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Papilliferous keratoameloblastoma is an extremely rare variant of ameloblastoma, a benign odontogenic tumor, with only seven cases reported in the English language literature. This variant presents with the metaplastic transformation of stellate reticulum-like cells to the extent of forming papillary structures exhibiting superficial keratinization of varying thickness. This paper describes the pathognomonic macroscopic features of this tumor observed during gross examination under the stereo zoom microscope that differentiate it from the other odontogenic tumors which have not been explored in the previously documented cases. Also, in this paper, a detailed comparison of the macroscopic features observed under the stereo zoom microscope during gross examination with the microscopic features of the histologic section has been described proving to be useful in the histological differential diagnosis of the keratinizing variants of ameloblastoma.
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Globally, it is evident that glioblastoma multiforme (GBM) is an aggressive malignant cancer with a high mortality rate and no effective treatment options. Glioblastoma is classified as the stage-four progression of a glioma tumor, and its diagnosis results in a shortened life expectancy. Treatment options for GBM include chemotherapy, immunotherapy, surgical intervention, and conventional pharmacotherapy; however, at best, they extend the patient's life by a maximum of 5 years. GBMs are considered incurable due to their high recurrence rate, despite various aggressive therapeutic approaches which can have many serious adverse effects. Ceramides, classified as endocannabinoids, offer a promising novel therapeutic approach for GBM. Endocannabinoids may enhance the apoptosis of GBM cells but have no effect on normal healthy neural cells. Cannabinoids promote atypical protein kinase C, deactivate fatty acid amide hydrolase enzymes, and activate transient receptor potential vanilloid 1 (TRPV1) and TRPV2 to induce pro-apoptotic signaling pathways without increasing endogenous cannabinoids. In previous in vivo studies, endocannabinoids, chemically classified as amide formations of oleic and palmitic acids, have been shown to increase the pro-apoptotic activity of human cancer cells and inhibit cell migration and angiogenesis. This review focuses on the biological synthesis and pharmacology of endogenous cannabinoids for the enhancement of cancer cell apoptosis, which have potential as a novel therapy for GBM. Please cite this article as: Duzan A, Reinken D, McGomery TL, Ferencz N, Plummer JM, Basti MM. Endocannabinoids are potential inhibitors of glioblastoma multiforme proliferation. J Integr Med. 2023; 21(2): 120-128.
Subject(s)
Humans , Glioblastoma/pathology , Endocannabinoids/therapeutic use , Brain Neoplasms/pathology , Cell Proliferation , Cell Line, Tumor , Cannabinoids/therapeutic useABSTRACT
Unmerited authorship in research papers is widely acknowledged to constitute research misconduct. In different contexts, it has been called “gift”, “honorary”, or “guest” authorship. Although several attempts have been made to address the issue, it remains a significant problem in research. In this paper, we discuss accepted criteria that qualify a person to be an author on a research publication and define what constitutes “gift authorship”. We also look at the scenario in India and try to identify the circumstances that have fostered this practice in academia in the country. Finally, we discuss the adverse effects of this practice on the research enterprise as a whole, and possible remedial measures.
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Methods@#We retrospectively reviewed the charts of consecutive patients who underwent one- or two-level ACDF using polyetheretherketone cages by multiple surgeons from January 2015 to June 2016. We excluded patients younger than 18 years old, patients who had prior surgery at the same level (s), those with two-stage procedures, and those with less than 3 months of followup. Fusion was determined using the “Song” criteria. Ordinal regression was used to determine predictors of fusion. Patient-reported outcomes (PRO) were analyzed. @*Results@#We identified 323 consecutive patients. Twenty-two patients met the exclusion criteria. A total of 435 operative levels were included in the 301 remaining patients. Interspace fusion did not significantly vary by increasing interspace height with fusion rates between 76.2% and 82.8% at a mean follow-up of 17.9±12.6 months. The effect of an increase in interspace height and neck pain PRO was available for 163 patients who underwent one-level ACDF at a mean follow-up period of 16.2±13.1 months. We found no significant difference in fusion rate or neck pain score with increasing interspace height from 1 to 8 mm. Ordinal regression demonstrated no significant predictors of fusion. @*Conclusions@#Interspace distraction from 1 to 8 mm did not result in significantly different pseudarthrosis rates or postoperative neck pain.
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OBJECTIVE@#Few studies to date have measured the real-time effects of consumption of common and commercially available Cannabis products for the treatment of headache and migraine under naturalistic conditions. This study examines, for the first time, the effectiveness of using dried Cannabis flower, the most widely used type of Cannabis product in the United States, in actual time for treatment of headache- and migraine-related pain and the associations between different product characteristics and changes in symptom intensity following Cannabis use.@*METHODS@#Between 06/10/2016 and 02/12/2019, 699 people used the Releaf Application to record real-time details of their Cannabis use, including product characteristics and symptom intensity levels prior to and following self-administration; data included 1910 session-level attempts to treat headache- (1328 sessions) or migraine-related pain (582 sessions). Changes in headache- or migraine-related pain intensity were measured on a 0-10 scale prior to, and immediately, following Cannabis consumption.@*RESULTS@#Ninety-four percent of users experienced symptom relief within a two-hour observation window. The average symptom intensity reduction was 3.3 points on a 0-10 scale (standard deviation = 2.28, Cohen's d = 1.58), with males experiencing greater relief than females (P < 0.001) and a trend that younger users (< 35 years) experience greater relief than older users (P = 0.08). Mixed effects regression models showed that, among the known (i.e., labeled) product characteristics, tetrahydrocannabinol levels 10% and higher are the strongest independent predictors of symptom relief, and this effect is particularly prominent in headache rather than migraine sufferers (P < 0.05), females (P < 0.05) and younger users (P < 0.001). Females and younger users also appear to gain greater symptom relief from flower labeled as "C. indica" rather than "C. sativa" or other hybrid strains.@*CONCLUSION@#These results suggest that whole dried Cannabis flower may be an effective medication for treatment of migraine- and headache-related pain, but the effectiveness differs according to characteristics of the Cannabis plant, the combustion methods, and the age and gender of the patient.
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OBJECTIVE@#Few studies to date have measured the real-time effects of consumption of common and commercially available Cannabis products for the treatment of headache and migraine under naturalistic conditions. This study examines, for the first time, the effectiveness of using dried Cannabis flower, the most widely used type of Cannabis product in the United States, in actual time for treatment of headache- and migraine-related pain and the associations between different product characteristics and changes in symptom intensity following Cannabis use.@*METHODS@#Between 06/10/2016 and 02/12/2019, 699 people used the Releaf Application to record real-time details of their Cannabis use, including product characteristics and symptom intensity levels prior to and following self-administration; data included 1910 session-level attempts to treat headache- (1328 sessions) or migraine-related pain (582 sessions). Changes in headache- or migraine-related pain intensity were measured on a 0-10 scale prior to, and immediately, following Cannabis consumption.@*RESULTS@#Ninety-four percent of users experienced symptom relief within a two-hour observation window. The average symptom intensity reduction was 3.3 points on a 0-10 scale (standard deviation = 2.28, Cohen's d = 1.58), with males experiencing greater relief than females (P < 0.001) and a trend that younger users (< 35 years) experience greater relief than older users (P = 0.08). Mixed effects regression models showed that, among the known (i.e., labeled) product characteristics, tetrahydrocannabinol levels 10% and higher are the strongest independent predictors of symptom relief, and this effect is particularly prominent in headache rather than migraine sufferers (P < 0.05), females (P < 0.05) and younger users (P < 0.001). Females and younger users also appear to gain greater symptom relief from flower labeled as "C. indica" rather than "C. sativa" or other hybrid strains.@*CONCLUSION@#These results suggest that whole dried Cannabis flower may be an effective medication for treatment of migraine- and headache-related pain, but the effectiveness differs according to characteristics of the Cannabis plant, the combustion methods, and the age and gender of the patient.
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Objective: To evaluate the efficacy of nasal continuous positiveairway pressure (nCPAP) in decreasing respiratory distress inbronchiolitis.Design: Randomized controlled trial.Setting: Tertiary-care hospital in New Delhi, India.Participants: 72 infants (age <1y) hospitalized with a clinicaldiagnosis of bronchiolitis were randomized to receive standardcare, or nCPAP in addition to standard care, in the first hour afteradmission. 23 parents refused to give consent for participation. 2infants did not tolerate nCPAP.Intervention: The outcome was assessed after 60 minutes. IfnCPAP was not tolerated or the distress increased, the infant wasswitched to standard care. Analysis was done on intention-to-treatbasis Main outcome measures: Change in respiratory rate,Silverman-Anderson score and a Modified Pediatric Society ofNew Zealand Severity Score.Results: 14 out of 32 in nCPAP group and 5 out of 35 in standardcare group had change in respiratory rate ?10 (P=0.008). Themean (SD) change in respiratory rate [8.0 (5.8) vs 5.1 (4.0),P=0.02] in Silverman-Anderson score [0.78 (0.87) vs 0.39 (0.73),P=0.029] and in Modified Pediatric Society of New ZealandSeverity Score [2.5 (3.01) vs. 1.08 (1.3), P=0.012] weresignificantly different in the nCPAP and standard care groups,respectively.Conclusion: nCPAP helped reduce respiratory distresssignificantly compared to standard care.
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Background & objectives: Acute myocardial infarction (AMI) is characterized by irreparable and irreversible loss of cardiac myocytes. Despite major advances in the management of AMI, a large number of patients are left with reduced left ventricular ejection fraction (LVEF), which is a major determinant of short and long term morbidity and mortality. A review of 33 randomized control trials has shown varying improvement in left ventricular (LV) function in patients receiving stem cells compared to standard medical therapy. Most trials had small sample size and were underpowered. This phase III prospective, open labelled, randomized multicenteric trial was undertaken to evaluate the efficacy in improving the LVEF over a period of six months, after injecting a predefined dose of 5-10 × 108 autologous mononuclear cells (MNC) by intra-coronary route, in patients, one to three weeks post ST elevation AMI, in addition to the standard medical therapy. Methods: In this phase III prospective, multicentric trial 250 patients with AMI were included and randomized into stem cell therapy (SCT) and non SCT groups. All patients were followed up for six months. Patients with AMI having left ventricular ejection fraction (LVEF) of 20-50 per cent were included and were randomized to receive intracoronary stem cell infusion after successfully completing percutaneous coronary intervention (PCI). Results: On intention-to-treat analysis the infusion of MNCs had no positive impact on LVEF improvement of ≥ 5 per cent. The improvement in LVEF after six months was 5.17 ± 8.90 per cent in non SCT group and 4.82 ± 10.32 per cent in SCT group. The adverse effects were comparable in both the groups. On post hoc analysis it was noted that the cell dose had a positive impact when infused in the dose of ≥ 5 X 108 (n=71). This benefit was noted upto three weeks post AMI. There were 38 trial deviates in the SCT group which was a limitation of the study. Interpretation & conclusions: Infusion of stem cells was found to have no benefit in ST elevation AMI. However, the procedure was safe. A possible benefit was seen when the predefined cell dose was administered which was noted upto three weeks post AMI, but this was not significant and needs confirmation by larger trials.
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STUDY DESIGN: Retrospective study. PURPOSE: To investigate safety profile of open door laminoplasty plates. OVERVIEW OF LITERATURE: Few reports have documented potential complications related to the use of cervical laminoplasty plates. METHODS: Records and radiographs of consecutive plated laminoplasty patients of one academic surgeon were analyzed. Group 1 had screw back-out, defined as change in screw position, and group 2 did not. RESULTS: Forty-two patients (mean age, 56.9) underwent "open-door" cervical laminoplasty using 165 plates. Mean follow-up was 24 months (range, 12-49 months). Mean Nurick grade improved from 2.1 to 0.9 postoperatively. Cervical lordosis (C2-7) was 12.1degrees preoperatively and 10.0degrees postoperatively. Range-of-motion was 27.0degrees preoperatively and 23.4degrees postoperatively. Partial screw back-out was noted in 27 of 165 plates (16.4%) and in 34 of 660 screws (5.2%). Of the 34 screws, 27 (79.4%) were at either the most cranial (12/27, 44.4%) or the most caudal (15/27, 55.5%) level. Cranially, 11/12 screws (91.7%) had back-out. Caudally, 9/15 lateral mass screws (60.0%) backed-out versus 6 laminar screws (40.0%). Of the 22 patients with screw back-out, 15 (68.2%) occurred <3 months postoperative and 6 (27.3%) occurred 4-12 months postoperative. No statistical differences were found between group 1 and 2 for age, gender, preoperative and postoperative lordosis, focal sagittal alignment, range-of-motion, or Nurick grade. Despite screw backout in 22 patients, there were no plate dislodgements, laminoplasty closure, or neurological deterioration. CONCLUSIONS: Although screw back-out may occur with the use of cervical laminoplasty plates, the use of these plates without a bone block appears to be safe and reliable. As screw back-out is most common at the cranial and caudal ends of the laminoplasty, we recommend using the maximum number of screws (typically 2 for the lateral mass and 2 for the spinous process) at these levels to secure the plate to the bone.
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Animals , Humans , Follow-Up Studies , Lordosis , Retrospective StudiesABSTRACT
In 2004, the US Center for Disease Control (CDC) published a paper showing that there is no link between the age at which a child is vaccinated with MMR and the vaccinated children’s risk of a subsequent diagnosis of autism. One of the authors, William Thompson, has now revealed that statistically significant information was deliberately omitted from the paper. Thompson first told Dr S Hooker, a researcher on autism, about the manipulation of the data. Hooker analysed the raw data from the CDC study afresh. He confirmed that the risk of autism among African American children vaccinated before the age of 2 years was 340% that of those vaccinated later.
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When assessing fitness levels, body composition is usually measured. The purpose of this study was to determine the overall efficacy of a body mass index [BM I] equation for predicting body composition with respect to college aged participants. Body composition was measured using dual-energy x-ray absorptiometry [DXA] and was estimated using the Womersley and Durnin BMI prediction equation. There was no significant [P=0.8] percent body fatt [%BF] difference between the BMI prediction equation and DXA [BMI Predicted=25 [10] [min=6; max=52] %PFvs DXA=25 [6] [min=10; max=45] %BF]. In addition, a significant correlation was found between the two approaches [r=0.79l, P=0.001]. However. both the standard error of estimate [6.32%BF] and total error [6.63 %BF] were outside acceptable ranges for prediction equations. The Womersley and Durnin equation for estimating %BF was not found to be a good estimate. Therefore, although the BMI predicted %BF has been previously found to predict skinfold estimated %BF, it does not appear valid in estimating %BF from DXA
Subject(s)
Humans , Anaerobiosis , Athletic Performance , Nutritional Status , Athletes , Sports Medicine , Absorptiometry, PhotonABSTRACT
We report a12-year-old child with pseudohypoparathyroidism (PHP) whose mother had pseudopseudohypoparathyroidism. The child had low serum calcium, high phosphorous and high parathormone (PTH) levels. PHP occurs due to a defect in the guanine nucleotide binding protein (G protein). She also had hypothyroidism which is known to utilize the G protein pathway. She developed T 1 diabetes mellitus (T1DM) while under follow-up. This is arguably the first time T1DM has been reported associated with PHP.
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To determine the chemical composition of Galla chinensis extract (GCE) by several analysis techniques and to compare the efficacy of GCE and its main component(s) in inhibition of enamel demineralization, for the development of future anticaries agents, main organic composition of GCE was qualitatively determined by liquid chromatography-time of flight-mass spectrometry (LC-TOF-MS) and quantified by high-performance liquid chromatography-diode array detector (HPLC-DAD). Inorganic ions were tested by inductively coupled plasma-atomic emission spectroscopy and F was especially measured by ion chromatography. Then, bovine enamel blocks were randomly divided into four treatment groups and were subjected to a pH-cycling regime for 12 times. Each cycle included 5-min applications with one of four treatments: 4 g⋅L(-1) GCE solution, 4 g⋅L(-1) gallic acid (GA) solution, 1 g⋅L(-1) NaF solution (positive control), deionized water (DDW, negative control), and then 60-min application in pH 5.0 acidic buffer and 5-min application in neutral buffer. Acidic buffers were retained for calcium analysis. The main organic composition of GCE were GA and its isomer, and, to a lesser extent, small molecule gallotannins. The content of GA in GCE was 71.3%±0.2% (w/w). Inorganic ions were present in various amounts, of which Ca was (136±2.82) µg⋅g(-1), and Zn was (6.8±0.1) µg⋅g(-1). No F was detected in GCE. In pH cycling, GA showed an effect similar to GCE in inhibiting enamel demineralization (P>0.05). GA was found to be the main effective, demineralization inhibiting component of GCE and could be a promising agent for the development of anticaries agents.
Subject(s)
Animals , Cattle , Calcium , Cariostatic Agents , Therapeutic Uses , Chromatography, High Pressure Liquid , Chromatography, Liquid , Dental Enamel , Drugs, Chinese Herbal , Chemistry , Therapeutic Uses , Gallic Acid , Therapeutic Uses , Hydrolyzable Tannins , Mass Spectrometry , Polyphenols , Random Allocation , Tooth DemineralizationABSTRACT
The purpose of this investigation was to compare a practical measurement of fat free mass index [FFMI] from bioelectrical impedance analysis [BIA] to the dual energy X-ray absorptiometry [DEXA] value in collegiate athletes. Thirty-three male baseball players and 16 female gymnasts volunteered to participate in this study during their respective pre-season. Subjects visited the laboratory once and had their measurements taken in the following order: weight, height, DEXA, and Omron HBF-500. The BIA device investigated was not a valid estimate of FFMI when compared to the DEXA. The TE was 0.93 kg/ m[2] for males and 0.78 kg/ m[2] for females. There were also significant mean differences between the BIA prediction and the DEXA value for males [BIA=20.6 kg/m[2] vs. DEXA=21.1 kg/m[2], P=0.007] and females [BIA=16.2 kg/m[2] vs. DEXA=17.5 kg/m[2], P=0.001]. The BIA device investigated in this study did not provide a valid estimate of FFMI in male and female collegiate athletes. Although there was a general tendency for the BIA to underestimate FFMI compared to DEXA, 98% of the estimates were within plus or minus 2 kg/ m[2]. Therefore, while slightly biased, BIA may provide a reasonable [+/- 2 kg/ m[2]] estimate of nutritional status for practitioners who are unable able to afford more expensive equipment
Subject(s)
Bacterial Capsules/adverse effects , Bacterial Capsules/therapeutic use , Diphtheria-Tetanus-Pertussis Vaccine , Haemophilus Vaccines/adverse effects , Haemophilus Vaccines/therapeutic use , Hepatitis B Vaccines , India/epidemiology , Mass Vaccination/legislation & jurisprudence , Mass Vaccination/standards , Meningitis, Haemophilus/epidemiology , Meningitis, Haemophilus/prevention & control , Vaccines, CombinedABSTRACT
India has over a century old tradition of development and production of vaccines. The Government rightly adopted self-sufficiency in vaccine production and self-reliance in vaccine technology as its policy objectives in 1986. However, in the absence of a full-fledged vaccine policy, there have been concerns related to demand and supply, manufacture vs. import, role of public and private sectors, choice of vaccines, new and combination vaccines, universal vs. selective vaccination, routine immunization vs. special drives, cost-benefit aspects, regulatory issues, logistics etc. The need for a comprehensive and evidence based vaccine policy that enables informed decisions on all these aspects from the public health point of view brought together doctors, scientists, policy analysts, lawyers and civil society representatives to formulate this policy paper for the consideration of the Government. This paper evolved out of the first ever ICMR-NISTADS national brainstorming workshop on vaccine policy held during 4-5 June, 2009 in New Delhi, and subsequent discussions over email for several weeks, before being adopted unanimously in the present form.
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Budgets , Decision Support Systems, Clinical , Evidence-Based Medicine , Humans , Immunization Programs , India , /economicsABSTRACT
We studied the etiology of bronchiolitis in Delhi. Respiratory syncytial virus (RSV) was the most commonly isolated virus in 72/245 infants (30%). RSV positive cases did not have more severe disease; this argues against routine use of ribavirin.