Head and Neck Diseases by Alexandros G.Sfakianakis: 05/03/17

Τετάρτη 3 Μαΐου 2017

Applying geochemical signatures of atmospheric dust to distinguish current mine emissions from legacy sources

Publication date: July 2017
Source:Atmospheric Environment, Volume 161
Author(s): Chenyin Dong, Mark Patrick Taylor
Resolving the source of environmental contamination is the critical first step in remediation and exposure prevention. Australia's oldest silver-zinc-lead mine at Broken Hill (>130 years old) has generated a legacy of contamination and is associated with persistent elevated childhood blood lead (Pb) levels. However, the source of environmental Pb remains in dispute: current mine emissions; remobilized mine-legacy lead in soils and dusts; and natural lead from geological weathering of the gossan ore body. Multiple lines of evidence used to resolve this conundrum at Broken Hill include spatial and temporal variations in dust Pb concentrations and bioaccessibility, Pb isotopic compositions, particle morphology and mineralogy. Total dust Pb loading (mean 255 μg/m²/day) and its bioaccessibility (mean 75% of total Pb) is greatest adjacent to the active mining operations. Unweathered galena (PbS) found in contemporary dust deposits contrast markedly to Pb-bearing particles from mine-tailings and weathered gossan samples. Contemporary dust particles were more angular, had higher sulfur content and had little or no iron and manganese. Dust adjacent to the mine has Pb isotopic compositions (²⁰⁸Pb/²⁰⁷Pb: 2.3197; ²⁰⁶Pb/²⁰⁷Pb: 1.0406) that are a close match (99%) to the ore body with values slightly lower (94%) at the edge of the city. The weight of evidence supports the conclusion that contemporary dust Pb contamination in Broken Hill is sourced primarily from current mining activities and not from weathering or legacy sources.

Graphical abstract

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Defective IL-4 signaling in T cells defines severe common variable immunodeficiency

Publication date: Available online 3 May 2017
Source:Journal of Autoimmunity
Author(s): Eli Taraldsrud, Børre Fevang, Silje F. Jørgensen, Kristine Moltu, Vera Hilden, Kjetil Taskén, Pål Aukrust, June H. Myklebust, Johanna Olweus
Common variable immunodeficiency (CVID) is defined by hypogammaglobulinemia and B-cell dysfunction, with significant clinical and immunological heterogeneity. Severe non-infectious complications, such as autoimmunity, granulomatous disease and splenomegaly, constitute a major cause of morbidity in CVID patients. T cells are generally regarded important for development of these clinical features. However, while T-cell abnormalities have been found in CVID patients, functional characteristics of T cells corresponding to well-defined clinical subtypes have not been identified. As common γ-chain cytokines play important roles in survival and differentiation of T cells, characterization of their signaling pathways could reveal functional differences of clinical relevance. We characterized CVID T cells functionally by studies of cytokine-induced signaling, and correlated the findings to defined clinical subtypes. Peripheral blood T cells from 29 CVID patients and 19 healthy donors were analyzed for i) phenotype, ii) cytokine-induced (interleukin (IL)-2, IL-4, IL-7 and IL-21) phosphorylation of signal transducer and activator of transcription (STAT) 3, STAT5 and STAT6, and iii) T-helper (Th)1/Th2 polarization. Expression of IL-4 receptor and downstream signaling molecules was measured.A subgroup of CVID patients (n = 7) was identified by impaired IL-4-induced p-STAT6 in naive and memory CD4 and CD8 T cells. This corresponded to patients with the largest accumulation of severe (non-infectious) complications. The signaling defect persisted over years and was not due to constitutively activated p-STAT6. The CD4 T cells were strongly Th1-skewed, but IL-4 signaling was impaired independently of Th status. However, IL-4Rα and Janus kinase (JAK) 1 mRNA levels were significantly lower than in normal donors, providing a likely mechanism for the defective IL-4-induced p-STAT6 and Th1-bias. In conclusion, we identified a subgroup of CVID patients with defective IL-4 signaling in T cells, with severe clinical features of inflammation and autoimmunity.

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High-risk cutaneous squamous cell carcinoma in a Japanese allogeneic bone marrow transplant recipient on long-term voriconazole

Abstract

Cutaneous squamous cell carcinomas arise as secondary cancers in hematopoietic stem cell transplant survivors. They have been documented primarily in Western cohorts and relatively little is known about their occurrence in Asian hematopoietic stem cell transplant recipients, with no reports of squamous cell carcinomas with high-risk features in Asian patients. We describe a case of a cutaneous squamous cell carcinoma with high-risk features on the scalp of a Japanese bone marrow transplant recipient approximately 6.5 years post-transplant, who was on long-term voriconazole. The history of a photodistributed erythema followed by the appearance of multiple actinic keratoses and solar lentigines, together with the rarity of cutaneous squamous cell carcinomas in Asian hematopoietic stem cell transplant cohorts revealed in our literature review, suggest that voriconazole use contributed to the development of high-risk squamous cell carcinoma in our patient.

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Phosphorylated signal transducer and activator of transcription 3 in the epidermis in adult-onset Still's disease

Abstract

Adult-onset Still's disease (AOSD) is characterized by multiple systemic inflammation of unknown etiology. Although the typical eruption of AOSD is salmon-pink rheumatoid rash on the trunk and extremities, persistent pruritic papules and plaques have also been reported. Correlations between serum cytokines, including interleukin-6 and -18, and disease activity in AOSD have been reported. Activated signal transducer and activator of transcription 3 (STAT3) is transported into the nucleus, where it functions as a transcription factor that regulates genes involved in cell survival and inflammation. To assess whether STAT3 was phosphorylated in skin samples from AOSD patients, we conducted immunohistochemical analysis of affected and unaffected lesions from four AOSD patients in comparison with 10 normal controls. Quantitative analysis was conducted by measuring the ratio of epidermal keratinocytes with phosphorylated STAT3 (p-STAT3)-positive nuclei to total epidermal keratinocytes. p-STAT3 was found to be more strongly expressed in the nuclei in the epidermis of AOSD than in normal controls. Quantification of the data revealed significant differences in staining for p-STAT3 between AOSD and normal skin. Our findings suggest that phosphorylation of STAT3 may be a potential therapeutic target for AOSD.

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Mycobacterium tuberculosis found at both skin lesions and Mantoux testing site in a patient with erythema induratum of Bazin

Abstract

Mycobacterium tuberculosis is very rarely found in erythema induratum of Bazin; recently, we found an unusual case with positive acid-fast bacilli and polymerase chain reaction for detecting M. tuberculosis in both skin lesions of the extremities and the site of Mantoux test.

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Food-dependent exercise-induced anaphylaxis due to shrimp associated with 43 kDa, a new antigen

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Gnathostomiasis caused by ingestion of raw Oncorhynchus masou ishikawae roe

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Case of reticulated acanthoma with sebaceous differentiation with clinicopathological surveillance

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Typical Chinese pedigree of autosomal dominant genetic disease: Neurofibromatosis type 1 with a novel frame-shift mutation

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Information for Readers

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5

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Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5

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Cost and health care utilization in patients with asthma and high oral corticosteroid use

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Michael S. Broder, Karina Raimundo, Ka Ming Ngai, Eunice Chang, Noelle M. Griffin, Liam G. Heaney

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Instructions for Authors

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5

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Editorial Board

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5

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Can we effectively use radiographic imaging and clinical parameters for making an earlier diagnosis of granulomatous interstitial lung disease in patients with common variable immunodeficiency?

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Terry Harville

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Allergenic extracts to diagnose and treat sensitivity to insect venoms and inhaled allergens

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Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Taruna Khurana, Jennifer L. Bridgewater, Ronald L. Rabin
ObjectiveTo review allergenic extracts used to diagnose or treat insect allergies, including how the extracts are manufactured and their measurements of potency or concentration.Data SourcesPeer-reviewed articles derived from searching PubMed (National Center for Biotechnology Information) about insect allergies and extract preparation. Encyclopedia of Life (http://www.eol.org/) and http://allergome.org/ were also referenced for background information on insects and associated allergens.Study SelectionsSearch terms used for the PubMed searches included insect allergens and allergies, Apidae, Vespidae, fire ants, cockroach allergies, insect allergen extract preparation, and standardization.ResultsHumans may be sensitized to insect allergens by inhalation or through stings. Cockroaches and moths are predominantly responsible for inhalation insect allergy and are a major indoor allergen in urban settings. Bees, fire ants, and wasps are responsible for sting allergy. In the United States, there are multiple insect allergen products commercially available that are regulated by the US Food and Drug Administration. Of those extracts, honeybee venom and insect venom proteins are standardized with measurements of potency. The remaining insect allergen extracts are nonstandardized products that do not have potency measurements.ConclusionSensitization to inhalational and stinging insect allergens is reported worldwide. Crude insect allergen extracts are used for diagnosis and specific immunotherapy. A variety of source materials are used by different manufacturers to prepare these extracts, which may result in qualitative differences that are not reflected in measurements of potency or protein concentration.

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Penicillin desensitization: Treatment of syphilis in pregnancy in penicillin-allergic patients

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Michele N. Pham, Hsi-en Ho, Mauli Desai

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Clinical characteristics of patients with chronic obstructive pulmonary disease overlapped with bronchial asthma

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Jing-bo Liang, Li-jin Liu, Qiu-hong Fang
BackgroundThe clinical characteristics of patients with chronic obstructive pulmonary disease overlapped with bronchial asthma (COPD-BA) have not been discussed thoroughly.ObjectiveTo reveal the clinical features of patients with COPD-BA, to evaluate the risk factors of COPD-BA, and to provide suggestions for COPD individualized therapy.MethodsA retrospective observational study was performed. A total of 182 patients with COPD (90 with COPD-BA and 92 with pure COPD) were recruited in the study. Information on the following items was collected: demographics, clinical manifestations, complications, laboratory findings, other histories, and inpatient treatments during exacerbation.ResultsA total of 182 patients were diagnosed with COPD, with 90 (49.45%) being classified as having COPD-BA. Patients with COPD-BA were more likely to be female (P = .004) and experienced more severe respiratory exacerbations (P = .04) despite being younger (P = .008). Those patients at onset of recurrent cough and sputum production were younger (P = .001). Significantly, a positive asthmatic family history (P = .03) was observed. Patients with COPD-BA usually had higher level of total serum IgE (although no differences were observed), had higher positive rates of the serum specific IgE (P = .004), and were more like to have an allergic history (P = .003). Allergic factor was the risk factor of COPD-BA (odds ratio, 4.477). During hospitalization, patients with COPD-BA tended to be treated with systemic corticosteroids (P = .008).ConclusionPatients with COPD-BA were characterized by persistent airflow limitation with unique clinical features. Allergic factor was associated with the presence of asthmatic characteristics in patients with COPD. When hospitalized for exacerbation, the individualized therapy for COPD-BA might include the use of corticosteroids systemically.

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How does autism spectrum disorder affect the risk and severity of childhood asthma?

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Urður Jónsdóttir, Jason E. Lang
BackgroundAutism spectrum disorder (ASD) and asthma are among the most common chronic disorders in childhood. Both are associated with altered immune regulation and share several risk factors. The effects of ASD on risk for later asthma and asthma severity remain unclear.ObjectiveTo determine whether ASD in children increases the risk of incident asthma and worsens asthma severity.MethodsWe performed 2 distinct analytic designs (case-control and retrospective longitudinal cohort) using a multistate electronic health records database to assess the odds of new asthma and asthma severity among children with ASD. In both designs, children with ASD were matched with children without ASD according to sex, age, race, ethnicity, location, and insurance status. Pulmonary function, controller medication prescriptions, asthma exacerbations, and asthma-related hospitalizations were collected. The effects of ASD on asthma risk and severity were assessed using multivariable linear and logistic regression.ResultsAmong children with asthma, ASD was associated with reduced exacerbations (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.54–0.92), better forced expiratory volume in 1 second/forced vital capacity ratio (0.876 vs 0.841, P < .001), and lower odds of airflow obstruction (OR, 0.53; 95% CI, 0.31–0.90) but had higher odds of asthma controller prescription (OR, 2.18; 95% CI, 1.62–2.93). In a longitudinal analysis of children without asthma, ASD was found to be protective for new asthma (OR, 0.44; 95% CI, 0.26–0.74).ConclusionAmong children with asthma, concomitant ASD is associated with better asthma-related outcomes but a higher controller treatment burden. In addition, our data did not support ASD as a risk factor for incident asthma.

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Associations between caesarean delivery and allergic outcomes

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Evelyn Xiu Ling Loo, Jordan Zheng Ting Sim, See Ling Loy, Anne Goh, Yiong Huak Chan, Kok Hian Tan, Fabian Yap, Peter D. Gluckman, Keith M. Godfrey, Hugo Van Bever, Bee Wah Lee, Yap Seng Chong, Lynette Pei-chi Shek, Mark Jean Aan Koh, Seng Bin Ang

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A case of atypical, complete DiGeorge syndrome without 22q11 mutation

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Cosby A. Stone, Mary Louise Markert, Roshini S. Abraham, Allison Norton

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Severe delayed-type hypersensitivity to chloramphenicol with systemic reactivation during intradermal testing

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Timothy J. Watts

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Use of a composite symptom score during challenge in patients with suspected aspirin-exacerbated respiratory disease

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Kevin A. Cook, Brian D. Modena, Nathan E. Wineinger, Katharine M. Woessner, Ronald A. Simon, Andrew A. White
BackgroundAspirin-exacerbated respiratory disease is characterized by asthma, chronic rhinosinusitis, nasal polyposis, and sensitivity to aspirin and other nonsteroidal anti-inflammatory drugs. Confirmation of the diagnosis requires provocation challenge with resulting upper and/or lower airways reactivity. Currently, determination of a positive challenge result is based solely on clinical judgment that synthesizes subjective symptoms and objective measures, as a concomitant increase in nasal or bronchial airways resistance is measured in only half of patients.ObjectiveTo describe a quantitative scoring system, based on symptoms typically reported during provocation challenge, used to identify a positive challenge result.MethodsA total of 115 patients were asked to record 10 symptoms, rated on a scale from 1 (mild) to 10 (most severe), at regular intervals during intranasal ketorolac with modified oral aspirin challenge performed in our office. Composite scores, a simple sum of all individual scores, were calculated at each time point and compared with baseline, prechallenge values.ResultsOne hundred of the 115 patients were determined to have a positive challenge result. A statistically significant difference in composite scores was observed in reactors vs nonreactors. All nonreactors recorded an increase in composite score of less than 5, whereas 69% of reactors recorded an increase of 5 or more.ConclusionOur 10-symptom composite score provides a quantitative and comparable measure of symptoms that typically present during a challenge with a positive result. Although an external validation is needed to confirm its diagnostic performance characteristics, a change in composite score of 5 or more appears to be specific to reactors.

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Atopic status and latex sensitization in a cohort of 1,628 students of health care faculties

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Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Anna Elena Wudy, Corrado Negro, Alessandro Adami, Francesca Larese Filon
BackgroundAtopic diseases have increased since the second half of the previous century. Atopic workers are at higher risk to be sensitized to latex, and the first years of exposure are supposed to be especially risky.ObjectiveTo assess atopic status and rate of latex sensitization in health care students starting their exposure to latex gloves.MethodsWe analyzed medical surveillance data from 1,628 health care students from 2010 to 2016. Students completed a questionnaire focused on their previous and current latex exposure and personal and family histories of allergic diseases; underwent skin prick testing with common allergens and latex extract (and/or total and latex-specific immunoglobulin E in serum); and underwent a medical examination.ResultsSkin prick test results for common inhalant allergens showed that 807 of 1,628 students (49.6%) had atopy. Atopy by skin prick testing was associated with male sex (odds ratio 1.49, 95% confidence interval 1.18–1.86), a personal history of oculorhinitis or asthma (odds ratio 10.22, 95% confidence interval 7.4–14.13), and atopic eczema (odds ratio 1.87, 95% confidence interval 1.05–3.36) at multivariate regression analysis. Eleven students (0.7% of total population) were found to be sensitized to latex and all had atopy.ConclusionDespite the high prevalence of atopy in health care students of Trieste, the latex sensitization rate is very low and comparable to general population. This is reasonably due to the low exposure to latex gloves at the time of the evaluation and to low latex release from the gloves currently used in our hospital.

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Comparison between skin prick test and serum immunoglobulin E by CAP system to inhalant allergens

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Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Young-Hee Nam, Soo-Keol Lee
BackgroundSkin prick tests (SPTs) and measurements of serum specific immunoglobulin E (sIgE) antibodies are the most commonly used diagnostic tools for confirming sensitization. However, disagreement between the tests has been observed.ObjectiveTo compare SPT and the CAP system for diagnosis of sensitization to common inhalant allergens.MethodsSubjects included 2,635 patients 10 to 90 years old who underwent analyses by SPT and CAP at the Dong-A University Hospital (Busan, Korea) from June 2011 through May 2016. The 2 test results were compared for 17 inhalant allergens.ResultsAgreement between the SPT and sIgE level was 75.3%. Overall agreement was moderate (κ = 0.59), with strong agreement for house dust mites and birch (κ > 0.7) and weak agreement for Tyrophagus putrescentiae and dog (κ < 0.3). When CAP was compared with SPT as the reference, the sensitivity was 75.8% and the specificity was 75.2%. Mean wheal size by SPT showed a positive correlation with sIgE levels (r = 0.59), which decreased with age.ConclusionThere was a discrepancy between SPT and CAP for diagnosing allergic sensitization among inhalant allergens. The allergic sensitization and correlation between the tests decreased with age. Cautious interpretation of the clinical relevance of allergen sensitization based on SPT and CAP results is required, especially in older patients.

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Physicians' experience and opinion on contraindications to allergen immunotherapy: The CONSIT survey

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Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Pablo Rodríguez del Rio, Constantinos Pitsios, Marina Tsoumani, Oliver Pfaar, Giannis Paraskevopoulos, Radoslaw Gawlik, Erkka Valovirta, Desirée Larenas-Linnemann, Pascal Demoly, Moises A. Calderón
BackgroundAllergen immunotherapy (AIT) is the only disease-modifying treatment in allergy but several contraindications limit its use.ObjectiveTo collect the outcome of using AIT in theoretically contraindicated situations in real patients in the Contraindications to Specific ImmunoTherapy (CONSIT) survey.MethodsThe CONSIT is an electronic European Academy of Allergy and Clinical Immunology survey conducted to gather the safety outcomes of patients undergoing subcutaneous, sublingual, or venom AIT and the opinions of physicians on each of 17 selected conditions: children younger than 5 years; starting AIT during pregnancy; controlled severe asthma; arrhythmias; coronary disease; cancer; autoimmune disease; bone marrow and solid organ transplantation; human immunodeficiency virus and acquired immunodeficiency syndrome; previous anaphylaxis during AIT; use of β-blockers, angiotensin-converting inhibitors, cyclosporine, and methotrexate; and inability to communicate. Safety using AIT was reported in a 3-point scale: 1, "no problems"; 2, "minor problems" (requiring only dose modifications); and 3, "major problems" (AIT not tolerated). Each physician was asked about the degree of contraindication that each condition should have: no contraindication (score 1), relative contraindication (score 2), or absolute contraindication (score 3).ResultsFive hundred twenty physicians (75% Europeans, 89% allergists) reported on approximately 45,000 patients undergoing AIT with any of these conditions. Major problems were infrequent, occurring more frequently in patients with asthma (9.9%) and with previous anaphylaxis from AIT (9.5%). Regarding opinions, experienced physicians scored a significantly lower mean for all conditions than non-experienced physicians for all routes.ConclusionMajor problems were infrequent and experienced physicians were less likely to be restrictive in the use of AIT.

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Early childhood allergy symptoms in relation to plasma selenium in pregnant mothers

Publication date: May 2017
Source:Annals of Allergy, Asthma & Immunology, Volume 118, Issue 5
Author(s): Daniela Podlecka, Iwona Stelmach, Joanna Jerzynska, Kinga Polanska, Beata Janasik, Jolanta Gromadzinska, Wojciech Wasowicz, Wojciech Hanke, Pawel Majak, Wlodzimierz Stelmach

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Vestibular syncope: A disorder associated with drop attack in Ménière’s disease

Experiments in humans and animals indicate that vestibular influx through vestibular sympathetic reflex is an important and vital part of the regulatory system of circulation. The otolith organ adjusts the circulatory responses through the vestibular sympathetic reflex during an upright stance and may trigger a vasovagal attack of syncope. The aim of the present study was to evaluate the prevalence and association of syncope attacks among patients with Ménière's disease (MD). Vestibular syncope was defined as a sudden and transient loss of consciousness, which subsides spontaneously in people with vestibular disorders and without localizing neurological deficit.

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Vestibular syncope: A disorder associated with drop attack in Ménière’s disease

Systemic Treatment Strategies for Patients with Hereditary Breast Cancer Syndromes

Hereditary breast cancer syndromes are associated with an increased risk of breast cancer and constitute a unique patient population, making up approximately 5%–10% of breast cancer cases in the United States. By virtue of the germline mutations that define these syndromes, invasive breast cancers in these patients have unique mechanisms that can be rationally targeted for therapeutic opportunities distinct from standard of care treatments in nongermline mutation associated breast cancers. This review intends to describe existing data on several of the most common hereditary breast cancer syndromes, including BRCA-related breast cancer syndrome, Li-Fraumeni syndrome, Cowden syndrome, Peutz-Jeghers syndrome, and hereditary diffuse gastric cancer syndrome, specifically focusing on rational therapeutics utilized in these distinct patient subgroups and completed or ongoing clinical trials evaluating their efficacy. By exploiting the distinct biologic features associated with these syndromes, tailored treatment strategies have the potential for improved efficacy and lower toxicity. Knowledge of the emergence of these targeted cancer therapies is critical for appropriate management in these patients, extending beyond treatment to highlight the need for appropriate genetic screening to allow for early recognition of these patients and therefore appropriate treatment. The Oncologist 2017;22:1–12

Implications for Practice.

Molecular testing allows for identification of germline mutations that place individuals at high risk for breast cancer and that are associated with distinct histopathology and molecular characteristics that define the invasive breast cancer cases that these patients develop. These unique characteristics may ultimately provide rational targets for systemic treatments with improvements in both morbidity and efficacy. Identification of patients with these germline mutations is important for not only appropriate screening and prophylaxis, but knowledge of therapies specifically targeting several of the most common hereditary breast cancer syndromes is essential to ensure appropriate treatment of invasive breast cancers in these patients.

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Hepatosplenic Candidiasis Without Prior Documented Candidemia: An Underrecognized Diagnosis?

Introduction.

Patients with a history of chemotherapy or stem cell transplantation (SCT) and prolonged neutropenia are at risk for hepatic and/or splenic seeding of Candida. In our experience, hepatosplenic candidiasis (HSC) without documented candidemia often remains unrecognized.

Case presentations.

We describe three cases of HSC without documented candidemia and the challenges in establishing the diagnosis and adequately treating this condition. The first patient had a history of SCT for treatment of breast cancer and was scheduled for hemihepatectomy for suspected liver metastasis. A second opinion at our institute resulted in the diagnosis of hepatic candidiasis without prior documented candidemia, for which she was treated successfully with fluconazole. The second case demonstrates the limitations of (blood and tissue) cultures and the value of molecular methods to confirm the diagnosis. Case 3 illustrates treatment challenges, with ongoing dissemination and insufficient source control despite months of antifungal therapy, eventually resulting in a splenectomy.

Literature review.

A structured literature search was performed for articles describing any patient with HSC and documented blood culture results. Thirty articles were available for extraction of data on candidemia and HSC. Seventy percent (131/187) of patients with HSC did not have documented candidemia. The majority of HSC events were described in hematologic patients, although some cases were described in patients with solid tumors treated with SCT (n = 1) or chemotherapy and a history of leukopenia (n = 2). Current guidelines and practices for diagnosis and treatment are described.

Conclusion.

Clinicians should be aware that HSC most often occurs without documented candidemia. In case of persistent or unexplained fever or lesions in the liver and/or spleen, a history of neutropenia should place disseminated candidiasis in the differential diagnosis. HSC is not limited to hematological patients and may occur in patients with solid tumors treated with bone marrow-suppressing chemotherapy or SCT. In the latter group, HSC as alternative diagnosis for hepatic metastasis should be considered when lesions are not typical for metastasis. This might prevent unnecessary surgery or inappropriate treatment. The Oncologist 2017;22:1–5

Implications for Practice.

Timely diagnosis of hepatosplenic candidiasis (HSC) is challenging, but can prevent further complications and dissemination, and may even prevent unnecessary invasive procedures. Clinicians should realize that HSC often occurs without documented candidemia and that sensitivity of blood cultures for candidemia is limited. HSC is not strictly limited to hematologic patients and might also occur in patients with solid tumors treated with intensive chemotherapy or stem cell transplantation. Increased awareness for HSC in patients with any history of neutropenia is of importance to increase detection and prevent serious sequelae.

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Prospective Evaluation of the Relationship Between Mechanical Stability and Response to Palliative Radiotherapy for Symptomatic Spinal Metastases

This study investigated the relationship between the degree of spinal instability, as defined by the Spinal Instability Neooplastic Score, and response to radiotherapy in patients with symptomatic spinal metastases in a multi-institutional cohort.

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Klotho protects human monocytes from LPS-induced immune impairment associated with immunosenescent-like phenotype

Publication date: Available online 3 May 2017
Source:Molecular and Cellular Endocrinology
Author(s): Jennifer Mytych, Maria Romerowicz-Misielak, Marek Koziorowski
In this study, we provide a new evidence on immunosenescent-like phenotype induction in low density monocytes due to the long-term treatment with lipopolysaccharide (LPS). We show that LPS caused oxidative and nitrosative stress through zinc downregulation and calcium accumulation. In turn, increased amounts of ROS/RNS and pro-inflammatory cytokines TNFα, IL-1β, IL-6 led to the irreversible DNA damage, persistent DDR activation, proliferation inhibition, reduction in cell growth and immune impairment. Furthermore, we provide evidence that klotho reduced levels of ROS/RNS and pro-inflammatory cytokines as well as upregulated secretion of anti-inflammatory IL-10 in LPS-treated monocytes, thus the observed DNA damage was less severe, promptly and properly fixed and cells quickly resumed normal proliferation and maintained their immune functionality. Therefore, klotho protein could be considered as a protective factor against immunosenescent-like phenotype in monocytes an issue relevant to many immune disorders.

Graphical abstract

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The receptor for advanced glycation endproducts mediates podocyte heparanase expression through NF-κB signaling pathway

Publication date: Available online 4 May 2017
Source:Molecular and Cellular Endocrinology
Author(s): Xiaofei An, Lin Zhang, Qiuming Yao, Ling Li, Bin Wang, Jisheng Zhang, Ming He, Jinan Zhang
Heparanase degrades heparan sulfate in glomerular basement membrane (GBM) and plays an important role in diabetic nephropathy (DN). However, its regulating mechanisms remain to be deciphered. Our present study showed that the major advanced glycation endproducts (AGEs), CML-BSA, significantly increased heparanase expression in cultured podocytes and the effect was blocked by the receptor for advanced glycation endproducts (RAGE) knockdown, antibody and antagonist. In addition, NF-κB p65 phosphorylation was elevated and the increased heparanase expression and secretion upon CML-BSA could be attenuated by NF-κB inhibitor PDTC. Mechanistically, CML-BSA activated heparanase promoter through p65 directly binding to its promoter. Furthermore, the in vivo study showed that serum and renal cortex AGEs levels, glomerular p65 phosphorylation and heparanase expression were significantly increased in DN mice. Taken together, our data suggest that AGEs and RAGE interaction increases podocyte heparanase expression by activating NF-κB signal pathway, which is involved in GBM damages of DN.

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Contact allergy in children with atopic dermatitis: a systematic review

Abstract

The importance of contact allergy in children with atopic dermatitis is frequently debated. Previously, patients with atopic dermatitis were believed to have a reduced ability to produce a type IV immunologic response. However, this belief has been challenged and authors have highlighted the risk of underestimating and overlooking allergic contact dermatitis in children with atopic dermatitis. Several studies have been published aiming to shed light on this important question but results are contradictory. To provide an overview of the existing knowledge, we systematically reviewed studies that report frequencies of positive patch test reactions in children with atopic dermatitis. We identified 436 manuscripts of which 31 met the inclusion criteria. Although the literature is conflicting, it is evident that contact allergy is a common problem in children with atopic dermatitis.

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Contact allergy in children with atopic dermatitis: a systematic review

Abstract

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Airway microbiome and responses to corticosteroids in corticosteroid-resistant asthma patients treated with acid suppression medications

Patients with refractory, difficult to treat asthma often have gastroesophageal reflux disease (GERD).1 Studies to date emphasize the complexity of interactions between the respiratory and gastrointestinal system. This makes it challenging to discern the mechanisms that link reflux and lung disease.1 Acid suppression medications—proton pump inhibitors (PPIs) and histamine receptor 2 antagonists (H2 blockers)—are widely prescribed in patients with asthma and chronic cough. Studies also report that esophageal microbiota are subject to change in health and disease, including in patients with esophagitis and GERD.

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Growth hormone disorders in adults

Publication date: February 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 31, Issue 1
Author(s): Paolo Marzullo, Flavia Prodam, Gianluca Aimaretti

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Keyword index

Publication date: February 2017
Source:Best Practice & Research Clinical Endocrinology & Metabolism, Volume 31, Issue 1

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Autotransplantation of teeth using computer-aided rapid prototyping of a three-dimensional replica of the donor tooth: a systematic literature review

This systematic review provides an overview of studies on autotransplantation techniques using rapid prototyping for preoperative fabrication of donor tooth replicas for preparation of the neo-alveolus. Different three-dimensional autotransplantation techniques and their treatment outcomes are discussed. The systematic literature search yielded 19 articles that satisfied the criteria for inclusion. These papers described one case–control study, four clinical observational studies, one study with a clinical and in vitro part, four in vitro studies, and nine case reports.

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Immediate implant placement into fresh extraction sockets versus delayed implants into healed sockets: A systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to compare the survival rate of the implants and the peri-implant tissue changes associated with implants inserted in fresh extraction sockets and those inserted in healed sockets. This review has been registered at PROSPERO under the number CRD42016043309. A systematic search was conducted by two reviewers independently in the databases PubMed/MEDLINE, Embase, and the Cochrane Library using different search terms; articles published until November 2016 were searched for.

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Biochemical markers of bone turnover in benign paroxysmal positional vertigo

by Sun Bin Lee, Chang Ho Lee, Young Ju Kim, Hyoung-Mi Kim

Objective

Several studies have suggested a possible relationship between recurrent benign paroxysmal positional vertigo (BPPV) and altered calcium homeostasis in the endolymph of the inner ear. The present study aimed to evaluate the association between Ca²⁺ and vitamin D status and BPPV occurrence as well as the status of bone biochemical markers in osteoporotic patients who were diagnosed with idiopathic BPPV.

Methods

The study included total 132 patients who were referred to our clinic between August 2008 and October 2013. Based on the bone mineral density (BMD) results, the subjects were divided into three groups: normal BMD (n = 34), osteopenia (n = 40) and osteoporosis (n = 58). The biochemical markers of bone turnover including serum Carboxy-terminal telopeptide of type I collagen (s-CTX), osteocalcin, alkaline phosphatase (ALP) and urinary free deoxypyridinoline (u-DPD), were analyzed, along with the serum Ca²⁺ and vitamin D levels.

Results

The mean serum calcium, phosphate and creatinine clearance levels were within the standard laboratory reference range. The incidence of vitamin D deficiency was 11.8% (4/34) in the normal BMD group, 15% (6/40) in the osteopenia group and 43.1% (25/58) in the osteoporosis group. There was a positive correlation between the 25(OH)D and BMD results in the patients with BPPV. Among the bone turnover markers, the osteocalcin and u-DPD levels were significantly elevated in the osteoporotic patients with BPPV. Multiple logistic regression analyses showed that osteoporosis and vitamin D deficiency were associated with BPPV.

Conclusion

Our findings suggest that the prevalence of BPPV in osteoporotic patients is associated with vitamin D deficiency and high bone turnover rates at systemic level, which could disturb local Ca²⁺ homeostasis in the inner ear.

http://ift.tt/2paCrWD

A smart gene delivery platform: Cationic oligomer

Publication date: Available online 3 May 2017
Source:European Journal of Pharmaceutical Sciences
Author(s): Ying Zhang, Zhiping Zhou, Xinyuan Zhu, Mingsheng Chen
Low transfection efficiency and high cytotoxicity of polymeric gene carriers have hampered the application of numerous polycations for gene therapy. To overcome this barrier, a cationic glycoconjugate of kanamycin and di(ethylene glycol) diacrylate was prepared via a facile approach. Nuclear magnetic resonance, Fourier transform infrared spectroscopy, and size exclusion chromatography were employed to investigate the resulting materials. Agarose gel electrophoresis, atomic force microscopy, and circular dichroism spectroscopy were used to record the interaction of the cationic oligomer and plasmid DNA. Finally, the cytotoxicity and transfection efficiency were evaluated by using COS-7 cells. The results indicated that cationic oligomers had been obtained and plasmid DNA was condensed into nanocomplexes, with a high transfection efficiency of the oligomer and a low toxicity in COS-7 cell line. It provided a novel perspective to develop gene carrier, with better safety and greater transfection efficiency, compared to traditional high molecular weight polymers.

Graphical abstract

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pH-dependent solubility and permeability profiles: A useful tool for prediction of oral bioavailability

Publication date: Available online 3 May 2017
Source:European Journal of Pharmaceutical Sciences
Author(s): P. Sieger, Y. Cui, S. Scheuerer
pH-dependent solubility - permeability profiles offer a simple way to predict bioavailability after oral application, if bioavailability is only solubility and permeability driven. Combining both pH-dependent solubility and pH-dependent permeability in one diagram provides a pH-window (=ΔpHsol-perm) from which the conditions for optimal oral bioavailability can be taken. The size of this window is directly proportional to the observed oral bioavailability. A set of 21 compounds, with known absolute human oral bioavailability, was used to establish this correlation. Compounds with ΔpHsol-perm<2 exhibit poor oral bioavailability (<25%). An increase of ΔpHsol-perm by one pH-unit increases oral bioavailability typically by approximately 25%. For compounds where ΔpHsol-perm≥3 but still showing poor bioavailability, most probably other pharmacokinetic aspects (e.g. high clearance), are limiting exposure. Interestingly, the location of this pH-window seems to have a negligible influence on the observed oral bioavailability. In scenarios, where the bioavailability is impaired by certain factors, like for example proton pump inhibitor co-medication or food intake, the exact position of this pH-window might be beneficial for understanding the root cause.

Graphical abstract

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Development and photoprotective effect of a sunscreen containing the antioxidants Spirulina and dimethylmethoxy chromanol on sun-induced skin damage

Publication date: 15 June 2017
Source:European Journal of Pharmaceutical Sciences, Volume 104
Author(s): Carla Souza, Patrícia M.B.G. Maia Campos
The literature claims that incorporation of antioxidants into sunscreens provides additional skin photoprotection by scavenging free radicals formed due to sun radiation, but there are limited in vivo studies that support this hypothesis. This study aims to examine whether addition of antioxidants to a broad-spectrum sunscreen increases its photoprotective effect in real-use conditions. Sunscreen formulations composed of stable UV filters (Tinosorb® S, Tinosorb® M, Uvinul® APlus, and Uvinul® T150) alone or in combination with antioxidants (Spirulina and dimethylmethoxy chromanol-loaded solid lipid nanoparticles) were developed and their appearance, odor, rheological behavior, Sun Protection Factor (SPF), and UVA protection were analyzed. Next, it was conducted a 3-month, single-blind clinical study with 44 healthy subjects (30–50years). Before and 28, 54, and 84days after twice-daily self application of the sunscreens on the face, the stratum corneum water content, transepidermal water loss, dermis echogenicity, and skin elasticity and pigmentation were measured. At the end of the study period, the volunteers answered a questionnaire containing terms related to sensory characteristics of the formulations. All formulations were stable and exhibited non-Newtonian and pseudoplastic behavior, in vivo SPF 30, and good UVA protection. Antioxidant supplementation to the sunscreen formulation significantly improved the skin pigmentation, the collagen degradation on the dermis and thereby the skin net elasticity after 84days of treatment compared to the sunscreen alone. Concerning safety, all formulations were considered non-irritant according to the sensorial analyses, whose results agreed with the clinical study findings.

Graphical abstract

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Preparation of liposomes containing small gold nanoparticles using electrostatic interactions

Publication date: Available online 3 May 2017
Source:European Journal of Pharmaceutical Sciences
Author(s): Gennaro A. Dichello, Takahiro Fukuda, Toru Maekawa, Raymond L.D. Whitby, Sergey V. Mikhalovsky, Mohammed Alavijeh, Ananth S. Pannala, Dipak K. Sarker
The development of liposome-nanoparticle colloid systems offers a versatile approach towards the manufacture of multifunctional therapeutic platforms. A strategy to encapsulate small metallic nanoparticles (<4nm) within multilamellar vesicles, effected by exploiting electrostatic interactions was investigated. Two liposome-gold nanoparticle (lipo-GNP) systems were prepared by the reverse-phase evaporation method employing cationic or anionic surface functionalised particles in combination with oppositely charged lipid compositions with subsequent post-formulation PEGylation. Structural characterisation using electron microscopy and elemental analysis revealed a regular distribution of GNPs between adjacent lipid bilayers of intact liposomes. Nanoparticle encapsulation efficacy of the two lipo-GNP systems was revealed to be significantly different (p=0.03), evaluated by comparing the ratio of measured lipid to gold concentration (loading content) determined by a colorimetric assay and atomic emission spectroscopy, respectively. It was concluded that the developed synthetic strategy is an effective approach for the preparation of liposome-nanoparticle colloids with potential to control the relative concentration of encapsulated particles to lipids by providing favourable electrostatic interactions.

Graphical abstract

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Effect of maximum inhalation flow and inhaled volume on formoterol drug deposition in-vitro from an Easyhaler® dry powder inhaler

Publication date: 15 June 2017
Source:European Journal of Pharmaceutical Sciences, Volume 104
Author(s): Mohamad Abadelah, Firisteh Hazim, Henry Chrystyn, Golshan Bagherisadeghi, Hassan Rahmoune, Hassan Larhrib
Most patients using dry powder inhalers (DPIs) do not achieve the inhalation parameters recommended for pharmacopoeial in-vitro dose emission testing. The dose emission characteristics of formoterol from an Easyhaler® have been measured using the Andersen Cascade Impactor (ACI) with a maximum inhalation flow (MIF) of 28.3, 60 and 90L/min and inhaled volumes (Vin) of 240, 750, 1500 and 2000mL. The total emitted dose (TED) was significantly higher at 90L/min (p<0.05), but the difference in the TED between low (28.3L/min) and high (90L/min) flow rate was significantly reduced by increasing the Vin. The fine particle dose (FPD) was higher (p<0.05) at 90L/min for all Vin values compared to 28.3 and 60L/min. Similarly the mass median aerodynamic diameter (MMAD) was smaller at 90L/min across all Vin values. Dose emission characteristics were lower at 240mL for both MIFs. The results for 240mL could be due to an insufficient Vin pulled through the ACI or incomplete emptying of the dose metering cup. This study shows that the FPD, %FPF and MMAD were not significantly affected by the vin≥750mL and that an inhaled volume as low as 750mL could be used with the ACI.

Graphical abstract

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Impact of front-of-pack nutrition information and label design on children's choice of two snack foods: Comparison of warnings and the traffic-light system

Publication date: 1 September 2017
Source:Appetite, Volume 116
Author(s): Alejandra Arrúa, María Rosa Curutchet, Natalia Rey, Patricia Barreto, Nadya Golovchenko, Andrea Sellanes, Guillermo Velazco, Medy Winokur, Ana Giménez, Gastón Ares
Research on the relative influence of package features on children's perception of food products is still necessary to aid policy design and development. The aim of the present work was to evaluate the relative influence of two front-of-pack (FOP) nutrition labelling schemes, the traffic light system and Chilean warning system, and label design on children's choice of two popular snack foods in Uruguay, wafer cookies and orange juice. A total of 442 children in grades 4 to 6 from 12 primary schools in Montevideo (Uruguay) participated in the study. They were asked to complete a choice-conjoint task with wafer cookies and orange juice labels, varying in label design and the inclusion of FOP nutrition information. Half of the children completed the task with labels featuring the traffic-light system (n = 217) and the other half with labels featuring the Chilean warning system (n = 225). Children's choices of wafer cookies and juice labels was significantly influenced by both label design and FOP nutritional labels. The relative impact of FOP nutritional labelling on children's choices was higher for the warning system compared to the traffic-light system. Results from the present work stress the need to regulate the design of packages and the inclusion of nutrient claims, and provide preliminary evidence of the potential of warnings to discourage children's choice of unhealthful products.

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Child feeding style is associated with food intake and linear growth in rural Ethiopia

Publication date: 1 September 2017
Source:Appetite, Volume 116
Author(s): Zeweter Abebe, Gulelat Desse Haki, Kaleab Baye
BackgroundLittle is known about mother-child feeding interactions and how this is associated with food intake and linear growth.ObjectiveTo characterize mother-child feeding styles and investigate their associations with accepted mouthful and linear growth in west Gojam, rural Ethiopia.Subjects/designTwo, in-home, meal observations of children aged 12–23 months (n = 100) were video-taped. The number of mouthful accepted was counted and the caregiver/child feeding styles were coded into positive/negative categories of self-feeding, responsive-feeding, active-feeding, social-behavior and distraction. Data on socio-demographic characteristics, child feeding practices, perception about child's overall appetite, and strategies adopted to overcome food refusal were collected through questionnaire-based interviews. Child and mothers' anthropometric measurements were also taken.ResultsStunting was highly prevalent (48%) and the number of mouthful accepted was very low. Offering breastmilk and threatening to harm were the main strategies adopted to overcome food refusal. Although all forms of feeding style were present, active positive feeding style was dominant (90%) and was positively associated with mouthful accepted. Talking with non-feeding partner (64%), and domestic animals (24%) surrounding the feeding place were common distractions of feeding. Feeding was mostly terminated by caregivers (75%), often prematurely. Overall, caregivers of stunted children had poorer complementary- and breast-feeding practices and were less responsive to child's hunger and satiation cues (P < 0.05). Positive responsive feeding behaviors were associated with child's number of mouthful accepted (r = 0.27; P = 0.007) and stunting (r = 0.4; P < 0.001).ConclusionLow complementary food intake in this setting is associated with caregivers' feeding style and stunting. Nutrition interventions that reinforce messages of optimal infant and young child feeding and integrate the promotion of responsive feeding behaviors are needed.

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Predicting sugar consumption: Application of an integrated dual-process, dual-phase model

Publication date: 1 September 2017
Source:Appetite, Volume 116
Author(s): Martin S. Hagger, Nadine Trost, Jacob J. Keech, Derwin K.C. Chan, Kyra Hamilton
Excess consumption of added dietary sugars is related to multiple metabolic problems and adverse health conditions. Identifying the modifiable social cognitive and motivational constructs that predict sugar consumption is important to inform behavioral interventions aimed at reducing sugar intake. We tested the efficacy of an integrated dual-process, dual-phase model derived from multiple theories to predict sugar consumption. Using a prospective design, university students (N = 90) completed initial measures of the reflective (autonomous and controlled motivation, intentions, attitudes, subjective norm, perceived behavioral control), impulsive (implicit attitudes), volitional (action and coping planning), and behavioral (past sugar consumption) components of the proposed model. Self-reported sugar consumption was measured two weeks later. A structural equation model revealed that intentions, implicit attitudes, and, indirectly, autonomous motivation to reduce sugar consumption had small, significant effects on sugar consumption. Attitudes, subjective norm, and, indirectly, autonomous motivation to reduce sugar consumption predicted intentions. There were no effects of the planning constructs. Model effects were independent of the effects of past sugar consumption. The model identified the relative contribution of reflective and impulsive components in predicting sugar consumption. Given the prominent role of the impulsive component, interventions that assist individuals in managing cues-to-action and behavioral monitoring are likely to be effective in regulating sugar consumption.

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Semiclassical calculations of electron impact Stark widths and shifts of singly ionized atom lines revisited

Publication date: September 2017
Source:Journal of Quantitative Spectroscopy and Radiative Transfer, Volume 198
Author(s): Branimir Blagojević, Nikola Konjević
The Stark broadening parameters for spectral lines of singly charged Mg II, Al II, Si II, Zn II, Sn II, Hg II, and Pb II ions, calculated in numerically improved semiclassical formalism of Griem are reported and compared with the original results of Griem for Mg, Al and Si ions and the semiclassical calculations in a version of Dimitrijević and Sahal-Bréchot for Mg ions. Detailed comparison with the experimental data is carried out, also.

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The impact of freshwater metal concentrations on the severity of histopathological changes in fish gills: A statistical perspective

Publication date: 1 December 2017
Source:Science of The Total Environment, Volumes 599–600
Author(s): A.R. Fonseca, L.F. Sanches Fernandes, A. Fontainhas-Fernandes, S.M. Monteiro, F.A.L. Pacheco
The purpose of this study was to relate the severity of histopathological changes in fish gills with changes in metal concentrations of freshwater samples, and to use the relationships as premature warnings of impairment in aquatic fauna populations. The investigated species were the native barbel (Luciobarbus bocagei) and boga (Pseudochondrostoma sp.), and the introduced trout (Oncorhynchus mykiss), collected from 6 northern Portuguese rivers in a total of 249 individuals. The sampling sites have been linked to different ecological status by the official authorities. The sampling has been repeated 4 times to cover different hydrologic and environmental conditions. The analyzed metals were aluminum, arsenic, cadmium, cobalt, chromium, copper, manganese, nickel, lead and zinc. For each fish, 30 filaments of a gill arch were observed in a light microscope, and the histopathological changes evaluated according to a 6-degree gradation scale that combines the extent and severity of each lesion. The relationships between the histopathological and the chemical results were investigated by the non-parametric Goodman Kruskal gamma correlation and Partial Least Squares regression (PLS). The statistical results highlighted the importance of filament epithelium proliferation (FEP) as key biomarker to the toxicity of sub lethal concentrations of metals, because FEP was significantly correlated with all analyzed metals and explained through PLS regression by concentration changes of Cu, Zn, Mn, Cr and As. A refined regression analysis, where histopathological data on the 3 species were processed in separate, revealed that FEP severity is especially sensitive to changes in metal concentrations in boga. Thus, monitoring studies on the ecological status of northern Portuguese rivers would benefit in time and cost if FEP is used as biomarker and boga as species. Naturally, the option for this species depends on the availability of boga individuals along the stream reaches selected for the monitoring programs.

Graphical abstract

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Magnetocaloric effect in Gd1−x Ndx Zn2

Publication date: 15 September 2017
Source:Journal of Magnetism and Magnetic Materials, Volume 438
Author(s): Keisuke T. Matsumoto, Koichi Hiraoka
The magnetization of Gd1-xNdxZn2(0<x⩽1) was measured to study the effect of Nd substitution in GdZn2 with a Curie temperature of 85K and a spin-reorientation transition temperature of 58K on the magnetocaloric effect. The Nd counterpart NdZn2 shows antiferromagnetic order at 23K. Samples of Gd1-xNdxZn2 (0<x⩽1) were prepared by the melt-growth method. In Nd-substituted systems, the anomaly due to spin-reorientation disappeared. For x⩾0.6, field-induced metamagnetic transitions were observed, indicating an antiferromagnetic ground state. This complex magnetism may originate from competition between ferromagnetic and antiferromagnetic interactions. Magnetic entropy change ΔSm was calculated based on the magnetization measurements. ΔSm was suppressed by Nd substitution for x values up to 0.6. For x=1 (NdZn2), the maximum value of ΔSm was −9J/K kg, which is almost the same as those of other Nd-based magnetocaloric materials.

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Facile synthesis of 2D Zn(II) coordination polymer and its crystal structure, selective removal of methylene blue and molecular simulations

Publication date: 5 September 2017
Source:Journal of Molecular Structure, Volume 1143
Author(s): Güneş Günay Sezer, Okan Zafer Yeşilel, Onur Şahin, Hasan Arslanoğlu, İlknur Erucar
A new coordination polymer {[Zn(μ3-ppda)(H2O)(μ-bpa)Zn(μ-ppda)(μ-bpa)]·4H2O}n (1) (ppda = 1,4-phenylenediacetate, bpa = 1,2-bis(4-pyridyl)ethane) has been synthesized by microwave-assisted reaction and characterized by elemental analysis, IR spectroscopy, single-crystal and powder X-ray diffractions. The asymmetric unit of 1 consists of two Zn(II) ions, two bpa ligands, two ppda ligands, one coordinated and four non-coordinated water molecules. In 1, ppda²⁻ anions are linked the adjacent Zn(II) centers to generate 1D double-stranded chains. These chains are connected into 2D sheets by the bridging bpa ligands. Atomically detailed modeling was performed to compute single and binary component adsorption isotherms of H2, CO2, CH4 and N2 in complex 1. Results showed that 1 exhibits a high adsorption selectivity towards CO2 due to its high affinity for CO2. Results of this study will be helpful to guide the microwave-assisted reaction of coordination polymers to design promising adsorbents for gas storage and gas separation applications. The luminescent property of 1 and the selective removal of dyes in 1 have been also discussed. Results showed that 1 can be a potential candidate for luminescence applications and can selectively adsorb methylene blue (MB) dye molecules.

Graphical abstract

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Antibiotic Stewardship im Alltag – „Fragen Sie Ihren Arzt und Apotheker!“

Anästhesiol Intensivmed Notfallmed Schmerzther 2017; 52: 274-286
DOI: 10.1055/s-0042-122109

Antibiotic Stewardship (ABS) lässt sich nicht alleine praktizieren. Ein gut etabliertes, interdisziplinäres ABS-Team mit Mandat und Deputat durch die Geschäftsführung kann den Anforderungen im Alltag und bei Ausnahmesituationen wie z. B. einem Ausbruch durch einen multiresistenten Erreger gerecht werden. Klinisch-infektiologische Kompetenz ist dabei für alle Teammitglieder grundlegend. Die Rollen des ABS-Teams bei einem Ausbruchsgeschehen wie dem hier beschriebenen durch einen 4MRGN A. baumannii sind vielfältig. Der rationale Einsatz von Reserveantibiotika und Dosisoptimierung von Antiinfektiva, z. B. durch therapeutisches Drug Monitoring (TDM), stehen dabei im Vordergrund. Durch restriktiven Einsatz von Antibiotika kann der antibiotische Selektionsdruck gesenkt und damit der Bildung weiterer Resistenzen entgegengewirkt werden. Der Einsatz von Reserveantibiotika im Rahmen eines Ausbruchsgeschehens führt zu erheblichen Kostensteigerungen bei gleichzeitig sinkenden Patientenzahlen. Interdisziplinarität zwischen der Hygiene, dem ABS-Team und den verschiedenen Kliniken sowie Unterstützung durch die Geschäftsführung sind wichtig für die Prävention und auch das Management von Ausbrüchen durch multiresistente Erreger.
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