Pediatric Allergy, Immunology, and Pulmonology, Ahead of Print.
https://ift.tt/2BV0X9f
Δευτέρα 27 Αυγούστου 2018
HMGB1 Binding to the RAGE Receptor Contributes to the Pathogenesis of Asthma
HMGB1 Binding to the RAGE Receptor Contributes to the Pathogenesis of Asthma
Pediatric Allergy, Immunology, and Pulmonology, Ahead of Print.
https://ift.tt/2PH0ZEr
Carnitine palmitoyltransferase type 2 deficiency: novel mutation in a Native South American family with whole-body muscle magnetic resonance imaging findings: two case reports
The myopathic form of carnitine palmitoyltransferase type II deficiency is an inherited autosomal recessive metabolic myopathy usually starting in childhood. Most reports have been on European and Japanese pop...
https://ift.tt/2oh5j0o
Early‐onset neutropenia after rituximab therapy for bullous pemphigoid
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2oflPhx
Scarring alopecia with follicular papules in a father and his daughter
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2Nokyjk
Early‐onset neutropenia after rituximab therapy for bullous pemphigoid
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2oflPhx
Scarring alopecia with follicular papules in a father and his daughter
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2Nokyjk
Concentrations and health risks of heavy metals in soils and crops around the Pingle manganese (Mn) mine area in Guangxi Province, China
Abstract
Heavy metal concentrations in agricultural fields and their ecological risks are a source of extensive concern worldwide. A field survey was conducted to investigate the present situation and health risks of heavy metals (Mn, Pb, Zn, Cu, and Cd) and crops (corn, green soybean, sweet potato, persimmon, cassava, and Chinese chestnut) around the Pingle manganese (Mn) mine site in Guangxi Province, China, which was abandoned 20 years ago. The results showed that the ranges of Mn, Pb, Zn, Cu, and Cd were 2706.54–6760.16, 229.37–275.84, 160.39–215.48, 58.11–75.30, and 5.78–6.98 mg kg−1, respectively, which were approximately 15.38–38.41, 11.76–14.15, 2.12–2.85, 2.09–2.71, and 21.64–28.75 times greater than their respective background values. Most of these concentrations exceeded the national standard for soil quality (grade 2) developed by the Ministry of Environmental Protection of China (1995). Contamination assessments based on the single contamination index (Pi), Nemerow multi-factor index (Pcom), and potential ecological risk index (RI) showed that the sampled soils were severely polluted with these heavy metals, especially Pb and Cd. Similarly, the crops were enriched with Pb and Cd, with concentrations of 10.22–41.78 and 2.33–5.37 mg kg−1, respectively, which were much higher than the threshold values of the national food standards. Contamination assessments with Pi and Pcom also showed that the crops were severely polluted with Pb and Cd. The bioaccumulation factor values for Cd were highest among the heavy metals, with an average mean of 0.66 in these six crops, demonstrating that Cd readily accumulates in these crops. An assessment showed that the health risk for adults living in the mining-impacted areas was significant. Our study strongly recommends that heavy metal contamination in agricultural soils and crops grown around the Pingle Mn mining-affected areas should be treated to mitigate the health risks.
https://ift.tt/2PGKlEV
Statement from NCI Director Dr. Norman E. Sharpless on the Death of Senator John McCain
Senator John McCain, a long-time supporter of cancer research, passed away on August 25.
https://ift.tt/2NpiGqx
The Relationship Between Statin Action On Thyroid Autoimmunity And Vitamin D Status: A Pilot Study
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0669-9309
Background Both vitamin D preparations and high-dose statin therapy were found to reduce thyroid antibody titers. Objective The purpose of this study was to assess whether vitamin D status determines the effect of statin therapy on thyroid autoimmunity. Methods The study population consisted of 39 euthyroid women with Hashimoto's thyroiditis and moderate or moderately high cardiovascular risk divided into two groups: women with vitamin D deficiency or insufficiency (group A; n=19) and women with normal vitamin D status (group B, n=20). All patients received atorvastatin therapy (20–40 mg daily) for the following 6 months. Plasma lipids, circulating levels of thyrotropin, free thyroid hormones, prolactin and 25-hydroxyvitamin D, titers of thyroid peroxidase and thyroglobulin antibodies, as well as Jostel's, the SPINA-GT and the SPINA-GD indices were assessed at the beginning and at the end of the study. Results The study completed all women. At baseline, with the exception of 25-hydroxyvitamin D, there were no significant differences between both study groups in plasma lipids, circulating hormone levels and titers of thyroid peroxidase and thyroglobulin antibodies. Despite improving plasma lipids in both study groups, atorvastatin reduced thyroid antibody titers only in women with normal vitamin D status. Moreover, in this group of patients, atorvastatin increased the SPINA-GT index. Circulating levels of the measured hormones, Jostel's thyrotropin index and the SPINA-GD index remained at a similar level throughout the study. Conclusions The results of the study suggest that the effect of atorvastatin therapy on thyroid autoimmunity depends on vitamin D status.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2wlPOJb
Elevation in Circulating Soluble CD40 Ligand Concentrations in Type 2 Diabetic Retinopathy and Association with its Severity
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0647-6860
Background To investigate the relationship between changes in circulating soluble CD40 ligand (sCD40L) levels and the presence and severity of type 2 diabetic retinopathy (DR). Subjects and methods sCD40L plasma concentrations were measured in 205 type 2 diabetes (T2DM) patients without DR (DWR; n=50) and with DR (n=155), the latter subdivided into non-proliferative diabetic retinopathy [NPDR; n=98 (63.2%)], or proliferative retinopathy [PDR; n=57 (36.8%)] patients. Results Receiver operating characteristic analysis provided good discriminatory power for sCD40L as predictor of DR presence, with high sensitivity and specificity. Categorizing DWR and DR patients into sCD40L quartiles, based on sCD40L concentrations in T2DM without DR, demonstrated statistically significant gradual increase in DR risk with increasing sCD40L levels. sCD40L levels were significantly higher in DR compared to DWR patients. Plasma sCD40L levels differed significantly according to DR severity, and correlated with diabetes duration, dyslipedimea, nephropathy, and presence of DR, but not with gender, age, SBP, DBP, FPG, HbA1c, T2DM medications. Linear regression analysis confirmed the association of increased sCD40L levels with DR, independent of others parameters; mean plasma sCD40L levels differing significantly according to DR severity. Conclusion Plasma sCD40L levels were positively associated with DR. The significant finding here is that sCD40L levels can be predictors of DR severity.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2P9kBQo
Statins and Colorectal Cancer – A Systematic Review
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0668-5692
Objectives Statins act by inhibiting 3-hydroxy-3-methylglutaryl-coenzyme A reductase and are an important drug class in the treatment of lipid disorders. They lower cholesterol levels and modulate cardiovascular disease risk in both primary and secondary prevention. In addition, some studies have shown that statins may have an effect on colorectal cancer development and treatment. Our objective is to summarize published studies on the effect of statins on colorectal carcinogenesis. Methods A systematic review of the PubMed and Cochrane databases was performed to identify studies published between April 2010 and April 2018 that investigated the association between statin use and colorectal cancer incidence, mortality, and treatment. Results Overall, 126 articles were identified with our search strategy. Based on the eligibility criteria, 69 studies were excluded from the review process. In vitro and animal studies have shown a potential chemopreventive effect of statins and their efficacy in adjuvant therapy of colorectal cancer. The anticarcinogenic effect on cancer risk in human studies was heterogeneous. Some studies reported better overall and cancer specific survival rates in patients using statins before and during colorectal cancer treatment. Statins also show a potential role in chemoprevention of colorectal cancer in patients with inflammatory bowel disease. Conclusions Accumulating evidence suggests that statins may have a role in colorectal cancer prevention and treatment. Further studies are necessary to define the associations between individual statin characteristics, their doses and colorectal cancer.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2wkfupI
Effect of Dapagliflozin on Insulin Secretion and Insulin Sensitivity in Patients with Prediabetes
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0664-7583
Aim To evaluate the effect of dapagliflozin on insulin secretion and insulin sensitivity in patients with prediabetes. Methods A randomized, double-blind, placebo-controlled clinical trial was carried out in 24 adults diagnosed with prediabetes and without pharmacological treatment. Patients were randomly assigned into two groups of 12 patients each to receive 10 mg of oral dapagliflozin or placebo once a day during 12 weeks. At baseline and at the end of the study, anthropometric and metabolic measurements were evaluated, including the first phase of insulin secretion, total insulin secretion, and insulin sensitivity. Results After dapagliflozin administration, there were significant decreases in body weight (80.8±16.3 vs. 77.8±14.9 kg, p=0.019), body mass index (30.3±3.5 vs. 29.2±3.1 kg/m2, p=0.023), waist circumference (100.6±13.5 vs. 96.2±11.8 cm, p=0.003), fasting glucose (5.9±0.4 vs. 5.1±0.3 mmol/L, p<0.001) and uric acid (334.3±70.8 vs. 262.9±60.7 mmol/L, p=0.032), with a tendency to increase the insulin sensitivity (1.94±0.72 vs. 2.63±1.04, p=0.064). Conclusion Dapagliflozin administration in patients with prediabetes decreased body weight, body mass index, waist circumference, fasting glucose, and uric acid, with a tendency to increase the insulin sensitivity without changes in insulin secretion.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2C1hl8e
FDA Clears First Tretinoin Lotion for Acne (Altreno)
Tretinoin 0.05% lotion provided the proven efficacy of tretinoin in a generally well-tolerated formulation; skin dryness, pain, swelling, irritation, and peeling were reported in 4% of patients or less in clinical trials.
FDA Approvals
https://ift.tt/2wvcLch
Memorial Hermann-Texas Medical Center Ranked Among the Top 20 Nationally in Adult ENT Care by US News & World Report
Memorial Hermann-Texas Medical Center's Otorhinolaryngology Service holds the 19th spot in the nation among hospitals that provide adult ENT care,...
https://ift.tt/2LzJ9jg
Toddler Enjoys Sound of Success
A new cochlear implant is helping 3-year-old Bellemere Hernandez hear for the first time. The toddler faces several disorders caused...
https://ift.tt/2PG7BCW
UTHealth Sponsors 2018 ORL Frontiers
More than 70 physicians and other health care professionals attended 2018 ORL Frontiers, an annual CME event that highlights emerging...
https://ift.tt/2LBhYow
Congratulations to Our Graduating Residents
Uma Ramaswamy, MD, and Matthew A. Tyler, MD, have completed their residencies in otorhinolaryngology at McGovern Medical School at UTHealth. ...
https://ift.tt/2MWrSpl
History of Eczema is Associated with More Severe Hospital Course in Children Hospitalized for Asthma
Asthma is a major cause of childhood morbidity in the United States. Poorly-controlled asthma results in recurrent emergency room visits, hospital admissions, and even death.1 Hospital admissions for asthma also incur significant cost to society.2 Identifying risk factors and comorbidities that contribute to severity of asthma during hospital admissions may improve asthma control and prevent further admissions. One recent study found that increased serum total IgE level is associated with patients admitted to the hospital for asthma, as compared to those being treated in an outpatient setting.
https://ift.tt/2wgXWKO
Management of Bilateral Facial Palsy
Bilateral facial paralysis is a rare entity that occurs in both pediatric and adult patients and can have congenital or acquired causes. When paralysis does not resolve with conservative or medical management, surgical intervention may be indicated. This article presents the authors' preferred technique for facial reanimation in patients with bilateral congenital facial paralysis. Specifically, a staged bilateral segmental gracilis transfer to ipsilateral nerve to masseter is discussed.
https://ift.tt/2PI4wCj
“My clothes, pillowcases, and bedsheets have turned green-colored!”
Introduction: Chromhidrosis is a rare disorder in which there is pigmentation of sweat in a variety of colors. The condition can be categorized into apocrine, pseudoeccrine, and true eccrine chromhidrosis. Although it does not cause serious health problem, it may be associated with psychologic stress and social embarrassment. We report a rare case of idiopathic chromhidrosis in a healthy middle-aged female with no significant medical history. A 56-year-old woman with no significant medical history and no personal history of skin cancer presented with a chief complaint "my clothes, pillows, and bedsheets have turned green-colored from my sweats." The patient has noticed light green-colored stains on her pillow cases, bedsheets, and her underwear, shirts, and bras for the past 6 months without any identifiable precipitants or triggers.
https://ift.tt/2wADXGH
Clinical assessment of the local tolerance and cosmetic efficacy of a topical skin care formulation used after 70% glycolic acid facial skin rejuvenation procedures in healthy female subjects: A randomized, controlled, evaluator-blind study
Background: Facial chemical peels are among the most widespread nonsurgical cosmetic procedures. Post-peeling guidelines recommend only the general use of topical emollients and the need for high factor broad spectrum sunscreens. However, clinical evidence on the use of specific emollients in this indication is limited.
https://ift.tt/2PIPlIZ
Clinical complications of lepra reactions: An in-patient experience from Pakistan
Introduction: The World Health Organization stated the global prevalence of leprosy as 176,176 cases at the end of 2015. Leprosy is an incapacitating infectious disease primarily affecting the skin and peripheral nerves. Immunologic complications of leprosy occur as immune-mediated lepra reactions type 1 and 2. These reactions remain a diagnostic dilemma for many physicians, dermatologists and neurologists. Despite the success of multidrug therapy these reactions cause considerable morbidity and physical disabilities by nerve damage.
https://ift.tt/2LvDBXd
Clinical evaluation of 11 investigational allergens in TRUE Test panel 3.2 in children and adolescents
Background: Epicutaneous patch testing is the criterion standard method to confirm contact sensitization, the first step in making the diagnosis of allergic contact dermatitis (ACD) in both adult and pediatric populations. Eleven new investigational allergens of the Thin-Layer Rapid Use Epicutaneous (TRUE) Test panels had been Food and Drug Administration (FDA) approved for adults for diagnosis of ACD, but not in children at the time of this study.
https://ift.tt/2PMUNLc
Clinical evaluation of a comprehensive topical antioxidant system in mildly to moderately photodamaged skin
Background: Topical antioxidants are fundamental to skin health. A product containing water-soluble, enzymatic, and lipid-soluble antioxidants provides protection at all cellular levels of the skin against the visible effects of ultraviolet (UV) and environmental damaging free-radicals.
https://ift.tt/2wAEqsr
Sensitive skin compatibility of cleansing wipes
Background: Individuals with sensitive skin should use skin cleansing products that are efficacious, nonirritating, and help maintain a healthy skin barrier. Facial cleansing wipes are a popular format used for general cleansing and make-up removal. A facial wipe was developed with nonionic surfactants, which were selected to provide nonirritating and efficacious cleansing, due to the surfactants' low protein-binding affinity. The unique blend of spun-lace nonwoven fibers in this facial wipe offers gentle and effective cleansing.
https://ift.tt/2PIswoL
The rates of herpes zoster, hepatitis c, and tuberculosis among patients with psoriasis treated with apremilast, biologics, conventional systemics, and corticosteroids in the U.S. MarketScan database
Background: Patients (pts) with psoriasis are at increased risk for infection. We compared rates of treated herpes zoster, hepatitis C (HepC), and tuberculosis (TB) by treatment in pts with psoriasis.
https://ift.tt/2wre0ZT
Point-of-care decision support for appropriate acne management
Background: Referral from primary care providers for acne is a costly process associated with high no-show rates and delayed treatment. We previously demonstrated that models of algorithm-based acne care may lead to reductions in the rate of dermatology referrals, missed appointments, and delayed treatment. In this retrospective chart analysis, we evaluate the impact of an electronic decision support tool on the management of patients referred for acne.
https://ift.tt/2PGvpXp
Superior even skin tone and antiaging benefit of combination of 4-hexyl resorcinol and niacinamide
Unevenness of skin tone is a pervasive problem that develops with aging and sun exposure. Skin color results from the action of multiple biologic pathways that primarily control melanin synthesis and distribution. In the present studies we explored the possibility of using a synergistic approach to enhance the efficacy of cosmetic products. We evaluated the in vitro and clinical efficacy of a combination of 4-hexyl resorcinol, a known tyrosinase inhibitor and niacinamide, a melanosome transfer inhibitor, both of which regulate two different process involved in the development of skin color.
https://ift.tt/2LvhQa1
Reasons for discontinuation of secukinumab between weeks 12 and 52 in psoriasis patients responsive to treatment at week 12
Background: Patients enrolled in RCTs are subject to strict study guidelines to ensure validity, thus limiting a patients' ability to manage their own treatment plan. As such, rates and reasons for treatment discontinuation reported in secukinumab RCTs may not correlate to outcomes seen in the real world. Therefore, we aimed to investigate reasons for discontinuation of secukinumab between weeks 12 and 52 in patients who achieved efficacious outcomes at week 12.
https://ift.tt/2PHxmTm
Noxious nocebos in dermatology
Importance: Negative expectations on the part of the patient or the dermatologist can negatively influence treatment responses resulting in the nocebo effect.
https://ift.tt/2LxeSl3
The burden of nail psoriasis: A real-world analysis from the Corrona Psoriasis Registry
Objective: Nail psoriasis (Pso) is often correlated with more severe psoriatic disease and is difficult to treat; only a few studies have shown its association with significant functional and psychosocial impairment. The objective of this study was to describe the impact of nail Pso on clinical and patient-reported outcomes (PROs) among patients enrolled in the Corrona Psoriasis Registry.
https://ift.tt/2PHBRNC
Sonidegib preplanned subgroup analyses of objective response rates: 30-month results from the BOLT study
Background: Sonidegib 200 mg once daily (qd) was approved in the United States for patients with locally advanced basal cell carcinoma (laBCC) not amenable to curative surgery or radiotherapy based on results of the phase 2 BOLT study (NCT01327053). The 30-month overall efficacy and safety data from the BOLT study have been presented; here we report the 30-month results from a preplanned subgroup analysis for the primary end point, the objective response rate (ORR), in patients with laBCC receiving 200 mg, data which have not been presented.
https://ift.tt/2Lws89N
Staphylococcus aureus biofilm in atopic dermatitis (AD): In vitro model and in vivo early AD study
Introduction and objectives: Biofilm is one of the most important virulence factors in infectious diseases; biofilm-associated bacteria show an innate resistance to antibiotics and host innate immune defenses. The presence of S. aureus biofilms in AD lesions has been described recently. In AD, biofilm seems to play a role in pruritus, inflammation and in resistance to antimicrobial peptides (PAMs). We used in vitro models to study the role of S. aureus and its biofilm in AD and to evaluate a lipid-replenishing balm specifically formulated for baby and child with atopic skin.
https://ift.tt/2PMUDU6
Patient profile of nonresponders to ustekinumab in moderate-to-severe psoriasis patients enrolled in the Corrona Psoriasis Registry
Objective: Describe the baseline characteristics of moderate to severe psoriasis (Pso) patients enrolled in the Corrona Psoriasis Registry who respond/did not respond to ustekinumab.
https://ift.tt/2LvhpMV
The impact of dermatology lectures on internal medicine residents
Background: Most medical students receive an average of 10 hours of dermatology teaching before starting residency, and only 25% take dermatology elective in medical school. Internal medicine (IM) residents regularly encounter dermatologic complaints and diseases, yet 63% of primary care residents state that they are inadequately prepared to diagnose common skin disorders. A recent study showed that an isolated didactic curriculum is a sufficient teaching method for IM residents, as measured by a multiple-choice test.
https://ift.tt/2PHwONi
Targeted phototherapy: An eight-year experience in a tertiary dermatologic center
Background: Targeted phototherapy is the localized delivery of ultraviolet (UV) light to affected areas of skin. The commonest indications for targeted UV therapy include localized psoriasis, vitiligo, atopic dermatitis, and lymphoproliferative skin disorders involving a limited area of the body or difficult-to-treat anatomic areas. In view of advancing treatment options in the field of phototherapy for common skin conditions, little has been published about targeted phototherapy in Asian patients, especially in big numbers.
https://ift.tt/2Lvhgcl
Subcorneal pustular dermatosis (Sneddon-Wilkinson disease): A case report with good reponse to cyclosporine and dapsone treatment
Introduction: Subcorneal pustular dermatosis (SCPD), or Sneddon-Wilkinson disease, is a rare chronic-relapsing skin disorder that manifests as flaccid sterile pustules without systemic symptoms. It typically presents in women over the age of 40, affecting the trunk and intertriginous areas. The treatment of choice is dapsone, although other drugs have been used. We report a 65-year-old woman with SCPD with a good response to cyclosporine and dapsone treatment.
https://ift.tt/2PG8MCp
Skin cancer with history of actinic keratosis: A large, urban, single-center, midwestern U.S. population observational study
Introduction: Actinic keratosis (AK) may be considered by some to be an incipient form of squamous cell carcinoma (SCC) as the rate of SCC in individuals with AK has been estimated at 0.025%-16%. There is much less reported evidence for AK association with basal cell carcinoma (BCC) and melanoma (MM). The aim of this study is to determine if an association exists between AK and nonmelanoma skin cancer (NMSC; SCC and BCC) and between AK and MM in a large midwestern U.S. patient population.
https://ift.tt/2LxeR0t
Scrofuloderma: Beyond a cutaneus tuberculosis
Science: Tuberculosis (TB) is a major public health issue worldwide. It has various clinical presentations making the diagnosis a challenge. Skin involvement is uncommon and scrofuloderma is the most frequent type of cutaneous TB. It results from direct dissemination to the skin of an underlying structure, primarily lymph nodes, and in rare cases can occur as a manifestation of miliary TB. An adequate anamnesis along with clinical suspicion are fundamental for timely diagnosis and treatment.
https://ift.tt/2PI7Fly
``Re-Using the internal mammary artery as recipient artery in cervicofacial reconstruction by fibular flap''
We have read with great interest Decaudaveine's anatomical study entitled "Using the internal mammary artery as recipient artery in cervicofacial reconstruction by fibular flap".1 We congratulate the authors for their interesting and innovative work, opening new perspectives of maxillofacial reconstructive surgery in patients with vessel-depleted neck area. We published last year a quite similar study in Surgical and Radiologic Anatomy.2 This paper was based on a medical thesis defended in our Faculty in 2016.
https://ift.tt/2wgzHMY
Letter responds to comment on published paper: “Using the internal mammary artery as recipient artery in cervicofacial reconstruction by fibular flap”
We have received the letter of J. Adnot about our study entitled "Using the internal mammary artery as recipient artery inervicofacial reconstruction by fibular flap" 1 and read it with great interest.
https://ift.tt/2wiquDK
One-Stage Treatment for Maxillo-Facial Asymmetry with Orthognathic and Contouring Surgery using virtual surgical planning and 3D-printed surgical templates
Asymmetry is one of the most common maxillo-facial deformities. One-stage treatment for maxillo-facial asymmetry with orthognathic and contouring surgery has been rarely reported. This retrospective study aims to investigate the feasibility of simultaneous orthognathic and facial bone contouring surgery with the help of virtual surgical planning and 3D-printed navigation templates for facial asymmetry.
https://ift.tt/2NoTmB3
Risk factors for developing capsular contracture in women after breast implant surgery: A systematic review of the literature
We thank Dr. Altundag for his interest in our review about risk factors for developing capsular contracture after breast implant surgery.1 Dr. Altundag postulates that adjuvant radiotherapy is also an important risk factor.
https://ift.tt/2wj795z
Annual variation patterns of the effluent water quality from a green roof and the overall impacts of its structure
Abstract
To explore the optimal combination of vegetation type, substrate type, and substrate thickness in a green roof and the interannual variation patterns of the runoff quality, eight green roof units were constructed in Shenzhen, China. Runoff quality of the eight units was monitored for 3 years (24 rainfall events). The rainfall event mean concentrations (EMC) were used to evaluate runoff quality as well as annual pollutant load. An orthogonal L8(24) experiment was designed to verify the significance of different factors. An optimal level of significant factors was selected to determine the optimal design of green roof. The optimal vegetation was Ophiopogon japonicus. The optimal substrate was modified perlite, while optimal substrate thickness was 200 mm. A three-year interannual variation analysis was performed on the optimal green roof. It was found that the interannual variation of each runoff quality index is different. The concentrations of SS, COD, and NH4+-N in the runoff decreased with years. The concentration of NO3−-N increased over time, while TP remained stable. The concentration of TN had certain volatility with no significant interannual variation. Overall, the runoff quality of the green roof improves over time. The optimal green roof's runoff quality in the third year including 11 rainfall events was monitored. Results showed that the effluent quality from the green roof was lower than that of precipitation. The average concentrations of SS, COD, NH4+-N, TN, and TP decreased respectively by 37.85%, 28.89%, 30.25%, 14.52%, and 12.93%, but NO3−-N increased by 69.91% comparing to the traditional roof.
https://ift.tt/2MUqQKx
Formation of 1,3,8-tribromodibenzo- p -dioxin and 2,4,6,8-tetrabromodibenzofuran in the oxidation of synthetic hydroxylated polybrominated diphenyl ethers by iron and manganese oxides under dry conditions
Abstract
Hydroxylated polybrominated diphenyl ethers (OH-PBDEs) are ubiquitous and highly toxic emerging endocrine disruptors found in surface and subsurface soils and clay deposits. Seriously, they could be easily transformed to the more toxic dioxins (PBDD/Fs) in photochemical processes and incineration, but the spontaneous formation of PBDD/Fs has rarely been reported. This study focused on the formation of 1,3,8-tribromodibenzo-p-dioxin (1,3,8-TrBDD) and 2,4,6,8-tetrabromodibenzofuran (2,4,6,8-TeBDF) from 2′-OH-BDE-68 and 2,2′-diOH-BB-80 under the oxidization of iron and manganese oxides (goethite and MnOx). Approximately 0.09 μmol/kg (2.33%) and 0.17 μmol/kg (4.15%) were transformed to 1,3,8-TrBDD and 2,4,6,8-TeBDF by goethite in 8 days and a higher conversion 0.15 μmol/kg (3.77%) and 0.23 μmol/kg (5.74%) were observed for MnOx in 4 days. However, the formation of PBDD/Fs, probably proceeding via Smiles rearrangements and bromine elimination processes, was greatly inhibited by the presence of water. Transformation of OH-PBDEs by goethite and MnOx was accompanied by release of Fe and Mn ions and the possible pathways for the formation of reaction products were proposed. In view of the ubiquity of OH-PBDEs and metal oxides in the environment, oxidation of OH-PBDEs mediated by goethite and MnOx is likely an abiotic route for the formation of PBDD/Fs.
https://ift.tt/2ocw3zj
Thrombocytopenia-associated multiple-organ failure (TAMOF): recognition and management
Thrombocytopenia-associated multiple-organ failure (TAMOF) is an increasingly fatal phenomenon that may be associated with sepsis. TAMOF results from immune dysregulation and impaired activity of A Disintegrin And Metalloproteinase with ThromboSpondin type 1 motif, member 13. Early recognition of this premorbid condition and specific management results in a significantly improved outcome. Herein, we report the presentation and management of a 2-year-old child with TAMOF who was successfully treated with plasma exchange and recovered without long-term sequelae.
https://ift.tt/2wghoYo
Corneal epithelial toxicity with intravitreal methotrexate in a case of B-cell lymphoma with ocular involvement
A 49-year-old woman, known case of diffuse large B-cell lymphoma, presented with complaints of floater in both eyes since 3 days. On examination, visual acuity was 0.18 logMAR in both eyes. Indirect ophthalmoscopy revealed presence of vitreous clumps. Vitreous biopsy was done and the histopathological report suggested a diagnosis of ocular lymphoma. The patient was treated with weekly injections of intravitreal methotrexate in both eyes. The patient developed severe photophobia, watering, redness and diminution of vision in the both eyes 2 days following the fifth dose of intravitreal methotrexate. Severe limbitis with annular corneal epitheliopathy and corneal haze was noted on slit-lamp examination. The patient was started on topical lubricants, antibiotic, ciclosporin, loteprednol, folinic acid and oral folic acid. Complete resolution was noted at 2-week follow-up. The patient, however, refused further injections and was kept on close follow-up to look for recurrence of the disease.
https://ift.tt/2P6dOXE
Paraneoplastic cerebellar degeneration as a manifestation of metastatic recurrent carcinoma breast: rare scenario
Carcinoma breast presenting with paraneoplastic cerebellar degeneration is a rare scenario. We report a case of a 52-year-old woman, which is a follow-up case of completely treated carcinoma breast presenting with paraneoplastic cerebellar degeneration which, on investigation, revealed metastatic disease with recurrence at previous scar site and metastasis to contralateral axilla. The patient was given pulse methyl prednisolone therapy and underwent wide local excision of nodule and right axillary lymph node dissection with 14 cycles of trastuzumab and paclitaxel as adjuvant therapy. However, there was no detectable change in neurological symptoms at 6-month follow-up postoperatively. This case report highlights the need for clinicians to be aware of all possible presentations of carcinoma breast and its recurrence, including rare manifestations as in this case.
https://ift.tt/2wijeIh
'Stony shoulder: an exuberant case of glenohumeral synovial chondromatosis with extra-articular extension
Description
A 27-year-old man presented with a history of 4-year duration of mechanical pain in the left shoulder and a progressive reduction in the range of movements. In the physical examination stands out a swelling of stony consistency on the posterior aspect of the left arm, pain with all active and passive movements of the left shoulder associated with limitation of active and passive abduction above 90°.
The blood tests were normal. The X-ray of the left shoulder showed multiple calcified intra-articular and extra-articular loose bodies (figure 1).
Figure 1
Conventional left shoulder radiography: multiple calcified intra-articular and extra-articular bodies.
A shoulder MRI was ordered demonstrating exuberant expansion of all joint spaces and recesses from the glenohumeral interface to the subcoracoid and subscapularis recess and along the tendon sheath of the long portion of the biceps, which suggested cartilaginous nature with...
https://ift.tt/2Nq3n0S
Recurrent chikungunya retinitis
Chikungunya is a systemic viral disease transmitted to humans by infected mosquitoes in endemic areas of Africa, Asia and more recently in the Americas. Chikungunya infection produces a sudden onset of fever, joint pains and erythematous skin eruption. A plethora of ocular manifestations have been described ranging from a non-specific conjunctivitis to exudative retinal detachment. Ocular chikungunya seems to respond well to corticosteroid therapy, and outcomes are usually better if treated early. Our patient acquired this infection on a travel to Mexico jungle. This was confirmed by ReverseTranscriptase-PCR test once she returned to the UK. The peculiarity of the case is the inordinate delay of almost a year in the onset of eye symptoms, from acquiring the viral infection. The ocular inflammation responded to systemic corticosteroid therapy with a favourable visual outcome. She developed a recurrence many months later which again responded well to a course of oral steroids.
https://ift.tt/2wicjyv
Red, white and blues: Darier disease and mood disorder
Description
A middle-aged woman presented with a progressively worsening rash for 25 years. The rash was foul smelling and tender, occurring symmetrically in the folds of her abdomen and lower legs. Her medical history was significant for major depressive disorder. She had been receiving care from multiple psychiatrists over the last 10 years, and she has been hospitalised in inpatient psychiatric facilities for acute psychotic episodes. She admitted to having two of five siblings with similar skin problems, both additionally having been diagnosed with mood disorders including bipolar disorder and major depressive disorder. The patient stated the other three siblings were healthy. On examination, the patient had plaques of confluent papules and foul-smelling, weeping patches which were distributed over the folds of her chest and abdomen, as well as the flexure surfaces of her bilateral lower extremities (figure 1). Examination of her nails revealed red and white...
https://ift.tt/2Pcv91n
Amyloidosis: a unifying diagnosis for nephrotic syndrome and congestive cardiac failure
Diagnosing patients simply with heart failure or nephrotic syndrome is insufficient, and clinicians should always search for the underlying causes of these syndromes. Amyloidosis represents a rare group of diseases in which abnormal protein, namely amyloid fibrils, build up in various organs. Presentation depends on which organ systems are involved, and symptoms could include breathlessness associated with fluid overload suggestive of cardiac and/or renal involvement and diarrhoea and weight loss, suggestive of gastrointestinal involvement. The authors present a case of congestive cardiac failure and nephrotic range proteinuria in a patient with persistent fluid overload secondary toamyloid light-chain (AL) amyloidosis.
https://ift.tt/2wiS6sG
Unusual case of dasatinib-associated acute bilateral hyphemas leading to blindness in a patient with chronic myeloid leukaemia
Chronic myeloid leukaemia (CML) is a myeloproliferative disorder with an incidence of 1–2 cases per 100 000 adults per year.1 Since the International Randomized Study of Interferon and STI571 trial (IRIS trial) in 2003, treatment with tyrosine kinase inhibitors (TKIs) has become the standard of care for patients with newly diagnosed CML in the chronic phase.2 Dasatinib is a second-generation TKI and is generally well tolerated, with cytopenias, gastrointestinal (GI) symptoms and fluid retention being the most commonly observed side effects.3–5 Bleeding complications, although unusual, have been reported with dasatinib, with an incidence ranging from 8% to 24%.3–6 The most commonly reported site of bleeding is the GI tract.3 5 We report an unusual case of dasatinib-associated bleeding presenting with acute bilateral hyphemas, which, to our knowledge, is the first report of its kind.
https://ift.tt/2PcuWeB
Resolution of bulbar and spinal symptoms postcranial dural arteriovenous fistula embolisation
Dural arteriovenous fistulas (DAVF) are uncommon lesions. Multiple classification systems have been proposed to attempt to describe these lesions. We describe the case of a patient with a dorsal epidural DAVF that, while cerebral in origin, presented with classic spinal DAVF symptoms. Following embolisation, the patient had complete radiographic and symptomatic resolution. Classification of these DAVFs by embryological development allows for potential stratification of DAVFs with a different biological aetiology and diverse characteristics to more fully understand disease mechanisms.
https://ift.tt/2wh90aQ
Chronic thromboembolic pulmonary hypertension: an enigma
Chronic thromboembolic pulmonary hypertension (CTEPH) is a form of pulmonary arterial hypertension (PAH) in which the pulmonary thrombus fails to resolve, resulting in occlusion and remodelling of pulmonary arteries.1 Timely diagnosis is critical since it is potentially curable by pulmonary thromboendarterectomy. Twenty five per cent of cases do not have a history of thromboembolic event. The diagnosis should be considered in the diagnostic work-up of PAH despite lack of history of episodes of thromboembolism. Here we are reporting a case of CTEPH with multiple systemic to pulmonary collaterals delineated by angiogram and CT.
https://ift.tt/2Pbhes7
Additional distal femoral osteotomy for insufficient correction after high tibial osteotomy
A 70-year-old man who was treated with a closed-wedge high tibial osteotomy (HTO) had recurrent right medial knee pain 12 years after the initial osteotomy. We planned a recorrection osteotomy because the patient led an active lifestyle, had well-preserved range of motion and the lateral compartment was still intact. According to preoperative deformity analysis, which indicated a tibia in slight valgus and a femur in moderate varus, recorrection of the distal femur was chosen. Seven degrees of biplanar distal femoral osteotomy (DFO) was performed using a contralateral version of the TomoFix Medial Distal Femur. At 1 year follow-up, the femorotibial angle had improved from 178° to 170°, and the Japanese Orthopaedic Association score had improved from 75 to 95 points. Additional DFO could be a viable alternative for total knee arthroplasty or recorrection HTO when the centre of the deformity is located at the distal femur.
https://ift.tt/2whMy1l
Challenging case of an intramedullary tibial abscess in the setting of chronic osteomyelitis
Description
This is the case of a 43-year-old wheelchair-user man with a history of hepatitis C, cirrhosis, intravenous drug abuse and a 2-year history of chronic right lower extremity ulcers who presented to the emergency department with 4 days of worsening right leg pain. On physical exam, there was a new area of fluctuance on the anterior tibial surface. Labs included a white cell count of 9.3 K/µL, C reactive protein of 129 mg/L and erythrocyte sedimentation rate of 90 mm/hour. A CT scan demonstrated proximal tibia osteomyelitis with an intramedullary abscess, surrounding soft tissue abscesses and septic arthritis of the knee joint (figure 1).
Figure 1
(A) Permeative appearance of the proximal tibial metaphysis and diaphysis with areas of cortical lucency and endosteal scalloping, suspicious for osteomyelitis. (B) Intramedullary fluid collection within the proximal tibial metaphysis/epiphysis, containing hyperattenuating contents with two punctate foci of air measuring approximately 6.7x4.7x16.6 cm,...
https://ift.tt/2Nolq7u
Tubular adenomas of the breast: a rare diagnosis
Tubular adenomas of the breast are rare benign tumours and few cases have been reported. Most often, the tumours are described as palpable, well-circumscribed masses in women of childbearing age and are commonly diagnosed as fibroadenomas both clinically and radiographically. Surgical excision is required for diagnosis and to prevent continuing growth. Here, we present two cases of these rare tumours, both with unusual presentations. The first case describes a very large specimen (10 cm x 9.5 cm x 4 cm mass) with tubular adenoma pathology, which is one of the largest reported in medical literature. The second case illustrates another rare specimen, a mixture of both tubular adenoma and fibroadenoma pathology. We elected to document these cases to assist in the management of these rare lesions. Our hope is that this will allow future physicians to better identify and treat the pathology with improved outcomes for these patients.
https://ift.tt/2whui8m
Weeping Leg'
Description
A 37-year-old daily wager from Uttar Pradesh in Northern India presented with multiple painless small nodules and granules discharging sinuses over the left leg. The lesions were uniformly distributed below the knee up to the ankle crease (figure 1). The skin was puckered and tethered to the underlying tissues. However, the foot and thigh of the involved limb and rest of the other limbs were absolutely symptom free. Radiographs showed erosion of the entire tibia and fibula with mixed sclerotic and osteolytic areas (figure 2, black arrows) along with sub tissue swelling and periosteal reactions (figure 2, white arrows). The culture of the grains in Modified Sabouraud Agar media supplemented with 0.5% yeast extract revealed Madurella mycetomatis from its characteristic colony of fruiting bodies.
Figure 1
Clinical photograph of the left leg of the patient showing multiple discharging sinuses with...
https://ift.tt/2Nj3KKq
Documented vancomycin-induced severe immune-mediated thrombocytopaenia
A 69-year-old man developed Propionibacterium acnes left knee hardware infection after suffering from an infected ingrown toenail. The hardware was removed and he was treated with intravenous vancomycin. Ten days after initiation of vancomycin, he developed severe thrombocytopaenia, epistaxis and petechiae. Vancomycin was discontinued, and platelets rapidly recovered. Serum vancomycin IgG were positive. Patient completed a 6-week course of ceftriaxone with no further complications.
https://ift.tt/2wcPTPp
Opioid toxicity with underlying tumour lysis syndrome in a patient with CMML: a diagnostic and therapeutic challenge
Use of strong opioids like morphine as analgesics for painful conditions in haematological malignancies is a challenging task. We report a unique case of chronic myelomonocytic leukaemia presenting with opioid toxicity overlapping with tumour lysis syndrome. The patient was on hydroxyurea-based chemotherapy for the primary disease. She was receiving oral morphine for abdominal pain due to splenomegaly. She was brought to the emergency in unresponsive state with pinpoint pupils. Opioid overdose leading to unconsciousness was suspected as the first diagnosis. Further workup revealed a final diagnosis of tumour lysis syndrome overlapping with opioid overdose. The patient was ventilated and started on naloxone infusion, and supportive measures for managing tumour lysis were added. The patient gradually improved and was extubated on the fifth day of ventilation. This case presents several learning points for the treating physician. Haematological malignancies have a dynamic course of disease with waxing and waning tumour burden during the course of chemotherapy. This fact should be kept in mind when prescribing strong opioids like morphine on outpatient basis to these patients. Massive tumour cell lysis during the course of chemotherapy may precipitate tumour lysis syndrome and may lead to renal dysfunction which makes the patient susceptible to morphine-related adverse effects. Pain physician should keep a watch for therapy-related adverse effects to avoid diagnostic and therapeutic dilemma associated with coexisting features of these two fatal conditions.
https://ift.tt/2P9Nj3z
Novel microguidewire-assist (MGA) manoeuver for coil embolisation of an unruptured middle cerebral artery aneurysm
We describe here a novel yet very simple technique, called microguidewire-assist (MGA) manoeuvre, for coil embolisation of unruptured intracranial aneurysms. A 79-year-old woman with a small, broad-necked middle cerebral artery (MCA) bifurcation aneurysm that incorporated the orifice of the acute-angled M2 superior trunk underwent coil embolisation. Since the balloon assist technique was not feasible, we inserted and retained only the microguidewire through M1 to the M2 superior trunk; subsequently, with appropriate use of the microguidewire, coil embolisation was completed. The MGA manoeuvre resulted in slight vessel straightening and subsequent changes in the angulation of the aneurysmal neck, with which stable placement of the platinum coil was successfully accomplished. For coil embolisation of small, broad-necked MCA aneurysms that partially straddle the M2 trunk, this manoeuvre might provide an effective therapeutic alternative if other techniques are not feasible.
https://ift.tt/2wjzPv9
Short stature and growth hormone deficiency: unexpected manifestations of McCune-Albright syndrome
McCune-Albright syndrome (MAS) is a rare disease characterised by triad of monostotic or polyostotic fibrous dysplasia, café au-lait skin spots and a variety of endocrine disorders; precocious puberty (PP) being the most common presenting symptom in female patients. Hyperfunction endocrinopathies including hyperthyroidism, growth hormone excess and cortisol excess are typical presentations in MAS. We present a case of 21-year-old woman with clinical and radiological characteristics of MAS triad; she presented with short stature which was attributed to both growth hormone deficiency and PP. Growth hormone deficiency in MAS has not been reported in English medical literature.
https://ift.tt/2P89CXC
Cobb syndrome (cutaneomeningospinal angiomatosis)
Description
A 62-year-old woman was referred to the orthopaedic oncology service for evaluation of a bleeding and enlarging soft tissue mass along the right anterior abdominal wall. She had a lifelong history of a cutaneous and subcutaneous vascular malformation, affecting the right lateral chest and right abdomen and extending proximally to involve the mid-thoracic spine. Her medical history was significant for a prior aborted attempted surgical resection of the vascular malformation in 1980 due to intraoperative bleeding. Her history also included L4–L5 laminectomy without fusion for lower extremity weakness without radicular symptoms in 1989 and coil embolisation of a T9 epidural fistula in 2011 to prevent any abnormal vascular flow. Examination of the bilateral lower extremity showed marked steppage gait with bilateral external rotation deformities and bilateral foot drop. Motor examination of the lower extremities revealed muscle power grading of 1/5 extensor hallucis longus bilaterally, 2/5 tibialis anterior...
https://ift.tt/2whue8C
Anti-AMPA receptor encephalitis associated with Medullary thyroid cancer
AMPA receptor (AMPAR) antibodies are a group of recently discovered antibodies which target the neuronal synaptic proteins causing B-cell (immune) mediated neuronal damage, resulting in various neurologic syndromes depending on the area of central nervous system involvement. These syndromes are mostly reversible if treated early. Tumour association has been reported in up to 60% of cases in the most recent case series with lung, breast, ovarian cancers and thymomas being the most commonly associated malignancies with these antibodies. We present here the first case of AMPAR encephalitis associated with medullary thyroid cancer. Our patient presented with cognitive dysfunction and behavioural changes over a period of 3 weeks, with a full recovery after starting immunotherapy, once the diagnosis of AMPAR limbic encephalitis was established. This case highlights the importance of early diagnosis and management of AMPAR encephalitis as these patients respond well to immunotherapy and can have an almost complete recovery.
https://ift.tt/2P8gnsc
Good vibrations: itch induction by whole body vibration exercise without the need of a pruritogen
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2PEl6D0
Acute effects of air pollution on type II diabetes mellitus hospitalization in Shijiazhuang, China
Abstract
Air pollution has been considered as an important contributor to diabetes development. However, the evidence is fewer in developing countries where air pollution concentrations were much higher. In this study, we conduct a time-series study to investigate the acute adverse effect of six air pollutants on type II diabetes mellitus (T2DM) hospitalization in Shijiazhuang, China. An over-dispersed passion generalized addictive model adjusted for weather conditions, day of the week, and long-term and seasonal trends was used. Finally, a 10-μg/m3 increase of fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) corresponded to 0.53% (95% confidence interval = 0.22–0.83), 0.32% (95% CI = 0.10–0.55), 0.55% (95% CI = 0.04–1.07), 1.27% (95% CI = 0.33–2.22), and 0.04% (95% CI = 0.02–0.06) increment of T2DM hospitalization, respectively. The effects of PM2.5, PM10, and CO were robust when adjusted for co-pollutants. The associations appeared to be a little stronger in the cool season than in the warm season. And stronger associations were found in male and elderly (≥ 65 years) than in female and younger people (35–65 years). Our results contribute to the limited data in the scientific literature on acute effects of air pollution on type II diabetes mellitus in developing countries. Main findings: This is the first adverse effect evidence of air pollution on T2DM in Shijiazhuang, a severely polluted city in China. Males were more vulnerable than females in severe pollution.
https://ift.tt/2wi7uFp
Granulysin, a novel marker for extranodal NK/T cell lymphoma, nasal type
Abstract
Granulysin is a cytolytic protein expressed in cytotoxic T and natural killer (NK) cells. Abnormal serum levels of granulysin in lymphomas with NK and cytotoxic phenotype have been shown to correlate with tumour progression. In this study, we investigated the expression pattern of granulysin in routine sections of normal and reactive lymphoid tissues as well as in a large series of lymphomas. In normal tissues, granulysin labelled a small population of cells that double immunostaining revealed to belong to the pool of cytotoxic T/NK cells. Among lymphoid neoplasms, the highest expression of granulysin (71%) was found in extranodal NK/T cell lymphomas of nasal type (ENKTL). To note is that 29% of ENKTLs, which were negative for one or more of classical cytotoxic markers strongly expressed granulysin. Furthermore, expression of granulysin was observed in rare cases of T cell lymphomas with a cytotoxic phenotype (i.e. ALK-negative anaplastic large cell lymphoma (26%), enteropathy-associated T cell lymphoma (12%) and peripheral T cell lymphoma, NOS (4%)). None of the investigated non-Hodgkin B cell lymphomas, Hodgkin lymphoma and plasma cell myeloma were granulysin positive. The results suggest granulysin as a novel marker for a subset of cytotoxic NK cell derived malignancies and its usefulness is highlighted in those ENKTLs that lack expression of other cytotoxic markers but retain granulysin expression.
https://ift.tt/2PcgUcV
Decision between contralateral and ipsilateral DIEP flap harvesting for unilateral breast reconstruction
Abstract
Background
Deep inferior epigastric artery perforator flap (DIEP/DIEAP) procedure is a common method for breast reconstruction after mastectomy. For unilateral breast reconstruction, harvesting of the flap can be done contralaterally or ipsilaterally. The aim of this study is to demonstrate a possible side difference in quality of abdominal skin perfusion from left to right and its causes, which could have implications on our selection of flap harvesting side, operating time, and flap design itself.
Methods
We performed thermographic imaging after induced hypothermia of the abdominal skin in 17 females to evaluate the quality of blood supply to each side of the abdominal wall. Additionally, we examined the diameter of the deep inferior epigastric artery, whether there is a difference in size correlating to the quality of blood supply of each side. Evaluation of our pre-operative thermographic imaging method was performed in four patients which underwent unilateral DIEP flap reconstruction regarding reduction of surgery time and assessment of overall outcome.
Results
Every subject showed a dominant side of perfusion (greater area of perfusion after set time). Furthermore, we discovered a side difference between left and right diameter of the deep inferior epigastric artery in each patient (0.2-mm mean difference; p = 0.0002). The rewarming process of the abdominal skin was faster (16 out of 17 subjects; 94.1%) (greater area of rewarming after set time) on the side with the greater diameter deep inferior epigastric artery. In our DIEP patients using thermographic imaging of the abdominal skin, we only performed perforator dissection on the preferable side. The consequence was a reduction in operating time of 25 minutes compared to careful dissection of both sides. None of our patients showed complications such as wound-healing disorders.
Conclusions
Thermographic assessment of the abdominal skin after hypothermia is easy to conduct and gives reproducible information about different areas of skin perfusion quality. The difference in rewarming speed from left to right is thought to be due to a larger diameter deep inferior epigastric artery, which translates into a superior perfusion, but does not necessarily correlate with the size of the perforators itself. The presented technique offers the potential to improve outcome, especially by lowering perfusion-related complications and reducing operation time by fast dissection of the non-dominant side while carefully dissecting the area of interest with fast thermographic rewarming results, and must therefore be investigated in future studies by measuring objective outcome results.
Level of Evidence: Level III, risk/prognostic
https://ift.tt/2MWBMak
CO 2 bio-fixation and biofuel production in an airlift photobioreactor by an isolated strain of microalgae Coelastrum sp. SM under high CO 2 concentrations
Abstract
Microalgae cultivation is a promising approach to remove ambient CO2 via photosynthesis process. This paper investigates the impact of high CO2 concentrations (6, 12, and 16%) on algae growth, CO2 biofixation, lipid and carbohydrate contents, and nutrient removal of newly isolated microalgae, Coelastrum sp. SM. In addition, the ability of microalgae to produce biodiesel at optimal condition was studied. The microalgae were cultivated in wastewater using an airlift photobioreactor. Under 12% CO2, the maximum biomass productivity and CO2 fixation rate were 0.267 g L−1 day−1 and 0.302 g L−1 h−1, respectively. Total Kjeldahl nitrogen (TKN), total phosphorous (TP), nitrate, and sCOD removal efficiency were 84.01, 100, 86.811, and 73.084%, respectively. Under 12% CO2 and at the same condition for cell growth, the highest lipid and carbohydrate contents were 3 7.91 and 58.45%, respectively. The composition of fatty acids methyl ester (FAME) of the microalga lipid was defined. Based on the obtained results and FAME profile, Coelastrum sp. SM was a suitable feedstock for biodiesel production and also, the organism had a great potential for CO2 biofixation, which is also more suitable than any other reported strains in other related studies.
https://ift.tt/2Pbz8v2
The Application of Fluorescence Laparoscopy in the Treatment of Adenocarcinoma of the Esophagogastric Junction
Conditions: Fluorescence Laparoscopy; Adenocarcinoma of the Esophagogastric Junction
Interventions: Procedure: fluorescent laparoscopic radical gastrectomy; Procedure: traditional laparoscopic radical gastrectomy
Sponsor: Dong Yang
Not yet recruiting
https://ift.tt/2oeE9rf
Interventions: Procedure: fluorescent laparoscopic radical gastrectomy; Procedure: traditional laparoscopic radical gastrectomy
Sponsor: Dong Yang
Not yet recruiting
https://ift.tt/2oeE9rf
Lesion Dosimetry With Iodine-124 in Metastatic Thyroid Carcinoma
Conditions: Thyroid Carcinoma; Metastatic Thyroid Carcinoma
Interventions: Device: PET/CT Scan; Drug: Iodine-124
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2BR2jl9
Interventions: Device: PET/CT Scan; Drug: Iodine-124
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2BR2jl9
EBV-TCR-T（YT-E-001） for Patients With EBV-positive Recurrent or Metastatic NPC Patients
Condition: Nasopharyngeal Carcinoma
Intervention: Biological: EBV-TCR-T (YT-E001) cells
Sponsors: Fujian Cancer Hospital; China Immunotech Co., Ltd.
Not yet recruiting
https://ift.tt/2oe2VaQ
Intervention: Biological: EBV-TCR-T (YT-E001) cells
Sponsors: Fujian Cancer Hospital; China Immunotech Co., Ltd.
Not yet recruiting
https://ift.tt/2oe2VaQ
Pain in Parkinson's Disease With Motor Fluctuations.
Condition: Parkinson Disease
Interventions: Drug: safinamide metansolfonato (12 weeks); Drug: rasagilina mesilato (12 weeks)
Sponsors: Universita di Verona; Azienda Ospedaliera Universitaria Integrata Verona
Recruiting
https://ift.tt/2BSKbHG
Interventions: Drug: safinamide metansolfonato (12 weeks); Drug: rasagilina mesilato (12 weeks)
Sponsors: Universita di Verona; Azienda Ospedaliera Universitaria Integrata Verona
Recruiting
https://ift.tt/2BSKbHG
177Lu-PP-F11N in Combination With Sacubitril for Receptor Targeted Therapy and Imaging of Metastatic Thyroid Cancer
Condition: Thyroid Cancer, Medullary
Interventions: Drug: 177Lu-PP-F11N; Drug: Sacuitril
Sponsors: University Hospital, Basel, Switzerland; Krebsforschung Schweiz, Bern, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, Villigen,Switzerland; University Hospital, Zürich; University Hospital Freiburg
Not yet recruiting
https://ift.tt/2okImK9
Interventions: Drug: 177Lu-PP-F11N; Drug: Sacuitril
Sponsors: University Hospital, Basel, Switzerland; Krebsforschung Schweiz, Bern, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, Villigen,Switzerland; University Hospital, Zürich; University Hospital Freiburg
Not yet recruiting
https://ift.tt/2okImK9
Predictor Analysis of Acute Radiation Oral Mucositis in NPC Patients Treated With IMRT/TOMO Combined Chemotherapy
Condition: Nasopharyngeal Carcinoma
Intervention:
Sponsor: Zhejiang Cancer Hospital
Recruiting
https://ift.tt/2BSK276
Intervention:
Sponsor: Zhejiang Cancer Hospital
Recruiting
https://ift.tt/2BSK276
The Application of Fluorescence Laparoscopy in the Treatment of Adenocarcinoma of the Esophagogastric Junction
Conditions: Fluorescence Laparoscopy; Adenocarcinoma of the Esophagogastric Junction
Interventions: Procedure: fluorescent laparoscopic radical gastrectomy; Procedure: traditional laparoscopic radical gastrectomy
Sponsor: Dong Yang
Not yet recruiting
https://ift.tt/2oeE9rf
Interventions: Procedure: fluorescent laparoscopic radical gastrectomy; Procedure: traditional laparoscopic radical gastrectomy
Sponsor: Dong Yang
Not yet recruiting
https://ift.tt/2oeE9rf
Lesion Dosimetry With Iodine-124 in Metastatic Thyroid Carcinoma
Conditions: Thyroid Carcinoma; Metastatic Thyroid Carcinoma
Interventions: Device: PET/CT Scan; Drug: Iodine-124
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2BR2jl9
Interventions: Device: PET/CT Scan; Drug: Iodine-124
Sponsor: Memorial Sloan Kettering Cancer Center
Recruiting
https://ift.tt/2BR2jl9
EBV-TCR-T（YT-E-001） for Patients With EBV-positive Recurrent or Metastatic NPC Patients
Condition: Nasopharyngeal Carcinoma
Intervention: Biological: EBV-TCR-T (YT-E001) cells
Sponsors: Fujian Cancer Hospital; China Immunotech Co., Ltd.
Not yet recruiting
https://ift.tt/2oe2VaQ
Intervention: Biological: EBV-TCR-T (YT-E001) cells
Sponsors: Fujian Cancer Hospital; China Immunotech Co., Ltd.
Not yet recruiting
https://ift.tt/2oe2VaQ
Pain in Parkinson's Disease With Motor Fluctuations.
Condition: Parkinson Disease
Interventions: Drug: safinamide metansolfonato (12 weeks); Drug: rasagilina mesilato (12 weeks)
Sponsors: Universita di Verona; Azienda Ospedaliera Universitaria Integrata Verona
Recruiting
https://ift.tt/2BSKbHG
Interventions: Drug: safinamide metansolfonato (12 weeks); Drug: rasagilina mesilato (12 weeks)
Sponsors: Universita di Verona; Azienda Ospedaliera Universitaria Integrata Verona
Recruiting
https://ift.tt/2BSKbHG
177Lu-PP-F11N in Combination With Sacubitril for Receptor Targeted Therapy and Imaging of Metastatic Thyroid Cancer
Condition: Thyroid Cancer, Medullary
Interventions: Drug: 177Lu-PP-F11N; Drug: Sacuitril
Sponsors: University Hospital, Basel, Switzerland; Krebsforschung Schweiz, Bern, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, Villigen,Switzerland; University Hospital, Zürich; University Hospital Freiburg
Not yet recruiting
https://ift.tt/2okImK9
Interventions: Drug: 177Lu-PP-F11N; Drug: Sacuitril
Sponsors: University Hospital, Basel, Switzerland; Krebsforschung Schweiz, Bern, Switzerland; Center for Proton Therapy, Paul Scherrer Institute, Villigen,Switzerland; University Hospital, Zürich; University Hospital Freiburg
Not yet recruiting
https://ift.tt/2okImK9
Predictor Analysis of Acute Radiation Oral Mucositis in NPC Patients Treated With IMRT/TOMO Combined Chemotherapy
Condition: Nasopharyngeal Carcinoma
Intervention:
Sponsor: Zhejiang Cancer Hospital
Recruiting
https://ift.tt/2BSK276
Intervention:
Sponsor: Zhejiang Cancer Hospital
Recruiting
https://ift.tt/2BSK276
Widespread keratosis pilaris in a patient with Noonan syndrome with multiple lentigines
International Journal of Dermatology, EarlyView.
https://ift.tt/2obKnrP
Resveratrol and ivacaftor are additive G551D CFTR‐channel potentiators: therapeutic implications for cystic fibrosis sinus disease
International Forum of Allergy &Rhinology, EarlyView.
https://ift.tt/2wgcgn2
Case of histiocytosis with bone involvement of fingers successfully treated with peginterferon‐α
The Journal of Dermatology, EarlyView.
https://ift.tt/2Luk6hq
Treatment of psoriasis and psoriatic arthritis with secukinumab after unsatisfactory response to ustekinumab in multiple sclerosis patient
The Journal of Dermatology, EarlyView.
https://ift.tt/2Lwj6cO
Case of anaphylaxis caused by black ginger in a dietary supplement
The Journal of Dermatology, EarlyView.
https://ift.tt/2MTHycZ
Evaluation of epicardial adipose tissue volume and coronary artery calcification in Japanese patients with psoriasis vulgaris
The Journal of Dermatology, EarlyView.
https://ift.tt/2NjLMHF
Case of anaphylaxis to lansoprazole confirmed by histamine release test and oral provocation test
The Journal of Dermatology, EarlyView.
https://ift.tt/2MVV9Am
Hurley III Hidradenitis Suppurativa Has an Aggressive Disease Course
Dermatology
https://ift.tt/2BQscBv
A Comparison of Vagal Nerve Stimulation and Responsive Neurostimulation for the Treatment of Medically Refractory Complex Partial Epilepsy
Background: Neuromodulatory applications such as vagus nerve stimulation (VNS) and responsive neurostimulation (RNS) are safe and effective strategies for medically intractable epilepsy secondary to complex partial seizures, but researchers have yet to compare their efficacies. Objective: The goal of this study is to compare VNS and RNS efficacy at reducing seizure frequency and complication rates in subjects with medically intractable epilepsy secondary to complex partial seizures. Methods: This is a retrospective chart review of 30 patients with medically intractable complex partial epilepsy, who underwent either VNS or RNS placement at a single institution between June 2012 and January 2016. There was a mean follow-up of 19 months. Seizure frequency reduction and complications were identified. Results: The median seizure frequency reduction was similar for VNS (66%) and RNS (58%). There was no major morbidity or mortality, and the frequency of minor complications was similar between VNS (15%) and RNS (18%). Conclusion: We found that VNS and RNS reduced the median seizure frequency similarly with no difference in morbidity or mortality. Further prospective studies are warranted as VNS and RNS therapy improves over time.
Stereotact Funct Neurosurg
https://ift.tt/2BZ1FSW
Stereotact Funct Neurosurg
https://ift.tt/2BZ1FSW
Sandmückenfieber – eine „vernachlässigte“ Krankheit
Zusammenfassung
Eine 45-jährige Patientin stellte sich mit Fieber, Durchfall, Gliederschmerzen, allgemeinem Krankheitsgefühl und einem juckenden papulösen Exanthem in der Ambulanz eines tropenmedizinischen Zentrums zur weiteren Diagnostik vor. Sie hatte zuvor 11 Tage Urlaub mit ihrer Familie in einem Bergdorf in Nordzypern gemacht. Dort habe es sehr viele kleine, stechende Fliegen oder Mücken gegeben. Nach der Rückkehr erkrankten sie und ihre Familie. Die körperliche Untersuchung war bis auf das Exanthem an den Beugeseiten der Extremitäten unauffällig. In der Routineblutuntersuchung fielen eine deutliche Erhöhung der Transaminasen und ein nur geringfügig erhöhtes C‑reaktives Protein (CRP) auf. Unter Berücksichtigung des Reiselandes, des Hinweises auf die „stechenden Fliegen" und der Klinik wurde in die differenzialdiagnostischen Überlegungen zur Ursache der Hepatitis auch das sog. Sandmückenfieber einbezogen. Es konnten Antikörper gegen das sizilianische Sandmückenfiebervirus (SFSV) nachgewiesen werden, die im Verlauf eine typische Dynamik zeigten, sodass die Diagnose eines Pappataci-Fiebers gestellt wurde. Die Kasuistik und eine kurze Zusammenstellung von Informationen über den Erreger, den Vektor, die Epidemiologie, Klinik, Diagnostik und Therapiemöglichkeiten sollen dazu anregen, Phlebovirusinfektionen als mögliche Differenzialdiagnose zu berücksichtigen, wenn Reisende oder Flüchtlinge nach Aufenthalt im Mittelmeerraum an schweren fieberhaften Erkrankungen mit Hepatitis und Hauterscheinungen oder aseptischen viralen Meningitiden erkranken.
https://ift.tt/2Lvf30g
Probe‐based confocal laser endomicroscopy for diagnosis of nasopharyngeal carcinoma in vivo
The Laryngoscope, EarlyView.
https://ift.tt/2ogs4S9
Free Flap Versus Pedicled Flap Reconstruction of Laryngopharyngeal Defects: A 10‐Year National Surgical Quality Improvement Program Analysis
The Laryngoscope, EarlyView.
https://ift.tt/2Pak6FF
Laryngeal Cryptococcoma Resulting in Airway Compromise in an Immunocompetent Patient: A Case Report
The Laryngoscope, EarlyView.
https://ift.tt/2oco9WD
Long‐term analysis of transorally resected p16 + Oropharynx cancer: Outcomes and prognostic factors
The Laryngoscope, EarlyView.
https://ift.tt/2PbwQw1
Sarcomatoid Carcinoma in the Parotid Gland: A Review of 30 Years of Experience
The Laryngoscope, EarlyView.
https://ift.tt/2odTU1s
Do All Patients With Head and Neck Cancer Require a Positron Emission Tomography Scan at Diagnosis?
The Laryngoscope, EarlyView.
https://ift.tt/2PaFZVs
A novel approach to skull‐base and orbital osteotomies through virtual planning and navigation
The Laryngoscope, EarlyView.
https://ift.tt/2MxLNM3
HPV status in unknown primary head and neck cancer: Prognosis and treatment outcomes
The Laryngoscope, EarlyView.
https://ift.tt/2PaFQ4m
Rhinosinusitis symptoms, smoking and COPD: prevalence and associations
Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2PHa67T
Allergen immunotherapy as add-on to biologic agents
Purpose of review In this review, we sought to outline many of the recent evidences about the available clinical trials in which biologic agents [i.e. omalizumab (OMA)] were associated as add-on to allergen-specific immunotherapy (AIT). Recent findings The available literature shows that OMA may be a valuable option as add-on to AIT for respiratory allergy, or food desensitization, especially in the escalation or build-up phases, in which adverse events are more commonly expected. The encouraging data for hymenoptera venom allergy remain limited to case reports, and no structured clinical trial is available. Summary Over the past decade, studies of OMA used with AIT have shown promising results. Today, big randomized, double-blind, placebo-controlled trials are needed to better select those patients who would benefit from the addition of OMA (or other biologic agents) to AIT, as well as optimal dosing schedules, optimal duration of treatments and, finally, adequate evaluation about pharmacoeconomic aspects. Correspondence to Carlo Lombardi, MD, Departmental Unit of Allergology & Pneumology, Fondazione Poliambulanza Hospital, Brescia, Italy. Tel: +39 030 3518555; e-mail: carlo.lombardi@poliambulanza.it Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
https://ift.tt/2PDqnuy
https://ift.tt/2PDqnuy
Office-based surgery and patient outcomes
Purpose of review The purpose of this review is to provide an update on the current knowledge about patient safety and outcomes in the office-based setting. Ambulatory procedures performed outside the hospital are steadily increasing, resulting in an increasing number and complexity of office-based procedures and patient comorbidities over the past two decades. In this review we focus on most recent outcomes studies encompassing different surgical specialties and patient populations. Recent findings Rates of complications in the office-based surgical (OBS) setting from the latest publications are similar to, or better than previously reported studies. Many of the studies published were in the field of plastic surgery, with a few publications on office vascular and dental procedures. The most common complications were haematomas, infections and venous thromboembolisms (VTE)s and pulmonary emboli. Death was a rare finding, though when it occurred, it was often associated with VTE/pulmonary emboli and abdominoplasties. Summary Overall, these studies contribute positively to the safety of office-based anaesthesia. As an increasing number of procedures migrate from the hospital setting to ambulatory and office-based environments, it will be critically important to continue ensuring patients are well tolerated. Correspondence to Richard D. Urman, MD, MBA, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA. Tel: +1 617 732 8222; e-mail: Rurman@bwh.harvard.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
https://ift.tt/2MxJg4v
https://ift.tt/2MxJg4v
Association of Postoperative Antibiotics With Surgical Site Infection in Mohs Micrographic Surgery
BACKGROUND Surgical site infection (SSI) is the most frequent complication of Mohs micrographic surgery. Previous studies have identified risk factors for SSI, but it is not known whether antibiotic prophylaxis mitigates this risk. OBJECTIVE To measure the association between antibiotic prophylaxis and SSI in a convenience sample of Mohs cases and to report on the utility of propensity scoring to control for confounding by indication in registry data. METHODS Data were drawn from a pilot quality improvement registry of 816 Mohs cases. The relationship between antibiotic prophylaxis and SSI was assessed with logistic regression modeling using propensity score methods to adjust for confounding. RESULTS One hundred fifty-one cases were prescribed antibiotic prophylaxis (18.5%). Of 467 cases with follow-up, 16 (3.4%) developed SSI. Infection rates were higher in subjects prescribed prophylaxis, but propensity adjustment reduced this effect. Adjusted odds of infection were 1.47-fold higher in subjects prescribed antibiotics and not statistically significant (95% confidence interval 0.29–7.39; p = .64). CONCLUSION Although there was no significant difference in SSI among patients prescribed prophylactic antibiotics, statistical precision was limited by the low incidence of infection. Larger population-based prospective registry studies including propensity adjustment are needed to confirm the benefit of prophylactic antibiotics in high-risk surgical cases. Address correspondence and reprint requests to: Sarah T. Arron, MD, PhD, Department of Dermatology, University of California, 1701 Divisadero Street 3rd Floor, San Francisco, CA 94115, or e-mail: Sarah.Arron@ucsf.edu The authors have indicated no significant interest with commercial supporters. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
https://ift.tt/2Lti2qh
https://ift.tt/2Lti2qh
Allergen immunotherapy as add-on to biologic agents
Purpose of review In this review, we sought to outline many of the recent evidences about the available clinical trials in which biologic agents [i.e. omalizumab (OMA)] were associated as add-on to allergen-specific immunotherapy (AIT). Recent findings The available literature shows that OMA may be a valuable option as add-on to AIT for respiratory allergy, or food desensitization, especially in the escalation or build-up phases, in which adverse events are more commonly expected. The encouraging data for hymenoptera venom allergy remain limited to case reports, and no structured clinical trial is available. Summary Over the past decade, studies of OMA used with AIT have shown promising results. Today, big randomized, double-blind, placebo-controlled trials are needed to better select those patients who would benefit from the addition of OMA (or other biologic agents) to AIT, as well as optimal dosing schedules, optimal duration of treatments and, finally, adequate evaluation about pharmacoeconomic aspects. Correspondence to Carlo Lombardi, MD, Departmental Unit of Allergology & Pneumology, Fondazione Poliambulanza Hospital, Brescia, Italy. Tel: +39 030 3518555; e-mail: carlo.lombardi@poliambulanza.it Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
https://ift.tt/2PDqnuy
https://ift.tt/2PDqnuy
Intracytoplasmic eosinophilic inclusion bodies with embryonic folliculosebaceous‐apocrine unit differentiation in syringocystadenoma papilliferum
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2od8Ahi
Εγγραφή σε:
Αναρτήσεις (Atom)