Prevalence of multiple system atrophy: A literature review.

INTRODUCTION: This paper aims to provide a literature overview on multiple system atrophy (MSA) prevalence in European and other pan-European populations. METHODS: A literature search (PubMed, EMBASE) was performed through 2022 to identify published studies on MSA prevalence in European countries. Of these search results, titles and abstracts were screened for relevance. A standardized assessment tool was used for systematically data extraction and comparison. For studies where only the incidence rate was reported, MSA prevalence was derived based on the incidence and duration of disease. RESULTS: A total of 24 studies conducted in 14 countries and published between 1995 and 2022 were identified. The prevalence of MSA was reported in 18 (75%) studies and was derived from six (25%) incidence studies. These studies were mainly prospective population-based studies or multi-center studies from specific regions or specialty clinical settings. Two earlier studies in Germany and the Netherlands were conducted using door-to-door design. The time period of evaluation of prevalence ranged from 1990 to 2018. The crude prevalence of MSA ranged from 0.5/100,000 in Spain to 17/100,000 in Japan. Age-specific prevalence rates were provided in five studies, and the reported age ranges varied. The gender-specific crude prevalence was estimated as 2.75/100,000 for men and 1.19/100.000 for women. The derived prevalence was higher (ranging from 0.7-18.9/100,000) than studies where the prevalence was reported. CONCLUSION: The variations observed in MSA prevalence may result from differences in age distributions of the study populations, study methodology, diagnostic criteria and case assessment strategies of MSA. Thus, the comparability of these studies is limited.

The immediate effects of vision-zero corridor upgrades on pedestrian crashes in New York: A before-and-after spatial point process approach.

The long-term effects of the Vision-Zero (VZ) approach in Scandinavia are well documented. In contrast, information regarding the immediate effects of VZ at the starting phase upon gradual implementation is scarce. Taking New York City as the case study, we analyzed both the local and global effects of the Vision-Zero gradual implementation on pedestrian crashes in the early stage of implementation starting from 2014. The data analysis comprised 8,165 pedestrian injury crashes. Using location data, the crashes were matched to VZ infrastructure improvement location, start and completion dates. The experimental design included a treatment and two types of control conditions, and we controlled for well-known covariates including traffic exposure, land use, and risk-prone areas. We estimated a Geyer Saturation model and kernel density function for modeling the effect of Vision-Zero on crash intensity and dispersion two years before and after the implementation of Vision-Zero. The results reveal a significant global decrease of 6.1 % (p = 0.004) in pedestrian crash incidence in the treated sections compared with the control group two years after the treatment, and a greater dispersion of pedestrian injuries following the policy implementation.

The effect of Nateglinide and Octreotide on follicular morphology and free radical scavenging system in letrazole-induced rat model of PCOS.

OBJECTIVE: To investigate the effects of octreotide and nateglinide on ovarian follicle count, ovarian tissue damage, biochemical parameters and free radical scavenging system in letrazole-induced rat model of PCOS. MATERIALS AND METHODS: Forty-two female Sprague-Dawley rats were divided into six groups. Group 1 (Control Group): after localizing the ovaries and the uterine horns, the abdominal wall was closed without any surgical procedure. Group 2 (PCOS Group): PCOS was induced by administrating Letrozole orally for 21 successive days. At the end of 21 days, rats underwent ovarian biopsies. The experimental PCOS model was considered successful in the presence of atretic follicles without granulosa cell stratification. Group 3 (PCOS + Nateglinide Group): Nateglinide was administered by oral dropper for 30 days to the rats in which PCOS model was created. Group 4 (Nateglinid only Group): 30 days of NG was applied to the rats without PCOS. Group 5 (PCOS+Octreotide Group): 0.1 mg/kg/day Octreotide was given intraperitoneally for 4 weeks to the rats in which PCOS model was created. Group 6 (Octreotide only Group): animals without PCOS given 0.1 mg/kg/day Octreotide at the end of the treatment, bilateral oophorectomy was performed and blood samples were collected from all groups. Ovarian tissue was stained immunohistochemically with TLR-4 in addition to conventional staining. In addition to follicle classification, ovarian damage was graded. Serum insulin, FSH and LH, TNF-α, IL-6, SHBG, SOD, IGF-1, MDA and GSH levels were also measured. RESULTS: The cystic and degenerated follicle density of PCOS group was high compared with the other groups. Both cystic and degenerated follicles were significantly reduced in PCOS+NG and PCOS+OC groups compared to PCOS group. There was no difference between the groups in terms of serum LH, FSH and insulin levels (p>0.05). Serum testosterone level was significantly higher in the PCOS group compared to the other groups (p<0.01). Adding OC or NG to PCOS groups did not cause significant changes in testosterone levels. TNF-α and IL-6 levels were high in PCOS group (p<0.03). IGF-1 and MDA levels were higher in PCOS than in other groups (p<0.03, p<0.01 respectively). Adding OC or NG to the treatment normalized IGF-1 and MDA levels. Serum GSH levels were significantly lower in the PCOS group (p<0.05). Adding NG to the treatment increased GSH levels. CONCLUSIONS: Both NG and OCT reverses atretic and degenerate follicle damage due to PCOS through TLR-4, antioxidant and anti-inflammatory pathways.

The examination of stress symptoms and posttraumatic growth in the patients diagnosed with Covid-19.

OBJECTIVE: COVID-19 infection can profoundly affect patients' lives. Coping with difficult life crises can also lead to increased stress or positive psychological change called post-traumatic growth. This research was conducted to examine the symptoms of stress and post-traumatic growth symptoms in the patients diagnosed with COVID-19 (Coronavirus). METHOD: The present study, which is in a descriptive design, was conducted with 175 patients who were discharged after being treated in the intensive care units with the diagnosis of COVID-19. The personal information form, the Posttraumatic Diagnostic Scale (PTDS), and the Posttraumatic Growth Inventory (PTGI) were used to collect data. RESULTS: The mean score for Posttraumatic Stress Symptoms of the participants was 19.18 ± 9.53, and the mean score for Posttraumatic Growth Inventory was 0.86 ± 0.47. In addition, a significant positive correlation was found between PTDS and PTGI mean scores (p < 0.001). As the degree of being affected by covid 19 increases, posttraumatic growth and traumatic stress symptom levels increase (p < 0.05). The posttraumatic growth levels increase as the time elapsed after the treatment of COVID-19 increases (p < 0.001). CONCLUSION: It was determined that after the traumatic experience (COVID-19), the participants had moderate traumatic stress symptoms, and they overcame this situation by experiencing growth. It is recommended to take preventive measures against the symptoms of stress and support the patients in terms of overcoming this process by getting stronger.

Author Correction: Computed tomographic perfusion imaging for the prediction of response transarterial radioembolization with Yttrium­90 glass microspheres of hepatocellular carcinoma.

Correction to: European Review for Medical and Pharmacological Sciences 2021; 25 (1): 366-375-DOI: 10.26355/eurrev_202101_24404-PMID: 33506926, published online on 15 January 2021. After publication, the authors applied to add some corrections to the paper. They added the following authors and affiliations • R. Kutlu, M.F. Erbay, A. Kahraman, E. Kekilli, M. Otlu Karadag • Department of Radiology, Inönü University Medicine Faculty, Malatya, Turkey Department of Nuclear Medicine, Inönü University Medicine Faculty, Malatya, Turkey Department of Nuclear Medicine, Turgut Ozal Training and Research Hospital, Malatya, Turkey They also modified the Acknowledgements section as follows "This study covers the topics of the specialist thesis of the authors. They would like to sincerely thank both Professor Ramazan Kutlu for his work on this subject and the Inönü University, the Department of Radiology and the Department of Nuclear Medicine". There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/24404.

Effectiveness of risk minimisation measures for valproate: a drug utilisation study in Europe, analysis of data from Spain. / Eficacia de las medidas de minimización de riesgos del ácido valproico: estudio de utilización del fármaco en Europa, análisis de datos de España.

INTRODUCTION: Risk minimisation measures for valproate were implemented in Spain in 2015. OBJECTIVE: The objective of this study is to assess the effectiveness of valproate risk minimisation measures in Spain intended to decrease the use of valproate as a first-line therapy, and to evaluate the prescribing patterns of valproate in women, including women of childbearing potential, in the pre- and post-implementation risk minimisation measures periods. MATERIALS AND METHODS: The prescribing patterns of valproate in females and women of childbearing potential before and after risk minimisation measures implementation were examined using the longitudinal patient data database, which includes patient information from two panels: primary care physicians and neurologists/psychiatrists. Primary endpoint was the proportion of initial valproate prescriptions with at least one medication related to the valproate indications before the valproate initiation date. RESULTS: The proportion of incident valproate prescriptions with previous use of medication related to valproate indications was 78.0% (95% CI, 73.9%; 81.5%), and 78.2% (74.5%; 81.4%) in the main pre-and post-implementation periods in the primary care physician panel. The corresponding figures for women of childbearing potential were 79.6% (73.6%; 84.5%) and 75.5% (69.7%; 80.6%), respectively. The incidence rate of pregnancies exposed to valproate (per 1,000 person-years) in women of childbearing potential decreased from 17.4 the entire pre-implementation to 8.5 in the entire post-implementation periods. CONCLUSION: After the implementation of risk minimisation measures for valproate in Spain, no meaningful change in prescribing was observed regarding the proportion of valproate initiations preceded by prior medication related to valproate indications. The preventative measures recommended for use of valproate in women of childbearing potential should be considered.

TITLE: Eficacia de las medidas de minimización de riesgos del ácido valproico: estudio de utilización del fármaco en Europa, análisis de datos de España.Introducción. En 2015 se aplicaron en España distintas medidas para la minimización de los riesgos (MMR) del ácido valproico. Objetivo. El objetivo de este estudio es evaluar la eficacia de las MMR del ácido valproico en España, con el fin de reducir el uso de ácido valproico como terapia de primera línea y evaluar los patrones de prescripción de ácido valproico en las mujeres, incluidas las mujeres en edad fértil (MEF), en los períodos previos y posteriores a la implementación de las MMR. Materiales y métodos. Los patrones de prescripción del ácido valproico en mujeres y MEF antes y después de la implementación de las MMR se examinaron utilizando la base de datos longitudinales de pacientes (longitudinal patient data, LPD por sus siglas en inglés), que incluye información de pacientes de dos paneles: médicos de atención primaria (MAP) y neurólogos/psiquiatras. El criterio principal de valoración fue la proporción de prescripciones iniciales de ácido valproico con al menos un medicamento relacionado con indicaciones de ácido valproico antes de la fecha de inicio del ácido valproico. Resultados. La proporción de prescripciones de ácido valproico secundarias con uso previo de medicamentos relacionados con indicaciones de ácido valproico fue del 78% ­intervalo de confianza (IC) al 95%: 73,9-81,5%­ y del 78,2% (IC al 95%: 74,5-81,4%) en los períodos principales previo y posterior a la implementación en el panel de MAP. Las cifras correspondientes a MEF fueron del 79,6% (IC al 95%: 73,6-84,5%) y del 75,5% (IC al 95%: 69,7-80,6%), respectivamente. La tasa de incidencia de embarazos expuestos al ácido valproico (por 1.000 personas-años) en MEF disminuyó de 17,4 en el período completo previo a la implementación a 8,5 en el período completo posterior a la implementación. Conclusión. Tras la implementación de las MMR del ácido valproico en España no se observó ningún cambio significativo en las prescripciones respecto a la proporción de iniciaciones de ácido valproico precedidas por medicación previa relacionada con indicaciones de ácido valproico. Se deben tener en cuenta las medidas preventivas recomendadas para el uso de ácido valproico en MEF.

Role of α- and ß-adrenergic signaling in phenotypic targeting: significance in benign and malignant urologic disease.

The urinary tract is highly innervated by autonomic nerves which are essential in urinary tract development, the production of growth factors, and the control of homeostasis. These neural signals may become dysregulated in several genitourinary (GU) disease states, both benign and malignant. Accordingly, the autonomic nervous system is a therapeutic target for several genitourinary pathologies including cancer, voiding dysfunction, and obstructing nephrolithiasis. Adrenergic receptors (adrenoceptors) are G-Protein coupled-receptors that are distributed throughout the body. The major function of α1-adrenoceptors is signaling smooth muscle contractions through GPCR and intracellular calcium influx. Pharmacologic intervention of α-and ß-adrenoceptors is routinely and successfully implemented in the treatment of benign urologic illnesses, through the use of α-adrenoceptor antagonists. Furthermore, cell-based evidence recently established the antitumor effect of α1-adrenoceptor antagonists in prostate, bladder and renal tumors by reducing neovascularity and impairing growth within the tumor microenvironment via regulation of the phenotypic epithelial-mesenchymal transition (EMT). There has been a significant focus on repurposing the routinely used, Food and Drug Administration-approved α1-adrenoceptor antagonists to inhibit GU tumor growth and angiogenesis in patients with advanced prostate, bladder, and renal cancer. In this review we discuss the current evidence on (a) the signaling events of the autonomic nervous system mediated by its cognate α- and ß-adrenoceptors in regulating the phenotypic landscape (EMT) of genitourinary organs; and (b) the therapeutic significance of targeting this signaling pathway in benign and malignant urologic disease. Video abstract.

Computed tomographic perfusion imaging for the prediction of response transarterial radioembolization with Yttrium­90 glass microspheres of hepatocellular carcinoma.

OBJECTIVE: The present study aimed to estimate the clinical value of quantitative computed tomography perfusion imaging (CTPI) parameters in predicting early treatment response, as determined by the modified response evaluation criteria in solid tumours (mRECIST), in patients with HCC who underwent transarterial radioembolization (TARE). PATIENTS AND METHODS: This retrospective cohort study included 54 patients with HCC who had TARE treatment between July 2018 and August 2019. Each patient was evaluated using CTPI before the procedure and in the first and third months after the procedure. In the third month, treatment response was determined based on mRECIST and used as a reference. ROC analysis was performed to determine the relationship between the CTPI parameters before treatment and one month after treatment and the treatment response. RESULTS: Significant cut-off values for three of the CTPI parameters - hepatic blood flow (BF), time to start (TTS) and hepatic perfusion index (HPI) - which were among the pre-treatment CTPI parameters, were found to predict progressive disease (PD). The TTS cut-off value was 1.29 (sensitivity: 86.7%; specificity: 6.7%), the BF cut-off value was 81.58 (sensitivity: 53.3%; specificity: 90%) and the HPI cut-off value was 88.26 (sensitivity: 33%; specificity: 96.7%). CONCLUSIONS: BV, TTS and HPI may be predictive for PD in HCC lesions in the third month after TARE treatment. In contrast, the CTPI parameters in the first month after TARE played no significant role in predicting the treatment response and determining the effects of TARE on the microvascular level.

Tadalafil Alone or in Combination with Tamsulosin for the Management for LUTS/BPH and ED.

PURPOSE OF REVIEW: Aim of our systematic review is to evaluate and summarize the efficacy and safety of tadalafil alone or in combination with tamsulosin for the management of lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). RECENT FINDINGS: Daily tadalafil, in particular 5 mg, according to retrieved studies, appears to be both safe and effective in treating LUTS/BPH and ED, compared with placebo or tamsulosin. The combination of daily tadalafil 5 mg and tamsulosin 0.4 mg allows a better improvement of LUTS compared with both the monotherapies, even if with an increased, but acceptable and tolerated, adverse events rate. After discontinuation of tamsulosin or tadalafil in patients previously treated with their combination, the improvement of LUTS retains significance compared with baseline. Tadalafil 5 mg should be considered a primary treatment option for patients with LUTS/BPH and ED. Evidence highlight an excellent tolerability, safety, and effectiveness profile, both alone or in combination with tamsulosin 0.4 mg. A better efficacy on LUTS relief has been observed for combination therapy, preserving also sexual function. The further switch to monotherapy allows to preserve LUTS relief, but tadalafil only is able to retain ED improvement. Our results support the evidence for a more and more tailored and modular LUTS treatment.

Assessment of the effectiveness of genital infection awareness training provided to women based on the IMB model.

BACKGROUND: Genital infections are one of the most common reasons for a hospital visit in the scope of reproductive health problems. The information-motivation-behavioral skills (IMB), therefore, is an appropriate model to provide women with accurate genital hygiene behaviors and develop effective sexual and reproductive health training programs. AIMS: This interventional study was conducted to assess the effectiveness of genital infection awareness training provided to women based on the IMB model. MATERIALS AND METHODS: Study sample consisted of 62 women (nexperimental= 31, ncontrol= 31) who were chosen based on a nonprobability sampling method from vocational courses of Ankara Keçiören municipality. The data collection form developed by the researchers, knowledge evaluation questions (KEQ), and genital hygiene behavior inventory (GHBI) were used to collect data. Data were obtained at training centers and through phone interviews. Another interview was conducted 1 month later and posttest procedures were completed. The Chi-square test, McNemar's, Mann-Whitney U test, and Wilcoxon Signed-Rank tests were used to calculate mean scores. RESULTS: The mean (SD) age was 39.1 (8.4) years for the women in the experimental group and 37.5 (6.7) for the women in the control group (P = 0.481). Pretest knowledge mean scores M (SD)experimental = 15.7 (2.4); and GHBI mean scores M (SD)experimental= 76.9 (11.1) were calculated. Mean scores showed an increase after the training in the experimental group [M (SD)post-test= 19.1 (1.2); M (SD)GHBI= 94.7 (2.6)] (P < 0.001). CONCLUSION: Based on these findings, it was concluded that the genital infection awareness training provided to women based on the IMB model, improved knowledge and acted as a positive reinforcer for the hygiene behaviors of the women.

The negative effect of desflurane on reproductive capacity in female rats.

AIM: The aim of this study was to determine the effect of desflurane on reproductive capacity in female rats through a study of biochemical evaluations. METHOD: After experimental procedure, the blood samples of female rats were collected, and the malondialdehyde, interleukin­1­beta, total glutathione and superoxide dismutase levels were measured to evaluate oxidative stress. In addition to biochemical evaluations, the reproductive performance of the experimental groups was also examined. RESULTS: The results of our study demonstrated that in blood samples of desflurane­treated groups of rats, the parameters indicating oxidative stress and inflammation increased, and antioxidant parameters decreased (p < 0.05). It was also proven that repeated desflurane doses caused infertility in female rats, prolonged the gestation period and reduced the number of offspring. CONCLUSIONS: This study showed that recurrent desflurane application can cause infertility problems through oxidative stress in female rats (Tab. 3, Fig. 1, Ref. 25).

Amputation predictors in diabetic foot ulcers treated with hyperbaric oxygen.

OBJECTIVE: Although hyperbaric oxygen therapy (HBOT) has long been used for diabetic foot ulcers (DFUs), its effectiveness is still controversial. The aim of this study was to investigate the efficacy of HBOT in the management of DFUs and identify amputation predictors. METHOD: Patients with chronic DFUs (Wanger grade 2-5) were included in the study, which took place between January 2010 and December 2012. HBOT, 100% oxygen, 2.4 atmosphere absolute (ATA) for 120 minutes, was administered to all patients in addition to standard treatment. DFUs were monitored for at least 3 years, or until healing or amputation occurred. RESULTS: Patients with a total of 146 chronic DFUswere recruited. Complete healing (69.6%) and significant improvement (17.9%) was observed in 87.5% of the patients. The cases with no improvement resulted in amputation (minor amputation: 15.0%; major amputation: 8.2%). The duration of diabetes (p=0.037), new wound formation (p=0.045), C-reactive protein (p=0.001) and Wagner grade (p=0.0001) were correlated with amputation in multiple regression analysis. Mortality was higher in the amputation group than in the non-amputation group (47.1 % versus 21.4 %, p=0.007). CONCLUSION: The inclusion of HBOT with standard treatment and a multidisciplinary approach may be useful in the treatment of DFUs. We found the most important predictors of amputation to be Wagner grade and wound infection. Multicentre, prospective, randomised studies are needed to provide more evidence.

Synthesis and Characterization of Nitro-, Trinitromethyl-, and Fluorodinitromethyl-Substituted Triazolyl- and Tetrazolyl-trihydridoborate Anions.

The problem of preparing energetic, exclusively mono-azolyl substituted hydridoborate anions in high yield and purity from [BH4 ]- and nitroazoles by hydrogen elimination was overcome by reacting the corresponding nitroazolate anions with the BH3 adducts BH3 ⋅S(CH3 )2 or BH3 ⋅THF. The highly-energetic, nitro-, trinitromethyl-, and fluorodinitromethyl- substituted triazolyl- and tetrazolyl-trihydridoborate anions were synthesized in this manner and characterized by vibrational and multinuclear NMR spectroscopy and their crystal structures. The use of excess BH3 resulted in some cases in the addition of a second BH3 molecule bound more-weakly to one of the nitrogen atoms of the azole ring. All monoazolyl-trihydridoborates were thermally less stable than the parent azolate anions. A decomposition product of tetraphenylphosphonium (5-(trinitromethyl)-5H-2λ4 -tetrazol-2-yl)trihydridoborate, the tetraphenyl-phosphonium (dinitro-1H-tetrazol-5-yl)methanide monohydrate, was also structurally characterized, providing some insight into the decomposition pathways of the nitromethyl-substituted azolyltrihydridoborate anions.

Synchronization dynamics on the picosecond time scale in coupled Josephson junction neurons.

Conventional digital computation is rapidly approaching physical limits for speed and energy dissipation. Here we fabricate and test a simple neuromorphic circuit that models neuronal somas, axons, and synapses with superconducting Josephson junctions. The circuit models two mutually coupled excitatory neurons. In some regions of parameter space the neurons are desynchronized. In others, the Josephson neurons synchronize in one of two states, in-phase or antiphase. An experimental alteration of the delay and strength of the connecting synapses can toggle the system back and forth in a phase-flip bifurcation. Firing synchronization states are calculated >70 000 times faster than conventional digital approaches. With their speed and low energy dissipation (10^{-17}J/spike), this set of proof-of-concept experiments establishes Josephson junction neurons as a viable approach for improvements in neuronal computation as well as applications in neuromorphic computing.

Changes in irisin levels in patients with hyperemesis gravidarum.

PURPOSE: The aim of this study was to compare levels of serum irisin in hyperemesis gravidarum (HG) patients to healthy gravidas. MATERIALS AND METHODS: Twenty pregnant women with hyperemesis gravidarum (Group 1) and 20 healthy pregnant women (Group 2) all of similar ages, body mass index, and all at similar pregnancy development comprised the study cohort. Fasting serum samples were obtained and measured for irisin levels. Comparisons between groups were done by Mann Whitney U (MWU) test and p < 0.05 was considered as statistically significant. RESULTS: All the patients in groups 1 and 2 were primigravid and age, gestational week, and body mass index values were similar. No statistically significant difference were present among these parameters (p > 0.05, MWU test). The plasma irisin concentrations in group 1 were significantly higher (irisin (average ±S D): 116.9 ± 32.3 ng/ml vs. 87.7 ± 26.2 ng/ml) compared to the control group. CONCLUSION: This study suggests a possible role of irisin, which might be involved in the pathology of HG.

Effects of diclofenac sodium on the hippocampus of rats with acute subdural hematoma: histological, stereological, and molecular approach.

This study was aimed at evaluating the potential effects of acute subdural hematoma (ASDH) and diclofenac sodium (DS) therapy following ASDH on the rat hippocampus. Twenty-four male Sprague Dawley rats were used and divided into four groups. 0.1 ml of non-heparinized autologous blood from the tail vein of the animals in the non-treatment group (NTG) and treatment group (TG) was injected into the subdural space. The TG received intramuscular diclofenac sodium at a 15 mg/kg dose daily from the postoperative second hour to the seventh day after the operation. The control group (CG) and sham group (SG) were used for control and sham operations, respectively. On the postoperative eighth day, all animals were sacrificed, and the hippocampi of all animals were stereologically and histologically evaluated. Also blood samples of the animals were biochemically analyzed. As a result of the study, the mean number of neurons in CA1, CA2, and CA3 regions of the hippocampus and the total number of neurons were decreased in the hippocampus samples of the NTG and especially the TG subjects. When comparing the second blood samples, there was no difference between the levels of adrenaline and serotonin among the groups. However, after the operation, noradrenalin levels in the treatment group were found to be higher than those of the sham and control groups (p < 0.05). In the NTG and TG, histopathological findings were observed such as Nissl condensation as well as completely dead and indistinguishable neurons with abnormally shaped, shrunken cytoplasm and nuclei. Also necrotic areas on the specimens of the TG were seen. In immunohistochemical sections, c-FOS positivity was decreased in the NTG and especially the TG. Otherwise, PGC-1 positive cells were increased in the NTG and especially the TG. In this study, it was shown for the first time by means of stereological techniques that using DS after ASDH caused a decrease in the number of hippocampal neurons (CA1, CA2, and CA3 regions).

Effects of prenatal diclofenac sodium exposure on newborn testis: a histomorphometric study.

Diclofenac sodium (DS) is used primarily to treat fever and to alleviate pain and inflammation. We investigated the effects of DS exposure during gestation on the testes of rat pups to investigate the safety of its use during the prenatal period. Pregnant rats were separated into control, saline, low dose, medium dose and high dose groups. DS was given between weeks 15 and 21 of gestation. Total numbers of spermatogonia and Sertoli cells were counted in the testes of 7-day-old male rats using the physical disector method. By the end of the study, the total number of Sertoli cells was decreased significantly in a dose dependent manner in the medium and high dose groups compared to controls. No significant differences were found in the total number of spermatogonia in the control, saline and low dose DS groups. Medium and high dose DS administration reduced the total number of spermatogonia compared to other groups. We suggest that prenatal administration of DS can cause deleterious effects on the testis development, especially in high doses.

Predicting discharge destination with admission outcome scores in stroke patients.

BACKGROUND: The goal of this study was to predict the discharge location for stroke patients. OBJECTIVE: To design a tool to assess a community discharge that will assist in development of individualized care plans and discharge planning. METHODS: Patients (N = 407) hospitalized for an acute stroke in an inpatient rehabilitation facility were used for this retrospective study. Admission data from the Functional Independence Measure (FIM) and Simplified Stroke Rehabilitation Assessment of Movement (S-STREAM) were used to determine predictive factors for a community discharge. RESULTS: Logistic regressions and chi-square analyses were used to determine admission factors that predict a community discharge and the cut off score for each predictive variable. The S-STREAM, Motor FIM, Total FIM, FIM Bladder, FIM bed transfer, FIM toilet transfer, FIM bathing, and FIM memory were predictive of a community discharge. A predictive tool with a sensitivity and specificity of 76% and 64% was developed using the combined relative risk scores of the S-Stream, FIM Bladder, FIM Bed Transfer and FIM Memory. CONCLUSIONS: By using outcome data at the time of admission, a discharge destination can be predicted for stroke patients with significant sensitivity and specificity.

Immunogenicity and safety of the 9-valent HPV vaccine in men.

OBJECTIVES: This study was designed to evaluate the immunogenicity and tolerability of a prophylactic 9-valent HPV (types 6/11/16/18/31/33/45/52/58) VLP (9vHPV) vaccine in young men 16-26 years of age in comparison to young women 16-26 years of age (the population that was used to establish 9vHPV vaccine efficacy). Safety and immunogenicity data from this study will be used to bridge 9vHPV vaccine efficacy findings in 16-26 year old women to 16-26 year old men. METHODS: This study enrolled 1106 heterosexual men (HM) and 1101 women who had not yet received HPV vaccination. In addition, 313 men having sex with men (MSM) were enrolled and were evaluated separately for immunogenicity because previous results showed that antibody responses to quadrivalent HPV (types 6/11/16/18) VLP (qHPV) vaccine were lower in MSM than in HM. All subjects were administered a 3-dose regimen (Day 1, Month 2, Month 6) of 9vHPV vaccine. Serum samples were collected for anti-HPV assays. Safety information was collected for ∼ 12 months. RESULTS: The geometric mean titers (GMTs) for HPV types 6, 11, 16, 18, 31, 33, 45, 52, and 58 for HM were non-inferior to those of women at Month 7. For all vaccine HPV types, Month 7 GMTs were numerically lower in MSM than in HM. Over 99.5% of subjects were seropositive at Month 7 for each vaccine HPV type. Administration of 9vHPV vaccine to both 16-26 year old men and women was generally well tolerated. CONCLUSIONS: These results support bridging the efficacy findings with 9vHPV vaccine in young women 16-26 years of age to men 16-26 years of age.

The evaluation of hemodynamic changes during the reperfusion phase in adult living donor liver transplantations: the role of cardiovascular problems.

OBJECTIVE: This study sought to evaluate the hemodynamic changes of and to analyze the effects of coronary artery disease (CAD) as well as its risk factors on hemodynamic parameters during the reperfusion phase (RP) in adult living donor liver transplantation (ALDLT). PATIENTS AND METHODS: This single-center retrospective study evaluated 154 adult patients being assessed from January 2001 to December 2013 for orthotopic liver transplantation (OLT). The patients were divided into separate groups according to the presence or absence of CAD and its risk factors, including diabetes, hypertension, dyslipidemia, smoking, sex, and age. The hemodynamic parameters were noted during the RP with respect to the patient files. The comparison of the groups and the effects of cardiovascular problems on hemodynamic parameters were statistically analyzed. RESULTS: A decrease of more than 20% in systolic arterial pressure was seen in 16 (16.7%), 7 (43.8%), and 17 (40.5%) patients without CAD, with CAD, and with its high risk factors (>2), respectively (P < .05). Moreover, diastolic hypotension was seen in 59 (38.3%) patients during RP; of those, 10 (62.5%) had CAD and 19 (45.2%) had CAD high-risk factors. The decline in both systolic and diastolic arterial pressure was significantly correlated with the increased number of risk factors (P < .05). CONCLUSIONS: RP in ALDLT remains an issue not only for the surgeons but also for the anesthesiologists. Clinicians should be aware of CAD and its risk factors before OLT and successful management of such problems are mandatory for hemodynamic stability during this formidable process.