Narrative Review of Incremental Hemodialysis.

The prescription of hemodialysis (HD) in patients with incident end-stage kidney disease (ESKD) is fundamentally empirical. The abrupt transition from nondialysis chronic kidney disease (CKD) to thrice-weekly in-center HD of much the same dialysis intensity as in those with prevalent ESKD underappreciates the progressive nature of kidney disease whereby the decline in renal function has been gradual and ongoing-including at the time of HD initiation. Adjuvant pharmacologic treatment (i.e., diuretics, acid buffers, potassium binders), coupled with residual kidney function (RKF), can complement an initial HD regimen of lower intensity. Barriers to less intensive HD in incident ESKD include risk of inadequate clearance of uremic toxins due to variable and unexpected loss of RKF, lack of patient adherence to assessments of RKF or adjustment of HD intensity, increased burden for all stakeholders in the dialysis units, and negative financial repercussions. A stepped dialysis regimen with scheduled transition from time-delineated twice-weekly HD to thrice-weekly HD could represent an effective and safe strategy to standardize incremental HD in patients with CKD transitioning to early-stage ESKD. Patients' adherence and survival as well as other clinical outcomes should be rigorously evaluated in clinical trials before large-scale implementation of different incremental schedules of HD. This review discusses potential benefits of and barriers to alternative dialysis regimens in patients with incident ESKD, with emphasis on twice-weekly HD with pharmacologic therapy, and summarizes in-progress clinical trials of incremental HD schedules

Efficacy of Hypnosis as a Treatment for Alopecia

Title: Efficacy of Hypnosis as a treatment for Alopecia Introduction: Hypnosis is an altered state of consciousness in which someone is more receptive to suggestions and modeling, and it can address psychological and physical symptoms that are aggravated by conscious and unconscious triggers.The intended outcome is a change in certain behaviors or patterns of thinking that patients have which can mitigate their stress load. Stress can induce and exacerbate alopecia, and patients often suffer increased stress due to the psychosocial burden of having a dermatological disease. A study showed that high levels of cortisol releasing hormones (CRH) were found to suppress hair shaft elongation and induce the regression phase of the hair cycle. Methods: A literature search was conducted on PubMed in October 2023 using the search terms “Hypnosis” AND “Alopecia”. Exclusion criteria included articles written in a language other than English. References that were not pertinent were removed from consideration. The literature search yielded 17 results. Three articles were excluded since they are not published in English. Results: There are several case reports and series that report hair regrowth and better mental wellbeing after hypnotic sessions. There have been three non controlled cohort studies. In the first study, only one patient experienced hair regrowth, while in the second one, 9 out of 12 participants had significant hair regrowth. All three studies reported an increase in well-being and a decrease in anxiety and depression. Discussion: Hypnosis can be an effective complementary treatment for patients suffering from alopecia, especially those with concurrent self esteem issues

The possible impact of sortilin in reducing HBsAg expression in chronic hepatitis B

Hepatitis B virus (HBV) infection is a major global health problem. Chronically infected people are at risk for progressive hepatic fibrosis and consequent cirrhosis. Hepatitis B surface antigen (HBsAg) level in serum is a complementary marker for intrahepatic HBV DNA and covalently closed circular DNA (cccDNA). Sortilin-1 (SORT1) has been reported to be involved in the post-Golgi vesicle trafficking of Apo lipoproteins degradation pathways. This study was designed to evaluate the hepatic and serum expression of HBsAg and its association with hepatic SORT1 gene expression in patients with chronic HBV. Thirty chronic hepatitis B patients with histological examination results were enrolled in this study. Liver biopsies were analyzed for hepatic HBsAg and SORT1 gene expression by immunohistochemistry and quantitative real time PCR (qRT-PCR), respectively. Twenty seven out of 30 (90%) liver biopsies had positive staining for HBsAg and showed a significant inverse association with hepatic SORT1 fold change gene expression (β=-0.5, P=0.042). There was significant association between HBV DNA levels and HBsAg expression in hepatocyte or serum titer of HBsAg (r=0.39, P=0.029; r=0.39, P=0.032 respectively). Serum ALT was also correlated with hepatic activity index (HAI) score (β=0.6, P=0.001). Inverse association between hepatic SORT1 gene expression and hepatic HBsAg expression indicates the possible role of sortilin in HBsAg particle formation. © 2016 Wiley Periodicals, Inc

Effects of auditory processing training on speech perception and brainstem plastisity in adolescents with autism spectrum disorders

Objective Autism spectrum disorder (ASD) is a neurodevelopmental disorderA major problem of ASD is speech perception impairment in the presence of background noise. Additionally, researchers have reported temporal auditory processing impairment in these patients. In the present study, we evaluated the effects of a temporal-based rehabilitation program on improvement of speech perception in the presence of noise using the speech auditory brainstem response (sABR). Materials & Methods Twenty-eight adolescents with high functional ASD with the mean age of 14.35±1.86 were randomly selected and divided into the ASD group (11 males and three females), and the control group (13 males and one female). All subjects had a normal hearing and intelligence threshold and had no history of neurological disorder. The speech perception test was performed in signal-to-noise ratios of zero and +10. The intervention group received a temporal processing-based auditory rehabilitation program and the control group received a conventional rehabilitation program (P<0.05 was considered significant). Results speech perception in noise after rehabilitation was significantly higher in intervention group (P <0.001) and the latency of all sABR waves in the rehabilitation group was lower than that of the control group. Conclusion Improvement of speech perception in noisy environments and the reduced latency of sABR waves after a temporal processing-based rehabilitation program and one month later, points to the role of auditory temporal processing training program highlight the role of brainstem neural plasticity in speech processin

Genetic factors in end-stage renal disease

Genetic factors in end-stage renal disease. Despite more aggressive treatment of diabetes, hypertension, and hyperlipidemia, the incidence and prevalence rates of end-stage renal disease (ESRD) continue to increase worldwide. The likelihood of developing chronic kidney disease in an individual is determined by interactions between genes and the environment. Familial clustering of nephropathy has repeatedly been observed in all population groups studied and for multiple etiologies of kidney disease. A three- to nine-fold greater risk of ESRD is observed in individuals with a family history of ESRD. Marked racial variation in the familial aggregation of kidney disease exists, with high rates in African American, Native American, and Hispanic American families. Disparate etiologies of nephropathy aggregate within African American families, as well. These data have led several investigators to search for genes linked to diabetic and other forms of nephropathy. Evidence for linkage to kidney disease has been detected and replicated at several loci on chromosomes 3q (types 1 and 2 diabetic nephropathy), 10q (diabetic and nondiabetic kidney disease), and 18q (type 2 diabetic nephropathy). Multicenter consortia are currently recruiting large numbers of multiplex diabetic families with index cases having nephropathy for linkage and association analyses. In addition, large-scale screening studies are underway, with the goals of better defining the overall prevalence of chronic kidney disease, as well as educating the population about risk factors for nephropathy, including family history. Given the overwhelming burden of kidney disease worldwide, it is imperative that we develop a clearer understanding of the pathogenesis of nephropathy so that individuals at risk can be identified and treated at earlier, potentially reversible, stages of their illness

The effect of working memory training on auditory stream segregation in auditory processing disorders children

Objectives: This study investigated the efficacy of working memory training for improving working memory capacity and related auditory stream segregation in auditory processing disorders children. Methods: Fifteen subjects (9-11 years), clinically diagnosed with auditory processing disorder participated in this non-randomized case-controlled trial. Working memory abilities and auditory stream segregation were evaluated prior to beginning and six weeks after completing the training program. Ten control subjects, who did not participate in training program, underwent the same battery of tests at time intervals equivalent to the trained subjects. Differences between the two groups were measured using a repeated measures analysis of variance. Results: The results of this study indicated children who received auditory working memory training performed significantly better on working memory abilities and auditory stream segregation task than children do not received training program. Discussion: Results from this case-control study support the benefits of working memory training for children with auditory processing disorders and indicate that training of auditory working memory is especially important for this population

Relation between working memory capacity and auditory stream segregation in children with auditory processing disorder

Background: This study assessed the relationship between working memory capacity and auditory stream segregation by using the concurrent minimum audible angle in children with a diagnosed auditory processing disorder (APD). Methods: The participants in this cross-sectional, comparative study were 20 typically developing children and 15 children with a diagnosed APD (age, 9-11years) according to the subtests of multiple-processing auditory assessment. Auditory stream segregation was investigated using the concurrent minimum audible angle. Working memory capacity was evaluated using the non-word repetition and forward and backward digit span tasks. Nonparametric statistics were utilized to compare the between- group differences. The Pearson correlation was employed to measure the degree of association between working memory capacity and the localization tests between the 2 groups. Results: The group with APD had significantly lower scores than did the typically developing subjects in auditory stream segregation and working memory capacity. There were significant negative correlations between working memory capacity and the concurrent minimum audible angle in the most frontal reference location (0° azimuth) and lower negative correlations in the most lateral reference location (60° azimuth) in the children with APD. Conclusion: The study revealed a relationship between working memory capacity and auditory stream segregation in children with APD. The research suggests that lower working memory capacity in children with APD may be the possible cause of the inability to segregate and group incoming information. © 2016, Shiraz University of Medical Sciences. All rights reserved

The Prebiotic and Probiotic Properties of Human Milk: Implications for Infant Immune Development and Pediatric Asthma

The incidence of pediatric asthma has increased substantially in recent decades, reaching a worldwide prevalence of 14%. This rapid increase may be attributed to the loss of “Old Friend” microbes from the human microbiota resulting in a less diverse and “dysbiotic” gut microbiota, which fails to optimally stimulate immune development during infancy. This hypothesis is supported by observations that the gut microbiota is different in infants who develop asthma later in life compared to those who remain healthy. Thus, early life exposures that influence gut microbiota play a crucial role in asthma development. Breastfeeding is one such exposure; it is generally considered protective against pediatric asthma, although conflicting results have been reported, potentially due to variations in milk composition between individuals and across populations. Human milk oligosaccharides (HMOs) and milk microbiota are two major milk components that influence the infant gut microbiota and hence, development of the immune system. Among their many immunomodulatory functions, HMOs exert a selective pressure within the infant gut microbial niche, preferentially promoting the proliferation of specific bacteria including Bifidobacteria. Milk is also a source of viable bacteria originating from the maternal gut and infant oral cavity. As such, breastmilk has prebiotic and probiotic properties that can modulate two of the main forces controlling the gut microbial community assembly, i.e., dispersal and selection. Here, we review the latest evidence, mechanisms and hypotheses for the synergistic and/or additive effects of milk microbiota and HMOs in protecting against pediatric asthma

A Review of the Efficacy of Popular Eye Cream Ingredients

Every year, there are new products on the market advertised to preserve a youthful appearance and reduce the signs of aging. One classic example is eye cream. Due to the periorbital region’s high susceptibility to damage from external factors, along with its tendency to demonstrate early signs of aging, periorbital skin is a common target for anti-aging therapy. While some of these ingredients have proven efficacious in clinical trials, others have not shown to be clinically significant. Various products contain different combinations, formulations, and doses of these ingredients. This review evaluates the efficacy of popular topical ingredients found in common eye creams, including retinoids, vitamin C, vitamin E, peptides, ceramides, hyaluronic acid, caffeine, and niacinamide

Lateral Growth of Three-Dimensional Turbidity Current for Supercritical Initial Conditions

The aim of this paper is to investigate the lateral growth of an unsteady turbulent inclined turbidity current. To do so, the Buckingham Π theorem together with a dimensional analysis are implemented to derive two appropriate relations, one of which relates the current width to the current length and the other one expresses the current width in terms of time. The coefficients of the two relations are determined experimentally. Based on the results obtained, three different regimes namely, inertia-viscous as the first regime, buoyancy-viscous, and gravity-viscous as the second and third regimes are distinguished within the current. The experimental results indicate that the lateral growth rate in the first regime is less than that in the second one. Based on the results obtained, the lateral growth in some particular regions is independent of slope, concentration, and volumetric flow rate variations