The Impact of Superior Labral Anterior to Posterior Lesions on Functional Status in Shoulder Instability: A Multicenter Cohort Study

BACKGROUND: Type IV superior labral anterior to posterior (SLAP) lesions, which are superior labral detachments associated with Bankart tears, are reported to occur in up to 25% of recurrent shoulder instability patients. However, the clinical implications of this finding are debatable. PURPOSE: To determine whether there are any functional differences between anterior instability patients with and without type IV SLAP lesions at the time of presentation and at short-term follow-up after surgical intervention. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A prospective, multicenter database was established to follow the clinical evolution of patients with shoulder instability. Patients were diagnosed as having a type IV SLAP lesion at the time of arthroscopic Bankart surgery (SLAP+). These patients were compared with a group of patients who simply had a Bankart lesion (SLAP-). The 2 groups had their functional outcomes (Western Ontario Shoulder Instability Index [WOSI]; Disability of the Arm, Shoulder, and Hand [QuickDASH]; and Walch-Duplay) compared prior to surgery and 1 year postoperatively. RESULTS: A total of 103 subjects were included in the study; of these, 56 (43 men, 13 women) completed 1-year follow-up. Twenty-three subjects had a type IV SLAP tear, and most had this repaired along with their Bankart lesion. At baseline, SLAP+ subjects had inferior QuickDASH scores compared with SLAP- subjects (37.8 vs 29.0) as well as poorer pain subscores on both the WOSI and QuickDASH. At 1-year follow-up, however, there were no significant differences in any of the outcome measures. CONCLUSION: A type IV SLAP lesion can be expected in 22% of patients with recurrent shoulder instability. This finding implies that at baseline, the patient will have slightly worse functional scores related to pain. However, following surgical management of the labral pathology, these patients will have equivalent functional outcomes at short-term follow-up. CLINICAL RELEVANCE: With surgical management of the superior and anteroinferior labrum, patients with type IV SLAP lesions will do as well as those with only Bankart tears. Thus, the presence of SLAP lesions should not alter the decision to provide surgical management and should not change the prognosis for a specific patient

Baseline characteristics and treatment of patients in prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial (PARADIGM-HF)

Aim<p></p> To describe the baseline characteristics and treatment of the patients randomized in the PARADIGM-HF (Prospective comparison of ARNi with ACEi to Determine Impact on Global Mortality and morbidity in Heart Failure) trial, testing the hypothesis that the strategy of simultaneously blocking the renin–angiotensin–aldosterone system and augmenting natriuretic peptides with LCZ696 200 mg b.i.d. is superior to enalapril 10 mg b.i.d. in reducing mortality and morbidity in patients with heart failure and reduced ejection fraction.<p></p> Methods<p></p> Key demographic, clinical and laboratory findings, along with baseline treatment, are reported and compared with those of patients in the treatment arm of the Studies Of Left Ventricular Dysfunction (SOLVD-T) and more contemporary drug and device trials in heart failure and reduced ejection fraction.<p></p> Results<p></p> The mean age of the 8442 patients in PARADIGM-HF is 64 (SD 11) years and 78% are male, which is similar to SOLVD-T and more recent trials. Despite extensive background therapy with beta-blockers (93% patients) and mineralocorticoid receptor antagonists (60%), patients in PARADIGM-HF have persisting symptoms and signs, reduced health related quality of life, a low LVEF (mean 29 ± SD 6%) and elevated N-terminal-proB type-natriuretic peptide levels (median 1608 inter-quartile range 886–3221 pg/mL).<p></p> Conclusion<p></p> PARADIGM-HF will determine whether LCZ696 is more beneficial than enalapril when added to other disease-modifying therapies and if further augmentation of endogenous natriuretic peptides will reduce morbidity and mortality in heart failure and reduced ejection fractio

Identification of Six Novel SOD1 Gene Mutations in Familial Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by the premature death of motor neurons. In approximately 10% of the cases the disease is inherited as autosomal dominant trait (FALS). It has been found that mutations in the Cu/Zn superoxide dismutase gene (SODl) are responsible for approximately 15% of FALS kindreds. We screened affected individuals from 70 unrelated FALS kindreds and identified 10 mutations, 6 of which are novel. Surprisingly, we have found a mutation in exon 3, which includes most of the active site loop and Zn2+ binding sites, a region where no previous SOD1 mutations have been found. Our data increase the number of different SODl mutations causing FALS to 55, a significant fraction of the 154 amino acids of this relatively small protei

Sensory and motor neuronopathy in a patient with the A382P TDP-43 mutation

Patients with TARDBP mutations have so far been classified as ALS, sometimes with frontal lobe dysfunction. A 66-year-old patient progressively developed a severe sensory disorder, followed by a motor disorder, which evolved over nine years. Symptoms started in the left hand and slowly involved the four limbs. Investigations were consistent with a mixed sensory and motor neuronopathy. A heterozygous change from an alanine to a proline at amino acid 382 was identified in exon 6 of the TARDPB gene (p.A382P). This case expands the phenotypic spectrum associated with mutations in the TARDBP gene and shows that sensory neurons can be severely damaged early in the course of the disease, following a propagating process, with an orderly progression from a focal starting point. A combination of severe sensory and motor neuronopathy is rarely encountered in clinical practice. The possibility of an A382P TDP-43 mutation should be considered in patients with such an association

Nanocomposite MFI-alumina and FAU-alumina Membranes: Synthesis, Characterization and Application to Paraffin Separation and CO2 Capture

Rouleau, L. Pirngruber, G. Guillou, F. Barrere-Tricca, C. Omegna, A. Valtchev, V. Pera-Titus, M. Miachon, S. Dalmon, J. A.International audienceIn this work, we report the preparation of thermally and mechanically resistant high-surface (24-cm2) nanocomposite MFI-alumina and FAUalumina membranes by pore-plugging synthesis inside the macropores of α-alumina multilayered tubular supports. The MFI membranes were prepared from a clear solution precursor mixture being able to easily penetrate into the pores of the support. The MFI membranes were evaluated in the separation of n-/i-butane mixtures. The synthesis reliability was improved by mild stirring. The most selective MFI membranes were obtained for supports with mean pore sizes of 0.2 and 0.8 μm. The MFI effective thickness could be reduced to less than 10 μm by impregnating the support with water prior to synthesis and by diluting the synthesis mixture. The best MFI membrane offered an excellent tradeoff between selectivity and permeance at 448 K, with separation factors for equimolar n-butane/i-butane mixtures up to 18 and n-butane mixture permeances as high as 0.7 μmol$\cdot$s-1$\cdot$m-2$\cdot$Pa-1.Furthermore, a novel nanocomposite FAU membrane architecture has been obtained by an original synthesis route including in situ seeding using a cold gel-like precursor mixture, followed by growth of the FAU material by hydrothermal synthesis in two steps using a clear solution of low viscosity. This new membrane showed interesting performance in the separation of an equimolar CO2/N2 mixture at 323 K, with CO2/N2 separation factors and mixture CO2 permeances up to 12 and 0.4 μmol$\cdot$s-1$\cdot$m-2$\cdot$Pa-1,respectively

Detection of antihydrogen annihilations with a Si-micro-strip and pure CsI detector

In 2002, the ATHENA collaboration reported the creation and detection of cold (~15 K) antihydrogen atoms [1]. The observation was based on the complete reconstruction of antihydrogen annihilations, simultaneous and spatially correlated annihilations of an antiproton and a positron. Annihilation byproducts are measured with a cylindrically symmetric detector system consisting of two layers of double sided Si-micro-strip modules that are surrounded by 16 rows of 12 pure CsI crystals (13 x 17.5 x 17 mm^3). This paper gives a brief overview of the experiment, the detector system, and event reconstruction. Reference 1. M. Amoretti et al., Nature 419, 456 (2002).Comment: 7 pages, 5 figures; Proceedings for the 8th ICATPP Conference on Astroparticle, Particle, Space Physics, Detectors and Medical Physics Applications (Como, Italy October 2003) to be published by World Scientific (style file included

Novel integrative genomic tool for interrogating lithium response in bipolar disorder

We developed a novel integrative genomic tool called GRANITE (Genetic Regulatory Analysis of Networks Investigational Tool Environment) that can effectively analyze large complex data sets to generate interactive networks. GRANITE is an open-source tool and invaluable resource for a variety of genomic fields. Although our analysis is confined to static expression data, GRANITE has the capability of evaluating time-course data and generating interactive networks that may shed light on acute versus chronic treatment, as well as evaluating dose response and providing insight into mechanisms that underlie therapeutic versus sub-therapeutic doses or toxic doses. As a proof-of-concept study, we investigated lithium (Li) response in bipolar disorder (BD). BD is a severe mood disorder marked by cycles of mania and depression. Li is one of the most commonly prescribed and decidedly effective treatments for many patients (responders), although its mode of action is not yet fully understood, nor is it effective in every patient (non-responders). In an in vitro study, we compared vehicle versus chronic Li treatment in patient-derived lymphoblastoid cells (LCLs) (derived from either responders or non-responders) using both microRNA (miRNA) and messenger RNA gene expression profiling. We present both Li responder and non-responder network visualizations created by our GRANITE analysis in BD. We identified by network visualization that the Let-7 family is consistently downregulated by Li in both groups where this miRNA family has been implicated in neurodegeneration, cell survival and synaptic development. We discuss the potential of this analysis for investigating treatment response and even providing clinicians with a tool for predicting treatment response in their patients, as well as for providing the industry with a tool for identifying network nodes as targets for novel drug discovery

Interstellar extinction and polarization -- A spheroidal dust grain approach perspective

We extend and investigate the spheroidal model of interstellar dust grains used to simultaneously interpret the observed interstellar extinction and polarization curves. We compare our model with similar models recently suggested by other authors, study its properties and apply it to fit the normalized extinction $A(\lambda)/A_{\rm V}$ and the polarizing efficiency $P(\lambda)/A(\lambda)$ measured in the near IR to far UV region for several stars seen through one large cloud. We conclude that the model parameter $\Omega$ being the angle between the line of sight and the magnetic field direction can be more or less reliably determined from comparison of the theory and observations. This opens a way to study the spatial structure of interstellar magnetic fields by using multi-wavelength photometric and polarimetric observations.Comment: 11 pages, 4 figures and 4 tables, To appear in MNRAS (added

Is the silicate emission feature only influenced by grain size?

The flattening of the 10mu silicate emission feature observed in the spectra of T Tauri and Herbig Ae/Be stars is usually interpreted as an indicator of grain growth. We show in this paper that a similar behaviour of the feature shape occurs when the porosity of composite grains varies. The fluffy aggregates, having inclusions of different sizes, were modeled by multi-layered spheres consisting of amorphous carbon, amorphous silicate and vacuum. It is also found that the inclusion of crystalline silicates in composite porous particles can lead to a shift of the known resonances and production of new ones.Comment: accepted by Astronomy & Astrophysics Letters; small revision after referee repor