Postoperative pain after arthroscopic versus open rotator cuff repair. A prospective study

Introduction: Although the arthroscopic technique is becoming the gold standard for rotator cuff tendon repair, there is no proof that this technique results in less postoperative pain compared to open repair. The aim of this study was to prospectively compare the postoperative pain level after arthroscopic or open rotator cuff repair and to define factors that could influence its course. Materials and methods: Between January 2012 and January 2013, 95 patients were operated for a rotator cuff tear: 45 using an arthroscopic technique and 50 an open technique. Daily analgesic use and self-evaluation of pain level using a visual analogic scale were recorded preoperatively and twice a day postoperatively during the first 6 weeks. These data were compared between the two groups and analyzed according to patients’ demographic data and preoperative evaluation of the tear. Results: The preoperative pain level was equivalent in the two groups (P = 0.22). Postoperatively, level-2 analgesic medication use was greater in the arthroscopic group after the 4th week (P = 0.01). A painfree shoulder was obtained before the 6th week in 75% and 66% of the patients after arthroscopic or open repair, respectively (P = 0.34). There was a positive correlation between the preoperative and postoperative pain level (r = 0.25; P = 0.02). Work compensation patients experienced more pain postoperatively (P = 0.08). Level-III analgesic medication use was greater for patients with massive rotator cuff tear (P = 0.001). Conclusion: No evidence was found on the superiority of arthroscopy versus open repair of rotator cuff tear concerning the postoperative pain level. The choice of the surgical technique should not be based on this argument

Decorin protein core affects the global gene expression profile of the tumor microenvironment in a triple-negative orthotopic breast carcinoma xenograft model

Decorin, a member of the small leucine-rich proteoglycan gene family, exists and functions wholly within the tumor microenvironment to suppress tumorigenesis by directly targeting and antagonizing multiple receptor tyrosine kinases, such as the EGFR and Met. This leads to potent and sustained signal attenuation, growth arrest, and angiostasis. We thus sought to evaluate the tumoricidal benefits of systemic decorin on a triple-negative orthotopic breast carcinoma xenograft model. To this end, we employed a novel high-density mixed expression array capable of differentiating and simultaneously measuring gene signatures of both Mus musculus (stromal) and Homo sapiens (epithelial) tissue origins. We found that decorin protein core modulated the differential expression of 374 genes within the stromal compartment of the tumor xenograft. Further, our top gene ontology classes strongly suggests an unexpected and preferential role for decorin protein core to inhibit genes necessary for immunomodulatory responses while simultaneously inducing expression of those possessing cellular adhesion and tumor suppressive gene properties. Rigorous verification of the top scoring candidates led to the discovery of three genes heretofore unlinked to malignant breast cancer that were reproducibly found to be induced in several models of tumor stroma. Collectively, our data provide highly novel and unexpected stromal gene signatures as a direct function of systemic administration of decorin protein core and reveals a fundamental basis of action for decorin to modulate the tumor stroma as a biological mechanism for the ascribed anti-tumorigenic properties

Monte Carlo studies of the intrinsic time-domain response of nanoscale three-branch junctions

We present a Monte Carlo time-domain study of nanostructured ballistic three-branch junctions (TBJs) excited by both step-function and Gaussian picosecond transients. Our TBJs were based on InGaAs 2-dimensional electron gas heterostructures and their geometry followed exactly the earlier experimental studies. Time-resolved, picosecond transients of both the central branch potential and the between-the-arms current demonstrate that the bandwidth of the intrinsic TBJ response reaches the THz frequency range, being mainly limited by the large-signal, intervalley scattering, when the carrier transport regime changes from ballistic to diffusive

A systematic review of maternal smoking during pregnancy and fetal measurements with meta-analysis

Funding: The study was supported by the European Cooperation in Science and Technology, who provided funds for publication. KMG is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and by the European Union's Seventh Framework Programme (FP7/2007-2013), projects Early Nutrition and ODIN under grant agreement numbers 289346 and 613977.Peer reviewedPublisher PD

Universal Finite Size Scaling Functions in the 3D Ising Spin Glass

We study the three-dimensional Edwards-Anderson model with binary interactions by Monte Carlo simulations. Direct evidence of finite-size scaling is provided, and the universal finite-size scaling functions are determined. Monte Carlo data are extrapolated to infinite volume with an iterative procedure up to correlation lengths xi \approx 140. The infinite volume data are consistent with a conventional power law singularity at finite temperature Tc. Taking into account corrections to scaling, we find Tc = 1.156 +/- 0.015, nu = 1.8 +/- 0.2 and eta = -0.26 +/- 0.04. The data are also consistent with an exponential singularity at finite Tc, but not with an exponential singularity at zero temperature.Comment: 4 pages, Revtex, 4 postscript figures include

Charge-based continuous model for long-channel Symmetric Double-Gate Junctionless Transistors

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Three-Terminal Junctions operating as mixers, frequency doublers and detectors: A broad-band frequency numerical and experimental study at room temperature

The frequency response of nanometric T- and Y-shaped three-terminal junctions (TTJs) is investigated experimentally and numerically. In virtue of the parabolic down-bending of the output voltage of the central branch obtained at room temperature under a push-pull fashion input, we analyze: the low-frequency performance (<1 MHz) of TTJs operating as mixers, their RF capability as doublers up to 4 GHz and detection at 94 GHz. Special attention is paid to the impedance matching and cut-off frequency of the measurement set-up. The numerical study is done by means of Monte Carlo simulations. We illustrate the intrinsic functionality of the device as frequency doubler or rectifier up to THz. The role of the width of the central branch on the highfrequency response is also explored, finding different cut-off frequencies for doubling and detection as a consequence of the diverse working principles of both mechanisms and the particular geometry of the TTJs.ROOTHz (FP7-243845

A High-Value, Low-Cost Bubble Continuous Positive Airway Pressure System for Low-Resource Settings: Technical Assessment and Initial Case Reports

Acute respiratory infections are the leading cause of global child mortality. In the developing world, nasal oxygen therapy is often the only treatment option for babies who are suffering from respiratory distress. Without the added pressure of bubble Continuous Positive Airway Pressure (bCPAP) which helps maintain alveoli open, babies struggle to breathe and can suffer serious complications, and frequently death. A stand-alone bCPAP device can cost $6,000, too expensive for most developing world hospitals. Here, we describe the design and technical evaluation of a new, rugged bCPAP system that can be made in small volume for a cost-of-goods of approximately$350. Moreover, because of its simple designﾗconsumergrade pumps, medical tubing, and regulators—it requires only the simple replacement of a ,$1 diaphragm approximately every 2 years for maintenance. The low-cost bCPAP device delivers pressure and flow equivalent to those of a reference bCPAP system used in the developed world. We describe the initial clinical cases of a child with bronchiolitis and a neonate with respiratory distress who were treated successfully with the new bCPAP device

Blood pressure and metabolic effects of acetyl-L-carnitine in type 2 diabetes: DIABASI randomized controlled trial

Context: Acetyl-L-carnitine (ALC), a mitochondrial carrier involved in lipid oxidation and glucose metabolism, decreased systolic blood pressure (SBP), and ameliorated insulin sensitivity in hypertensive nondiabetic subjects at high cardiovascular risk. Objective: To assess the effects of ALC on SBP and glycemic and lipid control in patients with hypertension, type 2 diabetes mellitus (T2D), and dyslipidemia on background statin therapy. Design: After 4-week run-in period and stratification according to previous statin therapy, patients were randomized to 6-month, double-blind treatment with ALC or placebo added-on simvastatin. Setting: Five diabetology units and one clinical research center in Italy. Patients: Two hundred twenty-nine patients with hypertension and dyslipidemic T2D &gt; 40 years with stable background antihypertensive, hypoglycemic, and statin therapy and serum creatinine &lt; 1.5 mg/ dL. Interventions: Oral ALC 1000 mg or placebo twice daily on top of stable simvastatin therapy. Outcome and Measures: Primary outcome was SBP. Secondary outcomes included lipid and glycemic profiles. Total-body glucose disposal rate and glomerular filtration rate were measured in subgroups by hyperinsulinemic-euglycemic clamp and iohexol plasma clearance, respectively. Results: SBP did not significantly change after 6-month treatment with ALC compared with placebo (-2.09mmHg vs-3.57mmHg, P = 0.9539). Serum cholesterol, triglycerides, and lipoprotein(a), as well as blood glucose, glycated hemoglobin, fasting insulin levels, homeostatic model assessment of insulin resistance index, glucose disposal rate, and glomerular filtration rate did not significantly differ between treatments. Adverse events were comparable between groups. Conclusions: Six-month oral ALC supplementation did not affect blood pressure, lipid and glycemic control, insulin sensitivity and kidney function in hypertensive normoalbuminuric and microalbuminuric T2D patients on background statin therapy