoms (Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, and Fatigue Severity Score), daily functioning (Lawton Instrumental Activities of Daily Living Scale), quality of life (EQ-5D-3L), knee function (KSS Knee and Function Score), perioperative and clinical characteristics (e.g. surgery duration, brand of implant, comorbidities), biochemical parameters (haemoglobin, C-reactive protein, creatinine), and patient satisfaction (20-item scale). Post-surgical improvement was defined as at least a two-point decrease in the patient's rating of pain interference with walking from baseline to 1 year. Hundred patients (mean age 64 ± 8 years and 93% female) consecutively admitted for uncomplicated primary TKA participated, and 79 with complete data were included in this analysis.
RESULTS: Pain generally decreased during the first postoperative year, from an average rating of 6 (SD = 3) to 1 (SD = 2). However, 18 of the 79 patients experienced no improvement in pain from baseline to 1 year. Factors associated with non-improvement of pain interference with walking after TKA included lower preoperative ratings of pain interference with walking (p < 0.001) and lower preoperative ratings of average pain (p = 0.004), active or very active levels of preoperative physical activity (p = 0.017), and higher ratings of worst pain on the first three postoperative days (p = 0.028). Pain at 1 year was the only predictor of lower patient satisfaction at 1 year.
CONCLUSIONS: Patients with low preoperative pain ratings or high preoperative levels of physical activity are at increased risk of non-improvement in knee pain after TKA. This finding should be taken into consideration when selecting appropriate candidates for TKA surgery. Orthopaedic surgeons should pay particular attention to patients reporting low pain interference with walking and consider other conservative or surgical treatment options before TKA. Effective strategies for detection and treatment of TKA patients with high pain ratings at early follow-up visits also need to be developed.
LEVEL OF EVIDENCE: Prognostic study, Level II.

PMID: 28916991 [PubMed - as supplied by publisher]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wlxylo
via IFTTT

BMJ papers on ear growth and didgeridoo for sleep apnea win Ig Nobel awards.

BMJ papers on ear growth and didgeridoo for sleep apnea win Ig Nobel awards.

BMJ. 2017 Sep 15;358:j4303

Authors: Tanne JH

PMID: 28916517 [PubMed - in process]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wlHQBG
via IFTTT

Resilience in Families of Children With Autism and Sleep Problems Using Mixed Methods.

Resilience in Families of Children With Autism and Sleep Problems Using Mixed Methods.

J Pediatr Nurs. 2017 Sep 12;:

Authors: Roberts CA, Hunter J, Cheng AL

Abstract
PURPOSE: About 80% of children with autism spectrum disorder (ASD) have sleep problems that may disrupt optimal family functioning. We explored the impact of sleep problems on families' resilience.
DESIGN AND METHODS: An explanatory sequential mixed methods design was used to discern whether resilience differed between families whose children with ASD have or do not have sleep problems, to seek predictors for family hardiness/resilience, and to determine whether narrative findings support, expand, or conflict quantitative findings.
RESULTS: Seventy complete surveys were returned from parents of children with ASD to compare sleep and family functioning. Fifty-seven children had sleep problems and six interviews regarding eight of these children were conducted. Parents of children with ASD and sleep problems had lower levels of resilience than those who slept well. Predictors of hardiness were social support, coping-coherence (stress management), and lower strain scores. Qualitative content analysis revealed a journey analogy with themes: finding the trailhead, dual pathways, crossing paths and choosing travel companions, forging new paths, resting along the way, and seeing the vistas.
CONCLUSIONS: Qualitative findings supported quantitative findings regarding the impact of sleep problems but also expanded them by illustrating how families' resilience and children's socialization improved over time. Social support predicted family hardiness. Parents revealed that sleep issues contributed to family strains and described their progression to resilience and embracing their child.
PRACTICE IMPLICATIONS: Findings support the need for community and provider advocacy and implicates a need for development of sleep interventions on behalf of families and children with ASD.

PMID: 28916433 [PubMed - as supplied by publisher]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2f2pb2V
via IFTTT

Assessing Changes in the Activity Levels of Breast Cancer Patients During Radiation Therapy.

Assessing Changes in the Activity Levels of Breast Cancer Patients During Radiation Therapy.

Clin Breast Cancer. 2017 Aug 24;:

Authors: Champ CE, Ohri N, Klement RJ, Cantor M, Beriwal S, Glaser SM, Smith RP

Abstract
BACKGROUND: Radiation therapy (RT) is often delivered after lumpectomy for women with breast cancer. A common perceived side effect of RT is fatigue, yet its exact effect on activity levels and sleep is unknown. In this study we analyzed the change in activity levels and sleep using an activity tracking device before, during, and after RT for women with early stage breast cancer and ductal carcinoma in situ who underwent adjuvant RT.
PATIENTS AND METHODS: After institutional review board approval, activity levels were quantified before, during, and after RT with measurements of steps, miles walked, calories burned, and sleep metrics in 10 women fitted with activity trackers. All data were uploaded and tabulated on a secure database. Multivariable linear regressions were used to evaluate changes in these variables over time during the RT course.
RESULTS: Median step count was 5047 per day (range, 2741-15,508) and distance traveled was 1.6 miles per day (range, 0.9-5.3). Step count, distance, and calories decreased by an average of 54 steps per day, 0.02 miles per day, and 3 calories per day (median calories 1822; range, 1461-2712) during RT, respectively. These changes were statistically significant (P < .001), but not clinically relevant. There was no significant change in sleep (average 6.8 hours per night; range, 5.5-8.3).
CONCLUSION: RT has a minimal effect on activity or sleep in women undergoing treatment for breast cancer. Activity levels varied greatly between patients in a population of women undergoing hypofractionated RT. Because increased activity levels correlate with improved outcomes, further studies evaluating attempts to increase physical activity during as well as after treatment with radiation are warranted.

PMID: 28916400 [PubMed - as supplied by publisher]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wlHPxC
via IFTTT

Childhood trauma, depression, and sleep quality and their association with psychotic symptoms and suicidality in schizophrenia.

Childhood trauma, depression, and sleep quality and their association with psychotic symptoms and suicidality in schizophrenia.

Psychiatry Res. 2017 Sep 07;:

Authors: Kilicaslan EE, Esen AT, Kasal MI, Ozelci E, Boysan M, Gulec M

Abstract
This study involved the examination of the relationship between childhood trauma and both psychotic symptoms and suicidality in patients with schizophrenia after controlling for the possible confounding factors, such as clinical features, depression, and sleep quality. The Childhood Trauma Questionnaire-Short Form, Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Pittsburgh Sleep Quality Index (PSQI), and the suicidality subscale of Mini-International Neuropsychiatric Interview (MINI) were administered to 199 patients with schizophrenia. We used sequential multiple stepwise regression analyses in which positive symptoms, negative symptoms, overall psychopathology, total symptoms of schizophrenia, and suicidality were dependent variables. Depressive symptomatology and childhood physical abuse significantly contributed to positive, negative, general psychopathology, and global schizophrenia symptomatology. Interestingly, general psychopathology scores were negatively associated with childhood physical neglect. Also, subjective sleep quality significantly contributed to positive schizophrenia symptoms. Although prior suicide attempts and depression were significant antecedents of suicidal ideation, no association between suicidality and both childhood trauma and sleep was found. Childhood physical abuse could have an impact on psychopathology in schizophrenia. In addition to childhood trauma, depression, sleep disturbances, and clinical features should be considered and inquired about in the course of clinical care of schizophrenia patients.

PMID: 28916298 [PubMed - as supplied by publisher]

from # All Medicine by Alexandros G. Sfakianakis via Alexandros G.Sfakianakis on Inoreader http://ift.tt/2wlHOty
via IFTTT