BD Group Research Articles

Comparison of inflammatory, nutrient, and neurohormonal indicators in patients with schizophrenia, bipolar disorder and major depressive disorder

Psychiatric disorders are severe, debilitating conditions with unknown etiology and are commonly misdiagnosed, when based solely on clinical interviews, because of overlapping symptoms and similar familial patterns. Until now, no valid and objective biomarkers have been used to diagnose and differentiate between psychiatric disorders. We compared clinically tested serum indicators in terms of inflammation (C-reactive protein, complement proteins C3 and C4, and serum Immunoglobulins A, M, and G), nutrients (homocysteine, folate, and vitamin B12), and neurohormones (adrenocorticotropic hormone and cortisol) in patients with schizophrenia (SCZ, n = 1659), bipolar disorder (BD, n = 1901), and major depressive disorder (MDD, n = 1521) to investigate potential biomarkers. A receiver operating characteristic (ROC) curve was used to analyze the diagnostic potential of these analytes. We found that compared with MDD, serum levels of C-reactive protein, C3, C4, and homocysteine were higher in SCZ and BD groups, and folate and vitamin B12 were lower in SCZ and BD groups. In contrast with BD, adrenocorticotropic hormone and cortisol increased in patients with MDD. Although ROC analysis suggested that they were not able to effectively distinguish between the three, these biological indicators showed different patterns in the three disorders. As such, more specific biomarkers should be explored in the future.

COMPARATIVE STUDY OF EFFECTIVENESS OF VENLAFAXINE, DULOXETINE AND SERTRALINE IN MANAGEMENT OF DIABETIC SENSORY NEUROPATHY

Objective: To compare efficacy of 3 commonly prescribed anti-depressants from classes’ selective serotoninreuptake inhibitor and serotonin-nor epinephrine reuptake inhibitors i.e. Venlafaxine, Duloxetine and Sertralinein the management of diabetic sensory neuropathy in subjects with type 2 diabetes mellitus.
 Study Design: Comparative, prospective study.
 Place and Duration of Study: Combined Military Hospital Jhelum, Mar 2018 to Jul 2018.
 Methodology: This study included 94 patients with metabolically stable type 2 Diabetes Mellitus with diabeticsensory neuropathy. Patients were randomly assigned into 3 treatment group, treatment group 1 (n1=29) receiving Venlafaxine 37.5mg × BD, treatment group 2 (n2=33) receiving duloxetine 30mg × BD and treatment group 3 (n3=25) receiving Sertraline 50mg × OD, each group being treated for 6 weeks, with optional dose titration fortnightly. The efficacy measure was done by revised Neuropathy Disability Score (NDS), measured at baseline and at the end of treatment period i.e. 6 weeks. The primary outcome of this study was “functional outcome” assessed by Disability Neuropathy scale (DNS) and overall improvement and adverse events were measured as secondary outcome measures.
 Results: There was significant improvement in Neuropathy Disability scale (DNS) at the end of treatment periodin all treatment groups from their baseline score, with comparable efficacy among all drug groups i.e. p-valuebetween venlafaxine and duloxetine, venlafaxine and sertraline were non-significant i.e. p>0.05 except betweenDuloxetine and Sertraline group where there was significant difference in efficacy (p<0.05). Good, moderate andmild improvement in symptoms was noticed in all study groups.
 Conclusion: Non-tricyclic Anti-depressants i.e. Venlafaxine..........

Comparison of Dexamethasone Composition with Bupivacaine and Dexmedetomidine with Bupivacaine and Bupivacaine alone in a Supraclavicular Block with Low Volume

Background: Regional blocks is a good alternative to general anesthesia in upper extremity surgeries. Supraclavicular is a kind of regional block which can be used to treat nerve block in the upper extremity. The ancillary drugs are nowadays used to enhance the quality and quantity of sensory and motor block. The present study has attempted to investigate the effect of three prescription drugs (composition Dexamethasone with Bupivacaine and Dexmedetomidine with Bupivacaine and Bupivacaine alone) on supraclavicular block. Methods: This parallel Design study was conducted in 2017 as a clinical trial at Ayatollah Taleghani Hospital in Tehran. For this purpose, 60 patients over the age of 18 and in class I, II of the American Anesthesiology Association (ASA) who were candidates for upper limb elective surgery, were enrolled. Patients included in the study (60 patients) were randomly divided into three equal groups (n= 20). Anesthesia procedure was performed for all patients in three equal groups. However, to evaluate the efficacy of selected drugs, different drugs were injected into each group. After completing the design and recording the results of the variables under study, the ttest was used to compare quantitative variables between the two groups. All statistical tests were performed in two domains (5% significance level) and SPSS 21 software was used for data analysis. Results: In the levels of intraoperative factors in the comparative conditions of the BB1 with BDexa2 and BB with BDex3 groups. However, Duration of Sensory Block (P=0.004) and Duration of Movement Block (P=0.001) were significantly different in BD and BDex groups. Conclusion: What can be clearly seen in the results are the significant changes of Duration of Sensory Block and Duration of Movement Block compared to the BDexa and BDex groups. Based on these results, in both cases we find a significant decrease in the measured duration in the BDexa group compared to the opposite group. Use of Bupivacaine + Dexamethasone has a more positive effect on Supraclavicular block compared to Bupivacaine + Dexmedetomidine and Bupivacaine alone.

Association of NAFLD and Insulin Resistance with Non Metastatic Bladder Cancer Patients: A Cross-Sectional Retrospective Study.

Among risk factors (apart from smoking) likely involved in bladder cancer (BCa), metabolic syndrome (MS), obesity and type 2 diabetes mellitus (T2DM) have been explored with contrasting results. In spite of these studies, there is little data on the association between nonalcoholic fatty liver disease (NAFLD), its main driver, i.e., insulin resistance (IR), and BCa. Implanting a cross-sectional retrospective study we tried to investigate both NAFLD and IR prevalence in a hospital based population of BCa patients. We studied laboratory data from 204 patients with histologically confirmed non metastatic BCa and 50 subjects with no BCa, but with bladder diseases (no Ca BD). We evaluated the presence of NAFLD by the triglycerides/glucose Index (TyG Index), using a cut-off of 0.59 and by the Aspartate Aminotransferase/Alanine Aminotransferase AST/ALT ratio. IR was assessed by the same TyG Index (cut-off 4.68) and the triglycerides/High-Density Lipoprotein HDL ratio (cut-off 2.197). The diagnosis of impaired fasting glucose (IFG), condition of prediabetes, as well as that of T2DM was assessed according to canonical guidelines. The TyG Index predicted NAFLD presence in both groups (p = 0.000), but the BCa group showed a major percentage of NAFLD cases with respect to no Ca BD group (59% versus 40%). A greater proportion of IR (47%) in BCa group than in no Ca BD one (37%) was evidenced by the TyG Index with its median value significantly different (p = 0.0092). This high rate of IR in the BCa group was confirmed by the triglycerides/HDL ratio (p = 0.02). Prediabetes and T2DM were more prevalent in the BCa group than no Ca BD group (p = 0.024). In this study a consistent NAFLD presence was found in BCa patients. This is an important comorbidity factor that deserves further consideration in prospective studies. The higher prevalence of NAFLD, IR, prediabetes and T2DM in the BCa group evidences the need that these disorders should be reckoned as adjunct factors that could impact on this cancerous disease.

Diagnosis of Beh\xe7et\u2019s disease: clinical characteristics, diagnostic criteria, and differential diagnoses

BackgroundThe diagnosis of Behçet disease (BD) is challenging in many cases. The purpose of this study was to describe the clinical characteristics of patients at a referral BD clinic.MethodsIn a retrospective study, we collected data from patients at a national referral Behçet clinic from November 2018–August 2019. A BD diagnosis was confirmed (BD group) or ruled out (Non-BD group), and the two groups were compared for differences.ResultsA total of 238 patients satisfied the inclusion criteria. Forty patients (16.8%) were finally diagnosed with BD. Ocular and genital lesions were significantly more prevalent in the BD group. A positive pathergy test and HLA-B51 were also significantly more common in BD. However, oral lesions, articular involvement, and gastrointestinal manifestations were similar between groups. Also, patients with BD were significantly more likely to have multi-organ (≥2 organ systems) involvement.ConclusionsBeing the first study to evaluate the clinical characteristics of patients who are visited at a referral BD clinic and are believed to have a high probability of Behçet, the results of this study are important from an epidemiological standpoint. Also, the findings of this study could be used by referral Behçet clinics, which evaluate and diagnose patients with a high pretest probability and atypical presentations of BD on a daily basis. The alternative diagnoses established in this study could be used as the list of the most common differential diagnoses for Behçet’s disease.

Cervical vestibular evoked myogenic potential and high-frequency audiometry results in Beh\xe7et\u2019s disease

BackgroundHearing is commonly impaired in Behçet’s disease (BD). Also, vestibular abnormalities as well as cochlear function affection have been found. The inflammatory process which leads to BD may be the cause of vestibular frequency audiometry abnormalities in those patients. The aim of this study is to assess hearing and vestibulo-colic reflex in Behçet patients using convential pure-tone audiometry (cPTA), high-frequency audiometry (HFA), and cervical vestibular evoked myogenic potential (cVEMP).ResultsThis study included 25 patients with BD (group I), whose age ranged from 21 to 45 years, with a mean age of 34.24 ± 7.07 years. The control group (group II) comprised 20 normal adults whose ages are between 21 and 45 years, with a mean age of 30.8 ± 8.02 years. The measured cVEMP parameters which include the mean peak latency of P13 and the mean peak latency of N23 were statistically significantly different between the patients suffering from BD and the control groups. All BD patients had high-frequency sensorineural hearing loss (SNHL) starting from 4 up to 12.5 kHz. The mean thresholds of the audiometry were significantly higher in the diseased group.ConclusioncVEMP testing can be used for the evaluation of the vestibulo-colic reflex in BD patients. The occurrence of hearing loss especially in high-frequency regions is a common finding in patients suffering from BD, and a HFA may be a valuable tool in early exploration of hearing loss in patients with BD.

Comparative evaluation of efficacy of external vibrating device and counterstimulation on child's dental anxiety and pain perception during local anesthetic administration: a clinical trial.

BackgroundThis study aimed to evaluate the efficacy of external vibrating devices and counterstimulation on a child's dental anxiety, apprehension, and pain perception during local anesthetic administration.MethodsThis was a prospective, randomized, parallel-arm, single-blinded interventional, clinical trial. One hundred children aged 4–11 years, requiring pulp therapy or extraction under local anesthesia (LA), were recruited and allocated equally into two groups (1:1) based on the interventions used: Group BD (n = 50) received vibration using a Buzzy® device {MMJ Labs, Atlanta, GE, USA} as a behavior guidance technique; Group CS (n = 50) received counterstimulation for the same technique. Anxiety levels [Venham's Clinical Anxiety Rating Scale (VCARS), Venham Picture Test (VPT), Pulse oximeter {Gibson, Fingertip Pulse Oximeter}, Beijing, China)] were assessed before, during, and after LA administration, while pain perception [Wong-Baker Faces Pain Rating Scale (WBFPS), Visual Analogue Scale (VAS)] was evaluated immediately after injection. Statistical analysis was performed using the Student's t-test to assess the mean difference between the two groups and the repeated measures ANOVA for testing the mean difference in the pulse rates. Statistical significance was set at P < 0.05.ResultsSignificant differences in mean pulse rate values were observed in both groups. In contrast, the children in the BD group had higher diminution (P < 0.05), whereas the mean VCARS and VPT scores were conspicuous (P < 0.05). Based on the mean WBFPS and VAS scores, delayed pain perception after LA injection was more prominent in the BD group than in the CS group.ConclusionExternal vibration using a Buzzy® device is comparatively better than counterstimulation in alleviating needle-associated anxiety in children requiring extraction and pulpectomy.

Surgery for Recurrent Biliary Carcinoma: Results for 5 Recurrent Cases

Introduction: Typically chemotherapy has been used as standard treatment and surgeries were rarely performed for recurrent extrahepatic biliary carcinoma (RBC). Thus whether surgery for RBC is feasible has remained unclear. Methods: From 2013 to 2019, 5 patients underwent radical resection for RBC at our institution. We retrospectively reviewed the medical data. Results: Recurrence sites were liver metastasis in 3 patients (LM group) and local or bile duct recurrence in 2 patients (BD group). In the LM group, the underlying pathology was distal bile duct carcinoma, gallbladder carcinoma and ampullary carcinoma. Limited resections of the liver were performed for all 3 patients in the LM group. There was no morbidity nor mortality. 1 patient with liver metastasis of gallbladder carcinoma survived 6 years after surgery for RBC. The other 2 patients had recurrence at 9 and 14 months after surgery. In the BD group, the underlying pathology was distal bile duct carcinoma and proximal bile duct carcinoma. 1 patient underwent pancreaticoduodenectomy in the primary surgery and extended right hemihepatectomy for RBC. The other underwent central bisegmentectomy of the liver in the primary surgery and right lateral sectionectomy of the liver for RBC. There was morbidity in 1 patient but no mortality. Both patients could achieve curative resection and survive without recurrence for 9 and 2 months after surgery for RBC. Conclusion: Surgery for RBC is technically demanding procedure but appears feasible and have a possibility of offering longer survival for selected patients but we should be cautious of indication.

Ultrasound-guided suprazygomatic maxillary nerve block in cleft palate surgery: The efficacy of adding dexmedetomidine to bupivacaine

ABSTRACT We have hypothesized that adding dexmedetomidine to bupivacaine in bilateral ultrasound-guided suprazygomatic maxillary nerve block (SMB) would provide prolonged postoperative analgesia following cleft palate (CP) repair. Children posted for CP repair were randomized to receive bilateral ultrasound-guided SMB, with either 0.15 ml/kg 0.25% bupivacaine on each side (B group; n = 40) or 0.5 µg/kg dexmedetomidine plus 0.15 ml/kg 0.25% bupivacaine on each side (BD group; n = 40). Children and Infants Postoperative Pain Scale (CHIPPS) was the primary outcome, the number of children required analgesia, the first time of rescue analgesia, the total nalbuphine consumption, sedation score, and time to feed were recorded. CHIPPS score was comparable between the two groups in the first 6 hours. However, it was significantly less in BD group than B group at 8 h, 12 h, 16 h, 20 h and 24 h postoperatively as well as the number of children required analgesia (7 vs. 26, respectively; P < 0.001) with delay of the first analgesic request (23.6 vs. 14.9 h) and reduced the total nalbuphine consumption (0.3 ± 0.7 vs. 2.1 ± 1.8 mg). Sedation score was higher in group BD at Postoperative Anesthesia Care Unit (P = 0.037). Time to feed was similar between both groups (P = 0.376). In bilateral SMB, the use of 0.5 µg/kg dexmedetomidine as an adjunct to bupivacaine 0.25% was associated with prolonged postoperative analgesia and decreased total analgesic consumption in children assigned for surgical correction of CP.

Assessment of long-term outcomes: aortic valve reimplantation versus aortic valve and root replacement with biological valved conduit in aortic root aneurysm with tricuspid valve.

We compared the long-term outcomes between aortic valve reimplantation [David V (DV)] and aortic valve and root replacement with biological valved conduit [Bentall-De Bono (BD)] for the patients with aortic root aneurysm with tricuspid valve. Among 876 patients who underwent aortic root replacement in our institution between 2005 and 2018, 371 patients who underwent DV (n = 199) or BD (n = 172) for aortic root aneurysm with tricuspid valve were retrospectively reviewed. Exclusion criteria included aortic stenosis, infective endocarditis, previous prosthetic aortic valve, bicuspid aortic valve, aortic dissection and mechanical Bentall procedure. Propensity score matching was performed based on the patient characteristics, matching 90 patients in each group. The primary end point was all-cause mortality. Secondary end points were reoperation for any cause and specifically for aortic valve-related cause. After propensity score matching, DV and BD groups each had 1 in-hospital mortality (1.1%). Survival at 10 years was 95.3% [95% confidence interval (CI) 85.8-98.5] in DV and 98.6% (95% CI 90.8-99.8) in BD (P = 0.345). The cumulative incidences of reoperation at 10 years in DV versus BD were 3.9% (95% CI 0.7-11.8) vs 18.1% (95% CI 6.9-33.4) for any cause (P = 0.046) and 1.9% (95% CI 0.1-8.8) vs 15.9% (95% CI 5.5-31.4) for aortic valve-related causes (P = 0.032). The reasons for valve-related reoperation were aortic insufficiency (3/5 in DV vs 5/10 in BD), aortic stenosis (0/5 vs 2/10) and infective endocarditis (2/5 vs 3/10). Both DV and BD procedures for patients with aortic root aneurysm with tricuspid valve resulted in excellent 10-year survival. All-cause and aortic valve-related reoperations were significantly less frequent with valve-sparing root replacement, suggesting an advantage of DV over biological BD.

Microbiome Analysis Investigating the Impacts of Fermented Spent Mushroom Substrates on the Composition of Microbiota in Weaned Piglets Hindgut.

The purpose of this study was to investigate the effects of fermented spent mushroom substrates (FSMS) on growth performance, serum biochemical, gut digestive enzyme activity, microbial community, genes expression of tight junction proteins, and volatile fatty acids in the hindgut (colon and cecum) of weaned piglets. A total of 100 weaned Yihao native pigs (native × Duroc, 50 males and 50 females) were allocated to two groups with five replicates and 10 pigs per replicate. Pigs in the control group were fed a basal diet (BD group), and the others were fed basal diets supplemented with 3% FSMS (FSMS group). Relative to the BD group, it had better results for final weight, average daily gain, and feed conversion ratio in the FSMS group but not significant (p > 0.05), which was accompanied by improved serum triiodothyronine, immunoglobulin G, and immunoglobulin A (p < 0.05) but lower serum total protein, albumin, total cholesterol, and total triglyceride during the overall period (p < 0.05). Similarly, FSMS significantly upregulated (p < 0.05) the messenger RNA expression of duodenal tight junction proteins such as tight junction protein 1, tight junction protein 2, and occludin. Meanwhile, isobutyric acid, valeric acid, and isovaleric acid levels were increased, whereas propanoic acid was decreased (p < 0.05) in the FSMS group than the BD group. In addition, the piglets in the FSMS group changed the microbial diversity in the colon and cecum. 16S rRNA gene sequencing-based compositional analysis of the colonic and cecal microbiota showed differences in the relative abundance of bacterial phyla (Firmicutes, Bacteroidetes, etc.), genus (Lactobacillus, Streptococcus, Roseburia, etc.), and species (Lactobacillus gasseri, Clostridium disporicum, etc.) between the BD and FSMS fed piglets. In conclusion, dietary supplementation with FSMS benefited to the intestinal mucosal barrier, immunity, and composition of the microbiota.

Validity of endocan as a biomarker in systemic sclerosis: relation to pathogenesis and disease activity

BackgroundSystemic sclerosis (SSc), an autoimmune disease, has endothelial dysfunction and tissue fibrosis. The lack of its specific activity markers urges the research. Endocan is an immunomodulatory protein associated with endothelial dysfunction. We aimed to measure of the endocan level in systemic sclerosis (SSc) patients’ sera to test its relation to disease activity and treatment responses. Also, to evaluate its specificity by comparing these data with Behçet’s disease (BD) and rheumatoid arthritis (RA) patients’ data.ResultsSSc and RA patients were in activity but in the BD group; eight were active and seven were inactive. The endocan level was higher in the three groups in comparison to the controls without statistically significant differences (p value RA 0.697, SSc 0.063, and BD 0.196). A statistically significant difference in endocan levels between SSc patients with and without vascular manifestations (pulmonary hypertension and finger pitting ulcers, p < 0.0001, p = 0.0097, respectively). There were no significant correlations between endocan level and the erythrocyte sedimentation rate and C-reactive protein (positive rheumatoid factor for RA) in the three groups (p > 0.05). There were no significant correlations between endocan level and activity scores in the three groups (p > 0.05). The cut-off value of endocan was 1.3 ng/ml.ConclusionEndocan is a non-specific marker for the vascular pathogenesis in systemic sclerosis but not a good predictor for its activity.

Neuroprotective Effect of Ketone Metabolism on Inhibiting Inflammatory Response by Regulating Macrophage Polarization After Acute Cervical Spinal Cord Injury in Rats.

ObjectiveTo investigate the effects of ketogenic metabolism on macrophage polarization, inflammation inhibition, and function recovery after acute spinal cord injury (SCI) in rats.MethodsSixty-four adult male Sprague–Dawley rats were randomly and equally divided into sham, standard diet (SD), ketone diet (KD), and 1, 3-butanediol (BD) groups. All animals underwent C5 unilateral laminectomy, whereas the SD, KD, and BD groups underwent C5 spinal cord hemi-contusion. The impact rod with a diameter of 1.5 mm was aligned 22.5° to the left and 1.4 mm to the midline, and then triggered to deliver a set displacement of 1.5 mm at a speed of 100 mm/s. The gene expression of inflammatory factors as well as the protein expression of inducible nitric oxide synthase, arginase-1, and inflammatory factors were measured at 1 week post-injury. Serum ketone and behavior were evaluated every second week for 12 weeks. Then, histological analyses of the gray and white matter at the epicenter were conducted at 12 weeks post-injury.ResultsThe serum ketone levels of the KD and BD groups were significantly increased when compared with the SD group. The gene and protein expression of TNF-α and IL-1β tended to increase after the SCI, but were inhibited in the KD and BD groups. The protein expression of inducible nitric oxide synthase, marker of M1 macrophage, was inhibited in the KD and BD groups; on the other hand, the expression of arginase-1, marker of M2 macrophage, was boosted in the KD and BD groups. The usage of the ipsilateral forelimb was higher in the KD group than in the SD group. The hemi-contusive injury resulted in an obvious ipsilateral lesion area at the epicenter, and there was no significant difference between groups regarding the lesion size. However, the spared gray matter area was significantly greater in the KD group than in the SD and BD groups.ConclusionThe present study suggests that ketogenic metabolism promotes macrophage polarization to M2, inhibits an inflammatory response, and alleviates the loss of gray matter after SCI. A higher ketone level, such as that induced by the ketogenic diet, seems to benefit function recovery after SCI.

Relationship between impulsivity, comorbid anxiety and neurocognitive functions in bipolar disorder

Objective The aim of the study is to examine the relationship between anxiety and impulsivity and to reveal the correlation of these variables with clinical and sociodemographic features. It is also aimed to investigate the relationship between impulsivity and anxiety with neurocognitive functions in bipolar disorder. Methods The sample of the study comprises of 71 patients with bipolar disorder type I without any comorbidity (BD), 37 patients with anxiety disorder comorbidity with bipolar disorder type I (BDAD), 52 patients with anxiety disorder (AD) and 50 healthy controls (HC). Participants completed Barratt Impulsivity Scale-11, State-Trait Anxiety Inventory 1–2, Panic Disorder Severity Scale (PDSS), brief version of Fear of Negative Evaluation Scale (FNES), Anxiety Sensitivity Index-3 (ASI-3), Trail-Making Test A–B, Digit Span Test, Stroop Test. Results PDSS scores, trait anxiety level, hypomanic and mixed episode numbers explain 26% of attention impulsivity. Gender and ASI-3 social dimensions explain 16% of motor impulsivity. Trait anxiety explains non-planning and total impulsivity at 26 and 24%, respectively. When neurocognitive impairment’s effect was controlled, it was found AD and BDAD groups had higher impulsivity levels than the BD and HC groups. Conclusion Anxiety disorder comorbidity increases impulsivity in bipolar disorder. KEYPOINTS In the presence of anxiety disorder spectrum comorbidity, bipolar disorder patients will have increased impulsivity and the clinical course may be more severe. Trait anxiety levels and anxiety sensitivity may be predictive factors for impulsivity. In the presence of anxiety disorder spectrum comorbidity, it should be taken into consideration that these patients may be more impulsive and should be treated with more care in terms of evaluation of the disorder.

Evaluation of Tumor Budding in Predicting Survival for Gastric Carcinoma Patients in Vietnam.

Background:Tumor budding (Bd) has been demonstrated to be a promising prognostic factor in many carcinomas and in gastric cancer. It may represent an optimal additional parameter that is helpful for risk stratification in gastric adenocarcinoma. Hence, the present research was designed to predict the survival outcomes of gastric cancer in Vietnam, applying the tumor budding criteria of the International Tumor Budding Consensus Conference (ITBCC) 2016.Methods:The present study was conducted on 109 gastric cancer patients who underwent surgery but did not receive neo-adjuvant chemotherapy from 2012 to 2015. The patients’ clinicopathological features were recorded. Bd was evaluated according to the 2016 ITBCC criteria and classified as Bd1 (0–4 buds), Bd2 (5–9 buds), and Bd3 (≥10 buds) grades, in addition to being categorized into 2 main Bd groups: low (<10 buds) and high (≥10 buds) Bd. Kaplan–Meier and log-rank models were applied to analyze survival proportions.Results:Of all the patients, 22.9% were classified as Bd1, 31.2% as Bd2, and 45.9% as Bd3 grades. Furthermore, 54.1% patients were categorized into the low and 45.9% into the high Bd groups. Patients with Bd1 and Bd2 grades (the low Bd group) exhibited the best prognosis, with 5-year overall survival (OS) rates of 85.7%, 90.8%, and90.3%, respectively. Patients with Bd3 grade (the high Bd group exhibited the worst prognosis, and none of them lived for 5 years (p < 0.001). Similar to OS rates, disease-free survival (DFS) rates markedly reduced from the Bd1 to Bd3 grade: Bd1, 95.0%; Bd2, 84.7%; and Bd3, 0% (p < 0.001).Conclusion:Patients with different gastric cancer Bd grades exhibited significantly different OS and DFS rates. The present study findings suggest that the ITBCC criteria can be used to stratify Bd for the treatment and prognosis of gastric cancer patients in Vietnam.

Chronic sigma-1 receptor activation ameliorates ventricular remodeling and decreases susceptibility to ventricular arrhythmias after myocardial infarction in rats

The present study aimed to assess the effect of sigma-1 receptor (S1R) stimulation on ventricular remodeling and susceptibility to ventricular arrhythmias (VAs) after myocardial infarction (MI) in rats. Wild-type male rats were placed into one of the following four treatment groups. For four weeks, animals in the Sham group and MI group received intraperitoneal (i.p.) injections of 0.9% saline (1 ml/kg/day); those in the MI + F group received fluvoxamine (FLV) (0.3 mg/kg/day); and those in the MI + F + BD group received FLV plus BD1047 (0.3 mg/kg/day). After that, the ventricular electrophysiological parameters were measured via the langendorff system. Ventricular fibrosis quantification was determined with Masson staining. Cardiac function was evaluated by echocardiography. The protein levels of S1R, connexin (Cx)43, Cav1.2, Kv4.2, Kv4.3, tyrosine hydroxylase (TH), nerve growth factor (NGF), growth-associated protein 43 (GAP43) were detected by Western blot assays. Our results indicated that fluvoxamine significantly prolonged the ventricular effective refractory period (ERP), shortened action potential duration (APD), reduced susceptibility to VAs after MI. Masson staining showed a decrease in ventricular fibrosis in the MI + F group. Furthermore, the contents of Cx43, S1R, Cav1.2, Kv4.2, Kv4.3 were increased in the MI + F group compared with the MI group (all P < 0.05). The contents of TH, NGF, GAP43 were reduced in the MI + F group compared with the MI group. (all P < 0.05). However, BD1047 reduces all of these effects of FLV. The results suggest that S1R stimulation reduces susceptibility to VAs and improves cardiac function by improving myocardial fibrosis, lightning sympathetic remodeling, electrical remodeling, gap junction remodeling and upregulating S1R content.

Brisket Disease Is Associated with Lower Volatile Fatty Acid Production and Altered Rumen Microbiome in Holstein Heifers

Simple SummaryDevelopment of the dairy industry in the high-altitude plateau environment through incorporation of Holstein cows is complicated by the risk of brisket disease. While the physiological effects of brisket disease are well-studied, its effects on rumen function and microbial community composition are not. There are clear shifts in volatile fatty acids production and rumen microbial community composition in Holstein heifers suffering from brisket disease. Observed shifts reveal key genera associated with healthy and disease states and suggest that bovine brisket disease is associated with impaired rumen functioning. This work supports further understanding of the roles of key rumen taxa in bovine brisket disease, with particular focus on candidate rumen biomarkers in healthy animals that may be able to reduce economic losses for farmers.Brisket disease is heritable but is also associated with non-genetic risk factors and effects of the disease on the rumen microbiome are unknown. Ten Holstein heifers were exposed to the plateau environment for three months and divided into two groups according to the index of brisket disease, the mean pulmonary arterial pressure (mPAP): brisket disease group (BD, n = 5, mPAP > 63 mmHg) and healthy heifer group (HH, n = 5, mPAP < 41 mmHg). Rumen fluid was collected for analysis of the concentrations of volatile fatty acids (VFAs). Extracted DNA from rumen contents was analyzed using Illumina MiSeq 16S rRNA sequencing technology. The concentration of total VFA and alpha-diversity metrics were significantly lower in BD group (p < 0.05). Ruminococcus and Treponema were significantly decreased in BD heifers (p < 0.05). Correlation analysis indicated that 10 genera were related to the mPAP (p < 0.05). Genera of Anaerofustis, Campylobacter, and Catonella were negatively correlated with total VFA and acetic acid (R < −0.7, p < 0.05), while genera of Blautia, YRC22, Ruminococcus, and Treponema were positively related to total VFA and acetic acid (R > 0.7; p < 0.05). Our findings may be a useful biomarker in future brisket disease work.

Avaliação de arritmias em cavalos atletas com baixo desempenho

O objetivo deste estudo foi correlacionar a importância de arritmias em cavalos de corrida Puro Sangue Inglês com baixo desempenho. Foram avaliados 16 equinos (10 machos e 6 fêmeas), com idade entre 2 e 6 anos e pesando 474,5 ± 39,4kg. Estes foram selecionados de acordo com a ocorrência ou não de baixo desempenho, em grupos: grupo baixo desempenho (BD) e grupo controle (CTL). Procedeu-se ao exame eletrocardiográfico contínuo (Holter), sendo avaliados em repouso e em exercício, padronizado para todos. Foram observadas arritmias em ambos os grupos, classificadas como bloqueio atrioventricular de segundo grau (BAV2), bloqueio sinusal (BS), complexo pré-ventricular prematuro (CPVP), complexo ventricular prematuro (CVP) e taquicardia ventricular (TV). BAV2 foi a arritmia mais frequente com média de 1,91 BAV2/h no grupo BD e 3,8 BAV2/h no grupo CTL. Quanto a ocorrência de BS, a média foi 0,76 BS/h no grupo BD e 0,72 BS/h no grupo CTL. Complexo pré-ventricular prematuro obteve média 0,12 CPVP/h no grupo CTL e 0,21 CPVP/h no grupo BD. A comparação de ocorrência de BAV2, BS, CPVP e DVP em ambos os grupos, não obteve diferença estatística significativa. Os resultados sugerem que não houve influência dessas arritmias no baixo desempenho dos animais avaliados.

Comparison of analgesic effect of peritonsillar infiltration with bupivacaine versus bupivacaine-dexamethasone in children undergoing tonsillectomy.

Objective: To compare analgesic effect of peritonsillar infiltration with bupivacaine versus bupivacaine-dexamethasone in children undergoing tonsillectomy. Study Design: Randomized Control study. Setting: Aziz Fatimah Hospital, Faisalabad. Period: 01-03-2018 to 31-12-2018. Material &amp; Methods: 80 patients were enrolled in the clinical study using non-probability consecutive sampling technique. They were divided into two groups, before start of surgery group BD received peritonsillar infiltration of bupivacaine and dexamethasone combination, whereas group B received local infiltration of bupivacaine only. Primary outcome measures were pain score recorded immediately after recovery of patient (0 hour) and at 2, 6, 12 and 24 hours after surgery and requirement for analgesia postoperatively. Other parameters recorded were time to first oral intake and sleep pattern over 24 hours. Results: Mean pain scores in group BD were 0.075, 0.225, 1.675, 0.75, 0.275 and in1 group B were 0.65, 0.975, 2.95, 1.5, 0.95 at 0, 2, 6, 12, 24 hours postoperatively respectively. 92.5% patients in group BD and &amp; 57.5% in group B had good sleep whereas 7.5% in group BD and 42.5% in group B had disturbed sleep. 6 patients in BD group and 26 in B group required analgesia. Conclusion: Our study concluded that infiltration of tonsillar fossa with bupivacaine – dexamethasone prior to the start of surgery provides better postoperative analgesia, early start of oral intake, less rescue analgesic requirements and better sleep pattern.

Personality and pediatric bipolar disorder: Toward personalizing psychosocial intervention

BackgroundPrevious research suggests that challenging temperament characteristics (i.e., low mood, irritability and rigidity) are associated with risk for the development of Pediatric Bipolar Disorder (PBD). This study aimed to investigate the connection between PBD and discrete dimensions of the Five Factor Model (FFM) of personality. MethodsYouth diagnosed with PBD I, II, or NOS, at high risk for the disorder (BD-HR) and healthy controls were recruited from the Child and Adolescent Psychiatry Outpatient Clinic at Stanford University School of Medicine. Researchers administered a personality inventory and evaluated current mood state. ResultsBD and BD-HR youth scored lower in Emotional Regulation than did HC youth (F (3, 70) = 10.75, p < .001). Within the BD and BD-HR groups, youth with high depression scores scored lower on Extraversion (F (3, 70) = 8.62, p < .001) and Conscientiousness (F (3, 70) = 4.53, p < .01). LimitationsA major limitation of this study is its cross-sectional design, precluding analysis of whether certain traits or clusters of traits predict PBD or other mood disorders. ConclusionsLow Emotional Regulation, Conscientiousness, and Agreeableness were associated with PBD; this personality profile clinically corresponds with youth diagnosed with PBD who present with difficulty regulating their emotions, vulnerability to stress, and emotional reactivity. Future research examining personality characteristics in PBD may elucidate further a specific profile to aid clinicians in developing psychosocial interventions for youth with and at high risk of developing PBD.