The real risks of steroid injection for plantar fasciitis, with a review of conservative therapies

This article presents a review of conservative therapies for plantar fasciitis pain reduction with a discussion of steroid therapy risks. The therapies reviewed include orthoses, stretching, extracorporeal shockwave, BTX-A, and corticosteroid injection/iontophoresis. These modes were included based on the availability of double blinded randomized controlled trials. We noted the following findings. Orthoses, regardless of type, can improve pain levels. Plantar stretching shows limited short-term benefit (1 month), but can reflect significant long-term improvement (10 months). Extracorporeal shockwave therapy shows equivocal benefit with some studies showing significant improvement and others showing none. Although BTX-A injections were the least studied, significant pain improvement was demonstrated in the short and long term. Steroid injection/iontophoresis showed significant improvement in the short term (1 month). Steroid therapy, when coupled with plantar stretching, can provide efficacious pain relief; however, steroid injections should be combined with ultrasound monitoring to reduce complications

Localization of Mineralocorticoid Receptors at Mammalian Synapses

In the brain, membrane associated nongenomic steroid receptors can induce fast-acting responses to ion conductance and second messenger systems of neurons. Emerging data suggest that membrane associated glucocorticoid and mineralocorticoid receptors may directly regulate synaptic excitability during times of stress when adrenal hormones are elevated. As the key neuron signaling interface, the synapse is involved in learning and memory, including traumatic memories during times of stress. The lateral amygdala is a key site for synaptic plasticity underlying conditioned fear, which can both trigger and be coincident with the stress response. A large body of electrophysiological data shows rapid regulation of neuronal excitability by steroid hormone receptors. Despite the importance of these receptors, to date, only the glucocorticoid receptor has been anatomically localized to the membrane. We investigated the subcellular sites of mineralocorticoid receptors in the lateral amygdala of the Sprague-Dawley rat. Immunoblot analysis revealed the presence of mineralocorticoid receptors in the amygdala. Using electron microscopy, we found mineralocorticoid receptors expressed at both nuclear including: glutamatergic and GABAergic neurons and extra nuclear sites including: presynaptic terminals, neuronal dendrites, and dendritic spines. Importantly we also observed mineralocorticoid receptors at postsynaptic membrane densities of excitatory synapses. These data provide direct anatomical evidence supporting the concept that, at some synapses, synaptic transmission is regulated by mineralocorticoid receptors. Thus part of the stress signaling response in the brain is a direct modulation of the synapse itself by adrenal steroids

Recent developments in genetics and medically assisted reproduction : from research to clinical applications

Two leading European professional societies, the European Society of Human Genetics and the European Society for Human Reproduction and Embryology, have worked together since 2004 to evaluate the impact of fast research advances at the interface of assisted reproduction and genetics, including their application into clinical practice. In September 2016, the expert panel met for the third time. The topics discussed highlighted important issues covering the impacts of expanded carrier screening, direct-to-consumer genetic testing, voiding of the presumed anonymity of gamete donors by advanced genetic testing, advances in the research of genetic causes underlying male and female infertility, utilisation of massively parallel sequencing in preimplantation genetic testing and non-invasive prenatal screening, mitochondrial replacement in human oocytes, and additionally, issues related to cross-generational epigenetic inheritance following IVF and germline genome editing. The resulting paper represents a consensus of both professional societies involved.Peer reviewe

A survey of z > 5.7 quasars in the sloan digital sky survey. III. Discovery of five additional quasars

We present the discovery of five new quasars at z > 5.7, selected from the multicolor imaging data of the Sloan Digital Sky Survey (SDSS). Three of them, at redshifts 5.93, 6.07, and 6.22, were selected from similar to1700 deg(2) of new SDSS Main Survey imaging in the northern Galactic cap. An additional quasar, at redshift 5.85, was discovered by co-adding the data obtained in the Fall Equatorial Stripe in the SDSS Southern Survey Region. The fifth object, at redshift 5.80, is selected from a nonstandard SDSS scan in the southern Galactic cap outside the Main Survey area. The spectrum of SDSS J162331.81+ 311200.5 ( z = 6.22) shows a complete Gunn-Peterson trough at z(abs) > 5.95, similar to the troughs detected in the other three z greater than or similar to 6.2 quasars known. We present a composite spectrum of the z > 5.7 quasars discovered in the SDSS to date. The average emission-line and continuum properties of z similar to 6 quasars exhibit no significant evolution compared with those at low redshift. Using a complete sample of nine z > 5.7 quasars, we find that the density of quasars with M-1450 < -26.7 at z similar to 6 is (6 +/- 2) x 10(-10) Mpc(-3) (H-0 = 65 km s(-1) Mpc(-1), Omega = 0.35, and Lambda = 0.65), consistent with our previous estimates. The luminosity distribution of the sample is fitted with a power-law luminosity function Psi( L) proportional to L-3.2 +/- 0.7, somewhat steeper than but consistent with our previous estimates