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Possible Treatment (possible + treatment)
Selected AbstractsStress and hippocampal plasticity: implications for the pathophysiology of affective disordersHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue S1 2001Bruce S. McEwen Abstract The hippocampal formation, a structure involved in declarative, spatial and contextual memory, is a particularly sensitive and vulnerable brain region to stress and stress hormones. The hippocampus shows a considerable degree of structural plasticity in the adult brain. Stress suppresses neurogenesis of dentate gyrus granule neurons, and repeated stress causes atrophy of dendrites in the CA3 region. In addition, ovarian steroids regulate synapse formation during the estrous cycle of female rats. All three forms of structural remodeling of the hippocampus are mediated by hormones working in concert with excitatory amino acids (EAA) and N -methyl- D -aspartate (NMDA) receptors. EAA and NMDA receptors are also involved in neuronal death that is caused in pyramidal neurons by seizures and by ischemia and prolonged psychosocial stress. In the human hippocampus, magnetic resonance imaging studies have shown that there is a selective atrophy in recurrent depressive illness, accompanied by deficits in memory performance. Hippocampal atrophy may be a feature of affective disorders that is not treated by all medications. From a therapeutic standpoint, it is essential to distinguish between permanent damage and reversible atrophy in order to develop treatment strategies to either prevent or reverse deficits. In addition, remodeling of brain cells may occur in other brain regions. Possible treatments are discussed. Copyright © 2001 John Wiley & Sons, Ltd. [source] Seizure Suppression by Adenosine A1 Receptor Activation in a Mouse Model of Pharmacoresistant EpilepsyEPILEPSIA, Issue 7 2003Nicolette Gouder Summary: Purpose: Because of the high incidence of pharmacoresistance in the treatment of epilepsy (20,30%), alternative treatment strategies are needed. Recently a proof-of-principle for a new therapeutic approach was established by the intraventricular delivery of adenosine released from implants of engineered cells. Adenosine-releasing implants were found to be effective in seizure suppression in a rat model of temporal lobe epilepsy. In the present study, activation of the adenosine system was applied as a possible treatment for pharmacoresistant epilepsy. Methods: A mouse model for drug-resistant mesial temporal lobe epilepsy was used, in which recurrent spontaneous seizure activity was induced by a single intrahippocampal injection of kainic acid (KA; 200 ng in 50 nl). Results: After injection of the selective adenosine A1 -receptor agonist, 2-chloro- N6 -cyclopentyladenosine (CCPA; either 1.5 or 3 mg/kg, i.p.), epileptic discharges determined in EEG recordings were completely suppressed for a period of ,3.5 h after the injections. Seizure suppression was maintained when 8-sulfophenyltheophylline (8-SPT), a non,brain-permeable adenosine-receptor antagonist, was coinjected systemically with CCPA. In contrast, systemic injection of carbamazepine or vehicle alone did not alter the seizure pattern. Conclusions: This study demonstrates that activation of central adenosine A1 receptors leads to the suppression of seizure activity in a mouse model of drug-resistant epilepsy. We conclude that the local delivery of adenosine into the brain is likely to be effective in the control of intractable seizures. [source] Population-based case,control study of morale in Parkinson's diseaseEUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2009J. Benito-León Background:, Parkinson's disease (PD) is associated with cognitive, psychiatric, and motor features. Each could contribute to a poor sense of well-being and low morale. A systematic study of morale in community-dwelling PD cases has not been performed. Methods:, A total of 52 PD cases and 260 matched controls from three Spanish communities were assessed using the Philadelphia Geriatric Center Morale Scale (PGCMS) (range = 0[low morale],17). The PGCMS includes three dimensions of psychological well-being: agitation, lonely dissatisfaction, and attitude toward own aging. Results:, The PGCMS score was lower in PD cases than controls (8.71 ± 3.64 vs. 11.03 ± 2.77, P < 0.001), as were the agitation subscore (3.36 ± 1.91 vs. 4.07 ± 1.59, P < 0.05), lonely dissatisfaction subscore (3.48 ± 1.36 vs. 4.11 ± 1.12, P < 0.01), and attitude toward own aging subscore (1.86 ± 1.37 vs. 2.85 ± 1.13, P < 0.001). In a linear regression analysis that adjusted for depressive symptoms and other covariates, PD cases had a lower PGCMS score than controls (P < 0.001). Conclusions:, Morale was significantly lower in community-dwelling PD cases than matched controls. The detection and possible treatment of this problem may improve the psychological well-being of patients with this disease. [source] Psidii guajavae folium extract as a possible treatment for primary dysmenorrhoeaFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 4 2007Article first published online: 14 JUN 2010 [source] The role of selective angiographic embolization of the musculo-skeletal system in haemophiliaHAEMOPHILIA, Issue 4 2009E. C. RODRIGUEZ-MERCHAN Summary., The incidence of haemarthrosis as a result of a spontaneous periarticular aneurysm in haemophilia is very low. In these circumstances, angiographic embolization might be considered as a promising therapeutic and coagulation factor saving option in joint bleeds not responding to replacement of coagulation factor to normal levels. Moreover, embolization should be considered as a possible treatment for postoperative pseudoaneurysms complicating total knee arthroplasty in haemophilia. However, the pathological process of aneurysmal bleeding and clotting factor replacement is entirely different. While embolization is the treatment of choice for some periarticular complications that may occur, it is by no means a panacea for all resistant periarticular bleeds in haemophilia or for postoperative bleeding which usually settles with clotting factor replacement. Another use of arterial embolization is for the treatment of haemophilic tumours of the pelvis, because they can act as a focus for infection and cause cutaneous fistulas. When they present perforations and infections of endogenous origin, their course is usually fatal. Suitable treatment has been investigated on numerous occasions, most of the literature agreeing that the only curative treatment is surgical resection. However, surgical resection after performing arterial embolization to reduce the vascularization of the pseudotumour is a good alternative, thereby reducing the size of the pseudotumour and the risk of bleeding complications during surgery. It is important to bear in mind that despite its efficacy, arterial embolization is an invasive procedure with a reported rate of complications up to 25% (16% minor, 7% serious, 2% death). [source] Having a child with asthma,Quality of life for Jordanian parentsINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 6 2009Nemeh Al-Akour DSN This study was conducted to assess the quality of life (QoL) of Jordanian parents of children with asthma and its associated factors. Three hundred and twenty-six parents of 200 children participated in the study. The Pediatric Asthma Caregivers' Quality of Life Questionnaire (PACQLQ) was used to measure how parents of children with asthma disease impaired their daily life during the previous week on two domains ,activity limitations' and ,emotional function'. In this study, parents of children with asthma scored their QoL during the past week moderately to the positive end of the scale but they scored more limitations in the domain of activities than in emotions. Parents in the same family scored activity domain fairly similar and there was a significant difference in their scoring of total emotional function. Parents with older children, living in the rural areas, mothers of children with mild asthma were associated with higher QoL. Children received needed daily asthma medication during the preceding week. Asthma medication might mean to the parents that the child was getting the best possible treatment. Further studies to identify the factors that influence QoL of parents of children with asthma in Jordan are needed. [source] Intrinsic and extrinsic erythropoietin enhances neuroprotection against ischemia and reperfusion injury in vitroJOURNAL OF NEUROCHEMISTRY, Issue 4 2006Ruiqin Liu Abstract This study was designed to investigate the neuroprotective effect of intrinsic and extrinsic erythropoietin (EPO) against hypoxia/ischemia, and determine the optimal time-window with respect to the EPO-induced neuroprotection. Experiments were conducted using primary mixed neuronal/astrocytic cultures and neuron-rich cultures. Hypoxia (2%) induces hypoxia-inducible factor-1, (HIF-1,) activity followed by strong EPO expression in mixed cultures and weak expression in neuron-rich cultures as documented by both western blot and RT,PCR. Immunoreactive EPO was strongly detected in astrocytes, whereas EPOR was only detected in neurons. Neurons were significantly damaged in neuron-rich cultures but were distinctly rescued in mixed cultures. Application of recombinant human EPO (rhEPO) (0.1 U/mL) within 6 h before or after hypoxia significantly increased neuronal survival compared with no rhEPO treatment. Application of rhEPO after onset of reoxygenation achieved the maximal neuronal protection against ischemia/reperfusion injury (6 h hypoxia followed 24 h reoxygenation). Our results indicate that HIF-1, induces EPO gene released by astrocytes and acts as an essential mediator of neuroprotection, prove the protective role of intrinsic astrocytic-neuronal signaling pathway in hypoxic/ischemic injury and demonstrate an optimal therapeutic time-window of extrinsic rhEPO in ischemia/reperfusion injury in vitro. The results point to the potential beneficial effects of HIF-1, and EPO for the possible treatment of stroke. [source] Clinical trial: gastric acid suppression in Hispanic adults with symptomatic gastro-oesophageal reflux disease , comparator study of esomeprazole, lansoprazole and pantoprazoleALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 2 2010D. Morgan Aliment Pharmacol Ther 2010; 32: 200,208 Summary Background, Hispanic-Americans are a rapidly growing population in the United States, yet gastro-oesophageal reflux disease (GERD) is not well studied in this population. Aim, To compare the efficacy of esomeprazole, lansoprazole and pantoprazole in suppressing gastric acid, including the area of the ,acid pocket,' in Hispanics with GERD. Methods, In this open-label, 3-way crossover study, 83 Hispanics with symptomatic GERD were randomized to 1 of 6 possible treatment sequences of three 5,7-day dosing periods with esomeprazole 40 mg, lansoprazole 30 mg and pantoprazole 40 mg daily separated by 10,17-day washout periods. Intragastric pH was measured for 24 h using dual probes with a distal and proximal (area of the ,acid pocket') electrode. Results, Esomeprazole suppressed intragastric acid (pH >4.0) significantly longer over 24 h (primary end point) compared with lansoprazole and pantoprazole (P < 0.0001), and proximal gastric acid (pH >4.0) significantly longer over 24 h compared with lansoprazole (P < 0.05) and pantoprazole (P < 0.0001). Conclusions, Esomeprazole was more effective than lansoprazole and pantoprazole in suppressing gastric acidity at both intragastric distal and proximal (area of the acid pocket) sites in Hispanics with GERD. Future studies are warranted to understand better the role of the acid pocket in GERD (Clinical trial numbers: D9612L00106; ClinicalTrials.gov: NCT00410592). [source] Bone marrow-derived stem cells in liver repair: 10 years down the lineLIVER TRANSPLANTATION, Issue 2 2010Eleanor S. Gilchrist Hematopoietic stem cells have potential in the field of regenerative medicine because of their capacity to form cells of different lineages. Bone marrow stem cells have been shown to contribute to parenchymal liver cell populations, and although this may not be functionally significant, it has sparked interest in the field of autologous stem cell infusion as a possible treatment for cirrhosis. In this review, we will examine the evidence for the contribution of bone marrow-derived cells to populations of liver cells and for the functional contribution of bone marrow-derived cells to both liver fibrosis and repair. The mechanisms by which cells are trafficked from the bone marrow to the liver are complex; the stromal derived factor-1/CXC receptor 4 axis is central to this process. There are limited data in liver injury, but we will examine findings from the bone marrow transplantation literature and discuss their relevance to liver disease. Stromal derived factor-1 also has a role in endogenous liver stem cell accumulation. Some groups have already started infusing autologous bone marrow cells into patients with cirrhosis. We will review these trials in the context of the basic science that we have discussed, and we will consider targets for investigation in the future. Liver Transpl 16:118,129, 2010. © 2010 AASLD. [source] mTOR inhibitors: An overviewLIVER TRANSPLANTATION, Issue 6 2001Peter Neuhaus MD Inhibitors of the mammalian target of rapamycin are a new class of immunosuppressants. In contrast to other macrolides, such as tacrolimus and cyclosporine A, they do not inhibit calcineurin and thus signal I of T-cell activation. By inhibiting signal III, the mechanism of action and side effects of sirolimus (rapamycin) and its derivative RAD are distinct from other immunosuppressants. Reports of synergism with cyclosporine A and tacrolimus in preclinical and clinical studies, avoidance of nephrotoxicity, and possible treatment or prevention of chronic allograft rejection are leading to high expectations for this new class of immunosuppressants. Furthermore, studies evaluating tolerance induction are being conducted. This review summarizes preclinical and clinical results published to date and exploits the future value of sirolimus and RAD for clinical transplantation. [source] 46 The feasibility of duodenum electrical stimulation to produce gastrointestinal symptoms in a clinical trialNEUROGASTROENTEROLOGY & MOTILITY, Issue 6 2006KA STECCO Introduction:, Proximal duodenal electrical stimulation with various energy parameters has been investigated as a possible treatment for various gastrointestinal (GI) myoelectrical diseases. Wide pulse width (millisecond) stimulation in the proximal duodenum can disrupt or entrain the normal myoelectrical rhythm and provide a potential feedback pathway to alter normal gastric function such as emptying, fundus tone, and intra-gastric pressure and subsequently produce specific symptoms that could affect eating behaviors. A specific level of electrical stimulation is necessary to elicit symptoms and serve as an indicator that energy parameters are adequate. However, there has been no published data correlating electrical threshold stimulation with symptom characterization. The goal of this study was to determine the average minimum pulse width necessary to elicit GI symptoms. Methods:, Eight patients underwent endoscopic placement of intraluminal electrodes in the proximal duodenum. Each patient received electrical stimulation in the millisecond (ms) range starting with a pulse width of 100 ms that was increased by intervals of 100 ms up to a maximum pulse width of 500 ms. The pulse repetition frequency was fixed at 12 CPM and each regimen was repeated for amplitudes ranging from 2 milliamps (mA) to 10 mA. Gastrointestinal symptom scores consisting of nausea, vomiting, satiety, fullness, pain, bloating and other, were taken at baseline and after each regimen change. Results:, There was an average minimum threshold necessary for elicitation of symptoms (293.7 + 41.7 ms, p-value = 0.063). The three most frequently reported GI symptoms were crampy abdominal pain, fullness, and bloating. Conclusions:, Electrical stimulation of the duodenum is feasible. A certain minimum threshold of duodenal electrical stimulation is necessary to elicit GI symptoms in patients. The intensity and patient tolerability of each specific GI symptom was able to be adjusted by changing a certain energy parameter within a regimen. Further research is warranted to evaluate the ability of duodenal electrical stimulation to produce GI symptoms that may alter eating behaviors. [source] Angiogenesis Therapy for the Treatment of Erectile DysfunctionTHE JOURNAL OF SEXUAL MEDICINE, Issue 7 2010Jeffrey J. Lysiak PhD ABSTRACT Introduction., Over the past 15 years, significant advances have been made in the treatment of erectile dysfunction (ED). The most significant of these advances has been pharmacological treatment of ED with phosphodiesterase type 5 (PDE5) inhibitors. This therapy greatly increased the awareness of ED and has helped stimulate research into the underlying causes of ED. While treatment with PDE5 inhibitors continues to be the current therapy of choice, approximately 40% of men treated with PDE5 inhibitors fail to have significant improvement in erectile function and PDE5 inhibitors do not reverse the vasculopathic processes associated with ED. With this in mind, new therapies must be developed. The treatment with angiogenic growth factors such as vascular endothelial cell growth factor (VEGF) may be one such therapy. Aim., This review will focus on defining key terms in the angiogenic process, angiogenic growth factors, and different delivery methods, and summarize results from angiogenic therapies for the treatment of ED. Methods., A review of the literature was performed on all angiogenic therapies for the treatment of ED. A brief review on the angiogenic factors was also performed Results., Angiogenic therapies for the treatment of ED are possible and promising; however, further investigation is needed to advance clinically. Conclusions., Although numerous studies have now employed angiogenic factors for the possible treatment of ED in several animal models, we are still not at the point to begin human investigations. Future studies need to examine proper dosage of the angiogenic agent, route of delivery, time course for delivery, and combination therapies. Lysiak JJ, Kavoussi PK, Ellati RT, Steers WD, and Annex BH. Angiogenesis therapy for the treatment of erectile dysfunction. J Sex Med 2010;7:2554,2563. [source] Transforming growth factor-,1 and ultraviolet A1 radiation increase production of vascular endothelial growth factor but not endothelin-1 in human dermal fibroblastsBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2000S. Trompezinski Background ,Normal and dysregulated wound healing involves fibroblast activation and angiogenesis, in which polypeptide factors such as transforming growth factor (TGF)-,, vascular endothelial growth factor (VEGF) and endothelin-1 (ET-1) play an important part. Ultraviolet (UV) A1 (365 nm) has recently received attention as a possible treatment for some dermal fibrotic disorders. Objectives,The aim of this study was to evaluate the effects of TGF-,1 and UVA1 radiation, as well as that of cobalt chloride, reported to mimic hypoxia both in vivo and in vitro, on the expression of VEGF and ET-1 by cultured human dermal fibroblasts. Methods,Levels of VEGF and ET-1 were measured by enzyme-linked immunosorbent assay and expression of neutral endopeptidase (NEP, CD10), known to degrade ET-1, was quantified by flow cytometric analysis after cell trypsinization. Results,Our results showed that the cells released minor amounts of VEGF and ET-1. Both TGF-,1 and UVA1 strongly increased VEGF secretion in a dose- and time-dependent manner, without significantly affecting ET-1 release. Irradiation of TGF-,1-stimulated fibroblasts resulted in a synergistic effect on increasing levels of VEGF but not ET-1 after 48 h. Cobalt chloride stimulated the secretion of VEGF by fibroblasts; the effects of TGF-,1 and cobalt were additive. However, no significant effect of cobalt chloride on ET-1 secretion was observed, suggesting that ET-1 production in fibroblasts is not oxygen-sensitive. The expression of NEP was not modified by TGF-,1 or UVA1 radiation. Addition of a neutralizing anti-CD10 antibody to fibroblast cultures downregulated CD10 expression at the cell surface without changing ET-1 levels in cell supernatants after 24 or 48 h. This suggests that membrane-bound NEP has minimal or no activity against secreted ET-1. Conclusions,Taken together, these results underline the major role played by TGF-,1 in increasing VEGF secretion by fibroblasts. This, as well as the documented effect of UVA1 on increasing VEGF production, may have implications for wound healing in vivo. [source] Long-term biomechanical properties of rabbit cornea after photodynamic collagen crosslinkingACTA OPHTHALMOLOGICA, Issue 1 2009Gregor Wollensak Abstract. Purpose:, Photodynamic riboflavin/ultraviolet-A (UVA)-induced collagen cross-linking, which increases the biomechanical stiffness of the human cornea by about 300%, has been introduced recently as a possible treatment for progressive keratoconus. The present study was undertaken to evaluate the longterm biomechanical effects of this new cross-linking treatment as a necessary prerequisite to its clinical success. Methods:, The corneas of the left eyes of nine male rabbits were cross-linked. The contralateral eyes served as controls. After removal of the central 7 mm of the epithelium, the corneas were treated with the photosensitizer riboflavin and UVA irradiation for 30 mins with an irradiance of 3 mW/cm2 using a 370-nm UVA double diode. Groups of three animals were killed immediately after treatment and at 3 and 8 months, respectively. Biomechanical stress,strain measurements were performed using a microcomputer-controlled biomaterial tester on 4 × 10-mm corneal strips. Results:, Corneal thickness in the treated rabbit cornea was 408 ± 20 ,m. A constant and significant increase in ultimate stress (of 69.7,106.0%), Young's modulus of elasticity (of 78.4,87.4%) and a decrease in ultimate strain (of 0.57,78.4%) were found over a time period of up to 8 months after cross-linking treatment. Conclusions:, Riboflavin/UVA-induced collagen cross-linking leads to a longterm increase in biomechanical rigidity which remains stable over time. These data support our previous longterm clinical observations and give hope that this new treatment will halt progressive keratoconus definitively. [source] Can early intake of dietary omega-3 predict childhood externalizing behaviour?ACTA PAEDIATRICA, Issue 11 2009A Waylen Abstract Aim:, To determine whether maternal and child intake of dietary omega-3 (n-3) fatty acids (FA), together with the presence or absence of breast-feeding, predicted psychiatric diagnosis of externalizing disorders in childhood. Methods:, Data concerning childhood externalizing disorders were collected from 8242 children aged 7.9 years in a large British cohort. Intake of n-3 FA was measured for the study mother during pregnancy and for the child at 3 years. Duration of breast-feeding was examined to account for moderating effects. Adjustment was made for a variety of potential confounders. Results:, Maternal intake of n-3 and breast-feeding predicted oppositional/conduct disorder and comorbid externalizing disorder before adjustment for confounding factors. However, there was no association between intake of n-3 by mother or child and any type of externalizing disorder once socio-demographic factors were taken into account. Conclusions:, Any association between intake of n-3 and childhood externalizing disorders appears to be strongly confounded with socio-demographic factors. This is important to note given the current popularity of n-3 as a possible treatment for behaviour problems related to inattention and impulsivity. Care must be taken that studies investigating this relationship account fully for factors associated with both behaviour and diet. [source] The Polder Computing Environment: a system for interactive distributed simulationCONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 13-15 2002K. A. Iskra Abstract The paper provides an overview of an experimental, Grid-like computing environment, Polder, and its components. Polder offers high-performance computing and interactive simulation facilities to computational science. It was successfully implemented on a wide-area cluster system, the Distributed ASCI Supercomputer. An important issue is an efficient management of resources, in particular multi-level scheduling and migration of tasks that use PVM or sockets. The system can be applied to interactive simulation, where a cluster is used for high-performance computations, while a dedicated immersive interactive environment (CAVE) offers visualization and user interaction. Design considerations for the construction of dynamic exploration environments using such a system are discussed, in particular the use of intelligent agents for coordination. A case study of simulatedabdominal vascular reconstruction is subsequently presented: the results of computed tomography or magnetic resonance imaging of a patient are displayed in CAVE, and a surgeon can evaluate the possible treatments by performing the surgeries virtually and analysing the resulting blood flow which is simulated using the lattice-Boltzmann method. Copyright © 2002 John Wiley & Sons, Ltd. [source] Prevalence of pigmentary disorders and their impact on quality of life: a prospective cohort studyJOURNAL OF COSMETIC DERMATOLOGY, Issue 3 2008Anne Taylor PA-S Summary Background, Pigmentary disorders are commonly seen in dermatology practice and can have a negative psychosocial impact on patients. Objective, This study aims to examine the prevalence of pigmentary disorders and their level of psychological and physical impact on patients. Methods, A prospective cohort study involved a sample of 140 patients undergoing skin exams at a private dermatology practice in North Carolina. Patient demographics and pigmentary diagnoses were obtained, and participants were asked to fill out a skin discoloration impact evaluation questionnaire. Descriptive and frequency analyses were performed. Results, Around 80% of the participants were diagnosed with one or more pigmentary disorders. About 47.3% of patients admitted of feeling self-conscious about their skin to some degree, 21.8% felt others focused on their skin, 32.7% felt unattractive because of their skin, 32.7% put effort into hiding pigment changes, and 23.6% felt their skin affected their activities. A limitation was the lack of diversity in the population studied (gender and skin type). Conclusions, Pigmentary disorders such as melasma, vitiligo, and lentigo pose significant negative impact on a person's health-related quality of life. Hence, there is a need for effective treatments of pigmentary disorders based on their prevalence and effect on quality of life. Healthcare providers should consider the impact of pigmentary disorders on health-related quality of life and educate patients on possible treatments. [source] The emerging role of epigenetic modifications and chromatin remodeling in spinal muscular atrophyJOURNAL OF NEUROCHEMISTRY, Issue 6 2009Sebastian Lunke Abstract As the leading genetic cause for infantile death, Spinal Muscular Atrophy (SMA) has been extensively studied since its first description in the early 1890s. Though today much is known about the cause of the disease, a cure or effective treatment is not currently available. Recently the short chain fatty acid valproic acid, a drug used for decades in the management of epilepsy and migraine therapy, has been shown to elevate the levels of the essential survival motor neuron protein in cultured cells. In SMA mice, valproic acid diminished the severity of the disease phenotype. This effect was linked to the ability of the short chain fatty acid to suppress histone deacetylase activity and activate gene transcription. Since then, the study of different histone deacetylase inhibitors and their epigenetic modifying capabilities has been of high interest in an attempt to find potential candidates for effective treatment of SMA. In this review, we summarize the current knowledge about use of histone deacetylase inhibitors in SMA as well as their proposed effects on chromatin structure and discuss further implications for possible treatments of SMA arising from research examining epigenetic change. [source] Lymphatic Filariasis of the Ovary and MesosalpinxJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 5 2001Dr. Seema Sethi Abstract We report 2 cases of filariasis, one in the ovary and the other in the mesosalpinx. In the first case, the patient underwent panhystrectomy and in the second case, right ovarian cystectomy with right salpingectomy were performed under general anaesthesia. Histopathology showed adult filarial worms in the dilated lymphatics of the right ovary, in the first case and in the mesosalpinx, in the second case. Both patients presented with complaints related to gynecological problems and not filariasis. Reports of filariasis in the literature and possible treatments and prevention strategies are also discussed. [source] Histopathologic Clusters Differentiate Subgroups Within the Nonspecific Diagnoses of CAN or CR: Preliminary Data from the DeKAF StudyAMERICAN JOURNAL OF TRANSPLANTATION, Issue 2 2010A. J. Matas The nonspecific diagnoses ,chronic rejection',CAN', or ,IF/TA' suggest neither identifiable pathophysiologic mechanisms nor possible treatments. As a first step to developing a more useful taxonomy for causes of new-onset late kidney allograft dysfunction, we used cluster analysis of individual Banff score components to define subgroups. In this multicenter study, eligibility included being transplanted prior to October 1, 2005, having a ,baseline' serum creatinine ,2.0 mg/dL before January 1, 2006, and subsequently developing deterioration of graft function leading to a biopsy. Mean time from transplant to biopsy was 7.5 ± 6.1 years. Of the 265 biopsies (all with blinded central pathology interpretation), 240 grouped into six large (n > 13) clusters. There were no major differences between clusters in recipient demographics. The actuarial postbiopsy graft survival varied by cluster (p = 0.002). CAN and CNI toxicity were common diagnoses in each cluster (and did not differentiate clusters). Similarly, C4d and presence of donor specific antibody were frequently observed across clusters. We conclude that for recipients with new-onset late graft dysfunction, cluster analysis of Banff scores distinguishes meaningful subgroups with differing outcomes. [source] Dopaminergic transplantation for parkinson's disease: Current status and future prospects,ANNALS OF NEUROLOGY, Issue 5 2009C. Warren Olanow MD, FRCPC Cell-based therapies that involve transplantation into the striatum of dopaminergic cells have attracted considerable interest as possible treatments for Parkinson's disease (PD). However, all double-blind, sham-controlled, studies have failed to meet their primary endpoints, and transplantation of dopamine cells derived from the fetal mesencephalon is associated with a potentially disabling form of dyskinesia that persists even after withdrawal of levodopa (off-medication dyskinesia). In addition, disability in advanced patients primarily results from features such as gait dysfunction, freezing, falling, and dementia, which are likely due to nondopaminergic pathology. These features are not adequately controlled with dopaminergic therapies and are thus unlikely to respond to dopaminergic grafts. More recently, implanted dopamine neurons have been found to contain Lewy bodies, suggesting that they are dysfunctional and may have been affected by the PD pathological process. Collectively, these findings do not bode well for the short-term future of cell-based dopaminergic therapies in PD. Ann Neurol 2009;66:591,596 [source] Principal Stratification Designs to Estimate Input Data Missing Due to DeathBIOMETRICS, Issue 3 2007Constantine E. Frangakis Summary We consider studies of cohorts of individuals after a critical event, such as an injury, with the following characteristics. First, the studies are designed to measure "input" variables, which describe the period before the critical event, and to characterize the distribution of the input variables in the cohort. Second, the studies are designed to measure "output" variables, primarily mortality after the critical event, and to characterize the predictive (conditional) distribution of mortality given the input variables in the cohort. Such studies often possess the complication that the input data are missing for those who die shortly after the critical event because the data collection takes place after the event. Standard methods of dealing with the missing inputs, such as imputation or weighting methods based on an assumption of ignorable missingness, are known to be generally invalid when the missingness of inputs is nonignorable, that is, when the distribution of the inputs is different between those who die and those who live. To address this issue, we propose a novel design that obtains and uses information on an additional key variable,a treatment or externally controlled variable, which if set at its "effective" level, could have prevented the death of those who died. We show that the new design can be used to draw valid inferences for the marginal distribution of inputs in the entire cohort, and for the conditional distribution of mortality given the inputs, also in the entire cohort, even under nonignorable missingness. The crucial framework that we use is principal stratification based on the potential outcomes, here mortality under both levels of treatment. We also show using illustrative preliminary injury data that our approach can reveal results that are more reasonable than the results of standard methods, in relatively dramatic ways. Thus, our approach suggests that the routine collection of data on variables that could be used as possible treatments in such studies of inputs and mortality should become common. [source] Prosthodontic decision-making: what unprompted information do dentists seek before prescribing treatment?JOURNAL OF ORAL REHABILITATION, Issue 1 2010R. OMAR Summary, This study explored the nature of the unprompted information that clinicians seek before making a treatment decision and whether this decision corresponded with the clinical parameters of the case. Interns, general practitioners (GP) and prosthodontists (n = 70, mean age 33 years, range 23,68) were presented with a written vignette of partial edentulism that included two spaces and were invited to ask any questions for the purpose of making a treatment recommendation. A list of 48 potential question/answer items was available to the interviewer, of which 38 were asked. These were then allotted to four thematic categories. Mean number of questions asked did not differ significantly amongst groups, although prosthodontists asked significantly more questions in the ,clinical and radiographic information' category than GPs (P = 0·0001) and interns (P = 0·003). The relationship between a prescribed treatment and questions asked was tested by dichotomizing all recommendations into ,possible' or ,not possible' based on the authors' knowledge of the actual case history. There were no significant differences amongst the groups in the frequency of prescribing ,possible' treatment (Pearson chi-square 0·083 and 0·108 for upper and lower spaces, respectively), but those who prescribed ,possible' treatment asked significantly more questions in the ,clinical and radiographic information' category, specifically about bone adequacy in the edentulous areas: upper jaw (P = 0·0001) and lower jaw (P = 0·003). It may be concluded that prosthodontists generally opted for more ,possible' treatments, as well as seeking items of information that seemed to improve the chance of making recommendations that conformed to the actual case characteristics. [source] | ||||||||||||||||||||||||||||