Head and Neck Diseases by Alexandros G.Sfakianakis: 09/16/17

Σάββατο 16 Σεπτεμβρίου 2017

Successful treatment with hyperbaric oxygen therapy for pneumatosis cystoides intestinalis as a complication of granulomatosis with polyangiitis: a case report

Although gastrointestinal involvement in patients with granulomatosis with polyangiitis is uncommon, it is associated with mild to severe life-threatening complications. We present a case of pneumatosis cystoi...

http://ift.tt/2x67tGg

Isolation and identification of antifungal peptides from Bacillus amyloliquefaciens W10

Abstract

Antifungal metabolites produced by Bacillus sp. W10, which was previously isolated from the tomato rhizosphere, were investigated. Strain W10 was identified as Bacillus amyloliquefaciens by analysis of its 16S rDNA and gyrB gene partial sequences. PCR analysis showed the presence of fenB, sfp, and ituD genes, coding for fengycin, surfactin, and iturin, respectively. A novel small antifungal peptide, designated 5240, produced by this strain was isolated by ammonium sulfate precipitation and Superdex 200 gel filtration chromatography. The 5240 peptide was stable at 100 °C for 20 min and remained active throughout a wide pH range (4–10). The antagonistic activity was not affected by protease K and trypsin. The purified 5240 peptide exhibited a broad inhibitory spectrum against various plant pathogenic fungi and was identified as iturin A (C₁₄-C₁₆). Moreover, matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry indicated the presence of fengycin A (C₁₄-C₁₅), fengycin B (C₁₆-C₁₇), and surfactin (C₁₃-C₁₆) isoforms in supernatants from strain W10. These results suggest that B. amyloliquefaciens W10 has significant potential as a biocontrol agent.

http://ift.tt/2jxXVOK

Development of silica protective layer on pyrite surface: a column study

Abstract

An appealing technique to prevent and/or minimize pyrite oxidation and subsequent acid generation in mine waste sites is the formation of a protective coating on the surface of sulfide grains. To investigate the conditions for the formation of an efficient coating on pyritic tailings, column tests were performed. These tests involved the treatment with a coating solution, which was continuously recycled through the packed bed of tailings. The coating solution was consisted of SiO₄⁻⁴ oxyanions, an oxidant (H₂O₂), and adjusted to pH 6. The effect of the volume of coating solution per mass of material (L/S ratio), Si concentration and treatment duration on coating formation was studied. Based on the results, a protective coating can be developed on the pyrite particles following treatment with a solution of 0.1 mM Si concentration, which resulted in the reduction of sulfate release by 84% compared to non-treated pyrite samples.

http://ift.tt/2xqiLVQ

Effects of moso bamboo ( Phyllostachys edulis ) invasions on soil nitrogen cycles depend on invasion stage and warming

Abstract

Plant invasions may alter soil nutrient cycling due to differences in physiological traits between the invader and species they displace as well as differences in responses to anthropogenic factors such as nitrogen deposition and warming. Moso bamboo is expanding its range rapidly around the world, displacing diverse forests. In addition, near expansion fronts where invasions are patchy, moso bamboo and other species each contribute soil inputs. Nitrogen transformations and greenhouse gas (GHG) emissions are important processes associated with nutrient availability and climate change that may be impacted by bamboo invasions. We collected soils from uninvaded, mixed, and bamboo forests to understand bamboo invasion effects on carbon and N cycling. We incubated soils with warming and N addition and measured net nitrification and N mineralization rates and GHG (CO₂ and N₂O) emissions. Mixed forest soils had higher pH and total N and lower total organic carbon and C/N than either uninvaded or bamboo forest soils. Bamboo forest soils had higher total carbon, dissolved organic carbon, and ammonium N but lower total and nitrate N than uninvaded forest soils. Soil GHG emissions did not vary among forest types at lower temperatures but bamboo forest soils had higher CO₂ and lower N₂O emissions at higher temperatures. While net N transformation rates were lower in bamboo and uninvaded forest soils, they were highest in mixed forest soils, indicating non-additive effects of bamboo invasions. This suggests that plant invasion effects on N transformations and GHG emissions with global change in forests partially invaded by bamboo are difficult to predict from only comparing uninvaded and bamboo-dominated areas.

http://ift.tt/2fdpWtE

TRPM8-Agonisten lindern Pruritus bei trockener Haut

Gegen chronischen Juckreiz infolge von trockener Haut könnte eine Kombination aus zwei TRPM8-Agonisten helfen. Eine Pilotstudie.

http://ift.tt/2h9uApD

Systemische Therapie bei Gehirnmetastasen

http://ift.tt/2haRIHJ

T-Vec in Kombination erhöht die Ansprechraten

http://ift.tt/2h9O6Cj

Metastasiertes uveales Melanom: kaum Erfolge

http://ift.tt/2h80Htr

Warzenartige Veränderungen am Genitale

http://ift.tt/2hae090

Junge Ärzte kämpfen gegen Vorurteile älterer Kollegen

Dass Nachwuchsmediziner ihr Bedürfnis nach Freizeit über die Nöte ihrer Patienten stellen und zu hohe Anforderungen an Ausbilder und künftige Arbeitgeber haben, ist reines Schubladendenken, finden junge Ärzte — und fordern ein neues Arbeitsklima.

http://ift.tt/2hauVfu

Plattenepithelkarzinom: Symptomatische perineurale Invasion trübt die Prognose

Perineurale Invasion gilt als prognostisch ungünstiger Faktor bei Plattenepithelkarzinomen der Haut. Dabei gibt es aber offenbar Unterschiede, je nachdem ob sich die Invasion klinisch bemerkbar macht oder nicht.

http://ift.tt/2hatHNx

Lichttherapie bei Pruritus: UV-B nicht mit UV-A kombinieren!

Ein Schweizer Ärzteteam hat untersucht, ob sich aus der Kombination kurzwelliger UV-B- mit längerwelliger UV-A-Strahlung ein klinisch relevanter Effekt auf Juckreiz ergibt.

http://ift.tt/2h7DB5W

Ein Dermatopathologe, zwei Meinungen

Dermatopathologische Diagnosen von Gewebe melanozytärer Male differieren nicht nur, wenn verschiedene Pathologen die Schnitte begutachten. Auch wenn derselbe Pathologe ein zweites Mal die gleiche Probe beurteilt, weichen die erste und zweite Diagnose häufig voneinander ab.

http://ift.tt/2h9Jnka

Inhaltsverzeichnis

http://ift.tt/2h7DAPq

Kooperation bietet allen mehr Chancen als Nachteile

http://ift.tt/2h9h4Ca

Gangrän in Skrotum und Perineum

http://ift.tt/2h89sDG

Melanom: Sentinelbiopsie kann warten

Bisher war unklar, ob ein Verschieben der Lymphknotenbiopsie Patienten mit einem Melanom eher schadet oder nützt. Dieser Unsicherheit wollten US-Ärzte ein Ende bereiten.

http://ift.tt/2h9JmN8

Psoriasis: Reviews selten von hoher Qualität

Ein spanisches Forscherteam hat systematische Übersichtsarbeiten zum Thema Psoriasis einer Qualitätskontrolle unterzogen. Gute Noten erhielten die wenigsten.

http://ift.tt/2h89lIg

Die Haut als „Touchpad“

Shiatsu ist eine japanische Form der ganzheitlichen Körperbehandlung. Dabei werden direkt unter der Haut verlaufende Energiekanäle per Druckmassage stimuliert, um die körpereigenen Selbstheilungskräfte anzuregen.

http://ift.tt/2h9ynmF

MEK-Inhibition beim inoperablen NRAS-mutierten Melanom

Wenn eine Immuntherapie bei fortgeschrittenem inoperablem NRAS-mutiertem malignem Melanom versagt, ist guter Rat teuer. In einer Phase-III-Studie wurden die Effizienz und Sicherheit des MEK-Inhibitors Binimetinib im Vergleich zu Dacarbazin getestet.

http://ift.tt/2h89cVe

Hiobsbotschaften zu übermitteln, fällt Ärzten oft schwer

Chirurgen aus den USA haben ein Tool entwickelt, das dabei helfen soll, schwierige Therapieentscheidungen oder schlechte Nachrichten mit Patienten oder Angehörigen zu besprechen. Allerdings zeigte sich, dass selbst geschulte Ärzte sich immer noch schwertun, kritisch Kranken schlechte Nachrichten zu vermitteln.

http://ift.tt/2h9ttWJ

Atopische Dermatitis: Erkrankungsalter verrät Allergierisiko

Die atopische Dermatitis kann bei Kindern offenbar abhängig von Erkrankungsalter und des Symptomenverlauf in vier verschiedene Untergruppen unterteilt werden. Dabei zeigen sich vor allem hinsichtlich der Wahrscheinlichkeit eines Etagenwechsels große gruppenspezifische Unterschiede.

http://ift.tt/2h9Lckt

Nicht jedes maligne Melanom ist schwarz

http://ift.tt/2h9tl9H

Bei Hautabszessen immer auch ein Antibiotikum?

Die Frage, ob sich bei Hautabszessen an Inzision und Drainage eine Antibiose anschließen sollte, ist auch heute noch nicht ganz geklärt. Dies herauszufinden, hat sich ein Forscherteam aus den USA zur Aufgabe gestellt.

http://ift.tt/2jzUWpc

Flexible Planning in Ravens?

Publication date: Available online 15 September 2017
Source:Trends in Cognitive Sciences
Author(s): Jonathan Redshaw, Alex H. Taylor, Thomas Suddendorf
Across two different contexts, Kabadayi and Osvath found that ravens preferentially selected items that could be used to obtain future rewards. Do these results demand a rethink of the evolution of flexible planning, or are there leaner alternative explanations for the performance of ravens?

http://ift.tt/2h9KhNt

AllergoOncology: Opposite Outcomes of Immune Tolerance in Allergy and Cancer

Abstract

While desired for the cure of allergy, regulatory immune cell subsets and non-classical Th2-biased inflammatory mediators in the tumour microenvironment can contribute to immune suppression and escape of tumours from immunological detection and clearance. A key aim in the cancer field is therefore to design interventions that can break immunological tolerance and halt cancer progression, whereas on the contrary allergen immunotherapy exactly aims to induce tolerance. In this position paper, we review insights on immune tolerance derived from allergy and from cancer inflammation, focusing on what is known about the roles of key immune cells and mediators. We propose that research in the field of AllergoOncology that aims to delineate these immunological mechanisms with juxtaposed clinical consequences in allergy and cancer may point to novel avenues for therapeutic interventions that stand to benefit both disciplines.

http://ift.tt/2yfDGsJ

Smoking cessation and response to periodontal treatment

Abstract

Smoking has detrimental oral effects. The aim of this study was to review the literature related to the impact of smoking cessation on periodontal health, periodontal disease and periodontal treatment outcome as well as to review the smoking cessation strategies and the dentist's role in the smoking cessation effort. Smoking cessation seems to have a positive effect on the periodontium, to decrease the risk for incidence and progression of periodontitis and to lead to a non-significant trend for greater mean probing depth reductions after non-surgical treatment over a 12-month period. Smoking cessation effect on the periodontium should be further investigated. Dentists should inform their patients on the harmful effect of smoking and the beneficial effect of smoking cessation on oral health. They should advise, motivate and support their patients to quit smoking. Smoking-control strategies should be incorporated in the dental practice. The dentist's role in the smoking cessation effort is important. Guidelines on smoking-control strategies applied in the dental office are required.

http://ift.tt/2xHqfVc

A clinical, randomized study on the influence of dental whitening on Streptococcus mutans population

Summary

Dental whitening with peroxides has been popularized through the at-home technique, which employs low concentrations of peroxide applied on individual trays. However, there are few clinical trials reporting the effects of its continuous use on oral microbiota. Thus, the purpose of the present clinical, randomized study was to evaluate the influence of at-home whitening treatment on Streptococcus mutans in saliva, buccal mucosa, and subgingival and supragingival plaque. Thirty volunteers were randomly divided into 2 study groups (n=15) according to the whitening therapy: G CP- whitening using 10% carbamide peroxide 4 hours daily for 21 days and G HP- whitening using 6% hydrogen peroxide 1.5 hours daily for 21 days. Samples from the predetermined locations were collected evaluation periods: T1- before, T2- immediately after and T3- 30 days after the beginning of the treatment. The microbiological evaluation was made using conventional and molecular methods. Student′s T test found a statistically significant decrease in S. mutans population in the subgingival and supragingival plaque for HP samples between T1 and T2 no difference was found between T1 and T3 regardless of the location and the whitening product used (α=0.05). Therefore, although HP reduced Streptococcus mutans during treatment, the levels returned to baseline when assessed 30 days after the treatment.

http://ift.tt/2f34YtX

AllergoOncology: Opposite Outcomes of Immune Tolerance in Allergy and Cancer

Abstract

http://ift.tt/2yfDGsJ

Tonsillectomy in adults: Analysis of indications and complications

Tonsillectomy is one of the surgical techniques most practiced by otolaryngologists, and despite being a relatively simple technique; it presents a considerable percentage of complications, such as postoperative bleeding. The aim of this study is to describe the surgical indications and most frequent complications, analyze whether surgical suture of the tonsillar pillars has an influence on bleeding, and study the data of hospital stay and its importance for the control of complications.

http://ift.tt/2xbxnaV

Tonsillectomy in adults: Analysis of indications and complications

TLR expression profile of human alveolar bone proper-derived stem/progenitor cells and osteoblasts

Alveolar bone proper-derived stem/progenitor cells (AB-MSCs) and alveolar osteoblasts (OBs) are pivotal cells with positive attributes in regenerative medicine. During regenerative approaches, AB-MSCs may interact with their surrounding environment via their expressed toll-like-receptors (TLRs). This study aimed to depict for the first time the TLRs expression profile of AB-MSCs and OBs.Cells were isolated from human alveolar bone proper, and STRO-1-immunomagnetically sorted to segregate AB-MSCs and OBs.

http://ift.tt/2f2Zqzk

CD4-T cell-restricted IL-2 signaling defect in a patient with a novel IFNGR1-deficiency

In depth analysis of immune function in a patient with a defined defect in IFNγR1 expression additionally identified an IL-2 associated signaling deficiency that was restricted primarily to the circulating CD4 T cell subset.

http://ift.tt/2xH6lty

A novel role for cilia function in atopy: ADGRV1 and DNAH5 interactions

This study in three family-based studies identified association between ADGRV1 and atopy and interaction between ADGRV1 and DNAH5, two genes that contribute to ciliary functions.

http://ift.tt/2jzquvh

A novel IKAROS haploinsufficiency kindred with unexpectedly late and variable B cell maturation defects

We report on the first truncating IKZF1 mutation associated with IKAROS haploinsufficiency and illustrate an unexpectedly late and variable block in central and peripheral B cell development in two patients and their asymptomatic mother.

http://ift.tt/2xHojMp

Effect of endotoxin and alum adjuvant vaccine on peanut allergy

Environmental endotoxin and alum-adjuvanted vaccines did not influence peanut-allergy development in mice. Exposure to alum and CpG-adjuvanted vaccines indirectly reduced allergic disease severity. Fecal metabolites differentiated mice based on disease severity.

http://ift.tt/2jzqoDV

Specific Allergy & Asthma Prevention Coming to an Age: A Milestone in Children

http://ift.tt/2xHol6Z

Developing biomarkers for predicting clinical relapse in pemphigus patients treated with rituximab

Rituximab is an effective therapy for pemphigus, although relapses are common.

http://ift.tt/2jxQebo

Removal of endrin and dieldrin isomeric pesticides through stereoselective adsorption behavior on the graphene oxide-magnetic nanoparticles

Abstract

A novel stereoselective removal behavior of isomeric endrin and dieldrin pesticides from sample solution is demonstrated using nanocomposite of graphene oxide (GO) and iron oxide (Fe₃O₄) magnetic nanoparticles (MNPs). The removal efficiency of endrin and dieldrin was found higher when GO-MNPs was used as a separating probe than the individual use of GO and MNPs. The removal efficiency of both the pesticides was found to be more favorable when the dosage amount of GO-MNPs was 30 mg for 30-min contact time with pH 4.0 at room temperature. The good correlation of determination (R ²) with 0.975 and 0.973 values obtained for endrin and dieldrin, respectively demonstrated a well fitting of Langmuir adsorption isotherm model. The higher removal percentage (86.0%) and higher slope value of Langmuir adsorption isotherm were estimated for endrin compared to dieldrin (74.0%). The reason for higher adsorption percentage of endrin is due to the endo-position of oxygen atom in molecule favors more interaction of molecules with GO-MNPs compared to the exo-position of oxygen present in dieldrin. In addition, the higher value of R ² for endrin and dieldrin demonstrated better suitability of pseudo-first-order and pseudo-second-order kinetic models, respectively. The advantages of the present method are use of simple UV-vis spectrophotometry for monitoring and low-cost use of GO-MNPs nanomaterial for the removal of pesticides from sample solution.

http://ift.tt/2f1RDlm

Three-dimensional strut plate for the treatment of mandibular fractures: a systematic review

The treatment of mandibular fractures by open reduction and internal fixation is very variable. Thus, there are many controversies about the best fixation system in terms of stability, functional recovery, and postoperative complications. This systematic review sought scientific evidence regarding the best indication for the use of three-dimensional (3D) plates in the treatment of mandibular fractures. A systematic search of the PubMed/MEDLINE, Elsevier/Scopus, and Cochrane Library databases was conducted to include articles published up until November 2016.

http://ift.tt/2jwTRhG

Oropharyngeal epignathus with partial facial duplication: report of a rare case

Foetal oral teratoma or epignathus is a rare benign condition that originates in the oropharyngeal region. The term 'teratoma' refers to a mass composed of poorly organized tissues derived from each of the three germ layers. Epignathus may occur when one twin ceases development during gestation and becomes vestigial to the fully formed dominant twin. The reported incidence of epignathus is approximately 1:35,000 to 1:200,000 live births. A unique case of partial facial duplication with gross histological and radiological evidence of partial duplication of the facial elements and organs is presented herein.

http://ift.tt/2xbE3WD

Examining the Time Course of Genital and Subjective Sexual Responses in Women and Men with Concurrent Plethysmography and Thermography

Publication date: Available online 15 September 2017
Source:Biological Psychology
Author(s): Jackie S. Huberman, Samantha J. Dawson, Meredith L. Chivers
Sexual response is a dynamic process, though there is limited knowledge of the time course and relationships among its psychological and physiological components. To address this gap, we concurrently assessed self-reported sexual arousal, genital temperature (with thermography), and genital vasocongestion (with vaginal photoplethysmography [VPP] or penile plethysmography [PPG]) during sexual and nonsexual films in 28 androphilic women (attracted to men) and 27 gynephilic men (attracted to women). Men and women had similarly strong agreement between subjective and genital responses (sexual concordance) with thermography, but this agreement was stronger in men than women with PPG/VPP. The time course of changes in self-reported arousal was most similar to changes in genital temperature (i.e., time to onset and peak response). Time-lagged correlations and multi-level modeling revealed changes in the strength of relationships between aspects of sexual response over time. Results highlight the dynamic nature of sexual response and drawbacks of relying on zero-order correlations to characterize sexual concordance.

http://ift.tt/2fqtHZs

Phalangeal morphology of Shanghuang fossil primates

Publication date: December 2017
Source:Journal of Human Evolution, Volume 113
Author(s): Daniel L. Gebo, Marian Dagosto, Xijun Ni, K. Christopher Beard
Here, we describe hundreds of isolated phalanges attributed to middle Eocene fossil primates from the Shanghuang fissure-fillings from southern Jiangsu Province, China. Extending knowledge based on previous descriptions of postcranial material from Shanghuang, this sample of primate finger and toe bones includes proximal phalanges, middle phalanges, and over three hundred nail-bearing distal phalanges. Most of the isolated proximal and middle phalanges fall within the range of small-bodied individuals, suggesting an allocation to the smaller haplorhine primates identified at Shanghuang, including eosimiids. In contrast to the proximal and middle phalanges from Shanghuang, there are a variety of shapes, sizes, and possible taxonomic allocations for the distal phalanges. Two distal phalangeal morphologies are numerically predominant at Shanghuang. The sample of larger bodied specimens is best allocated to the medium-sized adapiform Adapoides while the smaller ones are allocated to eosimiids on the basis of the commonality of dental and tarsal remains of these taxa at Shanghuang. The digit morphology of Adapoides is similar morphologically to that of notharctines and cercamoniines, while eosimiid digit morphology is unlike living anthropoids. Other primate distal phalangeal morphologies at Shanghuang include grooming "claws" as well as specimens attributable to tarsiids, tarsiiforms, the genus Macrotarsius, and a variety of adapiforms. One group of distal phalanges at Shanghuang is morphologically indistinguishable from those of living anthropoids. All of the phalanges suggest long fingers and toes for the fossil primates of Shanghaung, and their digit morphology implies arboreality with well-developed digital flexion and strong, grasping hands and feet.

http://ift.tt/2x4RaJT

Atypical PKC, PKCλ/ι, activates β-secretase and increases Aβ1−40/42 and phospho-tau in mouse brain and isolated neuronal cells, and may link hyperinsulinemia and other aPKC activators to development of pathological and memory abnormalities in Alzheimer’s Disease.

Publication date: Available online 15 September 2017
Source:Neurobiology of Aging
Author(s): Mini P. Sajan, Barbara C. Hansen, Margaret G. Higgs, C. Ron Kahn, Ursula Braun, Michael Leitges, Collin R. Park, David M. Diamond, Robert V. Farese
IntroductionHyperinsulinemia activates brain Akt and PKC-λ/ι and increases Aβ1−40/42 and phospho-tau in insulin-resistant animals.MethodsHere, we examined underlying mechanisms in mice, neuronal cells and mouse hippocampal slices.ResultsLike Aβ1−40/42, β-secretase activity was increased in insulin-resistant mice and monkeys. In insulin-resistant mice, inhibition of hepatic PKC-λ/ι is sufficient to correct hepatic abnormalities and hyperinsulinemia simultaneously reversed increases in Akt, aPKC, β-secretase and Aβ1−40/42, and restored acute Akt activation ; However, two aPKC inhibitors additionally blocked insulin's ability to activate brain PKC-λ/ι and thereby increase β-secretase and Aβ1−40/42. Furthermore, direct blockade of brain aPKC simultaneously corrected an impairment in novel object recognition in high-fat-fed insulin-resistant mice. In neuronal cells and/or mouse hippocampal slices, PKC-ι/λ activation by insulin, metformin or expression of constitutive PKC-ι provoked increases in β-secretase, Aβ1−40/42 and phospho-thr-231-tau that were blocked by various PKC-λ/ι inhibitors, but not by an Akt, inhibitor.ConclusionsPKC-λ/ι provokes increases in brain β-secretase, Aβ1−40/42 and phospho-thr-231-tau. Excessive signaling via PKC-λ/ι may link hyperinsulinemia and other PKC-λ/ι activators to pathological and functional abnormalities in Alzheimer's disease.

Graphical abstract

http://ift.tt/2wk6zGR

The flavonoid Baicalein attenuates cuprizone-induced demyelination via suppression of neuroinflammation

Publication date: Available online 15 September 2017
Source:Brain Research Bulletin
Author(s): Miho Hashimoto, Shinji Yamamoto, Kensuke Iwasa, Kota Yamashina, Masaki Ishikawa, Kei Maruyama, Francesca Bosetti, Keisuke Yoshikawa
Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system characterized by recurrent and progressive demyelination/remyelination cycles, neuroinflammation, oligodendrocyte loss, and axonal pathology. Baicalein isolated from the roots of Scutellaria baicalensis has been shown to exert anti-inflammatory and anti-oxidant effects. The cuprizone model is an established mouse model of MS and causes demyelination and motor dysfunction to induce neuroinflammation such as glial activation and pro-inflammatory cytokine production. To determine whether Baicalein attenuates cuprizone-induced demyelination, we administrated Baicalein to cuprizone-exposured mice. We found that Baicalein treatment attenuated cuprizone-induced demyelination, glial activation, pro-inflammatory cytokine expressions, and motor dysfunction. Our results suggest that Baicalein may be a useful therapeutic agent in demyelinating diseases to suppress neuroinflammation.

http://ift.tt/2h8BLhA

The P2X7 receptor in dorsal root ganglia is involved in HIV gp120-associated neuropathic pain

Publication date: Available online 14 September 2017
Source:Brain Research Bulletin
Author(s): Bing Wu, Lichao Peng, Jinyan Xie, Lifang Zou, Qicheng Zhu, Huaide Jiang, Zhihua Yi, Shouyu Wang, Yun Xue, Yun Gao, Guilin Li, Shuangmei Liu, Chunping Zhang, Guodong Li, Shangdong Liang, Huangui Xiong
Human immunodeficiency virus (HIV)-associated neuropathic pain is common, and studies have shown that HIV envelope glycoprotein 120 (gp120) can directly stimulate primary sensory afferent neurons causing hyperalgesia. The P2X7 receptor in the dorsal root ganglia (DRG) is involved in pain transmission and is closely related to the inflammatory and immune response. In this study, we aimed to explore the role of the P2X7 receptor in gp120-induced neuropathic pain using a rat model specific for this type of pain. The results showed that mechanical hyperalgesia, thermal hyperalgesia and P2X7 expression levels were increased in rats treated with gp120. The P2X7 antagonist, brilliant blue G (BBG), decreased hyperalgesia and P2X7 expression levels in rats treated with gp120. BBG also decreased IL-1β and TNF-α receptor expression and ERK1/2 phosphorylation levels and increased IL-10 expression in the gp120-treated rat DRG. In addition, P2X7 agonist (BzATP)-activated currents in DRG neurons cultured with gp120 were larger than those in control neurons, and the inhibitory effect of BBG on BzATP-induced currents in gp120-treated DRG neurons was larger than that in control neurons. Therefore, inhibition of the P2X7 receptor in rat DRG relieved gp120-induced mechanical hyperalgesia and thermal hyperalgesia.

http://ift.tt/2hae10b

Recent advances of controlled drug delivery using microfluidic platforms

Publication date: Available online 15 September 2017
Source:Advanced Drug Delivery Reviews
Author(s): Sharma T. Sanjay, Wan Zhou, Maowei Dou, Hamed Tavakoli, Lei Ma, Feng Xu, XiuJun Li
Conventional systematically-administered drugs distribute evenly throughout the body, get degraded and excreted rapidly while crossing many biological barriers, leaving minimum amounts of the drugs at pathological sites. Controlled drug delivery aims to deliver drugs to the target sites at desired rates and time, thus enhancing the drug efficacy, pharmacokinetics, and bioavailability while maintaining minimal side effects. Due to a number of unique advantages of the recent microfluidic lab-on-a-chip technology, microfluidic lab-on-a-chip has provided unprecedented opportunities for controlled drug delivery. Drugs can be efficiently delivered to the target sites at desired rates in a well-controlled manner by microfluidic platforms via integration, implantation, localization, automation, and precise control of various microdevice parameters. These features accordingly make reproducible, on-demand, and tunable drug delivery become feasible. On-demand self-tuning dynamic drug delivery systems have shown great potential for personalized drug delivery. This review presents an overview of recent advances in controlled drug delivery using microfluidic platforms. The review first briefly introduces microfabrication techniques of microfluidic platforms, followed by detailed descriptions of numerous microfluidic drug delivery systems that have significantly advanced the field of controlled drug delivery. Those microfluidic systems can be separated into four major categories, namely drug carrier-free micro-reservoir-based drug delivery systems, highly integrated carrier-free microfluidic lab-on-a-chip systems, drug carrier-integrated microfluidic systems, and microneedles. Microneedles can be further categorized into five different types, i.e. solid, porous, hollow, coated, and biodegradable microneedles, for controlled transdermal drug delivery. At the end, we discuss current limitations and future prospects of microfluidic platforms for controlled drug delivery.

Graphical abstract

http://ift.tt/2fprYDI

Multicenter Research Studies in Radiology

Publication date: Available online 15 September 2017
Source:Academic Radiology
Author(s): Brittany Z. Dashevsky, Zachary L. Bercu, Priya R. Bhosale, Kirsteen R. Burton, Arindam R. Chatterjee, L. Alexandre R. Frigini, Laura Heacock, Edward H. Herskovits, James T. Lee, Naveen Subhas, Ashish P. Wasnik, Soterios Gyftopoulos
Rationale and ObjectivesHere we review the current state of multicenter radiology research (MRR), and utilize a survey of experienced researchers to identify common advantages, barriers, and resources to guide future investigators.Materials and MethodsThe Association of University Radiologists established a Radiology Research Alliance task force, Multi-center Research Studies in Radiology, composed of 12 society members to review MRR. A REDCap survey was designed to gain more insight from experienced researchers. Recipients were authors identified from a PubMed database search, utilizing search terms "multicenter" or "multisite" and "radiology." The survey included investigator background information, reasons why, barriers to, and resources that investigators found helpful in conducting or participating in MRR.ResultsThe survey was completed by 23 of 80 recipients (29%), the majority (76%) of whom served as a primary investigator on at least one MRR project. Respondents reported meeting collaborators at national or international (74%) and society (39%) meetings. The most common perceived advantages of MRR were increased sample size (100%) and improved generalizability (91%). External funding was considered the most significant barrier to MRR, reported by 26% of respondents. Institutional funding, setting up a central picture archiving and communication system, and setting up a central database were considered a significant barrier by 30%, 22%, and 22% of respondents, respectively. Resources for overcoming barriers included motivated staff (74%), strong leadership (70%), regular conference calls (57%), and at least one face-to-face meeting (57%).ConclusionsBarriers to MRR include funding and establishing a central database and a picture archiving and communication system. Upon embarking on an MRR project, forming a motivated team who meets and speaks regularly is essential.

http://ift.tt/2x4mkRF

Low-intensity Vibration Therapy for Bone Health in Renal Osteodystrophy

Publication date: Available online 15 September 2017
Source:Academic Radiology
Author(s): Sachin Sharma, Garry E. Gold

http://ift.tt/2x4rtJl

Differential Aging Signals in Abdominal CT Scans

Publication date: Available online 15 September 2017
Source:Academic Radiology
Author(s): Nikita V. Orlov, Sokratis Makrogiannis, Luigi Ferrucci, Ilya G. Goldberg
Rationale and ObjectivesChanges in the composition of body tissues are major aging phenotypes, but they have been difficult to study in depth. Here we describe age-related change in abdominal tissues observable in computed tomography (CT) scans. We used pattern recognition and machine learning to detect and quantify these changes in a model-agnostic fashion.Materials and MethodsCT scans of abdominal L4 sections were obtained from Baltimore Longitudinal Study of Aging (BLSA) participants. Age-related change in the constituent tissues were determined by training machine classifiers to differentiate age groups within male and female strata ("Younger" at 50–70 years old vs "Older" at 80–99 years old). The accuracy achieved by the classifiers in differentiating the age cohorts was used as a surrogate measure of the aging signal in the different tissues.ResultsThe highest accuracy for discriminating age differences was 0.76 and 0.72 for males and females, respectively. The classification accuracy was 0.79 and 0.71 for adipose tissue, 0.70 and 0.68 for soft tissue, and 0.65 and 0.64 for bone.ConclusionsUsing image data from a large sample of well-characterized pool of participants dispersed over a wide age range, we explored age-related differences in gross morphology and texture of abdominal tissues. This technology is advantageous for tracking effects of biological aging and predicting adverse outcomes when compared to the traditional use of specific molecular biomarkers. Application of pattern recognition and machine learning as a tool for analyzing medical images may provide much needed insight into tissue changes occurring with aging and, further, connect these changes with their metabolic and functional consequences.

http://ift.tt/2x6Ddsw

Temporal changes in motor variability during prolonged lifting/lowering and the influence of work experience

Publication date: Available online 15 September 2017
Source:Journal of Electromyography and Kinesiology
Author(s): Alireza Sedighi, Maury A. Nussbaum
Ankle braces are a common treatment to reduce ankle sprain recurrence among individuals with chronic ankle instability (CAI). Bracing provides supplemental external joint stiffness and/or improved proprioceptive acuity. The goals of this study were to assess the effects of two ankle braces on joint position sense (JPS) and ankle stiffness, and determine whether bracing effects are reduced with localized muscle fatigue. Measures of JPS and ankle stiffness were obtained from participants with CAI (n=12) for three conditions (no brace, a neoprene wrap brace, and a semi-rigid brace), before and after inducing localized muscle fatigue at the ankle. Pre-fatigue JPS measures did not differ between brace conditions, but pre-fatigue stiffness was ∼0.8 and 2.5 Nm/rad (∼5 and 14%) greater for the semi-rigid brace than the neoprene and no brace conditions, respectively. Fatigue increased absolute JPS errors by 0.3° (∼6-12%) across all conditions. Stiffness was unaffected by fatigue among females. Among males, fatigue increased stiffness by 0.75 Nm/rad (∼3.3%) with the semi-rigid brace and decreased stiffness by 0.32 Nm/rad (1.5%) with no brace. The semi-rigid brace may better protect males from sprains while either brace may be effective for females.

http://ift.tt/2y5oNZ6

Effects of tetramethylpyrazine phosphate on pancreatic islet microcirculation in SD rats

Abstract

Purposes

Abnormal islet microcirculation impetus the insulin production and accelerates progression of Type 1 and 2 diabetes. In this study, we investigated whether tetramethylpyrazine phosphate (TMPP), a vasoactive substance, could regulate the islet microcirculation and insulin concentration and improve glycaemia in SD rats.

Methods

SD rats were randomly divided into two groups, the control and TMPP groups. Each group was further divided into three subgroups according to the intravenous injection of either saline, 15 or 30% glucose. The non-radioactive microsphere technique was adopted to measure the organ blood flow. Nitric oxide synthase (NOS) blocker l-NAME was used to address whether NO was involved in mediating the vasoactive effects of TMPP.

Results

In the TMPP group, TMPP increased the PBF (pancreatic blood flow), IBF (islet blood flow), and fIBF (fraction of islet blood flow out of pancreatic blood flow) by 57, 76 and 47%, respectively, after 30% glucose infusion, compared with the control, indicating that TMPP could regulate islet microcirculation. Furthermore, TMPP induced a 66% elevation of IBF and 37% of fIBF in the 30% glucose subgroups than the 15% ones. In 30% glucose-treated subgroups, TMPP improved the blood glucose concentration by 10%, compared with the control (19.3 ± 0.64 vs 17.32 ± 0.56 mmol/l, P < 0.05), without influencing the insulin secretion. Blocking NO formation prevented the enhanced PBF and IBF, evoking by TMPP with 30% glucose.

Conclusions

TMPP can regulate the pancreatic islet microcirculation and possess a hypoglycemia effect after glucose infusion through affecting the islet microcirculation.

http://ift.tt/2jAqrzA

A retrospective review of initial bisphosphonate infusion in an inpatient vs. outpatient setting for bisphosphonate naïve patients

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

http://ift.tt/2yeZ2q7

Evaluation of neurodevelopment of children with congenital hypothyroidism by the Denver Developmental Screening Test

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

http://ift.tt/2wk2baM

HLA class I expression predicts prognosis and therapeutic benefits from tyrosine kinase inhibitors in metastatic renal-cell carcinoma patients

Abstract

Purpose

Classical HLA class I antigen is highly involved in antigen presentation and adaptive immune response against tumor. In this study, we explored its predictive value for treatment response and survival in metastatic renal-cell carcinoma (mRCC) patients.

Experimental design

A TKI cohort of 111 mRCC patients treated with sunitinib or sorafenib and a non-TKI cohort of 160 mRCC patients treated with interleukin-2 or interferon-α-based immunotherapy at a single institution were retrospectively enrolled. HLA class I expression and cytotoxic T lymphocyte (CTL) density was assessed by immunohistochemistry on tissue microarrays. Association between HLA class I and CTL was also assessed in the TCGA KIRC cohort.

Results

In the TKI cohort, down-regulated HLA class I was associated with lower objective response rate of TKI therapy (P = 0.004), shorter overall survival (OS) (P = 0.001), and shorter progression free survival (PFS) (P < 0.001). Multivariate Cox regression model defined HLA expression as an independent prognostic factor for both OS [hazard ratio 1.687 (95% CI 1.045–2.724), P = 0.032] and PFS [hazard ratio 2.139 (95% CI 1.376–3.326), P = 0.001]. In the non-TKI cohort, HLA class I was not significantly associated with survival. HLA class I expression was associated with CTL infiltration and function, and its prognostic value was more predominant in CTL high-density tumors (P < 0.001) rather than CTL low-density tumors (P = 0.294).

Conclusions

Classical HLA class I expression can serve as a potential predictive biomarker for TKI therapy in mRCC patients. Its predictive value was restricted in CTL high-density tumors. However, further external validations and functional investigations are still required.

http://ift.tt/2x7d4Kd

How to unclog your ears: Eight home remedies

Clogged ears can cause discomfort, and may affect hearing and balance. Learn about eight different home remedies to treat clogged ears, and what to avoid.

http://ift.tt/2f1nEdD

Peucedanum japonicum extract attenuates allergic airway inflammation by inhibiting Th2 cell activation and production of pro-inflammatory mediators

Publication date: Available online 15 September 2017
Source:Journal of Ethnopharmacology
Author(s): Jin Mi Chun, A-reum Lee, Hyo Seon Kim, A Yeong Lee, Gyo Jeong Gu, Byeong Cheol Moon, Bo-In Kwon
Ethnopharmacological relevance:The root of Peucedanum japonicum Thunb is traditionally used to treat coughs, colds, headache and inflammatory diseases in Korea and Japan. Its effects on allergic lung inflammation have not been investigated.Aim of the study:To investigate the anti-asthmatic effects of Peucedanum japonicum extract (PJE) using a murine model of asthma and a lipopolysaccharide (LPS)-stimulated macrophage cell line.Materials and Methods:Mice underwent two rounds of sensitization with ovalbumin 1 week apart followed by four intranasal ovalbumin challenges on days 13–16. The control group received saline only. Two ovalbumin-sensitized groups were orally administered vehicle or PJE (200mg/kg) 5 days a week starting 1 week before the first ovalbumin sensitization. The third group was orally administered the asthma medication Montelukast (10mg/kg) on days 12–16. All animals were sacrificed on day 17. The lungs were assessed for histological features, inflammatory cell infiltration, Th2 cell activation and GATA-binding protein-3 (GATA-3) expression. The bronchoalveolar lavage fluid (BALF) was assessed for type 2 cytokine levels. The effect of PJE on the in vitro Th2 polarization of naïve CD4⁺ splenocytes and the production of pro-inflammatory mediators and cytokines by LPS-stimulated RAW 264.7 cells was evaluated.Results:PJE treatment inhibited OVA-induced inflammatory cell infiltration, eosinophilia, Th2 activation, and GATA-3 expression in the lung, reduced the interleukin (IL)−5 and IL-13 levels in BALF, down-regulated Th2 activation in vitro, and inhibited the macrophage production of inducible nitric oxide, cyclooxygenase-2, tumor necrosis factor-α, and IL-6. Conclusions:PJE attenuated allergic airway inflammation by inhibiting Th2 cell activation and macrophage production of inflammatory mediators. Peucedanum japonicum may be candidate therapy for allergic lung inflammation.

Graphical abstract

http://ift.tt/2fc14T8

Metagenomic Shotgun Sequencing and Unbiased Metabolomic Profiling Identify Specific Human Gut Microbiota and Metabolites Associated with Immune Checkpoint Therapy Efficacy in Melanoma Patients

Publication date: October 2017
Source:Neoplasia, Volume 19, Issue 10
Author(s): Arthur E. Frankel, Laura A. Coughlin, Jiwoong Kim, Thomas W. Froehlich, Yang Xie, Eugene P. Frenkel, Andrew Y. Koh
This is the first prospective study of the effects of human gut microbiota and metabolites on immune checkpoint inhibitor (ICT) response in metastatic melanoma patients. Whereas many melanoma patients exhibit profound response to ICT, there are fewer options for patients failing ICT—particularly with BRAF-wild-type disease. In preclinical studies, specific gut microbiota promotes regression of melanoma in mice. We therefore conducted a study of the effects of pretreatment gut microbiota and metabolites on ICT Response Evaluation Criteria in Solid Tumors response in 39 metastatic melanoma patients treated with ipilimumab, nivolumab, ipilimumab plus nivolumab (IN), or pembrolizumab (P). IN yielded 67% responses and 8% stable disease; P achieved 23% responses and 23% stable disease. ICT responders for all types of therapies were enriched for Bacteroides caccae. Among IN responders, the gut microbiome was enriched for Faecalibacterium prausnitzii, Bacteroides thetaiotamicron, and Holdemania filiformis. Among P responders, the microbiome was enriched for Dorea formicogenerans. Unbiased shotgun metabolomics revealed high levels of anacardic acid in ICT responders. Based on these pilot studies, both additional confirmatory clinical studies and preclinical testing of these bacterial species and metabolites are warranted to confirm their ICT enhancing activity.

http://ift.tt/2h8kIMR

Targeting immune modulatory pathways in cancer

Publication date: Available online 15 September 2017
Source:Clinical Immunology
Author(s): Philipp Beckhove

http://ift.tt/2fpFCqr

Depressed serum IgM levels in SLE are restricted to defined subgroups

Publication date: Available online 15 September 2017
Source:Clinical Immunology
Author(s): Caroline Grönwall, Uta Hardt, Johanna T. Gustafsson, Kerstin Elvin, Kerstin Jensen-Urstad, Marika Kvarnström, Giorgia Grosso, Johan Rönnelid, Leonid Padykov, Iva Gunnarsson, Gregg J. Silverman, Elisabet Svenungsson
Natural IgM autoantibodies have been proposed to convey protection from autoimmune pathogenesis. Herein, we investigated the IgM responses in 396 systemic lupus erythematosus (SLE) patients, divided into subgroups based on distinct autoantibody profiles. Depressed IgM levels were more common in SLE than in matched population controls. Strikingly, an autoreactivity profile defined by IgG anti-Ro/La was associated with reduced levels of specific natural IgM anti-phosphorylcholine (PC) antigens and anti-malondialdehyde (MDA) modified-protein, as well total IgM, while no differences were detected in SLE patients with an autoreactivity profile defined by anti-cardiolipin/β2glycoprotein-I. We also observed an association of reduced IgM levels with the HLA-DRB1*03 allelic variant among SLE patients and controls. Associations of low IgM anti-PC with cardiovascular disease were primarily found in patients without antiphospholipid antibodies. These studies further highlight the clinical relevance of depressed IgM, and suggest that low IgM levels in a SLE patient may reflect underlying immunological differences.

http://ift.tt/2x5566O

Depressed serum IgM levels in SLE are restricted to defined subgroups

Targeting immune modulatory pathways in cancer

Publication date: Available online 15 September 2017
Source:Clinical Immunology
Author(s): Philipp Beckhove

http://ift.tt/2fpFCqr

Antennal and behavioral responses of Mythimna separata (Walker) to three plant volatiles

Abstract

The oriental armyworm, Mythimna separata, is distributed widely in eastern Asia and Australia. The response of M.separata to 27 compounds identified from plant volatiles was determined from electroantennography (EAG) and wind tunnel results, which allowed an evaluation of the possible plant volatile compounds. The highest EAG values of males were elicited by trans-2,cis-6-nonadienal, and virgin females by benzyl alcohol. The amplitude in EAG dose-response was in the range of 0.24 to 2.87 mV. In the wind tunnel bioassays, significantly more females showed behavioral responses to wilting leaves and headspace collection of Pterocarya stenoptera rather than control. In addition, significantly more females flew upwind with beta-ocimene compared with the control. The number of females that landed at the source with cis-3-hexen-1-ol, phenylethyl alcohol, trans-2-nonenal, and 2-pentylfuran was significantly different from the number that moved towards control.

http://ift.tt/2wj7dnO

Bringing together raptor collections in Europe for contaminant research and monitoring in relation to chemicals regulations

Abstract

Raptors are good sentinels of environmental contamination and there is good capability for raptor biomonitoring in Europe. Raptor biomonitoring can benefit from natural history museums (NHMs), environmental specimen banks (ESBs) and other collections (e.g. specialist raptor specimen collections). Europe's NHMs, ESBs and other collections hold large numbers of raptor specimens and samples, covering long periods of time. These collections are potentially a valuable resource for contaminant studies over time and space. There are strong needs to monitor contaminants in the environment to support EU and national chemical management. However, data on raptor specimens in NHMs, ESBs and other collections are dispersed, few are digitised, and they are thus not easy to access. Specimen coverage is patchy in terms of species, space and time. Contaminant research with raptors would be facilitated by creating a framework to link relevant collections, digitising all collections, developing a searchable meta-database covering all existing collections, making them more visible and accessible for contaminant research. This would also help identify gaps in coverage and stimulate specimen collection to fill gaps in support of prioritised contaminant monitoring. Collections can further support raptor biomonitoring by making samples available for analysis on request.

http://ift.tt/2jyLPVK

A comparative study of inorganic elements in the blood of male and female Caspian pond turtles ( Mauremys caspica ) from the southern basin of the Caspian Sea

Abstract

Due to their bioaccumulation and biomagnification pathways, inorganic elements can accumulate in high-level aquatic organisms in the food web. Then, this species can be used to monitor the quality of the environment. Blood concentration of nine inorganic elements, including possible toxic metals (An, Cu, Mn, Se, As, Ni, Cd, Pb, and Hg), in 20 males and 20 females from eight different locations with high industry and agriculture activities in Iran were evaluated in this work. Additionally, size, sex, condition index, and locations were also included and analyzed. Among the essential elements, Zn and Se presented very high concentrations (56.14 ± 2.66 and 8.44 ± 0.77 μg/g ww, respectively) in all locations. Regarding possible toxic elements, Pb and Cd presented concerning concentrations as well (0.52 and 0.58 μg/g ww); this is especially true for Pb, an element found in very high concentrations in tissues of turtles from the same area in a previous study. The sex and the size of the individuals also had significant differences in concentration of Pb, Cd, As, and Hg.

http://ift.tt/2wjK4S9

Severe Thyrotoxicosis Secondary to Povidone-Iodine from Peritoneal Dialysis.

Severe Thyrotoxicosis Secondary to Povidone-Iodine from Peritoneal Dialysis.

Case Rep Endocrinol. 2017;2017:2683120

Authors: Lithgow K, Symonds C

Abstract
A 73-year-old male on home peritoneal dialysis (PD) with recent diagnosis of atrial fibrillation presented with fatigue and dyspnea. Hyperthyroidism was diagnosed with TSH < 0.01 mIU/L and FT4 > 100 pmol/L. He had no personal or family history of thyroid disease. There had been no exposures to CT contrast, amiodarone, or iodine. Technetium thyroid scan showed diffusely decreased uptake. He was discharged with a presumptive diagnosis of thyroiditis. Three weeks later, he had deteriorated clinically. Possible iodine sources were again reviewed, and it was determined that povidone-iodine solution was used with each PD cycle. Methimazole 25 mg daily was initiated; however, he had difficulty tolerating the medication and continued to clinically deteriorate. He was readmitted to hospital where methimazole was restarted at 20 mg bid with high dose prednisone 25 mg and daily plasma exchange (PLEX) therapy. Biochemical improvement was observed with FT4 dropping to 48.5 pmol/L by day 10, but FT4 rebounded to 67.8 pmol/L after PLEX was discontinued. PLEX was restarted and thyroidectomy was performed. Pathology revealed nodular hyperplasia with no evidence of thyroiditis. Preoperative plasma iodine levels were greater than 5 times the upper limit of normal range. We hypothesize that the patient had underlying autonomous thyroid hormone production exacerbated by exogenous iodine exposure from a previously unreported PD-related source.

PMID: 28912982 [PubMed]

http://ift.tt/2xGQE5J

Health-related quality of life in melanoma patients: Impact of melanoma-related limb lymphoedema

Publication date: November 2017
Source:European Journal of Cancer, Volume 85
Author(s): Caroline A. Gjorup, Mogens Groenvold, Helle W. Hendel, Karin Dahlstroem, Krzysztof T. Drzewiecki, Tobias W. Klausen, Lisbet R. Hölmich
AimTo explore health-related quality of life (HRQoL) in recurrence-free melanoma patients, with a focus on the association between melanoma-related limb lymphoedema and HRQoL.MethodsHRQoL was evaluated using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the breast cancer module (EORTC QLQ-BR23) subscales body image and future perspective, the Functional Assessment for Cancer Therapy-General subscale social/family well-being and the Hospital Anxiety and Depression Scale. Data were analysed using linear and ordinal logistic regression adjusting for age and gender.ResultsA total of 431 melanoma patients who had undergone wide local excision and axillary or inguinal sentinel lymph node biopsy (SLNB) and/or complete lymph node dissection (CLND) participated. No patients had had recurrence of the disease or had received adjuvant radiotherapy. The HRQoL scores improved with time after surgery. Melanoma-related limb lymphoedema was present in 109 patients (25%). Patients with lymphoedema had significantly worse HRQoL scores in the EORTC QLQ-C30 subscales global health status/quality of life, role and social functioning, fatigue, pain and financial difficulties, as well as in the QLQ-BR23 body image subscale. No associations were found between the limb affected (upper or lower limb), clinical stage of lymphoedema, duration of lymphoedema or type of surgery (SLNB or CLND) and HRQoL. We found an interaction with age and gender in the associations between lymphoedema and HRQoL: younger patients and women with lymphoedema had worse social functioning and women had significantly more impaired body image.ConclusionsThe negative impact of melanoma-related limb lymphoedema on HRQoL emphasises the importance of developing strategies for increasing awareness and improving prevention and treatment of lymphoedema.

http://ift.tt/2xafWYo

Isolated limb perfusion for locally advanced angiosarcoma in extremities: A multi-centre study

Publication date: November 2017
Source:European Journal of Cancer, Volume 85
Author(s): E.A. Huis in 't Veld, D.J. Grünhagen, C. Verhoef, H.G. Smith, A.C.J. van Akkooi, R. Jones, F. van Coevorden, A.J. Hayes, W.J. van Houdt
BackgroundAngiosarcomas are rare and aggressive soft-tissue sarcomas. The only potential curative treatment is complete surgical excision. This study reports the outcome of isolated limb perfusion (ILP) with high-dose melphalan and tumour necrosis factor α for locally advanced angiosarcoma.Material and methodsAll patients who underwent an ILP for angiosarcomas between 1991 and 2016 in three tertiary referral centres were identified from prospectively maintained databases.ResultsA total of 39 patients were included, with a median follow-up of 18 months (interquartile range 6.1–60.8). Of these patients, 23 (58.9%) patients had a complete response (CR) after ILP, 10 (25.6%) had a partial response, 4 (10.3%) had stable disease and 2 (5.1%) patients had progressive disease immediately after ILP. A total of 22 patients developed local progression (56.4%), whereas nine (23.1%) developed distant metastases. The patients with CR had a significantly prolonged median local progression-free survival (PFS) (15.4 versus 7.3 months, p = 0.015) when compared with non-CR patients, and a trend towards better median overall survival (81.2 versus 14.5 months, p = 0.054). Six patients underwent multiple ILPs, whereby the CR rate of the first, second and third ILPs were 60%, 80% and 67%, respectively. Thirteen (33.3%) patients needed further surgical intervention, consisting of resection in eight patients (20.5%) and amputation in five patients (12.8%).ConclusionILP is an effective treatment option for patients with locally advanced angiosarcoma in the extremities, resulting in a high number of CRs, a high limb salvage rate and prolonged local PFS.

http://ift.tt/2x6WvOD

Amorphous liquid metal electrodes enabled conformable electrochemical therapy of tumors

Publication date: November 2017
Source:Biomaterials, Volume 146
Author(s): Xuyang Sun, Bo Yuan, Wei Rao, Jing Liu
Electrochemical treatment of tumors (EChT) has recently been identified as a very effective way for local tumor therapy. However, hindered by the limited effective area of a single rigid electrode, multiple electrodes are often recruited when tackling large tumors, where too many electrodes not only complicate the clinical procedures but also aggravate patients' pain. Here we present a new conceptual electric stimulation tumor therapy through introducing the injectable liquid metal electrodes, which can adapt to complex tumor shapes so as to achieve desired therapeutic performance. This approach can offer evident merits for dealing with the complex physiological situations, especially for those irregular body cavities like stomach, colon, rectum or even blood vessel etc., which are hard to tackle otherwise. As it was disclosed from the conceptual experiments that, Unlike traditional rigid and uncomfortable electrodes, liquid metal possesses high flexibility to attach to any crooked biological position to deliver and adjust targeted electric field to fulfill anticipated tumor destruction. And such amorphous electrodes exhibit rather enhanced treatment effect of tumors. Further, we also demonstrate that EChT with liquid metal electrodes produced more electrochemical products during electrolysis. Transformations with the shapes of liquid metal provided an easily regulatable strategy to improve EChT efficiency, which can conveniently aid to achieve better output compared to multiple electrodes. In vivo EChT of tumors further clarified the effect of liquid metal electrodes in retarding tumor growth and increasing life spans.

http://ift.tt/2yeASfe

Hepatitis B surface antigen incorporated in dissolvable microneedle array patch is antigenic and thermostable

Publication date: November 2017
Source:Biomaterials, Volume 145
Author(s): Danielle Poirier, Frédéric Renaud, Vincent Dewar, Laurent Strodiot, Florence Wauters, Jim Janimak, Toshio Shimada, Tatsuya Nomura, Koki Kabata, Koji Kuruma, Takayuki Kusano, Masaki Sakai, Hideo Nagasaki, Takayoshi Oyamada
Alternatives to syringe-based administration are considered for vaccines. Intradermal vaccination with dissolvable microneedle arrays (MNA) appears promising in this respect, as an easy-to-use and painless method. In this work, we have developed an MNA patch (MNAP) made of hydroxyethyl starch (HES) and chondroitin sulphate (CS). In swines, hepatitis B surface antigen (HBsAg) formulated with the saponin QS-21 as adjuvant, both incorporated in HES-based MNAP, demonstrated the same level of immunogenicity as a commercially available aluminum-adjuvanted HBsAg vaccine, after two immunizations 28 days apart. MNAP application was associated with transient skin reactions (erythema, lump, scab), particularly evident when the antigen was delivered with the adjuvant. The thermostability of the adjuvanted antigen when incorporated in the HES-based matrix was also assessed by storing MNAP at 37, 45 or 50 °C for up to 6 months. We could demonstrate that antigenicity was retained at 37 and 45 °C and only a 10% loss was observed after 6 months at 50 °C. Our results are supportive of MNAP as an attractive alternative to classical syringe-based vaccination.

http://ift.tt/2whW7iQ

Nanomedicine for safe healing of bone trauma: Opportunities and challenges

Publication date: November 2017
Source:Biomaterials, Volume 146
Author(s): Shahed Behzadi, Gaurav A. Luther, Mitchel B. Harris, Omid C. Farokhzad, Morteza Mahmoudi
Historically, high-energy extremity injuries resulting in significant soft-tissue trauma and bone loss were often deemed unsalvageable and treated with primary amputation. With improved soft-tissue coverage and nerve repair techniques, these injuries now present new challenges in limb-salvage surgery. High-energy extremity trauma is pre-disposed to delayed or unpredictable bony healing and high rates of infection, depending on the integrity of the soft-tissue envelope. Furthermore, orthopedic trauma surgeons are often faced with the challenge of stabilizing and repairing large bony defects while promoting an optimal environment to prevent infection and aid bony healing. During the last decade, nanomedicine has demonstrated substantial potential in addressing the two major issues intrinsic to orthopedic traumas (i.e., high infection risk and low bony reconstruction) through combatting bacterial infection and accelerating/increasing the effectiveness of the bone-healing process. This review presents an overview and discusses recent challenges and opportunities to address major orthopedic trauma through nanomedical approaches.

http://ift.tt/2whW7zm

Past matrix stiffness primes epithelial cells and regulates their future collective migration through a mechanical memory

Publication date: November 2017
Source:Biomaterials, Volume 146
Author(s): Samila Nasrollahi, Christopher Walter, Andrew J. Loza, Gregory V. Schimizzi, Gregory D. Longmore, Amit Pathak
During morphogenesis and cancer metastasis, grouped cells migrate through tissues of dissimilar stiffness. Although the influence of matrix stiffness on cellular mechanosensitivity and motility are well-recognized, it remains unknown whether these matrix-dependent cellular features persist after cells move to a new microenvironment. Here, we interrogate whether priming of epithelial cells by a given matrix stiffness influences their future collective migration on a different matrix – a property we refer to as the 'mechanical memory' of migratory cells. To prime cells on a defined matrix and track their collective migration onto an adjoining secondary matrix of dissimilar stiffness, we develop a modular polyacrylamide substrate through step-by-step polymerization of different PA compositions. We report that epithelial cells primed on a stiff matrix migrate faster, display higher actomyosin expression, form larger focal adhesions, and retain nuclear YAP even after arriving onto a soft secondary matrix, as compared to their control behavior on a homogeneously soft matrix. Priming on a soft ECM causes a reverse effect. The depletion of YAP dramatically reduces this memory-dependent migration. Our results present a previously unidentified regulation of mechanosensitive collective cell migration by past matrix stiffness, in which mechanical memory depends on YAP activity.

Graphical abstract

http://ift.tt/2yeRR14

Clinical update regarding general anesthesia-associated neurotoxicity in infants and children.

Purpose of review: The U.S. Federal Drug Administration (FDA) recently released a warning stating that 'repeated or lengthy use of general anesthetic and sedation drugs during surgeries or procedures in children younger than 3 years or in pregnant women during their third trimester may affect the development of children's brains' ( http://ift.tt/2x7Abo0). The goal of this article is to review the most recent clinical studies which provide evidence that these concerns may be overstated for the majority of healthy young children who require surgery and anesthesia. Recent findings: Three large retrospective matched cohort studies published within the past year provide data on a total of 59 814 children exposed to general anesthesia before age 4 (including 30 021

http://ift.tt/2y5r1rb

Complications and unplanned admissions in nonoperating room procedures.

Purpose of review: The purpose of this article is to review complications and unplanned hospital admissions in patients presenting for ambulatory procedures requiring anesthesia care in the gastrointestinal endoscopy, bronchoscopy, and radiology suites. Recent findings: The range of ambulatory diagnostic and therapeutic procedures being undertaken in the gastrointestinal endoscopy, bronchoscopy, and radiology suites is expanding rapidly. Recent observational studies in gastrointestinal endoscopy confirm low incidences of complications and unplanned admissions. Deep propofol-based sedation is associated with more complications than lighter sedation. Older patients suffer more complications but obstructive sleep apnea does not appear to increase risk. Sedation improves patient comfort during bronchoscopy. Propofol-based sedation is associated with fewer complications than benzodiazepine-based sedation, but all combinations are associated with high patient satisfaction. Obesity and obstructive sleep apnea are not associated with worse outcomes in bronchoscopy patients. Sedation is increasingly required for interventions in the radiology suite. When patients are involved in choosing sedation depth, there is a trend to lighter sedation and high patient satisfaction. Summary: Sedation and anesthesia are required for the increasing number of increasingly complex procedures being undertaken outside the operating suite. Large randomized trials are required to define the optimum sedation drugs, sedation depth and sedation provider. Copyright (C) 2017 YEAR Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2x6MqkE

The relationship between the GJB3 c.538C>T variant and hearing phenotype in the Chinese population

Publication date: November 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 102
Author(s): Shasha Huang, Bangqing Huang, Guojian Wang, Dong Yang Kang, Xin Zhang, Xiaoxiao Meng, Pu Dai
BackgroundMutations in GJB3 were originally shown to underlie an autosomal dominant form of non-syndromic deafness in Chinese patients and the c.538C>T (p.R180*) variants caused high-frequency hearing loss. But after that, few reports have reported this mutation. This study investigated the relationship between the GJB3 c.538C>T variant and hearing phenotype in Chinese to assist with risk assessment and genetic counseling for hearing loss patients and their families.MethodThe study enrolled 5700 patients with hearing loss and 4600 normal subjects. Deafness gene mutations were distinguished using a gene chip. The GJB3 c.538C>T variant rate was calculated from the results.ResultOf the 5700 patients, 23 (0.40%) carried a GJB3 c.538C>T heterozygous variant; of these, 11 patients had other gene (GJB2/SLC26A4) mutations simultaneously. Most patients had moderate to profound hearing loss. All 23 patients were sporadic cases and had no family history of deafness. Of the 4600 normal individuals, 11 (0.24%) had GJB3 c.538C>T heterozygous variant. There was no statistical difference in incidence between the two groups.ConclusionsOur results showed that the GJB3 c.538C>T variant has a very low incidence in the Chinese population, and there was no clear evidence to support a role of the GJB3 c.538C>T variant in the autosomal dominant form of non-syndromic deafness. Our findings suggested that GJB3 c.538C>T does not contribute to hearing loss, and this conclusion will assist with genetic counseling and risk prediction for deafness related to the GJB3 c.538C>T variant.

http://ift.tt/2h7rYfk

Utility of screening questionnaire and polysomnography to predict postoperative outcomes in children

Publication date: November 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 102
Author(s): Hiromi Kako, Jennifer Tripi, Hina Walia, Dmitry Tumin, Mark Splaingard, Kris R. Jatana, Joseph D. Tobias, Vidya T. Raman
IntroductionThe prevalence of pediatric obstructive sleep apnea (OSA) has increased concurrently with the increasing prevalence of obesity. We have previously validated a short questionnaire predicting the occurrence of OSA on polysomnography (PSG). This follow-up study assessed the utility of the questionnaire in predicting postoperative outcomes.MethodsChildren undergoing surgery and completing a sleep study were prospectively screened for OSA using a short questionnaire. Procedures within 1 year of PSG were included in the analysis. Questionnaires were scored according to a cutoff previously deemed optimal for predicting OSA (apnea-hypopnea index ≥ 5) on the sleep study. Postoperative outcomes included prolonged (>60 min) length of stay (LOS) in the post-anesthesia care unit (PACU) and oxygen requirement in the PACU.ResultsThe study cohort included 185 patients (100/85 male/female) age 8 ± 4 years, undergoing adenotonsillectomy (n = 109), other ear, nose, and throat (ENT) procedures (n = 18), or non-ENT procedures (n = 58). There were 45 patients with OSA documented by PSG and 122 patients identified as likely to have OSA according to questionnaire responses (89% sensitivity, 41% specificity). PACU LOS was prolonged in 55/181 (30%) cases and supplemental oxygen was used in the PACU in 29/181 (16%) cases. In separate multivariable models, supplemental oxygen use in the PACU was more common if a patient scored ≥2/6 points on the short questionnaire scale (OR = 5.0; 95% CI: 1.3, 19.9; p = 0.023) or if the patient was diagnosed with OSA on PSG (OR = 4.6; 95% CI: 1.6, 13.5; p = 0.005). Neither OSA on PSG nor questionnaire score ≥2/6 were associated with prolonged PACU stay.ConclusionBoth OSA diagnosis based on the AHI and the questionnaire scale achieved comparable predictive value for the need for oxygen use in the PACU. The utility of the questionnaire in predicting rare adverse events (e.g., unplanned admission or rapid response team activation) remains to be determined. Our preliminary results support using a brief questionnaire scale for preoperative risk stratification among children with suspected OSA who have not had a formal sleep study.

http://ift.tt/2h9Uidp

Effects of pregabalin on postoperative pain after hysterectomy under spinal anesthesia with intrathecal morphine: a randomized controlled trial

Abstract

Purpose

To determine if preoperative pregabalin could decrease 24-h postoperative morphine consumption after spinal anesthesia with intrathecal morphine compared with placebo.

Methods

A randomized, double-blind, controlled trial was performed in the tertiary care center. Patients aged between 18 and 65 years who were American Society of Anesthesiologists class I–II and scheduled for abdominal hysterectomy with or without salpingo-oophorectomy were randomly allocated to a placebo or a pregabalin group. Patients received pregabalin 150 mg or placebo 1 h prior to anesthesia. Spinal anesthesia was achieved with 0.5% hyperbaric bupivacaine with morphine 0.2 mg. Intravenous patient-controlled analgesia morphine was provided postoperatively. Postoperative morphine consumption at 6, 12, and 24 h, time to first analgesic rescue, pain scores, adverse effects, and patient satisfaction were evaluated at 24 h after the operation.

Results

One hundred twenty-five patients were recruited and 119 patients (placebo N = 58, pregabalin N = 61) were included in the analysis. Forty-seven (81.0%) patients in the placebo group and 53 (86.9%) patients in the pregabalin group required morphine in the first 24 h. Median [IQR] 24-h morphine consumption was 4.0 [1.8, 10.0] mg in the placebo group and 5.0 [2.0, 11.0] mg in the prebagalin group, p = 0.60. There were no differences in cumulative morphine consumption at 6, 12, and 24 h postoperatively. The two groups also did not differ in time to first analgesic rescue, pain scores at rest and on movement, and side effects.

Conclusion

A single preoperative dose of pregabalin 150 mg did not reduce 24-h postoperative morphine consumption or pain scores or prolong the time to first analgesic rescue in spinal anesthesia with intrathecal morphine.

http://ift.tt/2yfhRcA

Erratum to “The “Crumple Zone” hypothesis: Association of frontal sinus volume and cerebral injury after craniofacial trauma” [J Craniomaxillofac Surg 45 (2017) 1094–1098]

The publisher regrets that Michael P. Grant's surname appeared incorrectly in the original article. It appears correctly above.

http://ift.tt/2x3dT9q

Comparing touch senses of naïve and expert panels through treated hair swatches. Which associated wordings correlate with hair physical properties?

Abstract

Objectives

The study i) compared sense of touch between a naïve and an expert panels, under visual or blind conditions, using differently treated hair swatches, ii) explored possible common wordings used by both panels and their possible links with some physical properties of hairs.

Methods

Two sets of 15 hair swatches of Caucasian and Chinese origins were differently treated (bleached, permed, brushed, etc) or organized (root-tip vs tip-root). These were evaluated by tactile assessments by two panels (105 naïve consumers and 10 hair experts) under visual or blind conditions, in two geographic locations. A series of 17 defined antonym adjectives, as descriptors, allowed responses of each panel to being scored and their preference mappings to being defined on a like-dislike scale. Hair swatches were measured and assessed by various instrumental techniques (bending, diameter, cuticle cohesion, alignments of hair).

Results

Apart from a few overlaps, all 15 hair swatches were well differentiated by both panels which showed a global agreement, making experts reliable assessors. Only 3 descriptors among 17 correlated with some objective measurements. Tactile-visual assessments differ from those performed tactile-blind in both panels. Agreements between both panels appear, however, closer under tactile-blind conditions.

Conclusion

Trained hair experts were confirmed as reliable representatives of a larger and naïve cohort, viewed as consumers. Hair swatches were well differentiated by both panels, with comparable descriptor rankings.

http://ift.tt/2xGCrpm

Growing evidence of the beneficial effects of a marine protein-based dietary supplement for treating hair loss

Summary

Background

Hair loss is a common condition among women with a range of causes including nutritional deficiencies.

Aims

To review the clinical data supporting the use of an oral marine supplement designed to promote hair growth.

Patients/Methods

Adult women with temporary thinning hair. Following an initial pilot study, five randomized, double-blind studies assessed the effectiveness of the oral marine supplement for promoting hair growth. Each study was approved by one or more institutional review boards.

Results

Together, these studies demonstrated the ability of oral marine supplements to increase the growth of terminal and vellus hairs, increase the diameter of terminal and vellus hairs, and decrease hair loss. This product is beneficial for men as well as women.

Conclusions

A dietary supplement containing a marine complex and other natural ingredients can safely and effectively promote hair growth and decrease hair shedding in women and men with thinning hair.

http://ift.tt/2fblbRh

Growing evidence of the beneficial effects of a marine protein-based dietary supplement for treating hair loss

Summary

Background

Hair loss is a common condition among women with a range of causes including nutritional deficiencies.

Aims

To review the clinical data supporting the use of an oral marine supplement designed to promote hair growth.

Patients/Methods

Results

Conclusions

A dietary supplement containing a marine complex and other natural ingredients can safely and effectively promote hair growth and decrease hair shedding in women and men with thinning hair.

http://ift.tt/2fblbRh

Unusually prolonged pemetrexed cytotoxicity in a patient with a lung adenocarcinoma: a case report

We describe a case of pemetrexed toxicities related to reabsorption by an ileal neobladder, which caused prolonged hematotoxicity and nephrotoxicity.

http://ift.tt/2x3QCny

Socioeconomic Variables of Patients with Spasmodic Dysphonia: A Preliminary Study

To characterize socioeconomic status (SES) variables of spasmodic dysphonia (SD) patients and determine their impact on voice outcomes after treatment with botulinum toxin.

http://ift.tt/2jx2Hw7

Does a mandibular access osteotomy improve survival in pT2 oral tongue cancers? Retrospective study at a single institution

The surgical approach to the resection of oral tongue cancers can involve transoral resection (TOR) or a temporary mandibulotomy access (TMA). There are no relevant guidelines, and the oncological safety of TOR needs consideration. The objective of this study was to investigate TMA and TOR in pT2 oral tongue cancer surgery with regard to cancer outcomes. Demographic, surgical, and histology data from primary pT2 tongue cancers were recorded and evaluated through multivariate Cox regression for local recurrence (LR), disease-free survival (DFS), and overall survival (OS).

http://ift.tt/2jyGcXG

Impact of resveratrol on bone repair in rats exposed to cigarette smoke inhalation: histomorphometric and bone-related gene expression analysis

This study investigated the effect of resveratrol on bone healing and its influence on the gene expression of bone-related markers in rats exposed to cigarette smoke. Two calvarial defects were created in each of 60 rats, which were assigned equally (n=20) to three groups: (1) resveratrol (10mg/kg)+smoke exposure (SMK+RESV); (2) placebo+smoke exposure (SMK+PLA); or (3) placebo+no smoke exposure (NS+PLA). Substances were administered daily for 30days following surgery. Smoke inhalation was started 7days before surgery and continued for 30days after surgery.

http://ift.tt/2xafae3

Otolaryngologic management of Down syndrome patients: what is new?.

Purpose of review: The management of children with Down syndrome as it pertains to the otolaryngologist continues to evolve. Obstructive sleep apnea (OSA) has dominated the recent literature, but other topics including hearing loss, swallowing, and perioperative considerations are also reported. Recent findings: The prevalence of OSA in children with Down syndrome ranges from 57 to 73% in certain cohorts, and, whereas adentonsillectomy can decrease Apnea-Hypopnea Index, up to 80% may have persistent OSA. Surgical techniques involving reduction of the base of tongue are effective for those who fail adenotonsillectomy, and it is expected that drug-induced sleep endoscopy may improve outcomes. New technology is also on the horizon that can assist with diagnosis and treatment including computational modelling and upper airway stimulation. Children with Down syndrome may not respond to medical management of eustachian tube dysfunction as well as normally developing children. In addition, there is a high prevalence of inner ear anomalies, increasing the risk for sensorineural hearing loss. Summary: Questions remain pertinent to the otolaryngologist regarding the ideal management of children with Down syndrome. Additional studies are necessary, to optimize understanding and treatment of this complex population, in particular as opportunities develop with technological advances. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2xGqHTO

Current chemotherapeutic regimens for brain metastases treatment

Abstract

Brain metastasis is a common complication in advanced systemic cancer, with an increasing incidence. The diagnosis of brain metastasis historically portended a dismal prognosis. The successful development of effective treatments for patients with brain metastasis is complicated by the differences among cancer subtypes, the limited understanding of the underlying pathophysiology of BM, the impact of the blood-brain barrier, and other factors. There is now renewed interest in treating this often devastating complication of cancer, and in understanding the underlying mechanisms of disease in this "sanctuary" site. Promising treatment strategies include brain-penetrant targeted therapies and immunotherapy, and strategies for enhanced delivery of therapy. This review highlights a selection of these approaches.

http://ift.tt/2x743Rg

Otolaryngologic management of Down syndrome patients: what is new?.

Flap repair of complex pilonidal sinus: a single institution experience

Abstract

Background

Healing of pilonidal cysts after initial excision remains a vexing problem for surgeons. While simple sinus can be managed with success, recurrence of the cyst after primary excision or sizeable sinus often requires a more complex repair; however, the morbidity and ultimate success of these procedures are unknown.

Methods

A retrospective review from 2009 to 2014 of all consecutive patients undergoing surgical intervention for pilonidal cyst disease from a single institution was performed. Management of pilonidal disease after excision with flap coverage was examined. Patient demographics, co-morbidities, procedural data, and post-operative outcomes were analyzed.

Results

Twenty-one flap patients were identified. These included 15 V-Y fasciocutaneous repairs, 5 rotational flaps, and 1 Romberg flap closure. Mean BMI was 32, mean defect size was 8 cm, and the patients have had an average of 1.05 attempts prior to the excision and flap repair. The flap group demonstrated 14% recurrence rate, 33% reoperation rate, and 47% dehiscence rate. Mean time to healing was 36.4 days.

Conclusions

Flap repairs for complex pilonidal cysts have high rates of recurrence, reoperation, and wound dehiscence. However, flap patients represent a more challenging repair with long operative times, blood loss, and large sinus size. Absence of the perfect approach to managing a complex sinus necessitates a thorough description of the problem and a discussion between the surgeon and the patient about the merits of each approach before a decision is made.

Level of Evidence: Level IV, therapeutic study.

http://ift.tt/2xpk4Es

Extraluminal biodegradable splint to treat upper airway anterior malacia: A preclinical proof of principle

Objective

Upper airway malacia highly complicates the treatment of benign laryngotracheal stenosis, and no ideal option is available to date. We here explore the use of extraluminal biodegradable splints in an animal model of long-segment anterior tracheomalacia (TM). We show the efficacy, as well as the tissue tolerance, of a custom-made biodegradable extraluminal device surgically inserted around the trachea.

Study Design

Preclinical animal study.

Methods

Anterior TM was induced in rabbits through an anterior neck approach by removing eight consecutive anterior tracheal rings without damaging the underlying mucosa. Malacia was corrected during the same surgery by pexy sutures, suspending the tracheal mucosa to an experimental biodegradable device. Symptoms, survival, and tissue reaction were compared to healthy and sham surgery controls.

Results

The model induced death by respiratory failure within minutes. Ten animals received the experimental treatment, and those who survived the perioperative period remained asymptomatic with a maximum follow-up of 221 days. Histological studies at programmed euthanasia showed complete degradation of the prosthesis, with significant remnant fibrosis around the trachea. However, the tracheal stiffness of test segments was comparatively less than that of control segments.

Conclusion

Extraluminal biodegradable splints rescued animals with a condition otherwise incompatible with life. It was well tolerated, leaving peritracheal fibrosis that was not as stiff as normal trachea. The external tracheal stiffening was sufficient for the test animals to live through the phase of severe acute hypercollapsibility. This represents a valid option to help pediatric patients with laryngotracheal stenosis and associated cartilaginous airway malacia.

Level of Evidence

NA. Laryngoscope, 2017

http://ift.tt/2x3OCf7

A paradigm for evaluation and management of the maxillary sinus before dental implantation

Objectives

To determine a paradigm for evaluating and managing maxillary sinus conditions before dental implantation via preoperative sinonasal assessment.

Study Design

Prospective cohort study.

Methods

Eighty-four patients who underwent dental implantation with or without sinus augmentation were included. Maxillary sinus conditions were classified into groups 1 to 6 according to cone-beam computed tomography (CT) findings: 1) nonspecific findings, 2) solitary polyp or cyst, 3) mucosal thickening, 4) air–fluid level or fluid accumulation, 5) near-total opacification of the maxillary or other paranasal sinus, and 6) calcification spots in the maxillary sinus. Dental implantation with or without sinus augmentation was suggested with postoperative sinus observation (groups 1–3), after medication for acute sinusitis (group 4), and after comprehensive treatment of chronic or fungal sinusitis (groups 5–6). Intraoperative and postoperative sinus-related complications were recorded.

Results

Two patients (groups 1 and 3) developed acute rhinosinusitis after sinus augmentation; both recovered completely with medical treatment. Schneiderian membrane perforation occurred during sinus lift surgery in six patients (group 1): five recovered after conservative medical therapy and close observation, whereas one required endoscopic sinus surgery and recovered well. No chronic rhinosinusitis developed after dental implantation.

Conclusion

Craniofacial CT is crucial for pre-dental implantation sinonasal evaluation. The risk of dental implant-related chronic rhinosinusitis is low for patients with cysts, polyps, or mucosal thickening in the maxillary sinus. However, preventive endoscopic sinus surgery is recommended for patients with incurable chronic rhinosinusitis, fungal sinusitis, and large polyps or cysts.

Level of Evidence

4. Laryngoscope, 2017

http://ift.tt/2x66QdB

Evolution of the endoscopic modified Lothrop procedure: A systematic review and meta-analysis

Objective

Since first described in the 1990s, the endoscopic modified Lothrop procedure (EMLP) has been the subject of a growing body of literature. We performed a review to compare indications and outcomes of EMLP in an early cohort of publications (1990–2008) versus a contemporary cohort (2009–2016) and compare outcomes associated with follow-up ≥2 years versus <2 years.

Data Sources

PubMed, SCOPUS and Cochrane databases.

Review Methods

An English-language search of the PubMed and Ovid databases was conducted to identify publications from 1990 to 2016 reporting clinical outcomes of EMLP. Meta-analysis was performed using Statistical Analysis System 9.4.

Results

A total of 1,205 patients were abstracted from 29 articles with a mean follow-up of 29.1 ± 10.3 months. The overall rate of significant or complete symptom improvement was 86.5% (95% confidence interval [CI]: 84.2%-88.7%). The overall patency rate was 90.7% (95% CI: 89.1%-92.3%), with a revision rate of 12.6% (95% CI: 10.6%-14.3%). Compared to the early cohort, patients in the contemporary cohort underwent EMLP more often for tumors (P < .001), had higher rates of complete or significant symptom improvement (90.0% vs. 82.6 %, P < .001); and trended toward greater patency rates (92.1% vs. 88.6%, P = .052). Compared to the short-term follow-up cohort, the long-term cohort showed no differences in symptom improvement or patency, but the revision rate was higher (14.5% vs. 9.2%, P = .016).

Conclusions

In the last decade, EMLP has been performed more frequently for tumors. Recent studies have demonstrated improved symptom outcomes and a trend toward improved patency rates. The revision rate increased significantly when follow-up exceeded 2 years. Laryngoscope, 2017

http://ift.tt/2x48GOp

Extraluminal biodegradable splint to treat upper airway anterior malacia: A preclinical proof of principle

Objective

Study Design

Preclinical animal study.

Methods

Results

Conclusion

Level of Evidence

NA. Laryngoscope, 2017

http://ift.tt/2x3OCf7

A paradigm for evaluation and management of the maxillary sinus before dental implantation

Objectives

To determine a paradigm for evaluating and managing maxillary sinus conditions before dental implantation via preoperative sinonasal assessment.

Study Design

Prospective cohort study.

Methods

Results

Conclusion

Level of Evidence

4. Laryngoscope, 2017

http://ift.tt/2x66QdB

Evolution of the endoscopic modified Lothrop procedure: A systematic review and meta-analysis

Objective

Data Sources

PubMed, SCOPUS and Cochrane databases.

Review Methods

Results

Conclusions

http://ift.tt/2x48GOp

Biomarker levels in gingival crevicular fluid of generalized aggressive periodontitis patients after non-surgical periodontal treatment

Abstract

Objectives

The aim of this study was to assess the effects of non-surgical periodontal treatment on gingival crevicular fluid (GCF) cytokines in patients with generalized aggressive periodontitis (GAgP), in relation to clinical parameters.

Materials and methods

Data were obtained from 16 GAgP patients and 15 periodontally healthy controls. Periodontal parameters and GCF biomarker levels were evaluated at baseline and repeated 3 and 6 months after treatment for GAgP subjects. Moderate and deep pocket sites were analyzed separately. The amount of interleukin (IL)-1β, IL-9, tumor necrosis factor (TNF)-α, platelet-derived growth factor (PDGF-bb), and vascular endothelial growth factor (VEGF) were measured using a highly specific and sensitive multiplex bead immunoassay.

Results

At baseline, cytokine levels in the moderate and deep pocket sites of GAgP patients were higher than those of the healthy control sites. In GAgP group, periodontal treatment led to improvement in all examined clinical parameters and resulted in a statistically significant reduction in the total amounts of IL-1β, VEGF, and TNF-α, in comparison to baseline, already 3 months after therapy in both moderate and deep pocket sites and of PDGF-bb in deep sites (p < 0.01). At the concentration level, only IL-1β and VEGF were affected.

Conclusion

Non-surgical treatment of GAgP provided significant clinical benefits leading to a marked decrease in the GCF levels of some pro-inflammatory and pro-angiogenic cytokines, but not of IL-9 and PDGF-bb.

Clinical relevance

Although the periodontal therapy successfully decreased clinical signs of inflammation, the GCF levels of some inflammatory cytokines were still elevated.

http://ift.tt/2x3Znho

Septum-based nasal tip plasty : A comparative study between septal extension graft and double-layered conchal cartilage extension graft.

Background: Septal extension graft is currently the most commonly used primary and secondary rhinoplasty technique in Asia because it provides maximal tip projection and rotational controllability. We designed this study to compare the tip projection amount and rotational controllability of the tip support between the septal extension graft based on the L-strut septum and double-layered conchal cartilage graft based on the full septum at the nasal tip. Method: A total 27 consecutive patients who underwent nasal tip plasty with the septal extension graft or double-layered conchal cartilage graft for purely esthetic reasons between March 2014 and July 2016. The nasal tip projection and columellar labial angle in preoperative (T0), immediate postoperative (T1, average 2 weeks after the operation), and postoperative (T2, on average 7 months after the operation) was analyzed with clinical photography Result: 14 patients (Group A) received septal extension graft whereas 13 patients (Group B) received double-layered conchal cartilage graft. 61% and 74% changes in tip projection ratio were immediately achieved and was maintained after surgery for Groups A and B, respectively (T2-T0/T1-T0; p = 0.722 for Group A and B). Therefore, the relapse ratio of this technique was 39% and 26% for Groups A and B. Conclusion: This comparative study between the septal extension graft and double-layered conchal cartilage graft showed that both nasal tip plasties are similar in terms of stability. Considering the fact that the double-layered conchal cartilage graft could preserve septal support, this technique could become an effective and safe alternative option for rhinoplasty. (C)2017American Society of Plastic Surgeons

http://ift.tt/2fqol0w

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Σάββατο 16 Σεπτεμβρίου 2017

Abstract

Abstract

Abstract

Abstract

Abstract

Summary

Abstract

Abstract

Graphical abstract

Graphical abstract

Abstract

Purposes

Methods

Results

Conclusions

Abstract

Purpose

Experimental design

Results

Conclusions

Graphical abstract

Abstract

Abstract

Abstract

Graphical abstract

Abstract

Purpose

Methods

Results

Conclusion

Abstract

Objectives

Methods

Results

Conclusion

Summary

Background

Aims

Patients/Methods

Results

Conclusions

Summary

Background

Aims

Patients/Methods

Results

Conclusions

Abstract

Abstract

Background

Methods

Results

Conclusions

Objective

Study Design