Videos uploaded by user “Dove Medical Press”
Computer-animated model of accommodation - Supplementary video: 25983
Supplementary video of the computer animated model from the original research paper published in Clinical Ophthalmology "Computer-animated model of accommodation and theory of reciprocal zonular action" by Daniel B Goldberg. Read the original research article here: http://www.dovepress.com/articles.php?article_id=8558 Abstract: This report presents a computer-animated model of the structures of accommodation based on new understanding of the anatomy of the zonular apparatus integrated with current understanding of the mechanism of accommodation. Analysis of this model suggests a new, consolidated theory of the mechanism of accommodation including a new theory of reciprocal zonular action. A three-dimensional animated model of the eye in accommodation and disaccommodation was produced in collaboration with an experienced medical animator. Current understanding of the anatomy of the zonule and the attachments of the vitreous zonule to the anterior hyaloid membrane is incomplete. Recent studies have demonstrated three components of the vitreous zonule: (1) anterior vitreous zonule (previously "hyalocapsular" zonule), which attaches the ciliary plexus in the valleys of the ciliary processes to the anterior hyaloid membrane in the region medial to the ciliary body and Weiger's ligament; (2) intermediate vitreous zonule, which attaches the ciliary plexus to the anterior hyaloid peripherally; and (3) posterior vitreous zonule, which creates a sponge-like ring at the attachment zone that anchors the pars plana zonules. The pars plana zonules attach posteriorly to the elastic choroid above the ora serrata. Analysis of the computer-animated model demonstrates the synchronized movements of the accommodative structures in accommodation and disaccommodation. Utilizing model-based reasoning, it is shown that the posterior zonules attach to and provide traction to the anterior vitreous membrane and Weiger's ligament. This model supports the concept that the ciliary body/zonule/anterior hyaloid complex contributes to the changes in the posterior lens capsule during accommodation, supporting an extralenticular component to accommodation and demonstrating an alternative to the "vitreous support" theories. There is a reciprocal action of the anterior zonules and the posterior zonules. During ciliary body contraction, the anterior zonules lose tension while the posterior zonules stretch and exert force on the posterior lens capsule playing a role in shaping the posterior lens thickness and curvature. During ciliary body relaxation, the posterior zonules lose tension as the lens flattens and is pulled back by the increasing tension of the anterior zonules.
Views: 179288 Dove Medical Press
Nattokinase and blood pressure – Video abstract [99553]
Video abstract of clinical trial report “Consumption of nattokinase is associated with reduced blood pressure and von Willebrand factor, a cardiovascular risk marker: results from a randomized, double-blind, placebo-controlled, multicenter North American clinical trial” published in the open access journal Integrated Blood Pressure Control by authors Jensen et al. Objective: The objective of this study is to evaluate the effects of consumption of nattokinase on hypertension in a North American hypertensive population with associated genetic, dietary, and lifestyle factors. This is in extension of, and contrast to, previous studies on Asian populations. Materials and methods: A randomized, double-blind, placebo-controlled, parallel-arm clinical study was performed to evaluate nattokinase, a fermented soy extract nattō from which vitamin K2 has been removed. Based on the results from previous studies on Asian populations, 79 subjects were enrolled upon screening for elevated blood pressure who consumed placebo or 100 mg nattokinase/d for the 8-week study duration. Blood collections were performed at baseline and 8 weeks for testing plasma renin activity, von Willebrand factor, and platelet factor-4. Seventy-four people completed the study with good compliance. Results: Consumption of nattokinase was associated with a reduction in both systolic and diastolic BP. The reduction in systolic BP was seen for both sexes but was more robust in males consuming nattokinase. The average reduction in diastolic BP in the nattokinase group from 87 mmHg to 84 mmHg was statistically significant when compared to that in the group consuming placebo, where the average diastolic BP remained constant at 87 mmHg, and reached a high level of significance for males consuming nattokinase, where the average diastolic BP dropped from 86 mmHg to 81 mmHg. A decrease in vWF was seen in the female population consuming nattokinase. In the subpopulation with low plasma renin activity levels at baseline, an increase was seen for 66% of the people after 8-week consumption of nattokinase, in contrast to only 8% in the placebo group. Conclusion: The data suggest that nattokinase consumption in a North American population is associated with beneficial changes to BP in a hypertensive population, indicating sex-specific mechanisms of action of nattokinase’s effect on vWF and hypertension. Keywords: subtilisin NAT, systolic blood pressure, diastolic blood pressure, von Willebrand factor, plasma renin activity The full article can be found here: https://www.dovepress.com/consumption-of-nattokinase-is-associated-with-reduced-blood-pressure-a-peer-reviewed-article-IBPC
Views: 10385 Dove Medical Press
Effect of melatonin on nocturnal blood pressure - Video abstract: 24603
Video abstract of paper "Effect of melatonin on nocturnal blood pressure: meta-analysis of randomized controlled trials" published in the journal Vascular Health and Risk Management by Ehud Grossman, Moshe Laudon, Nava Zisapel. Read the perspectives article here: http://www.dovepress.com/effect-of-melatonin-on-nocturnal-blood-pressure-meta-analysis-of-rand-peer-reviewed-article-VHRM Conclusion: Add-on controlled-release melatonin to antihypertensive therapy is effective and safe in ameliorating nocturnal hypertension, whereas fast-release melatonin is ineffective. It is necessary that larger trials of longer duration be conducted in order to determine the long-term beneficial effects of controlled-release melatonin in patients with nocturnal hypertension.
Views: 6181 Dove Medical Press
Sutureless intrascleral intraocular lens fixation – Supplementary Video [ID 101515]
Supplementary video of an original research paper “Sutureless intrascleral intraocular lens fixation with lamellar dissection of scleral tunnel” published in the open access journal Clinical Ophthalmology by Kawaji T, Sato T, Tanihara H. Purpose: To report the results of sutureless scleral fixation of a posterior chamber intraocular lens (IOL) by using our developed simple technique. Methods: We retrospectively reviewed the medical records of 48 eyes of 47 patients who underwent sutureless intrascleral IOL fixation by using our modified technique. A 25-gauge microvitreoretinal knife was used to perform sclerotomies and create limbus-parallel scleral tunnels with lamellar dissection in which the haptics were fixed. Results: The IOLs were fixed and centered well. The mean follow-up period was 26.7 months. Postoperative complications included smooth vitreous hemorrhage in four eyes (8.3%), cystoid macular edema in two eyes (4.2%), and iris capture of the IOL in two eyes (4.2%). No other complications, such as breakage of the IOL, spontaneous IOL dislocation, or retinal detachment, were detected during the follow-up period. Conclusion: The lamellar dissection of the limbus-parallel scleral tunnel can simplify the forceps-assisted introduction of the haptics into the scleral tunnel, and this technique seemed to be safe. Read the original research paper here: https://www.dovepress.com/sutureless-intrascleral-intraocular-lens-fixation-with-lamellar-dissec-peer-reviewed-article-OPTH
Views: 4976 Dove Medical Press
Visual migraine aura with or without headache - Video abstract: 30999
Video abstract of original research "Visual migraine aura with or without headache: association with right to left shunt and assessment following transcutaneous closure" published in the open access journal Clinical Ophthalmology by M Khalid Mojadidi, Hamidreza Khessali, Rubine Gevorgyan, et al. Conclusion: There is an increased prevalence of PFO among patients with migraine aura without headache. The closure of PFO correlates with improvement of the visual aura, suggesting a causative association between the presence of PFO and both visual aura and migraine headaches. Ophthalmologists should be aware of the association of right to left shunts with visual aura. Read this original research and sign up to receive Clinical Ophthalmology here: http://www.dovepress.com/visual-migraine-aura-with-or-without-headache-association-with-right-t-peer-reviewed-article-OPTH
Views: 7138 Dove Medical Press
Maternal immune system and fetal development – Video abstract 80652
Video abstract of review paper “The maternal immune system during pregnancy and its influence on fetal development” published in the Research and Reports in Biology journal by Morelli et al. The maternal immune system plays a critical role in the establishment, maintenance, and completion of a healthy pregnancy. However, the specific mechanisms utilized to achieve these goals are not well understood. Various cells and molecules of the immune system are key players in the development and function of the placenta and the fetus. Effector cells of the immune system act to promote and yet limit placental development. The T helper 1 (Th1)/T helper 2 (Th2) immune shift during pregnancy is well established. A fine balance between proinflammatory and anti-inflammatory influences is required. We herein review the evidence regarding maternal tolerance of fetal tissues and the underlying cell-mediated immune and humoral (hormones and cytokines) mechanisms. We also note the many unanswered questions in our understanding of these mechanisms. In addition, we summarize the clinical manifestations of an altered maternal immune system during pregnancy related to susceptibility to common viral, bacterial, and parasitic infections, as well as to autoimmune diseases. Read the review article here: https://www.dovepress.com/the-maternal-immune-system-during-pregnancy-and-its-influence-on-fetal-peer-reviewed-article-RRB
Views: 7739 Dove Medical Press
Topical steroid addiction in atopic dermatitis - Video abstract 69201
Video abstract of_review_paper "Topical steroid addiction in atopic dermatitis" published in the open access journal_Drug, Healthcare and Patient Safety_by_authors_Fukaya M, Sato K, Sato M, et al. Abstract: The American Academy of Dermatology published a new guideline regarding topical therapy in atopic dermatitis in May 2014. Although topical steroid addiction or red burning skin syndrome had been mentioned as possible side effects of topical steroids in a 2006 review article in the Journal of the American Academy of Dermatology, no statement was made regarding this illness in the new guidelines. This suggests that there are still controversies regarding this illness. Here, we describe the clinical features of topical steroid addiction or red burning skin syndrome, based on the treatment of many cases of the illness. Because there have been few articles in the medical literature regarding this illness, the description in this article will be of some benefit to better understand the illness and to spur discussion regarding topical steroid addiction or red burning skin syndrome. Read the full paper here: http://www.dovepress.com/topical-steroid-addiction-in-atopic-dermatitis-peer-reviewed-article-DHPS
Views: 7966 Dove Medical Press
Can near-infrared energy reach the brain for treatment of TBI? - Video abstract [78182]
Video abstract of review paper "Near-infrared photonic energy penetration: can infrared phototherapy effectively reach the human brain?" published in the open access journal Neuropsychiatric Disease and Treatment. Abstract: Traumatic brain injury (TBI) is a growing health concern effecting civilians and military personnel. Research has yielded a better understanding of the pathophysiology of TBI, but effective treatments have not been forthcoming. Near-infrared light (NIR) has shown promise in animal models of both TBI and stroke. Yet, it remains unclear if sufficient photonic energy can be delivered to the human brain to yield a beneficial effect. This paper reviews the pathophysiology of TBI and elaborates the physiological effects of NIR in the context of this pathophysiology. Pertinent aspects of the physical properties of NIR, particularly in regards to its interactions with tissue, provide the background for understanding this critical issue of light penetration through tissue. Our recent tissue studies demonstrate no penetration of low level NIR energy through 2 mm of skin or 3 cm of skull and brain. However, at 10–15 W, 0.45%–2.90% of 810 nm light penetrated 3 cm of tissue. A 15 W 810 nm device (continuous or non-pulsed) NIR delivered 2.9% of the surface power density. Pulsing at 10 Hz reduced the dose of light delivered to the surface by 50%, but 2.4% of the surface energy reached the depth of 3 cm. Approximately 1.22% of the energy of 980 nm light at 10–15 W penetrated to 3 cm. These data are reviewed in the context of the literature on low-power NIR penetration, wherein less than half of 1% of the surface energy could reach a depth of 1 cm. NIR in the power range of 10–15 W at 810 and 980 nm can provide fluence within the range shown to be biologically beneficial at 3 cm depth. A companion paper reviews the clinical data on the treatment of patients with chronic TBI in the context of the current literature. Read the original article here: http://www.dovepress.com/near-infrared-photonic-energy-penetration-can-infrared-phototherapy-ef-peer-reviewed-article-NDT
Views: 10587 Dove Medical Press
Immunotherapy for NSCLC - Video abstract 57550
Video abstract of review paper "New modalities of cancer treatment for NSCLC: focus on immunotherapy" published in the open access journal Cancer Management and Research by Davies. Abstract: Recent advances in the understanding of immunology and antitumor immune responses have led to the development of new immunotherapies, including vaccination approaches and monoclonal antibodies that inhibit immune checkpoint pathways. These strategies have shown activity in melanoma and are now being tested in lung cancer. The antibody drugs targeting cytotoxic T-lymphocyte-associated antigen-4 and programmed cell death protein-1 immune checkpoint pathways work by restoring immune responses against cancer cells, and are associated with unconventional response patterns and immune-related adverse events as a result of their mechanism of action. As these new agents enter the clinic, nurses and other health care providers will require an understanding of the unique efficacy and safety profiles with immunotherapy to optimize potential patient benefits. This paper provides a review of the new immunotherapeutic agents in development for lung cancer, and strategies for managing patients on immunotherapy. Read the review paper here: http://www.dovepress.com/new-modalities-of-cancer-treatment-for-nsclc-focus-on-immunotherapy-peer-reviewed-article
Views: 14832 Dove Medical Press
Pharmacology of palmitoylethanolamide
Video abstract of review paper "Evolution in pharmacologic thinking around the natural analgesic palmitoylethanolamide:from nonspecific resistance to PPAR-α agonist and effective nutraceutical" published in the open access Journal of Pain Research by author Jan M Keppel Hesselink. Abstract: The history of development of new concepts in pharmacology is a highly interesting topic. This review discusses scientific insights related to palmitoylethanolamide (PEA) and its progression over a period of six decades, especially in light of the work of the science sociologists, Ludwig Fleck and Thomas Kuhn. The discovery of the cannabis receptors and the nuclear peroxisome proliferator-activated receptors was the beginning of a completely new understanding of many important homeostatic physiologic mechanisms in the human body. These discoveries were necessary for us to understand the analgesic and anti-inflammatory activity of PEA, a body-own fatty amide. PEA is a nutrient known already for more than 50 years. PEA is synthesized and metabolized in animal cells via a number of enzymes and has a multitude of physiologic functions related to metabolic homeostasis. PEA was identified in the 1950s as a therapeutic principle with potent anti-inflammatory properties. Since 1975, its analgesic properties have been noted and explored in a variety of chronic pain states. Since 2008, PEA has been available as a nutraceutical under the brand names Normast® and PeaPure®. A literature search on PEA meanwhile has yielded over 350 papers, all referenced in PubMed, describing the physiologic properties of this endogenous modulator and its pharmacologic and therapeutic profile. This review describes the emergence of concepts related to the pharmacologic profile of PEA, with an emphasis on the search into its mechanism of action and the impact of failing to identify such mechanism in the period 1957--1993, on the acceptance of PEA as an anti-inflammatory and analgesic compound. Read the review paper here: http://www.dovepress.com/evolution-in-pharmacologic-thinking-around-the-natural-analgesic-palmi-peer-reviewed-article-JPR
Views: 2354 Dove Medical Press
S. boulardii supports microbiota regeneration - Video abstract [ID 85574]
Video abstract of a review paper "Saccharomyces boulardii CNCM I-745 supports regeneration of the intestinal microbiota after diarrheic dysbiosis – a review" published in the open access journal Clinical and Experimental Gastroenterology by Moré MI, Swindsinski A. Abstract: The probiotic medicinal yeast Saccharomyces cerevisiae HANSEN CBS 5926 (Saccharomyces boulardii CNCM I-745) is used for the prevention and treatment of diarrhea. Its action is based on multiple mechanisms, including immunological effects, pathogen-binding and antitoxinic effects, as well as effects on digestive enzymes. Correlated with these effects, but also due to its inherent properties, S. boulardii is able to create a favorable growth environment for the beneficial intestinal microbiota, while constituting extra protection to the host mucus layer and mucosa. This review focuses on the positive influence of S. boulardii on the composition of the intestinal microbiota. In a dysbiosis, as during diarrhea, the main microbial population (especially Lachnospiraceae, Ruminococcaceae, Bacteroidaceae, and Prevotellaceae) is known to collapse by at least one order of magnitude. This gap generally leads to transient increases in pioneer-type bacteria (Enterobacteriaceae, Bifidobacteriaceae, and Clostridiaceae). Several human studies as well as animal models demonstrate that treatment with S. boulardii in dysbiosis leads to the faster reestablishment of a healthy microbiome. The most relevant effects of S. boulardii on the fecal composition include an increase of short chain fatty acid-producing bacteria (along with a rise in short chain fatty acids), especially of Lachnospiraceae and Ruminococcaceae, as well as an increase in Bacteroidaceae and Prevotellaceae. At the same time, there is a suppression of pioneer bacteria. The previously observed preventive action of S. boulardii, eg, during antibiotic therapy or regarding traveler’s diarrhea, can be explained by several mechanisms, including a stabilizing effect on the healthy microbiota as well as possibly on the mucus layer. Several different dysbiotic situations could profit from the effects of S. boulardii CNCM I-745. Its additional potential lies in a general stabilization of the gut flora for at-risk populations. More studies are needed to explore the full potential of this versatile probiotic yeast. Read the review paper here: http://www.dovepress.com/saccharomyces-boulardii-cncm-i-745-supports-regeneration-of-the-intest-peer-reviewed-article-CEG
Views: 3651 Dove Medical Press
Intravenous magnetic nanoparticle hyperthermia - Video abstract 43770
Video abstract of original research paper "Intravenous magnetic nanoparticle hyperthermia" published in the open access journal International Journal of Nanomedicine by authors HS Huang and JF Hainfeld. Abstract: Magnetic nanoparticles heated by an alternating magnetic field could be used to treat cancers, either alone or in combination with radiotherapy or chemotherapy. However, direct intratumoral injections suffer from tumor incongruence and invasiveness, typically leaving undertreated regions, which lead to cancer regrowth. Intravenous injection more faithfully loads tumors, but, so far, it has been difficult achieving the necessary concentration in tumors before systemic toxicity occurs. Here, we describe use of a magnetic nanoparticle that, with a well-tolerated intravenous dose, achieved a tumor concentration of 1.9 mg Fe/g tumor in a subcutaneous squamous cell carcinoma mouse model, with a tumor to non-tumor ratio more than 16. With an applied field of 38 kA/m at 980 kHz, tumors could be heated to 60°C in 2 minutes, durably ablating them with millimeter (mm) precision, leaving surrounding tissue intact. Keywords: magnetic nanoparticles, hyperthermia, cancer, alternating magnetic field, intravenous delivery Read the original research paper here: http://www.dovepress.com/intravenous-magnetic-nanoparticle-cancer-hyperthermia-peer-reviewed-article-IJN
Views: 2189 Dove Medical Press
Pharmacophore modeling in drug discovery [46843]
Video abstract of review paper “Pharmacophore modeling: advances, limitations, and current utility in drug discovery” published in the open access Journal of Receptor, Ligand and Channel Research by authors Qing X, Lee XY, De Raeymaeker J, et al. Abstract: Pharmacophore modeling is a successful yet very diverse subfield of computer-aided drug design. The concept of the pharmacophore has been widely applied to the rational design of novel drugs. In this paper, we review the computational implementation of this concept and its common usage in the drug discovery process. Pharmacophores can be used to represent and identify molecules on a 2D or 3D level by schematically depicting the key elements of molecular recognition. The most common application of pharmacophores is virtual screening, and different strategies are possible depending on the prior knowledge. However, the pharmacophore concept is also useful for ADME-tox modeling, side effect, and off-target prediction as well as target identification. Furthermore, pharmacophores are often combined with molecular docking simulations to improve virtual screening. We conclude this review by summarizing the new areas where significant progress may be expected through the application of pharmacophore modeling; these include protein–protein interaction inhibitors and protein design. Read the full review paper here: http://www.dovepress.com/pharmacophore-modeling-advances-limitations-and-current-utility-in-dru-peer-reviewed-article-JRLCR
Views: 4950 Dove Medical Press
Dupilumab in the treatment of atopic dermatitis - Video Abstract ID 133661
Video abstract of review “Dupilumab: an evidence-based review of its potential in the treatment of atopic dermatitis” published in the open access journal Core Evidence by Eshtiaghi P, Gooderham MJ. Introduction: Atopic dermatitis (AD) is a recurrent, pruritic inflammatory skin disease with complex immunopathogenesis characterized by a dominant TH2 response. Dupilumab is an interleukin (IL)-4 receptor alpha antagonist that subsequently blocks IL-4 and IL-13 signaling. It has recently been approved for the treatment of adult patients with moderate-to-severe AD whose current treatment options are limited. Aim: This article reviews the evidence of clinical efficacy, safety, and patient-reported outcome (PRO) measures from Phase I–III trials of dupilumab in adult patients with moderateto- severe AD. Evidence review: Results from clinical trials of dupilumab in adults with moderate-to-severe AD have shown that weekly or biweekly dupilumab injections significantly improve clinical and PROs. Transcriptome and serum analyses also found that dupilumab significantly modulates the AD molecular signature and other TH2-associated biomarkers, compared with placebo. Additionally, concomitant use of dupilumab with topical corticosteroids (TCS) results in a greater improvement in signs and symptoms of AD than with dupilumab use alone. Throughout the trials, common adverse events were headaches, conjunctivitis, and injection site reactions. These were consistently mild–moderate and occurred with similar frequency between the treatment and placebo groups. Place in therapy: In adult patients with moderate-to-severe refractory AD, monotherapy or concomitant use of dupilumab with TCS holds great promise to significantly improve clinical outcomes and quality of life of the patient. Ongoing studies of dupilumab will help determine the clinical efficacy and safety profile of its long-term use. Finally, further economic evidence is warranted to compare the long-term costs and benefits of dupilumab with other currently available treatments for moderate-to-severe AD. Read the Review paper here: https://www.dovepress.com/dupilumab-an-evidence-based-review-of-its-potential-in-the-treatment-o-peer-reviewed-article-CE
Views: 2497 Dove Medical Press
Brief high-intensity exercise and blood glucose - Video abstract: 29222
Video abstract of review paper "The impact of brief hig-intensity exercise on blood glucose levels" published in the open access journal of Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy by O Peter Adams. Background: Moderate-intensity exercise improves blood glucose (BG), but most people fail to achieve the required exercise volume. High-intensity exercise (HIE) protocols vary. Maximal cycle ergometer sprint interval training typically requires only 2.5 minutes of HIE and a total training time commitment (including rest and warm up) of 25 minutes per session. The effect of brief high-intensity exercise on blood glucose levels of people with and without diabetes is reviewed. Methods: HIE (≥80% maximal oxygen uptake, VO2max) studies with ≤15 minutes HIE per session were reviewed. Results: Six studies of nondiabetics (51 males, 14 females) requiring 7.5 to 20 minutes/week of HIE are reviewed. Two weeks of sprint interval training increased insulin sensitivity up to 3 days postintervention. Twelve weeks near maximal interval running (total exercise time 40 minutes/week) improved BG to a similar extent as running at 65% VO2max for 150 minutes/week. Eight studies of diabetics (41 type 1 and 22 type 2 subjects) were reviewed. Six were of a single exercise session with 44 seconds to 13 minutes of HIE, and the others were 2 and 7 weeks duration with 20 and 2 minutes/week HIE, respectively. With type 1 and 2 diabetes, BG was generally higher during and up to 2 hours after HIE compared to controls. With type 1 diabetics, BG decreased from midnight to 6 AM following HIE the previous morning. With type 2 diabetes, a single session improved postprandial BG for 24 hours, while a 2-week program reduced the average BG by 13% at 48 to 72 hours after exercise and also increased GLUT4 by 369%. Conclusion: Very brief HIE improves BG 1 to 3 days postexercise in both diabetics and nondiabetics. HIE is unlikely to cause hypoglycemia during and immediately after exercise. Larger and longer randomized studies are needed to determine the safety, acceptability, long-term efficacy, and optimal exercise intensity and duration. Read this review paper and sign up to receive Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy: http://www.dovepress.com/the-impact-of-brief-high-intensity-exercise-on-blood-glucose-levels-peer-reviewed-article-DMSO
Views: 3573 Dove Medical Press
Treatment of negative symptoms in schizophrenia - Video abstract 43404
Video abstract of review paper "Addressing the unmet needs of patients with persistent negative symptoms of schizophrenia: emerging pharmacological treatment options" published in the open access journal Neuropsychiatric Disease and Treatment by Chue P, Lalonde JK. Abstract: The negative symptoms of schizophrenia represent an impairment of normal emotional responses, thought processes and behaviors, and include blunting or flattening of affect, alogia/aprosody, avolition/apathy, anhedonia, and asociality. Negative symptoms contribute to a reduced quality of life, increased functional disability, increased burden of illness, and poorer long-term outcomes, to a greater degree than positive symptoms. Primary negative symptoms are prominent and persistent in up to 26% of patients with schizophrenia, and they are estimated to occur in up to 58% of outpatients at any given time. Negative symptoms respond less well to medications than positive symptoms, and to date treatment options for negative symptoms have been limited, with no accepted standard treatment. Modest benefits have been reported with a variety of different agents, including second-generation antipsychotics and add-on therapy with antidepressants and other pharmacological classes. Recent clinical research focusing on negative symptoms target novel biological systems, such as glutamatergic neurotransmission. Different approaches include: enhancing N-methyl-D-aspartate receptor function with agents that bind directly to the glycine ligand site or with glycine reuptake inhibitors; influencing the metabotropic glutamate receptor (mGluR2/3) with positive allosteric modulators; and stimulating nicotinic acetylcholine receptors. In conclusion, the lack of clearly efficacious pharmacological treatments for the management of negative symptoms represents a significant unmet need, especially considering the importance of these symptoms on patient outcomes. Hence, further research to identify and characterize novel pharmacological treatments for negative symptoms is greatly needed. Keywords: negative symptoms, schizophrenia, NMDA receptor, glycine reuptake inhibitors, metabotropic glutamate receptor-2 (mGluR2), 7-alpha nicotinic acetylcholine receptor agonists Read the review paper here: http://www.dovepress.com/addressing-the-unmet-needs-of-patients-with-persistent-negative-sympto-peer-reviewed-article
Views: 4439 Dove Medical Press
Bioactivity of an Aloe vera-based Nerium oleander extract – video abstract 79871
Video abstract of original research paper “Antioxidant, anti-inflammatory, anti-apoptotic, and skin regenerative properties of an Aloe vera-based extract of Nerium oleander leaves (NAE -8®)” published in the open access journal Clinical, Cosmetic and Investigational Dermatology by Benson KF, Newman RA, Jensen GS. Objective: The goal for this study was to evaluate the effects of an Aloe vera-based Nerium oleander extract (NAE-8®), compared to an extract of A. vera gel alone (ALOE), and to an aqueous extract of N. oleander (AQ-NOE) in bioassays pertaining to dermatologic potential with respect to antioxidant protection, anti-inflammatory effects, and cytokine profiles in vitro. Methods: Cellular antioxidant protection was evaluated in three separate bioassays: The cellular antioxidant protection of erythrocytes (CAP-e) assay, protection of cellular viability and prevention of apoptosis, and protection of intracellular reduced glutathione levels, where the last two assays were performed using human primary dermal fibroblasts. Reduction of intracellular formation of reactive oxygen species (ROS) was tested using polymorphonuclear cells in the absence and presence of oxidative stress. Changes to cytokine and chemokine profiles when whole blood cells and human primary dermal fibroblasts were exposed to test products were determined using a 40-plex Luminex array as a method for exploring the potential cross-talk between circulating and skin-resident cells. Results: The NAE-8® provided significantly better antioxidant protection in the CAP-e bioassay than AQ-NOE. NAE-8® and AQ-NOE both protected cellular viability and intracellular reduced glutathione, and reduced the ROS formation significantly when compared to control cells, both under inflamed and neutral culture conditions. ALOE showed minimal effect in these bioassays. In contrast to the NAE-8®, the AQ-NOE showed induction of inflammation in the whole blood cultures, as evidenced by the high induction of CD69 expression and secretion of a number of inflammatory cytokines. The treatment of dermal fibroblasts with NAE-8® resulted in selective secretion of cytokines involved in collagen and hyaluronan production as well as re-epithelialization during wound healing. Conclusion: NAE-8®, a novel component of a commercial cosmetic product, showed beneficial antioxidant protection in several cellular models, without the induction of leukocyte activation and secretion of inflammatory cytokines. The biological efficacy of NAE-8® was unique from both ALOE and AQ-NOE. Read the original article here: http://www.dovepress.com/antioxidant-anti-inflammatory-anti-apoptotic-and-skin-regenerative-pro-peer-reviewed-article-CCID
Views: 8845 Dove Medical Press
Clinical and laboratory features of intestinal tuberculosis - Video Abstract 154235
Video abstract of original research paper “Clinical and laboratory features of intestinal tuberculosis” published in the open access journal Clinical and Experimental Gastroenterology by authors Patel and Yagnik. Background/aims: As increasing numbers of Crohn’s disease (CD) cases are being recognized in India, so the differential diagnosis of CD and gastrointestinal tuberculosis (GITB) is becoming increasingly important. If patients are misdiagnosed with GITB, toxicity may result from unnecessary anti-TB therapy and treatment of the primary disease (ie, CD) gets delayed. We therefore aimed to assess the accuracy of various parameters that can be used to predict GITB diagnosis at index evaluation. Materials and methods: This was a prospective, unicentric, observational study carried out in the gastroenterology department of a tertiary care hospital between August 2011 and January 2013. Patients who presented to our hospital and were suspected of having GITB were included in our study. Patients were then followed up over a 6-month period. Statistical analysis: Chi-square test was used to analyze the data. Results: Of the 69 patients with GITB, 49 (71.01%) had thickening of the involved part of the colon and 33 (47.83%) had abdominal lymphadenopathy. The ileocecal valve was involved in 58 patients (84.05%) Histological detection of granulomas had 78.95% specificity, 36.23% sensitivity, and 51.40% accuracy. Tuberculosis polymerase chain reaction was found to have 78.95% specificity, 71.01% sensitivity, and 73.83% accuracy. BACTEC-MGIT culture was found to have 100% specificity, 20.29% sensitivity, and 48.60% accuracy. Conclusion: Although histology is helpful in ruling out other conditions, TB-specific findings such as caseating granuloma and acid-fast bacilli are rarely seen. Instead, tuberculosis polymerase chain reaction has the highest diagnostic accuracy followed by BACTEC culture. Read the original research paper here https://www.dovepress.com/clinical-and-laboratory-features-of-intestinal-tuberculosis-peer-reviewed-article-CEG
Views: 2639 Dove Medical Press
Palmitoylethanolamide for treatment of neuropathic pain - Video abstract: 32143
Video abstract of case series "Therapeutic utility of palmitoylethanolamide in the treatment of neuropathic pain associated with various pathological conditions: a case series" published in the open access Journal of Pain Research by Jan M Keppel Hesselink and Thecla AM Hekker. Abstract: Palmitoylethanolamide (PEA), an endogenous fatty acid amide, has been demonstrated to bind to a receptor in the cell nucleus -- the peroxisome proliferator--activated receptor -- and performs a great variety of biological functions related to chronic and neuropathic pain and inflammation, as has been demonstrated in clinical trials. These include peripheral neuropathies such as diabetic neuropathy, chemotherapy-induced peripheral neuropathy, carpal tunnel syndrome, sciatic pain, osteoarthritis, low-back pain, failed back surgery syndrome, dental pains, neuropathic pain in stroke and multiple sclerosis, chronic pelvic pain, postherpetic neuralgia, and vaginal pains. Probably due to the fact that PEA is an endogenous modulator as well as a compound in food, such as eggs and milk, no serious side effects have been reported, nor have drug--drug interactions. This article presents a case series describing the application and potential efficacy and safety of PEA in the treatment of various syndromes associated with chronic pain that is poorly responsive to standard therapies. Read this case series and sign up to receive the Journal of Pain Research here: http://www.dovepress.com/therapeutic-utility-of-palmitoylethanolamide-in-the-treatment-of-neuro-peer-reviewed-article-JPR
Views: 3891 Dove Medical Press
Introduction of an alternative radiofrequency technique for sacroiliac joint - Video Abstract 129478
Video abstract of original research paper “Comparison of Quadripolar™ radiofrequency lesions produced by standard versus modified technique: an experimental model” published in the open access Journal of Pain Research by author Ramin Safakish. Abstract: Lower back pain (LBP) is a global public health issue and is associated with substantial financial costs and loss of quality of life. Over the years, different literature has provided different statistics regarding the causes of the back pain. The following statistic is the closest estimation regarding our patient population. The sacroiliac (SI) joint pain is responsible for LBP in 18%–30% of individuals with LBP. Quadrapolar™ radiofrequency ablation, which involves ablation of the nerves of the SI joint using heat, is a commonly used treatment for SI joint pain. However, the standard Quadrapolar radiofrequency procedure is not always effective at ablating all the sensory nerves that cause the pain in the SI joint. One of the major limitations of the standard Quadrapolar radiofrequency procedure is that it produces small lesions of ~4 mm in diameter. Smaller lesions increase the likelihood of failure to ablate all nociceptive input. In this study, we compare the standard Quadrapolar radiofrequency ablation technique to a modified Quadrapolar ablation technique that has produced improved patient outcomes in our clinic. The methodology of the two techniques are compared. In addition, we compare results from an experimental model comparing the lesion sizes produced by the two techniques. Taken together, the findings from this study suggest that the modified Quadrapolar technique provides longer lasting relief for the back pain that is caused by SI joint dysfunction. A randomized controlled clinical trial is the next step required to quantify the difference in symptom relief and quality of life produced by the two techniques. Read the full paper here: https://www.dovepress.com/comparison-of-quadrapolar-radiofrequency-lesions-produced-by-standard--peer-reviewed-article-JPR
Views: 3607 Dove Medical Press
Risk reduction of preterm birth with vaginal progesterone - Video abstract: 28944
Video abstract of review paper "Vaginal progesterone in risk reduction of preterm birth in women with short cervix in the midtrimester of pregnancy" published in the open access International Journal of Women's Health by Meena Khandelwal. Abstract: Preterm birth is a major health problem for the neonate, family, country, and society in general. Despite many risk factors being identified for women destined to deliver preterm, short cervical length detected on transvaginal ultrasound is the most plausible, practical and sensitive risk factor for prediction of spontaneous preterm birth. The definition of short cervix has varied in various studies, but most commonly accepted is #2.5 cm in the midtrimester of pregnancy, though risk of spontaneous preterm birth (sPTB) increases as the cervical length decreases. Vaginal progesterone, a naturally occurring steroid hormone, is the most bioavailable form of progesterone for uterine and cervical effects with the fewest side effects. Multiple prospective studies have consistently shown its benefits in decreasing sPTB rate in women with asymptomatic midtrimester short cervix. The safety for mother and fetus, and tolerability of vaginal progesterone, particularly the gel form, is also well established. Vaginal progesterone is a minimally invasive intervention that is not painful and is very safe, with reasonable cost where the benefits (even if argued to be small) clearly outweigh the risks. Thus there should be little hesitation for implementation of universal transvaginal cervical length screening and preventive vaginal progesterone treatment for women with short cervix. Read this review and sign up to receive the International Journal of Women's Health: http://www.dovepress.com/vaginal-progesterone-in-risk-reduction-of-preterm-birth-in-women-with--peer-reviewed-article-IJWH
Views: 3898 Dove Medical Press
Morgellons disease - Video Abstract ID 152343
Video abstract of review paper “History of morgellons disease: from delusion to definition” published in the open access Clinical, Cosmetic and Investigational Dermatology journal by authors Middelveen MJ, Fesler MC and Stricker RB. Abstract: Morgellons disease (MD) is a skin condition characterized by the presence of multicolored filaments that lie under, are embedded in, or project from skin. Although the condition may have a longer history, disease matching the above description was first reported in the US in 2002. Since that time, the condition that we know as MD has become a polemic topic. Because individuals afflicted with the disease may have crawling or stinging sensations and sometimes believe they have an insect or parasite infestation, most medical practitioners consider MD a purely delusional disorder. Clinical studies supporting the hypothesis that MD is exclusively delusional in origin have considerable methodological flaws and often neglect the fact that mental disorders can result from underlying somatic illness. In contrast, rigorous experimental investigations show that this skin affliction results from a physiological response to the presence of an infectious agent. Recent studies from that point of view show an association between MD and spirochetal infection in humans, cattle, and dogs. These investigations have determined that the cutaneous filaments are not implanted textile fibers, but are composed of the cellular proteins keratin and collagen and result from overproduction of these filaments in response to spirochetal infection. Further studies of the genetics, pathogenesis, and treatment of MD are warranted. View the original article here: https://www.dovepress.com/history-of-morgellons-disease-from-delusion-to-definition-peer-reviewed-article-CCID
Views: 3175 Dove Medical Press
CEST and T2ex MRI contrast agents for molecular imaging - Video abstract [81742]
Video abstract of review paper "Double agents and secret agents: the emerging fields of exogenous chemical exchange saturation transfer and T2-exchange magnetic resonance imaging contrast agents for molecular imaging" published in the open access journal Research and Reports in Nuclear Medicine by Iman Daryaei and Mark D Pagel. Abstract: Two relatively new types of exogenous magnetic resonance imaging contrast agents may provide greater impact for molecular imaging by providing greater specificity for detecting molecular imaging biomarkers. Exogenous chemical exchange saturation transfer (CEST) agents rely on the selective saturation of the magnetization of a proton on an agent, followed by chemical exchange of a proton from the agent to water. The selective detection of a biomarker-responsive CEST signal and an unresponsive CEST signal, followed by the ratiometric comparison of these signals, can improve biomarker specificity. We refer to this improvement as a “double-agent” approach to molecular imaging. Exogenous T2-exchange agents also rely on chemical exchange of protons between the agent and water, especially with an intermediate rate that lies between the slow exchange rates of CEST agents and the fast exchange rates of traditional T1 and T2 agents. Because of this intermediate exchange rate, these agents have been relatively unknown and have acted as “secret agents” in the contrast agent research field. This review exposes these secret agents and describes the merits of double agents through examples of exogenous agents that detect enzyme activity, nucleic acids and gene expression, metabolites, ions, redox state, temperature, and pH. Future directions are also provided for improving both types of contrast agents for improved molecular imaging and clinical translation. Therefore, this review provides an overview of two new types of exogenous contrast agents that are becoming useful tools within the armamentarium of molecular imaging. Read the original article here: https://www.dovepress.com/double-agents-and-secret-agents-the-emerging-fields-of-exogenous-chemi-peer-reviewed-article-RRNM
Views: 1541 Dove Medical Press
Near-infrared laser phototherapy for brain injury- Video abstract 65809
Video abstract of review paper "Treatments for traumatic brain injury with emphasis on transcranial near-infrared laser phototherapy" published in the open access journal Neuropsychiatric Disease and Treatment by authors Larry D Morries, Paolo Cassano and Theodore A Henderson. Abstract: Traumatic brain injury (TBI) is a growing health concern affecting civilians and military personnel. In this review, treatments for the chronic TBI patient are discussed, including pharmaceuticals, nutraceuticals, cognitive therapy, and hyperbaric oxygen therapy. All available literature suggests a marginal benefit with prolonged treatment courses. An emerging modality of treatment is near-infrared (NIR) light, which has benefit in animal models of stroke, spinal cord injury, optic nerve injury, and TBI, and in human trials for stroke and TBI. The extant literature is confounded by variable degrees of efficacy and a bewildering array of treatment parameters. Some data indicate that diodes emitting low-level NIR energy often have failed to demonstrate therapeutic efficacy, perhaps due to failing to deliver sufficient radiant energy to the necessary depth. As part of this review, we present a retrospective case series using high-power NIR laser phototherapy with a Class IV laser to treat TBI. We demonstrate greater clinical efficacy with higher fluence, in contrast to the bimodal model of efficacy previously proposed. In ten patients with chronic TBI (average time since injury 9.3 years) given ten treatments over the course of 2 months using a high-power NIR laser (13.2 W/0.89 cm2 at 810 nm or 9 W/0.89 cm2 at 810 nm and 980 nm), symptoms of headache, sleep disturbance, cognition, mood dysregulation, anxiety, and irritability improved. Symptoms were monitored by depression scales and a novel patient diary system specifically designed for this study. NIR light in the power range of 10–15 W at 810 nm and 980 nm can safely and effectively treat chronic symptoms of TBI. The clinical benefit and effects of infrared phototherapy on mitochondrial function and secondary molecular events are discussed in the context of adequate radiant energy penetration. Read the full paper here: http://www.dovepress.com/treatments-for-traumatic-brain-injury-with-emphasis-on-transcranial-ne-peer-reviewed-article-NDT
Views: 2472 Dove Medical Press
3D printing for patient-specific orthopedics – Video abstract [ID 99614]
Video abstract of a review paper “3D-printed patient-specific applications in orthopedics” published in the open access journal Orthopedic Research and Reviews by Wong KC. Abstract: With advances in both medical imaging and computer programming, two-dimensional axial images can be processed into other reformatted views (sagittal and coronal) and three-dimensional (3D) virtual models that represent a patients’ own anatomy. This processed digital information can be analyzed in detail by orthopedic surgeons to perform patient-specific orthopedic procedures. The use of 3D printing is rising and has become more prevalent in medical applications over the last decade as surgeons and researchers are increasingly utilizing the technology’s flexibility in manufacturing objects. 3D printing is a type of manufacturing process in which materials such as plastic or metal are deposited in layers to create a 3D object from a digital model. This additive manufacturing method has the advantage of fabricating objects with complex freeform geometry, which is impossible using traditional subtractive manufacturing methods. Specifically in surgical applications, the 3D printing techniques can not only generate models that give a better understanding of the complex anatomy and pathology of the patients and aid in education and surgical training, but can also produce patient-specific surgical guides or even custom implants that are tailor-made to the surgical requirements. As the clinical workflow of the 3D printing technology continues to evolve, orthopedic surgeons should embrace the latest knowledge of the technology and incorporate it into their clinical practice for patient-specific orthopedic applications. This paper is written to help orthopedic surgeons stay up-to-date on the emerging 3D technology, starting from the acquisition of clinical imaging to 3D printing for patient-specific applications in orthopedics. It 1) presents the necessary steps to prepare the medical images that are required for 3D printing, 2) reviews the current applications of 3D printing in patient-specific orthopedic procedures, 3) discusses the potential advantages and limitations of 3D-printed custom orthopedic implants, and 4) suggests the directions for future development. The 3D printing technology has been reported to be beneficial in patient-specific orthopedics, such as in the creation of anatomic models for surgical planning, education and surgical training, patient-specific instruments, and 3D-printed custom implants. Besides being anatomically conformed to a patient’s surgical requirement, 3D-printed implants can be fabricated with scaffold lattices that may facilitate osteointegration and reduce implant stiffness. However, limitations including high cost of the implants, the lead time in manufacturing, and lack of intraoperative flexibility need to be addressed. New biomimetic materials have been investigated for use in 3D printing. To increase utilization of 3D printing technology in orthopedics, an all-in-one computer platform should be developed for easy planning and seamless communications among different care providers. Further studies are needed to investigate the real clinical efficacy of 3D printings in orthopedic applications. View the original article here: https://www.dovepress.com/3d-printed-patient-specific-applications-in-orthopedics-peer-reviewed-article-ORR
Views: 2619 Dove Medical Press
360° suture trabeculotomy ab interno - video abstract 75739
Video abstract of case series paper “Prospective, noncomparative, nonrandomized case study of short-term outcomes of 360° suture trabeculotomy ab interno in patients with open-angle glaucoma” published in the Clinical Opthalmology journal by Sato T, Hirata A, and Mizoguchi T. Background: In this paper, we describe 360° suture trabeculotomy (360°LOT) ab interno and the short-term course in patients who underwent this procedure. Methods: We prospectively studied 12 patients (12 eyes) with open-angle glaucoma who underwent 360°LOT ab interno at the Sato Eye Clinic between February and July 2014. The surgical procedure involved making a 1.7 mm temporal corneal incision, exposing an approximately 15° opening in the inner wall of Schlemm’s canal (nasal side) using a Trabectome with a gonioscope, and inserting a 5-0 nylon suture rounded at the tip into Schlemm’s canal opened via the anterior chamber. The suture was then threaded around Schlemm’s canal, and the tip of the suture that emerged on the other side was then advanced through the opening to make a circumferential incision. Intraocular pressure (IOP), number of anti-glaucoma medications used, complications, and the surgery completion rate were prospectively studied. Results: Mean IOP, which was 19.4 mmHg at baseline, showed a significant decrease at each of the monthly observation points, reaching 13.8 mmHg at 6 months after surgery (P=0.0004, paired t-test). The mean number of anti-glaucoma medications decreased from 3.2 at baseline to 1.1 at 6 months after surgery. IOP spikes $30 mmHg were seen in 25% of patients, but there were no other serious complications and the surgery completion rate was 92%. Conclusion: The 360°LOT ab interno procedure preserves the conjunctiva and sclera, and has a high surgery completion rate when using the anterior chamber approach, and could therefore be an effective short-term treatment of open-angle glaucoma. Read the original article here: http://www.dovepress.com/prospective-noncomparative-nonrandomized-case-study-of-short-term-outc-peer-reviewed-article-OPTH
Views: 3116 Dove Medical Press
Choline in pregnancy - Video abstract: 36610
Video abstract of expert opinion paper "Nutrition in pregnancy: the argument for including a source of choline" published in the open access International Journal of Women's Health by Steven H Zeisel. Abstract: Women, during pregnancy and lactation, should eat foods that contain adequate amounts of choline. A mother delivers large amounts of choline across the placenta to the fetus, and after birth she delivers large amounts of choline in milk to the infant; this greatly increases the demand on the choline stores of the mother. Read this expert opinion paperp and sign up to receive International Journal of Women's Health here: http://www.dovepress.com/nutrition-in-pregnancy-the-argument-for-including-a-source-of-choline-peer-reviewed-article
Views: 826 Dove Medical Press
Intervention for MS gait and balance impairment  – Video abstract [128872]
Video abstract of original research paper “Effects of a multimodal intervention on gait and balance of subjects with progressive multiple sclerosis: a prospective longitudinal pilot study”published in the open access journal Degenerative Neurological and Neuromuscular Disease by Bisht et al. Purpose: To investigate the effects of a multimodal intervention including a modified Paleolithic diet, nutritional supplements, stretching, strengthening exercises with electrical stimulation of trunk and lower limb muscles, meditation and massage on walking performance and balance of subjects with progressive multiple sclerosis (MS). Materials and methods: Twenty subjects with mean (standard deviation) age of 51.7 (6.4) years and Expanded Disability Status Scale score of 6.2 (1) participated in a 12-month study. Assessments were completed at baseline, 3, 6, 9, and 12 months. Results: The entire cohort did not show significant changes in any of the assessments over 12 months except higher speed of walking toward the 10 feet mark during timed up and go (TUG) test at 6 months compared with baseline (mean change 7.9 cm/s [95% confidence interval {CI}]: 0.3, 15.2; p=0.041). Sub-group analysis revealed that 50% subjects (n=10) showed decrease in TUG time from baseline to at least 3 of 4 time-points post-intervention and were considered as responders (TUG-Res), the remaining 10 subjects were considered as nonresponders (TUG-NRes). Over 12 months, TUG-Res showed decreased mean TUG time by 31% (95% CI: −52%, −2%), increased median Berg Balance Scale scores (42 to 47), 30% increase in mean timed 25-foot walk speed (greater than 20% considered clinically significant) and increased speed of walk toward 10 feet mark during TUG by 11.6 cm/s (95% CI: −3.0, 25.9) associated with increases in step lengths and decrease in step duration. TUG-NRes showed deterioration in walking ability over 12 months. Comparison of TUG-Res and TUG-NRes showed no significant differences in adherence to intervention but better stride duration and longer step length at baseline for TUG-Res than for TUG-NRes (p less than 0.05). Conclusion: A multimodal lifestyle intervention may improve walking performance and balance in subjects with progressive MS who have mild-to-moderate gait impairment, whereas subjects with severe gait impairments may not respond to this intervention. Future trials should assess effects of this intervention in subjects with MS during early stages of the disease. Read the full paper here: https://www.dovepress.com/effects-of-a-multimodal-intervention-on-gait-and-balance-of-subjects-w-peer-reviewed-article-DNND
Views: 3182 Dove Medical Press
Lymphocytic leukemia-associated chromosomal abnormalities - Video abstract: 18669
Video abstract of review paper "Chronic lymphocytic leukemia-associated chromosomal abnormalities and miRNA deregulation" published in open access journal The Application of Clinical Genetics by Yvonne Kiefer, Christoph Schulte, Markus Tiemann, Joern Bullerdiek. Read the full paper here: http://www.dovepress.com/chronic-lymphocytic-leukemia-associated-chromosomal-abnormalities-and--peer-reviewed-article Abstract: Chronic lymphocytic leukemia is the most common leukemia in adults. By cytogenetic investigations major subgroups of the disease can be identified that reflect different routes of tumor development. Of these chromosomal deviations, trisomy 12 and deletions of parts of either the long arm of chromosome 13, the long arm of chromosome 11, or the short arm of chromosome 17 are most commonly detected. In some of these aberrations the molecular target has been identified as eg, ataxia telangiectasia mutated (ATM) in case of deletions of chromosomal region 11q22~23 and the genes encoding microRNAs miR-15a/16-1 as likely targets of deletions of chromosomal band 13q14.3. Of note, these aberrations do not characterize independent subgroups but often coexist within the metaphases of one tumor. Generally, complex aberrations are associated with a worse prognosis than simple karyotypic alterations. Due to smaller sizes of the missing segment the detection of recurrent deletions is not always possible by means of classical cytogenetics but requires more advanced techniques as in particular fluorescence in situ hybridization (FISH). Nevertheless, at this time it is not recommended to replace classical cytogenetics by FISH because this would miss additional information given by complex or secondary karyotypic alterations. However, the results of cytogenetic analyses allow the stratification of prognostic and predictive groups of the disease. Of these, the group characterized by deletions involving TP53 is clinically most relevant. In the future refined methods as eg, array-based comparative genomic hybridization will supplement the existing techniques to characterize CLL.
Views: 1843 Dove Medical Press
Differential diagnoses through an expanded VITAMINSABCDEK
Video abstract of Rapid Communication type paper “Practical way of creating differential diagnoses through an expanded VITAMINSABCDEK mnemonic” published in the open access journal Advances in Medical Education and Practice by author Zabidi-Hussin. Abstract: Having an organized, structured thinking process is critical in medicine. It is through this thinking process that enables one to go through the method of history-taking, which will eventually lead to making a definitive diagnosis and all other processes that follow. The use of mnemonic has been found to be useful for this purpose. The mnemonic VITAMINSABCDEK, is a convenient and practical way to assist in expanding the differential diagnoses and covers all possible causes of an illness. It is also easy to remember, as the vitamins whose letters are represented in this mnemonic cover the entire range of vitamins known. Read the rapid communication paper here: https://www.dovepress.com/practical-way-of-creating-differential-diagnoses-through-an-expanded-v-peer-reviewed-article-AMEP
Views: 561 Dove Medical Press
Lipoxins: nature’s way to resolve inflammation – Video abstract [ID 90380]
Video abstract of a review paper “Lipoxins: nature’s way to resolve inflammation” published in the open access Journal of Inflammation Research by Chandrasekharan JA and Sharma-Walia N. Abstract: An effective host defense mechanism involves inflammation to eliminate pathogens from the site of infection, followed by the resolution of inflammation and the restoration of tissue homeostasis. Lipoxins are endogenous anti-inflammatory, pro-resolving molecules that play a vital role in reducing excessive tissue injury and chronic inflammation. In this review, the mechanisms of action of lipoxins at the site of inflammation and their interaction with other cellular signaling molecules and transcription factors are discussed. Emphasis has also been placed on immune modulatory role(s) of lipoxins. Lipoxins regulate components of both the innate and adaptive immune systems including neutrophils, macrophages, T-, and B-cells. Lipoxins also modulate levels of various transcription factors such as nuclear factor κB, activator protein-1, nerve growth factor-regulated factor 1A binding protein 1, and peroxisome proliferator activated receptor γ and control the expression of many inflammatory genes. Since lipoxins and aspirin-triggered lipoxins have clinical relevance, we discuss their important role in clinical research to treat a wide range of diseases like inflammatory disorders, renal fibrosis, cerebral ischemia, and cancer. A brief overview of lipoxins in viral malignancies and viral pathogenesis especially the unexplored role of lipoxins in Kaposi’s sarcoma-associated herpes virus biology is also presented. Read the full paper here: https://www.dovepress.com/lipoxins-nature39s-way-to-resolve-inflammation-peer-reviewed-article-JIR
Views: 1211 Dove Medical Press
Rivaroxaban for stroke prevention in atrial fibrillation - Video abstract [30159]
Video abstract of review paper "Rivaroxaban as an oral anticoagulant for stroke prevention in atrial fibrillation" published in the open access journal Therapeutics and Clinical Risk Management by Turpie AGG. Abstract: Atrial fibrillation (AF) is the most common cardiac arrhythmia in the developed world and is associated with a fivefold increase in the risk of stroke, accounting for up to 15% of strokes in the general population. The European Society of Cardiology now recommends direct oral anticoagulants, such as rivaroxaban, apixaban, and dabigatran, in preference to vitamin K antagonist therapy for the prevention of stroke in patients with AF. This review focuses on the direct Factor Xa inhibitor rivaroxaban, summarizing the properties that make rivaroxaban appropriate for anticoagulant therapy in this indication (including its predictable pharmacokinetic and pharmacodynamic profile and once-daily dosing regimen) and describing data from the Phase III ROCKET AF trial, which showed once-daily rivaroxaban to be noninferior to warfarin for the prevention of stroke in patients with nonvalvular AF. In this trial, similar rates of major and nonmajor clinically relevant bleeding were observed; however, when compared with warfarin, rivaroxaban was associated with clinically significant reductions in intracranial and fatal bleeding. On the basis of these results, rivaroxaban was approved in both the United States and the European Union for the prevention of stroke and systemic embolism in patients with nonvalvular AF. Subanalyses of ROCKET AF data showed rivaroxaban to have consistent efficacy and safety across a wide range of patients, and studies to confirm these results in real-world settings are underway. This review also describes practical considerations for treatment with rivaroxaban in clinical practice (including dose reductions in specific high-risk patients, eg, those with renal impairment), recommendations for the transition from vitamin K antagonists to rivaroxaban, the management of bleeding events, and the measurement of rivaroxaban exposure. Read the full paper here: http://www.dovepress.com/rivaroxaban-as-an-oral-anticoagulant-for-stroke-prevention-in-atrial-f-peer-reviewed-article
Views: 6675 Dove Medical Press
Papillon–Lefèvre syndrome - Video abstract 76080
Video abstract of review paper “Papillon–Lefèvre syndrome: clinical presentation and management options” published in the Clinical, Cosmetic and Investigational Dentistry journal by Sreeramulu B, Shyam NDVN, Ajay P, et al. Papillon–Lefèvre syndrome (PLS) is a rare autosomal recessive disorder, characterized by diffuse palmoplantar keratoderma and precocious aggressive periodontitis, leading to premature loss of deciduous and permanent dentition at a very young age. Various etiopathogenic factors are associated with the syndrome, like immunologic alterations, genetic mutations, and the role of bacteria. Dentists play a significant role in the diagnosis and management of PLS as there are characteristic manifestations like periodontal destruction at an early age and an early eruption of permanent teeth. Here, we are presenting an elaborate review of PLS, its etiopathogenesis, clinical presentation, and management options. Original paper can be viewed here: http://www.dovepress.com/papillonndashlefegravevre-syndrome-clinical-presentation-and-managemen-peer-reviewed-article-CCIDE
Views: 2056 Dove Medical Press
Linking diet to acne metabolomics, inflammation, and comedogenesis - Video abstract 69135
Video abstract of review paper "Linking diet to acne metabolomics, inflammation, and comedogenesis: an update" published in the open access journal Clinical, Cosmetic and Investigational Dermatology by Melnik BC. Abstract: Acne vulgaris, an epidemic inflammatory skin disease of adolescence, is closely related to Western diet. Three major food classes that promote acne are: 1) hyperglycemic carbohydrates, 2) milk and dairy products, 3) saturated fats including trans-fats and deficient ω-3 polyunsaturated fatty acids (PUFAs). Diet-induced insulin/insulin-like growth factor (IGF-1)-signaling is superimposed on elevated IGF-1 levels during puberty, thereby unmasking the impact of aberrant nutrigenomics on sebaceous gland homeostasis. Western diet provides abundant branched-chain amino acids (BCAAs), glutamine, and palmitic acid. Insulin and IGF-1 suppress the activity of the metabolic transcription factor forkhead box O1 (FoxO1). Insulin, IGF-1, BCAAs, glutamine, and palmitate activate the nutrient-sensitive kinase mechanistic target of rapamycin complex 1 (mTORC1), the key regulator of anabolism and lipogenesis. FoxO1 is a negative coregulator of androgen receptor, peroxisome proliferator-activated receptor-γ (PPARγ), liver X receptor-α, and sterol response element binding protein-1c (SREBP-1c), crucial transcription factors of sebaceous lipogenesis. mTORC1 stimulates the expression of PPARγ and SREBP-1c, promoting sebum production. SREBP-1c upregulates stearoyl-CoA- and Δ6-desaturase, enhancing the proportion of monounsaturated fatty acids in sebum triglycerides. Diet-mediated aberrations in sebum quantity (hyperseborrhea) and composition (dysseborrhea) promote Propionibacterium acnes overgrowth and biofilm formation with overexpression of the virulence factor triglyceride lipase increasing follicular levels of free palmitate and oleate. Free palmitate functions as a “danger signal,” stimulating toll-like receptor-2-mediated inflammasome activation with interleukin-1β release, Th17 differentiation, and interleukin-17-mediated keratinocyte proliferation. Oleate stimulates P. acnes adhesion, keratinocyte proliferation, and comedogenesis via interleukin-1α release. Thus, diet-induced metabolomic alterations promote the visible sebofollicular inflammasomopathy acne vulgaris. Nutrition therapy of acne has to increase FoxO1 and to attenuate mTORC1/SREBP-1c signaling. Patients should balance total calorie uptake and restrict refined carbohydrates, milk, dairy protein supplements, saturated fats, and trans-fats. A paleolithic-like diet enriched in vegetables and fish is recommended. Plant-derived mTORC1 inhibitors and ω-3-PUFAs are promising dietary supplements supporting nutrition therapy of acne vulgaris. Read the original article here: http://www.dovepress.com/linking-diet-to-acne-metabolomics-inflammation-and-comedogenesis-an-up-peer-reviewed-article-CCID
Views: 1726 Dove Medical Press
Cisplatin-bearing SPIONs for targeted drug delivery - Video abstract 63433
Video abstract of original research paper "Development and characterization of magnetic iron oxide nanoparticles with a cisplatin-bearing polymer coating for targeted drug delivery" published in the open access International Journal of Nanomedicine by Unterweger H, Tietze R, Janko C, et al. Abstract A highly selective and efficient cancer therapy can be achieved using magnetically directed superparamagnetic iron oxide nanoparticles (SPIONs) bearing a sufficient amount of the therapeutic agent. In this project, SPIONs with a dextran and cisplatin-bearing hyaluronic acid coating were successfully synthesized as a novel cisplatin drug delivery system. Transmission electron microscopy images as well as X-ray diffraction analysis showed that the individual magnetite particles were around 4.5 nm in size and monocrystalline. The small crystallite sizes led to the superparamagnetic behavior of the particles, which was exemplified in their magnetization curves, acquired using superconducting quantum interference device measurements. Hyaluronic acid was bound to the initially dextran-coated SPIONs by esterification. The resulting amide bond linkage was verified using Fourier transform infrared spectroscopy. The additional polymer layer increased the vehicle size from 22 nm to 56 nm, with a hyaluronic acid to dextran to magnetite weight ratio of 51:29:20. A maximum payload of 330 μg cisplatin/mL nanoparticle suspension was achieved, thus the particle size was further increased to around 77 nm with a zeta potential of -45 mV. No signs of particle precipitation were observed over a period of at least 8 weeks. Analysis of drug-release kinetics using the dialysis tube method revealed that these were driven by inverse ligand substitution and diffusion through the polymer shell as well as enzymatic degradation of hyaluronic acid. The biological activity of the particles was investigated in a nonadherent Jurkat cell line using flow cytometry. Further, cell viability and proliferation was examined in an adherent PC-3 cell line using xCELLigence analysis. Both tests demonstrated that particles without cisplatin were biocompatible with these cells, whereas particles with the drug induced apoptosis in a dose-dependent manner, with secondary necrosis after prolonged incubation. In conclusion, combination of dextran-coated SPIONs with hyaluronic acid and cisplatin represents a promising approach for magnetic drug targeting in the treatment of cancer. Read the Original Research paper here: http://www.dovepress.com/development-and-characterization-of-magnetic-iron-oxide-nanoparticles--peer-reviewed-article-IJN.
Views: 2137 Dove Medical Press
Sustained release pregabalin with methylcobalamin in neuropathic pain - Video abstract 45271
Video abstract of original research paper Sustained-release pregabalin with methylcobalamin in neuropathic pain: an Indian real-life experience published in the open access International Journal of General Medicine by Yasmin U Dongre and Onkar C Swami. Introduction: Neuropathic pain is intense in nature and difficult to manage. Thus, the primary goal is maximum relief from pain. The aim of this study was to assess the efficacy and safety of a fixed-dose combination of sustained-release pregabalin and methylcobalamin in reducing neuropathic pain in Indian patients, in the real-life situation. Methods: This was a multicenter, prospective, open-labeled, single-arm, observational, 14-day study. Patients received fixed dose combination of 75 or 150 mg sustained-release pregabalin combined with 1500 mcg immediate release methylcobalamin, depending on the clinical requirement. Data was collected for pain reduction and other positive and negative symptoms associated with neuropathy, including hyperesthesia, paresthesia, numbness/tingling, burning sensation, muscle weakness, sleep disturbances, and impairment of movement. Pain intensity was measured on a ten-point visual analog scale (VAS) (0 represented "no pain," and 10 represented "worst pain ever"). The safety of the drug was also evaluated throughout the study duration. Data was analyzed using appropriate statistical methods. Results: The overall reduction in mean VAS score over 14 days was 72.3%. The reduction in mean VAS score was significant as early as the first week. Both positive and negative symptoms of peripheral neuropathy were significantly improved in greater than 50% patients within the 2 weeks. Giddiness (4.7%), followed by sedation (3.6%), dizziness (2.9%), drowsiness (2.3%), and nausea (2.3%) were the most commonly observed adverse effects. The overall efficacy and tolerability was rated as good to excellent by greater than 95% of the investigators and patients. Conclusion: Fixed dose combination of sustained-release pregabalin and methylcobalamin significantly reduced neuropathic pain, with significant improvement in both the positive and negative symptoms associated with neuropathy, in Indian patients and was well tolerated. Read the original research paper here: http://www.dovepress.com/sustained-release-pregabalin-with-methylcobalamin-in-neuropathic-pain--peer-reviewed-article
Views: 27076 Dove Medical Press
Progress, challenges, and potential applications of oral stem cells - video abstract 51009
Video abstract of review paper “From regenerative dentistry to regenerative medicine: progress, challenges, and potential applications of oral stem cells” published in the open access journal Stem Cells and Cloning: Advances and Applications by Li Xiao and Masanori Nasu. Abstract: Adult mesenchymal stem cells (MSCs) and epithelial stem cells play essential roles in tissue repair and self-healing. Oral MSCs and epithelial stem cells can be isolated from adult human oral tissues, for example, teeth, periodontal ligament, and gingiva. Cocultivated adult oral epithelial stem cells and MSCs could represent some developmental events, such as epithelial invagination and tubular structure formation, signifying their potentials for tissue regeneration. Oral epithelial stem cells have been used in regenerative medicine over 1 decade. They are able to form a stratified cell sheet under three-dimensional culture conditions. Both experimental and clinical data indicate that the cell sheets can not only safely and effectively reconstruct the damaged cornea in humans, but also repair esophageal ulcer in animal models. Oral MSCs include dental pulp stem cells (DPSCs), stem cells from exfoliated deciduous teeth (SHED), stem cells from apical papilla (SCAP), periodontal ligament stem cells (PDLSCs), and mesenchymal stem cells from gingiva (GMSCs). They are widely applied in both regenerative dentistry and medicine. DPSCs, SHED, and SCAP are able to form dentin–pulp complex when being transplanted into immunodeficient animals. They have been experimentally used for the regeneration of dental pulp, neuron, bone muscle and blood vessels in animal models and have shown promising results. PDLSCs and GMSCs are demonstrated to be ideal cell sources for repairing the damaged tissues of periodontal, muscle, and tendon. Despite the abovementioned applications of oral stem cells, only a few human clinical trials are now underway to use them for the treatment of certain diseases. Since clinical use is the end goal, their true regenerative power and safety need to be further examined. Read this review paper here http://www.dovepress.com/from-regenerative-dentistry-to-regenerative-medicine-progress-challeng-peer-reviewed-article-SCCAA
Views: 3517 Dove Medical Press
Usability of the ixekizumab autoinjector – Supplementary video [ID 113752]
Supplementary video of original research paper “Usability of a novel disposable autoinjector device for ixekizumab: results from a qualitative study and an open-label clinical trial, including patientreported experience” published in the open access journal Medical Devices: Evidence and Research by authors Callis Duffin et al. Read the original article here: https://www.dovepress.com/usability-of-a-novel-disposable-autoinjector-device-for-ixekizumab-res-peer-reviewed-article-MDER
Views: 4195 Dove Medical Press
Diabetes and tuberculosis control - Video abstract 45082
Video abstract of review paper "Worldwide increase in diabetes: implications for tuberculosis control" published in the open access journal Research and Reports in Tropical Medicine by Fisher-Hoch. Abstract: Diabetes presents a greater threat to global tuberculosis (TB) control than previously appreciated, with risk of reversing the achievements of several decades. An estimated 382 million people worldwide currently have diabetes, half of whom are undiagnosed. Most live in low- and middle-income countries alongside many of the two billion individuals infected with TB. Though the frequency of TB in type 1 diabetes was known for centuries, only recently have we observed the tripling of TB in type 2 diabetes, most significantly in high-burden TB populations such as in Peru, Russia, and the People's Republic of China. In India diabetes is estimated to have increased TB cases by 46% between 1998 and 2008. Diabetes is a greater long-term threat to TB control than human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) since ten-fold more people are affected by diabetes than HIV/AIDS in larger geographic areas. Diabetes in TB increases drug resistance, treatment failure, and mortality, and may increase the spread of drug-resistant strains. Delayed or missed diagnosis fuels transmission of TB and hinders control of diabetes. Tailored treatment for diabetes patients requires well-designed clinical trials. The World Health Organization (WHO) framework for care and control of diabetes and TB needs improved screening strategies. Determination of how best to establish bi-directional screening is hampered by lack of affordable and reliable methods. Recommendations include education of health care providers, patients, and communities. Structured diabetes programs with registries and effective follow-up could be modeled on and communicate with existing TB programs. Vital research should address new diagnostic tools, lowering cost and evaluation of intervention strategies, as well as better understanding of the impaired immune responses that make diabetes patients more susceptible to TB leading to targeted therapies. Solutions will require the combination of good science, good decision-making, adequate funding, and political will. Read the full paper here: http://www.dovepress.com/worldwide-increase-in-diabetes-implications-for-tuberculosis-control-peer-reviewed-article
Views: 5496 Dove Medical Press
Polymeric nanoparticles for targeted oncotherapy – Video abstract 56932
Video abstract of a review paper "Polymeric nanoparticles for targeted treatment in oncology: current insights" published in the open access International Journal of Nanomedicine by Prabhu RH, Patravale VB, Joshi MD. Abstract: Chemotherapy, a major strategy for cancer treatment, lacks the specificity to localize the cancer therapeutics in the tumor site, thereby affecting normal healthy tissues and advocating toxic adverse effects. Nanotechnological intervention has greatly revolutionized the therapy of cancer by surmounting the current limitations in conventional chemotherapy, which include undesirable biodistribution, cancer cell drug resistance, and severe systemic side effects. Nanoparticles (NPs) achieve preferential accumulation in the tumor site by virtue of their passive and ligand-based targeting mechanisms. Polymer-based nanomedicine, an arena that entails the use of polymeric NPs, polymer micelles, dendrimers, polymersomes, polyplexes, polymer–lipid hybrid systems, and polymer–drug/protein conjugates for improvement in efficacy of cancer therapeutics, has been widely explored. The broad scope for chemically modifying the polymer into desired construct makes it a versatile delivery system. Several polymer-based therapeutic NPs have been approved for clinical use. This review provides an insight into the advances in polymer-based targeted nanocarriers with focus on therapeutic aspects in the field of oncology. The full paper is available at: http://www.dovepress.com/polymeric-nanoparticles-for-targeted-treatment-in-oncology-current-ins-peer-reviewed-article-IJN
Views: 1211 Dove Medical Press
Effects of rose hip on cell longevity, skin wrinkles and elasticity - Video abstract 90092
Video Abstract of original research paper "The effectiveness of a standardized rose hip powder, containing seeds and shells of Rosa canina, on cell longevity, skin wrinkles, moisture, and elasticity" published in the open access journal of Clinical Interventions in Aging by L Phetcharat, K Wongsuphasawat and K Winther. Objective: To evaluate the effects of a rose hip powder (Hyben Vital®) made from seeds and shells on cell senescence, skin wrinkling, and aging. Methods: A total of 34 healthy subjects, aged 35–65 years, with wrinkles on the face (crow’s-feet) were subjected to a randomized and double-blinded clinical study of the effects of the rose hip powder, as compared to astaxanthin, a well-known remedy against wrinkles. During the 8-week study, half of the participants ingested the standardized rose hip product, while the other half ingested astaxanthin. Objective measurements of facial wrinkles, skin moisture, and elasticity were made by using Visioscan, Corneometer, and Cutometer at the beginning of the study, after 4 weeks, and after 8 weeks. Evaluation of participant satisfaction of both supplements was assessed using questionnaires. In addition, the effect of the rose hip preparation on cell longevity was measured in terms of leakage of hemoglobin through red cell membranes (hemolytic index) in blood samples kept in a blood bank for 5 weeks. Significance of all values was attained with P less than or equal to 0.05. Results: In the double-blinded study, the rose hip group showed statistically significant improvements in crow’s-feet wrinkles (P less than 0.05), skin moisture (P less than 0.05), and elasticity (P less than 0.05) after 8 weeks of treatment. A similar improvement was observed for astaxanthin, with P-values 0.05, 0.001, and 0.05. Likewise, both groups expressed equal satisfaction with the results obtained in their self-assessment. The rose hip powder further resulted in increased cell longevity of erythrocyte cells during storage for 5 weeks in a blood bank. Conclusion: Results suggest that intake of the standardized rose hip powder (Hyben Vital®) improves aging-induced skin conditions. The apparent stabilizing effects of the rose hip product on cell membranes of stored erythrocyte cells observed in this study may contribute to improve the cell longevity and obstructing skin aging. Read the original research paper here: https://www.dovepress.com/the-effectiveness-of-a-standardized-rose-hip-powder-containing-seeds-a-peer-reviewed-article-CIA
Views: 669 Dove Medical Press
IVIVR generalized model - Video abstract: 41401
Video abstract of original research paper "In vitro-in vivo relationship (IVIVR) generalized model based on artificial neural networks" published in the open access journal of Drug Design, Development and Therapy by Aleksander Mendyk, Paweł Tuszyński, Sebastian Polak et al. Read this original research and sign up to receive Drug Design, Development and Therapy here: http://www.dovepress.com/generalized-in-vitro-in-vivo-relationship-ivivr-model-based-on-artific-peer-reviewed-article-DDDT
Views: 1883 Dove Medical Press
Intellijoint HIP 3D mini-optical navigation tool for THA – Video abstract [ID 119161]
Video abstract of original research paper “Intellijoint HIP®: a 3D mini-optical navigation tool for improving intraoperative accuracy during total hip arthroplasty” published in the open access journal Medical Devices: Evidence and Research by Paprosky and Muir. Abstract: Total hip arthroplasty is an increasingly common procedure used to address degenerative changes in the hip joint due to osteoarthritis. Although generally associated with good results, among the challenges associated with hip arthroplasty are accurate measurement of biomechanical parameters such as leg length, offset, and cup position, discrepancies of which can lead to significant long-term consequences such as pain, instability, neurological deficits, dislocation, and revision surgery, as well as patient dissatisfaction and, increasingly, litigation. Current methods of managing these parameters are limited, with manual methods such as outriggers or calipers being used to monitor leg length; however, these are susceptible to small intraoperative changes in patient position and are therefore inaccurate. Computer-assisted navigation, while offering improved accuracy, is expensive and cumbersome, in addition to adding significantly to procedural time. To address the technological gap in hip arthroplasty, a new intraoperative navigation tool Intellijoint HIP has been developed. This innovative, 3D mini-optical navigation tool provides real-time, intraoperative data on leg length, offset, and cup position and allows for improved accuracy and precision in component selection and alignment. Benchtop and simulated clinical use testing have demonstrated excellent accuracy, with the navigation tool able to measure leg length and offset to within 1 mm and cup position to within 1 in both anteversion and inclination. This study describes the indications, procedural technique, and early accuracy results of the Intellijoint HIP surgical tool, which offers an accurate and easyto- use option for hip surgeons to manage leg length, offset, and cup position intraoperatively. Read the Original Research paper here: https://www.dovepress.com/intellijoint-hipreg-a-3d-mini-optical-navigation-tool-for-improving-in-peer-reviewed-article-MDER
Views: 2310 Dove Medical Press
Ethical decision making in pain management – Video abstract [ID 162926]
Video abstract of original research paper “Ethical decision making in pain management: a conceptual framework” published in the open access Journal of Pain Research by Carvalho et al. Introduction: The practice and study of pain management pose myriad ethical challenges. There is a consensual opinion that adequate management of pain is a medical obligation rooted in classical Greek practice. However, there is evidence that patients often suffer from uncontrolled and unnecessary pain. This is inconsistent with the leges artis, and its practical implications merit a bioethical analysis. Several factors have been identified as causes of uncontrolled and unnecessary pain, which deprive patients from receiving appropriate treatments that theoretically they have the right to access. Important factors include (with considerable regional, financial, and cultural differences) the following: 1) failure to identify pain as a priority in patient care; 2) failure to establish an adequate physician–patient relationship; 3) insufficient knowledge regarding adequate prescription of analgesics; 4) conflicting notions associated with drug-induced risk of tolerance and fear of addiction; 5) concerns regarding “last-ditch” treatments of severe pain; and 6) failure to be accountable and equitable. Objective: The aim of this article was to establish that bioethics can serve as a framework for addressing these challenging issues and, from theoretical to practical approaches, bioethical reflection can contextualize the problem of unrelieved pain. Methods: This article is organized into three parts. First, we illustrate that pain management and its undertreatment are indeed ethical issues. The second part describes possible ethical frameworks that can be combined and integrated to better define the ethical issues in pain management. Finally, we discuss possible directions forward to improve ethical decision making in pain management. Discussion: We argue that 1) the treatment of pain is an ethical obligation, 2) health science schools, especially medical training institutions, have the duty to teach pain management in a comprehensive fashion, and 3) regulatory measures, which prevent patients from access to opioid treatment as indicated in their cases, are unethical and should be reconsidered. Conclusion: Developing an ethical framework for pain management will result in enhanced quality of care, linking the epistemic domains of pain management to their anthropological foundations, thereby making them ethically sound. Read the full paper here: https://www.dovepress.com/ethical-decision-making-in-pain-management-a-conceptual-framework-peer-reviewed-article-JPR
Views: 1681 Dove Medical Press
Culture impacts key health care outcomes – Video abstract 126381
Video abstract of original research paper “The imperative of culture: a quantitative analysis of the impact of culture on workforce engagement, patient experience, physician engagement, value-based purchasing, and turnover” published in the Journal of Healthcare Leadership by Owens K, Eggers J, Keller S, et al. Abstract: Current uncertainty for the future of the health care landscape is placing an increasing amount of pressure on leadership teams to be prepared to steer their organization forward in a number of potential directions. It is commonly recognized among health care leaders that culture will either enable or disable organizational success. However, very few studies empirically link culture to health care-specific performance outcomes. Nearly every health care organization in the US specifies its cultural aspirations through mission and vision statements and values. Ambitions of patient-centeredness, care for the community, workplace of choice, and world-class quality are frequently cited; yet, little definitive research exists to quantify the importance of building high-performing cultures. Our study examined the impact of cultural attributes defined by a culture index (Cronbach’s alpha = 0.88) on corresponding performance with key health care measures. We mapped results of the culture index across data sets, compared results, and evaluated variations in performance among key indicators for leaders. Organizations that perform in the top quartile for our culture index statistically significantly outperformed those in the bottom quartile on all but one key performance indicator tested. The culture top quartile organizations outperformed every domain for employee engagement, physician engagement, patient experience, and overall value-based purchasing performance with statistical significance. Culture index top quartile performers also had a 3.4% lower turnover rate than the bottom quartile performers. Finally, culture index top quartile performers earned an additional 1% on value-based purchasing. Our findings demonstrate a meaningful connection between performance in the culture index and organizational performance. To best impact these key performance outcomes, health care leaders should pay attention to culture and actively steer workforce engagement in attributes that represent the culture index, such as treating patients as valued customers, having congruency between employee and organizational values, promoting employee pride, and encouraging the feeling that being a member of the organization is rewarding, in order to leverage culture as a competitive advantage. Read the full paper here: https://www.dovepress.com/the-imperative-of-culture-a-quantitative-analysis-of-the-impact-of-cul-peer-reviewed-article-JHL
Views: 2005 Dove Medical Press
Novel resveratrol nanodelivery systems - Video abstract: 37840
Video abstract of original research paper 'Video abstract bioavailability' to be published in the open access International Journal of Nanomedicine by Neves AR, Lúcio M, Martins S, et al. Introduction: Resveratrol is a polyphenol found in grapes and red wines. Interest in this polyphenol has increased due to its pharmacological cardio- and neuroprotective, chemopreventive, and antiaging effects, among others. Nevertheless, its pharmacokinetic properties are less favorable, since the compound has poor bioavailability, low water solubility, and is chemically unstable. To overcome these problems, we developed two novel resveratrol nanodelivery systems based on lipid nanoparticles to enhance resveratrol's oral bioavailability for further use in medicines, supplements, and nutraceuticals. Methods and materials: Solid lipid nanoparticles (SLNs) and nanostructured lipid carriers (NLCs) loaded with resveratrol were successfully produced by a modified hot homogenization technique. These were completely characterized to evaluate the quality of the developed resveratrol-loaded nanoparticles. Results: Cryo-scanning electron microscopy morphology studies showed spherical and uniform nanoparticles with a smooth surface. An average resveratrol entrapment efficiency of ~70% was obtained for both SLNs and NLCs. Dynamic light scattering measurements gave a Z-average of 150--250 nm, polydispersity index of ~0.2, and a highly negative zeta potential of around −30 mV with no statistically significant differences in the presence of resveratrol. These characteristics remained unchanged for at least 2 months, suggesting good stability. Differential scanning calorimetry studies confirmed the solid state of the SLNs and NLCs at both room and body temperatures. The NLCs had a less ordered crystalline structure conferred by the inclusion of the liquid lipid, since they had lower values for phase transition temperature, melting enthalpy, and the recrystallization index. The presence of resveratrol induced a disorder in the crystal structure of the nanoparticles, suggesting a favoring of its entrapment. The in vitro release studies on conditions of storage showed a negligible resveratrol release over several hours for both nanosystems and the in vitro simulation of gastrointestinal transit showed that the resveratrol remained mostly associated with the lipid nanoparticles after their incubation in digestive fluids. Conclusion: Both nanodelivery systems can be considered suitable carriers for oral administration, conferring protection to the incorporated resveratrol and allowing a controlled release after uptake. Read the full paper here: http://www.dovepress.com/articles.php?article_id=11880
Views: 1855 Dove Medical Press
Benefits of PGx for patients in a long-term care facility - Video Abstract 93480
Video abstract of original research paper “Initial assessment of the benefits of implementing pharmacogenetics into the medical management of patients in a long-term care facility” published in the open access journal Pharmacogenomics and Personalized Medicine by Saldivar et al. Abstract: The health care costs associated with prescription drugs are enormous, particularly in patients with polypharmacy (taking more than five prescription medications), and they continue to grow annually. The evolution of pharmacogenetics has provided clinicians with a valuable tool that allows for a smarter, more fine-tuned approach to treating patients for a number of clinical conditions. Applying a pharmacogenetics approach to the medical management of patients can provide a significant improvement to their care, result in cost savings by reducing the use of ineffective drugs, and decrease overall health care utilization. AltheaDx has begun a study to look at the benefits associated with incorporating pharmacogenetics into the medical management of patients who are on five or more medications. Applying pharmacogenetic guided PharmD recommendations across this patient population resulted in the elimination and/or replacement of one to three drugs, for 50% of the polypharmacy patient population tested, and an estimated US$621 in annual savings per patient. The initial assessment of this study shows that there is a clear opportunity for concrete health care savings solely from prescription drug management when incorporating pharmacogenetic testing. Read the original article here: https://www.dovepress.com/initial-assessment-of-the-benefits-of-implementing-pharmacogenetics-in-peer-reviewed-article-PGPM
Views: 609 Dove Medical Press
Islet cell transplantation for the treatment of type1 diabetes - video abstract 50789
Video abstract of review paper "Islet cell transplantation for the treatment of type 1 diabetes: recent advances and future challenges" published in the open access journal Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy by Bruni A, Pepper AR, and Shapiro AMJ. Abstract: Islet transplantation is a well-established therapeutic treatment for a subset of patients with complicated type I diabetes mellitus. Prior to the Edmonton Protocol, only 9% of the 267 islet transplant recipients since 1999 were insulin independent for .1 year. In 2000, the Edmonton group reported the achievement of insulin independence in seven consecutive patients, which in a collaborative team effort propagated expansion of clinical islet transplantation centers worldwide in an effort to ameliorate the consequences of this disease. To date, clinical islet transplantation has established improved success with insulin independence rates up to 5 years post-transplant with minimal complications. In spite of marked clinical success, donor availability and selection, engraftment, and side effects of immunosuppression remain as existing obstacles to be addressed to further improve this therapy. Clinical trials to improve engraftment, the availability of insulin-producing cell sources, as well as alternative transplant sites are currently under investigation to expand treatment. With ongoing experimental and clinical studies, islet transplantation continues to be an exciting and attractive therapy to treat type I diabetes mellitus with the prospect of shifting from a treatment for some to a cure for all. Read the full paper here: http://www.dovepress.com/islet-cell-transplantation-for-the-treatment-of-type-1-diabetes-recent-peer-reviewed-article
Views: 2684 Dove Medical Press
Hypercalcemia of malignancy and new treatment options - Video abstract 83681
Video abstract of review paper "Hypercalcemia of malignancy and new treatment options" published in the open access journal Therapeutics and Clinical Risk Management by Hillel Sternlicht and Ilya G Glezerman. Abstract: Hypercalcemia of malignancy affects up to one in five cancer patients during the course of their disease. It is associated with both liquid malignancies, commonly multiple myeloma, leukemia, and non-Hodgkins lymphoma and solid cancers, particularly breast and renal carcinomas as well as squamous cell carcinomas of any organ. The clinical manifestations of hypercalcemia are generally constitutional in nature and not specific to the inciting malignancy. Such physical manifestations can range from malaise to lethargy and confusion. Constipation and anorexia are common. Acute kidney injury is likely the most frequently encountered manifestation of end organ damage. Symptomatology is closely linked to both the absolute elevation of serum calcium levels and the rapidity of calcium rise. The majority of cases are humoral in etiology and related to parathyroid hormone-related protein (PTHrP). Approximately 20% of cases are the result of direct bone metastasis with extra-renal 1,25-dihydroxyvitamin D (calcitriol) and ectopic parathyroid hormone production likely accounting for less than 1% of cases. The diagnosis of hypercalcemia of malignancy is confirmed either by an elevated PTHrP or by an evidence of bone metastasis in the appropriate clinical setting. Treatment is predicated on the patient’s symptoms and absolute serum calcium level. Interventions are aimed at lowering the serum calcium concentration by inhibiting bone resorption and increasing urinary calcium excretion, the former accomplished via bisphosphonate therapy and the latter with aggressive hydration. Novel therapies for refractory disease include denosumab, a monoclonal antibody against the receptor activator of nuclear factor κB ligand, and the calcimimetic cinacalcet. Finally, anti-PTHrP antibodies have been successfully deployed in animal models of disease. Despite the efficacy of the above therapies, hypercalcemia of malignancy portends an ominous prognosis, indicating advanced and often refractory cancer with survival on the order of months. Read the original article here: https://www.dovepress.com/hypercalcemia-of-malignancy-and-new-treatment-options-peer-reviewed-article-TCRM
Views: 898 Dove Medical Press