A novel platform for electromagnetic navigated ultrasound bronchoscopy (EBUS)

Abstract

Purpose

Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) of mediastinal lymph nodes is essential for lung cancer staging and distinction between curative and palliative treatment. Precise sampling is crucial. Navigation and multimodal imaging may improve the efficiency of EBUS-TBNA. We demonstrate a novel EBUS-TBNA navigation system in a dedicated airway phantom.

Methods

Using a convex probe EBUS bronchoscope (CP-EBUS) with an integrated sensor for electromagnetic (EM) position tracking, we performed navigated CP-EBUS in a phantom. Preoperative computed tomography (CT) and real-time ultrasound (US) images were integrated into a navigation platform for EM navigated bronchoscopy. The coordinates of targets in CT and US volumes were registered in the navigation system, and the position deviation was calculated.

Results

The system visualized all tumor models and displayed their fused CT and US images in correct positions in the navigation system. Navigating the EBUS bronchoscope was fast and easy. Mean error observed between US and CT positions for 11 target lesions (37 measurements) was \(2.8\pm 1.0\)  mm, maximum error was 5.9 mm.

Conclusion

The feasibility of our novel navigated CP-EBUS system was successfully demonstrated. An EBUS navigation system is needed to meet future requirements of precise mediastinal lymph node mapping, and provides new opportunities for procedure documentation in EBUS-TBNA.

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Estimating needle tip deflection in biological tissue from a single transverse ultrasound image: application to brachytherapy

Abstract

Purpose

This paper proposes a method to predict the deflection of a flexible needle inserted into soft tissue based on the observation of deflection at a single point along the needle shaft.

Methods

We model the needle-tissue as a discretized structure composed of several virtual, weightless, rigid links connected by virtual helical springs whose stiffness coefficient is found using a pattern search algorithm that only requires the force applied at the needle tip during insertion and the needle deflection measured at an arbitrary insertion depth. Needle tip deflections can then be predicted for different insertion depths.

Results

Verification of the proposed method in synthetic and biological tissue shows a deflection estimation error of \(<\) 2 mm for images acquired at 35 % or more of the maximum insertion depth, and decreases to 1 mm for images acquired closer to the final insertion depth. We also demonstrate the utility of the model for prostate brachytherapy, where in vivo needle deflection measurements obtained during early stages of insertion are used to predict the needle deflection further along the insertion process.

Conclusion

The method can predict needle deflection based on the observation of deflection at a single point. The ultrasound probe can be maintained at the same position during insertion of the needle, which avoids complications of tissue deformation caused by the motion of the ultrasound probe.

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Semantic annotation of 3D anatomical models to support diagnosis and follow-up analysis of musculoskeletal pathologies

Abstract

Purpose

While 3D patient-specific digital models are currently available, thanks to advanced medical acquisition devices, there is still a long way to go before these models can be used in clinical practice. The goal of this paper is to demonstrate how 3D patient-specific models of anatomical parts can be analysed and documented accurately with morphological information extracted automatically from the data. Part-based semantic annotation of 3D anatomical models is discussed as a basic approach for sharing and reusing knowledge among clinicians for next-generation CAD-assisted diagnosis and treatments.

Methods

We have developed (1) basic services for the analysis of 3D anatomical models and (2) a methodology for the enrichment of such models with relevant descriptions and attributes, which reflect the parameters of interest for medical investigations. The proposed semantic annotation is ontology-driven and includes both descriptive and quantitative labelling. Most importantly, the developed methodology permits to identify and annotate also parts-of-relevance of anatomical entities.

Results

The computational tools for the automatic computation of qualitative and quantitative parameters have been integrated in a prototype system, the SemAnatomy3D framework, which demonstrates the functionalities needed to support effective annotation of 3D patient-specific models. From the first evaluation, SemAnatomy3D appears as an effective tool for clinical data analysis and opens new ways to support clinical diagnosis.

Conclusions

The SemAnatomy3D framework integrates several functionalities for 3D part-based annotation. The idea has been presented and discussed for the case study of rheumatoid arthritis of carpal bones; however, the framework can be extended to support similar annotations in different clinical applications.

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Automatic 3D reconstruction of electrophysiology catheters from two-view monoplane C-arm image sequences

Abstract

Purpose

Catheter guidance is a vital task for the success of electrophysiology interventions. It is usually provided through fluoroscopic images that are taken intra-operatively. The cardiologists, who are typically equipped with C-arm systems, scan the patient from multiple views rotating the fluoroscope around one of its axes. The resulting sequences allow the cardiologists to build a mental model of the 3D position of the catheters and interest points from the multiple views.

Method

We describe and compare different 3D catheter reconstruction strategies and ultimately propose a novel and robust method for the automatic reconstruction of 3D catheters in non-synchronized fluoroscopic sequences. This approach does not purely rely on triangulation but incorporates prior knowledge about the catheters. In conjunction with an automatic detection method, we demonstrate the performance of our method compared to ground truth annotations.

Results

In our experiments that include 20 biplane datasets, we achieve an average reprojection error of 0.43 mm and an average reconstruction error of 0.67 mm compared to gold standard annotation.

Conclusions

In clinical practice, catheters suffer from complex motion due to the combined effect of heartbeat and respiratory motion. As a result, any 3D reconstruction algorithm via triangulation is imprecise. We have proposed a new method that is fully automatic and highly accurate to reconstruct catheters in three dimensions.

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Chronic intermittent hypoxia leads to insulin resistance and impaired glucose tolerance through dysregulation of adipokines in non-obese rats

Abstract

Background and objectives

The aim of this study was to determine whether chronic intermittent hypoxia (CIH) could affect the secretion of adipokines, such as resistin, leptin, and adiponectin, in non-obese rats and to investigate the potential mechanisms.

Methods

An established rodent model of CIH was utilized, in which rats were exposed to varying oxygen levels (7–21 %) respectively over a period of 5 weeks. The area under the curve (AUCG) and the insulin resistance index (homeostasis model of assessment for insulin resistance index, HOMA-IR) were calculated. The levels of several secretory factors in the blood were measured by enzyme-linked immunosorbent assay (ELISA). The mRNA levels and protein expression in adipose tissues was measured by reverse transcription-polymerase chain reaction (RT-PCR).

Results

Glucose tolerance and the levels of adiponectin in non-obese rats were decreased in the CIH group both in the serum and adipose tissue compared with the controls, while the insulin resistance index and the levels of resistin and leptin were increased. Moreover, the expressions of hypoxia inducible factor-1α and lactate dehydrogenase A were significantly higher in chronic intermittent hypoxia rats than in control rats, suggesting the presence of adipose tissue hypoxia.

Conclusions

These results show that CIH leads to insulin resistance (IR) and impaired glucose tolerance (IGT) in a non-obese rodent model of obstructive sleep apnea-hypopnea syndrome, and these effects may be due to the dysregulation of adiponectin, resistin, and leptin.

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Response to Akar et al., regarding our study “Side effects to continuous positive airway pressure treatment for obstructive sleep apnoea”

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Re: Ulander et al.: Side effects to continuous positive airway pressure treatment for obstructive sleep apnoea: changes over time and association to adherence. (Sleep Breath. 2014 Dec;18(4):799-807)

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Chronic intermittent hypoxia leads to insulin resistance and impaired glucose tolerance through dysregulation of adipokines in non-obese rats

Abstract

Background and objectives

The aim of this study was to determine whether chronic intermittent hypoxia (CIH) could affect the secretion of adipokines, such as resistin, leptin, and adiponectin, in non-obese rats and to investigate the potential mechanisms.

Methods

An established rodent model of CIH was utilized, in which rats were exposed to varying oxygen levels (7–21 %) respectively over a period of 5 weeks. The area under the curve (AUCG) and the insulin resistance index (homeostasis model of assessment for insulin resistance index, HOMA-IR) were calculated. The levels of several secretory factors in the blood were measured by enzyme-linked immunosorbent assay (ELISA). The mRNA levels and protein expression in adipose tissues was measured by reverse transcription-polymerase chain reaction (RT-PCR).

Results

Glucose tolerance and the levels of adiponectin in non-obese rats were decreased in the CIH group both in the serum and adipose tissue compared with the controls, while the insulin resistance index and the levels of resistin and leptin were increased. Moreover, the expressions of hypoxia inducible factor-1α and lactate dehydrogenase A were significantly higher in chronic intermittent hypoxia rats than in control rats, suggesting the presence of adipose tissue hypoxia.

Conclusions

These results show that CIH leads to insulin resistance (IR) and impaired glucose tolerance (IGT) in a non-obese rodent model of obstructive sleep apnea-hypopnea syndrome, and these effects may be due to the dysregulation of adiponectin, resistin, and leptin.

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Response to Akar et al., regarding our study “Side effects to continuous positive airway pressure treatment for obstructive sleep apnoea”

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Influence of Flaxseed Oil on Fecal Microbiota, Egg Quality and Fatty Acid Composition of Egg Yolks in Laying Hens

Abstract

Although there have been many attempts to produce ω-3 fatty acid-rich eggs using alpha-linolenic acid (ALA) that is a popular fatty acid in the poultry feed industry, only limited knowledge about the effects of ALA-enriched diets on chicken fecal microbiota is currently available. Herein we examined the changes in the fecal microbiota composition, egg quality traits and fatty acid composition of the egg yolks of laying hens fed ALA-rich flaxseed oil for 8 weeks. The animals fed the experimental diets that contained 0 % (group C), 0.5 % (group T1), and 1.0 % (group T2) of flaxseed oil, respectively, and eggs and feces were obtained for the analyses. ω-3 fatty acids, including ALA, were increased in T1 and T2 compared with C. Furthermore, the freshness of eggs was improved with no side effects on the eggs. The diet also changed the fecal microbiota; Firmicutes was increased in T1 and T2 (48.6 to 83 and 79.6 %) and Bacteroidetes was decreased (40.2 to 8.8 and 4.2 %). Principal coordinate analysis revealed that Lactobacillus, among the 56 examined genera, was the most influenced bacterial group in terms of the fecal microbial community shifts. These results indicate that ALA-rich diets influenced both the egg and fecal microbiota in beneficial manners in laying hens although the association between the fatty acid composition of the egg yolk and the fecal microbiota was not clear. This study is a first step to understand the effect of flaxseed oil as well as intestinal microbiota of laying hens.

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Binariimonas pacifica gen. nov., sp. nov., a Novel Marine Bacterium of Family Sphingomonadaceae Isolated from East Pacific Ocean Surface Seawater

Abstract

A novel rod-shaped binary fission, and yellow-pigmented bacterial strain, JLT 2480^T, was isolated from surface seawater in the East Pacific Ocean. The strain is Gram negative and oxidase negative. Phylogenetic analyses based on 16S rRNA gene sequence indicate that strain JLT 2480^T falls in the family Sphingomonadaceae, sharing highest similarity (95.6 %) with the species Blastomonas ursincola. The DNA G+C content of JLT 2480^T is 65.5 mol%, and the sole respiratory quinone is coenzyme Q₁₀. The predominant polar lipids are sphingoglycolipids (SGL1 and SGL2), phosphatidylglycerols, phosphatidylethanolamines, phospholipids, glycolipids, and phosphatidylcholines. The predominant cellular fatty acids are C_16:0, C_18:0, C_18:1ω7c, C_12:0, and C_16:1ω7c. Strain JLT 2480^T is distinct from the B. ursincola type strain DSM 9006^T as reflected by major chemotaxonomic distinctions between the two. Furthermore, two notable characteristics of the genus Blastomonas, that is, the presence of bacteriochlorophyll a and the puf genes, are not detected in JLT 2480^T. On the basis of present evidence, we consider JLT 2480^T to be a novel species in a new genus of the family Sphingomonadaceae, and propose the name Binariimonas pacifica gen. nov., sp. nov., with strain JLT 2480^T (=CGMCC 1.12850^T = DSM 28646^T) to be the type strain for genus Binariimonas.

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Re: Ulander et al.: Side effects to continuous positive airway pressure treatment for obstructive sleep apnoea: changes over time and association to adherence. (Sleep Breath. 2014 Dec;18(4):799-807)

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Breast cancer subtype as a predictor for outcomes and control in the setting of brain metastases treated with stereotactic radiosurgery

Abstract

We investigated effects of breast cancer subtype on overall survival (OS), local and distant control, and time from initial diagnosis to brain metastases (BM). We also investigated advances in graded prognostic assessment (GPA) scores. A cohort of 72 patients treated for BM from breast cancer with Gamma Knife stereotactic radiosurgery at our institution from 2000 to 2014 had subtyping available and were used for this study. Median follow up for OS was 12 months and for control was 6 months. OS for luminal, HER2, and triple negative subtypes were 26, 20, and 22 months. OS when stratified by Sperduto et al. (J Clin Oncol 30(4):419–425, 2012) and Subbiah et al. (J Clin Oncol 33(20):2239–2245, 2015) GPAs were similar (p = 0.087 and p = 0.063). KPS and treatment modality were significant for OS (p = 0.002; p = 0.034). On univariate analysis, triple negative subtype and >3 BM were trending and significant for decreased OS (p = 0.084; p = 0.047). On multivariable analysis HER2, triple negative, and >3 BM were significant for OS (p = 0.022; p = 0.040; p = 0.009). Subtype was significant for response on a per lesion basis (p = 0.007). Subtype was trending towards significance when analyzing time from initial diagnosis to BM treatment (p = 0.064). Breast cancer subtype is an important prognostic factor when stratifying breast cancer patients with BM. The addition of number of BM to the GPA is a useful addition and should be further investigated. Subtype has an effect on lesion response, and also on rate of development BM after initial diagnosis.

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Delineation of MGMT Hypermethylation as a Biomarker for Veliparib-Mediated Temozolomide-Sensitizing Therapy of Glioblastoma

Background:

Sensitizing effects of poly-ADP-ribose polymerase inhibitors have been studied in several preclinical models, but a clear understanding of predictive biomarkers is lacking. In this study, in vivo efficacy of veliparib combined with temozolomide (TMZ) was evaluated in a large panel of glioblastoma multiforme (GBM) patient-derived xenografts (PDX) and potential biomarkers were analyzed.

Methods:

The efficacy of TMZ alone vs TMZ/veliparib was compared in a panel of 28 GBM PDX lines grown as orthotopic xenografts (8–10 mice per group); all tests of statistical significance were two-sided. DNA damage was analyzed by H2AX immunostaining and promoter methylation of DNA repair gene O6-methylguanine-DNA-methyltransferase (MGMT) by Clinical Laboratory Improvement Amendments–approved methylation-specific polymerase chain reaction.

Results:

The combination of TMZ/veliparib statistically significantly extended survival of GBM models (P < .05 by log-rank) compared with TMZ alone in five of 20 MGMT-hypermethylated lines (average extension in median survival = 87 days, range = 20–150 days), while the combination was ineffective in six MGMT-unmethylated lines. In the MGMT promoter–hypermethylated GBM12 line (median survival with TMZ+veliparib = 189 days, 95% confidence interval [CI] = 59 to 289 days, vs TMZ alone = 98 days, 95% CI = 49 to 210 days, P = .04), the profound TMZ-sensitizing effect of veliparib was lost when MGMT was overexpressed (median survival with TMZ+veliparib = 36 days, 95% CI = 28 to 38 days, vs TMZ alone = 35 days, 95% CI = 32 to 37 days, P = .87), and a similar association was observed in two nearly isogenic GBM28 sublines with an intact vs deleted MGMT locus. In comparing DNA damage signaling after dosing with veliparib/TMZ or TMZ alone, increased phosphorylation of damage-responsive proteins (KAP1, Chk1, Chk2, and H2AX) was observed only in MGMT promoter–hypermethylated lines.

Conclusion:

Veliparib statistically significantly enhances (P < .001) the efficacy of TMZ in tumors with MGMT promoter hypermethylation. Based on these data, MGMT promoter hypermethylation is being used as an eligibility criterion for A071102 (NCT02152982), the phase II/III clinical trial evaluating TMZ/veliparib combination in patients with GBM.

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A Prospective Investigation of PTEN Loss and ERG Expression in Lethal Prostate Cancer

Background:

PTEN is a tumor suppressor frequently deleted in prostate cancer that may be a useful prognostic biomarker. However, the association of PTEN loss with lethal disease has not been tested in a large, predominantly surgically treated cohort.

Methods:

In the Health Professionals Follow-up Study and Physicians' Health Study, we followed 1044 incident prostate cancer cases diagnosed between 1986 and 2009 for cancer-specific and all-cause mortality. A genetically validated PTEN immunohistochemistry (IHC) assay was performed on tissue microarrays (TMAs). TMPRSS2:ERG status was previously assessed in a subset of cases by a genetically validated IHC assay for ERG. Cox proportional hazards models adjusting for age and body mass index at diagnosis, Gleason grade, and clinical or pathologic TNM stage were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association with lethal disease. All statistical tests were two-sided.

Results:

On average, men were followed 11.7 years, during which there were 81 lethal events. Sixteen percent of cases had complete PTEN loss in all TMA cores and 9% had heterogeneous PTEN loss across cores. After adjustment for clinical-pathologic variables, complete PTEN loss was associated with lethal progression (HR = 1.8, 95% CI = 1.2 to 2.9). The association of PTEN loss (complete or heterogeneous) with lethal progression was only among men with ERG-negative (HR = 3.1, 95% CI = 1.7 to 5.7) but not ERG-positive (HR = 1.2, 95% CI = 0.7 to 2.2) tumors.

Conclusions:

PTEN loss is independently associated with increased risk of lethal progression, particularly in the ERG fusion–negative subgroup. These validated and inexpensive IHC assays may be useful for risk stratification in prostate cancer.

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Symptoms and QOL as Predictors of Chemoprevention Adherence in NRG Oncology/NSABP Trial P-1

Background:

Tamoxifen provides a 50% reduction in the incidence of breast cancer (BC) among high-risk women, yet many do not adhere to the five-year course of therapy. Using the prospective double-blind National Surgical Adjuvant Breast and Bowel Project P-1 study, we evaluated whether participant-reported outcomes were associated with drug adherence and whether baseline behavioral risk factors modified those associations.

Methods:

P-1 participants were randomly assigned to placebo vs tamoxifen (20mg/day). Mixed effects logistic regression was used to evaluate whether baseline or three-month SF-36 quality of life (QOL) mental and physical component summaries (MCS, PCS), and participant-reported symptoms (gynecologic, vasomotor, sexual, and other) predicted 12-month drug adherence (76–100% of assigned medication). The evaluation accounted for age, treatment, estimated breast cancer risk, education, baseline smoking, alcohol consumption, and obesity. All statistical tests were two-sided.

Results:

Participants enrolled at least three years before trial unblinding and without medically indicated discontinuation before 12 months were eligible for the present analyses (n = 10 576). At 12 months, 84.3% were adherent. Statistically significant predictors of adherence were: three-month MCS (odds ratio [OR] = 1.15 per 10 points, 95% confidence interval [CI] = 1.06 to 1.25); three-month gynecologic symptoms among moderate alcohol drinkers (OR = .79, 95% CI = 0.72 to 0.88); baseline vasomotor symptoms among participants assigned tamoxifen (OR = .88, 95% CI = 0.80 to 0.97); and three-month sexual symptoms among younger participants (OR = .89 at age 41 years, 95% CI = 0.80 to 0.99). The strongest association was with three-month other symptoms (OR = .77, 95% CI = 0.63 to 0.93). PCS was not associated with adherence. Symptom and QOL associations were not modified by smoking or obesity.

Conclusions:

Promoting QOL and managing symptoms early in therapy may be important strategies to improve adherence.

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Detection of the first OCA6 Italian patient in a large cohort of albino subjects

Oculocutaneous albinism (OCA) is characterized by general hypopigmentation of skin, hair and eye, and by specific ophthalmologic abnormalities caused by a deficiency in melanin biosynthesis. Hypopigmentation of the skin causes severe photosensitivity and an increase risk of developing sun-induced skin cancer. Eye and optic system abnormalities include congenital nystagmus, reduced pigmentation of the iris and retinal pigment epithelium, photophobia, foveal hypoplasia, reduced visual acuity and misrouting of the optic nerves, which can result in strabismus and reduced stereoscopic vision [1].

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Farewell from the Editors

Our term as Editor in Chief and Managing Editor of Digestive and Liver Disease (DLD) is coming to an end, as this is in fact the final issue produced under our leadership of the journal. After a 7-year course in this position, we can truly say that this has been a wonderful, challenging and highly stimulating journey through all fields of Gastroenterology and Hepatology. As is customary at the end of any cycle, we would take this occasion to reflect and draw some concluding remarks.

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Editorial Board

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Two metal stents for extensive oesophageal cancer

A 64 year-old man was admitted to our Gastroenterology Unit for dysphagia and weight loss. Computerized tomography scan showed a 15cm mass in the thoracic oesophagus, infiltrating the aorta and lymphatic structures, and liver metastasis. Upper endoscopy with biopsy was performed, showing squamous cell carcinoma.

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Sports Medicine, Vol. 45, Issue 12 - New Issue Alert

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New Issue Alert 11/29/2015 Dear Alexandros Sfakianakis, We are pleased to deliver your requested table of contents alert for Sports Medicine. Volume 45 Number 12 is now available online. Exercise to Improve Mobility in Healthy Aging Important news New: Sports Injuries - Prevention, Diagnosis, Treatment and Rehabilitation Edited by: Mahmut Nedim Doral and Jon Karlsson. Start reading on link.springer.com or recommend to your librarian. » Learn more In this issue Preface Exercise to Improve Mobility in Healthy Aging Urs Granacher & Tibor Hortobágyi » Abstract   » Full text HTML   » Full text PDF Systematic Review Effects of Three Types of Exercise Interventions on Healthy Old Adults' Gait Speed: A Systematic Review and Meta-Analysis Tibor Hortobágyi, Melanie Lesinski, Martijn Gäbler, Jessie M. VanSwearingen, Davide Malatesta & Urs Granacher » Abstract   » Full text HTML   » Full text PDF Systematic Review Effects of Strength Training Using Unstable Surfaces on Strength, Power and Balance Performance Across the Lifespan: A Systematic Review and Meta-analysis David G. Behm, Thomas Muehlbauer, Armin Kibele & Urs Granacher » Abstract   » Full text HTML   » Full text PDF Systematic Review Associations Between Measures of Balance and Lower-Extremity Muscle Strength/Power in Healthy Individuals Across the Lifespan: A Systematic Review and Meta-Analysis Thomas Muehlbauer, Albert Gollhofer & Urs Granacher » Abstract   » Full text HTML   » Full text PDF Systematic Review Dose–Response Relationships of Resistance Training in Healthy Old Adults: A Systematic Review and Meta-Analysis Ron Borde, Tibor Hortobágyi & Urs Granacher » Abstract   » Full text HTML   » Full text PDF Systematic Review Effects of Balance Training on Balance Performance in Healthy Older Adults: A Systematic Review and Meta-analysis Melanie Lesinski, Tibor Hortobágyi, Thomas Muehlbauer, Albert Gollhofer & Urs Granacher » Abstract   » Full text HTML   » Full text PDF Systematic Review Changes in Standing and Walking Performance Under Dual-Task Conditions Across the Lifespan Jan Ruffieux, Martin Keller, Benedikt Lauber & Wolfgang Taube » Abstract   » Full text HTML   » Full text PDF Systematic Review Predictive and Reactive Locomotor Adaptability in Healthy Elderly: A Systematic Review and Meta-Analysis Sebastian Bohm, Lida Mademli, Falk Mersmann & Adamantios Arampatzis » Abstract   » Full text HTML   » Full text PDF Acknowledgement to Referees Referees 2015 » Abstract   » Full text HTML   » Full text PDF Do you want to publish your article in this journal? Please visit the homepage of Sports Medicine for full details on: aims and scope editorial policy article submission Impact Factor: 5.038 (2014) Journal Citation Reports®, Thomson Reuters Read open access articles Click here to view all open access articles published in this journal. Interested in publishing your article open access? When you opt for Open Choice, you retain full copyright and your article is permanently freely available. Sign up for SpringerAlerts! Register for Springer's email services providing you with info on the latest books in your field. » Click here Important news Papers, the reference manager, for iPhone and iPad now totally free Full functionality, no in-app purchases or small print. Find, organize, read and share the research materials you care about, anytime, anywhere. Download today: http://ift.tt/1xaTMLk. » Learn more This email has been sent to alsfakia.journals2@blogger.com You are receiving this email because you have opted to receive information from SpringerAlerts as a registered user of our Table of Content Alert for journals. To ensure the delivery to your inbox, please add the sender address springer@alerts.springer.com to your allow list. To modify your subscription (including change of email address etc.), please go to http://ift.tt/Lqiruf and log in with your email address and password. To unsubscribe from this specific table of contents alert, please click here. To unsubscribe from ALL table of contents alerts, please click here. For all enquiries, problems or suggestions regarding this service, please contact onlineservice@springer.com. Springer respects your privacy and does not disclose, sell or rent your personal information to any nonaffiliated third parties without your consent. Please visit the Springer Privacy Statement. Springer-Verlag GmbH Heidelberg, Tiergartenstrasse 17, 69121 Heidelberg, Germany, phone: +49 6221 487 0, fax: +49 6221 487 8366 © Springer 2015, springer.com

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Mixed Streptococcus pneumoniae and Streptococcus pyogenes meningitis in an immunocompromised adult patient: a case report

IntroductionCommunity-acquired meningitis is a monomicrobial infection caused by either viruses or bacteria in the vast majority of patients. We report here one exceptional case of a patient with mixed bacterial meningitis due to Streptococcus pneumoniae and Streptococcus pyogenes.Case presentationWe report the case of a 68-year-old immunocompromised Caucasian man suffering from otitis and then meningitis caused by Streptococcus pneumoniae and Streptococcus pyogenes. Bacteria were undistinguishable by direct microscopic examination of the cerebrospinal fluid. He responded well to treatment with cefotaxime and dexamethasone, with no sequelae observed at the 4-month follow-up. Conclusions: This first reported case of mixed S. pneumoniae and S. pyogenes meningitis illustrates the life-threatening consequences of barotrauma in immunocompromised patients suffering from otorhinolaryngeal infections.

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Clinicopathological characteristics of tumours of the intraoral minor salivary glands in 170 Brazilian patients

Tumours of the minor salivary glands are relatively uncommon, and publications from around the world normally include tumours of both the minor and major salivary glands, making it difficult to assess their prevalence and distribution. Our aim was to evaluate retrospectively the clinicopathological features of a series of tumours of the intraoral minor salivary glands from two universities in Rio de Janeiro, Brazil, and to compare the data with those from other epidemiological studies. A total of 170 such tumours were diagnosed from 1942 to 2012, and were selected from two university departments of oral pathology.

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Retrospective analysis of process times for lacerations of the face in children: procedural sedation or general anaesthesia?

We find that procedural sedation is beneficial in the emergency department for children with simple lacerations of the face, and close liaison between specialties is necessary.

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Effects of mandibular advancement surgery on the temporomandibular joint and muscular and articular adaptive changes—a systematic review

The objective of this study was to assess the anatomical changes to the condyle and articular disc following mandibular advancement surgery, the adaptation of the masticatory muscles, and the improvement or worsening of temporomandibular disorders (TMD) in patients with pre-existing disorders and those who developed them following surgery. Four databases were searched systematically: PubMed, Scopus, Embase, and Cochrane Library. Of the 544 articles initially selected, 219 were duplicates and a further 165 were excluded on the basis of their titles and abstracts.

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Simultaneous implant placement with ridge augmentation using an autogenous bone ring transplant

The severely defective socket, in which implant placement within the remaining bone will result in a significantly off-axis implant position, precludes immediate implant placement and requires bone grafting as an initial surgical intervention. The aims of this study were to evaluate autogenous chin bone ring consolidation after the augmentation of severely defective sockets and the clinical application of these rings in the premolar–molar region with simultaneous implant placement in a one-stage procedure.

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Clinical and radiological outcomes of transoral endoscope-assisted treatment of mandibular condylar fractures

Fractures of the mandibular condyle are one of the most common craniofacial fractures. However, the diagnosis and treatment of these fractures is controversial because of the multiple surgical approaches available. The purposes of this study were to identify surgery-related technical tips for better outcomes and to evaluate the results as well as complications encountered during 7 years of endoscope use to supplement the limited intraoral approach in the treatment of mandibular condylar fractures.

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Information and Decision-Making Needs Among People with Anxiety Disorders: Results of an Online Survey

Abstract

Background

People with anxiety disorders are faced with treatment decisions considerably affecting their life. Patient decision aids are aimed at enabling patients to deliberate treatment options based on individual values and to participate in medical decisions.

Objective

This is the first study to determine patients' information and decision-making needs as a pre-requisite for the development of patient decision aids for anxiety disorders.

Methods

An online cross-sectional survey was conducted between January and April 2013 on the e-health portal http://www.psychenet.de by using a self-administered questionnaire with items on internet use, online health information needs, role in decision making and important treatment decisions. Descriptive and inferential statistical as well as qualitative data analyses were performed.

Results

A total of 60 people with anxiety disorders with a mean age of 33.3 years (SD 10.5) participated in the survey. The most prevalent reasons for online health information search were the need for general information on anxiety disorders, the search for a physician or psychiatrist and the insufficiency of information given by the healthcare provider. Respondents experienced less shared and more autonomous decisions than they preferred. They assessed decisions on psychotherapy, medication, and treatment setting (inpatient or outpatient) as the most difficult decisions.

Conclusion

Our results confirm the importance of offering patient decision aids for people with anxiety disorders that encourage patients to participate in decision making by providing information about the pros and cons of evidence-based treatment options.

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Systematic Review of Patients’ and Parents’ Preferences for ADHD Treatment Options and Processes of Care

Abstract

Background

Patient preferences are an important topic of study with respect to attention-deficit hyperactivity disorder (ADHD) interventions, as there are multiple treatment choices available, multiple developmental levels to consider, and multiple potential individuals involved in treatment (children, parents, and adults with ADHD). Stated preference methods such as discrete choice experiment (DCE), best-worst scaling (BWS), and other utility value methods such as standard gamble interview (SGI) and time trade-off (TTO) are becoming more common in research addressing preferences for ADHD treatments. A synthesis of this research may facilitate improved patient-centered and family-centered treatment for ADHD.

Objective

The purpose of this review was to synthesize reports across existing DCE, BWS, TTO, and SGI studies to assess which aspects of ADHD treatment are most studied as well as most preferred and influential in treatment decisions.

Data Sources

MEDLINE, PsycINFO.

Study Selection

A total of 41 studies referring to preferences for ADHD treatment were identified through the initial search and contact with researchers. Of these, 13 reported ADHD treatment preference data from a study using DCE, BWS, or SGI methods. No TTO studies were identified that met inclusion criteria.

Results

Methods and designs varied considerably across studies. Relatively few studies focused on preferences among children, adolescents, and adults compared with those that focused on the preferences of parents of children with ADHD. The majority of studies focused primarily on medication treatments, with many fewer focused on psychosocial treatments. Some studies indicated that parents of children with ADHD prefer to avoid stimulant medications in favor of behavioral or psychosocial interventions. Others report that parents see medication as a preferred treatment. Treatment outcome is a particularly salient attribute for treatment decisions for many informants.

Conclusions

Potential outcomes of various treatments play a proximal role in patients' and families' decisions for ADHD treatment. Because the majority of studies focus on medication treatments for children with ADHD, more research is necessary to understand preferences related to behavioral and other psychosocial treatments both as stand-alone interventions and used in combination with medication. Additional research is also needed to assess the treatment preferences of adults with ADHD. In general, DCE, BWS, and SGI methods allow measurement of patient preferences in a manner that approximates the uncertainty and trade-offs inherent in real-world treatment decision making and provides valuable information to inform patient-centered and family-centered treatment.

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Erratum to: Capturing Patient-Reported Outcome (PRO) Data Electronically: The Past, Present, and Promise of ePRO Measurement in Clinical Trials

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Assessing the Impact of Caring for a Person with Schizophrenia: Development of the Schizophrenia Caregiver Questionnaire

Abstract

Background

The responsibilities of caring for a person with schizophrenia may significantly impact informal caregivers' lives. The Zarit Burden Interview (ZBI) was originally developed to assess burden among caregivers of people with Alzheimer's disease.

Objective

This research was conducted to inform the development of a revised version of the ZBI, relevant to caregivers of people with schizophrenia.

Methods

Based on published qualitative research, the questionnaire was reviewed and modified in accordance with industry-standard guidelines. The resulting questionnaire [the Schizophrenia Caregiver Questionnaire (SCQ)] was then completed by 19 caregivers during cognitive debriefing interviews to assess understanding, relevance and comprehensiveness.

Results

Review of the ZBI resulted in a number of operational changes to improve face validity and potential sensitivity. Further questions were added based on key concepts identified in existing literature and minor phrasing alterations were made to improve content validity. Findings from caregiver interviews supported the content validity of the SCQ.

Conclusion

The SCQ provides a comprehensive view of caregivers' subjective experiences of caregiving and demonstrated strong face and content validity. The questionnaire will be important in both clinical assessment and evaluating the efficacy of interventions designed to reduce or alleviate caregiver burden. Future research will seek to establish the psychometric validity of the questionnaire.

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Is Shared Decision Making a Utopian Dream or an Achievable Goal?

Abstract

The idea of shared decision making (SDM) between patient and physician grew out of a generalized challenge to traditional social hierarchies that occurred in the middle of the last century. Governments have espoused SDM, thousands of articles about it have been published, and evidence has shown that it improves some of the healthcare processes as well as patient outcomes. Yet it has not been widely adopted. From their cross-disciplinary perspective (practical theology and clinical medicine), the authors locate this reluctance in the unfolding of scientific paradigm shifts, summarize the perceived risks and benefits of SDM and the evidence for each, and suggest practical, achievable approaches for clinicians. Finally, they explore some important emerging territories for SDM.

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The Predictive Value of Discrete Choice Experiments in Public Health: An Exploratory Application

Abstract

Objective

The objective of this study was to assess the predictive value of a discrete choice experiment (DCE) in public health by comparing stated preferences to actual behavior.

Methods

780 Type 2 diabetes mellitus (T2DM) patients received a questionnaire, containing a DCE with five attributes related to T2DM patients' willingness to participate in a combined lifestyle intervention. Panel mixed-multinomial-logit models were used to estimate the stated preferences based on 206 completed DCE questionnaires. Actual participation status was retrieved for 54 respondents based on patients' medical records and a second questionnaire. Predicted and actual behavior data were compared at population level and at individual level.

Results

Based on the estimated utility function, 81.8 % of all answers that individual respondents provided on the choice tasks were predicted correctly. The actual participation rate at the aggregated population level was minimally underestimated (70.1 vs. 75.9 %). Of all individual choices, 74.1 % were predicted correctly with a positive predictive value of 0.80 and a negative predictive value of 0.44.

Conclusion

Stated preferences derived from a DCE can adequately predict actual behavior in a public health setting.

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Balance Sheets Versus Decision Dashboards to Support Patient Treatment Choices: A Comparative Analysis

Abstract

Background

Growing recognition of the importance of involving patients in preference-driven healthcare decisions has highlighted the need to develop practical strategies to implement patient-centered shared decision-making. The use of tabular balance sheets to support clinical decision-making is well established. More recent evidence suggests that graphic, interactive decision dashboards can help people derive deeper a understanding of information within a specific decision context. We therefore conducted a non-randomized trial comparing the effects of adding an interactive dashboard to a static tabular balance sheet on patient decision-making.

Methods

The study population consisted of members of the ResearchMatch registry who volunteered to participate in a study of medical decision-making. Two separate surveys were conducted: one in the control group and one in the intervention group. All participants were instructed to imagine they were newly diagnosed with a chronic illness and were asked to choose between three hypothetical drug treatments, which varied with regard to effectiveness, side effects, and out-of-pocket cost. Both groups made an initial treatment choice after reviewing a balance sheet. After a brief "washout" period, members of the control group made a second treatment choice after reviewing the balance sheet again, while intervention group members made a second treatment choice after reviewing an interactive decision dashboard containing the same information. After both choices, participants rated their degree of confidence in their choice on a 1 to 10 scale.

Results

Members of the dashboard intervention group were more likely to change their choice of preferred drug (10.2 versus 7.5 %; p = 0.054) and had a larger increase in decision confidence than the control group (0.67 versus 0.075; p < 0.03). There were no statistically significant between-group differences in decisional conflict or decision aid acceptability.

Conclusion

These findings suggest that clinical decision dashboards may be an effective point-of-care decision-support tool. Further research to explore this possibility is warranted.

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Corrigendum to “Diagonal gaits in the feathertail glider Acrobates pygmaeus (Acrobatidae, Diprotodontia): Insights for the evolution of primate quadrupedalism” [J Hum Evol 86 (2015) 43–54]

Publication date: Available online 28 November 2015
Source:Journal of Human Evolution
Author(s): Nikolaos-Evangelos Karantanis, Dionisios Youlatos, Leszek Rychlik




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Environmental reconstruction and biostratigraphy of late Middle Pleistocene lakeshore deposits at Schöningen

Publication date: Available online 27 November 2015
Source:Journal of Human Evolution
Author(s): Brigitte Urban, Gerlinde Bigga
The Pleistocene sequence of Schöningen provides a key link between unglaciated and glaciated areas in western Central Europe and is an important point of reference for the subdivision of the glaciated late Middle Pleistocene. This locality yields palaeoecological and geological evidence of at least four interglacial periods prior to the Holocene and younger than the Elsterian glaciation. The Pleistocene deposits at Schöningen are valuable archives of climate, landscape, and human evolution, containing outstanding information on past environmental changes and human adaptation. This paper presents paleoenvironmental and biostratigraphical results from the Middle Pleistocene archeological lakeshore site of Schöningen, focusing on the so-called reference profile Schöningen 13 II of 2003. We discuss the lithological, palynological, and macrobotanical evidence and present a revised subdivision and reinterpretation of late phases of the Reinsdorf Interglacial.



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The Spear Horizon: First spatial analysis of the Schöningen site 13 II-4

Publication date: Available online 25 November 2015
Source:Journal of Human Evolution
Author(s): Utz Böhner, Jordi Serangeli, Pascale Richter
The Spear Horizon (Schöningen 13 II-4) from Schöningen, Lower Saxony, Germany, is one of the most important archeological sites dating to the Middle Pleistocene. Until today, the numerous finds have only been published individually, often outside of their context. Here we present for the first time the distribution map of the Spear Horizon together with a spatial analysis of the different categories of remains (flint, bones, and woods).The finds are situated in a 10 m wide belt, which runs parallel to a former lakeshore. The distribution of faunal remains correlates closely with the distribution of flint artifacts and wooden objects. We have been able to distinguish five different sectors that can be aligned with different events or activities. The greatest density of finds was evident within an area of 11 × 15 m, where most of the horse skulls were recovered. Some of the square meters contain more than 150 finds.During the excavation the profiles were continually documented and these data help us to reconstruct the shoreline of the paleo-lake with considerable accuracy. Over a distance of 60 m, the thickness and density of the organic mud and peat layers could be reconstructed in high resolution.The distribution of finds shows no preferred orientation or selection through size. The analyses only indicate small-scale dislocations and limited taphonomic alterations. The fraction of lithic artifacts with size ranges less than 2 cm are preserved, while some smaller bone fragments are missing.Most of the wooden artifacts are in-situ, but were deformed by the ice load during the Saalian ice age. While some small charcoal remains as well as a burnt artifact have been observed, there is no evidence of burnt bones.Our results allow a first insight into the formation history of the site.



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Bone taphonomy of the Schöningen “Spear Horizon South” and its implications for site formation and hominin meat provisioning

Publication date: Available online 25 November 2015
Source:Journal of Human Evolution
Author(s): Britt M. Starkovich, Nicholas J. Conard
This paper presents the faunal remains from the new excavation area at the Lower Paleolithic site of Schöningen. The focus of the study is on the southern extension of the main find horizon (Spear Horizon South), which includes the layer that yielded the famous Schöningen spears (13 II-4). Taxonomic data corroborate previous studies, that hominins primarily hunted Equus mosbachensis, a large Pleistocene horse. Equid body part representation at the site suggests that the animals were hunted and butchered locally. There is no evidence for density-mediated attrition in the assemblage. Weathering damage is uncommon, though there is ample evidence that carnivores had access to the bone. Carnivore bite sizes were measured and compared to experimental data provided by previous authors. Based on relationships between bite size and carnivore behavior and body size, we conclude that the primary modifying agents were large carnivores (i.e., wolves or saber-toothed cats). Previous studies show that carnivores often had secondary access to the remains, after hominins. Cut marks are commonly arranged haphazardly on the bones. This may indicate that multiple hominins participated in the butchery of horse skeletons, or that they were butchered over the course of hours or days. Cut marks on axial elements are more "orderly," which probably reflects the physical logistics of orienting one's body in relation to a large carcass. These data differ from sites formed by Middle and Upper Paleolithic hominins, which might suggest that in later times, a system of organized meat provisioning was already in place. Taken together, the faunal evidence from the Spear Horizon South indicates that late Lower Paleolithic hominins using the site understood the behaviors of different prey species, hunted socially to take down large game, and successfully competed with large carnivores on the landscape for primary access to ungulate remains.



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Delay in Presentation, Diagnosis and Treatment for Colorectal Cancer Patients in Jordan

Abstract

Purpose

Colorectal cancer (CRC) ranked first among cancers reported in males and second among cancers reported in females in Jordan in 2010. There has been no specific CRC-control programme in Jordan. Additionally, there has been no published study from Jordan or its neighbours on patient delays in presentation, diagnosis or treatment. Therefore, we conducted this study to assess these important quality indicators aiming to improve prognosis for CRC and to provide baseline data for future health promotion programmes for CRC in Jordan.

Methods

This project was a cross-sectional study on CRC patients at Al Bashir Hospital, Ministry of Health, and at the Military Oncology Centre of the Jordanian Royal Medical Services.

Results

The total number of participants was 189. The proportion of patients with presentation delay, diagnosis delay or treatment delay was 33.9, 68.1 and 32.6 %, respectively. The main reasons reported for delay in presentation were lack of knowledge that symptoms were suggestive of cancer (58.5 %), misdiagnosis by physicians or pharmacists (38.4 %) or the patient did not want to visit a doctor (3.1 %). Predictors of delay and mean time for presentation, diagnosis and treatment were identified.

Conclusions

Our results revealed that CRC patients in Jordan experience delays in presentation, Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation diagnosis, and, to a lesser degree, in treatment. This could justify the advanced stages at diagnosis and poor outcomes for CRC patients. Our findings provide baseline information for future CRC-control programmes in Jordan. We recommend that CRC prevention programmes in Jordan focus on early detection of CRC and target both patients and physicians.

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Paramedian pons infarction with wall-eye monocular internuclear ophthalmoplegia syndrome

Publication date: Available online 28 November 2015
Source:The Kaohsiung Journal of Medical Sciences
Author(s): You-Chia Chen, Lung Chan, Shiau-Shan Cho, Wei-Ting Chiou, Tzu-shiang Ko, Chaur-Jong Hu




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Cerebellar cognitive affective syndrome: Attention deficit–hyperactivity disorder episode of adolescent with cerebellar atrophy in a psychiatric ward

Publication date: Available online 28 November 2015
Source:The Kaohsiung Journal of Medical Sciences
Author(s): Chi Chang, Shun-Wun Siao




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Malakoplakie de la glande sous-mandibulaire chez un patient transplanté rénal

Publication date: Available online 28 November 2015
Source:Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
Author(s): E. Schwob, J.-D. Bouaziz, A. Saussine, M. Bagot, A. Dionyssopoulos, A. Rigolet
IntroductionLa malakoplakie (MP) est une granulomatose inflammatoire rare, survenant chez des patients immunodéprimés, en réponse à une infection à Escherichia coli. Les lésions sont le plus souvent localisées au tractus génito-urinaire, mais il existe une grande variabilité de la topographie et de l'aspect lésionnel.ObservationUn homme de 70ans, transplanté rénal et diabétique sous traitement immunosuppresseur présentait une volumineuse lésion sous-angulo-mandibulaire gauche d'évolution chronique, avec atteinte cutanée en regard, associée à une lésion bourgeonnante de la muqueuse buccale. L'examen anatomopathologique des biopsies concluait à une MP. Les prélèvements bactériologiques étaient positifs à E. coli. L'antibiothérapie a permis une nette régression de la lésion qui a pu être suivie de son exérèse chirurgicale. L'examen histologique de la pièce opératoire confirmait le diagnostic de MP ayant envahi la glande sub-mandibulaire.DiscussionLe diagnostic de MP est anatomopathologique. Il repose sur la présence des cellules de von Hansemann et de corps de Michaelis-Gutmann. Le traitement de la MP repose sur une antibiothérapie active ciblée contre les germes intracellulaires, éventuellement associée à une prise en charge chirurgicale. Nous présentons ici le premier cas décrit d'atteinte de la glande sub-mandibulaire.IntroductionMalakoplakia (MP) is a rare granulomatous disease, usually occurring in immunocompromised patients, linked to Escherichia coli infection. The lesions are usually located in the genitourinary tract, but there is a great variability in the topography and the clinical presentation.Case reportA 70-year-old diabetic kidney transplant patient under immunosuppressive treatment presented with a voluminous submandibular chronic lesion, involving the skin, associated with a burgeoning lesion of the oral mucosa. Histological examination of biopsies concluded to MP and bacteriological samples were positive for E. coli. Antibiotic treatment allowed for the regression of the lesion before surgical removal. Histological examination of resected material confirmed the diagnosis of invasive MP of the submandibular gland.DiscussionThe diagnosis of MP relies on histological examination, showing the presence of von Hansemann's cells and Michaelis- Gutmann bodies. The treatment is based on active antibiotics targeted against intracellular bacteria, possibly associated with surgery. We report the first case of MP involving the submandibular gland.



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iTRAQ protein profile analysis provides integrated insight into mechanisms of tolerance to TMV in tobacco (Nicotiana tabacum)

Publication date: 30 January 2016
Source:Journal of Proteomics, Volume 132
Author(s): Jing Wang, Xiao-ran Wang, Qi Zhou, Jin-miao Yang, Hong-xiang Guo, Li-jun Yang, Wei-qun Liu
To further investigate the mechanism of the plant tolerance to tobacco mosaic virus (TMV) infection, tobacco NC89 (N) hypersensitive to TMV and its natural mutant Yuyan8 (Y) with tolerance to TMV were employed for differential accumulation proteome analysis. There were 260 specifically accumulated proteins in Yuyan8 after 24h inoculation (Yd), and the accumulations of 285 proteins inherent in Y have changed after TMV infection. Equally, there were 183 specifically accumulated proteins in NC89 after 24h inoculation (Nd), and 132 proteins inherent in N have changed after TMV infection. These differential proteins were respectively enriched in two pathways, of which photosynthesis pathway was the common pathway in two varieties. In photoreaction system, the accumulations of differential proteins, especially D1 protein, were not decreased in Yd compared to Nd. The results indicated that maintaining the stability of D1 protein and reasonable utilization of the energy was the essential for tolerance to TMV infection. It was also revealed that 14-3-3 protein and PR4 was specific expressed, and the expression of LRR was enhanced in Yd, suggesting that regulation of defense protein mediated by 14-3-3 protein quickly activated resistance system and enhanced the plant tolerance to TMV infection.SignificanceThis is the first work that the molecular basis of tobacco tolerance was discussed basic on proteomic investigation performed on wild type and its natural mutant. Our results lay the foundation for development of molecular breeding and further proteome research in tobacco.

Graphical abstract

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Unexpected Tumor: Primary Asymptomatic Schwannoma in Thyroid Gland

Abstract

The discovery of a tumor as a primary schwannoma in the thyroid gland is rare (Andrion et al. in Virchows Arch 413:367–372, 1988). It represents less than 1 % of mesenchymal neoplasms of this gland. Therefore, few cases of this type are described in medical literature (Aron et al. in Cytopathology 16:206–209, 2005; Cashman et al. in Medscape J Med 10(8):201, 2008; Coleman et al. in AJR Am J Roentgenol 140:383–7, 1983). In this article, we introduce the clinical case of a 27-year-old female patient, who presented a nodular mass located in the neck region. This mass was not associated with other symptoms and during the imagistic investigation it appeared to be a thyroglossal duct cyst. A fine needle aspiration biopsy was performed which revealed benign mesenchymal cells. After a pathology study of the piece resected through a thyroidectomy, it was confirmed that the tumor had neural characteristics, the final diagnosis being a primary schwannoma. The importance of a cytology study is emphasized, since in this case, it made it possible to accurately diagnose a mesenchymal tumor, despite their low frequency. It constitutes a highly useful tool for diagnosing non-epithelial neoplasia of the thyroid gland.

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A double-blind randomized controlled trial to assess the efficacy of daylight photodynamic therapy with methyl-aminolevulinate vs. Placebo and daylight in patients with facial photodamage

Publication date: Available online 28 November 2015
Source:Actas Dermo-Sifiliográficas
Author(s): G. Sanclemente, G.A. Mancilla, G. Hernandez
BackgroundDaylight PDT (dPDT) is easy to use and does not require light equipment. Such therapy has been exhaustively proved to be successful in the treatment of actinic keratosis, but its use in skin photodamage remains unclear.ObjectiveTo evaluate dPDT's efficacy in skin facial photodamage.Patients and methodsThis was a parallel-group double-blind, randomized placebo-controlled trial. Sixty participants with symmetric facial photodamage were allocated to topical methyl aminolevulinate (MAL) and daylight vs. matching placebo and daylight. Primary outcome was global photodamage improvement/failure 1 month after the third session. Secondary outcomes included: pain evaluation; specific photodamage severity scores; sun irradiance quantification and Skindex-29 scores. Adverse events were also investigated.ResultsPrimary analysis included all randomized patients. All patients sun-exposed for 120min in 3 sessions. The risk of failure was lower in the MAL-dPDT group than in the placebo plus daylight group (RR: 0.18; 95% CI: 0.08–0.41). Mean solar irradiance (W/m²) during the first, second and third sessions was 480.82, 430.07 and 435.84, respectively. Items 5 and 14 of Skindex-29 in the MAL-dPDT group showed statistical significant differences. Two patients in the MAL-dPDT group had serious and non-serious events not directly related to the product.ConclusiondPDT with MAL was un-painful, effective and safe for the treatment of facial photodamage. Herpes simplex prophylaxis should be considered before sessions.



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Association between interleukin 8 −251 A/T and +781 C/T polymorphisms and osteosarcoma risk in Chinese population: a case–control study

Abstract

Interleukin-8 (IL-8) is an angiogenic chemokine that plays a potent role in both development and progression of many human malignancies. However, there are no data about the role of IL-8 polymorphism in development of osteosarcoma. A hospital-based case–control study was conducted among 190 patients with osteosarcoma and 190 healthy controls to investigate the possible association between the IL-8 −251 A/T and +781 C/T polymorphisms, respectively, and the risk of osteosarcoma. Significant differences of genotype distribution were observed between osteosarcoma cases and controls at the IL-8 −251T/A genotypes. Compared with the IL-8 −251T/A homozygote TT, the heterozygous TA genotype was associated with significantly increased risk for osteosarcoma (odds ratio (OR) = 2.16, 95 % confidence interval (CI) = (1.38–4.52), P = 0.021); the AA genotype was associated with increased risk for osteosarcoma (OR = 1.94, 95 % CI = 1.31–3.83, P = 0.018). TA and AA combined variants were associated with increased risk for osteosarcoma compared with the TT genotype (OR = 1.72, 95 % CI = 1.45–4.41, P = 0.023). Moreover, the genotype AA of IL-8 −251T/A carried a higher risk of osteosarcoma metastasis and later Enneking stages, compared with the TT genotype. However, the genotype and allele frequencies of IL-8 +781 C/T polymorphisms in osteosarcoma patients were not significantly different from controls. Our results showed that the IL-8 −251 A/T genotype was associated with increased risk for development and metastasis of osteosarcoma in Chinese Han population.

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Editorial Board

Publication date: 10 January 2016
Source:Journal of Proteomics, Volume 131





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Nucleolin overexpression is associated with an unfavorable outcome for ependymoma: a multifactorial analysis of 176 patients

Abstract

Ependymoma typically has a better overall survival rate than most gliomas. Only a few comprehensive clinical studies have been published, but these are mostly from Western countries and use small sample sizes. Histopathological classification is not sufficient to show variable outcomes, and fails to show prognostic markers of the diverse outcomes; hence, it is essential to understand biological mechanisms. In this study, 176 ependymoma samples (World Health Organization grade II and III) were reviewed at Huashan Hospital. Both children and adults were included. We performed multifactorial analyses of clinical prognostic factors and the biomolecular marker expressions of nucleolin, epidermal growth factor receptor (EGFR) and caveolae-associated protein caveolin-1 by immunohistochemistry. We identified the probabilities of progression-free survival and overall survival using univariate and multivariate statistical methods. The participants were diagnosed with ependymomas between 2002 and 2010, including distributions of tumor locations in intracranial and extracranial regions. Nucleolin was overexpressed in 67 % of our samples, demonstrating a subgroup with poor outcome; particularly infratentorial and anaplastic ependymomas. There was no significant correlation between the expression of EGFR and caveolin-1 and clinical outcomes. Clinically, inferior prognosis was observed with regard to age (<18 years), intracranial location, high grade ependymomas, and incomplete resection. We found that nucleolin was an unfavorable prognostic predictor for ependymomas. Moreover, our findings show a subset of aggravating outcomes in high-grade and posterior fossa tumors.

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TGF-β1 induces erlotinib resistance in non-small cell lung cancer by down-regulating PTEN

Publication date: February 2016
Source:Biomedicine & Pharmacotherapy, Volume 77
Author(s): Hua Shen, Dan Guan, Jianxin Shen, Min Wang, Xiaofeng Chen, Tongpeng Xu, Lianke Liu, Yongqian Shu
BackgroundTKI-acquired resistance is a tough obstacle for effectively treating NSCLC patients with EGFR mutant characteristics. T790M mutations and MET amplifications account for 70% of the acquired resistance, but the causes for the remaining 30% need elucidation.MethodsWe detected TGF-β1and PTEN expression levels in 51 NSCLC patients undergoing EGFR-TKI treatment using Immunohistochemistry (IHC) assay. We examined erlotinib sensitivity, apoptosis rate, and invasion ability in PC-9 cells and PC-9/TGF-β1 cells with CCK-8, flow cytometry, and trans-well assays. We examined and analyzed the AKT and ERK pathways' expression levels using western blot.ResultsHigh TGF-β1 and low PTEN expression levels were correlated with poor EGFR-TKI sensitivity and overall survival in 51 NSCLC samples. In vitro analysis revealed that TGF-β1 could reduce erlotinib sensitivity, increase anti-apoptosis ability and invasive characteristic in TKI-sensitive PC-9 cell lines by down-regulating PTEN and activating the Akt and ERK pathways.ConclusionsThe results suggest that TGF-β1 demonstrated another acquired erlotinib resistance by down-regulating PTEN expression.



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Progression-free and overall survival in patients with recurrent Glioblastoma multiforme treated with last-line bevacizumab versus bevacizumab/lomustine

Abstract

Bevacizumab (BEV) is widely used for treatment of patients with recurrent glioblastoma multiforme (GBM). 1-(2-Chlorethyl)-cyclohexyl-nitrosourea (CCNU, lomustine) monotherapy is an approved chemotherapeutical option for recurrent GBM. Recent evidence demonstrated a survival benefit of combined treatment with BEV and CCNU in patients with a first recurrence of GBM. We examined the outcome of recurrent GBM patients with BEV monotherapy versus BEV/CCNU therapy when used as last-line therapy. 35 patients with recurrent GBM treated between 2010 and 2014 were included in this retrospective study. Progression-free and overall survival was determined with reference to the beginning of BEV or BEV/CCNU therapy and initial diagnosis. 17 patients received BEV monotherapy, 18 patients received combined BEV and CCNU therapy. The impact of parameters such as IDH mutation, MGMT promoter methylation, tumor localization, histology and the number of surgeries were included in a multivariate ANOVA analysis. Furthermore, Karnofsky performance score (KPS), neurological function and toxicity were assessed. BEV/CCNU treatment led to an extension of PFS (6.11 months; 95 % CL 3.41–12.98 months; log-rank p = 0.00241) and OS (6.59 months; 95 % CL 5.51–16.3 months; log-rank p = 0.0238) of 2 months compared to BEV monotherapy. This survival advantage was independent of histology, IDH mutation status or the number of previous surgeries. Neurological function, KPS and toxicity were not significantly different between both treatment groups. Last-line therapy with BEV/CCNU results in a longer PFS and OS compared to BEV monotherapy and is well-tolerated. These findings confirm the role of these agents in the treatment of recurrent GBM and are in line with other studies.

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