Head and Neck Diseases by Alexandros G.Sfakianakis: 04/22/17

Σάββατο 22 Απριλίου 2017

The role of Compensatory Health Beliefs in eating behavior change: A mixed method study

Publication date: 1 September 2017
Source:Appetite, Volume 116
Author(s): Melanie A. Amrein, Pamela Rackow, Jennifer Inauen, Theda Radtke, Urte Scholz
Compensatory Health Beliefs (CHBs), defined as beliefs that an unhealthy behavior can be compensated for by engaging in another healthy behavior, are assumed to hinder health behavior change. The aim of the present study was to investigate the role of CHBs for two distinct eating behaviors (increased fruit and vegetable consumption and eating fewer unhealthy snacks) with a mixed method approach. Participants (N = 232, mean age = 27.3 years, 76.3% women) were randomly assigned to a fruit and vegetable or an unhealthy snack condition. For the quantitative approach, path models were fitted to analyze the role of CHBs within a social-cognitive theory of health behavior change, the Health Action Process Approach (HAPA). With a content analysis, the qualitative approach investigated the occurrence of CHBs in smartphone chat groups when pursuing an eating goal. Both analyses were conducted for each eating behavior separately. Path models showed that CHBs added predictive value for intention, but not behavior over and above HAPA variables only in the unhealthy snack condition. CHBs were significantly negatively associated with intention and action planning. Content analysis revealed that people generated only a few CHB messages. However, CHBs were more likely to be present and were also more diverse in the unhealthy snack condition compared to the fruit and vegetable condition. Based on a mixed method approach, this study suggests that CHBs play a more important role for eating unhealthy snacks than for fruit and vegetable consumption.

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Turkish version of the Intuitive Eating Scale-2: Validity and reliability among university students

Publication date: 1 July 2017
Source:Appetite, Volume 114
Author(s): Murat Bas, Kezban Esen Karaca, Duygu Saglam, Gozde Arıtıcı, Ecem Cengiz, Selen Köksal, Aylin Hasbay Buyukkaragoz
Intuitive Eating is defined as "the dynamic process-integrating attunement of mind, body, and food". The purpose of this study was, therefore, adapt the IES-2 to the Turkish language and reliability and validity of IES-2 among Turkish populations. We also examined the instrument's internal consistency and test-retest reliability and analysed the relationships between the IES-2 and several variables so as to evaluate the convergent and discriminant validity. Three hundred seventy-seven undergraduate and postgraduate women and men between the ages of 19–31 years (mean 22.3, SD = 3.53) attending two large private universities in Istanbul, Turkey. The best solution from the principal factors analysis of the 23 items of the IES-2 revealed four factors corresponding to the four subscales (F1: Eating for physical rather than emotional reasons; F2: Unconditional permission to eat; F3: Reliance on hunger and satiety cues; F4: Body-food choice congruence), as reported by the authors of the questionnaire. Bartlett's test of sphericity gave X² = 9043.49 (p < 0.001), while the Kaiser-Meyer-Olkin index was 0.87 (KMO were 0.89 for women and 0.83 for men). The test-retest reliability of the IES-2 was 0.88 for the IES-2 total score. The IES-2 had a = 0.82. These findings support the notion that intuitive eating is a viable concept for university students and the IES can be used to examine adaptive eating behaviors in this population.

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Pathogenic CD4+ T cells in patients with asthma

Publication date: Available online 22 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Lyndsey M. Muehling, Monica G. Lawrence, Judith A. Woodfolk
Asthma encompasses a variety of clinical phenotypes that involve distinct T cell–driven inflammatory processes. Improved understanding of human T-cell biology and the influence of innate cytokines on T-cell responses at the epithelial barrier has led to new asthma paradigms. This review captures recent knowledge on pathogenic CD4⁺ T cells in asthmatic patients by drawing on observations in mouse models and human disease. In patients with allergic asthma, TH2 cells promote IgE-mediated sensitization, airway hyperreactivity, and eosinophilia. Here we discuss recent discoveries in the myriad molecular pathways that govern the induction of TH2 differentiation and the critical role of GATA-3 in this process. We elaborate on how cross-talk between epithelial cells, dendritic cells, and innate lymphoid cells translates to T-cell outcomes, with an emphasis on the actions of thymic stromal lymphopoietin, IL-25, and IL-33 at the epithelial barrier. New concepts on how T-cell skewing and epitope specificity are shaped by multiple environmental cues integrated by dendritic cell "hubs" are discussed. We also describe advances in understanding the origins of atypical TH2 cells in asthmatic patients, the role of TH1 cells and other non-TH2 types in asthmatic patients, and the features of T-cell pathogenicity at the single-cell level. Progress in technologies that enable highly multiplexed profiling of markers within a single cell promise to overcome barriers to T-cell discovery in human asthmatic patients that could transform our understanding of disease. These developments, along with novel T cell–based therapies, position us to expand the assortment of molecular targets that could facilitate personalized treatments.

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Aggressive Behavior in Patients with Schizophrenia – What Causes It?

The definition of violence by World Health Organization (WHO, 2010) is actual or threatened violence done intentionally and unintentionally by using physical force, against any person leading to death, harm, injury and maladaptive behavior or deprivation. As ...

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Failure of the vascular hypothesis of multiple sclerosis in a rat model of chronic cerebrospinal venous insufficiency.

Failure of the vascular hypothesis of multiple sclerosis in a rat model of chronic cerebrospinal venous insufficiency.

Folia Neuropathol. 2017;55(1):49-59

Authors: Zakaria MMA, Mikhael SY, Hussein AKA, El-Din RAS, El-Malak HWA, Hewedi IH, Nadim HS

Abstract
Chronic cerebrospinal venous insufficiency (CCSVI) is a series of stenotic malformations in the cerebrospinal venous outflow routes, which is postulated to cause multiple sclerosis (MS). The hypotheses assumed that CCSVI leads to iron deposition which triggers inflammation and demyelination in MS. Invasive endovascular treatment of CCSVI was initiated based on the previous theory. The present study was designed to validate this hypothesis using a rat model of CCSVI. Bilateral jugular vein ligation (JVL) was performed on female albino rats (n = 15), and sham-operated rats (n = 15) were used as a control group. The rats were followed clinically for eight months and neurological examination detected no weakness or paralysis in the operated rats. At the end of the experiment, the rats were sacrificed and the brains were processed for histopathological examination of tissue sections stained by hematoxylin and eosin, myelin stain, silver impregnation, iron stain and immunohistochemical preparations for GFAP, CD68 and CD45. Semithin sections stained with toluidine blue were also examined. In the JVL group, increased iron deposition in the white matter was detected. An increase in the size and number of astrocytes along with increased GFAP immunoreactivity denoting reactive gliosis was also noted in the JVL group. However, no signs of demyelination, inflammation or axonopathy were detected. This study revealed that iron deposition in the JVL group as a model for CCSVI was not associated with cardinal histopathological findings of MS. It is therefore recommended that the invasive endovascular treatment of CCSVI should be reconsidered and further controlled clinical studies be carried out to provide a better understanding of the pathogeneses of MS..

PMID: 28430292 [PubMed - in process]

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Multiple cerebral fusiform aneurysms involving the posterior and anterior circulation including the anterior cerebral artery: a case report.

Multiple cerebral fusiform aneurysms involving the posterior and anterior circulation including the anterior cerebral artery: a case report.

Folia Neuropathol. 2017;55(1):73-76

Authors: Das S, Valyi-Nagy T

Abstract
Multiple fusiform aneurysms occurring in a single patient are very uncommon. Fusiform aneurysms affecting the anterior circulation are extremely rare and reported cases involve the middle cerebral artery and internal carotid artery. We report here a case of a 55-year-old African American male who had a history of multiple strokes and who was found unresponsive prior to his latest hospital admission. Neuroimaging was remarkable for multiple fusiform aneurysms involving segments of the anterior, middle and posterior cerebral arteries as well as subarachnoid and intraparenchymal hemorrhage. Unfortunately even after aggressive medical management, the patient did not show any signs of recovery and further management entailed comfort care measures only. The patient passed away shortly thereafter. Post-mortem examination confirmed the presence of multiple fusiform aneurysms with involvement of both the posterior and anterior circulation including the anterior cerebral artery as well as subarachnoid and intraparenchymal hemorrhage. Interestingly, there was no apparent site of aneurysm rupture identified to explain the hemorrhage. Our case is unusual in that the multiple fusiform aneurysms were found to extensively involve both the anterior and posterior circulation. Furthermore, our case demonstrates involvement of the anterior cerebral artery by fusiform aneurysms, which is also a very rare event. .

PMID: 28430295 [PubMed - in process]

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GRN mutation in a patient with a behavioral variant of frontotemporal lobar degeneration (bvFTD).

GRN mutation in a patient with a behavioral variant of frontotemporal lobar degeneration (bvFTD).

Folia Neuropathol. 2017;55(1):67-72

Authors: Walczysková S, Ressner P, Hilscherová Š, Kotlas J, Konrád J, Svobodová V

Abstract
The clinical spectrum of frontotemporal lobar degeneration (FTLD) is characterized by personality changes, language impairment, and executive function deficits. About 40% of FTLD cases have a family history of the disease, and the GRN gene is currently the most frequent genetic determinant. In cases of inherited FTLD with GRN mutations, parkinsonism is often an early sign due to greater grey matter atrophy in the caudate nucleus and bilateral atrophy in the thalamus. We investigated a female patient with signs of frontotemporal lobe atrophy and unilateral caudate nucleus atrophy on MRI. DNA was isolated from peripheral blood leukocytes and tested for GRN gene mutations. A pathogenic splice donor site mutation, c.708+1G>A, was found in the GRN gene. MRI showed unilateral caudate nucleus atrophy. This report extends the evidence for phenotypic and neuropathological heterogeneity in FTLD spectrum disorders due to splicing mutations in the GRN gene. .

PMID: 28430294 [PubMed - in process]

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Status of the brain antioxidant system at different growing periods after prenatal stress and N -acetyl cysteine administration.

Status of the brain antioxidant system at different growing periods after prenatal stress and N -acetyl cysteine administration.

Folia Neuropathol. 2017;55(1):38-48

Authors: Bernhardt LK, Madhyastha S, Bairy L, Kishore A

Abstract
Prenatal stress-induced neurobehavioral deficits observed in offspring are multifactorial, including oxidative stress in the developing brain. The time by which the developing brain acquires self-defense against oxidative stress is not clear. Hence in the present study we aimed to evaluate the brain antioxidant status during different developing periods. Further the study also evaluates the role of the glutathione precursor, N-acetyl cysteine (NAC) on the brain antioxidant status. Pregnant rats were subjected to restraint stress during an early or late gestational period. Another set of rats received NAC during the entire gestational period along with early or late gestational stress. The study parameters included several antioxidant studies directly from rat brain homogenate on postnatal day 24 or 48. Early or late gestational stress has caused severe oxidative stress in the developing brain on postnatal day 24 in all the parameters studied. However, brain reduced glutathione (GSH), superoxide dismutase (SOD) and total antioxidant activity (TAO) were not affected by either early or late gestational stress on postnatal day 48, but the brain malondialdehyde (MDA) level remained high and brain glutathione reductase (GSS-Rd) level remained low on postnatal day 48. Prenatal NAC treatment has reversed the oxidative damage in all the parameters on postnatal day 24 and also the brain MDA level and GSS-Rd level on postnatal day 48. This study confirms that the growing brain acquires antioxidant capacity over time but during early postnatal development it is vulnerable to oxidative stress and related neurological consequences. N-acetyl cysteine treatment during the prenatal period as an antioxidant supplement exerted a beneficiary effect in this study. Hence glutathione supplement in the nutritional source would be an idealistic approach to prenatal stress-induced neurological comorbidities in children..

PMID: 28430291 [PubMed - in process]

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Frequency and topography of small cerebrovascular lesions in vascular and in mixed dementia: a post-mortem 7-tesla magnetic resonance imaging study with neuropathological correlates.

Frequency and topography of small cerebrovascular lesions in vascular and in mixed dementia: a post-mortem 7-tesla magnetic resonance imaging study with neuropathological correlates.

Folia Neuropathol. 2017;55(1):31-37

Authors: De Reuck J, Auger F, Durieux N, Deramecourt V, Maurage CA, Cordonnier C, Pasquier F, Leys D, Bordet R

Abstract
Introduction: Mixed dementia (MixD) refers to a combination of definite Alzheimer's disease (AD) and vascular encephalopathy. The existence of a "pure" type of vascular dementia (VaD) is controversial. There is a need to find magnetic resonance imaging (MRI) characteristics allowing the distinction between VaD and MixD. The present post-mortem 7.0-tesla MRI compares the frequency or severity and the topography of the small cerebrovascular lesions in brains of patients with VaD and with MixD. Material and methods: Based on neuropathological criteria, 14 brains were classified as VaD, 24 as MixD and 11 as controls. Three coronal sections of a cerebral hemisphere and a horizontal section of a cerebellar hemisphere underwent T2 and T2* 7.0-tesla MRI examination. The mean values and topographic distribution of white matter changes (WMCs), lacunar infarcts (LIs), cortical microbleeds (CoMBs) and cortical microinfarcts (CoMIs) were determined and compared between the different groups. Results: Compared to the controls, both VaD and MixD brains had significantly more severe WMCs and increased numbers of CoMBs and CoMIs. Lacunar infarcts predominated only in the VaD cases. On mutual comparison of VaD and MixD brains, CoMBs and CoMIs predominated in the frontal lobe and the cerebellum of VaD, while were mainly present in the occipital lobe of MixD. White matter changes predominated in the temporal lobe of MixD cases. Lacunar infarcts were significantly increased in the corona radiata and putamen of VaD patients. Conclusions: The present post-mortem MRI study shows clear differences in the distribution and the types of cerebrovascular lesions on high-field MRI, confirming that VaD and MixD are different diseases. .

PMID: 28430290 [PubMed - in process]

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Evidence from spatial pattern analysis for the anatomical spread of α-synuclein pathology in Parkinson's disease dementia.

Evidence from spatial pattern analysis for the anatomical spread of α-synuclein pathology in Parkinson's disease dementia.

Folia Neuropathol. 2017;55(1):23-30

Authors: A Armstrong R

Abstract
The objective of this study was to determine whether there is evidence from quantitative morphometry and spatial pattern analysis to support the hypothesis of anatomical spread of -synuclein in Parkinson's disease dementia (PDD). Hence, clustering of -synuclein-immunoreactive Lewy bodies (LB), Lewy neurites (LN), and Lewy grains (LG) was studied in -synuclein-immunolabeled sections of cortical and limbic regions in 12 cases of PDD. The data suggested that: (1) LB, LN, and LG occurred in clusters which in 63% of regions were regularly distributed parallel to the tissue boundary, (2) in approximately 30% of cortical regions, the estimated cluster size of LB, LN, and LG was within the size range of cellular columns associated with the cortico-cortical pathways, (3) regularly distributed clusters were present in anatomically connected regions, and (4) the clustering pattern was similar to that of prion protein (PrPsc) deposits in Creutzfeldt-Jacob disease (CJD). The clustering patterns of LB, LN, and LG were similar to those exhibited by cellular inclusions in other synucleinopathies and by PrPsc deposits in prion disease and therefore, anatomical spread of pathogenic -synuclein could be involved in the pathogenesis of PDD..

PMID: 28430289 [PubMed - in process]

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Mesenchymal/proangiogenic factor YKL-40 related to glioblastomas and its relationship with the subventricular zone.

Mesenchymal/proangiogenic factor YKL-40 related to glioblastomas and its relationship with the subventricular zone.

Folia Neuropathol. 2017;55(1):14-22

Authors: Batista KMP, Eulate-Beramendi SA, Pińa KYÁR, Figueira PR, Canal AF, Chasin JMA, Meilan Á, Ugalde R, Vega IF

Abstract
Glioblastoma is the most common primary brain tumor. Despite multimodality therapy with aggressive microsurgical resection and adjuvant chemotherapy and radiotherapy, the median survival is below 15 months. Glioblastomas are heterogeneous tumors with high resistance to most chemotherapeutic drugs. According to reliable evidence, YKL-40, one of the best investigated chitinase-like protein, may facilitate invasion, migration and angiogenesis, and could be also responsible for temozolomide resistance in glioblastoma, thus conferring a dismal prognosis. Previous studies have demonstrated that glioblastoma stem cells give rise to endothelial cells through an YKL-40 influence. Such factor is closely related to the subventricular zone. This review focuses on the most recent theories involving the possible relationship between topographic gliomagenesis related to the subventricular zone and YKL-40..

PMID: 28430288 [PubMed - in process]

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Dysembryoplastic neuroepithelial tumour: insight into the pathology and pathogenesis.

Dysembryoplastic neuroepithelial tumour: insight into the pathology and pathogenesis.

Folia Neuropathol. 2017;55(1):1-13

Authors: Sontowska I, Matyja E, Malejczyk J, Grajkowska W

Abstract
Dysembryoplastic neuroepithelial tumour (DNT) is categorized as a benign glioneuronal neoplasm affecting children and young adults with chronic epileptic seizures. It is characterized by predominant intracortical localization and nodular architecture. Dysembryoplastic neuroepithelial tumour usually demonstrates a distinctive morphological pattern with a specific glioneuronal element but occasionally, its morphological picture is heterogeneous and unspecific. Thus, considering the morphology of DNT, three different histopathological subtypes are distinguished: simple, complex, and non-specific and diffuse. The DNT lesions are often related with focal cortical dysplasia (FCD) type IIIb, which is postulated to play a role in epileptogenicity. Moreover, the accompanying inflammation process might be implicated in DNT-related epileptogenesis. Dysembryoplastic neuroepithelial tumour is generally characterized by favourable prognosis and good results of surgical treatment. The pathogenesis and molecular mechanisms involved in DNT development remain uncertain. The main molecular findings are connected with BRAF alterations and activation of RAS/ERK, PI3K/AKT and mTOR signalling pathways. The present review summarizes the clinical, histopathological and molecular findings of DNT. The classification controversy, morphological heterogeneity and diagnostic problems are also discussed. .

PMID: 28430287 [PubMed - in process]

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Current evidence and the evolving role of sunitinib in the management of renal cell carcinoma.

Current evidence and the evolving role of sunitinib in the management of renal cell carcinoma.

Indian J Cancer. 2016 Jan-Mar;53(1):102-8

Authors: Noronha V, Joshi A, Bakshi G, Tongaonkar H, Prabhash K

Abstract
The development of targeted agents has expanded the anticancer arsenal available to oncologists and revolutionized the field of cancer treatment. In patients with advanced renal cell carcinoma (RCC), small molecule targeted therapies have improved clinical outcomes compared with cytokine-based treatments. Sunitinib malate is one such drug that has demonstrated clinical efficacy in patients with metastatic renal cell carcinoma (mRCC). This oral, multi-targeted tyrosine kinase inhibitor is approved for use in multiple countries for the treatment of advanced RCC and gastrointestinal stromal tumor patients who have progressed on imatinib therapy. In patients with advanced RCC, sunitinib significantly improves clinical outcomes with a favorable safety profile compared with conventional treatment with interferon-a. The clinically proven treatment and safety outcomes have led investigators to evaluate the merits of sunitinib therapy in the adjuvant and neoadjuvant setting in patients with mRCC. In the neoadjuvant setting, preliminary data suggest that sunitinib can effectively reduce the primary tumor and facilitate surgical resection in patients with locally advanced and mRCC. Post-operative complications were observed in some patients, but the overall safety profile and efficacy suggests that mRCC patients with surgically inoperable tumors may benefit from neoadjuvant sunitinib therapy. Ongoing clinical trials should provide insight into the value of sunitinib as adjuvant therapy.

PMID: 27146754 [PubMed - indexed for MEDLINE]

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Conversion Disorder, Functional Neurological Symptom Disorder, and Chronic Pain: Comorbidity, Assessment, and Treatment

Abstract

Purpose of Review

This paper examines the overlap of conversion disorder with chronic pain conditions, describes ways to assess for conversion disorder, and provides an overview of evidence-based treatments for conversion disorder and chronic pain, with a focus on conversion symptoms.

Recent Findings

Conversion disorder is a significant problem that warrants further study, given that there are not many well-established guidelines. Accurate and timely assessment should help move treatment in a more fruitful direction and avoid unnecessary medical interventions. Advances in neuroimaging may also help further our understanding of conversion disorder. Creating a supportive environment and a collaborative treatment relationship and improving understanding of conversion symptoms appear to help individuals diagnosed with conversion disorder engage in appropriate treatments. Novel uses of earlier treatments, such as hypnosis and psychodynamic approaches, could potentially be beneficial and require a more vigorous and systematic study.

Summary

There are treatments that produce significant improvements in functioning and reduction of physical symptoms from conversion disorder even for very severe cases. Hypnotherapy, cognitive behavioral therapy, and inpatient multidisciplinary treatment with intensive physiotherapy for severe cases have the most evidence to support reduction of symptoms. Components of treatment for conversion disorder overlap with treatments for chronic pain and can be used together to produce therapeutic effects for both conditions. Treatment needs to be tailored for each individual's specific symptoms.

http://ift.tt/2oAB16E

Conversion Disorder, Functional Neurological Symptom Disorder, and Chronic Pain: Comorbidity, Assessment, and Treatment

Abstract

Purpose of Review

Recent Findings

Summary

http://ift.tt/2oAB16E

Positive airway pressure adherence and mask interface in the setting of sinonasal symptoms

Objectives/Hypothesis

Despite reports of lower positive pressure adherence rates with oronasal masks, patients with sinonasal problems are often prescribed this interface over a nasal interface. The aim of this study was to characterize the relationship between mask type and therapy adherence in the setting of sinonasal symptoms.

Study Design

Retrospective case series with chart review.

Methods

We reviewed 328 patients who underwent positive pressure titration between January 2012 and May 2015. Follow-up adherence data were available for 218 patients (66.5%). Multivariate analysis examined whether patients with sinonasal symptoms have improved adherence with oronasal masks compared to nasal or nasal pillow interfaces.

Results

At a median follow-up of 95 days, positive pressure adherence in patients with sinonasal symptoms was highest with the nasal pillow interface. When compared with oronasal interfaces, the odds of adequate therapy adherence were >5 times greater with nasal pillow interfaces (odds ratio [OR] = 5.20, 95% confidence interval [CI] = 1.61-16.80, P = .006) and >3 times greater with nasal interfaces (OR = 3.67, 95% CI = 1.20-11.26, P = .02) in these symptomatic patients.

Conclusions

The presence of nasal problems does not predict the need for an oronasal mask. Positive pressure adherence rates are higher with nasal and nasal pillow interfaces compared to oronasal masks, even in patients with sinonasal complaints.

Level of Evidence

4. Laryngoscope, 2016

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Positive airway pressure adherence and mask interface in the setting of sinonasal symptoms

Objectives/Hypothesis

Study Design

Retrospective case series with chart review.

Methods

Results

Conclusions

Level of Evidence

4. Laryngoscope, 2016

http://ift.tt/2p4roiq

Impact of dose and surface features on plasmatic and liver concentrations of biodegradable polymeric nanocapsules

Publication date: Available online 22 April 2017
Source:European Journal of Pharmaceutical Sciences
Author(s): Líliam Teixeira Oliveira, Mônica Auxiliadora de Paula, Bruno Mendes Roatt, Giani Martins Garcia, Luan Silvestro Bianchini Silva, Alexandre Barbosa Reis, Carina Silva de Paula, José Mário Carneiro Vilela, Margareth Spangler Andrade, Gwenaelle Pound-Lana, Vanessa Carla Furtado Mosqueira
The effect of polymeric nanocapsule dose on plasmatic and liver concentrations 20min after intravenous administration in mice was evaluated. Nanocapsules were prepared with different polymers, namely, poly(D,L-lactide) (PLA), polyethylene glycol-block-poly(D,L-lactide) (PLA-PEG), and PLA with chitosan (PLA-Cs) and compared with a nanoemulsion. These formulations were labelled with a phthalocyanine dye for fluorescent detection. The nanostructures had narrow size distributions upon separation by asymmetric flow field flow fractionation with static and dynamic light scattering detection, with average hydrodynamic diameters in the 130–300nm range, negative zeta potentials, except PLA-Cs nanocapsules, which had a positive zeta potential. Flow cytometry revealed uptake mostly by monocytes and neutrophils in mice and human blood. PLA nanocapsules and the nanoemulsion showed dose-dependent plasma concentrations, where the percentage of plasmatic fluorescence increased with increasing administered dose. In contrast, PLA-PEG nanocapsules led to a dose-independent plasmatic profile. PLA-Cs nanocapsules showed the lowest plasmatic and liver levels of fluorescence at all administered doses and significant intravenous toxicity in mice. This work demonstrates the importance of considering the nanocarrier dose when evaluating pharmacokinetic and biodistribution data and emphasizes the role of surface features in determining the plasmatic and liver concentrations of a poorly soluble lipophilic encapsulated compound.

Graphical abstract

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Inheritable and sporadic non-autoimmune hyperthyroidism

Publication date: Available online 22 April 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism
Author(s): Carolina Ferraz, Ralf Paschke
Hyperthyroidism is a clinical state that results from high thyroid hormone levels which has multiple etiologies, manifestations, and potential therapies. Excluding the autoimmune Graves disease, autonomic adenomas account for the most import cause of non-autoimmune hyperthyroidism. Activating germline mutations of the TSH receptor are rare etiologies for hyperthyroidism. They can be inherited in an autosomal dominant manner (familial or hereditary, FNAH), or may occur sporadically as a de novo condition, also called: persistent sporadic congenital non-autoimmune hyperthyroidism (PSNAH). These three conditions: autonomic adenoma, FNAH and PSNAH constitute the inheritable and sporadic non-autoimmune hyperthyroidism. Particularities in epidemiology, etiology, molecular and clinical aspects of these three entities will be discussed in this review in order to guide to an accurate diagnosis allowing among others genetic counseling and presymptomatic diagnosis for the affected families. The optimal treatment based on the right diagnosis will avoid consequences of a persistent or relapsing hyperthyroidism.

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Erratum

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New Dermatologic Surgery iPad app

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Prevention of Thyroidectomy Scars in Korean Patients Using a New Combination of Intralesional Injection of Low-Dose Steroid and Pulsed Dye Laser Starting within 4 Weeks of Suture Removal

Background

Regulation of inflammation during the wound healing process reduces scar formation at the injury site.

Objective

To evaluate the effect of intralesional injection of low-dose steroid with pulsed dye laser on healing of early postoperative thyroidectomy scars.

Materials and Methods

Twenty Korean women with thyroidectomy scars were enrolled. All were treated with an intralesional injection of low-dose steroid (2 mg/mL) and 595-nm pulsed dye laser starting within 4 weeks of suture removal. The Vancouver Scar Scale (VSS), Global Assessment Score (GAS), and Patient Satisfaction Score were used in this evaluation.

Results

Average VSS scores were significantly lower after treatment. The GAS also indicated better cosmetic outcomes after steroid injection in the laser treatment group than after laser treatment only.

Conclusion

Early postoperative intralesional injection of low-dose steroid and pulsed dye laser treatment is effective and safe.

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Preliminary Comparison of Fractional Laser with Fractional Laser Plus Radiofrequency for the Treatment of Acne Scars and Photoaging

Background

The therapeutic approach to the treatment of acne scars and photoaging varies according to the type of lesion. Traditional carbon dioxide (CO₂) laser is associated with long healing times, persistent erythema, and high risk of post-inflammatory hyperpigmentation. Fractional laser technology, which involves the application of microscopic beams of pixilated light inducing focal zones of tissue injury surrounded by normal tissue, is currently used for the treatment of acne scars and photoaging.

Objective

To compare the results obtained using CO₂ fractional laser with those obtained using CO₂ fractional laser plus radiofrequency for the treatment of atrophic acne scars and photoaging by means of clinical evaluation and confocal laser.

Materials and Methods

Ten patients with photoaging and acne scars underwent a single treatment using both technologies. Investigators and patients evaluated the clinical effect of the treatments using digital photographs, dermatoscopy, and in vivo reflectance confocal microscopy before and immediately, 1 week, and 3 months after treatment.

Results and Conclusion

Our results underlined the high efficacy of combining CO₂ laser and radiofrequency, producing better results with fewer sessions, lower risks, and fewer side effects.

http://ift.tt/Oh8FvV

Retrospective Evaluation of Micro-focused Ultrasound for Lifting and Tightening the Face and Neck

Background

Microfocused ultrasound (MFU) is an effective means for tightening and lifting lax facial and neck skin.

Objective

To evaluate the safety and efficacy of MFU with visualization (MFU-V) for noninvasive treatment of facial and neck skin laxity 180 days after treatment and determine what lifestyle factors affect treatment outcomes.

Materials and Methods

Healthy women (N = 48) previously treated with MFU-V on the face and upper neck were enrolled. Depending on when MFU-V treatment occurred, subjects completed 90- or 180-day follow-up visits or both. Digital images of each subject were obtained before treatment and at follow-up visits.

Results

Data were obtained at 90 (N = 16) and 180 days (N = 45), and physician Global Aesthetic Improvement Scale (GAIS) scores demonstrated that 81.3% and 77.7% patients achieved improvement, respectively. At 90 and 180 days, subject GAIS scores showed 75% and 77.8% of subjects perceived improvement, respectively. At 180 days, blinded reviewer assessments indicated that 67% of subjects showed improvement in appearance. There was no association between improvement and age, Fitzpatrick skin type, alcohol intake, or major illness. One minor adverse event was reported.

Discussion

Although the data obtained at 90 days must be interpreted cautiously because of the smaller number of patients, subjects achieved significant lifting and tightening of facial and neck skin up to 180 days after one MFU treatment.

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Dynamic Hypoxia in Scar Tissue During Human Hypertrophic Scar Progression

Background

The skin color of human hypertrophic scar changes dynamically during scar progression.

Objective

To investigate whether hypoxia is dynamic during scar progression.

Methods

Thirty-five patients with early, proliferative, regressive, and mature scars were involved in this study. Tissue oxygen tension was measured before scar surgery. After surgery, the scar stage was further defined using hematoxylin and eosin staining, and microvessel density and hypoxia inducible factor-1 (HIF-1) expression were detected using immunohistochemistry to determine a correlation with oxygen level.

Results

Mild hypoxia is present in early scars, moderate hypoxia in proliferative scars, and severe hypoxia in regressive scars. Oxygen levels then return to normal in mature scars, which was consistent with the dynamic change in microvessel density. Meanwhile, HIF-1 expression also changed dynamically along with alteration in oxygen levels.

Conclusion

Hypoxia is dynamic in scar tissue and is possibly correlated with scar formation and regression.

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Mistaken Conclusions in a Nonmelanoma Skin Cancer Article Published in JAMA

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Evaluation of Nerves in Mohs Micrographic Surgery: Histologic Mimickers of Perineural Invasion and Nervous Tissue on Frozen Section

Background

Perineural invasion (PNI) is an important histologic finding and may be a negative prognostic factor for squamous cell carcinoma (SCC). It may be associated with more-aggressive tumor behavior. Mohs surgeons encounter microscopic PNI regularly and must be able to diagnose it accurately to guide care decisions.

Objective

To describe benign histologic mimickers of PNI and neural structures in SCC commonly encountered on frozen, hematoxylin and eosin–stained sections and to review how to differentiate them from PNI.

Methods and Materials

Review of the literature regarding histologic mimickers of PNI and additional contributions to frozen section PNI and nerve tissue mimickers.

Results

We describe benign findings, including arrector pili muscles, eccrine muscles, vessels, granulomatous inflammation, and eddies of SCC, that may each be mistaken for nerves or PNI. We discuss the ways in which they may be distinguished on frozen sections and review other commonly encountered entities that resemble PNI.

Conclusion

Perineural inflammation and peritumoral fibrosis are common mimickers of PNI on frozen section, although other mimickers exist on permanent sections. Normal structures may appear "neural" by way of frozen tissue orientation, processing, or inflammation and thus must be differentiated from nerve tissue and PNI during Mohs surgery.

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Comparison Study of Fractional Carbon Dioxide Laser Resurfacing Using Different Fluences and Densities for Acne Scars in Asians: A Randomized Split-Face Trial

Background

Ablative 10,600-nm carbon dioxide (CO₂) fractional laser treatments have shown favorable outcomes for atrophic acne scars.

Objective

To compare the efficacy and complications of fractional CO₂ laser treatments with different fluences and densities for acne scars.

Methods

Twenty patients were treated using a single session of fractional CO₂ laser in Deep FX mode. In Group A (n = 10), half of the face was treated with 20 mJ, density 10% and the other half with 20 mJ, density 20%. In Group B (n = 10), half of the face was treated with 10 mJ, density 10% and the other half with 20 mJ, density 10%. Patients were evaluated at baseline and 3 days, 1 week, 1 month, and 3 months after the procedure.

Results

There was no significant difference in efficacy between different laser settings within the groups, although adverse effects were more evident in patients treated with higher densities or fluences.

Conclusion

Factional CO₂ laser treatment using the Deep FX mode may provide a significant efficacy with lower fluence and density with fewer complications than with higher energies for acne scars.

http://ift.tt/1ikGR4E

Advantages of the Half-Circle Suture Needle for Reconstructing Small Cutaneous Surgical Wounds

http://ift.tt/2q2FuQX

Collagenase Followed by Compression for the Treatment of Earlobe Keloids

Background

Many therapeutic options are available for treating keloids, but success rates vary widely, and the keloids often recur. The Food and Drug Administration has recently approved intralesional collagenase for the treatment of Dupuytren's contracture. This medication has not been explored for the treatment of earlobe keloids, a common problem.

Objective

To evaluate the safety and clinical efficacy of intralesional collagenase followed by compression for the treatment of earlobe keloids.

Materials and methods

Six earlobe keloids in six patients were injected with a commercial collagenase preparation. Study participants were asked to use compression earrings daily thereafter. Patients were examined and photographed 1 day, 2 weeks, 4 weeks, 10 months, and 12 months after injection. Adverse events were assessed at each visit, and the keloids were measured and photographed.

Results

All patients had a decrease in the size of their earlobe keloid by an average of 50% (p = .02). Three of the six participants chose to have their earlobe keloids surgically excised for cosmetic reasons 6, 8, and 11 months after enrollment, so measurements for data analysis for these patients were taken after only 1, 1 and 10 months. All participants returned for follow-up at the last study visit 1 year after study commencement. The three patients who completed the study were pleased with the improvement of their earlobe keloid, although complete clearance was not achieved. Side effects included injection site swelling, tenderness, and one ulceration that spontaneously resolved within 2 weeks.

Conclusion

Intralesional collagenase followed by compression appears to be a safe and modestly effective treatment for earlobe keloids. This approach warrants further investigation in larger studies with longer follow-up in motivated patients who decline surgical excision.

http://ift.tt/1edns1c

Safety of Botulinum Toxin A in Aesthetic Treatments: A Systematic Review of Clinical Studies

Background

The use of botulinum toxin A (BoNT-A) for aesthetic treatments is growing steadily, and new safety data have been reported in recently published studies.

Objective

To investigate the safety data on the use of the three BoNT-A formulations approved for facial aesthetics from recent studies and to confirm their safety profiles.

Methods

The literature search was conducted using three online databases restricted to the timeframe from January 2000 to June 2012. Only clinical trials, randomized or open label, with safety as the primary or secondary endpoint, were included.

Results

Thirty-five papers were selected, with a total of subjects 8,787 studied. OnabotulinumtoxinA was used in 60.0% of the studies, abobotulinumtoxinA in 37.1%, and incobotulinumtoxinA in 2.8%. The glabella was the most investigated area (51.4%), followed by the upper face (25.7%), crow's feet (11.4%), and lower face (11.4%). Treatment-related adverse events were blepharoptosis (2.5%), brow ptosis (3.1%), and eye sensory disorders (3%) in the upper face and lip asymmetries and imbalances in the lower face (6.9%). All of these events resolved spontaneously.

Conclusion

The short-term safety profile of BoNT-A in cosmetic nonsurgical procedures was confirmed for all the three commercial formulations.

http://ift.tt/1ev4dnQ

Superficial Dermabrasion Versus Topical Tretinoin on Early Striae Distensae: A Randomized, Pilot Study

Background

Striae distensae (SD) is a common skin condition, with a prevalence ranging from 40% to 90%, depending on the population studied.

Objectives

To evaluate the efficacy of superficial dermabrasion and compare it with that of topical tretinoin cream in the treatment of narrow and early SD.

Materials and methods

Prospective, single-center, randomized, open-label study. Thirty-two women presenting with early, untreated SD (striae rubra) were included in this study. One group received 16 weekly sessions of superficial and localized dermabrasion, and the other used 0.05% tretinoin cream daily. Striae width and length were measured and compared between groups and over time. Global Aesthetic Improvement Scale scores and subject satisfaction were also assessed. Biopsies were performed for subjects who agreed to undergo this procedure, followed by histologic analyses of the skin samples.

Results

Both treatments were efficacious, with significant improvement in early SD from baseline, but there was no significant difference between the two treatments. Histologic assessment showed improvement in epidermal and dermal layers for the dermabrasion treatment group.

Conclusion

Both treatments had similar efficacy, but superficial dermabrasion had a lower frequency of side effects and better adherence of the patients.

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Free App for Consultation Imaging

http://ift.tt/2q30AhI

Use of Intralesional Poly-L-Lactic Acid in the Treatment of Corticosteroid-Induced Lipoatrophy

http://ift.tt/1jI0tQ3

Reversible Myopathy and Ophthalmoparesis After Low-Dose Finasteride Administration for Androgenic Alopecia

http://ift.tt/2q2NWzx

Rapid Development of Squamous Cell Carcinoma after Photodynamic Therapy

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Neoadjuvant Intralesional Methotrexate Before Surgery in Squamous Cell Carcinoma

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Spotlighting the Role of Photodynamic Therapy in Cutaneous Malignancy: An Update and Expansion

http://ift.tt/1m7eZpo

Understanding and Use of the American Joint Committee on Cancer Seventh Edition Guidelines for Cutaneous Squamous Cell Carcinoma: A Survey of Dermatologic Surgeons

Background

The seventh edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual was published in 2009, including an updated chapter on cutaneous squamous cell carcinoma (cSCC) and other cutaneous carcinomas. Notable improvements from the previous sixth edition include placement of Merkel cell carcinoma and cSCC of the eyelid in individual chapters, elimination of the 5-cm clinical breakpoint for T3, and addition of high-risk features for upstaging T1 to T2 independent of clinical tumor size. Despite these advances, several publications critical of the AJCC guidelines have surfaced in the literature since their release.

Objective

To further evaluate the use and applicability of the most-recent AJCC guidelines for cSCC.

Materials and Methods

A web-based survey of members of the American College of Mohs Surgery to gauge knowledge and application of the guidelines.

Conclusion

Although physician knowledge of the details of the guidelines was in line with expectations, some areas for improvement (e.g., coexistent immunosuppression incorrectly listed as a high-risk feature) remain. Also, the lack of change in practice, among Mohs surgeons or dermatopathologists, as a result of the guidelines is somewhat troubling and may be an area for further research.

http://ift.tt/1kmNnYZ

Granin-derived Peptides

Publication date: Available online 22 April 2017
Source:Progress in Neurobiology
Author(s): Josef Troger, Markus Theurl, Rudolf Kirchmair, Teresa Pasqua, Bruno Tota, Tommaso Angelone, Maria C. Cerra, Yvonne Nowosielski, Raphaela Mätzler, Jasmin Troger, Jaur R. Gayen, Vance Trudeau, Angelo Corti, Karen B. Helle
The granin family comprises altogether 7 different proteins originating from the diffuse neuroendocrine system and elements of the central and peripheral nervous systems. The family is dominated by three uniquely acidic members, namely chromogranin A (CgA), chromogranin B (CgB) and secretogranin II (SgII). Since the late 1980ies it has become evident that these proteins are proteolytically processed, intragranularly and/or extracellularly into a range of biologically active peptides; a number of them with regulatory properties of physiological and/or pathophysiological significance. The aim of this comprehensive overview is to provide an up-to-date insight into the distribution and properties of the well established granin-derived peptides and their putative roles in homeostatic regulations. Hence, focus is directed to peptides derived from the three main granins, e.g. to the chromogranin A derived vasostatins, betagranins, pancreastatin and catestatins, the chromogranin B-derived secretolytin and the secretogranin II-derived secretoneurin (SN). In addition, the distribution and properties of the chromogranin A- derived peptides prochromacin, chromofungin, WE14, parastatin, GE-25 and serpinins, the CgB-peptide PE-11 and the SgII-peptides EM66 and manserin will also be commented on. Finally, the opposing effects of the CgA- derived vasostatin-I and catestatin and the SgII-derived peptide SN on the integrity of the vasculature, myocardial contractility, angiogenesis in wound healing, inflammatory conditions and tumors will be discussed.

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FKBP51s signature in peripheral blood mononuclear cells of melanoma patients as a possible predictive factor for immunotherapy

Abstract

The inhibitory immune checkpoint PD-L1/PD1 promotes the alternative splicing of the FKBP5 gene, resulting in increased expression of its variant 4 in the peripheral blood mononuclear cells of melanoma patients. The variant 4 transcript is translated into the truncated FKBP51s protein. Given the importance of co-inhibitory signalling in tumour immune escape, here we tested the potential for using FKBP51s expression to predict immunotherapy outcomes. To do this, we immunophenotyped PBMCs from 118 melanoma patients and 77 age- and sex-matched healthy controls. Blood samples were collected before patients underwent ipilimumab treatment. In 64 of the 118 patients, FKBP51s expression was also assessed in regulatory T cells (Tregs). We found that each PBMC subset analysed contained an FKBP51s^pos fraction, and that this fraction was greater in the melanoma patients than healthy controls. In CD4 T lymphocytes, the FKBP51s^neg fraction was significantly impaired. Tregs count was increased in melanoma patients, which is in line with previous studies. Also, by analyses of FKBP51s in Tregs, we identified a subgroup of ipilimumab nonresponder patients (p = 0.002). In conclusion, FKBP51s-based immunophenotyping of melanoma patients revealed several profiles related to a negative immune regulatory control and identified an unknown Treg subset. These findings are likely to be useful in the selection of the patients that are candidate for immunotherapy.

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Comparative study of three kinds of fibula cutting guides in reshaping fibula for the reconstruction of mandible: An accuracy simulation study in vitro

In order to get predictable reassembling and higher accuracy in the reconstruction of the mandible, we designed three kinds of fibula cutting guides: (1) two-edge wide groove guide (WGG); (2) two-edge narrow groove guide (NGG); and (3) one-edge guide (OEG). The purpose of this study was to compare the accuracy of fibula remodelling using the three kinds of fibula cutting guides above in a simulation procedure in vitro.

http://ift.tt/2ogClAA

Cochlear implantation in children with anomalous cochleovestibular anatomy

Publication date: Available online 22 April 2017
Source:Auris Nasus Larynx
Author(s): Ana Sofia Melo, Jorge Martins, João Silva, Jorge Quadros, António Paiva
ObjectiveThe aim of the study is to assess the audiological and surgical outcome after cochlear implantation in children with inner ear malformation and to compare them with a group of congenitally deaf children implantees without inner ear malformation.IntroductionChildren with profound sensorineural deafness with malformations of the inner ear represent a challenge, accounting to 5–15% of congenital sensorineural deafness. These cases were originally regarded as a contraindication for cochlear implant surgery.MethodsRetrospective study of 26 patients with congenital inner ear malformation, from a total population of 329 cochlear implant patients. Radiological evaluation with high resolution computed tomography and magnet resonance was performed to all patients in order to evaluate all the preoperative conditions. All patients were tested using European Portuguese word discrimination tests (monosyllabic test, number test and sentences test), capacity of auditory performance (CAP) and speech intelligibility rating (SIR).ResultsIn all 7.9% of deaf children in our center study have inner ear abnormalities. All children underwent successful implantation. CAP yielded an average 7.1 (+/−1.7), SIR 4.3 (+/−1.0). The children without inner ear abnormalities did not achieve statistically significant better scores. Two children had a perilymph gusher, and there were no other complications.ConclusionCochlear implantation can be successfully performed in children with inner ear malformation. Audiological performance after cochlear implantation in malformed inner ears is comparable to that found in other congenitally deaf patients. The risk of CSF leak is associated with inner ear abnormalities and should be anticipated during surgery.

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In-ear medical devices for acoustic therapies in tinnitus treatments, state of the art

Publication date: Available online 21 April 2017
Source:Auris Nasus Larynx
Author(s): David Ibarra, Francisco Tavira-Sanchez, Manuel Recuero-Lopez, Brian W. Anthony
Cochrane reviews indicate there is very limited support for all forms of sound therapy and cognitive behavioral therapy has the strongest support. American Academy of Otolaryngology (AAO) recently published some guidelines which recommends Cognitive Behavioral Therapy (CBT) for tinnitus intervention, and only indicates that sound therapy should be considered an "option" for intervention.Nevertheless, acoustic therapy could lead to cause changes in the tinnitus perception and has been appreciated by the affected people for years. In the last decades, the use of sound or sound enrichment has become a central part of many tinnitus management programs used by audiologists, whether the intention was to mask tinnitus, suppress tinnitus, or interrupt the tinnitus generating neural activity.Several acoustic therapies have been developed and implemented in the last 40 years, but how can we determine which one is the most effective? We can determine the effects based on the results reported in many research studies, but in those studies are many factors that differ from one study to another, like in-ear medical devices used to apply acoustic therapy for tinnitus treatment.In this article, we review and analyze the different types of in-ear medical devices used in the most recently acoustic therapies in treatments against tinnitus, allowing us to identify the pros and cons. By our analysis, an optimal medical device could be characterized to enhance the application of acoustic therapies and in consequence the global results of the sound therapies that already exist. In this review, it was considered acoustic therapies, the technology implemented in medical devices and the clinical needs.

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The evaluation of pattern and quality of sleep in patients with chronic rhinosinusitis with nasal polyps

Publication date: Available online 22 April 2017
Source:Auris Nasus Larynx
Author(s): Uzdan Uz, Kıvanç Günhan, Hikmet Yılmaz, Halis Ünlü
ObjectiveThe goal of this study is to evaluate the impact of chronic rhinosinusitis with nasal polyps (CRSwNP) on sleep pattern and sleep quality before and after functional endoscopic sinus surgery using subjective and objective parameters.MethodsTwenty-two patients with CRSwNP were evaluated. All subjects underwent assessment by nasal endoscopy, rhinomanometry and computed tomography. Sleep pattern and sleep quality were evaluated by Pittsburgh sleep quality index (PSQI) and polysomnography (PSG). All patients were reassessed 6 months after surgery.ResultsNasal resistance decreased after the surgery (p<0.001). Postoperative PSQI scores were significantly lower than preoperative scores (p<0.001). The preoperative mean values of total apnea index and apnea-hypopnea index were 25.4 and 13.3, respectively. After surgery, the total apnea and apnea-hypopnea index had decreased significantly to 7.8 and 11.2, respectively (p=0.009 and 0.019, respectively).ConclusionIn patients with CRSwNP, functional endoscopic sinus surgery significantly ameliorates sleep pattern and sleep quality. CRSwNP may be a predisposing factor for sleep related respiratory disorders.

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Pleomorphic liposarcoma of the head and neck: Presentation of two cases and literature review

Publication date: Available online 22 April 2017
Source:American Journal of Otolaryngology
Author(s): Jay Agarwal, Sameep Kadakia, Abbas Agaimy, Anna Ogadzanov, Azita Khorsandi, Raymond L. Chai
BackgroundPleomorphic liposarcoma (PL) is an exceedingly rare tumor of the head and neck. This aggressive liposarcoma variant portends a poorer prognosis compared to more typical sarcomatous tumors.MethodsMulti-institutional study including two cases of PL, the first case occurring in the post-auricular region and the second in the cheek with later recurrence within the parotid bed.ResultsBoth patients were treated surgically with wide local excision. One patient required reoperation to obtain negative margins. The other patient underwent a total parotidectomy with neck dissection for recurrent intraparotid nodal disease. Both patients underwent adjuvant radiotherapy. No patient had evidence of recurrent disease with minimum one year follow-up.ConclusionAlthough the literature is sparse on this disease, wide surgical extirpation with negative margins and adjuvant radiation is recommended. Increased reports of this pathology can be helpful in providing practitioners with experienced-based information that can aid in early detection and treatment. We present the first case series of PL of the head and neck in the literature.

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Characterization of major natural and anthropogenic source profiles for size-fractionated PM in Yangtze River Delta

Publication date: 15 November 2017
Source:Science of The Total Environment, Volume 598
Author(s): Pulong Chen, Tijian Wang, Mei Dong, Matthew Kasoar, Yong Han, Min Xie, Shu Li, Bingliang Zhuang, Mengmeng Li, Tunan Huang
Samples of size-fractionated particles were collected from local natural and anthropogenic sources in two industrial cities in the Yangtze River Delta, using either grab/resuspension sampling or ambient air sampling. The chemical characterizations of twenty one source profiles were obtained, based on elements (Al, As, Ca, Cd, Cr, Cu, Fe, K, Mg, Mn, Na, Pb and Zn), soluble ions (Cl⁻, NO3⁻, SO4²⁻, NH4⁺, K⁺, Na⁺ and Ca²⁺) and carbonaceous material such as organic carbon (OC) and elemental carbon (EC). The profiles vary between sources from different areas, as well as between different particulate sizes. Results show that particulate matter that originated as soil dust, construction dust and fugitive dust is typically rich in crustal elements, especially Al, Ca, Fe and Mg, while the presence of calcium is found to be a hallmark of the cement industry and ceramic industry. Dominant compositions of particles from coal-fired power plants are variable, with OC ranging from 2.2%–27%. Garbage-fired power plant and cooking smoke particulate emissions are enriched in Na, Cl⁻, OC and K due to the presence of salty and organic matter. The element Fe, ranging from 6.1% to 26.0%, is found to be an important marker for steel production dust. Vehicle exhaust profiles are characterized by high abundances of OC (12.1%–53.6%) and EC (3.9%–20.0%). Burning of straw results in K (1.6%–7.2%) and OC (12.4%–25.9%) being the dominant composition. Preliminary work has also been done on establishing local industrial profiles such as textile, ceramic and electroplating industries. This work could be used in receptor model studies to estimate the contributions of different sources to the size-fractionated particulate matter in the Yangtze River Delta.

Graphical abstract

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Modelling drivers and distribution of lead and zinc concentrations in soils of an urban catchment (Sydney estuary, Australia)

Publication date: 15 November 2017
Source:Science of The Total Environment, Volume 598
Author(s): L.E. Johnson, T.F.A. Bishop, G.F. Birch
The human population is increasing globally and land use is changing to accommodate for this growth. Soils within urban areas require closer attention as the higher population density increases the chance of human exposure to urban contaminants. One such example of an urban area undergoing an increase in population density is Sydney, Australia. The city also possesses a notable history of intense industrial activity. By integrating multiple soil surveys and covariates into a linear mixed model, it was possible to determine the main drivers and map the distribution of lead and zinc concentrations within the Sydney estuary catchment. The main drivers as derived from the model included elevation, distance to main roads, main road type, soil landscape, population density (lead only) and land use (zinc only). Lead concentrations predicted using the model exceeded the established guideline value of 300mgkg⁻¹ over a large portion of the study area with concentrations exceeding 1000mgkg⁻¹ in the south of the catchment. Predicted zinc did not exceed the established guideline value of 7400mgkg⁻¹; however concentrations were higher to the south and west of the study area. Unlike many other studies we considered the prediction uncertainty when assessing the contamination risk. Although the predictions indicate contamination over a large area, the broadness of the prediction intervals suggests that in many of these areas we cannot be sure that the site is contaminated. More samples are required to determine the contaminant distribution with greater precision, especially in residential areas where contamination was highest. Managing sources and addressing areas of elevated lead and zinc concentrations in urban areas has the potential to reduce the impact of past human activities and improve the urban environment of the future.

Graphical abstract

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Surface sediment quality relative to port activities: A contaminant-spectrum assessment

Publication date: 15 October 2017
Source:Science of The Total Environment, Volumes 596–597
Author(s): Shen Yu, Bing Hong, Jun Ma, Yongshan Chen, Xiuping Xi, Jingbo Gao, Xiuqin Hu, Xiangrong Xu, Yuxin Sun
Ports are facing increasing environmental concerns with their importance to the global economy. Numerous studies indicated sediment quality deterioration in ports; however, the deterioration is not discriminated for each port activity. This study investigated a spectrum of contaminants (metals and organic pollutants) in surface sediments at 20 sampling points in Port Ningbo, China, one of the top five world ports by volume. The spectrum of contaminants (metals and organic pollutants) was quantified following marine sediment quality guidelines of China and USA and surface sediment quality was assessed according to thresholds of the two guidelines. Coupling a categorical matrix of port activities with the matrix of sedimentary contaminants revealed that contaminants were highly associated with the port operations. Ship repair posed a severe chemical risk to sediment. Operations of crude oil and coal loadings were two top activities related to organic pollutants in sediments while port operations of ore and container loadings discharged metals. Among the 20 sampling points, Cu, Zn, Pb, and DDT and its metabolites were the priority contaminants influencing sediment quality. Overall, surface sediments in Port Ningbo had relatively low environmental risks but ship repair is an environmental concern that must be addressed. This study provides a practical approach for port activity-related quality assessment of surface sediments in ports that could be applicable in many world sites.

Graphical abstract

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Pathogenic CD4+ T cells in patients with asthma

Asthma encompasses a variety of clinical phenotypes that involve distinct T cell–driven inflammatory processes. Improved understanding of human T-cell biology and the influence of innate cytokines on T-cell responses at the epithelial barrier has led to new asthma paradigms. This review captures recent knowledge on pathogenic CD4+ T cells in asthmatic patients by drawing on observations in mouse models and human disease. In patients with allergic asthma, TH2 cells promote IgE-mediated sensitization, airway hyperreactivity, and eosinophilia.

http://ift.tt/2q2LQj6

Physical performance in newly diagnosed hypothyroidism: a pilot study

Abstract

Objective

Hypothyroidism is complicated by neuromuscular symptoms (myalgias, slowness of movements, and tiredness) and signs (easy fatigability and cramps), which may have a negative impact on general well-being and quality of life. In a pilot, prospective, controlled study, we investigated the features of muscle dysfunction in hypothyroidism by disease questionnaire, biochemical measures, and physical performance tests.

Materials and Methods

Fifty-seven consecutive patients with newly diagnosed hypothyroidism were enrolled, 27 subclinical (S-Hypo) and 30 overt (O-Hypo). A series of 30 euthyroid subjects, with similar demographic characteristics, served as controls. Patients were administered a short disease questionnaire and underwent laboratory exams and standardized physical tests, both at baseline and after restoration of biochemical euthyroidism.

Results

Compared to euthyroid controls, the O-Hypo group showed significantly higher prevalence of neuromuscular symptoms and significantly higher serum creatine phosphokinase (CPK) levels (p value < 0.0001). S-Hypo had slightly higher CPK levels and prevalence of neuromuscular symptoms than controls. Both S-Hypo and O-Hypo patients performed worse than controls in the six-minute walking test. Differences between patients and controls in handgrip strength test and timed chair standing test failed to reach statistical significance (although a trend was noticeable), possibly due to the small sample size. In O-Hypo, an inverse correlation was found between CPK levels and the handgrip strength test (p value < 0.001). Restoration of euthyroidism was associated with normalization of questionnaire responses, six-minute walking test, as well as serum CPK levels.

Conclusion

In addition to neuromuscular symptoms, hypothyroidism is associated with abnormalities of physical performance. The six-minute walking test is the most valuable test to assess this aspect. In the pilot study, levothyroxine therapy could reverse muscle functional abnormalities.

http://ift.tt/2pQDknX

Is OperaVOX a clinically useful tool for the assessment of voice in a general ENT clinic?

Objective acoustic analysis is a key component of multidimensional voice assessment. OperaVOX is an iOS app which has been shown to be comparable to Multi Dimensional Voice Program for most principal measures ...

http://ift.tt/2pQMLnj

Is OperaVOX a clinically useful tool for the assessment of voice in a general ENT clinic?

Conservative management of mallet injuries: A national survey of current practice in the UK

Mallet injuries are common, and usually treated conservatively. Various systematic reviews have found a lack of evidence regarding best management and it is unclear whether this uncertainty is reflected in current UK practice.

http://ift.tt/2pRQyDX

Internationally adopted children with cleft lip and/or palate: A retrospective cohort study

The treatment approach for internationally adopted children with cleft lip and/or palate differs from locally born children with cleft lip and/or palate. They are older at initial presentation, may have had treatment abroad of different quality and are establishing new, still fragile relationships with their adoptive parents. The aim of this study was to describe the characteristics and initial care and treatment of this group.

http://ift.tt/2oxL39x

Delayed Primary Closure of Extensive Wounds Using the TopClosure System and Topical Negative Pressure Therapy

Dear Editor, Extensive skin defects can be a challenging problem for a reconstructive surgeon. Primary closure of such defects is limited by tension and ischemia that develop at the skin edges. In such situation, skin grafting, locoregional, or free flap surgery are often necessary. We want to share our experience in achieving primary closure of extensive wounds with the TopClosure system (IVT Medical Limited, Israel) in combination with negative pressure therapy. The external tissue expansion effect of the TopClosure and the wound contracting ability of negative pressure therapy synergistically facilitates primary closure of extensive defects.

http://ift.tt/2pRtZ1Y

External Validation of the Breast Reconstruction Risk Assessment Calculator

The Breast reconstruction Risk Assessment (BRA) Score estimates patient-specific risk for post-surgical complications using an individual's unique combination of pre-operative variables. In this report, we externally validate the BRA Score models for surgical site infection, seroma, and explantation in a large sample of intra-institutional patients who underwent prosthetic breast reconstruction.

http://ift.tt/2oxLe4G

An innovative method of planning and displaying flap volume in DIEP flap breast reconstructions

Determining the ideal volume of the harvested flap in order to achieve symmetry in deep inferior epigastric artery perforator (DIEP) flap breast reconstructions is complex. With preoperative imaging techniques such as 3D stereophotogrammetry and Computed Tomography Angiography (CTA) available nowadays, we can combine information to preoperatively plan the optimal flap volume to be harvested. In this proof-of-concept we investigated whether projection of a virtual flap planning onto the patient's abdomen using a projection method could result in harvesting the correct flap volume.

http://ift.tt/2pRHY8e

A Retrospective Study: Multivariate Logistic Regression Analysis of the Outcomes after Pressure Sores Reconstruction With Fasciocutaneous, Myocutaneous and Perforator Flaps

Despite significant advances in medical care and surgical techniques, pressure sore reconstruction is still prone to elevated rates of complication and recurrence. We conducted a retrospective study to investigate not only complication and recurrence rates following pressure sore reconstruction, but also preoperative risk stratification as well.

http://ift.tt/2oxPZeo

Postoperative outcomes of two- and three-dimensional planning in orthognathic surgery: A comparative study

Compared with conventional two-dimensional (2D) planning, three-dimensional (3D) planning in orthognathic surgery yields more accurate anatomical information and enables the precise positioning of maxillary and mandibular segments, particularly for patients with facial asymmetry. Accordingly, surgical outcomes achieved using 3D planning should be superior. This study determined the differences between the 2D and 3D planning techniques by comparing their surgical outcomes.

http://ift.tt/2pRr2yp

Facial skin rejuvenation by autologous dermal microfat transfer in photoaged patients: clinical evaluation and skin surface digital profilometry analysis

Cumulative, long-term exposure to solar ultraviolet radiation promotes premature skin aging characterized by wrinkle formation and reduced skin elasticity. In this study, we assessed whether microfat transfer could improve dermal and subcutaneous tissue thickness loss associated with photoaging. Twenty one patients affected by facial photoaging (photodamage grade II-IV; age range 35-62 years; 19 females, 2 males; all of Caucasian origin) were treated using minimally-invasive autologous dermal white fat transfer harvested with a recently designed microcannula.

http://ift.tt/2oxNARa

Women with symptoms of sleep-disordered breathing are less likely to be diagnosed and treated for sleep apnea than men

Women are often underrepresented at sleep clinics evaluating sleep-disordered breathing (SDB). The aim of the present study was to analyze gender differences in sleep apnea diagnosis and treatment in men and women with similar symptoms of SDB.

http://ift.tt/2oAtfcT

Evaluation of the Effect of JZP-110 in Patients with Narcolepsy Assessed Using the Maintenance of Wakefulness Test Censored to 20 Minutes

To evaluate the effects of JZP-110 on the Maintenance of Wakefulness Test (MWT) with data censored to include only the first 20 minutes of a 40-minute MWT.

http://ift.tt/2oUEwIz

Solvent-dependent transformation of aflatoxin B 1 in soil

Abstract

To date, all studies of aflatoxin B₁ (AFB₁) transformation in soil or in purified mineral systems have identified aflatoxins B₂ (AFB₂) and G₂ (AFG₂) as the primary transformation products. However, identification in these studies was made using thin layer chromatography which has relatively low resolution, and these studies did not identify a viable mechanism by which such transformations would occur. Further, the use of methanol as the solvent delivery vehicle in these studies may have contributed to formation of artifactual transformation products. In this study, we investigated the role of the solvent vehicle in the transformation of AFB₁ in soil. To do this, we spiked soils with AFB₁ dissolved in water (93:7, water/methanol) or methanol and used HPLC-UV and HPLC-MS to identify the transformation products. Contrasting previous published reports, we did not detect AFB₂ or AFG₂. In an aqueous-soil environment, we identified aflatoxin B_2a (AFB_2a) as the single major transformation product. We propose that AFB_2a is formed from hydrolysis of AFB₁ with the soil acting as an acid catalyst. Alternatively, when methanol was used, we identified methoxy aflatoxin species likely formed via acid-catalyzed addition of methanol to AFB₁. These results suggest that where soil moisture is adequate, AFB₁ is hydrolyzed to AFB_2a and that reactive organic solvents should be avoided when replicating natural conditions to study the fate of AFB₁ in soil.

http://ift.tt/2pRDWN2

Quality and readability of websites for patient information on tonsillectomy and sleep apnea

Tonsillectomy is a common treatment for obstructive sleep apnea (OSA). The Internet allows patients direct access to medical information. Since information on the Internet is largely unregulated, quality and readability are variable. This study evaluates the quality and readability of the most likely visited websites presenting information on sleep apnea and tonsillectomy.

http://ift.tt/2pQAkrV

Point-of-care ultrasound for oral and maxillofacial surgeons

Point-of-care ultrasound is an ultrasound examination that is made at the bedside by the examining clinician in the Accident and Emergency department, clinic, ward, or operating theatre, and it has been growing in popularity since it was first introduced in the 1990s. It is used as an adjunct to clinical examination to aid diagnosis or treatment. We have carried out a pilot survey to assess whether oral and maxillofacial surgeons in the United Kingdom either need or desire to make such an examination.

http://ift.tt/2q2GMLD

The evaluation of pattern and quality of sleep in patients with chronic rhinosinusitis with nasal polyps

The goal of this study is to evaluate the impact of chronic rhinosinusitis with nasal polyps (CRSwNP) on sleep pattern and sleep quality before and after functional endoscopic sinus surgery using subjective and objective parameters.

http://ift.tt/2p3US07

Cochlear implantation in children with anomalous cochleovestibular anatomy

The aim of the study is to assess the audiological and surgical outcome after cochlear implantation in children with inner ear malformation and to compare them with a group of congenitally deaf children implantees without inner ear malformation.

http://ift.tt/2pRg2Bq

The evaluation of pattern and quality of sleep in patients with chronic rhinosinusitis with nasal polyps

Cochlear implantation in children with anomalous cochleovestibular anatomy

Parotid gland involvement as an initial presentation of papillary thyroid carcinoma

Papillary thyroid carcinoma (PTC) is the most differentiated malignant thyroid neoplasm. Local metastases of PTC commonly occur in the regional lymph nodes, while distant metastases are mainly to the lung and bone. The case of a patient with PTC who presented with swelling of the parotid gland and neck, mimicking a primary parotid neoplasm, is presented herein. This case is unique due to the unexpected initial presentation of PTC with no signs of disease in the thyroid gland.

http://ift.tt/2p3NDFl

Dysphagia in a Patient with Cervical Dystonia

http://ift.tt/2ofuPWk

Ototoxicity of boric acid powder in a rat animal model

Publication date: Available online 22 April 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Murat Salihoglu, Salim Dogru, Enver Cesmeci, Halil Caliskan, Onuralp Kurt, Zafer Kuçukodaci, Atila Gungor
IntroductionBoric acid, which has antiseptic and acidic properties, is used to treat external and middle ear infections. However, we have not found any literature about the effect of boric acid powder on middle ear mucosa and inner ear.ObjectiveThe purpose of this study is to investigate possible ototoxic effects of boric acid powder (BAP) on cochlear outer hair cell function and histological changes in middle ear mucosa in a rat animal model.MethodsTwenty healthy, mature Wistar albino rats were used in this study. The rats were divided into two groups, Group A and Group B, each of which consisted of 10 rats. Initially, the animals in each group underwent distortion product otoacoustic emissions (DPOAE) testing of their right and left ears. After the first DPOAE test, a surgical microscope was used to make a small perforation in both ears of the rats in each group, and a second DPOAE test was used to measure both ears in all of the rats. BAP was applied to the right middle ear of the rats using tympanic membrane perforation, and the DPOAEs were measured immediately after the BAP application. The histological changes and DPOAEs were evaluated three days later in Group A and 40 days later in Group B.ResultsNo significant differences were found at all of the DPOAE frequencies. In Group A, mild inflammation of the middle ear mucosa was found on the third day after BAP application. In Group B, BAP caused mild inflammatory changes on the 40th day, which declined over time. Those changes did not lead to significant fibrosis within the mucosa.ConclusionIn rats, BAP causes mild inflammation in middle ear mucosa and it has no ototoxic effects on cochlear outer hair cell function in the inner ear of rats.

http://ift.tt/2p3SUwz

Trends in the prevalence of extreme obesity among Korean children and adolescents from 2001 to 2014

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print

http://ift.tt/2oxj3TD

Genotype-phenotype correlation in paediatric pheochromocytoma and paraganglioma: a single centre experience from India

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print

http://ift.tt/2oUk6PX

Preoperative radiation therapy: The ‘new’ targeted breast cancer treatment?

Publication date: June 2017
Source:European Journal of Cancer, Volume 78
Author(s): Charlotte E. Coles, Alain Fourquet, Philip Poortmans

http://ift.tt/2oghzAT

Utilidad de la 18F-FDG PET/TC en el linfoma cerebral primario

Publication date: Available online 21 April 2017
Source:Revista Española de Medicina Nuclear e Imagen Molecular
Author(s): Á. de-Bonilla-Damiá, R. Fernández-López, F.J. Capote-Huelva, F. de la Cruz-Vicente, J.J. Egea-Guerrero, I. Borrego-Dorado
ObjetivoEstudiar la utilidad de la ¹⁸F-FDG PET/TC en la evaluación inicial y valoración de la respuesta al tratamiento en el linfoma cerebral primario.Material y métodosSe analizaron retrospectivamente 18 pacientes diagnosticados de linfoma cerebral primario, subtipo histológico linfoma difuso de células grandes B, habiéndose realizado en todos ellos un estudio con ¹⁸F-FDG PET/TC y RM inicial y, en 7 casos, también tras la realización de tratamiento con el fin de valorar la respuesta.ResultadosLa ¹⁸F-FDG PET/TC inicial detectó un total de 26 depósitos hipermetabólicos frente a un total de 46 lesiones de la RM. La media del SUV máximo de las lesiones fue de 17,56 y del T/N, de 3,55. La concordancia de ambas pruebas para identificar el mismo número de lesiones fue moderada, obteniendo un índice kappa de 0,395 (p<0,001). En la valoración de la respuesta al tratamiento la RM identificó 16 lesiones frente a los 7 acúmulos patológicos de la ¹⁸F-FDG PET/TC. La concordancia de ambas pruebas para valorar el tipo de respuesta al tratamiento fue moderada (índice kappa 0,41) (p=0,04). Tanto en la evaluación inicial como en la valoración de la respuesta al tratamiento la PET/TC facilitó un cambio de estrategia en un 22% de los pacientes que presentaron lesiones fuera del parénquima cerebral.ConclusionesLa RM parece ser la técnica de elección en la valoración de la enfermedad cerebral en pacientes con linfoma cerebral primario, mientras que la PET/TC ha demostrado tener un papel importante en la valoración de la enfermedad extracerebral.ObjectiveTo study the usefulness of ¹⁸F-FDG PET/CT in the initial evaluation and in the response assessment in primary brain lymphoma.Material and methodsA retrospective analysis was carried out on 18 patients diagnosed with primary brain lymphoma, a histological subtype of diffuse large B-cell lymphoma, on whom an initial ¹⁸F-FDG PET/CT and MRI was performed, with 7 of the cases being analysed after the completion of treatment in order to assess response and clinical follow up.ResultsInitial ¹⁸F-FDG PET/CT showed 26 hypermetabolic foci, whereas 46 lesions were detected by MRI. The average SUV maximum of the lesions was 17.56 with T/N 3.55. The concordance of both tests for identifying the same number of lesions was moderate, obtaining a kappa index of 0.395 (P<.001). In the evaluation of treatment, MRI identified 16 lesions compared to 7 pathological accumulations observed by ¹⁸F-FDG PET/CT. The concordance of both tests to assess type of response to treatment was moderate (kappa index 0.41) (P=.04). In both the initial evaluation and the assessment of the response to treatment, PET/CT led to a change strategy in 22% of patients who had lesions outside the cerebral parenchyma.ConclusionsMRI appears to be the method of choice for detecting brain disease in patients with primary brain lymphoma, whereas ¹⁸F-FDG PET/CT seems to play a relevant role in the assessment of extra-cerebral disease.

http://ift.tt/2pQ3ZkN

Retrospective evaluation of the effectiveness of radiotherapy in patients with plantar fascitis (heel spurs)

Publication date: May–June 2017
Source:Reports of Practical Oncology & Radiotherapy, Volume 22, Issue 3
Author(s): Piotr Kędzierawski, Rafał Stando, Paweł Macek
AimThe aim of the study was the evaluation of the effectiveness of radiotherapy in patients with the feet pain caused by heel spurs.BackgroundTreatment options for patients reporting these symptoms include use of suitable orthopedic footwear, the use of general or topical non-steroidal anti-inflammatory drugs or steroids, physiotherapy, manual therapy, shock wave or appropriate surgical procedures. Radiotherapy is one of the method used in patients with chronic pain syndrome.Materials and methodsThe material consisted of 47 patients treated in Radiotherapy Department at the Holycross Cancer Center. The time of follow-up ranged from 1 to 129 months. After treatment patients were observed.ResultsDuring the first follow-up visit a complete relief of symptoms was observed in 37 patients, and the pain was felt by 10 patients for 4 months after the treatment. One patient was re-irradiated 6 months after treatment because of persistent pain. At 16 and 17 months after the onset of treatment, pain was reported by two patients. These patients were re-irradiated. One patient had recurrence of pain 48 months after completion of radiation. After the second irradiation the pain was relieved. The remaining patients, with the exception of two, experienced remission of pain, which has been documented. Tolerance of the treatment was very good. No complications of radiation were observed.ConclusionsRadiotherapy remains an attractive treatment for patients with inflammation of the heel fascia.

http://ift.tt/2q2hVHR

CT- and MRI-based gross target volume comparison in vestibular schwannomas

Publication date: May–June 2017
Source:Reports of Practical Oncology & Radiotherapy, Volume 22, Issue 3
Author(s): Bhudevi Soubhagya N. Kulkarni, Harjot Bajwa, Mukka Chandrashekhar, Sunil Dutt Sharma, Rohith Singareddy, Dileep Gudipudi, Shabbir Ahmad, Alok Kumar, N.V.N. Madusudan Sresty, Alluri Krishnam Raju
AimThis study represents an enumeration and comparison of gross target volumes (GTV) as delineated independently on contrast-enhanced computed tomography (CT) and T1 and T2 weighted magnetic resonance imaging (MRI) in vestibular schwannomas (VS).BackgroundMultiple imaging in radiotherapy improves target localization.Methods and materials42 patients of VS were considered for this prospective study with one patient showing bilateral tumor. The GTV was delineated separately on CT and MRI. Difference in volumes were estimated individually for all the 43 lesions and similarity was studied between CT and T1 and T2 weighted MRI.ResultsThe male to female ratio for VS was found to be 1:1.3. The tumor was right sided in 34.9% and left sided in 65.1%. Tumor volumes (TV) on CT image sets were ranging from 0.251cc to 27.27cc. The TV for CT, MRI T1 and T2 weighted were 5.15±5.2cc, 5.8±6.23cc, and 5.9±6.13cc, respectively. Compared to MRI, CT underestimated the volumes. The mean dice coefficient between CT versus T1 and CT versus T2 was estimated to be 68.85±18.3 and 66.68±20.3, respectively. The percentage of volume difference between CT and MRI (%VD: mean±SD for T1; 28.84±15.0, T2; 35.74±16.3) and volume error (%VE: T1; 18.77±10.1, T2; 23.17±13.93) were found to be significant, taking the CT volumes as the baseline.ConclusionsMRI with multiple sequences should be incorporated for tumor volume delineation and they provide a clear boundary between the tumor and normal tissue with critical structures nearby.

http://ift.tt/2poFFcN

Estimation of peripheral dose from Co60 beam in water phantom measured in Secondary Standard Dosimetry Laboratory, Pakistan

Publication date: May–June 2017
Source:Reports of Practical Oncology & Radiotherapy, Volume 22, Issue 3
Author(s): Muhammad Shahban, Babar Hussain, Khalid Mehmood, Shakeel Ur Rehman
BackgroundPeripheral or scatter dose harms neighbouring normal tissues during administration of dose to cancerous tissues, therefore, knowledge of peripheral dose is an important consideration in radiotherapy.AimIn present study, absorbed dose measurements in a water phantom were performed for three field sizes, 7×7cm², 10×10cm² and 15×15cm².Materials and methodsFor each field size, dose was measured at six depths below the front surface of the water phantom; 2.5–15cm with an interval of 2.5cm. Measurements were made at equal transverse distances along the horizontal axis, from 1cm to 6cm, on both sides of the central beam axis and normalized with central axis dose of each field. All measurements were made at the source to surface distance of 100cm.ResultsVariation of peripheral dose with lateral distance was analysed and an appropriate parametric equation for each field size and depth was constructed.ConclusionsThe peripheral radiation dose showed a strong dependence on field size and distance from field boundary.

http://ift.tt/2q2tHBS

Prospective evaluation of anxiety, depression and quality of life in medically inoperable early stage non-small cell lung cancer patients treated with stereotactic ablative radiotherapy

Publication date: May–June 2017
Source:Reports of Practical Oncology & Radiotherapy, Volume 22, Issue 3
Author(s): Jacek Rutkowski, Magdalena Szymanik, Maciej Blok, Joanna Kozaka, Renata Zaucha
AimThe aim of this prospective study was to evaluate the level of anxiety, depression, and quality of life (QoL) in medically inoperable patients with early stage non-small cell lung cancer (NSCLC) treated with stereotactic ablative radiotherapy (SABR).BackgroundProlonged survival is equally important as maintaining high QoL and good psychological functioning during the treatment of lung cancer. Nowadays available SABR has markedly changed clinical care and outcomes in the group of medically inoperable patients. To our knowledge, analysis of QoL and psychological state has not been performed in Polish patients with early NSCLC treated with SABR.Materials and methodsResearch group consisted of medically inoperable, early NSCLC (T1-2aN0M0) patients qualified to SABR. Patients were asked to complete Polish versions of the European Organization for Research and Treatment of Cancer Quality of Life – Core Questionnaire (EORTC QLQ-C30) with the Lung Cancer Questionnaire (LC13) and Hospital Anxiety and Depression Scale (HAD). These questionnaires were repeated 2 weeks and then 3 months after treatment completion.ResultsWe enrolled 51 patients who met the inclusion criteria. SABR did not deteriorate QoL and psychological functioning. On the contrary, clinically meaningful improvement was observed in emotional functioning, level of insomnia, anxiety and depression. Significantly worse improvement was shown in patients with chronic obstructive pulmonary disease (COPD).ConclusionsOur results confirm that SABR is well tolerated and does not have a deleterious effect on QoL and psychological state. Results of our study indicate the importance of additional psychological care in the group of patients with COPD.

http://ift.tt/2poE6vn

Dosimetric impact in the dose–volume histograms of rectal and vesical wall contouring in prostate cancer IMRT treatments

Publication date: May–June 2017
Source:Reports of Practical Oncology & Radiotherapy, Volume 22, Issue 3
Author(s): Laura Gómez, Carlos Andrés, Antonio Ruiz
AimThe main purpose of this study was to evaluate the differences in dose–volume histograms of IMRT treatments for prostate cancer based on the delineation of the main organs at risk (rectum and bladder) as solid organs or by contouring their wall.BackgroundRectum and bladder have typically been delineated as solid organs, including the waste material, which, in practice, can lead to an erroneous assessment of the risk of adverse effects.Materials and methodsA retrospective study was made on 25 patients treated with IMRT radiotherapy for prostate adenocarcinoma. 76.32Gy in 36 fractions was prescribed to the prostate and seminal vesicles. In addition to the delineation of the rectum and bladder as solid organs (including their content), the rectal and bladder wall were also delineated and the resulting dose–volume histograms were analyzed for the two groups of structures.ResultsData analysis shows statistically significant differences in the main parameters used to assess the risk of toxicity of a prostate radiotherapy treatment. Higher doses were received on the rectal and bladder walls compared to doses received on the corresponding solid organs.ConclusionsThe observed differences in terms of received doses to the rectum and bladder based on the method of contouring could gain greater importance in inverse planning treatments, where the treatment planning system optimizes the dose in these volumes. So, one should take into account the method of delineating of these structures to make a clinical decision regarding dose limitation and risk assessment of chronic toxicity.

http://ift.tt/2q29tIG

The semiconductor diode detector response as a function of field size and beam angle of high-energy photons

Publication date: May–June 2017
Source:Reports of Practical Oncology & Radiotherapy, Volume 22, Issue 3
Author(s): Tomasz Koper, Anna Kowalik, Sebastian Adamczyk
AimThe measurements of semiconductor diode detector response as a function of field size and beam angle of high-energy photons.BackgroundIn vivo dosimetry plays an important role in the therapeutic process of the patient. Because of the different orientation of the beam relative to the patient and different sizes of irradiation fields, it is extremely important to take into account the response of the detector depending on the angle and the size of the beam.Materials and methodsIn this study we used a 30cm×30cm×25cm PMMA slab phantom. On the surface of the phantom, various semiconductor detectors were placed sequentially in two configurations, angle and tilt.ResultsFor the measurements of the calibration factor based on the different value of the angle, the correction coefficient value was close to 1.00 for smaller values of the angle for all the detectors used in the energy range of 6–12MV. For the measurements, the calibration factor based on the size of the field of irradiation to the value of the correction coefficient is 1.00 for the field of 8cm×8cm and 10cm×10cm. With the increase field size, the correction factor shows a linear relationship in the direction of value less than 1.00.ConclusionFlat Detectors – used for both photon beams generated by the accelerating potential of 6MV and 20MV show a greater angular dependence than the cylindrical detectors. Also, the repeatability of measurements made using the flat detector is less as evidenced by larger standard deviations for the results.

http://ift.tt/2pokM1s

Coping with loss of ability vs. acceptance of disease in women after breast cancer treatment

Publication date: May–June 2017
Source:Reports of Practical Oncology & Radiotherapy, Volume 22, Issue 3
Author(s): Katarzyna Cieślak, Wojciech Golusiński
AimTo answer the question: is there a correlation between copying with the loss of ability and the acceptance of disease?BackgroundThe loss of ability is the beginning of a process of dealing with a widely understood dysfunction and its consequences. This happens owing to the lifting of the barriers that emerged due to the loss of ability and through the acquisition of skills that help an individual find their way in the new reality.Materials and methodsThe study included 90 patients with history of breast cancer. They were divided into two groups- I: up to five years from diagnosis, II: more than five years from diagnosis. The study was conducted using the Questionnaire on Coping With Ability Loss by P. Wolski, Acceptance of Illness Scale – B.J. Felton, T.A. Revenson, G.A. Hinrichsen, adapted by: Z. Juczyński.ResultsGroup I: it is positive weak correlation, meaning that the higher level of acceptance in the QCAL test, the higher acceptance of illness. Group II: there is no relation between acceptance of illness and the QCAL test acceptance scale and no relation between depression and the level of acceptance.ConclusionsThe more depressed a patient is and the less successful they are in dealing with the loss of ability, the lower their level of acceptance of illness. On the other hand, in time, it is struggle with the disability that plays more important role in the acceptance of the disease than the impact of negative emotions.

http://ift.tt/2oxfZGN

Is immunohistochemical evaluation of p16 in oropharyngeal cancer enough to predict the HPV positivity?

Publication date: May–June 2017
Source:Reports of Practical Oncology & Radiotherapy, Volume 22, Issue 3
Author(s): Paweł Golusiński, Jakub Pazdrowski, Mateusz Szewczyk, Maciej Misiołek, Wioletta Pietruszewska, Janusz Klatka, Sławomir Okła, Henryk Kaźmierczak, Andrzej Marszałek, Violetta Filas, Augusto Schneider, Michał M. Masternak, Katarzyna Stęplewska, Katarzyna Miśkiewicz-Orczyk, Wojciech Golusiński
AimOur goal was to determine the expression levels of p16 in the cohort of the OPSCC patients and evaluation of the pathological and clinical differences between these two groups including patients' survival.BackgroundHPV infection is the main causative factor of oropharyngeal cancer (OPSCC). Identification of HPV status in OPSCC requires positive evaluation of viral DNA integration into host cell however, p16 accumulation in the proliferating cell layers has been accepted as an alternative marker for HPV infection.Material and MethodsThe IHC staining for p16 has been performed in tumor tissue from 382 OPSCC patients. The sample was considered positive based on more than 70% of carcinoma tissue showing strong and diffused nuclear and cytoplasmic immunostaining. The clinicopathological characteristics of the patients including site, age, gender, tumor grade, tumor stage, the nodal status, smoking and survival have been analyzed when comparing p16 positive and p16 negative tumors.ResultsOut of our cohort in 38.2% cases positive staining for p16 has been recorded. Our analysis did not indicate significant differences in the distribution of the p16 positive patients and age of the patients, stage of the disease. Among the patients who have presented with the N+ neck, there were significantly more p16 positive tumors than in the group with N0 neck (p=0.0062). There was highly significant correlation between the expression of p16 and smoking (p<0.0001). The significant difference in survival (p<0.0001) with more favorable prognosis in the p16 positive group has been observed.ConclusionsOverexpression of p16 is accepted as a surrogate diagnostic marker for detecting HPV infection in oropharyngeal cancer. However, one should remember about existence of the small subgroups of p16 positive but HPV negative tumors, with relatively worse prognosis. Immunostaining for p16, however useful on everyday basis, should be complemented with other techniques in terms of reliable identification of the HPV infection.

http://ift.tt/2porrZE

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Σάββατο 22 Απριλίου 2017

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