Antioxidants as a treatment for acute pancreatitis: A meta-analysis

OBJECTIVE

To assess the efficacy of antioxidants in acute (AP) pancreatitis.

METHODS

We searched PubMed, Embase and the Cochrane library for all randomized controlled trials (RCT) involving administration of antioxidants in the therapy of AP until February 2012. AP studies were pooled to analyze the effect of antioxidants on hospital stay, mortality, and complications. Subgroup analyses were performed on the use of the antioxidant glutamine.

RESULTS

In total, eleven RCTs were included. Among patients with AP, antioxidant therapy resulted in a borderline significant reduction in hospital stay (mean difference -1.74; 95%CI -3.56 to 0.08), a significant decrease in complications (RR 0.66; 95%CI 0.46-0.95) and a non-significant decrease in mortality rate (RR 0.66; 95%CI 0.30-1.46). Subgroup analyses showed that glutamine significantly reduced complications (RR 0.51; 95%CI 0.34-0.78) and mortality rate (RR 0.33; 95%CI 0.13-0.85).

CONCLUSION

The present meta-analysis shows a possible benefit of glutamine supplementation in patients with acute pancreatitis. However, large randomized trials are needed to confirm these observations.

Early interactions between neuronal adaptation and voluntary control determine perceptual choices in bistable vision

At the onset of bistable stimuli, the brain needs to choose which of the competing perceptual interpretations will first reach awareness. Stimulus manipulations and cognitive control both influence this choice process, but the underlying mechanisms and interactions remain poorly understood. Using intermittent presentation of bistable visual stimuli, we demonstrate that short interruptions cause perceptual reversals upon the next presentation, whereas longer interstimulus intervals stabilize the percept. Top-down voluntary control biases this process but does not override the timing dependencies. Extending a recently introduced low-level neural model, we demonstrate that percept-choice dynamics in bistable vision can be fully understood with interactions in early neural processing stages. Our model includes adaptive neural processing preceding a rivalry resolution stage with cross-inhibition, adaptation, and an interaction of the adaptation levels with a neural baseline. Most importantly, our findings suggest that top-down attentional control over bistable stimuli interacts with low-level mechanisms at early levels of sensory processing before perceptual conflicts are resolved and perceptual choices about bistable stimuli are made.

Percept-choice sequences driven by interrupted ambiguous stimuli: a low-level neural model

Existing neural explanations of spontaneous percept switching under steady viewing of an ambiguous stimulus do not fit the fact that stimulus interruptions cause the same percept to reappear across many ON/OFF cycles. We present a simple neural model that explains the observed behavior and predicts several more complicated percept sequences, without invoking any "high-level" decision making or memory. Percept choice at stimulus onset, which differs fundamentally from standard percept switching, depends crucially on a hitherto neglected interaction between local "shunting" adaptation and a near-threshold neural baseline. Stimulus ON/OFF timing then controls the generation of repeating, alternating, or more complex choice sequences. Our model also explains "priming" versus "habituation" effects on percept choice, reinterprets recent neurophysiological data, and predicts the emergence of hysteresis at the level of percept sequences, with occasional noise-induced sequence "hopping."

Biological aspects of testicular sperm extraction

Since the first reports of successful pregnancies after treatment with intra cytoplasmic sperm injection (ICSI) in humans, intensive investigations focused on the use of testicular spermatozoa and immature sperm cells in the treatment of azoopsermic patients. Several studies explore the technical development of the preparation, isolation and cryo storage of testicular germ cells. Other studies focus on ICSI itself and try to identify the biochemical and biophysical processes involved in fertilisation after injection of a testicular sperm cell into a human oocyte. Indications for azoospermic patients to whom this first line treatment can be offered are becoming more defined. But one of the major concerns is of course the safety of the technique, especially, for the health and reproductive life of the babies born after application of ICSI with testicular germ cells. An evaluation of ICSI with testicular germ cells is presented in this manuscript.