BACKGROUND: Surgical defects in anatomically challenging locations, such as near free margins or crossing cosmetic subunits, may present reconstructive challenges to the dermatologic surgeon. For selected defects, Burow's grafts may produce functional and aesthetic results in a single operative session. OBJECTIVE: To describe the applications of the Burow's graft technique for the repair of defects after Mohs micrographic surgery. METHODS: An institutional review board-approved retrospective database review of surgical defects repaired with Burow's grafting after Mohs micrographic surgery at the Medical University of South Carolina was performed. The general technique of Burow's grafting is described, emphasizing proper graft sizing and direction of tension vectors. Varying anatomic locations and defect types are presented, with site-specific considerations and operative photographs. RESULTS: Burow's grafting provides ideal color and textural match, preserves subunit boundaries, results in a compact single-site wound, and may avoid complications of alternate repair choices. The tension vectors produced in closing the graft's harvest site may be designed to prevent distortion of free margins. Burow's grafting may be combined with hinge flaps to repair deep or avascular defects. CONCLUSION: Burow's grafts are reproducible, aesthetic, and useful reconstructive choices for a variety of surgical wounds. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2iXb3si
Πέμπτη 5 Ιανουαρίου 2017
Squamous Cell Carcinoma In Situ Upstaged to Invasive Squamous Cell Carcinoma: A 5-Year, Single Institution Retrospective Review.
BACKGROUND: Shave biopsy may not be able to accurately distinguish squamous cell carcinoma in situ (SCCIS) from invasive squamous cell carcinoma (SCC). Information on the incidence of biopsy-proven SCCIS upstaged to SCC after a more complete histologic examination is limited. OBJECTIVE: To determine the incidence and clinical risk factors associated with upstaging the biopsy diagnosis of SCCIS into invasive SCC based on findings during Mohs micrographic surgery (MMS). METHODS: All MMS cases of SCCIS performed between March 2007 and February 2012 were identified, MMS operative notes were examined, and invasive dermal components were confirmed by the MMS slide review. Upstaged SCCIS was defined as biopsy-diagnosed SCCIS subsequently found to be an invasive SCC during MMS. RESULTS: From 566 cases with the preoperative diagnosis of SCCIS, 92 (16.3%) cases were SCCIS upstaged to SCC. Location of ears, nose, lips, and eyelids, preoperative diameter >10 mm, and biopsy report mentioning a transected base were significant predictors of upstaged SCCIS. CONCLUSION: Considering the possibility that over 16% of SCCIS may be truly invasive SCC, biopsy-proven SCCIS should be treated adequately with margin-assessed treatment modalities such as surgical excision or Mohs surgery when indicated. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2hZ49o0
http://ift.tt/2hZ49o0
Broader Practice Indications for Mohs Surgical Defect Healing by Secondary Intention: A Survey Study.
BACKGROUND: Recent reports have indicated secondary intention (SI) healing utilization for Mohs surgical defects beyond conventionally accepted indications. OBJECTIVE: To characterize potentially more expansive guidelines for when SI healing is indicated or appropriate in dermatologic surgery. METHODS: A survey study was e-mailed to the American College of Mohs Surgery in 2015. A group of 293 respondents addressed factors influencing decisions to heal surgical defects secondarily. RESULTS: The most experienced surgeons were significantly more likely to heal deep and larger wounds secondarily. Many surgeons elect SI healing in patients with current or previous wound dehiscence, flap necrosis, or infection; in patients who have undergone skin cancer excisions before, or who are elderly, and; if the lesion was sent for permanent section, or when treating high-risk, large, recurrent, or aggressive tumors. CONCLUSION: Broader indications for SI healing of Mohs surgical defects may be appropriate than previously understood. In addition to concave, temporal, periocular, perinasal, and periauricular sites, SI healing may be appropriate for convex sites such as the scalp and anterior lower extremity, deep wounds, and large wounds, as well as wounds with dehiscence, flap necrosis, or infection. Certain patient-specific and lesional factors are also appropriate indications for SI healing. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2hZd4FX
http://ift.tt/2hZd4FX
Targeting Epidermal Growth Factor Receptor in Triple Negative Breast Cancer: New Discoveries and Practical Insights for Drug Development
Source:Cancer Treatment Reviews
Author(s): Ricardo Costa, Ami N. Shah, Cesar A. Santa-Maria, Marcelo R. Cruz, Devalingam Mahalingam, Benedito A. Carneiro, Young Kwang Chae, Massimo Cristofanilli, William J. Gradishar, Francis J. Giles
Triple negative breast cancer (TNBC) accounts for 10-20% of cases in breast cancer. Despite recent advances in the treatment of hormonal receptor + and HER2 + breast cancers, there are no targeted therapies available for TNBC. Evidence supports that most patients with TNBC express the transmembrane Epithelial Growth Factor Receptor (EGFR). However, early phase clinical trials failed to demonstrate significant activity of EGFR-targeted monoclonal antibodies and/or tyrosine kinase inhibitors. Here, we review the recent discoveries related to the underlying biology of the EGFR pathway in TNBC, clinical progress to date and suggest rational future approaches for investigational therapies in TNBC.
http://ift.tt/2iKKkQj
Conservative surgery for laryngeal chondrosarcoma: a review of the most recently proposed approaches.
Purpose of review: The aim of this study was to describe the most recent technical nuances for resection and reconstruction of Grade 1 and 2 laryngeal chondrosarcomas, with a special emphasis on those located at the level of the cricoid plate, which is the site of origin of the vast majority of these rare tumours. Recent findings: Even though inherently based on retrospective small clinical series or anecdotal case reports, a number of studies have been recently published focusing on conservative transoral and open-neck surgical procedures aimed at an oncologically sound removal of the tumour together with organ and function preservation. The open-neck conservative approaches herein reported can be roughly distinguished in those achieving a primary airway reconstruction by a tracheo-hyoido-epiglottopexy or an end-to-end crico-tracheal, thyro-crico-tracheal or thyro-tracheal anastomosis, and those requiring a single or double-staged transposition of different microvascular flaps, with or without cartilaginous graft insertion, to reconstruct a subtotal/total cricoidectomy and obtain a rigid and stable subglottic airway. Summary: No meaningful comparison in terms of oncologic and functional outcomes is still possible among the currently available conservative surgical strategies, due to the rarity of laryngeal chondrosarcomas and the heterogeneity of treatments proposed in the literature. However, a reasonable algorithm to approach this difficult clinical entity according to its site of origin and extent of cricoid circumference involved is herein presented. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2iP0lqH
http://ift.tt/2iP0lqH
Airway Management With a Stereotactic Headframe In Situ-A Mannequin Study.
Background: Stereotactic headframe-based imaging is often needed for target localization during surgery for insertion of deep brain stimulators. A major concern during this surgery is the need for emergency airway management while an awake or sedated patient is in the stereotactic headframe. The aim of our study was to determine the ease of emergency airway management with a stereotactic headframe in situ. Materials and Methods: We conducted an observational study using a mannequin. A Leksell stereotactic headframe was placed on a mannequin in the operating room and the frame was fixed to the operating room table. Anesthesia personnel were asked to insert a #4 laryngeal mask and then to intubate the mannequin, using both direct (DL) and video laryngoscopy (VL). In addition, participants were asked to perform the same airway techniques in the mannequin without the headframe. Data were analyzed for time taken for airway management using different devices with and without the headframe. In addition, we compared the time taken to secure the airway between different participant groups. Results: Thirty anesthesia personnel (7 residents, 12 fellows, and 11 consultants) participated in the study. With the headframe in situ, 97% of participants were able to insert a laryngeal mask on their first attempt; 93% and 97% of participants were able to intubate the mannequin using DL and VL respectively on their first attempt. Without the stereotactic headframe, all participants were able to insert the laryngeal mask and intubate on the first attempt. The average time taken to insert a laryngeal mask and intubate the mannequin using DL and VL with the headframe in situ was 39.3, 58.6, and 54.8 seconds, respectively. Conclusions: Our study showed that both laryngeal mask insertion and tracheal intubation can be performed with a stereotactic headframe in situ. A laryngeal mask is the quickest airway device to insert and can be inserted while the mannequin is in the standard surgical position. Further study is needed to validate the results in patients. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved
http://ift.tt/2jhLmX3
http://ift.tt/2jhLmX3
Hemodynamic monitoring in thoracic surgical patients.
http://ift.tt/2iik3rj
Efferent Vision Therapy.
Background: Traditional orthoptic therapy used by ophthalmologists, orthoptists, and optometrists is directed at improving visual acuity, ocular alignment, or both. For example, convergence exercises are used to treat convergence insufficiency (CI). However, other forms of "vision therapy" are directed at improving "visual processing and efficiency." The therapeutic regimen often entails repetitive ocular motor tasks performed during multiple office visits with a behavioral optometrist. These ocular motor tasks are used to treat diverse conditions such as learning disabilities, poor reading ability, dyslexia, and attention-deficit hyperactivity disorder (ADHD). Evidence regarding the efficacy of therapy directed at ocular motility for the treatment of multiple conditions is reviewed. Evidence Acquisition: Review of literature. Results: Randomized, controlled, double-masked studies show that convergence exercises reduce symptoms and improve signs of CI in otherwise healthy patients. However, the most efficacious convergence tasks, and the optimal duration and frequency of these tasks, remain unknown. Patients with learning disabilities, poor reading ability, dyslexia, or ADHD do not consistently have unique ocular motor deficits. Patients who acquire ocular motor deficits do not develop these conditions. There are no randomized, controlled studies that show treatment consisting of repetitive ocular motor tasks improves learning disabilities, reading, dyslexia, or ADHD. Conclusions: Convergence exercises effectively treat CI in healthy patients. The optimal treatment regimen is unknown. There is insufficient evidence to recommend "vision therapy" for the treatment of learning disabilities, impaired reading, dyslexia, or ADHD. (C) 2017 by North American Neuro-Ophthalmology Society
http://ift.tt/2hWKmam
http://ift.tt/2hWKmam
A Giant Tumefactive Virshow-Robin Space: A Rare Cause of a Homonymous Quadrantanopia.
A 53-year-old woman was found to have a left inferior homonymous quadrantanopia. Brain MRI disclosed a giant Virchow-Robin space compressing the right optic tract. After fenestration of this cystic lesion, most of the visual field loss resolved. Giant Virchow-Robin spaces may cause homonymous field defects which, with appropriate management, may improve. (C) 2017 by North American Neuro-Ophthalmology Society
http://ift.tt/2iKMTl6
http://ift.tt/2iKMTl6
Colon Metastasis to Residual Pituitary Macroadenoma causing Accelerated Growth: Case Report and Review of the Literature
Publication date: Available online 5 January 2017
Source:Interdisciplinary Neurosurgery
Author(s): Janissardhar Skulsampaopol, Wipawi Klaisuban, Ake Hansasuta
BackgroundMetastasis to post-surgical pituitary adenoma (PA) is extremely rare.Case DescriptionA 53-year-old man previously underwent endoscopic transsphenoidal surgery (TSS) for resection of PA and had stable annual post-operative magnetic resonance imaging for several years. Later, he had abdominal surgery for newly discovered malignant colon neoplasm. In addition, evidence of multiple lung metastases was subsequently discovered prompting chemotherapy. The patient, before his second TSS, presented with symptomatic visual field defect from rapidly enlarging residual PA causing mass effect to optic apparatus. Subsequently, second operation was performed with unremarkable intraoperative findings and postoperative course. However, histopathology revealed metastatic adenocarcinoma inside the PA.ConclusionsThis is the first reported case of metastasis from colon cancer to post-TSS PA.
http://ift.tt/2hX9Boc
Audiometric findings with voluntary tensor tympani contraction
Tensor tympani contraction may have a "signature" audiogram. This study demonstrates audiometric findings during voluntary tensor tympani contraction.
http://ift.tt/2hYSiWY
Microcystic adnexal carcinoma (MAC)-like squamous cell carcinoma as a differential diagnosis to Bell´s palsy: review of guidelines for refractory facial nerve palsy
Bell´s palsy is the most common cause of facial paralysis worldwide and the most common disorder of the cranial nerves. It is a diagnosis of exclusion, accounting for 60–75% of all acquired peripheral facial n...
http://ift.tt/2iWTngH
Audiometric findings with voluntary tensor tympani contraction
Tensor tympani contraction may have a "signature" audiogram. This study demonstrates audiometric findings during voluntary tensor tympani contraction.
http://ift.tt/2hYSiWY
Microcystic adnexal carcinoma (MAC)-like squamous cell carcinoma as a differential diagnosis to Bell´s palsy: review of guidelines for refractory facial nerve palsy
Bell´s palsy is the most common cause of facial paralysis worldwide and the most common disorder of the cranial nerves. It is a diagnosis of exclusion, accounting for 60–75% of all acquired peripheral facial n...
http://ift.tt/2iWTngH
Acral and digital angioleiomyomata: Fourteen year experience at the Cleveland Clinic and review of the literature
ABSTRACT
Background
Angioleiomyoma is a benign neoplasm thought to derive from the tunica media of small venous vessels. Angioleiomyomata most frequently occur in the lower extremities with less common occurrences on the trunk, head, and upper extremities. Few cases of acral and digital angioleiomyoma have been described in the literature.
Methods
We add a series of twenty-one patients with acral angioleiomyoma including six cases of digital angioleiomyoma to the body of clinical and histologic findings along with a review of the literature of digital angioleiomyomata.
Results
Digital angioleiomyoma are equally distributed between male and female patients and are more often painful than the angioleiomyoma of all body sites. Acral angioleiomyomata favor the feet over hands at a ratio of 2.5:1, while digital angioleiomyoma favor the fingers over toes at a ratio of 4.3:1.
Conclusions
We suggest that vascular leiomyoma be included in the differential diagnosis of smooth muscle tumors with particular regard to the digits of both the hands and feet. Digital angioleiomyomata differ from acral angioleiomyomata in their equal gender distribution, increased tendency to cause pain, and preponderance for the fingers over the toes.
http://ift.tt/2hX0MLd
Is Psoriasis an autoimmune disease: interpretations from an immunofluorescence based study
Abstract
Introduction
Psoriasis is a multisystem, immune-mediated inflammatory disease. Some authors have proposed an autoimmune basis for psoriasis; however, till date, it has not been definitely established. The present study was conducted to explore the autoimmune nature of psoriasis.
Materials and methods
This was a prospective study in which 43 psoriasis patients were assessed for detailed clinical, histopathological and immunopathological features to explore the diagnostic utility of subtypes, intensity, and number of immunoreactants in lesional and non-lesional skin in these patients. In addition, the sera of these patients were analyzed for the presence of various autoantibodies.
Results
The patients' age ranged from 14 to 75 years with a M:F ratio of 1.52:1. Nine patients(20.93%) were positive for anti-nuclear and 2(4.65%) for anti-smooth muscle antibodies. Direct immunofluorescence (DIF) was positive in 31(72%) biopsies from the lesional and 27(63%) biopsies from non-lesional skin. In all these DIF positive cases, granular deposits of C5b-9 were detected at the dermo-epidermal junction. No significant difference was observed on comparing the type and pattern of immunoreactant positivity, amongst lesional and non-lesional skin biopsies(p > 0.05).
Conclusion
No significant association between psoriasis and immunoreactant deposition as well as autoantibody seroprevalence was observed, thereby refuting a definite autoimmune basis for psoriasis.
http://ift.tt/2jhya4s
Influence of ultrasonic activation over final irrigants in the removal of photosensitizer from root canal walls after photodynamic therapy
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Matheus Albino Souza, Bianca Pazinatto, Karolina Frick Bischoff, Huriel Scartazzini Palhano, Doglas Cecchin, José Antônio Poli de Figueiredo
IntroductionThe aim of the present study was to evaluate the influence of ultrasonic activation (US) of the final irrigant in the removal of the photosensitizer from root canal walls after photodynamic therapy.MethodsThe root canals of 60 single-rooted bovine extracted teeth were filled with 0.01% methylene blue and submitted to photodynamic therapy for 90seconds. After that, the roots were divided into six groups (n=10) according to the final irrigation protocol: distilled water (DW), DW+US, 17% EDTA, QMix, EDTA+US, and QMix+US. Then, the samples were submitted to scanning electron microscopy where a scoring system was used to evaluate the images and effectiveness of proposed treatments in the cervical, middle and apical regions of the root canals. The data were statistically analyzed by the Kruskal-Wallis and Mann-Whitney U tests for intergroup comparisons as well as the Wilcoxon and Friedman tests for intragroup comparisons at 5% of significance.ResultsThe 17% EDTA+US and QMix+US treatments were most effective in the removal of the photosensitizer in all regions of the root canal; the difference was statistically significant when compared to all other groups (p<0.05). There were no significant differences in the intragroup analysis comparing the effectiveness in the different regions of the same group (p<0.05).ConclusionsUS can aid 17% EDTA and QMix in removing the photosensitizer after photodynamic therapy and contributes to cleaning root canal walls.
http://ift.tt/2ii0bVe
Seroprevalence of Cytomegalovirus Infection Among a Rural Population of Côte d'Ivoire
Viral Immunology Jan 2017, Vol. 30, No. 1: 54-57.
http://ift.tt/2iKtsJs
A framework for understanding sexual violence: Incentive-motivation and hierarchical control
Source:Aggression and Violent Behavior
Author(s): Frederick Toates, Wineke Smid, Jan van den Berg
The article applies an incentive-motivation model to sexual violence. It suggests that insights can be gained by looking at the biopsychological processes that underlie 'conventional behavior'. It argues that sexual violence, as in rape, arises from a fusion between (i) sexual motivation and (ii) sensation-seeking and varying strengths of dominance/aggression motivations. The excitatory part of the motivational system is rooted in brain dopamine and sexual violence is expressed in behavior when excitation exceeds inhibition. The assumptions are framed within the principle of the hierarchical control of behavior. The incentive-motivation and hierarchical framework can yield insights into such phenomena as planning and impulsivity, future discounting, habituation and escalation, violence as addiction, the role of fetishes, sexual fantasy, stress, drugs and brain development.
http://ift.tt/2ihSEGa
Prevalence of life-course-persistent, adolescence-limited, and late-onset offenders: A systematic review of prospective longitudinal studies
Source:Aggression and Violent Behavior
Author(s): Darrick Jolliffe, David P. Farrington, Alex R. Piquero, John F. MacLeod, Steve van de Weijer
Little is known about the prevalence, frequency, onset, and criminal career duration of life-course-persistent offenders (LCP), compared to adolescence-limited (AL) and late-onset offenders (LO), despite the importance of these categories in criminology. This article is the first to use a systematic approach to identify the prospective longitudinal studies which could possess relevant information and to summarize the outputs of these studies. The principal investigators of these studies were also contacted to assist in identifying relevant data. Overall, 55 prospective longitudinal studies were identified; of these 14 had produced information on the prevalence of the various offending types. In seven additional studies, data was made available to explore criminal career parameters of the various offending types. The results showed that the estimates of the prevalence of LCP, AL, and LO offending varied considerably, and that few studies include criminal career duration in their definitions of LCP offenders. Surprisingly, the average ages of onset for LCP and Al offenders were similar. Much more research on LCP, AL, and LO offenders, which includes a consideration of criminal career duration, is desperately needed.
http://ift.tt/2ii0cZl
Temporal Effect of Bariatric Surgery on Predicted 10-Year and Lifetime Cardiovascular Risk at 1 Month, 6 Months, and 5 Years Following Surgery: A Pilot Study
Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.
http://ift.tt/2ja8EtJ
A317491 relieved HIV gp120-associated neuropathic pain involved in P2X3 receptor in dorsal root ganglia
Source:Brain Research Bulletin
Author(s): Zhihua Yi, Shenqiang Rao, Shuai Ouyang, Yi Bai, Jinpu Yang, Yucheng Ma, Xinyao Han, Bing Wu, Lifang Zou, Tianyu Jia, Shanhong Zhao, Xiaju Hu, Qiongqiong Lei, Yun Gao, Shuangmei Liu, Hong Xu, Chunping Zhang, Shangdong Liang, Guilin Li
Glycoprotein 120 (gp120) is an HIV envelope glycoprotein. Gp120 can directly stimulate the primary sensory afferent neurons and cause hyperalgesia. The P2X3 receptor in dorsal root ganglia (DRG) is involved in the transmission of pain. In this study, we aimed to explore the role of the P2X3 receptor in gp120-induced neuropathic pain. Our data showed that mechanical and thermal hyperalgesia in rats treated with gp120 were increased compared to those in the control group. The expression levels of the P2X3 mRNA and protein in rats treated with gp120 were higher than those in the control group. The P2X3 antagonist A317491 decreased mechanical hyperalgesia and thermal hyperalgesia and the up-regulated expression levels of P2X3 mRNA and protein in rats treated with gp120. A317491 decreased ERK1/2 phosphorylation levels in the gp120-treated rat DRG. In addition, P2X3 agonist α,β-methylene ATP (α,β-meATP)-activated currents in DRG neurons cultured with gp120 were higher than those in control neurons. The inhibitory effect of A317491 on α,βme-ATP-induced currents in DRG neurons from the gp120-treated neurons was larger than that for control neurons. Molecular docking data showed that A317491 may be acted in the gp120 protein to inhibit the gp120 initiated the P2X3 activation, decrease the sensitizing DRG primary afferents and reduce the signal transmission of neuropathic pain in gp120-treated rats. Therefore, the inhibition of the P2X3 receptor in rat DRG neurons relieved gp120-induced mechanical hyperalgesia.
http://ift.tt/2hWzQQM
Amelioration of apelin-13 in chronic normobaric hypoxia-induced anxiety-like behavior is associated with an inhibition of NF-κB in the hippocampus
Source:Brain Research Bulletin
Author(s): Junming Fan, Lu Ding, Dongmei Xia, Danyang Chen, Pu Jiang, Wenhua Ge, Ru Zhao, Jinbin Guo, Xiaofang Fan, Feng Xue, Yongyu Wang, Sunzhong Mao, Lianggang Hu, Yongsheng Gong
Apelin, a small bioactive peptide, plays an important role in the pathogenesis of mood disorders through the endogenous ligand APJ. Although the anxiolytic effect of apelin is well established, the mechanisms are poorly understood. In this study, we hypothesized that apelin played an anxiolytic role in chronic normobaric hypoxia (CNH)-induced anxiety like behavior in mice, which might be associated with an inhibition of nuclear factor-κB (NF-κB) activation in the hippocampus. To this end, mice were exposed in a normobaric hypoxic chamber with a fraction of inspired oxygen (FIO2, ∼10%, 23h/d) with or without apelin-13 application (20 nmol.kg−1.d−1, i.p.), for 4 weeks. The anxiety-like behavior was tested by elevated plus maze and open field. Activities of NF-κB, microglial, and related signaling pathways in the hippocampus during this pathological process were examined. We found that CNH treatment decreased APJ but increased Iba-1 proteins expression, as well as nucleus translocation of p50 and p65 in the hippocampus, which were reversed by apelin-13 treatment. In addition, apelin-13 treatment ameliorated CNH-induced anxiety-like behavior in mice, suggesting anxiogenic effect of apelin-13 might be mediated by an inhibition of NF-κB activation in microglial of the hippocampus. Furthermore, apelin-13 treatment reversed p-CAMKII decrease in the hippocampus under CNH treatment. Apelin-13 treatment did not affect anxiety-like behavior and relative proteins expression in normoxia control mice. Finally, we found that rats with CNH treatment decreased APJ expression while enhanced NF-κB activation in the hippocampus, providing additional evidences that NF-κB activation in hippocampus in CNH-induced anxiety-like behavior in rats we reported previously might be associated with an inhibition of APJ activity. In conclusion, the present results illustrated that inhibition of APJ and promotion of NF-κB activation in the microglial of hippocampus might be involved in anxiogenic effect in CNH-exposed mice, and apelin-13 ameliorates CNH-induced anxiety-like behavior might be associated with an inhibition of NF-κB activation.
http://ift.tt/2jag5B7
Défaut d’information préalable : présomption de la souffrance morale et préjudice d’impréparation
Source:Médecine & Droit
Author(s): Nicolas Brunet
Le Conseil d'État, suivant son arrêt en date du 16 juin 2016, poursuit la définition du régime du préjudice d'impréparation résultant du manquement des professionnels de santé à leur obligation d'informer les patients, ainsi qu'en dispose l'article L. 1111-2 du Code de la santé publique. À cette précision, s'ajoute une nouvelle convergence entre jurisprudences administrative et judiciaire. Néanmoins, le Conseil d'État semble marquer le pas vers la reconnaissance d'un droit à l'information qu'avait pu laisser espérer la Cour de cassation.The Conseil d'État, relatively to the ruling dated the 16th of June 2016, keeps defining the legal regime of the harm of unpreparedness which consists in a violation of the health professionals' duty to inform their patients, based on article L. 1111-2 of Code de la santé publique. Moreover, it can be highlighted a shared understanding between the judicial and administrative jurisprudences. Yet, the Conseil d'État is likely withholding the patients' right to information that the Cour de cassation may have headed toward.
http://ift.tt/2iOmwgU
Mandibular reconstruction with vascularised bone flaps: a systematic review over 25 years
To explore the techniques for mandibular reconstruction with composite free flaps and their outcomes, we systematically reviewed reports published between 1990 and 2015. A total of 9499 mandibular defects were reconstructed with 6178 fibular, 1380 iliac crest, 1127 composite radial, 709 scapular, 63 serratus anterior and rib, 32 metatarsal, and 10 lateral arm flaps including humerus. The failure rate was higher for the iliac crest (6.2%, 66/1059) than for fibular, radial, and scapular flaps combined (3.4%, 202/6018) (p<0.001).
http://ift.tt/2iWCiTR
Are MIQE Guidelines Being Adhered to in qPCR Investigations in Photobiomodulation Experiments?
Photomedicine and Laser Surgery , Vol. 0, No. 0.
http://ift.tt/2iWGAuC
Personalizing Photobiomodulation Therapy
Photomedicine and Laser Surgery Jan 2017, Vol. 35, No. 1: 1-2.
http://ift.tt/2hYvqqW
The Effect of Photobiomodulation on the Sea Urchin Paracentrotus lividus (Echinodermata) by Using Higher-Fluence on Fertilization, Embryogenesis, and Larval Development: An In Vitro Study
Photomedicine and Laser Surgery , Vol. 0, No. 0.
http://ift.tt/2iWEydV
Fractional CO2 Laser: From Skin Rejuvenation to Vulvo-Vaginal Reshaping
Photomedicine and Laser Surgery , Vol. 0, No. 0.
http://ift.tt/2hYGcNI
Occupational asthma caused by sensitization to a cleaning product containing triclosan
A recent consensus statement has highlighted the increased risk of developing asthma after exposure to workplace and domestic cleaning products.1 Specific cleaning agents, such as benzylalkonium chloride, have been recognized as causes of occupational asthma by sensitization and now comprise a significant burden of work-related asthma. European Respiratory Society guidelines recommend that sensitizer-induced occupational asthma should be diagnosed by identifying the workplace as the cause and confirming sensitization to an asthmagen by specific inhalation challenge (SIC) in the absence of any available specific IgE tests.
http://ift.tt/2iKpSiw
Occupational asthma caused by sensitization to a cleaning product containing triclosan
A recent consensus statement has highlighted the increased risk of developing asthma after exposure to workplace and domestic cleaning products.1 Specific cleaning agents, such as benzylalkonium chloride, have been recognized as causes of occupational asthma by sensitization and now comprise a significant burden of work-related asthma. European Respiratory Society guidelines recommend that sensitizer-induced occupational asthma should be diagnosed by identifying the workplace as the cause and confirming sensitization to an asthmagen by specific inhalation challenge (SIC) in the absence of any available specific IgE tests.
http://ift.tt/2iKpSiw
Frequency and severity of reactions to a 325-mg aspirin dose during desensitization
The frequency with which patients with aspirin-exacerbated respiratory disease (AERD) react to 325 mg of aspirin during aspirin desensitization, or fail to react at all, is not fully known.
http://ift.tt/2iOlMrW
Frequency and severity of reactions to a 325-mg aspirin dose during desensitization
The frequency with which patients with aspirin-exacerbated respiratory disease (AERD) react to 325 mg of aspirin during aspirin desensitization, or fail to react at all, is not fully known.
http://ift.tt/2iOlMrW
Atlas-Based Mosaicing of Left Atrial 3-D Transesophageal Echocardiography Images
Source:Ultrasound in Medicine & Biology
Author(s): Harriët W. Mulder, Marijn van Stralen, Ben Ren, Alexander Haak, Max A. Viergever, Johan G. Bosch, Josien P.W. Pluim
Transesophageal echocardiography (TEE) is a promising imaging modality used to guide cardiac interventions, such as catheter ablation for the treatment of cardiac arrhythmias. These procedures rely on good visualization of the left atrium and pulmonary veins. To visualize these structures in a single volume, the acquisition, registration and fusion of multiple TEE views of the left atrium are required. We introduce atlas-based mosaicing as a method for the registration of images that are acquired according to a standardized protocol. Inspired by atlas-based segmentation approaches, compounded data of other patients serve as atlases for the registration of new data. The performance of atlas-based mosaicing is studied on 3-D TEE data of the left atrium and compared with that of regular pairwise registration. This study indicates that improved registration robustness and smaller registration errors are achieved with atlas-based mosaicing compared with regular pairwise registration. This is an important step toward the use of TEE for interventional guidance of ablation procedures.
http://ift.tt/2jhf5za
Cardiac Shear Wave Velocity Detection in the Porcine Heart
Source:Ultrasound in Medicine & Biology
Author(s): Hendrik J. Vos, Bas M. van Dalen, Ilkka Heinonen, Johan G. Bosch, Oana Sorop, Dirk J. Duncker, Antonius F.W. van der Steen, Nico de Jong
Cardiac muscle stiffness can potentially be estimated non-invasively with shear wave elastography. Shear waves are present on the septal wall after mitral and aortic valve closure, thus providing an opportunity to assess stiffness in early systole and early diastole. We report on the shear wave recordings of 22 minipigs with high-frame-rate echocardiography. The waves were captured with 4000 frames/s using a programmable commercial ultrasound machine. The wave pattern was extracted from the data through a local tissue velocity estimator based on one-lag autocorrelation. The wave propagation velocity was determined with a normalized Radon transform, resulting in median wave propagation velocities of 2.2 m/s after mitral valve closure and 4.2 m/s after aortic valve closure. Overall the velocities ranged between 0.8 and 6.3 m/s in a 95% confidence interval. By dispersion analysis we found that the propagation velocity only mildly increased with shear wave frequency.
http://ift.tt/2jh6VqC
Nodular Fasciitis: Sonographic–Pathologic Correlation
Source:Ultrasound in Medicine & Biology
Author(s): Ho-Hsian Yen, Hong-Jen Chiou, Yi-Hong Chou, Chih-Hsueh Chen, Wan-Yuo Guo
We evaluated nodular fasciitis (NF) in 19 patients, focusing on the correlation between its sonographic and histopathologic features. Sonograms were retrospectively reviewed, and the location, shape, margin, echogenicity, echogenic rim, peripheral hyper-echoic nodules, posterior enhancement and vascularity of the lesions were recorded. In the histopathologic analysis, three patterns—infiltrating, pushing border and well circumscribed—were identified, and culture-like tissue centers were classified according to the distribution of focal keloid-like collagen bundles: uneven or even. For the sonographic–pathologic correlation, most NF cases were inhomogeneously hypo-echoic and had an echogenic rim, with an infiltrating or pushing border pattern. In addition, all NF cases with the infiltrating pattern were observed to have peripheral hyper-echoic nodules in sonograms. Thus, echogenic rims may be associated with the peripheral adipose tissues in infiltrating pattern, and the degree of infiltration may be associated with specific sonographic features of NF.
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The steroid metabolite 16(β)-OH-androstenedione generated by CYP21A2 serves as a substrate for CYP19A1
Publication date: Available online 5 January 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): J. Neunzig, M. Milhim, L. Schiffer, Y. Khatri, J. Zapp, A. Sánchez-Guijo, M.F. Hartmann, S.A. Wudy, R. Bernhardt
The 21-hydroxylase (CYP21A2) is a steroidogenic enzyme crucial for the synthesis of mineralo- and glucocorticoids. It is described to convert progesterone as well as 17-OH-progesterone, through a hydroxylation at position C21, into 11-deoxycorticosterone (DOC) and 11-deoxycortisol (RSS), respectively. In this study we unraveled CYP21A2 to have a broader steroid substrate spectrum than assumed. Utilizing a reconstituted in vitro system, consisting of purified human CYP21A2 and human cytochrome P450 reductase (CPR) we demonstrated that CYP21A2 is capable to metabolize DOC, RSS, androstenedione (A4) and testosterone (T). In addition, the conversion of A4 rendered a product whose structure was elucidated through NMR spectroscopy, showing a hydroxylation at position C16-beta. The androgenic properties of this steroid metabolite, 16(β)-OH-androstenedione (16bOHA4), were investigated and compared with A4. Both steroid metabolites were shown to be weak agonists for the human androgen receptor. Moreover, the interaction of 16bOHA4 with the aromatase (CYP19A1) was compared to that of A4, indicating that the C16 hydroxyl group does not influence the binding with CYP19A1. In contrast, the elucidation of the kinetic parameters showed an increased Km and decreased kcat value resulting in a 2-fold decreased catalytic efficiency compared to A4. These findings were in accordance with our docking studies, revealing a similar binding conformation and distance to the heme iron of both steroids. Furthermore, the product of 16bOHA4, presumably 16-hydroxy-estrone (16bOHE1), was investigated with regard to its estrogenic activity, which was negligible compared to estradiol and estrone. Finally, 16bOHA4 was found to be present in a patient with 11-hydroxylase deficiency and in a patient with an endocrine tumor. Taken together, this study provides novel information on the steroid hormone biosynthesis and presents a new method to detect further potential relevant novel steroid metabolites.
Graphical abstract
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4-HYDROXYNONENAL PROTEIN ADDUCTS: KEY MEDIATOR IN RETT SYNDROME OXINFLAMMATION
Source:Free Radical Biology and Medicine
Author(s): Giuseppe Valacchi, Alessandra Pecorelli, Carlo Cervellati, Joussef Hayek
In the last 15 years a strong correlation between oxidative stress (OxS) and Rett syndrome (RTT), a rare neurodevelopmental disorder known to be caused in 95% of the cases, by a mutation in the methyl-CpG-binding protein 2 (MECP2) gene, has been well documented. Here, we revised, summarized and discussed the current knowledge on the role of lipid peroxidation byproducts, with special emphasis on 4-hydroxynonenal (4HNE), in RTT pathophysiology. The posttranslational modifications of proteins via 4HNE, known as 4HNE protein adducts (4NHE-PAs), causing detrimental effects on protein functions, appear to contribute to the clinical severity of the syndrome, since their levels increase significantly during the subsequent 4 clinical stages, reaching the maximum degree at stage 4, represented by a late motor deterioration. In addition, 4HNE-PA are only partially removed due to the compromised functionality of the proteasome activity, contributing therefore to the cellular damage in RTT. All this will lead to a characteristic subclinical inflammation, defined "OxInflammation", derived by a positive feedback loop between OxS byproducts and inflammatory mediators that in a long run further aggravates the clinical features of RTT patients. Therefore, in a pathology completely orphan of any therapy, aiming 4HNE as a therapeutic target could represent a coadjuvant treatment with some beneficial impact in these patients.
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Hyperbaric oxygen attenuates neuropathic pain and reverses inflammatory signaling likely via the Kindlin-1/Wnt-10a signaling pathway in the chronic pain injury model in rats
Hyperbaric oxygen (HBO) therapy is proven to attenuate neuropathic pain in rodents. The goal of the present study was to determine the potential involvement of the Kindlin-1/Wnt-10a signaling pathway during as...
http://ift.tt/2iHs9N8
Accuracy of mandibular measurements of sexual dimorphism using stabilizer equipment
Abstract The objective of this investigation was to compare the accuracy of mandibular measurements using a stabilizer (MS) with gold standard computed tomography (GS) images. Sixty mandibles were studied. Werth TomoScope HV Compact® was used to obtain CT images (GS), and the MS was also used. Analysis of the CT scans was performed using the VG Studio Max software® (Volume Graphics GmbH, Heidelberg, Germany), and MS was used after the proper positioning of the mandible. Descriptive and paired t test measures were used, and a ROC curve was calculated, as well as sensibility and specificity. MedCalc and STATA 13.0® were used (95% level of significance). Bicondylar breadth, bicoronoid breadth and minimum ramus breadth reached the highest concordance correlation coefficients at 0.99 (0.99-1.00), 0.99 (0.99–1.00) and 1.00 (0.99–1.00), respectively. Comparing observers with GS, the lowest accuracy was noted for the maximum mandibular length [0.59 (0.45–0.69), 0.64 (0.51–0.74)], the breadth of the right (0.14 (0.04–0.23), 0.14 (0.004–0.24)) and left mandibular body [0.14 (0.03–0.24), 0.16 (0.05-0.26)], and the right [0.58 (0.45–0.69), 0.63 (0.51–0.73) and left (0.59 (0.45–0.70), 0.59 (0.46–0.69)] mandibular angle. Various measurements exhibited good sensibility for males using MS: maximum mandibular length (78.12), bicondylar breadth (78.12), left mandibular notch breadth (84.37), and the left height of the mandibular body at the mental foramen (75.00). High specificity in discriminating females was observed for the left maximal ramus height (85.19), mandibular length (85.71), bicoronoid breadth (96.43), right height of the mandibular body at the mental foramen (82.19), bimental breadth (78.57), breadth right (92.86) and left (96.43) mandibular body, minimum ramus breadth (89.29), and left mandibular angle (85.71). MS was able to discriminate sexual dimorphism.
http://ift.tt/2hWGmBS
Antimicrobial activity of ozone and NaF-chlorhexidine on early childhood caries
Abstract An early childhood carie (ECC) is an extremely destructive form of tooth decay. The aim of this study was to investigate the action of ozone (O3), and the association of sodium fluoride (NaF) with chlorhexidine (CHX) on bacteria related to ECC. Overnight culture of the bacteria was performed. On exponential phase the suspension was adjusted (101-108 CFU/mL). A drop (10μL) of each concentration of bacteria was applied on sheep blood agar plates and treated with O3 (2, 20, 200, and 2,000 ppm); after 18 hours, recovery analysis of CFU verified the reduction of bacterial activity. For NaF-CHX, sterile 96-well plates were prepared and divided into groups: G1 (150 µL TSB); G2 (20 µL of bacteria + 25 µL CHX + 25 µL NaF); and G3 (150 µL TSB + 20 µL of bacteria + 50 µL water). The plates were verified by analysis of the optical density (0, 12, 14, 16, and 18 hours). The data from O3 test were submitted to ANOVA and Tukey's test (p < 0.05). For the data from NaF-CHX, the ANOVA 2-way and Bonferroni's test (p < 0.05) were used. The number of CFU/mL showed death > 3log10 (99.9%) for all bacteria (ozone ≥ 20ppm), while the combination of NaF-CHX was more effective (p < 0.001) compared to each substance tested alone and the control group. The antimicrobial agents tested were able to inhibit all bacteria tested; O3 seemed to be a good alternative for controlling progression of carious lesions, while the association of NaF-CHX showed to be a good antimicrobial with easy and inexpensive application.
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Association between the clinical severity of oral lichen planus and anti-TPO level in thyroid patients
Abstract This study considered a possible relationship between the severity of oral lichen planus (OLP), serum anti-TPO autoantibodies (TPOAb) titer and thyroid disease in OLP patients. Forty-six OLP patients with positive TPOAb results (> 35 IU/ml) who had also been diagnosed with thyroid disease were included in the study group. The control group consisted of 46OLP patients with no thyroid disease. The study and control groups (92) were divided to two subgroups of erosive OLP (EOLP) and non-erosive OLP (NEOLP). Serum TPOAb levels and IL-8 (to measure OLP severity) were evaluated using the independent t-test, chi-square and conditional logistic regression analysis (α = 0.05). A significant positive correlation was found between serum IL-8 and TPOAb levels in the study group (r = 0.783; p = 0.001). The positive blood levels of TPOAb were significantly associated with an increased risk of EOLP (OR = 4.02 at 95%CI; 1.21–13.4; p = 0.023). It is possible to used positive serum TPOAb levels in patients with OLP as in indicator of possible undetected thyroid disorders in those patients. Because erosive OLP has been associated with TPOAb in thyroid patients, it may be useful to determine TPOAb levels of such patients to diagnose a possible undetected thyroid disorders and follow-up for malignancy.
http://ift.tt/2iHo37I
Evaluation of dentin hypersensitivity treatment with glass ionomer cements: A randomized clinical trial
Abstract A randomized, double-blind, split-mouth clinical trial was performed compared the desensitizing efficacy of the resin-modified glass ionomer cement (GIC) ClinproTM XT (3M ESPE, Minnesota, USA) and the conventional GIC Vidrion R (SS White, Gloucester, UK) in a 6-month follow-up. Subjects were required to have at least two teeth with dentin hypersensitivity. Teeth were divided at random into 2 groups, one group received Clinpro XT and the other conventional GIC Vidrion R. Treatments were assessed by tactile and air blast tests using Visual Analogue Scale (VAS) at baseline, after 20 minutes, and at 7, 15, 21, 30, 90 and 180 days post-treatment. Twenty subjects (152 teeth) were included. Both tests (tactile and air blast) showed a significant reduction of dentin hypersensitivity immediately after the application of Vidrion R and Clinpro XT (20 min). VAS scores obtained along the 6-month follow-up were statistically lower when compared to initial rates (p < 0.05). Both GIC were able to reduce dentin hypersensitivity up to 6-month post-treatment period without statistically significant differences among them (p > 0.05). Both cements provided satisfactory results in long-term dental sensitivity reduction.
http://ift.tt/2hWJyNO
One-year aging effects on microtensile bond strengths of composite and repairs with different surface treatments
Abstract The present study aimed to evaluate effects of different surface treatments and aging of composite cylinders on bond strength of composite resin repair. Thirty-two composite cylinders were produced and divided into four groups according to type of surface treatment and storage time of composite cylinder and repair. Cylinder surface of control group (Gcontrol) received no treatment before composite repair. Other groups were sandblasted with aluminum oxide (GAl2O3), followed by silane (GAl2O3sil) or adhesive (GAl2O3ad). Composite cylinders were stored in artificial saliva for either 24 hours or 1 year. Repairs were performed and stored in artificial saliva for 24 hours or 1 year and repair strength was evaluated using microtensile bond strength test. Data were submitted to Student's t test, two-way ANOVA, and post hoc test for storage time and treatment (α = 0.05). Gcontrol group showed lower values of aging of composite cylinder and storage time of repair (24 hours or 1 year for both) compared with other groups (p < 0.05). GAl2O3ad and GAl2O3sil groups did not exhibit decreased microtensile bond strength with aged repairs (1 year; p > 0.05). Polymer degradation was significant for composite cylinders during the first year of storage in Gcontrol, GAl2O3, and GAl2O3ad groups (p < 0.05). In GAl2O3sil group, storage time of composite cylinders was not significant (p > 0.05). Aging of composite resin influenced bond strength of restoration repair for up to 1 year. Sandblasting with Al2O3, followed by application of silane layer, produced high bond strength after composite or repair aging.
http://ift.tt/2iHiExN
The efficacy of low-level 940 nm laser therapy with different energy intensities on bone healing
Abstract The aim of this study was to evaluate the efficacy of low-level 940 nm laser therapy with energy intensities of 5, 10 and 20 J/cm2 on bone healing in an animal model. A total of 48 female adult Wistar rats underwent surgery to create bone defects in the right tibias. Low-level laser therapy (LLLT) was applied immediately after surgery and on post-operative days 2, 4, 6, 8, 10 and 12 in three study groups with energy intensities of 5 J/cm2, 10 J/cm2 and 20 J/cm2 using a 940 nm Gallium-Aluminium-Arsenide (Ga-Al-As) laser, while one control group underwent only the tibia defect surgery. All animals were sacrificed 4 or 8 weeks post-surgery. Fibroblasts, osteoblasts, osteocytes, osteoclasts and newly formed vessels were evaluated by a histological examination. No significant change was observed in the number of osteocytes, osteoblasts, osteoclasts and newly formed vessels at either time period across all laser groups. Although LLLT with the 10 J/cm2 energy density increased fibroblast activity at the 4th week in comparison with the 5 and 20 J/cm2 groups, no significant change was observed between the laser groups and the control group. These results indicate that low-level 940 nm laser with different energy intensities may not have marked effects on the bone healing process in both phases of bone formation.
http://ift.tt/2hWJLRk
The role of bone conduction hearing aids in congenital unilateral hearing loss: A systematic review
To systematically review the literature on the audiological and/or quality of life benefits of a bone conduction hearing aid (BCHA) in children with congenital unilateral conductive or sensorineural deafness.
http://ift.tt/2iOaCUd
The protective role of tetramethylpyrazine against cisplatin-induced ototoxicity
The aim of the present study was to investigate the protective effect of tetramethylpyrazine (TMP) on cisplatin-induced ototoxicity in rats.
http://ift.tt/2iK6AJO
Dysequilibrium in a 5-year-old child with intrameatal vascular loops bilaterally
A 5 year-old boy was rather healthy until one month ago when loss of balance and muscle tone was noted by the parents. A battery of tests comprising electroencephalography, audiometry, caloric test and ocular vestibular evoked myogenic potential (oVEMP) test were performed, yet all tests showed normal responses. Conversely, cervical VEMP (cVEMP) test showed delayed responses bilaterally. MR imaging demonstrated bilaterally intrameatal vascular loops extending into both internal auditory canals. After a 3-month medication, delayed cVEMPs were resolved and returned to normal cVEMPs bilaterally, accompanied by subsidence of dysequilibrium.
http://ift.tt/2iO79oy
Obstructive sleep apnea in a 5 month old with tonsillar hypertrophy secondary to congenital neutropenia: Case report and literature review
Tonsillectomy and adenoidectomy (T&A) is the primary surgical treatment for obstructive sleep apnea (OSA) in children with tonsillar and adenoid hypertrophy (TAH). We present the case of a 5-month old male with congenital neutropenia who developed severe TAH during treatment with granulocyte colony-stimulating factor (G-CSF). He had severe OSA, decreased oral intake, and failure to thrive (FTT) which all improved after undergoing a successful intracapsular T&A. We describe a successful procedure to help alleviate symptoms of OSA and FTT in this young infant with congenital neutropenia who developed TAH during treatment with G-CSF.
http://ift.tt/2iKaLpj
Sinuclean Nebules treatment in children suffering from otitis media with effusion
Otitis media with effusion (OME) is an ear disorder defined by the presence of fluid in the middle ear without signs or symptoms of acute infection. The current randomized, double-blind, controlled study aimed to evaluate whether Sinuclean Nebules treatment, administered by nasal douche (Rinowash), could induce ear healing better than isotonic saline in children with OME.
http://ift.tt/2iJVS6j
A pilot trial of In vivo NRT sampling to increase medication adherence in community corrections smokers
Source:Addictive Behaviors, Volume 67
Author(s): Karen L. Cropsey, Peter S. Hendricks, Samantha Schiavon, Aaron Sellers, Morgan Froelich, Richard C. Shelton, Matthew J. Carpenter
BackgroundIndividuals in the criminal justice system demonstrate high rates of cigarette use (70–80%) and low adherence to smoking cessation medication. Educational approaches have not been shown to promote adherence or cessation, though medication sampling has boosted both use and cessation. The objective of the present study was to determine whether In vivo nicotine replacement therapy (NRT) sampling approach increases NRT adherence among criminal justice smokers during a subsequent quit attempt.MethodsWe conducted a pilot study with 43 community corrections smokers randomized to a 4-session (one 30-min session per week) precessation intervention of either In vivo NRT sampling (Session 1: patch; Session 2: gum; Session 3: combination NRT (cNRT); Session 4: review) vs. 4 time-matched sessions of standard smoking cessation with cNRT started after Session 1. Both groups received an additional 8weeks of cNRT following the four intervention sessions.ResultsDuring the in vivo administration of NRT, total withdrawal and craving severity significantly decreased from pre- to post-session compared to Control participants. In vivo participants evinced greater patch use at Session 4 and greater gum use through Week 8 relative to Controls.DiscussionIn vivo NRT sampling may increase NRT adherence relative to standard counseling sessions among criminal justice smokers. A larger trial of this novel intervention appears to be warranted.
http://ift.tt/2j9Oal4
Cognitive Dysfunction: Another reason to treat obstructive sleep apnea in stroke patients
None.
http://ift.tt/2iO4fQH
3D printing of large, complex metallic glass structures
Publication date: 5 March 2017
Source:Materials & Design, Volume 117
Author(s): Yiyu Shen, Yingqi Li, Chen Chen, Hai-Lung Tsai
Metallic glasses (MGs) or amorphous alloys although have superior mechanical properties their products are limited to simple geometries such as foils/plates or rods with thin section-thickness due to the requirement of high cooling rates. In this study, 3D, large dimensions of amorphous structures with complex geometry are manufactured by our newly developed Laser Foil Printing (LFP) technology. Zr-based (LM105, provided by Liquidmetal Technologies, Inc.) amorphous foils of 100μm thickness are used as feedstock, and they are laser welded, layer-by-layer, to become 3D amorphous structures. Test results by X-Ray diffraction (XRD), differential scanning calorimetry (DSC), and micro-hardness confirm that the printed structures at selected process parameters achieve the same or better degree of amorphization as the raw foils. A mathematical model was developed to calculate the heating and cooling rates during structure manufacturing which helps the selection of process parameters. This study expands MG products to 3D arbitrary geometries with large dimensions due to the inherited advantages of the LFP technology which would open many potential applications.
http://ift.tt/2hWEglL
Low temperature superplastic-like deformation and fracture behavior of nano/ultrafine-grained metastable austenitic stainless steel
Publication date: 5 March 2017
Source:Materials & Design, Volume 117
Author(s): G.S. Sun, L.X. Du, J. Hu, H. Xie, R.D.K. Misra
We describe here the low temperature superplastic-like deformation in a nano/ultrafine-grained metasable austenitic stainless steel tensile tested at a strain rate of 2.5×10−4s−1 and temperature of 600°C (~0.43 of the absolute melting point). The nano/ultrafine-grained structure was obtained via a combination of cold rolling (~93% in reduction), followed by reversion annealing treatments at 650°C for 10min, 30min, and 700°C for 2min, 5min, respectively, an approach previously adopted by Misra's group (references 11–16). The reversion of martensite to austenite was dominated by diffusional mechanism. The nano/ultrafine-grained steel exhibited superplastic-like behavior with maximum elongation approaching ~153% and strain rate sensitivity of ~0.22. Furthermore, tensile deformation behavior at 20°C and 600°C, and the corresponding fracture characteristics are discussed. Observations of fracture surface indicated that the fracture was characterized by line-up of voids along the striations, when tensile tested at 20°C. Whereas, the fracture surface at 600°C mainly consisted of uniform distribution of dimples. To further study the fracture mechanism during superplastic-like deformation, deformed structures from the longitudinal region close to the tip of the fracture surface were studied. The fracture surface of superplastic-like deformed steel was characterized by interlinkage of cavities.
Graphical abstract
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Effect of Mn-doping on the structure and electric properties of 0.64Pb(In0.5Nb0.5)O3-0.36PbTiO3 ceramics
Publication date: 5 March 2017
Source:Materials & Design, Volume 117
Author(s): Huimin Qiao, Chao He, Zujian Wang, Xiuzhi Li, Ying Liu, Xiaoming Yang, Hamel Tailor, Xifa Long
In order to study the effect of defect dipoles on relaxor-based ferroelectrics, 0.64Pb(In0.5Nb0.5)O3-0.36Pb(Ti1−xMnx)O3 (x=0−0.15) ferroelectric ceramics were synthesized using the two-step solid state reaction method. The phase structure, ferroelectric, piezoelectric and dielectric properties were investigated. Upon increasing the Mn content, the phase of the ceramics transforms from tetragonal to rhombohedral symmetry, the magnitude of remnant polarization and piezoelectric coefficient decreasing because of the hardening effect of the defect dipoles and the variation of composition. The coercive field, however, decreases from 22kV/cm to 12.5kV/cm with x≤0.04 initially owing to a phase transition, and then increasing since the defect dipoles provided a driving and stabilizing force for domain stability. The stabilizing force also resulted in constricted hysteresis loops for samples with composition of x≥0.04 after aging. The temperature dependence of dielectric properties showed that the Curie temperature decreased from 312°C (x=0) to 237°C (x=0.15), and the degree of relaxor behavior was enhanced with increase of Mn content. It indicates that the defect dipoles, confirmed by the existence of oxygen vacancies, play an important role in the electrical properties of Mn-doping PIN-PT ceramics.
Graphical abstract
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Construction and Validation of a Novel Disease-Specific Quality of Life Instrument for Patients with Primary Antibody Deficiency Disease (PADQOL -16)
A disease-specific Health-related Quality of Life survey was developed for adult patients with antibody immune deficiency disorders as a tool (PADQOL-16) for assessing a patient's QOL issues and their relation to clinical status.
http://ift.tt/2hYeIb0
A Case of an Extensive Keratocystic Odontogenic Tumor in the Mandible Reconstructed with a Custom-Made Total Joint Prosthesis
Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0036-1597585
The use of virtual surgical planning and computer-aided design/computer-aided manufacturing has previously been reported to enhance the planning for the reconstruction of mandibular continuity defects and to reduce surgical time. Reported is a case of a large keratocystic odontogenic tumor (KOT) affecting right hemimandible including the condylar neck. This case was initially reconstructed with a condyle-bearing reconstruction plate, but because of fatigue fracture 15 years later, a new reconstruction with a custom-made total joint temporomandibular prosthesis was performed.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Bone Allograft Segment Covered with a Vascularized Fibular Periosteal Flap: A New Technique for Pediatric Mandibular Reconstruction
Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0036-1593992
The free vascularized fibular graft is nowadays the preferred technique for pediatric mandibular reconstruction. Despite the versatility and proven efficacy for restoring the facial appearance and maxillomandibular function, those mandibular reconstructions with free vascularized fibula associate difficulties for a simultaneous restoration of the alveolar height and facial contour, which are derived from the height discrepancy between the fibula and the native mandible. In addition, the donor-site growth and morbidity are of special concern in the pediatric patient. We report a novel technique for pediatric mandibular reconstruction, in an 11-year-old girl, using a combination of a bone allograft segment with a vascularized fibular periosteal flap (VFPF), after resection of an Ewing sarcoma located at the right body of the mandible. The patient has showed optimal cosmetic, functional, and radiological outcomes, which have been maintained for 2.5 years, without detecting donor-site complications. Through this original technique, and based on the powerful osteogenic and vasculogenic properties of the pediatric VFPFs, we could effectively reconstruct a large mandibular defect providing a functional and aesthetic reconstruction, while avoiding the potential morbidity associated with the fibula resection.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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Audiometric findings with voluntary tensor tympani contraction
Abstract
Background
Tensor tympani contraction may have a "signature" audiogram. This study demonstrates audiometric findings during voluntary tensor tympani contraction.
Methods
Five volunteers possessing the ability to voluntarily contract their tensor tympani muscles were identified and enrolled. Tensor tympani contraction was confirmed with characteristic tympanometry findings. Study subjects underwent conventional audiometry. Air conduction and bone conduction threshold testing was performed with and without voluntary tensor tympani contraction.
Main outcome measure
Changes in air conduction and bone conduction thresholds during voluntary tensor tympani contraction.
Results
Audiometric results demonstrate a low frequency mixed hearing loss resulting from tensor tympani contraction. Specifically, at 250 Hz, air conduction thresholds increased by 22 dB and bone conduction thresholds increased by 10 dB.
Conclusions
Previous research has demonstrated a low frequency conductive hearing loss in the setting of tensor tympanic contraction. This is the first study to demonstrate a low frequency mixed hearing loss associated with tensor tympani contraction. This finding may aid in the diagnosis of disorders resulting from abnormal tensor tympani function. Tensor tympani contraction should be included on the differential for low frequency mixed hearing loss.
http://ift.tt/2j9EruL
Microcystic adnexal carcinoma (MAC)-like squamous cell carcinoma as a differential diagnosis to Bell´s palsy: review of guidelines for refractory facial nerve palsy
Abstract
Background
Bell´s palsy is the most common cause of facial paralysis worldwide and the most common disorder of the cranial nerves. It is a diagnosis of exclusion, accounting for 60–75% of all acquired peripheral facial nerve palsies. Our case shows the first case of a microcystic adnexal carcinoma-like squamous cell carcinoma as a cause of facial nerve palsy.
Case presentation
The patient, a 70-year-old Caucasian male, experienced subsequent functional impairment of the trigeminal and the glossopharyngeal nerve about 1½ years after refractory facial nerve palsy.
An extensive clinical work-up and tissue biopsy of the surrounding parotid gland tissue was not able to determine the cause of the paralysis. Primary infiltration of the facial nerve with subsequent spreading to the trigeminal and glossopharyngeal nerve via neuroanastomoses was suspected. After discussing options with the patient, the main stem of the facial nerve was resected to ascertain the diagnosis of MAC-like squamous cell carcinoma, and radiochemotherapy was subsequently started.
Conclusion
This case report shows that even rare neoplastic etiologies should be considered as a cause of refractory facial nerve palsy and that it is necessary to perform an extended diagnostic work-up to ascertain the diagnosis. This includes high-resolution MRI imaging and, as perilesional parotid biopsies might be inadequate for rare cases like ours, consideration of a direct nerve biopsy to establish the right diagnosis.
http://ift.tt/2hWgUBD
Protective effects of Tongxinluo on cerebral ischemia/reperfusion injury related to Connexin 43/Calpain II/Bax/Caspase-3 pathway in rat
Publication date: Available online 5 January 2017
Source:Journal of Ethnopharmacology
Author(s): Xiao Cheng, Zijun Hou, Jingbo Sun, Yan Huang, Lixin Wang, Ziyi Zhou, Li-Hua Zhou, Yefeng Cai
Ethnopharmacological relevanceTongxinluo (TXL) is a multifunctional traditional Chinese medicine and has been widely used in the treatment of cardiovascular and cerebrovascular diseases. Numerous studies demonstrate that TXL is a novel neuroprotective drug, however, the mechanisms are largely unknown.Aim of the studywe aimed to demonstrate the protective effect of TXL on cerebral ischemia/reperfusion (I/R) injury and provide the evidence for the involvement of Connexin 43/Calpain II/ Bax/Caspase-3 pathway in TXL-mediated neuroprotection.MethodsFocal cerebral I/R injury were induced by transient middle cerebral artery occlusion (MCAO, for 90min) in adult male Sprague-Dawley rats. We estimated the effects of TXL on I/R injury including neurological deficit assessment and cerebral infarct volume measurement via TTC staining, and detected the protein expression of Connexin 43 (Cx43) by western blot. Furthermore, after the intracerebroventricular injection of carbenoxolone (CBX, the inhibitor of Cx43) at 30min before MCAO surgery, Calpain II, Bax and cleaved Caspased-3 immunoreactivity in ischemic penumbra region was detected by immunofluorescent staining, and cell apoptosis was detected by TUNEL staining.ResultsTXL treatment greatly improved neurological deficit and reduced the infarction volume compared to MCAO with buffer treatment (P<0.05), and TXL pre-post treatment showed better results than TXL pre-treatment. TXL pre-post treatment significantly up-regulated Cx43 protein expression at 3d, 7d and 14d post-injury compared to MCAO with buffer treatment (P<0.05). Meanwhile, the immunoreactivity of Calpain II, Bax and cleaved Caspase-3 in ischemic penumbra region was obviously decreased by TXL pre-post treatment compared to MCAO group (P<0.05). However, with the treatment of the Cx43 inhibitor, CBX, the down-regulated effect of TXL on Calpain II, Bax and cleaved Caspase-3 immunoreactivity was abolished (P<0.05). Moreover, the protective effect of TXL against neuron apoptosis in penumbra region was conteracted by CBX (P<0.05).ConclusionsTXL could effectively protect against I/R injury and reduced cell death via Cx43/Calpain II/Bax/Caspase-3 pathway, which contribute to I/R injury prevention and therapy.
Graphical abstract
http://ift.tt/2j9HGmf
Traditional Chinese medicine for pulmonary fibrosis therapy: Progress and future prospects
Publication date: 23 February 2017
Source:Journal of Ethnopharmacology, Volume 198
Author(s): Liu-Cheng Li, Lian-Di Kan
Ethnopharmacological relevancePulmonary fibrosis (PF) is a chronic, debilitating and often lethal lung disorder. Despite the molecular mechanisms of PF are gradually clear with numerous researchers' efforts, few effective drugs have been developed to reverse human PF or even halt the chronic progression to respiratory failure. Traditional Chinese medicine (TCM), the main component of the medical practice used for more than 5000 years especially in China, often exerts wider action spectrum than previously attempted options in treating human diseases. Recent data have shown the anti-fibrotic benefits of the active ingredients from TCM in this field, which may represent an attractive source of the drug discovery against PF.Aim of the reviewThis review summarizes the pre-clinical and clinical evidence on the benefits of TCM and their active ingredients, and provides a comprehensive information and reliable basis for the exploration of new treatment strategies of botanical drugs in the therapy of PF.MethodsThe literature information was obtained from the scientific databases on ethnobotany and ethno medicines (up to Aug 2016), mainly from the Pubmed, Web of Science and CNKI databases, and was to identify the experimental studies on the anti-fibrotic role of the active agents from TCM and the involved mechanisms. The search keywords for such work included: "lung fibrosis" or "pulmonary fibrosis", and "traditional Chinese medicine", "extract" or "herb".ResultsA number of studies have shown that the active agents of single herbs and TCM formulas, particularly the flavonoids, glycosides and alkaloids, exhibit potential benefits against PF, the mechanisms of which appear to involve the regulation of inflammation, oxidant stress, and pro-fibrotic signaling pathways, etc. Besides, the processing methods for discovering TCM in treating PF were prospectively discussed.ConclusionThese research work have shown the therapeutic benefits of TCM in the treatment of PF. However, more continued researches should be undertaken to clarify the unconfirmed chemical composition and regulatory mechanisms, conduct standard clinical trials, and evaluate the possible side effects. The insights provided in present review will be needed for further exploration of botanical drugs in the development of PF therapy.
Graphical abstract
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Du-Huo-Ji-Sheng-Tang and its active component Ligusticum chuanxiong promote osteogenic differentiation and decrease the aging process of human mesenchymal stem cells
Publication date: 23 February 2017
Source:Journal of Ethnopharmacology, Volume 198
Author(s): Jir-You Wang, Wei-Ming Chen, Che-Sheng Wen, Shih-Chieh Hung, Pei-Wen Chen, Jen-Hwey Chiu
Ethnopharmacological relevancePostmenopausal osteoporosis is the most common bone disease worldwide. Information concerning the effects of herbal medicines on mesenchymal cell osteogenesis and senescence remains lacking.Aim of this studyThis study was designed to investigate the effects of Du-Huo-Ji-Sheng-Tang (DHJST), a Chinese herbal medicine and its active component Ligusticum chuanxiong on osteogenic differentiation and the aging process of human mesenchymal cells (hMSCs).Materials & methodshMSCs were used as in vitro model and osteogenesis was induced by administration of either osteogenesis inducing medium (OIM) or dexamethasone-depleted OIM (DDOIM) for 1-week or 2 weeks and the results were evaluated by measuring the formation of mineralization nodules. The effects of the compound recipe DHJST and its active component L. chuanxiong on hMSCs osteogenesis-related gene expression was determined by real-time PCR that targeted bone morphogenetic protein-2 (BMP2), RUNX2, ALP, COL-1, osteopontin (OPN), and osteocalcin (OCN). Antibodies against BMP-related signaling pathway proteins, such as BMP-2, ERK, SMAD 1/5/8, and RUNX2, were also detected at the protein level by Western blotting. Finally, the cumulative growth curve and senescence of the hMSCs were evaluated in order to assess the aging process.ResultsL. chuanxiong increased osteogenic activity in hMSCs and up-regulated BMP-2 and RUNX2 gene expression via the activation of SMAD 1/5/8 and ERK signaling. Furthermore DHJST also showed a trend towards promoting the same effects in the same system. In the absence of dexamethasone, DHJST did activate SMAD 1/5/8 and ERK signaling and hence increased RUNX2 protein expression in hMSCs. In addition, both DHJST and L. chuanxiong delayed the hMSCs aging process by decreasing cell senescence.ConclusionsWe concluded that DHJST and its active component L. chuanxiong are able to promote osteogenic activity and decrease hMSCs senescence as cells age.
Graphical abstract
http://ift.tt/2j9NeNs
Anti-inflammatory and antioxidant effect of modified Bazhengsan in a rat model of chronic bacterial prostatitis
Publication date: 23 February 2017
Source:Journal of Ethnopharmacology, Volume 198
Author(s): Youyi Xiong, Xingtao Qiu, Weijing Shi, Hao Yu, Xiaolin Zhang
Ethnopharmacological relevanceBazhengsan is a commonly used traditional Chinese prescription for the treatment of the urogenital system diseases for thousands of years, which decoction was first described in Prescriptions of the Bureau of Taiping People's Welfare Pharmacy in Song Dynasty.Aim of the studyIn this study, the potential of modified Bazhengsan (mBazhengsan) as a chronic bacterial prostate inflammation inhibitor was investigated in a rat model.Materials and methodsRat prostates were injected with Escherichia coli to induce inflammation by the sterile operation. The decoction of mBazhengsan was administered intragastrically once every day from the seventh day of modeling. After 8 weeks, prostates were lavaged with phosphate buffer saline (PBS) and lavages were collected to use for leukocyte and lecithin body count, and then prostate tissues were removed to detect prostate weight, prostate index and microbiological analyses. Prostate histopathological changes were detected by hematoxylin-eosin (HE) staining and masson staining. Bacterial growth in prostate was evaluated by the numbers of tissue culture colonies. The levels of interleukin (IL)-8, IL-1β and tumor necrosis factor (TNF)-a in serums and secretory immunoglobulin (SIg)-A in prostate fluids as well as the activities of superoxide dismutase (SOD) and glutathione peroxidase (GPx) in prostate tissues were detected by analysis kits.ResultsCompared with model group, treatment with mBazhengsan could significantly inhibit the recruitment of leukocyte to prostate tissues and the deposition of collagen fibers in stromas, suppressed bacterial growth in prostate tissues, decreased the numbers of leukocyte and lecithin body in prostate fluids, lowered prostate index, down-regulated the levels of inflammatory mediators (IL-1β, IL-8 and TNF-a) in serums and up-regulated the levels of SIgA in prostate fluids, and reduced the production of free radical in prostate tissues.ConclusionmBazhengsan can significantly suppress rat prostate inflammation and oxidative stress reaction, showing great therapeutic potential to the chronic bacterial prostatitis.
Graphical abstract
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Effects of Panax notoginseng ginsenoside Rb1 on abnormal hippocampal microenvironment in rats
Publication date: Available online 5 January 2017
Source:Journal of Ethnopharmacology
Author(s): Shiyun Wang, Minghong Li, Ying Guo, Chen Li, Lanou Wu, Xin-Fu Zhou, Yaohui Luo, Dong An, Shude Li, Haiyun Luo, Lijin Pu
Cerebral ischemia damages central neurons, and abnormal microenvironment in ischemic condition is the key factor to the damages. The increase of local concentration of glutamic acid, the overload of Ca2+, and the mitochondrial stress caused by release of cytochrome C are important factors of abnormal microenvironment in cerebral ischemia. In this study ginsenoside Rb1, a compound from Panax Notoginseng, was used to intervene abnormal environment of neurons in the hippocampal CA1 region in two animal models (microperfusion model and photothrombosis model). Results: Compared with the vehical in the sham group, ginsenoside had following effects. a) ginsenoside Rb1 increased the regional cerebral blood flow (rCBF) and the stability of neuronal ultrastructure in in the hippocampal CA1 region and improved the adaptability of neurons in two models. b) ginsenoside Rb1 improved the expression level of glial glutamate transporter1 (GLT-1) and reversed the uptake of glutamate (Glu) after ischemia, and as a result thereby decreased the excitability of Glu and the expression level of GLT-1 was proportional to the dose of ginsenoside Rb1 and similar to that of Nimodipine. c) ginsenoside Rb1 inhibited the expression level of NMDAR and the overload of Ca2+, thereby reducing neuronal damages. Meanwhile, the expression level of NMDAR was inversely proportional to the dose of ginsenoside Rb1, which was similar to that of Nimodipine. d) ginsenoside Rb1 decreased the release of cytochrome C (Cyt-C) and reduced the damages caused by neuronal mitochondrial stress. Meanwhile, the release of Cyt-C was inversely proportional to the dose of ginsenoside Rb1, which was similar to that of Nimodipine.Ginsenoside Rb1 may be as an effective drug for neuroprotection and improve cerebral blood flow after acute ischemia and prevent the secondary brain damage induced by stroke..
http://ift.tt/2j9EWVM
Drug-likeness prediction of chemical constituents isolated from Chinese materia medica Ciwujia
Publication date: Available online 5 January 2017
Source:Journal of Ethnopharmacology
Author(s): Shuai-nan Zhang, Xu-Zhao Li, Xu-yan Yang
Ethnopharmacological relevanceCiwujia (CWJ), one of the most commonly used Chinese materia medicas (CMMs), is derived from the roots, rhizomes, and stems of Acanthopanax senticosus harms (AS). CWJ has been used for the treatment of various central nervous system (CNS) and peripheral system diseases. Drug-likeness prediction can help to analyze the absorption, distribution, metabolism, and excretion (ADME) processes of the compounds in CWJ, as well as their potential therapeutic and toxic effects, which is of significance in the confirmation of the active material bases of CWJ.Materials and methodsThe ADME properties of the compounds were calculated through web based PreADMET program and ACD/I-Lab 2.0. The potential therapeutic and toxicity targets of these compounds were screened by the ChemQuery tool in DrugBank and T3DB.Results14/39 compounds had moderate or good oral bioavailability (OB). 29/39 compounds bound weakly to the plasma proteins. 18/39 compounds might pass across the blood-brain barrier (BBB). Most of these compounds showed low renal excretion ability. 25/39 compounds had 99 structurally similar drugs and 158 potential therapeutic targets. Additionally, 17/39 compounds had 53 structurally similar toxins and 126 potential toxicity targets.ConclusionOur study suggests that these compounds have a certain drug-likeness potentials, which are also likely to be the material bases of CWJ. These results may provide a reference for the safe use of CWJ and the expansion of its application scope.
Graphical abstract
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Audiometric findings with voluntary tensor tympani contraction
Abstract
Background
Tensor tympani contraction may have a "signature" audiogram. This study demonstrates audiometric findings during voluntary tensor tympani contraction.
Methods
Five volunteers possessing the ability to voluntarily contract their tensor tympani muscles were identified and enrolled. Tensor tympani contraction was confirmed with characteristic tympanometry findings. Study subjects underwent conventional audiometry. Air conduction and bone conduction threshold testing was performed with and without voluntary tensor tympani contraction.
Main outcome measure
Changes in air conduction and bone conduction thresholds during voluntary tensor tympani contraction.
Results
Audiometric results demonstrate a low frequency mixed hearing loss resulting from tensor tympani contraction. Specifically, at 250 Hz, air conduction thresholds increased by 22 dB and bone conduction thresholds increased by 10 dB.
Conclusions
Previous research has demonstrated a low frequency conductive hearing loss in the setting of tensor tympanic contraction. This is the first study to demonstrate a low frequency mixed hearing loss associated with tensor tympani contraction. This finding may aid in the diagnosis of disorders resulting from abnormal tensor tympani function. Tensor tympani contraction should be included on the differential for low frequency mixed hearing loss.
http://ift.tt/2j9EruL
Microcystic adnexal carcinoma (MAC)-like squamous cell carcinoma as a differential diagnosis to Bell´s palsy: review of guidelines for refractory facial nerve palsy
Abstract
Background
Bell´s palsy is the most common cause of facial paralysis worldwide and the most common disorder of the cranial nerves. It is a diagnosis of exclusion, accounting for 60–75% of all acquired peripheral facial nerve palsies. Our case shows the first case of a microcystic adnexal carcinoma-like squamous cell carcinoma as a cause of facial nerve palsy.
Case presentation
The patient, a 70-year-old Caucasian male, experienced subsequent functional impairment of the trigeminal and the glossopharyngeal nerve about 1½ years after refractory facial nerve palsy.
An extensive clinical work-up and tissue biopsy of the surrounding parotid gland tissue was not able to determine the cause of the paralysis. Primary infiltration of the facial nerve with subsequent spreading to the trigeminal and glossopharyngeal nerve via neuroanastomoses was suspected. After discussing options with the patient, the main stem of the facial nerve was resected to ascertain the diagnosis of MAC-like squamous cell carcinoma, and radiochemotherapy was subsequently started.
Conclusion
This case report shows that even rare neoplastic etiologies should be considered as a cause of refractory facial nerve palsy and that it is necessary to perform an extended diagnostic work-up to ascertain the diagnosis. This includes high-resolution MRI imaging and, as perilesional parotid biopsies might be inadequate for rare cases like ours, consideration of a direct nerve biopsy to establish the right diagnosis.
http://ift.tt/2hWgUBD
Creating dynamic virtual quarantines using “Pokémon Go” to limit infectious diseases spread
Publication date: Available online 5 January 2017
Source:Medical Hypotheses
Author(s): Martijn R. Tannemaat, N. Ahmad Aziz
http://ift.tt/2hXWtCH
Lack of Eye Discipline During Headers in High School Girls Soccer: A Possible Mechanism for Increased Concussion Rates
Publication date: Available online 5 January 2017
Source:Medical Hypotheses
Author(s): Joseph F. Clark, Hagar T. Elgendy-Peerman, Jon G. Divine, Robert E. Mangine, Kimberly A Hasselfeld, Jane C. Khoury, Angelo J. Colosimo
The sport of soccer is the fastest growing and most popular sport worldwide. With this growth and popularity, attention needs to be given to this athletic population. Sports related concussions is a topic that has gained attention both in the media and by governmental organizations, with growing initiatives in diagnosis, prevention and treatment. The act of soccer heading is thought to contribute to increased concussion incidence. Current evidence reveals that within the high school soccer athletic population, female athletes incur a higher concussion rate than males. This is often attributed to many things including differing cervical spinal musculature, skull thickness, etc., but a definitive reason has not yet been found. Other behaviors, such as field awareness and eye discipline on the field of play, may also be contributing factors that result in females incurring a greater concussion rate than males. For the purposes of this paper we define eye discipline as the ability to keep the eyes engaged in sporting activity with high risk potential.We present our hypothesis that high school female soccer players are more likely to have their eyes closed when in position for heading the ball as compared to high school male soccer players and this lack of visual awareness may increase the risk of concussion. Should these differences be substantiated between males and females, it may initiate and promote discussion of the need for vision training in the high school athletic setting. As a tool for injury prevention, vision training may improve specific visual parameters improving athletes' abilities to process the field of play and prepare for or avoid injury causing situations. Through ocular motor and visual conditioning, an athlete may become more eye disciplined, and more likely to have their eyes open during heading of the ball, and more likely to avoid concussions.
http://ift.tt/2iVYXjf
Prefabricated Flaps: Identification of Microcirculation Structure and Supercharging Technique Improving Survival Area
J reconstr Microsurg
DOI: 10.1055/s-0036-1597896
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Full text
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Complex Orofacial Reconstruction with the Intrinsic Chimeric Flap
J reconstr Microsurg
DOI: 10.1055/s-0036-1597656
Background Ablation of locally advanced or recurrent head and neck cancer often results in large composite orofacial defects with limited recipient vessels. These complex defects lend well to intrinsic chimeric flap reconstruction, which allows greater ability to inset various flap component tissue types than composite flaps and requires only one set of microvascular anastomoses. Methods A retrospective chart review was performed on all patients who underwent orofacial reconstruction with an intrinsic chimeric free flap from 2002 to 2015. Flaps with only one tissue type, such as two separate skin paddles with no additional component, were not considered chimeric flaps and therefore not included in this report. Patient demographic data, defect, and flap characteristics, as well as complications and outcomes were analyzed to create a guide for flap selection. Univariate and multivariate analysis was performed to determine risk factors for flap take-back and failure. Results Seventy-five patients underwent orofacial intrinsic chimeric free flap reconstruction. Results were organized based on defect characteristics to create a guide for flap selection. The number of chimeric flap components and operation duration were independently statistically associated with flap take-backs (p < 0.05). There were two (3%) total and five (7%) partial flap losses. Average follow-up time was 32.7 months. Conclusions Intrinsic chimeric flaps provide a versatile and elegant reconstructive option for a variety of complex orofacial defects. We provide a guide to facilitate decision making in flap selection for these challenging reconstructions and report factors associated with flap take-backs and losses.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
http://ift.tt/2hY0F57
Plantar flexor muscle weakness and fatigue in spastic cerebral palsy patients
Publication date: February 2017
Source:Research in Developmental Disabilities, Volume 61
Author(s): Daria Neyroud, Stéphane Armand, Geraldo De Coulon, Sarah R Dias Da Silva, Nicola A. Maffiuletti, Bengt Kayser, Nicolas Place
BackgroundPatients with cerebral palsy develop an important muscle weakness which might affect the aetiology and extent of exercise-induced neuromuscular fatigue.AimThis study evaluated the aetiology and extent of plantar flexor neuromuscular fatigue in patients with cerebral palsy.MethodsTen patients with cerebral palsy and 10 age- and sex-matched healthy individuals (∼20 years old, 6 females) performed four 30-s maximal isometric plantar flexions interspaced by a resting period of 2–3s to elicit a resting twitch. Maximal voluntary contraction force, voluntary activation level and peak twitch were quantified before and immediately after the fatiguing task.ResultsBefore fatigue, patients with cerebral palsy were weaker than healthy individuals (341±134N vs. 858±151N, p<0.05) and presented lower voluntary activation (73±19% vs. 90±9%, p<0.05) and peak twitch (100±28N vs. 199±33N, p<0.05). Maximal voluntary contraction force was not significantly reduced in patients with cerebral palsy following the fatiguing task (−10±23%, p>0.05), whereas it decreased by 30±12% (p<0.05) in healthy individuals.ConclusionsPlantar flexor muscles of patients with cerebral palsy were weaker than their healthy peers but showed greater fatigue resistance.What this paper addsCerebral palsy is a widely defined pathology that is known to result in muscle weakness. The extent and origin of muscle weakness were the topic of several previous investigations; however some discrepant results were reported in the literature regarding how it might affect the development of exercise-induced neuromuscular fatigue. Importantly, most of the studies interested in the assessment of fatigue in patients with cerebral palsy did so with general questionnaires and reported increased levels of fatigue. Yet, exercise-induced neuromuscular fatigue was quantified in just a few studies and it was found that young patients with cerebral palsy might be more fatigue resistant that their peers. Thus, it appears that (i) conflicting results exist regarding objectively-evaluated fatigue in patients with cerebral palsy and (ii) the mechanisms underlying this muscle fatigue − in comparison to those of healthy peers − remain poorly understood. The present study adds important knowledge to the field as it shows that when young adults with cerebral palsy perform sustained maximal isometric plantar flexions, they appear less fatigable than healthy peers. This difference can be ascribed to a better preservation of the neural drive to the muscle. We suggest that the inability to drive their muscles maximally accounts for the lower extent of exercise-induced neuromuscular fatigue in patients with cerebral palsy.
http://ift.tt/2iNuVB6
Systematic review of field-based physical fitness tests for children and adolescents with intellectual disabilities
Publication date: February 2017
Source:Research in Developmental Disabilities, Volume 61
Author(s): Marieke Wouters, Heleen M. Evenhuis, Thessa I.M. Hilgenkamp
BackgroundTesting physical fitness in children and adolescents with intellectual disabilities (ID) can be challenging. This review provides an overview on psychometric properties of field-based physical fitness tests studied in children and adolescents with ID.MethodsA literature search was performed in March 2014. Studies were included if they evaluated feasibility, reliability and/or validity of a field-based physical fitness test in children and adolescents with ID.ResultsTwenty-six papers met the inclusion criteria and described 18 tests on body composition (4), muscular strength (4), muscular endurance (6), and cardiorespiratory fitness (4). Best results on feasibility, reliability and/or validity were found for bioelectric impedance analysis, body mass index, grip strength, arm hang and distance run/walk tests. These results were mainly found in adolescents with mild to moderate ID.ConclusionSome tests were found feasible, reliable and/or valid in subgroups of children and adolescents with ID, but not in children and adolescents with all ages and levels of ID. Further assessment is needed before wider application in all children and adolescents with ID.
http://ift.tt/2iJz6eI
Participation of adults with visual and severe or profound intellectual disabilities: Definition and operationalization
Publication date: February 2017
Source:Research in Developmental Disabilities, Volume 61
Author(s): Gineke Hanzen, Ruth M.A. van Nispen, Annette A.J. van der Putten, Aly Waninge
BackgroundThe available opinions regarding participation do not appear to be applicable to adults with visual and severe or profound intellectual disabilities (VSPID). Because a clear definition and operationalization are lacking, it is difficult for support professionals to give meaning to participation for adults with VSPID.AimsThe purpose of the present study was to develop a definition and operationalization of the concept of participation of adults with VSPID.MethodsParents or family members, professionals, and experts participated in an online concept mapping procedure. This procedure includes generating statements, clustering them, and rating their importance. The data were analyzed quantitatively using multidimensional scaling and qualitatively with triangulation.ResultsA total of 53 participants generated 319 statements of which 125 were clustered and rated. The final cluster map of the statements contained seven clusters: (1) Experience and discover; (2) Inclusion; (3) Involvement; (4) Leisure and recreation; (5) Communication and being understood; (6) Social relations; and (7) Self-management and autonomy. The average importance rating of the statements varied from 6.49 to 8.95. A definition of participation of this population was developed which included these seven clusters.ConclusionsThe combination of the developed definition, the clusters, and the statements in these clusters, derived from the perceptions of parents or family members, professionals, and experts, can be employed to operationalize the construct of participation of adults with VSPID. This operationalization supports professionals in their ability to give meaning to participation in these adults. Future research will focus on using the operationalization as a checklist of participation for adults with VSPID.
http://ift.tt/2iNxtiC
Cognitive profiles of adults with high-functioning autism spectrum disorder and those with attention-deficit/hyperactivity disorder based on the WAIS-III
Publication date: February 2017
Source:Research in Developmental Disabilities, Volume 61
Author(s): Chieko Kanai, Ryuichiro Hashimoto, Takashi Itahashi, Masayuki Tani, Takashi Yamada, Haruhisa Ota, Akira Iwanami, Nobumasa Kato
The cognitive profile differences between adult patients with autism spectrum disorder (ASD) and those with attention-deficit/hyperactivity disorder (ADHD) are not well characterized. We examined the cognitive profiles of adults having either ASD (n=120) or ADHD (n=76) with no intellectual disabilities (IQ≥70) using the Wechsler Intelligence Scale III (WAIS-III). Verbal Intelligence (VIQ) − Performance Intelligence (PIQ) difference discrepancies were detected between the two groups. Information subtest scores of the Verbal Comprehension index and Arithmetic and Digit Span subtests of the Freedom from Distractibility index were significantly higher in ASD than in ADHD, while the Picture Completion subtest was significantly lower in ASD. To our knowledge, this is the first study to evaluate the difference in the cognitive profiles of adults with ASD and those with ADHD based on the WAIS III with a large number of participants.
http://ift.tt/2iJyyFO
European Breast Cancer Conference manifesto on breast centres/units
Publication date: February 2017
Source:European Journal of Cancer, Volume 72
Author(s): Fatima Cardoso, Luigi Cataliotti, Alberto Costa, Susan Knox, Lorenza Marotti, Emiel Rutgers, Marc Beishon
Manifesto—CALL TO ACTION• The 2016 deadline for all patients in European Union countries to access specialist, multidisciplinary breast cancer units or centres, will be missed by most countries, despite numerous resolutions and declarations issued since the year 2000 that have called for universal specialist services. This means that many women, and some men, do not receive optimal breast cancer care in Europe.• We call on policymakers and politicians to ensure, as soon as possible, that all women and men with breast cancer in Europe are treated in a specialist breast unit.To do this, we ask that policymakers and politicians, together with healthcare professionals and patient advocates:- Promote, in public and professional settings, the evidence that breast units staffed with specialist multidisciplinary teams deliver superior care and quality of life to women and men with breast cancer.- Acknowledge the evidence that treatment in multidisciplinary units lead to overall cost savings as well as higher quality of care.- Audit the current national provision of breast cancer care using accredited auditors.- Implement mandatory reimbursement and care models that mean treatment can only be carried out in specialist breast units.- Introduce a breast unit quality certification scheme that is accredited by an accreditation body.- Join European-wide scientific societies and groups that promote the availability and quality of breast units, and together commit to providing access to such units for all patients.
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