An enhanced recovery after surgery pathway: LOS reduction, rapid discharge and minimal complications after anterior cervical spine surgery

xlomafota.13 shared this article with you from Inoreader An enhanced recovery after surgery pathway: LOS reduction, rapid discharge and minimal complications after anterior cervical spine surgery Via Latest Results for BMC Musculoskeletal Disorders Abstract Background Enhance recovery after surgery (ERAS) is a new and promising paradigm for spine surgery. The purpose of this study is to investigate the effectiveness and safety of a multimodal and evidence-based ERAS pathway to the patients undergoing anterior cervical discectomy and fusion (ACDF). Methods The patients treated with the ACDF-ERAS pathway were compared with a historical cohort of patients who underwent ACDF before ERAS pathway implementation. Primary outcome was length of stay (LOS). Secondary outcomes included cost, MacNab grading, complication rates and 90-day readmission and reoperation. And perioperative factors and postoperative complications were reviewed. Results The ERAS protocol was composed of 21 components. More patients undergoing multi-level surgery (n ≥ 3) were included in the ERAS group. The ERAS group showed a shorter LOS and a lower cost than the conventional group. The postoperative satisfaction of patients in ERAS group was better than that in conventional group. In addition, the rate of overall complications was significantly higher in the conventional group than that in the ERAS group. There were no significant differences in operative time, postoperative drainage, or 90-day readmission and reoperation. Conclusions The ACDF-tailored ERAS pathway can reduce LOS, cost and postoperative complications, and improve patient satisfaction without increasing 90-day readmission and reoperation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The impact of low serum cholinesterase levels on survival in patients with colorectal cancer

xlomafota.13 shared this article with you from Inoreader The impact of low serum cholinesterase levels on survival in patients with colorectal cancer Via Latest Results for International Journal of Colorectal Disease Abstract Purpose Nutritional and inflammatory status have been associated with postoperative recurrence and poor survival in patients with colorectal cancer. The aim of the present study is to investigate the relationship between serum cholinesterase levels and postoperative outcomes among patients who underwent curative resection for colorectal cancer. Methods The study comprised 174 patients who had undergone curative resection for colorectal cancer. We explored the relationship between preoperative serum cholinesterase levels and disease-free survival and overall survival after curative resection. Then patients were divided into the high-cholinesterase group (n = 102) and the low-cholinesterase group (n = 72) to analyze their clinicopathological variables including other nutritional markers and systemic inflammatory responses. Results In multivariate analysis, lymph node metastasis (P = 0.011) and serum cholinesterase levels (P < 0.01) were independent predictors of disease-free survival, while lymph node metastasis (P = 0.013), serum cholinesterase levels (P < 0.01), and carbohydrate antigen19-9 (P = 0.022) were independent predictors of overall survival. In the low-cholinesterase group, neutrophil to lymphocyte ratio, (P = 0.021), C-reactive protein to albumin ratio (P < 0.01), and distant metastasis (P < 0.01) were higher, and prognostic nutritional index (P < 0.01) was lower compared with the high-cholinesterase group. Conclusion Preoperative low serum cholinesterase levels can be a prognostic factor for postoperative recurrence and poor prognosis in patients after curative resection for colorectal cancer, suggesting an important role of cholinesterase in the assessment of nutritional and inflammatory status in cancer patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

ECG Signal Quality Assessments of a Small Bipolar Single-Lead Wearable Patch Sensor

xlomafota.13 shared this article with you from Inoreader ECG Signal Quality Assessments of a Small Bipolar Single-Lead Wearable Patch Sensor Via Latest Results for Cardiovascular Engineering and Technology Abstract Purpose There is an increasing clinical interest in the adoption of small single-lead wearable ECG sensors for continuous cardiac monitoring. The purpose of this work is to assess ECG signal quality of such devices compared to gold standard 12-lead ECG. Methods The ECG signal from a 1-lead patch was systematically compared to the 12-lead ECG device in thirty subjects to establish its diagnostic accuracy in terms of clinically relevant signal morphology, wave representation, fiducial markers and interval and wave duration. One minute ECG segments with good signal quality was selected for analysis and the features of ECG were manually annotated for comparative assessment. Results The patch showed closest similarity based on correlation and normalized root-mean-square error to the standard ECG leads I, II, \({\text {V}_3}\) and \({\text {V}_4}\) . P-wave and QRS complexes in the patch showed sensitivity (Se) and positive predictive value (PPV) of at least 99.8% compared to lead II. T-wave representation showed Se and PPV of at least 99.9% compared to lead \({\text {V}_3}\) and \({\text {V}_4}\) . Mean errors for onset and offset of the ECG waves, wave durations, and ECG intervals were within 2 samples based on 125Hz patch ECG sampling frequency. Conclusion This study demonstrates the diagnostic capability with similar morphological representation and reasonable timing accuracy of ECG signal from a patch sensor compared to 12-lead ECG. The advantages and limitations of small bipolar single-lead wearable patch sensor compared to 12-lead ECG are discussed in the context of relevant differences in ECG signal for clinical applications. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Actively targeted delivery of SN38 by ultrafine iron oxide nanoparticle for treating pancreatic cancer

xlomafota.13 shared this article with you from Inoreader Actively targeted delivery of SN38 by ultrafine iron oxide nanoparticle for treating pancreatic cancer Via Latest Results for Investigational New Drugs Abstract Pancreatic cancer remains one of the most lethal cancers largely due to the inefficient delivery of therapeutics. Nanomaterials have been extensively investigated as drug delivery platforms, showing improved drug pharmacodynamics and pharmacokinetics. However, their applications in pancreatic cancer have not yet been successful due to limited tumor delivery caused by dense tumor stroma and distorted tumor vasculatures. Meanwhile, smaller-sized nanomaterials have shown improved tumor delivery and retention in various tumors, including pancreatic tumors, suggesting their potential in enhancing drug delivery. An ultrafine iron oxide nanoparticle (uIONP) was used to encapsulate 7-ethyl-10-hydroxyl camptothecin (SN38), the water-insoluble active metabolite of pancreatic cancer chemotherapy drug irinotecan. Insulin-like growth factor 1 (IGF-1) was conjugated to uIONP as a ligand for targeting pancreatic cancer cells overexpressing IGF-1 receptor (IGF1R). The SN38 loadi ng and release profile were characterized. The pancreatic cancer cell targeting using IGF1-uIONP/SN38 and subsequently induced cell apoptosis were also investigated. IGF1-uIONP/SN38 demonstrated a stable drug loading in physiological pH with the loading efficiency of 68.2 ± 3.5% (SN38/Fe, wt%) and < 7% release for 24 h. In tumor-interstitial- and lysosomal-mimicking pH (6.5 and 5.5), 52.2 and 91.3% of encapsulated SN38 were released over 24 h. The IGF1-uIONP/SN38 exhibited specific receptor-mediated cell targeting and cytotoxicity Ato MiaPaCa-2 and Panc02 pancreatic cancer cells with IC50 of 11.8 ± 2.3 and 20.8 ± 3.5 nM, respectively, but not to HEK293 human embryonic kidney cells. IGF1-uIONP significantly improved the targeted SN38 delivery to pancreatic cancer cells, holding the potential for in vivo theranostic applications. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Microbial associations for bioremediation. What does “microbial consortia” mean?

xlomafota.13 shared this article with you from Inoreader Microbial associations for bioremediation. What does "microbial consortia" mean? Via Latest Results for Applied Microbiology and Biotechnology Abstract Microbial associations arise as useful tools in several biotechnological processes. Among them, bioremediation of contaminated environments usually takes advantage of these microbial associations. Despite being frequently used, these associations are indicated using a variety of expressions, showing a lack of consensus by specialists in the field. The main idea of this work is to analyze the variety of microbial associations referred to as "microbial consortia" (MC) in the context of pollutants biodegradation and bioremediation. To do that, we summarize the origin of the term pointing out the features that an MC is expected to meet, according to the opinion of several authors. An analysis of related bibliography was done seeking criteria to rationalize and classify MC in the context of bioremediation. We identify that the microbe's origin and the level of human intervention are usually considered as a category to classify them as natural microbial consort ia (NMC), artificial microbial consortia (AMC), and synthetic microbial consortia (SMC). In this sense, NMC are those associations composed by microorganisms obtained from a single source while AMC members come from different sources. SMC are a class of AMC in which microbial composition is defined to accomplish a certain specific task. We propose that the effective or potential existence of the interaction among MC members in the source material should be considered as a category in the classification as well, in combination with the origin of the source and level of intervention. Cross-kingdom MC and new developments were also considered. Finally, the existence of grey zones in the limits between each proposed microbial consortia category is addressed. Key points • Microbial consortia for bioremediation can be obtained through different methods. • The use of the term "microbial consortia" is unclear in the specialized literature. • We propose a simplified classification for microbial consortia for bioremediation. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Increased migratory activity and cartilage regeneration by superficial-zone chondrocytes in enzymatically treated cartilage explants

xlomafota.13 shared this article with you from Inoreader Increased migratory activity and cartilage regeneration by superficial-zone chondrocytes in enzymatically treated cartilage explants Via Latest Results for BMC Musculoskeletal Disorders Abstract Background Limited chondrocyte migration and impaired cartilage-to-cartilage healing is a barrier in cartilage regenerative therapy. Collagenase treatment and delivery of a chemotactic agent may play a positive role in chondrocyte repopulation at the site of cartilage damage. This study evaluated chondrocyte migratory activity after enzymatic treatment in cultured cartilage explant. Differential effects of platelet-derived growth factor (PDGF) dimeric isoforms on the migratory activity were investigated to define major chemotactic factors for cartilage. Methods Full-thickness cartilage (4-mm3 blocks) were harvested from porcine femoral condyles and subjected to explant culture. After 15 min or 60 min of actinase and collagenase treatments, chondrocyte migration and infiltration into a 0.5-mm cartilage gap was investigated. Cell morphology and lubricin, keratan sulfate, and chondroitin 4 sulfate expression in superficial- and deep-zone chondrocytes were assessed. The chemotactic activities of PDGF-AA, −AB, and -BB were measured in each zone of chondrocytes, using a modified Boyden chamber assay. The protein and mRNA expression and histological localization of PDGF-β were analyzed by western blot analysis, real-time reverse transcription polymerase chain reaction (RT-PCR), and immunohistochemistry, and results in each cartilage zone were compared. Results Superficial-zone chondrocytes had higher migratory activity than deep-zone chondrocytes and actively bridged the cartilage gap, while metachromatic staining by toluidine blue and immunoreactivities of keratan sulfate and chondroitin 4 sulfate were detected around the cells migrating from the superficial zone. These superficial-zone cells with weak immunoreactivity for lubricin tended to enter the cartilage gap and possessed higher migratory activity, while the deep-zone chondrocytes remained in the lacuna and exhibited less migratory activity. Among PDGF isoforms, PDGF-AB maximized the degree of chemotactic activity of superficial zone chondrocytes. Increased expression of PDGF receptor-β was associated with higher migratory activity of the superficial-zone chondrocytes. Conclusions In enzymatically treated cartilage explant culture, chondrocyte migration and infiltration into the cartilage gap was higher in the superficial zone than in the deep zone. Preferential expression of PDGF receptor-β combined with the PDGF-AB dimeric isoform may explain the increased migratory activity of the superficial-zone chondrocytes. Cells migrating from superficial zone may contribute to cartilage regeneration. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients

xlomafota.13 shared this article with you from Inoreader The Ali Krogius procedure for treatment of patellofemoral instability should be regarded as obsolete even in skeletally immature patients Via Latest Results for BMC Musculoskeletal Disorders Abstract Background Several interventions are established for treating patellofemoral instability in adults. Fewer exist for pediatric patients without damaging the epiphysis. The Ali Krogius (AK) method is currently still being used. Most studies are not current and report varying results in small patient population. The aim of this study is to determine the long-term results of the AK method. Methods In this monocentric, retrospective study design, 33 knees in 33 patients who received the AK procedure for recurrent patellar dislocation were assessed. The average age was 20.8 years (range 6–40). The following functional scores were assessed: Kujala Score, Lysholm Score and Tegner Score. Subgroup analysis was done for patients ≤16 years of age. Available preoperative imaging was assessed for known risk factors. Results After an average follow-up of 7.8 years (Range 59–145 months), a total of 8 (24%) knees suffered a redislocation postoperatively. Seven of the eight dislocations occurred in patients ≤ 16 years of age. One knee (3%) was revised due to persistent pain. The median score was 86 points for the Kujala score and 90 for the Lysholm score. The median in the Tegner score was level 6. Clinically, the patellar glide was lateralized in 7 knees (21%) and an apprehension sign was triggered in 8 knees (24%). Conclusions Including the present study, the existing literature indicates a redislocation rate between 24 and 41% following AK. It should thus be regarded as obsolete even though it protects the epiphysis. Surgical interventions such as medial patellofemoral ligament reconstruction with femoral drilling distal to the epiphysis should be preferred. Trial registration Retrospectively registered: S-302/2016. Level of evidence III View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The time course of different neuromuscular adaptations to short-term downhill running training and their specific relationships with strength gains

xlomafota.13 shared this article with you from Inoreader The time course of different neuromuscular adaptations to short-term downhill running training and their specific relationships with strength gains Via Latest Results for European Journal of Applied Physiology Abstract Purpose Due to its eccentric nature, downhill running (DR) training has been suggested to promote strength gains through neuromuscular adaptations. However, it is unknown whether short-term chronic DR can elicit such adaptations. Methods Twelve untrained, young, healthy adults (5 women, 7 men) took part in 4 weeks' DR, comprising 10 sessions, with running speed equivalent to 60–65% maximal oxygen uptake ( \(\dot{V}\) O2max, assessed at weeks 0 and 4). Isometric and isokinetic knee-extensor maximal voluntary torque (MVT), vastus lateralis (VL) muscle morphology/architecture (anatomical cross-sectional area, ACSA; physiological CSA, PCSA; volume; fascicle length, Lf; pennation angle, PA) and neuromuscular activation (VL EMG) were assessed at weeks 0, 2 and 4. Results MVT increased by 9.7–15.2% after 4 weeks (p < 0.01). VL EMG during isometric MVT increased by 35.6 ± 46.1% after 4 weeks (p < 0.05) and correlated with changes in isometric MVT after 2 weeks (r = 0.86, p = 0.001). VL ACSA (+2.9 ± 2.7% and +7.1 ± 3.5%) and volume (+2.5 ± 2.5% and +6.6 ± 3.2%) increased after 2 and 4 weeks, respectively (p < 0.05). PCSA (+3.8 ± 3.3%), PA (+5.8 ± 3.8%) and Lf (+2.7 ± 2.2%) increased after 4 weeks (p < 0.01). Changes in VL volume (r = 0.67, p = 0.03) and PCSA (r = 0.71, p = 0.01) correlated with changes in concentric MVT from 2 to 4 weeks. \(\dot{V}\) O2max (49.4 ± 6.2 vs. 49.7 ± 6.3 mL·kg−1·min−1) did not change after 4 weeks (p = 0.73). Conclusion Just 4 weeks' moderate-intensity DR promoted neuromuscular adaptations in young, healthy adults, typically observed after high-intensity eccentric resistance training. Neural adaptations appeared to contribute to most of the strength gains at 2 and 4 weeks, while muscle hypertrophy seemed to contribute to MVT changes from 2 to 4 weeks only. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effects of eccentric hamstring exercise training in young female handball players

xlomafota.13 shared this article with you from Inoreader The effects of eccentric hamstring exercise training in young female handball players Via Latest Results for European Journal of Applied Physiology Abstract Purpose The multidimensional role of hamstring muscle group strength in athletic performance and injury prevention is well documented, and nordic hamstring exercise (NHE) is a popular method for the development of hamstring strength. Our aim was to examine the EMG characteristics of the eccentric NHE as well as the effects of long-term eccentric NHE training on muscle strength and vertical jump performance in 10- to 11-year-old female handball players. Methods Players from the same handball team were randomly assigned to an eccentric NHE training (13 players) or a control group (10 players). Both groups continued their regular handball training routine, but the NHE group performed additional eccentric NHE exercises once or twice a week, with progressively increasing volume, over 20 weeks. To test training effects, countermovement jump (CMJ) height, eccentric hamstring impulse, peak torque, and angle of peak torque were evaluated before, during and after the training period. In the pre-exercise test, EMG activity of the medial and lateral hamstring muscle was also assessed during NHE. Results Hamstring activities ranged between 98 and 129%. Lateral hamstring activity was greater than medial only in the right leg during NHE. Eccentric hamstring impulse improved in both legs at 10 weeks in both groups. Then, at 20 weeks, it remained unchanged in the NHE but decreased in controls. A similar adaptation was seen in eccentric hamstring torque, without change in the optimum knee angle. CMJ height improved only in the NHE. Conclusion It is concluded that NHE activates the hamstring musculature effectively, and a favourable mechanical adaptation to long-term NHE exercise in girls can be triggered as early as 11 years of age. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Enhancement of radiation response of breast cancer cells through the incorporation of Bi2S3 nanorods

xlomafota.13 shared this article with you from Inoreader Enhancement of radiation response of breast cancer cells through the incorporation of Bi2S3 nanorods Via Latest Results for Journal of Nanoparticle Research Abstract The aim of this work was to develop nanomaterials that can be used as sensitizers in radiotherapy treatment. The synthesis of bismuth sulfide (Bi2S3) particles with nanometer size by the hot injection method was studied as well as their behavior when coated with a biocompatible agent. The hot injection method allowed us to synthesize Bi2S3 nanorods measuring in average 4.2 ± 1.4 nm in width and 27.5 ± 16.3 nm in length. Moreover, to improve their biocompatibility, these nanorods were coated with polyvinylpyrrolidone with the purpose of studying the behavior of nanorods in the bloodstream. The results indicated that the suspensions were more stable when the media had protein components which may facilitate the blood circulation of the particles. The toxicity of the nanorods and their radiosensitization potential were evaluated and determined in breast cancer cells (MCF7). These results show that the synthesized nanorods did not evidence cytotoxicity up to a concentration of 2500 μg/mL, over 72 h of incubation. On the other hand, the sensitivity of MCF7 cells with and without nanorods in the culture medium, afterward irradiating them with a dose of 2 Gy 60Co gamma radiation source, showed a 38% increase in cell death when compared to cells that were only irradiated. Our results show that Bi2S3 nanorods are very promising as anticancer agents improving the efficiency of radiotherapy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.