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

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Παρασκευή 27 Ιουλίου 2018

Epidermal growth factor receptor peptide vaccination induces cross-reactive immunity to human EGFR, HER2, and HER3

Abstract

Current treatments for tumors expressing epidermal growth factor receptor (EGFR) include anti-EGFR monoclonal antibodies, often used in conjunction with the standard chemotherapy, radiation therapy, or other EGFR inhibitors. While monoclonal antibody treatment is efficacious in many patients, drawbacks include its high cost of treatment and side effects associated with multiple drug infusions. As an alternative to monoclonal antibody treatments, we have focused on peptide-based vaccination to trigger natural anti-tumor antibodies. Here, we demonstrate that peptides based on a region of the EGFR extracellular domain IV break immune tolerance to EGFR and elicit anti-tumor immunity. Mice immunized with isoforms of EGFR peptide p580–598 generated anti-EGFR antibody and T-cell responses. Iso-aspartyl (iso-Asp)-modified EGFR p580 immune sera inhibit in vitro growth of EGFR overexpressing human A431 tumor cells, as well as promote antibody-dependent cell-mediated cytotoxicity (ADCC). Antibodies induced by Asp and iso-Asp p580 bound homologous regions of the EGFR family members HER2 and HER3. EGFR p580 immune sera also inhibited the growth of the human tumor cell line MDA-MB-453 that expresses HER2 but not EGFR. Asp and iso-Asp EGFR p580 induced antibodies were also able to inhibit the in vivo growth of EGFR-expressing tumors. These data demonstrate that EGFR peptides from a region of the EGFR extracellular domain IV promote anti-tumor immunity, tumor cell killing, and antibodies that are cross reactive with ErbB family members.



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Impact of Hypothyroidism and Heart Failure on Hospitalization Risk

Thyroid, Ahead of Print.


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Effect of Tumor Size and Minimal Extrathyroidal Extension in Patients with Differentiated Thyroid Cancer

Thyroid, Ahead of Print.


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The Association of Reactive Oxygen Species Levels on Noise Induced Hearing Loss of High Risk Workers in Dr. Soetomo General Hospital Surabaya, Indonesia

Abstract

Excessive noise exposure could increase the production of reactive oxygen species in the cochlea, thus causing the risk of noise-induced hearing loss (NIHL). Noise is commonly found in the industrial sites. However, public places like hospital also can have noisy location which risk the workers of NIHL. To analyzed the correlation of reactive oxygen species and hearing impairment to employees at risk in the hospital. Participants were obtained by identifying the employees in hospital from 3813. They were examined for baseline characteristics, hearing loss and reactive oxygen species. Hearing loss was defined as audiometry and tympanometry level. The statistical test that used in this study is Chi square test (p < 0.05). The proportion of participant was 42.43 ± 10.72 years old in women (58.33%) and noise levels at Dr. Soetomo General Hospital was 98.15 ± 8.16 dB in range 85.39–112.90 dB. The prevalence of NIHL was 47.92% (audiometry) and 70.83% (otoacoustic emission). Reactive oxygen species estimated 5.55 ± 4.39 ng/ml. Statistical analysis of reactive oxygen species to audiometry (p = 0.993) and reactive oxygen species to otoacoustic emission (p = 0.647). Increased production of reactive oxygen species that cause hearing loss, but there was no correlation between reactive oxygen species and hearing loss in risk worker at the hospital.



https://ift.tt/2LsECEa

The Association of Reactive Oxygen Species Levels on Noise Induced Hearing Loss of High Risk Workers in Dr. Soetomo General Hospital Surabaya, Indonesia

Abstract

Excessive noise exposure could increase the production of reactive oxygen species in the cochlea, thus causing the risk of noise-induced hearing loss (NIHL). Noise is commonly found in the industrial sites. However, public places like hospital also can have noisy location which risk the workers of NIHL. To analyzed the correlation of reactive oxygen species and hearing impairment to employees at risk in the hospital. Participants were obtained by identifying the employees in hospital from 3813. They were examined for baseline characteristics, hearing loss and reactive oxygen species. Hearing loss was defined as audiometry and tympanometry level. The statistical test that used in this study is Chi square test (p < 0.05). The proportion of participant was 42.43 ± 10.72 years old in women (58.33%) and noise levels at Dr. Soetomo General Hospital was 98.15 ± 8.16 dB in range 85.39–112.90 dB. The prevalence of NIHL was 47.92% (audiometry) and 70.83% (otoacoustic emission). Reactive oxygen species estimated 5.55 ± 4.39 ng/ml. Statistical analysis of reactive oxygen species to audiometry (p = 0.993) and reactive oxygen species to otoacoustic emission (p = 0.647). Increased production of reactive oxygen species that cause hearing loss, but there was no correlation between reactive oxygen species and hearing loss in risk worker at the hospital.



https://ift.tt/2LsECEa

Comparison of glucagon-like peptide-1 receptor (GLP-1R) PET/CT, SPECT/CT and 3T MRI for the localisation of occult insulinomas: evaluation of diagnostic accuracy in a prospective crossover imaging study

Abstract

Purpose

Benign insulinomas are the most prevalent cause of endogenous hyperinsulinaemic hypoglycaemia (EHH) in adults, and because of their small size are difficult to localise. The purpose of the study was to test the diagnostic accuracy and clinical impact of glucagon-like peptide-1 receptor (GLP-1R) PET/CT using 68Ga-DOTA-exendin-4 in consecutive adult patients referred for localisation of insulinomas. The results were compared with 111In-DOTA-exendin-4 SPECT/CT, study-MRI and previously performed external CT and/or MRI (prior external CT/MRI).

Methods

We prospectively enrolled patients with neuroglycopenic symptoms due to EHH. GLP-1R PET/CT, SPECT/CT and study-MRI were performed in a randomised, crossover order within 3–4 days. The reference standard was surgery with histology and treatment outcome.

Results

From January 2014 until March 2017, 52 patients were recruited. All imaging and invasive procedures before recruitment identified suspicious lesions in 46.2% of patients. GLP-1R PET/CT, SPECT/CT and study-MRI detected suspicious lesions in 78.8%, 63.5% and 63.4% of patients, respectively. In 38 patients, conclusive histology was available for final analysis.

Accuracy (95% confidence interval) for PET/CT, SPECT/CT, study-MRI and prior external CT/MRI was 93.9% (87.8–97.5%), 67.5% (58.1–76.0%), 67.6% (58.0–76.1%) and 40.0% (23.9–57.9%), respectively (all P values < 0.01, except comparison of SPECT/CT and study-MRI with a P value = 1.0). Impact on clinical management was 42.3%, 32.7% and 33.3% for PET/CT, SPECT/CT and study-MRI, respectively. Percentage reading agreement was 89.5%, 75.7%, and 71.1% for PET/CT, SPECT/CT and study-MRI, respectively.

Conclusion

68Ga-DOTA-exendin-4 PET/CT performed significantly better than 111In-DOTA-exendin-4 SPECT/CT and MRI in the localisation of benign insulinomas and should be considered in patients where localisation fails with CT/MRI (ClinicalTrials.gov, NCT02127541).



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Harnessing CRISPR to combat human viral infections

Hendrik de Buhr | Robert Jan Lebbink

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Two siblings with metachromatic leukodystrophy caused by a novel identified homozygous mutation in the ARSA gene

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


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Resistance exercise alone improves muscle strength in growth hormone deficient males in the transition phase

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2uW8dM9

Prepubertal gynaecomastia in a boy with Peutz-Jeghers syndrome: managing the aromatase overexpression

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2NMJjFB

Maternal iodine excess: an uncommon cause of acquired neonatal hypothyroidism

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2uX7NVF

Intracranial pathologies associated with central diabetes insipidus in infants

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2NQIcEG

Foxa1 and Foxa2 in thymic epithelial cells (TEC) regulate medullary TEC and regulatory T-cell maturation

Publication date: Available online 27 July 2018

Source: Journal of Autoimmunity

Author(s): Ching-In Lau, Diana C. Yánez, Anisha Solanki, Eleftheria Papaioannou, José Ignacio Saldaña, Tessa Crompton

Abstract

The Foxa1 and Foxa2 transcription factors are essential for mouse development. Here we show that they are expressed in thymic epithelial cells (TEC) where they regulate TEC development and function, with important consequences for T-cell development. TEC are essential for T-cell differentiation, lineage decisions and repertoire selection. Conditional deletion of Foxa1 and Foxa2 from murine TEC led to a smaller thymus with a greater proportion of TEC and a greater ratio of medullary to cortical TEC. Cell-surface MHCI expression was increased on cortical TEC in the conditional Foxa1Foxa2 knockout thymus, and MHCII expression was reduced on both cortical and medullary TEC populations. These changes in TEC differentiation and MHC expression led to a significant reduction in thymocyte numbers, reduced positive selection of CD4+CD8+ cells to the CD4 lineage, and increased CD8 cell differentiation. Conditional deletion of Foxa1 and Foxa2 from TEC also caused an increase in the medullary TEC population, and increased expression of Aire, but lower cell surface MHCII expression on Aire-expressing mTEC, and increased production of regulatory T-cells. Thus, Foxa1 and Foxa2 in TEC promote positive selection of CD4SP T-cells and modulate regulatory T-cell production and activity, of importance to autoimmunity.



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Reconstruction with submental flap for aggressive orofacial cancer- an updated series

Publication date: Available online 27 July 2018

Source: American Journal of Otolaryngology

Author(s): Tam-Lin Chow, Wilson W.Y. Kwan, Siu-Chung Fung, Lai-In Ho, Ka-Lai Au

Abstract
Purpose

Submental flap is gaining popularity for head and neck reconstruction. We have reported in 2007 our early experience of using submental flap for aggressive orofacial malignancy. Novel flap design and application is described in this updated series.

Materials and Methods

15 patients who had received submental flap reconstruction after extirpation of newly diagnosed aggressive orofacial lesions were retrieved. The details of the flap harvest was studied for flap size, inclusion of mylohyoid muscle, antegrade versus retrograde blood supply, and compared with our previous series.

Results

The dimension of flap skin paddle was 30cm2 (range 20–72). Retrograde pedicle flow was used in 2(13.3%) patients. Mylohyoid muscle was included in the flap in 6(40%) patients. There was no total flap necrosis while partial flap necrosis occurred in 1 patient(6.7%). There was a significant increase of inclusion of mylohyoid muscle to the flap in this series (p = 0.02). Novel techniques including double-paddled flap skin to resurface full-thickness defect and chimeric osteocutaneous mandible submental flap for maxillary defect were successfully performed.

Conclusions

Submental flap is a viable reconstructive option in selected patients with aggressive orofacial malignancy. The indications are expanding and its technical modification is evolving and resulting in more innovative applications.



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Prognostic significance of normalized FDG-PET parameters in patients with multiple myeloma undergoing induction chemotherapy and autologous hematopoietic stem cell transplantation: a retrospective single-center evaluation

Abstract

Purpose

The purpose of this study was to determine retrospectively, through a single-center evaluation, whether FDG PET-CT normalized semi-quantitative parameters may predict response to induction chemotherapy (iChT) and hematopoietic stem cell transplantation (HSCT), as well as disease progression and progression-free survival in multiple myeloma (MM) patients, thus becoming a tool of personalized medicine.

Methods

Patients undergoing iChT and HSCT with baseline and post-treatment FDG PET-CTs from January 2008 to July 2015 were included. The following baseline and post-treatment parameters were obtained: SUVmax, SUVmean, SUVpeak, MTVsum, TLGsum, rPET (lesion SUVmax/liver SUVmax) and qPET (lesion SUVpeak/liver SUVmean). Baseline-to-post-treatment changes (Δ) were also calculated. Metabolic and clinical laboratory progression or response at follow-up were noted; time-to-metabolic-progression (TMP) was defined as the interval from post-treatment scan to eventual progression at follow-up FDG PET-CTs. Possible association between each functional parameter and metabolic/clinical-laboratory progression or response was determined. Kaplan-Meier curves allowed to depict the TMP trend according to FDG PET-CT parameters.

Results

Twenty-eight patients were included. Significantly higher ΔrPET and ΔqPET values were observed in ten patients with "metabolic response", with respect to 18 patients having "metabolic progression" (median 0.62 [IQR 0.32 – 1.34] vs median 0.00 [IQR -0.25 – 0.49] for ΔrPET; P = 0.045; median 0.51 [IQR 0.32 – 1.13] vs median 0.00 [IQR -0.31 – 0.67] for ΔqPET; P = 0.035). Neither normalized nor non normalized parameters differed significantly between the 20 patients with "clinical-laboratory response" and the eight patients with "clinical-laboratory progression". ΔrPET value lower than 0.38 and ΔqPET value lower than 0.27 predicted a significantly shorter TMP (P = 0.003 and P = 0.005, respectively).

Conclusions

Normalized semi-quantitative parameters are effective in predicting persistent response to treatment and shorter TMP in patients with MM undergoing iChT and HSCT.



https://ift.tt/2NQsedI

Diagnostic Algorithm for Evaluating Nasal Airway Obstruction

Nasal obstruction is a common symptom and can have a large impact on patient quality of life. There are numerous causes, including anatomic, congenital, inflammatory, infectious, neoplastic, toxic, and systemic. An algorithmic approach can aid in ensuring all pertinent patient information is incorporated into the final diagnosis and treatment plan. Key components include a thorough history, physical examination including modified Cottle and Cottle maneuver, patient-reported outcome measures and/or quality of life questionnaires, examination with and without decongestion, and nasal endoscopy. The resultant information can then be effectively used to narrow the differential and guide the next steps in management.

https://ift.tt/2LJK7NW

Small airway function in children with mild-to-moderate asthmatic symptoms and healthy controls

Background: Clinical significance of small airway obstruction in mild pediatric asthma is unclear.Objective: To evaluate small airway properties in children with mild-tomoderate asthmatic symptoms, and the association of small airway function with asthma control and exercise-induced bronchoconstriction (EIB).Methods: Children (5-10 years) with either recurrent wheezing (n=42) or persistent troublesome cough (n=16), and healthy controls (n=19) performed impulse oscillometry (IOS), spirometry, and multiple-breath nitrogen washout (MBNW) test.

https://ift.tt/2mNewwT

Management of anaphylaxis and allergies in patients with long QT syndrome - review of current evidence

Long QT syndrome (LQTS) represents a diverse group of inherited and acquired disorders of ventricular repolarization characterized by prolongation of the QT interval associated with an increased risk of life-threatening Torsades de Pointes (TdP) ventricular tachycardias. Symptoms of TdP ventricular tachycardia range from syncope, when TdP stops spontaneously, to cardiac arrest, when TdP deteriorates to ventricular fibrillation. The diagnosis of inherited LQTS (iLQTS) relies on prolonged QT interval in the electrocardiogram (ECG) or prolongation of the heart beat corrected QT interval (QTc) respectively, clinical and family history and/ or genetic testing 1.

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Direct oral amoxicillin challenge without antecedent penicillin skin testing in low-risk patients

Temino et al recently described outcomes of an outpatient penicillin skin testing initiative in an allergy clinic.1 Consistent with other studies, >90% of patients labeled as penicillin (PCN) allergic were found to be tolerant of PCN. This is in accordance with current guidelines encouraging routine PCN allergy verification in all comers with this diagnosis, in view of the substantial clinical and economic consequences of a PCN allergy label.

https://ift.tt/2mRekMZ

Use of Biomarkers to Identify Phenotypes and Endotypes of Severe Asthma

Severe asthma is a complex, heterogeneous set of diseases. The European Respiratory Society and American Thoracic Society Task Force define severe asthma as asthma that requires or remains uncontrolled despite treatment with systemic corticosteroids or high dose inhaled corticosteroids plus another controller such as a long acting beta agonist1. Lack of control can be determined by symptoms, lung function, or exacerbations, accounting for inter-individual variability in disease state and outcomes.

https://ift.tt/2Ai4Owb

Small airway function in children with mild-to-moderate asthmatic symptoms and healthy controls

Publication date: Available online 27 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Hanna Knihtilä, Anne Kotaniemi-Syrjänen, Anna S. Pelkonen, Mika J. Mäkelä, L Pekka Malmberg

Abstract

Background: Clinical significance of small airway obstruction in mild pediatric asthma is unclear.

Objective: To evaluate small airway properties in children with mild-tomoderate asthmatic symptoms, and the association of small airway function with asthma control and exercise-induced bronchoconstriction (EIB).

Methods: Children (5-10 years) with either recurrent wheezing (n=42) or persistent troublesome cough (n=16), and healthy controls (n=19) performed impulse oscillometry (IOS), spirometry, and multiple-breath nitrogen washout (MBNW) test. Exhaled nitric oxide (NO) was measured at multiple flow rates to determine alveolar NO concentration (CALV). Asthma control was evaluated with the Childhood Asthma Control Test (C-ACT), short-acting beta2-agonist (SABA) use within the past month, and asthma exacerbations within the past year.

Results: IOS, spirometry, and exhaled NO indices which are related to small airway function differed between children with recurrent wheezing and healthy controls, whereas only forced expiratory flow at 25-75% of the forced vital capacity (FEF25-75) was associated with persistent cough. MBNW indices showed no difference between the groups. Among symptomatic children, conducting airway ventilation inhomogeneity (Scond) and CALV were associated with asthma exacerbations (p=0.028 and p=0.002, respectively), and lung clearance index (LCI) and CALV were associated with EIB (p=0.044 and p=0.004, respectively). None of the proposed small airway indices was associated with the C-ACT score or SABA use.

Conclusion: Subtle changes were observed in the proposed small airway indices of IOS, spirometry, and exhaled NO among children with mild-tomoderate recurrent wheezing. Small airway dysfunction, expressed as ventilation inhomogeneity indices and CALV, was also associated with asthma exacerbations and EIB.



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Anatomical basis for simultaneous block of greater and third occipital nerves, with an ultrasound-guided technique

Abstract

Purpose

In some headache disorders, for which the greater occipital nerve block is partly effective, the third occipital nerve is also suggested to be involved. We aimed to establish a simple technique for simultaneously blocking the greater and third occipital nerves.

Methods

We performed a detailed examination of dorsal neck anatomy in 33 formalin-fixed cadavers, and deduced two candidate target points for blocking both the greater and third occipital nerves. These target points were tested on three Thiel-fixed cadavers. We performed ultrasound-guided dye injections into these points, examined the results by dissection, and selected the most suitable injection point. Finally, this target point was tested in three healthy volunteers. We injected 4 ml of local anesthetic and 1 ml of radiopaque material at the selected point, guided with a standard ultrasound system. Then, the pattern of local anesthetic distribution was imaged with computed tomography.

Results

We deduced that the most suitable injection point was the medial head of the semispinalis capitis muscle at the C1 level of the cervical vertebra. Both nerves entered this muscle, in close proximity, with little individual variation. In healthy volunteers, an anesthetic injected was confined to the muscle and induced anesthesia in the skin areas innervated by both nerves.

Conclusions

The medial head of the semispinalis capitis muscle is a suitable landmark for blocking the greater and third occipital nerves simultaneously, by which occipital nerve involvement in various headache disorders may be rapidly examined and treated.



https://ift.tt/2K2cWjV

The history and progress of local anesthesia: multiple approaches to elongate the action

Abstract

Analgesia and temporary inhibition of motor activity without interfering with central nervous function have been the essential merits of local anesthesia. Local anesthetics originated from cocaine have played a major role in local analgesia. However, the relatively short duration of action of local anesthetics has been a concern in intra- and post-operative analgesia. From the early age of modern local anesthesia, physicians and medical scientists had been struggling to control the active duration of local anesthetics. Such approach includes: development of long-acting local anesthetics, with physical tourniquet techniques, co-administration of other medicines such as vaso-constrictive agents or analgesics, development of mechanical devices to continuously or intermittently administer local anesthetics, and utilization of pharmaceutical drug delivery systems. In this review, the historical sequence of studies that have been performed in an effort to elongate the action of local anesthetics is presented, referring to epoch-making medical and scientific studies.



https://ift.tt/2Lu3E61

Preface to the Special issue for the 27th International complement workshop

Publication date: Available online 27 July 2018

Source: Molecular Immunology

Author(s): Andrea J. Tenner, John P. Atkinson, V. Michael Holers



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mTOR pathway activation in large vessel vasculitis

Publication date: Available online 27 July 2018

Source: Journal of Autoimmunity

Author(s): A. Maciejewski-Duval, C. Comarmond, A. Leroyer, M. Zaidan, A. Le Joncour, A.C. Desbois, J.P. Fouret, F. Koskas, P. Cluzel, M. Garrido, P. Cacoub, D. Saadoun

Abstract
Background

Mammalian target of rapamycin complex 1 (mTORC 1) drives the proinflammatory expansion of T helper (TH) type 1, TH17 cells and controls fibroblast proliferation, typical features of large vessel vasculitis (LVV) pathogenesis. Molecular pathways involved in arterial lesions of LVV are unknown.

Methods

We evaluate mTORC pathway activation in vascular aorta lesions and in T cell homeostasis of patients with LVV.

Results

Proliferation of both endothelial cells and vascular smooth-muscle cells was shown in vascular lesions in LVV. The vascular endothelium of proliferating aorta vessels from patients with LVV showed indications of activation of the mTORC1 pathway (S6RP phosphorylation). In cultured vascular endothelial cells, sera from patients with LVV stimulated mTORC1 through the phosphorylation of S6RP. mTORC1 activation was found also in Th1 and Th17 cells both systemically and in inflamed vessels. Patients with LVV exhibited a diminished S6RP phosphorylation in Tregs. Inhibition of mTORC1 pathway with rapamycin, increase Tregs and decrease effector CD4+IFNγ+, CD4+IL17+ and CD4+IL21+ T cells in patients with LVV.

Conclusions

We provided evidence that mTORC1 pathway has a central role in driving T cell inflammation and vascular lesions in LVV. Targeting mTORC pathway may represent a new therapeutic option in patients with LVV.



https://ift.tt/2OlrsGV

Hyperhidrosis: Five Things to Know

Public awareness of this medical condition is driving many patients out of the woodwork and into their provider's offices. Be ready to discuss the treatment options.
Medscape Dermatology

https://ift.tt/2mOS5aO

A Study on the In-Situ Melt Pool Size Estimation Method for Directed-Energy Additive Manufacturing Based on Modal Parameters

3D Printing and Additive Manufacturing, Ahead of Print.


https://ift.tt/2LMNROK

Robot-assisted laparoscopic surgery using DROP-IN radioguidance: first-in-human translation

Abstract

Purpose

Radioguided surgery has been widely used for clinical procedures such as sentinel node resections. In the (robot-assisted) laparoscopic setting radioguidance is realized using laparoscopic gamma probes, which have limited maneuverability. To increase the rotational freedom, a tethered DROP-IN gamma probe was designed. Here we present the first in vivo feasibility study of this technology in prostate cancer patients.

Methods

Ten patients scheduled for a sentinel node procedure received four injections into the prostate with (indocyanine green-)99mTechnetium-nanocolloid and underwent preoperative imaging (lymphoscintigraphy and SPECT/CT). The DROP-IN probe was inserted via the assistant port, still permitting the insertion and usage of additional laparoscopic tools.

Results

The sentinel nodes were resected using the da Vinci® Si robot under guidance of DROP-IN gamma tracing and fluorescence imaging. The surgeon was able to independently maneuver the DROP-IN probe using the ProGrasp® forceps of the da Vinci® robot and distinguish sentinel nodes from background signal (such as the injection site).

Conclusions

Overall the DROP-IN design proves to be a valuable tool for robot-assisted radioguided surgery approaches.



https://ift.tt/2NR3rpV

Thyroid® High-Impact Articles

thyroid-cover-july-2018.png

FREE ACCESS through August 9, 2018.
Read now:

Latest Impact Factor: 7.557
The Official Journal of: American Thyroid Association®

American Thyroid Association Statement on Postoperative Hypoparathyroidism: Diagnosis, Prevention, and Management in Adults
Lisa A. Orloff, Sam M. Wiseman, Victor J. Bernet, Thomas J. FaheyIII, Ashok R. Shaha, Maisie L. Shindo, Samuel K. Snyder, Brendan C. StackJr., John B. Sunwoo, and Marilene B. Wang

Does Reverse Triiodothyronine Testing Have Clinical Utility? An Analysis of Practice Variation Based on Order Data from a National Reference Laboratory
Robert L. Schmidt, Jonathan S. LoPresti, Michael T. McDermott, Suzanna M. Zick, and Joely A. Straseski

Needle Biopsy of Routine Thyroid Nodules Should Be Performed Using a Capillary Action Technique with 24- to 27-Gauge Needles: A Systematic Review and Meta-Analysis
William J. Moss, Andrey Finegersh, John Pang, Joseph A. Califano, Charles S. Coffey, Ryan K. Orosco, and Kevin T. Brumund

Changing Trend of Thyroglobulin Antibodies in Patients With Differentiated Thyroid Cancer Treated With Total Thyroidectomy Without 131I Ablation
Antonio Matrone, Francesco Latrofa, Liborio Torregrossa, Paolo Piaggi, Carla Gambale, Alessio Faranda, Debora Ricci, Laura Agate, Eleonora Molinaro, Fulvio Basolo, Paolo Vitti, and Rossella Elisei

Neoadjuvant BRAF- and Immune-Directed Therapy for Anaplastic Thyroid Carcinoma
Maria E. Cabanillas, Renata Ferrarotto, Adam S. Garden, Salmaan Ahmed, Naifa L. Busaidy, Ramona Dadu, Michelle D. Williams, Heath Skinner, G. Brandon Gunn, Horiana Grosu, Priyanka Iyer, Marie Claude Hofmann, and Mark Zafereo

The post <i>Thyroid<sup>®</sup></i> High-Impact Articles appeared first on American Thyroid Association.



https://ift.tt/2mOM1yZ

Thyroid® High-Impact Articles

thyroid-cover-july-2018.png

FREE ACCESS through August 9, 2018.
Read now:

Latest Impact Factor: 7.557
The Official Journal of: American Thyroid Association®

American Thyroid Association Statement on Postoperative Hypoparathyroidism: Diagnosis, Prevention, and Management in Adults
Lisa A. Orloff, Sam M. Wiseman, Victor J. Bernet, Thomas J. FaheyIII, Ashok R. Shaha, Maisie L. Shindo, Samuel K. Snyder, Brendan C. StackJr., John B. Sunwoo, and Marilene B. Wang

Does Reverse Triiodothyronine Testing Have Clinical Utility? An Analysis of Practice Variation Based on Order Data from a National Reference Laboratory
Robert L. Schmidt, Jonathan S. LoPresti, Michael T. McDermott, Suzanna M. Zick, and Joely A. Straseski

Needle Biopsy of Routine Thyroid Nodules Should Be Performed Using a Capillary Action Technique with 24- to 27-Gauge Needles: A Systematic Review and Meta-Analysis
William J. Moss, Andrey Finegersh, John Pang, Joseph A. Califano, Charles S. Coffey, Ryan K. Orosco, and Kevin T. Brumund

Changing Trend of Thyroglobulin Antibodies in Patients With Differentiated Thyroid Cancer Treated With Total Thyroidectomy Without 131I Ablation
Antonio Matrone, Francesco Latrofa, Liborio Torregrossa, Paolo Piaggi, Carla Gambale, Alessio Faranda, Debora Ricci, Laura Agate, Eleonora Molinaro, Fulvio Basolo, Paolo Vitti, and Rossella Elisei

Neoadjuvant BRAF- and Immune-Directed Therapy for Anaplastic Thyroid Carcinoma
Maria E. Cabanillas, Renata Ferrarotto, Adam S. Garden, Salmaan Ahmed, Naifa L. Busaidy, Ramona Dadu, Michelle D. Williams, Heath Skinner, G. Brandon Gunn, Horiana Grosu, Priyanka Iyer, Marie Claude Hofmann, and Mark Zafereo

The post <i>Thyroid<sup>®</sup></i> High-Impact Articles appeared first on American Thyroid Association.



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Accuracy of identifying the cricothyroid membrane in children using palpation

Abstract

Accurate identification of the cricothyroid membrane (CTM) has paramount importance in the event of a 'cannot intubate, cannot oxygenate' scenario. We sought to determine the ability of anesthesiologists to correctly identify the CTM in obese and non-obese children. Anesthesiologists were asked to mark the entry point of the cricothyroidotomy device with an ultraviolet invisible pen on obese and non-obese (BMI < 95th percentile for age and sex) children aged 7–12 years. A correct estimation was defined as a mark made between the upper and lower borders of the CTM and within the 3-mm midline. Twenty anesthesiologists palpated 30 obese and 50 non-obese children. The CTM was accurately identified with digital palpation in a total 55% of children, and there were no differences inaccurate identification rates of the CTM between obese and non-obese children [57 vs. 54%, respectively; median difference 3%; 95% confidence interval (− 20 to 25%); p = 0.82]. Accuracy was not correlated with any demographic or morphometric features of the children. Percutaneous identification of the CTM in children aged 7–12 years was poor and not significantly different for obese and non-obese children. Pre-procedural ultrasonography may help to identify the landmarks for cricothyroidotomy.



https://ift.tt/2ApFEfh

Opioids, gliosis and central immunomodulation

Abstract

Neuropathic pain is a common health problem that affects millions of people worldwide. Despite being studied extensively, the cellular and molecular events underlying the central immunomodulation and the pathophysiology of neuropathic pain is still controversial. The idea that 'glial cells are merely housekeepers' is incorrect and with respect to initiation and maintenance of neuropathic pain, microglia and astrocytes have important roles to play. Glial cells differentially express opioid receptors and are thought to be functionally modulated by the activation of these receptors. In this review, we discuss evidence for glia-opioid modulation of pain by focusing on the pattern of astrocyte and microglial activation throughout the progress of nerve injury/neuropathic pain. Activation of astrocytes and microglia is a key step in central immunomodulation in terms of releasing pro-inflammatory markers and propagation of a 'central immune response'. Inhibition of astrocytes before and after induction of neuropathic pain has been found to prevent and reverse neuropathic pain, respectively. Moreover, microglial inhibitors have been found to prevent (but not to reverse) neuropathic pain. As they are expressed by glia, opioid receptors are expected to have a role to play in neuropathic pain.



https://ift.tt/2Oo34nZ

Management of anaphylaxis and allergies in patients with long QT syndrome - review of current evidence

Publication date: Available online 27 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Tatjana Welzel, Victoria C. Ziesenitz, Stefanie Seitz, Birgit Donner, Johannes N. van den Anker



https://ift.tt/2AbCgo1

Direct oral amoxicillin challenge without antecedent penicillin skin testing in low-risk patients

Publication date: Available online 27 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Merin Kuruvilla, Jamie Thomas



https://ift.tt/2mMd0LB

Use of Biomarkers to Identify Phenotypes and Endotypes of Severe Asthma

Publication date: Available online 27 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Tara F Carr, Monica Kraft



https://ift.tt/2AfEnqZ

SHR-1210 in Combination With Apatinib and Chemotherapy in Patients With Advanced Esophageal Squamous Cell Cancer

Condition:   Esophageal Squamous Cell Carcinoma
Interventions:   Drug: SHR-1210;   Drug: Apatinib;   Drug: Irinotecan Injection;   Drug: Paclitaxel liposome;   Drug: Nedaplatin
Sponsor:   Chinese Academy of Medical Sciences
Not yet recruiting

https://ift.tt/2uRINiK

SUV Accuracy of PET/MR

Condition:   Positron Emission Tomography-Magnetic Resonance (PET-MR)
Interventions:   Diagnostic Test: Positron Emission Test / Magnetic Resonance (PET/MR);   Diagnostic Test: Positron Emission Test / Computed Tomography (PET/CT)
Sponsors:   Case Comprehensive Cancer Center;   National Institutes of Health (NIH)
Not yet recruiting

https://ift.tt/2LTH7f0

A Comparison of NETSPOT Imaging Versus F-FDG-PET in Head and Neck Cancer Patients

Condition:   Head and Neck Squamous Cell Carcinoma
Intervention:   Drug: The isotope 68Ga, NETSPOT and 18F-FDG-PET/CT
Sponsor:   West Virginia University
Not yet recruiting

https://ift.tt/2uUoJMF

Pembrolizumab in Treating Participants With Leukoplakia

Conditions:   Erythroleukoplakia;   Leukoplakia;   Verrucous Oral Leukoplakia
Intervention:   Biological: Pembrolizumab
Sponsors:   Jonsson Comprehensive Cancer Center;   National Cancer Institute (NCI);   Merck Sharp & Dohme Corp.
Not yet recruiting

https://ift.tt/2NPtoXf

Evaluation of HPV OncoTect ™ for the Etiological Diagnosis of HPV-induced Oropharyngeal Cancers

Condition:   Oropharyngeal Cancer
Intervention:   Diagnostic Test: HPV OncoTect™
Sponsor:   Gustave Roussy, Cancer Campus, Grand Paris
Recruiting

https://ift.tt/2LGZTt2

SHR-1210 in Combination With Apatinib and Chemotherapy in Patients With Advanced Esophageal Squamous Cell Cancer

Condition:   Esophageal Squamous Cell Carcinoma
Interventions:   Drug: SHR-1210;   Drug: Apatinib;   Drug: Irinotecan Injection;   Drug: Paclitaxel liposome;   Drug: Nedaplatin
Sponsor:   Chinese Academy of Medical Sciences
Not yet recruiting

https://ift.tt/2uRINiK

SUV Accuracy of PET/MR

Condition:   Positron Emission Tomography-Magnetic Resonance (PET-MR)
Interventions:   Diagnostic Test: Positron Emission Test / Magnetic Resonance (PET/MR);   Diagnostic Test: Positron Emission Test / Computed Tomography (PET/CT)
Sponsors:   Case Comprehensive Cancer Center;   National Institutes of Health (NIH)
Not yet recruiting

https://ift.tt/2LTH7f0

A Comparison of NETSPOT Imaging Versus F-FDG-PET in Head and Neck Cancer Patients

Condition:   Head and Neck Squamous Cell Carcinoma
Intervention:   Drug: The isotope 68Ga, NETSPOT and 18F-FDG-PET/CT
Sponsor:   West Virginia University
Not yet recruiting

https://ift.tt/2uUoJMF

Pembrolizumab in Treating Participants With Leukoplakia

Conditions:   Erythroleukoplakia;   Leukoplakia;   Verrucous Oral Leukoplakia
Intervention:   Biological: Pembrolizumab
Sponsors:   Jonsson Comprehensive Cancer Center;   National Cancer Institute (NCI);   Merck Sharp & Dohme Corp.
Not yet recruiting

https://ift.tt/2NPtoXf

Evaluation of HPV OncoTect ™ for the Etiological Diagnosis of HPV-induced Oropharyngeal Cancers

Condition:   Oropharyngeal Cancer
Intervention:   Diagnostic Test: HPV OncoTect™
Sponsor:   Gustave Roussy, Cancer Campus, Grand Paris
Recruiting

https://ift.tt/2LGZTt2

Pilonidal disease, hidradenitis suppurativa and follicular occlusion syndrome: a diagnostic challenge

L'articolo Pilonidal disease, hidradenitis suppurativa and follicular occlusion syndrome: a diagnostic challenge sembra essere il primo su European Review.



https://ift.tt/2v9rV67

Pilonidal disease, hidradenitis suppurativa and follicular occlusion syndrome: a diagnostic challenge

L'articolo Pilonidal disease, hidradenitis suppurativa and follicular occlusion syndrome: a diagnostic challenge sembra essere il primo su European Review.



https://ift.tt/2v9rV67

Editorial Board

Publication date: August 2018

Source: Cortex, Volume 105

Author(s):



https://ift.tt/2LQN1NT

What we ‘see’ when we read: Visualization and vividness in reading fictional narratives

Publication date: August 2018

Source: Cortex, Volume 105

Author(s): Renate Brosch

Abstract

Visualization is defined as the production of mental images in the process of reading (Esrock 2005: 633). This article is concerned with varieties of visualization during an absorbing reading of a fictional narrative, the mental images that range from an indistinct and largely automatic default visualization to the much more vivid images that occur at significant stages in the narrative. Neuroscientific studies of vision have collected a large and impressively varied body of experimental evidence for two major processing streams – the dorsal and the ventral-specialized for vision-for-action and vision for-perception respectively. Further experiments distinguish different dispositional specializations: visualizers with a high spatial visualizing ability demonstrating a more efficient use of resources in the dorsal pathway, and those with a high object visualization and more efficient use of the ventral pathway (Kozhevnikov et al., 2010: 29). We can assume that both types of mental processing will be prompted in fictional narratives with differences in prominence depending on their authors' inclinations and the design and purpose of the narrative text. According to Amedeo D'Angiulli (2013: 7), who conducted elaborate tests of vividness in mental imagery using written descriptive passages as stimulus, dynamic imagery was significantly less vivid than static imagery. These results confirm traditional literary criticism based on introspection which argues that detailed description of static objects elicits an especially lively imagination. However, narratives can provoke even stronger visualizations by rendering subjective moments of seeing in which a fictional character is emotionally involved. In encouraging readers to shift now and then from the default mode of motion-oriented visualizing to a more affective and more conscious object visualization, literary fictions exercise their power to evoke imaginings that one would not generate by oneself. This may indicate that literary narratives can prove a training ground for expanding one's visualizing capacities.



https://ift.tt/2LIVOof

Multimodal mental imagery

Publication date: August 2018

Source: Cortex, Volume 105

Author(s): Bence Nanay

Abstract

When I am looking at my coffee machine that makes funny noises, this is an instance of multisensory perception – I perceive this event by means of both vision and audition. But very often we only receive sensory stimulation from a multisensory event by means of one sense modality, for example, when I hear the noisy coffee machine in the next room, that is, without seeing it. The aim of this paper is to bring together empirical findings about multimodal perception and empirical findings about (visual, auditory, tactile) mental imagery and argue that on occasions like this, we have multimodal mental imagery: perceptual processing in one sense modality (here: vision) that is triggered by sensory stimulation in another sense modality (here: audition). Multimodal mental imagery is not a rare and obscure phenomenon. The vast majority of what we perceive are multisensory events: events that can be perceived in more than one sense modality – like the noisy coffee machine. And most of the time we are only acquainted with these multisensory events via a subset of the sense modalities involved – all the other aspects of these multisensory events are represented by means of multisensory mental imagery. This means that multisensory mental imagery is a crucial element of almost all instances of everyday perception.



https://ift.tt/2NPElb5

The role of mental imagery in mood amplification: An investigation across subclinical features of bipolar disorders

Publication date: August 2018

Source: Cortex, Volume 105

Author(s): Caitlin O'Donnell, Martina Di Simplicio, Randi Brown, Emily A. Holmes, Stephanie Burnett Heyes

Abstract

Vivid emotional mental imagery has been identified across a range of mental disorders. In bipolar spectrum disorders – psychopathologies characterized by mood swings that alternate between depression and mania, and include irritability and mixed affect states – mental imagery has been proposed to drive instability in both 'positive' and 'negative' mood. That is, mental imagery can act as an "emotional amplifier". The current experimental study tested this hypothesis and investigated imagery characteristics associated with mood amplification using a spectrum approach to psychopathology. Young adults (N = 42) with low, medium and high scores on a measure of subclinical features of bipolar disorder (BD), i.e., hypomanic-like experiences such as overly 'positive' mood, excitement and hyperactivity, completed a mental imagery generation training task using positive picture-word cues. Results indicate that (1) mood amplification levels were dependent on self-reported hypomanic-like experiences. In particular, (2) engaging in positive mental imagery led to mood amplification of both positive and negative mood in those participants higher in hypomanic-like experiences. Further, (3) in participants scoring high for hypomanic-like experiences, greater vividness of mental imagery during the experimental task was associated with greater amplification of positive mood. Thus, for individuals with high levels of hypomanic-like experiences, the generation of emotional mental imagery may play a causal role in their mood changes. This finding has implications for understanding mechanisms driving mood amplification in bipolar spectrum disorders, such as targeting imagery vividness in therapeutic interventions.



https://ift.tt/2LFZVl6

Art, the visual imagination and neuroscience: The Chauvet Cave, Mona Lisa's smile and Michelangelo's terribilitá

Publication date: August 2018

Source: Cortex, Volume 105

Author(s): John Onians

Abstract

This paper considers several types of imagination relevant to art historical enquiry. These are exemplified in artistic expressions ranging from palaeolithic paintings in the Chauvet Cave, to drawings, sculptures and buildings designed by Michelangelo and drawings and paintings by Leonardo, and are related to recent neuroscientific discoveries. From this it emerges that important types of imagination cannot be understood without an appreciation of the neural processes that underlie them and especially without an acknowledgement of the importance of neurochemistry.



https://ift.tt/2NPEeMH

The functional effects of prior motion imagery and motion perception

Publication date: August 2018

Source: Cortex, Volume 105

Author(s): Shuai Chang, Joel Pearson

Abstract

The functional sensory effects and commonalties between mental imagery of different visual features such as color, form or motion remains largely unknown. Mental imagery of static visual features, including color and orientation, can have a facilitative, priming effect on subsequent perception. However, whether motion imagery can have a similar effect remains unknown. Here we used the binocular rivalry method as a measure of motion mental imagery. After imagining or viewing motion of a particular direction, participants were required to report the dominant motion direction in a brief motion rivalry stimulus. We found that motion imagery can have a facilitative priming effect on subsequent motion rivalry perception, and this effect can be attenuated by concurrent expanding and contracting perceptual motion, but not by static or flickering uniform luminance. Unlike color or orientation imagery, the effect of motion imagery on subsequent rivalry was location independent. We also observed this facilitative priming effect with prior low-contrast perceptual motion, but prior high-contrast motion induced a suppressive effect. Simultaneous imagery and perceptual motion in opposite directions induced priming, while congruent directions did not. Counter to prior findings, these results suggest motion imagery can have a priming effect on perception and that the rivalry method can be used to assess visual motion imagery. These results provide evidence for visual imagery as a multi-feature structure.



https://ift.tt/2LFZNlC

Personality predicts the vibrancy of colour imagery: The case of synaesthesia

Publication date: August 2018

Source: Cortex, Volume 105

Author(s): Shyla R. Hossain, Julia Simner, Alberta Ipser

Abstract

In this study we show that personality traits predict the physical qualities of mentally generated colours, using the case of synaesthesia. Developmental grapheme-colour synaesthetes have the automatic lifelong association of colours paired to letters or digits. Although these colours are internal mental constructs, they can be measured along physical dimensions such as saturation and luminance. The personality of synaesthetes can also be quantified using self-report questionnaires relating, for example, to the five major traits of Conscientiousness, Extraversion, Agreeableness, Neuroticism, and Openness to Experience. In this paper, we bring together both types of quality by examining whether the personality of individual synaesthetes predicts their synaesthetic colours. Twenty grapheme-colour synaesthetes were tested with the Big Five Inventory (BFI) personality questionnaire. Their synaesthesia was also tested in terms of consistency and average colour saturation and luminance. Two major results were found: although personality did not influence the overall robustness (i.e., consistency) of synaesthesia, it predicted the nature of synaesthetes' colours: the trait of Openness was positively correlated with the saturation of synaesthetic colours. Our study provides evidence that personality and internal perception are intertwined, and suggests future avenues of research for investigating the associations between the two.



https://ift.tt/2NPNRLg

The blind mind: No sensory visual imagery in aphantasia

Publication date: August 2018

Source: Cortex, Volume 105

Author(s): Rebecca Keogh, Joel Pearson

Abstract

For most people the use of visual imagery is pervasive in daily life, but for a small group of people the experience of visual imagery is entirely unknown. Research based on subjective phenomenology indicates that otherwise healthy people can completely lack the experience of visual imagery, a condition now referred to as aphantasia. As congenital aphantasia has thus far been based on subjective reports, it remains unclear whether individuals are really unable to imagine visually, or if they have very poor metacognition – they have images in their mind, but are blind to them. Here we measured sensory imagery in subjectively self-diagnosed aphantasics, using the binocular rivalry paradigm, as well as measuring their self-rated object and spatial imagery with multiple questionnaires (VVIQ, SUIS and OSIQ). Unlike, the general population, experimentally naive aphantasics showed almost no imagery-based rivalry priming. Aphantasic participants' self-rated visual object imagery was significantly below average, however their spatial imagery scores were above average. These data suggest that aphantasia is a condition involving a lack of sensory and phenomenal imagery, and not a lack of metacognition. The possible underlying neurological cause of aphantasia is discussed as well as future research directions.



https://ift.tt/2LFZG9G

The neural correlates of visual imagery vividness – An fMRI study and literature review

Publication date: August 2018

Source: Cortex, Volume 105

Author(s): Jon Fulford, Fraser Milton, David Salas, Alicia Smith, Amber Simler, Crawford Winlove, Adam Zeman

Abstract

Using the Vividness of Visual Imagery Questionnaire we selected 14 high-scoring and 15 low-scoring healthy participants from an initial sample of 111 undergraduates. The two groups were matched on measures of age, IQ, memory and mood but differed significantly in imagery vividness. We used fMRI to examine brain activation while participants looked at, or later imagined, famous faces and famous buildings. Group comparison revealed that the low-vividness group activated a more widespread set of brain regions while visualising than the high-vividness group. Parametric analysis of brain activation in relation to imagery vividness across the entire group of participants revealed distinct patterns of positive and negative correlation. In particular, several posterior cortical regions show a positive correlation with imagery vividness: regions of the fusiform gyrus, posterior cingulate and parahippocampal gyri (BAs 19, 29, 31 and 36) displayed exclusively positive correlations. By contrast several frontal regions including parts of anterior cingulate cortex (BA 24) and inferior frontal gyrus (BAs 44 and 47), as well as the insula (BA 13), auditory cortex (BA 41) and early visual cortices (BAs 17 and 18) displayed exclusively negative correlations. We discuss these results in relation to a previous, functional imaging study of a clinical case of 'blind imagination', and to the existing literature on the functional imaging correlates of imagery vividness and related phenomena in visual and other domains.



https://ift.tt/2LQMBah

Eying the future: Eye movement in past and future thinking

Publication date: August 2018

Source: Cortex, Volume 105

Author(s): Mohamad El Haj, Quentin Lenoble

Abstract

We investigated eye movement during past and future thinking. Participants were invited to retrieve past events and to imagine future events while their scan path was recorded by an eye-tracker. Past thinking triggered more fixation (p < .05), and saccade counts (p < .05) than future thinking. Past and future thinking triggered a similar duration of fixations and saccades, as well as a similar amplitude of saccades. Interestingly, participants rated past thinking as more vivid than future thinking (p < .01). Therefore, the vividness of past thinking seems to be accompanied by an increased number of fixations and saccades. Fixations and saccades in past thinking can be interpreted as an attempt by the visual system to find (through saccades) and activate (through fixations) stored memory representations. The same interpretation can be applied to future thinking as this ability requires activation of past experiences. However, future thinking triggers fewer fixations and saccades than past thinking: this may be due to its decreased demand on visual imagery, but could also be related to a potentially deleterious effect of eye movements on spatial imagery required for future thinking.



https://ift.tt/2LFZwPC

Does apraxia support spatial and kinematic or mirror neuron approaches to social interaction? A commentary on Binder et al. (2017)

Publication date: Available online 2 November 2017

Source: Cortex

Author(s): Arran T. Reader, Matteo Candidi



https://ift.tt/2NQuzpb

An autistic-like profile of attention and perception in synaesthesia

Publication date: Available online 25 October 2017

Source: Cortex

Author(s): Jamie Ward, Paris Brown, Jasmine Sherwood, Julia Simner

Abstract

Synaesthesia and autism are two neurodevelopmental conditions that have been shown to co-occur more than expected by chance. The studies reported here test the hypothesis that increased sensory sensitivity and enhanced Attention-to-detail are core cognitive features that are shared between them. In Study 1, we administer self-report measures of sensory sensitivity and autistic traits (the Autism Spectrum Quotient, AQ) to a large heterogeneous sample of synaesthetes. Both sensory sensitivity and the Attention-to-detail subscale of the AQ show a "dose-like" relationship with synaesthesia: namely, more kinds of synaesthesia is related to a greater shift up the autistic spectrum. Study 2 uses two objective measures of visual perception/attention linked to autistic traits: Change Blindness and detection of local embedded figures. Both measures are shown here to be sensitive to the Attention-to-detail subscale of the AQ, and synaesthetes outperformed controls on both tasks. Synaesthetes appear to occupy a specific cognitive niche of having autistic-like traits linked to enhanced perception and attention. Whilst these typically occur in the absence of the traditional impairments that define autism, they may carry the cost of increased vulnerability to clinical levels of autism (Odds Ratio = 2.07).



https://ift.tt/2uWtsgy

Testing the effectiveness of cognitive interventions in alleviating accelerated long term forgetting (ALF)

Publication date: Available online 23 October 2017

Source: Cortex

Author(s): Monica Ricci, Toh Wong, Armin Nikpour, Laurie A. Miller

Abstract

It is well established that when retrieval or other forms of testing follow shortly after the acquisition of new information, long-term memory is improved in healthy subjects (Roediger & Karpicke, 2006). It is not known whether such early interventions would alleviate ALF, a condition in which early retention is normal, but there is a steep decline over longer intervals. A different behavioral intervention (i.e., an interposed recall of a story after a longer delay) was found to prevent subsequent memory loss in a single case with ALF (Jansari, Davis, McGibbon, Firminger, & Kapur, 2010; McGibbon & Jansari, 2013), but this has yet to be replicated. In the present study, we sought to test the effectiveness of early rehearsal as well as a later interposed recall on long term memory. Three men with ALF and 10 matched, healthy males (mean age = 67 yr; mean education = 15 yr) were compared for story recall following 3 early intervention conditions. There were two early rehearsal conditions: Repeated-Recall (2 additional recalls were requested in the initial 30 min interval) and Repeated Recall With Discussion (2 additional recalls plus discussion occurred in the initial 30 min interval) as well as a Control condition, in which there was no additional rehearsal in the first 30 min. Memory for 6 stories (2 in each condition) was tested at 0 min, 30 min, 1 day, 1 week and 4 weeks. In addition, to evaluate the possible sustaining effect of an additional retrieval ("booster recall") between 1 wk and 4 wk delays, 1 story from each of the early intervention conditions was recalled at 2 weeks' delay. Consistent with the profile characteristic of ALF, nonparametric statistics revealed no group differences at 0 or 30 min recalls. For Control stories, the ALF group's recall was impaired by 24 h delay. For stories in either of the early rehearsal conditions, the patients showed better retention, performing within normal limits until the 4 week recall. The "booster recall" session at 2 weeks benefitted the patients' retention at 4 weeks, with patients' mean recall remaining within normal limits only for those stories recalled at 2 weeks. These results indicate that behavioral interventions including early rehearsal in the first several min and a booster recall at a much later time point help to prevent ALF. Confirmation of the usefulness of these interventions in other cases and investigating whether these cognitive techniques can be extended to "real world" applications are the logical next steps.



https://ift.tt/2NJZQKg

The evolution of accelerated long-term forgetting: Evidence from the TIME study

Publication date: Available online 6 October 2017

Source: Cortex

Author(s): Sharon Savage, Serge Hoefeijzers, Fraser Milton, Claire Streatfield, Michaela Dewar, Adam Zeman

Abstract
Objective

Accelerated long-term forgetting (ALF) occurs when newly learned information decays faster than normal over extended delays. It has been recognised most frequently in temporal lobe epilepsy, including Transient Epileptic Amnesia (TEA), but can also be drug-induced. Little is known about the evolution of ALF over time and its impacts upon other memory functions, such as autobiographical memory (ABM). Here we investigate the long-term outcome of ALF and ABM in a group of patients with TEA and a single case of baclofen-induced ALF.

Methods

Study 1 involved a longitudinal follow-up of 14 patients with TEA over a 10-year period. Patients repeated a neuropsychological battery, three ALF measures (with free recall probed at 30-min and 1-week), and a modified Autobiographical Memory Interview (MAMI). Performance was compared with a group of healthy age-matched controls. In Study 2, patient CS, who previously experienced baclofen-induced ALF, was followed over 4 years, and re-tested now, 18 months after ceasing baclofen. CS repeated a neuropsychological battery, three ALF experimental tasks (each probed after 30 min and 1 week), and a modified autobiographical interview (AI). Her performance was compared with healthy age-matched controls.

Results

On ALF measures, the TEA group performed significantly below controls, but when analysed individually, 4 of the 7 patients who originally showed ALF no longer did so. In two, this was accompanied by improvements in ABM for recent but not remote memory. Patient CS no longer demonstrated ALF on standard lab-based tests and now appeared to retain new episodic autobiographical events with a similar degree of episodic richness as controls.

Conclusion

Long-term follow up suggests that ALF can resolve, with improvements translating to recent ABM in some cases.



https://ift.tt/2uWuZDm

Beyond time and space: The effect of a lateralized sustained attention task and brain stimulation on spatial and selective attention

Publication date: Available online 3 October 2017

Source: Cortex

Author(s): Nir Shalev, Linde De Wandel, Paul Dockree, Nele Demeyere, Magdalena Chechlacz

Abstract

The Theory of Visual Attention (TVA) provides a mathematical formalisation of the "biased competition" account of visual attention. Applying this model to individual performance in a free recall task allows the estimation of 5 independent attentional parameters: visual short-term memory (VSTM) capacity, speed of information processing, perceptual threshold of visual detection; attentional weights representing spatial distribution of attention (spatial bias), and the top-down selectivity index. While the TVA focuses on selection in space, complementary accounts of attention describe how attention is maintained over time, and how temporal processes interact with selection. A growing body of evidence indicates that different facets of attention interact and share common neural substrates. The aim of the current study was to modulate a spatial attentional bias via transfer effects, based on a mechanistic understanding of the interplay between spatial, selective and temporal aspects of attention. Specifically, we examined here: (i) whether a single administration of a lateralized sustained attention task could prime spatial orienting and lead to transferable changes in attentional weights (assigned to the left vs right hemi-field) and/or other attentional parameters assessed within the framework of TVA (Experiment 1); (ii) whether the effects of such spatial-priming on TVA parameters could be further enhanced by bi-parietal high frequency transcranial random noise stimulation (tRNS) (Experiment 2). Our results demonstrate that spatial attentional bias, as assessed within the TVA framework, was primed by sustaining attention towards the right hemi-field, but this spatial-priming effect did not occur when sustaining attention towards the left. Furthermore, we show that bi-parietal high-frequency tRNS combined with the rightward spatial-priming resulted in an increased attentional selectivity. To conclude, we present a novel, theory-driven method for attentional modulation providing important insights into how the spatial and temporal processes in attention interact with attentional selection.



https://ift.tt/2NOEP17

The potential of real-time fMRI neurofeedback for stroke rehabilitation: A systematic review

Publication date: Available online 18 September 2017

Source: Cortex

Author(s): Tianlu Wang, Dante Mantini, Celine R. Gillebert

Abstract

Real-time functional magnetic resonance imaging (rt-fMRI) neurofeedback aids the modulation of neural functions by training self-regulation of brain activity through operant conditioning. This technique has been applied to treat several neurodevelopmental and neuropsychiatric disorders, but its effectiveness for stroke rehabilitation has not been examined yet. Here, we systematically review the effectiveness of rt-fMRI neurofeedback training in modulating motor and cognitive processes that are often impaired after stroke. Based on predefined search criteria, we selected and examined 33 rt-fMRI neurofeedback studies, including 651 healthy individuals and 15 stroke patients in total. The results of our systematic review suggest that rt-fMRI neurofeedback training can lead to a learned modulation of brain signals, with associated changes at both the neural and the behavioural level. However, more research is needed to establish how its use can be optimized in the context of stroke rehabilitation.



https://ift.tt/2LEuIhZ

Longitudinal study of accelerated long-term forgetting in children with genetic generalized epilepsy: Evidence of ongoing deficits

Publication date: Available online 15 September 2017

Source: Cortex

Author(s): Jasmin Grayson-Collins, Michael B. Gascoigne, Belinda Barton, Richard Webster, Deepak Gill, Suncica Lah

Abstract

Accelerated long-term forgetting (ALF) is a recently described memory disorder characterised by adequate recall after short, but not long delays. Currently, the prevailing conceptualisation of ALF is of a seizure related phenomenon. The main aim of this study was to assess whether ALF subsides as epilepsy severity and seizures abate in children with genetic generalized epilepsy (GGE). Eighteen children with GGE were compared over time to 29 healthy controls on a range of cognitive measures. The primary outcome was a modified version of the California Verbal Learning Test for Children with a long delay (seven day) recall component. At approximately two years follow up, ALF was apparent, although epilepsy severity subsided and seizures resolved in many children. This result contrasts with the dominant conceptualisation of ALF being a seizure related phenomenon. Moreover, at follow-up, worse recall at the long delay was related to greater epilepsy severity at baseline and earlier age of seizure onset, but not to being seizure free at follow-up. While at follow-up worse recall at the long delay related to the worse baseline recall at the long delay, this recall did not relate to scores obtained on standardised memory tests at baseline. Our study suggests that ALF may not be seizure related and identifies factors associated with risk of ALF in children with GGE.



https://ift.tt/2NOEMSZ

Underestimation of house dust mite-specific IgE with extract-based ImmunoCAPs compared to molecular ImmunoCAPs

Publication date: Available online 27 July 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Huey-Jy Huang, Yvonne Resch-Marat, Azahara Rodriguez-Dominguez, Kuan-Wei Chen, Renata Kiss, Petra Zieglmayer, René Zieglmayer, DI, Patrick Lemell, Friedrich Horak, Rudolf Valenta, Susanne Vrtala

Summary

We identified 6 house dust mite (HDM) allergen molecules to comprising the majority of HDM IgE-binding components and show that molecular ImmunoCAPs based on these six allergens are superior to allergen extract-based ImmunoCAPs for quantifying HDM-specific IgE.



https://ift.tt/2mKD5dI

Expression of Corticosteroid Regulated Genes By Peripheral Blood Mononuclear Cells in Children with Asthma

Publication date: Available online 27 July 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Elena Goleva, Denise C. Babineau, Michelle A. Gill, Leisa P. Jackson, Baomei Shao, Zheng Hu, Andrew H. Liu, Cynthia M. Visness, Christine A. Sorkness, Donald Y.M. Leung, Alkis Togias, William W. Busse

Abstract
Background

Variability in response to inhaled corticosteroids may result in less than optimal asthma control and development of biomarkers assessing therapeutic efficacy of corticosteroids is important.

Objective

To examine whether in vitro peripheral blood mononuclear cell (PBMC) responses to corticosteroids relate to the clinical inhaled corticosteroid response.

Methods

PBMC were collected from 125 children with asthma (6-17 years) at enrollment (Visit 0, V0) and after one year of bimonthly guidelines-based management visits (Visit 6, V6). Difficult- versus easy-to-control asthma were defined as requiring daily therapy with ≥500 μg of fluticasone propionate (FLU) with/without a long-acting beta-agonist versus requiring ≤100 μg of FLU in at least 4 visits. mRNA levels of glucocorticoid receptor alpha (GRalpha), corticosteroid transactivation (FK binding protein 5 (FKBP5)) and transrepression markers (IL-8, TNFalpha) were measured by RT-PCR in freshly isolated cells and in response to 10-8 M FLU.

Results

Compared to easy-to-control, PBMC of difficult-to-control asthma had significantly lower GRalpha at V0 (p=0.05). A 30% increase in IL-8 suppression by FLU (p=0.04) and a trend for increased TNFalpha suppression by FLU between V0 and V6 (p=0.07) were observed in easy-to-control asthma. In contrast, no changes between V0 and V6 in the IL-8 and TNFalpha suppression by FLU were observed in difficult-to-control asthma. Corticosteroid-mediated transactivation (FKBP5 induction by FLU) increased in the PBMC of difficult- and easy-to-control asthma between V0 and V6 (p=0.05 and p=0.03 respectively).

Conclusions

PBMC of children with difficult-to-control asthma treated with guidelines-based therapy and requiring high dose inhaled corticosteroids had reduced in vitro responsiveness to corticosteroids.



https://ift.tt/2Ac83oY

Safety issues and recommendations for successful pregnancy outcome in systemic lupus erythematosus

Publication date: Available online 27 July 2018

Source: Journal of Autoimmunity

Author(s): Simran Kaur Nahal, Carlo Selmi, M. Eric Gershwin

Abstract

Systemic lupus erythematosus (SLE) primarily affects women of childbearing age. One of the major changes in SLE focuses on the timing of a successful pregnancy. In the past, pregnancy was strongly discouraged in SLE, especially in the presence of risk factors such as nephritis, use of immunosuppressive therapies, or positivity of specific autoantibodies such as anti-phospholipids and anti-Ro/SSA, La/SSBA. Thanks to our better knowledge on the disease and management, pregnancy success rates in SLE patients have significantly improved care by the a multidisciplinary team which fosters a successful pregnancy with minimal complications for the mother and fetus when the disease is inactive or in remission. This approach is based on a counseling phase before pregnancy, to assess SLE activity phase, specific medications, risk factors, and continues through pregnancy and lactation with significantly improved pregnancy outcomes. Further, we can now better define the risk of disease flares during pregnancy based on a better understanding of the changes in maternal immunity and its relationship with SLE-associated autoimmunity and chronic inflammation. There is wide consensus that women with SLE can have successful pregnancies as long as conception is planned in a phase of inactive disease, and when the patient is closely managed by a rheumatologist, high-risk OB/GYN, neonatologist, and other medical specialists as indicated. Preconception counseling is essential to assess the risk of both fetal and maternal complications as well as identify life-threatening contraindications. Particular attention should be used in those SLE cases that have nephritis, APS or positivity for aPL, pulmonary hypertension, and positive anti-Ro/SSA or anti-La/SSB antibodies. In conclusion, the use of specific guidelines on the management of SLE before and during pregnancy and lactation, and a better understanding of the use of immunosuppressive therapies have significantly increased pregnancy success.



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A Single-Arm, Open-Label, Phase IV Study to Evaluate the Efficacy of a Topical Formulation for Hyperkeratotic Actinic Keratosis Lesions

Abstract

Introduction

Actinic keratosis (AKs) are epidermal lesions that commonly occur in skin exposed to chronic cumulative UV irradiation. Untreated AK lesions can advance to squamous cell carcinoma. Current treatments of AK have many shortcomings; for instance, not all treatments can be used for the hyperkeratotic form of AK. The aim of this study was to test the efficacy and tolerability of a topical product containing 2,4,6-octatrienoic acid and urea for the treatment of hyperkeratotic AK lesions.

Methods

Forty male and female subjects with at least two hyperkeratotic AK lesions were enrolled in this single-arm, open-label phase IV study. The product was applied twice daily for two consecutive months. The efficacy endpoints were the reductions in the mean number of AK lesions per subject from baseline (T0) to the end of the trial (T1) and to three months after the end of the treatment period (T2).

Results

At T0, the mean (SD) number of lesions per subject was 3.65 (1.25). At the end of the treatment period (T1), this number had dropped (significantly, p < 0.0001) by 83.56%. The mean number of lesions per subject then decreased by 41.47% (p < 0.0001) between T1 and the three-month follow-up visit (T2). Complete elimination of lesions had occurred in 57.5% of the subjects at T1, and 82.5% (55% who had remained completely clear of lesions since T1, and 27.5% who had fully eliminated their lesions during the period from T1 to T2) at T2. No side effects were reported.

Conclusion

The application of a topical combination of 2,4,6-octatrienoic acid and urea twice daily for 60 consecutive days is a safe and effective treatment for hyperkeratotic AK lesions.

Funding

Giuliani SpA.



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Editorial Board w/barcode



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Table of Contents



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Pretreatment factors affecting traumatic tympanic membrane regeneration therapy using epidermal growth factor

Publication date: Available online 27 July 2018

Source: American Journal of Otolaryngology

Author(s): Zheng-Cai Lou, Wei Hong, Zihan-Lou

Abstract
Objective

The use of epidermal growth factor (EGF) to achieve closure of human traumatic tympanic membrane perforations (TMPs) was recently reported. However, pretreatment factors affecting healing outcomes have seldom been discussed. This study was performed to evaluate pretreatment factors contributing to the success or failure of TMP healing using EGF.

Design and participants

This was a retrospective cohort study of 95 TMPs who were observed for at least 6 months after EGF treatment. Eleven factors considered likely to affect healing outcome were evaluated by univariate and multivariate logistic regression analyses.

Interventions

Each traumatic TMP was treated by daily topical application of EGF. The main outcome measures were complete closure versus failure to close and mean closure time.

Results

A total of 95 patients were included in the analyses. The total closure rate was 92.6% at 6 months, and the mean closure time was 10.5 ± 4.8 days. The closure rate was not significantly different according to the duration of perforation ≤3 days and >3 days (P = 0.816). However, the mean closure time was significantly different according to the duration of perforation (P < 0.001). The perforation size did not affect the closure rate (P = 0.442). The mean closure time in the low-dose EGF group was significantly shorter than that in the high-dose EGF group (P = 0.001). Logistic regression analyses showed that perforations with preexisting myringosclerosis were more likely to fail to close compared to those without preexisting myringosclerosis (P = 0.001). Multivariate logistic regression analyses showed that the duration of perforation (P = 0.011), size of perforation (P < 0.001), and involvement of the malleus in perforation (P = 0.005) were factors independently correlated with closure time.

Conclusions

Daily application of EGF can be used to treat all traumatic TMPs. The size of the perforation and inverted edges did not affect the closure rate, and the most beneficial dosage was sufficient to keep the eardrum moist. Multivariate logistic regression analyses revealed a significant correlation between preexisting myringosclerosis and failure to heal. Nevertheless, the size of perforation, starting time of application, and malleus injury were independent prognostic factors for prolonged healing time.



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Successful Treatment of Acromegaly and Associated Hypogonadism with First-Line Clomiphene Therapy.

Related Articles

Successful Treatment of Acromegaly and Associated Hypogonadism with First-Line Clomiphene Therapy.

Case Rep Endocrinol. 2018;2018:7925019

Authors: Palacios JD, Komotar RJ, Kargi AY

Abstract
Clomiphene citrate (CC) has been reported as an effective add-on therapy to somatostatin analogs and dopamine agonists in patients with acromegaly accompanied by hypogonadism; its use as a single agent to treat acromegaly and associated hypogonadism following incomplete surgery has not been previously reported. We report the first case in which clomiphene was utilized as a single agent for the dual management of acromegaly and hypogonadism, not controlled by pituitary surgery alone. The treatment was well tolerated and proved to be effective after a process of treatment withdrawal and reintroduction. We propose that clomiphene may be considered as a cost-effective oral treatment option in select cases of hypogonadal acromegaly.

PMID: 30046497 [PubMed]



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Stimulation bei Schlafapnoe

Zusammenfassung

Zur Behandlung der obstruktiven Schlafapnoe (OSA) wird primär die Positivdrucktherapie eingesetzt. Aufgrund von Nebenwirkungen ist die Therapieadhärenz jedoch limitiert, daher ist eine erhebliche Anzahl an Patienten nicht oder nicht ausreichend behandelt. Aufgrund häufig auftretender Folgeerkrankungen, wie arterielle Hypertonie, koronare Herzkrankheit oder Diabetes mellitus, sowie der Folgen von regelmäßig auftretender Tagesschläfrigkeit ist eine Therapie der OSA dringend erforderlich. Neben der Unterkieferprotrusionsschiene oder Lagerungshilfen zur Verhinderung der Rückenlage stehen chirurgische Verfahren als Alternativtherapien zur Verfügung. Als weiteres Verfahren wird seit einigen Jahren die Hypoglossusnervstimulation bei ausgewählten Patienten eingesetzt. Hierbei handelt es sich um ein funktionell chirurgisches Verfahren, bei dem durch Stimulation des N. hypoglossus eine Aktivierung der Muskulatur des oberen Atemwegs erreicht wird.



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High-grade glioma associated immunosuppression does not prevent immune responses induced by therapeutic vaccines in combination with T reg depletion

Abstract

High-grade gliomas (HGG) exert systemic immunosuppression, which is of particular importance as immunotherapeutic strategies such as therapeutic vaccines are increasingly used to treat HGGs. In a first cohort of 61 HGG patients we evaluated a panel of 30 hematological and 34 plasma biomarkers. Then, we investigated in a second cohort of 11 relapsed HGG patients receiving immunomodulation with metronomic cyclophosphamide upfront to a DC-based vaccine whether immune abnormalities persisted and whether they hampered induction of IFNγ+ T-cell responses. HGG patients from the first cohort showed increased numbers of leukocytes, neutrophils and MDSCs and in parallel reduced numbers of CD4+/CD8+ T-cells, plasmacytoid and conventional DC2s. MDSCs and T-cell alterations were more profound in WHO IV° glioma patients. Moreover, levels of MDSCs and epidermal growth factor were negatively associated with survival. Serum levels of IL-2, IL-4, IL-5 and IL-10 were altered in HGG patients, however, without any impact on clinical outcome. In the immunotherapy cohort, 6-month overall survival was 100%. Metronomic cyclophosphamide led to > 40% reduction of regulatory T cells (Treg). In parallel to Treg-depletion, MDSCs and DC subsets became indistinguishable from healthy controls, whereas T-lymphopenia persisted. Despite low T-cells, IFNγ-responses could be induced in 9/10 analyzed cases. Importantly, frequency of CD8+VLA-4+ T-cells with CNS-homing properties, but not of CD4+ VLA-4+ T-cells, increased during vaccination. Our study identifies several features of systemic immunosuppression in HGGs. Metronomic cyclophosphamide in combination with an active immunization alleviates the latter and the combined treatment allows induction of a high rate of anti-glioma immune responses.



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Wide Awake Hand Surgery: By Donald H. Lalonde. Pp 263. Thieme Medical Publishers Inc., New York, NY, 2011. Price $119.99.

No abstract available

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Microscopic and Macroscopic Fat Embolism (MIFE and MAFE): Solving the puzzle with cases reports .

Introduction: The frequency of fat embolism mortality after liposuction has increased. As the only dependable evidence for this problem is that available in the medical literature, a study of clinical case reports is warranted. Materials and Methods: We reviewed the medical literature by searching for case reports of fat embolism after liposuction in humans who manifested either of the variants of the condition: microscopic fat embolism (MIFE) or macroscopic fat embolism (MAFE). We performed a literature search of the PubMed and PubMed Central (PMC) databases from the first case of fat embolism syndrome associated with liposuction reported until March 2017; keywords FAT EMBOLISM (FAT EMBOLISM SYNDROME), LIPOSUCTION, and CASE (((fat embolism) AND liposuction) AND case) were used. A detailed analysis of the data contained in the clinical case reports was conducted. Results: In total, 39 and 98 articles were found in PubMed and PMC, respectively, using the keywords ((fat+embolism)+AND+liposuction)+AND+case). After analysis, only 15 reports corresponded to cases of MAFE or MIFE after liposuction, and the basic statistics of the two proposed variants were examined. Conclusion: This work provides relevant information regarding very important characteristics of MIFE and MAFE. Despite the diagnostic difficulty, clinical diagnosis remains the gold standard for identifying MIFE and MAFE. The establishment of a rapid and timely diagnosis is of great help for appropriate treatment. Financial Disclosure Statement: The authors have nothing to disclose. No funding was received for this article Corresponding author: Dr. Héctor Durán. Calle 54 Num. 365 Int. 317, Centro Médico de las Américas, Colonia Centro, Mérida Yucatán México, CP 97000, E mail : hcdv@hotmail.com ©2018American Society of Plastic Surgeons

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Role Models in Academic Medicine

No abstract available

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A Critique of the Impact Factor and Ramifications of its Misuse in Plastic and Reconstructive Surgery: The Real Impact of the Impact Factor

The impact factor (IF) is used to compare the number of citations of a journal with its number of publications. Though first used to assess the significance of various journals, its very creator has stated it is an imperfect system. Presently, the IF overvalues the importance of large-readership journals and undervalues that of smaller more specialized journals. While no metric can serve as a perfect assessment of a journal's worth, it is vital when selecting journals for publication, resource allocation, funding, or citation to not only weigh the IF of a large-volume journal, but also the added value of lower IF but also effective specialized subspecialty journals. Financial Disclosure: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding Author: Oluwaseun A. Adetayo, MD FACS FAAP, Assistant Professor, Plastic Surgery, Section Chief, Pediatric Plastic Surgery, Director, Cleft-Craniofacial Center, Albany Medical Center & The Bernard & Millie Duker Children's Hospital at Albany Medical Center, 50 New Scotland Avenue, MC- 190, Albany, NY 12208, Phone: (518) 262-2229, Fax: (518) 262-6358, Email: Adetayo.md@gmail.com ©2018American Society of Plastic Surgeons

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“Autologous Fat Grafting as a Novel Antiestrogen Vehicle for the Treatment of Breast Cancer: Advantages and Technical Drawbacks.”

No abstract available

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Spotlight in Plastic Surgery: October 2018

No abstract available

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A Comprehensive Study of Oxidative Stress in Tinnitus Patients

Abstract

Oxidative stress is considered to be one of the molecular changes that are the underlying causes of tinnitus. The aim of this study was to investigate the dynamic thiol/disulphide homeostasis as a new oxidative stress parameter in tinnitus patients as well as to investigate the lipid hydroperoxide (LOOH), total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) parameters and compare the results with the results of the healthy control group. A prospective controlled trial was performed on tinnitus patients in Harran University hospital. A total of 70 subjects, including 35 tinnitus patients and 35 healthy individuals participated in this study. Their total thiol, native thiol levels and LOOH, TAS, TOS levels were measured in plasma of all tinnitus patients and healthy volunteers participants. TOS and OSI levels were significantly increased, and TAS levels were significantly lower in the patient groups compared with the control group (p < 0.01). Native thiol levels and Native thiol/total thiol ratios were significantly lower in the tinnitus group compared to the control group (p < 0.01). Disulphide level and disulphide/native thiol and disulphide/total thiol ratios were significantly higher in the patients (p < 0.01). Also, LOOH ratios were significantly higher in the tinnitus group (p < 0.01). The results of this study reveal that in tinnitus cases, the oxidative stress and antioxidant enzyme imbalance were more significant than in healthy control group. The nature of the relationship between oxidative stress and tinnitus should be clarified with larger studies.



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Reproducibility of CBCT image analysis: a clinical study on intrapersonal and interpersonal errors in bone structure determination

Abstract

Objective

For correct implant planning based on cone-beam computed tomography (CBCT), the bone contour must be accurately determined. Identification of the contour is difficult in bones with incomplete mineralization. In this clinical study, we investigated the intrapersonal and interpersonal reproducibilities of manual bone contour determination on CBCT images using a semi-automated computerized process.

Methods

The bone surface level in the area of the socket in 20 patients who had undergone tooth extraction from the upper jaw at 10 ± 1 weeks previously was determined on CBCT images. Two investigators with different levels of experience determined the bone structure initially (T0) and repeated the procedure after 3 months (T1). The bone structure marked on CBCT images was converted into a surface data set. The resulting data sets were superimposed on one another. In the analyses, the shortest distances between the datasets were identified and measured. The average deviations were statistically evaluated.

Results

The intrapersonal evaluation resulted in an average deviation of 0.18 mm across both investigators. The interpersonal analysis comparing the two investigators resulted in average deviations of 0.15 mm at T0 and 0.26 mm at T1. Significant differences were not found.

Conclusions

The low intrapersonal deviation indicates that the procedure has satisfactory reproducibility. All deviations were within the range of the selected resolution of the CBCT device. Application of a semi-automated procedure to detect the bone border in areas with incomplete mineralization is a predictable process.

Trial registration

The study was registered in the German Clinical Trials Register and the International Clinical Trials Registry Platform of the WHO: DRKS00004769, date of registration: 28 February 2013; and DRKS00005978, date of registration: 09 November 2015.



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Cutis laxa autosomique récessive : de nouveaux gènes identifiés

Publication date: Available online 26 July 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): O. Dereure



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Multiple capillary malformations of progressive onset: Capillary malformation–arteriovenous malformation syndrome (CM-AVM)

Publication date: Available online 26 July 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): G. Gourier, S. Audebert-Bellanger, P. Vourc'h, S. Fraitag, K. L'Hérondelle, A. Labouche, L. Misery, C. Abasq-Thomas

Summary
Background

Capillary malformation–arteriovenous malformation syndrome (CM-AVM) is an autosomal dominant disorder first described in 2003.

Patients and methods

An 8-year-old girl was referred for the progressive appearance of multiple capillary malformations in childhood, evocative of CM-AVM syndrome. Molecular analysis of the RASA1 gene revealed a mutation but further examinations did not show arteriovenous malformation.

Discussion

CM-AVM syndrome is an autosomal dominant disease caused by RASA1 gene mutations. More than 100 mutations have been identified to date. The EPHB4 gene may also be involved. Capillary malformations with particular characteristics are described. High-flow vascular malformations are associated in 18.5% of cases, with 7.1% being intracerebral.

Conclusion

CM-AVM syndrome is a recent diagnostic entity. Diagnosis should be considered in the presence of multifocal capillary malformations. This diagnosis may lead to the detection of high-flow arteriovenous malformation and raises the question of specific management for these patients.

Résumé
Introduction

Le syndrome malformations capillaires–malformation artérioveineuse (MC-MAV) a été décrit pour la première fois en 2003. Nous rapportons le cas d'une patiente ayant une présentation clinique caractéristique de ce syndrome.

Observation

Une fille de 8 ans nous était adressée en consultation pour l'apparition progressive d'une quinzaine d'angiomes plans au cours de l'enfance. Un syndrome MC-MAV de forme sporadique était évoqué devant l'aspect particulier de ces malformations capillaires. Cette hypothèse était confirmée par la mise en évidence d'une mutation du gène RASA1 à l'analyse génétique. Les explorations complémentaires ne mettaient pas en évidence de malformations artérioveineuses.

Discussion

Le syndrome MC-MAV résulte d'une mutation du gène RASA1, dont plus d'une centaine de mutations différentes ont été identifiées à ce jour. Plus récemment, des mutations du gène EPHB4 ont également été identifiées. Ce syndrome se manifeste chez 90 % des patients par des malformations capillaires multiples de petite taille, roses ou brunes, parfois entourées d'un halo blanc. Elles sont associées dans 18,5 % des cas à des malformations vasculaires à haut débit, dont 7,1 % sont intracérébrales.

Conclusion

Le syndrome MC-MAV est un syndrome récemment découvert, lié à des mutations hétérozygotes des gènes RASA1 ou EPHB4. Il doit être évoqué devant des malformations capillaires multifocales d'apparition progressive. Ce diagnostic peut conduire au dépistage d'une malformation artérioveineuse à flux rapide et soulève la question du suivi à proposer à ces patients.



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A Comprehensive Study of Oxidative Stress in Tinnitus Patients

Abstract

Oxidative stress is considered to be one of the molecular changes that are the underlying causes of tinnitus. The aim of this study was to investigate the dynamic thiol/disulphide homeostasis as a new oxidative stress parameter in tinnitus patients as well as to investigate the lipid hydroperoxide (LOOH), total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI) parameters and compare the results with the results of the healthy control group. A prospective controlled trial was performed on tinnitus patients in Harran University hospital. A total of 70 subjects, including 35 tinnitus patients and 35 healthy individuals participated in this study. Their total thiol, native thiol levels and LOOH, TAS, TOS levels were measured in plasma of all tinnitus patients and healthy volunteers participants. TOS and OSI levels were significantly increased, and TAS levels were significantly lower in the patient groups compared with the control group (p < 0.01). Native thiol levels and Native thiol/total thiol ratios were significantly lower in the tinnitus group compared to the control group (p < 0.01). Disulphide level and disulphide/native thiol and disulphide/total thiol ratios were significantly higher in the patients (p < 0.01). Also, LOOH ratios were significantly higher in the tinnitus group (p < 0.01). The results of this study reveal that in tinnitus cases, the oxidative stress and antioxidant enzyme imbalance were more significant than in healthy control group. The nature of the relationship between oxidative stress and tinnitus should be clarified with larger studies.



https://ift.tt/2JZ9zdu

Incidence of peri-operative paediatric cardiac arrest: Influence of a specialised paediatric anaesthesia team

BACKGROUND Peri-operative critical events are still a major problem in paediatric anaesthesia care. Access to more experienced healthcare teams might reduce the adverse event rate and improve outcomes. OBJECTIVE The current study analysed incidences of peri-operative paediatric cardiac arrest before and after implementation of a specialised paediatric anaesthesia team and training programme. DESIGN Retrospective cohort study with before-and-after analysis. SETTING Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany. PATIENTS A total of 36 243 paediatric anaesthetics (0 to 18 years) were administered between 2008 and 2016. INTERVENTION Implementation of a specialised paediatric anaesthesia team and training programme occurred in 2014 This included hands-on supervised training in all fields of paediatric anaesthesia, double staffing for critical paediatric cases and a 24/7 emergency team. A logistic regression analysis with risk factors (age, ASA physical status, emergency) was used to evaluate the impact of implementation of the specialised paediatric anaesthesia team. MAIN OUTCOME MEASURES Incidences of peri-operative paediatric cardiac arrest and anaesthesia-attributable cardiac arrest before and after the intervention. RESULTS Twelve of 25 paediatric cardiac arrests were classified as anaesthesia-attributable. The incidence of overall peri-operative paediatric cardiac arrest was 8.1/10 000 (95% CI 5.2 to 12.7) in the period 2008 to 2013 and decreased to 4.6/10 000 (95% CI 2.1 to 10.2) in 2014 to 2016. Likewise, the incidence of anaesthesia-attributable cardiac arrest was lower after 2013 [1.6/10 000 (95% CI 0.3 to 5.7) vs. 4.3/10 000 (95% CI 2.3 to 7.9)]. Using logistic regression, children anaesthetised after 2013 had nearly a 70% lower probability of anaesthesia-attributable cardiac arrest (odds ratio 0.306, 95% CI 0.067 to 1.397; P = 0.1263). For anaesthesia-attributable cardiac arrest, young age was the most contributory risk factor, whereas in overall paediatric cardiac arrest, ASA physical statuses 3 to 5 played a more important role. CONCLUSION In this study on incidences of peri-operative paediatric cardiac arrest from a European tertiary care university hospital, implementation of a specialised paediatric anaesthesia team and training programme was associated with lower incidences of peri-operative paediatric cardiac arrest and a reduced probability of anaesthesia-attributable cardiac arrest. Correspondence to Dr Andreas Hohn, MHBA, DESA, EDIC, Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany Tel: +49 221 478 82058; fax: +49 221 478 85574; e-mail: andreas.hohn@uk-koeln.de 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 Website (https://ift.tt/2ylyqmW). © 2018 European Society of Anaesthesiology

https://ift.tt/2vc07hx

Incidence of peri-operative paediatric cardiac arrest: Influence of a specialised paediatric anaesthesia team

BACKGROUND Peri-operative critical events are still a major problem in paediatric anaesthesia care. Access to more experienced healthcare teams might reduce the adverse event rate and improve outcomes. OBJECTIVE The current study analysed incidences of peri-operative paediatric cardiac arrest before and after implementation of a specialised paediatric anaesthesia team and training programme. DESIGN Retrospective cohort study with before-and-after analysis. SETTING Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Germany. PATIENTS A total of 36 243 paediatric anaesthetics (0 to 18 years) were administered between 2008 and 2016. INTERVENTION Implementation of a specialised paediatric anaesthesia team and training programme occurred in 2014 This included hands-on supervised training in all fields of paediatric anaesthesia, double staffing for critical paediatric cases and a 24/7 emergency team. A logistic regression analysis with risk factors (age, ASA physical status, emergency) was used to evaluate the impact of implementation of the specialised paediatric anaesthesia team. MAIN OUTCOME MEASURES Incidences of peri-operative paediatric cardiac arrest and anaesthesia-attributable cardiac arrest before and after the intervention. RESULTS Twelve of 25 paediatric cardiac arrests were classified as anaesthesia-attributable. The incidence of overall peri-operative paediatric cardiac arrest was 8.1/10 000 (95% CI 5.2 to 12.7) in the period 2008 to 2013 and decreased to 4.6/10 000 (95% CI 2.1 to 10.2) in 2014 to 2016. Likewise, the incidence of anaesthesia-attributable cardiac arrest was lower after 2013 [1.6/10 000 (95% CI 0.3 to 5.7) vs. 4.3/10 000 (95% CI 2.3 to 7.9)]. Using logistic regression, children anaesthetised after 2013 had nearly a 70% lower probability of anaesthesia-attributable cardiac arrest (odds ratio 0.306, 95% CI 0.067 to 1.397; P = 0.1263). For anaesthesia-attributable cardiac arrest, young age was the most contributory risk factor, whereas in overall paediatric cardiac arrest, ASA physical statuses 3 to 5 played a more important role. CONCLUSION In this study on incidences of peri-operative paediatric cardiac arrest from a European tertiary care university hospital, implementation of a specialised paediatric anaesthesia team and training programme was associated with lower incidences of peri-operative paediatric cardiac arrest and a reduced probability of anaesthesia-attributable cardiac arrest. Correspondence to Dr Andreas Hohn, MHBA, DESA, EDIC, Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany Tel: +49 221 478 82058; fax: +49 221 478 85574; e-mail: andreas.hohn@uk-koeln.de 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 Website (https://ift.tt/2ylyqmW). © 2018 European Society of Anaesthesiology

https://ift.tt/2vc07hx

Devitalisation of pathogens in stored pig slurry and potential risk related to its application to agricultural soil

Abstract

The study investigated the risks arising from application of pig slurry to soil in relation to viability of Salmonella typhimurium, Escherichia coli, total coliforms, faecal enterococci and eggs of Ascaris suum at different temperatures. Potential effect of changes in physico-chemical parameters, particularly dry matter (DM), pH and ammonia, were also investigated. Examination showed that S. typhimurium was devitalised after storage in the slurry for 115 days at 4 °C and after 90 days at 20 and 42 °C. Devitalization of E. coli and faecal entrerococci required more than 115 at temperature of 4 °C and faecal enterococci were recovered from slurry after 115 days of storage even at temperature of 20 °C. Total coliforms survived for 115 days at all investigated temperatures. Complete devitalization of A. suum eggs was not achieved even after 115 days at 42 °C. Our investigations indicated potential microbial and parasitic risk related to application of pig slurry to soil even after 115 days of storage.



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