Structural and optical properties of Mn0.5Zn0.5Fe2O4 nano ferrites: Effect of sintering temperature

Publication date: 1 June 2017
Source:Materials Chemistry and Physics, Volume 193
Author(s): Prashant Thakur, Rohit Sharma, Vineet Sharma, Pankaj Sharma
Mn-Zn ferrites have shown various remarkable applications e.g. in magnetic amplifiers, power transformers and electromagnetic interference etc. due to their high initial permeability. Mn–Zn ferrite powder (Mn0.5Zn0.5Fe2O4) has been prepared by the co-precipitation method and subsequently sintered at three different temperatures i.e. 973 K, 1173 K, 1373 K. Optical properties have been correlated with the structural properties. For structural properties X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM) and Fourier transform infrared spectroscopy (FTIR) have been employed. It has been observed that there is an increase in crystallite size with sintering from 973 K to 1373 K and FTIR confirms the formation of bond between metal ion and oxygen ion at the octahedral site and tetrahedral site. A red shift has been confirmed from UV–visible absorption spectra and photoluminescence spectra have been reported with an increase in sintering temperature.

Graphical abstract

http://ift.tt/2mhq38x

Acute Zonal Occult Outer Retinopathy Associated With Retrobulbar Optic Neuritis.

A 17-year-old girl presented with unilateral retrobulbar optic neuritis as well as bilateral funduscopic findings and outer retinal dysfunction suggestive of acute zonal occult outer retinopathy (AZOOR). Fundus autofluorescence abnormalities, visual field loss, and electroretinographic changes were supportive of bilateral AZOOR. MRI was consistent with the diagnosis of clinically isolated syndrome (CIS), which is defined as a central nervous system demyelinating event that may herald the onset of multiple sclerosis (MS). While AZOOR previously has been linked to MS and demyelinating white matter lesions in the brain, our case seems unique due to concurrent development of AZOOR and retrobulbar optic neuritis as a CIS. (C) 2017 by North American Neuro-Ophthalmology Society

http://ift.tt/2m1EwVR

Reducing aggression with martial arts: A meta-analysis of child and youth studies

Publication date: Available online 3 March 2017
Source:Aggression and Violent Behavior
Author(s): Anna Harwood, Michal Lavidor, Yuri Rassovsky
Martial arts are becoming a mainstream sport for energetic youth and their popularity extends globally. Following a comprehensive search of martial arts research, a critical review of the field and the psychological implications was conducted. The resulting meta-analysis examined the effect of martial arts on problematic externalizing behavior (aggression, anger, and violence). The final meta-analysis included twelve studies, with 507 participants (ages 6 to 18), where study type was a moderator. For nine intervention and longitudinal studies, there was a homogenous effect size of 0.65 (95% CI: 0.11, 1.03) indicating a medium effect, where martial arts improved aggression amongst the practicing youth. The other three one-time comparisons studies did not yield a homogenous effect size. Based on these analyses, it appears that martial arts has a potential to reduce externalizing behaviors in youth, although further research is needed to determine the mechanisms of change and specify the most relevant population groups for targeted interventions.



http://ift.tt/2m2qSzU

The Effects of Different Exercise Training Modalities on Plasma Proenkephalin Peptide F in Women

Publication date: Available online 3 March 2017
Source:Peptides
Author(s): William H. DuPont, William J. Kraemer, Bradley C. Nindl, Elaine C. Lee, Maren S. Fragala, Disa L. Hatfield, Lydia K. Caldwell, Emily M. Post, Matthew K. Beeler, Jeff S. Volek, Carl M. Maresh
Due to the important interactions of proenkephalin fragments (e.g., proenkephalin [107–140] Peptide F) to enhance activation of immune cells and potentially combat pain associated with exercise-induced muscle tissue damage, we examined the differential plasma responses of Peptide F to different exercise training programs. Participants were tested pre-training (T1), and after 8 weeks (T2) of training. Fifty-nine healthy women were matched and then randomly assigned to one of four groups: heavy resistance strength training (STR, n=18), high intensity endurance training (END, n=14), combined strength and endurance training (CMB, n=17), or control (CON, n=10). Blood was collected using a cannula inserted into a superficial vein in the antecubital fossa with samples collected at rest and immediately after an acute bout of 6 X 10 RM in a squat resistance exercise before training and after training. Prior to any training, no significant differences were observed for any of the groups before or after acute exercise. With training, significant (P≤0.95) elevations were observed with acute exercise in each of the exercise training groups and this effect was significantly greater in the CMB group. These data indicate that in untrained women exercise training will not change resting of plasma Peptide F concentrations but will result in significant increases in the immediate post-exercise responses. Such findings appear to indicate adrenal medullary adaptations opioid production significantly altered with exercise training.



http://ift.tt/2lGddh6

Management of elderly patients with early-stage medically inoperable endometrial cancer: Systematic review and National Cancer Database analysis

Publication date: Available online 3 March 2017
Source:Brachytherapy
Author(s): Sunil W. Dutta, Daniel M. Trifiletti, Surbhi Grover, Pamela Boimel, Timothy N. Showalter
PurposeTo evaluate the effectiveness of radiation therapy among elderly patients who are deemed medically inoperable.Methods and MaterialsWe searched PubMed to identify studies from the past 25 years that reported outcomes of medically inoperable endometrial cancer patients treated with radiation alone. The National Cancer Database (NCDB) was queried to identify patients 65 years and older with Stage I–II medically inoperable endometrial cancer. Univariable and multivariable models were performed to investigate the impact of prognostic factors on overall survival.ResultsThirteen papers met inclusion criteria for the systematic review. Overall survival for Stage I tumors at 5 years was 30–95%. Reported pelvic control for the 888 total patients with Stage I tumors was 80–100% and 61–89% for Stage II. Late complications for all patients treated ranged from 0% to 21% across patients. The NCDB analysis demonstrated that any radiotherapy was associated with improved survival over no local therapy. Combination therapy (external beam radiation therapy + brachytherapy) was associated with the most favorable survival with a hazard ratio (HR) of 0.442 (p < 0.001 over no radiotherapy), although benefits were also seen with external beam radiation therapy alone (HR 0.694, p < 0.001) and with brachytherapy alone (HR 0.499, p < 0.001) compared to no radiotherapy.ConclusionsThe available evidence suggests high rates of local control after radiation therapy for elderly women with Stage I–II medically inoperable endometrial cancer. Our analysis of the NCDB suggests that radiation therapy improves survival, and combination therapy provides the most favorable outcomes. Given a relatively favorable toxicity profile, definitive radiation therapy should be considered a preferred approach for patients with medically inoperable endometrial cancer.



http://ift.tt/2lAAP5W

Brachytherapy as part of the conservative treatment for primary and recurrent vulvar carcinoma

Publication date: Available online 3 March 2017
Source:Brachytherapy
Author(s): P. Castelnau-Marchand, A. Escande, R. Mazeron, E. Bentivegna, A. Cavalcanti, S. Gouy, C. Baratiny, P. Maroun, P. Morice, C. Haie-Meder, C. Chargari
PurposeThere are only scarce data on the place of brachytherapy (BT) for treatment of vulvar carcinoma. Our institutional experience of interstitial BT for vulvar carcinoma patients is reported.Methods and MaterialsClinical records of patients receiving low-dose-rate or pulsed-dose-rate BT as part of the primary treatment for primary/recurrent vulvar squamous cell carcinoma or as part of postoperative treatment between 2000 and 2015 were included. Patients, tumors, and treatment characteristics as well as clinical outcome were examined.ResultsA total of 26 patients treated with BT were identified. BT was delivered as part of primary intent treatment for locally advanced/recurrent cancer in 11 patients and as part of postoperative treatment in 15 patients. Median age at time of BT was 63 years (range, 41–88 years). Pulsed-dose-rate and low-dose-rate were used in 15 patients and 11 patients, respectively. BT was performed as a boost to the tumor bed following external beam radiotherapy (n = 13) or as the sole irradiation modality (n = 13). Total median dose at the level of primary tumor was 60 GyEQD2 (range, 55–60 GyEQD2). With mean followup of 41 months (range, 5 months–11.3 years), 11 patients experienced tumor relapse, and in two of them, site of relapse was only local. Three-year estimated disease-free survival and overall survival rates were 57% (95% confidence interval: 45–69%) and 81% (95% confidence interval: 72–90%), respectively. All toxicities were Grade 2 or less.ConclusionsInterstitial BT used as part of the primary or postoperative treatment of vulvar carcinoma is feasible with a satisfactory toxicity profile. Prognosis remains, however, dismal, with a high frequency of failures in patients with locally advanced tumors.



http://ift.tt/2mhjrad

Occupational mycosis fungoides – a case series

Abstract

Background

Mycosis fungoides (MF) is the most frequent type of cutaneous T-cell lymphoma. MF has long been considered to develop as the result of a combination of genetic defects and exogenous triggers. Although no specific MF-associated environmental trigger has been established to date, some studies have suggested that occupational exposures may occasionally trigger the onset of MF.

Objective

In this observational study, we aimed at underscoring the potential association between occupational exposure and MF.

Methods

We ascertained a cohort of 150 MF patients for possible occupational exposure.

Results

Five MF patients with occupational exposure were identified in our cohort. Three patients had intensive contact with aromatic hydrocarbons; two of them were working in the same plant and in the same unit for more than 30 years. The third patient had been in contact with aromatic hydrocarbons for a total of 8 years. Patient 4 had additional contact for 12 years with hydrazine, and patient 5 had been exposed for 3 years to formaldehyde.

Conclusion

The clustering of two cases of MF, an exceptionally rare disease, in the same plant unit, as well as the long-term, intense occupational exposure in other cases, substantiates the notion that occupational exposures may contribute to the pathogenesis of MF.

http://ift.tt/2lG0cnO

Oral lichen planus in childhood: a case series

Abstract

Background

Although the exact incidence of pediatric oral lichen planus (OLP) is unknown, the oral mucosa seems to be less commonly involved, and the clinical presentation is often atypical. The aim of the study is to present a case series of OLP in childhood.

Methods

From our database, we retrospectively selected and analyzed the clinical data of OLP patients under the age of 18 where the diagnosis had been confirmed by histopathological analysis.

Results

The case series from our database shows eight patients, four males and four females. The mean (±SD) age at the time of diagnosis of the disease was 13.5 (±2.73) years, ranging in age from 9 to 17. Clinically, a reticular pattern was present in six patients (75%), and the tongue was the most commonly involved oral site (six cases, 75%). We also report the first case of OLP in a 9-year-old girl affected by autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy.

Conclusions

We report the largest case series of pediatric OLP published in literature thus far. Differences in the disease between adults and pediatric patients have been detected, but further investigation and a larger case series are needed to establish any detailed differences in clinical outcomes.

http://ift.tt/2lkXZSu

An unusual case of multiple cutaneous Rosai-Dorfman disease involving two separate parts of the body

http://ift.tt/2lFZpmK

Blood-Brain Barrier Disruption was less under Isoflurane than Pentobarbital Anesthesia

http://otorhinolarygology.blogspot.com/2017/03/blood-brain-barrier-disruption-was-less.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Comparison of heater probe coagulation and argon plasma coagulation in the management of Mallory–Weiss tears and high-risk ulcer bleeding

Publication date: Available online 3 March 2017
Source:Arab Journal of Gastroenterology
Author(s): Mete Akin, Erhan Alkan, Yasar Tuna, Tolga Yalcinkaya, Bulent Yildirim
Background and study aimsUpper gastrointestinal (GI) bleeding is a common medical emergency. Endoscopic treatments often lead to better therapeutic outcomes than conventional conservative treatments. This study aimed to investigate and compare the use of heater probe coagulation (HPC) and argon plasma coagulation (APC) together with epinephrine injection for the treatment of Mallory–Weiss tears and high-risk ulcer bleeding.Patients and methodsA total of 97 patients (54 in the HPC group and 43 in the APC group) who were diagnosed with upper GI bleeding secondary to a Mallory–Weiss tear or high-risk gastric or duodenal ulcers were included in the study. Lesions were classified according to the Forrest classification. The HPC and APC groups were compared in terms of initial haemostasis, re-bleeding in the early period, need for surgery, average need for transfusion, and duration of hospital stay.ResultsThere were no significant differences between the HPC and APC groups in terms of ensuring initial haemostasis (98% vs. 97.5%, p>0.05), re-bleeding rates (17% vs. 19%, p>0.05), need for surgery (2% vs. 9%, p>0.05), average need for transfusion (3.7±2.11 vs. 3.4±2.95 units, p>0.05), and average duration of hospital stay (4.6±2.24vs. 5.3±3.23days, p>0.05).ConclusionThere was no difference between HPC and APC when used together with epinephrine injection for the treatment of Mallory–Weiss tear and high-risk ulcer bleeding.



http://ift.tt/2mh8up6

Non-invasive assessment of liver fibrosis in patients with hepatitis C: Shear wave elastography and colour Doppler velocity profile technique versus liver biopsy

Publication date: Available online 3 March 2017
Source:Arab Journal of Gastroenterology
Author(s): Ehab F. Moustafa, Nahed Makhlouf, Sahar M. Hassany, Ahmed Helmy, Ahmed Nasr, Moustafa Othman, Hany Seif, Manal Darwish, Howayda Hassan, Mohamed Hessen
Background and study aimsDetermination of the presence and degree of liver fibrosis is essential for the prognosis and treatment of patients with chronic hepatitis C. Non-invasive methods of assessing fibrosis have been developed to reduce the need for biopsy. We determined the efficacy of shear wave elastography (SWE) and colour Doppler velocity as non-invasive methods for the assessment of liver fibrosis compared to liver biopsy among patients with chronic hepatitis C virus (HCV) infection.Patients and methodsIn total, 117 patients with chronic HCV infection and 50 healthy age- and sex-matched control subjects were included. For each patient and control, abdominal ultrasonography, Doppler ultrasonography of the right portal vein (PV), and SWE were performed, whereas liver biopsy was performed for patients.ResultsThe mean value of the right PV maximum velocity was lower in patients with different stages of fibrosis than in controls (p<0.001). The mean value of liver stiffness determined by SWE was significantly higher in patients with different stages of fibrosis than in controls. Cutoff values for liver stiffness determined by SWE for assessing fibrosis stages were F2⩾4.815, F3⩾6.335, and F4=7.540 with a sensitivity of 84.6%, 96.2%, and 100.0%; specificity of 88.5%, 93.8%, and 100.0%; positive predictive value (PPV) of 93.6%, 98.0%, and 100.0%; negative predictive value (NPV) of 74.2%, 88.2%, and 100.0%; and overall accuracy of 85.9%, 95.6%, and 100.0% [area under the ROC curve (AUC): 0.89, 0.96, and 1.0], respectively. Cutoff values for the right PV maximum velocity for assessing fibrosis stages were F2<23.4, F3<21, and F4<20 with a sensitivity of 65.0%, 57.4%, and 57.1%; specificity of 59.8%, 76.4%, and 75.5%; PPV of 33.8%, 58.3%, and 32.0%; NPV of 84.4%, 75.7%, and 89.7%; and overall accuracy of 61.1%, 69.5%, and 72.5% (AUC: 0.614, 0.696, and 0.625), respectively.ConclusionSWE is effective for the non-invasive assessment of liver fibrosis in patients with HCV infection. SWE provides a more accurate correlation with liver fibrosis stage than colour Doppler velocity profile for the assessment of liver fibrosis, especially in advanced stages (F3 and F4).



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Radiotherapy of nasopharyngeal cancer using Rapidarc: dosimetric study

http://otorhinolarygology.blogspot.com/2017/03/radiotherapy-of-nasopharyngeal-cancer.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Middle Ear Obliteration with Blind-Sac Closure of the External Auditory Canal for Spontaneous CSF Otorrhea.

Middle Ear Obliteration with Blind-Sac Closure of the External Auditory Canal for Spontaneous CSF Otorrhea.

Otolaryngol Head Neck Surg. 2017 Mar;156(3):534-542

Authors: Stevens SM, Crane R, Pensak ML, Samy RN

Abstract
Outcome Objectives To (1) identify unique features of patients who underwent middle ear/mastoid obliteration with blind-sac closure of the external auditory canal for spontaneous cerebrospinal fluid (CSF) otorrhea and (2) explore outcomes. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods Adults treated for spontaneous cerebrospinal fluid otorrhea from 2007 through 2015 were reviewed and stratified into 2 groups based on the surgery performed: (1) 11 patients underwent middle ear/mastoid obliteration with blind-sac closure of the external auditory canal and (2) 26 patients underwent other procedures. Demographics, body mass index, revised cardiac risk index, Duke Activity Status Index scores, and anticoagulation use were documented. Audiologic data were gathered from pre- and postoperative visits. The primary outcome measure was leak recurrence. Complications were tabulated. Results Poor preoperative hearing was a relative indication for obliteration. Obliteration patients had higher body mass index (43.2 vs 34.9 kg/m2; P < .05), incidence of super-morbid obesity (45% vs 7.6%; P = .015), anticoagulation usage (36% vs 0%; P = .004), cardiac risk scores (1.2 vs 0.1 dB; P < .0004), and Duke Activity Status Index scores. There was 1 leak recurrence (9%). Major and minor complication rates were 9% and 36%, respectively. Mean follow-up was 30.8 ± 8.6 months. Conclusion Middle ear and mastoid obliteration with blind-sac closure of the external auditory canal is effective for treating spontaneous CSF otorrhea. The small cohort reviewed did not experience any major perioperative morbidity. The technique may be best suited for patients with poor hearing, the infirm, and those in whom craniotomy is contraindicated.

PMID: 28248604 [PubMed - in process]

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Histopathological Assessment of OASIS Ultra on critical sized wound healing: a pilot study

Abstract

Background

Dermatopathologists assess wounds secondary to trauma, infection, or oncologic resection that can be challenging to reconstruct. OASIS® Ultra, an extracellular matrix, has been described for use in chronic and burn wounds. The aim of this pilot study is to assess wound healing in post-traumatic and infective wounds treated with OASIS using histological markers of repair.

Methods

Adults with traumatic, infective or iatrogenic wound defects with size precluding primary closure were eligible. Half the wound was randomly assigned to receive OASIS plus standard therapy; the other half received standard of care (SOC) therapy. During dressing changes, standardized-scale photographs were taken and biopsies obtained. Histologic sections were reviewed for degree of acute inflammation and extent of tissue repair. Neutrophils, edema, hemorrhage, necrosis, fibroblasts, collagen density, and neovascularization were semiquantitatively assessed.

Results

Forty-four skin biopsies from seven patients with ten acute wounds met eligibility criteria. Histologically, OASIS samples demonstrated improved acute inflammation scores compared to SOC. No patients experienced OASIS related complications. OASIS-treated wound halves trended toward more wound contraction and improved tissue repair.

Conclusions

Our scoring system aids histopathological wound assessment. Treatment of critical-sized, post-traumatic, acute wounds with OASIS resulted in decreased inflammation, and potentially more advanced wound healing, compared to SOC.

http://ift.tt/KkipBP registration number: NCT01848821

http://ift.tt/2mRTdIC

Automated segmentation of MR imaging to determine normative central nervous system cerebrospinal fluid volumes in healthy volunteers

Publication date: Available online 2 March 2017
Source:Clinical Imaging
Author(s): J. Levi Chazen, Jonathan P. Dyke, Robert W. Holt, Laura Horky, Rachel A. Pauplis, Jacob Y. Hesterman, P. David Mozley, Ajay Verma
An accurate non-invasive method to determine total body cerebrospinal fluid volume has a number of potential diagnostic and therapeutic applications. Herein we describe a technique for automated segmentation of total body MRI data to determine cranial and spinal CSF volume in 15 healthy adults. These in vivo estimates of CSF volume exceed the standard reported volume of 150mL in human adults and provide normative data for diagnosis of disease states such as hydrocephalus and therapy including pharmacologic dosimetry. No correlation was observed between patient height or weight and total body CSF volume.



http://ift.tt/2lkHxBG

Prevalence of acne vulgaris and its impact of the quality of life among secondary school-aged adolescents in Sohag Province, Upper Egypt

Summary

Background

Acne vulgaris is the most common dermatological condition encountered in adolescents.

Aim

It was to determine the prevalence of acne vulgaris and its impact of the quality of life among adolescents attending secondary schools in Sohag Province, Upper Egypt.

Patients and methods

This was a cross-sectional study conducted in randomly selected governmental and technical secondary schools in Sohag Province, Upper Egypt. Approval was taken from the scientific research committee of Sohag Faculty of Medicine and also from Ministry of Education. Every student with acne was subjected to full medical history and local examination of head and neck to assess the severity of acne vulgaris. Assessment of the impact of acne vulgaris on their quality of life was carried out using self-reported validated specific questionnaire, the Cardiff Acne Disability Index (CADI).

Results

This study included 994 teenage secondary school students. The overall prevalence of acne vulgaris was 333 (33.5%). The mean age of the students with acne was 16.84±0.87. Acne vulgaris was more common among females than among males (200, 60% vs 133, 40%). The most common form of acne vulgaris was mild 178, 53%, followed by moderate form 135, 41%, and severe form 20, 6%. CADI score was significantly related to the disease grade and it was maximum among those with severe grade, followed by moderate and lastly mild disease grade.

Conclusion

Acne vulgaris is a common skin disease and has a valuable impact on quality of life among adolescents attending secondary schools in Sohag Province, Upper Egypt.

http://ift.tt/2lAeaGM

Citrus flavanones mildly interfere with pituitary-thyroid axis in old-aged male rats

Publication date: Available online 3 March 2017
Source:Acta Histochemica
Author(s): Marko Miler, Ivana Jarić, Jasmina Živanović, Vladimir Ajdžanović, Nasta Tanić, Verica Milošević, Branka Šošić-Jurjević
Citrus flavanones naringenin (NAR) and hesperetin (HES) are potent antioxidants that may contribute to maintenance of health at old age by improving cardiovascular and metabolic status. However, they may also affect thyroid hormone economy. Keeping in mind impaired thyroid function at older age, in this study we tested wheather NAR or HES administration potentiate this decline. NAR or HES were administrated orally (15mg/kg) to male 24-month-old Wistar rats during 4 weeks. Control groups received vehicle, sunflower oil. Qualitative and quantitative immunohistochemical and immunofluorescent expression of specific proteins and stereological analyses of thyroid tissue were performed. Thyroid stimulating hormone (TSH) and total thyroxine (T4) concentrations were measured in serum. Thyroid parenchyma of both flavanone-treated groups was characterized by lower (p<0.05) absolute and relative volume of luminal colloid, accompanied by elevated (p<0.05) relative volume of stroma in comparison with the controls. No hypertrophy or absolute thyroid volume change was detected. Intensity of immunopositive signal for thyroglobulin (Tg) and T4 bound to Tg (T4-Tg) increased (p<0.05) in the colloid of thyroid follicles after both flavanone treatments. Serum TSH increased (p<0.05) after NAR, while T4 remained unchanged after both treatments. In conclusion, NAR elevated serum TSH in old-aged males, thus being more potent than HES in altering pituitary-thyroid axis. However, changes in thyroid structure, namely moderate colloid depletion and higher Tg and T4-Tg protein expressions after both treatments, indicate preserved capacity of the gland to compensate flavanone interfering, and maintain T4 production in old-aged males.



http://ift.tt/2myWsIS

Immunohistochemical response in rats of beta-tricalcium phosphate (TCP) with or without BMP-2 in the production of collagen matrix critical defects

Publication date: Available online 3 March 2017
Source:Acta Histochemica
Author(s): Eloá Rodrigues Luvizuto, Júlio César Silva de Oliveira, Pedro Henrique Silva Gomes-Ferreira, Cassiano Costa Silva Pereira, Leonardo Perez Faverani, Cristina Antoniali, Roberta Okamoto
This study aimed to assess the biological response of BMP-2 (bone morphogenetic protein-2) in supplementation with β-tricalcium phosphate (TCP) as a carrier in the bone healing of surgical defects in rats' calvaria. A critical-size defect (5mm in diameter) was filled with β-TCP alone or added with that plus 5mg of BMP-2 at 5, 15, and 30 postoperative days. Histomorphometric and immunohistochemical (osteocalcin, collagen type I, and metalloproteinase-9) analysis was performed to assess the features of bone healing. Histological behavior and collagen type I labeling showed increased formation of the collagen matrix, leading to a higher percentage of newly formed bone and biomaterial for tissue and more total mineralization of pure TCP when compared to the other groups. The supplementation with BMP-2 promoted faster TCP remodeling; however, there was no statistically significant difference for the bone formed in both groups (P>0.05). Collagen-matrix formation and new bone formation reached maximum levels when the defects were filled with pure TCP, even exceeding the levels from BMP-2 supplementation.



http://ift.tt/2m26v63

Prevalence of acne vulgaris and its impact of the quality of life among secondary school-aged adolescents in Sohag Province, Upper Egypt

Summary

Background

Acne vulgaris is the most common dermatological condition encountered in adolescents.

Aim

It was to determine the prevalence of acne vulgaris and its impact of the quality of life among adolescents attending secondary schools in Sohag Province, Upper Egypt.

Patients and methods

This was a cross-sectional study conducted in randomly selected governmental and technical secondary schools in Sohag Province, Upper Egypt. Approval was taken from the scientific research committee of Sohag Faculty of Medicine and also from Ministry of Education. Every student with acne was subjected to full medical history and local examination of head and neck to assess the severity of acne vulgaris. Assessment of the impact of acne vulgaris on their quality of life was carried out using self-reported validated specific questionnaire, the Cardiff Acne Disability Index (CADI).

Results

This study included 994 teenage secondary school students. The overall prevalence of acne vulgaris was 333 (33.5%). The mean age of the students with acne was 16.84±0.87. Acne vulgaris was more common among females than among males (200, 60% vs 133, 40%). The most common form of acne vulgaris was mild 178, 53%, followed by moderate form 135, 41%, and severe form 20, 6%. CADI score was significantly related to the disease grade and it was maximum among those with severe grade, followed by moderate and lastly mild disease grade.

Conclusion

Acne vulgaris is a common skin disease and has a valuable impact on quality of life among adolescents attending secondary schools in Sohag Province, Upper Egypt.

http://ift.tt/2lAeaGM

A Clinically Meaningful Interpretation of the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) Scintigraphic Data

Publication date: Available online 2 March 2017
Source:Academic Radiology
Author(s): Paul Cronin, Ben A. Dwamena
Rationale and ObjectivesPulmonary embolism (PE) is a common condition associated with significant morbidity and mortality. Diagnostic test characteristics reported in terms of sensitivity and specificity are difficult to translate at the clinical level. More relevant measures are likelihood ratios (LRs), which can convert a pretest into a posttest probability. The aim of our study was to calculate the LRs and posttest probabilities for multiple-level test result for ventilation/perfusion (V/Q) lung scintigraphy and for perfusion scintigraphy combined with chest radiography using modified Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) II and the Prospective Investigative Study of Pulmonary Embolism Diagnosis (PISAPED) criteria for each clinical probability level for the most commonly used clinical prediction rules (CPR) using the PIOPED data.Materials and MethodsPE pretest probability was estimated for the most commonly used CPRs (Wells, Geneva, Miniati, and Charlotte) at each clinical probability level (two-, three-, and four-level). Multiple-level LRs (high, indeterminate, low, very low probability, and normal) and the positive, indeterminate, and negative results for V/Q scintigraphy, and the positive, indeterminate, and negative results for perfusion scintigraphy were generated and used to calculate posttest probabilities based on the sensitivity and specificity data from PIOPED for each clinical probability level (low, intermediate, and high) for each CPR. Nomograms were also created.ResultsThe LRs for a positive V/Q and perfusion scintigraphy test using modified PIOPED II and PISAPED criteria were 20.6, 11, and 23.7, and for a negative test result were 0.15, 0.16, and 0.2, respectively. In the three-level Wells score, the posttest probability for an initial low clinical probability PE for a positive, indeterminate, and negative test result, respectively, for V/Q scintigraphy is 56, 5, and 0.9; for perfusion scintigraphy with modified PIOPED 40, 7, and 0.9, and with PISAPED 59, not available (N/A), and 1.2; for an initial moderate clinical probability PE for V/Q scintigraphy 86, .22, and 4; for perfusion scintigraphy with modified PIOPED 77, 26, and 5, and with PISAPED 88, N/A, and 6; for an initial high clinical probability of PE for V/Q scintigraphy 95, 48, and 13; and for perfusion scintigraphy with modified PIOPED 92, 53, and 13, and with PISAPED 96, N/A, and 16.ConclusionsWith LRs >10, a positive test result for V/Q and perfusion scintigraphy can confirm the presence of PE. Only a normal test result has low enough LR to exclude PE.



http://ift.tt/2mkmQWa

Estimation of Observer Performance for Reduced Radiation Dose Levels in CT

Publication date: Available online 2 March 2017
Source:Academic Radiology
Author(s): Joel G. Fletcher, Lifeng Yu, Jeff L. Fidler, David L. Levin, David R. DeLone, David M. Hough, Naoki Takahashi, Sudhakar K. Venkatesh, Anne-Marie G. Sykes, Darin White, Rebecca M. Lindell, Amy L. Kotsenas, Norbert G. Campeau, Vance T. Lehman, Adam C. Bartley, Shuai Leng, David R. Holmes, Alicia Y. Toledano, Rickey E. Carter, Cynthia H. McCollough
Rationale and ObjectivesThis study aims to estimate observer performance for a range of dose levels for common computed tomography (CT) examinations (detection of liver metastases or pulmonary nodules, and cause of neurologic deficit) to prioritize noninferior dose levels for further analysis.Materials and MethodsUsing CT data from 131 examinations (abdominal CT, 44; chest CT, 44; head CT, 43), CT images corresponding to 4%–100% of the routine clinical dose were reconstructed with filtered back projection or iterative reconstruction. Radiologists evaluated CT images, marking specified targets, providing confidence scores, and grading image quality. Noninferiority was assessed using reference standards, reader agreement rules, and jackknife alternative free-response receiver operating characteristic figures of merit. Reader agreement required that a majority of readers at lower dose identify target lesions seen by the majority of readers at routine dose.ResultsReader agreement identified dose levels lower than 50% and 4% to have inadequate performance for detection of hepatic metastases and pulmonary nodules, respectively, but could not exclude any low dose levels for head CT. Estimated differences in jackknife alternative free-response receiver operating characteristic figures of merit between routine and lower dose configurations found that only the lowest dose configurations tested (ie, 30%, 4%, and 10% of routine dose levels for abdominal, chest, and head CT examinations, respectively) did not meet criteria for noninferiority. At lower doses, subjective image quality declined before observer performance. Iterative reconstruction was only beneficial when filtered back projection did not result in noninferior performance.ConclusionOpportunity exists for substantial radiation dose reduction using existing CT technology for common diagnostic tasks.



http://ift.tt/2mRRF1a

Self-Study

Publication date: Available online 2 March 2017
Source:Academic Radiology
Author(s): Jessica B. Robbins, David Sarkany
The Accreditation Council for Graduate Medical Education (ACGME) self-study is a new process for ACGME accredited radiology programs. This article serves to provide the reader with the evolution of ACGME accreditation leading to the conception of the self-study process, detail the self-study method, and offer practical advice to programs embarking upon their inaugural self-study.



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The Evolving Role of the Program Coordinator: Five Essential Skills for the Coordinator Toolbox

Publication date: Available online 2 March 2017
Source:Academic Radiology
Author(s): Joseph Stuckelman, Sylvia E. Zavatchen, Sally A. Jones
As ACGME (Accreditation Council for Graduate Medical Education) requirements have expanded and become increasingly more complex, so has the role of the program coordinator. Over the last decade, the knowledge and skills required to capably administer residency and fellowship training programs have increased in both volume and complexity. Today's coordinators are responsible for more than clerical tasks. They also function as managers and have greater roles in the development and implementation of program initiatives, policies, and outcomes. As a result, coordinators' roles and responsibilities have evolved to include management skills. To keep pace with the rapid and continuing change, it is imperative that coordinators continue to develop these skill sets to add value to their programs, institutions, and careers.



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A Simplified Approach to Encephalitis and Its Mimics

Publication date: Available online 1 March 2017
Source:Academic Radiology
Author(s): Colin D. McKnight, Aine M. Kelly, Myria Petrou, Anna E. Nidecker, Matthew T. Lorincz, Duaa K. Altaee, Stephen S. Gebarski, Bradley Foerster
Rationale and ObjectivesInfectious encephalitis is a relatively common cause of morbidity and mortality. Treatment of infectious encephalitis with antiviral medication can be highly effective when administered promptly. Clinical mimics of encephalitis arise from a broad range of pathologic processes, including toxic, metabolic, neoplastic, autoimmune, and cardiovascular etiologies. These mimics need to be rapidly differentiated from infectious encephalitis to appropriately manage the correct etiology; however, the many overlapping signs of these various entities present a challenge to accurate diagnosis. A systematic approach that considers both the clinical manifestations and the imaging findings of infectious encephalitis and its mimics can contribute to more accurate and timely diagnosis.Materials and MethodsFollowing an institutional review board approval, a health insurance portability and accountability act (HIPAA)-compliant search of our institutional imaging database (teaching files) was conducted to generate a list of adult and pediatric patients who presented between January 1, 1995 and October 10, 2013 for imaging to evaluate possible cases of encephalitis. Pertinent medical records, including clinical notes as well as surgical and pathology reports, were reviewed and correlated with imaging findings. Clinical and imaging findings were combined to generate useful flowcharts designed to assist in distinguishing infectious encephalitis from its mimics. Key imaging features were reviewed and were placed in the context of the provided flowcharts.ResultsFour flowcharts were presented based on the primary anatomic site of imaging abnormality: group 1: temporal lobe; group 2: cerebral cortex; group 3: deep gray matter; and group 4: white matter. An approach that combines features on clinical presentation was then detailed. Imaging examples were used to demonstrate similarities and key differences.ConclusionsEarly recognition of infectious encephalitis is critical, but can be quite complex due to diverse pathologies and overlapping features. Synthesis of both the clinical and imaging features of infectious encephalitis and its mimics is critical to a timely and accurate diagnosis. The use of the flowcharts presented in this article can further enable both clinicians and radiologists to more confidently differentiate encephalitis from its mimics and improve patient care.



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Bacterial Contamination of CT Equipment

Publication date: Available online 1 March 2017
Source:Academic Radiology
Author(s): John Childress, Debborah Burch, Cheryl Kucharski, Carol Young, Ella A. Kazerooni, Matthew S. Davenport
Rationale and ObjectiveThis study aimed to evaluate the use of an adenosine triphosphate (ATP) monitoring system to minimize surface contamination on inpatient computed tomography (CT) scanners.MethodsThe bore, table, and wrap of two quaternary care inpatient CT scanners (load/scanner: ~ 30–40 CT examinations/day) were assayed with bacterial cultures and an ATP detection system during six prospective iterative plan–do–check–act improvement cycles from January 6, 2016 to October 12, 2016. Per-cycle sampling was for eight consecutive weekdays. ATP detection was expressed as relative light units (RLUs) through a luciferase reaction, with >350 RLU considered contaminated per manufacturer recommendations. Culture swabs were placed into 6.5% NaCl broth, a Staphylococcus enrichment broth, and incubated aerobically at 37°C for 48 hours. Positive broths were plated to chromogenic Staphylococcus media. Culture rates (Fisher exact test) and RLU values (Mann-Whitney U test) were compared.ResultsIn Cycle 1, both culture results and median RLU values indicated the wrap was the most contaminated item (positive culture rate: 63% [10/16], median RLU interquartile range: 173 [IQR: 56–640]); however, RLU values were not predictive of per-sample culture results (P = .36). Following iterative improvements, RLU values at Cycle 6 were significantly lower than at peak (P = .02–.04) and within manufacturer's recommendations: all samples: 45 (IQR: 16–87), bore: 26 (IQR: 0–51), table: 68 (IQR: 21–89), wrap: 47 (IQR: 38–121).ConclusionThe Velcro wrap is the most contaminated item on a CT scanner, and special processes may be needed to ensure adequate cleansing. ATP detection is a crude surrogate for bacterial culture results but benefits from speed, reduced cost, and greater statistical power.



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Hands-on Physics Education of Residents in Diagnostic Radiology

Publication date: Available online 1 March 2017
Source:Academic Radiology
Author(s): Jie Zhang, Peter A. Hardy, David J. DiSantis, M. Elizabeth Oates
Rationale and ObjectivesThe American Board of Radiology Core Examination integrates assessment of physics knowledge into its overall testing of clinical radiology, with an emphasis on understanding image quality and artifacts, radiation dose, and patient safety for each modality or subspecialty organ system. Accordingly, achieving a holistic approach to physics education of radiology residents is a huge challenge. The traditional teaching of radiological physics—simply through didactic lectures—was not designed for such a holistic approach. Admittedly, time constraints and clinical demands can make incorporation of physics teaching into clinical practice problematic. We created and implemented a week-long, intensive physics rotation for fledgling radiology residents and evaluated its effectiveness.Materials and MethodsThe dedicated physics rotation is held for 1 week during the first month of radiology residency. It comprises three components: introductory lectures, hands-on practical clinical physics operations, and observation of clinical image production. A brief introduction of the physics pertinent to each modality is given at the beginning of each session. Hands-on experimental demonstrations are emphasized, receiving the greatest allotment of time. The residents perform experiments such as measuring radiation dose, studying the relationship between patient dose and clinical practice (eg, fluoroscopy technique), investigating the influence of acquisition parameters (kV, mAs) on radiographs, and evaluating image quality using computed tomography, magnetic resonance imaging, ultrasound, and gamma camera/single-photon emission computed tomography/positron emission tomography phantoms. Quantitative assessment of the effectiveness of the rotation is based on an examination that tests the residents' grasp of basic medical physics concepts along with written course evaluations provided by each resident.ResultsThe pre- and post-rotation tests show that after the physics rotation, the average correct score of 25 questions improved from 13.6 ± 2.4 to 19 ± 1.2. The survey shows that the physics rotation during the first week of residency is favored by all residents and that 1 week's duration is appropriate. All residents are of the opinion that the intensive workshop would benefit them in upcoming clinical rotations. Residents acknowledge becoming more comfortable regarding the use of radiation and providing counsel regarding radiation during pregnancy.ConclusionsAn immersive, short-duration, clinically oriented physics rotation is well received by new or less experienced radiology trainees, correlates basic physics concepts with their relevance to clinical imaging, and more closely parallels expectations of the American Board of Radiology Core Examination.



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Maintenance of membrane organization in the aging mouse brain as determining factor for preventing receptor dysfunction and for improving response to anti-Alzheimer treatments

Publication date: Available online 3 March 2017
Source:Neurobiology of Aging
Author(s): Julie Colin, Mélanie H. Thomas, Lynn Gregory-Pauron, Anthony Pincon, Marie-Claire Lanhers, Catherine Corbier, Thomas Claudepierre, Frances T. Yen, Thierry Oster, Catherine Malaplate-Armand
Although a major risk factor for Alzheimer's disease (AD), the "aging" parameter is not systematically considered in preclinical validation of anti-AD drugs. To explore how aging affects neuronal reactivity to anti-AD agents, the ciliary neurotrophic factor (CNTF)-associated pathway was chosen as a model. Comparison of the neuroprotective properties of CNTF in 6- and 18-month-old mice revealed CNTF resistance in the older animals associated with the exclusion of the CNTF-receptor subunits from rafts and their subsequent dispersion to non- raft cortical membrane domains. This age-dependent membrane remodelling prevented both the formation of active CNTF-receptor complexes and the activation of pro-survival STAT-3 and ERK1/2 pathways, demonstrating that age-altered membranes impaired the reactivity of potential therapeutic targets. CNTF-receptor distribution and CNTF signaling responses were improved in older mice receiving dietary docosahexaenoic acid, with CNTF-receptor functionality being similar to those of younger mice, pointing towards dietary intervention as a promising adjuvant strategy to maintain functional neuronal membranes, thus allowing associated receptors to respond appropriately to anti-AD agents.



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Unveiling the Role of Senescence-Induced Cellular Plasticity

Publication date: 2 March 2017
Source:Cell Stem Cell, Volume 20, Issue 3
Author(s): Jumpei Taguchi, Yasuhiro Yamada
Mice expressing Yamanaka factors develop teratomas containing iPSCs, suggesting that somatic cells are reprogrammable in vivo. Recent studies in Cell, Science, and this issue of Cell Stem Cell (Ocampo et al., 2016; Mosteiro et al., 2016; Chiche et al., 2017, respectively) report crosstalk between reprogramming and senescence, providing insights on cellular plasticity in multicellular organisms.

Teaser

Mice expressing Yamanaka factors develop teratomas containing iPSCs, suggesting that somatic cells are reprogrammable in vivo. Recent studies in Cell, Science, and this issue of Cell Stem Cell (Ocampo et al., 2016; Mosteiro et al., 2016; Chiche et al., 2016, respectively) report crosstalk between reprogramming and senescence, providing insights on cellular plasticity in multicellular organisms.


http://ift.tt/2m0OkiW

A Back Door to Cortical Development

Publication date: 2 March 2017
Source:Cell Stem Cell, Volume 20, Issue 3
Author(s): Gerd Kempermann
The mammalian cortex develops in an "inside-out" manner, as neural stem and progenitor cells lining the ventricles build the brain from within. Bifari et al. (2017), in this issue of Cell Stem Cell, find a small set of cortical neurons that appear to originate from radial glia-like progenitors in the meninges, suggesting an outside-in contribution to corticogenesis.

Teaser

The mammalian cortex develops in an "inside-out" manner, as neural stem and progenitor cells lining the ventricles build the brain from within. Bifari et al. (2017), in this issue of Cell Stem Cell, find a small set of cortical neurons that appear to originate from radial glia-like progenitors in the meninges, suggesting an outside-in contribution to corticogenesis.


http://ift.tt/2mRHz0u

Pericytes or Mesenchymal Stem Cells: Is That the Question?

Publication date: 2 March 2017
Source:Cell Stem Cell, Volume 20, Issue 3
Author(s): Elena Cano, Véronique Gebala, Holger Gerhardt
For almost a decade, mesenchymal stem cells (MSCs) were believed to reside as perivascular cells in vivo. In this issue of Cell Stem Cell, Guimarães-Camboa et al. (2017) challenge this idea and use lineage tracing to demonstrate that perivascular cells do not behave as tissue-specific progenitors in various organs, despite showing MSC potential in vitro.

Teaser

For almost a decade, mesenchymal stem cells (MSCs) were believed to reside as perivascular cells in vivo. In this issue of Cell Stem Cell, Guimarães-Camboa et al. (2017) challenge this idea and use lineage tracing to demonstrate that perivascular cells do not behave as tissue-specific progenitors in various organs, despite showing MSC potential in vitro.


http://ift.tt/2m0YzUe

Bridging the Gaps: iPSC-Based Models from CHIP to MDS to AML

Publication date: 2 March 2017
Source:Cell Stem Cell, Volume 20, Issue 3
Author(s): Kathrin M. Bernt
Myeloid malignancies exist on a spectrum from asymptomatic clonal hematopoiesis to overt leukemia and exhibit substantial clonal heterogeneity. Both aspects are challenging to capture in experimental models. In two landmark studies in this issue of Cell Stem Cell, Kotini et al. (2017) and Chao et al. (2017) establish iPSC-based experimental platforms that recapitulate disease stages and clonal architecture.

Teaser

Myeloid malignancies exist on a spectrum from asymptomatic clonal hematopoiesis to overt leukemia and exhibit substantial clonal heterogeneity. Both aspects are challenging to capture in experimental models. In two landmark studies in this issue of Cell Stem Cell, Kotini et al. (2017) and Chao et al. (2017) establish iPSC-based experimental platforms that recapitulate disease stages and clonal architecture.


http://ift.tt/2mRJnqd

Bringing a Leukemic Stem Cell Gene Signature into Clinics: Are We There Yet?

Publication date: 2 March 2017
Source:Cell Stem Cell, Volume 20, Issue 3
Author(s): Guillaume Richard-Carpentier, Guy Sauvageau
Prognostic markers that capture leukemia stem cell (LSC) activity can be useful for the risk stratification of acute myeloid leukemia (AML) patients. In a recent issue of Nature, Ng et al. (2016) develop a prognostic score based on a 17-gene expression signature of LSCs to predict outcome in AML patients.

Teaser

Prognostic markers that capture leukemia stem cell (LSC) activity can be useful for the risk stratification of acute myeloid leukemia (AML) patients. In a recent issue of Nature, Ng et al. (2016) develop a prognostic score based on a 17-gene expression signature of LSCs to predict outcome in AML patients.


http://ift.tt/2m12T5R

Unsaturated Fatty Acids Maintain Cancer Cell Stemness

Publication date: 2 March 2017
Source:Cell Stem Cell, Volume 20, Issue 3
Author(s): Abir Mukherjee, Hilary A. Kenny, Ernst Lengyel
Investigation of the metabolic regulation of cancer stem cells is an emerging field that offers promising approaches for identifying and targeting recalcitrant stem cell populations. In this issue of Cell Stem Cell, Li et al. (2017) indicate that increased lipid desaturation is essential to stem-like characteristics in ovarian cancer cells.

Teaser

Investigation of the metabolic regulation of cancer stem cells is an emerging field that offers promising approaches for identifying and targeting recalcitrant stem cell populations. In this issue of Cell Stem Cell, Li et al. (2017) indicate that increased lipid desaturation is essential to stem-like characteristics in ovarian cancer cells.


http://ift.tt/2mRICNI

DNA Damage-Induced HSPC Malfunction Depends on ROS Accumulation Downstream of IFN-1 Signaling and Bid Mobilization

Publication date: 2 March 2017
Source:Cell Stem Cell, Volume 20, Issue 3
Author(s): Alpaslan Tasdogan, Suresh Kumar, Gabriele Allies, Julia Bausinger, Franziska Beckel, Helmut Hofemeister, Medhanie Mulaw, Vikas Madan, Karin Scharffetter-Kochanek, Michaela Feuring-Buske, Konstanze Doehner, Günter Speit, A. Francis Stewart, Hans Joerg Fehling




http://ift.tt/2m0Ok2q

Study of TLP bonding of Ti-6Al-4V alloy produced by vacuum plasma spray forming and forging

Publication date: 5 May 2017
Source:Materials & Design, Volume 121
Author(s): Akbar Davoodi Jamaloei, Hamid Reza Salimijazi, Hossein Edris, Javad Mostaghimi
Due to the nature of the near-net-shape formed of Ti-6Al-4V alloy produced by vacuum plasma spray forming (VPSF), post-deposition heat treatment is necessary to achieve to the superior mechanical and physical properties. In this study, transient liquid phase (TLP) bonding of VPSF and forging Ti-6Al-4V alloy were investigated. Simultaneous joining process under equi-axed α phase heat treatment cycle was performed to achieve to a suitable microstructure and mechanical properties of both bonding area and parent metal. Different thicknesses of 2, 5, 10, and 25μm copper interlayer were used and the effect of the interlayer thickness was evaluated. Results showed that the joint region was wider in the TLP bonded VPSF alloy compared to the forged alloy under the same bonding conditions because of the higher diffusion rates in the VPSF alloy. The highest bonding shear strength was achieved for 2μm interlayer thickness. It was 452 and 492MPa for the TLP bonded VPSF and forged alloy, respectively. Increasing the interlayer thickness resulted in decreasing the bonding strength and increasing the hardness of the joint area due to the existence of Ti2Cu intermetallic compounds. The fracture analysis showed the brittle behavior due to the existence of the intermetallic compounds.

Graphical abstract

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Novel processing of Ag-WC electrical contact materials using spark plasma sintering

Publication date: 5 May 2017
Source:Materials & Design, Volume 121
Author(s): Nachiketa Ray, Bernd Kempf, Gunther Wiehl, Timo Mützel, Frank Heringhaus, Ludo Froyen, Kim Vanmeensel, Jef Vleugels
Ag-WC (60-40wt%) contact materials based on three WC particle size powders were doped with 0.1wt% Ni and processed by an appropriate powder pre-treatment followed by spark plasma sintering (SPS). The contacts produced were already bonded to a copper profile during SPS in order to eliminate additional processing steps. The SPS composites had a more homogeneous microstructure and were tougher and softer than the materials produced by conventional press-sinter-infiltration. The infiltrated contacts had a lower arc-erosion whereas the contacts produced by both processes had a similar contact resistance. The microstructure after switching confirmed that the SPS materials had a porous contact surface layer and were crack-free in contrast to their press-sinter-infiltrated equivalents.

Graphical abstract

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Experimental and numerical study of optimum thickness of porous silica transition layer in aeronautic laminated glass

Publication date: 5 May 2017
Source:Materials & Design, Volume 121
Author(s): Zhijun Feng, Xufeng Wang, Juntong Huang, Xibao Li, Jinshan Lu
The application of a porous silica (PS) transition layer in an inorganic-organic aeronautic laminated glass can effectively solve the material failure caused by the performance difference of the inorganic-organic materials. The effect of porous silica transition layer thickness on the mechanical and optical properties of laminated glass was investigated. The microstructure of the porous silica transition layer was analyzed by scanning electron microscopy. The film thickness was verified using a step profiler. The failure strength of laminated glass with the porous silica transition layer was tested by a universal testing machine. Finite element modeling of laminated glass with the porous silica transition layer was performed by ANSYS software. Tensile stress between the porous silica and the polyurethane was simulated for different porous silica film thicknesses. Experimental and theoretical results indicated that with the increasing the thickness of the transition film, the failure stress of the laminated glass increased. Improvements in the mechanical properties of the laminated glass are saturation at a PS thickness of approximately 3.8μm.

Graphical abstract

http://ift.tt/2lkFw8D

Integrating genomic data from high-throughput studies with computational modeling reveals differences in the molecular basis of hyposalivation between type 1 and type 2 diabetes

Abstract

Objectives

Both type 1 and type 2 diabetes are accompanied by a high prevalence of hyposalivation (decreased salivary secretion), resulting in oral tissue damage. However, the molecular basis for the hyposalivation is yet unknown. Identifying genes and proteins that account for diabetes-related hyposalivation will help understanding the basis for this condition and identifying disease biomarkers in saliva.

Materials and methods

We integrated genomic data from 110 high-throughput studies with computational modeling, to explore the relationship between diabetes and salivary glands on a genomic scale.

Results

A significant overlap exists between genes that are altered in both types of diabetes and genes that are expressed in salivary glands; 87 type 1 diabetes and 34 type 2 diabetes associated genes are also common to salivary glands. However, the overlap between these genes is not significant.

Conclusions

Type 1 and type 2 diabetes associated genes are involved in the salivary secretion process, but mostly at different parts of it. This suggests that type 1 and type 2 diabetes impair salivary secretion by affecting different processes in the salivary tissue.

Clinical relevance

The genomic characteristics of Type 1 and type 2 diabetes may explain differences in salivary gland tissues morphology and saliva composition in people with diabetes, and suggest candidate proteins for diabetes salivary biomarkers.

http://ift.tt/2mMh9h4

Is there enough evidence to use botulinum toxin injections for bruxism management? A systematic literature review

Abstract

Objective

The objective of the study was to conduct a systematic review of the literature assessing the effects of botulinum toxin (BoNT-A) injections in the management of bruxism.

Materials and methods

Search for articles involved the PubMed, Scopus, Web of Science, Embase, Cochrane, Scielo and Lilacs databases. Specific terms were used and the search carried out from 1980 to March 2016 by three independent researchers. Randomized controlled studies (RCTs), prospective and before–after studies that applied BoNT-A at the masseter and/or temporalis muscles were included.

Results

Three RCTs and two uncontrolled before–after studies out of 904 identified citations were included in this review. All five articles dealt with sleep bruxism and featured a small sample size. None of them was about awake bruxism. Two randomized clinical trials were double-blinded, with a control group using saline solution. Two studies used polysomnography/electromyography for sleep bruxism diagnosis, whilst others were based on history taking and clinical examination. All studies using subjective evaluations for pain and jaw stiffness showed positive results for the BoNT-A treatment. In contrast, the two studies using objective evaluations did not demonstrate any reduction in bruxism episodes, but a decrease in the intensity of muscles contractions.

Conclusion

Despite the paucity of works on the topic, BoNT-A seems to be a possible management option for sleep bruxism, minimizing symptoms and reducing the intensity of muscle contractions, although further studies are necessary especially as far as the treatment indications for bruxism itself is concerned.

Clinical relevance

BoNT-A has been increasingly diffused in dentistry over recent years, being also used for pain management in patients with bruxism. Nonetheless, there is no consensus about its effects in this disorder.

http://ift.tt/2m0VCTN

A novel catalytic way of comprising a β-nucleating agent in isotactic polypropylene: Catalyst design strategy and polymerization-assisted dispersion

Publication date: 24 March 2017
Source:Polymer, Volume 113
Author(s): Na Wang, Hui Niu, Yang Li
This article demonstrates a catalytic as well as efficient method to comprise a β-nucleating agent N,N'-dicyclohexyl-terephthalamide (DCTPA) into isotactic polypropylene (iPP) for the synthesis of β-crystalline-specified iPP (β-iPP). A novel DCTPA-based Ziegler-Natta catalyst was designed via a first modification step of DCTPA with TiCl4 and a subsequent supporting step of MgCl2-TiCl4-donor components on DCTPA, by which the final catalyst composition and morphology were facilely controlled, and the propylene polymerization was endowed with high activity as well as high stereospecificity. The chemical structure of the DCTPA supported Ti-Mg catalyst was investigated using FTIR, XPS and XRD, and the morphology of the catalyst particle and its polymers was monitored by SEM. Moreover, uniform dispersion of DCTPA fragments in iPP resin was realized through the in-reactor polymerization, benefiting from the catalyst-polymer morphological replication effect, followed by inducing the homogeneous β-modification of iPP with high efficiency after a melting-crystallization treatment of the polymers. This novel difunctional catalyst proved to be effective for both propylene isotactic polymerization and polymer β-modification.

Graphical abstract

http://ift.tt/2m1RNfi

Acid-degradable poly(ortho ester urethanes) copolymers for potential drug carriers: Preparation, characterization, in vitro and in vivo evaluation

Publication date: 7 April 2017
Source:Polymer, Volume 114
Author(s): Shengxiang Fu, Guanqing Yang, Jun Wang, Xin Wang, Xu Cheng, Rupei Tang
Herein, acid-degradable poly(ortho ester urethanes) (POEUs) were synthesized via polycondensation between an acid-labile ortho ester diamine and active esters of poly(ε-caprolactone) (PCL) diols with different molecular weights. The POEUs nanoparticles were easily fabricated using an oil-in-water emulsion technique, whose ortho ester bonds in main-chains could be degraded at different rate in acidic pHs. DOX was loaded into the nanoparticles with high drug loading efficiency. In vitro release studies demonstrate that DOX is released in a pH-dependent manner. In vitro cellular uptake confirms that DOX-loaded POEUs nanoparticles can be more readily internalized by two-dimensional (2D) cells and three-dimensional (3D) multicellular tumor spheroids (MCTS), resulting in efficient antitumor efficiency of cancer cells. In vivo biodistribution and antitumor effect were evaluated by H22 tumor-bearing mice. The results demonstrate that DOX-loaded POEUs nanoparticles show a prolonged blood circulation time and improved accumulation in solid tumor, leading to enhanced therapeutic efficacy.

Graphical abstract

http://ift.tt/2m1RMYM

Polypyrrole nanotubes: The tuning of morphology and conductivity

Publication date: 24 March 2017
Source:Polymer, Volume 113
Author(s): Irina Sapurina, Yu Li, Elizaveta Alekseeva, Patrycja Bober, Miroslava Trchová, Zuzana Morávková, Jaroslav Stejskal
Polypyrrole nanotubes rank among important functional materials with high application potential. They are prepared by the oxidative polymerization of pyrrole usually in the presence of methyl orange and represent conducting polymers with the highest bulk conductivity, 40–50 S cm⁻¹. The role of methyl orange in promoting the nanotubular morphology of polypyrrole is discussed on the basis of FTIR and Raman spectra. The model based on the organization of acid form of methyl orange molecules to an in-situ-generated solid template is proposed. Various factors controlling the morphology and conductivity of polypyrrole have been identified. Higher acidity of reaction medium or the addition of ethylene glycol increased the diameter of nanotubes or even converted nanotubes to globules, and the conductivity was reduced. Nanotubes have not been obtained at temperature elevated to 60 °C but one-dimensional polypyrrole morphology was surprisingly produced even when the oxidation of pyrrole took place in frozen reaction medium, in ice, at −24 °C. The counter-ions in iron(III) salt used for the oxidation and the presence of water-soluble polymers had virtually no influence on morphology and conductivity. On the other hand, a series of organic dyes used as replacement of methyl orange had substantial effect on both the nanotubular morphology and conductivity. The role of template formation is discussed by comparing methyl orange and ethyl orange dyes. While the former dye precipitates under acidic conditions and supports the growth of nanotubes, the latter does not and globules are obtained instead.

Graphical abstract

http://ift.tt/2m1OKnq

Direct arylation polycondensation of β-unprotected chalcogen heteroles under phosphine-free conditions

Publication date: 24 March 2017
Source:Polymer, Volume 113
Author(s): Shotaro Hayashi, Yoshihisa Kojima, Toshio Koizumi
We have demonstrated a direct arylation polycondensation of β-unprotected chalcogen heteroles (furan, thiophene and selenophene) under phosphine-free conditions. The polycondensation of furan and thiophene using a solid-supported palladium catalyst, Pd/C, gave alternating copolymers (Mn = 8000–10000), but the polycondensation of these monomers using common palladium catalysts such as Pd(OAc)2 gave insoluble polymeric products resulting from β-defects and network formation. Selenophene was a less reactive monomer for direct arylation using these catalysts, Pd/C and Pd(OAc)2, yielding low molecular weight copolymer (Mn < 2500). On the other hand, PdCl2 was the most effective catalyst for the polycondensation of selenophene. The high molecular weight polymer (Mn = 11800) could be obtained. The ¹H NMR and UV-vis absorption spectra of the polymers obtained from furan, thiophene and selenophene were similar to those of the polymers synthesized by Suzuki-Miyaura cross-coupling polycondensation.

Graphical abstract

http://ift.tt/2m1W6qS

Chemical sensing, thermal stability, electrochemistry and electrical conductivity of silver nanoparticles decorated and polypyrrole enwrapped boron nitride nanocomposite

Publication date: 24 March 2017
Source:Polymer, Volume 113
Author(s): Adil Sultan, Faiz Mohammad
In the present work, a nanocomposite of boron nitride (BN) and silver nanoparticles (Ag) enwrapped by polypyrrole (PPy) has been synthesized for first time via in situ chemical oxidative polymerization of pyrrole using ferric chloride. The structures of synthesized FeCl3 doped PPy, BN/Ag and PPy/Ag@BN nanocomposites were confirmed by fourier transform infrared spectroscopy, x-ray diffraction, thermogravimetric analysis, field emission scanning electron microscopy and transmittance electron microscopy technique. Our investigations showed that the electrical response of PPy/Ag@BN nanocomposite which contains a conductor (Ag), an insulator (BN) and a semiconductor (PPy), was greater than that of polypyrrole. The electrochemical supercapacitive performance shows that FeCl3 doped PPy has higher capacitance than PPy/Ag@BN which might be due to higher conductivity of PPy as PPy/Ag@BN shows poor conductivity due to the insulating nature of BN. The newly synthesized nanocomposite showed rapid CO2 sensing and significantly improved DC electrical conductivity.

Graphical abstract

http://ift.tt/2m1F7oP

Target Expression, Generation, Preclinical Activity, and Pharmacokinetics of the BCMA-T Cell Bispecific Antibody EM801 for Multiple Myeloma Treatment

Publication date: Available online 2 March 2017
Source:Cancer Cell
Author(s): Anja Seckinger, Jose Antonio Delgado, Samuel Moser, Laura Moreno, Brigitte Neuber, Anna Grab, Susanne Lipp, Juana Merino, Felipe Prosper, Martina Emde, Camille Delon, Melanie Latzko, Reto Gianotti, Remo Lüoend, Ramona Murr, Ralf J. Hosse, Lydia Jasmin Harnisch, Marina Bacac, Tanja Fauti, Christian Klein, Aintzane Zabaleta, Jens Hillengass, Elisabetta Ada Cavalcanti-Adam, Anthony D. Ho, Michael Hundemer, Jesus F. San Miguel, Klaus Strein, Pablo Umaña, Dirk Hose, Bruno Paiva, Minh Diem Vu
We identified B cell maturation antigen (BCMA) as a potential therapeutic target in 778 newly diagnosed and relapsed myeloma patients. We constructed an IgG-based BCMA-T cell bispecific antibody (EM801) and showed that it increased CD3⁺ T cell/myeloma cell crosslinking, followed by CD4⁺/CD8⁺ T cell activation, and secretion of interferon-γ, granzyme B, and perforin. This effect is CD4 and CD8 T cell mediated. EM801 induced, at nanomolar concentrations, myeloma cell death by autologous T cells in 34 of 43 bone marrow aspirates, including those from high-risk patients and patients after multiple lines of treatment, tumor regression in six of nine mice in a myeloma xenograft model, and depletion of BCMA⁺ cells in cynomolgus monkeys. Pharmacokinetics and pharmacodynamics indicate weekly intravenous/subcutaneous administration.

Graphical abstract

Teaser

Seckinger et al. show that B cell maturation antigen (BCMA) is universally and specifically expressed in normal and malignant plasma cells. They construct a BCMA-CD3 bispecific antibody that efficiently induces myeloma cell death by autologous T cells and depletes BCMA⁺ cells in cynomolgus monkeys.


http://ift.tt/2lFL1en

Membrane-Proximal Epitope Facilitates Efficient T Cell Synapse Formation by Anti-FcRH5/CD3 and Is a Requirement for Myeloma Cell Killing

Publication date: Available online 2 March 2017
Source:Cancer Cell
Author(s): Ji Li, Nicola J. Stagg, Jennifer Johnston, Michael J. Harris, Sam A. Menzies, Danielle DiCara, Vanessa Clark, Maria Hristopoulos, Ryan Cook, Dionysos Slaga, Rin Nakamura, Luke McCarty, Siddharth Sukumaran, Elizabeth Luis, Zhengmao Ye, Thomas D. Wu, Teiko Sumiyoshi, Dimitry Danilenko, Genee Y. Lee, Klara Totpal, Diego Ellerman, Isidro Hötzel, John R. James, Teemu T. Junttila
The anti-FcRH5/CD3 T cell-dependent bispecific antibody (TDB) targets the B cell lineage marker FcRH5 expressed in multiple myeloma (MM) tumor cells. We demonstrate that TDBs trigger T cell receptor activation by inducing target clustering and exclusion of CD45 phosphatase from the synapse. The dimensions of the target molecule play a key role in the efficiency of the synapse formation. The anti-FcRH5/CD3 TDB kills human plasma cells and patient-derived myeloma cells at picomolar concentrations and results in complete depletion of B cells and bone marrow plasma cells in cynomolgus monkeys. These data demonstrate the potential for the anti-FcRH5/CD3 TDB, alone or in combination with inhibition of PD-1/PD-L1 signaling, in the treatment of MM and other B cell malignancies.

Teaser

Li et al. report that the size and epitope location of the target play a key role in the efficiency of T cell activation induced by T cell-dependent bispecific antibodies (TDBs). They develop a TDB targeting FcRH5 expressed in all multiple myeloma tumor cells and show its potential in treating this disease.


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The human chorion contains definitive hematopoietic stem cells from the 15th week of gestation [RESEARCH ARTICLE]

Marcus O. Muench, Mirhan Kapidzic, Matthew Gormley, Alan G. Gutierrez, Kathryn L. Ponder, Marina E. Fomin, Ashley I. Beyer, Haley Stolp, Zhongxia Qi, Susan J. Fisher, and Alicia Barcena

We examined the contribution of the fetal membranes, amnion and chorion, to human embryonic and fetal hematopoiesis. A population of cells displaying a hematopoietic progenitor phenotype (CD34^++/+CD45^low cells) of fetal origin was present in the chorion at all gestational ages, associated with stromal cells or near blood vessels, but was absent in the amnion. Prior to 15 weeks of gestation, they lacked hematopoietic in vivo engraftment potential. Differences in the chemokine receptor and β1 integrin expression profiles of progenitors between the 1^st and 2^nd trimesters suggest that these cells had gestationally-regulated responses to homing signals and/or adhesion mechanisms that influenced their ability to colonize the stem cell niche. Definitive hematopoietic stem cells capable of multilineage and long-term reconstitution when transplanted in immunodeficient mice, were present in the chorion from 15-24 weeks' gestation, but were absent at term. The 2^nd trimester cells also engrafted secondary recipients in serial transplantation experiments. Thus, the human chorion contains functionally mature hematopoietic stem cells at mid-gestation.

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Folate receptor alpha is necessary for neural plate cell apical constriction during Xenopus neural tube formation [RESEARCH ARTICLE]

Olga A. Balashova, Olesya Visina, and Laura N. Borodinsky

Folate supplementation prevents up to 70% of neural tube defects (NTDs), which result from a failure of neural tube closure during embryogenesis. The elucidation of the mechanisms underlying folate action has been challenging. This study introduces Xenopus laevis as a model to determine the cellular and molecular mechanisms involved in folate action during neural tube formation. We show that knockdown of folate receptor-α (FRα) impairs neural tube formation and leads to NTDs. FRα knockdown in neural plate cells only is necessary and sufficient to induce NTDs. FRα-deficient neural plate cells fail to constrict, resulting in widening of the neural plate midline and defective neural tube closure. Pharmacological inhibition of folate action by methotrexate during neurulation induces NTDs by inhibiting folate interaction with its uptake systems. Our findings support a model for folate receptor interacting with cell adhesion molecules, thus regulating apical cell membrane remodeling and cytoskeletal dynamics necessary for neural plate folding. Further studies in this organism may unveil novel cellular and molecular events mediated by folate and lead to new means for preventing NTDs.

http://ift.tt/2lkhQRK

Ultrasonography and cytology as predictors of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP): Importance of the differential diagnosis with the invasive encapsulated follicular variant of papillary thyroid cancer

The noninvasive encapsulated follicular variant of papillary thyroid carcinoma (EFVPTC) has an excellent prognosis even if treated only by lobectomy.^1-3 Recently, it was proposed that this tumor should no longer be considered "cancer" and be given the denomination "noninvasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP).² There is great interest in knowing the preoperative characteristics of NIFTP since, in view of a high probability of this diagnosis (higher than that of malignancy), less extensive surgery would be more indicated.

This article is protected by copyright. All rights reserved.

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GEIS Guidelines for Gastrointestinal Sarcomas (GIST)

Publication date: Available online 2 March 2017
Source:Cancer Treatment Reviews
Author(s): Andrés Poveda, Xavier García del Muro, Jose Antonio López-Guerrero, Ricardo Cubedo, Virginia Martínez, Ignacio Romero, César Serrano, Claudia Valverde, Javier Martín-Broto
Gastrointestinal stromal sarcomas (GISTs) are the most common mesenchymal tumours originating in the digestive tract. They have a characteristic morphology, are generally positive for CD117 (c-kit) and are primarily caused by activating mutations in the KIT or PDGFRA genes(1). On rare occasions, they occur in extravisceral locations such as the omentum, mesentery, pelvis and retroperitoneum.GISTs have become a model of multidisciplinary work in oncology: the participation of several specialties (oncologists, pathologists, surgeons, molecular biologists, radiologists...) has forested advances in the understanding of this tumour and the consolidation of a targeted therapy, imatinib, as the first effective molecular treatment in solid tumours. Following its introduction, median survival of patients with advanced or metastatic GIST increased from 18 to more than 60 months. Sunitinib and Regorafenib are two targeted agents with worldwide approval for second- and third-line treatment, respectively, in metastatic GIST.



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A Comprehensive Review of Immunotherapies in Prostate Cancer

Publication date: Available online 2 March 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Manuel Caitano Maia, Aaron R. Hansen
Prostate cancer is the second most common malignant neoplasm in men worldwide and the fifth cause of cancer-related death. Although multiple new agents have been approved for metastatic castration resistant prostate cancer over the last decade, it is still an incurable disease. New strategies to improve cancer control are needed and agents targeting the immune system have shown encouraging results in many tumor types. Despite being attractive for immunotherapies due to the expression of various tumor associated antigens, the microenvironment in prostate cancer is relatively immunosuppressive and may be responsible for the failures of various agents targeting the immune system in this disease. To date, Sipuleucel-T is the only immunotherapy that has shown significant clinical efficacy in this setting, although the high cost and potential trial flaws have precluded its widespread incorporation into clinical practice. Issues with patient selection and trial design may have contributed to the multiple failures of immunotherapy in prostate cancer and provides an opportunity to tailor future studies to evaluate these agents more accurately. We have reviewed all the completed immune therapy trials in prostate cancer and highlight important considerations for the next generation of clinical trials.



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Influence of inter-train interval on the plastic effects of rTMS

Publication date: Available online 2 March 2017
Source:Brain Stimulation
Author(s): Robin F.H. Cash, Aisha Dar, Jeanette Hui, Leo De Ruiter, Julianne Baarbé, Peter Fettes, Sarah Peters, Paul B. Fitzgerald, Jonathan Downar, Robert Chen
BackgroundHigh frequency repetitive transcranial magnetic stimulation (rTMS) elicits plastic effects in excitatory and inhibitory circuits. Inter-train intervals (ITI) were initially incorporated into rTMS paradigms to avoid overheating and for safety considerations. Recent studies have shown that inclusion of ITI, as opposed to continuous stimulation, is essential for eliciting excitatory effects, but the optimal ITI remains unknown. Moreover, if ITI duration has no effect, it may be possible to substantially reduce treatment time for rTMS.HypothesisITI duration modulates the excitatory and disinhibitory effects of rTMS.MethodsrTMS (20Hz, 2 second trains, 1200 pulses, 100% RMT) was applied in 14 healthy individuals with ITI of 4s (duration: ∼3 min), 8s (∼5 min), 16s (∼9 min) or 32s (16.5 min) in sessions separated by ≥5 days. Effects on cortical excitability and GABAA receptor mediated short interval intracortical inhibition (SICI) were measured for 75 minutes following rTMS.ResultsThe time-course of increased cortical excitability following rTMS was independent of ITI duration. There was a striking influence of ITI on SICI, whereby disinhibition increased with shorter ITI duration. Changes in cortical excitability and SICI were independent of each other.ConclusionThese findings provide the first evidence to suggest that ITI may be substantially shortened without loss of rTMS effects, and warrant further investigation where rTMS is applied therapeutically. Furthermore, shorter ITIs result in greater disinhibitory effects which may be desirable in some clinical disorders and accelerated treatment paradigms. The tuning of the plasticity of cortical excitatory and inhibitory circuits to rTMS parameters in human cortex are independent.



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Framework for radiation pneumonitis risk stratification based on anatomic and perfused lung dosimetry

Abstract

Purpose

To design and apply a framework for predicting symptomatic radiation pneumonitis in patients undergoing thoracic radiation, using both pretreatment anatomic and perfused lung dose–volume parameters.

Materials and methods

Radiation treatment planning CT scans were coregistered with pretreatment [^99mTc]MAA perfusion SPECT/CT scans of 20 patients who underwent definitive thoracic radiation. Clinical radiation pneumonitis was defined as grade ≥ 2 (CTCAE v4 grading system). Anatomic lung dose–volume parameters were collected from the treatment planning scans. Perfusion dose–volume parameters were calculated from pretreatment SPECT/CT scans. Equivalent doses in 2 Gy per fraction were calculated in the lung to account for differences in treatment regimens and spatial variations in lung dose (EQD2_lung).

Results

Anatomic lung dosimetric parameters (MLD) and functional lung dosimetric parameters (pMLD_70%) were identified as candidate predictors of grade ≥ 2 radiation pneumonitis (AUC > 0.93, p < 0.01). Pairing of an anatomic and functional dosimetric parameter (e. g., MLD and pMLD_70%) may further improve prediction accuracy. Not all individuals with high anatomic lung dose (MLD > 13.6 GyEQD2_lung, 19.3 Gy for patients receiving 60 Gy in 30 fractions) developed radiation pneumonitis, but all individuals who also had high mean dose to perfused lung (pMLD_70% > 13.3 GyEQD2) developed radiation pneumonitis.

Conclusions

The preliminary application of this framework revealed differences between anatomic and perfused lung dosimetry in this limited patient cohort. The addition of perfused lung parameters may help risk stratify patients for radiation pneumonitis, especially in treatment plans with high anatomic mean lung dose. Further investigations are warranted.

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Abécédaire : qui suis-je ? X’…

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1
Author(s): O. Laccourreye, A. Werner, I. McGill, C. Martin




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Les polymorphismes de l’eNOS (synthase du monoxyde d’azote endothéliale) dans l’otite séromuqueuse

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1
Author(s): M. Ates, C. Cevik, R. Dokuyucu, O. Berber, S. Colak, M. Izmirli
ObjectifsL'otite séromuqueuse (OSM) est la pathologie la plus fréquente après une infection virale des voies respiratoires supérieures chez l'enfant. Les études indiquent le rôle important du monoxyde d'azote (NO) dans l'étiologie de la perte d'audition. Toutefois, il n'existe aucune étude portant sur le rôle des polymorphismes de la synthase du monoxyde d'azote endothéliale (eNOS) dans l'OSM. L'objectif de cette étude est d'évaluer les polymorphismes de l'eNOS chez l'enfant atteint d'OSM.Matériels et méthodesAu total, 89 patients atteints d'OSM et 85 sujets sains appariés en termes d'âge et de sexe ont été inclus dans l'étude. Tous les patients de l'étude ont été soumis à des examens ORL et audiologiques complets. Une analyse ADN a été réalisée avec la technique Polymerase Chain Reaction (PCR) à partir de prélèvements sanguins. Le produit PCR a été coupé par la technique Restriction Fragment Length Polymorphism (RFLP) avec l'enzyme BanII et contrôlé par électrophorèse au gel d'agarose.RésultatsÀ l'issue de l'analyse génétique, il n'y a pas de différence significative entre les patients et les témoins en termes de polymorphisme Glu298Asp de l'eNOS (G/G, G/T, T/T). Lors de la comparaison de ces groupes en termes de répartition des allèles, une relation significative a été constatée entre les patients et les témoins (p=0,037).ConclusionÀ notre connaissance, l'allèle G a été identifié comme prédisposant au développement d'une OSM. Cette étude est la première à indiquer la corrélation entre le polymorphisme G894T de l'eNOS et l'OSM en Turquie.



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Place de l’Oramorph en complément de l’ibuprofène et du paracétamol dans la prise en charge de la douleur après adéno-amygdalectomie chez l’enfant

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1
Author(s): R. Wei Chern Gan, T. Kamani, M. Daniel
IntroductionDepuis peu, la codéine n'est plus recommandée dans le traitement de la douleur après (adéno)-amygdalectomie chez l'enfant et l'administration d'Oramorph est proposée en complément du paracétamol et de l'ibuprofène. Ce travail rapporte les besoins réels en Oramorph sur une cohorte de patients.MéthodeEnquête téléphonique rétrospective concernant l'administration d'Oramorph auprès des parents d'enfants opérés d'une (adéno)-amygdalectomie.RésultatsSur les 56 enfants inclus, 41 (73,2 %) se sont vus administrer de l'Oramorph. Quatorze n'en ont pas eu car les parents n'en n'ont pas ressenti le besoin et 1 par peur d'effets secondaires. L'administration d'Oramorph a été source d'inquiétude chez 14 parents au total (25 %), surtout par crainte d'effets secondaires.ConclusionEnviron 3/4 des enfants opérés d'une (adéno)-amygdalectomie ont besoin, pour bénéficier d'une antalgie satisfaisante, d'Oramorph en plus du paracétamol et de l'ibuprofène. L'usage d'Oramorph est adapté à la prise en charge de la douleur après (adéno)-amygdalectomie.



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Améloblastome des maxillaires : prise en charge thérapeutique et taux de récidive

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1
Author(s): A. Laborde, R. Nicot, T. Wojick, J. Ferri, G. Raoul
IntroductionL'améloblastome est une tumeur bénigne odontogène rare à fort potentiel récidivant. Il représente 1 % des tumeurs des maxillaires. Cette étude avait pour but d'observer le taux de récidive des améloblastomes en fonction de leur type de traitement : radical ou conservateur.Patients et méthodesIl s'agissait de recenser de façon rétrospective entre 1991 et 2013 tous les patients ayant eu un diagnostic d'améloblastome, de recueillir leurs caractéristiques topographiques, radiologiques, histologiques, le type de traitement choisi : conservateur (marsupialisation, énucléation, curetage) ou radical (résection osseuse segmentaire interruptrice) et de comparer leurs taux de récidive.RésultatsNous avons inclus 27 patients, il y a eu 22 traitements conservateurs (TC) et 14 traitements radicaux (TR). Le taux de récidive était de 90,9 % dans le groupe TC et de 9,1 % dans le groupe TR avec p=0,025. La durée moyenne de suivi était de 56,2 mois.DiscussionLe taux de récidive du TC a été plus élevé que celui du TR. Ces résultats sont similaires à ceux retrouvés dans la littérature. Le choix du traitement doit s'adapter aux caractéristiques macroscopiques et histologiques de chaque tumeur ainsi qu'au patient.



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Apport diagnostique et pronostique de l’électromyographie dans les immobilités laryngées unilatérales de l’adulte

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1
Author(s): A. Focquet, Y. Péréon, S. Ségura, C. Ferron, O. Malard, F. Espitalier
ButsÉtudier l'apport diagnostique et pronostique de l'électromyographie laryngée (EMGL) face à un trouble de mobilité laryngée unilatérale chez l'adulte.Patients et méthodesÉtude rétrospective de 2007 à 2015 incluant les patients présentant une immobilité laryngée unilatérale et ayant eu une EMGL. Les tracés de type neurogène, normal ou myogène étaient confrontés au contexte clinique. Le potentiel de récupération d'une paralysie unilatérale, évalué par la présence de potentiels de réinnervation sur le tracé de l'EMGL, a été comparé à l'évolution de la mobilité laryngée en laryngoscopie.RésultatsSoixante-trois patients (âge moyen de 59 ans) ont été inclus, mais 2 ont été exclus. Le délai moyen entre l'apparition de l'immobilité et la réalisation de l'EMGL était de 7 mois. Sur un total de 61 patients, 85 % présentaient un tracé neurogène en faveur d'une atteinte nerveuse, 13 % un tracé normal en faveur d'une ankylose crico-aryténoïdienne et un avait une activité de type myogène. Les tracés neurogènes étaient le plus souvent secondaires à une intervention chirurgicale cervicale. Trois quarts des patients présentant des potentiels de réinnervation ont récupéré une mobilité laryngée. La valeur prédictive positive de l'EMGL était de 69,2 %. Trente-huit patients ont été réévalués à distance.ConclusionL'EMGL s'avère être un outil performant pour préciser l'origine d'une immobilité laryngée unilatérale chez l'adulte. Elle a aussi un rôle pronostique dans les paralysies laryngées, l'absence de potentiels de réinnervation pouvant faire proposer précocement une médialisation laryngée si nécessaire.



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Évaluation des symptômes nasosinusiens par l’auto-questionnaire DyNaChron : faut-il le remplir avant ou après la consultation ?

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1
Author(s): D.T. Nguyen, C. Rumeau, M. Felix-Ravelo, P.-L. Nguyen-Thi, R. Jankowski
ObjectifL'évaluation des doléances naso-sinusiennes par auto-questionnaire reste très subjective. Cependant, elle est un outil indispensable pour quantifier les symptômes. L'objectif de cette étude était de comparer les réponses au questionnaire DyNaChron rempli juste avant et juste après une consultation pour un dysfonctionnement nasosinusien chronique.Matériels et méthodesSoixante-dix-huit patients (l'âge moyen : 43,1±16,9 ans) qui ont consulté pour un dysfonctionnement nasosinusien chronique ont participé à cette étude prospective. Les patients ont rempli la version informatisée de l'auto-questionnaire DyNaChron dans une salle dédiée juste avant et juste après l'entretien médical et l'examen physique.RésultatsLes patients ont majoritairement tendance à coter leurs symptômes de façon moins sévère après la consultation. Une différence significative entre les scores moyens avant et après consultation était retrouvée pour l'obstruction nasale (différence de 0,94/10), la rhinorrhée antérieure (0,40) et postérieure (0,26), les troubles de l'odorat (0,65), les douleurs faciales/céphalées (0,65). Il n'y avait pas de différence avant-après pour la toux chronique.ConclusionLes scores de l'auto-évaluation d'un dysfonctionnement nasosinusien chronique sont modestement différents avant et après la consultation. L'interprétation de ces scores doit être prudente et tenir compte des facteurs qui ont pu éventuellement biaiser les réponses.



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Editorial Board

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1





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Paralysie faciale périphérique : parole, communication et fonction motrice orale

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1
Author(s): T. Movérare, A. Lohmander, M. Hultcrantz, L. Sjögreen
ObjectifsCette étude visait à examiner l'effet de la paralysie faciale périphérique unilatérale acquise sur la parole, la communication et les fonctions orales et à étudier la relation entre le degré de paralysie faciale et la capacité à articuler, le contrôle de la salive, la capacité à s'alimenter et la force labiale.Matériels et méthodesDans cette étude descriptive, 27 patients (15 hommes et 12 femmes, âge moyen 48 ans) atteints de paralysie faciale périphérique unilatérale ont été inclus s'ils avaient obtenu un score inférieur à 70 sur l'échelle de Sunnybrook. L'évaluation s'est déroulée lors de consultations ORL de routine sous la forme d'auto-questionnaires portant sur la force labiale, la capacité à articuler et l'intelligibilité, ainsi que sur la capacité ressentie à communiquer, à s'alimenter et à contrôler sa salive.RésultatsLes patients porteurs d'une paralysie faciale unilatérale avaient une force labiale significativement plus faible et une capacité à articuler, à manger et à contrôler leur salivation significativement inférieure en comparaison des données de référence des populations saines. Le degré de paralysie faciale était significativement corrélé à la force labiale mais pas à la capacité à articuler, à l'intelligibilité, à la capacité à communiquer ou à s'alimenter et à contrôler sa salivation.ConclusionLa paralysie faciale périphérique acquise peut affecter la communication et la capacité à s'alimenter et à contrôler sa salivation. Les médecins doivent savoir qu'il n'y a pas de corrélation directe entre le degré de paralysie faciale et son effet sur la communication, la capacité à s'alimenter et à contrôler sa salivation. Il est, par conséquent, recommandé aux médecins de poser des questions spécifiques liées à ces problèmes fonctionnels pendant les consultations de routine et de proposer l'éventuelle intervention d'un orthophoniste ou d'un kinésithérapeute.



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Recommandation de la SFORL. Prise en charge des épistaxis dans le cadre de l’HTA

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1
Author(s): J. Michel, V.P. Escabasse, E. Bequignon, B. Vérillaud, L. Robard, L. Crampette, O. Malard
ObjectifPrésenter les recommandations de la Société française d'oto-rhino-laryngologie (SFORL) concernant la prise en charge des épistaxis dans le cadre de l'hypertension artérielle.MéthodesUn groupe de travail multidisciplinaire a été chargé d'effectuer une revue de la littérature scientifique sur la thématique étudiée. À partir de ces textes et de l'expérience de chacun, des recommandations ont été rédigées, puis relues par un groupe de lecture indépendant du groupe de travail. Une réunion de synthèse a permis d'aboutir au texte final. Les recommandations proposées ont été classées en grade A, B, C ou accord professionnel selon un niveau de preuve scientifique décroissant.RésultatsIl est recommandé de mesurer la pression artérielle des patients à la phase aiguë d'une épistaxis (Grade A), de contrôler médicalement les chiffres tensionnels élevés à la phase aiguë du saignement afin de diminuer sa durée, de surveiller la tension artérielle au décours de l'épistaxis, de contrôler médicalement les chiffres tensionnels élevés au décours du saignement afin de diminuer le risque de récidive. En cas de persistance de chiffres tensionnels élevés au décours d'une épistaxis sévère, il est recommandé de demander un bilan cardiovasculaire pour rechercher une maladie hypertensive sous-jacente (Grade B).



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Rhabdomyosarcome primitif de la thyroïde avec thrombose auriculaire chez un adulte

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1
Author(s): B. Febrero, I. Oviedo, A. Ríos, J.M. Rodríguez
IntroductionLe rhabdomyosarcome (RMS) est la tumeur des tissus mous la plus fréquente chez l'enfant. Elle est rare chez l'adulte. L'atteinte de la thyroïde est exceptionnelle et seuls quatre cas ont été rapportés : deux RMS primitives chez des enfants et deux cas chez de jeunes adultes avec dissémination métastatique sur la thyroïde. Nous rapportons le premier cas de la littérature d'un RMS primitif de la thyroïde chez l'adulte avec syndrome cave supérieur.Cas cliniqueUn homme de 67ans a été admis pour un œdème du membre supérieur s'étendant jusqu'à la région latérocervicale. Le scanner a montré une masse de 6cm dans l'hémithyroïde avec thrombose veineuse jusqu'à l'oreillette. Une ponction à l'aiguille fine a indiqué une catégorie Bethesda III. La chirurgie a révélé une thyroïde de consistance pierreuse. Une biopsie peropératoire a montré une néoplasie indifférenciée et aucune intervention chirurgicale complémentaire n'a été réalisée. Le patient est décédé 48heures plus tard. Une histologie définitive a montré un RMS.DiscussionLa thrombose veineuse due à une tumeur thyroïdienne est peu fréquente. Les rares articles de la littérature recommandent l'exérèse des carcinomes thyroïdiens avec thrombose auriculaire le plus rapidement possible après le diagnostic. Toutefois, dans les cas de carcinomes anaplasiques ou peu différenciés, l'exérèse est controversée. Si, dans le cas présent, il y avait eu un diagnostic histologique préopératoire, la chirurgie n'aurait pas été indiquée.



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Recommandation de la SFORL (version courte). Prise en charge spécifique des épistaxis dans le cadre d’une maladie de Rendu-Osler

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1
Author(s): L. Robard, J. Michel, V. Prulière Escabasse, E. Bequignon, B. Vérillaud, O. Malard, L. Crampette
ObjectifLes auteurs exposent les recommandations de la Société française d'oto-rhino-laryngologie et de chirurgie de la face et du cou (SFORL) concernant la prise en charge spécifique des épistaxis dans le cadre d'une maladie de Rendu-Osler.MéthodesUn groupe de travail multidisciplinaire a été chargé d'effectuer une revue de la littérature scientifique sur la thématique étudiée. À partir de ces textes et de l'expérience de chacun, des recommandations ont été rédigées, puis relues par un groupe de lecture indépendant du groupe de travail. Une réunion de synthèse a permis d'aboutir au texte final. Les recommandations proposées ont été classées en grade A, B, C ou accord professionnel selon un niveau de preuve scientifique décroissant.RésultatsLe diagnostic de maladie de Rendu-Osler s'établit sur la présence de trois signes parmi les quatre critères de Curaçao. Devant une épistaxis aiguë, il est recommandé de réaliser une compression bi-digitale. L'embolisation est réservée aux épistaxis résistantes. Les méchages avec du matériel non résorbable ou des cautérisations sont contre-indiqués. L'éducation thérapeutique est indispensable. Le traitement des télangiectasies de la muqueuse nasale est possible en utilisant différents moyens locaux. En cas de contrôle insuffisant, il est recommandé d'utiliser l'acide tranexamique par voie systémique.



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Traitement original des sténoses ischémiques des transplants coliques. À propos de deux cas

Publication date: February 2017
Source:Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 134, Issue 1
Author(s): S. Daldoul, A. Moussi, S. Sayari, M. Ben Moussa
IntroductionLe traitement des sténoses ischémiques du transplant colique est mal codifié.Cas cliniqueNous rapportons deux observations de patientes opérées pour une sténose ischémique de l'extrémité cervicale d'un transplant colique. Ce traitement avait consisté en une résection de la sténose avec confection d'une nouvelle anastomose cervicale après mobilisation du transplant colique par cervico-sterno-laparotomie chez une patiente et un nouveau transplant iléo-colique remplaçant uniquement le segment sténosé de l'ancienne coloplastie chez la deuxième.DiscussionÀ travers ces deux observations, nous discutons la complexité des modalités thérapeutiques de cette complication.ConclusionLe traitement de choix d'une sténose ischémique du transplant colique est la résection avec confection d'une nouvelle anastomose ; parfois la confection d'un nouveau transplant constitue la seule alternative thérapeutique.



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