Selecting Trustworthy Papers.

No abstract available

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Hemorrhage and Infarction of the Conjunctiva and Orbit in Essential Thrombocythemia.

An 82-year-old woman who had a history of essential thrombocythemia presented with ocular pain, bleeding, and decreased visual acuity of the left eye. Orbital computed tomography revealed a relatively well-defined homogenous mass-like lesion in the left subconjunctival and intraconal space. Conjunctival biopsy showed acute inflammation with necrosis, vascular ectasia with thrombosis and hemorrhage. After the treatment with hydroxyurea and anagrelide, her symptom and lesion were markedly improved. Hematologic disorders like essential thrombocythemia should be considered in patients with severe spontaneous bleeding around the eye. (C) 2017 by Mutaz B. Habal, MD.

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Antibacterial Effect of Bacteriocin Isolated From Lactobacillus Plantarum ATCC 8014 on Postoperative Infection of Mandibular Fracture In Vivo.

Objective: The primary objective of this study was to verify the effects of bacteriocin in treatment of postoperative infection of mandibular fracture in vivo. Methods: Eighty-two mice were inoculated intravenously with staphylococcal suspensions. Bacterial cultures were obtained from implants. Blood samples were collected at 1, 2, 4, 6, and 8 hours after the injection of bacteriocins. Results: Bacteriocins have significant inhibitory effects on Staphylococcus aureus (P

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Clinical Manifestation of a Patient With Forehead Sparganosis.

Human sparganosis is a parasite infection caused by the larva of a tapeworm of the genus Spirometra. Ocular, central nervous system, auricular, pulmonary, intraosseous, intraperitoneal, and subcutaneous manifestations of this infection in the neck or inguinal region have been described. The authors report the rare occurrence of cutaneous forehead sparganosis of a 19-year-old male who presented with a soft subcutaneous mass in the forehead, along with a related literature review. (C) 2017 by Mutaz B. Habal, MD.

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Simple Percutaneous Transbuccal Approach for Management of Mandibular Angular Fracture.

Objective: To describe a relatively simple, easy, and safe technique for open reduction and internal fixation of the mandibular angle fracture using the combined modified percutaneous and oral approach with no special instrumentation. Patients and Methods: This study was carried out on 10 patients who had traumatic mandibular angle fractures. All patients were managed by open reduction and internal fixation. Intraoral exposure and reduction of the fracture was performed through the gingivolabial incision. Then, a modified percutaneous-transbuccal way was utilized for conduction of the microdrill shaft and screw driver to permit screws fixation with perpendicular relations between plate and inserted screws. Results: There were no registered soft tissue infections, wound dehiscence, occlusal defects, or facial nerve paresis. The mean surgical duration was 39.7 +/- 11.5 minutes. No patients were recorded to have unsatisfactory external scar and further intervention was not required. Conclusion: The described percutaneous approach to mandibular angle fracture can be done effectively and safely using available and operatively fabricated disposable tools. (C) 2017 by Mutaz B. Habal, MD.

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Burkitt Lymphoma in Adult With Atypical Clinical Presentation Primarily Involving the Oral Soft Tissue.

Non-Hodgkin lymphoma is the second most common neoplasm of the head and neck after squamous cell carcinoma. However, it accounts for only 3.5% of all malignancies of the oral cavity. Oral lesions are often a component of disseminated disease process that may involve regional lymph nodes or may at times represent the primary extra nodal form of the disease. Although, isolated oral lymphoma in adults is extremely rare, this paper presents a patient with Burkitt lymphoma in an adult male with atypical clinical presentation primarily involving the oral soft tissue. It is believed that the prognosis of Burkitt lymphoma depends on the extent of the disease, the patient's age, and the timing of diagnosis. Therefore, the role of the dentist in the early diagnosis and prompt referral of patients with Burkitt lymphoma cannot be overemphasized. (C) 2017 by Mutaz B. Habal, MD.

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Management of Pharyngocutaneous Fistula With Negative-Pressure Wound Therapy.

Background: Pharyngocutaneous fistula is a common complication of laryngopharyngeal surgery and is associated with increased morbidity and mortality. Beyond the classical management, negative-pressure wound therapy (NPWT) can be an alternative and effective treatment. Clinical Report: Two patients with pT3N0M0 squamous cell carcinoma of pyriform sinus were subjected to total laryngectomy and pharyngoesophageal reconstruction of a circular (patient 1) and an anterior wall defect (patient 2) with radial forearm free flap and pectoralis major muscle flap, respectively. Both developed a pharyngocutaneous fistula and NPWT was used. A significant decrease of the fistula aperture and exudate was observed after 22 and 21 days of NPWT in patients 1 and 2, respectively. After that standard wound care was instituted and closure of the fistulae was accomplished in 5 and 7 days, respectively. Conclusion: Negative-pressure wound therapy can be an effective treatment for pharyngocutaneous fistula closure, either in the setting of fistulae that persist besides multiple surgical revisions using muscle flaps or as a first-line therapy when fistulae develops. (C) 2017 by Mutaz B. Habal, MD.

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Improving the Results of Cross Lip Vermilion Flap in Cleft Patients.

Cross lip vermilion flap is a myomucosal flap that uses lower red lip to augment deficient upper lip vermilion. Technical note that helps in imitating upper lip tubercle structure is presented. Appropriate patient selection to prevent unfavorable results such as color mismatch, local vermilion excess, and lower lip thinning are presented. Indirect benefits of this flap for decreasing upper incisor tooth show and better balance of upper/lower lip thickness are discussed. (C) 2017 by Mutaz B. Habal, MD.

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Intracranial Anatomic Landmarks for Endoscopic Endonasal Transcribriform Approach to Anterior Skull Base.

Objectives: To help surgeons locating anatomic landmarks when performing endoscopic endonasal transcribriform approach to anterior skull base. Methods: High-resolution axial computed tomography (CT) images at thickness of 0.6 mm, and reconstructed 0.41-mm thick gapless sagittal and coronal CT images were taken from 123 subjects. Using mimics software, first located elementary points and line: nasal spine, midpoint of posterior hard palate and the line between them; then located measured points right/left posterior and anterior points; measured distances between measured points and from measured points to nasal spine and angles between lines connecting measured points to nasal spine and the basic line. Results: The distances from nasal spine to right/left posterior and anterior points of anterior skull base are 68.67 +/- 6.04 and 61.71 +/- 5.09 mm, corresponding angles are 45.89 +/- 4.20[degrees] and 72.07 +/- 4.06[degrees], respectively. The width and length of defect of anterior skull base are 24.45 +/- 2.62 and 31.03 +/- 4.96 mm; its area ranges from 373.75 +/- 94.08 to 800.91 +/- 195.07 mm2. Conclusions: The study provides information about anterior skull base anatomic landmarks, which can help surgeons to locate them and avoid relative complications during endoscopic endonasal transcribriform approach to anterior skull base. The measurements can be used as surgical indicators to investigate the landmarks. (C) 2017 by Mutaz B. Habal, MD.

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Simultaneous Autologus Mandible and Temporomandibular Joint Reconstruction.

Ablative surgery of mandible often necessitates combined reconstruction of the mandible and the temporomandibular joint. Fibula-free flaps with gap arthroplasty or osseochondral grafts are common procedures in the authors' practice. In search for a better reconstructive option free fibula flap is used together with a metatarsal bone flap for the vascular reconstruction of the mandibular body and the condyle at the same time. The 2 osseous-free flaps have been fused and used as a combined flow through double-free flap. The literature has been reviewed for other reconstructive options, but no alternatives providing autologous reconstruction of both the mandible and the condyle with vascular tissue have been found. This is a preliminary report of this new technique which the authors humbly think is very promising. (C) 2017 by Mutaz B. Habal, MD.

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Retropharyngeal Abscess Presenting With Sleep Apnea Syndrome.

Retropharyngeal abscess (RPA) is the second most common deep neck space infection after peritonsiller abscess in pediatric population. Major signs and symptoms on physical examination include fever, hypersalivation, odynophagia, reduced oral intake, sore throat, swelling on the neck, torticollis, limitation in neck mobility, and voice changes. In this paper, the authors present a case of RPA with unusual and interesting presenting symptoms in a 10-month-old infant that exhibit new-onset and worsening snoring and sleep apnea. The purposes of this manuscript are to present the authors' experience with this patient, to emphasize the diagnosis, clinical course, and management of RPA in infants, also to signify the importance of including RPA in the differential diagnosis of patients with sleep apnea syndrome. (C) 2017 by Mutaz B. Habal, MD.

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Unusual Association: Cerebral Arteriovenous Malformation and Chiari Type I Malformation.

Cerebral arteriovenous malformation (AVM) is a common type of cerebral vascular malformation. The imaging findings are enlarged vessels, thrombosed sinuses, and hemorrhage or gliosis on adjacent brain parenchyma. Magnetic resonance (MR) imaging can be used safely for diagnosis. Chiari type I malformation is characterized by a caudal descent of the cerebellar tonsil. Coincidence of cerebral AVM and Chiari type I malformation is very rare. In this paper, the authors report MR imaging findings of a patient with coincidence of cerebral AVM and Chiari type I malformation. (C) 2017 by Mutaz B. Habal, MD.

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Influence Factor in Thickness of Cyst Wall of Epidermal Cysts.

Purpose: An epidermal cyst is one of the most common benign tumors of the skin and its major treatment method is excision. Surgical excision is treatment of choice for epidermal cysts, but the cyst wall may be ruptured during operation, especially when the cyst wall is relatively thin. The incomplete excision of the cyst sometimes occurs because of a rupture of the cyst and incomplete excision may cause recurrence. The purpose of this study is to evaluate the factors that can influence the thickness of the cyst wall of epidermal cysts. Methods: From December 2008 to November 2013, medical records and tissue pathology slides of 290 patients with an epidermal cyst were reviewed retrospectively. The relationships among the regions, history of infection, the age of patients, and the thickness of the cyst and epidermis were analyzed. Results: There was no difference between thickness of cyst wall and site of occurrence and between thickness of epidermis and site of occurrence. The thickness of epidermal cyst wall with previous infection is thicker than those without infection episode (P = 0.01). However, the difference of thickness of epidermis above the cyst between with and without previous infection is not statistically significant (P = 0.641). The thickness of cyst wall and epidermis showed positive correlation (Pearson correlation coefficient 0.391, P = 0.01). Conclusion: From this study, there was a tendency cyst wall with the history of infection or incision and drainage is thicker. When surgical excision, more attention to excise epidermal cyst completely is needed for the prevention of recurrence of the cyst. (C) 2017 by Mutaz B. Habal, MD.

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Review of "Repealing the ACA Without a Replacement-The Risks to American Health Care" by Obama BH in N Engl J Med 376: 297-299, 2017.

No abstract available

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Tomographic Evaluation of Prevalence, Position, and Diameter of the Intraosseous Branch of the Posterior Superior Alveolar Artery in Fully Edentulous Individuals.

The objective of this study was to evaluate the presence, position, and diameter of the intraosseous branch (IObr) of the posterior superior alveolar artery in fully edentulous patients. Two-hundred five computed tomography scans of fully edentulous patients were analyzed. The presence of the IObr was investigated in the coronal plane at the lateral wall of the maxillary sinus. In patients in whom the IObr was detected, the artery diameter was measured, and the distance from the artery to the bone crest of the alveolar ridge, the maxillary sinus floor, and the distance of the maxillary sinus floor to the bone crest of the alveolar ridge were measured as well. A descriptive statistical analysis of these parameters was conducted. The IObr was identified in the maxillary sinus in 105 tomography images (51.2%), and its diameter varied between 0.8 and 3.3 mm (1.29 +/- 0.49 mm). The IObr presented with an artery diameter less than 1 mm in 29% of the patients, between 1 and 2 mm diameter in 61% of the patients and with a diameter larger than 2 mm in 10% of patients. Regarding the IObr topography, the distance from the artery to the floor of the maxillary sinus was 9.62 +/- 4.59 mm, and the distance from the artery to the top of crestal bone was 15.15 +/- 4.47 mm. At least 10% of edentulous patients are at risk of bleeding complications during interventions in the maxillary sinus. (C) 2017 by Mutaz B. Habal, MD.

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Evaluation of Dentoalveolar Trauma in Children and Adolescents: a Modified Classification System and Surgical Treatment Strategies for Its Management.

Objective: To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective. Patients and Methods: Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed. Results: A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department. The most common injury mechanism was falls. The trauma was graded as class II in most patients (41.65%). The anterior maxilla was injured in the majority of the patients (78.35%). In 230 patients (63%) the trauma involved the primary dentition. Two hundred eighty-nine of the patients were treated with local anesthesia on an emergency basis, while in the rest 76 patients general anesthesia was considered mandatory. Conclusions: Accurate diagnosis, timely treatment, and follow-up are critical for the management of dentoalveolar trauma in pediatric patients. A modified more detailed and severity-specific classification and guidelines for its surgical management may assist practitioners in decision making and effective treatment planning. (C) 2017 by Mutaz B. Habal, MD.

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Removable Partial Denture After Gunshot Injury: Five Year Follow-Up.

The aim of this study was to report a patient of rehabilitation with removable partial denture retained by implants in-patient who suffered injury after firearm shooting. A 19-year-old man presented to the hospital of the Val Paraiso city after being hit by a bullet in the right on the face, affecting the teeth 12 to 16. The surgery to remove the shards of teeth, and bullet was performed. Surgical team opted for installation of implants without bone grafts; however, due to extensive loss of alveolar bone, only 3 tilted implants (2 O3.75 x 8.5 mm and 1 O3.75 x 10 mm) were installed. After recovery, the patient was referred to the Aracatuba Dental School-UNESP for the rehabilitation on the affected region. The difficulty of rehabilitation with conventional fixed prostheses was verified during the prosthetic phase. This way, it was opted for rehabilitation with removable partial dentures associated with dental implant. Two attachment system ERA (ERA, Sterngold) were positioned in the bar to make the removable partial denture. After 5 years of follow-up, the authors can conclude that the use of removable partial denture retained by implants is effective for functional and aesthetic rehabilitation, favoring socialization and self-esteem of the patient. (C) 2017 by Mutaz B. Habal, MD.

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A Rare Complication of Cochlear Implantation After Magnetic Resonance Imaging: Reversion of the Magnet.

Cochlear implants are mechanical devices used for patients with severe sensory-neural hearing loss, which has an inner magnet. It is proven that 1.5 Tesla magnetic resonance imaging (MRI) scanners are safe to use in patients with cochlear implant. In our patient, the authors aim to introduce a rare complication caused after a 1.5 Tesla MRI scanning and the management of this situation; the reversion of the magnet of the implant without displacement and significance of surgery in management. (C) 2017 by Mutaz B. Habal, MD.

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Complications After Treatment of Head and Neck Venous Malformations With Sodium Tetradecyl Sulfate Foam.

Purpose: The aim of this study was to evaluate complications in patients with head and neck venous malformations (VMs) treated with foam sclerotherapy using sodium tetradecyl sulfate (STS). Methods: The authors retrospectively evaluated the complications, pain. and degree of satisfaction in 69 consecutive patients affected by cervicofacial VM managed with STS using the Tessari method in a single institution. Results: The average number of procedures for each patient was 2.1. The most frequent complication was blistering. We observed 1 patient of temporary weakness of a facial nerve branch, 1 paradoxical embolism, and 1 orbital compartment syndrome. The average pain score was 0 (no pain at all) (51.5%). There was no statistically significant correlation between patient satisfaction and the presence of complications or the degree of pain. Conclusions: Sclerotherapy with STS is an effective treatment that yields to very high patient satisfaction. This procedure has an overall low complication rate and is usually effective within a few sessions. However, severe complications may occur; these must be pointed out in the informed consent and the surgeon must be aware of and ready to quickly treat them to prevent long-term sequelae. (C) 2017 by Mutaz B. Habal, MD.

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Endoscopic Endonasal Repair of Isolated Medial Orbital Wall Fracture With Balloon Technique.

Endonasal endoscopic repair of medial orbital wall fractures is minimally invasive and benefits the patients. The authors describe the authors' modified balloon technique, which allows longer support of the orbital wall. From October 2010 through January 2016, the author repaired 9 isolated medial wall fractures by this method. Five patients were diagnosed as having enophthalmos of greater than 2 mm, and 6 patients had persistent diplopia before the operation. The herniated orbital contents that filled the anterior ethmoidal sinus were gently reduced with a 4-mm-diameter 0[degrees] sinus endoscope. Then a posterior nasal cavity balloon (Type B # 32014, KOKEN Co, Japan) was inserted into the ethmoidal sinus and filled with normal saline. The inflation tube of the balloon was sutured to the nasal cavity wall with absorbable sutures. After checking the status of the balloon, the inflation tube was ligated and cut so that it could be hidden inside the nasal cavity. The balloon was removed on an outpatient basis 6 to 7 weeks after the surgery. In this series, the mean inflation volume of the balloon was 1.6 mL, the mean period of leaving the balloon in place was 5.7 weeks, and the mean operative time was 38.6 minutes. Resolution of the preoperative diplopia and enophthalmos was achieved in all 9 patients, and there was no recurrence of prolapse of the orbital contents. This method allows leaving the balloon in place for a long period of time without interfering with daily life, which reduces the risk of rebulging of the orbital contents. (C) 2017 by Mutaz B. Habal, MD.

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Why Is It Surprising That Emotional Intelligence Matters?.

No abstract available

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An Improvement on Central Line Dressings Using an "Omental" Technique.

No abstract available

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Venous Air Embolism: The Severity Depends on Many Factors.

No abstract available

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Research Methodology: The Aims, Practices, and Ethics of Science.

No abstract available

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In Response.

No abstract available

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Atlas of Anatomy (Thieme Anatomy): Pragmatic Simplicity.

No abstract available

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Pectoralis and Serratus Fascial Plane Blocks Each Provide Early Analgesic Benefits Following Ambulatory Breast Cancer Surgery: A Retrospective Propensity-Matched Cohort Study.

BACKGROUND: Pectoralis and serratus blocks have been described recently for use in breast surgery, but evidence supporting their analgesic benefits is limited. This cohort study evaluates the benefits of adding a pectoralis or serratus block to conventional opioid-based analgesia (control) in patients who underwent ambulatory breast cancer surgery at Women's College Hospital between July 2013 and May 2015. We tested the joint hypothesis that adding a pectoralis or serratus block reduced postoperative in-hospital (predischarge) opioid consumption and nausea and vomiting (PONV). We also examined the 2 block types for noninferiority. METHODS: A total of 225 patients were propensity matched on 5 potential confounders among 3 study groups (75 per group): (1) pectoralis; (2) serratus; and (3) control. The propensity-matched cohort was used to evaluate the effect of the study group on postoperative in-hospital oral morphine equivalent consumption and PONV. We considered pectoralis noninferior to serratus block if it was noninferior for both outcomes, within 10 mg morphine and 17.5% in PONV incidence margins. Other outcomes included intraoperative fentanyl requirements, pain scores, time to first analgesic request, and duration of recovery room stay. RESULTS: Both pectoralis and serratus blocks were each associated with reduced postoperative in-hospital opioid consumption and PONV compared with control. Pectoralis was noninferior to serratus block for these 2 outcomes. Pectoralis and serratus blocks were each associated with reduced intraoperative fentanyl requirements, prolonged time to first analgesic request, and expedited recovery room discharge compared with control; there were no differences for the remaining outcomes. CONCLUSIONS: Pectoralis and serratus blocks were each associated with a reduction in postoperative in-hospital opioid consumption and PONV compared with conventional opioid-based analgesia after ambulatory breast cancer surgery. (C) 2017 International Anesthesia Research Society

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In Response.

No abstract available

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Posttransfusion Increase of Hematocrit per se Does Not Improve Circulatory Oxygen Delivery due to Increased Blood Viscosity.

BACKGROUND: Blood transfusion is used to treat acute anemia with the goal of increasing blood oxygen-carrying capacity as determined by hematocrit (Hct) and oxygen delivery (DO2). However, increasing Hct also increases blood viscosity, which may thus lower DO2 if the arterial circulation is a rigid hydraulic system as the resistance to blood flow will increase. The net effect of transfusion on DO2 in this system can be analyzed by using the relationship between Hct and systemic blood viscosity of circulating blood at the posttransfusion Hct to calculate DO2 and comparing this value with pretransfusion DO2. We hypothesized that increasing Hct would increase DO2 and tested our hypothesis by mathematically modeling DO2 in the circulation. METHODS: Calculations were made assuming a normal cardiac output (5 L/min) with degrees of anemia ranging from 5% to 80% Hct deficit. We analyzed the effects of transfusing 0.5 or more units of 300 cc of packed red blood cells (PRBCs) at an Hct of 65% and calculated microcirculatory DO2 after accounting for increased blood viscosity and assuming no change in blood pressure. Our model accounts for O2 diffusion out of the circulation before blood arriving to the nutritional circulation and for changes in blood flow velocity. The immediate posttransfusion DO2 was also compared with DO2 after the transient increase in volume due to transfusion has subsided. RESULTS: Blood transfusion of up to 3 units of PRBCs increased DO2 when Hct (or hemoglobin) was 60% lower than normal, but did not increase DO2 when administered before this threshold. CONCLUSIONS: After accounting for the effect of increasing blood viscosity on blood flow owing to increasing Hct, we found in a mathematical simulation of DO2 that transfusion of up to 3 units of PRBCs does not increase DO2, unless anemia is the result of an Hct deficit greater than 60%. Observations that transfusions occasionally result in clinical improvement suggest that other mechanisms possibly related to increased blood viscosity may compensate for the absence of increase in DO2. (C) 2017 International Anesthesia Research Society

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Topical Ropivacaine in Prevention of Post-Tonsillectomy Pain in Adults.

BACKGROUND: Post-tonsillectomy pain is 1 of the most intense postoperative pain conditions. However, optimal and sufficient postoperative analgesic treatment remains unclear. We investigated the effect of topical ropivacaine for post-tonsillectomy pain in 160 adult outpatient surgery patients over 2 postoperative weeks. METHODS: At the end of tonsillectomy, 2 swabs soaked in either 1% ropivacaine or saline were packed into the tonsillar beds for 5 minutes. We used ibuprofen and a combination of acetaminophen (500 mg)-codeine (30 mg) tablets as postoperative analgesics for 2 weeks. The primary outcome was pain intensity on swallowing measured on a numeric rating scale (NRSs) during the first postoperative week expressed as area under curve (AUC). The secondary endpoints included the worst pain experienced during the 2-hour follow-up in the postanesthesia care unit, pain intensity during the second postoperative week, and the number of ibuprofen and acetaminophen-codeine tablets consumed during the 2 postoperative weeks. RESULTS: During the first postoperative week, 120 patients out of 160 (75%) provided complete results, including data on their use of analgesics according to the instructions as well as completed and returned a questionnaire daily. A total of 101 patients (63%) did the same during the second postoperative week. Median (interquartile range [IQR]) of the primary outcome NRSs (AUC) was 38 (19) for the ropivacaine group and 37 (24) for the control group during the first postoperative week (P = .77, -1.0 estimated difference; 95% confidence interval [CI] for the difference, -7.0 to 5.0); no difference was found. Median (IQR) of NRS at rest (NRSr) (AUC) was 24.5 (19) for the ropivacaine group and 24 (22) for the control group during the first postoperative week (P = .96, 0.0 estimated difference; 95% CI for the difference, -5.0 to 5.0); no difference was found. Median (IQR) of the worst pain intensity values (NRSs or NRSr) (AUC) was 5 (3) for the ropivacaine group and 5 (3) for the control group (P = .44, 0.0 estimated difference; 95% CI for the difference, -1.0 to 0.5); no difference was found. During the second postoperative week, median (IQR) of the NRSs (AUC) was 17 (13) for the ropivacaine group and 21 (23) for the control group (P = .05, -4.0 estimated difference; 95% CI for the difference, -9.0 to 0.0) and median (IQR) of the NRSr (AUC) 10.5 (10) for ropivacaine group and 11 (13) for the control group (P = .42, -1.0 estimated difference; 95% CI for the difference, -5.0 to 2.0); no difference was found. The number of rescue analgesics (acetaminophen-codeine tablets) consumed during the second postoperative week was lower in the ropivacaine group than in the control group (median [IQR] of the consumption [AUC] was 10 [12] for the ropivacaine group and 16 [12] for the control group; P = .0008, -7.0 estimated difference; 95% CI of difference, -10 to -3.0). The groups showed no differences in overall risk for post-tonsillectomy bleeding. However, bleeding requiring hemostasis under local anesthesia was more common in the ropivacaine group (18% vs 8%, P = .048, 10% estimated difference; 95% CI for the difference, 0%-21%). CONCLUSIONS: Topical ropivacaine failed to reduce pain intensity during the first postoperative week. We observed no major adverse effects. (C) 2017 International Anesthesia Research Society

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Pediatric Anesthesiology: A Comprehensive Board Review.

No abstract available

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Commentary on Combined Jessner Solution and Trichloroacetic Acid Versus Trichloroacetic Acid Alone in the Treatment of Melasma in Dark-Skinned Patients.

No abstract available

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Functionality of Patients 75 Years and Older Undergoing Mohs Micrographic Surgery: A Multicenter Study.

BACKGROUND: Mohs surgery is indisputably a highly effective treatment for nonmelanoma skin cancers. In the current health care environment, physicians are challenged to provide high quality, efficacious care in a manner that is mindful of the patient's general health and well-being. We have used a functional assessment to evaluate older patients who present for Mohs surgery. OBJECTIVE: The purpose of this study is to categorize the functional status, using the Karnofsky Performance Status (KPS) Scale, of patients 75 years and older undergoing Mohs surgery of a nonmelanoma skin cancer and to identify distinguishing characteristics of lower functioning patients. METHODS: Patients 75 years and older undergoing Mohs surgery for nonmelanoma skin cancer at 8 separate geographically diverse sites were included. Patient and tumor characteristics were recorded. Physicians scored subjects on the KPS scale and administered a questionnaire to categorize the symptoms and impact of their skin cancer. RESULTS: A total of 291 subjects completed the study. The average KPS score was 90.1. 93.1% of our subjects had a KPS score of >=70. Subjects with a KPS score

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Distant Migration After Clandestine Silicone Injections: How Far Is Too Far?.

No abstract available

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Novel Approach to Treating Androgenetic Alopecia in Females With Photobiomodulation (Low-Level Laser Therapy).

BACKGROUND: Photobiomodulation, also referred to as low-level laser therapy (LLLT), has been studied and used for (among other diseases) the promotion of hair regrowth. OBJECTIVE/MATERIALS AND METHODS/RESULTS: A clinical study was developed to define the physiologic effects that occur when the human hair follicle and surrounding tissue structures are exposed to laser light using a novel device that is fitted with an array of laser diode sources operating at 650 nm and placed inside a sports cap to promote discretion while in use. The study demonstrates that low-level laser treatment of the scalp every other day for 17 weeks using the HANDI-DOME LASER device is a safe and effective treatment for androgenetic alopecia in healthy females between the ages of 18 to 60 with Fitzpatrick skin Types I to IV and Ludwig-Savin Baldness Scale I-2 to II-2 baldness patterns. Subjects receiving LLLT at 650 nm achieved a 51% increase in hair counts as compared with sham-treated control patients in this multicenter randomized controlled trial. CONCLUSION: These results suggest that the emerging technology of low-level laser therapy may play a potentially significant role in health care providers' armamentarium for the disease androgenic alopecia. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Subungual Eccrine Porocarcinoma: Rare but Possible.

No abstract available

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The Sterility of Partially Used Hyaluronic Acid Fillers After Long Storage.

BACKGROUND: Hyaluronic acid (HA) gel fillers represent most soft tissue augmentation procedures currently used, because they have lower rates of complications compared with other materials. Many patients do not consume an entire syringe of filler but may require a retouch or intermittent augmentation after some time. The remaining material is commonly stored in a specific environment for reuse by the same patient. OBJECTIVE: There are an insufficient number of recommendations concerning the safety of storing and reusing dermal fillers in the literature because of the paucity of studies. The aim of this study was to investigate the potential infectious contamination associated with the storage of HA fillers after patient treatment. METHODS: Hyaluronic acid from previously used syringes was stored at room temperature under sterile conditions for varying durations beginning from 2009. Later, the material was submitted for panculture, including gram-positive and gram-negative bacteria, mycobacteria, and fungi. RESULTS: No fungal or mycobacterial agents were cultured from any of the samples. There were a few positive bacterial cultures, but they were predominantly contaminated with normal skin surface flora. CONCLUSION: Although it is commonly practiced, the storage of HA fillers after initial patient injection carries a real but small risk of contamination. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Long-Term Outcomes of Melanoma In Situ Treated With Topical 5% Imiquimod Cream: A Retrospective Review.

BACKGROUND: Melanoma in situ (MIS) is a noninvasive form of melanoma for which nonsurgical therapeutic options continue to be explored. The off-label use of topical 5% imiquimod cream in the management of MIS has shown potential but reported recurrence rates vary considerably between 0% and 40%. Furthermore, the long-term efficacy of imiquimod is not well established. OBJECTIVE: To determine the recurrence rate of MIS among patients treated with topical 5% imiquimod cream at Dartmouth-Hitchcock Medical Center with at least 1 year of follow-up. METHODS: A retrospective chart review identified 12 patients with MIS who have been treated with topical 5% imiquimod cream for 6 to 12 weeks. Patients who underwent surgical treatment for MIS were excluded from analysis. RESULTS: Of 12 patients with histologically confirmed MIS treated with topical 5% imiquimod cream, there were 2 recurrences (17%) during a median follow-up time of 5.5 years. CONCLUSION: Although surgery is still considered the gold standard for the treatment of MIS, imiquimod may represent a potentially effective noninvasive treatment option for patient who are not surgical candidates. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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The Clinical and Histological Effect of a Low-Fluence Q-Switched 1,064-nm Neodymium: Yttrium-Aluminum-Garnet Laser for the Treatment of Melasma and Solar Lentigo in Asians: Prospective, Randomized, and Split-Face Comparative Study.

BACKGROUND: The low-fluence Q-switched 1,064-nm neodymium:yttrium-aluminum-garnet laser (QSNYL) is popular for melasma treatment among Asians. OBJECTIVE: This study was to evaluate the clinical and histological effects of the low-fluence QSNYL for treatment of melasma and solar lentigo. MATERIALS AND METHODS: In this randomized split-face clinical study, 22 patients with melasma or solar lentigo received low-fluence QSNYL weekly for 10 sessions on one cheek. The treatment efficacy was determined by Mexameter skin colorimetry, physician and patient assessment, and by evaluating histological changes. RESULTS: The treated sides had statistically significant reductions in the melanin and erythema indices (EI); 50.0% of melasma and 62.5% of solar lentigo patients had >50% clearance after the final treatment. The increased EI, vascularity, and mast cell activity in patients with melasma and large-sized solar lentigo showed no improvement. The recurrence rates were 16.7% and 12.7% for melasma and solar lentigo, respectively. Postinflammatory hyperpigmentation developed in 1 patient, but no serious side effects were noted. CONCLUSION: Low-fluence QSNYL is effective in treating melasma and small type solar lentigo in Asians. The authors' study also demonstrated that lesion thickness, vascularity, and mast cell activity can be used to predict the efficacy of the treatment of these lesions. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Commentary on The Effect of Plasma Rich in Growth Factors on Pattern Hair Loss.

No abstract available

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Clinical implications of acute pelvicaliceal hematoma formation during percutaneous catheter nephrostomy insertion

Publication date: May–June 2017
Source:Clinical Imaging, Volume 43
Author(s): Jessica K. Stewart, Tony P. Smith, Charles Y. Kim
PurposeTo determine the clinical implications of acute pelvicaliceal hematoma formation during percutaneous catheter nephrostomy (PCN) insertion.MethodsCollecting system hematoma burden was retrospectively assessed for 694 PCN insertions in 502 patients.ResultsPelvicaliceal hematoma formation occurred in 146 kidneys (21%) in 136 patients. Clinically significant blood loss occurred in 3 patients with hematomas within one week compared to 4 patients without hematomas (p=0.39). Twenty-four patients with hematomas underwent catheter exchange within one week, compared to 55 patients without hematomas (p=0.49).ConclusionPelvicaliceal hematoma formation after PCN insertion is not uncommon and is associated with very rare clinical sequelae.



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Improvement of mechanical and electrical properties of rotary swaged Al-Cu clad composites

Publication date: 5 June 2017
Source:Materials & Design, Volume 123
Author(s): Radim Kocich, Lenka Kunčická, Adéla Macháčková, Michal Šofer
In order to investigate modifications in electric resistivity, mechanical properties and structures of Al/Cu clad composite induced by various thermomechanical-treatments, work-pieces were swaged under two temperatures (25°C and 250°C) to three final diameters (10, 7.5 and 5mm) and subsequently subjected to two different heat treatments. The influence of the two swaging temperatures on formability of the clad composites was evaluated via tensile and bending tests with integrated detection of acoustic emission. The highest tensile strength (~500MPa) was recorded after semi-final swaging for both the composites. The strain imposed during the gradual swaging process significantly influenced hardness of both the metals within the composites, the development of which was non-linear. Structure analysis proved restoration processes in Cu to occur during swaging to 5mm at 25°C, however, at 250°C restoration occurred already during the last but one pass to 7.5mm. Heat treatment introduced further structure changes; the annealing temperature of 350°C also resulted in the development of an intermetallic layer on the Al/Cu interfaces, which also contributed to decreases in mechanical properties. Results of electric resistivity measurements showed all the composites to have higher conductivity than Al work-pieces swaged via the identical procedures.

Graphical abstract

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Magnetic anisotropy phase-graded A1/L10-FePt films on amorphous glass substrates

Publication date: 5 June 2017
Source:Materials & Design, Volume 123
Author(s): G. Barucca, Th. Speliotis, G. Giannopoulos, D. Niarchos, B. Rutkowski, A. Czyrska-Filemonowicz, E. Agostinelli, S. Laureti, A.M. Testa, G. Varvaro
Magnetic anisotropy phase-graded A1/L10-FePt films deposited on amorphous glass substrates were investigated combining ultra-high resolution electron microscopy and angular-dependent magnetic measurements. A highly textured (001) L10 FePt film was first deposited at the relative low temperature of 625K using an MgO/Cr underlayer stack, hence a second layer was grown while continuously decreasing the deposition temperature down to a final value ranging from 515K to 365K depending on the layer thickness (tg). This procedure leaded to the formation of a phase-graded system consisting of hard and soft magnetic phases separated by a rough nanometer-size interphase boundary, where the magnetic anisotropy gradually changes due to the variation of the relative amount of hard and soft phases across the whole film thickness. Electron microscopy analysis allowed the structure of the samples to be investigated at an atomic level. The A1 and L10-FePt phases were localized inside the film and the orientation relationships between their lattices were determined. The samples show a preferential perpendicular anisotropy up to tg=15nm and a significant reduction of the coercive field with the increase of the graded layer thickness (~30% for tg=5nm), suggesting their potential application as magnetic recording media.

Graphical abstract

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Measurements of the mechanical response of unidirectional 3D-printed PLA

Publication date: 5 June 2017
Source:Materials & Design, Volume 123
Author(s): Y. Song, Y. Li, W. Song, K. Yee, K.-Y. Lee, V.L. Tagarielli
Fully dense PLA blocks were manufactured by 3D-printing, depositing a polymer filament in a single direction via the fusion deposition method (FDM). Specimens were cut from printed blocks using conventional machining and were used to perform tension, compression and fracture experiments along different material directions. The elasto-plastic material response was found to be orthotropic and characterised by a strong tension-compression asymmetry; the material was tougher when loaded in the extrusion direction than in the transverse direction. The response of the unidirectional, 3D-printed material was compared to that of homogeneous injection-moulded PLA, showing that manufacturing by 3D-printing improves toughness; the effects of an annealing thermal cycle on the molecular structure and the mechanical response of the material were assessed.

Graphical abstract

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Linarin could protect myocardial tissue from the injury of Ischemia-reperfusion through activating Nrf-2

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Qian Yu, Xin Li, Xia Cao
ObjectivesAs we all know, oxidative stress was one of the most important causes of ischemia-reperfusion injury. And it was reported that Nrf-2 as an important regulator for oxidative stress could be activated by Linarin. Thus it would be interesting to find whether Linarin could inhibit ischemia-reperfusion injury through activating Nrf-2.MethodsIn this study, cell activity was detected by MTT assay and caspase-3 activity detection kit. And the expressions or activities of some signal proteins were evaluated by western-blot or activity detection kits. At last, the effect and mechanism of Linarin on heart tissues were verified in the ischemia-reperfusion model of isolated hearts.ResultsThe proliferation activity of cell was inhibited while the apoptosis rate was increased after hypoxia-reoxygenation. However, Linarin could inhibit these two variations. It was found that these effects of Linarin were related with the activation of Nrf-2 through PI3K/Akt signaling pathway. Meanwhile, the anti-oxidative enzymes, regulated by Nrf-2, were enhanced to against the oxidative stress caused by hypoxia-reoxygenation. And with the inhibition of oxidative stress, some proliferation and apoptosis related proteins such as NF-kB and Cytochrome C were adjusted to support the viability of cells. At last, these results were verified in the ischemia reperfusion experiment of isolated hearts.ConclusionsFrom this study, we assured that LIN could protect myocardial tissue from ischemia-reperfusion through activating Nrf-2.



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Current FDA-approved treatments for non-small cell lung cancer and potential biomarkers for its detection

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Karla A. Ruiz-Ceja, Yolanda I. Chirino
BackgroundLung cancer is the leading worldwide cancer with almost 1.5 million deaths every year. Some drugs for lung cancer treatment have been available on the market for decades, but novel drugs have emerged promising better outcomes, especially for Non-Small Cell Lung Cancer (NSCLC), which represents 75% of lung cancer cases. However, how much do drugs have evolved for NSCLC treatment? Are they sharing the same mechanism of action?AimIn this review we analyzed how the approved drugs by Federal Drug Agency for NSCLC have advanced in the last four decades identifying shared mechanism of action of medicines against NSCLC treatment and some of the potential biomarkers for early detection.ResultsCisplatin and its derivatives are still the most used therapy in combination with some other more specific drugs. However, increasing the survival rates seems to be a great challenge and research is moving into early detection through biomarkers but also trying to identify molecules such as those derived from the immune system, cell-free DNA, non-coding RNAs, but also polymorphisms to detect early tumor formation.ConclusionsCisplatin and derivatives have been one of the most successful therapies in spite of their side effects and low specificity. Some of the drugs developed after cisplatin discovery, have been targeted the epidermal growth factor receptor, anaplastic lymphoma kinase, programmed cell death 1 ligand and vascular endothelial growth factor. Since none of the pharmacological treatments in combination with radiation/surgery have extended dramatically the survival rate, research is now focused in early cancer detection in combination with precision medicine, which attempts to treat patients individually according to their stage and tumor characteristics.



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Artemisia sieberi Besser essential oil and treatment of fungal infections

Publication date: May 2017
Source:Biomedicine & Pharmacotherapy, Volume 89
Author(s): Mohaddese Mahboubi
A. sieberi essential oil has been used for treatment of hardly curable infectious ulcers in Middle East Medicine and has been famous due to its wormicide effects. In this review, we evaluated the potency of A. sieberi essential oil in treatment of fungal infections. We searched in PubMed Central, Science direct, Wiley, Springer, SID, and accessible books, reports, thesis. There is a lot of mixed information on chemical compositions of A. sieberi essential oil, but most articles reported α, β-thujones as the main components of essential oils. In vitro studies confirmed the antifungal activity of A. sieberi essential oil against saprophytes fungi, dermatophytes, Malassezia sp. and Candida sp. and these results were confirmed in six clinical studies. The clinical studies confirmed the superiority of A. sieberi essential oil (5%) lotion in improvement of clinical signs of fungal superficial diseases, and mycological laboratory examinations of dermatophytosis and pityriasis versicolor diseases than clotrimazole (1%) topical treatment. The recurrence rate of superficial fungal infections with dermatophytosis and pityriasis versicolor was statistically lower in A. sieberi essential oil (5%) lotion than clotrimazole. There are no adverse effects due to the application of A. sieberi essential oil in clinical studies. Despite, the efficacy of A. sieberi essential oil against Candida sp., there is no clinical study about their related infections. Investigation about the effects of A. sieberi essential oil on fungal virulence factors in order to identifying the exact mechanism of antifungal activity and clinical trials on Candida related diseases are recommended.

Graphical abstract

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Knockdown of SKA1 gene inhibits cell proliferation and metastasis in human adenoid cystic carcinoma

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Li-juan Zhao, Hong-li Yang, Ke-yi Li, Yue-hua Gao, Kai Dong, Zhong-hao Liu, Le-xin Wang, Bin Zhang
The spindle and kinetochore-associated complex subunit 1(SKA1) is a newly discovered gene, which has been associated with mitosis and tumorigenesis. However, its role insalivary adenoid cystic carcinoma (SACC) is still unknown, and the invasive and metastatic mechanism in SACC is still unclear. To explore the molecular mechanism of SKA1 in the process of malignant proliferation and metastasis in adenoid cystic cancer (ACC) cells, we employed lentivirus-mediated short hairpin RNA to knockdown SKA1 in SACC-83 cells. The results demonstrated that the lentivirus-mediated shRNA-targeting SKA1 lead to a significant down-regulation of SKA1 expression. Knockdown of SKA1 inhibited cell proliferation, cell invasion, migration and the cell cycle arrest. Furthermore, knockdown of SKA1 reduced the Ndc80, CDK4, Cyclin D1, Cyclin E1, Cyclin B1 and matrix metalloproteinase-9 (MMP-9) protein expression, but increased the p27 protein expression. These findings indicated that SKA1 might be a promising target for cancer gene therapy in human ACC.



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Therapeutic effect of quercetin in collagen-induced arthritis

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Nagaraja Haleagrahara, Socorro Miranda-Hernandez, Md Abdul Alim, Linda Hayes, Guy Bird, Natkunam Ketheesan
Quercetin, a bioactive flavonoid with anti-inflammatory, immunosuppressive, and protective properties, is a potential agent for the treatment of rheumatoid arthritis (RA). Collagen-induced arthritis (CIA) is the most commonly used animal model for studying the pathogenesis of RA. This study analysed the therapeutic role of quercetin in collagen-induced arthritis in C57BL/6 mice. The animals were allocated into five groups that were subjected to the following treatments: negative (untreated) control, positive control (arthritis-induced), arthritis+methotrexate, arthritis+quercetin, and arthritis+methotrexate+quercetin. Assessments of weight, oedema, joint damage, and cytokine production were used to determine the therapeutic effect of quercetin. This study demonstrated for the first time the anti-inflammatory and protective effects of quercetin in vivo in CIA. The results also showed that the concurrent administration of quercetin and methotrexate did not offer greater protection than the administration of a single agent. The use of quercetin as a monotherapeutic agent resulted in the lowest degree of joint inflammation and the highest protection. The reduced severity of the disease in animals treated with quercetin was associated with decreased levels of TNF-α, IL-1β, IL-17, and MCP-1. In conclusion, this study determined that quercetin, which was non-toxic, produced better results than methotrexate for the protection of joints from arthritic inflammation in mice. Quercetin may be an alternative treatment for RA because it modulates the main pathogenic pathways of RA.



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The effects of propofol on the growth behavior of hepatoma xenografts in Balb/c mice

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Yi Liu, Na Zhang, Quanjun Cao, Xuejie Cui, Qiaoling Zhou, Chengxiang Yang
ObjectiveStudies on the effects of propofol on the growth of hepatoma xenografts in Balb/c mice.MethodsIn an effort to establish a hepatoma-xenograft model of BALB/C mice, human hepatocellular carcinoma cells SMMC-7721 were inoculated subcutaneously into BALB/C mice. Forty mice were randomly divided into five different groups (n=8): control group (C group), Intralipid group (Y group), low dose (50mg/kg) propofol group (P1 group), medium dose (100mg/kg) propofol group (P2 group) and high dose (150mg/kg) propofol group (P3 group). The tumor volume was measured before treatment and every 3days after treatment (T0d-T18d, T0 represents time point before treatment, T3d-T18d represent time points every 3days after treatment for a total of 18 days). All mice were sacrificed 19days after drug withdrawal. The tumor masses were extracted, weighed, and the tumor inhibition rate of propofol was calculated. The protein levels of matrix metalloproteinase-2 (MMP-2) and vascular endothelial growth factor (VEGF) in the xenografted tumors were analyzed by immunohistochemistry staining.ResultsNo statistical significance in the tumor volume at T0d (before treatment), T3d (3days after treatment), and T6d (6days after treatment) among the five groups (P>0.05) could be determined. Compared to group C, the tumor volumes in the P1, P2, and P3 groups were found to be significantly decreased in size upon increasing the propofol dosages (P<0.05). There was no statistical significance at time points T9d-T18d in group Y compared to group C (P>0.05). The tumor weights in the P1, P2, and P3 groups were found to be significantly lower as the propofol dosages increased (P<0.05), with no statistical significance determined in group Y (P>0.05). MMP-2 and VEGF protein levels were found to be significantly lower in the P1, P2, and P3 groups as the propofol dosages increased (P<0.05), with no statistical significance in group Y (P>0.05).ConclusionWithin a certain range, propofol was found to inhibit tumor growth and expression of MMP-2 and VEGF proteins in hepatoma xenografts in BALB/C mice in a dose-dependent manner.



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Possible protective effect of royal jelly against cyclophosphamide induced prostatic damage in male albino rats; a biochemical, histological and immuno-histo-chemical study

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Sara Mohammed Naguib Abdel-Hafez, Rehab Ahmed Rifaai, Walaa Yehia Abdelzaher
Almost all the chemotherapy treat many cancer types effectively, but it leads to severe side effects. Chemotherapy like cyclophosphamide (CP) not works only on the active cells, such as cancer cells, but also acts on the healthy cells. Royal jelly (RJ) was reported to have a lot of therapeutic effects besides being an anti-oxidant and anti-cancer agent. The purpose of this study was to assess the possible protective role of RJ in ameliorating the toxic effects of CP overdose in the rat prostatic tissue. The rats were separated into 4 groups; control group, RJ group, CP group and RJ with CP group. Prostatic specimens were processed for biochemical, histological and immune-histo-chemical studies. The mean area fractions of eNOS and Bax expression were measured in all groups, and statistical analysis was carried out. The results showed that in CP treated group, there were marked biological changes in the form of significant increase in prostatic malondialdehyde (MDA) and C – reactive protein (CRP). Additionally there was a significant decrease in glutathione peroxidase (GPx) in prostatic tissue if compared with the control group. Furthermore, the histological changes showed marked acinar and stromal prostatic degeneration. Most prostatic acini showed less PAS reaction and more (eNOS and Bax) expression if compared with the control group. Concomitant administration of RJ with CP revealed a noticeable amelioration of these biochemical and histological changes. In conclusion, RJ provided biochemical and histo-pathological improvement in CP induced prostatic tissue toxicity. These findings revealed that this improvement was associated with a decrease in the tissue oxidative damage and apoptosis.



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Discovery of new dual PPARγ-GPR40 agonists with robust antidiabetic activity: Design, synthesis and in combo drug evaluation

Publication date: June 2017
Source:Biomedicine & Pharmacotherapy, Volume 90
Author(s): Sergio Hidalgo-Figueroa, Gabriel Navarrete-Vázquez, Samuel Estrada-Soto, Diana Giles-Rivas, Francisco J. Alarcón-Aguilar, Ismael León-Rivera, Abraham Giacoman-Martínez, Elizabeth Miranda Pérez, Julio C. Almanza-Pérez
The design of compounds 1 and 2 was based on the similar scaffold of pharmacophoric groups for PPARγ and GPR40 agonists. In order to find new compounds with improved biological activity, the current manuscript describes a new dual PPARγ-GPR40 agonist. We synthesized two compounds, which were prepared following a multistep synthetic route, and the relative mRNA expression levels of PPARγ, GLUT4, and GPR40 were quantified in cell culture, as well as insulin secretion and [Ca²⁺] intracellular levels. Compound 1 showed a 7-times increase in the mRNA expression of PPARγ, which in turn enhanced the expression levels of GLUT4 respect to control and pioglitazone. It also showed an increase of 2-fold in the [Ca²⁺]i level allowing an increment on insulin release, being as active as the positive control (glibenclamide), causing also an increase of 2-fold in mRNA expression of GPR40. Furthermore, the compound 2 showed lower activity than the compound 1. The ester of 1 showed antidiabetic activity at a 50mg/kg single dose in streptozotocin-nicotinamide-induced diabetic mice model. In addition, we achieved a molecular docking study of compound 1 on PPARγ and GPR40 receptors, showing a great affinity for both targets. We observed important polar interactions between the carboxylic group and main residues into the binding pocket. Therefore, the compound 1 has a potential for the development of antidiabetic agents with newfangled dual action.

Graphical abstract

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GC/MS analysis and potential cytotoxic activity of Calyptranthes grandifolia (O. Berg), Calyptranthes tricona (D. Legrand) and Myrciaria plinioides (D. Legrand) essential oil in RAW264.7 and CHO-K1 cells

Publication date: May 2017
Source:Biomedicine & Pharmacotherapy, Volume 89
Author(s): D. Faleiro, S.M. Immich, F. Majolo, L. Mayer, E.M. Ethur, M.I. Goettert
The search for new bioactive substances derived from natural products is daily growing. Among biologically active products used in therapeutic approaches, essential oils are described with wide range of therapeutic and pharmacological potential. Plants from Myrtaceae family have the presence of essential oils in its composition. Calyptranthes grandifolia, Calyptranthes tricona and Myrciaria plinioides species belong to this family and are used by the local population. However, there are no reports in the literature describing relevant characteristics about the potential and possible activities of these species. The aim of this study was to identify the main compounds, evaluate the antioxidant potential and investigate, in RAW264.7 and CHO-K1 cells, the cytotoxic activity of the essential oils from the leaves of C. grandifolia, C. tricona and M. plinioides plants, in order to ensure their use. The compounds were identified by GC–MS, antioxidant activity was determined by DPPH method and cytotoxicity was assessed by the Alamar Blue method, at 48 and 72h. The main compounds found in the essential oils were sesquiterpenes. None of the essential oils have antioxidant potential. In cytotoxicity assays, the essential oils from the plants in analysis showed moderate activity in the proposed conditions. The alterations observed between the data provided by the essential oils in question, between different cell lines, may be associated with their composition, suggesting action of minor compounds. These results may suggest that the essential oils from C. grandifolia, C. tricona and M. plinioides have considerable potential to be explored. Future studies will be conducted to obtain more information about the action pathway and potential of the identified compounds.



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EACMFS Prizes and Awards

The Council of EACMFS wishes to ensure that all members of the Association are aware of the current awards and prizes that are available. These are designed to provide educational support and also to allow the opportunity for trainees and those who have recently achieved specialist status to visit units outside their own departments.

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Editorial Board

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Announcements

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Effects of an 8-month exercise intervention on physical capacity, NT-proBNP, physical activity levels and quality of life data in patients with pulmonary arterial hypertension by NYHA class

Publication date: June 2017
Source:Data in Brief, Volume 12
Author(s): Alejandro Santos-Lozano, Paz Sanz-Ayan, Laura González-Saiz, Carlos A. Quezada-Loaiza, Carmen Fiuza-Luces, Angela Flox-Camacho, Diego Munguía-Izquierdo, Alfredo Santalla, María Morán, Pilar Escribano-Subías, Alejandro Lucia
This article provides descriptive detailed (pre and post) values of physical capacity variables, NT-proBNP, physical activity levels and quality of life in patients with pulmonary arterial hypertension (PH) (both, intervention and control group) by New York Heart Association (NYHA) class before and after an 8-month exercise intervention. The data are supplemental to our original Randomized Controlled Trial (RCT) entitled "Benefits of skeletal-muscle exercise training in pulmonary arterial hypertension: The WHOLEi+12 trial" (L. González-Saiz, C. Fiuza-Luces, F. Sanchis-Gomar, A. Santos-Lozano, C.A. Quezada-Loaiza, A. Flox-Camacho, D. Munguía-Izquierdo, I. Ara, A. Santalla, M. Morán, P. Sanz-Ayan, P. Escribano-Subías, A. Lucia A, 2017) [1].



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Datasets for transcriptomics, q-proteomics and phenotype microarrays of polyphosphate metabolism mutants from Escherichia coli

Publication date: June 2017
Source:Data in Brief, Volume 12
Author(s): Macarena Varas, Camilo Valdivieso, Cecilia Mauriaca, Javiera Ortíz-Severín, Alberto Paradela, Ignacio Poblete-Castro, Ricardo Cabrera, Francisco P. Chávez
Here, we provide the dataset associated with our research article on the polyphosphate metabolism entitled, "Multi-level evaluation of Escherichia coli polyphosphate related mutants using global transcriptomic, proteomic and phenomic analyses". By integrating different omics levels (transcriptome, proteome and phenome), we were able to study Escherichia coli polyphosphate mutant strains (Δppk1, Δppx, and Δppk1-ppx). We have compiled here all datasets from DNA microarrys, q-proteomic (Isotope-Coded Protein Labeling, ICPL) and phenomic (Phenotype microarray) raw data we have obtained in all polyP metabolism mutants.



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Live cell biosensing platforms using graphene-based hybrid nanomaterials

Publication date: 15 August 2017
Source:Biosensors and Bioelectronics, Volume 94
Author(s): Tae-Hyung Kim, Donghyun Lee, Jeong-Woo Choi
A novel strategy to precisely detect or monitor various biomaterials in living cells poses paramount importance in understanding cellular processes. Graphene, a newly emerged two-dimensional carbon material, has been widely utilized for biosensors owing to its multifarious characteristics including mechanical, electrical, and optical properties (e.g. stability, conductivity, fluorescence quenching and photoluminescence). In addition, graphene derivatives and their innate characteristics, such as biocompatibility low cytotoxicity and water solubility have facilitated the use of graphene-based materials for live cell biosensing, wherein graphene is utilized as a core material by itself or in combination with other functional nanomaterials to load target-specific probes, fluorescent dyes, and other signaling molecules. Such graphene-based hybrid nanomaterials have been employed to detect various cellular entities in living cells, including ions, biomolecules, genetic molecules, proteins, enzymes, and even whole cells. The following review will discuss a number of previous studies in which graphene-based hybrid constructs were used for live cell biosensing, and their potential applications in cancer research and stem cell therapy.



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Pseudomonas oryzihabitans sepsis in a 1-year-old child with multiple skin rashes: a case report

Pseudomonas oryzihabitans is a Pseudomonas bacterial organism rarely implicated in human infections. The bacterium has been isolated in a few reported cases of neurosurgical infections...

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Pseudomonas oryzihabitans sepsis in a 1-year-old child with multiple skin rashes: a case report

Pseudomonas oryzihabitans is a Pseudomonas bacterial organism rarely implicated in human infections. The bacterium has been isolated in a few reported cases of neurosurgical infections...

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Nasal Valve Reconstruction Using a Titanium Implant: An Outcomes Study

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1600900

Septoplasty alone is not always sufficient to correct nasal obstruction. Various techniques have been employed to repair nasal valve collapse and improve airflow.This article aimed to evaluate outcomes and quality of life following nasal valve reconstruction using a titanium implant in patients with nasal valve collapse.This is a single-center retrospective study that consisted of a telephone questionnaire of 37 quality-of-life measures and questions related to the surgical procedure and recovery process to evaluate postsurgical outcomes.Fifteen patients completed the survey. There was a significant improvement in nasal blockage/obstruction, breathing through the nose, sleeping, breathing through nose during exercise, the need to blow nose, sneezing, facial pain/pressure, fatigue, productivity, and restlessness/irritability after surgery. Overall, 100% of patients were satisfied with the results and would recommend this procedure. The most common postoperative complaints were pain (33%) and difficulty breathing (33%). Patients noticed no increase (20%) or a slight increase (73%) in the size of their nose. Sixty percent of patients cannot see the implant and 13% report the implant is barely noticeable.Nasal valve repair with a titanium implant was successful at improving symptoms of nasal obstruction and other quality-of-life issues. Satisfaction was high among all patients. The implants are palpable, thought to be visible by some patients, yet accepted by the majority of patients. This approach may be especially important in patients with prior nasal surgery but continue to experience refractory symptoms.
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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A Comparative Assessment of Postoperative Analgesic Efficacy of Lornoxicam versus Tramadol after Open Reduction and Internal Fixation of Mandibular Fractures

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1600901

Pain after any surgical procedure is inevitable but can be controlled by administration of analgesics in most cases. Postoperative pain after surgical treatment of mandibular fractures can be treated by nonsteroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics. The purpose of this study is to critically compare the postoperative analgesic efficacy of small doses of intravenous TRAMADOL (opioid analgesic) versus LORNOXICAM (NSAID) in patients with mandibular trauma undergoing open reduction and internal fixation (ORIF) and to assess the presence of any adverse effects due to NSAID or opioid use. Forty adult ASA grade I–II patients with mandibular trauma, scheduled for ORIF under general anesthesia in the Department of Oral and Maxillofacial Surgery, College of Dental Sciences, Davangere, were selected for the study. The patients were randomly assigned into a tramadol group (Group T) and a lornoxicam group (Group L) and were administered intravenous tramadol 50 mg and intravenous lornoxicam 8 mg, respectively, at specific postoperative intervals. Pain intensity was quantitatively assessed at the 2nd, 4th, 6th, 12th, and 24th postoperative hours using a visual analog scale of 10 cm. Adverse effects of the analgesics were also recorded and compared. Both the drugs resulted in a significant decrease in pain intensity from 2nd to 24th postoperative hours, but better pain control was observed in Group L at 24th postoperative hour. Only two patients experienced nausea and vomiting in Group T and one patient experienced gastric acidity in Group L. The comparative results clearly demonstrate that pain control by intravenous lornoxicam is significantly better than by intravenous tramadol at 24th postoperative hour after ORIF of mandibular trauma. Side effects produced by both the drugs were minor and had no apparent effect on the study results.
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Assessment of Fixation of Mandibular Interforaminal Fractures by Using a Single Second-Generation Headless Compression Screw: A Pilot Study

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0036-1594276

The aim of this article is to evaluate the efficacy of a single second-generation headless compression screw along with a lower arch bar in the fixation of interforaminal mandible fractures. A total of seven patients were included in the study. An open approach was used either intraorally or extraorally. A second-generation 3.0 HCS (headless compression screw), 24 to 32 mm in length, diameter at the head of 3.5 mm, smooth shaft with 2.0 mm and at the leading edge 3.0 mm (Synthes, Paoli, PA) was used for the fixation along with a lower arch bar. Postoperative clinical and radiographic follow-up was performed at 3 weeks, 3 months, 6 months, and 1 year. A single, cannulated HCS was found to be effective in fixation of interforaminal mandible fractures except in one case where a miniplate had to be applied subapically. Clinical and radiographic follow-up revealed accurate reduction and fixation in all cases and no postoperative occlusal disturbances. A single, second-generation HCS along with a lower arch bar provides good results when used for the fixation of interforaminal mandible fractures. Headless compression screw fixation of interforaminal mandible fracture is a simple, quick, economic, and efficient method of rigid fixation with minimum complications.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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The impact of oral Polypodium leucotomos extract on ultraviolet B response: A human clinical study

There is a rationale for adding systemic photoprotective agents to the current photoprotection regimen.

http://ift.tt/2nL0myG

Association Between Non-Infectious Uveitis and Thyroid Dysfunction: A Case Control Study

Thyroid , Vol. 0, No. 0.


http://ift.tt/2nKTO3a

Ultrasound-Pathology Discordant Nodules on Core-Needle Biopsy: Malignancy Risk and Management Strategy

Thyroid , Vol. 0, No. 0.


http://ift.tt/2nTO04j

Single-Session High-Intensity Focused Ultrasound Treatment in Large-Sized Benign Thyroid Nodules

Thyroid , Vol. 0, No. 0.


http://ift.tt/2nTEgXQ

Single-Session High-Intensity Focused Ultrasound Treatment in Large-Sized Benign Thyroid Nodules

Thyroid , Vol. 0, No. 0.


http://ift.tt/2nTEgXQ

Association Between Non-Infectious Uveitis and Thyroid Dysfunction: A Case Control Study

Thyroid , Vol. 0, No. 0.


http://ift.tt/2nKTO3a

Ultrasound-Pathology Discordant Nodules on Core-Needle Biopsy: Malignancy Risk and Management Strategy

Thyroid , Vol. 0, No. 0.


http://ift.tt/2nTO04j

Use of Thudichum nasal speculum for retraction during insertion of dental implants

The success of a minor surgical procedure depends on the proper exposure of the surgical site. A Thudichum nasal speculum is in common use for examination of the nose, but we recommend it for retraction while inserting a dental implant.

http://ift.tt/2n9ugJV

Deep Cuts to Cancer Research

Budget Plan Risks Hard-Fought Research Gains 

President Trump's budget proposal for FY 2018 calls for a drastic 20% cut to the National Institutes of Health.  The NIH funds the vast majority of cancer research in our nation.  Cuts of this size will wipe out the increases set in motion through the recently passed 21st Century Cures Act – and push back Esophageal Cancer research by many years.  You can make your voice heard by clicking on the link below.

ECAN is a founding member of the Deadliest Cancers Coalition and has signed on to a letter to Congress requesting that Congress reject the nearly $6 billion in cuts to the NIH budget and instead,

continue the vigilance on providing stable funding increases for the NIH and the National Cancer Institute (NCI) so that we can continue the basic and translational research that is critical to making advances on the nation's deadliest cancers. Specifically, we call on the 115^th Congress to support the nation's deadliest cancers by:

• Putting the National Institutes of Health (NIH) on a path of sustained growth by passing a final FY2017 appropriations bill that includes the Senate Appropriations Committee approved $34.1 billion for the NIH.
• Continuing to support critical research on the nation's deadliest cancers by passing an FY 2018 appropriations bill that increases the NIH budget by at least $2 billion and provides $300 million in additional funding for the Cancer Moonshot as designated in the 21st Century Cures Act. It is critical that the funding for the Cancer Moonshot supplement, not supplant, appropriated funding for the NIH and/or the NCI.
• Joining the Congressional Caucus on the Deadliest Cancers and by ensuring that there are no lapses in health coverage for this critical population. (Deadliest Cancers are defined as cancers with less than a 50% survival rate.)

Cutting research funding would hamper the important progress that we're making now. Because Esophageal Cancer is one of our nation's deadliest cancers, we cannot afford to wait. Lives hang in the balance. Historically, patients diagnosed with Esophageal Cancer have had very few treatment options, but we now have reason to believe the future can hold more promise.

Hope is on the horizon because of breakthroughs researchers are achieving now and expect to reach in years to come largely thanks to the important stand that Congress took in passing the 21st Century Cures Act, including the Cancer Moonshot.

Cancer research has always had bipartisan support in the United States.
Click here to Tell members of Congress they must stand up for Cancer Patients.

Your voice makes a difference.  Please make sure Congress hears it now!

The post Deep Cuts to Cancer Research appeared first on Esophageal Cancer Action Network.

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April is Esophageal Cancer Awareness Month

Esophageal Cancer Awareness Month is a time to increase public understanding about Esophageal Cancer and the risk factors that can lead to this devastating disease.  Esophageal Cancer has a dismal survival rate of less than 20 percent, largely because it is usually detected at late stages when treatment is rarely effective.  New therapies currently under study are showing promise in treating this deadly disease and so we hope that brighter days are on the horizon for patients at risk for this disease.  But, in addition to supporting the development of effective treatments and a cure, ECAN is dedicated to raising awareness about the risk factors that can lead to Esophageal Cancer so that patients can detect this disease at early, treatable stages – or even before it becomes cancer – so that more lives can be saved.

Two Types of Esophageal Cancer
Many people are aware that smoking and drinking can lead to cancer and both have been linked to one type of Esophageal Cancer called Esophageal Squamous Cell Carcinoma (ESCC).  Thankfully, that type of Esophageal Cancer is on the decline in the U.S. and most western nations.  But the other type of Esophageal Cancer known as Esophageal Adenocarcinoma (EAC) has been increasing in the western world at explosive rates.  It's estimated that the cases of this type of Esophageal Cancer has increased more than 600 percent in the past four decades.  Esophageal Adenocarcinoma is currently the fastest increasing cancer among American men.  And it is caused by Reflux Disease, sometimes called Acid Reflux or GERD.

Awareness can Save Lives
Here's the reason why awareness of this disease is so important: if Esophageal Cancer is caught at early stages, or in the case of EAC, before it even becomes cancer, patients' chances to survive increase dramatically.  A condition called Barrett's Esophagus is the precursor to Esophageal Adenocarcinoma.  It's estimated that more than 3 million Americans currently have Barrett's Esophagus – but only a small fraction of those patients are aware of those changes in their esophagus.  That means millions of Americans have no idea that they have a condition that could mean they are as much as 40 times more likely to develop a deadly cancer.  The reason it's important to discover Barrett's Esophagus before it becomes cancer is that when it's in that precursor stage, this condition is highly treatable and most patients who undergo treatment for this condition never go on to develop Esophageal Cancer.

The History of Esophageal Cancer Awareness Month
ECAN worked to establish Esophageal Cancer Awareness Month starting because no such observance existed before then.  It began with a proclamation in Maryland in 2009.  Since then, ECAN has worked with supporters to gain recognition of EC Awareness Month in states throughout the U.S. – and even in other countries, too.  With ECAN's support over the past 6 years, more than 150 gubernatorial declarations of EC Awareness Month have been achieved throughout the country and in some other nations, as well. April is now observed as Esophageal Cancer Awareness Month by companies, organizations and governments across the nation – and the world.

Providing Tools to Save Lives
In 2011, ECAN also began providing our Reach Out kits with posters, brochures and wristbands to the public at no charge, creating a veritable army of awareness raisers working to save lives. ECAN has sent thousands of kits across the U.S. and to other nations.  The feedback we receive tells us that it's worth it – lives are saved when our supporters Reach Out to raise awareness about Esophageal Cancer and its link to Reflux Disease.
You can order your Free Reach Out kit here.

Events that Make a Difference
ECAN has sponsored and supported multiple fundraising and awareness raising events around the country including walks, runs, bike rides, golf tournaments, dinners, library outreach, speaking events, art shows and more. ECAN volunteers have hosted more than 75 events to raise awareness across the U.S. and in other countries since 2010.

The Cancer Dancer – Taking Steps to Save Lives
In 2012, ECAN hosted the first gala in the U.S. ever to focus on Esophageal Cancer advocacy.  Our event was called the Cancer Dancer and featured many talented dance troupes.  But it was the moving speech our audience heard that made the evening spectacular.  Our keynote speaker shared a compelling story about her own battle with Esophageal Cancer.  ECAN was grateful to former Under Secretary of State and Congresswoman Ellen O'Kane Tauscher for her powerful words that evening and we remain grateful that she continues to be a trusted advisor to ECAN.

In 2013, the Cancer Dancer Gala honored the Greenebaum family's efforts to create a world-class cancer center at the University of Maryland in Baltimore where Esophageal Cancer is treated with care and expertise.  In 2014, the Cancer Dancer Gala went Hollywood with more than 300 guests and remarks by ECAN spokesman Stephen Bogart, the only son of Humphrey Bogart and Lauren Bacall.

Major Leagues & Major Cities
In April 2014, ECAN presented the first Esophageal Cancer Awareness event in professional sports at the Staples Center when the NBA's Los Angeles Clippers took on the Dallas Mavericks. Later that month, ECAN sponsored the first Esophageal Cancer Awareness race ever held in New York City; more than 1,000 attended the two-day festival that included a 5K, 10K and Half Marathon.

Seriously Funny
In 2015, ECAN launched its No Laughing Matter campaign – a public awareness effort that uses humor to help folks understand that reflux disease is a serious condition. The highlight of the campaign was An Evening with Jeff Foxworthy in Arlington, Virginia that brought a new audience to our message and entertained our supporters with a hilariously entertaining evening. Leading up to the event, ECAN hosted competitions in comedy clubs throughout the US providing up-and-coming comedians the chance to compete to be the opening act for Jeff Foxworthy and providing ECAN the opportunity to share a life-saving message to several major media markets and during entertaining nights out.

Reaching for the Stars
ECAN took awareness to new heights in 2015 with its Stories to Save Lives event in Los Angeles. More than 40 brave participants rappelled down 24 stories of the Hilton Universal City Hotel on behalf of someone who has faced Esophageal Cancer.  As the participants descended the building, the stories of the individuals they represented rang out for all to hear.  Two rappellers were EC survivors and a third was a patient battling Esophageal Cancer. This fun and moving day delivered a strong message about the importance of early detection and taking reflux disease seriously.

Fun and Games – and Awareness
In 2016, ECAN hosted its version of Hollywood Game Night with our Charm City Celebrity Game Night honoring a beloved and respected Baltimore television anchorman lost to Esophageal Cancer in 1987.  More than 20 on-air celebrities from eight television and radio stations competed to win the Jerry Turner Trophy, named for the Walter Cronkite of Baltimore who was taken too soon.

The post April is Esophageal Cancer Awareness Month appeared first on Esophageal Cancer Action Network.

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Anatomical Variation of Zygomatic Nerve Branches around Zygomaticus Major Muscle in Facelift

No abstract available

http://ift.tt/2m02U6M

Neurokinin-B regulates reproduction via inhibition of kisspeptin in a teleost, the striped bass

Kisspeptin and neurokinin B (NKB) are neuropeptides co-expressed in the mammalian hypothalamus and coordinately control GnRH signaling. We have found that Nkb and kisspeptin neurons are distinct in the teleost, striped bass (stb), and capitalized on this phenomenon to study the mode of action of Nkb and its related neuropeptide-F (Nkf), both of which are encoded by the tac3 gene. In vitro brain slices and in vivo administration studies revealed that Nkb/f consistently down-regulated kiss2, while antagonist (AntD) administration restored this effect. Overall, a minor effect was noted on gnrh1 expression, whereas Gnrh1 content in the pituitaries was reduced following Nkb/f treatment and increased with AntD. Concomitantly, immunostaining demonstrated that hypothalamic Nkb neurons border and densely innervate the largest kiss2 neuronal population in the hypothalamus, which also co-expresses Nkb receptor. No expression of Nkb receptor or Nkb neuronal projections were detected near/in Gnrh1 soma in the preoptic area. At the level of the pituitary, however, the picture was more complex: both Nkb/f and AntD upregulated lhb and fshb expression and Lh secretion in vivo. Together with the stimulatory effect of Nkb/f on Lh/Fsh secretion from pituitary cells, in vitro, this may indicate an additional independent action of Nkb/f within the pituitary, in which the hypothalamic pathway is more dominant. The current study demonstrates that Nkb/f utilize multiple pathways to regulate reproduction in the stb and that in the brain, Nkb mainly acts as a negative modulator of kiss2 to regulate the release of Gnrh1.

http://ift.tt/2nKXemI

Prevalence of Voice Disorders in Singers: Systematic Review and Meta-Analysis

The study aimed to review the prevalence of self-reported voice disorders in singers.

http://ift.tt/2nErQpB

Sleep Dentists: A Big Hit at NFLPA Annual Convention

Dr. Anthony Scianni, NFL Great Brenden Stai and Dr. Archie Roberts, Founder of Living Heart Foundation

The National Football League Players Association (NFLPA) recently chose Scottsdale, Arizona, to host its annual meeting for player representatives. Along with usual discussions of player wages, benefits, and positional elections, the Pro Player Health Alliance (PPHA), Living Heart Foundation, and Redirect Health offered free health screenings for former players.

More than 100 retired players took advantage of the screenings where they were assessed for body composition, blood pressure, pulmonary function, hearing, sleep apnea, and more. American Sleep and Breathing Academy (ASBA) Diplomates, Dr. Mark Castle, Dr. Dian Olah, Dr. Anthony Scianni and Dr. Kevin Mueller, were chosen to oversee the sleep apnea screenings. They later became known as the "Dream Team" by the end of the event, because they were able to help every player to get tested and referred to an ASBA dental sleep specialist for oral appliance therapy.

Dr. Rodolfo Ferrate speaking with a retired NFL player about sleep apnea

Dr. Rodolfo Ferrate, M.D., who flew from Utah to assist with the screenings at the NFLPA meeting, explained sleep apnea and its harmful effects. Dr. Ferrate mentioned, "A lot of these players know they have issues with sleep disordered breathing during the night, but many of them simply haven't been properly educated on how detrimental it can be to their health. These screenings are necessary to not only examine overall health, but to put the former players on the right path to a better quality of life by letting them know what's happening to their body and showing them treatment options."

 

For more information about overall health screenings for former NFL players, more information about the ASBA, or how to become a Diplomate of the ASBA, call David Gergen at 602-478-9713.

http://ift.tt/2muBawj

Central nervous system gliomas

Publication date: Available online 22 March 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Michele Reni, Elena Mazza, Silvia Zanon, Gemma Gatta, Charles J. Vecht
Evidence-based practical guidelines on diagnosis, prognosis, and treatment on the most frequent adult brain tumours are delineated. In Europe, 27,000 new cases of malignant glial tumours and 1,000 new cases of malignant ependymal tumours are diagnosed every year. The most common glial tumours are glioblastoma multiforme and anaplastic glioma, comprising more than 50% and 10%, respectively, of the total gliomas.Prognosis of gliomas is generally poor. Environmental and genetic factors have been correlated with an increased risk of developing brain tumours.Surgical resection represents the first treatment option for all histotypes.Role and timing of radiotherapy and chemotherapy as well as treatment for recurrent/progressive disease should be based on age, performance status, histopathological diagnosis, molecular markers, and previous therapy. Impaired neurocognitive and neuropsychological function is common in long-term survivors, regardless of the histology and grade of the tumour and should be taken into account in treatment planning.



http://ift.tt/2muuHBq

Impact of elimination diets on nutrition and growth in children with multiple food allergies.

Purpose of review: Growth and nutritional intake of children with cows' milk allergy and other food allergens has been thoroughly investigated in recent years across many different countries and age groups. An impaired growth in atopic children should not be attributed only to a high number of allergens and foods to be avoided, but to a general condition of 'sub-inflammation', which unfavorably affects the absorption and utilization of fuel and substrates. Atopic study participants may represent a good target for personalized nutrition and in this review we sought to outline many of the issues that should be taken into account when dietitians advise patients regarding food avoidance and expected effects on growth. Recent findings: The dietary management of food allergy requires appropriate dietary choices to maintain adequate growth, starting with special formulas in infancy. An emerging area of research is the fussy eating related to the exclusion of cow's milk and other foods during infancy and the long-term effects on eating habits and food preferences. Summary: Study participants with either mono or polyallergic diseases should ideally undergo the definition of their allergic and metabolic characteristics, to precisely adjust dietary interventions on an individual basis to support the genetic potential of growth and prevent unfavorable outcomes. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2nE77SC

To screen or not to screen for obstructive sleep apnea, that is the question

Screening tests are widely used, either in low disease prevalence populations, e.g. breast cancer screening, or more focused screening in patients declaring symptoms suggestive of a disease, such as CT coronary angiography for patients with chest pain. Three papers in this journal look at screening for obstructive sleep apnea (OSA) using questionnaires in varied populations with very different prevalences of OSA. However, there is surprisingly little evidence that such activities are valuable, or that they should divert resources away from patients with symptomatic OSA.

http://ift.tt/2nEzEr9

Impact of elimination diets on nutrition and growth in children with multiple food allergies.

Purpose of review: Growth and nutritional intake of children with cows' milk allergy and other food allergens has been thoroughly investigated in recent years across many different countries and age groups. An impaired growth in atopic children should not be attributed only to a high number of allergens and foods to be avoided, but to a general condition of 'sub-inflammation', which unfavorably affects the absorption and utilization of fuel and substrates. Atopic study participants may represent a good target for personalized nutrition and in this review we sought to outline many of the issues that should be taken into account when dietitians advise patients regarding food avoidance and expected effects on growth. Recent findings: The dietary management of food allergy requires appropriate dietary choices to maintain adequate growth, starting with special formulas in infancy. An emerging area of research is the fussy eating related to the exclusion of cow's milk and other foods during infancy and the long-term effects on eating habits and food preferences. Summary: Study participants with either mono or polyallergic diseases should ideally undergo the definition of their allergic and metabolic characteristics, to precisely adjust dietary interventions on an individual basis to support the genetic potential of growth and prevent unfavorable outcomes. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2nE77SC

Basophils, high-affinity IgE receptors and CCL2 in human anaphylaxis

We demonstrate a substantial reduction in circulating basophils and whole blood FcεRI gene expression during acute anaphylaxis. There was an increase in the major basophil chemotactic factor CCL2, which correlated with a decrease in basophils.

http://ift.tt/2murLoB

Thunderstorm Related Asthma Attacks

http://ift.tt/2mWs2wz

The Cellular Immune System Comes of Age

http://ift.tt/2mumJrY

Granulocyte transfusions in patients with chronic granulomatous disease and refractory infections: the NIH experience

Granulocyte transfusions are a relatively safe adjunctive therapeutic option for patients with chronic granulomatous disease and severe/refractory bacterial or fungal infections. Early initiation, high frequency and sustained therapy is associated with significantly better outcomes.

http://ift.tt/2mWneYf

Blood eosinophils predict therapeutic effects of a GATA3-specific DNAzyme in asthma patients

The effect of the GATA3-mRNA-specific DNAzyme SB010 treatment on EAR and LAR responses continuously increased with higher relative levels of blood eosinophils making them a suitable biomarker to stratify asthma patients for inhaled SB010 treatment.

http://ift.tt/2mul9Xq

Intestinal dendritic cell licensing through TLR4 is required for oral tolerance in allergic contact dermatitis

The commensal flora and expression of TLR4 on hematopoietic cells are essential for oral tolerance and suppression of DNFB-induced contact hypersensitivity. TLR4 conditions the mobilization of tolerogenic intestinal CD103+CD11b+ DCs carrying the allergen to MLNs.

http://ift.tt/2mWheP3

Receptor-interacting Protein Kinase 3 Controls Keratinocyte Activation in a Necroptosis-independent Manner and Promotes Psoriatic Dermatitis in Mice

RIPK3 in keratinocytes facilitates psoriatic inflammation by promoting cytokine and chemokine production, independent of the induction of necroptosis. Control of RIPK3 activation may be a novel therapeutic target for psoriasis.

http://ift.tt/2mupt8X

REDD1 links stress with IL-1β-mediated familial Mediterranean fever attack through autophagy-driven neutrophil extracellular traps

Stress-induced protein REDD1 is identified as a novel mediator in the pathogenesis of IL-1β-driven inflammation, through regulation of autophagy-mediated release of NETs. This study links environmental stress with inflammation in FMF attack as well as, with other IL-1β-associated autoinflammatory disorders.

http://ift.tt/2mWe4Lk

Peanut oleosins associated with severe peanut allergy - Importance of lipophilic allergens for comprehensive allergy diagnostics

Peanut oleosins are novel lipophilic allergens associated with severe allergic reactions. Their IgE-binding capacity is increased in roasted peanuts. Application of either purified natural or recombinant oleosins now closes a diagnostic gap.

http://ift.tt/2mupAS2

Long-Term Health-Related Quality of Life Outcomes in Digital Replantation versus Revision Amputation

J reconstr Microsurg
DOI: 10.1055/s-0037-1601052

Background Earlier, digit viability judged the success of digital replantation. Now, utility health-related quality of life (HRQOL) measures can better assess the impact of digital replantation. Methods Overall, 264 digital injury patients were sent a regimen of utility measures: Disabilities of the Arm, Shoulder and Hand (DASH) score, European Quality of Life 5 Dimensions, visual analog scale (VAS), time trade-off (TTO), and standard gamble (SG). Overall, 51 patients responded completely to all of these—36 replantation patients and 15 revision amputation patients. The utility results of these patients were stratified between replantation versus revision amputation; dominant hand replantation versus nondominant hand replantation; and dominant hand revision amputation versus nondominant hand revision amputation. Results The mean VAS score of replant (0.84) and revision amputation (0.75) groups was significantly different (p = 0.05). The mean DASH score of dominant hand replantations (29.72) and nondominant hand replantations (17.97) was significantly different (p = 0.027). The dominant hand revision amputation had higher anxiety levels in comparison to nondominant hand revision amputation (p = 0.027). Patients with two or more digits replanted showed a significant decrease in VAS, TTO, and SG scores in comparison to patients who only had one digit replanted (p = 0.009, 0.001, and 0.001, respectively). Conclusions This study suggests that HRQOL can offer better indices for outcomes of digital replantation. This shows some specific replantation cohorts have a significantly better quality of life when compared with their specific correlating revision amputation cohort. These findings can be employed to further refine indications and contraindications to replantation and help predict the quality of life outcomes.
[...]

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

http://ift.tt/2mukipl

Does cerebellar flocculus size affect subjective outcomes in pediatric auditory brainstem implantation

The objectives of study was to 1) Describe relevant surgical anatomy in defining and accessing the lateral recess for placement of electrode, 2) Propose a working classification for grades of Flocculus; 3) To determine if different grades of cerebellar flocculus effects placement of ABI electrode and subjective outcomes in implantees.

http://ift.tt/2n97iTo

Routine airway surveillance in pediatric tracheostomy patients

The aim of this study is to review airway findings in children with tracheostomies who underwent surveillance direct laryngoscopy and bronchoscopy (DLB) to determine the yield of routine airway evaluation in these patients.

http://ift.tt/2neHsPB

Impact of elimination diets on nutrition and growth in children with multiple food allergies.

Purpose of review: Growth and nutritional intake of children with cows' milk allergy and other food allergens has been thoroughly investigated in recent years across many different countries and age groups. An impaired growth in atopic children should not be attributed only to a high number of allergens and foods to be avoided, but to a general condition of 'sub-inflammation', which unfavorably affects the absorption and utilization of fuel and substrates. Atopic study participants may represent a good target for personalized nutrition and in this review we sought to outline many of the issues that should be taken into account when dietitians advise patients regarding food avoidance and expected effects on growth. Recent findings: The dietary management of food allergy requires appropriate dietary choices to maintain adequate growth, starting with special formulas in infancy. An emerging area of research is the fussy eating related to the exclusion of cow's milk and other foods during infancy and the long-term effects on eating habits and food preferences. Summary: Study participants with either mono or polyallergic diseases should ideally undergo the definition of their allergic and metabolic characteristics, to precisely adjust dietary interventions on an individual basis to support the genetic potential of growth and prevent unfavorable outcomes. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2nE77SC

Volumetric analysis of the maxillary, sphenoid and frontal sinuses: A comparative computerized tomography based study

Publication date: Available online 22 March 2017
Source:Auris Nasus Larynx
Author(s): Oded Cohen, Meir Warman, Moran Fried, Hagit Shoffel-Havakuk, Meital Adi, Doron Halperin, Yonatan Lahav
ObjectiveTo study volume characteristics of the maxillary, sphenoid and frontal sinuses among healthy Caucasians adults, using computed tomography (CT) scans.MethodsA retrospective, case series study in a single academic center, CT scans of 201 consecutive adult subjects, performed between January and September 2014, were reviewed for the volume and dimensions of the paranasal sinuses. Patients with documented sinus pathology or lack of pneumatization were excluded.The study population was subdivided by gender and age (50 men age 25–64; 51 men age ≥65; 50 women age 25–64, and 50 women age ≥65).ResultsThe mean volume of maxillary, sphenoid and frontal sinuses in the four groups were 12.75±4.38 cc; 4.00±1.99 cc and 2.92±2.57 cc, respectively. In both genders, older patients demonstrated a significantly lower volume of the maxillary and sphenoid sinuses (14.81±3.96 cc vs. 11.82±4.28 cc and 4.84±1.97 vs. 3.84±1.89 cc respectively; p<0.001). No age related difference was found in the frontal sinus. Males had significantly larger sinus volumes than females (p<0.001): maxillary 14.38±(4.64) vs. 12.23±(3.82) cc, sphenoid 4.74±(2.06) vs. 3.55±(1.73) cc, frontal 3.74±(2.97) vs. 3.21±(2.79) cc. No synergistic effect of age and gender was found.ConclusionVolumes of the paranasal sinuses correlates with age and gender. Age related volume degeneration is expected in the maxillary and sphenoid sinuses. This volume reduction may influence future surgical and therapeutic approaches in the geriatric population.



http://ift.tt/2mWj7Lw