Studies comparing carpal tunnel release with ultrasound guidance (CTR-US) to mini-open CTR (mOCTR) are limited. This randomized trial compared the efficacy and safety of these techniques.
In this ...multicenter randomized trial, patients were randomized (2:1) to unilateral CTR-US or mOCTR. Outcomes included Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS) and Functional Status Scale (BCTQ-FSS), numeric pain scale (0-10), EuroQoL-5 Dimension 5-Level (EQ-5D-5L), scar outcomes, and complications over 1 year.
Patients received CTR-US (n = 94) via wrist incision (mean 6 mm) or mOCTR (n = 28) via palmar incision (mean 22 mm). Comparing CTR-US with mOCTR, the mean changes in BCTQ-SSS (-1.8 versus -1.8;
= 0.96), BCTQ-FSS (-1.0 versus -1.0;
= 0.75), numeric pain scale (-3.9 versus -3.8;
= 0.74), and EQ-5D-5L (0.13 versus 0.12;
= 0.79) over 1 year were comparable between groups. Freedom from scar sensitivity or pain favored CTR-US (95% versus 74%;
= 0.005). Complications occurred in 2.1% versus 3.6% of patients (
= 0.55), all within 3 weeks postprocedure. There was one revision surgery in the CTR-US group, and no revisions for persistent or recurrent symptoms in either group.
CTR-US and mOCTR demonstrated similar improvement in carpal tunnel syndrome symptoms and quality of life with comparable low complication rates over 1 year of follow-up. CTR-US was performed with a smaller incision and associated with less scar discomfort.
Objective
The purpose of the study was to assess demographic features, rates of trauma exposure, prevalence of post‐traumatic stress and depressive symptoms in a group of urban, low‐income, ...African‐American women with type 1 or type 2 diabetes mellitus.
Research Design and Methods
We conducted a survey of (n = 290) low‐income, African‐American women seeking care in the diabetes clinic of an urban hospital and collected data on the demographic characteristics, childhood and nonchildhood abuse trauma exposure, and the severity of post‐traumatic stress and depressive symptoms using the Post‐traumatic Stress Disorder (PTSD) Symptom Scale (PSS) and the Beck Depression Inventory (BDI). In a subset of women with type 2 diabetes (n = 96), we assessed haemoglobin A1c to examine the relationship between psychopathology and glycaemic control.
Results
Of the overall sample, 61.7% reported exposure to trauma in their lifetime, and 30.4% and 29.3% had current PTSD and MDD, respectively. Exposure to both childhood and nonchildhood abuse trauma was associated with an increased PTSD and depressive symptom severity (P's < .05). PTSD diagnosis, but not depression, was associated with increased haemoglobin A1c (P = .002).
Conclusions
These data document high levels of trauma exposure, PTSD and depressive symptoms in diabetic African‐American women treated in a specialty clinic of an urban hospital setting. Furthermore, these data indicate that the presence of PTSD is negatively associated with glycaemic control.
Levels of trauma exposure, post‐traumatic stress disorder (PTSD) and depressive symptoms are high in diabetic African‐American women and adversely impact glycaemic control.
Vacuolar H+-ATPase (V-ATPase) binds actin filaments with high affinity (Kd = 55 nm; Lee, B. S., Gluck, S. L., and Holliday, L. S. (1999) J. Biol. Chem. 274, 29164–29171). We have proposed that this ...interaction is an important mechanism controlling transport of V-ATPase from the cytoplasm to the plasma membrane of osteoclasts. Here we show that both the B1 (kidney) and B2 (brain) isoforms of the B subunit of V-ATPase contain a microfilament binding site in their amino-terminal domain. In pelleting assays containing actin filaments and partially disrupted V-ATPase, B subunits were found in greater abundance in actin pellets than were other V-ATPase subunits, suggesting that the B subunit contained an F-actin binding site. In overlay assays, biotinylated actin filaments also bound to the B subunit. A fusion protein containing the amino-terminal half of B1 subunit bound actin filaments tightly, but fusion proteins containing the carboxyl-terminal half of B1 subunit, or the full-length E subunit, did not bind F-actin. Fusion proteins containing the amino-terminal 106 amino acids of the B1 isoform or the amino-terminal 112 amino acids of the B2 isoform bound filamentous actin withKd values of 130 and 190 nm, respectively, and approached saturation at 1 mol of fusion protein/mol of filamentous actin. The B1 and B2 amino-terminal fusion proteins competed with V-ATPase for binding to filamentous actin. In summary, binding sites for F-actin are present in the amino-terminal domains of both isoforms of the B subunit, and likely are responsible for the interaction between V-ATPase and actin filaments in vivo.
Interpretation biases, in which ambiguous information is interpreted negatively, have been hypothesized to place adolescent females at greater risk of developing anxiety and mood disorders than ...same‐aged males. We tested the hypothesis that adolescent girls interpret ambiguous scenarios more negatively, and/or less positively, than same‐aged males using the Adolescent Interpretation and Belief Questionnaire (N = 67, 11–15 years old). We also tested whether adolescent girls and boys differed in judging positive or negative interpretations to be more believable and whether the scenario content (social vs. non‐social) affected any sex difference in interpretation bias. The results showed that girls had higher average negative interpretation scores than boys, with no sex differences in positive interpretation scores. Girls and boys did not differ on which interpretation they found to be most believable. Both sexes reported that positive interpretations were less likely to come to mind, and were less believable, for social than for non‐social scenarios. These results provide preliminary evidence for sex differences in interpretation biases in adolescence and support the hypothesis that social scenarios are a specific source of anxiety to this age group. A greater understanding of the aetiology of interpretation biases will potentially enhance sex‐ and age‐specific interventions for anxiety and mood disorders.
The current study investigated the relationship between trauma exposure and psychopathology in a sample of predominately African-American women of low socioeconomic status (SES). Women (
N
= 7430) ...were recruited from medical clinics at two large public hospitals in Atlanta, GA, from 2005 to 2017. Women were assessed for sociodemographics, life-course trauma burden, posttraumatic stress disorder (PTSD), and major depressive disorder (MDD) utilizing self-report and structured clinical interview assessments. The effects of trauma exposure on current and lifetime PTSD and MDD were examined. Ninety-one percent of women reported trauma exposure, 83% reported a monthly household income of less than $2000, and 41% reported a history of arrest. Regarding psychiatric diagnoses, 30.8% met the criteria for probable MDD, and 32.3% met the criteria for probable PTSD. History of childhood abuse and total lifetime trauma significantly increased PTSD and depressive symptoms with additional incremental trauma exposure. PTSD and depressive symptom scores (95% CI) increased from 5.5 (5.0–6.1) and 8.4 (7.9–9.0) in the no trauma group to 20.8 (20.1–21.5) and 20.4 (19.7–21.2), respectively, in those exposed to four or more types of trauma. These results show high rates of adult and childhood trauma exposure, PTSD, MDD, and an additive effect of lifetime trauma exposure on the development of PTSD and MDD in a sample of low SES African-American women. These findings bring light to the high psychiatric symptom burden in this population and call for increased availability of interventions to address symptoms as well as policies aimed at reducing trauma exposure across the lifespan.
An abstract of a study by Langenberg et al on MDM2 inhibitor AMG 232 in patients with advanced p53 wild type (p53WT) solid tumors or multiple myeloma is presented. Phase I of the study investigated ...the administration of AMG 232 orally once daily on days 1-7 in 21 day cycles schedule to determine the maximum tolerated dose (MTD), safety, pharmacokinetics and biomarker activity of AMG 232 in patients with solid tumors. The second phase evaluated the efficacy of AMG 232 in patients with solid tumors with MDM2 amplification or potential MDM2 over expression or in patients with multiple myeloma. Results of the study are provided. The study concludes that AMG 232 is an oral selective MDM2 inhibitor which demonstrates p53 pathway activation with an acceptable PK and tolerability profile when administered in dosages of 240 mg in the (QD 7/21 days) schedule.
Vacuolar H + -ATPases (V-ATPases) are essential for acidification of intracellular compartments and for proton secretion from the plasma
membrane in kidney epithelial cells and osteoclasts. The ...cellular proteins that regulate V-ATPases remain largely unknown.
A screen for proteins that bind the V-ATPase E subunit using the yeast two-hybrid assay identified the cDNA clone coded for
aldolase, an enzyme of the glycolytic pathway. The interaction between E subunit and aldolase was confirmed in vitro by precipitation assays using E subunit-glutathione S -transferase chimeric fusion proteins and metabolically labeled aldolase. Aldolase was isolated associated with intact V-ATPase
from bovine kidney microsomes and osteoclast-containing mouse marrow cultures in co-immunoprecipitation studies performed
using an anti-E subunit monoclonal antibody. The interaction was not affected by incubation with aldolase substrates or products.
In immunocytochemical assays, aldolase was found to colocalize with V-ATPase in the renal proximal tubule. In osteoclasts,
the aldolase-V-ATPase complex appeared to undergo a subcellular redistribution from perinuclear compartments to the ruffled
membranes following activation of resorption. In yeast cells deficient in aldolase, the peripheral V 1 domain of V-ATPase was found to dissociate from the integral membrane V 0 domain, indicating direct coupling of glycolysis to the proton pump. The direct binding interaction between V-ATPase and
aldolase may be a new mechanism for the regulation of the V-ATPase and may underlie the proximal tubule acidification defect
in hereditary fructose intolerance.
Acid-base Gluck, Stephen L
The Lancet (British edition),
08/1998, Letnik:
352, Številka:
9126
Journal Article
Recenzirano
Acid-base disorders are common clinical problems resulting from a wide variety of pathophysiological conditions, including newly recognised acquired and genetic causes. The history and physical ...examination and measurement of blood and urinary indices allow identification of the underlying cause of these disorders in most cases. Treatment directed at correction of electrolyte abnormalities and the underlying cause for the disorder is essential for preventing the acute and long-term metabolic consequences of acid-base derangements.
Vacuolar H+-ATPases (V-ATPases) are multisubunit enzymes that acidify compartments of the vacuolar system of all eukaryotic cells. In osteoclasts, the cells that degrade bone, V-ATPases, are ...recruited from intracellular membrane compartments to the ruffled membrane, a specialized domain of the plasma membrane, where they are maintained at high densities, serving to acidify the resorption bay at the osteoclast attachment site on bone (Blair, H. C., Teitelbaum, S. L., Ghiselli, R., and Gluck, S. L. (1989) Science 249, 855–857). Here, we describe a new mechanism involved in controlling the activity of the bone-resorptive cell. V-ATPase in osteoclasts cultured in vitro was found to form a detergent-insoluble complex with actin and myosin II through direct binding of V-ATPase to actin filaments. Plating bone marrow cells onto dentine slices, a physiologic stimulus that activates osteoclast resorption, produced a profound change in the association of the V-ATPase with actin, assayed by coimmunoprecipitation and immunocytochemical colocalization of actin filaments and V-ATPase in osteoclasts. Mouse marrow and bovine kidney V-ATPase bound rabbit muscle F-actin directly with a maximum stoichiometry of 1 mol of V-ATPase per 8 mol of F-actin and an apparent affinity of 0.05 μm. Electron microscopy of negatively stained samples confirmed the binding interaction. These findings link transport of V-ATPase to reorganization of the actin cytoskeleton during osteoclast activation.
The success of Mycobacterium species as pathogens depends on their ability to maintain an infection inside the phagocytic vacuole of the macrophage. Although the bacteria are reported to modulate ...maturation of their intracellular vacuoles, the nature of such modifications is unknown. In this study, vacuoles formed around Mycobacterium avium failed to acidify below pH 6.3 to 6.5. Immunoelectron microscopy of infected macrophages and immunoblotting of isolated phagosomes showed that Mycobacterium vacuoles acquire the lysosomal membrane protein LAMP-1, but not the vesicular proton-adenosine triphosphatase (ATPase) responsible for phagosomal acidification. This suggests either a selective inhibition of fusion with proton-ATPase-containing vesicles or a rapid removal of the complex from Mycobacterium phagosomes.
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