Hearing Health Practices and Beliefs Among over 20 Year-olds in the Omani Population

Sultan Qaboos University Medical Journal. Aug, 2010  |  Pubmed ID: 21509236

The objective of this study was to investigate hearing health practices and beliefs among people over 20 years old in the Omani population.

A Supratentorial Primary Parenchymal Paraganglioma

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia. Jul, 2011  |  Pubmed ID: 21565510

Primary intracerebral paraganglioma is an unusual entity in the diagnostic armamentarium of the neurosurgeon. Only two patients have been described with a supratentorial intra-parenchymal subtype. We report a 40-year-old man who presented with features of raised intracranial pressure and secondary visual deterioration of short duration. His MRI showed a 2 cm by 2 cm by 2.5 cm, brilliantly enhancing lesion in the left frontal region with flow voids and disproportionate perilesional edema. Magnetic resonance angiography demonstrated a "sun-burst" appearance. The lesion was totally excised, with subsequent resolution of symptoms. Histopathology was reported as a paraganglioma. The systemic workup confirmed the primary intracerebral nature of the lesion. To our knowledge, this report documents a hitherto undescribed, exclusive intraparenchymal location of a rare benign lesion.

Successful Embolization of a Suprascapular Artery Aneurysm

Annals of Vascular Surgery. May, 2011  |  Pubmed ID: 21620668

A 45-year-old woman was referred to our service because 9 months earlier she had developed a pulsating mass on the right supraclavicular fossa and torticollis. Ultrasounds and computed tomographic arteriography showed the presence of a subclavian collateral artery aneurysm with a diameter of 21 mm. On selective arteriography, an aneurysm of a suprascapular artery arising directly from the right subclavian artery was reported. The presence of thoracic outlet syndrome was excluded. The aneurysm was successfully treated with ethylene-vinyl alcohol polymer, a liquid embolic agent. The patient was discharged on postoperative day 1 in good general condition. After 12 months, control ultrasounds confirmed the complete thrombosis of the aneurysm sac.

The Need for a Low-expense Universally Acceptable RhTSH Protocol

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. Jul, 2011  |  Pubmed ID: 21680682

Extinction of Care-Induced Vocalizations by a Desensitization Routine on a Palliative Care Unit

The American Journal of Hospice & Palliative Care. Sep, 2011  |  Pubmed ID: 21908456

Vocalizations during care occur frequently in patients with dementia, and are not uncommon in the palliative setting. Underlying trigger factors may include pain during movement, fear of being turned, startle reflex, attempts at verbal communication, environmental factors such as cold water, and other possible etiologies. A case of a 92 year old female who screamed and called out during bathing is presented. This patient with comorbid dementia and brain lesions did not respond to pre-event pain medication, and became somnolent due to opioid administration for presumed incident pain. A non-pharmacological approach, with a patient-centered focus rather than task orientation, succeeded in extinguishing the vocalizations after a period of six weeks.

Adult Mesenchymal Stem Cells and Cell Surface Characterization - a Systematic Review of the Literature

The Open Orthopaedics Journal. 2011  |  Pubmed ID: 21966340

Human adult mesenchymal stem cells (MSCs) were first identified by Friedenstein et al. when observing a group of cells that developed into fibroblastic colony forming cells (CFU-F). Ever since, the therapeutic uses and clinical applications of these cells have increased research and interest in this field. MSCs have the potential to be used in tissue engineering, gene therapy, transplants and tissue injuries. However, identifying these cells can be a challenge. Moreover, there are no articles bringing together and summarizing the cell surface markers of MSCs in adults. The purpose of this study is to summarize all the available information about the cell surface characterization of adult human MSCs by identifying and evaluating all the published literature in this field. We have found that the most commonly reported positive markers are CD105, CD90, CD44, CD73, CD29, CD13, CD34, CD146, CD106, CD54 and CD166. The most frequently reported negative markers are CD34, CD14, CD45, CD11b, CD49d, CD106, CD10 and CD31. A number of other cell surface markers including STRO-1, SH2, SH3, SH4, HLA-A, HLA-B, HLA-C, HLA-DR, HLA-I, DP, EMA, DQ (MHC Class II), CDIO5, Oct 4, Oct 4A, Nanog, Sox-2, TERT, Stat-3, fibroblast surface antigen, smooth muscle alpha-actin, vimentin, integrin subunits alpha4, alpha5, beta1, integrins alphavbeta3 and alphavbeta5 and ICAM-1 have also been reported. Nevertheless, there is great discrepancy and inconsistency concerning the information available on the cell surface profile of adult MSCs and we suggest that further research is needed in this field to overcome the problem.

Anthropometric Profile, Vertical Jump and Throwing Velocity, in Female Elite Anthropometric Profile, Vertical Jump and Throwing Velocity, in Female Elite Handball Players by Playing Positions

Journal of Strength and Conditioning Research / National Strength & Conditioning Association. Oct, 2011  |  Pubmed ID: 21997459

Female handball is a sport which has seen an accelerated development over the last decade. While anthropometric and physical characteristics have been studied for male sports team, in female handball, studies are scarce. The aim of this study was twofold: firstly, to describe anthropometric characteristics, throwing velocity, hand grip and muscular power of the lower limbs in female handball players, and secondly, to identify possible differences in these parameters in terms of individual playing positions (center, back, wing, pivot and goalkeeper). A total of 130 Spanish female elite handball players participated in the study (25.74 ± 4.84 years; 14.92 ± 4.88 years of playing experience). Anthropometric assessment was performed by all subjects following the International Society for the Advancement of Kinanthropometry (ISAK) protocols. Furthermore, all subjects performed a vertical jump test (Squat Jump and Countermovement Jump). Hand grip and throwing velocity in several situations were also assessed. A one-way analysis of variance (ANOVA), and a Tukey post hoc test were used to study differences among individual playing positions. Wings were less heavy, shorter and showed less arm span, than goalkeepers, backs and pivots. (p≤0.001). Additionally pivots were heavier than centers. Backs and pivots exhibited higher muscular mass than wings. Total player's somatotype was mesomorphy-endomorphy (3.89 - 4.28 - 2.29).Centers showed higher throwing velocity levels than wings in 9 m throws from just behind the line, with a goalkeeper. Backs exhibited higher hand grip values than wings. Statistical differences have been established between wings and others specific playing positions, especially with pivot and backs. Coaches can use this information in order to select players for the different specific positions.

Measurement of Atherosclerosis Markers in Patients With Periodontitis: A Case-Control Study

Journal of Periodontology. Nov, 2011  |  Pubmed ID: 22060049

Objective: Periodontitis is suggested to enhance the process of vascular inflammation leading to atherosclerosis. The present study explores the effect of periodontitis in relation to the clinical and ultrasound markers of carotid atherosclerosis. Methods: Sixty systemically healthy patients over 45 years of age (30 with chronic periodontitis and 30 without periodontitis) were studied in a university dental school. Traditional cardiovascular risk factors for atherosclerosis were evaluated. Carotid intima-media thickness (IMT) was assessed by ultrasound. Results: The IMT of the internal carotid was 0.77 and 0.81 mm, respectively, with no statistically significant differences between the two groups (p=0.538). There were significant differences in the presence of carotid atheroma plaques and the severity of periodontitis (p=0.003). In the logistic regression analysis, significant differences in terms of age and periodontitis were recorded in relation to the presence of atheroma plaques in the carotid intima. Conclusion: The severity of periodontitis was seen to influence the presence of carotid atheroma plaques.

A Smart Micro-drill for Cochleostomy Formation: A Comparison of Cochlear Disturbances with Manual Drilling and a Human Trial

Cochlear Implants International. Sep, 2011  |  Pubmed ID: 22333534

BACKGROUND: Cochleostomy formation is a key stage of the cochlear implantation procedure. Minimizing the trauma sustained by the cochlea during this step is thought to be a critical feature in hearing preservation cochlear implantation. The aim of this paper is firstly, to assess the cochlea disturbances during manual and robotic cochleostomy formation. Secondly, to determine whether the use of a smart micro-drill is feasible during human cochlear implantation. MATERIALS AND METHODS: The disturbances within the cochlea during cochleostomy formation were analysed in a porcine specimen by creating a third window cochleostomy, preserving the underlying endosteal membrane, on the anterior aspect of the basal turn of the cochlea. A laser vibrometer was aimed at this third window, to assess its movement while a traditional cochleostomy was performed. Six cochleostomies were performed in total, three manually and three with a smart micro-drill. The mean and peak membrane movement was calculated for both manual and smart micro-drill arms, to represent the disturbances sustained within cochlea during cochleostomy formation. The smart micro-drill was further used to perform live human robotic cochleostomies on three adult patients who met the National Institute of Health and Clinical Excellence criteria for undergoing cochlear implantation. RESULTS: In the porcine trial, the smart micro-drill preserved the endosteal membrane in all three cases. The velocity of movement of the endosteal membrane during manual cochleostomy is approximately 20 times higher on average and 100 times greater in peak velocity, than for robotic cochleostomy. The robot was safely utilized in theatre in all three cases and successfully created a bony cochleostomy while preserving the underlying endosteal membrane. CONCLUSIONS: Our experiments have revealed that controlling the force of drilling during cochleostomy formation and opening the endosteal membrane with a pick will minimize the trauma sustained by the cochlea by a factor of 20. Additionally, the smart micro-drill can safely perform a bony cochleostomy in humans under operative conditions and preserve the integrity of the underlying endosteal membrane.

Cochlear Implantation in a Patient with Sensori-neural Deafness Secondary to Charcot-Marie-Tooth Disease

Cochlear Implants International. Sep, 2011  |  Pubmed ID: 22333975

Objective and importance Charcot-Marie-Tooth (CMT) disease is the most common hereditary motor and sensory neuropathy and can result in profound sensori-neural hearing loss with deficiency in speech perception out of proportion to that which would be expected if the loss was cochlear in origin. This study investigates whether the reintroduction of auditory synchrony by means of cochlear implantation will improve speech perception in those with dys-synchrony related to impairment of temporal processing abilities secondary to CMT. Clinical presentation A 67-year-old male presented with a gradual but significant decrease in his hearing as part of a slowly progressing demyelinating peripheral neuropathy. On open-set speech discrimination he scored 0%. Intervention A Med-el Flex(SOFT) cochlear implant (CI) was fully inserted into the left ear with no surgical complications. The CI speech processor was fitted 1 month post-implantation and standardized speech assessments conducted at 1 week, 3 months, 9 months, and 21 months following initial fitting, gave open-set speech discrimination scores of 0, 0, 53, and 54%, respectively. Conclusion This report demonstrates that cochlear implantation is an option to rehabilitate severe-to-profound hearing loss in adults with auditory dys-synchrony secondary to CMT disease. Progress post-implantation is likely to be slower than for the average CI user.

Glaucoma Database

Bioinformation. 2011  |  Pubmed ID: 21383909

Glaucoma, a complex heterogenous disease, is the leading cause for optic nerve-related blindness worldwide. Primary open angle glaucoma (POAG) is the most common subset and by the year 2020 it is estimated that approximately 60 million people will be affected. MYOC, OPTN, CYP1B1 and WDR36 are the important candidate genes. Nearly 4% of the glaucoma patients have mutation in any one of these genes. Mutation in any of these genes causes disease either directly or indirectly and the severity of the disease varies according to position of the genes. We have compiled all the related mutations and SNPs in the above genes and developed a database, to help access statistical and clinical information of particular mutation. This database is available online at http:bicmku.in:8081/glaucoma The database, constructed using SQL, contains data pertaining to the SNPs and mutation information involved in the above genes and relevant study data. AVAILABILITY: The database is available for free at http:bicmku.in:8081/glaucoma.

The Direct Cost of Patients with Multiple Sclerosis: a Survey from Italian MS Centres

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. Dec, 2011  |  Pubmed ID: 21505911

Multiple sclerosis (MS) is a chronic progressive disease of the CNS causing disability and neurological symptoms that carry a substantial burden. Previous Italian studies appear outdated, and investigation on the burden of recently marketed drug treatments should provide further economic evidence for policy makers. The objective of the study was to investigate patterns of care, resource consumption and direct medical cost of MS, in the perspective of the public health-care provider. Ten MS experts from public centres extracted and reported data of all MS patients seen during 2009, using a detailed questionnaire. The data of 8,326 MS patients were analysed: the course was relapsing-remitting in 5,376 (62%), secondary progressive in 1,798 (23%) and primary progressive in 691 (9%); 461 (6%) had a clinically isolated syndrome. The EDSS score was 0-3.5 in 5,118 (61%) patients, 4-6.5 in 2,408 (29%) and 7-9.5 in 800 (10%). The average cost of diagnosis (N = 694) was 1,236 €/patient with large variations between centres due to the chosen diagnostic setting. The average direct medical cost for biological disease-modifying drugs (bio-DMD) was 10,444 €/patient/year (cost/patient by primary drug: 9,501 € for interferon (IFN)-beta1a-im; 8,553 € for IFN-beta1b; 11,255 € for IFN-beta1a-sc44; 9,883 € for IFN-beta1a-sc22; 8,174 € for glatiramer acetate (GA); 21,817 € for natalizumab) and 3,151 € for non-bio-DMD. The cost of diagnosis is largely influenced by care setting, due to local health-care provision patterns. The annual medical cost/patient is largely driven by the cost of drugs (89.2% of total); GA represents the least expensive bio-DMD in the Italian health-care setting.

Tobacco Addiction and The Risk of Upper Aerodigestive Tract Cancer in A Multicenter Case-Control Study

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337537

BACKGROUND: While previous studies on tobacco and alcohol and the risk of upper aerodigestive tract (UADT) cancers have clearly shown dose-response relations with the frequency and duration of tobacco and/or alcohol, studies on addiction to tobacco itself as a risk factor for UADT cancer have not been published, to our knowledge. The aim of this report is to assess whether smoking addiction is a risk factor for UADT SCC risk in the multicenter case-control study (ARCAGE) in Western Europe independent of tobacco smoking or alcohol drinking intensity or duration.METHODS: The analyses included 1,905 ever smoking UADT SCC cases (871 oral cavity/oropharynx, 814 hypopharynx/larynx, 127 esophagus, and 93 overlapping oral cavity/pharynx) and 1,489 ever smoking controls. The addiction variables included first cigarette after waking up, difficulty refraining from smoking in places where it is forbidden, and cigarettes per day. Odds ratios (OR) and 95% confidence intervals (95% CI) for UADT cancers with addiction variables were estimated with unconditional logistic regression, adjusting for center, age, sex, education level, alcohol consumption, and tobacco smoking.RESULTS: Among current smokers, 76.47% of cases were categorized in the highest addiction level, whereas 54.69% of controls were in that category. The participants who smoked their first cigarette within 5 minutes of waking up were two times more likely to develop UADT SCC (OR = 2.22, 95% CI 1.57-3.15) than those who smoked 60 minutes after waking up. A higher modified Fagerstram score, reflecting greater tobacco addiction, was associated with an increased risk of UADT SCC among current smokers, but not among former smokers.CONCLUSION: We observed that time to first cigarette after waking up was associated with UADT SCC risk, regardless of heavy smoking or alcohol drinking behaviors. These results are consistent with residual effect of smoking that was not captured by the questionnaire responses alone. Cancer Epidemiol Biomarkers Prev; 21(3); 1-9. ©2012 AACR.

Immune Responses Contribute to Depression, Fatigue, and Pain in Hematopoietic Stem Cell Transplant Recipients

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337541

Ruminant Fatty Acids and Prostate Cancer Risk in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study

Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology. Feb, 2012  |  Pubmed ID: 22337551

Peripheral Blood MRNA Expression Patterns to Differentiate Hepatocellular Carcinoma from Other Hepatic Diseases

Frontiers in Bioscience (Elite Edition). 2012  |  Pubmed ID: 22201899

Peripheral blood genes expressions profiling (GeXP) have been convinced to be more specific for the diagnosis of cancer and other diseases, and the GeXP system provides an ideal method to analyze multiple genes expression in one normalized and equable system. We aim to differentiate hepatocellular carcinoma from other hepatic diseases based on peripheral blood and the GeXP system. Fifteen selected hepatic diseases related genes with two house-keeping genes for normalization were detected by the GeXP system. The diagnosis model was based on K nearest neighbor classifier and cross validation, and software based on MATLAB software was built for differential diagnosis of hepatic diseases. Eight hepatic related genes were demonstrated to show an obvious statistic difference in expressions while the K nearest neighbors classifier showed that the accuracy for normal controls, hepatitis B, liver cirrhosis, hepatocellular carcinoma and the Other group was separately 80.57 %, 78.17 %, 84.48 %, 73.24 % and 85.85 %. The set of validation has been carried out to assess the accuracy of Model Two and the accuracy was even higher than the set of building for the model, except for the hepatitis B (HBV) group. A sensitive and specific GeXP system of eight genes has been developed for the accurate differential diagnosis of hepatic disease.

De Novo Identification of Viral Pathogens from Cell Culture Hologenomes

BMC Research Notes. Jan, 2012  |  Pubmed ID: 22226071

ABSTRACT: BACKGROUND: Fast, specific identification and surveillance of pathogens is the cornerstone of any outbreak response system, especially in the case of emerging infectious diseases and viral epidemics. This process is generally tedious and time-consuming thus making it ineffective in traditional settings. The added complexity in these situations is the non-availability of pure isolates of pathogens as they are present as mixed genomes or hologenomes. Next-generation sequencing approaches offer an attractive solution in this scenario as it provides adequate depth of sequencing at fast and affordable costs, apart from making it possible to decipher complex interactions between genomes at a scale that was not possible before. The widespread application of next-generation sequencing in this field has been limited by the non-availability of an efficient computational pipeline to systematically analyze data to delineate pathogen genomes from mixed population of genomes or hologenomes. FINDINGS: We applied next-generation sequencing on a sample containing mixed population of genomes from an epidemic with appropriate processing and enrichment. The data was analyzed using an extensive computational pipeline involving mapping to reference genome sets and de-novo assembly. In depth analysis of the data generated revealed the presence of sequences corresponding to Japanese encephalitis virus. The genome of the virus was also independently de-novo assembled. The presence of the virus was in addition, verified using standard molecular biology techniques. CONCLUSIONS: Our approach can accurately identify causative pathogens from cell culture hologenome samples containing mixed population of genomes and in principle can be applied to patient hologenome samples without any background information. This methodology could be widely applied to identify and isolate pathogen genomes and understand their genomic variability during outbreaks.

PIVKA-II Plasma Levels As Markers of Subclinical Vitamin K Deficiency in Term Infants

The Journal of Maternal-fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians. Feb, 2012  |  Pubmed ID: 22280352

Abstract Background: As the vitamin K content of human milk is low and the newborn infant's stores of vitamin K are small, vitamin K deficiency with hemorrhage in the newborn is a worldwide problem. Proteins Induced by Vitamin K Absence (PIVKA-II) are the inactive under-?-carboxylated forms of vitamin K-dependent clotting factors and they could be useful in predicting subclinical vitamin K deficiency (VKD). Objectives: To demonstrate that PIVKA-II are earlier markers of subclinical VKD than Prothrombin time (PT) in exclusively breast fed newborns. Methods: A prospective, controlled, randomized study, including 53 term newborns receiving vitamin K prophylaxis (0.5 mg im) at birth, was performed. At 30 days newborns were divided into three groups (G) receiving respectively: 25 ?g/die of vitamin K (G I), 12 ?g/die (G II) or placebo (G III). PIVKA II and PT were measured on 30th and 90th days of life. Results: G III and GII showed a significant increase in PIVKA II from 30 to 90 days of life respectively from 2.6 to 4.7 (p = 0.001) and from 2.3 to 3.5 (p<0.001). No significant changes were found in GI. PT showed no significant changes among groups. Conclusions: PT is a less sensitive marker than PIVKA II. Oral supplementation with 25 ?g/die avoids an increase of PIVKA II. Despite increased PIVKA II do not mean an impending occurrence of bleeding, they highlight a subclinical VKD and its relative risk.

Cox-2 Expression in Gingival Biopsies From Periodontal Patients is Correlated With Connective Tissue Loss

Journal of Periodontology. Feb, 2012  |  Pubmed ID: 22324469

Objectives: The objective of this study was to compare cyclooxygenase-2 (COX-2) protein expression in gingival biopsies from chronic periodontitis patients, gingivitis patients and individuals with no periodontal disease (control group) and to establish its relationship with clinical variables and connective tissue loss in lamina propria. Material and Methods: A cross-sectional and analytic study was conducted in 108 gingival biopsies from 52 patients with chronic periodontitis, 39 with gingivitis and 17 with no periodontal disease. All biopsies were processed for conventional histopathological study, immunohistochemical determination of COX-2 protein expression and automatic quantification of connective tissue by image analysis. Results: The protein expression of COX-2, mainly produced by plasma cells and monocytes, was significantly related to the presence of periodontal disease, bleeding index, intensity of inflammatory infiltrate and loss of connective tissue in lamina propria of gingival biopsies (p<0.01, Spearman test). COX-2 expression was also directly correlated with attachment loss (p<0.05, Spearman test). Conclusion: COX-2 protein expression is higher in patients with gingivitis and chronic periodontitis than in non-periodontal patients and is inversely correlated with the amount of connective tissue in lamina propria as determined by image analysis. This finding suggests that COX-2 participates in mechanisms and pathway signalling related to the destruction of fibrillar support structures of the periodontium.

PI and Fuzzy Logic Controllers for Shunt Active Power Filter--a Report

ISA Transactions. Jan, 2012  |  Pubmed ID: 21982358

This paper presents a shunt Active Power Filter (APF) for power quality improvements in terms of harmonics and reactive power compensation in the distribution network. The compensation process is based only on source current extraction that reduces the number of sensors as well as its complexity. A Proportional Integral (PI) or Fuzzy Logic Controller (FLC) is used to extract the required reference current from the distorted line-current, and this controls the DC-side capacitor voltage of the inverter. The shunt APF is implemented with PWM-current controlled Voltage Source Inverter (VSI) and the switching patterns are generated through a novel Adaptive-Fuzzy Hysteresis Current Controller (A-F-HCC). The proposed adaptive-fuzzy-HCC is compared with fixed-HCC and adaptive-HCC techniques and the superior features of this novel approach are established. The FLC based shunt APF system is validated through extensive simulation for diode-rectifier/R-L loads.