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

Δευτέρα 30 Ιουλίου 2018

Speech audiometry in noise: Development of the French-language VRB (vocale rapide dans le bruit) test

Publication date: Available online 30 July 2018

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): F. Leclercq, C. Renard, C. Vincent

Abstract
Introduction

Understanding speech in noise is a major challenge for most hearing-impaired subjects, with or without hearing aids. To overcome the weaknesses of French-language speech-in-noise tests, we developed a new instrument, with a balanced mix of difficulty of the speech material.

Material and methods

The speech material comprised 127 sentences taken from the "Marginal Benefit from Acoustic Amplification" (MBAA) corpus, each including 3 keywords. The noise was created using the "onde vocale globale" (global vocal wave: OVG), described by Dodelé. The 127 speech/noise pairs were recorded individually after root-mean-square equalization. The first experiment, on 10 normal-hearing adults, determined the signal-to-noise ratio (SNR) associated with 50% correct keyword identification in each sentence (SNR-50), using an ascending method with noise level set at 73 dB SPL. Relative levels between sentences and noise were then adjusted sentence by sentence to achieve an SNR-50 of 0 dB. The second experiment, with 12 normal-hearing adults, validated the equalization of sentence difficulty.

Results

Mean SNR-50 was −6.64 dB (σ = 1.47). Mean adjusted SNR-50 was 0.08 dB (σ = 0.55). Mean psychometric curve slope was 19.3%/dB, with low standard deviations, testifying to the sensitivity of the speech material.

Conclusion

The VRB (vocale rapide dans le bruit: rapid speech in noise) test is based on sentences from the MBAA corpus with background noise based on the OVG at different signal-to-noise ratios. The test is feasible and able to detect slight variations in speech-in-noise performance between subjects.



https://ift.tt/2AxkCeK

Interaction between stress, cytokines, and salivary cortisol in pregnant and non-pregnant women with gingivitis

Abstract

Objectives

The aim of this study was to compare the effects of periodontal treatment on the inflammatory markers in gingival crevicular fluid and the concentration of salivary cortisol between non-pregnant and pregnant women with gingivitis.

Materials and methods

This study included 30 non-pregnant women (mean age 27.93 ± 6.61 years) and 30 pregnant women (mean age 28.93 ± 4.04 years). Each participant presented with the clinical symptoms of generalized, moderate-to-severe gingivitis. Saliva samples were collected by using the spitting method, and gingival crevicular fluid (GCF) samples were collected by using the intrasulcular method at baseline and after 3 weeks. Non-surgical periodontal treatment (NPT) comprising scaling and oral hygiene instruction was administered after sample collection. The interleukin-6 and interleukin-10 levels in GCF and salivary cortisol concentrations were determined with using enzyme-linked immunosorbent assay.

Results

The pregnant women exhibited significantly deeper pockets (p < 0.05) and greater gingival inflammation (p < 0.05) than the non-pregnant women after periodontal therapy. Moreover, the levels of interleukin-6 in the GCF were significantly higher in the pregnant women compared to the non-pregnant women after periodontal therapy: 17.73 ± 9.82 pg per site and 8.08 ± 4.51 pg per site, respectively, p < 0.05. No differences in the levels of interleukin-10 were observed. The pregnant women also exhibited higher cortisol concentration in the saliva after periodontal therapy, compared to the non-pregnant women, while the levels of stress (as seen on the perceived stress scale-10) were similar in both groups.

Conclusions

Although non-surgical periodontal therapy may reduce the clinical parameters of gingivitis, increasing levels of stress in pregnancy may reduce the individual's response to it. However, further studies are necessary to substantiate these early findings.

Clinical relevance

Psychosocial stress may increase the risk of periodontal disease by altering the behavioral and immune responses of the individual. Therefore, the levels of stress should be taken into consideration in order to increase the efficacy of periodontal therapy in pregnant patients.



https://ift.tt/2KciSHd

Zinc deficiency and severe protein–energy malnutrition in a child with atopic eczema

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2mZF5z6

Zinc deficiency and severe protein–energy malnutrition in a child with atopic eczema

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2mZF5z6

Comparing the Prognostic Value of the Eighth Edition of the American Joint Committee on Cancer/Tumor Node Metastasis Staging System Between Papillary and Follicular Thyroid Cancer

Thyroid, Ahead of Print.


https://ift.tt/2v2yQyH

The Prognostic Impact of Tumor Size in Papillary Thyroid Carcinoma is Modified by Age

Thyroid, Ahead of Print.


https://ift.tt/2Kd00I3

Early Determinants of Thyroid Function Outcomes in Children with Congenital Hypothyroidism and a Normally Located Thyroid Gland: A Regional Cohort Study

Thyroid, Ahead of Print.


https://ift.tt/2LKefZR

Protective Effect of Ginseng on Salivary Dysfunction Following Radioiodine Therapy in a Mouse Model

Thyroid, Ahead of Print.


https://ift.tt/2KcjsEM

A Novel Mutation in NKX2-1 Shows Dominant-Negative Effects Only in the Presence of PAX8

Thyroid, Ahead of Print.


https://ift.tt/2LKefsP

Iron Deficiency May Predict Greater Risk for Hypothyroxinemia: A Retrospective Cohort Study of Pregnant Women in China

Thyroid, Ahead of Print.


https://ift.tt/2M2rmSN

Predicting Malignancy in Thyroid Nodules: Radiomics Score Versus 2017 American College of Radiology Thyroid Imaging, Reporting and Data System

Thyroid, Ahead of Print.


https://ift.tt/2vnfzHN

In Memoriam to the man behind the camera: David J LIM, MD November 27 1935–June 29, 2018

Publication date: Available online 30 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Bernd Fritzsch



https://ift.tt/2KcrugW

Specific Differences in Temporal Binding Aspects of the Attentional Blink in Chromosome 22q11.2 Deletion Syndrome

Publication date: Available online 31 July 2018

Source: Cortex

Author(s): Justin Kopec, Natalie Russo, Kevin M. Antshel, Wanda Fremont, Wendy R. Kates

Abstract

Chromosome 22q11.2 Deletion Syndrome (22q11DS) is a genetic syndrome characterized by a variety of cognitive impairments, including difficulty with attention. 22q11DS is the strongest known genetic risk factor for developing schizophrenia, a disorder characterized by impairments in visual attention and temporal binding processes. Here we examine a specific temporal visual attention phenomenon (the attentional blink; AB) within two rapid serial visual presentation tasks, and compare those with 22q11DS to groups of typically developing individuals matched on chronological (CA) and mental age (MA). Performance of individuals with 22q11DS was sensitive to differing task demands. On a Category Task, individuals with 22q11DS performed similarly to control groups on all measures of the AB, with the exception of lower detection accuracy of the first of two targets. In contrast, on a feature-based Color Task which required temporal binding of stimulus features, individuals with 22q11DS differed from CA and MA matched control groups on all AB performance measures, exhibiting lower target accuracy, more temporal binding errors, and a deeper, more protracted AB. Temporal binding in the visual domain is thought to be dependent on a serial attention mechanism that facilitates simultaneous firing of neurons in multiple areas of the visual cortex, activating short-term working memory for storage of bound features. Given the discrepancy between these two tasks, results suggest that temporal binding processes may be significantly affected in individuals with 22q11DS, a finding that importantly, has been previously demonstrated among individuals with schizophrenia.



https://ift.tt/2mVpWid

Does attenuated divisive normalization affect gaze processing in autism spectrum disorder? A commentary on Palmer et al. (2018)

Publication date: Available online 31 July 2018

Source: Cortex

Author(s): Ari Rosenberg, Adhira Sunkara



https://ift.tt/2KcI5Bs

Anodal transcranial direct current stimulation of the right dorsolateral prefrontal cortex impairs long-term retention of reencountered memories

Publication date: Available online 31 July 2018

Source: Cortex

Author(s): Miklós Marián, Ágnes Szőllősi, Mihály Racsmány

Abstract

Repeated encounter with encoded memories is often a fundamental component of long-term learning processes, however, the role of repeated access to encoded memories in long-term consolidation is yet to be clarified. Here we investigated whether the long-term retention of newly acquired associative memories is affected if one of the central areas of the attentional control network is stimulated before or after repeated access to acquired information. Non-clinical participants (undergraduate students, N = 118) were exposed to an associative verbal learning task. Following the initial learning of word pairs, memories for the word pairs were reencountered either by re-presenting the stimuli to the participants for restudying or by cued recall. The reencounter phase was either preceded by (Experiment 1) or followed by (Experiment 2) anodal transcranial Direct Current Stimulation of the right dorsolateral prefrontal cortex. Memory retention was assessed seven days after the reencounter phase. When we measured successful access to learned paired-associates in the reencounter phase, there was no difference between the anodal and sham stimulation condition in either Experiment 1 or 2. However, and importantly, anodal stimulation had a detrimental impact on long-term memory but only when stimulation preceded the reencountering of memories (in Experiment 1). Our results suggest that stimulation of the so-called control network during repeated access to acquired information disrupts the long-term retention of these memories. These findings are in line with earlier results showing that repeated access to learned information systematically decreases the involvement of control processes in retrieval and presumably promotes learning through the automatization of cue-target association. At a neural level, a possible substrate of repeated memory reencountering is a shift in frontohippocampal connectivity.



https://ift.tt/2LAExyp

Localization of an epileptic orgasmic feeling to the right amygdala, using intracranial electrodes

Publication date: Available online 31 July 2018

Source: Cortex

Author(s): Laurence Chaton, Maxime Chochoi, Nicolas Reyns, Renaud Lopes, Philippe Derambure, William Szurhaj

Abstract

The limbic system has well-known functions in the regulation of human emotions and behaviour in general and sexual behaviour in particular. However, it is not clear which components of the limbic system are involved in orgasmic feelings. Although orgasmic aura can be elicited by direct electrical stimulation of the right mesial temporal lobe, the location of spontaneous and isolated orgasmic auras have not yet been reported in the literature. Here, we report on the first case of spontaneous orgasmic aura associated with a discharge in the right amygdala, following an investigation with depth electrodes in a woman with temporal lobe epilepsy. Her ictal orgasmic feeling reportedly felt the same as her physiological orgasms. This case sheds light on the amygdala's key role in human sexual function.



https://ift.tt/2Kc5ent

X-Ray Microcomputed Tomography in Additive Manufacturing: A Review of the Current Technology and Applications

3D Printing and Additive Manufacturing, Ahead of Print.


https://ift.tt/2Khfwma

In vivo imaging reveals increased eosinophil uptake in the lungs of obese asthmatics

Publication date: Available online 30 July 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Neda Farahi, Chrystalla Loutsios, Nicola Tregay, Adam K.A. Wright, Rachid Berair, Laurence S.C. Lok, Daniel Gillett, Ian Cullum, Rosalind P. Simmonds, Charlotte Summers, Anna Wong, Chandra K. Solanki, John Buscombe, Pee Hwee Pang, Arthikkaa Thavakumar, A.Michael Peters, Christopher E. Brightling, Alison M. Condliffe, Edwin R. Chilvers

Capsule Summary

Using radiolabeled eosinophils coupled with SPECT/CT the authors quantify eosinophilic inflammation in the lungs of patients with asthma and focal pulmonary eosinophilic inflammation, revealing important differences in eosinophil kinetics between obese and non-obese asthmatics.



https://ift.tt/2NZCErU

Does a single-dose preemptive intravenous ibuprofen have an effect on postoperative pain relief after septorhinoplasty?

Publication date: Available online 30 July 2018

Source: American Journal of Otolaryngology

Author(s): Mustafa Sitki Gozeler, Muhammed Sedat Sakat, Korhan Kilic, Ozgur Ozmen, Abdullah Can, Ilker Ince

Abstract
Purpose

Septorhinoplasty is a surgical procedure widely employed by otolaryngologists and plastic surgeons. The purpose of this study was to investigate the effects of a single pre-emptive dose of iv ibuprofen on postoperative pain and opioid consumption in patients undergoing septorhinoplasty.

Material and methods

50 patients scheduled for septorhinoplasty were included in this prospective, randomized, double-blinded study. Control group (n = 25) was administered 100 mL iv saline solution 30 min preoperatively, while Ibuprofen group (n = 26) received 800 mg ibuprofen iv. in 100 Ml saline solution. Intravenous fentanyl was administered with a Patient Controlled Analgesia device after surgery for postoperative pain management. Postoperative pain was evaluated using a Visual Analogue Scale (VAS) with 0 representing no pain and 10 the worst pain possible.

Results

VAS scores at 10, 20, and 30 min and at 1, 2, 4, 8, 12 and 24 h were lower in the ibuprofen group than in the control group (p < 0.05). Total fentanyl consumption was lower in the ibuprofen group compared to the placebo group (148.8 ± 86.4 mcq vs 338.00 ± 81.00 mcq), respectively.

Conclusion

We suggest that the pre-emptive use of iv ibuprofen at a dosage of 800 mg 30 min before septorhinoplasty will be beneficial in reducing opioid consumption and pain scores.



https://ift.tt/2Ov746f

Spread of Activity Following TMS is related to Intrinsic Resting Connectivity to the Salience Network: A Concurrent TMS-fMRI study

Publication date: Available online 30 July 2018

Source: Cortex

Author(s): Colin Hawco, Aristotle Voineskos, Jennifer K.E. Steeves, Erin W. Dickie, Joseph D. Viviano, Jonathan Downar, Daniel M. Blumberger, Zafiris J. Daskalakis

Abstract

Transcranial magnetic stimulation (TMS) modulates activity at local and regions distal to the site of simulation. TMS has also been found to modulate brain networks, and it has been hypothesized that functional connectivity may predict the neuronal changes at local and distal sites in response to a TMS pulse. However, a direct relationship between resting connectivity and change in TMS-induced brain activation has yet to be demonstrated. Concurrent TMS-fMRI is a technique to directly measure this spread activity following TMS in real time. In twenty-two participants, resting-state fMRI scans were acquired, followed by four ten minute sessions of concurrent TMS-fMRI over the left dorsolateral prefrontal cortex. Seed-based functional connectivity to the individualized TMS target was examined using the baseline resting fMRI scan data, and the change of activity resulting from TMS was determined using a general linear model (High vs Low intensity TMS). While at the group level the spatial pattern of resting connectivity related to the pattern of TMS-induced cortical changes, there was substantial variability across individuals. This variability was further probed by examining individual's connectivity from the TMS target to six resting state networks. Only connectivity between the salience network and the TMS target site correlated with the RSC-TMS score. This suggests that resting state connectivity is correlated with TMS-induced changes in activity following DLPFC stimulation, particularly when the DLPFC target interacts with the salience network. These results highlight the importance of examining such relationships at the individual level and may help to guide individual treatment in clinical populations.



https://ift.tt/2LN83QJ

Laugier–Hunziker syndrome in endocrine clinical practice

EDM18-0025fig1.tif?width=755

Summary

Laugier–Hunziker syndrome (LHS) is a rare, benign and acquired disorder characterized by hyperpigmentation of the oral cavity and lips along with longitudinal melanonychia. No underlying systemic abnormalities or malignant predisposition is associated with it. In everyday clinical practice, an endocrinologist encounters certain endocrine conditions (e.g. Addison's disease, McCune–Albright syndrome) that present with, inter alia, mucocutaneous hyperpigmentation. Even though LHS is easily distinguished from endocrine entities mentioned earlier, diagnostic evaluation usually requires skilled and thorough practitioner. Since it is the diagnosis of exclusion, a number of systemic conditions must be ruled out prior to making the final diagnosis. However, its major differential diagnosis is primarily Peutz-Jeghers syndrome, which carries an increased risk of cancer. Here, we report a case of a young woman who was referred to the endocrinologist for diagnostic evaluation of dark-colored lesions of the oral cavity and nails. All performed laboratory tests were within reference range. Endoscopic gastrointestinal evaluation did not reveal neoplastic formations. Owing to an adult-onset, asymptomatic clinical course and negative diagnostic findings, we made a final diagnosis. In this case, target diagnostic evaluation notably reduced the need for additional expensive and invasive procedures and treatments.

Learning points:

Laugier–Hunziker syndrome is a rare, acquired cause of asymptomatic, benign mucocutaneous hyperpigmentation.

Prior to making a final diagnosis, certain medical entities with overlapping clinical features must be excluded.

Endocrine conditions that usually present with the hyperpigmentation of the skin and mucous membranes (e.g. Addison's disease, McCune–Albright syndrome) can be easily ruled out based on clinical and laboratory findings.

Its major differential diagnosis, Peutz-Jeghers syndrome is characterized by melanotic macules of the face and mouth, intestinal polyposis and significantly increased risk of different types of cancer, especially gastrointestinal.

Anamnesis, physical examination and target diagnostic evaluation reduce the need for additional invasive and expensive procedures and treatment.



https://ift.tt/2LNQiRq

Synthesis of stabilized hydroxyapatite nanosuspensions for enamel caries remineralization

Australian Dental Journal, EarlyView.


https://ift.tt/2M4GZcz

The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto’s Thyroiditis: A Pilot Study

06-2018-0238-endo_10-1055-a-0653-7108-1.

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0653-7108

Background Autoimmune thyroid disease is often accompanied by celiac disease. Objective The purpose of this study was to investigate whether a gluten-free diet affects thyroid autoimmunity, hypothalamic-pituitary-thyroid axis activity and thyroid function tests in women with Hashimoto's thyroiditis and incidentally found positive anti-tissue transglutaminase antibodies. Methods The study included 34 women with autoimmune thyroiditis divided into two group. The patients belonging to the first one (group A, n=16) complied with the gluten-free diet for 6 months, while the remaining patients (group B, n=18) remained without any dietary treatment. Serum titers of thyroid peroxidase and thyroglobulin antibodies, as well as serum levels of thyrotropin, free thyroid hormones and 25-hydroxyvitamin D were measured at the beginning of the study and 6 months later. Based on thyrotropin and free thyroid hormone levels, Jostel's thyrotropin index, the SPINA-GT index and the SPINA-GD index were calculated. Results All patients completed the study protocol. In group B, serum thyrotropin and free thyroid hormones levels, serum 25-hydroxyvitamin D levels as well as the calculated indices remained at the similar levels. The gluten-free diet reduced thyroid antibody titers, as well as slightly increased 25-hydroxyvitamin D levels and the SPINA-GT index. In group A, the impact on TPOAb and TgAb titers correlated with the changes in the SPINA-GT index, whereas the impact on TPOAb with the changes in 25-hydroxyvitamin D levels. Conclusions The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

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



https://ift.tt/2vj5BHr

Furazolidone‐containing triple and quadruple eradication therapy for initial treatment for Helicobacter pylori infection: A multicenter randomized controlled trial in China

Helicobacter, EarlyView.


https://ift.tt/2v84wTJ

Furazolidone‐containing triple and quadruple eradication therapy for initial treatment for Helicobacter pylori infection: A multicenter randomized controlled trial in China

Helicobacter, EarlyView.


https://ift.tt/2v84wTJ

Treatment of Sweet's syndrome in pregnancy

Dermatologic Therapy, EarlyView.


https://ift.tt/2v28KMj

Mohs micrographic surgery combined local flaps in treatment of EMPD: A retrospective case

Dermatologic Therapy, EarlyView.


https://ift.tt/2K7bYTD

Brimonidine tartrate gel plus topical steroid for the prevention of laser therapy‐related postinflammatory hyperpigmentation

Dermatologic Therapy, EarlyView.


https://ift.tt/2LQFa6i

Focal multimodality radiation therapy: A promising treatment for recalcitrant Darier disease

Dermatologic Therapy, EarlyView.


https://ift.tt/2K7bzAB

21st Chinese Society of Dermatology Annual Meeting, Hefei, Anhui, China

Dermatologic Therapy, EarlyView.


https://ift.tt/2v2UjYC

An enlightening tripartite event in Hanoi: Third Indochina Academy of Dermatology Conference, World Health Academy Dermatology Summit, and the Vietnamese Society of Dermatology Annual Meeting

Dermatologic Therapy, EarlyView.


https://ift.tt/2Kb25UR

A cost‐effective treatment model in dystrophic epidermolysis bullosa with congenital absence of skin

Dermatologic Therapy, EarlyView.


https://ift.tt/2LRuqo0

Treatment of Sweet's syndrome in pregnancy

Dermatologic Therapy, EarlyView.


https://ift.tt/2v28KMj

Mohs micrographic surgery combined local flaps in treatment of EMPD: A retrospective case

Dermatologic Therapy, EarlyView.


https://ift.tt/2K7bYTD

Brimonidine tartrate gel plus topical steroid for the prevention of laser therapy‐related postinflammatory hyperpigmentation

Dermatologic Therapy, EarlyView.


https://ift.tt/2LQFa6i

Focal multimodality radiation therapy: A promising treatment for recalcitrant Darier disease

Dermatologic Therapy, EarlyView.


https://ift.tt/2K7bzAB

21st Chinese Society of Dermatology Annual Meeting, Hefei, Anhui, China

Dermatologic Therapy, EarlyView.


https://ift.tt/2v2UjYC

An enlightening tripartite event in Hanoi: Third Indochina Academy of Dermatology Conference, World Health Academy Dermatology Summit, and the Vietnamese Society of Dermatology Annual Meeting

Dermatologic Therapy, EarlyView.


https://ift.tt/2Kb25UR

12th World Congress on Neurohypophysial Hormones Mangaratiba, Rio de Janeiro, Brazil – July 26th‐29th, 2017

Journal of Neuroendocrinology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Os1f9P

Central apelin administration and restraint stress induce hypothalamic cholecystokinin release through APJ receptor

Journal of Neuroendocrinology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2vlV6mH

Analysis of prolactin receptor expression in the murine brain using a novel prolactin receptor reporter mouse

Journal of Neuroendocrinology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Os1dPf

Evidence of probable subadult scurvy in the Early Medieval cemetery of Castel Tirolo, South Tyrol, Italy

International Journal of Osteoarchaeology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Ot9JgJ

Perinatal guanacos (Lama guanicoe) exploited by hunter‐gatherers from the Holocene of Argentine Pampas

International Journal of Osteoarchaeology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2AqcJYf

Gallbladder adenocarcinoma diagnosed from cutaneous metastases occurring along the tract of a ventriculoperitoneal shunt

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mUr3i3

In regard to “a tale of two clones: caldesmon staining in the differentiation of cutaneous spindle cell neoplasms”

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2K7qomI

Pediatric Cutaneous T‐Cell Post‐Transplant Lymphoproliferative Disorder: Case Report and Review of the Literature

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mSM1Ou

Evidence behind the use of molecular tests in melanocytic lesions and practice patterns of these tests by dermatopathologists

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2KajEVh

Seronegative Dermatomyositis Presenting with Features of Anti‐MDA5 Subtype

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mWHZ7P

Clinical and histopathologic manifestations of solid organ transplantation‐associated graft‐versus‐host disease involving the skin: A single‐center retrospective study

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2KcagjE

Lingual lymph nodes in patients with squamous cell carcinoma of the tongue and the floor of the mouth

Head &Neck, EarlyView.


https://ift.tt/2M358QI

Oncologic outcomes with transoral robotic surgery for supraglottic squamous cell carcinoma: Results of the French Robotic Surgery Group of GETTEC

Head &Neck, EarlyView.


https://ift.tt/2LRgaM0

Sinonasal renal cell‐like adenocarcinoma: Easily misdiagnosed sinonasal tumor

Head &Neck, EarlyView.


https://ift.tt/2M34YJ6

Identification of lymphatic channels in the tracheoesophageal groove during central neck dissection for thyroid cancer

Head &Neck, EarlyView.


https://ift.tt/2LUA4pL

Pretreatment metabolic tumor volume as a prognostic factor in HPV‐associated oropharyngeal cancer in the context of AJCC 8th edition staging

Head &Neck, EarlyView.


https://ift.tt/2M40WjP

Radiotherapy for extranodal classic Hodgkin lymphoma of the maxillary sinus: Case report and literature review

Head &Neck, EarlyView.


https://ift.tt/2M7I0As

Association between thyroid hormone levels, body composition, and insulin resistance in euthyroid subjects with normal thyroid ultrasound: The Kangbuk Samsung Health Study

Clinical Endocrinology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2v3i2HX

Effect of low‐dose dexamethasone on patients with elevated early follicular phase progesterone level and pregnancy outcomes in IVF‐ET treatment: a randomized controlled clinical trial

Clinical Endocrinology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2M0d3OK

The cortisol stress response induced by surgery: a systematic review and meta‐analysis

Clinical Endocrinology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2v1UcMD

Forthcoming Meetings

Clinical &Experimental Allergy, Volume 48, Issue 8, Page 1073-1073, August 2018.


https://ift.tt/2M7DfH6

Issue Information

Clinical &Experimental Allergy, Volume 48, Issue 8, Page 907-909, August 2018.


https://ift.tt/2v1IEcz

Implementing primary prevention of food allergy in infants: New BSACI guidance published

Clinical &Experimental Allergy, Volume 48, Issue 8, Page 912-915, August 2018.


https://ift.tt/2LPdL4r

Best of the Other Journals

Clinical &Experimental Allergy, Volume 48, Issue 8, Page 1074-1074, August 2018.


https://ift.tt/2Kgs2CI

A summer's tale

Clinical &Experimental Allergy, Volume 48, Issue 8, Page 910-911, August 2018.


https://ift.tt/2v2BMvz

Cover Image

Clinical &Experimental Allergy, Volume 48, Issue 8, Page i-i, August 2018.


https://ift.tt/2K6NlXb

Tumstatin fragment selectively inhibits neutrophil infiltration in experimental asthma exacerbation

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2M1peL7

Diagnostic utility of skin autofluorescence when patch test results are doubtful

Skin Research and Technology, EarlyView.


https://ift.tt/2M2UXMd

Revisiting, in vivo, the hair regreasing process by the Sebuprint method

Skin Research and Technology, EarlyView.


https://ift.tt/2v1Q1QX

The role of high‐frequency ultrasound in diagnosing myiasis: Report of a case and review of the literature

Skin Research and Technology, EarlyView.


https://ift.tt/2v2IHou

Topographic approach to the long‐term effect of solar exposure on facial skin of Korean automobile commuters

Skin Research and Technology, EarlyView.


https://ift.tt/2NY4QeG

Recent advancement in the early detection of melanoma using computerized tools: An image analysis perspective

Skin Research and Technology, EarlyView.


https://ift.tt/2v2IAt4

Transepidermal water loss, stratum corneum hydration, and skin surface pH of female African and Caucasian nursing students

Skin Research and Technology, EarlyView.


https://ift.tt/2LPa4vH

Otitis Media with Effusion in Nasal Polyposis and Outcomes Following Surgery: a Longitudinal Observational Study

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2v2HihI

Findings on 7000 mri of the iam: To scan or not to scan? : A retrospective cohort study

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2M0zPpS

Issue Information

Clinical Otolaryngology, Volume 43, Issue 4, Page ii-v, August 2018.


https://ift.tt/2M2XoOM

Cover Image

Clinical Otolaryngology, Volume 43, Issue 4, Page i-i, August 2018.


https://ift.tt/2LACOZL

Author Guidelines

Clinical Otolaryngology, Volume 43, Issue 4, Page 1192-1193, August 2018.


https://ift.tt/2K78Reo

Efficacy of fibre‐optic laryngeal potassium titanyl phosphate laser surgery under local anaesthesia for the treatment of vocal polyps: A prospective study of 65 patients

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Lz4pdQ

Antibiotic prophylaxis in clean head and neck surgery: A prospective randomized controlled trial

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Kb6W8N

Ménière’s disease with unremitting floating sensation is associated with canal paresis, gravity-sensitive dysfunction, mental illness, and bilaterality

The aim of the present study was to evaluate the association of neuro-otological examination, blood tests, and scoring questionnaire data with treatment-resistant intractability of persistent dizziness in Ménière's disease.

https://ift.tt/2K9eJUx

In situ and invasive melanoma in a high‐risk, New Zealand, population: A population‐based study

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2v2EiSp

A novel dermoscopic pattern observed in furuncular myiasis

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2KftYeq

The use of an innovative film‐forming topical gel in preventing Striae Gravidarum and treating Striae Distensae

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2LOkHPm

Multiple perianal ulcers due to suppositories

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2M7k3tq

Progress of an isolated collagenoma during pregnancy

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2LOkwDG

Gene Therapy for C1 Esterase Inhibitor Deficiency in a Murine Model of Hereditary Angioedema

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2LP9f65

Staphylococcus aureus small colony variants: prevalence in chronic rhinosinusitis and induction by antibiotics

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2M4v7HF

Hyper IgE in the Allergy Clinic‐ when is it Primary Immunodeficiency?

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2LK0ASB

microRNA‐146a is linked to the production of IgE in mice but not in Atopic Dermatitis patients

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2K9ePeQ

Stability of Diluted Neuromuscular Blocking Agents Utilized in Perioperative Hypersensitivity Evaluation

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2LK0lqF

Highlights of the 8th Drug Hypersensitivity Meeting: Amsterdam, April 19‐21, 2018

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2M3kmW2

Japanese cedar pollinosis in Tokyo residents born after massive national afforestation policy

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2v4u0RA

Efficacy and safety of SQ house dust mite sublingual immunotherapy‐tablet in Japanese children

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2M1kViV

Asthma diagnosis using integrated analysis of eosinophil microRNAs

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2M1kNjr

Prevention of allergy by virus‐like nanoparticles (VNP) delivering shielded versions of major allergens in a humanized murine allergy model

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2v14wop

Protective effects of breastfeeding on respiratory symptoms in infants with 17q21 asthma risk variants

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2M3SDEF

The soluble isoform of human FcɛRI is an endogenous inhibitor of IgE‐mediated mast cell responses

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2v4tF1g

De novo sensitization to Aspergillus fumigatus in adult asthma over a 10‐year observation period

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2M6tNDV

The Health and Economic Outcomes of Early Egg Introduction Strategies

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2LTWyXA

Characteristics and management of Asian skin

International Journal of Dermatology, EarlyView.


https://ift.tt/2viSu91

In situ and invasive melanoma in a high‐risk, New Zealand, population: A population‐based study

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2v2EiSp

A novel dermoscopic pattern observed in furuncular myiasis

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2KftYeq

The use of an innovative film‐forming topical gel in preventing Striae Gravidarum and treating Striae Distensae

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2LOkHPm

Multiple perianal ulcers due to suppositories

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2M7k3tq

Progress of an isolated collagenoma during pregnancy

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2LOkwDG

Unexpected positron emission tomography/computed tomography uptake in benign dermal naevus

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2Kftll4

Medicine and body image: resource planning for the poor. A memoir by Terence Ryan

International Journal of Dermatology, EarlyView.


https://ift.tt/2LDenuY

Retrospective analysis of a single‐center clinical experience toward development of curative treatment of 123 pemphigus patients with a long‐term follow‐up: efficacy and safety of the multidrug protocol combining intravenous immunoglobulin with the cytotoxic immunosuppressor and mitochondrion‐protecting drugs

International Journal of Dermatology, EarlyView.


https://ift.tt/2NUbNxg

Comments concerning “ALK positive primary cutaneous anaplastic large cell lymphoma: a case report and review of the literature”

International Journal of Dermatology, EarlyView.


https://ift.tt/2OsY01H

White and yellow dots as new trichoscopic signs of severe female androgenetic alopecia in dark skin phototypes

International Journal of Dermatology, EarlyView.


https://ift.tt/2vkUUUG

Chronic generalized pruritus without primary skin lesions: a longitudinal prospective observational study

International Journal of Dermatology, EarlyView.


https://ift.tt/2OqFk2y

Morphology, growth rate, and thickness of the nail plate during the pregnancy

International Journal of Dermatology, EarlyView.


https://ift.tt/2LBC6M6

An effective and promising treatment with adalimumab for impetigo herpetiformis with postpartum flare‐up

International Journal of Dermatology, EarlyView.


https://ift.tt/2NSWR2r

A study on gender differences in newly detected leprosy cases in Sichuan, China, 2000–2015

International Journal of Dermatology, EarlyView.


https://ift.tt/2LFY0xP

Clinical management of Anti‐TNF‐alpha‐induced psoriasis or psoriasiform lesions in inflammatory bowel disease patients: a systematic review

International Journal of Dermatology, EarlyView.


https://ift.tt/2vkUFce

Productivity changes following medical and surgical treatment of chronic rhinosinusitis by symptom domain

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2AopthZ

Effects of decongestant addition to intranasal corticosteroid for chronic rhinitis: a systematic review and meta‐analysis

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2LLajI5

Risk factors and strategies in nonadherence with subcutaneous immunotherapy: a real‐life study

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2AngQ7k

Nitric oxide‐releasing microparticles as a potent antimicrobial therapeutic against chronic rhinosinusitis bacterial isolates

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2v4ou1k

Reliability and validity of the Korean version of the Questionnaire of Olfactory Disorders

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2M4oCof

Sex bias in rhinology research

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2LQlsYm

Additional options in chronic rhinosinusitis management

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2M0vFOM

Tissue changes over time after polydioxanone thread insertion: An animal study with pigs

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2Ou5CRu

Topography of the dorsal nasal artery and its clinical implications for augmentation of the dorsum of the nose

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2Asp12o

A red pumpkin seed extract reduces melanosome transfer to keratinocytes by activation of Nrf2 signaling

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2mWdGy5

Applications and efficacy of platelet‐rich plasma in dermatology: A clinical review

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2AwngBs

Perspectives in cosmetic dermatology: What is in front of the mirror?

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2mUvzx3

Assessment of the moisturizing properties of a magnetic mask containing iron oxide particles

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2ArH0Gg

Comparison of three strip harvesting technqiues (Haber's, Pathomvanich's and Ahmad's techniques)

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2OvuCrI

Identification and integrated analysis of microRNA expression profiles in keloid

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2AwmZyq

Lipoma removal using a high‐frequency ultrasound‐guided injection of a Class III CE‐marked device—Empirical findings

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2mXoqw8

Antiaging efficacy of a retinaldehyde‐based cream compared with glycolic acid peel sessions: A randomized controlled study

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2Ar13oa

Oral propranolol for infantile hemangiomas beyond the proliferative phase

The Journal of Dermatology, EarlyView.


https://ift.tt/2Ovecj2

Rapid alteration of serum interleukin‐6 levels may predict the reactivity of i.v. cyclophosphamide pulse therapy in systemic sclerosis‐associated interstitial lung disease

The Journal of Dermatology, EarlyView.


https://ift.tt/2ApM25T

Increase in antinuclear antibody levels through biologic treatment for psoriasis

The Journal of Dermatology, EarlyView.


https://ift.tt/2mUvoln

Urticarial vasculitis and subcutaneous nodules in the extremities seen in a patient with mucopolysaccharidosis II after hematopoietic stem cell therapy

The Journal of Dermatology, EarlyView.


https://ift.tt/2AlwqjU

Indeterminate cell histiocytosis presenting as a single nodule of the nose

The Journal of Dermatology, EarlyView.


https://ift.tt/2OvubO6

Undifferentiated pleomorphic sarcoma in a patient with Cowden syndrome after radiotherapy for breast cancer

The Journal of Dermatology, EarlyView.


https://ift.tt/2Ar0Z7U

Characteristics of multiple basal cell carcinomas: The first study on Japanese patients

The Journal of Dermatology, EarlyView.


https://ift.tt/2Ovu2Ky

Effectiveness of etretinate/yokuinin combination therapy for lip squamous cell carcinoma

The Journal of Dermatology, EarlyView.


https://ift.tt/2Ar0Pxk

Azathioprine‐induced myelosuppression in two pemphigus vulgaris patients with homozygous polymorphism of NUDT15

The Journal of Dermatology, EarlyView.


https://ift.tt/2OvQtiz

Cutis laxa for diagnosis of γ1‐heavy‐chain deposition disease: Report of four cases

The Journal of Dermatology, EarlyView.


https://ift.tt/2Ama1Di

Tissue changes over time after polydioxanone thread insertion: An animal study with pigs

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2Ou5CRu

Topography of the dorsal nasal artery and its clinical implications for augmentation of the dorsum of the nose

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2Asp12o

A red pumpkin seed extract reduces melanosome transfer to keratinocytes by activation of Nrf2 signaling

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2mWdGy5

Applications and efficacy of platelet‐rich plasma in dermatology: A clinical review

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2AwngBs

Perspectives in cosmetic dermatology: What is in front of the mirror?

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2mUvzx3

Assessment of the moisturizing properties of a magnetic mask containing iron oxide particles

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2ArH0Gg

Comparison of three strip harvesting technqiues (Haber's, Pathomvanich's and Ahmad's techniques)

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2OvuCrI

Identification and integrated analysis of microRNA expression profiles in keloid

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2AwmZyq

Lipoma removal using a high‐frequency ultrasound‐guided injection of a Class III CE‐marked device—Empirical findings

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2mXoqw8

Antiaging efficacy of a retinaldehyde‐based cream compared with glycolic acid peel sessions: A randomized controlled study

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2Ar13oa

Keratin‐based particles for protection and restoration of hair properties

International Journal of Cosmetic Science, Volume 0, Issue ja, -Not available-.


https://ift.tt/2LQ1MDR

Predicting Lipstick Sensory Properties with Lab Tests

International Journal of Cosmetic Science, Volume 0, Issue ja, -Not available-.


https://ift.tt/2NWVQGB

An Updated Review of Clinical Methods in the Assessment of Aging Skin ‐ New Perspectives and Evaluation for Claims Support

International Journal of Cosmetic Science, Volume 0, Issue ja, -Not available-.


https://ift.tt/2v2CBV8

Skin sensitivity and skin microbiota: Is there a link?

Experimental Dermatology, EarlyView.


https://ift.tt/2AnG9WV

Serum Level of IL‐4 Predicts Response to Topical Immunotherapy with Diphenylcyclopropenone (DPCP) in Alopecia Areata

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2OuauGs

UVB‐inhibited H19 activates the melanogenesis axis by paracrine effects

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2AqABuX

RIP4 upregulates CCL20 expression through STAT3 signaling in cultured keratinocytes

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mXy8P2

SIG1459: A novel phytyl‐cysteine derived TLR2 modulator with in vitro and clinical anti‐acne activity

Experimental Dermatology, EarlyView.


https://ift.tt/2AqAtvt

Loss of Gata6 causes dilation of the hair follicle canal and sebaceous duct

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Ou5gKE

Corneocyte Proteomics: Applications to Skin Biology and Dermatology

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2AqAjUT

Characterization of stem‐like cancer cells in basal cell carcinoma and its surgical margins

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mXxqBm

Dissociated Skin Cells Regenerate Hair Follicles in a MicroWound, “The Punch Assay”

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2AqA7F9

Ex‐vivo fluorescence confocal microscopy for intraoperative, real time diagnoses of cutaneous inflammatory diseases: a preliminary study

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2OvTY90

Inactivation of autophagy leads to changes in sebaceous gland morphology and function

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2AqzRWH

A dipeptidyl peptidase‐4 inhibitor promotes wound healing in normoglycemic mice by modulating keratinocyte activity

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mXnnfG

Clinical Thyroidology®High-Impact Articles

FREE ACCESS through August 13, 2018.
Read Now:

Higher Preconception Maternal Iodine Intakes Are Associated with Higher Child IQ
Elizabeth N. Pearce 

Some Advanced Thyroid Cancer Patients Have a Prolonged Response to Lenvatinib
Brian W. Kim

Analysis of Clinical Factors 1 Year After Surgery for Thyroid Cancer Enables Prediction of Treatment-free Survival
Jerome M. Hershman 

New Genomic Sequencing Classifier in Cytologically Indeterminate Thyroid Nodules Shows Improved Results
Stephanie Fish

 

 

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



https://ift.tt/2KaH4db

Clinical Thyroidology®High-Impact Articles

FREE ACCESS through August 13, 2018.
Read Now:

Higher Preconception Maternal Iodine Intakes Are Associated with Higher Child IQ
Elizabeth N. Pearce 

Some Advanced Thyroid Cancer Patients Have a Prolonged Response to Lenvatinib
Brian W. Kim

Analysis of Clinical Factors 1 Year After Surgery for Thyroid Cancer Enables Prediction of Treatment-free Survival
Jerome M. Hershman 

New Genomic Sequencing Classifier in Cytologically Indeterminate Thyroid Nodules Shows Improved Results
Stephanie Fish

 

 

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



https://ift.tt/2KaH4db

Relapse rates in patients with unilesional primary cutaneous B‐cell lymphoma treated with radiation therapy: a single‐institution experience

British Journal of Dermatology, EarlyView.


https://ift.tt/2vm7yCT

Anthropometric factors and Breslow thickness: prospective data on 2570 cases of cutaneous melanoma in the population‐based Janus Cohort

British Journal of Dermatology, EarlyView.


https://ift.tt/2LAkGPQ

Patient preferences for topical treatment of actinic keratoses: a discrete‐choice experiment

British Journal of Dermatology, EarlyView.


https://ift.tt/2vkBTSt

Impact of anti‐interleukin‐17 treatment on cutaneous and genital human papillomavirus infection

British Journal of Dermatology, EarlyView.


https://ift.tt/2LAkFeK

Relapse of porphyria cutanea tarda after treatment with phlebotomy or 4‐aminoquinoline antimalarials: a meta‐analysis

British Journal of Dermatology, EarlyView.


https://ift.tt/2vlbZOn

The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from patients with atopic dermatitis

British Journal of Dermatology, EarlyView.


https://ift.tt/2LyIe7A

Cumulative exposure to biological therapy and risk of cancer in patients with psoriasis: a meta‐analysis of Psonet studies from Israel, Italy, Spain, the U.K. and Republic of Ireland

British Journal of Dermatology, EarlyView.


https://ift.tt/2vk2PSi

Is melanoma mortality declining in Spain? Analysis of trends from 1975 to 2016

British Journal of Dermatology, EarlyView.


https://ift.tt/2LEpxiO

Pembrolizumab‐associated mucous membrane pemphigoid in a patient with Merkel cell carcinoma

British Journal of Dermatology, EarlyView.


https://ift.tt/2vrk3xh

Evaluation of the reliability and validity of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) in pediatric cutaneous lupus among pediatric dermatologists and rheumatologists

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Ou2xko

Efficacy and safety of ixekizumab in a randomized, double‐blinded, placebo‐controlled phase IIIb study of patients with moderate‐to‐severe genital psoriasis

British Journal of Dermatology, EarlyView.


https://ift.tt/2vevMiq

Risk of skin cancer in people with vitiligo: a systematic review and meta‐analysis

British Journal of Dermatology, EarlyView.


https://ift.tt/2Ou2mWg

International Initiative for outcomes (INFO) for vitiligo: Workshops with vitiligo patients on repigmentation

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2vlbWCb

Correlation of psoriasis activity with socioeconomic status: cross‐sectional analysis of patients enrolled in the Psoriasis Longitudinal Assessment and Registry (PSOLAR)

British Journal of Dermatology, EarlyView.


https://ift.tt/2LBgWgY

Polysensitivity in delayed cutaneous adverse drug reactions to macrolides, clindamycin and pristinamycin: clinical history and patch testing

British Journal of Dermatology, EarlyView.


https://ift.tt/2vevfNs

Effective sirolimus treatment for refractory spindle cell haemangioma

British Journal of Dermatology, EarlyView.


https://ift.tt/2LAcTBr

Oral ulcers as a presentation of secondary syphilis

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2LCQN1q

Relapse rates in patients with unilesional primary cutaneous B‐cell lymphoma treated with radiation therapy: a single‐institution experience

British Journal of Dermatology, EarlyView.


https://ift.tt/2vm7yCT

Anthropometric factors and Breslow thickness: prospective data on 2570 cases of cutaneous melanoma in the population‐based Janus Cohort

British Journal of Dermatology, EarlyView.


https://ift.tt/2LAkGPQ

Patient preferences for topical treatment of actinic keratoses: a discrete‐choice experiment

British Journal of Dermatology, EarlyView.


https://ift.tt/2vkBTSt

Impact of anti‐interleukin‐17 treatment on cutaneous and genital human papillomavirus infection

British Journal of Dermatology, EarlyView.


https://ift.tt/2LAkFeK

Relapse of porphyria cutanea tarda after treatment with phlebotomy or 4‐aminoquinoline antimalarials: a meta‐analysis

British Journal of Dermatology, EarlyView.


https://ift.tt/2vlbZOn

The widespread use of topical antimicrobials enriches for resistance in Staphylococcus aureus isolated from patients with atopic dermatitis

British Journal of Dermatology, EarlyView.


https://ift.tt/2LyIe7A

Cumulative exposure to biological therapy and risk of cancer in patients with psoriasis: a meta‐analysis of Psonet studies from Israel, Italy, Spain, the U.K. and Republic of Ireland

British Journal of Dermatology, EarlyView.


https://ift.tt/2vk2PSi

Is melanoma mortality declining in Spain? Analysis of trends from 1975 to 2016

British Journal of Dermatology, EarlyView.


https://ift.tt/2LEpxiO

Pembrolizumab‐associated mucous membrane pemphigoid in a patient with Merkel cell carcinoma

British Journal of Dermatology, EarlyView.


https://ift.tt/2vrk3xh

Evaluation of the reliability and validity of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) in pediatric cutaneous lupus among pediatric dermatologists and rheumatologists

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Ou2xko

Efficacy and safety of ixekizumab in a randomized, double‐blinded, placebo‐controlled phase IIIb study of patients with moderate‐to‐severe genital psoriasis

British Journal of Dermatology, EarlyView.


https://ift.tt/2vevMiq

Risk of skin cancer in people with vitiligo: a systematic review and meta‐analysis

British Journal of Dermatology, EarlyView.


https://ift.tt/2Ou2mWg

International Initiative for outcomes (INFO) for vitiligo: Workshops with vitiligo patients on repigmentation

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2vlbWCb

Correlation of psoriasis activity with socioeconomic status: cross‐sectional analysis of patients enrolled in the Psoriasis Longitudinal Assessment and Registry (PSOLAR)

British Journal of Dermatology, EarlyView.


https://ift.tt/2LBgWgY

Polysensitivity in delayed cutaneous adverse drug reactions to macrolides, clindamycin and pristinamycin: clinical history and patch testing

British Journal of Dermatology, EarlyView.


https://ift.tt/2vevfNs

Effective sirolimus treatment for refractory spindle cell haemangioma

British Journal of Dermatology, EarlyView.


https://ift.tt/2LAcTBr

Oral ulcers as a presentation of secondary syphilis

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2LCQN1q

Performance of 111 In-labelled PSMA ligand in patients with nodal metastatic prostate cancer: correlation between tracer uptake and histopathology from lymphadenectomy

Abstract

Purpose

Intraoperative identification of lymph node (LN) metastases (LNM) detected on preoperative PSMA PET/CT may be facilitated by PSMA radioguided surgery with the use of a gamma probe. We evaluated the uptake of 111In-labelled PSMA ligand DKFZ-617 (referred to as 111In-PSMA-617) in unaffected LN and LNM at the level of single LN.

Methods

Six patients with prostate cancer (PCa) with suspicion of LNM on preoperative PSMA PET/CT underwent 111In-PSMA-617-guided lymphadenectomy (LA; four salvage LA and two primary LA). 111In-PSMA-617 (109 ± 5 MBq). was injected Intravenously 48 h prior to surgery Template LAs were performed in small subregions: common, external, obturator and internal iliac vessels, and presacral and retroperitoneal subregions (n = 4). Samples from each subregion were isolated aiming at the level of single LN. Uptake was measured ex situ using a germanium detector. Receiver operating characteristic (ROC) analysis was performed based on 111In-PSMA-617 uptake expressed as standardized uptake values normalized to lean body mass (SUL).

Results

Overall 310 LN (mean 52 ± 19.7) were removed from 74 subregions (mean 12 ± 3.7). Of the 310 LN, 35 turned out to be LNM on histopathology. Separation of the samples from all subregions resulted in 318 single specimens: 182 PCa-negative LN samples with 275 LN, 35 single LNM samples, 3 non-nodal PCa tissue samples and 98 fibrofatty tissue samples. The median SULs of nonaffected LN (0.16) and affected LN (13.2) were significantly different (p < 0.0001). Based on 38 tumour-containing and 182 tumour-free specimens, ROC analysis revealed an area under the curve of 0.976 (95% CI 0.95–1.00, p < 0.0001). Using a SUL cut-off value of 1.136, sensitivity, specificity, positive predictive value, negative predictive value and accuracy in discriminating affected from nonaffected LN were 92.1% (35/38), 98.9% (180/182), 94.6% (35/37), 98.4% (180/183) and 97.7% (215/220), respectively.

Conclusion

Ex situ analysis at the level of single LN showed that 111In-PSMA-617 had excellent ability to discriminate between affected and nonaffected LN in our patients with PCa. This tracer characteristic is a prerequisite for in vivo real-time measurements during surgery.



https://ift.tt/2AsgOv6

Tildrakizumab Gets EMA Panel Nod for Plaque Psoriasis

A European Medicines Agency panel has recommended tildrakizumab for the treatment of moderate to severe plaque psoriasis.
International Approvals

https://ift.tt/2NXCeC2

Tasks, competences and educational needs of dermatology health care providers in the public and private sectors.results of the EADV‐NWAG survey in Belgium

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mThfVD

The use of prp (platelet‐rich plasma) in patients affected by genital lichen sclerosus: clinical analysis and results

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2KaALGj

Polymorphisms in melanocortin system and MYG1 genes are associated with vitiligo

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mTgYC5

Lichen planus pigmentosus inversus in a Finnish man

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2KbDu2i

Incidence and characteristics of thick second primary melanomas. A study of the German Central Malignant Melanoma Registry

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mUAWwn

An original exploration of genital lichen sclerosus: the semantic connectivity map

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2K6bWeJ

Enhancing survival of Demodex mites in vitro

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2LAaZAS

Immune‐regulatory genes as possible modifiers of familial pityriasis rubra pilaris – lessons from a family with PRP and psoriasis

Journal of the European Academy of Dermatology and Venereology, EarlyView.


https://ift.tt/2KbD4ZM

Patients’ needs and psoriasis treatment

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mRAK0K

8% Capsaicin ‐ a hot medicine for neuropathic itch

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2K8RIB4

Forthcoming Events

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1391-1391, August 2018.


https://ift.tt/2LyxHcJ

RASopathic comedone‐like or cystic lesions induced by vemurafenib: a model of skin lesions similar but not identical to those induced by dioxins MADISH

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1368-1372, August 2018.


https://ift.tt/2KabLih

Characterizing clinicopathological and immunohistochemical findings in dermatomyositis panniculitis

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1231-1232, August 2018.


https://ift.tt/2mWOirX

Issue Information

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1225-1230, August 2018.


https://ift.tt/2Kb2B59

Pioneers in dermatology and venereology: An interview with Prof. Jose Maria Mascaro

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1235-1237, August 2018.


https://ift.tt/2LAhzr8

Aryl hydrocarbon receptor signalling in the skin and adverse vemurafenib effects

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1233-1234, August 2018.


https://ift.tt/2KaAh2X

Announcement

Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 8, Page 1392-1392, August 2018.


https://ift.tt/2mUxh1l

Adverse events associated with apremilast use and withdrawal for psoriasis in a real‐world setting

Journal of the European Academy of Dermatology and Venereology, EarlyView.


https://ift.tt/2KaxpDr

CD8+ Cytotoxic T Lymphocyte Responses and Viral Epitope Escape in Acute HIV-1 Infection

Viral Immunology, Ahead of Print.


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Maxillary sinusitis complicated by stroke

Publication date: Available online 30 July 2018

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): C. Fabre, I. Atallah, I. Wroblewski, C.A. Righini

Abstract
Introduction

Neurological complications of acute sinusitis are exceptional, but potentially serious.

Case report

The authors report the case of a 6-year-old diabetic girl who presented with middle cerebral artery ischemic stroke secondary to inflammatory arteritis of the left internal carotid artery in a context of bilateral acute maxillary sinusitis. MRI confirmed ischaemic stroke associated with carotid arteritis and complete obstruction of the maxillary sinuses. A favourable outcome was observed after endoscopic drainage of the sinuses associated with broad-spectrum antibiotic therapy.

Discussion

This complication was probably due to spread of an infectious inflammatory reaction of the intrapetrosal carotid artery and its branches via the pterygoid venous plexus. To our knowledge, this is the first published case report of maxillary sinusitis complicated by stroke.



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Reconstruction of the anterior wall of the frontal sinus by a custom-made titanium prosthesis after resection of a giant osteoma of the frontal sinus

Publication date: Available online 30 July 2018

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): J. Fanchette, B. Faucon, F. Cartry, M. Ratajczak

Abstract

Osteoma is a benign, usually asymptomatic bone tumour, frequently arising in the nose and paranasal sinuses. Surgical treatment is required when the patient becomes symptomatic or presents ophthalmological or neurological complications. Although an endoscopic approach is increasingly used, depending on the size and site of the osteoma, open surgery may be preferable and remains the standard treatment. This technical note describes a case of giant osteoma of the frontal sinus that required a bicoronal approach with reconstruction by a custom-made titanium prosthesis.



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“The changing face of anaphylaxis in adults and adolescents”

Publication date: Available online 30 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Debendra Pattanaik, Phil Lieberman, Jay Lieberman, Thanai Pongdee, Alexandria Tran Keene

Abstract
Background

Our institution has published serial studies of adults and adolescents experiencing anaphylactic events. The first series was published in 1993 and the last in 2006. It was our perception that the nature of anaphylactic episodes had changed over the two decades since the last review.

Objective

To determine whether the etiologies and presentations of anaphylaxis has changed over the last decade in our population.

Methods

Patient charts were identified based upon ICD-9 codes for anaphylactic shock. Charts identified were analyzed for clinical symptoms reported, comorbidities, etiology, investigative testing, and subsequent treatment. These cases were categorized as definitive, probable, or idiopathic based on history and results from testing, similar to our prior reports.

Results

We identified 281 possible cases, of which 218 met criteria for anaphylaxis. Among the cases, median age was 42 years (range 9-78) and 64% were female. In the review of cases, 85 (39%) were determined to have a definitive etiology, 57 a probable etiology (26%), and 76 (35%) were idiopathic. Interestingly, among those with a definitive cause, the most common etiology identified was galactose-alpha-1,3-galactose (α- gal), accounting for 28 cases (33%). Foods were the 2nd leading cause accounting for 24 cases (28%).

Conclusion

In this follow up report on anaphylaxis etiology from a single center, the most common etiology was α-gal. This varies greatly from the prior reports our center. Interestingly, the percent of cases attributed to idiopathic anaphylaxis decreased from 59% in our past report to 35% in this report, which could largely be explained by the number of α-gal cases.



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Searching for crab-borne antimicrobial peptides: Crustin from Portunus pelagicus triggers biofilm inhibition and immune responses of Artemia salina against GFP tagged Vibrio parahaemolyticus Dahv2

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Ravichandran Rekha, Baskaralingam Vaseeharan, Ramachandran Ishwarya, Mahalingam Anjugam, Naiyf S. Alharbi, Shine Kadaikunnan, Jamal M. Khaled, Mohammed N. Al-anbr, Marimuthu Govindarajan

Abstract

Marine organisms represent a huge source of novel compounds for the development of effective antimicrobial drugs. The present study focus on the purification of the antimicrobial peptide crustin from the haemolymph of the blue swimmer crab, Portunus pelagicus, by blue Sepharose CL-6B matrix assisted affinity column chromatography. Crustin showed a single band with a molecular mass of 17 kDa in SDS-PAGE analysis. The XRD analysis exhibited peaks at 32° and 45° while a distinct peak with a retention time of 1.8 min resulted in high performance liquid chromatography (HPLC) pointing out the crystalline nature and purity of crustin, respectively. Crustin purified from P. pelagicus (Pp-Cru) showed immunological activities, triggering encapsulation, phagocytosis on Sepharose beads and yeast (Saccharomyces cerevisiae) respectively. Furthermore, encapsulation of GFP tagged V. parahaemolyticus in Artemia salina and challenging study were assessed under CLSM and the potential of Pp-Cru was examined in vivo. In addition, the growth reduction and biofilm inhibition potential of Pp-Cru on Staphylococcus aureus, Enterococcus faecalis (Gram- positive bacteria) and Pseudomonas aeruginosa, Escherichia coli (Gram-negative bacteria) was evidenced by inverted and confocal laser scanning microscopic analysis, revealing that 100 μg/ml of Pp-Cru can disrupt the biofilm matrix thereby the thickness of biofilm was significantly reduced. Overall, the present investigation might provide a sensitive platform to realize the significant function of Pp-Cru in crustacean immune mechanism as well as its potential to bacterial growth inhibitor. The functional properties of purified Pp-Cru antimicrobial peptide may lead to a superior understanding of innate immune response in P. pelagicus species, which suggest the promising application for drug development in aquaculture.

Graphical abstract

Graphical abstract for this article



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Letter to the editor: “Sentinel node biopsy in early oral squamous cell carcinomas: Long-term follow-up and nodal failure analysis”

Publication date: Available online 30 July 2018

Source: Oral Oncology

Author(s): Tao Wang, Longjiang Li



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Clinical and genetic profiles of patients with X-linked agammaglobulinemia from southeast Turkey: Novel mutations in BTK gene

Publication date: Available online 30 July 2018

Source: Allergologia et Immunopathologia

Author(s): D. Doğruel, M. Serbes, A.Ş. Şaşihüseyinoğlu, M. Yılmaz, D.U. Altıntaş, A. Bişgin

Abstract
Background

X-linked agammaglobulinemia (XLA) is characterized by absent or severely reduced B cells, low or undetectable immunoglobulin levels, and clinically by extracellular bacterial infections which mainly compromise the respiratory tract. We aimed to analyze the clinical, immunological and genetic characteristics of 22 male children with XLA.

Methods

Twenty-two children with XLA from 12 unrelated families were enrolled in this study. Clinical and demographic features of patients, serum immunoglobulin levels, percentage of B cells and BTK gene mutations were reviewed retrospectively.

Results

We identified 12 different mutations in 22 patients from 12 unrelated families. The most frequent type of mutation was premature stop codon (33.3%). Ten mutations had been reported previously including three missense mutations (c.1774T>C, c.1684C>T, c.83G>T), three premature stop codons (c.1558C>T, c.1573C>T, c.753G>A), two splice-site (c.683-1G>A, c.1567-12_1567-9delTTTG) and two small nucleotide deletions (c.902-904_delAAG, c.179_181delAGA). Two novel mutations of the BTK gene were also presented and included one splice-site mutation (c.391+1G>C) and one premature stop codon mutation (c.1243_1243delG). Six out of 12 mutations of the BTK gene were located in the SH1 domain, two in the PH domain, two in the SH3 domain and two in the SH2 domain. Three patients had a history of severe infection before diagnosis. We did not identify any correlation between severity of clinical symptoms and the genotype.

Conclusions

Our results show that mutations in southeast Turkey could be different from those in the rest of the world and molecular genetic tests are an important tool for early confirmed diagnosis of XLA.



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Ménière’s disease with unremitting floating sensation is associated with canal paresis, gravity-sensitive dysfunction, mental illness, and bilaterality

Publication date: Available online 30 July 2018

Source: Auris Nasus Larynx

Author(s): Tadashi Kitahara, Masaharu Sakagami, Taeko Ito, Tomoyuki Shiozaki, Koichi Kitano, Akinori Yamashita, Ichiro Ota, Yoshiro Wada, Toshiaki Yamanaka

Abstract
Objective

The aim of the present study was to evaluate the association of neuro-otological examination, blood tests, and scoring questionnaire data with treatment-resistant intractability of persistent dizziness in Ménière's disease.

Methods

We managed 1520 successive vertigo/dizziness patients at the Vertigo/Dizziness Center in Nara Medical University from May 2014 to April 2018. Five hundred and twenty-two patients were diagnosed with Ménière's disease (522/1520; 34.3%) according to the 2015 diagnostic guideline of the International Classification of Vestibular Disorders. Among the patients with Ménière's disease there were 102 with intractable rotatory vertigo attacks for more than 3–6 months (102/522; 19.5%), including 20 bilateral cases (20/102; 19.6%), and 88 with intractable unremitting floating sensation rather than rotatory vertigo attacks for more than 3–6 months (88/522; 16.9%), including 28 bilateral cases (28/88; 31.8%). Sixty out of 88 cases with intractable unremitting floating sensation were unilateral and were enrolled for hospitalization to undergo neuro-otological examinations including pure-tone audiometry (PTA), the caloric test (C-test), vestibular evoked cervical myogenic potentials (cVEMP), subjective visual vertical (SVV) test, glycerol test (G-test), electrocochleogram (ECoG), inner ear magnetic resonance imaging (ieMRI), blood tests including anti-diuretic hormone (ADH) and bone alkaline phosphatase (BAP), and self-rating questionnaires of depression score (SDS). Data are presented as positive (+) ratios of the number of patients with examination and questionnaire data outside of the normal range.

Results

The ratios (+) were as follows: C-test = 33.3% (20/60), cVEMP = 25.0% (15/60), SVV = 50.0% (30/60), G-test = 55.0% (33/60), ECoG = 63.3% (38/60), ieMRI = 86.7% (52/60), ADH = 35.0% (21/60), BAP = 11.7% (7/60), and SDS = 40.0% (24/60). Multivariate regression analysis revealed that the periods of persistent dizziness were significantly longer in unilateral Ménière's patients with C-test(+), SVV(+), and SDS(+) compared with those with negative findings. Additionally, the periods in bilateral cases were significantly longer than those in unilateral ones.

Conclusions

Although approximately 70% of patients with Ménière's disease are usually treatable through the appropriate conservative medical therapy, the presence of canal paresis, gravity-sensitive dysfunction, neurosis/depression, and bilaterality may make the persistent dizziness intractable and may thus require additional treatments.



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The efficacy of hesperidin for treatment of acute otitis media

Publication date: Available online 30 July 2018

Source: Auris Nasus Larynx

Author(s): Erdem Atalay Cetinkaya, Osman Ciftci, Saadet Alan, M. Namık Oztanır, Nese Basak

Abstract
Objectives

In this experimental study, the effect of hesperidin on the treatment of acute otitis media (AOM) was investigated in an AOM-induced rat model.

Methods

In total, 35 rats were randomly divided into the following five groups (n = 7): group 1 (control), group 2 (AOM with no treatment), group 3 (AOM + antibiotic), group 4 (AOM + hesperidin), and group 5 (AOM + hesperidin + antibiotic). On day 14, group 3,4 and 5 rats were given antibiotic and hesperidin via gavages, respectively. Histopathological and immunological analyses were performed and the results analyzed.

Results

Serum levels of TNF-α, IL-4, IL-6 and IL-1β were significantly decreased in the hesperidin- and antibiotic-treated groups compared to the AOM group. The AOM + antibiotic and AOM + hesperidin groups demonstrated reduced histological damage compared to the AOM group. Between the AOM + antibiotic and AOM + hesperidin groups, significant differences in tympanic membrane thickness(ThicTM), inflammation(Inf), and sclerosis(Sc) values were observed. However, no difference in epithelial damage(DamEpith), was seen between the two groups. There was a significant difference in the AOM + antibiotic and AOM + antibiotic + hesperidin groups compared to AOM group (P < 0.001).

Conclusions

In this study, we observed that both antibiotic and hesperidin treatment reduced AOM symptoms in an AOM-induced rat model. The values in AOM + antibiotic + hesperidin group were markedly lower than those of the other groups. From our results, we propose that hesperidin, in combination with antibiotics, may provide a successful alternative treatment for AOM compared with antibiotics used alone.



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The role of radiation therapy in the treatment of metastatic cancer

Abstract

Radiation therapy continues to play an important role in the management of cancer. In this review, we discuss the use of radiation therapy to target and control micrometastatic disease (adjuvant use of radiation), or using stereotactic radiation therapy to address small volumes of gross disease, such as oligometastases, and finally the use of radiation therapy in the era of immunotherapy. Radiation therapy is commonly used to treat nodal basins suspected of harboring microscopic disease. More recently, computer and technical innovations have allowed radiation oncologists to treat small volumes of gross disease within the brain and also in the body with great success, adding to the cancer armamentarium. This modality of cancer treatment that began shortly after the discovery of X-rays by William Roentgen continues to evolve and finds new clinical applications which minimize toxicity while increasing effectiveness. The newly discovered interactions of high dose/fraction radiation (stereotactic radiosurgery) with immune check point inhibitors in melanoma is the latest example of how synergism can be achieved between two different modalities thus increasing the therapeutic ratio to control metastatic cancer.



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Prophylaxe des Vulva- und des Vaginalkarzinoms und ihrer Vorstufen

Zusammenfassung

Hintergrund

Vulva- und Vaginalkarzinome sind zunehmend diagnostizierte Tumorentitäten in Deutschland. Vulva- und Vaginalkarzinome entstehen über zwei unterschiedliche pathogenetische Mechanismen: Zum einen kann eine persistierende Infektion mit dem humanen Papillomvirus (HPV, v. a. Typ 16, 31, 33) über eine undifferenzierte vulväre/vaginale intraepitheliale Neoplasie (VIN/VAIN) zum invasiven Vulva‑/Vaginalkarzinom führen. Diese Tumoren finden sich eher bei jüngeren Frauen. Davon abzugrenzen ist das Vulvakarzinom der älteren Frauen, das auf dem Boden einer chronischen Hauterkrankung (z. B. Lichen sclerosus et atrophicus, LSA) über Mutationen im Tumorsuppressorgen p53 entsteht. Auch beim Vaginalkarzinom ist einer der Risikofaktoren ein Lichen sclerosus oder Lichen planus, diese Tumoren sind HPV-negativ. Daneben gibt es eine ganze Reihe von Tumoren, deren Ursache nicht bekannt ist.

Fragestellung

Gibt es primäre oder sekundäre Präventionsmaßnahmen, die die Entstehung dieser Tumoren verhindern können?

Ergebnisse

Die HPV-induzierten Vulva- und Vaginalkarzinome können zu einem bedeutenden Teil durch eine HPV-Impfung von HPV-naiven Frauen primär verhindert werden. Der nonavalente Impfstoff deckt die relevanten HPV-Typen 16, (18), 31 und 33 mit einer Wirksamkeit von 97 % ab, der bivalente Impfstoff hat eine vergleichbar hohe Effektivität aber nur für HPV16 und HPV18.

Ob das licheninduzierte Vulva‑/Vaginalkarzinom durch eine konsequente lokale Dauertherapie mit Kortison oder Calcineurininhibitoren primär präventiv verhindert werden kann wird diskutiert. Erste Daten, die darauf hindeuten, liegen vor.



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Bildgeführte radiologische Interventionen beim HCC

Zusammenfassung

Hintergrund

Bildgeführte Interventionen wie Radiofrequenz- oder Mikrowellenablation, CT-gesteuerte Brachytherapie oder Stereotaxie (SBRT), Chemoembolisation oder Yttrium-90(90Y)-Radioembolisation sind Teil aktueller Leitlinien zur Therapie des hepatozellulären Karzinoms (HCC) und unterliegen beständiger Validierung in aktuellen klinischen Studien.

Ziel

Dieser Artikel gibt einen Überblick über den aktuellen Stand der Evidenz und Leitlinienempfehlungen zu den genannten radiologischen, nuklearmedizinischen oder auch strahlentherapeutischen Verfahren.

Ergebnisse

Sowohl lokale Tumorablationen als auch die lokoregionäre Chemoembolisation sind Teil aller wesentlichen Leitlinien zur Behandlung des HCC. Die bildgeführten Tumorablationen im Stadium BCLC A oder auch BCLC 0 stellen sich mittlerweile als gleichwertige Alternative zur chirurgischen Resektion dar, wenn die Patientenselektion entsprechend adaptiert wird. Als lokoregionäre Therapie ist die Chemoembolisation im Stadium BCLC B bei gut erhaltener Leberfunktion und begrenzter Tumorlast Therapiestandard. Zum Einsatz der 90Y-Radioembolisation liegen bei BCLC B keine randomisierten Daten vor. Für BCLC C-Patienten ist die Chemoembolisation nicht indiziert. Als Alternativtherapie bei Systemtherapieversagen oder Kontraindikation für Sorafenib, aber auch mit Blick auf die deutlich verbesserte Verträglichkeit gegenüber Sorafenib kann die 90Y-Radioembolisation erwogen werden.



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Update zu uterinen Sarkomen

Zusammenfassung

Uterine Sarkome bilden eine inhomogene Gruppe seltener Tumoren der Uterusmuskulatur. Es sind meist aggressive Neoplasien, die vom uterinen Bindegewebe oder vom endometrialen Stroma ausgehen. Histologisch werden folgende Subtypen unterschieden: das Leiomyosarkom (LMS), das low-grade endometriale Stromasarkom (LG-ESS) und das high-grade endometriale Stromasarkom (HG-ESS) sowie das undifferenzierte Stromasarkom (UES). Die Inzidenz liegt bei 0,5–3,3 pro 100.000 Frauen pro Jahr; insgesamt bilden sie mit 1–2 % nur einen kleinen Anteil der uterinen Malignome. Eine andere Kategorie bilden uterine Sarkome gemischten Ursprungs, wie Adenosarkome, Karzinosarkome (maligne Müller-Mischtumoren) und andere heterologe Sarkome (z. B. Chondrosarkome, Liposarkome, Fibrosarkome etc.). Im Beitrag wird auf das spezifische Management der häufigen Entitäten (LMS, LG-ESS, HG-ESS und UES) Bezug genommen. Im August 2015 wurde die erste Version einer S2k-Leitlinie zu uterinen Sarkomen herausgegeben.



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Verhaltensstörung oder Schmerz?

Zusammenfassung

Hintergrund

Bei Menschen mit geistiger Beeinträchtigung werden Schmerzen zu selten und zu spät diagnostiziert. Diese Patienten erhalten trotz größerer Krankheitslast wesentlich weniger Schmerzmittel als Menschen ohne Behinderung.

Ergebnisse

An die Möglichkeit des Vorliegens von Schmerzen zu denken, ist dabei genauso entscheidend wie eine adäquate und sensible Diagnostik. Neben der Nutzung aller Mittel zur Verbesserung der Kommunikation (Erklärungen in leichter Sprache, Arbeiten mit Bildern und Symbolen) ist die Fremdauskunft zusätzlich oder ersatzweise häufig unverzichtbar (Befragung von Nahestehenden, spezielle Assessment-Instrumente). Jede Veränderung des Verhaltens muss als mögliche Ursache von Schmerzen (oder anderen Symptomen) aufmerksam registriert und weiter abgeklärt werden.

Schlussfolgerung

Die Schmerztherapie kann und sollte grundsätzlich wie bei nichtbehinderten Menschen durchgeführt werden, nichtmedikamentöse Maßnahmen stehen dabei im Vordergrund. Die Medikamentengabe sollte wie bei alten Menschen niedrig begonnen und nur langsam gesteigert werden. Mit häufigerem Einsatz von – ggf. auch probatorischer – Schmerztherapie lassen sich viele sog. Verhaltensstörungen adäquat und besser als mit Psychopharmaka behandeln.



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HOXB13 is not expressed in pleomorphic giant cell carcinoma of the bladder



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Reply to the letter “How to standardize the evaluation of tumor regression grading of gastrointestinal cancers after neoadjuvant therapy?” by Dr. Nasierowska-Guttmejer and Dr. Szawlowski, VIAR-D-18-00181



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Letter to the editor: reply to Valeria Barresi “HOXB13 is not expressed in pleomorphic giant cell carcinoma of the bladder”



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In this issue



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A case of multiple familial trichoepitheliomas responding to treatment with the Hedgehog signaling pathway inhibitor vismodegib

Abstract

Multiple familial trichoepitheliomas (MFT) is an autosomal dominantly inherited disease characterized by multiple skin appendage tumors. We describe a patient showing a continuous spectrum of follicular differentiated neoplasms including classical trichoepitheliomas but also infiltrative growing and finally metastasizing malignant follicular differentiated tumors. Germline mutation analysis revealed a nonsense mutation in the cylindromatosis (CYLD) gene. Gene expression analysis by real-time PCR of tumor tissue showed overexpression of glioma-associated oncogene Gli1 mRNA. Treatment with the Hedgehog pathway inhibitor vismodegib resulted in a significant regression of the highly differentiated trichoepitheliomas. Gli upregulation is indicative of an active Hedgehog signaling pathway. We hypothesize that its upregulation is indirectly caused by CYLD mutation which promotes tumor development. Vismodegib treatment could thus provide a new treatment option for patients with this debilitating disorder.



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Neuroendocrine tumor of the pancreas with rhabdoid feature

Abstract

Imaging of a 53-year-old Japanese man revealed two tumors in the liver and a tumor in the head of the pancreas with a swelling lymph node. A needle biopsy for the liver tumors was performed, revealing a neuroendocrine tumor. Enucleation, lymphadenectomy, and partial hepatectomy were performed. The microscopic examination identified many tumor cells with intracytoplasmic inclusions arranged in a nested, cord, or tubular fashion. The intracytoplasmic inclusions displayed densely eosinophilic globules and displaced the nuclei toward the periphery, which constitutes "rhabdoid" features. The tumor cells were positive for synaptophysin and weakly positive for NCAM, but negative for chromogranin A. Epithelial markers (AE1/AE3 and CAM5.2) accentuated intracytoplasmic globules. Pancreatic neuroendocrine tumors with rhabdoid features are very rare. Generally, rhabdoid features are aggressive and dedifferentiated characteristics of various types of tumor. Pancreatic neuroendocrine tumors containing rhabdoid cells tend to display extrapancreatic spread at the time of presentation, although some of these tumors with rhabdoid features are not always associated with aggressive behavior.



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How to standardize the evaluation of tumor regression grading of gastrointestinal cancers after neoadjuvant therapy?



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Cytogenetic and immunohistochemical study of 42 pigmented microcystic chromophobe renal cell carcinoma (PMChRCC)

Abstract

Pigmented microcystic chromophobe renal cell carcinoma (PMChRCC) is a recently described morphologic variant of ChRCC. We have identified 42 cases in 40 patients in the last 24 years. We have investigated their clinical, morphologic, immunohistochemical, and cytogenetic features. Chromosomal abnormalities of chromosomes 7 and 17 were evaluated by automated dual-color silver-enhanced in situ hybridization on paraffin-embedded tissue. Chromosomal imbalance was defined on the basis of changes in both chromosomal index and signal distribution. The main age was 60.20 years, being 34 males and 6 women. The mean tumor diameter was 4.84 cm, with 39 intrarenal tumors. Grossly, the tumors were solid with a brown dark colored. Microscopically, tumors consisted of pale and eosinophilic cells arranged in microcysts or microalveolar in a cribriform pattern; there were microcalcifications and a dark brown pigment, mostly extracellular. One case showed sarcomatoid transformation. All tumors were positive for epithelial membrane antigen (EMA), Claudin 7, and E-cadherin. Monosomy of 7 and 17 chromosomes was present in 1/36 cases and 2/37 cases, respectively. Polysomy of chromosome 7 and 17 was found in 26/36 cases and in 4/37, respectively. With a median follow-up of 74.05 months, 37 patients were alive without disease and two were alive with disease progression. PMChRCCs expand the morphologic spectrum of the ChRCC with an unusual immunohistochemical profile. Cytogenetically, they showed monosomy to chromosome (CHR) 17 as other ChRCCs and polysomy of CHR 7 infrequent to ChRCCs. We present the probably largest series of PMCRCC, confirming their low aggressive behavior, with exceptional sarcomatoid transformation and distant metastases.



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Comparative clinicopathological and cytomorphological analyses of peritoneal carcinomatosis associated with metastatic breast carcinoma and primary peritoneal/ovarian carcinoma in patients with a history of breast carcinoma

Abstract

Causes of peritoneal carcinomatosis (PC) in patients with a history of breast carcinoma include both metastatic breast carcinoma (MBC) and primary peritoneal/ovarian carcinoma (PPOC). The origin of PC is important to determine the appropriate treatment strategy. Cytological examination of the peritoneal fluid (PF), which may be the first diagnostic approach to PC, is of distinct value in confirming the presence of malignant cells and determining the origin of PC. We analyzed the clinicopathological and cytomorphological characteristics of 33 patients with a history of breast carcinoma whose PF cytology contained malignant cells. Cases showing positive immunoreactivity for PAX8 and a lack of GATA3 expression were considered as PPOC. Sixteen patients developed PC caused by PPOC. PPOC patients were characterized by early-stage primary breast carcinoma, absence of non-peritoneal MBC before PC, and normal serum levels of CEA and CA15-3. Fourteen PPOC patients had pathogenic germline BRCA mutations. Cytological examination revealed that most of the PPOC cases had a dominant papillary arrangement of the tumor cells with severe nuclear pleomorphism, occasional bizarre nuclei, and atypical mitotic figures. Patients with PPOC who underwent cytoreductive surgery had a significantly longer survival time compared to those who did not, or MBC patients. In patients with a history of breast carcinoma presenting with PC, the presence of early-stage primary breast carcinoma, no prior non-peritoneal MBC, and a dominant papillary cellular arrangement pattern in the PF cytology were independent predictors of PPOC. Cytoreductive surgery significantly improved survival for patients with PPOC.



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Acute liver failure secondary to ABVD use

Hodgkin's lymphoma (HL) is a type of cancer originating in the lymph nodes. The preferred therapy for advanced HL is a combination of chemotherapies including doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD). ABVD has been standard therapy for advanced HL. It is generally considered as safe and rarely has been reported to cause acute liver failure. We present a case of 79-year-old woman with HL, who developed acute liver failure secondary to first cycle of ABVD chemotherapy.



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Recurrent invasive group A streptococcal infection with four-limb amputation in an immunocompetent child

We report a previously well paediatric patient with two distinct presentations of invasive group A streptococcus (GAS) infection resulting in significant morbidity. The first episode, following GAS pharyngitis, involved multiorgan dysfunction syndrome. This included cardiorespiratory and acute hepatorenal failure and purpura fulminans that eventually necessitated four-limb amputation. The second episode occurred 12 months later, from undetermined aetiology, and resulted in septic shock. Molecular analysis of the emm gene and PCR for Serum Opacity Factor revealed that the initial isolate was M Type 4 and sof gene positive while the second isolate was M Type 1 and sof gene negative. Immunological investigations, including CH50, quantitative IgA, IgM and IgG, and flow cytometry measuring lymphocyte subsets, and vaccine response to measles, mumps, rubella and pneumococcus were normal. This is the first report of recurrent bacteraemia from different strains of Streptococcus pyogenes infection in an apparently immunocompetent child.



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Primary renal angiosarcoma

An older male patient with a history of tachycardia treated with atenolol presented to an outside hospital on 22 February 2017 with acute right flank pain. He had a CT scan which revealed a large right renal mass with acute haemorrhage. He was initially managed with interventional radiology guided embolism on 25 February 2017 due to the ongoing bleeding and haemodynamic instability. He was then transferred to our institution. He underwent right radical nephrectomy on 13 March 2017. His pathology revealed a 12.5x6x4.5 cm mass consistent with angiosarcoma of the right kidney with negative margins. Final pathology was pT2b with extension of the mass into the renal vein and perirenal adipose tissue. He was discharged soon after surgery. He was recommended to undergo adjuvant chemotherapy.



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Extensive Mongolian spots and normocephaly: an uncommon presentation of infantile Sandhoffs disease

Description 

A 10-month-old male infant was brought to us with developmental stagnation since 5 months of age. He attained age-appropriate developmental milestones until 5 months of age, however over the next 2 months, he did not gain any new milestones followed by subsequent developmental regression in the form of loss of neck holding ability, social smile, mother regard, visual fixation and cooing. He was a first born to non-consanguineous parents, at term by caesarean delivery (due to non-progression of labour). The antenatal and perinatal periods were normal. There was no history of seizures, exaggerated startle response and extrapyramidal symptoms. The family history was unremarkable. On examination, he had normal head size (46.2 cm, 50th centiles), dysmorphic facial features (flat nasal bridge, hypertelorism, thick upper lip and upturned nose), bilateral cherry-red spots, extensive Mongolian spots (figure 1) and hepatomegaly. He also had generalised hypotonia, hyperactive muscle stretch reflexes and bilateral...



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Platypnoea-orthodeoxia syndrome exacerbated by kyphosis progression

This is a case of an 86-year-old woman with gradually progressive dyspnoea and hypoxaemia that occurred after a cardiac surgery. It was underdiagnosed for several years, but diagnosis was triggered by the finding of hypoxaemia even during supplemental oxygen administration when in the upright position, such as when taking a shower, that rapidly improved when the patient returned to the supine position. A thorough workup disclosed platypnoea–orthodeoxia syndrome (POS) associated with right-to-left shunting through a patent foramen ovale (PFO). Percutaneous closure of the PFO was performed. After treatment, the patient's arterial oxygen saturation gradually recovered to 98% on room air while she was in the sitting position and her symptoms disappeared. Reviewing this case retrospectively, we determined that the deviation of the spine with kyphosis progression had apparently proceeded as POS worsened over time. We therefore hypothesised that kyphosis progression had played a major role in the POS progression.



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Liver failure associated with mahogany seed extract consumption

A 45-year-old woman presented to the emergency department with jaundice of 2 weeks' duration. This was associated with mahogany seed extract (Skyfruit supplement) consumption for 6 months prior to admission. Examination was normal apart from scleral icterus and grade 2 encephalopathy. Liver function tests showed a hepatocellular pattern of derangement: alanine transaminase, 1267 U/L (10–36); aspartatetransaminase, 1255 U/L (10–30); alkaline phosphatase, 124 U/L (22–104); bilirubin, 258 µmol/L (3–21) with a prolonged prothrombin time of 16.8 s (9.2–11.0). Viral hepatitis work-up was largely unremarkable and liver biopsy showed moderate inflammatory infiltrates (mostly lymphocytic with scattered eosinophils) in the periportal region and lobule with bridging necrosis, favouring drug-induced liver injury. Withdrawal of the drug resulted in normalisation of liver function.



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Posterior shoulder dislocation: its worth another look

A 40-year-old woman presented to the emergency department with a painful left shoulder following a fall from a mountain bike. A radiograph of the clavicle and shoulder was carried out. A diagnosis of fractured left clavicle was made, which was treated conservatively in a sling. On day 3, she was reviewed in the fracture clinic and was found to still be in pain with reduced movement of the shoulder joint. A repeat radiograph of the shoulder joint showed a posterior dislocation. This required a closed reduction under general anaesthesia.



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Unusual case of bilateral haemotympanum after endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA)

We present a case of bilateral haemotympanum (HT) during endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA). A 64 year-old-man underwent EBUS-TBNA for mediastinal lymph nodes (LN) staging. Medical history included emphysema and angina. Medication included aspirin until the day before procedure. Full blood count and clotting screen were normal. He received sedation (5 mg midazolam, 1000 mcg alfentanil) and topical anaesthesia (16 mL 1% lignocaine) but coughed excessively throughout the procedure. Left hilar LN was the only area sampled. Spontaneous bleeding ensued from both ears towards the end of the procedure. Patient remained haemodynamically stable. The procedure was aborted and otolaryngology consult sought. Otoscopy showed bilateral haematoma from anterior ear canal with normal tympanic membranes and no hearing loss. Nasendoscopy revealed erythematous ostium of both Eustachian tubes. Bleeding stopped spontaneously and patient required no further imaging or treatment. We report this case to increase awareness of this very rare complication resulting from excessive coughing during EBUS-TBNA.



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MYH9-related disorders: a rare cause of neonatal thrombocytopaenia

Myosin heavy chain 9-related disorders (MYH9RD) are a genetic condition characterised by large platelets and thrombocytopaenia. The May-Hegglin anomaly (MHA), an uncommon condition with a potential risk of bleeding complications once thought to be separate, is now known to be part of MYH9RD.

There are very limited data on the clinical course and neonatal/paediatric outcome in children with MHA. We present the case of a newborn with a normal physical examination whose mother had MHA. Peripheral blood examination revealed a platelet count of 16x109/L with giant platelets and neutrophils containing Döhle bodies. Neonatal brain ultrasound examination showed no haemorrhage. The infant received three platelet transfusions during the first 29 days of life, remaining asymptomatic. The genetic molecular test was positive for MYH9RD. It is important to identify at-risk infants with this condition and to initiate therapy to prevent related complications, if needed, in a multidisciplinary team approach.



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Fatal case of macrophage activation syndrome (MAS) in a patient with dermatomyositis and cytomegalovirus (CMV) viraemia

We describe a case of an adult with dermatomyositis (DM) who presents with a rash, high fevers, tachycardia and hypotension, initially concerning for an infectious aetiology or a DM flare. She was found to have cytomegalovirus viraemia which improved after starting valganciclovir. After extensive workup and lack of improvement with broad-spectrum antimicrobial therapy, intravenous immunoglobulin and steroids, the patient was diagnosed with macrophage activation syndrome after bone marrow biopsy and levels of soluble CD25 (soluble interleukin (IL)-2 receptor) and IL2 were obtained. Unfortunately, despite therapy with dexamethasone, anakinra and etoposide, the patient decompensated and the patient's family opted for comfort care. The patient subsequently expired in the intensive care unit.



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Florid hyperandrogenism due to a benign adrenocortical adenoma

A 26-year-old woman with a history of polycystic ovarian syndrome presented with secondary amenorrhea, worsening hirsutism, acne, deepening of voice and unexplained 10–20 kg weight gain. Her Ferriman-Gallway hirsutism score was 12 with cystic facial acne and increased masculine phenotype. Urine Beta-Human Chorionic Gonadotropins (bHCG) was negative. She had elevated serum testosterone of 551 ng/dL, androstenedione at 7.46 ng/mL and dehydroepiandrosterone sulfate (DHEAS) at 4243 µg/L. Overnight dexamethasone suppression test showed mildly unsuppressed cortisol (2.89 µg/dL). Urinary free cortisol along with paired serum cortisol and adrenocorticotrophic hormone (ACTH) tests were normal (55.4 µg/24 hours, 13.44 mcg/dL, 30.4 pg/mL respectively). Her leutinizing hormone (LH) was low(<0.1 mIU/mL), follicle stimulating hormone (FSH) low/normal (1.41 mIU/mL) with sex hormone binding globulin (SHBG) level 45nmol/L and the rest of the pituitary and adrenal workup was unremarkable. Thyroid stimulating hormone (TSH) was 2.15mU/mL. MRI revealed a 3.1 cm, indeterminate but well-defined left adrenal lesion and polycystic ovaries without abdominal lymphadenopathy. Given radiological appearances and despite biochemical concerns for adrenocortical malignancy, a multidisciplinary team meeting decision was made to proceed with laparoscopic adrenalectomy. Histology was consistent with a benign adenoma. Postoperatively, there was clinical and biochemical resolution of the disease.



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Unusual case of a small bowel leiomyoma presenting as an adnexal mass

This case report will discuss an interesting case of a premenopausal woman who presented with an adnexal mass consistent with a leiomyoma on imaging. However, intraoperatively, the mass was thought to be a gastrointestinal stromal tumour but histological diagnosis subsequently confirmed a leiomyoma arising from the small bowel.



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Acute liver failure and hepatic encephalopathy in exertional heat stroke

A 31-year-old man was brought to Accident & Emergency after collapsing during a race. On presentation, the patient had a temperature of 41.7°C (rectal). External cooling was started immediately. The patient was intubated in view of a Glasgow Coma Scale of 7 and was transferred to theintensive therapy unit. Laboratory results revealed an acute kidney injury, rhabdomyolysis, disseminated intravascular coagulopathy and acute liver failure. The patient was encephalopathic, jaundiced and difficult to sedate. His liver function continued to deteriorate with alanine aminotransferase (ALT) levels reaching 9207 U/L. King's Hospital Liver Centre, London was contacted for a possible liver transplant, and they advised an infusion of N-acetylcysteine. The following day liver function tests improved; thus, transplantation was not performed. The patient failed multiple sedation holds and required a tracheostomy. He continued to spike a fever. Despite no source of sepsis being found, the patient remained on broad spectrum antibiotics to cover for any potential infective causes until day 27. After 15 days, the patient's encephalopathy gradually improved. He was weaned off the ventilator and underwent intense physiotherapy. The patient was discharged from hospital one month after admission.



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Spinal myoclonus: a rare presentation of cervical myelopathy

Myoclonus describes a movement disorder characterised by brief, abrupt and involuntary contractions of muscles or groups of muscles, usually associated with intracranial lesions, with limited evidence linking it to spinal pathologies. The pathophysiology of spinal myoclonus is extensive and multifactorial. Infection, intramedullary and extramedullary space-occupying lesions, trauma, vascular abnormalities, degenerative processes and cervical spondylosis have been implicated with the disease, the latter been associated with cervical stenosis with no reported cases linking it to an underlying cervical disc herniation. Although medical therapy with clonazepam, levetiracetam, valproate, tetrabenazine hydrochloride and spinal block injections has been equivocal, spinal myoclonus secondary to disc herniation requires surgical intervention. This report describes a case of segmental spinal myoclonus, secondary to a herniated cervical intervertebral disc. After corpectomy and a cage-augmented fusion technique, the myoclonic symptoms resolved. To our knowledge, this was the first report to describe the successful management of discogenic spinal myoclonus with spinal surgery.



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Blast from the past: a novel complication of bronchopulmonary dysplasia

Description 

A 43-year-old Caucasian woman presented to her primary care physician for a retirement physical exam. She endorsed mild dyspnoea on exertion, but denied chest pain, cough or shortness of breath at rest. On physical exam, lungs were clear bilaterally with good air movement in all fields. Chest radiograph was normal except for a 6 mm nodular density noted in the right lower lobe. A non-contrast CT scan of the chest was performed revealing a 2 mm calcified granuloma. In addition, there were global, mild and uniform paraseptal emphysematous changes throughout the pleural surfaces of the lungs and the fissures (figures 1 and 2). Pulmonary work-up including spirometry, carbon monoxide diffusing capacity and testing for alpha-1 antitrypsin deficiency was normal. Further investigation revealed a history of premature birth, supported with mechanical ventilation (MV). We attributed her radiographic findings and symptoms to sequelae of bronchopulmonary dysplasia (BPD).



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Cardiac memory: an under-recognised cause of deep T wave inversion in a patient presenting with chest pain

T wave inversion (TWI) has many differential diagnoses with acute myocardial ischaemia being the highest on the list of potential causes. Cardiac T wave memory is a benign, under-recognised and clinically important phenomenon seen after periods of altered ventricular conduction. After normal ventricular conduction is restored, the T wave 'remembers' and mirrors the direction of the wide QRS complex. Therefore, negative T waves are seen in leads that had negative wide QRS complexes. We describe the case of a 60-year-old truck driver with chest pain, deep TWI and traditional cardiovascular risk factors. After ruling out significant myocardial ischaemia, it was crucial to determine the cause of his T wave changes to provide reassurance and provide commercial license medical clearance. While it is currently a diagnosis of exclusion, it remains an important clinical entity for clinicians to recognise to provide an explanation for certain T wave changes to avoid future unnecessary cardiac testing.



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Primary lymphoedema

Description 

A 32-year-old woman presented with a 20-year history of slowly progressive leg oedema with recurrent cellulitis. She was referred from her primary care physician. Her mother had the same condition. Physical examination revealed non-pitting bilateral leg oedema (figure 1). Stemmer's sign was positive. Lymphoscintigraphy showed non-visualisation of inguinal nodes 30 min postexercise and dermal backflow in the lower limbs (figure 2). Compression garments were used but failed. She underwent bilateral lower limb supermicrosurgical lymphaticovenular anastomosis (two times anastomosis and four times incisions) and her oedema markedly improved. Four years after the operation, she was well without relapse.

Figure 1

Non-pitting bilateral leg oedema.

Figure 2

Preoperative lymphoscintigraphy. Lymphoscintigraphy revealed no migration of radiopharmaceutical agent in the lower limbs.

Primary lymphoedema is due to a congenital and/or inherited condition associated with pathological development...



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Strangulated adnexa due to adhesion band after hysterectomy

Description

A 50-year-old woman was admitted to our hospital with a 2-day history of cramping pain of the lower abdomen. She also reported an episode of nausea and vomiting prior to admission. The patient had undergone total abdominal hysterectomy for uterine myoma. Her blood pressure was 100/60 mm Hg, pulse rate of 70 beats/min and axillary temperature of 36.5°C. The patient had mild direct tenderness of the lower abdomen, especially at the right lower quadrant, with no rebound tenderness or muscular guarding. Laboratory data showed a white cell count of 10 100/mm3 (normal limit of 4000–10 000/mm3) and a C reactive protein concentration of 17.25 mg/L (normal limit of 0–10 mg/L). A plain chest X-ray revealed no free air under diaphragm. Pelvic ultrasound demonstrated smooth bilocular cystic tumour within the right adnexa that has no colour flow on Doppler.

Contrast-enhanced abdominal CT showed a hypodense area measuring 4x3x3 cm in the region of right adnexa and a...



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Endovascular treatment of an aorto-oesophageal fistula caused by oesophageal cancer

Description 

Aorto-oesophageal fistula (AOF) is commonly the product of aortic aneurysms or iatrogenic injuries during endovascular aortic procedures; despite that, AOF is an uncommon medical condition. In rare cases, it can be the product of an oesophageal carcinoma. It is a fatal condition, and its treatment options are scarce due to its low incidence.1 2 The case presented herein aims to show an endovascular treatment for AOF.

A 50-year-old male patient presented with odynophagia, progressive dysphagia and weight loss for 4 months prior to the consultation. The patient sought the emergency healthcare service due to haematemesis and melena for 6 days. He was submitted to haemodynamic recovery, blood transfusion and to an upper gastrointestinal tract endoscopy, which revealed an ulcerative and vegetative tumouration on his oesophagus 25 cm below his upper dental arcade. Biopsy confirmed the hypothesis of a malignant oesophageal carcinoma with moderate cell differentiation. Despite the...



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Pleural coccidioidomycosis presenting as spontaneous pneumothorax

Coccidioides is a fungus endemic to Southwestern USA and Northern Mexico which can be asymptomatic or result in a well-defined clinical syndrome of community-acquired pneumonia. On rare occasion, coccidioidomycosis may have atypical presentations as in our patient, a 25-year-old man admitted with a 2-month history of progressive dyspnoea and cough. He was found to have a large right-sided pneumothorax with exudative pleural effusion which did not resolve following thoracentesis. Decortication was performed which revealed a dense rind of inflammatory tissue covering all lobes of his right lung. Histopathology demonstrated hyphae resembling Aspergillus, but culture and serology confirmed Coccidioides immitis. Following several months of antifungal therapy, he achieved complete clinical recovery with near-complete resolution of radiographic findings.



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GP Induction Chemotherapy us TPF Adjuvant Chemotherapy Combined With DDP Concurrent Chemoradiotherapy in the Treatment of Locally Advanced NPC

Condition:   Locally Advanced Nasopharyngeal Carcinoma
Interventions:   Drug: GP+CCRT;   Drug: TPF+CCRT
Sponsor:   Guiyang Medical University
Recruiting

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