Simple Febrile Seizure: The Role of Serum Sodium Levels in Prediction of Seizure Recurrence during the First 24 Hours

ObjectiveSimple febrile seizures are the most common form of childhood seizures,often recurring within the first twenty-four hours. This study was conducted to determine the probable role of low serum  sodium levels in predicting seizure recurrence in febrile children.Materials & MethodsFor the study, 226 patients with seizures, aged between 6 months to 5 years, were divided into 3 groups of simple febrile seizure, simple febrile seizure with recurrence, and the control group of afebrile patients with seizures. For all groups, serum sodium levels were evaluated.ResultsThe mean age of our cases, predominantly male, was 22 months. No significant difference was observed in the serum sodium levels between the simple febrile seizure and the simple febrile seizure with recurrence groups (P value 0.465); however a significant relative hyponatremia was observed in the simple febrile seizure group as compared to the afebrile seizure control group (P value: 0.016).ConclusionBased on the findings, although serum sodium levels cannot assist in prediction of recurrence of simple febrile seizures in children, relative hyponatremia may predispose the febrile child to occurrence of simple febrile seizure.

“It’s embarrassing. I get angry. I get frustrated.”: Understanding severe hypoglycemia and glucagon usage from the perspectives of people with type 1 diabetes

Introduction This study characterized the emotional impact of severe hypoglycemia, views of glucagon, and barriers to glucagon use from the perspective of adults with type 1 diabetes (T1D). Methods Participants included individuals recruited from the T1D Exchange online community. The current study conducted 7 focus groups consisting of adults with T1D (N = 38, average age 49.4, SD = 16.11 years). Average duration of diabetes was 34.4 years (SD = 17.3) and average self-reported A1c was 6.8 % (SD = 0.7). Focus group interviews were recorded, transcribed, and thematically analyzed. Results A range of emotions was expressed about severe hypoglycemia including fear, anxiety, stress, frustration, shame, and embarrassment. Participants frequently identified prescription cost and insurance deductibles as barriers to glucagon use. Participants were also concerned about ease of administration—how difficult it is to prepare the glucagon in an emergency. Many participants expressed a preference for auto-injectables over nasal administration. Timing of glucagon action and time to recovery were high priorities. Some participants, while they had not self-administered glucagon, were interested in a mini-dose glucagon they could self-administer. They also identified desirable characteristics of glucagon treatment including reduced cost, long shelf-life, and quick activation. Conclusions These results highlight the attitudes about severe hypoglycemia and emergency treatment with glucagon. Healthcare professionals should assess glucagon training needs and knowledge when they meet with their patients with diabetes

Functional outcome of lower limb following anterior cruciate ligament reconstruction; a prospective clinical study

Background: Both isokinetic testing and functional tests are commonly used to evaluate anterior cruciate ligament reconstructed (ACLR) patients. The object of this study was to evaluate motor performance of the knee and determine the relationship of isokinetic test scores to scores on a variety of lower extremity functional tests. Methods: Ten healthy subjects and eleven ACLR patients at least six months after surgery performed the following: knee isokinetic tests at 60 and 180 deg/sec; three functional tests including leg vertical jump, single hop, and triple cross-over hop for distance. The International Knee Document Committee Subjective Knee Evaluation Form (IKDCSKEF) was used to score the self-assessment of each study participant. Paired T-test was used to compare the involved and uninvolved knee. Pearson correlation coefficients were used to determine the relationship between the scores on the isokinetic test and functional tests. Significance was determined by P<0.05. Results: IKDCSKEF score was significantly lower in patients than control subjects. Quadriceps peak torque and functional test scores were significantly lower in the involved knee of the ACLR subjects compared to the uninvolved knee. Correlation coefficients of isokinetic peak torque to body weight and functional testing were not significant in patients or control subjects, whi1e the limb symmetry index (LSI) of the quadriceps isokinetics peak torque to body weight and the LSI of the functional tests were significant (r = 0.54 to 0.97). Conclusion: These results indicate a significant relationship between the LSI of various functional tests and the LSI of isokinetic testing among ACLR patients. Thus, in situations where an isokinetic dynamometer is not available, the LSI of functional tests can be used to estimate quadriceps deficiency for ACLR patients. © 2008, Tehran University of Medical Sciences. All rights reserved

Isokinetic and functional parameters in patients following reconstruction of the anterior cruciate ligament

Both isokinetic testing and functional tests are commonly used to evaluate patients following reconstruction of the anterior cruciate ligament (ACLR). To determine the relationship of scores on an isokinetic test to scores on a variety of lower extremity functional tests ten healthy subjects and eleven ACLR patients at least six months after surgery performed knee isokinetic test at 60 and 180 deg/sec and three functional tests: leg vertical jump, single hop, and triple cross-over hop for distance. Correlation coefficients of isokinetic peak torque to body weight and functional testing were not significant at the P < 0.05 level in patients or control subjects, whi1e ratio of involved to uninvolved knee quadriceps isokinetics peak torque and Limb Symmetry Index (LSI) of functional test were significant at the P < 0.05 level (r=0.54 to 0.97). These results indicate a significant relationship between the LSI of various functional tests and side-to-side ratio of isokinetic testing just in ACLR patients. © 2005 - IOS Press and the authors. All rights reserved

HSP70/IL-2 treated NK cells effectively cross the blood brain barrier and target tumor cells in a rat model of induced glioblastoma multiforme (GBM)

Natural killer (NK) cell therapy is one of the most promising treatments for Glioblastoma Multiforme (GBM). However, this emerging technology is limited by the availability of sufficient numbers of fully functional cells. Here, we investigated the efficacy of NK cells that were expanded and treated by interleukin-2 (IL-2) and heat shock protein 70 (HSP70), both in vitro and in vivo. Proliferation and cytotoxicity assays were used to assess the functionality of NK cells in vitro, after which treated and naïve NK cells were administrated intracranially and systemically to compare the potential antitumor activities in our in vivo rat GBM models. In vitro assays provided strong evidence of NK cell efficacy against C6 tumor cells. In vivo tracking of NK cells showed efficient homing around and within the tumor site. Furthermore, significant amelioration of the tumor in rats treated with HSP70/Il-2-treated NK cells as compared to those subjected to nontreated NK cells, as confirmed by MRI, proved the efficacy of adoptive NK cell therapy. Moreover, results obtained with systemic injection confirmed migration of activated NK cells over the blood brain barrier and subsequent targeting of GBM tumor cells. Our data suggest that administration of HSP70/Il-2-treated NK cells may be a promising therapeutic approach to be considered in the treatment of GBM. © 2020 by the authors. Licensee MDPI, Basel, Switzerland

Comparison of contrast sensitivity in β-thalassemia patients treated by deferoxamine or deferasirox

Purpose: To compare contrast sensitivity (CS) in multi-transfused β-thalassemia patients who received deferoxamine with those who received Osveral. Methods: In this cross sectional study a total of 60 β-thalassemia patients (30 used deferoxamine and 30 used deferasirox) were regarded as case group and 30 age and sex matched healthy subjects were selected as control group. All subjects had a set of examinations including refraction, visual acuity, Biomicroscopy, ophthalmoscopy and CS. Contrast threshold was assessed with the use of Freiberg visual acuity and contrast test under the mesopic light condition for three frequencies; 1, 5, 15. cpd. All data analysis was performed using SPSS, version 17. Results: In visual acuity tests, thalassemic patients did not have any problem. Contrast threshold was higher in thalassemic patients who infuse deferoxamine (1.87. ±. 0.63, 1.46. ±. 0.81, and 2.96. ±. 1.68 in 1, 5, and 15. cpd, respectively) than that of those who intake deferasirox (1.74. ±. 0.80 (P = 0.743), 0.99. ±. 0.74 (P = 0.047), and 2.42. ±. 1.36 (P = 0.321) for 1, 5, and 15. cpd, respectively), and also than healthy patients (1.33. ±. 0.58 (P = 0.009), 0.95. ±. 0.68 (P = 0.022), and 2.24. ±. 1.23 (P = 0.135) for 1, 5, and 15. cpd, respectively). Comparing those who used deferasirox with healthy subjects, contrast threshold was higher in deferasirox group at all special frequencies (P >. 0.05). No significant relationship was observed between CS values and duration of transfusion, serum ferritin concentration and dose of chelation therapy (P >. 0.05). Conclusions: CS tests can detect visual disturbance in thalassemic patients before the impairment of visual acuity. It is suggested that CS tests be included in their regular eye examination. © 2018 Spanish General Council of Optometry

Comparison of contrast sensitivity in β-thalassemia patients treated by deferoxamine or deferasirox

Purpose: To compare contrast sensitivity (CS) in multi-transfused β-thalassemia patients who received deferoxamine with those who received Osveral. Methods: In this cross sectional study a total of 60 β-thalassemia patients (30 used deferoxamine and 30 used deferasirox) were regarded as case group and 30 age and sex matched healthy subjects were selected as control group. All subjects had a set of examinations including refraction, visual acuity, Biomicroscopy, ophthalmoscopy and CS. Contrast threshold was assessed with the use of Freiberg visual acuity and contrast test under the mesopic light condition for three frequencies; 1, 5, 15. cpd. All data analysis was performed using SPSS, version 17. Results: In visual acuity tests, thalassemic patients did not have any problem. Contrast threshold was higher in thalassemic patients who infuse deferoxamine (1.87. ±. 0.63, 1.46. ±. 0.81, and 2.96. ±. 1.68 in 1, 5, and 15. cpd, respectively) than that of those who intake deferasirox (1.74. ±. 0.80 (P = 0.743), 0.99. ±. 0.74 (P = 0.047), and 2.42. ±. 1.36 (P = 0.321) for 1, 5, and 15. cpd, respectively), and also than healthy patients (1.33. ±. 0.58 (P = 0.009), 0.95. ±. 0.68 (P = 0.022), and 2.24. ±. 1.23 (P = 0.135) for 1, 5, and 15. cpd, respectively). Comparing those who used deferasirox with healthy subjects, contrast threshold was higher in deferasirox group at all special frequencies (P >. 0.05). No significant relationship was observed between CS values and duration of transfusion, serum ferritin concentration and dose of chelation therapy (P >. 0.05). Conclusions: CS tests can detect visual disturbance in thalassemic patients before the impairment of visual acuity. It is suggested that CS tests be included in their regular eye examination. © 2018 Spanish General Council of Optometry

Comparison of contrast sensitivity in β-thalassemia patients treated by deferoxamine or deferasirox Comparación de la sensibilidad de contraste en los pacientes con β-Talasemia tratados con Deferoxamina o Deferasirox

Purpose: To compare contrast sensitivity (CS) in multi-transfused β-thalassemia patients who received deferoxamine with those who received Osveral. Methods: In this cross sectional study a total of 60 β-thalassemia patients (30 used deferoxamine and 30 used deferasirox) were regarded as case group and 30 age and sex matched healthy subjects were selected as control group. All subjects had a set of examinations including refraction, visual acuity, Biomicroscopy, ophthalmoscopy and CS. Contrast threshold was assessed with the use of Freiberg visual acuity and contrast test under the mesopic light condition for three frequencies; 1, 5, 15 cpd. All data analysis was performed using SPSS, version 17. Results: In visual acuity tests, thalassemic patients did not have any problem. Contrast threshold was higher in thalassemic patients who infuse deferoxamine (1.87 ± 0.63, 1.46 ± 0.81, and 2.96 ± 1.68 in 1, 5, and 15 cpd, respectively) than that of those who intake deferasirox (1.74 ± 0.80 (P = 0.743), 0.99 ± 0.74 (P = 0.047), and 2.42 ± 1.36 (P = 0.321) for 1, 5, and 15 cpd, respectively), and also than healthy patients (1.33 ± 0.58 (P = 0.009), 0.95 ± 0.68 (P = 0.022), and 2.24 ± 1.23 (P = 0.135) for 1, 5, and 15 cpd, respectively). Comparing those who used deferasirox with healthy subjects, contrast threshold was higher in deferasirox group at all special frequencies (P > 0.05). No significant relationship was observed between CS values and duration of transfusion, serum ferritin concentration and dose of chelation therapy (P > 0.05). Conclusions: CS tests can detect visual disturbance in thalassemic patients before the impairment of visual acuity. It is suggested that CS tests be included in their regular eye examination. © 2018 Spanish General Council of Optometr

Tear Deformation Time and optical quality in eyes wearing silicone hydrogel contact lenses

Purpose To evaluate tear film stability and optical aberrations in eyes wearing plano Lotrafilcon B contact lenses (CL). Methods Tear Deformation Time (TDT) and aberrometric parameters were assessed in 86 normal emmetropic eyes before and 6 h after wearing CL. Result A statistically significant decrease in TDT and increase in root mean square (RMS) values of higher order aberrations (HOA) were revealed 6 h after CL insertion (both P < 0.001). The low order aberrations (LOA) RMS values measured with CL were higher than those in naked eyes, but the difference was not statistically significant. None of individual Zernike polynomials showed any significant alteration. Conclusion Our findings indicated that the Lotrafilcon B contact lens affects HOA more than LOA. The tear film was less stable after wearing CL. © 2016 Iranian Society of Ophthalmolog

Alternate processing of Flt1 transcripts is directed by conserved cis-elements within an intronic region of FLT1 that reciprocally regulates splicing and polyadenylation

The vascular endothelial growth factor receptor, Flt1 is a transmembrane receptor co-expressed with an alternate transcript encoding a secreted form, sFlt1, that functions as a competitive inhibitor of Flt1. Despite shared transcription start sites and upstream regulatory elements, sFlt1 is in far greater excess of Flt1 in the human placenta. Phorbol myristic acid and dimethyloxalylglycine differentially stimulate sFlt1 compared to Flt1 expression in vascular endothelial cells and in cytotrophoblasts. An FLT1 minigene construct containing exon 13, 14 and the intervening region, recapitulates mRNA processing when transfected into COS-7, with chimeric intronic sFlt1 transcripts arising by intronic polyadenylation and other Flt1/sFlt1 transcripts by alternate splicing. Inclusion of exon 15 but not 14 had a modest stimulatory effect on the abundance of sFlt1. The intronic region containing the distal poly(A) signal sequences, when transferred to a heterologous minigene construct, inhibited splicing but only when cloned in sense orientation, consistent with the presence of a directional cis-element. Serial deletional and targeted mutational analysis of cis-elements within intron 13 identified intronic poly(A) signal sequences and adjacent cis-elements as the principal determinants of the relative ratio of intronic sFlt1 and spliced Flt1. We conclude that intronic signals reciprocally regulate splicing and polyadenylation and control sFlt1 expression