Surgical aspects, finite element analysis and x-ray correlation of femoral neck changes in the osteoarthritic hip after hip resurfacing surgery

University of Technology, Sydney. Faculty of Science.Background: Hip resurfacing is a logical choice for the treatment of symptomatic osteoarthritis as the degenerative process affects primarily the articular surface. It has been tried previously but failed. Recent improvements in metallurgy, manufacture and engineering have resulted in the development of a new series of implants which appear to be much more successful. Over the last 10 years, they have been used with enthusiasm and increasing popularity. However, over the last two years or so, their popularity has diminished with an awareness of significant complications developing. The complications relate primarily to early fracture, and the possible development of adverse reactions to metal ions. Component position may be implicated in the development of these complications

Changes in Tinnitus Perception Following Cochlear Implantation and Hearing Aid Use

The purpose of this literature review is to identify changes in tinnitus post cochlear implantation and post amplification. Primarily subjective, qualitative measures including the Tinnitus Handicap Inventory, the Tinnitus Handicap Questionnaire, the Tinnitus Reaction Questionnaire, and the Tinnitus Questionnaire were used to obtain the data included. The questionnaires used were demonstrated to be valid in research. The results of this study indicate that both types of interventions consistently provide tinnitus relief or diminished tinnitus handicap among sufferers, although the mechanisms by which the suppression or reduction occurs may be a result of numerous factors. Cochlear implantation is more likely to result in post-operative tinnitus or in patients who did not report tinnitus previously or worsen pre-existing tinnitus, although it often resolves with time. Use of traditional amplification never resulted in tinnitus if tinnitus was not present previously; however, there were cases where amplification did not suppress tinnitus sufficiently such that perceived tinnitus handicap was eliminated altogether. Conclusion: both interventions have been demonstrated to often reduce tinnitus perception in sufferers

Variation in abundance and physiological status of juvenile chum salmon (Oncorhynchus keta) in relation to marine factors in Southeast Alaska

Thesis (M.S.) University of Alaska Fairbanks, 2015Little is known about the mechanisms influencing the critical early life stages of juvenile chum salmon (Oncorhynchus keta) from coastal to offshore marine waters. There is mounting evidence to suggest that fluctuations in early marine conditions affect juvenile salmon physiological status and year class strength. We investigated relationships of a suite of marine factors at local, regional, and basin scales to the physiological status and abundance of juvenile chum salmon in northern Southeast Alaska (SEAK) from 1997-2013. Correlation analyses were used to identify potential mechanisms influencing year class strength. Marine factors at the local scale were correlated to the observed physiological status of juvenile chum salmon: average June/July wind speed was negatively correlated to weight-at-length residuals, sea surface temperatures in July were positively correlated with length, and the June mixed-layer depth was positively correlated to the energy density of juvenile chum salmon in July. Marine factors at the regional scale influenced juvenile chum salmon abundance: freshwater discharge was positively correlated whereas upwelling was negatively correlated with abundance, linking high abundance to characteristics of strong Aleutian Low (AL) climatic conditions. Comparisons of juvenile chum salmon physiological status were also made between: 1) SEAK habitats (Icy Strait and the Eastern Gulf of Alaska, EGOA), 2) stock groups (hatchery and wild), and 3) years 2010 and 2011 possible mechanisms influencing productivity of chum salmon. Between habitats, length of juvenile chum salmon did not differ. However, both weight-at-length residuals and energy density values were significantly higher in the EGOA, irrespective of year, indicating juvenile salmon allocate energy to somatic growth in Icy Strait, while the EGOA may serve as a habitat for juvenile chum salmon to store energy as lipids. Between chum salmon stocks, wild stocks were shorter and had higher weight-at-length residuals than hatchery stocks. Between years, the 2010 ocean year was associated with a strong AL that coincided with higher physiological status of juvenile chum salmon and relatively higher returning adult commercial harvests and ocean survival of hatchery fish compared to the 2011 ocean year. Our results suggest differences in juvenile chum salmon physiological status in 2010 and 2011 coincided with positive and negative anomalies of the coupled ocean-atmosphere system, which were linked to previous winter environmental conditions, and have the potential to be used as a predictive salmon management tool to forecast year class strength in SEAK

New insights from SONAR indicate adding sodium glucose co-transporter 2 inhibitors to an endothelin receptor antagonist mitigates fluid retention and enhances albuminuria reduction

The diuretic effects achieved with sodium glucose co-transporter 2 inhibitors (SGLT2i) may offset fluid retaining effects of the endothelin receptor antagonist (ERA) atrasentan while effects on albuminuria and kidney protection of both drug classes may be complimentary due to distinct mechanisms of action. Here, post-hoc analysis of the SONAR trial, in patients with type 2 diabetes and chronic kidney disease, show that six-weeks treatment with combined SGLT2i/atrasentan versus atrasentan alone decreased body weight, a surrogate for fluid retention, and further decreased albuminuria. Thus, these promising findings support future clinical studies to characterize the long-term efficacy and safety of combined SGLT2i/ERA treatment

Evaluation of loop mediated isothermal amplification for diagnosis of Mycobacterium tuberculosis complex in clinical samples

Tuberculosis (TB) remains an important global public health problem. The lack of rapid and accurate diagnostic testing is an important impediment to global tuberculosis control. Loop mediated isothermal amplification (LAMP) is a rapid method for nucleic acid amplification. In this study, we assessed the performance of an in-house LAMP assay for the detection of tuberculosis. Six oligonucleotide primers specific for Mycobacterium tuberculosis complex were designed corresponding to IS6110 gene sequence. Optimization of LAMP reaction was performed. A total of 133 clinical sputum samples and 80 bacterial cultures were studied by LAMP method. Sensitivity of this assay for detection of genomic DNA was 5 fg. This assay successfully detected M. tuberculosis complex not only in the bacterial cultures but also in the clinical sputum samples from patients with TB. The sensitivity of LAMP in culturepositive samples was 100% (60/60) and the specificity in culture-negative samples was 95.9% (70/73, 95% confidence interval 91.3 to 98.7%). Thus, LAMP is a rapid, highly sensitive and specific DNA amplification technique for early diagnosis of TB.Key words: Loop mediated isothermal amplification (LAMP), polymerase chain reaction (PCR), IS6110 gene, Mycobacterium tuberculosis, diagnosis

Endothelin receptor antagonists for the treatment of diabetic and nondiabetic chronic kidney disease

Purpose of review To summarize new clinical findings of endothelin receptor antagonists (ERA) in various etiologies of kidney disease targeted in clinical trials. Recent findings Endothelin-1 is a multifunctional peptide with potential relevance to glomerular and tubulointerstitial kidney diseases. The phase 3 SONAR trial demonstrated a significant reduction in clinically relevant kidney outcomes for patients with diabetic kidney disease (DKD) after long-term treatment with the ERA, atrasentan, in addition to blockade of the renin-angiotensin-aldosterone system. Promising preclinical disease models and small clinical trials in non-DKD resulted in the initiation of phase 3 trials investigating the effects of long-term treatment with ERA in patients with immunoglobulin A (IgA) nephropathy and focal segmental glomeruloscelerosis (FSGS). The mechanisms by which ERA protects the kidneys have been extensively studied with evidence for the protection of tubule cells, podocytes, mesangial cells, the endothelial glycocalyx, and a reduction in glomerular perfusion pressure. The occurrence of fluid retention during ERA treatment, particularly in susceptible populations, necessitates strategies to support safe and effective treatment. Treatment with ERA induces long-term kidney protection in DKD. Phase 3 trials are underway to investigate ERA effects in patients with IgA nephropathy and FSGS