Head and Neck Diseases by Alexandros G.Sfakianakis: 02/26/17

Κυριακή 26 Φεβρουαρίου 2017

Secondary cutaneous peripheral T-cell lymphoma, unspecified, with generalized benign-looking dermatitis: a possibly distinct peripheral T-cell lymphoma

Abstract

Background

Cutaneous lymphomas are a heterogeneous group of tumors with various clinical manifestations, histological features, and prognoses.

Methods

Among 425 cases of cutaneous lymphoma, we describe eight cases of peripheral T-cell lymphoma, unspecified, presenting with generalized benign-looking dermatitis.

Results

Our case series included eight cases of secondary cutaneous peripheral T-cell lymphoma, unspecified. The observed clinical morphology features included drug eruption-like generalized morbilliform maculopatches in two cases, generalized folliculitis-like papules in two cases, and generalized eczematous dermatitis-like papules and patches in four cases. Histopathological examination demonstrated tumor cell infiltrates of mainly atypical, small-to-medium lymphoid cells that were perivascularly or periadnexally distributed throughout the dermis. Immunohistochemical staining results for CD2, CD3, CD4, and CD8 revealed that the tumor cells were T-cells.

Conclusion

This collection of cases and literature review emphasizes the need for clinical suspicion of peripheral T-cell lymphoma, unspecified, in the differential diagnosis of adult patients with refractory eczematous or benign-looking skin lesions.

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Tacrolimus 0.1% ointment applied under occlusion using cling film clears chronic actinic dermatitis resistant to systemic treatment

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Silk textile with antimicrobial AEM5772/5 (Dermasilk): a pilot study with positive influence on acne vulgaris on the back

Abstract

Background

The use of special silk textiles (Dermasilk) has shown positive effects on chronic inflammatory diseases like lichen sclerosus et atrophicus, atopic dermatitis, diabetic ulcerations, and vulvovaginal candidiasis.

Objective

Wearing T-shirts of this particular fabric could be useful in the management of patients with acne vulgaris on the back and trunk.

Material and Methods

Dermasilk T-shirts were given to 14 patients with acne vulgaris papulopustulosa on the back. The patients wore these shirts every night for 6 weeks, and their acne lesions were monitored. Dermasilk represents a polymerisate of fibroin, a silk protein, and antimicrobial AEM5772/5, an unsoluble colorless, odorless ammonium with antifungal and antibacterial ability.

Results

Photographic documentation before and after 6 weeks showed a clinically significant reduction in acne lesions on the back without any concomitant treatment or change in lifestyle and living conditions.

Discussion

The use of Dermasilk textiles in other subacute-chronic inflammatory skin diseases has shown positive effects. This is the first report on their safe and effective use in the management of acne vulgaris papulopustulosa corporis.

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Actinic prurigo as a hypersensitivity reaction type 4

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Melasma: systematic review of the systemic treatments

Abstract

Currently available treatment options for melasma include prevention of UV radiation, topical lightening agents, chemical peels, and light-based and laser therapies. However, none have shown effective and sustained results, with incomplete clearance and frequent recurrences. There has been increasing interest recently in oral medications and dietary supplements in improving melasma. We sought to evaluate the efficacy and safety/tolerability of oral medications and dietary supplements for the treatment of melasma. Multiple databases were systematically searched for randomized clinical trials (RCTs) evaluating the use of oral medication for treatment of melasma alone or in combination with other treatments. A total of eight RCTs met inclusion criteria. Oral medications and dietary supplements evaluated include tranexamic acid, Polypodium leucotomos extract, beta-carotenoid, melatonin, and procyanidin. These agents appear to have a beneficial effect on melasma improvement. In conclusion, oral medications have a role in melasma treatment and have been shown to be efficacious and tolerable with a minimal number and severity of adverse events. Therefore, dermatologists should keep oral medications and dietary supplements in their armamentarium for the treatment of melasma.

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Treatment of pyoderma gangrenosum, acne, suppurative hidradenitis (PASH) with weight-based anakinra dosing in a Hepatitis B carrier

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Pilot study on HPV-related cancer awareness and HPV vaccination in Ukrainian students

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Are genital ulcers always sexually transmitted? First report of scrotal ulcer caused by Serratia marcescens infection

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Epidemiology of rosacea in Colombia

Abstract

Background

Prevalence of rosacea has been estimated around the world in the range of 0–22%. In Colombia, the prevalence of rosacea remains unknown. The aim of this study was to determine the prevalence of rosacea and the frequencies of its subtypes in Colombia.

Methods

This cross-sectional, multicenter study was conducted in six outpatient dermatology clinics across Colombia. A total of 33 dermatologists conducted a comprehensive medical history and physical examination for all rosacea patients seen at their offices over the course of 2 months. All patients who accepted to participate were encouraged to answer a survey about the history of their illness.

Results

Of 10,204 outpatients evaluated for rosacea between July and August 2014, 291 rosacea patients were included in this study. The prevalence of rosacea subtypes in this cohort was: 45.3% erythematotelangiectatic (ETR) (n = 132), 48.7% papulopustular (PPR) (n = 142), 4.8% phymatous (n = 14), and 1% ocular (n = 3).

Conclusions

Overall, the prevalence in Colombia was 2.85%. Our data represent an important first step to understanding the current state of rosacea in Colombia. The prevalence of rosacea in Colombia is the highest in Latin America among a few reports published, which might be explained by geographic features. However, contrary to our expectations, the prevalence is lower than that in some European countries. We postulate that this finding may be due to methodological differences.

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Spectrum and clinical variants of giant cell elastolytic granuloma

Abstract

Background

Giant cell elastolytic granuloma, also known as annular elastolytic giant cell granuloma or actinic granuloma, is histologically characterized by elastophagocytosis. Recent studies have revealed various clinical presentations in both sun-exposed and non-sun-exposed areas.

Objectives

To clarify clinical characteristics based on case series observation.

Methods

We retrospectively reviewed patients who fulfilled the pathological diagnosis criteria for giant cell elastolytic granuloma seen at Mackay Memorial Hospital from 2000 to 2014. Patient characteristics, clinical presentation, duration, associated diseases, treatment, and prognosis were analyzed.

Results

A total of 22 patients were analyzed and categorized into three major variants. Eight patients with the "annular form" showed large annular lesions, which were usually associated with sun exposure. Six patients with the "papular form" presented with small papules. Eight patients in the "mixed form" group exhibited both papules and smaller annular plaques. The papular form had the youngest age of onset and shortest disease duration. The known consequences in 19 patients were resolved in seven, improved in three, recurred in four, and persisted in five patients.

Conclusions

The term "giant cell elastolytic granuloma" is more appropriate because these were not completely related to actinic changes and may be nonannular. The papular form is not easily recognizable without a biopsy.

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Herpes compuctorum: a cutaneous infection related to permanent tattoo

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Management of digital mucous cysts: a systematic review and treatment algorithm

Abstract

Digital mucous cysts (DMC) are benign, highly recurrent lesions of the digits. To date, there is still no treatment agreement on the treatment of DMC. Herein, we review available data on treatment modalities, including both surgical and nonsurgical techniques, and to provide a practical algorithm for the management of DMC. A systematic review was conducted using MEDLINE, EMBASE, and Cochrane databases. Articles studying the management of DMC were included in this review. A total of 40 articles were included in the review. The five most frequently used treatments for DMC were surgery (n = 849), expression of cyst content (n = 132), sclerotherapy (n = 119), corticosteroid injection (n = 108), and cryotherapy (n = 103). Surgery yielded the highest cure rate among all treatment modalities (95%) compared to sclerotherapy (77%), cryotherapy (72%), corticosteroid injection (61%), and expression of cyst content (39%) (P < 0.001). Surgery should be considered as the first-line treatment for DMC. Second-line treatments include sclerotherapy and cryotherapy. Third-line treatments include corticosteroid injections, expression of cyst content, and less-studied modalities. Surgery showed the highest cure rates. Future adequately designed randomized controlled trials are warranted to compare different treatment modalities.

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Molecular prevalence of Merkel cell polyomavirus in nonmelanoma skin cancer in a Brazilian population

Summary

Background

Merkel cell polyomavirus (MCPyV), a newly described oncogenic virus, has been found in association with tumours other than Merkel cell carcinoma (MCC). As yet, little is known about the involvement or influence of MCPyV on the development of these tumours and its prevalence in various populations.

Aim

To assess the prevalence of MCPyV DNA in cases of nonmelanoma skin cancer (NMSC).

Methods

The prevalence of MCPyV DNA was assessed in 96 cases of NMSC in a Brazilian population comprising 76 subjects, and these results were correlated with epidemiological and demographical data.

Results

MCPyV DNA was detected in 23 of 69 (33.3%) basal cell carcinomas, in 2 of 11 (18%) squamous cell carcinomas, 2 of 4 Bowen disease case, 0 of 1 MCC and 4 of 11 other skin disorders.

Conclusion

Despite the frequent detection of MCPyV DNA in NMSC, its possible role in the development of NMSC still needs further investigation.

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Successful treatment of refractory palmoplantar pustulosis with apremilast

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Multiple, spontaneous, noninflammatory cutaneous atrophic pits on the extremities

Click here for the corresponding questions to this CME article.

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Ecthyma gangrenosum without bacteraemia: evidence in favour of a broader definition

Summary

Ecthyma gangrenosum (EG) is often defined as a cutaneous manifestation of Pseudomonas aeruginosa septicaemia, typically secondary to neutropenia. There is increasing recognition that a broader definition is warranted, as numerous causative organisms and predisposing conditions have been reported. We describe two cases of EG that occurred without bacteraemia. In this atypical subset of cases, the skin is thought to represent the primary inoculation site from which haematogenous spread can occur.

The first case occurred in the context of human immunodeficiency virus (HIV) infection, a rarely reported association. The evidence base guiding clinicians on management of EG is very limited, particularly in relation to patients with HIV, in whom recurrence risk may be higher than normal. Recurrent EG is described in our second case, in an individual with Good syndrome, a rare association of thymoma and immunodeficiency.

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Palmar fasciitis and polyarthritis, a rare paraneoplastic syndrome related to ovarian cancer

Summary

Palmar fasciitis and polyarthritis syndrome (PFPAS) is an uncommon disorder characterized by diffuse inflammation of the palmar fascia, tendon sheaths, and joints of the fingers and wrists, which rapidly progresses to flexion contracture of the hands. This paraneoplastic syndrome, originally linked to ovarian carcinoma, has also been associated with multiple different malignancies. As PFPAS usually precedes the detection of cancer, its symptoms should raise the suspicion of an underlying malignancy and should be thoroughly investigated.

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‘Scaly’ tattoo reactions: is treatment mandatory?

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Cutaneous leishmaniasis associated with anti-tumour necrosis factor-α drugs: an emerging disease

Summary

Leishmaniasis is endemic in several geographic areas of the world. In each of these areas, particular species of Leishmania with differing aggressiveness to humans predominate. In the European Mediterranean basin, cutaneous leishmaniasis usually presents with discrete, self-healing skin lesions. Although it is known that tumour necrosis factor (TNF) inhibitors may increase the risk of developing infections such as tuberculosis, there is scarce literature on Leishmania infections in patients treated with these drugs. In recent months, we have observed three patients resident in the Catalan coast of Spain who were treated with TNF inhibitors for Crohn disease, and who developed unusually large and persistent cutaneous lesions of leishmaniasis. These lesions responded only to treatment with intravenous liposomal amphotericin B. In countries with a high incidence of infection by aggressive species of Leishmania, serological screening may be indicated to detect a possible latent leishmanial infection before prescription of TNF inhibitors.

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Mutations in AAGAB underlie autosomal dominant punctate palmoplantar keratoderma

Summary

Punctate palmoplantar keratoderma type 1 (PPPK1) is a rare autosomal dominant inherited skin disease, characterized by multiple hyperkeratotic lesions on the palms and soles. The causative gene for PPPK1 has been identified as AAGAB, which encodes α- and γ-adaptin-binding protein p34. We describe the clinical features in three unrelated families with PPPK1, and report three recurrent causative mutations in AAGAB.

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Cutaneous leucocytoclastic vasculitis with anti-EJ autoantibodies: mere coincidence or a manifestation of antisynthetase syndrome?

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Calendar of Events

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Editorial Board/Reviewing Committee

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Molecular prevalence of Merkel cell polyomavirus in nonmelanoma skin cancer in a Brazilian population

Summary

Background

Aim

To assess the prevalence of MCPyV DNA in cases of nonmelanoma skin cancer (NMSC).

Methods

The prevalence of MCPyV DNA was assessed in 96 cases of NMSC in a Brazilian population comprising 76 subjects, and these results were correlated with epidemiological and demographical data.

Results

MCPyV DNA was detected in 23 of 69 (33.3%) basal cell carcinomas, in 2 of 11 (18%) squamous cell carcinomas, 2 of 4 Bowen disease case, 0 of 1 MCC and 4 of 11 other skin disorders.

Conclusion

Despite the frequent detection of MCPyV DNA in NMSC, its possible role in the development of NMSC still needs further investigation.

http://ift.tt/2lLBGSV

Successful treatment of refractory palmoplantar pustulosis with apremilast

http://ift.tt/2l2dPkP

Multiple, spontaneous, noninflammatory cutaneous atrophic pits on the extremities

Click here for the corresponding questions to this CME article.

http://ift.tt/2lLBYsY

Ecthyma gangrenosum without bacteraemia: evidence in favour of a broader definition

Summary

http://ift.tt/2lLLf4n

Palmar fasciitis and polyarthritis, a rare paraneoplastic syndrome related to ovarian cancer

Summary

http://ift.tt/2l22UHS

‘Scaly’ tattoo reactions: is treatment mandatory?

http://ift.tt/2lLB1Rp

Cutaneous leishmaniasis associated with anti-tumour necrosis factor-α drugs: an emerging disease

Summary

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Mutations in AAGAB underlie autosomal dominant punctate palmoplantar keratoderma

Summary

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Cutaneous leucocytoclastic vasculitis with anti-EJ autoantibodies: mere coincidence or a manifestation of antisynthetase syndrome?

http://ift.tt/2lpjiOO

Interspersed Distribution of Selectivity to Kinematic Stimulus Features in Supragranular Layers of Mouse Barrel Cortex

<span class="paragraphSection"><div class="boxTitle">Abstract</div>Neurons in the primary sensory regions of neocortex have heterogeneous response properties. The spatial arrangement of neurons with particular response properties is a key aspect of population representations and can shed light on how local circuits are wired. Here, we investigated how neurons with sensitivity to different kinematic features of whisker stimuli are distributed across local circuits in supragranular layers of the barrel cortex. Using 2-photon calcium population imaging in anesthetized mice, we found that nearby neurons represent diverse kinematic features, providing a rich population representation at the local scale. Neurons interspersed in space therefore responded differently to a common stimulus kinematic feature. Conversely, neurons with similar feature selectivity were located no closer to each other than predicted by a random distribution null hypothesis. This finding relied on defining a null hypothesis that was specific for testing the spatial distribution of tuning across neurons. We also measured how neurons sensitive to specific features were distributed relative to barrel boundaries, and found no systematic organization. Our results are compatible with randomly distributed selectivity to kinematic features, with no systematic ordering superimposed upon the whisker map.</span>

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Regeneration of meniscus tissue using adipose mesenchymal stem cells-chondrocytes co-culture on a hybrid scaffold: In vivo study

Publication date: May 2017
Source:Biomaterials, Volume 126
Author(s): Lida Moradi, Mohammad Vasei, Mohammad M. Dehghan, Mohammad Majidi, Saeed Farzad Mohajeri, Shahin Bonakdar
The meniscus has poor intrinsic regenerative capacity and its damage inevitably leads to articular cartilage degeneration. We focused on evaluating the effects of Polyvinyl alcohol/Chitosan (PVA/Ch) scaffold seeded by adipose-derived mesenchymal stem cell (ASC) and articular chondrocytes (AC) in meniscus regeneration. The PVA/Ch scaffolds with different molar contents of Ch (Ch1, Ch2, Ch4 and Ch8) were cross-linked by pre-polyurethane chains. By increasing amount of Ch tensile modulus was increased from 83.51 MPa for Ch1 to 110 MPa for Ch8 while toughness showed decrease from 0.33 mJ/mm³ in Ch1 to 0.11 mJ/mm³ in Ch8 constructs. Moreover, swelling ratio and degradation rate increased with an increase in Ch amount. Scanning electron microscopy imaging was performed for pore size measurement and cell attachment. At day 21, Ch4 construct seeded by AC showed the highest expression with 24.3 and 22.64 folds increase in collagen II and aggrecan (p ≤ 0.05), respectively. Since, the mechanical properties, water uptake and degradation rate of Ch4 and Ch8 compositions had no statistically significant differences, Ch4 was selected for in vivo study. New Zealand rabbits were underwent unilateral total medial meniscectomy and AC/scaffold, ASC/scaffold, AC-ASC (co-culture)/scaffold and cell-free scaffold were engrafted. At 7 months post-implantation, macroscopic, histologic, and immunofluorescent studies for regenerated meniscus revealed better results in AC/scaffold group followed by AC-ASC/scaffold and ASC/scaffold groups. In the cell-free scaffold group, there was no obvious meniscus regeneration. Articular cartilages were best preserved in AC/scaffold group. The best histological score was observed in AC/scaffold group. Our results support that Ch4 scaffold seeded by AC alone can successfully regenerate meniscus in tearing injury and ASC has no significant contribution in the healing process.

Graphical abstract

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Dosimetric impact of contouring and image registration variability on dynamic 125I prostate brachytherapy

Publication date: Available online 24 February 2017
Source:Brachytherapy
Author(s): Hendrik Westendorp, Kathrin Surmann, Sandrine M.G. van de Pol, Carel J. Hoekstra, Robert A.J. Kattevilder, Tonnis T. Nuver, Marinus A. Moerland, Cornelis H. Slump, André W. Minken
PurposeThe quality of permanent prostate brachytherapy can be increased by addition of imaging modalities in the intraoperative procedure. This addition involves image registration, which inherently has inter- and intraobserver variabilities. We sought to quantify the inter- and intraobserver variabilities in geometry and dosimetry for contouring and image registration and analyze the results for our dynamic ¹²⁵I brachytherapy procedure.Methods and MaterialsFive observers contoured 11 transrectal ultrasound (TRUS) data sets three times and 11 CT data sets one time. The observers registered 11 TRUS and MRI data sets to cone beam CT (CBCT) using fiducial gold markers. Geometrical and dosimetrical inter- and intraobserver variabilities were assessed. For the contouring study, structures were subdivided into three parts along the craniocaudal axis.ResultsWe analyzed 165 observations. Interobserver geometrical variability for prostate was 1.1 mm, resulting in a dosimetric variability of 1.6% for V100 and 9.3% for D90. The geometric intraobserver variability was 0.6 mm with a V100 of 0.7% and D90 of 1.1%. TRUS–CBCT registration showed an interobserver variability in V100 of 2.0% and D90 of 3.1%. Intraobserver variabilities were 0.9% and 1.6%, respectively. For MRI–CBCT registration, V100 and D90 were 1.3% and 2.1%. Intraobserver variabilities were 0.7% and 1.1% for the same.ConclusionsProstate dosimetry is affected by interobserver contouring and registration variability. The observed variability is smaller than underdosages that are adapted during our dynamic brachytherapy procedure.

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Non-coding RNA: Exosomal microRNAs as novel adipokines

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Cancer genomics: ECdetect hunts extrachromosomal DNA

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Ultrasound Image Classification of Ductal Carcinoma in Situ (DCIS) of the Breast: Analysis of 705 DCIS Lesions1

Publication date: Available online 24 February 2017
Source:Ultrasound in Medicine & Biology
Author(s): Takanori Watanabe, Takuhiro Yamaguchi, Hiroko Tsunoda, Setsuko Kaoku, Eriko Tohno, Hidemitsu Yasuda, Kanako Ban, Koichi Hirokaga, Kumiko Tanaka, Takeshi Umemoto, Toshitaka Okuno, Yasuhisa Fujimoto, Shuichi Nakatani, Jun Ito, Ei Ueno
The Japan Association of Breast and Thyroid Sonology (JABTS) proposed, in 2003, a conceptual classification system for non-mass abnormalities to be applied in addition to the conventional concept of masses, to facilitate detecting ductal carcinoma in situ (DCIS) lesions. The aim of this study was to confirm the utility of this system and to clarify the distribution of these findings in DCIS lesions. Data on 705 surgically treated DCIS lesions from 16 institutions in Japan were retrospectively reviewed. All 705 DCIS lesions could be classified according to the JABTS classification system. The most frequent findings were hypo-echoic areas in the mammary gland (48.6%), followed by solid masses (28.0%) and duct abnormalities (10.2%) or mixed masses (8.1%). Distortion (1.3%), clustered microcysts (1.4%) and echogenic foci without a hypo-echoic area (2.5%) were uncommon. These results suggest that the concept of non-mass abnormalities is useful in detecting DCIS lesions.

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Semi-quantitative Strain Ratio Determined Using Different Measurement Methods: Comparison of Strain Ratio Values and Diagnostic Performance Using One- versus Two-Region-of-Interest Measurement

Publication date: Available online 24 February 2017
Source:Ultrasound in Medicine & Biology
Author(s): Jung Hyun Yoon, Mi Kyung Song, Eun-Kyung Kim
We evaluated the agreement and diagnostic performance of strain ratio values using measurements made with one and two user-defined regions of interest (ROIs) on breast elastography. Two hundred forty-three breast masses of 226 women (mean age: 48.2 y) were included. Ultrasonography (US) and elastography images of the masses were recorded. Strain ratio was measured twice on the same elastography image; strain ratio 1, applying one ROI at the target mass for measurement, and strain ratio 2, applying one ROI at the target mass and another ROI as reference strain. The two strain ratio measurements were in substantial agreement, with an intra-class correlation coefficient of 0.655 (95% confidence interval: 0.577–0.722). Specificity, positive predictive value and accuracy (cutoffs: 2.66 and 2.35) were significantly improved for US combined with the two strain ratio measurements (all p values < 0.05). Strain ratios measured using one or two user-defined ROIs were in substantial agreement, both contributing to the improved diagnostic performance of breast US.

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Design and Experimental Evaluation of a Quantified Depth Shave Biopsy Device—Proof of Concept

More diagnoses of skin cancer occur than all other cancers combined. The most common method to biopsy a skin lesion is the shave biopsy (SB), because of efficiency afforded to the provider and patient. However, it produces biopsy specimens with unknown and variable thickness. The present study examines an innovative SB prototype that quantifies the depth of specimen harvest at the time of tissue acquisition. Our objective was to design a quantified >1.1 mm depth of skin tissue harvest SB device that was easy to operate.

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Percutaneous needle fasciotomy for Dupuytren’s disease: minimizing morbidity

We read with interest the letter by Nikkhah and Kang in the January issue of the journal (1), describing anecdotal observations derived from a series of 150 patients treated with percutaneous needle fasciotomy (PNF). Nikkhah and Kang perform PNF along the lines described by Foucher et al. (2). Our own PNF practice differs in several significant respects. In particular, we question the requirement for wrist block, and we highlight differences in the positioning of the PNF sites, the gauge of needle and the post-operative splinting regime.

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Patient Experience of Sentinel Lymph Node Biopsy for Melanoma

Sentinel lymph node biopsy (SLNB) has become an established investigation for assessing microscopic nodal metastasis in melanoma. In a 10-year review of SLNB for melanoma at a single institution, our unit reported a complication rate of 6%1. Despite the widespread use of SLNB for melanoma there are no studies that evaluate patient experience. A method of identifying this information is the study of patient reported outcome measures (PROMs), defined by the Food and Drug Administration as a "measurement of any aspect of a patient's health status that comes directly from the patient".

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Is it time for a change in the approach to chemical burns? The role of Diphoterine® in the management of cutaneous and ocular chemical injuries

A multitude of household and occupational compounds have the potential to induce chemical burns to the eye and skin. Without prompt intervention, irreversible visual loss and disfigurement may prevail. Diphoterine® and Hexafluorine® are amphoteric, hypertonic, chelating solutions used in the management of general chemical and hydrofluoric acid burns respectively. They rapidly neutralise both acid and alkali agents without heat release and limit diffusion, making them superior to water irrigation alone.

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Story Retelling Skills in Persian Speaking Hearing-impaired Children

In recent years, there has been an increasing interest in seeking ways to evaluate children's language in a natural context. In Iran the study of language development skills in hearing impaired children is mainly focused on the development of early language skills and story retelling creates a valid way for assessing the effects of cochlear implant on complex linguistic usesuch as pragmatics. Pragmatic abilities, which refer to the actual use of language, are an important area in language. A number of researchers have reported that story retelling creates a valid way for assessing pragmatic and complex structures (1).

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Endoscopic middle ear exploration in pediatric patients with conductive hearing loss

To describe our indications, findings, and outcomes for transcanal endoscopic middle ear exploration in pediatric patients with conductive hearing loss of unknown etiology, without effusions.

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Lack of interaction between between NEMO and SHARPIN impairs linear ubiquitination and NF-κB activation, and leads to incontinentia pigmenti

We identified for the first time in human the NEMO domain involved in SHARPIN interaction which is dispensable for NF-κB signaling. Beside, HOIL-1, HOIP, and OTULIN deficiency we confirmed that defect of linear ubiquitination is responsible for human diseases.

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Graphical Abstracts

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Meet Our Editorial Board Member

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COMMENTARY: Magnetic Resonance Techniques Applied to Parkinson’s Disease

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Editorial: Brain Imaging and Automatic Analysis in Neurological and Psychiatric Diseases - Part II

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Detection of Dendritic Spines Using Wavelet Packet Entropy and Fuzzy Support Vector Machine

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Detection of Unilateral Hearing Loss by Stationary Wavelet Entropy

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Brain Tumor Segmentation Using Deep Belief Networks and Pathological Knowledge

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Stationary Wavelet Transform and AdaBoost with SVM Based Pathological Brain Detection in MRI Scanning

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Coarse Classification to Region-Scalable Refining for White Matter Lesions Segmentation in Multi-Channel MRI

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Differentiation of Glioblastoma and Lymphoma Using Feature Extraction and Support Vector Machine

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Mitochondrial Dysfunctions in Bipolar Disorder: Effect of the Disease and Pharmacotherapy

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Mitochondrial Dysfunctions in Bipolar Disorder: Effect of the Disease and Pharmacotherapy

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Mitochondrial Dysfunctions in Bipolar Disorder: Effect of the Disease and Pharmacotherapy

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Design, Synthesis and Evaluation of the Antidepressant and Anticonvulsant Activities of Triazole-Containing Benzo[d]oxazoles

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Multitarget Therapeutic Effect of Fasudil in APP/PS1transgenic Mice

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Antibacterial and anti-biofilm effects of sodium hypochlorite against Staphylococcus aureus isolates derived from patients with atopic dermatitis

Abstract

Introduction

Atopic dermatitis (AD) is characterised by an increased susceptibility for skin infections. Staphylococcus aureus is reported to dominate in AD lesions and reports have revealed the presence of staphylococcal biofilms. These infections contribute to aggravating the eczema. Sodium hypochlorite is known to reduce bacterial load of skin lesions as well as disease severity in AD patients but the effect on biofilms is unknown.

Objectives

The aim of this study was to investigate the antimicrobial and anti-biofilm effects of sodium hypochlorite against S. aureus isolates derived from patients with AD.

Materials and Methods

Skin biopsy derived from infected AD patient was examined by scanning electron microscopy (SEM). Using radial diffusion assays, biofilm assays and confocal laser scanning microscopy, we assessed the effect of sodium hypochlorite on S. aureus isolates derived from lesional skin of AD patients.

Results

SEM revealed clusters of coccoid bacteria embedded in fibrin and extracellular substances at the skin of a patient with infected AD. At concentrations of 0.01-0.08%, sodium hypochlorite showed antibacterial effects against planktonic cells. Eradication of S. aureus biofilms in vitro was observed in concentrations ranging from 0.01% to 0.16%. Confocal laser scanning microscopy confirmed these results. Finally, when human AD skin was subjected to sodium hypochlorite in an ex vivo model, a dose of 0.04% reduced the bacteria derived from AD skin.

Conclusions

Sodium hypochlorite has antimicrobial and anti-biofilm effects against clinical S. aureus isolates. Our findings suggest usage of a higher concentration than currently used in bleach baths of skin-infected AD patients.

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Antibacterial and anti-biofilm effects of sodium hypochlorite against Staphylococcus aureus isolates derived from patients with atopic dermatitis

Abstract

Introduction

Objectives

The aim of this study was to investigate the antimicrobial and anti-biofilm effects of sodium hypochlorite against S. aureus isolates derived from patients with AD.

Materials and Methods

Results

Conclusions

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Effect of adjuvanted and standard sublingual immunotherapy on respiratory function in pure rhinitis due to house dust mite over a 5-year period.

Effect of adjuvanted and standard sublingual immunotherapy on respiratory function in pure rhinitis due to house dust mite over a 5-year period.

World Allergy Organ J. 2017;10(1):7

Authors: Marogna M, Massolo A, Passalacqua G

Abstract
BACKGROUND: Allergen-specific immunotherapy (AIT) still remains the only causal treatment for IgE mediated respiratory diseases (rhinitis/asthma) In addition to the observed clinical decrease in symptoms, AIT can provide a long-lasting and preventive effect. In particular it can modify the progression from rhinitis to asthma.
METHODS: The study was observational, open, non randomized, controlled, prospective and performed in a real-life setting. Patients with pure mite-induced allergic rhinitis were followed-up, receiving adjuvanted SLIT (aSLIT), standard SLIT (sSLIT) or drug treatment alone, according to their preference starting between 2008 and 2009. The possible onset of asthma, changes in pulmonary function and bronchial hyperreactivity (BHR) were assessed over a 5-year horizon. Also the onset of new sensitizations and symptoms-medication score (SMS) were evaluated.
RESULTS: One hundred forty two patients fulfilling the inclusion criteria were assessed at baseline, and 124 had the 5-year evaluation (age range 8-57, 69 male). After 5 years of treatment, new sensitizations appeared differentially among treatments with 58.1% of new sensitizations in the drug treatment group, 13.2% in the sSLIT patients, and 8.1% in the aSLIT patients. At the end of 5 years, SMS significantly changed (P < 0.001) in all groups, with a negative trend for controls, as compared to the SLIT treatments. The SMS decreased in both SLIT groups at 5 years, with no change in patients on drug treatment alone. The use of salbutamol (absent at baseline), showed an overall increase only in the group receiving drugs alone with a significant difference at 5 years (P < 0.001). Considering the MCh challenge, there was a difference among treatments (P < 0.001) in PD20 after 5 years: the control group had a lower PD20 at 5 years. No significant difference in PD20 was detected between sSLIT and aSLIT. The FEV1 significantly decreased in controls, with no change in the sSLIT group and a significant increase in aSLIT as compared to sSLIT.
DISCUSSION: Despite the limitations inherent to a real-life setting study (absence of randomization and control, small sample size, lack of intermediate timepoint assessment) the results of this study evidenced that the investigated SLIT product, either adjuvanted or not, had a positive effect on the evolution of respiratory allergy due to house dust mite.
CONCLUSION: In the real life setting, considering a 5-year period, aSLIT and sSLIT reduced the onset of new sensistizations and maintained intact the pulmonary function, as compared to patients receiving drug treatment alone.

PMID: 28232857 [PubMed - in process]

http://ift.tt/2mAsgJs

An unusual cause of food-induced anaphylaxis in mothers.

An unusual cause of food-induced anaphylaxis in mothers.

World Allergy Organ J. 2017;10(1):3

Authors: Soh JY, Chiang WC, Huang CH, Woo CK, Ibrahim I, Heng K, Pramanick A, Lee BW

Abstract
BACKGROUND: Galacto-oligosaccharides (GOS) are prebiotics added to commercial milk formula of infants and mothers. In recent years, cases of allergy related to GOS in atopic children have been reported in the South East Asian region.
CASE PRESENTATIONS: We describe a series of pregnant (n = 4) and lactating mothers (n = 2) who developed anaphylactic reactions after consumption of maternal milk formula containing GOS. All six subjects had pre-existing atopy and a positive skin prick test to GOS and 5/5 of the subjects who were tested had positive basophil activation tests to GOS. All of the mothers and their babies had normal neonatal outcomes after the reactions.
CONCLUSIONS: The supplementation of GOS into milk and beverages in the Asian region should take into account the rare chance of allergenicity of GOS in the atopic population.

PMID: 28232856 [PubMed - in process]

http://ift.tt/2mAz6hZ

Anti-Cancer Drug Validation: the Contribution of Tissue Engineered Models.

Anti-Cancer Drug Validation: the Contribution of Tissue Engineered Models.

Stem Cell Rev. 2017 Feb 23;:

Authors: Carvalho MR, Lima D, Reis RL, Oliveira JM, Correlo VM

Abstract
Drug toxicity frequently goes concealed until clinical trials stage, which is the most challenging, dangerous and expensive stage of drug development. Both the cultures of cancer cells in traditional 2D assays and animal studies have limitations that cannot ever be unraveled by improvements in drug-testing protocols. A new generation of bioengineered tumors is now emerging in response to these limitations, with potential to transform drug screening by providing predictive models of tumors within their tissue context, for studies of drug safety and efficacy. Considering the NCI60, a panel of 60 cancer cell lines representative of 9 different cancer types: leukemia, lung, colorectal, central nervous system (CNS), melanoma, ovarian, renal, prostate and breast, we propose to review current "state of art" on the 9 cancer types specifically addressing the 3D tissue models that have been developed and used in drug discovery processes as an alternative to complement their study.

PMID: 28233276 [PubMed - as supplied by publisher]

http://ift.tt/2lZuCEQ

Correlation between pre-ramadan glycemic control and subsequent glucose fluctuation during fasting in adolescents with Type 1 diabetes

Abstract

Background

Even though patients with type 1 diabetes mellitus (T1DM) are exempted from fasting, the vast majority elect to fast against the advice of their healthcare providers. We have previously reported the incidence of wide fluctuations in blood glucose (BG) along with "unrecognized" severe hypoglycemia during Ramadan fasting in adolescents with T1DM. This report compares the continuous glucose monitoring (CGM) data during fasting in adolescents with T1DM according to their Pre-Ramadan diabetes control.

Methods

Children and adolescents with T1DM who intended to fast the month of Ramadan were asked to wear the CGM during fasting for a minimum of 3 days. Hypoglycemia, hyperglycemia, and severe hyperglycemia were identified as BG <70 mg/dL (3.9 mmol/L), BG 201–300 mg/dL (11.2–16.7 mmol/L), or BG >300 mg/dL (16.7 mmol/L) respectively, while normoglycemia was identified as BG 70–200 mg/dL (3.9–11.1 mmol/L). Patients were categorized as well-controlled (Group 1) and poorly controlled (Group 2) if the pre-fasting HbA1C was ≤8% (64 mmol/mol) and >8%, respectively. We compared the mean BG and the percentages of time spent in hypoglycemia, hyperglycemia, and severe hyperglycemia between the two groups using Chi-square (significant difference when P value was <0.05).

Results

A total of 21 patients were enrolled (15 females), age 15 ± 4 years, duration of diabetes 6 ± 3 years, and HbA1C 8.5 ± 1.0% (70 mmol/mol). There were 7 subjects in Group 1, mean HbA1C 7.5 ± 0.4, and 14 subjects in Group 2, mean HbA1C 9.1 ± 0.9. The mean ± SD BG was 174 ± 76 mg/dL versus 199 ± 98, (P < 0.05) in Group 1 and Group 2, respectively. The percentages of hypoglycemia, hyperglycemia, and severe hyperglycemia were significantly higher in Group 2, while there was a higher percentage of normoglycemia in Group 1. The overall durations of hypoglycemia, hyperglycemia, and severe hyperglycemia in Group 2 were longer by 30, 14, and 135%, respectively, than those in Group 1.

Conclusions

Glycemic control before Ramadan in adolescents with T1 DM appears to correlate with blood glucose profile during Ramadan fasting. Our data suggest that optimal glycemic control before Ramadan may reduce the potential risks associated with fasting and minimize glucose fluctuation.

http://ift.tt/2lnjmhS

Pediatric tuberculosis-human immunodeficiency virus co-infection in the United Kingdom highlights the need for better therapy monitoring tools: a case report

Tuberculosis is an infection that requires at least 6 months of chemotherapy in order to clear the bacteria from the patient's lungs. Usually, therapeutic monitoring is dependent on smear microscopy where a de...

http://ift.tt/2ledWoT

Computed tomography and anatomical measurements of critical sites for endosseous implants in the pterygomaxillary region: a cadaveric study

The aim of this study was to obtain computed tomography (CT) and physical measurements of the pterygomaxillary region to determine the anatomical and radiographic landmarks that clinicians need for pterygoid implant placement. Seventy-eight hemi-heads with an atrophic posterior maxilla from 46 cadaveric samples were measured using CT. Twenty-one hemi-heads were selected randomly for physical measurements. CT measurements showed that the mean and minimum distance between the maxillary tuberosity point (MT) and the most lateral lowest point of the pterygomaxillary fissure (PF) were 18.7mm and 10.0mm, respectively.

http://ift.tt/2mAhxyC

Opicapone for the treatment of Parkinson's disease.

Opicapone for the treatment of Parkinson's disease.

Expert Opin Pharmacother. 2017 Mar;18(4):445-453

Authors: Rodrigues FB, Ferreira JJ

Abstract
INTRODUCTION: Parkinson's disease (PD) is a progressive neurodegenerative disease. The currently available treatment options only have a symptomatic effect. With disease progression almost all antiparkinsonian pharmacological classes are tried, but the gold standard of pharmacological management is still L-dopa. Various strategies can be used to raise the dopaminergic tone. Catechol-O-methyltransferase (COMT) inhibitors attain this goal by decreasing L-dopa peripheral metabolism. Areas covered: Opicapone (Ongentys®) is a new COMT inhibitor developed to fulfill the need for more potent, safer and longer acting COMT inhibitors. This review puts into context opicapone's indications, its chemical and preclinical data, the pharmacodynamics and pharmacokinetic characteristics, and the efficacy and safety results delivered by clinical trials. Expert opinion: Opicapone is an efficacious COMT inhibitor. Its proprieties make it adequate for a once-a-day oral dose regimen. It has proved to reduce the off-time and to increase the on-time without troublesome dyskinesias in PD patients with motor fluctuations. The reported adverse events suggest an overall safe and well-tolerated profile. The most common adverse events were dyskinesia, and there were no issues of concern for hepatotoxicity, severe diarrhoea or chromaturia. Further evidence is still needed to conclude how it compares with other drugs for the treatment of motor fluctuations.

PMID: 28234566 [PubMed - in process]

http://ift.tt/2lUPEEh

Comparison of glycemic variability in Japanese patients with type 1 diabetes receiving insulin degludec versus insulin detemir using continuous glucose monitoring: a randomized, cross-over, pilot study.

Comparison of glycemic variability in Japanese patients with type 1 diabetes receiving insulin degludec versus insulin detemir using continuous glucose monitoring: a randomized, cross-over, pilot study.

Expert Opin Pharmacother. 2017 Mar;18(4):335-342

Authors: Takahashi H, Nishimura R, Onda Y, Ando K, Tsujino D, Utsunomiya K

Abstract
OBJECTIVE: To use continuous glucose monitoring (CGM) to compare glycemic variability in patients with type 1 diabetes (T1D) treated with insulin degludec (IDeg) versus insulin detemir (IDet).
METHODS: Ten patients with T1D were randomly assigned to receive once-daily IDeg, followed by twice-daily IDet, or vice versa. Glucose variability was evaluated by CGM after >4 weeks of the first insulin and again after crossover to the second insulin.
RESULTS: The total daily insulin dose (U/kg/day) and the total daily basal insulin dose (U/kg/day) were significantly lower during treatment with IDeg than with IDet [median (interquartile range): 0.55 (0.54-0.73) vs. 0.64 (0.54-0.83); P = 0.028, 0.24 (0.19-0.36) vs. 0.30 (0.19-0.39); P = 0.027]. The 24-hour mean glucose levels were not significantly different. However, their standard deviation (SD) was significantly smaller during treatments with IDeg than those with IDet [59.5 (39.5-71.0) vs. 72.8 (61.8-92.8); P = 0.008]. Their mean fasting glucose levels and the mean postprandial peak levels after breakfast and after dinner were significantly lower with IDeg.
CONCLUSIONS: A CGM-based comparison demonstrated that once-daily IDeg showed fewer glycemic fluctuations than twice-daily IDet. IDeg appears to stabilize blood glucose levels better during both daytime and nighttime (particularly, before and after breakfast) with a lower insulin dosage.

PMID: 28234565 [PubMed - in process]

http://ift.tt/2loMKEu

Nebivolol can be used for combination therapy in patients with autosomal dominant polycystic kidney disease.

Nebivolol can be used for combination therapy in patients with autosomal dominant polycystic kidney disease.

Expert Opin Pharmacother. 2017 Mar;18(4):455

Authors: Kocyigit I, Eroglu E, Ecder T

PMID: 28234564 [PubMed - in process]

http://ift.tt/2loQbLF

Latanoprostene bunod ophthalmic solution 0.024% for IOP lowering in glaucoma and ocular hypertension.

Latanoprostene bunod ophthalmic solution 0.024% for IOP lowering in glaucoma and ocular hypertension.

Expert Opin Pharmacother. 2017 Mar;18(4):433-444

Authors: Kaufman PL

Abstract
INTRODUCTION: Intraocular pressure (IOP)-lowering has been demonstrated to slow the progression or onset of visual field loss in open-angle glaucoma (OAG) or ocular hypertension (OHT). Pharmacological lowering of IOP is the most common initial intervention in patients with OAG or OHT, however, many patients will require more than one therapy to achieve target IOP. Latanoprostene bunod is a novel nitric oxide (NO)-donating prostaglandin F2α analog for the reduction of IOP. Areas covered: Current knowledge concerning the mechanism of action of latanoprostene bunod is presented. Additionally, clinical safety and efficacy data from published Phase 1 (KRONUS), Phase 2 (VOYAGER, CONSTELLATION) and Phase 3 (APOLLO, LUNAR, JUPITER) studies are reviewed. Expert opinion: Latanoprostene bunod is a dual mechanism, dual pathway molecule, consisting of latanoprost acid, which is known to enhance uveoscleral (unconventional) outflow by upregulating matrix metalloproteinase expression and remodeling of the ciliary muscle's extracellular matrix, linked to an NO-donating moiety, which enhances trabecular meshwork/Schlemm's canal (conventional) outflow by inducing cytoskeletal relaxation via the soluble guanylyl cyclase-cyclic guanosine monophosphate (sGC-cGMP) signaling pathway. Latanoprostene bunod 0.024% solution applied topically once daily appears more effective in reducing IOP in OHT and OAG subjects than either latanoprost or timolol, with a side effect profile similar to that of latanoprost.

PMID: 28234563 [PubMed - in process]

http://ift.tt/2loUneb

Magic pills: new oral drugs to treat chronic lymphocytic leukemia.

Magic pills: new oral drugs to treat chronic lymphocytic leukemia.

Expert Opin Pharmacother. 2017 Mar;18(4):411-425

Authors: Vitale C, Griggio V, Todaro M, Salvetti C, Boccadoro M, Coscia M

Abstract
INTRODUCTION: A deeper understanding of chronic lymphocytic leukemia (CLL) biology has led to the identification of new promising therapeutic targets. Different classes of molecules are currently under investigation and novel oral drugs have recently been approved or are in a late stage of clinical development. Areas covered: We present biological data illustrating the heterogeneous mechanisms of action of new oral drugs in CLL. Moreover, we provide clinical data from phase I to III studies, and discuss efficacy and side effects profile of these new therapies. Data are derived from peer-reviewed articles indexed in PubMed and from abstracts presented at major international meetings. Expert opinion: Novel oral drugs represent a valuable alternative to chemo-immunotherapy for patients with CLL, especially when high-risk disease features are present and when age or comorbidities preclude the use of standard treatments. Based on data from ongoing clinical trials, the indications of already approved agents will most likely be expanded and new options will soon be available. Moreover, treatment combinations will broaden the therapeutic armamentarium of physicians treating CLL. The availability of multiple choices is of benefit for patients with CLL, but also represents a challenge for the need of choosing the right drug for each patient.

PMID: 28234562 [PubMed - in process]

http://ift.tt/2lKlLo0

Assessment of diabetic neuropathy with emission tomography and magnetic resonance spectroscopy.

Assessment of diabetic neuropathy with emission tomography and magnetic resonance spectroscopy.

Nucl Med Commun. 2017 Feb 23;:

Authors: Rao H, Gaur N, Tipre D

Abstract
Diabetic neuropathies (DNs) are nerve-damaging disorders associated with diabetes. They are commonly attributed to peripheral nerves and primarily affect the limbs of the patient. They cause altered sensitivity to external stimuli along with loss in balance and reflexes of the affected patient. DNs are associated with a variety of clinical manifestations including autonomic failure and are caused by poor management of blood sugar levels. Imaging modalities provide vital information about early physiological changes in DNs. This review summarizes contributions by various teams of scientists in developing imaging methods to assess physiological changes in DNs and ongoing clinical trials where imaging modalities are applied to evaluate therapeutic intervention in DNs. Development of PET, single photon emission computed tomography, and magnetic resonance spectroscopy methods over the past 20 years are reviewed in the diagnostic assessment of DNs. Abnormal radiotracer pharmacokinetics and neurometabolite spectra in affected organs confirm physiological abnormalities in DN. With the use of the Siemens Biograph mMR and GE Signa - 60 cm (PET/MRI scanner), simultaneous acquisition of physiological and anatomical information could enhance understanding of DNs and accelerate drug development.

PMID: 28234786 [PubMed - as supplied by publisher]

http://ift.tt/2lZHv1y

Noninvasive detection of matrix metalloproteinase-9 in atherosclerotic lesions using technetium-99m-labeled single-photon emission computed tomography in vivo.

Noninvasive detection of matrix metalloproteinase-9 in atherosclerotic lesions using technetium-99m-labeled single-photon emission computed tomography in vivo.

Nucl Med Commun. 2017 Feb 23;:

Authors: Wang Z, Deng G, Zhang Z, Huang H, Zhao Y

Abstract
OBJECTIVE: Previous studies have suggested that matrix metalloproteinase (MMP) inhibitor uptake may offer a precise estimation of MMP activity in atherosclerotic lesions. In this study, we explored the feasibility of noninvasive detection of MMP-9 activity using technetium-99m-labeled matrix metalloproteinase-9 antibody (Tc-McAb) in vivo.
METHODS: ApoE-deficient (ApoE) atherosclerosis mice models (n=10) were induced through a high-cholesterol diet following ligation of their left common carotid artery. After 4 weeks, the models were verified through proton density-weighted and T2-weighted images obtained by MRI. C57BL/6 sham mice (n=8) were used as controls. In addition, normal mice (n=20) were used to characterize blood clearance. After radiolabeled McAb administration, single-photon emission computed tomography (SPECT) was performed. Subsequently, left common carotid arteries were harvested for ex-vivo autoradiograph imaging. Then, morphology and activity assays of MMP-9 were histologically and immunohistochemically examined.
RESULTS: MRI showed higher signal intensities in the left common carotid arteries with irregular stenoses in the lumen of blood vessels in atherosclerosis mice models in vivo. Atherosclerotic lesions on left common carotid artery specimens were also clearly visualized using SPECT 2 h after Tc-McAb administration in vivo. Note that the radiochemistry purity of the Tc-McAb used was 85-95%. Biodistribution studies have shown that the clearance of Tc-McAb from blood was rapid. In addition, atherosclerotic lesions were clearly visualized on radioautography film shadows ex vivo.
CONCLUSION: MMP-9 activities within the atherosclerotic lesions were noninvasively detected using Tc-labeled SPECT in vivo.

PMID: 28234785 [PubMed - as supplied by publisher]

http://ift.tt/2lZrd8W

Volumetric evaluation of pharyngeal segments in obstructive sleep apnea patients.

Volumetric evaluation of pharyngeal segments in obstructive sleep apnea patients.

Braz J Otorhinolaryngol. 2017 Jan 30;:

Authors: Rodrigues MM, Pereira Filho VA, Gabrielli MF, Oliveira TF, Batatinha JA, Passeri LA

Abstract
INTRODUCTION: Obstructive sleep apnea occurs by recurrent collapse of the upper airway during sleep, resulting in total (apnea) or partial (hypopnea) reduction of the airflow and has intimate relation with changes in the upper airway. Cone Beam CT allows the analysis of the upper airway and its volume by three-dimensional reconstruction.
OBJECTIVE: To evaluate a possible correlation between the volume of the upper airway and the severity of the obstructive sleep apnea.
METHODS: A retrospective study was performed reviewing polysomnographic data and Cone Beam CT records of 29 patients (13 males and 16 females). The correlation between the volume of the nasopharynx, the oropharynx and the total superior pharynx with the AHI was assessed by Pearson's rank correlation coefficient.
RESULTS: The obstructive sleep apnea severity division was: ten patients had severe, 7 had moderate, 6 had mild and 6 of them were healthy. The correlation between the nasopharynx, the oropharynx and the total superior pharynx volumes and the Apnea-Hypopnea-Index was respectively: -0.415 (p=0.025), 0.186 (p=0.334) and -0329 (p=0.089). The Spearman's rank controlled by the Body Mass Index, the age and the gender was: -0.206 (p=0.304), -0.155 (p=0.439) and 0.242 (p=0.284).
CONCLUSION: There is no correlation between the volume of the airway and the obstructive sleep apnea, assessed by Apnea-Hypopnea-Index and controlled by the Body Mass Index, the age and the gender. The volume of the upper airways as an isolated parameter did not correlate to the severity of the obstructive sleep apnea syndrome, and should be evaluated together with other factors.

PMID: 28233709 [PubMed - as supplied by publisher]

http://ift.tt/2le9m9S

Analysis of Audiometric Differences of Patients with and without Tinnitus in a Large Clinical Database.

Analysis of Audiometric Differences of Patients with and without Tinnitus in a Large Clinical Database.

Front Neurol. 2017;8:31

Authors: Gollnast D, Tziridis K, Krauss P, Schilling A, Hoppe U, Schulze H

Abstract
Human hearing loss (HL) and comorbidities like tinnitus pose serious problems for people's daily life, which in most severe cases may lead to social isolation, depression, and suicide. Here, we investigate the relationship between hearing deficits and tinnitus. To this end, we conducted a retrospective study on anonymized pure tone and speech audiometric data from patients of the ENT hospital Erlangen in which we compare audiometric data between patients with and without tinnitus. Overall data from 37,661 patients with sensorineural (SHL) or conductive HL (CHL) with (T, 9.5%) or without (NT, 90.5%) a tinnitus percept in different age groups and with different tinnitus pitches were included in this study. The results of the pure tone audiometry comparisons showed significant differences in T patients compared to NT patients. In young patients, we generally found lower hearing thresholds in T compared to NT patients. In adult patients, differences were more heterogeneous: hearing thresholds in T patients were lower in low frequency ranges, while they were higher at high frequencies. Furthermore, lower thresholds were more often found in CHL patients and could rarely be detected in SHL patients. In speech audiometry, only CHL patients with high-pitched tinnitus showed lower thresholds compared to NT patients' thresholds. The results of this study may point to a biologically plausible functional benefit on hearing thresholds in HL tinnitus patients. We hypothesize that the physiological mechanism of stochastic resonance counteracts HL by adding neuronal noise to the system. This neuronal noise may induce changes in the auditory pathway and finally-as a side effect of threshold improvement-lead to the development of a tinnitus percept. We propose a general model of changed hearing thresholds in T patients, being either decreased or increased compared to NT patients.

PMID: 28232817 [PubMed - in process]

http://ift.tt/2mks1WN

Endoscope-Assisted Microsurgical Subtemporal Keyhole Approach to the Posterolateral Suprasellar Region and Basal Cisterns.

Endoscope-Assisted Microsurgical Subtemporal Keyhole Approach to the Posterolateral Suprasellar Region and Basal Cisterns.

World Neurosurg. 2017 Feb 20;:

Authors: Rehder R, Cohen AR

Abstract
BACKGROUND: Refinements in optics and instrumentation have enabled surgeons to approach deep-seated intracranial pathologies with reduced exposure and brain retraction. The anterior subtemporal keyhole approach is a minimally invasive route to the posterolateral aspect of the suprasellar area and petroclival region.
OBJECTIVE: In this cadaveric study, we demonstrate the benefits of endoscope-assisted microsurgical techniques in the anterior subtemporal keyhole approach.
METHODS: The anterior subtemporal keyhole approach was performed bilaterally on five formalin-fixed human specimens using standard microneurosurgical methods. Dissections compared the exposure afforded by the microsurgical route to the endoscope-assisted technique, using zero and 30-degree angled rod-lenses. Anatomical relationships among the surgical target and the surrounding neurovascular structures were described.
RESULTS: Endoscope-assisted maneuvers enhanced the operative view afforded by the microscope and helped to minimize parenchymal retraction and neurovascular injury. Endoscope-assisted microsurgery provides a panoramic picture of the surgical target and its surroundings. It enables the operator to see into hidden corners beyond the microsurgical view. The endoscope provides enhanced visualization of the neurovascular structures located in the posterolateral suprasellar region, basal cisterns, upper and mid-clivus and interpeduncular region.
CONCLUSIONS: Endoscope-assisted microsurgery provides a means to approach selected lesions located in the posterolateral suprasellar region, perimesencephalic cisterns and upper and mid-clivus. Operative view can be maximized by introducing the zero and 30-degree angled endoscopes. Minimally invasive techniques help to optimize surgical exposure and lessen parenchymal retraction, thus improving control of the surrounding neurovascular structures.

PMID: 28232212 [PubMed - as supplied by publisher]

http://ift.tt/2mkrvIl

Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory Investigation.

Surgical Freedom Evaluation During Optic Nerve Decompression. Laboratory Investigation.

World Neurosurg. 2017 Feb 20;:

Authors: Di Somma A, Andaluz N, Gogela S, Cavallo LM, Keller JT, Prats-Galino A, Cappabianca P

Abstract
BACKGROUND AND AIMS: Various surgical routes have been used to decompress the intracanalicular optic nerve. Historically, a transcranial corridor was used, but more recently ventral approaches (endonasal and/or transorbital) have been proposed, individually or in combination. The present study aims to detail and quantify the amount of bony optic canal removal one may achieve via transcranial, transorbital and endonasal pathways. Additionally, the surgical freedom of each approach was analyzed.
METHODS: In 10 cadaveric specimens (20 canals), optic canals were decompressed via pterional, endoscopic endonasal, and endoscopic superior eyelid transorbital corridors. The surgical freedom and circumferential optic canal decompression afforded by each approach was quantitatively analyzed. Statistical comparison was carried using a non-paired Student t-test.
RESULTS: An open pterional transcranial approach allowed the greatest area of surgical freedom (transcranial: 10.9 ± 3.4 cm2; transorbital 3.7 ± 0.5 cm2; endonasal homolateral 1.1 ± 0.6 cm2 and endonasal contralateral 1.1 ± 0.5 cm2) with widest optic canal decompression when compared with the other two ventral routes (transcranial: 245.2°; transorbital: 177.9°; endonasal: 144.6°). These differences reached statistical significance for the transcranial approach.
CONCLUSIONS: This anatomical contribution provides a comprehensive evaluation of surgical access to the optic canal via three distinct, but complementary, approaches: transcranial, transorbital and endonasal. Our results show that, as expected, a transcranial approach achieved the widest degree of circumferential optic canal decompression and the greatest surgical freedom for manipulation of surgical instruments. Further surgical experience is necessary to determine the proper surgical indication for the transorbital approach to this pathology.

PMID: 28232210 [PubMed - as supplied by publisher]

http://ift.tt/2mkueBg

Usher Parsons (1788-1868) and his 19(th) Century Understanding and Surgical Treatment of Spinal Curvatures.

Usher Parsons (1788-1868) and his 19(th) Century Understanding and Surgical Treatment of Spinal Curvatures.

World Neurosurg. 2017 Feb 13;:

Authors: Tardieu GG, Topale N, Saker E, Loukas M, Oskouian RJ, Tubbs RS

Abstract
Usher Parsons was a prominent surgeon of the 19(th) century. However, his contributions to the understanding and treatment of spinal curvatures have been more or less forgotten. Herein, we review Parsons' theories, understanding, and treatment strategies for treating abnormal spinal curvatures. This glimpse into history offers insight into the thought processes and surgical strategies that were available in the early 19(th) century. It is pioneers in this field, such as Usher Parsons, on which our current understanding of spinal curvatures and its treatment is built.

PMID: 28232154 [PubMed - as supplied by publisher]

http://ift.tt/2mkv7Kj

Intracranial Subependymoma - A SEER analysis 2004-2013.

Intracranial Subependymoma - A SEER analysis 2004-2013.

World Neurosurg. 2017 Feb 13;:

Authors: Nguyen H, Doan N, Gelsomino M, Shabani S

Abstract
INTRODUCTION: Subependymoma are rare, slow-growing, benign tumors. Due to its scarcity, knowledge relating to survival remains lacking. Consequently, we explore the SEER database to evaluate prognostic / treatment factors associated with intracranial subependymoma.
METHODS: With the SEER-18 registry database, information from all patients diagnosed with intracranial subependymoma from 2004 to 2013 were extracted, including age, gender, race, occurrence of surgery, extent of primary surgery, receipt of radiation, tumor size, and follow-up data. Age-adjusted incidence rates, overall survival (OS), and cause-specific survival (CSS) were calculated. Cox proportional hazards model was employed for both univariate and multivariate analyses.
RESULTS: A total of 466 cases were identified. The overall incidence of intracranial subependymoma is 0.055 per 100,000 person-years [95 % confidence interval (CI) = 0.05-0.06]. Through multivariate analysis, age < 40 [hazards ratio (HR) = 0.21, p = 0.03], female gender [HR = 0.34, p = 0.03], location within ventricles or near brainstem [HR = 0.49, p = 0.04], and ocurrence of surgery [HR = 0.50, p = 0.02] were significant independent positive prognostic factors. Receipt of radiation did not show a significant relationship.
CONCLUSION: Clinical factors such as younger age, female gender, and location within ventricles or near brain stem demonstrated positive relationship with overall survival. For treatment options, surgery remains a mainstay option. No support for radiation therapy was identified.

PMID: 28232153 [PubMed - as supplied by publisher]

http://ift.tt/2mktdct

Effect of intra-arterial and intravenous nimodipine therapy of cerebral vasospasm after SAH on cerebrovascular reactivity and oxygenation.

Effect of intra-arterial and intravenous nimodipine therapy of cerebral vasospasm after SAH on cerebrovascular reactivity and oxygenation.

World Neurosurg. 2017 Feb 13;:

Authors: Hockel K, Diedler J, Steiner J, Birkenhauer U, Ernemann U, Schuhmann MU

Abstract
BACKGROUND: For the treatment and prevention of delayed cerebral ischemia after subarachnoid hemorrhage the vasodilating agent nimodipine (NDP) is widely employed. This study investigates the effect of NDP on the cerebrovascular autoregulation, assessed by pressure reactivity index (PRx), and brain tissue oxygenation (pbrO2) when given continuous intravenously, as intra-arterial bolus or during continuous intra-arterial therapy.
METHODS: Computerized continuous neuromonitoring-data (ICP, MAP, CPP, pbrO2, PRx) of 105 patients with aneurysmal SAH were retrospectively evaluated. The effect of NDP on all parameters was compared when applied intra-arterially for the treatment of severe macro-vasospasm leading to perfusion deficits either as bolus treatment (n=111 in 37 patients) or as continuous infusion (n=20 patients) to patients without or with only mild macro-vasospasm, who received either intravenous NDP or no NDP at all.
RESULTS: Compared to patients without treatment, the intravenous application of NDP was associated with a significantly higher PRx. Autoregulation was strongly and long lastingly affected (high PRx) in continuous intra-arterial NDP infusion, accompanied by a sustained improvement of pbrO2. Intra-arterial bolus NDP application resulted as well in a significant increase of pbrO2 and PRx; the induced effect, however, was transient and subsided within 6 hours. ICP, MAP, and CPP were not affected during the monitoring period.
CONCLUSION: The pharmacologically induced alteration of the cerebrovascular autoregulation by NDP correlates with changes of pbrO2 and indicates a beneficial effect on cerebral blood flow (CBF) if CPP is maintained. This effect is limited to a few hours after bolus treatment and milder for intravenous compared to intra-arterial application.

PMID: 28232152 [PubMed - as supplied by publisher]

http://ift.tt/2mkpxrh

Intraoperative visualization of subependymal arteries at the atrium supplying the descending motor pathway.

Intraoperative visualization of subependymal arteries at the atrium supplying the descending motor pathway.

World Neurosurg. 2017 Feb 13;:

Authors: Hanihara M, Sato S, Shibahara I, Saito R, Kanamori M, Sonoda Y, Kinouchi H, Tominaga T, Kumabe T

Abstract
OBJECTIVE: We previously disclosed that damage to the subependymal arteries (SEAs) caused by coagulation of the choroid plexus at the atrium, can result in infarction within the lateral posterior choroidal artery territory, followed by hemiparesis. The present study describes the intraoperative anatomical findings of the SEAs and choroid plexus at the atrium, those were verified only by a few cadaveric studies.
METHODS: Locations of the SEA and descending motor pathway were determined with the neuronavigation system and subcortical electrical stimulation in 8 cases of periatrial brain tumor. Indocyanine green (ICG) videoangiography was performed to verify the blood flow in the choroid plexus and SEAs.
RESULTS: Intraoperative visualization of the SEAs was successfully performed in all patients. The neuronavigation system and subcortical electrical stimulation mapping demonstrated that these SEAs penetrated into the descending motor pathway. ICG depicted the blood flow of the SEAs entering the wall of the lateral ventricle and adjacent brain parenchyma. The blood flow directions between the SEAs and choroid plexus were not uniform, as the SEAs were filled ahead of the choroid plexus in 3 cases, whereas the choroid plexus was filled first in the other 2 cases.
CONCLUSIONS: Manipulations to the inner side of the choroid plexus at the transition from the atrium to the body of lateral ventricle can damage the SEAs. Not only coagulation of the SEAs themselves, but also coagulation of choroid plexus itself may reduce the blood flow in the SEAs, resulting in ischemic complications at descending motor pathway.

PMID: 28232151 [PubMed - as supplied by publisher]

http://ift.tt/2mkv7tN

The History of Neurosurgery at the National Hospital, Queen Square, London. With some personal recollections from 1948 onwards. The Early Years.

The History of Neurosurgery at the National Hospital, Queen Square, London. With some personal recollections from 1948 onwards. The Early Years.

World Neurosurg. 2017 Feb 13;:

Authors: Powell MP

PMID: 28232150 [PubMed - as supplied by publisher]

http://ift.tt/2mkmKyl

Arterial Pseudoaneurysm Associated with Pancreas and Kidney Transplantation: A Case Report.

Arterial Pseudoaneurysm Associated with Pancreas and Kidney Transplantation: A Case Report.

Am J Case Rep. 2017 Feb 24;18:198-202

Authors: Arantes RM, Pantanali CA, Santos VR, Carneiro D'Albuquerque LA

Abstract
BACKGROUND Pseudoaneurysm is a rare vascular complication in pancreas transplantation. This complication develops from a disruption of the arterial continuity, usually related to trauma, infection, vasculitis, or complications in vascular procedures. CASE REPORT A 43-year-old man underwent simultaneous pancreas and kidney transplantation for end-stage renal disease. He subsequently developed acute pancreatitis and acute kidney cellular rejection as late complications, thus returning to hemodialysis. A new, uneventful kidney transplantectomy and living donor kidney transplant was performed. One year after the last transplant, the patient presented with moderate abdominal pain, fever, and a pulsatile tumor located in the right iliac fossa. A pseudoaneurysm located in the pancreatic Y graft was observed. The patient was treated using an endovascular and surgical approach. CONCLUSIONS A combined procedure using an endovascular and surgical approach promoted a good vascular control with a lower risk of bleeding in a rare case of pseudoaneurysm in a transplant patient.

PMID: 28232659 [PubMed - in process]

http://ift.tt/2mklxqV

Pan-mutant-IDH1 inhibitor BAY1436032 is highly effective against human IDH1 mutant acute myeloid leukemia in vivo.

Pan-mutant-IDH1 inhibitor BAY1436032 is highly effective against human IDH1 mutant acute myeloid leukemia in vivo.

Leukemia. 2017 Feb 24;:

Authors: Chaturvedi A, Herbst L, Pusch S, Klett L, Goparaju R, Stichel D, Kaulfuss S, Panknin O, Zimmermann K, Toschi L, Neuhaus R, Haegebarth A, Rehwinkel H, Hess-Stumpp H, Bauser M, Bochtler T, Struys EA, Sharma A, Bakkali A, Geffers R, Araujo-Cruz MM, Thol F, Gabdoulline R, Ganser A, Ho AD, von Deimling A, Rippe K, Heuser M, Krämer A

Abstract
Neomorphic mutations in isocitrate dehydrogenase 1 (IDH1) are frequently found in several human cancer types including acute myeloid leukemia (AML) and lead to the production of high levels of the oncometabolite (R)-2-hydroxyglutarate (R-2HG). Here we report the characterization of BAY1436032, a novel pan-mutant IDH1 inhibitor, both in vitro and in vivo. BAY1436032 specifically inhibits R-2HG production and colony growth, and induces myeloid differentiation of AML cells carrying IDH1R132H, IDH1R132C, IDH1R132G, IDH1R132L and IDH1R132S mutations. In addition, the compound impacts on DNA methylation and attenuates histone hypermethylation. Oral administration of BAY1436032 led to leukemic blast clearance, myeloid differentiation, depletion of leukemic stem cells and prolonged survival in two independent patient-derived xenograft IDH1 mutant AML mouse models. Together, BAY1436032 is highly effective against all major types of IDH1 mutant AML.Leukemia advance online publication, 24 February 2017; doi:10.1038/leu.2017.46.

PMID: 28232670 [PubMed - as supplied by publisher]

http://ift.tt/2mkExpl

Intracranial papillary endothelial hyperplasia (Masson's tumour) following gamma knife radiosurgery for temporal lobe epilepsy.

Intracranial papillary endothelial hyperplasia (Masson's tumour) following gamma knife radiosurgery for temporal lobe epilepsy.

Pract Neurol. 2017 Feb 23;:

Authors: Barritt AW, Merve A, Epaliyanage P, Aram J

Abstract
We present a rare case of intracranial papillary endothelial hyperplasia, or 'Masson's tumour,' following gamma knife radiosurgery for epilepsy. A 59-year-old woman presented with a 4-month history of escalating headaches and progressive neurological deficit. MR scan of brain showed enlargement of an enhancing right temporal lobe lesion, midline shift and obstructive hydrocephalus. She had previously undergone non-curative gamma knife radiosurgery at the age of 44 years for medically refractory complex partial seizures. Postprocedure imaging had shown signal change and enhancement within the right temporal lobe consistent with radiation necrosis, which remained stable over the next decade. Now, 15 years following radiosurgery, we suspected an intrinsic high-grade neoplasm, but surgical excision instead found a benign pseudoneoplasm. Papillary endothelial hyperplasia should be considered in the differential diagnosis for mass lesions following gamma knife radiosurgery, particularly as resection can be curative. Remarkably, she has become seizure free.

PMID: 28232387 [PubMed - as supplied by publisher]

http://ift.tt/2mkv7dh

Pediatric tuberculosis-human immunodeficiency virus co-infection in the United Kingdom highlights the need for better therapy monitoring tools: a case report

Anticancer Agents; +154 new citations

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Virgin coconut oil supplementation attenuates acute chemotherapy hepatotoxicity induced by anticancer drug methotrexate via inhibition of oxidative stress in rats.

http:--linkinghub.elsevier.com-ihub-imag

Virgin coconut oil supplementation attenuates acute chemotherapy hepatotoxicity induced by anticancer drug methotrexate via inhibition of oxidative stress in rats.

Biomed Pharmacother. 2017 Mar;87:437-442

Authors: Famurewa AC, Ufebe OG, Egedigwe CA, Nwankwo OE, Obaje GS

Abstract
BACKGROUND: The emerging health benefit of virgin coconut oil (VCO) has been associated with its potent natural antioxidants; however, the antioxidant and hepatoprotective effect of VCO against methotrexate-induced liver damage and oxidative stress remains unexplored. The study explored the antioxidant and hepatoprotective effects of VCO against oxidative stress and liver damage induced by anticancer drug methotrexate (MTX) in rats.
METHODS: Liver damage was induced in Wistar rats pretreated with dietary supplementation of VCO (5% and 15%) by intraperitoneal administration of MTX (20mg/kg bw) on day 10 only. After 12days of treatment, assays for serum liver biomarkers (aminotransferases), alkaline phosphatase, albumin and total protein as well as hepatic content of malondialdehyde, reduced glutathione and antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase) were carried out. Liver was used to examine histopathological changes.
RESULTS: MTX administration induced significant increase in serum liver enzymes along with marked decrease in albumin and total protein compared to control group. Hepatic activities of antioxidant enzymes were significantly decreased, while malondialdehyde increased significantly. Treatment with VCO supplemented diet prior to MTX administration attenuated MTX-induced liver injury and oxidative stress evidenced by significant improvements in serum liver markers, hepatic antioxidant enzymes and malondialdehyde comparable to control group. Histopathological alterations were prevented and correlated well with the biochemical indices.
CONCLUSION: The study suggests antioxidant and hepatoprotective effects of VCO supplementation against hepatotoxicity and oxidative damage via improving antioxidant defense system in rats. Our findings may have beneficial application in the management of hepatotoxicity associated with MTX cancer chemotherapy.

PMID: 28068634 [PubMed - indexed for MEDLINE]

http://ift.tt/2lZu7e8

Treatment of Lateral Skull Base and Posterior Cranial Fossa Lesions Utilizing the Extended Middle Cranial Fossa Approach.

Treatment of Lateral Skull Base and Posterior Cranial Fossa Lesions Utilizing the Extended Middle Cranial Fossa Approach.

Otol Neurotol. 2017 Feb 23;:

Authors: Roche JP, Goates AJ, Hasan DM, Howard MA, Menezes AH, Hansen MR, Gantz BJ

Abstract
OBJECTIVE: Define the indications and outcomes for subjects undergoing treatment utilizing the extended middle cranial fossa approach (EMCF).
STUDY DESIGN: Retrospective records review.
SETTING: University-based tertiary referral center.
PATIENTS: Subjects undergoing treatment of posterior cranial fossa (PCF) lesions.
INTERVENTION(S): EMCF exposure and treatment of the indicating PCF lesion.
MAIN OUTCOME MEASURE(S): Demographic, audiometric, and cranial nerve functioning variables were assessed.
RESULTS: Thirty-five subjects who underwent an EMCF exposure were identified over a 12-year period. The most common indication was meningioma (18; 51%) followed by schwannomas (six, 17%), and vascular lesions (five, 14%). Preoperative cranial nerve complaints were common (32, 94%) as were objective cranial nerve abnormalities on physical examination (21; 60%). Preoperative audiometric data from subjects with hearing demonstrated good functioning including pure-tone average (PTA) (21.7 ± 15.6 dB HL) and word understanding scores (95.1 ± 7.4%). Most (34, 97%) subjects had intact facial nerve function. The average length of stay was 11.6 days (median = 9). Cranial neuropathies were common postoperatively with 27 (79%) subjects demonstrating some objective cranial nerve dysfunction, the most common of which was trigeminal nerve hypesthesia (21, 61.7%). Subjects with identifiable pre- and postoperative audiometric data and preoperative hearing demonstrated small declines in the four-tone average (16.2 dB) and word recognition scores (22.4%). Two subjects (6%) had new profound hearing loss postoperatively.
CONCLUSIONS: The EMCF approach can provide safe and effective exposure of the anterior PCF.

PMID: 28234787 [PubMed - as supplied by publisher]

http://ift.tt/2msXCCc

Sinonasal imaging findings in granulomatosis with polyangiitis (Wegener granulomatosis): A systematic review.

Sinonasal imaging findings in granulomatosis with polyangiitis (Wegener granulomatosis): A systematic review.

Am J Rhinol Allergy. 2017 Jan 01;31(1):16-21

Authors: D'Anza B, Langford CA, Sindwani R

Abstract
BACKGROUND: Granulomatosis with polyangiitis (GPA) (Wegener granulomatosis) frequently presents in the head and neck, and the sinonasal cavity is among the most common areas affected. Although the clinical findings, histologic appearance, and laboratory workup have been described, characteristic findings and the distribution of disease on sinonasal imaging are not well established. The appropriate imaging modality to evaluate for sinonasal involvement is also unclear.
OBJECTIVE: To describe the imaging characteristics, distribution, and location of sinonasal pathology in patients with GPA as noted on computed tomography and magnetic resonance imaging modalities.
METHODS: A systematic review was conducted of English language articles, by using appropriate search terms, which reported the computed tomography and magnetic resonance imaging findings specific to sinonasal disease in adult subjects with GPA. Studies were included only when they focused primarily on specific imaging results in patients with GPA. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed.
RESULTS: A total of 50 articles were identified on an initial search of medical literature data bases. There were seven articles that comprised 224 patients who met inclusion criteria. All the articles were retrospective case series and descriptive in nature. A high incidence of patients with GPA who were imaged showed evidence of pathologic findings. The prevalence of key radiographic findings in patients with GPA were the following: mucosal thickening (87.7% of patients), bony destruction (59.9%), and septal erosion (59.4%). There were no randomized or prospective studies that compared imaging findings between patients with GPA and the controls, and no studies that correlated imaging findings with prognosis.
CONCLUSION: Sinus imaging in GPA revealed a spectrum of nonspecific findings. The constellation of septal erosion, mucosal thickening, and bony changes should raise suspicion for GPA. The current literature was insufficient to make any comments on the time course of sinonasal disease and imaging manifestations. Further comparative studies are needed to determine a role for sinonasal imaging in the diagnosis and prognosis of GPA.

PMID: 28234146 [PubMed - in process]

http://ift.tt/2msW4Z1

Allergic sensitization does not predispose to sinus inflammation in externalized paranasal sinuses.

Allergic sensitization does not predispose to sinus inflammation in externalized paranasal sinuses.

Am J Rhinol Allergy. 2017 Jan 01;31(1):3-6

Authors: Ahmadi N, Christensen JM, Barham HP, Oakley GM, Sacks R, Harvey RJ

Abstract
BACKGROUND: Chronic rhinosinusitis (CRS) has a multifactorial etiology, with a debate about the role of inhalant allergy in the pathogenesis of CRS.
OBJECTIVE: This study assessed the impact of allergy status on externalized paranasal sinuses after tumor resection to determine if a predisposition to inhalant allergy brought about additional inflammation after sinus surgery.
METHODOLOGY: A case-control study was performed on patients who had no history of CRS who underwent paranasal sinus tumor resection. Allergic sensitization was defined by a positive serum ImmunoCAP test result. Outcomes were measured at least 6 months after surgery by using the modified Lund-MacKay endoscopic score and the 22-item Sino-Nasal Outcome test, with rhinitis, sleep, psychological, ear and/or facial, and sinus subscores to assess the impact of allergy status on mucosal inflammation.
RESULTS: A total of 103 patients (53.44 ± 17.46 years; 46% women) were assessed. Of these, 61.17% were allergically sensitized at the time of surgery. Postsurgery endoscopic assessment was similar [the modified Lund-Mackay endoscopic score allergic sensitized 0.5 (1.7) versus nonallergic sensitized 0.0 (0.9); p = 0.15]. Sinonasal symptoms were also similar between the groups' 22-item Sino-Nasal Outcome test scores, allergic sensitized versus allergic nonsensitized, (allergic 28.9 ± 20.8 versus nonallergic 33.5 ± 19.7; p = 0.31), rhinitis score (5.9 ± 5.5 versus 6.4 ± 4.7; p = 0.66), sleep score (6.9 ± 5.9 versus 7.7 ± 4.8; p = 0.50), ear and/or facial symptom score (3.4 ± 3.6 versus 4.3 ± 3.3; p = 0.22), psychological score (6.9 ± 6.0 versus 8.3 ± 6.7; p = 0.29), and of nasal symptom score (6.4 ± 5.2 versus 7.0 ± 5.3; p = 0.61).
CONCLUSIONS: Externalization of the sinuses in patients with inhalant allergy did not bring about significant additional inflammation in patients after tumor surgery.

PMID: 28234140 [PubMed - in process]

http://ift.tt/2lKnLg0

Multitask box trainer for endoscopic endonasal skull base surgery: ENDOtrainer.

Multitask box trainer for endoscopic endonasal skull base surgery: ENDOtrainer.

World Neurosurg. 2017 Feb 20;:

Authors: Sanromán-Álvarez P, Simal-Julián JA, Miranda-Lloret Pablo

PMID: 28232211 [PubMed - as supplied by publisher]

http://ift.tt/2lKiNQv

Traumatic basilar artery entrapment with patency of pontine perforators and absence of significant brainstem infarction: report of an unusual case.

Traumatic basilar artery entrapment with patency of pontine perforators and absence of significant brainstem infarction: report of an unusual case.

BMJ Case Rep. 2016 Sep 19;2016:

Authors: Kliesch S, Bauknecht C, Bohner G, Liebig T, Siebert E

Abstract
We report a rare case of entrapment of the basilar artery into the sphenoid bone caused by a longitudinal fracture of the clivus. Using high resolution three-dimensional flat panel angiography, we show preservation of the basilar artery perforators in spite of severe stenosis of the entrapped segment of the basilar artery. There were no obvious signs and symptoms of posterior fossa stroke clinically or radiographically as far as could be assessed under given clinical circumstances.

PMID: 27646318 [PubMed - indexed for MEDLINE]

http://ift.tt/2lKrha1

Fifty-four-month survival in a 3-year-old child presenting with an aggressive metastatic dedifferentiated clival chordoma.

Fifty-four-month survival in a 3-year-old child presenting with an aggressive metastatic dedifferentiated clival chordoma.

BMJ Case Rep. 2016 Jun 09;2016:

Authors: Kearns C, Kearns C

Abstract
Dedifferentiated chordoma is a rare, aggressive, chemoresistant and radioresistant malignancy arising from notochord remnants that can occur anywhere along the spine. Incidence in patients under 20 years of age is 1 per 250 million. We report a case of dedifferentiated clival chordoma presenting in a 3-year-old boy with pulmonary metastasis, which responded unusually well to chemotherapy, achieving complete metastatic clearance and debulking of the primary tumour. Proton beam therapy achieved further tumour control, with excellent quality of life for multiple years. On disease relapse, an atypical lateral transcondylar surgical approach achieved complete macroscopic clearance but there was cutaneous seeding. This, and continued primary site activity, failed to be controlled with targeted therapy, traditional chemotherapy and photon radiation, resulting in gradual neurological decline and death. Intensive management resulted in above-average survival despite diagnosis late in the disease course, which may be of value directing investigation into optimal management.

PMID: 27284102 [PubMed - indexed for MEDLINE]

http://ift.tt/2l0Ew9J

Standard of Open Surgical Repair of Suprapubic Incisional Hernias.

Standard of Open Surgical Repair of Suprapubic Incisional Hernias.

World J Surg. 2017 Feb 23;:

Authors: Renard Y, Simonneau AC, de Mestier L, Teuma L, Meffert JL, Palot JP, Kianmanesh R

Abstract
BACKGROUND: Suprapubic incisional hernias (SIH) are a rare wall defect, whose surgical management is challenging because of limited literature. The proximity of the hernia to bone, vascular, nerve, and urinary structures, and the absence of posterior rectus sheath in this location imply adequate technique of surgical repair. We aimed to describe a cohort of female patients operated on for SIH after gynecological surgery using a homogeneous surgical technique and to report surgical outcomes.
METHODS: The records of all consecutive patients operated on for SIH in a specialized surgical center between January 2009 and January 2015 were retrospectively reviewed. The same open technique was performed, i.e., using a mesh placed inferiorly in the preperitoneal space of Retzius, with large overlap, and fixed on the Cooper's ligaments, through the muscles superiorly and laterally with strong tension, in a sublay or underlay position.
RESULTS: The cohort included 71 female patients. SIH were recurrent in 31% of patients and was related to cesarean in 32 patients (45.1%) and to gynecologic surgery in 39 patients (54.9%). The mesh was totally extraperitoneal in 76.1% of patients. The postoperative mortality rate was null. The rate of specific surgical complications was 29.6%. After a median follow-up of 30.3 months, the recurrence rate was 7%.
CONCLUSION: The open approach for SIH repair was safe and efficient. Due to the paucity of adequate scientific studies, this reproducible open method could help moving toward a standardization of SIH surgical management.

PMID: 28233064 [PubMed - as supplied by publisher]

http://ift.tt/2mAiwyu

Derivation and Validation of a Novel Physiological Emergency Surgery Acuity Score (PESAS).

Derivation and Validation of a Novel Physiological Emergency Surgery Acuity Score (PESAS).

World J Surg. 2017 Feb 23;:

Authors: Sangji NF, Bohnen JD, Ramly EP, Velmahos GC, Chang DC, Kaafarani HM

Abstract
BACKGROUND: We present a novel and abbreviated Physiological Emergency Surgery Acuity Score (PESAS) that assesses the severity of disease at presentation in patients undergoing Emergency Surgery (ES).
METHODS: Using the 2011 ACS-NSQIP database, we identified all patients who underwent "emergent" surgery. The following methodology was designed: (1) identification of independent predictors of 30-day mortality that are markers of acuity; (2) derivation of PESAS based on the relative impact (i.e., odds ratio) of each predictor; and (3) measurement of the c-statistic. The PESAS was validated using the 2012 ACS-NSQIP database.
RESULTS: From 24,702 ES cases, a 15-point score was derived. This included 10 components with a range of 0 and 15 points. Its c-statistic was 0.80. Mortality gradually increased from 1.7 to 40.6 to 100% at scores of 0, 8, and 15, respectively. In the validation phase, PESAS c-statistic remained stable.
CONCLUSION: PESAS is a novel score that assesses the acuity of disease at presentation in ES patients and strongly correlates with postoperative mortality risk. PESAS could prove useful for preoperative counseling and for risk-adjusted benchmarking.

PMID: 28233063 [PubMed - as supplied by publisher]

http://ift.tt/2mzZHeS

Chemical constituents from Melicope pteleifolia leaves.

Chemical constituents from Melicope pteleifolia leaves.

Phytochemistry. 2016 Oct;130:291-300

Authors: Nguyen NH, Ha TK, Choi S, Eum S, Lee CH, Bach TT, Chinh VT, Oh WK

Abstract
Five acetophenones bearing spiroketal-hexofuranoside rings, one di-C-glycosidic acetophenone and two benzopyrans, along with 16 known compounds were isolated from the leaves of Melicope pteleifolia. Structures of all the isolates were elucidated using extensive spectroscopic methods, including 1D, 2D-NMR and HRESIMS. All the isolates were also evaluated for their neuraminidase inhibitory activities against H1N1, H9N2, wild-type H1N1 and oseltamivir-resistant H1N1 (H274Y mutation) virus strains. Of the isolates, tamarixetin 3-robinobioside was found to exhibit the strongest enzymatic inhibition (IC50 24.93 ± 3.46, 23.19 ± 5.41, 26.67 ± 5.16 and 40.16 ± 4.50 μM, respectively). Selected candidates, kaempferol 3-robinobioside, kaempferol 3-O-β-d-glucopyranosyl (1 → 2)-α-d-xylopyranoside and tamarixetin 3-robinobioside, also showed moderate reductions in H1N1-induced cytopathic effects on MDCK cells.

PMID: 27374481 [PubMed - indexed for MEDLINE]

http://ift.tt/2msQVQG

Effectiveness of 23-valent pneumococcal polysaccharide vaccine on diabetic elderly.

http:--pt.wkhealth.com-pt-pt-core-templa

Effectiveness of 23-valent pneumococcal polysaccharide vaccine on diabetic elderly.

Medicine (Baltimore). 2016 Jun;95(26):e4064

Authors: Kuo CS, Lu CW, Chang YK, Yang KC, Hung SH, Yang MC, Chang HH, Huang CT, Hsu CC, Huang KC

Abstract
Diabetes mellitus is associated with increased risk of pneumonia, and 23-valent pneumococcal polysaccharide vaccine (PPV23) is recommended for prevention of pneumonia. However, the effectiveness of PPV23 remains unclear in the older diabetic patients who usually have compromised immune function.We used data extracted from the Taiwanese National Health Insurance Research Database (NHIRD) from 2000 to 2009 to conduct a population-based retrospective cohort study, comparing the incidence of pneumococcal diseases among PPV23-vaccinated and propensity-score matched PPV23-unvaccinated groups in diabetic elderly. The primary outcome was invasive pneumococcal diseases (IPDs), and the secondary outcomes were medical utilization.PPV23-vaccinated group had reduced risks of IPD (adjusted OR: 0.86, 95% CI: 0.78-0.94), respiratory failure (0.84, 0.77-0.93), and shorter length of hospitalization (-1.27 ± 0.19 days, P value: 0.0012). In flu-vaccinated group, subjects who received PPV23 had reduced risks of IPD, hospitalization, and respiratory failure; had shorter lengths of hospitalization; and less medical costs, than those without receiving PPV23. In not flu-vaccinated group, PPV23 vaccination was associated with reduced risks of IPD and respiratory failure. Receiving both vaccines could bring better protection in IPD, hospitalization, visits of emergency department, and respiratory failure.PPV23 vaccination was effective in prevention of pneumococcal diseases and reduction of medical utilization in diabetic elderly aged 75 and more. Receiving both vaccines resulted in better outcomes than PPV vaccination alone.

PMID: 27368047 [PubMed - indexed for MEDLINE]

http://ift.tt/2lV87jX

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Κυριακή 26 Φεβρουαρίου 2017

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