Head and Neck Diseases by Alexandros G.Sfakianakis: 01/11/17

Τετάρτη 11 Ιανουαρίου 2017

PROTON PUMP INHIBITION AND CANCER THERAPEUTICS; A SPECIFIC TUMOR TARGETING OR IT IS A PHENOMENON SECONDARY TO A SYSTEMIC BUFFERING?

Publication date: Available online 11 January 2017
Source:Seminars in Cancer Biology
Author(s): Enrico Spugnini, Stefano Fais
One of the unsolved mysteries in oncology includes the strategies that cancer cells adopt to cope with an adverse microenvironment. However, we knew, from the Warburg's discovery that through their metabolism based on sugar fermentation, cancer cells acidify their microenvironment and this progressive acidification induces a selective pressure, leading to the development of very malignant cells entirely armed to survive in the hostile microenvironment generated by their own metabolism. In the last decades a primordial role for proton exchangers has been supported as a key tumor advantage in facing off the acidic milieu. Proton exchangers do not allow intracellular acidification through a continuous elimination of H+ either outside the cells or within the internal vacuoles. This article wants to comment a translational process through that led to the preclinical demonstration that a class of proton pump inhibitors (PPI) exploited worldwide for peptic ulcer treatment and gastroprotection are indeed powerful chemosensitizers as well. In this process we achieved the clinical proof of concept that PPI may well be included in new anti-cancer strategies with a solid background and rationale.

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Environmental carcinogenesis and pH homeostasis: not only a matter of dysregulated metabolism

Publication date: Available online 11 January 2017
Source:Seminars in Cancer Biology
Author(s): Kévin Hardonniere, Laurence Huc, Odile Sergent, Jørn A. Holme, Dominique Lagadic-Gossmann
According to the World Health Organization, around 20% of all cancers would be due to environmental factors. Among these factors, several chemicals are indeed well recognized carcinogens. The widespread contaminant benzo[a]pyrene (B[a]P), an often used model carcinogen of the polycyclic aromatic hydrocarbons' family, has been suggested to target most, if not all, cancer hallmarks described by Hanahan and Weinberg. It is classified as a group I carcinogen by the International Agency for Research on Cancer; however, the precise intracellular mechanisms underlying its carcinogenic properties remain yet to be thoroughly defined. Recently, the pH homeostasis, a well known regulator of carcinogenic processes, was suggested to be a key actor in both cell death and Warburg-like metabolic reprogramming induced upon B[a]P exposure. The present review will highlight those data with the aim of favoring research on the role of H⁺ dynamics in environmental carcinogenesis.

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Thoracic Epidural Anesthesia and Prophylactic Three Times Daily Unfractionated Heparin Within an Enhanced Recovery After Surgery Pathway for Colorectal Surgery.

Background and Objectives: Venous thromboembolism (VTE) is a common cause of preventable harm. Perioperative thoracic epidural analgesia (TEA) presents a challenge to optimal VTE prophylaxis. Our primary aim was to characterize missed doses of VTE prophylaxis associated with epidural catheter placement and removal. Our secondary aim was to measure the effect of an enhanced recovery after surgery (ERAS) pathway on the rate of TEA-associated missed VTE prophylaxis. Methods: We retrospectively reviewed a prospectively collected database of 1264 colorectal surgery patients at a single academic center. Missed preoperative doses between TEA patients and non-TEA patients were compared. Missed postoperative unfractionated heparin (UFH) doses associated with epidural removal were compared before and after implementation of an ERAS program. Other data collected included demographic data, surgical indication, and thrombohemorrhagic complications. Results: Of the 445 TEA patients, 12.6% missed their preoperative heparin doses compared with 8.4% of patients without epidurals (P = 0.017). Of the TEA patients prescribed 3 times daily UFH, 22.5% missed one or more doses associated with epidural removal. The percent of patients missing at least one dose of UFH on epidural removal dropped from 28.1% before ERAS to 17.9% after the ERAS program (P = 0.023). Seven patients developed VTEs. There were zero epidural hematomas. Conclusions: Thoracic epidural analgesia was associated with a 1.5-fold increased risk of missed dose of preoperative VTE prophylaxis, which was not affected by implementation of an ERAS program. The implementation of an ERAS program reduced missed doses associated with epidural removal. This study highlights the challenge posed by providing VTE prophylaxis in the setting of perioperative neuraxial analgesia. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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Incidence of Local Anesthetic Systemic Toxicity in Orthopedic Patients Receiving Peripheral Nerve Blocks.

Background and Objectives: Peripheral nerve blocks are increasingly used. However, despite low complication rates, concerns regarding local anesthetic systemic toxicity remain. Although recent studies suggest that this severe complication has decreased considerably, there is a paucity of data about it on a national level. We sought to elucidate the incidence of local anesthetic systemic toxicity on a national level and therefore provide guidance toward the need for preparedness in daily anesthetic practice. Methods: We searched a large administrative database for patients who received peripheral nerve blocks for total joint arthroplasties from 2006 to 2014. Their discharge and billing data were analyzed for International Classification of Diseases, Ninth Revision, Clinical Modification codes coding for local anesthetic systemic toxicity or surrogate outcomes including cardiac arrest, seizures, and use of lipid emulsion on the day of surgery. Rates for these outcomes were determined cumulatively and over time. Results: We identified 238,473 patients who received a peripheral nerve block within the study period. The cumulative rate of outcomes among these patients in the study period was 0.18%. There was a significant decrease of overall outcome rates between 2006 and 2014. Use of lipid emulsion on the day of surgery increased significantly in total knee replacement from 0.02% 2006 to 0.26% in 2014. Conclusions: The incidence of local anesthetic systemic toxicity is low but should be considered clinically significant. Since it may cause substantial harm to the patient, appropriate resources and awareness to identify and treat local anesthetic systemic toxicity should be available wherever regional anesthesia is performed. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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"A Tale of Two Planes": Deep Versus Superficial Serratus Plane Block for Postmastectomy Pain Syndrome.

Introduction: Postmastectomy pain syndrome (PMPS) is a significant burden for breast cancer survivors. Although multiple therapies have been described, an evolving field of serratus anterior plane blocks has been described in this population. We describe the addition of the deep serratus anterior plane block (DSPB) for PMPS. Methods: Four patients with history of PMPS underwent DSPB for anterior chest wall pain. A retrospective review of these patients' outcomes was obtained through postprocedure interviews. Results: Three of the patients previously had a superficial serratus anterior plane block, which was not as efficacious as the DSPB. The fourth patient had a superficial serratus anterior plane that was difficult to separate with hydrodissection but had improved pain control with a DSPB. Conclusions: We illustrate 4 patients who have benefitted from a DSPB and describe indications that this block may be more efficacious than a superficial serratus plane block. Further study is recommended to understand the intercostal nerve branches within the lateral and anterior muscular chest wall planes. Copyright (C) 2017 by American Society of Regional Anesthesia and Pain Medicine.

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Long term neurobehavioral symptoms and return to productivity in Operation Enduring Freedom/Operation Iraqi Freedom Veterans with and without traumatic brain injury

Publication date: Available online 11 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Marianne H. Mortera, Stacy A. Kinirons, Jessie Simantov, Heidi Klingbeil
ObjectivesTo describe Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans who underwent the Comprehensive Traumatic Brain Injury Evaluation (CTBIE), differences between the traumatic brain injury (TBI) and non- traumatic brain injury (non-TBI) subgroups, and factors associated with return to productivity (RTP).DesignRetrospective medical record review.SettingVeterans Affairs Medical Center, Polytrauma/TBI Network Site.ParticipantsMedical records of 236 OEF/OIF Veterans who underwent the CTBIE between 2009-2013.InterventionsNot applicable.Main Outcome MeasuresDemographic characteristics, injury history, clinical presentation, and factors associated with RTP.ResultsVeterans (n=236) were male (90.7%), White (45.3%) or Black (34.7%), with half of Hispanic origin, and a mean age of 33 years. The mean time since injury was approximately 4 years. Reported symptoms were high, with greater than 90% reporting anxiousness, irritability, sleep difficulty, forgetfulness, and headaches.TBI diagnosis was found in 163 (69%) Veterans. The TBI subgroup was younger (TBI 32.5 years versus non-TBI 34.9 years, p=0.02), reported a greater number of injuries (p= 0.000), and had significantly higher rates of half of the reported symptoms. Greatest differences were noted with forgetfulness (TBI 95.7% versus non-TBI 79.5%, p=0.000), poor concentration (TBI 90.2% versus non-TBI 76.7%, p=0.007), and headaches (TBI 93.9% versus non-TBI 83.6%, p=0.014).RTP was 60.6% for the total Veteran population. Factors associated with RTP were race (white) (OR=2.00; 95%CI:1.13-3.55, p=0.018), sensitivity to light (OR=2.58; 95%CI:1.17-5.66, p=0.018), and fatigue (OR=3.68; 95%CI:1.51-8.95, p=0.004). Veterans that did RTP wessre three times less likely to report depression (OR=0.323; 95%CI:0.12-.85, p=0.022).ConclusionsVeterans reported a substantial number of lingering symptoms, with a higher prevalence in Veterans with TBI. Veterans with reported depression were less likely to RTP. Future research should focus on the relationship between depression and non-RTP and the effectiveness of VA services.

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Functional Electrical Stimulation for foot drop in Multiple Sclerosis: A Systematic Review and Meta-Analysis of the impact on gait speed

Publication date: Available online 11 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Linda Miller, Angus McFadyen, Anna C. Lord, Rebecca Hunter, Lorna Paul, Danny Rafferty, Roy Bowers, Paul Mattison
ObjectiveTo review the efficacy of functional electrical stimulation (FES) used for foot drop in people with multiple sclerosis (pwMS) on gait speed in short and long walking performance tests.Data sourcesFive databases (Cochrane Library, CINAHL, Embase, MEDLINE, Pubmed) and reference lists were searched.Study selectionStudies of both observational and experimental design where gait speed data in pwMS could be extracted were included.Data extractionData were independently extracted and recorded. Methodological quality was assessed using the Effective Public Health Practice Project (EPHPP) tool.Data synthesisNineteen studies (described in 20 articles) recruiting 490 pwMS were identified and rated moderate or weak, with none gaining a strong rating. All studies rated weak for blinding. Initial and ongoing orthotic and therapeutic effects were assessed with regards to the impact of FES on gait speed in short and long walking tests. Meta-analyses of the short walk tests revealed a significant initial orthotic effect (t = 2.14, p = 0.016) with a mean increase in gait speed of 0.05 meters per second (m/s) and ongoing orthotic effect (t = 2.81, p = 0.003) with a mean increase of 0.08m/s. There were no initial or ongoing effect on gait speed in long walk tests and no therapeutic effect on gait speed in either short or long walk tests.ConclusionsFES used for foot drop has a positive initial and ongoing effect on gait speed in short walking tests. Further fully-powered randomized controlled trials comparing FES with alternative treatments are required.

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Aquatic Exercise Therapy for People with Parkinson’s disease: a Randomized Controlled Trial

Publication date: Available online 12 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Louise M. Carroll, Daniele Volpe, Meg E. Morris, Jean Saunders, Amanda M. Clifford
ObjectiveTo evaluate the effects of aquatic exercise therapy on gait variability and disability compared to usual care for people with Parkinson's disease (PD).DesignSingle-blind randomized control trial (RCT).SettingA community based hydrotherapy pool in Ireland.ParticipantsTwenty one individuals with PD (Hoehn-Yahr Stages I-III).InterventionsParticipants were randomly assigned to either an aquatic exercise therapy group (45 minutes, twice a week for 6 weeks) or a control group that received usual care.Main Outcome Measure(s)The primary outcome measure was gait variability as measured using a Coda CX1 motion capture system. Secondary outcomes were quality of life measured on the Parkinson's Disease Questionnaire-39, freezing of gait and motor disability quantified by the Unified Parkinson Disease Rating Scale (UPDRS III). Feasibility was evaluated by measuring safety, adverse events and participant satisfaction.ResultsPeople in the aquatic therapy group and control group showed similar small improvements in gait variability. The aquatic therapy group showed greater improvements in disability than the control group (P<0.01). No differences between groups or over time were identified for freezing of gait or quality of life. Aquatic therapy sessions were safe and enjoyable with no adverse events.ConclusionsAquatic therapy appears feasible and safe for some people in the early stages of Parkinson's disease.

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LN2, CD10, and Ezrin Do Not Distinguish Between Atypical Fibroxanthoma and Undifferentiated Pleomorphic Sarcoma or Predict Clinical Outcome.

BACKGROUND: Atypical fibroxanthoma (AFX) is a rare cutaneous spindled cell neoplasm. For both diagnostic and therapeutic purposes, it is important to distinguish AFX from other poorly differentiated tumors, including undifferentiated pleomorphic sarcoma (UPS). OBJECTIVE: The authors aimed to identify the clinical, histologic, and immunohistochemical expression of LN2, ezrin, and CD10 in AFX and UPS tumors. METHODS AND MATERIALS: The authors retrospectively examined the charts of patients with AFX and UPS treated with Mohs micrographic surgery (MMS) at 2 academic institutions. Patient demographics, tumor characteristics, and clinical course data were collected. Immunohistochemical stains were performed on primary and recurrent AFX and UPS tumors with monoclonal antibodies against the B-cell marker LN2 (CD74), CD10, and ezrin. RESULTS: In the series of 169 patients with AFX included in this study, local recurrence was rare at 3%. In contrast, the seven patients with UPS had an aggressive clinical course with 1 local recurrence and 2 distant metastases. Immunohistochemistry staining for ezrin, LN2, and CD10 were similar in AFX and UPS tumors. CONCLUSION: AFX can be treated with MMS with rare instances of recurrence. Undifferentiated pleomorphic sarcoma has a more aggressive clinical course with increased risk for recurrence and metastasis. Staining with ezrin, LN2, and CD10 did not differentiate AFX or UPS tumors. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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The Effect of Waxing Versus Shaving on the Efficacy of Laser Hair Removal.

BACKGROUND: Excessive hair is undesirable and represents both a social and emotional burden, especially among females. Laser hair removal (LHR) has gained popularity in the past 2 decades. It is a common practice to instruct patients not to pluck or wax their hair before undergoing LHR; only shaving is allowed to improve the efficacy of the LHR. OBJECTIVE: To compare the percentage of hair reduction in preshaved versus prewax epilated axillae after LHR in healthy adult Saudi females. METHODS AND MATERIALS: This study is a quantitative experimental pilot clinical trial. Twenty female volunteers were enrolled into this study; all underwent 3 laser sessions using a long-pulsed alexandrite laser. Their left axilla was prewaxed and right axilla was preshaved immediately before laser treatment. Hair was counted manually before and 6 months after the third laser session. RESULTS: The right and left axillae both showed significant hair reduction, between the first session and the hair count 6 months after the third laser session. However, there was no statistically significant difference between these 2 means (p = .44). CONCLUSION: There is no statistical difference in hair reduction after LHR whether the area is preshaved or prewax epilated. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Batten Stitch: A Tissue-Sparing Technique for Correction of an Inverted Dog-Ear.

No abstract available

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Comparison of the American Joint Committee on Cancer Seventh Edition and Brigham and Women's Hospital Cutaneous Squamous Cell Carcinoma Tumor Staging in Immunosuppressed Patients.

BACKGROUND: The American Joint Committee on Cancer 7th edition (AJCC-7) and Brigham and Women's Hospital (BWH) staging criteria for cutaneous squamous cell carcinoma (cSCC) have not been validated in immunosuppressed patients. OBJECTIVE: To compare the AJCC-7 and BWH staging systems for cSCCs in immunosuppressed patients. METHODS AND MATERIALS: A single-institution retrospective cohort study of cSCCs in immunosuppressed patients. Risks of local recurrence (LR), nodal metastasis (NM), in-transit metastasis, and any poor outcome (PO) were compared among AJCC-7 and BWH tumor T stages. RESULTS: One hundred six patients had 412 primary invasive cSCCs. Eighty-five percent were AJCC-7 T1, and 15% T2. Risks of NM and PO for AJCC-7 T1 versus T2 were 0.9% versus 5% and 12.8% versus 23.3%, respectively, p

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Reconstruction of a Postoperative Mohs Defect of the Upper Cutaneous and Vermilion Lip Involving Cupid's Bow.

No abstract available

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The reconstructive options for oropharyngeal defects in the transoral robotic surgery framework

Publication date: Available online 11 January 2017
Source:Oral Oncology
Author(s): Giuseppe Meccariello, Filippo Montevecchi, Rossella Sgarzani, Andrea De Vito, Giovanni D'Agostino, Riccardo Gobbi, Chiara Bellini, Claudio Vicini
Transoral robotic surgery (TORS) is a fascinating new technique that has been proved to be a safe and feasible for selected oropharyngeal cancers. Furthermore, TORS offers several advantages in the treatment of locoregionally advanced cancers. Nevertheless, the careful selection of patients is the keypoint for a successful application of this therapeutic modality. However, the reconstruction of large oropharyngeal defects is challenging due to the restoration of velopharyngeal competency and swallowing. Moreover, the absence of mandibular splitting increases the difficulties faced by reconstructive surgeons. The paradigm for oropharyngeal reconstruction has undergone changes reflecting the overall change in the trend of the treatment alternatives over the last few decades. The flap choice and harvesting should be tailored in order to obtain significant advantages both in terms of function and should be easy to inset. In this review, we analysed the strengths and weaknesses of the various flaps used in the TORS framework.

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Commentary on: "Evaluation of variations in sinonasal region with computed tomography".

Commentary on: "Evaluation of variations in sinonasal region with computed tomography".

World J Radiol. 2016 Dec 28;8(12):933-934

Authors: Çağıcı CA

Abstract
This letter is a commentary on the article titled "Evaluation of variations in sinonasal region with computed tomography", published in the January 2016 issue of World Journal of Radiology. The authors definition of the secondary middle turbinate is incorrect. The authors stated that the secondary middle turbinate is an accessory turbinate that is seen between the superior and middle turbinates. It should originate from the middle meatus posterosuperior to the ethmoid infundibulum.

PMID: 28070246 [PubMed - in process]

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Horizontally root fractured teeth with pulpal vitality - two case reports.

Horizontally root fractured teeth with pulpal vitality - two case reports.

World J Radiol. 2016 Dec 28;8(12):928-932

Authors: Silva L, Álvares P, Arruda JA, Silva LV, Rodrigues C, Sobral AP, Silveira M

Abstract
This case study reports the successful outcome of horizontal root fractures of two different patients, which took place in permanent incisors. Report 1 describes a case of a 29-year-old patient who suffered a mandibular trauma affecting mainly the lower central incisors, caused by a car accident. A panoramic radiograph was taken right after the accident and showed a horizontal root fracture in the middle third of tooth 42, which went untreated. Report 2 illustrates a case of a 17-year-old male patient who searched for orthodontic therapy and the periapical radiograph showed horizontal root fracture in tooth 11 caused by a previous trauma, which went untreated as well. There was healing through the reestablishment of pulp activity and dental coloration without professional intervention.

PMID: 28070245 [PubMed - in process]

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Assessment of fetus during second trimester ultrasonography using HDlive software: What is its real application in the obstetrics clinical practice?

Assessment of fetus during second trimester ultrasonography using HDlive software: What is its real application in the obstetrics clinical practice?

World J Radiol. 2016 Dec 28;8(12):922-927

Authors: Tonni G, Grisolia G, Santana EF, Júnior EA

Abstract
AIM: To show imaging results from application of four-dimensional (4D) ultrasound lightening technique (HDlive™) in clinical obstetrics practice.
METHODS: Normal and abnormal fetuses at second and third trimester of pregnancy undergoing routine scan with 4D HDlive™ (5DUS) in the rendering mode are described. Realistic features of fetal structures were provided by 5DUS in the rendering mode. Normal anatomy as well as pathology like cleft lip, hypoplastic face, micrognathia, low-set ears, corpus callosum, arthrogryposis, aortic arch, left congenital diaphragmatic hernia are highlighted in this study. Anatomical details of the fetuses were provided by 5DUS with higher quality imaging modality compared to those obtained using conventional 2D/3D ultrasound.
RESULTS: Realistic views of fetal anatomy details were displayed by means of 5DUS in the rendering mode, with high image quality obtained either in low-risk or in high-risk obstetrics population. Corpus callosum, esophagus, and aortic arch were obtained in normal fetuses. Cleft lip, cleft lip and palate, micrognathia, hypoplastic face, low-set ears, arthrogryposis, left congenital diaphragmatic hernia, exomphalos, and clitoris hypertrophy were clearly rendered by 5DUS application.
CONCLUSION: The use of 5DUS in the rendering mode, when clinical available, was diagnostic in a variety of congenital anomalies, aided understanding of the parents-to-be and improved prenatal counseling and perinatal management.

PMID: 28070244 [PubMed - in process]

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Value of serial magnetic resonance imaging in the assessment of brain metastases volume control during stereotactic radiosurgery.

Value of serial magnetic resonance imaging in the assessment of brain metastases volume control during stereotactic radiosurgery.

World J Radiol. 2016 Dec 28;8(12):916-921

Authors: Sparacia G, Agnello F, Banco A, Bencivinni F, Anastasi A, Giordano G, Taibbi A, Galia M, Bartolotta TV

Abstract
AIM: To evaluate brain metastases volume control capabilities of stereotactic radiosurgery (SRS) through serial magnetic resonance (MR) imaging follow-up.
METHODS: MR examinations of 54 brain metastases in 31 patients before and after SRS were reviewed. Patients were included in this study if they had a pre-treatment MR examination and serial follow-up MR examinations at 6 wk, 9 wk, 12 wk, and 12 mo after SRS. The metastasis volume change was categorized at each follow-up as increased (> 20% of the initial volume), stable (± 20% of the initial volume) or decreased (< 20% of the initial volume).
RESULTS: A local tumor control with a significant (P < 0.05) volume decrease was observed in 25 metastases at 6-wk follow-up. Not significant volume change was observed in 23 metastases and a significant volume increase was observed in 6 metastases. At 9-wk follow-up, 15 out of 25 metastases that decreased in size at 6 wk had a transient tumor volume increase, followed by tumor regression at 12 wk. At 12-wk follow-up there was a significant reduction in volume in 45 metastases, and a significant volume increase in 4 metastases. At 12-mo follow-up, 19 metastases increased significantly in size (up to 41% of the initial volume). Volume tumor reduction was correlated to histopathologic subtype.
CONCLUSION: SRS provided an effective local brain metastases volume control that was demonstrated at follow-up MR imaging.

PMID: 28070243 [PubMed - in process]

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Computed tomography and patient risk: Facts, perceptions and uncertainties.

Computed tomography and patient risk: Facts, perceptions and uncertainties.

World J Radiol. 2016 Dec 28;8(12):902-915

Authors: Power SP, Moloney F, Twomey M, James K, O'Connor OJ, Maher MM

Abstract
Since its introduction in the 1970s, computed tomography (CT) has revolutionized diagnostic decision-making. One of the major concerns associated with the widespread use of CT is the associated increased radiation exposure incurred by patients. The link between ionizing radiation and the subsequent development of neoplasia has been largely based on extrapolating data from studies of survivors of the atomic bombs dropped in Japan in 1945 and on assessments of the increased relative risk of neoplasia in those occupationally exposed to radiation within the nuclear industry. However, the association between exposure to low-dose radiation from diagnostic imaging examinations and oncogenesis remains unclear. With improved technology, significant advances have already been achieved with regards to radiation dose reduction. There are several dose optimization strategies available that may be readily employed including omitting unnecessary images at the ends of acquired series, minimizing the number of phases acquired, and the use of automated exposure control as opposed to fixed tube current techniques. In addition, new image reconstruction techniques that reduce radiation dose have been developed in recent years with promising results. These techniques use iterative reconstruction algorithms to attain diagnostic quality images with reduced image noise at lower radiation doses.

PMID: 28070242 [PubMed - in process]

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The emotive nature of conflict monitoring in the medial prefrontal cortex

Publication date: Available online 11 January 2017
Source:International Journal of Psychophysiology
Author(s): Blair Saunders, Hause Lin, Marina Milyavskaya, Michael Inzlicht
The detection of conflict between incompatible impulses, thoughts, and actions is a ubiquitous source of motivation across theories of goal-directed action. In this overview, we explore the hypothesis that conflict is emotive, integrating perspectives from affective science and cognitive neuroscience. Initially, we review evidence suggesting that the mental and biological processes that monitor for information processing conflict—particularly those generated by the anterior midcingulate cortex—track the affective significance of conflict and use this signal to motivate increased control. In this sense, variation in control resembles a form of affect regulation in which control implementation counteracts the aversive experience of conflict. We also highlight emerging evidence proposing that states and dispositions associated with acceptance facilitate control by tuning individuals to the emotive nature of conflict, before proposing avenues for future research, including investigating the role of affect in reinforcement learning and decision making.

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A current perspective on the oncopreventive and oncolytic properties of selective serotonin reuptake inhibitors

Publication date: March 2017
Source:Biomedicine & Pharmacotherapy, Volume 87
Author(s): Daniel P. Radin, Parth Patel
Current cancer research strongly focuses on identifying novel pathways that can be selectively exploited in the clinic and identifying drugs capable of exploiting cancer vulnerabilities. Occasionally, drugs identified to exploit a cancer-specific vulnerability are on the market for clinical indications in another disease area. Rebranding them as anti-cancer drugs is a process commonly referred to as drug repurposing and is typically a faster method than bringing a novel drug to market. Selective serotonin reuptake inhibitors (SSRIs) are primarily used for treating several types of depression, but over the past two decades mounting evidence suggests that drugs in this class have oncolytic properties and reduce the risk of certain cancers. In the current work, we discuss how the secondary mechanisms of action associated with these drugs mediate their oncolytic effect. In particular, sertraline limits tumor growth by abrogating the PI3K/akt signaling pathway, a growth pathway shown to be constitutively active in multiple cancers. Fluoxetine has been shown to activate the AMPA-type glutamate receptor, induce massive calcium influx and mitochondrial calcium overload and induce caspase-9-dependent apoptosis. This receptor being highly overexpressed in cancer stem cells may explain why SSRIs lower the risk of multiple types of cancer. Fluoxetine has also been shown to inhibit multidrug resistance pumps, increasing the efficacy of several standard chemotherapies. Given the vast potential of SSRIs in treating cancer, these drugs should be more heavily used not only in treating cancer-related depression, but in combating cancer and increasing the efficacy of standard of care chemotherapies.

http://ift.tt/2iJ7JAL

Commentary on: "Evaluation of variations in sinonasal region with computed tomography".

Commentary on: "Evaluation of variations in sinonasal region with computed tomography".

World J Radiol. 2016 Dec 28;8(12):933-934

Authors: Çağıcı CA

PMID: 28070246 [PubMed - in process]

http://ift.tt/2iJ68e8

Horizontally root fractured teeth with pulpal vitality - two case reports.

Horizontally root fractured teeth with pulpal vitality - two case reports.

World J Radiol. 2016 Dec 28;8(12):928-932

Authors: Silva L, Álvares P, Arruda JA, Silva LV, Rodrigues C, Sobral AP, Silveira M

PMID: 28070245 [PubMed - in process]

http://ift.tt/2iIZKDX

Assessment of fetus during second trimester ultrasonography using HDlive software: What is its real application in the obstetrics clinical practice?

Assessment of fetus during second trimester ultrasonography using HDlive software: What is its real application in the obstetrics clinical practice?

World J Radiol. 2016 Dec 28;8(12):922-927

Authors: Tonni G, Grisolia G, Santana EF, Júnior EA

PMID: 28070244 [PubMed - in process]

http://ift.tt/2iIWVT4

Value of serial magnetic resonance imaging in the assessment of brain metastases volume control during stereotactic radiosurgery.

Value of serial magnetic resonance imaging in the assessment of brain metastases volume control during stereotactic radiosurgery.

World J Radiol. 2016 Dec 28;8(12):916-921

Authors: Sparacia G, Agnello F, Banco A, Bencivinni F, Anastasi A, Giordano G, Taibbi A, Galia M, Bartolotta TV

PMID: 28070243 [PubMed - in process]

http://ift.tt/2iJ2rVH

Computed tomography and patient risk: Facts, perceptions and uncertainties.

Computed tomography and patient risk: Facts, perceptions and uncertainties.

World J Radiol. 2016 Dec 28;8(12):902-915

Authors: Power SP, Moloney F, Twomey M, James K, O'Connor OJ, Maher MM

PMID: 28070242 [PubMed - in process]

http://ift.tt/2iJ01Xl

Exosome-SIRPα, a CD47 blockade increases cancer cell phagocytosis

Publication date: March 2017
Source:Biomaterials, Volume 121
Author(s): Eunee Koh, Eun Jung Lee, Gi-Hoon Nam, Yeonsun Hong, Eunji Cho, Yoosoo Yang, In-San Kim
CD47, a "don't eat me" signal, is over-expressed on the surface of most tumors that interacts with signal regulatory protein α (SIRPα) on phagocytic cells. By engaging SIRPα, CD47 limits the ability of macrophages to engulf tumor cells, which acts as a major phagocytic barrier. In this study, we developed an exosome-based immune checkpoint blockade that antagonizes the interaction between CD47 and SIRPα. These exosomes harboring SIRPα variants (SIRPα-exosomes) were sufficient to induce remarkably augmented tumor phagocytosis, lead to prime effective anti-tumor T cell response. Given that clustering of native CD47 provides a high binding avidity to ligate dimerized SIRPα on macrophage, nature-derived exosomes could be appreciable platform to antagonize CD47. Disruption of CD47-SIRPα interaction by SIRPα-exosomes leads to an increase in cells being engulfed by macrophages and a concomitant inhibition of tumor growth in tumor-bearing mice. Moreover, SIRPα-exosomes therapy promotes an intensive T cell infiltration in syngeneic mouse models of cancer, raising the possibility of CD47-targeted therapies to unleash both an innate and adaptive anti-tumor response. Note that very small amount of exosomal SIRPα proteins could effectively lead to phagocytic elimination of tumor cells both in vitro and in vivo. Our results suggest that superlative exosome-based platform has broad potential to maximize the therapeutic efficacy of membrane-associated protein therapeutics.

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Engineered gadolinium-doped carbon dots for magnetic resonance imaging-guided radiotherapy of tumors

Publication date: March 2017
Source:Biomaterials, Volume 121
Author(s): Fengyi Du, Lirong Zhang, Li Zhang, Miaomiao Zhang, Aihua Gong, Youwen Tan, Jiawen Miao, Yuhua Gong, Mingzhong Sun, Huixiang Ju, Chaoyang Wu, Shenqiang Zou
The effectiveness of radiotherapy can decrease due to inaccurate positioning of machinery and inherent radioresistance of tumors. To address this issue, we present a novel theranostic nanoplatform based on gadolinium-doped carbon dots (Gd-doped CDs) designed specifically for magnetic resonance imaging (MRI)-guided radiotherapy of tumors. The Gd-doped CDs (∼18 nm) with dispersibility in water and stable photoluminescence were synthesized via a one-step hydrothermal approach. After tail vein injection of the Gd-doped CDs, they exhibited a relatively long circulation time (∼6 h), enabled efficient passive tumor targeting. Gd-doped CDs accumulate in the kidney and could be cleared out of the body from bladder. Importantly, they exhibited favorable biocompatibility with excellent performance in longitudinal relaxivity rate (r1) of 6.45 mM⁻¹S⁻¹ and radiosensitization enhancements. These results show that Gd-doped CDs are excellent T1 contrast agents and radiosensitizers, possessing great promise for MRI-guided radiotherapy of tumors.

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Editorial board

Publication date: March 2017
Source:Biomaterials, Volume 120

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Central nervous system vasculitis in adults: An update

Publication date: Available online 11 January 2017
Source:Autoimmunity Reviews
Author(s): Lívia Almeida Dutra, Alexandre Wagner Silva de Souza, Gabriela Grinberg-Dias, Orlando Graziani Povoas Barsottini, Simone Appenzeller
Primary central nervous system vasculitis (PCNSV) is a challenging diagnosis due to broad clinical manifestations and variable specificity and sensitivity of laboratory and imaging diagnostic tools. Differential diagnosis include reversible cerebral vasoconstriction syndrome (RCVS), secondary vasculitis of the CNS and other noninflammatory vasculopathies. Brain biopsy is essential for definitive diagnosis and to exclude mimickers. Recent data show data large-vessel PCNSV present worse prognosis when compared to small-vessel PCNSV. Herein we review diagnosis and management of PCNSV, secondary vasculitis of CNS and RCVS.

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Syntheses, structures, luminescent and photocatalytic properties of two Zn(II) coordination polymers assembled with mixed bridging N-donors and 2-(4-carboxyphenyl)-4,5-imidazole dicarboxylic acid ligand

Publication date: 15 April 2017
Source:Journal of Molecular Structure, Volume 1134
Author(s): Gang Yuan, Kui-Zhan Shao, Xiang-Rong Hao, Pei-Ying Zhan, Zhong-Min Su
Two new Zn(II) coordination polymers with the formulas of {[Zn3(HCpIDC)2(4,4′-bipy)(H2O)]·4H2O}n (1) and {[Zn2(CpIDC)(BIMB)]·H2O}n (2) [H4CpIDC = 2-(4-carboxyphenyl)-4,5-imidazole dicarboxylic acid, 4,4′-bipy = 4,4′-bipyridine, and BIMB = 1,4-bis(1-imidazolyl)benzene] have been successfully synthesized. Both complexes 1 and 2 feature 3D frameworks in which the IDC groups of HCpIDC^3- and CpIDC⁴⁻ ligands link metal nodes leading to infinite 21 helical chains. The HCpIDC^3- and CpIDC⁴⁻ anions exhibit two coordination modes (μ4–kN,O: kN′,O′: kO″,O‴: kO″″ and μ5–kN,O: kN′,O′: kO″,O‴: kO″″: kO) in different coordination environments. Further structural analyses show that 1 and 2 are topologically bimodal 4-connected net and trinodal (3,4,6)-connected net, respectively. As is expected, two complexes with good thermal stability displayed strong fluorescence emissions in the solid state at the room temperature. Moreover, complex 1 has some extent of photocatalytic activities for RhB.

Graphical abstract

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Central nervous system vasculitis in adults: An update

Histidine-functionalized carbon-based dot-Zinc(II) nanoparticles as a novel stabilizer for Pickering emulsion synthesis of polystyrene microspheres

Publication date: 1 May 2017
Source:Journal of Colloid and Interface Science, Volume 493
Author(s): Li Ruiyi, Li Zaijun, Liu Junkang
Carbon-based dots (CDs) are nanoparticles with size-dependent optical and electronic properties that have been widely applied in energy-efficient displays and lighting, photovoltaic devices and biological markers. However, conventional CDs are difficult to be used as ideal stabilizer for Pickering emulsion due to its irrational amphiphilic structure. The study designed and synthesized a new histidine-functionalized carbon dot-Zinc(II) nanoparticles, which is termed as His-CD-Zn. The His-CD was made via one-step hydrothermal treatment of histidine and maleic acid. The His-CD reacted with Zn²⁺ to form His-CD-Zn. The as-prepared His-CD-Zn was used as a solid particle surfactant for stabilizing styrene-in-water emulsion. The Pickering emulsion exhibits high stability and sensitive pH-switching behaviour. The introduction of S2O8²⁻ triggers the emulsion polymerization of styrene. The resulted polystyrene microsphere was well coated with His-CDs on the surface. It was successfully used as an ideal adsorbent for removal of heavy metallic ions from water with high adsorption capacity. The study also provides a prominent approach for fabrication of amphiphilic carbon-based nanoparticles for stabilizing Pickering emulsion.

Graphical abstract

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Liquid-liquid extraction studies on Zn(II) and Cd(II) using phosphonium ionic liquid (Cyphos IL 104) and recovery of zinc from zinc plating mud

Publication date: 28 April 2017
Source:Separation and Purification Technology, Volume 177
Author(s): Harshit Mahandra, Rashmi Singh, Bina Gupta
The present study describes partition behavior of Zn(II) and Cd(II) from acidic chloride medium using Cyphos IL 104 [trihexyl(tetradecyl)phosphonium bis 2,4,4-(trimethylpentyl)phosphinate] diluted in toluene. Factors affecting the extraction such as concentration of extractant and H⁺, nature of diluent, equilibration time and temperature have been evaluated. Loading and regeneration capacity along with the stability of extractant have also been assessed. The data obtained have been used to determine the stoichiometry of the extracted complex that was found to be 1:2 i.e., two moles of extractant per mole of Zn(II)/Cd(II). Effect of temperature on distribution suggested the process to be exothermic and spontaneous with ΔG° values of −39.63±4.27kJ/mol and −65.91±0.4kJ/mol for zinc and cadmium, respectively. The extraction behavior of associated metal ions namely Cu(II), Ni(II), Co(II), Fe(II)/(III) and Mn(II) has been studied and conditions for their separation from zinc and cadmium have been optimized. Based on the extraction data a separation scheme was designed and applied to a synthetic multi element mixture for the recovery of zinc and cadmium. The potential of the extractant for the recovery of zinc from zinc plating mud is assessed.

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Supramolecular architectures in luminescent Zn(II) and Cd(II) complexes containing imidazole derivatives: Crystal structures, vibrational and thermal properties, Hirshfeld surface analysis and electrostatic potentials

Publication date: 15 April 2017
Source:Journal of Molecular Structure, Volume 1134
Author(s): Alejandro Di Santo, Gustavo A. Echeverría, Oscar E. Piro, Hiram Pérez, Aida Ben Altabef, Diego M. Gil
Three novel zinc and cadmium complexes with 1-methylimidazole and 2-methylimidazole as ligands, mono-nuclear dichloro-bis(1-methylimidazole) zinc(II) and dibromo-bis(2-methylimidazole)cadmium(II) monohydrate complexes, and poly-nuclear bis(1-methylimidazole)-di-(μ2-bromo)cadmium(II) complex, namely, compounds 1–3, respectively, have been synthesized. The complexes were characterized by IR and Raman spectroscopies, thermal analysis and fluorescence. All the compounds exhibit interesting luminescent properties in solid state originated from intra-ligand (π→π*) transitions. Crystal structures of 1–3 were determined by single-crystal X-ray diffraction. Compound 1 crystallizes in P21/n space group, the Zn(II) ion lies at a crystal general position in a tetrahedral environment, and the mono-nuclear units are weakly bonded to one another by CH⋯Cl hydrogen bonds. Compound 2 crystallizes in Pnma space group, and mirror-related tetrahedral units around Cd(II) ion are H-bonded through a water molecule. Compound 3 crystallizes in P21/c space group, and the Cd(II) ion presents a centrosymmetric octahedral coordination. Neighboring and equatorial edge-sharing octahedra conform a polymeric arrangement that extends along the crystal a-axis. Weak hydrogen bonds are the major driving forces in the crystal packing of the three complexes. Hirshfeld surface analysis reveals a detailed scrutiny of intermolecular interactions experienced by each complex. The surfaces mapped over dnorm property highlight the X···H (X = Cl, Br) as the main intermolecular contacts for the three complexes, being also relevant the presence of O⋯H contacts for complex 2. The surfaces mapped over Shape index and curvedness properties for the two Cd complexes allow identify π ^… π stacking interactions which are absent in the Zn complex. 2D fingerprint plots have been used to quantify the relative contribution of the intermolecular contacts to crystal stability of compounds, showing the crucial importance of weak interactions in building different supramolecular architectures. Furthermore, molecular electrostatic potentials for visualizing and quantifying the attractive character of interactions were calculated.

Graphical abstract

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Lead(II) extraction from aqueous solutions by pyridine extractants

Publication date: 28 April 2017
Source:Separation and Purification Technology, Volume 177
Author(s): Aleksandra Wojciechowska, Karolina Wieszczycka, Irmina Wojciechowska, Andrzej Olszanowski
In this work, the Pb(II) extraction from chloride and chloride/nitrate solution with novel hydrophobic extractants: 1-(3-pyridyl)undecan-1-one oxime and its pyridinium salts (3-[1-(hydroxyimine)undecyl]-1-propylpyridinium bromide and 3-[1-(hydroxyimine)undecyl]-1-propylpyridinium chloride) was discussed. The extraction efficiency strongly depended on chloride and extractant concentration, as well as the extractant structure. The conducted calculations indicated that lead(II) was extracted as PbCl3⁻ and PbCl4²⁻ without the mineral acid participation in the complex structure. The most efficient extractant of lead(II) from the concentrated chloride solutions was 3-[1-(hydroxyimine)undecyl]-1-propylpyridinium chloride. Laboratory-scale experiments indicated that 3-[1-(hydroxyimine)undecyl]-1-propylpyridinium chloride can be proposed as a selective Pb(II) extractant from the Pb-Zn-Cu and Pb-Zn-Fe mixtures.

Graphical abstract

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Microstructural, mechanical and corrosion characteristics of heat-treated Mg-1.2Zn-0.5Ca (wt%) alloy for use as resorbable bone fixation material

Publication date: May 2017
Source:Journal of the Mechanical Behavior of Biomedical Materials, Volume 69
Author(s): Hamdy Ibrahim, Andrew D. Klarner, Behrang Poorganji, David Dean, Alan A. Luo, Mohammad Elahinia
Mg-Zn-Ca alloys have grabbed most of the recent attention in research attempting to develop an Mg alloy for bone fixation devices due to their superior biocompatibility. However, early resorption and insufficient strength remain the main problems that hinder their use. Heat treatment has previously been thoroughly studied as a post-shaping process, especially after the fabrication of complex parts (e.g. porous structures) by 3D-printing or powder metallurgy. In this work, the effect of heat treatment on Mg-1.2Zn-0.5Ca (wt%) alloy's microstructural, mechanical and corrosion properties was studied. The surface morphology of samples was characterized by optical microscopy, scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), and x-ray diffraction (XRD). Hardness, compression and tensile tests were conducted, while the in vitro corrosion characteristics of the prepared samples were determined using potentiodynamic polarization (PDP) and immersion tests. It was found that increasing the age hardening duration up to 2–5h increased the heat-treated Mg-1.2Zn-0.5Ca alloy's mechanical properties. Further increase in the age hardening duration did not result in further enhancement in mechanical properties. Similarly, heat treatment significantly altered the Mg-1.2Zn-0.5Ca alloy's in vitro corrosion properties. The corrosion rate of the Mg-1.2Zn-0.5Ca alloy after the heat treatment process was reduced to half of that for the as-cast alloy. XRD results showed the formation of biocompatible agglomerations of hydroxyapatite (HA) and magnesium hydroxide (Mg(OH)2) on the corroded surface of the heat-treated Mg-1.2Zn-0.5Ca alloy samples. The performed heat treatment process had a significant effect on both mechanical and corrosion properties of the prepared Mg-1.2Zn-0.5Ca alloy. The age hardening duration which caused the greatest increase in mechanical and the most slowed corrosion rate for Mg-1.2Zn-0.5Ca alloy material was between 2 and 5h.

Graphical abstract

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Malignant transformation of a long-standing submental dermoid cyst to a carcinosarcoma: a case report

Submental dermoid cysts are uncommon midline cysts which occur due to entrapment of ectoderm between the second and third branchial arches during embryogenesis. Most dermoid cysts of the head and neck are beni...

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Changes in the cerebellar and cerebro-cerebellar circuit in type 2 diabetes

Publication date: Available online 11 January 2017
Source:Brain Research Bulletin
Author(s): Peng Fang, Jie An, Xin Tan, Ling-Li Zeng, Hui Shen, Shijun Qiu, Dewen Hu
Currently, 422 million adults suffer from diabetes worldwide, leading to tremendous disabilities and a great burden to families and society. Functional and structural MRIs have demonstrated that patients with type 2 diabetes mellitus (T2DM) exhibit abnormalities in brain regions in the cerebral cortex. However, the changes of cerebellar anatomical connections in diabetic patients remains unclear. In the current study, diffusion tensor imaging deterministic tractography and statistical analysis were employed to investigate abnormal cerebellar anatomical connections in diabetic patients. This is the first study to investigate the altered cerebellar anatomical connectivity in T2DM patients. Decreased anatomical connections were found in the cerebellar and cerebro-cerebellar circuits of T2DM patients, providing valuable new insights into the potential neuro-pathophysiology of diabetes-related motor and cognitive deficits.

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Malignant transformation of a long-standing submental dermoid cyst to a carcinosarcoma: a case report

The see-saw of immune dysregulation association of diverse organ autoimmune conditions in a woman. Evolution over twenty-seven years

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