Feasibility of external beam radiation for prevention of restenosis following balloon angioplasty

PURPOSE: Brachytherapy has been shown to inhibit neointima formation after vascular balloon injury. This study was done to test the feasibility of low dose external radiation for prevention of restenosis in a non-stented balloon injury model. MATERIALS AND METHODS: Twelve red Duroc swine underwent balloon overdilation injury of both iliac arteries. Twelve Gy was delivered to one side using a Theratron T-1000 Cobalt unit with the other side used as the control. Twelve weeks post injury arteriograms were performed. The animals were then sacrificed and iliac arteries explanted. Histomorphometric analysis of arterial cross sections was performed. Results: Neointima formation was observed in all arteries. Unilateral thrombosis was noted in two animals. The mean neointimal thickness in the radiated and control arteries was 0.63 +/- 0.17 mm and 0.72 +/- 0.31 mm, respectively. The differences in minimal luminal diameter and the neointimal thickness between the two groups were not statistically significant. Complications included superficial hair loss in the radiation port in 4 animals, and 2 deaths prior to the completion date (1 of hemorrhagic enteritis possibly related to the radiation, and 1 of iliac rupture). CONCLUSION: External radiation at this low dose is not effective in preventing vascular restenosis following balloon injury in this animal model.     

Methylphenidate treatment induces oxidative stress in young rat brain

Methylphenidate (MPH) is frequently prescribed for the treatment of attention deficit/hyperactivity disorder. Psychostimulants can cause long-lasting neurochemical and behavioral adaptations. Here, we evaluated oxidative damage in the rat brain and the differential age-dependent response to MPH after acute and chronic exposure. We investigated the oxidative damage, assessed by the thiobarbituric acid reactive species (TBARS), and the protein carbonyl assays in cerebellum, prefrontal cortex, hippocampus, striatum, and cerebral cortex of young (25 days old) and adult (60 days old) male Wistar rats after acute and chronic exposure to MPH. Chronic MPH-treated young rats presented a dose-dependent increase in TBARS content and protein carbonyls formation in specific rat brain regions. In the acute exposure, only MPH highest dose increased lipid peroxidation in the hippocampus. No difference in protein carbonylation was observed among groups in all structures analyzed. In adult rats, we did not find oxidative damage in both acute and chronic treatment. Chronic exposure to MPH in induces oxidative damage in young rat brain, differentially from chronic exposure during adulthood. These findings highlight the need for further research to improve understanding of MPH effects on developing nervous system and the potential consequences in adulthood resulting from early-life drug exposure.     

Choledocholithiasis in elderly patients with gallbladder in situ - is ERCP sufficient?

Abstract

Introduction: Along with increased life expectancy, the proportion of elderly patients with choledocholithiasis will increase and with this, the need for endoscopic cholangiopancreatography (ERCP). Current recommendations suggest laparoscopic cholecystectomy in all patients with choledocholithiasis to prevent biliary events. However, adherence to these recommendations is low, especially in older patients.

Methods: Retrospective study that included non-cholecystectomized patients aged >?=75 years who underwent ERCP for choledocholithiasis from 2013–2016 (n?=?131). A new biliary event was defined as the need for a new ERCP, cholecystitis, cholangitis or gallstone pancreatitis.

Aim: The aim of this study was to compare the outcomes of new biliary events and mortality in cholecystectomized vs non-cholecystectomized patients after ERCP.

Results: Cholecystectomy was performed in 22% of the patients (92% laparoscopic). The post-cholecystectomy complication rate was 13% and the mortality rate was 7%. During the follow-up period (669?±?487 days) a new biliary event occurred in 20% of patients - 10% new ERCP, 9% cholecystitis, 9% cholangitis and 2% pancreatitis. Cholecystectomized patients had fewer events (7% vs 24%, p?=?.048) and longer time to event (p?=?.016). There was no statistically significant difference in all-cause mortality (14% vs 27%, p?=?.13), mortality related to lithiasis (0% vs 9%, p?=?.11) or time to mortality from all causes (p?=?.07) and related to biliary events (p?=?.07).

Conclusions: In this group of elderly patients, cholecystectomy after ERCP prevented the occurrence of new biliary events but resulted in a non-statistically significant difference in mortality.     

Using an Aging Services Agency/University Partnership to Study Informal Caregiver Respite Programs

By the year 2030, 13 % of the world’s population will be aged 65 years or older. At some point, many of these older adults will require some form of informal caregiving from family members and/or friends. Furthermore, 40 % of the caregivers caring for these elders currently are between the ages of 50 and 64, making caregiving an important productive aging activity. As a result of the doubling of the 65?+?age group globally by the year 2050, caregiving will become an important social and public health concern. And, the labor and services provided by caregivers will continue to be a critical activity of productive aging. For this reason, it is imperative that research examining the impact of caregiver respite programs on caregiver outcomes, including caregiver strain, general health, and emotional well-being, be conducted in order to meet the needs of future informal caregivers. In this paper, the authors answer the following question: How can researchers effectively partner with community-based agencies to carry out caregiver respite program studies that bridge academia and every day practice, and inform policymakers about the values of community-based caregiver respite programs for the caregivers of frail older adults? The question is answered by: 1) describing the factors that contributed to the success of one university/community-based partnership, 2) describing, and reporting, the results of two caregiver respite program studies conducted by the partnership, and 3) discussing the lessons learned as well as the future research opportunities that resulted from the university/community-based agency research partnership.     

Drug-induced anaphylaxis: a decade review of reporting to the Portuguese Pharmacovigilance Authority

Purpose

Anaphylaxis is a potentially fatal systemic adverse drug reaction (ADR). It is an unpredictable and mostly dose-independent event that occurs suddenly following exposure to the causative drug. Our objective was to characterize a case series of anaphylactic reactions reported to the Portuguese Pharmacovigilance authority during the past decade. Patients’ demographic data and implicated drugs were analyzed as well as the severity of the ADR and time trends.

Methods

This study was a retrospective analysis of episodes of anaphylaxis, defined according to the Second Symposium on the Definition and Management of Anaphylaxis Criteria, reported to the Portuguese Pharmacovigilance System between 1 January 2000 and 1 November 2010

Results

Amongst the 16,157 ADR reported to the Portuguese Pharmacovigilance System during the 10-year study period, we found 918 (6 %) cases of anaphylaxis that met the proposed criteria. The age of the patients varied from 7 days to 91 years, with 87 cases (9 %) of anaphylaxis involving patients under 18 years of age. There was an overall female predominance (67 %), but the majority of pediatric patients were male (56 %). There was a trend toward increased reporting as the decade progressed, and 31 % (284) of all anaphylaxis cases were reported during the last 2 years of the study period. Of the anaphylaxis episodes reported, 19 % led to hospitalization and 24 (3 %) had a fatal outcome. Antibiotics were responsible for most cases (17 %) followed by nonsteroidal anti-inflammatory drugs/acetaminophen (13 %), antineoplastic/cytotoxic drugs and immune-modulators. Vaccines and radiographic contrast media were also important contributors to an anaphylactic event.

Conclusions

In this series of drug-related anaphylaxis, we found that most of the reported episodes were associated with widely used drugs, such as antibiotics and analgesics. Anaphylaxis can occur at any age. The female gender was more highly represented, with the exception of pediatric patients.     

Evaluation of pH levels and calcium ion release in various calcium hydroxide endodontic dressings

OBJECTIVE: The purpose of this study was to evaluate Ca(2+) release and pH of 3 calcium hydroxide-based products used routinely as intracanal dressings, as well as the new gutta-percha points with calcium hydroxide. STUDY DESIGN: The pH and Ca(2+) release were assessed using Calen with camphorated paramonochlorophenol, saline calcium hydroxide paste, LC paste (Lopes and Costa paste-calcium hydroxide with olive oil), and calcium hydroxide containing gutta-percha points. The materials were inserted in polyethylene tubes and immersed in deionized water. The pH variation and Ca(2+) release were monitored periodically for 4 weeks. RESULTS: After 72 hours, materials 1 and 2 raise the pH from 9.6 and 8.2 to 11.4 and 11.3, respectively, while a small change was observed for materials 3 and 4. The calcium concentration released from materials 1, 2, 3, and 4 after 72 hours was 6.54, 4.98, 1.31, and 1.74 mg/dL, respectively. CONCLUSION: Calen plus camphorated paramonochlorophenol and saline calcium hydroxide paste exhibited the highest calcium release and pH levels.     

GUINEA-BISSAU'S PLANTS: IN VITRO SUSCEPTIBILITY STUDIES ON NEISSERIA GONORRHOEAE

Abstract

Extracts from different parts of Cassia sieberiana, Chamaechrista nigricans, Guiera senegalensis, Lippia chevalieri, Pavetta oblongifolia, Piliostigma thonningii, Senna podocarpa and Terminalia macroptera were examined for in vitro antibacterial activity. These species were collected in the Contúboel region (Guinea-Bissau) which were used by the traditional healer's of the Fulani ethny to treat several disorders including venereal diseases (Diniz, 1996). Fifteen plant extracts were tested against nine strains of Neisseria gonorrhoeae, including penicillin and tetracycline resistant strains. All the extracts exhibited antibacterial activity against all the tested strains. Two of the most active extracts (from Guiera senegalensis leaves and Terminalia macroptera root) were partitioned with different solvents and tested for antiNeisseria gonorrhoeae activity.

     

Constituents of Polyalthia jucunda. and Their Cytotoxic Effect on Human Cancer Cell Lines

Abstract

4-Hydroxy-4, 7-dimethyl-α.-tetralone (1), 4,5-dihydroblumenol A (2), N.-trans.-feruloyltyramine (3), and 24–methylenelanosta-7, 9(11)-dien-3-β., 15α.-diol (4) were isolated from the stem bark of Polyalthia jucunda. (Piere) Finet & Gagnep (Annonaceae). All the compounds were evaluated for their effects on growth of four human tumor cell lines [ER(+) MCF-7, ER(?) MDA-MB-23, SF 268, and NCI-H460] and of a non–tumor cell line (MRC-5). Only compound 4 exhibited a dose-dependent growth inhibitory effect against both tumor and non–tumor cell lines but with less effect on the latter. Using the TUNEL assay, it was found that the inhibitory effect of compound 4 on NCI-H460 cells was probably caused by apoptosis.