Reliability and validity of the Greek adaptation of the Modified Barthel Index in neurorehabilitation patients.

BACKGROUND: The Modified Barthel Index (MBI) (Shah version) is a widely used functional assessment measure with greater sensitivity and improved reliability compared to the original Barthel Index. AIM: The aim of this study was to adapt the MBI for use in Greece and measure its reliability and validity on a Greek neuro-rehabilitation population. DESIGN: Observational study. SETTING: KAT Hospital Rehabilitation Clinic and National Rehabilitation Centre in Athens, Greece. POPULATION: A total of 100 rehabilitation inpatients and outpatients consisting of 50 stroke and 50 spinal cord injury (SCI) patients were evaluated. METHODS: The MBI underwent the proper translation and cultural adaptation procedure as required by the World Health Organization and was administered to 100 rehabilitation patients. For criterion validity evaluation all patients were also assessed with the Katz Index of Independence in Activities of Daily Living (Katz Index) and the 36-Item Short Form Survey (SF-36) physical functioning subscale, both questionnaires having been validated for use in Greece. RESULTS: The unidimensionality solution was rejected and a two- factor solution was adopted based on exploratory and confirmatory factor analysis (Factor 1 - Transfers and Activities of Daily Living, Factor 2 - Mobility). Very high correlation was presented between the Katz Index score and the Greek MBI Factor 1 (r=0.888, P<0.001) and total score (r=0.873 P<0.001) respectively and high with MBI Factor 2 (r=0.561, P<0.001). High correlation was observed between the SF-36 physical functioning subscale score with MBI Factor 1 (r=0.522, P<0.001), MBI Factor 2 (r=0.590, P<0.001) and MBI Total score (r=0.580, P<0.001). The internal consistency of the MBI Factor 1, Factor 2 and Total score was 0.920, 0.860 and 0.923 respectively. Test-retest reliability was remarkably consistent (total score 0.994, P<0.001). CONCLUSIONS: The Greek version of the Modified Barthel Index has been found to exhibit satisfactory levels of reliability and validity. CLINICAL REHABILITATION IMPACT: The Greek MBI adaptation is an adequate and useful instrument for use on Greek neuro-rehabilitation patients.

The effect of table olive wastewater extract administration on the adult ovariectomised rat model of osteoporosis.

Recent efforts for alternative non-pharmaceutical treatments for postmenopausal osteoporosis are focused on nutritional measures. The aim of this study was to investigate the effect of table olive wastewater extract (OE) administration on bone mineral density (BMD) and biomechanical strength in ovariectomised rats. Thirty mature 9-month-old female Wistar rats were separated into three groups of ten: Control, Ovariectomised (OVX) and OVX + OE. BMD was measured before ovariectomy, 3 and 6 months afterwards. At the end of the study, blood, both femurs and tibias, internal organs and abdominal fat were collected. After 3 months, the percentage changes from baseline of the total and proximal tibial BMD of the OVX + OE group were both higher compared with the OVX group (P < 0·005). Similar results were found after 6 months, when the percentage changes from baseline of the total and proximal tibial BMD of the OVX + OE group were both higher compared with the OVX group (P < 0·005). Biomechanical testing of the femurs did not reveal any statistically significant difference between the groups. Body weights throughout the study, organs' and abdominal fat ratios to final body weight and blood results (alanine aminotransferase (ALT), gamma-glutamyltransferase (γ-GT), total cholesterol, HDL-cholesterol, LDL-cholesterol, Ca and P) were within normal limits and did not show any significant difference between the treated and untreated groups. As a conclusion, the administration of OE for 6 months protected tibial BMD loss in comparison with the untreated OVX group without causing adverse effects.

Comparison of the excretory capacities of erythropoietin and U-74389G concerning serum creatinine levels / Comparación de las capacidades excretoras de eritropoyetina y U-74389G respecto a los niveles de creatinina sérica

Introduction This study compared the excretory effects, the erythropoietin (Epo) and antioxidant drug U-74389G exert on serum creatinine levels through kidneys. 2 preliminary studies were used for this purpose including respectively one drug used in a renal ischemia­reperfusion (IR) protocol of an animal model. The preliminary studies are part of the present work. The subjects were pretreated in preliminary studies but the results of the same subjects were simply compared in the current work. Materials and methods The serum creatinine levels were evaluated at the 60th reperfusion min (for groups A, C and E) and at the 120th reperfusion min (for groups B, D and F) after IR in the 60 rats. Groups A and B received no drugs, rats from groups C and D were administered with Epo, whereas rats from groups E and F were administered with U-74389G. Results The first preliminary study recommended a non-significant excretory effect of Epo (p-value = 0.4430 > 0.05) than placebo for serum creatinine levels. The second preliminary study proved a very significant excretory effect of U-74389G (p-value = 0.0005 < 0.05) than placebo for serum creatinine levels. These 2 studies were co-evaluated since they came from the same experimental setting. The outcome of the co-evaluation was that U-74389G has at least 5-fold significant excretory action (p-value = 0.0000 < 0.05) than Epo for serum creatinine levels. Conclusions The U-74389G presents surprising effective excretory potencies for serum creatinine levels maybe of great importance in hemodialysis patients.

Introducción Este estudio comparó los efectos excretores que la eritropoyetina (Epo) y el fármaco antioxidante U-74389G ejercen sobre los niveles de creatinina sérica a través de los riñones. Se utilizaron 2 estudios preliminares incluyendo, respectivamente, un fármaco utilizado en una rata protocolo de reperfusión de isquemia renal. Los estudios preliminares son parte del presente trabajo. Los sujetos fueron pretratados en estudios preliminares, pero los resultados de los mismos sujetos fueron comparados simplemente en el trabajo actual. Materiales y métodos Se evaluaron los niveles de creatinina sérica en la 60.ª reperfusión en minutos (para los grupos A, C y E) y en la 120.ª reperfusión en minutos (para los grupos B, D y F) después de isquemia renal en las 60 ratas. Los grupos A y B no recibieron fármacos, a las ratas de los grupos C y D se les administró Epo, mientras que las ratas de los grupos E y F se les administró U-74389G. Resultados El primer estudio preliminar recomendó un efecto excretor no significativo de la Epo (valor p = 0,4430 > 0,05) comparado con el placebo para los niveles de creatinina sérica. El segundo estudio preliminar demostró un efecto excretor muy significativo del U-74389G (valor p = 0,0005 < 0,05) comparado con el placebo para los niveles de creatinina sérica. Estos 2 estudios fueron coevaluados, ya que procedían del mismo entorno experimental. El resultado fue que el U-74389G tiene una acción excretora significativa de al menos 5 veces (p = 0,0000 < 0,05) la Epo para los niveles de creatinina sérica. Conclusiones El U-74389G presenta sorprendentes potencias excretoras efectivas para los niveles de creatinina sérica, tal vez de gran importancia en pacientes en hemodiálisis.

Comparison of the Acute Hematopoietic Capacities of Erythropoietin and U-74389G Concerning Hematocrit Levels.

AIM: This study compared the hematopoietic capacities of erythropoietin (Epo) and antioxidant drug U-74389G, based on 2 preliminary studies. The provided results on hematocrit levels augmentation were co-evaluated in a hypoxia reoxygenation protocol of an animal model. MATERIALS AND METHODS: Hematocrit levels were evaluated at the 60th reoxygenation min (for groups A, C and E) and at the 120th reoxygenation min (for groups B, D and F) in 60 rats. Groups A and B received no drugs, rats from groups C and D were administered with Epo; whereas rats from groups E and F were administered with U-74389G. RESULTS: The first preliminary study of Epo non-significantly increased the hematocrit levels by 0.24%+1.38% (p-value=0.8586). The second preliminary study of U-74389G significantly raised the hematocrit levels by 3.16%+1.33% (p-value=0.0196). These 2 studies were co-evaluated since they came from the same experimental setting. The outcome of the co-evaluation was that U-74389G has approximately 12.66-fold higher hematopoietic potency than Epo (p-value=0.0000). CONCLUSION: The anti-oxidant capacities of U-74389G provide satisfactory acute hematopoietic properties; presenting approximately 12.66-fold hematocrit level rise than epo (p-value=0.0000).

Promoting Undergraduate Surgical Education: Current Evidence and Students' Views on ESMSC International Wet Lab Course.

BACKGROUND: Undergraduate Surgical Education is becoming an essential element in the training of the future generation of safe and efficient surgeons. Essential Skills in the Management of Surgical Cases (ESMSC), is an international, joint applied surgical science and simulation-based learning wet lab course. METHODS: We performed a review of the existing literature on the topic of undergraduate surgical education. Following that, we analyzed the feedback questionnaire received 480 from 2 recent series of ESMSC courses (May 2015, n = 49 and November 2015, n = 40), in order to evaluate European Union students' (UK, Germany, Greece) views on the ESMSC course, as well as on the undergraduate surgical education. Results Using a 10 point graded scale, the overall ESMSC concept was positively evaluated, with a mean score of 9.41 ± 0.72 (range: 8-10) and 8.94 ± 1.1 (range: 7-10). The majority of delegates from both series [9.86 ± 0.43 (range: 8-10) and 9.58 ± 0.91 (range: 6-10), respectively] believed that ESMSC should be incorporated in the undergraduate surgical curriculum. Comparison of responses from the UK to the Greek Medical Student, as well as the findings from the third and fourth year versus the fifth and sixth year Medical Students, revealed no statistically significant differences pertaining to any of the questions (p > 0.05). CONCLUSIONS: Current evidence in the literature supports the enhancement of surgical education through the systematic use of various modalities that provide Simulation-Based Training (SBT) hands-on experience, starting from the early undergraduate level. The findings of the present study are in agreement with these previous reports.

Acute effect of the antioxidant drug U-74389G on hematocrit levels during hypoxia and reoxygenation injury in rats / Efeito agudo do fármaco antioxidante U-74389G sobre os níveis de hematócrito durante a lesão induzida por hipóxia e reoxigenação em ratos

Aims: This experimental study evaluated the effect of the antioxidant drug U-74389G on hematocrit levels using a rat model of hypoxia and reoxygenation following an established protocol. Methods: Forty rats with a mean weight of 231.875 g were employed in the study. Hematocrit levels were determined at 60 min (groups A and C) and at 120 min (groups B and D) after starting reoxygenation. Groups A and B received no drugs, whereas U-74389G was administered to rats for groups C and D. Results: U-74389G administration significantly increased hematocrit levels by 4.73%±2.25% (p=0.0435). Reoxygenation time increased hematocrit levels non significantly by 3.96%±2.29% (p=0.1025). U-74389G administration combined with reoxygenation time significantly increased hematocrit levels by 3.16%±1.33% (p=0.0196). Conclusions: U-74389G administration, whether it interacted or not with reoxygenation time, significantly increased hematocrit levels in the short term in a rat model of hypoxia and reoxygenation.

Objetivos: Este estudo experimental avaliou o efeito da droga antioxidante U-74389G nos níveis de hematócrito, utilizando um modelo murino de hipóxia e reoxigenação, de acordo com um protocolo estabelecido. Métodos: Quarenta ratos com um peso médio de 231,875 g foram utilizados no estudo. Os níveis de hematócrito foram determinados aos 60 min (grupos A e C) e aos 120 minutos (grupos B e D) após o início da reoxigenação. Os grupos A e B não receberam nenhuma droga, enquanto que a U-74389G foi administrada aos ratos dos Grupos C e D. Resultados: A administração de U-74389G aumentou significativamente os níveis de hematócrito em 4,73%±2,25% (p=0,0435). O tempo de reoxigenação aumentou não significativamente os níveis de hematócrito em 3,96%±2,29% (p=0,1025). Aadministração de U-74389G combinada com o tempo de reoxigenação aumentou significativamente os níveis de hematócrito em 3,16%±1,33 (p=0,0196). Conclusões: A administração de U-74389G, quer interagindo ou não com o tempo de reoxigenação, aumentou significativamente, no curto prazo, os níveis de hematócrito em um modelo murino de hipóxia e reoxigenação.

Melatonin attenuates high fat diet-induced fatty liver disease in rats.

AIM: To investigate melatonin's preventive action in oxidative stress in a rat model with high fat diet-induced non-alcoholic fatty liver disease (NAFLD). METHODS: NAFLD was induced by high fat diet (HFD) in adult, male, Wistar rats, weighing 180-230 g. After acclimatization for one week, they were randomly assigned to 6 experimental groups that comprised animals on regular diet plus 5 or 10 mg/kg melatonin, for 4 or 8 wk; animals on HFD, with or without 5 or 10 mg/kg melatonin, for 4 or 8 wk; and animals on HFD for 8 or 12 wk, with melatonin 10 mg/kg for the last 4 wk. Liver damage was assessed biochemically by the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and histologically. Lipid peroxidation and oxidative stress were assessed by malondialdehyde and glutathione levels in liver tissue. Lipidemic indices and portal vein pressure were also measured. RESULTS: Compared to rats not receiving melatonin, rats on 5 or 10 mg/kg of melatonin had lower mean liver weight (-5.0 g and -4.9 g) (P < 0.001) and lower liver weight to body weight ratio (-1.0%) (P < 0.001), for the two doses, respectively. All rats fed HFD without melatonin developed severe, grade III, steatosis. Rats on HFD with concurrent use of melatonin showed significantly less steatosis, with grade III steatosis observed in 1 of 29 (3.4%) rats on 10 mg/kg melatonin and in 3 of 27 (11.1%) rats on 5 mg/kg melatonin. Melatonin was ineffective in reversing established steatosis. Melatonin also had no effect on any of the common lipidemic serum markers, the levels of which did not differ significantly among the rats on HFD, irrespective of the use or not of melatonin. Liver cell necrosis was significantly less in rats on HFD receiving melatonin than in those not on melatonin, with the AST levels declining by a mean of 170 U/L (P = 0.01) and 224 U/L (P = 0.001), and the ALT levels declining by a mean of 62.9 U/L (P = 0.01) and 93.4 U/L (P < 0.001), for the 5 and 10 mg/kg melatonin dose, respectively. Melatonin mitigated liver damage due to peroxidation and oxidative stress in liver tissue as indicated by a significant decline in MDA production by 12.7 (P < 0.001) and 12.2 (P < 0.001) µmol/L /mg protein /mg tissue, and a significant increase in glutathione by 20.1 (P = 0.004) and 29.2 (P < 0.001) µmol/L /mg protein /mg tissue, for the 5 and 10 mg/kg melatonin dose, respectively. CONCLUSION: Melatonin can attenuate oxidative stress, lessen liver damage, and improve liver histology in rats with high fat diet-induced NAFLD, when given concurrently with the diet.

Detection of prostate cancer by sialic acid level in patients with non-diagnostic levels of prostate-specific antigen.

INTRODUCTION: Ideally, there will be reproducible markers easily and non-invasively available to test for malignancy, or alternative procedures when there is no accurate marker available. For prostate cancer, one of the most common cancers in men, levels of prostate-specific antigen (PSA) lack specificity and sensitivity for the determination of malignancy when they fall within a range of values termed the 'grey zone'. OBJECTIVE: To examine the predictive value of sialic acid in prostate neoplasms. STUDY DESIGN: In our study of diagnostic accuracy we recruited 70 men complaining of urinary symptoms who presented in the urology department as outpatients or inpatients. All patients were checked with biopsy and pathology in order to relate benign and malignant lesions of the prostate to levels of sialic acid, a member of a family of acetylated products of neuraminic acid, which has so far proved to be a very sensitive and accurate marker of malignancy. RESULTS: The sialic acid level was found to be elevated in patients with prostate cancer (mean 75.06±10.4 mg/dl) and reduced in patients with benign prostate hyperplasia (mean 57.086±8.7 mg/dl) (p<0.01); it had a sensitivity of 86% and specificity of 84% in diagnosing malignancy. CONCLUSION: Sialic acid can be used as an adjunct in predicting prostate malignancy when PSA values fall in the grey zone.

Increased self-report of obsessive-compulsive behaviors among hemodialysis patients: a case-control study.

BACKGROUND: Patients with end-stage renal insufficiency undergoing hemodialysis show important psychiatric morbidity, particularly increased depression and anxiety. Obsessive-compulsive symptoms, however, are much less frequently investigated. The purpose of the present study was thus to assess obsessive-compulsive symptoms in hemodialysis patients. METHOD: Patients treated at an outpatient hospital hemodialysis unit (July 2007) were compared with controls on scores on the Maudsley Obsessional-Compulsive Inventory (MOCI) and its checking, cleaning, slowness, and doubting components as well as on measures of emotional (Beck Depression Inventory-Fast Screen), anxiety (Beck Anxiety Inventory), and cognitive (Trail Making Test) status. Student t tests, analyses of covariance, or nonparametric tests were used. Correlations were applied between behavioral outcomes and demographic, clinical, and laboratory data of patients. RESULTS: Patients showed more obsessive traits than controls on the MOCI total score (P < .001) and on the checking, cleaning, and doubting subscales. Significant differences between groups occurred also in Beck Depression and Anxiety Inventories (P ≤ .001). The MOCI total score did not correlate with marital status, education level, duration of hemodialysis, or the other psychological instrument scores in patients. By contrast, the MOCI total score was associated with the level of creatinine, and it showed an inverse correlation with the urea reduction ratio in patients (P < .05). CONCLUSIONS: Obsessive-compulsive symptoms may constitute an important aspect of the psychiatric profile of patients undergoing hemodialysis. Potential interpretation involves disease- and treatment-associated factors or adaptive responses to emergence of otherwise uncontrollable stress.

ERp29, an endoplasmic reticulum secretion factor is involved in the growth of breast tumor xenografts.

Cancer cells are committed to an actively secretory state that facilitates communication with their microenvironment. We have addressed the role of ERp29, a novel endoplasmic reticulum secretion factor in mammary carcinogenesis using MCF-7 human breast cancer cells as a model. Xenografts originating from cells stably transfected with dominant-negative form of ERp29 were smaller and better differentiated than those derived from cells overexpressing wild-type ERp29. Similar effects were observed by siRNA-mediated ERp29 silencing in xenografts. However, unlike xenografts, the modulation of ERp29 in vitro did not affect the rate of cell proliferation. In addition, we have evaluated the expression of ERp29 in the resting and lactating mammary glands of mice as well as in the human primary breast tumors. About 25% of breast cancers and also lactating mammary glands were expressing ERp29 while the resting glands did not. Taken together these data suggest the active involvement of ERp29 in the malignant conversion of mammary epithelial cells.

Effect of lipid levels and lipid-lowering therapy on restenosis after coronary artery stenting.

BACKGROUND: Recent experimental and clinical data suggest that lowering serum lipid levels with statins may prevent or delay the process of restenosis. The purpose of this trial is to determine whether lipid levels relate to restenosis and/or whether statin therapy can prevent or delay the process of restenosis after intracoronary stenting. METHODS: One hundred thirty-six patients who underwent single coronary artery stenting from June 1995 to June 1997 in our institution were included in the study. All these patients were followed for at least 9 months (mean 392+/-148 days) for major adverse cardiac events (MACE). We defined as MACE the occurrence of death, myocardial infarction, or need for target lesion revascularization. From this cohort, 103 patients had at least one lipid parameter from the lipid profile evaluated within 2 months from the date of the procedure. Patients who had the stent because of an acute myocardial infarction were included in the study only if their lipid profile was evaluated before or at least 6 weeks after the event. Patients with triglyceride levels above 500 had both triglyceride and low-density lipoprotein cholesterol levels excluded from the statistical analysis. Patients were divided into two groups based on lipid levels: normal (Group I; n=31) and elevated (Group II; n=72). Patient outcomes were also analyzed by statin therapy use. RESULTS: There was no significant difference in MACE rates between the two groups when outcomes were analyzed by lipid levels (22.6% versus 20.8% P=0.8). Furthermore, outcomes were analyzed by use of statin therapy (Group III, n=53, on statin versus Group IV, n=50, on no statin). There was also no difference in MACE rates between the two groups (20.8% versus 22%; P=0.8). CONCLUSION: The process of restenosis has unique features that differentiate it from atherosclerosis. Although lipid-lowering therapy is crucial in delaying the process of atherosclerosis, its role in the prevention of restenosis is yet to be proven.

Therapeutic value of melatonin in an experimental model of liver injury and regeneration.

Melatonin has marked antioxidant properties. The aim of the present study was to evaluate the therapeutic effect of melatonin on acute liver injury induced in rats by carbon tetrachloride (CCl4), allyl alcohol (AA) and their combination. A total of 108 male Wistar rats were divided into 12 experimental groups according to their treatment regimen (n = 5-10 rats in each group). Melatonin (100 mg/kg body weight, BW) was administered 6 hr (a) after a single dose of CCl4 (intragastrically 0. 66 mL/kg BW diluted 1:1 v/v with corn oil); (b) a single dose of AA (intraperitonealy, 0.62 mmol/kg BW 1:50 v/v in 0.9% saline solution); and (c) a combination of the above substances. Rats were sacrificed at 24 and 48 hr post-toxin administration and the therapeutic effect of melatonin was investigated by assessment of histopathological changes and lipid peroxidation alterations determined by measuring tissue malondialdehyde plus 4-hydroxy-nonenal (MDA + 4-HNE), plasma MDA and plasma levels of liver enzymes. The levels of a key antioxidant, glutathione (GSH), were measured in liver tissue homogenates. Hepatic necrosis was significantly reduced in the melatonin-treated rats 48 hr after administration of CCl4, AA and CCl4 + AA. The levels of hepatic enzymes in plasma were found to be significantly reduced at 24 and 48 hr in the CCl4 + AA treated rats after melatonin administration. Additionally, MDA and MDA + 4-HNE concentrations were significantly reduced at 24 and 48 hr time-points in all groups that received melatonin. GSH levels were decreased in liver after the toxic substances administration, whereas melatonin reversed this effect. In conclusion, a single dose of melatonin decreased hepatic injury induced by CCl4, AA and CCl4 + AA. The inhibition of the oxidative stress and therefore lipid peroxidation by melatonin in CCl4 and AA administered animals, may constitute the protective mechanism of melatonin against acute liver injury.