Axillary Failure in Patients Treated with MammoSite Accelerated Partial Breast Irradiation

Background  

The risk of axillary failure (AF) after accelerated partial breast irradiation (APBI) using MammoSite brachytherapy is unknown and has been source of concern as the axillary region is not treated with this technique. We aimed to determine the rate of AF in patients treated with APBI and identify factors associated with its occurrence.     

Association between spasticity and the level of motor function with quality of life in community dwelling Iranian young adults with spastic cerebral palsy

Background

Consequences of cerebral palsy in adulthood can affect physical, psychological capabilities and quality of life. The purpose of this study was to investigate the relationship between quality of life with spasticity and level of motor function in Iranian young adults with spastic cerebral palsy who were community dweller.

Methods

In an analytical cross sectional study, 77 participants with spastic cerebral palsy (44 women, 33 men) with age range of 20 to 40 years; (mean age 26.19±5 yr) took part in this study. They were enrolled from three Raad Rehabilitation Goodwill complexes in Tehran and Karaj cities. All subjects were recruited through convenient sampling. Severity of Spasticity for knee flexors was measured with Modified Tardieu Scale. In addition, the level of motor function, and quality of life were assessed respectively through Gross Motor Function Classification System and World Health Organization Quality of life questionnaire (WHOQOL- BREF). To analyze data, Pearson and spearman correlation coefficient was used.

Results

No correlation found between quality of life with knee flexor muscles spasticity and level of motor function (p> 0.05).

Conclusion

Quality of life as a multi dimensional concept has been impacted by many factors such as physical status, environmental issues and culture. Possibly, severity of spasticity and level of function have a less pronounced effect on quality of life in community dwelling adults with cerebral palsy.     

Heme oxygenase-derived carbon monoxide modulates gonadotropin-releasing hormone release in immortalized hypothalamic neurons

Heme oxygenase (HO), the main enzyme deputed to heme metabolism, has been identified as two main isoforms called HO-1 and HO-2 both present in the central nervous system. Heme oxygenase has been shown to regulate the hypothalamic release of neuropeptides such as corticotrophin-releasing hormone and arginin-vasopressin. The aim of this study was to investigate and further characterize the presence of HO in gonadotropin-releasing hormone (GnRH) secreting hypothalamic neurons, GT1-7 and the role of HO by-products on GnRH secretion. The pulsatile release of GnRH from scattered hypothalamic neurons is the key regulator of mammalian fertility in the central nervous system. GT1-7 cells are immortalized hypothalamic neurons, characterized by spontaneous electrical activity and pulsatile GnRH release, resembling the central control pathway of the hypothalamic pituitary gonadal axis (HPG) in mammals. Hemin, the substrate of HO, significantly stimulated HO activity in static cultures, causing a rapid increase in GnRH release. Neither biliverdin nor bilirubin were able to mimic this rapid stimulatory effect, which was instead caused by carbon monoxide. Evidence of a possible involvement of prostaglandin E₂ in the HO by-product modulated GnRH secretion was reported. The hemin-evoked effect on GT1-7 neurons suggests a direct activity of HO by-products on the hypothalamic neuropeptide secretion, and claims for a possible role of CO in both the modulation of gonadotropin secretion and crosstalk among HPG and stress axis within the mammalian hypothalamus.     

Problem-based learning (PBL): assessing students' learning preferences using VARK

OBJECTIVE: This study was conducted to describe learning styles of third year nursing students. DESIGN: An interventional study Setting: a public university in Jordan. SUBJECTS: Used a purposive sample of 92 nursing students who were enrolled in maternity nursing course. MAIN OUTCOME MEASURES: Measure the difference in learning styles of nursing students after introducing an intervention of PBL as a teaching methodology. RESULTS: The dominant learning preference of the students was the read/write preference followed by the kinesthetic, still most of the students represented a multimodal learning preference. No significant difference was found between males and females. A significant difference in the learning preferences of the students in the pre-post test was found. In the pretest the mean of the total VARK score 13.9 (SD=2) where as in the post test the mean of the total VARK score=16.5 (SD=3.5). In the pre-test 54% of students had a multimodal preference whereas 68% of students have a multimodal preference post-test. CONCLUSIONS: Most students are able to learn effectively as long as the instructor provides different learning activities in the areas assessed in VARK. Active learning might be enhanced in large classrooms by presenting models and demonstrations, discussions, debates, answering questions, and role playing.     

Intra-rater reliability of the Modified Modified Ashworth Scale (MMAS) in the assessment of upper-limb muscle spasticity

The aim of this study was to investigate the intra-rater reliability of the Modified Modified Ashworth Scale (MMAS) in the upper limb of patients with hemiparesis and to determine the effect of pain and contracture presence on the reliability of the MMAS. For this test-retest study 30 patients with hemiparesis were included. One physiotherapist using the MMAS, randomly rated the spasticity of shoulder adductors, elbow flexors, and wrist flexors in the affected upper limb of each patient with hemiparesis twice with at least a 1 week interval between testing sessions. The presence of pain and contracture during passive stretch was recorded. The magnitude of the contracture was measured by a goniometer. The quadratic weighted kappa statistics was very good for the upper limb spasticity (κw= 0.84). Intra-rater reliability was good for shoulder adductors (κw=0.75), and very good for elbow flexors and wrist flexors (κw 0.86 and 0.90, respectively). There were no differences between the weighted kappa values for muscle groups (p>0.05). The intra-rater reliability was also good in the presence of pain or contracture. The MMAS had very good intra-rater reliability in the assessment of upper limb spasticity in patients with hemiparesis. The presence of pain during shoulder abduction or contracture of the shoulder adductors had no influence on the reliability of the MMAS (κ w=0.75, 0.77, respectively).     

Glomus tumor of the duodenum: a case report

We describe a rare case of glomus tumor of the duodenum. The tumor was detected in a 46-year-old man being investigated for episodes of gastrointestinal bleeding. The excised specimen showed a 2.3 x 1.5 x 1.5 cm gray-tan tumor involving the mucosa and the submucosa. The overlying mucosa was focally ulcerated. Histologically, the tumor had a solid pattern of sharply demarcated, round glomus cells with prominent pericytoma-like vessels of varying sizes. The neoplastic cells stained for vimentin, smooth muscle actin, and focally for synaptophysin. These histologic and immunohistochemical features are consistent with a diagnosis of glomus tumor of the duodenum.     

Application of nanomedicine for crossing the blood–brain barrier: Theranostic opportunities in multiple sclerosis

Multiple sclerosis (MS) is an autoimmune neurodegenerative disease characterized with immunopathobiological events, including lymphocytic infiltration into the central nervous system (CNS), microglia activation, demyelination and axonal degeneration. Although several neuroprotective drugs have been designed for the treatment of MS, complete remission is yet matter of debate. Therefore, development of novel therapeutic approaches for MS is of a high priority in immunological research. Nanomedicine is a recently developed novel medical field, which is applicable in both diagnosis and treatment of several cancers and autoimmune diseases. Although there is a marked progress in neuroimaging through using nanoparticles, little is known regarding the therapeutic potential of nanomedicine in neurological disorders, particularly MS. Moreover, the majority of data is limited to the MS related animal models. In this review, we will discuss about the brain targeting potential of different nanoparticles as well as the role of nanomedicine in the diagnosis and treatment of MS and its animal model, experimental autoimmune encephalomyelitis.