51 research outputs found
Symptoms of depression in patients with cancer of the head and neck undergoing radiotherapy treatment: a prospective study
Transplantation of Specific Human Astrocytes Promotes Functional Recovery after Spinal Cord Injury
Repairing trauma to the central nervous system by replacement of glial support
cells is an increasingly attractive therapeutic strategy. We have focused on the
less-studied replacement of astrocytes, the major support cell in the central
nervous system, by generating astrocytes from embryonic human glial precursor
cells using two different astrocyte differentiation inducing factors. The
resulting astrocytes differed in expression of multiple proteins thought to
either promote or inhibit central nervous system homeostasis and regeneration.
When transplanted into acute transection injuries of the adult rat spinal cord,
astrocytes generated by exposing human glial precursor cells to bone
morphogenetic protein promoted significant recovery of volitional foot
placement, axonal growth and notably robust increases in neuronal survival in
multiple spinal cord laminae. In marked contrast, human glial precursor cells
and astrocytes generated from these cells by exposure to ciliary neurotrophic
factor both failed to promote significant behavioral recovery or similarly
robust neuronal survival and support of axon growth at sites of injury. Our
studies thus demonstrate functional differences between human astrocyte
populations and suggest that pre-differentiation of precursor cells into a
specific astrocyte subtype is required to optimize astrocyte replacement
therapies. To our knowledge, this study is the first to show functional
differences in ability to promote repair of the injured adult central nervous
system between two distinct subtypes of human astrocytes derived from a common
fetal glial precursor population. These findings are consistent with our
previous studies of transplanting specific subtypes of rodent glial precursor
derived astrocytes into sites of spinal cord injury, and indicate a remarkable
conservation from rat to human of functional differences between astrocyte
subtypes. In addition, our studies provide a specific population of human
astrocytes that appears to be particularly suitable for further development
towards clinical application in treating the traumatically injured or diseased
human central nervous system
Anxiety and Depression in Adults with Autism Spectrum Disorder: A Systematic Review and Meta-analysis
Adults with autism spectrum disorder (ASD) are thought to be at disproportionate risk of developing mental health comorbidities, with anxiety and depression being considered most prominent amongst these. Yet, no systematic review has been carried out to date to examine rates of both anxiety and depression focusing specifically on adults with ASD. This systematic review and meta-analysis examined the rates of anxiety and depression in adults with ASD and the impact of factors such as assessment methods and presence of comorbid intellectual disability (ID) diagnosis on estimated prevalence rates. Electronic database searches for studies published between January 2000 and September 2017 identified a total of 35 studies, including 30 studies measuring anxiety (n = 26 070; mean age = 30.9, s.d. = 6.2 years) and 29 studies measuring depression (n = 26 117; mean age = 31.1, s.d. = 6.8 years). The pooled estimation of current and lifetime prevalence for adults with ASD were 27% and 42% for any anxiety disorder, and 23% and 37% for depressive disorder. Further analyses revealed that the use of questionnaire measures and the presence of ID may significantly influence estimates of prevalence. The current literature suffers from a high degree of heterogeneity in study method and an overreliance on clinical samples. These results highlight the importance of community-based studies and the identification and inclusion of well-characterized samples to reduce heterogeneity and bias in estimates of prevalence for comorbidity in adults with ASD and other populations with complex psychiatric presentations
Reproductive constraints influence habitat accessibility, segregation, and preference of sympatric albatross species
Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
Background
Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis.
Methods
A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis).
Results
Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent).
Conclusion
Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified
Coagulase-Negative Staphylococcal Infections in Vascular Surgery: Epidemiology and Pathogenesis
Deformation induced by ethanol substitution in normal and tension wood of chestnut (Castanea sativa Mill.) and simarouba (Simarouba amara Aubl.)
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