Marijuana is the most widely used illicit substance in Canada. To date, no conclusive study has looked at the epidemiologic basis of marijuana use and head and neck cancer (HNC). Due to the imminent recreation...
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Based on immunologic phenotypes underlying asthma, use of monoclonal antibody based therapies is becoming the new standard of care for severe, corticosteroid refractory clinical symptoms. Patients may qualify ...
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Skin lesions are very common among organ transplant recipients (OTR), particularly infections and tumors, because of the immunosuppressive state these patients are put in.
177 OTR were examined. Skin lesions were categorized into neoplastic, infectious, and inflammatory diseases.
The mean age of OTR was 52 years, the mean age at transplantation was 42.7 years, and kidney was the most common organ transplanted (72%). Skin lesions were found in 147 patients (83%). Cutaneous infections were seen in 106 patients (60%). Warts (30%) had the larger incidence and were associated with azathioprine (P = 0.026), cyclosporine (P = 0.006), and tacrolimus (P = 0.009). Superficial mycoses occurred in 16% of OTR, mostly onychomycosis, which was associated with tacrolimus (P = 0.040). Actinic keratosis (AK) occurred in 31% of patients and cutaneous tumors in 56%. Squamous cell carcinoma (SCC) was the most common tumor type affecting 36% of OTR (n = 64), with invasive SCC predominating over in situ SCC, whereas basal cell carcinoma (BCC) accounted for 17%. Both SCC and BCC were more numerous in patients' skin type I (P < 0.05). SCC was more frequent (36%) in combined kidney and liver recipients (P = 0.004), and BCC was associated with cyclosporine (P = 0.047). Inflammatory complications (acne, alopecia, hypertrichosis, and gingival overgrowth) were observed in 17.5% of patients.
Organ transplant recipients must be regularly evaluated by dermatologists, who should be alert to the onset of infections and skin (pre)malignant diseases in these patients.
Myiasis, or the invasion of living tissues of humans and other mammals by dipterous larvae, is considered the world's fourth most common travel‐associated skin disease after cutaneous larval migrants, pyodermas, and pruritic arthropod‐reactive dermatitis.
The present study recorded the cause, anatomical position, and severity of the wounds of myiasis patients admitted to 11 hospitals located in the central region of Sri Lanka from
February 2016 to July 2017.
Altogether, 28 myiasis incidences were noted within the study period. Of the total identified myiasis patients, nine were female while the remainder were male. The greatest number of patients was recorded from the Mawanella Base Hospital and Peradeniya Teaching Hospital (seven patients each). The ages of recorded patients ranged between 30 and 92 years with the average being 59.4 years. The greatest number of myiasis cases was diagnosed in wounds located in lower limbs (24). In addition, scalp, urogenital, and umbilical infestations were recorded. Eighteen out of the total patients had diabetes mellitus, and two patients suffered from filarial lymphedema. Psychiatric illnesses were a predisposing factor of larval infestation of six patients including the recorded scalp and two urogenital myiasis patients. Of the 28 myiasis cases, 27 were caused by the old world screwworm, Chrysomya bezziana Villeneuve (Diptera: Calliphoridae), and one by the blowfly, Chrysomya megacephala Fabricius (Diptera: Calliphoridae).
The awareness of patients with ulcers about this disease helps to decrease further risk of being infected by fly larvae.
Despite widespread antiretroviral coverage in Botswana, Kaposi's sarcoma (KS) remains among the most common malignancies. To date, adult KS in Botswana is not well characterized. The diagnosis relies on clinical suspicion that is often confirmed by histopathology given the implications of treatment; however, this poses a significant resource burden.
We conducted a retrospective review of the cohort of patients biopsied for possible KS at Princess Marina Hospital, the main dermatology referral site in Botswana, from September 2008 through June 2015 to describe the demographics, human immunodeficiency virus (HIV) characteristics, and clinical presentations of these patients. Histopathologic diagnoses were reviewed, and positive predictive value (PPV) was used to characterize the accuracy of clinical suspicion of KS.
A total of 441 patients received 450 biopsies where KS was on the differential diagnosis, and 239 patients (54%) were ultimately diagnosed with KS. The KS cohort was more likely to be male (58% vs. 37%, P < 0.001), HIV positive (94% vs. 85%, P < 0.05), and have lower CD4 counts at the time of biopsy (274 cells/μl vs. 362 cells/μl, P < 0.05). The PPV of clinical suspicion of KS was 58%. When KS was not histopathologically diagnosed, clinically benign diseases were found in 17%, medically significant conditions requiring alternative therapies in 78%, and life‐threatening diseases in 5%.
Our study reinforces the risk factors in development of KS. The poor PPV supports the important role of histology in KS diagnosis to both ensure appropriate treatment and prevent overtreatment. Improved accessibility to biopsy and augmentation of local dermatopathologic services would likely improve diagnostic accuracy and treatment.
Skin diseases in the population are universal, common, and can cause significant economic burden. The impact of skin diseases in the national public healthcare system is complex and poorly studied. This study analyzes the prevalence of skin diseases in a hospital setting within the National Public Health System of Mexico and describes the main associated characteristics.
Information was obtained from the 2015 hospital discharge database of the public healthcare system of Mexico. Pathologies that result in a direct dermatological condition were included according to chapter XII of the Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD ‐ 10) and grouped according to the classification of the report, The burden of skin diseases in the United States.
In 2015, a total of 9,230,968 hospital discharges were registered nationwide, of which 170,917 discharges (1.85%) reported a dermatological disease as the main diagnosis; five states account for 40.79% of the cases reported in Mexico. Half of all the cases corresponded to skin infections (32.08%, n = 54,843) and non‐cancerous skin growths (27.80%, n = 47,515), and 59.71% were adult patients between 18 and 65 years of age.
Understanding of the configuration of skin diseases in a hospital setting and public healthcare system is warranted to develop effective public policies and research for the development of effective, safe, high‐quality care processes for the main groups of identified diseases.
The purpose of this work was to compare methods of detecting nonrecurrent laryngeal nerves (NRLNs).
Specificity and sensitivity were compared in three NRLN detection methods: CT, electromyography (EMG), and A‐B point comparison.
A total of 73 intraoperative pictures and 36 CT details of NRLNs are presented. Incidence of NRLN was 0.39%. Type I NRLN accounted for 50.7%, type IIA 45.2%, type IIB 4.1%. The NRLN median latency was 2.13 ms vs 3.00 ms median in an RLN control group (P < .001). When the threshold was set to 2.5 ms, EMG latency detection had 96.7% sensitivity and 91.6% specificity for detecting NRLN, and the A‐B point comparison algrithm had 97.3% sensitivity and 92.5% specificity. Combining EMG latency detection with A‐B point comparison achieved 100% sensitivity and specificity for detecting NRLN.
This is the largest series of NRLN presented in the literature. Latency shorter than 2.50 ms combined with the A‐B point comparison method is the ideal algorithm procedure for early NRLN identification.
The publisher regrets that the abstract was missing in the original publication of this article.
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The present article discusses the first reported case of adenoid cystic carcinoma (ACC) metastasis from a submandibular gland to the larynx. Both treatments of distant metastasis of ACC and secondary laryngeal tumor are challenging. Despite its slow progression, ACC is associated with high rates of local recurrence, distant metastasis, and poor prognosis. Patients with secondary laryngeal cancer often have other concurrent metastatic lesions. Therefore, treatment selection should consider the biological behavior of the tumor and characteristics of the laryngeal lesion, along with the general condition and quality of life of the patient.
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Thank you for allowing us to respond to the letter by Arshad and colleagues1 on a topical and important issue. We agree that this is an important subject that should not be overlooked.
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We read with interest the reply from Rudman and colleagues1 to our publication2 but disagree with their assertion that blue dye must be used to increase the accuracy of sentinel lymph node biopsy (SLNB) for melanoma. In our series, the use of blue dye did not improve the sensitivity of intra-operative sentinel node identification but increased the number of nodes harvested by 5%. Our findings correspond with a meta-analysis performed by Niebling et al in 2016,3 where pooled analysis of 66 studies showed a 99% SLN identification rate using radiocolloid without blue dye.
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With improvements in the super-micro surgical technique, lymphaticovenular anastomosis (LVA) has become an effective treatment for obstructive lymph edema1. Recently, indocyanine green (ICG) dye lymphography makes it possible to visualize lymph vessels. LVA requires specific veins in the field. However veins come in a variety of sizes, and options for anastomosis i.e. end to end, end to side and side to end are chosen to deal with the discrepancies between lymph vessels and veins2. On the other hand, lymph vessels are sometimes bunched.
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We read with great interest Ranson et als' recent publication, 'Sentinel lymph node biopsy in melanoma: which hot nodes should be harvested and is blue dye really necessary?'.1 This article retrospectively analysed 42 nodal basins in which greater than one node had been harvested, comparing the overall sensitivity of their blue dye and radiocolloid procedures with the sensitivity that might have be achieved had, theoretically, cold blue nodes been left in situ. They state that this approach could have resulted in a 5% reduction in the number of nodes harvested with no apparent change in sensitivity.
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Advancements in lower extremity reconstruction have made free tissue transfer for open lower limb fractures the gold standard of care in many units.1–2 Decisions regarding the use of fasciocutaneous versus muscle flaps are both surgeon and patient dependent. Muscle flaps are specifically unsightly to patients in the early stages of their reconstruction. However, the free Gracilis flap is quick to raise, with predictable anatomy, minimal donor site morbidity and is the workhorse flap for lower extremity reconstruction in our unit.
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Thumb defects after crush injury or amputation are common. The first dorsal metacarpal flap or Foucher flap is an island flap that was described as an alternative in the coverage of the distal stump or any other tissue loss in the thumb.1 The donor site is the skin from the dorsal aspect of the proximal phalanx of the index finger and second metacarpal head, which is usually grafted.
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Synchronicity of the oral commissure movement of a bilateral smile is a significant goal for reconstruction in facial reanimation and may only be guaranteed with use of the facial nerve as a donor nerve. Yet over the years several studies report some degree of spontaneity in certain patients when using a non-facial donor nerve, which indicates that synchronous initiation of the smile might be achievable with other donor nerves. We designed a prospective cohort study to evaluate whether pre-operative involuntary activation of the masseteric nerve during smile predicts development of a synchronous smile development when using the masseteric nerve for reanimation.
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Composite Antero-Lateral Thigh (ALT) flap with vascularized fascia lata can reconstitute patellar tendon integrity and knee soft tissue coverage in one stage. However, long term evidence of outcomes is lacking. This work analyses long term functional results, comparing subtotal and total reconstruction of patellar tendon, and respective function of the extensor apparatus.
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Invented over 80 years ago, aerosol cans are now part of our everyday life. Body deodorants and air fresheners are readily available in any supermarket. Aerosol-related frostbites are being seen more often over last two decades and many cases are seen following deliberate self-harm from readily-available deodorant cans. 'Frosting is a practice increasingly seen in paediatric and adolescent patients.1 Although occasional aerosol-related frostbites have been reported widely, no treatment guidelines have been proposed to date.
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Obesity and type 2 diabetes are a veritable global pandemic. There is an imperative to develop new therapies for these conditions that can be delivered at scale to patients, which deliver effective and titratable weight loss, amelioration of diabetes, prevention of diabetic complications and improvements in cardiovascular health. Although agents based on glucagon‐like peptide‐1 (GLP‐1) are now in routine use for diabetes and obesity, the limited efficacy of such drugs means that newer agents are required. By combining the effects of GLP‐1 with other gut and metabolic hormones such as glucagon (GCG), oxyntomodulin, glucose‐dependent insulinotropic peptide (GIP) and peptide YY, we may obtain improved weight loss, increased energy expenditure and improved metabolic profiles. Drugs based on dual agonism of GLP1R/GCGR and GLP1R/GIPR are being actively developed in clinical trials. Triple agonism, for example with GLPR1/GCGR/GIPR unimolecular agonists or using GLP‐1/oxyntomodulin/peptide YY, is also being explored. Multi‐agonist drugs seem set to deliver the next generation of therapies for diabetes and obesity soon.
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To explore brain morphological alterations associated with age and sex hormone levels between premenopausal and perimenopausal women using magnetic resonance imaging (MRI) T1‐weighted structural images.
Thirty‐two premenopausal women with a mean age of 47.75 years (S.D. = 1.55 years) and twenty‐five recently perimenopausal women with a mean age of 51.60 years (S.D. = 1.63 years) were evaluated for sex hormone levels, including prolactin (PRL), follicle‐stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), free testosterone (free‐T), and progesterone (P). A 3.0 Tesla MRI scanner was utilized to acquire T1 images. Voxel‐based morphometry (VBM) was used to evaluate changes in gray matter volume between the two groups. The general linear model was applied with false discovery rate (FDR) correction for between group voxel‐wise statistics. Spearman partial correlation analyses were conducted between age, sex hormone levels and regions of gray matter volume showing significant differences between the two groups.
Compared with premenopausal women, perimenopausal women showed decreased gray matter volume in the left putamen, right pallidum, right inferior parietal gyrus (IPG), right superior frontal gyrus (SFG) (orbital part) and right postcentral gyrus (PG) (p < 0.05, FDR corrected). The gray matter volume in the left putamen and right pallidum were negatively correlated with age among the 57 enrolled women. The levels of FSH and LH were positively correlated with gray matter volume changes in the right pallidum.
The VBM analysis revealed that age and menopause per se lead to gray matter volume reduction in certain brain structures. These structural changes might be potential causes of sexual dysfunction, nervous system degeneration and depression, which need to be examined in future studies. Our findings might provide evidence and guide future research in understanding the menopausal transition.
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Ghrelin is a gastric hormone that has been implicated in the neurobiology of alcohol drinking. We have recently developed a ghrelin receptor (GHSR) knockout (KO) rat model, which exhibits reduced food consumption and body weight. In addition, recent preliminary work suggests that the gut‐microbiome, which appears to interact with the ghrelin system, may modulate alcohol drinking. Here, we investigated the effects of GHSR deletion on alcohol consumption utilizing GHSR KO and wild type (WT) rats in three separate alcohol consumption paradigms: 1. operant self‐administration (30 min sessions); 2. drinking in the dark (DID; 4 h sessions); 3. intermittent access (24 h sessions). These paradigms model varying degrees of alcohol consumption. Furthermore, we sought to investigate the gut‐microbiome composition of GHSR KO and WT rats before and after alcohol exposure. We found that the GHSR KO rats self‐administered significantly less alcohol compared with WT rats in the operant paradigm, and consumed less alcohol than WT in the initial stages of the DID paradigm. No genotype differences were found in the intermittent access test. In addition, we found a significant decrease in gut‐microbial diversity after alcohol exposure in both genotypes. Thus, the present results indicate that the ghrelin system may be involved in drinking patterns that result in presumably increased alcohol exposure levels and that GHSR may constitute a potential pharmacological target for the reduction of binge‐alcohol consumption. The potential functional role of the gut‐microbiome in alcohol drinking, and interaction with the ghrelin system, is an interesting topic for further investigation.
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The cover image is based on the Original Article A dense mapping study of six European AITD susceptibility regions in a large Chinese Han Cohort of Graves' disease by Wei Liu et al., DOI: 10.1111/cen.13847. Design Credit: Qianyue Zhang.
Exacerbation or reactivation of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) in persons infected with psoriasis during treatment with biologics is a documented concern with use of tumor necrosis factor (TNF) inhibitors. Much less is known, however, about these risks in relation to newer biologic drugs including ustekinumab (interleukin (IL)‐12/23 inhibition).
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Exacerbation or reactivation of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) in persons infected with psoriasis during treatment with biologics is a documented concern with use of tumor necrosis factor (TNF) inhibitors. Much less is known, however, about these risks in relation to newer biologic drugs including ustekinumab (interleukin (IL)‐12/23 inhibition).
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While familial clustering of asthma is known, few studies have reported on the relative roles of paternal and maternal asthma, and the role of maternal asthma control in pregnancy on the risk for asthma in the child.
We aimed to investigate the relative roles of paternal asthma, maternal asthma, and maternal asthma control during pregnancy on the risk of asthma or recurrent wheeze in 3‐year old children how prenatal and cord blood vitamin D status might affect this risk.
Data from 806 women, their partners (biologic fathers of the infant), and their children participated in the Vitamin D Antenatal Asthma Reduction Trail (VDAART, clinicaltrialsgov identification number NCT00920621) were used for this cohort analysis. The parental report of physician‐diagnosed asthma or recurrent wheeze in offspring was the main outcome. Weibull regression models for interval‐censored event times were used to estimate the main variables of interests and additional covariates on the outcome.
The highest risk was observed among children with both parents being asthmatic relative to non‐asthmatic parents (aHR=2.30, 95%CI: 1.35‐3.84), and less so if only the mother was asthmatic (aHR=1.70, 95%CI: 1.17‐2.40). In the subset of children born to asthmatic mothers, the risk for asthma was higher in those who were born to mothers whose asthma was uncontrolled (aHR=1.60, 95%CI: 1.02‐2.54). Children whose mothers had sufficient vitamin D status (25Hydroxyvitamin D≥30 ng/mL) at early and late pregnancy and had cord blood vitamin D sufficiency demonstrated a lower risk of asthma/recurrent wheeze than children who had insufficient vitamin D status at birth (aHR=0.47, 95%CI: 0.27‐0.83).
Careful attention to maternal asthma control, monitoring vitamin D status and correcting insufficiency at early pregnancy and maintaining the sufficiency status throughout pregnancy have potential preventive roles in offspring asthma or recurrent wheeze.
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Die systemische Therapie des nichtkleinzelligen Lungenkarzinoms (NSCLC) ändert sich aktuell fundamental und mit beeindruckender Dynamik. Patienten mit fortgeschrittener Erkrankung werden aufgrund von Biomarkeranalysen entweder mit Immuntherapie, einer Kombination aus Immun- und Chemotherapie oder mit genetisch stratifizierten Therapien behandelt. Eine besondere Herausforderung stellen erworbene Resistenzen dar. Das zunehmende Verständnis für die molekularen Ursachen der Resistenz ermöglicht die Entwicklung potenterer Inhibitoren.
In diesem Review sollen der gegenwärtige Therapiestandard und die aktuellen Entwicklungen der zielgerichteten Therapien für fortgeschrittene NSCLC dargestellt werden.
Dieses Review basiert auf der Zusammenfassung und Interpretation von Publikationen zu präklinischen und klinischen Studien im Bereich der zielgerichteten Therapie des fortgeschrittenen NSCLC.
Zielgerichtete Therapien gegen aktivierende Mutationen im EGFR- und BRAF-Gen sowie ALK- und ROS1-Fusionen stellen bereits den Erstlinienstandard für etwa 15 % der Patienten mit fortgeschrittenen NSCLC dar. Diese Entwicklung hat in retrospektiven Auswertungen zu einem deutlich verlängerten Überleben in diesen Subgruppen geführt. Für weitere Aberrationen werden zielgerichtete Therapien entwickelt, sodass aktuell für etwa 30 % der Patienten eine zielgerichtete Therapieoption besteht. Inhibitoren der neuen Generation zeichnen sich durch eine hohe Wirksamkeit gegen Tumoren mit erworbener Tyrosinkinaseinhibitor(TKI)-Resistenz und bessere Verträglichkeit aus und werden zunehmend in Erstlinie eingesetzt. Um molekulare Ursachen zu verstehen und die wirksamste Therapie auszuwählen, nimmt die Rebiopsie in der Resistenz einen besonderen Stellenwert ein.
Seit langer Zeit war bekannt, dass Patienten mit isolierten ZNS oder Nebennierenmetastasen einer potentiell kurativen Therapie zugeführt werden können. Diese Daten konnten in retrospektiven und z. T. prospektiven Studien bestätigt und auf weitere Organe ausgedehnt werden. Diese Erkenntnisse führten zur Definition eines neuen Stadiums M1b in der 8. UICC Klassifikation.
Eine selektive Literaturrecherche wurde durchgeführt.
Obgleich zum jetzigen Zeitpunkt Daten zum Gesamtüberleben noch nicht vorliegen, so ergibt sich aus den bisherigen prospektiven Daten ein einheitliches Bild, welches für die Anwendung von lokaltherapeutischen Maßnahmen in diesem Kontext spricht. Ungeklärt bleiben in diesen Studien jedoch noch die richtige Sequenz der Therapie, die Wahl der Behandlungsmodalitäten sowie die Bedeutung von Lymphknotenmetastasen. Das NSCLC metastasiert üblicherweise in die Leber, Lunge, Nebenniere, das Hirn sowie in die Knochen. Interessanterweise finden sich stark unterschiedliche klinische Verläufe in Abhängigkeit der Metastasenlokalisation und einem synchronen oder metachronen auftreten der Metastasen. Beim Vorliegen von Nebennierenmetastasen ist die solitäre ipsilaterale Manifestation mit den längsten Überlebensraten assoziiert. Zur Therapie der Nebennierenmetastase bieten sich sowohl die stereotaktische Bestrahlung als auch die chirurgische Resektion an. Standardtherapie bei Fehlen einer entsprechenden ALK(„anaplastic lymphoma kinase")- bzw. EGFR(„epithelial growth factor receptor")-Treibermutation stellt aktuell noch die platinhaltige Kombinationschemotherapie dar. Bei isolierten ZNS(zentrales Nervensystem)-Metastasen sollte Patienten eine stereotaktische Präzisionsstrahlentherapie oder eine Operation mit anschließender Tumorbettnachbestrahlung angeboten werden. Bei solitären Knochenmetastasen ohne Rückenmarkkompression bietet sich die lokal ablative Radiotherapie als durchaus gleichwertige und in vielen Fällen weniger langfristig körperlich einschränkende Therapiemaßnahme im Vergleich zu operativ-resezierenden Maßnahmen an.
Basierend auf der ausgeprägten Heterogenität der Patientengruppen im Stadium III des nichtkleinzelligen Lungenkarzinoms („non-small-cell lung cancer", NSCLC) – trotz der etwas differenzierteren neuen 8. Stadieneinteilung der Union Internationale Contre le Cancer (UICC)/International Association for the Study of Lung Cancer (IASLC) – wird eine zunehmend individualisierte Therapie dieser Patienten notwendig. Die initiale interdisziplinäre Einschätzung der Operabilität ist ein wesentlicher Faktor für die Therapieselektion. Die kombinierte simultane Chemostrahlentherapie bleibt für die Mehrzahl der Patienten im Stadium III die Standardbehandlung. Dieser Behandlung sollte sich aber – basierend auf den eindeutig und klinisch relevant positiven Ergebnissen der PACIFIC-Studie – eine konsolidierende Behandlung mit Durvalumab über 12 Monate bei positiver PD-L1-Expression im Tumor anschließen. Für die interdisziplinär als potenziell operabel eingeschätzten Patienten werden weiter multimodale Behandlungsprotokolle unter Einschluss der Operation den Standard darstellen. Aufgrund der positiven Datenlage für die Immuntherapie beim NSCLC in der Gruppe der inoperablen Patienten ergeben sich nun zwangsläufig auch in den lokal begrenzten Stadien hochrelevante Chancen für eine Integration der Checkpointinhibition in den Therapiealgorithmus, welche zukünftig detailliert im Rahmen von prospektiven klinischen Studien analysiert werden sollten.
Publication date: Available online 22 November 2018
Source: Trends in Endocrinology & Metabolism
Author(s): Eylem Kulkoyluoglu-Cotul, Alexandra Arca, Zeynep Madak-Erdogan
Estrogens and estrogen receptors (ERs) regulate metabolism in both normal physiology and in disease. The metabolic characteristics of intrinsic breast cancer subtypes change based on their ER expression. Crosstalk between estrogen signaling elements and several key metabolic regulators alters metabolism in breast cancer cells, and enables tumors to rewire their metabolism to adapt to poor perfusion, transient nutrient deprivation, and increased acidity. This leads to the selection of drug-resistant and metastatic clones. In this review we discuss studies revealing the role of estrogen signaling elements in drug resistance development and metabolic adaptation during breast cancer progression.
Rosacea has been reported to be associated with psychiatric disorders. Nevertheless, a nationwide study of the relationship between rosacea and comorbid psychiatric diseases in an Asian population has not been conducted. The aim of this study was to clarify the role of rosacea in the various psychiatric disorders by using a nationwide database in Taiwan. Data were obtained from the National Health Insurance Research Database of Taiwan from 2000 to 2013. In total, 7881 patients with rosacea and 31 524 age‐ and sex‐matched controls were enrolled. Patients with rosacea tended to have more coexisting psychiatric disorders. After adjusting for age, sex, comorbidity and residence/regions, the adjusted hazard ratio (HR) of psychiatric disorders for patients with rosacea was 2.761 (95% CI = 2.650–2.877, P < 0.001). Among them, the highest adjusted HR are phobic disorder and obsessive–compulsive disorder of 7.841 (95% CI = 7.526–8.170, P < 0.001) and 6.389 (95% CI = 6.132–6.657, P < 0.001), respectively. The National Health Insurance Research Database of Taiwan does not include the information about rosacea subtypes, severity and laboratory parameters. In conclusion, rosacea is related to various psychiatric disorders. In addition to anxiety and depression, patients are also at increased risk of phobic disorder and obsessive–compulsive disorder.
Publication date: Available online 22 November 2018
Source: American Journal of Otolaryngology
Author(s): Ian-James Malm, Lisa M. Rooper, Justin A. Bishop, Selmin Karatayli Ozgursoy, Alexander T. Hillel, Lee M. Akst, Simon R. Best
Laryngeal squamous cell carcinoma (LSCC) is strongly associated with tobacco use, but recent reports suggest an increasing incidence of LSCC in patients without traditional risk factors, suggesting an alternative etiology of tumorigenesis. The purpose of this study is to characterize this non-smoking population and to compare immunohistochemical markers in tumor specimens from non-smokers and smokers with LSCC.
A retrospective chart review of patients with LSCC at Johns Hopkins Hospital (JHH) was performed. A tissue microarray (TMA) was constructed with tumor specimen from non-smokers with stage and age-matched smokers and stained for a variety of immunologic and molecular targets.
In the JHH cohort of 521 patients, 12% (n = 63) were non-smokers. Non-smokers were more likely to be <45 years old at time of diagnosis (OR 4.13, p = 0.001) and to have glottic tumors (OR 2.46, p = 0.003). The TMA was comprised of tumors from 34 patients (14 non-smokers, 20 smokers). Only 2 patients (6%) were human-papillomavirus (HPV) positive by high-risk RNA in situ hybridization (ISH). There was no correlation between smoking status and p16 (p = 0.36), HPV-ISH positivity (p = 0.79), phosphatase and tensin homolog (PTEN, p = 0.91), p53 (p = 0.14), or programmed death-ligand 1 (PD-L1, p = 0.27) expression.
Non-smokers with LSCC are more likely to be younger at the time of diagnosis and have glottic tumors than smokers with LSCC. In TMA analysis of stage and age-matched specimens from smoker and non-smokers with LSCC, the pattern of expression for common molecular and immunologic markers is similar. Further, HPV does not appear to be a major causative etiology of LSCC in either smokers or non-smokers in our cohort of patients.
Publication date: Available online 22 November 2018
Source: American Journal of Otolaryngology
Author(s): Renhui Chen, Qian Cai, Faya Liang, Peiliang Lin, Ling Chen
To confirm the pre-treatment diagnosis of parapharyngeal space malignancy could aid the treatment plan.
For patients with suspected malignant parapharyngeal space tumors following preoperative imaging, oral biopsy was conducted for pathological diagnosis with the use of 22-G biopsy needles.
A total of 11 patients were enrolled. There were three previously diagnosed cases of head and neck malignancy, and eight cases were newly diagnosed. The tumor diameters were in the range of 3 to 5.5 cm. Ten cases (90.9%) achieved positive results, of which eight cases (72.7%) obtained positive results with one puncture and two cases obtained positive pathological results with two punctures. One case did not obtain positive results with two punctures; open surgical resection was performed for this patient. There were no complications such as needle track implantation, heavy bleeding or neurological damage symptoms during the puncture process.
Oral biopsy is a minimally invasive, safe and effective technique for the diagnosis of parapharyngeal space tumors. It is easy to operate and could facilitate a comprehensive treatment plan for parapharyngeal space malignancies.
Publication date: Available online 22 November 2018
Source: American Journal of Otolaryngology
Author(s): Zhuofu Liu, Wei Hua, Huankang Zhang, Jingjing Wang, Xiaole Song, Li Hu, Hanyu Lu, Dehui Wang
Juvenile nasopharyngeal angiofibroma (JNA) is non-metastasizing but potentially locally destructive tumor of the nasopharynx. It can destroy the skull base and invade into the cerebrum. Surgical management is the primary standard but residual disease is always a risk factor. We aimed to determine the risk factors for residual disease and usual sites for these residual tumors.
The medical records of 131 patients (mean age 17.6 ± 6.8, range 9–71 years) with histologically proven JNA were retrospectively analyzed. The surgeries were all nasal endoscopic approaches, with or without assistant incision.
The prevalence of residual disease was 16.8%. Risk factors associated with JNA recurrence included tumor stage, intraoperative bleeding, and the year in which the operation was performed. The pterygoid canal, pterygoid process, and pterygopalatine foramen were the most frequent locations for residual tumor.
Surgical management should take particular care for the pterygoid canal, petrygoid process, and pterygopalatine foramen. Contrast-enhanced CT and MRI are effective tools to evaluate complete JNA excision in the first two days after primary surgery. Careful exploration of these areas may be the key to avoid residual JNA.
Publication date: Available online 22 November 2018
Source: American Journal of Otolaryngology
Author(s): Resit Murat Acikalin, Cemal Haci, Fazilet Altin, Yalcin Alimaoglu
Tinnitus is a common disease in public. It is not only associated with neuronal, muscular, vascular pathologies, but also with related psychological parameters. In this study, we aimed to investigate the relationship between tinnitus, anxiety and depression in patients undergoing tympanoplasty.
Patients with tinnitus and operated for chronic otitis media were included in our study. Before and after the operation, tinnitus handicap inventory, beck anxiety and depression scales were filled and pre- and postoperative values were compared. In addition, our patients were divided into two groups as tinnitus improve and did not improve and differences between them were investigated.
148 patients were included in our study. Of 148 patients, 60 were male and 88 were female. There was no significant difference between the patients with and without tinnitus when the dermografic features, hearing levels and physical examination findings were compared.
After the operation, the patients who did not improve tinnitus had higher levels of depression and depression than others (<0.001).
As a result of our study, anxiety and depression scales of the patients whose tinnitus did not improve were found to be higher than the patients whose tinnitus improved.
Publication date: Available online 22 November 2018
Source: American Journal of Otolaryngology
Author(s): Brent A. Chang, S. Ryan Hall, Brittany E. Howard, Gregory S. Neel, Carrlene Donald, Devyani Lal, Thomas H. Nagel, Richard E. Hayden
Large anterior skull base, orbital, and high facial defects can present a challenging reconstructive problem. Limited data exists in the literature on the use of a submental flap for reconstructing such defects. We aimed to describe the feasibility, success, and advantages of using variations of the submental flap for reconstruction of anterior skull base, orbital, and high facial defects.
Outcomes measured included flap method, flap survival, flap size, reconstructive site complications, donor site complications, and length of hospital stay.
Nine patients were identified that underwent submental flap reconstruction of anterior skull base, orbital, or high facial soft tissue defects. There were 5 pedicled, 2 hybridized, and 2 free submental flap reconstructions. Flap survival was 100%. One flap required leech therapy for early post-operative venous congestion. Average flap skin paddle size was 63.7 cm2. Average length of hospital stay was 7.3 days. No complications from the donor site were reported.
Different variations on the submental flap are viable options for reconstruction of high defects in the head and neck. Such flaps have a number of unique qualities that are suitable for reconstruction of anterior skull base, orbital, and high facial defects.
Publication date: January 2019
Source: Oral Oncology, Volume 88
Author(s): Mari-Alina Timoshchuk, Preston Dekker, Daniel S. Hippe, Upendra Parvathaneni, Jay J. Liao, George E. Laramore, Jasjit K. Dillon
Radiation therapy is commonly used to treat head and neck malignancies. While there is abundant research regarding photon radiation therapy, literature on neutron radiotherapy (NRT) and oral complications is limited. This study aims to determine: (1) the 6-year and 10-year locoregional control and survival rates, (2) factors associated with locoregional control and survival and (3) the frequency of oral complications in patients undergoing NRT for salivary gland malignancies.
This is a retrospective cohort study. The sample was composed of patients with salivary gland malignancies treated with NRT between 1997 and 2010. Data were extracted from patient charts, telephone surveys, and social security records. Multivariate competing risk and Cox regression models were used to assess predictors of locoregional control and survival.
The sample was composed of 545 subjects with a mean age of 54.2 years (±16). The predominant tumor and location were adenoid cystic carcinoma (47%) and the parotid (56%). Multivariate analysis indicated that positive surgical margins, biopsied/inoperable malignancies, neck involvement, and lymphovascular invasion were prognostic risk factors associated with decreased survival. The 6- and 10-year locoregional control rates were 84% and 79%. The 6- and 10-year survival rates were 72% and 62%. Osteoradionecrosis developed in 3.4% of subjects.
The 6- and 10-year locoregional control and survival rates compare favorably to rates reported for conventional photon radiation. Osteoradionecrosis rates were comparable to that of photon radiation treatment (2–7%). Given the potential benefits of NRT, healthcare professionals should be educated regarding its indications and oral complications.
The purpose of this study was to investigate unmet supportive care needs in patients treated with total laryngectomy and its associated factors.
In this cross‐sectional study, 283 patients who underwent total laryngectomy completed questions on supportive care needs (Supportive Care Needs Survey [SCNS]). Median time since total laryngectomy surgery was 7 years (range 0‐37 years). The prevalence of unmet supportive care needs and its associated factors were investigated using logistic regression analyses.
Unmet supportive care needs were highest for the head and neck cancer‐specific functioning domain (53%), followed by the psychological (39%), physical and daily living (37%), health system, information, and patient support (35%), sexuality (23%), and lifestyle (5%) domains. Seventy‐one percent reported at least one low, moderate, or high unmet need. Female sex, living alone, and having a voice prosthesis were positively associated with unmet needs on 1 domain (P < .05). A worse health‐related quality of life was associated with unmet needs on all domains.
The majority of patients who underwent total laryngectomy report at least one low, moderate, or high unmet supportive care need.
We aimed to investigate the feasibility of diagnosing head and neck schwannomas using core‐needle biopsy (CNB), and to compare this technique to fine‐needle aspiration cytology (FNAC).
We designed a prospective case series in which 52 FNAC and 29 CNB samples from 48 patients with head and neck schwannoma were analyzed. Patient demographics, pathological results, and complications were also evaluated.
Of the 81 total specimens, 24/52 (46.2%) of the FNAC and 0/29 (0.0%) of the CNB samples were unsatisfactory (P < .001). Specific diagnoses of schwannoma, including "suspicious schwannoma" and "consistent with schwannoma," were obtained from 10/52 (19.2%) of the FNAC samples and 28/29 (96.6%) of the CNB samples (P < .001). Major complications such as hematoma or permanent nerve injury did not occur in patients who underwent either method.
CNB can diagnose schwannomas with a higher accuracy than FNAC without increasing the rate of complications.
To evaluate the performance of 18F‐fluorodeoxy‐d‐glucose positron emission tomography‐computed tomography (18F‐FDG PET/CT) in identifying local failure and regional failure following curative radiotherapy or surgery for head and neck squamous cell carcinoma.
A comprehensive literature search identified studies published between January 2010 and August 2016. Diagnostic performance of 18F‐FDG PET/CT was evaluated for local failure/regional failure stratified by treatment‐to‐scan time interval of ≤3 versus >3 months.
Twenty‐four studies (2627 patients) were included. Compared to ≤3 months, 18F‐FDG PET/CT performed >3 months showed significantly improved sensitivity (87% vs 60%, P = 0.020) and specificity (93% vs 84%, P < 0.001) for local failure. There was no significant difference in sensitivity (79% vs 56%, P = 0.100) or specificity (95% vs 97%, P = 0.35) for regional failure >3 versus ≤3 months.
This meta‐analysis confirms high specificity but modest sensitivity of posttreatment 18F‐FDG PET/CT for local failure and regional failure. Sensitivity and specificity are significantly improved when 18F‐FDG PET/CT is performed >3 months for local failure.
Cortactin (CTTN) is located on chromosome 11q13 and is associated with invasiveness in various cancer entities. CTTN protein expression could be a prognosticator of oral squamous cell carcinoma (OSCC) in terms of recurrence and survival.
CTTN‐dependent invasion was performed using migration assay in human papillomavirus‐negative head and neck squamous cell carcinoma (HNSCC) cells. Cortactin protein analysis in tissue microarrays was used for correlation with clinical parameters, as well as for survival analysis. Gene expression profiling in HNSCC cells was performed to unreveal CTTN signaling.
Knockdown of CTTN in HNSCC cells showed less invasion in vitro. Gene expression profiling showed various deregulated genes known to be involved in progression. We confirmed the link between CTTN overexpression and progression in a large clinical cohort. High expression was associated with worse overall and progression‐free survival.
We propose CTTN for managing OSCC in terms of adjuvant therapy and aftercare. Furthermore, our study reveals new potential targets in CTTN signaling for individualized OSCC therapy.
Glomus tumors are rare and benign hypervascular tumors. Surgery represented the mainstay of their treatment, even if it has been associated with high morbidity and mortality rates. Recently, the treatment shifted to a multimodal approach and Gamma Knife radiosurgery represents one of the treatment options.
Authors retrospectively analyzed the clinical and radiological outcome of a series of patients who underwent Gamma Knife radiosurgery for glomus tumors.
Thirty patients underwent Gamma Knife radiosurgery. Mean tumor volume was 7.69 cc (range 0.36‐24.6). Mean tumor margin dose was 16 Gy (range 13‐18). Median follow‐up was of 91 months (mean 90; range 11‐172). Overall clinical control rate was 100%; overall volumetric tumor control rate was 96.6%. Patients' and tumors' characteristics, treatment data, and outcome have been analyzed.
Gamma Knife radiosurgery represents a safe and effective treatment for glomus tumors. Longer follow‐up and larger cohort studies are needed to definitively outline the role of Gamma Knife radiosurgery for glomus tumors.
Publication date: Available online 22 November 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Justin C. Morse, Ping Li, Kim A. Ely, Meghan H. Shilts, Todd J. Wannemuehler, Li-Ching Huang, Quanhu Sheng, Naweed I. Chowdhury, Rakesh K. Chandra, Suman R. Das, Justin H. Turner
Potential effects of aging on chronic rhinosinusitis (CRS) pathophysiology have not been well defined, but may have important ramifications given a rapidly aging U.S. and world population.
The goal of the current study was to determine whether advanced age is associated with specific inflammatory CRS endotypes or immune signatures.
Seventeen mucus cytokines and inflammatory mediators were measured in 147 CRS patients. Hierarchical cluster analysis was used to identify and characterize inflammatory CRS endotypes as well as determine whether age was associated with specific immune signatures.
A CRS endotype with a pro-inflammatory, neutrophilic immune signature was enriched with older patients. In the overall cohort, patients 60 years and older had elevated mucus levels of IL-1β, IL-6, IL-8, and TNF-α when compared to their younger counterparts. Increases in pro-inflammatory cytokines were associated with both tissue neutrophilia and symptomatic bacterial infection/colonization in aged patients.
Aged CRS patients have a unique inflammatory signature that corresponds to a neutrophilic pro-inflammatory response. Neutrophil-driven inflammation in aged CRS patients may be less likely to respond to corticosteroids and may be closely linked with chronic microbial infection or colonization.
Publication date: November 2018
Source: Annales de Dermatologie et de Vénéréologie, Volume 145, Issue 11
Author(s):
Publication date: Available online 22 November 2018
Source: Clinical Immunology
Author(s): Emma Weeding, Patrick Coit, Srilakshmi Yalavarthi, Mariana J. Kaplan, Jason S. Knight, Amr H. Sawalha
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thromboembolic events and pregnancy loss. We sought to characterize the DNA methylation profile of primary APS in comparison to healthy controls and individuals with SLE. In primary APS neutrophils compared to controls, 17 hypomethylated and 25 hypermethylated CpG sites were identified. Notable hypomethylated genes included ETS1, a genetic risk locus for SLE, and PTPN2, a genetic risk locus for other autoimmune diseases. Gene ontology analysis of hypomethylated genes revealed enrichment of genes involved in pregnancy. None of the differentially methylated sites in primary APS were differentially methylated in SLE neutrophils, and there was no demethylation of interferon signature genes in primary APS as is seen in SLE. Hypomethylation within a single probe in the IFI44L promoter (cg06872964) was able to distinguish SLE from primary APS with a sensitivity of 93.3% and specificity of 80.0% at a methylation fraction of 0.329.
Publication date: Available online 22 November 2018
Source: Clinical Immunology
Author(s): Amr H. Sawalha
Publication date: Available online 22 November 2018
Source: Cortex
Author(s): Muhammet Ikbal Sahan, Steve Majerus, Michael Andres, Wim Fias
This study aimed at establishing the neural basis of magnitude processing of multiple numbers from working memory. We designed a numerical landmark task and embedded it in a fragmented trial event-related fMRI design, allowing to separate encoding from decision processing. An attentional localiser task not involving numbers allowed further functional specification. The results show that in a numerical landmark task the right anterior intraparietal sulcus is involved in number encoding while more posterior parietal regions, bilateral superior parietal lobule and right inferior parietal lobule, provide domain-general support in the form of constructing a working memory representation or orienting spatial attention within that mental representation during number comparison. The results are in line with earlier studies reporting a functional distinction between anterior and posterior parietal contributions to number processing and further specify their role at a functional level.
Publication date: Available online 22 November 2018
Source: Magnetic Resonance Imaging
Author(s): Richard C. Semelka, John P. Prybylski, Miguel Ramalho
The molecular structure, charge, thermodynamic and kinetic stability are approximately the same for gadodiamide and gadoversetamide, the main substantive difference is that gadodiamide is manufactured with 5% free ligand to form Omniscan® and gadoversetamide with 10% free ligand to form OptiMARK®.
To determine the relative risk of Nephrogenic Systemic Fibrosis (NSF) between gadodiamide (Omniscan®) and gadoversetamide (OptiMARK®) and to explore the potential contribution of the amount of excess ligand added to their commercial formulations.
In this retrospective observational study, the number of doses and NSF cases associated with these agents were calculated based on two different approaches: the number of doses was determined based on pharmaceutical companies' information, and the number of unconfounded NSF cases was obtained from the previously published literature based on a legal database. A second analysis estimates the number of doses and NSF cases from the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS).
Approximately 87 million and 12 million doses of Omniscan® and OptiMARK®, respectively, have been administered worldwide since their original approval for use in the various countries throughout the world. A total of 197 and 8 unconfounded cases of NSF have been reported with Omniscan® and OptiMARK®, rendering an incidence of 2.3/million and 0.7/million for these agents, respectively. The FAERS analysis suggested reported incidences of 13.1/million and 5.0/million.
There is an approximately 3-fold greater incidence of NSF from Omniscan® than OptiMARK®. The difference in incidence might reflect the lesser quantity of added free ligand to the formulation of Omniscan®.
Publication date: Available online 22 November 2018
Source: Magnetic Resonance Imaging
Author(s): Colin Hansen, Vishwesh Nath, Allison E. Hainline, Kurt G. Schilling, Prasanna Parvathaneni, Roza G. Bayrak, Justin A. Blaber, Okan Irfanoglu, Carlo Pierpaoli, Adam W. Anderson, Baxter P. Rogers, Bennett A. Landman
Diffusion weighted MRI (DWMRI) and the myriad of analysis approaches (from tensors to spherical harmonics and brain tractography to body multi-compartment models) depend on accurate quantification of the apparent diffusion coefficient (ADC). Signal drift during imaging (e.g., due to b0 drift associated with heating) can cause systematic non-linearities that manifest as ADC changes if not corrected. Herein, we present a case study on two phantoms on one scanner. Different scan protocols exhibit different degrees of drift during similar scans and may be sensitive to the order of scans within an exam. Vos et al. recently reviewed the effects of signal drift in DWMRI acquisitions and proposed a temporal model for correction. We propose a novel spatial-temporal model to correct for higher order aspects of the signal drift and derive a statistically robust variant. We evaluate the Vos model and propose a method using two phantoms that mimic the ADC of the relevant brain tissue (0.36–2.2 × 10–3 mm2/s) on a single 3 T scanner. The phantoms are (1) a spherical isotropic sphere consisting of a single concentration of polyvinylpyrrolidone (PVP) and (2) an ice-water phantom with 13 vials of varying PVP concentrations. To characterize the impact of interspersed minimally weighted volumes ("b0's"), image volumes with b-value equal to 0.1 s/mm2 are interspersed every 8, 16, 32, 48, and 96 diffusion weighted volumes in different trials. Signal drift is found to have spatially varying effects that are not accounted for with temporal-only models. The novel model captures drift more accurately (i.e., reduces the overall change per-voxel over the course of a scan) and results in more consistent ADC metrics.
To investigate the differences in clinical characteristics and long-term treatment outcomes according to antinuclear antibody(ANA) and rheumatoid factor(RF) positivity and the correlation between pain-related and hematological indices in temporomandibular disorders(TMD) patients.
Clinical examinations were done following the Research Diagnostic Criteria for TMD in 257 patients. Comprehensive screening along with psychological and hematological evaluations (ANA, RF, complete blood cell count, C-reactive protein[CRP] and erythrocyte sedimentation rate[ESR]) were conducted. Clinical characteristics and treatment outcomes were statistically compared between ANA/RF positive and negative groups.
Thirty-nine patients showed ANA/RF positivity. Male patients had smaller comfortable mouth opening(CMO)(p = 0.033) and maximum mouth opening(MMO)(p = 0.016) ranges with more painful neck muscles on palpation when RF/ANA positive. Pain duration, intensity, disability days and psychological distress levels were also higher in RF/ANA positive male patients. Significant correlation was shown in ESR with pain duration(p < 0.05) and numeric rating scale(NRS) before treatment(p < 0.05), CRP with NRS before treatment(p < 0.01), and red blood cell (RBC) with pain intensity(p < 0.05), NRS before treatment(p < 0.01), CMO(p < 0.01), pain on palpation of cervical muscles(p < 0.01), CMO(p < 0.05), and MMO(p < 0.05) 6 months after treatment.
These results may point towards a nonspecific autoimmune disposition in a subgroup of TMD patients. RF and ANA could be considered as a screening test for the detection of autoimmune phenomena in TMD.
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print
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Marijuana is the most widely used illicit substance in Canada. To date, no conclusive study has looked at the epidemiologic basis of marijuana use and head and neck cancer (HNC). Due to the imminent recreational legalization of marijuana in Canada, the epidemiologic relationship between marijuana use and HNC is becoming increasingly important.
To examine the epidemiologic characteristics of HNC patients who are recreational marijuana users.
This study was conducted at a single tertiary care centre from 2011 to 2014. Patients were enrolled consecutively at time of diagnosis of malignancy. Data was prospectively collected and included socioeconomic factors, alcohol/tobacco history, tumor characteristics, and treatment modality. Marijuana use was defined as current usage on an at least weekly basis.
Eight hundred seventy-nine patients met inclusion and exclusion criteria. Seventy-four (8.4%) patients were classified as marijuana users. Compared to non-users, marijuana users were less likely to be married (p = 0.048) and had less significant tobacco smoking history (p = 0.004). There were no significant differences between other socioeconomic factors or local and regional disease (p > 0.05). Marijuana users differed in the proportion of cancers stratified by primary site (p < 0.0001), with higher rates of p16+ oropharyngeal cancers, and treatment modality (p < 0.0001), with more use of chemoradiation.
HNC patients who were marijuana users were less likely to be married and smoke tobacco. They have a distinct cancer site prevalence and are more likely to be treated by chemoradiation. Understanding the epidemiological breakdown of marijuana users amongst HNC patients will be a useful adjunct for future studies.
Cosmetics, Vol. 5, Pages 69: Enzyme-Catalysed Conversion of Atranol and Derivatives into Dimeric Hydrosoluble Materials: Application to the Preparation of a Low-Atranol Oakmoss Absolute
Cosmetics doi: 10.3390/cosmetics5040069
Authors: Hélène Bouges André Monchot Sylvain Antoniotti
Oakmoss absolute, a solvent extract from Evernia prunastri, is a valuable fragrance ingredient widely used in fine fragrance for almost two centuries. Some minor components of oakmoss absolute, such as atranol and chloroatranol, are attested contact allergens and their presence in fragrance and cosmetic products should be as low as possible. In this context, we have developed an enzyme-based protocol upon which these undesirable molecules are converted in a hydrosoluble dimeric material, and thus easily separated from the absolute by liquid–liquid extraction. Analytical and sensory analyses were performed to confirm the specificity of the process, the absence of alteration of the olfactory quality of the absolute, and the final titles of atranol and chloroatranol, which eventually were observed in the ppm range. This highly sustainable process is a viable alternative to conventional time-, energy-, and manpower-consuming techniques to produce very low-atranol oakmoss absolute.
Cosmetics, Vol. 5, Pages 68: Seaweeds as Source of Bioactive Substances and Skin Care Therapy—Cosmeceuticals, Algotheraphy, and Thalassotherapy
Cosmetics doi: 10.3390/cosmetics5040068
Authors: Leonel Pereira
Riverine, estuarine, and coastal populations have always used algae in the development of home remedies that were then used to treat diverse health problems. The empirical knowledge of various generations originated these applications, and their mechanism of action is, in most cases, unknown, that is, few more scientific studies would have been described beyond simple collection and ethnographic recording. Nevertheless, recent investigations, carried out with the purpose of analyzing the components and causes that alter the functioning and the balance of our organism, are already giving their first results. Water, and especially sea water is considered as essential to life on our planet. It sings all the substances necessary and conducive to the development of the living being (minerals, catalysts, vitamins, amino acids, etc.). Oceans cover over 70% of Earth, being home to up to 90% of the organisms in the planet. Many rich resources and unique environments are provided by the ocean. Additionally, bioactive compounds that multiple marine organisms have a great potential to produce can be used as nutraceuticals, pharmaceuticals, and cosmeceuticals. Both primary and secondary metabolites are produced by algae. The first ones are directly implicated in development, normal growth, or reproduction conditions to perform physiological functions. Stress conditions, like temperature changes, salinity, environmental pollutants, or UV radiation exposure cause the performance of secondary metabolites. In algae, proteins, polysaccharides, fatty acids, and amino acids are primary metabolites and phenolic compounds, pigments, vitamins, sterols, and other bioactive agents, all produced in algae tissues, are secondary metabolites. These algal active constituents have direct relevance in cosmetics.
Das PAPA-Syndrom, eine Kombination bestehend aus pyogener steriler Arthritis, Pyoderma gangraenosum und Akne, ist eine autosomal-dominant vererbbare Erkrankung, die durch eine Mutation im PSTPIP1(„proline-serine-threonine phosphatase interacting protein 1")-Gen auf dem für das Prolin-Serin-Threonin-Phosphatase-interagierende Protein 1 kodierenden Chromosom 15 verursacht wird. Eine Verbindung mit Morbus Crohn (MC), Autoimmunerkrankungen der Leber und dem PAPA-Syndrom wurde in der Literatur bisher noch nicht beschrieben.
In dieser Arbeit untersuchten wir intensiv eine Familie mit 3 betroffenen Mitgliedern (Mutter und 2 Kinder), diagnostizierten ein PAPA-Syndrom neu sowie zusätzlich intestinale und hepatobiliäre autoimmune Symptome.
Wir führten eine tiefe Phänotypisierung sowie dermatologische, radiologische, rheumatologische, gastroenterologische, histologische und genetische Analysen bei den 3 Betroffenen dieser Familie durch.
Bei allen 3 Familienmitgliedern konnte ein PAPA-Syndrom mit einer krankheitsverursachenden Mutation c.688G > A (p.Ala230Thr) im PSTPIP1-Gen nachgewiesen werden. Der jüngere Sohn hatte zusätzlich einen Morbus Crohn, die Mutter eine Colitis ulcerosa (CU) und ein Overlap-Syndrom zwischen Autoimmunhepatitis (AIH) und primär sklerosierender Cholangitis (PSC) entwickelt. Bei allen 3 Betroffenen konnte keine Mutation im NOD2(„nucleotide binding oligomerization domain containing protein 2")-Gen nachwiesen werden.
Die Assoziation von PAPA-Syndrom mit einem Morbus Crohn und Autoimmunerkrankungen der Leber könnte eine Symptomerweiterung des PAPA-Syndroms, also ähnliche pathogenetische Mechanismen dieser Symptome, oder sogar ein neues Syndrom darstellen. Zukünftig sollten Patienten mit PAPA-Syndrom sorgfältig auf intestinale und hepatobiliäre Erkrankungen untersucht werden.
In dem präsentierten Fall stellte die entstandene Defektgröße nach Resektion eines Dermatofibrosarcoma protuberans im Bereich der exponierten Gesichtshaut eine Überschreitung der Versorgungsmöglichkeit mit lokalen Lappenplastiken dar. Mit den Mitteln der konventionellen Wundheilung in Kombination mit einem gemeshten Spalthauttransplantat ist eine plastisch-ästhetische Weichteilversorgung mit einem ästhetisch zufriedenstellenden Ergebnis möglich gewesen.
Publication date: Available online 22 November 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): Elissa M. Abrams, Allan B. Becker, Stanley J. Szefler
Publication date: Available online 22 November 2018
Source: Annals of Allergy, Asthma & Immunology
Author(s): William J. Lavery, Jonathan A. Bernstein
Acute-on-chronic liver failure (ACLF) is an acute liver decompensation that occurs within 4 weeks on the basis of chronic liver disease. At present, the treatments of ACLF include general supportive treatment, etiological treatment, prevention and treatment of complications, artificial liver treatment, and liver transplantation. Many studies suggest that stem cell therapy may become a new treatment for patients with ACLF. Our department has also tried the application of this treatment. Now, there are three cases of stem cell therapy for patients with ACLF by our department which will be briefly reported.
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We present the case of an 8-year-old girl with hemophagocytic lymphohistiocytosis secondary to a Salmonella typhi infection. She received antibiotic treatment and intravenous immunoglobulin with complete resolution of the symptoms. We present a review of previously reported pediatric cases and propose a gradual approach to treatment.
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