Head and Neck Diseases by Alexandros G.Sfakianakis: 01/13/18

Σάββατο 13 Ιανουαρίου 2018

An integrated fuzzy-based advanced eutrophication simulation model to develop the best management scenarios for a river basin

Abstract

Assessment of water quality status of a river with respect to its discharge has become prerequisite to sustainable river basin management. The present paper develops an integrated model for simulating and evaluating strategies for water quality management in a river basin management by controlling point source pollutant loadings and operations of multi-purpose projects. Water Quality Analysis and Simulation Program (WASP version 8.0) has been used for modeling the transport of pollutant loadings and their impact on water quality in the river. The study presents a novel approach of integrating fuzzy set theory with an "advanced eutrophication" model to simulate the transmission and distribution of several interrelated water quality variables and their bio-physiochemical processes in an effective manner in the Ganges river basin, India. After calibration, simulated values are compared with the observed values to validate the model's robustness. Fuzzy technique of order preference by similarity to ideal solution (F-TOPSIS) has been used to incorporate the uncertainty associated with the water quality simulation results. The model also simulates five different scenarios for pollution reduction, to determine the maximum pollutant loadings during monsoon and dry periods. The final results clearly indicate how modeled reduction in the rate of wastewater discharge has reduced impacts of pollutants in the downstream. Scenarios suggesting a river discharge rate of 1500 m³/s during the lean period, in addition to 25 and 50% reduction in the load rate, are found to be the most effective option to restore quality of river Ganges. Thus, the model serves as an important hydrologic tool to the policy makers by suggesting appropriate remediation action plans.

http://ift.tt/2EFwSXC

Balloon dilation of the Eustachian tube: clinical experience in the management of 126 children.

Balloon dilation of the Eustachian tube: clinical experience in the management of 126 children.

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):509-512

Authors: Tisch M, Maier H, Sudhoff H

Abstract
Balloon dilation of the Eustachian tube has been recently introduced as a novel and minimally invasive method for treating chronic obstructive Eustachian tube dysfunction. For the first time worldwide, we assessed the role of this technique in the treatment of children with Eustachian tube dysfunction who did not respond to other treatments. We retrospectively analysed the medical records of 60 children (mean age: 6.3 years, range: 28 months to 12 years) who underwent balloon dilation of the Eustachian tube using the Bielefeld balloon catheter. In addition, the parents of a further 66 children who underwent balloon dilation (mean age: 8 years, range: 4 to 13 years) were asked to complete a standardised written questionnaire and were interviewed by telephone about the postoperative course of their children. There were no complications during surgery. Clinical symptoms improved in more than 80% of patients. No patient reported a deterioration of symptoms. Of the participating parents, 81.3% were very satisfied or satisfied with the outcome of treatment. Balloon dilation is a rapid, simple and safe method for the treatment of both adults and children with Eustachian tube dysfunction that does not respond to other treatments. Further studies, ideally multicentre studies, are required in order to optimise the definition of existing and potential new indications for this treatment approach and to establish this treatment in the management of children with refractory chronic Eustachian tube dysfunction.

PMID: 29327736 [PubMed - in process]

http://ift.tt/2DaBR5z

Acquired sensorineural hearing loss in children: current research and therapeutic perspectives.

Acquired sensorineural hearing loss in children: current research and therapeutic perspectives.

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):500-508

Authors: Ralli M, Rolesi R, Anzivino R, Turchetta R, Fetoni AR

Abstract
The knowledge of mechanisms responsible for acquired sensorineural hearing loss in children, such as viral and bacterial infections, noise exposure, aminoglycoside and cisplatin ototoxicity, is increasing and progressively changing the clinical management of affected patients. Viral infections are by far the most relevant cause of acquired hearing loss, followed by aminoglycoside and platinum derivative ototoxicity; moreover, cochlear damage induced by noise overexposure, mainly in adolescents, is an emerging topic. Pharmacological approaches are still challenging to develop a truly effective cochlear protection; however, the use of steroids, antioxidants, antiviral drugs and other small molecules is encouraging for clinical practice. Most of evidence on the effectiveness of antioxidants is still limited to experimental models, while the use of corticosteroids and antiviral drugs has a wide correspondence in literature but with controversial safety. Future therapeutic perspectives include innovative strategies to transport drugs into the cochlea, such as molecules incorporated in nanoparticles that can be delivered to a specific target. Innovative approaches also include the gene therapy designed to compensate for abnormal genes or to make proteins by introducing genetic material into cells; finally, regenerative medicine (including stem cell approaches) may play a central role in the upcoming years in hearing preservation and restoration even if its role in the inner ear is still debated.

PMID: 29327735 [PubMed - in process]

http://ift.tt/2DbYQgr

Clinical study of extrapulmonary head and neck tuberculosis in an urban setting.

Clinical study of extrapulmonary head and neck tuberculosis in an urban setting.

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):493-499

Authors: Monga S, Malik JN, Jan S, Bahadur S, Jetley S, Kaur H

Abstract
Tuberculosis (TB) of the head and neck region is quite common in endemic countries, but is still misdiagnosed due to its varied presentation and different sites of involvement. The aims of the present study were to present the diversities of presentation of head and neck tuberculosis with the diagnostic predicaments faced during evaluation and to assess treatment response to anti-tubercular treatment (ATT). We analysed 48 patients with head and neck tuberculosis who presented to the Department of Otorhinolaryngology in our tertiary care urban hospital over a period of two years from 2013 to 2015 and recorded their data, which included presenting complaints, local and systemic examination findings, investigation results and treatment outcomes. The results showed that majority (64.5%) of cases were female and none of the patients were HIV positive. The most common manifestation was cervical lymphadenopathy (81.25%) with level II being the most commonly affected (31.3%). Three of the 48 patients had coexisting pulmonary TB. Fine needle aspiration cytology (FNAC), histopathological diagnosis and acid fast bacilli (AFB) staining were used to confirm diagnosis. All patients were treated with Category I ATT, which achieved cure in 96.8% of cases. Though cervical lymphadenitis is the most common presentation of head and neck TB, isolated involvement of the sinonasal region, larynx, oral cavity and other sub-sites are not solely unknown entities. It is, therefore, important for clinicians to be aware of atypical and misleading presentations and consider TB as a major differential diagnosis in the head and neck region, even in non-immunocompromised individuals.

PMID: 29327734 [PubMed - in process]

http://ift.tt/2mDoYYn

Orthopaedic treatment effects of functional therapy on the sagittal pharyngeal dimensions in subjects with sleep-disordered breathing and Class II malocclusion.

Orthopaedic treatment effects of functional therapy on the sagittal pharyngeal dimensions in subjects with sleep-disordered breathing and Class II malocclusion.

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):479-485

Authors: Pavoni C, Cretella Lombardo E, Lione R, Bollero P, Ottaviani F, Cozza P

Abstract
The purpose of this cephalometric study was to evaluate the craniofacial changes induced by functional treatment of mandibular advancement with special regard to pharyngeal sagittal airway dimensions, tongue and hyoid bone position in subjects with sleep-disordered breathing (SDB) and dentoskeletal Class II malocclusions compared with an untreated Class II control group. 51 subjects (24 female, 27 male; mean age 9.9 ± 1.3 years) with Class II malocclusion and SDB consecutively treated with a functional appliance (Modify Monobloc, MM) were compared with a control group of 31 subjects (15 males, 16 females; mean age 10.1 ± 1.1) with untreated Class II malocclusion. For the study group, mode of breathing was defined by an otorhinolaryngologist according to complete physical examination. The parents of all participants completed a modified version of the paediatric sleep questionnaire, PSQ-SRBD Scale, by Ronald Chervin (the Italian version in 22 items form) before and after the trial. Lateral cephalograms were available at the start and end of treatment with the MM. Descriptive statistics were used for all cephalometric measurements in the two groups for active treatment changes. Significant, favourable skeletal changes in the mandible were observed in the treated group after T2. Significant short-term changes in sagittal airway dimensions, hyoid position and tongue position were induced by functional therapy of mandibular advancement in subjects with Class II malocclusion and SDB compared with untreated controls. After orthodontic treatment, a significant reduction in diurnal symptoms was observed in 45 of the 51 participants who had received an oral appliance. Orthodontic treatment is considered to be a potential therapeutic approach for SDB in children. Orthodontists are playing an increasingly important role in managing snoring and respiratory problems by oral mandibular advancement devices and rapid maxillary expansion.

PMID: 29327733 [PubMed - in process]

http://ift.tt/2D6IOW2

Transoral robotic surgery in Eagle's syndrome: our experience on four patients.

Transoral robotic surgery in Eagle's syndrome: our experience on four patients.

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):454-457

Authors: Kim DH, Lee YH, Cha D, Kim SH

Abstract
Eagle's syndrome is characterised by focal pain in the tonsillar fossa on wide mouth opening or head rotation and various accompanying symptoms. While the syndrome is difficult to diagnose, shortening the styloid process via a transoral or transcervical surgical approach has been shown to be the most effective treatment. The aim of this article was to document our experience with a transoral robotic approach to treat Eagle's syndrome and to present the outcomes of four patients. We reviewed the cases of four patients with Eagle's syndrome who underwent transoral robotic surgery (TORS). The average age of patients was 53.75 years, and there were equal numbers of males and females. The styloid processes were reconstructed in 3D from the preoperative CT scans and were measured as an average of 4.18 cm (range 3.3-5.1). The mean set-up time and operation times were less than 10 minutes and 30 minutes, respectively. All patients were completely relieved of symptoms, and were able to restart an oral diet on post-operative day 1. No patient suffered intraoperative or postoperative complication, including cranial nerve injury, haemorrhage, or deep neck infection. In our experience, transoral excision of the styloid process via a robotic approach can be considered as a feasible treatment option for Eagle's syndrome.

PMID: 29327731 [PubMed - in process]

http://ift.tt/2mtqYl3

High stiffness polymer composite with tunable transparency

Publication date: Available online 12 January 2018
Source:Materials Today
Author(s): Peter Samora Owuor, Varun Chaudhary, Cristiano F. Woellner, V Sharma, R.V. Ramanujan, Anthony S. Stender, Matias Soto, Sehmus Ozden, Enrique V. Barrera, Robert Vajtai, Douglas S. Galvão, Jun Lou, Chandra Sekhar Tiwary, Pulickel M. Ajayan
Biological materials are multifunctional performing more than one function in a perfect synergy. These materials are built from fairly simple and limited components at ambient conditions. Such judicious designs have proven elusive for synthetic materials. Here, we demonstrate a multifunctional phase change (pc) composite from simple building blocks, which exhibits high stiffness and optical transmittance control. We show an increase of more than one order of magnitude in stiffness when we embed paraffin wax spheres into an elastomer matrix, polydimethylsiloxane (PDMS) in a dynamic compression test. High stiffness is mainly influenced by presence of microcrystals within the wax. We further show fast temperature-controlled optical switching of the composite for an unlimited number of cycles without any noticeable mechanical degradation. Through experimental and finite element method, we show high energy absorption capability of pc-composite. Based on these properties, the pc-composite could be used as an effective coating on glasses for cars and windows. This simple approach to multi-functionality is exciting and could pave way for designs of other multifunctional materials at the macro-scale.

Graphical abstract

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Heterogeneous catalysis by gold and gold-based bimetal nanoclusters

Publication date: Available online 12 January 2018
Source:Nano Today
Author(s): Jianbo Zhao, Rongchao Jin
Gold and gold-based bimetallic catalysts have shown great potential for many important chemical transformation reactions owing to their good activity and high selectivity under relatively mild conditions. However, elucidating their structure-property relationships remains a major challenge because of size distributions and ill-defined structures (i.e. structural heterogeneity) of conventional nanoparticle catalysts. Recently, controlled synthesis of homogold and gold-based bimetal nanoclusters with precise atom numbers have been accomplished, and more importantly their atomic structures have been elucidated, which provide new model systems for understanding the catalytic behavior at the atomic level. Due to their ultra-small size, gold and bimetal nanoclusters exhibit unique properties, which contribute to novel catalysts or precatalysts for many chemical reactions. Herein, we review the recent progress in the catalytic research of atomically precise gold and gold-based bimetal nanoclusters. Specifically, this review covers the application of nanoclusters with or without ligands as catalysts for reactions such as selective oxidation, selective hydrogenation, C–C coupling and photocatalysis. Finally, we provide some future perspectives about metal nanocluster catalysis.

Graphical abstract

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Hydrogeochemical processes and influence of seawater intrusion in coastal aquifers south of Chennai, Tamil Nadu, India

Abstract

Seawater intrusion promotes the salinity of groundwater, and it poses a great environmental impact on a global scale. The present study was carried out to determine the hydrogeochemical processes and influence of seawater intrusion in the coastal aquifers using geophysical, geochemical, and stable isotope techniques. The true resistivity value ranges from 0.5 to 8008.5 Ω-m which has been measured using vertical electrical sounding (VES) based on the Schlumberger method. About 33 groundwater samples were collected during post-monsoon (POM) (January 2012) and pre-monsoon (PRM) (June 2012) seasons from open and bore wells and were analyzed for major ions and stable isotopes. EC, Na⁺, and Cl⁻ were high in groundwater of wells near salt pan, the Buckingham Canal, and backwater regions. Around 45% of the groundwater of this study area is of Na⁺-Cl⁻ type due to salinisation. Reverse ion exchange and silicate weathering are the dominant processes controlling the geochemistry of groundwater. Saturation indexes (SI) of halite (SI_halite) and gypsum (SI_gypsum) versus sulfate show an increasing trend line from > 0 to < 0, which implies higher dissolution of minerals and hints increasing salinization during both seasons. The value of Na⁺/Cl⁻ ranges between 0.7 and 2.4 (POM) and from 0.6 to 2.8 (PRM). The molar ratio suggested that around 25% of the groundwater samples are with values similar to those of seawater. Further, the groundwater is also affected by saline backwater, salt pan activities, and Buckingham Canal. Some locations are also are affected by anthropogenic, agricultural activities and geochemical processes. Heavy stable isotopes were found to be dominant in the coastal region due to seawater intrusion. Stable isotopes of δ¹⁸O range from − 5.6 to − 2.9‰ during both periods. About 201 km² of this area is affected by salinization. It is necessary to reduce pumping and plan for physical barriers to create freshwater ridges for controling the seawater intrusion.

http://ift.tt/2r55DE1

Exposure to nanoscale and microscale particulate air pollution prior to mining development near a northern indigenous community in Québec, Canada

Abstract

This study serves as a baseline characterization of indoor and outdoor air quality in a remote northern indigenous community prior to the start of a major nearby mining operation, including measurements of nanoparticles, which has never been performed in this context before. We performed aerosol sample collection and real-time aerosol measurements at six different locations at the Cree First Nation of Waswanipi and the Montviel campsite, located 45 km west of the Cree First Nation of Waswanipi, in the south of the Nord-du-Québec region. High concentrations of airborne nanoparticles (up to 3.98 × 10⁴ ± 8.9 × 10³ cm⁻³ at 64.9-nm midpoint particle diameter) and fine particles (up to 1.99 × 10³ ± 1.6 × 10² cm⁻³ at 0.3-μm midpoint particle diameter) were measured inside a residential home, where we did not find any ventilation or air filtration systems. The most abundant particle sizes by mass were between 0.19 and 0.55 μm. The maximum concentration of analyzed heavy metals was detected at the d₅₀ cut-off particle size of 0.31 μm; and the most abundant heavy metals in the aerosol samples were Al, Ba, Zn, Cu, Hg, and Pb. We concluded that the sources of the relatively high indoor particle concentrations were likely laundry machines and cooking emissions in the absence of a sufficient ventilation system. However, the chemical composition of particles resulting from mining activities is expected to be different from that of the aerosol particles from indoor sources. Installation and proper maintenance of sufficient ventilation and air filtration systems may reduce the total burden of disease from outdoor and indoor air pollution and remediate infiltrated indoor particulate pollution from the mining sources as well.

http://ift.tt/2myV1Zg

Ecotoxicity thresholds for ametryn, diuron, hexazinone and simazine in fresh and marine waters

Abstract

Triazine and urea herbicides are two groups of photosystem II inhibiting herbicides frequently detected in surface, ground and marine waters. Yet, there are few water quality guidelines for herbicides. Ecotoxicity thresholds (ETs) for ametryn, hexazinone and simazine (triazine herbicides) and diuron (a urea herbicide) were calculated using the Australian and New Zealand method for deriving guideline values to protect fresh and marine ecosystems. Four ETs were derived for each chemical and ecosystem that should theoretically protect 99, 95, 90 and 80% of species (i.e. PC99, PC95, PC90 and PC80, respectively). For all four herbicides, the phototrophic species were significantly more sensitive than non-phototrophic species, and therefore, only the former data were used to calculate the ETs. Comparison of the ET values to measured concentrations in 2606 samples from 15 waterways that discharge to the Great Barrier Reef (2011–2015) found three exceedances of the simazine PC99, regular exceedances (up to 30%) of the PC99 in a limited number of rivers for ametryn and hexazinone and frequent (> 40%) exceedances of the PC99 and PC95 ETs in at least four waterways for diuron. There were no exceedances of the marine ETs in inshore reef areas. Further, ecotoxicity data are required for ametryn and hexazinone to fresh and marine phototrophic species, for simazine to marine phototrophic species, for tropical phototrophic species, repeated pulse exposures and long-term (2 to 12 months) exposures to environmentally relevant concentrations.

http://ift.tt/2r1JhmC

Uphill/downhill nystagmus.

Uphill/downhill nystagmus.

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):513-518

Authors: Gufoni M

Abstract
Differential diagnosis between peripheral and central spontaneous nystagmus can be difficult to classify (as peripheral or central) even on the basis of criteria recommended in the recent literature. The aim of this paper is to use the combination of spontaneous nystagmus and ocular tilt reaction to determine the site of origin of the disease that causes nystagmus. We propose to classify the nystagmus in: 1) "Uphill" nystagmus in which the nystagmus takes on an inclined plane and the direction of the fast phase is towards the hypertropic eye (this type of nystagmus is likely peripheral); 2) "Downhill" nystagmus when the nystagmus beats toward the hypotropic eye (this type of nystagmus is likely central); 3) "Flat" nystagmus when the plane on which nystagmus beats is perfectly horizontal: in this case, we cannot say anything about the site of lesion (it was only detected in 15% of cases). The spatial position of nystagmus vector has to be considered as an intrinsic characteristic of the nystagmus itself (as direction, frequency, angular velocity etc.) and must be reported in the description, possibly giving an indication of the site of damage (peripheral or central). In particular, similar results are obtained by comparing the inclination of the nystagmus with the head impulse test (HIT, considered the best bedside test now available). It seems that this sign may confirm HIT for safer diagnosis or replace it in case of doubt. In contrast, in case of "Flat" nystagmus (probably attributable to the fact that the utricular maculae are spared), HIT can replace observation of the plane of the nystagmus. Thus, the two signs confirm and integrate each other. The test does not require additional time and is not tedious for the patient. It is proposed that it be included in the evaluation of spontaneous nystagmus in everyday clinical practice.

PMID: 29327737 [PubMed - in process]

http://ift.tt/2DbYRRx

Balloon dilation of the Eustachian tube: clinical experience in the management of 126 children.

Balloon dilation of the Eustachian tube: clinical experience in the management of 126 children.

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):509-512

Authors: Tisch M, Maier H, Sudhoff H

PMID: 29327736 [PubMed - in process]

http://ift.tt/2DaBR5z

Acquired sensorineural hearing loss in children: current research and therapeutic perspectives.

Acquired sensorineural hearing loss in children: current research and therapeutic perspectives.

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):500-508

Authors: Ralli M, Rolesi R, Anzivino R, Turchetta R, Fetoni AR

PMID: 29327735 [PubMed - in process]

http://ift.tt/2DbYQgr

Orthopaedic treatment effects of functional therapy on the sagittal pharyngeal dimensions in subjects with sleep-disordered breathing and Class II malocclusion.

Orthopaedic treatment effects of functional therapy on the sagittal pharyngeal dimensions in subjects with sleep-disordered breathing and Class II malocclusion.

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):479-485

Authors: Pavoni C, Cretella Lombardo E, Lione R, Bollero P, Ottaviani F, Cozza P

PMID: 29327733 [PubMed - in process]

http://ift.tt/2D6IOW2

A miRNA signature suggestive of nodal metastases from laryngeal carcinoma.

A miRNA signature suggestive of nodal metastases from laryngeal carcinoma.

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):467-474

Authors: Ricciardiello F, Capasso R, Kawasaki H, Abate T, Oliva F, Lombardi A, Misso G, Ingrosso D, Leone CA, Iengo M, Caraglia M

Abstract
The discovery that miRNAs are frequently deregulated in tumours offers the opportunity to identify them as prognostic and diagnostic markers. The aim of this multicentric study is to identify a miRNA expression profile specific for laryngeal cancer. The secondary endpoint was to identify specific deregulated miRNAs with potential as prognostic biomarkers for tumour spread and nodal involvement, and specifically to search for a miRNA pattern pathognomonic for N+ laryngeal cancer and for N- tissues. We identified 20 miRNAs specific for laryngeal cancer and a tissue-specific miRNA signature that is predictive of lymph node metastases in laryngeal carcinoma characterised by 11 miRNAs, seven of which are overexpressed (upregulated) and four downregulated. These results allow the identification of a group of potential specific tumour biomarkers for laryngeal carcinoma that can be used to improve its diagnosis, particularly in early stages, as well as its prognosis.

PMID: 29327732 [PubMed - in process]

http://ift.tt/2mt3wEl

Transoral robotic surgery in Eagle's syndrome: our experience on four patients.

Transoral robotic surgery in Eagle's syndrome: our experience on four patients.

Acta Otorhinolaryngol Ital. 2017 Dec;37(6):454-457

Authors: Kim DH, Lee YH, Cha D, Kim SH

PMID: 29327731 [PubMed - in process]

http://ift.tt/2mtqYl3

Gallbladder ascariasis in Kosovo – focus on ultrasound and conservative therapy: a case series

Ascaris lumbricoides is one of the most common intestinal infections in developing countries, including Kosovo. In contrast to migration to the bile duct, migration of the worm to the gallbladder, due to the narr...

http://ift.tt/2D9UoQd

Efficient degradation of triclosan by an endophytic fungus Penicillium oxalicum B4

Abstract

Triclosan (TCS), a widely used antimicrobial and preservative agent, is an emerging contaminant in aqueous and soil environment. Microbial degradation of TCS has not been reported frequently because of its inhibition of microbe growth. To explore the new microbial resources for TCS biodegradation, fungal endophytes were isolated and screened for the degradation potential. The endophytic strain B4 isolated from Artemisia annua L. showed higher degradation efficiency and was identified as Penicillium oxalicum based on its morphology and ITS sequences of ribosomal DNA. In both medium and synthetic wastewater, TCS (5 mg/L) was almost completely degraded within 2 h by the strain B4. The high capacity of TCS uptake (127.60 ± 8.57 mg/g dry weight, DW) of fungal mycelium was observed during the first 10 min after TCS addition. B4 rapidly reduced initial content (5.00 mg/L) of TCS to 0.41 mg/L in medium in 10 min. Then, the accumulation of TCS in mycelium was degraded from 0.45 to 0.05 mg/g DW after 1-h treatment. The degradation metabolites including 2-chlorohydroquinone, 2, 4-dichloropheno, and hydroquinone were found to be restrained in mycelia. The end products of the biodegradation in medium showed no toxicity to Escherichia coli. The new characteristics of high adsorption, fast degradation, and low residual toxicity highlight the potential of endophytic P. oxalicum B4 in TCS bioremediation.

http://ift.tt/2CYhJ39

Variability and reliability of POP concentrations in multiple breast milk samples collected from the same mothers

Abstract

Risk assessment of infant using a realistic persistent organic pollutant (POP) exposure through breast milk is essential to devise future regulation of POPs. However, recent investigations have demonstrated that POP levels in breast milk collected from the same mother showed a wide range of variation daily and monthly. To estimate the appropriate sample size of breast milk from the same mother to obtain reliable POP concentrations, breast milk samples were collected from five mothers living in Japan from 2006 to 2012. Milk samples from each mother were collected 3 to 6 times a day through 3 to 7 days consecutively. Food samples as the duplicated method were collected from two mothers during the period of breast milk sample collection. Those were employed for POP (PCBs, DDTs, chlordanes, and HCB) analysis. PCB concentrations detected in breast milk samples showed a wide range of variation which was maximum 63 and 60% of relative standard deviation (RSD) in lipid and wet weight basis, respectively. The time course trend of those variations among the mothers did not show any typical pattern. A larger amount of PCB intake through food seemed to affect 10 h after those concentrations in breast milk in lipid weight basis. Intraclass correlation coefficient (ICC) analyses indicated that the appropriate sample size for good reproducibility of POP concentrations in breast milk required at least two samples for lipid and wet weight basis.

http://ift.tt/2DrCTHY

Sb content dependent thermoelectric properties of the p-type ZnO:Sb films fabricated by oxidation method

Publication date: 1 May 2018
Source:Applied Surface Science, Volume 439
Author(s): Guojian Li, Xiao Lin, Shiying Liu, Baohai Jia, Qiang Wang
It is important to fabricate stable p-type ZnO:Sb thermoelectric (TE) films for the p-n homojunction TE devices that convert waste heat directly into electricity. In this study, the ZnO:Sb films with different Sb contents were prepared by oxidizing evaporated Zn-Sb films in oxygen. The film with a high Sb content (5.32%) is easy to form Zn4Sb3 and ZnSb compound in the wurtzite ZnO. The resistivity has a sharply reduction with the Sb content from 0.228 Ω·m of 3.95% Sb to 4.68 × 10⁻⁵ Ω·m of 5.32% Sb. The lowest resistivity is lower at least one order of magnitude than the results of others with the similar Sb content. The Seebeck coefficient indicates that the 5.32% Sb film remains stable p-type conduction. The carrier concentration is about 10²⁰ cm⁻³ and is higher at least one order of magnitude than the other results. Raman analysis indicates that the peak of E2high related O sublattice vibrations indicates that the O sites are substituted by Sb³⁺ ions, which increases the carrier concentration. However, the mobility is relatively weak because the intrinsic host lattice defects activated as vibrating complexes. The power factor of the p-type ZnO:Sb of the 5.32% Sb film at 427 °C is 46.79 μW/m·K².

Graphical abstract

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Effects of ZnO nanoparticles in the Caspian roach (Rutilus rutilus caspicus)

Publication date: 1 June 2018
Source:Science of The Total Environment, Volume 626
Author(s): K. Khosravi-Katuli, G. Lofrano, H. Pak Nezhad, A. Giorgio, M. Guida, F. Aliberti, A. Siciliano, M. Carotenuto, E. Galdiero, E. Rahimi, G. Libralato
Most studies investigating the toxicity of zinc oxide nanoparticles (ZnO NPs) focused on the effect of size, whereas exposure concentration and duration remained poorly understood. In this study, the effect of acute and sub-acute exposures of ZnO NPs on Zn compartmentalization and biomarkers' expression were investigated in Rutilus rutilus caspicus (Caspian roach) considering various exposure scenarios: i) the assessment of the concentration-response curves and median lethal concentration (LC50); ii) the assessment of the effects of organisms exposed at LC50 value and one tenth of LC50 value of ZnO NPs suspensions for 4 d and 28 d, respectively; iii) the assessment of 14 d depuration period. The same concentrations of ZnSO4 were investigated. The highest Zn accumulation was detected in gill after sub-acute exposure (4.8 mg/L; 28 d) followed by liver, kidney and muscle. In gill, liver and muscle, Zn from Zn NPs accumulated higher concentrations. Depuration (14 d) decreased Zn content in each organ, but no complete removal occurred except for muscle. Biomarkers' activity was significantly over expressed after treatments, but depuration brought back their values to background levels and most effects were related to acute concentrations (48 mg/L; 4 d) and in presence of ZnSO4. Histopathological analyses showed that the exposure to ZnO NPs increased lesions in gill, liver and kidney, with a direct proportionality between alterations and Zn accumulated in the target organs. After depuration, lesions regressed for both ZnO NPs and ZnSO4, but not in a complete way. These data could contribute to increase the knowledge about ZnO NPs risk assessment in aquatic vertebrates, suggesting that the size of ZnO NPs can influence biomarker and histopathological effects.

Graphical abstract

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Characterizing heavy metals in combined sewer overflows and its influence on microbial diversity

Publication date: 1 June 2018
Source:Science of The Total Environment, Volume 625
Author(s): Zuxin Xu, Jun Wu, Huaizheng Li, Yanbo Chen, Jin Xu, Lijun Xiong, Jin Zhang
This study characterized the pollution levels and potential ecological risk of heavy metals in combined sewer overflows (CSOs) and their effects on microbial diversity in nearby riparian sediments. The chemical fractionations of Zn, Cd, Cr, and Cu in dry-weather flows, wet-weather flows (CSO discharges), sewer sediments, and surface runoffs were determined. Geo-accumulation (Igeo) and ecological risk (RI) indexes were employed for metal risk assessment. DNA extraction and polymerase chain reaction (PCR) amplification on the Illumina MiSeq platform were conducted. The results show that heavy metals contents in fine-sized fractions have higher values than those in coarse-sized fractions. Chemical fractionation analysis suggests that Zn and Cd are two of the most bioavailable metals impacted by anthropogenic activities. Cr and Cu contents in CSOs are relatively stable and could exist for extended periods. According to the RI analysis, CSOs pose a considerable risk (RI-G2) to receiving waters due to the higher bioavailability of Cd, which was consistent with the Igeo index. Furthermore, under the stress of the highly-bioavailable Cd and Cu, Gram +ves in the riparian benthic sediment gradually became dominant with metal-tolerance property. Therefore, long-term exposure to highly bioavailable metals could exhibit great impacts on microbial diversity.

Graphical abstract

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Solvent extraction of zinc from synthetic Zn-Cd-Mn chloride solution using D2EHPA: Optimization and thermodynamic studies

Publication date: 31 May 2018
Source:Separation and Purification Technology, Volume 197
Author(s): Hossein Jafari, Hadi Abdollahi, Mahdi Gharabaghi, Ali Asghar Balesini
The extraction of zinc in the presence of manganese and cadmium from chloride solution with di 2 ethyl hexyl phosphoric acid (D2EHPA) in kerosene diluent were comprehensively investigated. The extraction experiments were carried out in order to determine the influential parameters in the conditions of A:O ratio of 1:1, pH range of 1–6, temperatures of 30 °C, 40 °C and 50 °C in an aqueous solution with concentrations of 5 g/L of zinc, manganese and cadmium. The variety of influential parameters in the process such as equilibrium pH, concentration of D2EHPA, temperature, contact time, initial concentration of ions and also thermodynamic parameters of zinc extraction in chloride solution were precisely evaluated. The results showed that in the optimal condition of pH = 2.5–3, temperature 40 °C and [D2EHPA] = 10 v/v, the extraction of Zn, Mn and Cd were 97%, 14% and 3% respectively. ΔpH0.5^Zn-Mn and ΔpH0.5^Zn-Cd in this condition respectively equal to 2.5 and more than 5.25. Also, the study indicated that the predominant zinc species extracted by D2EHPA was ZnCl⁺. Based on thermodynamic studies, the values of ΔH^o, ΔS^o and ΔG^o for zinc extraction in condition of temperature 40 °C and [D2EHPA] = 10 v/v are 25.65 kJ.mol⁻¹, 79.20 J·K⁻¹·mol⁻¹ and 0.86 kJ·mol⁻¹ respectively. Furthermore, the results showed that under constant concentration of D2EHPA, changes in the initial concentrations of Zn, Mn and Cd in the chloride solution were most effective in their separation.

Graphical abstract

http://ift.tt/2qXxgyC

Facile preparation of fluorescent layered double hydroxide polymeric composites through the photo-induced surface-initiated controlled living polymerization

Publication date: 1 May 2018
Source:Applied Surface Science, Volume 439
Author(s): Junyu Chen, Meiying Liu, Qiang Huang, Ruming Jiang, Hongye Huang, Fengjie Deng, Yuanqing Wen, Jianwen Tian, Xiaoyong Zhang, Yen Wei
(Zn/Al) layered double hydroxide (LDH) based fluorescence probes have been facilely fabricated via photo-induced surface-initiated reversible addition-fragmentation chain transfer (RAFT) polymerization, which demonstrated green fluorescence, good biocompatibility and excellent dispersion performance in aqueous solution. The as prepared (Zn/Al)LDH polymeric composites were modified with 2-methacryloyloxyethyl phosphorylcholine (MPC), acrylic acid (AA) and diacroloyl-fluorescein (Ac-Fl). Among them, the comonomers MPC and AA were used to endow their water dispersibility, biocompatibility and potential drug carriers, while the Ac-Fl was served both as the fluorescence signal and photocatalyst for RAFT polymerization. A series of characterization methods, including ¹H nuclear magnetic resonance spectroscopy, Fourier transform infrared spectroscopy, transmission electronic microscopy, thermogravimetric analyses, X-ray photoelectron spectroscopy were employed to conform the successful of surface modification of LDH through photo-induced surface-initiated RAFT polymerization. Besides, UV-vis absorption spectra and fluorescence spectra were adopted to evaluate the optical characteristics of as prepared (Zn/Al)LDH-co-Poly(MPC-AA-Fl) composites, which exhibited high intense green fluorescence. Furthermore, the endocytosis behavior indicates that (Zn/Al)LDH-co-Poly(MPC-AA-Fl) composites could be potentially used in cell imaging and even drug delivery application for their excellent biocompatibility and all advantages described above.

Graphical abstract

http://ift.tt/2mAiqJZ

Contamination characteristics and source apportionment of heavy metals in topsoil from an area in Xi’an city, China

Publication date: 30 April 2018
Source:Ecotoxicology and Environmental Safety, Volume 151
Author(s): Xiuduan Chen, Xinwei Lu
As soil-extractable elements potentially pose ecological and health risks, identifying their contamination characteristics and sources is crucial. Therefore, to understand topsoil trace elements in the urban ring zone from the Second Ring Road to the Third Ring of Xi'an city in China, we determined the concentrations of Zn, Co, V, As, Cu, Mn, Ba, Ni and Pb, and analyzed the sources of the contamination. The results showed that the individual pollution indices of Pb, Co, Cu, Zn, Ba, Ni, Mn, As, and V were 1.79, 1.48, 1.41, 1.33, 1.20, 1.07, 1.04, 0.99, and 0.99, respectively. Evaluation with the aid of the pollution load index (PLI) indicated slight soil contamination by these elements in the study area. Using the positive matrix factorization (PMF) method, we identified four sources of contamination, namely (1) a natural source, (2) traffic emission source, (3) industrial emission source, and (4) mixed source. PMF is an effective tool for source apportionment of heavy metals in topsoil. The contribution rates of the natural source, traffic source, mixed source, and industrial source to the heavy metal contamination were specified as 25.04%, 24.71%, 24.99%, and 25.26%, respectively. Considering the above, any attempt to reduce the soil environmental cost of urban development, has to take into account the heavy metal contamination of the topsoil from industries, traffic, and other activities.

http://ift.tt/2mAeLf2

Consensus Recommendations for Treatment Strategies in Indians Using Botulinum Toxin and Hyaluronic Acid Fillers

Background: Indians constitute one of the largest population groups in the world. Facial anthropometry, morphology, and age-related changes in Indians differ from those of other ethnic groups, necessitating a good understanding of their facial structure and the required aesthetic treatment strategies. However, published recommendations specific to Indians are few, particularly regarding combination treatment. Methods: The Indian Facial Aesthetics Expert Group (19 dermatologists, plastic surgeons, and aesthetic physicians with a mean 15.5 years' aesthetic treatment experience) met to develop consensus recommendations for the cosmetic facial use of botulinum toxin and hyaluronic acid fillers, alone and in combination, in Indians. Treatment strategies and dosage recommendations (agreed by ≥ 75% of the group) were based on results of a premeeting survey, peer-reviewed literature, and the experts' clinical experience. Results: The need for combination treatment increases with age. Tear trough deficiency is the most common midface indication in Indian women aged 20–40 years. In older women, malar volume loss and jowls are the most common aesthetic concerns. Excess medial soft tissue on a relatively smaller midface precedes age-related sagging. Hence, in older Indians, fillers should be used peripherally to achieve lift and conservatively in the medial zones to avoid adding bulk medially. The shorter, wider lower face requires 3-dimensional correction, including chin augmentation, to achieve increased facial height and the oval shape desired by most Indian women. Conclusions: These recommendations give physicians treating Indians worldwide a better understanding of their unique facial characteristics and provide treatment strategies to achieve optimal aesthetic outcomes.

http://ift.tt/2CX3xvl

Monobloc Reconstruction of Dome, Medial Crura, and Columella with Gamma-Shaped Costal Cartilage Graft

Summary: In severe nasal deformities, the original cartilages are removed, or they become unusable because of previous operations. Costal cartilage (CC) is one of the most important tools for the replacement of deficient nasal osteocartilaginous framework. In 4 secondary and 1 tertiary rhinoplasty cases with severe deformities of medial and lateral crura of the lower lateral cartilages, we have prepared a long strut graft from a CC and then split the graft tip 5–6 mm vertically into 2 equal halves to create a gamma (υ)-shaped strut graft. We have sutured the base of this graft to the nasal spine and/or the bases of the medial crural remnants. Then, we have prepared lateral crural grafts and secured the grafts over lateral crural remnants. Then we curved the split tip winglets of the υ-shaped strut graft to both sides and sutured them to lateral crural grafts in order to create a new dome. Splitting of the CC strut graft reduces the need for extensive suturing at the tip, obtains smoother contours and ensures graft economy, and provides an original and stable dome shape. The bending capacity of the CC is limited in middle-aged patients. Costal allografts from a young cadaver can be a good alternative. υ-shaped costal crural graft is useful for medial crural and domal monobloc reconstruction in secondary and tertiary cases.

http://ift.tt/2D0WqOm

The Superiorly Based Partial Rectus Abdominis and External Oblique Flap: A New Technique for Breast Asymmetry Reconstruction

Summary: Breast asymmetry has a wide spectrum of presentations with several employable strategies for surgical correction. Historically, the external oblique muscle has proven to be a versatile flap option for the reconstruction of both local and distant defects. It has also been described for use in breast reconstruction for coverage of the lower pole of implant prostheses. The external oblique muscle flap can be harvested in several ways to capture overlying fat and skin. In this study, we describe the use of a superiorly based partial rectus and external oblique flap for surgical correction of lower pole breast hypoplasia. This flap provides vascularized autologous volume to the lower pole of the breast with minimal donor morbidity. Other advantages of this flap are that it can increase the nipple to inframammary fold distance and lower the inframammary fold. This technique represents an evolution of an under-utilized flap and is the first study describing the use of the external oblique flap in the management of breast asymmetry.

http://ift.tt/2CXmy0R

Combined fMRI- and eye movement-based decoding of bistable plaid motion perception

Publication date: 1 May 2018
Source:NeuroImage, Volume 171
Author(s): Gregor Wilbertz, Madhura Ketkar, Matthias Guggenmos, Philipp Sterzer
The phenomenon of bistable perception, in which perception alternates spontaneously despite constant sensory stimulation, has been particularly useful in probing the neural bases of conscious perception. The study of such bistability requires access to the observer's perceptual dynamics, which is usually achieved via active report. This report, however, constitutes a confounding factor in the study of conscious perception and can also be biased in the context of certain experimental manipulations. One approach to circumvent these problems is to track perceptual alternations using signals from the eyes or the brain instead of observers' reports. Here we aimed to optimize such decoding of perceptual alternations by combining eye and brain signals. Eye-tracking and functional magnetic resonance imaging (fMRI) was performed in twenty participants while they viewed a bistable visual plaid motion stimulus and reported perceptual alternations. Multivoxel pattern analysis (MVPA) for fMRI was combined with eye-tracking in a Support vector machine to decode participants' perceptual time courses from fMRI and eye-movement signals. While both measures individually already yielded high decoding accuracies (on average 86% and 88% correct, respectively) classification based on the two measures together further improved the accuracy (91% correct). These findings show that leveraging on both fMRI and eye movement data may pave the way for optimized no-report paradigms through improved decodability of bistable motion perception and hence for a better understanding of the neural correlates of consciousness.

http://ift.tt/2FA4B64

Outdoor pollen is a trigger of child and adolescent asthma ED presentations: a systematic review and meta-analysis

Abstract

Background

In the context of increased asthma exacerbations associated with climatic changes such as thunderstorm asthma, interest in establishing the link between pollen exposure and asthma hospital admissions has intensified. Here, we systematically reviewed and performed a meta-analysis of studies on pollen and ED attendance.

Methods

A search for studies with appropriate search strategy in Medline, Embase, Web of Science and CINAHL was conducted. Each study was assessed for quality and risk of bias. The available evidence was summarised both qualitatively and meta-analysed using random effects models when moderate heterogeneity was observed.

Results

Fourteen studies were included. The pollen taxa investigated differed between studies, allowing meta-analysis only of the effect of grass pollen. A statistically significant increase in the percentage change in the mean number of asthma ED presentations (MPC) (pooled results from three studies) was observed for an increase in 10 grass pollen grains per cubic meter of exposure 1.88% (95%CI = 0.94%, 2.82%). Time series studies showed positive correlations between pollen concentrations and ED presentations. Age stratified studies found strongest associations in children aged 5 to 17 years old.

Conclusion

Exposure to ambient grass pollen is an important trigger for childhood asthma exacerbations requiring ED attendance. As pollen exposure is increasingly a problem especially in relation to thunderstorm asthma, studies with uniform measures of pollen and similar analytical methods are necessary to fully understand its impact on human health.

http://ift.tt/2DtRJh0

How does dose impact on the severity of food-induced allergic reactions, and can this improve risk assessment for allergenic foods?

Abstract

Quantitative risk assessment for food allergens has made considerable progress in recent years, yet acceptability of its outcomes remains stymied because of the limited extent to which it has been possible to incorporate severity as a variable. Reaction severity, particularly following accidental exposure, depends on multiple factors, related to the allergen, the host and any treatments which might be administered. Some of these factors are plausibly still unknown. Quantitative risk assessment shows that limiting exposure through control of dose reduces the rates of reactions in allergic populations, but its impact on the relative frequency of severe reactions at different doses is unclear. Food challenge studies suggest that the relationship between dose of allergenic food and reaction severity is complex even under relatively controlled conditions. Because of these complexities, epidemiological studies provide very limited insight into this aspect of the dose-response relationship. Emerging data from single-dose challenges suggest that graded food challenges may overestimate the rate of severe reactions. It may be necessary to generate new data (such as those from single dose-challenges) to reliably identify the effect of dose on severity for use in quantitative risk assessment. Success will reduce uncertainty in the susceptible population and improve consumer choice.

http://ift.tt/2D0ktgi

Submental artery island flap with simultaneous level I neck dissection

Abstract

Background

The purpose of this study was to illustrate the submental island flap elevation technique with simultaneous level I neck dissection followed by the inset and reconstruction of an oropharyngeal defect.

Methods

A 63-year-old patient with a T2N1M0 human papillomavirus-positive squamous cell carcinoma of the tonsil was treated with concurrent chemoradiotherapy (cisplatin + 66 Gy). A local recurrence 2.5 years after treatment was treated surgically and reconstructed with a submental island flap.

Results

There were no complications and oral diet was initiated at 2 weeks and the gastrostomy tube was removed 1 month postoperatively. A video demonstration of the submental island flap elevation is included with a focus on how levels 1A and 1B can be dissected safely and this can be viewed online on Head & Neck's home page at http://ift.tt/13H5MtY.

Conclusion

The submental island flap can be performed safely with a level I neck dissection for head and neck reconstruction.

http://ift.tt/2mzvuiu

The complement system in the airway epithelium – an overlooked host defense mechanism and therapeutic target?

Publication date: Available online 12 January 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Hrishikesh S. Kulkarni, M. Kathryn Liszewski, Steven L. Brody, John P. Atkinson

http://ift.tt/2D7xYyR

Mumps infection but not childhood vaccination induces persistent polyfunctional CD8+ T-cell memory

Publication date: Available online 12 January 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Jelle de Wit, Maarten E. Emmelot, Martien C.M. Poelen, Rob S. van Binnendijk, Saskia van der Lee, Debbie van Baarle, Wanda G.H. Han, Cécile A.C.M. van Els, Patricia Kaaijk

http://ift.tt/2AWoYXy

Expressed parental concern regarding childhood stuttering and the Test of Childhood Stuttering

Publication date: Available online 12 January 2018
Source:Journal of Communication Disorders
Author(s): Victoria Tumanova, Dahye Choi, Edward G. Conture, Tedra A. Walden
PurposeThe purpose of the present study was to determine whether the Test of Childhood Stuttering observational rating scales (TOCS; Gillam et al., 2009) (1) differed between parents who did versus did not express concern (independent from the TOCS) about their child's speech fluency; (2) correlated with children's frequency of stuttering measured during a child-examiner conversation; and (3) correlated with the length and complexity of children's utterances, as indexed by mean length of utterance (MLU).MethodParticipants were 183 young children ages 3:0–5:11. Ninety-one had parents who reported concern about their child's stuttering (65 boys, 26 girls) and 92 had parents who reported no such concern (50 boys, 42 girls). Participants' conversational speech during a child-examiner conversation was analyzed for (a) frequency of occurrence of stuttered and non-stuttered disfluencies, and (b) MLU. Besides expressing concern or lack thereof about their child's speech fluency, parents completed the TOCS observational rating scales documenting how often they observe different disfluency types in speech of their children, as well as disfluency-related consequences.ResultsThere were three main findings. First, parents who expressed concern (independently from the TOCS) about their child's stuttering reported significantly higher scores on the TOCS Speech Fluency and Disfluency-Related Consequences rating scales. Second, children whose parents rated them higher on the TOCS Speech Fluency rating scale produced more stuttered disfluencies during a child-examiner conversation. Third, children with higher scores on the TOCS Disfluency-Related Consequences rating scale had shorter MLU during child-examiner conversation, across age and level of language ability.ConclusionsFindings support the use of the TOCS observational rating scales as one documentable, objective means to determine parental perception of and concern about their child's stuttering. Findings also support the notion that parents are reasonably accurate, if not reliable, judges of the quantity and quality (i.e., stuttered vs. non-stuttered) of their child's speech disfluencies. Lastly, findings that some children may decrease their verbal output in attempts to minimize instances of stuttering – as indexed by relatively low MLU and a high TOCS Disfluency-Related Consequences scores – provides strong support for sampling young children's speech and language across various situations to obtain the most representative index possible of the child's MLU and associated instances of stuttering.

http://ift.tt/2DrdQ7N

"Hell J Nucl Med"[jour]; +28 new citations

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

"Hell J Nucl Med"[jour]

These pubmed results were generated on 2018/01/13

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/2mz3yeS

"Hell J Nucl Med"[jour]; +28 new citations

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

"Hell J Nucl Med"[jour]

These pubmed results were generated on 2018/01/13

http://ift.tt/2mz3yeS

Angiogenesis inhibitor; +51 new citations

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

Angiogenesis inhibitor

These pubmed results were generated on 2018/01/13

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Prevalence of Bovine Aortic Arch Variant in Patients with Aortic Dissection and its Implications in the Outcome of Patients with Acute Type B Aortic Dissection

Publication date: Available online 12 January 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Spyridon N. Mylonas, Arthurs Barkans, Marius Ante, Jens Wippermann, Dietmar Böckler, Jan Sigge Brunkwall
Objective/BackgroundTo investigate the prevalence of bovine arch (BA) among patients with type A and B aortic dissection, and to provide insight into the implication of this variation on the outcome of patients with acute or subacute type B aortic dissection (a/sTBAD).MethodsThis retrospective cohort analysis includes patients with a/sTBAD admitted between January 2006 and December 2016. Computed tomographic angiograms (CTAs) of patients referred because of type A aortic dissection were also re-evaluated with regard to the presence of BA. As a control group, 110 oncological patients who had undergone a chest CTA for disease staging during the study period were enrolled. A total of 154 patients with a/sTBAD and 168 with type A aortic dissection were identified during the study period.ResultsAn overall prevalence of 17.6% for BA variants was revealed. The comparison between patients with aortic dissection and the control group showed no statistically significant difference in BA prevalence (17.7% vs. 17.3%; p = 1.0). No statistically significant difference in BA prevalence was observed when comparing patients with type A aortic dissection with those with type B aortic dissection (16.6% vs. 18.8%; p = .66). During a median follow-up period of 27.8 months, 30 patients died. The mortality rate among patients presenting a BA variant was 34.5%, whereas among patients without, it was 16.0% (p = .04). Multivariate analysis revealed the presence of a BA as an independent predictor of mortality (adjusted odds ratio 3.4, 95% confidence interval 1.2–9.8).ConclusionThe BA should be considered as a predictor of the outcome for patients with type B aortic dissection.

http://ift.tt/2r2aRQJ

Respiratory Phenotypes for Preterm Infants, Children, and Adults: Bronchopulmonary Dysplasia and More.

Respiratory Phenotypes for Preterm Infants, Children, and Adults: Bronchopulmonary Dysplasia and More.

Ann Am Thorac Soc. 2018 Jan 12;:

Authors: Collaco JM, McGrath-Morrow SA

Abstract
Ongoing advancements in neonatal care since the late 1980's have led to increased numbers of premature infants surviving well beyond the neonatal period. As a result of increased survival, many individuals born preterm manifest chronic respiratory symptoms throughout infancy, childhood and adult life. The archetypical respiratory disease of prematurity, bronchopulmonary dysplasia (BPD), is the second most common chronic pediatric respiratory disease after asthma. However, there are several commonly held misconceptions. These misconceptions include that BPD is rare, that BPD resolves within the first few years of life, and that BPD does not impact respiratory health in adult life. This focused review article describes a spectrum of respiratory conditions that individuals born prematurely may experience throughout their lifespan. Specifically, this review provides quantitative estimates of the number of individuals with alveolar, airway, and vascular phenotypes associated with BPD as well as non-BPD respiratory phenotypes such as airway malacia, obstructive sleep apnea, and control of breathing issues. Furthermore, this review illustrates what is known about the potential for progression and/or lack of resolution of these respiratory phenotypes in childhood and adult life. Recognizing the spectrum of respiratory phenotypes associated with individuals born preterm and providing comprehensive and personalized care to these individuals may help to modulate adverse respiratory outcomes in later life. .

PMID: 29328889 [PubMed - as supplied by publisher]

http://ift.tt/2AWNacm

"Zhonghua Yi Xue Za Zhi"[jour]; +26 new citations

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

"Zhonghua Yi Xue Za Zhi"[jour]

These pubmed results were generated on 2018/01/13

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The comparative efficacy of brodalumab in patients with moderate-to-severe psoriasis: a systematic literature review and network meta-analysis.

The comparative efficacy of brodalumab in patients with moderate-to-severe psoriasis: a systematic literature review and network meta-analysis.

J Dermatolog Treat. 2018 Jan 11;:1-39

Authors: Sawyer L, Fotheringham I, Wright E, Yasmeen N, Gibbons C, Holmen Møller A

Abstract
PURPOSE: To evaluate the relative efficacy of brodalumab compared with approved biologic therapies and apremilast for moderate-to-severe psoriasis.
METHODS: We searched MEDLINE, Embase and Cochrane for randomized controlled trials reporting induction phase responses. The primary analysis examined the proportion of patients achieving Psoriasis Area Severity Index (PASI) 50, 75, 90 or 100 responses using a random-effects Bayesian multinomial likelihood model with probit link, with and without adjustment for variation in study-level placebo responses.
RESULTS: A total of 54 studies were included. Based on PASI 100 response, the most efficacious therapies were brodalumab 210mg every two weeks (Q2W) and ixekizumab. Brodalumab 210mg Q2W was significantly more efficacious than adalimumab, apremilast, brodalumab 140mg Q2W, etanercept, infliximab, secukinumab and ustekinumab. Results were consistent for PASI 50, 75 and 90 outcomes and all sensitivity analyses.
CONCLUSIONS: Our findings are consistent with pivotal trials which indicate that high levels of complete clearance can be achieved with brodalumab. Based on existing evidence, induction-phase efficacy of brodalumab is similar to ixekizumab and superior to other approved therapies, including anti-TNFs, apremilast, secukinumab and ustekinumab.

PMID: 29323542 [PubMed - as supplied by publisher]

http://ift.tt/2CWNycx

Future Oncology; +49 new citations

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

Future Oncology

These pubmed results were generated on 2018/01/13

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upper respiratory tract infection; +49 new citations

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

upper respiratory tract infection

These pubmed results were generated on 2018/01/13

http://ift.tt/2EDK7b8

Primary Orbital Melanoma: Presentation, Treatment, and Long-term Outcomes for 13 Patients.

Primary Orbital Melanoma: Presentation, Treatment, and Long-term Outcomes for 13 Patients.

Front Oncol. 2017;7:316

Authors: Rose AM, Luthert PJ, Jayasena CN, Verity DH, Rose GE

Abstract
Background: Periocular melanoma is a rare but often deadly malignancy that arises in the uvea (commonest origin), conjunctiva or orbit (rarest primary site). Melanoma accounts for 5-10% of metastatic/secondary orbital malignancies, but only a tiny proportion of primary orbital neoplasia. Primary orbital melanoma (POM) is exceedingly rare, with approximately 50 cases reported to date.
Methods: All patients seen in the orbital unit at a tertiary referral hospital (1991-2016) with a biopsy-proven diagnosis of POM were identified from a diagnostic database and were studied. The case notes, imaging, surgical approach, and histology were reviewed.
Results: Thirteen patients (five male; 38%) presented with isolated malignant melanoma of the orbit, for which no other primary site was identified at presentation or during an average follow-up of 44 months (median 22; range 0-13 years). The patients presented between the ages of 40 and 84 years (mean 55.5; median 48 years) and typically gave a short history of rapidly increasing proptosis and eyelid swelling. On the basis of history, a malignant lesion was suspected in most patients and all underwent incisional biopsy, with debulking of the mass in 10 (77%) patients, and skin-sparing exenteration in 3/13 (23%). Ten patients underwent orbital radiotherapy and the survival to date ranged from 9 months to 14 years (mean 55 months; median 23 months); two patients received solely palliative care for widespread disease and one patient refused orbital radiotherapy. Five of the 13 (38%) patients died from the disease.
Discussion: POM is a very rare malignancy, but clinical analysis of this cohort gives insight into disease presentation and prognosis. The tumor typically presents with a rapidly progressive, well-defined mass that is, in some cases, amenable to macroscopically intact excision. Unusual for malignant melanoma, some of these patients can show an unusually long period of quiescent disease after surgical debulking and radiotherapy.

PMID: 29326884 [PubMed]

http://ift.tt/2mr8pOa

Metabolic Plasiticy in Cancers-Distinct Role of Glycolytic Enzymes GPI, LDHs or Membrane Transporters MCTs.

Metabolic Plasiticy in Cancers-Distinct Role of Glycolytic Enzymes GPI, LDHs or Membrane Transporters MCTs.

Front Oncol. 2017;7:313

Authors: Ždralević M, Marchiq I, de Padua MMC, Parks SK, Pouysségur J

Abstract
Research on cancer metabolism has recently re-surfaced as a major focal point in cancer field with a reprogrammed metabolism no longer being considered as a mere consequence of oncogenic transformation, but as a hallmark of cancer. Reprogramming metabolic pathways and nutrient sensing is an elaborate way by which cancer cells respond to high bioenergetic and anabolic demands during tumorigenesis. Thus, inhibiting specific metabolic pathways at defined steps should provide potent ways of arresting tumor growth. However, both animal models and clinical observations have revealed that this approach is seriously limited by an extraordinary cellular metabolic plasticity. The classical example of cancer metabolic reprogramming is the preference for aerobic glycolysis, or Warburg effect, where cancers increase their glycolytic flux and produce lactate regardless of the presence of the oxygen. This allows cancer cells to meet the metabolic requirements for high rates of proliferation. Here, we discuss the benefits and limitations of disrupting fermentative glycolysis for impeding tumor growth at three levels of the pathway: (i) an upstream block at the level of the glucose-6-phosphate isomerase (GPI), (ii) a downstream block at the level of lactate dehydrogenases (LDH, isoforms A and B), and (iii) the endpoint block preventing lactic acid export (MCT1/4). Using these examples of genetic disruption targeting glycolysis studied in our lab, we will discuss the responses of different cancer cell lines in terms of metabolic rewiring, growth arrest, and tumor escape and compare it with the broader literature.

PMID: 29326883 [PubMed]

http://ift.tt/2mtKnlF

The Role of Class IA Phosphatidylinositol-4,5-Bisphosphate 3-Kinase Catalytic Subunits in Glioblastoma.

The Role of Class IA Phosphatidylinositol-4,5-Bisphosphate 3-Kinase Catalytic Subunits in Glioblastoma.

Front Oncol. 2017;7:312

Authors: Pridham KJ, Varghese RT, Sheng Z

Abstract
Phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K) plays a critical role in the pathogenesis of cancer including glioblastoma, the most common and aggressive form of brain cancer. Targeting the PI3K pathway to treat glioblastoma has been tested in the clinic with modest effect. In light of the recent finding that PI3K catalytic subunits (PIK3CA/p110α, PIK3CB/p110β, PIK3CD/p110δ, and PIK3CG/p110γ) are not functionally redundant, it is imperative to determine whether these subunits play divergent roles in glioblastoma and whether selectively targeting PI3K catalytic subunits represents a novel and effective strategy to tackle PI3K signaling. This article summarizes recent advances in understanding the role of PI3K catalytic subunits in glioblastoma and discusses the possibility of selective blockade of one PI3K catalytic subunit as a treatment option for glioblastoma.

PMID: 29326882 [PubMed]

http://ift.tt/2mrroIt

Editorial: Update on the Treatment of Metastatic Non-small Cell Lung Cancer (NSCLC) in New Era of Personalised Medicine.

Editorial: Update on the Treatment of Metastatic Non-small Cell Lung Cancer (NSCLC) in New Era of Personalised Medicine.

Front Oncol. 2017;7:311

Authors: Melosky B

PMID: 29322030 [PubMed]

http://ift.tt/2mrC6ib

Influencing Cancer Screening Participation Rates-Providing a Combined Cancer Screening Program (a 'One Stop' Shop) Could Be a Potential Answer.

Influencing Cancer Screening Participation Rates-Providing a Combined Cancer Screening Program (a 'One Stop' Shop) Could Be a Potential Answer.

Front Oncol. 2017;7:308

Authors: Bobridge A, Price K, Gill TK, Taylor AW

Abstract
Introduction: Participation in established cancer screening programs remains variable. Therefore, a renewed focus on how to increase screening uptake, including addressing structural barriers such as time, travel, and cost is needed. One approach could be the provision of combined cancer screening, where multiple screening tests are provided at the same time and location (essentially a 'One Stop' screening shop). This cohort study explored both cancer screening behavior and the acceptability of a combined screening approach.
Methods: Participants of the North Western Adelaide Health Study (NWAHS), South Australia were invited to participate in a questionnaire about cancer screening behaviors and the acceptability of a proposed 'One Stop' cancer screening shop. Data were collected from 10th August 2015 to 18th January 2016, weighted for selection probability, age, and sex and analyzed using descriptive and multivariable logistic regression analysis.
Results: 1,562 people, 52% female (mean age 54.1 years ± 15.2) participated. Reported screening participation was low, the highest being for Pap Smear (34.4%). Common reasons for screening participation were preventing sickness (56.1%, CI 53.2-59.0%), maintaining health (51%, CI 48-53.9%), and free program provision (30.9%, CI 28.2-33.6%). Females were less likely to state that screening is not beneficial [OR 0.37 (CI 0.21-0.66), p < 0.001] and to cite sickness prevention [OR 2.10 (CI 1.46-3.00), p < 0.001] and free program [OR 1.75 (CI 1.22-2.51), p < 0.003] as reasons for screening participation. Of those who did not participate, 34.6% (CI 30.3-39.1%) stated that there was nothing that discouraged them from participation, with 55- to 64-year olds [OR 0.24 (CI 0.07-0.74), p < 0.04] being less likely to cite this reason. 21% (CI 17.2-24.8%) thought they did not need screening, while a smaller proportion stated not having time (6.9%, CI 4.9-9.7%) and the costs associated with screening (5.2%, CI 3.5-7.7%). The majority of participants (85.3%, CI 81.9-88.2%) supported multiple screening being offered at the same time and location.
Conclusion: Identified screening behaviors in this study are similar to those reported in the literature. The high support for the concept of combined cancer screening demonstrates that this type of approach is acceptable to potential end users and warrants further investigation.

PMID: 29322029 [PubMed]

http://ift.tt/2mrAIvP

High-Content Monitoring of Drug Effects in a 3D Spheroid Model.

High-Content Monitoring of Drug Effects in a 3D Spheroid Model.

Front Oncol. 2017;7:293

Authors: Mittler F, Obeïd P, Rulina AV, Haguet V, Gidrol X, Balakirev MY

Abstract
A recent decline in the discovery of novel medications challenges the widespread use of 2D monolayer cell assays in the drug discovery process. As a result, the need for more appropriate cellular models of human physiology and disease has renewed the interest in spheroid 3D culture as a pertinent model for drug screening. However, despite technological progress that has significantly simplified spheroid production and analysis, the seeming complexity of the 3D approach has delayed its adoption in many laboratories. The present report demonstrates that the use of a spheroid model may be straightforward and can provide information that is not directly available with a standard 2D approach. We describe a cost-efficient method that allows for the production of an array of uniform spheroids, their staining with vital dyes, real-time monitoring of drug effects, and an ATP-endpoint assay, all in the same 96-well U-bottom plate. To demonstrate the method performance, we analyzed the effect of the preclinical anticancer drug MLN4924 on spheroids formed by VCaP and LNCaP prostate cancer cells. The drug has different outcomes in these cell lines, varying from cell cycle arrest and protective dormancy to senescence and apoptosis. We demonstrate that by using high-content analysis of spheroid arrays, the effect of the drug can be described as a series of EC50 values that clearly dissect the cytostatic and cytotoxic drug actions. The method was further evaluated using four standard cancer chemotherapeutics with different mechanisms of action, and the effect of each drug is described as a unique multi-EC50 diagram. Once fully validated in a wider range of conditions, this method could be particularly valuable for phenotype-based drug discovery.

PMID: 29322028 [PubMed]

http://ift.tt/2mrPva9

Allograft for Myeloma: Examining Pieces of the Jigsaw Puzzle.

Allograft for Myeloma: Examining Pieces of the Jigsaw Puzzle.

Front Oncol. 2017;7:287

Authors: Malek E, El-Jurdi N, Kröger N, de Lima M

Abstract
Multiple myeloma (MM) cure remains elusive despite the availability of newer anti-myeloma agents. Patients with high-risk disease often suffer from early relapse and short survival. Allogeneic hematopoietic cell transplantation (allo-HCT) is an "immune-based" therapy that has the potential to offer long-term remission in a subgroup of patients, at the expense of high rates of transplant-related morbidity and mortality. Donor lymphocyte infusion (DLI) upon disease relapse after allo-HCT is able to generate an anti-myeloma response suggestive of a graft-versus-myeloma effect. Allo-HCT provides a robust platform for additional immune-based therapy upon relapse including DLI and, maintenance with immunomodulatory drugs and immunosuppressive therapy. There have been conflicting findings from randomized prospective trials questioning the role of allo-HCT. However, to this date, allo-HCT remains the only potential curable treatment for MM and its therapeutic role needs to be better defined especially for patients with high-risk disease. This review examines different aspects of this treatment and summarizes ongoing attempts at improving its therapeutic index.

PMID: 29322027 [PubMed]

http://ift.tt/2EEwUz5

Characterization of CD34+ hematopoietic cells in systemic mastocytosis: potential role in disease dissemination

Abstract

Background

Recent studies show that most systemic mastocytosis (SM) patients, including indolent SM (ISM) with (ISMs+) and without skin lesions (ISMs-), carry the KIT D816V mutation in PB leukocytes. We investigated the potential association between the degree of involvement of BM hematopoiesis by the KIT D816V mutation and the distribution of different maturation-associated compartments of bone marrow (BM) and peripheral blood (PB) CD34⁺ hematopoietic precursors (HPC) in ISM, and identified the specific PB cell compartments that carry this mutation.

Methods

The distribution of different maturation-associated subsets of BM and PB CD34⁺ HPC from 64 newly-diagnosed (KIT-mutated) ISM patients and 14 healthy controls was analyzed by flow cytometry. In 18 patients distinct FACS-purified PB cell compartments were also investigated for the KIT mutation.

Results

ISM patients showed higher percentages of both BM and PB MC-committed CD34⁺ HPC vs. controls, particularly among ISM cases with MC-restricted KIT mutation (ISM_MC); this was associated with progressive blockade of maturation of CD34⁺ HPC to the neutrophil lineage from ISM_MC to multilineage KIT-mutated cases (ISM_ML). Regarding the frequency of KIT-mutated cases and cell populations in PB, variable patterns were observed, the percentage of KIT-mutated PB CD34⁺ HPC, eosinophils, neutrophils, monocytes and T-cells increasing from ISMs-_MC and ISMs+_MC to ISM_ML patients.

Conclusion

The presence of the KIT D816V mutation in PB of ISM patients is associated with (early) involvement of circulating CD34⁺ HPC and multiple myeloid cell subpopulations, KIT-mutated PB CD34⁺ HPC potentially contributing to early dissemination of the disease.

http://ift.tt/2FxTsCQ

Multidimensional endotypes of chronic rhinosinusitis and their association with treatment outcomes

Abstract

Background

The expression of chronic rhinosinusitis (CRS) is multidimensional. Disease heterogeneity in patients with CRS remains poorly understood. This study aimed to identify endotypes of CRS using cluster analysis by integrating multidimensional characteristics and to explore their association with treatment outcomes.

Methods

A total of 28 clinical variables and 39 mucosal cellular and molecular variables were analyzed using principal component analysis. Cluster analysis was performed on 246 prospectively recruited Chinese CRS patients with at least one-year post-operative follow-up. Difficult-to-treat CRS was characterized in each generated cluster.

Results

Seven subject clusters were identified. Cluster 1 (13.01%) was comparable to the classic well-defined eosinophilic CRS with polyps, having severe disease and the highest proportion of difficult-to-treat CRS. Patients in cluster 2 (16.26%) and cluster 4 (13.82%) had relatively lower proportions of presence of polyps and presented mild inflammation with moderate proportions of difficult-to-treat cases. Subjects in cluster 2 were highly atopic. Cluster 3 (7.31%) and cluster 6 (21.14%) were characterized by severe or moderate neutrophilic inflammation, respectively, and with elevated levels of IL-8 and high proportions of difficult-to-treat CRS. Cluster 5 (4.07%) was a unique group characterized by the highest levels of IL-10 and lacked difficult-to-treat cases. Cluster 7 (24.39%) demonstrated the lowest symptom severity, a low proportion of difficult-to-treat CRS, and low inflammation load. Finally, we found that difficult-to-treat CRS was associated with distinct clinical features and biomarkers in the different clusters.

Conclusions

Distinct clinicopathobiologic clusters of CRS display differences in clinical response to treatments and characteristics of difficult-to-treat CRS.

http://ift.tt/2EE4UeW

The asthma-rhinitis multimorbidity is associated with IgE polysensitization in adolescents and adults

Abstract

Background

Children with multimorbid asthma and rhinitis show IgE polysensitization to several allergen sources. This association remain poorly studied in adolescents and adults using defined allergen molecules. We investigated IgE sensitization patterns towards a broad panel of aeroallergen components in adults and adolescents with a focus on individuals with asthma and rhinitis multimorbidity.

Methods

IgE reactivity to 64 microarrayed aeroallergen molecules was determined with the MeDALL-chip in samples from the French EGEA study (n=840, age=40.7±17.1) and the Swedish population-based birth cohort BAMSE (n=786, age=16±0.26). The age- and sex-adjusted associations between the number of IgE-reactive allergen molecules (≥0.3 ISU) and the asthma-rhinitis phenotypes were assessed using a negative binomial model.

Results

Groups representing four phenotypes were identified: no asthma-no rhinitis (A-R-; 30% in EGEA and 54% in BAMSE), asthma alone (A+R-; 11% and 8%), rhinitis alone (A-R+; 15% and 24%), and asthma-rhinitis (A+R+; 44% and 14%). The numbers of IgE-reactive aeroallergen molecules significantly differed between phenotypes (median in A-R-, A+R-, A-R+ and A+R+: 0, 1, 2 and 7 in EGEA and 0, 0, 3, and 5 in BAMSE). As compared to A-R- subjects, the adjusted ratio of the mean number of IgE-reactive molecules was higher in A+R+ than in A+R- or A-R+ (10.0, 5.4 and 5.0 in EGEA and 7.2, 0.7 and 4.8 in BAMSE).

Conclusion

The A+R+ phenotype combined the sensitization pattern of both the A-R+ and A+R-phenotypes. This multimorbid polysensitized phenotype seems to be generalizable to various ages and allergenic environments and may be associated with specific mechanisms.

http://ift.tt/2FA3mnc

Prevalence, severity, and risk factors for acute exacerbations of nasal and sinus symptoms by chronic rhinosinusitis status

Abstract

Background

Nasal and sinus symptoms (NSS) are common to many health conditions, including chronic rhinosinusitis (CRS). Few studies have investigated the occurrence and severity of, and risk factors for, acute exacerbations of NSS (AENSS) by CRS status (current, past, or never met European Position Paper on Rhinosinusitis [EPOS] criteria for CRS).

Methods

Four seasonal questionnaires were mailed to a stratified random sample of Geisinger primary care patients. Logistic regression was used to identify individual characteristics associated with AENSS occurrence and severity by CRS status (current long-term, current recent, past, never) using EPOS subjective symptoms-only (EPOS_S) CRS criteria. We operationalized three AENSS definitions based on prescribed antibiotics or oral corticosteroids, symptoms, and symptoms with purulence.

Results

Baseline and at least one follow-up questionnaires were available from 4,736 subjects. Self-reported NSS severity with exacerbation was worst in the current long-term CRS group. AENSS was common in all subgroups examined and generally more common among those with current EPOS_S CRS. Seasonal prevalence of AENSS differed by AENSS definition and CRS status. Associations of risk factors with AENSS differed by definition, but CRS status, body mass index, asthma, hay fever, sinus surgery history, and winter season consistently predicted AENSS.

Conclusions

In this first longitudinal, population-based study of three AENSS definitions, NSS and AENSS were both common, sometimes severe, and differed by EPOS_S CRS status. Contrasting associations of risk factors for AENSS by the different definitions suggest a need for a standardized approach to definition of AENSS.

http://ift.tt/2EE4Mfs

The urgent need for a harmonized severity scoring system for acute allergic reactions

Abstract

The accurate assessment and communication of the severity of acute allergic reactions is important to patients, clinicians, researchers, the food industry, public health and regulatory authorities. Severity has different meanings to different stakeholders with patients and clinicians rating the significance of particular symptoms very differently. Many severity scoring systems have been generated, most focusing on the severity of reactions following exposure to a limited group of allergens. They are heterogeneous in format, none has used an accepted developmental approach and none has been validated. Their wide range of outcome formats has led to difficulties with interpretation and application. Therefore there is a persisting need for an appropriately developed and validated severity scoring system for allergic reactions that works across the range of allergenic triggers and addresses the needs of different stakeholder groups. We propose a novel approach to develop and then validate a harmonized scoring system for acute allergic reactions, based on a data-driven method that is informed by clinical and patient experience and other stakeholders' perspectives. We envisage two formats: (i) a numerical score giving a continuum from mild to severe reactions that is clinically meaningful and is useful for allergy healthcare professionals and researchers; and (ii) a three grade based ordinal format that is simple enough to be used and understood by other professionals and patients. Testing of reliability and validity of the new approach in a range of settings and populations will allow eventual implementation of a standardized scoring system in clinical studies and routine practice.

http://ift.tt/2FwKTYK

Allergy - Committed to Progress in Allergy and Immunology

Abstract

After more than 8 years, our terms as Co-Editors-in-Chief have now reached an end. We are thankful for having had the privilege to serve the community in this position. We think that we have reached our original goal of increasing the overall quality of the journal (1). The science which is reported every month in Allergy is of high quality and wide interest, largely contributing to the development of the fields of Allergy and Immunology. The impact of the journal is high, as reflected by its present impact factor of 7.36.

http://ift.tt/2EBtTPZ

B cell lymphoproliferative disorders; +105 new citations

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

B cell lymphoproliferative disorders

These pubmed results were generated on 2018/01/13

http://ift.tt/2D90JKZ

Long-term patient-related outcome measures of septoplasty: a systematic review

Abstract

Purpose

Septoplasty is a common rhinological procedure intended to relieve symptoms of chronic nasal obstruction. However, there remains a question as to whether patients obtain symptom improvement and are satisfied with surgical outcomes in the months and years after septoplasty. This review aims to evaluate the long-term efficacy of functional septoplasty for nasal septal deviation.

Methods

A systematic review of the literature was conducted from November 2014 to March 2016 using the Cochrane, EMBASE, and PubMed databases. Prospective trials concerning functional septoplasty, which assessed subjective outcomes and included long-term follow-up data (≥ 9 month post-septoplasty) were included.

Results

2189 articles were screened with seven meeting the criteria for inclusion. Patient satisfaction was assessed in six studies, with rates of satisfaction provided in three of these, ranging from 69 to 100%. Two studies assessed the degree of patient satisfaction, with one study indicating that 88% of patients were moderately satisfied or better at 1 year post-op, and the other reporting that 50% of patients were satisfied. In assessing symptom relief, several methods were used, including validated questionnaires, with varying degrees of improvement in nasal obstruction reported.

Conclusions

Septoplasty appears to be a far from perfect treatment for nasal obstruction due to septal deviation. However, given the heterogeneity of data and lack of randomized controlled trials (RCTs), future RCTs and use of validated questionnaires would enable generation of superior levels of evidence. We suggest future prospective trials evaluating prognostic factors in septoplasty, to better inform patients and facilitate the development of guidelines for surgical intervention.

http://ift.tt/2Db70Wp

More Than a Decade of Molecular Diagnostic Cytopathology Leading Diagnostic and Therapeutic Decision-Making.

More Than a Decade of Molecular Diagnostic Cytopathology Leading Diagnostic and Therapeutic Decision-Making.

Arch Pathol Lab Med. 2018 Jan 12;:

Authors: Salto-Tellez M

PMID: 29328776 [PubMed - as supplied by publisher]

http://ift.tt/2DsJNwz

Breast Specimen Processing and Reporting With an Emphasis on Margin Evaluation.

Breast Specimen Processing and Reporting With an Emphasis on Margin Evaluation.

Arch Pathol Lab Med. 2018 Jan 12;:

Authors: Guidi AJ, Tworek JA, Mais DD, Souers RJ, Blond BJ, Brown RW

Abstract
CONTEXT: The College of American Pathologists (CAP) developed protocols for reporting pathologic characteristics of breast cancer specimens, including margin status. The Society of Surgical Oncology (SSO) and the American Society for Radiation Oncology (ASTRO) published treatment guidelines regarding margins in patients with invasive cancer; and SSO, ASTRO, and the American Society of Clinical Oncology (ASCO) recently published guidelines for patients with ductal carcinoma in situ.
OBJECTIVE: - To assess current practices among pathologists with regard to the processing/reporting of breast specimens, assess compliance with CAP cancer protocols, and assess alignment with SSO/ASTRO and SSO/ASTRO/ASCO guidelines.
DESIGN: - A survey concerning breast specimen processing/reporting was distributed to pathologists enrolled in the CAP Performance Improvement Program in Surgical Pathology.
RESULTS: - Ninety-four percent (716 of 764 respondents) and 91% (699 of 769 respondents) define positive margins as "tumor on ink" for invasive cancer and ductal carcinoma in situ, respectively, in compliance with CAP cancer protocols and with SSO/ASTRO and SSO/ASTRO/ASCO guidelines. Of 791 respondents who provided details regarding methods for margin evaluation, 608 (77%) exclusively examine perpendicular margins, facilitating guideline compliance. However, 183 of 791 respondents (23%) examine en face margins in at least a subset of specimens, which may preclude guideline compliance in some cases. When separate cavity (shave) margins are examined, while 517 of 586 respondents (88%) ink these specimens, 69 of 586 (12%) do not, and this may also preclude guideline compliance in some cases.
CONCLUSIONS: - A substantial proportion of survey participants report margin status for breast cancer specimens in a manner consistent with CAP cancer protocols, and in alignment with SSO/ASTRO and SSO/ASTRO/ASCO guidelines. However, there are opportunities for some laboratories to modify procedures in order to facilitate more complete adherence to guidelines.

PMID: 29328775 [PubMed - as supplied by publisher]

http://ift.tt/2CZxWoC

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Σάββατο 13 Ιανουαρίου 2018

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