Thermal conductivity of electrospinning chain-aligned polyethylene oxide (PEO)

Publication date: 21 April 2017
Source:Polymer, Volume 115
Author(s): Chenhao Lu, Sum Wai Chiang, Hongda Du, Jia Li, Lin Gan, Xing Zhang, Xiaodong Chu, Youwei Yao, Baohua Li, Feiyu Kang
Polymer fibers' thermal conductivity along its axis direction are usually much better compared to that of the bulk. Many researches indicate that three main factors have significant impact on polymer fiber's thermal conductivity, which are crystallinity, molecular alignment and crystalline grain orientation of the polymer. Most research focus on polyethylene (PE) because of its relatively high crystallinity. Here, we report exceptionally high thermal conductivity on electrospun polyethylene oxide (PEO) nanofibers, which is an important semicrystalline polymer. This indicates that semicrystalline polymers like PEO can also obtain high thermal conductivity, which may be used in areas such as electronic devices. Its thermal conductivity improved about 150 times over bulk polymer. By using infrared spectroscopy, we evidenced that improvement in thermal conductivity was ascribed to increased molecular alignment. And we discussed the relationship between molecular alignment and crystalline grain orientation, as well as their contribution to the thermal conductivity of PEO fibers. We found that for PEO nanofibers, preferred molecular alignment in the amorphous region has significant contributed to high thermal conductivity.

Graphical abstract

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Polyethylene/polyhedral oligomeric silsesquioxanes composites: Dielectric, thermal and rheological properties

Publication date: 21 April 2017
Source:Polymer, Volume 115
Author(s): Meng Guo, Éric David, Michel Fréchette, Nicole R. Demarquette
Composites of low-density polyethylene (LDPE) containing 1 wt% and 5 wt% polyhedral oligomeric silsesquioxanes (POSS) of different substituents (methyl, isobutyl, isooctyl) were obtained by extrusion. The composites' potential application in high-voltage (HV) power cable insulation was investigated by broadband dielectric spectroscopy, progressive-stress breakdown tests, and surface partial discharge tests. Thermal conductivity and viscoelastic characteristic were also examined as they play an important role in both material property and manufacture. Additional measurements using scanning electron microscopy and differential scanning calorimetry were carried out to obtain information for possible performance explanations. The results showed that POSS could enhance the erosion resistance and slightly improve the thermal conductivity of LDPE without compromising its dielectric breakdown strength or unfavorably increasing its dielectric permittivity or viscosity.

Graphical abstract

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Finsler geometry modeling and Monte Carlo study of 3D liquid crystal elastomer

Publication date: 7 April 2017
Source:Polymer, Volume 114
Author(s): Keita Osari, Hiroshi Koibuchi
We study a three-dimensional (3D) liquid crystal elastomer (LCE) in the context of Finsler geometry (FG) modeling, where FG is a mathematical framework for describing anisotropic phenomena. The LCE is a 3D rubbery object and has remarkable properties, such as the so-called soft elasticity and elongation, the mechanisms of which are unknown at present. To understand these anisotropic phenomena, we introduce a variable σ, which represents the directional degrees of freedom of a liquid crystal (LC) molecule. This variable σ is used to define the Finsler metric for the interaction between the LC molecules and bulk polymers. Performing Monte Carlo (MC) simulations for a cylindrical body between two parallel plates, we numerically find the soft elasticity in MC data such that the tensile stress and strain are consistent with reported experimental results. Moreover, the elongation is also observed in the results of MC simulations of a spherical body with free boundaries, and the data obtained from the MC simulations are also consistent with existing experimental results.

Graphical abstract

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Mediastinal syndrome from plasmablastic lymphoma in human immunodeficiency virus and human herpes virus 8 negative patient with polycythemia vera: a case report

Plasmoblastic lymphoma is a rare and aggressive subtype of diffuse large B cell lymphoma, which occurs usually in the jaw of immunocompromised subjects.

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Vergleich der Kombination aus IMRT und IGRT mit konventioneller 3D-CRT bei der Bestrahlung des Prostatakarzinoms

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Gas gangrene in the deep spaces of the head and neck visualized on computed tomography images

Abstract

Cellulitis accompanied by gas gangrene is a rapidly-spreading and potentially fatal infection. Here, we present a case of gas gangrene in the deep spaces of the head and neck in an elderly woman, diagnosed by computed tomography (CT). An 86-year-old woman with Alzheimer's disease, hypertension, hyperlipidemia, and osteoporosis was referred to our institute by her local dentist. The patient exhibited trismus caused by severe swelling in the left submandibular area. CT images of the head and neck area showed swelling of the cervical tissue with air in the parapharyngeal and masticator spaces. She was treated with antibiotics, followed by drainage. Although the therapy was continued, the patient died from a cardiac complication on hospital day 42. Our case highlights the usefulness of CT for diagnosing gas gangrene in the deep spaces of the head and neck in a woman with Alzheimer's disease.

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Fusion imaging: a bipartite approach

Abstract

Image fusion is the process of registering and combining multiple images from single or multiple imaging modalities to improve the imaging quality and applicability. It reduces randomness and redundancy to increase the diagnostic value of images for better assessment of medical problems. Fusion imaging was designed to overcome the disadvantages of morphological and/or functional imaging, and attempts to provide inputs that improve treatment planning, resulting in better prognostication. This review attempts to summarize the techniques and their applications in head and neck imaging.

http://ift.tt/2n2K4xY

Upper airway imaging in sleep-disordered breathing: role of cone-beam computed tomography

Abstract

Objective

To review recent use of three-dimensional (3D) imaging, specifically cone-beam computed tomography (CBCT), in the analysis of the upper airway for diagnosis or treatment outcomes in patients with sleep-disordered breathing (SDB).

Types of studies reviewed

Literature review of relevant medical and dental studies utilizing 3D imaging to assess the upper airway.

Results

Imaging of the upper airway provided insight into potential areas of obstruction. Accessibility of CBCT to dentists is reflected in several applications of upper airway diagnosis, treatment planning, and different treatment outcomes, as well as association with craniofacial development. However, multiple deficiencies in image acquisition, 3D reconstruction, and analysis are evident.

Practical implications

The role of CBCT in the analysis of the upper airway is growing; however, critical limitations remain. An understanding of these limitations, clarification of misconceptions, and improvements in analysis methods are required to ensure proper use and development of CBCT.

http://ift.tt/2n8pSg4

E-cigarettes and oral health: a balanced viewpoint

Abstract

The topic of e-cigarettes and oral health is of utmost importance and we were pleased to see this addressed by a recent review that was published in Oral Diseases (Javed et al., 2017). However, we would like to raise several concerns with this review.

This article is protected by copyright. All rights reserved.

http://ift.tt/2ngPaZI

A Comparative Study of Models of Geriatric Assessment and the Implementation of Recommendations by Primary Care Physicians

Rejuvenation Research , Vol. 0, No. 0.


http://ift.tt/2nuZYnH

Increased Adipose and Muscle Insulin Sensitivity Without Changes in Serum Adiponectin in Young Female Collegiate Athletes

Metabolic Syndrome and Related Disorders , Vol. 0, No. 0.


http://ift.tt/2nuKFLR

Auricular complications in parotid, temporal bone, infratemporal fossa, and lateral skull base surgery

Patrick S. Carpenter, MD; Ryan C. Burgette, MD; John P. Leonetti, MD; Sam J. Marzo, MD

Abstract

Neoplasms located in the parotid region, temporal bone, infratemporal fossa, and lateral skull base represent a challenge due to their difficult anatomic location and surrounding neurovascular structures. A variety of surgical approaches are appropriate to access this area, although several of them can place the auricular blood supply in danger. If the auricular blood supply is compromised, ischemia and, eventually, avascular necrosis of the auricle can occur. Auricular necrosis often can cause patients a delay in adjuvant radiation therapy and result in the need for additional reconstructive procedures. Therefore, it is imperative to identify risk factors associated with the development of this disabling complication. We conducted a retrospective review of 32 individuals undergoing treatment of benign and malignant lesions in the parotid gland, infratemporal fossa, and lateral skull base. To identify potential risk factors for auricular necrosis, the patients were analyzed based on the type of neoplasm (malignant or benign), risk factors affecting blood flow (diabetes mellitus, smoking history, prior radiation, prior surgery), body mass index, and the length of surgery. In our population examined, 3 instances of auricular necrosis occurred. None of the potential risk factors proved to be statistically significant (although malignant pathology approached significance at p = 0.07). Two of the patients required an auriculectomy with reconstruction. The third had multiple postoperative clinic visits for surgical debridement. Although no potential risk factors were statistically significant, surgeons should remain cognizant of the auricular blood supply while performing surgery via preauricular and postauricular approaches to this area.

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Estimation of partitioning of airflow in septal surgery: A prospective study with reference to the NOSE scale

Indranil Sen, MS; Mainak Dutta, MS; Dibakar Haldar, MD; Ramanuj Sinha, DLO, MS, DNB

Abstract

Improper patient selection for septal surgery often has been found to result in therapeutic failure, and there needs to be an objective assessment of nasal obstruction before the surgery and for postoperative follow-up that can be applied in the routine otolaryngology practice. The purpose of this study is to assess the usefulness of a cost-effective device for objective measurement of the nasal airway partitioning in selecting patients for septal surgery and for postoperative outcome evaluation. A hospital-based, prospective, observational study was carried out in a tertiary-care teaching institution involving 74 patients waiting for septal surgery. Each patient was exposed to subjective assessment of nasal obstruction by the Nasal Obstruction Symptom Evaluation (NOSE) scale and objective measurement by Nasal Partitioning Ratio (NPR) using a new device, Nasal Airway Partition Meter (NAPM), once before and twice after surgery. Overall, average NOSE score and NPR values were 66.42 ± 9.42 and 0.57 ± 0.18, respectively, at preoperative assessment (correlation coefficient 0.441). Sixty of the 74 patients had high values for both NPR and NOSE scores (Group 1), but in the remaining 14, NPR values were found to be lower despite high NOSE scores (Group 2). Postsurgery, the NOSE score and NPR values were significantly reduced in Group 1. In contrast, participants in Group 2 showed no alteration in the values of both the parameters after the same operative maneuver. However, 2 patients in Group 1 had NOSE score and NPR values unaltered, while 1 patient in Group 2 had a reduced NOSE score after surgery. Therefore, the validity of the new equipment was calculated to be 96.7% sensitive and 92.9% specific to identify patients who needed to undergo septal surgery for their nasal obstruction. It can be deduced from the present study that NAPM can be a cost-effective device for clinicians to objectively measure nasal airway obstruction and screen patients for septal surgery.

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Estimation of partitioning of airflow in septal surgery: A prospective study with reference to the NOSE scale

Indranil Sen, MS; Mainak Dutta, MS; Dibakar Haldar, MD; Ramanuj Sinha, DLO, MS, DNB

Abstract

Improper patient selection for septal surgery often has been found to result in therapeutic failure, and there needs to be an objective assessment of nasal obstruction before the surgery and for postoperative follow-up that can be applied in the routine otolaryngology practice. The purpose of this study is to assess the usefulness of a cost-effective device for objective measurement of the nasal airway partitioning in selecting patients for septal surgery and for postoperative outcome evaluation. A hospital-based, prospective, observational study was carried out in a tertiary-care teaching institution involving 74 patients waiting for septal surgery. Each patient was exposed to subjective assessment of nasal obstruction by the Nasal Obstruction Symptom Evaluation (NOSE) scale and objective measurement by Nasal Partitioning Ratio (NPR) using a new device, Nasal Airway Partition Meter (NAPM), once before and twice after surgery. Overall, average NOSE score and NPR values were 66.42 ± 9.42 and 0.57 ± 0.18, respectively, at preoperative assessment (correlation coefficient 0.441). Sixty of the 74 patients had high values for both NPR and NOSE scores (Group 1), but in the remaining 14, NPR values were found to be lower despite high NOSE scores (Group 2). Postsurgery, the NOSE score and NPR values were significantly reduced in Group 1. In contrast, participants in Group 2 showed no alteration in the values of both the parameters after the same operative maneuver. However, 2 patients in Group 1 had NOSE score and NPR values unaltered, while 1 patient in Group 2 had a reduced NOSE score after surgery. Therefore, the validity of the new equipment was calculated to be 96.7% sensitive and 92.9% specific to identify patients who needed to undergo septal surgery for their nasal obstruction. It can be deduced from the present study that NAPM can be a cost-effective device for clinicians to objectively measure nasal airway obstruction and screen patients for septal surgery.

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Fiddler's neck: A review

Calvin W. Myint, MD; Amy L. Rutt, DO; Robert T. Sataloff, MD, DMA, FACS

Abstract

Fiddler's neck is a common dermatologic condition associated with instrument use in violin and viola players. It typically manifests as a submandibular and/or supraclavicular lesion. It is a benign condition, but it may be mistaken for lymphedema or a salivary gland malignancy. Otolaryngologists who treat patients with fiddler's neck should be aware of appropriate management protocols and the need to avoid surgical excision. We obtained informed consent from 3 violinists to present their cases as specific examples of fiddler's neck. In addition, we present a literature review based on our PubMed search for articles about this instrument-induced dermatitis. The literature suggests that submandibular fiddler's neck is caused by mechanical pressure and shear stress on the skin and that it can present as erythema, scarring, edema, and lichenification. Supraclavicular fiddler's neck, on the other hand, is caused by allergic contact dermatitis, and it can present as an eczematous, scaly, and/or vesicular lesion. In most cases, a good history (especially of string instrument use), physical examination, and a patch test are sufficient to diagnose this condition. Management of fiddler's neck includes a topical steroid, proper instrument handling, neck padding, changing the instrument's materials, and/or reducing the amount of playing time. Surgical excision is usually not advisable.

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Fiddler's neck: A review

Calvin W. Myint, MD; Amy L. Rutt, DO; Robert T. Sataloff, MD, DMA, FACS

Abstract

Fiddler's neck is a common dermatologic condition associated with instrument use in violin and viola players. It typically manifests as a submandibular and/or supraclavicular lesion. It is a benign condition, but it may be mistaken for lymphedema or a salivary gland malignancy. Otolaryngologists who treat patients with fiddler's neck should be aware of appropriate management protocols and the need to avoid surgical excision. We obtained informed consent from 3 violinists to present their cases as specific examples of fiddler's neck. In addition, we present a literature review based on our PubMed search for articles about this instrument-induced dermatitis. The literature suggests that submandibular fiddler's neck is caused by mechanical pressure and shear stress on the skin and that it can present as erythema, scarring, edema, and lichenification. Supraclavicular fiddler's neck, on the other hand, is caused by allergic contact dermatitis, and it can present as an eczematous, scaly, and/or vesicular lesion. In most cases, a good history (especially of string instrument use), physical examination, and a patch test are sufficient to diagnose this condition. Management of fiddler's neck includes a topical steroid, proper instrument handling, neck padding, changing the instrument's materials, and/or reducing the amount of playing time. Surgical excision is usually not advisable.

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Mechanical venous anastomosis in head and neck microvascular reconstruction as an equivalent to the gold standard

Eric Thorpe, MD; Yash Patil, MD

Abstract

To define the most successful and efficient manner to perform venous microvascular anastomoses, the effectiveness of mechanical venous anastomosis in head and neck microvascular reconstruction is reviewed. Head and neck reconstruction with free flap techniques has become the norm and gold standard for large defects. This retrospective, multicenter case series of a single microvascular surgeon's experience with mechanical venous anastomoses specifically assessed the effectiveness of head and neck reconstruction and the complications associated with it. Data were collected from two separate academic centers and are reported from a consecutive series of patients over the course of 10 years. All patients underwent microvascular reconstruction of the head and neck region using venous couplers and flap survival. Flap survival was greater than 98% using mechanical venous couplers as the primary means for venous outflow in this series of 402 consecutive patients and 431 total microvascular flaps. Venous couplers were performed in every instance. The study shows that mechanical venous anastomosis provides a highly effective and efficient means for venous outflow in head and neck microvascular reconstruction, and should be considered equivalent to the gold standard suture technique, even in the most difficult cases.

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Mechanical venous anastomosis in head and neck microvascular reconstruction as an equivalent to the gold standard

Eric Thorpe, MD; Yash Patil, MD

Abstract

To define the most successful and efficient manner to perform venous microvascular anastomoses, the effectiveness of mechanical venous anastomosis in head and neck microvascular reconstruction is reviewed. Head and neck reconstruction with free flap techniques has become the norm and gold standard for large defects. This retrospective, multicenter case series of a single microvascular surgeon's experience with mechanical venous anastomoses specifically assessed the effectiveness of head and neck reconstruction and the complications associated with it. Data were collected from two separate academic centers and are reported from a consecutive series of patients over the course of 10 years. All patients underwent microvascular reconstruction of the head and neck region using venous couplers and flap survival. Flap survival was greater than 98% using mechanical venous couplers as the primary means for venous outflow in this series of 402 consecutive patients and 431 total microvascular flaps. Venous couplers were performed in every instance. The study shows that mechanical venous anastomosis provides a highly effective and efficient means for venous outflow in head and neck microvascular reconstruction, and should be considered equivalent to the gold standard suture technique, even in the most difficult cases.

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Auricular solitary gouty tophus in a young adult

Chao-Yin Kuo, MD; Chih-Hung Wang, MD, PhD

The auricle, with its supersaturation of blood uric acid due to decreased temperature and reduced blood flow, is prone to develop gouty tophi.

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Auricular complications in parotid, temporal bone, infratemporal fossa, and lateral skull base surgery

Patrick S. Carpenter, MD; Ryan C. Burgette, MD; John P. Leonetti, MD; Sam J. Marzo, MD

Abstract

Neoplasms located in the parotid region, temporal bone, infratemporal fossa, and lateral skull base represent a challenge due to their difficult anatomic location and surrounding neurovascular structures. A variety of surgical approaches are appropriate to access this area, although several of them can place the auricular blood supply in danger. If the auricular blood supply is compromised, ischemia and, eventually, avascular necrosis of the auricle can occur. Auricular necrosis often can cause patients a delay in adjuvant radiation therapy and result in the need for additional reconstructive procedures. Therefore, it is imperative to identify risk factors associated with the development of this disabling complication. We conducted a retrospective review of 32 individuals undergoing treatment of benign and malignant lesions in the parotid gland, infratemporal fossa, and lateral skull base. To identify potential risk factors for auricular necrosis, the patients were analyzed based on the type of neoplasm (malignant or benign), risk factors affecting blood flow (diabetes mellitus, smoking history, prior radiation, prior surgery), body mass index, and the length of surgery. In our population examined, 3 instances of auricular necrosis occurred. None of the potential risk factors proved to be statistically significant (although malignant pathology approached significance at p = 0.07). Two of the patients required an auriculectomy with reconstruction. The third had multiple postoperative clinic visits for surgical debridement. Although no potential risk factors were statistically significant, surgeons should remain cognizant of the auricular blood supply while performing surgery via preauricular and postauricular approaches to this area.

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Thyroglossal duct cyst

Lester D. Thompson, MD

Most patients present with a mobile, painless midline neck mass, usually inferior to the hyoid bone, showing movement with tongue protrusion.

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Auricular solitary gouty tophus in a young adult

Chao-Yin Kuo, MD; Chih-Hung Wang, MD, PhD

The auricle, with its supersaturation of blood uric acid due to decreased temperature and reduced blood flow, is prone to develop gouty tophi.

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Posterior epistaxis from inferior meatus: An endoscopic view

Jae Hoon Lee, MD

Most of the bleeding in posterior epistaxis originates from the posterior end of the lateral aspect of the middle and inferior turbinates and the lateral wall of the meatuses.

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Thyroglossal duct cyst

Lester D. Thompson, MD

Most patients present with a mobile, painless midline neck mass, usually inferior to the hyoid bone, showing movement with tongue protrusion.

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Efficacy of Intralipid infusion in reducing amphotericin-B-associated nephrotoxicity in head and neck invasive fungal infection: A randomized, controlled trial

Mehrdad Hasibi, MD; Sirous Jafari, MD; Seyyed Ali Dehghan Manshadi, MD; Marjan Asadollahi, MD; Mohammadreza Salehi, MD; Varasteh Vakili Zarch, MD; Ali Kouhi, MD

Abstract

Amphotericin B deoxycholate (ABD) is the best therapeutic agent available for the treatment of most systemic fungal infections. However, some untoward adverse effects such as nephrotoxicity may limit its appropriate therapeutic use. We conducted a randomized, controlled trial ofthe infusion of fat emulsion (Intralipid) shortly after the infusion of ABD to evaluate its effects on reducing ABD-associated nephrotoxicity. Our patient population was made up of 31 patients who were randomized into two groups: an intervention group (n = 16) and a control group (15 patients). There were no statistically significant differences between the two groups in demographic or clinical variables. All patients received 1mg/kg/day of ABD in dextrose 5%. In addition, the patients in the intervention arm received Intralipid 10%, which was started as soon as possible within 1 hour after the infusion of ABD. ABD-associated nephrotoxicity was defined as a minimum 50% increase in baseline serum creatinine to a minimum of 2mg/dl. We also measured daily serum creatinine changes during the first 2 weeks of treatment, and we compared some other relevant indices of renal function, as well as ABD-related hypokalemia. We found no statistically significant differences between the two treatments in terms of ABD-associated nephrotoxicity or any of the other indices. We conclude that the administration of Intralipid 10% early after infusion of ABD in dextrose 5% does not have any effect in decreasing ABD-associated nephrotoxicity or hypokalemia.

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Posterior epistaxis from inferior meatus: An endoscopic view

Jae Hoon Lee, MD

Most of the bleeding in posterior epistaxis originates from the posterior end of the lateral aspect of the middle and inferior turbinates and the lateral wall of the meatuses.

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The use of high-resolution pharyngeal manometry as biofeedback in dysphagia therapy

Ashli O'Rourke, MD; Kate Humphries, MS

HRPM biofeedback therapy may be particularly beneficial for patients with sensory deficits by providing a visual mechanism for accurate exercise and strategy implementation.

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Efficacy of Intralipid infusion in reducing amphotericin-B-associated nephrotoxicity in head and neck invasive fungal infection: A randomized, controlled trial

Mehrdad Hasibi, MD; Sirous Jafari, MD; Seyyed Ali Dehghan Manshadi, MD; Marjan Asadollahi, MD; Mohammadreza Salehi, MD; Varasteh Vakili Zarch, MD; Ali Kouhi, MD

Abstract

Amphotericin B deoxycholate (ABD) is the best therapeutic agent available for the treatment of most systemic fungal infections. However, some untoward adverse effects such as nephrotoxicity may limit its appropriate therapeutic use. We conducted a randomized, controlled trial ofthe infusion of fat emulsion (Intralipid) shortly after the infusion of ABD to evaluate its effects on reducing ABD-associated nephrotoxicity. Our patient population was made up of 31 patients who were randomized into two groups: an intervention group (n = 16) and a control group (15 patients). There were no statistically significant differences between the two groups in demographic or clinical variables. All patients received 1mg/kg/day of ABD in dextrose 5%. In addition, the patients in the intervention arm received Intralipid 10%, which was started as soon as possible within 1 hour after the infusion of ABD. ABD-associated nephrotoxicity was defined as a minimum 50% increase in baseline serum creatinine to a minimum of 2mg/dl. We also measured daily serum creatinine changes during the first 2 weeks of treatment, and we compared some other relevant indices of renal function, as well as ABD-related hypokalemia. We found no statistically significant differences between the two treatments in terms of ABD-associated nephrotoxicity or any of the other indices. We conclude that the administration of Intralipid 10% early after infusion of ABD in dextrose 5% does not have any effect in decreasing ABD-associated nephrotoxicity or hypokalemia.

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Atypical parathyroid adenoma with diffuse fibrosis

Christine M. Clark, BA; Sakeena J. Payne, MD; Joshua I. Warrick, MD; David Goldenberg, MD, FACS

Atypical parathyroid adenomas are infrequently encountered and can present a diagnostic challenge, as they share overlapping clinical and histologic features with parathyroid carcinoma.

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The use of high-resolution pharyngeal manometry as biofeedback in dysphagia therapy

Ashli O'Rourke, MD; Kate Humphries, MS

HRPM biofeedback therapy may be particularly beneficial for patients with sensory deficits by providing a visual mechanism for accurate exercise and strategy implementation.

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Atypical parathyroid adenoma with diffuse fibrosis

Christine M. Clark, BA; Sakeena J. Payne, MD; Joshua I. Warrick, MD; David Goldenberg, MD, FACS

Atypical parathyroid adenomas are infrequently encountered and can present a diagnostic challenge, as they share overlapping clinical and histologic features with parathyroid carcinoma.

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Mediastinal syndrome from plasmablastic lymphoma in human immunodeficiency virus and human herpes virus 8 negative patient with polycythemia vera: a case report

Plasmoblastic lymphoma is a rare and aggressive subtype of diffuse large B cell lymphoma, which occurs usually in the jaw of immunocompromised subjects.

http://ift.tt/2nMNZ1W

Expression of unusual immunohistochemical markers in mucinous breast carcinoma

Publication date: Available online 21 March 2017
Source:Acta Histochemica
Author(s): Rodrigo de Andrade Natal, Sophie F. Derchain, Marina Pavanello, Geisilene R. Paiva, Luis O. Sarian, José Vassallo
BackgroundMucinous breast carcinoma is characterized by the production of variable amounts of mucin. Some studies have addressed immunohistochemical characterization of mucinous breast carcinoma using a limited set of antibodies. However, the purpose of the present study was to investigate a larger panel of markers not widely used in daily practice and to determine their pathological implications.MethodsForty patients diagnosed with mucinous breast carcinoma were enrolled. An immunohistochemical study was performed on whole sections of paraffin embedded tissue, using antibodies for the following markers: estrogen receptor alpha and beta, progesterone receptor, androgen receptor, HER2, EGFR, Ki-67, E-cadherin, β-catenin, p53, chromogranin, synaptophysin, GCDFP15, mammaglobin, and CDX2.ResultsThe pure mucinous type was more prevalent in older patients and more frequently expressed GCDFP15. Capella type B presented more frequently with a high Ki-67 index and neuroendocrine differentiation. Although there was a lower frequency of vascular invasion and lymph node metastases in the pure type, the difference was not statistically significant. No case expressed CDX2 (a marker for gastrointestinal tumors), while 85% of the cases expressed at least one of the two typical breast markers (GCDFP15 and mammaglobin), suggesting that these markers may be reliably used for differential diagnosis. Expression of estrogen receptor beta was related to the presence of mucin cell producing lymph node metastasis, with potential prognostic and predictive value.Conclusionour findings support the immunohistochemical homogeneity of mucinous breast carcinomas because only minor differences were found when subgrouping them into Capella types A and B or into types pure and mixed.



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Draft genome of the fungus-growing termite pathogenic fungus Ophiocordyceps bispora (Ophiocordycipitaceae, Hypocreales, Ascomycota)

Publication date: April 2017
Source:Data in Brief, Volume 11
Author(s): Benjamin H. Conlon, Jannette Mitchell, Z. Wilhelm de Beer, Christian Carøe, M. Thomas P. Gilbert, Jørgen Eilenberg, Michael Poulsen, Henrik H. de Fine Licht
This article documents the public availability of genome sequence data and assembled contigs representing the partial draft genome of Ophiocordyceps bispora. As one of the few known pathogens of fungus-farming termites, a draft genome of O. bispora represents the opportunity to further the understanding of disease and resistance in these complex termite societies. With the ongoing attempts to resolve the taxonomy of the Hypocralaean family, more genetic data will also help to shed light on the phylogenetic relationship between sexual and asexual life stages. Next generation sequence data is available from the European Nucleotide Archive (ENA) under accession PRJEB13655; run numbers: ERR1368522, ERR1368523, and ERR1368524. Genome assembly available from ENA under accession numbers: FKNF01000001–FKNF01000302. Gene prediction available as protein fasta, nucleotide fasta and GFF file from Mendeley Data with accession doi:10.17632/r99fd6g3s4.2 (http://ift.tt/2ngBwWw).



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Direct and indirect alcohol biomarkers data collected in hair samples - multivariate data analysis and likelihood ratio interpretation perspectives

Publication date: June 2017
Source:Data in Brief, Volume 12
Author(s): Eugenio Alladio, Agnieszka Martyna, Alberto Salomone, Valentina Pirro, Marco Vincenti, Grzegorz Zadora
The concentration values of direct and indirect biomarkers of ethanol consumption were detected in blood (indirect) or hair (direct) samples from a pool of 125 individuals classified as either chronic (i.e. positive) and non-chronic (i.e. negative) alcohol drinkers. These experimental values formed the dataset under examination (Table 1). Indirect biomarkers included: aspartate transferase (AST), alanine transferase (ALT), gamma-glutamyl transferase (GGT), mean corpuscular volume of the erythrocytes (MCV), carbohydrate-deficient-transferrin (CDT). The following direct biomarkers were also detected in hair: ethyl myristate (E14:0), ethyl palmitate (E16:0), ethyl stearate (E18:1), ethyl oleate (E18:0), the sum of their four concentrations (FAEEs, i.e. Fatty Acid Ethyl Esters) and ethyl glucuronide (EtG; pg/mg). Body mass index (BMI) was also collected as a potential influencing factor. Likelihood ratio (LR) approaches have been used to provide predictive models for the diagnosis of alcohol abuse, based on different combinations of direct and indirect alcohol biomarkers, as described in "Evaluation of direct and indirect ethanol biomarkers using a likelihood ratio approach to identify chronic alcohol abusers for forensic purposes" (E. Alladio, A. Martyna, A. Salomone, V. Pirro, M. Vincenti, G. Zadora, 2017) [1].



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Data on chemical activation of Wnt/β-catenin during axolotl limb regeneration

Publication date: April 2017
Source:Data in Brief, Volume 11
Author(s): Sabina Wischin, Cristina Castañeda-Patlán, Martha Robles-Flores, Jesús Chimal-Monroy
Limb amputation in axolotls was performed to obtain data demonstrating that a chemical agonist of Wnt (int-related protein)/β-catenin signalling can have a role in axolotl limb regeneration (Wischin et al., 2017) [1]. The data revealed that active β-catenin protein was present during limb regeneration in some Leydig cells in the epithelium; after the chemical treatment, it was observed in more Leydig cells. In addition, the chemical agonist of Wnt generated distinct limb malformation.



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Dataset of the human homologues and orthologues of lipid-metabolic genes identified as DAF-16 targets their roles in lipid and energy metabolism

Publication date: April 2017
Source:Data in Brief, Volume 11
Author(s): Lavender Yuen-Nam Fan, Paula Saavedra-García, Eric Wing-Fai Lam
The data presented in this article are related to the review article entitled 'Unravelling the role of fatty acid metabolism in cancer through the FOXO3-FOXM1 axis' (Saavedra-Garcia et al., 2017) [24]. Here, we have matched the DAF-16/FOXO3 downstream genes with their respective human orthologues and reviewed the roles of these targeted genes in FA metabolism. The list of genes listed in this article are precisely selected from literature reviews based on their functions in mammalian FA metabolism. The nematode Caenorhabditis elegans gene orthologues of the genes are obtained from WormBase, the online biological database of C. elegans. This dataset has not been uploaded to a public repository yet.



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Data on IL-10R neutralization-induced chronic colitis in Lipocalin 2 deficient mice on BALB/c background

Publication date: April 2017
Source:Data in Brief, Volume 11
Author(s): Vishal Singh, Beng San Yeoh, Marit Nilsen-Hamilton, Thorsten Berger, Tak W. Mak, Matam Vijay-Kumar
The data herein is related to the research article entitled "Microbiota-inducible Innate Immune, Siderophore Binding Protein Lipocalin 2 is Critical for Intestinal Homeostasis" (Singh et al., 2016) [1] where we have demonstrated that C57BL/6 Lipocalin 2 deficient mice (Lcn2KO) developed chronic colitis upon anti-interleukin-10 receptor (αIL-10R) monoclonal antibody administration. In the present article, we evaluated the susceptibility of BALB/c Lcn2KO mice and their WT littermates to the αIL-10R neutralization-induced chronic colitis. Our data showed that αIL-10R mAb-treated BALB/c Lcn2KO mice exhibited severe chronic colitis (i.e., splenomegaly, colomegaly, colonic pathology, and incidence of rectal prolapse) when compared to WT mice.



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A novel dataset on horizontal property rights in 126 jurisdictions

Publication date: April 2017
Source:Data in Brief, Volume 11
Author(s): Giuseppe Dari-Mattiacci, Carmine Guerriero
The law and the economy are deeply influenced by horizontal property rights, which are the rules regulating legal direct and indirect takings between private parties. To foster research on the determinants and impact of these institutions, we illustrate here a novel data set partially employed in (Dari-Mattiacci, Giuseppe, Carmine Guerriero, 2015; Dari-Mattiacci, Giuseppe, Carmine Guerriero, Zhenxing Huang, 2016) [3,4], and (Guerriero Carmine, 2016) [6] and describing the acquisition of ownership through adverse possession of personal and real property and the use of government takings to transfer real property from a private party to another private party in 126 jurisdictions. These data are based on the laws and judicial decisions prevailing in each jurisdiction between 1981 and 2011.



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Data of self-made Taq DNA polymerase prepared for screening purposes

Publication date: April 2017
Source:Data in Brief, Volume 11
Author(s): E.V. Konovalova, A.A. Schulga, T.I. Lukyanova, E.J. Woo, S.M. Deyev
DNA analysis is a key procedure in genetic engineering. Nowadays the analysis is often done by PCR with Taq DNA polymerase. Although the last enzyme price is quite low, demand for numerous analyses results in much money expenditure which are not affordable for many laboratories. In a meanwhile, many screening tasks do not require the highly purified enzyme. Taking into account the enzyme unique properties it makes possible to marginally simplify its production without resorting to costly or lengthy techniques such as column chromatography and/or dialysis. Here the data of routine usage of Taq DNA polymerase prepared according to the protocol developed in our laboratory is presented. The protocol takes only several hours to realize and does not need qualified personnel or expensive equipment. Yet it gives the enzyme preparation suitable for most screening purposes. The isolated Taq DNA polymerase stock can be stored as ammonium sulfate suspension in a refrigerator for prolonged period, not less than 6 months. The working enzyme solution is prepared from the stock suspension on demand, not more than once in a month and can be stored also in a refrigerator.



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Nicotinamide for skin cancer chemoprevention

Abstract

Nicotinamide (vitamin B₃) has a range of photoprotective effects in vitro and in vivo; it enhances DNA repair, reduces UV radiation-induced suppression of skin immune responses, modulates inflammatory cytokine production and skin barrier function and restores cellular energy levels after UV exposure. Pharmacological doses of nicotinamide have been shown to reduce actinic keratoses and nonmelanoma skin cancer incidence in high-risk individuals, making this a nontoxic and accessible option for skin cancer chemoprevention in this population.

http://ift.tt/2nEGr4w

Nicotinamide for skin cancer chemoprevention

Abstract

Nicotinamide (vitamin B₃) has a range of photoprotective effects in vitro and in vivo; it enhances DNA repair, reduces UV radiation-induced suppression of skin immune responses, modulates inflammatory cytokine production and skin barrier function and restores cellular energy levels after UV exposure. Pharmacological doses of nicotinamide have been shown to reduce actinic keratoses and nonmelanoma skin cancer incidence in high-risk individuals, making this a nontoxic and accessible option for skin cancer chemoprevention in this population.

http://ift.tt/2nEGr4w

RelB attenuates cigarette smoke extract-induced apoptosis in association with transcriptional regulation of the aryl hydrocarbon receptor

Publication date: July 2017
Source:Free Radical Biology and Medicine, Volume 108
Author(s): Matthew Iu, Michela Zago, Angela Rico de Souza, Manuella Bouttier, Swati Pareek, John H. White, Qutayba Hamid, David H. Eidelman, Carolyn J. Baglole
Chronic obstructive pulmonary disease (COPD) is a chronic and prevalent respiratory disease caused primarily by long term inhalation of cigarette smoke. A major hallmark of COPD is elevated apoptosis of structural lung cells including fibroblasts. The NF-κB member RelB may suppress apoptosis in response to cigarette smoke, but its role in lung cell survival is not known. RelB may act as a pro-survival factor by controlling the expression of superoxide dismutase 2 (SOD2). SOD2 is also regulated by the aryl hydrocarbon receptor (AhR), a ligand-activated transcription factor that suppresses cigarette smoke-induced apoptosis. As the AhR is also a binding partner for RelB, we speculate that RelB suppresses cigarette smoke-induced apoptosis by regulating the AhR. Using an in vitro model of cigarette smoke exposure (cigarette smoke extract [CSE]), we found that CSE down-regulated RelB expression in mouse lung fibroblasts, which was associated with elevated levels of cleaved PARP. Genetic ablation of RelB elevated CSE-induced apoptosis, including chromatin condensation, and reduced mitochondrial function. There was also more reactive oxygen species production in RelB^-/- cells exposed to CSE. While there was no alteration in Nrf2 expression or localization between RelB^-/- and wild type cells in response to CSE, RelB^-/- cells displayed significantly decreased AhR mRNA and protein expression, concomitant with loss of AhR target gene expression (Cyp1a1, Cyp1b1, Nqo1). Finally, we found that RelB binds to the Ahr gene at 3 sites to potentially increase its expression via transcriptional induction. These data support that RelB suppresses cigarette smoke-induced apoptosis, potentially by increasing the AhR. Together, these two proteins may comprise an important cell survival signaling pathway that reduces apoptosis upon cigarette smoke exposure.

Graphical abstract

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Mitogen-Activated Protein Kinase Phosphatase 1 (MKP-1) in Macrophage Biology and Cardiovascular Disease. A Redox-Regulated Master Controller of Monocyte Function and Macrophage Phenotype

Publication date: Available online 19 March 2017
Source:Free Radical Biology and Medicine
Author(s): Hong Seok Kim, Reto Asmis
MAPK pathways play a critical role in the activation of monocytes and macrophages by pathogens, signaling molecules and environmental cues and in the regulation of macrophage function and plasticity. MAPK phosphatase 1 (MKP-1) has emerged as the main counter-regulator of MAPK signaling in monocytes and macrophages. Loss of MKP-1 in monocytes and macrophages in response to metabolic stress leads to dysregulation of monocyte adhesion and migration, and gives rise to dysfunctional, proatherogenic monocyte-derived macrophages. Here we review the properties of this redox-regulated dual-specificity MAPK phosphatase and the role of MKP-1 in monocyte and macrophage biology and cardiovascular diseases.



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Stimulating CD27 to quantitatively and qualitatively shape adaptive immunity to cancer

Timothy NJ Bullock

http://ift.tt/2nulf0V

An antigen to remember: regulation of B cell memory in health and disease

Aleta Pupovac | Kim L Good-Jacobson

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Stromal networking: cellular connections in the germinal centre

Alice E Denton | Michelle A Linterman

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Plasma cell and memory B cell differentiation from the germinal center

Dan Suan | Christopher Sundling | Robert Brink

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Deconstructing the germinal center, one cell at a time

Chad R Dufaud | Louise J McHeyzer-Williams | Michael G McHeyzer-Williams

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TOPLESS mediates brassinosteroid control of shoot boundaries and root meristem development in Arabidopsis thaliana [RESEARCH ARTICLE]

Ana Espinosa-Ruiz, Cristina Martinez, Miguel de Lucas, Norma Fabregas, Nadja Bosch, Ana I. Cano-Delgado, and Salome Prat

The transcription factor bri1-EMS-SUPRESSOR1 (BES1) is a master regulator of brassinosteroid (BR)-regulated gene expression. BES1 together with BRASSINAZOLE-RESISTANT1 (BZR1) drive activated or repressed expression of several genes, and have a prominent role in negative regulation of BR synthesis. Here, we report that BES1 interaction with TOPLESS (TPL), via its ERF-associated amphiphilic repression EAR motif, is essential for BES1-mediated control of organ boundary formation in the SAM and the regulation of the quiescent center (QC) cell division in roots. We show that TPL binds via BES1 to the promoters of the CUC3 and BRAVO targets and suppresses their expression. Ectopic expression of TPL leads to similar organ boundary defects and alterations in the QC cell division rate as the bes1-d mutation, while bes1-d defects are suppressed by the dominant interfering tpl-1 protein, with these effects respectively correlating with changes in CUC3 and BRAVO expression. Together, our data unveil a pivotal role of the co-repressor TOPLESS in the shoot and root meristems, which relies on its interaction with BES1 and regulation of BES1 target gene expression.

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Lomustine induced acute pulmonary toxicity in a pediatric medulloblastoma survivor

Venkatraman Radhakrishnan, Jayachandran Perumal, Shirley Sundersingh, Tenali Sagar

South Asian Journal of Cancer 2017 6(1):38-39



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Opisthorchiasis, hypercholesterolemia, and cholangiocarcinoma: A reappraisal

Beuy Joob, Viroj Wiwanitkit

South Asian Journal of Cancer 2017 6(1):35-35



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Surgical management of bronchopulmonary carcinoids: A single center experience

Ashish Jakhetiya, Pankaj Kumar Garg, Rambha Pandey, Palaniappan Ramanathan, Sunil Kumar, Debojit Nath, Durgatosh Pandey

South Asian Journal of Cancer 2017 6(1):6-10

Introduction: Bronchopulmonary carcinoids are uncommon tumors with relatively indolent biological behavior but a distinct malignant potential. Surgery is the mainstay of treatment. Our aim was to study preoperative characteristics, surgical approaches, and outcome in patients with bronchopulmonary carcinoid tumors. Patients and Methods: This retrospective study was done in the Department of Surgical Oncology of a Tertiary Teaching Hospital of North India. The case records of all the patients who underwent surgical treatment for lung neoplasms and were diagnosed to have bronchopulmonary carcinoids were reviewed. Details concerning the clinical presentation, preoperative therapy, operative procedure, postoperative complications, and outcome were retrieved from the case records. Results: Sixteen patients who underwent surgical treatment were found to have bronchopulmonary carcinoids on histopathological examination. The median age of the patients was 34 years (range 18–62 years). There were 11 men and five women. All patients were symptomatic, and the median duration of symptoms was 12 months (range 6–72 months) before presentation. Six patients had received antitubercular treatment before presentation, and one patient had been treated with chemotherapy due to misdiagnosis. Surgical procedures included six pneumonectomies (one with carinoplasty), four bilobectomies, three lobectomies, and three bronchoplastic procedures (two with lobectomy and one with bilobectomy). There was no postoperative mortality; three patients had morbidity in the form of lobar collapse, prolonged pleural collection, and surgical site infection. With a median follow-up time of 11 months (range 2–85 months), all the 16 patients are alive and disease-free. Conclusions: Delayed presentation and misdiagnosis of bronchial carcinoid are major concerns in North India. Adequate surgical resection can be performed without undue morbidity and is associated with good long-term results.

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Efficacy of erlotinib as first-line maintenance therapy in patients with locally advanced or metastatic nonsmall cell lung cancer who have not experienced disease progression or unacceptable toxicity during chemotherapy

Senthil Rajappa, Dinesh Chandra Doval, Jaydip Biswas, Shekar Patil, Naresh Somani, Sankar Srinivasan, Shailesh Bondarde, Nitin S Palwe, Binay Swarup

South Asian Journal of Cancer 2017 6(1):1-5

Background: First-line maintenance with erlotinib in nonsmall cell lung cancer (NSCLC) patients without progression after four cycles of chemotherapy was well tolerated and significantly prolonged progression-free survival (PFS) compared with placebo. Aim and Design: This open-label, single arm, Phase IV, interventional study was designed to evaluate erlotinib as first-line maintenance after chemotherapy in Indian NSCLC patients. Primary efficacy objective was to evaluate PFS rate (PFSR) at week 52 and secondary objectives were determination of PFS, overall survival (OS), overall response rate (ORR), disease control rate, and safety. Subjects and Methods: Patients were treated with erlotinib until disease progression/death/unacceptable toxicity or end of study. Patients with disease progression underwent scheduled clinical assessments every 12 weeks thereafter. Kaplan–Meier estimates were used to evaluate PFSR, PFS, and OS. The ORR was summarized using number and percentage along with two-sided 95% Clopper–Pearson confidence interval. The incidence of adverse events (AEs) and serious AEs (SAEs) was tabulated according to severity, outcome, and relationship to erlotinib. Results: Of the 51 enrolled patients, 47 patients completed the study (2: Continuing treatment, 41: Disease progression, and 4: Death) and four patients discontinued treatment (3: Lost to follow-up; 1: Withdrew consent). PFSR was 22.5% at 12 months, median PFS 99 days (14.14 weeks), and median OS was 671 days (22 months). The probability of OS was 74.5% at 14 months. The ORR was 25.5%, and disease control rate was 55.3%. AEs were reported in 62.7% and SAE in 7.8% of patients. Common AEs were diarrhea and rash. Conclusions: Erlotinib was well tolerated by Indian patients in first-line maintenance setting and resulted in median PFS of 14 weeks and median OS of 22 months better than previously reported and with no new safety concerns in this population.

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Billiary obstruction in a metastatic tumor of the pancreas from breast cancer

Bajpai Jyoti, Chauhan Bharat, Thippeswamy Ravi, Ramani K Subhash, Patil Asawari, Gupta Sudeep

South Asian Journal of Cancer 2017 6(1):10-10



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A rare case of brain metastasis in a patient with osteosarcoma

Dinesh Chandra Doval, Mithun Chacko, Rupal Sinha, Kumardeep Dutta Choudhury, Ajay Sharma, Avinash Rao, RS Jaggi, Anurag Mehta

South Asian Journal of Cancer 2017 6(1):36-37



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A tertiary care experience with paclitaxel and cetuximab as palliative chemotherapy in platinum sensitive and nonsensitive in head and neck cancers

Vanita Noronha, Vijay M Patil, Amit Joshi, Atanu Bhattacharjee, Davinder Paul, Sachin Dhumal, Shashikant Juvekar, Supreeta Arya, Kumar Prabhash

South Asian Journal of Cancer 2017 6(1):11-14

Background: The combination of paclitaxel and cetuximab (PaCe) has led to an encouraging response rate in Phase 2 setting with limited toxicity. The aim of our study was to assess the efficacy of this regimen in our setting in platinum sensitive and nonsensitive patients. Methods: This was a retrospective analysis of head and neck cancer patients treated with weekly PaCe as palliative chemotherapy between May 2010 and August 2014. The standard schedule of cetuximab along with 80 mg/m2 of weekly paclitaxel was administered till either disease progression or withdrawal of patient's consent. The toxicity and response were noted in accordance with CTCAE version 4.02 and RECIST version 1.1 criteria, respectively. The response rates between platinum sensitive and nonsensitive patients were compared by Chi-square test. Overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan–Meier survival method and log-rank test was used for comparison. Cox proportional hazard model was used for identification of factors affecting PFS and OS. Results: One Hundred patients with a median age of 52 years (interquartile range: 46–56 years) were included. Forty-five patients (45%) were platinum insensitive, whereas 55 patients (55%) were platinum sensitive. In platinum insensitive patients and sensitive patients, the response rates were 38.5% and 22.2%, respectively (P = 0.104), whereas the symptomatic benefit in pain was seen in 89.5% and 71.7%, respectively (P = 0.044). The median PFS in platinum insensitive and sensitive patients were 150 and 152 days, respectively (P = 0.932), whereas the median OS was 256 days (95% confidence interval [95% CI]: 168.2–343.8 days) and 314 days (95% CI: 227.6–400.4 days), respectively (P = 0.23). Nineteen patients (19%) had grades 3–4 adverse events during chemotherapy. Conclusion: Weekly paclitaxel combined with cetuximab has promising efficacy and good tolerability in the palliative setting in advanced head and neck cancer in both platinum sensitive and insensitive patients.

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Fatty but starving marrow! Gelatinous transformation of bone marrow secondary to plasma cell disorder and all-trans-retinoic acid therapy: A report of two cases

Manu Goyal, Anurag Gupta, Swathi Yarlagadda, Anil Handoo

South Asian Journal of Cancer 2017 6(1):40-41



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Duplicate publication and the need to strengthen editorial policy of the journal

Natasha Das

South Asian Journal of Cancer 2017 6(1):35-36



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Ineffective legislation affecting health of adolescents

Mukesh Sharma, Purnima Thakur, Raman Chauhan, Anjna Sharma

South Asian Journal of Cancer 2017 6(1):39-40



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Role of neoadjuvant chemotherapy in advanced carcinoma of the hypopharynx and larynx

Poonam Joshi, Amit Joshi, Vanita Norohna, Pankaj Chaturvedi, Vijay Patil, Jai Prakash Agarwal, Shashikant Juvekar, Kumar Prabhash

South Asian Journal of Cancer 2017 6(1):15-19

Background: To assess the response rate and impact of neoadjuvant chemotherapy (NACT) in advanced carcinoma of the hypopharynx and larynx. Materials and Methods: This is a retrospective case series of 80 patients with locally advanced laryngopharynx carcinoma who received NACT from April 2010 to October 2011 at our tertiary care center. The patients received NACT either for achieving resectability or for organ preservation. Results: Majority of the patients (60%) had T4 a disease. Grade 3 and 4 neutropenia was seen in 18%, febrile neutropenia in 4%, mucositis in 4%, diarrhea in 5%, and vomiting in 3% patients. Resectability could be achieved in 34%, and larynx was preserved in 51% patients at a mean follow-up of 13 months. Conclusions: NACT was safe with acceptable toxicity. Majority of the patients who achieved resectability had oropharyngeal involvement. NACT followed by concurrent chemoradiotherapy could provide a high rate of organ preservation.

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Comparative evaluation of iodine-131 metaiodobenzylguanidine and 18-fluorodeoxyglucose positron emission tomography in assessing neural crest tumors: Will they play a complementary role?

Soumyakanti Kundu, Purushottam Kand, Sandip Basu

South Asian Journal of Cancer 2017 6(1):31-34

Background: 18-Fluorodeoxyglucose positron emission tomography (FDG-PET) has established a role in the evaluation of several malignancies. However, its precise clinical role in the neural crest cell tumors continues to evolve. Purpose: The purpose of this study was to compare iodine-131 metaiodobenzylguanidine (131I-MIBG) and FDG-PET of head to head in patients with neural crest tumors both qualitatively and semiquantitatively and to determine their clinical utility in disease status evaluation and further management. Materials and Methods: A total of 32 patients who had undergone 131I-MIBG and FDG-PET prospectively were evaluated and clinicopathologically grouped into three categories: neuroblastoma, pheochromocytoma, and medullary carcinoma thyroid. Results: In 18 patients of neuroblastoma, FDG PET and 131I-MIBG showed patient-specific sensitivity of 84% and 72%, respectively. The mean maximum standardized uptake value (SUVmax) of primary lesions in patients with unfavorable histology was found to be relatively higher than those with favorable histology (5.18 ± 2.38 vs. 3.21 ± 1.69). The mean SUVmaxof two common sites (posterior superior iliac spine [PSIS] and greater trochanter) was higher in patients with involved marrow than those with uninvolved one (2.36 and 2.75 vs. 1.26 and 1.34, respectively). The ratio of SUVmaxof the involved/contralateral normal sites was 2.16 ± 1.9. In equivocal bone marrow results, the uptake pattern with SUV estimation can depict metastatic involvement and help in redirecting the biopsy site. Among seven patients of pheochromocytoma, FDG-PET revealed 100% patient-specific sensitivity. FDG-PET detected more metastatic foci than 131I-MIBG (18 vs. 13 sites). In seven patients of medullary carcinoma thyroid, FDG-PET localized residual, recurrent, or metastatic disease with much higher sensitivity (32 metastatic foci with 72% patient specific sensitivity) than 131I-MIBG, trending along the higher serum calcitonin levels. Conclusions: FDG-PET is not only a good complementary modality in the management of neural crest cell tumors but also it can even be superior, especially in cases of 131I-MIBG nonavid tumors.

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Long-term survival in a case of metastatic papillary renal cell carcinoma

Abdul Monem Essam, Ajit Venniyoor, Suresh Nagdev, Itrat Mehdi, Bassim Al Bahrani

South Asian Journal of Cancer 2017 6(1):19-19



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Safety and tolerability of Peg-grafeel™, a pegfilgrastim, for the prophylactic treatment of chemotherapy-induced neutropenia and febrile neutropenia: A prospective, observational, postmarketing surveillance study in India

Vineet Talwar, Sharanabasappa S Nirni, Krishna Mohan Mallavarapu, Anupama Ramkumar, Nitu Sinha

South Asian Journal of Cancer 2017 6(1):20-24

Background: A granulocyte colony-stimulating factor, pegfilgrastim, is efficacious though expensive for prophylactic treatment of chemotherapy-induced neutropenia and febrile neutropenia. Biologics available and accessible today, having acceptable safety-efficacy profiles, require postapproval studies for better understanding of such drugs in clinical settings. Aim: This postmarketing surveillance study evaluated the safety of prophylactic Peg-grafeel™ (pegfilgrastim) in cancer patients with chemotherapy-induced neutropenia. Settings and Design: This prospective, noninterventional, single-arm, open-label study was conducted at 10 study sites in India. Methods: Patients received subcutaneous 6 mg Peg-grafeel™ approximately 24 h following chemotherapy as part of routine patient care. Statistical Analysis: Data were summarized descriptively. Results: The study included 250 patients (male: female = 36.4%:63.6%; median age, 54 [16–80] years). Most patients had Stage III (33.2%) or IV (41.6%) cancers and received cyclophosphamide (37.2%) and doxorubicin (31.6%) as chemotherapy. On an average, 4 Peg-grafeel™ doses were administered per patient. Treatment-emergent adverse events (AEs) were reported in 115 (46%) patients, the most common being vomiting (11.6%), pain (11.2%), nausea (8.4%), and constipation (8.4%). Peg-grafeel™-related AEs included pain (3.2%), asthenia (2.4%), and arthralgia (1.2%). Bone pain (0.4%) and extremity pain (1.2%) were rare. Grade 3/4 neutropenia and febrile neutropenia occurred in 4 (1.6%) and 3 (1.2%) patients, respectively. Serious AEs included vomiting (2.8%) and pyrexia (2%). No new safety concerns were identified. None of the five deaths was considered related to Peg-grafeel™. Conclusion: The overall safety profile of Peg-grafeel™ was consistent with the expected safety profile of pegfilgrastim in patients with advanced malignancies in a clinical setting.

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Treatment planning challenges for prosthesis prostate cancer patients in radiation therapy

N Adhikari, Dinesh Babu Pandey

South Asian Journal of Cancer 2017 6(1):37-38



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Epedimiologic, clinical profile and factors affecting the outcome in febrile neutropenia

Kalpathi Krishnamani, Linga Vijay Gandhi, Gundeti Sadashivudu, Digumarti Raghunadharao

South Asian Journal of Cancer 2017 6(1):25-27

Background: Febrile neutropenia (FN) is common in cancer patients particularly hematologic malignancies due to intensive cytotoxic chemotherapy. It is an important cause of morbidity, mortality and treatment delays. The risk is greater in patients with ANC < 500/ mm3 and increases dramatically in those with ANC < 100/ mm3 and duration of neutropenia more than 1 week. Aims and Objectives: The purpose of this study was to evaluate the incidence, demographic characteristics, clinical profile, mortality, outcome and factors affecting the outcome in patients with febrile neutropenia (FN) admitted at our Center between January 2011 and November 2012. Materials and Methods: All cases of FN admitted in our Institute between January 2011 and November 2012 were analyzed. Data was analyzed using IBM statistic SPSS version 19. Results: A total of 333 episodes of FN were reviewed. Hematologic malignancies accounted for 299 (89.7%) episodes and 88% of all the episodes had grade 4 neutropenia. There was a significant association noted between high serum bilirubin, creatinine and outcome. Isolation of an organism from blood culture, positive findings on chest X-ray and fungal infection was associated with higher mortality . Association between transfusion requirements and outcome was analyzed and it was observed that patients who had multiple component transfusions vs single component ones were at a significantly higher risk of death. There were only 7 deaths noted among the patient population. Conclusion: Leukemias are the leading cause of FN at our Institute. Higher bilirubin, creatinine, chest imaging favoring pneumonia, positive isolates and multiple transfusions had significant association with mortality. Large scale prospective studies are needed to determine the association of preemptive therapy with higher mortality. The outcome of high risk FN in this study is favorable.

http://ift.tt/2n2raaz

Pediatric hematological malignancy: Identification of issues involved in the road to diagnosis

Jeyaanth P Venkatasai, Srividya Srinivasamaharaj, Latha Magatha Sneha, Julius Xavier Scott, Anu Kurian Baby, Mahalakshmi Rajan

South Asian Journal of Cancer 2017 6(1):28-30

Introduction: Childhood malignancy, although a rare phenomenon, is still the leading cause of mortality in the pediatric population. Early diagnosis and treatment are imperative for the achievement of optimal prognosis. The study of factors facilitating the delay in diagnosis is thus of utmost importance, to both shorten the diagnostic delay and allow for early therapeutic intervention, facilitating a higher prognosis. Objective: To assess the referral pattern and the identification of potential delays in the diagnosis of childhood malignancy in a developing country. Methodology: The study was conducted in the Pediatric Hematology and Oncology department of Sri Ramachandra University, Chennai, India. The study included randomly selected 70 pediatric patients diagnosed with a hematological malignancy, from July 2012-August 2013. The parents were interviewed using a prepared questionnaire about patient symptomatology, interaction with healthcare providers, final diagnosis, and referral details. Data were statistically analyzed using Statistica® (STATsoft). Results: 70 patients were included in the study (69% boys, 31% girls). The diagnostic delay was primarily due to the delay experienced in the healthcare system, with a mean delay of 26 days (Median: 18; Range: 5-39). Those from a lower socioeconomic background and whom opted for a non-allopathic treatment approach experienced higher diagnostic delays. Diagnostic time was significantly shorter for those who visited a pediatrician versus the patients who visited a general physician or super specialties (P = 0.043). Conclusions: Diagnostic delay is often associated with an extensive disease presentation, an aggressive therapeutic approach, and has a negative impact on patient prognosis. To lower mortality rate and facilitate a favourable prognosis, diagnosis requires a high degree of clinical suspicion and immediate intervention.

http://ift.tt/2n2iXTH

First reported case of alveolar soft part sarcoma in constitutional mismatch repair deficiency syndrome tumor spectrum - diagnosed in one of the siblings with constitutional mismatch repair deficiency

Mitul Bipinchandra Modi, Pratik N Patel, Vishal M Modi, Shailee P Mehta, Ramrao G Nilkanthe, Priyesh H Patel, Priti P Trivedi, Dhaval H Jetly

South Asian Journal of Cancer 2017 6(1):41-43



http://ift.tt/2n7WOFe

Decision Tools to Improve Personalized Care in Cardiovascular Disease: Moving the Art of Medicine Toward Science.

Author: Yeh, Robert W. MD, MSc; Kramer, Daniel B. MD, MPH

Page: 1097-1100

http://ift.tt/2mn9CZK

Biological Valves in Younger Patients Undergoing Aortic Valve Replacement: A Word of Caution.

Author: Briffa, Norman MB ChB, MD; Chambers, John B. MD

Page: 1101-1103

http://ift.tt/2nMlS2S

VideoEndocrinology™ High-Impact Videos

FREE ACCESS through April 3, 2017.

Extended Endonasal Transsellar Transplanum Endoscopic Removal of Craniopharyngioma
Fan Zhao, Walavan Sivakumar, Amy Eisenberg, Garni Barkhoudarian, Chester F. Griffiths, Daniel F. Kelly

Management of Complex Airway Caused by Massive Retropharyngeal Goiter
Seth Kay, Mark A. Fritz, Gregory N. Postma, David J. Terris

Transoral Endoscopic Total Parathyroidectomy in Renal Hyperparathyroidism Patient
Thanyawat Sasanakietkul, Wirada Wandee, Pornpeera Jitpratoom, Angkoon Anuwong

Transoral Endoscopic Thyroidectomy Vestibular Approach
Thanyawat Sasanakietkul, Tobias Carling

Robotic Bilateral Cortical-Preserving Adrenalectomy in an MEN2A Patient with Steroid Allergy
Nisar Zaidi, Zanati Ahmed, Jesse Gutnick, Eren Berber

The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.

http://ift.tt/2mO9rTq

VideoEndocrinology™ High-Impact Videos

FREE ACCESS through April 3, 2017.

Extended Endonasal Transsellar Transplanum Endoscopic Removal of Craniopharyngioma
Fan Zhao, Walavan Sivakumar, Amy Eisenberg, Garni Barkhoudarian, Chester F. Griffiths, Daniel F. Kelly

Management of Complex Airway Caused by Massive Retropharyngeal Goiter
Seth Kay, Mark A. Fritz, Gregory N. Postma, David J. Terris

Transoral Endoscopic Total Parathyroidectomy in Renal Hyperparathyroidism Patient
Thanyawat Sasanakietkul, Wirada Wandee, Pornpeera Jitpratoom, Angkoon Anuwong

Transoral Endoscopic Thyroidectomy Vestibular Approach
Thanyawat Sasanakietkul, Tobias Carling

Robotic Bilateral Cortical-Preserving Adrenalectomy in an MEN2A Patient with Steroid Allergy
Nisar Zaidi, Zanati Ahmed, Jesse Gutnick, Eren Berber

The post VideoEndocrinology™ High-Impact Videos appeared first on American Thyroid Association.

http://ift.tt/2mO9rTq

FDA OKs Longer-Lasting Juvederm Vollure XC for Laugh Lines

Juvederm Vollure XC (Allergan) is indicated for injection into facial tissue to correct moderate to severe facial wrinkles and folds in adults older than age 21 years.
FDA Approvals

http://ift.tt/2nEdndn

Radiation-induced hypothyroidism after IMRT for nasopharyngeal carcinoma: Clinical and dosimetric predictors in a prospective cohort study

Hypothyroidism (HT) is one of the most common late side effects described in literature after radiation to the cervical region for malignancies including nasopharyngeal carcinoma (NPC) [1–3]. The incidence of post-radiation HT varied in different reports, with most reported between 40% and 50% [4–15]. Half of the events occurred within 5years of follow up, with a peak incidence at 1–2years after radiation [4,6,7,9,13–17]. The major risk factors of HT identified included age [7,12,15,18], sex [2,9,10,12,18], the addition of chemotherapy [11,12], neck surgery [1–3,11,17], radiation dose [1,2,4,6–8,12,16], fractionation [7], pretreatment thyroid volume [4,6,10,16], the volume of thyroid irradiated [1,4–6,8–10,15] and the duration of follow up [9,12,13].

http://ift.tt/2mOg9sw

Exercise Combined With Ultrasound Attenuates Neuropathic Pain in Rats Associated With Downregulation of IL-6 and TNF-[alpha], but With Upregulation of IL-10.

BACKGROUND: Although there are several evidences that suggest efficacies of therapeutic ultrasound (TU) or treadmill exercise (TE) to alleviate nerve injury-associated pain, molecular mechanisms are less clear. We aimed to investigate the impact of TU and/or TE on neuropathic pain induced by chronic constriction injury (CCI) of the sciatic nerve and their roles of proinflammatory and anti-inflammatory cytokines. METHODS: Rats were randomly divided into (n = 10 per group) sham operation (sham), CCI procedure followed by false application of TU (CCI + TU0), CCI procedure followed by false application of TU and TE (CCI + TU0 + TE), CCI, and CCI procedure followed by TU alone (CCI + TU), TE alone (CCI + TE), or both TU and TE (CCI + TU + TE) groups. TU and TE were administered daily, starting on postoperative day 8 (POD 8) for 3 weeks. Mechanical and thermal hypersensitivity, tumor necrosis factor-[alpha] (TNF-[alpha]), interleukin-10 (IL-10), and IL-6 in the sciatic nerve were assessed on PODs 14 and 28. Data were analyzed by 1-way, 2-way, or 3-way analysis of variance of repeated measures or 1-way analysis of variance. RESULTS: After the interventions, there was statistical significance (all P

http://ift.tt/2ntC7F2

Recombinant Factor VIIa Is Associated With Increased Thrombotic Complications in Pediatric Cardiac Surgery Patients.

BACKGROUND: : Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls. METHODS: : We retrospectively reviewed medical records and pharmacy data from all neonates and children who underwent congenital cardiac surgery between May 1, 2011, and October 31, 2013, at Boston Children's Hospital, and identified those who received rFVIIa during the perioperative period. Using existing knowledge, we chose 10 factors associated with bleeding after cardiac surgery to be used in our propensity score: age, sex, body weight, neonates, prematurity, previous sternotomy, cardiopulmonary bypass time, deep hypothermic circulatory arrest time, aortic cross-clamp time, and the operative surgeon. We then used propensity-matched analysis to match children treated with rFVIIa with 2 controls. The primary outcome was thrombotic complications. Secondary outcomes included reexploration for bleeding, length of cardiac intensive care unit stay, length of hospital stay, and 30-day mortality. RESULTS: : One hundred forty-nine patients received perioperative rFVIIa during the study period. Propensity matching yielded 143 rFVIIa patients matched to 2 control patients each (n = 286). Three control patients were found to have received rFVIIa during the perioperative course and were removed from the analysis, for a total of 283 control patients. The administration of rFVIIa was associated with an increased incidence of thrombotic complications (20% vs 8%; odds ratio [OR]: 3.9 [95% confidence interval {CI}: 2.6-5.9], P

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The Input Is Reflected in the Output: Evaluating Neurophysiologic Monitors With Simulated Data.

No abstract available

http://ift.tt/2nLV2YP

A Perioperative Smoking Cessation Intervention With Varenicline, Counseling, and Fax Referral to a Telephone Quitline Versus a Brief Intervention: A Randomized Controlled Trial.

BACKGROUND: The effectiveness of perioperative interventions to quit smoking with varenicline has not been compared with brief interventions. Our objective was to determine the efficacy of a comprehensive smoking cessation program versus a brief intervention for smoking cessation. METHODS: In this prospective, multicenter study, 296 patients were randomized to participate in a smoking cessation program (one 10- to 15-minute counseling session, pharmacotherapy with varenicline, an educational pamphlet, and a fax referral to a telephone quitline); or brief advice and self-referral to a telephone quitline. The primary outcome was the 7-day point prevalence (PP) abstinence at 12 months after surgery. Secondary outcomes included abstinence at 1, 3, and 6 months. Multivariable generalized linear regression was used to identify independent variables related to abstinence. RESULTS: The 7-day PP abstinence for the smoking cessation program versus brief advice group was 42.4% vs 26.2% (relative risk [RR], 1.62; 95% confidence interval [CI], 1.16-2.25; P = .003) at 12 months. The 7-day PP abstinence at 1, 3, and 6 months was higher in the smoking cessation group versus the brief advice group: 45.7% vs 25.5% (RR, 1.79; 95% CI, 1.29-2.49; P

http://ift.tt/2mmBVrb

A High Preoperative Pain and Symptom Profile Predicts Worse Pain Outcomes for Children After Spine Fusion Surgery.

BACKGROUND: : Preoperative pain predicts persistent pain after spine fusion, yet little is understood about the nature of that pain, related symptoms, and how these symptoms relate to postoperative pain outcomes. This prospective study examined children's baseline pain and symptom profiles and the association between a high symptom profile and postoperative outcomes. METHODS: Seventy children (aged 10-17 years) scheduled for correction of idiopathic scoliosis completed pain and symptom surveys during their preoperative visit (ie, pain intensity [0-10 numeric rating scores], a pediatric version of the 2011 fibromyalgia survey criteria [including pain locations and symptom severity scale], neuropathic pain symptoms [painDETECT], and Patient-Reported Outcome Measurement System measures of fatigue, depression, function, pain interference, and pain catastrophizing). Pain intensity and total analgesic use were recorded daily postoperatively and for 2 weeks after discharge. A 2-step cluster analysis differentiated a high and low pain and symptom profile at baseline, and a multivariate main effects regression model examined the association between pain profile and posthospital discharge pain and analgesic outcomes. RESULTS: The cluster analysis differentiated 2 groups of children well characterized by their baseline symptom reporting. Thirty percent (95% confidence interval [CI], 20.2%-41.8%) had a high symptom profile with higher depression, fatigue, pain interference, a pediatric version of the fibromyalgia survey criteria symptoms, neuropathic pain, and catastrophizing. Girls were more likely than boys to be clustered in the high symptom profile (odds ratio [OR], 5.76 [95% CI, 1.20-27.58]; P = .022) as were those with preoperative pain lasting >3 months (OR, 3.42 [95% CI, 1.21-9.70]; P = .018). Adjusting for sex, age, and total in-hospital opioid consumption, high cluster membership was independently associated with higher self-reported pain after discharge (mean difference +1.13 point [97.5% CI, 0.09-2.17]; P = .015). Children in the high symptom cluster were more likely to report ongoing opioid use at 2 weeks compared with the low symptom group (87% vs 50%; OR, 6.5 [95% CI, 1.30-33.03]; P = .015). At 6 months, high symptom cluster membership was associated with higher pain intensity, higher pain interference, and ongoing analgesic use (P

http://ift.tt/2nLQPnN

Not Just Individuals: The Importance of Collaborative Systems of Pediatric Surgical Care.

No abstract available

http://ift.tt/2nXDto0

In Response.

No abstract available

http://ift.tt/2ntLjJx

The First US Clinical Experience With Computer-Assisted Propofol Sedation: A Retrospective Observational Comparative Study on Efficacy, Safety, Efficiency, and Endoscopist and Patient Satisfaction.

BACKGROUND: : Computer-assisted propofol sedation (CAPS) is now approved for moderate sedation of American Society of Anesthesiologists (ASA) class I and II patients undergoing routine endoscopy. As the first US medical center to adopt CAPS for routine clinical use, we compared patient and endoscopist satisfaction with CAPS versus midazolam and fentanyl (MF) sedation. METHODS: Patients who underwent elective outpatient upper endoscopy and colonoscopy with CAPS were compared with concurrent patients sedated with MF. The primary end points were patient satisfaction (measured by the validated Patient Sedation Satisfaction Index [PSSI]), and endoscopist satisfaction (Clinician Sedation Satisfaction Index [CSSI]). Secondary end points included procedural success rates, polyp detection rates, adverse events, and procedure/recovery times. Multivariable regression was used for comparative analysis. RESULTS: CAPS was utilized to sedate 244 patients, of whom 55 underwent upper endoscopy, 173 colonoscopy, and 16 double procedures. During the same period, 75 upper endoscopies, 223 colonoscopies, and 30 doubles were performed with MF on similar patients. For upper endoscopy, the procedural success rate was 98.2% for CAPS versus 98.7% for MF (P = .96), whereas for colonoscopy, the success rate was 98.9% versus 98.8% (P = .59). Colonoscopic polyp detection rate was 54.5% for CAPS and 59.3% for MF (P = .67). Procedure times were similar between CAPS and MF. For CAPS, the mean recovery time was 26.4 versus 39.1 minutes for MF (P

http://ift.tt/2mmRY8r

In Response.

No abstract available

http://ift.tt/2nXQwpt

In Response.

No abstract available

http://ift.tt/2mmSUd9

Do-Not-Resuscitate Status Is Associated With Increased Mortality But Not Morbidity.

BACKGROUND: : Do-not-resuscitate (DNR) orders instruct medical personnel to forego cardiopulmonary resuscitation in the event of cardiopulmonary arrest, but they do not preclude surgical management. Several studies have reported that DNR status is an independent predictor of 30-day mortality; however, the etiology of increased mortality remains unclear. We hypothesized that DNR patients would demonstrate increased postoperative mortality, but not morbidity, relative to non-DNR patients undergoing the same procedures. METHODS: :Using the American College of Surgeons National Surgical Quality Improvement Program database for 2007 to 2013, we performed a retrospective analysis to compare DNR and non-DNR cohorts matched by the most common procedures performed in DNR patients. We employed univariable and multivariable logistic regression to characterize patterns of care in the perioperative period as well as identify independent risk factors for increased mortality and assess for the presence of "failure to rescue." RESULTS: : The most common procedures performed on DNR patients were emergent and centered on immediate symptom relief. When adjusting for preoperative factors, DNR patients were still found to have increased incidence of postoperative mortality (odds ratio 2.54 [2.29-2.82], P

http://ift.tt/2nXO1Ub

Effects of a Lidocaine-Loaded Poloxamer/Alginate/CaCl2 Mixture on Postoperative Pain and Adhesion in a Rat Model of Incisional Pain.

BACKGROUND: Pain and adhesion are problematic issues after surgery. Lidocaine has analgesics and anti-inflammatory properties, and poloxamer/alginate/CaCl2 (PACM) is a known antiadhesive agent. We hypothesized that the novel combination of lidocaine as chemical barrier and PACM as physical barrier would be beneficial for both postoperative pain and adhesion. The purpose of this study was to investigate the effects of lidocaine-loaded PACM in a rat model of incisional pain. Primary outcome was to evaluate between-group differences for the mechanical withdrawal threshold (MWT) measured by von Frey filament in various concentrations of lidocaine-loaded PACM applied, PACM applied, and sham-operated groups. METHODS: Male Sprague-Dawley rats were used for the postoperative pain model. After plantar incision and adhesion formation, 0.5%, 1%, 2%, and 4% lidocaine-loaded PACM, PACM only, nothing, and 4% lidocaine only were applied at the incision site in groups PL0.5, PL1, PL2, PL4, P, S, and L4, respectively. MWT using a von Frey filament and serum levels of tumor necrosis factor-[alpha], interleukin (IL)-1[beta], IL-6, and high-sensitivity C-reactive protein were measured. Rats were euthanized 2 weeks after surgery, and inflammation and fibrosis were assessed with microscopy. Data were analyzed using the Kruskal-Wallis test, multivariate analysis of variance, and linear mixed-effect model. To compare MWT at each time point, analysis of variance with Bonferroni correction was used. RESULTS: Multivariate analysis of variance showed that 4% lidocaine-loaded PACM significantly raised the MWT up to 6 and 8 hours after surgery compared with lidocaine-unloaded groups S and P, respectively; 2% lidocaine-loaded PACM significantly increased the MWT at 4 hours after surgery compared with groups S and C. Linear mixed-effect model showed that the MWT (estimated difference in means [95% confidence interval]) was significantly increased in groups PL2 and PL4 (6.58 [2.52-10.63], P = .002; 11.46 [7.40-15.51], P

http://ift.tt/2mmyz7A

Irony and the Elephant in the Review.

No abstract available

http://ift.tt/2nXX9bq

Process Improvement Initiative for the Perioperative Management of Patients With a Cardiovascular Implantable Electronic Device.

BACKGROUND: Economic, personnel, and procedural challenges often complicate and interfere with efficient and safe perioperative care of patients with cardiovascular implantable electronic devices (CIEDs). In the context of a process improvement initiative, we created and implemented a comprehensive anesthesiologist-run perioperative CIED service to respond to all routine requests for perioperative CIED consultations at a large academic medical center. This study was designed to determine whether this new care model was associated with improved operating room efficiency, reduced institutional cost, and adequate patient safety. METHODS: We included patients with a CIED and a concurrent cohort of patients with the same eligibility criteria but without a CIED who underwent first-case-of-the-day surgery during the periods between February 1, 2008, and August 17, 2010 (preintervention) and between March 4, 2012, and August 1, 2014 (postintervention). The primary end point was delay in first-case-of-the day start time. We used multiple linear regression to compare delays in start times during the preintervention and postintervention periods and to adjust for potential confounders. A patient safety database was queried for CIED-related complications. Cost analysis was based on labor minutes saved and was calculated using nationally published administrative estimates. RESULTS: A total of 18,148 first-case surgical procedures were performed in 15,100 patients (preintervention period-7293 patients and postintervention period-7807 patients). Of those, 151 (2.1%) patients had a CIED in the preintervention period, and 146 (1.9%) had a CIED in the postintervention period. After adjustment for imbalances in baseline characteristics (age, American Society of Anesthesiologists physical status, and surgical specialty), the difference in mean first-case start delay between the postintervention and preintervention periods in the cohort of patients with a CIED was -16.7 minutes (95% CI, -26.1, -7.2). The difference in mean delay between the postintervention and preintervention periods in the cohort without a CIED was -4.7 minutes (95% CI, -5.4, -3.9). There were 3 CIED-related adverse events during the preintervention period and none during the postintervention period. Based on reduction in first-case start delay, the intervention was associated with cost savings (estimated institutional savings $14,102 annually, or $94.06 per CIED patient), with a return on investment ratio of 2.18 over the course of the postintervention period. CONCLUSIONS: Based on our experience, specially trained anesthesiologists can provide efficient and safe perioperative care for patients with CIEDs. Other centers may consider implementing a similar strategy as our specialty adopts the perioperative surgical home model. (C) 2017 International Anesthesia Research Society

http://ift.tt/2mmL2bz

Correction: Identification of Potential Novel Biomarkers and Signaling Pathways Related to Otitis Media Induced by Diesel Exhaust Particles Using Transcriptomic Analysis in an In Vivo System

by Hyo Jeong Kim, So Young Kim, Jee Young Kwon, Yeo Jin Kim, Seung Hun Kang, Won-Hee Jang, Jun Ho Lee, Myung-Whan Suh, Jae-Jun Song, Young Rok Seo, Moo Kyun Park

http://ift.tt/2mlMB9I

Correction: Identification of Potential Novel Biomarkers and Signaling Pathways Related to Otitis Media Induced by Diesel Exhaust Particles Using Transcriptomic Analysis in an In Vivo System

by Hyo Jeong Kim, So Young Kim, Jee Young Kwon, Yeo Jin Kim, Seung Hun Kang, Won-Hee Jang, Jun Ho Lee, Myung-Whan Suh, Jae-Jun Song, Young Rok Seo, Moo Kyun Park

http://ift.tt/2mlMB9I

Immunotherapy for food allergy.

Purpose of review: The current review discusses strategies for administering specific immunotherapy (SIT) for the treatment of food allergy. It focuses on three delivery routes for food allergens, immunomodulatory adjuvants and allergen modifications. Recent findings: Interest in SIT for food allergy has been increasing significantly. Sublingual immunotherapy is effective for desensitization with a very favorable adverse event profile. Epicutaneous immunotherapy is also effective, most notably in younger children, with a high rate of local reactions. Oral immunotherapy demonstrates high efficacy, but with a higher risk of gastrointestinal and systemic adverse events. The need for long-term application to sustain desensitization is currently unclear. Immunomodulatory adjuvants may be added to enhance or diminish the immunogenicity of proteins, whereas genetic modifications of food allergens are designed to limit the risk of adverse reactions and address the issues of standardization and supply. Summary: SIT for food allergy is reaching the point where it may soon be used routinely in clinical practice. Current research focuses on new delivery routes and methods to enhance the effectiveness of the therapy while minimizing the risk of adverse reactions. Future efforts are underway to determine the optimal dose for each delivery method and the length of maintenance dosing required to retain the protective effect. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2ntDTpF

Application of telepractice for head and neck cancer management: a review of speech language pathology service models.

Purpose of review: Head and neck cancer (HNC) is a complex and heterogeneous disease, requiring specialist intervention from a multidisciplinary team including speech language pathology (SLP). Unfortunately, multiple patient and service-related challenges exist which currently limit equitable access to SLP support for all individuals. This review highlights the existing evidence for different telepractice models designed to help patients and services optimize management of swallowing and communication disorders arising from HNC. Recent findings: Emerging evidence exists for using computerized screening to enhance the identification of treatment-related toxicities and assist referrals to services, including SLP. Asynchronous telepractice applications are being used to assist delivery of intensive home-based dysphagia therapy, whereas videoconferencing can offer a feasible and effective method to support ongoing management for patients with limited access to local specialist SLP services. Patient and clinician satisfaction with all models has been high. Summary: SLP services can be redesigned to incorporate a range of telepractice models to optimize clinical care at different stages of the HNC survivorship pathway. Early evidence supports telepractice can improve patient access to services, enhance outcomes, and optimize health service efficiency; however, further systematic research is needed into these models, particularly relating to large-scale implementation and costs/economic analyses. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2mJ5Bu2

Immunotherapy for food allergy.

Purpose of review: The current review discusses strategies for administering specific immunotherapy (SIT) for the treatment of food allergy. It focuses on three delivery routes for food allergens, immunomodulatory adjuvants and allergen modifications. Recent findings: Interest in SIT for food allergy has been increasing significantly. Sublingual immunotherapy is effective for desensitization with a very favorable adverse event profile. Epicutaneous immunotherapy is also effective, most notably in younger children, with a high rate of local reactions. Oral immunotherapy demonstrates high efficacy, but with a higher risk of gastrointestinal and systemic adverse events. The need for long-term application to sustain desensitization is currently unclear. Immunomodulatory adjuvants may be added to enhance or diminish the immunogenicity of proteins, whereas genetic modifications of food allergens are designed to limit the risk of adverse reactions and address the issues of standardization and supply. Summary: SIT for food allergy is reaching the point where it may soon be used routinely in clinical practice. Current research focuses on new delivery routes and methods to enhance the effectiveness of the therapy while minimizing the risk of adverse reactions. Future efforts are underway to determine the optimal dose for each delivery method and the length of maintenance dosing required to retain the protective effect. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2ntDTpF