Regional Cerebral Oxygen Saturation Changes After Decompressive Craniectomy for Malignant Cerebral Venous Thrombosis: A Prospective Cohort Study

Background: Decompressive craniectomy (DC) is a life-saving intervention for malignant cerebral venous thrombosis (CVT). Earlier studies have shown increase in cerebral oxygenation after DC in traumatic brain injury but similar studies are lacking in CVT. We hypothesized that regional cerebral (tissue) oxygen saturation (rSO2) on the side of CVT is lower than the contralateral side and improves after DC. Materials and Methods: In this prospective cohort study, rSO2 was monitored using near-infrared spectroscopy technique, before and after DC on both cerebral hemispheres. Data regarding factors likely to affect rSO2 such as systolic blood pressure, partial pressure of oxygen and carbon dioxide in blood (PaO2 and PaCO2), and hemoglobin were simultaneously collected. The primary outcome measure was pre-post change in rSO2 on the ipsilateral cerebral hemisphere. The secondary outcomes were in-hospital mortality and duration of postoperative hospital stay. Results: Seventeen patients underwent DC during the 6-month study period. Their mean age was 39.2±12.4 years. The pre-post DC change in rSO2 on the hemisphere with CVT was significant (mean difference=3.6%; 95% confidence interval, 1.5-5.7; P=0.002). One patient died in the hospital. There was no difference in the duration of postoperative hospital stay (10 d [range, 6 to 21 d] vs. 14 d [range, 1 to 30 d], P=0.92) between patients with preoperative ipsilateral rSO2 60%. There was no correlation between PaO2, PaCO2, systolic blood pressure, and hemoglobin with rSO2. Conclusions: Patients with malignant CVT had a lower rSO2 on ipsilateral side of the lesion, which improved significantly after DC. Preoperative rSO2 was not correlated with the duration of hospital stay. The authors have no funding or conflicts of interest to disclose. Address correspondence to: Kamath Sriganesh, DM, Department of Neuroanaesthesia and Neurocritical Care, 3rd Floor, Neurosciences Faculty Block, NIMHANS, Hosur Road, Bengaluru 560029, India (e-mail: drsri23@gmail.com). Received November 7, 2017 Accepted January 25, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved

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In vivo optical coherence tomography imaging in a case of mucous membrane pemphigoid and a negative Nikolsky's sign

Abstract

There is currently a growing interest in new diagnostic tools of the oral cavity and mucosa which are non-invasive, repeatable and reliable. A diagnosis of a suspected, autoimmune pathology was made regarding a 57-year-old patient with desquamative gingivitis. However, a negative Nikolsky's sign did not seem to indicate a diagnosis of mucous membrane pemphigoid neither was there any indication as to the optimum location for an incisional biopsy. As an imaging method, the use of optical coherence tomography (OCT) has enabled the obtaining of tomographic (cross-sectional) scans of tissue. Such images are acquired prior to and after verifying Nikolsky's sign, thereby enabling the clinician to identify the presence (or not) of subepithelial bullae. Thereafter, an assessment of changes in the subepithelium (the split) can be performed, even in the absence of a suitable clinical picture, such as, for example, a negative Nikolsky's sign. Histological analysis and the use of indirect immunofluorescence have facilitated a diagnosis of mucous membrane pemphigoid, an autoimmune pathology, which can be confirmed with the appearance of subepithelial bullae. OCT was found to be a valid, non-invasive, auxiliary diagnostic device, capable of revealing in vivo and real-time bullae, which were hitherto clinically undetectable.

http://ift.tt/2FzPKZS

Phacomatosis pigmentovascularis type 2b (phacomatosis cesioflammea) with double superior vena cava, abdominal varicosities, and natal tooth: Novel associations

Abstract

Phacomatosis pigmentovascularis is characterized by coexistent extensive cutaneous vascular (capillary) and pigmentary anomalies. We describe a 2-month-old infant presenting with classic features of phacomatosis pigmentovascularis 2b (phacomatosis cesioflammea). He was also found to have hitherto unreported associations in the form of extensive venous anomalies presenting as striking abdominal wall varicosities and persistent left superior vena cava and natal tooth.

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Retronychia a little-known cause of paronychia: A report of two cases in adolescent patients

Abstract

Retronychia is a clinical condition resulting from embedding of the nail plate into the proximal nail fold. We report two adolescent girls, 14 and 16 years of age, with a history of chronic proximal paronychia of the great toe, one of them developing osteomyelitis. After failure of treatment with several systemic antibiotics, nail avulsion was performed, leading us to the diagnosis of retronychia and with rapid and complete resolution of symptoms in both cases. Delay in diagnosis of retronychia can lead to local complications and prolonged discomfort.

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Nipple adenoma in a 2-year-old boy

Abstract

Nipple adenoma is an uncommon proliferative process of the breast and predominantly occurs in women aged 40-50. Its incidence is extremely low in men, and it has not been reported in a boy. Although nipple adenoma is rare and benign, being familiar with it is important because it clinically resembles Paget disease and histologically adenocarcinoma. We report a case of nipple adenoma in a boy.

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Efficacy and safety of topical application of 15% and 10% potassium hydroxide for the treatment of Molluscum contagiosum

Abstract

Background/Objectives

Molluscum contagiosum is the most common skin infection in children. One topical treatment used for Molluscum contagiosum is potassium hydroxide. The objective of this study was to compare the efficacy of potassium hydroxide topical treatment at different concentrations with that of placebo in terms of complete clearing of Molluscum contagiosum lesions and to assess the safety and tolerance of potassium hydroxide topical treatment.

Methods

This was a double-blind randomized clinical trial of three treatments (potassium hydroxide 10%, potassium hydroxide 15%, placebo) applied once daily up to complete clearing of lesions (maximum duration 60 days) in 53 children aged 2-6 years in primary health care pediatric offices in Catalonia, Spain.

Results

In the intention-to-treat analysis, potassium hydroxide 10% (58.8%, P = .03) and potassium hydroxide 15% (64.3%, P = .02) had efficacy superior to that of placebo (18.8%). The number of Molluscum contagiosum lesions was significantly reduced with potassium hydroxide 10% and 15%. The main efficacy outcome was achieved in 58.8% of children in the potassium hydroxide 10% group (P = .03 vs placebo) and in 64.3% of children in the potassium hydroxide 15% group (P = .02 vs placebo). Potassium hydroxide 10% and 15% were not significantly different in efficacy from each other. Potassium hydroxide 10% and placebo were better tolerated than potassium hydroxide 15%. No adverse events were reported during the study period.

Conclusions

Potassium hydroxide 10% and 15% demonstrated high rates of efficacy in clearing Molluscum contagiosum lesions, with potassium hydroxide 10% being better tolerated.

http://ift.tt/2HLvWDt

Effects of pregnancy on skin properties: A biomechanical approach

Abstract

Background

A woman's skin is dramatically affected by pregnancy. Its biomechanical properties are critical for resisting highly stressed areas. The aim of this work was to evaluate the impact of pregnancy on the mechanical properties of skin, as well as to evaluate the imprint that pregnancy leaves on the skin after delivery.

Materials and Methods

Suction tests using a cutometer were performed on 15 non-pregnant women and 26 pregnant women at 8 months of pregnancy and 4 months after delivery. Areas of abdomen and thighs were studied.

Results

Significant differences between the non-pregnant and 8-month pregnant groups were observed. Our data demonstrate that skin becomes less elastic and less deformable on the abdomen during pregnancy. On the thighs, a loss of elasticity and firmness was also observed. At 4 months after delivery, the skin did not return to its initial state.

Conclusion

This study showed that the mechanical properties of skin changed drastically during pregnancy compared to the non-pregnant condition and that these properties remain altered 4 months after delivery. In addition to alterations in abdominal skin during pregnancy, we also observed mechanical changes on the thighs, which are less subject to stretching.

http://ift.tt/2F66B8w

Expression of miR-200c and its clinicopathological significance in patients with colorectal cancer

Publication date: Available online 26 February 2018
Source:Pathology - Research and Practice
Author(s): Mee Sook Roh, Hyoun Wook Lee, Sang Bong Jung, Kyungeun Kim, Eun Hee Lee, Moon-il Park, Jae Seok Lee, Mee-Seon Kim
MicroRNA-200c (miR-200c) is known to play a pivotal role in the regulation of epithelial-to-mesenchymal and mesenchymal-to-epithelial transition processes. However, the biological function of miR-200c in human carcinogenesis remains controversial. We examined the association of miR-200c expression with various clinicopathological factors, including KRAS mutation status and survival, in patients with colorectal cancer (CRC). The expression level of miR-200c was evaluated in 109 paired CRC and normal tissue samples using quantitative reverse transcription polymerase chain reaction. The KRAS mutation status of the CRC samples was determined using the PNAClamp™ KRAS Mutation Detection kit. Compared with the normal tissue group, miR-200c expression was significantly upregulated in the CRCs (P < .001). The expression of miR-200c was increased in CRCs with higher grade (P = .009), advanced stage (P = .042), and lymphovascular invasion (P = .003). Thirty-one CRCs (28.4%) had KRAS mutations in codon 12 or 13. CRCs with KRAS mutations had significantly higher miR-200c expression than CRCs with wild-type KRAS (P = .003). In survival analysis, high miR-200c expression was correlated with worse overall survival (P = .017) and recurrence-free survival (P = .048). Our results indicate that miR-200c is involved in tumor progression and aggressiveness in CRCs, and this oncogenic role of miR-200c may be triggered by activation of the KRAS signaling pathway.



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The report of two cases with multiple sulfatase deficiency resulting from a rare similar gene mutation

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Clinical characteristics and management of patients with rosacea in a tertiary dermatology center in Singapore from 2009 to 2013

Abstract

Introduction

Rosacea is a common chronic facial skin disease. A multiethnic society such as Singapore provides an opportunity to evaluate the demographic characteristics and their impact on clinical outcome in rosacea.

Aims

The aim of this study was to evaluate characteristics and outcome of rosacea in a multiracial population in Singapore.

Methods

Records of all rosacea patients between January 2009 and December 2013 were retrospectively retrieved from the electronic medical records (EMR). Descriptive analysis was performed to understand the characteristics of patients with rosacea. Multivariate logistic regression was used to evaluate the associations between the various variables and types of rosacea as well as the clinical outcome.

Results

A total of 1340 patients were identified. The mean age at presentation was 42.8 years with a female predominance (65%). Most of the patients had erythematotelangiectatic rosacea (ETR) (56.3%) followed by papulopustular rosacea (PPR) (37%). With multinomial logistic regression, controlling for age, gender, and known triggers, Indians and Caucasians were more likely to have PPR compared to ETR (OR: 3.4, P = 0.01 and OR: 2.1, P = 0.01 respectively). Patients who had phymatous rosacea are also more likely to be older males (OR: 3.82 95% CI 1.64–8.92, P = 0.002).

Conclusion

The epidemiology and outcome of rosacea among local patients were studied. Rosacea is more common among certain racial groups such as Chinese, Caucasian, and other races. The clinical subtypes also seem to be related to races of certain skin colors and might be related to varied natural intrinsic responses to the sun among different racial groups.

http://ift.tt/2BQiJbU

Clinical profile of dermatological emergencies and intensive care unit admissions in a tertiary care center – an Indian perspective

Abstract

Background

Although dermatology is largely considered as an outpatient specialty, dermatological conditions comprise 5–8% of cases presenting to the emergency department. The need for a dermatological intensive care unit is widely acknowledged due to the increasing incidence of acute skin failure. Very few studies have been done to characterize the common conditions seen in the emergency department and intensive care units. We undertook this study to analyze the spectrum of dermatological conditions presenting to the emergency department and the clinical profile of patients admitted to the intensive care unit.

Methods

A prospective study was conducted for 9 months. Patients requiring primary dermatological consultation in the emergency department and patients admitted in the dermatology intensive care unit were examined, and their clinical variables were statistically analyzed.

Results

A total of 248 cases were seen in the emergency department, out of which 72 (29.1%) cases were admitted and 176 (70.9%) were treated in the emergency department on an outpatient basis. The most common condition seen in non-admitted patients was acute urticaria (28.9%). The most common cause for admission in patients presenting to the emergency department was erythroderma (23.6%). Sixty-two patients were admitted to the intensive care unit, the most common diagnosis being erythroderma (40.3%).

Conclusions

This prospective study aimed to provide an insight into the types of cases evaluated in the emergency department by dermatologists in a large tertiary care hospital in coastal Karnataka in South India.

http://ift.tt/2oolee3

Onycholemmal carcinoma: a case report with its molecular profiling

Onycholemmal carcinoma (OC), also called microcystic nail bed carcinoma by some authors¹, is a slow-growing malignant epithelial tumor originating from the nail bed epithelium. Since the first description by Alessi and collegues in 2004², only twelve other cases have been described in the English literature, so far^1,3-7.

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Is HPV vaccination of pregnant women really safe?

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Fate of estrogens in a pilot-scale step-feed anoxic/oxic wastewater treatment system controlling by nitrogen and phosphorus removal

Abstract

The control measures for estrogens in the aquatic environment are topics of growing concern. It is a meaningful issue to finding optimal process parameters for efficient removal of estrogens with the purpose of efficient total nitrogen (TN) or total phosphorus (TP) removal in sewage treatment plants. The present paper is concerned with the relationships between the estrogen removal and TN or TP removal in a pilot-scale three-stage anoxic/oxic (A/O) system treating real municipal wastewater. The total removal efficiency for estrone (E1) and 17β-estradiol (E2) and their sulfate and glucuronide conjugates were on average 87% in the pilot-scale system. The concentrations of the sulfate and glucuronide conjugates of estrogens (E1 and E2) in the system were much lower than the estrogens, which might be caused by the rapid degradation of conjugates in the pilot-scale system. The average removal efficiencies of E1 and E2 and their sulfate and glucuronide conjugates were significantly lower under high TP removal conditions than those under high TN removal conditions that suggested that the ammonia oxidation promotes estrogen degradation. When the system achieved efficient TN removal, the concentrations of both E1 and E2 were generally lower in the aerobic zones than those in the anoxic zones. Instead, when the system achieved efficient TP removal conditions, the estrogen concentrations were higher in the aerobic zones than in the anoxic zones. However, it was thought that the variation of the concentrations of the estrogen conjugates had weak influence on concentrations of the free estrogens. The increase of the free estrogens in the aerobic zones could be attributed to the release of the estrogens adsorbed on the sludge. The variation of estrogens in a three-stage A/O system can be properly estimated and measured by a binary linear regression model with the variables of TP and TON (NO₂⁻-N and NO₃⁻-N), which is probably the important information for the improvement and optimization of wastewater treatment processes to obtain higher removal efficiency for estrogens.

http://ift.tt/2GK519I

Is HPV vaccination of pregnant women really safe?

http://ift.tt/2owKsG9

[Dumbbell malignant dorsal schwannoma embolized and operated by single posterior approach].

Related Articles

[Dumbbell malignant dorsal schwannoma embolized and operated by single posterior approach].

Neurocirugia (Astur). 2018 Feb 19;:

Authors: Zabalo G, de Frutos D, García JC, Ortega R, Guelbenzu JJ, Zazpe I

Abstract
We report a case of a 41 years old patient complaining of chronic dorsalgia. MRI showed a well defined intradural extramedular dumbbell-shaped lesion, associated to a left paravertebral tumor at D5-D6 level. The tumor was embolizated prior to surgery. Following she underwent a D4-D6 laminotomy, left D5-D6 costotransversectomy and resection of the intracanal extradural part of the lesion with section of the left D5 nerve. Posteriorly, complete resection of the extracanal portion of the tumor was performed by a postero-lateral approach. The anatomopathologic diagnosis was a malignant schwannoma. After the surgery, the patient required adyuvant radiotherapic treatment. Malignant schwannoma is a very uncommon tumor which belongs to the malignant peripheral nerve sheath tumors (MPNST). It develops from Schwann cells. It is frequently associated with type 1 neurofibromatosis. MPNST usually present local recurrence and can metastatize.

PMID: 29472158 [PubMed - as supplied by publisher]

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Spinal Cord Stimulation 50 Years Later: Clinical Outcomes of Spinal Cord Stimulation Based on Randomized Clinical Trials—A Systematic Review

To assess the efficacy of spinal cord stimulation (SCS) for each indication, one must critically assess each specific clinical outcome to identify outcomes that benefit from SCS therapy. To date, a comprehensive review of clinically relevant outcome-specific evidence regarding SCS has not been published. We aimed to assess all randomized controlled trials from the world literature for the purpose of evaluating the clinical outcome-specific efficacy of SCS for the following outcomes: perceived pain relief or change pain score, quality of life, functional status, psychological impact, analgesic medication utilization, patient satisfaction, and health care cost and utilization. Interventions were SCS, without limitation to the type of controls or the type of SCS in the active arms. For each study analyzed, a quality assessment was performed using a validated scale that assesses reporting, external validity, bias, confounding, and power. Each outcome was assessed specific to its indication, and the primary measure of each abovementioned outcome was a summary of the level of evidence. Twenty-one randomized controlled trials were analyzed (7 for trunk and limb pain, inclusive of failed back surgery syndrome; 8 for refractory angina pectoris; 1 for cardiac X syndrome; 3 for critical limb ischemia; 2 for complex regional pain syndrome; and 2 for painful diabetic neuropathy). Evidence assessments for each outcome for each indication were depicted in tabular format. Outcome-specific evidence scores were established for each of the abovementioned indications, providing both physicians and patients with a summary of evidence to assist in choosing the optimal evidence-based intervention. The evidence presented herein has broad applicability as it encompasses a breadth of patient populations, variations of SCS therapy, and comparable controls that, together, reflect comprehensive clinical decision making. Accepted for publication October 22, 2017. Address correspondence to: Nagy Mekhail, MD, PhD, Cleveland Clinic, C25, 9500 Euclid Ave, Cleveland, OH 44195 (e-mail: mekhain@ccf.org). The authors declare no conflict of interest. Copyright © 2018 by American Society of Regional Anesthesia and Pain Medicine.

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Altered density, composition and microanatomical distribution of infiltrating immune cells in cutaneous squamous cell carcinoma of organ transplant recipients

Summary

Background

The inflammatory tumor microenvironment is crucial for effective tumor control and long-term immunosuppression has been identified as a major risk factor for skin carcinogenesis. In solid organ transplant recipients (OTR) undergoing long-term pharmacologic immunosuppression an increased incidence of cutaneous squamous cell carcinoma (SCC) and more aggressive tumor growth compared to immunocompetent patients (IC) has been reported.

Objectives

To determine the density and phenotype of immune cells infiltrating SCC and surrounding skin in OTR, and to characterize the microanatomical distribution patterns in comparison to IC.

Methods

We analyzed immune cell infiltrates within SCC and at defined regions of interest (ROI) of tumor- surrounding skin in formalin-fixed paraffin-embedded (FFPE) tissue of 20 renal transplant patients and 18 carefully matched IC by high-resolution semi-automated microscopy on complete tissue sections stained for CD4, CD8, CD20 and CD68.

Results

The overall immune cell density of SCC arising in OTR was significantly reduced compared to IC. Particularly CD4+ infiltrates at the directly invasive margin and tumor vicinity, intratumoral CD8+ T cell densities and the overall density of CD20+ tumor-infiltrating B cells (TIL-B) were significantly reduced in tissue of OTR.

Conclusions

Immune cells infiltrates within SCC and at defined ROI of tumor-surrounding skin in OTR differ markedly in their composition and microanatomical distribution compared to tumors arising in IC. Our findings substantially broaden the understanding of how long-term systemic immunosuppression modulates the local inflammatory microenvironment in the skin and at the site of invasive SCC.

This article is protected by copyright. All rights reserved.

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Altered density, composition and microanatomical distribution of infiltrating immune cells in cutaneous squamous cell carcinoma of organ transplant recipients

Summary

Background

The inflammatory tumor microenvironment is crucial for effective tumor control and long-term immunosuppression has been identified as a major risk factor for skin carcinogenesis. In solid organ transplant recipients (OTR) undergoing long-term pharmacologic immunosuppression an increased incidence of cutaneous squamous cell carcinoma (SCC) and more aggressive tumor growth compared to immunocompetent patients (IC) has been reported.

Objectives

To determine the density and phenotype of immune cells infiltrating SCC and surrounding skin in OTR, and to characterize the microanatomical distribution patterns in comparison to IC.

Methods

We analyzed immune cell infiltrates within SCC and at defined regions of interest (ROI) of tumor- surrounding skin in formalin-fixed paraffin-embedded (FFPE) tissue of 20 renal transplant patients and 18 carefully matched IC by high-resolution semi-automated microscopy on complete tissue sections stained for CD4, CD8, CD20 and CD68.

Results

The overall immune cell density of SCC arising in OTR was significantly reduced compared to IC. Particularly CD4+ infiltrates at the directly invasive margin and tumor vicinity, intratumoral CD8+ T cell densities and the overall density of CD20+ tumor-infiltrating B cells (TIL-B) were significantly reduced in tissue of OTR.

Conclusions

Immune cells infiltrates within SCC and at defined ROI of tumor-surrounding skin in OTR differ markedly in their composition and microanatomical distribution compared to tumors arising in IC. Our findings substantially broaden the understanding of how long-term systemic immunosuppression modulates the local inflammatory microenvironment in the skin and at the site of invasive SCC.

This article is protected by copyright. All rights reserved.

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SSET Project: Cost-effectiveness Analysis of Surgical Specialty Emergency Trays in the Emergency Department

Background: We hypothesize that reusable, on-site specialty instrument trays available to plastic surgery residents in the emergency department (ED) for bedside procedures are more cost-effective than disposable on-site and remote re-usable operating room (OR) instruments at our institution. Methods: We completed a cost-effectiveness analysis comparing the use of disposable on-site kits and remote OR trays to a hypothetical, custom, reusable tray for ED procedures completed by PRS residents. Material costs of existing OR trays were used to estimate the purchasing and use-cost of a custom on-site tray for the same procedures. Cost of per procedure 'consult time' was estimated using procedure and resident salary. Results: Sixteen bedside procedures were completed over a 4.5 month period. A mean of 2.14 disposable kits were used per-procedure. Mean consultation time was 1.66 hours. Procedures that used OR trays took 3 times as long as procedures that used on-site kits (4 vs. 1.1 hours). Necessary, additional instruments were unavailable for 75% of procedures. Mean cost of using disposable kits and OR trays was $115.03/procedure versus an estimated $26.67/procedure cost of using a custom tray, yielding $88.36/procedure cost-savings. Purchase of a single custom tray ($1,421.55) would be redeemed after 2.3 weeks at 1 procedure/day. Purchasing 4 trays has projected annual cost-savings of $26,565.20. Conclusion: The purchase of specialized procedure trays will yield valuable time and cost-savings while providing quality patient care. Improving time efficiency will help achieve the Accreditation Council of Graduate Medical Education (ACGME) goals of maintaining resident well-being and developing quality improvement competency.

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Neuraxial Anesthesia During Cesarean Delivery for Placenta Previa With Suspected Morbidly Adherent Placenta: A Retrospective Analysis

BACKGROUND: General anesthesia (GA) is often selected for cesarean deliveries (CD) with placenta previa and suspected morbidly adherent placenta (MAP) due to increased risk of hemorrhage and hysterectomy. We reviewed maternal outcomes and risk factors for conversion to GA in a cohort of patients undergoing CD and hysterectomy under neuraxial anesthesia (NA). METHODS: We performed a single-center, retrospective cohort study of parturients undergoing nonemergent CD for placenta previa with suspected MAP from 1997 to 2015. Patients were classified according to whether they received GA, NA, or intraoperative conversion from NA to GA. The primary outcome measure was postoperative acuity, defined as the need for intensive care unit admission, arterial embolization, reoperation, or ongoing transfusion with ≥3 units packed red blood cells. We additionally identified variables positively associated with intraoperative conversion from NA to GA during hysterectomy. Confounding was controlled with logistic regression models. RESULTS: Of 129 patients undergoing nonemergent CD for placenta previa with suspected MAP, 122 (95%) received NA as the primary anesthetic. NA was selected in the majority of patients with a body mass index ≥40 kg/m2 (9 of 10, 90%), a history of ≥3 prior CDs (18 of 20, 90%), suspected placenta increta or percreta (29 of 35, 83%), and Mallampati classification ≥3 (19 of 21, 90%). Of 72 patients with NA at the time of delivery who required hysterectomy, 15 (21%) required conversion to GA intraoperatively. Converted patients had a higher rate of major packed red blood cell transfusion (60% vs 25%; P = .01), with similar rates of massive transfusion (9% vs 7%; P = 1.0). Converted patients also had a higher incidence of postoperative acuity (47% vs 4%; P

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Point-of-Care Fibrinogen Testing in Pregnancy

Agreement between estimated fibrinogen concentration via thromboelastography and traditional assays is not established in the parturient. We therefore recruited 56 parturients and performed Clauss and functional fibrinogen level (FLEV) tests. Mean difference of measurements was 36.8 mg/dL (95% CI, 21.8–51.9) with a standard deviation of 52.8 mg/dL. Calculated limits of agreement were 140.2 mg/dL (95% CI, 166.3–114.6) and −66.6 mg/dL (95% CI, −40.8 to −92.5), within the maximum allowable difference of 165 mg/dL. We therefore conclude that while most measurements fell within the limits of agreement, more work is needed to clearly define the role of this test in the obstetric population. Accepted for publication December 29, 2017. Funding: None. The authors declare no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://ift.tt/KegmMq). Summary Statement: In this study, the relationship between formal laboratory Clauss and thromboelastography-derived fibrinogen counts is examined. Reprints will not be available from the authors. Address correspondence to Daniel Katz, MD, Icahn School of Medicine at Mount Sinai, 1 Gustave L Levy Pl, Box 1010 KCC 8th Floor, New York, NY 10029. Address e-mail to Daniel.Katz@mountsinai.org. © 2018 International Anesthesia Research Society

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Pupillary Dilation Reflex Measurement: Ideal Time—Pre- or Postsurgery?

No abstract available

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Treatment of Chronic Pain Conditions: A Comprehensive Handbook

No abstract available

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Analgesic Effects of Oxycodone Relative to Those of Sufentanil, in the Presence of Midazolam, During Endoscopic Injection Sclerotherapy for Patients With Cirrhosis and Esophageal Varices

BACKGROUND: We evaluated the efficacy and gastroenterologist/patient satisfaction of midazolam combined with oxycodone, relative to that of midazolam combined with sufentanil, for anesthesia during endoscopic injection sclerotherapy (EIS) in patients with cirrhosis and esophageal varices. METHODS: Patients with cirrhosis (20–69 years of age), body mass index, 18–25 kg/m2, American Society of Anesthesiology patient classification physical status I–II who underwent elective EIS were randomly assigned to 1 of 2 groups. In this prospective, double-blinded, randomized controlled trial, 1 group received midazolam and oxycodone (n = 64), and the other group received midazolam and sufentanil (n = 63). Primary and secondary outcome measures were compared between groups. The primary outcome measure was the incidence of hypoxia. Secondary outcome measures included perioperative limb movement, need for rescue analgesics, need for additional sedative propofol, specified adverse reactions (postoperative myoclonus, nausea, vomiting, dizziness, and drowsiness), gastroenterologist satisfaction, and patient satisfaction with postoperative analgesia. RESULTS: Patients in the midazolam–oxycodone group had 32% fewer episodes of hypoxia than did those in the midazolam–sufentanil group (95% confidence interval [CI], –45% to –18%; P

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Perioperative Temperature Management

No abstract available

http://ift.tt/2CjuNU2

Inflammation Triggered by the Use of Blood Products

No abstract available

http://ift.tt/2sT8Mrl

In Response

No abstract available

http://ift.tt/2F1Tky6

Does A Low 6-Minute Walk Distance Predict Elevated Postoperative Troponin?

Our study of 100 major vascular and renal transplant patients evaluated the 6-minute walk test (6MWT) as an indicator of perioperative myocardial injury, using troponin as a marker. Using logistic regression and the area under the receiving operator characteristic curve, we compared the 6MWT to the Revised Cardiac Risk Index and metabolic equivalents. Only the 6MWT was associated with elevated postoperative troponins (95% CI, 0.98–0.99). However, the 6MWT area under the receiving operator characteristic curve (0.71 [95% CI, 0.57–0.85]) was not different from the Revised Cardiac Risk Index (P = .23) or metabolic equivalents (P = .14). The 6MWT may have a role in cardiac risk stratification in the perioperative setting. Accepted for publication January 16, 2018. Funding: None. The authors declare no conflicts of interest. Institutional review board contact information: 310-825-5344; webIRBHelp@research.ucla.edu. Reprints will not be available from the authors. Address correspondence to Dana L. Russell, MPH, Department of Anesthesiology, David Geffen School of Medicine, University of California Los Angeles, 757 Westwood Pl, Los Angeles, CA 90095. Address e-mail to danarussell@mednet.ucla.edu. © 2018 International Anesthesia Research Society

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The Migration of Caudally Threaded Thoracic Epidural Catheters in Neonates and Infants

BACKGROUND: The migration of pediatric thoracic epidural catheters via a thoracic insertion site has been described. We assessed the migration of caudally threaded thoracic epidural catheters in neonates and infants at our institution. METHODS: The anesthesia records and diagnostic imaging studies of neonates and infants who had caudal epidural catheters placed during a 26-month period at our hospital were analyzed. Imaging studies were reviewed for changes in epidural catheter tip position. RESULTS: Eighty-five patients 1–325 days of age (median, 51 days; interquartile range, 39–78 days) and weights of 2.5–9.5 kg (median, 5 kg; interquartile range, 4.3–5.8 kg) met the study criteria. Fifty-four (64%) of the patients (95% CI, 52%–73%) experienced catheter migration of 1 or more vertebral levels (range, 3 levels caudad [outward] to 3 levels cephalad [inward]), and 23 (27%) of the patients (95% CI, 18%–38%) experienced catheter migration to the T4 level or higher. Migration of 2 or more vertebral levels occurred only in children who weighed

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Beyond the “E” in OSCE

No abstract available

http://ift.tt/2sWbbS0

Correlation Coefficients: Appropriate Use and Interpretation

Correlation in the broadest sense is a measure of an association between variables. In correlated data, the change in the magnitude of 1 variable is associated with a change in the magnitude of another variable, either in the same (positive correlation) or in the opposite (negative correlation) direction. Most often, the term correlation is used in the context of a linear relationship between 2 continuous variables and expressed as Pearson product-moment correlation. The Pearson correlation coefficient is typically used for jointly normally distributed data (data that follow a bivariate normal distribution). For nonnormally distributed continuous data, for ordinal data, or for data with relevant outliers, a Spearman rank correlation can be used as a measure of a monotonic association. Both correlation coefficients are scaled such that they range from –1 to +1, where 0 indicates that there is no linear or monotonic association, and the relationship gets stronger and ultimately approaches a straight line (Pearson correlation) or a constantly increasing or decreasing curve (Spearman correlation) as the coefficient approaches an absolute value of 1. Hypothesis tests and confidence intervals can be used to address the statistical significance of the results and to estimate the strength of the relationship in the population from which the data were sampled. The aim of this tutorial is to guide researchers and clinicians in the appropriate use and interpretation of correlation coefficients. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Accepted for publication January 11, 2018. Funding: None. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Patrick Schober, MD, PhD, MMedStat, Department of Anesthesiology, VU University Medical Center, De Boelelaan 1117, 1081HV Amsterdam, the Netherlands. Address e-mail to p.schober@vumc.nl. © 2018 International Anesthesia Research Society

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Treatment Patterns and Clinical Outcomes in Neonates Diagnosed With Respiratory Distress Syndrome in a Low-Income Country: A Report From Bangladesh

Respiratory distress syndrome remains a leading cause of neonatal mortality worldwide. This retrospective study describes practice patterns for respiratory distress syndrome in a resource-limited setting and seeks to identify both risk factors for mortality and beneficial treatment modalities. Health, demographic, and treatment data were collected. Potential associations were analyzed using univariable and multivariable logistic regression. Of 104 children included for analysis, 38 died. Although most children were initially treated with noninvasive respiratory support, 59 progressed to invasive ventilation. Requirement for invasive ventilation was associated with death. A clear trend toward improved survival in mechanically ventilated patients was seen with surfactant administration. Accepted for publication January 11, 2018. Funding: This study was supported in part by the National Institutes of Heath (NIH) Building Interdisciplinary Research Careers in Women's Health (BIRCWH) NIH K12HD043441 scholar funds to G.L. The project described was supported by NIH through grant number UL1TR001857. Support for data collection on-site in Bangladesh ($650 total) was provided via the crowd-funding website https://experiment.com/. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Richard M. Hubbard, MD, 710 Beaver St, Sewickley, PA 15143. Address e-mail to rhubbardmd@gmail.com. © 2018 International Anesthesia Research Society

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Research Needs Assessment for Children With Obstructive Sleep Apnea Undergoing Diagnostic or Surgical Procedures

Recent concerns have been raised about the quality and safety of adenotonsillectomy, a common surgery performed to treat obstructive sleep apnea (OSA) in children. OSA is a risk factor for opioid-related perioperative respiratory complications including those associated with anoxic brain injury or death. Our objective was to identify controversial issues related to the care of children with OSA. A standardized Delphi consensus technique involving an interdisciplinary group of 24 pediatric OSA experts identified 3 key issues: "postoperative disposition, preoperative screening, and pain management." These topics are prime candidates for future systematic reviews and will guide Society of Anesthesia and Sleep Medicine–related research endeavors. Accepted for publication December 19, 2017. Funding: This study was supported solely by institutional and/or departmental sources. The authors declare no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (http://ift.tt/KegmMq). Reprints will not be available from the authors. Address correspondence to Kimmo T. Murto, MD, FRCPC, Department of Anesthesiology and Pain Medicine, Children's Hospital of Eastern Ontario-Ottawa Children's Treatment Center, University of Ottawa, 401 Smyth Rd, Ottawa, ON K1H 8L1, Canada. Address e-mail to kmurto@cheo.on.ca. © 2018 International Anesthesia Research Society

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Opioid Omission Is Not Opioid Sparing. Response to “Surgery-Induced Opioid Dependence: Adding Fuel to the Fire?”

No abstract available

http://ift.tt/2CjBlSy

Development and Initial Evaluation of a Novel, Ultraportable, Virtual Reality Bronchoscopy Simulator: The Computer Airway Simulation System

BACKGROUND: Virtual reality (VR) simulation is an effective and safe method of teaching bronchoscopic skills. Few VR bronchoscopy simulators exist; all are expensive. The present study aimed to describe the design, development, and evaluation of a new, affordable, VR bronchoscopy simulator. METHODS: Anesthesiologists and engineers collaborated to design and develop the Computer Airway Simulation System (CASS), an iPad-based, high-fidelity, VR bronchoscopy simulator. We describe hardware and software development, as well as the technical and teaching features of the CASS. Twenty-two senior anesthesiologists evaluated various aspects of the simulator (using a 5-point Likert scale) to assess its face validity. RESULTS: Anesthesiologists performed a simulated bronchoscopy (mouth to carina) with a median (range) procedural time of 66 seconds (30–96). The simulator's ease of use was rated 4.3 ± 0.8 and the bronchoscope proxy's handling 4.0 ± 0.7. Criticisms included that excessive system reactivity created handling difficulties. Anatomical accuracy, 3-dimensional bronchial segmentation, and mucosal texture were judged to be very realistic. The simulator's usefulness for teaching and its educational value were highly rated (4.9 ± 0.3 and 4.8 ± 0.4, respectively). CONCLUSIONS: We describe the design, development, and initial evaluation of the CASS—a new, ultraportable, affordable, VR bronchoscopy simulator. The simulator's face validity was supported by excellent assessments from senior anesthesiologists with regard to anatomical realism, quality of graphics, and handling performance, even though some future refinements are required. All the practitioners agreed on the significant educational potential of the CASS. Accepted for publication December 29, 2017. Funding: Cardiocentro Ticino's Department of Cardiac Anesthesia and Intensive Care in Lugano, Switzerland, employs Gabriele Casso and Tiziano Cassina. This institution received financial support for the CASS research and development project from the Foundation for Cardiological Research and Education and the FLAVA Foundation (Fondation Latine des Voies Aériennes), both charitable (not-for-profit) organizations. Conflicts of Interest: See Disclosures at the end of the article. Reprints will not be available from the authors. Address correspondence to Gabriele Casso, MD, Department of Cardiac Anesthesia and Intensive Care, Cardiocentro Ticino, Lugano, Switzerland. Address e-mail to gabriele.casso@cardiocentro.org. © 2018 International Anesthesia Research Society

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Follicular Thyroid Carcinoma in a Country of Endemic Iodine Deficiency (1994–2013)

Background. Follicular thyroid cancer (FTC) has historically been linked to iodine deficiency. Although Ghana is among the iodine deficient regions of the world, the proportions, trends, and the clinical features of FTCs have not been studied as a single disease entity. The aim of this study was to determine the relative frequencies, trends, and the clinicopathological characteristics of FTCs among all thyroid malignancies in our institution. Materials and Methods. This was a retrospective study from January 1994 to December 2013. Data were analysed using SPSS software version 23 (Chicago) and Graph pad prism version 5.00. Results. Follicular thyroid cancer was the second thyroid malignancy (35.0%) and showed a gradual rise in relative proportions over the period. The male-female ratio was 1 : 1.5. The mean ages were 46.9 (SD ±17.3) for males and 46.4 (SD ±13.3) years for females. Enlarged palpable anterior neck swelling was the commonest symptom in males (86.7%) and females (91.3%) (). Hurthle cell carcinoma was the commonest variant of FTC, with 26.7% males and 10.6% females (). Distant spread was found in 23.3% of males compared to 19.1% of females (). The common sites of distant spread were bones (57.2%) in males and cervical lymph nodes (44.4%) in females (). Conclusion. Follicular thyroid cancer was the second common thyroid malignancy (35.0%) with a gradual rise in trend over the study period and male-female ratio of 1.5 : 1. Large anterior neck swelling was the commonest clinical presentation of FTC.

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"In Vivo"[jour]; +34 new citations

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

"In Vivo"[jour]

These pubmed results were generated on 2018/02/25

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

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"Med Oral Patol Oral Cir Bucal"[jour]; +18 new citations

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

"Med Oral Patol Oral Cir Bucal"[jour]

These pubmed results were generated on 2018/02/25

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

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Effect of Eucommia ulmoides Oliv., Gynostemma pentaphyllum (Thunb.) Makino, and Curcuma longa L. on Th1- and Th2-cytokine responses and human leukocyte antigen-DR expression in peripheral blood mononuclear cells of septic patients

Publication date: 10 May 2018
Source:Journal of Ethnopharmacology, Volume 217
Author(s): Huang-Pin Wu, Yin-Ku Lin
Ethnopharmacological relevanceMany traditional Chinese medicines (TCM), such as Eucommia ulmoides Oliv., Gynostemma pentaphyllum (Thunb.) Makino, and Curcuma longa L., have been reported to have various immune-modulatory effects.Aim of the studyTo determine the effects of extracts from these three TCM on type 1 T help (Th1)- and Th2-cytokine responses and human leukocyte antigen (HLA)-DR expression in peripheral blood mononuclear cells (PBMCs) obtained from septic patients.Materials and methodsLipopolysaccharide (LPS)-stimulated PBMCs of healthy controls and septic patients were cultured for 48 hs with or without 0.05/0.1 mg/ml of TCM extract. HLA-DR expression in monocytes was detected using flow cytofluorimetry. The interferon [IFN]-γ, tumor necrosis factor [TNF]-α, interleukin (IL)− 2, IL-5, IL-10, and IL-13 levels in supernatants were measured with a human enzyme-linked immunosorbent assay.ResultsTreatment with either 0.05 or 0.1 mg/ml of C. longa L. extract significantly restored the percentage of HLA-DR-positive monocytes, which was decreased by LPS in control and patient groups. Treatment with 0.05 or 0.1 mg/ml E. ulmoides Oliv. and C.longa L. extract decreased IL-10 production from LPS-stimulated PBMCs of controls and patients. In patients with sepsis, C. longa L. extract decreased IL-10 production to a greater degree than did E. ulmoides Oliv extract. Although IFN-γ, TNF-α, or IL-13 productions from LPS-stimulated PBMCs were influenced by E. ulmoides Oliv., G. pentaphyllum (Thunb.) Makino, or C. longa L. in control or sepsis groups in this study, only the influence of IL-10 was consistent in both control and sepsis groups.ConclusionsBy enhancing monocyte HLA-DR expression and decreasing IL-10 production, C. longa L. might help restore inflammatory responses in septic patients to eradicate pathogens.

Graphical abstract

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Arachidonic acid metabonomics study for understanding therapeutic mechanism of Huo Luo Xiao Ling Dan on rat model of rheumatoid arthritis

Publication date: 10 May 2018
Source:Journal of Ethnopharmacology, Volume 217
Author(s): Nannan Wang, Xiaoning Zhao, Jiaxin Huai, Yiran Li, Congcong Cheng, Kaishun Bi, Ronghua Dai
Ethnopharmacological relevanceHuo Luo Xiao Ling Dan (HLXLD), a traditional Chinese medicine (TCM), is commonly used for the treatment of rheumatoid arthritis (RA).Aim of the studyTo explore the potential therapeutic mechanism of HLXLD on anti-inflammatory activity.Materials and methodsA metabolomic approach based on UFLC–MS/MS to profile arachidonic acid (AA) metabolic changes was used. The cyclooxygenase (COX) and lipoxygenase (LOX) catalyzed metabolites in plasma were quantified on 7, 14, 21, and 28 days after the rats injected with Complete Freund's adjuvant and orally administrated with HLXLD, methotrexate and dexamethasone in parallel as the positive control drugs.ResultsNineteen metabolites involved in COX and LOX pathways in RA model group were significant increased compared with normal group (P < 0.05), including 12-hydroxyeicosatetraenoic acid (12-HETE), 15-HETE, 8-HETE, leukotriene B4(LTB4), prostaglandin E2 (PGE2), PGI2, PGD2, PGF2α, thromboxane B2 (TXB2), etc. From day 7 to day 28, the trajectory direction of HLXLD group and positive control groups gradually moved towards the initial space, and the concentrations of AA and its metabolites after HLXLD treatment were significantly reduced in dual pathways compared to control groups.ConclusionHLXLD induced a substantial change in the AA metabolic profiles through refrain the expression of COX and LOX. The present investigation also highlights that distinct ingredients of this formula tend to inhibit different target to achieve a therapeutic effect.

Graphical abstract

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Laparoscopic repair of vesicovaginal fistulae with a transperitoneal approach at Universitas Gadjah Mada Urological Institute: a case report

A vesicovaginal fistula is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault. In addition, the sequelae f...

http://ift.tt/2opagVA

Frightened by the perpetrator’s voice: Startle responsivity and cognitive processing predict earwitness speaker identification

Publication date: Available online 25 February 2018
Source:Biological Psychology
Author(s): Maartje J. Schreuder, Thomas Meyer, Alana C. Krix
This study was inspired by the case of a robbery victim who was startled and reminded of the crime upon hearing a stranger's voice, while not clearly recognizing the speaker. To investigate whether specific voices can modulate startle reactions and thereby predict speaker identification, we presented an audio hijack scenario to 84 participants and afterwards asked them to identify the perpetrator among neutral and negative speech fragments, while measuring flash-evoked eye-blink startle responses. Furthermore, we addressed data-driven cognitive processing during the audio scenario as a potential moderator in voice discrimination. Negative speech and the perpetrator's voice led to potentiated startle. Enhanced startle was positively associated with voice discrimination, but only in neutral speech fragments. In negative fragments, this association was weakened as a function of self-reported levels of data-driven processing during encoding. Thus, startle responses can generally predict accurate voice recognition, but speech emotionality and cognitive processing moderate this relationship.



http://ift.tt/2F24bI7

Structural design, synthesis and substituent effect of hydrazone-N-acylhydrazones reveal potent immunomodulatory agents

Publication date: Available online 25 February 2018
Source:Bioorganic & Medicinal Chemistry
Author(s): Cássio S. Meira, José Maurício dos Santos Filho, Caroline C. Sousa, Pâmela S. Anjos, Jéssica V. Cerqueira, Humberto A. Dias Neto, Rafael G. da Silveira, Helena M. Russo, Jean-Luc Wolfender, Emerson F. Queiroz, Diogo R.M. Moreira, Milena B.P. Soares
4-(Nitrophenyl)hydrazone derivatives of N-acylhydrazone were synthesized and screened for suppress lymphocyte proliferation and nitrite inhibition in macrophages. Compared to an unsubstituted N-acylhydrazone, active compounds were identified within initial series when hydroxyl, chloride and nitro substituents were employed. Structure-activity relationship was further developed by varying the position of these substituents as well as attaching structurally-related substituents. Changing substituent position revealed a more promising compound series of antiinflammatory agents. In contrast, an N-methyl group appended to the 4-(nitrophenyl)hydrazone moiety reduced activity. Antiinflammatory activity of compounds is achieved by modulating IL-1β secretion and prostaglandin E2 synthesis in macrophages and by inhibiting calcineurin phosphatase activity in lymphocytes. Compound SintMed65 was advanced into an acute model of peritonitis in mice, where it inhibited the neutrophil infiltration after being orally administered. In summary, we demonstrated in great details the structural requirements and the underlying mechanism for antiinflammatory activity of a new family of hydrazone-N-acylhydrazone, which may represent a valuable medicinal chemistry direction for the antiinflammatory drug development in general.

Graphical abstract

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Synthesis, antitumor activity and DNA binding features of benzothiazolyl and benzimidazolyl substituted isoindolines

Publication date: Available online 25 February 2018
Source:Bioorganic & Medicinal Chemistry
Author(s): Irena Sović, Samy Jambon, Sandra Kraljević Pavelić, Elitza Markova-Car, Nataša Ilić, Sabine Depauw, Marie-Hélène David-Cordonnier, Grace Karminski-Zamola
In this paper novel isoindolines substituted with cyano and amidino benzimidazoles and benzothiazoles were synthetized as new potential anti-cancer drugs. The new structures were evaluated for antiproliferative activity, cell cycle changes, cell death, as well as DNA binding and topoisomerase inhibition properties on selected compounds. Results showed that all tested compounds exerted antitumor activity, especially amidinobenzothiazole and amidinobenzimidazole substituted isoindolin-1-ones and benzimidazole substituted 1-iminoisoindoline that showed antiproliferative effect in the submicromolar range. Moreover, the DNA-binding properties of selected compounds were evaluated by biophysical and biochemical approaches including thermal denaturation studies, circular dichroism spectra analyses and topoisomerase I/II inhibition assays and results identified some of them as strong DNA ligands, harboring or not additional topoisomerase II inhibition and able to locate in the nucleus as determined by fluorescence microscopy. In conclusion, we evidenced novel cyano- and amidino-substituted isoindolines coupled with benzimidazoles and benzothiazoles as topoisomerase inhibitors and/or DNA binding compounds with potent antitumor activities.

Graphical abstract

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Sexuality in the lives of people with intellectual disabilities: A meta-ethnographic synthesis of qualitative studies

Publication date: April 2018
Source:Research in Developmental Disabilities, Volume 75
Author(s): Charlotte Whittle, Catherine Butler
BackgroundThe normalisation movement calls for more recognition of the sexual rights of people with intellectual disabilities to challenge classically paradoxical cultural beliefs: 'hypersexual' versus 'asexual'.AimsThis meta-ethnographic qualitative synthesis aimed to explore the voices of people with intellectual disabilities in regards to their experiences and perceptions of sexuality using a Coordinated Management of Meaning framework to derive new conceptual understandings of how their sexuality exists within multiple contexts.Methods and proceduresA systematic literature search and quality assessment yielded 16 studies that met the inclusion criteria and were synthesised following the method of meta-ethnography.Outcomes and resultsFour core themes were identified; 'Sociocultural Norms'; 'Under Others Power'; 'Sexual Identity' and 'Sexual Experience'.Conclusions and implicationsApplication of the hierarchical Coordinated Management of Meaning model suggested caregivers contextual beliefs about people with intellectual disabilities' sexuality inhibited or facilitated positive expressions of sexuality over and above individual needs and desires. Rights-based cultural messages provided the only context that led to positive sexuality outcomes and research that explores sexuality within this context is much needed. The Coordinated Management of Meaning model identified by this research may act as a framework to support the reflective-practice of caregivers.



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Editorial Board

Publication date: March 2018
Source:Autoimmunity Reviews, Volume 17, Issue 3





http://ift.tt/2HNermm

Editorial Board

Publication date: March 2018
Source:Autoimmunity Reviews, Volume 17, Issue 3





http://ift.tt/2HNermm

Should Multiple Vessels be Recanalised for Tissue Loss Irrespective of Pedal Anatomy and Angiosome?

Publication date: Available online 24 February 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Sikandar Z. Khan, Hasan H. Dosluoglu




http://ift.tt/2FwLlGX

Interoception sensitivity in the parental brain during the first months of parenting modulates children's somatic symptoms six years later: The role of oxytocin

Publication date: Available online 24 February 2018
Source:International Journal of Psychophysiology
Author(s): Eyal Abraham, Talma Hendler, Orna Zagoory-Sharon, Ruth Feldman
Interoception, the perception and interpretation of one's own bodily signals, is a key aspect of human caregiving that impacts infant health and well-being across life. Interoception relies on limbic structures, mainly the amygdala, and the agranular visceromotor cortex, particularly the anterior insula (AI), that integrate with the oxytocin (OT) system to support interoceptive sensitivity. Here, we used functional magnetic resonance imaging (fMRI) to examine whether interoception sensitivity in the parent's brain during the first months of parenting combines with sensitive parenting and OT-system functionality to predict children's somatic symptoms six years later. We followed 45 primary-caregiving first-time mothers and fathers and their infants across the first six years of parenting. In infancy (Time 1), parents' brain response to infant stimuli was imaged, salivary OT measured, and parent-infant interactions coded for parent sensitivity. In preschool (Time 2), parent and child's OT and parent sensitivity were measured again. At six years (Time 3), parents reported on children's somatic symptoms. Greater activation of the parent's AI bilaterally when his/her child was an infant predicted lower child somatic problems at six years. Parent sensitivity partially mediated the links between parental AI activation and child somatic symptoms. In addition, greater parental bilateral amygdala activity predicted higher child OT levels at 3 years and parental OT moderated the relations between preschoolers' OT and later somatic symptoms. Our findings chart two independent cross-generational pathways from interoception sensitivity in the parent's brain and child somatization. The first defines an evolutionary-ancient path including the amygdala and the OT system that support mammalian attention to arousal modulations in response to social cues; the second, via the AI, implicates higher-order interoceptive representations of bodily responses and affective states that underpins human embodiment.



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Expression profiles of stemness genes in gastrointestinal stromal tumor

Publication date: Available online 25 February 2018
Source:Human Pathology
Author(s): Chenguang Bai, Xiaohong Liu, Jingjing Xu, Chen Qiu, Runqiu Wang, Jianming Zheng
Gastrointestinal stromal tumor (GIST) is believed to originate from intestinal cells of Cajal or their stem-cell precursors, and expresses stemness-related markers, such as CD117, CD34, DOG1 and nestin. To further characterize phenotypic features of GISTs, we examined expression profiles of a panel of stemness genes in GISTs, by analyzing existing gene expression profiling datasets. Our results showed that mRNA levels of B-lymphoma moloney murine leukaemia virus insertion region-1 (BMI1), kruppel-like factor 4 (KLF4), sal-like protein 4 (SALL4) and telomerase reverse transcriptase (TERT) were significantly unregulated in GISTs. Subsequently, protein expression of BMI1 and TERT was identified in GIST specimens by immunohistochemistry. Especially, we found that high expression of nuclear BMI1 was associated with large tumor size (P = 0.0239), high mitotic count (P < 0.01), high Ki-67 index (P = 0.0357), advanced National Institute of Health (NIH) criteria (P = 0.0025) and advanced World Health Organization (WHO) classification (P < 0.01) in GISTs. Functional and pathway enrichment analysis showed that most of BMI1's coexpressed genes were involved in tumor growth-related process, such as regulation of cell cycle and proliferation. Furthermore, we confirmed RAS oncogene family (RAB18) and limb development membrane protein 1 (LMBR1) genes as novel targets for BMI1 in GIST cells. These results provide valuable information for the expression profiles of stemness genes in GISTs, and identified nuclear BMI1 as an important marker of GIST cell proliferation and progression.



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Primary low-grade fibromyxoid sarcoma of breast: A rare case report with immunohistochemical and fluorescence in situ hybridization detection

Publication date: Available online 25 February 2018
Source:Human Pathology
Author(s): Yutao Zhang Master, Dan Wan Master, Fuping Gao Master
Low-grade fibromyxoid sarcoma (LGFMS) is a rare tumor with a bland histological appearance but malignant biological behavior. Primary LGFMS of breast has not been described in the English-language literature. Here, we report a 58-year-old Chinese female patient who presented with a painless mass in the right breast for more than 30 years. The tumor consists of spindle cells resembling fibroblasts and includes two kinds of morphological change, which are alternating collagenized hypocellular zone and cell-rich myxoid area. There are more arcades of curvilinear blood vessels. The spindle cells are not heteromorphic and mitotic figures are scarce. Immunostaining shows tumor cells are positive for vimentin, mucin4, CD99 and Bcl-2, but negative for SMA, desmin, S100, CD34, ALK and myogenin. FUS gene rearrangement is positively detected by FISH. The patient has been followed up for 59 months and is in a favorable condition. This rare location of LGFMS should be noted.



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Familial PDGFRA mutation- syndrome: somatic and gastrointestinal phenotype

Publication date: Available online 25 February 2018
Source:Human Pathology
Author(s): Paul N. Manley, Suzan Abu-Abed, Richard Kirsch, Andrea Hawrysh, Nicole Perrier, Harriet Feilotter, Aaron Pollett, Robert Riddell, Lawrence Hookey, Jagdeep S. Walia
Germline activating platelet derived growth factor receptor alpha (PDGFRA) mutations have been described in four families. All the index patients have presented with multiple mesenchymal tumors of the gastrointestinal tract. We identified a fifth family with four first-degree relatives that harbor a PDGFRA exon 18 (D846V) germline mutation. The affected kindred have a unique phenotype including coarse facies and skin, broad hands and feet, and previously undescribed premature tooth loss. While the index patient presented with multiple small bowel inflammatory fibroid polyps (IFPs) and has a gastric gastrointestinal stromal tumor (GIST), no tumors have yet been identified in other family members. We describe the pathology, genetics and the incomplete penetrance and variable expressivity of the familial PDGFRA-mutation syndrome referencing the mouse knock-in Pdgfra model. We speculate on the role of the telocyte, a recently described CD34, PDGFRA+ stromal cell, in the development of inflammatory fibroid polyps and the somatic phenotype.



http://ift.tt/2EPTmtj

Differences and similarities in early vocabulary development between children with hearing aids and children with cochlear implant enrolled in 3-year auditory verbal intervention

Publication date: May 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 108
Author(s): Lone Percy-Smith, Maria Hallstrøm, Jane Lignel Josvassen, Jeanette Hølledig Mikkelsen, Lena Nissen, Eveline Dieleman, Per Cayé-Thomasen
ObjectiveThe overall objective of this study was to evaluate the implementation of a Nordic Auditory Verbal (AV) intervention for children with all degrees and types of hearing impairment (HI) using all kinds of hearing technology. A first specific objective was to identify differences and similarities in early vocabulary development between children with cochlear implant (CI) compared with children with hearing aids (HAs)/Bone anchored hearing aids (Bahs) enrolled in a 3-year AVprogram, and to compare the group of children with HI to a control group of children with normal hearing (NH). A second specific objective was to study universal neonatal hearing screening (UNHS) using the 1-3-6 Early Hearing Detection and Intervention (EHDI) guidelines.IntroductionEffect of AV intervention for children with HI using different hearing technology is not thoroughly studied. It is relevant to question, whether children with mild to moderate HI encounter the same intensive need for AV intervention as children with congenital deafness.MethodsA longitudinal and comparative study design was used involving two cohorts of children, i.e. 36 children with CI and 19 children with HA/Bahs. The children were the first in Denmark to receive a 3-year AV intervention by formally trained AV-practitioners. Children were tested annually with standardized speech and language tests, i.e. Peabody Picture Vocabulary test, Reynell test and a Danish test for active vocabulary, Viborgmaterialet. Categorical variables were compared using Fischer's exact test and continuous variables were compared using Wilcoxon-Mann-Whitney test, as data was not normally distributed.ResultsMedian age of diagnosis was 6 months and median age at intervention was 13 and 12 months respectively. There was no statistically significant difference between the two groups in terms of scores according to age equivalency for the three tests. However, there was a significant difference between children with HI regardless of hearing technology and children with NH.ConclusionChildren with HI progressed over a three-year period, but they did not reach the same level as children with NH. The high completion rate of 98,2% of families over a three-year period indicates the relevance of AV practice in a Nordic country. Children were diagnosed later than 3 months and intervention also started later than recommended. A result that warrants further investigation.



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Influence of dressing application time after breast augmentation on cutaneous colonization: A randomized clinical trial.

Influence of dressing application time after breast augmentation on cutaneous colonization: A randomized clinical trial.

J Plast Reconstr Aesthet Surg. 2018 Feb 20;:

Authors: Mendes DA, Veiga DF, Veiga-Filho J, Loyola ABAT, Paiva LF, Novo NF, Sabino-Neto M, Ferreira LM

Abstract
Concepts regarding the best way to treat a surgical wound vary, in literature, ranging from no dressing use to dressing maintenance for 24 to 48 hours or until suture removal. This study aimed to evaluate the influence of the length of dressing maintenance after breast augmentation with implants on cutaneous colonization and surgical site infection. This is a two-arm, parallel group, randomized clinical trial. Eighty patients who were candidates for augmentation mammoplasty with silicone implants were randomly allocated to two groups, in which the dressing was removed on postoperative day 1 (group A, n = 40) or postoperative day 6 (group B, n = 40). Cutaneous colonization was examined by culturing samples collected before and after dressing removal. The criteria defined by the Centers for Disease Control and Prevention were used to assess surgical site infection. No significant difference regarding cutaneous colonization was observed between groups before dressing application. On postoperative day 6, significantly more bacterial growth was observed in group A (p = 0.01). No surgical site infection occurred. We concluded that maintaining the dressing for 6 days led to a lower cutaneous colonization but did not influence surgical site infection rates.

PMID: 29475792 [PubMed - as supplied by publisher]

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Breast reconstruction and risk of arm lymphedema development: A meta-analysis.

Breast reconstruction and risk of arm lymphedema development: A meta-analysis.

J Plast Reconstr Aesthet Surg. 2018 Feb 21;:

Authors: Siotos C, Sebai ME, Wan EL, Bello RJ, Habibi M, Cooney DS, Manahan MA, Cooney CM, Seal SM, Rosson GD

Abstract
BACKGROUND: Lymphedema remains a significant complication following breast cancer surgery when there is axillary lymph node intervention. Previous systematic reviews have identified risk factors for breast cancer-related lymphedema, including increased BMI, number of lymph nodes dissected and radiotherapy. However, they have not examined the effect of breast reconstruction on lymphedema occurrence. In this systematic review and meta-analysis, we sought to evaluate the association between breast reconstruction (BR) and lymphedema.
METHODS: We searched PubMed (1966-2016), Embase (1966-2016), Scopus (2004-2016) and Google Scholar (2004-2016) for studies involving breast reconstruction and upper-extremity lymphedema or breast cancer-related lymphedema. Our primary outcome was lymphedema occurrence. We performed a meta-analysis using random effects due to heterogeneity of the studies.
RESULTS: Our search strategy identified 934 articles. After screening, 19 studies were included in our meta-analysis evaluating outcomes based on number of patients (7501) or number of breasts surgically treated (2063). Breast reconstruction was significantly associated with lower odds of lymphedema (p < 0.001) compared to mastectomy only or breast-conserving surgery. Lymphedema rates were not statistically significantly different between patients undergoing implant-based or autologous BR.
CONCLUSIONS: Breast reconstruction is associated with lower rates of lymphedema compared to mastectomy only or breast conserving surgery patients. Although the study does not prove causation, we hypothesize that this association is likely due to multiple factors, including a self-selecting population and mechanisms through which BR may contribute to primary or secondary prevention of lymphedema. Further prospective studies are needed to clarify this beneficial relationship between breast reconstruction and reduced lymphedema risk.

PMID: 29475791 [PubMed - as supplied by publisher]

http://ift.tt/2FuhbE7

Risk of alcohol use disorder among South African university students: The role of drinking motives

Publication date: July 2018
Source:Addictive Behaviors, Volume 82
Author(s): J. Maphisa Maphisa, Charles Young




http://ift.tt/2CGw03C

Why I eat at night: A qualitative exploration of the development, maintenance and consequences of Night Eating Syndrome

Publication date: 1 June 2018
Source:Appetite, Volume 125
Author(s): James A. Shillito, James Lea, Stephanie Tierney, Jacqueline Cleator, Sara Tai, John P.H. Wilding
Night Eating Syndrome (NES), as a diagnosis, presents as a combination of disordered eating, sleep and mood. Patients identified as having both NES and obesity demonstrate poorer outcomes in terms of weight loss compared to those with NES only. However, research focusing on psychological factors associated with NES remains relatively underdeveloped. This study aimed to explore the relationship between NES and the experience of emotion from the perspective of patients accessing a weight management service. Ten adults who met diagnostic criteria for moderate or full NES took part in a semi-structured interview. Data were analysed using a constructivist approach to grounded theory. A core concept to emerge from the analysis was termed 'emotional hunger'; reflecting an urge or need to satiate a set of underlying unmet emotional needs. It was underpinned by the following interrelated themes: (1) Cultivating a dependency on food; (2) Relying on food to regulate emotions; (3) Understanding the significance of night-time; (4) Acknowledging the consequences of night eating. This study provides an in-depth understanding of the relationship between NES and the experience of emotion from the perspective of patients attending a weight management service. Results have potential to inform future service development, particularly around the adoption of a more holistic approach to night eating behaviours.



http://ift.tt/2CJew6v

Stress and psychological constructs related to eating behavior are associated with anthropometry and body composition in young adults

Publication date: 1 June 2018
Source:Appetite, Volume 125
Author(s): Katie C. Hootman, Kristin A. Guertin, Patricia A. Cassano
BackgroundThe transition to college is associated with weight gain, but the relation between eating behavior indicators and anthropometric outcomes during this period remains unclear.ObjectiveWe aimed to evaluate sex differences in stress, emotional eating, tendency to overeat, and restrained eating behavior, and determine whether the psycho-behavioral constructs assessed immediately prior to starting college are associated with anthropometry and adiposity at the start of college, and with first-semester weight gain.MethodsA prospective study administered the Three Factor Eating Questionnaire (TFEQ), Satter Eating Competence Inventory, and Perceived Stress Scale (PSS) to 264 participants one month before college. Body composition was assessed via dual energy X-ray absorptiometry (DXA) at the start of college, and anthropometry (weight, height, waist circumference [WC]) was collected at the beginning and end of the first semester. Ordinary least squares regression tested the cross-sectional association of baseline psychological and behavioral scales with baseline DXA and anthropometry, and the longitudinal association with change in anthropometry.ResultsAmong 264 participants, 91% (241) had baseline data, and 66% (173) completed follow-up. In sex-adjusted linear regression models, baseline TFEQ disinhibited and emotional (DE; EE) eating sub-scales were positively associated with baseline weight (P = 0.003; DE, P = 0.014; EE), body mass index (BMI, P = 0.002; DE, P = 0.001; EE), WC (P = 0.004; DE, P = 0.006; EE) and DXA fat mass index (P = 0.023; DE, P = 0.014; EE). Baseline PSS was positively associated with subsequent changes in weight and WC among males only (Pinteraction = 0.0268 and 0.0017 for weight and WC, respectively).ConclusionCollege freshmen with questionnaire scores indicating a greater tendency to overeat in response to external cues and emotions tended to have greater weight, BMI, and WC at the start of college. Males with higher perceived stress at college entrance subsequently gained significantly more weight in the first semester, but no such relation was evident in females.



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Intragastric preloads of l-tryptophan reduce ingestive behavior via oxytocinergic neural mechanisms in male mice

Publication date: 1 June 2018
Source:Appetite, Volume 125
Author(s): Sarah N. Gartner, Fraser Aidney, Anica Klockars, Colin Prosser, Elizabeth A. Carpenter, Kiriana Isgrove, Allen S. Levine, Pawel K. Olszewski
Human and laboratory animal studies suggest that dietary supplementation of a free essential amino acid, l-tryptophan (TRP), reduces food intake. It is unclear whether an acute gastric preload of TRP decreases consumption and whether central mechanisms underlie TRP-driven hypophagia. We examined the effect of TRP administered via intragastric gavage on energy- and palatability-induced feeding in mice. We sought to identify central mechanisms through which TRP suppresses appetite. Effects of TRP on consumption of energy-dense and energy-dilute tastants were established in mice stimulated to eat by energy deprivation or palatability. A conditioned taste aversion (CTA) paradigm was used to assess whether hypophagia is unrelated to sickness. c-Fos immunohistochemistry was employed to detect TRP-induced activation of feeding-related brain sites and of oxytocin (OT) neurons, a crucial component of satiety circuits. Also, expression of OT mRNA was assessed with real-time PCR. The functional importance of OT in mediating TRP-driven hypophagia was substantiated by showing the ability of OT receptor blockade to abolish TRP-induced decrease in feeding. TRP reduced intake of energy-dense standard chow in deprived animals and energy-dense palatable chow in sated mice. Anorexigenic doses of TRP did not cause a CTA. TRP failed to affect intake of palatable yet calorie-dilute or noncaloric solutions (10% sucrose, 4.1% Intralipid or 0.1% saccharin) even for TRP doses that decreased water intake in thirsty mice. Fos analysis revealed that TRP increases activation of several key feeding-related brain areas, especially in the brain stem and hypothalamus. TRP activated hypothalamic OT neurons and increased OT mRNA levels, whereas pretreatment with an OT antagonist abolished TRP-driven hypophagia. We conclude that intragastric TRP decreases food and water intake, and TRP-induced hypophagia is partially mediated via central circuits that encompass OT.



http://ift.tt/2CJeueT

A TRACER 3D Co-Culture tumour model for head and neck cancer

Publication date: May 2018
Source:Biomaterials, Volume 164
Author(s): Miki Young, Darren Rodenhizer, Teresa Dean, Elisa D'Arcangelo, Bin Xu, Laurie Ailles, Alison P. McGuigan
Cancer-associated fibroblasts (CAFs) are a key component of the tumour microenvironment and have been shown to play an important role in the progression of cancer. To probe these tumour-stroma interactions, we incorporated CAFs derived from head and neck cancer patients and squamous carcinoma cells of the hypopharynx (FaDu) into the Tissue Roll for the Analysis of Cellular Environment and Response (TRACER) platform to establish a co-culture platform that simulates the CAF-tumour microenvironmental interactions in head and neck tumours. TRACER culture involves infiltrating cells into a thin fibrous scaffold and then rolling the resulting biocomposite around a mandrel to generate a 3D and layered structure. Patterning the fibrous scaffold biocomposite during fabrication enables control over the specific location of different cell populations in the rolled configuration. Here, we optimized the seeding densities and configurations of the CAF and FaDu cell tissue sections to enable a robust 3D co-culture system under normoxic conditions. Co-culture of CAFs with FaDu cells produced negligible effects on radiation resistance, but did produce increases in proliferation rate and invasive cell migration at 24 and 48 h of culture. Our study provides the basis for use of our in vitro co-culture TRACER model to investigate the tumour-stroma interactions, and to bridge the translational gap between preclinical and clinical studies.



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Editorial Board

Publication date: April 2018
Source:Biomaterials, Volume 162





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Molecular characterization of primary humic-like substances in fine smoke particles by thermochemolysis–gas chromatography–mass spectrometry

Publication date: May 2018
Source:Atmospheric Environment, Volume 180
Author(s): Xingjun Fan, Siye Wei, Mengbo Zhu, Jianzhong Song, Ping'an Peng
In this study, the molecular structures of primary humic-like substances (HULIS) in fine smoke particles emitted from the combustion of biomass materials (including rice straw, corn straw, and pine branches) and coal, and atmospheric HULIS were determined by off-line tetramethylammonium hydroxide thermochemolysis coupled with gas chromatography and mass spectrometry (TMAH-GC/MS). A total of 89 pyrolysates were identified by the thermochemolysis of primary and atmospheric HULIS. The main groups were polysaccharide derivatives, N-containing compounds, lignin derivatives, aromatic acid methyl ester, aliphatic acid methyl ester, and diterpenoid derivatives. Both the type and distribution of pyrolysates among primary HULIS were comparable to those in atmospheric HULIS. This indicates that primary HULIS from combustion processes are important contributors to atmospheric HULIS. Some distinct differences were also observed. The aromatic compounds, including lignin derivatives and aromatic acid methyl ester, were the major pyrolysates (53.0%–84.9%) in all HULIS fractions, suggesting that primary HULIS significantly contributed aromatic structures to atmospheric HULIS. In addition, primary HULIS from biomass burning (BB) contained a relatively high abundance of lignin and polysaccharide derivatives, which is consistent with the large amounts of lignin and cellulose structures contained in biomass materials. Aliphatic acid methyl ester and benzyl methyl ether were prominent pyrolysates in atmospheric HULIS. Moreover, some molecular markers of specific sources were obtained from the thermochemolysis of primary and atmospheric HULIS. For example, polysaccharide derivatives, pyridine and pyrrole derivatives, and lignin derivatives can be used as tracers of fresh HULIS emitted from BB. Diterpenoid derivatives are important markers of HULIS from pine wood combustion sources. Finally, the differences in pyrolysate types and the distributions between primary and atmospheric HULIS suggested that the primary HULIS would undergo many atmospheric processes to reconstruct the macromolecular organic matter in atmospheric aerosols.



http://ift.tt/2FtYmku

Preparation of PEGylated cationic nanoliposome-siRNA complexes for cancer therapy.

Preparation of PEGylated cationic nanoliposome-siRNA complexes for cancer therapy.

Artif Cells Nanomed Biotechnol. 2018 Feb 23;:1-9

Authors: Haghiralsadat F, Amoabediny G, Naderinezhad S, Forouzanfar T, Helder MN, Zandieh-Doulabi B

Abstract
Cationic liposomes have been investigated as non-viral vectors for gene delivery for more than a decade to overcome challenges associated with viral gene delivery. However, due to instability of liposomes, siRNA delivery is still a serious problem. In this study, we developed stealth PEGylated liposome formulations and focused on the effects of PEGylated liposomes on parameters related to size, zeta potential, polydispersity index, siRNA-loading efficiency and long-term stability of the siRNA-liposome complex. We were able to generate siRNA lipoplexes that could be very efficiently loaded, did not aggregate, could be stored at 4 °C for at least 6 months with only marginal release (1-5%) of siRNA and enhanced intracellular delivery of siRNA. Moreover, we could demonstrate that PEGylation positively contributed to all these parameters compared to liposomes, which were not PEGylated. The prepared lipoplex was successfully silenced J1P1 expression in MG-63 osteosarcoma cell line. In conclusion, our novel PEGylated liposomes have high potential for systemic delivery of siRNA and can improve in vivo stability of free siRNA and also siRNA lipoplexes.

PMID: 29475393 [PubMed - as supplied by publisher]

http://ift.tt/2EQ3CSv

Nucleoside diphosphate kinase 2 confers acquired 5-fluorouracil resistance in colorectal cancer cells.

Nucleoside diphosphate kinase 2 confers acquired 5-fluorouracil resistance in colorectal cancer cells.

Artif Cells Nanomed Biotechnol. 2018 Feb 23;:1-10

Authors: Wen S, Wang X, Wang Y, Shen J, Pu J, Liang H, Chen C, Liu L, Dai P

Abstract
Colorectal cancer (CRC) is the third leading cause of cancer-related deaths worldwide. 5-fluorouracil (5-FU)-based chemotherapeutic regimens are routinely used for the treatment of patients with CRC. However, recurrence and chemotherapeutic drug resistance limit the survival rates of patients with CRC. DNA methylation participates in diverse cellular processes by regulating the transcription of a large number of genes expression, cell division, apoptosis, cell adhesion and differentiation, and metabolism, thus it might mediate chemoresistance. Using an Illumina Infinium HD Assay, DNA methylation levels in a human 5-FU-resistant HCT-8 CRC cell line (HCT-8/FU) and its progenitor cell line HCT-8 were analysed. A total of 16,580 differentially methylated genes were identified, of which 8885 were hypermethylated and 7695 were hypomethylated in resistant cells. Among these genes, NME2 (nucleoside diphosphate kinase 2) exhibited a significant difference in methylation between cell lines and has known roles in gastric cancer and breast cancer; accordingly, we hypothesized that it plays a role in acquired resistance in CRC. Knockdown of NME2 restored 5-FU sensitivity in 5-FU-resistant CRC cells, reduced cell survival and increased cell apoptosis; and overexpression of NME2 in HCT-8 cells results in the acquisition of resistance to 5-FU, this alteration enhanced HCT-8 cells growth abilities and reduced apoptosis. These findings suggest that NME2 mediates chemoresistance to 5-FU in CRC and that specific NME2 inhibition could optimize 5-FU-based chemotherapy of CRC.

PMID: 29475390 [PubMed - as supplied by publisher]

http://ift.tt/2EPfTGN

Ion-sensitive in situ hydrogels of natamycin bilosomes for enhanced and prolonged ocular pharmacotherapy: in vitro permeability, cytotoxicity and in vivo evaluation.

Ion-sensitive in situ hydrogels of natamycin bilosomes for enhanced and prolonged ocular pharmacotherapy: in vitro permeability, cytotoxicity and in vivo evaluation.

Artif Cells Nanomed Biotechnol. 2018 Feb 23;:1-12

Authors: Janga KY, Tatke A, Balguri SP, Lamichanne SP, Ibrahim MM, Maria DN, Jablonski MM, Majumdar S

Abstract
Delivery of therapeutic molecules into the deeper ocular compartments is mainly hampered by short precorneal residence and limited transmembrane permeability of topically administered drugs. Hence, the current study was undertaken to fabricate the ion-sensitive in situ gels of natamycin (NT) bilosomes (NB) for efficient ocular delivery. The effect of cholesterol and sodium taurocholate proportion on the properties of the bilosomes were studied and the formulation with better physicochemical properties was optimized and utilized to derive the in situ gelling system (IG). The impact of type/composition of gelling agent on the formation and characteristics of the hydrogel was investigated. The hydrogel formed from IG with 0.3% w/v gellan gum showed optimal viscoelastic and adhesive characteristics. The ocular safety and cytocompatibility of NB and its IG was confirmed by corneal histology and in vitro cytotoxicity evaluation. A 6- to 9-fold enhancement in the transcorneal flux of NB demonstrated efficient ocular penetration of bilosomes. Moreover, the superior mean dose normalized NT levels in the ocular tissues of rabbits treated with optimized NB and IG illustrated the effectiveness of bilosomes loaded ion-sensitive in situ hydrogels as a potential platform for the improved and prolonged ocular pharmacotherapy.

PMID: 29475386 [PubMed - as supplied by publisher]

http://ift.tt/2CH9tUb

Immunological compatibility status of placenta-derived stem cells is mediated by scaffold 3D structure.

Immunological compatibility status of placenta-derived stem cells is mediated by scaffold 3D structure.

Artif Cells Nanomed Biotechnol. 2018 Feb 23;:1-9

Authors: Azizian S, Khatami F, Modaresifar K, Mosaffa N, Peirovi H, Tayebi L, Bahrami S, Redl H, Niknejad H

Abstract
Placenta-derived amniotic epithelial cells (AECs), a great cell source for tissue engineering and stem cell therapy, are immunologically inert in their native state; however, immunological changes in these cells after culture and differentiation have challenged their applications. The aim of this study was to investigate the effect of 2D and 3D scaffolds on human lymphocyte antigens (HLA) expression by AECs. The effect of different preparation parameters including pre-freezing time and temperature was evaluated on 3D chitosan-gelatine scaffolds properties. Evaluation of MHC class I, HLA-DR and HLA-G expression in AECs after 7 d culture on 2D bed and 3D scaffold of chitosan-gelatine showed that culture of AECs on the 2D substrate up-regulated MHC class I and HLA-DR protein markers on AECs surface and down-regulated HLA-G protein. In contrast, 3D scaffold did not increase protein expression of MHC class I and HLA-DR. Moreover, HLA-G protein expression remained unchanged in 3D culture. These results confirm that 3D scaffold can remain AECs in their native immunological state and modification of physical properties of the scaffold is a key regulator of immunological markers at the gene and protein expression levels; a strategy which circumvents rejection challenge of amniotic stem cells to be translated into the clinic.

PMID: 29475368 [PubMed - as supplied by publisher]

http://ift.tt/2EN4Cqq

Effectiveness of Systemic Treatments for Pyoderma Gangrenosum:A Systematic Review of Observational Studies & Clinical Trials

Summary

Background

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis with substantial morbidity. Currently, there is no consensus on gold-standard treatments.

Objectives

Our primary objective was to review the effectiveness of systemic therapy for PG.

Methods

We searched Cochrane Central, Cochrane DSR, EMBASE, MEDLINE, PubMed, and Web of Science for 24 systemic therapies for PG. Primary outcomes were complete healing and clinical improvement; secondary outcomes were time-to-healing and adverse effects.

Results

We found 3,326 citations, of which 375 articles underwent full-text review, and 41 studies met inclusion criteria. There were 704 participants amongst 26 retrospective cohort studies, 3 prospective cohort studies, 7 case series, 1 case-control study, 2 open-label trials, and 2 randomized controlled trials (RCT). Systemic corticosteroids were the most studied (n=32 studies), followed by cyclosporine (n=21), biologics (n=16), and oral dapsone (n=11). One RCT (STOP-GAP, n=121) showed that prednisolone and cyclosporine were similar, with 15-20% complete healing at 6-weeks and 47% at 6-months. Another RCT (n=30) found that infliximab was superior to placebo at 2-weeks (46% vs. 6% response), with 21% complete healing rate at 6-weeks. Two uncontrolled trials showed 60% and 37.5% healing in four months with canakinumab and infliximab, respectively; other data suggest that patients with concurrent IBD may benefit from biologics. The remaining studies were of poor quality and small sample sizes, though supported the use of corticosteroids, cyclosporine, and biologics.

Conclusions

Systemic corticosteroids, cyclosporine, infliximab, and canakinumab had the most evidence in treating PG. However, current literature is limited to small and lower-quality studies with substantial heterogeneity.

This article is protected by copyright. All rights reserved.

http://ift.tt/2CnhSk2

Use of emollients and topical glucocorticoids among adolescents with eczema – datafrom the population-based birth cohort BAMSE

Summary

Background

Knowledge regarding how adolescents treat their eczema is sparse.

Objectives

To explore the use of emollients and topical glucocorticoids in adolescents with eczema in relation to sex and disease severity, and to study dispensing patterns of topical glucocorticoids.

Methods

Questionnaire-based data on symptoms of eczema, eczema severity and treatment with emollients and topical glucocorticoids were obtained from 3,108 adolescents in the Swedish population-based birth cohort BAMSE. Severity of reported eczema was evaluated with the BAMSE Eczema Severity Score (BESS) in a questionnaire and with the Patient-Oriented Eczema Measure in clinically examined subjects with current eczema (n = 247). Information on dispensed topical glucocorticoids was obtained from the Swedish Prescribed Drug Register.

Results

In all, 10% reported eczema in the preceding year: 73% mild, 17% moderate and 10% severe according to BESS. Almost all used emollients, whereas use of topical glucocorticoids was reported by 55%, with no significant difference between sexes. The likelihood of treatment with emollients and topical glucocorticoids increased when the adolescents had symptoms of current eczema (OR_Adj 5.95, 95% CI 1.90-18.8), but not if they had more severe eczema compared to mild eczema (OR_Adj 1.57, 95% CI 0.58-4.25). Among those with reported eczema, 24% had a topical glucocorticoid dispensed in the preceding year and among those with moderate to severe current eczema 25% had dispensed a potent topical glucocorticoid.

Conclusions

This population-based study indicates that adolescents with eczema are undertreated or completely untreated, even those with severe eczema.

This article is protected by copyright. All rights reserved.

http://ift.tt/2oufIpk

Novel in vivo observations of scrotal Nannizzia gypsea infection

Abstract

Tinea cruris is a common dermatophytosis, which usually firstly involved the intertriginous fold near the scrotum. Although dermatophytes may colonize the scrotum, they typically do not infect scrotal skin. However, tinea of scrotum is seldom reported as a specific type of Microsporum gypseum infection, presenting as white-paint-dot appearance, scutular-like or pseudomembranous-like lesions in immunocompromised or immunocompetent patients^1-6. According to the newest taxonomy, M. gypseum is now called Nannizia gypsea⁷. Herein we report novel in vivo observations of five cases of scrotal tinea caused by N. gypsea (formerly Microsporum gypseum) in immunocompetent patients.

This article is protected by copyright. All rights reserved.

http://ift.tt/2oq6hbj

Association between childhood atopic dermatitis, cutaneous, extracutaneous and systemic infections

Abstract

Atopic dermatitis (AD) is associated with higher risk of skin infections. US population-based studies found that childhood AD is associated with increased risk of caregiver-reported extra-cutaneous infections. We sought to confirm whether AD in childhood is associated with increased rates of healthcare diagnosed cutaneous and extra-cutaneous infections.

This article is protected by copyright. All rights reserved.

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Unique clinical and serological features of bullous pemphigoid associated with dipeptidyl peptidase-4 inhibitors

Abstract

Recently, several cases of bullous pemphigoid (BP) associated with the use of a dipeptidyl peptidase-4 (DPP-4) inhibitor, a type of antihyperglycemic drug, have been reported (DPP4i-BP).^1,2 Béné reported a strong association between DPP-4 inhibitor use and the risk of BP.³ The juxtamembranous extracellular non-collagenous 16a (NC16a) domain of type XVII collagen (COL17, also termed BP180) is a major target epitope of autoantibodies in BP.⁴ A recent study found that BP cases whose autoantibodies bound to BP180 at regions other than NC16a exhibited a non-inflammatory phenotype with fewer erythemas. Intriguingly, half of these cases had taken DPP-4 inhibitors at the time of development of BP.⁵ In this study, we explored whether DPP4i-BP exhibited any unique clinical and serological features as suggested by the previous study.

This article is protected by copyright. All rights reserved.

http://ift.tt/2CiRJmh

Tanning Addiction: Conceptualisation, Assessment, and Correlates

Abstract

Background

Research into problematic tanning (or 'tanning addiction') has markedly increased over the past few years. Although several excessive tanning instruments exist, most of these are psychometrically poor, not theoretically anchored, and have mainly been used on small samples.

Objective

Against this background, a new tanning addiction scale was developed based on a specific theoretical approach utilising core addiction criteria.

Methods

A scale comprising seven items (i.e. salience/craving, mood modification, tolerance, withdrawal, conflict, relapse/loss of control, and problems) was administered online to a cross-sectional convenience sample of 23,537 adults (M_age=35.8 years, SD=13.3), together with an assessment of demographic factors, the five-factor model of personality, and symptoms of obsessive-compulsive disorder, anxiety and depression.

Results

A confirmatory factor analysis showed that a one-factor model showed an optimal fit with the data collected (RMSEA=.050 [90% CI=.047–.053], CFI=.99, TLI=.99). High factor loadings (.781–.905, all p<.001) and coefficient omega indicator of reliability (ω=.941 [95% CI=.939–.944]) were also found using the new scale. In a multiple linear regression analysis, tanning addiction was positively associated with being female, not being in a relationship, extroversion, neuroticism, anxiety and obsessive-compulsiveness. It was also found that educational level, intellect/openness and depression were inversely associated with tanning addiction.

Conclusions

The new scale, Bergen Tanning Addiction Scale (BTAS), showed good psychometric properties, and is the first scale to fully conceptualise tanning addiciton within a contemporary addiction framework. Given this, the BTAS may potentially assist future clinical practice in providing appropriate patient care, prevention and disease management.

This article is protected by copyright. All rights reserved.

http://ift.tt/2ox1aoU