Debates in allergy medicine: food intolerance does not exist

Background: The term "intolerance" is not mentioned in the World Allergy Organization (WAO) document on allergy nomenclature. "Intolerance" has been used to describe some non-immunological diseases. However, pediatric gastroenterologists mix allergy and intolerance, e.g. by using the term "cow's milk protein allergy/intolerance (CMPA/I)", lumping together all types of mechanisms for not tolerating cow's milk. The basis for this mix is the fact that double-blind oral food challenges are time-consuming and expensive. Therefore, cow's milk exclusion and reintroduction is proposed to be used in primary care for the diagnosis of CMPA in children with common gastrointestinal (GI) problems such as colic and constipation. This may lead to a widespread use of hypoallergenic formulas in children without proven CMPA. In lay language, intolerance describes "not tolerating".ObjectiveTo discuss the reasons why the term "intolerance" should not be used in the area of allergy. Results: Presently, intolerance is not part of the allergy nomenclature. It is used by lay persons to describe "not tolerating". Pediatricians use intolerance to describe non-immunological hypersensitivity such as lactose intolerance which is acceptable. However, using the mixed term CMPA/I describing a variety of gastrointestinal symptoms in children, should be avoided. The WAO Nomenclature does not clearly distinguish between non-IgE-mediated allergy and non-allergic hypersensitivity. Conclusion: The term "intolerance" should not be used within the area of allergy. Intolerance should be better defined and the term restricted to some non-immunological/non-allergic diseases and not mixed with allergy, e.g. by using the term CMPA/I. A revision of the WAO nomenclature is proposed.

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Debates in allergy medicine: food intolerance does exist

Background: Health care professionals and patients mix and mingle (hyper)sensitivity, allergy and intolerance. The consequences are discrepancies which result in confusion. The following is a very personal point of view, intended to start a debate to come to consensus.ObjectivesWe aimed to clarify the proposed terminology for the primary health care professional from the point of view of the pediatric gastroenterologist. Results: Many patients present with symptoms "related to food ingestion". We propose to use this wording if no underlying mechanism can be identified. Intolerance should be restricted to carbohydrate malabsorption causing symptoms. Allergy is restricted to IgE mediated allergy and non-IgE manifestations that can only be explained through an immune mediated mechanism, such as food induced atopic dermatitis and allergic colitis with blood in the stools. Unfortunately, primary heath care physicians have no diagnostic tools for non-IgE mediated allergy. A positive challenge test is a proof of a food-induced symptom, but does not proof that the immune system is involved. (Hyper)sensitivity suggests immune mediated mechanisms and should therefore not be used. The pathophysiologic mechanism of many food-related symptoms is unclear. The same symptom can be caused by allergy or be considered functional, such as infantile colic, gastro-esophageal reflux and constipation related to cow's milk ingestion in infants. In fact, "functional" is used if the pathophysiologic mechanism causing the symptom cannot be explained. Since the long term outcome of "allergy" differs substantially from "functional symptom", allergy should not be used inappropriate. Conclusion: "Food related symptom" should be used in each patient in which the pathophysiologic mechanism is not clear. Intolerance means a carbohydrate malabsorption that causes symptoms. Allergy should be used when the immune system is involved.

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Should ALPPS be Used for Liver Resection in Intermediate-Stage HCC?

Abstract

Background

Extended liver resections in patients with hepatocellular carcinoma (HCC) are problematic due to hepatitis, fibrosis, and cirrhosis. Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) has been promoted as a novel method to induce hypertrophy for patients with extensive colorectal liver metastases, but outcomes in HCC have not been well investigated.

Methods

All patients registered in the international ALPPS Registry (www.alpps.org) from 2010 to 2015 were studied. Hypertrophy of the future liver remnant, perioperative morbidity and mortality, age, overall survival, and other parameters were compared between patients with HCC and patients with colorectal liver metastases (CRLM).

Results

The study compared 35 patients with HCC and 225 patients with CRLM. The majority of patients undergoing ALPPS for HCC fall into the intermediate-stage category of the Barcelona clinic algorithm. In this study, hypertrophy was rapid and extensive for the HCC patients, albeit lower than for the CRLM patients (47 vs. 76 %; p < 0.002). Hypertrophy showed a linear negative correlation with the degrees of fibrosis. The 90-day mortality for ALPPS used to treat HCC was almost fivefold higher than for CRLM (31 vs. 7 %; p < 0.001). Multivariate analysis showed that patients older than 61 years had a significantly reduced overall survival (p < 0.004).

Conclusion

The ALPPS approach induces a considerable hypertrophic response in HCC patients and allows resection of intermediate-stage HCC, albeit at the cost of a 31 % perioperative mortality rate. The use of ALPPS for HCC remains prohibitive for most patients and should be performed only for a highly selected patient population younger than 60 years with low-grade fibrosis.

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TruSight Cancer Sequencing Panel reveals pharmacogenetic variants associated with sensitivity to chemotherapy in lung cancer

Abstract

Lung cancer is the most common cause of cancer death worldwide, and its prognosis and treatment response rate as well as the survival rate remain poor. In our study, we performed next generation sequencing (NGS) with cancer panel (Illumina) for 19 Bulgarian patients with both non-small cell lung cancer (NSCLC; 18 patients) and neuroendocrine tumor (1 patient) and focused on common polymorphisms which define proven or reported sensitivity to platinum-based therapy. We report reference SNP (rs)1042522 (TP53), rs2228001 (XPC), rs2227983 (EGFR), rs1799793, and rs13181 (ERCC2) single nucleotide polymorphism variants which have been detected in our patients in homozygous and/or heterozygous state. Therefore, we give important information to confirm the role of those polymorphisms in tumor resistance and recurrence after chemotherapy treatment. The results reveal that TruSight Cancer Panel could be a useful clinical tool for determining pharmacogenetic variants associated with the effect of chemotherapy.

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Glycation Contributes to Interaction Between Human Bone Alkaline Phosphatase and Collagen Type I

Abstract

Bone is a biological composite material comprised primarily of collagen type I and mineral crystals of calcium and phosphate in the form of hydroxyapatite (HA), which together provide its mechanical properties. Bone alkaline phosphatase (ALP), produced by osteoblasts, plays a pivotal role in the mineralization process. Affinity contacts between collagen, mainly type II, and the crown domain of various ALP isozymes were reported in a few in vitro studies in the 1980s and 1990s, but have not attracted much attention since, although such interactions may have important implications for the bone mineralization process. The objective of this study was to investigate the binding properties of human collagen type I to human bone ALP, including the two bone ALP isoforms B1 and B2. ALP from human liver, human placenta and E. coli were also studied. A surface plasmon resonance-based analysis, supported by electrophoresis and blotting, showed that bone ALP binds stronger to collagen type I in comparison with ALPs expressed in non-mineralizing tissues. Further, the B2 isoform binds significantly stronger to collagen type I in comparison with the B1 isoform. Human bone and liver ALP (with identical amino acid composition) displayed pronounced differences in binding, revealing that post-translational glycosylation properties govern these interactions to a large extent. In conclusion, this study presents the first evidence that glycosylation differences in human ALPs are of crucial importance for protein–protein interactions with collagen type I, although the presence of the ALP crown domain may also be necessary. Different binding affinities among the bone ALP isoforms may influence the mineral-collagen interface, mineralization kinetics, and degree of bone matrix mineralization, which are important factors determining the material properties of bone.

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Higher Level of Dickkopf-1 is Associated with Low Bone Mineral Density and Higher Prevalence of Vertebral Fractures in Patients with Ankylosing Spondylitis

Abstract

Patients with ankylosing spondylitis (AS) have an increased risk of bone loss and vertebral fractures. In this study, we explored the hypothesis that the excess bone loss and vertebral fractures might be related with the activity of the Wingless signaling pathway, and in particular with the serum levels of its circulating inhibitors, Sclerostin and Dickkopf-1 (DKK1). We recruited 71 patients diagnosed with AS. Lateral radiographs of the total spine were analyzed to detect the presence of vertebral fractures, and bone mineral density (BMD) was assessed in all patients using dual X-ray absorptiometry at lumbar spine and proximal femoral site. Blood samples were obtained and levels of C-reactive protein (CRP), DKK1, and Sclerostin were measured. Blood samples from 71 healthy sex- and age-matched volunteers were collected to be used as controls. Vertebral fractures were detected more commonly among men than in women (29 vs 8 %, respectively). DKK1, but not Sclerostin serum levels, were inversely correlated to lumbar spine Z-score BMD. Patients with one or more prevalent vertebral fractures had significantly higher DKK1 levels, without significant difference in Sclerostin serum levels. A significant positive correlation was found between DKK1 serum levels and CRP (r = 0.240, p = 0.043). The association we found between serum DKK1 levels and BMD values and vertebral fracture prevalence suggests that DKK1 might contribute to the severity of osteoporosis in AS.

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Hepatitis C Status and Infectious Complications in the Surgical Intensive Care Unit: a Retrospective Analysis of 1,941 Consecutive Patients

Hepatitis C Virus (HCV) infection is thought to be associated with immune dysfunction. We hypothesized that HCV status would be associated with increased infectious complications in the SICU.

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The Number of Inpatient Consultations is Negatively Correlated with Patient Satisfaction in Patients with Prolonged Hospital Stays

In long stay patients, having fewer inpatient consultations was the strongest predictor of patient satisfaction with physician communication. Examination of patient- level data in clinically relevant subgroups may be a useful way to identify targets for quality improvement.

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An in vivo model for postinflammatory hyperpigmentation: an analysis of histological, spectroscopic, colorimetric and clinical traits

Summary

Background

Acne vulgaris is a common condition that occurs in all skin types. Postinflammatory hyperpigmentation (PIH) is often associated with acne in patients of darker skin types, making it a common complaint in dermatology offices. Despite this, there is limited understanding of and effective treatment options for PIH.

Objectives

The study objective was to validate an in vivo model for PIH and to compare the clinical, histological and spectroscopic characteristics of artificially induced PIH and acne-induced PIH.

Methods

A nonblinded, nonrandomized pilot study was performed. Thirty subjects served as their own control in which four sites treated with 35% trichloroacetic acid (TCA) solution and four truncal acne pustules were followed for 8 weeks and were evaluated clinically and histologically, and by colorimetry and spectroscopy.

Results

The initial phases of inflammation between TCA- and acne-induced PIH differ. However, clinical evaluations were similar on and after day 14. Acne- and TCA-induced lesions were clinically, histologically and spectroscopically indistinguishable at day 28.

Conclusions

Clinical, spectroscopic and histological similarities of acne-induced and TCA-induced PIH at day 28 suggest that TCA-induced PIH can be a reproducible model for the study of acne-induced PIH.

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Asthma education material for children and their families; a global survey of current resources

One of the keys to high quality paediatric asthma management is the provision of age appropriate information regarding the disease and its management. In order to determine whether the generation of a minimum dataset of information which can be translated into a wide range of languages might be used to assist children and their parents around the world, we undertook a survey of national Member Societies of the World Allergy Organization (WAO) to determine what educational material on asthma for children and their families already exists.A questionnaire was developed using Survey Monkey and distributed in 2014 to 263 representatives of the WAO member Societies from 95 countries.Thirty-three replies were received from thirty-one countries. The survey highlighted a considerable disparity in availability of material among the responding countries, with some countries reporting that information was freely available in hard copy and online and others reporting a lack of suitable material locally.The results highlight the need to develop a core set of simple, clear and consistent age appropriate information that can be easily translated and delivered in a cultural and educationally effective format.

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Debates in allergy medicine: food intolerance does not exist

Background: The term "intolerance" is not mentioned in the World Allergy Organization (WAO) document on allergy nomenclature. "Intolerance" has been used to describe some non-immunological diseases. However, pediatric gastroenterologists mix allergy and intolerance, e.g. by using the term "cow's milk protein allergy/intolerance (CMPA/I)", lumping together all types of mechanisms for not tolerating cow's milk. The basis for this mix is the fact that double-blind oral food challenges are time-consuming and expensive. Therefore, cow's milk exclusion and reintroduction is proposed to be used in primary care for the diagnosis of CMPA in children with common gastrointestinal (GI) problems such as colic and constipation. This may lead to a widespread use of hypoallergenic formulas in children without proven CMPA. In lay language, intolerance describes "not tolerating".ObjectiveTo discuss the reasons why the term "intolerance" should not be used in the area of allergy. Results: Presently, intolerance is not part of the allergy nomenclature. It is used by lay persons to describe "not tolerating". Pediatricians use intolerance to describe non-immunological hypersensitivity such as lactose intolerance which is acceptable. However, using the mixed term CMPA/I describing a variety of gastrointestinal symptoms in children, should be avoided. The WAO Nomenclature does not clearly distinguish between non-IgE-mediated allergy and non-allergic hypersensitivity. Conclusion: The term "intolerance" should not be used within the area of allergy. Intolerance should be better defined and the term restricted to some non-immunological/non-allergic diseases and not mixed with allergy, e.g. by using the term CMPA/I. A revision of the WAO nomenclature is proposed.

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Debates in allergy medicine: food intolerance does exist

Background: Health care professionals and patients mix and mingle (hyper)sensitivity, allergy and intolerance. The consequences are discrepancies which result in confusion. The following is a very personal point of view, intended to start a debate to come to consensus.ObjectivesWe aimed to clarify the proposed terminology for the primary health care professional from the point of view of the pediatric gastroenterologist. Results: Many patients present with symptoms "related to food ingestion". We propose to use this wording if no underlying mechanism can be identified. Intolerance should be restricted to carbohydrate malabsorption causing symptoms. Allergy is restricted to IgE mediated allergy and non-IgE manifestations that can only be explained through an immune mediated mechanism, such as food induced atopic dermatitis and allergic colitis with blood in the stools. Unfortunately, primary heath care physicians have no diagnostic tools for non-IgE mediated allergy. A positive challenge test is a proof of a food-induced symptom, but does not proof that the immune system is involved. (Hyper)sensitivity suggests immune mediated mechanisms and should therefore not be used. The pathophysiologic mechanism of many food-related symptoms is unclear. The same symptom can be caused by allergy or be considered functional, such as infantile colic, gastro-esophageal reflux and constipation related to cow's milk ingestion in infants. In fact, "functional" is used if the pathophysiologic mechanism causing the symptom cannot be explained. Since the long term outcome of "allergy" differs substantially from "functional symptom", allergy should not be used inappropriate. Conclusion: "Food related symptom" should be used in each patient in which the pathophysiologic mechanism is not clear. Intolerance means a carbohydrate malabsorption that causes symptoms. Allergy should be used when the immune system is involved.

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Should ALPPS be Used for Liver Resection in Intermediate-Stage HCC?

Abstract

Background

Extended liver resections in patients with hepatocellular carcinoma (HCC) are problematic due to hepatitis, fibrosis, and cirrhosis. Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) has been promoted as a novel method to induce hypertrophy for patients with extensive colorectal liver metastases, but outcomes in HCC have not been well investigated.

Methods

All patients registered in the international ALPPS Registry (www.alpps.org) from 2010 to 2015 were studied. Hypertrophy of the future liver remnant, perioperative morbidity and mortality, age, overall survival, and other parameters were compared between patients with HCC and patients with colorectal liver metastases (CRLM).

Results

The study compared 35 patients with HCC and 225 patients with CRLM. The majority of patients undergoing ALPPS for HCC fall into the intermediate-stage category of the Barcelona clinic algorithm. In this study, hypertrophy was rapid and extensive for the HCC patients, albeit lower than for the CRLM patients (47 vs. 76 %; p < 0.002). Hypertrophy showed a linear negative correlation with the degrees of fibrosis. The 90-day mortality for ALPPS used to treat HCC was almost fivefold higher than for CRLM (31 vs. 7 %; p < 0.001). Multivariate analysis showed that patients older than 61 years had a significantly reduced overall survival (p < 0.004).

Conclusion

The ALPPS approach induces a considerable hypertrophic response in HCC patients and allows resection of intermediate-stage HCC, albeit at the cost of a 31 % perioperative mortality rate. The use of ALPPS for HCC remains prohibitive for most patients and should be performed only for a highly selected patient population younger than 60 years with low-grade fibrosis.

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Decreased level of osteopontin in children with allergic rhinitis during sublingual immunotherapy

Sublingual immunotherapy (SLIT) is proven to be very effective in the treatment of allergic rhinitis (AR), but its regulatory mechanism and biomarkers for predicting efficacy are still unknown. Osteopontin (OPN), as a recently described Th2 inflammation related protein, plays key role in the pathogenesis of AR. The aim of this study was to identify the expression and role of OPN during SLIT in children.

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Hepatitis C Status and Infectious Complications in the Surgical Intensive Care Unit: a Retrospective Analysis of 1,941 Consecutive Patients

Hepatitis C Virus (HCV) infection is thought to be associated with immune dysfunction. We hypothesized that HCV status would be associated with increased infectious complications in the SICU.

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Development and validation of a checklist for assessing recorded performance of laparoscopic inguinal hernia repair

Despite a need for video assessment for the performance transabdominal preperitoneal procedure (TAPP), the present assessment tools have not been validated for the use of evaluation of the recorded performance. We aimed to develop a checklist for the evaluation of the recorded performance of TAPP.

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The Number of Inpatient Consultations is Negatively Correlated with Patient Satisfaction in Patients with Prolonged Hospital Stays

In long stay patients, having fewer inpatient consultations was the strongest predictor of patient satisfaction with physician communication. Examination of patient- level data in clinically relevant subgroups may be a useful way to identify targets for quality improvement.

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Peri-operative outcomes of elective inflow revascularization for lower extremity claudication in the ACS-NSQIP database

We compared the early post-operative morbidity and mortality rates of contemporary aortofemoral bypass (AFB) and other inflow procedures for claudication.

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Asthma education material for children and their families; a global survey of current resources

One of the keys to high quality paediatric asthma management is the provision of age appropriate information regarding the disease and its management. In order to determine whether the generation of a minimum dataset of information which can be translated into a wide range of languages might be used to assist children and their parents around the world, we undertook a survey of national Member Societies of the World Allergy Organization (WAO) to determine what educational material on asthma for children and their families already exists.A questionnaire was developed using Survey Monkey and distributed in 2014 to 263 representatives of the WAO member Societies from 95 countries.Thirty-three replies were received from thirty-one countries. The survey highlighted a considerable disparity in availability of material among the responding countries, with some countries reporting that information was freely available in hard copy and online and others reporting a lack of suitable material locally.The results highlight the need to develop a core set of simple, clear and consistent age appropriate information that can be easily translated and delivered in a cultural and educationally effective format.

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Debates in allergy medicine: food intolerance does not exist

Background: The term "intolerance" is not mentioned in the World Allergy Organization (WAO) document on allergy nomenclature. "Intolerance" has been used to describe some non-immunological diseases. However, pediatric gastroenterologists mix allergy and intolerance, e.g. by using the term "cow's milk protein allergy/intolerance (CMPA/I)", lumping together all types of mechanisms for not tolerating cow's milk. The basis for this mix is the fact that double-blind oral food challenges are time-consuming and expensive. Therefore, cow's milk exclusion and reintroduction is proposed to be used in primary care for the diagnosis of CMPA in children with common gastrointestinal (GI) problems such as colic and constipation. This may lead to a widespread use of hypoallergenic formulas in children without proven CMPA. In lay language, intolerance describes "not tolerating".ObjectiveTo discuss the reasons why the term "intolerance" should not be used in the area of allergy. Results: Presently, intolerance is not part of the allergy nomenclature. It is used by lay persons to describe "not tolerating". Pediatricians use intolerance to describe non-immunological hypersensitivity such as lactose intolerance which is acceptable. However, using the mixed term CMPA/I describing a variety of gastrointestinal symptoms in children, should be avoided. The WAO Nomenclature does not clearly distinguish between non-IgE-mediated allergy and non-allergic hypersensitivity. Conclusion: The term "intolerance" should not be used within the area of allergy. Intolerance should be better defined and the term restricted to some non-immunological/non-allergic diseases and not mixed with allergy, e.g. by using the term CMPA/I. A revision of the WAO nomenclature is proposed.

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Table of Contents

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Debates in allergy medicine: food intolerance does exist

Background: Health care professionals and patients mix and mingle (hyper)sensitivity, allergy and intolerance. The consequences are discrepancies which result in confusion. The following is a very personal point of view, intended to start a debate to come to consensus.ObjectivesWe aimed to clarify the proposed terminology for the primary health care professional from the point of view of the pediatric gastroenterologist. Results: Many patients present with symptoms "related to food ingestion". We propose to use this wording if no underlying mechanism can be identified. Intolerance should be restricted to carbohydrate malabsorption causing symptoms. Allergy is restricted to IgE mediated allergy and non-IgE manifestations that can only be explained through an immune mediated mechanism, such as food induced atopic dermatitis and allergic colitis with blood in the stools. Unfortunately, primary heath care physicians have no diagnostic tools for non-IgE mediated allergy. A positive challenge test is a proof of a food-induced symptom, but does not proof that the immune system is involved. (Hyper)sensitivity suggests immune mediated mechanisms and should therefore not be used. The pathophysiologic mechanism of many food-related symptoms is unclear. The same symptom can be caused by allergy or be considered functional, such as infantile colic, gastro-esophageal reflux and constipation related to cow's milk ingestion in infants. In fact, "functional" is used if the pathophysiologic mechanism causing the symptom cannot be explained. Since the long term outcome of "allergy" differs substantially from "functional symptom", allergy should not be used inappropriate. Conclusion: "Food related symptom" should be used in each patient in which the pathophysiologic mechanism is not clear. Intolerance means a carbohydrate malabsorption that causes symptoms. Allergy should be used when the immune system is involved.

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Polyploidy Formation in Doxorubicin-Treated Cancer Cells Can Favor Escape from Senescence

Cancer cells can undergo stress-induced premature senescence, which is considered to be a desirable outcome of anticancer treatment. However, the escape from senescence and cancer cell repopulation give rise to some doubts concerning the effectiveness of the senescence-induced anticancer therapy. Similarly, it is postulated that polyploidization of cancer cells is connected with disease relapse. We postulate that cancer cell polyploidization associated with senescence is the culprit of atypical cell divisions leading to cancer cell regrowth.

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Combining Optical Reporter Proteins with Different Half-lives to Detect Temporal Evolution of Hypoxia and Reoxygenation in Tumors

Here we have developed a hypoxia response element driven imaging strategy that combined the hypoxia-driven expression of two optical reporters with different half-lives to detect temporal changes in hypoxia and hypoxia inducible factor (HIF) activity. For this purpose, human prostate cancer PC3 cells were transfected with the luciferase gene fused with an oxygen-dependent degradation domain (ODD-luc) and a variant of the enhanced green fluorescent protein (EGFP). Both ODD-luciferase and EGFP were under the promotion of a poly-hypoxia-response element sequence (5xHRE).

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Autofluorescence Imaging of Tumor Heterogeneity in Response to Treatment

Subpopulations of cells that escape anti-cancer treatment can cause relapse in cancer patients. Therefore, measurements of cellular-level tumor heterogeneity could enable improved anti-cancer treatment regimens. Cancer exhibits altered cellular metabolism, which affects the autofluorescence of metabolic cofactors NAD(P)H and FAD. The optical redox ratio (fluorescence intensity of NAD(P)H divided by FAD) reflects global cellular metabolism. The fluorescence lifetime (amount of time a fluorophore is in the excited state) is sensitive to microenvironment, particularly protein-binding.

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Breast Cancer Cell Colonization of the Human Bone Marrow Adipose Tissue Niche

BACKGROUND/OBJECTIVES: Bone is a preferred site of breast cancer metastasis, suggesting the presence of tissue-specific features that attract and promote the outgrowth of breast cancer cells. We sought to identify parameters of human bone tissue associated with breast cancer cell osteotropism and colonization in the metastatic niche. METHODS: Migration and colonization patterns of MDA-MB-231-fLuc-EGFP (luciferase-enhanced green fluorescence protein) and MCF-7-fLuc-EGFP breast cancer cells were studied in co-culture with cancellous bone tissue fragments isolated from 14 hip arthroplasties.

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Asthma education material for children and their families; a global survey of current resources

One of the keys to high quality paediatric asthma management is the provision of age appropriate information regarding the disease and its management. In order to determine whether the generation of a minimum dataset of information which can be translated into a wide range of languages might be used to assist children and their parents around the world, we undertook a survey of national Member Societies of the World Allergy Organization (WAO) to determine what educational material on asthma for children and their families already exists.A questionnaire was developed using Survey Monkey and distributed in 2014 to 263 representatives of the WAO member Societies from 95 countries.Thirty-three replies were received from thirty-one countries. The survey highlighted a considerable disparity in availability of material among the responding countries, with some countries reporting that information was freely available in hard copy and online and others reporting a lack of suitable material locally.The results highlight the need to develop a core set of simple, clear and consistent age appropriate information that can be easily translated and delivered in a cultural and educationally effective format.

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Debates in allergy medicine: food intolerance does not exist

Background: The term "intolerance" is not mentioned in the World Allergy Organization (WAO) document on allergy nomenclature. "Intolerance" has been used to describe some non-immunological diseases. However, pediatric gastroenterologists mix allergy and intolerance, e.g. by using the term "cow's milk protein allergy/intolerance (CMPA/I)", lumping together all types of mechanisms for not tolerating cow's milk. The basis for this mix is the fact that double-blind oral food challenges are time-consuming and expensive. Therefore, cow's milk exclusion and reintroduction is proposed to be used in primary care for the diagnosis of CMPA in children with common gastrointestinal (GI) problems such as colic and constipation. This may lead to a widespread use of hypoallergenic formulas in children without proven CMPA. In lay language, intolerance describes "not tolerating".ObjectiveTo discuss the reasons why the term "intolerance" should not be used in the area of allergy. Results: Presently, intolerance is not part of the allergy nomenclature. It is used by lay persons to describe "not tolerating". Pediatricians use intolerance to describe non-immunological hypersensitivity such as lactose intolerance which is acceptable. However, using the mixed term CMPA/I describing a variety of gastrointestinal symptoms in children, should be avoided. The WAO Nomenclature does not clearly distinguish between non-IgE-mediated allergy and non-allergic hypersensitivity. Conclusion: The term "intolerance" should not be used within the area of allergy. Intolerance should be better defined and the term restricted to some non-immunological/non-allergic diseases and not mixed with allergy, e.g. by using the term CMPA/I. A revision of the WAO nomenclature is proposed.

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Debates in allergy medicine: food intolerance does exist

Background: Health care professionals and patients mix and mingle (hyper)sensitivity, allergy and intolerance. The consequences are discrepancies which result in confusion. The following is a very personal point of view, intended to start a debate to come to consensus.ObjectivesWe aimed to clarify the proposed terminology for the primary health care professional from the point of view of the pediatric gastroenterologist. Results: Many patients present with symptoms "related to food ingestion". We propose to use this wording if no underlying mechanism can be identified. Intolerance should be restricted to carbohydrate malabsorption causing symptoms. Allergy is restricted to IgE mediated allergy and non-IgE manifestations that can only be explained through an immune mediated mechanism, such as food induced atopic dermatitis and allergic colitis with blood in the stools. Unfortunately, primary heath care physicians have no diagnostic tools for non-IgE mediated allergy. A positive challenge test is a proof of a food-induced symptom, but does not proof that the immune system is involved. (Hyper)sensitivity suggests immune mediated mechanisms and should therefore not be used. The pathophysiologic mechanism of many food-related symptoms is unclear. The same symptom can be caused by allergy or be considered functional, such as infantile colic, gastro-esophageal reflux and constipation related to cow's milk ingestion in infants. In fact, "functional" is used if the pathophysiologic mechanism causing the symptom cannot be explained. Since the long term outcome of "allergy" differs substantially from "functional symptom", allergy should not be used inappropriate. Conclusion: "Food related symptom" should be used in each patient in which the pathophysiologic mechanism is not clear. Intolerance means a carbohydrate malabsorption that causes symptoms. Allergy should be used when the immune system is involved.

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Asthma education material for children and their families; a global survey of current resources

One of the keys to high quality paediatric asthma management is the provision of age appropriate information regarding the disease and its management. In order to determine whether the generation of a minimum dataset of information which can be translated into a wide range of languages might be used to assist children and their parents around the world, we undertook a survey of national Member Societies of the World Allergy Organization (WAO) to determine what educational material on asthma for children and their families already exists.A questionnaire was developed using Survey Monkey and distributed in 2014 to 263 representatives of the WAO member Societies from 95 countries.Thirty-three replies were received from thirty-one countries. The survey highlighted a considerable disparity in availability of material among the responding countries, with some countries reporting that information was freely available in hard copy and online and others reporting a lack of suitable material locally.The results highlight the need to develop a core set of simple, clear and consistent age appropriate information that can be easily translated and delivered in a cultural and educationally effective format.

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Debates in allergy medicine: food intolerance does not exist

Background: The term "intolerance" is not mentioned in the World Allergy Organization (WAO) document on allergy nomenclature. "Intolerance" has been used to describe some non-immunological diseases. However, pediatric gastroenterologists mix allergy and intolerance, e.g. by using the term "cow's milk protein allergy/intolerance (CMPA/I)", lumping together all types of mechanisms for not tolerating cow's milk. The basis for this mix is the fact that double-blind oral food challenges are time-consuming and expensive. Therefore, cow's milk exclusion and reintroduction is proposed to be used in primary care for the diagnosis of CMPA in children with common gastrointestinal (GI) problems such as colic and constipation. This may lead to a widespread use of hypoallergenic formulas in children without proven CMPA. In lay language, intolerance describes "not tolerating".ObjectiveTo discuss the reasons why the term "intolerance" should not be used in the area of allergy. Results: Presently, intolerance is not part of the allergy nomenclature. It is used by lay persons to describe "not tolerating". Pediatricians use intolerance to describe non-immunological hypersensitivity such as lactose intolerance which is acceptable. However, using the mixed term CMPA/I describing a variety of gastrointestinal symptoms in children, should be avoided. The WAO Nomenclature does not clearly distinguish between non-IgE-mediated allergy and non-allergic hypersensitivity. Conclusion: The term "intolerance" should not be used within the area of allergy. Intolerance should be better defined and the term restricted to some non-immunological/non-allergic diseases and not mixed with allergy, e.g. by using the term CMPA/I. A revision of the WAO nomenclature is proposed.

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Debates in allergy medicine: food intolerance does exist

Background: Health care professionals and patients mix and mingle (hyper)sensitivity, allergy and intolerance. The consequences are discrepancies which result in confusion. The following is a very personal point of view, intended to start a debate to come to consensus.ObjectivesWe aimed to clarify the proposed terminology for the primary health care professional from the point of view of the pediatric gastroenterologist. Results: Many patients present with symptoms "related to food ingestion". We propose to use this wording if no underlying mechanism can be identified. Intolerance should be restricted to carbohydrate malabsorption causing symptoms. Allergy is restricted to IgE mediated allergy and non-IgE manifestations that can only be explained through an immune mediated mechanism, such as food induced atopic dermatitis and allergic colitis with blood in the stools. Unfortunately, primary heath care physicians have no diagnostic tools for non-IgE mediated allergy. A positive challenge test is a proof of a food-induced symptom, but does not proof that the immune system is involved. (Hyper)sensitivity suggests immune mediated mechanisms and should therefore not be used. The pathophysiologic mechanism of many food-related symptoms is unclear. The same symptom can be caused by allergy or be considered functional, such as infantile colic, gastro-esophageal reflux and constipation related to cow's milk ingestion in infants. In fact, "functional" is used if the pathophysiologic mechanism causing the symptom cannot be explained. Since the long term outcome of "allergy" differs substantially from "functional symptom", allergy should not be used inappropriate. Conclusion: "Food related symptom" should be used in each patient in which the pathophysiologic mechanism is not clear. Intolerance means a carbohydrate malabsorption that causes symptoms. Allergy should be used when the immune system is involved.

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Table of Contents

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Polyploidy Formation in Doxorubicin-Treated Cancer Cells Can Favor Escape from Senescence

Cancer cells can undergo stress-induced premature senescence, which is considered to be a desirable outcome of anticancer treatment. However, the escape from senescence and cancer cell repopulation give rise to some doubts concerning the effectiveness of the senescence-induced anticancer therapy. Similarly, it is postulated that polyploidization of cancer cells is connected with disease relapse. We postulate that cancer cell polyploidization associated with senescence is the culprit of atypical cell divisions leading to cancer cell regrowth.

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Combining Optical Reporter Proteins with Different Half-lives to Detect Temporal Evolution of Hypoxia and Reoxygenation in Tumors

Here we have developed a hypoxia response element driven imaging strategy that combined the hypoxia-driven expression of two optical reporters with different half-lives to detect temporal changes in hypoxia and hypoxia inducible factor (HIF) activity. For this purpose, human prostate cancer PC3 cells were transfected with the luciferase gene fused with an oxygen-dependent degradation domain (ODD-luc) and a variant of the enhanced green fluorescent protein (EGFP). Both ODD-luciferase and EGFP were under the promotion of a poly-hypoxia-response element sequence (5xHRE).

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Autofluorescence Imaging of Tumor Heterogeneity in Response to Treatment

Subpopulations of cells that escape anti-cancer treatment can cause relapse in cancer patients. Therefore, measurements of cellular-level tumor heterogeneity could enable improved anti-cancer treatment regimens. Cancer exhibits altered cellular metabolism, which affects the autofluorescence of metabolic cofactors NAD(P)H and FAD. The optical redox ratio (fluorescence intensity of NAD(P)H divided by FAD) reflects global cellular metabolism. The fluorescence lifetime (amount of time a fluorophore is in the excited state) is sensitive to microenvironment, particularly protein-binding.

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Breast Cancer Cell Colonization of the Human Bone Marrow Adipose Tissue Niche

BACKGROUND/OBJECTIVES: Bone is a preferred site of breast cancer metastasis, suggesting the presence of tissue-specific features that attract and promote the outgrowth of breast cancer cells. We sought to identify parameters of human bone tissue associated with breast cancer cell osteotropism and colonization in the metastatic niche. METHODS: Migration and colonization patterns of MDA-MB-231-fLuc-EGFP (luciferase-enhanced green fluorescence protein) and MCF-7-fLuc-EGFP breast cancer cells were studied in co-culture with cancellous bone tissue fragments isolated from 14 hip arthroplasties.

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Asthma education material for children and their families; a global survey of current resources

One of the keys to high quality paediatric asthma management is the provision of age appropriate information regarding the disease and its management. In order to determine whether the generation of a minimum dataset of information which can be translated into a wide range of languages might be used to assist children and their parents around the world, we undertook a survey of national Member Societies of the World Allergy Organization (WAO) to determine what educational material on asthma for children and their families already exists.A questionnaire was developed using Survey Monkey and distributed in 2014 to 263 representatives of the WAO member Societies from 95 countries.Thirty-three replies were received from thirty-one countries. The survey highlighted a considerable disparity in availability of material among the responding countries, with some countries reporting that information was freely available in hard copy and online and others reporting a lack of suitable material locally.The results highlight the need to develop a core set of simple, clear and consistent age appropriate information that can be easily translated and delivered in a cultural and educationally effective format.

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Outcome of orthodontic mini-implant loss in relation to interleukin 6 polymorphisms

Mini-implants (MIs) are used increasingly for orthodontic anchorage and their success may require some osseointegration, which is affected by the underlying host immune-inflammatory response. Interleukin 6 (IL-6) is a cytokine expressed during the host response after a trauma or infection. The aim of this study was to investigate the association of clinical characteristics and IL6 tag single nucleotide polymorphisms (which capture the information of the whole gene in terms of genetic variability) with the loss of MIs for orthodontic anchorage.

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Flat detector C-arm CT-guided transthoracic needle biopsy of small (≤2.0 cm) pulmonary nodules: diagnostic accuracy and complication in 100 patients

Abstract

Purpose

This study aimed at assessing the usefulness of flat detector cone-beam CT virtual navigation-guided transthoracic needle biopsy of small (≤2.0 cm) pulmonary nodules in terms of diagnostic accuracy and complications to evaluate the diagnostic performance and complications of small pulmonary nodules under cone-beam CT (CBCT) guidance.

Materials and methods

A total of 100 patients with 100 solid lung nodules were retrospectively enrolled to undergo transthoracic needle biopsy (TNB) procedures. The mean diameter of lesions was 1.25 cm ± 0.39 (range 0.50–2.00 cm). The needle path was carefully planned and calculated on the CBCT virtual navigation guidance system, which acquired 3D CT-like cross-sectional images. Diagnostic performance, complication rate, and patient radiation exposure were investigated.

Results

The technical success rate of TNB under iGuide CBCT virtual navigation system was 99 % (99/100). The sensitivity, specificity, and accuracy of TNB of small nodules under iGuide CBCT virtual navigation guidance were 98.7 % (77/78), 90.5 % (19/21), and 97.0 % (96/99), respectively. The number of pleural passages with coaxial needle, biopsies, and CBCT acquisitions were 1.09 ± 0.32, 1.20 ± 0.47, and 3.06 ± 1.35, respectively. Complications occurred in 22 (22 %) cases. The mean total procedure time was 12.84 min ± 3.74, resulting in a mean exposure dose of 7.6 mSv ±3.1.

Conclusions

Flat detector Cone-beam CT-guided TNB is a highly accurate and safe diagnostic method for small (≤2.0 cm) lung nodule.

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Long-term prognosis of tooth autotransplantation: a systematic review and meta-analysis

The aim of this study was to systematically review the prognosis of autotransplanted teeth followed up for a period of 6 years or more. A literature search was conducted in five databases and the eligibility criteria were established. The outcomes evaluated were the survival rate, percentage of abnormal mobility, pulpal conditions, and percentage of root resorption. The searches identified 1848 articles, and after evaluation against the eligibility criteria, six were included. Data related to outcome measures were extracted from the studies and a meta-analysis was performed.

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Opening doors to compensation for nuclear workers – The Bellingham Herald

The Bellingham Herald

Opening doors to compensation for nuclear workers The Bellingham Herald They include bone and renal cancer, some leukemias, lung cancer, multiple myeloma, some lymphomas, and primary cancers of the bile ducts, brain, breast, colon, esophagus, gallbladder, liver, ovary, pancreas, pharynx, salivary gland, small intestine, …

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Menstrual cycle phase at the time of rape does not affect recovery of semen or amplification of STR profiles of a suspect in vaginal swabs

Abbreviated title: Effect of menses in forensic investigation of rapes

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Menstrual cycle phase at the time of rape does not affect recovery of semen or amplification of STR profiles of a suspect in vaginal swabs

Abbreviated title: Effect of menses in forensic investigation of rapes

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Cancer burden in Vietnam: P2 – The culprits – Tuoitrenews (press release)

Tuoitrenews (press release)

Cancer burden in Vietnam: P2 – The culprits Tuoitrenews (press release) Photo: Tuoi Tre. Meanwhile, liver and stomach cancer account for 80 percent of infection-related cancers among males. Several other types of cancer, including anal, penile, vaginal, vulvar, tongue and throat cancer, are also found to have links with …

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Protocol for Three-dimensional Confocal Morphometric Analysis of Astrocytes

Astrocytes in the CNS change their functional and structural properties in response to harmful stimuli. This report presents a protocol for assessment of three-dimensional astrocyte morphology in diseased conditions or after therapeutic interventions.

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Long-term prognosis of tooth autotransplantation: a systematic review and meta-analysis

The aim of this study was to systematically review the prognosis of autotransplanted teeth followed up for a period of 6 years or more. A literature search was conducted in five databases and the eligibility criteria were established. The outcomes evaluated were the survival rate, percentage of abnormal mobility, pulpal conditions, and percentage of root resorption. The searches identified 1848 articles, and after evaluation against the eligibility criteria, six were included. Data related to outcome measures were extracted from the studies and a meta-analysis was performed.

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Menstrual cycle phase at the time of rape does not affect recovery of semen or amplification of STR profiles of a suspect in vaginal swabs

Abbreviated title: Effect of menses in forensic investigation of rapes

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Opening doors to compensation for nuclear workers – The Bellingham Herald

The Bellingham Herald

Opening doors to compensation for nuclear workers The Bellingham Herald They include bone and renal cancer, some leukemias, lung cancer, multiple myeloma, some lymphomas, and primary cancers of the bile ducts, brain, breast, colon, esophagus, gallbladder, liver, ovary, pancreas, pharynx, salivary gland, small intestine, …

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In Memoriam: Jean Maleville, 1927–2015

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