Risk factors of pediatric tinnitus: Systematic review and meta-analysis

Objectives/Hypothesis

Medications for pediatric tinnitus are not widely used due to a lack of evidence-based information. The modification of risk factors is essential in pediatric tinnitus; however, there is a lack of systematic reviews despite several reports on risk factors. This study performed a systematic review and meta-analysis of available literature to evaluate risk factors of pediatric tinnitus.

Methods

Studies reporting the risk factors of pediatric tinnitus were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases for studies published from database inception to 2016. The selected articles included clinical or epidemiological studies conducted with at least 50 subjects and at least one risk factor, including age, gender, hearing loss, noise exposure, or smoking.

Results

Eleven studies involving a total of 28,358 individuals were identified. Increased age was not a significant risk factor with a standardized median difference of 0.16 (95% confidence interval [CI]: −0.01 to 0.33). However, there was a significant correlation between increased age and tinnitus in the adolescent population. The odds ratio (OR) was 1.37 for female gender (95% CI: 1.17 to 1.60), 2.39 for hearing loss (95% CI: 1.48 to 3.87), and 11.35 for noise exposure (95% CI: 1.87 to 68.77). Two studies in adolescents showed statistical significance for smoking as a risk factor in developing tinnitus (OR: 6.05, 95% CI: 1.81 to 20.21).

Conclusions

Older-aged adolescents, as well as those who are females and those with hearing loss may have a higher risk of tinnitus. Noise exposure in the general pediatric population and smoking in adolescents may represent especially important risk factors in pediatric tinnitus. Laryngoscope, 2017

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Adult normative data for phonatory aerodynamics in connected speech

Objectives/Hypothesis

To establish normative values for phonatory aerodynamic measurements in connected speech across adult ages and gender.

Study Design

Prospective data collection across group design.

Methods

One hundred fifty adults aged >18 years without voice complaints were stratified into three equal-age groups (group 1 [ages 18–39 years]; group 2 [ages 40–59 years], and group 3 [ages 60 + years]) and two equal-gender groups (male and female) resulting in 25 participants in each category. Participants read the first four sentences of the Rainbow Passage at comfortable pitch and loudness to obtain a connected speech sample. The following dependent variables were analyzed: breath number, reading passage duration, mean phonatory airflow, inspiratory airflow duration, and expiratory airflow duration.

Results

A gender effect was found for mean phonatory airflow, with males showing significantly greater phonatory airflow than females during connected speech (P < .001). Number of breaths was significantly greater for group 3 than group 2 (P < .001) and group 1 (P < .001). Duration, and inspiratory and expiratory airflow durations were all significantly greater for group 3 (P < .001) than group 2 (P < .001) than group 1 (P < .001).

Conclusions

This study provides normative data for phonatory aerodynamics in adult connected speech. Significant age and gender effects were observed. Laryngoscope, 2017

http://ift.tt/2lFDikN

Risk factors of pediatric tinnitus: Systematic review and meta-analysis

Objectives/Hypothesis

Medications for pediatric tinnitus are not widely used due to a lack of evidence-based information. The modification of risk factors is essential in pediatric tinnitus; however, there is a lack of systematic reviews despite several reports on risk factors. This study performed a systematic review and meta-analysis of available literature to evaluate risk factors of pediatric tinnitus.

Methods

Studies reporting the risk factors of pediatric tinnitus were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases for studies published from database inception to 2016. The selected articles included clinical or epidemiological studies conducted with at least 50 subjects and at least one risk factor, including age, gender, hearing loss, noise exposure, or smoking.

Results

Eleven studies involving a total of 28,358 individuals were identified. Increased age was not a significant risk factor with a standardized median difference of 0.16 (95% confidence interval [CI]: −0.01 to 0.33). However, there was a significant correlation between increased age and tinnitus in the adolescent population. The odds ratio (OR) was 1.37 for female gender (95% CI: 1.17 to 1.60), 2.39 for hearing loss (95% CI: 1.48 to 3.87), and 11.35 for noise exposure (95% CI: 1.87 to 68.77). Two studies in adolescents showed statistical significance for smoking as a risk factor in developing tinnitus (OR: 6.05, 95% CI: 1.81 to 20.21).

Conclusions

Older-aged adolescents, as well as those who are females and those with hearing loss may have a higher risk of tinnitus. Noise exposure in the general pediatric population and smoking in adolescents may represent especially important risk factors in pediatric tinnitus. Laryngoscope, 2017

http://ift.tt/2ymZ56Q

Adult normative data for phonatory aerodynamics in connected speech

Objectives/Hypothesis

To establish normative values for phonatory aerodynamic measurements in connected speech across adult ages and gender.

Study Design

Prospective data collection across group design.

Methods

One hundred fifty adults aged >18 years without voice complaints were stratified into three equal-age groups (group 1 [ages 18–39 years]; group 2 [ages 40–59 years], and group 3 [ages 60 + years]) and two equal-gender groups (male and female) resulting in 25 participants in each category. Participants read the first four sentences of the Rainbow Passage at comfortable pitch and loudness to obtain a connected speech sample. The following dependent variables were analyzed: breath number, reading passage duration, mean phonatory airflow, inspiratory airflow duration, and expiratory airflow duration.

Results

A gender effect was found for mean phonatory airflow, with males showing significantly greater phonatory airflow than females during connected speech (P < .001). Number of breaths was significantly greater for group 3 than group 2 (P < .001) and group 1 (P < .001). Duration, and inspiratory and expiratory airflow durations were all significantly greater for group 3 (P < .001) than group 2 (P < .001) than group 1 (P < .001).

Conclusions

This study provides normative data for phonatory aerodynamics in adult connected speech. Significant age and gender effects were observed. Laryngoscope, 2017

http://ift.tt/2lFDikN

Reply to: Regarding complications following completion lymphadenectomy

Publication date: Available online 1 November 2017
Source:European Journal of Surgical Oncology
Author(s): J.A. Moody, D.L. Wallace, J.T. Hardwicke




http://ift.tt/2inWj6x

Geographic Disparity in Liver Allocation: Time to Act or Have Others Act for us

No abstract available

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International Data Base Populated by Anonymous Social Networking to Study Transplant Tourism

No abstract available

http://ift.tt/2A9jOrS

Management of pediatric psoriasis with acitretin: A review

Abstract

Psoriasis is a chronic inflammatory disease of the skin which can occur at any age-group. Psoriasis in childhood is not uncommon and has genetic susceptibility but usually, an environmental trigger such as infection is thought to initiate the disease process. Pediatric psoriasis has profound effects on both physical and psychosocial health of the patient. Treatment of mild psoriasis can be done with topical therapies but those which do not respond to topical therapies can be treated with phototherapy and systemic therapies. The use of systemic therapies in childhood is mainly based on the published data, case series, expert opinion and the experience as there is the lack of controlled trials in the age group. Based on the experience retinoids are probably the second line drugs for the treatment of pediatric psoriasis which do not respond to topical therapies and phototherapy. Using acitretin in a low dose and with proper physical examinations and laboratory investigations will reduce the hazard of potential serious adverse events. This article gives the review of the use of acitretin in pediatric psoriasis.

http://ift.tt/2iTw8IX

Management of pediatric psoriasis with acitretin: A review

Abstract

Psoriasis is a chronic inflammatory disease of the skin which can occur at any age-group. Psoriasis in childhood is not uncommon and has genetic susceptibility but usually, an environmental trigger such as infection is thought to initiate the disease process. Pediatric psoriasis has profound effects on both physical and psychosocial health of the patient. Treatment of mild psoriasis can be done with topical therapies but those which do not respond to topical therapies can be treated with phototherapy and systemic therapies. The use of systemic therapies in childhood is mainly based on the published data, case series, expert opinion and the experience as there is the lack of controlled trials in the age group. Based on the experience retinoids are probably the second line drugs for the treatment of pediatric psoriasis which do not respond to topical therapies and phototherapy. Using acitretin in a low dose and with proper physical examinations and laboratory investigations will reduce the hazard of potential serious adverse events. This article gives the review of the use of acitretin in pediatric psoriasis.

http://ift.tt/2iTw8IX

Impulsive Responding in Threat and Reward Contexts as a Function of PTSD Symptoms and Trait Disinhibition

Publication date: Available online 1 November 2017
Source:Journal of Anxiety Disorders
Author(s): Naomi Sadeh, Jeffrey M. Spielberg, Jasmeet P. Hayes
We examined current posttraumatic stress disorder (PTSD) symptoms, trait disinhibition, and affective context as contributors to impulsive and self-destructive behavior in 94 trauma-exposed Veterans. Participants completed an affective Go/No-Go task (GNG) with different emotional contexts (threat, reward, and a multidimensional threat/reward condition) and current PTSD, trait disinhibition, and risky/self-destructive behavior measures. PTSD interacted with trait disinhibition to explain recent engagement in risky/self-destructive behavior, with Veterans scoring high on trait disinhibition and current PTSD symptoms reporting the highest levels of these behaviors. On the GNG task, commission errors were also associated with the interaction of PTSD symptoms and trait disinhibition. Specifically, PTSD symptoms were associated with greater commission errors in threat vs. reward contexts for individuals who were low on trait disinhibition. In contrast, veterans high on PTSD and trait disinhibition exhibited the greatest number of commission errors in the multidimensional affective context that involved both threat and reward processing. Results highlight the interactive effects of PTSD and disinhibited personality traits, as well as threat and reward systems, as risk factors for impulsive and self-destructive behavior in trauma-exposed groups. Findings have clinical implications for understanding heterogeneity in the expression of PTSD and its association with disinhibited behavior.



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A Network Perspective on Comorbid Depression in Adolescents with Obsessive-compulsive Disorder

Publication date: Available online 1 November 2017
Source:Journal of Anxiety Disorders
Author(s): Payton J. Jones, Patrick Mair, Bradley C. Riemann, Beth L. Mugno, Richard J. McNally
People with obsessive-compulsive disorder [OCD] frequently suffer from depression, a comorbidity associated with greater symptom severity and suicide risk. We examined the associations between OCD and depression symptoms in 87 adolescents with primary OCD. We computed an association network, a graphical LASSO, and a directed acyclic graph (DAG) to model symptom interactions. Models showed OCD and depression as separate syndromes linked by bridge symptoms. Bridges between the two disorders emerged between obsessional problems in the OCD syndrome, and guilt, concentration problems, and sadness in the depression syndrome. A directed network indicated that OCD symptoms directionally precede depression symptoms. Concentration impairment emerged as a highly central node that may be distinctive to adolescents. We conclude that the network approach to mental disorders provides a new way to understand the etiology and maintenance of comorbid OCD-depression. Network analysis can improve research and treatment of mental disorder comorbidities by generating hypotheses concerning potential causal symptom structures and by identifying symptoms that may bridge disorders.

Graphical abstract

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Interleukin-33 promotes the inflammatory reaction in chronic rhinosinusitis with nasal polyps by NF-κB signaling pathway

OBJECTIVE: Interleukin (IL)-33 promotes T helper (Th2) immune response and may be involved in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). Using murine and human specimens, we evaluated the role of IL-33 in CRSwNP.

MATERIALS AND METHODS: To establish CRSwNP, Balb/c mice were sensitized with house dust mite, followed up by intranasal exposure to Staphylococcus aureus to stimulate the inflammatory response of nasal mucosa. The hematoxylin-eosin staining and total serum IgE were used to the successful construction of CRSwNP model. For mechanistic studies, we blocked mice with IL-33 and the Th2 cells counts in tissue were detected. Th2 cytokine expression of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24 in control group, CRSwNP group and IL-33 blockade group at 12 weeks after CRSwNP model establishment, were analyzed by qRT-PCR. Meanwhile, the relative mRNA and protein expression levels of NF-κB, MyD88 and TLR7 were detected after IL-33 blockade. To document the inflammatory response in patients with CRSwNP, The relative mRNA expression of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24 in control individuals and patients with CRSwNP (chronic rhinosinusitis with nasal polyps) were analyzed by qRT-PCR.

RESULTS: The CRSwNP model was successfully constructed. After IL-33 blocked, the relative expression of IL-33 and Th2 cells counts were reduced significantly. CRSwNP mice showed overproduction of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24 and IL-33 blockade inhibited the expression of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24. Furthermore, IL-33 blockade decreased the mRNA levels of NF-κB, MyD88 and TLR7, and also restrained the protein expression of them. On the other hand, patients' specimens with CRSwNP showed high levels of Th2 cytokines including IL-33, IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24.

CONCLUSIONS: CRSwNP is associated with overexpression of IL-33, with subsequent activation of Th2 immune response by NF-κB signaling pathway.

L'articolo Interleukin-33 promotes the inflammatory reaction in chronic rhinosinusitis with nasal polyps by NF-κB signaling pathway sembra essere il primo su European Review.

http://ift.tt/2huItQ1

Interleukin-33 promotes the inflammatory reaction in chronic rhinosinusitis with nasal polyps by NF-κB signaling pathway

OBJECTIVE: Interleukin (IL)-33 promotes T helper (Th2) immune response and may be involved in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). Using murine and human specimens, we evaluated the role of IL-33 in CRSwNP.

MATERIALS AND METHODS: To establish CRSwNP, Balb/c mice were sensitized with house dust mite, followed up by intranasal exposure to Staphylococcus aureus to stimulate the inflammatory response of nasal mucosa. The hematoxylin-eosin staining and total serum IgE were used to the successful construction of CRSwNP model. For mechanistic studies, we blocked mice with IL-33 and the Th2 cells counts in tissue were detected. Th2 cytokine expression of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24 in control group, CRSwNP group and IL-33 blockade group at 12 weeks after CRSwNP model establishment, were analyzed by qRT-PCR. Meanwhile, the relative mRNA and protein expression levels of NF-κB, MyD88 and TLR7 were detected after IL-33 blockade. To document the inflammatory response in patients with CRSwNP, The relative mRNA expression of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24 in control individuals and patients with CRSwNP (chronic rhinosinusitis with nasal polyps) were analyzed by qRT-PCR.

RESULTS: The CRSwNP model was successfully constructed. After IL-33 blocked, the relative expression of IL-33 and Th2 cells counts were reduced significantly. CRSwNP mice showed overproduction of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24 and IL-33 blockade inhibited the expression of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24. Furthermore, IL-33 blockade decreased the mRNA levels of NF-κB, MyD88 and TLR7, and also restrained the protein expression of them. On the other hand, patients' specimens with CRSwNP showed high levels of Th2 cytokines including IL-33, IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24.

CONCLUSIONS: CRSwNP is associated with overexpression of IL-33, with subsequent activation of Th2 immune response by NF-κB signaling pathway.

L'articolo Interleukin-33 promotes the inflammatory reaction in chronic rhinosinusitis with nasal polyps by NF-κB signaling pathway sembra essere il primo su European Review.

http://ift.tt/2huItQ1

Anterior palatoplasty in the treatment of obstructive sleep apnoea - a systemic review.

Related Articles

Anterior palatoplasty in the treatment of obstructive sleep apnoea - a systemic review.

Acta Otorhinolaryngol Ital. 2017 Oct 31;:

Authors: Pang KP, Pang EB, Pang KA, Rotenberg B

Abstract
This study seeks to determine the objective and subjective success rates of anterior palatoplasty and its variants for the treatment of obstructive sleep apnoea (OSA). A systematic review with two independent searches of Medline, PubMed, Cochrane Library and Evidence Based Medicine Reviews was performed to identify publications relevant to OSA and anterior palatoplasty. All relevant studies published before 30 June 2015 were included. Six studies were included in the systematic review. The numbers of patients in each paper ranged from 13 to 77 (total=240), and mean age ranged from 21 to 51 years. Substantial and consistent improvement in polysomnography (PSG) outcomes were observed in patients after the anterior palatoplasty, with or without multilevel surgery. The results showed that the anterior palatoplasty technique provides significantly improvement in the post-operative AHI. The mean pre-operative AHI (in the 6 papers) improved from 16.3 to 7.1, the snore visual analogue scale improved from 7.5 to 3.1 and the Epworth score reduced from 11.3 to 7.3 post-operatively. The overall pro-rated pooled success rate for all the patients was 72.5%, with a mean follow-up of 17.3 months. Anterior palatoplasty is an effective option in the management of patients with mild to moderate OSA.

PMID: 29087404 [PubMed - as supplied by publisher]

http://ift.tt/2zm57EJ

Nerve and vein preserving neck dissections for oral cancers: a prospective evaluation of spinal accessory nerve function and internal jugular vein patency following treatment.

Related Articles

Nerve and vein preserving neck dissections for oral cancers: a prospective evaluation of spinal accessory nerve function and internal jugular vein patency following treatment.

Acta Otorhinolaryngol Ital. 2017 Oct 31;:

Authors: Kumar Reddy GR, Hulikal N, Lakshmi AY, Vengamma B

Abstract
Nerve and vein preserving modification of the radical neck dissection is commonly used in the management of oral squamous cell cancers. There is limited literature addressing nerve function and vein patency following treatment. We prospectively analysed 65 patients with nerve conduction study using surface electromyography at baseline, 1 month and 6 months post-surgery and colour Doppler of the internal jugular vein at baseline and 1 month post-surgery. We also studied functional outcomes of nerve sparing with arm abduction test and Neck Dissection Quality of Life questionnaire. There was a statistically significant increase in mean latency of motor action potential and decrease in the mean amplitude of the motor action potential following surgery, suggesting nerve dysfunction. Following surgery, there was a significant decrease in the diameter of the vein as well as an increase in the velocity of blood flow; there was partial thrombus in 5% of individuals. In conclusion, even though nerve dysfunction compromised shoulder abduction, vein dysfunction rarely resulted in any significant clinical impact.

PMID: 29087403 [PubMed - as supplied by publisher]

http://ift.tt/2z6ngUd

Modification of growth, immunologic and feeding parameters in children with OSAS after adenotonsillectomy.

Related Articles

Modification of growth, immunologic and feeding parameters in children with OSAS after adenotonsillectomy.

Acta Otorhinolaryngol Ital. 2017 Oct 31;:

Authors: Cassano M, Russo G, Granieri C, Ciavarella D

Abstract
Obstructive sleep apnoea syndrome can cause growth delay in children. Adeno-tonsillectomy can resolve the syndrome in most cases. The aim of our study is to examine modifications in clinical and laboratory growth and immunological parameters and food intake changes in OSAS children after surgery. Twenty-eight children with severe OSAS associated with adeno-tonsillar hypertrophy were submitted to paediatric evaluation to calculate auxologic parameters (weight, height, BMI and standard deviation scores), a blood draw to evaluate growth (GH; IGF-1) and immunological parameters (IgG; IgA; IgM) and a dietitian evaluation to calculate caloric intake before and after 3 months following adeno-tonsillectomy. Mean height and weight values in the study group were slightly inferior to same-age children mean according to the percentile values. After surgery, both height and BMI increased significantly at 3-months follow-up: mean height increased 2.93 cm (p = 0.0001); BMI values greatly increased by 0.72 kg/m2 (p = 0.009). Standard deviation scores increased significantly for height (p = 0.03), weight (p = 0.001) and BMI (p = 0.001). These values significantly increased, despite almost unchanged caloric intake between the pre- and post-surgery period (90 ± 24 vs 91 ± 27 kcal/kg/day; p > 0.05). In all children, age-related GH values were normal and did not show any significant increase, while IGF-1 values significantly increased during the study period (p = 0.01). Regarding immunological parameters, only IgA levels decreased after surgery and maintained a value that was higher than normal (> 70 mg/dL). In conclusion, children affected by adenotonsillar hypertrophy and OSAS do not show significant growth delay, but they do experience a slowdown in growth rate. After adeno-tonsillectomy, the speed of growth soon increases, as weight and growth increase notwithstanding an unchanged food intake. Moreover, surgery does not cause reduction in the efficiency of the immune system.

PMID: 29087402 [PubMed - as supplied by publisher]

http://ift.tt/2iR2yn4

From CT scanning to 3D printing technology: a new method for the preoperative planning of a transcutaneous bone-conduction hearing device.

Related Articles

From CT scanning to 3D printing technology: a new method for the preoperative planning of a transcutaneous bone-conduction hearing device.

Acta Otorhinolaryngol Ital. 2017 Oct 31;:

Authors: Canzi P, Marconi S, Manfrin M, Magnetto M, Carelli C, Simoncelli AM, Fresa D, Beltrame M, Auricchio F, Benazzo M

Abstract
The aim of the present study was to assess the feasibility and utility of 3D printing technology in surgical planning of a transcutaneous boneconduction hearing device (Bonebridge®) (BB), focusing on the identification of the proper location and placement of the transducer. 3D printed (3DP) models of three human cadaveric temporal bones, previously submitted to CT scan, were created with the representation of a topographic bone thickness map and the sinus pathway on the outer surface. The 3DP model was used to detect the most suitable location for the BB. A 3DP transparent mask that faithfully reproduced the surface of both the temporal bone and the 3DP model was also developed to correctly transfer the designated BB area. The accuracy of the procedure was verified by CT scan: a radiological marker was used to evaluate the degree of correspondence of the transducer site between the 3DP model and the human temporal bone. The BB positioning was successfully performed on all human temporal bones, with no difficulties in finding the proper location of the transducer. A mean error of 0.13 mm was found when the transducer site of the 3DP model was compared to that of the human temporal bone. The employment of 3D printing technology in surgical planning of BB positioning showed feasible results. Further studies will be required to evaluate its clinical applicability.

PMID: 29087401 [PubMed - as supplied by publisher]

http://ift.tt/2iSX77h

Rescue therapy with bismuth quadruple regimen in patients with Helicobacter pylori -resistant strains

Abstract

Background

Bismuth quadruple therapy (BQT) is the recommended rescue therapy for Helicobacter pylori (H. pylori) infection. This study aimed to assess the efficacy and safety of a 10-day BQT regimen in patients who failed previous therapies and were infected with multiresistant H. pylori strains

Materials and methods

Helicobacter pylori-infected patients underwent endoscopy, culture, and susceptibility test for clarithromycin, metronidazole, and levofloxacin. Treatment with three-in-one capsule (Pylera®) four times daily and esomeprazole 20 mg twice daily for 10 days was administered. Treatment-emergent adverse events (TEAEs) were registered.

Results

A total of 116 patients with persistent H. pylori infection following at least one eradication therapy attempt were treated. Overall, resistance toward clarithromycin was detected in 80% of strains, toward metronidazole in 70%, and levofloxacin in 47.5%, with dual or triple resistance in 72.5% of cases. An eradication rate of 81.0% (95% CI: 73.0-87.1) and 87.0% (95% CI: 79.4-92.1) at ITT and PP analyses, respectively, was achieved. The cure rate remained high until it was used as fourth-line regimen, while it dropped to low values (<67%) in those patients with more than 4 therapy failures. A total of 65.7% (95% CI: 56.4-74.0) patients complained of TEAEs.

Conclusions

Our data found that bismuth-based quadruple regimen is effective as rescue therapy for curing patients infected with multiresistant H. pylori strains.

http://ift.tt/2A1xjsK

Rescue therapy with bismuth quadruple regimen in patients with Helicobacter pylori -resistant strains

Abstract

Background

Bismuth quadruple therapy (BQT) is the recommended rescue therapy for Helicobacter pylori (H. pylori) infection. This study aimed to assess the efficacy and safety of a 10-day BQT regimen in patients who failed previous therapies and were infected with multiresistant H. pylori strains

Materials and methods

Helicobacter pylori-infected patients underwent endoscopy, culture, and susceptibility test for clarithromycin, metronidazole, and levofloxacin. Treatment with three-in-one capsule (Pylera®) four times daily and esomeprazole 20 mg twice daily for 10 days was administered. Treatment-emergent adverse events (TEAEs) were registered.

Results

A total of 116 patients with persistent H. pylori infection following at least one eradication therapy attempt were treated. Overall, resistance toward clarithromycin was detected in 80% of strains, toward metronidazole in 70%, and levofloxacin in 47.5%, with dual or triple resistance in 72.5% of cases. An eradication rate of 81.0% (95% CI: 73.0-87.1) and 87.0% (95% CI: 79.4-92.1) at ITT and PP analyses, respectively, was achieved. The cure rate remained high until it was used as fourth-line regimen, while it dropped to low values (<67%) in those patients with more than 4 therapy failures. A total of 65.7% (95% CI: 56.4-74.0) patients complained of TEAEs.

Conclusions

Our data found that bismuth-based quadruple regimen is effective as rescue therapy for curing patients infected with multiresistant H. pylori strains.

http://ift.tt/2A1xjsK

Personality biomarkers of pathological gambling: A machine learning study

Publication date: 15 January 2018
Source:Journal of Neuroscience Methods, Volume 294
Author(s): Antonio Cerasa, Danilo Lofaro, Paolo Cavedini, Iolanda Martino, Antonella Bruni, Alessia Sarica, Domenico Mauro, Giuseppe Merante, Ilaria Rossomanno, Maria Rizzuto, Antonio Palmacci, Benedetta Aquino, Pasquale De Fazio, Giampaolo R. Perna, Elena Vanni, Giuseppe Olivadese, Domenico Conforti, Gennarina Arabia, Aldo Quattrone
BackgroundThe application of artificial intelligence to extract predictors of Gambling disorder (GD) is a new field of study. A plethora of studies have suggested that maladaptive personality dispositions may serve as risk factors for GD.New methodHere, we used Classification and Regression Trees algorithm to identify multivariate predictive patterns of personality profiles that could identify GD patients from healthy controls at an individual level.Forty psychiatric patients, recruited from specialized gambling clinics, without any additional comorbidity and 160 matched healthy controls completed the Five-Factor model of personality as measured by the NEO-PI-R, which were used to build the classification model.ResultsClassification algorithm was able to discriminate individuals with GD from controls with an AUC of 77.3% (95% CI 0.65–0.88, p<0.0001). A multidimensional construct of traits including sub-facets of openness, neuroticism and conscientiousness was employed by algorithm for classification detection.Comparison with existing method(s)To the best of our knowledge, this is the first study that combines behavioral data with machine learning approach useful to extract multidimensional features characterizing GD realm.ConclusionOur study provides a proof-of-concept demonstrating the potential of the proposed approach for GD diagnosis. The multivariate combination of personality facets characterizing individuals with GD can potentially be used to assess subjects' vulnerability in clinical setting.



http://ift.tt/2zpDbjB

Cross-Institutional Evaluation of a Mastoidectomy Assessment Instrument

Publication date: Available online 1 November 2017
Source:Journal of Surgical Education
Author(s): Thomas Kerwin, Brad Hittle, Don Stredney, Paul De Boeck, Gregory Wiet
ObjectiveThe objective of this work is to obtain validity evidence for an evaluation instrument used to assess the performance level of a mastoidectomy. The instrument has been previously described and had been formulated by a multi-institutional consortium.DesignMastoidectomies were performed on a virtual temporal bone system and then rated by experts using a previously described 15 element task-based checklist. Based on the results, a second, similar checklist was created and a second round of rating was performed.SettingTwelve otolaryngological surgical training programs in the United States.ParticipantsIn all, 65 mastoidectomy performances were evaluated coming from 37 individuals with a variety of temporal bone dissection experience, from medical students to attending physicians. Raters were attending surgeons from 12 different institutions.ResultsIntraclass correlation scores varied greatly between items in the checklist with some being low and some being high. Percentage agreement scores were similar to previous rating instruments. There is strong evidence that a high score on the task-based checklist is necessary for a rater to consider a mastoidectomy to be performed at the level of an expert but a high score is not a sufficient condition.ConclusionsRewording of the instrument items to focus on safety does not result in increased reliability of the instrument. The strong result of the Necessary Condition Analysis suggests that going beyond simple correlation measures can give extra insight into grading results. Additionally, we suggest using a multiple point scale instead of a binary pass/fail question combined with descriptive mastery levels.



http://ift.tt/2h4I6yJ

Trends in breast imaging: an analysis of 21years of formal scientific abstracts at the Radiological Society of North America

Publication date: May–June 2018
Source:Clinical Imaging, Volume 49
Author(s): Samantha L. Heller, Abbas Charlie, James S. Babb, Linda Moy, Yiming Gao
PurposeTo capture shifts in breast imaging through 21years of scientific meeting abstracts.Materials and methodsRSNA meeting programs (1995–2015) were searched to identify breast imaging scientific oral abstracts. Abstract year, author gender and degree, country, state, study design, modality, topic, funding and disclosures were recorded. Spearman correlation was performed.ResultsThere was an increase in %women first authors (rs=0.81, p<0.001), in %international abstracts (rs=−0.64, p=0.0002) and in industry funding (rs=0.766, p<0.001).Conclusion%Women first author presenters and %international presence and %industry support increased over time. These areas of flux may be useful for continued tracking.



http://ift.tt/2h4Ic9p

Shear Wave Elastography in Thyroid Nodules with Indeterminate Cytology: Results of a Prospective Bicentric Study

Thyroid Nov 2017, Vol. 27, No. 11: 1441-1449.


http://ift.tt/2lGfFsu

Low Malignancy Rates in Fine-Needle Aspiration Cytologies in a Primary Care Setting in Germany

Thyroid Nov 2017, Vol. 27, No. 11: 1385-1392.


http://ift.tt/2ylLlsZ

The 2017 Bethesda System for Reporting Thyroid Cytopathology

Thyroid Nov 2017, Vol. 27, No. 11: 1341-1346.


http://ift.tt/2lGaQzh

Future Meetings

Thyroid Nov 2017, Vol. 27, No. 11: 1461-1461.


http://ift.tt/2ymVpBY

Shear Wave Elastography in Thyroid Nodules with Indeterminate Cytology: Results of a Prospective Bicentric Study

Thyroid Nov 2017, Vol. 27, No. 11: 1441-1449.


http://ift.tt/2lGfFsu

Low Malignancy Rates in Fine-Needle Aspiration Cytologies in a Primary Care Setting in Germany

Thyroid Nov 2017, Vol. 27, No. 11: 1385-1392.


http://ift.tt/2ylLlsZ

The 2017 Bethesda System for Reporting Thyroid Cytopathology

Thyroid Nov 2017, Vol. 27, No. 11: 1341-1346.


http://ift.tt/2lGaQzh

Future Meetings

Thyroid Nov 2017, Vol. 27, No. 11: 1461-1461.


http://ift.tt/2ymVpBY

Contribution of 3D printing to mandibular reconstruction after cancer

Publication date: Available online 1 November 2017
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): A. Dupret-Bories, S. Vergez, T. Meresse, F. Brouillet, G. Bertrand
Three-dimensional (3D) printing is booming in the medical field. This technology increases the possibilities of personalized treatment for patients, while lowering manufacturing costs. To facilitate mandibular reconstruction with fibula free flap, some companies propose cutting guides obtained by CT-guided moulding. However, these guides are prohibitively expensive (€2,000 to €6,000). Based on a partnership with the CNRS, engineering students and a biomedical company, the authors have developed cutting guides and 3D-printed mandible templates, deliverable in 7days and at a lower cost. The novelty of this project is the speed of product development at a significantly lower price. In this technical note, the authors describe the logistic chain of production of mandible templates and cutting guides, as well as the results obtained. The goal is to allow access to this technology to all patients in the near future.



http://ift.tt/2iS9mRt

Prognostic factors for parotid metastasis of cutaneous squamous cell carcinoma of the head and neck

Publication date: Available online 1 November 2017
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): C. Bobin, P. Ingrand, B. Dréno, E. Rio, O. Malard, F. Espitalier
BackgroundCutaneous squamous cell carcinoma (CSCC) develops on the head in 80% of cases. Parotid metastasis (PM) is rare, but treatment, which associates surgery and radiation therapy, is heavy and prognosis poor.Material and methodsAll cases of parotidectomy for PM of CSCC of the head and neck between 2005 and 2015 were studied retrospectively. Epidemiologic, oncologic and therapeutic data were analyzed. Overall and specific survival were calculated following Kaplan-Meier. Log-rank and Cox models were used to identify prognostic factors for PM.ObjectivesThe principal study objective was to identify factors for survival in PM from CSCC of the head and neck.ResultsThirty-five patients were included. Mean time to onset of PM was 13months. Overall 1-, 2- and 5-year survival was respectively 70, 66 and 59%. Independent prognostic factors comprised immunodepression, age at treatment, positive CSCC margins, macroscopic facial nerve involvement, and metastatic cervical adenopathies.ConclusionThe study confirmed an association of several independent prognostic factors at the stage of parotid lymph-node metastasis, related to patient, primary CSCC and PM. Complete primary resection is essential to reduce the risk of PM. Intensified radiologic and clinical surveillance should enable early diagnosis.



http://ift.tt/2z7m7vH

Reexamining mechanic’s hands as a characteristic skin finding in dermatomyositis

Publication date: Available online 2 November 2017
Source:Journal of the American Academy of Dermatology
Author(s): Josef Symon S. Concha, Joseph F. Merola, David Fiorentino, Victoria P. Werth
Mechanic's hands is a poorly defined clinical finding that has been reported in a variety of rheumatologic diseases. Morphologic descriptions include hyperkeratosis on the sides of the digits that sometimes extends to the distal tips, diffuse palmar scale, and, more recently observed, linear discrete scaly papules in a similar lateral distribution. The association of mechanic's hands with dermatomyositis, although recognized, is still debatable. In this review, most studies have shown that mechanic's hands is commonly associated with dermatomyositis and displays histopathologic findings of interface dermatitis, colloid bodies and interstitial mucin which are consistent with a cutaneous connective tissue disease. A more specific definition of this entity would help to determine its usefulness in classifying and clinically identifying patients with dermatomyositis, with implications related to subsequent screening for associated comorbidities in this setting.



http://ift.tt/2z4R9nL

Therapeutic pearl: 5-fluorouracil tattoo for idiopathic guttate hypomelanosis

Publication date: Available online 2 November 2017
Source:Journal of the American Academy of Dermatology
Author(s): Carlos Gustavo Wambier, Sarah Perillo de Farias Wambier, Maria Teresa Pereira Soares, Juliano Breunig, Mark Aaron Cappel, Marina Landau




http://ift.tt/2iTBxiY

Cause specific mortality in adults with atopic dermatitis

Publication date: Available online 2 November 2017
Source:Journal of the American Academy of Dermatology
Author(s): Jacob P. Thyssen, Lone Skov, Alexander Egeberg
BackgroundAdult atopic dermatitis (AD) has been associated with several co-morbidities, but cause-specific mortality risk is unknown.ObjectivesTo examine cause-specific death rates and risk in adults with AD.MethodsWe performed cross-linkage of nationwide health care and cause of death registers. Adult patients with AD were matched with 10 controls per study subject. We calculated incidence rates per 1,000 person-years and hazard ratios (HRs) of cause-specific death with 95% confidence intervals (95% CIs) using Cox proportional hazards models.ResultsA total of 8,686 patients and 86,860 matched controls were studied. The risk of death, due to any cause, was significantly increased in patients with AD (HR 1.27, 95%CI 1.11-1.45). Significant causes included cardiovascular (HR 1.45; 95%CI 1.07-1.96), infectious (HR 3.71; 95% CI 1.43-9.60) and urogenital diseases (HR 5.51; 95%CI 1.54-19.80). No increased risk of death due to cancer, endocrine, neurological, psychiatric, respiratory, or gastroenterological disease was observed.LimitationsThe results might not be generalizable to patients seen exclusively by primary care physicians.ConclusionsAdults with atopic dermatitis had slightly increased risk of death during follow-up. While the risk of death from cardiovascular, urogenital, and infectious diseases was slightly elevated among patients with AD, the absolute risk was very low.



http://ift.tt/2z4R4At

Porcine Xenografts for Surgical Defects: A Single Center Experience with 128 Cases

Publication date: Available online 2 November 2017
Source:Journal of the American Academy of Dermatology
Author(s): Sean Marzolf, Divya Srivastava, Rajiv I. Nijhawan




http://ift.tt/2iRxXpw

A simple device for ablation of keloidal tissue and serial deposition of intralesional drugs

Publication date: Available online 2 November 2017
Source:Journal of the American Academy of Dermatology
Author(s): Savita Yadav, Somesh Gupta




http://ift.tt/2z6Yfbw

Down-regulation of Noggin and miR-138 coordinately promote osteogenesis of mesenchymal stem cells

Abstract

Mesenchymal stem cells (MSCs) can differentiate to osteocytes under suitable conditions. In recent years, micro-nucleotides have been progressively used to modulate gene expression in cells due to the consideration of safety. Our present study aimed to investigate whether co-delivery of Noggin-siRNA and antimiR-138 enhances the osteogenic effect of MSCs. Using a murine MSC line, C3H/10T1/2 cells, the delivery efficiency of Noggin-siRNA and antimiR-138 into MSCs was evaluated by quantitative real-time polymerase chain reaction (qRT-PCR). Cell phenotype and proliferation capacity was assessed by flow cytometry and MTT assay respectively. The osteogenesis of MSCs was tested by Alkaline Phosphatase (ALP) staining, qRT-PCR, and western blot analyses. Our results demonstrated that the expression of Noggin and miR-138 were significantly silenced in MSCs by Noggin-siRNA and/or antimiR-138 delivery, while the phenotype and proliferation capacity of MSCs were not affected. Down-regulation of Noggin and miR-138 cooperatively promoted osteogenic differentiation of MSCs. The ALP positive cells reached about 83.57 ± 10.18%. Compared with single delivery, the expression of osteogenic related genes, such as Alp, Col-1, Bmp2, Ocn and Runx2, were the highest in cells with co-delivery of the two oligonucleotides. Moreover, the protein level of RUNX2, and the ratios of pSMAD1/5/SMAD1/5 and pERK1/2/ERK1/2 were significantly increased. The activation of Smad, Erk signaling may constitute the underlying mechanism of the enhanced osteogenesis process. Taken together, our study provides a safe strategy for the clinical rehabilitation application of MSCs in skeletal deficiency.

http://ift.tt/2h4Tsmw

Quantitative image analysis of protein expression and colocalization in skin sections

Abstract

Immunofluorescence (IF) and in situ proximity ligation assay (isPLA) are techniques that are used for in situ protein expression and colocalization analysis, respectively. However, an efficient quantitative method to analyze both IF and isPLA staining on skin sections is lacking. Therefore, we developed a new method for semi-automatic quantitative layer-by-layer measurement of protein expression and colocalization in skin sections using the free open-source software CellProfiler. As a proof of principle, IF and isPLA of ichthyosis-related proteins TGm-1 and SDR9C7 were examined. The results indicate that this new method can be used for protein expression and colocalization analysis in skin sections.

This article is protected by copyright. All rights reserved.

http://ift.tt/2zqBNgu

Safety, efficacy, and drug survival of biologics and biosimilars for moderate-to-severe plaque psoriasis

Abstract

Background

Real-life data on newer biologic and biosimilar agents for moderate-to-severe psoriasis are lacking.

Objectives

To examine safety, efficacy, and time to discontinuation (drug survival) of biologics (adalimumab, etanercept, infliximab, secukinumab, and ustekinumab) and compare originators with biosimilars (i.e. Enbrel with Benepali, and Remicade with Remsima).

Methods

The DERMBIO registry contains data on all Danish patients with moderate-to-severe plaque psoriasis treated with biologics. We examined patients treated between January 1^st, 2007 and March 31^st, 2017. We used Kaplan-Meier survival curves and Cox-regression to examine drug survival patterns.

Results

A total of 3495 treatment series (2161 patients) were included (adalimumab n=1332, etanercept n=579, infliximab n=333, ustekinumab n=1055, and secukinumab n=196). Secukinumab had the highest number of PASI100 respondants, but also the lowest drug survival among all biologics. Ustekinumab had the highest drug survival overall. There were no significant differences in discontinuation risk between originator and biosimilar versions of infliximab or etanercept. Treatment with higher-than-approved dosages was frequent for all drugs except for adalimumab and secukinumab. Adverse events (predominantly infections) were most frequent for secukinumab and showed an increased (albeit low) incidence of cardiovascular events compared with the other agents.

Conclusions

Ustekinumab was associated with the highest drug survival, and secukinumab with the lowest, albeit that most patients on secukinumab were non-naïve. Switching from originator to biosimilar had no significant impact on drug survival, and the safety profiles were comparable. Adverse events occurred most frequently with secukinumab. Future studies are warranted to assess the long-term safety of novel biologics for psoriasis.

This article is protected by copyright. All rights reserved.

http://ift.tt/2xLyRqh

Population-based Clinical Practice Research Datalink study using algorithm modelling to identify the true burden of hidradenitis suppurativa

Summary

Background

Epidemiology data regarding hidradenitis suppurativa (HS) are conflicting and prevalence estimates vary 80-fold, from 0.05% in a population-based study, to 4%.

Objectives

To assess the hypothesis that previous population-based studies under-estimated true HS prevalence by missing undiagnosed cases.

Methods

We performed a population-based observational and case-control study using the UK Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics data. Physician-diagnosed cases in CPRD were identified from specific Read codes. Algorithms identified unrecognised 'proxy' cases, with at least five Read code records for boils in flexural skin sites. Validation of proxy cases was undertaken with General Practitioner questionnaires to confirm criteria-diagnosed cases. A case-control study assessed disease associations.

Results

On 30 June 2013, 23,353 physician-diagnosed HS cases were documented in 4,364,308 research-standard records. 68,890 proxy cases were identified, reduced to 10,146 criteria-diagnosed cases after validation, extrapolated from 107 completed questionnaires (61% return rate). Overall point prevalence was 0.77% (95% CI 0.76% to 0.78%). An additional 18,417 cases had a history of 1-4 flexural skin boils.

In physician-diagnosed cases, ORs for current smoker and obesity (BMI>30) were 3.61 (95% CI 3.44 to 3.79) and 3.29 (95% CI 3.14 to 3.45). HS was associated with type 2 diabetes, Crohn's disease, hyperlipidaemia, acne and depression and not associated with ulcerative colitis or polycystic ovary syndrome.

Conclusions

Contrary to results of previous population-based studies, HS is relatively common, with a UK prevalence of 0.77%, one-third being unrecognised, criteria-diagnosed cases using the most stringent disease definition. If probable cases are included, HS prevalence rises to 1.19%.

This article is protected by copyright. All rights reserved.

http://ift.tt/2z5Mzpk

Safety, efficacy, and drug survival of biologics and biosimilars for moderate-to-severe plaque psoriasis

Abstract

Background

Real-life data on newer biologic and biosimilar agents for moderate-to-severe psoriasis are lacking.

Objectives

To examine safety, efficacy, and time to discontinuation (drug survival) of biologics (adalimumab, etanercept, infliximab, secukinumab, and ustekinumab) and compare originators with biosimilars (i.e. Enbrel with Benepali, and Remicade with Remsima).

Methods

The DERMBIO registry contains data on all Danish patients with moderate-to-severe plaque psoriasis treated with biologics. We examined patients treated between January 1^st, 2007 and March 31^st, 2017. We used Kaplan-Meier survival curves and Cox-regression to examine drug survival patterns.

Results

A total of 3495 treatment series (2161 patients) were included (adalimumab n=1332, etanercept n=579, infliximab n=333, ustekinumab n=1055, and secukinumab n=196). Secukinumab had the highest number of PASI100 respondants, but also the lowest drug survival among all biologics. Ustekinumab had the highest drug survival overall. There were no significant differences in discontinuation risk between originator and biosimilar versions of infliximab or etanercept. Treatment with higher-than-approved dosages was frequent for all drugs except for adalimumab and secukinumab. Adverse events (predominantly infections) were most frequent for secukinumab and showed an increased (albeit low) incidence of cardiovascular events compared with the other agents.

Conclusions

Ustekinumab was associated with the highest drug survival, and secukinumab with the lowest, albeit that most patients on secukinumab were non-naïve. Switching from originator to biosimilar had no significant impact on drug survival, and the safety profiles were comparable. Adverse events occurred most frequently with secukinumab. Future studies are warranted to assess the long-term safety of novel biologics for psoriasis.

This article is protected by copyright. All rights reserved.

http://ift.tt/2xLyRqh

Population-based Clinical Practice Research Datalink study using algorithm modelling to identify the true burden of hidradenitis suppurativa

Summary

Background

Epidemiology data regarding hidradenitis suppurativa (HS) are conflicting and prevalence estimates vary 80-fold, from 0.05% in a population-based study, to 4%.

Objectives

To assess the hypothesis that previous population-based studies under-estimated true HS prevalence by missing undiagnosed cases.

Methods

We performed a population-based observational and case-control study using the UK Clinical Practice Research Datalink (CPRD) linked to Hospital Episode Statistics data. Physician-diagnosed cases in CPRD were identified from specific Read codes. Algorithms identified unrecognised 'proxy' cases, with at least five Read code records for boils in flexural skin sites. Validation of proxy cases was undertaken with General Practitioner questionnaires to confirm criteria-diagnosed cases. A case-control study assessed disease associations.

Results

On 30 June 2013, 23,353 physician-diagnosed HS cases were documented in 4,364,308 research-standard records. 68,890 proxy cases were identified, reduced to 10,146 criteria-diagnosed cases after validation, extrapolated from 107 completed questionnaires (61% return rate). Overall point prevalence was 0.77% (95% CI 0.76% to 0.78%). An additional 18,417 cases had a history of 1-4 flexural skin boils.

In physician-diagnosed cases, ORs for current smoker and obesity (BMI>30) were 3.61 (95% CI 3.44 to 3.79) and 3.29 (95% CI 3.14 to 3.45). HS was associated with type 2 diabetes, Crohn's disease, hyperlipidaemia, acne and depression and not associated with ulcerative colitis or polycystic ovary syndrome.

Conclusions

Contrary to results of previous population-based studies, HS is relatively common, with a UK prevalence of 0.77%, one-third being unrecognised, criteria-diagnosed cases using the most stringent disease definition. If probable cases are included, HS prevalence rises to 1.19%.

This article is protected by copyright. All rights reserved.

http://ift.tt/2z5Mzpk

A PTX/nitinol stent combination with temperature-responsive phase-change 1-hexadecanol for magnetocaloric drug delivery: Magnetocaloric drug release and esophagus tissue penetration

Publication date: January 2018
Source:Biomaterials, Volume 153
Author(s): Zhu Jin, Keqin Wu, Jingwen Hou, Kunhong Yu, Yuanyuan Shen, Shengrong Guo
An antitumor drug/esophagus stent combination can palliatively relieve malignant esophageal stricture and exert local chemotherapy to cancer. It is vital for effective treatment of cancer to control drug release and facilitate drug penetration into deep tissue after the combination is placed in the malignant strictured esophagus part. In this study, we firstly designed and prepared a novel antitumor drug/esophagus stent combination: a magnetocaloric nitinol stent coated with a bilayered film that consisted of one ethylene-vinyl acetate copolymer (EVA) layer as drug blocking layer and one EVA layer containing 10% paclitaxel (PTX) and 30% temperature sensitive phase-change fatty alcohol (1-tetradecanol, 1-hexadecanol or 1-octadecanol). The drug release and penetration into rabbit esophagus wall from the combination were investigated. It was found that, under an alternating electromagnetic field at a power of 0.1 kW, the combination was heated to 43 °C, the PTX was faster and more released from the combination, as well as the amount of PTX in esophagus tissue or its deep muscle tissue penetrated from the combination was much higher than that without alternating electromagnetic field. The pathological data showed that the combination was biocompatible and safe after placement in rabbit esophagus even under an alternating electromagnetic field. Overall, the PTX could be magnetocalorically released and effectively penetrated into esophagus wall from the PTX/nitinol stent combination.

Graphical abstract

http://ift.tt/2iTExMu

Editorial board

Publication date: January 2018
Source:Biomaterials, Volume 152





http://ift.tt/2iTysQ0

Molecular mechanism of Gd@C82(OH)22 increasing collagen expression: Implication for encaging tumor

Publication date: January 2018
Source:Biomaterials, Volume 152
Author(s): Jing Liu, Seung-gu Kang, Peng Wang, Yue Wang, Xiaonan Lv, Ying Liu, Fei Wang, Zonglin Gu, Zaixing Yang, Jeffrey K. Weber, Ning Tao, Zhihai Qin, Qing Miao, Chunying Chen, Ruhong Zhou, Yuliang Zhao
Gadolinium-containing fullerenol Gd@C82(OH)22 has demonstrated low-toxicity and highly therapeutic efficacy in inhibiting tumor growth and metastasis through new strategy of encaging cancer, however, little is known about the mechanisms how this nanoparticle regulates fibroblast cells to prison (instead of poison) cancer cells. Here, we report that Gd@C82(OH)22 promote the binding activity of tumor necrosis factor (TNFα) to tumor necrosis factor receptors 2 (TNFR2), activate TNFR2/p38 MAPK signaling pathway to increase cellular collagen expression in fibrosarcoma cells and human primary lung cancer associated fibroblasts isolated from patients. We also employ molecular dynamics simulations to study the atomic-scale mechanisms that dictate how Gd@C82(OH)22 mediates interactions between TNFα and TNFRs. Our data suggest that Gd@C82(OH)22 might enhance the association between TNFα and TNFR2 through a "bridge-like" mode of interaction; by contrast, the fullerenol appears to inhibit TNFα-TNFR1 association by binding to two of the receptor's cysteine-rich domains. In concert, our results uncover a sequential, systemic process by which Gd@C82(OH)22 acts to prison tumor cells, providing new insights into principles of designs of cancer therapeutics.



http://ift.tt/2z5ojDH

Dual-targeting Wnt and uPA receptors using peptide conjugated ultra-small nanoparticle drug carriers inhibited cancer stem-cell phenotype in chemo-resistant breast cancer

Publication date: January 2018
Source:Biomaterials, Volume 152
Author(s): Jasmine Miller-Kleinhenz, Xiangxue Guo, Weiping Qian, Hongyu Zhou, Erica N. Bozeman, Lei Zhu, Xin Ji, Y.Andrew Wang, Toncred Styblo, Ruth O'Regan, Hui Mao, Lily Yang
Heterogeneous tumor cells, high incidence of tumor recurrence, and decrease in overall survival are the major challenges for the treatment of chemo-resistant breast cancer. Results of our study showed differential chemotherapeutic responses among breast cancer patient derived xenograft (PDX) tumors established from the same patients. All doxorubicin(Dox)-resistant tumors expressed higher level of cancer stem-like cell biomarkers, including CD44, Wnt and its receptor LRP5/6, relative to Dox-sensitive tumors. To effectively treat resistant tumors, we developed an ultra-small magnetic iron oxide nanoparticle (IONP) drug carrier conjugated with peptides that dually targeted to Wnt/LRP5/6 and urokinase plasminogen activator receptor (uPAR). Our results showed that simultaneous binding to LRP5/6 and uPAR by the dual receptor targeted IONPs was required to inhibit breast cancer cell invasion. Molecular analysis revealed that the dual receptor targeted IONPs significantly inhibited Wnt/β-catenin signaling and cancer stem-like phenotype of tumor cells, with marked reduction of Wnt ligand, CD44 and uPAR. Systemic administration of the dual targeted IONPs led to nanoparticle-drug delivery into PDX tumors, resulting in stronger tumor growth inhibition compared to non-targeted or single-targeted IONP-Dox in a human breast cancer PDX model. Therefore, co-targeting Wnt/LRP and uPAR using IONP drug carriers is a promising therapeutic approach for effective drug delivery to chemo-resistant breast cancer.

Graphical abstract

http://ift.tt/2iTnH00

A new near-infrared persistent luminescence nanoparticle as a multifunctional nanoplatform for multimodal imaging and cancer therapy

Publication date: January 2018
Source:Biomaterials, Volume 152
Author(s): Junpeng Shi, Xia Sun, Shenghui Zheng, Jinlei Li, Xiaoyan Fu, Hongwu Zhang
Multifunctional nanoplatforms with multimodal imaging and cancer therapy capabilities have attracted attention in biomedical applications. Near-infrared persistent luminescence nanoparticles (NPLNPs) were considered one of the most promising candidates for constructing multifunctional nanoplatforms due to the absence of in situ excitation and high signal-to-noise ratios (SNRs). Here, we report a novel NPLNP mSiO2@Gd3Ga5O12:Cr³⁺, Nd³⁺ (mSiO2@GGO) as multifunctional nanoplatforms for multimodal imaging and cancer therapy. These NPs exhibited a persistent luminescence (745 nm) of more than 3 h in the first near-infrared window (NIR-I) after UV excitation, which can realize high SNRs and long-term in vivo imaging. Moreover, these NPs showed excellent NIR luminescence (1067 nm) in the second near-infrared window (NIR-II) under 808 nm excitation, which is more suitable for deep tissue imaging due to the lower photon scattering and deeper tissue penetration of NIR-II luminescence. Furthermore, the host Gd3Ga5O12 with high Gd³⁺ concentration showed a high r1 value (10.70 mM⁻¹ s⁻¹) and was suitable for T1 MR imaging. The mesoporous silica nanoparticles (mSiO2) served as a framework to control the mSiO2@GGO particle morphology and provide low toxicity and drug loading capacity for cancer therapy.

Graphical abstract

http://ift.tt/2iRWpHl

Ultrasensitive MRI detection of spontaneous pancreatic tumors with nanocage-based targeted contrast agent

Publication date: January 2018
Source:Biomaterials, Volume 152
Author(s): Takahito Kawano, Masaharu Murata, Jeong-Hun Kang, Jing Shu Piao, Sayoko Narahara, Fuminori Hyodo, Nobuhito Hamano, Jie Guo, Susumu Oguri, Kenoki Ohuchida, Makoto Hashizume
Contrast agents with greater specificity and sensitivity are required for the diagnosis of pancreatic cancers by magnetic resonance imaging (MRI). In this study, small heat shock protein 16.5 (Hsp16.5)-based nanocages conjugated to gadolinium(III)-chelated contrast agents and iRGD peptides (which target neuropilin-1 expressed on pancreatic cancer cells) were developed. To investigate whether template size influences relaxivity, nanocages with one to four hydrophobic domains were designed. MRI data showed that larger nanocages had higher T1 relaxivity than smaller nanocages, which resulted from a reduction in molecular tumbling rates caused by an increase in nanocage size, and a robust cage structure resulting from the introduction of hydrophobic domains. For in vivo MRI studies, the engineered nanocages were evaluated using the Kras^G12D; Trp53^R172H; Pdx-1Cre (KPC) transgenic mouse models, which develop clinically relevant pancreatic tumor under normal processes of angiogenesis, immune function and inflammation. Molecular MRI with protein nanocages was enabled to detect neuropilin-1-positive cells and to produce strong signal enhancement of spontaneous pancreatic tumors in KPC genetically engineered mouse models. Novel iRGD-modified nanocages displayed potential as a specific and sensitive MRI contrast agent for the diagnosis of pancreatic tumors for clinical translation.

Graphical abstract

http://ift.tt/2iRWoDh

Bioengineering a non-genotoxic vector for genetic modification of mesenchymal stem cells

Publication date: January 2018
Source:Biomaterials, Volume 152
Author(s): Xuguang Chen, Alireza Nomani, Niket Patel, Faranak S. Nouri, Arash Hatefi
Vectors used for stem cell transfection must be non-genotoxic, in addition to possessing high efficiency, because they could potentially transform normal stem cells into cancer-initiating cells. The objective of this research was to bioengineer an efficient vector that can be used for genetic modification of stem cells without any negative somatic or genetic impact. Two types of multifunctional vectors, namely targeted and non-targeted were genetically engineered and purified from E. coli. The targeted vectors were designed to enter stem cells via overexpressed receptors. The non-targeted vectors were equipped with MPG and Pep1 cell penetrating peptides. A series of commercial synthetic non-viral vectors and an adenoviral vector were used as controls. All vectors were evaluated for their efficiency and impact on metabolic activity, cell membrane integrity, chromosomal aberrations (micronuclei formation), gene dysregulation, and differentiation ability of stem cells. The results of this study showed that the bioengineered vector utilizing VEGFR-1 receptors for cellular entry could transfect mesenchymal stem cells with high efficiency without inducing genotoxicity, negative impact on gene function, or ability to differentiate. Overall, the vectors that utilized receptors as ports for cellular entry (viral and non-viral) showed considerably better somato- and genosafety profiles in comparison to those that entered through electrostatic interaction with cellular membrane. The genetically engineered vector in this study demonstrated that it can be safely and efficiently used to genetically modify stem cells with potential applications in tissue engineering and cancer therapy.

Graphical abstract

http://ift.tt/2iTynfa

Pain, Psychological Comorbidities, Disability, and Impaired Qualify of Life in Hidradenitis Suppurativa

Abstract

Purpose of Review

Hidradenitis suppurativa (HS) is a chronic, painful dermatologic disease characterized by recurrent inflammatory nodules and abscesses of intertriginous areas such as the axilla and groin. People with HS suffer from greater pain and associated psychological comorbidities, including depression, anxiety, disability, and impairments in quality of life (QoL), compared to those with other dermatologic conditions. Our review focuses on the occurrence of pain and these relationships.

Recent Findings

The existing literature indicates that acute and chronic pain, depression, anxiety, and disability all contribute to poor quality of life in individuals with HS. Despite the central role of pain and distress in the presentation of HS, few studies have empirically evaluated the impact of pain and gaps remain in the existing psychosocial literature. There are no formal guidelines for treating HS-specific pain or psychological comorbidities.

Summary

The results of this review show a clear and pressing need to develop treatment recommendations and effective interventions for addressing acute and chronic pain, psychological comorbidities, disability, and impaired quality of life among people with HS. This review outlines a multidisciplinary approach to treating and managing pain and psychological comorbidities.

http://ift.tt/2ymtD8M

Pain, Psychological Comorbidities, Disability, and Impaired Qualify of Life in Hidradenitis Suppurativa

Abstract

Purpose of Review

Hidradenitis suppurativa (HS) is a chronic, painful dermatologic disease characterized by recurrent inflammatory nodules and abscesses of intertriginous areas such as the axilla and groin. People with HS suffer from greater pain and associated psychological comorbidities, including depression, anxiety, disability, and impairments in quality of life (QoL), compared to those with other dermatologic conditions. Our review focuses on the occurrence of pain and these relationships.

Recent Findings

The existing literature indicates that acute and chronic pain, depression, anxiety, and disability all contribute to poor quality of life in individuals with HS. Despite the central role of pain and distress in the presentation of HS, few studies have empirically evaluated the impact of pain and gaps remain in the existing psychosocial literature. There are no formal guidelines for treating HS-specific pain or psychological comorbidities.

Summary

The results of this review show a clear and pressing need to develop treatment recommendations and effective interventions for addressing acute and chronic pain, psychological comorbidities, disability, and impaired quality of life among people with HS. This review outlines a multidisciplinary approach to treating and managing pain and psychological comorbidities.

http://ift.tt/2ymtD8M

A Note From the Editors

http://ift.tt/2zqMu2P

Editorial: Innovations in Study Design—A Call for Creative Solutions

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Comparison of Sociodemographic and Health-Related Characteristics of UK Biobank Participants With Those of the General Population

Abstract

The UK Biobank cohort is a population-based cohort of 500,000 participants recruited in the United Kingdom (UK) between 2006 and 2010. Approximately 9.2 million individuals aged 40–69 years who lived within 25 miles (40 km) of one of 22 assessment centers in England, Wales, and Scotland were invited to enter the cohort, and 5.5% participated in the baseline assessment. The representativeness of the UK Biobank cohort was investigated by comparing demographic characteristics between nonresponders and responders. Sociodemographic, physical, lifestyle, and health-related characteristics of the cohort were compared with nationally representative data sources. UK Biobank participants were more likely to be older, to be female, and to live in less socioeconomically deprived areas than nonparticipants. Compared with the general population, participants were less likely to be obese, to smoke, and to drink alcohol on a daily basis and had fewer self-reported health conditions. At age 70–74 years, rates of all-cause mortality and total cancer incidence were 46.2% and 11.8% lower, respectively, in men and 55.5% and 18.1% lower, respectively, in women than in the general population of the same age. UK Biobank is not representative of the sampling population; there is evidence of a "healthy volunteer" selection bias. Nonetheless, valid assessment of exposure-disease relationships may be widely generalizable and does not require participants to be representative of the population at large.

http://ift.tt/2zbRnfd

Invited Commentary: Can Estimation of Sodium Intake Be Improved by Borrowing Information From Other Variables?

Abstract

Estimation of dietary sodium intake is problematic. The most accurate measure is average sodium excretion from multiple 24-hour urine collections, but such an approach is impractical. Using data from the Women's Health Initiative, Prentice et al. (Am J Epidemiol. 2017;186(9):1035–1043) assessed the relationship of calibrated estimates of sodium and potassium excretion with cardiovascular outcomes. The calibrated estimates were a function of self-reported sodium-to-potassium ratio from a food frequency questionnaire, age, body mass index, race, supplement use, smoking status, educational level, income, and aspirin use. In general, associations with outcomes using the calibrated estimates were in the expected direction: direct for the sodium-to-potassium ratio and sodium intake and indirect for potassium. The unexpected associations were an increased risk of hemorrhagic stroke with lower sodium-to-potassium ratio and sodium intake and increased risk with higher potassium intake, along with a null relationship of sodium intake with ischemic stroke. Overall, our assessment is that the authors have improved the estimation of mean dietary sodium and potassium intakes. However, more work is needed to show that calibrated estimates actually improve estimation of future clinical events. If this methodological issue can be successfully addressed, their approach has the potential to improve estimation of dietary sodium and potassium intakes in observational studies.

http://ift.tt/2zoQArU

Prentice et al. Respond to “Improving Estimation of Sodium Intake”

http://ift.tt/2zc5gd5

Associations of Biomarker-Calibrated Sodium and Potassium Intakes With Cardiovascular Disease Risk Among Postmenopausal Women

Abstract

Studies of the associations of sodium and potassium intakes with cardiovascular disease incidence often rely on self-reported dietary data. In the present study, self-reported intakes from postmenopausal women at 40 participating US clinical centers are calibrated using 24-hour urinary excretion measures in cohorts from the Women's Health Initiative, with follow-up from 1993 to 2010. The incidence of hypertension was positively related to (calibrated) sodium intake and to the ratio of sodium to potassium. The sodium-to-potassium ratio was associated with cardiovascular disease incidence during an average follow-up period of 12 years. The estimated hazard ratio for a 20% increase in the sodium-to-potassium ratio was 1.13 (95% confidence interval (CI): 1.04, 1.22) for coronary heart disease, 1.20 (95% CI: 1.01, 1.42) for heart failure, and 1.11 (95% CI: 1.04, 1.19) for a composite cardiovascular disease outcome. The association with total stroke was not significant, but it was positive for ischemic stroke and inverse for hemorrhagic stroke. Aside from hemorrhagic stroke, corresponding associations of cardiovascular disease with sodium and potassium jointly were positive for sodium and inverse for potassium, although some were not statistically significant. Specifically, for coronary heart disease, the hazard ratios for 20% increases were 1.11 (95% CI: 0.95, 1.30) for sodium and 0.85 (95% CI: 0.73, 0.99) for potassium; and corresponding values for heart failure were 1.36 (95% CI: 1.02, 1.82) for sodium and 0.90 (95% CI: 0.69, 1.18) for potassium.

http://ift.tt/2zqMtfh

Mammographic Density Reduction as a Prognostic Marker for Postmenopausal Breast Cancer: Results Using a Joint Longitudinal-Survival Modeling Approach

Abstract

Previous studies have linked reductions in mammographic density after a breast cancer diagnosis to an improved prognosis. These studies focused on short-term change, using a 2-stage process, treating estimated change as a fixed covariate in a survival model. We propose the use of a joint longitudinal-survival model. This enables us to model long-term trends in density while accounting for dropout as well as for measurement error. We studied the change in mammographic density after a breast cancer diagnosis and its association with prognosis (measured by cause-specific mortality), overall and with respect to hormone replacement therapy and tamoxifen treatment. We included 1,740 women aged 50–74 years, diagnosed with breast cancer in Sweden during 1993–1995, with follow-up until 2008. They had a total of 6,317 mammographic density measures available from the first 5 years of follow-up, including baseline measures. We found that the impact of the withdrawal of hormone replacement therapy on density reduction was larger than that of tamoxifen treatment. Unlike previous studies, we found that there was an association between density reduction and survival, both for tamoxifen-treated women and women who were not treated with tamoxifen.

http://ift.tt/2zc5aSL

A Multinomial Regression Approach to Model Outcome Heterogeneity

Abstract

When a risk factor affects certain categories of a multinomial outcome but not others, outcome heterogeneity is said to be present. A standard epidemiologic approach for modeling risk factors of a categorical outcome typically entails fitting a polytomous logistic regression via maximum likelihood estimation. In this paper, we show that standard polytomous regression is ill equipped to detect outcome heterogeneity and will generally understate the degree to which such heterogeneity may be present. Specifically, nonsaturated polytomous regression will often a priori rule out the possibility of outcome heterogeneity from its parameter space. As a remedy, we propose to model each category of the outcome as a separate binary regression. For full efficiency, we propose to estimate the collection of regression parameters jointly using a constrained Bayesian approach that ensures that one remains within the multinomial model. The approach is straightforward to implement in standard software for Bayesian estimation.

http://ift.tt/2zpLHz8

Correcting the Standard Errors of 2-Stage Residual Inclusion Estimators for Mendelian Randomization Studies

Abstract

Mendelian randomization studies use genotypes as instrumental variables to test for and estimate the causal effects of modifiable risk factors on outcomes. Two-stage residual inclusion (TSRI) estimators have been used when researchers are willing to make parametric assumptions. However, researchers are currently reporting uncorrected or heteroscedasticity-robust standard errors for these estimates. We compared several different forms of the standard error for linear and logistic TSRI estimates in simulations and in real-data examples. Among others, we consider standard errors modified from the approach of Newey (1987), Terza (2016), and bootstrapping. In our simulations Newey, Terza, bootstrap, and corrected 2-stage least squares (in the linear case) standard errors gave the best results in terms of coverage and type I error. In the real-data examples, the Newey standard errors were 0.5% and 2% larger than the unadjusted standard errors for the linear and logistic TSRI estimators, respectively. We show that TSRI estimators with modified standard errors have correct type I error under the null. Researchers should report TSRI estimates with modified standard errors instead of reporting unadjusted or heteroscedasticity-robust standard errors.

http://ift.tt/2zbcdey

Comprehensive Analysis of Prevalence, Epidemiologic Characteristics, and Clinical Characteristics of Monoinfection and Coinfection in Diarrheal Diseases in Children in Tanzania

Abstract

The role of interactions between intestinal pathogens in diarrheal disease is uncertain. From August 2010 to July 2011, we collected stool samples from 723 children admitted with diarrhea (cases) to 3 major hospitals in Dar es Salaam, Tanzania, and from 564 nondiarrheic children (controls). We analyzed the samples for 17 pathogens and assessed interactions between coinfections in additive and multiplicative models. At least one pathogen was detected in 86.9% of the cases and 62.8%, of the controls. Prevalence of coinfections was 58.1% in cases and 40.4% in controls. Rotavirus, norovirus genogroup II, Cryptosporidium, and Shigella species/enteroinvasive Escherichia coli were significantly associated with diarrhea both as monoinfections and as coinfections. In the multiplicative interaction model, we found 2 significant positive interactions: rotavirus + Giardia (odds ratio (OR) = 23.91, 95% confidence interval (CI): 1.21, 470.14) and norovirus GII + enteroaggregative E. coli (OR = 3.06, 95% CI: 1.17, 7.98). One significant negative interaction was found between norovirus GII + typical enteropathogenic E. coli (OR = 0.09, 95% CI: 0.01, 0.95). In multivariate analysis, risk factors for death were presence of blood in stool and severe dehydration. In conclusion, coinfections are frequent, and the pathogenicity of each organism appears to be enhanced by some coinfections and weakened by others. Severity of diarrhea was not affected by coinfections.

http://ift.tt/2zpKKGU

Sex Differences in the Association Between Pain and Injurious Falls in Older Adults: A Population-Based Longitudinal Study

Abstract

We investigated whether there are sex differences in the association between pain and incident injurious falls. A total of 2,934 people (ages ≥60 years) from the population-based Swedish National Study on Aging and Care in Kungsholmen (2001–2004) participated. Participants were followed up for 3 and 10 years for falls leading to hospitalization or outpatient care. Data were analyzed with flexible parametric survival models that adjusted for potential confounders. During the first 3 years of follow-up, 67 men and 194 women experienced an injurious fall, and over 10 years of follow up, 203 men and 548 women experienced such a fall. In men, the presence of pain, having pain that was at least mild, having pain that affected several daily activities, and having daily pain all significantly increased the likelihood of incurring an injurious fall during the 3-year follow-up period. The multivariate-adjusted hazard ratios ranged from 1.78 (95% confidence interval: 1.00, 3.15) for the presence of pain to 2.89 (95% confidence interval: 1.41, 5.93) for several daily activities' being affected by pain. Results for the 10-year follow-up period were similar. No significant associations were detected in women. Although pain is less prevalent in men than in women, its impact on risk of injurious falls seems to be greater in men.

http://ift.tt/2zbca2m

A novel splicing mutation in SMPX is linked to nonsyndromic progressive hearing loss

X-linked nonsyndromic hearing impairment is the rarest form of genetic hearing loss and represents only a minor fraction of all cases. The aim of this study was to investigate the cause of X-linked nonsyndromic sensorineural hearing loss in a three-generation American family.

http://ift.tt/2z6du4B

Management trends of infantile hemangioma: A national perspective

The primary management of infantile hemangioma (IH) has changed since 2008, with the initiation of propranolol. The change that propranolol has affected on resource utilization is unknown.

http://ift.tt/2iV3zul

Effects of transient auditory deprivation during critical periods on the development of auditory temporal processing

The central auditory pathway matures through sensory experiences and it is known that sensory experiences during periods called critical periods exert an important influence on brain development. The present study aimed to investigate whether temporary auditory deprivation during critical periods (CPs) could have a detrimental effect on the development of auditory temporal processing.

http://ift.tt/2z7L0Yg

Activation of CRF/CRFR1 signaling in the basolateral nucleus of the amygdala contributes to chronic forced swim-induced depressive-like behaviors in rats

Publication date: 15 February 2018
Source:Behavioural Brain Research, Volume 338
Author(s): Lin Chen, Song Li, Jie Cai, Tian-Jiao Wei, Ling-Yu Liu, Hong-Yan Zhao, Bo-Heng Liu, Hong-Bo Jing, Zi-Run Jin, Min Liu, You Wan, Guo-Gang Xing
The basolateral nucleus of the amygdala (BLA) plays a key role in processing stressful events and affective disorders. Previously we have documented that exposure of chronic forced swim (FS) to rats produces a depressive-like behavior and that sensitization of BLA neurons is involved in this process. In the present study, we demonstrated that chronic FS stress (CFSS) could activate corticotrophin-releasing factor (CRF)/CRF receptor type 1 (CRFR1) signaling in the BLA, and blockade of CRF/CRFR1 signaling by intra-BLA injection of NBI27914 (NBI), a selective CRFR1 antagonist, could prevent the CFSS-induced depressive-like behaviors in rats, indicating that activation of CRF/CRFR1 signaling in the BLA is required for CFSS-induced depression. Furthermore, we discovered that exposure of chronic FS to rats could reinforce long-term potentiation (LTP) at the external capsule (EC)-BLA synapse and increase BLA neuronal excitability, and that all these alterations were inhibited by CRFR1 antagonist NBI. Moreover, we found that application of exogenous CRF also may facilitate LTP at the EC-BLA synapse and sensitize BLA neuronal excitability in normal rats via the activation of CRFR1. We conclude that activation of CRF/CRFR1 signaling in the BLA contributes to chronic FS-induced depressive-like behaviors in rats through potentiating synaptic efficiency at the EC-BLA pathway and sensitizing BLA neuronal excitability.



http://ift.tt/2xMAUua

Modified single prolonged stress reduces cocaine self-administration during acquisition regardless of rearing environment

Publication date: 15 February 2018
Source:Behavioural Brain Research, Volume 338
Author(s): Rebecca S. Hofford, Mark A. Prendergast, Michael T. Bardo
Until recently, there were few rodent models available to study the interaction of post-traumatic stress disorder (PTSD) and drug taking. Like PTSD, single prolonged stress (SPS) produces hypothalamic-pituitary-adrenal (HPA) axis dysfunction and alters psychostimulant self-administration. Other stressors, such as isolation stress, also alter psychostimulant self-administration. However, it is currently unknown if isolation housing combined with SPS can alter the acquisition or maintenance of cocaine self-administration. The current study applied modified SPS (modSPS; two hours restraint immediately followed by cold swim stress) to rats raised in an isolation condition (Iso), enrichment condition (Enr), or standard condition (Std) to measure changes in cocaine self-administration and HPA markers. Regardless of rearing condition, rats exposed to modSPS had greater corticosterone (CORT) release and reduced cocaine self-administration during initial acquisition compared to non-stressed controls. In addition, during initial acquisition, rats that received both Iso rearing and modSPS showed a more rapid increase in cocaine self-administration across sessions compared to Enr and Std rats exposed to modSPS. Following initial acquisition, a dose response analysis showed that Iso rats were overall most sensitive to changes in cocaine unit dose; however, modSPS had no effect on the cocaine dose response curve. Further, there was no effect of either modSPS or differential rearing on expression of glucocorticoid receptor (GR) in hypothalamus, medial prefrontal cortex, amygdala, or nucleus accumbens. By using modSPS in combination with Iso housing, this study identified unique contributions of each stressor to acquisition of cocaine self-administration.



http://ift.tt/2A7RiXG

Autologous breast reconstruction using the immediately lipofilled extended latissimus dorsi flap

–The latissimus dorsi flap is a popular choice for autologous breast reconstruction. To dramatically improve volume, we report our experience of using the immediately lipofilled extended latissimus dorsi flap and show it is a valid option for autologous breast reconstruction.

http://ift.tt/2gW2ZIE

Optimizing donor site closure following bilateral breast reconstruction with abdominal-based free flaps

The abdomen is the primary donor site for autologous free flap breast reconstruction, but violation of the rectus abdominus complex can result in significant morbidity.1, 2 Abdominal hernias and bulges are the most concerning donor site complications in the long term, but early wound complications also contribute to significant morbidity during the initial postoperative period. In order to minimize the risk of hernias and bulges, reinforcement of the abdominal wall with placement of mesh may be necessary particularly in the setting of bilateral breast reconstruction.

http://ift.tt/2imDKPX

Rectus femoris branch: an alternative blood supply for a distally based anterolateral thigh flap

Successful raising of a distally-based anterolateral thigh (dALT) flap mainly depends on a well-developed lateral circumflex femoral artery (LCFA) descending branch and an intact vascular connection between the descending branch and the vascular network of the knee. However, in some clinical scenarios, the descending branch is hypoplastic or the vascular connection of the knee is compromised. We present six cases of using dALT flaps in soft tissue defect reconstruction of the knee with either of the above-mentioned conditions.

http://ift.tt/2gVso5r

Distally based sural neuro-fasciocutaneous perforator flap for foot and ankle reconstruction: surgical modifications for flap pedicle and donor site closure without skin graft

The conventional procedure of the sural neuro-fasciocutaneous flap enables the supply of blood and venous drainage by increasing the width of the adipofascial tissue and preserving tiny venous return routes. Moreover, skin graft is a common method for donor site closure, which may lead to some complications and influence the aesthetic appearance. We report modifications for a distally based sural neuro-fasciocutaneous perforator flap and a relaying flap for donor site closure without skin graft.

http://ift.tt/2im5btj

Importance of sentinel lymphatic node biopsy in detection of early micrometastases in patients with cutaneous squamous cell carcinoma

Cutaneous squamous cell carcinoma (CSCC) is the second most common malignant skin cancer with a tendency to spread via lymphogenic pathway. Metastases are found in 2% - 6 % of cases. The aim of this study was to determine CSCC micrometastases when non-invasive examination methods do not detect them.

http://ift.tt/2gSJQr3

A systematic review of near-infrared spectroscopy in flap monitoring: current basic and clinical evidence and prospects

Recently, near-infrared spectroscopy (NIRS) has been reported to be a reliable non-invasive modality for free flap monitoring; however, the history of its application in flap monitoring is short, and there is no definite consensus regarding its use at present.

http://ift.tt/2im4P5X

Retrobulbar hematoma: a systematic review of factors related to outcomes

Retrobulbar hematoma (RBH), a rare but serious condition, can result in permanent vision loss. Although it is a known complication following trauma or facial fracture reduction, sinus surgery, or blepharoplasty, factors related to patient outcomes are not well-defined. A systematic review was performed to determine the relation of patient/treatment factors to outcomes.

http://ift.tt/2gSJzEx

A flap based on the plantar digital artery arch branch to improve appearance of reconstructed fingers: anatomical and clinical application

To investigate blood supply features of the flap based on the plantar digital artery arch and arch branch artery, and the treatment of outcomes of reconstructed fingers by the plantar digital artery arch branch island flap.

http://ift.tt/2imDErz

Hormone-dependent medial preoptic/lumbar spinal cord/autonomic coordination supporting male sexual behaviors

Publication date: Available online 31 October 2017
Source:Molecular and Cellular Endocrinology
Author(s): Donald W. Pfaff, Michael J. Baum
Testosterone (T) can act directly through neural androgen receptors (AR) to facilitate male sexual behavior; however, T's metabolites also can play complicated and interesting roles in the control of mating. One metabolite, dihydrotestosterone (DHT) binds to AR with significantly greater affinity than that of T. Is that important behaviorally? Another metabolite, estradiol (E), offers a potential alternative route of facilitating male mating behavior by acting through estradiol receptors (ER). In this review we explore the roles and relative importance of T as well as E and DHT at various levels of the neuroaxis for the activation of male sex behavior in common laboratory animals and, when relevant research findings are available, in man.



http://ift.tt/2zpH1Jq

Fe3O4 and metal–organic framework MIL-101(Fe) composites catalyze luminol chemiluminescence for sensitively sensing hydrogen peroxide and glucose

Publication date: 1 March 2018
Source:Talanta, Volume 179
Author(s): Xue Qian Tang, Yi Dan Zhang, Zhong Wei Jiang, Dong Mei Wang, Cheng Zhi Huang, Yuan Fang Li
In this work, Fe3O4 and metal–organic framework MIL-101(Fe) composites (Fe3O4/MIL-101(Fe)) was demonstrated to possess excellent catalytic property to directly catalyze luminol chemiluminescence without extra oxidants. We utilized Fe3O4/MIL-101(Fe) to develop a ultra-sensitive quantitative analytical method for H2O2 and glucose. The possible mechanism of the chemiluminescence reaction had been investigated. Under optimal conditions, the relative chemiluminescence intensity was linearly proportional to the logarithm of H2O2 concentration in the range of 5–150nM with a limit of detection of 3.7nM (signal-to-noise ratio = 3), and glucose could be linearly detected in the range from 5 to 100nM and the detection limit was 4.9nM (signal-to-noise ratio = 3). Furthermore, the present approach was successfully applied to quantitative determination of H2O2 in medical disinfectant and glucose in human serum samples.

Graphical abstract

http://ift.tt/2iSTNJx

Maintenance of Certification: A Grandfatherly Ethical Analysis

http://ift.tt/2zpADlc

Rosacea comorbidities and future research: The 2017 update by the National Rosacea Society Expert Committee

Although causal relationships have not been determined, many recent studies have uncovered associations between rosacea and increased risk for a variety of systemic disorders, many with potentially serious outcomes (Table I).1-17 This might significantly increase the clinical significance of rosacea because evidence that rosacea might be an outcome of systemic inflammation is mounting. In addition, current scientific knowledge has pointed to a variety of promising research avenues that might help further illuminate rosacea's etiology, pathophysiology, and clinical implications.

http://ift.tt/2z5A2Ck

Merkel Cell Carcinoma: Current United States Incidence and Projected Increases based on Changing Demographics

Merkel cell carcinoma (MCC) incidence rates are rising and strongly age-associated, relevant for an aging population.

http://ift.tt/2zoFQK6

Reexamining mechanic’s hands as a characteristic skin finding in dermatomyositis

Mechanic's hands is a poorly defined clinical finding that has been reported in a variety of rheumatologic diseases. Morphologic descriptions include hyperkeratosis on the sides of the digits that sometimes extends to the distal tips, diffuse palmar scale, and, more recently observed, linear discrete scaly papules in a similar lateral distribution. The association of mechanic's hands with dermatomyositis, although recognized, is still debatable. In this review, most studies have shown that mechanic's hands is commonly associated with dermatomyositis and displays histopathologic findings of interface dermatitis, colloid bodies and interstitial mucin which are consistent with a cutaneous connective tissue disease.

http://ift.tt/2zoFTFM

The Use of Vessel Loop to Bolster Mattress Sutures and to Prevent Scars

http://ift.tt/2zbVNmi

Therapeutic pearl: 5-fluorouracil tattoo for idiopathic guttate hypomelanosis

http://ift.tt/2zc1sbQ

A simple device for ablation of keloidal tissue and serial deposition of intralesional drugs

http://ift.tt/2zckm2s

Cause specific mortality in adults with atopic dermatitis

Adult atopic dermatitis (AD) has been associated with several co-morbidities, but cause-specific mortality risk is unknown.

http://ift.tt/2zpAEFM

Beyond JAAD January 2018

http://ift.tt/2zbGgTx

Porcine Xenografts for Surgical Defects: A Single Center Experience with 128 Cases

http://ift.tt/2zoFVgS

Influence of pneumococcal conjugate vaccines on acute otitis media in Japan

This study investigated: (i) changes in the incidence of acute otitis media (AOM) following introduction of public funding for free inoculation with 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13, respectively) and (ii) changes in the rate of myringotomies for AOM (MyfA) in children 1year following the publication of the first edition of the clinical practice guidelines for the diagnosis and management of AOM in children in Japan.

http://ift.tt/2z6tXrO

Synthesis, spectral characterization and computed optical analysis of potent triazole based compounds

Publication date: 5 February 2018
Source:Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy, Volume 190
Author(s): Sajjad H. Sumrra, Fazila Mushtaq, Muhammad Khalid, Muhammad Asam Raza, Muhammad Faizan Nazar, Bakhat Ali, Ataualpa A.C. Braga
Biologically active triazole Schiff base ligand (L) and metal complexes [Fe(II), Co(II), Ni(II), Cu(II) and Zn(II)] are reported herein. The ligand acted as tridentate and coordinated towards metallic ions via azomethine-N, triazolic-N moiety and deprotonated-O of phenyl substituents in an octahedral manner. These compounds were characterized by physical, spectral and analytical analysis. The synthesized ligand and metal complexes were screened for antibacterial pathogens against Chromohalobacter salexigens, Chromohalobacter israelensi, Halomonas halofila and Halomonas salina, antifungal bioassay against Aspergillus niger and Aspergellus flavin, antioxidant (DPPH, phosphomolybdate) and also for enzyme inhibition [butyrylcholinesterase (BChE) and acetylcholinesterase (AChE)] studies. The results of these activities indicated the ligand to possess potential activity which significantly increased upon chelation. Moreover, vibrational bands, frontier molecular orbitals (FMOs) and natural bond analysis (NBO) of ligand (1) were carried out through density functional theory (DFT) with B3lYP/6-311++G (d,p) approach. While, UV–Vis analysis was performed by time dependent TD-DFT with B3lYP/6-311++G (d,p) method. NBO analysis revealed that investigated compound (L) contains enormous molecular stability owing to hyper conjugative interactions. Theoretical spectroscopic findings showed good agreement to experimental spectroscopic data. Global reactivity descriptors were calculated using the energies of FMOs which indicated compound (L) might be bioactive. These parameters confirmed the charge transfer phenomenon and reasonable correspondence with experimental bioactivity results.

Graphical abstract

http://ift.tt/2z6rZrf

The influence of microorganisms in allergic diseases

Publication date: November–December 2017
Source:Allergologia et Immunopathologia, Volume 45, Issue 6
Author(s): M. Tortajada-Girbés, Javier Torres-Borrego




http://ift.tt/2A7gXjp

Epidemiology and pathophysiology of malignancy in common variable immunodeficiency?

Publication date: November–December 2017
Source:Allergologia et Immunopathologia, Volume 45, Issue 6
Author(s): A. Tak Manesh, G. Azizi, A. Heydari, F. Kiaee, M. Shaghaghi, N. Hossein-Khannazer, R. Yazdani, H. Abolhassani, A. Aghamohammadi
Common variable immunodeficiency (CVID) is a diagnostic category of primary immunodeficiency (PID) which may present with heterogeneous disorders including recurrent infections, autoimmunity, granulomatous diseases, lymphoid and other types of malignancies. Generally, the incidence of malignancy in CVID patients is around 1.5–20.7% and usually occurs during the 4th–6th decade of life. Non-Hodgkin lymphoma is the most frequent malignancy, followed by epithelial tumours of stomach, breast, bladder and cervix. The exact pathological mechanisms for cancer development in CVID are not fully determined; however, several mechanisms including impaired genetic stability, genetic predisposition, immune dysregulation, impaired clearance of oncogenic viruses and bacterial infections, and iatrogenic causes have been proposed to contribute to the high susceptibility of these patients to malignancies.



http://ift.tt/2xNaR6j

Is the evidence of breast feeding protection against coeliac disease real?

Publication date: November–December 2017
Source:Allergologia et Immunopathologia, Volume 45, Issue 6
Author(s): A. Girbovan, G. Sur, G. Samasca, I. Lupan
Many recent studies discredit breastfeeding protection against coeliac disease. We will try to answer the question: "Is the evidence of breast feeding protection against coeliac disease real?"



http://ift.tt/2A7gLAH

Under the superficial dichotomy pathogen and allergen are two manifestations of same immune activation and pathogenesis mechanisms

Publication date: November–December 2017
Source:Allergologia et Immunopathologia, Volume 45, Issue 6
Author(s): S. Patel
Pathogens and allergens are deemed as two contrasting facets of host immune status, deficiency and exuberant. In silico domain analysis of a diverse panel of pathogen and allergen proteins has revealed the shortcoming of this notion. Both the pathogen and allergen proteins elicit immune activation, with the outcome of immune agitation depending on the pathogen strain, allergen exposure duration, and host factors. Pathogens can replicate within the host and constantly irritate the immune system, leading to blood coagulation, respiratory collapse and death. Allergens, being non-viable, can only provoke the immune system transiently; however, depending on the allergen dose and extent exposed to, inflammation and fatality can occur. In silico analysis of pathogen and allergen proteins showed the conserved domains to be AAA, WR1, VKc, Kelch, Hr1, HAMP, HELICc, Dak2, CHAD, CHASE2, Galanin, PKS_TE, Robl_LC7, Excalibur, DISIN, etc. This exciting discovery can have far-reaching effects in drug target identification approaches.



http://ift.tt/2xM8MYe

Characterization of upper airway obstruction using cine MRI in children with residual obstructive sleep apnea after adenotonsillectomy

Objectives/Background: Tonsillectomy and adenoidectomy (T&A) leads to resolution of obstructive sleep apnea (OSA) in most children. However, it persists in about 25-40%. Cinematic magnetic resonance imaging (cine MRI) can aid management of persistent OSA by localizing airway obstruction. We describe our experience in implementing and optimizing a cine MRI protocol using a 3 Tesla MRI scanner and the use of dexmedetomidine for sedation to improve reproducibility, safety and diagnostic accuracy.Patients/Methods: Patients aged 3-18 years who underwent cine MRI for evaluation of persistent OSA after T&A and failed positive airway pressure (PAP) therapy were included.

http://ift.tt/2z59hAu

Multiple nights of partial sleep deprivation do not affect prospective remembering at long delays

Prospective memory is defined as remembering to do something at a particular moment in the future and may be modulated by sleep. Here, we investigated whether multiple nights of partial sleep deprivation would affect the successful retrieval of intentions. Fifty-nine adolescents (mean age ± SD: 16.1 ± 0.6 years) were instructed to remember to press specific keys in response to the target words presented during a semantic categorization task in the future. Their memory was tested after five nights of either 5-h (sleep restriction group) or 9-h time-in-bed (control group).

http://ift.tt/2h2Gdm8

Daytime Sleepiness, Driving Performance, Reaction Time and Inhibitory Control during Sleep Restriction Therapy for Chronic Insomnia Disorder

Sleep restriction therapy (SRT) is a largely untested single treatment component of cognitive-behaviour therapy for insomnia. To date, the evidence for contraindications for SRT is limited to very few studies. The present study investigated the objective and subjective daytime consequences during the acute phase of SRT for adults diagnosed Chronic Insomnia Disorder.

http://ift.tt/2z6hRyQ

Nocturnal sleep architecture in idiopathic hypersomnia: a systematic review and meta-analysis

Current sleep medicine nosology places increased importance on nocturnal polysomnographic sleep recordings in the diagnosis of central nervous system disorders of hypersomnolence, particularly idiopathic hypersomnia (IH).

http://ift.tt/2h4vK9G