Head and Neck Diseases by Alexandros G.Sfakianakis: 02/04/18

Κυριακή 4 Φεβρουαρίου 2018

Subcutaneous methotrexate in patients with moderate to severe psoriasis: a critical appraisal

Summary

Aim

Warren et al¹ set out to assess the effect of an intensified dosing schedule of subcutaneous methotrexate in patients with moderate to severe chronic plaque psoriasis.

Setting and design

This is a prospective, double-blind, randomised (3:1), placebo-controlled study, conducted across 16 centres in Germany, France, the Netherlands, and the UK.

Study exposure

Methotrexate-naïve adults with a diagnosis of moderate to severe chronic plaque psoriasis for at least 6 months before baseline were randomly assigned to receive weekly subcutaneous injections of either methotrexate at a starting dose of 17.5 mg, or placebo for 16 weeks (first phase).Dose escalation to 22.5 mg/week was implemented after 8 weeks if patients did not achieve PASI 50. Treatment was combined with folic acid 5 mg/week. The first phase of the study was followed by an open-label period from 16-52 weeks (second phase), in which both groups received weekly methotrexate injections. At week 24, dose escalation to 22.5 mg/week was possible in patients not achieving PASI 50.

Outcomes

Psoriasis severity was measured using the PASI (Psoriasis Area and Severity Index). The authors also used two other psoriasis severity measures and two quality of life measures, looked at safety indices and performed a sub-study analysing paired skin biopsies at baseline and week 16 (histopathology, immunohistochemistry and expression of interleukin (IL)17A, interferon-γ and tumour necrosis factor-α).

Primary outcome measures

The primary outcome was the proportion of patients reaching PASI 75 at week 16.

Results

120 patients were included in this trial, most of whom were middle-aged white men with longstanding psoriasis and a mean BMI of 30.1 kg/m². PASI 75 was achieved in 41% of patients receiving methotrexate vs. 10% of patients receiving placebo (RR 3.93, 95% CI 1.31–11.81; p=0.0026) at week 16. Subcutaneous methotrexate was generally well tolerated, with no serious adverse events related to this treatment over the 52-week study.

Conclusions

Warren et al conclude that the 52-week risk-benefit profile of subcutaneous methotrexate is favourable in patients with psoriasis.

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Oral retinoids and depression

Abstract

We are concerned about the content and possible misinterpretation of a research letter by Le Moigne et al. published on 19 June 2017 in the British Journal of Dermatology online.[1]

We share the concern expressed by the authors about possible psychiatric effects of oral retinoids. However, case reports rank low in the hierarchy of evidence, as a result of their inherent limitations, including publication bias and a lack of control groups.

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Subcutaneous methotrexate in patients with moderate to severe psoriasis: a critical appraisal

Summary

Aim

Warren et al¹ set out to assess the effect of an intensified dosing schedule of subcutaneous methotrexate in patients with moderate to severe chronic plaque psoriasis.

Setting and design

This is a prospective, double-blind, randomised (3:1), placebo-controlled study, conducted across 16 centres in Germany, France, the Netherlands, and the UK.

Study exposure

Outcomes

Primary outcome measures

The primary outcome was the proportion of patients reaching PASI 75 at week 16.

Results

Conclusions

Warren et al conclude that the 52-week risk-benefit profile of subcutaneous methotrexate is favourable in patients with psoriasis.

http://ift.tt/2EH6oGu

Oral retinoids and depression

Abstract

We are concerned about the content and possible misinterpretation of a research letter by Le Moigne et al. published on 19 June 2017 in the British Journal of Dermatology online.[1]

http://ift.tt/2GPAY1k

Improved artefact removal from EEG using Canonical Correlation Analysis and spectral slope

Publication date: 15 March 2018
Source:Journal of Neuroscience Methods, Volume 298
Author(s): Azin S. Janani, Tyler S. Grummett, Trent W. Lewis, Sean P. Fitzgibbon, Emma M. Whitham, Dylan DelosAngeles, Hanieh Bakhshayesh, John O. Willoughby, Kenneth J. Pope
BackgroundContamination of scalp measurement by tonic muscle artefacts, even in resting positions, is an unavoidable issue in EEG recording. These artefacts add significant energy to the recorded signals, particularly at high frequencies. To enable reliable interpretation of subcortical brain activity, it is necessary to detect and discard this contamination.New methodWe introduce a new automatic muscle-removal approach based on the traditional Blind Source Separation-Canonical Correlation Analysis (BSS-CCA) method and the spectral slope of its components. We show that CCA-based muscle-removal methods can discriminate between signals with high correlation coefficients (brain, mains artefact) and signals with low correlation coefficients (white noise, muscle). We also show that typical BSS-CCA components are not purely from one source, but are mixtures from multiple sources, limiting the performance of BSS-CCA in artefact removal. We demonstrate, using our paralysis dataset, improved performance using BSS-CCA followed by spectral-slope rejection.ResultThis muscle removal approach can reduce high-frequency muscle contamination of EEG, especially at peripheral channels, while preserving steady-state brain responses in cognitive tasks.Comparison with existing methodsThis approach is automatic and can be applied on any sample of data easily. The results show its performance is comparable with the ICA method in removing muscle contamination and has significantly lower computational complexity.ConclusionWe identify limitations of the traditional BSS-CCA approach to artefact removal in EEG, propose and test an extension based on spectral slope that makes it automatic and improves its performance, and results in performance comparable to competitors such as ICA-based artefact removal.

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Carvacrol prevents impairments in motor and neurochemical parameters in a model of progressive parkinsonism induced by reserpine

Publication date: May 2018
Source:Brain Research Bulletin, Volume 139
Author(s): Lívia Cristina R.F. Lins, Marina F. Souza, José Marcos M. Bispo, Auderlan M. Gois, Thaís Cristina S. Melo, Rayr Antonio S. Andrade, Lucindo J. Quintans-Junior, Alessandra M. Ribeiro, Regina H. Silva, José R. Santos, Murilo Marchioro
Parkinson's disease (PD) is a neurodegenerative disease characterized by a progressive degeneration of dopaminergic neurons in the substantia nigra pars compact (SNpc), with consequent depletion of dopamine in the striatum, which gives rise to the characteristic motor symptoms of PD. Although its etiology is unknown, several studies have suggested that oxidative stress plays a critical function in the pathophysiology of PD, and antioxidant agents could be helpful to slown down the dopaminergic neurodegeneration. Carvacrol (CA) is a phenolic monoterpene found in essential oils of many aromatic plants that presents antioxidant and neuroprotective effects. This study aimed to assess the effect of CA in a reserpine (RES)-induced rat model of PD. Male Wistar rats received 15 s.c. injections of 0.1 mg/kg RES or vehicle, every other day, concomitantly to daily i.p. injections of CA (12.5 or 25 mg/kg) or vehicle. Across the treatment, the animals were submitted to behavioral evaluation in the catalepsy test (performed daily), open field test (7th day) and assessment of vacuous chewing movements (12th, 20th and 30th days). Upon completion of behavioral tests, rats were perfused and their brains underwent tyrosine hydroxylase (TH) immunohistochemical analysis. Our results showed that CA (12.5 e 25 mg/kg) prevented the increase in catalepsy behavior and number of vacuous chewing movements, but failed to revert the decreased open-field locomotor activity induced by RES. In addition, CA in both doses prevented the decrease in TH immunostaining induced by RES in the SNpc and dorsal striatum. Taken together, our results suggest that CA shows a protective effect in a rat model of PD, preventing motor and neurochemical impairments induced by RES. Thus, the use of CA as a promising new strategy for the prevention and/or treatment of PD may be considered.

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A new mobile learning module using smartphone wallpapers in identification of medical fungi for medical students and residents

Abstract

Introduction

Medical students and residents will encounter many cutaneous fungal infections in medical practice. However, the training for identification of medical fungi has been insufficient due to limited lecture-based courses. The objective of this study was to evaluate the impact of using smartphone-based wallpapers in learning the microscopic morphology and colony characteristics of medical fungi for medical students and residents.

Methods

A smartphone-based wallpaper learning module using a wallpaper-changing software application (app) was introduced in this 3-week training course. Twenty-six participants were enrolled and divided into two groups: nondermatology trainees, including medical students and postgraduate year one (PGY-1) doctors who have not yet specialized, and dermatology trainees (dermatology residents). All of the participants completed a 3-week training course, and the effectiveness of the module was evaluated by pre- and post-course multiple-choice examinations.

Results

Both nondermatology and dermatology trainees scored significantly higher in post-course examinations than pre-course examinations (P < 0.001). The dermatology trainees performed better than nondermatology trainees in the pre-course examinations (P < 0.001). In the post-course examinations, no significant difference in scores was noted between dermatology and nondermatology trainees (P = 0.573).

Discussion

The smartphone-based wallpaper learning module was effective in helping medical students and residents learn and memorize morphologic characteristics of fungi. In comparison to conventional lecture-based learning, this new mobile module was more readily accessible and convenient for learners to engage in learning.

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Disseminated actinomycetoma due to Nocardia wallacei

Abstract

Background

Actinomycetoma caused by Nocardia usually responds well to antibiotics. Emerging species of Nocardia, such as N. wallacei, can be a therapeutic challenge.

Aims

Confirm the therapeutic effectivity of linezolid in multidrug resistant Nocardia Wallacei actinomycetoma.

Materials and Methods

We evaluated the medical management of an 18-year-old man with multidrug resistant actinomycetoma of the left leg caused by N. transvalensis complex treated 17 years ago with linezolid 1200 mg a day. This bacteria was recently reclassified as Nocardia Wallacei by specific molecular biology technique.

Results

The infection was cured after 3 months of treatment; the patient remained asymptomatic for the past 17 years. No adverse effects were found.

Discussion

Frequently, strains of N. transvalensis complex have aminoglycoside resistance; in this case, we highlight the effectiveness of linezolid for the successful medical management of multidrug resistant actinomycetoma.

Conclusion

Linezolid can be an alternative for the treatment of multidrug resistant Nocardia Wallacei.

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Treatment response to omalizumab in patients with refractory chronic spontaneous urticaria

Abstract

Background

Previous clinical trials have demonstrated the efficacy and safety of the anti-IgE monoclonal antibody omalizumab in chronic spontaneous urticaria (CSU) not responding to antihistamine treatment. The primary aim of our study was to describe the response patterns of patients with refractory CSU treated with omalizumab in a real-world clinical setting.

Methods

A retrospective analysis of medical records of 20 patients with refractory CSU was performed. Demographic, clinical, and laboratory features were retrieved and analyzed in correlation with treatment data.

Results

Mean age of our patient population was 54.5 years, while the majority were females (15/20 cases, 75%). Mean disease duration prior to omalizumab administration was 21.8 months. All patients had a history of chronic urticaria, refractory to high antihistamine and corticosteroid treatment, and responded favorably to omalizumab after administration of 1–5 doses of omalizumab; complete response was observed in 17/20 patients (85%) and well-controlled disease in the remaining 3/20 patients (15%). In a subset of cases (6/20, 30%), best response to omalizumab was achieved after interval administration of a 9-day course of methylprednisolone (total dose of 188 mg). Late response to omalizumab (after three-month treatment) was significantly correlated (P = 0.026) with shorter disease duration before initiation of omalizumab.

Conclusion

In the present series, omalizumab, either alone or in combination with a short-term course of corticosteroids, was highly effective in resolution of refractory CSU. Furthermore, disease duration prior to omalizumab had a significant effect on timing of response.

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Role of Eustachian Dysfunction and Primary Sclerotic Mastoid Pneumatisation Pattern in Aetiology of Squamous Chronic Otitis Media: A Correlative Study

Abstract

Squamous chronic otitis media (COM) implies formation of a retraction pocket (inactive form) or frank cholesteatoma (active form) in pars tensa or pars flaccida of tympanic membrane. A retraction pocket or frank cholesteatoma are believed to occur due to tubal dysfunction. The present study was undertaken to investigate the pattern of mastoid pneumatisation and Eustachian dysfunction by dynamic slow motion videoendoscopy (DSVE) in cases of both, active and inactive type of squamous chronic otitis media (COM). 52 patients (65 ears) comprising of twenty-six ears with pars flaccida squamous disease and 39 ears with Pars Tensa squamous disease were enrolled for the study. DSVE findings, in terms of grade and type of Eustachian dysfunction were noted. Mastoid pneumatization pattern on CT-scans, and peroperative status of mastoid pneumatisation, especially contracted mastoid with anteriorly placed sigmoid sinus or low lying dura were also recorded for every case while performing tympano-mastoidectomy. Primary sclerotic/diploic type of mastoid pneumatisation pattern and Eustachian dysfunction were found to have inverse relationship in the cases of squamous otitis media. Eustachian dysfunction, diagnosed on DSVE, had significant association with both pars flaccida (P = 0.0001) and pars tensa disease (P = 0.0007). Primary sclerotic or diploic mastoid were found to be more common in ears with pars flaccida squamous disease than pars tensa COM (46.15% vs. 38.46%, P < 0.05).

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Phase 1/2 study assessing the safety and efficacy of dabrafenib and trametinib combination therapy in Japanese patients with BRAF V600 mutation-positive advanced cutaneous melanoma

Abstract

The combination of dabrafenib and trametinib demonstrated encouraging antitumor activity and tolerability, at initial analysis, in Japanese patients with BRAF V600 mutant advanced melanoma warranting further investigation. This study evaluated the safety and tolerability, pharmacokinetics (PK) and preliminary efficacy of dabrafenib 150 mg b.i.d. plus trametinib 2 mg q.d. in Japanese patients with BRAF V600E/K mutant solid tumors (phase 1) and melanoma (phase 2). Phase 1 was primarily intended to assess safety and tolerability as assessed by adverse events (AE), and the primary end-point in phase 2 was to assess confirmed overall response rate (ORR). The secondary end-points in phase 1 included PK, confirmed/unconfirmed ORR and duration of response (DOR). The secondary end-points in phase 2 were PK, unconfirmed ORR, DOR, safety and tolerability. A total of 12 cutaneous melanoma patients were enrolled in the study (six in phase 1 and six in phase 2) and received the combination therapy of dabrafenib and trametinib. Common AE (≥50.0%) included pyrexia (75%), increased aspartate aminotransferase (67%), peripheral edema (50%) and nasopharyngitis (50%). The investigator-assessed ORR was reported in five patients (83%) in phase 1 and was also reported in five patients (83%; 95% confidence interval, 35.9–99.6; P < 0.0001) in phase 2. Plasma concentrations of both dabrafenib and trametinib seemed to a reach steady state by week 3. Overall, efficacy and PK properties for the dabrafenib plus trametinib combination in Japanese patients were comparable with those seen in global studies.

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Efficacy of oral cholecalciferol on rhododendrol-induced vitiligo: A blinded randomized clinical trial

Abstract

Rhododendrol (RD), 4-(4-hydroxyphenyl)-2-butanol, inhibits melanin synthesis and has been used for skin-whitening cosmetic products. RD has been very effective in lightening skin pigmentation, but some persons have developed so-called RD vitiligo, in which vitiligo starts on the face, neck and hands where topical RD has been applied and even extended over skin areas where RD has not been applied. RD vitiligo lesions in some patients have lasted for years and have been resistant to conventional vitiligo treatments. We examined the effects of cholecalciferol on RD vitiligo in a blinded randomized clinical trial. Forty-eight female RD vitiligo patients were recruited for the trial and were randomized into two groups: the vitamin D (VD)-intervention group that received daily 5000 IU cholecalciferol for 5 months and the control group. Three blinded investigators scored vitiligo improvement by comparing photographic images of baseline and at 5-month observation. Serum 25(OH)D3 of RD vitiligo patients was not significantly different from age-matched healthy volunteers. Twenty-two in the VD-intervention group and 23 in the control group completed the 5-month observation. Serum 25(OH)D3 levels were significantly increased after the 5-month VD intervention, while the control group did not change. The improvement scores were significantly higher in the VD-intervention group than the control group. The improvement scores were positively correlated with the serum 25(OH)D3 levels after the 5-month intervention period but not before the treatment. This blinded randomized clinical trial showed favor in administrating 5000 IU cholecalciferol daily to RD vitiligo patients.

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Case of atopic dermatitis concurrent with idiopathic thrombocytopenic purpura, whose serum thymus and activation-regulated chemokine level remained undetectable

Abstract

We report a 9-year-old Japanese female patient with atopic dermatitis associated with idiopathic thrombocytopenic purpura. She demonstrated high serum immunoglobulin (Ig)E and IgE specific to several environmental allergens, but extremely low serum thymus and activation-regulated chemokine (TARC) levels regardless of the disease progression. This case suggests platelets as the main source of serum TARC.

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The Potential Role of Bile Acids in Acquired Laryngotracheal Stenosis

Objective

Gastroesophageal reflux is thought to be a risk factor for laryngotracheal stenosis. Bile acids are a component of gastric refluxate and have previously been implicated in the development of fibrosis in other airway subsites. There is clear evidence that bile acids reflux into the upper airway. We therefore investigated the potential role of bile acids in the pathophysiology of laryngotracheal fibrosis and stenosis, specifically investigating the highly conserved process of epithelial–mesenchymal transition (EMT).

Study Design

Translational research study.

Methods

Human primary tracheal epithelial cells (PTECs) were challenged with the four most common digestive bile acids (cholic, chenodeoxycholic, deoxycholic, and lithocholic). EMT markers transforming growth factor (TGF)-β1, Matrix metalloproteinase (MMP)-9, and procollagen proteins were measured in the supernatant at 48 hours via enzyme-linked immunosorbent assay. Real-time polymerase chain reaction was also used to measure E-cadherin and fibronectin expression.

Results

Significantly greater concentrations of TGF-β1 and MMP-9 were measured in the culture supernatants of cells treated with each bile acid at 10 µmol/L. Lithocholic acid and deoxycholic acid induced significantly increased expression of procollagen protein. Upregulation of fibronectin and downregulation of E-cadherin were observed with all bile acids, except for deoxycholic acid.

Conclusion

This is the first proof of principle demonstration that physiologically relevant bile acid challenge induces EMT mechanisms in PTECs. This implies a potential role for bile acids in laryngotracheal scarring and airway remodeling of potential translational significance in laryngotracheal stenosis.

Level of Evidence

NA. Laryngoscope, 00:000–000, 2018

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In Response to Should Infants Who Fail Their Newborn Hearing Screen Undergo Cytomegalovirus Testing?

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The survival impact of surgical therapy in squamous cell carcinoma of the hard palate

Objective

To describe the incidence and determinants of survival of patients with squamous cell carcinoma of the hard palate (SCCHP) between the years of 1973 to 2014 using the Surveillance, Epidemiology, and End Results (SEER) database.

Methods

Retrospective, population-based cohort study of patients in the SEER tumor registry who were diagnosed with SCCHP from 1973 to 2014. Outcomes and measures included overall survival (OS) and disease-specific survival (DSS).

Results

A total of 1,489 cases of primary SCCHP were identified. Of those, 53.2% were females and 47.8% presented with stage IV disease. The mean age at diagnosis was 69.8 years. Overall survival at 2, 5, and 10 years was 44%, 33%, and 21%, respectively. A total of 66.2% of patients underwent surgery (with or without radiation therapy [RT]); 20.1% received RT; and 22.4% had both surgical and RT. On multivariate analysis, RT, advanced age, stage, and grade were associated with worse OS and DSS (P < 0.05). Surgical therapy (with or without radiation) was an independent favorable predictor of OS and DSS (P < 0.05).

Conclusion

SCCHP is relatively infrequent tumor that portends an overall poor prognosis when advanced stage and a greater prognosis when early stage. Surgical therapy was found to be an independent predictor for improved OS and DSS, whereas RT was associated with reduced OS and DSS.

Level of Evidence

4. Laryngoscope, 2018

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Stem cells enhance reperfusion following ischemia: Validation using laser speckle imaging in predicting tissue repair

Objectives

The lack of real-time assessment of vascular perfusion changes remains a major weakness in assessing the efficacy of bone marrow stromal cells (BMSC) therapeutic ischemia reperfusion (I/R) injury. This study provides for the first time the real-time in vivo perfusion monitoring in I/R mice with BMSC therapy.

Study Design

Animal model.

Methods

Surgically created cutaneous flaps perfused by the inferior epigastric vessels were subjected to 3.5 hours of ischemia/reperfusion. Wound healing and vascular perfusion were assessed by Image-J and laser speckle contrast analysis (LSCA) in three groups (sham, I/R, and I/R + BMSC). BMSC tracking was quantified in an additional two groups (with/without I/R) using intravital fluorescent microscopy. The histopathology of skin flaps was examined by hematoxylin and eosin stain. Infiltrated macrophages were analyzed by confocal immunofluorescent microscopy.

Results

Postischemic tissues treated with BMSC demonstrated significantly greater survival than I/R control. On days 3 to 7 postreperfusion, both proximal and distal areas in BMSC-treated flaps demonstrated greater levels of perfusion than untreated I/R flaps (P < 0.05). Intravital fluorescent microscopy revealed that numbers of labeled BMSC were significantly increased in the distal area compared to the proximal area in both with and without ischemic mice. Histological examination showed lower necrosis and infiltrated inflammatory cells in I/R + BMSC-treated mice versus I/R controls.

Conclusion

BMSC accumulated in I/R flaps and exerted beneficial effects including: 1) improving vascular perfusion and 2) attenuating inflammatory cell infiltration. LSCA facilitates monitoring of the real-time restitution of perfusion during flap wound healing in experimental animals and could also similarly applied in clinical investigations.

Level of Evidence

NA. Laryngoscope, 2018

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Circadian anosmia: A rare clinical presentation

We report the case of a 27-year-old female who presented with a peculiar story of anosmia fluctuating in a circadian manner. Olfactory function appeared an hour after breakfast, was normal during daytime, and disappeared in the early evening. Imaging confirmed chronic rhinosinusitis (CRS). Initial systemic, followed by topical steroid treatment, rapidly and sustainably reversed this condition. The olfactory fluctuation paralleled the endogenous steroid production. This suggests that slight congestion changes in a chronically inflamed nasal mucosa may have been sufficient to induce this circadian anosmia. The importance of identifying fluctuation of olfactory function as a sign of CRS is emphasized and discussed. Laryngoscope, 2018

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Double-blind, placebo-controlled study with alginate suspension for laryngopharyngeal reflux disease

Objective

Treatment for laryngopharyngeal reflux disease (LPRD) is challenging because of delays in recognition and poor responsiveness to proton-pump inhibitor therapy. The aim of this study was to determine the efficacy and safety of liquid alginate suspension for treating LPRD.

Methods

A double-blind, placebo-controlled, prospective study comparing 8 weeks of treatment with Alginos Oral Suspension (TTY Biopharm Co. Ltd., Taipei, Taiwan) (sodium alginate 1,000 mg three times daily) with a placebo was conducted on patients who fulfilled the criteria of at least one symptom consistent with LPRD, a total reflux symptom index (RSI) score of > 10, and a total reflux finding score (RFS) of > 5. Those with erosive gastroesophageal reflux disease, as evidenced through screened transnasal upper gastrointestinal endoscopy, were excluded. Efficacy was assessed by RSI, RFS, and ambulatory multichannel intraluminal impedance and pH (MII-pH) monitoring.

Results

A total of 80 patients aged 22 to 72 years were enrolled. Compared with baseline, both Alginos (TTY Biopharm Co. Ltd.) and the placebo significantly reduced the total RSI (P < 0.001) and the total number of reflux episodes shown by MII-pH monitoring (P < 0.05) after 8 weeks of treatment. However, liquid alginate suspension was unable to show superiority over the placebo. The incidence of various adverse events from Alginos (TTY Biopharm Co. Ltd.) was relatively low (7.7%) and mild.

Conclusion

This study showed that liquid alginate suspension was well tolerated by LPRD patients. It effectively improved symptoms and reflux numbers but was unable to show superiority over placebo. As observed in previous studies, a great placebo effect was present. The importance of lifestyle modification could not be overlooked.

Level of Evidence

2. Laryngoscope, 00:000–000, 2018

Single-center, vehicle-controlled study including healthy volunteers aged 18-50 years. A capsaicin solution was applied topically on the subject's forearm to induce local inflammation. Measurements of capsaicin-induced increase in dermal blood flow, within the region of interest, were performed by laser Doppler imaging (LDI) (reference method) and D-OCT.

Results

Sixteen subjects were enrolled. A good correlation was shown between D-OCT and LDI, using the image processing workflow. Therefore, D-OCT offers an easy-to-use alternative to LDI, with good repeatability, new robust morphological features (dermal-epidermal junction localization), and quantification of the distribution of vessel size and changes in this distribution induced by capsaicin. The visualization of the vessel network was improved through bloc filtering and artifact removal. Moreover, the assessment of vessel size distribution allows a fine analysis of the vascular patterns.

Conclusion

The newly developed image processing workflow enhances the technical capabilities of D-OCT for the accurate detection and characterization of microcirculation in the skin. A direct clinical application of this image processing workflow is the quantification of the effect of topical treatment on skin vascularization.

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Primary purulent bacterial pericarditis due to Streptococcus intermedius in an immunocompetent adult: a case report

Acute purulent bacterial pericarditis is of rare occurrence in this modern antibiotic era. Primary involvement of the pericardium without evidence of underlying infection elsewhere is even rarer. It is a rapid...

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Socio-economic patterning in early mortality of patients aged 0–49 years diagnosed with primary bone cancer in Great Britain, 1985–2008

Publication date: April 2018
Source:Cancer Epidemiology, Volume 53
Author(s): Karen Blakey, Richard G. Feltbower, Peter W. James, Gillian Libby, Charles Stiller, Paul Norman, Craig Gerrand, Richard J.Q. McNally
BackgroundStudies have shown marked improvements in survival between 1981 and 2000 for Ewing sarcoma patients but not for osteosarcoma. This study aimed to explore socio-economic patterning in early mortality rates for both tumours.ProcedureThe study analysed all 2432 osteosarcoma and 1619 Ewing sarcoma cases, aged 0–49 years, diagnosed in Great Britain 1985–2008 and followed to 31/12/2009. Logistic regression models were used to calculate risk of dying within three months, six months, one year, three years and five years after diagnosis. Associations with Townsend deprivation score and its components were examined at small-area level. Urban/rural status was studied at larger regional level.ResultsFor osteosarcoma, after age adjustment, mortality at three months, six months and one year was associated with higher area unemployment, OR = 1.05 (95% CI 1.00, 1.10), OR = 1.04 (95% CI 1.01, 1.08) and OR = 1.04 (95% CI 1.02, 1.06) respectively per 1% increase in unemployment. Mortality at six months was associated with greater household non-car ownership, OR = 1.02 (95% CI 1.00, 1.03). For Ewing sarcoma, there were no significant associations between mortality and overall Townsend score, nor its components for any time period. For both tumours increasing mortality was associated with less urban and more remote rural areas.ConclusionsThis study found that for osteosarcoma, early mortality was associated with residence at diagnosis in areas of higher unemployment, suggesting risk of early death may be socio-economically determined. For both tumours, distance from urban centres may lead to greater risk of early death.

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The impact of rectal cancer tumor height on recurrence rates and metastatic location: A competing risk analysis of a national database

Publication date: April 2018
Source:Cancer Epidemiology, Volume 53
Author(s): Knut M. Augestad, Deborah S. Keller, Paul M. Bakaki, Johnie Rose, Siran M. Koroukian, Tom Øresland, Conor P. Delaney
BackgroundThe impact of rectal cancer tumor height on local recurrence and metastatic spread is unknown. The objective was to evaluate the impact of rectal cancer tumor height from the anal verge on metastatic spread and local recurrence patterns.MethodsThe Norwegian nationwide surgical quality registry was reviewed for curative rectal cancer resections from 1/1/1996-12/15/2006. Cancers were stratified into five height groups: 0–3 cm, >3–5 cm, >5–9 cm, >9–12 cm, 12 cm–HI. Competing risk and proportional hazards models assessed the relationship between tumor height and patterns of metastasis and survival.Results6859 patients were analyzed. After median follow-up of 52 months (IQR 20–96), 26.7% (n = 1835) experienced recurrence. With tumors >12 cm, the risk of liver metastases increased (crude HR 1.49, p = 0.03), while lung metastases decreased (crude HR 0.66, p = 0.03), and risk of death decreased (crude HR 0.81, p = 0.001) The cumulative incidence of pelvic recurrence were highest for the low tumors (p = 0.01). Median time to liver metastases was 14months (IQR 7–24), lung metastases 25months (IQR 13–39), pelvic recurrence 19months (IQR10-32), (p < 0.0001). Time to metastases in liver and lungs were significantly associated with tumor height (p < 0.001)ConclusionThere are distinct differences in metastatic recurrence patterns and time to recurrence from different anatomic areas of the rectum. In crude analyses, tumor height impacted metastatic spread to the liver and lungs. However, when adjusting for treatment variables, the hazard of metastatic spread to the liver and lungs are limited. Nevertheless, time to metastases in liver and lungs is significantly impacted by tumor height. Venous drainage of the rectal cancer may be a significant contributor of rectal cancer metastatic spread, but further research is warranted.

Graphical abstract

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Anaplastic thyroid carcinoma in Denmark 1996–2012: A national prospective study of 219 patients

Publication date: April 2018
Source:Cancer Epidemiology, Volume 53
Author(s): Gitte Bjørn Hvilsom, Stefano Christian Londero, Christoffer Holst Hahn, Sten Schytte, Henrik Baymler Pedersen, Peer Christiansen, Katalin Kiss, Stine Rosenkilde Larsen, Marie Louise Jespersen, Giedrius Lelkaitis, Christian Godballe
BackgroundAnaplastic thyroid carcinoma (ATC) is the least common but most malignant thyroid cancer. We aimed to examine the characteristics as well as evaluate the incidence, prognostic factors, and if introduction of a fast track cancer program might influence survival in a cohort of ATC patients.MethodsA cohort study based on prospective data from the national Danish thyroid cancer database DATHYRCA and the national Danish Pathology Register including 219 patients diagnosed from 1996 to 2012, whom were followed until death or through September 2014.ResultsWe found the median age in the 7th decade, the majority of patients being women presenting with a growing mass at the neck, diagnosed with stage T4b disease. At diagnosis, 56% of the patients had lymph node metastasis and 38% distant metastasis.We observed one- and five-year survival of 20.7% and 11.0%, respectively.Both univariate and multivariate analyses showed age (above 73.6 years), respiratory impairment, T4b stage, and distant metastasis at diagnosis to be significant prognostic factors. Further, introduction of a national fast track cancer program increased survival nearly two-fold.ConclusionAs new information, our study adds "respiratory impairment at diagnosis" and "introduction of a national fast track cancer program" to the list of already established prognostic indicators for ATC.

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Population risk factors for late-stage presentation of cervical cancer in sub-Saharan Africa

Publication date: April 2018
Source:Cancer Epidemiology, Volume 53
Author(s): Tessa S. Stewart, Jennifer Moodley, Fiona M. Walter
BackgroundCervical cancer is the most prevalent malignancy in sub-Saharan Africa (SSA) with many women only seeking professional help when they are experiencing symptoms, implying late-stage malignancy and higher mortality rates. This ecological study assesses population-level exposures of SSA women to the numerous risk factors for HPV infection and cervical cancer, against late-stage presentation of cervical cancer.Materials and methodA literature review revealed the relevant risk factors in SSA. Open-access databases were mined for variables closely representing each risk factor. A proxy for late-stage presentation was used (ratio of incidence-to-mortality, IMR), and gathered from IARC's GLOBOCAN 2012 database. Variables showing significant correlation to the IMR were used in stepwise multiple regression to quantify their effect on the IMR.ResultsCountries with high cervical cancer mortality rates relative to their incidence have an IMR nearer one, suggesting a larger proportion of late-stage presentation. Western Africa had the lowest median IMR (1.463), followed by Eastern Africa (IMR = 1.595) and Central Africa (IMR = 1.675), whereas Southern Africa had the highest median IMR (1.761). Variables selected for the final model explain 65.2% of changes seen in the IMR. Significant predictors of IMR were GDP (coefficient = 2.189 × 10⁻⁶, p = 0.064), HIV infection (−1.936 × 10⁻³, p = 0.095), not using a condom (−1.347 × 10⁻³, p = 0.013), high parity (−1.744 × 10⁻², p = 0.008), and no formal education (−1.311 × 10⁻³, p < 0.001).ConclusionUsing an IMR enables identification of factors predicting late-stage cervical cancer in SSA including: GDP, HIV infection, not using a condom, high parity and no formal education.

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A new approach to estimate time-to-cure from cancer registries data

Publication date: April 2018
Source:Cancer Epidemiology, Volume 53
Author(s): Olayidé Boussari, Gaëlle Romain, Laurent Remontet, Nadine Bossard, Morgane Mounier, Anne-Marie Bouvier, Christine Binquet, Marc Colonna, Valérie Jooste
BackgroundCure models have been adapted to net survival context to provide important indicators from population-based cancer data, such as the cure fraction and the time-to-cure. However existing methods for computing time-to-cure suffer from some limitations.MethodsCure models in net survival framework were briefly overviewed and a new definition of time-to-cure was introduced as the time TTC at which P(t), the estimated covariate-specific probability of being cured at a given time t after diagnosis, reaches 0.95. We applied flexible parametric cure models to data of four cancer sites provided by the French network of cancer registries (FRANCIM). Then estimates of the time-to-cure by TTC and by two existing methods were derived and compared. Cure fractions and probabilities P(t) were also computed.ResultsDepending on the age group, TTC ranged from to 8 to 10 years for colorectal and pancreatic cancer and was nearly 12 years for breast cancer. In thyroid cancer patients under 55 years at diagnosis, TTC was strikingly 0: the probability of being cured was >0.95 just after diagnosis. This is an interesting result regarding the health insurance premiums of these patients. The estimated values of time-to-cure from the three approaches were close for colorectal cancer only.ConclusionsWe propose a new approach, based on estimated covariate-specific probability of being cured, to estimate time-to-cure. Compared to two existing methods, the new approach seems to be more intuitive and natural and less sensitive to the survival time distribution.

Graphical abstract

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Events Diary

Publication date: Available online 4 February 2018
Source:Materials Today

http://ift.tt/2E3iQ6t

Piezoelectric scaffold squeezes cells into action

Publication date: Available online 4 February 2018
Source:Materials Today
Author(s): Cordelia Sealy

http://ift.tt/2nKynNd

Events Diary

Publication date: Available online 4 February 2018
Source:Materials Today

http://ift.tt/2DZCRe1

Roles of the anterior basolateral amygdalar nucleus during exposure to a live predator and to a predator-associated context

Publication date: 16 April 2018
Source:Behavioural Brain Research, Volume 342
Author(s): Ricardo Passoni Bindi, Marcus Vinicius C. Baldo, Newton Sabino Canteras
The basolateral amygdala complex, which includes the lateral, basolateral and basomedial nuclei, has been implicated in innate and contextual fear responses to predator threats. In the basolateral complex, the lateral and posterior basomedial nuclei are able to process predator odor information, and they project to the predator-responsive hypothalamic circuit; lesions in these amygdalar sites reduce innate responses and practically abolish contextual fear responses to predatory threats. In contrast to the lateral and posterior basomedial nuclei, the basolateral nucleus does not receive direct information from predator olfactory cues and has no direct link to the predator-responsive hypothalamic circuit. No attempt has previously been made to determine the specific role of the basolateral nucleus in fear responses to predatory threats, and we currently addressed this question by making bilateral N-methyl-D-aspartate lesions in the anterior basolateral nucleus of the amygdala (BLAa), which is often regarded as being contiguous with the lateral amygdalar nucleus, and tested both innate and contextual fear in response to cat exposure. Accordingly, BLAa lesions decreased both innate and contextual fear responses to predator exposure. Considering the targets of the BLAa, the nucleus accumbens appears to be a potential candidate to influence innate defensive responses to predator threats. The present findings also suggest that the BLAa has a role in fear memory of predator threat. The BLAa is likely involved in memory consolidation, which could potentially engage BLAa projection targets, opening interesting possibilities in the investigation of how these targets could be involved in the consolidation of predator-related fear memory.

http://ift.tt/2E30Nxa

Sex differences in rat decision-making: The confounding role of extraneous feeder sampling between trials

Publication date: 16 April 2018
Source:Behavioural Brain Research, Volume 342
Author(s): Clifford H. Donovan, Scott A. Wong, Sienna H. Randolph, Rachel A. Stark, Robbin L. Gibb, Aaron J. Gruber
Although male and female rats appear to perform differently in some tasks, a clear picture of sex differences in decision-making has yet to develop. This is in part due to significant variability arising from differences in strains and tasks. The aim of this study was to characterize the effects of sex on specific response elements in a reinforcement learning task so as to help identify potential explanations for this variability. We found that the primary difference between sexes was the propensity to approach feeders out of the task context. This extraneous feeder sampling affects choice on subsequent trials in both sexes by promoting a lose-shift response away from the last feeder sampled. Female rats, however, were more likely to engage in this extraneous feeder sampling, and therefore exhibited a greater rate of this effect. Once trials following extraneous sampling were removed, there were no significant sex differences in any of the tested measures. These data suggest that feeder approach outside of the task context, which is often not recorded, could produce a confound in sex-based differences of reinforcement sensitivity in some tasks.

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Reversible inactivation of interpeduncular nucleus impairs memory consolidation and retrieval but not learning in rats: A behavioral and molecular study

Publication date: 16 April 2018
Source:Behavioural Brain Research, Volume 342
Author(s): Leila Khatami, Fariba Khodagholi, Fereshteh Motamedi
The Interpedundular nucleus (IPN) is a small midbrain structure located deeply between the two cerebral peduncles. The strategic placement of this nucleus makes it a possible relay between structures involved in the modulation of hippocampal theta rhythm activity. In this study we aimed to investigate how reversible inactivation of IPN could affect the acquisition, consolidation and retrieval phases of memory in passive avoidance (PA) and Morris water maze (MWM) tasks. To support our data, molecular studies were performed in order to detect possible changes in the expression of proteins related to learning and memory in the hippocampus. To address this issue rats' IPN was reversibly inactivated by microinjection of lidocaine hydrochloride (4%). After the behavioral studies, the phosphorylation of CREB and P70, and c-fos expression levels in the hippocampus were determined using western blotting and immunohistochemistry respectively. Our results in the PA and MWM tasks showed that IPN reversible inactivation could impair immediate post training consolidation and retrieval while it had no effect on the acquisition phase. In addition, there was a deficit in the retention of the MWM working memory. Our data showed the ratio of pCREB/CREB, pP70/P70 and c-fos expression in the hippocampus significantly decreased after IPN reversible inactivation. Collectively, the results show that behaviorally defined changes could be due to what happens molecularly in the hippocampus after IPN reversible inactivation. It is concluded that IPN not only makes part of a network involved in the modulation of hippocampal theta rhythm activity, but also is actively engaged in hippocampal memory formation.

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Differential requirement of de novo Arc protein synthesis in the insular cortex and the amygdala for safe and aversive taste long-term memory formation

Publication date: 16 April 2018
Source:Behavioural Brain Research, Volume 342
Author(s): Kioko Guzmán-Ramos, Archana Venkataraman, Jean-Pascal Morin, Daniel Osorio-Gómez, Federico Bermúdez-Rattoni
Several immediate early genes products are known to be involved in the facilitation of structural and functional modifications at distinct synapses activated through experience. The IEG-encoded protein Arc (activity regulated cytoskeletal-associated protein) has been widely implicated in long-term memory formation and stabilization. In this study, we sought to evaluate a possible role for de novo Arc protein synthesis in the insular cortex (IC) and in the amygdala (AMY) during long-term taste memory formation. We found that acute inhibition of Arc protein synthesis through the infusion of antisense oligonucleotides administered in the IC before a novel taste presentation, affected consolidation of a safe taste memory trace (ST) but spared consolidation of conditioned taste aversion (CTA). Conversely, blocking Arc synthesis within the AMY impaired CTA consolidation but had no effect on ST long-term memory formation. Our results suggest that Arc-dependent plasticity during taste learning is required within distinct structures of the medial temporal lobe, depending on the emotional valence of the memory trace.

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Review: Limb regeneration in humans: dream or reality?

Publication date: Available online 3 February 2018
Source:Annals of Anatomy - Anatomischer Anzeiger
Author(s): Lorenzo Alibardi
Appendage regeneration occurs by a sequence of events resembling those that take place during development in the embryo. This requires embryonic conditions such as hydration and hyaluronate content where Wnt and other signaling pathways, together with non- coding RNAs, can be re-expressed. These conditions among vertebrates are fully met only in amputated limbs of amphibians, likely because they are neotenic and maintain larval characteristics, including immaturity of their immune system and permanence of numerous stem cells. Although some key genes orchestrating limb regeneration are also present in amniotes, including humans, these genes are not expressed after injury. In amniotes a key problem for regeneration derives from the efficient immune system, largely deficient in anamniotes. As a consequence, wounds and appendage loss tend to scar instead of regenerating. Efforts of regenerative medicine in the attempt to induce the regrowth of limbs in humans must produce outgrowths with high hydration and hyaluronate content in order to create the immune-suppressed conditions similar to those present during development. The induced blastema must be manipulated for long periods of time in order to maintain the same regions present during limb development, an apical epidermal ridge and a polarizing region that forms gradients of expression of Wnt, Shh, FGF, BMP and Hox-genes. Pharmacological treatments to direct the regenerating limb into normal growth without risk of inducing abnormal or tumorigenic growth must be monitored during the course of the regeneration process − a medical treatment lasting years to fully regain the size of the lost appendage.

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Vitamin D deficiency in childhood: old lessons and current challenges

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

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Influence of primitive Biłgoraj horses on the glossy buckthorn (Frangula alnus)-dominated understory in a mixed coniferous forest

Publication date: February 2018
Source:Acta Oecologica, Volume 87
Author(s): Daniel Klich
Changes in the understory dominated by glossy buckthorn Frangula alnus via the influence of primitive horses were analyzed in a 28-year-old enclosure in the village of Szklarnia at the Biłgoraj Horse-Breeding Centre near Janów Lubelski (eastern Poland). The analysis was conducted in 20 circular plots (30 m²) defined in adjacent, similar forest stands (enclosed and control). Disturbance by the horses, mainly through trampling, caused numerous paths to form within the glossy buckthorn-dominated understory and led to a decrease in density of stems of lower height classes (30–80 and 81–130 cm, respectively). An increase in species diversity at the expense of glossy buckthorn density was also observed. The horses' trampling caused an increase in Padus avium density and the encroachment of other woody plant species that were less shade-tolerant and grew well in soils rich in nutrients. An increase in the density of woody plants over 180 cm above ground was observed within the enclosure, which was probably the result of the horses' excretion of feces. The results presented here provide new insight into the ecological role that horses play in forest-meadow landscape mosaics, which, via altering the development of vegetation, may contribute to an increase in biodiversity within forest habitats.

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Bilirubin in the Liver–Gut Signaling Axis

Publication date: Available online 3 February 2018
Source:Trends in Endocrinology & Metabolism
Author(s): Abdul-Rizaq Hamoud, Lauren Weaver, David E. Stec, Terry D. Hinds
Bilirubin is a component of the heme catabolic pathway that is essential for liver function and has been shown to reduce hepatic fat accumulation. High plasma bilirubin levels are reflective of liver disease due to an injurious effect on hepatocytes. In healthy liver, bilirubin is conjugated and excreted to the intestine and converted by microbes to urobilinoids, which are reduced to the predominant pigment in feces, stercobilin, or reabsorbed. The function of urobilinoids in the gut or their physiological relevance of reabsorption is not well understood. In this review, we discuss the relationship of hepatic bilirubin signaling to the intestinal microbiota and its regulation of the liver–gut axis, as well as its capacity to mediate these processes.

http://ift.tt/2s5xOD4

Maternal Exercise Improves the Metabolic Health of Adult Offspring

Publication date: Available online 3 February 2018
Source:Trends in Endocrinology & Metabolism
Author(s): Johan E. Harris, Lisa A. Baer, Kristin I. Stanford
The intrauterine environment can modulate the course of development and confer an enduring effect on offspring health. The effects of maternal diet to impair offspring metabolic health are well established, but the effects of maternal exercise on offspring metabolic health have been less defined. Because physical exercise is a treatment for obesity and type 2 diabetes (T2D), maternal exercise is an appealing intervention to positively influence the intrauterine environment and improve the metabolic health of offspring. Recent research has provided insights into the effects of maternal exercise on the metabolic health of adult offspring, which is the focus of this review.

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Editorial Board and Contents

Publication date: February 2018
Source:Trends in Endocrinology & Metabolism, Volume 29, Issue 2

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Squeezing Flux Out of Fat

Publication date: Available online 4 February 2018
Source:Trends in Endocrinology & Metabolism
Author(s): Alba Gonzalez-Franquesa, Mary-Elizabeth Patti
Merging transcriptomics or metabolomics data remains insufficient for metabolic flux estimation. Ramirez et al. integrate a genome-scale metabolic model with extracellular flux data to predict and validate metabolic differences between white and brown adipose tissue. This method allows both metabolic phenotyping and the identification of potential therapeutic targets for obesity.

http://ift.tt/2GNt8oQ

ATP Citrate Lyase: A New Player Linking Skeletal Muscle Metabolism and Epigenetics

Publication date: Available online 31 January 2018
Source:Trends in Endocrinology & Metabolism
Author(s): Haisen Li, Vittorio Sartorelli
Intermediates generated in several metabolic processes are used to regulate transcription through covalent histone and DNA modifications. In Cell Reports, Das et al. show that acetyl-coenzyme A (acetyl-CoA) generated by ATP citrate lyase (ACL) is utilized to acetylate histone H3 at MyoD regulatory regions, resulting in increased MyoD expression and improved muscle regeneration after injury.

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The Common and Distinct Features of Brown and Beige Adipocytes

Publication date: Available online 20 January 2018
Source:Trends in Endocrinology & Metabolism
Author(s): Kenji Ikeda, Pema Maretich, Shingo Kajimura
Two types of thermogenic fat cells, brown adipocytes and beige adipocytes, play a key role in the regulation of systemic energy homeostasis in mammals. Both brown fat and beige fat possess thermogenic properties in addition to common morphological and biochemical characteristics, including multilocular lipid droplets and cristae-dense mitochondria. Recent studies also identify features that are distinct between the two types of thermogenic fat cells, such as their developmental regulation and function. Of particular interest is the role of beige fat in the regulation of glucose homeostasis via uncoupling protein 1 (UCP1)-independent mechanisms. A better understanding of the underlying causes of these characteristics of brown and beige fat will allow us to specifically manipulate these cells to improve systemic energy metabolism and glucose homeostasis.

http://ift.tt/2GOqTBB

Non-Pharmacological Interventions for Improving Postpartum Maternal Sleep: A Systematic Review and Meta-Analysis

Evidence suggests that poor postpartum sleep quality is a risk factor for the development of postpartum depression. As such, non-pharmacological interventions have been developed to help improve sleep in the postpartum period. The primary aims of this systematic review and meta-analysis were to determine if non-pharmacological interventions improved maternal sleep and to compare the effectiveness of different intervention types. Secondary aims included examining effects on maternal mood and infant sleep.

http://ift.tt/2E19nIH

Horizontal and vertical sections of scalp biopsy specimens from dermatomyositis patients with scalp involvement

Scalp involvement in dermatomyositis manifests as a pruritic eruption with erythema and scaling associated with nonscarring alopecia. We characterized the histologic features of scalp dermatomyositis using horizontal and vertical sections. Characteristic findings of scalp dermatomyositis include preserved follicular architecture, hair counts consistent with chronic telogen effluvium, telangiectasia and mucin.

http://ift.tt/2Eic3VP

Skin in the Game: Existing and Upcoming Physician Payment Models in Dermatology

http://ift.tt/2FJyUqn

Efficacy and Safety of Topical Oxymetazoline Cream 1.0% for Treatment of Persistent Facial Erythema Associated With Rosacea: Findings From the Two Phase 3, 29-Day, Randomized, Controlled REVEAL Trials

Most rosacea treatments targeting inflammatory lesions do not improve persistent facial erythema.Topical oxymetazoline hydrochloride cream 1.0% effectively reduced erythema versus vehicle in patients with moderate to severe persistent facial erythema of rosacea, with favorable tolerability.Topical oxymetazoline represents a new treatment option for patients with persistent erythema of rosacea.

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Consultative Teledermatology in the Emergency Department and Inpatient Wards: A Survey of Potential Referring Providers.

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Surgical treatment of axillary bromhidrosis by combining suction-curettage with subdermal undermining through a miniature incision

The suction-curettage technique has been widely applied in the treatment of axillary bromhidrosis. However, it can only moderately eradicate the malodor. From 2011 to 2013, we performed the suction-curettage procedure alone in 91 patients with primary axillary bromhidrosis (group A). From 2014 to 2016, we refined the suction-curettage technique by performing wide subdermal scissors undermining through a miniature incision in 80 patients (group B). Through a miniature incision at the inferior pole of the central axillary crease, the entire subcutaneous tissues containing apocrine glands were initially dissected with scissors within the axillary area and then the undermined apocrine glands were removed by suction-curettage.

http://ift.tt/2GO66ye

Quality of life improvement after chest wall masculinization in female-to-male transgender patients: a prospective study using the BREAST-Q and body uneasiness test

Background: Chest reconstruction in many female-to-male (FTM) transgender individuals is an essential element of treatment for their gender dysphoria. In existing literature, there are very few longitudinal studies utilizing validated survey tools to evaluate patient reported outcomes surrounding this surgery. The purpose of our study is to prospectively evaluate patient reported satisfaction, improvement in body image, and quality of life following FTM chest wall reconstruction. Methods: Our study was a prospective analysis of FTM patients who underwent chest reconstruction by a single surgeon (C.A.) between April 2015 and June 2016.

http://ift.tt/2s76PqN

Does drug-induced sleep endoscopy predict surgical success of limited palatal muscle resection in patients with obstructive sleep apnea?

The aims of this study were to determine the associated factors affecting the success rate of limited palatal muscle resection (LPMR), and to investigate whether drug-induced sleep endoscopy (DISE) could predict the therapeutic response to LPMR in patients with obstructive sleep apnea obstructive sleep apnea (OSA).

http://ift.tt/2s7vY4M

Coverage of the dorsal surface of a digit based on a pedicled free-style perforator flap concept

Reconstruction of the finger and thumb dorsum has been considered difficult due to the need for a thin and flexible flap, and the surrounding tissue is sometimes insufficient for a local flap. The purpose of this report is to describe our concept for finger and thumb dorsum reconstruction with free-style perforator flaps and our clinical experience with transfer of various perforator flaps.

http://ift.tt/2FFElGD

“Reply - preventing the cheese-wire effect by combining steri-strips” and sutures for the management of lacerations in thin-skinned individuals. january 2017 volume 70, issue 1, pages 134-136.”

We read with interest the experimental results attaining to the technical tip of using the Steri-Strip/Suture combination. This method is indeed a useful technique in helping prevention of the cheese-wiring seen in frail skinned individuals although the application of this can be sometimes difficult, particularly if the wound is moist. The application of Steri-Strips can be quite problematic in the actively, or prone to, bleeding wound and in this instance, we would advocate the simple adjunct of using tincture of benzoin as a topical adhesive agent.

http://ift.tt/2EcC4pn

Mutual inhibition of lateral inhibition: a network motif for an elementary computation in the brain

Publication date: April 2018
Source:Current Opinion in Neurobiology, Volume 49
Author(s): Minoru Koyama, Avinash Pujala
A series of classical studies in non-human primates has revealed the neuronal activity patterns underlying decision-making. However, the circuit mechanisms for such patterns remain largely unknown. Recent detailed circuit analyses in simpler neural systems have started to reveal the connectivity patterns underlying analogous processes. Here we review a few of these systems that share a particular connectivity pattern, namely mutual inhibition of lateral inhibition. Close examination of these systems suggests that this recurring connectivity pattern ('network motif') is a building block to enforce particular dynamics, which can be used not only for simple behavioral choice but also for more complex choices and other brain functions. Thus, a network motif provides an elementary computation that is not specific to a particular brain function and serves as an elementary building block in the brain.

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A disinhibitory circuit motif and flexible information routing in the brain

Publication date: April 2018
Source:Current Opinion in Neurobiology, Volume 49
Author(s): Xiao-Jing Wang, Guangyu Robert Yang
In the mammalian neocortex, an area typically receives inputs from, and projects to, dozens of other areas. Mechanisms are needed to flexibly route information to the right place at the right time, which we term 'pathway gating'. For instance, a region in your brain that receives signals from both visual and auditory pathways may want to 'gate in' the visual pathway while 'gating out' the auditory pathway when you try to read a book surrounded by people in a noisy café. In this review, we marshall experimental and computational evidence in support of a circuit mechanism for flexible pathway gating realized by a disinhibitory motif. Moreover, recent work shows an increasing preponderance of this disinhibitory motif from sensory areas to association areas of the mammalian cortex. Pathway input gating is briefly compared with alternative or complementary gating mechanisms. Predictions and open questions for future research on this puzzle about the complex brain system will be discussed.

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The promise and perils of causal circuit manipulations

Publication date: April 2018
Source:Current Opinion in Neurobiology, Volume 49
Author(s): Steffen BE Wolff, Bence P Ölveczky
The development of increasingly sophisticated methods for recording and manipulating neural activity is revolutionizing neuroscience. By probing how activity patterns in different types of neurons and circuits contribute to behavior, these tools can help inform mechanistic models of brain function and explain the roles of distinct circuit elements. However, in systems where functions are distributed over large networks, interpreting causality experiments can be challenging. Here we review common assumptions underlying circuit manipulations in behaving animals and discuss the strengths and limitations of different approaches.

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Orbitofrontal Damage Reduces Auditory Sensory Response in Humans

Publication date: Available online 3 February 2018
Source:Cortex
Author(s): Julia W.Y. Kam, Anne-Kristin Solbakk, Ingrid Funderud, Tor Endestad, Torstein R. Meling, Robert T. Knight

http://ift.tt/2E1EMP0

Distribution and transfer of potentially toxic metal(loid)s in Juncus effusus from the indigenous zinc smelting area, northwest region of Guizhou Province, China

Publication date: 15 May 2018
Source:Ecotoxicology and Environmental Safety, Volume 152
Author(s): Yishu Peng, Jun Chen, Huairui Wei, Shibin Li, Tao Jin, Ruidong Yang
We collected samples (i.e., the aerial parts and roots of Juncus effusus and their growth media) in the indigenous zinc smelting area in the northwest region of Guizhou Province, China, and we measured and analyzed potentially toxic metal(loid)s (arsenic, As; cadmium, Cd; chromium, Cr; copper, Cu; mercury, Hg; lead, Pb and zinc, Zn) in these samples. The results include the following: First, there is a high concentration of one or more potentially toxic metal(loid)s in the slag and surrounding soil in the research area. This situation might be caused by metal(loid) damage or contamination due to the circumstances. Additionally, Juncus effusus in the indigenous zinc smelting area are contaminated by some potentially toxic metal(loid)s; since they are used for Chinese medical materials, it is especially significant that their As, Cd and Pb concentrations are greater than their limited standard values. Finally, both the bioconcentration factors and transfer factors for most potentially toxic metal(loid)s in Juncus effusus are less than 1 in the study area. Therefore, we suggest that Juncus effusus could be used for phytostabilization or as a pioneer plant for phytoremediation of potentially toxic metal(loid)s because it has a tolerance and exclusion mechanism for these metal(loid)s in the research district.

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Maize straw decorated with sulfide for tylosin removal from the water

Publication date: 15 May 2018
Source:Ecotoxicology and Environmental Safety, Volume 152
Author(s): Xuetao Guo, Yongyuan Yin, Chen Yang, Zhi Dang
MS-ZnS and MS-ZnS:Mn complexes were synthesized via a simple method. The results showed that sulfide was successfully loaded on the maize straw. The results of fitting the experimental data showed that the sorption conforms to the pseudo-second-order kinetics, and the TYL sorption on MS fit the Henry model well, but the Freundlich model was more suited to MS-ZnS and MS-ZnS:Mn. In addition, the kf values of MS-ZnS (206.0(mg/kg)/(mg/L)ⁿ) and MS-ZnS:Mn (382.5(mg/kg)/(mg/L)ⁿ) were significantly greater than that of MS (72.2(mg/kg)/(mg/L)ⁿ), indicating that ZnS and ZnS:Mn could improve the sorption capacity of TYL on MS. The pH, ionic strength and temperature influence the sorption process, and the sorption ability of TYL on MS-ZnS and MS-ZnS:Mn showed little change when the solution pH was > 5; the amount of TYL sorption on the adsorbents gradually decreased with the increasing concentration of KNO3. Electrostatic interactions, H bonding and hydrophobic interactions are involved in the sorption of TYL on MS, MS-ZnS and MS-ZnS:Mn, and compared with MS, the main mechanism is surface complexation. This research can provide technical support for the utilization of biomass and the restoration of water polluted by antibiotics.

Graphical abstract

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Steps toward understanding the impact of early emotional experiences on disordered eating: The role of self-criticism, shame, and body image shame

Publication date: 1 June 2018
Source:Appetite, Volume 125
Author(s): Ana Carolina Gois, Cláudia Ferreira, Ana Laura Mendes
In research, it has been suggested that early threatening emotional experiences, characterized by abuse, rejection, neglect or absence of affiliative signals may activate maladaptive defensive responses. Further, several studies have emphasised the association between the recall of early emotional experiences and eating psychopathology. However, this relationship does not seem to be direct. Thus, the current study explored the mediator roles of self-criticism and shame (general and body image-focused shame) in the link between early emotional experiences and the engagement in disordered eating, while controlling for the effect of body mass index. The sample of this study included 552 female participants, aged between 18 and 40 years old.The path analysis indicated that the absence of early positive emotional experiences was associated with disordered eating behaviours, through an increased perception of being negatively perceived as inferior or unattractive by others, self-critical attitudes, and body image-focused shame. The tested model accounted for 63% of body image shame and for 67% of disordered eating's variance, and showed an excellent model fit. These findings suggest that shame and self-criticism are defensive mechanisms associated with early threatening emotional experiences, which may trigger disordered eating behaviours.These data appear to offer important research and clinical implications supporting the development of intervention community programs for body and eating difficulties, that specifically target shame (general and body image-focused shame) and self-criticism, through the development of more adaptive emotional regulation strategies.

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Premenstrual appetite and emotional responses to foods among women with premenstrual dysphoric disorder

Publication date: 1 June 2018
Source:Appetite, Volume 125
Author(s): Ju-Yu Yen, Tai-Ling Liu, I-Ju Chen, Su-Yin Chen, Chih-Hung Ko
The aim of the study was to evaluate changes in late-luteal appetite for highly sweet (HS) and highly salty and fatty (HSF) foods in women with premenstrual dysphoric disorder (PMDD). After initial assessment in a psychiatric interview, the premenstrual symptoms screening tool (PSST) was used to identify women with moderate-to-severe premenstrual symptoms. Sixty-seven women with PMDD and 74 healthy controls were evaluated in the early-follicular and late-luteal (pre-menstrual) phases of the menstrual cycle. Because the PSST is designed to assess symptoms only in the late-luteal phase, an 11-point Likert scale was used to rate PMDD symptoms once a week in the evaluation mentioned previously and the following two menstrual cycles. Participants were shown pictures of 15 highly sweet (HS) and 15 highly salty and fatty (HSF) foods, desire to eat each food was rated on an eleven-point Likert scale (0, "none at all"; 10, "extreme desire"), and sweet-food craving was rated using the food craving-state questionnaire. Emotional responses to the foods were measured with a four-point Likert scale we previously validated. Depression, irritability, and impulsivity were measured with standard psychiatric instruments. Women with PMDD, but not control women, had late-luteal phase elevations in desire to eat HS food, sweet-food craving and emotional responses to HS foods. Desire to eat for HSF foods did not differ significantly across the menstrual cycle between groups. There were significant correlations between emotional responses to and desire to eat HS foods. Moreover, late-luteal phase irritability and impulsivity scores were associated with desire to eat HS foods. These data suggest that targeted assessment of increased late-luteal appetites for HS foods may facilitate clinical interventions in women with PMDD.

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Pre- and postprandial variation in implicit attention to food images reflects appetite and sensory-specific satiety

Publication date: 1 June 2018
Source:Appetite, Volume 125
Author(s): Graeme R. Davidson, Timo Giesbrecht, Anna M. Thomas, Tim C. Kirkham
Implicit attentional processes are biased toward food-related stimuli, with the extent of that bias reflecting relative motivation to eat. These interactions have typically been investigated by comparisons between fasted and sated individuals. In this study, temporal changes in implicit attention to food were assessed in relation to natural, spontaneous changes in appetite occurring before and after an anticipated midday meal. Non-fasted adults performed an emotional blink of attention (EBA) task at intervals, before and after consuming preferred, pre-selected sandwiches to satiety. Participants were required to detect targets within a rapid visual stream, presented after task-irrelevant food (preferred or non-preferred sandwiches, or desserts) or non-food distractor images. All categories of food distractor preferentially captured attention even when appetite levels were low, but became more distracting as appetite increased preprandially, reducing task accuracy maximally as hunger peaked before lunch. Postprandially, attentional capture was markedly reduced for images of the specific sandwich type consumed and, to a lesser extent, for images of other sandwich types that had not been eaten. Attentional capture by images of desserts was unaffected by satiation. These findings support an important role of selective visual attention in the guidance of motivated behaviour. Naturalistic, meal-related changes in appetite are accompanied by changes in implicit attention to visual food stimuli that are easily detected using the EBA paradigm. Preprandial enhancement of attention capture by food cues likely reflects increases in the incentive motivational value of all food stimuli, perhaps providing an implicit index of wanting. Postprandial EBA responses confirm that satiation on a particular food results in relative inattention to that food, supporting an important attentional component in the operation of sensory-specific satiety.

http://ift.tt/2E1Ecko

Similar taste-nutrient relationships in commonly consumed Dutch and Malaysian foods

Publication date: 1 June 2018
Source:Appetite, Volume 125
Author(s): Pey Sze Teo, Astrid W.B. van Langeveld, Korrie Pol, Els Siebelink, Cees de Graaf, See Wan Yan, Monica Mars
Three recent studies showed that taste intensity signals nutrient content. However, current data reflects only the food patterns in Western societies. No study has yet been performed in Asian culture. The Malaysian cuisine represents a mixture of Malay, Chinese and Indian foods. This study aimed to investigate the associations between taste intensity and nutrient content in commonly consumed Dutch (NL) and Malaysian (MY) foods. Perceived intensities of sweetness, sourness, bitterness, umami, saltiness and fat sensation were assessed for 469 Dutch and 423 Malaysian commonly consumed foods representing about 83% and 88% of an individual's average daily energy intake in each respective country. We used a trained Dutch (n = 15) and Malaysian panel (n = 20) with quantitative sensory Spectrum™ 100-point rating scales and reference solutions, R1 (13-point), R2 (33-point) and R3 (67-point). Dutch and Malaysian foods had relatively low mean sourness and bitterness (<R1), but higher mean sweetness, saltiness and fat sensation (between R1 and R2). Mean umami taste intensity of Malaysian foods (15-point) was higher than that of Dutch foods (8-point). Positive associations were found between sweetness and mono- and disaccharides (R² = 0.67 (NL), 0.38 (MY)), between umami and protein (R² = 0.29 (NL), 0.26 (MY)), between saltiness and sodium (R² = 0.48 (NL), 0.27 (MY)), and between fat sensation and fat content (R² = 0.56 (NL), 0.17(MY)) in Dutch and Malaysian foods (all, p < 0.001). The associations between taste intensity and nutrient content are not different between different countries, except for fat sensation-fat content. The two dimensional basic taste-nutrient space, representing the variance and associations between tastes and nutrients, is similar between Dutch and Malaysian commonly consumed foods.

http://ift.tt/2nFPVu7

A multidimensional approach to understanding the potential risk factors and covariates of adult picky eating

Publication date: 1 June 2018
Source:Appetite, Volume 125
Author(s): Jordan M. Ellis, Rebecca R. Schenk, Amy T. Galloway, Hana F. Zickgraf, Rose Mary Webb, Denise M. Martz
ObjectiveAdult picky eating (PE) has received increased attention in the eating behavior literature due to its important association with adult avoidant-restrictive food intake disorder (ARFID). The current study tested a model of potential risk factors of adult PE behavior, including perceived early parental feeding practices. An exploratory model was also utilized to understand associations with different aspects of adult PE behaviors.MethodsA sample of 1339 US adults recruited through Amazon's MTurk completed an online survey that included the recently developed Adult Picky Eating Questionnaire (APEQ), retrospective reports of parental feeding practices, and other measures of eating behavior and demographic variables. A structural equation modeling procedure tested a series of regression models that included BMI and disordered eating behaviors as covariates.ResultsSEM modeling indicated that retrospective reports of greater parental pressure to eat, higher disgust sensitivity, lower PE age of onset, and experiencing an aversive food event were associated with general adult PE behavior. Results also indicated parental encouragement of healthy eating may be a protective factor, and that men endorsed higher levels of adult PE. Exploratory analyses indicated that cross-sectional predictors and covariates were differentially related to specific aspects of PE as measured by the APEQ subscales.ConclusionsEarly experiences, including parental approaches to feeding, appear to be potential risk factors of PE behavior in adults. A nuanced understanding of adult PE is important for the prevention and treatment of severe PE behaviors, related psychosocial impairment, and ARFID.

http://ift.tt/2E17e3H

Ultrasensitive microfluidic paper-based electrochemical/visual biosensor based on spherical-like cerium dioxide catalyst for miR-21 detection

Publication date: 15 May 2018
Source:Biosensors and Bioelectronics, Volume 105
Author(s): Xiaolu Sun, He Wang, Yannan Jian, Feifei Lan, Lina Zhang, Haiyun Liu, Shenguang Ge, Jinghua Yu
In this work, an electrochemical biosensor based on Au nanorods (NRs) modified microfluidic paper-based analytical devices (μPADs) were constructed for sensitive detection of microRNA (miRNA) by using cerium dioxide - Au@glucose oxidase (CeO2-Au@GOx) as an electrochemical probe for signal amplification. Au NRs were synthesized by in-situ growth method in μPADs surface to enhance the conductivity and modified hairpin probe through Au-S bonds. The construction of "the signal transducer layer" was carried out by GOx catalyzing glucose to produce H2O2, which was further electrocatalyzed by CeO2. After the biosensor was constructed, an obvious electrochemical signal was observed from the reduction of H2O2. In order to make the detection more convincing, the visual detection was performed based on the oxidation of 3,3′,5,5′-tetramethylbenzidine by H2O2 with the help of Exonuclease I. The electrochemical biosensor provided a wide linear range of 1.0fM to 1000fM with a relatively low detection limit of 0.434fM by the electrochemical measurement. Linear range of 10fM to 1000fM with a relatively low detection limit of 7.382fM was obtained by visual detection. The results indicated the proposed platform has potential utility for detection of miRNA.

http://ift.tt/2DWvpMv

Homogeneous and label-free electrochemiluminescence aptasensor based on the difference of electrostatic interaction and exonuclease-assisted target recycling amplification

Publication date: 15 May 2018
Source:Biosensors and Bioelectronics, Volume 105
Author(s): Jiancong Ni, Weiqiang Yang, Qingxiang Wang, Fang Luo, Longhua Guo, Bin Qiu, Zhenyu Lin, Huanghao Yang
The difference of electrostatic interaction between free Ru(phen)3²⁺ and Ru(phen)3²⁺ embedded in double strand DNA (dsDNA) to the negatively charged indium tin oxide (ITO) electrode has been applied to develop a homogeneous and label-free electrochemiluminescence (ECL) aptasensor for the first time. Ochratoxin A (OTA) has been chosen as the model target. The OTA aptamer is first hybridized with its complementary single strand DNA (ssDNA) to form dsDNA and then interacted with Ru(phen)3²⁺ via the grooves binding mode to form dsDNA-Ru(phen)3²⁺ complex, which remains negatively charged feature as well as low diffusion capacity to the negatively charged ITO electrode surface owing to the electrostatic repulsion. Meanwhile, the intercalated Ru(phen)3²⁺ in the grooves of dsDNA works as an ECL signal reporter instead of the labor-intensive labeling steps and can generate much more ECL signal than that from the labeling probe. In the presence of target, the aptamer prefers to form an aptamer-target complex in lieu of dsDNA, which induces the releasing of Ru(phen)3²⁺ from the dsDNA-Ru(phen)3²⁺ complex into the solution. With the assistance of RecJf exonuclease (a ssDNA specific exonuclease), the released ssDNA and the aptamer in the target-complex were digested into mononucleotides. In the meantime, the target can be also liberated from OTA-aptamer complex and induce target cycling and large amount of free Ru(phen)3²⁺ present in the solution. Since Ru(phen)3²⁺ contains positive charges, which can diffuses easily to the ITO electrode surface because of electrostatic attraction, causing an obviously enhanced ECL signal detected. Under the optimal conditions, the enhanced ECL of the system has a linear relationship with the OTA concentration in the range of 0.01–1.0 ng/mL with a detection limit of 2 pg/mL. This innovative system not only expands the immobilization-free sensors in the electrochemiluminescent fields, but also can be developed for the detection of different targets easily with the same strategy by changing the aptamer used.

http://ift.tt/2EGHg2k

Simultaneous determination of ascorbic acid, dopamine and uric acid by a novel electrochemical sensor based on N2/Ar RF plasma assisted graphene nanosheets/graphene nanoribbons

Publication date: 15 May 2018
Source:Biosensors and Bioelectronics, Volume 105
Author(s): Lavanya Jothi, Sudarsan Neogi, Saravana kumar Jaganathan, Gomathi Nageswaran
A novel nitrogen/argon (N2/Ar) radio frequency (RF) plasma functionalized graphene nanosheet/graphene nanoribbon (GS/GNR) hybrid material (N2/Ar/GS/GNR) was developed for simultaneous determination of ascorbic acid (AA), dopamine (DA) and uric acid (UA). Various nitrogen mites introduced into GS/GNR hybrid structure was evidenced by a detailed microscopic, spectroscopic and surface area analysis. Owing to the unique structure and properties originating from the enhanced surface area, nitrogen functional groups and defects introduced on both the basal and edges, N2/Ar/GS/GNR/GCE showed high electrocatalytic activity for the electrochemical oxidations of AA, DA, and UA with the respective lowest detection limits of 5.3, 2.5 and 5.7 nM and peak-to-peak separation potential (ΔEP) (vs Ag/AgCl) in DPV of 220, 152 and 372 mV for AA/DA, DA/UA and AA/UA respectively. Moreover, the selectivity, stability, repeatability and excellent performance in real time application of the fabricated N2/Ar/GS/GNR/GCE electrode suggests that it can be considered as a potential electrode material for simultaneous detection of AA, DA, and UA.

http://ift.tt/2E0lOEC

Autonomous DNA nanomachine based on cascade amplification of strand displacement and DNA walker for detection of multiple DNAs

Publication date: 15 May 2018
Source:Biosensors and Bioelectronics, Volume 105
Author(s): Kun Wang, Meng-Qi He, Fu-Heng Zhai, Jin Wang, Rong-Huan He, Yong-Liang Yu
DNA can be modified to function as a scaffold for the construction of a DNA nanomachine, which can then be used in analytical applications if the DNA nanomachine can be triggered by the presence of a diagnostic DNA or some other analyte. We herein propose a novel and powerful DNA nanomachine that can detect DNA via combining the tandem strand displacement reactions and a DNA walker. Three different DNA sensing platforms are described, where the whole DNA machine was constructed on a gold electrode (GE). This cascade multiple amplification strategy exhibited an excellent sensitivity. Under optimal conditions, the electrochemical sensor could achieve a detection limit of 36 fM with a linear range from 50 to 500 fM. In particular, the electrochemical sensor could easily distinguish the base mutations. More interestingly, the DNA nanomachine could be used to construct analog AND and OR logic gates. We demonstrate that electrochemical signals generated from the different input combinations can be used to distinguish multiple target DNAs. The practical applicability of the present biosensor is demonstrated by the detection of target DNA in human serum with satisfactory results, which holds great potential for a future application in clinical diagnosis.

Graphical abstract

http://ift.tt/2EG0jKm

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Κυριακή 4 Φεβρουαρίου 2018

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