Τρίτη 27 Απριλίου 2021

Chronic administration of pharmacological doses of angiotensin 1-7 and iodoangiotensin 1-7 has minimal effects on blood pressure, heart rate, and cognitive function of spontaneously hypertensive rats

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Physiol Rep. 2021 Apr;9(7):e14812. doi: 10.14814/phy2.14812.

ABSTRACT

Cardiovascular diseases are the principal cause of death worldwide, with hypertension being the most common cardiovascular disease risk factor. High blood pressure (BP) is also associated with an increased risk of poor cognitive performance and dementia including Alzheimer's disease. Angiotensin 1-7 (Ang 1-7), a product of the renin-angiotensin system (RAS), exhibits central and peripheral actions to reduce BP. R ecent data from our lab reveals that the addition of a non-radioactive iodine molecule to the tyrosine in position 4 of Ang 1-7 (iodoAng 1-7) makes it ~1000-fold more potent than Ang 1-7 in competing for the 125 I-Ang 1-7 binding site (Stoyell-Conti et al., 2020). Moreover, the addition of the non-radioactive iodine molecule increases (~4-fold) iodoAng 1-7's ability to bind to the AT1 receptor (AT1R), the primary receptor for Ang II. Preliminary data indicates that iodoAng 1-7 can also compete for the 125 I-Ang IV binding site with a low micromolar IC50. Thus, our aims were to compare the effects of chronic treatment of the Spontaneously Hypertensive Rat (SHR) with iodoAng 1-7 (non-radioactive iodine isotope) and Ang 1-7 on arterial pressure, heart rate, and cognitive function. For this study, male SHRs were divided into three groups and treated with Saline, Ang 1-7, or iodoAng 1-7 administrated subcutaneously using a 28-day osmotic mini pump. Systolic BP was m easured non-invasively by the tail-cuff technique. Cognitive function was assessed by Y-Maze test and novel object recognition (NOR) test. We have demonstrated in SHRs that subcutaneous administration of high doses of iodoAng 1-7 prevented the increase in heart rate with age, while Ang 1-7 showed a trend toward preventing the increase in heart rate, possibly by improving baroreflex control of the heart. Conversely, neither Ang 1-7 nor iodoAng 1-7 administered subcutaneously affected BP nor cognitive function.

PMID:33904655 | DOI:10.14814/phy2.14812

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Increasing prediction accuracy of pathogenic staging by sample augmentation with a GAN

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by ChangHyuk Kwon, Sangjin Park, Soohyun Ko, Jaegyoon Ahn

Accurate prediction of cancer stage is important in that it enables more appropriate treatment for patients with cancer. Many measures or methods have been proposed for more accurate prediction of cancer stage, but recently, machine learning, especially deep learning-based methods have been receiving increasing attention, mostly owing to their good prediction accuracy in many applications. Machine learning methods can be applied to high throughput DNA mutation or RNA expression data to predict cancer stage. However, because the number of genes or markers generally exceeds 10,000, a considerable number of data samples is required to guarantee high prediction accuracy. To solve this problem of a small number of clinical samples, we used a Generative Adversarial Networks (GANs) to augment the samples. Because GANs are not effective with whole genes, we first selected significant genes using DNA mutation data and random forest feature ranking. Next, RNA expression data for selected genes were expanded using GANs. We compared the classification accuracies using original dataset and expanded datasets generated by proposed and existing methods, using random forest, Deep Neural Networks (DNNs), and 1-Dimensional Convolutional Neural Networks (1DCNN). When using the 1DCNN, the F1 score of GAN5 (a 5-fold increase in data) was improved by 39% in relation to the original data. Moreover, the results using only 30% of the data were better than those using all of the data. Our attempt is the first to use GAN for augmentation using numeric data for both DNA and RNA. The augmented datasets obtained using the proposed method demonstrated significantly increased classification accuracy for most cases. By using GAN and 1DCNN in the prediction of cancer stage, we confirmed that good results can be obtained even with small amounts of samples, and it is expected that a great deal of the cost and time required to obtain clinical samples will be reduced. The proposed sample augmentatio n method could also be applied for other purposes, such as prognostic prediction or cancer classification.
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Die Behandlung von Schilddrüsenmalignomen aus HNO-ärztlicher Sicht

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Laryngorhinootologie
DOI: 10.1055/a-1475-4939

Einleitung Die Zahl der Schilddrüsenmalignome zeigt eine deutliche Zunahme. Da die Schilddrüse an der HNO-Klinik Bad Hersfeld im Fokus steht, war dies für uns Anlass, unsere Behandlungsresultate zu untersuchen und Erfahrungen darzustellen. Material und Methoden Es handelt sich um eine Untersuchung beginnend im Jahre 2014 bis zum Juli 2020. Es wurden alle Patienten mit Schilddrüsenmalignomen erfasst und wichtige demografische und medizinische Parameter wie Alter, Geschlecht, Histologie, Calcium, OP-Dauer, Rekurrensparese etc. registriert. Ergebnisse Es wurden insgesamt 63 Patienten mit malignen Schilddrüsenerkrankungen eingeschlossen. Davon waren 42 weiblichen und 21 männlichen Geschlechts. Die Altersspanne reichte von 11 bis zu 95 Jahren. Patienten mit differenzierten Schilddrüsenkarzinomen waren im Schnitt jünger als diejenigen mit anaplastischen Malignomen. Histologisch dominierten die papillären Schilddrüsenkarzinome mit 65 % (n = 41) gegenüber anderen Varianten wie dem follikulären (n = 6), medullären (n = 5) und entdifferenzierten Karzinom (n = 6). Alle Patienten wurden einer operativen Behandlung unterzogen; postoperativ erhielten die Betroffenen mit fortgeschrittenen, differenzierten Karzinomen eine Radiojodtherapie. Von den Patienten mit einem entdifferenzierten Karzinom sind alle ihrem Leiden erlegen, während nach unserer Kenntnis nur eine Betroffene mit einem differenzierten Malignom tumorbedingt verstorben ist. Schlussfolgerung In die Behandlung von malignen Schilddrüsenerkrankungen ist der HNO-Arzt eingebunden. Wie bei den benignen Erkrankungen der endokrinen Halsorgane ist eine interdisziplinäre Zusammenarbeit entscheidend.
[...]

Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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Dermatomyositis als paraneoplastisches Syndrom bei Kopf-Hals-Malignomen: Fallserie & Literaturreview

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Laryngorhinootologie
DOI: 10.1055/a-1408-6551

Einleitung/Ziel Die Dermatomyositis (DM) ist eine seltene Erkrankung, die sich klinisch durch Schwäche und Schmerzen proximaler Muskeln sowie fliederfarbene Hautveränderungen manifestiert. In fast einem Fünftel der Fälle ist die DM mit dem Auftreten von Tumorerkrankungen assoziiert. Ziel dieser Untersuchung ist die Bewertung der Bedeutung der DM als paraneoplastisches Syndrom bei Malignomen im Kopf-Hals-Bereich unter Berücksichtigung der aktuellen Literatur. Material/Methoden Nach retrospektiver Krankenaktenanalyse der Jahre 2008–2018 von Patienten mit Kopf-Hals-Malignomen fanden sich 8 Patienten mit einer Dermatomyositis: 4 Patienten mit Tonsillenkarzinom, 1 Patient mit Nasopharynxkarzinom, 1 Patient mit Parotiskarzinom und 2 Patienten mit Lymphomen. Es wurden die Diagnostik, Therapie und Behandlungsergebnisse der Fälle beschrieben. Zudem erfolgte eine selektive Analyse der Literatur (PubMed) zur DM bei HNO-Tumoren. Bei dieser fanden sich insgesamt 290 Fälle: die Malignome waren in 283 Fällen im Nasopharynx, in 5 Fällen in der Tonsille und in 2 Fällen im Hypopharynx lokalisiert. Ergebnisse/Schlussfolgerung Eine DM als paraneoplastisches Syndrom bei Kopf-Hals-Malignomen ist selten. Sie tritt häufiger in Assoziation mit Nasopharynxkarzinomen und selten bei Tonsillenkarzinomen auf.Das gehäufte Auftreten der DM bei Kopf-Hals-Malignomen in Abhängigkeit von der ethnischen Verteilung (Nasopharynxkarzinome – asiatische Abstammung, Tonsillenkarzinom – kaukasische Abstammung) ist möglicherweise auch auf regionale Inzidenzunterschiede der genannten Tumorentitäten zurückzuführen.Bei Patienten mit einer DM sollte ein Tumorausschluss auch im Kopf-Hals-Bereich erfolgen, insbesondere bei Vorliegen einer zervikalen Lymphadenopathie. Der Verlauf einer tumorassoziierten DM wird durch die Tumortherapie positiv beeinflusst. Therapeutisch ist aber auch eine konsequente Behandlung der DM die Grundlage für eine erfolgreiche Tumortherapie.
[...]

Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

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Revision canal-wall down surgery: comparison of surgical outcomes with three different techniques

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Eur Arch Otorhinolaryngol. 2021 Apr 27. doi: 10.1007/s00405-021-06829-y. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to analyze the role of the endoscope in revision canal-wall down (CWD) tympanomastoid surgery and compare its use to the more traditional microscopic approach. Moreover, we aim to investigate functional outcomes of revision surgeries in a cohort of two tertiary reference centers.

METHODS: A total of 103 patients undergoing revision surgery after previous CWD tympanomastoidectomy were included in the present study and divided in three groups according to the surgical technique used: endoscope exclusive (n = 22), combined (n = 35) and microscope exclusive (n = 46). Data regarding surgical indications, pre-operative clinical and audiological assessments, intraoperative findings and surgical considerations were extracted. During follow-up, data regarding anatomic and audiologic outcomes were collected a nd persistence or recurrence of the disease assessed.

RESULTS: The most frequent sites of cholesteatoma recurrence or persistence was the anterior epitympanum. There was a statistically significant ABG improvement of - 6.02 dB HL (95% CI - 8.87 to - 3.16, p < 0.001) between pre-operative and postoperative ABG, without significant effect of surgical technique. During follow-up, no significant differences regarding disease or otorrhea control were observed. Duration of surgery and hospitalization was shorter in the endoscopic cohort without statistical significance. Intra- and postoperative complications were lower in the endoscopic group.

CONCLUSION: Revision CWD surgery can take advantage of the endoscope as a minimally invasive exclusive or adjunct tool to traditional microscopic procedures. Outcome measures of endoscopic revision CWD surgery showed anatomic and functional results comparable to those of the microscopic group. The complication rate, the duration of su rgery and hospitalization were favorable in the endoscopic group.

PMID:33904981 | DOI:10.1007/s00405-021-06829-y

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Δευτέρα 26 Απριλίου 2021

Homologación lingüística al idioma español, en población chilena, de la herramienta Sunnybrook Facial Grading System para evaluar parálisis facial. Estudio piloto

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Resumen Introducción: La parálisis facial es una patología muy común. La escala "Sunnybrook Facial Grading System" (SFGS) se ha posicionado como una herramienta útil y confiable para su evaluación y evolución. Objetivo: Homologar lingüísticamente desde el idioma inglés al español la escala SFGS en una muestra de población chilena. Material y Método: Tres kinesiólogos chilenos con dominio comprobado del idioma inglés tradujeron la escala SFGS al español. Un comité creó una primera versión de la SFGS en español. Posteriormente, un profesional del Instituto Chileno-Británico tradujo la primera versión nuevamente al inglés (retrotraducción). El comité definió la segunda versión de la SFGS. Finalmente, los investigadores llevaron a cabo los pilotajes. Resultados: En dos pruebas piloto, veinte sujetos respondieron correctamente el total de las expresiones solicitadas. Conclusión: Esta versión de la escala SFGS homologada lingüísticamente al esp añol puede ser aplicada a la población chilena.
Abstract Introduction: Facial paralysis is a very common pathology. The Sunnybrook Facial Grading System (SFGS) scale has positioned itself as a useful and reliable tool for its evaluation and follow up. Aim: To linguistically homologate the SFGS scale in a sample of the Chilean population from English to Spanish. Material and Method: Three Chilean kinesiologists with English proficiency translated the SFGS scale into Spanish. A committee developed a first version of the SFGS in Spanish. Subsequently, a professional from the Chilean-British Institute translated the first version back into English (back-translation). The committee defined the second version of the SFGS. Finally, the investigators carried out the pilots. Results: In two pilot tests, twenty subjects correctly answered the total of the expressions requested. Conclusion: This version of the SFGS scale linguistically homologated to Spanish can be applied to the Chi lean population.
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Valores referenciales de posturografía basada en Nintendo Wii en población chilena

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Resumen Introducción: La posturografía es un método de exploración complementario para valorar el grado de desplazamiento del centro de gravedad (COP); no debe usarse de forma aislada al evaluar equilibrio, pero se acepta para seguimiento de la respuesta a tratamiento. Es de baja disponibilidad, por su alto costo comercial. Como alternativa se documenta la plataforma Wii Balance Board (WBB) de Nintendo para registro posturográfico. Objetivo: Describir valores de normalidad en parámetros posturográficos en población chilena sin patología vestibular, usando un registro simple y accesible. Material y Método: Estudio transversal de valores referenciales en herramienta para evaluación del equilibrio. Se registraron valores posturográficos con versión adaptada del Sensory Organization Test (SOT) a adultos sanos. Mediciones con software WBB Sway Program mediante WBB. Se midieron índices somatosensorial, visual y vestibular, y patrones de control postural en ejes anter oposterior y mediolateral durante SOT-adaptado. Resultados: Se obtuvieron valores de velocidad de desplazamiento del COP, área del COP y desviaciones estándar correspondientes para 4 situaciones del SOT-adaptado de 35 sujetos entre 18-65 años, 21 mujeres, 14 hombres. Discusión: WBB permitió evaluar estos parámetros en población sana, como aproximación a determinar rangos de referencia. Esta herramienta de uso rápido y accesible constituye una alternativa útil para determinar patrones de control postural en sujetos sanos. Presentamos valores a utilizar como rango referencial en nuestra población; se sugiere utilizar estos valores como objetivo terapéutico en rehabilitación vestibular en pacientes evaluados en conjunto con otros parámetros clínico-sintomáticos.
Abstract Introduction: Posturography is a complementary method for evaluating the center of pressure (COP) displacement; it should not be used in isolation when assessing balance, but it is accepted for fo llow-up of the treatment response. Due to its high commercial cost and low availability, we documented the Nintendo Wii Balance Board (WBB) as an alternative for posturography. Aim: To describe the normal range of posturography parameters in the Chilean population without vestibular pathology, using a simple and accessible registry method. Material and Method: Cross-sectional study of referential values in a balance assessment tool. Posturography values were registered using an adapted version of the Sensory Organization Test (SOT) on healthy adults. Measurements with WBB Sway Program software through WBB. With adapted-SOT, somatosensory, visual and vestibular indices, as well as anterior/posterior and mediolateral axes postural control patterns, were measured. Results: Values of displacement velocity of the COP, COP area and corresponding standard deviations were obtained for 4 SOT-adapted situations from 35 subjects between 18-65 years, 21 women, 14 men. Discussion: As an appr oach to determine referential range values, WBB allowed to evaluate these parameters in healthy population. To determine healthy subjects postural control patterns this quick and accessible tool is a useful alternative. We present referential range values to use in our population; it is suggested to use these values as therapeutic objectives in vestibular rehabilitation in patients evaluated along with other clinical-symptomatic parameters.
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