The involvement of musculoskeletal system and its influence on postural stability in children and young adults with cystic fibrosis

Background

Cystic fibrosis (CF) affects the musculoskeletal system via a multifactorial pathway that includes vitamin D deficiency and involvement of respiratory muscles such as intercostals due to recurrent upper and lower respiratory tract infections. Eventual result is the deterioration of musculoskeletal health and posture in CF patients. Postural stability is directly affected by posture and can be compromised in every musculoskeletal problem. The aim of this study is to evaluate musculoskeletal system and postural stability in patients with CF.

Methods

Patients with CF over six years of age and age and sex-matched control groups were included in the study. Cobb angle and thoracic kyphosis angles were measured on the spine radiographs. Both patients and control group were examined with pediatric gait, arms, legs and spine scale (pGALS). They also were evaluated with a NeuroCom Balance Master for their postural stability.

Results

Fifty-one patients with CF and 94 healthy controls participated in the study. In results of the pGALS examination, CF group had significantly more pathological findings than the control group in lower extremity appearance and movement (p?=?0.006 and p?=?0.01) and spine appearance and movement (p?=?0.001 and p?=?0.022) domains. The tandem walking speed was significantly higher in controls with a mean of 24.45?±?7.79 while it was 20.47?±?6.95 in the CF group (p?=?0.03). Various limits of stability parameters also showed significant differences. Medium correlations were found between musculoskeletal examination and postural stability parameters.

Conclusion

In patients with CF, a systematic but simple musculoskeletal examination can detect pathologies, which are more frequent than the normal population. These pathologies show a medium correlation with the involvement of postural stability.

     

MiR-339 and especially miR-766 reactivate the expression of tumor suppressor genes in colorectal cancer cell lines through DNA methyltransferase 3B gene inhibition

It is observed that upregulation of DNMT3B enzyme in some cancers, including colon cancer, could lead to silencing of tumor suppressor genes. MiR-339 and miR-766 have been predicted to target 3′UTR of DNMT3B gene. Luciferase reporter assay validated that individual and co-transfection of miR-766 and miR-339 into the HEK293T cell reduced luciferase activity to 26% ± 0.41%, 43% ± 0.42 and 64% ± 0.52%, respectively, compared to the control (P < 0.05). Furthermore, transduction of miR-339 and miR-766 expressing viruses into colon cancer cell lines (SW480 and HCT116) decreased DNMT3B expression (1.5, 3-fold) and (3, 4-fold), respectively. In addition, DNA methylation of some tumor suppressor genes decreased. Expression of these genes such as SFRP1 (2 and 1.6-fold), SFRP2 (0.07 and 4-fold), WIF1 (0.05 and 4-fold), and DKK2 (2 and 4-fold) increased in SW-339 and SW-766 cell lines; besides, expression increments for these genes in HCT-339 and HCT-766 cell lines were (2.8, 4-fold), (0.005, 1.5-fold), (1.7 and 3-fold) and (0.04, 1.7-fold), respectively. Also, while in SW-766, cell proliferation reduced to 2.8% and 21.7% after 24 and 48 hours, respectively, SW-339 showed no reduced proliferation. Meanwhile, HCT-766 and HCT-339 showed (3.5%, 12.8%) and (18.8%, 33.9%) reduced proliferation after 24 and 48 hours, respectively. Finally, targeting DNMT3B by these miRs, decreased methylation of tumor suppressor genes such as SFRP1, SFRP2, WIF1 and DKK2 in the mentioned cell lines, and returned the expression of these tumor suppressor genes which can contribute to lethal effect on colon cancer cells and reducing tumorigenicity of these cells.     

The effects of implantable collamer lens implantation on higher order aberrations

AIM: To evaluate the changes in higher order aberrations (HOAs) after implantable collamer lens (ICL; Staar Surgical, Nidau, Switzerland) implantation. METHODS: Totally 30 eyes of 18 patients with myopia were included in this study with an average age of 25.77y (min: 21, max: 40). Refraction, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), HOAs (entire, corneal and internal) were evaluated preoperatively and three months postoperatively. Ocular aberrations were measured by using iTrace (Tracey Technology, Houston, Texas, USA). SPSS (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp) was used for the statistical analysis and the interpretation of the data. P values of less than 0.05 were considered statistically significant. RESULTS: The preoperative mean spherical power was -9.01 D (min: -5.00, max: -13.00) and the mean cylindrical error was -2.40 D (min: -0.50, max: -4.75). The postoperative mean residual spherical power was -0.73 D (min: -0.20, max: -1.75) and the mean cylindrical error was -0.89 D (min: -0.18, max: -2.09). Analyses were made on root mean square (RMS) values of total HOAs (tHOAs), spherical aberration, coma and trefoil as entire, corneal and internal components. The differences in entire tHOAs and in internal tHOAs were significant. There was no significant change found in spherical aberrations. The differences in entire coma and in internal coma were significant. There was no significant change found in corneal coma. With respect to trefoil, the only significant difference was in internal trefoil. CONCLUSION: The ICL implantation corrects the refractive error successfully and changes entire and internal HOAs of the eye.     

Antiparkinsonian activity of L-propyl-L-leucyl-glycinamide or melanocyte-inhibiting factor in MPTP-treated common marmosets.

The neuropeptide melanocyte-inhibiting factor (MIF) or L-propyl-L-leucyl-glycinamide (PLG) has been reported in some studies to improve the motor signs of Parkinson's disease (PD) and in rodent models of PD. In this study of oral and intravenous MIF in N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-lesioned marmosets, a wide range of doses of MIF administered alone (0.25, 1, 2, 5, 10, 20 mg/kg orally) did not increase locomotor activity, relieve motor disability, or induce dyskinesias. When MIF (1.0 and 5.0 mg/kg orally or 10 and 20 mg/kg intravenously) was administered concomitantly with levodopa/benserazide, no significant differences in motor function or dyskinesias were observed compared with levodopa/benserazide alone. The results of this first study of MIF in the marmoset MPTP model provide no encouragement for the reinvestigation of MIF in the clinical management of the motor signs of PD.     

Toronto Facial Grading System: interobserver reliability.

The Toronto Facial Grading System (TFGS) is an observer scale for rating facial nerve dysfunction. The TFGS scores aspects of resting symmetry, symmetry of voluntary movement, and synkinesis for each division of the face (subscores) and then provides calculated total scores and an overall composite score of facial function. The developers of the scale have validated its sensitivity for identifying small changes in facial dysfunction and the independence of the different components measured. Herein we report our results in a study of interobserver reliability using the TFGS. Twenty-five patients from the Massachusetts Eye and Ear Infirmary Facial Nerve Center with varying degrees of facial paresis, paralysis, and synkinesis were videotaped, and the video recordings were scored by 5 independent observers using the TFGS. Intraclass correlation coefficients (kappa) and 95% confidence intervals were calculated for subscores and for each total and composite score. Intraclass correlation coefficients ranged from 0.59 to 0.85, all considered substantial to near-perfect agreement between observers. We believe the TFGS is superior to other scales by virtue of its sensitivity, comprehensiveness, ease of use, and interobserver reliability. The TFGS presently appears to be the best option in those situations in which accurate and precise documentation of facial function is required.     

Extraordinarily elevated CA19-9 in benign conditions: a case report and review of the literature.

Carbohydrate antigen CA19-9 is commonly used in the diagnosis of pancreatic and biliary malignancies. However, increases in its level in benign conditions such as acute cholangitis or pancreatitis have also been reported. A 79-year-old woman presented with cholangitis and a pancreatic pseudocyst while showing elevation of CA19-9 up to 35,500 U/mL. The patient was adequately treated and at two months' follow-up the CA19-9 level had returned to normal.     

Vitamins A,C, and E and selenium in the treatment of idiopathic sudden sensorineural hearing loss

This study evaluated the effectiveness of vitamins A, C, and E, with selenium, in the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL). This was a prospective, controlled study performed at a tertiary teaching and research hospital. Over a 32-month period, patients were treated with either our standard ISSNHL treatment regimen plus vitamins A, C, and E and selenium (ACE+ group) or with only our standard ISSNHL treatment regimen (ACE? group). The demographics, additional symptoms, mean initial and final hearing levels, mean hearing gain, and recovery data were compared between the two groups. The ACE+ group, consisting of 70 (55.5 %) patients, received vitamin A (natural beta-carotene, 26,000 IU), vitamin C (ascorbic acid, 200 mg), vitamin E (d-alpha-tocopherol, 200 IU), and selenium (50 μg) twice daily for 30 days in addition to our ISSNHL treatment regimen: methylprednisolone at an initial dose of 1 mg/kg body weight per day, tapered over 14 days; Rheomacrodex^® [(10 g of dextran and 0.9 g of NaCl)/100 ml] 500 ml daily for 5 days; Vastarel^® 20-mg tablet (20 mg of trimetazidine dihydrochloride) three times daily for 30 days; and ten 60-min hyperbaric oxygen (HBO) sessions (2.5 absolute atmospheres of 100 % O₂), once daily, starting the day of hospitalization. The ACE? group comprised 56 (44.4 %) patients, who received only our ISSNHL treatment regimen. The mean hearing gains were 36.2 ± 20.3 dB in the ACE+ group and 27.1 ± 20.6 dB in the ACE? group. The mean hearing gain rates were significantly higher in the ACE+ group than in the ACE? group (p = 0.014). Treatment with vitamins A, C, and E and selenium was effective in ISSNHL patients undergoing treatment with methylprednisolone, dextran, trimetazidine dihydrochloride, and HBO, and might be more effective when the initial hearing level is below 46 dB.     

Bacterial change in external auditory canal upon antisepsis with povidone-iodine during tympanoplasty

European Archives of Oto-Rhino-Laryngology - The aim of this single-arm prospective study was to determine the flora of the external auditory canal (EAC) in inactive chronic otitis media and...