The effect of baclofen combined with a proton pump inhibitor in patients with refractory laryngopharyngeal reflux: a prospective, open‐label study in thirty‐two patients

Abstract

Thirty‐two patients with refractory LPR confirmed by 24‐h MII‐pH were given a 3‐month course of baclofen 10 mg three times a day combined with PPI 15 mg twice a day.

Changes in RSI and reflux‐related quality of life from baseline to after treatment were evaluated.

MII‐pH monitoring of refractory LPR patients showed that the number of non‐acid reflux was much higher than acid reflux in laryngopharyngeal reflux and full‐column reflux.

After 3 months of PPI + baclofen medication, most RSI items and quality of life score showed a significant improvement compared to the baseline score, and the percentage of responders at 3 months was 53.1%.

In our experience, when a PPI therapy is unresponsive to LPR patients, baclofen can be considered as a second treatment option.

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fMRI reveals a lack of sleep increases sensitivity to pain

Senior author Matthew Walker, with the University of California, Berkeley, and colleagues placed a pad on the legs of 25 healthy, well-rested adults until the temperature was unbearable, according to a Berkeley News release. On average, that topped out at 111 degrees Fahrenheit. But, after enduring a sleep-deprived night that average dropped to nearly 107 degrees. After reviewing fMRI data, Walker and colleagues observed a decrease in activity in the nucleus accumbens and insular cortex, r...

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Illinois center’s MRI ‘Caring Suite’ takes the stress out of exams

A new 1,700 square foot Caring Suite was added on to the Center for Health to house the wider MRI machine. Designed to help patients suffering from anxiety and claustrophobia, the room contains colored lights that are adjustable by the patient and allows them to choose what music is played throughout the exam. Wood detail makes the room feel less like an exam room and a leafy tree against a summer sky is displayed on the ceiling as patients look up to prepare for their MRI. "In the past th...

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Non-gated chest CT reliable for measuring coronary calcifications

"Vascular calcification is a common pathological feature of many diseases such as atherosclerosis, diabetes, and chronic kidney disease, and one of the important reasons for the high morbidity and mortality of cardiovascular and cerebrovascular diseases," wrote first author Yuhuan Chen, MD with Shaanxi University of Chinese Medicine in Xianyang, Shaanxi, China, and colleagues. Somewhat recently, CAC scoring with ECG-gated CT has become the non-invasive reference standard for detecting calc...

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Total-body PET/CT scanner granted FDA approval

The technology can capture three-dimensional (3D) images of the entire human body at one bed position and requires 40-times less radiation than current methods, according to a recent company press release. United Imaging made its U.S. market debut in November at RSNA 2018 in Chicago, where Simon Cherry, PhD and Ramsey Badawi, PhD, of UC Davis, presented a prototype of the system and the first images taken by the device. "The human images the uEXPLORER produces have been nothing shor...

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New imaging technique could extend perception of microscopes, endoscopes

The technique is a form of "non-line-of-sight imaging," which usually requires expensive and specialized equipment to see objects around corners. This method, however, only requires a standard digital camera and may soon be applied to medical imaging technologies such as microscopes or endoscopes to improve the detection of tumors or help physicians see around bones in medical images, according to the report. Charles Saunders, an electrical and computer engineering graduate student at Bo...

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Brain MRIs reveal young adults with above average blood pressure have lower brain volumes

Individuals in their 20s and 30s with above normal blood pressure—over 120/80 millimeters of mercury (mmHg)—showed loss of gray matter volume in certain areas of the brain responsible for memory, emotions, and language, among other functions. The findings could help streamline how and when above normal levels of blood pressure in young adults should be monitored and managed. "Previously the assumption has been that brain damage related to high blood pressure results over years of evident...

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Apple, Aetna launch new app that notifies users of cheaper imaging exams

Through an Apple Watch, the app called Attain will reward Aetna customers for meeting certain fitness goals and completing health-related tasks such as getting more sleep, improving nutrition and increasing mindfulness. The app will also notify users to get vaccinations, refill medications or indicate when a lower-cost option for imaging exams and lab tests are available. Attain will also let participants earn points as they complete their activity goals and recommended healthy tasks, wh...

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Female stroke victims less likely to receive specialized imaging than men

Hospitalized women with ischemic stroke are less likely than men to be evaluated by stroke specialists and receive specialized imaging scans and other diagnostic testing in hospitals, according to research being presenting at this year's American Stroke Association International Stroke Conference in Honolulu, as detailed in an American Heart Association press release. Roughly 140,000 Americans die from stroke each year, according to the Centers for Disease Control and Prevention (CDC). Acc...

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Deep learning network detects, localizes fractures on wrist x-rays

Prior studies have demonstrated that CNNs can detect fractures on radiographs, wrote first author Yee Liang Thian, MD, of National University of Singapore and colleagues, but these methods focus on classifying images as either fractures or non-fractures with no localization component. This broad classification makes it hard for clinicians to verify results. "The task of object detection involves two fundamental questions about an image: what object is in it, and where it is within the im...

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NIH-backed study identifies brain biomarkers tied to severe PTSD

A prominent theory for why some symptoms of PTSD develop cite a traumatic event in which a person may learn to view the people, locations and objects during the event as dangerous if they become associated with the traumatic situation. PTSD symptoms emerge when things perceived to be safe during a threatening situation continue to ignite fearful responses after the event has occurred, according to the study published in Nature Neuroscience. "Researchers have thought that the experience of ...

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Many women receive unnecessary mammograms before breast reduction surgery

After looking through the records of more than 52,000 women (mean age of 43) evaluated for breast reduction between 2009 and 2015, the authors found nearly one-third of those younger than 40 underwent mammography prior to surgery. Additionally, the study showed 30 percent of women ages 30 to 39 had mammograms before elective surgery—five times higher than that seen in other women their age, according to the study. "Altering screening mammography for patients younger than 40 years in the...

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AI saves radiologists time by triaging chest x-rays, but is it clinically feasible?

"The initial results reported here are exciting as they demonstrate that an AI system can be successfully trained using a very large database of routinely acquired radiologic data," said co-author Giovanni Montana, PhD, of the University of Warwick in Coventry, England, in a prepared statement. "With further clinical validation, this technology is expected to reduce a radiologist's workload by a significant amount by detecting all the normal exams so more time can be spent on those requiring ...

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Vancouver risk calculator found to improve lung cancer screening

Authors of the research, published Jan. 22 in Radiology, did report the Vancouver method was less specific and less accurate when it came to subsolid nodules. In the study, researchers scored more than 4,400 nodules taken from 2,813 patients as part of the National Lung Screening Trial (NLST). The nodules were scored using VRC with nine parameters and Lung-RADS. Of the total, 4,078 nodules were solid, 330 were subsolid. On a per-nodule basis, VRC achieved a sensitivity, specificity and ...

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How imaging, 3D printing gave one man a new face

Underwood, who had suffered a self-inflicted gunshot wound, was missing his upper and lower jaw, facial bones, gums, all 32 teeth, the roof and floor of his mouth, part of his tongue, his lower eyelids, cheeks, nose and parts of his nasal passage when he was admitted to NYU Langone days earlier. Prior to the face transplant surgery, Rodriguez and his team took CT scans of Underwood's face. The scans were then sent to a company in Michigan called Materialise, who converted the scans into ...

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What are the Types of Medical Waste

There are many different types of medical waste, categorised largely by the types of materials uses and the waste disposal methods. In general, in the UK medical waste is separated into two main types: hazardous and non-hazardous. In the US and other parts of the world, there are four major types of medical waste: General, Infectious, Hazardous and Radioactive. In this article we will explore what they are, how they should be handled and why incineration is the best all-round solution for...

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Values in transformational sustainability science: four perspectives for change

Abstract

Despite the normative nature of sustainability, values and their role in sustainability transformations are often discussed in vague terms, and when concrete conceptualizations exist, they widely differ across fields of application. To provide guidance for navigating the complexity arising from the various conceptualizations and operationalization of values, here, we differentiate four general perspectives of how and where values are important for transformation related sustainability science. The first perspective, surfacing implicit values, revolves around critical reflection on normative assumptions in scientific practices. Sustainability transformations concern fundamental ethical questions and are unavoidably influenced by assumptions sustainability scientists hold in their interactions with society. The second perspective, negotiating values, is related to the values held by different actors in group decision processes. Developing and implementing solution options to sustainability problems requires multiple values to be accounted for in order to increase civic participation and social legitimacy. The third perspective, eliciting values, focuses on the ascription of values to particular objects or choices related to specific sustainability challenges, for example, valuations of nature. The fourth perspective, transforming through values, highlights the dynamic nature and transformational potential of values. Value change is complex but possible, and may generate systemic shifts in patterns of human behaviours. Explicit recognition of these four interconnected values perspectives can help sustainability scientists to: (1) move beyond general discussions implying that values matter; (2) gain an awareness of the positionality of one's own values perspective when undertaking values related sustainability research; and (3) reflect on the operationalizations of values in different contexts.

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[ASAP] Secondary Orbital Interactions Enhance the Reactivity of Alkynes in Diels–Alder Cycloadditions

Journal of the American Chemical Society

DOI: 10.1021/jacs.8b13088

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[ASAP] Unified Mechanism of Oxygen Atom Transfer and Hydrogen Atom Transfer Reactions with a Triflic Acid-Bound Nonheme Manganese(IV)–Oxo Complex via Outer-Sphere Electron Transfer

Journal of the American Chemical Society

DOI: 10.1021/jacs.8b12935

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[ASAP] Structure of Prototypic Peptide Transporter DtpA from in Complex with Valganciclovir Provides Insights into Drug Binding of Human PepT1

Journal of the American Chemical Society

DOI: 10.1021/jacs.8b11343

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