Rapid Administration of Antibiotics for Reducing Fever Days in Patients Receiving Hematopoietic Stem Cell Transplantation.

Background and Objectives: Neutropenic fever (NF) is a major cause of mortality and morbidity in patients undergoing hematopoietic stem cell transplantation (HSCT). To date, no study has discussed the relationship of fever days in HSCT with the time between recording the fever and administering antibiotics. This study aimed to examine the association between fever days in HSCT and the time interval between recording the fever and intravenous (IV) antibiotics to the febrile neutropenia patient. Materials and Methods: A total of 22 patients who developed NF after HSCT in one hospital were analyzed. Patients who received IV antibiotics injection within 30 min were categorized in group A and those who received the injection after 30 min were categorized in group B. Fever was defined by an attack with an oral temperature of 38.3 °C. Patients' characteristics and possible risk factors were recorded and analyzed. Results: Groups A and B had 14 and 8 patients, respectively. Patient characteristics, including age, diagnosis, sex, and antibiotics level, were similar between the two groups. The median duration of fever days was 1.5 (range, 1−5) in group A and 6.5 (range, 1−14) in group B (p = 0.003). Multivariant analysis of possible independent impact factors of "fever days in HSCT" was performed. The odds ratio of "antibiotics given time" was 4.00 (95% confidence interval [CI] = 2.26 to 7.22, p = 0.001). The "antibiotics level" did not affect the NF period (odds ratio = −0.80, 95% CI = −2.40 to 1.07, p = 0.453). Conclusions: Rapid IV administration of antibiotics (<30 min after fever attack) can reduce the fever days in patients undergoing HSCT.

Effects of Hyperosmolar Dextrose Injection in Patients With Rotator Cuff Disease and Bursitis: A Randomized Controlled Trial.

OBJECTIVE: To determine whether dextrose prolotherapy offers clinical benefits in patients with shoulder pain and bursitis. DESIGN: Double-blinded, randomized controlled trial. SETTING: Outpatient rehabilitation department of a single medical center. PARTICIPANTS: Patients (N=50) who had received a diagnosis of shoulder pain and bursitis through clinical tests and ultrasound examination. INTERVENTIONS: Participants were randomly assigned to the 15% dextrose injection (D15W) group or the placebo group to receive either D15W or normal saline injection, respectively. All participants received ultrasound-guidance bursal injection every 2 weeks for a total of 3 injections. MAIN OUTCOME MEASURES: The primary outcome was maximal pain level while performing activities. The secondary outcomes included resting pain level, function and disability assessment results, and ultrasonographic parameters. Participants were followed up for 3 months after completion of the injection course. RESULTS: No significant differences in baseline characteristics were observed between the D15W and placebo groups. Significant time effects were observed for all outcome parameters (all P<.05); however, time × group effects were nonsignificant for all outcomes, except for tissue elasticity (P=.026). CONCLUSIONS: Supporting evidence is insufficient regarding the clinical benefits of 15% dextrose bursal injection administered through 3 sessions in patients with chronic shoulder pain and bursitis. The findings indicate that these injections may increase the tissue stiffness of the supraspinatus tendon, as indicated by elastography assessment results, but further research is required to determine the nature of such changes in elastography findings.

Targeting ß-tubulin/CCT-ß complex induces apoptosis and suppresses migration and invasion of highly metastatic lung adenocarcinoma.

Metastasis, the movement of cancer cells from one site to another, is responsible for the highest number of cancer deaths, especially in lung cancer patients. In this study, we first identified a prognostic marker of lung adenocarcinoma, TCP-1 ß subunit (chaperonin-containing TCP-1ß; CCT-ß). We showed a compound that disrupted the interaction of CCT-ß with ß-tubulin killed a highly metastatic non-small cell lung cancer cell line CL1-5 through inducing Endoplasmic reticulum stress and caspases activation. Moreover, at the dosage of EC20, the compound inhibited migration and invasion of the lung cancer cells by suppressing matrix metalloproteinase (MMP)-2/9 and epithelial-mesenchymal transition (EMT)-related proteins through downregulating mitogen-activated protein kinases (MAPKs), Akt/ß-catenin and integrin-focal adhesion kinase signaling pathways. Unlike the anticancer drugs, such as Taxol, that target the adenosine triphosphate site of ß-tubulin, this study reveals a therapeutic target, ß-tubulin/CCT-ß complex, for metastatic human lung adenocarcinoma. The study demonstrated CCT-ß as a prognostic marker. Targeting ß-tubulin/CCT-ß complex caused apoptosis and inhibited invasion/migration of CCT-ß overexpressed, highly metastatic lung adenocarcinoma.

Association between the volume of inpatient rehabilitation therapy and the risk of all-cause and cardiovascular mortality in patients with ischemic stroke.

OBJECTIVE: To investigate the relationship between the volume of inpatient rehabilitation therapy and mortality among patients with acute ischemic stroke, as well as to assess whether the association varies with respect to stroke severity. DESIGN: A retrospective study with a cohort of consecutive patients who had acute ischemic stroke between January 1, 2008, and June 30, 2009. SETTING: Referral medical center. PARTICIPANTS: Adults with acute ischemic stroke (N=1277) who were admitted to a tertiary hospital. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Stroke-related mortality. RESULTS: During the median follow-up period of 12.3 months (ranging from January 1, 2008, to December 31, 2009), 163 deaths occurred. Greater volume of rehabilitation therapy was associated with a reduced risk of all-cause and cardiovascular mortality (P for trend <.001 for both). Compared with the first tertile, the third tertile of rehabilitation volume was associated with a 55% lower risk of all-cause mortality (hazard ratio [HR]=.45; 95% confidence interval [CI], .30-.65) and a 50% lower risk of cardiovascular mortality (HR=.50; 95% CI, .31-.82). The association did not vary with respect to stroke severity (P for interaction = .45 and .73 for all-cause and cardiovascular mortality, respectively). CONCLUSIONS: The volume of inpatient rehabilitation therapy and mortality were significantly inversely related in the patients with ischemic stroke. Thus, further programs aimed at promoting greater use of rehabilitation services are warranted.

Ultrasonographic appearance of subungual glomus tumors.

BACKGROUND: To describe the sonographic (US) features of pathologically confirmed subungual glomus tumors. METHODS: We retrospectively analyzed cases of pathologically confirmed subungual glomus tumors in patients presenting between December 1, 2008 and October 31, 2012, selected from cases in the musculoskeletal US database of a single institution. RESULTS: Data on 14 patients with pathologically proven glomus tumors were retrieved from the US database. The tumor size ranged from 1.9 to 10.0 mm (mean ± SD, 5.3 ± 2.3 mm). Well-circumscribed tumors with clear margins were identified on US in 12 cases (86%): 11 (92%) tumors were hypoechoic and 1 (8%) was isoechoic. On power or color Doppler US, 11 of these 12 tumors (92%) appeared hypervascular. Two of the 14 tumors did not show a clearly circumscribed mass on gray-scale US, and bony erosion was the only US finding in one of the two cases. Seven of the 14 patients (50%) showed focal bony erosion in the underlying phalangeal bone. CONCLUSIONS: A hypervascular mass in the nail bed was the most common US finding associated with subungual glomus tumors. We found that focal hypervascularity supports the diagnosis, and bony erosion is commonly associated with digital glomus tumors.

Micropatterned stretching system for the investigation of mechanical tension on neural stem cells behavior.

In this study, we developed a feasible and reliable stretching platform combined with photolithography and microfluidic techniques to investigate the effect of directional tensile force and guiding microchannel on neural stem cell (NSC) behavior. Different stretching modes and culture conditions were conducted to investigate the mechanoresponse of NSCs on micropatterned substrate and to verify the effects of tension on NSCs maturation, axon sprouting, neurite outgrowth and orientation. From the results, we found that neurite extension and axon elongation were significantly enhanced and neurites were more directional orientated to parallel direction as stretching was experienced. The mechanical tension apparently influenced NSCs differentiation toward neuronal cells under stretching condition. The neuronal maturity also showed a significant difference when compared with parallel and vertical micropatterned channels. It is suggested that mechanical tension not only can guide neurites orientation and direction, but also promote their elongation length and trigger neural stem cells differentiation into mature neuronal cells. FROM THE CLINICAL EDITOR: This group of investigators report the development of a feasible and reliable stretching platform combined with photolithography and microfluidic techniques to investigate the effects of directional tensile force and guiding microchannel on neural stem cell behavior. They demonstrate that neurite extension and axon elongation could be significantly enhanced, and neuronal maturity can also be improved.

Changes in physicochemical properties of corn starch upon modifications by atmospheric pressure plasma jet.

The influences of atmospheric pressure plasma jet on different physicochemical properties of corn starch were evaluated after treated with the plasma jet (30 min) at different strengths (400 W-800 W). Our results demonstrated that residual aging effects of plasma on starch could be eliminated by washing the treated samples with distilled water at a ratio of 1:30, w/v. After plasma and washing treatments, significant (p < 0.05) reductions in pasting properties including peak viscosity, final viscosity, and setback of starch samples (up to -87.1%, -92.0%, and -93.3%, respectively) were observed with increasing plasma intensity. Apparently, plasma jet could increase the solubility and paste clarity of starch sample. Surface morphological characterization illustrated that plasma etching resulted in some physical changes on starch granules. Modifications in these physicochemical properties of corn starch by employing the plasma jet treatment might be useful in food applications requiring starch ingredients of low viscosity and high paste clarity.

Study of autonomic nervous activity of night shift workers treated with laser acupuncture.

OBJECTIVE: The aim of this study was to evaluate the impact of laser acupuncture on the autonomic nervous system (ANS) of the night shift worker. BACKGROUND DATA: Many articles have demonstrated that levels of affective disorders and stress are high in night shift workers. We applied laser energy to the Neiguan point (PC6) to examine the impact of laser acupuncture on the ANS of 45 healthy young males who were night shift workers and evaluated their heart-rate variability (HRV). MATERIALS AND METHODS: The laser group (n = 15) received laser acupuncture (9.7 J/cm(2), 830 nm) for 10 min, and the placebo group (n = 15) received sham laser treatment. The effects before and after this intervention on the HRV of the subjects were assessed, along with those seen after 30 min of lying down. RESULTS: After treatment and after the 30-min rest period, the independent-sample t-test showed that both groups exhibited statistically significant differences in high-frequency (HF) HRV, low-frequency (LF) HRV, and the LF:HF ratio of HRV (p < 0.05). Compared with the placebo group, the paired-samples t-test showed that after laser treatment the treatment group had a statistically significant improvement in HF HRV (p = 0.001), LF HRV (p = 0.001), and the LF:HF HRV ratio (p = 0.02). CONCLUSIONS: Laser acupuncture stimulation applied to the Neiguan point increased vagal activity and suppression of cardiac sympathetic nerves. This effect was positive and could be used to help patients who have circadian rhythm disorders.