Head and Neck Diseases by Alexandros G.Sfakianakis: 09/05/18

Background: There is clinical and experimental evidence that botulinum toxin applied to the healthy side of patients with facial paralysis positively affects functional recovery of the paralyzed side. We created an experimental model to study the effects of botulinum toxin injection in the gastrocnemius muscle contralateral to the side of tibial nerve lesion/repair in rats. Methods: Fifty rats were allocated into five groups: I: control; II: tibial nerve section; III: tibial nerve section, immediate neurorrhaphy; IV: tibial nerve section, immediate neurorrhaphy and botulinum toxin injected into the contralateral gastrocnemius muscle; V: botulinum toxin injected into the gastrocnemius muscle, no surgery. Assessment tools included a walking track, electromyography, gastrocnemius muscle weight measurement, and histological analysis of the nerve. Results: Paralysis in group V was transient, with function returning to normal at 8 weeks. At 12 weeks, group V had lower latency levels. At week 12, group IV showed higher functional outcomes and amplitude levels than group III, and lower muscle atrophy on the side injected with botulinum toxin than group V. Conclusions: Transient paralysis of the contralateral gastrocnemius muscle by abobotulinumtoxinA improved functional recovery in rats that underwent section and repair of the tibial nerve. Presented at: American Society for Peripheral Nerve Annual Meeting (ASPN) 2017 in Waikoloa, Hawaii. Financial Disclosure Statement: The authors have no financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding author: Alessandra Grassi Salles, Rua Joaquim Floriano, 466, cj. 2102, São Paulo 04534-002, Brazil. Tel/Fax: 55-11-3078-1009, E-mail: agsalles30@gmail.com ©2018American Society of Plastic Surgeons

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Clockwise and Counterclockwise Le Fort I Movements Influence Nasolabial Morphology Differently

Introduction: Le Fort I maxillary advancements are reported to affect nasal proportions. However, there is a no significant data on the three-dimensional nasal changes that occur with differential lateral plane adjustment (clockwise (CW) and counterclockwise (CCW) movements) during Le Fort I maxillary advancements. The purpose of this study was to analyze and compare nasolabial soft tissue changes after Le Fort I CW and CCW repositioning. Methods: Single-piece Le Fort I advancements were included in this morphometric study. A retrospective study of patients split into CW and CCW groups was performed. Pre- and postoperative 3D photographs (VECTRA, Canfield, Fairfield, NJ) were analyzed. Nasolabial anthropometric measurements were recorded (Mirror). Two observers verified the landmarks. Statistical analysis involved paired t test to compare pre- and postoperative nasolabial measurements. Results: Twenty-four patients were evaluated (12 per group), with 22 distinct nasolabial relationships measured. CCW showed a statistically significant increase in alar width (3.6mm, P

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Neural Perforasomes of the Upper Extremity

Background: In the setting of the rapid advancement of integumentary vascular knowledge, we hypothesized that the extrinsic blood supply to the major peripheral nerves of the upper extremity could be categorized into discrete neural "perforasomes". Methods: Total limb perfusion of the arterial system was performed with gelatin-red lead oxide in cadaveric upper limbs. The perforating vessels to the radial, median and ulnar nerves were identified, confirmed with fluoroscopy and dissected. Distances to major anatomic landmarks of the upper extremity were measured. Additional cadaveric limbs' nerves were dissected and source arteries were selectively cannulated and injected to assess specific contribution to extrinsic nerve perfusion. The perfusion of each nerve was then calculated among all specimens. Results: The radial, median and ulnar nerve perforators were mapped. The corresponding neural perforasomes were mapped. The distal portions of the superficial radial nerve (SRN) and the posterior interosseous nerve (PIN) demonstrated a lack of staining. Similarly, at the carpal tunnel and at the proximal 25% of the median nerve (corresponding to the pronator teres), the nerve lacked vascular staining. At Guyon's canal and the flexor carpi ulnaris (FCU) the ulnar nerve demonstrated a lack of vascular staining. Conclusions: Peripheral nerves can be divided into neural perforasomes with limited overlap. The extrinsic perfusion of peripheral nerves is highly segmental. Absent staining within the nerves correspond to common sites of compression: carpal tunnel and pronator teres for the median nerve, supinator for the PIN, and Guyon's canal and the FCU for the ulnar nerve. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. This research was supported by the American Foundation for Surgery of the Hand. This research was supported by the Piedmont Orthopaedic Foundation. This research has not been presented at any meetings. All named authors hereby declare that they have no conflicts of interest to disclose. This study is deemed exempt by the Duke University Institutional Review Board, Pro00075741. This research is supported by the Piedmont Orthopaedic Foundation. This research is supported by the American Foundation for Surgery of the Hand. Corresponding author: Steven Koehler, MD, Department of Orthopaedic Surgery, SUNY Downstate Medical Center, 450 Clarkson Ave, MSC 30, Brooklyn, NY 11203, Email: steven.koehler@downstate.edu ©2018American Society of Plastic Surgeons

https://ift.tt/2PIGJ4f

Effects of Extracorporeal Shock Wave Therapyon Distraction Osteogenesis in Rat Mandible

Background: Distraction osteogenesis (DO) has widespread clinical use in the treatment of congenital and acquired craniofacial deformities. Nonetheless, during the prolonged consolidation period, the newly regenerated bone carries the risk of complications. One of the proposed methods to enhance bone healing and shorten the consolidation period is extracorporeal shock wave therapy (ESWT). In the field of orthopedics, ESWT has been shown to induce neovascularization and promote tissue regeneration. We investigated whether ESWT can accelerate bony consolidation and regeneration in distraction osteogenesis of the rat mandible and at which stage of DO it should be applied. Methods: 24 male Sprague Dawley rats were subjected to DO of the right mandible (latency period, 3 days; distraction period, 10 days, 0.5 mm/day). Experimental groups: group I (control) no ESWT: group II received ESWT (0.18 mJ/mm2) at the latency period; group III received ESWT (0.18 mJ/mm2) at the consolidation period. Explants were removed for evaluation following four weeks of consolidation. Results: Histological evaluation showed well developed cortical cortex and a higher degree of bone formation and mature bone in group III; µCT showed significantly increased bone mineral density, bone volume fraction and trabecular thickness; immunohistochemistry demonstrated significantly increased expression of Bone Morphogenetic Protein-2, Vascular Endothelial Growth Factor and PCNA. Conclusions: ESWT application at the consolidation period during DO in the rat mandible enhances bone formation, osteogenic and angiogenic growth factors, improves bone mechanical properties and accelerates bone mineralization. Financial Disclosure Statement: he authors declare that they have no conflict of interest. No funding was received for this article. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding author: Jiriys George Ginini, DMD, Rambam Health Care Campus, 8 Ha'Aliyah Street, Haifa 35254, Israel, Phone: +972-503330896, Fax: +972-7772557, Email: jiriysginini@technion.ac.il ©2018American Society of Plastic Surgeons

https://ift.tt/2Nnc7rM

“Non-invasive flap preconditioning by foam-mediated external suction improves the survival of fascio-cutaneous axial-pattern flaps in a type-2 diabetic murine model”

Background: Advances in reconstructive surgery are leading to an increased number of flaps at risk for ischemic necrosis, either due to intrinsic (e.g., larger flap size) or extrinsic (e.g., diabetes) factors. Yet, methods to pre-operatively improve flap vascularity and limit post-operative ischemia are lacking. Non-invasive suction, using either a macro-deformational silicone-cup interface (External Volume Expansion, EVE) or a micro-deformational polyurethane-foam interface (F-EVE), has shown to induce angiogenesis in tissues. We investigated whether, by increasing the vascular density of flaps, the pre-operative use of EVE/F-EVE (preconditioning) improves flap survival in an obesity-induced diabetic animal model. Methods: Db/Db mice underwent either mechanical stimulation with suction for 5 days using either EVE, or F-EVE, or received no stimulation (n = 8 per group). Five days after the last stimulation, a critical-sized, axial-pattern, fascio-cutaneous flap was raised in all animals. Post-operatively, flap survival was monitored with digital imaging for 10 days. Following this period, flaps were harvested to assess tissue survival, angiogenesis, and inflammation, utilizing histology and PCR. Results: F-EVE preconditioning significantly increased the viable flap area (+28%), the viable flap volume (+27%), the flap capillary density (+36%), in comparison to controls; VEGF was also upregulated (>300%). In contrast, EVE resulted in severe inflammatory response and increased flap necrosis. Conclusions: F-EVE improves flap survival in obese diabetic mice. This procedure may allow for improved clinical rates of flap survival in high-risk patients. Acknowledgments, conflict of interest and role of funding sources disclosure statement: Authors are thankful to KCI, Inc. for providing the pumps and the foam-shaped Interface used in this study. Dr. Orgill serves as a consultant and has received sponsored research grants from KCI to Brigham and Women's Hospital. Authors declare no actual or potential conflict of interest: in addition, they disclose no commercial or financial associations, personal or other relationships with other people or organizations that could inappropriately influence the reported manuscript or create a conflict of interest with the information presented. This study was funded by a research grant from the Gillian Reny Stepping Strong Foundation to Brigham and Women's Hospital. Ethics: The displayed study was carried out with respect to high ethical standards. All the studies have been approved, when required, by the appropriate ethics committee and have, therefore, been performed in accordance and in compliance with the World Medical Association Declaration of Helsinki (June 1964) and subsequent amendments. Meetings at which the paper has been presented: None. Corresponding author: Giorgio Giatsidis (* corresponding author), Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital - Harvard Medical School, 75 Francis St., Boston MA 02115, T: 617-525-7837, F: 617-730-2855, E: ggiatsidis@bwh.harvard.edu ©2018American Society of Plastic Surgeons

https://ift.tt/2PGWLeZ

Pretibial Lymphoplasmacytic Plaque in Children: Case Report and Review of the Literature

Abstract: An 8-year-old girl presented with a persistent 5 × 2-cm violaceous doughy plaque on the left lower leg. Histologic examination revealed hyperkeratosis, variable but mild epidermal hyperplasia, and vacuolar interface changes with melanin pigment incontinence confined to the papillary dermis. A diagnosis of pretibial lymphoplasmacytic plaque in children was made. This report outlines the clinical characteristics of this entity and a review of other cases reported in the literature. Correspondence: David N. Adam, MD, FRCPC, DABD, 95 Bayly Street West Suite G -02, Ajax, ON L1S 7K8, Canada (e-mail: dnadam@gmail.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Acquired Dermal Melanocytosis Associated With Diffuse Systemic Sclerosis in a White Patient

Abstract: We report a case of a 65-year-old man who developed an asymptomatic bluish spot that affected the flank and left lumbar region with the onset 10 years prior. He had a history of diffuse systemic sclerosis with anti-Scl-70–positive antibodies. The appearance of the skin lesion coincided with the onset of his disease. The skin biopsy was consistent with the diagnosis of acquired dermal melanocytosis. The relationship between the appearance of acquired pigmented macules and spots and systemic sclerosis has been known for years, although it is an infrequent finding. Correspondence: Lidia Ossorio-García, MD, Department of Dermatology, Hospital Universitario Puerta del Mar, Ana de Viya Av, 21 Cadiz, Andalusia 11009, Spain (e-mail: lidia.osga@gmail.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2oLgYFm

Reflectance Confocal Microscopy Can Help the Dermatopathologist in the Diagnosis of Challenging Skin Lesions

Abstract: Despite the successful assignment of Current Procedural Terminology codes, there are barriers to incorporating in vivo reflectance confocal microscopy (RCM) into daily practice. Importantly, the dermatopathologist can play a key role in interpreting RCM images and can use these images to correlate with histopathology. Herein, we describe, using a case series, how RCM can be incorporated into the dermatopothalogist's practice. We also summarize the criteria for RCM diagnosis of common neoplasms. Correspondence: Jane M. Grant-Kels, MD, UCONN Dermatology Department, 21 South Road, Farmington, CT 06032 (e-mail: grant@uchc.edu). H. Rabinovitz and M. Oliviero have received honoraria in the past from Caliber, the company that produces RCM. J.M. Grant-Kels and H. Rabinovitz have also received equipment in the past from Caliber. There were no payments for conducting or publicizing this study. The remaining authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2PK35md

Hypopigmented Interface T-Cell Dyscrasia and Hypopigmented Mycosis Fungoides: A Comparative Study

Abstract: Hypopigmented interface T-cell dyscrasia (HITCD) is a distinct form of lymphoid dyscrasia that may progress to hypopigmented mycosis fungoides (HMF). We compared both diseases as regards their CD4/CD8 phenotype and expression of granzyme B and tumor necrosis factor-alpha (TNF-α) and how these are affected by narrow-band UVB (nb-UVB). The study included 11 patients with HITCD and 9 patients with HMF. They received nb-UVB thrice weekly until complete repigmentation or a maximum of 48 sessions. Pretreatment and posttreatment biopsies were stained using anti CD4, CD8, TNF-α, and granzyme B monoclonal antibodies. Epidermal lymphocytes were CD8 predominant in 54.5% and 66.7% of HITCD and HMF cases, respectively, whereas dermal lymphocytes were CD4 predominant in 63.6% and 66.7%, respectively. Significantly, more dermal infiltrate was encountered in HMF (P = 0.041). In both diseases, granzyme B was only expressed in the dermis, whereas TNF-α was expressed both in the epidermis and dermis. No difference existed as regards the number of sessions needed to achieve repigmentation or cumulative nb-UVB dose reached at end of study. (P > 0.05). Narrow-band UVB significantly reduced only the epidermal lymphocytes in both diseases (P ≤ 0.05) with their complete disappearance in 8 (72.7%) HITCD and 6 (66.7%) HMF cases. In both diseases, nb-UVB did not affect granzyme B or TNF-α expression (P > 0.05). In conclusion, both diseases share the same phenotype, with HITCD being a milder form of T-cell dysfunction. In both diseases, epidermal lymphocytes are mainly CD8+-exhausted cells lacking cytotoxicity, whereas dermal cells are mostly reactive cells exerting antitumor cytotoxicity. Tumor necrosis factor-alpha mediates hypopigmentation in both diseases and prevents disease progression. Repigmentation after nb-UVB in both diseases occurs before and independently from disappearance of the dermal infiltrate. Correspondence: Mona R. E. Abdel-Halim, MD, Dip Dermpath (ICDP-UEMS), Dermatology Department, Cairo University, Kasr Al Aini Street, Cairo 11562, Egypt (e-mail: abdelhalimmona@gmail.com). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2oLsHDK

Refractory Hand Dermatitis With Massive Thumb Enlargement

No abstract available

https://ift.tt/2NS7frC

Alveolar Soft-Part Sarcoma of the Tongue

Abstract: Alveolar soft-part sarcoma is a rare neoplasm of unknown histogenesis that accounts for less than 1% of all soft-tissue sarcomas. The tumor is highly vascularized with small vascular spaces separating nests of cells, and from cytogenetic point of view, is characterized by chromosome rearrangement der(17)t(X:17)(p11:q25) that results in the ASPL-TFE3 translocation. It can occur at any age, but it is most common between 15 and 35 years of age. The prognosis is poor, despite the relatively slow growth of the tumor. We present here an atypical case of alveolar soft-part sarcoma in which the age of the patient, the location, and the histopathologic characteristics of the lesion represented a diagnostic challenge. Correspondence: Luis Requena, MD, Department of Dermatology, Fundación Jiménez Díaz, Avenida Reyes Católicos 2, 28040 Madrid, Spain (e-mail: lrequena@fjd.es). V. Alegría-Landa and V. Lora have contributed equally in the performance of this article. The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2oLsu3q

Differentiated vulvar intraepithelial neoplasia (dVIN): the most helpful histological features and the utility of cytokeratins 13 and 17

Abstract

Differentiated vulvar intraepithelial neoplasia (dVIN) is the precursor lesion of HPV-negative vulvar squamous cell carcinoma (VSCC). The histopathological diagnosis of dVIN can be challenging, as it often resembles vulvar non-neoplastic epithelial disorders (NNED), especially lichen sclerosus (LS). We aimed to establish the most specific and reproducible histological features of dVIN and assessed cytokeratin 13 (CK13) and cytokeratin 17 (CK17) immunohistochemistry as a diagnostic aid. Consecutive cases of dVIN (n = 180) and LS (n = 105) from the period 2010 to 2013 were reviewed using a checklist of histological features. Each feature was recorded as 'present' or 'absent' and statistical comparison (dVIN vs LS) was made. Interobserver agreement between two pairs of pathologists was assessed for a subset of cases of dVIN (n = 31) and LS and other NNED (n = 23). Immunohistochemistry with CK13, CK17, MIB1 and p53 was performed on dVIN, LS, and other NNED cases. Macronucleoli, features of disturbed maturation and angulated nuclei were significantly more common in dVIN than LS (p < 0.001). We found 'substantial agreement' for the diagnosis of dVIN (κ = 0.71). Macronucleoli and deep keratinisation had the highest agreement. In dVIN, the mean percentage of cells staining with CK13 was 15 and with CK17, this was 74. For LS, the mean percentage of cells staining with CK13 was 31, and with CK17, this was 41. By plotting receiver operating characteristic curves (ROC), an area under the curve (AUC) of 0.52 was obtained for CK13, and an AUC of 0.87 was obtained for CK17. The most helpful histological features for diagnosing dVIN were macronucleoli, features of disturbed maturation, and angulated nuclei. Increased CK17 expression may have promise for supporting dVIN diagnosis.

https://ift.tt/2MS4Y3d

Novel KHDRBS1-NTRK3 rearrangement in a congenital pediatric CD34-positive skin tumor: a case report

Abstract

Cutaneous spindle-cell neoplasms in adults as well as children represent a frequent dilemma for pathologists. Along this neoplasm spectrum, the differential diagnosis with CD34-positive proliferations can be challenging, particularly concerning neoplasms of fibrohistiocytic and fibroblastic lineages. In children, cutaneous and superficial soft-tissue neoplasms with CD34-positive spindle cells are associated with benign to intermediate malignancy potential and include lipofibromatosis, plaque-like CD34-positive dermal fibroma, fibroblastic connective tissue nevus, and congenital dermatofibrosarcoma protuberans. Molecular biology has been valuable in showing dermatofibrosarcoma protuberans and infantile fibrosarcoma that are characterized by COL1A1-PDGFB and ETV6-NTRK3 rearrangements respectively. We report a case of congenital CD34-positive dermohypodermal spindle-cell neoplasm occurring in a female infant and harboring a novel KHDRBS1-NTRK3 fusion. This tumor could belong to a new subgroup of pediatric cutaneous spindle-cell neoplasms, be an atypical presentation of a plaque-like CD34-positive dermal fibroma, of a fibroblastic connective tissue nevus, or represent a dermatofibrosarcoma protuberans with an alternative gene rearrangement.

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Effect of intravitreal dexamethasone on macular edema in von Hippel-Lindau disease assessed using swept-source optical coherence tomography: a case report

Von Hippel-Lindau disease is a rare hereditary syndrome caused by germinal mutations in a von Hippel-Lindau tumor-suppressing gene. Retinal hemangioblastoma is the ocular hallmark lesion of von Hippel-Lindau d...

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Sudden death after valve-in-valve procedure due to delayed coronary obstruction: a case report

Valve-in-valve transcatheter aortic valve implantation for degenerated aortic bioprostheses is an effective option for patients at high risk for redo surgery, even if it may be burdened by complications more c...

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Obesity, Visceral Fat, and Hypertension-Related Complications

Metabolic Syndrome and Related Disorders, Ahead of Print.

https://ift.tt/2Q8nqCw

Can the Plasma Concentration Ratio of Triglyceride/High-Density Lipoprotein Cholesterol Identify Individuals at High Risk of Cardiovascular Disease During 40-Year Follow-Up?

Metabolic Syndrome and Related Disorders, Ahead of Print.

https://ift.tt/2M2FMBU

Determining Factors of Arterial Stiffness in Subjects with Metabolic Syndrome

Metabolic Syndrome and Related Disorders, Ahead of Print.

https://ift.tt/2Q9SyS2

Predictive Value of Lipid Accumulation Product, Fatty Liver Index, Visceral Adiposity Index for Metabolic Syndrome According to Menopausal Status

Metabolic Syndrome and Related Disorders, Ahead of Print.

https://ift.tt/2wKJ32T

Variation in the Plasma Levels of Polyunsaturated Fatty Acids in Control vis-à-vis Nonalcoholic Fatty Liver Disease Subjects and Its Possible Association with Gut Microbiome

Metabolic Syndrome and Related Disorders, Volume 16, Issue 7, Page 329-335, September 2018.

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NASH in Nondiabetic Endocrine Disorders

Metabolic Syndrome and Related Disorders, Volume 16, Issue 7, Page 315-320, September 2018.

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An acral papulovesicular eruption

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2PJV2px

An acral papulovesicular eruption

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2PJV2px

Awake Craniotomy During Pregnancy

No abstract available

https://ift.tt/2wM9mXk

Macroglossia During Awake Craniotomy: A Near Miss

No abstract available

https://ift.tt/2wMj5w6

Ketamine and Electroconvulsive Therapy for Depression

No abstract available

https://ift.tt/2wLGkHq

An Unusual Presentation of Tapia Syndrome Mimicking a Partial Wallenberg Syndrome Following Anterior Cervical Spine Surgery

No abstract available

https://ift.tt/2ClfMBS

Perioperative Care for Pediatric Patients With Penetrating Brain Injury: A Review

Traumatic brain injury (TBI) continues to be the leading cause of death and acquired disability in young children and adolescents, due to blunt or penetrating trauma, the latter being less common but more lethal. Penetrating brain injury (PBI) has not been studied extensively, mainly reported as case reports or case series, due to the assumption that both types of brain injury have common pathophysiology and consequently common management. However, recommendations and guidelines for the management of PBI differ from those of blunt TBI in regards to neuroimaging, intracranial pressure (ICP) monitoring, and surgical management including those pertaining to vascular injury. PBI was one of the exclusion criteria in the second edition of guidelines for the acute medical management of severe TBI in infants, children, and adolescents that was published in 2012 (it is referred to as "pediatric guidelines" in this review). Many reviews of TBI do not differentiate between the mechanisms of injury. We present an overview of PBI, its presenting features, epidemiology, and causes as well as an analysis of case series and the conclusions that may be drawn from those and other studies. More clinical trials specific to penetrating head injuries in children, focusing mainly on pathophysiology and management, are needed. The term PBI is specific to penetrating injury only, whereas TBI, a more inclusive term, describes mainly, but not only, blunt injury.

https://ift.tt/2wQF5qp

Journal Club

No abstract available

https://ift.tt/2CnSxXT

Anesthesia for Same Day Discharge After Craniotomy: Review of a Single Center Experience

Same day discharge or outpatient surgery for intracranial procedures has become possible with the advent of image-guided minimally invasive approaches to surgery and availability of short-acting anesthetic agents. In addition, patient satisfaction and the benefits of avoiding hospital stay have resulted in the evolution of neurosurgical day surgery. We reviewed our experience and the available literature to determine the perioperative factors involved which have promoted and will improve this concept in the future. Craniotomy and biopsy for supratentorial brain tumors and surgical clipping of intact cerebral aneurysms have been successfully performed as day surgeries. Patient perceptions and satisfaction surveys have helped in better understanding and delivery of care and successful outcomes. There are major differences in health care across the globe along with socioeconomic, medicolegal, and ethical disparities, which must be considered before widespread application of this approach. Nevertheless, collaborative effort by surgeons, anesthesiologists, and nurses can help in same day discharge of patients after cranial neurosurgery.

https://ift.tt/2oHciQu

Toxic Epidermal Necrolysis in a Neurosurgical Patient

No abstract available

https://ift.tt/2CnStaB

Ketamine Anesthesia Does Not Improve Depression Scores in Electroconvulsive Therapy: A Randomized Clinical Trial

Background: Although interest in ketamine use during electroconvulsive therapy (ECT) has increased, studies have been equivocal with regard to its efficacy. The aims of this clinical trial were to evaluate ketamine's antidepressive effects in ECT as a primary anesthetic, determine ketamine's tolerability when compared with standard anesthesia, and determine if plasma brain-derived neurotrophic factor (BDNF) is necessary for treatment response. Materials and Methods: Adults meeting criteria for treatment-resistant depression undergoing index course ECT received either methohexital (1 to 2 mg/kg) or ketamine (1 to 2 mg/kg) anesthesia in this dual-arm double-blinded randomized clinical trial (NCT02752724). The primary outcome of this study is change in depression questionnaire scores before and after ECT. Seizure data, depression severity using self-reported and clinician-assessed questionnaires, cognitive scoring, and plasma BDNF concentrations were obtained before and after completion of ECT. Results: There were no differences in seizure lengths, hemodynamics, or seizure stimuli between the ketamine (n=23;138 ECTs) and methohexital (n=27;159 ECTs) groups. Depression scores improved similarly after ECT in both groups. In the methohexital group, 15% of patients failed to achieve adequate seizures and were switched to ketamine and 26% were converted to bilateral ECT stimulus, whereas all ketamine patients achieved adequate seizures and only 4% required bilateral stimulus. Plasma BDNF increased after ECT only in the ketamine group. Conclusions: Our data show that ketamine does not significantly improve depression when compared with methohexital as a single induction agent for ECT, increases serum BDNF and does not increase rates of post-ECT agitation. Ketamine use in ECT may have some benefits for some patients that are not captured through standard depression assessment questionnaires alone.

https://ift.tt/2oHchMq

High Flow Nasal Cannula, A Novel Approach to Airway Management in Awake Craniotomies

No abstract available

https://ift.tt/2wNxnwn

Cerebral Oxygen Saturation During Electroconvulsive Therapy: A Secondary Analysis of a Randomized Crossover Trial

Background: Electroconvulsive therapy (ECT) causes acute changes in cerebral perfusion and oxygenation. Near-infrared spectroscopy is a novel, noninvasive technique to assess cerebral oxygen saturation (cSO2). We hypothesized that cSO2 increases during ECT and more so with atropine premedication and decreases when systemic desaturation (peripheral oxygen saturation 60% at any measured time point, even in those with systemic desaturation. Conclusions: ECT increased cSO2 irrespective of atropine premedication. cSO2 was lower when systemic desaturation occurred. Future studies should explore the effect of cerebral oxygenation changes during ECT on outcome of psychiatric conditions.

https://ift.tt/2oHbJWS

The Old and the New: An Enhanced Vision for JNA

No abstract available

https://ift.tt/2wJCBJD

Red Cell Distribution Width After Subarachnoid Hemorrhage

Background: High red cell distribution width (RDW) values have been associated with increased hospital mortality in critically ill patients, but few data are available for subarachnoid hemorrhage (SAH). Methods: We analyzed an institutional database of adult (>18 y) patients admitted to the Department of Intensive Care after nontraumatic SAH between January 2011 and May 2016. RDW (normal value, 10.9% to 13.4%) was obtained daily from admission for a maximum of 7 days, from routine blood analysis. We recorded the occurrence of delayed cerebral ischemia (DCI), and neurological outcome (assessed using the Glasgow Outcome Scale [GOS]) at 3 months. Results: A total of 270 patients were included (median age 54 y—121/270 male [45%]), of whom 96 (36%) developed DCI and 109 (40%) had an unfavorable neurological outcome (GOS, 1 to 3). The median RDW on admission was 13.8 [13.3 to 14.5]% and the highest value during the intensive care unit (ICU) stay 14.2 [13.6 to 14.8]%. The RDW was high (>13.4%) in 177 patients (66%) on admission and in 217 (80%) at any time during the ICU stay. Patients with a high RDW on admission were more likely to have an unfavorable neurological outcome. In multivariable regression analysis, older age, a high WFNS grade on admission, presence of DCI or intracranial hypertension, previous neurological disease, vasopressor therapy and a high RDW (OR, 1.1618 [95% CI, 1.213-2.158]; P=0.001) during the ICU stay were independent predictors of unfavorable neurological outcome. Conclusions: High RDW values were more likely to result in an unfavorable outcome after SAH. This information could help in the stratification of SAH patients already on ICU admission.

https://ift.tt/2wOWsb5

Journal Club

No abstract available

https://ift.tt/2CnS5c9

Safety Outcomes Following Spine and Cranial Neurosurgery: Evidence From the National Surgical Quality Improvement Program

Background: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was used to establish predictors for 30-day postoperative complications following spine and cranial neurosurgery. Materials and Methods: The ACS-NSQIP participant use files were queried for neurosurgical cases between 2005 and 2015. Prevalence of postoperative complications following neurosurgery was determined. Nested multivariable logistic regression analysis was used to identify demographic, comorbidity, and perioperative characteristics associated with any complication and mortality for spine and cranial surgery. Results: There were 175,313 neurosurgical cases (137,029 spine, 38,284 cranial) identified. A total of 23,723 (13.5%) patients developed a complication and 2588 (1.5%) patients died. Compared with spine surgery, cranial surgery had higher likelihood of any complication (22.2% vs. 11.1%; P

https://ift.tt/2oHbCuq

MRI Sedation for Patient With Spinal Myoclonus

No abstract available

https://ift.tt/2CoGpGl

Effects of Transcutaneous Electrical Acupoint Stimulation on the Stress Response During Extubation After General Anesthesia in Elderly Patients Undergoing Elective Supratentorial Craniotomy: A Prospective Randomized Controlled Trial

Background: Elderly patients have an increased risk of a stress response during extubation after general anesthesia. In this study, we aimed to investigate whether transcutaneous electrical acupoint stimulation (TEAS) might decrease the stress response and improve the quality of recovery in elderly patients after elective supratentorial craniotomy. Materials and Methods: In this prospective randomized controlled study, patients were randomly assigned to either a TEAS group (n=37) or a control group (n=38). The primary outcomes were the hemodynamic parameters and plasma concentrations of epinephrine, norepinephrine, and cortisol. The secondary outcome included the consumption of remifentanil and propofol, time to extubation and reorientation, extubation quality score, postoperative quality of recovery, and postoperative complications. Results: Compared with the control group, hemodynamic parameters and plasma concentrations of epinephrine, norepinephrine, and cortisol during extubation were decreased in the TEAS group. TEAS reduced the consumption of remifentanil (P

https://ift.tt/2oLe4QR

Simultaneous Surgical Decompression of Bilateral Subdural Hematoma and an Administration of Epidural Blood Patch for Spontaneous Intracranial Hypotension

No abstract available

https://ift.tt/2wKYW9M

Hemodynamic Instability and Cardiovascular Events After Traumatic Brain Injury Predict Outcome After Artifact Removal With Deep Belief Network Analysis

Background: Hemodynamic instability and cardiovascular events heavily affect the prognosis of traumatic brain injury. Physiological signals are monitored to detect these events. However, the signals are often riddled with faulty readings, which jeopardize the reliability of the clinical parameters obtained from the signals. A machine-learning model for the elimination of artifactual events shows promising results for improving signal quality. However, the actual impact of the improvements on the performance of the clinical parameters after the elimination of the artifacts is not well studied. Materials and Methods: The arterial blood pressure of 99 subjects with traumatic brain injury was continuously measured for 5 consecutive days, beginning on the day of admission. The machine-learning deep belief network was constructed to automatically identify and remove false incidences of hypotension, hypertension, bradycardia, tachycardia, and alterations in cerebral perfusion pressure (CPP). Results: The prevalences of hypotension and tachycardia were significantly reduced by 47.5% and 13.1%, respectively, after suppressing false incidents (P=0.01). Hypotension was particularly effective at predicting outcome favorability and mortality after artifact elimination (P=0.015 and 0.027, respectively). In addition, increased CPP was also statistically significant in predicting outcomes (P=0.02). Conclusions: The prevalence of false incidents due to signal artifacts can be significantly reduced using machine-learning. Some clinical events, such as hypotension and alterations in CPP, gain particularly high predictive capacity for patient outcomes after artifacts are eliminated from physiological signals.

https://ift.tt/2wNG1vL

Scalp Block: Tool for Diagnosis in Postoperative Headache of Unknown Origin

No abstract available

https://ift.tt/2CpLWwp

An unusual case of melanocytic matricoma in a young pregnant woman

Australasian Journal of Dermatology, EarlyView.

https://ift.tt/2NQmi55

An unusual case of melanocytic matricoma in a young pregnant woman

Australasian Journal of Dermatology, EarlyView.

https://ift.tt/2NQmi55

Aus der Gutachtenpraxis: Überdosierung eines topischen α-Sympathomimetikums – ein Behandlungsfehler

Laryngo-Rhino-Otol 2018; 97: 639-640
DOI: 10.1055/a-0652-6199

Article in Thieme eJournals:
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Kommentar der Schriftleitung

Laryngo-Rhino-Otol 2018; 97: 596-597
DOI: 10.1055/a-0652-6144

Article in Thieme eJournals:
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Endoskopische Sinuschirurgie: Checkliste hilft Problemfälle vorab zu entdecken

Laryngo-Rhino-Otol 2018; 97: 600-601
DOI: 10.1055/a-0621-1877

Error M et al. Single-Blinded Prospective Implementation of a Preoperative Imaging Checklist for Endoscopic Sinus Surgery. Otolaryngol Head Neck Surg 2018; 158: 177–180 Amerikanische HNO-Ärzt/innen untersuchten, ob die Einführung einer präoperativen radiologischen Checkliste die Identifizierung von kritischen Variationen in der Anatomie der Nasennebenhöhlen bei Patienten verbessert, die sich einer endoskopischen Sinuschirurgie unterziehen.
[...]

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Fehlbildungschirurgie von Nase und Lippe

Laryngo-Rhino-Otol 2018; 97: 652-654
DOI: 10.1055/a-0652-6254

Article in Thieme eJournals:
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Penetration/Aspiration bei gesunden Erwachsenen: ein unterschätztes Phänomen?

Laryngo-Rhino-Otol 2018; 97: 601-602
DOI: 10.1055/a-0621-2095

Butler SG et al. Aspiration as a Function of Age, Sex, Liquid Type, Bolus Volume, and Bolus Delivery Across the Healthy Adult Life Span. Ann Otol Rhinol Laryngol 2018; 127: 21–32 Mittels funktioneller endoskopischer Schluck-Untersuchung (FEES) wurden Faktoren bestimmt, die im Verlauf des Erwachsenenlebens das Eindringen und die Aspiration während des Schluckens beeinflussen. Die amerikanischen HNO-Ärzt/innen vermuteten, dass bei gesunden Älteren ein höherer Fettgehalt in Flüssigkeiten, das Bolusvolumen, die Aufnahme mit einem Strohhalm, fortgeschrittenes Alter und männliches Geschlecht das Aspirationsrisiko erhöht.
[...]

Article in Thieme eJournals:
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Stents und Platzhalter in der endoskopischen endonasalen Nasennebenhöhlenchirurgie

Laryngo-Rhino-Otol 2018; 97: 606-614
DOI: 10.1055/a-0646-4223

In der endonasalen endoskopischen Chirurgie kam es im letzten Jahrzehnt zu Fortschritten durch ein verbessertes Verständnis der Mikroanatomie, den Zugewinn additiver medikamentöser Therapieoptionen und die Optimierung der instrumentellen Technik. In den gleichen Kontext kann die Weiterentwicklung und Beforschung röhrenförmiger oder solider Platzhalter („stents" oder „spacer") mit und ohne simultane Freisetzung von Medikamenten gestellt werden – der vorliegende Übersichtsbeitrag stellt den aktuellen Stand dieser Entwicklungen vor.
[...]

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Strategien zur Vermeidung von Burnout bei Ärzten

Laryngo-Rhino-Otol 2018; 97: 603-603
DOI: 10.1055/a-0656-9290

West CP. Dyrbye LN. Erwin PJ. et al. Interventions to prevent and reduce physian burn out: A systematic review and metaanalysis. Lancet 2016; 388: 2273 – 2281 Burnout wird von der Psychologin C. Marflach definiert als Zustand, in dem Ärzte eine Erosion an Werten, Würde, Geist und Motivation in ihrer Arbeit erleben. Die dabei auftretende sogenannte Depersonalisation meint eine zynische Grundhaltung und fehlende innere Verbindung zum Inhalt der Medizin, dem Wohl der Patienten.
[...]

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Fragen für die Facharztprüfung

Laryngo-Rhino-Otol 2018; 97: 650-651
DOI: 10.1055/a-0652-6210

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Allergiediagnostik mit dem Pricktest

Laryngo-Rhino-Otol 2018; 97: 604-605
DOI: 10.1055/a-0652-6177

Article in Thieme eJournals:
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Die minimal-invasive Cochlea-Implantation – Chirurgische Machbarkeit und erste klinische Erfahrungen

Laryngo-Rhino-Otol
DOI: 10.1055/a-0671-2233

Hintergrund: In den vergangenen Jahren wurden die Indikationen zur Cochleaimplantation ausgeweitet und gleichzeitig schonendere operative Vorgehensweisen entwickelt. Methoden und Patienten: Das hier vorgestellte und von uns entwickelte Verfahren kombiniert eine verkürzte retroauriculäre Hautinzision von 25 mm Länge mit einer Reduzierung der Mastoidbohrung, der konsequenten Nutzung des Rundfensterzugangs und der Bohrung einer temporalen Implantatmulde (sog. Bremer Zugang). In der vorliegenden Arbeit werden erste Erfahrungen und Ergebnisse mit einem minimal-invasiven Vorgehen (MiCI) bei n = 31Patienten im Alter zwischen 9–79 Jahren berichtet. Ergebnisse: Es gelang die Länge des retroauriculären Hautschnitts auf im Mittel 29,7 mm, die Fläche der Mastoidbohrung auf 20mm2 und die Verweildauer um 0,55 Tage zu reduzieren. Es zeigte sich eine signifikante Lernkurve bei der Verkürzung der OP-Zeiten (p < 0.03). Die Frequenz und Art der Komplikationen entsprach der eines konventionellen Vorgehens. Schlußfolgerung: Die minimal-invasive Cochleaimplantation ist eine zuverlässige und sichere Methode zur Implantatversorgung.
[...]

Article in Thieme eJournals:
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What is new in HIES? Recent insights from the interface of primary immune deficiency and atopy

Purpose of review Understanding the pathophysiology of monogenic primary immunodeficiency (PID) with atopic presentation has pivotal implications for intervention strategies and potentially wider polygenic atopic-related traits. This review will discuss advances in gene discovery arising from monogenic defects at the interface between PID and atopy, notably the hyper-IgE syndromes. Recent findings Key molecular pathways underlying development of primary atopic diseases have recently been proposed. We test this classification through reviewing novel genes reported in the last 2 years and compare insights from pathway-analysis of genome-wide association studies (GWAS) of atopic-related traits. Growing access to next-generation sequencing (NGS) has resulted in a surge in gene discovery, highlighting the utility and some pitfalls of this approach in clinical practice. The variability of presenting phenotypes reveals important gene-dosage effects. This has important implications for therapeutic strategies such as protein stabilization and modulators of JAK-STAT or TH2-cytokine signalling. We also consider the therapeutic implications raised by CARD11 deficiency, and wider applications of NGS including polygenic risk score in atopy. Summary Disorders presenting at the interface between PID and allergy are often difficult to diagnose, with serious consequences if missed. Application of NGS has already provided critical insights to pathways enabling targeted therapeutic interventions, and potential wider translation to polygenic disorders. Correspondence to Mark J. Ponsford, Immunodeficiency Centre for Wales, University Hospital of Wales; Cardiff University, Cardiff, UK. E-mail: ponsfordm@cardiff.ac.uk Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.co-allergy.com). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Recognition of the peripheral airway impairment phenotype in well controlled asthmatic children

Although current National Asthma Education and Prevention Program (NAEPP) asthma guidelines1 have proven effective, a considerable number of children2 and adults3 experience poor asthma control. The peripheral airways defined as distal to the 7th or 8th generation of the tracheobronchial tree, with an intra-luminal diameter of < 2 mm4 are major sites of airway impairment including airway obstruction5 and inflammation6 in persistent asthma. Overall estimates determined peripheral impairment affects at least 50 percent of adults7, and children8 with persistent asthma.

https://ift.tt/2M2Dt1w

Comparison of comorbid diagnoses in children with and without eosinophilic esophagitis in a large population

Eosinophilic esophagitis (EoE) is a chronic immune-mediated inflammatory condition characterized by esophageal dysfunction with associated eosinophilic infiltration of the esophageal mucosa, occurring in 1/2000 individuals.1,2 Since the 1990s, EoE has been recognized as a clinically distinct condition, being seen with increasing incidence and prevalence over time, and currently accounting for the most common cause of chronic dysphagia in pediatric patients in the developed world.3-6 The pathophysiology is frequently recognized as a food allergy-driven process, characterized by a TH2-type immune response, with a high rate of concomitant IgE-mediated food allergy observed in patients.

https://ift.tt/2QdgHrc

Updated Guidelines on Complex Regional Pain Syndrome in Adults

A multidisciplinary team representing 28 professional bodies has updated the guidelines for the management of Complex regional Pain Syndrome (CRPS), published by the Royal College of Physicians of England (RCP) 2018. The author represented the British Association of Plastic, Reconstructive and Aesthetic Surgeons in this process and is an author of the guidelines. This article summarises the updated guidelines and highlights aspects relevant to Plastic and Reconstructive Surgery.

https://ift.tt/2Q5o7wp

Septocutaneous thoracodorsal artery perforator flaps: a retrospective cohort study

This study aimed to investigate the versatility of septocutaneous thoracodorsal artery perforator flaps in various areas in the body and the running pattern of septocutaneous perforators.

https://ift.tt/2M0YwBK

Determining Post-Operative Outcomes After Cleft Palate Repair: A Systematic Review and Meta Analysis

A lack of high level evidence exists on the outcomes of different cleft palate repair techniques. A critical appreciation for the complication rates of common repair techniques is paramount to optimize cleft palate care.

https://ift.tt/2Q5nVNH

Comments on “Long-term outcome of patients with or without osseointegrated implants after resection of mandibular ameloblastoma and reconstruction with vascularized bone graft: Functional assessment and quality of life”

Dear editor:

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Stress-related hormones in association with periodontal condition in adolescents—results of the epidemiologic LIFE Child study

Abstract

Objectives

The aim of this study was to investigate the associations between blood levels of stress-related hormones and early signs of periodontal disease in children and adolescents.

Materials and methods

Within the LIFE (Leipzig research center for civilization diseases) Child study, 498 adolescents (10 to 18 years) were included. Early signs of periodontal inflammation were measured by probing depth (PD) at six index teeth (16, 11, 26, 36, 31, 46). Blood levels of stress-related hormones (cortisol, dehydroepiandosterone-sulfate [DHEA-S]) and, additionally interleukine-6 (IL-6) were measured. Socioeconomic status, oral hygiene, orthodontic appliances, and nutritional status, recorded by body-mass-index-standard-deviation-score (BMI-SDS), were considered as confounding factors. Additionally, in 98 participants, an oral chairside active matrix metalloproteinase-8 (aMMP-8) test was performed. Statistical tests are the Mann-Whitney U tests, chi-squared tests and multivariate logistic regression model.

Results

IL-6, BMI-SDS as well as positive aMMP-8 test result were significantly associated with maximum PD > 3 mm (p < 0.05). However, no statistically significant associations between stress-related hormones (cortisol and DHEA-S) and presence of maximum PD > 3 mm were found (p > 0.05). Higher DHEA-S and BMI were associated with positive aMMP-8 result, even after adjusting for age and gender (p = 0.027, p_adj = 0.026).

Conclusion

The results reveal no associations between PD and stress-related hormones cortisol and DHEA-S. aMMP-8 test result might be associated with DHEA-S level. Nutritional status seems to influence periodontal disease in adolescents.

Clinical relevance

DHEA-S and BMI-SDS show associations with early signs of periodontal disease in adolescents aged 10 to 18 years. This association should be confirmed by the investigation of high-risk groups.

https://ift.tt/2NRMwUM

Selenium application alters soil cadmium bioavailability and reduces its accumulation in rice grown in Cd-contaminated soil

Abstract

Selenium (Se) alleviates cadmium (Cd) accumulation in several plants. Nevertheless, it is still unclear why it has such effect. Thus, this study aimed to investigate the effects of Se on soil Cd bioavailability, and Cd accumulation in flooded rice plants, and to determine the mechanisms underlying these effects. Concentration of Cd and Se in different rice tissues was determined along Cd and Se concentrations in the soil solution and soil Cd fractions. Results showed that exogenous selenite and selenate treatments significantly increased rice grain Se by 4.25- and 2.39-fold and decreased Cd by 36.5% and 25.3% relative to control treatment, respectively. The addition of Se to Cd-contaminated soil significantly decreased total Cd concentration in the soil solution by 11.2–13.0%, increased soil pH by 0.06–0.32 units, and enhanced soil Cd immobilization in relation to control. Exogenous Se also reduced diethylenetriaminepentaacetic acid-Cd, exchangeable, and residual Cd but increased the levels of Cd bound to carbonate and iron and manganese oxides. Thus, amending Cd-contaminated soil with Se may help decrease Cd content as well as increase Se levels in rice grain, as Se may mitigate Cd accumulation in rice plants by increasing soil pH, reducing Cd bioavailability, and inhibiting Cd translocation from roots to shoots.

https://ift.tt/2CntiFh

A review on removal of siloxanes from biogas: with a special focus on volatile methylsiloxanes

Abstract

The occurrence of siloxanes is a major barrier to use of biogas as renewable energy source, and removal of siloxanes from biogas before combustion is needed. The siloxane can be transformed into silicon dioxide (SiO₂) through the combustion process in engine, which will be deposited on the spark plug, cylinder, and impeller to form the silica layer, causing the wear and damage of the engine parts, and shorten the life of the engine and affect the utilization efficiency of the biogas. This paper reviewed some methods and technologies for siloxanes removal from biogas. There are three commercial available technologies to remove siloxanes: adsorption, absorption, and cryocondensation. Other newer technologies with better prospects for development also have made a research progress, including membrane, catalysts, biotrickling filters. This work introduces the source and characterization of siloxanes in biogas, reviews the scientific progress of siloxanes removal, and discusses the development direction and further research of removal siloxanes.

https://ift.tt/2MMwQWp

Estimation of formaldehyde occupational exposure limit based on genetic damage in some Iranian exposed workers using benchmark dose method

Abstract

The present study evaluated an occupational exposure level for formaldehyde employing benchmark dose (BMD) approach. Dose–response relationship was determined by utilizing cumulative occupational exposure dose and DNA damage. Based on this goal, outcome of comet assay for some Iranian exposed people in occupational exposure individuals was used. In order to assess formaldehyde exposure, 53 occupationally exposed individuals selected from four melamine tableware workshops and 34 unexposed subjects as a control group were examined. The occupational exposure dose was carried out according to the NIOSH-3500 method, and the DNA damage was obtained by employing comet assay in peripheral blood cells. EPA Benchmark Dose Software was employed for calculating BMD and BMDL. Cumulative exposure dose of formaldehyde was between of 2.4 and 1972 mg. According to the findings of the current study, the induction of DNA damage in the exposed persons was increased tail length and tail moment (p < 0.001), when compared to controls. Finally, an acceptable dose–response relationship was obtained in three-category information between formaldehyde cumulative exposure doses and genetic toxicity. BMDL was 0.034 mg/m³ (0.028 ppm), corresponding to genetic damage of peripheral blood cells. It can be concluded that the occupational permissible limit in Iranian people could be at levels lower than OSHA standards.

https://ift.tt/2M0olSt

Evaluation of (–)-borneol derivatives against the Zika vector, Aedes aegypti and a non-target species, Artemia sp.

Abstract

Zika, dengue, and chikungunya are vector-borne diseases of pronounced concern transmitted by the mosquito Aedes aegypti Linn. (Diptera: Culicidae). The most important method to avoid outbreaks is to control mosquito spreading by the employment of insecticides and larvicides. Failure to control mosquito dispersal is mostly accounted to Ae. aegypti resistance to currently available larvicides and insecticides, encouraging the development of novel pesticides. In addition, the excessive use of larvicides poses serious threats to human health and the environment. Evaluation of natural products as larvicides in an attempt to overcome this situation is often found in the literature because products originated from nature are considered less toxic to non-target species and more eco-friendly. (–)-Borneol is a bicyclic monoterpene present in essential oils with moderate larvicidal activity. On account of these facts, it was of our interest to synthesize (–)-borneol ester derivatives aiming to study its structure-activity relationships against Ae. aegypti larvae. With the goal to estimate toxicity to a non-target species, evaluation of the lethal concentration 50% (LC₅₀) on Artemia sp. (Artemiidae) and calculation of selectivity towards Ae. aegypti were carried out. The most potent derivative, (–)-Bornyl chloroacetate, exhibited the highest suitability index, demonstrating lower environmental toxicity than other borneol ester derivatives. A parabolic relationship between (–)-borneol esters larvicidal activity and partition coefficient (Log P) was achieved and a correlation equation obtained, validating the importance of lipophilicity to the larvicidal activity of these compounds.

https://ift.tt/2NpsjsE

Pulse Pressure and Outcome in Kidney Transplantation: Results From the Collaborative Transplant Study

Background Systolic (SBP) and diastolic blood pressure (DBP) are important predictors of graft and patient survival in renal transplantation. Pulse pressure (PP), the difference between systolic and diastolic pressure, has been associated with cardiovascular and renal morbidity in nontransplant epidemiological studies and clinical trials. Methods In this large retrospective analysis of prospectively collected data, transplant recipients from 1995 to 2015 were examined for patient and death-censored graft survival. Results In 43 006 recipients a higher 1-year PP was significantly associated with inferior 10-year patient and death-censored graft survival. In patients aged ≥60 SBP but not DBP was associated with 10-year survival, an effect that was pronounced in patients with a normal SBP of

https://ift.tt/2wLAt48

Pulse Pressure: A Risk Factor for Renal Transplant Failure or a Useful Therapeutic Target?

No abstract available

https://ift.tt/2Q87Jvd

How Far can we Expand Donor Age Criteria for Pancreas Transplantation?

No abstract available

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Reply to “How Far can we Expand Donor Age Criteria for Pancreas Transplantation?”

No abstract available

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Commentary on Making a Case for the Use of Platelet-Rich Plasma in Cicatricial Alopecia

No abstract available

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Laser Ablation of the Recipient Area With Platelet-Rich Plasma–Enriched Epidermal Suspension Transplant in Vitiligo Surgery: A Pilot Study

BACKGROUND Noncultured epidermal cell suspension transplantation is a very popular surgical modality for treating vitiligo. However, the procedure can be modified to improve results. OBJECTIVE To study the extent of repigmentation with noncultured trypsinized fragmented epidermal suspension using platelet-rich plasma (PRP) as a suspending agent and pixel erbium yttrium aluminium garnet laser for ablation of recipient area in patients with stable vitiligo. MATERIALS AND METHODS Autologous noncultured tiny epidermal fragments suspended in PRP were grafted on superficially pixel erbium YAG laser-ablated vitiligo lesions in 10 patients. The repigmentation was evaluated over a period of 6 months using a digital image analysis system. RESULTS Repigmentation was observed as early as 2 weeks after the treatment. Of 20 lesions, 12 (60%) showed excellent response; of which 10 lesions (50%) showed complete repigmentation in 8 weeks only. There were no milia or keloid formation, donor-site scarring, stuck on appearance at recipient site or infection. CONCLUSION This study indicates that PRP-enriched epidermal suspension transplant (LA-PEEST) has the potential to improve the rate of healing and repigmentation in vitiligo patches. Further investigations and larger controlled trials are required to establish this technique as a rapid surgical method to restore pigmentation. Address correspondence and reprint requests to: Suruchi Garg, MD, Department of Dermatology, Aesthetic Surgery, and Intervention Dermatology, Aura Skin Institute, S.C.O. 44-45, First Floor, Madhya Marg, Sector 9-D, Chandigarh 160009, India, or e-mail: gargsuruchi01@gmail.com 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.

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Botulinum Toxin for Depression: More Than Skin Deep

No abstract available

https://ift.tt/2oI5q5p

Neurological and Ophthalmological Manifestations of Varicella Zoster Virus

Background: Approximately 1 million new cases of herpes zoster (HZ) occur in the United States annually, including 10%–20% with herpes zoster ophthalmicus (HZO). Postherpetic neuralgia, a debilitating pain syndrome occurs in 30% HZ, whereas 50% HZO develop ophthalmic complications. Diplopia from cranial nerve palsy occurs in less than 30% HZO, whereas optic neuropathy is seen in less than 1% HZO. We reviewed recent developments in the diagnosis, treatment, and prevention of HZ as well as neurological and ophthalmological complications of relevance to the neuro-ophthalmologist. Evidence Acquisition: We searched the English language literature on Pubmed and Google scholar for articles relevant to the various sections of this review. Results: Antiviral treatment should be initiated within 48–72 hours of onset of HZ and HZO to decrease pain and reduce complications. We recommend neuroimaging in all patients with neuro-ophthalmic manifestations such as diplopia and acute vision loss. Diagnostic confirmation using polymerase chain reaction and serology on paired serum and cerebrospinal fluid samples should be obtained in those with neurological signs and symptoms or abnormal imaging. Patients with neurological and/or retinal varicella zoster virus (VZV) infection should be treated promptly with intravenous acyclovir. Patients with isolated optic neuropathy or cranial nerve palsy can be managed with oral antivirals. The prognosis for visual recovery is good for patients with isolated optic neuropathy and excellent for patients with isolated ocular motor cranial nerve palsy. Conclusions: HZ produces a spectrum of potentially blinding and life-threatening complications that adversely affect quality of life and increase health care costs. Individuals at risk for HZ, such as the elderly and immunocompromised, should be encouraged to receive the highly effective VZV vaccine to prevent HZ and its complications. Address correspondence to Sachin Kedar, MD, Nebraska Medical Center, Omaha, NE 68198-8435; E-mail: sachin.kedar@unmc.edu S. Kedar, reports being a coinventor for the Advanced Pupil Simulator licensed by EON Reality Inc. J. R. Berger, grants from Biogen, during the conduct of the study; personal fees from Amgen, personal fees from Astra-Zeneca, personal fees from Janssen, personal fees from Millennium/Takeda, personal fees from Novartis, personal fees from Biogen, personal fees from Roche, personal fees from Genentech, personal fees from Genzyme/Sanofi, personal fees from Inhibikase, personal fees from Forward Pharma, personal fees from Johnson and Johnson, personal fees from Pfizer, and personal fees from Eisai, outside the submitted work. The remaining author reports no conflicts of interest. © 2018 by North American Neuro-Ophthalmology Society

https://ift.tt/2NRpk9f

Understanding Malignancies of the Thyroid Gland: Institutional Experience

Abstract

To study the epidemiological, pathological characters and determine survival in patients diagnosed of having thyroid gland malignancies. Retrospective chart review of patients having thyroid gland malignancies, which were managed by the two senior authors at our tertiary care institute from January 2000 to December 2006, were performed and evaluated in terms of various clinical, operative and histological parameters. Patients in which follow up of at least 10 years are available were included in the study. Survival was enquired telephonically in those patients who got cured and did not consent to come for follow up. Slides were reviewed. Statistical analysis was done using SPSS statistical software. Kaplan–Meier method was used for calculating survival. A total of 182 patients were included in the study. Papillary carcinoma was the commonest malignant lesion with a frequency of 87.91% followed by follicular carcinoma (7.69%), medullary carcinoma (3.29%) and anaplastic carcinoma (1.09%). Female predominance was seen (F:M–5.06:1). The 5 year and 10 year survival rates were 89% and 73% respectively. The most common postoperative squeal was transient hypocalcaemia, seen in (27/182) 15% patients which was followed by permanent hypocalcaemia 16/182 (8.79%), transient recurrent laryngeal nerve paresis 12/182 (6.59%) and permanent recurrent laryngeal nerve palsy 8/182 (4.39%). Thyroid malignancies affect all age groups and have good long term prognosis. Management yields promising results and hence early and adequate treatment is emphasized.

https://ift.tt/2Q7fSjq

Otoprotective Effects of Stephania tetrandra S. Moore Herb Isolate against Acoustic Trauma

Abstract

Noise is the most common occupational and environmental hazard, and noise-induced hearing loss (NIHL) is the second most common form of sensorineural hearing deficit. Although therapeutics that target the free-radical pathway have shown promise, none of these compounds is currently approved against NIHL by the United States Food and Drug Administration. The present study has demonstrated that tetrandrine (TET), a traditional Chinese medicinal alkaloid and the main chemical isolate of the Stephania tetrandra S. Moore herb, significantly attenuated NIHL in CBA/CaJ mice. TET is known to exert antihypertensive and antiarrhythmic effects through the blocking of calcium channels. Whole-cell patch-clamp recording from adult spiral ganglion neurons showed that TET blocked the transient Ca²⁺ current in a dose-dependent manner and the half-blocking concentration was 0.6 + 0.1 μM. Consistent with previous findings that modulations of calcium-based signaling pathways have both prophylactic and therapeutic effects against neural trauma, NIHL was significantly diminished by TET administration. Importantly, TET has a long-lasting protective effect after noise exposure (48 weeks) in comparison to 2 weeks after noise exposure. The otoprotective effects of TET were achieved mainly by preventing outer hair cell damage and synapse loss between inner hair cells and spiral ganglion neurons. Thus, our data indicate that TET has great potential in the prevention and treatment of NIHL.

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Deep vs. moderate neuromuscular blockade during laparoscopic surgery: A systematic review and meta-analysis

BACKGROUND Previous studies have reported that deep neuromuscular block (posttetanic-count 1 to 2 twitches) improves surgical conditions during laparoscopy compared with moderate block (train-of-four count: 1 to 2 twitches). However, comparisons of surgical conditions were made using different scales and assessment intervals with variable results. OBJECTIVE To explore the heterogeneity of previous comparisons between deep and moderate neuromuscular block. DESIGN Systematic review and meta-analysis of randomised controlled trials (RCTs). DATA SOURCES Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched from inception to October 2017. ELIGIBILITY CRITERIA Our meta-analysis included RCTs comparing the effects of deep with moderate neuromuscular block on surgical field conditions during laparoscopic surgery. The frequency of excellent or good operating conditions on a surgical rating scale was compared. Heterogeneity was assessed by subgroup analyses. RESULTS Eleven RCTs involving 844 patients were included. On the surgical rating scale, the frequency of excellent or good operating conditions was higher with deep block compared with a moderate block (odds ratio 2.83, 95% confidence interval 1.34 to 5.99, P = 0.007, I2 = 59%). We analysed surgical rating according to the number of assessments made. There was a significant difference in surgical rating with multiple assessments, but no difference when the assessment was made on only one occasion. A significant difference in rating was noted with variable abdominal pressures; there was no significant difference with the same fixed abdominal pressure. Trial sequential analysis demonstrated that the cumulative z-curve crossed the O′Brien–Fleming significance boundary. However, required information size was not achieved. CONCLUSION Deep block was associated with excellent or good surgical rating more frequently than moderate block. However, this finding was not consistent on subgroup analyses based on frequencies of assessment of surgical conditions and abdominal pressure. Further studies are required to address the heterogeneity and power shortage demonstrated by the trial sequential analysis. Correspondence to Won Ho Kim, MD, PhD, Department of Anesthesiology and Pain Medicine, Institute of the Research of the Perioperative Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea Tel: +82 2 2072 2462; fax: +82 2 747 5639; e-mail: wonhokim.ane@gmail.com Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (https://ift.tt/2ylyqmW). © 2018 European Society of Anaesthesiology

https://ift.tt/2wLuQD1

Deep vs. moderate neuromuscular blockade during laparoscopic surgery: A systematic review and meta-analysis

Otoprotective Effects of Stephania tetrandra S. Moore Herb Isolate against Acoustic Trauma

Abstract

https://ift.tt/2Co52CW

Understanding Malignancies of the Thyroid Gland: Institutional Experience

Abstract

https://ift.tt/2Q7fSjq

Treatment of Refractory Granuloma Faciale With Intralesional Rituximab

This case series describes the results of intralesional rituximab treatment in men with granuloma faciale.

https://ift.tt/2PGOmYX

Necrotic Plaque on the Distal Nose With Diffuse Crateriform Nodules

A man in his 30s presented with a progressively necrotic plaque on the nose, scattered nodules on the extremities, and erythematous papules on the arms and legs. What is your diagnosis?

https://ift.tt/2NfxBa1

Complementary and Alternative Medicine Therapies for Psoriasis

This systematic review summarizes the evidence on the efficacy of the most studied complementary and alternative medicine therapies for treatment of plaque psoriasis and discusses those treatments with the most robust available evidence.

https://ift.tt/2PGOlUT

Predictions, Surprises, and the Future of the Dermatology Workforce

With the debut of managed care in the 1980s, experts in the physician workforce portended an impending surplus of specialist physicians, including dermatologists. Despite these dire predictions, a dermatology workforce shortage was identified in the late 1990s, with an associated geographical imbalance. Since then, the overall shortage has only modestly abated, so it would not be surprising to find that an urban-rural workforce maldistribution has persisted. Indeed, in this issue of JAMA Dermatology, Feng and colleagues present physician data from 1995 to 2013 demonstrating that the maldistribution of dermatologists may well have worsened. They show an overall increase in density of dermatologists but a widening gap between metropolitan vs nonmetropolitan and rural communities. Additionally, the ratio of younger compared with older dermatologists (using a cutoff of age 55 years, the approximate mean physician age in the United States) increased in urban settings and simultaneously decreased in rural settings, a distribution that may cause this gap to grow.

https://ift.tt/2MQgvjC

Comparison of Dermatologist Density Between Urban and Rural Counties in the United States

This study analyzes county-level data from nationwide US data to compare dermatologist density between urban and rural areas.

https://ift.tt/2NPkTf5

Laser Treatment Performed Decades After Napalm Burns

This case report describes the use of laser treatment beginning in 2015 to treat napalm burns sustained by the famous Vietnamese "Napalm Girl" in 1972.

https://ift.tt/2MSEkHx

Detection of Glycemia and Osmolarity Changes Using Eye Examinations

Metabolic Syndrome and Related Disorders, Ahead of Print.

https://ift.tt/2wH9gQT

The role of ADAMTS4 and ADAMTS9 in cardiovascular disease in premature ovarian insufficiency and idiopathic hypogonadotropic hypogonadism

Abstract

Purpose

We aimed to determine the relation of a disintegrin and metalloproteinase with thrombospondin motifs-4 (ADAMTS4), and a disintegrin and metalloproteinase with thrombospondin motifs-9 (ADAMTS9) with cardiovascular disease (CVD) risk, in ovarian dysfunction patients with premature ovarian insufficiency (POI), and idiopathic hypogonadotropic hypogonadism (IHH).

Methods

43 IHH and 44 POI patients were enrolled to this case–control study. Serum hormonal parameters, lipid profiles, ADAMTS4 and ADAMTS9 levels were measured. Lipid accumulation product (LAP) index, visceral adiposity index (VAI), and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. The patients with at least two out of the four following criteria were accepted to have increased CVD risk; waist-to-hip ratio (WHR) ≥ 0.8, waist circumference (WC) ≥ 79 cm, triglycerides (TG) ≥ 150 mg/dL, high-density lipoprotein cholesterol (HDL-C) < 50 mg/dL. Serum ADAMTS4 and ADAMTS9 levels were measured by enzyme-linked immunosorbent assay (ELISA).

Results

ADAMTS4 and ADAMTS9 levels were significantly higher in the IHH group than the POI group (p = 0.002, and p = 0.013, respectively). IHH group had significantly higher levels of insulin, HOMA-IR index, and LAP index (p = 0.006, p = 0.005, and p = 0.013, respectively). The mean age of patients in the IHH group (23.60 ± 5.64 years) was significantly lower than the POI group (31.05 ± 6.03 years), (p < 0.001). Odds ratios (OR) were 1.236 (95% CI 1.055–1.447) and 1.002 (95% CI 1.000–1.004) for LAP index and ADAMTS4, respectively, in the IHH group. These two parameters found to have high predictivity for CVD risk in the IHH group (p = 0.009 and p = 0.028, respectively).

Conclusion

The lower levels of ADAMTS4 in the POI group, when compared with the IHH patients pointed out that even limited hormone secretion and ovulation in the POI group, may have protective effect on cardiovascular system. The higher levels of ADAMTS4 and LAP index in the IHH group demonstrated the increased risk of these patients for CVD.

https://ift.tt/2oHDfnp

Blimp-1, a negative regulator of Th9 development, orchestrates the resolution of airway inflammation in allergic asthma

Publication date: Available online 5 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Susetta Finotto

https://ift.tt/2M2iU5c

A novel LRBA mutation presents with normal CTLA-4 and overactive Th17 immunity

Publication date: Available online 5 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Marieke De Bruyne, Delfien J. Bogaert, Koen Venken, Lien Van den Bossche, Carolien Bonroy, Lisa Roels, Simon J. Tavernier, Els van de Vijver, Ann Driessen, Marielle van Gijn, Laura Gámez-Diaz, Dirk Elewaut, Bodo Grimbacher, Filomeen Haerynck, Nicolette Moes, Melissa Dullaers

https://ift.tt/2MMUbXT

The Genetic Landscape of SCID in the US and Canada in the Current Era (2010-2018)

Publication date: Available online 5 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Christopher C. Dvorak, Elie Haddad, Rebecca H. Buckley, Morton J. Cowan, Brent Logan, Linda M. Griffith, Donald B. Kohn, Sung-Yun Pai, Luigi Notarangelo, William Shearer, Susan Prockop, Neena Kapoor, Jennifer Heimall, Sonali Chaudhury, David Shyr, Sharat Chandra, Geoff Cuvelier, Theodore Moore, Shalini Shenoy, Fred Goldman

https://ift.tt/2LZYbPK

Novel cytoskeletal mutations with immunodeficiency: why is the raven like a writing desk?

Publication date: Available online 4 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Mikko RJ. Seppänen

https://ift.tt/2NjREny

Die Radiotherapie des Pleuramesothelioms – Klinische Praxisleitlinie der American Society of Clinical Oncology

https://ift.tt/2NPp76q

Test All Pregnant Women for Syphilis Early, USPSTF Says

Screen all pregnant women for syphilis early in pregnancy, the USPSTF urges in a statement reaffirming its 2009 recommendation, as troubling trends show a recent doubling of cases of congenital syphilis.
Medscape Medical News

https://ift.tt/2CjoGQk

Pulmonary artery sarcoma mimicking pulmonary embolism

Description

A 62-year-old woman with diabetes presented with progressive exertional dyspnoea, chest pain and palpitation for several months. She had no history of leg oedema, fever, bodyweight change and general weakness. Therefore, she received associated exams at cardiovascular outpatient department. Transthoracic echocardiogram showed right atrium and ventricle dilatation with severe pulmonary hypertension. Besides, a thrombus-like mobile mass was noted at right ventricle and pulmonary artery (figure 1, video 1). Pulmonary embolism, as one of the life-threatening conditions, was our tentative diagnosis, and she was transferred to the emergency department. Chest CT showed multifocal filling defects at right ventricle, main pulmonary artery trunk and bilateral pulmonary arteries with several lung nodules (figure 2). Primary tumour or metastasis was our final impression by image study. Finally, the patient underwent surgery, which confirmed the mass to be pulmonary artery intimal sarcoma, not a large thrombus (

https://ift.tt/2PzXRcu

Improvement in lung function following medialisation thyroplasty in a postbilateral lung transplant patient

A 59-year-old man underwent external medialisation thyroplasty for his left unilateral vocal cord paralysis (UVCP) secondary to recent thoracic surgery. The patient had undergone bilateral lung transplant for idiopathic pulmonary fibrosis and was referred to the ear, nose and throat surgical team with new-onset voice hoarseness. Examination confirmed left UVCP, and after failing conservative management a decision was made to perform external medialisation thyroplasty. Following an uneventful procedure, the patient's phonation returned to normal, and remarkably on spirometry there was evidence of significant improvement in lung function. Despite case series demonstrating subjective improvement in respiration, this is the first documented case, to our knowledge, of significant improvement in spirometry following this procedure.

https://ift.tt/2wKybmH

Autism and trichotillomania in an adolescent boy

An adolescent with autism spectrum disorder and improperly treated attention deficit hyperactivity disorder presented with recurrent hair pulling. Treatment with selective serotonin reuptake inhibitor and stimulant improved these conditions.

https://ift.tt/2NQRxNm

Staring at the stars: a case of gastrointestinal basidiobolomycosis from the Indian subcontinent

Description

A 24-year-old male patient from the hot and arid state of Rajasthan, India, presented with low-grade fever, dull aching lower abdominal pain, loss of weight and loss of appetite for 2 years. In addition, he had frequent episodes of colicky abdominal pain and vomiting. He was evaluated elsewhere prior to presenting at our hospital. A contrast-enhanced computed axial tomography of the abdomen revealed diffuse circumferential thickening of the ileocecal region (figure 1). A fine -needle aspiration cytology revealed features suggestive of non-specific inflammation. He did not respond to multiple courses of antibiotics and was taken up for laparotomy, in which the affected segment of intestine was resected. On gross examination, the resected segment of bowel showed multiple areas of necrosis and small perforations. Histopathological examination (HPE) revealed panmural inflammation of the intestine with eosinophilic microabscesses. Broad aseptate hyphae were noted and reported as mucormycosis. Postoperatively, he...

https://ift.tt/2oGXYHV

Unusual ocular manifestations following viper bite

We report a case of a 70-year-old farmer admitted for viper bite who presented with bilateral hyphema and angle closure attack. He was managed conservatively with topical steroids and cycloplegics. He responded well and was discharged after 2 weeks.

https://ift.tt/2NS4Soy

Effect of topiramate on sweat chloride level while screening for cystic fibrosis

Cystic fibrosis is the most common life-limiting genetic condition in Caucasians caused by Cystic Fibrosis Transmembrane conductance Regulator (CFTR) gene mutations. Sweat chloride is the current gold standard for diagnosis where values >60 mmol/L are diagnostic and values >30 mmol/L are indeterminate. There is limited literature on the effect of medications on the sweat chloride values. We report a case of topiramate being responsible for false-positive testing which resulted in overutilisation of medical resources and psychosocial stress on the family. Topiramate should be considered during the interpretation of the gold standard testing as one of the cause of false-positive sweat tests.

https://ift.tt/2wKxYQr

Electrical impedance tomography effectively used in a case of paediatric pulmonary Langerhans cell histiocytosis

A 2-year-old boy with severe pulmonary Langerhans cell histiocytosis presented in extreme respiratory failure. He was intubated and ventilated. Despite maximal support, he deteriorated and needed extremely high ventilator pressures. An electrical impedance tomography monitor was used to inform management. This is a monitoring technique which is not used in children due to the lack of suitable interface devices and a lack of randomised clinical evidence. Despite technical difficulties, a good signal was achieved. This informed management and enabled the selection of a suitable ventilator strategy, facilitating weaning. Electrical impedance tomography is a viable technology for use in paediatric critical respiratory failure. This is a non-invasive and safe technology which adds individual patient information which is not available through any other modalities. We urge equipment manufacturers to develop belts which will allow routine application of this life-saving technology in children.

https://ift.tt/2NPiqBp

Cervical aortic arch: an unusual cause of a pulsatile neck mass

A 72-year-old man presented with epistaxis on two occasions requiring admission. Prior to performing a bilateral sphenopalatine artery ligation diathermy, anaesthetic concern was raised regarding what the patient described as a 'congenital aortic aneurysm', with an overlying scar secondary to explorative surgery as a child. The abnormality was a cervical aortic arch (CAA). CAA is a rare vascular anomaly, which most commonly manifests as a pulsatile neck mass. In this case, we discuss the differential diagnosis for a pulsatile neck mass and considerations to be made in the workup. We also highlight the importance of cardiovascular risk factor management in patients with CAA.

https://ift.tt/2wOTnb3

Historical Evolution of the Polymorphous Adenocarcinoma

Abstract

The 2017 World Health Organization Classification of Head and Neck Tumors introduced for the first time the diagnostic terminology "cribriform variant of polymorphous adenocarcinoma". This nomenclature attempts to reconciliate the ongoing taxonomical controversy related to cribriform adenocarcinoma of tongue. In order to better understand this classification conundrum, it is imperative for pathologist to comprehend the historical evolution of polymorphous adenocarcinoma formerly known as polymorphous "low grade" adenocarcinoma. This review highlights our understanding of these tumors since their origins.

https://ift.tt/2NgkhlC

Historical Evolution of the Polymorphous Adenocarcinoma

Abstract

https://ift.tt/2NgkhlC

Importance of TLR9-IL23-IL17 axis in inflammatory bowel disease development: Gene expression profiling study

Publication date: Available online 5 September 2018

Source: Clinical Immunology

Author(s): Sanja Dragasevic, Biljana Stankovic, Aleksandra Sokic-Milutinovic, Tomica Milosavljevic, Tamara Milovanovic, Snezana Lukic, Sanja Srzentic Drazilov, Kristel Klaassen, Nikola Kotur, Sonja Pavlovic, Dragan Popovic

Abstract

Background and aims

Mucosal gene expression have not been fully enlightened in inflammatory bowel disease (IBD). Aim of this study was to define IL23A, IL17A, IL17F and TLR9 expression in different IBD phenotypes.

Methods

Evaluation of mRNA levels was performed in paired non-inflamed and inflamed mucosal biopsies of newly diagnosed 50 Crohn's disease (CD) and 54 ulcerative colitis (UC) patients by quantitative real-time PCR analysis.

Results

IL17A and IL17F expression levels were significantly increased in inflamed IBD mucosa. Inflamed CD ileal and UC mucosa showed increased IL23A, while only inflamed CD ileal samples showed increased TLR9 mRNA level. Correlation between analysed mRNAs levels and endoscopic and clinical disease activity were found in UC, but only with clinical activity in CD.

Conclusion

Both CD and UC presented expression of Th17-associated genes. Nevertheless, expression profiles between different disease forms varies which should be taken into account for future research and therapeutics strategies.

https://ift.tt/2LYYiuX

Principles of adoptive T cell therapy in cancer

Abstract

Adoptive cell therapy (ACT) utilizing either tumor-infiltrating lymphocyte (TIL)-derived T cells or T cells genetically engineered to express tumor recognizing receptors has emerged as a powerful and potentially curative therapy for several cancers. Many ACT-based therapies have recently entered late-phase clinical testing, with several T cell therapies already achieving regulatory approval for the treatment of patients with B cell malignancies. In this review, we briefly outline the principles of adoptively transferred T cells for the treatment of cancer.

https://ift.tt/2NQvl6b

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Τετάρτη 5 Σεπτεμβρίου 2018

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