Is there a purpose to medicine? Joseph, Jacob
Journal of evaluation in clinical practice,
June 2021, Volume:
27, Issue:
3
Journal Article
Peer reviewed
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
3.
Sodium Intake and Heart Failure Patel, Yash; Joseph, Jacob
International journal of molecular sciences,
12/2020, Volume:
21, Issue:
24
Journal Article
Peer reviewed
Open access
Sodium is an essential mineral and nutrient used in dietary practices across the world and is important to maintain proper blood volume and blood pressure. A high sodium diet is associated with ...increased expression of β-myosin heavy chain, decreased expression of α/β-myosin heavy chain, increased myocyte enhancer factor 2/nuclear factor of activated T cell transcriptional activity, and increased salt-inducible kinase 1 expression, which leads to alteration in myocardial mechanical performance. A high sodium diet is also associated with alterations in various proteins responsible for calcium homeostasis and myocardial contractility. Excessive sodium intake is associated with the development of a variety of comorbidities including hypertension, chronic kidney disease, stroke, and cardiovascular diseases. While the American College of Cardiology/American Heart Association/Heart Failure Society of America guidelines recommend limiting sodium intake to both prevent and manage heart failure, the evidence behind such recommendations is unclear. Our review article highlights evidence and underlying mechanisms favoring and contradicting limiting sodium intake in heart failure.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Selenium (Se) is a trace nutrient that promotes human health through its incorporation into selenoproteins in the form of the redox-active amino acid selenocysteine (Sec). There are 25 selenoproteins ...in humans, and many of them play essential roles in the protection against oxidative stress. Selenoproteins, such as glutathione peroxidase and thioredoxin reductase, play an important role in the reduction of hydrogen and lipid hydroperoxides, and regulate the redox status of Cys in proteins. Emerging evidence suggests a role for endoplasmic reticulum selenoproteins, such as selenoproteins K, S, and T, in mediating redox homeostasis, protein modifications, and endoplasmic reticulum stress. Selenoprotein P, which functions as a carrier of Se to tissues, also participates in regulating cellular reactive oxygen species. Cellular reactive oxygen species are essential for regulating cell growth and proliferation, protein folding, and normal mitochondrial function, but their excess causes cell damage and mitochondrial dysfunction, and promotes inflammatory responses. Experimental evidence indicates a role for individual selenoproteins in cardiovascular diseases, primarily by modulating the damaging effects of reactive oxygen species. This review examines the roles that selenoproteins play in regulating vascular and cardiac function in health and disease, highlighting their antioxidant and redox actions in these processes.
OBJECTIVE Surgical robotics has demonstrated utility across the spectrum of surgery. Robotics in spine surgery, however, remains in its infancy. Here, the authors systematically review the evidence ...behind robotic applications in spinal instrumentation. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Relevant studies (through October 2016) that reported the use of robotics in spinal instrumentation were identified from a search of the PubMed database. Data regarding the accuracy of screw placement, surgeon learning curve, radiation exposure, and reasons for robotic failure were extracted. RESULTS Twenty-five studies describing 2 unique robots met inclusion criteria. Of these, 22 studies evaluated accuracy of spinal instrumentation. Although grading of pedicle screw accuracy was variable, the most commonly used method was the Gertzbein and Robbins system of classification. In the studies using the Gertzbein and Robbins system, accuracy (Grades A and B) ranged from 85% to 100%. Ten studies evaluated radiation exposure during the procedure. In studies that detailed fluoroscopy usage, overall fluoroscopy times ranged from 1.3 to 34 seconds per screw. Nine studies examined the learning curve for the surgeon, and 12 studies described causes of robotic failure, which included registration failure, soft-tissue hindrance, and lateral skiving of the drill guide. CONCLUSIONS Robotics in spine surgery is an emerging technology that holds promise for future applications. Surgical accuracy in instrumentation implanted using robotics appears to be high. However, the impact of robotics on radiation exposure is not clear and seems to be dependent on technique and robot type.
This pharmacoepidemiology study uses US pharmacy data to compare prescriptions for hydroxychloroquine/chloroquine and azithromycin in February to April 2020 vs 2019, and vs the top 10 most commonly ...prescribed drugs in the same year, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers.
The aims of this study were to (1) quantify the multidimensional attributes of male and female basketball athletes under 16 years of age (U16) and under 18 years of age (U18), and (2) identify ...attributes that distinguish selection into a talent pathway according to sex and age group.
67 male and 71 female athletes competing in U16 and U18 selection trials for a state based Australian basketball talent pathway completed a multidimensional testing battery. The test battery consisted of anthropometric, physical (20- linear sprint, countermovement jump height, Yo-Yo Intermittent Recovery Test Level 2), technical (Basketball Jump Shooting Accuracy Test), tactical (video decision making), and psychological (Sports Orientation Questionnaire, Psychological Performance Inventory-Alternative) assessments. Mean differences and independent t-tests were used to assess comparative differences between selected and non-selected athletes within each age and sex cohort. Stepwise discriminant analyses were used to identify attributes that were the strongest discriminators of selection in each group (male U16, male U18, female U16, and female U18).
The discrimminant models showed for male U16 athletes smaller height (ES = -0.18) and greater shooting accuracy (ES = 0.52) was most discriminant of selection. Results were largely homogenous for male U18 athletes with lower visualisation score (ES = -0.62) most discriminant of selection. In female cohorts, faster 20-m sprint time (ES = -0.66) and taller height (ES = 0.58) was most discriminant of selection in U16 athletes while greater shooting accuracy (ES = 0.67), countermovement jump height (ES = 1.04), and height (ES = 0.65) was most discriminant of selection in U18 athletes.
These results emphasise the differing selection priorities within adolescent basketball cohorts according to sex and age group. The testing of anthropometric, physical and technical attributes may hold particular utility in adolescent female basketball given their identified importance to selection across U16 and U18 cohorts.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
OBJECT Minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) and lateral lumbar interbody fusion (LLIF) are 2 currently popular techniques for lumbar arthrodesis. The authors compare ...the total risk of each procedure, along with other important complication outcomes. METHODS This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant studies (up to May 2015) that reported complications of either MI-TLIF or LLIF were identified from a search in the PubMed database. The primary outcome was overall risk of complication per patient. Secondary outcomes included risks of sensory deficits, temporary neurological deficit, permanent neurological deficit, intraoperative complications, medical complications, wound complications, hardware failure, subsidence, and reoperation. RESULTS Fifty-four studies were included for analysis of MI-TLIF, and 42 studies were included for analysis of LLIF. Overall, there were 9714 patients (5454 in the MI-TLIF group and 4260 in the LLIF group) with 13,230 levels fused (6040 in the MI-TLIF group and 7190 in the LLIF group). A total of 1045 complications in the MI-TLIF group and 1339 complications in the LLIF group were reported. The total complication rate per patient was 19.2% in the MI-TLIF group and 31.4% in the LLIF group (p < 0.0001). The rate of sensory deficits and temporary neurological deficits, and permanent neurological deficits was 20.16%, 2.22%, and 1.01% for MI-TLIF versus 27.08%, 9.40%, and 2.46% for LLIF, respectively (p < 0.0001, p < 0.0001, p = 0.002, respectively). Rates of intraoperative and wound complications were 3.57% and 1.63% for MI-TLIF compared with 1.93% and 0.80% for LLIF, respectively (p = 0.0003 and p = 0.034, respectively). No significant differences were noted for medical complications or reoperation. CONCLUSIONS While there was a higher overall complication rate with LLIF, MI-TLIF and LLIF both have acceptable complication profiles. LLIF had higher rates of sensory as well as temporary and permanent neurological symptoms, although rates of intraoperative and wound complications were less than MI-TLIF. Larger, prospective comparative studies are needed to confirm these findings as the current literature is of relative poor quality.
Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) has a variable clinical course for which predicting prognosis is difficult. However, the role of blood biomarkers in RA-ILD is ...ill-defined. The aim of this study was to investigate the prognostic value of Krebs von den Lungen-6 (KL-6) levels in RA-ILD patients. The medical records of 84 patients with RA-ILD were retrospectively reviewed. Plasma KL-6 levels were measured by Nanopia KL-6 assay (SEKISUI MEDICAL, Tokyo), using latex-enhanced immunoturbidimetric assay. The median follow-up period was 61 months. Mean age was 61.4 years, 45.2% were men, 44.0% were ever-smokers, and 35.7% showed a usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography. The median KL-6 level at baseline was 741.2 U/mL (interquartile range, 439.7-1308.9 U/mL). On multivariate logistic regression analysis, a high KL-6 level (≥ 640 U/mL) was an independently associated with a UIP pattern (odds ratio OR, 5.173; P = 0.005) with old age (OR, 1.104, P = 0.005). On multivariate Cox analysis, a high KL-6 level (≥ 685 U/mL) was an independent prognostic factor for the mortality (hazard ratio HR, 2.984; P = 0.016) with a older age (HR, 1.061; P = 0.030), male sex (HR, 3.610; P = 0.001), lower forced vital capacity (HR, 0.957; P = 0.002), and a UIP pattern (HR, 4.034; P = 0.002). Our results suggest that high KL-6 levels might be useful as a biomarker for the presence of a UIP pattern and prognosis in patients with RA-ILD.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
ABSTRACTJoseph, J, Woods, C, and Joyce, C. Relationship between repeated kicking performance and maximal aerobic capacity in elite junior Australian football. J Strength Cond Res 34(8)2294–2301, ...2020—Australian football (AF) is a physically demanding game, requiring players to engage in a range of anaerobic activities interspersed with prolonged aerobic exercise. Coupled, players have to perform a range of technical skills, the most fundamental of which being to effectively kick (dispose) the ball. The aim of this study was to ascertain the extent to which aerobic capacity influenced kicking performance in AF. Twenty four elite U18 players competing in the same U18 competition performed the Australian football kicking (AFK) test 3 times with the Yo-Yo IR2 completed twice (between each AFK), with no rest between all 3 AFKs. Linear mixed models (LMMs) reported the extent to which kicking speed and accuracy scores were influenced by the level reached on the yo-yo IR2. Results indicated that players who recorded a higher level on the Yo-Yo IR2 produced a faster average kicking speed after each AFK (p < 0.01), whereas for all players, kicking speed was faster and more accurate on their dominant kicking leg regardless of score on the Yo-Yo IR2 (p < 0.01). The LMMs also reported that those who maintained kicking speeds after 2 Yo-Yo IR2 also had higher competition kicking efficiency than those who reported reduced kicking speeds. These results show that aerobically proficient U18 AF players who attain a relatively higher score on the Yo-Yo IR2 may be better equipped at preserving their kicking speed. Thus, coaches may wish to integrate both technical and aerobic drills in an attempt to preserve a playerʼs capability to execute ball disposals with a high velocity.
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