Source:DNA Repair, Volume 61
http://ift.tt/2DkxMbm
Τρίτη 26 Δεκεμβρίου 2017
Transitions into young adulthood: Extent to which alcohol use, perceived drinking norms, and consequences vary by education and work statuses among 18–20year olds
Source:Addictive Behaviors, Volume 79
Author(s): Christine M. Lee, Jennifer M. Cadigan, Anne M. Fairlie, Melissa A. Lewis
IntroductionWith many young adults pursuing post-secondary education and many working, understanding the importance of education and work roles on alcohol use are of developmental and clinical importance. Utilizing a sample of 18–20year-olds transitioning from adolescence to young adulthood, the current study examined how social role statuses in education (i.e., not in school, 2-year students, 4-year students) and work status (i.e., unemployed, employed part-time, employed full-time) were associated with alcohol use, alcohol-related consequences, and perceived drinking norms.MethodParticipants were 18–20year old young adults (54% female) participating in a one-time online survey about alcohol use and sexual behavior. Regression models were conducted to examine associations between school status and work status with alcohol related outcomes.ResultsIndividuals who were unemployed had a significantly lower likelihood of any heavy episodic drinking (HED) in the past month, consumed fewer drinks per week, and experienced fewer alcohol-related consequences compared to individuals who worked full-time. Individuals who worked part-time consumed fewer drinks per week and had lower perceived drinking norms compared to individuals who worked full-time. No significant associations were found for alcohol use and consequences by education status.DiscussionWorking full-time is a risk factor for HED, greater weekly drinking and negative alcohol-related consequences when compared to young adults who are unemployed, and to a lesser extent with young adults working part-time. Workplace interventions may be one approach to reach heavy drinking young adults.
http://ift.tt/2CaQdCd
Response to Stephane Renaud et al.
Source:Radiotherapy and Oncology
Author(s): Wen-Chi Yang, Jin-Yuan Shih, Chao-Chi Ho, Feng-Ming Hsu
http://ift.tt/2zAP8hN
Effect of glucocorticoid treatment on BAFF and APRIL expression in patients with immune thrombocytopenia (ITP)
Source:Clinical Immunology
Author(s): Julian Kamhieh-Milz, Nuha Ghosoun, Viktor Sterzer, Abdulgabar Salama
Immune thrombocytopenic purpura (ITP) is an idiopathic bleeding disorder. B cell activating factor (BAFF) and 'A proliferation-inducing ligand' (APRIL) have regulatory effects on B and T cells and may represent relevant factors in the pathogenesis of ITP. Serum levels and gene expression were investigated in ITP patients. Both BAFF and APRIL serum levels were significantly elevated in active ITP. However, gene expression analysis revealed both factors to have a tendency toward downregulation. Glucocorticoid treatment significantly reduced BAFF but not APRIL serum levels, which may be mediated by differences in transcription factor binding sites. The glucocorticoid receptor binding site is present in the BAFF promotor region, but not in the APRIL promotor region. Prednisolone in combination with vitamin D3 may be effective in reducing APRIL serum levels. In conclusion, glucocorticoid treatment exerts different regulatory effects on both BAFF and APRIL, whereas antioxidant supplementation may also be beneficial in reducing serum levels.
http://ift.tt/2pFXjtB
Effect of glucocorticoid treatment on BAFF and APRIL expression in patients with immune thrombocytopenia (ITP)
Publication date: Available online 26 December 2017
Source:Clinical Immunology
Author(s): Julian Kamhieh-Milz, Nuha Ghosoun, Viktor Sterzer, Abdulgabar Salama
Immune thrombocytopenic purpura (ITP) is an idiopathic bleeding disorder. B cell activating factor (BAFF) and 'A proliferation-inducing ligand' (APRIL) have regulatory effects on B and T cells and may represent relevant factors in the pathogenesis of ITP. Serum levels and gene expression were investigated in ITP patients. Both BAFF and APRIL serum levels were significantly elevated in active ITP. However, gene expression analysis revealed both factors to have a tendency toward downregulation. Glucocorticoid treatment significantly reduced BAFF but not APRIL serum levels, which may be mediated by differences in transcription factor binding sites. The glucocorticoid receptor binding site is present in the BAFF promotor region, but not in the APRIL promotor region. Prednisolone in combination with vitamin D3 may be effective in reducing APRIL serum levels. In conclusion, glucocorticoid treatment exerts different regulatory effects on both BAFF and APRIL, whereas antioxidant supplementation may also be beneficial in reducing serum levels.
http://ift.tt/2pFXjtB
YouTube Medicine
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
Hypopharyngeal Evaluation in Obstructive Sleep Apnea with Awake Flexible Laryngoscopy: Validation and Updates to Cormack-Lehane and Modified Cormack-Lehane Scoring Systems
Abstract
Objective
To validate the use of Cormack-Lehane and Modified Cormack-Lehane scoring systems to classify patterns of hypopharyngeal airway visualization seen during awake flexible laryngoscopy among patients with obstructive sleep apnea.
Study Design
Validation study using samples collected from a prospective database.
Setting
University Medical Center.
Participants
Data was obtained from a retrospective review of a prospective database of flexible fiberoptic examination recordings in 274 consecutive OSA subjects (Stanford Sleep Medicine/Surgery Clinic).
Main Outcome Measures
Single still images from awake fiberoptic laryngoscopy examinations of the vocal cords from 90 different patients were presented to 2 experts and 4 novice raters. Raters used two grading systems (Cormack-Lehane scale and Modified Cormack-Lehane) to rate vocal cord visualization. Percent agreement and Cohen's kappa statistical analysis were used to evaluate inter-rater reliability and intra-rater reliability for each grading system. Feedback from the participants was then used to propose updates to further improve upon the existing grading scales for their applicability to awake flexible endoscopy.
Results
The Cormack-Lehane and Modified Cormack-Lehane scale both communicate un-obstructed and restricted views of the vocal cords reliably. Compared to the 4-grade scale, however, a modified 5-grade Vocal Cord Grading System allows for better objective communication of common variations in hypopharyngeal airway visualization.
Conclusion
We propose a 5-Grade Vocal Cord Grading System that builds upon existing grading systems to allow for efficient and reliable communication of hypopharyngeal airway examination during awake fiberoptic laryngoscopy.
This article is protected by copyright. All rights reserved.
http://ift.tt/2DXz5xS
From equilibrium lamellae to out-of-equilibrium cylinders in triblock copolymer nanolayers obtained via multilayer coextrusion
Publication date: 31 January 2018
Source:Polymer, Volume 136
Author(s): Juan-Sebastián Montana, Sébastien Roland, Emmanuel Richaud, Guillaume Miquelard-Garnier
Multilayer coextrusion was used to obtain nanolayered films of self-assembled commercial triblock copolymer poly(methyl methacrylate-b-butyl acrylate-b-methyl methacrylate) (MAM) confined by poly(methyl methacrylate) (PMMA). The MAM layer thickness was varied from 30 nm to 500 nm (i.e. roughly 1 to 15–20 nanodomains) by changing either the number of multiplying elements or the chill roll draw ratio. The as-extruded triblock morphology within the layers was identified as cylindrical using transmission electronic microscopy (TEM) and small-angle X-ray scattering (SAXS). Surprisingly, this differs from the lamellar morphology identified at equilibrium in bulk and thin films for this triblock. Moreover, as the triblock layer thickness is decreased, the triblock morphology is constrained into a preferential orientation. Slightly different packings were observed on films with similar layer thicknesses but achieved with different processing routes. This one-step and industrially scalable method allowing long-range control of the self-assembly is of interest for engineering applications with large quantity of materials needed.
Graphical abstract
http://ift.tt/2lecx3s
Severe ophthalmoplegia and myocarditis following the administration of pembrolizumab
Source:European Journal of Cancer
Author(s): Fadi Nasr, Elie El Rassy, Georgina Maalouf, Carine Azar, Fadi Haddad, Jeanine Helou, Caroline Robert
http://ift.tt/2zAnkdi
When politicians really decide that nation health is a top priority: the Danish model
Source:European Journal of Cancer
Author(s): Marc Hamoir
http://ift.tt/2zA8P9J
Neural stem cells in neuropsychiatric disorders
Publication date: February 2018
Source:Current Opinion in Neurobiology, Volume 48
Author(s): Roberto Sacco, Emanuele Cacci, Gaia Novarino
The precise control of neural stem cell (NSC) proliferation and differentiation is crucial for the development and function of the human brain. Here, we review the emerging links between the alteration of embryonic and adult neurogenesis and the etiology of neuropsychiatric disorders (NPDs) such as autism spectrum disorders (ASDs) and schizophrenia (SCZ), as well as the advances in stem cell-based modeling and the novel therapeutic targets derived from these studies.
http://ift.tt/2C7yA6D
Precursor Frequency and Affinity Determine B Cell Competitive Fitness in Germinal Centers, Tested with Germline-Targeting HIV Vaccine Immunogens
Publication date: Available online 26 December 2017
Source:Immunity
Author(s): Robert K. Abbott, Jeong Hyun Lee, Sergey Menis, Patrick Skog, Meghan Rossi, Takayuki Ota, Daniel W. Kulp, Deepika Bhullar, Oleksandr Kalyuzhniy, Colin Havenar-Daughton, William R. Schief, David Nemazee, Shane Crotty
How precursor frequencies and antigen affinities impact interclonal B cell competition is a particularly relevant issue for candidate germline-targeting HIV vaccine designs because of the in vivo rarity of naive B cells that recognize broadly neutralizing epitopes. Knowing the frequencies and affinities of HIV-specific VRC01-class naive human B cells, we transferred B cells with germline VRC01 B cell receptors into congenic recipients to elucidate the roles of precursor frequency, antigen affinity, and avidity on B cell responses following immunization. All three factors were interdependently limiting for competitive success of VRC01-class B cells. In physiological high-affinity conditions using a multivalent immunogen, rare VRC01-class B cells successfully competed in germinal centers (GC), underwent extensive somatic hypermutation, and differentiated into memory B cells. The data reveal dominant influences of precursor frequency, affinity, and avidity for interclonal GC competition and indicate that germline-targeting immunogens can overcome these challenges with high-affinity multimeric designs.
Graphical abstract
Teaser
It is not clear how precursor frequencies and antigen affinities impact interclonal B cell competition. Abbott et al. show these parameters interdependently limit germinal center B cell fitness. When these variables are matched to the human physiological range, HIV bnAb precursor B cells compete in germinal centers, undergo extensive mutation, and form memory.http://ift.tt/2CaGZnn
Structural Activation of Pro-inflammatory Human Cytokine IL-23 by Cognate IL-23 Receptor Enables Recruitment of the Shared Receptor IL-12Rβ1
Publication date: Available online 26 December 2017
Source:Immunity
Author(s): Yehudi Bloch, Laura Bouchareychas, Romain Merceron, Katarzyna Składanowska, Lien Van den Bossche, Sammy Detry, Srinath Govindarajan, Dirk Elewaut, Filomeen Haerynck, Melissa Dullaers, Iannis E. Adamopoulos, Savvas N. Savvides
Interleukin-23 (IL-23), an IL-12 family cytokine, plays pivotal roles in pro-inflammatory T helper 17 cell responses linked to autoimmune and inflammatory diseases. Despite intense therapeutic targeting, structural and mechanistic insights into receptor complexes mediated by IL-23, and by IL-12 family members in general, have remained elusive. We determined a crystal structure of human IL-23 in complex with its cognate receptor, IL-23R, and revealed that IL-23R bound to IL-23 exclusively via its N-terminal immunoglobulin domain. The structural and functional hotspot of this interaction partially restructured the helical IL-23p19 subunit of IL-23 and restrained its IL-12p40 subunit to cooperatively bind the shared receptor IL-12Rβ1 with high affinity. Together with structural insights from the interaction of IL-23 with the inhibitory antibody briakinumab and by leveraging additional IL-23:antibody complexes, we propose a mechanistic paradigm for IL-23 and IL-12 whereby cognate receptor binding to the helical cytokine subunits primes recruitment of the shared receptors via the IL-12p40 subunit.
Graphical abstract
Teaser
IL-23, a human cytokine under intense clinical targeting, is pivotal to cellular responses underlying widespread inflammatory and autoimmune diseases, such as psoriasis and rheumatoid arthritis. Bloch et al. determine the structure of IL-23 bound by one of its receptors, IL-23R, and reveal how IL-23R activates IL-23 for recruiting IL-12Rβ1 to the signaling assembly. Together with identifying an interaction hotspot, such findings may contribute to additional approaches for the mechanistic and therapeutic interrogation of receptor complexes mediated by IL-12 family members.http://ift.tt/2C92GE3
Itching for answers: Prevalence and severity of pruritus in psoriasis
Abstract
Background/Objectives
Pruritus is the most frequently reported complaint or symptom for psoriasis patients. Despite the morbidity associated with pruritus in psoriasis few studies have evaluated the prevalence of itch in psoriasis with the current use of biological agents.
Method
This was a multi-site cross-sectional observational study conducted in New South Wales, Australia. Psoriasis patients were approached during their outpatient clinic, phototherapy or private consultations. Data on psoriasis characteristics, severity and treatment were collected. The patients were then asked to complete a survey regarding the frequency, severity and aggravators of their psoriasis.
Results
Data were collected from 179 patients with a mean age of 52.3 years, of whom 55% were male. Altogether 63 (35%) had a psoriasis area severity index (PASI) > 10, 42 (24%) were on biological agents and 84 (47%) were receiving phototherapy. The number of patients who reported itch all the time was 40 (22%), most of the time 48 (27%), and never 19 (11%). Patients with nail psoriasis were significantly less likely to have itch all or most of the time (P = 0.01). Itch all or most of the time was significantly more likely in patients with PASI > 10 (P = 0.013). No treatment was associated with reduced itch. Itch was reported to be most frequent in the winter season.
Conclusion
Few patients with psoriasis do not suffer from pruritus. Despite their promise, biological agents are not associated with reduced itch.
http://ift.tt/2pD0UIJ
Mycosis fungoides occurring at the site of previous herpes zoster eruption
Abstract
Numerous clinicopathological variants of mycosis fungoides have been described in the literature. Dermatomal or zosteriform mycosis fungoides is one reported variant but a clear aetiology has never been documented. We report a case of mycosis fungoides proved by biopsy and immunohistochemistry that developed in a 55-year-old man at the site of previous herpes zoster eruption. We also present a review of the relevant literature to add to the understanding of rare variants of mycosis fungoides and aid in the clinical recognition of zosteriform mycosis fungoides.
http://ift.tt/2DUFjib
Disrupting the Approach to Sudden Cardiac Death: From Vulnerable Ejection Fraction to Vulnerable Patient.
Author: Chugh, Sumeet S. MD
Page: 7-9
http://ift.tt/2Di782H
Fasting Versus Nonfasting and Low-Density Lipoprotein Cholesterol Accuracy.
Author: Sathiyakumar, Vasanth MD; Park, Jihwan MA; Golozar, Asieh MD, PhD; Lazo, Mariana MD, PhD; Quispe, Renato MD, MHS; Guallar, Eliseo MD, MPH; Blumenthal, Roger S. MD; Jones, Steven R. MD; Martin, Seth S. MD, MHS
Page: 10-19
http://ift.tt/2C9jsTv
The Future of Low-Density Lipoprotein Cholesterol in an Era of Nonfasting Lipid Testing and Potent Low-Density Lipoprotein Lowering.
Author: Farukhi, Zareen MD; Mora, Samia MD, MHS
Page: 20-23
http://ift.tt/2Di6WAv
Mortality and Cerebrovascular Events After Heart Rhythm Disorder Management Procedures.
Author: Lee, Justin Z. MBBS *,; Ling, Jayna CNP *,; Diehl, Nancy N. BS; Hodge, David O. MS; Padmanabhan, Deepak MBBS; Killu, Ammar M. MBBS; Madhavan, Malini MBBS; Noseworthy, Peter A. MD; Kapa, Suraj MD; McLeod, Christopher J. MBChB, PhD; Cha, Yong-Mei MD; Deshmukh, Abhishek J. MBBS; Srivathsan, Komandoor MD; Kusumoto, Fred M. MD; Shen, Win-Kuang MD; Friedman, Paul A. MD; Munger, Thomas M. MD; Asirvatham, Samuel J. MD; Packer, Douglas L. MD; Mulpuru, Siva K. MD
Page: 24-33
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The Truth Is in the Details: The Case for Not Missing the Trees for the Forest.
Author: Voigt, Andrew MD; Saba, Samir MD
Page: 34-37
http://ift.tt/2Dk4Sb8
Association of Pediatric Medical Emergency Teams With Hospital Mortality.
Author: Kutty, Shelby MD, PhD, MHCM; Jones, Philip G. MS; Karels, Quentin MBA; Joseph, Navya MD; Spertus, John A. MD, MPH; Chan, Paul S. MD, MSc
Page: 38-46
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Rapid Response Teams in Pediatric Patients: Well Intentioned, but Do They Really Help?.
Author: Koch, Joshua MD; Das, Sandeep R. MD, MPH
Page: 47-48
http://ift.tt/2DgqHsn
Carotid Stent Fractures Are Not Associated With Adverse Events: Results From the ACT-1 Multicenter Randomized Trial (Carotid Angioplasty and Stenting Versus Endarterectomy in Asymptomatic Subjects Who Are at Standard Risk for Carotid Endarterectomy With Significant Extracranial Carotid Stenotic Disease).
Author: Weinberg, Ido MD; Beckman, Joshua A. MD; Matsumura, Jon S. MD; Rosenfield, Kenneth MD; Ansel, Gary M. MD; Chaturvedi, Seemant MD; Gray, William MD; Metzger, D. Chris MD; Riles, Tom MD; Shu, Yu PhD; Wechsler, Lawrence MD; Jaff, Michael R. DO
Page: 49-56
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Runx1 Deficiency Protects Against Adverse Cardiac Remodeling After Myocardial Infarction.
Author: McCarroll, Charlotte S. BVMS, PhD *,; He, Weihong MD, PhD *,; Foote, Kirsty PhD; Bradley, Ashley MRes; Mcglynn, Karen PhD; Vidler, Francesca MRes; Nixon, Colin; Nather, Katrin PhD; Fattah, Caroline PhD; Riddell, Alexandra Vet, MB, MRes; Bowman, Peter MRes; Elliott, Elspeth B. PhD; Bell, Margaret; Hawksby, Catherine; MacKenzie, Scott M. PhD; Morrison, Liam J. BVMS, PhD; Terry, Anne BSc; Blyth, Karen PhD; Smith, Godfrey L. PhD; McBride, Martin W. PhD; Kubin, Thomas PhD; Braun, Thomas MD, PhD; Nicklin, Stuart A. PhD; Cameron, Ewan R. BVMS, PhD; Loughrey, Christopher M. BVMS, PhD
Page: 57-70
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Honoring 50 Years of Clinical Heart Transplantation in Circulation: In-Depth State-of-the-Art Review.
Author: Stehlik, Josef MD, MPH; Kobashigawa, Jon MD; Hunt, Sharon A. MD; Reichenspurner, Hermann MD, PhD; Kirklin, James K. MD
Page: 71-87
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Effect of Basal Insulin Glargine on First and Recurrent Episodes of Heart Failure Hospitalization: The ORIGIN Trial (Outcome Reduction With Initial Glargine Intervention).
Author: Gerstein, Hertzel C. MD, MSc; Jung, Hyejung MSc; Ryden, Lars MD, PhD; Diaz, Rafael MD; Gilbert, Richard E. MBBS, PhD; Yusuf, Salim DPhil; On behalf of the ORIGIN Investigators
Page: 88-90
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Extended-Duration Betrixaban Reduces the Risk of Rehospitalization Associated With Venous Thromboembolism Among Acutely Ill Hospitalized Medical Patients: Findings From the APEX Trial (Acute Medically Ill Venous Thromboembolism Prevention With Extended Duration Betrixaban Trial).
Author: Chi, Gerald MD; Yee, Megan K. MPH; Amin, Alpesh N. MD; Goldhaber, Samuel Z. MD; Hernandez, Adrian F. MD; Hull, Russell D. MD; Cohen, Alexander T. MD; Harrington, Robert A. MD; Gibson, C. Michael MS, MD
Page: 91-94
http://ift.tt/2C9vIDE
Letter by Ye et al Regarding Article, "Association Between Fetal Congenital Heart Defects and Maternal Risk of Hypertensive Disorders of Pregnancy in the Same Pregnancy and Across Pregnancies".
Author: Ye, Ziliang MD; Su, Qiang MD, PhD; Li, Lang MD, PhD
Page: 95-96
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Response by Boyd et al to Letter Regarding Article, "Association Between Fetal Congenital Heart Defects and Maternal Risk of Hypertensive Disorders of Pregnancy in the Same Pregnancy and Across Pregnancies".
Author: Boyd, Heather A. PhD; Basit, Saima MSc; Wohlfahrt, Jan MSc, DrMed; Oyen, Nina MD, MPH, DrMed
Page: 97-98
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Letter by Locorotondo et al Regarding Article, "Association Between Midwall Late Gadolinium Enhancement and Sudden Cardiac Death in Patients with Dilated Cardiomyopathy and Mild and Moderate Left Ventricular Systolic Dysfunction".
Author: Locorotondo, Gabriella MD, PhD; Manfredi, Riccardo MD, MBA; Crea, Filippo MD, PhD
Page: 99-100
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Response by Halliday et al to Letter Regarding Article, "Association Between Midwall Late Gadolinium Enhancement and Sudden Cardiac Death in Patients with Dilated Cardiomyopathy and Mild and Moderate Left Ventricular Systolic Dysfunction".
Author: Halliday, Brian P. MBChB; Pennell, Dudley J. MD; Prasad, Sanjay K. MD
Page: 101-102
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2017 American Heart Association Focused Update on Pediatric Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Author: Atkins, Dianne L. MD, FAHA, Chair; de Caen, Allan R. MD; Berger, Stuart MD, FAHA; Samson, Ricardo A. MD; Schexnayder, Stephen M. MD; Joyner, Benny L. Jr MD, MPH; Bigham, Blair L. MD, MSc; Niles, Dana E. MS; Duff, Jonathan P. MD, MEd; Hunt, Elizabeth A. MD, MPH, PhD; Meaney, Peter A. MD, MPH
Page: e1-e6
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2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
Author: Kleinman, Monica E. MD, Chair; Goldberger, Zachary D. MD, MSc, FAHA; Rea, Thomas MD, MPH; Swor, Robert A. DO; Bobrow, Bentley J. MD, FAHA; Brennan, Erin E. MD, MMEd; Terry, Mark MPA, NRP; Hemphill, Robin MD, MPH; Gazmuri, Raul J. MD, PhD; Hazinski, Mary Fran MSN, RN, FAHA; Travers, Andrew H. MD, MSc
Page: e7-e13
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Neural phase locking predicts BOLD response in human auditory cortex
Source:NeuroImage, Volume 169
Author(s): Hiroyuki Oya, Phillip E. Gander, Christopher I. Petkov, Ralph Adolphs, Kirill V. Nourski, Hiroto Kawasaki, Matthew A. Howard, Timothy D. Griffiths
Natural environments elicit both phase-locked and non-phase-locked neural responses to the stimulus in the brain. The interpretation of the BOLD signal to date has been based on an association of the non-phase-locked power of high-frequency local field potentials (LFPs), or the related spiking activity in single neurons or groups of neurons. Previous studies have not examined the prediction of the BOLD signal by phase-locked responses. We examined the relationship between the BOLD response and LFPs in the same nine human subjects from multiple corresponding points in the auditory cortex, using amplitude modulated pure tone stimuli of a duration to allow an analysis of phase locking of the sustained time period without contamination from the onset response. The results demonstrate that both phase locking at the modulation frequency and its harmonics, and the oscillatory power in gamma/high-gamma bands are required to predict the BOLD response. Biophysical models of BOLD signal generation in auditory cortex therefore require revision and the incorporation of both phase locking to rhythmic sensory stimuli and power changes in the ensemble neural activity.
http://ift.tt/2DT7hLc
Effects of a hydroethanolic extract of Boophone disticha bulb on anxiety-related behaviour in naive BALB/c mice
Publication date: 25 March 2018
Source:Journal of Ethnopharmacology, Volume 214
Author(s): William Pote, Shamiso Musarira, Donald Chuma, Louis L. Gadaga, Ellen Mwandiringana, Dexter Tagwireyi
Ethnopharmacological relevanceBoophone disticha is one of the most important medicinal bulbs of Southern Africa. Previous in vitro studies have shown that it's crude ethanolic extracts and some alkaloidal phytoconstituents possesses high affinity for the serotonin transporter protein (SERT) and serotonin receptor 1a (5HT1a) which are both implicated in the pathogenesis and treatment of anxiety disorders. However, there are no in vivo studies that validates the anxiolytic actions of the plant.Aim of the studyThis study was therefore set to determine the anxiolytic-like activity of an orally administered hydroethanolic extract of B. disticha bulbs in naive mice using the behavioural tests of anxiety.Materials and methodsNaïve adult male BALB/c mice were randomly placed into five treatment groups (n=6–10): vehicle control (10ml/kg 0.9% NaCl), positive control (1mg/kg diazepam) and the hydroethanolic extract of B. disticha (10, 25 and 40mg/kg p.o.). Souk test, elevared plus maze and open field tests were used to evaluate the anxiolytic-like activity of the B. disticha extract.ResultsDiazepam-treated mice exhibited higher number of sector visits and line crossings in the ST, rearings in the OF and head dips in the EPM than the control (p<0.05). B. disticha extract treated groups expressed higher sector visits at 10mg/kg, and, unprotected head dips at 25mg/kg in the ST, as well as, open arm time entries at 10mg/kg dose, and unprotected head dips at all doses in the EPM than the control group (p<0.05). The 25mg/kg B. disticha dose group exhibited highest anxiolytic-like activity in both the ST and OF, while the 10mg/kg was most active in the EPM.ConclusionThe extract of B. disticha exerted good anxiolytic-like activity in both the ST and OF at medium dose (25mg/kg), while the low dose (10mg/kg) showed prominent anxiolytic-like activity in the EPM.
Graphical abstract
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Total and fraction content of elements in volcanic soil: Natural or anthropogenic derivation
Publication date: 1 June 2018
Source:Science of The Total Environment, Volume 625
Author(s): Valeria Memoli, Enrique Eymar, Carlos García-Delgado, Francesco Esposito, Lucia Santorufo, Anna De Marco, Rossella Barile, Giulia Maisto
Soil element composition derives from parent material disaggregation during pedogenesis and weathering processes but also by anthropogenic inputs. Elements are present in soils in different chemical forms that affect their availability and mobility. The aim of the study was to evaluate the main derivation, natural or anthropogenic, of elements in the soils of the Vesuvius National Park (a natural environment strongly affected by human impacts). Besides, the effects of age of the lava from which soils derive, different vegetation covers, traffic fluxes along the two roads connecting the Vesuvius crater and altitudes of the sites on the pseudo-total element concentrations and on their contents in different fraction of soil were investigated. To reach the aims, BCR (Bureau Commun de Référence) sequential extraction was performed in order to determine the distribution of elements into: acid-soluble, reducible, oxidizable and residual fractions. The relationship between the main environmental media and distribution of elements was discussed using non-metric multidimensional scaling (NMDS). The findings showed that, with the exception of Cd, Cu, Pb and Zn that would seem to derive also from human activities, the other investigated elements (Al, As, B, Ba, Ca, Cd, Cr, Cu, Fe, K, La, Mg, Mn, Na, Ni, P, Pb, Si, Ti, V, W and Zn) mainly had a natural derivation. Among the investigated elements, only Cd could represent a potential high risk for the studied andosols. The highest element accumulations in the soils at low altitude could be attributable to an integrated effect of plant cover, vicinity of downtowns and traffic flux. The acid-soluble fraction of elements appeared more linked to lava age; the reducible and oxidizable ones to plant cover; the residual one to the chemical composition of the parent material that gave origin to the soils.
Graphical abstract
http://ift.tt/2DX03Gb
Application of selectrodialysis for the removal of As from metallurgical process waters: Recovery of Cu and Zn
Publication date: 29 April 2018
Source:Separation and Purification Technology, Volume 195
Author(s): M. Reig, X. Vecino, C. Valderrama, O. Gibert, J.L. Cortina
In this work, selectrodialysis (SED) was used to separate arsenic (As(V)) from copper (Cu(II)) and zinc (Zn(II)) of acidic metallurgical process streams by integrating non-selective and selective membranes. The separation process is determined by the chemical speciation of the involved elements. In this case, As(V) is mainly present as anionic species (H2AsO4−), while Cu(II) and Zn(II) are mainly present as cationic species although partially complexed as neutral complexes (CuSO4 and ZnSO4). A lab set-up was used to conduct the experimental tests with different type of standard and monovalent selective ion-exchange membranes. The results obtained showed that by SED configuration it was possible to recover around 80 ± 0.2% of Cu(II), 87 ± 0.2% of Zn(II) and 95 ± 0.3% of As(V) from the feed solution to the rich-product streams with an energy consumption of 2.6 ± 0.2 kWh/kg CuSO4+ZnSO4. Furthermore, a Cu/Zn-rich stream with a purity of both divalent cations of 99.8% (0.02% of As(V)) was achieved by means of SED. Overall, the results herein gathered suggest that SED is an efficient separation technology for Cu(II) and Zn(II) recovery from mining and metallurgical acidic streams.
Graphical abstract
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Neurophysiological correlates of word processing deficits in isolated reading and isolated spelling disorders
Publication date: Available online 24 December 2017
Source:Clinical Neurophysiology
Author(s): Sarolta Bakos, Karin Landerl, Jürgen Bartling, Gerd Schulte-Körne, Kristina Moll
ObjectiveIn consistent orthographies, isolated reading disorders (iRD) and isolated spelling disorders (iSD) are nearly as common as combined reading-spelling disorders (cRSD). However, the exact nature of the underlying word processing deficits in isolated versus combined literacy deficits are not well understood yet.MethodsWe applied a phonological lexical decision task (including words, pseudohomophones, legal and illegal pseudowords) during ERP recording to investigate the neurophysiological correlates of lexical and sublexical word-processing in children with iRD, iSD and cRSD compared to typically developing (TD) 9-year-olds.ResultsTD children showed enhanced early sensitivity (N170) for word material and for the violation of orthographic rules compared to the other groups. Lexical orthographic effects (higher LPC amplitude for words than for pseudohomophones) were the same in the TD and iRD groups, although processing took longer in children with iRD. In the iSD and cRSD groups, lexical orthographic effects were evident and stable over time only for correctly spelled words.ConclusionsOrthographic representations were intact in iRD children, but word processing took longer compared to TD. Children with spelling disorders had partly missing orthographic representations.SignificanceOur study is the first to specify the underlying neurophysiology of word processing deficits associated with isolated literacy deficits.
http://ift.tt/2Djt7Gr
Hemitransdomal versus Dome-Binding Suture
Facial plast Surg
DOI: 10.1055/s-0036-1598014
The dome-binding suture (DBS) and hemitransdomal suture (HTS) are suture techniques used to narrow and define the nasal tip. The DBS can create a pinched, unnatural appearance, while the HTS puts the lateral crus in a more favorable orientation. This allows a natural contour between the nasal tip and alar lobule while maintaining alar margin support. Objective measurement of the rotational axis of the lateral crus between the DBS and the HTS has not been reported in the literature. To determine whether the DBS or HTS technique results in a more favorable rotational axis of the lateral crus as measured by the alar surface septal angle (ASSA). Open rhinoplasty with cephalic trim and placement of a DBS or HTS was performed in 6 cadaveric heads, for a total of 12 lower lateral cartilages at the VirtuOHSU Simulation and Surgical Training Center at Oregon Health and Science University (OHSU). ASSA measurements were taken at baseline and after placement of either a DBS or HTS. A total of 36 ASSA measurements were obtained. The median baseline ASSA prior to suture placement was 142 degrees (interquartile range [IQR]: 131.5–145 degrees), following DBS placement was 141 degrees (IQR: 33–150.5 degrees), and following HTS placement was 112 degrees (IQR: 108–117 degrees). There was no statistically significant difference of ASSA measurements between baseline and DBS placement (p = 0.24), but there was a statistically significant difference between baseline and HTS (p < 0.0001) and between DBS and HTS (p < 0.0001). The HTS technique creates a more favorable rotational axis of the lateral crus as compared with the DBS, as measured by the ASSA. This study provides objective data to support the use of the HTS for nasal tip contouring.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
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Frontal Fibrosing Alopecia: A Retrospective Analysis of 72 Patients from a German Academic Center
Facial plast Surg
DOI: 10.1055/s-0037-1615281
Frontal fibrosing alopecia (FFA) describes the scarring, band-like recession of the frontotemporal hairline. Treatment is difficult, and currently, no evidence-based therapy exists. The purpose of this study is to report clinical features and treatment responses in a large cohort of patients with FFA. The authors analyzed a series of 72 patients with a clinical or histologic diagnosis of FFA. A total of 70 patients were female (97.2%), and 2 were male (2.8%). In females, the first onset of FFA was postmenopausal in 81.4% (n = 57). Documented eyebrow loss was present in 61.1% (n = 44), whereas involvement of eyelashes and body hair was reported in only 4.2% (n = 3) and 5.6% (n = 4), respectively. Clinical symptoms were itching (40.3%, n = 29) and trichodynia (4.2%, n = 3) in the alopecic area. Virtually all patients were treated with topical high-potency steroids. Additional treatments were topical tacrolimus, systemic retinoids, and hydroxychloroquine. A total of 48 patients (66.7%) received a combination of high-potency steroids with topical pimecrolimus. In this subgroup, subjective improvement or disease stabilization was reported by 64.6% (n = 31), and the hairline was stabilized on average after 9 to 12 months of therapy. The combination therapy of topical high-potency steroids with pimecrolimus may be an effective and steroid-saving treatment for FFA.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Otoplasty Online Information: A Comprehensive Analysis of the Websites and Videos that Patients View Regarding Cosmetic Ear Surgery
Facial plast Surg
DOI: 10.1055/s-0037-1615280
Physicians should be aware of both websites and videos available online regarding the otoplasty procedure to provide quality care. This study systematically analyzes the authorships, reliability, quality, and readability of the websites, as well as the authorships and primary objectives of the videos regarding otoplasty. Validated instruments were used to analyze the reliability, quality, and readability of websites, and videos were systematically categorized and analyzed. A Google search was conducted, and the first five pages of results were included in this study. After excluding unrelated websites, the remaining 44 websites were categorized by authorship (physician, patient, academic, or unaffiliated) and were analyzed using the validated DISCERN instrument for reliability and quality, as well as various other validated instruments to measure readability. A YouTube search was also conducted, and the first 50 relevant videos were included in the study. These videos were categorized by authorship and their primary objective. Website authorships were physician-dominated. Reliability, quality, and overall DISCERN score differ between the four authorship groups by a statistically significant margin (Kruskall–Wallis test, p < 0.05). Unaffiliated websites were the most reliable, and physician websites were the least reliable. Academic websites were of the highest quality, and patient websites were of the lowest quality. Readability did not differ significantly between the groups, though the readability measurements made showed a general lack of material easily readable by the general public. YouTube was likewise dominated by physician-authored videos. While the physician-authored videos sought mainly to inform and to advertise, patient-authored videos sought mainly to provide the patient's perspective. Academic organizations showed very little representation on YouTube, and the YouTube views on otoplasty videos were dominated by the top 20 videos, which represented over 93% of the total views of videos included in this study.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Bullying and peer violence among children and adolescents in residential care settings: A review of the literature
Source:Aggression and Violent Behavior
Author(s): Angela Mazzone, Annalaura Nocentini, Ersilia Menesini
The present paper offers a review of the phenomena of bullying and peer violence among children and adolescents living in residential care settings (RCS). The review was conducted on four databases (Scopus, Web of Science, PsycINFO and ERIC). Findings of the 31 full-text papers included in the present work showed that bullying and peer violence involve various forms of direct and indirect attacks. While bullying in RCS involves severe and repeated aggressive actions, peer violence seems to be characterized by distinct levels of severity; i.e., low-level attacks are infrequent and isolated, whereas high level attacks may be severe and frequent. Several individual factors, such as age, gender, and length of stay in RCS were found to be associated with both bullying and peer violence. Contextual risk factors such as activities, structure and facility size, along with a residential peer culture characterized by a high level of hierarchy and a poor emotional bond between children and staff, contributed to bullying and peer violence. Furthermore, findings of the studies included in the present review showed that both perpetrators and victims manifest a number of behavioral and psychological problems. Overall, the present study offers a picture of bullying and peer violence among institutionalized children. However, distinct operationalization of constructs among studies, together with the use of different methods and measures, made comparisons among studies difficult. Future research should overcome these limitations in order to promote validity and compatibility of research in this field of study.
http://ift.tt/2Caopf8
Diagnosis and management of peristomal pyoderma gangrenosum: A systematic review
Peristomal pyoderma gangrenosum (PPG) is an uncommon subtype of pyoderma gangrenosum. PPG is a challenging condition to diagnose and treat; no evidence-based guidelines exist.
http://ift.tt/2BVtKd4
Comorbidity scores associated with limited life expectancy in the very elderly with nonmelanoma skin cancer
There is controversy regarding nonmelanoma skin cancer (NMSC) treatment in the very elderly, with some suggesting that this population may not live long enough to benefit from invasive treatments. Tools to assess limited life expectancy (LLE) exist, but performance in the very elderly NMSC population has not been well-defined.
http://ift.tt/2zxOSQB
A Split-Face, Single-Blinded, Randomized Controlled Comparison of Alexandrite 755 nm Picosecond Laser vs. Alexandrite 755 nm Nanosecond Laser in the Treatment of Acquired Bilateral Nevus of Ota-like Macules (ABNOM)
Q-switched alexandrite lasers (QSAL) have been used for the treatment of acquired bilateral nevus of Ota-like macules (ABNOM). Currently, picosecond alexandrite laser (PSAL) pulses have become available for pigmentary disorders. However, no studies have compared PSAL and QSAL in the treatment of ABNOM.
http://ift.tt/2BSZgZk
Inhibition of protein tyrosine phosphatase 1B (PTP1B) and α-glucosidase by xanthones from Cratoxylum cochinchinense, and their kinetic characterization
Publication date: Available online 26 December 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Zuopeng Li, Yeong Hun Song, Zia Uddin, Yan Wang, Ki Hun Park
Cratoxylum cochinchinense displayed significant inhibition against protein tyrosine phosphatase 1B (PTP1B) and α-glucosidase, both of which are key target enzymes to attenuate diabetes and obesity. The compounds responsible for both enzymes inhibition were identified as twelve xanthones (1-12) among which compounds 1 and 2 were found to be new ones. All of them simultaneously inhibited PTP1B with IC50s of (2.4-52.5 µM), and α-glucosidase with IC50 values of (1.7-72.7 µM), respectively. Cratoxanthone A (3) and γ-mangostin (7) were estimated to be most active inhibitors against both PTP1B (IC50 = 2.4 µM for 3, 2.8 µM for 7) and α-glucosidase (IC50 = 4.8 µM for 3, 1.7 µM for 7). In kinetic studies, all isolated xanthones emerged to be mixed inhibitors of α-glucosidase, whereas they behaved as competitive inhibitors of PTP1B. In time dependent experiments, compound 3 showed isomerization inhibitory behavior with following kinetic parameters: Kiapp = 2.4 µM; k5 = 0.05001 µM-1S-1 and k6 = 0.02076µM-1S-1.
Graphical abstract
http://ift.tt/2l2jXHR
Theoretical Research in Structure Characteristics of Different Inhibitors and Differences of Binding Modes with CBP Bromodomain
Publication date: Available online 26 December 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Xue-Song Wang, Qing-Chuan Zheng
The CBP (CREB (cAMP responsive element binding protein) binding protein) bromodomain (BRD) could recognize and bind with acetyl K382 of human tumor suppressor protein p53 which the mutation of encoding gene might cause human cancers. CBP-BRD serves as a promising drug target for several disease pathways and a series of effective drug have been discovered. In this study, molecular dynamics (MD) simulations and molecular mechanics generalized born surface area (MM-GB/SA) approaches were performed to investigate the different binding modes between five inhibitors with CBP-BRD. Based on the energy and conformation analyses, a potent core fragment is chosen to act as the starting point for new inhibitor design by means of LUDI and rational drug design approaches. Then, T.E.S.T and molinspirition were applied to evaluate oral bioavailability and drug promiscuity of the new molecules. These results shed light on the idea for further inhibitor design.
Graphical abstract
http://ift.tt/2kZMhKW
A cell surface clicked navigation system to direct specific bone targeting
Publication date: Available online 26 December 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Young Kim, Zhe Zhang, Jae-Hyuck Shim, Tae Sup Lee, Ching-Hsuan Tung
Cell therapies are promising up-and-coming therapeutic strategies for many diseases. For maximal therapeutic benefits, injected cells have to navigate their way to a designated area, including organ and tissue; unfortunately, the majority of therapeutic cells are currently administered without a guide or homing device. To improve this serious shortcoming, a functionalization method was developed to equip cells with a homing signal. Its application was demonstrated by applying an Azadibenzocyclooctyne-bisphosphonate (ADIBO-BP) and azide paired bioorthogonal chemistry on cells for bone specific homing. Jurkat T cells and bone marrow derived stromal cells (BMSCs) were cultured with tetraacetylated N-azidoacetyl-D-mannosamine (Ac4ManNAz) to place unnatural azido groups onto the cell's surface; these azido groups were then reacted with ADIBO-BP. The tethered bisphosphonates were able to bring Jurkat cells to hydroxyapatite, the major component of bone, and mineralized SAOS-2 cells. The incorporated BP groups also enhanced the specific affinity of BMSCs to mouse femur bone fragments in vitro. The introduced navigation strategy is expected to have a broad application in cell therapy, because through the biocompatible ADIBO and azide reactive pair, various homing signals could be efficiently anchored onto therapeutic cells.
Graphical abstract
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One-step Synthesis of Carbohydrate Esters as Antibacterial and Antifungal Agents
Publication date: Available online 26 December 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Madher N. AlFindee, Qian Zhang, Yagya Prasad Subedi, Jaya P. Shrestha, Yukie Kawasaki, Michelle Grilley, Jon Y. Takemoto, Cheng-Wei Tom Chang
Carbohydrate esters are biodegradable, and the degraded adducts are naturally occurring carbohydrates and fatty acids which are environmentally friendly and non-toxic to human. A simple one-step regioselective acylation of mono-carbohydrates has been developed that leads to the synthesis of a wide range of carbohydrate esters. Screening of these acylated carbohydrates revealed that several compounds were active against a panel of bacteria and fungi, including Staphylococcus aureus. methicillin-resistant S. aureus (MRSA), Candida albicans, Cryptococcus neoformans, Aspergillus flavus and Fusarium graminearum. Unlike prior studies on carbohydrate esters that focus only on antibacterial applications, our compounds are found to be active against both bacteria and fungi. Furthermore, the synthetic methodology is suitable to scale-up production for a variety of acylated carbohydrates. The identified lead compound, MAN014, can be used as an antimicrobial in applications such as food processing and preservation and for treatment of bacterial and fungal diseases in animals and plants.
Graphical abstract
http://ift.tt/2l256NL
New branched amino acids for high affinity dendrimeric DC-SIGN ligands
Publication date: Available online 26 December 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Laurent Cattiaux, Vanessa Porkolab, Franck Fieschi, Jean-Maurice Mallet
A branched amino acid was synthesized from methyl glucopyranoside; this amino acid presents three amino groups protected by Fmoc and one acid group and can be used in classic peptide synthesis. In parallel, similar azido terminated blocks were synthesized.Successive coupling reaction and deprotection afforded dendrimers with up to 27 azido functional groups. As an example of application, D-mannose and L-fucose residues were linked through CuAAC coupling and resulting glycodendrimers were evaluated in their interaction with DC-SIGN using SPR competition assay.
Graphical abstract
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A review on the hybrids of hydroxycinnamic acidas multi-target-directed ligands against Alzheimer's disease
Publication date: Available online 26 December 2017
Source:Bioorganic & Medicinal Chemistry
Author(s): Xiao Zhang, Xixin He, Qiuhe Chen, Junfeng Lu, Simona Rapposelli, Rongbiao Pi
Alzheimer's disease (AD), a complex chronic progressive central nervous system degenerative disease and a public health problem of the world, often characters cognitive dysfunction accompaning aggression and depression, and may lead to death. More attentions should be paid on it because there is no modified strategy against AD till now. AD is featured with the loss of cholinergic neurons, the amyloid-beta peptide (Aβ) plaques and the neurofibrillary tangles and several hypotheses were established to explain the pathogenesis of AD. Hydroxycinnamic acids,including caffeic acid (CA) and ferulic acid (FA) are widely distributed in natural plants and fruits. CA and FA exert various pharmacological activities, including anti-inflammatory, antioxidant, neuroprotection, anti-amyloid aggregation and so on. All these pharmacological activities are associated with the treatment of AD. Here we summarized the pharmacological activities of CA and FA, and their hybrids as multi-target-directed ligands (MTDLs) against AD. The future application of CA and FA was also discussed, hoping to provide beneficial information for the development of CA- and FA-based MTDLs against AD.
Graphical abstract
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Immune Mechanisms of Oral Immunotherapy
Source:Journal of Allergy and Clinical Immunology
Author(s): Michael D. Kulis, Sarita U. Patil, Erik Wambre, Brian P. Vickery
Oral immunotherapy (OIT) has reproducibly demonstrated successful desensitization in food-allergic subjects completing clinical trials and, in some studies, sustained unresponsiveness. These clinical outcomes have been associated with characteristic modifications in the allergen-specific immune response, but a detailed synthesis of OIT's mechanisms of action is lacking. In this Rostrum, we review the current evidence regarding the human immune response to OIT, explore possible mechanisms, and identify knowledge gaps for future research.
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A Propensity Matched Comparison for Open and Endovascular Treatment of Post-carotid Endarterectomy Restenosis
Publication date: Available online 26 December 2017
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Walter Dorigo, Aaron Fargion, Elena Giacomelli, Raffaele Pulli, Fabrizio Masciello, Sara Speziali, Giovanni Pratesi, Carlo Pratesi
ObjectivesTo compare results of open and endovascular management of post-carotid endarterectomy (CEA) restenosis.MethodsThis was a retrospective single centre matched case control study. From 2005 to 2015, 148 consecutive interventions for post-CEA restenosis were performed: 80 cases received carotid artery stenting (CAS) and 68 cases received redo CEA. Propensity score based matching was performed in a 1:1 ratio to compare outcomes. Coronary artery disease, degree of the carotid restenosis, timing of the re-intervention with respect to the primary intervention (greater or less than 24 months) and the presence of ipsilateral brain lesions were the covariates included in the matching. Peri-operative outcomes were analysed with χ2 tests, while late results were estimated by Kaplan–Meier methods.ResultsAfter propensity matching, 32 CAS interventions were matched with 32 redo CEAs. There were no peri-operative deaths or strokes. Cranial nerve palsy occurred in seven patients in the redo CEA group. Median duration of follow-up was 36 months (interquartile range 24–60; range 6–120). The estimated 5 year survival rate was 94% in the CAS group and 72% in the redo CEA group (p=.1, log rank 2.4). There were no significant differences between the groups in terms of stroke free survival. In the CAS group, no severe restenosis were found, while in the redo CEA group eight patients had severe restenosis or occlusion of the operated carotid artery. Freedom from secondary restenosis at 4 years was 100% in the CAS group and 72.5% in the redo CEA group (p=.005, log rank 7.9). The corresponding figures in terms of freedom from secondary re-intervention were 100% and 83%, respectively (p=.02, log rank 4.8).ConclusionsCAS and redo CEA in patients with post-CEA restenosis provided similar peri-operative results in a sample of equivalent patients. CAS patients had better follow-up results in terms of secondary restenosis and re-interventions. Further analysis is required with a larger number of patients and a longer follow-up time.
http://ift.tt/2CcFQhD
Short-term effects of electrical nerve stimulation on spinal reciprocal inhibition depend on gait phase during passive stepping
Source:Journal of Electromyography and Kinesiology
Author(s): Hiroki Obata, Tetsuya Ogawa, Matija Milosevic, Noritaka Kawashima, Kimitaka Nakazawa
A combination of electrical nerve stimulation (ENS) and passive or active cyclic movements (i.e., pedaling and stepping) has been suggested to induce stronger short-term effects in spinal circuits as compared to either intervention alone. The purpose of the present study is to determine whether the effects of ENS during passive stepping are dependent on the timing of the stimulation during the stepping cycle. A total of 10 able-bodied participants were recruited for the study. Two interventions were assessed during passive ground stepping: 1) ENS of the common peroneal nerve (CPN) during the swing phase (ENSswing) and 2) stance phase (ENSstance). ENS was applied at the motor threshold intensity on the tibialis anterior muscle for a total of 30 min. Spinal reciprocal inhibition (RI) was assessed by conditioning the H-reflex in the soleus muscle with electrical stimulation to the CPN before (baseline), as well as 5, 15, and 30 min after each intervention. Compared to the baseline, the amount of RI was increased 5 and 15 min after the ENSswing intervention, whereas it was decreased after the ENSstance intervention. This suggests that ENS has a phase-dependent effect on RI during passive stepping. Overall, the results imply that phase-dependent timing of ENS is essential for guiding plasticity in the spinal circuits.
http://ift.tt/2lcJ6yM
The effect of age and gender on the genetic regulation of serum 25-hydroxyvitamin D - the FIN-D2D Population-Based Study
Publication date: Available online 26 December 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Maija E Miettinen, Melissa C Smart, Leena Kinnunen, Sirkka Keinänen-Kiukaanniemi, Leena Moilanen, Hannu Puolijoki, Juha Saltevo, Heikki Oksa, Graham A. Hitman, Jaakko Tuomilehto, Markku Peltonen
In addition to sunlight and dietary sources, several genes in the metabolic pathway of vitamin D affect serum 25-hydroxyvitamin D (25OHD) concentration. It is not known whether this genetic regulation is influenced by host characteristics. We investigated the effect of age and gender on the genetic regulation of serum 25OHD concentration.In total, 2868 Finnish men and women aged 45-74 years participated in FIN-D2D population-based health survey in 2007. Of the 2822 participants that had serum 25OHD concentration available, 2757 were successfully genotyped. Age and gender-dependent association of SNPs with serum 25OHD concentration was studied in 10 SNPs with previously found association with vitamin D metabolites.Associations of 3 SNPs with serum 25OHD concentration were dependent on age with greater effects on younger (≤60 y) than older (>60y) adults (rs10783219 in VDR, rs12512631 in GC and rs3794060 in NADSYN1/DHCR7; pinteraction=0.03, 0.02 and 0.01, respectively). The results suggested a novel association between serum 25OHD concentration and rs8082391 in STAT5B gene in men but not in women (pinteraction=0.01). After multiple testing correction with false discovery rate method, two age-dependent interactions (rs3794060 in NADSYN1/DHCR7 gene and rs12512631 in GC gene) remained statistically significant.This is the first study to suggest that genetic regulation of serum 25OHD concentration is age-dependent. Our results also indicated a novel association between serum 25OHD concentration and SNP in STAT5B gene in men. The results need to be confirmed in future studies preferably in a larger sample.
http://ift.tt/2l1gNE5
The sinonasal microbiota, neural signaling, and depression in chronic rhinosinusitis
Background
The complex relationships between the human microbiota, the immune system, and the brain play important roles in both health and disease, and have been of increasing interest in the study of chronic inflammatory mucosal conditions. We hypothesized that the sinonasal microbiota may act as a modifier of interkingdom neural signaling and, subsequently, mental health, in the upper respiratory inflammatory condition chronic rhinosinusitis (CRS). In this study we investigated associations between the sinonasal microbiota; local concentrations of the neurotransmitters serotonin, dopamine, and γ-aminobutyric acid (GABA); and depression severity in a cohort of 14 CRS patients and 12 healthy controls.
Methods
Subject demographics, clinical severity scores, depression index scores, and sinonasal swab and mucus samples were collected at the time of surgery. Bacterial communities were characterized from swabs by 16S rRNA gene-targeted sequencing and quantified by quantitative polymerase chain reaction. Mucus concentrations of the neurotransmitters serotonin, dopamine, and GABA were quantified by enzyme-linked immunosorbent assay.
Results
Several commonly "health-associated" sinonasal bacterial taxa were positively associated with higher neurotransmitter concentrations and negatively associated with depression severity. In contrast, several taxa commonly associated with an imbalanced sinonasal microbiota negatively associated with neurotransmitters and positively with depression severity. Few significant differences were identified when comparing between control and CRS subject groups, including neurotransmitter concentrations, depression scores, or sinonasal microbiota composition or abundance.
Conclusion
The findings obtained lend support to the potential for downstream effects of the sinonasal microbiota on neural signaling and, subsequently, brain function and behavior.
http://ift.tt/2C8Qvau
Osteologic analysis of ethnic differences in supernumerary ethmoidal foramina: implications for endoscopic sinus and orbit surgery
Background
Knowledge of the position of the ethmoidal arteries is critical to enable safe endoscopic sinus and orbital surgery. The presence of a third or "middle" ethmoid variant has recently become more relevant as endoscopic intraconal surgery continues to advance. The purpose of this study was to quantify the presence of supernumerary (ie, over 2) ethmoid foramina in different ethnicities and genders.
Methods
Morphometric osteologic measurements were performed in 273 orbits. Prevalence of supernumerary ethmoid foramina and orbital length data were obtained from human skulls of Asian (n = 54), Caucasian (n = 70), African (n = 39), Hispanic (n = 49), and Middle Eastern (n = 61) derivation. Correlations between gender, ethnicity, symmetry, orbital floor, and lamina papyracea length were assessed by analysis of variance, paired t test, and χ2 test.
Results
Supernumerary foramina were identified in 95 of 273 orbits (34.79%). A significantly higher prevalence was seen in Asian (42.59%), African (41.02%), and Hispanic (41.00%) skulls as compared with Caucasian (25.71%) and Middle Eastern (22.95%) skulls (p < 0.05 for all). The length of the orbital floor was significantly shorter in the Asian (3.35 ± 1.52 cm) specimens (p < 0.01). Asians were found to have the highest risk of ethmoid artery injury compared with the other ethnic groups (ratio of number of supernumerary foramina to orbital floor length = 0.72).
Conclusion
Supernumerary ethmoidal foramina were common among all orbits studied. Orbits of Asian and African derivation had significantly greater numbers of ethmoidal foramina, both unilaterally and symmetrically and within a shorter orbital length, suggesting a greater proximity between the ethmoidal vessels. Surgeons should be alert to the possible presence of middle ethmoidal vessels during endoscopic sinus and orbital approaches.
http://ift.tt/2lcfPEm
A case of radiation-induced bullous morphea/lichen sclerosus overlap in a breast cancer patient
Source:Reports of Practical Oncology & Radiotherapy, Volume 23, Issue 1
Author(s): Erik Petersen, Laila Yazdani, Sharon R. Hymes
Radiation induced morphea (RIM) is an increasingly common complication of radiation treatment for malignancy as early detection has made more patients eligible for non-surgical treatment options. In many cases, the radiation oncologist is the first person to learn of the initial skin changes, often months before a dermatologist sees them. In this paper we present a breast cancer patient who developed a rare bullous variant of RIM, which delayed her diagnosis and subsequent treatment. It is imperative to diagnose RIM early as it carries significant morbidity and permanent deformity if left untreated. The lesions typically present within 1 year of radiation therapy and extend beyond the radiated field. RIM is often mistaken for radiation dermatitis or cellulitis. Bullae, when present, are often hemorrhagic in appearance, which can serve as another clinical clue. It is important to refer these patients for a full gynecologic exam as there can be concurrent anogenital lichen sclerosus et atrophicus which is both debilitating and carries a long term risk for squamous cell carcinoma. Treatment with systemic agents is often necessary, and can be managed by a dermatologist. The most proven regimen in the literature appears to be methotrexate, with our without concurrent narrow band UVB phototherapy.
http://ift.tt/2l1Jh0D
Isolated unilateral adrenal gland hemorrhage following motor vehicle collision: a case report and review of the literature
Adrenal gland trauma is a rare condition that typically stems from blunt force trauma, and is associated with multiple organ injuries. Alternatively, isolated adrenal gland trauma is extremely rare, accounting...
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Poly (ethylene-co-vinyl alcohol) is a suitable substrate for human olfactory neuroepithelial cell differentiation in vitro through a defined regulatory pathway
Publication date: Available online 26 December 2017
Source:Acta Biomaterialia
Author(s): Sheng-Tien Li, Tai-Horng Young, Tsung-Wei Huang
Olfactory dysfunction significantly influences patients' life quality, but currently has no adequate treatment. Poly (ethylene-co-vinyl alcohol) (EVAL) mediates cell adhesion, growth and modulates differentiation of neural stem cells. However, whether EVAL is a suitable substrate to establish an in vitro culture system that can promote development and differentiation of human olfactory neuroepithelial cells (HONCs) remains unexplored. This study isolates and cultures HONCs on controls and EVAL films for 21 days. The effects of treatment are assessed using immunocytochemistry, microarray analysis, quantitative PCR, ELISA and western blots following culturing. Most of the cell morphology on controls is epithelial and expresses markers of sustatencular cells (SCs), cadherin-1 and cytokeratin18, whereas the main population on EVAL presents as morphology with extended thin processes and possesses markers of mature olfactory sensory neurons (OSNs), olfactory marker protein (OMP). Microarray analyses reveal neuropeptide Y (NPY) and amphiregulin (AREG) are the two important regulating factors on EVAL films. HONCs cultured on EVAL films enhance the development of mature OSNs through NPY signaling, and significantly decrease the growth of SCs by blocking epidermal growth factor receptor (EGFR) activation. EVAL is a potential biomaterial to serve as an ideal substrate for treating olfactory dysfunction in the future.Statement of significanceOlfaction not only contributes to enjoyments of food, but provides a clue to escape from dangerous environmental hazards. However, loss of smell is commonly progressive and there is no good prognostic approach for olfactory dysfunction. Here, we use poly (ethylene-co-vinyl alcohol) (EVAL) to establish an in vitro culture system that promotes development and differentiation of human olfactory neuroepithelial cells. We show that EVAL not only enhances the development of mature olfactory sensory neurons through neuronpeptide Y signaling, but significantly protects the olfactory neuroepithelium from metaplasia by inhibiting EGFR activation. Therefore, EVAL is a potential biomaterial to serve as an ideal substrate for treating olfactory dysfunction in the future.
Graphical abstract
http://ift.tt/2BHfDE0
A novel lateral flow immunoassay for the rapid detection of anti-Dsg3 IgG serum autoantibodies in pemphigus vulgaris
Abstract
Pemphigus vulgaris (PV) is a severe autoimmune blistering disease of the skin and mucous membranes. As autoantibodies play an essential role in the disease pathogenesis, the serological detection of anti-desmoglein 3 IgG represents a central tool in the diagnosis of the disease. In this study, we show the validation of a novel lateral flow immunoassay (LFIA) which rapidly detects anti-desmoglein 3 (Dsg3) IgG in human serum. In contrast to other diagnostic procedures, the assay is compact and simple to perform and delivers a fast "yes" or "no" answer within 10 min without additional hardware requirements for test evaluation. For validation a blinded collection of 200 sera including 100 sera from 14 PV patients, 75 sera from 24 bullous pemphigoid patients, and 25 sera from 6 patients with pemphigus foliaceus collected at different time points during disease was used. Presence or non-presence of anti-Dsg3 IgG within sera was confirmed using a commercially available Dsg3-ELISA. For qualitative evaluation Dsg3-LFIA test results were assessed by two independent groups of human observers. Furthermore quantitative evaluation using POCScan reader was applied. The Dsg3-LFIA demonstrated reliable test results with a sensitivity and specificity of 78.1% and 97.1%, respectively. Test results from POCScan and human observers showed a substantial agreement. The Dsg3-LFIA represents a new diagnostic tool for the immediate and reliable detection of anti-desmoglein 3 serum IgG autoantibodies that does not require additional hardware. Further prospective trials are warranted to validate the Dsg3 LFIA in pemphigus.
This article is protected by copyright. All rights reserved.
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Chemoradiation vs Immunotherapy and Radiation for Head and Neck Cancer
Condition: Head and Neck Squamous Cell Carcinoma
Interventions: Drug: Pembrolizumab; Radiation: Radiation therapy; Drug: Cisplatin
Sponsors: Loren Mell, MD; Merck Sharp & Dohme Corp.
Not yet recruiting
http://ift.tt/2CaA53C
Interventions: Drug: Pembrolizumab; Radiation: Radiation therapy; Drug: Cisplatin
Sponsors: Loren Mell, MD; Merck Sharp & Dohme Corp.
Not yet recruiting
http://ift.tt/2CaA53C
Corrigendum to “Projections from the lowest lumbar and sacral-caudal segments to the cerebellar cortex in the rat: An anterograde tracing study” [Neurosci. Res. 114 (January) (2017) 43–54]
Source:Neuroscience Research
Author(s): Matsuo Matsushita
http://ift.tt/2pwQ9Yu
The Potential Therapeutic Effects of Ergothioneine in Pre-eclampsia
Publication date: Available online 25 December 2017
Source:Free Radical Biology and Medicine
Author(s): Robert N. Kerley, Cathal McCarthy, Douglas B. Kell, Louise C. Kenny
Ergothioneine (ERG), is a water-soluble amino acid that is derived entirely from dietary sources. It has received much attention as a therapeutic agent due to its anti-oxidant properties, and there are claims of preferential accumulation within high oxidative stress organs. Pre-eclampsia, a condition accompanied by increased oxidative stress, is one of the leading causes of maternal morbidity and mortality. Despite intense research efforts, its aetiologies remain somewhat unclear and there are still no effective treatment options. Clinical trials of the anti-oxidants vitamin C and vitamin E have proven largely ineffective with little improvement in clinical outcome or even a negative response. This could be explained in part by their inability to permeate the plasma and mitochondrial membranes and scavenge mitochondria-derived superoxide species, and for the former by the fact that it is actually a pro-oxidant in the presence of unliganded iron. ERG accumulates within tissues through the action of a specific organic cation transporter, SLC22A4 (previously referred to as OCTN1), which is possibly also expressed in mammalian mitochondria. Mitochondrial dysfunction has been implicated in a variety of vascular diseases including pre-eclampsia. This review discusses the use of ERG as a possibly mitochondrial-targeted anti-oxidant, focusing on its physical properties, potential mechanisms of action, safety profile and administration in relation to pregnancies complicated by pre-eclampsia.
Graphical abstract
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An insertion mutation in HOXC13 underlies pure hair and nail ectodermal dysplasia with lacrimal duct obstruction
Abstract
Pure hair and nail ectodermal dysplasia (PHNED; MIM 602032, 614929, and 614931) is an autosomal recessive ED that is characterized by hypotrichosis and nail dystrophy only, without further ectodermal or non-ectodermal alterations. To date, homozygous mutations in three genes have been reported to cause PHNED: KRT85 (MIM 602767), encoding keratin, type II cuticular Hb5 like; KRT74 (MIM 608248), encoding keratin, type II cytoskeletal 74; and HOXC13 (MIM 142976), encoding Homeobox C13. Here, we studied the genetic basis of PHNED in an Iranian kindred, displaying double consanguinity (Fig. 1a-g).
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Response to: ‘Human orf complicated by epidermolysis acquisita’
Abstract
Dear editor, we read with great interest the article 'Human orf complicated by epidermolysis bullosa acquisita' by Zeulgaray and colleagues.1 Recently, a Moroccan patient who contracted orf (fig. 1a) after slaughtering a sheep during Eid Al-Adha was admitted to our hospital and developed a similar pruritic vesiculobullous eruption predominantly on the hands and forearms (fig. 1b). Hematoxylin and eosin staining of punch biopsies from areas of the vesicullobullous eruption showed spongiotic dermatitis with eosinophilia, most consistent with an id reaction.
This article is protected by copyright. All rights reserved.
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Aberrant DNA methylation is associated with aggressive clinicopathological features and poor survival in cutaneous melanoma
Abstract
Background
Promoter methylation of tumor suppressor genes (TSGs) has recently been implicated in the pathogenesis of several types of cancer. Regarding melanoma, over a hundred genes that contribute to its pathogenesis have been identified to be aberrantly hypermethylated. This is a retrospective observational study that aims to analyze the prevalence of CpG island methylation in a series of primary melanoma, to identify the associations with the main clinicopathological features, and to explore the prognostic significance of methylation in melanoma survival.
Materials and Methods
DNA methylation was analyzed using methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) in a series of 170 melanoma formalin-fixed paraffin embedded (FFPE) tumor samples. The relationship between the methylation status, known somatic mutations and clinicopathological features was evaluated. Disease-free survival (DFS) and overall survival (OS) were displayed by the Kaplan-Meier method.
Results
In the entire cohort, one or more genes were detected to be methylated in 55% of the patients. The most prevalent methylated genes were RARB 31%, PTEN 24%, APC 16%, CDH13 16%, ESR1 14%, CDKN2A 6%, and RASSF1 5%. An association between aberrant methylation and aggressive clinicopathological features was observed (older age, increased Breslow, presence of mitosis and ulceration, fast-growing melanomas, advancing stage, and TERT mutations). Furthermore, Kaplan-Meier survival analysis showed a correlation of methylation and poorer DFS and overall survival OS.
Conclusions
Aberrant methylation of TSGs is a frequent event in melanoma. It is associated to aggressive clinicopathological features and poorer survival. Epigenetic alterations may represent a significant prognostic marker with utility in routine practice.
This article is protected by copyright. All rights reserved.
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A possible association between BP230-type bullous pemphigoid and dementia: report of two elderly cases
Bullous pemphigoid (BP) is the most common autoimmune blistering disease, and it features itchy oedematous erythemas and tense bullae on the whole body most commonly in the elderly. BP180 is the most common autoantigens of BP, and BP230 is the only target of autoantibodies in approximately 8% of patients with BP1. It has been reported that elderly patients with BP sometimes have comorbidities associated with neurological disease (ND) including dementia2. BP antigens and their isoforms can be identified in skin as well as in neuronal tissues, suggesting that exposure of the neuronal antigen may lead to an immune reaction against the epithelial isoform3. Here, we describe two elderly cases of BP with dementia in which the autoantibodies reacted to BP230 but not to BP180 (BP230-BP).
This article is protected by copyright. All rights reserved.
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Point mutation in p14ARF-specific exon 1β of CDKN2A causing familial melanoma and astrocytoma
Abstract
Rarely, melanoma is dominantly inherited, with CDKN2A mutations accounting for >85% of mutation-positive families (1). CDKN2A encodes two, non-homologous proteins, p16 and p14ARF, with individually unique first exons (1α and 1β, respectively) and alternative reading frames. Over 95% of the CDKN2A mutations in familial melanoma occur in the p16 transcript (1).
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Magnetoencephalography shows atypical sensitivity to linguistic sound sequences in autism spectrum disorder.
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Magnetoencephalography shows atypical sensitivity to linguistic sound sequences in autism spectrum disorder.
Neuroreport. 2016 Sep 07;27(13):982-6
Authors: Brennan JR, Wagley N, Kovelman I, Bowyer SM, Richard AE, Lajiness-O'Neill R
Abstract
Neuroscientific evidence points toward atypical auditory processing in individuals with autism spectrum disorders (ASD), and yet, the consequences of this for receptive language remain unclear. Using magnetoencephalography and a passive listening task, we test for cascading effects on speech sound processing. Children with ASD and age-matched control participants (8-12 years old) listened to nonce linguistic stimuli that either did or did not conform to the phonological rules that govern consonant sequences in English (e.g. legal 'vimp' vs. illegal 'vimk'). Beamformer source analysis was used to isolate evoked responses (0.1-30 Hz) to these stimuli in the left and the right auditory cortex. Right auditory responses from participants with ASD, but not control participants, showed an attenuated response to illegal sequences relative to legal sequences that emerged around 330 ms after the onset of the critical phoneme. These results suggest that phonological processing is impacted in ASD, perhaps because of cascading effects from disrupted initial acoustic processing.
PMID: 27468112 [PubMed - indexed for MEDLINE]
http://ift.tt/2DfXXQD
Postoperative mortality and morbidity following non-cardiac surgery in a healthy patient population
Abstract
Purpose
Perioperative mortality ranges from 0.4% to as high as nearly 12%. Currently, there are no large-scale studies looking specifically at the healthy surgical population alone. The primary objective of this study was to report 30-day mortality and morbidity in healthy patients and define any risk factors.
Methods
Using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) dataset, all patients assigned an American Society of Anesthesiologists physical status (ASA PS) classification score of 1 or 2 were included. Further patients were excluded if they had a comorbidity or underwent a procedure not likely to classify them as ASA PS 1 or 2. Multivariable logistic regression was performed to identify predictors of the outcomes, in which odds ratios (OR) and 95% confidence intervals (95% CI) were reported.
Results
There were 687,552 healthy patients included in the final analysis. Following surgery, 0.7, 7.0, and 0.7 per 1000 persons experienced 30-day mortality, sepsis, and stroke or myocardial infarction, respectively. Healthy patients greater than 80 years of age had the highest odds for mortality (OR 17.7, 95% CI 12.4–25.1, p < 0.001). Case duration was associated with increased mortality, especially in cases greater than or equal to 6 h (OR 3.0, 95% CI 2.0–4.5, p < 0.001).
Conclusions
Thirty-day mortality and morbidity is, as expected, lower in the healthy surgical population. Age may be an indication to further risk stratify patients that are ASA PS 1 or 2 to better reflect perioperative risk.
http://ift.tt/2De9wYn
Variation in loss of immunity shapes influenza epidemics and the impact of vaccination.
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Variation in loss of immunity shapes influenza epidemics and the impact of vaccination.
BMC Infect Dis. 2017 Sep 19;17(1):632
Authors: Woolthuis RG, Wallinga J, van Boven M
Abstract
BACKGROUND: Protective antibody immunity against the influenza A virus wanes in 2-7 years due to antigenic drift of the virus' surface proteins. The duration of immune protection is highly variable because antigenic evolution of the virus is irregular. Currently, the variable nature of the duration of immunity has had little attention in analyses of the impact of vaccination, including cost-effectiveness studies.
METHODS: We developed a range of mathematical transmission models to investigate the effect of variable duration of immunity on the size of seasonal epidemics. The models range from simple conceptual to more realistic, by distinguishing between infection- versus vaccination-induced immunity, by inclusion of primary vaccine failure, by assuming a leaky vaccine, and by the inclusion of age-dependent contact patterns.
RESULTS: We show that annual variation in the duration of immunity causes large variation in the size of epidemics, and affects the effectiveness of vaccination. Accumulation of susceptible individuals in one or more mild seasons results in a disproportionately large outbreak in a subsequent season. Importantly, variation in the duration of immunity increases the average infection attack rate when the vaccination coverage is around the outbreak threshold. Specifically, in a tailored age-stratified model with a realistic reproduction number (R 0 = 1.4) and vaccination coverage of 25%, we find that the attack rate in unvaccinated children (<10 years old) is negligible if the duration of immunity is constant, while on average 2.8% (2.5-97.5% percentiles: 1.8-4.1%) of the children are infected if the duration of immunity is variable. These findings stem from the buildup of susceptibility over multiple seasons by waning of immunity, and the nonlinear relation between susceptibility and infection attack rates.
CONCLUSIONS: The models illustrate that variation in the duration of immunity impacts the long-term effectiveness of vaccination, and that vaccine effectiveness cannot be judged for each year in isolation. Our findings have implications for vaccination strategies that aim to maximize the vaccination coverage while extending the age range of persons eligible for vaccination.
PMID: 28927373 [PubMed - indexed for MEDLINE]
http://ift.tt/2l2qa6P
Editor's Perspectives - December 2017.
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Editor's Perspectives - December 2017.
Int J Surg. 2017 Dec;48:305-306
Authors: Lau JWY
PMID: 29275800 [PubMed - in process]
http://ift.tt/2Dfmsxj
Patient-reported experiences on supportive care strategies following the introduction of the first Swedish national cancer strategy and in accordance with the new patient act.
Patient-reported experiences on supportive care strategies following the introduction of the first Swedish national cancer strategy and in accordance with the new patient act.
Acta Oncol. 2017 Dec 25;:1-11
Authors: Westman B, Kirkpatrick L, Ebrahim F, Henriksson R, Sharp L
Abstract
INTRODUCTION: Several supportive care strategies are described in Swedish legislation and policy documents, such as the National Cancer Strategy and the Patient act. No previous systematic evaluation from a patient perspective has been performed. The aim of this study was to evaluate how these supportive care strategies are experienced by patients treated for cancer in the Stockholm-Gotland region.
MATERIAL AND METHODS: In this cross-sectional study, we identified patients (diagnosed with gynaecological, haematological, upper gastrointestinal and head and neck cancer during 2014) from the Swedish Cancer Register. The European Organization of Research and Treatment of Cancer, EORTC, Quality of Life Questionnaires, QLQ-C30, Information QLQ-INFO25 and a study-specific questionnaire was used to collect data during follow-up after cancer treatment. We collected data on 869 cancer patients' perception of availability and access to supportive care strategies and how they were experienced.
RESULTS: Among the supportive care strategies suggested in the legislation and policy documents, just over half of the patients (n = 393, 53%) reported that they had access to a contact nurse, while 43% (n = 312) had received an individual written care plan and 16% (n= 137) had been referred to palliative care. Only 29% (n = 218) of the patients reported that they had received information about patient advocacy groups and 8% (n= 62) on medical second opinions from their cancer care team.
DISCUSSION: The supportive care strategies suggested in Swedish legislation and policy documents may be useful but are only available for some patients. The implementation goals for the National Cancer Strategy and the Swedish Patient act have not been reached.
PMID: 29276836 [PubMed - as supplied by publisher]
http://ift.tt/2zxjYI8
Recurrent post-tonsillectomy bleeding due to an iatrogenic facial artery pseudoaneurysm.
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Recurrent post-tonsillectomy bleeding due to an iatrogenic facial artery pseudoaneurysm.
Acta Otolaryngol Case Rep. 2017;2(1):103-106
Authors: Choi KJ, Cheng T, Cobb MI, Sajisevi MB, Gonzalez LF, Ryan MA
Abstract
This is a report of an illustrative case of recurrent post-tonsillectomy bleeding that was caused by an iatrogenic facial artery pseudoaneurysm and controlled by endovascular embolization. A 37 year-old female who underwent bilateral tonsillectomy for chronic tonsillitis had recurrent secondary hemorrhage despite multiple operative interventions to control the bleeding. Because of the recurrent nature of the bleeding, an angiography of the external carotid artery was performed demonstrating a pseudoaneurysm of the left facial artery with active extravasation. This was successfully embolized with ethylene vinyl alcohol copolymer and the bleeding did not recur. Most post-operative bleeds can be managed with bedside or intraoperative interventions. However, pseudoaneurysms should be considered in the differential diagnosis of recurrent bleeds refractory to surgical control.
PMID: 29276771 [PubMed]
http://ift.tt/2BSJJsw
Pyridostigmine for the Reversal of Severe Adverse Reactions to Botulinum Toxin in Children.
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Pyridostigmine for the Reversal of Severe Adverse Reactions to Botulinum Toxin in Children.
J Pediatr. 2017 Dec 22;:
Authors: Boerner RM, Young DL, Gnagi SH, White DR, Halstead LA
Abstract
Therapeutic botulinum toxin injections are commonly performed in pediatric otolaryngology. Aerodigestive complications from botulinum toxin injections, although rare, may be serious. Oral pyridostigmine is effective in the symptomatic treatment of these complications. We report 2 cases of aerodigestive complications arising from injection of botulinum toxin that were successfully treated with pyridostigmine.
PMID: 29275924 [PubMed - as supplied by publisher]
http://ift.tt/2BS7r89
[Advances in the management of cervical lymphadenopathies of unknown primary; advances in diagnostic imaging and surgical modalities and new international staging system].
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[Advances in the management of cervical lymphadenopathies of unknown primary; advances in diagnostic imaging and surgical modalities and new international staging system].
Bull Cancer. 2017 Dec 21;:
Authors: Troussier I, Klausner G, Morinière S, Blais E, Jean-Christophe Faivre, Champion A, Geoffrois L, Pflumio C, Babin E, Maingon P, Thariat J
Abstract
INTRODUCTION: Cervical lymphadenopathies of unknown primary represent 3 % of head and neck cancers. Their diagnostic work up has largely changed in recent years. This review provides an update on diagnostic developments and their potential therapeutic impact.
MATERIALS AND METHODS: This is a systematic review of the literature.
RESULTS: In recent years, changes in epidemiology-based prognostic factors such as human papilloma virus (HPV) cancers, advances in imaging and minimally invasive surgery have been integrated in the management of cervical lymphadenopathies of unknown primary. In particular, systematic use of PET scanner and increasing practice of robotic or laser surgery have contributed to increasing detection rate of primary cancers. These allow more adapted and personalized treatments. The impact of changes in the eighth TNM staging system is discussed.
CONCLUSION: The management of cervical lymphadenopathies of unknown primary cancer has changed significantly in the last 10 years. On the other hand, practice changes will have to be assessed.
PMID: 29275831 [PubMed - as supplied by publisher]
http://ift.tt/2BRXgAs
[Epidemiological investigation on 2 133 hospitalized patients with electrical burns].
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[Epidemiological investigation on 2 133 hospitalized patients with electrical burns].
Zhonghua Shao Shang Za Zhi. 2017 Dec 20;33(12):732-737
Authors: Jiang MJ, Li Z, Xie WG
Abstract
Objective: To analyze the epidemiological characteristics of the hospitalized patients with electrical burns in Institute of Burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital (hereinafter referred to as Institute of Burns of Wuhan Third Hospital), so as to provide reference for the prevention and treatment of electrical burns. Methods: Medical records of all hospitalized burn patients in Institute of Burns of Wuhan Third Hospital from January 2004 to December 2016 were collected. Genders, ages, social categories, seasons of injury, total burn areas, depths of wounds, electrical voltages of injury, sites of wound, treatment methods, amputation rates, lengths of hospital stay, operation costs, hospitalization costs, and treatment outcomes of the electrical burn patients were collected. Treatment methods, lengths of hospital stay, operation costs, and hospitalization costs of the thermal burn patients were collected and compared with those of the electrical burn patients. Electrical voltages of injury, amputation rates, operation costs, hospitalization costs, and treatment outcomes were compared and analyzed between the electrical contact burn patients and the electrical arc burn patients. Data were processed with Chi-square test and Wilcoxon rank-sum test. Results: During the 13 years, 23 534 burn patients were admitted to Institute of Burns of Wuhan Third Hospital, among whom 2 133 (9.1%) were with electrical burns, without obvious variation in admission number of electrical burn patients every year. There were 1 418 patients (66.5%) with electrical contact burns and 715 patients (33.5%) with electrical arc burns. The ratio of male to female was 11.2∶1.0 among the electrical burn patients with known genders. The proportions of three age groups of more than 20 years old and less than or equal to 30 years old, more than 30 years old and less than or equal to 40 years old, and more than 40 years old and less than or equal to 50 years old were relatively higher, which were 18.3% (391/2 133), 22.1% (471/2 133), and 24.6% (525/2 133), respectively. The first three social category groups in proportions were workers, peasants, and preschool children, which were 57.9% (1 235/2 133), 14.6% (311/2 133), and 6.0% (128/2 133), respectively. Among the electrical burn patients with known seasons of injury, most cases were injured in summer (659 cases, accounting for 34.1%), obviously more than the proportions in autumn (537 cases, accounting for 27.8%), spring (455 cases, accounting for 23.5%), and winter (283 cases, accounting for 14.6%), with χ(2) values from 8.414 to 149.573, P values below 0.01. The group of patients with total burn areas less than 10% total body surface area (TBSA) occupied the highest proportion (1 603 cases, accounting for 75.15%), among whom 229 (10.74%) were with scattered small wounds which were less than 1% TBSA. The percentage of electrical contact burn patients with deep wounds was 79.1% (1 122/1 418), which was obviously higher than 2.5% (18/715) of the electrical arc burn patients (χ(2)=381.741, P<0.001). Among the patients with known electrical voltages of injury, patients injured by high voltage among the electrical contact burn patients accounted for 78.4% (469/598), which was obviously higher than 8.7% (11/127) of the electrical arc burn patients (χ(2)=227.893, P<0.001). The most common wound site of the electrical burn patients was upper limbs (1 650 cases, accounting for 63.2%), followed by lower limbs (382 cases, accounting for 14.6%), head and neck (292 cases, accounting for 11.2%), trunk (247 cases, accounting for 9.5%), and hip and perineum (40 cases, accounting for 1.5%). The operation rate of electrical burn patients was 32.4% (691/2 133), obviously higher than 19.1% (3 860/20 209)of the thermal burn patients during the same period (χ(2)=210.255, P<0.001). Wounds of 116 electrical contact burn patients were repaired with free flap by vascular anastomosis, of which 9 (7.8%) failed. The length of hospital stay, the operation cost, and the hospitalization cost of electrical burn patients were (28±29) d, (9 534±16 935) and (44 258±93 012) Yuan, respectively, obviously longer or higher than those of the thermal burn patients during the same period [(17±19) d, (2 990±8 916) and (23 291±88 340) Yuan, respectively, with Z values from -21.323 to -10.996, P values below 0.001]. The amputation rate and the death rate of electrical burn patients were 3.8% (82/2 133) and 0.8% (16/2 133) respectively. Compared with those of electrical arc burn patients, the amputation rate and the operation cost of electrical contact burn patients were obviously higher (χ(2)=36.970, Z=-11.351, P values below 0.001), and the length of hospital stay of electrical contact burn patients was obviously longer (Z=-5.181, P<0.001). There were no significant differences in hospitalization cost and treatment outcome between the electrical contact burn patients and the electrical arc burn patients (Z=-1.461, χ(2)=1.673, P values above 0.05). Conclusions: The number and the proportion of hospitalized electrical burn patients in Institute of Burns of Wuhan Third Hospital were relatively high, indicating a hard task of prevention for electrical burns in Wuhan area. Working-age workers and farmers, and preschool children were the key groups in prevention from electrical burns. The length of hospital stay, the operation cost, and the hospitalization cost of electrical burn patients were obviously higher than those of thermal burn patients. The amputation rate and the operation cost of electrical contact burn patients were obviously higher than those of electrical arc burn patients, but there were no obvious differences in hospitalization cost or treatment outcome between them. Actively using tissue flaps including free flap to repair of wounds may be helpful to reduce the amputation rate, improve the results, and shorten the time of treatment.
PMID: 29275613 [PubMed - in process]
http://ift.tt/2BSdREp
[Expression of integrin αvβ3, CXC chemokine receptor 4 and CXC chemokine receptor 7 and their relationship with lymph node metastasis in squamous cell carcinoma of head and neck].
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[Expression of integrin αvβ3, CXC chemokine receptor 4 and CXC chemokine receptor 7 and their relationship with lymph node metastasis in squamous cell carcinoma of head and neck].
Zhonghua Kou Qiang Yi Xue Za Zhi. 2017 Dec 09;52(12):723-729
Authors: Li P, Li WL, Qi JX
Abstract
Objective: To investigate the expression of integrin αvβ3, CXC chemokine receptor (CXCR)4 and CXCR7 and their relationship with lymph node metastasis in squamous cell carcinoma of head and neck (SCCHN). Methods: The expression of integrin αvβ3, CXCR4 and CXCR7 was detected by immunohistochemistry SABC in 92 cases of primary SCCHN, metastatic lymph node, normal oral mucosa tissues and normal lymph nodes. Results: The positive rate of the expression of integrin αvβ3, CXCR4 and CXCR7 was 75% (69/92), 81%(75/92) and 76%(70/92), respectively in primary SCCHN, and was 82%(75/92), 76%(70/92) and 65%(60/92), respectively in metastatic lymph node. The expression of integrin αvβ3 and CXCR4 in primary SCCHN (r=0.813, P<0.05) and lymph node metastasis (r=0.541, P<0.05) was positively correlated. Integrin αvβ3 and CXCR7 expression in primary SCCHN (r=0.683, P<0.05) and lymph node metastasis (r=0.708, P<0.05) was positively correlated. CXCR4 and CXCR7 expression in primary SCCHN (r=0.644, P<0.05) and lymph node metastasis (r=0.707, P<0.05) had a positive correlation. The expression level was associated with tumor size (P=0.040, 0.001, 0.009), lymph node metastasis (P=0.001, 0.000, 0.000) and surrounding tissue invasion (P=0.046, 0.002, 0.001), but not related to age (P=0.097, 0.274, 0.162), gender (P=0.103, 0.309, 0.187). Conclusions: The overexpression of integrin αvβ3, CXCR4 and CXCR7 in primary head and neck squamous carcinoma and metastatic lymph nodes was related to lymph node metastasis. The co-expression of integrin αvβ3, CXCR4 and CXCR7 may play a synergistic role in lymphatic metastasis of SCCHN.
PMID: 29275565 [PubMed - in process]
http://ift.tt/2C7kFuy
Antibiotic Prophylaxis in Endoscopic Endonasal Pituitary and Skull Base Surgery.
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Antibiotic Prophylaxis in Endoscopic Endonasal Pituitary and Skull Base Surgery.
World Neurosurg. 2017 Oct;106:912-918
Authors: Milanese L, Zoli M, Sollini G, Martone C, Zenesini C, Sturiale C, Farneti P, Frank G, Pasquini E, Mazzatenta D
Abstract
OBJECTIVE: Postoperative infection is a potentially dramatic consequence in endoscopic endonasal surgery. The aim of this study was to assess the efficacy of our intraoperative antibiotic prophylaxis by analyzing the risk factors of postoperative meningitis in our series.
METHODS: Each endoscopic endonasal procedure performed since 1998 in patients with no preoperative infections and a follow-up longer than 30 days were included and retrospectively reviewed. Antibiotic protocol consisted in single antibiotic administration of ampicillin/sulbactam 3 g or cefazolin 2 g on induction; no postoperative administrations were performed after 2005. All cases of cerebrospinal fluid (CSF) leak, meningitis, and systemic infection were recorded.
RESULTS: Two thousand thirty-two procedures matched the inclusion criteria (median age 50 years; range: 1-89 years, male/female ratio: 1:1.12). Intraoperative CSF leak occurred in 32.8% of the cases and postoperative CSF leak in 3.4%. The rate of meningitis was 0.69%; other systemic infections were observed in 0.44% of cases. Meningitis was statistically associated with intra- and postoperative CSF leak (P < 0.001). Other risk factors were the intradural extension of the tumors and their malignant histology. Extended approaches producing wide osteodural defects were correlated with a greater risk of meningitis (P < 0.001).
CONCLUSIONS: All surgical maneuvers to prevent, detect, and quickly repair intra- and postoperative CSF leak are crucial to avoid postoperative meningitis. The proposed prophylaxis protocol is comparable in safety to those recommended in literature as assessed by the low rate of meningitis.
PMID: 28736350 [PubMed - indexed for MEDLINE]
http://ift.tt/2tySX54
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