Rimas Jankūnas
Lithuanian University of Health Sciences, 57
08:45-09:00
Serum Magnesium Is The Most Frequently Used Laboratory Test For Evaluating Clinical Magnesium Status. Hypomagnesemia Has Been Associated With Many Chronic Diseases, But Currently No Consensus For A Normal Magnesemia Range Exists, Nationally Or Internationally. In Addition, Reports As Early As 1983 Showed That Means Of Serum Mg Are Similar In Both Hospitalized And Healthy Subjects, But The Variance Of Those Hospitalized Is Wider Than The Healthy Group. A Low Serum Magnesium Is A Definite Sign Of Magnesium Deficiency; However, Values Within The Reference Range Do Not Rule Out Deficiencies. A Recent Review And Many Hospital Laboratories And Researchers Use Symptomatic Hypomagnesemia To Define The Lower Range Marking Hypomagnesemia, But There Is A Large Range Of Serum Mg Above These Values Which Are Asymptomatic And Yet Do Not Denote A Fully “healthy” Magnesium Status. Two Independent Groups Have Recently Designated 0.85 – 0.95 Mmol/L As A Reliable Serum Mg Reference Range, But Only The Lower Boundary Marker, I.e. 0.85 Mmol/L Is Evidence Based. A Reliable, Evidence-based Upper Limit Of A Health Serum Mg Has Yet To Be Ascertained, And It Is Possible That Serum Mg Alone May Not Be Adequate To Designate A Compromised Magnesium Status That Is Asymptomatic Yet Portending Future Development Of Chronic Disease. According To The Current Data, An Increase In The Lower Limit Value For Serum Magnesium To 0.85 Mmol/L (2.1 Mg/dL) Is Required From A Health Point Of View. The Best Way To Diagnose A Magnesium Deficiency Is Based On The Clinical Symptoms And The Presence Of Risk Factors (anamnesis) In Combination With The Serum Magnesium.
O. Mickeis Head Of The Department Of Radiotherapy And Radiation Oncology, And Clinical Director Of The Franziskus Hospital Bielefeld, Germany, Teaching Hospital Of The Hannover Medical School (MHH). He Is The Associate Editor Of “Trace Elements And Electrolytes”- Official Organ Of The – "Society Of Magnesium Research", Germany, And – German Working Group “Trace Elements And Electrolytes In Radiation Oncology” AKTE, Germany. He Is President Of The German Magnesium Society And Chairman Of The German Working Group “Trace Elements And Electrolytes In Radiation Oncology” AKTE. One Main Focus Of His Scientific Interest Is Complementary And Alternative Medicine, Micronutrients, Traditional Medicine, And Trace Elements And Electrolytes. He Authored More Than250 Publications In Peer Reviewed National And International Scientific Journalsand Has Been Invited As Speaker At National And International Meetings.
Listen to this article
POCUS Is A Critical Diagnostic Tool In The Acute Care Setting, Allowing Clinicians To Rapidly Assess Cardiac Function In The Context Of The Patient's Clinical Condition. POCUS Performed By Anaesthesiologists Significantly Impact The Clinical Management Of Patients Scheduled For Noncardiac Surgery. Clinical Findings Were Confirmed By Follow-up Formal Transthoracic >90% Of The Time And No Severe Aortic Stenosis, Severe Ventricular Dysfunction, Or Significant Pericardial Effusion Were Missed. In The Perioperative Period, POCUS Allows For The Anaesthesiologist As A Perioperative Physician To Check For Coexisting Diagnosis, Categorize Shock, Respiratory Failure, And Ongoing Effects Of Therapeutic Treatments. Real Time Physiologic Data Reflect Dynamic Changes In Response To Medical Therapies And Follow The Evolution Of Critical Illness By Serial Examinations, Allowing For The Integration Of POCUS Findings Into A Complete Management Plan. This Brief Report Aims To Identify The Indications, Clinical Impact On Management Decisions, Andperioperative Focused Cardiac Ultrasound Accuracy In Patients Scheduled For Non-cardiac Surgery.
Anahita Dabo-Trubelja Is Clinical Member In The Department Of Anaesthesiology And Critical Care At Memorial Sloan Kettering Cancer Center In NYC. She Serves As Director Of Onco-Anesthesia Fellowship Program And Director Of POCUS, A Program She Initiated. Her Interest Focuses On Promoting Onco-Anaesthesiology As A Subspecialty And Integrating POCUS Into Daily Practice To Guide Management In The Perioperative Period.
Listen to this article
Introduction: Extracranial Internal Carotid Artery (ICA) Pseudoaneurysmsin Children, Although Uncommon, Are Life-threatening. Covered Stents Are A Good Alternative Treatment, As They Avoid The Risk Of Open Surgery And Preserve The Internal Carotid Artery.Long- Term Outcomes Were Unknown Until Recently. Report: In August 2008, A 3-years-old Child Was Treated With A Covered Stent For A Pseudoaneurysm In The Extracranial ICA. A Long-term Follow Up Is Presented. Results: The Child Was Discharged With Full Recovery And Without Neurological Sequelae. He Has Been Followed-up And Has Remained Asymptomatic For 12 Years, With CTA- Confirmed Internal Carotid Artery Patency, Without Deformation Or Evidence Of Significant Re- Stenosis. Conclusion: This The First Report Of The Long-term Outcome Of A Covered Stent In A Child Treated At 3 Years Of Age, With A 12-year Follow-up. The Good Performance Of The Covered Stent In This Case Reinforces Its Adoption As A First-line Option In The Treatment Of Extra Cranial ICA Pseudoaneurysms In Children.
• Prof. Roberto Sánchez, MD Professor Of Surgery • Faculty Of Medicine- University Of Concepción- CHILE Fellow Of The American College Of Surgeons • Ancien Resident Etranger Des Hopitaux De Paris • MembreAsocieeEtrangerSociété De ChirurgieVasculaire Et Endovasculaire De Langue Francaise (SCVE) • Non-european Membership European Society Of Vascular And Endovascular Surgery (ESVS)
Listen to this article
Background: Prolonged exposure to opioids has a negative influence on physical and mental health. Currently,little is known about the risk of prolonging opioids after first postoperative use. Aim: A study was conducted to define the proportion of postoperative patients that use oxycodone longer than prescribed todetermine risk factors of prolonged use. Method: This retrospective single-center nested case–control study was performed in the Elisabeth Tweesteden Hospital, Tilburg, The Netherlands. Thestudy population consisted of postoperative adult patients who received an oxycodone prescription at discharge between April2018 and June 2020. The primary outcome was the proportion of patients with at least one refill of oxycodone during a follow-upperiod of 30 days. The secondary outcome was the association of potential risk factors with oxycodone refills. Univariateand multivariate logistic regression analyses were performed to determine the association between the variables and outcome. Results: 1,203 patients were included of which 280 (23.3%) received one or more refill. Age (adjusted odds ratio 1.01 [95%confidence interval 1.00–1.02]), length of stay (1.10 [1.06–1.14], a Numeric Rating Scale pain score of four or higher (1.52[1.14–2.01]), use of the continuous release form of only (2.15 [1.60–2.89]) and admission to various hospital departments wereassociated with a refill of oxycodone. Conclusion: The proportion of patients with a refill of oxycodone was 23.3%. This could result in chronic oxycodone use and potential misuse. Patients with the determined risk factors may be a suitable population for future interventions to minimize prolonged use.
Dr. Barbara Maat is clinical pharmacist at the Elisabeth TweeSteden hospital in Tilburg, The Netherlands. She completed her PhD in 2014 (Optimization of electronic prescribingin pediatric patients). Her main fields of interest in clinical practice are pharmacotherapy for surgical patients and pediatric pharmacotherapy. Her scientific work focuses on medication management, medication safety, electronic clinical decision support and technological innovations. Most of her studies have a pharmacoepidemiologic design, but she increasingly uses qualitative research methods in addition.
Listen to this article
Background: An indirect outcome of the Covid-19 pandemic has been higher adoption and acceptance of telemedicine and virtual visits, but such visits are short-timed, lacking in data persistence and continuity in the care of patients. Our published work (Zahedi et al. 2022) proposed designing a medical system (called wepital with virtual avatars for patients and connecting them with real-time and continued medical care. Methods: Sixty patients with gastrointestinal problems participated in the experiment using the wepital prototype and wearable sensors. The patients interacted with GI specialists in a group setting, as uniquely enabled by wepital to maintain patient anonymity and privacy. Results: First, our work showed the proof-of-concept of the feasibility of our design. Second, the research experiment with real patients shows high patient satisfaction with physicians and our prototype design. Furthermore, patients generally had positive feelings and beliefs about their real avatars. Conclusion: Our work shows that real avatars have the potential to represent people in critical contexts, such as medical care. Our work also provides a theoretical-based framework for the assessment of patent-based technologies and technology-assisted delivery modes. Our work has practical and policy implications for persistent patient care at home, short-term rehab centers, and hospitals.
Nitin Walia is a Clinical Professor of Information Systems in the W. P. Carey School of Business at Arizona State University. He received his Ph.D. degree in Information Systems from the University of Wisconsin-Milwaukee. He also holds M.S. degrees from Oakland University, MI, and Pune University, India. His work has been published in several national and international journals, including the Journal of Management Information Systems, Journal of Information Technology Case and Application Research, Information & Management, Electronic Commerce Research, IEEE Transactions on Software Engineering, IEEE Intelligent Systems Journal, and International Journal of Electronic Business Management
Listen to this article
Objective: To assess the prevalence and factors associated with dysglycemia (diabetes and prediabetes) in older people living with HIV infection. Method: This was a cross-sectional, analytical study with 59 older people living with HIV and using antiretroviral therapy, recruited by convenience sampling in two HIV referral hospitals in Recife (PE), between May/2018 and February/2020. The prevalence and factors associated with dysglycemia were analyzed by Chi-square, Fisher Exact, Kruskal-Wallis and Mann-Whitney tests. Results: The mean age of the 59 older peple 64.3 years and 66.1% were male. The prevalence of diabetes and prediabetes was 20.3% and 35.6%, respectively, and the significant risk factors were physical activity,coronary disease, riskof cardiovascular disease in ten years, HDL cholesterol levels and glycemia. Conclusion: A high prevalence of diabetes and prediabetes was observed in older people living with HIV. Interventions aimed at older people with HIV and the risk of diabetes and prediabetes are necessary, especially those with a sedentary life style, with a relevant cardiovascular risk and biochemical changes that participate in metabolic syndrome.
Listen to this article
Background: Major antihypertensive drug classes excluding Imidazoline Receptor Agonists (IRAs) have been demonstrated to reduce cardiovascular morbidity and mortality. In 2017, Latvia and Lithuania had the highest cardiovascular mortality among the Eastern, Central, Northern, and Western Member States of the European Union (EU). Cardiovascular mortality in Estonia is much lower than in Lithuania and Latvia. Objective: To evaluate the consumption of Imidazoline Receptor Agonists in the Baltic States and its potential implications. Materials and Methods: The study included data on the sales of Imidazoline Receptor Agonists in Lithuania, Latvia, and Estonia; the marketing authorization databases of the competent authorities; the guidelines on the treatment of hypertension, and the reimbursement conditions. Results: The study showed a very high consumption of the Imidazoline Receptor Agonists in Lithuania and Latvia. From 2016 to 2019, the average consumption of Imidazoline Receptor Agonists in Lithuania was 15.5 times higher than in Estonia; in Latvia, it was 8.9 times higher than in Estonia. The guidelines recommend the use of the Imidazoline Receptors Agonists as one of the last options in hypertension therapy, but the marketing authorizations do not restrict their line of therapy. Conclusions: Consumption of IRAs in Lithuania and Latvia is very high. The authorized use of the IRAs in the EU Member States is not in line with the guidelines on the management of arterial hypertension and therefore patients might be deprived of therapies that reduce the cardiovascular risk. The drug regulatory authorities of the EU should review the data on the safety and efficacy of the IRAs and restrict their therapeutic indications if necessary.
Rimas Jankūnas is working as an associated professor at Lithuanian University of Health Sciences (started in this university in 1994). He is also Director at Health Law Institute of Lithuania (since 2021).
Listen to this article
Introduction: Gadolinium-based contrast (GBCAs) agents are routinely used for improving the clarity of body images obtained by magnetic resonance imaging (MRI). Skin tests (ST) are the main tools to investigate suspicions of GBCA hypersensitivity reactions (HR). The place of drug provocation test (DPT) is not well established. The aim of our study was to study the negative predictive value (NPV) of ST in patients with a past-history of HR to GBCAs, by addressing the occurrence of new HR upon reexposure after the negative allergy workup. Methods: We performed a retrospective analysis, based on the Drug and Allergy Hypersensitivity Database (DAHD) of the Allergy Unit of the University Hospital of Montpellier. Patients tested by ST with GBCAs from 2012 to 2021 were included. Information about reinjection of GBCAs, was searched on the electronic health record on hospital network and completed by a questionnaire by phone or mail, when it was not found. Patients were asked about their experience with ST and the confidence they had in the allergy work-up. Results: We identified 165 patients. Among them, there were 134 women (81.2%). Sixty-two patients (37.5%) answered the questionnaire by the time of the analysis (data collection ongoing). 54 patients (32.7% of the whole cohort) having an MRI were reinjected with GBCAs (which could be identified in 76% of situations). In this group, most index reactions (81.4%) were immediate, one third (19 patients, 35.2%) being anaphylactic (with or without shock). Seven patients (12.9%) described a reaction: in 2 and 3 cases the reaction was localized and generalized erythema, respectively, one case reacted with dizziness and another one described throat oedema. Conclusion: Our results confirm small rates of reactions after reinjection of GBCAs, in patients with negative ST. The NPV in our study was high (87%) and the breakthrough reactions were not severe. The strength of this study is the large sample of patients followed in real-life conditions. It adds up to the scarce knowledge of drug allergy work-up for GBCAs.
Listen to this article
Synthesis of silver nanoparticles (Ag-NPs) have been extensively studied in the literature due to their broad biocidal ability byforming of silver complexes with various cell parts such as responsible proteins for RNA-DNA replication or cell membrane. Ag-NPs therefore inhibit vital functions of the target cell.Colloidal Ag-NPs have been used in disinfection products for wound healing, animal husbandry, surface and air disinfectant to fight with the variety of infections.Ag-NPs are susceptible to environmental conditions based on the product content such as pH, ion type, concentration, electronegativity and viscosity of the medium where nanoparticles either agglomerate or aggregate. To gain and preserve anti-microbial property of Ag-NPs, stability of particlesholds critical importance.Herein, product development strategy based on nanoparticle stability is highly important to achieve the desired abilities of NP.In literature, formulations containing chlorine ion such as chlorhexidine or NaCl produce AgCl bridges between the particles found to inhibit its anti-bacterial ability due to aggregation. At pH values lower than 5.5, Ag-NPs starts lose their electrostatic OH- barrier which results with agglomeration. However, using oxidants in the synthesis, oxidizes Ag0 to Ag+ leading to dissolution of Ag-NPs. The behavior of Ag NPs can be observed using UV-visible spectroscopy, dynamic light scattering (DLS), transmission electron microscopy (TEM), zeta-potential measurements while the relation between the biological efficiency of Ag-NPs can be measured with disk diffusion method and minimum inhibitory concentration (MIC) assays. With this product development strategy, synthesizing Ag-NPs with minimum amount of silver, efficient and highly stable could be achieved for sterilization applications.With this development strategy to use Ag-NPs, stable and efficient formulations could be developed using minimum amount of silver for such products.
Mert Saraçoğlu studied Material and Metallurgy Engineering at the İstanbul Technical University (ITU), Turkey and graduated in 2021.He had been researching on develop stable silver nanoparticles using non-toxic chemicals for medical industry. Currently, he does his MSc degree in the same university, the research group of Prof. Timur. He works in NANOSILVER Inc. as a co-founder responsible of product development and R&D as well.
Listen to this article
Open heart surgery has become more readily available worldwide, especially in the West, whilst it remains elusive for the majority of the people in Sub-Saharan Africa, and Zimbabwe in particular. Efforts to provide the service began in the 1950s and open-heart surgery became a regular service from 1989 to 2003. From 1997, Zimbabwe went through a phase of political and economic turmoil resulting in the disruption of meaningful service. This study seeks to make the case for prioritization of domestic resources toward open heart surgery, taken as learning from African countries that faced a similar predicament such as Ghana but who have since been able to sustain their programs. To ensure the success of the program, the following are necessary: the requisite personnel, equipment, consumables, and competitive remuneration. The plan is to work with Government, the private sector, and other players to harness resources toward sustainable open heart surgery in Zimbabwe
Simukayi Percy Machawira is a Cardiothoracic surgeon heading the Department of Cardiothoracic Surgery at Parirenyatwa Group of Hospitals. He graduated in MBChB in 1997 and MMed Surgery in 1996 at the University of Zimbabwe, School of Medicine. He obtained a Fellowship in Cardiothoracic Surgery in 2014 through the University of the Witwatersrand, South Africa. Simukayi has published several articles in the cardio thoracic and genral surgery. He is currently leading the process of resuscitating open heart surgery at Parirenyatwa Group of Hospitals.
Listen to this article
When colonizing the lower genital tract of pregnant women, GBS may cause premature birth and stillbirth. If transmitted to the newborn, it may result in life-threatening illnesses, including sepsis, meningitis, and pneumonia. Moreover, through continuous evolution, GBS can use its original structure and unique factors to greatly improve its survival rate in the human body. This review discusses the key virulence factors that facilitate GBS invasion and colonization and their action mechanisms. A comprehensive understanding of the role of virulence factors in GBS infection is crucial to develop better treatment options and screen potential candidate molecules for the development of the vaccine.
Yuxin Liu is a junior in the China-UK Dual Degree Joint Programme (Queen Mary University of London Biomedical Sciences, Nanchang University Clinical Medicine) with a 3.70 GPA in freshman and sophomore years and in the top 3% of thetwo years. She was twice awarded a special scholarship. She is the Project leader of the Gold Award in the8th China International Collage Students “Internet+” Innovation and Entrepreneurship Competition.
Listen to this article
COVID-19 has drastically disrupted the lives of many people globally, and the havoc it has wreaked has shattered world economies. The effects of COVID-19 in Eswatini (formerly Swaziland) are threatening the very foundations of the country. Referenced in the national language, its effects manifest in the perceptions and experiences shared among Swazis (emaSwati) about the scourge. This article investigates the pandemic’s impact on Swati (siSwati) and the ways in which Swazis adapted their language-related tropes in the face of unprecedented social and economic disruptions. Data are drawn from government briefings, news bulletins, media interviews and addresses. The findings demonstrate that COVID-19 has produced neologisms and expressions that index Swazis cultural views. While a morpho-syntactic analysis of the neologisms demonstrates that they derive from varied word-building mechanisms and exhibit COVID-19’s distinctive characteristics of transmissibility, pathology, and annihilation, the measures to contain COVID-19 are presented aesthetically to dispel the anxiety associated with the pandemic.
Listen to this article
Scope: Missing data is a common problem in general applied studies, and specially in clinical trials. An improper treatment of missing data may have serious implications for the accuracy of inferences of many clinical studies. Then, it is necessary to provide rigorously validated methodological tools that allow tackling this problem. Furthermore, for implementing sensitivity analysis, several multiple imputation methods exist, like sequential imputation, which restricts to monotone missingness, and Bayesian, where the imputation and analysis models differ, entailing overestimation of variance. Also, full conditional specification provides a conditional interpretation of sensitivity parameters, requiring further calibration to get the desired marginal interpretation. Objectives: The aim of this work is to present a multiple imputation procedure, based on a multivariate linear regression model, which keeps compatibility in sensitivity analysis under intermittent missingness, providing a marginal interpretation of the elicited parameters. Methods used: We conduct two simulation studies, one on a standard setting and another in a more demanding setting, which show that the proposed method of multiple imputation behaves well with longitudinal data and remains robust under demanding constraints. Its use is illustrated in a real case study on Cuban vaccines against COVID-19, where a simulation and a sensitivity analysis are conducted. Conclusion: We conclude the possibility of situations not covered by the existing methods and well suited for our proposal, which allows more efficient handling of a given multivariate linear regression structure. These situations comprise the delta-adjustment setting, an instance of sensitivity analysis; control-based imputation, an approach to sensitivity analysis that imputes missing data in the test drug group using a model built from the control group; as well as other settings.
Listen to this article
Electromagnetic emissions from everyday wireless technologies are an ever- present environmental stressor affecting biological systems. One of the most important affected organs is the heart, whose innate electromagnetic processes are interfered with by man-made non-ionising radiation (NIR) emitted from wirelessly communicating devices. In this paper, we present the weight of evidence for such effects for multiple biological systems, including the cardiovascular system and related biochemistry. This evidence was derived from papers collated within the ORSAA database (ODEB). Experiments investigating exposures from real world devices and living near mobile phone base stations show the effects of radiofrequencies on the heart and cardiovascular system. Studies with rats and humans show changes in heart rate, lipids, blood pressure, and structure and function, as well as increases in the risk of heart tumors and cardiomyopathy in experimental animals. Significant biological effects of NIR exposures below guideline ‘safety limits’ were found in 79% (n=256) of the experimental papers and 66% (n=166) of the epidemiological papers from ODEB that investigated real world exposures. In particular, one of the major biological factors underlying heartdisease, oxidative stress, had over 100 papers showing effects (>90% of publications on this topic). The SWISS research group BERENIS found significant evidence of increased oxidative stress from NIR, even in the low-dose range. This understanding has not yet reached most cardiologists, as it is not yet included in institutional training. This paper will assist with understanding by describing plausible mechanisms underlying oxidative stress. Also presented are the classical clinical presentations for patients who are acutely sensitive to NIR exposures and a set of best practice guidelines for treating patients affected by electromagnetic exposures and generally for using technology more safely in coronary care settings. Mitigating this biological stressor could positively affect bed stays prognosis and, perhaps most importantly, preventative care.
Dr. Erica Mallery-Blythe, is a UK-trained medical doctor with a decade of experience in hospital medicine of various disciplines within multiple countries. Emergency Trauma Medicine is her area of expertise in hospital. In training for this speciality, she has a broad base of medical experience which includes surgery, anaesthesiology, obstetrics, pediatrics and intensive care (both neonatal and adult). In 2008, she began researching the biological effects of non-ionising radiation with a special interest in Electromagnetic Hypersensitivity (EHS). She is currently the Founding Director of the Physicians’ Health Initiative for Radiation and Environment (PHIRE), Special Expert and European Representative at the International Committee on the Biological Effects of Electromagnetic Fields (ICBE-EMF), Medical Advisor for Oceania Radiofrequency Scientific Advisory Association (ORSAA), Honorary Member of British Society for Ecological Medicine (BSEM), Medical Advisor for Electro sensitivity UK (ES-UK), Medical Advisor at International Guidelines on Non-Ionising Radiation (IGNIR).
Listen to this article
Decreased left ventricle (LV) function caused by genetic mutations or injury often leads to debilitating and fatal cardiovascular disease. LV-cardiomyocytes are, therefore, a potentially valuable therapeutical target. Human pluripotent stem cell derived cardiomyocytes(hPSC-CMs) generated using current protocols are neither homogenous nor mature, which reduces their utility. Here we exploited cardiac development knowledge to devise a LV-cardiomyocyte differentiation protocol from hPSCs. Correct mesoderm patterning and retinoic acid pathway blocking were essential to generate near-homogenous hPSC-LV-CMs. As expected, hPSC-LV-CMs transit via first heart field progenitors and display typical ventricular action potentials. Unexpectedly,hPSCLV-CMs exhibit increased metabolism,reduced proliferation and improved cytoarchitecture and functional maturity compared to age-matched cardiomyocytes generated using the standard WNT-ON/WNT-OFF protocol. Of note was the calcium response to sarcoplasmic reticulum specific inhibitors (ryanodine and thapsigargin), which showed that hPSC-LV-CMs have more appropriate drug-responses. This increase in maturity is also observed in engineered heart tissues (EHTs) made from hPSC-LV-CMs, which are better organised, produce higher force andhave a slower beating ratebut can be paced to physiological levels. This demonstrates themechanical load induced maturity exerted by the EHTs was additive rather than transformative. Together, we show that hPSC-LV-CMs with mature properties can be rapidly obtained (in 20 days), even without exposure to reported maturation regimes. These cells are, therefore, a suitable model to study LV development and disease and will likely enable more faithful LVspecific cardiotoxicity screens. Moreover, this work opens the possibility of like-for-like cell replacement therapy becoming an accessible treatment for heart failure patients. British Heart Foundation (BHFFS/12/37/29516; RM/17/1/33377), Wellcome Trust (210987/Z/18/Z), Medical Research Council (MR/R017050/01;MR/X50287X/1), LifeArc (LifeArc-Crick Translation Fund) and Francis Crick Institute (FC001157).
Andreia was awarded her PhD from University of Aberdeen and in her PhD used stem cells to study pancreas development. She then moved to the University of Cambridge for a Post Doc with Professor Roger Perdersen, where she researched mesoderm specification using embryos and stem cells. Later she was awarded a BHF intermediate fellowship to study heart-chamber specification in Sir Jim Smith’s laboratory at the NIMR. After a 2 year career break, she was awarded a Wellcome Trust Career re-entry fellowship to continue her work on heart-chamber development at the Francis Crick Institute. Her experience includes human stem cells research and embryology. Her work has led to the submission of two patents arising from human stem cell studies. Andreia has collaborators in Europe and the USA. She is now trying to commercialise her left ventricle cardiomyocyte model for pharma use and her team is working in both academic and translational projects.
Listen to this article
Since the meniscus is an important stabilizing structure of the knee joint and has a significant role in load-bearing and shock absorption, so the complete structural and functional reconstructions of the teared menisci should be done not only after partial meniscectomy but also post total meniscectomy. So far, animal experiments and good clinical practice have showed that the total meniscus allograft transplantation (TMAT) after total meniscectomy has partially solved the problem of structural and functional reconstructions after total meniscectomy. However, partial meniscectomy will also lead to accelerated knee degeneration, and its proportion is much higher than that of patients with total meniscectomy. Herein, the feasibility of partial meniscus allograft transplantations (PMAT) after partial meniscectomy was investigated for the first time by using the 40% posterior horn meniscectomy model of the medial meniscus in Beagle dogs, and also for the first time, TMAT group and the total meniscectomy group were used as control groups. Compared with the TMAT, the transcriptomics evaluation, scanning electron microscope observation, histological regeneration and structure, biomechanical property, inflammation environment, and the knee function post PMAT were more similar to that of normal meniscus was first reported. This study provides a PMAT scheme with clinical translational value for the complete structural and functional reconstruction of the patients with partial meniscectomy and fills the gap in the field of teared meniscus therapy on the basis of quite well clinical applications of the meniscus repair and the TMAT.
Jia-Kuo Yu, PhD supervisor, director of the Institute of Sports Medicine of Peking University, director of the Department of Sports Medicine and Knee Surgery of Peking University Third Hospital. Studied in Germany as a senior visiting scholar between 1999 and 2001. Expert enjoying the special allowance of The State Council. Chairman of Geriatric Sports Medicine Branch of Chinese Society of Gerontology and Geriatrics. Group leader of Passive Implants of Medical Device Classification Technical Committee of State Drug Administration. Vice chairman of biomaterial advanced manufacturing branch of Chinese biomaterials Society. 99 English articles were published as the first author or corresponding author. 10 monographs of the chief editor or deputy chief editor. 66 patents have been granted (including 18 invention patents), 32 patents have been converted. The total amount of conversion exceeds RMB 100 million.
Listen to this article
This study aims to verify if the use of intravascular laser irradiation of blood (ILIB) influences the reduction of pain and increases the range of motion in opening and closing of the mouth in children and adolescents with Temporomandibular Disorders (TMD). Methods: This will be a blind, randomized and controlled clinical trial, which will be carried out on children between 6 and 12 years of age who enter the Catholic University of Uruguay, Faculty of Health Sciences, Postgraduate School, for treatment. To be included, children must present temporomandibular disorders, based on the diagnostic criteria will be the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Forty-five participants will be randomized to three groups: Group 1 – ILIB with 2 sessions of 20 minutes for 12 weeks (n=15); Group 2 – Placebo laser application with 2 sessions of 20 minutes for 12 weeks (n=15); Group 3 – Control with no treatment (n=15). Irradiation will be performed by continuous and direct transcutaneous application to the radial artery, by means of a bracelet that inserts the laser beam. The laser to be used is infrared, power 100 mW ±20%, wavelength 808nm ±10 nm, continuous application. RDC/TMD and pain evaluated through a visual analog scale will be the outcome measures. Discussion: Due to the low level of evidence, new studies are needed on the effect of ILIB in children with TMD.
Ferreira Sertaje María Roxana is currently under a PhD Graduate Program in Applied Rehabilitation in Health Sciences Universidad Católica del Uruguay Universidad Nueve de Julio San Pabl. She is a specialist in Orthodontics and FacialBucomaxillo Orthopedic. She is working as a professor Orthopedics Course in the Specialty of Orthodontics and Buco Maxillofacial Orthopedics
Listen to this article
Individuals with mild cognitive impairment (MCI) were at increased risk of conversion to dementia. The KleebBuaDaeng (KBD) formula could be the alternative treatment option for MCI through multi-target activities. However, the lack of clinical trial, therefore, need to be studied in our research. Forty patients with MCI were randomly assigned to receive the KBD capsule or placebo at a dose of 1,000 mg twice a day for three months. They were monitored cognitive functions by the Montreal Cognitive Assessment (MoCA) assessment test and blood chemistry assessment every one month. We found that the KBD-treated group had no significant differences on the MoCA test compared to placebo. Moreover, there was no alter in biochemical parameters of the liver, and renal function was observed which could confirm the safety of this KBD formula.
Natdanai Musigavong is presently head of research and development in Thai traditional medicine at Chao PhyaAbhaibhubejhr hospital, ministry of public health, Thailand. He started working as a pharmacist for this public hospital in 2010. His expertise is in the area of clinical study of Thai traditional medicine. The career overview is to supervise the design and writing of protocols, case report forms, and informed consent forms for clinical trials. Additionally, he has to direct the planning and implement all activities required to conduct and monitor complex clinical trials and ensures that good clinical practices are followed.
Listen to this article
Purpose: Mastocheck®, a proteomic-based blood assay, has been developed for early diagnosis of breast cancer. The purpose of this study is whether Mastocheck® is useful as a postoperative follow-up. Methods: A total of 255 patients were analyzed. The patients were classifed into longitudinal monitoring and recurrence/ nonrecurrence cohorts. The longitudinal monitoring cohort consisted of 111 patients. In this cohort, blood analyses were performed three times (before surgery, 8 weeks after surgery, and between 6 months and one year after surgery), and a comparative analysis of the values of Mastocheck® and individual proteins at each time point was performed. The recurrence/ nonrecurrence cohort consisted of 144 patients who had been followed up for more than 1 year, and the blood marker values at the time of local recurrence were compared to those of nonrecurrence patients. Results: In the longitudinal monitoring cohort analysis, in 81 of 111 patients were diagnosed with breast cancer with Mastocheck® and the sensitivity was 73.0%. Of 111 patients in the longitudinal monitoring cohort, 108 had two blood analyses (before and 8 weeks after surgery), and three serial blood analyses were performed on 53 patients. The Mastocheck® value that were in the cancer range of 73.0% (in 81 of 111 patients) of patients before surgery, was within the normal range of 68.5% (in 74 of 108 patients) at 8 weeks after surgery and 88.7% (in 47 of 53 patients) from 6 months to 1 year after surgery. The value of Mastocheck® was signifcantly decreased after surgery compared to before surgery (p<0.001). In the recurrence/nonrecurrence cohort analysis, the Mastocheck® values were in the cancer range in 38 out of 63 recurrence patients and within the normal range in 66 of 81 nonrecurrence patients (sensitivity of 60.3% and specifcity of 80.2%). Conclusions: Mastocheck® is expected to be used as a blood marker tool to aid in the early detection of recurrence during follow-up after breast cancer surgery.
Yumi Kim is working as anassistant professorat CHA University School of Medicine under the department of surgery.
Listen to this article
As DNA sensing has vast technology for researchers and other biotechnologists, we have introduced emerging class of azo and guanidine based molecules. We synthesized three new compounds (UA1, UA6, and UA7) and checked their potential application towards DNA sensing specially in alcoholic medium. These compounds were characterized in the solid and solution phase. These synthesized materials were characterized by elemental analysis, FTIF, UV-Visible, 1H NMR and 13C NMR spectroscopy. DNA interaction was further investigated by cyclic voltammetry and hydrodynamic studies. The results showed that compounds have moderate DNA binding properties such as binding constants are ranged 7.2×103, 2.4×103, 0.2×103 M-1, for UA1, UA6 and UA7 respectively. Upon binding with DNA, there was change of colour in solution can be easily seen with naked eye. This change in colour is due to blue shift in λmax value. These results indicated the potential of synthesized compounds as DNA sensors with detection limit 1.8, 5.8 and 4.0 ngµl-1 for UA1, UA6 and UA7 respectively. It is concluded that the binding mode is electrostatic and binding strength is moderate and is less than the other existing DNA sensing molecules. The good changes in wavelength indicated that better DNA sensors specially in ethanolic medium.
Listen to this article
Immune checkpoint inhibitors have achieved unprecedented success in cancer immunotherapy. With the exception of a few candidate biomarkers, the prognostic role of soluble immune checkpoint-related proteins in clear cell renal cell cancer (ccRCC) patients is largely uninvestigated. We profiled the circulating levels of 14 immune checkpoint-related proteins panel (BTLA, GITR, HVEM, IDO, LAG-3, PD-1, PD-L1, PD-L2, Tim-3, CD28, CD80, CD137, CD27 and CTLA-4) and their associations with the risk of recurrence and death in 182 ccRCC patients using a multiplex Luminex assay. Gene expression in tumors from a subset of participating patients (n = 47) and another 533 primary ccRCC from TCGA were analyzed to elucidate potential mechanisms. Our primary endpoint is overall survival; secondary endpoint is recurrence-free survival. Multivariate Cox proportional hazard model, unconditional logistic regression model, and Kaplan-Meier analysis were applied in the study.sTIM3 and sLAG3 were significantly associated with advanced (stage III) disease (P < 0.05). sPD-L2 was the strongest predictor of recurrence (HR 2.51, 95%CI 1.46-4.34, P = 9.33E-04), whereas high sBTLA and sTIM3 was associated with decreased survival (HR 6.02, 95%CI 2.0-18.1, P = 1.39E-03 and HR 3.12, 95%CI 1.44-6.75, P = 3.94E-03, respectively). Risk scores based on sTIM3 and sBTLA indicated that the soluble immune checkpoint-related proteins jointly predicted recurrence and death risks of ccRCC (P = 0.01 and 4.44E-04, respectively). Moreover, sLAG3 and sCD28 were found negatively correlated with cytolytic activity of T cells in tumors (rho = -0.31 and - 0.33, respectively).Our study provides evidence that soluble immune checkpoint-related proteins may associate with advanced disease, recurrence and survival in ccRCC patients, which highlights the prognostic values of soluble immune checkpoint-related proteins. Future independent validation in prospective studies is warranted.
Xifeng Wu, M.D., Ph.D., is Dean and Professor of School of Public Health; Vice President of The Second Affiliated Hospital of School of Medicine; Director of National Institute for Data Science in Health and Medicine; Director of Center for Big Data Research in Medical Insurance & Health Policy at Zhejiang University; China National Top Expert; and Zhejiang Province Top Expert. Dr. Wu’s research focus has been on human genetics and health big data.
Listen to this article
Poor access to quality health services, especially in urban slums, is a global challenge. Given similar challenges in Nairobi’s Kibra informal settlement area, we collaborated with the Langata/Kibra sub-county health management team to conduct a pilot program for improving the quality of child health services delivered by health care providers (HCPs). The pilot introduced a digital mHealth platform to HCPs working in Kibra informal settlement area in Nairobi. This mHealth platform was compliant to WHO’s recommended guideline for integrated management of newborn and child illnesses (IMNCI) and was designed to help sick child assessment, diagnosis and management by HCPs. We aimed to determine if using this digital platform, coupled with supportive supervision and community outreach, would lead to improve compliance to the IMNCI guideline for assessment, diagnosis and treatment of sick children. We conducted baseline (February 2019) assessment, trained selected HCPs on the mHealth platform on handheld android tablets, conducted end line (March 2020) and measured any change in HCP’s compliance to IMNCI guidelines. Total 89 HCPs were the mHealth platform users during end line assessment. When asked about the choice of antibiotic for treating childhood pneumonia, we found proportion of HCPs who preferred Amoxycillin dispersible tablet, the recommended treatment for childhood pneumonia, increased from 3% at baseline to 38% at end line. Proportion of HCPs who were aware that antibiotics should NOT be used for the management of simple diarrhea increased from 14% (at baseline) to 50% (at end line). At end line, more than 90% HCPs were found compliant in their practice to IMNCI guidelines for sick child assessment, diagnosis and management. These results demonstrate the use of the IMNCI compliant mHealth platforms as a potential important effective way to improve capacity and compliance among HCPs who are serving communities like Kibra informal settlement in Nairobi, Kenya.
Elsie Nzale Sang is a Project Coordinator for Nairobi Programmes at Save the Children International in Kenya. She has a degree in BSc Food Nutrition and Dietetics from Kenyatta University. She has 13 years of experience working in health and nutrition programmes in humanitarian and development settings
Listen to this article
Background and Objective: Fidgetin-like 1 (FIGNL1) participates in tumor resistance by playing the function of homologous recombination repair(HRR). However, the role of FIGNL1 in non-small cell lung cancer (NSCLC) is still unclear. This study aims to understand the expression of FIGNL1 in NSCLC and preliminarily explore its relationship with cisplatin resistance. Methods: FIGNL1 messenger RNA (mRNA) was analyzed in 1018 NSCLC tissues and 111 adjacent tissues using The Cancer Genome Atlas program.FIGNL1mRNA in cisplatin-resistant and cisplatin-sensitive cell lines was analyzed by the Gene Expression Omnibus project. FIGNL1 protein was detected in 58 NSCLC tissues and 58 adjacent tissues by immunohistochemistry.The relationship between FIGNL1, clinical pathological characteristics and disease-free survival was retrospectively analyzed. Gene ontology was used to analyze the biological process mainly involving FIGNL1, and STRING online constructed its protein interaction network and screened the key genes (hub genes). Results:The Cancer Genome Atlas showed that FIGNL1mRNA was higher in 1018 NSCLC tissues than in 111 adjacent tissues (P<0.05). In the dataset “GSE157692,” FIGNL1mRNA was higher in cisplatin-resistant cell lines (P=3.80e-05). The hub genes in FIGNL1 and HRR directions are RAD51 and CCDC36. Immunohistochemistry showed that the FIGNL1 protein in 58 NSCLC tissues was higher than that in 58 adjacent tissues (P<0.01).FIGNL1 is associated with gender, histopathological type, and nerve invasion in NSCLC.The disease-free survival in NSCLC patients with high FIGNL1 expression was shorter (P=0.032). Conclusion:FIGNL1 is associated with poor prognosis in NSCLC, and cisplatin resistance may be involved.These observations provide a clinical basis for exploring FIGNL1 as a potential biomarker for cisplatin resistance in NSCLC.
Listen to this article
Objective: Arsenic exposure is associated with the induction of hepatotoxicity. Current study was aimed to investigate the hepato-protective ability of polyphenolic components of Tamarixaphylla (TA) ethanolic extract against sodium arsenite (SA)-induced liver injury of rats. Methods & Results: Significantly, higher quantities of phenolic (318.7±2.5 mgg−1GAE) and flavonoid (250.69 ±3.3 mgg−1QE) contents were present. Inhibitory concentration (IC50) exhibited an excellent potential for antioxidant (IC50= 25.99 μg/mL) assay. High performance liquid chromatography (HPLC) confirmed the existence of myercetin (10.40ppm), sinapic acid (2.131ppm), kaempferol (0.486ppm), caffeic acid (5.094 ppm). Forty-two rats were divided into 7 groups. Group 1 received normal saline (2 mL/kg/day, orally for 21 days), Group 2 received SA (10mg/kg/day for 21 days), and Group 3 received SA alone for 7 days (10mg/kg) and continues with silymarine for 21 days (25mg/kg orally). Group 4, 5, 6 received SA alone for 7 days and continue with TA extract up to 21 days (125mg/kg, 250mg/kg, and 500mg/kg orally) respectively, and Group 7 received TA extract (500mg/kg) for 21 days. SA was administered to all treated groups for 21 days. Treatment with polyphenolic ethanolic extract of TA restored the hepatic indices and oxidative markers in a dose-dependent manner. The upregulation in tumor necrosis factor-α, interleukin-6, and cyclooxygenase-2 upon SA treatment suggesting inflammation was normalized by the treatment of rats. Above mentioned biochemical findings were supported well with histopathological screening.
Shaher Bano is a registered Pharmacist, Researcher and currently working as clinical research coordinator in research Centre of a trust hospital. After Pharmacy graduation in 2011, she started to practice my pharmacy profession from The Children‘s Hospital & the institute of child health, Lahore. Later on, she had served as retail/community pharmacist in a Private sector. Subsequently, having years of experience, she completed her M.Phil.
Listen to this article