Κυριακή 14 Ιανουαρίου 2018
Foreign body removal assisted by an intraoral ultrasound probe
Abstract
Ultrasonography has recently been applied to the field of oral and maxillofacial surgery because of its noninvasiveness and ease of use. However, traditional transducers are not used in the intraoral area because of their large size. A novel intraoral transducer was introduced with size, volume, and axis modifications. This new transducer allows the surgeon to approach the intraoral region during dental procedures. This report describes a case of successful removal of a foreign body using the newly developed intraoral ultrasound probe. Precise localization and minimally invasive removal of the foreign body using the intraoral transducer were simultaneously conducted. Because of its many advantages, this intraoral ultrasound transducer has the potential to be applied in oral and maxillofacial surgery.
http://ift.tt/2r6vP11
Agricultural non-point source pollution management in a reservoir watershed based on ecological network analysis of soil nitrogen cycling
Abstract
The Miyun Reservoir plays a pivotal role in providing drinking water for the city of Beijing. In this research, ecological network analysis and scenario analysis were integrated to explore soil nitrogen cycling of chestnut and Chinese pine forests in the upper basin of the Miyun Reservoir, as well as to seek favorable fertilization modes to reduce agricultural non-point source pollution. Ecological network analysis results showed that (1) the turnover time was 0.04 to 0.37 year in the NH4+ compartment and were 15.78 to 138.36 years in the organic N compartment; (2) the Finn cycling index and the ratio of indirect to direct flow were 0.73 and 11.92 for the chestnut forest model, respectively. Those of the Chinese pine forest model were 0.88 and 29.23, respectively; and (3) in the chestnut forest model, NO3− accounted for 96% of the total soil nitrogen loss, followed by plant N (2%), NH4+ (1%), and organic N (1%). In the Chinese pine forest, NH4+ accounted for 56% of the total soil nitrogen loss, followed by organic N (34%) and NO3− (10%). Fertilization mode was identified as the main factor affecting soil N export. To minimize NH4+ and NO3− outputs while maintaining the current plant yield (i.e., 7.85e0 kg N/year), a fertilization mode of 162.50 kg N/year offered by manure should be adopted. Whereas, to achieve a maximum plant yield (i.e., 3.35e1 kg N/year) while reducing NH4+ and NO3− outputs, a fertilization mode of 325.00 kg N/year offered by manure should be utilized. This research is of wide suitability to support agricultural non-point source pollution management at the watershed scale.
http://ift.tt/2DdtDuj
Pustular psoriasis and related pustular skin diseases
Summary
Patients with pustular psoriasis or related pustular diseases may have genetic abnormalities impairing the function of key players of the innate skin immune system. Recently, identification of these abnormalities has changed the paradigm of several of these diseases. These include generalized pustular psoriasis, palmoplantar pustular psoriasis and acrodermatitis continua of Hallopeau, and also drug-induced acute exanthematous generalized pustular eruption. Identified mutations in IL36RN, CARD14 and AP1S3 in different groups of patients lead to enhanced inflammatory cascade in several cellular subtypes including keratinocytes, and to the recruitment and activation of neutrophils and macrophages. These insights have unveiled pathophysiological features that shift the existing paradigms and emphasize the autoinflammatory nature of skin pustular disorders. They also highlight the crucial role of the innate immune system across entities belonging to the psoriasis disease spectrum, allowing identification of new appealing therapeutic targets.
http://ift.tt/2FE0fLe
Pustular psoriasis and related pustular skin diseases
Summary
Patients with pustular psoriasis or related pustular diseases may have genetic abnormalities impairing the function of key players of the innate skin immune system. Recently, identification of these abnormalities has changed the paradigm of several of these diseases. These include generalized pustular psoriasis, palmoplantar pustular psoriasis and acrodermatitis continua of Hallopeau, and also drug-induced acute exanthematous generalized pustular eruption. Identified mutations in IL36RN, CARD14 and AP1S3 in different groups of patients lead to enhanced inflammatory cascade in several cellular subtypes including keratinocytes, and to the recruitment and activation of neutrophils and macrophages. These insights have unveiled pathophysiological features that shift the existing paradigms and emphasize the autoinflammatory nature of skin pustular disorders. They also highlight the crucial role of the innate immune system across entities belonging to the psoriasis disease spectrum, allowing identification of new appealing therapeutic targets.
http://ift.tt/2FE0fLe
Increased sensitivity and high specificity of indirect immunofluorescence in detecting IgG subclasses for diagnosis of bullous pemphigoid
Summary
Background
Indirect immunofluorescence (IIF) microscopy on monkey oesophagus is an important assay for the diagnosis of bullous pemphigoid (BP). Its relatively low sensitivity (60–80%) may be partly due to insufficient detection of minor IgG subclasses.
Aim
To determine the operating characteristics of an IgG subclass in IIF.
Methods
We designed a retrospective, dual-centre, controlled cohort study on sera from 64 BP sera that had been rated as false negatives by traditional IIF microscopy, and assessed circulating IgG1, IgG3 and IgG4 autoantibodies.
Results
The sensitivities of IIF in detecting IgG1, IgG3, IgG4 and all three in combination were 45.3%, 18.8%, 32.8% and 48.4%, respectively. Specificities were > 97%.
Conclusion
Detection of IgG subclass (especially IgG1 and IgG4) autoantibodies by IIF on monkey oesophagus can significantly improve diagnostic performance of IIF microscopy for diagnosis of BP.
http://ift.tt/2r9dIY8
Evaluation of universal immunohistochemical screening of sebaceous neoplasms in a service setting
Summary
Background
Muir–Torre syndrome (MTS) is a subtype of Lynch syndrome, which encompasses the combination of sebaceous skin tumours or keratoacanthomas and internal malignancy, due to mutations in DNA mismatch repair genes. Sebaceous neoplasms (SNs) may occur before other malignancies, and may lead to the diagnosis, which allows testing of other family members, cancer surveillance, risk-reducing surgery or prevention therapies.
Aim
To evaluate the efficacy of universal immunohistochemistry (IHC) screening of SNs in a service setting.
Methods
Patients with SNs were ascertained by a regional clinical pathology service over a 3-year period. Results of tumour IHC, clinical genetics notes and germline genetic testing were retrospectively reviewed.
Results
In total, 62 patients presented with 71 SNs; 9 (15%) of these patients had previously diagnosed MTS. Tumour IHC was performed for 50 of the 53 remaining patients (94%); 26 (52%) had loss of staining of one or more mismatch repair proteins. Fifteen patients were referred to the Clinical Genetics department, and 10 patients underwent germline genetic testing. Two had a new diagnosis of MTS confirmed, with heterozygous pathogenic mutations detected in the MSH2 and PMS2 genes (diagnostic yield 20%). The PMS2 mutation was identified in a 57-year-old woman with a sebaceous adenoma and history of endometrial cancer; to our knowledge, this is the first time a PMS2 mutation has been reported in MTS.
Conclusions
Universal IHC screening of SNs is an effective method to identify cases for further genetic evaluation. Rates of referral to clinical genetics were only moderate (58%). Increased awareness of MTS could help improve the rate of onward referral.
http://ift.tt/2mEp95I
Serum levels of psoriasin (S100A7) and koebnerisin (S100A15) as potential markers of atherosclerosis in patients with psoriasis
Summary
Background
Psoriasin (S100A7) and koebnerisin (S100A15) are proinflammatory proteins upregulated in psoriasis, but their relation to atherosclerosis remains unclear.
Aim
To evaluate the role of serum psoriasin and koebnerisin as possible markers for subclinical atherosclerosis in patients with psoriasis.
Methods
Serum levels of psoriasin and koebnerisin were measured by ELISA in 45 patients with psoriasis and in 45 healthy controls (HCs). Intima–media thickness (IMT) of the right and left common carotid arteries was measured to detect the presence of subclinical atherosclerosis. Clinical severity of psoriasis was estimated using the Psoriasis Area and Severity Index (PASI).
Results
Compared with HCs, patients with psoriasis had significantly higher levels of psoriasin (26.61 ± 22.45 ng/mL vs. 6.31 ± 1.68 ng/mL, P < 0.001) and koebnerisin (21.2 ± 13.12 ng/mL vs. 12.2 ± 4.67 ng/mL, P = 0.001), and significantly higher IMT values (1.07 ± 0.4 mm vs. 0.61 ± 0.1 mm, P < 0.001). A positive correlation was observed between IMT and PASI (r = 0.78, P < 0.001), serum psoriasin (r = 0.48, P > 0.01) and serum koebnerisin (r = 0.48, P < 0.01). Patients with psoriasis with subclinical atherosclerosis had higher serum levels of koebnerisin compared with patients without subclinical atherosclerosis (P = 0.04), which was not observed for psoriasin (P = 0.94).
Conclusion
Serum psoriasin and koebnerisin correlate with IMT, underlining their value as a potential link between psoriasis and atherosclerosis. In particular, koebnerisin seems to be a useful marker of subclinical atherosclerosis in patients with psoriasis.
http://ift.tt/2r8osGi
Increased sensitivity and high specificity of indirect immunofluorescence in detecting IgG subclasses for diagnosis of bullous pemphigoid
Summary
Background
Indirect immunofluorescence (IIF) microscopy on monkey oesophagus is an important assay for the diagnosis of bullous pemphigoid (BP). Its relatively low sensitivity (60–80%) may be partly due to insufficient detection of minor IgG subclasses.
Aim
To determine the operating characteristics of an IgG subclass in IIF.
Methods
We designed a retrospective, dual-centre, controlled cohort study on sera from 64 BP sera that had been rated as false negatives by traditional IIF microscopy, and assessed circulating IgG1, IgG3 and IgG4 autoantibodies.
Results
The sensitivities of IIF in detecting IgG1, IgG3, IgG4 and all three in combination were 45.3%, 18.8%, 32.8% and 48.4%, respectively. Specificities were > 97%.
Conclusion
Detection of IgG subclass (especially IgG1 and IgG4) autoantibodies by IIF on monkey oesophagus can significantly improve diagnostic performance of IIF microscopy for diagnosis of BP.
http://ift.tt/2r9dIY8
Evaluation of universal immunohistochemical screening of sebaceous neoplasms in a service setting
Summary
Background
Muir–Torre syndrome (MTS) is a subtype of Lynch syndrome, which encompasses the combination of sebaceous skin tumours or keratoacanthomas and internal malignancy, due to mutations in DNA mismatch repair genes. Sebaceous neoplasms (SNs) may occur before other malignancies, and may lead to the diagnosis, which allows testing of other family members, cancer surveillance, risk-reducing surgery or prevention therapies.
Aim
To evaluate the efficacy of universal immunohistochemistry (IHC) screening of SNs in a service setting.
Methods
Patients with SNs were ascertained by a regional clinical pathology service over a 3-year period. Results of tumour IHC, clinical genetics notes and germline genetic testing were retrospectively reviewed.
Results
In total, 62 patients presented with 71 SNs; 9 (15%) of these patients had previously diagnosed MTS. Tumour IHC was performed for 50 of the 53 remaining patients (94%); 26 (52%) had loss of staining of one or more mismatch repair proteins. Fifteen patients were referred to the Clinical Genetics department, and 10 patients underwent germline genetic testing. Two had a new diagnosis of MTS confirmed, with heterozygous pathogenic mutations detected in the MSH2 and PMS2 genes (diagnostic yield 20%). The PMS2 mutation was identified in a 57-year-old woman with a sebaceous adenoma and history of endometrial cancer; to our knowledge, this is the first time a PMS2 mutation has been reported in MTS.
Conclusions
Universal IHC screening of SNs is an effective method to identify cases for further genetic evaluation. Rates of referral to clinical genetics were only moderate (58%). Increased awareness of MTS could help improve the rate of onward referral.
http://ift.tt/2mEp95I
Serum levels of psoriasin (S100A7) and koebnerisin (S100A15) as potential markers of atherosclerosis in patients with psoriasis
Summary
Background
Psoriasin (S100A7) and koebnerisin (S100A15) are proinflammatory proteins upregulated in psoriasis, but their relation to atherosclerosis remains unclear.
Aim
To evaluate the role of serum psoriasin and koebnerisin as possible markers for subclinical atherosclerosis in patients with psoriasis.
Methods
Serum levels of psoriasin and koebnerisin were measured by ELISA in 45 patients with psoriasis and in 45 healthy controls (HCs). Intima–media thickness (IMT) of the right and left common carotid arteries was measured to detect the presence of subclinical atherosclerosis. Clinical severity of psoriasis was estimated using the Psoriasis Area and Severity Index (PASI).
Results
Compared with HCs, patients with psoriasis had significantly higher levels of psoriasin (26.61 ± 22.45 ng/mL vs. 6.31 ± 1.68 ng/mL, P < 0.001) and koebnerisin (21.2 ± 13.12 ng/mL vs. 12.2 ± 4.67 ng/mL, P = 0.001), and significantly higher IMT values (1.07 ± 0.4 mm vs. 0.61 ± 0.1 mm, P < 0.001). A positive correlation was observed between IMT and PASI (r = 0.78, P < 0.001), serum psoriasin (r = 0.48, P > 0.01) and serum koebnerisin (r = 0.48, P < 0.01). Patients with psoriasis with subclinical atherosclerosis had higher serum levels of koebnerisin compared with patients without subclinical atherosclerosis (P = 0.04), which was not observed for psoriasin (P = 0.94).
Conclusion
Serum psoriasin and koebnerisin correlate with IMT, underlining their value as a potential link between psoriasis and atherosclerosis. In particular, koebnerisin seems to be a useful marker of subclinical atherosclerosis in patients with psoriasis.
http://ift.tt/2r8osGi
Outpatient erbium:YAG (2940 nm) laser treatment for snoring: a prospective study on 40 patients
Abstract
Snoring is a sleep phenomenon due to the partial upper airway obstruction during sleep which causes vibration of the tissues of the rhino-oro-hypopharynx and less frequently the larynx. This study evaluated the use and effectiveness of the erbium:YAG 2940-nm laser as an adjunctive in providing treatment for patients suffering from chronic snoring-related sleep disorders. A prospective study of 40 consecutive patients with snoring and sleep disorders was performed, assessing data before and after three Er:YAG laser treatment sessions. During laser treatment, the pain was almost absent. There were no side effects, except a very mild sore throat in 1 out of 40 patients. The patient's evaluation of satisfaction of the results obtained after the treatments showed that 85% of cases were very satisfied, 5 patients (12.5%) reported being fairly satisfied with the treatment and only 1 subject (2.5%) was not satisfied. Mallampati, Friedman Tongue Position, and degree of O (oropharynx) at nose oropharynx hypopharynx and larynx classification were significantly decreased after the laser sessions. The decrease of Epworth Sleepiness Scale and Visual Analogue Scale for loudness of snoring, waking up during sleep because of snoring, dry mouth on waking, and choking was all statistically significant. The incidence of dreaming during the night also raised significantly; 30/40 (75%) of cases perceived less tightness in their throat and better breathing after treatment. These results were stable at 20 months follow-up (14–24 q) in 72% of cases. Nonsurgical and non-invasive Er:YAG laser treatment demonstrated to be a valid procedure in reducing the loudness of snoring.
http://ift.tt/2B3nJpK
High final energy of gallium arsenide laser increases MyoD gene expression during the intermediate phase of muscle regeneration after cryoinjury in rats
Abstract
The aim of this study was to determine the effects of gallium arsenide (GaAs) laser on IGF-I, MyoD, MAFbx, and TNF-α gene expression during the intermediate phase of muscle regeneration after cryoinjury 21 Wistar rats were divided into three groups (n = 7 per group): untreated with no injury (control group), cryoinjury without GaAs (injured group), and cryoinjury with GaAs (GaAs-injured group). The cryoinjury was induced in the central region of the tibialis anterior muscle (TA). The region injured was irradiated once a day during 14 days using GaAs laser (904 nm; spot size 0.035 cm2, output power 50 mW; energy density 69 J cm−2; exposure time 4 s per point; final energy 4.8 J). Twenty-four hours after the last application, the right and left TA muscles were collected for histological (collagen content) and molecular (gene expression of IGF-I, MyoD, MAFbx, and TNF-α) analyses, respectively. Data were analyzed using one-way ANOVA at P < 0.05. There were no significant (P > 0.05) differences in collagen density and IGF-I gene expression in all experimental groups. There were similar (P < 0.05) decreases in MAFbx and TNF-α gene expression in the injured and GaAs-injured groups, compared to control group. The MyoD gene expression increased (P = 0.008) in the GaAs-injured group, but not in the injured group (P = 0.338), compared to control group. GaAs laser therapy had a positive effect on MyoD gene expression, but not IGF-I, MAFbx, and TNF-α, during intermediary phases (14 days post-injury) of muscle repair.
http://ift.tt/2Dd8fp2
RAS testing for colorectal cancer patients is reliable in European laboratories that pass external quality assessment
Abstract
Wild-type status of KRAS and the NRAS gene (exon 2, 3, and 4) in the tumor should be determined before treatment of metastatic colorectal cancer (mCRC) patients with EGFR-targeting agents. There is a large variation in test methods to determine RAS status, and more sensitive detection methods were recently introduced. Data from quality assessment programs indicate substantial error rates. This study assessed the completeness and correctness of RAS testing in European laboratories that successfully passed external quality assessment (EQA). Participants were requested to send material of their most recent ten patients with mCRC who had been tested for RAS status. Isolated DNA, a hematoxylin and eosin stained tissue slide with a marked area for macrodissection and accompanying patient reports were requested. Samples were reevaluated in a reference laboratory by using a next-generation sequencing approach. In total, 31 laboratories sent in the requested material (n = 309). Despite regulations for anti-EGFR therapy, one institute did not perform full RAS testing. Reanalysis was possible for 274 samples with sufficient DNA available. In the hotspot codons of KRAS and NRAS, seven discordant results were obtained in total, five of them leading to a different prediction of anti-EGFR therapy efficacy (2%; n = 274). Results show that oncologists can rely on the quality of laboratories with good performance in EQA. Oncologists need to be aware that the testing laboratory participates successfully in EQA programs. Some EQA providers list the good performing laboratories on their website.
http://ift.tt/2mB2Hu7
Possible protective effect of the algae spirulina against nephrotoxicity induced by cyclosporine A and/or gamma radiation in rats
Abstract
The present study was conducted to evaluate the possible protective role of the algae spirulina (Sp) against nephrotoxicity and oxidative stress which are the main secondary effects induced by the immunosuppressant drug CSA and/or ionizing radiation. In this study, male rats were given Sp (1 g/kg) either for 15 days before irradiation (6.5 Gy) or 5 days before and 10 days concomitant with CSA (25 mg/kg). Markers used to assess renal injury included serum creatinine, urea, glucose, albumin, protein, and lipid profile as well as kidney content of reduced glutathione (GSH); lipid peroxidation (thiobarbituric acid reactive substances (TBARS)); nitrite and superoxide dismutase (SOD) activity. In addition, some trace elements (Zn and Mg) were estimated in kidney. Apoptosis was assessed by immunohistochemical estimation of caspase-3 expression in addition to histopathological examination. Results revealed that gamma radiation and/or CSA induced elevation in urea, creatinine, lipids, and glucose while decreasing albumin and protein levels. There was a noticeable increase in kidney content of GSH, TBARS, and nitrite. Meanwhile, profound decrease in kidney SOD activity was observed. Treatment with Sp significantly reversed the changes induced by CSA and/or gamma radiation in renal function tests. Spirulina also ameliorated kidney oxidative stress through decreasing GSH, TBARS, and nitrite kidney content while increasing SOD activity. Histopathological examination further confirmed Sp protective efficacy. Moreover, kidney caspase-3 expression that was triggered by CSA and/or gamma radiation was decreased. In conclusion, spirulina can be regarded as a promising renoprotective natural agent against renal injury induced by CSA and/or gamma radiation.
http://ift.tt/2FFcffp
Diurnal variations in personal care products in seawater and mussels at three Mediterranean coastal sites
Abstract
The presence of personal care products (PCPs) in the marine environment is of major concern. PCPs, UV filters, and musks can enter the marine environment indirectly through wastewater or directly via recreational activities. We conducted this study to document patterns in the occurrence of seven PCPs at three coastal sites impacted by recreational activities during 1 day. The study focused on diurnal variations in these seven PCPs in seawater and indigenous mussels. In seawater, UV filters showed diurnal variations that mirrored variations in recreational activities at the sites. Ethylhexyl methoxycinnamate (EHMC) and octocrylene (OC) water concentrations increased from under the limit of quantification in the morning to 106 and 369 ng/L, respectively, when recreational activities were the highest. In mussels, diurnal variations in OC were observed, with the lowest concentrations recorded in the morning and then increasing throughout the day. As Mytilus spp. are widely used as sentinels in coastal pollution monitoring programs (mussel watch), our findings on diurnal variations could enhance sampling recommendations for recreational sites impacted by PCPs.
http://ift.tt/2EJ8Haz
Frontmatter
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: i-iv
http://ift.tt/2EHKa63
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
Volume: 31
Issue: 1
Pages: 1-3
http://ift.tt/2FBzsiI
Allergic and non-allergic skin reactions associated with growth hormone therapy: elucidation of causative agents
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 5-11
http://ift.tt/2EHK9z1
Adherence to growth hormone therapy in children and its potential barriers
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 13-20
http://ift.tt/2FCNdxm
Short-term adverse effects of testosterone used for priming in prepubertal boys before growth hormone stimulation test
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 21-24
http://ift.tt/2EEQdbp
Growth response to growth hormone treatment in patients with SHOX deficiency can be predicted by the Cologne prediction model
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 25-31
http://ift.tt/2FCNaSc
WHO 2006 Child Growth Standards overestimate short stature and underestimate overweight in Japanese children
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 33-38
http://ift.tt/2EGhOci
Identifying depressive symptoms among diabetes type and the impact on hemoglobin A1c
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 39-44
http://ift.tt/2FAzTK3
Insulin resistance and lung function in obese asthmatic pre-pubertal children
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 45-51
http://ift.tt/2EGUFq8
Obesity is associated with vitamin D deficiency in Danish children and adolescents
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 53-61
http://ift.tt/2FCN8K4
Daily sitting time associated with the risk of metabolic syndrome in Korean adolescents
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 63-69
http://ift.tt/2EH0Vhu
Molecular basis and clinical presentation of classic galactosemia in a Croatian population
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 71-75
http://ift.tt/2FCN64U
Clinical outcome in a series of pediatric patients with congenital generalized lipodystrophies treated with dietary therapy
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 77-83
http://ift.tt/2EEQcUT
Spondyloepiphyseal or spondylometaphyseal dysplasia in ancient Greek art
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 85-86
http://ift.tt/2FDyeDk
Sirolimus therapy for congenital hyperinsulinism in an infant with a novel homozygous KCNJ11 mutation
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 87-89
http://ift.tt/2EEQf31
Veganism as a cause of iodine deficient hypothyroidism
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 91-94
http://ift.tt/2FCMX1m
A case of Riley Ruvalcaba syndrome with a novel PTEN mutation accompanied by diffuse testicular microlithiasis and precocious puberty
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 95-99
http://ift.tt/2EIJ1uG
Addison’s disease presenting with perimyocarditis
Journal Name: Journal of Pediatric Endocrinology and Metabolism
Volume: 31
Issue: 1
Pages: 101-105
http://ift.tt/2FCMT1C
Refractory Ventricle Arrhythmias Alternating with Pulseless Electrical Activity in a Young Woman Rescued by Extracorporeal Cardiopulmonary Resuscitation
Introduction. Extracorporeal cardiopulmonary resuscitation (ECPR) is a challenging approach for treating refractory out-of-hospital cardiac arrest (OHCA). Case Presentation. The authors describe a case of a 40-year-old Caucasian female who suffered from refractory OHCA, was admitted to a hospital while receiving ongoing cardiopulmonary resuscitation, and was connected to venoarterial extracorporeal membrane oxygenation 73 minutes after collapse. Ventricular tachyarrhythmias alternating with pulseless electrical activity resolved after eight hours. Following complete cardiac and neurological recovery, only adenoviral genome was found in myocardial biopsy. After 11 months, another episode of identical arrhythmias was rescued by an implantable cardioverter-defibrillator. Conclusion. Adequate prehospital and early hospital logistics is a prerequisite for successfully implementing extracorporeal cardiopulmonary resuscitation for refractory OHCA.
http://ift.tt/2EIj3I6
Genetic Knockdown and Pharmacologic Inhibition of Hypoxia-Inducible Factor (HIF) Hydroxylases.
| Related Articles |
Genetic Knockdown and Pharmacologic Inhibition of Hypoxia-Inducible Factor (HIF) Hydroxylases.
Methods Mol Biol. 2018;1742:1-14
Authors: Pickel C, Taylor CT, Scholz CC
Abstract
Reduced oxygen supply that does not satisfy tissue and cellular demand (hypoxia) regularly occurs both in health and disease. Hence, the capacity for cellular oxygen sensing is of vital importance for each cell to be able to alter its energy metabolism and promote adaptation to hypoxia. The hypoxia-inducible factor (HIF) prolyl hydroxylases 1-3 (PHD1-3) and the asparagine hydroxylase factor-inhibiting HIF (FIH) are the primary cellular oxygen sensors, which confer cellular oxygen-dependent sensitivity upon HIF as well as other hypoxia-sensitive pathways, such as nuclear factor κB (NF-κB). Studying these enzymes allows us to understand the oxygen-dependent regulation of cellular processes and has led to the development of several putative novel therapeutics, which are currently in clinical trials for the treatment of anemia associated with kidney disease. Pharmacologic inhibition and genetic knockdown are commonly established techniques in protein biochemistry and are used to investigate the activity and function of proteins. Here, we describe specific protocols for the knockdown and inhibition of the HIF prolyl hydroxylases 1-3 (PHD1-3) and the asparagine hydroxylase factor-inhibiting HIF (FIH) using RNA interference (RNAi) and hydroxylase inhibitors, respectively. These techniques are essential tools for the analysis of the function of the HIF hydroxylases, allowing the investigation and discovery of novel functions and substrates of these enzymes.
PMID: 29330785 [PubMed - in process]
http://ift.tt/2DdEX8H
Variant of a persistent hypoglossal artery supplying only the posterior inferior cerebellar artery diagnosed by magnetic resonance angiography: a case report.
| Related Articles |
Variant of a persistent hypoglossal artery supplying only the posterior inferior cerebellar artery diagnosed by magnetic resonance angiography: a case report.
Surg Radiol Anat. 2018 Jan 12;:
Authors: Uchino A, Suzuki C
Abstract
Very rarely, a persistent hypoglossal artery supplies only the posterior inferior cerebellar artery without connection to the basilar artery. Few cases diagnosed by catheter angiography have been reported. We diagnosed a case using magnetic resonance angiography.
PMID: 29330558 [PubMed - as supplied by publisher]
http://ift.tt/2D9inPj
Attenuation of noise-induced hyperactivity in the dorsal cochlear nucleus by pre-treatment with MK-801.
| Related Articles |
Attenuation of noise-induced hyperactivity in the dorsal cochlear nucleus by pre-treatment with MK-801.
Brain Res. 2018 Jan 09;:
Authors: Criddle MW, Godfrey DA, Kaltenbach JA
Abstract
It has previously been hypothesized that hyperactivity of central auditory neurons following exposure to intense noise is a consequence of synaptic alterations. Recent studies suggest the involvement of NMDA receptors in the induction of this hyperactive state. NMDA receptors can mediate long term changes in the excitability of neurons through their involvement in excitotoxic injury and long term potentiation and depression. In this study, we examined the effect of administering an NMDA receptor blocker on the induction of hyperactivity in the dorsal cochlear nucleus (DCN) following intense sound exposure. Our prediction was that if hyperactivity induced by intense sound exposure is dependent on NMDA receptors, then blocking these receptors by administering an NMDA receptor antagonist just before animals are exposed to intense sound should reduce the degree of hyperactivity that subsequently emerges. We compared the levels of hyperactivity that develop in the DCN after intense sound exposure to activity recorded in control animals that were not sound exposed. One group of animals to be sound exposed received intraperitoneal injection of MK-801 twenty minutes preceding the sound exposure, while the other group received injection of saline. Recordings performed in the DCN 26-28 days post-exposure revealed increased response thresholds and widespread increases in spontaneous activity in the saline-treated animals that had been sound exposed, consistent with earlier studies. The animals treated with MK-801 preceding sound exposure showed similarly elevated thresholds but an attenuation of hyperactivity in the DCN; the attenuation was most robust in the high frequency half of the DCN, but lower levels of hyperactivity were also found in the low frequency half. These findings suggest that NMDA receptors are an important component of the hyperactivity-inducing mechanism following intense sound exposure. They further suggest that blockade of NMDA receptors may offer a useful therapeutic approach to preventing induction of noise-induced hyperactivity-related hearing disorders, such as tinnitus and hyperacusis.
PMID: 29329983 [PubMed - as supplied by publisher]
http://ift.tt/2Dvyi7P
Case Series Analysis of New Zealand Reports of Rapid Intense Potentiation of Warfarin by Roxithromycin.
| Related Articles |
Case Series Analysis of New Zealand Reports of Rapid Intense Potentiation of Warfarin by Roxithromycin.
Drug Saf. 2018 Jan 12;:
Authors: Savage RL, Tatley MV
Abstract
INTRODUCTION: We undertook an analysis of all the reports to the New Zealand Centre for Adverse Reactions Monitoring of a roxithromycin/warfarin interaction after two recent reports described intense rapid warfarin potentiation. The interaction was first published in 1995. Cytochrome P450 3A4 inhibition has been the proposed mechanism but has limited biologic plausibility. There are suggestions that the clinical significance of the interaction may be increased by severe illness, polypharmacy, renal dysfunction, older age and increased warfarin sensitivity.
METHODS: To investigate the potentiating effect of warfarin on roxithromycin in this New Zealand case series, the reports were reviewed to identify patients at risk, compare the reporting pattern with published Australian data and evaluate the appropriateness of current prescribing advice.
RESULTS: Thirty patient reports were identified. The age range was 23-88 years, mean 66.8, median 73.0 (standard deviation 17.7) and the international normalised ratios after roxithromycin commencement ranged from 3.6 to 16.7 (mean 7.6, median 7.6, standard deviation 3.6). For eight patients with measurements on day 3, international normalised ratios were 4.3-16.7 (mean 10.4, median 8.8, standard deviation 4.4). Four patients had serious haemorrhage. Indications for roxithromycin were a range of respiratory tract infections. Anticoagulation was stable for most patients prior to acute infection. Serious infection occurred in 54.5% (12 of 22 patients with information). Polypharmacy (five or more medicines daily) was used by 36.7% of patients long term, increasing acutely to 83.3%, including additional potentially interacting medicines. Warfarin daily dose (1.5-13.0 mg, mean 4.4, median 4.0, standard deviation 2.2) was moderate to low. Pre-roxithromycin international normalised ratio values ranged from 1.4 to 3.7, mean and median 2.5, standard deviation 0.5. A high proportion of interactions were observed between warfarin and roxithromycin compared with other macrolides and compared with cytochrome P450 3A4-related macrolide interactions. The pattern was similar to published Australian data.
CONCLUSION: In this case series, the high prevalence of acute polypharmacy, including potentially interacting medicines, and serious infection suggests that they may have contributed to warfarin potentiation and increased the clinical significance of a roxithromycin/warfarin interaction.
PMID: 29330715 [PubMed - as supplied by publisher]
http://ift.tt/2DckQYC
Use of a Pulsed Radiofrequency Energy Device (PEAK Plasmablade™) in Neuromodulation Implant Revisions.
| Related Articles |
Use of a Pulsed Radiofrequency Energy Device (PEAK Plasmablade™) in Neuromodulation Implant Revisions.
World Neurosurg. 2018 Jan 09;:
Authors: Ughratdar I, Kawsar KA, Mitchell R, Selway R, Ashkan K
Abstract
BACKGROUND: Battery replacement or revision surgery for neuromodulation implants is conventionally performed using sharp dissection. Meticulous dissection within thick scar tissue is vital to avoid damage to surrounding lead(s) which could result in more extensive revision surgery. Traditional electrosurgery devices are contraindicated as the emitted energy can be transferred to the hardware resulting in implant or tissue damage with severe consequent complications.
OBJECTIVE: We report our experience and potential applications of a novel, pulsed monopolar radiofrequency energy device (PEAK PlasmaBlade™, Medtronic plc) which facilitates dissection around implants without the risk of damaging or transmitting energy through the system.
METHODS: A two-centre retrospective study to review the indications, safety and efficacy of the PlasmaBlade in 57 cases requiring either neuromodulation system replacement or revision. Deep brain stimulator (DBS) battery replacements were undertaken in 45 cases, 8 vagal nerve stimulator battery revisions, 2 intrathecal baclofen system revision, 1 DBS extension revision and 1 DBS scar revision around the cranial portion of the lead.
RESULTS: All cases proceeded without adverse event, damage to lead/generator and with a subjective and objective impression of significant time savings. Average operating times for battery replacements were reduced from 37 to 26 minutes (p=0.015).
CONCLUSION: In our experience, the PlasmaBlade is safe to use in revising/replacing neuromodulation implants. We observed no damage or transmission of energy to the implants or leads; additional advantages of the system include reduced operating times, less damage to surrounding tissue and the potential to facilitate revision procedures in awake patients under local anaesthesia.
PMID: 29330080 [PubMed - as supplied by publisher]
http://ift.tt/2mDLHDv
Impact of Platelet Transfusion on Intracerebral Hemorrhage (ICH) in Patients on Antiplatelet Therapy - An Analysis Based on ICH Score.
| Related Articles |
Impact of Platelet Transfusion on Intracerebral Hemorrhage (ICH) in Patients on Antiplatelet Therapy - An Analysis Based on ICH Score.
World Neurosurg. 2018 Jan 09;:
Authors: Arnone GD, Kumar P, Wonais MC, Esfahani DR, Campbell-Lee SA, Charbel FT, Amin-Hanjani S, Alaraj A, Seicean A, Mehta AI
Abstract
OBJECTIVE: Platelet transfusions for intracerebral hemorrhage (ICH) patients on antiplatelet therapy (APT) remain controversial. Diverging past research and differences in platelet preparation warrant further investigation of this topic. In this study, the association between platelet transfusion and clinical outcomes of ICH is investigated in patients matched by ICH score, a validated predictor of mortality.
METHODS: A consecutive review of all patients from 2012 to 2015 with non-traumatic ICH was performed. Risk factors including demographics, medical comorbidities, APT use, and ICH score were reviewed. Standardized differences were used to assess baseline characteristics; logistic regression models were performed to determine whether platelet transfusions were associated with adverse outcomes, both before and after matching for ICH score.
RESULTS: 538 non-traumatic ICH patients were investigated. 168 patients were on APT; 71 were excluded. 39 (40%) patients received platelet transfusions and 58 (60%) did not. An overall mortality rate was 9.3% was measured, with 29.9% of patients enduring complications. In the unmatched cohort, patients that received platelet transfusions were more likely to deteriorate (OR 4.7), undergo surgical intervention during their hospital stay (OR 7.2), be discharged with a worse modified Rankin Scale (OR 3.6), and die (OR 6.1). After matching by ICH score, platelet transfusion was not a significant predictor for any negative outcome.
CONCLUSIONS: This is the first analysis of platelet transfusions in ICH patients based on ICH score. For patients on APT, platelet transfusion is not associated with clinical outcomes in an ICH score-matched sample.
PMID: 29330079 [PubMed - as supplied by publisher]
http://ift.tt/2DttBer
Intraoperative flow cytometry enables the differentiation of primary central nervous system lymphoma from glioblastoma.
| Related Articles |
Intraoperative flow cytometry enables the differentiation of primary central nervous system lymphoma from glioblastoma.
World Neurosurg. 2018 Jan 09;:
Authors: Koriyama S, Nitta M, Shioyama T, Komori T, Maruyama T, Kawamata T, Muragaki Y
Abstract
OBJECTIVE: Accurate preoperative and intraoperative differentiation between primary central nervous system lymphoma (PCNSL) and glioblastoma (GBM) is sometimes difficult. Distinguishing between these tumors during surgery is important because surgical treatment is different between the two tumors. In this study, we established a new method of intraoperative differentiation between PCNSL and GBM using intraoperative flow cytometry (iFC), and we retrospectively tested whether iFC was useful for the intraoperative diagnosis of PCNSL and GBM.
METHODS: We analyzed the iFC data of 250 patients, representing 28 PCNSL and 222 GBM, and then evaluated aneuploidy and S-phase population.
RESULTS: Aneuploidy was detected in 54.5% of GBM cases but in only 7.14% of PCNSL cases. Aneuploidy indicated GBM, but it was difficult to distinguish PCNSL from GBM when a tumor had a diploid pattern. Thus, for tumors without aneuploidy, we evaluated the S-phase population: S2, the ratio of the average height of the S-phase to the height of the diploid peak. S2 was significantly higher in PCNSL than in GBM. Based on these results, we established an algorithm for differentiating between PCNSL and GBM using DNA aneuploidy and S2. Finally, comparing this new iFC algorithm and the permanent pathological diagnosis, the sensitivity was 89.3%, the specificity was 93.7%, and the accuracy was 93.2%.
CONCLUSIONS: Therefore, iFC is useful for the intraoperative differentiation between PCNSL and GBM and it aids in intraoperative decision-making within a short time. The accuracy of intraoperative diagnosis of these tumors appears to be higher with the combination of iFC and intraoperative rapid pathological diagnosis.
PMID: 29330078 [PubMed - as supplied by publisher]
http://ift.tt/2DtWG9G
Blood ethanol levels are not related to coagulation changes, as measured by thromboelastography, in traumatic brain injury patients.
| Related Articles |
Blood ethanol levels are not related to coagulation changes, as measured by thromboelastography, in traumatic brain injury patients.
World Neurosurg. 2018 Jan 09;:
Authors: Rao AJ, Laurie Lin A, Hilliard C, Fu R, Lennox T, Barbosa RR, Rowell SE
PMID: 29330077 [PubMed - as supplied by publisher]
http://ift.tt/2mzpKFF
Frontoethmoidal Schwannoma with Exertional Cerebrospinal Fluid Rhinorrhea: a Case Report and Review of the Literature.
| Related Articles |
Frontoethmoidal Schwannoma with Exertional Cerebrospinal Fluid Rhinorrhea: a Case Report and Review of the Literature.
World Neurosurg. 2018 Jan 09;:
Authors: Yoneoka Y, Akiyama K, Seki Y, Hasegawa G, Kakita A
Abstract
BACKGROUND: Frontoethmoidal schwannomas are rare. No case manifesting exertional cerebrospinal fluid (CSF) rhinorrhea has ever been reported to the best of our knowledge.
CASE DESCRIPTION: In this report, we describe an extremely rare case of frontoethmoidal schwannoma extending through the olfactory groove (OG) with exertional CSF rhinorrhea as the initial symptom. A 50-year-old woman was presented to our clinic for frequent nasal discharge on exertion. A postcontrast computed tomographic scan demonstrated heterogeneously enhanced tumor from the anterior cranial fossa to the anterior ethmoid sinus. A gadolinium-enhanced T1-weighted magnetic resonance image revealed a well-defined heterogeneously enhanced tumor situated in the midline anterior cranial fossa and the anterior ethmoid sinus. After the resection, the defect of the right anterior skull base was reconstructed with a fascia graft and adipose tissue taken from the abdomen as well as a pedicle periosteum flap. A histological examination revealed the tumor as schwannoma. Her rhinorrhea completely resolved. She regained sense of smell and taste one month after the operation.
CONCLUSION: According to previous reports, para/peri-OG schwannomas can be divided into four types: subfrontal; nasoethomoidal; frontoethomoidal; and ethomofrontal. Among them, a frontoethomoidal schwannoma can manifest exertional CSF rhinorrhea as an initial symptom.
PMID: 29330076 [PubMed - as supplied by publisher]
http://ift.tt/2FzBy2q
Adipocytes affect castration-resistant prostate cancer cells to develop the resistance to cytotoxic action of NK cells with alterations of PD-L1/NKG2D ligand levels in tumor cells.
| Related Articles |
Adipocytes affect castration-resistant prostate cancer cells to develop the resistance to cytotoxic action of NK cells with alterations of PD-L1/NKG2D ligand levels in tumor cells.
Prostate. 2018 Jan 12;:
Authors: Xu L, Shen M, Chen X, Zhu R, Yang DR, Tsai Y, Keng PC, Chen Y, Lee SO
Abstract
BACKGROUND: Obesity affects prostate cancer (PCa) progression, and the periprostatic adipose tissue adjacent to the prostate is considered a driving force of disease progression. Adipocytes are the main cell population in adipose tissues and their paracrine role contributes to PCa progression, however its implication in modulating immune reactions remains largely unknown. We investigated the adipocyte role in controlling the susceptibility of castration-resistant PCa (CRPC) cells to the cytotoxic action of natural killer (NK) cells.
METHODS: Using primary NK cells as the NK cell source, NK cell cytotoxicities to CRPC cells, either control media treated or adipocyte-conditioned media (CM) treated, were tested in lactate dehydrogenase (LDH) release-based assays. The levels of programmed death receptor ligand (PD-L1) and NK group 2D (NKG2D) ligands in adipocyte CM-treated CRPC cells were analyzed in qPCR analyses. Effects of blocking adipocyte action on altering PD-L1/NKG2D ligand levels and the susceptibility of CRPC cells to NK cell cytotoxicity were investigated.
RESULTS: We found NK cell cytotoxicity to CRPC cells decreases when tumor cells are treated with adipocyte CM associated with PD-L1 and NKG2D ligand level alterations. Further, we discovered that the JAK/Stat3 signaling pathway was responsible for the adipocyte CM effect. Two adipokine molecules, IL-6 and leptin, were shown to be important in activation of the JAK/Stat3 signaling in CRPC cells to modulate the PD-L1/NKG2D ligand level alteration. Adding the inhibitors of JAK/Stat3 signaling or neutralizing antibodies of IL-6 or leptin increased the susceptibility of CRPC cells to NK cell action.
CONCLUSIONS: Blocking the adipocyte effect by inhibiting the IL-6/leptin-JAK/Stat3 signaling axis may enhance NK cell mediated immunity to CRPC cells and this strategy may help to develop future therapeutics to treat obese PCa patients.
PMID: 29330929 [PubMed - as supplied by publisher]
http://ift.tt/2DaGqxv
Prospective trial evaluating the sensitivity and specificity of 3,4-dihydroxy-6-[18F]-fluoro-L-phenylalanine (18F-DOPA) PET and MRI in patients with recurrent gliomas.
| Related Articles |
Prospective trial evaluating the sensitivity and specificity of 3,4-dihydroxy-6-[18F]-fluoro-L-phenylalanine (18F-DOPA) PET and MRI in patients with recurrent gliomas.
J Neurooncol. 2018 Jan 13;:
Authors: Youland RS, Pafundi DH, Brinkmann DH, Lowe VJ, Morris JM, Kemp BJ, Hunt CH, Giannini C, Parney IF, Laack NN
Abstract
Treatment-related changes can be difficult to differentiate from progressive glioma using MRI with contrast (CE). The purpose of this study is to compare the sensitivity and specificity of 18F-DOPA-PET and MRI in patients with recurrent glioma. Thirteen patients with MRI findings suspicious for recurrent glioma were prospectively enrolled and underwent 18F-DOPA-PET and MRI for neurosurgical planning. Stereotactic biopsies were obtained from regions of concordant and discordant PET and MRI CE, all within regions of T2/FLAIR signal hyperintensity. The sensitivity and specificity of 18F-DOPA-PET and CE were calculated based on histopathologic analysis. Receiver operating characteristic curve analysis revealed optimal tumor to normal (T/N) and SUVmax thresholds. In the 37 specimens obtained, 51% exhibited MRI contrast enhancement (M+) and 78% demonstrated 18F-DOPA-PET avidity (P+). Imaging characteristics included M-P- in 16%, M-P+ in 32%, M+P+ in 46% and M+P- in 5%. Histopathologic review of biopsies revealed grade II components in 16%, grade III in 43%, grade IV in 30% and no tumor in 11%. MRI CE sensitivity for recurrent tumor was 52% and specificity was 50%. PET sensitivity for tumor was 82% and specificity was 50%. A T/N threshold > 2.0 altered sensitivity to 76% and specificity to 100% and SUVmax > 1.36 improved sensitivity and specificity to 94 and 75%, respectively. 18F-DOPA-PET can provide increased sensitivity and specificity compared with MRI CE for visualizing the spatial distribution of recurrent gliomas. Future studies will incorporate 18F-DOPA-PET into re-irradiation target volume delineation for RT planning.
PMID: 29330751 [PubMed - as supplied by publisher]
http://ift.tt/2mDH3Fz
Comparable survival using a CMV-matched or a mismatched donor for CMV+ patients undergoing T-replete haplo-HSCT with PT-Cy for acute leukemia: a study of behalf of the infectious diseases and acute leukemia working parties of the EBMT.
| Related Articles |
Comparable survival using a CMV-matched or a mismatched donor for CMV+ patients undergoing T-replete haplo-HSCT with PT-Cy for acute leukemia: a study of behalf of the infectious diseases and acute leukemia working parties of the EBMT.
Bone Marrow Transplant. 2018 Jan 12;:
Authors: Cesaro S, Crocchiolo R, Tridello G, Knelange N, Van Lint MT, Koc Y, Ciceri F, Gülbas Z, Tischer J, Afanasyev B, Bruno B, Castagna L, Blaise D, Mohty M, Irrera G, Diez-Martin JL, Pierelli L, Pioltelli P, Arat M, Delia M, Fagioli F, Ehninger G, Aljurf M, Carella AM, Ozdogu H, Mikulska M, Ljungman P, Nagler A, Styczynski J
Abstract
The role of donor CMV serostatus in the setting of non T-cell depleted haplo-HSCT with post-transplant cyclophosphamide (PT-Cy) has not been specifically addressed so far. Here we analyzed the impact of the donor CMV serological status on the outcome of 983 CMV seropositive (CMV+), acute leukemia patients receiving a first, non T-cell depleted haplo-HSCT registered in the EBMT database. The 1-year NRM was 21.3% (95% CI: 18.4-24.8) and 18.8% (95% CI: 13.8-25.5) in the CMV D+/R+ and D-/R+ pairs, respectively (p = 0.40). Similarly, 1-year OS was 55.1% (95% CI: 50.1-58.0) and 55.7% (95% CI: 48.0-62.8) in the same groups (p = 0.50). The other main outcomes were comparable. No difference in NRM nor OS was observed after stratification for the intensity of conditioning and multivariate anaysis confirmed the lack of significant association with NRM or OS. In conclusion, the choice of a CMV-seronegative donor did not impair early survival of CMV-seropositive patients with acute leukemia after a first, non T-cell depleted haploidentical HSCT and PT-Cy among this series of 983 consecutive patients. Future research may focus on the assessment of the hierarchy of all the donor variables.
PMID: 29330396 [PubMed - as supplied by publisher]
http://ift.tt/2mBRfhL
Minimal/measurable residual disease in AML: consensus document from ELN MRD Working Party.
| Related Articles |
Minimal/measurable residual disease in AML: consensus document from ELN MRD Working Party.
Blood. 2018 Jan 12;:
Authors: Schuurhuis GJ, Heuser M, Freeman S, Béné MC, Buccisano F, Cloos J, Grimwade D, Haferlach T, Hills RK, Hourigan CS, Jorgensen JL, Kern W, Lacombe F, Maurillo L, Preudhomme C, van der Reijden BA, Thiede C, Venditti A, Vyas P, Wood BL, Walter RB, Döhner K, Roboz GJ, Ossenkoppele GJ
Abstract
Measurable residual disease (MRD, previously termed minimal residual disease) is an independent, post-diagnosis, prognostic indicator in acute myeloid leukemia (AML) that is important for risk stratification and treatment planning, in conjunction with other well-established clinical, cytogenetic, and molecular data assessed at diagnosis. MRD can be evaluated using a variety of multi-parameter flow cytometry (MFC) and molecular protocols but, to date, these approaches have not been qualitatively or quantitatively standardized, making their use in clinical practice challenging. The objective of this work was to identify key clinical and scientific issues in the measurement and application of MRD in AML, to achieve consensus on these issues, and to provide guidelines for the current and future use of MRD in clinical practice. The work was accomplished over two years, during four meetings by a specially designated MRD working party of the European LeukemiaNet (ELN). The group included 24 faculty with expertise in AML hematopathology, molecular diagnostics, clinical trials, and clinical medicine, from 19 institutions in Europe and the USA. The manuscript is dedicated to the memory of our esteemed colleague David Grimwade, a pioneer in the field of MRD in AML, and an active participant in the present work.
PMID: 29330221 [PubMed - as supplied by publisher]
http://ift.tt/2mDiKHC
Neuroendocrine Tumor Heterogeneity Adds Uncertainty to the World Health Organization 2010 Classification: Real-World Data from the Spanish Tumor Registry (R-GETNE).
| Related Articles |
Neuroendocrine Tumor Heterogeneity Adds Uncertainty to the World Health Organization 2010 Classification: Real-World Data from the Spanish Tumor Registry (R-GETNE).
Oncologist. 2018 Jan 12;:
Authors: Nuñez-Valdovinos B, Carmona-Bayonas A, Jimenez-Fonseca P, Capdevila J, Castaño-Pascual Á, Benavent M, Pi Barrio JJ, Teule A, Alonso V, Custodio A, Marazuela M, Segura Á, Beguiristain A, Llanos M, Martinez Del Prado MP, Diaz-Perez JA, Castellano D, Sevilla I, Lopez C, Alonso T, Garcia-Carbonero R
Abstract
BACKGROUND: 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.
PMID: 29330208 [PubMed - as supplied by publisher]
http://ift.tt/2mB6aIS
Clinical log data analysis for assessing the accuracy of the CyberKnife fiducial-free lung tumor tracking system.
| Related Articles |
Clinical log data analysis for assessing the accuracy of the CyberKnife fiducial-free lung tumor tracking system.
Pract Radiat Oncol. 2017 Nov 04;:
Authors: Nakayama M, Nishimura H, Mayahara H, Nakamura M, Uehara K, Tsudou S, Harada A, Akasaka H, Sasaki R
Abstract
PURPOSE: The CyberKnife Xsight Lung Tracking (XLT) and 1-View tracking systems can synchronize beam targeting to a visible lung tumor with respiratory motion during irradiation without requiring internal fiducial markers. The systems use a correlation model that relates external marker positions to tumor positions as well as a prediction model that predicts the target's future position. In this study, the correlation and prediction model uncertainties related to the CyberKnife fiducial-free tumor tracking system were evaluated using clinical log data.
METHODS AND MATERIALS: Data from 211 fractions in 42 patients with lung tumors were analyzed. Log files produced by the CyberKnife Synchrony system were acquired after each treatment; the mean correlation and prediction errors for each patient were calculated. Additionally, we examined the tracking tumor-related parameters and analyzed the relationships between the model errors and tracking tumor-related parameters.
RESULTS: The overall means ± standard deviations (SDs) of the correlation errors were 0.70 ± 0.43 mm, 0.36 ± 0.16 mm, 0.44 ± 0.22 mm, and 0.95 ± 0.43 mm for the superoinferior (SI), left-right (LR), anteroposterior (AP), and radial directions, respectively. The overall means ± SDs of the prediction errors were 0.13 ± 0.11 mm, 0.03 ± 0.02 mm, 0.03 ± 0.02 mm, and 0.14 ± 0.11 mm for the SI, LR, AP, and radial directions, respectively. There were no significant differences in these errors between the XLT and 1-View tracking methods. The tumor motion amplitude was moderately associated with the correlation error and strongly related to the prediction error in the SI and radial directions.
CONCLUSIONS: Clinical log data analysis can be used to determine the necessary margin sizes in treatment plans to compensate for correlation and prediction errors in the CyberKnife fiducial-free lung tumor tracking system. The tumor motion amplitude may facilitate margin determination.
PMID: 29329997 [PubMed - as supplied by publisher]
http://ift.tt/2mCd6ph
The Future of LGBT Cancer Care: Practice and Research Implications.
| Related Articles |
The Future of LGBT Cancer Care: Practice and Research Implications.
Semin Oncol Nurs. 2018 Jan 09;:
Authors: Rice D, Schabath MB
Abstract
OBJECTIVES: To synthesize state of the knowledge collected in this volume and propose future directions for lesbian, gay, bisexual and transgender (LGBT) cancer practice, education, research, and advocacy.
DATA SOURCES: Current and extant literature.
CONCLUSION: Health care disparities that are known but not yet fully elucidated in the LGBT population carry into the cancer arena. Substantially more effort is required in the domains of patient care, nursing practice, nursing and patient-facing services provider education, patient education, nursing and interprofessional research, governmental commitment, professional organization action, and patient advocacy.
IMPLICATIONS FOR NURSING PRACTICE: Professional nurses are committed to the uniqueness of each individual and respect and value the health and well-being of each individual. To that commitment, oncology nurses are positioned to advance the research in the field, which will help to clarify the issues and concerns related to LGBT cancer, address the health care inequities in this important population, and lead to improved outcomes for all.
PMID: 29329960 [PubMed - as supplied by publisher]
http://ift.tt/2mC9KTs
Cancer immunotherapy beyond immune checkpoint inhibitors.
| Related Articles |
Cancer immunotherapy beyond immune checkpoint inhibitors.
J Hematol Oncol. 2018 Jan 12;11(1):8
Authors: Marin-Acevedo JA, Soyano AE, Dholaria B, Knutson KL, Lou Y
Abstract
Malignant cells have the capacity to rapidly grow exponentially and spread in part by suppressing, evading, and exploiting the host immune system. Immunotherapy is a form of oncologic treatment directed towards enhancing the host immune system against cancer. In recent years, manipulation of immune checkpoints or pathways has emerged as an important and effective form of immunotherapy. Agents that target cytotoxic T lymphocyte-associated molecule-4 (CTLA-4), programmed cell death receptor-1 (PD-1), and programmed cell death ligand-1 (PD-L1) are the most widely studied and recognized. Immunotherapy, however, extends beyond immune checkpoint therapy by using new molecules such as chimeric monoclonal antibodies and antibody drug conjugates that target malignant cells and promote their destruction. Genetically modified T cells expressing chimeric antigen receptors are able to recognize specific antigens on cancer cells and subsequently activate the immune system. Native or genetically modified viruses with oncolytic activity are of great interest as, besides destroying malignant cells, they can increase anti-tumor activity in response to the release of new antigens and danger signals as a result of infection and tumor cell lysis. Vaccines are also being explored, either in the form of autologous or allogenic tumor peptide antigens, genetically modified dendritic cells that express tumor peptides, or even in the use of RNA, DNA, bacteria, or virus as vectors of specific tumor markers. Most of these agents are yet under development, but they promise to be important options to boost the host immune system to control and eliminate malignancy. In this review, we have provided detailed discussion of different forms of immunotherapy agents other than checkpoint-modifying drugs. The specific focus of this manuscript is to include first-in-human phase I and phase I/II clinical trials intended to allow the identification of those drugs that most likely will continue to develop and possibly join the immunotherapeutic arsenal in a near future.
PMID: 29329556 [PubMed - in process]
http://ift.tt/2mD4FtQ
Assessment of vestibular-evoked myogenic potentials and video head impulse test in type 2 diabetes mellitus patients with or without polyneuropathy.
| Related Articles |
Assessment of vestibular-evoked myogenic potentials and video head impulse test in type 2 diabetes mellitus patients with or without polyneuropathy.
Eur Arch Otorhinolaryngol. 2018 Jan 13;:
Authors: Kalkan M, Bayram A, Gökay F, Cura HS, Mutlu C
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.
PMID: 29330601 [PubMed - as supplied by publisher]
http://ift.tt/2DbWQFb
The impact of acoustic neuroma on long-term quality-of-life outcomes in the United Kingdom.
| Related Articles |
The impact of acoustic neuroma on long-term quality-of-life outcomes in the United Kingdom.
Eur Arch Otorhinolaryngol. 2018 Jan 12;:
Authors: Lodder WL, van der Laan BFAM, Lesser TH, Leong SC
Abstract
OBJECTIVE: To quantify the impact of acoustic neuroma on the quality-of-life (QOL) patients in the United Kingdom.
STUDY DESIGN: Online questionnaire survey.
PATIENTS: Members of the British Acoustic Neuroma Association received PANQOL questionnaires.
RESULTS: Of the 880 BANA members contacted, 397 (45.1%) responded, although only 359 had complete datasets for analysis. Composite QOL scores were as follows: for microsurgery 58 (SD 35), for radiotherapy 56 (SD18), for combination of surgery and radiotherapy 49 (SD 14), and for the observation group 54 (SD 20). No statistical significance with ANOVA (p = 0.532). Mean (SD) composite QOL scores were as follows: for follow-up < 6 52 (SD 18), for follow-up 6-10 55 (SD 20) and follow-up > 10 years 65 (SD 45). Overall, these values were significantly different compared by ANOVA (p < 0.001). Patients with facial paralysis showed no statistical significant differences between the different treatment groups.
CONCLUSIONS: Short- (< 6 years) and long-term (> 10 years) QOL outcomes show no significant differences between the different treatment groups.
PMID: 29330600 [PubMed - as supplied by publisher]
http://ift.tt/2D2k9h4
Infraorbital foramen localization in orbitozygomatic fractures: a CT study with intraoperative finding.
| Related Articles |
Infraorbital foramen localization in orbitozygomatic fractures: a CT study with intraoperative finding.
Eur Arch Otorhinolaryngol. 2018 Jan 12;:
Authors: El-Anwar MW, Sweed AH
Abstract
OBJECTIVE: The aim of this study was to assess the infraorbital foramen (IOF) using CT in patients with Zygomaticomaxillary complex (ZMC) fractures (midface fracture).
PATIENTS AND METHODS: This prospective study was carried out on 49 patients had ZMC fractures (98 sides) and 27 patients (54 sides) with craniomaxillofacial fractures rather than fractured ZMC as a control. Using CT, position of IOF was documented on 3D view in relation to inferior orbital rim, tooth root relation and finally with a novel imaginary line passing between anterior nasal spine and whitnall tubercle.
RESULTS: Position of IOF had fixed anatomical landmark: just lateral to a line drawn between the anterior nasal spine to whitnall tubercle (clinically between nasal tip-lateral canthal ligament) and lateral to vertical plane to root of maxillary canine also with variable distance from inferior orbital rim ranged from 4.56 to 18.03 mm with a mean of 7.9 ± 2.447 mm.
CONCLUSION: Even though ZMC fractures disturb the anatomical location of the ZMC bones, there are still preserved reliable fixed landmarks maxillofacial surgeons can depend on to identify and preserve ION.
PMID: 29330599 [PubMed - as supplied by publisher]
http://ift.tt/2D1xiHs
Satisfaction in rhinoplasty: the possible impact of anxiety and functional outcome.
| Related Articles |
Satisfaction in rhinoplasty: the possible impact of anxiety and functional outcome.
Eur Arch Otorhinolaryngol. 2018 Jan 12;:
Authors: Koybasi S, Bicer YO, Seyhan S, Kesgin S
Abstract
BACKGROUND: Rhinoplasty is a complex but commonly applied surgical procedure. Patient satisfaction is the least discussed but one of the most important determinants of surgical success.
OBJECTIVES: Evaluation of the patient satisfaction together with surgeon satisfaction were the main goals of this study. The roles of anxiety, gender, age and follow-up period were also studied.
PATIENTS AND METHODS: 53 eligible patients operated by the first two authors within the previous 2 years were enrolled in the study. The medical records were reviewed for demographic data as well as the details of the surgical procedure. Functional and esthetic satisfactions of the patients were evaluated by VAS and ROE respectively. Surgeon satisfaction was evaluated by VAS in crosswise manner. Anxiety was measured by STAI_s and STAI_t scales.
RESULTS: The analysis concerning esthetic results as well as functional results did not reveal any significant difference between the two surgeons (p = 0.132, p = 0.43 respectively). ROE scores were significantly different among patients with "good" and "very good" functional results. The difference between surgeon satisfaction and patient satisfaction was found to be insignificant (p = 0.273). Correlation analysis yielded a positive correlation between STAI_I and STAI_II (Pearson r = 0.335, p = 0.014) but not between STAI scores and ROE scores. Moreover, there was no relation between anxiety scores and the functional results. Likely, gender as well as age, follow-up, and surgical technique were not found to have any effect on patient satisfaction either.
CONCLUSION: Patient satisfaction is preferential in rhinoplasty. In our patient series, patient satisfaction was shown to be correlated with functional outcome but not with surgeon satisfaction. Anxiety was not found to have a significant impact on results of rhinoplasty. Our results should be interpreted cautiously keeping in mind that our patients' primary drive for rhinoplasty was functional.
PMID: 29330598 [PubMed - as supplied by publisher]
http://ift.tt/2Dfw0f2
Inpatient treatment of patients with idiopathic sudden sensorineural hearing loss: a population-based healthcare research study.
| Related Articles |
Inpatient treatment of patients with idiopathic sudden sensorineural hearing loss: a population-based healthcare research study.
Eur Arch Otorhinolaryngol. 2018 Jan 12;:
Authors: Heuschkel A, Geißler K, Boeger D, Buentzel J, Esser D, Hoffmann K, Jecker P, Mueller A, Radtke G, Guntinas-Lichius O
Abstract
PURPOSE: The aim was to determine inpatient treatment rates of idiopathic sudden sensorineural hearing loss (ISSNHL) with focus on diagnostics, treatment, and outcome.
METHODS: A retrospective population-based study in the federal state Thuringia in 2011 and 2012 was performed on all 490 inpatients (51% females, median age: 60 years) treated for ISSNHL (Median duration: 7 days). The association between analyzed parameters and the probability of recovery was tested using univariable and multivariable statistics.
RESULTS: The inpatient treatment rate for ISSNHL was 11.23 per 100,000. 172 patients (35%) had an outpatient treatment prior to inpatient treatment. For pure-tone audiometry of the three most affected frequencies (3PTAmax), the initial median hearing loss was 66.67 dB, the median absolute hearing gain ΔPTAabs was 10.0 dB, and the median relative hearing gain in relation with the contralateral side ΔPTArel contral was 30.86%. 51% of the patients reached a ΔPTAabs of ≥ 10 dB. About 2 of 5 patients recovered to a ΔPTArel contral ≥ 50% or reached ≤ 10 dB of contralateral ear. The multivariate analysis revealed that an ISSNHL on the left side [Hazard ratio (HR) = 1.6.88; confidence interval (CI) = 1.161-2.454], no down-sloping audiogram type (HR = 2.016; CI = 1.391-2.921), and no prior outpatient prednisolone treatment (HR = 2.374; CI = 1.505-3.745) were independent factors associated with better recovery (ΔPTAabs ≥ 10 dB).
CONCLUSION: Inpatient treatment of ISSNHL is variable in daily practice. The population-based recovery rate was worse than reported in clinical trials. More standardization and clearer criteria for outpatient, inpatient, and salvage therapy are needed.
PMID: 29330597 [PubMed - as supplied by publisher]
http://ift.tt/2FApbmU
Letter to the Editor regarding "Use of both anterograde and retrograde internal mammary vessels in the bipedicled deep inferior epigastric perforator flap for unilateral breast reconstruction".
| Related Articles |
Letter to the Editor regarding "Use of both anterograde and retrograde internal mammary vessels in the bipedicled deep inferior epigastric perforator flap for unilateral breast reconstruction".
J Plast Reconstr Aesthet Surg. 2017 Dec 27;:
Authors: See JL, Przybylska J, MacLennan L, Malata CM
PMID: 29329744 [PubMed - as supplied by publisher]
http://ift.tt/2EFRgrs
Assessment of vestibular-evoked myogenic potentials and video head impulse test in type 2 diabetes mellitus patients with or without polyneuropathy.
| Related Articles |
Assessment of vestibular-evoked myogenic potentials and video head impulse test in type 2 diabetes mellitus patients with or without polyneuropathy.
Eur Arch Otorhinolaryngol. 2018 Jan 13;:
Authors: Kalkan M, Bayram A, Gökay F, Cura HS, Mutlu C
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.
PMID: 29330601 [PubMed - as supplied by publisher]
http://ift.tt/2DbWQFb
Association of Homocysteine with Aysmptomatic Intracranial and Extracranial Arterial Stenosis in Hypertension Patients.
| Related Articles |
Association of Homocysteine with Aysmptomatic Intracranial and Extracranial Arterial Stenosis in Hypertension Patients.
Sci Rep. 2018 Jan 12;8(1):595
Authors: Wang Y, Zhang J, Qian Y, Tang X, Ling H, Chen K, Li Y, Gao P, Zhu D
Abstract
Elevated plasma homocysteine (Hcy) is suggested as an independent risk factor for stroke. We aimed to investigate the association of Hcy concentration with intracranial atherosclerosis (ICAS) and extracranial AS (ECAS) in hypertensive patients without stroke in Chinese population and to explore modified effect of methylenetetrahydrofolate reductase (MTHFR) C677T on their relationship. The stenosis of intracranial and extracranial arteries were evaluated in a total of 929 subjects through computerized tomographic angiography (CTA) from aortic arch to the skull base. Hcy concentration showed significantly association with both ICAS (OR: 1.105; 95% CI: 1.057-1.155) and ECAS (OR: 1.096; 95% CI: 1.047-1.146) for 1 µmol/L increment in Hcy. Meanwhile, hyperhomocysteinemia (≥15 µmol/L) was also displayed association with ICAS (OR: 1.587; 95% CI: 1.029-2.446) and ECAS (OR: 2.164; 95% CI: 1.392-3.364) after fully adjustment. Furthermore, in the subgroup analysis, such association remained significant only in the subjects that were younger, with normal renal function and with MTHFR 677 C allele. Our study showed the significant association of Hcy with ECAS and ICAS in asymptomatic hypertension patients. Hcy played a universal effect on the cervico-cerebral atherosclerosis. Such association was modified by the MTHFR C677T genotype.
PMID: 29330520 [PubMed - in process]
http://ift.tt/2FznJRF
Frontoethmoidal Schwannoma with Exertional Cerebrospinal Fluid Rhinorrhea: a Case Report and Review of the Literature.
| Related Articles |
Frontoethmoidal Schwannoma with Exertional Cerebrospinal Fluid Rhinorrhea: a Case Report and Review of the Literature.
World Neurosurg. 2018 Jan 09;:
Authors: Yoneoka Y, Akiyama K, Seki Y, Hasegawa G, Kakita A
Abstract
BACKGROUND: Frontoethmoidal schwannomas are rare. No case manifesting exertional cerebrospinal fluid (CSF) rhinorrhea has ever been reported to the best of our knowledge.
CASE DESCRIPTION: In this report, we describe an extremely rare case of frontoethmoidal schwannoma extending through the olfactory groove (OG) with exertional CSF rhinorrhea as the initial symptom. A 50-year-old woman was presented to our clinic for frequent nasal discharge on exertion. A postcontrast computed tomographic scan demonstrated heterogeneously enhanced tumor from the anterior cranial fossa to the anterior ethmoid sinus. A gadolinium-enhanced T1-weighted magnetic resonance image revealed a well-defined heterogeneously enhanced tumor situated in the midline anterior cranial fossa and the anterior ethmoid sinus. After the resection, the defect of the right anterior skull base was reconstructed with a fascia graft and adipose tissue taken from the abdomen as well as a pedicle periosteum flap. A histological examination revealed the tumor as schwannoma. Her rhinorrhea completely resolved. She regained sense of smell and taste one month after the operation.
CONCLUSION: According to previous reports, para/peri-OG schwannomas can be divided into four types: subfrontal; nasoethomoidal; frontoethomoidal; and ethomofrontal. Among them, a frontoethomoidal schwannoma can manifest exertional CSF rhinorrhea as an initial symptom.
PMID: 29330076 [PubMed - as supplied by publisher]
http://ift.tt/2FzBy2q
Effect of individualized distal femoral valgus resection angle in primary total knee arthroplasty: A systematic review and meta-analysis involving 1300 subjects.
| Related Articles |
Effect of individualized distal femoral valgus resection angle in primary total knee arthroplasty: A systematic review and meta-analysis involving 1300 subjects.
Int J Surg. 2018 Jan 09;:
Authors: Zhou K, Ling T, Xu Y, Li J, Yu H, Wang H, Zhou Z, Pei F
Abstract
BACKGROUND: Proper limb alignment and implant positioning are important for successful total knee arthroplasty (TKA). Whether any differences exist in restoration of limb alignment for valgus knees between fixed and individual femoral valgus correction angle (VCA) for distal femoral resection remains unknown.
METHODS: The PubMed, Medline, Embase, and Wangfang databases were searched to identify studies comparing individualized VCA and fixed VCA in the distal femoral valgus resection. The primary outcomes were the mechanical femorotibial angle (MFT angle) and the proportion of postoperative alignment deviation within ±3°. The secondary outcomes were femoral valgus correction angle (VCA), component angle (α angle and β angle).
RESULTS: Six studies with 1167 TKAs were analyzed quantitatively. The coronal limb alignments in individualized group were closer to neutral than fixed group with a mean 0.77° difference (95% CI, -1.43 to -0.11; P = .022; I2 = 71.0%). Moreover, there were more patients' postoperative alignment deviation within neutral ±3° in the individualized group (RR, 1.23; 95% CI, 1.09 to 1.38; P = .00; I2 = 36.4%). The α angle were closer to neutral in the individualized group, and there's 1.2° more deviation from neutral in the fixed group (95% CI, 0.99 to 1.41; P = .00; I2 = 0%). No difference was found in the β angle between groups (WMD, 0.85; 95% CI, -0.09 to 1.78; P = .075; I2 = 88.3%).
CONCLUSIONS: This systematic review and meta-analysis demonstrated that the individualized VCA for distal femoral resection could enhance the accuracy of postoperative limb alignment and femoral component alignment in the coronal plane. However, further high-quality RCTs and well-designed trials are still needed.
PMID: 29329788 [PubMed - as supplied by publisher]
http://ift.tt/2mu9ogD
Outcomes of multisegmental transforaminal enlarged decompression plus posterior pedicle screw fixation for multilevel lumbar spinal canal stenosis associated with lumbar instability.
| Related Articles |
Outcomes of multisegmental transforaminal enlarged decompression plus posterior pedicle screw fixation for multilevel lumbar spinal canal stenosis associated with lumbar instability.
Int J Surg. 2018 Jan 09;:
Authors: Sun C, Tian WJ, Liu HX, Guan PG
Abstract
PURPOSE: The aim of this study was to evaluate the clinical and radiologic results of multisegmental transforaminal enlarged decompression (TED) plus posterior pedicle screw fixation in the treatment of multilevel lumbar spinal canal stenosis (LSCS) with lumbar instability (MLSCSI).
METHODS: 113 patients with MLSCSI underwent surgery were recruited in this study. All patients were suffering from symptoms typical of degenerative LSCS and treated with either TED plus fusion (TEDF group) or conventional laminectomy plus fusion (CLF group). Clinical and radiologic parameters were evaluated. The clinical data, including Visual Analog Scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), operative time, intraoperative blood loss, postoperative drainage, hospital stay, and the rate of postoperative complications, were assessed. With respect to radiologic parameters, mean disc height (MDH) and lumbar lordotic angle (LLA) were measured using plain radiographs. Patient satisfaction was evaluated according to the North American Spine Society (NASS) Outcome Questionnaire.
RESULTS: No serious complications occurred during the follow-up. The operative time was significantly shorter for TEDF group than for CLF group, and similar results were found with regard to the blood loss and postoperative drainage (p < .05). The improvements in ODI, leg and back VAS scores were observed in both groups after surgery and follow-up (P < .05). In the last follow-up, ODI and back VAS scores in TEDF group were significantly higher than those in CLF group (P < .05). Regarding radiologic variants, MDH and LLA were improved after operation for 3 months (P > .05) and were all well maintained in the final follow-up in both groups. Patients in TEDF group were more satisfied than patients in the CLF group (85.2% vs 76.9%, p = .092).
CONCLUSIONS: Satisfactory clinical and radiological outcomes can be achieved with the use of multisegmental TED plus lumbar fusion for the treatment of MLSCSI. This technique can reduce surgically induced instability and obviously improve the symptoms and signs of the patients, suggesting a safe and effective therapeutic procedure for MLSCSI.
PMID: 29329787 [PubMed - as supplied by publisher]
http://ift.tt/2D4eaIR
Clinicopathological and prognostic significance of lymphocyte to monocyte ratio in patients with gastric cancer: A meta-analysis.
| Related Articles |
Clinicopathological and prognostic significance of lymphocyte to monocyte ratio in patients with gastric cancer: A meta-analysis.
Int J Surg. 2018 Jan 09;:
Authors: Ma JY, Liu Q
Abstract
BACKGROUND: Recently, the lymphocyte-to-monocyte ratio (LMR) has been reported to be a prognostic factor in multiple malignancies. The current study was designed to assess the prognostic value of pretreatment LMR in gastric cancer (GC).
METHODS: MEDLINE, EMBASE, Cochrane, and CNKI databases were searched until April 2017. Eligible articles were defined as studies assessing the prognostic role of pretreatment LMR in GC. Pooled hazard ratios (HRs) for overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) were calculated using fixed-effects or random-effects models.
RESULTS: A total of six studies comprising 4908 patients were included in the study. Pooled results showed that low LMR was significantly associated with decreased OS (HR: 0.66, 95% confidence interval [CI]: 0.54-0.82, p < .001), but not with poor DFS/RFS (HR: 0.71, 95% CI: 0.38-1.32, p = .004). The unfavorable prognostic impact of low LMR on OS was observed in patients of different disease stages and cut-off values. Moreover, low LMR was significantly related to age (>median), gender (male), CEA (>5 ng/ml), tumor size (>3 cm), TNM stage (III-IV), lymph node metastasis, and distant metastasis.
CONCLUSIONS: Low pretreatment LMR may be a significant prognostic biomarker for poor OS in patients with GC.
PMID: 29329786 [PubMed - as supplied by publisher]
http://ift.tt/2CZlLYZ
Gongylonema pulchrum infection in the human oral cavity: A case report and literature review.
| Related Articles |
Gongylonema pulchrum infection in the human oral cavity: A case report and literature review.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 Dec 08;:
Authors: Xiaodan L, Zhensheng W, Ying H, Hongwei L, Jianqiu J, Peiru Z, Sha S, Zhimin Y
Abstract
Gongylonema infection is a zoonotic disease occurring throughout the world and is mainly caused by consumption of contaminated water and raw food. Adult Gongylonema worms can exist as parasites in the human body for up to 10 years and cause symptoms of local irritation in the oral cavity, esophagus, and pharynx. Herein, we report a rare case in which live Gongylonema pulchrum was detected and extracted from the oral cavity of a woman. The pathogen was confirmed as G. pulchrum on the basis of microscopic examination and morphologic analysis. The patient's symptoms resolved immediately after surgical removal of the parasite, and the patient has been advised not to drink water that has not been boiled and to avoid consuming unwashed raw vegetables.
PMID: 29329982 [PubMed - as supplied by publisher]
http://ift.tt/2D17xHj
Early and Locally Advanced Metaplastic Breast Cancer: Presentation and Survival by Receptor Status in Surveillance, Epidemiology, and End Results (SEER) 2010-2014.
| Related Articles |
Early and Locally Advanced Metaplastic Breast Cancer: Presentation and Survival by Receptor Status in Surveillance, Epidemiology, and End Results (SEER) 2010-2014.
Oncologist. 2018 Jan 12;:
Authors: Schroeder MC, Rastogi P, Geyer CE, Miller LD, Thomas A
Abstract
BACKGROUND: 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.
PMID: 29330212 [PubMed - as supplied by publisher]
http://ift.tt/2r7NJAC
Multifunctional hybrid graphene oxide for circulating tumor cell isolation and analysis.
| Related Articles |
Multifunctional hybrid graphene oxide for circulating tumor cell isolation and analysis.
Adv Drug Deliv Rev. 2018 Jan 09;:
Authors: PramaniK A, Jones S, Gao Y, Sweet C, Vangara A, Begum S, Ray PC
Abstract
Even in 21st century, >90% cancer-associated deaths are caused by metastatic disease. Circulating tumor cells (CTCs), which circulate in the blood stream after release from primary tumors, extravasate and form fatal metastases in different organs. Several clinical trials indicate that CTCs can be used as a liquid biopsy of tumors for early diagnosis of cancers. Since CTCs are extremely rare and exhibit heterogeneous biology due to epithelial-mesenchymal transition (EMT), oncologists continue to face enormous challenges in using CTCs as a true "liquid biopsy" for cancer patients. Recent advancements in nanoscience allow us to design nano-architectures with the capability of targeted CTCs isolation and identification. In the current review, we discuss contribution from different groups on the development of graphene oxide based nanoarchitecture for effective isolation and accurate identification of CTCs from whole blood. In the last few years, using zero-dimensional (0D), two dimensional (2D) and three dimensional (3D) multifunctional hybrid graphene oxide (GO), different types of nanoarchitectures have been designed. These nanoarchitectures represent a highly powerful platform for CTC diagnosis. We discuss the major design criteria that have been used to develop hybrid GO nanoarchitectures for selective capture and accurate identification of heterogeneous CTCs from whole blood. At the end, we conclude with the promises, major challenges, and prospect to clinically translate the identification of CTCs using GO based nanotechnology.
PMID: 29329995 [PubMed - as supplied by publisher]
http://ift.tt/2muHNf6
Prospects for chimeric antigen receptor-modified T cell therapy for solid tumors.
| Related Articles |
Prospects for chimeric antigen receptor-modified T cell therapy for solid tumors.
Mol Cancer. 2018 Jan 12;17(1):7
Authors: Zhang E, Gu J, Xu H
Abstract
The potential for adoptive cell immunotherapy as a treatment against cancers has been demonstrated by the remarkable response in some patients with hematological malignancies using autologous T cells endowed with chimeric antigen receptors (CARs) specific for CD19. Clinical efficacy of CAR-T cell therapy for the treatment of solid tumors, however, is rare due to physical and biochemical factors. This review focuses on different aspects of multiple mechanisms of immunosuppression in solid tumors. We characterize the current state of CAR-modified T cell therapy and summarize the various strategies to combat the immunosuppressive microenvironment of solid tumors, with the aim of promoting T cell cytotoxicity and enhancing tumor cell eradication.
PMID: 29329591 [PubMed - in process]
http://ift.tt/2r3dwdb
The use of eculizumab in gemcitabine induced thrombotic microangiopathy.
| Related Articles |
The use of eculizumab in gemcitabine induced thrombotic microangiopathy.
BMC Nephrol. 2018 Jan 12;19(1):9
Authors: Krishnappa V, Gupta M, Shah H, Das A, Tanphaichitr N, Novak R, Raina R
Abstract
BACKGROUND: Thrombotic microangiopathy (TMA) secondary to gemcitabine therapy (GiTMA) is a very rare pathology that carries a poor prognosis, with nearly half of the cases progressing to end stage renal disease. GiTMA is most commonly associated with adenocarcinomas, most notably pancreatic cancers. The mainstay of management is withdrawal of the offending drug and supportive care. Plasmapheresis has a limited role and hemodialysis may help in the management of fluid overload secondary to renal failure. Furthermore, a C5 inhibitor, eculizumab, has been successfully used in the treatment of GiTMA.
CASE PRESENTATION: A 64-year-old Caucasian female with history of pancreatic adenocarcinoma on gemcitabine chemotherapy presented with signs and symptoms of fluid overload and was found to have abnormal kidney function. Her BP was 195/110 mmHg, serum creatinine 4.48 mg/dl, hemoglobin 8.2 g/dl, platelets 53 × 103/cmm, lactate dehydrogenase 540 IU/L, and was found to have schistocytes on blood film. A diagnosis of TMA secondary to gemcitabine therapy was suspected. Hemodialysis for volume overload and daily plasmapheresis were initiated. After six days of plasmapheresis, renal function did not improve. Further work up revealed ADAMTS 13 activity >15%, low C3, and stool culture and Shiga-toxin PCR were negative. Renal biopsy was consistent with TMA. Gemcitabine was discontinued, but renal function failed to improve and eculizumab therapy was considered due to suspicion of aHUS. Serum creatinine >2.26 mg/dl and a platelet count of >/= 30 × 109/L is highly suggestive of aHUS, while TTP is more likely when creatinine is <2.26 mg/dl and platelet count of <30 × 109/L. She received intravenous eculizumab for eight months, which resulted in significant improvement of renal function. Other markers of hemolysis, namely LDH and bilirubin, also rapidly improved following eculizumab therapy. Plasmapheresis and hemodialysis were discontinued after two and eight weeks of initiation respectively.
CONCLUSION: Chemotherapy induced TMA is very rare and requires a high index of clinical suspicion for timely diagnosis. Discontinuation of the offending drug and supportive care is the main stay of treatment; however, eculizumab has been shown to be beneficial in GiTMA. Further research is required to validate this approach.
PMID: 29329518 [PubMed - in process]
http://ift.tt/2mxm1Y6
The Pathophysiological Basis and Surgical Management of Ranula are Established: Reply.
| Related Articles |
The Pathophysiological Basis and Surgical Management of Ranula are Established: Reply.
World J Surg. 2018 Jan 12;:
Authors: Kokong D, Iduh A, Chukwu I, Mugu J, Nuhu S, Augustine S
PMID: 29330593 [PubMed - as supplied by publisher]
http://ift.tt/2r6TlLa
Otolaryngology/head and neck region manifestations of Brucella
Objectives/Hypothesis
Patients with Brucella infection present with nonspecific symptoms originating from different organs. In this study, we investigated the manifestations involving principally the otolaryngology/head and neck region.
Study Design
Retrospective cohort chart review.
Methods
A retrospective analysis of patients diagnosed with brucellosis in a tertiary medical center. Medical records of 55 patients treated for positive Brucella blood cultures between 2007 and 2016 were analyzed. Clinical manifestations localized to the otolaryngology/head and neck region were evaluated.
Results
Most patients (78%) in our study group lived in rural areas. There was an almost equal gender distribution and a wide age range (2–77 years). Nonspecific symptoms, including fever (71%), fatigue (31%), weight loss (20%), and night sweats (32.7%) were the most common. Of the specific organ systems affected by Brucella, the osteoarthritic system was most commonly infected (45.5%). Three patients (5.5%) presented with predominantly localized otolaryngology/head and neck region symptoms, consisting of necrotic lymphadenopathy or a thyroid abscess. All patients underwent drainage procedures, and the diagnosis was confirmed by positive blood and pus cultures. Complete resolution was achieved with prolonged antibiotic treatment.
Conclusions
Brucella infection should be suspected in patients with nonspecific constitutional symptoms associated with neck lymphadenopathy or thyroid abscess, especially in those living in rural areas. A high index of suspicion is mandatory for proper diagnosis and treatment. Formal drainage and prolonged antibiotic treatments are required. We strongly recommend simple drainage and not excision as the mainstay of surgical treatment.
Level of Evidence
4. Laryngoscope, 2018
http://ift.tt/2DfNeJp
Εγγραφή σε:
Αναρτήσεις (Atom)