Head and Neck Diseases by Alexandros G.Sfakianakis: 07/18/18

Τετάρτη 18 Ιουλίου 2018

Chronic laryngopharyngeal vagal neuropathy

Michael S. Benninger, Andrea Campagnolo
Braz J Otorhinolaryngol.2018;84:401-3

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Comparison of the recovery rate of otomycosis using betadine and clotrimazole topical treatment

Mohammad Reza Mofatteh, Zahra Naseripour Yazdi, Masoud Yousefi, Mohammad Hasan Namaei
Braz J Otorhinolaryngol.2018;84:404-9

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Body mass index and acoustic voice parameters: is there a relationship?

Lourdes Bernadete Rocha de Souza, Marquiony Marques dos Santos
Braz J Otorhinolaryngol.2018;84:410-5

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Free tissue flaps in head and neck reconstruction: clinical application and analysis of 93 patients of a single institution

Jiwang Liang, Tao Yu, Xu Wang, Yuejiao Zhao, Fengqin Fang, Wei Zeng, Zhendong Li
Braz J Otorhinolaryngol.2018;84:416-25

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Outcomes of external septorhinoplasty in a Turkish male population

Gamze Didem Kilci, Engin Başer, Ayşegül Verim, Ömer Faruk Çalim, Bayram Veyseller, Orhan Özturan, Ahmet Altintaş, Mustafa Çelik
Braz J Otorhinolaryngol.2018;84:426-34

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Turkish validity and reliability of Eustachian tube dysfunction questionnaire‐7

Erdoğan Özgür, Cem Bilgen, Beyhan Cengiz Özyurt
Braz J Otorhinolaryngol.2018;84:435-40

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Evaluating the ototoxicity of an anti‐MRSA peptide KR‐12‐a2

Chung Man Sung, Hong Chan Kim, Yong Beom Cho, Song Yub Shin, Chul Ho Jang
Braz J Otorhinolaryngol.2018;84:441-7

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Influence of chronic lymphocytic thyroiditis on the risk of persistent and recurrent disease in patients with papillary thyroid carcinoma and elevated antithyroglobulin antibodies after initial therapy

Marina Carvalho S. Côrtes, Pedro Weslley Rosario, Gabriela Franco Mourão, Maria Regina Calsolari
Braz J Otorhinolaryngol.2018;84:448-52

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25 (OH) D3 levels, incidence and recurrence of different clinical forms of benign paroxysmal positional vertigo

Sinisa Maslovara, Silva Butkovic Soldo, Anamarija Sestak, Katarina Milinkovic, Jasna Rogic‐Namacinski, Anamarija Soldo
Braz J Otorhinolaryngol.2018;84:453-9

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Performance of the phonatory deviation diagram in the evaluation of rough and breathy synthesized voices

Leonardo Wanderley Lopes, Jonas Almeida de Freitas, Anna Alice Almeida, Priscila Oliveira Costa Silva, Giorvan Ânderson dos Santos Alves
Braz J Otorhinolaryngol.2018;84:460-72

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IRF6 rs2235375 single nucleotide polymorphism is associated with isolated non‐syndromic cleft palate but not with cleft lip with or without palate in South Indian population

Venkatesh Babu Gurramkonda, Altaf Hussain Syed, Jyotsna Murthy, Bhaskar V.K.S. Lakkakula
Braz J Otorhinolaryngol.2018;84:473-7

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Short‐term evaluation of tegumentary changes of the nose in oral breathers undergoing rapid maxillary expansion

Fauze Ramez Badreddine, Reginaldo Raimundo Fujita, Mario Cappellette
Braz J Otorhinolaryngol.2018;84:478-85

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Anthropometric study of the caucasian nose in the city of Curitiba: relevance of population evaluation

Annelyse Cristine Ballin, Bettina Carvalho, José Eduardo Lutaif Dolci, Renata Becker, Cezar Berger, Marcos Mocellin
Braz J Otorhinolaryngol.2018;84:486-93

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Quality of life and cochlear implant: results in adults with postlingual hearing loss

Aline Faria de Sousa, Maria Inês Vieira Couto, Ana Claudia Martinho‐Carvalho
Braz J Otorhinolaryngol.2018;84:494-9

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Water protection after tympanostomy (Shepard) tubes does not decrease otorrhea incidence ‐ retrospective cohort study

João Subtil, Ana Jardim, André Peralta Santos, João Araújo, José Saraiva, João Paço
Braz J Otorhinolaryngol.2018;84:500-5

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Factors associated with voice disorders among the elderly: a systematic review

Amanda Cibelly Brito Gois, Leandro de Araújo Pernambuco, Kenio Costa de Lima
Braz J Otorhinolaryngol.2018;84:506-13

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Degree of tinnitus improvement with stapes surgery – a review

Aliciane Mota G. Cavalcante, Isabella Monteiro de Castro Silva, Bianca Jessica Neves, Carlos Augusto Oliveira, Fayez Bahmad Jr
Braz J Otorhinolaryngol.2018;84:514-8

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A rare laryngeal tumor in a patient with thyroid papillary cancer: granular cell tumor

Sheng‐Yao Cheng, Li‐Hsiang Cheng, Yi‐Shu Liao, Wen‐Sen Lai
Braz J Otorhinolaryngol.2018;84:519-22

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Parotid Masson's tumor: case report

Filippo Carta, Sara Sionis, Valeria Ledda, Clara Gerosa, Roberto Puxeddu
Braz J Otorhinolaryngol.2018;84:523-5

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A case of bilateral inferior concha bullosa connecting to maxillary sinus

Soo Kweon Koo, Ji Seung Moon, Sung Hoon Jung, Mi Jin Mun
Braz J Otorhinolaryngol.2018;84:526-8

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A murine model of wheat versus potato allergy: Patatin and 53kDa protein are the potential allergen from potato

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Ibtessam Tahir Ansari, Taihua Mu

Abstract

Wheat allergy is the most common around the world as gluten is the potential allergen. People diagnosed with wheat allergy were mainly substitute with other novel food such as potato though it is also being reported for allergenic manifestations. Thus there is an increasing demand for developing a BALB/c mice model to empathize the allergic properties of potato protein and its fractions. Purified potato protein showed lower IgE-binding capacity (474.39 ± 0.6 ng/mL) even in higher concentration (30 mg/mL) compared to wheat gluten (1418.28 ± 0.17 ng/mL, 5mg/mL). Immediate active cutaneous hypersensitivity reaction, vascular leakage, intestinal permeability and lung's inflammatory cell infiltration was also ascertained comparatively lower in potato protein than wheat gluten. Furthermore, patatin (43 kDa) and protease inhibitors (∼21 kDa) were purified and separated, and patatin exhibited higher hypersensitivity score than that of protease inhibitors. Immuno-detection assays indicated that patatin and 53 kDa protein in potato protein showed specific Ig-E binding capacity, and 53 kDa was adenosyl homocysteinase identified by LC–MS/MS.

Graphical abstract

Graphical abstract for this article

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VAX1 Gene Associated Non-syndromic Cleft lip with or without Palate in Western Han Chinese

Publication date: Available online 18 July 2018

Source: Archives of Oral Biology

Author(s): Bi-He Zhang, Jia-Yu Shi, Yan-Song Lin, Bing Shi, Zhong-Lin Jia

ABSTRACT

Objective

Non-syndromic cleft lip with or without palate (NSCL/P) is one of the most common human birth defects, it results from multiple genetic and environmental risk factors. Recently, GWA studies identified associations between NSCL/P and two genetic risk loci, rs7078160 and rs4752028, at VAX1.

Design

Currently, we tried to investigate the roles of the two loci among 302 NSCL/P trios (129 non-syndromic cleft lip only (NSCLO) trios and 173 non-syndromic cleft lip and cleft palate (NSCLP) trios) from Western Han Chinese. The two SNPs were genotyped by SNPscan method; Hardy–Weinberg equilibrium test, allelic TDT and parent-of-origin effect were performed by PLINK software, and genotypic TDT and haplotype by FBAT software.

Results

Allelic TDT analysis revealed allele A at rs7078160 was over-transmitted among NSCL/P group (P = 0.0086, OR_transmission = 1.36, 95%CI: 1.08-1.72). Parent-of-origin effect analysis revealed a paternal special over-transmission of allele A at rs708260 in NSCL/P group (P = 0.0079). Haplotype AC of rs7078160-rs4752028 was significant over-transmitted in the NSCL/P group.

Conclusions

Our study firstly confirmed that allele A at rs7078160 at VAX1 gene was a risk factor for NSCL/P in Western Han Chinese population.

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Effect of Metformin on Dental Pulp Stem Cells Attachment, Proliferation and Differentiation Cultured on Biphasic Bone Substitutes

Publication date: Available online 18 July 2018

Source: Archives of Oral Biology

Author(s): Behzad Houshmand, Zohreh Tabibzadeh, Saeed Reza Motamedian, Farnaz Kouhestani

Abstract

Objective

To evaluate to the effect of metformin on attachment of human dental pulp stem cells (hDPSCs) and their proliferation and osteogenic differentiation on biphasic hydroxyapatite/beta-tricalcium phosphate granules of macro-porous biphasic calcium phosphate (MBCP).

Materials and methods

This in vitro study included four groups: A:hDPSCs + MBCP + Metfromin, B:hDPSCs + MBCP, C:hDPSCs + Metformin and D:hDPSCs (control). Attachment of hDPSCs to bone granules in groups A and B was observed by scanning electron microscopy on days 1 and 7 of cultivation. Cell viability was assessed by MTT assay on days 1, 3, and 7 after cell seeding. Differentiation of the hDPSCs was assessed by measurement of alkaline phosphatase activity on days 3, 7, 14 and 21 after cell culturing in standard and osteogenic media. The data was analyzed by two-way ANOVA at a significance level of p = 0.05.

Results

The hDPSCs had firmly attached to the surface of MBCP granules, especially in group A. The MTT values increased in all groups from day 1 to day 7 (p < 0.001). The highest MTT values were observed in group C followed by the control group and groups A and B (p < 0.001). Alkaline phosphatase activity also increased in all groups between days 3 to 21 (p < 0.001) except between days 7 and 14 in standard media (p = 0.094). In standard media, groups with MBCP granules (A and B) showed higher activity (p < 0.05). In osteogenic media, the groups with metformin (A and C) showed higher alkaline phosphatase activity (p < 0.05).

Conclusion

This in vitro study showed that 100 Mol/L metformin increased attachment and proliferation of hDPSCs on biphasic granules. Osteogenic differentiation of hDPSCs also increased in the presence of metformin.

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Effect of palm oil alone or associated to stannous solution on enamel erosive-abrasive wear: a randomized in situ/ex vivo study

Publication date: Available online 18 July 2018

Source: Archives of Oral Biology

Author(s): Franciny Querobim Ionta, Catarina Ribeiro Barros de Alencar, Natália Mello dos Santos, Bianca Tozi Portaluppe Bergantin, Poliana Pacifico Val, Heitor Marques Honório, Thais Marchini de Oliveira, Daniela Rios

Abstract

Objective

Palm oil has demonstrated preventive potential against initial erosive demineralization in vitro. This in situ study evaluated the effect of palm oil alone or associated with stannous-containing (Sn) solution on preventing enamel loss from an erosive/abrasive challenge.

Design

This single-blind, randomized, crossover in situ/ex vivo study was developed in four phases (one per group of five days) with sixteen volunteers. Enamel blocks (n = 256) were allocated to groups according to the treatment: Palm oil; Palm oil plus Sn solution; Sn solution – positive control; and Deionized water - negative control. Half of the enamel blocks of each group was subjected to erosion and the other half to erosion + abrasion. The daily ex vivo protocol consisted of four citric acid immersions (2 minutes). Before the first and third acid exposure, the blocks were treated with the test solutions (1 drop/block) for 1 minute followed by acid immersion and abrasive challenge (toothpaste was applied on all blocks and half were brushed for 15 seconds/block). Enamel loss was quantified profilometrically and data were analyzed by two-way ANOVA and Tukey's test (p < 0.05).

Results

A significant difference was found for type of treatment (p < 0.001); wear condition (p = 0.38) and the treatment x condition interaction (p = 0.33) was non-significant. Palm oil associated or not to Sn solution significantly reduced enamel wear in comparison with the negative control but did not differ from the positive control (p > 0.05).

Conclusions

Palm oil was able to prevent enamel loss under erosive and erosive + abrasive challenges in a similar extend to stannous-containing commercial solution.

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Buccal space tumours

Publication date: Available online 18 July 2018

Source: Auris Nasus Larynx

Author(s): Zubair Hasan, Darius Tan, Malcolm Buchanan, Carsten Palme, Faruque Riffat

Abstract

Objective

To review the available literature as it pertains to the buccal space with a specific focus on the pathologies encountered within this space. Clinical presentation, investigations, and surgical approaches to the region are also reviewed.

Methods

A systematic review of the available literature was performed on buccal space tumours from 1980 to 2017. Data was extracted on clinical presentation, investigations and surgical approaches to the buccal space. The pathologies encountered in the buccal space were reviewed and presented.

Results

Forty-nine unique articles were reviewed, with a total 217 patients. The age of the patients ranged from 0 to 83 with a mean age of 45.8. A total of 51 pathologies were reported. The majority of these were vascular and salivary gland pathologies. The majority of salivary gland neoplasms were malignant. However a wide variety of benign and malignant soft tissue tumours were also reported to occur in this region.

Conclusions

The buccal space is a small and complex region with a variety of pathologies occurring within it. This review clarifies the differential diagnosis of a mass which presents in this area and the pathologies which occur within it.

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Journal of the American Academy of Dermatology: Original article Comorbidities in alopecia areata: A systematic review and meta-analysis

Publication date: Available online 18 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Solam Lee, Hanil Lee, Chung Hyeok Lee, Won-Soo Lee

Abstract

Background

Alopecia areata (AA) may be associated with various systemic diseases according to several studies.

Objective

To identify prevalent and incident diseases in AA patients and quantify their prevalence and odds and hazard ratio compared with those in non-AA controls.

Methods

A systematic review of the studies published before February 28, 2018 was performed using MEDLINE, Embase, Web of Science and Cochrane Library databases. Observational studies on prevalent or incident diseases in AA patients were included, whereas studies limited to pediatrics or providing only laboratory results or continuous data were excluded. Inverse variance method with random-effects model was used for meta-analyses.

Results

Eighty-seven studies were analyzed. Atopic diseases, metabolic syndrome, Helicobacter pylori infection, lupus erythematosus, iron deficiency anemia, thyroid diseases, psychiatric diseases, vitamin D deficiency, and audiologic and ophthalmic abnormalities were more prevalent in AA patients. AA patients had a higher risk of developing autoimmune diseases.

Limitations

Some diseases were investigated by an insufficient number of studies to be meta-analyzed. Meta-analysis on incident diseases was not performed owing to the limited availability on cohort studies.

Conclusion

AA is associated with various systemic and psychiatric diseases. Physicians are encouraged to evaluate and manage potential comorbid conditions to achieve better outcomes.

https://ift.tt/2O1awoN

Long-term sheltering mustaches reduce incidence of lower lip actinic keratosis

Publication date: Available online 18 July 2018

Source: Journal of the American Academy of Dermatology

Author(s): Deede Y. Liu, Muhammad I. Gul, Jo Wick, Anand N. Rajpara, Prescilia Isedeh, Ting Wang, Daniel J. Aires

https://ift.tt/2NsFvJD

Reduction in the colonization of Staphylococcus aureus on the skin surface under calcium-/magnesium-depleted conditions.

http:--media.wiley.com-assets-7315-19-Wi

Reduction in the colonization of Staphylococcus aureus on the skin surface under calcium-/magnesium-depleted conditions.

Lett Appl Microbiol. 2018 Jun 20;:

Authors: Amagai Y, Makita Y, Takai M, Muko R, Matsuda H, Tanaka A

Abstract
Excessive expansion of Staphylococcus aureus is associated with several skin diseases, including atopic dermatitis (AD). Recently, we have demonstrated that washing skins with ultra-pure soft water containing little bivalent metal ions improved skin conditions of atopic subjects. In this study, we investigated the roles of calcium or magnesium on the proliferation of S. aureus both in vitro and in vivo. Depletion of calcium and magnesium in the culture medium significantly suppressed the expansion of S. aureus growth. When S. aureus, diluted with water containing calcium/magnesium at the concentration of medium-hard water (83·0 mg l-1 as CaCO3 ) or the one that contains little calcium/magnesium, was applied onto the tape-stripped skin of Hos:HR-1 mice, growth of S. aureus in water without those minerals on the skin was suppressed. These results suggest that depletion of both calcium and magnesium abrogate the proliferation of S. aureus not only in the culture system but also on the skin surface of mice. Since colonization of S. aureus on the skin is well-known to exacerbate AD symptoms, usage of ultra-pure soft water containing less calcium and magnesium may improve the skin condition through the suppression of S. aureus growth on the skin of patients with skin problems.

PMID: 30015352 [PubMed - as supplied by publisher]

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Mast Cells Stimulated with Peptidoglycan from Staphylococcus aureus Augment the Development of Th1 Cells.

http:--www.organizedchaostech.com-jpps-j

Mast Cells Stimulated with Peptidoglycan from Staphylococcus aureus Augment the Development of Th1 Cells.

J Pharm Pharm Sci. 2018;21(1):296-304

Authors: Matsui K, Kanai S, Ikuta M, Horikawa S

Abstract
BACKGROUND: The skin of patients with atopic dermatitis (AD) is superficially colonized by Staphylococcus aureus. We have previously found that percutaneous permeation of peptidoglycan (PEG) from S. aureus increases the number of mast cells in the dermis, as seen in skin lesions of AD patients. The purpose of the present study was to clarify the influence of PEG on T helper type 1 (Th1)/ T helper type 2 (Th2) cell development mediated by mast cells.
METHODS: Mast cells were induced by long-term culture of murine spleen cells in medium supplemented with tumor necrosis factor (TNF)- a. Ovalbumin (OVA) peptide-pulsed mast cells were incubated with naïve Th cells in the presence or absence of PEG. Five days later, Th cells in the culture were stimulated with phorbol 12-myristate 13-acetate (PMA) and ionomycin, and Th1/Th2 cytokine production was investigated by enzyme-linked immunosorbent assay.
RESULTS: It was confirmed that the mast cells we obtained had surface expression of I-Ad, worked as antigen-presenting cells, and induced Th1 cell and Th2 cell development. The stimulation of mast cells with PEG enhanced the development of Th1 cells but not that of Th2 cells. The increase of Th1 cell development stimulated by PEG was associated with an increase in the expression of Notch ligand Delta 1 in the mast cells. Furthermore, treatment of mast cells with the macrolide antibiotic josamycin suppressed Th1 cell development and this was correlated with a reduction of both Delta 1 expression and interleukin (IL)-12 production in mast cells.
CONCLUSIONS: Colonization of S. aureus on the lesioned skin of AD patients contributes to not only an increase in the number of mast cells but also Th1 cell development mediated by mast cells in the dermis and subsequent induction of chronic inflammation, which is characterized by up-regulation of the Th1 cytokine, interferon (IFN)- g. Therefore, application of josamycin to the lesional skin of AD patients may provide relief from chronic inflammation mediated by mast cells.

PMID: 30012242 [PubMed - in process]

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Cosmetics, Vol. 5, Pages 45: A Novel Stilbene-Like Compound That Reduces Melanin through Inhibiting Melanocyte Differentiation and Proliferation without Inhibiting Tyrosinase

Cosmetics, Vol. 5, Pages 45: A Novel Stilbene-Like Compound That Reduces Melanin through Inhibiting Melanocyte Differentiation and Proliferation without Inhibiting Tyrosinase

Cosmetics doi: 10.3390/cosmetics5030045

Authors: Kristy Martinson Noah Stueven Aaron Monte Cheng-chen Huang

Cosmetic practices that use skin-lightening agents to obtain desired skin tones or treat pigment abnormalities have been popular worldwide. However, the molecular and cellular mechanisms of these agents are still largely unknown. Here we identified a family of compounds, with the lead compound named A11, that exhibited strong pigment reduction in developing zebrafish embryos. The pigment inhibition lasted for several days and is effective both before and after melanogenesis. By comparison with several known skin-lightening compounds, A11 appeared to be more potent and caused slower pigment recovery after withdrawal. A11, however, did not inhibit tyrosinase or cause apoptosis in melanocytes. We further found that A11 suppressed proliferation in melanocytes and reduced the number of differentiated melanocytes by activating MAPK (mitogen-activated protein kinase) and Akt. Finally, A11 also caused melanin reduction in mammalian melanocytes. Together, A11 might be a potent skin-lightening agent with novel mechanisms.

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Site-specific investigation and spatial modeling of canopy drip effect on element concentrations in moss

Abstract

In this study, the canopy drip effect on the exposure of forests to atmospheric deposition of potentially toxic metals and nitrogen (N) and element accumulation was investigated. Thereby, the respective element concentrations of metals and N in moss specimens were investigated by example of North-Western Germany. To this end, on the one hand, the concentrations of Al, As, Cd, Cr, Cu, Fe, Hg, Pb, Ni, Sb, V, Zn, and N in mosses sampled under, outside, and at the edge of forest canopies were examined for statistical significant differences. On the other hand, vegetation structures parameterizing the canopy drip effect were quantified by use of information collected, in addition to the element data, at each moss sampling site. The statistical relations between ratios of vegetation parameters and ratios of element concentrations were modeled by regression analysis, and the respective element concentration in moss was geostatistically estimated and mapped for unsampled locations throughout Germany. This article tackles regression models with R² > 0.5 (Cu, Hg, Pb, Sb, and N) to adapt the element concentrations measured at the 400 sites of the European Moss Survey (EMS) to three different features of hypothetical vegetation structures. To this end, the continuum of vegetation structures were represented as follows: open land (meadows) described by a leaf area index (LAI) value of 2.96 and under canopy sites in coniferous forests represented by a LAI value of 11. The arithmetic mean of LAI values at 400 EMS sites throughout Germany amounts to 5.1. The element concentrations for these target LAIs representing three site categories were calculated and mapped. Then, these LAI-dependent element concentration maps were compared with the maps depicting the spatial patterns of "pure" element concentrations. Spatial differences were evaluated and supposed to be of great value for the validation of atmospheric deposition modeling.

https://ift.tt/2Luhdyc

Spatial and temporal variations in the geochemistry of shallow groundwater contaminated with nitrate at a residential site

Abstract

The concentrations of nitrate (NO₃⁻), major ions, and dissolved inorganic carbon (DIC) and the stable carbon isotopes of DIC (δ¹³C_DIC) in shallow groundwater below a 45 × 60 m residential property was investigated over a period of 38 months. Our aim was to identify the processes which control the spatial and temporal distribution of NO₃⁻ in the shallow groundwater and assess water-rock interactions linked to denitrification. Groundwater sampled quarterly from eight locations showed an average NO₃⁻ concentration of 36.8 mg/L and a range between 0.1 and 214.9 mg/L compared to the US EPA maximum contaminant level of 10 mg/L. Heterogeneity in nitrate distribution was from residential application of N-based fertilizers offsite and from onsite application on flower beds and for lawn care. The temporal behavior of nitrate at all eight groundwater locations was markedly different and independent of seasonal hydrologic variations. Nitrate attenuation was spatially controlled by heterogeneous denitrification and rain dilution near roof drains. Groundwater locations with active denitrification were characterized by higher DIC concentrations and lower δ¹³C_DIC from organic carbon mineralization and by higher ionic concentrations from weathering of aquifer minerals. The variation in the relative standard deviations (RSD) of the measured parameters over space (RSD-s) and time (RSD-t) was highest for NO₃⁻ associated with variable spatiotemporal input and lowest for pH, pCO₂, and δ¹³C_DIC indirectly controlled by denitrification. Denitrification induced mineral weathering products such as DIC, Ca²⁺, Mg²⁺, and HCO₃⁻ showed medium to high RSD-s and RSD-t. The RSD-s and RSD-t were positively correlated (R² = 0.85) with the RSD-s showing approximately twofold higher magnitude than RSD-t due to greater variability between monitoring wells locations than variability at each groundwater location over time. Nitrate contamination and denitrification represent important long-term driver of aquifer weathering and changes in groundwater geochemistry below residential communities.

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Electrophysiological Monitoring During Percutaneous Trigeminal Nerve Ganglion Block

No abstract available

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Antiviral RNA interference in mammals

Shou-Wei Ding | Qingxia Han | Jinyan Wang | Wan-Xiang Li

https://ift.tt/2NsCR6A

Gutartige Parotistumore: moderne Therapiekonzepte

Laryngo-Rhino-Otol
DOI: 10.1055/a-0633-0820

Bei gutartigen Parotistumoren ist es ein vorrangiges Behandlungsziel, die Morbidität des operativen Eingriffs zu senken. Standardisiertes intraoperatives Vorgehen und Verfahren zur Minimierung des Operationsumfangs konnten das Risiko einer bleibenden Fazialisparese deutlich senken. Aktuelle evidenzbasierte Therapieverfahren und mögliche Komplikationen nach Parotidektomie werden in diesem Beitrag näher erläutert.
[...]

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

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Transorale videoendoskopische Resektion von Kopf-Hals-Tumoren in 4-Hand-Technik

Laryngo-Rhino-Otol
DOI: 10.1055/a-0654-5376

Einleitung Videoendoskopische Operationsverfahren in 4-Hand-Technik sind bereits in der Visceralchirurgie bei laparoskopischen Eingriffen sowie bei der Hypophysenchirurgie etabliert. Auch in der Tumorchirurgie im Kopf-Hals-Bereich gewinnt die transorale videoendoskopische Resektion von Tumoren in 4-Hand-Technik (TOVR) zunehmend an Bedeutung. Material und Methoden Seit März 2013 wurden erfolgreich 28 transorale videoendoskopische Tumorresektionen von Oropharynx (n = 5) –, Hypopharynx (n = 12) – und Larynxkarzinomen (n = 11) in 4-Hand-Technik durchgeführt. Ergebnisse In allen 28 Fällen wurde transoral eine R0-Resektion ohne Erweiterung des Eingriffs durch einen Zugang von transcervikal erreicht. Auch bei Patienten mit schlechter Beweglichkeit im HWS-Bereich (n = 9) gelang durch den Einsatz von Winkeloptiken über ein Kleinsasser- oder Weerda-Rohr per TOVR eine transorale R0-Tumorresektion. Schlußfolgerungen Die TOVR ist ein effektives, preisgünstiges und minimalinvasives Operationsverfahren bei Tumoren im Kopf-Hals-Bereich mit zahlreichen Vorteilen im Vergleich zur CO2-Laserresektion und stellt eine echte Alternative zu den herkömmlichen Resektionsverfahren dar.
[...]

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

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Successful Percutaneous Coronary Intervention for Atherosclerotic Coronary Lesion with Anomalous Origin of the Right Coronary Artery

Congenital coronary artery anomalies, including anomalous origin of a coronary artery, can manifest as life-threatening conditions, such as myocardial infarction or arrhythmia, and may even lead to sudden death associated with specific congenital anatomical features. Such arteries can also develop atherosclerotic lesions. This report describes the case of a 75-year-old man who was admitted to our hospital due to exertional dyspnea. The right coronary artery was found to originate from the left coronary sinus and exhibit tight stenosis due to atherosclerosis, causing effort angina pectoris. This case highlights the fact that coronary artery anomalies can cause angina pectoris via both atherosclerotic and nonatherosclerotic effects, and successful revascularization was achieved noninvasively via percutaneous coronary angioplasty.

https://ift.tt/2LjxLMu

Pearls for the middle fossa approach in acoustic neuroma surgery

Purpose of review To discuss the use of the middle fossa craniotomy for resection of vestibular schwannomas; to present pearls of and modifications to the approach. Recent findings The middle fossa craniotomy allows for hearing preservation in the resection of intracanalicular vestibular schwannomas. Over recent years, the approach has been modified to address larger tumors with a limited cerebellopontine angle component. Positive identification of the superior semicircular canal allows for rapid exposure of the internal auditory canal (IAC). Removal of cerebrospinal fluid from the posterior fossa during exposure of the IAC allows for removal of the middle fossa retractor; reinforced silicone sheeting is used to protect the middle fossa dura during further drilling. The use of the endoscope has allowed for more complete dissection at the fundus of the IAC, including tumors lateral to the transverse crest. Summary Technical modifications to the middle fossa craniotomy have allowed for a shorter duration of temporal lobe retraction intraoperatively and more complete resection of tumors with fundal involvement. Correspondence to Eric P. Wilkinson, MD, House Clinic, 2100 W 3rd St, Ste 111, Los Angeles, CA 90057, USA. Tel: +1 213 483 9930; e-mail: ewilkinson@houseclinic.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uzmLkv

Functional considerations in oral cavity reconstruction

Purpose of review The treatment of oral cavity cancer may impair speech and swallowing function. Optimizing posttreatment function may lead to significant improvement of quality of life. Recent findings Although oncologic control remains the main goal of treatment for oral cavity cancer, posttreatment function for surviving patients has over the last decades been recognized as an important secondary outcome. Reconstruction of oral cavity defects range from primary closure to advanced microvascular reconstruction, including multiple tissue types. Free flap reconstruction has greatly enhanced the ability to tailor transferred tissue to specific defects. In this review, we describe recent findings in reconstruction of tongue defects, including data from perforator flaps. We also summarize recent evidence regarding reinnervated flaps. Summary When vascularized tissue is needed, it remains unclear how the reconstructive choice impacts postoperative outcome, although in many situations it appears to be dominated by the donor site morbidity rather than the reconstructive technique. Despite numerous case series, the functional impact of motor and sensory reinnervation in vascularized tissue remains unknown. Although perforator flaps have emerged as a promising flap option, with favorable donor site morbidity, their ultimate impact on functional outcomes remains unclear, whereas the success rate appears to be lower than traditional flaps. Correspondence to Patrik Pipkorn, MD, Department of Otolaryngology, Head and Neck Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8057, St. Louis, MO 63110, USA. Tel: +1 314 362 6599; fax: +1 314 362 7522; e-mail: ppipkorn@wustl.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2zRx8VL

Conjunctival provocation tests: prediction of seasonal allergy

Purpose of review The conjunctival provocation test (CPT) is often used to clearly identify the specific allergen causing the symptoms of allergic rhinoconjunctivitis but also to assess the clinical efficacy of an allergen immunotherapy (AIT). As there is no consensus about its predictive value, the aim of this publication is to evaluate under which conditions the CPT can predict the symptom severity during the allergy season after previous AIT. Recent findings Three out of four randomized controlled trials (RCTs) showed a correlation between CPT reactivity and symptoms occurring under natural allergen exposure after previous AIT. Furthermore, one RCT found that performing the CPT 4 weeks after initiating AIT can identify early responders who also show a benefit during the season. Another RCT suggested that conducting the CPT prior to starting AIT can be used to identify patients who may benefit more from treatment than others. Summary The assessment of the reviewed literature led us to the conclusion that the CPT has a predictive value and can consequently be used to assess the efficacy of an administered AIT if performed according to a standardized challenge protocol with high-quality allergen extracts. Correspondence to Ralph Mösges, Institute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany. Tel: +49 172 2056230; e-mail: ralph@moesges.de Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2zNz9lR

Globalization and anaphylaxis

Purpose of review To understand the impact of globalization in the management of anaphylaxis and identify potential strategies to improve patients' care and prevention. Recent findings Developments in the field of anaphylaxis have been consistently following these globalization trends offering possibilities of collaborations of the allergy community and integrated international initiatives to reach quality care of allergic patients worldwide. Summary Globalization is the process of interaction and integration between people, companies, and governments worldwide. Developments in the field of anaphylaxis have been following these globalization trends offering possibilities of collaborations and integrated international initiatives to reach quality care of allergic patients worldwide. Complex disorders, such as anaphylaxis, have called for complex integrative strategies, leading to a new acceptance of outside traditions. Allergy is encouraging us to accept holistic and integrative medical practices as viable options. With the dissolution of multinational boundaries and the universal free access to information, the notion of holistic and global-based care is emerging as the new reality of the medicine. We strongly believe that the integrated action plan to the management and prevention of anaphylaxis, just possible through the globalization, is a key health, political and economical move that advocates for the best practice of allergology. Correspondence to Luciana Kase Tanno, MD, PhD, Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, 371, av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France. Tel: +33 467336107; fax: +33 467633645; e-mail: luciana.tanno@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uxxR9v

Seasonal ocular allergy and pollen counts

Purpose of review The purpose of the article is to provide a historical overview of literature regarding pollen sensitization and ocular allergy with an emphasis on developments that have occurred over the past 5 years. Recent findings Currently, pollen studies have examined the molecular and cellular pathways involved in initiating allergic conjunctivitis to find targets for therapeutics. Studies have also documented the threshold, linear increase and plateau point in the relationship between pollen levels and allergic conjunctivitis symptoms. Summary Traditionally, intact pollen grains are counted as a means of correlating patient symptoms to allergen exposure. However, establishing a dose–response relationship between pollen grain exposure and allergic conjunctivitis has proven to be difficult. It has been observed that ocular allergies induce a two-fold response including early-phase and late-phase IgE-mediated reactions. Sensitization itself is a combination of pollen exposure over time in genetically predisposed individual. However, symptoms appear to reach an asymptotic point at which clinical severity plateaus. More studies are needed to clearly define differences in pollen sensitization by plant species. Correspondence to Leonard Bielory, MD, University Asthma and Allergy Associates, 400 Mountain Ave, Springfield, NJ 07081, USA. Tel: +1 973 912 9817; e-mail: drlbielory@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2zPdnhz

Cosmetics and ocular allergy

Purpose of review The purpose of this review was to explore recent developments in the study of ocular cosmetics, as they pertain to adverse reactions that can be attributed to them. Recent findings Immunologically mediated adverse reactions to cosmetics are most commonly the result of sensitization to preservatives, fragrances and dyes used in these products. Metals such as nickel, cobalt, chromium and lead are used in products such as eye shadows and eye liners as well as toy makeup sets in amounts greater than the recommended amount of 1 ppm. Cosmetics make up the majority of fragrance-induced contact dermatitis. Recently, a free smartphone app was developed by American Contact Dermatitis Society that holds promise in better enabling patients to utilize their patch test data while shopping for cosmetics. Summary Both immediate and delayed hypersensitivity reactions linked to cosmetics are often the result of sensitization to preservatives, fragrances and additives in the products themselves. Despite significant advances in our understanding of these reactions, further research will be necessary to elucidate the mechanisms behind these reactions and bring this knowledge to the bedside as to improve patient care with potential cosmetic-based related allergic disorders. Correspondence to Leonard Bielory, MD, University Asthma and Allergy Associates, 400 Mountain Ave, Springfield, NJ 07081, USA. Tel: +1 973 912 9817; e-mail: drlbielory@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uvpKdT

Topical antihistamines, mast cell stabilizers, and dual-action agents in ocular allergy: current trends

Purpose of review To address the current trends of therapeutic mechanisms for treatment of allergic conjunctivitis (AC), based on topical antihistamines and mast cell stabilizers (MCS). Recent findings The antihistamine drug alcaftadine has H4 receptor inverse agonism, anti-inflammatory and MCS activities. The antihistamines levocabastine and azelastine are more effective than placebo in treatment of AC symptoms in randomized controlled trials (RCTs). The topical dual-action antihistamines/MCS olopatadine, azelastine, ketotifen, and epinastine are commonly used in Europe and in the United States for mild subtypes of AC. For the main symptoms of AC, ocular itch and conjunctival hyperemia, epinastine 0.05% was superior to placebo, but equal or more effective than olopatadine 0.1%, while the later was more effective than ketotifen. High concentration olopatadine 0.77% had longer duration of action, better efficacy on ocular itch, and a similar safety profile to low-concentration olopatadine 0.2%. The new formulas of topical dual-action agents present longer duration of action, leading to a decreased frequency of use. Summary The topical dual-action agents are the most effective agents treating signs and symptoms of mild forms of AC. There is superiority to the high-concentration olopatadine drug over other agents on ocular itch, with prolonged effect when used once-daily. Correspondence to Prof. Abraham Solomon, Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Kiryat Hadassah, Ein-Kerem, POB 1200, Jerusalem 91120, Israel. Tel: +972 50 7874664; e-mail: dr.avi.solomon@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2zUYYRk

Adults and children with anaphylaxis in the emergency room: why it is not recognized?

Purpose of review Despite many international guidelines have been published in the last 10 years, anaphylaxis continues to be underdiagnosed, undernotified, and undertreated. Anaphylactic reactions in adults and children in emergency departments are frequently not recognized, leading to underutilization of epinephrine, and a higher risk of death. Recent findings A few studies have been recently published showing that educational intervention for both physicians and other healthcare professionals improve diagnosis and treatment of anaphylaxis. Moreover, the new International Classification of Diseases, 11th edition improved classification of anaphylaxis, making it easier to be notified. Summary Anaphylaxis is a life-threatening hypersensitivity reaction that is most frequently seen by emergency physicians and nurses than allergists or immunologists. Education seems to be best strategy to improve management of this severe condition. Correspondence to Marcelo V. Aun, MD, PhD, Faculdade Israelita de Ciências da Saúde (FICS) Albert Einstein, Avenida Brigadeiro Luis Antonio 4267, 01401-002 São Paulo, SP, Brazil. Tel: +55 11 983080404; e-mail: marcelovivoloaun@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uw1bxp

Pearls for the middle fossa approach in acoustic neuroma surgery

Functional considerations in oral cavity reconstruction

Interplay between acute phase response and coagulation/fibrinolysis in chronic spontaneous urticaria

Chronic spontaneous urticaria (CSU) is associated with activation of systemic inflammatory response and coagulation/fibrinolysis.

https://ift.tt/2O49Y1I

Summary of the updated international consensus diagnostic criteria for eosinophilic esophagitis: AGREE conference,

EoE is a global health condition that has steady increased over the last few decades and is now reported on all continents, with an estimated incidence of 4 per 100,000. Diagnostic Guidelines on eosinophilic esophagitis (EoE) were published in 2007 and updated in 2011.1,2 EoE is defined as a clinicopathological condition that is likely immune or antigen driven, and characterized clinically by symptoms of esophageal dysfunction and histologically by ≥15 eosinophils per high power field (eos/hpf).

https://ift.tt/2NpDDBa

Long-term sheltering mustaches reduce incidence of lower lip actinic keratosis

https://ift.tt/2LmvpfL

Journal of the American Academy of Dermatology: Original article Comorbidities in alopecia areata: A systematic review and meta-analysis

Alopecia areata (AA) may be associated with various systemic diseases according to several studies.

https://ift.tt/2Jz8kSb

Microscale dispersion behaviors of dust particles during coal cutting at large-height mining face

Abstract

In order to ensure safe production and occupational health at a large-mining-height fully mechanized mining face in a coal mine, the present study firstly establishes an airflow-dust coupled model based on gas/solid two-phase flow equations and combines numerical simulation and field measurement for analyzing the dispersion pattern of dust particles with various sizes for different coal cutter locations. Results show that, due to the existence of drums, airflow deviates from the original direction and enters the footway. Driven by the airflow, dust particles enter the footway at different locations depending on coal cutter locations. The coal-cutting location (denoted as P_rl) and the location where dust particles enter the footway (denoted as P_dt) are correlated as follows: P_dt(P_rl) = − 0.0007P_rl² + 1.0343P_rl − 3.3536. When P_rl < 55 m, dust particles produced by the rear drum during coal cutting enter the footway earlier than those produced by the front drum, leading to the first and second dust concentration peaks in respiratory zones of footway. Dust suppression effects are assessed in these regions based on the first and second dust concentration peaks. Due to the superposition of the concentration fields associated with dust particles 2.5, 7, and 20 μm in diameter, dust concentration 25 m down the leeward side of the coal cutter can reach 1440 mg/m³. The concentration of dust particles with a diameter of 40 μm drops steadily and approaches 0 at the return corner. The dust particles 80 μm in diameter are fully settled within 22 m down the leeward side of the coal cutter. A comparison with the field measurement indicates that the present simulation results are highly accurate.

Graphical abstract

https://ift.tt/2NrBViN

Blunt trauma to the antecubital fossa causing brachial artery injury and minor fractures around the elbow joint, an easily missed diagnosis with potential devastating consequences: a case report

Blunt trauma causing brachial artery injury in a young patient is very rare. Cases of brachial artery injury may be associated with closed elbow dislocation or instability. Elbow dislocation may not be evident...

https://ift.tt/2JzboOj

Buccal space tumours

Campbell de Morgan Spots (Cherry Angiomas) Show Endothelial Proliferation

Abstract: Campbell de Morgan spots (also known as adult hemangiomas, cherry angiomas, or senile angiomas) show clinical and histopathological features that make them distinct. Despite this, they are not included as benign vascular tumors in the current classification by the International Society for Vascular Anomalies (ISSVA). In the current study, we investigated the proliferation rate (Ki67) of the endothelia of 23 cases of Campbell de Morgan spots, as well as the immunoexpression of Wilms tumor protein 1 (WT1) by these vascular anomalies. The youngest patient was 24 years old (range: 24–80; mean: 52.61). Ten patients were women (43.48%). All cases showed intense cytoplasmic expression of WT1 by the endothelia in 80%–100% of the endothelial cells. Ki67 demonstrated proliferation by the endothelia of all vascular lesions. A mean of 1077.6 nuclei were evaluated per case. Eight cases showed a very low proliferation (less than 0.5% of the nuclei). In the other 15 cases, the proliferation ranged from 0.59% to 3.59% (mean: 1.89%). Correspondence: Angel Fernandez-Flores, MD, PhD, Department of Cellular Pathology, Servicio de Anatomía Patologica, Hospital El Bierzo, Medicos sin Fronteras 7, 24411, Ponferrada, Spain (e-mail: dermatopathonline@gmail.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uN6Vlu

Indeterminate Cell Histiocytosis and Mycosis Fungoides. A Hitherto Unreported Association

No abstract available

https://ift.tt/2msZR9U

Uncommon Histopathological Variants of Malignant Melanoma: Part 1

Abstract: Despite new horizons opened by recent advances in molecular pathology, histological evaluation still remains the diagnostic gold standard regarding cutaneous melanocytic neoplasms. Several histological variants of melanoma have been described, and their knowledge is crucial for accurate diagnosis and classification of cases with unusual clinicopathological features. Uncommon histological variants of melanoma have been described based on a broad constellation of features, including architectural pattern, stromal alterations, cytological attributes, and other morphological properties. This review is aimed at providing an extensive discussion of unusual but distinctive histopathological variants of melanoma. Correspondence: Lorenzo Cerroni, MD, Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, A-8036 Graz, Austria (e-mail: lorenzo.cerroni@medunigraz.at). All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uJHb9D

Do Patterns of Reconstruction Choices After Mohs Surgery Vary by Specialty? A Pilot Study of Mohs Surgeons and Facial Plastic Surgeons

BACKGROUND Differences in approach to repair a specified defect after Mohs micrographic surgery (MMS) between specialties have not been previously examined. OBJECTIVE To assess the difference in frequency of which reconstruction repairs are selected after MMS, among Mohs surgeons and facial plastic surgeons (FPS), and evaluate whether the level of satisfaction with the final repair outcome differed between specialties. MATERIALS AND METHODS The study was approved by the Saint Louis University Institutional Review Board. A link to the survey was distributed to members of American College of Mohs Surgery (ACMS) and American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), between January and May 2016. RESULTS The reconstructive procedure selected most often ("top choice") was not significantly different between Mohs surgeons and FPS for the majority of the images. There was no material difference in how dermatologists and FPS rate the aesthetic outcome of the 3 presented closure types, with the exception of one closure type—nose with graft. CONCLUSION Mohs surgeons were found to more likely cluster around a single preference for their reconstruction technique compared with FPS, in which a higher percentage of surgeons also selected other options. Address correspondence and reprint requests to: Ian A. Maher, MD, 1755 S. Grand Avenue, 2nd Floor, St. Louis, MO 63104, or e-mail: maheria@slu.edu Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (https://ift.tt/2bw6lgr). The authors have indicated no significant interest with commercial supporters. A.O. Kurta and D. Sarhaddi contributed equally to the project and are co-first authors. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2LhfEXD

Injectable Platelet-, Leukocyte-, and Fibrin-Rich Plasma (iL-PRF) in the Management of Androgenetic Alopecia

BACKGROUND The role of enriched autologous plasmas in androgenetic alopecia (AGA) management is emerging in recent literature. OBJECTIVE In this prospective study, the authors aimed to confirm that the induction of a minor local trauma immediately followed by injections of an enriched plasma made of a strongly concentrated platelet fraction, a robust white cell presence, concentrated fibrinogen, and other plasma proteins (injectable leukocyte platelet-rich fibrin [iL-PRF]) could be able to produce positive clinical results in patients with AGA. MATERIALS AND METHODS A 2-injection regimen was instituted, with a 3-month interval between the 2 interventions. A treatment group (TG) and a control group (CG) were instituted. Macrophotographs were taken at baseline and after 6 months, and rated by 5-people expert panel (blinded to this assignment) using the 15-point scale proposed by Jaeschke to evaluate the clinical change. RESULTS Overall, TG showed better scores compared with the CG in all 5 classes of global physician assessment at baseline, all age groups, and in both sexes, and such differences always reached statistical significance. A greater severity at baseline showed a larger improvement after treatment in the TG. CONCLUSION This study provides preliminary evidence that the biological composition of the iL-PRF is of crucial importance in ensuring a good degree of clinical efficacy in patients with AGA. Address correspondence and reprint requests to: Andrea Paradisi, MD, Dermatology Unit, "Cristo Re" General Hospital, Via delle Calasanziane 25, 00168 Rome, Italy, or e-mail: aparad78@gmail.com This work has been supported in part by the "Progetto Ricerca Corrente—2016" of the Italian Ministry of Health. The authors have indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2Lrcwsk

Surgical Site Infections After Dermatologic Surgery in Immunocompromised Patients: A Single-Center Experience

BACKGROUND Immunosuppression is often considered as an indication for antibiotic prophylaxis to prevent surgical site infections (SSI) while performing skin surgery. However, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. PATIENTS AND METHODS All patients of the Department of Dermatology and Allergology at the University Hospital of RWTH Aachen in Aachen, Germany, who underwent hospitalization for a dermatologic surgery between June 2016 and January 2017 (6 months), were followed up after surgery until completion of the wound healing process. The follow-up addressed the occurrence of SSI and the need for systemic antibiotics after the operative procedure. Immunocompromised patients were compared with immunocompetent patients. The investigation was conducted as a retrospective analysis of patient records. RESULTS The authors performed 284 dermatologic surgeries in 177 patients. Nineteen percent (54/284) of the skin surgery was performed on immunocompromised patients. The most common indications for surgical treatment were nonmelanoma skin cancer and malignant melanomas. Surgical site infections occurred in 6.7% (19/284) of the cases. In 95% (18/19), systemic antibiotic treatment was needed. Twenty-one percent of all SSI (4/19) were seen in immunosuppressed patients. CONCLUSION According to the authors' data, immunosuppression does not represent a significant risk factor for SSI after dermatologic surgery. However, larger prospective studies are needed to make specific recommendations on the use of antibiotic prophylaxis while performing skin surgery in these patients. Address correspondence and reprint requests to: Galina Balakirski, MD, Department of Dermatology and Allergology, University Hospital of Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany, or e-mail: galina.balakirski@ukbonn.de The authors have indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2JBPY2P

Unique Tumor Heterogeneity Within a Single Locally Advanced Basal Cell Carcinoma Resulting in Partial Response Despite Continuous Vismodegib Treatment

No abstract available

https://ift.tt/2LonEWA

Emerging Nonsurgical Therapies for Locally Advanced and Metastatic Nonmelanoma Skin Cancer

BACKGROUND Locally advanced and metastatic nonmelanoma skin cancer (NMSC) not amenable to surgical resection requires a different approach to therapy. OBJECTIVE To review the efficacy and adverse effects of emerging treatment options for locally advanced and metastatic NMSC. MATERIALS AND METHODS A comprehensive search on PubMed was conducted to identify relevant literature investigating the role of program cell death 1 (PD-1) inhibitor, cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) inhibitor, epidermal growth factor receptor (EGFR) inhibitor, and Hedgehog pathway inhibitors in the treatment of NMSC. RESULTS PD-1 inhibitor and CTLA-4 inhibitor have shown promising efficacy with tolerable side-effect profiles in the treatment of NMSC, although the number of cases reported is limited. Currently, 3 larger-scale clinical trials are investigating PD-1 inhibitor therapy for NMSC. Similarly, EGFR inhibitor demonstrated marginal success in unresectable cutaneous squamous cell carcinomas. Hedgehog pathway inhibitors were approved by the US FDA for treatment of locally advanced and metastatic basal cell carcinomas and have shown favorable efficacy. Common adverse effects included muscle spasm, alopecia, and dysgeusia. CONCLUSION Systemic therapies including PD-1 inhibitors and CTLA-4 inhibitors have demonstrated early promising results for difficult-to-treat NMSC. Future studies are necessary to optimize treatment outcome. Address correspondence and reprint requests to: Michael R. Migden, MD, Departments of Dermatology and Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street, 1452, Houston, TX 77030, or e-mail: mrmigden@mdanderson.org M.R. Migden has participated on advisory boards and received honoraria from Genentech, Inc.,; Novartis Pharmaceuticals Corporation; Eli Lilly and Company; and Sun Pharmaceutical Industries. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uFk0xg

Pediatric Nasal Obstruction

Nasal obstruction is one of the most common problems seen by pediatric otolaryngologists. Prompt treatment of nasal obstruction can be critical in newborns and infants because of their obligatory nasal breathing. Older children will typically have more inflammatory, infectious, or traumatic causes of nasal obstruction. Nasal obstruction can lead to a significant decrease in the quality of life in children along with an increase health care expenditures.

https://ift.tt/2utNb7h

Bone tissue reaction, setting time, solubility, and pH of root repair materials

Abstract

Objectives

This study aims to compare the bone tissue reaction, setting time, solubility, and pH of NeoMTA Plus, Biodentine (BD), and MTA Angelus (MTA-A).

Materials and methods

Initial and final setting times (n = 7) and solubility up to 7 days (n = 11) were evaluated in accordance with ASTM C266–15 and ANSI/ADA Specification No. 57, respectively. pH (n = 10) was measured up to 28 days. Bone tissue reactions in 48 rats' femur were histologically analyzed after 7, 30, and 90 days. ANOVA and Tukey's tests compared setting time, solubility, and pH data; bone reactions data were compared by Kruskal-Wallis and Dunn's tests.

Results

NeoMTA Plus had longer initial and final setting times than MTA-A and BD (P < 0.05). At 7 days, BD showed the highest solubility, similar to NeoMTA Plus (P > 0.05) and different from MTA-A (P < 0.05). NeoMTA Plus had a progressive mass loss over time; at 7 days, it was significantly different from the initial mass (P < 0.05). BD showed higher pH in the periods assessed when compared to the other materials (P < 0.05). Bone tissue repair had no differences between groups in each experimental period (P > 0.05). All groups presented no difference from 30 to 90 days (P > 0.05) and had better bone repair at 90 days than at 7 days (P < 0.05).

Conclusions

NeoMTA Plus, BD, and MTA-A showed satisfactory setting time, high mass loss, alkaline pH, and allowed bone repair.

Clinical relevance

Calcium silicate-based cements are indicated for multiple clinical situations. NeoMTA Plus and BD showed satisfactory physical-chemical and biological properties, being considered as alternatives to MTA-A, as root repair materials for clinical use.

https://ift.tt/2zNgmHC

Effects of non-thermal atmospheric plasma treatment on dentin wetting and surface free energy for application of universal adhesives

Abstract

Objectives

The study aims to evaluate the effects of non-thermal atmospheric plasma (NTAP) treatments on dentin wetting and surface free energy (SFE) and compare the effects of NTAP treatment, etch-and-rinse, and self-etch protocols for application of universal adhesives.

Materials and methods

Mid-coronal dentin of intact third molars was used to measure contact angles of distilled water, ethylene-glycol, and diiodomethane and calculate SFE following different NTAP preset treatments (feeding gas consisting of pure He, He + 1% O₂, He + 1.5% O₂), power input (1 or 3 W), and tip-to-surface distance (2, 4, or 8 mm). Contact angles of reference liquids and SFE of dentin following He + 1.5% O₂ at 3-W and 4-mm treatment was compared to phosphoric acid etching. Contact angles of Single Bond Universal (SBU; 3M ESPE) and Clearfil Universal Bond (CUB; Kuraray Noritake) were measured following NTAP, etch-and-rinse, and self-etch protocols.

Results

NTAP significantly reduced contact angles of reference liquids and increased dentin SFE compared to untreated dentin (p < 0.05). O₂ intensified the effect of He NTAP (p < 0.05). NTAP and phosphoric acid increased dentin polarity and Lewis base surface characteristics. Phosphoric acid increased contact angles of adhesives compared to the self-etch protocol (p < 0.05). NTAP resulted in lower adhesive contact angles than phosphoric acid, the difference being statistically significant for CUB (p < 0.05). Compared to the self-etch protocol, NTAP slightly reduced CUB contact angle but not that of SBU (p > 0.05).

Conclusions

He NTAP with and without O₂ increased dentin wetting and SFE, surpassing the effect of phosphoric acid and lowering adhesive contact angles. NTAP produced no apparent micro-morphological changes on dentin surface comparable to acid etching.

Clinical significance

NTAP treatment of dentin prior to adhesive application increases dentin wetting and surface free energy facilitating better adhesive distribution on dentin surface compared to phosphoric acid etching and similar to the "self-etch" application protocol.

https://ift.tt/2uv5ER0

Hair mercury concentrations in the spotted seal ( Phoca largha ) pups from the Sea of Japan

Abstract

This publication presents the results of a study of the total mercury (THg) concentration in the fetal hair (lanugo) of the young spotted seals inhabiting the Peter the Great Bay, Sea of Japan. We analyzed samples from pups that were collected in 2014–2017 at the seal breeding grounds. The concentration of total mercury was determined by atomic absorption spectrometry. The concentration of THg ranged from 1.52 to 6.68 μg/g dry weight. Mercury concentration in the lanugo exceeds that found in the environment (bottom sediments, sea water) and in other animals inhabiting the Bay. At the same time, the level was generally lower than that found in young seals of most other pinniped species (Steller sea lion Eumetopias jubatus, Northern fur seal Callorhinus ursinus, Harbor seal Phoca vitulina richardsi, Northern elephant seal Mirounga angustirostris, California sea lion Zalophus californianus) from the North Pacific.

https://ift.tt/2zRoKpm

Efficacy & Safety of OPN-375 Adults With Bilateral Nasal Polyps Using Nasoendoscopic Video

Condition: Bilateral Nasal Polyposis
Intervention: Drug: OPN-375
Sponsor: Optinose US Inc.
Recruiting

https://ift.tt/2zO4vZR

A Phase 1b Dose Escalation/Expansion Study of Abexinostat in Combination With Pembrolizumab in Patients With Advanced Solid Tumor Malignancies

Conditions: Stage III Cutaneous Melanoma; Stage IV Cutaneous Melanoma; Locally Advanced Melanoma; Locally Advanced Solid Neoplasm; Metastatic Head and Neck Squamous Cell Carcinoma; Metastatic Malignant Solid Neoplasm; Metastatic Melanoma; Metastatic Urothelial Carcinoma; Non-Small Cell Lung Carcinoma; Stage IB Lung Cancer AJCC v7; Stage III Cutaneous Squamous Cell Carcinoma of the Head and Neck AJCC v8; Stage III Lung Cancer AJCC v8; Stage III Ureter Cancer AJCC v8; Stage IIIA Lung Cancer AJCC v8; Stage IIIB Lung Cancer AJCC v8; Stage IIIC Lung Cancer AJCC v8; Stage IV Cutaneous Squamous Cell Carcinoma of the Head and Neck AJCC v8; Stage IV Lung Cancer AJCC v8; Stage IV Ureter Cancer AJCC v8; Stage IVA Lung Cancer AJCC v8; Stage IVB Lung Cancer AJCC v8
Interventions: Drug: Abexinostat; Biological: Pembrolizumab
Sponsors: Rahul Aggarwal; Xynomic Pharmaceuticals, Inc.
Not yet recruiting

https://ift.tt/2mswQLL

Efficacy & Safety of OPN-375 Adults With Bilateral Nasal Polyps Using Nasoendoscopic Video

Condition: Bilateral Nasal Polyposis
Intervention: Drug: OPN-375
Sponsor: Optinose US Inc.
Recruiting

https://ift.tt/2zO4vZR

A Phase 1b Dose Escalation/Expansion Study of Abexinostat in Combination With Pembrolizumab in Patients With Advanced Solid Tumor Malignancies

Papuloerythroderma of Ofuji successfully treated with methotrexate

Dermatologic Therapy, EarlyView.

https://ift.tt/2uLplD7

Hyaluronic acid filler for skin rejuvenation: The role of diet on outcomes. A pilot study

Dermatologic Therapy, EarlyView.

https://ift.tt/2LhqLQ5

Papuloerythroderma of Ofuji successfully treated with methotrexate

Dermatologic Therapy, EarlyView.

https://ift.tt/2uLplD7

Hyaluronic acid filler for skin rejuvenation: The role of diet on outcomes. A pilot study

Dermatologic Therapy, EarlyView.

https://ift.tt/2LhqLQ5

Experimental Study of Build Orientation in Direct Metal Laser Sintering of 17-4PH Stainless Steel

3D Printing and Additive Manufacturing, Ahead of Print.

https://ift.tt/2LuleCK

Efficacy and safety of rupatadine in Japanese adult and adolescent patients with chronic spontaneous urticaria: A double-blind, randomized, multicenter, placebo-controlled clinical trial

Publication date: Available online 18 July 2018

Source: Allergology International

Author(s): Michihiro Hide, Takamasa Suzuki, Ayaka Tanaka, Hiroshi Aoki

Abstract

Background

Rupatadine, a novel nonsedating second-generation H1-antihistamine with antiplatelet-activating factor activity, has been used in the treatment of allergic rhinitis and urticaria in European countries since 2003. However, its efficacy and safety in Japanese patients with chronic spontaneous urticaria (CSU) are unknown.

Methods

We conducted a prospective, multicenter, randomized, placebo-controlled, double-blind study in adolescent and adult CSU outpatients aged 12 to < 65 years (JAPIC-CTI No. 152786). Overall, 94, 91, and 92 eligible patients orally received placebo, rupatadine 10 mg, and 20 mg once daily for 2 weeks, respectively. The primary endpoint was change from baseline to the second week of treatment in total pruritus score (TPS, sum of daytime and nighttime pruritus scores).

Results

The results yielded a least squares mean TPS difference of −1.956 between rupatadine 10 mg versus placebo, and −2.121 between rupatadine 20 mg versus placebo (analysis of covariance, both P < 0.001). The incidence of adverse events was 8.5% for placebo, 20.9% for rupatadine 10 mg, and 17.4% for rupatadine 20 mg. Somnolence was the only adverse drug reaction to rupatadine reported in 2 or more subjects. No serious or clinically significant adverse events were observed.

Conclusions

The primary and secondary efficacy endpoints consistently favored rupatadine 10 and 20 mg doses over the placebo. No noteworthy dose-related increase in the incidence of adverse drug reactions was observed. Rupatadine is safe and effective at a dose of 10 mg once daily, and can be safely increased to 20 mg once daily, as necessary.

https://ift.tt/2JxY5xz

Human Th9 differentiation is dependent upon STAT3 to restrain STAT1-mediated inhibition

Publication date: Available online 18 July 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Yuan Zhang, Andrea M. Siegel, Guangping Sun, Tom Dimaggio, Alexandra F. Freeman, Joshua D. Milner

Abstract

Background

Patients with loss of function (LOF) signal transducer and activator of transcription 3 (STAT3) mutations have dermatitis, enhanced IgE production despite a relative lack of immediate hypersensitivity, recurrent infection, and an increased rate of lymphoma, in addition to a number of skeletal and connective tissue abnormalities. Gain of function (GOF) STAT1 mutant patients also have susceptibility to candidiasis and sinopulmonary infection, as well as autoimmunity and squamous cell carcinoma, in addition to even more broad phenotypes.

Objective

Because of the link between Th9 cells and allergic inflammation, autoimmunity and anti-tumor surveillance, and because evidence shows either the role for STAT3 or STAT1 in Th9 differentiation conflicts, we wished to determine the status on this lineage of STAT1GOF and STAT3LOF in humans.

Methods

We detected IL-9 levels and Th9 differentiation of STAT3LOF and STAT1GOF patients, together with Th9 transcript factors, and partially rescued their deficiency in vitro by adding cytokines they lacked or transfecting key molecules.

Results

We found that PBMCs or sorted naïve CD4+ T cells from STAT3LOF and STAT1GOF patients had impaired Th9 generation/differentiation. STAT3 inhibition in normal Th9 cultures diminished early IL-21 induction and late IL-9 production, while exogenous IL-21 enhanced Th9 differentiation even with STAT3 inhibition, by restoring SOCS3 expression and thus inhibiting excessive p-STAT1 activation. Furthermore, exogenous expression of SOCS3 or either T-bet or STAT1 RNAi in STAT3 LOF cells partially rescued IL-9 differentiation.

Conclusion

Collectively, these results suggest that human Th9 differentiation depends on normal p-STAT3 and IL-21 production to suppress p-STAT1 activation and T-bet transcription.

Graphical abstract

Graphical abstract for this article

https://ift.tt/2Noip6U

Editorial Board

Publication date: August 2018

Source: Journal of Autoimmunity, Volume 92

Author(s):

https://ift.tt/2zZHbZh

Immunomodulatory effect of thymoquinone on atopic dermatitis

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Hina Aslam, Muhammad Shahzad, Arham Shabbir, Sabeen Irshad

Abstract

Background

Atopic dermatitis (AD) or atopic eczema is a skin disease characterized with itching, increased serum level of immunoglobulin E, and peripheral eosinophilia. Thymoquinone (TQ) is an important ingredient of Nigella sativa seeds having antioxidant and anti-inflammatory effects.

Objective

Present study investigates the immunomodulatory effects of Thymoquinone (TQ) in mice model of atopic dermatitis.

Methods

Ear pinnas of mice were sensitized and challenged with DNCB (2–4 di nitro chloro benzene) to induce AD-like lesions. The mice were then treated with TQ and tacrolimus, both orally and topically. Ear thickness and weight were measured along with gross changes. Total and differential leukocyte counts were measured in blood. Total serum IgE levels were measured by enzyme linked immunosorbent assay (ELISA). The mRNA expression levels of IL-4, IL-5, and IFN-γ in ear tissue were measured using reverse transcription polymerase chain reaction (RT-PCR).

Results

Both oral and topical thymoquinone showed the potential to improve atopic dermatitis by significantly reducing the inflammatory cells infiltration in the blood (p <  0.001) and improving the dermatitis score (p < 0.001). Significant reduction in ear thickness (p < 0.001) and IgE levels (p < 0.001) were also observed. TQ and tacrolimus also significantly attenuated mRNA expression levels of IL-4, IL-5 and IFN-γ (p <  0.001).

Conclusions & clinical relevance

Taken together, our results showed that oral and topical application of thymoquinone exerts immunomodulatory effects in animal model of atopic dermatitis, suggesting further studies and clinical trials to establish it as a candidate nutraceutical for the treatment of AD.

https://ift.tt/2zQ6woi

Molecular identification and gene expression profiles of the T cell receptors and co-receptors in developing red-tailed phascogale (Phascogale calura) pouch young

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Casey R. Borthwick, Lauren J. Young, Julie M. Old

Abstract

Expressed coding sequences were identified for the T cell receptors TCRα, TCRβ, TCRγ, TCRδ, TCRμ, and co-receptors CD3ε, CD4, and CD8α in the red-tailed phascogale (Phascogale calura). Expression of these genes was examined in the developing thymus and spleen of pouch young and juvenile individuals to detect any changes in expressionrelative to developmental stages. Transcripts of CD3ε, CD4, TCRδ and TCRμ were first detected in the thorax at 1 day postpartum (dpp), and transcripts of all target genes were detected in the thymus from 3 dpp, and the spleen from 17 dpp. The relative expression of all target genes changed significantly over the course of pouch life and was associated with histological milestones of both the thymus and the spleen. Peak gene expression was observed early in pouch life in the thymus, with a decrease in expression associated with timing of thymic involution, while expression peaked later in the spleen and was associated with the initial differentiation of the red and white pulp and a population of T cells forming the periarterial lymphatic sheath (PALS). Active expression of these target genes within the thymus and spleen indicates that the young marsupials are actively developing immunocompetence during pouch life.

https://ift.tt/2mqpdp1

A novel Aβ epitope vaccine based on bacterium-like particle against Alzheimer’s disease

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Lu Fu, Yongqing Guo, Yao Sun, Yue Dong, Jiaxin Wu, Bin Yu, Haihong Zhang, Xianghui Yu, Hui Wu, Wei Kong

Abstract

Amyloid-beta (Aβ) plaque accumulation in the brain is one of the hallmarks of Alzheimer's disease (AD). Immunotherapy against Aβ was considered a potential strategy for reducing the Aβ load in the brain. However, none of the Aβ immunotherapies have produced clinically meaningful results to date, due to poor safety or lack of efficacy. Thus, we aimed to design a safe and effective vaccine against AD. In this study, we used bacterium-like particles (BLPs) as carriers and different copy numbers of the Aβ 1-6 peptide as epitopes to design four Aβ active immunization vaccines. The epitopes containing different copy numbers of the Aβ 1-6 peptide were specifically loaded on the surface of BLPs via fusion with a peptidoglycan anchoring domain. These four BLP-based Aβ vaccines successfully induced high levels of Aβ42-specific antibodies in mice. However, none of the vaccines induced a T-cell-mediated immune response. Importantly, the antibodies induced by these four vaccines were effective in blocking Aβ42 oligomer toxicity at the cellular level. Among the four vaccines, 6copy-Aβ 1-6 -PA-BLP was the most effective in inducing Aβ-specific antibodies, indicating that a suitable epitope copy number is critical for high immunogenicity of the BLP-based vaccine. Furthermore, high levels of serum Aβ-specific antibodies could still be detected 3 months after the final administration of 6copy-Aβ 1-6 -PA-BLP. Thus, 6copy-Aβ 1-6 -PA-BLP may be a potential therapeutic treatment for AD.

https://ift.tt/2uMch0n

Myeloid-derived suppressor cells exacerbate Sjögren’s syndrome by inhibiting Th2 immune responses

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Jingjing Qi, Dan Li, Guoping Shi, Xuefang Zhang, Yuchen Pan, Huan Dou, Genhong Yao, Yayi Hou

Abstract

Myeloid-derived suppressor cells (MDSCs) can regulate various aspects of immune responses based on their potent immune-suppressive activity. Studies reported that MDSCs participated in many autoimmune diseases. However, the role of MDSCs in Sjögren's syndrome (SS) is unknown. In this study, we determined the frequencies and function of MDSCs in non-obese diabetic (NOD) mice and SS patients. The NOD mice were adoptively transferred with MDSCs or treated with anti-Gr1 antibody. Results showed that peripheral MDSCs increased significantly with the development of SS-like syndrome in NOD mice and the percentage of MDSCs was higher in SS patients than healthy controls. The SS-like syndrome aggravated after transfer of MDSCs in NOD mice. The deletion of MDSCs in NOD mice alleviated SS-like syndrome. Mechanistically, MDSCs down-regulated the percentages of Th2 cells in NOD mice and SS patients. In summary, our findings suggested that MDSCs exacerbated Sjögren's syndrome by inhibiting Th2 cells.

https://ift.tt/2mqwkO4

Humanin prevents high glucose-induced monocyte adhesion to endothelial cells by targeting KLF2

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Xiaohui Wang, Ziheng Wu, Yangyan He, Hongkun Zhang, Lu Tian, Chengfei Zheng, Tao Shang, Qianqian Zhu, Donglin Li, Yunjun He

Abstract

Endothelial dysfunction and vascular complications induced by hyperglycemia play an important role in the pathological development of atherosclerosis in diabetes. Humanin, a 24-amino acid mitochondria-derived polypeptide, has displayed its cytoprotective effects in diverse cell types and tissues. In the current study, we aimed to characterize the effects of humanin on high glucose-induced endothelial dysfunction. Firstly, we found that humanin treatment induced the expression of Krüppel-like factor 2 (KLF2), an essential transcriptional regulator of endothelial function, at the transcriptional level in human umbilical vein endothelial cells (HUVECs). Additionally, our results indicate that humanin treatment regulated the expression of KLF2 target genes such as endothelial nitric oxide synthase (eNOS) and endothelin-1 (ET-1). Evidence demonstrated that the effects of humanin on KLF2 expression was mediated by the phosphorylation of extracellular signal regulated kinase 5 (ERK5). Furthermore, humanin restored high glucose-induced reduction of KLF2 expression. We also showed that humanin significantly reduced the expression of vascular cell adhesion molecule 1 (VCAM-1) and E-selectin. Notably, humanin treatment markedly prevented high glucose-induced attachment of the monocyte THP-1 cells to HUVECs. However, knockdown of KLF2 abolished these effects. Lastly, we report that humanin treatment inhibited high glucose-induced secretion of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). These findings suggest that humanin may have therapeutic potential for the treatment of hyperglycemia-associated endothelial dysfunction.

https://ift.tt/2uMcaSv

Summary of the updated international consensus diagnostic criteria for eosinophilic esophagitis: AGREE conference,

Publication date: Available online 18 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Jonathan M. Spergel, Evan S. Dellon, Chris A. Liacouras, Ikuo Hirano, Javier Molina-Infante, Albert J. Bredenoord, Glenn T. Furuta, On behalf of the participants of AGREE

https://ift.tt/2L6uAZm

Delayed Adverse Skin Effects After PD-1-Inhibitor Therapy

Eczema, psoriasis, and lupuslike reactions can occur even months after starting or stopping these drugs, so patients need to be monitored on an ongoing basis.
Medscape Medical News

https://ift.tt/2NoaBC2

A phase I pharmacokinetic and pharmacodynamic study of GTI-2040 in combination with gemcitabine in patients with solid tumors

Abstract

Purpose

GTI-2040 is a novel antisense oligonucleotide inhibitor of the R2 subunit of ribonucleotide reductase. This phase I study assessed safety and maximum tolerated dose (MTD) of GTI-2040 in combination with weekly gemcitabine in patients with advanced solid tumors.

Methods

GTI-2040 was given as a 14-day continuous intravenous infusion, while gemcitabine was administered on days 1, 8, and 15. This combination was repeated every 4 weeks and study followed a modified 3 + 3 Fibonacci schema. Incidence, severity of adverse events, pharmacokinetics (PK), and pharmacodynamics (PD) was assessed. Responses were assessed using RECIST criteria version 1.0 with CT scans performed after every other cycle.

Results

A total of 16 patients received at least one dose of GTI-2040/gemcitabine and were included in the safety analysis. The MTD of this regimen is 100 mg/m²/day of GTI-2040 over 14 days combined with 400 mg/m²/day of gemcitabine administered weekly on days 1, 8, and 15. The dose-limiting toxicities (DLTs) included grade 3 fatigue and thrombocytopenia with hematemesis (both at 100/600 mg/m²/day). The most common adverse events were grade 1/2 fatigue, nausea, vomiting, diarrhea, and anorexia. There was no evidence of alteration in gemcitabine PKs. PD modulation of R2mRNA expression in peripheral blood mononuclear cells was observed. No objective tumor response was observed although stable disease was seen in 25% patients.

Conclusions

The combination of GTI-2040 and gemcitabine has an acceptable safety profile in a heavily pre-treated patient population with advanced solid tumors. No clear signal of anti-tumor activity was observed; however, several patients had prolonged stable disease.

https://ift.tt/2mqAvcX

Sunscreen Use and Melanoma Risk Among Young Australian Adults

This population-based, case-control family study of data collected for the Australian Melanoma Family Study assesses the association of sunscreen use in childhood and early adulthood with the risk of cutaneous melanoma before age 40 years.

https://ift.tt/2mqvmSb

Spiky Skin in a Renal Transplant Recipient

A woman in her 70s with a cadaveric renal transplant presented with a 1-year history of a facial cutaneous eruption and mildly pruritic lesions, initially affecting malar cheeks and eyebrows and subsequently spreading to involve the nose, chin, upper trunk, and extremities. What is your diagnosis?

https://ift.tt/2uFGJsU

Timing of Onset of Adverse Cutaneous Reactions Associated With PD-1 Inhibitor Therapy

This observational study assesses the timing of onset of cutaneous reactions after initiation of programmed cell death protein 1 therapy in patients with metastatic melanoma or carcinoma.

https://ift.tt/2mwXNxX

A Comparison of Tanning Habits Among Gym Tanners and Other Tanners

This survey study evaluates the incidence of tanning in adults who use indoor gyms.

https://ift.tt/2uIrdwI

Effect of Stress Ball Use or Hand-holding on Anxiety During Skin Cancer Excision

This randomized clinical trial examines the effects of hand-holding vs stress ball use compared with usual care on anxiety in patients undergoing excisional removal of nonmelanoma skin cancer of the head or neck with local anesthesia.

https://ift.tt/2moXlBs

Scabies—An Ancient Disease With Unanswered Questions in Modern Times

This Viewpoint discusses the global disease burden of scabies, as well as its diagnosis and treatment.

https://ift.tt/2uIr2S4

Novel frontiers in detecting cancer metastasis

Abstract

Cancer microenvironment is the critical battle ground between the cancer cells and host response. Thus, more emphasis is directed to study the relationship between cancer cells and the stromal cells. Multiplex microscopy is an emerging technique in which multiple cell populations within the cancer microenvironment may be stained so that spatial relationship between cancer cells and, in particular, the immune cells may be studied during different stages of cancer development. Recent discovery of mutational burden and neoantigens in cancer has opened new landscapes in the interaction of host immune cells and cancer neoantigens. The emerging role of miRNAs may become an added dimension to study cancer beyond traditional pathway of DNA directed RNA being associated with the malignant behavior of cancer. Circulating tumor cells, cancer markers and ctDNA can be used as markers for circulating cancer cells in the blood. Further studies are needed to validate if liquid biopsy of cancer may become a routine clinical tool to screen cancer or follow patients for recurrence or responses to treatment.

https://ift.tt/2NX3Qs5

Venous air embolism in a patient with a massive upper gastrointestinal bleeding

Description

Emergency medical responders (EMS) were called in for a subject who developed multiple generalised tonic-clonic seizures attributed to hydrocodone-acetaminophen overdose and possible upper gastrointestinal (GI) bleeding. His medical history was significant for peptic ulcer disease status post partial gastrectomy, chronic alcoholism, polysubstance abuse, factor V Leiden mutation with recurrent deep venous thrombosis and pulmonary embolism on warfarin treatment. On his way to the hospital, EMS had difficulty obtaining an intravenous access, and was only successful after three attempts, and the patient was started on intravenous fluids and naloxone. In the emergency room he had an episode of massive bleeding per rectum and was haemodynamically unstable. Fluid resuscitation was started, second intravenous access was obtained and nasogastric tube was placed. CT of the chest, abdomen and pelvis without contrast (figure 1) demonstrated a small amount of air in the right atrium, main pulmonary artery, and right lower lobe segmental and...

https://ift.tt/2Jva4Mh

Splenic torsion: a rare cause of abdominal pain

Splenic torsion is an exceedingly rare but clinically important disease process that should be recognised promptly by the treating physician. In this condition, there is twisting of the spleen along its vascular pedicle, subsequently leading to abdominal pain in the setting of organ ischaemia. Vascular thrombosis and splenic infarction may ensue. Torsion has been described in cases of a known wandering spleen. Abnormal development of the splenic suspensory ligaments may predispose a patient to a wandering spleen. Treatment of splenic torsion is typically surgical, with goals of preservation of the spleen if possible.

We present a case of a young woman who presented with left-sided chest and abdominal pain and was found to have splenic torsion with complete splenic infarction. Surgical intervention was required, and splenectomy was performed. In this case presentation, we outline the multidisciplinary approach needed to care for the patient with this rare condition.

https://ift.tt/2L5nPqr

Aggressive myxoinflammatory fibroblastic sarcoma with multiple site metastases

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare soft tissue sarcoma which was initially observed in acral sites and characterised by spindle cells, pleomorphic bizarre cells and distinctive large Reed-Sternberg–like cells admixed with an intense inflammatory cell infiltrates. MIFS manifests as a slow growing often superficial lesion which can be mistaken as infectious or chronic inflammatory process or benign tumours such as nodular fasciitis, giant cell tumour of tendon sheath or synovial pseudocyst. We report a rare presentation of a MIFS in a 38-year-old man with extensive local spread from subcutaneous tissue to the ankle joint and bones as well as multiple synchronous metastases to lung, sixth rib and vertebra. Our case is peculiar for its aggressive clinical behaviour with short duration, fast growth and extensive metastases, a feature infrequent in MIFS.

https://ift.tt/2Jzlyy7

Rare cause for a common presentation: isolated pulmonary valve endocarditis yet another mimicker

Isolated pulmonary valve endocarditis (PVE) is a rare condition. Known risk factors in previous case reports were intravenous drug abuse and congenital heart disease. Epidemiology of PVE has been changing. It is now being reported specially following invasive healthcare-related procedures even in patients with structurally normal heart. Vast majority of patients present with respiratory symptoms and diagnosis of endocarditis may be challenging unless there is high index of suspicion. Various microorganisms had been isolated as aetiological agents; however, Enterococcus faecalis is being increasingly isolated. PVE mostly managed conservatively with intravenous antibiotics with option for surgical intervention in specific situations. We present a patient with isolated PVE due to E. faecalis following colonoscopy and polypectomy with predisposing risk factor of alcohol excess, mimicking clinically as pneumonia and radiologically as a neoplastic lesion.

https://ift.tt/2L79xWg

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Τετάρτη 18 Ιουλίου 2018

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