Noisy galvanic vestibular stimulation (nGVS) delivered at imperceptible intensities can improve vestibular function in health and disease. Here we evaluated whether nGVS effects on vestibular function are only present during active stimulation or may exhibit relevant post-stimulation aftereffects. Initially, nGVS amplitudes that optimally improve posture were determined in 13 healthy subjects. Subsequently, effects of optimal nGVS amplitudes on vestibular roll-tilt direction recognition thresholds (DRT) were examined during active and sham nGVS. Ten of 13 subjects exhibited reduced DRTs during active nGVS compared to sham stimulation (p < 0.001). These 10 participants were then administered to 30 mins of active nGVS treatment while being allowed to move freely. Immediately post-treatment , DRTs were increased again (p = 0.044), reverting to baseline threshold levels (i.e. were comparable to the sham nGVS thresholds), and remained stable in a follow-up assessment after 30 min. After three weeks, participants returned for a follow-up experiment to control for learning effects, in which DRTs were measured during and immediately after 30 min application of sham nGVS. DRTs during both assessments did not differ from baseline level. These findings indicate that nGVS does not induce distinct post-stimulation effects on vestibular motion perception and favor the development of a wearable technology that continuously delivers nGVS to patients in order to enhance vestibular function.
Adipose tissue is considered to have endocrine properties, including factors that are considered to have angiogenic activity. The current study aimed to evaluate whether there was a difference in the efficacy of bevacizumab for metastatic colon cancer patients according to their BMI (kg/m). A retrospective review of the medical records of consecutive patients who were treated with bevacizumab from diagnosis for metastatic colon cancer between 2005 and 2011 was carried out. Data extracted from medical files included demographics, height, weight, comorbidities, treatment protocols, time to tumor progression (TTP), and time of death. Variables were further evaluated with respect to TTP and overall survival (OS). The final analysis included 184 patients. The median TTP was 11.7 months and the median survival was 27.6 months. Chemotherapy dose reduction [P>0.001, hazard ratio (HR)=0.6, 95% confidence interval (CI) 0.4-0.8] and male sex (P=0.03, HR=0.7, 95% CI 0.5-1.0) predicted shorter TTP. Multivariate analysis indicated that metastatic disease at initial presentation and/or diabetes were associated with worse OS: the median OS for diabetes was 20 versus 28.3 months for patients without diabetes (P=0.008, HR=2, 95% CI 1.2-3.4) and 23 months for patients with metastatic disease at initial presentation versus 31.4 months for recurrent disease (P=0.008, HR=1.6, 95% CI 1.1-2.2). No differences were found for different BMIs subdivided into groups with respect to OS (P=0.84) or TTP (P=0.75). Our study did not show that bevacizumab is less effective in patients with a high BMI. It did show that diabetes and/or metastatic disease at initial diagnosis are associated with a poorer outcome.
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