Effects of electromagnetic fields emitted by GSM phones on working memory: a meta-analysis.

BACKGROUND AND OBJECTIVE: Current treatments for Alzheimer's Disease (AD) do not affect the course of the illness and brain stimulation techniques are increasingly promoted as potential therapeutic interventions for AD. This study reviews the effects of electromagnetic field (EMF) exposure versus sham exposure on working memory (WM) performance of healthy human participants. METHOD: Online literature databases and previous systematic reviews were searched for studies of EMF and WM in participants without reported memory problems. Two thousand eight hundred and fifty seven studies were identified, and 10 studies met the inclusion criteria. An assessment of study quality was completed, and separate, random effects meta-analyses were conducted for each of the three WM tasks included: n-back, substitution and digit span forward. RESULTS: No differences were found between participants exposed to active EMF versus sham conditions in any of the three working memory tasks examined. CONCLUSION: Results indicate that EMF does not affect WM during the n-back, substitution and digit-span tasks. Future studies should focus on the possible effects of chronic exposure to EMF in older adults with AD using a battery of comparable WM and attention tasks, before EMF can be seriously considered as a potential modulator of WM in AD. Copyright © 2016 John Wiley & Sons, Ltd.

Tumour-infiltrating lymphocytes predict for outcome in HPV-positive oropharyngeal cancer.

BACKGROUND: Human papillomavirus (HPV)-positive oropharyngeal cancer (OPSCC) is associated with improved survival compared with HPV-negative disease. However, a minority of HPV-positive patients have poor prognosis. Currently, there is no generally accepted strategy for identifying these patients. METHODS: We retrospectively analysed 270 consecutively treated OPSCC patients from three centres for effects of clinical, pathological, immunological, and molecular features on disease mortality. We used Cox regression to examine associations between factors and OPSCC death, and developed a prognostic model for 3-year mortality using logistic regression analysis. RESULTS: Patients with HPV-positive tumours showed improved survival (hazard ratio (HR), 0.33 (0.21-0.53)). High levels of tumour-infiltrating lymphocytes (TILs) stratified HPV-positive patients into high-risk and low-risk groups (3-year survival; HPV-positive/TIL(high)=96%, HPV-positive/TIL(low)=59%). Survival of HPV-positive/TIL(low) patients did not differ from HPV-negative patients (HR, 1.01; P=0.98). We developed a prognostic model for HPV-positive tumours using a 'training' cohort from one centre; the combination of TIL levels, heavy smoking, and T-stage were significant (AUROC=0·87). This model was validated on patients from the other centres (detection rate 67%; false-positive rate 5.6%; AUROC=0·82). INTERPRETATION: Our data suggest that an immune response, reflected by TIL levels in the primary tumour, has an important role in the improved survival seen in most HPV-positive patients, and is relevant for the clinical evaluation of HPV-positive OPSCC.

Fulminant jejuno-ileitis following ablation of enteric glia in adult transgenic mice.

To investigate the roles of astroglial cells, we targeted their ablation genetically. Transgenic mice were generated expressing herpes simplex virus thymidine kinase from the mouse glial fibrillary acidic protein (GFAP) promoter. In adult transgenic mice, 2 weeks of subcutaneous treatment with the antiviral agent ganciclovir preferentially ablated transgene-expressing, GFAP-positive glia from the jejunum and ileum, causing a fulminating and fatal jejuno-ileitis. This pathology was independent of bacterial overgrowth and was characterized by increased myeloperoxidase activity, moderate degeneration of myenteric neurons, and intraluminal hemorrhage. These findings demonstrate that enteric glia play an essential role in maintaining the integrity of the bowel and suggest that their loss or dysfunction may contribute to the cellular mechanisms of inflammatory bowel disease.

Salvage treatment for inoperable neck nodes in head and neck cancer using combined iridium-192 brachytherapy and surgical reconstruction.

The results of debulking surgery and re-irradiation with radioactive implants (brachytherapy) are reported for 39 patients with inoperable metastatic neck nodes from primary head and neck cancers. For 13 patients conventional salvage by partial debulking surgery and brachytherapy proved effective, with 68 per cent control at 1 year, but six patients suffered severe radiation fibrosis, necrosis and contractures. Some 26 patients were treated by combined tumour debulking, skin resurfacing and brachytherapy implant. Initial tumour control and freedom from serious toxicity was achieved in 24 patients. Local control was achieved in 63 per cent of patients at 1 year, with a serious morbidity rate of 12 per cent.

Induction of members of the Fos/Jun family of immediate-early genes in identified hypothalamic neurons: in vivo evidence for differential regulation.

In situ hybridization was used to measure the expression of members of the Fos/Jun family of immediate-early genes in hypothalamic neurons in vivo following defined stimuli that utilize different afferent pathways. Only c-jun messenger RNA was expressed in the hypothalamic supraoptic and paraventricular nuclei of control animals. Intravenous infusions of sodium chloride solutions of different tonicity produced a range of plasma osmolalities within physiological limits. While the induction of c-fos and jun B messenger RNAs followed the stimulus intensity, the expression of c-jun was repressed at low levels of stimulation. A higher level of osmotic stimulation was able to co-induce c-jun with the c-fos, jun B and fos B genes, suggesting that other signalling pathways may then be activated. Parturition or systemic administration of cholecystokinin, that activate supraoptic and paraventricular neurons via ascending afferent pathways from the brainstem, both induced c-fos, but not the other genes, in the magnocellular nuclei. Use of double in situ hybridization confirmed that, unlike with osmotic stimulation, induction of c-fos only occurred in oxytocin neurons. These two stimuli did not cause a concomitant repression of c-jun messenger RNA expression in magnocellular oxytocin neurons. These patterns of induction provide evidence for the differential regulation of members of this family of genes in a physiological context.

A cost-benefit analysis of the post-operative use of antibiotic ear drops following grommet insertion.

A prospective randomized controlled study was carried out to investigate the effect of prophylactic antibiotic ear drops used for five days after bilateral grommet insertion. The average improvement in the hearing threshold was significantly better in ears in which there was an effusion (16 dB) compared with no effusion (9 dB). The drops had no significant effect upon grommet function at three months measured by blockage rates, extrusion rates or improvement in pure tone audiometry whether or not there was an effusion. The drops were not therefore cost-effective.

Expression of inducible cAMP early repressor (ICER) in hypothalamic magnocellular neurons.

Cyclic AMP-responsive genes are regulated both positively and negatively by a number of constitutively expressed nuclear proteins. These proteins bind to cAMP-responsive DNA elements in their target genes and they are activated by protein kinase A-mediated phosphorylation. The cAMP response element modulator gene encodes for several constitutively expressed products. However, a second intronic promoter within the gene is inducible and produces another negatively acting transcription factor, inducible cAMP early repressor (ICER). ICER shows a diurnal pattern of expression in the pineal gland, but to date it has not been noted elsewhere in the brain. Here we show expression of ICER mRNA in hypothalamic magnocellular neurons following osmotic stimulation over a time course consistent with a modulatory effect on the expression of other immediate-early genes, such as c-fos. However, since ICER was not present in magnocellular neurons during parturition, its presence is not a prerequisite for the transient expression of c-fos.

Haemorrhage as a complication of inferior turbinectomy: a comparison of anterior and radical trimming.

A study was conducted to see whether the turbinectomy technique used influenced the incidence of haemorrhage. In a group of 214 patients who underwent bilateral turbinate surgery, haemorrhage occurred in 0.9% of those who had anterior turbinectomy and 5.8% who had radical turbinectomy (P < 0.05). It is concluded that confining excision to the anterior end of the inferior turbinate offers the advantage of a lower incidence of haemorrhage.

Non-tuberculous mycobacterial infections presenting as salivary gland masses in children: investigation and conservative management.

Non-tuberculous mycobacterial (NTM) infections in children commonly present as cervicofacial masses. The importance of early diagnosis is in the exclusion of infection requiring treatment, particularly tuberculosis and the rare case of malignancy. Five children with NTM presenting with salivary gland masses illustrate the value of skin testing with new tuberculins and the place of fine-needle aspiration cytology in the investigation of these infections. Four children who were skin tested reacted specifically to one of the new tuberculins, two indicating infection with Mycobacterium malmoense, confirmed by culture, the others responding to tuberculins from M. scrofulaceum and M. avium-intracellulare, neither having a positive culture. The one case not skin tested produced M. avium-intracellulare on culture. All five patients were managed conservatively. The place for conservative management when the facial nerve is at risk and extensive skin excision is indicated are discussed.

Hearing loss associated with weapons noise exposure: when to investigate an asymmetrical loss.

The air conduction thresholds in the right and left ears, and the interaural asymmetry of thresholds at 0.5, 1, 2, 3, 4 and 6 kHz were measured in a group of 225 soldiers exposed to a variety of weapon noise who were referred for assessment because of a deterioration in hearing on routine testing. At 0.5 and 1 kHz the threshold levels rarely exceeded 25 dB and the interaural asymmetry was 10 dB or less in 90 per cent of cases. The degree of hearing loss and interaural asymmetry increased as the frequency increased, with the average loss being significantly greater in the left ear at 2, 3, 4 and 6 kHz. Recommendations are made for the selection of cases of asymmetrical hearing loss exposed to weapon noise which require further investigation to exclude a retrocochlear cause or to define spurious hearing threshold levels.

Potential efficacy and toxicity of GM1 ganglioside against trimethyltin-induced brain lesions in rats: comparison with protracted food restriction.

GM1 ganglioside (one week each at 10, 5, and 2.5 mg GM1/kg per day, ip) or gradual food restriction leading to a reduction in body weight to 75% of control were tested for their ability to block or reverse histopathologic and behavioral effects of trimethyltin (TMT) poisoning in rats. TMT (a single oral gavage of 6.0 mg TMT HCI/kg body weight) reduced hippocampal weight, decreased hippocampal cell counts, decreased autoshaped learning measures, and suppressed progressive fixed ratio (PFR) lever pressing without affecting stable lever pressing. Neither GM1 nor greater food restriction affected hippocampal weight. Greater food restriction prevented TMT's effects on autoshaping but not on PFR behavior, was without behavioral effects in animals not treated with TMT, and did not affect hippocampal histology. GM1 prevented certain TMT-induced decrements in autoshaping and PFR behavior but also suppressed autoshaping and stimulated stable fixed ratio behavior in animals not treated with TMT. GM1 also reduced hippocampal serotonin concentration, another "lesion-like" change. GM1 blocked TMT-induced hippocampal CA3b cell loss, but did not protect CA3c cells, the main locus of TMT hippocampal damage. The results support the idea that exogenous GM1 is a potent neuroactive agent with complex actions in intact organisms, potentially beneficial and potentially toxic. Like GM1, food restriction induces complex and potentially beneficial effects, but it lacked GM1's biochemical and behavioral "side effects" (i.e. toxicity) in these experiments.

Nursing staff stress in an intensive care unit.

The stresses associated with nursing in an intensive care unit were assessed. A comparison was drawn between a group of Black and a group of White nurses. Proposals aimed at reducing the observed stress patterns are suggested.