Σφακιανάκης Αλέξανδρος
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5 Άγιος Νικόλαος
Κρήτη 72100
00302841026182
00306932607174
alsfakia@gmail.com

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Τετάρτη 15 Νοεμβρίου 2017

Coronary risk assessment at X-ray dose equivalent ungated chest CT: Results of a multi-reader study

Publication date: May–June 2018
Source:Clinical Imaging, Volume 49
Author(s): Michael Messerli, Lukas Hechelhammer, Sebastian Leschka, René Warschkow, Simon Wildermuth, Ralf W. Bauer
ObjectivesTo determine the value of ultra-low dose chest CT with tin filtration for ordinal coronary artery calcium (CAC) risk scoring.Methods50 patients were prospectively included and underwent clinical standard dose chest CT (1.8±0.7mSv) and ultra-low dose CT (0.13±0.01mSv). Four radiologists estimated presence and extent of CAC.ResultsWeighted kappa values for CAC were 0.76–0.97 in standard dose and 0.75–0.95 in ultra-low dose CT (p<0.001). Good to excellent agreement was observed for CAC ordinal risk assessment, with readers reporting identical risk in 81% of cases.ConclusionCAC risk can be qualitatively assessed from X-ray dose equivalent ungated chest CT.



http://ift.tt/2A3R2MM

An overview of methods to mitigate artifacts in optical coherence tomography imaging of the skin

Abstract

Background

Optical coherence tomography (OCT) of skin delivers three-dimensional images of tissue microstructures. Although OCT imaging offers a promising high-resolution modality, OCT images suffer from some artifacts that lead to misinterpretation of tissue structures. Therefore, an overview of methods to mitigate artifacts in OCT imaging of the skin is of paramount importance. Speckle, intensity decay, and blurring are three major artifacts in OCT images. Speckle is due to the low coherent light source used in the configuration of OCT. Intensity decay is a deterioration of light with respect to depth, and blurring is the consequence of deficiencies of optical components.

Method

Two speckle reduction methods (one based on artificial neural network and one based on spatial compounding), an attenuation compensation algorithm (based on Beer-Lambert law) and a deblurring procedure (using deconvolution), are described. Moreover, optical properties extraction algorithm based on extended Huygens-Fresnel (EHF) principle to obtain some additional information from OCT images are discussed.

Results

In this short overview, we summarize some of the image enhancement algorithms for OCT images which address the abovementioned artifacts. The results showed a significant improvement in the visibility of the clinically relevant features in the images. The quality improvement was evaluated using several numerical assessment measures.

Conclusion

Clinical dermatologists benefit from using these image enhancement algorithms to improve OCT diagnosis and essentially function as a noninvasive optical biopsy.



http://ift.tt/2mvUR7t

Liquid marble interaction gate for collision-based computing

Publication date: Available online 14 November 2017
Source:Materials Today
Author(s): Thomas C. Draper, Claire Fullarton, Neil Phillips, Ben P.J. de Lacy Costello, Andrew Adamatzky
Liquid marbles are microliter droplets of liquid, encapsulated by self-organized hydrophobic particles at the liquid/air interface. They offer an efficient approach for manipulating liquid droplets and compartmentalizing reactions in droplets. Digital fluidic devices employing liquid marbles might benefit from having embedded computing circuits without electronics and moving mechanical parts (apart from the marbles). We present an experimental implementation of a collision gate with liquid marbles. Mechanics of the gate follows principles of Margolus' soft-sphere collision gate. Boolean values of the inputs are given by the absence (FALSE) or presence (TRUE) of a liquid marble. There are three outputs: two outputs are trajectories of undisturbed marbles (they only report TRUE when just one marble is present at one of the inputs), one output is represented by trajectories of colliding marbles (when two marbles collide they lose their horizontal momentum and fall), this output reports TRUE only when two marbles are present at inputs. Thus the gate implements AND and AND-NOT logical functions. We speculate that by merging trajectories representing AND-NOT output into a single channel one can produce a one-bit half-adder. Potential design of a one-bit full-adder is discussed, and the synthesis of both a pure nickel metal and a hybrid nickel/polymer liquid marble is reported.



http://ift.tt/2jtQKaV

Patch testing in Israeli children with suspected allergic contact dermatitis: A retrospective study and literature review

Abstract

Background/objectives

Childhood allergic contact dermatitis is recognized as a significant clinical problem. The objective was to evaluate the rate of positive patch tests in Israeli children with clinically suspected allergic contact dermatitis, identify possible sex and age differences, compare results with those in Israeli adults, and review pediatric studies in the literature.

Methods

The study sample included 343 children and adolescents (197 female, 146 male; 1-18 years of age, mean age 11.8 years) with clinically suspected allergic contact dermatitis who underwent patch testing with a standard pediatric series of 23 allergens at a tertiary medical center from 1999 to 2012. Data on clinical characteristics and test results were collected retrospectively from the medical files.

Results

Ninety-eight subjects (28.6%) (75 girls [38.1%], 23 boys [15.8%]) had at least one positive reaction. The most frequent reactions were to nickel sulfate, followed by potassium dichromate and cobalt chloride. Nickel sulfate sensitivity was more common in girls, especially those younger than 3 years and older than 12 years. The prevalence of contact sensitization was similar in subjects with and without atopic dermatitis (50% and 51%, respectively).

Conclusion

Nickel is the most common allergen in Israeli children, especially girls. Patch testing should be performed in children with clinically suspected allergic contact dermatitis regardless of atopic background.



http://ift.tt/2z5AljM

Ethnic differences in stratum corneum functions between Chinese and Thai infants residing in Bangkok, Thailand

Abstract

Background/Objectives

Ethnic and racial differences in infant skin have not been well characterized. The purpose of this study was to establish whether there are ethnic differences and similarities in the stratum corneum (SC) functions of Thai and Chinese infants.

Methods

Healthy infants 6 to 24 months of age (N = 60; 30 Thai, 30 Chinese) who resided in Bangkok, Thailand, were enrolled. Transepidermal water loss (TEWL) and SC hydration (capacitance) on the thigh, buttock, and upper arm were measured. Ceramide content was determined in the SC on the upper arm.

Results

SC hydration was not remarkably different between the two ethnicities at any site measured, but TEWL was significantly higher in Chinese infants than in Thai infants at all sites. Hydration of the SC was not significantly correlated with age in either ethnicity. TEWL had significant but weak correlations with age on the thigh and upper arm in Thai infants. Ceramide content was significantly higher in Chinese SC than in Thai SC. No relationship between ceramide content and TEWL or hydration was observed in either ethnicity.

Conclusion

The significant differences in TEWL and ceramide contents between Chinese and Thai infant skin could prove useful in designing skin care and diapering products that are best suited for each ethnicity.



http://ift.tt/2A1nHlT

Kinematic Analysis of Scapular Movements in Patients with Facioscapulohumeral Muscular Dystrophy

Publication date: Available online 14 November 2017
Source:Journal of Electromyography and Kinesiology
Author(s): C. Savcun Demirci, E. Turgut, E. Ayvat, Ö. Onursal, F. Ayvat, T.İ. Yıldız, İ. Düzgün, M. Kılınç, S. Aksu Yıldırım
The purpose of this study is to evaluate scapular movements by the three- dimensional electromagnetic system during shoulder elevation in FSHMD patients, and to compare the results with healthy individuals. 10 patients with FSHMD and 10 healthy individuals were included in the study. Scapular anterior-posterior tilt, upward-downward rotation and internal-external rotation at 30°, 60° and 90° were evaluated using the three-dimensional electromagnetic system during the elevation of the upper limbs in the scapular plane. Humerothoracic elevation levels on the dominant and non-dominant sides were found to be lower in the patients than healthy individuals (p<0.001). Both scapula were rotated downwards at 30° (dominant / non-dominant p<0.001) and 60° (dominant p=0.009, non-dominant p=0.04) of humerothoracic elevation, the scapula was rotated internally at 30° of humerothoracic elevation on the non-dominant side (p=0.03), and the scapula was tilted posteriorly at 90° of humerothoracic elevation on the non-dominant side (p=0.009) in patients. These existing abnormal patterns of the scapula in the patients increase the risk of impairment, pain, impingement and instability especially in the activities that require arm elevation. It is thought that physiotherapy approaches should first be emphasized to improve scapular stabilization and strengthening exercises should then be performed for the shoulder girdle muscles.



http://ift.tt/2z6EnIQ

Localised sampling of myoelectric activity may provide biased estimates of cocontraction for gastrocnemius though not for soleus and tibialis anterior muscles

S10506411.gif

Publication date: Available online 14 November 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Maria Vinti, Jean-Michel Gracies, Marco Gazzoni, Taian Vieira
Proper muscle activity quantification is highly relevant to monitor and treat spastic cocontraction. As activity may distribute unevenly within muscle volumes, particularly for pennate calf muscles, surface electromyograms (EMGs) detected by traditional bipolar montage may provide biased estimations of muscle activity. We compared cocontraction estimates obtained using bipolar vs grids of electrodes (high-density EMG, HD-EMG). EMGs were collected from medial gastrocnemius, soleus and tibialis anterior during isometric plantar and dorsi-flexion efforts at three levels (30%, 70% and 100% MVC), knee flexed and extended. Cocontraction index (CCI) was estimated separately for each electrode pair in the grid. While soleus and tibialis anterior CCI estimates did not depend on the detection system considered, for gastrocnemius bipolar electrodes provided larger cocontraction estimates than HD-EMG at highest effort levels, at both knee angles (ANOVA; P<0.001). Interestingly, HD-EMG detected greater gastrocnemius EMGs distally during plantar flexions, and greater CCI values proximally during dorsiflexions. These results suggest that bipolar electrodes: i) provide reliable estimates of soleus and tibialis anterior cocontraction; ii) may under-or overestimate gastrocnemius cocontraction, depending on their distal or proximal position.



http://ift.tt/2mvNNaX

Postural changes in orthodontic patients treated with clear aligners: a rasterstereographic study

Publication date: Available online 14 November 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Parrini Simone, Comba Benedetta, Rossini Gabriele, Ravera Serena, Cugliari Giovanni, De Giorgi Ilaria, Deregibus Andrea, Castroflorio Tommaso
BackgroundCorrelation between malocclusions and body posture has been discussed in the last decades, but there is still a lack of consensus in existing literature. Rasterstereography allows tridimensional reconstruction of the spine, starting from the back surface analysis. So far studies which tested modifications of rasterstereographic parameters during orthodontic treatment, comparing with those obtained from untreated control group, are not available. Clear aligner treatment produces alteration of vertical height due to the occlusal coverage and, subsequently, a stimulation of periodontal receptors which causes an inhibition of the jaw closing muscles and, hypothetically, changes in mandibular posture.ObjectivesEvaluate possible correlations between orthodontic treatment and posture.Materials and MethodsRasterstereographic values of 15 untreated patients and of 15 patients treated with clear aligners were compared at baseline, after 1, 3 and 6 months. Rasterstereographic parameters considered were the following: the kyphotic angle, the lordotic angle, the upper thoracic inclination, and the pelvic inclination.ResultsCorrelations between Kyphosis Angle, Upper Toracic Inclination and Pelvic Inclination and body posture were found after 6 months of treatment with clear aligners.ConclusionsOcclusal coverage caused by aligners could influence body posture not only for upper spine sections but also lower spine sections.



http://ift.tt/2mwohCo

Tailored coefficients in the algorithm to assess reconstructed light extinction at urban sites: A comparison with the IMPROVE revised approach

Publication date: January 2018
Source:Atmospheric Environment, Volume 172
Author(s): S. Valentini, V. Bernardoni, D. Massabò, P. Prati, G. Valli, R. Vecchi
Estimates of light extinction and visibility are routinely performed by the U.S. Interagency Monitoring of Protected Visual Environments (IMPROVE) network using a simple algorithm which assesses light extinction coefficient (bext) at remote and rural sites from concentrations of major particulate matter (PM) species, NO2, and Rayleigh scattering from clear-air gaseous components. Following the same approach, in this paper an equation with tailored (i.e. site-specific) coefficients was implemented with the aim of reducing uncertainties and assumptions of the IMPROVE algorithm for applications at polluted urban sites. Major differences compared to IMPROVE algorithm are: 1) dry mass extinction efficiencies calculated using a discrete dipole approximation code with aerosol size distributions measured at our monitoring site as input data; 2) site-specific water growth functions computed separately for ammonium sulfate, ammonium nitrate, and organic matter; 3) fine soil evaluated using an equation previously adopted at our urban site; 4) aerosol absorption component assessed directly through filter-based optical measurements. Details about the calculations performed are reported in the paper and the comparison with the IMPROVE revised algorithm is discussed.The tailored approach here proposed to estimate reconstructed light extinction was applied to PM2.5 test samples collected on purpose in Milan (Italy), where heavy pollution episodes occur during winter periods. In addition, visual range was calculated applying the Koschmieder equation and compared to visibility measured at the nearby Milano-Linate airport obtaining a fairly good correlation.

Graphical abstract

image


http://ift.tt/2zMqUTz

Contrasting aerosol optical and radiative properties between dust and urban haze episodes in megacities of Pakistan

elsevier-non-solus.png

Publication date: January 2018
Source:Atmospheric Environment, Volume 173
Author(s): Muhammad Iftikhar, Khan Alam, Armin Sorooshian, Waqar Adil Syed, Samina Bibi, Humera Bibi
Satellite and ground based remote sensors provide vital information about aerosol optical and radiative properties. Analysis of aerosol optical and radiative properties during heavy aerosol loading events in Pakistan are limited and, therefore, require in-depth examination. This work examines aerosol properties and radiative forcing during Dust Episodes (DE) and Haze Episodes (HE) between 2010 and 2014 over mega cities of Pakistan (Karachi and Lahore). Episodes having the daily averaged values of Aerosol Optical Depth (AOD) exceeding 1 were selected. DE were associated with high AOD and low Ångström Exponent (AE) over Karachi and Lahore while high AOD and high AE values were associated with HE over Lahore. Aerosol volume size distributions (AVSD) exhibited a bimodal lognormal distribution with a noticeable coarse mode peak at a radius of 2.24 μm during DE, whereas a fine mode peak was prominent at a radius 0.25 μm during HE. The results reveal distinct differences between HE and DE for spectral profiles of several parameters including Single Scattering Albedo (SSA), ASYmmetry parameter (ASY), and the real and imaginary components of refractive index (RRI and IRI). The AOD-AE correlation revealed that dust was the dominant aerosol type during DE and that biomass burning and urban/industrial aerosol types were pronounced during HE. Aerosol radiative forcing (ARF) was estimated using the Santa Barbra DISORT Atmospheric Radiative Transfer (SBDART) model. Calculations revealed a negative ARF at the Top Of the Atmosphere (ARFTOA) and at the Bottom Of the Atmosphere (ARFBOA), with positive ARF within the Atmosphere (ARFATM) during both DE and HE over Karachi and Lahore. Furthermore, estimations of ARFATM by SBDART were shown to be in good agreement with values derived from AERONET data for DE and HE over Karachi and Lahore.



http://ift.tt/2zMr39z

Correction to: Abstracts

Abstract

In Poster Sessions, the first-author name was missing from the authorship group originally listed for Abstract PS-13-001 (page S176), entitled "Gastric carcinoma with lymphoid stroma: Analysis of microsatellite instability and Epstein-Barr virus status". The correct authorship group is shown above.



http://ift.tt/2AKYBEc

Correction to: Abstracts

Abstract

In Poster Sessions, the first-author name was missing from the authorship group originally listed for Abstract PS-01-004 (page S52), entitled "Clinicopathological features of microinvasive breast cancer". The correct authorship group is shown above.



http://ift.tt/2AL6gCB

Correction to: Abstracts

Abstract

Due to an error with the registration system, the following abstract was regrettably omitted from the Poster Sessions. The abstract should have been included as PS-13-116 and displayed on page S199.



http://ift.tt/2ikrSis

Guidelines for Contributing Authors



http://ift.tt/2ilsZyf

Editorial Board



http://ift.tt/2ALPrau

Table of Contents



http://ift.tt/2ilUxUq

Guidelines for Contributing Authors



http://ift.tt/2ilsZyf

Editorial Board



http://ift.tt/2ALPrau

Table of Contents



http://ift.tt/2ilUxUq

Cardioprotection of dapagliflozin and vildagliptin in cardiac reperfusion injury rats

Sodium-glucose cotransporter 2 inhibitor (SGLT2-i) effects on cardiac ischemia/reperfusion (I/R) injury are unclear. Unlike SGLT2-i, dipeptidyl peptidase 4 inhibitors (DPP4-i) have shown effective cardioprotection in cardiac I/R injury. We aimed to investigate whether SGLT2-i reduces myocardial dysfunction and myocardial injury to a greater extent than DPP4-i in obese-insulin resistant rats with/without cardiac I/R injury. The high fat (HF) diet induced obese-insulin resistant rats were divided into 4 groups and received the following treatments for 28 days: vehicle (HFV); vildagliptin at a dosage of 3 mg/kg/day (HFVil); dapagliflozin at a dosage of 1 mg/kg/day (HFDa); and combination drugs (HFDaVil). At the end, I/R injury was induced by a 30-minute left anterior descending coronary occlusion and 120-minute reperfusion. Dapagliflozin showed a greater efficacy than vildagliptin in improving the metabolic impairments, low frequency/high frequency (LF/HF) ratio, systolic blood pressure and left ventricular (LV) function in comparison to HFV rats. In cardiac I/R injury, Dapagliflozin had a greater efficacy than vildagiptin in decreasing mitochondrial DRP1, cleaved caspase 3, LV dysfunction and infarct size in comparison to HFV rats. However, the combined therapy showed the greatest efficacy in attenuating LV dysfunction, mitochondrial DRP1 and infarct size in comparison to HFV rats. In conclusion, dapagliflozin has a more pronounced effect than vildagliptin in obese-insulin resistant rats for the improvement of LV function. In rats with cardiac I/R injury, although dapagliflozin had a greater efficacy on cardioprotection than vildagliptin, the combined therapy exerted the highest cardioprotective effects potentially through reducing mitochondrial fission.



http://ift.tt/2hE99Br

Nonrigid motion compensation in compressed sensing reconstruction of cardiac cine MRI

S0730725X.gif

Publication date: Available online 14 November 2017
Source:Magnetic Resonance Imaging
Author(s): Azar Tolouee, Javad Alirezaie, Paul Babyn
In this work, a robust nonrigid motion compensation approach, is applied to the compressed sensing reconstruction of dynamic cardiac cine MRI sequences. Respiratory and cardiac motion separation coupled with a registration algorithm is used to provide accurate reconstruction of dynamic cardiac images. The proposed scheme employs a variable splitting based optimization strategy to enable joint motion estimation along with reconstruction. We define the recovery as an energy minimization scheme utilizing an objective function that combines data consistency, spatial smoothness, and motion penalties. The validation of the proposed algorithm using numerical phantom and in-vivo cine MRI data demonstrates reconstruction of cardiac MRI data with less spatio-temporal blurring and motion artifacts from extensively under-sampled data. The proposed method is observed to provide improved reconstructions over state-of-the-art motion compensation schemes.



http://ift.tt/2mz0lOW

Factors associated to oral health related quality of life in patients with diabetes

Abstract

Aims

Oral pathologies are prevalent in diabetes, and they may affect the quality of life and patient's perception of their oral health. The aim of this study was to investigate the factors associated to oral health-related quality of life of patients with diabetes.

Methods

A cross-sectional study was conducted involving 316 patients visiting a hospital diabetic unit. Sociodemographic, oral and medical care data were recorded, and a General Oral Health Assessment Index (GOHAI) questionnaire was completed. A multivariable analysis was performed.

Results

Of the 316 study participants, 61.7% had type 2 diabetes (T2DM), and 20.5% had poorly controlled diabetes. Forty-five percent had at least one oral complication, 55% had visited a dentist within the past year, and 67% reported having poor oral health and 281 answered the GOHAI questionnaire. A low GOHAI score (≤ 50) was obtained for 24.6% of the patients and was associated with T2DM (OR=2.15, CI95% 0.95-5.15), poorer oral health (OR=2.31, CI95%1.04-5.44), dry mouth sensation (OR=2.76, CI95% 1.36-5.72), and use of a removable prosthesis (OR=4.22, CI95% 1.93-9.49).

Conclusion

Oral health status was poorer and had a negative effect on the quality of life among patients with T2DM, possibly contributing to poorly balanced nutrition.

This article is protected by copyright. All rights reserved.



http://ift.tt/2z5ffSC

How Are Proteins Reduced in the Endoplasmic Reticulum?

Publication date: Available online 15 November 2017
Source:Trends in Biochemical Sciences
Author(s): Lars Ellgaard, Carolyn S. Sevier, Neil J. Bulleid
The reversal of thiol oxidation in proteins within the endoplasmic reticulum (ER) is crucial for protein folding, degradation, chaperone function, and the ER stress response. Our understanding of this process is generally poor but progress has been made. Enzymes performing the initial reduction of client proteins, as well as the ultimate electron donor in the pathway, have been identified. Most recently, a role for the cytosol in ER protein reduction has been revealed. Nevertheless, how reducing equivalents are transferred from the cytosol to the ER lumen remains an open question. We review here why proteins are reduced in the ER, discuss recent data on catalysis of steps in the pathway, and consider the implications for redox homeostasis within the early secretory pathway.



http://ift.tt/2yKFSYY

Use of an intraoperative navigation system and piezoelectric surgery for styloidectomy in a patient with Eagle’s syndrome: a case report

Elongated styloid process syndrome (Eagle's syndrome) is the term given to the symptomatic elongation of the styloid process or the mineralization of the stylohyoid or stylomandibular ligament. The two commonl...

http://ift.tt/2AQPuTh

Use of an intraoperative navigation system and piezoelectric surgery for styloidectomy in a patient with Eagle’s syndrome: a case report

Elongated styloid process syndrome (Eagle's syndrome) is the term given to the symptomatic elongation of the styloid process or the mineralization of the stylohyoid or stylomandibular ligament. The two commonl...

http://ift.tt/2AQPuTh

Repair of maxillary cystic bone defects with mesenchymal stem cells seeded on a cross-linked serum scaffold

Tissue engineering combining cross-linked serum scaffolds with bone-derived mesenchymal stem cells has displayed excellent results for repair of maxillofacial bone defects in animal models, but it had not been tested in humans yet. We present here a pilot clinical trial using autologous bone-derived mesenchymal stem cells (H-MSV) grown in a serum cross-linked scaffold (BioMax) for treatment of maxillary cysts in 9 patients. Cells obtained from alveolar bone were seeded in the BioMax scaffold prepared from autologous serum, expanded under GMP conditions, and subjected to osteogenic differentiation for 3-4 weeks before application.

http://ift.tt/2APfzSZ

Should Hospitals Market Opioid-Sparing Analgesia to Patients?.

No abstract available

http://ift.tt/2zGbiU1

Comparison of Continuous Proximal Versus Distal Adductor Canal Blocks for Total Knee Arthroplasty: A Randomized, Double-Blind, Noninferiority Trial.

Background and Objectives: Adductor canal blocks (ACBs) are associated with improved analgesia, preserved quadriceps strength, and decreased length of hospitalization after total knee arthroplasty (TKA). However, controversy remains regarding the ideal location of a continuous block within the adductor canal, and it remains unclear whether similar clinical benefits are obtained irrespective of block location. In this randomized, double-blind, noninferiority study, we hypothesized that a continuous proximal ACB provides postoperative analgesia that is no worse than a continuous distal ACB. Methods: Subjects presenting for unilateral TKA were randomized in a 1:1 ratio to either a continuous proximal or distal ACB group. The primary outcome of this noninferiority study was opioid consumption within the first 24 hours following surgery. Secondary outcomes included quadriceps strength, pain scores, distance ambulated, and patient satisfaction. Results: Seventy-three subjects, 36 from the proximal group and 37 from the distal group, completed the study per protocol. The intention-to-treat analysis demonstrated a cumulative mean intravenous morphine equivalent consumption difference between the proximal and distal groups of -7.2 mg (95% confidence interval, -14.8 to 0.4; P

http://ift.tt/2A2MkyX

Radiofrequency Procedures to Relieve Chronic Hip Pain: An Evidence-Based Narrative Review.

Background and Objectives: Chronic hip pain from osteoarthritis and other degenerative conditions is a common problem. A few publications have recently reported analgesic success of radiofrequency (RF) procedures on nerves innervating the hip, but interpretation is hampered by lack of clarity regarding indications, clinical protocols, anatomic targets, and longevity of benefit from RF procedures. Methods: We reviewed the following medical literature databases for publications on RF procedures on the hip joint for chronic pain: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar through February 28, 2017. Existing knowledge on innervation of the hip joint was synthesized. Data on analgesic and functional outcomes and adverse effects measured at any time points following the interventions were also collected, analyzed, and reported in this narrative review. Results: Fourteen publications on ablative RF treatments of innervation of the hip joint were identified. A high success rate of these procedures in relieving chronic pain of the hip joint was reported at 8 days to 36 months after the procedures, but none of the publications were randomized controlled trials. There was evidence for improvement in function and a lack of serious adverse events of RF treatments. Conclusions: Radiofrequency treatments for the sensory innervation of the hip joint have the potential to reduce pain secondary to degenerative conditions. Ongoing concerns remain regarding the anatomic targets, as well as quality, procedural aspects, and monitoring of outcomes in publications on this topic. Randomized controlled trials of high methodological quality are required to further elaborate the role of these interventions in this population. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

http://ift.tt/2zF8eHH

Cervical Foraminal Epidural Blood Patch for the Targeted Treatment of Refractory Cerebrospinal Fluid Leakage From a Dural Sleeve.

Epidural blood patches (EBPs) are routinely used to treat symptoms (eg, headaches) associated with spontaneous intracranial hypotension. Although cerebrospinal fluid leakage commonly involves the periforaminal areas of the cervical or thoracic spine, EBPs have been historically performed at the lumbar level. Recent evidence suggests that targeting the causative spinal segment may provide greater clinical benefits. While previous reports have targeted foraminal leaks with segmental thoracic or cervical injections, we present a case report detailing the novel use of a navigable epidural catheter to perform a selective EBP at the C7/T1 foramen. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

http://ift.tt/2A2Mdn1

Anatomic Study of Innervation of the Anterior Hip Capsule: Implication for Image-Guided Intervention.

Background and Objectives: The purpose of this cadaveric study was to determine the pattern of anterior hip capsule innervation and the associated bony landmarks for image-guided radiofrequency denervation. Methods: Thirteen hemipelvises were dissected to identify innervation of the anterior hip capsule. The femoral (FN), obturator (ON), and accessory obturator (AON) nerves were traced distally, and branches supplying the anterior capsule documented. The relationships of the branches to bony landmarks potentially visible with ultrasound were identified. Results: The anterior hip capsule received innervation from the FNs and ONs in all specimens and the AON in 7 of 13 specimens. High branches of the FN (originating above the inguinal ligament) were found exclusively in 12 specimens and passed between the anterior inferior iliac spine and the iliopubic eminence. The ONs were innervated exclusively by high branches (proximal to the division), by low branches (from the posterior branch), and by both in 4, 5, and 4 specimens, respectively. The most consistent landmark was the inferomedial acetabulum (radiographic "teardrop"). When present, the AON coursed over the iliopubic eminence before innervating the anterior hip capsule. Conclusions: Branches of the FNs and ONs consistently provided innervation to the anterior hip capsule. The AON also contributed innervation in many specimens. The relationship of the articular branches from these 3 nerves to the inferomedial acetabulum and the space between the anterior inferior iliac spine and iliopubic eminence may suggest potential sites for radiofrequency ablation. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

http://ift.tt/2zF86YJ

The Omental Free Flap—A Review of Usage and Physiology

J reconstr Microsurg
DOI: 10.1055/s-0037-1608008

Background The omental flap has a rich history of use over the last century, and specifically as a free flap in the last four decades. It has a wide variety of applications in reconstructive surgery and has shown itself to be a reliable donor tissue. We seek to review the properties that make the omental free flap a valuable tool in reconstruction, as well as its many surgical applications in all anatomic regions of the body. Methods We conducted a narrative review of the literature on Medline and Google Scholar. We reviewed basic science articles discussing the intrinsic properties of omental tissue, along with clinical papers describing its applications. Results The omental free flap is anatomically suitable for harvest and wound coverage and has molecular properties that promote healing and improve function at recipient sites. It has demonstrated utility in a wide variety of reconstructive procedures spanning the head and neck, extremities, and viscera and for several purposes, including wound coverage, lymphedema treatment, and vascularization. It is also occasionally employed in the thoracic cavity and chest wall, though more often as a pedicled flap. More novel uses include its use for cerebrospinal fluid leaks. Conclusions The omental free flap is a valuable option for reconstructive efforts in nearly all anatomic regions. This is a result of its inherent anatomy and vascularity, and its angiogenic, immunogenic, and lymphatic properties.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text



http://ift.tt/2iX7Rhk

Thrombosis Prevention with Botulinum Toxin A after Traumatic Crush Injury in a Rat Model

J reconstr Microsurg
DOI: 10.1055/s-0037-1607437

Background Revascularized digits may fail because of vessel thrombosis. The current study aimed to develop a standard model for crush injury in the rat femoral artery to evaluate the antithrombotic effect of perivascular botulinum toxin A (BTX-A) injection. Methods We explored bilateral femoral arteries of 10 rats using a microscopic technique. The crush injury was reproduced using a bulldog clamp. One randomly chosen leg of each rat was injected with BTX-A. The other side received normal saline as its own control. After 24 hours, the femoral arteries were ligated distal to the trauma site and were divided between the traumatized and ligated sites. Results All arteries injected with BTX-A had pulsatile bleeding without thrombosis. Arteries injected with normal saline had thrombosis without bleeding, except for one with oozing. The results showed the efficacy of BTX-A and its potential use in microvascular trauma (p < 0.001). Conclusion The use of BTX-A preoperatively in the emergency department may help reduce traumatic stress and subsequent thrombosis and improve trauma management results. Complementary studies are needed to assess the ability of BTX-A to reduce thrombosis and vasospasm and improve survival of traumatized digits.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text



http://ift.tt/2iY9knF

Novel Therapies For Alopecia Areata: The Era Of Rational Drug Development

The treatments for Alopecia Areata (AA) have evolved over the decades from broad and non-specific therapies, to those that are now more targeted and rationally selected. This was achieved by close co-operation and communication between clinicians and basic scientists, which resulted in the elucidation and understanding of the unique pathophysiology of AA. In this review, we discuss this evolution, and how novel therapies for AA has changed over the decades, what we have in our current arsenal of drugs for this potentially devastating disease, and what the future holds.

http://ift.tt/2iZ16M8

Type I IFN related NETosis in Ataxia Telangiectasia and Artemis deficiency

Enhanced type I IFN response observed in AT, Artemis deficiency and SAVI, exert tissue damage through neutrophil-driven chronic processes, providing a common target to manage inflammatory syndromes in diseases with active type I IFN signature.

http://ift.tt/2zLG0Zw

Targeting of Rac1 prevents bronchoconstriction and airway hyperresponsiveness

The molecular mechanisms responsible for airway smooth muscle cells (aSMC) contraction and proliferation in airway hyperresponsiveness (AHR) associated with asthma are still largely unknown. The small GTPases of the Rho family (RhoA, Rac1 and Cdc42) play a central role in SMC functions including migration, proliferation and contraction.

http://ift.tt/2j0CiTJ

Patients with atopic dermatitis and history of eczema herpeticum elicit HSV-specific type 2 immune responses

An increased type 2 and in parallel decreased type 1 T cell immune response to herpes simplex virus 1 may lead to the clinical phenotype of eczema herpeticum.

http://ift.tt/2zNsO6n

14-3-3z sequesters cytosolic T-bet, up-regulating IL-13 in Tc2 and scleroderma CD8+ lymphocytes

Interleukin(IL)-13-producing CD8+ T cells have been implicated in the pathogenesis of type-2 driven inflammatory human conditions. We have shown that CD8+IL-13+ cells play a critical role in cutaneous fibrosis, the most characteristic feature of systemic sclerosis (scleroderma; SSc). However, the molecular mechanisms underlying IL-13 and other type-2 cytokine production by CD8+ T cells remain unclear.

http://ift.tt/2iZ55Z9

ORAI1 mutations abolishing store-operated Ca2+ entry cause anhidrotic ectodermal dysplasia with immunodeficiency (EDA-ID)

Store-operated Ca2+ entry (SOCE) through Ca2+ release-activated Ca2+ (CRAC) channels is an essential signaling pathway in many cell types. CRAC channels are formed by ORAI1, ORAI2 and ORAI3 proteins and activated by stromal interaction molecule 1 (STIM1) and STIM2. Mutations in ORAI1 and STIM1 genes that abolish SOCE cause a combined immunodeficiency (CID) syndrome that is accompanied by autoimmunity and non-immunological symptoms.

http://ift.tt/2zKCGxR

Defects in plasma cell differentiation is associated with primary immunodeficiency in humans



http://ift.tt/2iX9ewk

Serration pattern analysis for differentiating epidermolysis bullosa acquisita from other pemphigoid diseases

Direct immunofluorescence microscopy (DIF) of a skin biopsy specimen is the reference standard for the diagnosis of pemphigoid diseases (PD). Serration pattern analysis enables differentiation of epidermolysis bullosa acquisita (EBA) from other PD using DIF microscopy alone. However, practice gaps need to be addressed for implication of this technique in daily routine diagnostics.

http://ift.tt/2A0JJVT

Endoscopic Carpal Tunnel Release with and without Sedation

Background: This study evaluates outcomes and complications with endoscopic carpal tunnel release (eCTR) performed with local anesthesia (LOCAL) only versus local anesthesia with sedation (SEDATION). We hypothesize that patient outcomes and satisfaction will be equivalent in both groups irrespective of anesthesia type. Methods: One hundred fifty-four consecutive patients undergoing eCTR with either LOCAL or SEDATION protocols were prospectively enrolled in a study of satisfaction and outcomes. The patients were surveyed preoperatively and at 2-weeks and 3-months postoperatively to evaluate satisfaction, symptoms, complications, and disability using the QuickDASH survey, the Levine-Katz carpal tunnel survey, and a customized LIKERT scale. Results: The hypothesis was upheld. Both groups of patients reported high levels of satisfaction (96% in LOCAL and 93% in SEDATION groups at 3 weeks). Disability, pain, and symptom scores did not differ significantly between groups at either postoperative time point. Following surgery, patients in the SEDATION group recalled more mean preoperative anxiety (4/10 versus 2.03/10 at 3 months). If they were to undergo the surgery again, patients in the SEDATION group were likely to desire either sedation (68%) or general anesthesia (29%) while patients in the LOCAL group were likely to wish for similar local-only anesthesia (78%). There were no reoperations or epinephrine-related complications in either group. Conclusions: Patients undergoing eCTR experience similar levels of satisfaction and outcomes with LOCAL and SEDATION protocols. The findings of this study confirm that both methods of anesthesia provide excellent results and allow for surgeons and patients to choose freely between the two anesthetic techniques. Financial Disclosure Statement: The authors have nothing to disclose. No funding was received for this research. Presented at: American Society for Surgery of the Hand annual meeting 2016 in Austin, TX, USA Author contributions: Tulipan: Data gathering, data analysis, manuscript preparation Kim: Data gathering, data analysis, manuscript preparation Ilyas: Data gathering, data analysis, manuscript preparation Matzon: Data gathering, data analysis, manuscript preparation This study was approved by the institutional review board at Thomas Jefferson University *CORRESPONDING AUTHOR: Jacob Tulipan, MD, 1025 Walnut St, Suite 516 College, Philadelphia, PA, United States. (215) 955-1500, (215) 503-0530, Jacob.tulipan@gmail.com ©2017American Society of Plastic Surgeons

http://ift.tt/2jw0qS3

Cleft-Related Orthognathic Surgery Based On Maxillary Vertical Lengthening Of the Anterior Facial Height

Background: The conventional approach during orthognathic surgery for cleft-related deformities has largely focused on restoration of maxilla retrusion, using the maxillary advancement as a standard treatment objective. However, we thought the maxillary vertical shortening and deficient incisor show could be the additional key elements of cleft-related deformities. Although slight vertical lengthening can be obtained with only maxillary advancement, it would not be enough to obtain satisfactory aesthetical results in terms of the anterior facial height. We hypothesized that vertical deficiency as well as anteroposterior maxillary retrusion exists in cleft-related deformities. Therefore, orthognathic surgery including intentional vertical lengthening and advancement would be better than the conventional simple advancement. Methods: A new approach was used to treat consecutive patients with dentofacial deformities between December 2007 and December 2016. The inclusion criterion was patients with cleft-related deformities. Results: Forty-one patients with cleft-related dentofacial deformities were included. The distance from the nasion to the incisor tip was 76.70 mm, angle of the lines connecting the sella, nasion, and point A was 74.03∘, and the incisor show was 1.02 mm. Corresponding measurements in forty patients without clefts were 81.57 mm, 80.08∘, and 3.38 mm, respectively. Postoperatively, the average vertical lengthening achieved was 0.88 mm in simple maxillary advancement group and 7.65 mm in intentional vertical lengthening accompanied by the maxillary advancement group. Conclusions: Our results suggest that simultaneous maxillary vertical lengthening with horizontal advancement is a viable approach to orthognathic surgery for cleft-related deformities given the long-term stability of outcomes demonstrated in this study. Financial Disclosure Statement: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Acknowledgment: This article was presented at 2016 EACMFS in London, England. Corresponding author: Jong Woo Choi, M.D., Ph.D., MMM, Associate Professor, Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center, 388-1 PungNap-2Dong, SongPa-Gu, Seoul 138-736, Korea, Phone: 82-2-3010-3604; Fax: 82-2-476-7471, E-mail: pschoi@amc.seoul.kr ©2017American Society of Plastic Surgeons

http://ift.tt/2hDzH5N

Reconstruction of Microtias with Constricted Ear Features: A 22-Year Experience

Background: The surgical correction of 'microtias with constricted ear features' has remained a challenge due to the variable shape and large volume of the remnant cartilage and skin involved. In order to clarify how this remnant cartilage and skin should be treated, we have reviewed and analyzed cases operated at our Center. Methods: A total of 167 cases of Microtia with Constricted Ear Features, operated from 1992 to 2014, were included in the study. They were reviewed through medical records and photographs, analysis of surgical methods, and postoperative outcomes. Results: A total of 141 cases (84 percent) were followed for 2 months to 13 years (an average of 28 months). The average score given to the aesthetic outcomes, rated on a four-point Likert scale (i.e., 1=poor, 2=fair, 3=good, 4=excellent), was 3.1. For framework construction, we used remnant cartilage saving methods (n=37) or remnant cartilage replacement methods (n=104). The average (median) scores for the aesthetic outcome for these methods were 2.56 (3) and 3.36 (4), respectively. The difference in these scores was statistically significant (P

http://ift.tt/2hDzzmP

Gender Confirmation Surgery Using the Pedicle Transverse Colon Flap for Vaginal Reconstruction: A Clinical Outcome and Sexual Function Evaluation Study

Introduction: Vaginal reconstruction and vaginoplasty are indicated in vaginal agenesis, following pelvic tumor resection, trauma and for gender confirmation surgery. Different surgical options have been described when using these techniques. Herein, we present the clinical outcomes and sexual function evaluation using the pedicle transverse colon flap (TCF) for gender confirmation surgery in transgender women. Methods: This is a retrospective chart review of all transgender women who underwent gender confirmation surgery using the pedicle TCF. Demographics, etiology, procedure specifics and surgical outcomes were recorded and analyzed. Sexual function was measured using the Female Sexual Function Index (FSFI) and the female genital self-image scale (FGSIS) one year after surgery. Results: 15 patients underwent gender confirmation surgery using the pedicle transverse colon flap. Average age was 20, (range: 18-32 years), average OR time was 10.1 hours; (8-12.5 hrs.). The average length and width of the flaps was 15 cm and 2.8 cm respectively. During a 12-year follow-up, two complications were reported: one patient had pain due to narrowing at the introitus vaginalis, which required intervention and one patient had excessive amount of secretions in the first month which subsided at the third month after surgery. The mean FSFI score was 28.6 (range 24-31). All patients achieved a normal sexual function as indicated by a FSFI score of 25 or more. For the FGSIS, the mean total score was 20.0 ± 4.5 (range: 7- 28). Conclusion: The pedicle transverse colon flap is another valuable alternative method for vaginoplasty with promising results and minor complications. Financial Disclosure:None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding Author: Oscar J. Manrique M.D., Senior Associated Consultant, Assistant Professor of Surgery, Division of Plastic and Reconstructive Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, Tel: +1-507-284-3214; Fax: +1-507-284-5994, Email: manrique.oscar@mayo.edu ©2017American Society of Plastic Surgeons

http://ift.tt/2jufpfg

Nose and lips graft variants: a subunit anatomical study

Background. In the field of Vascularized Composite tissue Allotransplantation (VCA), the surgical design of facial subunit grafts is an evolving concept. The purpose of the present paper is to study the possibilities to divide the historical nose and lips face transplant into several morphological and functional subunit grafts, depending on their respective supply. Methods. Our study was conducted in 20 adult cadavers. The facial artery and its branches were dissected bilaterally in 16 fresh and 4 embalmed heads. Nasolabial perfusion was assessed by selective injection of methylene blue and eosin (n=2) or indian ink (n=2) in superior labial artery (SLA) and distal facial artery (DFA). Dynamic perfusion through the DFA was illustrated by fluoroscopy (n=3). Three nose-upper lip grafts were harvested and injected with barium sulfate for micro-Angio CT analysis. Finally, three isolated nasal and bilabial grafts were procured and their vascular patency assessed by fluoroscopy. Results. DFA can perfuse the entire nose, septum and upper lip, without any contribution of SLA. A dense anastomotic network indeed exists between the respective distal rami of both vessels. Furthermore, the exclusion of SLA from the harvested nasal subunit allowed safe bilabial subunit procurement, from the same specimen. Conclusions. Our results demonstrate the feasibility of harvesting nasal and labial subunits, in an isolated or a combined manner. These results can find applications in subunit autologous replantation, allotransplantation, allogenic face partial retransplantation, and in the emerging field of vascularized composite tissue engineering. Financial Disclosure Statement: The authors have no conflict of interest to disclose. This work was financially supported by a Fondation Saint-Luc Grant, FSR-UCL (Fonds Spécial de la Recherche) and Fonds Dr. Gaëtan Lagneaux. The content of the work is solely the responsibility of the authors. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Acknowledgments: We would like to thank Mrs. Pascale Segers and Mr Walter Hudders for manuscript editing, Mrs. Michelle Cougnon and Mr Eric Legrand for administrative support, Mr. Bernard Caelen and Mrs. Maïté Van de Woestijne for assistance in cadaver procurement, Prof. Anne Bol for Micro-CT acquisition support. Conflict of interest: none. Authorships: JD Designed study, performed part of experimental manipulations, reviewed and interpreted all data, wrote article, gave approval for publication. LM Performed part of experimental manipulations, participated to data collection and analysis, gave approval for publication AG Performed part of experimental manipulations, participated to data collection and analysis, revised article, gave approval for publication MV Performed radiographic acquisition and reconstruction, reviewed and interpreted data, gave approval for publication. PG Supported experiments, reviewed and interpreted data, revised article, gave approval for publication. CB Supported experiments, reviewed and interpreted data, revised article, gave approval for publication. BL Supported experiments and designed study, reviewed data, revised article extensively, gave final approval for publication. Corresponding author: Benoît Lengelé, MD, PhD, FRCS, UCL/IREC/MORF,, Avenue E. Mounier 51, Bte B1.52.04, B-1200 Brussels (BELGIUM) Tel: +3227645251, Fax: + 3227645225, E-mail : benoit.lengele@uclouvain.be ©2017American Society of Plastic Surgeons

http://ift.tt/2hDmfil

The helsinki face transplantation: surgical aspects and one-year outcome

Since 2005, at least 38 facial transplantations have been performed worldwide. We herein describe the surgical technique and one year clinical outcome in Finland's first face transplant case.

http://ift.tt/2zI0X9E

The Acoustic Voice Quality Index Version 03.01 for the Japanese-speaking Population

We aimed to determine the most appropriate syllable number for analyzing the Acoustic Voice Quality Index for the Japanese-speaking population (AVQIv3-JP) and to validate AVQIv3-JP using the determined syllable number.

http://ift.tt/2zL2bio

The Origins of Verb Learning: Preverbal and Postverbal Infants' Learning of Word–Action Relations

Purpose
This experiment examined English- or Spanish-learning preverbal (8–9 months, n = 32) and postverbal (12–14 months, n = 40) infants' learning of word–action pairings prior to and after the transition to verb comprehension and its relation to naturally learned vocabulary.
Method
Infants of both verbal levels were first habituated to 2 dynamic video displays of novel word–action pairings, the words /wem/ or /bæf/, spoken synchronously with an adult shaking or looming an object, and tested with interchanged (switched) versus same word–action pairings. Mothers of the postverbal infants were asked to report on their infants' vocabulary on the MacArthur–Bates Communicative Development Inventories (Fenson et al., 1994).
Results
The preverbal infants looked longer to the switched relative to same pairings, suggesting word–action mapping, but not the postverbal infants. Mothers of the postverbal infants reported a noun bias on the MacArthur–Bates Communicative Development Inventories; infants learned more nouns than verbs in the natural environment. Further analyses revealed marginal word–action mapping in postverbal infants who learned fewer nouns and only comprehended verbs (post–verb comprehension), but not in those who learned more nouns and also produced verbs (post–verb production).
Conclusions
These findings on verb learning from inside and outside the laboratory suggest a developmental shift from domain-general to language-specific mechanisms. Long before they talk, infants learning a noun-dominant language learn synchronous word–action relations. As a postverbal language-specific noun bias develops, this learning temporarily diminishes.
Supplemental Materials
http://ift.tt/2zKIDwu

http://article/doi/10.1044/2017_JSLHR-L-17-0085/2664213/The-Origins-of-Verb-Learning-Preverbal-and

Reduction of olfactory sensitivity during normobaric hypoxia

Acute mountain sickness (AMS) is caused by a low partial pressure of oxygen and may occur above 2500m. The aim of this research was to evaluate olfactory and gustatory abilities of healthy subjects during baseline conditions and after seven hours of normobaric hypoxia.

http://ift.tt/2zHolo0

Diagnostic criteria for Patulous Eustachian Tube: A proposal by the Japan Otological Society

Patulous Eustachian Tube (PET) is of increasing importance in otology. However, despite the abundance of diseases requiring a differential diagnosis from PET, such as superior semicircular canal dehiscence syndrome, perilymphatic fistula, acute low-tone sensorineural hearing loss, etc., there are currently no established diagnostic criteria for PET.In view of these circumstances, the Japan Otological Society (JOS) Eustachian Tube Committee proposed the diagnostic criteria for Patulous Eustachian Tube in 2012, in order to promote clinical research on PET.

http://ift.tt/2zFqAbF

Impaired cerebrovascular reactivity in obstructive sleep apnea: A case-control study

Obstructive sleep apnea (OSA) is an independent risk factor for stroke. Little is known about the cerebrovascular hemodynamic changes during apnea. Hypercapnia occurs in apneas and hypopneas, and a reduced cerebral vasodilatory response to CO2 could compromise the cerebral blood flow (CBF). Therefore, we aimed to evaluate whether the apnea−hypopnea index (AHI) affected the cerebrovascular response to CO2.

http://ift.tt/2A2Dj90

Reduction of olfactory sensitivity during normobaric hypoxia

Acute mountain sickness (AMS) is caused by a low partial pressure of oxygen and may occur above 2500m. The aim of this research was to evaluate olfactory and gustatory abilities of healthy subjects during baseline conditions and after seven hours of normobaric hypoxia.

http://ift.tt/2zHolo0

Improving surgical results in complex nerve anatomy during implantation of selective upper airway stimulation

The following report presents a case of two late embedded hypoglossus branches during implantation of an upper airway stimulation device that caused a mixed activation of the tongue when included in the stimulation cuff. In the end, correct cuff placement could be achieved by careful examination of the hypoglossal nerve anatomy, precise nerve dissection, tongue motion analysis and intraoperative nerve monitoring.

http://ift.tt/2A2D8dQ

Diagnostic criteria for Patulous Eustachian Tube: A proposal by the Japan Otological Society

Patulous Eustachian Tube (PET) is of increasing importance in otology. However, despite the abundance of diseases requiring a differential diagnosis from PET, such as superior semicircular canal dehiscence syndrome, perilymphatic fistula, acute low-tone sensorineural hearing loss, etc., there are currently no established diagnostic criteria for PET.In view of these circumstances, the Japan Otological Society (JOS) Eustachian Tube Committee proposed the diagnostic criteria for Patulous Eustachian Tube in 2012, in order to promote clinical research on PET.

http://ift.tt/2zFqAbF

Persistent Upper Lip Swelling in a Young Woman

No abstract available

http://ift.tt/2jui88s

Florid Granuloma Annulare–Like Reaction in Regional Lymph Nodes After “Regression” of Red Pigment in Tattoos

Abstract: A healthy 50-year-old woman had a tattoo performed on the posterior aspect of her neck and another on the dorsum of her left foot. Several weeks later, she noted redness, tenderness, and intense pruritis at both tattoo sites. Treatment with cephalexin and hydrocortisone cream was instituted, without success. Within a few months, the red, but not black, pigment had disappeared from both tattoos and was replaced by pale areas of scarring. Persistently enlarged left supraclavicular and suboccipital lymph nodes were excised 7 and 10 months after receipt of the tattoos, respectively. The nodes were pigmented on gross examination, and on microscopy, a granuloma annulare–like reaction was observed. Normal lymphoid tissue was seen to be replaced by large palisading granulomas with central degenerative change, abundant stromal mucin, and scattered deposits of tattoo pigment. Histochemical stains, tissue culture, and serological studies revealed no evidence of infection. There are rare reports of granuloma annulare–like reactions in tattoos, and these are believed to represent delayed-type hypersensitivity reactions. Our case is unique in the observation of this reaction pattern in regional lymph nodes, and it expands the spectrum of complications known to be associated with tattoos. Reprints: Michael D. Carter, MD, PhD, Michigan Medicine Department of Pathology, Traverwood II 2910 Huron Parkway, Suite C Ann Arbor, MI 48105-3450 (e-mail: michacar@med.umich.edu). The authors declare no conflicts of interest. Ethical approval: This article does not contain any study with animals or human participants performed by any of the authors. Informed consent: Informed consent was obtained from the individual included in the case study. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2hCu3R5

Bupivacaine as an Adjunct to Lidocaine in Mohs Micrographic Surgery: A Prospective Randomized Controlled Trial.

BACKGROUND: In Mohs micrographic surgery (MMS), the standard local anesthetic agent used is lignocaine with adrenaline. However, MMS can be prolonged; thus reinjections of local anesthetics are often required. OBJECTIVE: Is 0.5% bupivacaine with 1:200,000 epinephrine a useful adjunctive treatment when compared with the use of 1% lidocaine with 1:100,000 epinephrine in MMS for the nose? METHODS: Participants undergoing MMS received 2.5 mL of 1% lidocaine with 1:100,000 epinephrine before commencement of Stage 1. At the end of Stage 1, participants were randomized sequentially to either 2.5 mL 0.5% bupivacaine with 1:200,000 epinephrine (Group A) or 2.5 mL of 1% lidocaine with 1:100,000 epinephrine (Group B). Effectiveness of anesthesia was assessed using 30 G needle to 5 points of the wound before further stage or repair. RESULTS: Fifty-one patients were randomized, 26 to Group A, and 25 to Group B. No differences between the 2 groups in size of defect and time lapse between time of injection and time of testing were observed. Seven of 25 were tested positive in Group B. Zero of 26 tested positive in Group A (p = .003, 95% confidence interval: 10%-46%). CONCLUSION: Adjunctive use of 0.5% bupivacaine with 1:200,000 epinephrine is effective in prolonging anesthesia in MMS. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2mrSBOx

Influence of Syringe Volume on Foam Stability in Sclerotherapy for Varicose Vein Treatment.

BACKGROUND: Despite the popularity of sclerotherapy for treating varicose veins, it still exhibits various problems, such as pulmonary embolism, deep-vein thrombosis, phlebitis, and visual disorders. OBJECTIVE: To investigate syringe volume influence on foam stability, obtain the foam decay rule, and provide a reference for clinics. MATERIALS AND METHODS: Five types of syringes are used to prepare foam at room temperature with various liquid-gas ratios. Foam decay process experiments were performed 5 times and recorded by video. The stability indices used include drainage time, half-life, bubble diameter, bubble surface density, and drainage rate. RESULTS: The 30 and 2-mL syringes, respectively, recorded the highest and lowest drainage speeds. Foam drainage time and half-life, differences varied between 15 and 70 seconds, and 20 and 100 seconds, respectively. Foam bubble diameters were distributed over 0.1 to 2.0 mm with roughly 200 to 700 bubbles per square centimeter. CONCLUSION: Increased syringe volume causes the bubble diameter to increase. Thus, foam dispersion increases and foam half-life decreases; hence, foam becomes unstable. It is, thus, better to use a small syringe several times to prepare foam in clinics using segmented injections. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2z5PbXG

Role of Hyaluronidase in the Treatment of Hypertrophic Scars.

No abstract available

http://ift.tt/2z5u6wq

Dog Ear Regression in Function of Skin Elasticity.

No abstract available

http://ift.tt/2myfG2e

Rhinophyma: A Treatment Review.

BACKGROUND: Rhinophyma is the overgrowth of sebaceous glands in nasal tissue and its etiology unclear. Without treatment, rhinophyma can be progressive and cause concern both with respect to function and cosmesis. OBJECTIVE: The objective of this work is to describe treatment options for rhinophyma and their respective risks and benefits. MATERIALS AND METHODS: A PubMed search was performed to include the terms "rhinophyma" and "treatment." RESULTS: Numerous physically destructive modalities exist for treatment of rhinophyma, falling primarily into 3 categories: mechanical destruction, directed electrical energy/radiofrequency, and directed laser energy. CONCLUSION: There are multiple treatment modalities available to dermatologists for the treatment of rhinophyma. To the best of our knowledge, there are no randomized, prospective, control studies for any treatment, which makes it difficult to recommend a single treatment over another. Nonetheless, it is important to recognize that scarring and hypopigmentation most often occur on or near the nasal ala. Moreover, risks may increase if tissue destruction extends to the papillary dermis or pilosebaceous units are ablated. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2z6rFcS

IFC (Ed. Board)

alertIcon.gif

Publication date: October 2017
Source:Brain Research Bulletin, Volume 135





http://ift.tt/2mvjcKr

Comparison of two Jatropha species (Euphorbiaceae) used popularly to treat snakebites in Northeastern Brazil: Chemical profile, inhibitory activity against Bothrops erythromelas venom and antibacterial activity

Publication date: 1 March 2018
Source:Journal of Ethnopharmacology, Volume 213
Author(s): Juliana Félix-Silva, Jacyra A.S. Gomes, Júlia M. Fernandes, Angela K.C. Moura, Yamara A.S. Menezes, Elizabeth C.G. Santos, Denise V. Tambourgi, Arnóbio A. Silva-Junior, Silvana M. Zucolotto, Matheus F. Fernandes-Pedrosa
Ethnopharmacological relevanceJatropha species (Euphorbiaceae) are largely used in traditional medicine to treat different pathologies in Africa, Asia and Latin America. In Northeastern Brazilian folk medicine, several Jatropha species, such as Jatropha gossypiifolia L. and Jatropha mollissima (Pohl) Baill., are indistinctly used to treat snakebites.Aim of the studyTo compare two of the Brazilian most used Jatropha species for snakebites (J. gossypiifolia and J. mollissima), in relation to their ability to inhibit local edematogenic activity of Bothrops erythromelas snake venom in mice, their in vitro antibacterial activity and phytochemical profile.Material and methodsAqueous leaf extracts of J. gossypiifolia (AEJg) and J. mollissima (AEJm) were prepared by decoction. AEJg and AEJm were compared chemically, by thin layer chromatography (TLC) and high-performance liquid chromatography with diode array detection (HPLC-DAD) analysis. They were also pharmacologically compared, using the mouse model of paw edema induced by Bothrops erythromelas snake venom (BeV), and in vitro by broth microdilution and agar dilution antimicrobial tests.ResultsFlavonoids were detected as the major compounds in both extracts. However, AEJg and AEJm showed quantitatively different chemical profiles by HPLC-DAD. AEJg presented fewer peaks of flavonoids than AEJm, however, when the intensity of peaks were analyzed, these compounds were at high concentration in AEJg, even using the same concentration of both extracts. Differences were also observed in the biological activity of the two extracts. While no difference was observed when the extracts were administered by oral route (P > 0.05), by the intraperitoneal route AEJg presented anti-edematogenic activity significantly (P < 0.001) higher than AEJm. In antimicrobial assays, only AEJg presented antibacterial activity against Staphylococcus epidermidis, Staphylococcus aureus and Bacillus cereus.ConclusionsAlthough used indistinctly by folk medicine, our results suggested that AEJg is more active than AEJm in relation to its antiedematogenic and antibacterial activities. Significant differences were observed in their phytochemical profiles, especially a higher content of C-glycosylated flavonoids in the most active species, which could justify the different biological effects observed. These findings strengthen the potentiality of J. gossypiifolia species for use as complementary treatment for local effects induced by Bothrops venoms and could be helpful for distinction of the species and control quality assessment of future herbal medicines based on Jatropha plants.

Graphical abstract

image


http://ift.tt/2z5Y5nW

Pfaffia paniculata (Brazilian ginseng) extract modulates Mapk and mucin pathways in intestinal inflammation

Publication date: 1 March 2018
Source:Journal of Ethnopharmacology, Volume 213
Author(s): C.A.R.A. Costa, A.E.V. Quaglio, L.C. Di Stasi
Ethnopharmacological relevancePfaffia paniculata is an endemic Brazilian plant traditionally used against fatigue, stress, inflammation and low immune system as well as with proven intestinal anti-inflammatory activity.Aim of the studyTo evaluate intestinal anti-inflammatory effects of P. paniculata on the mRNA abundance of Hsp70, Heparanase, Mapk1, Mapk3, Mapk6, Mapk9, Muc1, Muc2, Muc3, Muc4, and NF-κB, as well as the mucin content in colonic samples.Material and methodsIntestinal inflammation was induced by TNBS and rats were divided into groups that received vehicle or 25, 50, 100, or 200mg/kg of P. paniculata extract, p.o., started 2h after inflammation induction and continued daily for 7 days. At the end of the procedure, the animals were killed and their colon samples were obtained for RT-qPCR analysis and mucin histochemical study with PAS/Alcian blue stain. The inflammatory process was confirmed with colon macroscopic analysis and myeloperoxidase (MPO) activity.ResultsP. paniculata at 200mg/kg significantly decreased macroscopic damage score, extension of lesion and colonic MPO activity. Besides, P. paniculata at a dose of 25mg/kg was also able to significantly decrease Hsp70, while treatment with 50mg/kg reduced Mapk3 and increased Muc4. At dose of 100mg/kg P. paniculata increased Mapk1, Muc3, Muc4, and decreased Mapk3. Finally, at the 200mg/kg P. paniculata reduced Mapk3. The heparanase, NF-κB, Mapk6, Mapk9, Muc1 and Muc2 mRNA abundances were not altered after P. paniculata treatments.ConclusionIntestinal anti-inflammatory activity of P. paniculata was related to modulation of Mapks and mucin gene expression, as well as mucus secretion in intestinal inflammation.

Graphical abstract

image


http://ift.tt/2z4y8Fp

A thirteen-week oral toxicity study of So-ochim-tang-gami-bang, a traditional Korean medicine, in Sprague–Dawley rats

Publication date: 1 March 2018
Source:Journal of Ethnopharmacology, Volume 213
Author(s): Mi Ju Lee, Myoung Jun Kim, Yang-Chun Park, Jeong June Choi, Mirim Jin, In Chul Jung
Ethnopharmacological relevanceSo-ochim-tang-gamibang (SOCG) is a traditional Korean medicine formulated to control internal energy flow (Qi) and has been prescribed to improve stress-induced depressive disorders.Aim of the studySOCG has been used in clinical practice for the last two decades and its efficacy against stress-induced thoracic pain has been suggested. Although SOCG has been used as an herbal formula in Korean medicine, its toxicity has not yet been evaluated. In this study, we evaluated the safety of SOCG through a 13-week general toxicity study in rats.Material and methodsSOCG was administered by oral gavage to rats at doses of 0 (control), 800, 2000, and 5000mg/kg/day over a 13-week period. Toxicity testing was conducted by evaluating mortality, clinical signs, body weight, food consumption, urinalysis, hematology, serum biochemistry, organ weight, necropsy, and histopathology compared with the concurrent control.ResultsSOCG-related changes were noted in clinical signs and urinalysis. The observed clinical signs were compound-colored stool and salivation. Urinalysis results revealed brown or amber colored urine and elevated levels of protein. However, these changes were not considered to be adverse.ConclusionsThe no-observed-adverse-effect-level of SOCG was determined to be above 5000mg/kg in both male and female rats. The result of this study can lay the foundation for the application of SOCG in humans and prove useful for detailed investigations on the toxicity or pharmacological effects of SOCG.

Graphical abstract

image


http://ift.tt/2z45RyH

Ethnopharmacological implications of quantitative and network analysis for traditional knowledge regarding the medicinal use of animals by indigenous people in Wolchulsan National Park, Korea

Publication date: 1 March 2018
Source:Journal of Ethnopharmacology, Volume 213
Author(s): Geun Kim, Hyun Kim, Mi-Jang Song
Ethnopharmacological relevanceThe purpose of this study was to record, analyze, and identify ethnopharmacological implications for oral traditional knowledge regarding the medicinal use of animals by indigenous people living in Wolchulsan National Park, Korea.Materials and methodsData were collected through interviews, informal meetings, open and group discussions, and observations guided by semi-structured questionnaires. Data were analyzed via quantitative analysis of informant consensus factor and fidelity level, and network analysis, including centrality and clustering analysis.ResultsA total of 46 families, 59 genera, and 60 species of animals, as well as 373 methods of usage, were recorded. Fish comprised 31.7% of the total animal species recorded, followed by mammals at 20.0%, arthropods at 18.3%, and mollusks at 11.7%. Of these animals, 48.0% were utilized as food and 46.1% for medicinal use. Quantitative analysis showed that the category with the highest degree of consensus from informants was veterinary ailments (informant consensus factor value, 0.96). This was followed by poisonings (0.93), pains (0.92), genitourinary system disorders (0.91), cuts and wounds (0.89), and other medical conditions. The lowest degree of consensus was for skin diseases and disorders (0.57). There were 8 species of animals with a fidelity level of 100%, after eliminating from the animals analyzed that were mentioned only once. Finally, using network analysis, Gallus gallus domesticus and Gloydius brevicaudus were defined as species with meaningful medicinal use, while lack of vigor and lung diseases were defined as significant ailments in the study area.ConclusionThis study validates that local communities use animals not only for food but also for medicinal purposes as crucial therapeutic measures. Therefore, the conservation of fauna and preservation of traditional knowledge need to be seriously considered to maintain the health and well-being of the local communities. Network analysis clarified the series of ailments for which each animal species is preferentially used and helped confirm the order of priority when prescribing animal components for medicinal use. The traditional knowledge recorded in the present study will provide the basic data to develop new medicines for the bioindustry.

Graphical abstract

image


http://ift.tt/2z53c7W

Editorial Board

alertIcon.gif

Publication date: December 2017
Source:Cancer Treatment Reviews, Volume 61





http://ift.tt/2z4E3dp

Differential roles of kallikrein-related peptidase 6 in malignant transformation and ΔNp63β-mediated epithelial-mesenchymal transition of oral squamous cell carcinoma

S13688375.gif

Publication date: December 2017
Source:Oral Oncology, Volume 75
Author(s): Naoki Kaneko, Shintaro Kawano, Kaori Yasuda, Yuma Hashiguchi, Taiki Sakamoto, Ryota Matsubara, Yuichi Goto, Teppei Jinno, Yasuyuki Maruse, Masahiko Morioka, Taichi Hattori, Shoichi Tanaka, Hideaki Tanaka, Tamotsu Kiyoshima, Seiji Nakamura
We previously reported that epithelial-to-mesenchymal transition (EMT) was mediated by ΔNp63β in oral squamous cell carcinoma (OSCC). In this study, DNA microarray analyses were performed using ΔNp63β-overexpressing OSCC cells to identify genes associated with ΔNp63β-mediated EMT. Thereby, we focused on kallikrein-related peptidase (KLK) 6, most up-regulated following ΔNp63β-overexpression, that activates protease-activated receptors (PARs). In RT-PCR analyses, ΔNp63 was positively associated with KLK6 and PAR2 and negatively with PAR1 in OSCC cells. By ΔNp63 knockdown, KLK6 and PAR2 expression was decreased and PAR1 was increased. Furthermore, KLK6 knockdown led to enhancing migration and invasion, and inhibiting proliferation, suggesting EMT-phenotypes. Although, in the KLK6 or PAR2 knockdown cells, phosphorylation of ERK was reduced, it was restored in the KLK6 knockdown OSCC cells treated with recombinant KLK6 proteins. Immunohistochemistry showed ΔNp63, KLK6, and PAR2 were more strongly expressed in the epithelial dysplasia and central region of OSCC than normal oral epithelium, whereas PAR1 expression was undetectable. Interestingly, at the invasive front of OSCC, ΔNp63, KLK6, and PAR2 were reduced, but PAR1 was elevated. In addition, the OSCC patients with decreasing KLK6 expression at the invasive front had more unfavourable prognosis. These results suggested differential roles of KLK6 in malignant transformation and EMT; high ΔNp63β expression up-regulates KLK6-PAR2 and down-regulates PAR1, inducing malignant transformation in oral epithelium with stimulating proliferation through ERK signal activation. Moreover, KLK6-PAR2 expression is down-regulated and PAR1 is up-regulated when ΔNp63β expression is decreased, leading to EMT with enhancing migration and invasion through ERK signal reduction at the invasive front.



http://ift.tt/2ARJIRw

Intracellular trafficking of a dynein-based nanoparticle designed for gene delivery

Publication date: 15 January 2018
Source:European Journal of Pharmaceutical Sciences, Volume 112
Author(s): Marianna Teixeira de Pinho Favaro, Ugutz Unzueta, Martí de Cabo, Antonio Villaverde, Neus Ferrer-Miralles, Adriano Rodrigues Azzoni
The success of viruses in the delivery of the viral genome to target cells relies on the evolutionary selection of protein-based domains able to hijack the intermolecular interactions through which cells respond to intra- and extracellular stimuli. In an effort to mimic viral infection capabilities during non-viral gene delivery, a modular recombinant protein named T-Rp3 was recently developed, containing a DNA binding domain, a dynein molecular motor interacting domain, and a TAT-derived transduction domain. Here, we analyzed at the microscopic level the mechanisms behind the cell internalization and intracellular trafficking of this highly efficient modular protein vector. We found that the protein has the ability to self-assemble in discrete protein nanoparticles resembling viral capsids, to bind and condense plasmid DNA (pDNA), and to interact with eukaryotic cell membranes. Confocal and single particle tracking assays performed on living HeLa cells revealed that the T-Rp3 nanoparticles promoted an impressive speed of cellular uptake and perinuclear accumulation. Finally, the protein demonstrated to be a versatile vector, delivering siRNA at efficiencies comparable to Lipofectamine™. These results demonstrate the high potential of recombinant modular proteins with merging biological functions to fulfill several requirements needed to obtain cost-effective non-viral vectors for gene-based therapies.

Graphical abstract

image


http://ift.tt/2iXtFcB

Intraoperative vasoplegia: methylene blue to the rescue!

Purpose of review To evaluate the efficacy, dosing, and safety of methylene blue (MTB) in perioperative vasoplegic syndrome (VS). Recent findings Vasoplegic syndrome is a state of persistent hypotension with elevated cardiac output, low filling pressures, and low systemic vascular resistance (SVR). It occurs in up to 25% of patients undergoing cardiac surgery with cardiopulmonary bypass, can last up to 72 h, and is associated with a high mortality rate. MTB has been found to increase SVR and decrease vasopressor requirements in vasoplegic syndrome by inhibiting nitric oxide synthase, thus limiting the generation of nitric oxide, while inhibiting activation of soluble guanylyl cyclase and preventing vasodilation. MTB has been used in postgraft reperfusion during liver transplantation and anaphylaxis in a limited number of cases. Additionally, this medication has been used in septic shock with promising results, but similar to the cardiac surgical population, the effects of MTB administration on clinical outcomes has yet to be elucidated. Summary MTB should be considered during vasoplegic syndrome in cardiac surgery with cardiopulmonary bypass and usage may be more effective in an early critical window, prior to end-organ hypoperfusion. Other perioperative scenarios of MTB use show promise, but additional studies are required to develop formative conclusions. Correspondence to Kamrouz Ghadimi, MD, Divisions of Cardiothoracic Anesthesia and Critical Care Medicine, Department of Anesthesiology, Duke University Medical Center, Box 3094/HAFS 5691G, Durham, NC 27710, USA. Tel: +1 919 681 6532; e-mail: Kamrouz.Ghadimi@duke.edu Copyright © 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2il0Jvz

Vitamin C in sepsis

Purpose of review This narrative review summarizes recent insights into the role of vitamin C in sepsis. Recent findings Septic shock remains a major source of morbidity and mortality in critically ill patients. Although many nutritional supplements have previously been tested unsuccessfully, vitamins are still being explored as a therapeutic option in septic patients. In particular, vitamin C-containing regimens as adjunctive therapy in sepsis have received much attention. Summary In-vitro evidence supports a critical role for vitamin C in cellular mechanisms relevant to the pathophysiology of sepsis. However, whether this justifies therapeutic use of vitamin C in septic patients remains uncertain. Correspondence to Karsten Bartels, MD, MS, Assistant Professor, Department of Anesthesiology, University of Colorado Denver, 12401 E. 17th Avenue, Leprino Office Building, 7th Floor, MS B-113, Aurora, CO 80045, USA. Tel: +1 720 848 6752; fax: +1 720 848 7375; e-mail: karsten.bartels@ucdenver.edu Copyright © 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2AK0Is7

Anticipated and unanticipated difficult airway management

Purpose of review Management of difficult airway is far from optimal despite of continuous progress in science and technology. The purpose of this review is to summarize the current research in the field and bring readers up to date. Recent findings New technologies for intubation make providers more confident to handle difficult airways, but there is lack of evidence indicating the reduction in incidence of 'cannot intubate cannot ventilate (CICV)'. Optimization of mask ventilation should reduce the incidence of difficult mask ventilation but it is greatly underappreciated. Even optimization of preoxygenation is not directly associated with any decreased incidence of difficult airway, but it prolongs time of safe apnea oxygenation; therefore, is likely to improve the outcome of the patients if CICV occurs. Summary Improvement of managing difficult airway relies on optimized mask ventilation, utilization of the appropriate tools for intubation, maximization of the safe apnea oxygenation time, prompt surgical airway in response to severe hypoxia in case effective noninvasive interventions are not achievable. It seems that a simplified and concise algorithm of difficult airway management needs to be established in order to enable providers to easily remember and execute. Correspondence to Yandong Jiang, MD, PhD, Department of Anesthesiology, Vanderbilt University Medical Center, 1301 Medical Center Drive, 4648 TVC, Nashville, TN 37232-5614, USA. Tel: +1 615 343 9419; fax: +1 615 936 6493; e-mail: yandong.jiang@vanderbilt.edu Copyright © 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2AK16qz

Pulmonary effects of aging

Purpose of review As the population ages, the increase in chronic illnesses among patients with decreasing lung function will pose a major public health challenge. Determining which elderly patients are fit for surgery is an increasingly important skill. Anesthetic care of elderly patients requires an understanding of the effects that chronic diseases have on normal age-related changes in physiology and function. Postoperative respiratory complications are significantly increased in patients over 65 years of age, especially those with preexisting diseases. Recent findings Advanced age is associated with changes in the immunity of the pulmonary system. Dysregulation of pro-inflammatory mediators and antimicrobial defense systems contribute to a reduction in pulmonary function and its response to infections. Aging is also associated with a disruption of the function of alveolar macrophages, neutrophils, and natural killer cells. Summary Aging can increase the risk of postoperative complications because of a loss of physiologic reserve and airway defenses. These limitations may only become apparent after the stressors of surgery and anesthesia. Correspondence to Daniel Tran, MD, Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, TMP 3rd floor, New Haven, CT 06520-8051, USA. Tel: +1 203 785 2802; e-mail: daniel.tran@yale.edu Copyright © 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2ikpl7U

DIEP Flap Breast Reconstruction in Patients with Breast Ptosis: 2-Stage Reconstruction Using 3-Dimensional Surface Imaging and a Printed Mold

imageBackground: Autologous breast reconstruction can be performed for breasts with ptosis to a certain extent, but if patients desire to correct ptosis, mastopexy of the contralateral breast is indicated. However, accurate prediction of post-mastopexy breast shape is difficult to make, and symmetrical breast reconstruction requires certain experience. We have previously reported the use of three-dimensional (3D) imaging and printing technologies in deep inferior epigastric artery perforator (DIEP) flap breast reconstruction. In the present study, these technologies were applied to the reconstruction of breasts with ptosis. Methods: Eight breast cancer patients with ptotic breasts underwent two-stage unilateral DIEP flap breast reconstruction. In the initial surgery, tissue expander (TE) placement and contralateral mastopexy are performed simultaneously. Four to six months later, 3D bilateral breast imaging is performed after confirming that the shape of the contralateral breast (post-mastopexy) is somewhat stabilized, and a 3D-printed breast mold is created based on the mirror image of the shape of the contralateral breast acquired using analytical software. Then, DIEP flap surgery is performed, where the breast mold is used to determine the required flap volume and to shape the breast mound. Results: All flaps were engrafted without any major perioperative complications during both the initial and DIEP flap surgeries. Objective assessment of cosmetic outcome revealed that good breast symmetry was achieved in all cases. Conclusions: The method described here may allow even inexperienced surgeons to achieve reconstruction of symmetrical, non-ptotic breasts with ease and in a short time. While the requirement of two surgeries is a potential disadvantage, our method will be particularly useful in cases involving TEs, i.e., delayed reconstruction or immediate reconstruction involving significant skin resection.

http://ift.tt/2jdoLfh

Central Serous Chorioretinopathy Associated With Fingolimod Treatment.

No abstract available

http://ift.tt/2jt90kK

Lupus Nephritis: Persistent Challenges, New Approaches

Publication date: December 2017
Source:Clinical Immunology, Volume 185
Author(s): Chaim Putterman




http://ift.tt/2AOWeRA

Editorial Board

Publication date: December 2017
Source:Clinical Immunology, Volume 185





http://ift.tt/2yI62LR

Lupus Nephritis: Persistent Challenges, New Approaches

Publication date: December 2017
Source:Clinical Immunology, Volume 185
Author(s): Chaim Putterman




http://ift.tt/2AOWeRA

Editorial Board

Publication date: December 2017
Source:Clinical Immunology, Volume 185





http://ift.tt/2yI62LR

Booster influenza vaccination confers additional immune responses in an elderly, rural community-dwelling population

S01966553.gif

Publication date: Available online 14 November 2017
Source:American Journal of Infection Control
Author(s): Masahide Matsushita, Seisho Takeuchi, Naoko Kumagai, Masaaki Morio, Chise Matsushita, Kazumi Arise, Toshihide Awatani
This study aimed to examine the effects of a booster vaccination in elderly people using 2 doses of trivalent inactivated influenza vaccine during the 2012-2013 influenza epidemic. Seroprotection rates against the A(H1N1)pdm09 strain in younger elderly people (aged 61-75 years) and the A(H3N2) and B strains in both younger elderly people (aged 61-75 years) as well as very elderly people (aged 76-102 years) did not decrease at 22 weeks after vaccination. This approach confers long-lasting antibody responses and may be useful in clinical practice.



http://ift.tt/2mxJZ9g

Dry Cleaning, Some Chlorinated Solvents and Other Industrial Chemicals.

This volume of the IARC Monographs evaluates the carcinogenic risks to humans posed by exposures in the dry cleaning industry, by eight chlorinated solvents and related chemicals, and by an additional group of seven industrial chemicals. Dry cleaning is evaluated in the first and most extensive monograph. Concerning exposures to specific chemicals, tetrachloroethylene is identified as the most commonly used solvent during the last two to three decades. The evaluation also considers exposure to the wide range of chemicals used in the treatment of spots. A review of epidemiological studies on dry cleaning indicates that the risks for cancers at two cites, urinary bladder and oesophagus, may be increased by employment in dry cleaning. The monograph concludes that dry cleaning entails exposures that are possibly carcinogenic to humans.

http://ift.tt/2zIbjX5

Total caloric eye speed in patients with vestibular migraine

S01960709.gif

Publication date: Available online 14 November 2017
Source:American Journal of Otolaryngology
Author(s): Adam Thompson-Harvey, Anthony A. Mikulec
PurposeVestibular migraine is a common cause of dizziness that lacks a known objective test. This study examined total eye speed on caloric testing as a diagnostic marker for vestibular migraine.Materials and methodsRetrospective chart review of patients seen in a tertiary otologic practice between 2004 and 2016 who had undergone caloric testing with water irrigation and had a diagnosis of vestibular migraine (n=34). A group of patients with benign paroxysmal positional vertigo (n=10) were used as a control group. Patients were grouped into quartiles based on total eye speed.ResultsOnly patients in the lowest quartile (total eye speed<79) had a diagnosis of vestibular migraine. All other quartiles included a mix of control and vestibular migraine patients.ConclusionLow total eye speed may be suggestive of a diagnosis of vestibular migraine, but most patients with vestibular migraine do not have low total eye speed.



http://ift.tt/2ARE9T1

New Techniques to Predict Response to Immunotherapy

The latest immunotherapy trials suggest that all subgroups benefit, yet not all patients do well. A group of French researchers is tackling this conundrum head-on.
Medscape Oncology

http://ift.tt/2hsNJn4

Single Dose of Azithromycin Effective for Latent Yaws


Reuters Health Information

http://ift.tt/2hy9iq3

Celebrities at Conferences: A Welcome Distraction?

Medical meetings often host famous speakers, but Tom Hanks's appearance at a recent cardiology conference was for entertainment purposes only.
theheart.org on Medscape

http://ift.tt/2jtKzmY

Adaptive optics imaging of inherited retinal diseases

Adaptive optics (AO) ophthalmoscopy allows for non-invasive retinal phenotyping on a microscopic scale, thereby helping to improve our understanding of retinal diseases. An increasing number of natural history studies and ongoing/planned interventional clinical trials exploit AO ophthalmoscopy both for participant selection, stratification and monitoring treatment safety and efficacy. In this review, we briefly discuss the evolution of AO ophthalmoscopy, recent developments and its application to a broad range of inherited retinal diseases, including Stargardt disease, retinitis pigmentosa and achromatopsia. Finally, we describe the impact of this in vivo microscopic imaging on our understanding of disease pathogenesis, clinical trial design and outcome metrics, while recognising the limitation of the small cohorts reported to date.



http://ift.tt/2iiF07O

Macroeconomic dataset for generating macroeconomic volatility among selected countries in the Asia Pacific region

D23523409.gif

Publication date: February 2018
Source:Data in Brief, Volume 16
Author(s): Yee Peng Chow, Junaina Muhammad, Bany Ariffin Amin Noordin, Fan Fah Cheng
This data article provides macroeconomic data that can be used to generate macroeconomic volatility. The data cover a sample of seven selected countries in the Asia Pacific region for the period 2004–2014, including both developing and developed countries. This dataset was generated to enhance our understanding of the sources of macroeconomic volatility affecting the countries in this region. Although the Asia Pacific region continues to remain as the most dynamic part of the world's economy, it is not spared from various sources of macroeconomic volatility through the decades. The reported data cover 15 types of macroeconomic data series, representing three broad categories of indicators that can be used to proxy macroeconomic volatility. They are indicators that account for macroeconomic volatility (i.e. volatility as a macroeconomic outcome), domestic sources of macroeconomic volatility and external sources of macroeconomic volatility. In particular, the selected countries are Malaysia, Thailand, Indonesia and Philippines, which are regarded as developing countries, while Singapore, Japan and Australia are developed countries. Despite the differences in level of economic development, these countries were affected by similar sources of macroeconomic volatility such as the Asian Financial Crisis and the Global Financial Crisis. These countries were also affected by other similar external turbulence arising from factors such as the global economic slowdown, geopolitical risks in the Middle East and volatile commodity prices. Nonetheless, there were also sources of macroeconomic volatility which were peculiar to certain countries only. These were generally domestic sources of volatility such as political instability (for Thailand, Indonesia and Philippines), natural disasters and anomalous weather conditions (for Thailand, Indonesia, Philippines, Japan and Australia) and over-dependence on the electronic sector (for Singapore).



http://ift.tt/2zI7st5

The metagenome of bromeliads phytotelma in Puerto Rico

D23523409.gif

Publication date: February 2018
Source:Data in Brief, Volume 16
Author(s): Kiara M. Rodriguez-Nuñez, Jesie M. Rullan-Cardec, Carlos Rios-Velazquez
Bromeliads tank water or phytotelma is an eutrophic microenvironment where microorganisms have evolved to resist sudden changes in pH and nutritional competition. Metagenomics studies have been poorly studied in bromeliads and environmental DNA (eDNA) characterization for its microenvironment is deficient in Puerto Rico. Therefore, the data represents the microbial communities inhabiting bromeliads phytotelma. eDNA was extracted using Metagenomic DNA Isolation Kit for Water. Next-Generation-Sequencing technology (Illumina MiSeq) was used for sequencing the isolated eDNA. This data provides an insight about diversity and functional depiction of microorganisms inhabiting bromeliads phytotelma. The data of this metagenome is available in the BioSample Submission Portal as Bioproject PRJNA39461 and Sequence Read Archive (SRA) accession number SRP114300. MG-RAST metagenomic analysis server is located under the study ID mgp79812.



http://ift.tt/2hw9h28

Data on crystal organization in the structure of the Fab fragment from the NIST reference antibody, RM 8671

D23523409.gif

Publication date: February 2018
Source:Data in Brief, Volume 16
Author(s): D.T. Gallagher, I. Karageorgos, J.W. Hudgens, C.V. Galvin
The reported data describe the crystallization, crystal packing, structure determination and twinning of the unliganded Fab (antigen-binding fragment) from the NISTmAb (standard reference material 8671). The raw atomic coordinates are available as Protein Data Bank structure 5K8A and biological aspects are described in the article, (Karageorgos et al., 2017) [1]. Crystal data show that the packing is unique, and show the basis for the crystal's twinned growth. Twinning is a common and often serious problem in protein structure determination by x-ray crystallography [2]. In the present case the twinning is due to a small deviation (about 0.3nm) from 4-fold symmetry in the primary intermolecular interface. The deviation produces pseudosymmetry, generating slightly different conformations of the protein, and alternating strong and weak forms of key packing interfaces throughout the lattice.



http://ift.tt/2zGTRlX

Draft genome sequence of Japanese wood mouse, Apodemus speciosus

D23523409.gif

Publication date: February 2018
Source:Data in Brief, Volume 16
Author(s): Masatoshi Matsunami, Daiji Endo, Naruya Saitou, Hitoshi Suzuki, Manabu Onuma
The wood mouse (genus Apodemus) is one of the most common rodents in broad-leaf forests in the temperate zone of the Palaearctic region. Molecular studies of wood mice have critically enhanced the understanding of their evolution and ancestral biogeographic events. However, their molecular data are currently only limited to partial mitochondrial sequences and a few genes. Therefore, we sequenced the wood mouse genome to facilitate the acquisition of useful resources for inferring their molecular evolution. We sampled a wild wood mouse at Tsukuba, Japan, and sequenced its whole-genome using the Illumina Hiseq. 2000. To reduce the risk of non-randomness, three paired-end libraries (insert sizes: 150, 300, and 500bp) and, two mate-pair reads (insert sizes: 8 and 20kbp) were constructed. In total, we generated approximately 210 Gbp data. From these sequences, we reconstructed 336,124 scaffolds. These data will enhance our understanding of the evolution and ecological factors that affect their genetic constitution. The genome scaffolds generated are available in the National Center Biotechnology Information (NCBI) BioProject with accession number PRJDB5914.



http://ift.tt/2hw9ane

A validation dataset for Macaque brain MRI segmentation

Publication date: February 2018
Source:Data in Brief, Volume 16
Author(s): Yaël Balbastre, Denis Rivière, Nicolas Souedet, Clara Fischer, Anne-Sophie Hérard, Susannah Williams, Michel E. Vandenberghe, Julien Flament, Romina Aron-Badin, Philippe Hantraye, Jean-François Mangin, Thierry Delzescaux
Validation data for segmentation algorithms dedicated to preclinical images is fiercely lacking, especially when compared to the large number of databases of Human brain images and segmentations available to the academic community. Not only is such data essential for validating methods, it is also needed for objectively comparing concurrent algorithms and detect promising paths, as segmentation challenges have shown for clinical images.The dataset we present here is a first step in this direction. It comprises 10 T2-weighted MRIs of healthy adult macaque brains, acquired on a 7T magnet, along with corresponding manual segmentations into 17 brain anatomic labelled regions spread over 5 hierarchical levels based on a previously published macaque atlas (Calabrese et al., 2015) [1].By giving access to this unique dataset, we hope to provide a reference needed by the non-human primate imaging community. This dataset was used in an article presenting a new primate brain morphology analysis pipeline, Primatologist (Balbastre et al., 2017) [2]. Data is available through a NITRC repository (http://ift.tt/2hw93Ik).



http://ift.tt/2zJZ4tj

Diagnostic Accuracy of Pediatric Teledermatology Using Parent-Submitted Photographs

This randomized clinical trial assesses whether smartphone photographs of pediatric skin conditions taken by parents are of sufficient quality to permit accurate diagnosis.

http://ift.tt/2AOAaXz

Underuse of Sentinel Lymph Node Biopsy for Squamous Cell Carcinoma

This study examines the underuse of the sentinel lymph node biopsy in the management of high-risk squamous cell carcinoma.

http://ift.tt/2yJ0jW2

Vegetating Darier Disease Treated With Botulinum Toxin

This case report describes a patient with vegetating Darier disease treated with botulinum toxin.

http://ift.tt/2ANBxpn

Treatment for Livedoid Vasculopathy

This systematic review uses the MEDLINE and EMBASE databases to identify the available therapies for livedoid vasculopathy and their clinical outcomes.

http://ift.tt/2yJvfFK

Hyperpigmented Cutaneous Plaques With Ulceration on the Legs

A woman in her 80s had a well-demarcated, oval ulcer with a violaceous, dusky border and central yellow fibrin mixed with granulation tissue and numerous violaceous to dull red, indurated plaques on the legs. What is your diagnosis?

http://ift.tt/2AIjmAE

Event-related brain potentials and the study of reward processing: Methodological considerations

S01678760.gif

Publication date: Available online 14 November 2017
Source:International Journal of Psychophysiology
Author(s): Olave E. Krigolson
There is growing interest in using electroencephalography and specifically the event-related brain potential (ERP) methodology to study human reward processing. Since the discovery of the feedback related negativity (Miltner et al., 1997) and the development of theories associating the feedback related negativity and more recently the reward positivity with reinforcement learning, midbrain dopamine function, and the anterior cingulate cortex (i.e., Holroyd and Coles, 2002) researchers have used the ERP methodology to probe the neural basis of reward learning in humans. However, examination of the feedback related negativity and the reward positivity cannot be done without an understanding of some key methodological issues that must be taken into account when using ERPs and examining these ERP components. For example, even the component name – the feedback related negativity – is a source of debate within the research community as some now strongly feel that the component should be named the reward positivity (Proudfit, 2015). Here, ten key methodological issues are discussed – confusion in component naming, the reward positivity, component identification, peak quantification and the use of difference waveforms, frequency (the N200) and component contamination (the P300), the impact of feedback timing, action, and task learnability, and how learning results in changes in the amplitude of the feedback-related negativity/reward positivity. The hope here is to not provide a definitive approach for examining the feedback related negativity/reward positivity, but instead to outline the key issues that must be taken into account when examining this component to assist researchers in their study of human reward processing with the ERP methodology.



http://ift.tt/2muqKgD

Integrative transcriptome and proteome analyses define marked differences between Neospora caninum isolates throughout the tachyzoite lytic cycle

Publication date: Available online 14 November 2017
Source:Journal of Proteomics
Author(s): P. Horcajo, D. Xia, N. Randle, E. Collantes-Fernández, J. Wastling, L.M. Ortega-Mora, J. Regidor-Cerrillo
Neospora caninum is one of the main causes of transmissible abortion in cattle. Intraspecific variations in virulence have been widely shown among N. caninum isolates. However, the molecular basis governing such variability have not been elucidated to date. In this study label free LC-MS/MS was used to investigate proteome differences between the high virulence isolate Nc-Spain7 and the low virulence isolate Nc-Spain1H throughout the tachyzoite lytic cycle. The results showed greater differences in the abundance of proteins at invasion and egress with 77 and 62 proteins, respectively. During parasite replication, only 19 proteins were differentially abundant between isolates. The microneme protein repertoire involved in parasite invasion and egress was more abundant in the Nc-Spain1H isolate, which displays a lower invasion rate. Rhoptry and dense granule proteins, proteins related to metabolism and stress responses also showed differential abundances between isolates. Comparative RNA-seq analyses during tachyzoite egress were also performed, revealing an expression profile of genes associated with the bradyzoite stage in the low virulence Nc-Spain1H isolate. The differences in proteome and RNA expression profiles between these two isolates reveal interesting insights into likely mechanisms involved in specific phenotypic traits and virulence in N. caninum.SignificanceThe molecular basis that governs biological variability in N. caninum and the pathogenesis of neosporosis has not been well-established yet. This is the first study in which high throughput technology of LC-MS/MS and RNAseq is used to investigate differences in the proteome and transcriptome between two well-characterized isolates. Both isolates displayed different proteomes throughout the lytic cycle and the transcriptomes also showed marked variations but were inconsistent with the proteome results. However, both datasets identified a pre-bradyzoite status of the low virulence isolate Nc-Spain1H. This study reveals interesting insights into likely mechanisms involved in virulence in N. caninum and shed light on a subset of proteins that are potentially involved in the pathogenesis of this parasite.

Graphical abstract

image


http://ift.tt/2zHsyIC

Αρχειοθήκη ιστολογίου