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

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Κυριακή 7 Οκτωβρίου 2018

Application of Stem Cells for Bone Regeneration in Critical-Sized Defects

Abstract

Purpose of Review

To discuss tissue bioengineering for critical-sized bone defects. To review the current stem cells that are in use and to describe the importance of an animal model for studying critical-sized bone defects.

Recent Findings

Bone marrow mesenchymal stem cells (MSCs) are well investigated. Recently, other sources of MSCs have been identified and studied in critical-sized bone defects. As for animal models, several have been used to evaluate the use of stem cells in promoting regeneration in critical-sized bone defects. This review specifically focuses on one of the most widely used and accepted models, the rodent calvarium.

Summary

Stem cell therapy is promising for bone regeneration, especially for critical-sized bone defects. Additional studies are needed to better understand both the properties and mechanisms of the different types of stem cells, and to develop animal models that mimic human biology.



https://ift.tt/2E4zSkX

Do we need noninvasive biomarkers for delayed graft function after kidney transplantation?

No abstract available

https://ift.tt/2ylETPS

Perfusion of Porcine Kidneys with Macromolecular Heparin Reduces Early Ischemia Reperfusion Injury

Background Previously we have been able to demonstrate the possibility of coating the inner surface of the renal arteries in porcine kidneys with a heparin conjugate during hypothermic machine perfusion (HMP). The purpose of this study was to assess the efficacy of this treatment in reducing early ischemia-reperfusion injury. Method Brain death was induced in male landrace pigs by stepwise volume expansion of an epidural balloon catheter until negative cerebral perfusion pressure was obtained. Both kidneys (matched pairs; n=6+6) were preserved for 20 hours by HMP during which 50 mg heparin conjugate was added to 1 of the HMP systems (treated group). A customized ex vivo normothermic oxygenated perfusion (NP) system with added exogenous creatinine was used to evaluate early kidney function. Blood, urine and histological samples were collected during the subsequent 3 hours of NP. Results Kidney weight was lower at the end of NP (p=0.017) in the treated group compared to control kidneys. The rate of decline in creatinine level was faster (p=0.024), total urinary volume was higher (p=0.031) and the level of urine neutrophil gelatinase-associated lipocalin (NGAL) was lower (p=0.031) in the treated group. Histologically, less tubular changes were seen (p=0.046). During NP intrarenal resistance remained lower (p

https://ift.tt/2pHyFG3

Date palm ash-MgAl-layered double hydroxide composite: sustainable adsorbent for effective removal of methyl orange and eriochrome black-T from aqueous phase

Abstract

Date palm ash (DPA) and MgAl-layered double hydroxide (LDH) composites were synthesized by the co-precipitation method and characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscope (SEM), X-ray diffraction (XRD), and Brunauer–Emmett–Teller (BET). The DPA-MgAl-LDH (DPA/MgAl) composites were employed for the removal of methyl orange (MO) and eriochrome black-T (EBT) from aqueous phase. Incorporation of 33.33% (w/w) DPA into the layers of MgAl increased the surface area from 44.46 to 140.65 m2/g, which leads to the improved adsorption performance. The maximum adsorption capacity of DPA/MgAl (1:2) at 298 K was 242.98 and 425.16 (mg/g) for MO and EBT, respectively. The adsorption data of dyes were adequately fitted by a pseudo-second-order and Langmuir isotherm model. The composite showed excellent reusability performance up to three cycles. Addition of DPA into MgAl-LDH resulted in an effective low-cost adsorbent for decontamination of dyes from wastewater.

Graphical abstract



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The first case of thrombocytopenia, anasarca, fever, renal impairment or reticulin fibrosis, and organomegaly (TAFRO) syndrome with unilateral adrenal necrosis: a case report

TAFRO syndrome, which was first reported in 2010 in Japan, is a relatively rare disease characterized by thrombocytopenia, anasarca, fever, renal impairment, reticulin fibrosis, and organomegaly. Although this...

https://ift.tt/2ypoSbC

Low-power laser alters mRNA levels from DNA repair genes in acute lung injury induced by sepsis in Wistar rats

Abstract

Acute lung injury (ALI) is defined as respiratory failure syndrome, in which the pathogenesis could occur from sepsis making it a life-threatening disease by uncontrolled hyperinflammatory responses. A possible treatment for ALI is the use of low-power infrared lasers (LPIL), whose therapeutical effects depend on wavelength, power, fluence, and emission mode. The evaluation mRNA levels of repair gene related to oxidative damage after exposure to LPIL could provide important information about the modulation of genes as treatment for ALI. Thus, the aim of this study was to evaluate the mRNA levels from OGG1, APEX1, ERCC2, and ERCC1 genes in lung tissue from Wistar rats affected by ALI and after exposure to LPIL (808 nm; 100 mW). Adult male Wistar rats (n = 30) were randomized into six groups (n = 5, for each group): control, 10 J/cm2 (2 J), 20 J/cm2 (5 J), ALI, ALI + LPIL 10 J/cm2 and ALI + LPIL 20 J/cm2. ALI was induced by intraperitoneal E. coli lipopolysaccharide injection (10 mg/kg). Lungs were removed, and samples were withdrawn for total RNA extraction, cDNA synthesis, and mRNA levels were evaluated by RT-qPCR. Data normality was verified by Kolmogorov-Smirnov, comparisons among groups were by Student's t test, Mann-Whitney test, one-way ANOVA, Kruskal-Wallis followed by post-tests. Data showed that OGG1 (0.39 ± 0.10), ERCC2 (0.67 ± 0.24), and ERCC1 (0.60 ± 0.19) mRNA levels are reduced in ALI group when compared with the control group (1.00 ± 0.07, 1.03 ± 0.25, 1.01 ± 0.16, respectively) and, after LPIL, mRNA relative levels from DNA repair genes are altered when compared to non-exposed ALI group. Our research shows that ALI alter mRNA levels from genes related to base and nucleotide excision repair genes, suggesting that DNA repair is part of cell response to sepsis, and that photobiomodulation could modulate the mRNA levels from these genes in lung tissue.



https://ift.tt/2y5Z0SO

Nutrients and non-essential elements in edible crops following long-term mineral and compost fertilization of a Mediterranean agricultural soil

Abstract

The effects of long-term soil fertilizations on nutrient and non-essential element concentrations in edible parts of three crops important in human diet were investigated repeating four treatments (biowaste compost, biowaste compost plus mineral nitrogen, mineral NPK, unfertilized control) for seven consecutive years (2007–2014). Fruits of Solanum lycopersicum cv San Marzano collected in 2011 and 2012, bulbs of Allium cepa cv Bianca di Pompei collected in 2012 and 2013, and bulbs of Foeniculum vulgare cv Orbit collected in 2014 were analyzed. Wide variations in element concentrations were observed along time and among species, with Ca, K, Mg, and Na higher in fennel bulbs and Cd, Cr, Mn, Ni, Pb, and Zn higher in tomato fruits, where Cd reached concentrations up to ninefold higher than the permitted values (EU Regulation n. 488/2014). Despite the enrichments in soil total Cu and available Cd, Fe, K, Mn, and Zn concentrations due to long-term fertilization with biowaste compost (alone or with mineral fertilizers), plants showed lower micronutrient and non-essential element concentrations in respect to those on unfertilized soils. Considering the potential toxicity for human beings of these mobile and persistent elements, the obtained findings reassure on the safe use of biowaste compost in agriculture. Overall, this study suggests the use of compost as the most advisable fertilization practice and highlights the need of multiple crops analysis in evaluating the effects of long-term soil fertilization on their chemical composition.



https://ift.tt/2Og0kNi

Rhinosectan® spray (containing xyloglucan) on the ciliary function of the nasal respiratory epithelium; results of an in vitro study

To assess the effects of Rhinosectan® spray, a medical device containing xyloglucan, on nasal ciliary function (in MucilAir™Nasal cells).

https://ift.tt/2y6mebI

Tinnitus and Cognition: Linked?

Abstract

Tinnitus is conscious auditory perception without corresponding external stimuli resulting from neuronal activity along auditory pathway either in peripheral or central auditory system. The exact origin, pathophysiologic pathway and its treatment is still under exploration. The main risk factor is hearing loss, but can occur in patients with normal hearing. Auditory brainstem response test helps to objectify this subjective complaint and aid in locating its origin. P300 is late latency auditory evoked potential, objective marker of cognitive potential. The purpose of our study was to ascertain any significant difference in P300 latency and amplitude values in cases of sensorineural hearing loss with tinnitus when compared to controls (normal hearing subjects) and also to find any correlation between severity of tinnitus and cognition. This was a case control study conducted at the department of ENT at Safdarjung Hospital, New Delhi between September 2016 to March 2018. The study comprised of one hundred and six patients, out of which fifty five patients were having sensorineural hearing loss with tinnitus and fifty one patients were normal hearing subjects. General medical and audiological history and examination was done. Significant increase in P300 latency and decrease in P300 amplitude was found in sensorineural hearing loss with tinnitus cases on comparing with controls. The similar pattern of P300 values was observed on increasing severity of tinnitus and degree of hearing loss. Hence, results revealed the role of cognition and involvement of central auditory pathway in tinnitus generation.



https://ift.tt/2zXGQ76

A Study on Etiopathogenesis of Vocal Cord Paresis and Palsy in a Tertiary Centre

Abstract

To identify patients of vocal cord paresis and palsy and to establish an etiological diagnosis based on a study performed in a tertiary centre. Study was done prospectively in the Department of ENT in KIMS Hospital, Bangalore, for 1 year, from June 2016 to June 2017. 100 patients with vocal cord paresis and palsy were identified and examined by using various tests and investigations to establish the etiology. Most of the patients presented with complaints of change in voice (92%). Some of the other common presenting complaints included noisy breathing and difficulty in swallowing, difficulty in voice production and vocal fatigue and cough. Unilateral paralysis (82%) was found to be more common than bilateral paralysis (18%), of which left (52%) was more commonly affected than right (48%) vocal cord. The most common age group affected was 51–60 years (24%) followed by 61–70 years (19%). Males (60%) were affected more than females (40%) in a ratio of 3:2 and among the affected males 73% were known smokers. The most common cause of vocal cord paresis and palsy was found to be idiopathic (38%), followed by primary laryngeal growths (27%). Other causes included carcinomas of lung, thyroid and oesophagus, traumatic, inflammatory, systemic diseases like Rheumatoid arthritis, Hypertension leading to stroke. Identifying the exact etiopathogenesis of vocal cord paresis and palsy in patients has been difficult and is very important in order to establish a proper diagnostic and treatment protocol for these patients.



https://ift.tt/2C1rikc

Tinnitus and Cognition: Linked?

Abstract

Tinnitus is conscious auditory perception without corresponding external stimuli resulting from neuronal activity along auditory pathway either in peripheral or central auditory system. The exact origin, pathophysiologic pathway and its treatment is still under exploration. The main risk factor is hearing loss, but can occur in patients with normal hearing. Auditory brainstem response test helps to objectify this subjective complaint and aid in locating its origin. P300 is late latency auditory evoked potential, objective marker of cognitive potential. The purpose of our study was to ascertain any significant difference in P300 latency and amplitude values in cases of sensorineural hearing loss with tinnitus when compared to controls (normal hearing subjects) and also to find any correlation between severity of tinnitus and cognition. This was a case control study conducted at the department of ENT at Safdarjung Hospital, New Delhi between September 2016 to March 2018. The study comprised of one hundred and six patients, out of which fifty five patients were having sensorineural hearing loss with tinnitus and fifty one patients were normal hearing subjects. General medical and audiological history and examination was done. Significant increase in P300 latency and decrease in P300 amplitude was found in sensorineural hearing loss with tinnitus cases on comparing with controls. The similar pattern of P300 values was observed on increasing severity of tinnitus and degree of hearing loss. Hence, results revealed the role of cognition and involvement of central auditory pathway in tinnitus generation.



https://ift.tt/2zXGQ76

A Study on Etiopathogenesis of Vocal Cord Paresis and Palsy in a Tertiary Centre

Abstract

To identify patients of vocal cord paresis and palsy and to establish an etiological diagnosis based on a study performed in a tertiary centre. Study was done prospectively in the Department of ENT in KIMS Hospital, Bangalore, for 1 year, from June 2016 to June 2017. 100 patients with vocal cord paresis and palsy were identified and examined by using various tests and investigations to establish the etiology. Most of the patients presented with complaints of change in voice (92%). Some of the other common presenting complaints included noisy breathing and difficulty in swallowing, difficulty in voice production and vocal fatigue and cough. Unilateral paralysis (82%) was found to be more common than bilateral paralysis (18%), of which left (52%) was more commonly affected than right (48%) vocal cord. The most common age group affected was 51–60 years (24%) followed by 61–70 years (19%). Males (60%) were affected more than females (40%) in a ratio of 3:2 and among the affected males 73% were known smokers. The most common cause of vocal cord paresis and palsy was found to be idiopathic (38%), followed by primary laryngeal growths (27%). Other causes included carcinomas of lung, thyroid and oesophagus, traumatic, inflammatory, systemic diseases like Rheumatoid arthritis, Hypertension leading to stroke. Identifying the exact etiopathogenesis of vocal cord paresis and palsy in patients has been difficult and is very important in order to establish a proper diagnostic and treatment protocol for these patients.



https://ift.tt/2C1rikc

Clinical Thyroidology®High-Impact Articles

CT-september.png

Mary Ann Liebert, Inc., publishers and the American Thyroid Association salute Jerry Hershman, MD for his superb leadership and years as Editor-in-Chief of Clinical Thyroidology. We are pleased to welcome our new incoming editor in 2019, Angela Leung, MD, and wish her well in this important new role.

We invite you to read these top-read papers with free access through October 19, 2018.
Read Now:

The Increased Incidence of Thyroid Cancer Is Worldwide
Jerome M. Hershman 

No Benefit of Levothyroxine Among Pregnant Hypothyroid and/or Hypothyroxinemic Women on Offspring IQ at Age 9 years
Angela M. Leung 

Surgery for Hyperthyroidism Lowers Cardiovascular Mortality Compared with Radioactive Iodine
Andrew J. Day, Michael W. Yeh, Masha J. Livhits 

Does Normal TSH Mean Euthyroidism in L-T4 Treatment?
Jacques Orgiazzi 

Most "Recurrences" of Thyroid Cancer Represent Persistent Rather Than Recurrent Disease
Martin Biermann and Katrin Brauckhoff 

Validation of American Thyroid Association Ultrasound Risk Assessment of Thyroid Nodules Selected for Ultrasound Fine-Needle Aspiration
Stephanie A. Fish 

 

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



https://ift.tt/2Rvctff

VideoEndocrinology™ High-Impact Videos

ve-cover.jpg

VideoEndocrinology™
The Official Journal of: American Thyroid Association

FREE ACCESS through October 20, 2018.
Watch now:

Thyroid Fine-Needle Aspiration and Smearing Techniques
Mitsuyoshi Hirokawa, Ayana Suzuki, Akira Miyauchi

Thyroid Fine Needle Aspiration Smear Preparation
Juan Munoz Pena, Jeffrey Arnold 

Transoral Endoscopic Thyroidectomy Vestibular Approach
Angkoon Anuwong, Thanyawat Sasanakietkul, Pornpeera Jitpratoom 

An Elusive Parathyroid: Interesting Case Presentation
Anton F. Engelsman, Robert F. Parkyn, Andrew Carter, James Christie, Leigh W. Delbridge 

Delphian Lymph Node Dissection: Surgical Dissection Technique as Illustrated by the Johns Hopkins Head and Neck Endocrine Surgery Division
Vaninder K. Dhillon, Jonathon O. Russell, Ralph P. Tufano 

 

The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.



https://ift.tt/2PjM2rn

Clinical Thyroidology®High-Impact Articles

CT-september.png

Mary Ann Liebert, Inc., publishers and the American Thyroid Association salute Jerry Hershman, MD for his superb leadership and years as Editor-in-Chief of Clinical Thyroidology. We are pleased to welcome our new incoming editor in 2019, Angela Leung, MD, and wish her well in this important new role.

We invite you to read these top-read papers with free access through October 19, 2018.
Read Now:

The Increased Incidence of Thyroid Cancer Is Worldwide
Jerome M. Hershman 

No Benefit of Levothyroxine Among Pregnant Hypothyroid and/or Hypothyroxinemic Women on Offspring IQ at Age 9 years
Angela M. Leung 

Surgery for Hyperthyroidism Lowers Cardiovascular Mortality Compared with Radioactive Iodine
Andrew J. Day, Michael W. Yeh, Masha J. Livhits 

Does Normal TSH Mean Euthyroidism in L-T4 Treatment?
Jacques Orgiazzi 

Most "Recurrences" of Thyroid Cancer Represent Persistent Rather Than Recurrent Disease
Martin Biermann and Katrin Brauckhoff 

Validation of American Thyroid Association Ultrasound Risk Assessment of Thyroid Nodules Selected for Ultrasound Fine-Needle Aspiration
Stephanie A. Fish 

 

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



https://ift.tt/2Rvctff

VideoEndocrinology™ High-Impact Videos

ve-cover.jpg

VideoEndocrinology™
The Official Journal of: American Thyroid Association

FREE ACCESS through October 20, 2018.
Watch now:

Thyroid Fine-Needle Aspiration and Smearing Techniques
Mitsuyoshi Hirokawa, Ayana Suzuki, Akira Miyauchi

Thyroid Fine Needle Aspiration Smear Preparation
Juan Munoz Pena, Jeffrey Arnold 

Transoral Endoscopic Thyroidectomy Vestibular Approach
Angkoon Anuwong, Thanyawat Sasanakietkul, Pornpeera Jitpratoom 

An Elusive Parathyroid: Interesting Case Presentation
Anton F. Engelsman, Robert F. Parkyn, Andrew Carter, James Christie, Leigh W. Delbridge 

Delphian Lymph Node Dissection: Surgical Dissection Technique as Illustrated by the Johns Hopkins Head and Neck Endocrine Surgery Division
Vaninder K. Dhillon, Jonathon O. Russell, Ralph P. Tufano 

 

The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.



https://ift.tt/2PjM2rn

Topical application of phenytoin or nifedipine-loaded PLGA microspheres promotes periodontal regeneration in vivo

Publication date: Available online 6 October 2018

Source: Archives of Oral Biology

Author(s): Xiao-Heng Zhao, Franklin R. Tay, Yan-Jun Fang, Liu-Yan Meng, Zhuan Bian

Abstract
Objectives

Gingival recession and alveolar bone loss are common manifestations of periodontitis. Periodontal regeneration is the ideal strategy for rehabilitating periodontal tissue defects and preventing tooth loss. The present study examined whether localized, topical application of gingival overgrowth-inducing drugs, phenytoin, nifedipine or cyclosporine, induces periodontal regeneration.

Methods

Polylactic-co-glycolic acid (PLGA) was used as the carrier for preparation of phenytoin, nifedipine or cyclosporine-loaded PLGA microspheres, using an oil-in-water emulsification technique. The drug-loaded microspheres were delivered to periodontal defects created on alveolar ridges mesial to the first maxillary molars of Sprague-Dawley rats. After eight weeks, the operation area in each rat, including the maxillary molars and periodontal tissues, was harvested and evaluated by micro-computed tomography, histochemical and immunohistochemical analyses.

Results

Physical parameters representative of periodontal regeneration, including the length of new alveolar bone (p < 0.01) and the area of new alveolar bone (p < 0.01) were significantly improved in the phenytoin group. Compared to other groups, the phenytoin group demonstrated increased expression of COL-1, VEGF-A, osteoblast and osteoclast markers (BMP-2, TGF-β1, OCN and TRAP staining), as well as decreased expression of MMP-8.

Conclusions

Results of the present study provided new evidence that localized, controlled release of phenytoin confers therapeutic benefits toward gingival recession and alveolar bone loss. Phenytoin appears to be a promising drug that promotes periodontal regeneration.



https://ift.tt/2yoepx0

Non-nucleoside reverse transcriptase inhibitors (NNRTIs)-induced Stevens-Johnson syndrome and gynecomastia in an HIV-infected child: A case report

Publication date: Available online 6 October 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): B. Saka, A.S. Akakpo, A. Bassowa, A.N. Dapam, G. Mahamadou, J.N. Teclessou, A. Mouhari-Toure, A.Y. Laouali, E. Mensah, K. Kombaté, P. Pitché

Summary
Background

Non-nucleoside reverse transcriptase inhibitors (NNRTIs) are antiretroviral drugs often used in the first-line treatment regimen of HIV1 infection worldwide. We report a case of successive gynecomastia and Stevens-Johnson syndrome (SJS) respectively induced by efavirenz and nevirapine in a single patient.

Case report

A 16-year-old boy, HIV1-infected since birth, was started on antiretroviral treatment (ART) in August 2015 and was taking a regimen comprising abacavir, lamivudine and efavirenz. In April 2016, when his weight reached 35 kg, abacavir was replaced with tenofovir. Bilateral breast enlargement, previously hidden by the patient, was diagnosed two years after the start of ART. History-taking, physical examination and laboratory tests ruled out known causes of gynecomastia, and efavirenz was thus considered the most likely cause. This drug was then withdrawn and replaced with nevirapine in July 2017. Thirty-three days after the patient started nevirapine treatment, a skin rash appeared. Physical examination revealed erythematous macules and flaccid bullae with estimated skin detachment of 10%. There were also conjunctival, buccal and genital lesions. A diagnosis was made of SJS induced by nevirapine. Three months after withdrawal of efavirenz, breast size decreased by 3 cm on the left breast and 2 cm on the right breast; two months after the SJS, cutaneous sequelae alone persisted, such as diffuse hyperchromic macules.

Discussion

Recognition of gynecomastia as a side-effect of efavirenz is important to allow the condition to be treated while it is still potentially reversible. Moreover, when efavirenz is replaced, a protease inhibitor should be preferred to nevirapine.

Résumé
Introduction

Les inhibiteurs non nucléosidiques de la transcriptase inverse (INNTI) sont des antirétroviraux souvent utilisés en première ligne du traitement de l'infection par le VIH1. Nous rapportons un cas de gynécomastie bilatérale sévère et de syndrome de Stevens-Johnson (SSJ) respectivement induits par l'efavirenz et la névirapine chez un même patient.

Observation

Un garçon de 16 ans, infecté par le VIH1 depuis la naissance, était mis en août 2015 sous abacavir, lamivudine et efavirenz. En avril 2016, son poids atteignant 35 kg, l'abacavir était remplacé par le tenofovir. Une augmentation bilatérale de volume mammaire, dissimulée par le patient, était diagnostiquée deux ans après le début du traitement. L'histoire de la maladie, l'examen physique et les examens de laboratoire écartant les principales causes connues de gynécomastie, la responsabilité de l'efavirenz était alors considérée comme la plus vraisemblable. Ce médicament était donc retiré et remplacé par la névirapine en juillet 2017. Trente-trois jours après le début du traitement par la névirapine, une éruption cutanée apparaissait. À l'examen physique, on notait des macules érythémateuses et des bulles flasques avec un décollement cutané estimé à 10 % de la surface corporelle. Il existait également des lésions conjonctivales, buccales et génitales. Le diagnostic de SSJ induit par la névirapine était retenu. Trois mois après le retrait de l'efavirenz, la taille des seins diminuait de 3 cm à gauche et 2 cm à droite ; deux mois après le SSJ, il persistait uniquement des séquelles cutanées à type de macules hyperchromiques diffuses.

Discussion

La recherche d'une gynécomastie comme effet indésirable de l'efavirenz est importante afin d'intervenir au moment où elle peut encore être réversible. Par ailleurs, en cas de substitution de l'efavirenz, un inhibiteur de protéase devrait être préféré à la névirapine.



https://ift.tt/2IHRFNm

Epigenome-wide association study of peripheral blood mononuclear cells in systemic lupus erythematosus: Identifying DNA methylation signatures associated with interferon-related genes based on ethnicity and SLEDAI

Publication date: Available online 7 October 2018

Source: Journal of Autoimmunity

Author(s): Stancy Joseph, Nysia I. George, Bridgett Green-Knox, Edward L. Treadwell, Beverly Word, Sarah Yim, Beverly Lyn-Cook

Abstract

Systemic lupus erythematosus (SLE or lupus) is a heterogeneous autoimmune disease characterized by the involvement of multiple organs and the production of antinuclear antibodies. DNA methylation plays an important role in the pathogenesis of lupus. We have performed an epigenome-wide DNA methylation study in lupus and healthy control (non-lupus) subjects to identify epigenetic patterns in lupus characterized ethnicity and SLE disease activity index (SLEDAI). A total of fifty-seven lupus patients (39 African American (AA) and 18 European American (EA)) and 33 healthy controls (17 AA and 16 EA) were studied. Differential DNA methylation between lupus patients and controls was assessed for approximately 485,000 CpG sites across the genome. We identified 41 differentially methylated sites (associated with 30 genes) between lupus and control s subjects, 85% of which were hypomethylated. Significant hypomethylation of differentially methylated sites was associated with several interferon-related genes, including MX1, IFI44L, PARP9, DT3XL, IFIT1, IFI44, RSAD2, PLSCR1, and IRF7. Several of these associated genes were also hypomethylated in comparisons between AA lupus and AA non-lupus subjects and between lupus patients with SLEDAI>6 and non-lupus subjects. Our analysis of gene expression data through RT-PCR confirmed these findings. Thus, the results indicate epigenetics susceptibility in lupus, which may be associated with SLEDAI score and ethnicity. In addition, our findings support the importance of the Type 1 interferon pathway in lupus pathogenesis.



https://ift.tt/2yj369F

Restricted self-diffusion of adsorbed water in MIL-100(Al)

Publication date: Available online 7 October 2018

Source: Magnetic Resonance Imaging

Author(s): Tobias Splith, Frank Stallmach

Abstract

An extended two-site exchange model is presented, which is used to evaluate pulsed field gradient (PFG) nuclear magnetic resonance (NMR) measurements of water in the nanoporous metal-organic framework MIL-100(Al). Here the water molecules exchange between the inter- and the intracrystalline space during the observation time, but are also restricted in their movement by the crystal surface. The evaluation of temperature and loading dependent PFG NMR data yields information about the intracrystalline diffusion process, the radius of the restricting geometry and the time constants of the exchange process. The intracrystalline mean residence time is found to decrease with increasing temperature, which allows an estimate of the heat of adsorption under the equilibrium conditions of the NMR measurements.



https://ift.tt/2IGcxEM

In situ reaction monitoring in heterogeneous catalysts by a benchtop NMR spectrometer

Publication date: Available online 6 October 2018

Source: Magnetic Resonance Imaging

Author(s): Markus Leutzsch, Andrew J. Sederman, Lynn F. Gladden, Michael D. Mantle

Abstract

Understanding the reactivity and mass transport properties of porous heterogenous catalysts is important for the development of new materials. Whereas MRI has previously been used to correlate chemical kinetics and hydrodynamics under operando conditions, this paper demonstrates that a modern benchtop NMR spectrometer is a suitable alternative to obtain diverse reaction information in porous heterogeneous catalyst materials on a smaller scale. Besides information about the chemical conversion within the pores, it can also be used to study changes of surface interaction by T1/T2 NMR relaxometry techniques and changes in mass transport by PFG NMR from a single chemical reaction.



https://ift.tt/2CsVsOg

To transfuse or not to transfuse? Jehovah’s Witnesses and postoperative hemorrhage in pediatric otolaryngology

Publication date: Available online 6 October 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Andrew J. Redmann, Melissa Schopper, Armand H. Matheny Antommaria, Judith Ragsdale, Alessandro de Alarcón, Michael J. Rutter, Catherine K. Hart, Charles M. Myer

Abstract
Objectives

Discuss the ethical issues in the management of postoperative hemorrhage in pediatric patients whose parents are Jehovah's Witnesses (JW) and 2) Describe a framework for shared decision making in this population.

Methods

A recall review of pediatric otolaryngology patients with parents of the JW faith and postoperative hemorrhage was performed over a year long period at a single institution. The literature on transfusions for JW minors was reviewed.

Results

Two patients were identified. The first patient had a severe post-tonsillectomy hemorrhage requiring multiple emergency operative interventions. The child developed a hemoglobin of 5.2 g/dl and received an emergent transfusion against parents' wishes. The child subsequently did not require further intervention. The second patient hemorrhaged after a supraglottoplasty and was administered erythropoietin and iron infusion but did not require transfusion (hemoglobin nadir 7.9 g/dl). In both cases hematology was consulted, and extensive discussion with the families and the JW Hospital Liaison Committee occurred.

Conclusions

The risks of hemorrhage should be discussed with JW parents of patients undergoing even routine otolaryngologic surgery. In these cases, early shared decision making with family, the JW Hospital Liaison committee, and hematology was pursued regarding mutually acceptable interventions. Aggressive non-transfusion based resuscitation was carried out to minimize the likelihood of transfusion. In the first case, danger to the patient's life eventually necessitated transfusion in accordance with the patient's best interest and previous case law. A defined framework involving all stake-holders, including Pastoral Care, in the event of postoperative hemorrhage is critical.



https://ift.tt/2QBhy4k

Using single cell analysis for translational studies in immune mediated diseases: Opportunities and challenges

Publication date: November 2018

Source: Molecular Immunology, Volume 103

Author(s): Siddhartha Sharma, Louis Gioia, Brian Abe, Marie Holt, Anne Costanzo, Lisa Kain, Andrew Su, Luc Teyton

Abstract

The difficulty of studying small tissue samples and rare cell populations have been some of the main limitations in performing efficient translational studies of immune mediated diseases. Many of these conditions are grouped under the name of a single disease whilst there are strong suggestions that disease heterogeneity leads to variable disease progression as well as therapeutic responses. The recent development of single cell techniques, such as single cell RNA sequencing, gene expression profiling, or multiparametric cytometry, is likely to be a turning point. Single cell approaches provide researchers the opportunity to finally dissect disease pathology at a level that will allow mechanistic classifications and precision therapeutic strategies. In this review, we will give an overview of the current and developing repertoire of single cell techniques, the benefits and limitations of each, and provide an example of how single cell techniques can be utilized to understand complex immune mediated diseases and their translation from mouse to human.



https://ift.tt/2E1UoT1

Patient preferences regarding the communication of biopsy results in the general otolaryngology clinic

Publication date: Available online 7 October 2018

Source: American Journal of Otolaryngology

Author(s): Anirudh Saraswathula, Jennifer Y. Lee, Uchechukwu C. Megwalu

Abstract
Objectives

To determine the preferred methods of communicating biopsy results for patients in our comprehensive otolaryngology clinic, and to examine factors associated with preferring remote vs. in-person communication of results.

Study design

Cross-sectional study.

Setting

Academic comprehensive otolaryngology clinic.

Subjects and methods

A survey instrument was administered to 107 consecutive adult otolaryngology patients undergoing head and neck fine needle aspiration biopsy from March 1, 2017 to April 30, 2018 assessing their health literacy using the Brief Health Literacy Score and their preferred method of notification of biopsy results (in-person vs. remote).

Results

69% of patients preferred remote notification of their biopsy results (either by telephone or via an online portal). 54% of patients prioritized clear explanation of the results as the most important factor when communicating a malignant result. Adequate health literacy was associated with lower odds of preferring in-person notification (adjusted odds ratio 0.11, 95% CI 0.03 to 0.39). Patients who prioritized clear explanation of the results were more likely to prefer in-person notification (adjusted OR 4.13, 95% CI 1.31 to 14.88).

Conclusions

A significant proportion of patients in our comprehensive otolaryngology clinic undergoing fine needle aspiration biopsy preferred remote communication of their biopsy results. Patients most valued clear explanations from the provider and prompt receipt of the result when communicating malignant results. This highlights the need for individualized results communication plans, for patients undergoing biopsy.



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