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Journal Cover Biomedical Journal
  [SJR: 0.406]   [H-I: 3]   [3 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 2319-4170 - ISSN (Online) 2320-2890
   Published by Elsevier Homepage  [2970 journals]
  • Quantifying cell behaviors in negative-pressure induced monolayer cell
           movement

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): Shu-Er Chow, Carl Pai-Chu Chen, Chih-Chin Hsu, Wen-Chung Tsai, Jong-Shyan Wang, Ning-Chun Hsu
      Background Negative-pressure of 125 mmHg (NP) has been shown to accelerate wound healing. Effects of NP on human keratinocyte behaviors during wound healing process were highlighted in this study. Methods An NP incubator incorporating the electric cell–substrate impedance sensing (ECIS) technique has been built to quantify monolayer keratinocytes movement in serum-free media at the ambient pressure (AP) and NP for 12 h. Monolayer cell motions were continuously recorded by ECIS in the frequency range of 22.5–64 kHz. Membrane capacitance (Cm), cell–substratum resistance (α), and cell–cell junction resistance (Rb) were evaluated in cells at the different pressures. Results A greater monolayer cell migration distance was found in cells at NP. Decreased cell–substratum adhesion reflected in the significantly low α (AP:NP = ∼5 Ω0.5:∼3 Ω0.5⋅cm), decreased integrin expression, and increased cell–substratum distance were seen in cells at NP. A significantly increased Cm (AP:NP = ∼4:∼8 μF/cm2) in association with increased membrane ruffling and microtubule filaments were observed early in the monolayer cell movement at NP. A progressive drop in the Rb from 1.2 Ω·cm2 to 0.8 Ω·cm2 corresponding to the gradually decreased E-cadherin expressions were observed 6 h after wound closure after NP treatment. Conclusion A quick membrane ruffling formation, an early cell–substratum separation, and an ensuing decrease in the cellular interaction occur in cells at NP. These specific monolayer cell behaviors at NP have been quantified and possibly accelerate wound healing.


      PubDate: 2016-05-17T16:25:35Z
       
  • Stimulation of transforming growth factor-beta-1 and contact with type I
           collagen cooperatively facilitate irreversible transdifferentiation in
           proximal tubular cells

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): Chieh-Li Yen, Yi-Jung Li, Hsin-Hsu Wu, Cheng-Hao Weng, Cheng-Chia Lee, Yung-Chang Chen, Ming-Yang Chang, Tzung-Hai Yen, Hsiang-Hao Hsu, Cheng-Chieh Hung, Chih-Wei Yang, Ya-Chung Tian
      Background By transdifferentiation, proximal tubular cells (PTC) have been considered as a source of interstitial myofibroblasts. We examined the combined effect of transforming growth factor-beta-1 (TGF-β1) stimulation and contact with type I collagen on PTC transdifferentiation. Methods Human kidney-2 cells were grown on type I substratum with the concurrent stimulation of TGF-β1. Results Following addition of TGF-β1, cells acquired an elongated fibroblastic appearance and an increase in α-smooth muscle actin (α-SMA) expression, a myofibroblastic marker. Upon addition of TGF-β1, E-cadherin expression, an epithelial marker, was reduced, while cytokeratin expression, another epithelial marker, remained unaltered. Following removal of TGF-β1, PTC regained an epithelial appearance and E-cadherin expression reverted to the unstimulated level, suggesting incomplete and reversible transdifferentiation. Addition of TGF-β1 to cells grown on type I collagen demonstrated a cooperatively increased α-SMA expression and decreased E-cadherin and cytokeratin expressions, suggesting more complete transdifferentiation. Co-stimulation of TGF-β1 and contact with type I collagen led to a stable cell phenotype and persistently decreased E-cadherin, which was not reversed upon removal of TGF-β1, indicating irreversible transdifferentiation. Addition of TGF-β1 or type I collagen caused a 4-fold increase in migratory cell number as compared to the control, whereas addition of both TGF-β1 and type I collagen led to an 11-fold increase. Conclusions TGF-β1 alone results in a reversible and incomplete transdifferentiation. The combination of TGF-β1 and exposure to type I collagen leads to an irreversible and complete PTC transdifferentiation.


      PubDate: 2016-05-17T16:25:35Z
       
  • Current and future alternative therapies for beta-thalassemia major

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): Edouard de Dreuzy, Kanit Bhukhai, Philippe Leboulch, Emmanuel Payen
      Beta-thalassemia is a group of frequent genetic disorders resulting in the synthesis of little or no β-globin chains. Novel approaches are being developed to correct the resulting α/β-globin chain imbalance, in an effort to move beyond the palliative management of this disease and the complications of its treatment (e.g. life-long red blood cell transfusion, iron chelation, splenectomy), which impose high costs on healthcare systems. Three approaches are envisaged: fetal globin gene reactivation by pharmacological compounds injected into patients throughout their lives, allogeneic hematopoietic stem cell transplantation (HSCT), and gene therapy. HSCT is currently the only treatment shown to provide an effective, definitive cure for β-thalassemia. However, this procedure remains risky and histocompatible donors are identified for only a small fraction of patients. New pharmacological compounds are being tested, but none has yet made it into common clinical practice for the treatment of beta-thalassemia major. Gene therapy is in the experimental phase. It is emerging as a powerful approach without the immunological complications of HSCT, but with other possible drawbacks. Rapid progress is being made in this field, and long-term efficacy and safety studies are underway.


      PubDate: 2016-05-17T16:25:35Z
       
  • Helicobacter pylori infection: An overview of bacterial virulence factors
           and pathogenesis

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): Cheng-Yen Kao, Bor-Shyang Sheu, Jiunn-Jong Wu
      Helicobacter pylori pathogenesis and disease outcomes are mediated by a complex interplay between bacterial virulence factors, host, and environmental factors. After H. pylori enters the host stomach, four steps are critical for bacteria to establish successful colonization, persistent infection, and disease pathogenesis: (1) Survival in the acidic stomach; (2) movement toward epithelium cells by flagella-mediated motility; (3) attachment to host cells by adhesins/receptors interaction; (4) causing tissue damage by toxin release. Over the past 20 years, the understanding of H. pylori pathogenesis has been improved by studies focusing on the host and bacterial factors through epidemiology researches and molecular mechanism investigations. These include studies identifying the roles of novel virulence factors and their association with different disease outcomes, especially the bacterial adhesins, cag pathogenicity island, and vacuolating cytotoxin. Recently, the development of large-scale screening methods, including proteomic, and transcriptomic tools, has been used to determine the complex gene regulatory networks in H. pylori. In addition, a more available complete genomic database of H. pylori strains isolated from patients with different gastrointestinal diseases worldwide is helpful to characterize this bacterium. This review highlights the key findings of H. pylori virulence factors reported over the past 20 years.


      PubDate: 2016-05-17T16:25:35Z
       
  • New mechanisms of bacterial arsenic resistance

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): Hung-Chi Yang, Barry P. Rosen
      Arsenic is the most pervasive environmental substance and is classified by the International Agency for Research on Cancer as a Group 1 human carcinogen. Nearly every organism has resistance pathways for inorganic arsenic, and in bacteria, their genes are found in arsenic resistance (ars) operons. Recently, a parallel pathway for organic arsenicals has been identified. The ars genes responsible for the organoarsenical detoxification includes arsM, which encodes an As(III) S-adenosylmethionine methyltransferase, arsI, which encodes a C–As bond lyase, and arsH, which encodes a methylarsenite oxidase. The identification and properties of arsM, arsI and arsH are described in this review.


      PubDate: 2016-05-17T16:25:35Z
       
  • Helicobacter pylori's road to colonization

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): Emma Louise Walton
      In this issue of the Biomedical Journal we learn about the virulence factors that have made Helicobacter pylori such a successful pathogen. We also highlight some in vitro findings that may shed light on epithelial–mesenchymal transition that occurs during renal fibrosis. This issue also includes the findings of clinical trials testing the effectiveness of drugs to limit nausea in chemotherapy patients and the symptoms of alcohol withdrawal syndrome.


      PubDate: 2016-05-17T16:25:35Z
       
  • Combination of palonosetron, aprepitant, and dexamethasone as primary
           antiemetic prophylaxis for cisplatin-based chemotherapy

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): Chan-Keng Yang, Chiao-En Wu, Chuang-Chi Liaw
      Background The purpose of this study was to evaluate the efficacy of combined treatment with the long-acting 5-hydroxytryptamine receptor-3 antagonist, palonosetron, the neurokinin-1 receptor antagonist, oral aprepitant, and dexamethasone as primary antiemetic prophylaxis for cancer patients receiving highly emetogenic cisplatin-based chemotherapy. Methods Chemotherapy-naïve patients received the triple combination of palonosetron (0.25 mg), aprepitant (125 mg on day 1 and 80 mg on days 2 and 3), and dexamethasone (20 mg) from the beginning of highly emetogenic chemotherapy with cisplatin-based (≥50 mg/m2) regimens. The primary endpoint was a complete response (no emetic episodes and no rescue antiemetics) during the days 1–6. Results Sixty-nine hospitalized patients receiving chemotherapy from September 2012 to October 2014 were analyzed. Complete response of vomiting and nausea-free was achieved in 97.1% and 85.5% of patients in the first cycle, respectively, and 96.7% and 83.6% of patients in the second cycle, respectively. Common adverse events in all 69 patients included constipation (43%), hiccup (26%), and headache (4%). Conclusion The combination of palonosetron, aprepitant, and dexamethasone as primary antiemetic prophylaxis for cancer patients with highly emetogenic cisplatin-based chemotherapy is effective.


      PubDate: 2016-05-17T16:25:35Z
       
  • Factors affect stability of intertrochanteric fractures when elderly
           patients fall

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): Po-Han Chen, Chi-Chuan Wu, Wen-Jer Chen
      Background Factors affecting the stability of intertrochanteric fractures when elderly patients fall are few to be reported. In this retrospective study, possible factors were investigated. Methods Two hundred and twenty-three consecutive elderly patients (≥65 years) with intertrochanteric fractures due to low energy injuries were studied. Patient age, gender, body mass index (BMI), body weight and height were compared between fractures with stable (AO/OTA type A1, intact lesser trochanter, 80 patients) and unstable (AO/OTA types A2, A3, displaced lesser trochanter or reverse obliquity fractures, 143 patients) types. Statistical approaches with univariate and multivariate analyses were performed. Results There was no statistical difference in patient gender, age, body weight or height between patients with stable and unstable fractures in both univariate and multivariate analysis. However, BMI was statistically higher in patients with unstable fractures (22.7 vs 21.4, p = 0.01) in univariate analysis, but without a difference in multivariate analysis (p = 0.07). Conclusions Stability of intertrochanteric fractures may be not associated with gender, age, body weight and height or BMI when elderly patients fall. Bone mineral density or impact direction may be other possible contributing factors but requires further proofs.


      PubDate: 2016-05-17T16:25:35Z
       
  • A randomized, open-label, standard controlled, parallel group study of
           efficacy and safety of baclofen, and chlordiazepoxide in uncomplicated
           alcohol withdrawal syndrome

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): K. Girish, K. Vikram Reddy, Lakshmi V. Pandit, H.P. Pundarikaksha, R. Vijendra, K. Vasundara, R. Manjunatha, Moulya Nagraj, R. Shruthi
      Background Alcohol withdrawal syndrome (AWS) is a distressing condition, generally controlled by benzodiazepines (BZD's). Baclofen, a gamma-aminobutyric acid-B (GABAB) agonist, has also shown promising results in controlling AWS. As there are few studies comparing the efficacy and tolerability of chlordiazepoxide with baclofen, the present study was taken up. The objective of this study was to compare efficacy and tolerability of baclofen with chlordiazepoxide in uncomplicated AWS. Methods Sixty subjects with uncomplicated AWS were randomized into two groups of 30 each, to receive baclofen (30 mg) or chlordiazepoxide (75 mg) in decremented fixed dose regime for 9 days. Clinical efficacy was assessed by Clinical Institute Withdrawal Assessment for Alcohol-Revised Scale (CIWA-Ar) and tolerability by the nature and severity of adverse events. Lorazepam was used as rescue medication. Secondary efficacy parameters were Clinical Global Impression scores, symptom-free days, and subject satisfaction as assessed by visual analog scale. This study was registered with Clinical Trial Registry-India (CTRI/2013/04/003588), also subsequently registered with WHO's ICTRP clinical trial portal. Results Both baclofen and chlordiazepoxide showed a consistent reduction in the total CIWA-Ar scores. However, chlordiazepoxide showed a faster and a more effective control of anxiety and agitation requiring lesser lorazepam supplementation, and also showed a better subject satisfaction compared to baclofen. Both the drugs showed good tolerability with mild self-limiting adverse events. Conclusion The present study demonstrates that baclofen is not as good as chlordiazepoxide in the treatment of uncomplicated AWS. However, baclofen might be considered as an alternative.


      PubDate: 2016-05-17T16:25:35Z
       
  • Effects of long-term light, darkness and oral administration of melatonin
           on serum levels of melatonin

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): Naser Farhadi, Majid Gharghani, Zahra Farhadi
      Background Continuous light or darkness has various effects on different systems. In the present research work, the effects of constant light and darkness exposure of male rats and oral administration of exogenous melatonin on the serum levels of melatonin have been studied. Methods Thirty adult male Wistar rats were divided into six groups of: (1) Control, (2) melatonin, (3) light, (4) light and melatonin, (5) darkness, and (6) darkness and melatonin. All groups were placed according to light conditions for 10 days. Melatonin was administered orally after a period of 10 days to Groups 2, 4, and 6 (10 mg/kg of body weight). Serum levels of melatonin were measured using ELISA. Results The results showed the significant difference on serum melatonin in darkness, no light, and control groups. Although serum levels of melatonin were different in melatonin groups, the difference is not significant. Conclusions We concluded that being exposed to continuous darkness leads to an increase in serum melatonin.


      PubDate: 2016-05-17T16:25:35Z
       
  • Type 4 renal tubular acidosis in a kidney transplant recipient

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): Manjunath Kulkarni
      We report a case of a 66-year-old diabetic patient who presented with muscle weakness 2 weeks after kidney transplantation. Her immunosuppressive regimen included tacrolimus, mycophenolate mofetil, and steroids. She was found to have hyperkalemia and normal anion gap metabolic acidosis. Tacrolimus levels were in therapeutic range. All other drugs such as beta blockers and trimethoprim – sulfamethoxazole were stopped. She did not respond to routine antikalemic measures. Further evaluation revealed type 4 renal tubular acidosis. Serum potassium levels returned to normal after starting sodium bicarbonate and fludrocortisone therapy. Though hyperkalemia is common in kidney transplant recipients, determining exact cause can guide specific treatment.


      PubDate: 2016-05-17T16:25:35Z
       
  • Reply to: “Medical record review for faculty promotion: A cohort
           analysis”

    • Abstract: Publication date: February 2016
      Source:Biomedical Journal, Volume 39, Issue 1
      Author(s): B.V. Murlimanju



      PubDate: 2016-05-17T16:25:35Z
       
  • The two faces of invariant natural killer T cells

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): Emma L. Walton
      In this issue of the Biomedical Journal, we take a look at some of the immune system's most peculiar cells, invariant natural killer T cells, which have features of both innate and adaptive cells. We also highlight a clinical study revealing that high serum phosphate levels could show that it's time to start dialysis in patients with chronic kidney diseases. Finally, this issue also includes some case reports, including an unusual case of aspergillosis related to long-term inhaler use.


      PubDate: 2016-05-17T16:25:35Z
       
  • Natural killer T cells

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): Jean Kanellopoulos



      PubDate: 2016-05-17T16:25:35Z
       
  • Antigen specificity of invariant natural killer T-cells

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): Alysia M. Birkholz, Mitchell Kronenberg
      Natural killer T-cells, with an invariant T-cell antigen receptor α-chain (iNKT cells), are unique and conserved subset of lymphocytes capable of altering the immune system through their rapid and potent cytokine responses. They are reactive to lipid antigens presented by the CD1d molecule, an antigen-presenting molecule that is not highly polymorphic. iNKT cell responses frequently involve mixtures of cytokines that work against each other, and therefore attempts are underway to develop synthetic antigens that elicit only strong interferon-gamma (IFNγ) or only strong interleukin-4 responses but not both. Strong IFNγ responses may correlate with tighter binding to CD1d and prolonged stimulation of iNKT cells, and this may be useful for vaccine adjuvants and for stimulating anti-tumor responses. iNKT cells are self-reactive although the structure of the endogenous antigen is controversial. By contrast, bacterial and fungal lipids that engage the T-cell receptor and activate IFNγ from iNKT cells have been identified from both pathogenic and commensal organisms and the responses are in some cases highly protective from pathogens in mice. It is possible that the expanding knowledge of iNKT cell antigens and iNKT cell activation will provide the basis for therapies for patients suffering from infectious and immune diseases and cancer.


      PubDate: 2016-05-17T16:25:35Z
       
  • Regulatory role of natural killer T cells in diabetes

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): Celine Tard, Ophelie Rouxel, Agnes Lehuen
      Type 1 and type 2 diabetes are growing public health problems. Despite having different pathophysiologies, both diseases are associated with defects in immune regulation. Invariant natural killer T (iNKT) cells are innate-like T cells that recognize glycolipids presented by CD1d. These cells not only play a key role in the defense against pathogens, but also exert potent immunoregulatory functions. The regulatory role of iNKT cells in the prevention of type 1 diabetes has been demonstrated in murine models and analyzed in diabetic patients. The decreased frequency of iNKT cells in non-obese diabetic mice initially suggested the regulatory role of this cell subset. Increasing the frequency or the activation of iNKT cells with agonists protects non-obese diabetic mice from the development of diabetes. Several mechanisms mediate iNKT regulatory functions. They can rapidly produce immunoregulatory cytokines, interleukin (IL)-4 and IL-10. They induce tolerogenic dendritic cells, thereby inducing the anergy of autoreactive anti-islet T cells and increasing the frequency of T regulatory cells (Treg cells). Synthetic agonists are able to activate iNKT cells and represent potential therapeutic treatment in order to prevent type 1 diabetes. Growing evidence points to a role of immune system in glucose intolerance and type 2 diabetes. iNKT cells are resident cells of adipose tissue and their local and systemic frequencies are reduced in obese patients, suggesting their involvement in local and systemic inflammation during obesity. With the discovery of potential continuity between type 1 and type 2 diabetes in some patients, the role of iNKT cells in these diseases deserves further investigation.


      PubDate: 2016-05-17T16:25:35Z
       
  • Shared neurocircuitry underlying feeding and drugs of abuse in Drosophila

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): Dan Landayan, Fred W. Wolf
      The neural circuitry and molecules that control the rewarding properties of food and drugs of abuse appear to partially overlap in the mammalian brain. This has raised questions about the extent of the overlap and the precise role of specific circuit elements in reward and in other behaviors associated with feeding regulation and drug responses. The much simpler brain of invertebrates including the fruit fly Drosophila, offers an opportunity to make high-resolution maps of the circuits and molecules that govern behavior. Recent progress in Drosophila has revealed not only some common substrates for the actions of drugs of abuse and for the regulation of feeding, but also a remarkable level of conservation with vertebrates for key neuromodulatory transmitters. We speculate that Drosophila may serve as a model for distinguishing the neural mechanisms underlying normal and pathological motivational states that will be applicable to mammals.


      PubDate: 2016-05-17T16:25:35Z
       
  • The challenges of amblyopia treatment

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): Gail D.E. Maconachie, Irene Gottlob
      The treatment of amblyopia, particularly anisometropic (difference in refractive correction) and/or strabismic (turn of one eye) amblyopia has long been a challenge for many clinicians. Achieving optimum outcomes, where the amblyopic eye reaches a visual acuity similar to the fellow eye, is often impossible in many patients. Part of this challenge has resulted from a previous lack of scientific evidence for amblyopia treatment that was highlight by a systematic review by Snowdon et al. in 1998. Since this review, a number of publications have revealed new findings in the treatment of amblyopia. This includes the finding that less intensive occlusion treatments can be successful in treating amblyopia. A relationship between adherence to treatment and visual acuity has also been established and has been shown to be influenced by the use of intervention material. In addition, there is growing evidence of that a period of glasses wearing only can significantly improve visual acuity alone without any other modes of treatment. This review article reports findings since the Snowdon's report.


      PubDate: 2016-05-17T16:25:35Z
       
  • A study of malignancy rates in different diagnostic categories of the
           Bethesda system for reporting thyroid cytopathology: An institutional
           experience

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): P. Arul, C. Akshatha, Suresh Masilamani
      Background The Bethesda system for reporting thyroid cytopathology (TBSRTC) was introduced to standardize the communication of fine-needle aspiration cytology (FNAC) interpretation between clinicians and pathologists. This study was undertaken to evaluate the diagnostic utility of TBSRTC for reporting thyroid FNACs and rate of malignancy in each diagnostic category of TBSRTC. Methods A total of 603 thyroid FNAC results were retrieved retrospectively between July 2012 and January 2015 and reclassified according to TBSRTC. Of these, 392 cases had a histopathological follow-up. The FNACs results were compared to the histopathological diagnoses and the malignancy rates of each diagnostic categories of TBSRTC were calculated. Results Of the 603 FNACs, nondiagnostic were 16 (2.7%), benign were 393 (65.2%), atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) were 60 (10%), follicular neoplasm/suspicious for a follicular neoplasm (FN/SFN) were 64 (10.6%), suspicious for malignancy (SM) were 32 (5.3%), and malignant were 38 (6.3%). In 392 cases, there was follow-up histopathology. The malignancy rate for nondiagnostic, benign, AUS/FLUS, FN/SFN, SM, and malignant categories were 0%, 0.8%, 24.4%, 28.9%, 70.8%, and 100%, respectively. Conclusion Our study validated the efficacy of TBSRTC. In conclusion, the malignancy rate of AUS/FLUS in this study was higher than the risk mentioned in TBSRTC and other published studies. Hence, AUS/FLUS category patients in our setup warrant further workup including ultrasound and/or thyroid scan in addition to immediate repeat FNAC.


      PubDate: 2016-05-17T16:25:35Z
       
  • Predictive value of circulating osteonectin in patients with ischemic
           symptomatic chronic heart failure

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): Alexander E. Berezin, Alexander A. Kremzer
      Background Osteonectin (OSN) plays a pivotal role in cardiac remodeling, but predictive value for OSN in ischemic chronic heart failure (CHF) has not been defined. The aim of the study was to evaluate the prognostic value of OSN for cumulative survival and hospitalization among patients with ischemic-induced CHF. Methods A total of 154 patients with ischemic symptomatic moderate-to-severe CHF were enrolled in the study at discharge from the hospital. Observation period was up to 3 years (156 weeks). Blood samples for biomarkers measurements were collected at baseline prior to study entry. ELISA methods for measurements of circulating level of OSN were used. Results During a median follow-up of 2.18 years, 21 participants died and 106 subjects were re-admitted. Medians of circulating levels of OSN in survival and died patient cohorts were 670.96 ng/mL (95% confidence interval [CI] = 636.53–705.35 ng/mL) and 907.84 ng/mL (95% CI = 878.02–937.60 ng/mL). Receiver operation characteristic curve analysis has shown that cut off point of OSN concentration for cumulative survival function was 845.15 ng/mL. It has been found a significant divergence of Kaplan–Meier survival curves in patients with high (>845.15 ng/mL) and low (<845.15 ng/mL) concentrations of OSN. Circulating OSN independently predicted all-cause mortality (odds ratio [OR] = 1.23; 95% CI = 1.10–1.36; p < 0.001), CHF-related death (OR = 1.46; 95% CI = 1.22–1.80; p < 0.001), and also CHF-related re-admission (OR = 1.92; 95% CI = 1.77–2.45; p < 0.001) within 3 years of observation period. Conclusion Increased circulating secreted protein acidic and rich in cysteine family member OSN associates with increased 3-year CHF-related death, all-cause mortality, and risk for recurrent hospitalization due to CHF.


      PubDate: 2016-05-17T16:25:35Z
       
  • Serum phosphate as an additional marker for initiating hemodialysis in
           patients with advanced chronic kidney disease

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): Yueh-An Lu, Shen-Yang Lee, Hui-Yi Lin, Yen-Chun Liu, Huang-Kai Kao, Yung-Chang Chen, Ya-Chung Tian, Cheng-Chieh Hung, Chih-Wei Yang, Hsiang-Hao Hsu
      Background Reconsidering when to initiate renal replacement therapy (RRT) in patients with chronic kidney disease (CKD) has been emphasized recently. With evolving modern aged and diabetes-prone populations, conventional markers of uremia are not sufficient for determining the optimal timing for dialysis initiation. This retrospective cohort study examined the association between hyperphosphatemia and uremic patients who need RRT registration. Methods All patients from the department of nephrology in one tertiary medical center in northern Taiwan who had advanced CKD and estimated glomerular filtration rates <8 mL/min/1.73 m2 from July 2009 to May 2013 were enrolled. We reviewed the medical records and collected data on demographics, comorbidities, underlying diseases, duration of nephrology care, use of phosphate binders, and laboratory results. Univariable and multivariable logistic regression models were used to identify factors associated with hemodialysis initiation decision making. Results During the study period, 209 of 292 patients with advanced CKD were enrolled in hemodialysis program and 83 patients (controls) were not. Univariable analysis indicated that male sex, current smoking, diabetes mellitus, hypertension, coronary artery disease, high serum creatinine level, and high serum phosphate level were associated with initiation of hemodialysis. Multivariable analysis indicated that those with higher serum phosphate level (odds ratio [OR] = 2.4, 95% confidence interval [CI] = 1.6–3.5, p = 1.4 × 10−5) and being in nephrology care for <12 months (OR = 0.4, 95% CI = 0.2–0.8, p = 0.016) tended to be significant markers for hemodialysis initiation. Conclusion Hyperphosphatemia, in addition to conventional laboratory markers and uremic symptoms, may be a useful marker to determine timing of hemodialysis initiation in patients with advanced CKD.


      PubDate: 2016-05-17T16:25:35Z
       
  • No benefit on functional outcomes and dislocation rates by increasing head
           size to 36 mm in ceramic-on-ceramic total hip arthroplasty

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): Yu-Der Lu, Shih-Hsiang Yen, Feng-Chih Kuo, Jun-Wen Wang, Ching-Jen Wang
      Background Ceramic-on-ceramic (COC) total hip arthroplasty (THA) has gained popularity since improvements in wear characteristics and longevity. Whether large ceramic femoral heads (≥36 mm) have increased postoperative range of motion (ROM) and a lower dislocation rate is not clear. This study aimed to compare functional outcomes and early complications between large-head (≥36 mm) and smaller-head (≤32 mm) COC prostheses with a minimum follow-up of 12 months. Methods A total of 95 consecutive uncemented COC THAs were performed in 90 patients between January 2012 and July 2013. Of these, 49 patients (smaller-head group) received third generation and 41 patients (large-head group) received fourth generation COC prostheses. Harris hip score (HHS), Western Ontario and McMaster Universities Arthritis index (WOMAC), and ROM of the hip pre- and post-operatively were compared, as well as the presence of early complications. Results Postoperative HHSs (88.4 vs. 89.3, p = 0.34) and WOMAC scores (12.0 vs. 11.0, p = 0.111) were not different between the groups. Postoperative flexion ROM was lower in the smaller-head group (98.8° vs. 106.1°, p < 0.001), but there were no differences in extension, abduction, adduction, internal rotation, and external rotation. One patient in each group reported a grinding noise. There was one dislocation (1.9%) in the smaller-head group, and none in the large-head group (p = 0.371). No infections or loosening of the components occurred. Conclusions Large-head COC articulation provided better flexion, but functional outcomes and early complications are similar to the smaller-head COC.


      PubDate: 2016-05-17T16:25:35Z
       
  • Comparing the outcomes of different postgraduate year training programs in
           Taiwan

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): Peng-Wei Hsu, Ming-Ju Hsieh, Ren-Huei Fu, Jing-Long Huang, Mei-Chen Liao, Shih-Tseng Lee
      Background Postgraduate year training programs play an important role in the development of a comprehensive medical education. The goal of these training programs is to inculcate in physicians the expected level of skill in patient care. After the initiation of such programs in the USA, Europe, and Japan, studies were conducted in Taiwan to investigate relevant training methods, and a training system was established in 2003. Beginning with 3-month programs, followed by 6-month programs, the programs were constantly modified and enhanced by the establishment of the 1-year training program in 2011. This year was the transition period from the 6-month programs to the 1-year programs. Methods We used a 50-item multiple choice question (MCQ) test and six 10-min stations for objective structured clinical examination (OSCE), which was composed of four stations relating to standardized patients and two stations concerning the clinical skill evaluation, to evaluate the learning results of the trainees. The trainees were divided into four groups according to the training program. Results There was no significant difference between the performance of the 6 months and 1-year groups. The p values were 0.424 in the MCQ test and 0.082 in the OSCE evaluation. Conclusion A well-designed postgraduate training program should develop trainees’ competencies. The results of this study may provide useful insight for ways to improve the design of training programs. Further investigation to better understand the impact of different programs is warranted.


      PubDate: 2016-05-17T16:25:35Z
       
  • Primary aspergillosis of vocal cord: Long-term inhalational steroid use
           can be the miscreant

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): Arpita Saha, Kaushik Saha, Uttara Chatterjee
      Primary laryngeal aspergillosis is extremely rare, especially in an immunocompetent host. It is commonly found as a part of systemic infection in immunocompromised patients. A case of vocal cord aspergillosis with no systemic extension in an immunocompetent patient on long-term steroid metered dose inhaler (MDI) is presented here, because of its rarity. The present case is a 28-year-old asthmatic female who was on inhalational steroid for 8 years, presented with sudden onset of severe dysphonia for 5 days. Fiberoptic laryngoscopy demonstrated whitish plaque involving right vocal cord, clinically suggestive of fungal laryngitis. Microlaryngeal laser surgery was performed with stripping of the plaque. Histopathology demonstrated ulcerated hyperplastic squamous epithelium with masses of fungal hyphae, which was confirmed to be Aspergillus species on fungal culture. This rare but serious adverse effect of long-term steroid MDI use must be kept in mind while treating an asthmatic patient. We also present a brief review of literature of laryngeal aspergillosis.


      PubDate: 2016-05-17T16:25:35Z
       
  • A trigger-happy soldier with bilateral ptosis and dysphagia

    • Abstract: Publication date: December 2015
      Source:Biomedical Journal, Volume 38, Issue 6
      Author(s): F.M.H. Ahmad, K.V.S. Hari Kumar
      Muscular dystrophy encompasses a group of disorders characterized by the progressive weakness of the skeletal muscles. These disorders are mostly inherited and have characteristic age and muscle group predilection. Lingual muscle involvement is an unusual feature in patients with the muscular dystrophy and helps in the differential diagnosis. We recently encountered a serving soldier presenting with complaints of bilateral ptosis and dysphagia of 5 years duration. Examination showed bilateral ptosis, percussion myotonia, generalized muscular atrophy including that of tongue muscles, and a characteristic hatchet facies. Investigations revealed elevated creatine kinase and myotonic discharges on electromyography leading to a diagnosis of myotonic dystrophy type 1. Muscular dystrophy has a varied presentation and can pose a diagnostic problem in clinical practice. We present the case to highlight the differential diagnosis of tongue atrophy in patients with muscular dystrophy.


      PubDate: 2016-05-17T16:25:35Z
       
 
 
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