A Pilot Study of Brief, Stepped Behavioral Activation for Primary Care Patients with Depressive Symptoms.

In a prior pilot study with primary care patients experiencing depressive symptoms, we observed positive outcomes for a behavioral activation protocol involving one visit and three calls. We aimed to pilot test a stepped version with flexible numbers of contacts. Fifteen primary care patients scoring 5-14 on the Patient Health Questionnaire-9 engaged in the three-tiered telephone-based intervention: (1) two calls (15-20 min each); (2) one 30-60 min encounter followed by two calls; and (3) one to six calls. Participants completed assessments at pre-treatment, post-treatment, and three months later. Participants improved from baseline to post-treatment and three months later for depressive symptoms, anxiety symptoms, and disability. Most participants (9 of 15) engaged in the first tier only, averaging less than one hour of contact, and reported benefits and high satisfaction. This intervention showed preliminary evidence of feasibility, acceptability, satisfaction, and benefits, warranting further pilot testing with primary care personnel.

Continuous Laparoscopic Closure of the Linea Alba with Barbed Sutures Combined with Laparoscopic Mesh Implantation (IPOM Plus Repair) As a New Technique for Treatment of Abdominal Hernias.

Despite extensive experience and significant reduction of complications in recent years, laparoscopic treatment of complex abdominal hernias is a challenge even for the experienced endoscopic surgeon. Patients with severe incisional hernias or symptomatic rectus diastasis benefit from the closure of the linea alba as a morphological and physiological reconstruction of the abdominal wall followed by mesh implantation. Occasionally, an additional component separation is necessary. In open surgery, this is associated with very large wound areas, postoperative seromas, poor wound healing and, in the worst case, mesh infections. To avoid these complications, we operate these complex reconstructions completely endoscopically. Our concept is based on a laparoscopic closure of the linea alba through an ongoing, barbed non-resorbable 1-0 suture (polybutester) and final reinforcement by an intraperitoneal-onlay mesh (IPOM-Plus). For the treatment of complex abdominal hernias with a width of more than 10 cm, we performed an endoscopic anterior bilateral component separation. This allows the surgeon to combine the advantages of the open abdominal wall reconstruction with those of laparoscopic hernia repair. Between May 2015 and June 2017, we treated 42 patients with abdominal hernias by laparoscopic continuous hernia defect closure and complementary mesh implantation, whereby a complex reconstruction with additional endoscopic anterior component separation was performed in five patients. In this article, we will present this innovative technique of endoscopic/laparoscopic hernia repair in complex abdominal hernias.

Benzoxazinoids in Prostate Cancer Patients after a Rye-Intensive Diet: Methods and Initial Results.

Rye bread contains high amounts of benzoxazinoids, and in vitro studies have shown suppressive effects of selected benzoxazinoids on prostate cancer cells. Thus, research into benzoxazinoids as possible suppressors of prostate cancer is demanded. A pilot study was performed in which ten prostate cancer patients received a rye-enriched diet 1 week prior to prostatectomy. Plasma and urine samples were collected pre- and postintervention. Ten prostate biopsies were obtained from each patient and histologically evaluated. The biopsies exhibited concentrations above the detection limit of seven benzoxazinoids ranging from 0.15 to 10.59 ng/g tissue. An OPLS-DA analysis on histological and plasma concentrations of benzoxazinoids classified the subjects into two clusters. A tendency of higher benzoxazinoid concentrations toward the benign group encourages further investigations. Benzoxazinoids were quantified by an optimized LC-MS/MS method, and matrix effects were evaluated. At low concentrations in biopsy and plasma matrices the matrix effect was concentration-dependent and nonlinear. For the urine samples the general matrix effects were small but patient-dependent.

Moderate strontium loading induces rickets in rats with mild chronic renal failure.

BACKGROUND/AIMS: Renal osteodystrophy and eventually osteoporosis are serious long-term complications in children with end-stage renal disease before and after renal transplantation. Strontium (Sr) salts are used for treatment of osteoporosis in adults. METHODS: To evaluate the time-dependent effects of Sr on growth plate morphology and their reversibility, chronic renal failure (CRF) rats received either normal or Sr-loaded drinking water (2 g/l; ±200 mg/kg/day) for periods of 2, 6 and 12 weeks with or without subsequent washout periods of 0, 2, 4 or 8 weeks. RESULTS: While weight gain was not affected by Sr loading, a significant enlargement of the entire growth plate, mainly due to expansion of the hypertrophic zone, was already present after 2 weeks. Sr-loaded animals showed increased osteoid areas and reduced bone formation rates at 2, 6 and 12 weeks compared to controls. This was accompanied by reduced PTH levels and increased serum bone alkaline phosphatase activity. After the washout periods these effects were reversed. In general, the height of the hypertrophic zone was positively correlated with osteoid area and negatively correlated with bone formation rate. CONCLUSION: Moderate Sr loading in CRF rats results in rapid development of rickets, which is reversible after washout.

Ibandronate affects bone growth and mineralization in rats with normal and reduced renal function.

Bisphosphonates have been shown to attenuate ectopic calcification in experimental uremia. While they are known to reduce bone turnover, the effects on endochondral bone formation have not yet been addressed. To address this issue, we administered male Sprague-Dawley rats weekly subcutaneous injections of either vehicle or ibandronate (1.25 µg/kg body weight) for a total of 10 weeks. The rats were randomly allocated into one of four groups: (1) vehicle-treated, sham-operated rats; (2) ibandronate-treated, sham-operated rats; (3) vehicle-treated, 5/6 nephrectomized rats; (4) ibandronate-treated, 5/6 nephrectomized rats. Bones were double labeled with tetracycline and demeclocycline in vivo, and tibiae were removed for analysis. Weight gain was similar in all groups. Ibandronate reduced body length gain and tibial growth rate in the sham-operated animals but not in the rats showing chronic renal failure (CRF). The height of the proliferative zone of the epiphyseal growth plate was reduced in the ibandronate-treated controls and tended to be reduced in CRF rats. A significant correlation between tibial growth rate and height of the proliferative zone was observed. Mineral apposition rates were significantly reduced in ibandronate-treated, sham-operated rats and tended to be reduced in CRF rats. In conclusion, ibandronate interferes with tibial growth and bone mineralization in young rats with normal and reduced renal function.

Exodoncia y tratamiento periodontal en pacientes de riesgo hemostático / Tooth extraction and periodontal treatment in patients with hemostatic risk

Se plantea un método de acción en exodoncia y tratamiento periodontal en pacientes de riesgo hemostático. Se analizan 193 intervenciones en 110 pacientes, 95 de ellos anticoagulados crónicos y 15 con algún tipo de hemopatía. Las intervenciones fueron realizadas en todos los casos con aplicación de Tissucol en el alvéolo o en la encía operada, sin suspender la medicación en los anticoagulados. un 87.6 por ciento de los postoperatorios cursaron sin inconvenientes y el 12.4 por ciento restante presentó sangrados leves, resueltos ambulatoriamente. No se encontró relación entre la complejidad de la intervención y el resultado hemostático obtenido

Exodoncia y tratamiento periodontal en pacientes de riesgo hemostático / Tooth extraction and periodontal treatment in patients with hemostatic risk

Se plantea un método de acción en exodoncia y tratamiento periodontal en pacientes de riesgo hemostático. Se analizan 193 intervenciones en 110 pacientes, 95 de ellos anticoagulados crónicos y 15 con algún tipo de hemopatía. Las intervenciones fueron realizadas en todos los casos con aplicación de Tissucol en el alvéolo o en la encía operada, sin suspender la medicación en los anticoagulados. un 87.6 por ciento de los postoperatorios cursaron sin inconvenientes y el 12.4 por ciento restante presentó sangrados leves, resueltos ambulatoriamente. No se encontró relación entre la complejidad de la intervención y el resultado hemostático obtenido (AU)

Enfermedades estomatológicas y Sindrome de Inmunodeficiencia Adquirida / Stomatological diseases and AIDS

El propósito de este trabajo es tratar las enfermedades estomatológicas relacionadas con el Sindrome de Inmunodeficiencia Adquirida, haciendo referencia a las infecciones oportunistas, la leucoplasia vellosa y el sarcoma de Kaposi. Se desarrollan traumas vinculadas con las infecciones micóticas, bacteriana y virósicas; enfermedades relacionadas con glándulas salivales y tumores. También se describen los aspectos terapéuticos y la situación actual del SIDA en la República Argentina

Enfermedades estomatológicas y Sindrome de Inmunodeficiencia Adquirida / Stomatological diseases and AIDS

El propósito de este trabajo es tratar las enfermedades estomatológicas relacionadas con el Sindrome de Inmunodeficiencia Adquirida, haciendo referencia a las infecciones oportunistas, la leucoplasia vellosa y el sarcoma de Kaposi. Se desarrollan traumas vinculadas con las infecciones micóticas, bacteriana y virósicas; enfermedades relacionadas con glándulas salivales y tumores. También se describen los aspectos terapéuticos y la situación actual del SIDA en la República Argentina (AU)