Head and Neck Diseases by Alexandros G.Sfakianakis: 01/12/18

Παρασκευή 12 Ιανουαρίου 2018

The computed tomography adrenal wash-out analysis properly classifies cortisol secreting adrenocortical adenomas

Abstract

Purpose

Adrenocortical lesions are characterized through imaging, hormonal and histopathological analysis. Our aim was to compare the radiological features of adrenocortical lesions with their cortisol-secreting status and histopathological Weiss score.

Methods

Seventy five patients operated between 2004 and 2016 in the University Hospital of Nancy for either adrenocortical carcinomas (ACC) or adrenocortical adenomas (ACA) were enrolled in this study. We collected cortisol parameters, Computed Tomography (CT) scans (unenhanced density, wash-out (WO) analysis) and ¹⁸F-Fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) datas. The histopathological Weiss score ultimately differentiates ACA (score ≤ 2) from ACC (score ≥ 3). One-way ANOVA, Fisher's exact and unpaired t tests were used for statistical analysis with significancy reached at p < 0.05.

Results

There were 23 ACC and 52 ACA with 40 patients (53%) who had an autonomous secretion of cortisol. On CT scan, ACC were larger compared to ACA (108 vs. 37 mm, p < 0.0001). A roughly similar proportion of cortisol-secreting (22/25) and non-secreting (15/19) ACA were atypical (i.e., unenhanced density value ≥ 10 Hounsfield Units [HU]), however 85% of cortisol-secreting vs. 40% of non-secreting ACA were classified as benigns by the relative WO analysis (p = 0.08). Likewise, there was a trend for a higher ¹⁸F-FDG uptake in cortisol-secreting ACA compared to non-secreting ACA (p = 0.053).

Conclusions

The relative adrenal WO analysis consolidates the benign nature of an ACA, especially in case of cortisol oversecretion, a condition known to compromise the diagnostic accuracy of the 10 HU unenhanced CT attenuation threshold.

http://ift.tt/2DnUmkt

Cover Image

The cover image, by Dajiang Song et al., is based on the Original Article Chimeric thoracoacromial artery perforator flap for one-staged reconstruction of complex pharyngoesophageal defects: A single unit experience, DOI: 10.1002/hed.24962

http://ift.tt/2D6lDep

Issue Information

http://ift.tt/2D5Z49I

The computed tomography adrenal wash-out analysis properly classifies cortisol secreting adrenocortical adenomas

Abstract

Purpose

Methods

Results

Conclusions

http://ift.tt/2DnUmkt

Biodegradation of plastics: current scenario and future prospects for environmental safety

Abstract

Plastic is a general term used for a wide range of high molecular weight organic polymers obtained mostly from the various hydrocarbon and petroleum derivatives. There is an ever-increasing trend towards the production and consumption of plastics due to their extensive industrial and domestic applications. However, a wide spectrum of these polymers is non-biodegradable with few exceptions. The extensive use of plastics, lack of waste management, and casual community behavior towards their proper disposal pose a significant threat to the environment. This has raised growing concerns among various stakeholders to devise policies and innovative strategies for plastic waste management, use of biodegradable polymers especially in packaging, and educating people for their proper disposal. Current polymer degradation strategies rely on chemical, thermal, photo, and biological procedures. In the presence of proper waste management strategies coupled with industrially controlled biodegradation facilities, the use of biodegradable plastics for some applications such as packaging or health industry is a promising and attractive option for economic, environmental, and health benefits. This review highlights the classification of plastics with special emphasis on biodegradable plastics and their rational use, the identified mechanisms of plastic biodegradation, the microorganisms involved in biodegradation, and the current insights into the research on biodegradable plastics. The review has also identified the research gaps in plastic biodegradation followed by future research directions.

http://ift.tt/2EAG3bW

Immunotherapy, an evolving approach for the management of triple negative breast cancer: converting non-responders to responders

Publication date: Available online 12 January 2018
Source:Critical Reviews in Oncology/Hematology
Author(s): Mai F. Tolba, Hany A. Omar
Immunotherapy comprises a promising new era in cancer therapy. Immune checkpoint inhibitors targeting either the programmed death (PD)-1 receptor or its ligand PD-L1 were first approved by the Food and Drug Administration (FDA) for the management of metastatic melanoma in 2011. The approval of this class is being extended to include other types of immunogenic tumors. Although breast cancer (BC) was first categorized as non-immunogenic tumor type, there are certain subsets of BC that showed a high level of tumor infiltrating lymphocytes (TILs). Those subsets include the triple negative breast cancer (TNBC) and HER-2 positive breast tumors. Preliminary data from clinical trials presented promising outcomes for patients with advanced stage/metastatic TNBC. While the objective response rate (ORR) was relatively low, it is still promising because of the observation that the patients who respond to the treatment with immune checkpoint blockade have favorable prognosis and often show a significant increase in the overall survival. Therefore, the main challenge is to find ways to enhance the tumor response to such therapy and to convert the non-responders to responders. This will consequently bring new hopes for patients with advanced stage metastatic TNBC and help to decrease death tolls from this devastating disease. In the current review, we are highlighting and discussing the up-to-date strategies adopted at either the preclinical or the clinical settings to enhance tumor responsiveness to immunotherapy.

http://ift.tt/2DaMPI1

Rheumatoid disease: an unusual cause of relapsing meningoencephalitis

A 73-year-old man presented with three episodes of dysphasia and disinhibited behaviour, a single seizure and transient ischaemic attack-like events characterised by right arm and/or leg weakness. These episodes were separated by month-long asymptomatic intervals. Medical history included rheumatoid arthritis, which was clinically quiescent on leflunomide.

Repeated cerebrospinal fluid examination showed a persistent lymphocytosis with mildly reduced glucose and elevated protein; oligoclonal bands and viral PCR were negative. MRI of the brain was initially normal, but 7 months after initial presentation revealed meningeal enhancement with bifrontal cortical hyperintensities on T2/fluid-attenuated inversion recovery. Brain biopsy demonstrated necrotising granulomatous meningitis with mixed T cell and B cell infiltrates and without evidence of vasculitis or infection. Serum anticyclic citrullinated peptide antibodies were strongly positive.

The diagnosis of rheumatoid meningoencephalitis was made on the basis of brain biopsy findings and serological evidence of active rheumatoid disease. Steroids and rituximab therapy were started leading to clinical stabilisation.

http://ift.tt/2D4aVoG

Bancroftian filariasis associated with male sterility

Description

A 33-year-old man presented with recurrent pain and swelling in the inguinal region since the last 8 years, occasional fever and loss of sex drive. The pain and swelling usually lasted for 2–3 weeks with a pain-free interval of 4–5 months. He felt that the size of the left testis is gradually reducing. He had been married for more than 5 years without having any children. Clinical examination revealed swelling and tenderness of the scrotum more on the right (figure 1A).

Fro Figure 1

(A) A 33-year- old man with right-sided testicular swelling. (B) Ultrasonography of the scrotum reveals a hypoechogenic, small right testis with irregularly echogenicity in periphery due to fibrosis. (C) Colour Doppler reveals absence of vascular flow on right-side testis.

Ultrasound examination showed swelling of both epididymis with the outer area appearing irregularly echogenic due to fibrosis (figure 1B)....

http://ift.tt/2AW4oXa

Case of chest pain in a young man

A young man with a history of smoking presented with acute-onset chest pain after lifting weights. He also noticed a change in his voice, tightness in his neck and difficulty breathing. A chest radiograph showed soft tissue emphysema in the neck. A CT scan of the chest revealed moderate amount of pneumomediastinum tracking into the neck and down to the diaphragm. He was haemodynamically stable and had no hypoxia or dysphagia. He was monitored for 48 hours and discharged home after resolution of his symptoms. A chest radiograph repeated after 6 weeks was normal.

http://ift.tt/2AW4puc

Central nervous system graft-versus-host disease (CNS-GvHD) after allogeneic haematopoietic stem cell transplantation

A 60-year-old man presented with impaired consciousness and psychomotor agitation after a second allogeneic haematopoietic stem cell transplantation (HSCT) from a matched unrelated donor for acute myeloid leukaemia. Clinical, biological and radiological evidence suggested a diagnosis of central nervous system graft-versus-host disease (CNS-GvHD). After intrathecal infusion of methylprednisolone, the clinical symptoms as well as the radiological abnormalities disappeared. The present report illustrates the difficulties in the diagnosis and the management of CNS-GvHD, a very rare and still challenging neurological complication that can occur after allogeneic HSCT.

http://ift.tt/2D4aQkS

Spontaneous splenic rupture as a rare complication of G-CSF injection

Splenic rupture is an infrequent and underdiagnosed side effect of granylocyte colony-stimulating factor (G-CSF). We report the case of a 54-year-old woman with brain and bone metastasis in a lung adenocarcinoma who was admitted for faintness 28 days after a G-CSF injection. Abdominal CT scan confirmed the diagnosis of splenic rupture. A conservative treatment was chosen using a peritoneal cleansing during laparoscopic surgery. Clinicians should be aware of this rare toxicity as it could be severe, but easily reversible using appropriate surgical treatment. Even if prognosis remains poor for patients with lung cancer, invasive procedures could be considered in this rapidly evolving setting, especially in case of reversible adverse event.

http://ift.tt/2AVS5u7

Cutis marmorata telangiectatica congenita and major lower limb asymmetry

A 39-week-old male newborn presented at birth with atrophic erythematous and purpuric skin lesions, in a typical right-sided segmental distribution. Lesions were persistent and unaffected by rewarming in the postpartum period. Postnatal echocardiogram showed a predominance of the right cavities and an upper atrial septal defect. Cerebral and abdominal ultrasound were normal along with ophthalmological examination. On follow-up, lower limbs asymmetry was noted. The right lower limb was shorter in length and had a smaller diameter. At 6 months, the right lower limb was 1.5 cm shorter than the left, most likely related to nutritive vessels malformations. The discrepancy was even more pronounced at the age of 9 months. This leg-length asymmetry can lead to severe functional limitations in the future.

http://ift.tt/2D4aPgO

Vitamin B12 deficiency: unusual cause of jaundice in an adolescent

Vitamin B₁₂ deficiency in vegans is a known cause of megaloblastic anaemia. We report an adolescent girl who presented with jaundice and weight loss for 6 months secondary to vitamin B₁₂ deficiency, leading to megaloblastic anaemia. Replacement with vitamin B₁₂ reversed her symptoms, resulting in weight gain, and normalised her haemoglobin, red blood cell morphology, bilirubin levels and serum vitamin B₁₂ levels.

http://ift.tt/2D69ruh

Multiple cranial nerve palsies secondary to a recurrence of Hansens disease

Description

A 31-year-old Indian man presented with drooping of the right eyelid since 1 month, slight deviation of the angle of the mouth to the right since 20 days, difficulty in swallowing (initially with regard to solids, and later on with regard to liquids) since 15 days, nasal regurgitation since 15 days and a nasal twang since 15 days. His past history was not significant, with no history of fever, weight loss, diarrhoea, swollen glands, rash, disfigurement of the hands and feet, loss of eyebrows, or any history suggestive of limb weakness, numbness or tingling. He was not on any medications. None of his parents had any health problems.

He had been previously treated for multibacillary leprosy (Hansen's disease) 3 years back and had taken treatment for 1 year for the same.

On examination, he was found to have bilateral lower motor neuron (LMN)-type glossopharyngeal and vagus nerve palsy; right-sided oculomotor nerve palsy as evidenced...

http://ift.tt/2D4aMl8

Cutaneous larva migrans with pulmonary involvement

Description

After returning from a Carribean cruise, a 52-year-old woman spent an afternoon sitting on a sandy beach in Martinique with her husband. An initial burning sensation over her buttocks was followed the next day by an intensely pruritic eruption with 'red pinprick marks'. This was unsuccessfully treated on the cruise ship with antibiotics, antifungal agents, as well as topical and intramuscular steroids. Examination on day 10 revealed a serpiginous rash over her buttocks with a large number of discrete papular lesions (figure 1). The patient's husband was noted to be itching and examination revealed a rash with equivalent distribution and morphology (figure 2). A clinical diagnosis of cutaneous larva migrans was made.

Figure 1

Florid, serpiginous rash located on the buttock region of the patient.

Figure 2

Rash with identical morphology affecting the same region of patient's...

http://ift.tt/2AVpwNa

Rare cause of isolated severe coagulation failure in cirrhosis: traditional healing with fenugreek

Patients with cirrhosis develop decompensation events during the natural history of the disease that encompass ascites, variceal bleeding, hepatic encephalopathy and jaundice. Coagulation failure, defined using the international normalised ratio, even though not a decompensation event, is important in patients with stratifying cirrhosis into those who require liver transplantation for long-term survival. Isolated coagulation failure in cirrhosis is rare and usually occurs with use of anticoagulants in the setting of vascular diseases. We reported the case of a patient with compensated cirrhosis in whom, isolated severe coagulation failure was found to be due to excessive use of fenugreek milk porridge as part of traditional healing. The coagulation failure was promptly reversed with avoidance of fenugreek and supplementation with vitamin K.

http://ift.tt/2D6gAun

Hepatic portal venous gas after diving

Description

A 68-year-old man with diabetes and chronic kidney disease presented with severe epigastric pain and nausea 30 min after scuba diving in Ishigaki Island, southern part of Okinawa Prefecture, Japan. He dived to 10 m (32.8 ft) twice, for an hour each diving. The length of bottom time was unknown. The temperature of the water was 29.0°C (84.2°F). His vital signs were stable. On palpation of abdomen, there was no evidence of guarding and tenderness. There was also no rash. Venous blood gas showed a pH of 7.314 and lactate of 3.03 mmol/L. Other laboratory values were unremarkable, including liver function tests and creatine kinase. An abdominal CT without contrast was performed because he had a history of allergic reaction to contrast agent. Abdominal CT demonstrated hepatic portal venous gas (HPVG, figures 1 and 2) and gases in the mesenteric vein (figure 2) and femoral vein (

http://ift.tt/2AW4nT6

Case of acute severe postpartum urinary incontinence: an extravesical subsphincteric prolapsed ureterocoele

A 32-year-old woman presents to outpatients 10 days postpartum, with symptoms of an intermittent vaginal lump and urinary incontinence. Vaginal examination revealed no demonstrable prolapse or stress incontinence. A swelling in the bladder was noted during an antenatal scan suggesting a ureterocoele. She was referred for pelvic floor physiotherapy in the first instance. Forty-eight hours later, she represented to casualty with discomforting vaginal lump symptoms and continuous urinary incontinence. At this stage on vaginal inspection, there was an evident dusky lump emerging from the urethra with continuous incontinence. An extravesical subsphincteric prolapsed ureterocoele was evident, 5 cm beyond the external urethral meatus. The diagnosis was confirmed with an MRI scan which demonstrated the prolapsed obstructing ureterocoele causing significant left-sided hydroureteronephrosis. The ureterocoele was managed with a cystoscopy and transurethral incision of the ureterocoele under anaesthesia, which facilitated drainage and resolution. At 3-month postoperatively, the patient remains continent and satisfied.

http://ift.tt/2D6gva3

Assessment of vestibular-evoked myogenic potentials and video head impulse test in type 2 diabetes mellitus patients with or without polyneuropathy

Abstract

This study aimed to compare cervical vestibular-evoked myogenic potentials (cVEMP), ocular vestibular-evoked myogenic potentials (oVEMP) and video head impulse test (vHIT) results between patients with type 2 diabetes mellitus (DM) or diabetic polyneuropathy (DPN) and healthy controls to determine vestibular end-organ pathologies. The participants in the present study consisted of three groups: the type 2 DM group (n = 33 patients), the DPN group (n = 33 patients), and the age- and sex-matched control group (n = 35). Cervical VEMP, oVEMP and vHIT were performed for each participant in the study and test results were compared between the groups. Peak-to-peak amplitudes of cVEMP (p13–n21) and oVEMP (n10–p15) were significantly lower in the DM and DPN groups than the control group. The values of vHIT were not statistically different between the groups. To our knowledge, the present study is the first report investigating oVEMP and cVEMP responses combined with vHIT findings in patients with DM and DPN. Vestibular end-organ pathologies can be determined via clinical vestibular diagnostic tools in spite of prominent vestibular symptoms in patients with type 2 DM as well as patients with DPN.

http://ift.tt/2EFeRZE

Biochemical changes in mussels submitted to different time periods of air exposure

Abstract

Intertidal species face multiple stressors on a daily basis due to their particular habitat. The submergence at high tide in the aquatic environment and emergence at low tide to the aerial environment, associated with a wide variation of abiotic parameters, along with anthropogenic contamination are some of the daily stresses that these organisms are exposed to. With such a dynamic environment, organisms developed strategies that allow them to avoid or tolerate these stressors. Among these species, bivalves are some of the most hypoxia tolerant, being commonly used as a biomonitoring tool due to their capacity to accumulate pollutants from the environment and reflect the imposed toxic impacts. However, when evaluating the response ability of organisms to different stressors under laboratory conditions, it is not common to consider the fact that exposure to tides can act as a confounding factor. The present study assessed the effects of air exposure on the biochemical (metabolic capacity, energy reserves, and oxidative stress related biomarkers) performance of intertidal Mytilus galloprovincialis mussels. Specimens of M. galloprovincialis were submitted once every 24 h to different periods of air exposure (3 and 6 h) for 14 days, under constant air and seawater temperature (19 ± 1 °C). Results obtained revealed that air exposure can cause biochemical changes in mussels. The present findings demonstrated that individuals exposed to air induced superoxide dismutase (SOD) and catalase (CAT) activity as mechanisms to withstand the abiotic changes while mobilizing lipid content as the principal source of energy, and increasing protein content possibly as a result of an increase in the number of antioxidant defense enzymes. Moreover, individuals under air exposure suffered higher oxidative damage while showing higher metabolic rate. Results demonstrated that longer periods of air exposure induced more injuries, since individuals emerged during 6 h presented higher oxidative stress than individuals under 3 h of air exposure.

http://ift.tt/2Dr5xJu

If at first you don't succeed: Assessing influences associated with mothers' reoffering of vegetables to preschool age children

Publication date: 1 April 2018
Source:Appetite, Volume 123
Author(s): Clare E. Holley, Claire Farrow, Emma Haycraft
Repeatedly offering vegetables has been shown to be one of the most effective methods for increasing acceptance and subsequent intake in young children. In order to increase successful offerings of vegetables and resultant consumption amongst young children, it is necessary to consider the influences on maternal reoffering of vegetables. This study aimed to investigate the relationships between mothers' tendency to reoffer vegetables and a range of demographic factors and psychological variables. A cross-sectional design was used, where mothers completed questionnaires assessing how often they reoffer rejected vegetables, concerns for economic factors, and a range of possible child and maternal influences. Mothers of preschool children were recruited from toddler groups across Leicestershire, UK, as well as online. Spearman's correlations were run to look for associations between demographic and psychological factors with maternal reoffering of vegetables. Significantly associated factors were then entered into a stepwise regression to predict maternal reoffering of vegetables. Mothers were significantly less likely to reoffer rejected vegetables if they were concerned about time, money, and waste, were influenced by their child's mood, or were concerned about their child having tantrums. Moreover, mothers who consumed more vegetables themselves reoffered vegetables more frequently. Regression analyses revealed that mothers' concern about food waste and tantrums, as well as maternal vegetable consumption, all significantly predicted mothers' reoffering of vegetables. With these findings in mind, mothers should be educated and supported with how to tackle and minimise children's tantrums during feeding, as well as being made aware of effective methods for avoiding food waste. Moreover, given that mothers' own vegetable consumption is associated with lower reoffering of vegetables to their child, interventions which seek to increase familial vegetable consumption should be pursued.

http://ift.tt/2DcouBI

Anthony Sclafani: Consummate scientist

Publication date: 1 March 2018
Source:Appetite, Volume 122
Author(s): Joseph R. Vasselli, Gerard P. Smith
In this article we review the scientific contributions of Anthony Sclafani, with specific emphasis on his early work on the neural substrate of the ventromedial hypothalamic (VMH) hyperphagia-obesity syndrome, and on the development of diet-induced obesity (DIO). Over a period of 20 years Sclafani systematically investigated the neuroanatomical basis of the VMH hyperphagia-obesity syndrome, and ultimately identified a longitudinal oxytocin-containing neural tract contributing to its expression. This tract has since been implicated in mediating the effects of at least two gastrointestinal satiety factors. Sclafani was one of the first investigators to demonstrate DIO in rats as a result of exposure to multiple palatable food items (the "supermarket diet"), and concluded that diet palatability was the primary factor responsible for DIO. Sclafani went on to investigate the potency of specific carbohydrate and fat stimuli for inducing hyperphagia, and in so doing discovered that post-ingestive nutrient effects contribute to the elevated intake of palatable food items. To further investigate this effect, he devised an intragastric infusion system which allowed the introduction of nutrients into the gut paired with the oral intake of flavored solutions, an apparatus her termed the "electronic esophagus". Sclafani coined the term "appetition" to describe the effect of intestinal nutrient sensing on post-ingestive appetite stimulation. Sclafani's productivity in the research areas he chose to investigate has been nothing short of extraordinary, and his studies are characterized by inventive hypothesizing and meticulous experimental design. His results and conclusions, to our knowledge, have never been contradicted.

http://ift.tt/2msTzXt

Neutralising the meat paradox: Cognitive dissonance, gender, and eating animals

Publication date: 1 April 2018
Source:Appetite, Volume 123
Author(s): Elisha Dowsett, Carolyn Semmler, Heather Bray, Rachel A. Ankeny, Anna Chur-Hansen
Meat eating is a common behaviour, despite many people claiming to like, love, and care about animals. The apparent disconnection between not wanting animals to suffer, yet killing them for food, has been termed the 'meat paradox.' In this experimental study (N = 460), participants completed pre-affect, post-affect, meat attachment, and attitude towards animals questionnaires, under two conditions: exposure to the life of an Australian meat lamb, and information about the nutritional benefits of meat. A factorial MANOVA revealed that negative affect was significantly greater when participants were exposed to the meat-animal connection; however, more entrenched attitudes towards animals and attachment to meat remained unaffected. Significant gender effects were found across all variables: most notably, meat attachment differed according to gender, decreasing in women and increasing in men when exposed to the meat-animal condition. Open-ended responses were subjected to content analysis to understand participants' future meat-consumption preferences and accompanying reasoning strategies. Findings from the present study contribute to understanding how cognitive dissonance and inconsistencies are rationalised by meat consumers.

http://ift.tt/2DcVBFs

The convergence of psychology and neurobiology in flavor-nutrient learning

Publication date: 1 March 2018
Source:Appetite, Volume 122
Author(s): Kevin P. Myers
Flavor evaluation is influenced by learning from experience with foods. One main influence is flavor-nutrient learning (FNL), a Pavlovian process whereby a flavor acts as a conditioned stimulus (CS) that becomes associated with the postingestive effects of ingested nutrients (the US). As a result that flavor becomes preferred and intake typically increases. This learning powerfully influences food choice and meal patterning. This paper summarizes how research elucidating the physiological and neural substrates of FNL has progressed in parallel with work characterizing how FNL affects perception, motivation, and behavior. The picture that emerges from this work is of a robust system of appetition (a term coined by Sclafani in contrast to the better-understood satiation signals) whereby ingested nutrients sensed in the gut evoke positive motivational responses. Appetition signals act within a meal to promote continued intake in immediate response to gut feedback, and act in the longer term to steer preference towards sensory cues that predict nutritional consequences.

http://ift.tt/2mrmtXS

Self-affirmation improves self-control over snacking among participants low in eating self-efficacy

Publication date: 1 April 2018
Source:Appetite, Volume 123
Author(s): Susan Churchill, Donna C. Jessop, Ricky Green, Peter R. Harris
ObjectiveIndividuals low in eating self-efficacy are at particular risk of engaging in unhealthy eating behaviours, including the consumption of high calorie snacks. The elevated levels of snacking displayed by these individuals can largely be attributed to their experiencing low self-control over the avoidance of such foods (Hankonen, Kinnunen, Absetz, & Jallinoja, 2014). Interventions are thus required to boost self-control over snacking among those low in eating self-efficacy. Self-affirmation has been shown to boost self-control among individuals with depleted resources in other domains (Schmeichel & Vohs, 2009). The purpose of the current study was to test the hypothesis that a self-affirmation manipulation would similarly increase self-control over snacking for individuals low in eating self-efficacy.MethodsAt baseline, participants (N = 70) completed measures of dietary restraint and eating self-efficacy. In the main study, participants completed either a self-affirmation or a control task immediately before undertaking a joystick category judgment task that assessed self-control over snacking.ResultsHierarchical multiple regression analysis revealed the predicted significant interaction between eating self-efficacy and self-affirmation, demonstrating that self-affirmation moderated the association between eating self-efficacy and self-control over snacking. Johnson-Neyman regions of significance confirmed that for participants low in eating self-efficacy the self-affirmation manipulation resulted in higher levels of self-control. Unexpectedly, however, for participants high in eating self-efficacy the self-affirmation manipulation was found to be associated with lower levels of self-control.ConclusionsFindings supported the hypothesis that a self-affirmation manipulation would boost self-control over snacking among individuals low in eating self-efficacy. Self-affirmation may thus provide a useful technique for strengthening self-control in relation to the avoidance of unhealthy foods among individuals who find it difficult to manage challenging dietary situations.

http://ift.tt/2D7xg47

Editorial Board

Publication date: 1 March 2018
Source:Appetite, Volume 122

http://ift.tt/2msSMG6

Behavioral evidence that select carbohydrate stimuli activate T1R-independent receptor mechanisms

Publication date: 1 March 2018
Source:Appetite, Volume 122
Author(s): Alan C. Spector, Lindsey A. Schier
Three decades ago Tony Sclafani proposed the existence of a polysaccharide taste quality that was distinguishable from the taste generated by common sweeteners and that it was mediated by a separate receptor mechanism. Since that time, evidence has accumulated, including psychophysical studies conducted in our laboratory, buttressing this hypothesis. The use of knockout (KO) mice that lack functional T1R2 + T1R3 heterodimers, the principal taste receptor for sugars and other sweeteners, have been especially informative in this regard. Such KO mice display severely diminished electrophysiological and behavioral responsiveness to sugars, artificial sweeteners, and some amino acids, yet display only slightly impaired concentration-dependent responsiveness to a representative polysaccharide, Polycose. Moreover, although results from gene deletion experiments in the literature provide strong support for the primacy of the T1R2 + T1R3 heterodimer in the taste transduction of sugars and other sweeteners, there is also growing evidence suggesting that there may be T1R-independent receptor mechanism(s) activated by select sugars, especially glucose. The output of these latter receptor mechanisms appears to be channeled into brain circuits subserving various taste functions such as cephalic phase responses and ingestive motivation. This paper highlights some of the findings from our laboratory and others that lend support for this view, while emphasizing the importance of considering the multidimensional nature of taste function in the interpretation of outcomes from experiments involving manipulations of the gustatory system.

http://ift.tt/2DcVsBU

Knowledge, attitudes and practices of schoolchildren toward whole grains and nutritional outcomes in Malaysia

Publication date: 1 April 2018
Source:Appetite, Volume 123
Author(s): H.C. Koo, C.L. Lee, A.S. Nur Hidayah, A.R. Nurain Hazwani
Whole grains play an important role in regulating body weight. However, interventions aimed to increase whole grains consumption have had limited impact on body mass index for age z-score (BAZ) due to insufficient understanding of knowledge, attitudes and practices (KAP) toward whole grains. This survey aimed to evaluate whole grains KAP among schoolchildren, as well as to investigate the associations of whole grains KAP with BAZ among the schoolchildren in Negeri Sembilan, Malaysia. This cross-sectional survey was conducted among 380 schoolchildren aged 9–11 years, cluster sampled from six randomly selected schools. Data were collected through a validated self-administered guided questionnaire. Body weight and height were measured. A majority of the schoolchildren had normal body weight (56.6%), moderate whole grains knowledge (42.6%), as well as neutral attitudes (66.1%) and poor practices (58.9%) toward whole grains consumption. Significant positive associations were found between knowledge and attitudes (r = 0.337; p < .01), attitudes and practices (r = 0.150; p < .01) and knowledge and practices (r = 0.190; p < .01). Further, whole grains consumption's practices was associated with BAZ after adjusting for sex, gender, race and area where children lived in (p < .001). Outcome of this present study implies that positive change in whole grain knowledge would help to inculcate positive attitudes and cultivate better practices toward whole grain consumption, which may be useful in lower BAZ among schoolchildren in Negeri Sembilan, Malaysia. This study reveals the importance of KAP toward whole grains among children to assist in identification of specific preventive childhood obesity actions.

http://ift.tt/2FnGVSq

A randomised controlled trial of manualized cognitive remediation therapy in adult obesity

Publication date: 1 April 2018
Source:Appetite, Volume 123
Author(s): Jayanthi Raman, Phillipa Hay, Kate Tchanturia, Evelyn Smith
ObjectiveResearch has indicated that individuals with obesity have neurocognitive deficits, especially in cognitive flexibility that may in turn impact on their weight loss and maintenance. Consequently, we examined the efficacy of a manualised face-to-face cognitive remediation therapy for obesity (CRT-O) within a randomised controlled trial, in terms of improving cognitive flexibility, reducing binge eating behaviour, improving quality of life and helping with weight loss.Methods80 adults with obesity (body mass index >30 kg/m²), 70% binge eaters, received three weekly sessions of group Behavioural Weight Loss (BWL) and then were randomised to 8 sessions of individual CRT-O or to a no-treatment control group.ResultsMixed-effects model analyses revealed that the CRT-O group had a significant improvement in their cognitive flexibility at post-treatment and 3-month follow-up compared to the control group (Cohen's d = 0.96 to 2.1). 68% of those in the CRT-O group achieved a weight loss of 5% or more at follow-up compared to only 15% of the controls (Cohen's d = 1.3). Changes in set-shifting predicted changes in weight (p < .05). Binge eating reduced in the CRT-O group compared to the control (Cohen's d = 0.80).DiscussionThis is the first study showing the efficacy of CRT-O for obesity. Future CRT-O studies with longer follow-ups and pairing it with longer BWL programs are needed.Trials registry (ANZCTR)12613000537752.Date of ANZCTR registration14 May 2013.

http://ift.tt/2DcVg5E

Social influences on adolescents’ dietary behavior in Catalonia, Spain: A qualitative multiple-cases study from the perspective of social capital

Publication date: 1 April 2018
Source:Appetite, Volume 123
Author(s): Elena Carrillo-Álvarez, Jordi Riera-Romaní, Olga Canet-Vélez
Adolescence has been referred to as the last best chance to prevent adult non-communicable diseases. Gaining further evidence on the psychosocial determinants of health behaviors, particularly the impact of peers, social networks and media on diet, is necessary to develop appropriate preventive strategies. Based on a multiple-cases study, our aim was to discuss the social influences on adolescents' dietary behavior from a social capital perspective. Participants were reached through four high-schools in different Catalan rural-urban and socioeconomic contexts. Our results confirm the different layout of social capital in the community, school, peers and family. In our sample, family and peers are the most influent sources of social capital in relation to dietary behaviors, inducing both protective and damaging effects.

http://ift.tt/2msyPPx

Introduction to the Columbia University Appetitive Behavior Festschrift in honor of Anthony Sclafani and Karen Ackroff

Publication date: 1 March 2018
Source:Appetite, Volume 122
Author(s): Allan Geliebter

http://ift.tt/2mqWaRX

Conditioned flavor preferences in animals: Merging pharmacology, brain sites and genetic variance

Publication date: 1 March 2018
Source:Appetite, Volume 122
Author(s): Richard J. Bodnar
The elucidation of the behavioral, neurochemical, neuroanatomical and genetic substrates mediating the development of conditioned flavor preferences (CFP) is one of the multi-faceted scientific contributions that Dr. Anthony Sclafani has made to the study of food intake. This review summarizes the results of thirty-five publications over nearly twenty years of collaborations between the Sclafani and Bodnar laboratories. This includes the different approaches employed to study the orosensory (flavor-flavor) and post-ingestive (flavor-nutrient) processes underlying CFP including its acquisition (learning) and expression. It describes how CFP is elicited by different sugars (sucrose, glucose, fructose) and fats (corn oil) in rats, and how strain-specific CFP effects can be observed through the use of inbred mouse strains to evaluate genetic variance. The roles of pharmacological substrates (dopamine, glutamate, opioids, acetylcholine, GABA, cannabinoids) mediating sugar- and fat-CFP acquisition and expression are elucidated. Finally, neuroanatomical sites of action (nucleus accumbens, amygdala, medial prefrontal and orbital frontal cortices, lateral hypothalamus) are evaluated at which dopamine signaling mediates acquisition and expression of different forms of CFP.

http://ift.tt/2D9yZFV

Gut–brain nutrient sensing in food reward

Publication date: 1 March 2018
Source:Appetite, Volume 122
Author(s): Ari Shechter, Gary J. Schwartz
For the past several decades, vagal and hormonal gut–brain negative feedback signaling mechanisms that promote satiety and subsequent suppression of food intake have been explored. In addition, a separate positive feedback process termed "appetition," involving postoral signaling from the gut to the brain, has been shown to promote food intake and produce flavor–nutrient preference conditioning. Afferent fibers emerging from the vagus nerve form the main pathway by which information is relayed from the abdominal viscera to the hindbrain and eventually other higher brain regions involved in food intake. Using a specialized subdiaphragmatic vagal deafferentation technique, it was observed that gut vagal and splanchnic afferents play a role in the negative feedback control of satiety after nutrient intake; however, these afferents are not required for nutrient reinforcement or flavor–nutrient preference conditioning, thereby highlighting the distinction between the processes of satiation and appetition. By linking these physiological and behavioral processes to a neurochemical mechanism, it was found that striatal dopamine release induced by intragastric glucose infusion is involved in sweet appetite conditioning. The mechanisms underlying appetition are still being investigated but may involve other nondopaminergic neurochemical systems and/or presently undiscovered hormonal mediators. Future work to delineate the biological mechanisms whereby appetition drives increased intake and conditioned food preference in response to ingestion should take a multifaceted approach by integrating hormonal, neurophysiological, and behavioral techniques.

http://ift.tt/2mtOLku

Progressive ratio (PR) schedules and the sipometer: Do they measure wanting, liking, and/or reward? A tribute to Anthony Sclafani and Karen Ackroff

Publication date: 1 March 2018
Source:Appetite, Volume 122
Author(s): H.R. Kissileff, M. Herzog
This paper honors the contributions made by Anthony (Tony) Sclafani and Karen Ackroff to both the Columbia University Seminar on Appetitive Behavior and to the field of ingestive behavior in general. We review their use of the progressive ratio (PR) licking paradigm, to determine whether the taste of sucrose, independent of its post-ingestive effects, is always positively reinforcing in animals. They demonstrated a monotonic increase in licking as concentration increased, and obtained results identical to those obtained with a lever-pressing paradigm, but licking was easier and more natural than lever pressing. The PR paradigm was translated to evaluate liquid food reward value in humans. An instrument (the sipometer) was devised that initially permitted a few seconds access to small amounts of a sweet beverage as the participants increased the time to obtain it in 3–5-sec increments. The device went through two refinements and currently delivers the reinforcer and measures the pressure exerted to obtain it. The sipometer is compared with other techniques for measuring motivation and reward. The use of the sipometer and the PR method are discussed in relation to the theoretical challenges inherent in measuring motivation and pleasure, from both psychological and behavioral economics perspectives, and why it is or is not important to separate these processes for both theoretical and practical applications.

http://ift.tt/2DcNr08

Ultrasensitive electrochemical immuno-sensing platform based on gold nanoparticles triggering chlorpyrifos detection in fruits and vegetables

Publication date: 15 May 2018
Source:Biosensors and Bioelectronics, Volume 105
Author(s): Anita Talan, Annu Mishra, Sergei A. Eremin, Jagriti Narang, Ashok Kumar, Sonu Gandhi
Chlorpyrifos (chl) is an organophosphate pesticide extensively used in agriculture and highly toxic for human health. Fluorine doped tin-oxide (FTO) based electrochemical nanosensor was developed for chlorpyrifos detection with gold nanoparticles (AuNPs) and anti-chlorpyrifos antibodies (chl-Ab). AuNPs provides high electrical conductivity and specific resistivity, thus increases the sensitivity of immunoassay. High electrical conductivity of AuNPs reveals that it promotes the redox reaction for better cyclic voltammetry. Based on the intrinsic conductive properties of FTO-AuNPs complex, chl-Ab was immobilized onto AuNPs surface. Under optimized conditions, the proposed FTO based nanosensor exhibited high sensitivity and stable response for the detection of chlorpyrifos, ranging from 1fM to 1µM with limit of detection (LOD) up to 10fM. The FTO-AuNPs sensor was successfully employed for the detection of chlorpyrifos in standard as well in real samples up to 10nM for apple and cabbage, 50nM for pomegranate. The proposed FTO-AuNPs nanosensor can be used as a quantitative tool for rapid, on-site detection of chlorpyrifos traces in real samples when miniaturized due to its excellent stability, sensitivity, and simplicity.

http://ift.tt/2D8oO4F

Three-dimensional graphene biointerface with extremely high sensitivity to single cancer cell monitoring

Publication date: 15 May 2018
Source:Biosensors and Bioelectronics, Volume 105
Author(s): Xiahua Wang, Aiping Liu, Yun Xing, Hongwei Duan, Weizhong Xu, Qi Zhou, Huaping Wu, Cen Chen, Benyong Chen
We developed a three-dimensional biointerface of graphene-based electrical impedance sensor for metastatic cancer diagnosis at single-cell resolution. Compared with traditional impedance sensor with two-dimensional interface, the graphene biointerface mimiced the topography and somatotype features of cancer cells, achieving more comprehensive and thorough single cell signals in the three-dimensional space. At the nodes of physiological behavior change of single cell, namely cell capture, adhesion, migration and proliferation, the collected electrical signals from graphene biointerface were about two times stronger than those from the two-dimensional gold interface due to the substantial increase in contact area and significant improvement of topographical interaction between cells and graphene electrode. Simultaneous CCD recording and electrical signal extraction from the entrapped single cell on the graphene biointerface enabled to investigate multidimensional cell-electrode interactions and predict cancerous stage and pathology.

Graphical abstract

http://ift.tt/2DasqD6

Early and Locally Advanced Metaplastic Breast Cancer: Presentation and Survival by Receptor Status in Surveillance, Epidemiology, and End Results (SEER) 2010–2014

AbstractBackground.Metaplastic breast cancer (MBC) is a rare disease subtype characterized by an aggressive clinical course. MBC is commonly triple negative (TN), although hormone receptor (HR) positive and human epidermal growth receptor 2 (HER2) positive cases do occur. Previous studies have reported similar outcomes for MBC with regard to HR status. Less is known about outcomes for HER2 positive MBC.Materials and Methods.Surveillance, Epidemiology, and End Results Program data were used to identify women diagnosed 2010–2014 with MBC or invasive ductal carcinoma (IDC). Kaplan‐Meier curves estimated overall survival (OS) and multivariate Cox models were fitted. For survival analyses, only first cancers were included, and 2014 diagnoses were excluded to allow for sufficient follow‐up.Results.Our MBC sample included 1,516 women. Relative to women with IDC, women with MBC were more likely to be older (63 vs. 61 years), black (16.0% vs. 11.1%), and present with stage III disease (15.6% vs. 10.8%). HER2 positive and HER2 negative/HR positive MBC tumors represented 5.2% and 23.0% of cases. For MBC overall, 3‐year OS was greatest for women with HER2 positive MBC (91.8%), relative to women with TN (75.4%) and HER2 negative/HR positive MBC (77.1%). This difference was more pronounced for stage III MBC, for which 3‐year OS was 92.9%, 47.1%, and 42.2% for women with HER2 positive, TN, and HER2 negative/HR positive MBC, respectively. A multivariate Cox model of MBC demonstrated that HER2 positive tumors (relative to TN) were associated with improved survival (hazard ratio = 0.32, 95% confidence interval [CI] 0.13–0.79). In a second Cox model of exclusively HER2 positive tumors, OS did not differ between MBC and IDC disease subtypes (hazard ratio = 1.16, 95% CI 0.48–2.81).Conclusion.In this contemporary, population‐based study of women with MBC, HER2 but not HR status was associated with improved survival. Survival was similar between HER2 positive MBC and HER2 positive IDC. This suggests HER2 positive MBC is responsive to HER2‐directed therapy, a finding that may offer insights for additional therapeutic approaches to MBC.Implications for Practice.This population‐based study reports recent outcomes, by receptor status, for women with metaplastic breast cancer. Survival in metaplastic breast cancer is not impacted by hormone receptor status. To the authors' knowledge, this is the first report indicating that women with human epidermal growth receptor 2 (HER2) positive metaplastic breast cancer have survival superior to women with HER2 negative metaplastic breast cancer and survival similar to women with HER2 positive invasive ductal carcinoma. This information can be used for counseling patients diagnosed with metaplastic breast cancer. Further understanding of HER2 positive metaplastic breast cancer could offer insights for the development of therapeutic approaches to metaplastic breast cancer more broadly.

http://ift.tt/2CWoTFa

Trastuzumab Plus Pertuzumab Resistance Does Not Preclude Response to Lapatinib Plus Trastuzumab in HER2‐Amplified Colorectal Cancer

AbstractHuman epidermal growth factor 2 (HER2) amplification represents a distinct molecular subgroup of colorectal cancers that is associated with anti‐epidermal growth factor receptor resistance and sensitivity to dual HER2 targeting. Although clinical trials have reported activity for trastuzumab/pertuzumab and trastuzumab/lapatinib combinations, there are no reports on lapatinib plus trastuzumab activity after resistance to trastuzumab plus pertuzumab. Presented are three cases of HER2 amplified colorectal cancer that developed acquired refractoriness to trastuzumab pertuzumab with subsequent clinical benefit to lapatinib plus trastuzumab, highlighting the potential for HER2 tyrosine kinase inhibition plus trastuzumab in overcoming trastuzumab/pertuzumab resistance.

http://ift.tt/2CYM4OX

Neuroendocrine Tumor Heterogeneity Adds Uncertainty to the World Health Organization 2010 Classification: Real‐World Data from the Spanish Tumor Registry (R‐GETNE)

AbstractBackground.Gastroenteropancreatic neuroendocrine neoplasms (GEP‐NENs) are a complex family of tumors of widely variable clinical behavior. The World Health Organization (WHO) 2010 classification provided a valuable tool to stratify neuroendocrine neoplasms (NENs) in three prognostic subgroups based on the proliferation index. However, substantial heterogeneity remains within these subgroups, and simplicity sometimes entails an ambiguous and imprecise prognostic stratification. The purpose of our study was to evaluate the prognostic impact of histological differentiation within the WHO 2010 grade (G) 1/G2/G3 categories, and explore additional Ki‐67 cutoff values in GEP‐NENs.Subjects, Materials, and Methods.A total of 2,813 patients from the Spanish National Tumor Registry (RGETNE) were analyzed. Cases were classified by histological differentiation as NETs (neuroendocrine tumors [well differentiated]) or NECs (neuroendocrine carcinomas [poorly differentiated]), and by Ki‐67 index as G1 (Ki‐67 <2%), G2 (Ki‐67 3%–20%), or G3 (Ki‐67 >20%). Patients were stratified into five cohorts: NET‐G1, NET‐G2, NET‐G3, NEC‐G2, and NEC‐G3.Results.Five‐year survival was 72%. Age, gender, tumor site, grade, differentiation, and stage were all independent prognostic factors for survival. Further subdivision of the WHO 2010 grading improved prognostic stratification, both within G2 (5‐year survival: 81% [Ki‐67 3%–5%], 72% [Ki‐67 6%–10%], 52% [Ki‐67 11%–20%]) and G3 NENs (5‐year survival: 35% [Ki‐67 21%–50%], 22% [Ki‐67 51%–100%]). Five‐year survival was significantly greater for NET‐G2 versus NEC‐G2 (75.5% vs. 58.2%) and NET‐G3 versus NEC‐G3 (43.7% vs. 25.4%).Conclusion.Substantial clinical heterogeneity is observed within G2 and G3 GEP‐NENs. The WHO 2010 classification can be improved by including the additive effect of histological differentiation and the proliferation index.Implications for Practice.Gastroenteropancreatic neuroendocrine neoplasms are tumors of widely variable clinical behavior, roughly stratified by the World Health Organization (WHO) 2010 classification into three subgroups based on proliferation index. Real‐world data from 2,813 patients of the Spanish Registry RGETNE demonstrated substantial clinical heterogeneity within grade (G) 2 and G3 neuroendocrine neoplasms. Tumor morphology and further subdivision of grading substantially improves prognostic stratification of these patients and may help individualize therapy. This combined, additive effect shall be considered in future classifications of neuroendocrine tumors and incorporated for stratification purposes in clinical trials.

http://ift.tt/2CWRIB7

Cultured allogeneic fibroblast injection versus fibroblasts cultured on amniotic membrane scaffold for dystrophic epidermolysis bullosa treatment

Abstract

Background

Different methods of fibroblast application have been examined to treat recessive dystrophic epidermolysis bullosa (RDEB).

Objective

To compare the effects of intradermal injection of cultured allogeneic fibroblasts in healing RDEB wounds with that of fibroblasts seeded on amniotic membrane scaffolds (FAMS) or standard wound care (SWC) with Vaseline gauze as controls.

Materials &Methods

Seven patients were recruited, and seven wounds were assessed in each patient: three wounds were treated with injection of intradermal fibroblasts, three were treated with FAMS, and one was dressed with SWC. Changes in wound size were assessed after 2 and 12 weeks of treatment. Qualitative wound scores (QWS) were used to assess wound severity. Additionally, biopsies and antigen mapping were performed to detect type-VII collagen in the dermoepidermal junction.

Results

In both treated areas, the QWS and wound size were significantly decreased (P<0.0001), whereas there were no changes in control group (P=0.29). After 2 and 12 weeks of treatment, the wound size was significantly decreased in wounds that were treated with fibroblast injection compared with those treated with FAMS (P<0.0001); but no significant changes were found in control group.

Conclusion

Fibroblast injection has been shown to promote healing of RDEB wounds and is superior to FAMS or the control treatment.

http://ift.tt/2CZZQBe

Differential effects of phototherapy, adalimumab and betamethasone/calcipotriol on effector and regulatory T cells in psoriasis

Summary

Background

Psoriasis is a chronic T cell-mediated skin disease with marked social and economic burdens. Current treatments are unsatisfactory, with unpredictable remission times and incompletely understood modes of action. Recent advances in our understanding of the pathogenesis of psoriasis identify the imbalance between CD4⁺ T effector cells, particularly the T helper (Th) 17 subset, and regulatory T cells (Treg) as key to the development of psoriatic lesions, and therefore a novel therapeutic target.

Objectives

To quantify in patients the effects of three commonly used psoriasis treatment modalities on the Th1, Th2, Th17 and Treg subsets, and test whether any change correlates with clinical response.

Methods

Using flow cytometry to enumerate Th1, Th2, Th17 and Treg subsets in blood and skin of psoriatic patients before and after receiving any of the following treatments; narrow band UVB (NB-UVB), adalimumab and topical betamethasone/calcipotriol combination (Dovobet^®).

Results

All patients responded clinically to treatments. NB-UVB significantly increased the numbers of circulating and skin Treg, while, by contrast, adalimumab reduced Th17 cells in these compartments, and Dovobet had dual effects by both increasing Treg and reducing Th17 cells.

Conclusions

The differential effects reported here for the above-mentioned treatment modalities could be exploited to optimize or design therapeutic strategies to better overcome the inflammatory drivers and restore the Th17/Treg balance in psoriasis.

http://ift.tt/2DtFOQA

Reduction of hyaluronan and increased expression of HYBID (KIAA1199) correlate with clinical symptoms in photoaged skin

Summary

Background

Hyaluronan (HA) metabolism in skin fibroblasts is mediated by HYBID (HYaluronan Binding protein Involved in hyaluronan Depolymerisation, KIAA1199) and HA synthases 1/2 (HAS1/2). However, photoageing-dependent changes in HA and their molecular mechanisms, and the relationship between HA metabolism and clinical symptoms in photoaged skin remain elusive.

Objectives

We examined amount, size and tissue distribution of HA and expression levels of HYBID and HAS1/2 in photoaged skin, and analysed their relationships to the degree of photoageing.

Methods

Photoageing-dependent changes of HA were investigated by studying skin biopsies isolated from photoprotected and photoexposed areas of the same donors, and the relationship between HA and photoageing symptoms such as skin wrinkling and sagging was examined.

Results

Skin biopsy specimens showed that amount and size of HA are decreased in the photoexposed skin compared to the photoprotected skin, and this was accompanied by increased expression of HYBID and decreased expression of HAS1/2, respectively. Histologically, HA staining in the papillary dermis was decreased in photoexposed skin, showing reverse correlation with HYBID expression. HYBID expression in the photoexposed skin directly correlated with skin roughness and sagging parameters, and reduced HA staining in the papillary dermis in the photoexposed skin positively correlated with these symptoms.

Conclusions

These data demonstrate that imbalance between HYBID-mediated HA degradation and HAS-mediated HA synthesis may contribute to enhanced HA catabolism in the photoaged skin, and suggest that HYBID-mediated HA reduction in the papillary dermis is related to skin wrinkling and sagging of photoaged skin.

http://ift.tt/2CWnFtE

Oral propranolol for infantile haemangioma may be associated with transient gross motor delay

Abstract

Oral propranolol, first-line therapy for infantile haemangioma (IH) threatening functional impairment or cosmetic disfigurement, readily crosses the blood-brain barrier. Subsequently therefore, there are concerns about potential effects on infant development. Phillips et al. followed 200 children prescribed propranolol, observing sedative effects during treatment and reported gross motor abnormalities in 13 of 188 children, 7 of whom had delayed age (17-20 months) at first walking.

http://ift.tt/2DtPdHX

A case of xeroderma pigmentosum complementation group C with diverse clinical features

Abstract

Xeroderma pigmentosum (XP) is an autosomal recessive disease characterized by sensitivity to sunlight and increased risk of skin cancers. XP is classified into seven nucleotide excision repair-deficient types (A–G) and a variant type¹. Differential diagnosis of XP from other genetic pigmentary disorders such as dyschromatosis symmetrica hereditaria (DSH) and dyschromatosis universalis hereditaria (DUH) should be considered, which is sometimes difficult without DNA repair tests or a genetic diagnosis². DSH and DUH are autosomal dominant diseases characterized by hypo-and hyperpigmented maculae. Recently, ABCB6 was identified as a responsible gene for DUH³.

http://ift.tt/2CXANP8

Cultured allogeneic fibroblast injection versus fibroblasts cultured on amniotic membrane scaffold for dystrophic epidermolysis bullosa treatment

Abstract

Background

Different methods of fibroblast application have been examined to treat recessive dystrophic epidermolysis bullosa (RDEB).

Objective

Materials &Methods

Results

Conclusion

Fibroblast injection has been shown to promote healing of RDEB wounds and is superior to FAMS or the control treatment.

http://ift.tt/2CZZQBe

Differential effects of phototherapy, adalimumab and betamethasone/calcipotriol on effector and regulatory T cells in psoriasis

Summary

Background

Objectives

To quantify in patients the effects of three commonly used psoriasis treatment modalities on the Th1, Th2, Th17 and Treg subsets, and test whether any change correlates with clinical response.

Methods

Results

Conclusions

http://ift.tt/2DtFOQA

Reduction of hyaluronan and increased expression of HYBID (KIAA1199) correlate with clinical symptoms in photoaged skin

Summary

Background

Objectives

We examined amount, size and tissue distribution of HA and expression levels of HYBID and HAS1/2 in photoaged skin, and analysed their relationships to the degree of photoageing.

Methods

Results

Conclusions

http://ift.tt/2CWnFtE

Oral propranolol for infantile haemangioma may be associated with transient gross motor delay

Abstract

http://ift.tt/2DtPdHX

A case of xeroderma pigmentosum complementation group C with diverse clinical features

Abstract

http://ift.tt/2CXANP8

Expression of YAP and TAZ in molluscum contagiosum virus infected skin

Abstract

The Hippo signaling pathway, which is highly conserved in organisms ranging from Drosophila to mammals, plays a key role in organ size control, cellular proliferation, survival and tumorigenesis¹ Yes-associated protein (YAP) is the major downstream effector of Hippo signaling pathway and transcriptional co-activator with PDZ-binding motif (TAZ) is a YAP paralog. Recently, Zhang et al. found that YAP/TAZ acts as natural inhibitors of TANK binding kinase 1 (TBK1), which is a key component for cytosolic nucleic acid sensing antiviral defense and antiviral physiology²

http://ift.tt/2CUV6g1

Acknowledgment to reviewers—2017

http://ift.tt/2r1vCMj

Immune Cytokines and Their Receptors in Inflammatory Pain

Publication date: Available online 12 January 2018
Source:Trends in Immunology
Author(s): Andrew D. Cook, Anne D. Christensen, Damini Tewari, Stephen B. McMahon, John A. Hamilton
There is burgeoning interest in the interaction between the immune and nervous systems. Pain is mediated by primary sensory neurons (nociceptors) that can respond to a variety of thermal, mechanical and chemical signals. Cytokines are now recognized as important mediators of inflammatory pain. They can induce nociceptor sensitization indirectly via mediators, wherein neurons become primed and thus become more responsive to stimulation; alternatively, there is also evidence that cytokines can directly activate neurons via their specific receptors present on the neuronal cells. We review here the evidence for and against these respective mechanisms, focusing on arthritis and inflammatory skin models. A number of striking inconsistencies amongst the conclusions made in the literature are highlighted and discussed.

http://ift.tt/2D9RACI

3D imaging, 3D printing and 3D virtual planning in endodontics

Abstract

The adoption and adaptation of recent advances in digital technology, such as three-dimensional (3D) printed objects and haptic simulators, in dentistry have influenced teaching and/or management of cases involving implant, craniofacial, maxillofacial, orthognathic and periodontal treatments. 3D printed models and guides may help operators plan and tackle complicated non-surgical and surgical endodontic treatment and may aid skill acquisition. Haptic simulators may assist in the development of competency in endodontic procedures through the acquisition of psycho-motor skills. This review explores and discusses the potential applications of 3D printed models and guides, and haptic simulators in the teaching and management of endodontic procedures. An understanding of the pertinent technology related to the production of 3D printed objects and the operation of haptic simulators are also presented.

http://ift.tt/2AUpFk8

Disseminated histoplasmosis in an immunocompetent patient - utility of skin scrape cytology in diagnosis: a case report

Histoplasma capsulatum is a dimorphic fungus predominately found in soils enriched with bird and bat excreta. Although several cases of histoplasmosis have been reported in India, diagnosis using cytology has bee...

http://ift.tt/2AUS6yn

Black dots in palmoplantar warts –challenging a concept: A histopathologic study

http://ift.tt/2CVTOBy

Combined acitretin and Candida antigen versus either agent alone in the treatment of recalcitrant warts

http://ift.tt/2CWRCK5

Multiple Melanonychia Striata as a Sign of Connective Tissue Disorders

http://ift.tt/2CVWyyM

Role of Graft versus Host Disease in the Development of Secondary Skin Cancers in Hematopoietic Stem Cell Transplant Recipients: A Meta-analysis

http://ift.tt/2DmYL7f

Assessing the Outcomes, Risks, and Costs of Local vs. General Anesthesia: A Review with Implications for Cutaneous Surgery

General anesthesia is still used for some cutaneous procedures.Local anesthesia provides outcomes that are at least equal to general anesthesia and with significantly lower costs.Local anesthesia should be used when feasible.

http://ift.tt/2Do91MB

Topical Betaxolol for Treating Relapsing Paronychia with Pyogenic Granuloma-Like Lesions Induced by Epidermal Growth Factor Receptor Inhibitors

http://ift.tt/2CUqfjH

Growth and growth hormone: recent papers on efficacy and adverse effects of growth hormone and World Health Organisation growth standards

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

http://ift.tt/2mp39e4

Genetic mutations associated with neonatal diabetes mellitus in Omani patients

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

http://ift.tt/2DaDAaX

Daily sitting time associated with the risk of metabolic syndrome in Korean adolescents

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

http://ift.tt/2mqQTcR

Synovial sarcomas of the upper aero-digestive tract: is there a role for conservative surgery?

Purpose of review To present the current state of knowledge concerning the role of conservative surgery in the treatment of synovial sarcomas of the upper aero-digestive tract (UADT). Recent findings The wider experience on synovial sarcomas involving the extremities and the results of retrospective reports focused on head and neck synovial sarcomas tend to justify a conservative surgical approach when dealing with tumors involving the UADT. Summary UADT synovial sarcomas is an extremely rare clinical entity (only around 50 cases reported in the literature, with four more herein presented from our own surgical series), with no clear guidelines concerning its treatment. Resection should be aimed to an en-bloc removal of the tumor within uninvolved surgical margins. In fit patients, a conservative surgical approach should be preferred if it does not interfere with a complete resection and reasonable functional outcomes. Adjuvant treatments (radiotherapy and/or chemotherapy) are frequently needed in view of the aggressive behavior of such tumor, but they should be balanced according to patient's characteristics and tumor risk factors (grade, size, and previous treatments). Correspondence to Cesare Piazza, MD, Department of Otorhinolaryngology – Head and Neck Surgery, Fondazione IRCCS – National Cancer Institute of Milan, University of Milan, 20133 Milan, Italy. Tel: +39 02 23902793; fax: +39 02 23902760. E-mail: cesare.piazza@istitutotumori.mi.it, ceceplaza@libero.it Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2ATYrKw

"J Drugs Dermatol"[jour]; +16 new citations

16 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"J Drugs Dermatol"[jour]

These pubmed results were generated on 2018/01/12

PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.

http://ift.tt/2mya05E

"Ann Plast Surg"[jour]; +17 new citations

17 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

"Ann Plast Surg"[jour]

These pubmed results were generated on 2018/01/12

http://ift.tt/2mxjmP5

Vasodilation during Normothermic Machine Perfusion; Preventing the No-Reflow Phenomena

No abstract available

http://ift.tt/2AV9ItQ

Landscape of Living Multi-organ Donation in the United States: A Registry-Based Cohort Study

ABSTRACTBackgroundThe donation of multiple allografts from a single living donor is a rare practice, and the patient characteristics and outcomes associated with these procedures are not well described.MethodsUsing the SRTR registry, we identified 101 living multi-organ donors and their 133 recipients.ResultsThe 49 sequential (donations during separate procedures) multi-organ donors provided grafts to 81 recipients: 21 kidney-then-liver, 15 liver-then-kidney, 5 lung-then-kidney, 3 liver-then-intestine, 3 kidney-then-pancreas, 1 lung-then-liver, and 1 pancreas-then-kidney. Of these donors, 38% donated 2 grafts to the same recipient and 15% donated 2 grafts as non-directed donors. Compared to recipients from first-time, single organ living donors, recipients from second-time living donors had similar graft and patient survival. The 52 simultaneous (multiple donations during one procedure) multi-organ donors provided 2 grafts to 1 recipient each: 48 kidney-pancreas and 4 liver-intestine. Donors had median (IQR) 13.4 [8.3-18.5] years of follow-up for mortality. There was one reported death of sequential donor (2.5 years after second donation). Few post-donation complications were reported over median (IQR) 116 (0-295) days follow-up; however, routine living donor follow-up data were sparse. Recipients of kidneys from second-time living donors had similar graft (p=0.8) and patient survival (p=0.4) when compared to recipients from first-time living donors. Similarly recipients of livers from second-time living donors had similar graft survival (p=0.8) and patient survival (p=0.7) when compared to recipients from first-time living donors.ConclusionsCareful documentation of outcomes is needed to ensure ethical practices in selection, informed consent, and post-donation care of this unique donor community. Background The donation of multiple allografts from a single living donor is a rare practice, and the patient characteristics and outcomes associated with these procedures are not well described. Methods Using the SRTR registry, we identified 101 living multi-organ donors and their 133 recipients. Results The 49 sequential (donations during separate procedures) multi-organ donors provided grafts to 81 recipients: 21 kidney-then-liver, 15 liver-then-kidney, 5 lung-then-kidney, 3 liver-then-intestine, 3 kidney-then-pancreas, 1 lung-then-liver, and 1 pancreas-then-kidney. Of these donors, 38% donated 2 grafts to the same recipient and 15% donated 2 grafts as non-directed donors. Compared to recipients from first-time, single organ living donors, recipients from second-time living donors had similar graft and patient survival. The 52 simultaneous (multiple donations during one procedure) multi-organ donors provided 2 grafts to 1 recipient each: 48 kidney-pancreas and 4 liver-intestine. Donors had median (IQR) 13.4 [8.3-18.5] years of follow-up for mortality. There was one reported death of sequential donor (2.5 years after second donation). Few post-donation complications were reported over median (IQR) 116 (0-295) days follow-up; however, routine living donor follow-up data were sparse. Recipients of kidneys from second-time living donors had similar graft (p=0.8) and patient survival (p=0.4) when compared to recipients from first-time living donors. Similarly recipients of livers from second-time living donors had similar graft survival (p=0.8) and patient survival (p=0.7) when compared to recipients from first-time living donors. Conclusions Careful documentation of outcomes is needed to ensure ethical practices in selection, informed consent, and post-donation care of this unique donor community. Contact Information: Macey L. Henderson, JD, PhD, Assistant Professor, Department of Surgery, Johns Hopkins School of Medicine, 2000 E. Monument Street, Baltimore, MD 21205, (443) 287-664 (tel) 410-614-2079 (fax), macey@jhmi.edu AUTHORSHIP M.L.H. participated in research design, writing of the paper, and performance of the research. S.D.R. participated in research design, writing of the paper, and performance of the research. A.G.T. participated in research design, writing of the paper, and data analysis. C.M.H. participated in performance of the research and writing of the paper. A.A.S. participated in data analysis and writing of the paper. M.G.B. participated in data analysis and writing of the paper. T.S.P. participated in the writing of the paper and performance of the research. A.B.M. participated in the research design and data analysis. J.G.W. participated in the research design and writing of the paper. M.M.W. participated in writing of the paper. K.L.L. participated in writing of the paper and performance of the research. D.L.S. participated in the performance of the research and oversaw the project. *MLH and SRD contributed equally to this manuscript Disclosures: The authors have no conflicts of interest to disclose. Funding: Funding for this study was provided by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) grant numbers K01DK114388-01 (PI: Henderson), F32DK105600 (PI: DiBrito), 4R01DK096008-04 (PI: Segev), 5K01DK101677-02 (PI: Massie), and 5K24DK101828-03 (PI: Segev), 1F32DK109662-01 (PI: Holscher) and by the Agency for Healthcare Research and Quality (AHRQ) grant number K01HS024600 (PI: Purnell). Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2mvvr7s

Hepatitis E Virus Infection in Kidney Transplant Patients: A Single-center Study

No abstract available

http://ift.tt/2qVZkCx

Expanding the Morphologic Heterogeneity of Stromal Changes in Molluscum Contagiosum Infection

No abstract available

http://ift.tt/2D5cumt

Primary Cutaneous Spindle Cell Squamous Carcinoma Expressing Smooth Muscle Actin: Diagnostic Pitfalls

Abstract: Alpha smooth muscle actin (SMA) belongs to the actin proteins. It is a known immunohistochemical marker for tumors of mesenchymal origin. There have been reports of expression of SMA in certain epithelial malignancies in the head and neck and genital regions. In this study, the authors report a primary cutaneous spindle cell squamous carcinoma expressing SMA. Both high- and low-molecular-weight keratins and p63 were positive, and S100 protein, SOX10, MART-1/Melan-A, and muscle-specific actin stains were negative. This case highlights that an epithelial tumor could express a mesenchymal marker, thereby making the diagnosis problematic. Reprints: Jag Bhawan, MD, Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, 609 Albany Street, Boston, MA 02118 (e-mail: jbhawan@bu.edu). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2AUe2ty

High-sensitivity Troponins in Liver Transplantation: How Will They Change Our Practice?

No abstract available

http://ift.tt/2D52BFf

Deceased Donor Organ Transplantation Performed in the United States for Non- Citizens and Non-Residents

Since 2012, the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) has required transplant centers to record the citizenship and residency status of patients undergoing transplantation in the United States. This policy replaced the 5% threshold of the non-US citizen/non-U.S. residents (NC/NR) undergoing organ transplantation that could result in an audit of transplant center activity. We analyzed the frequency of NC/NR deceased donor organ transplants and wait list registrations at all US transplant centers using data provided by UNOS for that purpose to the UNOS Ad Hoc International Relations Committee. During the period of 2013 – 2016, 1,176 deceased donor transplants (of all organs) were performed in NC/NR candidates (1.2 % of the total number of transplants). There were 5 kidney and 7 liver transplant centers that performed > 5% of the deceased donor kidney and deceased donor liver transplants respectively in NC/NR during the years 2014-2016 with a total of 147 deceased donor kidney transplants and 120 deceased donor liver transplants in NC/NR. This report was prepared to fulfill the transparency policy of UNOS to assure a public trust in the distribution of organs. When viewed with a public awareness of deceased donor organ shortages, it suggests the need for a more comprehensive understanding of current NC/NR activity in the US. Patterns of organ specific NC/NR registrations and transplantations at high-volume centers should prompt a review of transplant center practices to determine whether the deceased donor and center resources may be compromised for their US patients. Corresponding author: Francis L. Delmonico, francis_delmonico@neds.org, 617 413 5311, Massachusetts General Hospital, 55 Fruit Street/White Bldg 505, Boston, Massachusetts, 02114-2696 Please be advised that all authors contributed The initial writing was done by FD SG and NA The other authors reviewed the drafts for their revisions Similarly for the Resubmission FD SG and NA developed draft that each author commented and contributed There is no conflict of interest Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2AViQ1B

ALK Gene Fusions in Epithelioid Fibrous Histiocytoma: A Study of 14 Cases, With New Histopathological Findings

Abstract: Previous studies showed that ALK is often positive in epithelioid fibrous histiocytoma (EFH). Two cases of EFH with ALK gene fusions have been recorded. Our objective was to study a series of EFH to present histopathological variations of EFH, identify novel ALK gene fusions, and determine whether there is a correlation between histopathological features and particular gene. We investigated 14 cases of EFH, all ALK immunopositive. The cases were assessed histopathologically as well as for ALK and TFE-3 rearrangements using FISH and ALK gene fusions using next-generation sequencing. The analysis of the sequencing results was performed using the Archer Analysis software (v5; ArcherDX Inc). The study group consisted of 8 female and 6 male patients, ranging in age from 18 to 79 years (mean 42 years; median 37.5 years). All presented with a solitary lesion. Microscopically, most lesions were polypoid and composed of epithelioid cells with ample cytoplasm. In addition, a variable number of bi-, tri-, or multinucleated, spindled, multilobated, cells with eccentric nuclei, cells with nuclear pseudoinclusions, mucinous, and grooved cells were admixed. In 5 cases, the predominant epithelioid cell component consisted of rather small cells, whereas spindled cells dominated in 3 cases. Of these, 2 lesions were composed rather of pale eosinophilic to clear cells, occasioning a resemblance to PEComa or leiomyoma. Immunohistochemically, all cases expressed ALK and 11 were positive for TFE-3. The break apart test for ALK was positive in 11 cases, whereas specimens from the remaining 3 cases were not analyzable. ALK genes fusions were found in all but 3 cases and included SQSTM1-ALK (3), VCL-ALK (3), TMP3-ALK (2), PRKAR2A-ALK (1), MLPH-ALK (1), and EML4-ALK (1). No correlation between histological features and type of ALK fusion was found. TFE-3 break apart test was negative. It is concluded that ALK-immunopositive EFH shows ALK gene fusions that involve various protein-coding genes, implicated in a variety of biological processes. Rare variants of EFH rather consist of spindled "non-epithelioid" cells. Reprints: Dmitry V. Kazakov, MD, PhD, Sikl's Department of Pathology, Charles University Medical Faculty Hospital, Alej Svobody 80, 304 60 Pilsen, Czech Republic (e-mail: kazakov@medima.cz). Supported in part by a Charles University project (SVV 260 391/2017). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2AUdtzW

The impact of combined warm ischemia time on development of acute kidney injury in donation after circulatory death liver transplantation: Stay within the golden hour

AbstractBackgroundAcute kidney injury (AKI) is a common complication after liver transplantation and more frequently observed when high-risk grafts, such as DCD grafts are used. Our aim was to investigate the impact of the ischemia periods on development of AKI in DCD liver transplantation.MethodsWe performed a 2-center retrospective study with 368 DCD graft-recipients. Donor warm ischemia time (DWIT) was divided into agonal phase (withdrawal of life-support – cardiac arrest) and asystolic phase (cardiac arrest – start cold perfusion). We introduced a new period of warm ischemia: the combined warm ischemia time (combined WIT), that was defined as the sum of DWIT and recipient warm ischemia time (RWIT).ResultsAKI was observed in 65% of the recipients and severe AKI in 41% (KDIGO stage 2/3). The length of combined WIT increased significantly with AKI severity: 61 minutes in recipients without AKI up to 69 minutes in recipients with the most severe form of AKI (p

http://ift.tt/2D85yVO

Cutaneous Nodules and Violaceous Patches on the Legs

No abstract available

http://ift.tt/2D7pUy6

Beta Cell Death by Cell-Free DNA and Outcome after Clinical Islet Transplantation

AbstractBackgroundOptimizing engraftment and early survival after clinical islet transplantation is critical to long-term function, but there are no reliable, quantifiable measures to assess beta cell death. Circulating cell free DNA (cfDNA) derived from beta cells has been identified as a novel biomarker to detect cell loss, and was recently validated in new-onset type 1 diabetes and in islet transplant patients.MethodsHerein we report beta cell cfDNA measurements after allotransplantation in 37 subjects and the correlation with clinical outcomes.ResultsA distinctive peak of cfDNA was observed 1hr after transplantation in 31/37 (83.8%) of subjects. The presence and magnitude of this signal did not correlate with transplant outcome. The 1hr signal represents dead beta cells carried over into the recipient after islet isolation and culture, combined with acute cell death post infusion. Beta cell cfDNA was also detected 24hrs posttransplant (8/37 subjects, 21.6%). This signal was associated with higher 1-month insulin requirements (p=0.04), lower 1-month stimulated C-peptide levels (p=0.01) and overall worse 3-month engraftment, by insulin independence (ROC:AUC=0.70, p=0.03) and Beta 2 score (ROC:AUC=0.77, p=0.006).ConclusionscfDNA-based estimation of beta cell death 24hrs after islet allotransplantation correlates with clinical outcome and could predict early engraftment. Background Optimizing engraftment and early survival after clinical islet transplantation is critical to long-term function, but there are no reliable, quantifiable measures to assess beta cell death. Circulating cell free DNA (cfDNA) derived from beta cells has been identified as a novel biomarker to detect cell loss, and was recently validated in new-onset type 1 diabetes and in islet transplant patients. Methods Herein we report beta cell cfDNA measurements after allotransplantation in 37 subjects and the correlation with clinical outcomes. Results A distinctive peak of cfDNA was observed 1hr after transplantation in 31/37 (83.8%) of subjects. The presence and magnitude of this signal did not correlate with transplant outcome. The 1hr signal represents dead beta cells carried over into the recipient after islet isolation and culture, combined with acute cell death post infusion. Beta cell cfDNA was also detected 24hrs posttransplant (8/37 subjects, 21.6%). This signal was associated with higher 1-month insulin requirements (p=0.04), lower 1-month stimulated C-peptide levels (p=0.01) and overall worse 3-month engraftment, by insulin independence (ROC:AUC=0.70, p=0.03) and Beta 2 score (ROC:AUC=0.77, p=0.006). Conclusions cfDNA-based estimation of beta cell death 24hrs after islet allotransplantation correlates with clinical outcome and could predict early engraftment. aThese authors contributed equally to this study. bJoint senior authors. Corresponding author contact information: A.M. James Shapiro, MD, PhD, Canada Research Chair in Transplantation Surgery and Regenerative Medicine, Professor, Director of Clinical Islet and Living Donor Liver Transplant Programs, Clinical Islet Transplant Program, University of Alberta. 2000 College Plaza, 8215-112th St, Edmonton T6G 2C8, Canada. amjs@islet.ca, Telephone: +1-780-4077330, Fax: +1-780-4078259 Authorship: B.L.G-L., B.G., R.S., Y.D. and A.M.J.S. designed research studies; B.L.G-L, T.K., P.S., D.O., A.J.M. and A.M.J.S. performed transplant procedures; D.N. and S.P processed plasma and analyzed cfDNA; B.L.G-L., T.K, A.R.P., P.C., B.G., R.S., Y.D. and A.M.J.S. acquired and analyzed data; and B.L.G-L., B.G., R.S., Y.D. and A.M.J.S. wrote the paper. Disclosure: The authors declare no conflicts of interest. Funding: B.G-L. is supported through the Alberta Innovates: Health Solutions (AIHS) Clinician Fellowship and through the CNTRP. A.P. is supported through AIHS Postgraduate Fellowship and CNTRP. A.M.J.S. is supported through AIHS, and holds a Canada Research Chair in Transplantation Surgery and Regenerative Medicine funded through the Government of Canada. AMJS is also funded by AIHS Collaborative Research and Innovation Opportunity Team Award and the Diabetes Research Institute Foundation of Canada (DRIFCan). Supported by grants from the Juvenile Diabetes Research Foundation (JDRF) (3-SRA-2014-38-Q-R, to Y.D and A.M.J.S), National Institute of Health (NIH) (HIRN grant UC4 DK104216, to Y.D), DON foundation (Stichting Diabetes Onderzoek Nederland) (to Y.D), the European Union (ELASTISLET project, to Y.D.) and the Kahn foundation (to Y.D, R.S and B.G). Supported in part by a grant from The United States Agency for International Development (USAID) American Schools and Hospitals Abroad Program for the upgrading of the Hebrew University sequencing core facility. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2AV0QEJ

Cutaneous Angiosarcoma of the Eyelid Mimicking Morbihan Disease

Background: Cutaneous angiosarcoma presents clinically in numerous ways, and can be mistaken for a different clinical entity, particularly when arising at unusual anatomic locations such as the eyelid. Case Presentation: A 57-year-old woman presented with a 1-year history of eyelid swelling. Concurrent imaging was also suggestive of an edematous process. Multiple superficial biopsies showed nonspecific dermal inflammation and interstitial edema. A diagnosis of Morbihan disease (chronic and idiopathic lymphedema of the eyelid) was rendered, and the patient was treated with compression and local therapy without clinical improvement. Three years after initial presentation, a diagnostic blepharoplasty was performed revealing a deep dermal vascular proliferation composed of anastomosing vascular channels with an atypical endothelial lining. A diagnosis of cutaneous angiosarcoma was ultimately made. Conclusions: This case illustrates a unique presentation of cutaneous angiosarcoma and the implications of different biopsy techniques in acquiring the correct diagnosis. Reprints: Rami N. Al-Rohil, MBBS, 1161 21st Avenue South, C3321B Medical Center North, Nashville, TN 37232 (e-mail: rami.n.al-rohil@vanderbilt.edu). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2AUwthP

Asymptomatic Acquired Facial Hyperpigmentation

No abstract available

http://ift.tt/2D5cfYB

Case of Congenital Self-Healing Reticulohistiocytosis Expanding the Spectrum of Blueberry Muffin Baby

Abstract: Congenital self-healing reticulohistiocytosis (CSHRH) is a benign, rare variant of histiocytosis. This condition can present phenotypically as blueberry muffin baby. This is the case of a male neonate with skin involvement of papulonodular violaceous lesions, which resolved spontaneously. The diagnosis of CSHRH is confirmed using histopathology and immunohistochemistry. Reprints: Sara Cano Bará, Dermatology Department, Hospital Universitario del Valle, Universidad del Valle, Calle 5 No. 36 08, Cali, Colombia (e-mail: vargas.natalia@correounivalle.edu.co). The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2AUzHBI

Circulating Hormones and Mammographic Density in Premenopausal Women

Abstract

Prior research suggests that several endogenous hormones in premenopausal women are associated with breast cancer risk; however, few studies have evaluated associations of endogenous hormones with mammographic density (MD) in premenopausal women. We conducted a cross-sectional study of plasma hormone levels in relation to MD among 634 cancer-free premenopausal women in the Nurses' Health Study II. We measured percent MD from screening mammograms using a computer-assisted method. We assayed estradiol, estrone, and estrone sulfate in blood samples timed in early follicular and mid-luteal phases of the menstrual cycle as well as testosterone, androstenedione, progesterone, dehydroepiandrosterone (DHEA), DHEA sulfate, sex hormone–binding globulin (SHBG), and anti-Müllerian hormone in luteal or untimed samples. We used multivariable linear regression to quantify the association of %MD with quartiles of each hormone, adjusting for age, body mass index, and breast cancer risk factors. Women in the highest quartile of follicular estradiol levels had significantly greater %MD compared to those in the lowest quartile [difference, 6.7 percentage points; 95% confidence interval (CI) 2.2, 11.3; p-trend < 0.001]. Similar associations were observed for follicular free estradiol but not luteal-phase estradiol. Also, women in the top (vs. bottom) quartile of free testosterone had significantly lower %MD (difference, − 4.7; 95% CI − 8.7, − 0.8; p-trend = 0.04). Higher SHBG was significantly associated with higher percent MD (difference, 4.8; 95% CI 1.1, 8.6; p-trend = 0.002). Percent MD was not strongly associated with other measured hormones. Results were similar in analyses that excluded women with anovulatory cycles. Our findings suggest that follicular estradiol and SHBG may play an important role in premenopausal percent MD.

http://ift.tt/2CWx3gO

Sex and self-confidence: Do genital enhancements help?

What is genital cosmetic surgery, what are your options, and what should you look out for? We give you an overview based on specialist insights.

http://ift.tt/2CW915w

Sex and self-confidence: Do genital enhancements help?

What is genital cosmetic surgery, what are your options, and what should you look out for? We give you an overview based on specialist insights.

http://ift.tt/2CW915w

Predictive coding of visual object position ahead of moving objects revealed by time-resolved EEG decoding

Publication date: 1 May 2018
Source:NeuroImage, Volume 171
Author(s): Hinze Hogendoorn, Anthony N. Burkitt
Due to the delays inherent in neuronal transmission, our awareness of sensory events necessarily lags behind the occurrence of those events in the world. If the visual system did not compensate for these delays, we would consistently mislocalize moving objects behind their actual position. Anticipatory mechanisms that might compensate for these delays have been reported in animals, and such mechanisms have also been hypothesized to underlie perceptual effects in humans such as the Flash-Lag Effect. However, to date no direct physiological evidence for anticipatory mechanisms has been found in humans. Here, we apply multivariate pattern classification to time-resolved EEG data to investigate anticipatory coding of object position in humans. By comparing the time-course of neural position representation for objects in both random and predictable apparent motion, we isolated anticipatory mechanisms that could compensate for neural delays when motion trajectories were predictable. As well as revealing an early neural position representation (lag 80–90 ms) that was unaffected by the predictability of the object's trajectory, we demonstrate a second neural position representation at 140–150 ms that was distinct from the first, and that was pre-activated ahead of the moving object when it moved on a predictable trajectory. The latency advantage for predictable motion was approximately 16 ± 2 ms. To our knowledge, this provides the first direct experimental neurophysiological evidence of anticipatory coding in human vision, revealing the time-course of predictive mechanisms without using a spatial proxy for time. The results are numerically consistent with earlier animal work, and suggest that current models of spatial predictive coding in visual cortex can be effectively extended into the temporal domain.

http://ift.tt/2D59J3I

Stereotypical modulations in dynamic functional connectivity explained by changes in BOLD variance

Publication date: 1 May 2018
Source:NeuroImage, Volume 171
Author(s): Katharina Glomb, Adrián Ponce-Alvarez, Matthieu Gilson, Petra Ritter, Gustavo Deco
Spontaneous activity measured in human subject under the absence of any task exhibits complex patterns of correlation that largely correspond to large-scale functional topographies obtained with a wide variety of cognitive and perceptual tasks. These "resting state networks" (RSNs) fluctuate over time, forming and dissolving on the scale of seconds to minutes. While these fluctuations, most prominently those of the default mode network, have been linked to cognitive function, it remains unclear whether they result from random noise or whether they index a nonstationary process which could be described as state switching.In this study, we use a sliding windows-approach to relate temporal dynamics of RSNs to global modulations in correlation and BOLD variance. We compare empirical data, phase-randomized surrogate data, and data simulated with a stationary model. We find that RSN time courses exhibit a large amount of coactivation in all three cases, and that the modulations in their activity are closely linked to global dynamics of the underlying BOLD signal.We find that many properties of the observed fluctuations in FC and BOLD, including their ranges and their correlations amongst each other, are explained by fluctuations around the average FC structure. However, we also report some interesting characteristics that clearly support nonstationary features in the data. In particular, we find that the brain spends more time in the troughs of modulations than can be expected from stationary dynamics.

http://ift.tt/2mmBZnY

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Παρασκευή 12 Ιανουαρίου 2018

Abstract

Purpose

Methods

Results

Conclusions

Abstract

Purpose

Methods

Results

Conclusions

Abstract

Abstract

Abstract

Graphical abstract

Abstract

Background

Objective

Materials &Methods

Results

Conclusion

Summary

Background

Objectives

Methods

Results

Conclusions

Summary

Background

Objectives

Methods

Results

Conclusions

Abstract

Abstract

Abstract

Background

Objective

Materials &Methods

Results

Conclusion

Summary

Background

Objectives

Methods

Results

Conclusions

Summary

Background

Objectives

Methods

Results

Conclusions

Abstract

Abstract

Abstract

Abstract

Abstract

Αρχειοθήκη ιστολογίου