Head and Neck Diseases by Alexandros G.Sfakianakis: 11/17/17

Παρασκευή 17 Νοεμβρίου 2017

The semantic system is involved in mathematical problem solving

Publication date: 1 February 2018
Source:NeuroImage, Volume 166
Author(s): Xinlin Zhou, Mengyi Li, Leinian Li, Yiyun Zhang, Jiaxin Cui, Jie Liu, Chuansheng Chen
Numerous studies have shown that the brain regions around bilateral intraparietal cortex are critical for number processing and arithmetical computation. However, the neural circuits for more advanced mathematics such as mathematical problem solving (with little routine arithmetical computation) remain unclear. Using functional magnetic resonance imaging (fMRI), this study (N = 24 undergraduate students) compared neural bases of mathematical problem solving (i.e., number series completion, mathematical word problem solving, and geometric problem solving) and arithmetical computation. Direct subject- and item-wise comparisons revealed that mathematical problem solving typically had greater activation than arithmetical computation in all 7 regions of the semantic system (which was based on a meta-analysis of 120 functional neuroimaging studies on semantic processing). Arithmetical computation typically had greater activation in the supplementary motor area and left precentral gyrus. The results suggest that the semantic system in the brain supports mathematical problem solving.

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Comparing multilayer brain networks between groups: Introducing graph metrics and recommendations

Publication date: 1 February 2018
Source:NeuroImage, Volume 166
Author(s): Kanad Mandke, Jil Meier, Matthew J. Brookes, Reuben D. O'Dea, Piet Van Mieghem, Cornelis J. Stam, Arjan Hillebrand, Prejaas Tewarie
There is an increasing awareness of the advantages of multi-modal neuroimaging. Networks obtained from different modalities are usually treated in isolation, which is however contradictory to accumulating evidence that these networks show non-trivial interdependencies. Even networks obtained from a single modality, such as frequency-band specific functional networks measured from magnetoencephalography (MEG) are often treated independently. Here, we discuss how a multilayer network framework allows for integration of multiple networks into a single network description and how graph metrics can be applied to quantify multilayer network organisation for group comparison. We analyse how well-known biases for single layer networks, such as effects of group differences in link density and/or average connectivity, influence multilayer networks, and we compare four schemes that aim to correct for such biases: the minimum spanning tree (MST), effective graph resistance cost minimisation, efficiency cost optimisation (ECO) and a normalisation scheme based on singular value decomposition (SVD). These schemes can be applied to the layers independently or to the multilayer network as a whole. For correction applied to whole multilayer networks, only the SVD showed sufficient bias correction. For correction applied to individual layers, three schemes (ECO, MST, SVD) could correct for biases. By using generative models as well as empirical MEG and functional magnetic resonance imaging (fMRI) data, we further demonstrated that all schemes were sensitive to identify network topology when the original networks were perturbed. In conclusion, uncorrected multilayer network analysis leads to biases. These biases may differ between centres and studies and could consequently lead to unreproducible results in a similar manner as for single layer networks. We therefore recommend using correction schemes prior to multilayer network analysis for group comparisons.

http://ift.tt/2islRjO

Q-switched 532nm laser energy causes significant vascular damage in the capillary plexus – how does this affect laser tattoo removal?

Abstract

Tattoos can be effectively removed using Q-switched and picosecond lasers at four wavelengths – 1064, 755, 694 and 532nm^1,2,3,4. However, there are two particular problems with the 532nm line. Firstly, it is well absorbed by the melanin in the epidermis, due to its relatively high absorption coefficient⁵, (μ_{a_mel} = 56 cm⁻¹ for typical Caucasian skin). Secondly, 532nm is also strongly absorbed in the haemoglobin located in the capillary plexus⁵ (μ_{a_HbO} = 260 cm⁻¹).

http://ift.tt/2j3exuc

How well are reporting guidelines and trial registration used by dermatology journals to limit bias? A meta-epidemiological study

Abstract

Reporting guidelines were created to ensure research is reported in a transparent, complete manner that minimizes reporting bias. Further, these guidelines assist editors and peer reviewers when reviewing manuscripts for publication and readers when critically appraising published articles ¹. Though reporting guidelines and trial registration have been associated with improved reporting quality, the full effect of these guidelines has yet to manifest because many journals do not require their use ².

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The expanding spectrum of clinical phenotypes associated with PSTPIP1 mutations: from PAPA to PAMI syndrome and beyond

Abstract

Mutations in the PSTPIP1 gene encoding proline-serine-threonine-phosphatase interactive protein 1 were first identified in an autosomal dominant syndrome called PAPA associated with pyogenic sterile arthritis, pyoderma gangrenosum (PG) and cystic acne.^1,2. We report a patient with an autoinflammatory syndrome called PSTPIP1-associated myeloid-related proteinemia inflammatory (PAMI) syndrome.³ A 23-year-old man had a 3-year-history of skin ulcerations.

http://ift.tt/2j3eheS

Response to ‘Clinical presentation of terbinafine-induced severe liver injury and the value of laboratory monitoring: a critically appraised topic’

Abstract

We read with interest the article by Kramer et al entitled "Clinical presentation of terbinafine-induced severe liver injury and the value of laboratory monitoring: a critically appraised topic". ¹ We would like to bring to focus our experience in this regard. With increasing concerns of reduced susceptibility to terbinafine² and an upsurge of recalcitrant cutaneous dermatophytoses, dermatologists in India have been using higher doses of terbinafine for cutaneous dermatophytoses, as used in the early literature with this drug (upto 500mg/day in single or divided doses) ³; and for longer periods of time.

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Response to “IL-36 in hidradenitis suppurativa: Evidence for a distinctive pro-inflammatory role and a key factor in the development of an inflammatory loop”

Abstract

we read with interest the recent paper of Hessam et al.¹ regarding the involvement of IL-36 in hidradenitis suppurativa (HS). They have showed that agonist members of IL-36 were significantly overexpressed in HS lesional skin.

http://ift.tt/2j4mOy1

Chronic sun exposure is associated with distinct histone acetylation changes in human skin

Abstract

Background

Photoaging is attributed to continuous sunlight or artificial UV exposure and manifests the clinical and histological changes of skin. Epigenetic changes have been found to be involved in the pathogenesis of photoaging. However, the underlying mechanisms are unclear.

Objectives

To analyse histone modification patterns in sun-exposed and non-exposed skins, and identify the abnormally histone modified-genes related to photoaging.

Methods

Skin biopsies were collected both from the outer forearm (sun-exposed area) and the buttock (sun-protected area) in 20 healthy middle-aged female volunteers. Global histone H3/H4 acetylation and H3K4/H3K9 methylation statuses were assessed by ELISA. Expression levels of HATs and HDACs were measured by RT-qPCR and western blot. ChIP-chip assay with anti-acetyl-histone H3 antibody in sun-exposed Pool (combining six sun-exposed skin samples) and non-exposed Pool (combining six non-exposed skin samples) was conducted to explore the abnormal histone H3 acetylation genes related to photoaging, then ChIP-qPCR was followed to verify the results of ChIP-chip.

Results

We observed higher global histone H3 acetylation level, increased P300 and decreased HDAC1 and SIRT1 expression in sun-exposed skins, compared with matched non-exposed skins. Further, ChIP-chip assay results showed that 227 genes displayed significant hyperacetylation of histone H3, and 81 genes displayed significant hypoacetylation of histone H3 between the two groups. Histone H3 acetylations levels on the promoters of PDCD5, ITIH5, MMP1 and AHR were positively correlated with the mRNA expression of the corresponding gene.

Conclusions

Chronic sun exposure induced histone H3 hyperacetylation may play a critical role in the pathogenesis of skin photoaging.

http://ift.tt/2zSl1UV

Aprepitant improves refractory pruritus in primary cutaneous T-cell lymphomas: experience of the Spanish Working Group on Cutaneous Lymphomas

Abstract

Aprepitant has shown a promising anti-itch activity in several cases of cutaneous T-cell lymphomas (CTCLs)^1-8. We sought to determine its antipruritic efficacy in a large multicenter series of CTCLs patients with refractory pruritus and, secondarily, to define possible clinical predictors of response.A retrospective, analytical review of the Spanish Working Group on Cutaneous Lymphoma database was designed to collect patients with CTCLs and refractory pruritus, treated with aprepitant from 2009 to 2013.

http://ift.tt/2j3CJg8

Q-switched 532nm laser energy causes significant vascular damage in the capillary plexus – how does this affect laser tattoo removal?

Abstract

http://ift.tt/2j3exuc

How well are reporting guidelines and trial registration used by dermatology journals to limit bias? A meta-epidemiological study

Abstract

http://ift.tt/2zQMt5f

The expanding spectrum of clinical phenotypes associated with PSTPIP1 mutations: from PAPA to PAMI syndrome and beyond

Abstract

http://ift.tt/2j3eheS

Response to ‘Clinical presentation of terbinafine-induced severe liver injury and the value of laboratory monitoring: a critically appraised topic’

Abstract

http://ift.tt/2zSl0QR

Response to “IL-36 in hidradenitis suppurativa: Evidence for a distinctive pro-inflammatory role and a key factor in the development of an inflammatory loop”

Abstract

http://ift.tt/2j4mOy1

Chronic sun exposure is associated with distinct histone acetylation changes in human skin

Abstract

Background

Objectives

To analyse histone modification patterns in sun-exposed and non-exposed skins, and identify the abnormally histone modified-genes related to photoaging.

Methods

Results

Conclusions

Chronic sun exposure induced histone H3 hyperacetylation may play a critical role in the pathogenesis of skin photoaging.

http://ift.tt/2zSl1UV

Aprepitant improves refractory pruritus in primary cutaneous T-cell lymphomas: experience of the Spanish Working Group on Cutaneous Lymphomas

Abstract

http://ift.tt/2j3CJg8

Correction to: Pain, Psychological Comorbidities, Disability, and Impaired Quality of Life in Hidradenitis Suppurativa

Abstract

The original version of this article contains an error in the spelling of the title. The title should read: Pain, Psychological Comorbidities, Disability, and Impaired Quality of Life in Hidradenitis Suppurativa.

http://ift.tt/2isSBJu

Correction to: Pain, Psychological Comorbidities, Disability, and Impaired Quality of Life in Hidradenitis Suppurativa

Abstract

http://ift.tt/2isSBJu

Correction to: A bibliometric analysis of research on haze during 2000–2016

Abstract

The original version of this article unfortunately contains mistakes.

http://ift.tt/2AYQogz

Allergen manufacturing and quality aspects for allergen immunotherapy in Europe and the United States: An analysis from the EAACI AIT Guidelines Project

Abstract

Adequate quality is essential for any medicinal product to be eligible for marketing. Quality includes verification of the identity, content and purity of a medicinal product in combination with a specified production process and its control. Allergen products derived from natural sources require particular considerations to ensure adequate quality. Here, we describe key aspects of the documentation on manufacturing and quality aspects for allergen immunotherapy products in the European Union and the United States. In some key parts, requirements in these areas are harmonized while other fields are regulated separately between both regions. Essential differences are found in the use of Reference Preparations, or the requirement to apply standardized assays for potency determination. Since the types of products available are different in specific regions, regulatory guidance for such products may also be available in one specific region only, such as for allergoids in the European Union. Region-specific issues and priorities are a result of this. As allergen products derived from natural sources are inherently variable in their qualitative and quantitative composition, these products present special challenges to balance the variability and ensuring batch-to-batch consistency. Advancements in scientific knowledge on specific allergens and their role in allergic disease will consequentially find representation in future regulatory guidelines.

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Copyright

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1

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Contributors

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1

http://ift.tt/2yWIK57

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1

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Forthcoming Issues

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1

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Castleman Disease

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): Frits van Rhee, Nikhil C. Munshi

http://ift.tt/2AYR1H2

Castleman Disease

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): Frits Van Rhee, Nikhil C. Munshi

http://ift.tt/2yUtVQB

Epidemiology of Castleman Disease

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): David Simpson

Teaser

Castleman disease is a rare entity, including unicentric Castleman disease (UCD), human herpesvirus-8 plus Castleman disease (HHV-8+MCD), and idiopathic multicentric Castleman disease (iMCD). UCD is the most common at 16 per million person years and occurs at every age. HHV-8+MCD incidence varies widely, mostly affecting human immunodeficiency virus–positive men. iMCD is likely a more heterogeneous disease with an estimated incidence of 5 per million person years. Improved definitions should improve understanding of the epidemiology of Castleman disease and its subtypes.

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Castleman Disease Pathogenesis

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): David C. Fajgenbaum, Dustin Shilling

Teaser

Castleman disease (CD) describes a group of heterogeneous disorders with common lymph node histopathologic features, including atrophic or hyperplastic germinal centers, prominent follicular dendritic cells, hypervascularization, polyclonal lymphoproliferation, and/or polytypic plasmacytosis. The cause and pathogenesis of the four subtypes of CD (unicentric CD; human herpesvirus-8-associated multicentric CD; polyradiculoneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, and skin changes [POEMS]-associated multicentric CD; and idiopathic multicentric CD) vary considerably. This article provides a summary of our current understanding of the cause, cell types, signaling pathways, and effector cytokines implicated in the pathogenesis of each subtype.

http://ift.tt/2yWIhQp

The Role of Interleukin-6 in Castleman Disease

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): Kazuyuki Yoshizaki, Shinichi Murayama, Hiroki Ito, Tomohiro Koga

Teaser

Since its discovery, improvements in treating Castleman disease and its variants have centered on interleukin-6 (IL-6). IL-6 was discovered from T-cell factors (BCDF or BSF-2), which induced B-cell maturation. Most symptoms of the plasma cell variant of Castleman disease are linked to the hyperfunction of IL-6, constitutively produced in the affected lymph nodes (1989), suggesting IL-6 is key in the pathogenesis of multicentric Castleman disease (MCD). The results of several studies have shown that most MCD symptoms and abnormal laboratory results are improved by anti-IL-6 MCD treatments, such as tocilizumab, a humanized anti-IL-6 receptor antibody, and siltuximab, an anti-IL-6 antibody.

http://ift.tt/2AV6gkd

Pathology of Castleman Disease

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): David Wu, Megan S. Lim, Elaine S. Jaffe

Teaser

The term Castleman disease encompasses several distinct lymphoproliferative disorders with different underlying disease pathogenesis, and clinical outcomes. It includes unicentric and multicentric diseases with limited versus significant systemic symptoms, respectively. Importantly, the histopathologic features encountered in the various forms of Castleman disease are diverse, and for the most part, lack specificity, because they are seen to varying degrees in different clinical variants of Castleman disease, and in reactive (autoimmune/infectious) and malignant (lymphoma) contexts. Accordingly, accurate clinical diagnosis of Castleman disease requires careful and thorough clinicopathologic correlation. An overview of the key histopathologic features of Castleman disease is presented.

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Diagnosis of Castleman Disease

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): Raphaël Szalat, Nikhil C. Munshi

Teaser

Castleman disease (CD) is a rare and heterogenous group of disorders sharing in common an abnormal lymph node pathology. CD comprises distinct subtypes with different prognoses. Unicentric CD and multicentric CD are featured by specific systemic manifestations and may be associated with Kaposi sarcoma, non-Hodgkin and Hodgkin lymphoma, and POEMS syndrome. Multicentric CD is classically associated with systemic symptoms and poorer prognosis. In this article, the authors review how to diagnose the disease, keeping in context the clinical findings, biochemical changes and complications associated with CD.

http://ift.tt/2AYQYuQ

Unicentric Castleman Disease

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): Raymond S.M. Wong

Teaser

Unicentric Castleman disease (UCD) is a rare lymphoproliferative disorder that manifests typically as proliferation of a single lymph node or region of lymph nodes. Histologically, hyaline vascular variant is found in a majority of UCDs. UCD commonly presents in younger patient populations. Patients with UCD may be asymptomatic or present with symptoms related to mass effects on surrounding structures. It is difficult to achieve a definitive diagnosis by imaging alone. Histologic examination of the lesion remains the gold standard for diagnosis. Complete surgical resection is the best primary treatment modality for UCD resulting in excellent long-term survival and low recurrence rates.

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Treatment of Kaposi Sarcoma Herpesvirus–Associated Multicentric Castleman Disease

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): Kathryn Lurain, Robert Yarchoan, Thomas S. Uldrick

Teaser

Kaposi sarcoma herpesvirus (KSHV)-associated multicentric Castleman disease (MCD) is a rare, polyclonal lymphoproliferative disorder characterized by flares of inflammatory symptoms, edema, cytopenias, lymphadenopathy, and splenomegaly. Diagnosis requires a lymph node biopsy. Pathogenesis is related to dysregulated inflammatory cytokines, including human and viral interleukin-6. Rituximab alone or in combination with chemotherapy, such as liposomal doxorubicin, has led to an overall survival of over 90% at 5 years. Experimental approaches to treatment include virus activated cytotoxic therapy with high-dose zidovudine and valganciclovir and targeting human interleukin-6 activity. Despite successful treatment of KSHV-MCD, patients remain at high risk for developing non-Hodgkin lymphomas.

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Treatment of Idiopathic Castleman Disease

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): Frits van Rhee, Amy Greenway, Katie Stone

Teaser

Important progress has been made in the treatment of idiopathic multicentric Castleman disease (iMCD) with the introduction of interleukin-6 targeting monoclonal antibodies. This article describes the clinical results obtained with different treatment modalities and uses this evidence to provide treatment guidelines for the practicing clinician. Much is still to be learned about the pathophysiology of iMCD and further research is urgently needed to develop novel and curative treatment approaches for all patients.

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TAFRO Syndrome

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): Takuro Igawa, Yasuharu Sato

Teaser

TAFRO syndrome is a newly recognized variant of idiopathic multicentric Castleman disease (iMCD) that involves a constellation of syndromes: thrombocytopenia (T), anasarca (A), fever (F), reticulin fibrosis (R), and organomegaly (O). Thrombocytopenia and severe anasarca accompanied by relatively low serum immunoglobulin levels are characteristic clinical findings of TAFRO syndrome that are not present in iMCD-not otherwise specified (iMCD-NOS). Lymph node biopsy is recommended to exclude other diseases and to diagnose TAFRO syndrome, which reveals characteristic histopathological findings similar to hyaline vascular-type CD. TAFRO syndrome follows a more aggressive course, compared with iMCD-NOS, and there is no standard treatment.

http://ift.tt/2AXEG5S

POEMS Syndrome

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): Angela Dispenzieri, Taxiarchis Kourelis, Francis Buadi

Teaser

POEMS syndrome is a rare paraneoplastic syndrome secondary to a plasma cell dyscrasia. Recognition of a combination of peripheral neuropathy, organomegaly, endocrinopathy, monoclonal plasmaproliferative disorder, skin changes, papilledema, extravascular volume overload, sclerotic bone lesions, thrombocytosis, and Castleman disease is the first step in managing the disease. Increased blood levels of vascular endothelial growth factor are usually confirmatory. This rare disorder should not be missed, especially if the patient has a putative diagnosis of chronic inflammatory polyradiculoneuropathy, a lambda restricted monoclonal gammopathy, and thrombocytosis, and is not responding as expected to immunomodulatory therapy commonly used for chronic inflammatory polyradiculoneuropathy.

http://ift.tt/2yTEVgW

POEMS Syndrome

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): Arnaud Jaccard

Teaser

Treatment of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome should be directed at the underlying plasma cell clone with risk-adapted therapy based on the extent of the plasma cell disorder. Radiation therapy is effective for patients with a localized presentation, without bone marrow involvement, and 1 to 3 bone lesions. Patients with disseminated disease should receive, preferably, high-dose chemotherapy with peripheral blood transplantation. Low-dose melphalan and dexamethasone or new agents used in myeloma are also effective. The most promising agent is lenalidomide, which could be given before high-dose therapy or radiation to get rapid neurologic responses.

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The Peripheral Neuropathies of POEMS Syndrome and Castleman Disease

Publication date: February 2018
Source:Hematology/Oncology Clinics of North America, Volume 32, Issue 1
Author(s): Michelle L. Mauermann

Teaser

Polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell disorder, skin changes (POEMS) syndrome is a rare paraneoplastic disorder. The polyneuropathy can be the presenting symptom and is typically a painful, motor-predominant polyradiculoneuropathy often mimicking chronic inflammatory demyelinating polyradiculoneuropathy. The presence of a lambda monoclonal protein, elevated vascular endothelial growth factor, systemic features, and treatment resistance are clues to the diagnosis. Castleman disease (CD) is seen in a subset of these patients, and when present the neuropathy is similar but less severe. In contrast, in those patients with purely CD, the neuropathy is often a mild, painless distal sensory neuropathy.

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8 Cereals proteins

Publication date: 2018
Source:Proteins in Food Processing
Author(s): N. Guerrieri, M. Cavaletto
The cereals are the most important food crop in the world; the proteins of maize, rice, and wheat are the most popular energy food. Since the world demand for food is constantly increasing, minor cereals and pseudocereal proteins are gaining more and more attention. They have been utilized from ancient times for the production of local traditional foods; now, they are introduced on international markets as innovative products and healthy foods. Cereal proteins are mainly stored in the endosperm, the largest portion of the seed, and are traditionally classified in albumin, globulin, prolamin, and glutelin. This chapter highlights the impact of cereal proteins on functional properties for food processing, since the bulk of all cereals, with the exception of rice, are consumed in processed foods.

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8 Cereals proteins

Allergen manufacturing and quality aspects for allergen immunotherapy in Europe and the United States: An analysis from the EAACI AIT Guidelines Project

Abstract

http://ift.tt/2yVh68E

Hypermethylated ZNF582 and PAX1 genes in oral scrapings collected from cancer-adjacent normal oral mucosal sites are associated with aggressive progression and poor prognosis of oral cancer

Publication date: December 2017
Source:Oral Oncology, Volume 75
Author(s): Shih-Jung Cheng, Chi-Feng Chang, Hui-Hsin Ko, Yi-Ching Liu, Hsin-Hui Peng, Huei-Jen Wang, Hsiao-Shan Lin, Chun-Pin Chiang
ObjectiveThis study assessed whether hypermethylated ZNF582 and PAX1 genes in oral scrapings are correlated with the progression and prognosis of oral squamous cell carcinoma (OSCC).Materials and methodsMethylation levels of ZNF582 and PAX1 genes in oral scrapings, collected from the cancer and adjacent normal oral mucosal sites of 80 OSCC patients before surgical cancer excision, were quantified using real-time methylation-specific PCR after bisulfite conversion.ResultsBoth the mean methylation (M)-indices of ZNF582 and PAX1 genes in oral scrapings were significantly higher at the cancer sites than at the adjacent normal oral mucosal sites (both P < .001). In the oral scrapings collected from the adjacent normal oral mucosal sites, the higher M-index of methylated ZNF582 (ZNF582^m) was significantly correlated with a more advanced clinical stage (P = .04). Moreover, the higher M-index of methylated PAX1 (PAX1^m) was significantly related to larger tumor size (P = .046). When the 80 OSCC patients were classified based on gene methylation tests, using the oral scrapings collected from the adjacent normal oral mucosal sites, we found a significantly shorter 3-year overall survival in ZNF582^m-positive, PAX1^m-positive, and ZNF582^m/PAX1^m-positive OSCC patients than in ZNF582^m-negative (P = .02), PAX1^m-negative (P = .04), and ZNF582^m/PAX1^m-negative OSCC patients (P = .02), respectively. Multivariate Cox regression analyses identified ZNF582^m and ZNF582^m/PAX1^m as independent unfavorable prognostic factors.ConclusionHypermethylated ZNF582 and PAX1 genes in the oral scrapings collected from adjacent normal oral mucosal sites rather than cancer sites are associated with aggressive progression and poor prognosis of OSCC.

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Patient-reported health outcomes in patients with non-melanoma skin cancer and actinic keratosis: Results from a large scale observational study analysing effects of diagnoses and disease progression

Abstract

Background

Non-melanoma skin cancer (NMSC) and actinic keratosis (AK) are very common among fair-skinned individuals. A disease continuum from AK to squamous cell carcinoma (SCC) has been frequently postulated. AK and NMSC may influence quality of life (QL) of patients, and it can be suspected that disease progression entails a QL reduction. The purpose of this study was to document QL in patients with NMSC and AK using the health-outcome questionnaire EQ-5D-5L.

Methods

The study was designed as a non-interventional, prospective, cross-sectional study. Patients with AK, SCC, basal cell carcinoma (BCC) or multiple diagnoses were enrolled in this study in 29 dermatological centres across Germany. Patients were asked to complete the EQ-5D-5L (compromising EQ Index and EQ VAS), and the dermatologists provided diagnosis, disease history and treatment data.

Results

A total of 1,184 patients were enrolled and diagnosed as follows: 73% AK, 49% BCC and 17% SCC. 66% had a single diagnosis, 28% two different diagnoses and 6% three different diagnoses. QL was strongly associated with patients' diagnosis. Patients with a single AK diagnosis had significantly higher mean EQ VAS (78) than patients with BCC (74), SCC (72), and BCC plus SCC (69), p < .050. When the effects of disease progression were calculated, patients with AK plus SCC reported significantly less mean EQ VAS (71) than patients with a single AK diagnosis (78), p < .011.

Conclusions

While rarely being imminently life-threatening, NMSC and AK have an impact on QL as quantified by the EQ-5D-5L. This impact is associated with diagnosis (AK vs. NMSC) and clinical progression (AK vs. AK plus SCC). Both lead to a clear decline in QL. This shows that disease progression is perceived and judged as detrimental by patients and that AK and NMSC should be diligently treated to preserve and restore QL.

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Expression of the clock gene Rev-erbα in the brain controls the circadian organization of food intake and locomotor activity, but not daily variations of energy metabolism

Abstract

The nuclear receptor REV-ERBα is part of the molecular clock mechanism and thought to be involved in a variety of biological processes within metabolically active peripheral tissues as well. To investigate whether Rev-erbα (also known as Nr1d1) in the brain plays a role in the daily variations of energy metabolism, feeding behaviour and the sleep-wake cycle, we studied mice with global (GKO) or brain (BKO) deletion of Rev-erbα. Mice were studied both in a light-dark cycle and constant darkness, and 24-h variations of Respiratory quotient (RQ) and energy expenditure, as well as the temporal patterns of rest-activity and feeding behavior were recorded. The RQ increase of GKO mice was not detected in BKO animals, indicating a peripheral origin for this metabolic alteration. Arrhythmic patterns of locomotor activity were only found in BKO mice. By contrast, the circadian rhythm of food intake was lost both in GKO and BKO mice, mostly by increasing the number of daytime meals. These changes in the circadian pattern of feeding behaviour were, to some extent, correlated with a loss of rhythmicity of hypothalamic Hcrt (also named Orx) mRNA levels. Together, these findings highlight that Rev-erbα in the brain is involved in the temporal partitioning of feeding and sleep, whereas its effects on energy metabolism are mainly exerted through its peripheral expression.

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Sodium chloride pica causing recurrent nephrolithiasis in a patient with iron deficiency anemia: a case report

Iron deficiency anemia is a common finding in women of child-bearing age. Pica, or the ingestion of non-food or non-nutritive items, is a well-known manifestation of iron deficiency. A high sodium diet increas...

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Metabolic Profile in Patients with Mild Obstructive Sleep Apnea

Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.

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Facilitating effects of Buyang Huanwu decoction on axonal regeneration after peripheral nerve transection

Publication date: 1 March 2018
Source:Journal of Ethnopharmacology, Volume 213
Author(s): Ki-Joong Kim, Uk Namgung
Ethnopharmacological relevanceIn traditional Asian medicine, Buyang Huanwu decoction (BYHWD) has been used for the treatment of cardiovascular and neurological disorders. Recent experimental studies have begun to provide evidence on the protective effects of BYHWD on injured peripheral nerves.Aim of the studyTo examine whether BYHWD was effective in inducing axonal regeneration after peripheral nerve transection, and if so, how it acted on the nerve.Materials and methodsThe sciatic nerve in rats was transected and resutured 0, 1, or 4 weeks later. BYHWD was orally administered daily into the animals with nerve transection and coaptation (NTC). Axonal regeneration was measured by immunofluorescence staining of NF-200 and superior cervical ganglion 10 (SCG10) and by retrograde tracing method. Changes of protein levels in the sciatic nerve were analyzed by western blot analysis. Effects of BYHWD and its constituents on neurite outgrowth were analyzed in cultured dorsal root ganglion (DRG) neurons. Hot plate and treadmill training tests were performed to assess the levels of functional recovery after nerve injury.ResultsThe rate of axonal regeneration was attenuated by delayed coaptation after transection, but improved by BYHWD treatment. Levels of phospho-Erk1/2 and Cdc2 phosphorylation of vimentin, measured as indicators of the activation of regenerating axons and supportive Schwann cells, were increased in the sciatic nerve of NTC animals, and their distribution in the proximal and distal nerves were affected by BYHWD treatment. Treatment of BYHWD during the period of chronic denervation significantly increased axonal regeneration when analyzed by immunofluorescence staining and retrograde tracing methods. Neurite outgrowth of DRG neurons cocultured with Schwann cells from the chronically transected sciatic nerves was enhanced by BYHWD treatment. Radix Paeoniae Rubra induced neurite outgrowth most efficiently among all herbal constituents of BYHWD. Finally, hot plate and treadmill training tests demonstrated that BYHWD administration significantly improved the sensorimotor nerve function in NTC animals.ConclusionsOur data suggest that BYHWD treatment may contribute to the timely interaction between regenerating axons and distal Schwann cells in the transected nerve and facilitate axonal regeneration.

Graphical abstract

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Curcuzedoalide contributes to the cytotoxicity of Curcuma zedoaria rhizomes against human gastric cancer AGS cells through induction of apoptosis

Publication date: 1 March 2018
Source:Journal of Ethnopharmacology, Volume 213
Author(s): Eun Bee Jung, Tuy An Trinh, Tae Kyoung Lee, Noriko Yamabe, Ki Sung Kang, Ji Hoon Song, Sungyoul Choi, Sanghyun Lee, Tae Su Jang, Ki Hyun Kim, Gwi Seo Hwang
Ethnopharmacological relevanceCurcuma zedoaria Roscoe (Zingiberaceae), also known as white turmeric or zedoaria, has been used in Ayurveda and traditional Chinese medicine to treat various cancers, and it possesses several sesquiterpenoid compounds.ObjectiveThis study aimed to evaluate the therapeutic effects of a methanolic (MeOH) extract of C. zedoaria rhizomes, as well as its active constituents, against gastric cancer, which is a frequently diagnosed cancer in South Korea.Materials and methodsRepeated column chromatography, together with semi-preparative HPLC purification, was used to separate the bioactive constituents from the C. zedoaria MeOH extract. The cytotoxic effects of the C. zedoaria MeOH extract and its active compounds were measured in human gastric cancer AGS cells. Expression of proteins related to apoptosis was evaluated using Western blotting analysis.ResultsThe MeOH extract of C. zedoaria rhizomes exerted a cytotoxic effect on AGS cells (IC50: 96.60 ± 4.87μg/mL). Based on the bioactivity-guided fractionation for antiproliferative activity, a chemical investigation of the MeOH extract led to the isolation of five sesquiterpenes including isoprocurcumenol (1), germacrone (2), curzerenone (3), curcumenol (4), and curcuzedoalide (5). Among these, curcuzedoalide demonstrated the strongest effect in suppressing gastric cancer cell proliferation in a dose-dependent manner with an IC50 value of 125.11±2.77μM. Western blotting analysis showed that curcuzedoalide inhibited AGS human gastric cancer cell viability by activating caspase-8, caspase-9, caspase-3, and PARP, which contributed to apoptotic cell death in AGS human gastric cancer cells.ConclusionThese data indicate that curcuzedoalide contributed to the cytotoxicity of C. zedoaria by activating the cleavage of caspases and PARP, which are representative markers for apoptosis. Therefore, curcuzedoalide is a positive candidate for the development of novel chemotherapeutics.

Graphical abstract

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The Challenge of Emerging Viruses

Viral Immunology , Vol. 0, No. 0.

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The Unexpected Impact of Vaccines on Secondary Bacterial Infections Following Influenza

Viral Immunology , Vol. 0, No. 0.

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Victimization and Human Immunodeficiency Virus-Related Risk Among Transgender Women in India: A Latent Profile Analysis

Violence and Gender , Vol. 0, No. 0.

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Patients with Spitz nevi in the Greek population: Epidemiologic, Clinical, and histopathological characteristics

Abstract

Background

Spitz nevi may present with clinical and histopathological atypical features that do not affect patient prognosis, but may become worrisome for patients ≥40 years presenting with newly appearing SN.

Objective

Patient characteristics and sun behavior patterns were investigated in correlation with age. SN characteristics and histopathological attributes were also investigated in correlation with age.

Methods

Patients with histopathologicaly confirmed diagnosis of SN were invited for a clinical examination. Data such as skin type, number of banal/atypical nevi, sun exposure patterns, personal/family history etc., were collected. Histopathology preparations were re-examined by two different histopathologists and characteristics were collected based on a prespecified checklist. Patients were afterwards followed-up every 6 months.

Results

110 patients with SN were identified and assigned to 3 age groups. The most common area of presentation was the trunk, for the ≥40 years age group, and the limbs for the other age groups. Patients ≥40 years had a higher possibility of presenting with a nevus count ≥50 and at least one atypical nevus compared to the other age groups. Patients ≥40 years presented more commonly with a history of painful sunburn (100%) before the appearance of the SN, used less sunscreen, had higher sun exposure times and more clinical signs of solar skin damage compared to the other age groups. Finally, patients ≥40 years presented more commonly with signs of histopathological atypia such as presence of mitoses, cellular atypia and prominent nucleolus.

Conclusion

Patients ≥40 were more likely to report a history of longer sun exposure times, of never using a sunscreen and of having a history of painful sunburn. However, the importance of this observation remains to be elucidated since these patients also presented more commonly with lesions located on non-sun exposed areas (trunk), and higher nevus/atypical nevus counts.

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Acute and Recurrent Facial Pustulosis: A Unique Clinical Entity?

We report a series of three patients encountered in a tertiary referral center that share a rare constellation of clinical and histopathologic findings. In each case, a healthy female patient reported recurrent episodes of rapidly-appearing, tightly-clustered, fine pustules on a background of light erythema involving the chin, forehead, cheeks, and neck (Figure 1). These episodic eruptions, which occurred approximately 4-6 episodes per year, were associated with mild pruritus, and relapsed and remitted within 5 days without therapeutic intervention.

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A Slowly Developed Severe Cutaneous Adverse Reaction to Idelalisib

Intracellular signal mediator phosphatidylinositol-3-kinase (PIK3K) –δ, an isoform of PIK3K, is expressed in hematopoietic cells especially in lymphoid lineage 1. Idelalisib is a novel PIK3K-δ targeted kinase inhibitor which is approved for relapsed follicular B-cell non-Hodgkin lymphoma as a monotherapy and in combination with rituximab, an anti-CD20 antibody, for relapsed chronic lymphocytic leukemia (CLL) 2. Only one case describing the clinical features of severe cutaneous adverse reaction (SCAR) of idelalisib in detail has been previously published 3. Here we expand the clinical picture of SCAR caused by idelalisib with its histological profile.

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Plantar Eumycetoma by Madurella mycetomatis in a heart-transplanted patient living in Portugal

Eumycetoma is a chronic granulomatous fungal infection of dermal and subcutaneous tissue rarely seen in Europe. It is characterized by a painless subcutaneous mass with drainage of macroscopic grains through sinus tracts,^1,2 spreading with severe tissue destruction, including fascia and bone.

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Finding the needle in the haystack is teledermoscopy's task

We read with interest the recent letter in this journal by Kukutsch et al. as to the opinion of an international group of experts on dermoscopy about the practice of teledermoscopy (TDC) between primary care physicians (PCPs) and a remote dermatologist.

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Sodium chloride pica causing recurrent nephrolithiasis in a patient with iron deficiency anemia: a case report

Recognizing the haystack is the task of the primary care physician

In a reply to our letter Ferrandiz and colleagues wondered why dermoscopy experts did not already fully embrace teledermoscopy (TD) for suspicious pigmented skin lesions.¹ Our study showed that the structure of the health systems that were investigated differed, with countries where primary care physicians (PCP) hold a gate keeper function and others with direct access to a dermatologist. Significant differences in waiting time and travel distance were observed.² Since we believe that there is enough evidence that the addition of high quality dermoscopic pictures to a teleconsultation leads to higher accuracy of the diagnosis we did not investigate this question in our survey.

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Editorial Board

Publication date: November 2017
Source:Artificial Intelligence in Medicine, Volume 83

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Editorial Board

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Optimal blood pressure decreases acute kidney injury after gastrointestinal surgery in elderly hypertensive patients: A randomized study

To determine the appropriate mean arterial pressure (MAP) control level for elderly patients with hypertension during the perioperative period.

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Bi-orifice approach to nasal intubation in children: A case series of anticipated difficult airways undergoing orthognathic surgeries

Airway management of pediatric patients with craniofacial disorders can be challenging, especially when compounded by the surgical requirement for nasal intubation. Life-threatening complications can occur during induction of general anesthesia in patients with abnormal anatomy (laryngospasm, inability to mask ventilate due to obstruction, total loss of airway, death) [1,2,3]. Although awake nasal fiberoptic intubation (FOI) is a common method of securing adult difficult airways, it may not be appropriate for children due to emotional, physiological, and anatomical differences.

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The effect of sevoflurane compared to propofol maintenance on post-surgical quality of recovery in patients undergoing an ambulatory gynecological surgery: A prospective, randomized, double-blinded, controlled, clinical trial

The main objective of the current investigation was to evaluate the effect of propofol used as anesthetic maintenance compared to sevoflurane on global post-surgical quality of recovery in female patients undergoing ambulatory gynecological surgery.

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A case of midazolam anaphylaxis during a pediatric patient's first anesthetic

Perioperative anaphylaxis remains a relatively rare (with an estimated incidence 1:3,5000 to 1:20,000) but important cause of morbidity and mortality [1]. Common causes include neuromuscular blockers, antibiotics, and latex [1,2]. Diagnosis of perioperative anaphylaxis may be delayed, as general anesthesia may mask the characteristic symptoms of hypotension, rash, and airway swelling. Herein we present a case of midazolam anaphylaxis in a child's first anesthetic.

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Anesthetic management of a patient with benign tracheal tumor identified at induction of general anesthesia

Benign tumors of the tracheobronchial tree are quite rare [1] and are sometimes misdiagnosed as asthma or chronic obstructive pulmonary disease (COPD) when the symptoms are not severe [1,2,3]. Delayed diagnosis is common and these tumors may not be identified for a long time if they are slow growing [1,2,3]. In such cases, routine examinations such as chest radiography will not reveal the tumor before elective surgery [1,3] and it is possible that induction of general anesthesia will be initiated before the anesthetist recognizes that there is a tumor in the tracheobronchial tree.

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Intermittent bilateral anterior sub-costal quadratus lumborum block for effective analgesia in lower abdominal surgery

As one of new quadratus lumborum (QL) blocks, the anterior sub-costal QL block has been reported to be an effective analgesic in lower abdominal surgery [1]. However, there have been no reports on the efficacy of the anterior sub-costal QL block over the long postoperative period. In this article, we report two successful cases of intermittent anterior sub-costal QL block in lower abdominal surgery for pain management during the long postoperative period.

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A novel approach for performing ultrasound-guided maxillary nerve block

Maxillary nerve block has traditionally been performed using fluoroscopy. In recent years, ultrasonography has provided a useful method for needle guidance when performing maxillary nerve block, as well as other blocks [1–5]. The coronoid approach is popular for ultrasound guidance [1–4]. However, this approach is challenging due to some disadvantages of the technique.

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Combined spinal epidural in a parturient with tinea versicolor

Tinea versicolor is a benign condition with a prevalence of 2–8% in the United States [1]. The yeast, Malassezia globosa, a normal component of skin flora, can become pathogenic with exposure to heat and humidity and in immunosuppressive conditions such as pregnancy. Tinea versicolor responds to antifungal medications but recurrence is common. We present a case of a pregnant patient with a longstanding diagnosis of tinea versicolor in whom we performed a combined spinal technique for labor analgesia after exploring and discussing the theoretical risks.

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Postpartum tubal ligation: A retrospective review of anesthetic management at a single institution and a practice survey of academic institutions

The primary aim was to evaluate institutional anesthetic techniques utilized for postpartum tubal ligation (PPTL). Secondarily, academic institutions were surveyed on their clinical practice for PPTL.

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Surgeon assisted quadratus lumborum block – ‘Gaurav-Aditi’ technique case series

Quadratus lumborum block (QLB) is a new abdominal wall block which has been used successfully for the post operative pain management of patients undergoing abdominal surgeries [1,2]. Classically QLB can be given in four different approaches using ultrasound [3]. In many developing countries like India ultrasound is still not available at all centers. Many times in patients with central obesity it is difficult to perform this block using ultrasound [4]. So we present a new 'Gaurav-Aditi' technique of performing the QLB, wherein post-operative pain of six patients who were undergoing open radical nephrectomy was managed successfully.

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Anesthetic management for retrieval of a large aspirated denture in a patient with Parkinson's disease

Airway foreign body aspiration is uncommon in adults. It is particularly likely in patients with impaired cough reflexes and reduced sensorium due to drugs, alcohol, or neurological dysfunction. Dental prosthetics are the most common foreign bodies aspirated in patients with Parkinson's disease [1]. If a large denture is aspirated, the airway can become totally obstructed. Below, we describe the challenging anesthetic management of a patient with Parkinson's disease who required removal of a large intratracheal denture via rigid bronchoscopy.

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Reversal of trend in near infrared spectroscopy [NIRS] values in a patient with carotid artery stenosis

Near Infrared Spectroscopy (NIRS) monitors continuous non-invasive regional oxygen balance within the frontal cerebral cortex. Cerebral vasoneural coupling ensures that local brain metabolism increase is met normally with augmented regional blood flow [1]. Anaesthetics agents play a vital role and so rising doses of cortical suppressant anaesthetics may increase rSO2 as oxygen consumption is decreased [2].

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Strategies to prevent ischemic optic neuropathy following major spine surgery: A narrative review

Postoperative vision loss following a major spine operation is a rare but life-changing event. Most of reports have been linked to ischemic optic neuropathy, and patients undergoing surgery for scoliosis correction or posterior lumbar fusion seem to be at the highest risk. Despite that some key risk factors have been identified, much of the pathophysiology still remain unknown. In fact, whereas only a minority of patients at high risk will present this complication, others with similar risk factors undergoing different procedures may not develop it at all.

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Medicaid insurance as primary payer predicts increased mortality after total hip replacement in the state inpatient databases of California, Florida and New York

To confirm the relationship between primary payer status as a predictor of increased perioperative risks and post-operative outcomes after total hip replacements.

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Incidence of complications in the post-anesthesia care unit and associated healthcare utilization in patients undergoing non-cardiac surgery requiring neuromuscular blockade 2005–2013: A single center study

The use of neuromuscular blockade agents (NMBA), had been associated with significant residual post-operative paralysis and morbidity. There is a lack of clinical evidence on incidence of postoperative complications within the post-anesthesia care unit (PACU) in patients exposed to intraoperative NMBA's. This study aims to estimate the incidence of post-operative complications associated with use of NMBAs and assessing its association with healthcare resource utilization.

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Measuring satisfaction and anesthesia related outcomes in a surgical day care centre: A three-year single-centre observational study

To evaluate patient satisfaction and patient reported anaesthesia related outcome parameters after outpatient surgery.

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Paraneuraxial Nerve Blocks: A well-defined novel terminology that is clinically essential for regional anesthesia

We read with great interest the articles "Clinical Experiences of the Continuous Thoracolumbar Interfascial Plane (TLIP) Block" by Ueshima et al. [1]. We would like to share our thoughts regarding this study as we have performed several continuous (TLIP) Blocks in the past 2months.

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Emergency surgery in a newborn patient with severe congenital hypothyrodism

We aimed to discuss anaesthesia management in a newborn with severe hypothyroidism for whom we could not provide hypothyroidism treatment due to tracheoesophageal fistula and anal atresia.

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Postpartum infective endocarditis with Enterococcus faecalis in Japan: a case report

The clinical characteristics of infective endocarditis include the presence of predisposing cardiac disease, a history of illegal drug use, and high morbidity in the elderly. Only a few cases of the disease af...

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Two Scientific Awards for papers published in Sleep Medicine

Under the auspices of the World Association of Sleep Medicine (WASM), Elsevier has established two scientific awards for young basic and clinical sleep specialists in honor of Christian Guilleminault and Elio Lugaresi, respectively. The awards are a tribute to Dr. Guilleminault's and Dr. Lugaresi's contributions to establish the field of Sleep Medicine, its journal and its Society.

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Editorial Board

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Effect of laser activated bleaching on the chemical stability and morphology of intracoronal dentin

Publication date: February 2018
Source:Archives of Oral Biology, Volume 86
Author(s): Fabiane Carneiro Lopes, Renato Roperto, Anna Akkus, Ozan Akkus, Regina Guenka Palma-Dibb, Manoel Damião de Sousa-Neto
ObjectivesTo evaluate the effect of the bleaching with 35% hydrogen peroxide either activated or not by a 970nm diode laser on the chemical stability and dentin surface morphology of intracoronary dentin.MethodsTwenty-seven slabs of intracoronary dentin specimens (3×3mm) were distributed into three groups (n=9), according to surface treatment: HP – 35% hydrogen peroxide (1×4'), DL – 970nm diode laser (1×30"/0,8W/10Hz), HP+DL – 35% HP activated with 970nm diode laser (1×30"/0,8W/10Hz leaving the gel in contact to the surface for 4′ after activation). Three Raman spectra from each fragment were obtained to calculate the mean intensity of peaks of inorganic component (a.u.), organic collagen content (a.u.), and the ratio of inorganic/organic content, before and after treatment. Analyses of the samples by confocal laser microscopy were performed to evaluate the surface roughness, percentage of tubules, perimeter and area percentage of tubules, before and after treatment. Data were analyzed by Kruskal-Wallis, Dunn's, and Wilcoxon test (P<0.05).ResultsData analysis showed that HP+DL did not change the inorganic content peaks 8.31 [29.78] or the inorganic/organic ratio 3.37 [14.67] (P>0.05). Similarly, DL did not affect the chemical stability of the dentin surface (P>0.05). However, HP significantly increased inorganic content peaks 10.87 [22.62], as well as the inorganic/organic ratio 6.25 [27.78] (P<0.05). Regarding the morphological alterations, all surface treatments increase tubules exposure; HP treatment significantly increases perimeter and area percentage; and HP+DL increases surface roughness.ConclusionsBleaching HP combined with DL offers an improvement in terms of intracoronal dentin surface protection, yielding better maintenance of dentin chemical stability and morphology.

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New roles and controls of mast cells

Eric Espinosa | Salvatore Valitutti

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Recent advances in inflammasome biology

David E Place | Thirumala-Devi Kanneganti

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Type I interferon-mediated autoinflammation and autoimmunity

Stefanie Kretschmer | Min Ae Lee-Kirsch

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Mechanisms of propofol attenuation of ketamine-induced neonatal brain injury

OBJECTIVE: We studied the mechanisms of protective effects of propofol on ketamine-induced damage to neonatal cognitive function.

MATERIALS AND METHODS: We utilized a rat model of ketamine anaesthesia. Eighty neonatal rats (7 days after birth) were divided into four groups: normal saline group, ketamine group, and low- and high-dose propofol combined with ketamine groups. Six hours after anaesthesia, we obtained hippocampal tissue, and quantified apoptotic index and total protein concentration, and assessed global proteomics changes induced by two tested drugs. The latter changes were documented by two-dimensional electrophoresis and matrix-assisted laser desorption/ ionization time of flight mass spectrometry. To evaluate cognitive functions, water maze test was applied after animals grew for 21 days. We further repeated proteomics studies at 21 days post-anaesthesia.

RESULTS: Ketamine markedly up-regulated apoptotic index and decreased total protein concentration. Propofol dose-dependently reverted these adverse changes. Six hours post-anaesthesia, combined propofol and ketamine administration up-regulated the following proteins in the hippocampus: PD1A3, NDUFB10, HSPA8, ATP5JD, and PSMA1. Furthermore, the following proteins were down-regulated: PPIA, PKM2, GFAP, NSE, PPIA, PKM2, and GFAP. After 21 days, animals treated with ketamine showed marked disturbances in cognitive function as demonstrated by increased time of the water maze test, whereas propofol diminished these changes. In addition, expression of proteins largely normalized in propofol-treated animals, with only two up-regulated proteins (FUBP3 and PRDX5) and three down-regulated proteins (GAPDH, AKR1A1, and VCP).

CONCLUSIONS: Adverse effects of ketamine on cognitive function are reverted by propofol, also through beneficial effects on protein expression in the hippocampus.

L'articolo Mechanisms of propofol attenuation of ketamine-induced neonatal brain injury sembra essere il primo su European Review.

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Lumbar Spine Anatomy in Women Sustaining Unintentional Dural Puncture During Labor Epidural Placement: A Descriptive Study Using Magnetic Resonance Imaging and Ultrasound.

Background and Objectives: Unintentional dural puncture is one of the most frequent complications of the epidural technique. One previous study suggested that atypical sonoanatomy of the ligamentum flavum/dura mater unit may be a risk factor for this complication. In this study, we describe the anatomy of the lumbar spine, assessed by magnetic resonance imaging (MRI) and ultrasound, in women sustaining unintentional dural puncture during epidural catheter placement for labor analgesia. Methods: We approached women who sustained a recognized unintentional dural puncture. Following consent, technical aspects of the epidural catheter placement were documented. Postpartum MRI of the lumbar spine and bedside spinal ultrasound were performed. Ultrasound images of the ligamentum flavum/dura mater unit in the transverse view were classified as typical, atypical, or inconclusive. Magnetic resonance imaging images were reviewed by a neuroradiologist, who was blinded to the level of the puncture. Results: We included 10 women with unintentional dural punctures in the study. In 5 of the 10 women, these dural punctures occurred despite epidural catheter insertion by experienced practitioners. These women had a mean body mass index of 28.5 kg/m2 (range, 24-38 kg/m2). Two women suffered dural punctures twice. Ultrasound imaging in the paramedian view produced typical images in all patients. In the transverse view, 7 of 10 women showed atypical or inconclusive images, with atypical images seen at either L4/5 or L5/S1. Magnetic resonance imaging results revealed no anatomical abnormalities, with the exception of 1 woman who showed a ligamentum flavum gap away from the puncture site. Conclusions: Our results suggest that unintentional dural punctures occur in likely anatomically normal women. Furthermore, the transverse ultrasound views may fail to demonstrate typical ligamentum flavum/dura mater unit at the lower lumbar levels despite its confirmed presence by MRI. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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Postpartum infective endocarditis with Enterococcus faecalis in Japan: a case report

Using Citrus aurantifolia essential oil for the potential biocontrol of Colocasia esculenta (taro) leaf blight caused by Phytophthora colocasiae

Abstract

The aim of this work was to evaluate the antimicrobial activities of leaves and epicarp of Citrus aurantifolia essential oil against Phytophthora colocasiae, the causative agent of taro leaf blight. Oils were extracted by hydrodistillation, and their chemical composition was determined by gas chromatography and gas chromatography coupled with mass spectrometry. Antimicrobial activities of oils were tested in vitro against mycelium growth and sporangium production. In situ tests were done on healthy taro leaves, and the necrosis symptoms were evaluated. Results showed that the essential oil extraction yields from leaves and epicarp were 0.61 and 0.36%, respectively. Limonene (48.96%), bornyl acetate (14.18%), geraniol (10.53%), geranial (3.93%), and myrcene (3.14%) were the main components in leaf oil, while limonene (59.09%), cis-hydrate sabinene (7.53%), geranial (5.61%), myrtenol (5.02%), and terpinen-4-ol (3.48%) were the main components in epicarp oil. Both oils exhibited antimicrobial activities with total inhibition of the mycelium growth at 500 and 900 ppm for leaf and epicarp, respectively. The highest inhibitory concentration of sporangium production was 400 (72.84%) and 800 ppm (80.65%) for leaf and epicarp oil, respectively. For the standard fungicide (metalaxyl), the total inhibition value of mycelial growth and sporangium production was 750 ppm. In situ tests showed that, at 5000 ppm, total inhibition (100%) was obtained for a preventive test, while 50% of the inhibition was observed for a curative test when leaf oil was applied. When epicarp essential oil was applied at 5000 ppm, 47.5 and 16.66% of the reduction of leaf necrosis were observed for the preventive and curative test, respectively. There were positive correlations between both the oil concentration and the reduction of necrosis caused by P. colocasiae. These findings suggest that the C. aurantifolia essential oil could serve as an eco-friendly biocontrol for the management of taro leaf blight.

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Intrapartum assessment of fetal well-being

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Treatment withdrawal and end-of-life care in the intensive care unit

1F052C063A07

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Prehabilitation

1I052A073J03

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Anaesthesia for head and neck cancer surgery

1C012A013A02

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Principles of resource allocation in critical care

1I022C073J02

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Treatment withdrawal and end-of-life care in the intensive care unit

1F052C063A07

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Prehabilitation

1I052A073J03

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Anaesthesia for head and neck cancer surgery

1C012A013A02

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You Will Never Walk Alone: A Simulation Experience for Caregiver’s Family and Friends

No abstract available

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Enhanced Recovery After Surgery: Current Controversies and Concerns

No abstract available

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Dr Ted Eger Obituary

No abstract available

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The “Ear-Sternal Notch” Line—How Should You Lie?

No abstract available

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General Anesthesia Imposes Negative Effects on Heart Rate and Blood Pressure Regulation in Patients With a History of Head and Neck Radiation Therapy

BACKGROUND: Head and neck radiation therapy (HNRT) impairs baroreflex sensitivity, and it may potentiate the effects of anesthetics on heart rate (HR) and blood pressure (BP) regulation. Currently, the impacts of HNRT on HR and BP under anesthesia remain unclear. METHODS: In this study, 472 patients with primary oral cavity or oropharyngeal cancer at all stages were examined. Half of the patients underwent HNRT plus surgery. The other half underwent surgery only and was matched with the treatment patients according to age, sex, and body mass index at a 1:1 ratio. The HRs and BPs in the 2 groups during anesthetic induction, skin incision, and emergence were compared retrospectively. A multivariable model of repeated measures with unstructured covariance structure was used to examine the associations of HNRT with intraoperative HRs and BPs after adjusting for baseline HR and BP, time, use of β-blockers, history of chemotherapy, and American Society of Anesthesiologists physical status score. BPs and HRs were collected every 5 minutes. The baseline HR and BP measurements were not included in the outcome vector and were only used as adjustment for baselines. RESULTS: Compared with corresponding baseline values in controls, the baseline HR was significantly higher (P = .0012) and the baseline systolic BP was lower (P

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When Is “Never Enough” (Data) … Enough?

No abstract available

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Intraoperative Anemia Monitoring: Another Obstacle to Blood Conservation in the Surgical Patient

No abstract available

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Subcellular Energetics and Metabolism: A Cross-Species Framework

No abstract available

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The Aortocaval Compression Conundrum

No abstract available

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Understanding the Significance of Aerosolized Vasodilator Use in Pulmonary Hypertension: What Is Numerically, Statistically, and Clinically Meaningful?

No abstract available

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Do No Harm, Except Unto Thyself

No abstract available

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Do You Do What I Do? Cardiac Anesthesia Surveys From Around the Globe

No abstract available

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Effect of an Intravenous Dexamethasone Added to Caudal Local Anesthetics to Improve Postoperative Pain: A Systematic Review and Meta-analysis With Trial Sequential Analysis

BACKGROUND: Caudal anesthesia has been used for postoperative pain control in pediatric surgical patients, but the duration of the analgesic effect is occasionally unsatisfactory. Intravenous steroids have been shown to be effective for postsurgical pain management after certain surgeries. The aim of this meta-analysis with trial sequential analysis (TSA) was to evaluate the analgesic effect of steroids in patients administered with caudal anesthesia. METHODS: This study was a systematic review and meta-analysis. A search of published literature was conducted in the MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials databases and in trial registration sites. Randomized controlled trials that compared intravenous steroids with a placebo in pediatric patients who had received caudal anesthesia for surgery were included in the study. The primary outcomes from the present meta-analysis were the analgesic duration and the number of patients who required rescue analgesics. The analgesic duration and incidence of rescue use were summarized using mean difference or risk ratio with a 97.5% confidence interval (CI), respectively. If the 97.5% CI of the mean difference or risk ratio included a value of 0 or 1, respectively, we considered the difference not to be significant. We used the random effects model to combine the results. Heterogeneity was quantified with the I2 statistic. The quality of the trials was evaluated using the Cochrane methodology. Moreover, a TSA with a risk of type 1 error of 2.5% and power of 90% was performed. We established the minimum clinically meaningful difference of analgesic duration as 3 hours. The target sample size for meta-analysis was also calculated in the TSA. We also assessed adverse events. RESULTS: Six trials with 424 patients were included; 211 patients received intravenous steroids. All trials compared dexamethasone of at least 0.5 mg/kg dose with a placebo. Dexamethasone prolonged the duration of caudal analgesia (mean difference, 244 minutes; 97.5% CI, 188–300). Heterogeneity was considerable with an I2 value of 94.8%. Quality of evidence was very low. The TSA suggested that only 17.0% of the target sample size had been reached, but the cumulative Z score crossed the trial sequential monitoring boundary to indicate a benefit. Rescue use was reported in 4 studies with 260 patients. Rescue use was not significantly reduced in the dexamethasone group (risk ratio, 0.53; 97.5% CI, 0.09–3.30; I2, 98.7%). No increase in adverse events was reported. CONCLUSIONS: Intravenous dexamethasone prolongs the analgesic duration of caudal anesthesia. Trials to investigate the effectiveness of a lower dose of the dexamethasone in prolonging analgesic effects would be of interest. Further trials with a low risk of bias are necessary.

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Association of Surgery and Anesthesia With Mental Disorder Diagnoses: What Would Sir Austin Bradford Hill Say?

No abstract available

http://ift.tt/2irluFZ

Opioid Prescribing for the Treatment of Acute Pain in Children on Hospital Discharge

BACKGROUND: The epidemic of nonmedical use of prescription opioids has been fueled by the availability of legitimately prescribed unconsumed opioids. The aim of this study was to better understand the contribution of prescriptions written for pediatric patients to this problem by quantifying how much opioid is dispensed and consumed to manage pain after hospital discharge, and whether leftover opioid is appropriately disposed of. Our secondary aim was to explore the association of patient factors with opioid dispensing, consumption, and medication remaining on completion of therapy. METHODS: Using a scripted 10-minute interview, parents of 343 pediatric inpatients (98% postoperative) treated at a university children's hospital were questioned within 48 hours and 10 to 14 days after discharge to determine amount of opioid prescribed and consumed, duration of treatment, and disposition of unconsumed opioid. Multivariable linear regression was used to examine predictors of opioid prescribing, consumption, and doses remaining. RESULTS: Median number of opioid doses dispensed was 43 (interquartile range, 30–85 doses), and median duration of therapy was 4 days (interquartile range, 1–8 days). Children who underwent orthopedic or Nuss surgery consumed 25.42 (95% confidence interval, 19.16–31.68) more doses than those who underwent other types of surgery (P

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Closed-Set Speech Discrimination Tests for Assessing Young Children.

Objective: The main objective of this study is to obtain data assessing normative scores, test-retest reliability, critical differences, and the effect of age for two closed-set consonant-discrimination tests. Design: The two tests are intended for use with children aged 2 to 8 years. The tests were evaluated using normal-hearing children within the appropriate age range. The tests were (1) the closed-set consonant confusion test (CCT) and (2) the consonant-discrimination subtest of the closed-set Chear Auditory Perception Test (CAPT). Both were word-identification tests using stimuli presented at a low fixed level, chosen to avoid ceiling effects while avoiding the use of background noise. Each test was administered twice. Results: All children in the age range 3 years 2 months to 8 years 11 months gave meaningful scores and were able to respond reliably using a computer mouse or a touch screen to select one of four response options displayed on a screen for each trial. Assessment of test-retest reliability showed strong agreement between the two test runs (interclass correlation >= 0.8 for both tests). The critical differences were similar to those for other monosyllabic speech tests. Tables of these differences for the CCT and CAPT are provided for clinical use of the measures. Performance tended to improve with increasing age, especially for the CCT. Regression equations relating mean performance to age are given. Conclusions: The CCT is appropriate for children with developmental age in the range 2 to 4.5 years and the CAPT is appropriate as a follow-on test from the CCT. If a child scores 80% or more on the CCT, they can be further tested using the CAPT, which contains more advanced vocabulary and more difficult contrasts. This allows the assessment of consonant perception ability and of changes over time or after an intervention. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Being Mindful in Managing Pain: Integrative Medicine in Chronic Pain Management

No abstract available

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Using Integrative Medicine in Pain Management: An Evaluation of Current Evidence

Complementary medicine therapies are frequently used to treat pain conditions such as headaches and neck, back, and joint pain. Chronic pain, described as pain lasting longer than 3–6 months, can be a debilitating condition that has a significant socioeconomic impact. Pharmacologic approaches are often used for alleviating chronic pain, but recently there has been a reluctance to prescribe opioids for chronic noncancer pain because of concerns about tolerance, dependence, and addiction. As a result, there has been increased interest in integrative medicine strategies to help manage pain and to reduce reliance on prescription opioids to manage pain. This article offers a brief critical review of integrative medical therapies used to treat chronic pain, including nutritional supplements, yoga, relaxation, tai chi, massage, spinal manipulation, and acupuncture. The goal of this article is to identify those treatments that show evidence of efficacy and to identify gaps in the literature where additional studies and controlled trials are needed. An electronic search of the databases of PubMed, The Cochrane Library, EMBASE, PsycINFO, and Science Citation Index Expanded was conducted. Overall, weak positive evidence was found for yoga, relaxation, tai chi, massage, and manipulation. Strong evidence for acupuncture as a complementary treatment for chronic pain that has been shown to decrease the usage of opioids was found. Few studies were found in which integrative medicine approaches were used to address opioid misuse and abuse among chronic pain patients. Additional controlled trials to address the use of integrative medicine approaches in pain management are needed.

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Massive Transfusion Protocols: When to Turn On, and Off, the Fire Hose

No abstract available

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Initiation and Termination of Massive Transfusion Protocols: Current Strategies and Future Prospects

The advent of massive transfusion protocols (MTP) has had a significant positive impact on hemorrhaging trauma patient morbidity and mortality. Nevertheless, societal MTP guidelines and individual MTPs at academic institutions continue to circulate opposing recommendations on topics critical to MTPs. This narrative review discusses up-to-date information on 2 such topics, the initiation and termination of an MTP. The discussion for each begins with a review of the recommendations and supporting literature presented by MTP guidelines from 3 prominent societies, the American Society of Anesthesiologists, the American College of Surgeons, and the task force for Advanced Bleeding Care in Trauma. This is followed by an in-depth analysis of the main components within those recommendations. Societal recommendations on MTP initiation in hemorrhaging trauma patients emphasize the use of retrospectively validated massive transfusion (MT) prediction score, specifically, the Assessment of Blood Consumption and Trauma-Associated Severe Hemorrhage scores. Validation studies have shown that both scoring systems perform similarly. Both scores reliably identify patients that will not require an MT, while simultaneously overpredicting MT requirements. However, each scoring system has its unique advantages and disadvantages, and this review discusses how specific aspects of each scoring system can affect widespread applicability and statistical performance. In addition, we discuss the often overlooked topic of initiating MT in nontrauma patients and the specific tools physicians have to guide the MT initiation decision in this unique setting. Despite the serious complications that can arise with transfusion of large volumes of blood products, there is considerably less research pertinent to the topic of MTP termination. Societal recommendations on MTP termination emphasize applying clinical reasoning to identify patients who have bleeding source control and are adequately resuscitated. This review, however, focuses primarily on the recommendations presented by the Advanced Bleeding Care in Trauma's MTP guidelines that call for prompt termination of the algorithm-guided model of resuscitation and rapidly transitioning into a resuscitation model guided by laboratory test results. We also discuss the evidence in support of laboratory result–guided resuscitation and how recent literature on viscoelastic hemostatic assays, although limited, highlights the potential to achieve additional benefits from this method of resuscitation.

http://ift.tt/2j3f27K

Ion-imprinted electrospun nanofibers of chitosan/1-butyl-3-methylimidazolium tetrafluoroborate for the dynamic expulsion of thorium (IV) ions from mimicked effluents

Abstract

The present study explores the innocuous, biocompatible, and extremely competent molecularly imprinted chitosan/RTIL electrospun nanofibers having average diameter of 30 nm for the expulsion of thorium (IV) ions from the mimicked effluent waste. The extended Flory–Huggins theory and three-dimensional molecular modeling have been effectively premeditated via Materials Studio software for enumerating the inter-miscibility and compatibility (Chi parameter (χ) = 1.019, mixing energy (E_mix) = 0.603 kcal/mol) of the chitosan/RTIL (1-butyl-3-methylimidazolium tetrafluoroborate). The maximum adsorption efficiency is found to be 90% at a neutral pH of 7, and a temperature of 298 K within 120 min. The adsorption process was extensively studied by two-parameter adsorption isotherms like Langmuir, Freundlich, Temkin, and Dubinin–Radushkevich (D–R) and three-parameter models like Redlich–Paterson and Sips isotherm. Pseudo-second-order kinetics model (R² = 0.982) and Langmuir isotherm (R² = 0.994) bestowed the best fitting on chitosan/RTIL nanofibers for the adsorption of Th (IV) ions. The thermodynamic study reveals the spontaneity and exothermic nature of the reaction. The experimental analysis conjoint with isotherm and kinetic models, and simulation study establish the applicability of chitosan/RTIL nanofibers for the expulsion of Th (IV) and other toxic metal ions from the effluents.

Graphical abstract

Ion-imprinted electrospun nanofiber for expulsion of thorium (IV) ion

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Comprehensive study of the mountainous lake sediments in relation to natural and anthropogenic processes and time (Mały Staw Lake, Poland)

Abstract

The Sudety Mts. form a chain of mountains in the South of Poland and during the last 200 years were subjected to strong industrial and agricultural pressure. The records of these human-induced changes are stored in natural archives like lake sediments. For the comprehensive study, three sediment cores taken from Mały Staw Lake (Sudety Mts.) were analyzed for the concentration of K, Na, Mn, Fe, Cu, Mg, Zn, Cd, Cr, Ni, Pb and radioactivity of ¹³⁷Cs and ²¹⁰Pb. As a result of the studies, the bathymetry map was developed and the sources of solid material supplied to the lake were identified. The geochronology studies of the cores were performed using ²¹⁰Pb method, to evaluate model of time changes in the sediment. Radioactivity of ²¹⁰Pb_uns (determined indirectly by ²¹⁰Po) ranged from 1051 ± 64 to 12 ± 8 Bq kg⁻¹. The ¹³⁷Cs radioactivity was determined directly by gamma spectrometry and varied from 525 ± 37 Bq kg⁻¹ for top layers to 9.80 ± 5.40 Bq kg⁻¹ for the bottom of the core. Two characteristic peaks of ¹³⁷Cs radioactivity related to the global fallouts after nuclear weapons testing and the Chernobyl accident were observed and used to confirm ²¹⁰Pb dating method. Chemometrics analysis of the chosen metal's concentrations combined with sample dating showed distinct imprint of human activity on the studied area.

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Masthead

Publication date: November–December 2017
Source:Brachytherapy, Volume 16, Issue 6

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Publication date: November–December 2017
Source:Brachytherapy, Volume 16, Issue 6

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Editorial Board

Publication date: November–December 2017
Source:Brachytherapy, Volume 16, Issue 6

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Acknowledgement of referees

Publication date: November–December 2017
Source:Brachytherapy, Volume 16, Issue 6

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American College of Radiology–American Brachytherapy Society practice parameter for electronically generated low-energy radiation sources

Publication date: November–December 2017
Source:Brachytherapy, Volume 16, Issue 6
Author(s): Phillip M. Devlin, Laurie E. Gaspar, Ivan Buzurovic, D. Jeffrey Demanes, Michael E. Kasper, Subir Nag, Zoubir Ouhib, Joshua H. Petit, Seth A. Rosenthal, William Small, Paul E. Wallner, Alan C. Hartford
BackgroundThis collaborative practice parameter technical standard has been created between the American College of Radiology and American Brachytherapy Society to guide the usage of electronically generated low energy radiation sources (ELSs). It refers to the use of electronic X-ray sources with peak voltages up to 120 kVp to deliver therapeutic radiation therapy.Main FindingsThe parameter provides a guideline for utilizing ELS, including patient selection and consent, treatment planning, and delivery processes. The parameter reviews the published clinical data with regard to ELS results in skin, breast, and other cancers.ConclusionsThis technical standard recommends appropriate qualifications of the involved personnel. The parameter reviews the technical issues relating to equipment specifications as well as patient and personnel safety. Regarding suggestions for educational programs with regard to this parameter,it is suggested that the training level for clinicians be equivalent to that for other radiation therapies. It also suggests that ELS must be done using the same standards of quality and safety as those in place for other forms of radiation therapy.

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Reply to Letter to the Editor regarding “Robotic or non-robotic transoral laryngectomy”

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Pneumoparotitis as a complication of long-term oronasal positive airway pressure for sleep apnea

Abstract

Background

Parotid swelling is rarely caused by pneumoparotitis from retrograde insufflation of air into Stensen's duct. Previous reports have identified occupational exposures, self-induced habits, exercise, spirometry, and short-term positive pressure airway ventilation as causes of salivary duct insufflation.

Methods

We present 2 cases of pneumoparotitis in patients on long-term oronasal continuous positive airway pressure (CPAP) for obstructive sleep apnea.

Results

A diagnosis of pneumoparotitis was made by CT scan in case 1 and sialography in case 2. Patients were advised to transition from oronasal to nasal-only CPAP. One patient was successfully transferred and had good symptomatic improvement, whereas the second patient did not tolerate nasal CPAP and had persistent symptoms on oronasal CPAP.

Conclusion

Long-term use of oronasal CPAP is a potential cause of pneumoparotitis.

http://ift.tt/2yTkRvg

Top 10 research priorities in head and neck cancer: Results of an Alberta priority setting partnership of patients, caregivers, family members, and clinicians

Abstract

Background

The epidemiology, etiology, and management of head and neck cancer are evolving. Understanding the perspectives and priorities of nonresearchers regarding treatment uncertainties is important to inform future research.

Methods

Using the James Lind Alliance approach, patients, caregivers, and clinicians responded to a survey regarding their unanswered questions about treating and managing head and neck cancer. Distinct uncertainties were extracted from responses and sorted into themes. Uncertainties already answered in the literature were removed. Those remaining were ranked by patients and clinicians to develop a short list of priorities, which were discussed at a workshop and reduced to the top 10.

Results

One hundred sixty-one respondents posed 818 uncertainties, culminating in 77 for interim ranking and 27 for discussion at a workshop. Participants reached consensus on the top 10, which included questions on prevention, screening, treatment, and quality of life.

Conclusion

Nonresearchers can effectively collaborate to establish priorities for future research in head and neck cancer.

http://ift.tt/2AZmNnh

Predictive factors for osteoradionecrosis of the jaws: A retrospective study

Abstract

Background

Osteoradionecrosis of the jaw (ORNJ) is a well-recognized complication of radiotherapy. The purpose of this study was to assess predictive factors for the development of ORNJ.

Methods

A retrospective study of 325 patients with head and neck squamous cell carcinoma (HNSCC) treated at one institution between January 1, 1999, and December 31, 2008, was conducted. Outcome measure was the presence/absence of ORNJ. Time to event was recorded and Cox proportional hazard regression analysis was used to determine statistically significant predictive factors.

Results

Fifty-nine patients had ORNJ. Statistical analysis using Cox regression analysis identified several statistically significant variables: dentoalveolar surgery; peri-resective surgery of the jaw; continued tobacco usage after radiotherapy, diabetes mellitus type 2 (DM2); and total radiation dose.

Conclusion

Patients at greater risk of developing ORNJ can be identified and measures can be instituted to reduce its incidence and expedite management when it does occur.

http://ift.tt/2yTrKwz

Letter to the Editor regarding “Robotic or non-robotic transoral laryngectomy”

http://ift.tt/2yTkKzQ

Reply to Letter to the Editor regarding “Robotic or non-robotic transoral laryngectomy”

http://ift.tt/2AZmQzt

Pneumoparotitis as a complication of long-term oronasal positive airway pressure for sleep apnea

Abstract

Background

Methods

We present 2 cases of pneumoparotitis in patients on long-term oronasal continuous positive airway pressure (CPAP) for obstructive sleep apnea.

Results

Conclusion

Long-term use of oronasal CPAP is a potential cause of pneumoparotitis.

http://ift.tt/2yTkRvg

Top 10 research priorities in head and neck cancer: Results of an Alberta priority setting partnership of patients, caregivers, family members, and clinicians

Abstract

Background

Methods

Results

Conclusion

Nonresearchers can effectively collaborate to establish priorities for future research in head and neck cancer.

http://ift.tt/2AZmNnh

Predictive factors for osteoradionecrosis of the jaws: A retrospective study

Abstract

Background

Osteoradionecrosis of the jaw (ORNJ) is a well-recognized complication of radiotherapy. The purpose of this study was to assess predictive factors for the development of ORNJ.

Methods

Results

Conclusion

Patients at greater risk of developing ORNJ can be identified and measures can be instituted to reduce its incidence and expedite management when it does occur.

http://ift.tt/2yTrKwz

Changes in bone mineral density related to changes in serum 25-OH vitamin D concentrations over a two-year period in postmenopausal women

http://ift.tt/2zazezf

Somatostatin receptor subtype 1 might be a predictor of better response to therapy in medullary thyroid carcinoma

Abstract

Purpose

Medullary thyroid carcinoma (MTC) is a malignant neoplasm of parafollicular cells. Because it is a neuroendocrine tumor, it has known somatostatin receptors (SSTRs). The actual frequencies of the SSTR subtypes and their potential influences (by binding with endogenous somatostatin) on MTC cell proliferation have not been fully elucidated to date. The present study evaluated the occurrence of SSTR subtypes 1, 2, 3 and 5 as well as the possible role that each subtype plays in the clinical evolution of patients with MTC.

Methods

This retrospective, longitudinal study analyzed thyroid surgical material from 42 patients with MTC. Immunohistochemical staining was performed with monoclonal antibodies against subtypes 1, 2, 3 and 5 of SSTR. The histological material was classified as negative, focal positive or diffuse positive, in relation to each of the SSTR subtypes. The initial response to treatment, clinical course and patient mortality rate were assessed and related to the presence of SSTR subtypes.

Results

The most prevalent SSTR subtype was SSTR 3, which was found in 81% of the patients, when considering any pattern of positivity. However, subtype 2 had the lowest number of positive patients, with 28.6% demonstrating any positive pattern. Subtypes 1 and 5 had an intermediate prevalence of positivity, with subtype 1 present in 45.2% of the patients and subtype 5 positive in 54.8% of the patients, when considering any pattern of positivity. The presence of STR 1, in the form of diffuse positivity, independently predicted a better response to the initial therapy, with a hazard ratio (HR) of 4.80 (p = 0.03).

Conclusion

This is the first study to show the correlation of the presence of SSTR1, detected by monoclonal immunohistochemical techniques, and better response to initial treatment and possibly better long-term clinical response in patients with MTC. In addition, these patients had low positivity rates for SSTR2, which might explain the low sensitivity of diagnostic and limited therapeutic response to octrotide based radioisotopes.

http://ift.tt/2mCrz72

Impact of thyroid disease on testicular function

Abstract

Introduction

Testis was considered unresponsive to thyroid hormone for a long time. However, like in animals, the presence of thyroid hormone receptors in different testicular cell types was demonstrated also in humans. Accordingly, thyrotoxicosis and hypothyroidism have remarkable effects on testicular function and more extensively on fertility.

Review

Thyrotoxicosis and hypothyroidism are associated with changes affecting the endocrine, sexual, or reproductive functions. Particularly, compared with controls, hyperthyroid patients have higher serum SHBG and lower free and bioavailable testosterone concentrations, a higher rate of astheno-zoospermia, oligo-zoospermia, and terato-zoospermia, and a higher prevalence of sexual disturbances, such as premature ejaculation. In hypothyroid patients, hormonal changes are in the opposite direction compared with hyperthyroid patients.

Summary

Thyroid hormone regulates a number of functions in the testis, such as proliferation and differentiations of non-germ cells, steroidogenesis, and sperm motility. Furthermore, thyroid hormone regulates testicular redox status. Consequently, thyroid hormone excess or deficiency can affect testicular function at different levels.

Conclusions

In view of the high prevalence of thyrotoxicosis and hypothyroidism, a considerable part of infertile patients may harbor overt or subclinical thyroid disease. Identification and management of thyrotoxicosis/hypothyroidism associated infertility needs the collaboration of andrologists, endocrinologists, gynecologists, and general practitioners.

http://ift.tt/2zb0Y78

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Παρασκευή 17 Νοεμβρίου 2017

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