Inflammatory response of nanoparticles: Mechanisms, Consequences, and Strategies for Mitigation.

Numerous nano-dimensioned materials have been generated as a result of several advancements in nanoscale science such as metallic nanoparticles (mNPs) which have aided in the advancement of related research. As a result, several significant nanoscale materials are being produced commercially. It is expected that in the future, products that are nanoscale, like mNPs, will be useful in daily life. Despite its benefits, the widespread use of metallic nanoparticles and nanotechnology has negative effects and puts human health at risk because of their continual accumulation in closed biological systems, along with their complex and diverse migratory and transformation pathways. Once within the human body, nanoparticles (NPs) disrupt the body's natural biological processes and trigger inflammatory responses. These NPs can also affect the immune system by activating separate pathways that either function independently or interact with one another. Cytotoxic effects, inflammatory response, genetic material damage, and mitochondrial dysfunction are among the consequences of mNPs. Oxidative stress and reactive oxygen species (ROS) generation caused by mNPs depends upon a multitude of factors that allow NPs to get inside cells and interact with biological macromolecules and cell organelles. This review focuses on how mNPs cause inflammation and oxidative stress, as well as the disrupt cellular signaling pathways that support these effects. In addition, possibilities and problems to be reduced are addressed to improve future research on the creation of safer and more environmentally friendly metal-based nanoparticles for commercial acceptance and sustainable use in medicine and drug delivery.

Comparative phytochemical study of methanolic and ethanolic extracts of Thymus linearis and their antibacterial and antioxidant potential.

Thymus linearis (Thyme) is a medicinal plant widely distributed throughout Asia. Various parts of thyme are utilized for diverse medicinal purposes, including its use as a tonic and diuretic, for cough relief, as a flavoring agent, in treating dysentery, and for alleviating stomach disorders. Numerous studies have been conducted to explore the unexploited potential of thyme. Thyme was collected from the northern region of Pakistan, and sun-mediated extraction was conducted. Phytochemical analysis, utilizing GC-MS, revealed numerous bioactive phytochemical constituents with disease-preventing roles, including detoxifying agents, antioxidants, anticancer compounds, dietary fiber, neuropharmacological agents, and immunity-potentiating agents, in the methanolic and ethanolic (14 days) extracts of the flower, leaf, and stem. The 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay results indicated that the ethanolic and methanolic extracts of the stem exhibited the highest antioxidant activity, reaching up to 67.34% and 62.73%, respectively, while the values for the flower and leaf extracts (both methanol and ethanol) were around 60%. The IC50 (half maximal inhibitory concentration) values were also calculated for all the samples, ranging between 7 and 9 µg/mL. Positive antibacterial and antifungal effects against Bacillus subtilis and Escherichia coli, as well as Aspergillus niger (fungi), were observed only in the extracts of the flower (both methanol and ethanol). The sun-mediated technique was used for extraction for the first time in this study. Therefore, this study introduces a novel approach to the extraction of bioactive compounds from medicinal plants, ultimately contributing to the development of herbal drugs with more convenient and cost-effective methods.

Clinical Trial Design in Ulcerative Colitis: Interpreting Evolving Endpoints Based on Post Hoc Analyses of the Vedolizumab Phase 3 Trials GEMINI 1 and VISIBLE 1.

Background: The 12-point total Mayo score including a Physician's Global Assessment (PGA) of disease activity has been used to assess outcomes in clinical trials for ulcerative colitis (UC). In 2016, the US Food and Drug Administration (FDA) issued guidance advising the removal of the PGA in future trials. We examined how endpoints in UC trials have evolved and conducted a post hoc analysis of the GEMINI 1 and VISIBLE 1 trials to understand how the use of a 9-point modified Mayo score, excluding PGA, compares with the total Mayo score. Methods: Endpoint definitions of clinical remission in phase 3 trials were extracted from published literature and ClinicalTrials.gov. The difference (%Δ) between the proportions of patients in GEMINI 1 and VISIBLE 1 achieving clinical remission with vedolizumab versus placebo at week 52 was measured according to 4 endpoint definitions. Results: Trials completed up to the end of 2019 used the total Mayo score to assess clinical remission. Most trials that were completed or estimated to be completed by June 2020 or later used modified Mayo scores. Post hoc analysis revealed decreasing endpoint stringency was associated with increasing %Δ values. The modified Mayo score definition most like the definition recommended by the FDA produced %Δ values like those reported using the total Mayo score in GEMINI 1 and VISIBLE 1. Conclusions: Endpoint definitions for UC clinical trials have evolved following FDA guidance. The efficacy of vedolizumab, measured using modified Mayo scoring, was comparable to values reported using the total Mayo score.

Comparative photocatalytic study of visible light driven BiVO4, Cu2O, and Cu2O/BiVO4 nanocomposite for degradation of antibiotic for wastewater treatment.

Semiconductor-based photocatalysts have become increasingly used in the removal of pollutants from wastewater, especially antibiotics. A series of composite-based cuprous oxide and bismuth vanadate (Cu2O/BiVO4) composite-based photocatalysts were synthesized by using the chemical method. The structure of the Cu2O/BiVO4 composite was verified by using x-ray diffraction, scanning electron microscopy, photoluminescence, Fourier transform infrared spectroscopy, and UV-visible spectra. The degradation of methylene blue (MB) and tetracycline (TC) was investigated to check the photocatalytic activity of the Cu2O/BiVO4 composite series. The quantity of Cu2O was varied from 1% to 7% by weight to prepare the series of Cu2O/BiVO4 composites. The analysis of results verified that 5% Cu2O/BiVO4 exhibits an outstanding photocatalytic activity as compared to 1%, 3%, and 7% Cu2O/BiVO4, pure Cu2O, and pure BiVO4 under visible light irradiation. The optimum value of photocatalytic degradation achieved with 5% Cu2O/BiVO4 was 97% for MB dye and 95% for TC in 120 min, which is greater than the photocatalytic degradation of pure BiVO4 (MB 45% and TC 72%), pure Cu2O (MB 57% and TC 80%), 1% Cu2O/BiVO4 (MB 72% and TC 85%), 3% Cu2O/BiVO4 (MB 83% and TC 88%), and 7% Cu2O/BiVO4 (MB 87% and TC 91%). The stability and reusability of Cu2O/BiVO4 were also investigated. To check the major role of trapping in degradation, a trapping experiment was also performed by using three trapping agents: BQ, EDTA, and tBuOH. The results showed that Cu2O/BiVO4 exhibits an improved photocatalytic activity in the degradation of antibiotics in polluted water because the recombination rate of the electron-hole pair decreased and the surface area increased, which increased the active sites for redox reactions. Such a photocatalytic composite with high efficiency has various applications, such as energy production, environmental remediation, and water remediation.

The leukemia inhibitory factor regulates fibroblast growth factor receptor 4 transcription in gastric cancer.

PURPOSE: The gastric adenocarcinoma (GC) represents the third cause of cancer-related mortality worldwide, and available therapeutic options remain sub-optimal. The Fibroblast growth factor receptors (FGFRs) are oncogenic transmembrane tyrosine kinase receptors. FGFR inhibitors have been approved for the treatment of various cancers and a STAT3-dependent regulation of FGFR4 has been documented in the H.pylori infected intestinal GC. Therefore, the modulation of FGFR4 might be useful for the treatment of GC. METHODS: To investigate wich factors could modulate FGFR4 signalling in GC, we employed RNA-seq analysis on GC patients biopsies, human patients derived organoids (PDOs) and cancer cell lines. RESULTS: We report that FGFR4 expression/function is regulated by the leukemia inhibitory factor (LIF) an IL-6 related oncogenic cytokine, in JAK1/STAT3 dependent manner. The transcriptomic analysis revealed a direct correlation between the expression of LIFR and FGFR4 in the tissue of an exploratory cohort of 31 GC and confirmed these findings by two external validation cohorts of GC. A LIFR inhibitor (LIR-201) abrogates STAT3 phosphorylation induced by LIF as well as recruitment of pSTAT3 to the promoter of FGFR4. Furthermore, inhibition of FGFR4 by roblitinib or siRNA abrogates STAT3 phosphorylation and oncogentic effects of LIF in GC cells, indicating that FGFR4 is a downstream target of LIF/LIFR complex. Treating cells with LIR-201 abrogates oncogenic potential of FGF19, the physiological ligand of FGFR4. CONCLUSIONS: Together these data unreveal a previously unregnized regulatory mechanism of FGFR4 by LIF/LIFR and demonstrate that LIF and FGF19 converge on the regulation of oncogenic STAT3 in GC cells.

Activation of GPBAR1 attenuates vascular inflammation and atherosclerosis in a mouse model of NAFLD-related cardiovascular disease.

While patients with nonalcoholic fatty liver disease (NAFLD) are at increased risk to develop clinically meaningful cardiovascular diseases (CVD), there are no approved drug designed to target the liver and CVD component of NAFLD. GPBAR1, also known as TGR5, is a G protein coupled receptor for secondary bile acids. In this study we have investigated the effect of GPBAR1 activation by BAR501, a selective GPBAR1 agonist, in Apolipoprotein E deficient (ApoE-/-) mice fed a high fat diet and fructose (Western diet), a validated model of NAFLD-associated atherosclerosis. Using aortic samples from patients who underwent surgery for abdominal aneurism, and ex vivo experiments with endothelial cells and human macrophages, we were able to co-localize the expression of GPBAR1 in CD14+ and PECAM1+ cells. Similar findings were observed in the aortic plaques from ApoE-/- mice. Treating ApoE-/- mice with BAR501, 30 mg/kg for 14 weeks, attenuated the body weight gain while ameliorated the insulin sensitivity by increasing the plasma concentrations of GLP-1 and FGF15. Activation of GPBAR1 reduced the aorta thickness and severity of atherosclerotic lesions and decreased the amount of plaques macrophages. Treating ApoE-/- mice reshaped the aortic transcriptome promoting the expression of anti-inflammatory genes, including IL-10, as also confirmed by tSNE analysis of spleen-derived macrophages. Feeding ApoE-/- mice with BAR501 redirected the bile acid synthesis and the composition of the intestinal microbiota. In conclusion, GPBAR1 agonism attenuates systemic inflammation and improve metabolic profile in a genetic/dietetic model of atherosclerosis. BAR501 might be of utility in the treatment for NAFLD-related CVD.

ENTERPRET: A Randomized Controlled Trial of Vedolizumab Dose Optimization in Patients With Ulcerative Colitis Who Have Early Nonresponse.

BACKGROUND & AIMS: Patients with ulcerative colitis (UC) may experience nonresponse to biologics, possibly as a result of low drug exposure. This trial assessed the efficacy of dose optimization in patients with UC who have early nonresponse to vedolizumab and high drug clearance. METHODS: ENTERPRET was a phase 4, open-label, randomized, controlled trial that included patients with moderate to severe UC who had high drug clearance at week 5 (serum concentration, <50 µg/mL) and nonresponse to standard vedolizumab treatment at week 6. At week 6, eligible patients were randomized 1:1 to receive standard dosing (300 mg every 8 weeks) or dose-optimized vedolizumab (600 mg at week 6, then 300 mg every 4 weeks; or 600 mg at week 6, then 600 mg every 4 weeks [based on week 5 serum concentration]). The primary end point was endoscopic improvement at week 30. RESULTS: Of 278 enrolled patients, 132 (47.5%) had a clinical response at week 6. From week 6, 108 patients received standard (n = 53) or dose-optimized vedolizumab (n = 55); among patients with nonresponse at week 6, 86.5% had high drug clearance. At week 30, 10 patients (18.9%) who received standard vedolizumab had endoscopic improvement vs 8 patients (14.5%) who received dose-optimized vedolizumab. Five patients (9.4%) who received standard vedolizumab had clinical remission at week 30 vs 5 patients (9.1%) who received dose-optimized vedolizumab; clinical response was observed in 17 (32.1%) and 17 patients (30.9%), respectively. Safety event rates were similar among treatment groups. CONCLUSIONS: In patients with early nonresponse and high drug clearance, vedolizumab dose optimization is probably not required. A proportion of patients benefited from continued treatment irrespective of the dose received. CLINICALTRIALS: gov: NCT03029143.

Vedolizumab, Adalimumab, and Methotrexate Combination Therapy in Crohn's Disease (EXPLORER).

BACKGROUND & AIMS: Although biologics have revolutionized the treatment of Crohn's disease (CD), an efficacy ceiling has been reached. Combining biologic therapies may improve remission rates. METHODS: EXPLORER, a phase 4, single-arm, open-label study, evaluated triple combination therapy with vedolizumab (300 mg on day 1, weeks 2 and 6, and then every 8 weeks), adalimumab (160 mg on day 2, 80 mg at week 2, then 40 mg every 2 weeks), and methotrexate (15 mg weekly) in biologic-naïve patients with newly diagnosed, moderate- to high-risk CD. Endoscopic remission at week 26 (primary end point; Simple Endoscopic Score for CD ≤2), clinical remission at weeks 10 and 26 (secondary end point; Crohn's Disease Activity Index <150), and incidences of adverse events and serious adverse events were evaluated. RESULTS: Among 55 enrolled patients, the mean CD duration was 0.4 years, the mean baseline Simple Endoscopic Score for CD was 12.6, and the mean baseline Crohn's Disease Activity Index was 265.5. At week 26, 19 patients (34.5%) were in endoscopic remission. At weeks 10 and 26, 34 (61.8%) and 30 patients (54.5%), respectively, were in clinical remission. Post hoc Bayesian analysis showed that the probabilities that triple combination therapy produced a higher endoscopic remission rate (33.5%; 95% credible interval, 22.4-45.7) than placebo (14%), vedolizumab monotherapy (27%), or adalimumab monotherapy (30%) were 99.9% or higher, 86.3%, and 71.4%, respectively. Six patients had serious adverse events. CONCLUSIONS: Combination therapy resulted in endoscopic and clinical remission at week 26 in 34.5% and 54.5% of patients, respectively, with no safety signal related to the treatment regimen. This supports further evaluation of combination therapy in CD. CLINICALTRIALS: gov number: NCT02764762.

Green synthesis of graphene-based metal nanocomposite for electro and photocatalytic activity; recent advancement and future prospective.

The presence of pollutants in waste water is a demanding problem for human health. Investigations have been allocated to study the adsorptive behavior of graphene-based materials to remove pollutants from wastewater. Graphene (GO) due to its hydrophilicity, high surface area, and oxygenated functional groups, is an effective adsorbent for the removal of dyes and heavy metals from water. The disclosure of green synthesis opened the gateway for the economic productive methods. This article reveals the fabrication of graphene-based composite from aloe vera extract using a green method. The proposed mechanism of GO reduction via plant extract has also been mentioned in this work. The mechanism associated with the removal of dyes and heavy metals by graphene-based adsorbents and absorptive capacities of heavy metals has been discussed in detail. The toxicity of heavy metals has also been mentioned here. The Polyaromatic resonating system of GO develops significant π-π interactions with dyes whose base form comprises principally oxygenated functional groups. This review article illustrates a literature survey by classifying graphene-based composite with a global market value from 2010 to 2025 and also depicts a comparative study between green and chemical reduction methods. It presents state of art for the fabrication of GO with novel adsorbents such as metal, polymer, metal oxide and elastomers-based nanocomposites for the removal of pollutants. The current progress in the applications of graphene-based composites in antimicrobial, anticancer, drug delivery, and removal of dyes with photocatalytic efficacy of 73% is explored in this work. It gives a coherent overview of the green synthesis of graphene-based composite, various prospective for the fabrication of graphene, and their biotoxicity.

Investigation on the role of graphene-based composites for in photocatalytic degradation of phenol-based compounds in wastewater: a review.

The ineptitude of conventional water management systems to eradicate noxious compounds leads to the development of advanced treatment systems. The disclosure of graphene-based photocatalytic degradation for the eradication of phenolic compounds has become the "apple of the eye" for many researchers. This review article describes the advanced research progress during the period of 2008-2021 in graphene-based nanocomposites and discusses their different synthesis methods. We will also talk about the applications of nanocomposite in water splitting, dye degradation, solar fuel generations, and organic transformations. Multicomponent heterojunction structure, co-catalyst cohering, and noble metal coupling have been inspected to enhance the photocatalytic performance of graphene-based composite by increasing charge separation and stability. The photocatalytic system's remarkable stability has been described in terms of facile recyclability. The adsorption ability of phenolic compounds has been addressed in the form of Langmuir and Freundlich adsorption isotherm with various factors (pH, concentration, the intensity of light, the effect of catalyst, the effect of time, etc.). The purpose of this review is to survey mechanisms and processes that enlist graphene-based composite in terms of efficacy and dose of catalyst required to attain 99% degradation. Nanoparticles may cause toxicity and a pretext for their toxicity has been mentioned. Finally, it is anticipated that this article could allocate consequential knowledge to fabricating graphene-based composites that are in crucial demand of being discussed in future research.

Parametric Optimization for Quality of Electric Discharge Machined Profile by Using Multi-Shape Electrode.

The electrical discharge machining (EDM) process is one of the most efficient non-conventional precise material removal processes. It is a smart process used to intricately shape hard metals by creating spark erosion in electroconductive materials. Sparking occurs in the gap between the tool and workpiece. This erosion removes the material from the workpiece by melting and vaporizing the metal in the presence of dielectric fluid. In recent years, EDM has evolved widely on the basis of its electrical and non-electrical parameters. Recent research has sought to investigate the optimal machining parameters for EDM in order to make intricate shapes with greater accuracy and better finishes. Every method employed in the EDM process has intended to enhance the capability of machining performance by adopting better working conditions and developing techniques to machine new materials with more refinement. This new research aims to optimize EDM's electrical parameters on the basis of multi-shaped electrodes in order to obtain a good surface finish and high dimensional accuracy and to improve the post-machining hardness in order to improve the overall quality of the machined profile. The optimization of electrical parameters, i.e., spark voltage, current, pulse-on time and depth of cut, has been achieved by conducting the experimentation on die steel D2 with a specifically designed multi-shaped copper electrode. An experimental design is generated using a statistical tool, and actual machining is performed to observe the surface roughness, variations on the surface hardness and dimensional stability. A full factorial design of experiment (DOE) approach has been followed (as there are more than two process parameters) to prepare the samples via EDM. Regression analysis and analysis of variance (ANOVA) for the interpretation and optimization of results has been carried out using Minitab as a statistical tool. The validation of experimental findings with statistical ones confirms the significance of each operating parameter on the output parameters. Hence, the most optimized relationships were found and presented in the current study.

Comparison of physiotherapy with and without intra-articular corticosteroid injection for treatment of frozen shoulder: A comparative study.

OBJECTIVE: To compare the combination of corticosteroid injection and physiotherapy with physiotherapy alone in patients of frozen shoulder in terms of SPADI score. METHODS: This study included 80 patients of either gender from PMC and affiliated hospitals of Faisalabad with ages between 18-55 years having frozen shoulder of either gender with more than 1 month duration. Patients having frozen shoulder secondary to trauma, cerebrovascular accident and taking steroid injections were excluded. Combination of corticosteroid injection and physiotherapy was performed in combination therapy group (n=40) and physiotherapy alone was performed in Single therapy group (n=40). RESULTS: A total of 80 patients, 30(37.5%) males and 50(62.5%) females were selected for the study. Each group, combination therapy and single therapy had 40 patients each. The combination therapy group included 18(45.0%) males and 22(44.0%) females whereas the single therapy group comprised of 12(39.9%) males and 28(70%) females. The treatment method was independent of duration of disease (p= 0.251 for c2= 1.317). After six weeks of treatment, the t-test applied on SPADI score showed that combined treatment is better than the single treatment method (p= 0.016). However, both treatment methods were found same after stratification of duration of disease. CONCLUSIONS: Combination of corticosteroid injection and physiotherapy is more effective than the physiotherapy alone in resolving the shoulder pain and disability of shoulder.

Correlates of mothers' nutritional status in developing economies: Evidence from demographic and health surveys.

The study investigates the determinants of the nutritional status of mothers in developing countries. For a panel of 38 developing countries, data were obtained from the nationally representative Demographic and Health Surveys (DHS). Married women of reproductive age group (15 to 45 years), currently living with their husbands were selected as the target population. Body mass index was used as a proxy measure to gauge the nutritional status. Both bivariate and multivariate statistical analyses were employed to assess the socioeconomic determinants of mothers' nutritional status. The findings from both descriptive and probability analyses identified the mothers' poor educational status, early marriage, high fertility rate, low birth interval, low women empowerment status, household poverty, and belonging to rural areas as the main determinants of poor nutritional status of mothers in developing countries; hence, there is a need to focus more on this group in order to stop the sustained transmission of intergenerational malnutrition.

Encephalopathy of Unclear Etiology: A Diagnostic Dilemma.

INTRODUCTION: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a potentially fatal condition caused by drug exposure resulting in hypersensitivity reaction with involvement of different organ systems. CASE PRESENTATION: We present a case of a 65-year-old man with a recent history of right total knee arthroplasty complicated by wound infection on a regimen of vancomycin who was transferred to our hospital for further management of fever, rigors, altered mental status, acute hypoxic respiratory failure, acute kidney injury, and development of an erythematous rash. DISCUSSION: DRESS syndrome was considered definite in this patient according to the European Registry of Severe Cutaneous Adverse Reaction Criteria, also known as RegiSCAR. To our knowledge, metabolic encephalopathy associated with multiorgan dysfunction resulting from vancomycin-induced DRESS syndrome has not been reported. CONCLUSION: A thorough analysis of recent medication history is essential for the prompt identification and management of this condition.

Soybean herbage yield, nutritional value and profitability under integrated manures management.

Organic manures are more preferred and environmentally friendly than chemical fertilizers for minimally contaminating soil, water and environmental resources, but the determination of right source of organic manures continues to remain an unexplored aspect. Considering the important issue, a multi-year field trial was carried out to determine the response of forage soybean to four sources of nutrients such as chemical fertilizers (IF), poultry litter (PL), bovine's farm yard slurry (BFYS) and sewage sludge (SS) and their seven binary combinations (PL+BFYS, PL+SS, PL+IF, BFYS+SS, BFYS+IF, SS+IF and PL+BFYS+SS). Supplementation of organic manures with mineral fertilizers remained superior to their sole application, particularly BFYS + IF was found significantly (p≤0.05) superior for yielding the highest fresh biomass (23.9, 26.4 and 25.7 t ha-1) with improved nutritional quality. The same combination of integrated fertilizer management also recorded higher sustainability as per sustainable forage yield index along with the highest net income and the benefit-cost ratio. PL and SS applied in conjunction with IF performed better than sole or binary application of organic manures. Therefore, BFYS + IF may be recommended for adoption to produce comparable forage yield and nutritional quality of soybean along with reducing dependency on chemical fertilizers.

Transient Arrhythmia in a Patient With Human Granulocytic Anaplasmosis: An Uncanny Presentation.

This is a case of a 69-year-old male, with well-controlled rheumatoid arthritis and benign prostatic hyperplasia, who presented with fever and generalized weakness. He was found to have atrial fibrillation on his second emergency department visit and later diagnosed with human granulocytic anaplasmosis (HGA). Atrial fibrillation subsided with the commencement of HGA-specific treatment. This is the first case of HGA and atrial fibrillation reported in the English literature. It highlights the importance of being vigilant for unusual presentations of tick-borne diseases in the endemic areas.

Refractive index of biological tissues: Review, measurement techniques, and applications.

Refractive index (RI) is a characteristic optical variable that controls the propagation of light in the medium (e.g., biological tissues). Basic research with the aim to investigate the RI of biological tissues is of paramount importance for biomedical optics and associated applications. Herein, we reviewed and summarized the RI data of biological tissues and the associated insights. Different techniques for the measurement of RI of biological tissues are also discussed. Moreover, several examples of the RI applications from basic research, clinics and optics industry are outlined. This study may provide a comprehensive reference for RI data of biological tissues for the biomedical research and beyond.

Cognitive behaviour therapy for white coat hypertension-causing latrophobia in adults: randomized controlled trial.

OBJECTIVE: To see whether cognitive behaviour therapy improves blood pressure-oriented latrophobia in adults to manage white coat hypertension. METHODS: Present study was conducted at the Kidney Centre, Sialkot, Pakistan from December 2017 to November 2018, and comprised latrophobic attendees of kidney patients without initially exploring the reason of phobia. Either of the intervention or control group was allotted, randomly. The intervention group underwent 20 weekly sessions of the therapy. Pre- and posttherapy systolic blood pressure (at home and medical clinic) of both the groups was recorded alongside self-perceived level of phobia in subjects of only treatment group. RESULTS: Of 30 subjects of intervention group, 22 (73.3%) completed the therapy. However, control (N = 30) stayed intact. Age statistics were, as: M = 38.2, SD = 11.8, range 20-56 years with male predominance. Moreover, 12 (54.4%) or 20 (90.9%) of them reported severe latrophobia or onset of phobia after childhood, respectively. After therapy, 17 (77.3%) subjects communicated improvement in fear. A significant decline in mean systolic blood pressure was noted in pre- to posttherapy record (149 vs.142 mm of Hg, respectively; t(21)= 8.829, p = 0.0001). CONCLUSION: Generally, cognitive behaviour therapy improves blood pressure-oriented latrophobia in adults.

Optimal Colonoscopic Surveillance Interval After Normal Baseline Screening Colonoscopy.

The optimal colonoscopic surveillance interval in the Chinese population is unclear. The present study aimed to assess the optimal colonoscopic surveillance interval after normal baseline screening colonoscopy to avoid overuse or underuse of colonoscopy. This retrospective study included individuals with normal baseline colonoscopy who had undergone at least 2 follow-up colonoscopy examinations at the Digestive Endoscopy Center of our hospital between 2000 and 2013. The risk factors for adenoma and the optimal colonoscopic surveillance interval were assessed. A total of 1,005 individuals (419 men; mean age, 49.34 ± 13.29 years) were included in the study. Of these, 169 individuals had adenomas at colonoscopic surveillance (mean, 1.32 ± 0.79 procedures). The mean adenoma diameter was 0.54 ± 0.38 cm, and the mean number of adenomas was 1.76 ± 1.29. The mean adenoma surveillance interval was 4.76 ± 2.89 years. The risk factors for adenoma identification were age more than 50 years and male gender. The optimal colonoscopic surveillance interval was 4.76 years according to an adenoma detection rate of 5%. The optimal colonoscopic surveillance interval is around 5 years for individuals with normal baseline colonoscopy. Age more than 50 years and male gender are risk factors for adenoma identification.