Bethesda Hospital

About: Bethesda Hospital is a healthcare organization based out in Ambur, Tamil Nadu, India. It is known for research contribution in the topics: Population & Helicobacter pylori. The organization has 386 authors who have published 472 publications receiving 15193 citations.

Music therapy interaction patterns in relation to borderline personality disorder (BPD) patients

Abstract: Music therapy for patients suffering from borderline personality disorder (BPD) has been a standard treatment option for many years in in-patient psychiatric work The BPD symptoms, such as identity disturbance, emotional regulation and unstable relationships, lead to challenging and stormy therapy sessions for all therapists of all disciplines In music therapy, difficulties in treatment include, for example, the patient’s refusal to play, extreme loud music or withdrawal from the process This article presents the method and results of a systematic qualitative research of 20 BPD female patients undergoing individual psychoanalytical music therapy in an acute psychiatric context The aim of the research was to identify typical interaction patterns, arising from the relationship between patient and therapist and also from the significance of music The method “forming types by understanding” is based on the well-known sociological research method of “ideal types” Abstracted results are generated by contr

A High Malaria Prevalence Identified by PCR among Patients with Acute Undifferentiated Fever in India.

Abstract: Background Approximately one million malaria cases were reported in India in 2015, based on microscopy. This study aims to assess the malaria prevalence among hospitalised fever patients in India identified by PCR, and to evaluate the performance of routine diagnostic methods. Methods During June 2011-December 2012, patients admitted with acute undifferentiated fever to seven secondary level community hospitals in Assam (Tezpur), Bihar (Raxaul), Chhattisgarh (Mungeli), Maharashtra (Ratnagiri), Andhra Pradesh (Anantapur) and Tamil Nadu (Oddanchatram and Ambur) were included. The malaria prevalence was assessed by polymerase chain reaction (PCR), routine microscopy, and a rapid diagnostic test (RDT) with PCR as a reference method. Results The malaria prevalence by PCR was 19% (268/1412) ranging from 6% (Oddanchatram, South India) to 35% (Ratnagiri, West India). Among malaria positive patients P. falciparum single infection was detected in 46%, while 38% had P. vivax, 11% mixed infections with P. falciparum and P. vivax, and 5% P. malariae. Compared to PCR, microscopy had sensitivity of 29% and specificity of 98%, while the RDT had sensitivity of 24% and specificity of 99%. Conclusions High malaria prevalence was identified by PCR in this cohort. Routine diagnostic methods had low sensitivity compared to PCR. The results suggest that malaria is underdiagnosed in rural India. However, low parasitaemia controlled by immunity may constitute a proportion of PCR positive cases, which calls for awareness of the fact that other pathogens could be responsible for the febrile disease in submicroscopic malaria.

Assesment of the Biological Activity of Chemically Immobilized rhBMP‐2 on Titanium surfaces in vivo

Abstract: Previously it has been shown that recombinant human bone morphogenetic protein (rhBMP-2) can be chemically immobilized by “anchor molecules” on titanium surfaces for serving as a drug delivery device. This opened the question of whether the insoluble immobilized rhBMP-2 retained its activity in comparison to the same amount of soluble rhBMP-2 included with the implant samples. Electropolished titanium miniplates (10 × 6 × 0.8 mm) were “surface-enhanced” by a novel treatment with chromosulfuric acid and then coated with a total amount of 150–200 ng rhBMP-2 prepared by recombinant technology. Periosteal flaps (7 × 20 mm) were detached and isolated from the anterior surface of the tibiae of adult rabbits and wrapped around the titanium sample plates which were then implanted in the M. gastrocnemius. In the first experimental group various controls without rhBMP-2 were combined (n = 12). In the second experimental group implants with chemically immobilized rhBMP-2 (n = 8) were compared with implants to which non-immobilized soluble rhBMP-2 was added (n = 8). Animals were sacrificed after 28 days and a quantitative evaluation was carried out by means of serial sections. Untreated control plates showed bone formation in 2/12 implants, rhBMP-2 coated implants in 6/8 and implants with free rhBMP-2 administered subperiostally in 8/8 cases. In the case of rhBMP-2 coated implants the induced bone had direct contact to the implant in all cases while in the group with free administered rhBMP-2 the bone had no contact to the implant in two cases, but was separated by a fibrous capsule. Bone volume, bone surface area, and trabecular number displayed no difference between the two rhBMP-2-groups. However, in the biocoated group a tendency to an increase in the bone-implant contact area was evident. No differences in osteoid area, osteoid perimeter and eroded perimeter were detected. We conclude that in the case of non-immobilized rhBMP-2 there is the danger for formation of fibrous tissue between the implant and the newly formed bone and in addition the generation of ectopic bone at inappropriate places. In contrast chemically immobilized rhBMP-2 does not have these drawbacks and at the same time displays a biological activity on surfaces similar to that of soluble rhBMP-2 demonstrating that biomaterial surfaces can be tailored for a selective and specific interaction with the target tissue. Abschatzung der biologischen Aktivitat von chemisch immobilisiertem rhBMP-2 auf Titanoberflachenin vivo In bisherigen Arbeiten konnte gezeigt werden, dass rekombinantes humanes Bone Morphogenetic Protein (rhBMP-2), welches in vitro aktiv ist, kovalent auf Titanoberflachen immobilisiert werden kann. Es erhebt sich die Frage, ob das in dieser Form immobilisierte rhBMP-2 seine biologische Aktivitat in vivo behalt. Die Oberflache von elektropolierten Titanplattchen (10 × 6 × 0.8 mm) wurde durch Behandlung mit Chromschwefelsaure veredelt und die Plattchen wurden anschliesend mit einer Gesamtmenge von 150–200 ng rhBMP-2 beschichtet, das mittels rekombinanter DNA-Technologie in E. coli gewonnen wurde. Von der Vorderkante der Tibia erwachsener Kaninchen wurde ein 7 × 20 mm groser Perioststreifen entnommen, die Titanplattchen damit umwickelt und das Komposit dann in den M. gastrocnemius implantiert. Die Experimente wurden in zwei Hauptgruppen aufgeteilt. In der ersten Versuchsgruppe wurden verschiedene Kontrollen in Abwesenheit von rhBMP-2 zusammengefasst (n = 12). In der zweiten Versuchsgruppe wurde die biologische Reaktion auf chemisch immobilisiertes rhBMP-2 (n = 8) mit nicht-immobilisiertem loslichem rhBMP-2 in der Periosttasche (n = 8) verglichen. Die Versuchsdauer betrug 28 Tage. Die quantitative Analyse der Knochenneubildung wurde an Serienschnitten durchgefuhrt. Wahrend es in der ersten Versuchsgruppe bei Implantaten ohne rhBMP-2 wie zu erwarten nur in 2/12 Fallen zu einer ganz geringen Knochenneubildung kam, zeigte sich eine deutliche Knochenneubildung bei 6/8 Implantaten mit chemisch immobilisiertem rhBMP-2 und bei 8/8 Implantaten mit freiem rhBMP-2. Bei immobilisiertem rhBMP-2 hatte der neugebildete Knochen in allen Fallen einen unmittelbaren Kontakt zur Implantatoberflache, wahrend bei freiem rhBMP-2 der Knochen in 2 Fallen keinen Kontakt zum Implantat aufwies, sondern von einer Bindegewebsschicht getrennt war. Hinsichtlich Knochenvolumen, Knochenoberflache und Trabekelzahl ergab sich kein Unterschied zwischen immobilisiertem und freiem rhBMP-2. Die Parameter Osteoidflache, Osteoidumfang und erodierter Umfang zeigten ebenfalls keine Gruppenunterschiede. Wir schliesen, dass im Falle des nicht-immobilisierten rhBMP-2 die Gefahr eines fibrosen Interfaces zwischen Implantat und neugebildetem Knochen und der Induktion von ektopischem Knochen an ungewollter Stelle besteht. Im Gegensatz dazu zeigt kovalent immobilisiertes rhBMP-2 auf Titanoberflachen eine ahnlich hohe biologische Aktivitat wie losliches rhBMP-2 ohne die obengenannten Gefahren. Oberflachen von Biomaterialien konnen somit durch rhBMP-2 Beschichtungen so verandert werden, dass eine spezifische Interaktion mit dem Zielgewebe induziert wird.

Computer-Based Diagnostic Expert Systems in Rheumatology: Where Do We Stand in 2014?

Abstract: Background. The early detection of rheumatic diseases and the treatment to target have become of utmost importance to control the disease and improve its prognosis. However, establishing a diagnosis in early stages is challenging as many diseases initially present with similar symptoms and signs. Expert systems are computer programs designed to support the human decision making and have been developed in almost every field of medicine. Methods. This review focuses on the developments in the field of rheumatology to give a comprehensive insight. Medline, Embase, and Cochrane Library were searched. Results. Reports of 25 expert systems with different design and field of application were found. The performance of 19 of the identified expert systems was evaluated. The proportion of correctly diagnosed cases was between 43.1 and 99.9%. Sensitivity and specificity ranged from 62 to 100 and 88 to 98%, respectively. Conclusions. Promising diagnostic expert systems with moderate to excellent performance were identified. The validation process was in general underappreciated. None of the systems, however, seemed to have succeeded in daily practice. This review identifies optimal characteristics to increase the survival rate of expert systems and may serve as valuable information for future developments in the field.

Loss of Dickkopf 3 Promotes the Tumorigenesis of Basal Breast Cancer.

Abstract: Dickkopf 3 (DKK3) has been associated with tumor suppression of various tumor entities including breast cancer. However, the functional impact of DKK3 on the tumorigenesis of distinct molecular breast cancer subtypes has not been considered so far. Therefore, we initiated a study analyzing the subtype-specific DKK3 expression pattern as well as its prognostic and functional impact with respect to breast cancer subtypes. Based on three independent tissue cohorts including one in silico dataset (n = 30, n = 463 and n = 791) we observed a clear down-regulation of DKK3 expression in breast cancer samples compared to healthy breast tissue controls on mRNA and protein level. Interestingly, most abundant reduction of DKK3 expression was detected in the highly aggressive basal breast cancer subtype. Analyzing a large in silico dataset comprising 3,554 cases showed that low DKK3 mRNA expression was significantly associated with reduced recurrence free survival (RFS) of luminal and basal-like breast cancer cases. Functionally, DKK3 re-expression in human breast cancer cell lines led to suppression of cell growth possibly mediated by up-regulation of apoptosis in basal-like but not in luminal-like breast cancer cell lines. Moreover, ectopic DKK3 expression in mesenchymal basal breast cancer cells resulted in partial restoration of epithelial cell morphology which was molecularly supported by higher expression of epithelial markers like E-Cadherin and down-regulation of mesenchymal markers such as Snail 1. Hence, we provide evidence that down-regulation of DKK3 especially promotes tumorigenesis of the aggressive basal breast cancer subtype. Further studies decoding the underlying molecular mechanisms of DKK3-mediated effects may help to identify novel targeted therapies for this clinically highly relevant breast cancer subtype.