Head and Neck Diseases by Alexandros G.Sfakianakis: 12/28/17

Πέμπτη 28 Δεκεμβρίου 2017

Progressive delayed hemidystonia following clinically mild traumatic brain injury

A 16-year-old boy presented with progressive left hemidystonia over 3 years. The possibilities of symptomatic hemidystonia due to focal lesions such as infarct (vasculitis), tumours, tuberculoma, arteriovenous malformations or heredodegenerative disorders such as Wilson disease were considered. Imaging showed a peculiar scar involving right basifrontal region extending upto anterior, centromedian and dorsomedial nuclei of thalamus due to blowout fracture of roof of orbit. This scar was responsible for progressive left hemidystonia. On probing the history, it was revealed that patient had sustained a mild traumatic brain injury (mTBI) 3 years ago. Burke-Fahn-Marsden dystonia severity rating scale showed improvement from 19 to 6 after treatment with tablet trihexyphenidyl 16 mg and clonazepam 1 mg. A linear scar reaching upto thalamus due to blowout fracture of roof of orbit following clinically mTBI is unique. Delayed, progressive hemidystonia has been reported following severe head injury, however is less common following clinically mTBI.

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Endobronchial metastasis of mixed Mullerian tumour of the uterus

Endobronchial metastasis occurs in only 2%–5% of non-pulmonary cancers. Here we report on an 84-year-old woman who presented with breathlessness and light-headedness while on holiday in Australia, 2 years post-treatment for endometrial cancer. Initial CT pulmonary angiogram identified a soft tissue mass in the left hemithorax. A chest radiograph performed after repatriation was consistent with a large left pleural effusion, but bedside ultrasound showed a lobulated mass involving the left hemidiaphragm. A pleural procedure in the traditional 'triangle of safety' would have resulted in inadvertent puncture of the underlying mass. Serial imaging confirmed the mass was rapidly progressing, and metastatic malignant mixed Mullerian endometrial carcinoma was diagnosed by endobronchial biopsy. A tunnelled intrapleural catheter was inserted for symptom relief, and the patient deteriorated and died at home 2 weeks later. To our knowledge, this is the first case of endobronchial metastasis from malignant mixed Mullerian tumour of the uterus.

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Intramural oesophageal haematoma following traumatic neck injury

This case describes a previously well 90-year-old woman who presented with neck pain, swelling, dysphagia and hoarseness following a motor vehicle collision. Oesophageal oedema was visualised on CT of cervical spine and subsequent CT angiography highlighted an actively bleeding intramural oesophageal haematoma (IOH) extending from the cervical oesophagus to the carina. This rare phenomenon (IOH) has been described as a possible consequence of blunt trauma to the neck; however, we found no cases resulting from acceleration/deceleration injury. Although this was a potentially life-threatening injury, our patient made a full recovery with conservative management.

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A novel bivalent fusion vaccine induces broad immunoprotection against Staphylococcus aureus infection in different murine models

Publication date: Available online 28 December 2017
Source:Clinical Immunology
Author(s): Liuyang Yang, Heng Zhou, Ping Cheng, Yun Yang, Yanan Tong, Qianfei Zuo, Jiao Luo, Qiang Feng, Quanming Zou, Hao Zeng
With more and more drug-resistant Staphylococcus aureus strains emerging in hospitals, there is an urgent need to develop an effective vaccine to combat S. aureus infection. In this study, we constructed a novel bivalent fusion vaccine, SpA-DKKAA-FnBPA37-507 (SF), based on the D domain of staphylococcal protein A (SpA) and the A domain of fibronectin-binding protein A (FnBPA). Immunisation with SF induced a more ideal protective effect compared with the single components alone in a sepsis model. It also showed broad immunoprotection against seven FnBPA isotypes. Vaccination with SF induced strong antibodies responses and Th1/Th17 polarized cellular responses. Further we demonstrated the protective effect of antibodies by the opsonophagocytic assay (OPA) and passive immunisation. Moreover, vaccination with SF showed protective efficacy in a murine pneumonia model and skin abscess model. These results suggest that SF can be regarded as a promising vaccine candidate for the prevention of S. aureus infections.

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A novel bivalent fusion vaccine induces broad immunoprotection against Staphylococcus aureus infection in different murine models

Appendicular and breast cancers in an old lady: a case report

Abstract

The presence of two or more malignant tumors of different histological entities in an individual is referred to as multiple primary malignant neoplasms (MPMN). These are becoming more frequently encountered and reported in clinical practice nowadays. Majority of MPMN are diagnosed in elderly, where senility might alter the management plan. Despite the increased reporting of MPMN in the literature, only a few elaborated on the management of such cases. Also, the combination of synchronous primary appendicular and breast cancers—to our knowledge—has never been reported. Here we present the first report of an appendicular adenocarcinoma synchronously presenting along with invasive ductal carcinoma of the breast. We highlight the diagnostic essentials and the multidisciplinary management approach including surgical excision and adjuvant therapy.

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Endoscopic management of duodeno-ileal fistula secondary to diffuse B-cell lymphoma

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Abstract

Lymphoma arising in the gastrointestinal tract is relatively common and can affect multiple sites. The development of a gastrointestinal fistula secondary to lymphoma is very rare and has not previously been reported between the duodenum and ileum. This is the first reported care where a fistula secondary to lymphoma has been treated by an endoscopic covered duodenal stent occluding the defect rather than surgical intervention. This strategy permitted early commencement of curative intent chemotherapy which led to tumour shrinkage and fistula closure.

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Acute cholecystitis in a parastomal hernia causing a small bowel obstruction

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Abstract

A parastomal hernia is the abnormal protrusion of intra-abdominal tissue and organs through a defect in the abdominal wall around an ostomy. Commonly, they involve intra-abdominal fat, omentum or bowel. However, there are rare cases that involve other organs. We present the case of an 89-year-old gentleman with a gallbladder in his parastomal hernia. Due to his acute cholecystitis, the distended gallbladder compressed adjacent bowel loops in the parastomal hernia, resulting in a mechanical bowel obstruction. The patient was treated with antibiotics and a nasogastric tube. As his cholecystitis resolved his ostomy function returned.

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Emotion dysregulation and smoking among treatment-seeking smokers

Publication date: April 2018
Source:Addictive Behaviors, Volume 79
Author(s): Andrew H. Rogers, Jafar Bakhshaie, Andres G. Viana, Kara Manning, Nubia A. Mayorga, Lorra Garey, Amanda M. Raines, Norman B. Schmidt, Michael J. Zvolensky
IntroductionThere has been increased scholarly interest in advancing the study of emotion dysregulation and substance use. However, there is limited study of emotion dysregulation in the context of smoking. The current study examined the emotion dysregulation global construct and sub facets in relation to negative affect reduction expectancies, coping motives, perceived barriers for quitting, and the severity of problems experienced during quit attempts.MethodTreatment seeking smokers (n=469; 48.2% female, Mage=36.59, SD=13.58) enrolled in a smoking cessation trial and completed baseline measures of smoking cognitions and emotion dysregulation.ResultsResults indicated that the emotion dysregulation global score was significantly associated with each of the smoking dependent variables. Additionally, difficulty accessing emotion regulation strategies and difficulty engaging in goal-directed behavior were significantly associated with the dependent variables.ConclusionOverall, this is the first study to evaluate relations between multidimensional facets of emotion dysregulation and clinically relevant smoking variables. Emotion dysregulation may be an important treatment target for changing smoking.

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Trauma exposure and heavy drinking and drug use among college students: Identifying the roles of negative and positive affect lability in a daily diary study

Publication date: April 2018
Source:Addictive Behaviors, Volume 79
Author(s): Nicole H. Weiss, Krysten W. Bold, Ateka A. Contractor, Tami P. Sullivan, Stephen Armeli, Howard Tennen
Trauma exposure is linked to heavy drinking and drug use among college students. Extant research reveals positive associations between negative affect lability and both trauma exposure and alcohol use. This study aimed to extend past research by using daily diary methods to test whether (a) individuals with (versus without) trauma exposure experience greater negative and positive affect lability, (b) negative and positive affect lability are associated with heavy drinking and drug use, and (c) negative and positive affect lability mediate the relations between trauma exposure and heavy drinking and drug use. Participants were 1640 college students (M age=19.2, 54% female, 80% European American) who provided daily diary data for 30days via online surveys. Daily diaries assessed negative and positive affect and substance use (i.e., percent days of heavy drinking, percent days of drug use, total number of drugs used). Individuals with (versus without) a history of trauma exposure demonstrated higher levels of negative and positive affect lability. Negative, but not positive, affect lability was associated with percent days of heavy drinking, percent days of drug use, and total number of drugs used, and mediated the associations between trauma exposure and heavy drinking and drug use outcomes. Findings provide support for the underlying role of negative affect lability in the relations between trauma exposure and heavy drinking and drug use among college students, suggesting that treatments targeting negative affect lability may potentially serve to reduce heavy drinking and drug use among trauma-exposed college students.

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Identity as a cannabis user is related to problematic patterns of consumption among emerging adults

Publication date: April 2018
Source:Addictive Behaviors, Volume 79
Author(s): Claire E. Blevins, Ana M. Abrantes, Bradley J. Anderson, Celeste M. Caviness, Debra S. Herman, Michael D. Stein
IntroductionCannabis use has become a more normative, socially-acceptable behavior in the United States, despite research indicating that frequent use may become problematic for some individuals. Emerging adulthood, a time of identity development, is the most common time for cannabis use. Cannabis self-concept, or one's identification with cannabis as part of their personality or identity, is one factor that may influence use behavior. This study extends previous research that reported a link between self-concept, motivational factors, and normative beliefs by evaluating relationships between cannabis self-concept, motives for use, motivation to change, perceived descriptive norms, as well as cannabis-related outcomes (use, using alone, and cannabis-related problems).MethodsEmerging adults who used cannabis in the previous month (n=345, 53.9% male, mean age 21.0, 67.5% Non-Latino White) were recruited from a community sample for a health behaviors study. Participants were assessed for explicit cannabis self-concept, frequency of use, problems associated with use, motives for use, motivation to change, and normative beliefs about others' use.ResultsParticipants reported using cannabis on an average of 17.9 (SD=11.1) days of the previous month. Correlational analyses revealed that cannabis self-concept was positively associated with frequency of use, use-related problems, several motives for use, descriptive norms, and with using cannabis alone. Multivariate analyses revealed that rates of use, problems, and social and enhancement motives were independently and positively associated (p<0.05) with cannabis self-concept, while self-concept was negatively associated with desire to reduce cannabis use.ConclusionsCannabis self-concept may be a marker for more problematic patterns of use.

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Effects of alcohol and cigarette use on the initiation, reinitiation, and persistence of cannabis use from adolescence to emerging adulthood

Publication date: April 2018
Source:Addictive Behaviors, Volume 79
Author(s): Sanjana Pampati, Anne Buu, Yi-Han Hu, Carlos F. Mendes de Leon, Hsien-Chang Lin
ObjectiveAdolescent cannabis use has been associated with several negative outcomes. A previous study on an adult sample found alcohol and cigarette use to be associated with three cannabis use stages: initiation, reinitiation, and persistence, which represent distinct periods of use regarding progression and severity. Yet, the risk factors associated with these important stages have never been examined in a longitudinal study spanning adolescence to emerging adulthood.MethodsUsing longitudinal data from Add Health Waves 1–3, 1775 nonusers, 200 prior users, and 384 current users of cannabis were identified who were at risk of cannabis use initiation, reinitiation, and persistence, respectively. Three logistic regressions were conducted to examine the effects of prior cigarette and alcohol use on the three cannabis use stages, controlling for sociodemographic factors.ResultsEarly onset of cigarette use (OR=2.04, p=0.006) and higher alcohol use frequency (OR=1.40, p<0.001) were associated with cannabis use initiation. Greater cigarette use quantity was associated with a lower likelihood of reinitiation of cannabis use (OR=0.58, p=0.02). Increased cannabis use frequency (OR=1.72, p=0.006) and higher alcohol use frequency (OR=1.32, p=0.048) were associated with persistence of cannabis use. Sociodemographic factors such as household income, sex, and being older adolescents were associated with different cannabis use stages.ConclusionsPrior cigarette and alcohol use affect the risk of initiation, reinitiation, and persistence of cannabis use. The specific risk factors vary across different cannabis use stages. Interventions to prevent adolescent cannabis use should recognize these different risk factors and tailor to the stages of cannabis use.

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Editorial Board and Contents

Publication date: January 2018
Source:Trends in Immunology, Volume 39, Issue 1

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Play It Again, SAM: Macrophages Control Peripheral Fat Metabolism

Publication date: Available online 28 December 2017
Source:Trends in Immunology
Author(s): Kevin A. Guttenplan, Shane A. Liddelow
Macrophages and other immune cells are increasingly recognized to have unique and nontraditional functions in various tissues of the body. In a recent issue of Nature Medicine, Pirzgalska et al. [1] characterized a unique set of tissue-specialized macrophages that modulate the connection between the nervous system and subcutaneous fat.

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Reishi mushroom Ganoderma lucidum Modulates IgA production and alpha-defensin expression in the rat small intestine

Publication date: 25 March 2018
Source:Journal of Ethnopharmacology, Volume 214
Author(s): Atsuhito Kubota, Masaki Kobayashi, Sota Sarashina, Reiko Takeno, Keisuke Okamoto, Katsuya Narumi, Ayako Furugen, Yuji Suzuki, Natsuko Takahashi, Ken Iseki
Ethnopharmacological relevanceImmunoglobulin A (IgA) secretion and alpha-defensins play a role in the innate immune system to protect against infection. Ganoderma lucidum (W.Curt.: Fr.) P. Karst. (Reishi) is a well-known mushroom in traditional Chinese medicine. This study aimed to determine the effects of Reishi on IgA secretion from Peyer's patch (PP) cells and alpha-defensin-5 (RD-5) and RD-6 expression in the rat small intestine.Materials and methodsThe rats received an oral injection of 0.5–5mg/kg of Reishi powder (1mL/kg) by sonde. All animals were euthanized 24h after Reishi administration. We examined RD-5, RD-6, and Toll-like receptor (TLR) 4 mRNA levels in the jejunum, ileum, and in Peyer's patches (PP) through quantitative real-time PCR analysis. IgA secretion from PP was measured through enzyme-linked immunosorbent assay of the supernatant after primary culture.ResultsReishi increased IgA secretion in the presence of lipopolysaccharide (LPS) and increased TLR4 mRNA levels, but had no effect on the viability of PP cells. Moreover, Reishi increased RD-5, RD-6, and TLR4 mRNA levels significantly in the ileum in a concentration-dependent manner.ConclusionsReishi can induce IgA secretion and increase the mRNA levels of RD-5 and RD-6 in the rat small intestine, through a TLR4-dependent pathway. The present results indicate that Reishi might reduce the risk of intestinal infection.

Graphical abstract

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METTL14 Inhibits Hematopoietic Stem/Progenitor Differentiation and Promotes Leukemogenesis via mRNA m6A Modification

Publication date: Available online 28 December 2017
Source:Cell Stem Cell
Author(s): Hengyou Weng, Huilin Huang, Huizhe Wu, Xi Qin, Boxuan Simen Zhao, Lei Dong, Hailing Shi, Jennifer Skibbe, Chao Shen, Chao Hu, Yue Sheng, Yungui Wang, Mark Wunderlich, Bin Zhang, Louis C. Dore, Rui Su, Xiaolan Deng, Kyle Ferchen, Chenying Li, Miao Sun, Zhike Lu, Xi Jiang, Guido Marcucci, James C. Mulloy, Jianhua Yang, Zhijian Qian, Minjie Wei, Chuan He, Jianjun Chen
N⁶-methyladenosine (m⁶A), the most prevalent internal modification in eukaryotic messenger RNAs (mRNAs), plays critical roles in many bioprocesses. However, its functions in normal and malignant hematopoiesis remain elusive. Here, we report that METTL14, a key component of the m⁶A methyltransferase complex, is highly expressed in normal hematopoietic stem/progenitor cells (HSPCs) and acute myeloid leukemia (AML) cells carrying t(11q23), t(15;17), or t(8;21) and is downregulated during myeloid differentiation. Silencing of METTL14 promotes terminal myeloid differentiation of normal HSPCs and AML cells and inhibits AML cell survival/proliferation. METTL14 is required for development and maintenance of AML and self-renewal of leukemia stem/initiation cells (LSCs/LICs). Mechanistically, METTL14 exerts its oncogenic role by regulating its mRNA targets (e.g., MYB and MYC) through m⁶A modification, while the protein itself is negatively regulated by SPI1. Collectively, our results reveal the SPI1-METTL14-MYB/MYC signaling axis in myelopoiesis and leukemogenesis and highlight the critical roles of METTL14 and m⁶A modification in normal and malignant hematopoiesis.

Graphical abstract

Teaser

The role of N⁶-methyladenosine (m⁶A) modification in normal and malignant hematopoiesis remains elusive. Weng et al. report the essential role of METTL14, a key component of the m⁶A methyltransferase complex, in self-renewal and differentiation of hematopoietic/leukemic stem cells and reveal the SPI1-METTL14-MYB/MYC signaling axis in myelopoiesis and leukemogenesis.

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Reconstruction of the Human Colon Epithelium In Vivo

Publication date: Available online 28 December 2017
Source:Cell Stem Cell
Author(s): Shinya Sugimoto, Yuki Ohta, Masayuki Fujii, Mami Matano, Mariko Shimokawa, Kosaku Nanki, Shoichi Date, Shingo Nishikori, Yoshihiro Nakazato, Tetsuya Nakamura, Takanori Kanai, Toshiro Sato
Genetic lineage tracing has revealed that Lgr5⁺ murine colon stem cells (CoSCs) rapidly proliferate at the crypt bottom. However, the spatiotemporal dynamics of human CoSCs in vivo have remained experimentally intractable. Here we established an orthotopic xenograft system for normal human colon organoids, enabling stable reconstruction of the human colon epithelium in vivo. Xenografted organoids were prone to displacement by the remaining murine crypts, and this could be overcome by complete removal of the mouse epithelium. Xenografted organoids formed crypt structures distinctively different from surrounding mouse crypts, reflecting their human origin. Lineage tracing using CRISPR-Cas9 to engineer an LGR5-CreER knockin allele demonstrated self-renewal and multipotency of LGR5⁺ CoSCs. In contrast to the rapidly cycling properties of mouse Lgr5⁺ CoSCs, human LGR5⁺ CoSCs were slow-cycling in vivo. This organoid-based orthotopic xenograft model enables investigation of the functional behaviors of human CoSCs in vivo, with potential therapeutic applications in regenerative medicine.

Graphical abstract

Teaser

Sugimoto et al. established an orthotopic xenotransplantation system for human normal colon organoids. Using LGR5-CreER knockin organoids for genetic lineage tracing, they demonstrated the self-renewal and multipotency of LGR5⁺ colon stem cells in mouse colon. Interestingly, human LGR5⁺ colon stem cells showed slower cycling than those of mice in vivo.

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METTL14 Inhibits Hematopoietic Stem/Progenitor Differentiation and Promotes Leukemogenesis via mRNA m6A Modification

Graphical abstract

Teaser

Reconstruction of the Human Colon Epithelium In Vivo

Graphical abstract

Teaser

Synthesis, characterization, and mechanical and dynamic mechanical studies of β-alanine trimer-grafted SBR

Publication date: 31 January 2018
Source:Polymer, Volume 136
Author(s): Yihong Zhao, Lin Fu, Li Jia
Two β-alanine trimer-grafted SBRs with varied grafting densities, 3a and 3b, have been synthesized. The grafting density of 3b is about twice of that of 3a. FT-IR and DSC evidences suggest that the β-alanine trimer segments in both 3a and 3b exist exclusively in the β-sheet secondary structure, and the β-sheets stack to form crystals in the continuous SBR phase. The Tm of the β-sheet crystals in 3b is higher than the Tm of those in 3a. This likely suggests that the size of the crystals is somewhat larger in 3b than in 3a. TEM revealed that the β-sheet crystals are rod-like, with lengths on the order of a few tens of nanometers and widths of a few nanometers. The aspect ratio is much lower than that of the β-sheet crystals in segmented TPEs. The most prominent difference in the tensile behavior between 3a and 3b is strain hardening. The former is devoid of strain hardening, while the latter displays strong strain hardening. Overall, the high β-alanine content in 3b leads to improvement of stiffness, ultimate strength and overall toughness at the sacrifice of extensibility and elastic recovery compared to 3a. Dynamic mechanical studies showed that both 3a and 3b display very low loss factors, typical for TPEs with monodisperse hard segments that form β-sheet crystals, at temperatures up to 105 °C.

Graphical abstract

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Nanomaterials at the neural interface

Publication date: June 2018
Source:Current Opinion in Neurobiology, Volume 50
Author(s): Denis Scaini, Laura Ballerini
Interfacing the nervous system with devices able to efficiently record or modulate the electrical activity of neuronal cells represents the underlying foundation of future theranostic applications in neurology and of current openings in neuroscience research. These devices, usually sensing cell activity via microelectrodes, should be characterized by safe working conditions in the biological milieu together with a well-controlled operation-life. The stable device/neuronal electrical coupling at the interface requires tight interactions between the electrode surface and the cell membrane. This neuro-electrode hybrid represents the hyphen between the soft nature of neural tissue, generating electrical signals via ion motions, and the rigid realm of microelectronics and medical devices, dealing with electrons in motion. Efficient integration of these entities is essential for monitoring, analyzing and controlling neuronal signaling but poses significant technological challenges. Improving the cell/electrode interaction and thus the interface performance requires novel engineering of (nano)materials: tuning at the nanoscale electrode's properties may lead to engineer interfacing probes that better camouflaged with their biological target. In this brief review, we highlight the most recent concepts in nanotechnologies and nanomaterials that might help reducing the mismatch between tissue and electrode, focusing on the device's mechanical properties and its biological integration with the tissue.

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Widespread papular eruption in an infant

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Association of the CYP17 MSP AI (T-34C) and CYP19 codon 39 (Trp/Arg) polymorphisms with susceptibility to acne vulgaris

Summary

The aim of this study was to detect the association of the cytochrome P450 (CYP) 17 T-34C and CYP19 T<C polymorphisms with the risk of acne vulgaris (AV). The study enrolled 198 patients with AV (mild, moderate and severe) and 195 unrelated age-matched healthy controls from western Iran who had Kurdish ethnic background. The presence of the CYP17 TC genotype significantly increased the risk of mild, moderate and severe AV by 2.68, 2.28 and 2.94 times, respectively, while the presence of the CYP19 TC genotype significantly elevated the risk of overall AV and mild AV by 2.1 and 3.2 times, respectively. There was a synergy between the CYP 17 TC and CYP19 TT genotypes, which increased the risk of AV by 2.45-fold (P < 0.001). To our knowledge, this is the first study showing that the CYP17 T-34C and CYP19 T<C variants and their synergy are associated with susceptibility to AV in an Iranian population.

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Local versus landscape-scale effects of anthropogenic land-use on forest species richness

Publication date: January 2018
Source:Acta Oecologica, Volume 86
Author(s): G. Buffa, S. Del Vecchio, E. Fantinato, V. Milano
The study investigated the effects of human-induced landscape patterns on species richness in forests. For 80 plots of fixed size, we measured human disturbance (categorized as urban/industrial and agricultural land areas), at 'local' and 'landscape' scale (500 m and 2500 m radius from each plot, respectively), the distance from the forest edge, and the size and shape of the woody patch. By using GLM, we analyzed the effects of disturbance and patch-based measures on both total species richness and the richness of a group of specialist species (i.e. the 'ancient forest species'), representing more specific forest features. Patterns of local species richness were sensitive to the structure and composition of the surrounding landscape. Among the landscape components taken into account, urban/industrial land areas turned out as the most threatening factor for both total species richness and the richness of the ancient forest species. However, the best models evidenced a different intensity of the response to the same disturbance category as well as a different pool of significant variables for the two groups of species. The use of groups of species, such as the ancient forest species pool, that are functionally related and have similar ecological requirements, may represent an effective solution for monitoring forest dynamics under the effects of external factors. The approach of relating local assessment of species richness, and in particular of the ancient forest species pool, to land-use patterns may play an important role for the science-policy interface by supporting and strengthening conservation and regional planning decision making.

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Complex foraging ecology of the red harvester ant and its effect on the soil seed bank

Publication date: January 2018
Source:Acta Oecologica, Volume 86
Author(s): Pedro Luna, Juan Héctor García-Chávez, Wesley Dáttilo
Granivory is an important interaction in the arid and semi-arid zones of the world, since seeds form an abundant and nutritious resource in these areas. While species of the genus Pogonomyrmex have been studied in detail as seed predators, their impact on seed abundance in the soil has not yet been explored in sufficient depth. We studied the impact of the harvesting activities of the ant Pogonomyrmex barbatus on seed abundance in the soil of the Zapotitlán valley, Mexico. We found that P. barbatus activity significantly impacts the abundance of seeds in the soil, which is lower in the sites where P. barbatus forages than it is in sites with no recorded foraging. We also found that P. barbatus distributes intact seeds of three tree species, two of which are nurse plants, and could consequently be promoting the establishment of these species. Using tools derived from graph theory, we observed that the ant-seed interactions exhibit a nested pattern; where more depredated seed species seem to be the more spatially abundant in the environment. This study illustrates the complex foraging ecology of the harvester ant P. barbatus and elucidates its effect on the soil seed bank in a semi-arid environment.

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Elevated native terrestrial snail abundance and diversity in association with an understory shrub, Berberis thunbergii, in a North American deciduous forest

Publication date: January 2018
Source:Acta Oecologica, Volume 86
Author(s): Ryan M. Utz, Timothy A. Pearce, Danielle L. Lewis, Joseph C. Mannino
Invasive terrestrial plants often substantially reshape environments, yet how such invasions affect terrestrial snail assemblages remains understudied. We investigated how snail assemblages in deciduous forest soils with dense Berberis thunbergii (Japanese barberry), an invasive shrub in eastern North America, differ from forest areas lacking the shrub. Leaf litter and soil samples were collected from forest patches with dense B. thunbergii understories and adjacent control areas within two exurban forest tracts in western Pennsylvania, U.S.A. Snails were identified to species and quantified by standard diversity metrics. Contrary to our expectations, snails were significantly more abundant and diverse in B. thunbergii-invaded areas. Despite differences in abundance, the snail community composition did not differ between invaded and control habitats. The terrestrial snail assemblage we observed, which was composed entirely of native species, appears to respond favorably to B. thunbergii invasion and therefore may not be negatively impacted by physicochemical changes to soils typically observed in association with the plant. Such findings could reflect the fact that B. thunbergii likely creates more favorable habitat for snails by creating cooler, more humid, and more alkaline soil environments. However, the snail assemblages we retrieved may consist mostly of species with high tolerance to environmental degradation due to a legacy of land use change and acid deposition in the region.

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Evaluation of topical liposome incorporated clove oil in the treatment of idiopathic palmar hyperhidrosis: Single-blinded placebo-controlled study

Summary

Introduction

Palmar hyperhidrosis is of great concern to patients because of its physical, occupational, and psychological impact on quality of life. Topical clove oil has been used in many conditions due to its major component Eugenol that exerts blocking effect on nerve transmission.

Aim of the work

To assess the efficacy of topical liposome incorporated clove oil in decreasing the rate of sweating among patients with idiopathic palmar hyperhidrosis.

Patients and method

Forty patients with palmar hyperhidrosis were treated with clove oil 45% in liposome and another twenty patients were treated as a control group with 0.9% saline solution and evaluation was carried out before and after treatment through gravimetry testing and hyperhidrosis disease severity scale (HDSS).

Result

The gravimetry testing among clove oil-treated group showed that the mean sweating rate before treatment was 80.5 ± 41.85 (SD) mg/min which decreased significantly after treatment to 52.98 ± 37.94(SD) mg/min (P value < .001). On the other hand, the placebo-treated group,(control) the mean sweating rate before treatment was 77.40 ± 29.29(SD) which did not show significant improvement after placebo application 77.35 ± 28.29(SD; P value = .957).

Conclusion

The topical application of 45% clove oil in liposome twice daily for 2 weeks showing promising result evidenced by declining in the rate of palmar sweating among patients with idiopathic palmar hyperhidrosis.

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Tattoos: Evaluation of knowledge about health complications and their prevention among students of Tricity universities

Summary

Introduction

Tattooing is a very popular form of body modification among young people. However, this kind of procedure entails the risk of various health complications. The objective of the study was to evaluate the students' knowledge about contraindications, complications, and health risks that skin tattooing may cause. Additionally, the purpose of the study was to assess how the profile of education (medical vs nonmedical) impacts on the knowledge of the respondents.

Methods

We surveyed a group of 1199 people, of which 326 (27%) had tattoos. The base of the study is an anonymously filled, author's online survey consisting of 25 questions.

Results

Eighty six percent of the students from the Medical University of Gdańsk indicated the risk of HCV virus infection during tattooing, while only 34% of students from other Tricity universities were aware of this danger. Sixty seven percent of people with tattoos felt that having them does not affect any diagnostic and therapeutic procedures. Most of respondents mentioned the tattoo artist (79%) and the Internet (73%) as a source of information before having a tattoo, while only 5% and 8% respondents asked a doctor or read medical literature about it. Fourty nine percent of respondents reported that before the procedure, tattooist failed to ask them about their health condition and medications.

Conclusions

Knowledge of students about safety, contraindications, and complications associated with the performance of tattooing is insufficient. As a result, a need for a better education on the topic for both people who are getting tattoos and tattooists appears evident.

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Balloon dilatation of the Eustachian tube in adult patients with chronic dilatory tube dysfunction: a retrospective cohort study

Abstract

Objectives

The aim of this study is to assess the subjective and objective short-term results and safety of transnasal balloon dilatation of the Eustachian tube (BET) in adult patients with chronic dilatory Eustachian tube dysfunction (ETD).

Design

Retrospective cohort study. Data collection was performed preoperatively, 1 and 3 months after BET.

Setting

Tertiary referral hospital.

Participants

A cohort of 42 consecutive patients (66 ears).

Main outcome measures

ETDQ-7 score, bone conduction threshold, air-bone gap, the ability to perform Valsalva's and/or Toynbee's manoeuvre, tympanic membrane and middle ear conditions were collected pre- and postoperatively. Subjective satisfaction and complications were collected postoperatively.

Results

The ETDQ-7 score improved significantly from 4.28 to 3.09 1 month postoperatively and from 4.10 to 2.96 3 months postoperatively. Bone conduction thresholds did not differ significantly postoperatively. A significant improvement of air-bone gap was found postoperatively. The tympanic membrane and middle ear condition showed improvement in 62%. Subjective satisfaction 1 and 3 months postoperatively was around 43 and 48%. A small number of minor (self-limiting) complications did occur.

Conclusions

BET has shown to be a safe intervention, which may have a positive effect on objective and subjective indicators for chronic dilatory ETD in adult patients. We observed subjective positive effects in less than half of the patients. For certain indications, there was a measurable positive effect on the findings of the eardrum and ETDQ-7, whereas in other patients it seemed not to have any effect at all. Careful patient selection may improve this success rate. Randomized controlled trials with a prolonged follow-up are required to assess the value of BET in comparison to grommets.

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Effect of Cu and Zn ion-exchange locations on mordenite performance in dimethyl ether carbonylation

Publication date: June 2018
Source:Microporous and Mesoporous Materials, Volume 263
Author(s): Allen A.C. Reule, Vinay Prasad, Natalia Semagina
Cu²⁺ and Zn²⁺ ion-exchange locations in mordenite (MOR) were evaluated using infrared spectroscopy, pore-size distribution, and temperature-programmed reduction. Isolated copper ions were the most abundant ion-exchanged species, as detected by UV-vis spectroscopy, in addition to oxide nanoparticles, with no presence of binuclear species, which was assigned to a low copper loading of 0.3 Cu/Al. The characterization revealed that only zinc could exchange in 8-membered rings. Hartree-Fock modeling confirmed copper exchange into 12-membered rings involving at least one T1 atom, and zinc exchange in T4 sites and in 8-membered structures, including T3 sites. Copper ion exchange did not offer improvement in the dimethyl ether carbonylation rate or selectivity over acidic mordenite. Zinc ion exchange led to the selectivity and stability improvement with some loss of activity. This work contributes to the understanding of acid and metal site contribution to DME carbonylation and contributes to the understanding for Cu²⁺ and Zn²⁺ ion-exchange locations in MOR with a low metal/Al loading (<0.2).

Graphical abstract

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Towards a better understanding of long-term wood-chemistry variations in old-growth forests: A case study on ancient Pinus uncinata trees from the Pyrenees

Publication date: 1 June 2018
Source:Science of The Total Environment, Volume 625
Author(s): Andrea Hevia, Raúl Sánchez-Salguero, J. Julio Camarero, Allan Buras, Gabriel Sangüesa-Barreda, J. Diego Galván, Emilia Gutiérrez
Dendrochemical studies in old forests are still underdeveloped. Old trees growing in remote high-elevation areas far from direct human influence constitute a promising biological proxy for the long-term reconstructions of environmental changes using tree-rings. Furthermore, centennial-long chronologies of multi-elemental chemistry at inter- and intra-annual resolution are scarce. Here, we use a novel non-destructive method by applying Micro X-ray fluorescence (μXRF) to wood samples of old Pinus uncinata trees from two Pyrenean high-elevation forests growing on acidic and basic soils. To disentangle ontogenetic (changes in tree age and diameter) from environmental influences (e.g., climate warming) we compared element patterns in sapwood (SW) and heartwood (HW) during the pre-industrial (1700–1849) and industrial (1850–2008) periods. We quantified tree-ring growth, wood density and relative element concentrations at annual (TRW, tree-ring) to seasonal resolution (EW, earlywood; LW, latewood) and related them to climate variables (temperature and precipitation) and volcanic eruptions in the 18th and 19th centuries. We detected differences for most studied elements between SW and HW along the stem and also between EW and LW within rings. Long-term positive and negative trends were observed for Ca and K, respectively. Cl, P and S showed positive trends during the industrial period. However, differences between sites were also notable. Higher values of Mg, Al, Si and the Ca/Mn ratio were observed at the site with acidic soil. Growing-season temperatures were positively related to growth, maximum wood density and to the concentration of most elements. Peaks in S, Fe, Cl, Zn and Ca were linked to major volcanic eruptions (e.g., Tambora in 1815). Our results reveal the potential of long-term wood-chemistry studies based on the μXRF non-destructive technique to reconstruct environmental changes.

Graphical abstract

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Toxicity of the readily leachable fraction of urban PM2.5 to human lung epithelial cells: Role of soluble metals

Publication date: April 2018
Source:Chemosphere, Volume 196
Author(s): Simonetta Palleschi, Barbara Rossi, Giovanna Armiento, Maria Rita Montereali, Elisa Nardi, Simona Mazziotti Tagliani, Marco Inglessis, Antonio Gianfagna, Leopoldo Silvestroni
Fine airborne particulate matter (PM2.5) has been repeatedly associated with adverse health effects in humans. The PM2.5 soluble fraction, and soluble metals in particular, are thought to cause lung damage. Literature data, however, are not consistent and the role of leachable metals is still under debate. In this study, Winter and Summer urban PM2.5 aqueous extracts, obtained by using a bio-compatible solution and different contact times at 37 °C, were used to investigate cytotoxic effects of PM2.5 in cultured lung epithelial cells (A549) and the role played by the leachable metals Cu, Fe, Zn, Ni, Pb and Cd. Cell viability and migration, as well as intracellular glutathione, extracellular cysteine, cysteinylglycine and homocysteine concentrations, were evaluated in cells challenged with both PM2.5 extracts before and after ultrafiltration and artificial metal ion solutions mimicking the metal composition of the genuine extracts. The thiol oxidative potential was also evaluated by an abiotic test. Results demonstrate that PM2.5 bioactive components were released within minutes of PM2.5 interaction with the leaching solution. Among these are i) low MW (<3 kDa) solutes inducing oxidative stress and ii) high MW and/or water-insoluble compounds largely contributing to thiol oxidation and to increased homocysteine levels in the cell medium. Cu and/or Ni ions likely contributed to the effects of Summer PM2.5 extracts. Nonetheless, the strong bio-reactivity of Winter PM2.5 extracts could not be explained by the presence of the studied metals. A possible role for PM2.5 water-extractable organic components is discussed.

Graphical abstract

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Blood derivatives awaken in regenerative medicine strategies to modulate wound healing

Publication date: Available online 28 December 2017
Source:Advanced Drug Delivery Reviews
Author(s): Bárbara B. Mendes, Manuel Gómez-Florit, Pedro S. Babo, Rui L. Reis, Rui M.A. Domingues, Manuela E. Gomes
Blood components play key roles in the modulation of the wound healing process and, together with the provisional fibrin matrix ability to selectively bind bioactive molecules and control its spatial-temporal presentation, define the complex microenvironment that characterize this biological process. As a biomimetic approach, the use of blood derivatives in regenerative strategies has awaken as a source of multiple therapeutic biomolecules. Nevertheless, and despite their clinical relevance, blood derivatives have been showing inconsistent therapeutic results due to several factors, including proper control over their delivery mechanisms. Herein, we highlight recent trends on the use biomaterials to protect, sequester and deliver these pools of biomolecules in tissue engineering and regenerative medicine approaches. Particular emphasis is given to strategies that enable to control their spatiotemporal delivery and improve the selectivity of presentation profiles of the biomolecules derived from blood derivatives rich in platelets. Finally, we discussed possible directions for biomaterials design to potentiate the aimed regenerative effects of blood derivatives and achieve efficient therapies.

Graphical abstract

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Reliability and validity study of Sino-nasal outcome test 22 (Thai version) in chronic rhinosinusitis

Abstract

Background

Chronic rhinosinusitis (CRS) is one of common health conditions that affects patients' health-related quality of life. Our purpose is to assess the reliability and validity of Thai-version of Sino-Nasal Outcome Test 22 in chronic rhinosinusitis.

Methods

Permission for translation of SNOT-22 from English language to Thai language was obtained from the developer. The translation process was done based on the international standard of translation method. A total of 80 subjects were recruited into the study and divided into two groups comprising of 50 patients with chronic rhinosinusitis and 30 healthy volunteers. Cronbach's α and Intraclass correlation coefficient were evaluated for its reliability. Validity test was evaluated against VAS score, SF-36 (Thai version) questionnaire and CT scan (based on Lund-Mackay score). Responsiveness was assessed between pre-operative and post-operative scores in 34 patients.

Results

The Thai version of SNOT-22 showed good reliability according to high value of Cronbach's α coefficient (r = 0.929) and intraclass correlation coefficient (r = 0.935). It also showed good validity by its ability to differential the patients with chronic rhinosinusitis from normal (p < 0.001), and different severity of symptoms (p < 0.05). In addition, the SNOT-22 Thai version also showed good responsiveness when compared between pre-operative and post-operative scores (p < 0.001) and also well-performed in effect size calculation (1.37).

Conclusion

We demonstrated that Thai -version of SNOT-22 has good reliability and validity, suitable for evaluation of chronic rhinosinusitis symptoms together with severity of the disease and response to treatment.

Trial registration

Thai clinical trials registry TCTR20170320003. Date of registration 20/03/2017 (retrospectively registered).

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Causes of higher symptomatic airway load in patients with chronic rhinosinusitis

Abstract

Background

Chronic rhinosinusitis display a variety of different phenotypes. The symptoms of disease are characterised by various signs and symptoms such as nasal congestion, nasal discharge, pressure sensation in the face and reduced or complete loss of smell.

In a patient population undergoing functional endoscopic sinonasal surgery (FESS) for chronic rhinosinusitis, we wanted to investigate the clinical features and explore if the presence of biofilm, nasal polyps or other disease characteristic could serve as predictor for the symptomatic load. A patient group undergoing septoplasty without disease of the sinuses was included as control.

Methods

The Sinonasal outcome test (SNOT-20), EPOS visual analogue scale (VAS) and the Lund-Mackey CT score (LM CT score) were used to examine 23 patients with chronic rhinosinusitis without nasal polyps (CRSsNP), 30 patient with nasal polyps (CRSwNP) and 22 patients with septal deviation. Tissue samples were collected prospectively during surgery. The cohort has previously been examined for the presence of biofilm.

Results

Patients with CRSsNP and CRSwNP had significantly higher degree of symptoms compared to the septoplasty group (SNOT-20 scores of 39.8, 43.6 and 29.9, respectively, p = 0.034). There were no significant differences in the total SNOT-20 or VAS symptoms scores between the CRSsNP and CRSwNP subgroups. However patients with nasal polyps showed significantly higher scores of symptoms related to sinonasal discomfort such as cough, runny nose and need to blow nose (p = 0.011, p = 0.046, p = 0.001 respectively). Patients with nasal polyps showed a significantly higher LM CT score compared to patients without polyps (12.06 versus 8.00, p = 0.001). The presence of biofilm did not impact the degree of symptoms.

Conclusion

The presence of nasal polyp formations in CRS patients was associated with a higher symptomatic airway load as compared to patients without polyps. These findings suggest that nasal polyps could be an indicator of more substantial sinonasal disease. The presence of biofilm did not impact the degree of symptoms, however, as biofilm seem to be a common feature of chronic rhinosinusitis (89% in this cohort), it is more likely to be involved in the development of the CRS, rather than being a surrogate marker for increased symptomatic load.

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Founder mutation in IKBKAP gene causes vestibular impairment in familial dysautonomia

Publication date: February 2018
Source:Clinical Neurophysiology, Volume 129, Issue 2
Author(s): Joel V. Gutiérrez, Horacio Kaufmann, Jose-Alberto Palma, Carlos Mendoza-Santiesteban, Vaughan G. Macefield, Lucy Norcliffe-Kaufmann
ObjectiveTo assess vestibular function in patients with familial dysautonomia (FD), a hereditary sensory and autonomic neuropathy – caused by a mutation in the IKBKAP gene (c.2204 + 6 T>C) – and characterized by marked gait ataxia.MethodsCervical and vestibular evoked myogenic potentials (cVEMPs and oVEMPs) were recorded from the sternocleidomastoid (SCM) and extraocular muscles in 14 homozygous patients, 2 heterozygous patients, and 15 healthy controls during percussion of the forehead.ResultscVEMP and oVEMP amplitudes were significantly lower, and peak latencies significantly delayed, in the FD patients. There were no differences in overall EMG during attempted maximal voluntary contractions of the SCM muscle, suggesting intact efferent function. The two heterozygotes with a minor haplotype missense (R696P) mutation in exon 19 of the IKBKAP gene had cVEMP responses less affected than the homozygous.ConclusionsThe founder mutation in the IKBKAP gene affects the development of vestibular afferent pathways, leading to attenuated cVEMPs.SignificanceVestibular abnormalities may contribute to the gait ataxia in FD.

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Interhemispheric motor interactions in hemiparetic children with perinatal stroke: Clinical correlates and effects of neuromodulation therapy

Publication date: February 2018
Source:Clinical Neurophysiology, Volume 129, Issue 2
Author(s): Derek Eng, Ephrem Zewdie, Patrick Ciechanski, Omar Damji, Adam Kirton
ObjectiveBrain stimulation and constraint therapy may enhance function after perinatal stroke but mechanisms are unknown. We characterized interhemispheric interactions (IHI) in hemiparetic children and explored their relationship to motor function and neuromodulation.MethodsForty-five hemiparetic perinatal stroke subjects aged 6–19 years completed a clinical trial of repetitive-transcranial magnetic stimulation (rTMS) and constraint therapy. Paired-pulse TMS measured IHI in cases and normal controls. Suprathreshold conditioning stimuli preceded contralateral test stimuli bidirectionally: stroke to non-stroke (SNS) and non-stroke to stroke (NSS). Primary outcome was the interhemispheric ratio (IHR) between conditioned and test only MEP amplitudes X100 (<100 implied inhibition). Motor outcomes at baseline and post-intervention were compared to IHR.ResultsProcedures were well tolerated. IHI occurred bidirectionally in controls. Eighteen stroke participants had complete data. IHR were increased in stroke participants in both directions. SNS IHR was >100 (facilitation) in 39% of measurements and correlated with better motor function. NSS IHR correlated with poorer motor function. Intervention-induced clinical change was not associated with IHR.ConclusionsInterhemispheric interactions are altered and related to clinical function, but not necessarily neuromodulation, in children with perinatal stroke.SignificanceAdding interhemispheric interactions to evolving models of developmental plasticity following early injury may advance neuromodulation strategies.

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Predicting reactivity threshold in children with anaphylaxis to peanut

Abstract

Background

Peanut allergy necessitates dietary restrictions, preferably individualised by determining reactivity threshold through an oral food challenge (OFC). However, risk of systemic reactions often precludes OFC in children with severe peanut allergy.

Objective

We aimed to determine if clinical and/or immunological characteristics were associated with reactivity threshold in children with anaphylaxis to peanut and secondarily, to investigate if these characteristics were associated with severity of the allergic reaction during OFC.

Methods

A double-blind placebo controlled food challenge (DBPCFC) with peanut was performed in 96 5-15-year-old children with a history of severe allergic reactions to peanut and/or sensitisation to peanut (skin prick test (SPT) ≥ 3 mm or specific immunoglobulin E (s-IgE) ≥ 0.35 kUA/L). Investigations preceding the DBPCFC included a structured interview, SPT, lung function measurements, serological immunology assessment (IgE, IgG and IgG₄), basophil activation test (BAT) and conjunctival allergen provocation test (CAPT). International standards were used to define anaphylaxis and grade the allergic reaction during OFC.

Results

During DBPCFC, all 96 children (median age 9.3, range 5.1, 15.2) reacted with anaphylaxis (moderate objective symptoms from at least two organ systems). Basophil activation (CD63+ basophils ≥ 15%), peanut SPT and the ratio of peanut s-IgE/total IgE were significantly associated to reactivity threshold and lowest observed adverse events level (LOAEL) (all p < 0.04). Basophil activation best predicted very low threshold level (< 3 mg of peanut protein), with an optimal cut-off of 75.8% giving a 93.5% negative predictive value. None of the characteristics were significantly associated with the severity of allergic reaction.

Conclusion and Clinical Relevance

In children with anaphylaxis to peanut, basophil activation, peanut SPT and the ratio of peanut s-IgE/total Ig-E were associated with reactivity threshold and LOAEL, but not with allergy reaction severity.

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Post-tonsillectomy hemorrhage: Underlying factors and prevention

Tonsillectomy is the most frequently applied treatment for recurrent tonsillitis, tonsillar focal infection, and obstructive sleep apnea (OSA), while post-tonsillectomy hemorrhage (PTH) is a common complication. Although with continual innovation in techniques of tonsillectomy and surgical instruments, PTH still occur except for the different incidence of PTH. Thus, PTH remains a controversial subject in otolaryngology. Recently, in an excellent work, Burton and colleagues refined a technique to reduce PTH [1].

http://ift.tt/2EabkCY

Editorial Board

Publication date: January 2018
Source:Journal of Anxiety Disorders, Volume 53

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Publisher Acknowledgement

Publication date: January 2018
Source:Journal of Anxiety Disorders, Volume 53

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Gut Microbes Egested during Bites of Infected Sand Flies Augment Severity of Leishmaniasis via Inflammasome-Derived IL-1β

Publication date: Available online 28 December 2017
Source:Cell Host & Microbe
Author(s): Ranadhir Dey, Amritanshu B. Joshi, Fabiano Oliveira, Lais Pereira, Anderson B. Guimarães-Costa, Tiago D. Serafim, Waldionê de Castro, Iliano V. Coutinho-Abreu, Parna Bhattacharya, Shannon Townsend, Hamide Aslan, Alec Perkins, Subir Karmakar, Nevien Ismail, Morgan Karetnick, Claudio Meneses, Robert Duncan, Hira L. Nakhasi, Jesus G. Valenzuela, Shaden Kamhawi
Leishmania donovani parasites are the cause of visceral leishmaniasis and are transmitted by bites from phlebotomine sand flies. A prominent feature of vector-transmitted Leishmania is the persistence of neutrophils at bite sites, where they protect captured parasites, leading to enhanced disease. Here, we demonstrate that gut microbes from the sand fly are egested into host skin alongside Leishmania parasites. The egested microbes trigger the inflammasome, leading to a rapid production of interleukin-1β (IL-1β), which sustains neutrophil infiltration. Reducing midgut microbiota by pretreatment of Leishmania-infected sand flies with antibiotics or neutralizing the effect of IL-1β in bitten mice abrogates neutrophil recruitment. These early events are associated with impairment of parasite visceralization, indicating that both gut microbiota and IL-1β are important for the establishment of Leishmania infections. Considering that arthropods harbor a rich microbiota, its potential egestion after bites may be a shared mechanism that contributes to severity of vector-borne disease.

Graphical abstract

Teaser

Neutrophils recruited to sand fly bite sites shelter Leishmania, augmenting disease. Dey et al. demonstrate that egestion of sand fly gut microbes into host skin primes the inflammasome to produce IL-1β, which sustains neutrophil recruitment. Removing gut microbiota or blocking IL-1β before transmission abolishes neutrophil recruitment and impairs Leishmania dissemination.

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Leukotriene B4-Mediated Neutrophil Recruitment Causes Pulmonary Capillaritis during Lethal Fungal Sepsis

Publication date: Available online 28 December 2017
Source:Cell Host & Microbe
Author(s): Esther K.S. Lee, Mark R. Gillrie, Lu Li, Jason W. Arnason, Jung Hwan Kim, Liane Babes, Yuefei Lou, Amir Sanati-Nezhad, Stephen K. Kyei, Margaret M. Kelly, Christopher H. Mody, May Ho, Bryan G. Yipp
Candida albicans bloodstream infection causes fungal septicaemia and death in over half of afflicted patients. Polymorphonuclear leukocytes (PMN) mediate defense against invasive candidiasis, but their role in protection versus tissue injury and sepsis is unclear. We observe PMN intravascular swarming and subsequent clustering in response to C. albicans yeast in a lethal septic mouse and human pulmonary circulation model. Live C. albicans sequester to the endothelium and are immediately captured by complement-dependent PMN chemotaxis, which is required for host survival. However, complement activation also leads to Leukotriene B4 (LTB4)-mediated intravascular PMN clustering and occlusion, resulting in capillaritis with pulmonary hemorrhage and hypoxemia. This clustering is unique to fungi and triggered by fungal cell wall components. PMN clustering is absent in mice lacking LTB4-receptor, and capillaritis is attenuated upon pharmacological LTB4 blockade without affecting phagocytosis. Therefore, therapeutically disrupting infection-induced capillaritis may limit organ injury without impairing host defense during fungal sepsis.

Graphical abstract

Teaser

Fungal sepsis has a high mortality rate. Using live imaging, Lee, et al. discovered that the lung bloodstream is an important site of host defense; however, fungi caused extensive vessel occlusions due to leukotriene-meditated neutrophil capillaritis. Inhibiting occlusion improved lung function and outcomes, thus revealing a therapeutic target.

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Bacteria Facilitate Enteric Virus Co-infection of Mammalian Cells and Promote Genetic Recombination

Publication date: Available online 28 December 2017
Source:Cell Host & Microbe
Author(s): Andrea K. Erickson, Palmy R. Jesudhasan, Melinda J. Mayer, Arjan Narbad, Sebastian E. Winter, Julie K. Pfeiffer
RNA viruses exist in genetically diverse populations due to high levels of mutations, many of which reduce viral fitness. Interestingly, intestinal bacteria can promote infection of several mammalian enteric RNA viruses, but the mechanisms and consequences are unclear. We screened a panel of 41 bacterial strains as a platform to determine how different bacteria impact infection of poliovirus, a model enteric virus. Most bacterial strains, including those extracted from cecal contents of mice, bound poliovirus, with each bacterium binding multiple virions. Certain bacterial strains increased viral co-infection of mammalian cells even at a low virus-to-host cell ratio. Bacteria-mediated viral co-infection correlated with bacterial adherence to cells. Importantly, bacterial strains that induced viral co-infection facilitated genetic recombination between two different viruses, thereby removing deleterious mutations and restoring viral fitness. Thus, bacteria-virus interactions may increase viral fitness through viral recombination at initial sites of infection, potentially limiting abortive infections.

Graphical abstract

Teaser

Enteric viruses rely on intestinal bacteria for replication and transmission. By screening a diverse panel of bacterial strains, Erickson et al. demonstrate that bacteria differentially bind poliovirus and that some bacterial strains promote viral co-infection and genetic recombination, thus enhancing viral fitness.

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Transcranial magnetic stimulation of the precuneus enhances memory and neural activity in prodromal Alzheimer's disease

Publication date: 1 April 2018
Source:NeuroImage, Volume 169
Author(s): Giacomo Koch, Sonia Bonnì, Maria Concetta Pellicciari, Elias P. Casula, Matteo Mancini, Romina Esposito, Viviana Ponzo, Silvia Picazio, Francesco Di Lorenzo, Laura Serra, Caterina Motta, Michele Maiella, Camillo Marra, Mara Cercignani, Alessandro Martorana, Carlo Caltagirone, Marco Bozzali
Memory loss is one of the first symptoms of typical Alzheimer's disease (AD), for which there are no effective therapies available. The precuneus (PC) has been recently emphasized as a key area for the memory impairment observed in early AD, likely due to disconnection mechanisms within large-scale networks such as the default mode network (DMN). Using a multimodal approach we investigated in a two-week, randomized, sham-controlled, double-blinded trial the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) of the PC on cognition, as measured by the Alzheimer Disease Cooperative Study Preclinical Alzheimer Cognitive Composite in 14 patients with early AD (7 females). TMS combined with electroencephalography (TMS-EEG) was used to detect changes in brain connectivity. We found that rTMS of the PC induced a selective improvement in episodic memory, but not in other cognitive domains. Analysis of TMS-EEG signal revealed an increase of neural activity in patients' PC, an enhancement of brain oscillations in the beta band and a modification of functional connections between the PC and medial frontal areas within the DMN.Our findings show that high-frequency rTMS of the PC is a promising, non-invasive treatment for memory dysfunction in patients at early stages of AD. This clinical improvement is accompanied by modulation of brain connectivity, consistently with the pathophysiological model of brain disconnection in AD.

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Diagnostics and therapy of vestibular schwannomas - an interdisciplinary challenge.

Diagnostics and therapy of vestibular schwannomas - an interdisciplinary challenge.

GMS Curr Top Otorhinolaryngol Head Neck Surg. 2017;16:Doc03

Authors: Rosahl S, Bohr C, Lell M, Hamm K, Iro H

Abstract
Vestibular schwannomas (VS) expand slowly in the internal auditory canal, in the cerebellopontine angle, inside the cochlear and the labyrinth. Larger tumors can displace and compress the brainstem. With an annual incidence of 1:100,000 vestibular schwannoma represent 6-7% of all intracranial tumors. In the cerebellopontine angle they are by far the most neoplasm with 90% of all lesions located in this region. Magnetic resonance imaging (MRI), audiometry, and vestibular diagnostics are the mainstays of the clinical workup for patients harboring tumors. The first part of this paper delivers an overview of tumor stages, the most common grading scales for facial nerve function and hearing as well as a short introduction to the examination of vestibular function. Upholding or improving quality of life is the central concern in counseling and treating a patient with vestibular schwannoma. Preservation of neuronal function is essential and the management options - watchful waiting, microsurgery and stereotactic radiation - should be custom-tailored to the individual situation of the patient. Continuing interdisciplinary exchange is important to monitor treatment quality and to improve treatment results. Recently, several articles and reviews have been published on the topic of vestibular schwannoma. On the occasion of the 88th annual meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck surgery a special volume of the journal "HNO" will be printed. Hence this presentation has been designed to deviate from the traditional standard which commonly consists of a pure literature review. The current paper was conceptually woven around a series of interdisciplinary cases that outline examples for every stage of the disease that show characteristic results for management options to date. Systematic clinical decision pathways have been deduced from our experience and from results reported in the literature. These pathways are graphically outlined after the case presentations. Important criteria for decision making are size and growth rate of the tumor, hearing of the patient and the probability of total tumor resection with preservation of hearing and facial nerve function, age and comorbidity of the patient, best possible control of vertigo and tinnitus and last but not least the patient's preference and choice. In addition to this, the experience and the results of a given center with each treatment modality will figure in the decision making process. We will discuss findings that are reported in the literature regarding facial nerve function, hearing, vertigo, tinnitus, and headache and reflect on recent studies on their influence on the patient's quality of life. Vertigo plays an essential role in this framework since it is an independent predictor of quality of life and a patient's dependence on social welfare. Pathognomonic bilateral vestibular schwannomas that occur in patients suffering from neurofibromatosis typ-2 (NF2) differ from spontaneous unilateral tumors in their biologic behavior. Treatment of neurofibromatosis type-2 patients requires a multidisciplinary team, especially because of the multitude of separate intracranial and spinal lesions. Off-label chemotherapy with Bevacizumab can stabilize tumor size of vestibular schwannomas and even improve hearing over longer periods of time. Hearing rehabilitation in NF2 patients can be achieved with cochlear and auditory brainstem implants.

PMID: 29279723 [PubMed]

http://ift.tt/2pOuQlm

Recent surgical options for vestibular vertigo.

Recent surgical options for vestibular vertigo.

GMS Curr Top Otorhinolaryngol Head Neck Surg. 2017;16:Doc01

Authors: Volkenstein S, Dazert S

Abstract
Vertigo is not a well-defined disease but a symptom that can occur in heterogeneous entities diagnosed and treated mainly by otolaryngologists, neurologists, internal medicine, and primary care physicians. Most vertigo syndromes have a good prognosis and management is predominantly conservative, whereas the need for surgical therapy is rare, but for a subset of patients often the only remaining option. In this paper, we describe and discuss different surgical therapy options for hydropic inner ear diseases, Menière's disease, dehiscence syndromes, perilymph fistulas, and benign paroxysmal positional vertigo. At the end, we shortly introduce the most recent developments in regard to vestibular implants. Surgical therapy is still indicated for vestibular disease in selected patients nowadays when conservative options did not reduce symptoms and patients are still suffering. Success depends on the correct diagnosis and choosing among different procedures the ones going along with an adequate patient selection. With regard to the invasiveness and the possible risks due to surgery, in depth individual counseling is absolutely necessary. Ablative and destructive surgical procedures usually achieve a successful vertigo control, but are associated with a high risk for hearing loss. Therefore, residual hearing has to be included in the decision making process for surgical therapy.

PMID: 29279721 [PubMed]

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Diagnostic potential and future directions of biomarkers in gingival crevicular fluid and saliva of periodontal diseases: Review of the current evidence

Publication date: March 2018
Source:Archives of Oral Biology, Volume 87
Author(s): Noha Ayman Ghallab
ObjectivesThe holy grail of biomarker research in periodontology is to develop a high impact diagnostics which have a significant impact on clinical decision-making, patient outcomes and healthcare providers. In the field of periodontal diagnostics, oral fluid-based biomarkers have been studied mainly in the gingival crevicular fluid (GCF) and saliva.MethodsA literature search was performed using the Cochrane library and PubMed databases from 2000 to January 2017.ResultsCurrently, there are more than 90 different components in the GCF that have been investigated as diagnostic and prognostic markers of periodontal disease progression involving; inflammatory mediators, markers of oxidative stress, host-derived enzymes, tissue-breakdown products and mediators of bone homeostasis. Furthermore, various biomarkers in saliva have been proposed which reveal a promising outlook for saliva as a key diagnostic medium for periodontal disease. Recent systematic reviews with high value of evidence have shown that potential salivary biomarkers can provide important complimentary diagnostic information and can be used as tests for screening diagnosis, prognosis and predicting periodontal disease progression.ConclusionFuture developments in proteomic analysis and personalized medicine will pave the way allowing novel diagnostic tools. Still, the application into the field of dentistry will depend on how practitioners will apply this into their daily clinical practice.Clinical relevanceStill, the application into the field of dentistry will depend on how practitioners will apply this into their daily clinical practice.

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Elevated expression of activated TH2 cells and milk-specific TH2 cells in milk-induced eosinophilic esophagitis

Eosinophilic esophagitis (EoE) is an allergic inflammatory disease that is triggered by food allergens and characterized by progressive esophageal dysfunction. Esophageal biopsy specimens are characterized by eosinophilia and expression of TH2 cytokines.

http://ift.tt/2pRCmMb

Risk factors and clinical outcomes associated with fixed airflow obstruction in older adults with asthma

Asthma in older adults is associated with increased morbidity and mortality compared with asthma in younger patients. Fixed airflow obstruction (FAO) is associated with decreased survival in younger patients, but its significance remains unclear in older adults with asthma.

http://ift.tt/2E8fJGJ

Living in lower income zip codes is associated with more severe chronic rhinosinusitis

Chronic rhinosinusitis (CRS) is a chronic inflammatory condition afflicting the upper airways. In 2014, approximately 29.4 million adults reported being told by a doctor or other health professional in the past 12 months that they had sinusitis.1 The pathogenesis of CRS is multifactorial, likely due to a combination of host and environmental factors.2 Determining whether the host factors are due to nonmodifiable, such as race, or modifiable risk variables is important. Previous analyses of the effect of socioeconomic status on CRS have yielded conflicting results.

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Efficacy of omalizumab treatment in a man with occupational asthma and eosinophilic granulomatosis with polyangioitis

Omalizumab is a humanized monoclonal antibody that binds to free-circulating immunoglobulin E (IgE). Several studies have shown the clinical efficacy of omalizumab in severe, persistent allergic asthma, including occupational cases.1

http://ift.tt/2E8Ip23

The importance of reducing risk in peanut allergy: Current and future therapies

The prevalence of peanut allergy has steadily increased during the past 10 years, especially in children. A 2009 to 2010 survey of more than 40,000 children (aged 0–17 years) in the United States found that peanut allergy was the most common food allergy, affecting 2% (1.5 million) of children nationwide.1 Data from a 2014 meta-analysis of 29 studies from multiple European countries using various reporting methods estimated the occurrence of peanut allergy to be 0.3% (by positive food challenge result) to 4.1% (by peanut specific IgE positivity) in children aged 2 to 5 years and 0.4% (by self-reporting) to 9.8% (by peanut specific IgE positivity) in children aged 6 to 17 years.

http://ift.tt/2pRZQB0

Mevalonate kinase deficiency presenting as recurrent rectal abscesses and perianal fistulae

We present the case of a 13-month-old, nonconsanguineous, Hispanic boy with rectal abscesses and perianal fistulae beginning at 2 months of age. At the time of initial consultation, he had undergone 11 prior operations for abscess drainage. His infectious history was notable for recurrent upper respiratory tract infections, acute otitis media, chronic diarrhea, and an episode of thrush that resolved with oral nystatin at 2 months of age. He did not have a history of pneumonia, growth failure, or signs of endocrinopathy.

http://ift.tt/2E4WqxQ

High Annual Hospital Volume is Associated with Decreased in Hospital Mortality and Complication Rates Following Treatment of Abdominal Aortic Aneurysms: Secondary Data Analysis of the Nationwide German DRG Statistics from 2005 to 2013

Publication date: Available online 27 December 2017
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Matthias Trenner, Andreas Kuehnl, Michael Salvermoser, Benedikt Reutersberg, Sarah Geisbuesch, Volker Schmid, Hans-Henning Eckstein
ObjectivesThe aim of this study was to analyse the association between annual hospital procedural volume and post-operative outcomes following repair of abdominal aortic aneurysms (AAA) in Germany.MethodsData were extracted from nationwide Diagnosis Related Group (DRG) statistics provided by the German Federal Statistical Office. Cases with a diagnosis of AAA (ICD-10 GM I71.3, I71.4) and procedure codes for endovascular aortic repair (EVAR; OPS 5–38a.1*) or open aortic repair (OAR; OPS 5–38.45, 5–38.47) treated between 2005 and 2013 were included. Hospitals were empirically grouped to quartiles depending on the overall annual volume of AAA procedures. A multilevel multivariable regression model was applied to adjust for sex, medical risk, type of procedure, and type of admission. Primary outcome was in hospital mortality. Secondary outcomes were complications, use of blood products, and length of stay (LOS). The association between AAA volume and in hospital mortality was also estimated as a function of continuous volume.ResultsA total of 96,426 cases, of which 11,795 (12.6%) presented as ruptured (r)AAA, were treated in >700 hospitals (annual median: 501). The crude in hospital mortality was 3.3% after intact (i)AAA repair (OAR 5.3%; EVAR 1.7%). Volume was inversely associated with mortality after OAR and EVAR. Complication rates, LOS, and use of blood products were lower in high volume hospitals. After rAAA repair, crude mortality was 40.4% (OAR 43.2%; EVAR 27.4%). An inverse association between mortality and volume was shown for rAAA repair; the same accounts for the use of blood products. When considering volume as a continuous variate, an annual caseload of 75–100 elective cases was associated with the lowest mortality risk.ConclusionsIn hospital mortality and complication rates following AAA repair are inversely associated with annual hospital volume. The use of blood products and the LOS are lower in high volume hospitals. A minimum annual case threshold for AAA procedures might improve post-operative results.

http://ift.tt/2CjRKn8

Feasibility Study of a Novel Thoraco-abdominal Aortic Hybrid Device (SPIDER-graft) in a Translational Pig Model

Publication date: Available online 28 December 2017
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Eike S. Debus, Tilo Kölbel, Anna Duprée, Günter Daum, Harleen L. Sandhu, Daniel Manzoni, Sabine H. Wipper
BackgroundThe hybrid SPIDER-graft consists of a proximal descending aortic stent graft and a conventional six branched Dacron graft for open abdominal aortic repair. Technical feasibility with regard to avoiding thoracotomy and extracorporeal circulation (ECC) during thoraco-abdominal aortic hybrid repair and peri-procedural safety of this novel device are unknown.Material and methodsThis was a feasibility and safety study in domestic pigs (75–85 kg). The abdominal aorta including iliac bifurcation, left renal artery, and visceral arteries were exposed via retroperitoneal access. The right iliac branch was first temporarily anastomosed end to side to the distal aorta via partial clamping. During inflow reduction and infra-coeliac cross-clamping, the coeliac trunk (CT) was divided and the proximal stent graft portion of the SPIDER-graft was deployed into the descending aorta via the CT ostium. Retrograde visceral and antegrade aorto-iliac blood flow was maintained via the iliac side branch. The visceral, renal, and iliac arteries were sequentially anastomosed, finally replacing the first iliac end to side anastomosis. Technical success, blood flow, periods of ischaemia, and peri-procedural complications were evaluated after intra-operative completion angiography and post-operative computed tomography angiography.ResultsSix animals underwent successful thoracic stent graft deployment and distal open reconstruction without peri-operative death. The median thoracic graft implantation time was 4.5 min, and the median ischaemia times before reperfusion were 10 min for the CT, 8 min for the superior mesenteric artery, 13 min for the right renal artery, and 22 min for the left renal artery. Angiography demonstrated appropriate graft implantation and blood flow measurements confirmed sufficient blood flow through all side branches.ConclusionIn this translational pig model, thoraco-abdominal hybrid repair using the novel SPIDER-graft was successful in avoiding thoracotomy and ECC. Technical feasibility and safety appear promising, but need to be reassessed in humans.

http://ift.tt/2Dq08Ba

CONTRIBUTION OF PHOTODYNAMIC THERAPY IN WOUND HEALING: A SYSTEMATIC REVIEW

Publication date: Available online 28 December 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Vanessa Nesi-Reis, Daniele Stéfanie Sara Lopes Lera-Nonose, Jully Oyama, Marielle Priscila Paula Silva-Lalucci, Izabel Galhardo Demarchi, Sandra Mara Alessi Aristides, Jorge Juarez Vieira Teixeira, Thaís Gomes Verzignassi Silveira, Maria Valdrinez Campana Lonardoni
ObjectiveWe researched articles that used photodynamic therapy (PDT) in skin wound healing in humans.MethodsThe systematic review was conducted throughout scientific articles that investigated the action of PDT on wound healing in humans, published from July 2005 to March 2017, in the data bases PubMed and LILACS.ResultsThe main types of wound described in selected articles in this review were chronic ulcer, non-melanoma skin cancer. For accomplishing the PDT, second generation of photosensitizing agents with laser or light emitting diode were used. The studies demonstrated that PDT contribute in several ways to the wound healing process: leading to cellular death; reducing or increasing inflammation; stimulating fibroblasts proliferation and, consequently, of collagen and elastin; raising transforming growth factor beta and metalloproteinases. Based on this, PDT provided good results in wound healing process, acting in several steps and accelerating tissue repair.ConclusionsPDT improved healing in many wound models in humans, revealing itself as a promising therapeutic modality, stimulating wound healing and remodelling.

http://ift.tt/2E9gfEr

Longitudinal Serum and Urine Steroid Metabolite Profiling in a 46,XY Infant with Prenatally Identified POR Deficiency

Publication date: Available online 28 December 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Hiroyuki Ono, Chikahiko Numakura, Keiko Homma, Tomonobu Hasegawa, Seiji Tsutsumi, Fumiko Kato, Yasuko Fujisawa, Maki Fukami, Tsutomu Ogata
Although POR deficiency (PORD) is assumed to be accompanied by excessive placental androgen accumulation and enhanced adrenal and testicular androgen production via the backdoor pathway as well as compromised testicular androgen production via the frontdoor pathway, there is no direct evidence for the flux of excessive placental androgens into the fetal circulation and for the production of dihydrotestosterone (DHT) via the backdoor pathway. We examined longitudinal serum and urine steroid metabolite profiles in a 46,XY infant with PORD who was prenatally identified because of the progressive fetal masculinization and maternal virilization from the mid-gestation and the presence of fetal radio-humeral synostosis and was confirmed to have compound heterozygous mutations of POR (p.Q201X and p.R457H). The results showed (1) markedly and inappropriately elevated serum androstenedione and testosterone (T) values at birth, (2) a markedly increased serum DHT value with a normal DHT/T ratio at birth, (3) transient elevation of serum T and DHT values accompanied by a normal DHT/T ratio and concomitant elevations of intermediate steroid metabolites on both the frontdoor and backdoor pathways at 30 days of age, and (4) persistent PORD-compatible urine steroid profiles. Although the data obtained from a single infantile patient are too premature to be generalized, they imply: (1) the transfer of excessive placental androgens into the fetal as well as the maternal circulations from the mid-gestation, (2) lack of a clinically discernible amount of DHT production via the adrenal backdoor pathway around birth, and (3) the activation of both the frontdoor and backdoor pathways in the testis around the mini-puberty, with no production of a clinically discernible amount of DHT via the testicular backdoor pathway.

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Duplicated membrane estrogen receptors in the European sea bass (Dicentrarchus labrax): phylogeny, expression and regulation throughout the reproductive cycle

Publication date: Available online 28 December 2017
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Patrícia I.S. Pinto, André R. Andrade, M. Dulce Estêvão, M. Victoria Alvarado, Alicia Felip, Deborah M. Power
The numerous estrogen functions reported across vertebrates have been classically explained by their binding to specific transcription factors, the nuclear estrogen receptors (ERs). Rapid non-genomic estrogenic responses have also been recently identified in vertebrates including fish, which can be mediated by membrane receptors such as the G protein-coupled estrogen receptor (Gper). In this study, two genes for Gper, namely gpera and gperb, were identified in the genome of a teleost fish, the European sea bass. Phylogenetic analysis indicated they were most likely retained after the 3R teleost-specific whole genome duplication and raises questions about their function in male and female sea bass. Gpera expression was mainly restricted to brain and pituitary in both sexes while gperb had a widespread tissue distribution with higher expression levels in gill filaments, kidney and head kidney. Both receptors were detected in the hypothalamus and pituitary of both sexes and significant changes in gpers expression were observed throughout the annual reproductive season. In female pituitaries, gpera showed an overall increase in expression throughout the reproductive season while gperb levels remained constant. In the hypothalamus, gpera had a higher expression during vitellogenesis and decreased in fish entering the ovary maturation and ovulation stage, while gperb expression increased at the final atresia stage. In males, gpers expression was constant in the hypothalamus and pituitary throughout the reproductive cycle apart from the mid- to late testicular development stage when a significant up-regulation of gpera occurred in the pituitary. The differential sex, seasonal and subtype-specific expression patterns detected for the two novel gper genes in sea bass suggests they may have acquired different and/or complementary roles in mediating estrogens actions in fish, namely on the neuroendocrine control of reproduction.

http://ift.tt/2leQs5U

Gender effects in allergology – Secondary publications and update

http://ift.tt/2BTcv8p

Gender aspects and influence of hormones on bronchial asthma – Secondary publication and update

There is good evidence for gender-specific differences in asthma regarding all affected areas, from intra- to extra-cellular mediators to the whole organ structure und functioning of the lung. These result fro...

http://ift.tt/2Cemitb

Adverse reactions to food: the female dominance – A secondary publication and update

Gender-specific differences are evident in food intolerance and allergy. In this review, we will highlight and summarize the dissimilarities in prevalence of adverse food reactions, focusing on IgE-mediated fo...

http://ift.tt/2BQ3Weu

Sex hormone allergy: clinical aspects, causes and therapeutic strategies – Update and secondary publication

Sex hormone allergy as a clinical syndrome has been known for almost a century. Due to the diversity of clinical presentation regarding symptoms and disease patterns, the optimal patient care represents an eno...

http://ift.tt/2CivjBy

Gender aspects in allergies of pets – A secondary publication and update

Allergies need not only affect humans; this multifactorial and complex disease can also affect animals. Comparative allergology investigates the many similarities between the pathogenesis, clinics, diagnosis, ...

http://ift.tt/2BPdq9X

Value of external carotid artery resistive index for diagnosis of cavernous sinus dural arteriovenous fistula and determination of malignant type

Publication date: May–June 2018
Source:Clinical Imaging, Volume 49
Author(s): Chai Kobkitsuksakul, Wasawat Soratcha, Ekachat Chanthanaphak
PurposeCavernous sinus dural arteriovenous fistula (CSDAVF) causes hemodynamic disturbance in the arteries, which is detected by carotid Doppler sonography (CDS). The objective of the study was designed for validation of CDS in the diagnosis of CSDAVF.Material and methods42 CSDAVF patients confirmed by angiography were enrolled. All patients were performed CDS before angiography. Evaluations of CDS parameters were compared with control subjects.ResultsThe ECA resistive index (RI) shows the best performance. The highest yield shown on left ECA RI and increased from 78.6% to 91.7% on malignant-typed.ConclusionCDS may be beneficial as the screening tool for CSDAVF.

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Current diagnostic procedures for diagnosing vertigo and dizziness.

Current diagnostic procedures for diagnosing vertigo and dizziness.

GMS Curr Top Otorhinolaryngol Head Neck Surg. 2017;16:Doc02

Authors: Walther LE

Abstract
Vertigo is a multisensory syndrome that otolaryngologists are confronted with every day. With regard to the complex functions of the sense of orientation, vertigo is considered today as a disorder of the sense of direction, a disturbed spatial perception of the body. Beside the frequent classical syndromes for which vertigo is the leading symptom (e.g. positional vertigo, vestibular neuritis, Menière's disease), vertigo may occur as main or accompanying symptom of a multitude of ENT-related diseases involving the inner ear. It also concerns for example acute and chronic viral or bacterial infections of the ear with serous or bacterial labyrinthitis, disorders due to injury (e.g. barotrauma, fracture of the oto-base, contusion of the labyrinth), chronic-inflammatory bone processes as well as inner ear affections in the perioperative course. In the last years, diagnostics of vertigo have experienced a paradigm shift due to new diagnostic possibilities. In the diagnostics of emergency cases, peripheral and central disorders of vertigo (acute vestibular syndrome) may be differentiated with simple algorithms. The introduction of modern vestibular test procedures (video head impulse test, vestibular evoked myogenic potentials) in the clinical practice led to new diagnostic options that for the first time allow a complex objective assessment of all components of the vestibular organ with relatively low effort. Combined with established methods, a frequency-specific assessment of the function of vestibular reflexes is possible. New classifications allow a clinically better differentiation of vertigo syndromes. Modern radiological procedures such as for example intratympanic gadolinium application for Menière's disease with visualization of an endolymphatic hydrops also influence current medical standards. Recent methodical developments significantly contributed to the possibilities that nowadays vertigo can be better and more quickly clarified in particular in otolaryngology.

PMID: 29279722 [PubMed]

http://ift.tt/2Dqxuzz

Preventing Falls and Fall-Related Injuries at Home.

Preventing Falls and Fall-Related Injuries at Home.

Am J Nurs. 2018 Jan;118(1):58-61

Authors: Powell-Cope G, Thomason S, Bulat T, Pippins KM, Young HM

Abstract
: This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home.The articles in this new installment of the series explain principles for promoting safe mobility that nurses should reinforce with family caregivers. Each article also includes an informational tear sheet-Information for Family Caregivers-that contains links to instructional videos. To use this series, nurses should read the article first, so they understand how best to help family caregivers, and then encourage the caregivers to watch the videos and ask questions. For additional information, see Resources for Nurses.

PMID: 29280811 [PubMed - in process]

http://ift.tt/2BOJ9bk

Classifying clinical notes with pain assessment using machine learning.

Classifying clinical notes with pain assessment using machine learning.

Med Biol Eng Comput. 2017 Dec 26;:

Authors: Fodeh SJ, Finch D, Bouayad L, Luther SL, Ling H, Kerns RD, Brandt C

Abstract
Pain is a significant public health problem, affecting millions of people in the USA. Evidence has highlighted that patients with chronic pain often suffer from deficits in pain care quality (PCQ) including pain assessment, treatment, and reassessment. Currently, there is no intelligent and reliable approach to identify PCQ indicators inelectronic health records (EHR). Hereby, we used unstructured text narratives in the EHR to derive pain assessment in clinical notes for patients with chronic pain. Our dataset includes patients with documented pain intensity rating ratings > = 4 and initial musculoskeletal diagnoses (MSD) captured by (ICD-9-CM codes) in fiscal year 2011 and a minimal 1 year of follow-up (follow-up period is 3-yr maximum); with complete data on key demographic variables. A total of 92 patients with 1058 notes was used. First, we manually annotated qualifiers and descriptors of pain assessment using the annotation schema that we previously developed. Second, we developed a reliable classifier for indicators of pain assessment in clinical note. Based on our annotation schema, we found variations in documenting the subclasses of pain assessment. In positive notes, providers mostly documented assessment of pain site (67%) and intensity of pain (57%), followed by persistence (32%). In only 27% of positive notes, did providers document a presumed etiology for the pain complaint or diagnosis. Documentation of patients' reports of factors that aggravate pain was only present in 11% of positive notes. Random forest classifier achieved the best performance labeling clinical notes with pain assessment information, compared to other classifiers; 94, 95, 94, and 94% was observed in terms of accuracy, PPV, F1-score, and AUC, respectively. Despite the wide spectrum of research that utilizes machine learning in many clinical applications, none explored using these methods for pain assessment research. In addition, previous studies using large datasets to detect and analyze characteristics of patients with various types of pain have relied exclusively on billing and coded data as the main source of information. This study, in contrast, harnessed unstructured narrative text data from the EHR to detect pain assessment clinical notes. We developed a Random forest classifier to identify clinical notes with pain assessment information. Compared to other classifiers, ours achieved the best results in most of the reported metrics. Graphical abstract Framework for detecting pain assessment in clinical notes.

PMID: 29280092 [PubMed - as supplied by publisher]

http://ift.tt/2BQaEBa

The lateral habenula interacts with the hypothalamo-pituitary adrenal axis response upon stressful cognitive demand in rats

Publication date: 2 April 2018
Source:Behavioural Brain Research, Volume 341
Author(s): Victor Mathis, Brigitte Cosquer, Alexandra Barbelivien, Karine Herbeaux, Béatrice Bothorel, Dominique Sage-Ciocca, Vincent-Joseph Poirel, Chantal Mathis, Lucas Lecourtier
The lateral habenula (LHb) is involved in emotional and cognitive behaviors. Recently, we have shown in rats that blockade of excitatory inputs to the LHb not only induced deficits of memory retrieval in the water maze, but also altered swim strategies (i.e., induced excessive thigmotaxis). The latter observation, although consistent with the occurrence of memory deficits, could also possibly be the consequence of an excessive level of stress, further suggesting a role for the LHb in the stress response in our behavioral paradigm. To test this hypothesis we performed in rats intra-LHb infusion of 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX, 267 ng/side in 0.3 μL), or vehicle, and assessed the responsiveness of the hypothalamo-pituitary adrenal (HPA) axis to environmental stressful or non-stressful situations. We have measured plasma corticosterone (CORT) concentrations at different time points before and following intra-LHb infusion of CNQX – or of the same volume of vehicle – in three conditions: during the probe test of a water maze experiment; in an anxiety test, the elevated plus maze; and in a home cage condition. Whereas there were no differences in the home cage condition and in the elevated plus maze, in the water maze experiment we observed that CNQX-treated rats presented, along with memory deficits, a higher level of blood CORT than vehicle-treated rats. These results suggest that perturbations of the modulation of the HPA axis are consecutive to the alteration of LHb function, whether it is the result of a defective direct control of the LHb over the HPA axis, or the consequence of memory deficits.

http://ift.tt/2pQUqWU

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Πέμπτη 28 Δεκεμβρίου 2017

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Αρχειοθήκη ιστολογίου