Immigration issue boosts Brewer in Arizona race

PHOENIX – As the year began, Arizona Gov. Jan Brewer faced a competitive field of fellow Republicans who wanted her job, with some GOP critics sensing she was particularly vulnerable as she sought voter approval of a sales tax increase she’d proposed to shore up the state budget.

Report: Fido’s Food Could Make Kids Sick

Fido’s food may be making kids sick, a government report warns, detailing the first known salmonella outbreak in humans, mostly young children, linked to pet food.

NC schools begin new sex ed programs

North Carolina teachers are preparing for new sex education classes that will give students more information about contraceptives than in previous years.

Girls’ early puberty raises health concerns

American girls are hitting puberty earlier than ever – a change that puts them at higher risk for behavioral problems as adolescents and breast cancer as adults, a new study shows.

Effectiveness Of Statins In Question

As the world’s most-prescribed class of medications, statins indisputably qualify for the commercial distinction of “blockbuster.” About 24 million Americans take the drugs – marketed under such commercial names as Pravachol, Mevacor, Lipitor, Zocor and Crestor – largely to stave off heart attacks and strokes.

Sorting when early memory loss signals big threat

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E-cigarette maker agrees to halt sales in Oregon

A leading distributor of electronic cigarettes has agreed to halt sales in Oregon, Attorney General John Kroger announced Monday.

Large waistline link to early death

A fat belly can be fatal, a study involving many thousands of men and women has revealed.

Swine Flu Pandemic Over? WHO To Decide

The World Health Organization says it will likely decide Tuesday whether to declare the swine flu pandemic over.

Law snuffs out mailing smokes to deployed troops

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6 Simple Tricks That Help Smokers Quit

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WHO: Swine Flu Pandemic Over

The World Health Organization says the swine flu pandemic is over. WHO Director-General Margaret Chan says the world is now moving into the “post-pandemic” phase.

Heart transplant

Description: heart transplant surgery on Christopher Schroeder at Arkansas Children’s Hospital.

Gray matter reduction associated with systemic chemotherapy for breast cancer: a prospective MRI study

Abstract  

Brain gray matter alterations have been reported in cross-sectional magnetic resonance imaging (MRI) studies of breast cancer
patients after cancer treatment. Here we report the first prospective MRI study of women undergoing treatment for breast cancer,
with or without chemotherapy, as well as healthy controls. We hypothesized that chemotherapy-associated changes in gray matter
density would be detectable 1 month after treatment, with partial recovery 1 year later. Participants included breast cancer
patients treated with (CTx+, N = 17) or without (CTx?, N = 12) chemotherapy and matched healthy controls (N = 18). MRI scans were acquired at baseline (after surgery but before radiation, chemotherapy, and/or anti-estrogen treatment),
1 month after completion of chemotherapy (M1), and 1 year later (Y1). Voxel-based morphometry (VBM) was used to evaluate gray
matter density differences between groups and over time. There were no between-group gray matter differences at baseline.
Group-by-time interactions showed declines from baseline to M1 in both cancer groups relative to controls. Within-group analyses
indicated that at M1 relative to baseline the CTx+ group had decreased gray matter density in bilateral frontal, temporal,
and cerebellar regions and right thalamus. Recovery was seen at Y1 in some regions, although persistent decreases were also
apparent. No significant within-group changes were found in the CTx? or control groups. Findings were not attributable to
recency of cancer surgery, disease stage, psychiatric symptoms, psychotropic medication use, or hormonal treatment status.
This study is the first to use a prospective, longitudinal approach to document decreased brain gray matter density shortly
after breast cancer chemotherapy and its course of recovery over time. These gray matter alterations appear primarily related
to the effects of chemotherapy, rather than solely reflecting host factors, the cancer disease process, or effects of other
cancer treatments.

• Content Type Journal Article
• DOI 10.1007/s10549-010-1088-4
• Authors
  • Brenna C. McDonald, Center for Neuroimaging, Department of Radiology and Imaging Sciences and the Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, 950 W. Walnut St., R2 E124, Indianapolis, IN 46202, USA
  • Susan K. Conroy, Center for Neuroimaging, Department of Radiology and Imaging Sciences and the Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, 950 W. Walnut St., R2 E124, Indianapolis, IN 46202, USA
  • Tim A. Ahles, Department of Psychiatry and the Norris Cotton Cancer Center, Dartmouth Medical School, Hanover, NH USA
  • John D. West, Center for Neuroimaging, Department of Radiology and Imaging Sciences and the Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, 950 W. Walnut St., R2 E124, Indianapolis, IN 46202, USA
  • Andrew J. Saykin, Center for Neuroimaging, Department of Radiology and Imaging Sciences and the Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, 950 W. Walnut St., R2 E124, Indianapolis, IN 46202, USA

• Journal Breast Cancer Research and Treatment
• Online ISSN 1573-7217
• Print ISSN 0167-6806

Reply to Tejani and Schwenger

Reply to Tejani and Schwenger

• Content Type Journal Article
• DOI 10.1007/s00134-010-2011-5
• Authors
  • Kwok M. Ho, Intensive Care Unit, Royal Perth Hospital, School of Population Health, University of Western Australia, Perth, WA Australia

• Journal Intensive Care Medicine
• Online ISSN 1432-1238
• Print ISSN 0342-4642

Reorganising the pandemic triage processes to ethically maximise individuals’ best interests

Abstract

Purpose  

To provide a revised definition, process and purpose of triage to maximise the number of patients receiving intensive care
during a crisis.

Methods  

Based on the ethical principle of virtue ethics and the underlying goal of providing individual patients with treatment according
to their best interests, the methodology of triage is reassessed and revised.

Results  

The decision making processes regarding treatment decisions during a pandemic are redefined and new methods of intensive care
provision recommended as well as recommending the use of a 'ranking' system for patients excluded from intensive care, defining
the role of non-intensive care specialists, and applying two types of triage as 'organisational triage' and 'treatment triage'
based on the demand for intensive care.

Conclusion  

Using a different underlying ethical basis upon which to plan for a pandemic crisis could maximise the number of patients
receiving intensive care based on individual patients' best interests.

• Content Type Journal Article
• DOI 10.1007/s00134-010-1986-2
• Authors
  • Andrew Tillyard, Derriford Hospital, Plymouth, UK

• Journal Intensive Care Medicine
• Online ISSN 1432-1238
• Print ISSN 0342-4642

Low and “supranormal” central venous oxygen saturation and markers of tissue hypoxia in cardiac surgery patients: a prospective observational study

Abstract

Purpose  

To characterize incidence of low, normal and "supranormal" central venous oxygen saturation (ScvO₂) and the relation to markers of tissue hypoxia, course and outcome in cardiac surgery patients.

Methods  

Prospective, observational study in a university multidisciplinary 50-bed intensive care unit including 205 consecutive patients
undergoing elective cardiac surgery. Data were split into training and test data sets and subjected to 50 replications of
fivefold cross-validation to estimate lower and upper bounds of ScvO₂ indicative of impaired tissue oxygenation.

Results  

Both low (?60.8%) and supranormal (?77.4%) ScvO₂ were associated with an unfavorable course, while the logistic EuroSCORE for risk adjustment was comparable between groups.
Incidences of abnormal ScvO₂ were 13.2% low and 30.7% supranormal. Patients with low ScvO₂ and an uneventful course initially presented with normal lactate levels, whereas patients with supranormal ScvO₂ displayed consistently higher serum lactate levels. High ScvO₂ values were associated with the use of ?-mimetics and signs of systemic inflammation. Mortality rates were comparable for
patient populations presenting either low (14.8%) or supranormal ScvO₂ (7.9%) and higher than normals (0%, p < 0.001). Lactate was comparably increased in patients that ultimately died, irrespective whether they had low or supranormal
ScvO₂ values. In contrast, neither low nor supranormal ScvO₂ was associated with altered gastric pCO_2.

Conclusions  

High ScvO₂ is an under-recognized warning sign for impaired tissue oxygenation in the peri-operative period. Including values ?77.4%
as 'normal' impaired performance of ScvO₂ monitoring to predict a complicated perioperative course.

• Content Type Journal Article
• DOI 10.1007/s00134-010-1980-8
• Authors
  • Suzanne Perz, Department of Anesthesiology and Critical Care Therapy, Jena University Hospital, 07740 Jena, Germany
  • Thomas Uhlig, Department of Anesthesiology and Critical Care Therapy, Jena University Hospital, 07740 Jena, Germany
  • Matthias Kohl, Department of Anesthesiology and Critical Care Therapy, Jena University Hospital, 07740 Jena, Germany
  • Donald L. Bredle, Department of Kinesiology, University of Wisconsin, Eau Claire, WI 54702, USA
  • Konrad Reinhart, Department of Anesthesiology and Critical Care Therapy, Jena University Hospital, 07740 Jena, Germany
  • Michael Bauer, Department of Anesthesiology and Critical Care Therapy, Jena University Hospital, 07740 Jena, Germany
  • Andreas Kortgen, Department of Anesthesiology and Critical Care Therapy, Jena University Hospital, 07740 Jena, Germany

• Journal Intensive Care Medicine
• Online ISSN 1432-1238
• Print ISSN 0342-4642

Transcranial Doppler for brain death after decompressive craniectomy: persistence of cerebral blood flow with flat EEG

Transcranial Doppler for brain death after decompressive craniectomy: persistence of cerebral blood flow with flat EEG

• Content Type Journal Article
• DOI 10.1007/s00134-010-2008-0
• Authors
  • E. Vicenzini, Department of Neurosciences, Sapienza University of Rome, Viale dell'Universita 30, 00185 Rome, Italy
  • S. Pro, Department of Neurosciences, Sapienza University of Rome, Viale dell'Universita 30, 00185 Rome, Italy
  • F. Randi, Department of Neurosciences, Sapienza University of Rome, Viale dell'Universita 30, 00185 Rome, Italy
  • P. Pulitano, Department of Neurosciences, Sapienza University of Rome, Viale dell'Universita 30, 00185 Rome, Italy
  • G. Spadetta, Intensive Care Unit, Sapienza University of Rome, Rome, Italy
  • M. Rocco, Intensive Care Unit, Sapienza University of Rome, Rome, Italy
  • V. Di Piero, Department of Neurosciences, Sapienza University of Rome, Viale dell'Universita 30, 00185 Rome, Italy
  • G. L. Lenzi, Department of Neurosciences, Sapienza University of Rome, Viale dell'Universita 30, 00185 Rome, Italy
  • O. Mecarelli, Department of Neurosciences, Sapienza University of Rome, Viale dell'Universita 30, 00185 Rome, Italy

• Journal Intensive Care Medicine
• Online ISSN 1432-1238
• Print ISSN 0342-4642

Secondary adrenal insufficiency in the acute phase of pediatric traumatic brain injury

Abstract

Purpose  

A high incidence of secondary adrenal insufficiency (AI) has been reported several months after a traumatic brain injury (TBI)
in pediatric patients. Data from studies in adults suggest that AI may occur during the acute phase of TBI, with potential
negative effects in the management of these vulnerable patients. The aim of this study was to describe the prevalence and
the characteristics of AI in the acute phase of pediatric TBI.

Methods  

Adrenal function was systematically evaluated in patients admitted to the pediatric intensive care unit following a TBI. Serial
measurements of cortisol (9 samples) and adrenocorticotropic hormone (ACTH) were drawn from the second morning to the third
morning post admission. Secondary AI was defined as all cortisols <200 nmol/l (6 ?g/dl) with ACTH <12 pmol/l.

Results  

Twenty-eight patients (2–15 years old) were evaluated. Secondary AI occurred in ten (36%) patients. AI was more frequent in
patients with intracranial hypertension (p < 0.05). Patients with AI required longer mechanical ventilation (p < 0.05), and a non-significant trend for a higher Pediatric Logistic Organ Dysfunction score (p = 0.09) and greater norepinephrine dose (p = 0.11) was observed.

Conclusions  

Secondary AI is frequent during the acute phase of pediatric TBI, particularly when intracranial hypertension is present.
Systematic assessment of pituitary function after TBI appears to be essential. A randomized clinical trial is warranted to
evaluate the benefits of hormonal replacement therapy in TBI patients with AI.

• Content Type Journal Article
• DOI 10.1007/s00134-010-2012-4
• Authors
  • Clementine Dupuis, Department of Pediatrics, Pediatric Endocrinology, University Hospital of Grenoble, 38043 Grenoble Cedex 9, France
  • Sebastien Thomas, Pediatric Intensive Care Unit, University Hospital of Grenoble, 38043 Grenoble Cedex 9, France
  • Patrice Faure, Department of Integrated Biology, University Hospital of Grenoble, 38043 Grenoble Cedex 9, France
  • Armelle Gayot, Pediatric Intensive Care Unit, University Hospital of Grenoble, 38043 Grenoble Cedex 9, France
  • Amelie Desrumaux, Pediatric Intensive Care Unit, University Hospital of Grenoble, 38043 Grenoble Cedex 9, France
  • Isabelle Wroblewski, Pediatric Intensive Care Unit, University Hospital of Grenoble, 38043 Grenoble Cedex 9, France
  • Thierry Debillon, Pediatric Intensive Care Unit, University Hospital of Grenoble, 38043 Grenoble Cedex 9, France
  • Guillaume Emeriaud, Pediatric Intensive Care Unit, University Hospital of Grenoble, 38043 Grenoble Cedex 9, France

• Journal Intensive Care Medicine
• Online ISSN 1432-1238
• Print ISSN 0342-4642

Autoregulation of ventilation with neurally adjusted ventilatory assist on extracorporeal lung support

Abstract

Purpose  

Extracorporeal membrane oxygenation (ECMO) can support oxygenation and carbon dioxide elimination in severe lung failure.
Usually it is accompanied by controlled mechanical ventilation. Neurally adjusted ventilatory assist (NAVA) is a new mode
of ventilation triggered by the diaphragmatic electrical activity and controlled by the patient's respiratory centre, which
may allow a close interaction between ventilation and extracorporeal perfusion. This pilot study intended to measure the physiologic
ventilatory response in patients with severe lung failure treated with ECMO and NAVA. We hypothesized that the combination
of both methods could automatically provide a protective ventilation with optimized blood gases.

Methods  

We report a case series of six patients treated with ECMO for severe lung failure. In the recovery phase of the disease, patients
were ventilated with NAVA and ventilatory response and gas exchange parameters were measured under different sweep gas flows
and temporarily inactivated ECMO.

Results  

Tidal volumes on ECMO ranged between 2 and 5 ml/kg predicted body weight and increased up to 8 ml/kg with inactivated ECMO.
Peak inspiratory pressure reached 19–29 cmH₂O with active, and 21–45 cmH₂O with inactivated ECMO. Ventilatory response to decreased sweep gas flow was rapid, and patients immediately regulated PaCO₂ tightly towards a physiological pH value. Increase in minute ventilation was a result of increased breathing frequency and
tidal volumes, and protective ventilation was only abandoned if pH control was not achieved.

Conclusions  

With NAVA ventilatory response to decreased ECMO sweep gas flow was rapid, and patients immediately regulated PaCO₂ tightly towards a physiological pH value. Therefore, combination of NAVA and ECMO may permit a closed-loop ventilation with
automated protective ventilation.

• Content Type Journal Article
• DOI 10.1007/s00134-010-1982-6
• Authors
  • Christian Karagiannidis, Department of Internal Medicine II, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
  • Matthias Lubnow, Department of Internal Medicine II, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
  • Alois Philipp, Department of Cardiothoracic Surgery, University Hospital of Regensburg, Regensburg, Germany
  • Guenter A. J. Riegger, Department of Internal Medicine II, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
  • Christof Schmid, Department of Cardiothoracic Surgery, University Hospital of Regensburg, Regensburg, Germany
  • Michael Pfeifer, Department of Internal Medicine II, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
  • Thomas Mueller, Department of Internal Medicine II, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany

• Journal Intensive Care Medicine
• Online ISSN 1432-1238
• Print ISSN 0342-4642

Homeopathic doctor uses venom to treat Afghans

The hundreds of patients who flock to Mohammad Sherzad’s homeopathic clinic in northern Afghanistan are greeted with a glass case of snakes and a covered glass dish of scorpions.

Restoring arterial pressure with norepinephrine improves muscle tissue oxygenation assessed by near-infrared spectroscopy in severely hypotensive septic patients

Abstract

Purpose  

To examine the consequences of administration of norepinephrine on muscle tissue oxygenation in severely hypotensive septic
shock patients.

Methods  

This was a prospective observational study conducted in a medical intensive care unit of a university hospital. We included
28 septic shock patients that received early volume resuscitation. All were eligible for receiving norepinephrine because
of life-threatening hypotension and low diastolic arterial pressure. Muscle tissue oxygen saturation (StO₂) and its changes during a vascular occlusion test were measured at the level of the thenar eminence using a near-infrared
spectroscopy (NIRS) device. Transpulmonary thermodilution cardiac index (CI) and NIRS-derived variables were obtained before
and after the mean arterial pressure (MAP) was increased by norepinephrine. The baseline StO₂ and the vascular occlusion test-derived variables of 17 healthy volunteers were measured and served as controls.

Results  

In healthy volunteers, StO₂ ranged between 75 and 90% and StO₂ recovery slopes ranged between 1.5 and 3.4%/s. Administration of norepinephrine, which was associated with an increase in
MAP from 54 ± 8 to 77 ± 9 mmHg (p < 0.05), also induced increases in CI from 3.14 ± 1.03 to 3.61 ± 1.28 L/min/m² (p < 0.05), in StO₂ from 75 ± 9 to 78 ± 9% (p < 0.05) and in StO₂ recovery slope from 1.0 ± 0.6 to 1.5 ± 0.7%/s (p < 0.05).

Conclusions  

Norepinephrine administration aimed at achieving a MAP higher than 65 mmHg in septic shock patients with life-threatening
hypotension resulted in improvement of NIRS variables measured at the level of the thenar eminence.

• Content Type Journal Article
• DOI 10.1007/s00134-010-2013-3
• Authors
  • Jean-Francois Georger, Service de reanimation medicale, Centre Hospitalo-Universitaire de Bicetre, Assistance Publique-Hopitaux de Paris, EA 4046, Universite Paris Sud, 78, rue du General Leclerc, 94 270 Le Kremlin-Bicetre, France
  • Olfa Hamzaoui, Service de reanimation medicale, Centre Hospitalo-Universitaire de Bicetre, Assistance Publique-Hopitaux de Paris, EA 4046, Universite Paris Sud, 78, rue du General Leclerc, 94 270 Le Kremlin-Bicetre, France
  • Anis Chaari, Service de reanimation medicale, Centre Hospitalo-Universitaire de Bicetre, Assistance Publique-Hopitaux de Paris, EA 4046, Universite Paris Sud, 78, rue du General Leclerc, 94 270 Le Kremlin-Bicetre, France
  • Julien Maizel, Service de reanimation medicale, Centre Hospitalo-Universitaire de Bicetre, Assistance Publique-Hopitaux de Paris, EA 4046, Universite Paris Sud, 78, rue du General Leclerc, 94 270 Le Kremlin-Bicetre, France
  • Christian Richard, Service de reanimation medicale, Centre Hospitalo-Universitaire de Bicetre, Assistance Publique-Hopitaux de Paris, EA 4046, Universite Paris Sud, 78, rue du General Leclerc, 94 270 Le Kremlin-Bicetre, France
  • Jean-Louis Teboul, Service de reanimation medicale, Centre Hospitalo-Universitaire de Bicetre, Assistance Publique-Hopitaux de Paris, EA 4046, Universite Paris Sud, 78, rue du General Leclerc, 94 270 Le Kremlin-Bicetre, France

• Journal Intensive Care Medicine
• Online ISSN 1432-1238
• Print ISSN 0342-4642

Regional tidal ventilation and compliance during a stepwise vital capacity manoeuvre

Abstract

Purpose  

To determine whether, during mechanical ventilation, an optimal positive end-expiratory pressure (PEEP) can be identified
by measurement of regional tidal volume and compliance [V
_T(reg), C
_RS(reg)].

Methods  

Sixteen anaesthetized intubated neonatal piglets underwent a stepwise vital capacity manoeuvre performed during pressure control
ventilation, with 5 cmH₂O PEEP increments to 25 cmH₂O, and decrements to 0 cmH₂O. Peak inflating pressure was 10 cmH₂O above PEEP throughout. The manoeuvre was performed in the normal lung, after repeated saline lavage and after surfactant
therapy. Global V
_T and C
_RS were measured at the airway opening; V
_T(reg) and C
_RS(reg) were measured in the ventral, medial and dorsal lung using electrical impedance tomography (EIT).

Results  

Most uniform distribution of regional tidal ventilation was noted during PEEP decrements after lung recruitment, at varying
PEEP levels. In the lavaged and surfactant-treated lung the PEEP optimal for ventilation distribution was also associated
with highest mean V
_T(reg) [lavaged: 95 ± 9.3% of maximum, mean ± standard deviation (SD); surfactant-treated: 92 ± 17%] and global V
_T (96 ± 10%; 96 ± 15%). Regional C
_RS plots clearly demonstrated co-existent ventral overdistension and dorsal recruitment, particularly during PEEP increments;
whereas during PEEP decrements, peak C
_RS(reg) values showed considerable interregional concordance [e.g. peak C
_RS(reg) in the lavaged left lung; ventral: 0.017 ± 0.0036; medial: 0.016 ± 0.0054; dorsal: 0.017 ± 0.0073 cmH₂O^?1; P = 0.98, analysis of variance (ANOVA)].

Conclusions  

After lung recruitment, a PEEP level can be identified by EIT at which tidal ventilation is uniformly distributed, with associated
concordance in compliance between lung regions. Bedside monitoring of regional tidal ventilation and compliance using EIT
may thus aid in PEEP selection.

• Content Type Journal Article
• DOI 10.1007/s00134-010-1995-1
• Authors
  • Peter A. Dargaville, Department of Paediatrics, Royal Hobart Hospital and University of Tasmania, Liverpool Street, Hobart, TAS 7000, Australia
  • Peter C. Rimensberger, Pediatric and Neonatal Intensive Care Unit, Children's Hospital, University of Geneva, Geneva, Switzerland
  • Inez Frerichs, Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Schleswig-Holstein, Campus Kiel, Kiel, Germany

• Journal Intensive Care Medicine
• Online ISSN 1432-1238
• Print ISSN 0342-4642

Early postoperative delirium after open-heart cardiac surgery is associated with decreased bispectral EEG and increased cortisol and interleukin-6

Abstract

Purpose  

It is difficult to substantiate the clinical diagnosis of postoperative delirium with objective parameters in intensive care
units (ICU). The purpose of this study was to analyze (1) whether the bilateral bispectral (BIS) index, (2) cortisol as a
stress marker, and (3) interleukin-6 as a marker of inflammation were different in delirious patients as compared to nondelirious
ones after cardiac surgery.

Methods  

On the first postoperative day, delirium was analyzed in 114 patients by using the confusion assessment method for ICU (CAM-ICU).
Bilateral BIS data were determined; immediately thereafter plasma samples were drawn to analyze patients' blood characteristics.
The current ICU medication, hemodynamic characteristics, SOFA and APACHE II scores, and artificial ventilation were noted.

Results  

Delirium was detected at 19.1 ± 4.8 h after the end of surgery in 32 of 114 patients (28%). Delirious patients were significantly
older than nondelirious ones and were artificially ventilated 4.7-fold more often during the testing. In delirious patients,
plasma cortisol and interleukin-6 levels were higher (p = 0.01). The mean BIS index was significantly lower in delirious patients (72.6 (69.6–89.1); median [interquartile range
(IQR), 25th–75th percentiles] than in nondelirious patients, 84.8 (76.8–89.9). BIS EEG raw data analysis detected significant
lower relative alpha and higher theta power. A significant correlation was found between plasma cortisol levels and BIS index.

Conclusions  

Early postoperative delirium after cardiac surgery was characterized by increased stress levels and inflammatory reaction.
BIS index measurements showed lower cortical activity in delirious patients with a low sensitivity (27%) and high specificity
(96%).

• Content Type Journal Article
• DOI 10.1007/s00134-010-2004-4
• Authors
  • Konstanze Plaschke, Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
  • Philipp Fichtenkamm, Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
  • Christoph Schramm, Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
  • Steffen Hauth, Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
  • Eike Martin, Department of Anesthesiology, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
  • Markus Verch, Department of Cardiac Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
  • Matthias Karck, Department of Cardiac Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
  • Jurgen Kopitz, Department of Pathology, University of Heidelberg, Im Neuenheimer Feld 220, 69120 Heidelberg, Germany

• Journal Intensive Care Medicine
• Online ISSN 1432-1238
• Print ISSN 0342-4642

Cholesterol toxicity in pancreatic islets from LDL receptor-deficient mice

Cholesterol toxicity in pancreatic islets from LDL receptor-deficient mice

• Content Type Journal Article
• DOI 10.1007/s00125-010-1868-8
• Authors
  • J. C. de Souza, Departamento de Anatomia, Biologia Celular, Fisiologia e Biofisica, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Rua Monteiro Lobato 255, Campinas, 13083-862 Brazil
  • C. A. M. de Oliveira, Departamento de Anatomia, Biologia Celular, Fisiologia e Biofisica, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Rua Monteiro Lobato 255, Campinas, 13083-862 Brazil
  • E. M. Carneiro, Departamento de Anatomia, Biologia Celular, Fisiologia e Biofisica, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Rua Monteiro Lobato 255, Campinas, 13083-862 Brazil
  • A. C. Boschero, Departamento de Anatomia, Biologia Celular, Fisiologia e Biofisica, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Rua Monteiro Lobato 255, Campinas, 13083-862 Brazil
  • H. C. F. de Oliveira, Departamento de Anatomia, Biologia Celular, Fisiologia e Biofisica, Instituto de Biologia, Universidade Estadual de Campinas (UNICAMP), Rua Monteiro Lobato 255, Campinas, 13083-862 Brazil

• Journal Diabetologia
• Online ISSN 1432-0428
• Print ISSN 0012-186X

Forschung im Fach

Zusammenfassung  

Positive Veranderungen in unserem Fach wurden immer angesto?en von Menschen, die ihre wissenschaftliche Neugier und Kreativitat
in den Dienst der Frauengesundheit gestellt haben. Das Leitbild des wissenschaftlichen Arztes, des physician scientist – wenn es denn jemals jenseits romantischer Vorstellungen existiert hat – ist heute gefahrdeter denn je. Die hohen Anspruche
an sinnvolle Forschung konnen nur noch in gro?eren Verbunden erfullt werden. In Teilbereichen unseres Fachs gibt es solche
Forschungsverbunde, doch vor allem fur die Konkurrenz um Forschungsgelder der offentlichen Hand scheint unser Fach nur ma?ig
gut gerustet. Fur die Entwicklung von „physician scientists" mussen die Anforderungen an Forschung und Klinik zeitlich und
personell entflochten werden. Eine flexible, aber strukturierte Forderung forschungsengagierter Frauenarzte kann dann den
Kontakt zwischen klinischer Kompetenz und wissenschaftlicher Expertise herstellen. Die dargestellten Analysen und Losungsvorschlage
stammen von Mitarbeitern der Universitatsfrauenkliniken Munchen, Dusseldorf, Erlangen, Frankfurt a.M. und Ulm.

• Content Type Journal Article
• DOI 10.1007/s00129-010-2565-x
• Authors
  • C. Scholz, Klinik und Poliklinik fur Frauenheilkunde und Geburtshilfe, Klinikum der Universitat Munchen, Standort Innenstadt, Maistr. 11, 80337 Munchen, Deutschland
  • K. Friese, Klinik und Poliklinik fur Frauenheilkunde und Geburtshilfe, Klinikum der Universitat Munchen, Standort Innenstadt, Maistr. 11, 80337 Munchen, Deutschland

• Journal Der Gynakologe
• Online ISSN 1433-0393
• Print ISSN 0017-5994

„Wir mussen uns den Herausforderungen stellen“

„Wir mussen uns den Herausforderungen stellen"

• Content Type Journal Article
• DOI 10.1007/s00129-010-2560-2
• Authors
  • R. Kreienberg, Universitatsfrauenklinik und Poliklinik, Prittwitzstr. 43, 89070 Ulm, Deutschland

• Journal Der Gynakologe
• Online ISSN 1433-0393
• Print ISSN 0017-5994

18F-fluorodeoxyglucose positron emission tomography and computed tomography in anaplastic thyroid cancer

Abstract

Purpose  

Our aim was to evaluate in anaplastic thyroid carcinoma (ATC) patients the value of ¹⁸F-FDG PET/CT compared with total body computed tomography (CT) using intravenous contrast material for initial staging, prognostic
assessment, therapeutic monitoring and follow-up.

Methods  

Twenty consecutive ATC patients underwent PET/CT for initial staging. PET/CT was performed again during follow-up. The gold
standard was progression on imaging follow-up (CT or PET/CT) or confirmation with another imaging modality.

Results  

A total of 265 lesions in 63 organs were depicted in 18 patients. Thirty-five per cent of involved organs were demonstrated
only with PET/CT and one involved organ only with CT. In three patients, the extent of disease was significantly changed with
PET/CT that demonstrated unknown metastases. Initial treatment modalities were modified by PET/CT findings in 25% of cases.
The volume of FDG uptake (?300 ml) and the intensity of FDG uptake (SUV_max ?18) were significant prognostic factors for survival. PET/CT permitted an earlier assessment of tumour response to treatment
than CT in 4 of the 11 patients in whom both examinations were performed. After treatment with combined radiotherapy and chemotherapy,
only the two patients with a negative control PET/CT had a confirmed complete remission at 14 and 38 months; all eight patients
who had persistent FDG uptake during treatment had a clinical recurrence and died.

Conclusion  

FDG PET/CT appears to be the reference imaging modality for ATC at initial staging and seems promising in the early evaluation
of treatment response and follow-up.

• Content Type Journal Article
• DOI 10.1007/s00259-010-1570-6
• Authors
  • Thomas Poisson, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Desiree Deandreis, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Sophie Leboulleux, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Francois Bidault, Department of Radiology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Guillaume Bonniaud, Department of Medical Physics, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Sylvain Baillot, Department of Epidemiology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Anne Auperin, Department of Epidemiology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Abir Al Ghuzlan, Department of Pathology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Jean-Paul Travagli, Department of Endocrine Surgery, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Jean Lumbroso, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Eric Baudin, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France
  • Martin Schlumberger, Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy and University Paris-Sud XI, 94805 Villejuif Cedex, France

• Journal European Journal of Nuclear Medicine and Molecular Imaging
• Online ISSN 1619-7089
• Print ISSN 1619-7070

Recanalization of Dialysis Catheter-Related Subclavian Vein Occlusion Using a Re-Entry Device: Report of Two Patients

Recanalization of Dialysis Catheter-Related Subclavian Vein Occlusion Using a Re-Entry Device: Report of Two Patients

• Content Type Journal Article
• DOI 10.1007/s00270-010-9955-2
• Authors
  • Elias N. Brountzos, Second Department of Radiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Haidari, 124 62 Athens, Greece
  • Ourania Preza, Second Department of Radiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Haidari, 124 62 Athens, Greece
  • Alexios Kelekis, Second Department of Radiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Haidari, 124 62 Athens, Greece
  • Irene Panagiotou, Second Department of Radiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Haidari, 124 62 Athens, Greece
  • Nikolaos Kelekis, Second Department of Radiology, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Haidari, 124 62 Athens, Greece

• Journal CardioVascular and Interventional Radiology
• Online ISSN 1432-086X
• Print ISSN 0174-1551

Diffusion-weighted MRI for detecting liver metastases: importance of the b-value

Diffusion-weighted MRI for detecting liver metastases: importance of the b-value

• Content Type Journal Article
• DOI 10.1007/s00330-010-1919-z
• Authors
  • Thomas C. Kwee, Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
  • Taro Takahara, Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands

• Journal European Radiology
• Online ISSN 1432-1084
• Print ISSN 0938-7994

Common genetic polymorphisms in Moyamoya and atherosclerotic disease in Europeans

Abstract

Purpose  

Moyamoya is the most common cerebrovascular disease in children in Japan. The disease’s etiology is still widely unknown.
Several publications describe histopathological changes in the walls of affected vessels similar to those seen in atherosclerosis.
In this study, we analyzed the DNA of European patients with Moyamoya disease for single nucleotide polymorphisms associated
with atherosclerotic changes.

Methods  

We genotyped 17 SNPs in or adjacent to 11 genes (ELN, LIMK1, CDKN2A/B, CXCL12, Pseudogene ENSG00000197218, PSRC1, MTHFD1L,
SMAD3, MIA3, PDGF-B, TIMP2) comparing 40 DNA samples of Moyamoya disease patients to 68 healthy controls from central Europe.
The mean age of onset of Moyamoya disease (MMD)-related symptoms was 15.4 years of age. Genotyping was performed by sequencing
the SNP containing genetic regions with custom-made primers.

Results  

We found strong association of one SNP (rs599839 [A/G], OR?=?2.17, 95% CI?=?1.17, 4.05; p?=?0.01) with the risk allele G located in the 3? UTR region of the PSRC-1 gene. Three further SNPs (rs8326, rs34208922, rs501120)
in or adjacent to the genes ELN and CXCL12 showed tendencies towards risk alleles with p values between 0.1 and 0.2 but did not reach statistical significance in our cohort.

Conclusions  

Our results indicate a possible parallel of common processes in the genesis of Moyamoya disease and atherosclerotic disease.
Further analyses in larger European cohorts and replication in patients of different ethnicity may lead to possible early
detection of patients at risk for developing MMD and subsequently to future causative therapies.

• Content Type Journal Article
• DOI 10.1007/s00381-010-1241-8
• Authors
  • Constantin Roder, Department of Neurosurgery, University of Tubingen, Hoppe-Seyler-Strasse 3, 72076 Tubingen, Germany
  • Vera Peters, Department of Neurosurgery, University of Tubingen, Hoppe-Seyler-Strasse 3, 72076 Tubingen, Germany
  • Hidetoshi Kasuya, Division of Neurosurgery, Medical Center East, Tokyo Women's Medical University, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567 Japan
  • Tsutomu Nishizawa, Tokyo Women's Medical University and International Research and Educational Institute for Integrated Medical Sciences, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
  • Yayoi Takehara, Tokyo Women's Medical University and International Research and Educational Institute for Integrated Medical Sciences, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 Japan
  • Daniela Berg, Department of Neurodegeneration, Hertie-Institute for Clinical Brain Research and German Center for Neurodegenerative Diseases (DZNE), Hoppe-Seyler-Str. 3, 72076 Tubingen, Germany
  • Claudia Schulte, The Hertie-Institute for Clinical Brain Research, Department of Neurodegenerative Diseases, University of Tubingen, Hoppe-Seyler-Strasse 3, 72076 Tubingen, Germany
  • Nadia Khan, Department of Neurosurgery and Stanford Stroke Center, Stanford University School of Medicine, 300 Pasteur Drive, Boswell Building, A301, Stanford, CA 94305-5327, USA
  • Marcos Tatagiba, Department of Neurosurgery, University of Tubingen, Hoppe-Seyler-Strasse 3, 72076 Tubingen, Germany
  • Boris Krischek, Department of Neurosurgery, University of Tubingen, Hoppe-Seyler-Strasse 3, 72076 Tubingen, Germany

• Journal Child’s Nervous System
• Online ISSN 1433-0350
• Print ISSN 0256-7040

ASPM gene expression in medulloblastoma

Abstract

Purpose  

Medulloblastomas are the most common malignant tumors of the central nervous system in childhood. The incidence is about 19–20%
between children younger than 16 years old with peak incidence between 4 and 7 years. Despite its sensibility to no specific
therapeutic means like chemotherapy and radiotherapy, the treatment is very aggressive and frequently results in regression,
growth deficit, and endocrine dysfunction. From this point of view, new treatment approaches are needed such as molecular
targeted therapies. Studies in glioblastoma demonstrated that ASPM gene was overexpressed when compared to normal brain and ASPM inhibition by siRNA-mediated inhibits tumor cell proliferation and neural stem cell proliferation, supporting ASPM gene as a potential molecular target in glioblastoma. The aim of this work was to evaluate ASPM expression in medulloblastoma fragment samples, and to compare the results with the patient clinical features.

Methods  

Analysis of gene expression was performed by quantitative PCR real time using SYBR Green system in tumor samples from 37 children.
The t test was used to analyze the gene expression, and Mann–Whitney test was performed to analyze the relationship between gene
expressions and clinical characteristics. Kaplan–Meier test evaluated curve survival.

Results  

All samples overexpressed ASPM gene more than 40-fold. However, we did not find any association between the overexpressed samples and the clinical parameters.

Conclusion  

ASPM overexpression may modify the ability of stem cells to differentiate during the development of the central nervous system,
contributing to the development of medulloblastoma, a tumor of embryonic origin from cerebellar progenitor cells.

• Content Type Journal Article
• DOI 10.1007/s00381-010-1252-5
• Authors
  • Tania M. Vulcani-Freitas, Institute of Pediatric Oncology (GRAACC), Pediatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Najsla Saba-Silva, Institute of Pediatric Oncology (GRAACC), Pediatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Andrea Cappellano, Institute of Pediatric Oncology (GRAACC), Pediatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Sergio Cavalheiro, Neurology and Neurosurgery Department, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Sueli K. N. Marie, Department of Neurology, University of Sao Paulo, Sao Paulo, Brazil
  • Sueli M. Oba-Shinjo, Department of Neurology, University of Sao Paulo, Sao Paulo, Brazil
  • Suzana M. F. Malheiros, Neurology and Neurosurgery Department, Federal University of Sao Paulo, Sao Paulo, Brazil
  • Silvia Regina Caminada de Toledo, Institute of Pediatric Oncology (GRAACC), Pediatric Department, Federal University of Sao Paulo, Sao Paulo, Brazil

• Journal Child’s Nervous System
• Online ISSN 1433-0350
• Print ISSN 0256-7040

Endoscopic third ventriculostomy for hydrocephalus in children younger than 1 year of age

Abstract

Objective  

The purpose of this study is to assess the role of endoscopic third ventriculostomy (ETV) in the treatment of hydrocephalus
in children under 1 year of age. The authors analyzed data of ETV in their institution.

Methods  

Between January 1995 and December 2008, 52 ETV procedures were performed for the treatment of hydrocephalus in 49 infants
(32 male and 17 female). Their age ranged from 6 days to just under 12 months (mean age 6.2 months). The cause of hydrocephalus
was occlusive in 43 patients (aqueduct stenosis in 31, Chiari II malformation in eight, Dandy–Walker cyst in two, quadrigeminal
lipoma in one, and cerebellopontine angle arachnoid cyst in one patient). Communicating hydrocephalus was caused by intraventricular
hemorrhage, meningitis, and/or ventriculitis in six patients.

Results  

The overall success rate was 69.4% with mean follow-up period of 68.2 months. Patients with aqueduct stenosis had a higher
success rate of ETV which was 77.4%. Seven infants were born preterm, six of them required a permanent ventriculoperitoneal
shunts (VPS; P?=?0.003). Malfunctioned VPS was removed in two patients following ETV. There was one death from intracranial hemorrhage, two cerebrospinal
fluid leaks, and one meningitis.

Conclusion  

Endoscopic third ventriculostomy can be considered a possible treatment procedure alternative to VPS for the treatment of
occlusive hydrocephalus in infants. ETV was effective in full-term infants while the results in low birth weight, preterm
infants were poor. Success of ETV is not only age dependent but also etiology dependant. Infants with occlusive hydrocephalus
treated with VPS, who present with shunt failure, could be treated by ETV and removal of the shunt device.

• Content Type Journal Article
• DOI 10.1007/s00381-010-1254-3
• Authors
  • Essam A. Elgamal, Neurosurgery Division, College of Medicine and King Khalid University Hospital, King Saud University, P O Box 7805, Riyadh, 11472 Saudi Arabia
  • Abdel-Azim El-Dawlatly, Anesthesia Department, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia
  • Waleed R. Murshid, Neurosurgery Division, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
  • Sherif M. F. El-Watidy, Neurosurgery Division, College of Medicine and King Khalid University Hospital, King Saud University, P O Box 7805, Riyadh, 11472 Saudi Arabia
  • Zain Al-Abedin B. Jamjoom, Neurosurgery Division, College of Medicine and King Khalid University Hospital, King Saud University, P O Box 7805, Riyadh, 11472 Saudi Arabia

• Journal Child’s Nervous System
• Online ISSN 1433-0350
• Print ISSN 0256-7040

Spherical aberration and higher order aberrations with Balafilcon A (PureVision) and Comfilcon A (Biofinity)

Abstract

Background  

Advances in the optical design of soft contact lenses have seen certain manufacturers incorporate aspheric optics into soft
lenses in an attempt to reduce spherical aberration, to provide superior visual performance. The aim of this study is to determine
the on-eye differences in spherical aberration and higher order aberrations (HOA) between the Bausch and Lomb PureVision (Balafilcon
A) and the CooperVision Biofinity (Comfilcon A).

Methods  

Twenty subjects were recruited in a prospective, randomized, unilateral study. The right eye was dilated and HOA measured
with the NIDEK OPD-Scan. Each eye was fitted randomly with a ?3.00D PureVision and a ?3.00D Biofinity, and HOA were measured
with lenses in situ across a 6 mm pupil. Paired t-tests were performed to determine HOA differences with the lenses in situ compared to baseline.

Results  

Aberrometry was successfully performed on all subjects. Statistical analysis indicated no changes in spherical aberration,
but changes in other HOA. With the PureVision, there were increases in Zernike terms Z₃¹ (from 0.01 ?m to ?0.11 ?m), Z₄^-2 (from 0.01 ?m to 0.13 ?m) and Z₅^-1 (from ?0.01 ?m to 0.03 ?m). With the Biofinity there was an increase in Zernike term Z₃³ (from 0.00 ?m to 0.09 ?m).

Conclusions  

No statistically significant changes occurred in spherical aberration. The PureVision caused statistically significant increases
in Z₃¹, Z₄^-2 and Z₅^-1, and the Biofinity caused an increase in Z₃³. Clinically significant changes (>0.1 ?m) occurred with terms Z₃¹ and Z₄^-2 with the PureVision only.

• Content Type Journal Article
• DOI 10.1007/s00417-010-1476-9
• Authors
  • Colm McAlinden, School of Biomedical Sciences, University of Ulster, Cromore Road, Coleraine, BT52 1SA UK
  • Jonathan E. Moore, Cathedral Eye Clinic, University of Ulster, 25-51 York Street, Belfast, BT15 1ED UK
  • Victoria E. McGilligan, School of Biomedical Sciences, University of Ulster, Cromore Road, Coleraine, BT52 1SA UK
  • Tara C. B. Moore, School of Biomedical Sciences, University of Ulster, Cromore Road, Coleraine, BT52 1SA UK

• Journal Graefe’s Archive for Clinical and Experimental Ophthalmology
• Online ISSN 1435-702X
• Print ISSN 0721-832X

Effects of sweep VEP parameters on visual acuity and contrast thresholds in children and adults

Abstract

Background  

There are many parameters that may impact the thresholds obtained with sweep visually evoked potentials (sVEP), yet a number
of these parameters have not been systematically studied, and there is no recognised standard for sVEP recording. In this
study, the effects of electrode placement, temporal frequency, sweep direction, presence of a fixation target, stimulus area,
and sweep duration on visual acuity (VA) and contrast thresholds of the sVEP were investigated. Additionally, the effect of
these parameters on the number of viable threshold readings obtained from five active electrodes was investigated.

Methods  

Participants were six children (aged 6-8 years) and six adults (aged 17-30 years) with normal vision. Binocular sVEP VA and
contrast thresholds were measured for two electrode placements (ISCEV and PowerDiva) of five active electrodes, three temporal
frequencies (6, 7.5, and 10 Hz), two sweep directions (low to high and high to low), presence or absence of a fixation target,
three stimulus areas, and three sweep durations.

Results  

There were differences between adults and children with respect to visual acuity, the adults having better VA than the children
(p?=?0.033 in experiment 2). Overall, there were more viable readings at 7.5 Hz than at either 10 or 6 Hz (p?=?0.0014 for VA and 0.001 for contrast thresholds). The adults performed better (in terms of viable readings) with the fixation
target than without it (p?=?0.04). The smallest stimulus size used gave rise to fewer viable readings in both adults and children (p?=?0.022 for VA and 0.0001 for contrast thresholds). The other parameters (electrode placement, sweep direction and sweep
duration) did not give rise to significant differences.

Conclusions  

A temporal frequency of 7.5 Hz, a stimulus area of 4° or larger for VA and 10° or larger for contrast thresholds, and the
use of a fixation target gave more viable readings, and may be indicated for future application. Consideration of the number
of viable readings showed more differences between parameters than the actual thresholds, and it is suggested that more readings
presumably would yield more reliable threshold measurements.

• Content Type Journal Article
• DOI 10.1007/s00417-010-1469-8
• Authors
  • Fahad M. Almoqbel, School of Optometry, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
  • Naveen K. Yadav, SUNY College of Optometry, 33 West 42nd Street, New York, NY 10036, USA
  • Susan J. Leat, School of Optometry, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
  • Liseann M. Head, School of Optometry, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
  • Elizabeth L. Irving, School of Optometry, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada

• Journal Graefe’s Archive for Clinical and Experimental Ophthalmology
• Online ISSN 1435-702X
• Print ISSN 0721-832X

TTF1 expression in normal lung neuroendocrine cells and related tumors: immunohistochemical study comparing two different monoclonal antibodies

Abstract  

Thyroid transcription factor-1 (TTF1) regulates lung morphogenesis and differentiation, and its immunohistochemical expression
is used for identifying lung neoplasms. The 8G7G3/1 antibody has been used in previous studies, but a different and more sensitive
anti-TTF1 antibody, named SPT24, has become commercially available. Since the immunohistochemical expression of TTF1 in normal
lung neuroendocrine (NE) cells has not been previously investigated and its utility in the diagnosis of lung NE tumors is
a controversial issue, we studied the TTF1 expression in normal adult and fetal lungs, in 83 pulmonary NE neoplasms, in 131
non-lung NE tumors and in 36 metastases from these neoplasms using these two antibodies. A TTF1 immunoreactivity was demonstrated
in normal fetal and adult NE cells when using the SPT24 clone. Conversely, using the 8G7G3/1 antibody, only rare fetal neuroendocrine
cells were TTF1 positive while adult NE cells were negative. The SPT24 clone identified TTF1 expression in more carcinoids,
most of them peripherally located, and poorly differentiated NE carcinomas than the 8G7G3/1 clone. Non-pulmonary well-differentiated
NE tumors were negative for both antibodies. Among the 45 non-pulmonary poorly differentiated NE carcinomas 11% were positive
for 8G7G3/1 and 18% for SPT24. TTF1 expression in metastases perfectly reflected that detected in the related primary tumors.
Our results indicate that the SPT24 antibody is more sensitive than the 8G7G3/1 clone for labeling lung carcinoids and it
appears particularly useful in detecting peripheral neoplasms. In addition, the expression of TTF1 in normal NE cells suggests
a possible role for the transcription factor in their development and differentiation.

• Content Type Journal Article
• DOI 10.1007/s00428-010-0954-0
• Authors
  • Stefano La Rosa, Department of Pathology, Ospedale di Circolo, Viale Borri 57, 21100 Varese, Italy
  • Anna Maria Chiaravalli, Department of Pathology, Ospedale di Circolo, Viale Borri 57, 21100 Varese, Italy
  • Claudia Placidi, Department of Human Morphology, University of Insubria, Varese, Italy
  • Nikolaos Papanikolaou, Department of Human Morphology, University of Insubria, Varese, Italy
  • Michele Cerati, Department of Pathology, Ospedale di Circolo, Viale Borri 57, 21100 Varese, Italy
  • Carlo Capella, Department of Pathology, Ospedale di Circolo, Viale Borri 57, 21100 Varese, Italy

• Journal Virchows Archiv
• Online ISSN 1432-2307
• Print ISSN 0945-6317

“Neurohereditary diseases” charity association (Armenia)

"Neurohereditary diseases" charity association (Armenia)

• Content Type Journal Article
• DOI 10.1007/s00431-010-1272-x

• Journal European Journal of Pediatrics
• Online ISSN 1432-1076
• Print ISSN 0340-6199

What to eat when off treatment and living with involuntary weight loss and cancer: a systematic search and narrative review

Abstract

Purpose  

The aim of this study was to report a systematic search and narrative review of the evidence base that can inform dietary
advice for patients off treatment living with cancer cachexia syndrome (CCS).

Methods  

Searches were conducted in MEDLINE, EMBASE, PsycINFO and CINAHL databases for publications about diet and cancer patients
off treatment with symptoms of CCS. The following limits were applied: English language, from September 1998 to September
2008 and adults. In addition, a hand search included the reference lists of papers identified. Seven hundred and eighteen
abstracts were assessed against inclusion/exclusion criteria and 88 were selected for full text independent examination by
two researchers. Information from 48 papers was extracted, quality assessed, thematically analyzed and presented as a narrative
synthesis.

Results  

Two dominant perspectives emerged on what should be eaten by weight-losing cancer patients. The majority of authors advocated
a nutrient-dense diet, facilitated by nutritional counselling. The alternative approach was to advise the patient to 'eat
what they want'. There is little robust evidence to justify either approach as able to deliver on the range of physical and
psychosocial objectives that they aim to achieve.

Conclusion  

A new model for the delivery of nutritional care may benefit cancer patients (off treatment) living with weight loss. The
proposed model integrates the two identified perspectives to facilitate optimal food intake taking into account the patient’s
(1) disease symptoms and treatment side effects (2) emotional adaptation to illness and (3) social circumstances. Research
is needed to establish which of these obstacles to eating can be changed for which patient groups to improve patient outcomes.

• Content Type Journal Article
• DOI 10.1007/s00520-010-0964-0
• Authors
  • Jane B. Hopkinson, School of Health Sciences, University of Southampton, Southampton, UK
  • Ikumi Okamoto, Macmillan Research Unit, School of Health Sciences, University of Southampton, Southampton, UK
  • Julia M. Addington-Hall, School of Health Sciences, University of Southampton, Southampton, UK

• Journal Supportive Care in Cancer
• Online ISSN 1433-7339
• Print ISSN 0941-4355

Further evidence that methylenetetrahydrofolate reductase A1298C polymorphism is a risk factor for schizophrenia

Abstract  

Previous work suggests that the methylenetetrahydrofolate reductase gene (MTHFR) functional polymorphism A1298C may be a risk factor for schizophrenia. In this study, the genetic association between the
MTHFR A1298C polymorphism and schizophrenia was investigated in 379 patients with schizophrenia and 380 age- and sex-matched controls
subjects. The results showed an association between the 1298C allele and the disorder (OR 1.39, 95% confidence interval 1.08–1.79).
This provides further evidence that the MTHFR A1298C polymorphism may play a role in conferring risk for schizophrenia in the Chinese Han population.

• Content Type Journal Article
• DOI 10.1007/s00702-010-0442-3
• Authors
  • Chen Zhang, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wan Ping Nan Road, 200030 Shanghai, People's Republic of China
  • Bin Xie, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wan Ping Nan Road, 200030 Shanghai, People's Republic of China
  • Yasong Du, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wan Ping Nan Road, 200030 Shanghai, People's Republic of China
  • Wenhong Cheng, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wan Ping Nan Road, 200030 Shanghai, People's Republic of China
  • Yiru Fang, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wan Ping Nan Road, 200030 Shanghai, People's Republic of China
  • Shunying Yu, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wan Ping Nan Road, 200030 Shanghai, People's Republic of China

• Journal Journal of Neural Transmission
• Online ISSN 1435-1463
• Print ISSN 0300-9564

Reply to the letter: “Histology of the internal inguinal ring: it is really a novelty?” by Barria et al. Hernia (2010) 14:339–340

Reply to the letter: "Histology of the internal inguinal ring: it is really a novelty?" by Barria et al. Hernia (2010) 14:339–340

• Content Type Journal Article
• DOI 10.1007/s10029-010-0714-8
• Authors
  • G. Amato, Department of General Surgery, Urgency and Organ Transplantation, University of Palermo, Palermo, Italy

• Journal Hernia
• Online ISSN 1248-9204
• Print ISSN 1265-4906

Cognitive deficits in multiple sclerosis: a review of functional MRI studies

Abstract  

Cognitive dysfunction frequently occurs during the course of multiple sclerosis (MS). In patients with MS the severity of
cognitive manifestations is not closely related to indices of structural brain damage. Neuroplasticity may contribute to the
maintenance of normal performance despite scattered brain lesions. Changes in functional organization of the cerebral cortex
have been reported by functional magnetic resonance imaging (fMRI) studies in MS. fMRI studies provide an interesting way
of understanding how the brain changes its functional organization in response to MS, and might be useful in the study of
the effects of rehabilitative or pharmacological therapy on brain plasticity. The purpose of this review is to examine major
fMRI studies focusing on cognitive dysfunction in MS.

• Content Type Journal Article
• DOI 10.1007/s10072-010-0379-1
• Authors
  • Francesca Caramia, Department of Neurological Sciences, University of Rome "La Sapienza", Viale dell'Universita 30, 00185 Rome, Italy
  • E. Tinelli, Department of Neurological Sciences, University of Rome "La Sapienza", Viale dell'Universita 30, 00185 Rome, Italy
  • A. Francia, Department of Neurological Sciences, University of Rome "La Sapienza", Viale dell'Universita 30, 00185 Rome, Italy
  • C. Pozzilli, Department of Neurological Sciences, University of Rome "La Sapienza", Viale dell'Universita 30, 00185 Rome, Italy

• Journal Neurological Sciences
• Online ISSN 1590-3478
• Print ISSN 1590-1874

Vitamin D improves overall immune function

(NaturalNews) A recent study out of the University of Tampere in Finland has found that vitamin D helps to prevent respiratory infections. In the study, supplementing with vitamin D resulted in more than half the participants who took it staying healthy throughout the trial, compared to just over 30 percent in the control group.

Dr. Ilkka Laaksi and her team evaluated a group of 164 males going into the military to see if vitamin D supplementation affected their overall health. They gave part of the group 400 international units (IU) of vitamin D a day for six months, and the other part of the group a placebo pill for the same period of time. Those who took vitamin D experienced greater overall health and less respiratory infections than those who did not.

Laaksi was quick to say that the study reveals “some evidence” that vitamin D helps prevent respiratory infections, but that such a benefit is not entirely clear.

Though 400 IU of vitamin D a day meets recommended government intake recommendations, many in the medical profession are now realizing that this level is far too low to offer much therapeutic effect. Some suspect that if a higher dose had been used in the study, the effects would have been even more significant.

This hypothesis was illustrated in a recent Japanese study that administered 1,200 IU doses of vitamin D to schoolchildren. Those who took this dose every day had a much lower chance of developing influenza than others.

It is, however, unclear which form of vitamin D the team used in the Finland study. Vitamin D2 is not as effective as vitamin D3, but researchers often use D2 in study trials, which can make vitamin D appear less effective.

Sources for this story include:

http://www.reuters.com/article/idUSTRE67444320100805

White button mushrooms enhance the immune system to fight infections and cancer

(NaturalNews) Scientists have long known that certain types of mushrooms have anti-tumor activity. But what about widely available, common white button mushrooms (WBMs)? Known by the botanical name Agaricus bisporus, they are a tasty addition to everything from salads to pizzas — and, it turns out, they do have powerful health building properties. Agricultural Research Service (ARS) funded studies have shown white button mushrooms enhance the activity of critical cells in the body’s immune system.

Although WBMs make up about 90 percent of the total mushrooms consumed in the United States, little research has been conducted into their nutritional value until the last few years. In groundbreaking animal and lab research conducted at the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University, scientists have now documented how WBMs boost the immune system by increasing the production of proteins that fight disease-causing pathogens. The research team, which included HNRCA director Simin Meydani and his colleague, Dayong Wu, from the HNRCA Nutritional Immunology Laboratory, discovered the mushrooms have a positive impact on immune system cells classified as dendritic cells.

This is important because dendritic cells (DCs) can make white blood cells known as T cells that are crucial to a strong and healthy immune system. Dendritic cells recognize and then deactivate or destroy invading microbes such as bacteria and viruses or antigens (any substances that cause the immune system to respond). What’s more, they may play a role in fighting cancer.

The HNRCA researchers found that the immune system boosting effect of white button mushrooms was related to dosage — the more mushrooms, the more pronounced the immune response. “WBM promote DC maturation and enhance their antigen-presenting function,” the scientists wrote in their research paper, which was published in The Journal of Nutrition. “This effect may have potential in enhancing both innate and T cell-mediated immunity leading to a more efficient surveillance and defense mechanism against microbial invasion and tumor development.”

Another group of scientists at the City of Hope’s Beckman Research Institute in Duarte, California, published a study in Cancer Research that suggests consuming 100 grams of WBMs per day could suppress breast tumor growth in women. The research team concluded: “White button mushrooms may be an important dietary constituent for reducing the incidence of hormone-dependent breast cancer in women. Prevention strategies involving mushrooms are readily available, affordable, and acceptable to the general public…The information gained from our study can aid in the design of more highly developed and effective breast cancer prevention strategies involving dietary constituents such as mushrooms.”

For more information:

http://www.ars.usda.gov/is/AR/archive/jul10/immunity0710.htm

http://www.ncbi.nlm.nih.gov/pubmed/18287364

http://cancerres.aacrjournals.org/content/66/24/12026.full

Vitaminwater revealed as non-healthy beverage by Coca-Cola’s own lawyers (opinion)

(NaturalNews) Do you ever wonder things like “Who is actually gullible enough to think that Vitaminwater is healthy?” Although that question may seem demeaning or even arrogant, it turns out that the Coca-Cola company (which owns the Vitaminwater brand) is essentially asking that exact question.

How so? In response to a recent lawsuit against Coca-Cola filed by the Center for Science in the Public Interest (CSPI), Coke’s attorneys replied in court briefings that, “…no consumer could reasonably be misled into thinking vitaminwater was a healthy beverage.”

Except, of course, millions of consumers were misled into believing precisely that. This illusion was helped in no small part by Coca-Cola’s advertising of Vitaminwater, which blatantly positions it as a health-enhancing beverage. Even the name itself implies that the product is made solely out of vitamins and water.

But of course it isn’t.

“Sugarwater” might be a better name
If Vitaminwater were accurately named, it would actually be called Sugarwater. Its first two ingredients are, not surprisingly, sugar and water (the sugar coming in the form of crystalline fructose, a processed sweetener that has been linked to health problems) (http://www.naturalnews.com/029371_fructose_health.html).

In addition to the sugar and water, Vitaminwater contains a smattering of synthetic vitamin chemicals that any informed health consumer probably wouldn’t want to ingest. So in reality, Vitaminwater is really sugar water with the addition of synthetic chemicals that happen to be called “vitamins” (but which are not the natural, plant-based nutrients your body would greatly prefer).

So what we have now with Vitaminwater is a beverage that’s positioned and marketed as a health-enhancing beverage, yet its own corporate lawyers dismiss any notion that the beverage is “healthy.” How, then, can Coca-Cola get away with advertising Vitaminwater as a healthy beverage?

Simple: Because corporations use advertisements to lie to consumers. And virtually no one in the history of corporate advertising has mastered the art of deception better than Coca-Cola — a company whose products have contributed to untold numbers of diabetes victims while being positioned as cool, hip drinks that make you feel energized or inspired.

Coca-Cola isn’t really in the business of selling beverages, you see. It’s in the business of selling the illusion of happiness in a bottle or a can. Buy their products, say the advertisements, and you too can feel happiness (or freedom, or sexiness or whatever). But what Coca-Cola delivers isn’t really happiness at all: Many of Coke’s products deliver the liquid sugars, artificial chemical sweeteners and bone-dissolving acids (like phosphoric acid) that promote disease and suffering. And no reasonable person would equate degenerative disease with happiness.

Misleading name, misleading labels
Speaking of disease, how much sugar is actually in Vitaminwater? A lot more than you might think: While the label claims only 13 grams of sugar per serving, one bottle of vitamin water is actually 2.5 servings, meaning that you’re chugging down 32 grams of liquid sugars with every bottle.

That’s just one of the many “deceptive and unsubstantiated claims” pointed out by CSPI in its lawsuit against Coca-Cola. It is this lawsuit that resulted in Coke’s lawyers making the incredible statement that no reasonable person could possibly conclude Vitaminwater was a healthy beverage.

Lawyers, by the way, can argue absolutely anything — even if it makes no sense. And they can do it with a straight face, too. If you’re looking for a professional liar, hire a lawyer. Coca-Cola seems to already have its share working at their headquarters in Atlanta.

Using its lawyers, Coca-Cola tried to argue its way out of this CSPI lawsuit, but that effort was rejected by the courts. “A federal judge has denied Coca-Cola’s motion to dismiss a lawsuit over what the CSPI says are deceptive and unsubstantiated claims on the company’s “vitaminwater” line of soft drinks,” touts an article on the CSPI website (http://www.cspinet.org/new/201007231.html)

That same announcement goes on to quote Judge John Gleeson of the U.S. District Court for the Eastern District of New York, who says “The names of the drinks, along with other statements on the label have the potential to reinforce a consumer’s mistaken belief that the product is comprised of only vitamins and water.”

CSPI’s litigation director Steve Gardner adds, “For too long, Coca-Cola has been exploiting Americans’ desire to eat and drink more healthfully by deceiving them into thinking that vitaminwater can actually prevent disease. In fact, vitaminwater is no more than non-carbonated soda, providing unnecessary added sugar and contributing to weight gain, obesity, diabetes, and other diseases. We look forward to representing all Americans whom Coke has deceived.”

Who really drinks Vitaminwater?
Reading all this, you might wonder who drinks Vitaminwater in the first place. I’ve never even tried the beverage myself because I read ingredients labels and I don’t drink liquid sugars.

But most consumers don’t read labels. Even if they attempted to, most consumers are simply unable to decode what food labels really mean. People simply believe whatever is most prominently displayed on the front of the package, which in this case are the two words “vitamin” and “water.”

On top of that, mainstream consumers are disturbingly gullible. If a product is positioned as being healthy, that’s what people believe it’s for, even if it makes no sense whatsoever. After all, why do so many people believe Slim-Fast will make them lose weight even though it’s made mostly from processed refined sugar?

Slim-Fast, by the way, never technically claims it’s a weight loss product. It dances around that claim with all sorts of other gray-area language that implies it is a weight loss product without making any direct claims. If pushed in the courts, its manufacturer would no doubt pull the same thing Coca-Cola just did and proclaim that no reasonable person could conclude that Slim-Fast is a weight loss product.

You see, big food companies are masters at making implied claims about their products that, upon closer inspection, are blatantly false. There are all sorts of false claims found on the labels of popular food products: A chocolate milk product made with sugar claims it “builds strong bones!” A liquid meal substitute sold in cans and made mostly with sugars and milk proteins claims to provide “balanced nutrition!” A product for diabetics claims to be “sugar free” but neglects to mention it’s sweetened with a chemical that may actually promote diabetes.

The list of examples like these is endless. And thanks to these food corporation deceptions, consumers are faced with a food product minefield when attempting to intelligently shop for foods.

That’s why several years ago I developed the Honest Food Guide (http://honestfoodguide.org), a free downloadable guide that explains which foods are truly good for your health (and which are not).

Download it now and check it out for yourself.

In the mean time, don’t buy Vitaminwater. Unless, of course, you think you could use 32 grams of liquid sugars and some synthetic vitamin chemicals in your diet. And if you somehow think that Vitaminwater is healthy, the Coca-Cola corporation thinks you are a fool.

Sources for this story include:

http://recipes.howstuffworks.com/vitaminwater2.htm

http://cspinet.org/new/pdf/order_on_m-dismiss_doc_44.pdf

http://www.cspinet.org/new/201007231.html

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