Hypnosis to Reduce Distress in Children Undergoing Anorectal Manometry: A Randomized Controlled Pilot Trial

Background/Aims@#To assess the effectiveness and feasibility of a brief session of hypnosis to reduce distress in children with functional constipationundergoing anorectal manometry (ARM). @*Methods@#A partially-blinded randomized controlled pilot trial was conducted in children 4-18 years old scheduled for ARM. Children were randomized to receive a brief session of hypnosis prior to ARM or standard care. Non-blinded and blinded observers rated the child’s level of distress using the Observation Scale of Behavioral Distress and a 4-point-Likert scale, respectively. Differences between groupswere analyzed using Fisher’s exact test or Mann-Whitney U test as appropriate. @*Results@#Data from 32 children (15 hypnosis and 17 standard care) were analyzed. Prior to insertion of the catheter, the observed mean levels of distress were lower in the hypnosis group according to both the non-blinded observer (median 0.0 [interquartile range {IQR} 0.0-0.3] vs 1.4 [IQR 0.3-2.4]; P = 0.009) and the blinded observer (median 0.0 [IQR 0.0-0.0] vs 0.5 [IQR 0.0-1.0]; P = 0.044). During ARM, observed and reported levels of distress did not differ significantly. In the hypnosis group, 92.9% of parents and childrenreported that hypnosis helped the child to relax. There were no significant differences in resting pressure, squeeze pressure, or duration of the procedure between both groups. @*Conclusion@#A brief session of hypnosis for children before ARM is an easily incorporable intervention that lowers distress levels prior to theprocedure and is positively perceived by children and parents.

"Library and Information Science" Literature in Web of Science: What a Decade Tells Us About Scholarly Collaboration in the Field (2007-2016) / Literatura sobre "Bibliotecología y Ciencias de la Información" en Web of Science: Qué nos dice una década sobre la colaboración académica en el campo (2007-2016)

Abstract Ensuring access to published research is increasingly important for demonstrating research impact, supporting wide readership, creating interest in collaboration, and making way for funding opportunities. This article provides a bibliometric analysis of publications from 2007-2016 in the Web of Science (WOS) database to update understanding of recent international library science research as a means of discussing research impact and scientific collaboration. The methodology is a descriptive analysis of publications retrieved from the WOS database using keywords "library science" and WOS-generated subject descriptor "Information Science & Library Science." Analysis focused on descriptive data related to our research questions including representation of countries, languages, and journals. The findings reveal that most publications are published by researchers with institutional affiliations in the United States and in English. Library and information science research continues to be strong in collaboration, but international and interdisciplinary collaborations are still low in this sample. The dataset reflects that co- and multi-authored publications have the highest WOS citation counts, reinforcing the value of scholarly collaboration. This research provides a baseline to chart future growth in Library Science research publications and collaborations.

Resumen Asegurar el acceso a la investigación publicada es cada vez más importante para demostrar el impacto de la investigación, apoyar un amplio número de lectores, crear interés en la colaboración y dar paso a oportunidades de financiamiento. Este artículo proporciona un análisis bibliométrico de las publicaciones 2007-2016 en la base de datos de Web of Science (WOS) para actualizar la comprensión de la internacionalización reciente de la investigación en el campo de la bibliotecología como medio para discutir el impacto de la investigación y la colaboración científica. La metodología es un análisis descriptivo de las publicaciones recuperadas de la base de datos de WOS, utilizando las palabras clave "Bibliotecología" y el encabezado de materia "Ciencia de la información y biblitecología" generado por WOS. El análisis se centró en datos descriptivos relacionados con las preguntas de investigación, incluida la representación de países, idiomas y revistas, así como patrones de autoría con colaboraciones internacionales, nacionales, intrainstitucionales e interdisciplinarias y recuentos de citas. Los hallazgos revelan que la mayoría de los artículos son publicados en inglés, por investigadores con afiliaciones institucionales en los Estados Unidos. Las investigaciones sobre Bibliotecología y Ciencias de la Información continúan siendo sólidas en colaboración, pero las colaboraciones internacionales e interdisciplinarias aún son bajas en esta muestra. El conjunto de datos refleja que las publicaciones de coautoría y de múltiples autores tienen el mayor número de citas de WOS, lo que refuerza el valor de la colaboración académica. Esta investigación proporciona una base para registrar el futuro crecimiento de las publicaciones y colaboraciones de investigación en Bibliotecología.

2,6-and 3,5-dimethylaniline-induced mutagenesis in Chinese hamster ovary cells expressing human cytochrome P450 1A2 and sulfotransferase

Aim: The aim of this study was to test the hypothesis that human cytochrome P450 1A2 (CYP1A2) and sulfotransferase (SULT) contribute to the phase I and II bioactivation of 2,6-dimethylaniline (2,6-DMA) and 3,5-dimethylaniline (3,5-DMA) in affecting the incidence of genotoxicity.Methodology: 5P3H1 cells carrying cytochrome P450 1A2 (CYP1A2) and SULT cells were treated with various concentrations of 2,6-and 3,5-DMA for 48 hr or their N-hydroxyl and aminophenol metabolites for 1 hr in the absence or presence of 2,6-Dichloro-4-nitrophenol (DCNP). Cell lethality was assayed by trypan blue exclusion and induced mutagenesis of adenine phosphoribosyl transferase (aprt) gene was also evaluated. Results: A significant dose-dependent increase in cytotoxicity and mutant fraction was observed after treatment with 2,6- and 3,5-DMA, and their metabolites; N-hydroxy and aminophenol metabolites are more potent than the parent compounds. Addition of sulfotransferase inhibitor DCNP decreased the cytotoxic and mutagenic effects of 2,6- and 3,5-DMA, and their metabolites in a dose-dependent manner. Interpretation: This research indicate that 2,6 and 3,5-DMA are mutagenic, and their toxicity in model systems depend on metabolic activation. This activation is mediated by CYP1A2 and SULT enzymes

The role of nucleotide excision repair on 2,6- and 3,5-dimethylaniline-induced genotoxicity

Aim: To examine the possible role of nucleotide excision repair (NER) in affecting the ultimate mutagenic potency of 2,6- and 3,5-dimethylaniline (DMA) and their metabolites.Methodology: Two cell lines, nucleotide excision repair (NER)-proficient AA8 and deficient UV5 cells were treated with 50, 100, 250, 500 and 1000 μM of 2,6- and 3,5-DMA for 48 hr or their N-hydroxyl and aminophenol metabolites for 1 hr. Cell survival was determined by trypan blue exclusion assay, and 8-azaadenine-resistant mutants at adenine phosphoribosyltransferase (aprt) gene locus were evaluated.Results: A dose-dependent increase in cytotoxicity and mutant fraction was observed in AA8 and UV5 cells, treated with 2,6- and 3,5-DMA and their metabolites, but showed considerable variation in potency; N-hydroxyl and aminophenol metabolites of 2,6- and 3,5-DMA in serum-free α-minimal essential medium (MEM) having the highest potency, and 2,6- and 3,5-DMA in regular MEM at least. Repair-deficient UV5 cells were more sensitive to cytotoxic and mutagenic action than repair-proficient AA8 cells. Interpretation: These findings suggest that 2,6- and 3,5-DMA-induced DNA damage response may trigger cytotoxicity and mutagenicity when not completely repaired

Facilitating health professional scholarship through a workshop series at the University of Rwanda

BACKGROUND: Scholarly writing and effective presentation skills are important for dissemination of research results and the extension of knowledge. Lack of confidence, practice, and technical skills in scholarly writing are barriers to publishing and presenting in sub-Saharan Africa. OBJECTIVES: To address these obstacles, a six-month writing workshop was delivered to faculty at the University of Rwanda. METHODS: The workshop design required participants meet every two weeks to learn about scholarship/medical writing through both didactic and theory application. Evaluation processes measured participants' satisfaction with the workshops, degree of motivation to pursue scholarly activities, and amount of transfer of theory and knowledge. RESULTS: Attendance at the workshops varied from 9 to 80 participants with a mean attendance of 23.The participants self-reported their understanding of the theory at the beginning and at the conclusion of the workshops resulting in an increase of 4.0 point difference on a scale of 0 to 10 in knowledge and understanding of workshop content. CONCLUSION: At the conclusion of the series 77% of participants confirmed they had developed an abstract or draft manuscript during the workshop, 69% planned to publish in the next year, and 85% noted they planned to deliver a presentation at a conference within the next year

The utility of live video capture to enhance debriefing following transcatheter aortic valve replacement.

Background: The surgical and procedural specialties are continually evolving their methods to include more complex and technically difficult cases. These cases can be longer and incorporate multiple teams in a different model of operating room synergy. Patients are frequently older, with comorbidities adding to the complexity of these cases. Recording of this environment has become more feasible recently with advancement in video and audio capture systems often used in the simulation realm. Aims: We began using live capture to record a new procedure shortly after starting these cases in our institution. This has provided continued assessment and evaluation of live procedures. The goal of this was to improve human factors and situational challenges by review and debriefing. Setting and Design: B‑Line Medical’s LiveCapture video system was used to record successive transcatheter aortic valve replacement (TAVR) procedures in our cardiac catheterization/laboratory. An illustrative case is used to discuss analysis and debriefing of the case using this system. Results and Conclusions: An illustrative case is presented that resulted in long‑term changes to our approach of these cases. The video capture documented rare events during one of our TAVR procedures. Analysis and debriefing led to definitive changes in our practice. While there are hurdles to the use of this technology in every institution, the role for the ongoing use of video capture, analysis, and debriefing may play an important role in the future of patient safety and human factors analysis in the operating environment.

PPARγ induces growth inhibition and apoptosis through upregulation of insulin-like growth factor-binding protein-3 in gastric cancer cells

Peroxisome proliferator activator receptor-gamma (PPARγ) is a ligand-activated transcriptional factor involved in the carcinogenesis of various cancers. Insulin-like growth factor-binding protein-3 (IGFBP-3) is a tumor suppressor gene that has anti-apoptotic activity. The purpose of this study was to investigate the anticancer mechanism of PPARγ with respect to IGFBP-3. PPARγ was overexpressed in SNU-668 gastric cancer cells using an adenovirus gene transfer system. The cells in which PPARγ was overexpressed exhibited growth inhibition, induction of apoptosis, and a significant increase in IGFBP-3 expression. We investigated the underlying molecular mechanisms of PPARγ in SNU-668 cells using an IGFBP-3 promoter/luciferase reporter system. Luciferase activity was increased up to 15-fold in PPARγ transfected cells, suggesting that PPARγ may directly interact with IGFBP-3 promoter to induce its expression. Deletion analysis of the IGFBP-3 promoter showed that luciferase activity was markedly reduced in cells without putative p53-binding sites (-Δ1755, -Δ1795). This suggests that the critical PPARγ-response region is located within the p53-binding region of the IGFBP-3 promoter. We further demonstrated an increase in PPARγ-induced luciferase activity even in cells treated with siRNA to silence p53 expression. Taken together, these data suggest that PPARγ exhibits its anticancer effect by increasing IGFBP-3 expression, and that IGFBP-3 is a significant tumor suppressor.

Is initial preservation of deep tendon reflexes in West Nile Virus paralysis a good prognostic sign?

Typical West Nile virus paralysis is characterized by muscle weakness, decreased tone, and loss of deep tendon reflexes attributed to destruction of anterior horn cells. Two cases in which deep tendon reflexes were initially preserved in the presence of profound and persistent muscle weakness are presented here. In both cases, deep tendon reflexes were later severely attenuated or lost, while weakness of the involved muscles remained profound and unchanged. Both patients showed good motor recovery at 6 months. Initial preservation of deep tendon reflexes in the presence of persistent muscle weakness indicates that in the early stages of disease, the muscle weakness in these two cases was not caused by destruction of anterior horn cells. Pathology involving anterior horns preceding AHC destruction could potentially disrupt upper motor neuron pathways to anterior horn cells, causing weakness with initial preserved deep tendon reflexes.

Cost-Effectiveness Study of Three Antimalarial Drug Combinations in Tanzania

Background: As a result of rising levels of drug resistance to conventional monotherapy; the World Health Organization (WHO) and other international organisations have recommended that malaria endemic countries move to combination therapy; ideally with artemisinin-based combinations (ACTs). Cost is a major barrier to deployment. There is little evidence from field trials on the cost-effectiveness of these new combinations. Methods and Findings: An economic evaluation of drug combinations was designed around a randomised effectiveness trial of combinations recommended by the WHO; used to treat Tanzanian children with non-severe slide-proven malaria. Drug combinations were: amodiaquine (AQ); AQ with sulfadoxine-pyrimethamine (AQ+SP); AQ with artesunate (AQ+AS); and artemether-lumefantrine (AL) in a six-dose regimen. Effectiveness was measured in terms of resource savings and cases of malaria averted (based on parasitological failure rates at days 14 and 28). All costs to providers and to patients and their families were estimated and uncertain variables were subjected to univariate sensitivity analysis. Incremental analysis comparing each combination to monotherapy (AQ) revealed that from a societal perspective AL was most cost-effective at day 14. At day 28 the difference between AL and AQ+AS was negligible; both resulted in a gross savings of approximately US$1.70 or a net saving of US$22.40 per case averted. Varying the accuracy of diagnosis and the subsistence wage rate used to value unpaid work had a significant effect on the number of cases averted and on programme costs; respectively; but this did not change the finding that AL and AQ+AS dominate monotherapy.Conclusions: In an area of high drug resistance; there is evidence that AL and AQ+AS are the most cost-effective drugs despite being the most expensive; because they are significantly more effective than other options and therefore reduce the need for further treatment. This is not necessarily the case in parts of Africa where recrudescence following SP and AQ treatment (and their combination) is lower so that the relative advantage of ACTs is smaller; or where diagnostic services are not accurate and as a result much of the drug goes to those who do not have malaria

The microsatellite polymorphism of heme oxygenase-1 is associated with baseline plasma IL-6 level but not with restenosis after coronary in-stenting / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Vascular smooth muscle cells (VSMCs) can express heme-oxygenase (HO), a rate-limiting enzyme in the degradation of heme to bilirubin, ferritin and carbon monoxide (CO). VSMC-derived CO can suppress VSMC proliferation and may serve as an antiproliferation factor. The promoter region of HO-1 shows a polymorphism with different (GT) n repeats that has been reported to differently induce gene expression. The objective of this study was to examine the effect of this variation on the occurrence of restenosis after in-stent treatment in patients with coronary artery disease.</p><p><b>METHODS</b>Candidates who underwent coronary stent implantation were genotyped for the HO-1 promoter polymorphism using polymerase chain reaction (PCR) and automated DNA capillary sequencer. Serum levels of IL-6 and C-reactive protein (CRP) were obtained at baseline, 24 hours and 48 hours after stenting. The primary end point for the study was angiographic evidence of in-stent restenosis at 6 months. All parameters for evaluation of restenosis were analysed by quantitative computer-assisted angiographic analysis (QCA).</p><p><b>RESULTS</b>One hundred and eighty-seven patients who underwent coronary stent implantation were studied of whom 27.8% showed > or = 50% restenosis after 6 months. The distribution of (GT) n repeats of all patients in the promoter region of HO-1 genotype ranged from 22 to 42, with (GT) 25 and (GT) 32 being the two most common alleles. The allelic repeats were divided into the short class (S) with 29 (GT) n, the middle class (M) with 30-37 (GT) n and the long class (L) with 38 (GT) n. There was no significant difference in the restenosis between the genotype groups or between post operation levels of inflammation markers, but carriers of the S allele (n = 120) had 33.3% lower baseline IL-6 compared with non-S carriers (n = 67, P = 0.0008).</p><p><b>CONCLUSIONS</b>Although no association was observed between the HO-1 promoter polymorphism and coronary in-stent restenosis following the stent procedure, the association with plasma IL-6 levels suggests that HO-1 S allele might protect from the atherosclerotic inflammatory process.</p>

Achados oftalmológicos em AIDS: avaliaçäo de 445 casos atendidos em um ano / Ophtalmological manifestations in AIDS: evaluation of 445 patients in one year

Os autores avaliaram 445 pacientes HIV positivos e identificaram as manifestaçöes oftalmológicas presentes nesses pacientes. OBJETIVO. Identificar e correlacionar as alteraçöes oftalmológicas com dados de literatura, bem como correlacioná-las com as diversas manifestaçöes clínicas presentes na síndrome. MÉTODOS. Foram estudados 445 pacientes ambulatoriais HIV (com 66 por cento e sem 34 por cento AIDS), sendo 87 por cento do sexo masculino e 58,2 por cento homossexuais, no período de um ano, atendidos na Escola Paulista de Medicina, Hospital Säo Paulo. RESULTADOS. Do total de pacientes examinados, 52 por cento apresentaram alteraçöes oculares secundárias à infecçäo pelo HIV ao primeiro exame (27 por cento bilaterais). A retinite por citomegalovírus esteve presente em 25 por cento deles, seguida por toxoplasmose ocular (8,5 por cento), retinite por herpes (3,6 por cento), papiledema (2,2 por cento), atrofia óptica (1,6 por cento), phthisis bulbi (1,5 por cento), coroidite multifocal (1,2 por cento), hemorragia retiniana (0,9 por cento), uveíte por sífilis (0,6 por cento) e oclusäo da veia central da retina (0,2 por cento). CONCLUSAO. Nossos dados estäo de acordo com a literatura mundial, com exceçäo feita à retinocoroidite por toxoplasmose, que mostrou muito maior freqüência em nosso meio, se comparada à da literatura. Pudemos observar, também, uma alta taxa de descolamento de retina secundário à inflamaçäo intra-ocular. Nenhum caso de coroidite por Pneumocystis carinii foi diagnosticado nessa época

Clinical Report of 46 Intracranial Tumors with LINAC Based Stereotactic Radiosurgery / 대한치료방사선과학회지

Between July 1988 and December 1992, we treated 45 patients who had deep seated inoperable or residual and/or recurrent intracranial tumors using LINAC based stereotactic radiosurgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, Catholic University Medical College. Treated intracranial tumors included pituitary tumors(n=15), acoustic neurinomas(n=8), meningiomas(n=7), gliomas(n=6), craniopharyngiomas(n=4), pinealomas(n=3), hemangioblastomas(n=2), and solitary metastatic tumor from lung cancer (n=1). The dimension of treatment field varied from 0.23 to 42.88 cm3(mean ; 7.26 cm3). The maximum tumor doses ranging from 5 to 35.5 Gy (mean; 29.9 Gy) were given, and depended on patients' age, target volume, location of lesion and previous history of irradiation. There were 22 male and 23 female patients. The age was varied from 5 to 74 years of age(a median age; 43 years). The mean duration of follow-up was 35 months (2~55 months). To date, 18(35.1%) of 46 intracranial tumors treated with SRS showed absent or decrease of the tumor by serial follow-up CT and/or MRI and 16(34.8%) were stationary, e.g. growth arrest. From the view point of the clinical aspects, 34(73.9%) of 46 tumors were considered improved status, that is, alive with no evidence of active tumor and 8(17.4%) of them were stable, alive with disease but no deterioration as compared with before SRS. Although there showed slight increase of the tumor in size according to follow-up imagings of 4 cases(pituitary tumor 1, acoustic neurinomas 2, pinealoma 1), they still represented clinically stable status. Clinically, two(4.4%) patients who were anaplastic astrocytoma(n=1) and metastatic brain tumor(n=1) were worsened following SRS treatment. So far, no serious complications were found after treatment. The minor degree headache which could be relieved by steroid or analgesics and transient focal hair loss were observed in a few cases. There should be meticulous long term follow-up in all cases.

Seis pacientes com oftalmia simpática: experiência de 13 anos / Six patients with sympathetic ophthalmia: 13-year experience

Entre 1972 e 1986, do total de 1.780 pacientes com uveíte, 6 pacientes (0,4%) foram diagnosticados como portadores de oftamia simpática e tratados no centro de uveítes da Escola Paulista de Medicina (Hospital Säo Paulo), Brasil. Dois eram do sexo feminino, sendo três brancos, um preto, um índio e um oriental. A idade média dos pacientes foi de 31 anos (variando de 5 a 75 anos) e o tempo decorrido entre o trauma (acidental em 4 e cirúrgico em 2) foi de 2 a 8 meses em 5 pacientes e de vários anos no sexto. Cinco dos 6 olhos acidentados apresentaram mesmo no final do tratamento amaurose neste olho e o outro paciente C.D. a 1 metro. No olho näo traumatizado 3 pacientes terminaram com visäo inferior a 20/200. A inflamaçäo estava clinicamente ausente em 2 dos olhos traumatizados tendo o diagnóstico sido confirmado por exame histológico em parte dos olhos examinados (4/6). Todos os pacientes receberam corticóide sendo que ciclofosfamida e clorambucil foram associados a dois pacientes distintos

Analisis de los movimientos oculares secuenciales rapidos ("saccades") durante la lectura: comparacion entre sujetos normales y dislexicos. / Analysis of sequential saccadic eye movement during the act of reading: comparison between normal and dyslexic subjects

Los ninos dislexicos tienen las siguientes alteraciones en los movimientos oculares la lectura: 1) Incremento en la duracion del tiempo total del barrido, 2) prolongacion de los periodos de latencia intermovimientos oculares rapidos, 3) dismetria de movimientos oculares rapidos, 4) aumento del numero de estos movimientos. Estas alteraciones las encontramos ante la presencia de movimientos oculares rapidos de busqueda, de seguimiento lento y de funcion vestibular normales. Las principales conclusiones son: a)Los movimientos oculares secuenciales rapidos son anormales en los ninos dislexicos; b) normalmente, los movimientos secuenciales rapidos de los ojos se preprograman en conjunto, en tanto que los ninos dislexicos los tienen que programar separadamente; c) no sabemos si estas alteraciones indiquen alteraciones motoras o perceptuales; d) El sitio de la alteracion se localiza probablemente en el lobulo frontal, y e) el analisis visual que realizan los ninos dislexicos es por letras, y no silabicamente como en los sujetos normales