Repeat stent implementation for recanalization of the proximal right coronary artery: a case report

A stent in a false lumen is a common cause of stent occlusion after coronary percutaneous coronary artery intervention therapy, particularly in the culprit lesion of acute myocardial infarction. Here, we prese...

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BCG Therapy for Type 1 Diabetes: Restoration of Balanced Immunity and Metabolism

Publication date: Available online 29 December 2018

Source: Trends in Endocrinology & Metabolism

Author(s): Willem M. Kühtreiber, Denise L. Faustman

The bacillus Calmette–Guerin (BCG) vaccine is a microorganism developed as a vaccine for tuberculosis 100 years ago and used as therapy for bladder cancer 40 years ago. More recently, BCG has shown therapeutic promise for type 1 diabetes (T1D) and several other autoimmune diseases. In T1D, BCG restored blood sugars to near normal, even in patients with advanced disease of >20 years duration. This clinically important effect may be driven by resetting of the immune system and the shifting of glucose metabolism from overactive oxidative phosphorylation, a state of minimal sugar utilization, to aerobic glycolysis, a state of high glucose utilization, for energy production. The mechanistic findings support the Hygiene Hypothesis and reveal the immune and metabolic synergy of mycobacterial reintroduction in modern humans.

http://bit.ly/2AnnCaN

Diffusion kurtosis imaging of endometrial carcinoma: Correlation with histopathological findings

Publication date: Available online 30 December 2018

Source: Magnetic Resonance Imaging

Author(s): Ichiro Yamada, Junichiro Sakamoto, Daisuke Kobayashi, Naoyuki Miyasaka, Kimio Wakana, Noriko Oshima, Akira Wakabayashi, Yukihisa Saida, Ukihide Tateishi, Yoshinobu Eishi

Abstract

Purpose

In this study, we aimed to determine the usefulness of diffusion kurtosis imaging (DKI) as a noninvasive method for the evaluation of tumor invasion depth, histological grade, and lymph node metastasis in patients with endometrial carcinoma (EMC).

Materials and methods

Our institutional review board approved this retrospective study and waived informed consent. In total, 24 patients suspected of having EMC were examined by a 1.5-T magnetic resonance imaging. DKI data were obtained using a single-shot echo-planar imaging sequence with four b values (0, 500, 1000, and 2000 s/mm²). Kurtosis (K), diffusivity (D), and apparent diffusion coefficient (ADC) maps were generated and compared with histopathological findings.

Results

K maps from all patients identified the junctional zone as a distinct high-K zone (1.443 ± 0.362). This zone was significantly different from the zone of endometrium and outer myometrium (0.678 ± 0.179 and 0.694 ± 0.113, respectively; P < 0.001). K and D values of all EMCs were significantly different from those of all normal uterine wall layers. K and D values were significantly correlated with histological grades of endometrioid adenocarcinomas (r = 0.799, P < 0.001 and r = −0.799, P < 0.001, respectively), while ADC values were not (r = −0.243, P = 0.382). Metastatic and nonmetastatic lymph nodes showed significantly different K (P = 0.001) and D (P = 0.001) values, but not ADC values (P = 0.827).

Conclusions

DKI may be clinically useful for the noninvasive evaluation of depth of tumor invasion, histological grade, and lymph node metastasis in patients with EMC.

http://bit.ly/2VjM4ms

Widespread positive selection on cetacean TLR extracellular domain

Publication date: February 2019

Source: Molecular Immunology, Volume 106

Author(s): Shixia Xu, Ran Tian, Yurui Lin, Zhenpeng Yu, Zepeng Zhang, Xu Niu, Xiaohong Wang, Guang Yang

Abstract

Toll like receptors (TLRs), key members of innate immune system, can recognize a wide diversity of pathogens and initiate both innate and adaptive immune responses in vertebrate. Cetaceans must have faced new challenges of pathogens when their terrestrial relatives transitioned from the terrestrial to aquatic environment. Here, we sequenced the extracellular domain (ECD) of 10 TLRs in cetacean lineages because this region involved in the recognition of pathogens. A total of 148 sites ranging between 5–26 codons (0.01%–4.83%) were identified to be robust candidates of positive selection at the ECD of 10 TLRs. In addition, the majority (90.54%) of these positively selected codons were found to have radical amino acid changes, which strengthen the evidence of positive selection. Importantly, more radical amino acid changes in selected sites were enriched in the period of early evolutionary transition from land to semi-aquatic and from semi-aquatic to full-aquatic habitat, which might endow cetaceans with a faster adaptation to new pathogens as they transitioned into novel habitat. Interestingly, similar selective intensity was detected in both viral and non-viral TLRs in cetaceans, which was not in line with previous studies on primates and birds that reported stronger positive selection in non-viral TLRs than in viral TLRs. This result may be explained by the fact that cetaceans might have faced diversity of bacteria and viruses during its transitions from terrestrial to aquatic environment whereas both primates and birds probably being affected by only a restricted number of related viruses due to their homogeneous habitat.

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Association between the intestinal microbiota and allergic sensitization, eczema, and asthma: A systematic review

Publication date: Available online 29 December 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Petra Zimmermann, Nicole Messina, William W. Mohn, B. Brett Finlay, Nigel Curtis

The intestinal microbiota plays an important role in development of the immune system and regulation of immune responses. This review summarizes the association between the intestinal microbiota and the development of allergic sensitization, eczema, and asthma in neonates and children. Overall, a greater relative abundance of Bacteroidaceae, Clostridiaceae, and Enterobacteriaceae and a lower relative abundance of Bifidobacteriaceae and Lactobacillaceae is associated with the development of allergic sensitization, eczema, or asthma. Reduced bacterial diversity can be associated with the development of allergic disease. The association between the composition of the intestinal microbiota and the development of allergic disease or asthma is less consistent in older children than in neonates, suggesting that early-life microbial exposure plays a more important role. Inconsistencies in the results reported from different studies might partly be explained by heterogeneity in design, study populations, diagnostic criteria, microbiota analysis methods, and reporting on different taxonomic levels. Larger studies that better account for antenatal and postnatal factors will further help determine specific microbial intestinal signatures associated with increased risk of allergy and asthma. This will enable the early identification of infants at high risk and facilitate novel strategies and interventions to prevent and treat these conditions, including modifying the intestinal microbiota early in life.

http://bit.ly/2Tl4rpi

Thermography: High sensitivity and specificity diagnosing contact dermatitis in patch testing

Publication date: Available online 29 December 2018

Source: Allergology International

Author(s): Florian Anzengruber, Fayez Alotaibi, Lilian S. Kaufmann, Adhideb Ghosh, Martin R. Oswald, Julia-Tatjana Maul, Barbara Meier, Lars E. French, Mathias Bonmarin, Alexander A. Navarini

Abstract

Background

Patch testing of contact allergens to diagnose allergic contact dermatitis (ACD) is a traditional, useful tool. The most important decision is the distinction between allergic and irritant reactions, as this has direct implications on diagnosis and management. Our objective was to evaluate a new method of non-contact infrared reading of patch tests. Secondary objectives included a possible correlation between the intensity of the patch test reaction and temperature change.

Methods

420 positive reactions from patients were included in our study. An independent patch test reader assessed the positive reactions and classified them as allergic (of intensity + to +++) or irritant (IR). At the same time, a forward-looking infrared (FLIR) camera attachment for an iPhone was used to acquire infrared thermal images of the patch tests, and images were analyzed using the FLIR ONE app.

Results

Allergic patch test reactions were characterized by temperature increases of 0.72 ± 0.67 °C compared to surrounding skin. Irritant reactions only resulted in 0.17 ± 0.31 °C temperature increase. The mean temperature difference between the two groups was highly significant (p < 0.0001) and therefore was used to predict the type of contact dermatitis.

Conclusions

Thermography is a reliable and effective way to distinguish between allergic and irritant contact dermatitis.

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Support for Parents of Deaf Children: Common Questions and Informed, Evidence-based Answers

Publication date: Available online 29 December 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Tom Humphries, Poorna Kushalnagar, Gaurav Mathur, Donna Jo Napoli, Christian Rathmann, Scott Smith

Abstract

To assist medical and hearing-science professionals in supporting parents of deaf children, we have identified common questions that parents may have and provide evidence-based answers. In doing so, a compassionate and positive narrative about deafness and deaf children is offered, one that relies on recent research evidence regarding the critical nature of early exposure to a fully accessible visual language, which in the United States is American Sign Language (ASL). This evidence includes the role of sign language in language acquisition, cognitive development, and literacy. In order for parents to provide a nurturing and anxiety-free environment for early childhood development, signing at home is important even if their child also has the additional nurturing and care of a signing community. It is not just the early years of a child's life that matter for language acquisition; it's the early months, the early weeks, even the early days. Deaf children cannot wait for accessible language input. The whole family must learn simultaneously as the deaf child learns. Even moderate fluency on the part of the family benefits the child enormously. And learning the sign language together can be one of the strongest bonding experiences that the family and deaf child have.

http://bit.ly/2s31iyx