The course of MIB-1 expression by cerebral macrophages following human brain injury

The course of MIB-1 expression by brain macrophages adjacent to cortical contusions has been immunohistochemically investigated during the first 30 weeks after human brain injury, in order to provide data for a forensic wound age estimation. A positive nuclear staining for MIB-1 could be observed earliest after a postinfliction interval of 3 days and regularly in cases with a survival time between 7 and 14 days, whereas in uninjured brain tissue (control group) no cellular MIB-1 reactivity was visible.     

Investigation of four novel male androgenetic alopecia susceptibility loci: no association with female pattern hair loss

Female pattern hair loss (FPHL) is a common hair loss disorder in women and has a complex mode of inheritance. The etiopathogenesis of FPHL is largely unknown; however, it is hypothesized that FPHL and male pattern baldness [androgenetic alopecia (AGA)] share common genetic susceptibility alleles. Our recent findings indicate that the major AGA locus, an X-chromosome region containing the androgen receptor and the ectodysplasin A2 receptor (EDA2R) genes, may represent a common genetic factor underlying both early-onset FPHL and AGA. This gives further support for the widespread assumption of shared susceptibility loci for FPHL and AGA. However, we could not demonstrate association of further AGA risk loci, including 20p11, 1p36.22, 2q37.3, 7p21.1, 7q11.22, 17q21.31, and 18q21.1, with FPHL. Interestingly, a recent study identified four novel AGA risk loci in chromosomal regions 2q35, 3q25.1, 5q33.3, and 12p12.1. In particular, the 2q35 locus and its gene WNT10A point to an as-yet unknown involvement of the WNT signaling pathway in AGA. We hypothesized that the novel loci and thus also the WNT signaling may have a role in the etiopathogenesis of FPHL and therefore examined the role of these novel AGA risk loci in our FPHL samples comprising 440 German and 145 UK affected patients, 500 German unselected controls (blood donors), and 179 UK supercontrols. Patients and controls were genotyped for the top two single nucleotide polymorphisms at each of the four AGA loci. However, none of the genotyped variants displayed any significant association. In conclusion, the results of this study provide no support for the hypothesis that the novel AGA loci influence susceptibility to FPHL.     

Protective Effectiveness of Cystamine Versus Delay of Exposure,Body Temperature and Protein Linkage

Summary

In rats which received an intraperitoneal injection of cystamine, the protective effectiveness against whole-body irradiation reached a maximum 10 min after administration. No correlation existed between the total amount of cystamine detected in different tissues at various time-intervals after injection and the degree of protection afforded. Neither was there any parallelism between the time variations of protective effectiveness and the amount of free or protein-bound cystamine in the tissues.     

The POCUS Pulse Check: A Case Series on a Novel Method for Determining the Presence of a Pulse Using Point-of-Care Ultrasound

BackgroundDuring cardiopulmonary resuscitation, pulse checks must be rapid and accurate. Despite the importance placed on the detection of a pulse, several studies have shown that health care providers have poor accuracy for detection of central pulses by palpation. To date, the use of point-of-care ultrasound (POCUS) in cardiac arrest has focused on the presence of cardiac standstill and diagnosing reversible causes of the arrest.ObjectiveThis case series highlights a simple, novel approach to determine whether pulses are present or absent by using POCUS compression of the central arteries.DiscussionUsing this technique, we found that a POCUS pulse check can be consistently performed in < 5 s and is clearly determinate, even when palpation yields indeterminate results.ConclusionsIn this case series, the POCUS pulse check was a valuable adjunct that helped to change management for critically ill patients. Future prospective studies are required to determine the accuracy of this technique and the impact on patient outcomes in a larger cohort.     

The PROMISE study protocol: a multicenter prospective study of process optimization with interdisciplinary and cross-sectoral care for German patients receiving hip and knee endoprostheses

Background and purpose — Knee and hip replacement are common and increasing procedures, and an optimized care process that could be implemented in different settings would be useful. The PROMISE trial investigates whether a new care process works equally in different German settings and how the results compare with current non-standardized care.Patients and methods — This multi-center prospective mixed-method study includes 2,000 German patients receiving arthritis-related hip or knee endoprostheses. An interdisciplinary and cross-sectoral care process was developed and implemented in 3 German hospitals with different levels of care, and corresponding rehabilitation centers were included to bridge the gap after acute care.Duration and outcome — The PROMISE trial recruited patients between May 2018 and March 2020. Follow-up will end in February 2021. Assessments are performed at: examination on clinical indication, 1 week before surgery, on the day of surgery, at the end of hospitalization, end of the rehabilitation program, and 3 months, 6 months, and 12 months after surgery. Outcomes include patient-reported outcomes, medical examination findings, and routinely collected data regarding the surgery and complications. Guideline-based interviews are conducted with selected patients and care partners. The primary endpoint is the presence of chronic pain at 12 months after surgery. Secondary endpoints are the number of recognized pre-existing conditions, physical activity at 12 months after surgery, use of medical services, quality of life, and interactions between care partners.Trial registration — The trial is registered with the German Clinical Trials Register (https://www.drks.de; DRKS00013972; March 23, 2018).

With demographic changes joint replacement is becoming one of the most frequently performed surgeries. In Germany, approximately 175,000 total hip arthroplasties (THA) (IQTIG 2018a) and 148,000 total knee arthroplasties (TKA) (IQTIG 2018b) are performed each year.These replacement procedures are associated with various risks and complications, including infection and thrombosis, as well as a considerable financial burden. Moreover, 7% to 23% of patients with THA and 10% to 34% of patients with TKA report an unfavorable long-term outcome (Beswick et al. 2012). Due to the high number of these interventions, clinical, patient-centered, and economic results might be improved by even minor advancements in the treatment process. In Germany no generally applicable evidence-based treatment standard has yet been developed. Thus, the current care system does not achieve its full potential, including the cost–benefit ratio.The PROMISE trial aims to improve the care process in Germany based on the principles of the Enhanced Recovery after Surgery Society (ERAS). An ERAS path is defined to optimally prepare the patient for an intervention with minimized stress and stress reactions, maintained homeostasis, and avoiding catabolism that leads to loss of protein, muscle strength, and cellular dysfunction (Ljungqvist 2012). The ERAS approach has been applied to numerous elective procedures and provides approximately 30–50% reductions in the complication rate and length of stay (Ljungqvist et al. 2017). Because of a call for certified intersectoral centers to improve the quality of care (IGES Institut 2016), the PROMISE study involves 3 hospitals with different levels of care, including all required departments, as well as 5 inpatient and outpatient rehabilitation centers. Standard operating procedures defined by an interdisciplinary panel, and a central database for continuous evaluations, audits, and improvements (Ljungqvist et al. 2017) aim to minimize loss of potential effectiveness due to insufficient coordination, lack of common therapeutic goals, incomplete information flow, and separate data collection.     

The Importance of Method Selection in Determining Product Integrity for Nutrition Research

The American Herbal Products Association estimates that there as many as 3000 plant species in commerce. The FDA estimates that there are about 85,000 dietary supplement products in the marketplace. The pace of product innovation far exceeds that of analytical methods development and validation, with new ingredients, matrixes, and combinations resulting in an analytical community that has been unable to keep up. This has led to a lack of validated analytical methods for dietary supplements and to inappropriate method selection where methods do exist. Only after rigorous validation procedures to ensure that methods are fit for purpose should they be used in a routine setting to verify product authenticity and quality. By following systematic procedures and establishing performance requirements for analytical methods before method development and validation, methods can be developed that are both valid and fit for purpose. This review summarizes advances in method selection, development, and validation regarding herbal supplement analysis and provides several documented examples of inappropriate method selection and application.