Efficacy of a wheat polar lipid complex in reducing hair loss and improving hair growth in healthy women: A randomized, double-blind, placebo-controlled clinical study

OBJECTIVE

Hair loss is a major source of psychological distress for affected people. Safe and natural ingredients are therefore needed to help reduce hair loss and stimulate hair growth. This pilot clinical study aimed at exploring the efficacy of a wheat polar lipid complex (WPLC, Ceramosides™), containing sphingolipids and digalactosyl diglycerides, on hair characteristics improvement in women showing acute hair shedding.

METHODS

Sixty-six women presenting a proportion of hair in the telogen phase greater than 15% were recruited and allocated to two groups, each including at least 10 postmenopausal women. For 84 days, participants consumed 30 mg/day of the WPLC supplement, or the placebo. Their hair characteristics were assessed after 56 and 84 days using phototrichogram evaluations of hairs in anagen/telogen phases, measuring hair shedding by a pull test, hair diameter and elongation at break point, hair growth and scalp sebum content. Hair density and volume were also clinically evaluated. All these parameters were also investigated in the subgroup of postmenopausal women.

RESULTS

WPLC supplementation decreased telogen hair density/proportion while increasing the anagen hair density/proportion. These effects were significant compared with the placebo as early as within 56 days. It also led to reduced hair shedding upon pull test analyses. If no changes were evidenced in hair diameter, WPLC improved hair growth and resistance to breakage after 84 days. Clinical evaluations also showed hair density and volume improvement. Furthermore, supplementation decreased scalp sebum content in women with oily hair. The beneficial effects were also observed in the subgroup of postmenopausal women. Finally, WPLC supplementation improved participants' perception of their hair conditions.

CONCLUSION

Through a reducing effect on hair shedding and a stimulating effect on hair reappearance and growth, WPLC dietary supplementation was shown to significantly reduce hair loss in women.

Dietary supplementation with a wheat polar lipid complex improves skin conditions in women with dry skin and mild-to-moderate skin aging

BACKGROUND

Aging, menopause, and seasonal changes alter the lipid composition of the outermost skin layer, the stratum corneum, resulting in dry and itchy skin.

AIMS

This clinical trial aimed at evaluating the effects of a wheat polar lipid complex (WPLC) on skin characteristics in women showing dry and wrinkled skin, investigating its effects in a subgroup of postmenopausal women, and assessing if benefits were maintained after supplementation.

METHODS

Seventy-two women with dry and wrinkled skin were recruited in this double-blind, randomized, parallel-group study, and allocated to three groups of 24 subjects, each including at least 10 postmenopausal women. For 56 days, subjects consumed the WPLC supplement (oil or powder), or the placebo. Skin hydration, transepidermal water loss (TEWL), elasticity, and profilometry were evaluated at baseline, after 14, 28, and 56 days of supplementation, and 56 days after the end of supplementation. Additionally, a lipidomic analysis was performed to examine changes in superficial skin layers over 56 days.

RESULTS

Dietary supplementation with WPLC rapidly improved all parameters. It increased skin hydration, smoothness, and elasticity while decreasing TEWL, roughness, and wrinkle depth after only 14 days of supplementation. These effects were also observed in the subpopulation of postmenopausal women and led to an improved self-perception of skin. For all the parameters, outcomes were not maintained after the supplementation was stopped. The lipidomic analysis revealed 10 compounds evolving over the 56 days of WPLC supplementation.

CONCLUSION

WPLC supplementation improved skin hydration, smoothness, elasticity, and wrinkledness within 14 days and, as expected, did not last after supplementation was stopped.

The World's First Acne Dysbiosis-like Model of Human 3D Ex Vivo Sebaceous Gland Colonized with Cutibacterium acnes and Staphylococcus epidermidis

Acne-prone skin is associated with dysbiosis involving Cutibacterium acnes (C. acnes) and Staphylococcus epidermidis (S. epidermidis) causing increased seborrhea in sebaceous glands (SG) and inflammation. Human primary sebocytes were cultivated using 1.106 UFC/mL C. acnes Type IA (facial acne, ATCC6919) and/or 1.105 UFC/mL S. epidermidis (unknown origin, ATCC12228) for 48 h in our SEB4GLN-optimized media without antibiotics. Bacteria and sebocytes were enumerated and assessed to determine their viability. Lipid production was imaged and quantified via Nile Red staining. SG with hair follicles were microdissected from healthy skin and cultured using 1.105 UFC/mL C. acnes Type 1A and/or 1.104 UFC/mL S. epidermidis (wild-type facial skin strain) through prior fixation and immunostaining for MC5R, C. acnes and nuclei (DAPI) via Z-stack confocal microscopy bioimaging (Leica SP5X & FIJI software, Version 2.9.0). C. acnes growth was not impacted when co-cultivated with sebocytes (2D) or SG (3D) models. Phylotype IA stimulated sebocyte lipid production, which had no impact on viability. The S. epidermidis reference strain overproliferated, inducing sebocyte mortality. For 3D SG model, culture conditions were optimized using a wild-type facial skin strain at a lower concentration, 1:10 ratio to C. acnes, reduced contact time, sequential inoculation and rinsing step. Bioimaging revealed strong C. acnes labeling in the active areas of the pilosebaceous unit. S. epidermidis formed biofilm, which was distributed across the SG via non-specific fluorescence imaging. We developed an innovative model of a sebaceous gland that mimics acne-prone skin with lipid overproduction and virulent phylotype IA C. acnes inoculation.

Effect of the supplementation of virgin coriander seed oil on reducing reactivity in healthy women with sensitive skin: a randomized double-blind placebo-controlled pilot clinical study

Sensitive skin is a common condition that affects many people in the world, especially women. This syndrome is defined by the occurrence of unpleasant sensations such as stinging and burning in response to stimuli that should not normally provoke such sensations. Coriander seed oil (CSO) is a 100% virgin oil of coriander seeds and boasts a specific composition of fatty acids, mainly petroselinic acid (60–75%). It has demonstrated its ability to regulate inflammation (NF-κB pathway) and nociception (TRPA1 pathway), two mechanisms supporting sensitive skin, in previous in vitro research. It was, therefore, a good candidate to be tested in vivo on sensitive skin conditions. A pilot clinical study was conducted to evaluate the effect of this ingredient on healthy women showing excessive skin reactions, mainly redness and discomfort when subjected to external stress. The results showed that the daily consumption of 200 mg of CSO for 28 days effectively reduced redness induced by stripping stress and itching induced by stinging stress. It also improved the perception of skin sensitivity and reactivity after 56 days of consumption. These clinical results confirmed that CSO is a promising ingredient to contribute to reducing reactivity in sensitive skin.

Comparison of wheelchair securement systems designed for use in large accessible transit vehicles (LATVs)

Design challenges in wheelchair securement for fixed-route, large accessible transit vehicles (LATVs) often create difficulties for passengers who use wheelchairs and operational inefficiencies for public transit agencies. Recent innovations in wheelchair securement technology for LATVs may reduce these challenges. This study explored the usability of three commercially available wheelchair securement systems in a static laboratory environment: a four-point, forward-facing (4P-FF) securement system, a three-point, forward-facing (3P-FF) securement system, and a semi-automated, rear-facing (SA-RF) securement system. Three groups of mobility device users (manual wheelchair users, power wheelchair users, and scooter users) (n = 36) completed wheelchair securement tasks in a full-scale mock-up of an LATV. For the 19 participants who did not use the occupant restraint system (ORS), perceived usability and securement time were compared across the securement systems. Using multiple usability rating scales, most participants reported that each of the systems would be acceptable for regular use. However, the majority indicated an overall preference for the SA-RF, and most rated the SA-RF system as easier, faster, and requiring less assistance to use than the 4P-FF and 3P-FF systems. Alternatives to conventional 4P-FF wheelchair securement in LATVs may thus improve boarding efficiency and transit independence of passengers who use wheelchairs.

Infectious Coryza: Persistence, Genotyping, and Vaccine Testing

The reemergence of infectious coryza (IC) caused by Avibacterium paragallinarum (AP) as an acute and occasionally chronic respiratory disease in domestic poultry has caused severe losses in several U.S. states. The disease is also associated with decreased egg production in layers and increased condemnations from air sac infections in broilers. A series of applied experiments were performed to elucidate the persistence of AP in infected broiler flocks, to genotype AP strains isolated from field cases, and to evaluate commercial and autogenous vaccine protection in commercial and specific-pathogen-free (SPF) chickens. Experimental evaluation of environmental persistence suggests that AP did not persist more than 12 hr in a hypothetically contaminated environment. Additionally, other detected potential pathogens such as Gallibacterium anatis and infectious bronchitis virus caused mild respiratory signs in the exposed birds. The HMTp210 and HagA genes of four IC field strains were sequenced and compared with published sequences of HMTp210 and HagA. The HMTp210 phylogeny showed a marginally imperfect clustering of the sequences in genogroups A, B, and C. Although not definitive, this phylogeny provided evidence that the four field strains aligned with previously characterized serovar C strains. Moreover, the base pair homology of the four strains was 100% identical to serovar C reference strains (H-18 and Modesto). HagA phylogeny was unclear, but interestingly, the IC field strains were 100% homologous to C-1 strains reported from Mexico and Ecuador. Finally, vaccine protection studies in commercial hens indicate that clinical signs are induced by a combination of IC and other concomitant pathogens infecting commercial birds. Additionally, vaccine protection experiments performed in SPF hens indicated that protection provided by the two commercial vaccines tested provided a reduction in clinical signs and bacterial shedding after two applications.

Partners' motivations for accommodating posttraumatic stress disorder symptoms in service members: The reasons for accommodation of PTSD scale

Emerging research reinforces the importance of partner accommodation in the interpersonal context of posttraumatic stress disorder (PTSD). A better understanding of partners' motivations for accommodation is needed to help refine or design interventions that target accommodation. To explore partners' motivations, we created the Reasons for Accommodation of PTSD Scale (RAPS) and evaluated it in 263 female partners of male Army soldiers who had returned from a deployment within the past 2 years. Soldiers completed a measure of military-related PTSD, and partners completed a measure of accommodation and the newly created RAPS. Factor analysis of the RAPS yielded a clear, 3-factor solution suggesting the following reasons for accommodating: (1) Relationship & Obligation, or a desire for positive relationship outcomes and a sense of duty or responsibility; (2) Helping Recovery, or a belief that avoidance was helpful for the service member; and (3) Conflict Avoidance/Helplessness, or a desire to avoid conflict or simply not knowing what else to do. Analyses of these factors in relation to soldiers' PTSD clusters indicated that hyperarousal symptoms were uniquely associated with relationship and obligation motivations, re-experiencing symptoms were uniquely associated with helping recovery motivations, and emotional numbing symptoms were uniquely associated with conflict avoidance and helplessness motivations. Furthermore, conflict avoidance and helplessness accounted for the greatest variance in partners' accommodation frequency and distress. Assessment of partners' accommodative behaviors, as well as their motivations for engaging in accommodation, may aid in treatment planning and enhance outcomes for couples in which one individual has PTSD.

Systematic alteration of ATAC-seq for profiling open chromatin in cryopreserved nuclei preparations from livestock tissues

The use of Assay for Transposase-Accessible Chromatin (ATAC-seq) to profile chromatin accessibility has surged over the past years, but its applicability to tissues has been very limited. With the intent of preserving nuclear architecture during long-term storage, cryopreserved nuclei preparations from chicken lung were used to optimize ATAC-seq. Sequencing data were compared with existing DNase-seq, ChIP-seq, and RNA-seq data to evaluate library quality, ultimately resulting in a modified ATAC-seq method capable of generating high quality chromatin accessibility data from cryopreserved nuclei preparations. Using this method, nucleosome-free regions (NFR) identified in chicken lung overlapped half of DNase-I hypersensitive sites, coincided with active histone modifications, and specifically marked actively expressed genes. Notably, sequencing only the subnucleosomal fraction dramatically improved signal, while separation of subnucleosomal reads post-sequencing did not improve signal or peak calling. The broader applicability of this modified ATAC-seq technique was tested using cryopreserved nuclei preparations from pig tissues, resulting in NFR that were highly consistent among biological replicates. Furthermore, tissue-specific NFR were enriched for binding motifs of transcription factors related to tissue-specific functions, and marked genes functionally enriched for tissue-specific processes. Overall, these results provide insights into the optimization of ATAC-seq and a platform for profiling open chromatin in animal tissues.

Comparing refractive outcomes of a standard industry toric IOL calculator using anterior corneal astigmatism and total corneal refractive power

PURPOSE

To evaluate refractive outcomes for a standard industry calculator using anterior corneal astigmatism or total corneal refractive power.

METHODS

This prospective interventional study evaluated the refractive outcomes of 56 eyes using a standard industry calculator (Zeiss ZCalc) and a digital IOL alignment software. After A-constant optimisation the ZCalc was recalculated with two different keratometry values using appropriate refractive indices: anterior corneal astigmatism (ACA) by IOLMaster 700 and total corneal refractive power (TCRP) by Pentacam. The Barrett toric calculator was used as a reference.

RESULTS

Undercorrection of 0.04 ± 0.42 D after 1 week and 0.13 ± 0.48 D after 3 months was achieved for the spherical equivalent by using a standard industry calculator. IOL misalignment was 2.8° ± 3.4° using a digital alignment system. For the ZCalc, the mean absolute error could be reduced from 0.19 ± 0.40 D using ACA to 0.04 ± 0.48 D when considering total corneal refractive power (p = 0.06). The Barrett calculator delivered better refractive outcomes than using a standard industry calculator with ACA measurements only (- 0.06 ± 0.43 D; p < 0.01).

CONCLUSION

Reliable and accurate refractive outcomes in toric IOL calculation were achieved by using the ZCalc calculator. The prediction error for a widely used standard industry toric IOL calculator could be reduced by using measured total corneal refractive power.

Genotypic Characterization of Emerging Avian Reovirus Genetic Variants in California

This study focuses on virus isolation of avian reoviruses from a tenosynovitis outbreak between September 2015 and June 2018, the molecular characterization of selected isolates based on partial S1 gene sequences, and the full genome characterization of seven isolates. A total of 265 reoviruses were detected and isolated, 83.3% from tendons and joints, 12.3% from the heart and 3.7% from intestines. Eighty five out of the 150 (56.6%) selected viruses for sequencing and characterization were successfully detected, amplified and sequenced. The characterized reoviruses grouped in six distinct genotypic clusters (GC1 to GC6). The most represented clusters were GC1 (51.8%) and GC6 (24.7%), followed by GC2 (12.9%) and GC4 (7.2%), and less frequent GC5 (2.4%) and GC3 (1.2%). A shift on cluster representation throughout time occurred. A reduction of GC1 and an increase of GC6 classified strains was noticed. The highest homologies to S1133 reovirus strain were detected in GC1 (~77%) while GC2 to GC6 homologies ranged between 58.5 and 54.1%. Over time these homologies have been maintained. Seven selected isolates were full genome sequenced. Results indicated that the L3, S1 and M2 genes, coding for proteins located in the virus capsid accounted for most of the variability of these viruses. The information generated in the present study helps the understanding of the epidemiology of reoviruses in California. In addition, provides insights on how other genes that are not commonly studied add variability to the reovirus genome.

The 2018 rift eruption and summit collapse of Kīlauea Volcano

In 2018, Kīlauea Volcano experienced its largest lower East Rift Zone (LERZ) eruption and caldera collapse in at least 200 years. After collapse of the Pu'u 'Ō'ō vent on 30 April, magma propagated downrift. Eruptive fissures opened in the LERZ on 3 May, eventually extending ~6.8 kilometers. A 4 May earthquake [moment magnitude (M _w) 6.9] produced ~5 meters of fault slip. Lava erupted at rates exceeding 100 cubic meters per second, eventually covering 35.5 square kilometers. The summit magma system partially drained, producing minor explosions and near-daily collapses releasing energy equivalent to M _w 4.7 to 5.4 earthquakes. Activity declined rapidly on 4 August. Summit collapse and lava flow volume estimates are roughly equivalent-about 0.8 cubic kilometers. Careful historical observation and monitoring of Kīlauea enabled successful forecasting of hazardous events.

Comparison of Two Toric IOL Calculation Methods

PURPOSE

To compare two calculators for toric intraocular lens (IOL) calculation and to evaluate the prediction of refractive outcome.

METHODS

Sixty-four eyes of forty-five patients underwent cataract surgery followed by implantation of a toric intraocular lens (Zeiss Torbi 709 M) calculated by a standard industry calculator using front keratometry values. Prediction error, median absolute error, and refractive astigmatism error were evaluated for the standard calculator. The predicted postoperative refraction and toric lens power values were evaluated and compared after postoperative recalculation using the Barrett calculator.

RESULTS

We observed a significant undercorrection in the spherical equivalent (0.19 D) by using a standard calculator (p ≤ 0.05). According to the Baylor nomogram and the refractive influence of posterior corneal astigmatism (PCA), undercorrection of the cylinder was lower for patients with WTR astigmatism, because of the tendency of overcorrection. An advantage of less residual postoperative SE, sphere, and cylinder for the Barrett calculator was observed when retrospectively comparing the calculated predicted postoperative refraction between calculators (p ≤ 0.01).

CONCLUSION

Consideration of only corneal front keratometric values for toric lens calculation may lead to postoperative undercorrection of astigmatism. The prediction of postoperative refractive outcome can be improved by using appropriate methods of adjustment in order to take PCA into account.

Post-traumatic stress disorder in parturients delivering by caesarean section and the implication of anaesthesia: a prospective cohort study

Background

Post-traumatic stress disorder (PTSD) occurs in 1–7% of women following childbirth. While having a caesarean section (C-section) is known to be a significant risk factor for postpartum PTSD, it is currently unknown whether coexisting anaesthesia-related factors are also associated to the disorder. The aim of this study was to assess anaesthesia-linked factors in the development of acute postpartum PTSD.

Methods

We performed a prospective cohort study on women having a C-section in a tertiary hospital in Switzerland. Patients were followed up six weeks postpartum. Patient and procedure characteristics, past morbidity or traumatic events, psychosocial status and stressful perinatal events were measured. Outcome was divided into two categories: full PTSD disease and PTSD profile. This was based on the number of DSM-IV criteria of the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV) present. The PTSD Checklist Scale and the Clinician Administered PTSD Scale were used for measurement.

Results

Of the 280 patients included, 217 (77.5%) answered the questionnaires and 175 (62.5%) answered to an additional phone interview. Twenty (9.2%) had a PTSD profile and six (2.7%) a PTSD. When a full predictive model of risk factors for PTSD profile was built using logistic regression, maternal prepartum and intrapartum complications, anaesthetic complications and dissociative experiences during C-section were found to be the significant predictors for PTSD profile.

Conclusion

This is the first study to show in parturients having a C-section that an anaesthesia complication is an independent risk factor for postpartum PTSD and PTSD profile development, in addition to known perinatal and maternal risk factors.

Accumulation of liquid hydrocarbons in catalyst pores during cobalt-catalyzed Fischer–Tropsch synthesis

Formation, vaporization and accumulation of liquid hydrocarbon products during FTS in a single catalyst pore.

EUS-Guided Bile Duct Drainage (EUBD) in 95 Patients

PURPOSE

Bile duct stenting during ERCP has long been established as the gold standard for the treatment of biliary obstruction. However, when the ampulla cannot be reached or bile duct cannulation fails, percutaneous or surgical drainage is performed. The study aimed to investigate the feasibility and long-term outcome of a potential alternative intervention, EUS-guided transluminal biliary drainage (EUBD), in a representative number of patients.

MATERIALS AND METHODS

All patients undergoing EUBD were included in a prospectively collected single-center database over a 10-year period. Feasibility was characterized by technical and clinical success, including long-term follow-up data.

RESULTS

From IV/2002 - XI/2012, 10 832 EUS and 8756 ERCP procedures were performed. Simultaneously, 223 PTCD and 95 EUBD were performed. Cholangiography was achieved in 93/95 patients (97.9 %). However, in one patient stone extraction was executed by means of the rendezvous technique. Therefore, drainage was not necessary. Intention to treat with EUS-guided drainage was given in 80/94 patients (86.9 %) using different techniques depending on anatomical variations and requirements. The cause of bile duct obstruction could not be cured in 77 patients (malignancy). In 18 patients, a benign (n = 15) or unknown etiology (n = 3) of bile duct stenosis was found. The complication rate was 15.7 % (mortality, 1.1 %; n = 1/95). The follow-up ranged from 3 - 60 months with reintervention in 3 patients.

CONCLUSION

EUBD is a promising therapy for bile duct obstruction in patients predominantly with malignant diseases. Using EUBD, an excellent interventional approach is available for long-term internal drainage to prevent percutaneous drainage (PTCD). EUS-guided drainage is challenging and needs extraordinary interventional expertise, preferentially in tertiary gastroenterological and endoscopic centers.

Cytokeratin 19-fragments (CYFRA 21-1) as a novel serum biomarker for response and survival in patients with advanced pancreatic cancer

Background:

CYFRA 21-1 serves as biomarker in several epithelial malignancies. However, its role in pancreatic cancer (PC) has not yet been investigated.

Methods:

Within a prospective single-centre study serial blood samples were collected from patients with confirmed advanced PC. Pre-treatment values and weekly measurements of CYFRA 21-1, carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (assessed by Elecsys 2010, Roche Diagnostics) during palliative first-line chemotherapy were obtained. Biomarker data were correlated with objective response (determined by RECIST) as well as time to progression (TTP) and overall survival (OS) using uni- and multivariate analyses.

Results:

Seventy-eight patients were included, 45% of these received treatment in prospective clinical trials. Median TTP was 3.9 months, median OS 7.7 months. Pre-treatment CYFRA 21-1 levels were significantly associated with performance status (P=0.0399) and stage of disease (P=0.0001). Marker values before chemotherapy and at the 2-month staging of all three markers were considered significant predictors for objective treatment response. Pre-treatment CYFRA 21-1 levels, as well as CA 19-9 values, could be applied to define subgroups (categorised by tertiles) with a different OS outcome (CYFRA: 14.8 vs 7.1 vs 4.8 months, CA 19-9: 14.2 vs 7.1 vs 5.2 months; P<0.0001). CYFRA 21-1 and CA 19-9 (both as categorised and as continuous variables) showed a highly significant correlation with TTP and OS at nearly all-time points assessed in univariate analysis. In multivariate analysis, only CYFRA 21-1 and performance status were independent predictors for OS.

Conclusions:

CYFRA 21-1 may serve as a valuable tool for monitoring treatment response and assessing prognosis in advanced PC.

Trehalose-6-phosphate synthase from the cat flea Ctenocephalides felis and Drosophila melanogaster: gene identification, cloning, heterologous functional expression and identification of inhibitors by high throughput screening

Trehalose phosphate synthase (EC 2.4.1.15; TPS) is the crucial enzyme for the biosynthesis of trehalose, the main haemolymph sugar of insects, and therefore a potential insecticidal molecular target. In this study, we report the functional heterologous expression of Drosophila melanogaster TPS, the gene identification, full length cDNA cloning and functional expression of cat flea (Ctenocephalides felis) TPS, and the Michaelis-Menten constants for their specific substrates glucose-6-phosphate and uridinediphosphate-glucose. A novel high throughput screening-compatible TPS assay and its use for the identification of the first potent insect TPS inhibitors from a large synthetic compound collection (>115 000 compounds) is described. One compound class that emerged in this screening, the 4-substituted 2,6-diamino-3,5-dicyano-4H-thiopyrans, was further investigated by analysing preliminary structure-activity relationships. Here, compounds were identified that show low µM to high nM half maximal inhibitory concentrations on insect TPS and that may serve as lead compounds for the development of insecticides with a novel mode of action.

Effects of different extraction buffers on peanut protein detectability and lateral flow device (LFD) performance

The accidental uptake of peanuts can cause severe health reactions in allergic individuals. Reliable determination of traces of peanuts in food products is required to support correct labelling and therefore minimise consumers' risk. The immunoanalytical detectability of potentially allergenic peanut proteins is dependent on previous heat treatment, the extraction capacity of the applied buffer and the specificity of the antibody. In this study a lateral flow device (LFD) for the detection of peanut protein was developed and the capacity of 30 different buffers to extract proteins from mildly and strongly roasted peanut samples as well as their influence on the test strip performance were investigated. Most of the tested buffers showed good extraction capacity for putative Ara h 1 from mildly roasted peanuts. Protein extraction from dark-roasted samples required denaturing additives, which were proven to be incompatible with LFD performance. High-pH buffers increased the protein yield but inhibited signal generation on the test strip. Overall, the best results were achieved using neutral phosphate buffers but equal detectability of differently altered proteins due to food processing cannot be assured yet for immunoanalytical methods.

Evaluation of the GlideScope for tracheal intubation in patients with cervical spine immobilisation by a semi-rigid collar

Application of cervical collars may reduce cervical spine movements but render tracheal intubation with a standard laryngoscope difficult if not impossible. We hypothesised that despite the presence of a Philadelphia Patriot cervical collar and with the patient's head taped to the trolley, tracheal intubation would be possible in 50 adult patients using the GlideScope and its dedicated stylet. Laryngoscopy was attempted using a Macintosh laryngoscope with a size 4 blade, and the modified Cormack-Lehane grade was scored. Subsequently, laryngoscopy with the GlideScope was graded and followed by tracheal intubation. All patients' tracheas were successfully intubated with the GlideScope. The median (IQR) intubation time was 50 s (43-61 s). The modified Cormack-Lehane grade was 3 or 4 at direct laryngoscopy. It was significantly reduced with the GlideScope (p < 0.0001), reaching grade 2a in most patients. Tracheal intubation in patients wearing a semi-rigid collar and having their head taped to the trolley is possible with the help of the GlideScope.

Ex utero intrapartum treatment (EXIT), a resuscitation option for intra-thoracic foetal pathologies

The ex utero intrapartum treatment (EXIT) procedure is designed to guarantee sufficient oxygenation for a foetus at risk of airway obstruction. This is achieved by improving lung ventilation, usually by establishing an airway during caesarean delivery whilst preserving the foetal-placental circulation temporarily. Indications for the EXIT procedure have extended from its original use in reversing iatrogenic tracheal obstruction in congenital diaphragmatic hernia to naturally occurring upper airway obstructions. We report our experience with a new and rarely mentioned indication for the EXIT procedure, intra-thoracic volume expansions. The elaboration of lowest risk scenarios through balancing risks with alternative options, foetal or neonatal intervention and coordination between professionals from various disciplines are the most important conditions for a successful EXIT procedure. The EXIT procedure requires a caesarean section that specifically differs from the traditional caesarean section during which uterine tone is maintained to minimize maternal bleeding. To guarantee foetal oxygenation during the EXIT procedure, profound uterine relaxation is desired. To gain time with optimal placental oxygenation in order to safely perform an airway intervention in a baby at risk of hypoxia may require deep inhalation anaesthesia and/or tocolytic agents. We review the EXIT procedure and present a case series from the University Hospital of Geneva that contrasts with the common indication for the EXIT procedure usually based on upper airway obstruction by its exclusive indication for intra-thoracic malformations/diseases.

Ex utero intrapartum treatment (EXIT), a resuscitation option for intra-thoracic foetal pathologies

The ex utero intrapartum treatment (EXIT) procedure is designed to guarantee sufficient oxygenation for a foetus at risk of airway obstruction. This is achieved by improving lung ventilation, usually by establishing an airway during caesarean delivery whilst preserving the foetal-placental circulation temporarily. Indications for the EXIT procedure have extended from its original use in reversing iatrogenic tracheal obstruction in congenital diaphragmatic hernia to naturally occurring upper airway obstructions. We report our experience with a new and rarely mentioned indication for the EXIT procedure, intra-thoracic volume expansions. The elaboration of lowest risk scenarios through balancing risks with alternative options, foetal or neonatal intervention and coordination between professionals from various disciplines are the most important conditions for a successful EXIT procedure. The EXIT procedure requires a caesarean section that specifically differs from the traditional caesarean section during which uterine tone is maintained to minimize maternal bleeding. To guarantee foetal oxygenation during the EXIT procedure, profound uterine relaxation is desired. To gain time with optimal placental oxygenation in order to safely perform an airway intervention in a baby at risk of hypoxia may require deep inhalation anaesthesia and/or tocolytic agents. We review the EXIT procedure and present a case series from the University Hospital of Geneva that contrasts with the common indication for the EXIT procedure usually based on upper airway obstruction by its exclusive indication for intra-thoracic malformations/diseases.

Microarray analysis reveals influence of the sesquiterpene lactone parthenolide on gene transcription profiles in human epithelial cells

Sesquiterpene lactones are known for their anti-inflammatory activity which has been proven in various assays on DNA, mRNA and protein level. Here we report on the change in the gene expression profile in TNF-alpha stimulated human 293 cells after treatment with parthenolide using a cDNA microarray analysis. Twenty-one of 7028 genes were found to be up- and 18 down-regulated. They encode for chemoattractants, immune system proteins, glycoproteins, metabolism, serine proteinases, and transcription factors. Confirmatory analyses were carried out using quantitative real-time RT-PCR (TaqMan). Additional studies with selected genes revealed the concentration-dependent influence of parthenolide on the expression of these genes.