Head and Neck Diseases by Alexandros G.Sfakianakis: 03/03/17

Παρασκευή 3 Μαρτίου 2017

Trans-oral robotic assisted tongue base mucosectomy for investigation of cancer of unknown primary in the head and neck region. The UK experience

Abstract

Introduction

The diagnosis of cancer of unknown primary (CUP) in head and neck occurs when the treating clinicians have utilised all available diagnostic tests and failed to identify the origin of the disease. There is no agreed consensus on which diagnostic investigations to use, or the order in which to use them in, although broad recommendations exist. Small tumours arising in the tongue base can be below the limits of resolution of conventional diagnostic techniques. Given the difficulty in targeting the tongue base, current practice involves blind random biopsies, which leads to a variable detection rate.

Robotically assisted surgical removal of the tongue base, tongue base mucosectomy (TBM) has been shown to improve diagnostic yield. This study reports the diagnostic hit rate for tongue base primaries using this technique from three centres in the UK.

Methods

Thirty-two patients from three UK head and neck cancer centres were classified as CUP after clinical examination, cross-sectional imaging, PET-CT as well as tonsillectomy and guided biopsies failed to identify a primary tumour.

Results

The primary tumour site was identified in the tongue base in 53% (n=17) of patients. In 15 patients the tumour was in the ipsliateral tongue base (88%) while in two cases (12%) the tumour was located in contra lateral tongue base.

Conclusion

Trans-oral robotic assisted TBM raises the possibility of identifying over 50% of tumours that would otherwise be classified as CUP. Identifying these in the contralateral tongue base has implications for treatment planning and outcome.

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Long term clinical and prosthetic outcomes of soft liner and clip attachments for bar/implant overdentures. A randomized controlled clinical trial

Abstract

Background

Long term clinical and prosthetic outcomes of soft liner attachments for bar/implant overdentures was not sufficiently investigated.

Objectives

The aim of this trial was to evaluate clinical and prosthetic outcomes of resilient liner and clip attachments for bar/implant-retained mandibular overdenture after 7 years.

Methods

Thirty edentulous male participants received 2 implants in the canine areas of the mandible. Three months later, implants were splinted with a resilient bar. Mandibular overdentures were connected to the bars with either clip (CR group, n=15) or resilient liner (RR group, n=15) attachments. Plaque index (PI), gingival index (GI), probing depth (PD), vertical bone loss (VBL), horizontal bone loss (HBLO) and prosthetic complications (PC) were evaluated at denture delivery (T0), 6 (T_6m), 12 (T1), 24 (T2), 36 (T3), 48 (T4), 60 (T5), 72 (T6) and 84 (T7) months after insertion.

Results

PI, and GI increased significantly with time for CR and decreased significantly for RR (p<.001). PD increased at T1 (CR) and T6m (RR) then decreased thereafter (p<.05). VBL increased significantly with time in both groups (p<.005). HBLO increased at T2 (CR) and T1(RR) then decreased thereafter. CR recorded significant higher PI, GI, PD, VBLO and HBLO compared to RR at all observation times (p<.042). The survival rates were 96.6% and 100% for CR and RR after 7 years. The most common PC for CR and RR were clip wears and separation of the resilient liner from the denture base respectively.

Conclusion

Within the limitations of this study, resilient liner attachments are recommended for bar/implant retained mandibular overdentures than clip attachments in terms of peri-implant tissue health and prosthetic complications after 7-years.

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Realistic kinetic loading of the jaw system during single chewing cycles: a finite element study

Summary

Although knowledge of short-range kinetic interactions between antagonistic teeth during mastication is of essential importance for ensuring interference-free fixed dental reconstructions, little information is available. In this study, the forces on and displacements of the teeth during kinetic molar biting simulating the power stroke of a chewing cycle were investigated by use of a finite-element model that included all the essential components of the human masticatory system, including an elastic food bolus. We hypothesized that the model can approximate the loading characteristics of the dentition found in previous experimental studies. The simulation was a transient analysis, i.e. it considered the dynamic behavior of the jaw. In particular, the reaction forces on the teeth and joints arose from contact, rather than nodal forces or constraints. To compute displacements of the teeth, the periodontal ligament (PDL) was modeled by use of an Ogden material model calibrated on the basis of results obtained in previous experiments. During the initial holding phase of the power stroke, bite forces were aligned with the roots of the molars until substantial deformation of the bolus occurred. The forces tilted the molars in the buccolingual and mesiodistal directions, but as the intrusive force increased the teeth returned to their initial configuration. The Ogden material model used for the PDL enabled accurate prediction of the displacements observed in experimental tests. In conclusion, the comprehensive kinetic finite element model reproduced the kinematic and loading characteristics of previous experimental investigations.

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Cover 1

Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3

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Brief Overview of This Month's JACI

Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3

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Reply

Publication date: Available online 3 March 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Phillip L. Lieberman, Dale T. Umetsu, Gillis J. Carrigan, Abdelkader Rahmaoui

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Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3

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Editorial Board

Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3

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Information for Readers

Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3

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News & Notes

Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3

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MicroRNA-155 is a critical regulator of type 2 innate lymphoid cells and IL-33 signaling in experimental models of allergic airway inflammation

Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3
Author(s): Kristina Johansson, Carina Malmhäll, Patricia Ramos-Ramírez, Madeleine Rådinger
BackgroundAllergic airway inflammation is triggered by allergen exposure through several steps including release of IL-33, which promotes cytokine (IL-5, IL-13) production by type 2 innate lymphoid cells (ILC2s). MicroRNA (miR)-155 has recently been described to regulate adaptive responses in allergic inflammation. However, the role of miR-155 in the regulation of ILC2s remains unexplored.ObjectiveWe sought to elucidate the contribution of miR-155 in ILC2 expansion using experimental murine models of allergic airway inflammation.MethodsTo determine the role of miR-155 in the regulation of ILC2s in allergic airway inflammation, miR-155 deficient (miR-155^−/−) and wild-type (WT) mice were subjected to acute or chronic allergen-induced inflammation or treated with recombinant IL-33.ResultsmiR-155 was 10-fold upregulated in WT-derived ILC2s in response to IL-33. Furthermore, miR-155^−/− mice demonstrated impaired lung IL-33 levels in response to allergen challenge and the number of ILC2s was significantly reduced in allergen-challenged miR-155^−/− mice compared with WT mice. Exogenous IL-33 treatment revealed that miR-155 is needed for IL-33–induced ILC2 expansion and eosinophilic airway inflammation. Indeed, ILC2s from IL-33–challenged miR-155^−/− lungs exhibited impaired proliferation, GATA-3 expression, and IL-13 production as compared with IL-33–challenged WT ILC2s.ConclusionsOur findings for the first time demonstrate that ILC2s and IL-33 signaling are regulated by miR-155 in allergic airway inflammation.

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CME Activities Calendar

Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3

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Targeted strategies directed at the molecular defect: Toward precision medicine for select primary immunodeficiency disorders

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Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3
Author(s): Luigi D. Notarangelo, Thomas A. Fleisher
Primary immunodeficiency disorders (PIDs) represent a range of genetically determined diseases that typically have increased susceptibility to infections and in many cases also have evidence of immune dysregulation that often presents as autoimmunity. Most recently, the concept of gain-of-function mutations associated with PIDs has become well recognized and adds a new dimension to the understanding of this group of disorders, moving beyond the more commonly seen loss-of-function mutations. The rapidly expanding genetic defects that have been identified in patients with previously uncharacterized PIDs has opened up the potential for targeted therapy directed at the specific disease-causing abnormality. This has been driven by linking PID-specific genetic defects to the associated unique abnormalities in cellular signaling pathways amenable to directed therapies. These include agents that either block overactive or enhance underresponsive cellular pathways. Selected primary immunodeficiencies were chosen, the genetic defects of which have been recently characterized and are amenable to targeted therapy, as a reflection of the power of precision medicine.

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Targeted strategies directed at the molecular defect: Toward precision medicine for select primary immunodeficiency disorders

Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3

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New frontiers in the therapy of primary immunodeficiency: From gene addition to gene editing

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Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3
Author(s): Donald B. Kohn, Caroline Y. Kuo
The most severe primary immune deficiency diseases (PIDs) have been successfully treated with allogeneic hematopoietic stem cell transplantation for more than 4 decades. However, such transplantations have the best outcomes when there is a well-matched donor available because immune complications, such as graft-versus-host disease, are greater without a matched sibling donor. Gene therapy has been developed as a method to perform autologous transplantations of a patient's own stem cells that are genetically corrected. Through an iterative bench-to-bedside-and-back process, methods to efficiently add new copies of the relevant gene to hematopoietic stem cells have led to safe and effective treatments for several PIDs, including forms of severe combined immune deficiency, Wiskott-Aldrich syndrome, and chronic granulomatous disease. New methods for gene editing might allow additional PIDs to be treated by gene therapy because they will allow the endogenous gene to be repaired and expressed under its native regulatory elements, which are essential for genes involved in cell processes of signaling, activation, and proliferation. Gene therapy is providing exciting new treatment options for patients with PIDs, and advances are sure to continue.

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Treatment of infants identified as having severe combined immunodeficiency by means of newborn screening

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Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3
Author(s): Morna J. Dorsey, Christopher C. Dvorak, Morton J. Cowan, Jennifer M. Puck
Severe combined immunodeficiency (SCID) is characterized by severely impaired T-cell development and is fatal without treatment. Newborn screening (NBS) for SCID permits identification of affected infants before development of opportunistic infections and other complications. Substantial variation exists between treatment centers with regard to pretransplantation care, and transplantation protocols for NBS identified infants with SCID, as well as infants with other T-lymphopenic disorders detected by using NBS. We developed approaches to management based on the study of infants identified by means of NBS for SCID who received care at the University of California, San Francisco (UCSF). From August 2010 through October 2016, 32 patients with NBS-identified SCID and leaky SCID from California and other states were treated, and 42 patients with NBS-identified non-SCID T-cell lymphopenia were followed. Our center's approach supports successful outcomes; systematic review of our practice provides a framework for diagnosis and management, recognizing that more data will continue to shape best practices.

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Immune defects caused by mutations in the ubiquitin system

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Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3
Author(s): Amos Etzioni, Aaron Ciechanover, Eli Pikarsky
The importance of the ubiquitin system in health and disease has been widely recognized in recent decades, with better understanding of the various components of the system and their function. Ubiquitination, which is essential to almost all biological processes in eukaryotes, was also found to play an important role in innate and adaptive immune responses. Thus it is not surprising that mutations in genes coding for components of the ubiquitin system cause immune dysregulation. The first defect in the system was described 30 years ago and is due to mutations in the nuclear factor κB (NF-κB) essential modulator, a key regulator of the NF-κB pathway. With use of novel sequencing techniques, many additional mutations in different genes involved in ubiquitination and related to immune system function were identified. This can be clearly illustrated in mutations in the different activation pathways of NF-κB, which result in aberrations in production of various proinflammatory cytokines. The inherited diseases typically manifest with immunodeficiency, autoimmunity, or autoinflammation. In this perspective we provide a short description of the ubiquitin system, with specific emphasis given to its role in the immune system. The various immunodeficiency conditions identified thus far in association with defective ubiquitination are discussed in more detail.

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A Special Thank-You to Our Reviewers

Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3

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The Editors' Choice

Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3
Author(s): Cezmi A. Akdis, Zuhair K. Ballas

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News Beyond Our Pages

Publication date: March 2017
Source:Journal of Allergy and Clinical Immunology, Volume 139, Issue 3
Author(s): Marc E. Rothenberg, Jean Bousquet

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Methylprednisolone aceponate for atopic dermatitis

Abstract

Background

The 4th generation topical corticosteroids (TCS) have demonstrated a most favorablerisk–benefit ratio. Methylprednisolone aceponate (MPA) is a non-halogenated corticosteroid with a methyl group at C6, which confers higher intrinsic activity. MPA is included in the group of potent TCS (category III/IV).

Methods

A literature review is carried out of the clinical efficacy, pharmacokinetics, and adverse effects of MPA, especially for the treatment of atopic dermatitis (AD).

Results

Several clinical studies support the use of MPA in infants and children, with minimal local or systemic adverse effects reported. The pharmacokinetic profile and the low rate of adverse effects of MPA are most suitable for the treatment of atopic dermatitis (AD), a chronic disease with frequent flaring that can involve extensive areas of the skin.

Conclusions

Most patients with AD can be easily brought into control with the use of only TCS. Achieving a complete healing of eczema is key in AD, and once the skin is clinically healthy, emollients can be used according to the physician and patient preferences. Physicians should be trained in the recognition of early or subtle manifestations of active eczema that are most suitably treated with topical TCS to achieve a most rapid and satisfactory control of the disease. If the whole area with eczema is not treated, active eczema will remain and treatment will be ineffective. Insufficient use of TCS will lead to inefficiency and frustration.

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Effects of combined prokinetic administration on gastric emptying in critically ill patients

Publication date: Available online 3 March 2017
Source:Arab Journal of Gastroenterology
Author(s): Afshin Gholipour Baradari, Mohammad Reza Khajavi, Abolfazl Firouzian, Abbas Alipour, Hojatallah Daneshpour, Yunes Panahi, Amirhossein Sahebkar
Background and study aimsCombination of prokinetic drugs with different mechanisms of action is frequently used when feeding intolerance is not improved with a single agent. In this study, we evaluated the effect of combined infusion of neostigmine and metoclopramide on gastric passage in critically ill patients in the intensive care unit (ICU).Patients and methodsThis study is a randomized double-blind controlled trial in 90 patients between 20 and 60years of age who were under mechanical ventilation and had gastric residual volumes (GRVs) >120mL 3h after the last lavage. Patients were randomly assigned to one of the following three groups: intravenous neostigmine 2.5mg, intravenous metoclopramide 20mg, and combination of both agents at the mentioned doses. Gastric volume aspiration was first performed before starting the study and then at 3, 6, 9, and 12h after the infusion of study drugs was finished. Increase in gastric lavage was defined as an aspiration volume of >120mL.ResultsIn total, 86 cases in the three groups completed the treatment (all 90 patients included in the study were analysed according to an intention-to-treat approach). There was no significant difference detected at baseline in age, intubation duration, albumin, haemoglobin, haematocrit, total leucocytic count (WBC), Na, K, Mg, and sequential organ failure assessment score between the study groups. In the combination group, 96.7% of patients showed GRV improvement (GRV<120cc), whereas in the metoclopramide and neostigmine groups, 50% and 43.3% of the patients, respectively, showed improvement (p<0.001). The frequency of overall adverse effects in the metoclopramide, neostigmine, and combination groups were 3.3%, 16.7%, and 10%, respectively (p=0.28).ConclusionsThe present results suggested that combination therapy with metoclopramide and neostigmine decreases GRV in critically ill patients with a higher efficacy than monotherapies.

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Lichen scrofulosorum: importance of early recognition

Summary

Lichen scrofulosorum (LS), a tuberculid affecting children and young adults, usually presents with asymptomatic skin-coloured to erythematous follicular and perifollicular papules over the trunk and extremities. An underlying focus of tuberculosis can be detected, but occasionally other mycobacterial infections may be responsible. The eruption is associated with a positive tuberculin test or positive interferon-gamma release assay. Perifollicular granulomas and absence of bacilli are the histopathological characteristics. LS can go unsuspected because of its waxing and waning course and close resemblance to other dermatoses. This article reviews the different clinical presentations and various associations of LS. We reiterate that the focus of internal infection may be subtle and go undetected, emphasizing the need for correct diagnosis and early treatment.

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Lichen scrofulosorum: importance of early recognition

Summary

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Visual acuity, oncologic, and toxicity outcomes with 103Pd vs. 125I plaque treatment for choroidal melanoma

Publication date: Available online 3 March 2017
Source:Brachytherapy
Author(s): Kirtesh R. Patel, Roshan S. Prabhu, Jeffrey M. Switchenko, Mudit Chowdhary, Caroline Craven, Pia Mendoza, Hasan Danish, Hans E. Grossniklaus, Thomas M. Aaberg, Thomas Aaberg, Sahitya Reddy, Elizabeth Butker, Chris Bergstrom, Ian R. Crocker
PurposeTo evaluate outcomes of choroidal melanoma patients treated with ¹²⁵I or ¹⁰³Pd plaque brachytherapy.Methods and MaterialsFrom 1993 to 2012, our institution treated 160 patients with ¹⁰³Pd (56.1%) and 125 patients with ¹²⁵I (43.9%) plaque brachytherapy. Tumor outcomes, visual acuity (VA), and toxicity were compared. Multivariate analyses (MVAs) and propensity score analysis were used to help address differences in baseline characteristics.ResultsMedian followup was longer for ¹²⁵I patients, 52.7 vs. 43.5 months (p < 0.01). At baseline, ¹⁰³Pd patients had lower rates of VA worse than 20/200 (4.4% vs. 16%, p = 0.002), T3–T4 tumors (17.5% vs. 32.8%, p = 0.03), and transpupillary thermotherapy use (3.1% vs. 9.6%, p = 0.001). Both ¹⁰³Pd and ¹²⁵I provided >90% 3-year overall survival and >93% 5-year secondary enucleation-free survival. On MVA, radionuclide was not predictive for tumor outcomes. A higher percentage maintained vision better than 20/40 with ¹⁰³Pd (63% vs. 35%, p = 0.007) at 3 years. MVA demonstrated ¹⁰³Pd radionuclide (odds ratio [OR]: 2.12, p = 0.028) and tumor height ≤5 mm (OR: 2.78, p = 0.017) were associated with VA better than 20/40. Propensity score analysis matched 23 ¹²⁵I with 107 ¹⁰³Pd patients. ¹⁰³Pd continued to predict better VA at 3 years (OR: 8.10, p = 0.014). On MVA for the development of VA worse than 20/200 or degree of vision loss, radionuclide was not significant. Lower rates of radiation retinopathy were seen with ¹⁰³Pd than ¹²⁵I (3 years: 47.3% vs. 63.9%, p = 0.016), with radionuclide significant in MVA.ConclusionsBoth ¹²⁵I and ¹⁰³Pd achieve excellent tumor control. An increased probability of long-term VA better than 20/40 and reduced risk of radiation retinopathy is associated with ¹⁰³Pd.

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Olfactory and gustatory functions in patients with non-complicated type 1 diabetes mellitus

Abstract

The aim of this study was to evaluate any possible relationship between diabetic state and olfactory and gustatory functions in patients with non-complicated diabetes mellitus type 1 (T1D), and also to present evidence of the association between olfactory and gustatory scores and HbA1c values and disease durations. The study included 39 patients with non-complicated T1D and 31 healthy controls. Clinical characteristics such as age, gender, duration of disease, education levels and biochemical analyses (fasting blood glucose, urea, creatinine, total cholesterol, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein (HDL-C), triglyceride, HbA1c, C-peptide, postprandial blood glucose) were measured. Subjective olfactory and gustatory tests were performed for all participants. There were no significant differences in olfactory tests between the two groups (odor thresholds 8.63 ± 0.91 vs. 8.55 ± 0.57, p = 0.66; odor discrimination 12.97 ± 0.80 vs. 12.74 ± 0.79, p = 0.24; odor identification 13.81 ± 0.98 vs. 13.72 ± 0.89, p = 0.69; TDI score 35.34 ± 1.94 vs. 34.97 ± 1.4, p = 0.37). There were also no significant differences in gustatory tests between the two groups (bitter 3.45 ± 0.51 vs. 3.44 ± 0.50, p = 0.90; sweet 3.32 ± 0.48 vs. 3.38 ± 0.49, p = 0.60; salty 3.13 ± 0.72 vs. 3.10 ± 0.72, p = 0.88; total score of taste 13.16 ± 1.61 vs. 13.13 ± 1.22, p = 0.92). Comparison of gustatory and olfactory scores according to disease duration of type 1 diabetes mellitus patients revealed that there were no differences between groups (all p > 0.05). T1D without complications may not be associated with olfactory and gustatory dysfunction according to subjective testing. We also found that gustatory and olfactory functions may not be related with HbA1c values and disease duration in non-complicated T1D.

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Adaptation and validation of the Dutch version of the nasal obstruction symptom evaluation (NOSE) scale

Abstract

The nasal obstruction symptom evaluation (NOSE) scale is a validated disease-specific, self-completed questionnaire for the assessment of quality of life related to nasal obstruction. The aim of this study was to validate the Dutch (NL-NOSE) questionnaire. A prospective instrument validation study was performed in a tertiary academic referral center. Guidelines for the cross-cultural adaptation process from the original English language scale into a Dutch language version were followed. Patients undergoing functional septoplasty or septorhinoplasty and asymptomatic controls completed the questionnaire both before and 3 months after surgery to test reliability and validity. Additionally, we explored the possibility to reduce the NOSE scale even further using graded response models. 129 patients and 50 controls were included. Internal consistency (Cronbach's alpha 0.82) and test–retest reliability (intraclass correlation coefficient 0.89) were good. The instrument showed excellent between-group discrimination (Mann–Whitney U = 85, p < 0.001) and high response sensitivity to change (Wilcoxon rank p < 0.001). The NL-NOSE correlated well with the score on a visual analog scale measuring the subjective sensation of nasal obstruction, with exception of item 4 (trouble sleeping). Item 4 provided the least information to the total scale and item 3 (trouble breathing through nose) the most, particularly in the postoperative group. The Dutch version of the NOSE (NL-NOSE) demonstrated satisfactory reliability and validity. We recommend the use of the NL-NOSE as a validated instrument to measure subjective severity of nasal obstruction in Dutch adult patients.

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Olfactory and gustatory functions in patients with non-complicated type 1 diabetes mellitus

Abstract

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Adaptation and validation of the Dutch version of the nasal obstruction symptom evaluation (NOSE) scale

Abstract

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Evidence-Based Tightrope Walking: The 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum

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Thyroid Mar 2017, Vol. 27, No. 3: 309-311.

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Evidence-Based Tightrope Walking: The 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum

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Thyroid Mar 2017, Vol. 27, No. 3: 309-311.

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The proteomic profile of the acquired enamel pellicle according to its location in the dental arches

Publication date: Available online 3 March 2017
Source:Archives of Oral Biology
Author(s): Talita Mendes da Silva Ventura, Luiza de Paula Silva Cassiano, Cíntia Maria de Souza e Silva, Even Akemi Taira, Aline de Lima Leite, Daniela Rios, Marília Afonso Rabelo Buzalaf
ObjectiveThis study evaluated the variation in the protein profile of the acquired enamel pellicle (AEP) formed in vivo according to its location in the dental arches.DesignThe AEP was formed for 120minutes in 9 volunteers. Pellicle formed at upper+lower anterior facial (ULAFa; teeth 13-23 and 33-43), upper anterior palatal (UAPa; teeth 13-23), lower anterior lingual (LALi; teeth 33-43), upper+lower posterior facial (ULPFa; teeth 14-17 24 to 27, 34 to 37 and 44 to 47), upper posterior palatal (UPPa; teeth 14 to 17 and 24 to 27) and lower posterior lingual (LPLi; teeth 34 to 37 and 44 to 47) regions was collected separately and processed for analysis by label-free LC-ESI-MS/MS.ResultsThree-hundred sixty three proteins were identified in total, twenty-five being common to all the locations, such as Protein S100-A8, Lysozyme C, Lactoferrin, Statherin, Ig alpha-2, ALB protein, Myeloperoxidase and SMR3B. Many proteins were found exclusively in the AEP collected from one of the regions (46-UAPa, 33-LALi, 59-ULAFa, 31-ULPFa, 44-LPLi and 39-UPPa).ConclusionsThe protein composition of the AEP varied according to its location in the dental arches. These results provide important insights for understanding the differential protective roles of the AEP as a function of its location in the dental arches.

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Lung Mass as the Complement to Lung Air Content in Quantitative CT of the COPD Lung

Publication date: April 2017
Source:Academic Radiology, Volume 24, Issue 4
Author(s): Eric A. Hoffman, John D. Newell

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Comparative Effectiveness of Imaging Modalities for the Diagnosis and Treatment of Intussusception

Publication date: Available online 3 March 2017
Source:Academic Radiology
Author(s): Anne G. Carroll, Richard G. Kavanagh, Caoilfhionn Ni Leidhin, Noelle M. Cullinan, Lisa P. Lavelle, Dermot E. Malone
Rationale and ObjectivesThe purpose of this study was to critically appraise and compare the diagnostic performance of imaging modalities that are used for the diagnosis of intussusception and methods used in the treatment of ileocolic intussusception.MethodsA focused clinical question was constructed and the literature was searched using the patient, intervention, comparison, outcome (PICO) method comparing radiography, ultrasound, and computed tomography in the detection of intussusception. The same methods were used to compare pneumatic (gas) reduction and hydrostatic (liquid) reduction using saline, water-soluble contrast, and barium. Retrieved articles were appraised and assigned a level of evidence based on the Oxford University Centre for Evidence-Based Medicine hierarchy of validity for diagnostic studies.ResultsThe retrieved sensitivity for the diagnosis of intussusception using plain radiography is 48% (95% confidence interval [CI], 44%–52%), with a specificity of 21% (95% CI, 18%–24%). The retrieved sensitivity for the diagnosis of intussusception using ultrasound is 97.9% (95% CI, 95%–100%), with a specificity of 97.8% (95% CI, 97%–99%). Based on a good quality meta-analysis, the combined success rate of gas enema reduction was shown to be 82.7% (95% CI, 79.9%–85.6%) compared to a combined success rate of 69.6% (95% CI, 65.0%–74.1%) for liquid enema reduction.ConclusionsThe best available evidence recommends ultrasound as the diagnostic modality of choice for the diagnosis of ileocolic intussusception in children. In stable children without signs of peritonism, nonoperative reduction is the treatment of choice. Pneumatic (gas) reduction enema has been shown to be superior to hydrostatic (liquid) enema reduction.

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“An approach to the dizzy patient”: Revisited

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Importance of an Interprofessional Team Approach in Achieving Improved Management of the Dizzy Patient

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Pitch Matching between Electrical Stimulation of a Cochlear Implant and Acoustic Stimuli Presented to a Contralateral Ear with Residual Hearing

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Automated Smartphone Threshold Audiometry: Validity and Time Efficiency

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The Effect of Signal-to-Noise Ratio on Linguistic Processing in a Semantic Judgment Task: An Aging Study

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The Effect of Learning Modality and Auditory Feedback on Word Memory: Cochlear-Implanted versus Normal-Hearing Adults

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Pediatric Minimum Speech Test Battery

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Audiological Rehabilitation for Facilitating Hearing Aid Use: A Review

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JAAA CEU Program

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Patient-Centered Anesthesia Triage System Predicts ASA Physical Status.

BACKGROUND: The purpose of this study was to validate a patient-centered anesthesia triage system (PCATS) by examining its association with, and predictive value of, ASA physical status (PS) classification. ASA PS classification is a widely used indicator of health status and the predictor of risk of perioperative complications. Thus, ASA PS is a good triage point such that healthy surgical patients (ASA PS I and II) undergoing low-complexity surgery are assessed by telephone, whereas less-healthy patients (ASA PS III and IV) or those patients undergoing highly complex surgery are seen in person at a presurgical clinic. However, ASA PS is not commonly available in electronic health records or easily determined by nonanesthesiologists. PCATS criteria, including the number of prescription medications used daily, body mass index (BMI), age, and surgical complexity, are readily available in electronic health records. Nonclinical scheduling personnel can use PCATS to make appropriate preassessment appointments for elective surgical patients before surgery. METHODS: After getting approval from the University of Florida IRB for an exempt study, 300 -consecutive patients scheduled in the presurgical clinic over a 1-week span were retrospectively enrolled. Each of the records was reviewed and collated for study identification number, number of prescription medications, BMI, and ASA PS classification assigned on the day of surgery. In addition, a surgical complexity score was assigned to each procedure (high, moderate, minimal). The association between PCATS and individual PCATS criteria and ASA PS was assessed by [chi]2 test. The utility of PCATS to discriminate between ASA PS classifications was assessed using receiver operating characteristic (ROC) curves as well as other indicators of clinical validity: sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and positive clinical utility index ([CIU+] = sensitivity x PPV) and negative CIU ([CIU-] = specificity x PPV). RESULTS: BMI (P = .002), age (P = .01), surgical complexity (P 35, age > 80 years, 5 or more prescriptions, and high surgical complexity. Eighty-seven percent of patients with any PCATS criterion were ASA PS classification III or IV. From ROC curve analysis, PCATS emerged as a significant, and moderately good, predictor of ASA PS class (area under the curve = 0.75, 95% confidence interval [CI] = 0.69-0.83). PCATS was highly sensitive (0.88, 95% CI = 0.84-0.92) and specific (0.74; 95% CI = 0.61-0.86), and had excellent utility in confirmation/case finding (CUI+ = 0.83, 95% CI = 0.82-0.84) and moderate utility in screening out cases (CUI- = 0.43, 95% CI = 0.41-0.44). CONCLUSION: PCATS serves as a useful, and valid, predictor of ASA PS classification. Thus, it may also serve as a tool to triage patients to an appropriate venue for preoperative assessment that can be utilized by nonclinical schedulers. Using a simple tool such as PCATS may help streamline the presurgical patient experience and improve clinic staff utilization. (C) 2017 International Anesthesia Research Society

http://ift.tt/2mPCfew

Nucleation and growth mechanisms of nano-scaled Si precipitates in Al-7Si supersaturated solid solution

Publication date: 5 May 2017
Source:Materials & Design, Volume 121
Author(s): Maowen Liu, Hui Fu, Lixi Tian, Wenlong Xiao, Qiuming Peng, Chaoli Ma
A dense uniform distribution of nano-scaled Si precipitates has been achieved in Al-7Si alloy by high pressure solution treatment (HPST) and aging treatment. Precipitation behavior of Si phase was investigated using transmission electron microscopy (TEM). The results reveal that Si clusters initially precipitate from the Al(Si) solid solution, providing preferable nucleation sites for the equilibrium Si phase. The Si crystals exhibit spherical shape at first, and then grow rapidly parallel to {111}Si planes. The shortage of growth ledges on {111} interfaces leads to the inhibition of growth perpendicular to these planes, which results in Si triangles and platelets with high aspect ratio. An equation about the relationship between the relative free energy and the equilibrium ledge densities on Al-Si interfaces was proposed.

Graphical abstract

http://ift.tt/2loBkEY

Psychophysiological Measurement of Backward Response Activation in the Prioritized Processing Paradigm.

Author: Miller, Jeff

DOI: 10.1037/xhp0000356

Publication Date: POST AUTHOR CORRECTIONS, 2 March 2017

http://ift.tt/2lGcz2k

Temporal Binding and Internal Clocks: No Evidence for General Pacemaker Slowing.

Author: Fereday, Richard; Buehner, Marc J.

DOI: 10.1037/xhp0000370

Publication Date: POST AUTHOR CORRECTIONS, 2 March 2017

http://ift.tt/2mofvVP

The Necessity of Visual Attention to Scene Categorization: Dissociating "Task-Relevant" and "Task-Irrelevant" Scene Distractors.

Author: Gronau, Nurit; Izoutcheev, Anna

DOI: 10.1037/xhp0000365

Publication Date: POST AUTHOR CORRECTIONS, 2 March 2017

http://ift.tt/2lGiHHJ

Time and temperature mediated evolution of CDHA from ACP nanoparticles in deep eutectic solvents: Kinetic and thermodynamic considerations

Publication date: 15 May 2017
Source:Materials & Design, Volume 122
Author(s): Mohammad Karimi, Saeed Hesaraki, Masoud Alizadeh, Asghar Kazemzadeh
Calcium phosphate (CP) nanoparticles were synthesized in choline chloride-urea deep eutectic solvent (DES). The effect of synthesis time and temperature on crystallinity, particulate properties, and elemental/chemical purity of the CP nanoparticles were investigated by X-ray diffraction, field emission scanning electron microscopy, energy dispersive X-ray spectroscopy, and Fourier transform infra-red spectroscopy. The results confirmed the formation of amorphous calcium phosphate (ACP) nanoparticles (at 25°C for 10min) with spherical morphology, mean diameter of 29nm, and high elemental-structural purity. The increase of synthesis time from 10min to 48h at 25°C had no significant influence on the phase transformation of ACP nanoparticle so that the nanoparticles showed high degree of amorphization after 48h. The crystallization of particles rapidly rose upon increase of the synthesis temperature so that the nanoparticles of calcium-deficient hydroxyapatite (CDHA) with percent crystallinity of ~97% were obtained in choline chloride-urea DES at 150°C after 24h. Kinetic and thermodynamic studies revealed that upon increase of temperature from 25 to 150°C, the rate constant and Gibbs free energy for growth of CP crystals in the DES rises from 8.70×10⁻⁴ to 1.37×10⁻³min⁻¹ and 3.22×10⁺² to 4.57×10⁺²KJ·mol⁻¹, respectively.

Graphical abstract

http://ift.tt/2loGXTI

Cyclopropenone-masked dibenzocyclooctyne end-functionalized polymers from reversible addition-fragmentation chain transfer polymerization

Publication date: 7 April 2017
Source:Polymer, Volume 114
Author(s): Lin Qu, Ying Wu, Peng Sun, Ke Zhang, Zhengping Liu
Functional reversible addition-fragmentation chain transfer polymerization (RAFT) agent was developed to have a cyclopropenone-masked dibenzocyclooctyne end group. RAFT polymerization was then explored on three typical types of vinyl monomers in free radical polymerization such as styrene, methyl methacrylate, and tert-butyl acrylate. The living polymerization behaviors were demonstrated for all three cases, which guaranteed the production of well-defined polystyrene, poly (methyl methacrylate), and poly (tert-butyl acrylate) end-functionalized with cyclopropenone-masked dibenzocyclooctyne groups from the convenient RAFT polymerization technique. Under UV irradiation, the cyclopropenone-masked dibenzocyclooctyne end group could be quantitatively changed to dibenzocyclooctyne clickable group, which was widely used in the metal-free strain-promoted azide-alkyne cycloaddition (SPAAC) click reaction. Subsequently, using the dibenzocyclooctyne end-functionalized polymers as building blocks, a practical and efficient metal-free method was developed for the formation of topological polymers including block and bottlebrush polymers based on the SPAAC click reaction.

Graphical abstract

http://ift.tt/2lG6cMu

Sharp and strong “Brill transition” of poly(hexamethylene dithiocarbonate)

Publication date: 24 March 2017
Source:Polymer, Volume 113
Author(s): Ti-Peng Zhao, Annamaria Celli, Xiang-Kui Ren, Jia-Ru Xu, Shuang Yang, Chen-Yang Liu, Er-Qiang Chen
In this paper, the reversible crystal-crystal transition of poly(hexamethylene dithiocarbonate) (PHMDC) has been systematically studied. According to various experimental results, we confirm that the transition shares the common features with Brill transition that is widely observed in nylons. This transition is clearly associated with the reversible trans-gauche conformational transformation of the methylene sequences in the crystal lattice. Therefore, in addition to its analogue poly(octamethylene carbonate) POMC (ACS Macro Lett. 2015, 4, 317–321), PHMDC can be considered as a new example of the polymers exhibiting Brill transition outside the nylon family. Careful examination of the experimental data reveals that for PHMDC the enthalpy ratio of the Brill transition to the melting is a constant of ∼2/3, independent of the crystallization condition applied. Furthermore, the difference between the Brill transition temperatures determined from heating and cooling is also a constant, which is of ∼4 °C. These new observations are obtained because the Brill transition of PHMDC is sharp and possesses a large transition enthalpy. Such a transition is associated with that the methylene segments in PHMDC can change their conformation between trans and gauche rapidly and completely in a narrow temperature interval.

Graphical abstract

http://ift.tt/2lG6cvY

Near-infrared luminescent erbium complexes with 8-hydroxyquinoline-terminated hyperbranched polyester

Publication date: 24 March 2017
Source:Polymer, Volume 113
Author(s): Dan Liu, Chengjian Li, Yaling Xu, Dapeng Zhou, Hongmei Wang, Ping Sun, Huasheng Jiang
Novel 8-hydroxyquinoline-terminated hyperbranched polyesters (1-HBPQ and 2-HBPQ) were synthesized and characterized by ¹H-NMR and UV-Vis analyses. Then, two erbium complexes (1-HBPQ-Er³⁺-HQ and 2-HBPQ-Er³⁺-HQ) were prepared by using 1-HBPQ or 2-HBPQ as the macromolecular ligand and 8-hydroxyquinoline (HQ) as a second ligand. The FTIR spectra and UV-Vis absorption spectra confirmed that both the macromolecular ligand and the second ligand were successfully coordinated with Er³⁺ ions. The erbium complexes emitted intense near-infrared luminescence at about 1530 nm, which corresponds to the ⁴I13/2-⁴I15/2 transition of Er³⁺ ions. Moreover, their full width at half maximum (FWHM) values were greater than 80 nm. The erbium complexes exhibited good solubility in conventional solvents and excellent near-infrared luminescence properties, indicating their promising potential as gain medium materials in optical amplification devices.

Graphical abstract

http://ift.tt/2lFQqBk

Ignoring Memory Hints: The Stubborn Influence of Environmental Cues on Recognition Memory.

Author: Selmeczy, Diana; Dobbins, Ian G.

DOI: 10.1037/xlm0000383

Publication Date: POST AUTHOR CORRECTIONS, 2 March 2017

http://ift.tt/2mPAChd

Accessibility Limits Recall From Visual Working Memory.

Author: Rajsic, Jason; Swan, Garrett; Wilson, Daryl E.; Pratt, Jay

DOI: 10.1037/xlm0000387

Publication Date: POST AUTHOR CORRECTIONS, 2 March 2017

http://ift.tt/2lozHXK

Reading Time Allocation Strategies and Working Memory Using Rapid Serial Visual Presentation.

Author: Busler, Jessica N.; Lazarte, Alejandro A.

DOI: 10.1037/xlm0000392

Publication Date: POST AUTHOR CORRECTIONS, 2 March 2017

http://ift.tt/2mPF9QO

A Two-Phase Model of Resource Allocation in Visual Working Memory.

Author: Ye, Chaoxiong; Hu, Zhonghua; Li, Hong; Ristaniemi, Tapani; Liu, Qiang; Liu, Taosheng

DOI: 10.1037/xlm0000376

Publication Date: POST AUTHOR CORRECTIONS, 2 March 2017

http://ift.tt/2loxtYx

Predicting and Priming Thematic Roles: Flexible Use of Verbal and Nonverbal Cues During Relative Clause Comprehension.

Author: Kowalski, Alix; Huang, Yi Ting

DOI: 10.1037/xlm0000389

Publication Date: POST AUTHOR CORRECTIONS, 2 March 2017

http://ift.tt/2mPDpGY

The Case of the Missing Visual Details: Occlusion and Long-Term Visual Memory.

Author: Williams, Carrick C.; Burkle, Kyle A.

DOI: 10.1037/xlm0000393

Publication Date: POST AUTHOR CORRECTIONS, 2 March 2017

http://ift.tt/2loFHjx

Combined venomics, antivenomics and venom gland transcriptome analysis of the monocoled cobra (Naja kaouthia) from China

Publication date: Available online 3 March 2017
Source:Journal of Proteomics
Author(s): Ning Xu, Hong-Yan Zhao, Yin Yin, Shan-Shan Shen, Lin-Lin Shan, Chuan-Xi Chen, Yan-Xia Zhang, Jian-Fang Gao, Xiang Ji
We conducted an omics-analysis of the venom of Naja kaouthia from China. Proteomics analysis revealed six protein families [three-finger toxins (3-FTx), phospholipase A2 (PLA2), nerve growth factor, snake venom metalloproteinase (SVMP), cysteine-rich secretory protein and ohanin], and venom-gland transcriptomics analysis revealed 28 protein families from 79 unigenes. 3-FTx (56.5% in proteome/82.0% in transcriptome) and PLA2 (26.9%/13.6%) were identified as the most abundant families in venom proteome and venom-gland transcriptome. Furthermore, N. kaouthia venom expressed strong lethality (i.p. LD50: 0.79μg/g) and myotoxicity (CK: 5939U/l) in mice, and showed notable activity in PLA2 but weak activity in SVMP, l-amino acid oxidase or 5′ nucleotidase. Antivenomic assessment revealed that several venom components (nearly 17.5% of total venom) from N. kaouthia could not be thoroughly immunocaptured by commercial Naja atra antivenom. ELISA analysis revealed that there was no difference in the cross-reaction between N. kaouthia and N. atra venoms against the N. atra antivenom. The use of commercial N. atra antivenom in treatment of snakebites caused by N. kaouthia is reasonable, but design of novel antivenom with the attention on enhancing the immune response of non-immunocaptured components should be encouraged.Biological significanceThe venomics, antivenomics and venom-gland transcriptome of the monocoled cobra (Naja kaouthia) from China have been elucidated. Quantitative and qualitative differences are evident when venom proteomic and venom-gland transcriptomic profiles are compared. Two protein families (3-FTx and PLA2) are found to be the predominated components in N. kaouthia venom, and considered as the major players in functional role of venom. Other protein families with relatively low abundance appear to be minor in the functional significance. Antivenomics and ELISA evaluation reveal that the N. kaouthia venom can be effectively immunorecognized by commercial N. atra antivenom, but still a small number of venom components could not be thoroughly immunocaptured. The findings indicate that exploring the precise composition of snake venom should be executed by an integrated omics-approach, and elucidating the venom composition is helpful in understanding composition-function relationships and will facilitate the clinical application of antivenoms.

Graphical abstract

http://ift.tt/2mlrXVQ

Proteomic analysis of chondromodulin-I-induced differentiation of mesenchymal stem cells into chondrocytes

Publication date: Available online 2 March 2017
Source:Journal of Proteomics
Author(s): Shuang-chun Xing, Lian-xin Du, Wei Zhou, Yu-qiang Hu, Ya Feng, Hong-feng Liang, Lin Sang, Min Qi, Li-jie Zhai, Zhi-qiang Wang
To identify novel proteins that might help clarify the molecular mechanisms underlying chondromodulin-I (ChM-I) induction of mesenchymal stem cells (MSCs) differentiate into chondrocytes. MSCs are triggered to differentiate into chondrocytes, which are recognized as important factors in cartilage tissue engineering. ChM-I is a glycoprotein that stimulates the growth of chondrocytes and inhibits angiogenesis in vitro. In this study, the proteomic approach was used to evaluate protein changes between undifferentiated MSCs and ChM-I-transfected MSCs. The expression of the protein spots was analyzed using two-dimensional gel electrophoresis. Then, 14 protein spots were identified between MSCs and ChM-I-transfected MSCs. 309 proteins were identified using mass spectrometry (MS). The differentially regulated proteins were categorized and annotated using Protein Analysis Through Evolutionary Relationships (PANTHER) analysis with the aid of the Database for Annotation, Visualization and Integrated Discovery (DAVID) tool. These proteins are included in a variety of metabolic pathways and signal transduction pathways, such as focal adhesion, glycolysis, actin cytoskeleton regulation, and ribosome. These results demonstrate novel information about the molecular mechanism by which ChM-I induce MSCs to differentiate into chondrocytes. These results also provide a solid foundation for the development of tissue-engineered cartilage.

Graphical abstract

http://ift.tt/2mlrWRM

Klinefelter syndrome: cardiovascular abnormalities and metabolic disorders

Abstract

Klinefelter syndrome (KS) is one of the most common genetic causes of male infertility. This condition is associated with much comorbidity and with a lower life expectancy. The aim of this review is to explore more in depth cardiovascular and metabolic disorders associated to KS. KS patients have an increased risk of cerebrovascular disease (standardized mortality ratio, SMR, 2.2; 95% confidence interval, CI, 1.6–3.0), but it is not clear whether the cause of the death is of thrombotic or hemorrhagic nature. Cardiovascular congenital anomalies (SMR, 7.3; 95% CI, 2.4–17.1) and the development of thrombosis or leg ulcers (SMR, 7.9; 95% CI, 2.9–17.2) are also more frequent in these subjects. Moreover, cardiovascular abnormalities may be at least partially reversed by testosterone replacement therapy (TRT). KS patients have also an increased probability of endocrine and/or metabolic disease, especially obesity, metabolic syndrome and type 2 diabetes mellitus. The effects of TRT on these abnormalities are not entirely clear.

http://ift.tt/2lG1spX

Nodular fasciitis of the breast clinically resembling breast cancer in an elderly woman: a case report

Nodular fasciitis is a benign reactive proliferative lesion of fibroblast cells, which can occur throughout the body. However, it has rarely been reported in the breast of an elderly woman.

http://ift.tt/2mWlCgK

Early inflammatory changes in radiation-induced oral mucositis

Abstract

Purpose

Early inflammation is a major factor of mucosal reactions to radiotherapy. Pentoxifylline administration resulted in a significant amelioration of radiation-induced oral mucositis in the mouse tongue model. The underlying mechanisms may be related to the immunomodulatory properties of the drug. The present study hence focuses on the manifestation of early inflammatory changes in mouse tongue during daily fractionated irradiation and their potential modulation by pentoxifylline.

Materials and methods

Daily fractionated irradiation with 5 fractions of 3 Gy/week (days 0–4, 7–11) was given to the snouts of mice. Groups of 3 animals per day were euthanized every second day between day 0 and 14. Pentoxifylline (15 mg/kg, s. c.) was administered daily from day 5 to the day before sacrifice. The expression of the inflammatory proteins TNFα, NF-κB, and IL-1β were analysed.

Results

Fractionated irradiation increased the expression of all inflammatory markers. Pentoxifylline significantly reduced the expression of TNFα and IL-1β, but not NF-κB.

Conclusion

Early inflammation, as indicated by the expression of the inflammatory markers TNFα, NF-κB, and IL-1β, is an essential component of early radiogenic oral mucositis. Pentoxifylline differentially modulated the expression of different inflammatory markers. The mucoprotective effect of pentoxifylline does not appear to be based on modulation of NF-κB-associated inflammation.

http://ift.tt/2lEENul

Trimethylamine removal by plant capsule of Sansevieria kirkii in combination with Bacillus cereus EN1

Abstract

Trimethylamine (TMA) contamination produces a strong "fishy" odor and can cause pathological changes in humans. By screening native microorganisms from Sansevieria kirkii exposed to 100 ppm TMA, it was shown that endophytic bacteria number 1 (EN1) and number 2 (EN2) have a higher TMA tolerance and removal capacity than other bacteria species in a closed system. In addition, EN1 and EN2 demonstrated the ability to produce high quantities of indole-3-acetic acid (IAA) and use 1-aminocyclopropane-1-carboxylic acid (ACC), which is found normally in plant growth-promoting bacteria (PGPB). Moreover, 16S ribosomal DNA (rDNA) sequences of EN1 and EN2 identification showed that EN1 and EN2 was the same bacteria species, Bacillus cereus. B. cereus EN1 was chosen to apply with S. kirkii to remove TMA in a plant capsule, which was compared to control conditions. It was found that 500 g of soil with S. kirkii inoculated with B. cereus EN1 had a higher TMA removal efficiency than other conditions. Moreover, the flow rate of TMA-contaminated gas was varied (0.03–1 L min⁻¹) to calculate the loading rate and elimination capacity. The maximum loading rate of 500 g soil with B. cereus EN1-inoculated S. kirkii was 2500 mg m⁻³ h⁻¹, while other conditions showed only around 250–750 mg m⁻³ h⁻¹. Therefore, a plant capsule with B. cereus EN1-inoculated S. kirkii had the potential to be applied in TMA-contaminated air.

http://ift.tt/2m5Tytt

Examining predictors of chemical toxicity in freshwater fish using the random forest technique

Abstract

Chemical pollution is one of the main issues globally threatening the enormous biodiversity of freshwater ecosystems. The toxicity of substances depends on many factors such as the chemical itself, the species affected, environmental conditions, exposure duration, and concentration. We used the random forest technique to examine the factors that mediate toxicity in a set of widespread fishes and analyses of covariance to further assess the importance of differential sensitivity among fish species. Among 13 variables, the 5 most important predictors of toxicity with random forests were, by order of importance, the chemical substance itself (i.e., Chemical Abstracts Service number considered as a categorical factor), octanol-water partition coefficient (log P), pollutant prioritization, ecological structure-activity relationship (ECOSAR) classification, and fish species for 50% lethal concentrations (LC₅₀) and the chemical substance, fish species, log P, ECOSAR classification, and water temperature for no observed effect concentrations (NOECs). Fish species was a very important predictor for both endpoints and with the two contrasting statistical techniques used. Different fish species displayed very different relationships with log P, often with different slopes and with as much importance as the partition coefficient. Therefore, caution should be exercised when extrapolating toxicological results or relationships among species. In addition, further research is needed to determine species-specific sensitivities and unravel the mechanisms behind them.

http://ift.tt/2m5H310

Lactational exposure to abamectin induced mortality and adverse biochemical and histopathological effects in suckling pups

Abstract

Information about the adverse effects of lactation transfer of abamectin (ABA) is important for human health, especially in the third-world countries where breastfeeding is the only source of nutrition for infants. So, the present study was undertaken to evaluate the adverse effects of breastfeeding exposure to ABA on oxidative damage and liver and kidney dysfunction in suckling rats. Dams were orally administered ABA at a doses 22.10, 11.05, and 2.21 mg a.i./kg b.wt from postnatal day 1 (PND1) until day 20 (PND20). The signs of toxicity and high mortality were recorded in suckling male (67.5%) and female (55.0%) pups whose mother exposed to the ABA at dose 22.1 mg a.i./kg b.wt. ABA induced significantly decrease in body weights of mothers and their male and female pups and significant increase in relative liver weights. It caused oxidative stress in the liver and kidney of mothers and their pups by increasing the level of malondialdehyde (MDA) and decreased activities of superoxide dismutase (SOD) and glutathione-transferase (GST). ABA altered the level of serum liver and kidney dysfunction biomarkers either in the mothers or their male and female pups in a dose-dependent manner. It caused histopathological alterations in the liver and kidney tissues. It can be decided that ABA was accumulated in mother's milk, transferred through breast feeding, and induced mortality in their suckling pups. It caused oxidative stress, lipid peroxidation, and biochemical and histopathological alterations in the liver and kidney of mothers and their suckling pups. The results in the present study add some information about the adverse effect of lactation transfer of ABA, which is important for human health in the third-world countries where breastfeeding may be the only source of nutrition for infants in the first and most critical weeks of life.

http://ift.tt/2m4tSvR

Reclamation of Cr-contaminated or Cu-contaminated agricultural soils using sunflower and chelants

Abstract

Chromium (Cr) and copper (Cu) are pollutants with a strong environmental impact. "Green biotechnology" as phytoremediation represents a sustainability opportunity for soil reclamation. In this study, we evaluated the possibility to reclaim agricultural soils located in the Solofrana valley, contaminated by Cr or Cu. Chromium contamination derives by repeated flooding events of Solofrana rivers containing Cr because of leather tanning plants, while Cu soil pollution was due to the use of Cu-rich pesticides in agriculture. Both metals showed a very low bioavailability. In order to perform an assisted phytoremediation of polluted fields, we carried out a preliminary ex situ experimentation testing for the first time sunflowers (cv. Pretor) and chelants (ethylenediaminetetraacetic acid (EDTA) and/or ethylene diamine disuccinate (EDDS)), useful when metal bioavailability is low. No symptoms of toxicity were observed in sunflowers grown on both soils, while biomass was improved when EDDS was added. Cr and Cu bioavailability was only slightly enhanced by chelants at the end of the treatments. Both Cr and Cu were mainly accumulated in the roots; moreover, Cu was also translocated to the aboveground organs in the presence of EDTA. The ex situ experimentation demonstrated that assisted phytoremediation is a very slow process not useful in the case of persistent pollution.

http://ift.tt/2m4CSB4

Degradation of chloramphenicol by potassium ferrate (VI) oxidation: kinetics and products

Abstract

The oxidation of chloramphenicol (CAP) by potassium ferrate (VI) in test solution was studied in this paper. A series of jar tests were performed at bench scale with pH of 5–9 and molar ratio [VI/CAP] of 16.3:1–81.6:1. Results showed that raising VI dose could improve the treatment performance and the influence of solution pH was significant. VI is more reactive in neutral conditions, presenting the highest removal efficiency of CAP. The rate law for the oxidation of CAP by VI was first order with respect to each reactant, yielding an overall second-order reaction. Furthermore, five oxidation products were observed during CAP oxidation by VI. Results revealed that VI attacked the amide group of CAP, leading to the cleavage of the group, while benzene ring remained intact.

http://ift.tt/2m5RJwZ

Phonak's Rechargeable Hearing Aid Wins International Design Award

The rechargeable hearing aid, Audéo B-R, by Phonak (https://www.phonak.com/) was recognized for its smart charging designs with the 2017 iF DESIGN AWARD. Audéo B-R was selected from 5,575 entries to receive the award in the product category by 58 independent experts from 19 countries. The iF panel of judges lauded the device's rechargeable features, which include a 30-minute charging option offering six hours of immediate use and a power pack that provides power for seven full charges for two hearing aids. Thomas Lang, senior vice president of marketing at Phonak, said, "The award underlines our efforts to pair the highest standards in hearing performance, ease of use, and innovation with outstanding design to help people with hearing loss live better lives."

The iF Design Award (http://ift.tt/1UbvApr) is given out by the iF International Forum Design GmbH in the product, communication and service design, architecture and interior architecture, and professional concepts categories. All award winners are featured in the iF WORLD DESIGN GUIDE, the iF design app, and are showcased at the iF design exhibition Hamburg.

Published: 3/3/2017 9:00:00 AM

http://ift.tt/2m5HjNy

Nerve Blocks Under General Anesthesia: Time to Liberalize Indications?.

No abstract available

http://ift.tt/2mWnnum

Anterior Suprascapular Nerve Block Versus Interscalene Brachial Plexus Block for Shoulder Surgery in the Outpatient Setting: A Randomized Controlled Patient- and Assessor-Blinded Trial.

Background and Objectives: The interscalene brachial plexus block (ISB), a potent option to control pain after shoulder surgery, has notable adverse effects. The anterior suprascapular nerve block (SSNB) might provide comparable analgesia and cause less grip-strength impairment. These characteristics were studied in this randomized controlled patient- and assessor-blinded trial. Methods: Outpatients were randomized to single-shot ultrasound-guided SSNB (10 mL ropivacaine 1%) or ISB (20 mL ropivacaine 0.75%) before general anesthesia for arthroscopic shoulder surgery. Pain (Numerical Rating Scale, 0-10), grip strength, degree of satisfaction, and strength of recommendation were assessed. Results: We randomized 168 patients to each group and analyzed 164 in the SSNB group and 165 in the ISB group. Nerve blocks were successful in 98% of the patients from each group. Both procedures provided good postoperative analgesia, and the mean pain level for SSNB was slightly but significantly lower by 0.32 units (95% confidence interval, 0.18-0.46; P

http://ift.tt/2m61R8P

Interactions micro-organismes et voies aériennes distales : spécificités pédiatriques

Publication date: Available online 3 March 2017
Source:Revue des Maladies Respiratoires
Author(s): J. de Blic, J. Brouard, A. Vabret, A. Deschildre
Le spectre des virus à tropisme respiratoire s'élargit et des maladies émergentes sont régulièrement décrites depuis une quinzaine d'années. L'origine de ces virus respiratoires émergents peut être zoonotique (par franchissement de barrière d'espèce, après mutations pour les virus à ARN tels que les virus aviaires influenza de type A ou les coronavirus), ou liée aux nouvelles techniques d'identification (métapneumovirus, bocavirus). Les relations entre bronchiolite et asthme sont désormais mieux appréhendées grâce au suivi prospectif de cohortes de nouveau-nés. Le rôle des rhinovirus devient prépondérant par rapport au virus respiratoire syncytial. L'identification de facteurs de prédispositions immunologiques, fonctionnelles, atopiques et génétiques, pour la survenue de l'asthme après une infection à rhinovirus suggère que l'infection virale révèle un terrain prédisposé plutôt qu'elle est à l'origine de l'asthme. Le rôle des bactéries dans l'histoire naturelle de l'asthme commence également à être mieux cerné. Les résultats de la cohorte danoise COPSAC ont montré la fréquence des identifications bactériennes au cours des épisodes sifflants avant 3 ans, ainsi que l'impact de la colonisation bactérienne à l'âge de un mois sur la survenue de l'asthme à l'âge de 5 ans. Le rôle des infections bactériennes dans l'asthme sévère du jeune enfant est également discuté.The spectrum of respiratory viruses is expanding and emerging diseases have been described regularly over the last fifteen years. The origin of these emerging respiratory viruses may be zoonotic (by crossing species barrier, after changes to RNA viruses such as avian influenza virus type A or coronaviruses), or related to the use of new identification techniques (metapneumovirus, bocavirus). The relationship between bronchiolitis and asthma is now better understood thanks to prospective follow up of birth cohorts. The role of rhinovirus has become predominant with respect to respiratory syncytial virus. The identification of predisposing factors immunological, functional, atopic and genetic, for the onset of asthma after rhinovirus infection suggests that viral infection reveals a predisposition rather than itself being a cause of asthma. The role of bacteria in the natural history of asthma is also beginning to be better understood. The results of the COPSAC Danish cohort have shown the frequency of bacterial identification during wheezy episodes before 3 years, and the impact of bacterial colonization at the age of one month on the onset of asthma by age 5 years. The role of bacterial infections in severe asthma in young children is also discussed.

http://ift.tt/2mPuNjV

Numéro 2/2017. Réponses

Publication date: Available online 3 March 2017
Source:Revue des Maladies Respiratoires

http://ift.tt/2mPnzfq

Nodular fasciitis of the breast clinically resembling breast cancer in an elderly woman: a case report

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The impact of time to treatment initiation on survival from head and neck cancer in north-eastern Italy

Publication date: April 2017
Source:Oral Oncology, Volume 67
Author(s): Jerry Polesel, Carlo Furlan, Silvia Birri, Vittorio Giacomarra, Emanuela Vaccher, Giuseppe Grando, Carlo Gobitti, Federico Navarria, Ornella Schioppa, Emilio Minatel, Ettore Bidoli, Luigi Barzan, Giovanni Franchin
ObjectivesTo evaluate the impact of time to treatment initiation (TTI) on overall survival in patients with head-and-neck squamous cell carcinoma (HNSCC).Materials and methodsIn the period 2003–2009, 1616 HNSCC patients were diagnosed in Friuli Venezia Giulia Region, Northeastern Italy, including 462 oral, 346 oropharyngeal, 212 hypopharyngeal, and 596 laryngeal cancers. Clinical information, including date and type of first treatment, and follow-up were retrieved from the regional Cancer Registry and a population-based health database collecting comprehensive health information on people living in the Region. Multivariate hazard ratio (HR) and confidence intervals (CI) were calculated through Cox model.ResultsOverall, the median TTI was 28days, (Q1-Q3: 13–45days), but significant variations emerged according to anatomical site, cancer stage, treatment approach, and care transition to specialized centers. Five-year overall survival decreased with increasing treatment delay from 62% for TTI<30days to 39% for TTI≥90days (p<0.01). HR of death was 1.13 (95% CI: 0.92–1.39) for TTI between 45–89days, and 1.47 (1.05–2.05) for TTI≥90days. The association between TTI and poor prognosis was stronger for laryngeal cancers and early-stage HNSCCs. Further, care transition from community hospitals to specialized centers was associated to a better prognosis (HR=0.73; 95% CI: 0.60–0.88).ConclusionOur study findings suggest that HNSCC patients treated within 45days from diagnosis have increased survival probabilities and that early-stage patients suffered the most from treatment delay. Furthermore, care transition to specialized centers –though competitive to timely treatment– improves survival by providing the most innovative technologies and treatment approaches.

http://ift.tt/2lFAPlj

Regulating Damage from Sterile Inflammation: A Tale of Two Tolerances

Publication date: Available online 3 March 2017
Source:Trends in Immunology
Author(s): Shin-Rong Wu, Pavan Reddy
The severity of immunopathology from non-infectious inflammation is mainly understood and is managed by targeting immune cells. However, the role of target tissues in determining damage severity has been largely overlooked. Here, we discuss the concept of 'tissue tolerance' for tissue-intrinsic programs that ameliorate organ damage in the setting of sterile immunopathology.

http://ift.tt/2lFnVDS

SOP – Aufnahmekriterien auf die Palliativstation

http://ift.tt/2lIN7Kp

Investigation of the Effects of Speech Signal Length on Vocal Disorder Sorting Done Via Dynamic Pattern Modeling

Development of a noninvasive method for separating different vocal fold diseases is an important issue concerning vocal analysis. Due to the time variations along a pathologic vocal signal, application of dynamic pattern modeling tools is expected to help in the detection of defects that occur in the speech production mechanism.

http://ift.tt/2lIEe3x

A Review of Hyaluronic Acid and Hyaluronic Acid-based Hydrogels for Vocal Fold Tissue Engineering

Vocal fold scarring is a common cause of dysphonia. Current treatments involving vocal fold augmentation do not yield satisfactory outcomes in the long term. Tissue engineering and regenerative medicine offer an attractive treatment option for vocal fold scarring, with the aim to restore the native extracellular matrix microenvironment and biomechanical properties of the vocal folds by inhibiting progression of scarring and thus leading to restoration of normal vocal function. Hyaluronic acid is a bioactive glycosaminoglycan responsible for maintaining optimum viscoelastic properties of the vocal folds and hence is widely targeted in tissue engineering applications.

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Cross-Cultural Adaptation and Validation of the Italian Version of the Voice Symptom Scale (I-VoiSS)

To evaluate the reliability and validity of the Italian Voice Symptom Scale (I-VoiSS).

http://ift.tt/2mnRbTR

Periosteal fasciitis in a 7-year old girl: a diagnostic dilemma

Periosteal fasciitis, considered a subtype of nodular fasciitis, is a rare benign soft tissue mass often misdiagnosed as a malignant lesion due to its fast and infiltrative growth pattern and histological features. Nodular fasciitis is usually found in the upper extremities in adults and in the head and neck region in children. Incorrect diagnosis may lead to overtreatment, potentially causing disturbed orofacial development in growing children. A rapidly growing asymptomatic mass, initially suspected to be a malignant bone tumour, was found in the left angle area of the mandible in a healthy 7-year-old girl.

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First signs of late-presenting cervical lymph node metastasis in oral cancers during follow-up

One of the most important prognostic factors in oral squamous cell carcinoma (OSCC) is the presence of lymph node metastasis. Therefore, the early detection of late-presenting cervical lymph node metastasis is important. Although many studies have assessed diagnostic modalities for detecting metastatic cervical lymph nodes, no study has evaluated the process, especially first signs, for detecting late-presenting cervical lymph node metastasis. A retrospective analysis comparing methods for detecting the first signs of late-presenting lymph node metastasis was performed.

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Sarcoidosis of the ocular adnexa

Sarcoidosis is an idiopathic multisystem disorder that commonly affects the lung, skin, lymph nodes, and eye. The ocular involvement ranges from 25% to 60%, with anterior uveitis being the most common ophthalmic manifestation in systemic sarcoidosis.1 Orbital and adnexal involvements are historically rare. The most common orbital manifestation is lacrimal gland involvement manifesting as dacryoadenitis.1 We present a rare case of sarcoidosis of the ocular adnexa in a man with clinical features suggestive of chronic dacryocystitis.

http://ift.tt/2m4cqrl

Sarcoidosis of the ocular adnexa

2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum

Thyroid Mar 2017, Vol. 27, No. 3: 315-389.

http://ift.tt/2lEZBBT

Future Meetings

Thyroid Mar 2017, Vol. 27, No. 3: 479-480.

http://ift.tt/2lFdcJp

2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum

Thyroid Mar 2017, Vol. 27, No. 3: 315-389.

http://ift.tt/2lEZBBT

Future Meetings

Thyroid Mar 2017, Vol. 27, No. 3: 479-480.

http://ift.tt/2lFdcJp

Allergy is associated with reduced risk of glioma: A meta-analysis

Publication date: Available online 3 March 2017
Source:Allergologia et Immunopathologia
Author(s): C. Zhang, Q.-X. Zhu
BackgroundIncreasing evidences suggest that allergy may reduce the risk of glioma, so it is necessary to perform an up-to-data literature search and investigate this relationship by meta-analysis.MethodsWe identified the included studies by searching PubMed and Web of Science and excluding irrelevant or ineligible articles. Nineteen studies from 15 articles, including 8435 cases and 118,719 controls, were selected for data extraction and synthesis.ResultsPooled outcomes showed that there was an inverse association between allergy and risk of glioma (OR=0.64, 95% CI=0.52–0.78, P<0.001). Meanwhile, asthma and eczema would reduce the risk of glioma by 33% and 23% (OR=0.67, 95% CI=0.59–0.75, P<0.001; OR=0.77, 95% CI=0.68–0.86, P<0.001), respectively. Sensitivity analyses confirmed the stability of these findings. Besides, no publication biases were detected regarding all the investigations.ConclusionsOverall or specific allergy is protective against glioma. More prospective cohort studies or molecular laboratory experiments are warranted to elucidate the causation and key mechanism.

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Neurogenic bladder dysfunction does not correlate with astrocyte and microglia activation produced by graded force in a contusion-induced spinal cord injury

Publication date: Available online 3 March 2017
Source:Brain Research Bulletin
Author(s): Alvaro Munoz
Rodent models for the study of neurogenic bladder dysfunction after spinal cord injury (SCI) are difficult to standardize, particularly when evaluating the specific contribution of the SCI to end-organ function. The purpose of this study was to evaluate the degree of bladder dysfunction associated with a highly reproducible, contusion-induced SCI in female rats. An infinite horizon impactor was used to create a contusion SCI with a magnitude of either 100 or 150 kDyne at the T8/T9 thoracic region of female Sprague-Dawley rats. Locomotor function, and the presence of astrocytes (positive regions for Glial Fibrillary Acidic Protein) and microglia (positive cells for the integrin CD11b) at the SCI site were determined at four weeks after SCI. Similarly, cystometric properties were characterized in urethane anesthetized rats at four weeks post-SCI. The significant increases in astrocyte and microglia in the T8/T9 region in all of the SCI animals did not correlate with locomotor impairment or bladder dysfunction. After performing the cystometric studies substantial differences were found in both SCI groups when compared to intact animals, specifically a high frequency of non-voiding contractions, different durations for intraluminal pressure-high frequency oscillations, intercontractile intervals, impaired micturition volumes, and estimated voiding efficiency. These results suggest that a contusion SCI can increase microglia and astrocyte activation without a strong association with bladder dysfunction. The present study will be important for precise considerations about correlating the intensity of a SCI with impairment outcomes at both locomotor or organ function levels.

http://ift.tt/2mnpFpq

Commentary on “The Impact of Patient Demographics, Anatomy, Comorbidities and Peri-operative Planning on the Primary Functional Maturation of Autogenous Radiocephalic Arteriovenous Fistula”

Publication date: Available online 3 March 2017
Source:European Journal of Vascular and Endovascular Surgery
Author(s): S.K. Kakkos, I.A. Tsolakis

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Two cases of Mazabraud syndrome and identification of a GNAS R201H mutation by next-generation sequencing

http://ift.tt/2m43u5a

Gene promoter-associated CpG island hypermethylation in squamous cell carcinoma of the tongue

Abstract

The present study was undertaken to explore and validate novel hypermethylated DNA regions in squamous cell carcinoma of the tongue (SCCT). Genome-wide methylation changes were identified by differential methylation hybridization (DMH) microarray and validated by bisulfite genome sequencing (BGS). The results were compared against datasets from The Cancer Genome Atlas head and neck squamous cell carcinoma (TCGA-HNSCC), Gene Expression Omnibus (GSE26549), and ArrayExpress (E-MTAB-1328). DMH identified 116 hypomethylated and 241 hypermethylated regions. Of the latter, 24 were localized to promoter or 5′-UTR regions. By BGS, promoter sequences of DAPK1, LRPPRC, RAB6C, and ZNF471 were significantly hypermethylated in tumors when compared with matched normal tissues (P < 0.0001). A TCGA-HNSCC dataset (516 cases of cancer and 50 normal tissue samples) further confirmed hypermethylation of DAPK1, RAB6C, and ZNF471. Sensitivity and specificity of methylation markers for a diagnosis of cancer were in the range of 70–100% in our study and from TCGA-HNSCC datasets, with an area under curve (AUC) of 0.83 and above. Kaplan-Meier survival analysis of TCGA-HNSCC expression data revealed that patients with low expressions of DAPK1, RAB6C, and ZNF471 showed poorer survival than patients with high expression (P = 0.02). Human papillomavirus (HPV) was found in 55% of cases, HPV16 being the predominant genotype. DAPK1 immunohistochemical staining was lower in SCCT than in normal buccal epithelial cells. This is the first study to report hypermethylation of LRPPRC, RAB6C, and ZNF471 in SCCT and its diagnostic and prognostic potentials in a specific head and neck squamous cell carcinoma.

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Fístula csc lateral e deiscência facial por cole

Fístula csc lateral e deiscência facial por col

http://ift.tt/2mBD2TK

Fístula csc lateral e deiscência facial por cole

Fístula csc lateral e deiscência facial por col

http://ift.tt/2mBD2TK

Current Status of Targeted Radioprotection and Radiation Injury Mitigation and Treatment Agents: A Critical Review of the Literature

Publication date: Available online 2 March 2017
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Noah S. Kalman, Sherry S. Zhao, Mitchell S. Anscher, Alfredo I. Urdaneta
As more cancer patients survive their disease, concerns about radiotherapy-induced side effects have increased. The concept of radioprotection and radiation injury mitigation and treatment offers the possibility to enhance the therapeutic ratio of radiotherapy by limiting radiotherapy-induced normal tissue injury without compromising its anti-tumor effect. Advances in the understanding of the underlying mechanisms of radiation toxicity have stimulated radiation oncologists to target these pathways across different organ systems. These generalized radiation injury mechanisms include production of free radicals such as superoxides, activation of inflammatory pathways, and vascular endothelial dysfunction leading to tissue hypoxia. There is a significant body of literature evaluating the effectiveness of various treatments in preventing, mitigating or treating radiation induced normal tissue injury. While some reviews have focused on a specific disease site or agent, this critical review focuses on a mechanistic classification of activity and assesses multiple agents across different disease sites. The classification of agents used herein further offers a useful framework to organize the multitude of treatments that have been studied. Many commonly available treatments have demonstrated benefit in prevention, mitigation, and/or treatment of radiation toxicity and warrant further investigation. These drug-based approaches to radioprotection and radiation injury mitigation and treatment represent an important method of making radiotherapy safer.

http://ift.tt/2lEdEYh

Top Five Things to Tell Patients: Preventing Skin Cancer

These messages may resonate most with young, fair-skinned patients at risk for skin cancer.
CDC Expert Commentary

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IL-31 Inhibitor Improves Atopic Dermatitis

An interleukin-31 inhibitor significantly improved pruritus for patients whose moderate to severe atopic dermatitis did not respond to topical therapy, a phase 2 clinical trial found.
Medscape Medical News

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Characteristics of Zika Virus Rash Identified

Reuters Health Information

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Effectiveness Between Early and Late Closure of Rectal Cancer Patients with Temporary Ileostomy: A Prospective Study

Publication date: Available online 2 March 2017
Source:Current Problems in Cancer
Author(s): Li Zhen, Yanan Wang, Ze Zhang, Tongwei Wu, Ruoyan Liu, Tingting Li, Liying Zhao, Haijun Deng, Xiaolong Qi, Guoxin Li
Background & aimsA temporary stoma is often used in rectal cancer surgery to protect a distal anastomosis, which remains a major concern after rectal cancer surgery, particularly after low anterior resection. The temporary stoma is scheduled for closure. However, the optimal time of closure of the protecting stoma remains unclear due to sparse studies and data. We aimed to detect the efficacy of between early and late temporary ileostomy closure in patients with rectal cancer during or after neoadjuvant chemotherapy (NACRT).MethodWe conducted a prospective, two-group design between early and late ileostomy closure group in patients after rectal cancer surgery with temporary stoma. Participants were recruited in a teaching hospital in Guangzhou, China. 161 patients confirmed diagnosis of rectal cancer underwent curative surgery and temporary ileostomy. Paticipants with temporary ileostomy received closure surgery after one (early) or six (late) months were assessed by clinical parameters and quality of life (QOL).ResultsPatients in late closure (LC) group received more adjuvant chemotherapy cycles but with comparable incidence of stoma closure-related complications and length of hospital stay compared to early closure (EC) group.ConclusionParticipants in LC group with standardized postoperative chemotherapy might have a better prognosis compared with those in EC group. An increased emphasis should be given to choose the optimal closure time of rectal cancer patients with temporary ileostomy. Colorectal nurses could provide support to physician for observation of prognosis of different closure time.

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Progress in difficult airway management

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The role of Perioperative Surgical Home on health and longevity in society: importance of the surgical prehabilitation program

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Hemi-facial reconstruction following extensive crush avulsion injury of the face

Abstract

Post-traumatic facial defects need to be treated sensitively, as the emotional repercussions and possible deformity can have lasting effects on the patient's psychological well-being. Thus, the management of posttraumatic facial injuries requires meticulous planning and adherence to both aesthetic and reconstructive principles. We describe the case of a 29-year-old male who underwent multistage reconstruction following extensive facial injuries. The clinical challenges presented by this rare case and steps of the reconstruction procedure are presented. Sequential flaps that were placed during the restoration survived, and the patient had no lasting donor site morbidity. Post-surgery, the patient's self-confidence was dramatically improved, as were his interactions with his family and friends. Careful planning and staged microvascular procedures were important in the management of this patient with severe injuries. The patient was rehabilitated and able to live a near-normal life, without the need for synthetic implants or lifelong immune suppression.

Level of Evidence: Level V, therapeutic study.

http://ift.tt/2mBf3Uv

Stereographic measurement of orbital volume, a digital reproducible evaluation method

Background/Aims

Up to date, no standardised reproducible orbital volume measurement method is available. Therefore, this study aimed to investigate the accuracy of a new measurement method, which delineates the boundaries of orbital cavity three-dimensionally (3D).

Methods

In order to calculate the orbital volume from axial CT slice images of the patients, using our first described measurement method, the segmentation of the orbital cavity and the bony skull was performed using Amira 3D Analysis Software. The files were then imported into the Blender program. The stereographic skull model was aligned based on the Frankfurt horizontal plane and superposed according to defined anatomical reference points. The anterior sectional plane ran through the most posterior section of the lacrimal fossa and the farthest dorsal point of the anterior latero-orbital margin, which is positioned perpendicular to the Frankfurt horizontal plane. The volume of each orbital cavity was then determined automatically by the Blender program.

Results

The 10 consecutive subjects (5 female, 5 male) with mean age of 50.3±21.3 years were considered for analysis in the current study. The first investigator reported a mean orbital volume of 20.24±1.01 cm3 in the first and 20.25±1.03 cm3 in the second evaluation. Furthermore, the intraclass correlation coefficient (ICC) showed an excellent intrarater agreement (ICC=0.997). Additionally, the second investigator detected a mean orbital volume of 20.20±1.08 cm3 in his assessment, in which an excellent inter-rater agreement was found in ICC (ICC=0.994).

Conclusions

This method provides a standardised and reproducible 3D approach to the measurement of the orbital volume.

http://ift.tt/2mmUKK8

Biphasic growth of orbital volume in Chinese children

Objective

The aim of this study was to map out the developmental curve of the orbital volume of Chinese children aged 1–15 years.

Methods

CT scanning was performed on 109 children and the orbital volume, interlateral orbital rim distance (IORD), and extent of exophthalmos were measured on the CT images and plotted against age.

Results

The development of the orbit structure followed a biphasic pattern. The first growth phase was before 3 years and the second growth phase was between 7 years and 12 years of age. The growth speed in the first phase was about 3 times that of the second one (first vs second phase: 2.28 cm³/year vs 0.67 cm³/year for orbital volume, 5.01 mm/year vs 1.57 mm/year for IORD, 1.29 mm/year vs 0.42 mm/year for the exophthalmos). During development, there was no significant difference between the left and right orbits. There was no significant difference between boys and girls before 12 years of age. However, after 12 years of age, boys had significantly larger orbital volumes (22.16±2.28 cm³/year vs 18.57±1.16 cm³/year, p<0.001) and a greater IORD (96.29±3.18 mm/year vs 91.00±4.54 mm/year, p<0.001) than girls.

Conclusions

In Chinese children, the development of orbital volume follows a biphasic pattern and a sex difference becomes significant after the age of 12 years.

http://ift.tt/2mURYZh

A retrospective study of the influence of the vitreomacular interface on macular oedema secondary to retinal vein occlusion

Aims

To compare anti-vascular endothelial growth factor (VEGF) treatment outcomes for macular oedema (ME) secondary to retinal vein occlusion (RVO) based on vitreoretinal interface (VRI) status.

Methods

This retrospective case series includes treatment-naive eyes diagnosed with RVO and treated with anti-VEGF injections. Eyes were stratified based on international VRI classification schema at baseline into three groups—vitreomacular traction (group A), no posterior vitreous detachment (PVD) (group B) and PVD without vitreomacular attachment (group C). Fifty-two eyes were identified based on inclusion/exclusion criteria. The primary endpoint was change in central subfield thickness (CST) on optical coherence tomography at 6 months.

Results

There were no statistically significant differences in baseline characteristics of patients with RVO when stratified by VRI subgroups. After 6 months of treatment, there was no statistically significant difference in the change in CST from baseline between VRI cohorts (p=0.11). There was a trend demonstrating the greatest improvement in CST in eyes in group A compared with eyes in groups B and C (–224.13 μm, –160.88 μm and –50.92 μm, respectively, p=0.11 between cohorts). Mean change in logarithm of the minimum angle of resolution visual acuity from baseline to month 6 in group A compared with groups B and C was –0.25, –0.14 and –0.13, respectively (p=0.64 between cohorts).

Conclusions

We did not identify an association between VRI status and treatment outcomes with anti-VEGF agents for ME secondary to RVO.

http://ift.tt/2mmG9OY

Ecotoxicological characterization of polyoxyethylene glycerol ester non-ionic surfactants and their mixtures with anionic and non-ionic surfactants

Abstract

This paper reports on a study that investigated the aquatic toxicity of new non-ionic surfactants derived from renewable raw materials, polyoxyethylene glycerol ester (PGE), and their binary mixtures with anionic and non-ionic surfactants. Toxicity of pure PGEs was determined using representative organisms from different trophic levels: luminescent bacteria (Vibrio fischeri), microalgae (Pseudokirchneriella subcapitata), and freshwater crustaceans (Daphnia magna). Relationships between toxicity and the structural parameters such as unit of ethylene oxide (EO) and hydrophilic-lipophilic balance (HLB) were evaluated. Critical micellar concentration (CMC) in the conditions of the toxicity test was also determined. It was found that the toxicity of the aqueous solutions of PGE decreased when the number of EO units in the molecule, HLB, and CMC increased. PGEs showed lower CMC in marine medium, and the toxicity to V. ficheri is lower when the CMC was higher. Given their non-polar nature, narcosis was expected to be the primary mode of toxic action of PGEs. For the mixture of surfactants, we observed that the mixtures with PGE that had the higher numbers of EO units were more toxic than the aqueous solutions of pure surfactants. Moreover, we found that concentration addition was the type of action more likely to occur for mixtures of PGE with lower numbers of EO units with non-ionic surfactants (alkylpolyglucoside and fatty alcohol ethoxylate), whereas for the mixture of PGE with lower EO units and anionic surfactant (ether carboxylic derivative), the most common response type was response addition. In case of mixtures involving amphoteric surfactants and PGEs with the higher numbers of EO units, no clear pattern with regard to the mixture toxicity response type could be observed.

http://ift.tt/2m4acK3

Environmental behavior of sulfadiazine, sulfamethazine, and their metabolites

Abstract

Sulfonamides are one of the most frequently used antibiotics worldwide. Therefore, processes that determine their fate in the environment are of great interest. In the present work, biodegradation as biotic process and hydrolysis and photolysis as abiotic processes were investigated. In biodegradation experiments, it was found out that sulfonamides (sulfadiazine and sulfamethazine) and their N ⁴-acetylated metabolites were not readily biodegradable. The results showed that decrease of concentrations were in the range from 4% for sulfadiazine to 22% for N ⁴-acetylsulfamethazine. Hydrolytic experiments examined at pH values normally found in the environment also showed their resistance. However, photolysis proved to be significant process for decreasing concentrations of sulfonamides and their metabolites in three various aqueous matrices (Milli-Q water, river water, and synthetic wastewater). In addition, influence of ubiquitous water constituents (Cl⁻, NO₃⁻, SO₄²⁻, PO₄³⁻, and humic acids) was also investigated, showing their different impact on photolysis of investigated pharmaceuticals. The results showed that photolysis followed first-order kinetics in all cases. The obtained results are very important for assesing the environmental fate of sulfonamides and their metabolites in the aquatic environment.

http://ift.tt/2mUGUvc

How interacting fungal species and mineral nitrogen inputs affect transfer of nitrogen from litter via arbuscular mycorrhizal mycelium

Abstract

In the karst landscape, widespread in the world including southern China, soil nutrient supply is strongly constrained. In such environments, arbuscular mycorrhizal (AM) fungi may facilitate plant nutrient uptake. However, the possible role of different AM fungal species, and their interactions, especially in transferring nitrogen (N) from litter to plant, is poorly understood. We conducted two microcosm experiments to investigate the role that two karst soil AM fungi, Glomus etunicatum and Glomus mosseae, play in the transfer of N from decomposing litter to the host plant and to determine how N availability influences these processes. In experiment 1, Cinnamomum camphora tree seedlings were grown in compartments inoculated with G. etunicatum. Lolium perenne leaf litter labeled with δ¹⁵N was added to the soil in unplanted compartments. Compartments containing the δ¹⁵N labeled litter were either accessible to hyphae but not to seedling roots or were not accessible to hyphae or roots. The addition of mineral N to one of the host compartments at the start of the experiment significantly increased the biomass of the C. camphora seedlings, N content and N:P ratio, AM mycelium length, and soil microbial biomass carbon and N. However, significantly, more δ¹⁵N was acquired, from the leaf litter by the AM hyphae and transferred to the host when mineral N was not added to the soil. In experiment 2, in which C. camphora seedlings were inoculated with both G. etunicatum and G. mosseae rather than with G. mosseae alone, there was a significant increase in mycelial growth (50.21%), in soil microbial biomass carbon (417.73%) in the rhizosphere, and in the amount of δ¹⁵N that was transferred to the host. These findings suggest that maintaining AM fungal diversity in karst soils could be important for mediating N transfer from organic material to host plants in N-poor soils.

http://ift.tt/2m47pk8

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Παρασκευή 3 Μαρτίου 2017

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