Human-Induced Neural and Mesenchymal Stem Cell Therapy Combined with a Curcumin Nanoconjugate as a Spinal Cord Injury Treatment.

We currently lack effective treatments for the devastating loss of neural function associated with spinal cord injury (SCI). In this study, we evaluated a combination therapy comprising human neural stem cells derived from induced pluripotent stem cells (iPSC-NSC), human mesenchymal stem cells (MSC), and a pH-responsive polyacetal-curcumin nanoconjugate (PA-C) that allows the sustained release of curcumin. In vitro analysis demonstrated that PA-C treatment protected iPSC-NSC from oxidative damage in vitro, while MSC co-culture prevented lipopolysaccharide-induced activation of nuclear factor-κB (NF-κB) in iPSC-NSC. Then, we evaluated the combination of PA-C delivery into the intrathecal space in a rat model of contusive SCI with stem cell transplantation. While we failed to observe significant improvements in locomotor function (BBB scale) in treated animals, histological analysis revealed that PA-C-treated or PA-C and iPSC-NSC + MSC-treated animals displayed significantly smaller scars, while PA-C and iPSC-NSC + MSC treatment induced the preservation of ß-III Tubulin-positive axons. iPSC-NSC + MSC transplantation fostered the preservation of motoneurons and myelinated tracts, while PA-C treatment polarized microglia into an anti-inflammatory phenotype. Overall, the combination of stem cell transplantation and PA-C treatment confers higher neuroprotective effects compared to individual treatments.

Modeled Wide-Awake, Local-Anesthetic, No-Tourniquet Surgical Procedures Do Not Impair Driving Fitness: An Experimental On-Road Noninferiority Study.

BACKGROUND: The use of wide-awake, local-anesthetic, no-tourniquet (WALANT) surgical techniques is increasingly common, and patients commonly ask whether they may drive home following these procedures. The impact of a numb hand and bulky dressing on driving fitness is unknown, and there is no literature to guide surgeons when counseling these patients. Thus, the primary objective of the present study was to determine driving fitness following a modeled-WALANT procedure. METHODS: Twelve right-handed individuals (6 male and 6 female) with an average age of 50 years (range, 38 to 64 years) were enrolled. An instrumented vehicle was used to obtain driving kinematic and behavioral data, thus allowing for a multidimensional assessment of driving fitness. Participants first performed a drive to establish baseline kinematic metrics. The route included both public streets and a closed course. Several driving tasks were assessed, including reverse parking, parallel parking, and perpendicular parking. The total course length was 18 miles (29 kilometers) and took 45 to 55 minutes to complete. After the first drive, 10 mL of 1% lidocaine was injected in the volar aspect of the right wrist and another 10 mL was injected into the right carpal tunnel to model the anesthetic used for a WALANT carpal tunnel release, and a bulky soft dressing was applied. The modeled-WALANT drive included an identical route and tasks, in addition to a surprise event to evaluate emergency responsiveness. Driving metrics were analyzed for noninferiority of the modeled-WALANT state to baseline driving. RESULTS: The modeled-WALANT state showed noninferiority to baseline driving on all 11 analyzed dimensions of driving behavior compared with the control drives. In the modeled-WALANT state, participants drove more conservatively, braked harder, and steered more smoothly. All participants safely performed the 3 parking tasks and emergency response maneuver. Driving fitness in the modeled-WALANT state was noninferior to driving fitness in the preoperative drive. CONCLUSIONS: A modeled-WALANT state has no clinically relevant negative impact on driving fitness, and thus surgeons should not discourage patients from driving home after unilateral WALANT surgical hand procedures. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Exploring Latino College Students' Sexual Behaviors in Relation to Their Sexual Attitudes, Religiousness, and Spirituality.

The purpose of this study was to examine the relationship between religiosity, spirituality, sexual attitudes, and sexual behaviors among Latino and non-Latino college students. The sample included 230 undergraduate college students enrolled at a mid-sized University in the western USA. Sexual behaviors among Latinos were significantly correlated with sexual attitudes and spiritual disclosure in close relationships. However, sexual behaviors for non-Latino respondents were only significantly related to sexual attitudes, not indices of religiousness or spirituality. Sexual educators, health educators, college-level instructors, and counselors can use these results to help Latino and non-Latino students alike understand the relationship between their religious and spiritual beliefs, sexual attitudes, and sexual behaviors.

Long-term ω-3 fatty acid supplementation induces anti-stress effects and improves learning in rats.

Chronic stress leads to secretion of the adrenal steroid hormone corticosterone, inducing hippocampal atrophy and dendritic hypertrophy in the rat amygdala. Both alterations have been correlated with memory impairment and increased anxiety. Supplementation with ω-3 fatty acids improves memory and learning in rats. The aim of this study was to evaluate the effects of ω-3 supplementation on learning and major biological and behavioral stress markers. Male Sprague-Dawley rats were randomly assigned to three experimental groups: 1) Control, 2) Vehicle, animals supplemented with water, and 3) ω-3, rats supplemented with ω-3 (100 mg of DHA+25 mg of EPA). Each experimental group was divided into two subgroups: one of which was not subjected to stress while the other was subjected to a restraint stress paradigm. Afterwards, learning was analyzed by avoidance conditioning. As well, plasma corticosterone levels and anxiety were evaluated as stress markers, respectively by ELISA and the plus-maze test. Restraint stress impaired learning and increased both corticosterone levels and the number of entries into the open-arm (elevated plus-maze). These alterations were prevented by ω-3 supplementation. Thus, our results demonstrate that ω-3 supplementation had two beneficial effects on the stressed rats, a strong anti-stress effect and improved learning.

A cautionary note on the use of the adaptive up-down method.

Up-down staircases with equal sizes for the steps up and down are widely used to estimate detection and discrimination thresholds in psychoacoustics, but the conventional average-of-reversals estimator does not converge on its presumed percent point in Yes-No tasks or in two-alternative forced-choice detection tasks. The particular percent point of convergence is partly determined by the relative size of the steps with respect to the spread (inverse of slope) of the underlying psychometric function. In particular, threshold is increasingly underestimated as the spread of the psychometric function decreases. This characteristic may have serious consequences when thresholds estimated via up-down staircases are compared across conditions in which the spread of the psychometric function varies, because then these thresholds do not represent comparable measures of performance. This paper documents the misbehavior of the average-of-reversals estimator under up-down rules and types of forced-choice task that are in common use in psychoacoustics but which have not been studied before in simulations. It is also shown that a relatively simple modification of the up-down design (namely, using steps up and down of different size and in a certain ratio depending only on the task and the up-down rule being used) stabilizes the performance of these staircases.

Reminder and 2AFC tasks provide similar estimates of the difference limen: a reanalysis of data from Lapid, Ulrich, and Rammsayer (2008) and a discussion of Ulrich and Vorberg (2009).

Lapid, Ulrich, and Rammsayer (2008) reported that estimates of the difference limen (DL) from a two-alternative forced choice (2AFC) task are higher than those obtained from a reminder task. This article reanalyzes their data in order to correct an error in their estimates of the DL from 2AFC data. We also extend the psychometric functions fitted to data from both tasks to incorporate an extra parameter that has been shown to allow obtaining accurate estimates of the DL that are unaffected by lapses. Contrary to Lapid et al.'s conclusion, our reanalysis shows that DLs estimated with the 2AFC task are only minimally (and not always significantly) larger than those estimated with the reminder task. We also show that their data are contaminated by response bias, and that the small remaining difference between DLs estimated with 2AFC and reminder tasks can be reasonably attributed to the differential effects that response bias has in either task as they were defined in Lapid et al.'s experiments. Finally, we discuss a novel approach presented by Ulrich and Vorberg (2009) for fitting psychometric functions to 2AFC discrimination data.

Tpeak-Tend and Tpeak-Tend dispersion as risk factors for ventricular tachycardia/ventricular fibrillation in patients with the Brugada syndrome.

OBJECTIVES: Our objective in this study was to evaluate Tpeak-Tend interval (Tp-e) and other electrocardiographic parameters as risk factors for recurrence of life-threatening cardiac events in patients with the Brugada syndrome (BS). BACKGROUND: The Tp-e interval in the electrocardiogram (ECG) has been reported to predict life-threatening arrhythmias in the long QT syndrome. METHODS: Twenty-nine patients with the ECG pattern of BS and 29 healthy age- and gender-matched controls were studied. The follow-up period was 42.65 +/- 24.42 months (range 11 to 108 months). RESULTS: Upon presentation, five patients had suffered aborted sudden death, five syncope, and two presyncope. Eleven patients with the ECG pattern of BS had a prolonged (>460 ms) QTc in V2 but usually not in inferior or left leads. No patient had abnormally prolonged QT dispersion. Programmed electrical stimulation induced ventricular tachycardia/fibrillation in 5 out of 26 patients. Inducibility did not predict recurrence of events. Cardioverter-defibrillators were implanted in 14 patients (all symptomatic and two asymptomatic). During follow-up, nine symptomatic patients experienced recurrences. Previous cardiac events and a QTc >460 ms in V2 were significant risk factors (p = 0.00002 and p = 0.03, respectively). Tp-e and Tp-e dispersion were significantly prolonged in patients with recurrences versus patients without events (104.4 and 35.6 ms vs. 87.4 and 23.2 ms; p = 0.006 and p = 0.03, respectively) or controls (90.7 and 17.9 ms; p = 0.02 and p = 0.001, respectively). CONCLUSIONS: Our study demonstrates significant correlation between previous events, QTc >460 ms in V2, Tp-e, and Tp-e dispersion and occurrence of life-threatening arrhythmic events, suggesting that these parameters may be useful in risk stratification of patients with the Brugada syndrome.

Uso del tabaco entre los jóvenes colombianos Retos para los profesionales en salud pública / Use of the tobacco, among Colombian young people

El incremento en el índice del uso del tabaco y sus derivados entre los jóvenes colombianosrepresenta un llamado para los especialistas en salud pública para que consideren el control deltabaco una prioridad en el área de prevención.El objetivo de este artículo es documentar los daños del tabaco en el cuerpo humano, el incrementodel tabaquismo entre los jóvenes colombianos, y explorar el papel de los programas de prevenciónen la reducción de este problema.

Increasing tobacco use rates among Colombian youth exemplify the need to make prevention top public health priority.The purpose of this article is to document the adverse effects of tobacco in the human body,the increases in tobacco use among Colombian youth, and to explore the role of prevention indecreasing this public health problem.

Megacolon primario adquirido del adulto: tratamiento quirúrgico / Surgical treatment of the adquired adult primary megacolon

Los autores presentan 56 pacientes operados por megacolon entre 1955 y 1985. La anatomía patológica y la epiopatogenia de la afección, es detallada. Las técnicas quirúrgicas empleadas son mencionadas y la operación de Black es seleccionada como la mejor. Esta técnica quirúrgica es descripta minuciosamente. Las complicaciones postoperatorias y la mortalidad son mencionadas.

Megacolon primario adquirido del adulto: tratamiento quirúrgico / Surgical treatment of the adquired adult primary megacolon

Los autores presentan 56 pacientes operados por megacolon entre 1955 y 1985. La anatomía patológica y la epiopatogenia de la afección, es detallada. Las técnicas quirúrgicas empleadas son mencionadas y la operación de Black es seleccionada como la mejor. Esta técnica quirúrgica es descripta minuciosamente. Las complicaciones postoperatorias y la mortalidad son mencionadas.(AU)