No abstract available
https://ift.tt/2QJC1nQ
Τετάρτη 14 Νοεμβρίου 2018
Function and Strength after Free Abdominally Based Breast Reconstruction: A 10-year follow-up
BACKGROUND: The long-term impact of abdominally-based free flap breast reconstruction is incompletely understood. The aim of this study is to provide long-term, subjective and objective health data on abdominally based free flap breast reconstruction patients with specific attention to the effects of laterality, flap type and obesity. METHODS: Patients enrolled in this prospective study between 2005 and 2010 and completed preoperative, early (
https://ift.tt/2Pr5Vke
https://ift.tt/2Pr5Vke
Pakistan Comprehensive Fistula Classification: A novel Scheme and Algorithm for management of palatal fistula/dehiscence
Background: It is not easy to find a management based classification of palatal fistula in the literature. A few attempts have been made to classify the wide variety of fistulae which do not describe the fistula details comprehensively and guide towards its management. We have come across wide variety of fistulae which could not be classified according to any of the prevailing classification systems. The presented classification gives a clear and exact understanding of location and size of fistula/dehiscence. Palatal function has been included as one of the important determinants for devising a management plan. Based on this classification, we have proposed an algorithm which encompasses clear guidelines for surgical treatment of these fistulae. Materials and Methods: Over the last 15 years, our team operated upon 2537 palatal fistula patients. The medical records of these patients were reviewed to determine the location, size and velopharyngeal competence. A new classification and algorithm were developed.Results: Out of 2537 patients, 2258 patients had midline fistulae, 208 patients had lateral fistulae and 53 patients had subtotal fistulae. There were 18 patients with dehiscence. Recurrence developed in 181 patients. Conclusion: We believe that this classification and algorithm can help follow a practical approach to manage palatal fistulae and dehiscence. Financial Disclosure: None. ACKNOWLEDGMENT: We are grateful to Prof. Herman Sailer, Founder/Chairman of Cleft Children International, Zurich, Switzerland, for supervision and guidance of our Cleft Program in Pakistan & Afghanistan. ©2018American Society of Plastic Surgeons
https://ift.tt/2PsPpjV
https://ift.tt/2PsPpjV
Identification of paddy crop phenological parameters using dual polarized SCATSAT-1 (ISRO, India) scatterometer data
Abstract
Paddy crop is one of the foremost food crops in the world. Human consumption accounts for 85% of total production of paddy. Paddy delivers 21% of human per capita energy and 15% of per capita protein. The present study focused on estimating the crop phenological parameters. The phenological parameters were estimated using soil moisture active passive (SMAP), MODIS NDVI, and SCATSAT-1 scatterometer data. The statistical models adopted in the study are two-parameter Gaussian distribution and two-parameter logistic distributions. The puddling stage is the first phenological stage, and it is estimated by the application of soil wetness index (SWI) and anomaly method. The transplanting stage is estimated using the anomaly method. The heading stages are estimated using statistical models, and it is found that Gaussian distribution is the best-fitted model. The harvesting stage is identified using SCATSAT-1 scatterometer and MODIS NDVI data. A chi-square test and degrees of freedom are used to identify the performance and comparison of statistical models. Chi-square test measure is equal to 80.561 and corresponding tabulated chi-square value with N-K-1 degrees of freedom that is equal to 117 is 151.929. The null hypothesis is not rejected.
https://ift.tt/2QJ2Clb
Enantioselective degradation of the chiral alpha-cypermethrin and detection of its metabolites in five plants
Abstract
Alpha-cypermethrin (α-cypermethrin), an important chiral pyrethroid insecticide, is frequently detected in human samples. Because of the possible human health risks caused by α-cypermethrin, we studied dynamics, residues, and metabolism of α-cypermethrin in five common vegetables (tomato, cucumber, rape, cabbage, and pepper) on enantiomeric levels after foliar spray. α-Cypermethrin was qualified by a HP-5 column and its enantiomers could be separated by gas chromatograph (GC) using a BGB-172 chiral column. The results of degradation showed that α-cypermethrin dissipated rapidly in vegetables with half-lives being only 2.85–8.88 days. Stereoselective degradation was observed on pepper and cucumber while the two metabolites (cis-DCCA and 3-PBA) of α-cypermethrin were not detected during its dissipation in all plants. This is the first evidence of enantioselective degradation of α-cypermethrin in the five common vegetables and the results should be considered in future environmental risk and food safety evaluations.
https://ift.tt/2PqK1h3
Antibody-Based Therapies for Cutaneous T-Cell Lymphoma
Abstract
Cutaneous T-cell lymphomas (CTCLs) are a group of non-Hodgkin's lymphomas that present in the skin. In early-stage disease, the course is generally chronic and indolent; however, in advanced stages of disease, therapies rarely provide long-lasting responses, and the only potential curative therapy is allogeneic hematopoietic stem-cell transplantation. This has led to the search for novel targeted therapies to better treat more advanced stages of CTCLs that cannot be controlled by typical treatment regimens. One area of advancement has been the development of antibodies specifically targeted to cell types that are known to be involved in CTCL. At present, brentuximab vedotin, an antibody–drug conjugate composed of an anti-cluster of differentiation (CD)-30 antibody covalently linked to monomethyl auristatin E, is approved for the treatment of CD30+ lymphoproliferative disorders [lymphomatoid papulosis (LyP) and primary cutaneous-anaplastic large-cell lymphoma (pc-ALCL)] as well as transformed CD30+ mycosis fungoides (MF). Additionally, mogamulizumab, an anti-chemokine receptor 4 (CCR4) monoclonal antibody, is approved for patients with MF or Sézary syndrome (SS) for whom one prior systemic therapy has failed. Trials are underway looking into the use of immune checkpoint inhibitors in the treatment of CTCLs. As we continue to research CTCL, and as antibody-based therapies continue to advance, more antibody-specific targeted therapy could provide alternative treatment regimens for patients with advanced CTCL.
https://ift.tt/2K4kEvy
Basophil Activation Test: Old and New Applications in Allergy
Abstract
Purpose of Review
The basophil activation test (BAT) using flow cytometry has supplanted traditional methods of measuring basophil degranulation using histamine and other mediator release, and can be used for clinical applications as well as to explore the immune mechanisms of effector cell response to allergen. This review discusses the advancements made in clinical, diagnostic and laboratory research of allergy utilizing an ever-evolving BAT.
Recent Findings
Being an in vitro surrogate of the allergic reaction that happens in vivo in the sick patient, the BAT can be used to support the diagnosis of various allergic conditions, such as food, drug, respiratory and insect venom allergies, and the assessment of clinical response to allergen-specific immunotherapy and other immunomodulatory treatments. The BAT can also be used for research purposes to explore the mechanisms of allergy and tolerance at the level of the basophil, for instance by manipulating IgE and IgG and their receptors and by studying intracellular signalling cascade in response to allergen.
Summary
This review covers the applications of the BAT to the clinical management of allergic patients and the increased understanding of the mechanisms of immune response to allergens as well as technological advancements made in recent years.
https://ift.tt/2K4pj0B
Increased salivary AKR1B10 level: association with progression and poor prognosis of oral squamous cell carcinoma
Abstract
Background
Aldo‐keto reductase family 1 member B10 (AKR1B10) expression in oral squamous cell carcinoma (OSCC) tissue specimens is correlated with the progression and prognosis of OSCC.
Methods
Saliva samples were obtained from 35 normal controls and 86 patients with OSCC before cancer surgery. The AKR1B10 levels were determined using enzyme‐linked immunosorbent assay (ELISA).
Results
The mean salivary AKR1B10 levels were significantly higher in the patients with OSCC than in the normal controls (P < .001). Higher salivary AKR1B10 levels were significantly associated with larger tumor size, more advanced clinical stage, and areca quid chewing habit. Patients with OSCC with a higher salivary AKR1B10 level (>646 pg/mL) had a significantly poorer survival than those with a lower (≤646 pg/mL) salivary AKR1B10 level (P = .026).
Conclusion
The salivary AKR1B10 level may be a promising biomarker for screening high‐risk patients with OSCC and monitoring the progression of OSCC.
https://ift.tt/2K3oa9m
Basophil Activation Test: Old and New Applications in Allergy
Abstract
Purpose of Review
The basophil activation test (BAT) using flow cytometry has supplanted traditional methods of measuring basophil degranulation using histamine and other mediator release, and can be used for clinical applications as well as to explore the immune mechanisms of effector cell response to allergen. This review discusses the advancements made in clinical, diagnostic and laboratory research of allergy utilizing an ever-evolving BAT.
Recent Findings
Being an in vitro surrogate of the allergic reaction that happens in vivo in the sick patient, the BAT can be used to support the diagnosis of various allergic conditions, such as food, drug, respiratory and insect venom allergies, and the assessment of clinical response to allergen-specific immunotherapy and other immunomodulatory treatments. The BAT can also be used for research purposes to explore the mechanisms of allergy and tolerance at the level of the basophil, for instance by manipulating IgE and IgG and their receptors and by studying intracellular signalling cascade in response to allergen.
Summary
This review covers the applications of the BAT to the clinical management of allergic patients and the increased understanding of the mechanisms of immune response to allergens as well as technological advancements made in recent years.
https://ift.tt/2K4pj0B
Distinctive impact of polystyrene nano-spherules as an emergent pollutant toward the environment
Abstract
The increasing load of nanoplastic pollution in the environment has become a major concern toward human and environmental safety. The current investigation mainly focused on assessing the toxic behavior of nanoplastics (polystyrene nano-spheres (PNS)) toward blood cells and marine crustacean. The study also investigated the temporal stability of PNS under different water matrices and its size-dependent sedimentation behavior in the sea water dispersion. The nano-dispersion showed mean particle size of 561.4 ± 0.80 and 613.7 ± 0.11 nm for PNS 1 and 781.4 ± 0.80 and 913.7 ± 0.11 nm for PNS 2 in lake and seawater, respectively after 48-h incubation, which is ~ 8-fold increase from its original size. The LC50 value against Artemia salina and lymphocytes were found to be 4.82 and 8.79 μg/mL, and 75 μg/mL, respectively for PNS 1 and PNS 2. The genotoxic study reveals that around 50% of lymphocytes were affected by both PNS at 50 μg/mL concentration, whereas the cytotoxic studies on RBC and lymphocytes showed 50% toxicity only at 100 μg/mL concentration. The genotoxic study displayed numerous tri- and multi-nucleated cells. The biochemical profile of A. salina exposed to lethal concentration demonstrated a significant decrease in the total protein, reduced glutathione, and catalase activity and increase in lipid peroxidation activity as a result of PNS permeation to tissues. In conclusion, the present study demonstrated that the polystyrene nano-spheres are emerging pollutant in the environment and are hazardous to humans.
https://ift.tt/2z8Ihis
Interference mechanism of Sophora alopecuroides L. alkaloids extract on host finding and selection of the Asian citrus psyllid Diaphorina citri Kuwayama (Hemiptera: Psyllidae)
Abstract
Manipulating insect behavior through the deployment of semiochemicals offers a promising opportunity for protecting crops in a sustainable manner. Therefore, there is still a significant opportunity for the development of natural crop protectants as eco-friendly tools in pest management. In this context, the aim of the current investigation is to find a novel prophylactic against the Asian citrus psyllid (ACP) and to gain a better understanding of the host-finding and selection ability of the ACP towards Murraya paniculata seedlings treated with Sophora alopecuroides alkaloids extract (SAAE). Our results indicate that foliar application of SAAE influences the psyllid host-finding and selection process. The behavioral assay with M. paniculata seedlings treated with 15 and 30 mg/mL of SAAE, with masked visual cues, revealed that only 6.6 and 10.4% psyllids were able to locate the host in the vials. The results also indicate that citrus psyllids mainly rely on both visual and olfaction in host-finding and selection. In choice settling experiments, psyllids settled almost completely on control seedlings rather than on seedlings treated with SAAE at a concentration of 30 mg/mL. Chemical analyses of the alkaloids extract revealed the presence of sophocarpine (33.90%), sophoridine (6.23%), anagyrine (2.77%), matrine (2.38%), lupanine (1.68%) aphylline (0.89%), and sophoramine (0.75%). In further behavioral bioassays with the dominant alkaloids sophocarpine and sophoridine, the alkaloids repelled ACP at higher concentrations of 50 and 70 mg/mL as compared to SAAE. Furthermore, the 50 mg/mL (1:1, v/v) combination of sophocarpine and sophoridine displayed a synergistic effect and showed the maximum behavioral effect as compared to the individual alkaloid. Based on our results, SAAE makes M. paniculata seedlings unattractive to the psyllids, and therefore, alkaloids could be used in reducing the colonization of citrus plants, subsequently curtailing HLB infection.
https://ift.tt/2OEnKXT
AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie 2018; S 01 Article in Thieme...
AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie 2018; S 01
Article in Thieme eJournals:
Table of contents | Congress
https://ift.tt/2RSOXYQ
Traumatische Verletzungen des zentralen Nervensystems
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 668-681
DOI: 10.1055/s-0043-118969
Traumatische Verletzungen des zentralen Nervensystems stellen die Folge einer äußeren Gewalteinwirkung auf Gehirn oder Rückenmark dar. Sowohl das Schädel-Hirn-Trauma als auch das spinale Trauma sind dynamische Krankheitsbilder, die besondere Anforderungen an Diagnostik und Therapie stellen und somit in spezialisierten Zentren versorgt werden sollten.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2K2VRbh
Gefährliche Verzögerung: Warten erhöht Mortalität bei Sepsis
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 644-645
DOI: 10.1055/a-0727-4782
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
https://ift.tt/2B3I01A
Neurointensivmedizin: aneurysmatische Subarachnoidalblutung – State of the Art
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 654-667
DOI: 10.1055/s-0043-118963
Die spontane, nicht traumatische Subarachnoidalblutung ist eine lebensbedrohliche Erkrankung, die mit vielfältigen Komplikationen und einer hohen Morbidität und Mortalität vergesellschaftet ist. In den ersten 24 Stunden hat die Ausschaltung der Blutungsursache Vorrang. Die Patienten sollen intensivmedizinisch überwacht und behandelt werden. Stringente Diagnostik und konsequente Behandlung verbessern das Outcome der Patienten nachweislich.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2K0b4JZ
ICU: längeres Überleben durch Delirprophylaxe mit Haloperidol?
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 645-645
DOI: 10.1055/a-0727-5752
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
https://ift.tt/2K3A4jF
Geburtshilfliche Anästhesie und postoperative Überwachung
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 696-702
DOI: 10.1055/s-0043-111309
Die von ASA (American Society of Anesthesiologists) und SOAP (Society for Obstetric Anesthesia and Perinatology) für das Jahr 2016 aktualisierten Leitlinien sind eine Handlungsempfehlung in erster Linie für Anästhesisten, die auf das anästhesiologische Management Gebärender, nicht operative und operative Entbindung sowie auf die postpartale Versorgung und Analgesie fokussiert.
[...]
Georg Thieme Verlag KG Stuttgart · New York
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Mukopolysaccharidose: hohes Anästhesierisiko bei Kindern
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 645-646
DOI: 10.1055/a-0727-6682
Georg Thieme Verlag KG Stuttgart · New York
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Neurointensivmedizin
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 652-653
DOI: 10.1055/a-0668-4925
Georg Thieme Verlag KG Stuttgart · New York
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Schmerztherapeutische Aspekte bei Tumoroperationen
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 704-717
DOI: 10.1055/s-0043-104600
Trotz einer Vielzahl von Therapieoptionen wird die Akutschmerztherapie nach onkologischen Operationen häufig als unzureichend beschrieben. Neben einer unzureichenden Akutschmerztherapie können weitere Faktoren eine Hypersensitivierung und Chronifizierung sowie den Verlauf der Tumorerkrankung beeinflussen. Dieser Beitrag erklärt pathophysiologische Hintergründe und erläutert geeignete Therapiemodalitäten.
[...]
Georg Thieme Verlag KG Stuttgart · New York
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Neuromonitoring und Therapieentscheidungen auf der Intensivstation
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 682-695
DOI: 10.1055/s-0043-118971
Bei Patienten mit einer akuten Hirnschädigung besteht das Risiko einer weiteren neurologischen Verschlechterung aufgrund der Entwicklung eines sekundären Hirnschadens. Ziel des Neuromonitorings ist es frühzeitig pathophysiologische Veränderung des Gehirns zu erkennen um adäquate diagnostische und therapeutische Maßnahmen einzuleiten, um die Entstehung eines sekundären Hirnschadens zu vermeiden. Neben der klassischen Methode des klinischen Neuromonitorings bei wachen Patienten werden invasive Methoden mit Implantation von Messsonden zur Bestimmung des Hirndruckes, des zerebralen Sauerstoffpartialdruckes sowie des Hirnmetabolismus bei komatösen Patienten angewendet. Ein elektrophysiologisches Monitoring mittels Elektrokortikografie oder evozierter Potenziale sowie die Messung des zerebralen Blutflusses liefert ergänzende Informationen. Die Indikationen und die klinische Relevanz der verschiedenen Monitoring-Techniken werden im Hinblick auf eine Optimierung der Behandlung von Patienten mit akuten zerebralen Schädigungen besprochen.
[...]
Georg Thieme Verlag KG Stuttgart · New York
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„Ich muss genau hier sein!“
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 650-651
DOI: 10.1055/a-0663-1715
Georg Thieme Verlag KG Stuttgart · New York
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Metabolische Azidose unter Paracetamol – eine ungewöhnliche Nebenwirkung
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 718-722
DOI: 10.1055/a-0636-2595
Die metabolische Azidose ist bei hospitalisierten Patienten keine Rarität. Doch nur selten ist eine metabolische Azidose mit erweiterter Anionenlücke unter chronischer Paracetamol-Therapie und konsekutiver transienter 5-Oxoprolin-Akkumulation (Pyroglutaminsäure) bei Erwachsenen beschrieben 1, 2, 3, 4. Dieser Beitrag stellt einen solchen Fall dar und erläutert die wenig bekannte Pathogenese.
[...]
Georg Thieme Verlag KG Stuttgart · New York
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Carney Complex
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0753-4943
Carney complex is a rare, autosomal dominant, multiple endocrine neoplasia and lentiginosis syndrome, caused in most patients by defects in the PRKAR1A gene, which encodes the regulatory subunit type 1α of protein kinase A. Inactivating defects of PRKAR1A lead to aberrant cyclic-AMP-protein kinase A signaling. Patients may develop multiple skin abnormalities and a variety of endocrine and non-endocrine tumors. Endocrine manifestations include primary pigmented nodular adrenocortical disease, that may cause Cushing syndrome, growth-hormone secreting pituitary adenoma or pituitary somatotropic hyperplasia which can result in acromegaly, as well as gonadal and thyroid tumors. Non-endocrine tumors associated with Carney complex include myxomas of the heart, breast, and other sites, psamommatous melanotic schwannomas, breast ductal adenomas, osteochondromyxomas, and a predisposition to a number of malignancies from adrenal to pancreatic and liver cancer.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
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Treatment of Refractory Adrenocortical Carcinoma with Thalidomide: Analysis of 27 Patients from the European Network for the Study of Adrenal Tumours Registry
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0747-5571
Objective Adrenocortical carcinoma (ACC) is a rare malignancy with a dismal prognosis. In advanced stages, tumour control by mitotane and cytotoxic chemotherapy is often temporary and salvage treatments are warranted. Methods Retrospective cohort study of participants in the prospective European Networks for the Study of Adrenal Tumours (ENSAT) registry. Main outcome measures were best response during treatment, progression-free survival (PFS), both measured according to RECIST 1.1 by two blinded radiologists, and overall survival (OS). Results Twenty-seven patients (13 males; median age 44.1 years) progressing after mitotane and a median of 4 further systemic treatments were included. Thalidomide was administered as tolerated with a starting dose of 50 mg and target dose of 200 mg /d. The median interval between treatment initiation and first imaging was 10.5 (4.4-17.5) weeks. The best response to treatment was stable disease (SD, n=2) and progressive disease (n=25), with a median PFS of 11.2 weeks and a median OS of 36.4 weeks. The first patient with SD discontinued treatment due to mild epistaxis and diarrhea after 22.3 weeks. The second patient had SD at the second treatment evaluation after 25.2 weeks and continued thalidomide but then had clinical progression and deceased after 54.3 weeks. In general, thalidomide induced only mild or moderate adverse effects (mainly fatigue and gastrointestinal complaints). Conclusion Thalidomide was overall well tolerated but resulted in disease control in only 2/27 (7.4%) patients. In the absence of predictive response markers, thalidomide should only be considered in exceptional cases as a salvage therapy in ACC.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
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Association of HLA Class II alleles and Haplotypes with Type 1 Diabetes in Tunisian Arabs
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0754-5586
The molecular association of HLA class II with type 1 diabetes (T1DM) was investigated in Tunisian Arabs using 3 kinds of analyses. The first was a case-control association study, using Relative Predispositional Effects method, involved 137 T1DM cases and 258 control subjects. The second was family-based association-linkage study, using Transmission Disequilibrium Test, and covering 50 Tunisian families comprising 73 T1DM patients and 100 parents. The third was a wide correlation study between 4 DRB1 alleles (DRB1*03, *04, *11, *15) and T1DM in 52 countries, using Spearman's Rho. Results from Case-control and family-based association studies showed that DRB1*03 and DRB1*04 alleles predispose to T1DM in Tunisian Arabs. Conversely, only DRB1*11 was protective for T1DM. DRB1*04-DQB1*03 haplotype was consistently associated positively with T1DM; DRB1*03/DRB1*04 genotype had the highest risk of T1DM development. Compared to DRB1*03, HLA-DRB1*04 was associated with higher T1DM incidence. Thus, the contribution of HLA class II to T1DM genetic susceptibility must be evaluated with regards to specific HLA alleles, genotypes, and haplotypes, and also ethnic and racial background.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
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Hypoglycemia and Glucagon Utilization in Insulin-Treated Diabetic Patients *
Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0741-6763
Background First choice of therapy for severe hypoglycemia outside hospital environment is glucagon injection, an undertaught and underused remedy. Aim of this study was to investigate knowledge about glucagon therapy, possession rate and usage rate in insulin-treated diabetic patients, with special emphasis on history of hypoglycemia and severe hypoglycemia episodes. Methods In this cross-sectional study, 300 insulin-treated diabetic patients (146 males and 154 females, mean age 61.1±16.4 years) were recruited from comprehensive Diabetes Center in Croatia. Specialized self-administered, 13-item questionnaire regarding glucagon therapy and history of hypoglycemia was obtained from each patient, as well as data collected from medical history documentation. Results Experience of hypoglycemic episode was reported by 233 (77.7%), and severe hypoglycemia by 73 (24.3%) patients. Participants with experience of hypoglycemia have significantly longer diabetes duration (17.2±11.2 vs. 11.9±8.5 years, P<0.001) and lower BMI values (26.38±3.97 vs. 31.11±7.17 kg/m2, P<0.001). Knowledge about glucagon therapy had 55.3% patients, 44.7% obtained it from the pharmacy, while glucagon was used in 35.6% cases of severe hypoglycemia. Glucagon knowledge was better in patients that attended at least one diabetes lecture (P=0.038), while educational level showed no statistical significance (P=0.286). Main significant positive predictor of glucagon knowledge was history of severe hypoglycemia (OR 4.71, 95% CI 1.38 – 16.02, P=0.013). Conclusions Glucagon therapy was underused in treating severe hypoglycemia. It is highly important to emphasize value of quality education as one of the fundamentals of good diabetes management.
[...]
© Georg Thieme Verlag KG Stuttgart · New York
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AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie 2018; S 01 Article in Thieme...
AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie 2018; S 01
Article in Thieme eJournals:
Table of contents | Congress
https://ift.tt/2RSOXYQ
Traumatische Verletzungen des zentralen Nervensystems
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 668-681
DOI: 10.1055/s-0043-118969
Traumatische Verletzungen des zentralen Nervensystems stellen die Folge einer äußeren Gewalteinwirkung auf Gehirn oder Rückenmark dar. Sowohl das Schädel-Hirn-Trauma als auch das spinale Trauma sind dynamische Krankheitsbilder, die besondere Anforderungen an Diagnostik und Therapie stellen und somit in spezialisierten Zentren versorgt werden sollten.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2K2VRbh
Gefährliche Verzögerung: Warten erhöht Mortalität bei Sepsis
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 644-645
DOI: 10.1055/a-0727-4782
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
https://ift.tt/2B3I01A
Neurointensivmedizin: aneurysmatische Subarachnoidalblutung – State of the Art
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 654-667
DOI: 10.1055/s-0043-118963
Die spontane, nicht traumatische Subarachnoidalblutung ist eine lebensbedrohliche Erkrankung, die mit vielfältigen Komplikationen und einer hohen Morbidität und Mortalität vergesellschaftet ist. In den ersten 24 Stunden hat die Ausschaltung der Blutungsursache Vorrang. Die Patienten sollen intensivmedizinisch überwacht und behandelt werden. Stringente Diagnostik und konsequente Behandlung verbessern das Outcome der Patienten nachweislich.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2K0b4JZ
ICU: längeres Überleben durch Delirprophylaxe mit Haloperidol?
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 645-645
DOI: 10.1055/a-0727-5752
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
https://ift.tt/2K3A4jF
Geburtshilfliche Anästhesie und postoperative Überwachung
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 696-702
DOI: 10.1055/s-0043-111309
Die von ASA (American Society of Anesthesiologists) und SOAP (Society for Obstetric Anesthesia and Perinatology) für das Jahr 2016 aktualisierten Leitlinien sind eine Handlungsempfehlung in erster Linie für Anästhesisten, die auf das anästhesiologische Management Gebärender, nicht operative und operative Entbindung sowie auf die postpartale Versorgung und Analgesie fokussiert.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2K0j8KM
Mukopolysaccharidose: hohes Anästhesierisiko bei Kindern
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 645-646
DOI: 10.1055/a-0727-6682
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
https://ift.tt/2B3HjW2
Neurointensivmedizin
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 652-653
DOI: 10.1055/a-0668-4925
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
https://ift.tt/2B3HXmq
(Über-)Leben nach Lungenversagen: die DACAPO-Studie
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 646-647
DOI: 10.1055/a-0727-6029
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
https://ift.tt/2K3A3fB
Schmerztherapeutische Aspekte bei Tumoroperationen
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 704-717
DOI: 10.1055/s-0043-104600
Trotz einer Vielzahl von Therapieoptionen wird die Akutschmerztherapie nach onkologischen Operationen häufig als unzureichend beschrieben. Neben einer unzureichenden Akutschmerztherapie können weitere Faktoren eine Hypersensitivierung und Chronifizierung sowie den Verlauf der Tumorerkrankung beeinflussen. Dieser Beitrag erklärt pathophysiologische Hintergründe und erläutert geeignete Therapiemodalitäten.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2B3HVLk
Herzstillstand nach Infarkt: bessere Ergebnisse mit mechanischer Kreislaufunterstützung
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 647-648
DOI: 10.1055/a-0727-6465
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
https://ift.tt/2B3Hhxo
Neuromonitoring und Therapieentscheidungen auf der Intensivstation
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 682-695
DOI: 10.1055/s-0043-118971
Bei Patienten mit einer akuten Hirnschädigung besteht das Risiko einer weiteren neurologischen Verschlechterung aufgrund der Entwicklung eines sekundären Hirnschadens. Ziel des Neuromonitorings ist es frühzeitig pathophysiologische Veränderung des Gehirns zu erkennen um adäquate diagnostische und therapeutische Maßnahmen einzuleiten, um die Entstehung eines sekundären Hirnschadens zu vermeiden. Neben der klassischen Methode des klinischen Neuromonitorings bei wachen Patienten werden invasive Methoden mit Implantation von Messsonden zur Bestimmung des Hirndruckes, des zerebralen Sauerstoffpartialdruckes sowie des Hirnmetabolismus bei komatösen Patienten angewendet. Ein elektrophysiologisches Monitoring mittels Elektrokortikografie oder evozierter Potenziale sowie die Messung des zerebralen Blutflusses liefert ergänzende Informationen. Die Indikationen und die klinische Relevanz der verschiedenen Monitoring-Techniken werden im Hinblick auf eine Optimierung der Behandlung von Patienten mit akuten zerebralen Schädigungen besprochen.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2B3HUHg
„Ich muss genau hier sein!“
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 650-651
DOI: 10.1055/a-0663-1715
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
https://ift.tt/2K0maid
Metabolische Azidose unter Paracetamol – eine ungewöhnliche Nebenwirkung
Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 718-722
DOI: 10.1055/a-0636-2595
Die metabolische Azidose ist bei hospitalisierten Patienten keine Rarität. Doch nur selten ist eine metabolische Azidose mit erweiterter Anionenlücke unter chronischer Paracetamol-Therapie und konsekutiver transienter 5-Oxoprolin-Akkumulation (Pyroglutaminsäure) bei Erwachsenen beschrieben 1, 2, 3, 4. Dieser Beitrag stellt einen solchen Fall dar und erläutert die wenig bekannte Pathogenese.
[...]
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Abstract | Full text
https://ift.tt/2B4gnp9
The correlation between the concentration of hepcidin in serum and the occurrence of insulin resistance and hyperandrogenemia in women with polycystic ovary syndrome
OBJECTIVE: Scarce clinical and experimental studies suggest that hepcidin can be a protein participating in the development of metabolic disorders, while its synthesis and concentration in the circulation outside of the iron metabolism parameters can be influenced by hormones. The aim of the present study was to determine the correlation between the concentration of hepcidin in serum and the occurrence of insulin resistance and hyperandrogenemia in women with PCOS.
PATIENTS AND METHODS: Five groups of women with PCOS were divided based on: correct body mass (17 without hyperandrogenemia and insulin resistance – G1; 17 with hyperandrogenemia and without insulin resistance – G2; 11 without hyperandrogenemia and with insulin resistance – G3; 10 with hyperandrogenemia and insulin resistance – G4), metabolic and hormonal parameters and selected markers of iron metabolism.
RESULTS: Serum glucose levels were significantly higher in the group G3 than G1 and in the group G4 than G1 and G2. Serum insulin levels and HOMA–IR values were significantly higher in the groups G3 and G4 than G1 and G2. Serum androstenedione levels were significantly higher in the group G2 than G1 and G3 than G2. Serum transferrin levels were significantly lower in the group G1 than in the reaming study groups.
CONCLUSIONS: It has been demonstrated that insulin resistance and hyperandrogenemia appear to be the factors decreasing the concentration of transferrin circulation, but not the remaining parameters of the iron metabolism in the studied women. No relationship between the concentration of hepcidin circulation and other studied parameters of the iron metabolism and the parameters of the carbohydrate metabolism was discovered. Androstenedione can stimulate hepcidin synthesis in women with PCOS with correct body mass.
L'articolo The correlation between the concentration of hepcidin in serum and the occurrence of insulin resistance and hyperandrogenemia in women with polycystic ovary syndrome sembra essere il primo su European Review.
https://ift.tt/2FzJPrt
Hematopoietic cell transplantation for asymptomatic X-linked lymphoproliferative syndrome type 1
X-linked lymphoproliferative disease type 1 (XLP1) is a rare primary immune deficiency, which is caused by SH2D1A gene mutations. XLP1 is commonly associated with Epstein–Barr virus (EBV)-associated hemophagocyti...
https://ift.tt/2RRgqKk
Aberrant localization of FOXJ1 correlates with the disease severity and comorbidities in patients with nasal polyps
Upper airway inflammatory diseases are associated with abnormal expression of nasal epithelial forkhead-box J1 (FOXJ1) which regulates motile cilia formation. We sought to investigate whether aberrant FOXJ1 lo...
https://ift.tt/2DHDHva
Clinical outcomes and response of patients applying topical therapy for pyoderma gangrenosum: A prospective cohort study
Pyoderma gangrenosum is a painful ulcerating disease. The current evidence base for treatment is limited. In a large prospective study of topical treatments, 44% of patients were healed by 6 months. Ulcer size was a predictor of healing, and 15% of patients with pyoderma gangrenosum had a recurrence. Clobetasol propionate 0.05% is a potentially useful first-line therapy for patients with pyoderma gangrenosum, particularly for patients with small lesions.
https://ift.tt/2FwqfvQ
Acquired cold urticaria: Clinical features, particular phenotypes, and disease course in a tertiary care center cohort
Acquired cold urticaria (ACU) is characterized by the development of wheals, angioedema, or both after cold exposure. Age at diagnosis, disease severity, and response to the ice cube challenge test predicted both prognosis and response to therapy. Proper characterization of the type of acquired cold urticaria allows for appropriate counseling and choice of therapy.
https://ift.tt/2qLxRkd
Multivariate analysis of potential risk factors for lymph node metastasis in patients with cutaneous squamous cell carcinoma of the head and neck
Risk factors for metastasis from cutaneous squamous cell carcinoma are incorporated in tumor staging by the seventh edition of the American Joint Committee on Cancer Cancer Staging Manual.We confirmed most risk factors, and also identified moderate differentiation as a predictor for lymph node metastasis. Moderate differentiation can be considered in tumor staging.
https://ift.tt/2qK7Lhn
Premalignant and Malignant Mucosal lesions: Clinical and Pathological Findings Part II. Premalignant and malignant mucosal lesions
Part 2 of this 2-part continuing medical education series discusses the clinical and histopathologic features of common premalignant and malignant lesions of the oral cavity. It is imperative for dermatologists to be able to recognize suspicious lesions, determine biopsy need, counsel, and refer patients presenting with premalignant or malignant conditions appropriately. Given the higher rates of mortality and morbidity of oral mucosal malignancies due to late diagnosis, appropriate treatment with multidisciplinary care in a timely manner is essential to these neoplasms.
https://ift.tt/2FoERNS
Benign Oral Mucosal Lesions: Clinical and Pathological Findings Part I- Benign Oral Mucosal lesions
A diverse spectrum of benign oral mucosal lesions exists, presenting as either isolated oral findings or in association with dermatological conditions. Oral lesions can closely resemble one another; therefore, it is important for clinicians to be able to recognize their distinctive features and recognize benign versus malignant disease and when a biopsy is warranted. 1 In this continuing medical education series, we review oral anatomy and the clinical attributes of several benign lesions of the oral cavity along with the appropriate management and therapeutic modalities.
https://ift.tt/2qOOUln
The “Rule of 10s” versus the “Rule of 2s”: High complication rates after conventional excision with postoperative margin assessment of specialty site versus trunk and proximal extremity melanomas
The "Rule of 10s" defines the high rate of complications after conventional excision of specialty site melanomas.Segregating melanomas into high- and low-risk categories for local surgical complications is an important step to develop consensus guidelines that specify indications for Mohs surgery or slow Mohs to improve outcomes.
https://ift.tt/2Fkb88H
Mast cell chymase impairs bronchial epithelium integrity by degrading cell‐junction molecules of epithelial cells
Abstract
Background
An increased degree of mast cell (MC) degranulation and damage to the epithelial lining are prominent features of bronchial asthma. In asthmatic airways, it seems likely that epithelial cells will be exposed to increased concentrations of proteases from MC, though their actions on the epithelium are still not very clear.
Methods
Bronchial rings from human lung tissue or 16HBE cell monolayer were incubated with MC‐chymase in different doses or various inhibitors. The sections of paraffin‐embedded tissue were haematoxylin‐eosin stained and computerized by image analysis for epithelial damage‐scale‐evaluation; the cell viability, proliferation, adhesion, LDH release were assayed; the expressions of gelatinases, cell‐junction molecules and structure proteins of 16HBE were examined.
Results
MC‐Chymase was found to provoke profound changes in the morphology of bronchi epithelial layer. Following incubation with chymase there was 40% reduction of the length of epithelium that was intact, with detachment of columnar epithelial cells and basal cells. Chymase reduced epithelial cell proliferation and induced cell detachment, which were associated with the changes in secretion and activation of matrix metalloproteinase‐2/9. In intact epithelial cell layers, immunocytochemistry study revealed that chymase reduced the expressions of occludin, claudin‐4, ZO‐1, E‐cadherin, focal adhesion kinase and cytokeratin. Overall data of this study indicated that MC‐chymase can influence tissue remodelling, disrupt epithelial cell‐junctions, inhibit wound healing and impair the barrier function of epithelium, resulting in dysfunction of airway wall and ECM remodelling in pathogenesis of asthma.
Conclusions
MC‐chymase plays a key role in inducing the damage to bronchial epithelium in asthma.
This article is protected by copyright. All rights reserved.
https://ift.tt/2qKD2k6
New insights into the origin of mast cells
Abstract
Single‐cell RNA‐sequencing and colony‐forming assays suggest that bone marrow hematopoietic stem and progenitor cells traverse through a differentiation landscape before commitment to the mast cell and other cell lineages.1 However, the bone marrow contribution for the formation of tissue‐resident mast cells has been questioned, and the prenatal origin of mast cells was recently uncovered.2 Through fate mapping experiments Gentek et al2 elegantly demonstrated that mast cells arise during two distinct waves of the embryonic development, one from the yolk sac and the other via the aorta‐gonad‐mesonephros.
This article is protected by copyright. All rights reserved.
https://ift.tt/2FpQc0d
Modified bolster dressing with continuous suction improves skin graft survival for an oral cavity wound
Skin engraftment of intraoral defects is known to be inconsistent due to mobility of the oral structure, uneven wounds, and accumulation of saliva under the skin graft. To improve the success rate of oral skin...
https://ift.tt/2FmFOGq
Silicone-based simulation models for peripheral nerve microsurgery
There is a need for a peripheral nerve model on which surgeons-in-training can simulate the repair of nerve injuries at their own pace. Although practicing on animal models/cadavers is considered the "gold standard" of microsurgical training, the proposed model aims to provide a platform for improving the technical skills of surgical trainees prior to their practice on cadaver/animal models. In addition, this model has the potential to serve as a standardized test medium for assessing the skill sets of surgeons.
https://ift.tt/2qMF2bV
Skin shop: A new model for high volume skin cancer care
Non-melanoma skin cancer incidence is increasing in New Zealand. Increased cost of care has led to service pressure and a review of models of care. A high volume skin surgery service at Waikato Hospital has been developed to reduce service costs. This study examines the oncological safety of the new model.
https://ift.tt/2Fk66cj
Prognostic impact of regression in patients with primary cutaneous melanoma >1 mm in thickness
The impact of histologic regression on sentinel lymph node biopsy (SLNB) status and on clinical outcome is uncertain.
https://ift.tt/2PuJ6fu
Management of Complex Arteriovenous Malformations Using a Novel Combination Therapeutic Algorithm
This case series assesses the efficacy and tolerability of sirolimus as an adjuvant therapy for endovascular embolization in the management of complicated extracranial head and neck arteriovenous malformations.
https://ift.tt/2xpldet
https://ift.tt/2xpldet
Machine Learning and Health Care Disparities in Dermatology
This viewpoint discusses the limitations of machine learning in diagnostics involving skin of color.
https://ift.tt/2LLoJsz
https://ift.tt/2LLoJsz
Antiphospholipid Syndrome Following Pembrolizumab Treatment of Stage IIIB Unresectable Melanoma
The case report describes the occurrence of antiphospholipid syndrome following pembrolizumab treatment of stage IIIB unresectable melanoma.
https://ift.tt/2xpkCtf
https://ift.tt/2xpkCtf
Avoiding and Managing Medicare Fraud and Abuse Investigations of Mohs Surgery
This Viewpoint discusses ways dermatologists can manage and avoid investigations by the US Department of Justice and the Centers for Medicare & Medicaid Services for alleged Medicare fraud and abuse related to Mohs surgery.
https://ift.tt/2AS7EYS
https://ift.tt/2AS7EYS
An Atypical Figurate Erythema With Seasonal Recurrences
A woman had a large annular erythematous plaque on her back that had centrifugally expanded. She had mild pruritus that had not responded to antihistamine therapy or topical steroids and reported a 20-year history of the plaques recurring every summer and resolving by autumn. What is your diagnosis?
https://ift.tt/2LHsjnv
https://ift.tt/2LHsjnv
Vasculitis
This Patient Page describes vasculitis, focusing especially on skin vasculitis, how to recognize it, and how it might be treated.
https://ift.tt/2OP4nfG
https://ift.tt/2OP4nfG
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
https://ift.tt/2MQgvjC
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
https://ift.tt/2PGOlUT
Introducing “Images in Dermatology”
It is often said that dermatology is a "visual specialty." While it is more than that, there is no escaping the central importance of the clinical examination to dermatologic diagnosis. The appearance, the morphology, the shape and distribution of lesions—these features are the illustration of illness, the manifestation of cutaneous or even systemic disease. The critical role of the physical examination, imparting the ability to make a diagnosis visually, is part of the art of dermatology and is shared by few other medical specialties.
https://ift.tt/2P9rvFE
https://ift.tt/2P9rvFE
An Atrophic and Spiny Eruption of the Palms
A woman presented with a pruritic and burning hyperpigmented eruption on the bilateral palms; examination revealed well-marginated brown atrophic patches on the bilateral palms extending focally onto the volar aspect of the wrist and surmounted by spiny keratotic pits in the palmar creases. What is your diagnosis?
https://ift.tt/2N8U30N
https://ift.tt/2N8U30N
Translating Data on Trends in Disease Management to Decisions
Quantifying health care utilization is an important first step in understanding how to efficiently and effectively deliver health care to patients. Actinic keratoses (AKs) are among the most common clinical diagnoses encountered by dermatologists, and treatment aims to reduce patient discomfort and potential for malignant transformation. Given an aging population, disease burden will likely increase, highlighting the need for understanding trends in AK treatment and reimbursement.
https://ift.tt/2PPtpLB
https://ift.tt/2PPtpLB
Alopecia Universalis and Chronic Graft-vs-Host Disease Treated With Ruxolitinib
This case report describes alopecia universalis and chronic graft-vs-host disease occurring after allogenic hematopoietic stem-cell transplantation and treated with ruxolitinib.
https://ift.tt/2NZNpyK
https://ift.tt/2NZNpyK
Exercise for Leg Ulcers
In this issue of JAMA Dermatology, Jull et al use meta-analysis to suggest an additional healing benefit of exercise in patients with venous leg ulcers (VLUs). Combining and analyzing data from 5 relatively small studies (the largest with 63 participants), the authors found that 61% of participants (57 of 94) who exercised and received compression healed at 12 weeks compared with 46% (44 of 96) of participants who received compression alone. Although the type of exercise administered varied among the trials, the results were driven by 2 studies that used progressive resistance exercises involving calf muscle strengthening coupled with physical activity (walking). In addition to providing rationale for an adjunctive therapeutic modality for patients with VLUs, this article also highlights the power of properly performed meta-analysis to provide clarity where previously none existed.
https://ift.tt/2P31Kqp
https://ift.tt/2P31Kqp
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
https://ift.tt/2NPkTf5
Glycolic Acid Plus Lovastatin-Cholesterol Combination Cream to Treat Congenital Ichthyoses
This case series evaluates the use of topical glycolic acid plus a lovastatin-cholesterol combination cream to treat autosomal recessive congenital ichthyoses.
https://ift.tt/2MpSj2i
https://ift.tt/2MpSj2i
Trajectories of Nevus Development From Age 3 to 16 Years in the Colorado Kids Sun Care Program Cohort
This longitudinal cohort study describes nevus acquisition from the ages of 3 to 16 years among white youths and evaluates variation by sex, Hispanic ethnicity, and body sites that are chronically vs intermittently exposed to the sun.
https://ift.tt/2MpSvyy
https://ift.tt/2MpSvyy
Acrodermatitis Continua of Hallopeau
This case report describes the occurrence of acrodermatitis continua of Hallopeau being mistaken for recurrent cellulitis.
https://ift.tt/2P5R4Yb
https://ift.tt/2P5R4Yb
Use of Actinic Keratosis Destruction in the Medicare Part B Fee-for-Service Population
This billing claims analysis uses the Medicare Part B Physician/Supplier Procedure Summary Master Files and National Summary Data to evaluate trends in the use and costs of actinic keratosis destruction.
https://ift.tt/2PPrI0N
https://ift.tt/2PPrI0N
Exercise-induced anaphylaxis associated with the use of bee pollen
The use of alternative and complementary medicine, including herbal supplements, is widespread in the United States. Some supplements have been associated with allergic reactions, even anaphylaxis. One such over-the-counter (OTC) supplement is bee pollen. This product is derived from pollen loads collected by honeybees and held together via enzymes secreted in the saliva of the bees. It contains various pollens that can vary based on the path of the individual insect as well the geographical location and associated plant species.
https://ift.tt/2DkITEs
Too Many Thyroid Ultrasound Exams Lead to an Increase in the Diagnosis of Low-Risk Thyroid Cancer
Clinical Thyroidology, Volume 30, Issue 11, Page 519-522, November 2018.
https://ift.tt/2OIUXRK
Randomized, Controlled Trials Show That Treatment of Subclinical Hypothyroidism Does Not Improve Quality of Life, Cognition, Blood Pressure, or BMI
Clinical Thyroidology, Volume 30, Issue 11, Page 496-499, November 2018.
https://ift.tt/2z8njjK
Which Factors Predict the Outcome of Ablative Radioactive Iodine Treatment of Hyperthyroid Graves' Disease?
Clinical Thyroidology, Volume 30, Issue 11, Page 500-504, November 2018.
https://ift.tt/2ODUi4h
Levothyroxine Treatment Improves Miscarriage Risk, But Not Live Birth Rates, in Women with Subclinical Hypothyroidism or TPO Antibody Positivity Undergoing ART
Clinical Thyroidology, Volume 30, Issue 11, Page 526-528, November 2018.
https://ift.tt/2z8nf3u
A Thyroid Hormone Transporter Mutant Causes Delayed Hypothyroidism Selectively in the Brain
Clinical Thyroidology, Volume 30, Issue 11, Page 505-507, November 2018.
https://ift.tt/2OIUQpi
Vemurafenib Restores Radioiodine Uptake in Some Metastatic Thyroid Cancers
Clinical Thyroidology, Volume 30, Issue 11, Page 516-518, November 2018.
https://ift.tt/2z8SSda
High-Dose Radioactive Iodine Ablation Decreases Local Recurrence for High-Risk Papillary Thyroid Cancer
Clinical Thyroidology, Volume 30, Issue 11, Page 508-510, November 2018.
https://ift.tt/2OKJKjV
Symptoms Strongly Drive the Consideration of Alternative Thyroid Hormone–Replacement Options in Patients with Hypothyroidism
Clinical Thyroidology, Volume 30, Issue 11, Page 523-525, November 2018.
https://ift.tt/2z9Q5Ac
Low-Dose Radioiodine Ablation Is Equally Effective as High-Dose Ablation in Patients with Low-Risk Thyroid Cancer on Long-Term Follow-up
Clinical Thyroidology, Volume 30, Issue 11, Page 511-515, November 2018.
https://ift.tt/2OJejqc
CASE REPORT: An Extensively Necrotic Hürthle-Cell Carcinoma Mimicked a Thyroid Abscess
Clinical Thyroidology, Volume 30, Issue 11, Page 529-533, November 2018.
https://ift.tt/2zb1Xlv
Larger ascending aorta in primary aldosteronism: a 3-year prospective evaluation of adrenalectomy vs. medical treatment
Abstract
Objective
Primary aldosteronism is associated with higher cardiovascular morbidity as compared with essential hypertension. Vascular complications encompass myocardial infarction and cerebrovascular events. Aortic damage in primary aldosteronism has never been explored, although a few cases of ascending aorta aneurisms have been reported.
Design and methods
We consecutively enrolled patients affected by primary aldosteronism (n = 45) and compared them with patients affected by essential hypertension (n = 47), on an outpatient setting. Echocardiographic data of patients with primary aldosteronism were collected during a mean follow-up of 3 years, in subjects who underwent adrenal surgery (n = 12) and those on mineralocorticoid receptor antagonists (n = 33).
Results and conclusion
We found that patients with primary aldosteronism had larger ascending aorta diameters than those with essential hypertension before starting any specific treatment. Patients with primary aldosteronism did not show significant changes in the size of ascending aorta during a mean of 3 years of follow-up, irrespective of the type of treatment (medical vs. surgical treatment). A longer follow-up will better clarify if worsening of the aortic damage may be better prevented by surgery rather than by mineralocorticoid receptor antagonists.
https://ift.tt/2DmaOnl
Confounders of severe asthma: diagnoses to consider when asthma symptoms persist despite optimal therapy
Asthma can often be challenging to diagnose especially when patients present with atypical symptoms. Therefore, it is important to have a broad differential diagnosis for asthma to ensure that other conditions...
https://ift.tt/2Tixvyy
Larger ascending aorta in primary aldosteronism: a 3-year prospective evaluation of adrenalectomy vs. medical treatment
Abstract
Objective
Primary aldosteronism is associated with higher cardiovascular morbidity as compared with essential hypertension. Vascular complications encompass myocardial infarction and cerebrovascular events. Aortic damage in primary aldosteronism has never been explored, although a few cases of ascending aorta aneurisms have been reported.
Design and methods
We consecutively enrolled patients affected by primary aldosteronism (n = 45) and compared them with patients affected by essential hypertension (n = 47), on an outpatient setting. Echocardiographic data of patients with primary aldosteronism were collected during a mean follow-up of 3 years, in subjects who underwent adrenal surgery (n = 12) and those on mineralocorticoid receptor antagonists (n = 33).
Results and conclusion
We found that patients with primary aldosteronism had larger ascending aorta diameters than those with essential hypertension before starting any specific treatment. Patients with primary aldosteronism did not show significant changes in the size of ascending aorta during a mean of 3 years of follow-up, irrespective of the type of treatment (medical vs. surgical treatment). A longer follow-up will better clarify if worsening of the aortic damage may be better prevented by surgery rather than by mineralocorticoid receptor antagonists.
https://ift.tt/2DmaOnl
MM-398 and Ramucirumab in Treating Patients With Gastric Cancer or Gastroesophageal Junction Adenocarcinoma
Conditions: Clinical Stage III Gastric Cancer AJCC v8; Clinical Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8; Clinical Stage IV Gastric Cancer AJCC v8; Clinical Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8; Clinical Stage IVA Gastric Cancer AJCC v8; Clinical Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8; Clinical Stage IVB Gastric Cancer AJCC v8; Clinical Stage IVB Gastroesophageal Junction Adenocarcinoma AJCC v8; Locally Advanced Unresectable Gastric Adenocarcinoma; Metastatic Gastroesophageal Junction Adenocarcinoma; Metastatic Unresectable Gastric Adenocarcinoma; Pathologic Stage III Gastric Cancer AJCC v8; Pathologic Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IIIA Gastric Cancer AJCC v8; Pathologic Stage IIIA Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IIIB Gastric Cancer AJCC v8; Pathologic Stage IIIB Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IIIC Gastric Cancer AJCC v8; Pathologic Stage IV Gastric Cancer AJCC v8; Pathologic Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IVB Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage III Gastric Cancer AJCC v8; Postneoadjuvant Therapy Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IIIA Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IIIB Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IV Gastric Cancer AJCC v8; Postneoadjuvant Therapy Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IVB Gastroesophageal Junction Adenocarcinoma AJCC v8; Unresectable Gastroesophageal Junction Adenocarcinoma
Interventions: Drug: Liposomal Irinotecan; Other: Quality-of-Life Assessment; Other: Questionnaire Administration; Biological: Ramucirumab
Sponsors: University of Southern California; National Cancer Institute (NCI); Ipsen
Not yet recruiting
https://ift.tt/2B656EF
Interventions: Drug: Liposomal Irinotecan; Other: Quality-of-Life Assessment; Other: Questionnaire Administration; Biological: Ramucirumab
Sponsors: University of Southern California; National Cancer Institute (NCI); Ipsen
Not yet recruiting
https://ift.tt/2B656EF
Study Evaluating Safety and Efficacy of Bimiralisib in Patients With Head and Neck Squameous Cell Carcinoma
Condition: HNSCC
Intervention: Drug: Bimiralisib
Sponsor: PIQUR Therapeutics AG
Not yet recruiting
https://ift.tt/2K2G78h
Intervention: Drug: Bimiralisib
Sponsor: PIQUR Therapeutics AG
Not yet recruiting
https://ift.tt/2K2G78h
Binary Oncolytic Adenovirus in Combination With HER2-Specific CAR VST, Advanced HER2 Positive Solid Tumors (VISTA)
Conditions: Bladder Cancer; Head and Neck Squamous Cell Carcinoma; Cancer of the Salivary Gland; Lung Cancer; Breast Cancer; Gastric Cancer; Esophageal Cancer; Colorectal Cancer; Pancreatic Adenocarcinoma
Intervention: Biological: CAdVEC
Sponsors: Baylor College of Medicine; The Methodist Hospital System; Texas Children's Hospital
Not yet recruiting
https://ift.tt/2B5fCMA
Intervention: Biological: CAdVEC
Sponsors: Baylor College of Medicine; The Methodist Hospital System; Texas Children's Hospital
Not yet recruiting
https://ift.tt/2B5fCMA
MM-398 and Ramucirumab in Treating Patients With Gastric Cancer or Gastroesophageal Junction Adenocarcinoma
Conditions: Clinical Stage III Gastric Cancer AJCC v8; Clinical Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8; Clinical Stage IV Gastric Cancer AJCC v8; Clinical Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8; Clinical Stage IVA Gastric Cancer AJCC v8; Clinical Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8; Clinical Stage IVB Gastric Cancer AJCC v8; Clinical Stage IVB Gastroesophageal Junction Adenocarcinoma AJCC v8; Locally Advanced Unresectable Gastric Adenocarcinoma; Metastatic Gastroesophageal Junction Adenocarcinoma; Metastatic Unresectable Gastric Adenocarcinoma; Pathologic Stage III Gastric Cancer AJCC v8; Pathologic Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IIIA Gastric Cancer AJCC v8; Pathologic Stage IIIA Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IIIB Gastric Cancer AJCC v8; Pathologic Stage IIIB Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IIIC Gastric Cancer AJCC v8; Pathologic Stage IV Gastric Cancer AJCC v8; Pathologic Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8; Pathologic Stage IVB Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage III Gastric Cancer AJCC v8; Postneoadjuvant Therapy Stage III Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IIIA Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IIIB Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IV Gastric Cancer AJCC v8; Postneoadjuvant Therapy Stage IV Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IVA Gastroesophageal Junction Adenocarcinoma AJCC v8; Postneoadjuvant Therapy Stage IVB Gastroesophageal Junction Adenocarcinoma AJCC v8; Unresectable Gastroesophageal Junction Adenocarcinoma
Interventions: Drug: Liposomal Irinotecan; Other: Quality-of-Life Assessment; Other: Questionnaire Administration; Biological: Ramucirumab
Sponsors: University of Southern California; National Cancer Institute (NCI); Ipsen
Not yet recruiting
https://ift.tt/2B656EF
Interventions: Drug: Liposomal Irinotecan; Other: Quality-of-Life Assessment; Other: Questionnaire Administration; Biological: Ramucirumab
Sponsors: University of Southern California; National Cancer Institute (NCI); Ipsen
Not yet recruiting
https://ift.tt/2B656EF
Study Evaluating Safety and Efficacy of Bimiralisib in Patients With Head and Neck Squameous Cell Carcinoma
Condition: HNSCC
Intervention: Drug: Bimiralisib
Sponsor: PIQUR Therapeutics AG
Not yet recruiting
https://ift.tt/2K2G78h
Intervention: Drug: Bimiralisib
Sponsor: PIQUR Therapeutics AG
Not yet recruiting
https://ift.tt/2K2G78h
Binary Oncolytic Adenovirus in Combination With HER2-Specific CAR VST, Advanced HER2 Positive Solid Tumors (VISTA)
Conditions: Bladder Cancer; Head and Neck Squamous Cell Carcinoma; Cancer of the Salivary Gland; Lung Cancer; Breast Cancer; Gastric Cancer; Esophageal Cancer; Colorectal Cancer; Pancreatic Adenocarcinoma
Intervention: Biological: CAdVEC
Sponsors: Baylor College of Medicine; The Methodist Hospital System; Texas Children's Hospital
Not yet recruiting
https://ift.tt/2B5fCMA
Intervention: Biological: CAdVEC
Sponsors: Baylor College of Medicine; The Methodist Hospital System; Texas Children's Hospital
Not yet recruiting
https://ift.tt/2B5fCMA
Reduced Itch Associated With Dupilumab Treatment In 4 Patients With Prurigo Nodularis
This case report describes itch reduction in 4 patients with prurigo nodularis following treatment with dupilumab.
https://ift.tt/2QI3czt
https://ift.tt/2QI3czt
A Meta-analysis of Benefits and Harms of Omalizumab in Patients With Chronic Idiopathic Urticaria
This meta-analysis of 67 observational studies analyzes the effectiveness and adverse event rate of omalizumab therapy in patients with chronic idiopathic urticaria and compares these findings with those of randomized clinical trials conducted among similar patients.
https://ift.tt/2PugP8I
https://ift.tt/2PugP8I
Coral Dermatitis
This case report describes a cerebriform plaque with sharply demarcated, pink, erythematous borders on the leg of a woman after she came in contact with coral.
https://ift.tt/2QI90Jp
https://ift.tt/2QI90Jp
Dupilumab Treatment for Generalized Prurigo Nodularis
This case series report of 3 patients assesses the effectiveness of dupilumab in the treatment of generalized prurigo nodularis.
https://ift.tt/2Pugx1C
https://ift.tt/2Pugx1C
Factors Associated With Persistent Atopic Dermatitis in Children
This clinical birth cohort study evaluates the association of genetic, environmental, clinical, and social factors with the persistence of atopic dermatitis at age 13 years among children born to parents with asthma.
https://ift.tt/2QI39DN
https://ift.tt/2QI39DN
Bilateral Round Scar-like Lesions on the Face of a Young Man
A 26-year-old man presents with a several-year history of persistent round lesions with a scar-like appearance on his face. What is your diagnosis?
https://ift.tt/2PuNZVM
https://ift.tt/2PuNZVM
A phase I clinical study of a cocktail vaccine of Wilms’ tumor 1 (WT1) HLA class I and II peptides for recurrent malignant glioma
Abstract
Purpose
The safety and clinical efficacy of WT1 human leukocyte antigen (HLA) class I peptide vaccine have been established, but the safety of a cocktail vaccine of WT1 HLA class I and II peptides has not. To verify its safety, we performed a phase I clinical trial for patients with recurrent malignant gliomas and assessed the immunological responses and survival data.
Patients and methods
Fourteen HLA-A*24:02-positive patients with recurrent malignant glioma (2 with grade 3, 12 with grade 4) were enrolled. Every week, the patients received alternately a vaccine containing 3 mg of WT1 HLA-A*24:02-restricted (HLA class I) peptide and a cocktail vaccine of the HLA class I peptide and one of 0.75, 1.5 or 3 mg of the WT1 HLA class II peptide. For patients who showed no significant adverse effects within 6 weeks, the WT1 vaccine was continued at 2–4-week intervals.
Results
Eleven of the 14 patients completed WT1 vaccination for 6 weeks, while 3 patients dropped out earlier due to disease progression. All patients showed grade I level of skin disorders at the injection sites. No grade III/IV toxicity or dose-limiting toxicity was observed for any dose of WT1 HLA class II peptide. Six of the 14 patients had stable disease at 6 weeks. Median OS and 1-year OS rates were 24.7 weeks and 36%, respectively.
Conclusion
The safety of a cocktail vaccine of WT1 HLA class I and II peptides for malignant gliomas was verified. This vaccine is, therefore, considered promising for patients with recurrent malignant glioma.
https://ift.tt/2B6ELGK
Hormonal control of vas deferens fluid volume and aquaporin expression in rats
Abstract
Precise regulation of vas deferens fluid volume which is important for sperm survival might be influenced by testosterone. In order to investigate changes in vas deferens fluid volume and aquoporins (AQP) isoforms expression under testosterone influence, orchidectomized Sprague–Dawley rats were given 125 and 250 µg/kg/day testosterone with or without flutamide, an androgen receptor blocker or finasteride, a 5alpha-reductase inhibitor for seven consecutive days. Following treatment completion, vas deferens was perfused and changes in the fluid secretion rate and osmolality were determined in the presence of acetazolamide. Rats were then sacrificed and vas deferens was harvested for histology, tissue expression and distribution analyses of AQP-1, AQP-2, AQP-5, AQP-7 and AQP-9 proteins by Western blotting and immunohistochemistry, respectively. Our findings indicate that testosterone causes vas deferens fluid secretion rate to increase, which was antagonized by acetazolamide. Fluid osmolality increased following testosterone treatment and further increased when acetazolamide was given. Co-administration of flutamide or finasteride with testosterone causing both fluid secretion rate and osmolality to decrease. Histology revealed increased size of vas deferens lumen with increased thickness of vas deferens stroma. Expression of AQP-1, AQP-2 and AQP-9 were detected in vas deferens but not AQP-5 and AQP-7, and the levels of these proteins were increased by testosterone treatment mainly at the apical membrane of vas deferens epithelium. In conclusion, increased in vas deferens fluid secretion rate under testosterone influence mediated via the up-regulation of AQP-1, 2 and 9 might be important for vas deferens fluid homeostasis in order to ensure normal male fertility.
https://ift.tt/2B5TiSR
Could Music Minimize Discomfort and Pain During Office-Based ENT Surgery?
Background. Video-assisted endoscopic radiofrequency inferior turbinate volume reduction (RFVTR) is one of the most common surgical therapies for inferior turbinate hypertrophy (ITH). Despite all the technical and surgical advancement, it is advisable to reduce as low as possible the intraoperative discomfort. The aim of this study is to evaluate the role of music in reducing patient discomfort during RFVTR. Materials and Methods. Twenty-three patients with chronic nasal obstruction due to ITH and candidate to RFVTR are included. Before the procedure each patient filled in a completed Italian version of the state anxiety questionnaire (State-Trait Anxiety Inventory), SNOT 22 questionnaire, VAS, and chose their favourite music to be played during RFVTR. All patients evaluate the intraoperative discomfort with a visual analog scale (VAS) and for each patient, vital parameters such as blood pressure and heart rate were recorded 15 minutes before the procedure, during and after RFVTR. Results. The intraoperative VAS scores during listening to music (5.7 ± 2.42 vs 6.7 ± 1.97; p
https://ift.tt/2OIi3s3
Assessment of heavy metal release into the soil after mine clearing in Halgurd-Sakran National Park, Kurdistan, Iraq
Abstract
The aim of this study was to assess the heavy metal pollution in soils after mine clearance and disposal through controlled explosions in dugout pits during demining operations at two hotspot areas, in the Halgurd-Sakran National Park (HSNP). This investigation was undertaken in order to reveal the concentration level, migration and enrichment in various heavy metals present in polluted soils. Eighteen samples, nine sampling positions at each site, were collected. The current study used inductively coupled plasma-emission spectroscopy (ICP-ES) methodology to determine the concentration levels of Cu, Pb, Zn, Ni, Co, Mn, As and Cr in the soil samples as important toxic contaminants resulting from the demining process. The results show concentration levels of 63.33, 16.22, 116.44, 328, 32.66, 1594.33, 7 and 291.55 ppm in site 1 for Cu, Pb, Zn, Ni, Co, Mn, As and Cr, respectively, while site 2 gave 72.55, 17, 102.55, 296.55, 32, 1851.88, 9.11 and 308.77 ppm. Soil enrichment factor (EF) in sites 1 and 2 of the heavy metals Ni, Cr, Mn, Co and Cu ranged from extremely high enrichment to moderate-high enrichment, respectively. The geo-accumulation (I-geo) index indicated contamination levels that ranged from very strongly to moderately contaminated soil for Ni, Cr, Mn, Co and Cu, respectively. On the other hand, the pollution load index (PLI) showed all values from all samples in both sites were above 1 indicating totally contaminated areas. However, the most polluting heavy metals in the soil at both sites are Ni and Cr with high contamination levels attributed to the controlled mines' detonations. In conclusion, these mines' detonations are producing residual heavy metals in the soil that are potentially harmful to the vegetation cover, animals and ultimately humans.
https://ift.tt/2B6nXzi
Destabilization of polyethylene and polyvinylchloride structure by marine bacterial strain
Abstract
Plastics are recalcitrant and inert to degrade, and destabilization leads to accumulate in the terrestrial and marine ecosystems; need for the development of strategies for reducing these plastic wastes in a sustainable manner would be revolutionary. We studied the bacterial adherence, degradation and destabilization of polyvinylchloride (PVC), low-density polyethylene (LDPE), and high-density polyethylene (HDPE) by marine bacterial strain AIIW2 by a series of analytical and microscopic observations over 3 months. Based on 16S rRNA gene sequence and the phylogenetic analysis of the strain AIIW2, it showed 97.39% similarity with Bacillus species. Degradation of plastics was determined by the weight loss after 90 days with bacterial strain which detected up to 0.26 ± 0.02, 0.96 ± 0.02, and 1.0 ± 0.01% for PVC, LDPE, and HDPE films, respectively over initial weights. The mineralization of plastic film was found to be maximum in LDPE followed by HDPE and PVC. Bacterial interaction had increased roughness and deteriorated the surface of plastics which is revealed by the scanning electron microscope and atomic force microscope. Bending vibrations of the alkane rock chain (–CH2 and –CH3) and carbonyl (–CO) regions in LDPE and HDPE films, while there was slight stretching in the hydroxyl (–OH) regions of carboxylic acid in PVC which is evidenced through Fourier transform infrared spectral studies, suggested the oxidative activities of the bacteria. Though, the bacterial activity was higher on the LDPE and HDPE than PVC film which may be due to the presence of chlorine atom in PVC structure making it more versatile. The results of the present study revealed the ability of marine bacterial strain for instigating their colonization over plastic films and deteriorating the polymeric structure.
https://ift.tt/2K3JxYk
Targeting the polarization of tumor-associated macrophages and modulating mir-155 expression might be a new approach to treat diffuse large B-cell lymphoma of the elderly
Abstract
Aging immune deterioration and Epstein–Barr (EBV) intrinsic mechanisms play an essential role in EBV-positive diffuse large B-cell lymphoma (DLBCL) of the elderly (EBV + DLBCLe) pathogenesis, through the expression of viral proteins, interaction with host molecules and epigenetic regulation, such as miR-155, required for induction of M1 phenotype of macrophages. This study aims to evaluate the relationship between macrophage polarization pattern in the tumor microenvironment and relative expression of miR-155 in EBV + DLBCLe and EBV-negative DLBCL patients. We studied 28 EBV + DLBCLe and 65 EBV-negative DLBCL patients. Tumor-associated macrophages (TAM) were evaluated by expression of CD68, CD163 and CD163/CD68 ratio (degree of M2 polarization), using tissue microarray. RNA was extracted from paraffin-embedded tumor samples for miR-155 relative expression study. We found a significantly higher CD163/CD68 ratio in EBV + DLBCLe compared to EBV-negative DLBCL. In EBV-negative DLBCL, CD163/CD68 ratio was higher among advanced-staged/high-tumor burden disease and overexpression of miR-155 was associated with decreased polarization to the M2 phenotype of macrophages. The opposite was observed in EBV + DLBCLe patients: we found a positive association between miR-155 relative expression and CD163/CD68 ratio, which was not significant after outlier exclusion. We believe that the higher CD163/CD68 ratio in this group is probably due to the presence of the EBV since it directly affects macrophage polarization towards M2 phenotype through cytokine secretion in the tumor microenvironment. Therapeutic strategies modulating miR-155 expression or preventing immuno-regulatory and pro-tumor macrophage polarization could be adjuvants in EBV + DLBCLe therapy since this entity has a rich infiltration of M2 macrophages in its tumor microenvironment.
https://ift.tt/2PZBFwh
Editorial Board and Contents
Publication date: December 2018
Source: Trends in Endocrinology & Metabolism, Volume 29, Issue 12
Author(s):
https://ift.tt/2QINunU
La relation médecin/malade : d’un tact dermatologique
Publication date: Available online 13 November 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): E. Fiat
https://ift.tt/2DlHqxF
Modified bolster dressing with continuous suction improves skin graft survival for an oral cavity wound
Abstract
Background
Skin engraftment of intraoral defects is known to be inconsistent due to mobility of the oral structure, uneven wounds, and accumulation of saliva under the skin graft. To improve the success rate of oral skin graft, we proposed a novel and simple dressing technique for intraoral skin graft to control saliva accumulation, in comparison with the conventional bolster dressing.
Methods
We retrospectively reviewed 31 patients reconstructed with skin graft in their intraoral defect. The patients were divided into two groups; conventional bolster group (n = 21) and modified bolster group (n = 10). In the modified bolster group, a polyvinyl alcohol sponge was designed to fit the skin graft and a suction drain was inserted with tagging suture to apply continuous suction. We analyzed the success rate, the size of the skin grafts and clinical variables of each method.
Results
The overall success rate of oral skin graft was not different between the two groups (90.0 and 90.5%). However, partial necrosis in the engrafted skin was observed frequently in the control group (57.1% versus 20.0%). The relative engrafted area was significantly higher in the modified bolster group (55.0 ± 11.6% versus 23.0 ± 18.7%, p = 0.015). The duration of bolster dressing and the time to start an oral diet were shorter in the modified bolster group.
Conclusions
Our modified method could be easily applied for removing saliva accumulation under a skin graft and for enhancing skin engraftment of an oral cavity wound.
https://ift.tt/2K579vE
Persistent IKKα phosphorylation induced apoptosis in UVB and Poly I:C co-treated HaCaT cells plausibly through pro-apoptotic p73 and abrogation of IκBα
Publication date: December 2018
Source: Molecular Immunology, Volume 104
Author(s): Wuxiyar Otkur, Fang Wang, Weiwei Liu, Toshihiko Hayashi, Shin-ichi Tashiro, Satoshi Onodera, Takashi Ikejima
Abstract
Toll-like receptor 3 (TLR3), a member of pattern recognition receptors, is reported to initiate skin inflammation by recognizing double-strand RNA (dsRNA) released from UVB-irradiated cells. Recently, we have discovered the NF-κB pathway activated by TLR3 is involved in apoptosis of UVB-Poly I:C-treated HaCaT cells. The real culprit for apoptosis has not been precisely identified since the system of NF-κB pathway is complex. In this study, we silenced main transcriptional factors in NF-κB family, RelA, RelB and c-Rel, but to our surprise the results show that none of them participate in apoptosis induction in UVB-Poly I:C-treated HaCaT cells. Therefore, we moved to investigate the apoptosis-associated molecules in the upstream of NF-κB pathway. We firstly checked the expression of IκBα, an NF-κB inhibitor. UVB (4.8 mJ/cm2) and Poly I:C (0.3 μg/mL) co-treatment decreased IκBα expression level in a time-dependent manner. Silencing IκBα with siRNA further enhanced UVB-Poly I:C-induced cell death. We then investigated IκB kinase (IKK) complex that contributes to the degradation of IκBα. IKK is composed of IKKα, IKKβ and NEMO. Treatment with IKK-16, an IKKα/β inhibitor, significantly diminished UVB-Poly I:C-induced IκBα degradation and thus apoptosis. Silencing either IKKα or NEMO but not IKKβ with corresponding siRNA inhibited apoptosis. Tumor repressor p73, a homologue of p53, is reported to mediate IKKα-induced apoptosis in DNA damage response. Silencing p73 reduced cell apoptosis in UVB-Poly I:C-treated HaCaT cells. In summary, UVB and Poly I:C co-treatment activates IKKα and NEMO, which diminishes anti-apoptotic IκBα, resulting in enhancement of apoptosis through p73. The findings partially clarify the possible molecular mechanism of pro-apoptotic NF-κB pathway activated by TLR3 in the fate of UVB-irradiated epidermis.
https://ift.tt/2Q05TPC
Acetylcholinesterase activity and bone biochemical markers in premature and full-term neonates
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
https://ift.tt/2B5NpVS
Papillary Thyroid Carcinoma as a Lateral Neck Cyst: A Cystic Metastatic Node versus an Ectopic Thyroid Tissue.
| Related Articles |
Papillary Thyroid Carcinoma as a Lateral Neck Cyst: A Cystic Metastatic Node versus an Ectopic Thyroid Tissue.
Case Rep Endocrinol. 2018;2018:5198297
Authors: Rahmat F, Kumar Marutha Muthu A, S Raja Gopal N, Jo Han S, Yahaya AS
Abstract
Papillary thyroid carcinoma is the most common thyroid malignancy and frequently metastasizes to regional lymph nodes. Occasionally, metastatic lymph nodes are palpable without the evidence of primary tumour. Papillary thyroid carcinoma of lateral neck cyst is a rare condition. It may arise from thyroid primary which underwent cystic degeneration or true malignant transformation of ectopic thyroid tissue. Herein, we reported two cases with preoperative diagnosis of benign lateral neck cyst but postoperative histopathological results showed primary papillary thyroid carcinoma. Ultrasonography and computed tomography of the neck in both cases showed no significant thyroid lesion. However, the patient in Case 2 was subjected for total thyroidectomy and histopathological results showed the origin of primary tumour. In conclusion, thorough investigations including total thyroidectomy are indicated in cases of papillary thyroid carcinoma of lateral neck cyst. This practice is to ensure that this type of thyroid cancer can be detected earlier because it has a very good prognosis if treated earlier.
PMID: 30420925 [PubMed]
https://ift.tt/2zRBgSz
Nasal Blowing Induces Subcutaneous Emphysema Post Penetrating Mastoid Tip Trauma
Publication date: Available online 13 November 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Yehuda Schwarz, Ala'a Hamdan, Jean Yves Sichel, Pierre Attal
Abstract
We describe the case of a child with an isolated penetrating trauma to the mastoid tip. Nasal blowing consequently induced air bubbles coming through the mastoid cutaneous fistula and causing extensive subcutaneous neck emphysema. A computed tomography (CT) demonstrated a right mastoid tip bone fracture with extensive cervical subcutaneous emphysema. The patient was treated conservatively with antibiotics and did not require operative intervention. His subsequent course was uncomplicated. This case emphasizes the importance of taking seriously even what seems to be a minor skin laceration.
https://ift.tt/2K0L5Ce
Pediatric acquired subglottic stenosis: Associated costs and comorbidities of 7,981 hospitalizations
Publication date: Available online 13 November 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Khashayar Arianpour, Suzanne N. Forman, Patrick Karabon, Prasad John Thottam
Abstract
Objectives
Numerous risk factors have been characterized for acquired subglottic stenosis (ASGS) in the pediatric population. This analysis explores the comorbidities of hospitalized ASGS patients in the United States and associated costs and length of stay (LOS).
Methods
A retrospective analysis of the Kids' Inpatient Database (KID) from 2009 to 2012 for inpatients ≤ 20 years of age who were diagnosed with ASGS. International Classification of Diseases, Clinical Modification, Version 9 diagnosis codes were used to extract diagnoses of interest from 14, 045, 425 weighted discharges across 4179 hospitals in the United States. An algorithm was created to identify the most common co-diagnoses and subsequently evaluated for total charges and LOS.
Results
ASGS was found in 7981 (0.06%) of total discharges. The mean LOS in discharges with ASGS is 13.11 days while the mean total charge in discharges with ASGS is $114,625; these values are significantly greater in discharges with ASGS than discharges without ASGS. Patients with ASGS have greater odds of being co-diagnosed with gastroesophageal reflux, Trisomy 21, other upper airway anomalies and asthma, while they have lower odds of being diagnosed with prematurity and dehydration. Aside from Trisomy 21 and asthma, hospitalizations of ASGS patients with the aforementioned comorbidities incurred a greater LOS and mean total charge.
Conclusion
Our analysis identifies numerous comorbidities in children with ASGS that are associated with increased resource utilization amongst US hospitalizations. The practicing otolaryngologist should continue to advocate interdisciplinary care and be aware of the need for future controlled studies that investigate the management of such comorbidities.
https://ift.tt/2B4IuEI
Relationship between Obstructive Sleep Apnea and Difficulty of Anesthesia Induction in Children Undergoing Tonsillectomy
Publication date: Available online 13 November 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Sarah B. Jacob, Guerin M. Smith, Whitney N. Rebholz, Elizabeth D. Cash, Sasi R. Kalathoor, Julie L. Goldman, Swapna K. Chandran
Abstract
OBJECTIVE
To determine whether anesthesiologists need to rely on polysomnography (PSG) when predicting need for airway intervention during induction in patients with sleep-disordered breathing (SDB).
METHODS
Prospective case-control observational study at a tertiary care pediatric hospital. Children between the ages of 2-17 undergoing tonsillectomy were divided into three groups: those presenting with OSA observed by history and/or physical examination alone (SDB; n=33), those with OSA determined by preoperative PSG (OSA; n=32), and a control group (n=35) undergoing tonsillectomy for recurrent tonsillitis. An anesthesiologist ranked each case on the level of intervention required to maintain ventilation.
RESULTS
Age, height and BMI were associated with greater induction difficulty (r's>.225, p's<.025). Compared to controls, induction difficulty was significantly greater for the SDB group (mean difference=-.751, 95% confidence interval [CI]=-1.241, -.261, p=.003), but not for the OSA group (p=.061). No significant difference in induction difficulty was observed between SDB and OSA groups. In a subgroup analysis of the OSA group, an apnea-hypopnea index (AHI) >10 correlated with increased level of intervention during induction (r=.228, p=.022). Race was also associated with AHI >10 (odds ratio=3.859, 95% CI=1.485, 10.03, p=.006).
CONCLUSION
Children with OSA undergoing tonsillectomy require more airway intervention during induction than children with recurrent tonsillitis. Age and BMI were correlated with greater induction difficulty, suggesting that PSG data be considered in light of these clinical characteristics to ensure an optimal postoperative course for children undergoing tonsillectomy.
https://ift.tt/2K0KXCK
Failure to Accurately Disclose Conflicts of Interest in Article Published in JAMA Otolaryngology-Head & Neck Surgery.
Failure to Accurately Disclose Conflicts of Interest in Article Published in JAMA Otolaryngology-Head & Neck Surgery.
JAMA Otolaryngol Head Neck Surg. 2018 Oct 26;:
Authors: Baselga J
PMID: 30422229 [PubMed - as supplied by publisher]
https://ift.tt/2OIREKG
Missing Conflict of Interest Disclosure.
Missing Conflict of Interest Disclosure.
JAMA Otolaryngol Head Neck Surg. 2018 Oct 26;:
Authors:
PMID: 30422227 [PubMed - as supplied by publisher]
https://ift.tt/2z88k9t
Characterizing the Normative Voice Tremor Frequency in Essential Vocal Tremor.
Characterizing the Normative Voice Tremor Frequency in Essential Vocal Tremor.
JAMA Otolaryngol Head Neck Surg. 2018 Oct 25;:
Authors: Paige C, Hopewell BL, Gamsarian V, Myers B, Patel P, Garrett CG, Francis DO
Abstract
Importance: Essential vocal tremor (EVT) is a neurologic voice disorder characterized by periodic fluctuations in pitch and loudness that can hinder intelligibility. Defining the normative range of vocal tremor frequency may assist in diagnosis and provide insight into disease mechanisms.
Objective: To characterize the normative voice tremor frequency in EVT (in hertz).
Design, Setting, and Participants: Cross-sectional observational study of 160 patients with EVT. The setting was a tertiary voice center. Participants were identified from a database of consecutive patients diagnosed as having laryngeal movement disorders between January 1, 1990, and April 1, 2017.
Main Outcomes and Measures: The following 3 methods measured the frequency of tremor experienced by patients with EVT: perceptual method, computerized peak detection method, and laryngeal electromyography method. Within-person and population-level tremor frequencies were compared across modalities to assess measurement reliability and consistency and to characterize the normal distribution of tremor frequencies in this population.
Results: Among 160 participants (median age, 70 years; interquartile range [IQR], 64-77 years; 90.6% female [n = 145]), the median frequency of EVT was consistently between 4 and 5 Hz across all 3 methods (perceptual, 4.8 Hz [IQR, 4.4-5.5 Hz]; computerized peak detection, 4.6 Hz [IQR, 4.2-5.0 Hz]; and laryngeal electromyography, 4.3 Hz [IQR, 3.8-5.0 Hz]). The mean in-person differences between each measurement method were not clinically meaningful (range, 0.1-0.5 Hz). Including all interquartile ranges across measurement modalities, the normative tremor frequency range for EVT was 3.8 to 5.5 Hz.
Conclusions and Relevance: To our knowledge, this is the largest study to date to characterize the normal frequency of tremor in patients with EVT. The normative frequency of EVT (range, 3.8-5.5 Hz) falls within a much narrower range than previously reported. Those whose frequency is outside this range may still have EVT but should be carefully evaluated for potential other causes of vocal tremor. Defining characteristics of EVT may aid appropriate diagnosis and improve understanding of this disease.
PMID: 30422171 [PubMed - as supplied by publisher]
https://ift.tt/2RW9wUl
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