Burnout and resilience in anaesthesia and intensive care medicine

1H022H013J02

http://ift.tt/2rHDJvV

Management of elective laryngectomy

1CO12A013A02

http://ift.tt/2rcldbt

Long-term treatment of Cushing’s disease with pasireotide: 5-year results from an open-label extension study of a Phase III trial

Abstract

Background

Treating hypercortisolism in patients with Cushing's disease after failed surgery often requires chronic medication, underlining the need for therapies with favourable long-term efficacy and safety profiles.

Methods

In a randomised, double-blind study, 162 adult patients with persistent/recurrent or de novo Cushing's disease received pasireotide. Patients with mean urinary free cortisol at/below the upper limit of normal or clinical benefit at month 12 could continue receiving pasireotide during an open-ended, open-label phase, the outcomes of which are described herein.

Results

Sixteen patients received 5 years of pasireotide treatment. Among these, median (95% confidence interval) percentage change from baseline in mean urinary free cortisol was −82.6% (−89.0, −41.9) and −81.8% (−89.8, −67.4) at months 12 and 60. Eleven patients had mean urinary free cortisol ≤ upper limit of normal at month 60. Improvements in clinical signs were sustained during long-term treatment. The safety profile of pasireotide at 5 years was similar to that reported after 12 months. Fifteen of 16 patients experienced a hyperglycaemia-related adverse event; glycated haemoglobin levels were stable between months 6 and 60. Adverse events related to hyperglycaemia, bradycardia, gallbladder/biliary tract, and liver safety were most likely to first occur by month 6; adverse event severity did not tend to worsen over time.

Conclusions

This represents the longest prospective trial of a medical therapy for Cushing's disease to date. A subset of patients treated with pasireotide maintained biochemical and clinical improvements for 5 years, with no new safety signals emerging. These data support the use of pasireotide as an effective long-term therapy for some patients with Cushing's disease.

http://ift.tt/2s9YPoa

Dermoscopic images of malignant and benign skin lesions

http://sfaki.blogspot.com/2017/06/using-watson-to-diagnose-skin-cancer.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Tilt-induced cardio-inhibitory reflex syncope (BIOSync trial) : 12-item questionnaire to distinguish between complete transient loss of consciousness (i.e., syncope) and pre-syncope or other minor symptoms and, additionally, to provide a standardized categorical description of the clinical presentation of syncope including duration, reproducibility with previous episodes, presence of prodromes, presence of witnesses, context, and consequences of the episode.

http://sfaki.blogspot.com/2017/06/12-item-questionnaire-to-distinguish.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Comparative Evaluation of the Embrasure Wire versus Arch Bar Maxillomandibular Fixation in the Management of Mandibular Fractures: Are Arch Bars Replaceable?

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1603453

The aim of this prospective study was to appraise the role of embrasure wiring in the treatment of mandibular fractures over the arch bar as adjunctive techniques of maxillomandibular fixation (MMF). This study was conducted on 40 patients who were surgically treated for mandibular fractures with accessory use of MMF (embrasure: group A vs. arch bars: group B). All patients were evaluated for demographic data, etiology, and location of fracture. Characteristically, the complications, including wire injury, infection, and malocclusion, were recorded. The data were analyzed using Student's t-test and chi-square test as appropriate. Statistical significance was set at p < 0.05). In this study, data from 40 patients were included. In group A (embrasure wiring), time required for placement of MMF was significantly less than (7.85 ± 0.81 minutes) that in group B, and also there was less incidence of wire prick to the operator in group A than in group B (p < 0.05). However, in terms of wire prick and malocclusion, no statistically significant difference was noted in groups A and B (p > 0.05). Patient treated with embrasure wiring intermaxillary fixation had better outcomes especially in terms of time of placement and less incidence of wire prick injury when compared with arch bar.
[...]

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

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

http://ift.tt/2rSzAUF

Multi-institutional Analysis of Surgical Management and Outcomes of Mandibular Fracture Repair in Adults

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0037-1603460

Mandibular fractures are rare, most commonly occurring in young male patients who present with facial trauma. The etiology, incidence, and presentation vary among previous publications depending on cultural and socioeconomic factors of the region of origin. This multi-institutional study aims to present demographic characteristics, surgical treatment, and clinical outcomes of surgical repair of mandible fractures in the United States. An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) adult databases of the years 2006 through 2014 was performed identifying 940 patients with an International Classification of Diseases, version 9 (ICD-9) diagnosis of either closed or open fracture of the mandible. Preoperative, perioperative, and postoperative details were categorized and evaluated for these two cohorts. Multivariate analysis was performed to detect risk factors related to any complications. Patients were predominantly male (85.7%), young with a mean age of 34.0 ± 14.8 years, and relatively healthy with body mass index of 23.6 ± 8.2 and an American Society of Anesthesiologists (ASA) class of 1 or 2 (84.4%). However, more than half were regular smokers (51.1%). The top five most frequent procedures performed for mandibular repair were exclusively open surgical approaches with internal, external, or interdental fixation in both cohorts. Patients with open fractures were more often admitted as emergencies, treated inpatient, required longer operative times, and presented with more contaminated wounds (p < 0.05). Overall, medical (1.7%) and surgical complications (3.7%) were low. A high ASA class 3 or above and emergency operations were identified as risk factors for medical adverse events. Despite frequent concomitant injuries after trauma and a diverse array of mandibular injury types, our patient sample demonstrated favorable outcomes and low complication rates. Open surgical techniques were the most common procedures in this study representing the American population.
[...]

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

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

http://ift.tt/2rSBF2D

Hypothyreose nach Hemithyreoidektomie − überraschend häufige Komplikation während der Nachsorge

Laryngo-Rhino-Otol
DOI: 10.1055/s-0043-110856

Hintergrund Hemithyreoidektomie ist eine häufige Behandlung einseitiger Schilddrüsenknoten. Postoperative Hypothyreose ist eine häufig unterschätzte Komplikation. Wir untersuchten Inzidenz, Zeitpunkt, Symptomatik sowie mögliche Risikofaktoren der postoperativen Hypothyreose. Material und Methoden 127 Patienten nach Hemithyreoidektomie wurden mit retrospektiver Datenanalyse sowie strukturierter Befragung der nachbetreuenden Hausärzte und Endokrinologen untersucht. Patienten wurden mit dem postoperativen TSH als hypothyreot (> 4.0 mU/L) oder euthyreot (0.4–4.0 mU/L) klassifiziert. Schilddrüsenhormone wurden nach 4–6 Wochen, 6 Monaten und 1 Jahr gemessen. Ergebnisse 55 Patienten (43 %) entwickelten eine postoperative Hypothyreose und 72 (57%) blieben euthyreot. Die Hypothyreose zeigte sich innerhalb der ersten 2 Monaten bei 39 Patienten (71 %), zwischen 2–6 Monaten bei 13 Patienten (24 %) sowie nach 6–12 Monaten bei 3 Patienten (5 %). 33 Patienten (60 %) waren zum Zeitpunkt der Diagnose asymptomatisch. Nur 16 Patienten (29 %) hatten Symptome. Der präoperative TSH Wert war signifikant höher in der Gruppe der hypothyreoten Patienten (1.64), verglichen mit der euthyreoten Gruppe (1.13, P = 0.0017). Die anderen Variablen wie Alter, Geschlecht und präoperativen Werte von T3, T4, Calcium und PTH zeigten keinen signifikanten Unterschied. Schlussfolgerung Die postoperative Hypothyreose ist eine häufige Komplikation nach Hemithyreoidektomie, welche nicht verpasst werden sollte. Präoperativ erhöhter TSH Wert ist ein Risikofaktor für die postoperative Hypothyreose. Alle Patienten nach Hemithyreoidektomie sollten postoperative TSH Kontrollen nach 4–6 Wochen, 6 Monaten und 12 Monaten haben.
[...]

Georg Thieme Verlag KG Stuttgart · New York

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

http://ift.tt/2rHqgnO

Hypothyreose nach Hemithyreoidektomie − überraschend häufige Komplikation während der Nachsorge

Laryngo-Rhino-Otol
DOI: 10.1055/s-0043-110856

Hintergrund Hemithyreoidektomie ist eine häufige Behandlung einseitiger Schilddrüsenknoten. Postoperative Hypothyreose ist eine häufig unterschätzte Komplikation. Wir untersuchten Inzidenz, Zeitpunkt, Symptomatik sowie mögliche Risikofaktoren der postoperativen Hypothyreose. Material und Methoden 127 Patienten nach Hemithyreoidektomie wurden mit retrospektiver Datenanalyse sowie strukturierter Befragung der nachbetreuenden Hausärzte und Endokrinologen untersucht. Patienten wurden mit dem postoperativen TSH als hypothyreot (> 4.0 mU/L) oder euthyreot (0.4–4.0 mU/L) klassifiziert. Schilddrüsenhormone wurden nach 4–6 Wochen, 6 Monaten und 1 Jahr gemessen. Ergebnisse 55 Patienten (43 %) entwickelten eine postoperative Hypothyreose und 72 (57%) blieben euthyreot. Die Hypothyreose zeigte sich innerhalb der ersten 2 Monaten bei 39 Patienten (71 %), zwischen 2–6 Monaten bei 13 Patienten (24 %) sowie nach 6–12 Monaten bei 3 Patienten (5 %). 33 Patienten (60 %) waren zum Zeitpunkt der Diagnose asymptomatisch. Nur 16 Patienten (29 %) hatten Symptome. Der präoperative TSH Wert war signifikant höher in der Gruppe der hypothyreoten Patienten (1.64), verglichen mit der euthyreoten Gruppe (1.13, P = 0.0017). Die anderen Variablen wie Alter, Geschlecht und präoperativen Werte von T3, T4, Calcium und PTH zeigten keinen signifikanten Unterschied. Schlussfolgerung Die postoperative Hypothyreose ist eine häufige Komplikation nach Hemithyreoidektomie, welche nicht verpasst werden sollte. Präoperativ erhöhter TSH Wert ist ein Risikofaktor für die postoperative Hypothyreose. Alle Patienten nach Hemithyreoidektomie sollten postoperative TSH Kontrollen nach 4–6 Wochen, 6 Monaten und 12 Monaten haben.
[...]

Georg Thieme Verlag KG Stuttgart · New York

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

http://ift.tt/2rHqgnO

Diagnosis and following up of Ménière’s disease using multifrequency tympanometry—Cutoff values and temporal changes in measurements

This study aimed to verify cutoff values for G width (the width of bimodal peaks for the waveform obtained when measuring conductance at 2000Hz) in Japanese individuals diagnosed with Ménière's disease (MD) using multifrequency tympanometry (MFT) and to determine the relationship between the G width and ability to hear low-pitched sounds using measurements over time.

http://ift.tt/2r1jcjq

Diagnosis and following up of Ménière’s disease using multifrequency tympanometry—Cutoff values and temporal changes in measurements

This study aimed to verify cutoff values for G width (the width of bimodal peaks for the waveform obtained when measuring conductance at 2000Hz) in Japanese individuals diagnosed with Ménière's disease (MD) using multifrequency tympanometry (MFT) and to determine the relationship between the G width and ability to hear low-pitched sounds using measurements over time.

http://ift.tt/2r1jcjq

Monoclonal antibodies against IL-5 or IL-5 receptor alpha (mepolizumab, reslizumab, benralizumab), IL-13 (lebrikizumab, tralokinumab), IL-4 receptor alpha (dupilumab), Immune globuline E (IgE) (omalizumab), anti-Thymic Stromal Lymphopoitin (TSLP) (tezepelumab) and small molecule therapies such as prostaglandin D2 blockers (fevipiprant, timapiprant). New Anti-Eosinophil Drugs for asthma and COPD

http://sfaki.blogspot.com/2017/06/monoclonal-antibodies-against-il-5-or.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Next generation sequencing of oncogenes and tumor suppressor genes in odontogenic myxomas

Abstract

Background

Mutations previously considered drivers of malignant neoplasms also occur in benign tumors. From the biological perspective, the study of malignant and benign neoplasms is equally relevant. The study of rare tumors contributes to the understanding of the more common ones, as both could share the same hallmark genetic drivers. The identification of driver mutations in benign tumors is facilitated by the fact that they harbor quiet genomes. Pathogenic mutations have being described in benign epithelial odontogenic tumors, such as ameloblastomas and adenomatoid odontogenic tumors. However, the molecular pathogenesis of odontogenic myxoma (OM), a benign aggressive mesenchymal tumor, is still poorly characterized, precluding the development of personalized therapy. Aiming to find druggable genetic mutations, we investigated in OM, mutations in 50 genes commonly mutated in cancer.

Methods

We used targeted next generation sequencing to interrogate about 2,800 COSMIC mutations in OM.

Results

Missense single nucleotide variants were detected in KDR, TP53, PIK3CA, KIT, JAK3, however, these did not include pathogenic mutations.

Conclusion

Contrarily to other myxoid human neoplasms, these aggressive tumors do not harbor pathogenic mutations in genes commonly mutated in human cancers or if they do, these mutations probably occur in a low proportion of cases.

This article is protected by copyright. All rights reserved.

http://ift.tt/2t0uhlf

Mutation of Angiopoietin-1 Gene Associates with a New Type of Hereditary Angioedema

A missense variant in the angiopoietin-1 gene (ANGPT1) represents a novel and independent mechanism leading to vascular permeability and angioedema. Impairment of the endothelial ANGPT1-TIE2 ligand-receptor system may be involved in the pathophysiology of HAE.

http://ift.tt/2r8n9qr

Allergic Rhinitis and its Impact on Asthma (ARIA) Guidelines – 2016 Revision

Allergic rhinitis affects 10 to 40% of the population. It reduces quality of life, school and work performance, and is a frequent reason for office visits in general practice. Medical costs are large but avoidable costs associated with lost work productivity are even larger than those incurred by asthma. New evidence has accumulated since the last revision of the Allergic Rhinitis and its Impact on Asthma – ARIA guidelines in 2010 prompting its update.

http://ift.tt/2rSd6mC

Paradoxical roles of dual oxidases in cancer biology

Publication date: September 2017
Source:Free Radical Biology and Medicine, Volume 110
Author(s): Andrew C. Little, Arvis Sulovari, Karamatullah Danyal, David E. Heppner, David J. Seward, Albert van der Vliet
Dysregulated oxidative metabolism is a well-recognized aspect of cancer biology, and many therapeutic strategies are based on targeting cancers by altering cellular redox pathways. The NADPH oxidases (NOXes) present an important enzymatic source of biological oxidants, and the expression and activation of several NOX isoforms are frequently dysregulated in many cancers. Cell-based studies have demonstrated a role for several NOX isozymes in controlling cell proliferation and/or cell migration, further supporting a potential contributing role for NOX in promoting cancer. While various NOX isoforms are often upregulated in cancers, paradoxical recent findings indicate that dual oxidases (DUOXes), normally prominently expressed in epithelial lineages, are frequently suppressed in epithelial-derived cancers by epigenetic mechanisms, although the functional relevance of such DUOX silencing has remained unclear. This review will briefly summarize our current understanding regarding the importance of reactive oxygen species (ROS) and NOXes in cancer biology, and focus on recent observations indicating the unique and seemingly opposing roles of DUOX enzymes in cancer biology. We will discuss current knowledge regarding the functional properties of DUOX, and recent studies highlighting mechanistic consequences of DUOX1 loss in lung cancer, and its consequences for tumor invasiveness and current anticancer therapy. Finally, we will also discuss potentially unique roles for the DUOX maturation factors. Overall, a better understanding of mechanisms that regulate DUOX and the functional consequences of DUOX silencing in cancer may offer valuable new diagnostic insights and novel therapeutic opportunities.

Graphical abstract

http://ift.tt/2s9N15e

Incidence, prevalence, and risk of selected ocular disease in adults with atopic dermatitis

Ocular comorbidities are common in atopic dermatitis (AD) as the result of the disease itself or the use of medication. No large-scale epidemiologic data exist on the prevalence of ocular comorbidities in adults with AD.

http://ift.tt/2s9MDUq

Frequency of and risk factors for tumor upstaging after wide local excision of primary cutaneous melanoma

Detecting a more advanced stage of the primary melanoma after wide local excision and reconstruction can complicate patient counseling about prognosis, management of surgical margins, and indications for sentinel lymph node biopsy.

http://ift.tt/2sJgikB

Histopathologic features of melanoma in difficult-to-diagnose lesions: A case-control study

Dermatopathology is considered the gold standard for melanoma diagnosis, but a subset of cases is difficult to diagnose by histopathology.

http://ift.tt/2sa3Kpg

Healing lotion formula with proven superiority to Rx and therapeutic moisturizing lotions translates into improvements in stratum corneum biology and barrier resilience

Barrier integrity and therefore skin dryness falls along a spectrum—from normal to atopic—based on a number of genetic and environmental factors. The outermost layers of the epidermis (stratum corneum, SC) are key for maintaining skin health and barrier quality. For moderate to severe dry skin, the ideal moisturizer should provide initial and sustained hydration as well as repairing the barrier from within. Barrier resilience is indicated by improved SC parameters on regression. The goals of this research were to compare improvement in hydration from a healing test lotion with a combination of high glycerin, petrolatum, and fatty acid versus Rx and marketed therapeutic lotions and to demonstrate improvement in barrier resilience.

http://ift.tt/2sadzTU

Combined preoperative measurement of three inferior alveolar canal factors using computed tomography predicts the risk of inferior alveolar nerve injury during lower third molar extraction

A retrospective cohort study was performed to assess the clinical usefulness of combination assessment using computed tomography (CT) images in patients undergoing third molar extraction. This study included 85 patients (124 extraction sites). The relationship between cortication status, buccolingual position, and shape of the inferior alveolar canal (IAC) on CT images and the incidence of inferior alveolar nerve (IAN) injury after third molar extraction was evaluated. IAN injury was observed at eight of the 124 sites (6.5%), and in five of 19 sites (26.3%) in which cortication was absent+the IAC had a lingual position+the IAC had a dumbbell shape.

http://ift.tt/2rSqE1h

Craniofacial and extracraniofacial anomalies in craniofacial macrosomia: A multicenter study of 755 patients

Craniofacial microsomia (CFM) is a congenital malformation of structures derived from the first and second pharyngeal arches leading to underdevelopment of the face. However, besides the craniofacial underdevelopment, extracraniofacial anomalies including cardiac, renal and skeletal malformation have been described. The aim of this study is to analyse a large population of patients with regard to demographics, typical phenotypes including craniofacial and extracraniofacial anomalies, and the correlations between the different variables of this condition.

http://ift.tt/2s2nF8x

A comparison of the outcomes of four minimally invasive treatment methods for anterior disc displacement of the temporomandibular joint

The purpose of this study was to compare the effectiveness of four non-surgical conservative treatment methods for temporomandibular disorders (TMD). The study group comprised 40 patients with unilateral TMD who fell into group II of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Patients were divided into four groups according to the treatment method: splint therapy, arthrocentesis, medical therapy, and low-level laser therapy. Magnetic resonance imaging (MRI) was performed before treatment and at the 1-month follow-up.

http://ift.tt/2r8bnME

Post- operative alar base symmetry in complete unilateral cleft lip and palate- a prospective study

In the evolution of cleft lip repair, there have been continuous attempts to minimize local trauma and to improve lip and nasal appearances. In order to obtain an aesthetically balanced development of midface, the primary surgical correction of the nasolabial area is of paramount importance. In this study, the importance of a back-cut extending cephalically above the inferior turbinate at the mucocutaneous junction which elevates the nostril floor on the cleft side for the purpose of achieving symmetry of the alar bases are analyzed by pre and post-operative photographic anthropometry.

http://ift.tt/2s9JdAY

Determining the outcomes of post mastectomy radiation therapy delivered to the definitive implant in patients undergoing one and two stage implant based breast reconstruction: A systematic review and meta-analysis

Post mastectomy radiation therapy is known to increase complication rate and implant loss in implant based breast reconstruction. The purpose of this study was to systematically review the literature regarding outcome of PMRT delivered to the permanent/definitive implant.

http://ift.tt/2sJmA3E

Massively Metastatic Dermatofibrosarcoma Protuberans With Fibrosarcomatous Transformation Years After Surgical Resection.

No abstract available

http://ift.tt/2rHlirf

Determinants and Timeline of Perioperative Anxiety in Mohs Surgery.

BACKGROUND: Patients undergoing Mohs micrographic surgery (MMS) exhibit anxiety relating to cancer cure or the expected cosmetic outcome. OBJECTIVE: To obtain quantitative measurements of perioperative cancer and cosmetic anxiety levels in first-time MMS patients. Parameters influencing anxiety and its natural course were assessed. METHODS: Prospective, single-blinded, questionnaire study of 173 patients undergoing MMS of the face. Anxiety levels were assessed using a visual analog scale preoperatively and postoperatively over 6 months. RESULTS: Mohs patients demonstrate a trend to greater or equal anxiety about cancer over cosmesis at all measured time points, but differences only reached statistical significance beginning 1 week postoperatively. Clinically relevant lowering of cancer anxiety levels is delayed until 3 months postoperatively. Cosmetic anxiety reaches a clinically relevant improvement by 1 week. The intuitive predictors of cosmetic anxiety, namely female gender and younger age, were quantitatively reinforced in this study. The predictor of cancer anxiety was the use of preoperative lorazepam. CONCLUSION: To maximize patient care, Mohs surgeons must be aware of covert patient anxieties and the parameters, which influence these anxieties. Identifying and anticipating the course of cancer- and cosmetic-related anxieties will reduce patient fears, improving their satisfaction with the MMS experience. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2rHmqvb

Commentary on The New Opt-Out Dutch National Breast Implant Registry- Lessons learnt from the road to implementation

After the PIP crisis in 2010, the Australian Breast Device Registry dataset was shared with countries including Austria, Australia, Canada, France, Germany, Ireland, Italy, Netherlands, New Zealand, South Africa, UK and USA via the newly formed ICOBRA (International Collaboration of Breast Registry Activities)1, 2.

http://ift.tt/2sadlfD

Surgical correction of cryptotia combined with an ultra-delicate split-thickness skin graft in continuity with a full-thickness skin rotation flap

Cryptotia is a common congenital ear deformity in Asian populations. In cryptotia, a portion of the upper ear is hidden and fixed in a pocket of the skin of the mastoid. Here, we describe our method for cryptotia correction combined with an ultra-delicate split-thickness skin graft in continuity with a full-thickness skin rotation flap.

http://ift.tt/2sJxC8P

Dermoscopy in Facilitating the Recognition of Poikiloderma of Civatte.

No abstract available

http://ift.tt/2rbZznS

Cryolipolysis for Reduction of Arm Fat: Safety and Efficacy of a Prototype CoolCup Applicator With Flat Contour.

BACKGROUND: Cryolipolysis of the arms has been shown to be an effective but somewhat time-consuming process. OBJECTIVE: The study evaluated safety and efficacy of a contoured cup cryolipolysis applicator for reduction of arm fat. The prototype was designed to maximize tissue contact with the cooling surface to improve comfort, while reducing treatment time by 25 minutes. METHODS AND MATERIALS: Both arms were treated using a prototype device that delivered treatment in 35 minutes at -11[degrees]C. Photographic and ultrasound documentation was captured at baseline and 12 weeks post-treatment. Efficacy was assessed by photo review and measurement of fat reduction in ultrasound images. Immediately after 1, 4, and 12 weeks post-treatment, clinical assessments were performed to evaluate treatment areas and sensory alterations. RESULTS: Thirty women were enrolled and completed treatments to both arms. Ultrasound measurements found mean fat layer reduction of 3.2 mm with an SD of 2.7 mm. Blinded independent photo review found 85.2% correct identification of baseline photographs by at least 2/3 of reviewers. There were no unanticipated adverse device effects. Four study subjects experienced numbness in the treatment area beyond the 12-week visit that subsequently resolved without intervention. CONCLUSION: These data suggest that the CoolCup prototype applicator provides rapid, safe, and effective arm treatment. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2rc68GX

Mohs Melanoma Chemosurgery Simplified to a Single Brief Caustic Application: Possible Vaccine Effect.

No abstract available

http://ift.tt/2rHsYK6

Novel Camera Mounting Technique for Dermatologic Surgeries.

No abstract available

http://ift.tt/2rc3EIx

A Prospective, Randomized, Single-Blind Study Comparing Cyanoacrylate Adhesives to Sutures for Wound Closure in Skin Cancer Patients.

BACKGROUND: Cyanoacrylate tissue adhesives are not more likely to result in wound dehiscence or infection than sutured closures. However, suturing is the gold standard for optimal cosmetic appearance of scars. OBJECTIVE: To determine whether cyanoacrylate tissue adhesives produce a cosmetic outcome equivalent to sutures at 3 months. Secondary outcomes include time for wound closure, time spent on wound care, and surgeon and patient satisfaction. METHODS AND MATERIALS: Seventy-one patients scheduled for skin cancer excision at Beverly Hospital were included in this prospective, randomized, single-blind study. Cosmetic appearance was assessed by a masked panel of dermatologists and plastic surgeons who evaluated digital photographs. Secondary outcomes were assessed by nursing recordings and patient and surgeon evaluations. RESULTS: There was no significant difference in wound appearance (Visual Analog Scale: p = .4693, modified Hollander Wound Evaluation Score: p = .6413) between adhesives and sutures. It was faster and easier for a surgeon to use adhesives, and subjects spent less time caring for and were more satisfied by wounds sealed with adhesives than sutures. CONCLUSION: Cyanoacrylate tissue adhesives produce cosmetic outcomes that are not statistically significantly different than sutures; furthermore, they are associated with fast application, easy wound care, and patient satisfaction. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2rHlaIl

Prospective, Split-Face, Randomized, Long-Term Blinded Objective Comparison of the Performance and Tolerability of Two New Hyaluronic Acid Fillers.

BACKGROUND: There are requirements for long-term, objective comparisons of hyaluronic acid (HA) dermal fillers. OBJECTIVE: To compare efficacy and tolerability of ART FILLER Universal (AFU) and ART FILLER Fine lines (AFFL) with the existing HA fillers for the treatment of nasolabial folds and crow's feet. MATERIALS AND METHODS: Prospective, randomized, rater- and patient-blind, split-face comparison of AFU with JUVEDERM Ultra 3 (JUV) and AFFL with FIRST LINES PureSense (FLPS). The severity of nasolabial folds and crow's feet was assessed by independent blinded evaluators using the Lemperle scale at baseline, day (D) 30/D45, D90, and D180. Tolerability, Global Aesthetic Improvement Scale (GAIS), wrinkle volumes, and skin thickness and density were also measured at D30/D45, D90, and D180. RESULTS: At D30 and D180 respectively, 61 and 67 patients were assessed. Scores for nasolabial folds and crow's feet showed statistically significant improvements at D30, D90, and D180. AFU and AFFL were noninferior to JUV and FLPS, respectively. Most patients showed GAIS improvements, maintained until at least D180 and significant increases of collagen synthesis in crow's feet and nasolabial folds. Treatments were well tolerated. CONCLUSION: AFU and AFFL are noninferior to comparators. The methodology used represents a novel approach to augment existing clinical assessment of HA fillers. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2rbZv7C

Use of Turn-in Skin Flaps for Nasal Lining Reconstruction.

BACKGROUND: Reconstruction of the nasal lining is the most difficult part of complex nasal reconstruction because the mucosa has a unique texture and fineness. Many techniques, ranging from skin grafts to local flaps, have been applied for the reconstruction of the mucosa. In some cases, even free flaps have been used. OBJECTIVE: The aim of this study was to discuss the feasibility of using turn-in flaps in nasal reconstruction. MATERIALS AND METHODS: Seventeen patients with full-thickness nasal defects underwent reconstruction with turn-in flaps. In all the patients, the bone structure was formed using cartilage grafts, and the skin defects were reconstructed using paramedian forehead flaps. A rhinoplasty procedure was added in 10 of the patients. RESULTS: Necrosis was not observed in any of the flaps, and the results were satisfactory for all the patients. CONCLUSION: This technique provided enough support for the onlay cartilage grafts, and the flap was thin enough to avoid any nasal airway obstruction. In selected patients, this technique can also be used in conjunction with a rhinoplasty procedure. (C) 2017 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2rHqsnl

Recurrent Tumors Referred for Mohs Micrographic Surgery: A 12-Year Experience at a Single Academic Center.

BACKGROUND: Mohs micrographic surgery (MMS) is used for treatment of primary and recurrent tumors. Compared with primary tumors, recurrent tumors are often more aggressive. OBJECTIVE: To understand differing characteristics between primary versus recurrent tumors treated by MMS. MATERIALS AND METHODS: The authors conducted a retrospective review of a 12-year period at 1 academic center. Recurrent tumors were defined as recurrent if previously treated with cryotherapy, topical chemotherapeutics, electrodesiccation and curettage, or excision. Statistical analysis was conducted with p

http://ift.tt/2rbPjMw

Three-Dimensional Imaging as a Novel Method of Evaluating the Longevity of Hyaluronic Acid Fillers in a Mouse Model.

No abstract available

http://ift.tt/2rHn3Ve

Atypical neurofibromatosis type 1 with unilateral limb hypertrophy mimicking overgrowth syndrome

Summary

Neurofibromatosis type 1 (NF1; OMIM 162200), a dominantly inherited multitumor syndrome, results from mutations in the Neurofibromin 1 (NF1) gene. We present the case of a Hungarian woman with the clinical phenotype of NF1 over her whole body and the clinical features of unilateral overgrowth involving her entire left leg. This unusual phenotype suggested either the atypical form of NF1 or the coexistence of NF1 and overgrowth syndrome. Direct sequencing of the genomic DNA isolated from peripheral blood revealed a novel frameshift mutation (c.5727insT, p.V1909fsX1912) in the NF1 gene. Next-generation sequencing of 50 oncogenes and tumour suppressor genes, performed on the genomic DNAs isolated from tissue samples and peripheral blood, detected only wild-type sequences. Based on these results, we concluded that the patient is affected by an unusual phenotype of NF1, and that the observed unilateral overgrowth of the left leg might be a rare consequence of the identified c.5727insT mutation.

http://ift.tt/2s28kVG

Clinical outcomes in a specialist male genital skin clinic: prospective follow-up of 600 patients

Summary

It is important to assess outcomes for medical interventions in order to focus scarce resources on outcomes with a known positive benefit. An open, observational study was performed to assess the clinical outcomes of 600 male patients with a genital skin problem attending a specialist secondary care dermatology facility. Patients were mainly referred by general practitioners and genitourinary medicine physicians. Outcome was measured at 3 and 6 months, and was determined by clinical examination and assessment of patient symptoms. The mean age of the group was 45.3 years. The commonest diagnoses were lichen sclerosus (30.5%), balanitis (17.3%), eczema (12.8%), lichen planus (7.3%), psoriasis (7.2%) and benign lesions (5.5%). The commonest presenting symptoms were genital rash (43%), genital soreness, pain or burning (17.5%), and penile lesions (15.7%). Lichen sclerosus and all forms of balanitis were more common in uncircumcised patients, whereas lichen planus was more common in circumcised males. Short-term outcome was excellent, with 11.5% of patients being reassured and discharged on their first visit, and after 6 months 58% of all patients were clear and 12% had improved. Only 4.5% reported no improvement in symptoms. Diagnostic biopsy demonstrated malignant or premalignant lesions in nearly a fifth of those having a procedure. Close working with urological and genitourinary medicine colleagues is important to manage the various aspects of male health.

http://ift.tt/2t0hRd4

Meta-analyses of RELN variants in neuropsychiatric disorders

Publication date: 14 August 2017
Source:Behavioural Brain Research, Volume 332
Author(s): Na Chen, Yanping Bao, Yanxue Xue, Yan Sun, Die Hu, Shiqiu Meng, Lin Lu, Jie Shi
Reelin is a critical extracellular matrix glycoprotein and implicated in neurodevelopment and psychiatric disorders in animal model studies. The genetic polymorphism of RELN has also been reported to be associated with several psychiatric disorders, but the results remain controversial. Here, we conducted meta-analyses of RELN gene SNPs and related neuropsychiatric disorders (schizophrenia, autistic spectrum disorders, attention-deficit hyperactivity disorder, Alzheimer's disease and bipolar disorders). A total of 12 SNPs (rs736707, rs362691, rs607755, rs2229864, rs7341475, rs262355, rs362719, rs11496125, g.-888G>C, rs2299356, rs528528, and rs4298437) in RELN gene were included into meta-analyses. Subgroup analyses based on ethnicity were performed. We found that RELN rs736707 was significantly related with psychiatric disorders (schizophrenia, autism spectrum disorders and attention-deficit hyperactivity disorder) in Asian group (C vs T, OR=1.26, 95% CI=1.13–1.41, P<0.01, FDR<0.01), and rs7341475 was only significantly associated with reduced risk of schizophrenia in Caucasian (A vs G, OR=0.88, 95% CI=0.82–0.95, P<0.01, FDR<0.01). No association of other SNPs and psychiatric disorders is found. These findings suggest a role of RELN SNPs in psychiatric diseases, and indicate that further researches in populations with different genetic background and studies with larger sample size are of great value.



http://ift.tt/2rRShYd

Companion of oral movements with limb movements in patients with sleep bruxism: preliminary findings

Sleep bruxism (SB) patients show a higher incidence of leg movements than normal subjects.

http://ift.tt/2saa14r

The MO-meatocanalplasty: a modification of the M-meatoplasty to address the superior quadrants and the bony canal

Abstract

The meatoplasty of the external auditory canal is a frequently performed otologic procedure in recurrent otitis externa, eczema or frequent accumulation of cerumen due to a narrow meatus of the external ear canal. Numerous surgical techniques have been described. The M-meatoplasty described by Mirck for addressing the external meatus is widely used. However, this technique does not sufficiently enlarge the external ear canal in all cases. Specifically in patients where the ear canal narrowing is most prominent in the postero- and/or anterosuperior quadrants of the lateral meatus the technique needs some modifications. In these cases, an oblique conversion of the M-meatoplasty, the MO-meatocanalplasty, is useful. In cases where the bony canal is also narrow this modification allows for a bony canalplasty while avoiding a retro-auricular approach. The MO-meatocanalplasty can be used in combination with myringoplasty and tympanoplasty.

http://ift.tt/2rS9m4x

The MO-meatocanalplasty: a modification of the M-meatoplasty to address the superior quadrants and the bony canal

Abstract

The meatoplasty of the external auditory canal is a frequently performed otologic procedure in recurrent otitis externa, eczema or frequent accumulation of cerumen due to a narrow meatus of the external ear canal. Numerous surgical techniques have been described. The M-meatoplasty described by Mirck for addressing the external meatus is widely used. However, this technique does not sufficiently enlarge the external ear canal in all cases. Specifically in patients where the ear canal narrowing is most prominent in the postero- and/or anterosuperior quadrants of the lateral meatus the technique needs some modifications. In these cases, an oblique conversion of the M-meatoplasty, the MO-meatocanalplasty, is useful. In cases where the bony canal is also narrow this modification allows for a bony canalplasty while avoiding a retro-auricular approach. The MO-meatocanalplasty can be used in combination with myringoplasty and tympanoplasty.

http://ift.tt/2rS9m4x

Clinical outcomes in a specialist male genital skin clinic: prospective follow-up of 600 patients

Summary

It is important to assess outcomes for medical interventions in order to focus scarce resources on outcomes with a known positive benefit. An open, observational study was performed to assess the clinical outcomes of 600 male patients with a genital skin problem attending a specialist secondary care dermatology facility. Patients were mainly referred by general practitioners and genitourinary medicine physicians. Outcome was measured at 3 and 6 months, and was determined by clinical examination and assessment of patient symptoms. The mean age of the group was 45.3 years. The commonest diagnoses were lichen sclerosus (30.5%), balanitis (17.3%), eczema (12.8%), lichen planus (7.3%), psoriasis (7.2%) and benign lesions (5.5%). The commonest presenting symptoms were genital rash (43%), genital soreness, pain or burning (17.5%), and penile lesions (15.7%). Lichen sclerosus and all forms of balanitis were more common in uncircumcised patients, whereas lichen planus was more common in circumcised males. Short-term outcome was excellent, with 11.5% of patients being reassured and discharged on their first visit, and after 6 months 58% of all patients were clear and 12% had improved. Only 4.5% reported no improvement in symptoms. Diagnostic biopsy demonstrated malignant or premalignant lesions in nearly a fifth of those having a procedure. Close working with urological and genitourinary medicine colleagues is important to manage the various aspects of male health.

http://ift.tt/2t0hRd4

Atypical neurofibromatosis type 1 with unilateral limb hypertrophy mimicking overgrowth syndrome

Summary

Neurofibromatosis type 1 (NF1; OMIM 162200), a dominantly inherited multitumor syndrome, results from mutations in the Neurofibromin 1 (NF1) gene. We present the case of a Hungarian woman with the clinical phenotype of NF1 over her whole body and the clinical features of unilateral overgrowth involving her entire left leg. This unusual phenotype suggested either the atypical form of NF1 or the coexistence of NF1 and overgrowth syndrome. Direct sequencing of the genomic DNA isolated from peripheral blood revealed a novel frameshift mutation (c.5727insT, p.V1909fsX1912) in the NF1 gene. Next-generation sequencing of 50 oncogenes and tumour suppressor genes, performed on the genomic DNAs isolated from tissue samples and peripheral blood, detected only wild-type sequences. Based on these results, we concluded that the patient is affected by an unusual phenotype of NF1, and that the observed unilateral overgrowth of the left leg might be a rare consequence of the identified c.5727insT mutation.

http://ift.tt/2s28kVG

Sinus hypoplasia in the cystic fibrosis rat resolves in the absence of chronic infection

Background

Sinus hypoplasia is a hallmark characteristic in cystic fibrosis (CF). Chronic rhinosinusitis (CRS) is nearly universal from a young age, impaired sinus development could be secondary to loss of the cystic fibrosis transmembrane conductance regulator (CFTR) or consequences of chronic infection during maturation. The objective of this study was to assess sinus development relative to overall growth in a novel CF animal model.

Methods

Sinus development was evaluated in CFTR^−/− and CFTR^+/+ rats at 3 stages of development: newborn; 3 weeks; and 16 weeks. Microcomputed tomography (microCT) scanning, cultures, and histology were performed. Three-dimensional sinus and skull volumes were quantified.

Results

At birth, sinus volumes were decreased in CFTR^−/− rats compared with wild-type rats (mean ± SEM: 11.3 ± 0.85 mm³ vs 14.5 ± 0.73 mm³; p < 0.05), despite similar weights (8.4 ± 0.46 gm vs 8.3 ± 0.51 gm; p = 0.86). CF rat weights declined by 16 weeks (378.4 ± 10.6 gm vs 447.4 ± 15.9 gm; p < 0.05), sinus volume increased similar to wild-type rats (201.1 ± 3.77 gm vs 203.4 ± 7.13 gm; p = 0.8). The ratio of sinus volume to body weight indicates hypoplasia present at birth (1.37 ± 0.12 vs 1.78 ± 0.11; p < 0.05) and showed an increase compared with CFTR^+/+ animals by 16 weeks (0.53 ± 0.02 vs 0.46 ± 0.02; p < 0.05). Rats did not develop histologic evidence of chronic infection.

Conclusion

CF rat sinuses are smaller at birth, but develop volumes similar to wild-type rats with maturation. This suggests that loss of CFTR may confer sinus hypoplasia at birth, but normal development ensues without chronic sinus infection. ©2017 ARSAAOA, LLC.

http://ift.tt/2rcgXZK

Congenital Vomer Agenesis: Report of Two Cases.

Related Articles

Congenital Vomer Agenesis: Report of Two Cases.

Iran J Otorhinolaryngol. 2017 May;29(92):171-174

Authors: Bakhshaee M, Tavakol S, Teimouri Y

Abstract
INTRODUCTION: Congenital vomer agenesis is an extremely rare condition in which the vomer bone does not fully develop, which can lead to septal perforation.
CASE REPORT: We report two cases with a defect in the vomer bone in the posteroinferior portion of the septum, found accidentally while performing a pre-operative CT scan for nasal obstruction evaluation. They were diagnosed with congenital vomer agenesis.
CONCLUSION: There are afew reports of vomer agenesis in literatures. By increasing usage of sinonasal endoscopic examination,we expect to address more cases in the future.

PMID: 28589112 [PubMed - in process]

http://ift.tt/2r53cB2

Chondroradionecrosis of the Larynx in a Patient with Laryngeal: A Case Report.

Related Articles

Chondroradionecrosis of the Larynx in a Patient with Laryngeal: A Case Report.

Iran J Otorhinolaryngol. 2017 May;29(92):179-180

Authors: Ahmadi A, Salem MM, Safdarian M, Ilkhani S, Hamidian R, Cheraghipour M, Daneshvar A, Izadi F

Abstract
INTRODUCTION: Actinomycosis of the larynx has been rarely reported in the literature and usually occurs in patients with a history of laryngeal carcinoma and radiation therapy. However, its co-existence with chondroradionecrosis due to radiotherapy is even rarer. The most common site of infection is the cervicofacial region, especially in the submandibular area.
CASE REPORT: Here we report a 63-year-old male with a history of chemoradiotherapy because of laryngeal cancer 1 year earlier who presented with laryngeal actinomycosis. After prolonged penicillin-based treatment, the patient underwent thyroid cartilage defect reconstructive surgery because of a laryngocutaneous fistula due to chondroradionecrosis. The diagnosis, work-up, and management of the case are discussed, as well as a review of the literature.
CONCLUSION: Although actinomycotic infection of the larynx is rare, it should be considered in the differential diagnosis of laryngeal complaints, especially in immunocompromised patients.

PMID: 28589113 [PubMed - in process]

http://ift.tt/2sGiMjs

Acute Otitis Media-Induced Gradenigo Syndrome, a Dramatic Response to Intravenous Antibiotic.

Related Articles

Acute Otitis Media-Induced Gradenigo Syndrome, a Dramatic Response to Intravenous Antibiotic.

Iran J Otorhinolaryngol. 2017 May;29(92):165-169

Authors: Kazemi T

Abstract
INTRODUCTION: Petrositis is a rare but severe complication of acute otitis media and mastoiditis. Despite efficient antibiotic therapy, there are still reports of both intratemporal and intracranial complications of otitis media with the potential risk of high morbidity and mortality. Petrositis has traditionally been treated with surgery, but recent advances in imaging, with improved antibiotic treatment, allow more conservative management.
CASE REPORT: In this case report we describe the clinical course and treatment of a 33-year-old man with petrous apicitis who presented with severe otalgia, retro-orbital pain, and sixth cranial nerve palsy Gradenigo syndrome. Our patient showed a dramatic response to intravenous antibiotics only, without need for any surgical intervention, even myringotomy.
CONCLUSION: It seems that early detection and management of this syndrome before development of other intratemporal or intracranial complications may prevent the need for surgical intervention.

PMID: 28589111 [PubMed - in process]

http://ift.tt/2s24qMG

Laryngo-Tracheo-Bronchial Foreign Bodies in Children: Clinical Presentations and Complications.

Related Articles

Laryngo-Tracheo-Bronchial Foreign Bodies in Children: Clinical Presentations and Complications.

Iran J Otorhinolaryngol. 2017 May;29(92):155-159

Authors: Amer HS, El-Anwar MW, Raafat A, AlShawadfy M, Sobhy E, Ahmed SA, Maaty AM

Abstract
INTRODUCTION: Foreign-body (FB) aspiration in the airway of children is a life-threatening clinical situation responsible for many deaths each year. The aim of this study was to evaluate the different clinical presentations, methods of diagnosis, types and complications of FB inhalation in the pediatric age group.
MATERIALS AND METHODS: The study included patients who presented with a definitive or suspicious history of FB aspiration. Detailed data for each patient were recorded concerning the age, sex, nature and site of the FB, presenting symptoms and signs, and radiological findings.
RESULTS: Fifty-six patients were enrolled in this study. The age of patients ranged from 6 months to 14 years, with a mean age of 4.5 years. Sixty percent of patients were under 3 years of age. The time interval between aspiration of foreign body and onset of diagnosis ranged from 2 hours to 5 months. Thirty-four (60.7%) patients had normal chest X-ray findings, while opaque FB was seen in eight patients (14.3%). Signs of bronchitis were seen in five patients (9%), while pneumonia and atelectasis were seen in six (10.7%) and three cases (5.3%), respectively.
CONCLUSION: FB aspiration is a life-threatening clinical situation, with children <3 years of age being most commonly affected. FB aspiration must be considered a matter of emergency, especially in the case of organic FBs. This study aimed to increase the awareness of laryngo-tracheo-bronchial FBs, as early diagnosis and management decrease the incidence of complications and make removal of aspirated FB easier.

PMID: 28589109 [PubMed - in process]

http://ift.tt/2sZO0BJ

Asthma and Allergic Rhinitis Correlation in Palm Tree Workers of Jahrom City in 2016.

Related Articles

Asthma and Allergic Rhinitis Correlation in Palm Tree Workers of Jahrom City in 2016.

Iran J Otorhinolaryngol. 2017 May;29(92):147-154

Authors: Farahmand Fard MA, Khanjani N, Arabi Mianroodi A, Ashrafi Asgarabad A

Abstract
INTRODUCTION: Allergic rhinitis and asthma can be related to occupation. The present study aimed to investigate the correlation between asthma or allergic rhinitis and employment in the palm tree gardens of Jahrom, Iran.
MATERIALS AND METHODS: This was a cross-sectional study including 50 palm tree garden workers and a control group of 50 office employees. Data collection included demographics, as well as standard International Study of Asthma and Allergies in Childhood (ISAAC) and A New Symptom-Based Questionnaire for Predicting the Presence of Asthma (ASQ) questionnaires. Data were analyzed using SPSS22. Descriptive statistics, chi-square test, t-test, and logistics regression were used to analyze data.
RESULTS: The correlation between asthma and occupation was significant ( P=0.046); and asthma prevalence was higher in palm tree garden workers. However, no relationship was observed between age, duration of employment, smoking cigarettes, hookah, or opium addiction with asthma. Furthermore, in this study, no significant relation was observed between the prevalence of asthma and contact with dust, contact with pets' skin and hair, family history of asthma, or the use of perfume and air freshener. The symptoms of allergic rhinitis (including sneezing, runny nose, and blocked nose) were significantly greater in palm tree garden workers (P=0.038). These symptoms in both workers and office employees were higher in spring.
CONCLUSION: In our study, allergic rhinitis and asthma were more common in palm tree garden workers than in the general population. According to our study, people working in this occupation should take necessary precautions.

PMID: 28589108 [PubMed - in process]

http://ift.tt/2t01ptr

Head and Neck Cancers in North-East Iran: A 25 year Survey.

Related Articles

Head and Neck Cancers in North-East Iran: A 25 year Survey.

Iran J Otorhinolaryngol. 2017 May;29(92):137-145

Authors: Emadzadeh M, Shahidsales S, Mohammadian Bajgiran A, Salehi M, Massoudi T, Nikfarjam Z, Salehi M

Abstract
INTRODUCTION: Cancers are among the worst noncommunicable diseases around the world. Head and neck cancers are ranked as the fifth most common cancers worldwide. As there are different distributions of risk factors around the world, the incidence of these cancers varies from one place to another.
MATERIALS AND METHODS: We conducted a descriptive analytic cross-sectional study, based on census-based records from the private oncology clinic in Mashhad, Iran. Data from 1,075 patients with head and neck cancers were analyzed from 1986 to 2010. We categorized the duration of study into five periods: 1986-1990, 1991-1995, 1996-2000, 2001-2005, and 2006-2010. Head and neck cancers refers to cancers originating from seven sites in the head and neck including the nasal cavity, oral cavity, pharynx, larynx, salivary glands, paranasal sinuses, and thyroid.
RESULTS: Data of 1,075 patients were analyzed. 66.2% were male. Mean ± standard deviation (SD) age at the time of diagnosis was 55.37±15.55 years. The most frequent type of head and neck cancer was larynx cancer (36%), followed by pharynx (28.5%), oral (17.5%), thyroid (6.8%), sinus (6.4%), salivary gland (4.10%), and nasal cancer (0.70%). although larynx cancer was the most frequent cancer over the whole study duration, there was a significant (P=0.04) difference in the relative frequency of these cancers across the five time periods. There was a significant difference in mean age between cancer categories (P<0.001). The only cancer with a different mean age at different time periods was pharynx cancer (P=0.02). There was a significant difference between sex and cancer categories (P<0.001).
CONCLUSION: Laryngeal cancer was the most common head and neck cancer over the whole duration of this study. The differences in the patterns of other head and neck cancers could be due to geographical differences and also different risk factors and lifestyles all over the world. Further investigations in these fields are suggested in future studies.

PMID: 28589107 [PubMed - in process]

http://ift.tt/2sGbk81

Rate of Occult Cervical Lymph Node Involvement in Supraglottic Squamous Cell Carcinoma.

Related Articles

Rate of Occult Cervical Lymph Node Involvement in Supraglottic Squamous Cell Carcinoma.

Iran J Otorhinolaryngol. 2017 May;29(92):133-136

Authors: Motiee Langroudi M, Amirzargar B, Amali A, Sadeghi M, Jafar M, Hoseini MR, Tavakolnejad F

Abstract
INTRODUCTION: To assess the rate of cervical lymph node involvement in patients with supraglottic squamous cell carcinoma (SCC) with no lymph node in clinical assessments and radiological studies.
MATERIALS AND METHODS: Fifty-six patients who underwent elective dissection of the cervical lymph node of the second through fourth level were enrolled, and pathologic evaluation of the dissected lymph nodes was performed. Lymph node involvement and association between tumor grade, smoking and gender with lymph node involvement were assessed.
RESULTS: The rate of the occult neck metastasis in this series was 37.5%. There was no statistically significant association between lymph node involvement and tumor grade, smoking, or gender.
CONCLUSION: Based on the results of our study, we recommend elective bilateral neck dissection in all stages of N0 supraglottic SCC patients.

PMID: 28589106 [PubMed - in process]

http://ift.tt/2s23jMN

The Prevalence of Hearing Loss in Patients with Hepatitis B Infection Compared with Healthy Volunteers.

Related Articles

The Prevalence of Hearing Loss in Patients with Hepatitis B Infection Compared with Healthy Volunteers.

Iran J Otorhinolaryngol. 2017 May;29(92):127-132

Authors: Gholami Parizad E, Gerami Matin H, Gholami Parizad E, Khosravi A

Abstract
INTRODUCTION: Hepatitis B virus is a virus that creates significant hepatic and extra-hepatic complications, with widespread prevalence across the community and body systemic involvement, and can impact on hearing performance. This study aims to evaluate hearing loss among individuals with hepatitis B compared with healthy subjects.
MATERIALS AND METHODS: In this case-control study, 83 HBsAg-positive patients with a 1-year history of disease were selected for pure tone audiometry (PTA) testing, while 108 HBsAg-negative patients were selected as the control group. Subjects in both groups were aged 20-40 years. The threshold was set at 25 db for hearing loss. Final data were analyzed using SPSS software.
RESULTS: Significant differences were found between the case group and control group in average PTA and hearing loss. There was also a significant difference between the two groups in average PTA at frequencies of 250, 4,000, and 8,000 Hz, but not at speech frequencies of 500, 1,000 and 2,000 Hz, despite the difference in average PTA.
CONCLUSION: According to significant differences in average PTA between patients with hepatitis B virus and healthy subjects in this study, hearing loss may be attributed to the presence HBV of in the patient group.

PMID: 28589105 [PubMed - in process]

http://ift.tt/2s24nR0

Intratympanic Injection of Dexamethasone and Electrocochleographic Data in Cases of Definite One Sided Refractory Meniere's Disease.

Related Articles

Intratympanic Injection of Dexamethasone and Electrocochleographic Data in Cases of Definite One Sided Refractory Meniere's Disease.

Iran J Otorhinolaryngol. 2017 May;29(92):121-125

Authors: Dabiri Satri S, Gharibi R, Nejadian F, Yazdani N, Hoseinabadi R, Rezazadeh N, Firouzifar MR, Babaei S

Abstract
INTRODUCTION: Meniere's disease (MD) is a disease of the inner ear that presents itself with repeated episodes of vertigo (96.2%), tinnitus (91.1%), and sensorineural hearing loss (87.7 %). In this article we sought to assess the effects of intratympanic (IT) injections of dexamethasone on definite cases of MD using electrocochleography (ECOG).
MATERIALS AND METHODS: In this hospital-based case series in 36 patients, we measured audiometric values and ECOG in all patients before, 1 month and 6 months after 4-mg/mL IT injections of dexamethasone.
RESULTS: Four patients (11%) had improved hearing following the intervention. No difference in pure tone audiometry (PTA) was observed following IT injections (P=0.492), while speech discrimination score (SDS) was significantly improved (P=0.008). There was a significant improvement in vertigo 1 month after IT injections (P<0.001), although this effect did not last for 6 months. No significant change in ECOG was observed between before and after treatment (P=0.052).
CONCLUSION: IT dexamethasone injections can improve vertigo in definite cases of MD, although it seems that the effect is only temporary.

PMID: 28589104 [PubMed - in process]

http://ift.tt/2r5h1PE

Efficacy of Autologous Platelet-rich Plasma Glue in Weight Loss Sequelae Surgery and Breast Reduction: A Prospective Study: Erratum

No abstract available

http://ift.tt/2pv0EWX

Technical Tip: Mark Scarpa's Fascia to Facilitate Proper Abdominal Closure During Autologous Breast Reconstruction

No abstract available

http://ift.tt/2qQX2n1

A 10-year Follow-up of a Free Vascularized Fibula Flap Clavicle Reconstruction in an Adult

Summary: The free vascularized fibula flap has been widely used for clavicle reconstruction. Limited evidence exists for the long-term outcome of clavicle reconstruction using the free vascularized fibula flap in adults. We report the functional and aesthetic outcome in a 52-year old man a decade after clavicle reconstruction using a free vascularized fibula flap in combination with a modified Richardson Hook Plate. At the 10-year follow-up, panoramic shoulder X-ray showed the modified Richardson Hook Plate had remained firmly in place with the fibula and the hook positioned beneath the acromion. Functionally, the patient presented with a constant shoulder score of 77, with a pain-free symmetrical full range of motion. In conclusion, reconstruction of lateral clavicle defect using free vascularized fibula flap in conjunction with modified Richardson Hook plate may provide patients with excellent long-term functional and aesthetic outcomes.

http://ift.tt/2q99zkl

Sinus hypoplasia in the cystic fibrosis rat resolves in the absence of chronic infection

Background

Sinus hypoplasia is a hallmark characteristic in cystic fibrosis (CF). Chronic rhinosinusitis (CRS) is nearly universal from a young age, impaired sinus development could be secondary to loss of the cystic fibrosis transmembrane conductance regulator (CFTR) or consequences of chronic infection during maturation. The objective of this study was to assess sinus development relative to overall growth in a novel CF animal model.

Methods

Sinus development was evaluated in CFTR^−/− and CFTR^+/+ rats at 3 stages of development: newborn; 3 weeks; and 16 weeks. Microcomputed tomography (microCT) scanning, cultures, and histology were performed. Three-dimensional sinus and skull volumes were quantified.

Results

At birth, sinus volumes were decreased in CFTR^−/− rats compared with wild-type rats (mean ± SEM: 11.3 ± 0.85 mm³ vs 14.5 ± 0.73 mm³; p < 0.05), despite similar weights (8.4 ± 0.46 gm vs 8.3 ± 0.51 gm; p = 0.86). CF rat weights declined by 16 weeks (378.4 ± 10.6 gm vs 447.4 ± 15.9 gm; p < 0.05), sinus volume increased similar to wild-type rats (201.1 ± 3.77 gm vs 203.4 ± 7.13 gm; p = 0.8). The ratio of sinus volume to body weight indicates hypoplasia present at birth (1.37 ± 0.12 vs 1.78 ± 0.11; p < 0.05) and showed an increase compared with CFTR^+/+ animals by 16 weeks (0.53 ± 0.02 vs 0.46 ± 0.02; p < 0.05). Rats did not develop histologic evidence of chronic infection.

Conclusion

CF rat sinuses are smaller at birth, but develop volumes similar to wild-type rats with maturation. This suggests that loss of CFTR may confer sinus hypoplasia at birth, but normal development ensues without chronic sinus infection. ©2017 ARSAAOA, LLC.

http://ift.tt/2rcgXZK

CMV-specific T Cell Monitoring Offers Superior Risk Stratification of CMV-seronegative Kidney Transplant Recipients of a CMV-seropositive Donor.

Background: Detectable CMV-specific T cells in CMV-seronegative kidney transplant recipients (KTRs) have been attributed to an absence of circulating antibodies despite CMV-sensitization. The diagnostic value of CMV-specific T cells, however, needs to be implemented in risk stratification for CMV-replication. Methods: 326 KTRs were studied and classified with respect to CMV-serostatus and presence of CMV-specific T cells. Samples were collected pretransplantation, at +1, +2, and +3 months posttransplantation. CMV-specific T cells directed to CMV-IE1 and CMV-pp65 were measured by interferon-[gamma] Elispot assay. Results: 19/67 D+R- KTRs (28%) showed pretransplant CMV-specific T cells. Although no differences were observed for CMV-replication, KTRs with CMV-specific T cells presented with lower initial and peak CMV-loads (p

http://ift.tt/2t0bZ3o

Blockade of HLA Antibody-Triggered Classical Complement Activation in Sera from Subjects Dosed with the Anti-C1s Monoclonal Antibody TNT009 - Results from a Randomized First-in-Human Phase 1 Trial.

Background: Complement may play a key role in antibody-mediated rejection (ABMR). A promising therapeutic approach may be classical pathway (CP) inhibition at the level of early component C1. Methods: In this first-in-human, double-blind, randomized placebo-controlled phase 1 trial, we evaluated the safety and complement inhibitory effect of TNT009, a humanized monoclonal anti-C1s antibody. Sixty-four adult healthy volunteers received either single (n=48; 7 consecutive cohorts: 0.3-100 mg/kg) or 4 weekly infusions (n=16; 2 consecutive cohorts: 30 and 60 mg/kg per infusion) of TNT009 or placebo. To assess the effect of treatment on complement activity, sera from dosed subjects were analysed in a CP activation assay evaluating C3d deposition on HLA-coated microbeads spiked with alloantibodies. Results: Single doses of TNT009 at 3-100 mg/kg uniformly and profoundly inhibited HLA antibody-mediated C3d deposition (>=86% after 60 min), whereby the duration of CP inhibition (2-14 days) was dose-dependent. Four weekly doses persistently blocked complement for 5-6 weeks. Ex vivo serum CP activity was profoundly inhibited when TNT009 concentrations exceeded 20 [mu]g/mL. Infusions were well tolerated without serious or severe adverse events. Conclusions: Treatment with TNT009 was safe and potently inhibited CP activity. Future studies in patients are required to assess the potential of TNT009 for preventing or treating ABMR. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2s2feub

DHRS9 is a Stable Marker of Human Regulatory Macrophages.

Background: The human regulatory macrophage (Mreg) has emerged as a promising cell type for use as a cell-based adjunct immunosuppressive therapy in solid organ transplant recipients. In this brief report, dehydrogenase/reductase 9 (DHRS9) is identified as a robust marker of human Mregs. Materials and Methods: The cognate antigen of a mouse monoclonal antibody raised against human Mregs was identified as DHRS9 by immunoprecipitation and MALDI-MS sequencing. Expression of DHRS9 within a panel of monocyte-derived macrophages was investigated by quantitative PCR, immunoblotting and flow cytometry. Results: DHRS9 expression discriminated human Mregs from a panel of in vitro derived macrophages in other polarisation states. Likewise, DHRS9 expression distinguished Mregs from a variety of human monocyte-derived tolerogenic antigen-presenting cells in current development as cell-based immunotherapies, including Tol-DC, Rapa-DC, DC-10 and PGE2-induced MDSC. A subpopulation of DHRS9-expressing human splenic macrophages was identified by immunohistochemistry. Expression of DHRS9 was acquired gradually during in vitro development of human Mregs from CD14+ monocytes and was further enhanced by IFN-[gamma] treatment on day 6 of culture. Stimulating Mregs with 100 ng/ml lipopolysaccharide for 24-hours did not extinguish DHRS9 expression. Dhrs9 was not an informative marker of mouse Mregs. Conclusion: DHRS9 is a specific and stable marker of human Mregs. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Inhibition of spleen tyrosine kinase reduces renal allograft injury in a rat model of acute antibody-mediated rejection in sensitized recipients.

Background: Organ transplantation into sensitized patients with preexisting donor-specific antibodies (DSA) is very challenging. Spleen tyrosine kinase (Syk) promotes leukocyte recruitment and activation via signalling through various cell surface receptors. We investigated whether a selective Syk inhibitor (GS-492429) could suppress antibody-mediated rejection (AMR) in a rat model of AMR in sensitized recipients. Methods: Recipient Lewis rats (RT1l) were immunized with donor (Dark Agouti, RT1av1) spleen cells (day -5). Recipients underwent bilateral nephrectomy and orthotopic renal transplantation (day 0). Cellular rejection was minimized by tacrolimus treatment from day -1. Groups received GS-492429 (30mg/kg/bid) (n=11) or vehicle (n=12) from 1hr before transplantation until being killed on day 3. Results: Vehicle treated recipients developed graft dysfunction on day 1 which rapidly worsened by day 3. Histology showed severe damage (thrombosis, acute tubular injury, capillaritis) and infiltration of many Syk+ leukocytes. GS-492429 did not affect graft dysfunction on day 1, but treatment reduced allograft damage and prevented the rapid deterioration of graft function on day 3. GS-492429 reduced the prominent macrophage infiltrate and reduced the M1 proinflammatory response. Neutrophil and NK cell infiltration and capillary thrombosis were also significantly reduced by GS-492429 treatment. Serum DSA levels and the deposition of IgG and C4d in the allograft were equivalent in the 2 groups. Conclusion: Treatment with a Syk inhibitor significantly reduced renal allograft injury in a model of severe antibody-mediated damage in highly sensitized recipients. Further studies are warranted to determine whether Syk inhibition is a potential adjunctive treatment in clinical AMR. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Effects of binary metal combinations on zinc, copper, cadmium and lead uptake and distribution in Brassica juncea

Publication date: December 2017
Source:Journal of Trace Elements in Medicine and Biology, Volume 44
Author(s): Kutrowska Agnieszka, Małecka Arleta, Piechalak Aneta, Masiakowski Waclaw, Hanć Anetta, Barałkiewicz Danuta, Andrzejewska Barbara, Zbierska Janina, Tomaszewska Barbara
The interaction between lead, copper, cadmium and zinc in their binary combinations was investigated in Indian mustard seedlings (Brassica juncea L. var. Malopolska). Fourteen-days-old seedlings were treated with Pb(NO3)2, CuSO4, CdCl2, ZnSO4 at 50μmol of metal ion concentration and at 25μmol of each metal ion in combinations. Metal combinations were generally more inhibiting in terms of biomass production. This inhibiting effect followed an order: Cu+Cd>Cu+Zn, Cd+Pb>Cu+Pb>Zn+Pb, Cu>Cd>Zn>Zn+Cd>Pb. We observed synergistic and antagonistic effects of metal uptake in binary metal treatments, suggesting metal crosstalk at the plant uptake site. Metal content in plant tissues varied among different combinations. The metal concentrations followed an order of Pb>Cu>Zn>Cd in roots, Zn>Cu>Pb>Cd in the stem and Zn>Cu>Cd>Pb in leaves. Presence of metals altered the distribution of micronutrients (Cu, Zn) in plants: Cu concentration was lowered in roots and leaves and increased in stems; Zn content was increased in plants, with stems having up to 4 or 5 times more Zn than in control plants.



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Sensitivity of the glochidia (larvae) of freshwater mussels (Bivalvia: Unionida: Hyriidae) to cadmium, cobalt, copper, lead, nickel and zinc: Differences between metals, species and exposure time

Publication date: 1 December 2017
Source:Science of The Total Environment, Volumes 601–602
Author(s): Scott J. Markich
Freshwater mussels (Bivalvia: Unionida) are among the most threatened freshwater faunal groups worldwide. Metal contamination is one threat that has been linked to declining mussel population distribution and abundance. This study determined the sensitivity (valve closure) of the glochidia (larvae) of six species of Australian freshwater mussels to cadmium (Cd), cobalt (Co), copper (Cu), lead (Pb), nickel (Ni) and zinc (Zn), key metal contaminants impacting urbanized coastal rivers in south-eastern Australia (home to ~50% of the population), in a soft reconstituted freshwater (hardness 42mgCaCO3L⁻¹; alkalinity 22mgCaCO3L⁻¹ and pH7.0) over 72h. The sensitivity of each mussel species to each metal increased 2.5-fold with increasing exposure time from 24 to 72h. The most sensitive mussel species (Cucumerunio novaehollandiae), across all metals and exposure times, was ~60% more sensitive than the least sensitive species (Velesunio ambiguus). The relative sensitivity of glochidia to the six selected metals, across all mussel species and exposure times, was: Cu>Cd>Pb>Co=Ni>Zn. Glochidia were most sensitive to Cu and least sensitive to Zn. Quantitatively, the toxicity of Cu was 3-fold more than Cd, 8-fold more than Pb, 14-fold more than Co or Ni and 16-fold more than Zn. The cell surface binding affinities (conditional log K values) of Cd (range 6.65–6.94), Co (6.04–6.29), Cu (7.17–7.46), Ni (6.02–6.29), Pb (6.24–6.53) or Zn (5.96–6.23), pooled for all mussel species after 72h exposure, were positively related to metal sensitivity. The chronic no effect concentrations (NECs) of Cu, Ni and Zn were below (i.e. glochidia were more sensitive than) their national freshwater guideline values, indicating that freshwater mussels may not be adequately protected for these metals in urbanized coastal rivers within south-eastern Australia.

Graphical abstract

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Clinical outcomes of female breast cancer according to BRCA mutation status

Publication date: August 2017
Source:Cancer Epidemiology, Volume 49
Author(s): Deirdre P. Cronin-Fenton, Anders Kjærsgaard, Mette Nørgaard, Inge Søkilde Pedersen, Mads Thomassen, James A. Kaye, Lia Gutierrez, Claire Telford, Jan Lewis, Jerzy E. Tyczynski, Henrik Toft Sørensen
BackgroundTo investigate breast cancer prognosis (disease-free (DFS) and overall survival (OS)) among carriers of germline BRCA mutations (BRCAm) in Denmark.MethodsWe identified all women in Central and Northern Denmark diagnosed with breast cancer during 2004–2011. We retrieved information on germline BRCAm testing from Clinical Genetics departments and clinical/treatment characteristics from population-based medical registries. Follow-up for recurrence, new primary cancer, and mortality extended from 180days after diagnosis until 31/12/2012. We estimated median DFS and OS and five-year cumulative incidence and incidence rates (IR/1000 person-years), and 95% confidence intervals (95% CI), for each outcome.ResultsAmong 9874 patients, 523 (5%) underwent BRCA testing—90 were BRCAm carriers, 433 were BRCA wildtype (BRCAwt). Compared with BRCAwt women, BRCAm carriers were younger, had lower stage, and ER- and HER2- tumors. Median time from diagnosis to BRCA testing was 0.91 years and 1.3 years in BRCAm and BRCAwt women; median follow-up to first event was 3.9 and 3.4 years, respectively. Five-year DFS and OS were higher in BRCAm than BRCAwt women: 88% (95%CI=78.3–93.5) vs. 75.3% (95%CI=70.2–79.6) and 97.8% (95%CI=91.4–99.4) vs 92.2% (95%CI=88.5–94.7), respectively. Five-year IRs of recurrence were 36.7/1000 person-years (95%CI=15.8–72.2) in the BRCAm cohort vs. 58.4 (95%CI=42.9–77.6) in the BRCAwt cohort.ConclusionsBRCAm carriers may have a better prognosis than BRCAwt women. However, limited testing conducted mainly during follow-up, yielded low numbers for precise estimations, and may be attributable to selection bias.



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Subcutaneous lipomas: A minimally invasive method for resection of subcutaneous lipomas preserving retaining ligaments

Abstract

Background

Lipomas are common benign tumors usually located in the subcutaneous tissues. Resection of lipomas frequently requires incisions equal to the diameter of the tumor. The "squeeze technique" with a small incision is well-described, but is frequently not successful, particularly for lipomas in the shoulder region. We report a method for resection of subcutaneous lipomas that preserves retaining ligaments.

Methods

Lipomas are characterized by high signal intensity on T1- and T2-weighted images on magnetic resonance imaging. Retaining ligaments demonstrate low signal intensity on T1-weighted images and high signal intensity on T2-weighted images with fat-suppression. Through a 1 in. incision, lipomas were detached from the retaining ligaments bluntly with a finger. Tumors were then extracted either in a piecemeal fashion or with the "squeeze technique." Complete lipoma resection was visually confirmed through the incisions. For the current report, we analyzed 18 large lipomas resected by this method, with "large" defined as equal to or greater than 5 cm in diameter.

Results

The 18 patients included four males and 14 females with a mean age of 53.4 (26–72). The mean lipoma size was 6.6 cm [5–12]. Locations included the shoulder in nine cases (50%), the upper arm in five cases (28%), the back in two cases (11%), and the thigh in two cases (11%). Retaining ligaments were identified by MRI in all cases. Lipomas were located between retaining ligaments at the periphery of the tumor. All three lipomas larger than 10 cm were located in the shoulder. There was no difference in the technical difficulty of resection of these compared with lipomas less than 10 cm in diameter. There were no cases of chronic pain or residual hypoesthesia at the incision sites.

Conclusions

The method is an easy and minimally invasive way to achieve complete resection, even for large lipomas, regardless of anatomical location. The method may contribute to reduction of side effects including residual hypoesthesia and chronic pain at the incision site, due to the small incision and preservation of retaining ligaments, which may contain cutaneous nerves.

Level of Evidence: Level IV, therapeutic study.

http://ift.tt/2s287Sz

Reducing Uncertainty: Predictors of Stopping Chemotherapy Early and Shortened Survival Time in Platinum Resistant/Refractory Ovarian Cancer—The GCIG Symptom Benefit Study

AbstractBackground.Clinicians and patients often overestimate the benefits of chemotherapy, and overall survival (OS), in platinum resistant/refractory ovarian cancer (PRROC). This study sought to determine aspects of health‐related quality of life and clinicopathological characteristics before starting chemotherapy that were associated with stopping chemotherapy early, shortened survival, and death within 30 days of chemotherapy.Materials and Methods.This study enrolled women with PRROC before starting palliative chemotherapy. Health‐related quality of life was measured with EORTC QLQ‐C30/QLQ‐OV28. Chemotherapy stopped within 8 weeks of starting was defined as stopping early. Logistic regression was used to assess univariable and multivariable associations with stopping chemotherapy early and death within 30 days of chemotherapy; Cox proportional hazards regression was used to assess associations with progression‐free and OS.Results.Low baseline global health status (GHS), role function (RF), physical function (PF), and high abdominal/gastrointestinal symptom (AGIS) were associated with stopping chemotherapy early (all p < .007); low PF and RF remained significant after adjusting for clinicopathological factors (both p < .0401). Most who stopped chemotherapy early had Eastern Cooperative Oncology Group Performance Score 0–1 at baseline (79%); PF, RF, and GHS remained independently significant predictors of stopping chemotherapy early in this subgroup. Death within 30 days of chemotherapy occurred in 14%. Low GHS, RF, and PF remained significantly associated with death within 30 days of chemotherapy after adjusting for clinicopathological factors (all p < .012).Conclusion.Women with low GHS, RF, or PF before starting chemotherapy were more likely to stop chemotherapy early, with short OS. Self‐ratings of GHS, RF, and PF could improve patient‐clinician communication regarding prognosis and help decision‐making in women considering chemotherapy for PRROC. The Oncologist 2017;22:1–8Implications for Practice.Measuring aspects of health‐related quality of life when considering further chemotherapy in platinum resistant/refractory ovarian cancer (PRROC) could help identify women with a particularly poor prognosis who are unlikely to benefit from chemotherapy and could therefore be spared unnecessary treatment and toxicity in their last months of life. Self‐ratings of global health status, role function, and physical function could improve patient‐clinician communication regarding prognosis and help decision‐making in women considering chemotherapy for PRROC.

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Corrigendum to “Risk stratification and pattern of cardiotoxicity in pediatric Ewing sarcoma” [J. Egypt Natl. Cancer Instit. 29 (2017) 53–56]

Publication date: Available online 7 June 2017
Source:Journal of the Egyptian National Cancer Institute
Author(s): Emad Moussa, Manal Zamzam, Ahmed Kamel, Zeinab Salah, Iman Attia, Lina Gaber, Ranin Soliman, Sameera Ezzat




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Reduction in all-cause otitis media-related outpatient visits in children after PCV10 introduction in Brazil

by Ana L. Sartori, Ruth Minamisava, Ana L. Bierrenbach, Cristiana M. Toscano, Eliane T. Afonso, Otaliba L. Morais-Neto, José L. F. Antunes, Elier B. Cristo, Ana Lucia Andrade

Few studies have reported the effect of 10-valent pneumococcal conjugate vaccine (PCV10) on otitis media (OM) in infants. In particular, no population-based study in upper-middle income countries is available. In 2010, Brazil introduced PCV10 into its routine National Immunization Program using a 3+1 schedule. We measured the impact of PCV10 on all-cause OM in children. An interrupted time-series analysis was conducted in Goiânia/Brazil considering monthly rates (per 100,000) of all-cause OM outpatient visits in children aged 2–23 months. We used case-based data from the Outpatient Visits Information System of the Unified Health System coded for ICD-10 diagnosis for the period of August/2008 to July/2015. As a comparator, we used rates of outpatient visits due to all-other causes. The relative reduction of all-cause OM and all-other causes of outpatient visits were calculated as the difference between the predicted and observed cumulative rates of the PCV10 post-vaccination period. We then subtracted the relative reduction of all-other causes of outpatient visits from all-cause OM to obtain the impact of PCV10 on OM. In total, 6,401 OM outpatient visits were recorded in 4,793 children aged 2–23 months. Of these, 922 (19.2%) children had more than one OM episode. A significant reduction in all-cause OM visits was observed (50.7%; 95%CI: 42.2–59.2%; p = 0.013), while the reduction in visits due to all-other causes was 7.7% (95% CI 0.8–14.7%; p

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An Improved Three-Vessel Occlusion Model of Global Cerebral Ischemia in Rats

Publication date: Available online 8 June 2017
Source:Brain Research Bulletin
Author(s): Dmitriy N. Atochin, Galina A. Chernysheva, Oleg I. Aliev, Vera I. Smolyakova, Anton N. Osipenko, Sergey V. Logvinov, Anna A. Zhdankina, Tatiana M. Plotnikova, Mark B. Plotnikov
We developed an improved three-vessel occlusion model of global cerebral ischemia in rats. This method consists in cessation of cerebral blood flow by accessing a. carotis communis sin. through the ventral surface of the neck as well as tr. brachiocephalicus and a. subclavia sinistra through the first intercostal space, bypassing the pleural cavity and excluding pneumothorax. After the occlusion of the vessels that resulted in interruption of their blood flow, according to laser-Doppler flowmetry, there was a sharp decline in local cerebral blood flow in the visual cortex to 4±1% of the initial level. After restoring the level of local cerebral blood flow at the 5th minute, 10th minute, 20th minute and 24th hour of reperfusion, the levels of local cerebral blood flow were 51±7%, 41±5%, 35±8% and 54±9% of the initial level, respectively. Histo-quantitative analysis of changes in neurons of the hippocampus of rats showed that after ischemic injury, the numerical density of neurons in hippocampal zone CA1 in the observed 1mm² region decreased by 29%, 22%, and 35%, respectively, compared to sham-operated animals (p<0.05). By the first day after global cerebral ischemia, the experimental group had shown a mean neurological deficit score equal to 7.5±1.0 and 7.9±0.7 points, followed by a decrease up to score 6.5±1.1 and 5.9±0.7 on the third day, 4.6±0.8 and 4.7±0.5 on the fifth day (on chloral hydrate and propofol anesthesia correspondently).

Graphical abstract

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Different patterns of changes between actin dynamics and synaptic density in the rat’s primary visual cortex during a special period of visual development

Publication date: Available online 8 June 2017
Source:Brain Research Bulletin
Author(s): Mei-Qing Chen, Ai-Ling Bi, Yue-Ying Zhang, Qin Yan, Yuan-Yuan Sun, Xiu-Yan Zhang, Xian-Zhen Ma, Hong-Sheng Bi
In our previous study, we found that the normalized levels of the synaptosomal filament actin (F-actin) to monomeric global actin (G-actin) ratio in the primary visual cortex (V1) of rats was significantly lower on postnatal day (P) 45 compared with P30, however, the synaptic density in the monocular area of primary visual cortex (V1M) maintained a stable high level from P30 to P45. The mechanisms underlying the different patterned of change in synaptic density and actin rearrangements from P30 to P45 are unclear. During visual development, there is a synaptic pruning process in the binocular segment of primates' visual cortex (V1B) and we suppose the pruning activity may contribute to the decreased synaptosomal F-actin to G-actin ratio. To address this issue, first, samples were derived from the region of V1B for TEM analysis but no significant difference was demonstrated between the P30 and P45 groups. In addition, the expression of PSD-95 detected by immunobloting in the synaptosomes of V1 at P30 and P45 also showed no significant difference. Combined with the previous results of actin dynamics in the V1 and synaptic density in the V1M, we conclude that the synaptic density and actin dynamics in the rats' primary visual cortex are inter-related but not absolutely identical. This study suggests actin cytoskeleton not only provides the structural basis but also regulates a various array of cellular activities underlying synaptic function. Besides, it highlights a further research of synaptic pruning.



http://ift.tt/2t0ea70

Reduction in all-cause otitis media-related outpatient visits in children after PCV10 introduction in Brazil

by Ana L. Sartori, Ruth Minamisava, Ana L. Bierrenbach, Cristiana M. Toscano, Eliane T. Afonso, Otaliba L. Morais-Neto, José L. F. Antunes, Elier B. Cristo, Ana Lucia Andrade

Few studies have reported the effect of 10-valent pneumococcal conjugate vaccine (PCV10) on otitis media (OM) in infants. In particular, no population-based study in upper-middle income countries is available. In 2010, Brazil introduced PCV10 into its routine National Immunization Program using a 3+1 schedule. We measured the impact of PCV10 on all-cause OM in children. An interrupted time-series analysis was conducted in Goiânia/Brazil considering monthly rates (per 100,000) of all-cause OM outpatient visits in children aged 2–23 months. We used case-based data from the Outpatient Visits Information System of the Unified Health System coded for ICD-10 diagnosis for the period of August/2008 to July/2015. As a comparator, we used rates of outpatient visits due to all-other causes. The relative reduction of all-cause OM and all-other causes of outpatient visits were calculated as the difference between the predicted and observed cumulative rates of the PCV10 post-vaccination period. We then subtracted the relative reduction of all-other causes of outpatient visits from all-cause OM to obtain the impact of PCV10 on OM. In total, 6,401 OM outpatient visits were recorded in 4,793 children aged 2–23 months. Of these, 922 (19.2%) children had more than one OM episode. A significant reduction in all-cause OM visits was observed (50.7%; 95%CI: 42.2–59.2%; p = 0.013), while the reduction in visits due to all-other causes was 7.7% (95% CI 0.8–14.7%; p

http://ift.tt/2rQvjRk

Plant metabolism as studied by NMR spectroscopy

Publication date: Available online 8 June 2017
Source:Progress in Nuclear Magnetic Resonance Spectroscopy
Author(s): Catherine Deborde, Annick Moing, Léa Roch, Daniel Jacob, Dominique Rolin, Patrick Giraudeau
The study of plant metabolism impacts a broad range of domains such as plant cultural practices, plant breeding, human or animal nutrition, phytochemistry and green biotechnologies. Plant metabolites are extremely diverse in terms of structure or compound families as well as concentrations. This review attempts to illustrate how NMR spectroscopy, with its broad variety of experimental approaches, has contributed widely to the study of plant primary or specialized metabolism in very diverse ways. The review presents recent developments of one-dimensional and multi-dimensional NMR methods to study various aspects of plant metabolism. Through recent examples, it highlights how NMR has proved to be an invaluable tool for the global characterization of sample composition within metabolomic studies, and shows some examples of use for targeted phytochemistry, with a special focus on compound identification and quantitation. In such cases, NMR approaches are often used to provide snapshots of the plant sample composition. The review also covers dynamic aspects of metabolism, with a description of NMR techniques to measure metabolic fluxes – in most cases after stable isotope labelling. It is mainly intended for NMR specialists who would be interested to learn more about the potential of their favourite technique in plant sciences and about specific details of NMR approaches in this field. Therefore, as a practical guide, a paragraph on the specific precautions that should be taken for sample preparation is also included. In addition, since the quality of NMR metabolic studies is highly dependent on approaches to data processing and data sharing, a specific part is dedicated to these aspects. The review concludes with perspectives on the emerging methods that could change significantly the role of NMR in the field of plant metabolism by boosting its sensitivity. The review is illustrated throughout with examples of studies selected to represent diverse applications of liquid-state or HR-MAS NMR.

Graphical abstract

http://ift.tt/2rGOIpq

Biocontrol of the toxigenic plant pathogen Fusarium culmorum by soil fauna in an agroecosystem

Abstract

In 2011 and 2013, a field experiment was conducted in a winter wheat field at Adenstedt (northern Germany) to investigate biocontrol and interaction effects of important members of the soil food web (Lumbricus terrestris, Annelida; Folsomia candida, Collembola and Aphelenchoides saprophilus, Nematoda) on the phytopathogenic fungus Fusarium culmorum in wheat straw. Therefore, soil fauna was introduced in mesocosms in defined numbers and combinations and exposed to either Fusarium-infected or non-infected wheat straw. L. terrestris was introduced in all faunal treatments and combined either with F. candida or A. saprophilus or both. Mesocosms filled with a Luvisol soil, a cover of different types of wheat straw and respective combinations of faunal species were established outdoors in the topsoil of a winter wheat field after harvest of the crop. After a time span of 4 and 8 weeks, the degree of wheat straw coverage of mesocosms was quantified to assess its attractiveness for the soil fauna. The content of Fusarium biomass in residual wheat straw and soil was determined using a double-antibody sandwich (DAS)-ELISA method. In both experimental years, the infected wheat straw was incorporated more efficiently into the soil than the non-infected control straw due to the presence of L. terrestris in all faunal treatments than the non-infected control straw. In addition, Fusarium biomass was reduced significantly in all treatments after 4 weeks (2011: 95–99%; 2013:15–54%), whereupon the decline of fungal biomass was higher in faunal treatments than in non-faunal treatments and differed significantly from them. In 2011, Fusarium biomass of the faunal treatments was below the quantification limit after 8 weeks. In 2013, a decline of Fusarium biomass was observed, but the highest content of Fusarium biomass was still found in the non-faunal treatments after 8 weeks. In the soil of all treatments, Fusarium biomass was below the quantification limit. The earthworm species L. terrestris revealed a considerable potential as an effective biocontrol agent contributing to a sustainable control of a Fusarium plant pathogen in wheat straw, thus reducing the infection risk for specific plant diseases in arable fields.

http://ift.tt/2s97eZ1

Comparison of Techniques to Determine Human Skeletal Muscle Voluntary Activation

Publication date: Available online 8 June 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Anastasia Zarkou, Scott Stackhouse, Stuart A. Binder-Macleod, Samuel C.K. Lee
Determining volitional activation (VA) can provide insights on the cause of muscle weakness in orthopedic and neurological populations. Two electrical stimulation techniques are traditionally used to quantify VA: interpolation (IT) and superimposition (CAR). IT allows for a more accurate VA estimation, however it requires individuals to be stimulated twice, compared to once for CAR, and thus increases stimulation associated discomfort. To date, there is no agreement on what is the best practical technique for calculating quadriceps VA. This paper aims to address this problem by determining what reference force (i.e., using either peak force or force at the time of stimulation) and type of stimulation (train of pulses (burst), doublet, and twitch) is the best technique to use. Our findings showed that the IT with the force at the time of stimulation as a reference should be used to determine VA and that when a burst was used, the VA ratio computations were more accurate. Additionally, using a twitch with a 2ms pulse duration produced reliable VA calculations and may be an acceptable alternative for pain- sensitive subjects. Accurate assessment of VA deficits can help clinicians design rehabilitation programs that are based on subject-specific strength impairments and are more effective.



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Desorption of micropollutant from spent carbon filters used for water purifier

Abstract

In this study, to examine the accumulated micropollutants in the spent carbon filter used in the water purifier, first, the method to desorb micropollutant from the activated carbon was developed and optimized. Then, using this optimized desorption conditions, we examined which micropollutants exist in spent carbon filters collected from houses in different regions in Korea where water purifiers were used. A total of 11 micropollutants (caffeine (CFF), acetaminophen (ACT), sulfamethazine (SMA), sulfamethoxazole (SMZ), metoprolol (MTP), carbamazepine (CBM), naproxen (NPX), bisphenol-A (BPA), ibuprofen (IBU), diclofenac (DCF), and triclocarban (TCB)) were analyzed using LC/MS-MS from the spent carbon filters. CFF, NPX, and DCF had the highest detection frequencies (>60%) in the carbon filters (n = 100), whereas SMA, SMZ, and MTP were only detected in the carbon filters, but not in the tap waters (n = 25), indicating that these micropollutants, which exist less than the detection limit in tap water, were accumulated in the carbon filters. The regional micropollutant detection patterns in the carbon filters showed higher levels of micropollutants, especially NPX, BPA, IBU, and DCF, in carbon filters collected in the Han River and Nakdong River basins where large cities exist. The levels of micropollutants in the carbon filter were generally lower in the regions where advanced oxidation processes (AOPs) were employed at nearby water treatment plants (WTPs), indicating that AOP process in WTP is quite effective in removing micropollutant. Our results suggest that desorption of micropollutant from the carbon filter used can be a tool to identify micropollutants present in tap water with trace amounts or below the detection limit.

http://ift.tt/2s1A8cz

Effects of nanoparticles in species of aquaculture interest

Abstract

Recently, it was observed that there is an increasing application of nanoparticles (NPs) in aquaculture. Manufacturers are trying to use nano-based tools to remove the barriers about waterborne food, growth, reproduction, and culturing of species, their health, and water treatment in order to increase aquaculture production rates, being the safe-by-design approach still unapplied. We reviewed the applications of NPs in aquaculture evidencing that the way NPs are applied can be very different: some are direclty added to feed, other to water media or in aquaculture facilities. Traditional toxicity data cannot be easily used to infer on aquaculture mainly considering short-term exposure scenarios, underestimating the potential exposure of aquacultured species. The main outputs are (i) biological models are not recurrent, and in the case, testing protocols are frequently different; (ii) most data derived from toxicity studies are not specifically designed on aquaculture needs, thus contact time, exposure concentrations, and other ancillary conditions do not meet the required standard for aquaculture; (iii) short-term exposure periods are investigated mainly on species of indirect aquaculture interest, while shrimp and fish as final consumers in aquaculture plants are underinvestigated (scarce or unknown data on trophic chain transfer of NPs): little information is available about the amount of NPs accumulated within marketed organisms; (iv) how NPs present in the packaging of aquacultured products can affect their quality remained substantially unexplored. NPs in aquaculture are a challenging topic that must be developed in the near future to assure human health and environmental safety.

Graphical abstract

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Congenital nasal obstruction in infants: A retrospective study and literature review

Publication date: August 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Vijay A. Patel, Michele M. Carr
ObjectivesTo identify etiologies of congenital nasal obstruction and describe clinical practice patterns in the evaluation, diagnosis, and treatment of symptomatic infants.MethodsAn electronic chart review from 1/1/2006–10/1/2016 for all patients with a diagnosis of nasal obstruction within the first six months of life using ICD-9 and 10 codes 478.19 and J34.89.ResultsA total of 34 patients were evaluated by the Division of Otolaryngology for this chief complaint. 38% of neonates were born premature and 32% were admitted to the NICU at birth, with a female-to-male ratio of 1:1.4. Presenting signs and symptoms included: stertor (44%), cyanosis (24%), stridor (24%), retractions (21%), rhinorrhea (21%), apnea (12%), and epistaxis (8%). 47% of patients received ancillary radiographic imaging (CT or MRI). Diagnoses observed include: midnasal stenosis (38%), pyriform aperture stenosis (21%), choanal stenosis (12%), dacryocystocele (6%), microrhinia (6%), septal deviation (6%), nasopharyngeal reflux (3%), nasopharyngeal teratoma (3%), neonatal rhinitis (3%), and pharyngeal wall collapse (3%). 71% of patients were noted to have bilateral nasal obstruction. 41% of infants were found to have an associated ear, nose, and throat anomaly. 15% of patients required surgical intervention. The mean time-to-resolution was 240 days.ConclusionCongenital nasal obstruction has a broad differential diagnosis: the timing, onset, and laterality of symptoms can provide insights into the source of upper airway compromise. Most infants improve through conservative management (i.e. suctioning, humidification) and medical therapies (i.e. intranasal drops, nasal sprays).



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Visual cortex activation decrement following cochlear implantation in prelingual deafened children

Publication date: August 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 99
Author(s): Jiahao Liu, Maojin Liang, Yuebo Chen, Yajing Wang, Yuexin Cai, Suijun Chen, Ling Chen, Xianghui Li, Zeheng Qiu, Jiajia Jiang, Junbo Wang, Yiqing Zheng
ObjectiveVisual take-over of the auditory cortex in prelingual deaf children has been widely reported. However, there have been few studies on visual cortex plasticity after cochlear implantation (CI). In this study, we investigated the hypothesis that extrinsic auditory stimulation following CI in prelingual deafened children can induce visual cortex plasticity.MethodVisual evoked potentials (VEPs) were recorded in 37 CI children (4 groups with different use times) and 8 control subjects, in response to sound and nonsound stimuli. Latency and amplitude were analyzed for the P1, N1 and P2 components on the Oz electrode. Comparisons of VEP were conducted between the sound and nonsound stimuli and among different groups in order to view evidence of visual cortex reorganization.ResultsThe latency of the P2 component was significantly longer at the occipital site (Oz) in CI 0M than those in the other four groups. After the effect of age was excluded, a significant negative correlation was found between CI usage and P2 latency of nonsound stimuli. Occipital P1N1 latency and P1 amplitude were not affected by group or stimulus category. However, the N1 and P2 amplitudes were significantly larger in response to a sound stimulus than to a nonsound stimulus.ConclusionOur findings suggest that P2 latency develops with CI usage and may be a biomarker of visual cortex plasticity.



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