Therapeutic Actions Physical Therapy

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The Relationship between Autism Spectrum Disorder and Melatonin during Fetal Development.

Related Articles The Relationship between Autism Spectrum Disorder and Melatonin during Fetal Development. Molecules. 2018 Jan 18;23(1): Authors: Jin Y, Choi J, Won J, Hong Y Abstract The aim of this review is to clarify the interrelationship between melatonin and autism spectrum disorder (ASD) during fetal development. ASD refers to a diverse range of neurodevelopmental disorders characterized by social deficits, impaired communication, and stereotyped or repetitive behaviors. Melatonin, which is secreted by the pineal gland, has well-established neuroprotective and circadian entraining effects. During pregnancy, the hormone crosses the placenta into the fetal circulation and transmits photoperiodic information to the fetus allowing the establishment of normal sleep patterns and circadian rhythms that are essential for normal neurodevelopment. Melatonin synthesis is frequently impaired in patients with ASD. The hormone reduces oxidative stress, which is harmful to the central nervous system. Therefore, the neuroprotective and circadian entraining roles of melatonin may reduce the risk of neurodevelopmental disorders such as ASD. PMID: 29346266 [PubMed - in process]

Synergistic Impact of Training Followed By on-Site Support on Hiv Clinical Practice: A Mixed Design Study in Uganda with Pre/Post and Cluster Randomized Trial Components.

Related Articles Synergistic Impact of Training Followed By on-Site Support on Hiv Clinical Practice: A Mixed Design Study in Uganda with Pre/Post and Cluster Randomized Trial Components. J Acquir Immune Defic Syndr. 2018 Jan 16;: Authors: Burnett S, Mubiru N, Imani P, Mbonye MK, Fisher L, Colebunders R, Manabe YC, Weaver MR Abstract BACKGROUND: Task-shifting can expand antiretroviral therapy access, but little is known about effective approaches to improve clinical practice among mid-level practitioners' (MLP) such as clinical officers, nurses, and midwives. The Integrated Infectious Diseases Capacity-Building Evaluation compared training alone to training combined with on-site support (OSS). METHODS: Two MLP each from 36 health facilities attended the five-week Integrated Management of Infectious Disease training. Following training, 18 facilities randomly assigned to arm A received OSS for nine months, while 18 arm B facilities did not. Clinical faculty assessed MLP HIV clinical practice on six tasks: history taking, physical examination, laboratory investigations, diagnosis, treatment, and patient education. We analyzed the effect of training alone and training combined with OSS as the pre/post change within each arm. We analyzed the incremental effect of OSS with a difference-in-difference analysis that compared changes between arms. RESULTS: Training alone and training combined with OSS significantly improved clinical practice in patient history taking (13% and 24% increase, respectively), physical examination (54% and 71%), laboratory investigations (32% and 20%) and diagnosis (31% and 51%). Combined training and OSS also improved patient education significantly (72% increase). Effect sizes for training combined with OSS were larger than for training alone except for laboratory investigations, and the effects were robust in sensitivity analyses. The incremental effect of OSS on diagnosis was significant (adjusted relative relative risk=1.23; 95% CI=1.00-1.50). CONCLUSION: Combined training and OSS improved MLP HIV clinical practice over training alone and can contribute to continued expansion of access to antiretroviral therapy.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. PMID: 29346184 [PubMed - as supplied by publisher]

Promotion of Exercise in Multiple Sclerosis Through Healthcare Providers.

Related Articles Promotion of Exercise in Multiple Sclerosis Through Healthcare Providers. Exerc Sport Sci Rev. 2018 Jan 15;: Authors: Motl RW, Barstow EA, Blaylock S, Richardson E, Learmonth YC, Fifolt M Abstract Participation in exercise yields meaningful benefits among persons with multiple sclerosis(MS), yet this population engages in low rates of health-promoting physical activity. The disconnect between evidence of benefits and rates of participation requires consideration of new opportunities for changing this health behavior. The current paper hypothesizes that the patient-provider interaction offers a fertile opportunity for promoting exercise behavior in MS. PMID: 29346161 [PubMed - as supplied by publisher]

2016 New Horizons Lecture: Beyond Imaging-Radiology of Tomorrow.

Related Articles 2016 New Horizons Lecture: Beyond Imaging-Radiology of Tomorrow. Radiology. 2018 Jan 18;:171503 Authors: Hricak H Abstract This article is based on the New Horizons lecture delivered at the 2016 Radiological Society of North America Annual Meeting. It addresses looming changes for radiology, many of which stem from the disruptive effects of the Fourth Industrial Revolution. This is an emerging era of unprecedented rapid innovation marked by the integration of diverse disciplines and technologies, including data science, machine learning, and artificial intelligence-technologies that narrow the gap between man and machine. Technologic advances and the convergence of life sciences, physical sciences, and bioengineering are creating extraordinary opportunities in diagnostic radiology, image-guided therapy, targeted radionuclide therapy, and radiology informatics, including radiologic image analysis. This article uses the example of oncology to make the case that, if members in the field of radiology continue to be innovative and continuously reinvent themselves, radiology can play an ever-increasing role in both precision medicine and value-driven health care. © RSNA, 2018. PMID: 29346031 [PubMed - as supplied by publisher]

Role of the Lymphatic System in the Pathogenesis of Hypertension in Humans.

Related Articles Role of the Lymphatic System in the Pathogenesis of Hypertension in Humans. Lymphat Res Biol. 2018 Jan 18;: Authors: Chachaj A, Puła B, Chabowski M, Grzegrzółka J, Szahidewicz-Krupska E, Karczewski M, Janczak D, Dzięgiel P, Podhorska-Okołów M, Mazur G, Gamian A, Szuba A Abstract BACKGROUND: Recent studies, mainly on animal models, have suggested that negatively charged glycosaminoglycans, macrophages, and lymph vessels in the skin interstitium may serve as extrarenal control of sodium balance and blood pressure. The aim of the study was to prove the hypothesis that skin interstitium has a role in the pathogenesis of hypertension in humans. METHODS AND RESULTS: We have examined skin biopsies in 91 patients from the department of surgery who had elective surgery with abdominal skin incision: 43 were hypertensive, 14 had resistant hypertension, and 34 with normal blood pressure as control group (median patients' age in these groups estimated accordingly 64 vs. 64 vs. 61.5; p > 0.05). We have studied (1) the content of Na+, water, accumulation of macrophages (CD68), and density of lymphatic vessels (D2-40) and blood vessels (CD31) in the specimens of abdominal skin taken at the time of surgery and (2) plasma NT-proANP, vascular endothelial growth factor (VEGF)-C, and VEGF-D concentrations. The study groups differed in skin expression of CD68 (control vs. hypertension vs. resistant hypertension groups were accordingly: 3.33 vs. 4.00 vs. 8.33; p = 0.005) and in serum concentration of VEGF-C (5792 vs. 4348 vs. 3974 pg/mL; p = 0.026). Differences among groups in plasma NT-proANP levels were close to statistical significance (p = 0.056). CONCLUSIONS: Our results confirm that skin interstitium may be involved in the pathogenesis of essential hypertension in humans. Lower levels of VEGF-C in hypertensive groups suggest that impairment of lymphangiogenesis and protective function of the skin lymphatic system may play a role in the pathogenesis of hypertension. PMID: 29346014 [PubMed - as supplied by publisher]

Deletion of estrogen receptor alpha in skeletal muscle results in impaired contractility in female mice.

Related Articles Deletion of estrogen receptor alpha in skeletal muscle results in impaired contractility in female mice. J Appl Physiol (1985). 2018 Jan 18;: Authors: Collins BC, Mader TL, Cabelka CA, Iñigo MR, Spangenburg EE, Lowe DA Abstract Estradiol deficiency in females can result in skeletal muscle strength loss, and treatment with estradiol mitigates the loss. There are three primary estrogen receptors and estradiol elicits effects through these receptors in various tissues. Ubiquitous estrogen receptor α (ERα) knockout mice exhibit numerous biological disorders, but little is known regarding the specific role of ERα in skeletal muscle contractile function. The purpose of this study was to determine the impact of skeletal muscle specific ERα deletion on contractile function, hypothesizing that ERα is a main receptor through which estradiol affects muscle strength in females. Deletion of ERα specifically in skeletal muscle (skmERαKO) did not affect body mass compared to wild-type littermates (skmERαWT) until 26 wk of age at which time body mass of skmERαKO began to increase disproportionally. Overall, skmERαKO mice had low strength demonstrated in multiple muscles and by several contractile parameters. Isolated extensor digitorum longus muscles from skmERαKO mice produced 16% less eccentric and 16-26% less submaximal and maximal isometric forces and isolated soleus muscles were more fatigable with impaired force recovery relative to skmERαWT. In vivo maximal torque productions by plantar- and dorsi-flexors were 16 and 12% lower in skmERαKO than skmERαWT mice and skmERαKO muscles had low phosphorylation of myosin regulatory light chain. Plantarflexors also generated 21-32% less power, submaximal isometric and peak concentric torques. Data support the hypothesis that ablation of ERα in skeletal muscle results in muscle weakness, suggesting that the beneficial effects of estradiol on muscle strength are receptor mediated through ERα. PMID: 29345963 [PubMed - as supplied by publisher]

Multi-potent Natural Scaffolds Targeting Amyloid Cascade: In search of Alzheimer's Disease Therapeutics.

Related Articles Multi-potent Natural Scaffolds Targeting Amyloid Cascade: In search of Alzheimer's Disease Therapeutics. Curr Top Med Chem. 2018 Jan 16;: Authors: Chakraborty S Abstract Alzheimer's disease (AD) once considered a rare disorder emerges as a major health concern in recent times. The disease pathogenesis is very complex and yet to be understood completely. However, "Amyloid Cascade" is the central event in disease pathogenesis. Several proteins of the amyloid cascade are currently being considered as potential targets for AD therapeutics discovery. Many potential compounds are in clinical trials, but till now there is no known cure for the disease. Recent years have witnessed remarkable research interest in search of novel concepts in drug designing for AD. Multi-targeted ligand design is a paradigm shift in conventional drug discovery. In this process rather than designing ligands targeting a single receptor, novel ligands have been designed/synthesized that can simultaneously target many pathways involved in disease pathogenesis. Here, recent developments in computational drug designing protocols to identify multi-targeted ligand for AD have been discussed. Therapeutic potential of different multi-potent compounds also has been discussed briefly. Prime emphasis has been given to multi-potent ligand from natural resources. Polyphenols are an interesting group of compounds that shows efficacy against wide range of disease and have the property to exhibit multi-potency. Several groups attempted to identify novel multi-potent phytochemicals for AD therapy. Multi-potency of several polyphenols or compounds synthesized using the poly-phenolic scaffolds has been briefly discussed here. However, the multi-targeted drug designing for AD is still in early stages, more advancement in drug designing method/algorithm developments are urgently required to discover more efficient compounds for AD therapeutics. PMID: 29345580 [PubMed - as supplied by publisher]

Daily Bicycling in Older Adults May Be Effective to Reduce Fall Risks - A Case Control Study.

Related Articles Daily Bicycling in Older Adults May Be Effective to Reduce Fall Risks - A Case Control Study. J Aging Phys Act. 2018 Jan 18;:1-21 Authors: Batcir S, Melzer I Abstract Older adults gain many health benefits from riding bicycles regularly. We aimed to explore whether older persons who ride bicycles regularly have better balance than controls. Balance control and voluntary stepping were assessed in 20 older adults aged 65 to 85 who live in an agricultural community village who regularly ride bicycles (BR), and 30 age- and gender-matched non-bicycle riders (NBR). Self-reported function and fear of fall were also assessed. Bicycle riders showed significantly better balance, faster voluntary stepping, and better self-reported advanced lower extremity function compared with NBR. The results might suggest that bicycling regularly preserves balance control and speed of voluntary stepping in older adults because bicycling might maintain specific balance coordination patterns. The results should be treated with caution since BR were older adults who selected an active life style (i.e., bicycling as well as living in an agricultural village) that may bias the results. PMID: 29345533 [PubMed - as supplied by publisher]

Cancer-associated cachexia.

Related Articles Cancer-associated cachexia. Nat Rev Dis Primers. 2018 Jan 18;4:17105 Authors: Baracos VE, Martin L, Korc M, Guttridge DC, Fearon KCH Abstract Cancer-associated cachexia is a disorder characterized by loss of body weight with specific losses of skeletal muscle and adipose tissue. Cachexia is driven by a variable combination of reduced food intake and metabolic changes, including elevated energy expenditure, excess catabolism and inflammation. Cachexia is highly associated with cancers of the pancreas, oesophagus, stomach, lung, liver and bowel; this group of malignancies is responsible for half of all cancer deaths worldwide. Cachexia involves diverse mediators derived from the cancer cells and cells within the tumour microenvironment, including inflammatory and immune cells. In addition, endocrine, metabolic and central nervous system perturbations combine with these mediators to elicit catabolic changes in skeletal and cardiac muscle and adipose tissue. At the tissue level, mechanisms include activation of inflammation, proteolysis, autophagy and lipolysis. Cachexia associates with a multitude of morbidities encompassing functional, metabolic and immune disorders as well as aggravated toxicity and complications of cancer therapy. Patients experience impaired quality of life, reduced physical, emotional and social well-being and increased use of healthcare resources. To date, no effective medical intervention completely reverses cachexia and there are no approved drug therapies. Adequate nutritional support remains a mainstay of cachexia therapy, whereas drugs that target overactivation of catabolic processes, cell injury and inflammation are currently under investigation. PMID: 29345251 [PubMed - in process]

Developing single-entity theranostic: drug-based fluorescent nanoclusters with augmented cytotoxicity.

Related Articles Developing single-entity theranostic: drug-based fluorescent nanoclusters with augmented cytotoxicity. Nanomedicine (Lond). 2018 Jan 18;: Authors: Chatterjee B, Raza A, Ghosh SS Abstract AIM: To develop methotrexate (MTX) templated luminescent gold nanoclusters (NCs) as a single unit nanotheranostic for cancer therapy and to assess its potential as an alternative to the parent drug, for drug delivery vehicles (DDVs). METHODS: Theranostics were synthesized and extensively characterized. The stability of the theranostic and its bioimaging aptitude were evaluated. The antiproliferative propensity of the theranostic was gauged with cell viability assays and was supplemented with cytometry-based assays. Feasibility of delivering the MTX NCs instead of parent drug on a DDV was also checked. RESULTS: MTX NCs displayed remarkable physical characteristics and augmented cytotoxicity with a robust stability in phosphate-buffered saline and serum. MTX NCs also demonstrated their amenability to being loaded on a DDV (chitosan folic acid nanoparticles) while retaining their physical and cytotoxic profile. CONCLUSION: Generation of next level drug-based theranostics with the potential of replacing the free drug in drug delivery platforms. PMID: 29345211 [PubMed - as supplied by publisher]

Low NT-proBNP levels in overweight and obese patients do not rule out a diagnosis of heart failure with preserved ejection fraction.

Related Articles Low NT-proBNP levels in overweight and obese patients do not rule out a diagnosis of heart failure with preserved ejection fraction. ESC Heart Fail. 2018 Jan 18;: Authors: Buckley LF, Canada JM, Del Buono MG, Carbone S, Trankle CR, Billingsley H, Kadariya D, Arena R, Van Tassell BW, Abbate A Abstract BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome that presents clinicians with a diagnostic challenge. The use of natriuretic peptides to exclude a diagnosis of HFpEF has been proposed. We sought to compare HFpEF patients with N-terminal pro-brain natriuretic peptide (NT-proBNP) level above and below the proposed cut-off. METHODS: Stable patients (n = 30) with left ventricular (LV) ejection fraction ≥ 50% were eligible if they had a diagnosis of HF according to the European Society of Cardiology diagnostic criteria. Characteristics of patients with NT-proBNP below (≤125 pg/mL) and above (>125 pg/mL) the diagnostic criterion were compared. RESULTS: There were 19 (66%) women with median age 54 years. Half were African American (16, 53%), and most were obese. There were no significant differences in clinical characteristics or medication use between groups. LV end-diastolic volume index was greater in high NT-proBNP patients (P = 0.03). Left atrial volume index, E/e' ratio, and E/e' ratio at peak exercise were not significantly different between NT-proBNP groups. Peak oxygen consumption (VO2 ), VO2 at ventilatory threshold, and ventilatory efficiency measures were impaired in all patients and were not significantly different between high and low NT-proBNP patients. CONCLUSIONS: NT-proBNP was below the proposed diagnostic cut-off point of 125 pg/mL in half of this obese study cohort. Cardiac diastolic dysfunction and cardiorespiratory fitness were not significantly different between high and low NT-proBNP patients. These data indicate that excluding the diagnosis of HFpEF based solely on NT-proBNP levels should be discouraged. PMID: 29345112 [PubMed - as supplied by publisher]

Occupational therapy publications by Australian authors: A bibliometric analysis.

Related Articles Occupational therapy publications by Australian authors: A bibliometric analysis. Aust Occup Ther J. 2018 Jan 18;: Authors: Brown T, Gutman SA, Ho YS Abstract BACKGROUND: Bibliometrics refers to the collection and measurement of publishing and citation data configurations with the goal of quantifying the influence of scholarly activities. Advantages of bibliometrics include the generation of quantitative indicators of impact, productivity, quality and collaboration. Those parties who benefit from the results of bibliometric analysis include researchers, educators, journal publishers, employers and research funding bodies. METHODS: A bibliometric analysis was completed of peer-reviewed literature from 1991 to 2015, written by Australian occupational therapists (who were able to be identified as such), and indexed in the Science Citation Index-Expanded (SCI-Expanded) or the Social Sciences Citation Index (SSCI) databases. "Occupational therapy" and "occupational therapist(s)" were used as keywords to search journal articles' publication title, abstract, author details, keywords and KeyWord Plus. RESULTS: Between 1991 and 2015, 752 peer-reviewed journal articles were published by Australian occupational therapy authors. On average, those articles had 3.7 authors, 35 references, and were nine pages in length. The top four journals in which Australian occupational therapists published were Australian Occupational Therapy Journal, British Journal of Occupational Therapy, American Journal of Occupational Therapy, and Physical and Occupational Therapy in Paediatrics. The four Australian institutions that generated the largest number of occupational therapy articles were the University of Queensland, University of Sydney, La Trobe University, and Monash University. The top four countries with whom Australian authors collaborated in manuscript writing were the United Kingdom, United States, Canada and Sweden. CONCLUSION: The volume of occupational therapy peer-reviewed literature has grown over the last two decades. Australian authors have and continue to make significant contributions to the occupational therapy body of knowledge nationally and internationally. PMID: 29344965 [PubMed - as supplied by publisher]

Potent peptide-conjugated silicon phthalocyanines for tumor photodynamic therapy.

Related Articles Potent peptide-conjugated silicon phthalocyanines for tumor photodynamic therapy. J Cancer. 2018;9(2):310-320 Authors: Liu Q, Pang M, Tan S, Wang J, Chen Q, Wang K, Wu W, Hong Z Abstract Phthalocyanines (Pcs) are a group of promising photosensitizers for use in photodynamic therapy (PDT). However, their extremely low solubility and their strong tendency to aggregate in aqueous solution greatly restrict their application. Conjugation of Pc macrocycles with peptide ligands could be a very useful strategy to optimize the physical properties of Pcs not only by increasing their water solubility and reducing their aggregation but also by endowing the conjugates with a tumor-targeting capability. To develop highly potent photosensitizers for tumor PDT, we prepared new peptide-conjugated photosensitizers using silicon Pc (SiPc), which has much higher photodynamic activity than zinc Pcs, as the light activation moiety and the cRGDfK peptide (or simply cRGD) as the peptide moiety. A polyethylene glycol linker and an extra carboxylic acid group were also tested for introduction into the conjugates to optimize the conjugate structure. The conjugates' photophysical and photodynamic behaviors were then carefully evaluated and compared using in vitro and in vivo experiments. One of the prepared conjugates, RGD-(Linker)2-Glu-SiPc, showed excellent physical properties and photodynamic activity, with an EC50 (half maximal effective concentration) of 10-20 nM toward various cancer cells. This conjugate eradicated human glioblastoma U87-MG tumors in a xenograft murine tumor model after only one dose of photodynamic treatment, with no tumor regrowth during observation for up to 35 days. The conjugate RGD-(Linker)2-Glu-SiPc thus showed highly promising potential for use in tumor treatment. PMID: 29344278 [PubMed]

Immunotherapy of patient with hepatocellular carcinoma using cytotoxic T lymphocytes ex vivo activated with tumor antigen-pulsed dendritic cells.

Related Articles Immunotherapy of patient with hepatocellular carcinoma using cytotoxic T lymphocytes ex vivo activated with tumor antigen-pulsed dendritic cells. J Cancer. 2018;9(2):275-287 Authors: Wang Y, Yang X, Yu Y, Xu Z, Sun Y, Liu H, Cheng J, Liu M, Sha B, Li L, Ding N, Li Z, Jin H, Qian Q Abstract Purpose The aim of this study was to evaluate the clinical response of immunotherapy with dendritic cell-cytotoxic T lymphocytes (DC-CTLs) in patients with hepatocellular carcinoma (HCC). Method Sixty-eight patients with a confirmed diagnosis of HCC and who received follow-up until December 2015 were enrolled. We measured immune phenotypes of DCs and activated T cells using flow cytometry and clinical indexes using an electrochemiluminescence method. Results DCs exhibited up-regulation of the maturation markers CD83, CD80, CD11c, and CD86 on day8. Levels of IFN-γ and TNF-α were higher in the DCs pulsed with tumor-associated antigens (TAAs) than in DCs with a non-proliferative recombinant adenovirus. The percentage of regulatory T cells (Tregs) decreased in patients after DC-CTLs therapy. In addition, serum levels of AFP, AFP-L3, ALT, and CA19-9 were significantly reduced in these patients. Quality of life was improved, especially on physical functioning scales. Median overall survival (OS) and progression-free survival (PFS) were 8.2 months and 4.3 months, respectively, for the control group and 12.8 months and 9 months, respectively, for the DC-CTL group. Patients treated with DC-CTLs therapy showed a statistically significant PFS and OS curve (OS: p=0.016; PFS: p<0.0001). In addition, no serious adverse reactions were observed. Conclusion This study indicated that Tregs, as well as serum levels of AFP, AFP-L3, ALT, and CA19-9, which were correlated with a poor prognosis, decreased after DC-CTL treatments. The OS, PFS and the quality of life of HCC patients partially improved. PMID: 29344274 [PubMed]

Visible-Near Infrared Spectroscopic Assessment of Urogenital Tissue in Premenopausal and Postmenopausal Women.

Related Articles Visible-Near Infrared Spectroscopic Assessment of Urogenital Tissue in Premenopausal and Postmenopausal Women. Clin Med Insights Womens Health. 2018;11:1179562X17749608 Authors: Farage MA, Cambron T, Liu KZ Abstract Background: A clinical study was conducted to evaluate the feasibility of using visible and near-infrared (NIR) spectroscopy as a potential noninvasive measure of genital skin health in premenopausal and postmenopausal women. Methods: A total of 45 female subjects (aged 21-70 years), all of whom gave fully informed consent to participate, were enrolled in the study and assigned to 1 of 3 groups: 15 premenopausal (Pre-M), 15 postmenopausal receiving hormone replacement therapy (Post-M HRT), and 15 postmenopausal receiving no form of hormone replacement therapy (Post-M non-HRT). Spectral measurements were taken at the vaginal mucosa, and spectral data were evaluated for the erythema index (EI), hemoglobin index (HI), bilirubin/β-carotene, and melanin. The color index (CI; calculated as the ratio of absorbance at 480 nm/540 nm) was also determined. Results were compared with previously published results on biomarkers and physical characteristic of genital tissue measured on the same groups of women. Results: Spectral measurements from the Post-M Non-HRT subjects indicated a significant reduction in HI compared with the Pre-M group (P = .0003) and to the Post-M HRT group (P < .0001). Similarly, EI was reduced in the Post-M Non-HRT (P < .0001 and P = .0041 for the Pre-M and Post-M HRT groups, respectively). In contrast, the Post-M Non-HRT subjects exhibited a significant increase in β-carotene compared with the Pre-M subjects (P = .0098). Bilirubin and melanin were not significantly affected. The Post-M Non-HRT group exhibited a significant increase in CI, indicating a shift away from the hemoglobin absorption region (510-620 nm wavelength) and toward the bilirubin/β-carotene absorption region (450-490 nm wavelength). This change was significant when compared with both the Pre-M group (P < .0001) and the Post-M HRT group (P = .0048). The changes in spectral measurements were consistent with previously reported changes in physical parameters (vaginal atrophy, increased pH, decreased skin temperature) and with decreased concentrations of the biomarkers histamine and histidine. Conclusions: Hemodynamic spectral characteristics differ in postmenopausal vaginal tissue compared with tissue in premenopausal women, with decreased absorbance in the hemoglobin absorption region (510-620 nm wavelength) and an increased absorbance in the bilirubin/β-carotene absorption region (450-490 nm wavelength). A change in absorbance in the visible and NIR wavelengths is a promising, additional measure of genital skin health related to menopause and vulvovaginal atrophy. PMID: 29344000 [PubMed]

Calibration and validation of an item bank for measuring general physical function of patients in medical rehabilitation settings.

Related Articles Calibration and validation of an item bank for measuring general physical function of patients in medical rehabilitation settings. Patient Relat Outcome Meas. 2018;9:11-16 Authors: Cook KF, Kallen MA, Hayes D, Deutscher D, Fritz JM, Werneke MW, Mioduski JE Abstract Objective: The objective of this study was to report the item response theory (IRT) calibration of an 18-item bank to measure general physical function (GPF) in a wide range of conditions and evaluate the validity of the derived scores. Methods: All 18 items were administered to a large sample of patients (n=2337) who responded to the items in the context of their outpatient rehabilitation care. The responses, collected 1997- 2000, were modeled using the graded response model, an IRT model appropriate for items with two or more response options. Inter-item consistency was evaluated based on Cronbach's alpha and item to total correlations. Validity of scores was evaluated based on known-groups comparisons (age, number of health problems, symptom severity). The strength of a single, general factor was evaluated using a bi-factor model. Results were used to evaluate IRT assumption and as an indicator of construct validity. Local independence of item responses was also evaluated. Results: Response data met the assumptions of unidimensionality and local independence. Explained common variance of a single general factor was 0.88 (omega hierarchical =0.86). Only two of the 153 pairs of item residuals were flagged for local dependence. Inter-item consistency was high (0.93) as were item to total correlations (mean =0.61). Substantial variation was found in both IRT location (difficulty) and discrimination parameters. All omnibus known-groups comparisons were statistically significant (p<0.001). Conclusion: Item responses fit the IRT unidimensionality assumptions and were internally consistent. The usefulness of GPF scores in discriminating among patients with different levels of physical function was confirmed. Future studies should evaluate the validity of GPF scores based on an adaptive administration of items. PMID: 29343994 [PubMed]

Does transcutaneous electrical nerve stimulation reduce pain and improve quality of life in patients with idiopathic chronic orchialgia? A randomized controlled trial.

Related Articles Does transcutaneous electrical nerve stimulation reduce pain and improve quality of life in patients with idiopathic chronic orchialgia? A randomized controlled trial. J Pain Res. 2018;11:77-82 Authors: Tantawy SA, Kamel DM, Abdelbasset WK Abstract Background: Chronic orchialgia is defined as testicular pain, which may be either unilateral or bilateral, lasting for more than 3 months. It disturbs a patient's daily activities and quality of life (QoL), inciting the patient to search for treatments to alleviate the pain. It is estimated that 25% of chronic orchialgia cases are idiopathic. Purpose: The purpose of this study was to investigate how effective transcutaneous electrical nerve stimulation (TENS) is in pain reduction and how it consequently affects the QoL in patients with idiopathic chronic orchialgia (ICO). Patients and methods: Seventy-one patients were randomly assigned to group A (study group), which included 36 patients who received TENS and analgesia, and group B (control group), which included 35 patients who received analgesia only. The outcome measures were the participants' demographic data and results of the visual analog scale (VAS) and QoL questionnaire. These outcomes were measured before and after 4 weeks of treatment and at 2-month follow-up. Results: The results showed that compared to pretreatment, there was a significant reduction in pain postintervention and at 2-month follow-up in group A (P<0.0001 and <0.001, respectively; F=7.1) as well as a significant improvement in QoL at these time points (P<0.0001 and <0.0001, respectively). There were no significant differences in the VAS score and QoL in group B at different time points of evaluation. Conclusion: The findings indicate that TENS is effective in reducing pain and improving patients' QoL in cases of ICO. TENS is an easy-to-use, effective, noninvasive, and simple method for ICO-associated pain control and QoL improvement. PMID: 29343983 [PubMed]

Yoga-Based Postoperative Cardiac Rehabilitation Program for Improving Quality of Life and Stress Levels: Fifth-Year Follow-up through a Randomized Controlled Trial.

Related Articles Yoga-Based Postoperative Cardiac Rehabilitation Program for Improving Quality of Life and Stress Levels: Fifth-Year Follow-up through a Randomized Controlled Trial. Int J Yoga. 2018 Jan-Apr;11(1):44-52 Authors: Amaravathi E, Ramarao NH, Raghuram N, Pradhan B Abstract Objectives: This study was aimed to assess the efficacy of yoga-based lifestyle program (YLSP) in improving quality of life (QOL) and stress levels in patients after 5 years of coronary artery bypass graft (CABG). Methodology: Three hundred patients posted for elective CABG in Narayana Hrudayalaya Super Speciality Hospital, Bengaluru, were randomized into two groups: YLSP and conventional lifestyle program (CLSP), and follow-up was done for 5 years. Intervention: In YLSP group, all practices of integrative approach of yoga therapy such as yama, niyama, asana, pranayama, and meditation were used as an add-on to conventional cardiac rehabilitation. The control group (CLSP) continued conventional cardiac rehabilitation only. Outcome Measures: World Health Organization (WHO)-QOL BREF Questionnaire, Perceived Stress Scale, Positive and Negative Affect Scale (PANAS), and Hospital Anxiety and Depression Scale (HADS) were assessed before surgery and at the end of the 5th year after CABG. As data were not normally distributed, Mann-Whitney U-test was used for between-group comparisons and Wilcoxon's signed-rank test was used for within-group comparisons. Results: At the end of 5 years, mental health (P = 0.05), perceived stress (P = 0.01), and negative affect (NA) (P = 0.05) have shown significant improvements. WHO-QOL BREF score has shown improvements in physical health (P = 0.046), environmental health (P = 0.04), perceived stress (P = 0.001), and NA (P = 0.02) in YLSP than CLSP. Positive affect has significantly improved in CLSP than YLSP. Other domains of WHO-QOL-BREF, PANAS, and HADS did not reveal any significant between-group differences. Conclusion: Addition of long-term YLSP to conventional cardiac rehabilitation brings better improvements in QOL and reduction in stress levels at the end of 5 years after CABG. PMID: 29343930 [PubMed]

First two bilateral hand transplantations in India (Part 3): Rehabilitation and immediate outcome.

Related Articles First two bilateral hand transplantations in India (Part 3): Rehabilitation and immediate outcome. Indian J Plast Surg. 2017 May-Aug;50(2):161-167 Authors: Sharma M, Iyer S, Kishore P, Mathew J, Vijayaraghavan S, Sankaran R, Nair AN, Janarthanan R, Wakure A, Reddy R, Chetan Mali SM, Varma V, Chaudhari A, Dhake S, Omkumar A Abstract Introduction: This report covers the strategies adopted for rehabilitation for the first and second dual hand transplants performed in India. Materials and Methods: The team, under a trained physiatrist, including physiotherapy and occupational therapy personnel, was involved in the management of both these patients. The management protocol was developed considering previous reports as well as our management strategies in the rehabilitation of the replanted hands. The involvement of the team with the patients started in the 1st week itself and continued on a daily basis for the entire year. Results: Outcome analysis was performed at 6 months and 1 year using the disability of shoulder and hand evaluation and hand transplant scoring system. Functional magnetic resonance imaging was done at the end of 1 year to assess the cortical integration of the transplanted hand. Conclusion: Despite more than 110 hands being transplanted worldwide, hand transplant remains an experimental procedure. It is still not considered the "standard of care" for hand amputees. Outcome analyses performed worldwide do indicate that the procedure can provide a substantial improvement in the quality of life for the hand amputee, especially the bilateral amputees. PMID: 29343891 [PubMed]

Microdosimetric Modeling of Biological Effectiveness for Boron Neutron Capture Therapy Considering Intra- and Intercellular Heterogeneity in 10B Distribution.

Related Articles Microdosimetric Modeling of Biological Effectiveness for Boron Neutron Capture Therapy Considering Intra- and Intercellular Heterogeneity in 10B Distribution. Sci Rep. 2018 Jan 17;8(1):988 Authors: Sato T, Masunaga SI, Kumada H, Hamada N Abstract We here propose a new model for estimating the biological effectiveness for boron neutron capture therapy (BNCT) considering intra- and intercellular heterogeneity in 10B distribution. The new model was developed from our previously established stochastic microdosimetric kinetic model that determines the surviving fraction of cells irradiated with any radiations. In the model, the probability density of the absorbed doses in microscopic scales is the fundamental physical index for characterizing the radiation fields. A new computational method was established to determine the probability density for application to BNCT using the Particle and Heavy Ion Transport code System PHITS. The parameters used in the model were determined from the measured surviving fraction of tumor cells administrated with two kinds of 10B compounds. The model quantitatively highlighted the indispensable need to consider the synergetic effect and the dose dependence of the biological effectiveness in the estimate of the therapeutic effect of BNCT. The model can predict the biological effectiveness of newly developed 10B compounds based on their intra- and intercellular distributions, and thus, it can play important roles not only in treatment planning but also in drug discovery research for future BNCT. PMID: 29343841 [PubMed - in process]
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