Publication date: Available online 3 February 2018
Source:Allergologia et Immunopathologia
Author(s): A. Golshiri-Isfahani, M. Amizadeh, M.K. Arababadi
Allergic rhinitis, as an allergic and nasal hypersensitivity disease, is associated with the inflammation of nasal mucosa. It appears that innate immune receptors are the important risk factors in the pathogenesis of the inflammatory disease. Toll-like receptors (TLRs) are the most important receptors of innate immunity; their crucial roles in the recognition of allergens and subsequently pathogenesis of allergic diseases have been evaluated recently. TLR3, 7 and 8 are the intracellular members of the innate immune receptors and recognize intracellular single and double strand RNAs. This review article collected the investigations regarding the roles of TLR3, 7 and 8 in the allergic rhinitis pathogenesis.
https://ift.tt/2GqIAK1
Κυριακή 25 Μαρτίου 2018
The roles of toll like receptor 3, 7 and 8 in allergic rhinitis pathogenesis
Assessment of IL-31 levels and disease severity in children with atopic dermatitis
Publication date: Available online 17 March 2018
Source:Allergologia et Immunopathologia
Author(s): D. Ozceker, M. Bulut, A. Celik Ozbay, F. Dilek, M. Koser, Z. Tamay, N. Guler
Introduction and objectivesAtopic dermatitis is a chronic, relapsing, highly pruritic, inflammatory skin disease characterized by typical localization with increasing prevalence of 10–20% in children. Pruritus is one of the major diagnostic criteria of atopic dermatitis and also the main complaint altering quality-of-life of affected patients, inducing and aggravating inflammation. Although pruritus is the absolute symptom of AD, the etiology has not been fully explained yet and current antihistamine therapies are ineffective.The aim of the study was to assess the correlation between IL-31 level and disease severity in patients with atopic dermatitis through Severity SCORing of Atopic Dermatitis (SCORAD) index and the degree of itching assessed subjectively.Material and methodsOne hundred thirty-five children were enrolled in the study in total, 70 children with diagnosis of atopic dermatitis and 65 healthy children in control group. Data on demographic features (age, gender, family history of atopy) and laboratory values of serum eosinophil, total IgE, IgM, IgA, IgG levels and skin prick test results were collected through patient files. The disease severity was assessed by SCORAD index. IL-31 levels were measured with human IL-31 ELISA kit.ResultsThe statistical analysis showed that IL-31 level was significantly higher in AD patients than in the control group (AD vs CG, p 0.0001). There was no significant difference in IL-31 levels between the three subgroups divided according to the SCORAD severity score (p:0.27).ConclusionIL-31 levels were significantly higher in AD patients compared to control group but irrelevant to the disease severity.
https://ift.tt/2GcBXHY
Knowledge on asthma, food allergies, and anaphylaxis: Assessment of elementary school teachers, parents/caregivers of asthmatic children, and university students in Uruguaiana, in the state of Rio Grande do Sul, Brazil
Publication date: Available online 12 January 2018
Source:Allergologia et Immunopathologia
Author(s): M. Urrutia-Pereira, L.P. Mocellin, R.B. de Oliveira, L. Simon, L. Lessa, D. Solé
IntroductionAllergic diseases have become an increasingly common reality in the last years, extending beyond the family context.ObjectiveAssessing the level of knowledge on asthma, food allergies and anaphylaxis of asthmatic children's parents/caregivers (PC), elementary school teachers (EST) and university students (US) in Uruguaiana, RS, Brazil.Method577 individuals (PC – N=111; EST – N=177; US – N=299) took part in the study, answering the Newcastle Asthma Knowledge Questionnaire (validated for Portuguese) and another questionnaire on Food Allergy (FA) and anaphylaxis.ResultsAlthough PC have asthmatic children, their asthma knowledge level was average, slightly above that of EST and EU. The lack of knowledge on passive smoking, use of medications and their side effects should be highlighted. US have shown to be better informed about FA and anaphylaxis. However, even though a significant proportion of respondents know the most common symptoms of FA and anaphylaxis, few named subcutaneous adrenaline as the drug of choice for treating anaphylaxis. Although a significant number of respondents know about the possibility of anaphylactic reactions happening at school or in activities outside the school, we were surprised by the absence of conditions in schools to provide emergency care to such students.ConclusionDespite the high prevalence of allergic diseases in childhood, asthmatic children's parents/caregivers, elementary school teachers and university students have inadequate levels of knowledge to monitor these patients.
https://ift.tt/2Gq1Rv6
Is vitamin D level associated with the natural course of atopic dermatitis?
Publication date: Available online 17 March 2018
Source:Allergologia et Immunopathologia
Author(s): M. Dogru
Introduction and objectivesAtopic dermatitis (AD) is a chronic inflammatory disease of the skin. Apart from its well-known role on calcium metabolism, vitamin D is reported to affect skin functions. The study aims were to: compare the vitamin D levels of children with AD and healthy children; investigate the relationship between the severity of AD and vitamin D levels; and investigate the effect of vitamin D on the natural course of AD.Patients or materials and methodsSixty-nine patients with AD were enrolled. Seventy healthy children were assigned as control group. Clinical and demographic features of groups were recorded. The skin prick test, eosinophil counts, immunoglobulin (Ig) E levels and serum 25 OH cholecalciferol (25OHD3) levels were measured. After at least 4 years of follow-up, patients were re-evaluated for natural course of AD.ResultsMean 25OHD3 level was lower in patient group vs. control group; 19.86±6.7ng/mL (min–max: 6.8–40) vs. 24.07±9.08ng/mL, respectively, (p=0.002). Mean 25OHD3 levels, and vitamin D status were significantly different between AD severity groups. (p<0.05). In terms of vitamin D status in the pairwise comparison, vitamin D deficiency was greater in children with severe and moderate AD groups (respectively, p=0.005, p=0.018). In Tukey's post hoc analysis for 25OHD3 level, the 25OHD3 levels of severe AD are significantly lower than mild or moderate AD (respectively, p=0.001, p=0.026). There was a negative correlation between 25OHD3 levels and severity of AD (r=−0.480; p=0.001). In patients reassessed after 4 years: age, the age of AD onset, vitamin D deficiency, SCORAD level and severe AD were higher in the persistent group vs. remission group, 25OHD3 levels were higher in the remission group vs. persistent group (p<0.05).ConclusionsMean vitamin D levels were lower in patients with AD. A negative correlation between vitamin D levels and disease severity was documented. Vitamin D may affect the natural course of atopic dermatitis. There is a need for more comprehensive studies in this regard.
https://ift.tt/2pEJ70P
Evaluation of an intervention to improve the management of allergens in school food services in the city of Barcelona
Publication date: Available online 15 February 2018
Source:Allergologia et Immunopathologia
Author(s): M. Fontcuberta-Famadas, G. Serral, M.J. López, P. Balfagón, E. García-Cid, L. Caballé-Gavaldà
BackgroundAn intervention to promote the development of an allergen control plan (ACP) and preventive measures for the management of allergens in school food services was implemented in all schools of Barcelona city over a three-year period (2013–2015) by the public health services. The present study aimed to assess changes regarding the management of food allergens in school food services in Barcelona after an intervention conducted by the public health services of the city.MethodsSchool meal operators of a random sample of 117 schools were assessed before and after the intervention using a structured questionnaire. The questionnaire collected general information on the students and their demand for special menus, and included 17 closed questions regarding the implementation of specific preventive measures for the management of allergens. Based on these 17 questions, a food safety score was calculated for each school. The improvement in these scores was evaluated.ResultsThe results showed positive increments in the percentage of implementation of 12 of the 17 preventive measures assessed. The percentage of school food services with an implemented ACP increased by 49%. Schools with external and internal food supplies increased their scores by 16.5% and 19.6%, respectively. The greatest improvements were observed in smaller food services and in schools located in districts with low gross household incomes.ConclusionsThe intervention was effective in improving school food services' management of allergens and in reducing the differences found among food services in the pre-intervention survey. We must also focus efforts on reducing socio-economic inequalities linked to the management of allergens.
https://ift.tt/2Gq1zV2
Adherence to pharmacotherapy improves school performance in children with rhinitis and asthma
Publication date: Available online 17 March 2018
Source:Allergologia et Immunopathologia
Author(s): J. Sánchez, A. Sánchez, R. Cardona
BackgroundAdherence to pharmacotherapy reduces symptoms of asthma and rhinitis, however, little is known of its impact on school performance.ObjectiveTo evaluate the impact of pharmacotherapy in absenteeism and school performance in a child population.MethodsA cross-sectional study, carried out in eight schools. All participants and their parents were given a questionnaire assessing parameters related to respiratory diseases and pharmacotherapy. Data on school performance was obtained from the academic history of each child who participated in the study. Adherence to pharmacotherapy was classified as a correct use of therapy for more than five days per week.Results1109 children agreed to participate. Students were divided into two groups: symptomatic (36%) and asymptomatic (63%). The symptomatic group had a higher frequency of school absenteeism (1 vs. 3.1days/year/patient p<0.01) and lower academic performance (failed: 20% vs. 33% p<0.01). After dividing the symptomatic group between adherents and non-adherents to the pharmacotherapy, the group of adherents had a similar school performance to the asymptomatic group and it was significantly different from the no-adherent group.ConclusionRespiratory symptoms are associated with poor school performance and with an increase in school absenteeism, but adherence to pharmacotherapy can reduce these negative impacts in children.
https://ift.tt/2G8Mow9
Development and characterization of an allergoid of cat dander for immunotherapy
Publication date: Available online 17 January 2018
Source:Allergologia et Immunopathologia
Author(s): J.P. Sola, Y. Pedreño, A. Cerezo, M. Peñalver-Mellado
BackgroundAllergy to cats is a frequent cause of sensitization to indoor allergens and currently there are few alternatives to specific immunotherapy with cat native extracts. The objective is to develop and characterize a new allergoid to increase the tools available for use in clinical practice.MethodsThe allergoid cat dander extract (ACD) was developed from a native cat dander extract (NCD) by modification with glutaraldehyde, and the optimal process control was determined by SDS-PAGE, DOT BLOT and determination of free amine groups. The ACD was characterized in protein profile by SDS-PAGE, size exclusion chromatography (SEC) and peptide footprint. The allergenic profile of ACD was determined by immunoblot, IgE CAP inhibition and IgG competition ELISA. The major allergen content in NCD was obtained by the ELISA sandwich protocol and was extrapolated to ACD.ResultsThe control process determined the optimal development of the allergoid. The ACD obtained contains 182.28μg/mg of protein and 11.90μg/mg of Fel d 1. SDS-PAGE and SEC confirmed the presence of high molecular weight proteins in ACD, and the peptide footprint showed the presence of Fel d 1 and Fel d 7. The high degree of polymerization was evidenced with the determination of the reduction of lysine residues in the allergoid, resulting 91.96%. The ACD showed a significant loss of allergenicity respect to NCD, while the IgG-binding capacity was maintained.ConclusionsThe ACD obtained presents a good safety profile, so would be a good alternative for treatment of cat allergy.
https://ift.tt/2Gq1kt6
Acknowledgment to reviewers
Publication date: March–April 2018
Source:Allergologia et Immunopathologia, Volume 46, Issue 2
https://ift.tt/2G96gPQ
Sublingual immunotherapy in children
Publication date: March–April 2018
Source:Allergologia et Immunopathologia, Volume 46, Issue 2
Author(s): M. Tortajada-Girbés, C. Rivas-Juesas
https://ift.tt/2Gpr4pH
An international comparison of risk factors between two regions with distinct differences in asthma prevalence
Publication date: Available online 24 March 2018
Source:Allergologia et Immunopathologia
Author(s): K. Madani, E. Vlaski, D.C. Rennie, M. Sears, J.A. Lawson
Background and purposeInvestigation of the geographic variation in asthma prevalence can improve our understanding of asthma etiology and management. The purpose of our investigation was to compare the prevalence of asthma and wheeze among adolescents living in two distinct international regions and to investigate reasons for observed differences.MethodsA cross-sectional survey of 13–14 year olds was completed in Saskatoon, Canada (n=1200) and Skopje, Republic of Macedonia (n=3026), as part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3 study. Surveys were self-completed by students following the ISAAC protocol. Multiple logistic regression models were used to investigate associations with reports of asthma and current wheeze. A mediation analysis was then completed.ResultsAsthma prevalence was much higher in Saskatoon than Skopje (21.3% vs. 1.7%) as was the prevalence of current wheeze (28.2% vs. 8.8%). Higher paracetamol (acetaminophen) use was a consistent risk factor for asthma and wheeze in both locations and showed dose-response relationships. In both countries, paracetamol use and physical activity mediated some of the association for both asthma and wheeze. In Saskatoon, among those with current wheeze, 42.6% reported ever having a diagnosis of asthma compared to 10.2% among Skopje adolescents.ConclusionsThe results suggest that the variation in risk factors between the two locations may explain some of the differences in the prevalence of asthma and wheeze between these two study sites. However, diagnostic labeling patterns should not be ruled out as another potential explanatory factor.
https://ift.tt/2Gap4hP
Efficacy and safety of sublingual immunotherapy with Dermatophagoides farinae drops in pre-school and school-age children with allergic rhinitis
Publication date: March–April 2018
Source:Allergologia et Immunopathologia, Volume 46, Issue 2
Author(s): L.-X. Tang, X.-J. Yang, P.-P. Wang, W.-T. Ge, J. Zhang, Y.-L. Guo, J. Lu, J. Tai, Y.-M. Zhang, X. Ni
BackgroundThe safety and efficacy of sublingual immunotherapy (SLIT) have been confirmed by many studies. However, in China, the research on efficacy and safety in young and older children with allergic rhinitis (AR) is still rare.ObjectiveThe aim of this retrospective study is to evaluate the efficacy and safety of SLIT with Dermatophagoides farinae drops in pre-school and school-age children with AR.MethodsA total of 282 subjects aged 2–13 years with AR received a two-year course of sublingual immunotherapy along with pharmacotherapy. According to the age, patients were defined as the pre-school group (2–6 years old, n=116) and school-age group (7–13 years old, n=166). Total nasal rhinitis symptom scores (TNSS), visual analogue score (VAS) and total medication scores (TMS) were evaluated at four time points: baseline, after SLIT for half a year, one year and two years. The adverse events (AEs) were evaluated at each visit.ResultsAfter two-year SLIT, the four rhinitis symptom scores, TNSS, VAS and TMS scores were significantly lower than baseline (all P<0.05). The comparison of efficacy between one and two-year duration showed no significant difference in global clinical outcomes (all P>0.05). In addition, there were no significant differences between the pre-school and school-age group in TNSS (all P>0.05), VAS (all P>0.05) and TMS scores (P>0.05) after SLIT for half a year, one year and two years. No severe systemic AEs were reported.ConclusionSLIT with D. farinae drops is clinically effective and safe in pre-school and school-age patients with house dust mites (HDMs)-induced AR.
https://ift.tt/2Gti2Im
Diagnostic criteria for acute food protein-induced enterocolitis syndrome. Is the work in progress?
Publication date: Available online 15 February 2018
Source:Allergologia et Immunopathologia
Author(s): S. Miceli Sopo, G. Bersani, C. Fantacci, A. Romano, S. Monaco
Food protein-induced enterocolitis syndrome (FPIES) is a non IgE-mediated gastrointestinal food allergic disorder. Some diagnostic criteria have been published for acute FPIES. Of course, they are not all the same, so the clinician must choose which ones to adopt for his/her clinical practice. We present here a brief review of these criteria and, through two clinical cases, show how the choice of one or the other can change the diagnostic destiny of a child with suspect FPIES.
https://ift.tt/2G9Odcj
Haploidentical stem cell transplantation in a boy with chronic granulomatous disease
Publication date: Available online 17 January 2018
Source:Allergologia et Immunopathologia
Author(s): A. Regueiro-García, S. Fariña-Nogueira, J.Á. Porto-Arceo, J.M. Couselo-Sánchez
Chronic granulomatous disease is a primary immunodeficiency caused by mutations in any one of the five components of the NADPH oxidase in phagocytic leucocytes. This causes impaired microbial killing, which leads to severe life-threatening bacterial and fungal infections. Currently, allogenic hematopoietic stem cell transplantation (HSCT) is the only curative treatment for chronic granulomatous disease, although gene therapy may provide a new therapeutic option for the treatment of patients with CGD. Haploidentical HSCT provides a potentially curative treatment option for patients who lack a suitably HLA-matched donor, but only a few cases have been reported in the literature. Herein, we report a boy with X-linked chronic granulomatous disease treated successfully by haploidentical HSCT with post-transplant cyclophosphamide using a treosulfan-based conditioning regimen.
https://ift.tt/2GsO4nJ
Small-airway dysfunction precedes the development of asthma in children with allergic rhinitis
Publication date: Available online 12 January 2018
Source:Allergologia et Immunopathologia
Author(s): E. Skylogianni, M. Triga, K. Douros, K. Bolis, K.N. Priftis, S. Fouzas, M.B. Anthracopoulos
BackgroundEpidemiological evidence suggests the existence of a direct link between allergic rhinitis (AR) and asthma. Several studies also support the presence of small-airway dysfunction (SAD) in non-asthmatic children with AR. However, it remains unknown whether SAD can predict the progression of AR to asthma. Our objective was to explore the existence of SAD in non-asthmatic children with AR and to assessed its ability to predict the development of asthma.MethodsSeventy-three 6-year-old children with intermittent moderate-severe AR but without asthma symptoms/medication within the last two years, underwent spirometry and measurement of respiratory resistance (Rrs) and reactance (Xrs) before and after bronchodilation (BD) (300mcg salbutamol). Lung function measurements were performed in the absence of nasal symptoms and repeated at AR exacerbation. SAD was defined as >30% decrease in Rrs or >50% increase in Xrs at 6 or 8Hz post-BD. Participants were followed for five years.ResultsTwenty-three children (31.5%) developed asthma; this group presented significant post-BD changes in Rrs and Xrs, but only at AR exacerbation. The ability of these changes to predict the development of asthma was exceptional and superior to that of the spirometric parameters. SAD (22 children, 30.1%), emerged as the single most efficient predictor of asthma, independently of other risk factors such as parental asthma, personal history of eczema and type of allergic sensitisation.ConclusionSAD precedes the development of asthma in children with AR. Changes in respiratory impedance at AR exacerbation may assist in identifying those at risk to progress to asthma.
https://ift.tt/2pFMPaw
Increase of natural killer cells in children with liver transplantation-acquired food allergy
Publication date: Available online 16 February 2018
Source:Allergologia et Immunopathologia
Author(s): F. Mori, C. Angelucci, A. Cianferoni, S. Barni, G. Indolfi, A. Casini, G. Mangone, M. Materassi, N. Pucci, C. Azzari, E. Novembre
BackgroundTransplantation-acquired food allergies (TAFA) are frequently reported and considered to be caused by immunosuppressive therapy.The aim of this study was to investigate the allergic and immunologic responses in children who had liver or kidney transplantations.MethodsTwelve children receiving liver transplantations and 10 children receiving kidney transplantations were investigated. All children underwent the allergy work-up and in most of them, lymphocyte screening and serum cytokine measurements were also performed.ResultsTAFA were found in 7/12 (58%) children with liver transplantations and in none of the 10 children with kidney transplantations. The mean age at transplantation was significantly lower in children who underwent liver transplantations (p<0.001). The immunosuppressive therapy administered to children with liver transplantation was tacrolimus in 11 patients and cyclosporine in one patient, while all 10 children with kidney transplantation received tacrolimus plus mycophenolate. The most common antigenic food was egg. The natural killer (NK) cell numbers were significantly higher in liver-transplant children than in kidney-transplant children. No significant differences were found in the serum cytokine levels.ConclusionsThis study confirms that liver-transplant children treated with tacrolimus alone have a higher risk of developing TAFA than kidney-transplant children treated with tacrolimus plus mycophenolate. NK cells might be involved in this difference.
https://ift.tt/2GthH8y
Exposure to dogs but not cats is associated to a decrease in the prevalence in atopic dermatitis amongst school-children
Publication date: Available online 15 February 2018
Source:Allergologia et Immunopathologia
Author(s): M. Bedolla-Barajas, J. Morales-Romero, T.I. Bedolla-Pulido, T.R. Bedolla-Pulido, C. Meza-López, N.A. Pulido-Guillén
IntroductionThe association regarding the exposure to pets, especially cats and dogs, and the prevalence of allergic diseases is inconsistent.ObjectiveWe analyzed the role played by early exposure to dogs or cats in the prevalence of allergic diseases amongst school-aged children.MethodThrough a cross-sectional study, we examined 756 children, aged 6–7; these candidates were selected through cluster sampling. We inquired about the exposure that these children had had to dogs and cats, and whether these pets spent most of their time indoors or outdoors during the first year of the child's life. In order to identify the prevalence of allergic diseases and their symptoms, each child's parent completed the International Study of Asthma and Allergies in Childhood questionnaire.ResultsExposure to outdoor dogs was associated to nocturnal coughing, odds ratio (OR) 0.64, with a confidence interval of 95% (95% CI) 0.43–0.95 and with atopic dermatitis (OR: 0.39; 95% CI: 0.20–0.76). Interestingly, exposure to outdoor cats was associated to nocturnal coughing (OR: 0.51; 95% CI: 0.32–0.83) and current rhinitis symptoms (OR: 0.59; 95% CI 0.36–0.97). After carrying out the multivariate analyses, only exposure to dogs, both indoor and outdoor, was significantly associated to a decrease in the prevalence of atopic dermatitis OR 0.40 (95% CI: 0.20–0.79) and OR 0.38 (95% CI: 0.18–0.83), respectively.ConclusionOur findings suggest that exposure to dogs, whether they be indoor or outdoor pets, is associated to a decreased prevalence in atopic dermatitis.
https://ift.tt/2GbgQ9c
Pine nut allergy in Korean children: Clinical characteristics and diagnostic values of specific IgE against pine nuts
Publication date: Available online 12 February 2018
Source:Allergologia et Immunopathologia
Author(s): E. Lee, K. Jeong, J. Lee, S. Lee
BackgroundHypersensitivity reactions to pine nuts in children have been occasionally encountered recently, although reports on pine nut allergy cases are rare worldwide. The study aimed to feature clinical and laboratory findings pertaining to pine nut allergy in Korean children.MethodsForty-two subjects were enrolled through a retrospective review of medical records, from September 2010 to December 2015, at the Department of Pediatrics in Ajou University Hospital. The demographic profiles, clinical characteristics, and laboratory findings were evaluated.ResultsTwenty-four patients showed immediate-type reactions after exposure to pine nuts (the allergic group), while the remaining 18 were atopic controls, who exhibited no allergic symptoms (the tolerant group). The median age of the subjects in the allergic group was three years. More than half of the subjects in this group experienced allergic symptoms within 5min, and seven of them experienced anaphylaxis. The median level of pine nut-specific immunoglobulin E (sIgE) in the allergic group (1.62kUA/L) was significantly higher (p=0.014) than that in the tolerant group (0.11kUA/L), with an optimal cut-off level of 0.40kUA/L (sensitivity, 66.7% and specificity, 77.8%). The positive decision point of pine nut-sIgE (specificity, 100%) to distinguish the allergic and tolerant groups was 2.84kUA/L. However, there was no difference in pine nut-sIgE levels between the anaphylaxis and non-anaphylaxis cases.ConclusionAbout 30% of children with pine nut allergy experienced anaphylaxis. The optimal cut-off level of pine nut-sIgE to distinguish the allergic and tolerant groups was 0.40kUA/L and the positive decision point was 2.84kUA/L.
https://ift.tt/2IOsoRr
Immunomodulation of allergic response in children and adolescents: What we can learn from lymphatic filarial infection
Publication date: March–April 2018
Source:Allergologia et Immunopathologia, Volume 46, Issue 2
Author(s): A.M. Aguiar-Santos, S. Montenegro, Z. Medeiros, A. Rocha, C.N.L. Morais, A.R. Silva, C. Bonfim, T.R. Costa, E.S.C. Sarinho
BackgroundAlthough it is well known that allergic diseases involve a strong Th2 immune response, with production of high levels of specific IgE allergen, knowledge on the association between filarial infection and allergies, among paediatric patients is scarce.ObjectiveTo evaluate the allergic response patterns in cases of filarial infection by comparing peripheral eosinophils, total IgE levels, immediate hypersensitivity and cytokine levels in children and adolescents in Brazil.MethodsThis was an exploratory study with three groups: (I) with filarial infection and without allergic diseases; (II) without filarial infection and with allergic diseases; and (III) without filarial infection and without allergic diseases. The prick test and specific IgE tests for aeroallergens were performed using five antigens. Peripheral eosinophils and total IgE were also evaluated. IL-4 and IL-5 were determined using whole-blood culture stimulated by three antigens.ResultsEosinophilia and elevated levels of total IgE (≥400IU/dl) were observed in all groups. The prick test was positive in 56.6% of the cases. Group I presented hypersensitive responses similar to the allergic disease groups. In the whole-blood culture stimulated by Dermatophagoides pteronyssinus, average IL-4 production did not differ significantly among the groups, but IL5 production resulting from stimulation was greater in the allergic disease groups (p<0.05).ConclusionsThe allergic response pattern in group with filarial infection was similar to that of the groups with and without allergic diseases, but the response to IL-5 in the culture stimulated by D. pteronyssinus was an exclusive characteristic of the allergic group.
https://ift.tt/2pGNJDx
Fluticasone in mild to moderate atopic dermatitis relapse: A randomized controlled trial
Publication date: Available online 17 January 2018
Source:Allergologia et Immunopathologia
Author(s): E. Rubio-Gomis, I. Martinez-Mir, F.J. Morales-Olivas, A. Martorell-Aragones, V. Palop-Larrea, A. Bernalte-Sesé, J.C. Cerda-Mir, P. Polo-Martín, I. Febrer, L. Aranda-Grau, I. Llosa-Cortes, Mª.J. Tejedor-Sanz, J.C. Julia-Benito, T. Alvarez-de-Laviada-Mulero, Mª.V. Planelles-Cantarino, E. Apolinar-Valiente, M. Loriente-Tur, A.M. Abella-Bazataqui, I. Alvarez-Gonzalez, C. Morales-Carpi, Mª.E. Burches-Greus, A.B. Ferrer-Bautista, R. Felix-Toledo, D. Marmaneu-Laguia, V.E. Garcia-Martinez, Mª.A. Beltran-Marques, B. Rodriguez-Gracia
BackgroundThe long-term efficacy of corticosteroids to prevent atopic dermatitis (AD) relapses has partially been addressed in children. This study compared an intermittent dosing regimen of fluticasone propionate (FP) cream 0.05% with its vehicle base in reducing the risk of relapse in children with stabilized AD.MethodsA randomized controlled, multicentric, double-blind trial was conducted. Children (2–10 years) with mild/moderate AD (exclusion criteria: >30% affected body surface area and/or head) were enrolled into an Open-label Stabilization Phase (OSP) of up to 2 weeks on twice daily FP. Those who achieved treatment success entered the Double-blind Maintenance Phase (DMP). They were randomly allocated to receive FP or vehicle twice-weekly on consecutive days for 16 weeks. The primary study endpoint was relapse rate; time to relapse and severity of disease were also studied. Kaplan–Meier estimates were calculated.ResultsFifty-four patients (29 girls) entered the OSP (23 mild AD) and 49 (26 girls) continued into the DMP. Mean age was 5.5 (SD: 2.8) and 5.1 (SD: 2.3) yrs for FP and vehicle groups, respectively. Four patients withdrew from the DMP (two in every group). Patients treated with FP twice weekly had a 2.7 fold lower risk of experiencing a relapse than patients treated with vehicle (relative risk 2.72, SD: 1.28; p=0.034). FP was also superior to vehicle for delaying time to relapse. Both treatment therapies were well tolerated.ConclusionThis long-term study shows that twice weekly FP provides an effective maintenance treatment to control the risk of relapse in children with AD.
https://ift.tt/2IQhHxA
Loss of tolerance for fishes previously tolerated in children with fish food protein induced enterocolitis syndrome
Publication date: Available online 17 January 2018
Source:Allergologia et Immunopathologia
Author(s): S. Miceli Sopo, C. Fantacci, G. Bersani, A. Romano, S. Monaco
We describe two case reports presenting some novel information on fish FPIES. Fish FPIES to one fish does not always start at the same time to other fish. Additionally, development of tolerance to the index fish do not necessarily imply tolerance to other reactive fish. This reflects on the best management of children with FPIES fish.
https://ift.tt/2Gbge3o
Imaging and Management of Thoracic Trauma
Source:Seminars in Ultrasound, CT and MRI
Author(s): Alex Newbury, Jon D. Dorfman, Hao S. Lo
Thoracic injury results from penetrating and blunt trauma and is a major contributor to overall trauma morbidity and mortality in the United States. Modern imaging algorithms utilize ultrasound, CXR, and CT with intravenous contrast to accurately diagnose and effectively treat patients with acute thoracic trauma. This review focuses on the etiologies, signs and symptoms, imaging, and management of several life-threatening thoracic injuries including tracheobronchial rupture, pulmonary parenchymal injury, hemothorax, pneumothorax, diaphragmatic rupture, and axial skeleton injury.
https://ift.tt/2IS5VCN
Smoking, environmental tobacco smoke and occupational irritants increase the risk of chronic rhinitis.
| Related Articles |
Smoking, environmental tobacco smoke and occupational irritants increase the risk of chronic rhinitis.
World Allergy Organ J. 2018;11(1):6
Authors: Hisinger-Mölkänen H, Piirilä P, Haahtela T, Sovijärvi A, Pallasaho P
Abstract
Background: Allergic and non-allergic rhinitis cause a lot of symptoms in everyday life. To decrease the burden more information of the preventable risk factors is needed. We assessed prevalence and risk factors for chronic nasal symptoms, exploring the effects of smoking, environmental tobacco smoke, exposure to occupational irritants, and their combinations.
Methods: In 2016, a postal survey was conducted among a random population sample of 8000 adults in Helsinki, Finland with a 50.5% response rate.
Results: Smoking was associated with a significant increase in occurrence of chronic rhinitis (longstanding nasal congestion or runny nose), but not with self-reported or physician diagnosed allergic rhinitis. The highest prevalence estimates of nasal symptoms, 55.1% for chronic rhinitis, 49.1% for nasal congestion, and 40.7% for runny nose, were found among smokers with occupational exposure to gases, fumes or dusts.Besides active smoking, also exposure to environmental tobacco smoke combined with occupational exposure increased the risk of nasal symptoms.
Conclusions: Smoking, environmental tobacco smoke, and occupational irritants are significant risk factors for nasal symptoms with an additive pattern. The findings suggest that these factors should be systematically inquired in patients with nasal symptoms for appropriate preventive measures. (192 words).
PMID: 29568342 [PubMed]
https://ift.tt/2ujw1LP
Local and remote black carbon sources in the Metropolitan Area of Buenos Aires
Source:Atmospheric Environment, Volume 182
Author(s): Melisa Diaz Resquin, Daniela Santágata, Laura Gallardo, Darío Gómez, Cristina Rössler, Laura Dawidowski
Equivalent black carbon (EBC) mass concentrations in the fine inhalable fraction of airborne particles (PM2.5) were determined using a 7-wavelength Aethalometer for 17 months, between November 2014 and March 2016, for a suburban location of the Metropolitan Area of Buenos Aires (MABA), Argentina. In addition to describing seasonal and diurnal black carbon (BC) cycles for the first time in this region, the relative contributions of fossil fuel and remote and local biomass burning were determined by distinguishing different carbonaceous components based on their effect on light attenuation for different wavelengths. Trajectory analyses and satellite-based fire products were used to illustrate the impact of long-range transport of particles emitted by non-local sources. EBC data showed a marked diurnal cycle, largely modulated by traffic variations and the height of the boundary layer, and a seasonal cycle with monthly median EBC concentrations (in μg/m3) ranging from 1.5 (February) to 3.4 (June). Maximum values were found during winter due to the combination of prevailingly stable atmospheric conditions and the increase of fossil fuel emissions, derived primarily from traffic and biomass burning from the domestic use of wood for heating. The use of charcoal grills was also detected and concentrated during weekends. The average contribution of fossil fuel combustion sources to EBC concentrations was 96%, with the remaining 4% corresponding to local and regional biomass burning. During the entire study period, only two events were identified during which EBC concentrations attributed to regional biomass burning accounted for over 50% of total EBC; these events demonstrate the relevance of agricultural and forestry activities that take place far from the city yet whose emissions can affect the urban atmosphere of the MABA.
https://ift.tt/2DUPRMT
Emission characteristics and chemical components of size-segregated particulate matter in iron and steel industry
Source:Atmospheric Environment, Volume 182
Author(s): Jia Jia, Shuiyuan Cheng, Sen Yao, Tiebing Xu, Tingting Zhang, Yuetao Ma, Hongliang Wang, Wenjiao Duan
As one of the highest energy consumption and pollution industries, the iron and steel industry is regarded as a most important source of particulate matter emission. In this study, chemical components of size-segregated particulate matters (PM) emitted from different manufacturing units in iron and steel industry were sampled by a comprehensive sampling system. Results showed that the average particle mass concentration was highest in sintering process, followed by puddling, steelmaking and then rolling processes. PM samples were divided into eight size fractions for testing the chemical components, SO42− and NH4+ distributed more into fine particles while most of the Ca2+ was concentrated in coarse particles, the size distribution of mineral elements depended on the raw materials applied. Moreover, local database with PM chemical source profiles of iron and steel industry were built and applied in CMAQ modeling for simulating SO42− and NO3− concentration, results showed that the accuracy of model simulation improved with local chemical source profiles compared to the SPECIATE database. The results gained from this study are expected to be helpful to understand the components of PM in iron and steel industry and contribute to the source apportionment researches.
https://ift.tt/2GrBDsn
The purinergic P2X7 ion channel receptor—a ‘repair’ receptor in bone
Source:Current Opinion in Immunology, Volume 52
Author(s): Niklas Rye Jørgensen
A strong skeleton relies on adaptation to varying physical demands and on maintenance of the bone tissue in order to avoid accumulation of micro-damage. In bone, the purinergic P2X7 ion channel receptor is expressed on both cells of the stromal lineage such as the bone forming osteoblasts and the mechano-sensing osteocytes and on cells belonging to the immune-related monocyte–macrophage lineage, the bone resorbing osteoclasts. Recent studies have demonstrated that the receptor plays important roles in the anabolic responses to mechanical loading on bone and, together with the pannexin1 hemi-channel, in the process of initiating bone remodeling in response to micro-damage. Thus, the receptor is crucial in skeletal mechano-transduction and in the continuous repair process. However, under pathophysiological conditions such as diabetes with high glucose concentrations or glucocorticoid-treatment the receptor is downregulated thus blunting the important effects it has for maintaining a healthy and strong skeleton.
https://ift.tt/2pD2Nmq
Assessment of CTNNB1 gene mutations and β-catenin immunoexpression in salivary gland pleomorphic adenomas and adenoid cystic carcinomas
Abstract
β-Catenin exerts multiple functions in several neoplasms, playing a major role in cell signaling and tumor progression. This study analyzed possible CTNNB1 mutations in salivary gland pleomorphic adenomas (PAs) and adenoid cystic carcinomas (ACCs), and determined possible differences in β-catenin immunoexpression in relation to these mutations, as well as histopathological aspects of these tumors. Twenty-four PAs (15 cell-rich and 9 cell-poor tumors) and 24 ACCs (10 tubular, 8 cribriform, and 6 solid tumors) were selected for the analysis of β-catenin distribution and cellular localization. Furthermore, β-catenin expression was evaluated using the H-score scoring system. Mutations in CTNNB1 exon 3 were investigated by the single-strand conformational polymorphism test. Diffuse β-catenin expression was more frequently observed in ACCs compared to PAs (P = 0.008). No significant difference in β-catenin cellular localization was observed between these tumors (P = 0.098). Comparisons between PA and ACC cases revealed a higher median H-score in the latter (P = 0.036). Cell-rich PAs exhibited a trend for higher H-score than cell-poor tumors (P = 0.060), whereas lower H-scores were observed in cribriform ACCs when compared to tubular and solid ACCs (P = 0.042). Mutations in CTNNB1 were observed in 6 PAs and 7 ACCs, with no significant difference in H-scores for β-catenin according to mutation status (P = 0.135). β-Catenin is important in the pathogenesis of salivary gland PAs and ACCs. In addition, CTNNB1 exon 3 mutations do not seem to significantly influence β-catenin cytoplasmic/membranous expression or nuclear translocation in these tumors.
https://ift.tt/2Gme587
Intrathecal gadolinium-enhanced MR cisternography in patients with otorhinorrhea: 10-year experience of a tertiary referral center.
Intrathecal gadolinium-enhanced MR cisternography in patients with otorhinorrhea: 10-year experience of a tertiary referral center.
Neuroradiology. 2018 Mar 23;:
Authors: Nacar Dogan S, Kizilkilic O, Kocak B, Isler C, Islak C, Kocer N
Abstract
PURPOSE: Despite a considerable amount of literature that has been published about the use of intrathecal gadolinium-enhanced MR cisternography (IGE-MRC), there is still relatively lack of evidence as to its long-term effects. Our purpose in this study was twofold: firstly, to assess the long-term safety of the IGE-MRC; secondly, to evaluate the diagnostic performance of IGE-MRC for detecting cerebrospinal fluid (CSF) leak in otorhinorrhea patients.
METHODS: We retrospectively reviewed our imaging and clinical database for the patients admitted to our department for the evaluation of their otorhinorrhea between 2008 and 2017. Two radiologists evaluated the imaging studies independently. Consensus data was used in the analysis. Medical record review and phone call were used for the long-term follow-up.
RESULTS: The retrospective review yielded 166 patients. Rhinorrhea was present in 150 (90.4%) patients and otorrhea in 16 (9.6%) patients. Overall, 67 patients (40.5% of all patients) underwent operation for repair of the CSF leak site. Beta-transferrin test was available and positive in 57 (34.3%) patients. Overall sensitivity of IGE-MRC and paranasal high-resolution CT (HRCT) was 89.3 and 72%, respectively. Within the first 24 h after the procedure, none of the patients experienced a significant complication or adverse reaction. Ninety-nine patients (59.6%) had medical record and telephone follow-up. The mean follow-up duration with call was 37.1 months. Three (3%) patients complained about severe headache 3-4 weeks after the procedure.
CONCLUSIONS: IGE-MRC is a minimally invasive and highly sensitive imaging technique. No adverse side effect during our long-term follow-up might strengthen and support the safety of IGE-MRC.
PMID: 29572604 [PubMed - as supplied by publisher]
https://ift.tt/2pE3ZW0
Chemokines and cancer: new immune checkpoints for cancer therapy
Nathan Karin
https://ift.tt/2I6cbWD
Engineering T cells for adoptive therapy: outsmarting the tumor
Andre Kunert | Reno Debets
https://ift.tt/2IOpBYm
Vaccination antigrippale et mucoviscidose. Impact d’une campagne d’incitation à la vaccination antigrippale chez les patients du Centre de ressources et de compétences de la mucoviscidose (CRCM) mixte de Dunkerque et leurs soignants
Publication date: Available online 24 March 2018
Source:Revue des Maladies Respiratoires
Author(s): M. Scalbert-Dujardin, A. Boldron, E. Leroy, J. Bazin, E. Froment-Leclercq
IntroductionL'objectif principal de ce travail est d'évaluer l'efficacité d'actions préventives contre la grippe dans les populations étudiées. L'objectif secondaire est d'analyser les mécanismes amenant à un changement de comportement vis-à-vis de la vaccination antigrippale dans ces mêmes populations.MéthodesÉtude interventionnelle, prospective, réalisée par un questionnaire anonyme portant sur la couverture vaccinale (CV) antigrippale et les motifs de vaccination et non-vaccination, proposé aux patients suivis pour mucoviscidose (n=67) du CRCM mixte de Dunkerque et leurs soignants (n=117), avant (avril 2014) et après (avril 2015) campagne d'information et d'actions de prévention primaire (vaccination sur les lieux de travail, créneaux horaires élargis).RésultatsEn 2015, le taux de couverture vaccinale (TC) du personnel soignant augmente à 65,63 % contre 27,55 % en 2014, (χ2[1]=29,17, p<0,0001). Chez les patients, enfants et adultes, aucune différence significative n'a été observée, entre 2014 et 2015 (χ2[1]=0,24, NS) dont le TC avant campagne était déjà optimum.ConclusionsSensibiliser à la vaccination antigrippale permet d'augmenter la CV du personnel de santé. Trois leviers principaux ont été identifiés : la nécessité de communiquer sur la vaccination auprès des soignants, la facilité d'accès à la vaccination et le positionnement en faveur de la vaccination des médecins et cadres de santé.IntroductionThe main aim of this study is to evaluate the effectiveness of preventive actions regarding influenza in the studied populations. The secondary objective is to analyze and understand the mechanisms which bring about a behavioural change regarding influenza vaccination.MethodsThe interventional and prospective study was undertaken in the form of an anonymous questionnaire about influenza vaccination coverage and about the reasons for vaccinating or not vaccinating. The studied populations were patients followed for cystic fibrosis (n=67) in the Dunkerque cystic fibrosis treatment centre and their health care workers (n=117), before (April 2014) and after (April 2015) an information campaign and primary prevention actions (vaccination in the workplace with expanded time slots) in collaboration with the department of occupational medicine.ResultsIn 2015, the vaccination coverage rate of health care workers rose to 65.63%, that is to say 2.38 times more than in 2014 (27.55%). This difference is significant (χ2[1]=29.17, P<0.0001). However, no significant difference between 2014 and 2015 was observed among patients (children and adults) (χ2[1]=0.24, NS) whose vaccination coverage was already optimal before the study.ConclusionsRaising awareness among health care workers about vaccination against influenza increases the coverage rate and decreases outbreaks of virus infection in the care services and among patients at risk. Three main levers were identified: the necessity of providing information on influenza vaccination to health care workers, the ease of vaccination access and the attitude towards vaccination of supervisory staff (health executives/doctors).
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Helicobacter, Volume 23, Issue 2, April 2018.
Helicobacter, Volume 23, Issue 2, April 2018.
https://ift.tt/2DTAvbu
Helicobacter, Volume 23, Issue 2, April 2018.
Helicobacter, Volume 23, Issue 2, April 2018.
https://ift.tt/2DTAvbu
Skin Research and Technology, Ahead of Print.
Skin Research and Technology, Ahead of Print.
https://ift.tt/2Gqp3d2
Skin Research and Technology, Ahead of Print.
Skin Research and Technology, Ahead of Print.
https://ift.tt/2G8skdp
Comparison of long-term functional results between standard supracricoid laryngectomy and modified technique with sternohyoid muscle
Publication date: Available online 24 March 2018
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Selçuk Güneş, Kadir Serkan Orhan, Bora Başaran, Mehmet Çelik, Erkan Kıyak
IntroductionLaryngeal cancer is the most common cancer of the upper respiratory tract. The main methods of treatment included surgery (partial laryngectomy and total laryngectomy) and radiation therapy. Laryngeal dysfunction is seen after both treatment modalities.ObjectiveThe aim of the study is to compare postoperative functional results of the standard supracricoid partial laryngectomy technique and a modified supracricoid partial laryngectomy technique using the sternohyoid suscle.MethodsIn total, 29 male patients (average years 58.20±9.00 years; range 41–79 years) with laryngeal squamous cell carcinoma who underwent supra cricoid partial laryngectomy were included. The patients were divided into two groups in terms of the surgical techniques. In Group A, all patients underwent standard supracricoid partial laryngectomy technique between January 2007 and November 2011. In Group B, all patients underwent modified supracricoid partial laryngectomy between August 2010 and November 2011. Fiberoptic endoscopic evaluation of swallowing test, short version of the voice handicap index scores, and the MD Anderson dysphagia inventory, the time of oral feeding and the decanulation of the patients after surgery of each groups were compared.ResultsThe mean maximum phonation time was 8.68±4.21s in Group A and 15.24±6.16s in Group B (p>0.05). The S/Z (s/s) ratio was 1.23±0.35 in Group A and 1.08±0.26 in Group B (p>0.05); the voice handicap index averages were 9.86±4.77 in Group A and 12.42±12.54 in Group B (p>0.05); the fiberoptic endoscopic evaluation of swallowing test averages were calculated as 12.73±3.08 in Group A and 13.64±1.49 in Group B (p>0.05). In the MD Anderson dysphagia inventory, evaluation of swallowing, the emotional, physical, and functional scores were 29.21±4.11, 32.21±6.85, and 20.14±2.17 in the Group B, and 29.20±2.54, 32.4±4.79, and 19±1.92 in Group A, respectively.ConclusionAlthough there is no statistical difference in functional outcome comparisons, if rules are adhered to in preoperative patient selection, modified supracricoid partial laryngectomy can be applied safely and meaningful gains can be achieved in functional outcomes.
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Preservation of residual hearing after cochlear implant surgery: an exploration of residual hearing function in a group of recipients at cochlear implant units
Publication date: Available online 24 March 2018
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Katherine Gautschi, Katijah Khoza-Shangase, Dhanashree Pillay
IntroductionThe preservation of residual hearing is becoming increasingly important in cochlear implant surgery. Conserving residual hearing is a positive prognostic indicator for improved hearing abilities.ObjectiveThe primary aim of the study was to explore the preservation of residual hearing following cochlear implantation in a group of recipients at two major cochlear implant centers.MethodsA quantitative paradigm was adopted and exploratory research conducted within a retrospective data review design. The sample consisted of 50 surgical records and 53 audiological records from 60 observations (53 patients, seven of whom were implanted bilaterally). The records were selected using purposive sampling and consisted of records from participants ranging from six to 59 years of age. The average time of when the postoperative audiograms were performed in the current study was 24.7 months (s.d.=±9.0). Data were analyzed through both qualitative and inferential statistics and a comparative analysis of unaided pre- and postoperative audiological test results was conducted.ResultsResults indicated a high success rate of 92% preservation of residual hearing with half of the sample exhibiting complete preservation in cochlear implant recipients across all frequencies postoperatively. A total postoperative hearing loss was found in only 8% of cochlear implantees across all frequencies. There was no relationship between preoperative hearing thresholds and preservation of hearing postoperatively. The two main surgical techniques used in the current study were the contour on stylet and the advance off-stylet techniques, with the majority of surgeons utilizing a cochleostomy approach. From the findings, it became apparent that the majority of cases did not have any reported intraoperative complications. This is a positive prognostic indicator for the preservation of residual hearing.ConclusionFindings suggest improved cochlear implant surgical outcomes when compared to previous studies implying progress in surgical techniques. The surgical skill and experience of the surgeon are evidenced by the minimal intraoperative complications and the high success rate of hearing preservation. This is a positive prognostic indicator for individuals with preoperative residual hearing as the preserved residual hearing allows for the potential of electro-acoustic stimulation, which in turn has its own hearing benefits.
https://ift.tt/2uiu2rd
Epidural angiolipoma: A rare cause of spinal cord compression.
Epidural angiolipoma: A rare cause of spinal cord compression.
Int J Surg Case Rep. 2018 Mar 15;45:72-76
Authors: Rkhami M, Kedous MA, Achoura S, Zehani A, Bahri K, Zammel I
Abstract
INTRODUCTION: Angiolipomas are benign, slow growing lesions, almost always located subcutaneously in the trunc or limbs. They are composed of mature lipocytes admixed with abnormal blood vessels. Spinal epidural angiolipoma are rare accounting for approximately 0.14-1.2% of all spinal axis tumors and 2-3% of epidural spinal tumors.
PRESENTATION OF CASE: We report the case of a 65 years-old-woman, presenting with complete paraplegia installed since 7 months. Magnetic resonance imaging (MRI) showed an epidural dorsal fatty mass. The patient recovered immediately after surgery. The pathological examination concluded to an angiolipoma.
DISCUSSION: Angiolipoma patients most commonly have long-lasting pain and then develop progressive neurological symptoms secondary to spinal cord compression. The mean duration of symptom progression at diagnosis is 1 year. MRI is the most reliable examination for the diagnosis of spinal angiolipoma. Total resection is the treatment of choice. No adjuvant treatment is indicated. Since SAL are very haemorrhagic lesions, preoperative embolization is recommended.
CONCLUSION: We think that spinal cord compression caused by angiolipoma have very good functional prognosis, even if tardily diagnosed.
PMID: 29573600 [PubMed - as supplied by publisher]
https://ift.tt/2DSnHCu
Perforation of abdominal esophagus following nasogastric feeding tube intubation: A case report.
Perforation of abdominal esophagus following nasogastric feeding tube intubation: A case report.
Int J Surg Case Rep. 2018 Mar 15;45:67-71
Authors: Numata Y, Ishii K, Seki H, Yasui N, Sakata M, Shimada A, Matsumoto H
Abstract
INTRODUCTION: Perforation of the abdominal esophagus caused by nasogastric tube (NGT) intubation has been rarely reported in adults.
PRESENTATION OF CASE: A 73-year-old man was admitted to our hospital with pneumonia. He had been bedridden long-term and had previously undergone a gastrectomy for gastric ulcer. Since admission was prolonged, and he required enteral feeding because of his inability to swallow, a NGT was inserted blindly. The next day, he had a high fever and abdominal pain. Abdominal computed tomography scan revealed that the tube was inserted through the wall of the abdominal esophagus into the abdominal cavity. In the emergency surgery, we sutured the perforated site of abdominal esophagus and patched it with lesser omentum. The postoperative course was good.
DISCUSSION: Abdominal esophageal perforation due to NGT insertion is very rare. The cause of perforation was suggested to be an abnormal deformity created by adhesion due to previous distal gastrectomy and long-term bedridden status. A chest X-ray usually is performed to confirm the position of the NGT tube. In this case, a frontal radiographic view apparently showed the NGT placed in the stomach.
CONCLUSION: When NGT is inserted to such patients, frontal and lateral radiographic views or fluoroscopic guidance should be obtained.
PMID: 29573599 [PubMed - as supplied by publisher]
https://ift.tt/2pEFojH
Clinical value of 11C-methionine positron emission tomography in persistent primary hyperparathyroidism-A case report with a mediastinal parathyroid adenoma.
Clinical value of 11C-methionine positron emission tomography in persistent primary hyperparathyroidism-A case report with a mediastinal parathyroid adenoma.
Int J Surg Case Rep. 2018 Mar 15;45:63-66
Authors: Møller ML, Rejnmark L, Arveschoug AK, Højsgaard A, Rolighed L
Abstract
INTRODUCTION: Primary hyperparathyroidism (PHPT) is a common endocrine disorder caused by pathologic growth of one or more of the parathyroid glands. Parathyroidectomies (PTX) in patients with PHPT are procedures with low morbidity, few complications, and a high cure rate. However, the parathyroid glands may be found at various anatomical locations and occasionally they are intrathoracic.
CASE PRESENTATION: We present a 57-year-old patient with PHPT. Before the first and second operation, the preoperative imaging indicated pathologic parathyroid tissue in the neck. Due to postoperative persistent hypercalcemia we performed a 11C-methionine positron emission tomography (11C-MET-PET/CT). The scan showed a focus with increased activity in the mediastinum. Due to persistent disease, an ectopic parathyroid gland in the mediastinum was suspected. At a third operation, the parathyroid adenoma was resected through an anterolateral thoracotomy. Biochemical values normalized and bone mineral density improved postoperatively. Hence, an ectopic localization of a parathyroid gland should be considered during the preoperative planning of a PTX, especially in the re-operative setting. A multidisciplinary effort is necessary to address an intrathoracic adenoma.
CONCLUSION: Ectopic parathyroid glands should be suspected when positive sestaMIBI uptake is seen in the mediastinum and other types of imaging (e.g. contrast enhanced CT scan or PET-CT) may confirm the finding of an ectopic parathyroid adenoma. From the present case and previous studies we found 11C-MET-PET/CT valuable in difficult PHPT cases.
PMID: 29573598 [PubMed - as supplied by publisher]
https://ift.tt/2pJd4Nl
Laparoscopic Roux-en-Y gastric bypass in a patient with situs inversus totalis: Case report, technical tips and review of the literature.
Laparoscopic Roux-en-Y gastric bypass in a patient with situs inversus totalis: Case report, technical tips and review of the literature.
Int J Surg Case Rep. 2018 Mar 15;45:56-62
Authors: Atwez A, Keilani Z
Abstract
INTRODUCTION: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has proven over the years to be one of the most effective bariatric procedures. It is highly technical, and therefore is mostly performed by bariatric and metabolic surgeons. Although Situs Inversus Totalis (SIT) is a very rare congenital condition, surgeons do occasionally have to operate intra-abdominally on those patients, consequently facing some challenges related to the unusual anatomy.
CASE PRESENTATION: We describe a rare case of LRYGB for chronic morbid obesity on a 43 year old patient with pre-operative diagnosis of situs inversus totalis without Kartagener's syndrome, using slight modification from the usual technique based on anatomical correlation without the need to change the surgeon's position or switching trocar placements as described in previous papers. This could help surgeons in general reduce the potential challenges faced when performing such procedure.
CONCLUSION: Situs Inversus Totalis is a rare congenital condition, but surgeons in general do encounter those patients throughout their career. This rare condition should not solely be an indication for an open approach as minimally invasive surgery, whether laparoscopic or robotic, is safe and should still be considered the standard of care approach. Bariatric surgery is one of the most technical intra-abdominal procedures mainly due to the patients' body habitus, different instrumentations used, and the different anastomoses created. Gastric bypass and bariatric surgery in general can be safely performed on patients with SIT without the need for major adjustment to the surgeon's position, trocar placement or instruments used.
PMID: 29573597 [PubMed - as supplied by publisher]
https://ift.tt/2IP9aLk
Lemierre's syndrome following perianal abscess: A case report.
Lemierre's syndrome following perianal abscess: A case report.
Int J Surg Case Rep. 2018 Mar 16;45:51-55
Authors: Aljarrah Q, Khazaleh Y, Al-Jarrah M, Oldbury JW, Abou-Foul AK
Abstract
INTRODUCTION: Lemierre's syndrome (LS) is a rare and life-threatening condition characterized by suppurative thrombophlebitis of the internal jugular vein (IJV), and a history of head and neck (H&N) sepsis. LS is usually caused by Fusobacterium necrophorum, which is part of the normal flora in the oro-pharynx, and the digestive and urogenital tracts. We here report the first case of LS following perianal sepsis.
PRESENTATION OF CASE: A 60-year-old man with a painful left neck swelling, dysphagia and worsening sepsis was referred from a peripheral unit where he had an incision and drainage of a perianal abscess a week earlier. Urgent Doppler ultrasound and computed tomographic scans demonstrated suppurative thrombophlebitis of the left IJV, and the patient was subsequently commenced on intravenous Piperacillin/Tazobactam and heparin. The symptoms gradually improved, and the patient was eventually discharged on the 10th day.
DISCUSSION: Vigilant examination of the H&N region searching for a primary source is paramount, but LS following infections in the gastrointestinal or uro-genital tracts has also been described. A high index of suspicion is required for diagnosis, especially in patients with unresolving pharyngitis with a unilateral neck swelling, and septicaemia. Early resuscitation and treatment with broad-spectrum parenteral antimicrobials are important for favourable outcome.
CONCLUSION: LS is well known to specialists in the H&N region, but other disciplines like general surgery, urology, or obstetrics and gynaecology might also rarely encounter the disease. We present a case of LS complicating a perianal abscess that was successfully treated with good outcome.
PMID: 29573596 [PubMed - as supplied by publisher]
https://ift.tt/2I1cZMe
“Quality of Life in Adults with Non-Syndromic Craniosynostosis”
https://ift.tt/2IQE5qL
Genetics of non-syndromic craniosynostosis
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New Developments Are Improving Flexor Tendon Repair
https://ift.tt/2IRFtJI
Requirements for successful trachea transplantation; a study in the rabbit model
https://ift.tt/2pG2UNr
Assessing technical performance and determining the learning curve in cleft palate surgery using a high fidelity cleft palate simulator
https://ift.tt/2IQDVj9
A novel small animal model of irradiated, implant based breast reconstruction
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Targeted muscle reinnervation: considerations for future implementation in adolescents and younger children
https://ift.tt/2IRFeyi
Acellular Human Dermal Allograft as a Graft for Nasal Septal Perforation Reconstruction
https://ift.tt/2IQDKV1
Vertical growth phase as a prognostic factor for sentinel lymph node positivity in thin melanomas: a systematic review and meta-analysis
https://ift.tt/2ISJUUA
Utilizing “Black Bone” MRI in Craniofacial Virtual Surgical Planning: A Comparative Cadaver Study
https://ift.tt/2IQJiP6
Metastasis to Paranasal Sinuses from Carcinoma of Prostate: Report of a Case and Review of the Literature
Metastasis from distant primary tumors is extremely rare in the paranasal sinuses with few hundred cases in the literature. Metastatic carcinoma of the prostate is even rarer, despite being one of the most common tumors, with only 24 cases published. In this article, we report a case of a 58-year-old male presenting with epistaxis and nasal obstruction as initial symptoms of a metastatic prostate carcinoma in the ethmoid cells and maxillary sinus.
https://ift.tt/2IPfToN
[Benign aggressive vascular anomalies in children].
[Benign aggressive vascular anomalies in children].
Bull Cancer. 2018 Mar 20;:
Authors: Boccara O, Maruani A, Léauté-Labrèze C
Abstract
Superficial vascular anomalies constitute a large group of malformative and tumoral conditions developed from all types of vessels. Vascular tumors are the result of cellular hyperplasia, whereas vascular malformations (VMs) are constituted of dysplastic vessels. The classification from International Society for the Study of Vascular Anomalies (ISSVA) is based on this pathogenic difference. The most common vascular tumor is infantile hemangioma, which treatment, when necessary, is propranolol. Congenital hemangiomas and tumors that might be complicated with Kasabach-Merritt phenomenon, i.e. deep thrombocytopenia, are much rarer. Management of Kasabach-Merritt phenomenon is now largely based on sirolimus. Low-flow VMs include capillary, venous and lymphatic malformations; arteriovenous malformations are high-flow malformations. These different types of VMs might be combined. Currently, there is an increasing work in delineating the different entities based on molecular findings. Treatment of VMs depends on the impairment linked to them, and is decided case by case, in pluridisciplinary consultations. Interventional treatments, especially surgery and sclerotherapy, are usually partially efficient, and management of patients with VMs increasingly involves medical drugs. First-line treatment of coagulation disorders associated with venous malformations is based on low molecular weight heparin; sirolimus seems efficient in hemorrhagic complications refractory to usual treatment. Sirolimus is about to become the standard treatment in painful inflammatory manifestations of mixed and/or complicated lymphatic malformations.
PMID: 29571951 [PubMed - as supplied by publisher]
https://ift.tt/2ISzpAq
Protective Effects of Micronized Purified Flavonoid Fraction (MPFF) on a Novel Experimental Model of Chronic Venous Hypertension
Publication date: Available online 24 March 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Maria das Graças C de Souza, Fatima ZGA Cyrino, Jorge J de Carvalho, Vanessa Blanc-Guillemaud, Eliete Bouskela
ObjectivesTo assess protective effects of micronized purified flavonoid fraction (MPFF) on microcirculation in an original chronic model of hind limb venous hypertension with low blood flow in small animals.MethodsVein ligatures were performed on male hamsters, as follows: A-right femoral vein; A + B-right femoral vein and its right branch; A + C-right femoral vein and its left branch; A + B + C-right femoral and its right and left branches; D-external right iliac vein. In sham operated groups, similar vascular dissections were performed without ligatures. Superficial (epigastric) and central (jugular) venous pressure evaluations were made during a 10 week period. Hamsters subjected to A + B + C and D ligatures were selected for leukocyte rolling and sticking, functional capillary density (FCD), and venular and arteriolar diameter observations. D ligature was selected to evaluate pharmacological treatment efficacy. MPFF (100 mg/kg), concomitant active flavonoids of MPFF (diosmetin, hesperidin, linarin, and isorhoifolin) (10 mg/kg), diosmin (100 mg/kg) or drug vehicle were administered orally during 2 weeks before vein ligature and 6 weeks thereafter.ResultsA, A + B and A + C models maintained venous return through collaterals. From the 2nd to the 10th weeks after vein ligatures, A + B + C and D models elicited a progressive increase of superficial venous pressure (3.83 ± 0.65 vs. 8.56 ± 0.72 mmHg, p < .001 and 4.13 ± 0.65 vs. 9.35 ± 0.65 mmHg, p < .001, respectively) with significant changes to the microcirculation. As D model significantly increased superficial venous pressure without affecting central venous pressure, it was used to evaluate the long-term effects of treatment. Compared with vehicle, MPFF, concomitant active flavonoids of MPFF, and diosmin, significantly decreased leukocyte-endothelium interaction and prevented FCD reduction. Only MPFF significantly prevented venular enlargement as observed in the vehicle treated group.ConclusionMPFF was more effective than diosmin in improving all microvascular variables. The superiority of MPFF over diosmin alone can be explained by the synergistic beneficial effects of the association between diosmin and active flavonoids of MPFF.
https://ift.tt/2ujtWQe
A hydatic cyst of the appendix mimicking a uterine lateral mass: a case report
Hydatic cyst is a zoonotic disease caused by Echinococcus granulosus. It is a public health problem in Tunisia and remains endemic. It occurs in intra-abdominal organs in 10–15% of the cases, particularly in t...
https://ift.tt/2Gc6VQM
Efficacy, safety and predictive indicators of apatinib after multilines treatment in advanced nonsquamous nonsmall cell lung cancer: Apatinib treatment in nonsquamous NSCLC.
Efficacy, safety and predictive indicators of apatinib after multilines treatment in advanced nonsquamous nonsmall cell lung cancer: Apatinib treatment in nonsquamous NSCLC.
Asia Pac J Clin Oncol. 2018 Mar 24;:
Authors: Wu D, Liang L, Nie L, Nie J, Dai L, Hu W, Zhang J, Chen X, Han J, Ma X, Tian G, Han S, Long J, Wang Y, Zhang Z, Xin T, Fang J
Abstract
AIM: Patients with advanced nonsquamous nonsmall cell lung cancer (NSCLC) who experienced progression with two or more lines chemotherapy have no treatment options that clearly confer a survival benefit. As a novel vascular endothelial growth factor receptor-2 tyrosine kinase inhibitor, apatinib has a certain antitumor effect for various solid tumors. The present study evaluated the efficacy and safety of apatinib in advanced nonsquamous NSCLC as salvage treatment in Chinese real-world practice.
METHODS: Twenty-eight patients were enrolled in this observational study from October 2015 to May 2017. Progression-free survival (PFS) and overall survival (OS) were graphed by Kaplan-Meier curve and intergroup comparisons were carried out by log-rank test. Objective response rate (ORR), disease control rate (DCR) and adverse effects (AEs) were also evaluated.
RESULTS: Seven patients obtained partial response, and 18 obtained stable disease, representing an ORR of 26% and a DCR of 93%. Median PFS and OS were 3 (95% confidence interval [CI] 2.6-3.4) and 7.4 (95% CI 1.3-13.5) months, respectively. The efficacy analysis showed that Eastern Cooperative Oncology Group (ECOG) performance status 0-1 was correlated with prolonged OS and PFS (P < 0.05), and hypertension during apatinib treatment was correlated with prolonged OS (P < 0.05). Cox regression showed that ECOG performance status (P < 0.01) (RR = 0.231) (95% CI 0.083-0.642) and hypertension during apatinib treatment (P = 0.05) were predictive indicators for apatinib treatment. Grade 3-4 AEs with incidences of 10% or greater were hypertension (21%), hand-foot syndrome (14%) and proteinuria (11%) which could be relieved by dose reduction.
CONCLUSION: In conclusion, apatinib has a certain therapeutic effect in patients with advanced nonsquamous NSCLC. ECOG performance status and hypertension during apatinib might be predictive indicators for treatment efficacy.
PMID: 29573236 [PubMed - as supplied by publisher]
https://ift.tt/2ukKJSM
Interruption of lactate uptake by inhibiting mitochondrial pyruvate transport unravels direct antitumor and radiosensitizing effects.
Interruption of lactate uptake by inhibiting mitochondrial pyruvate transport unravels direct antitumor and radiosensitizing effects.
Nat Commun. 2018 Mar 23;9(1):1208
Authors: Corbet C, Bastien E, Draoui N, Doix B, Mignion L, Jordan BF, Marchand A, Vanherck JC, Chaltin P, Schakman O, Becker HM, Riant O, Feron O
Abstract
Lactate exchange between glycolytic and oxidative cancer cells is proposed to optimize tumor growth. Blocking lactate uptake through monocarboxylate transporter 1 (MCT1) represents an attractive therapeutic strategy but may stimulate glucose consumption by oxidative cancer cells. We report here that inhibition of mitochondrial pyruvate carrier (MPC) activity fulfils the tasks of blocking lactate use while preventing glucose oxidative metabolism. Using in vitro 13C-glucose and in vivo hyperpolarized 13C-pyruvate, we identify 7ACC2 as a potent inhibitor of mitochondrial pyruvate transport which consecutively blocks extracellular lactate uptake by promoting intracellular pyruvate accumulation. Also, while in spheroids MCT1 inhibition leads to cytostatic effects, MPC activity inhibition induces cytotoxic effects together with glycolysis stimulation and uncompensated inhibition of mitochondrial respiration. Hypoxia reduction obtained with 7ACC2 is further shown to sensitize tumor xenografts to radiotherapy. This study positions MPC as a control point for lactate metabolism and expands on the anticancer potential of MPC inhibition.
PMID: 29572438 [PubMed - in process]
https://ift.tt/2pDiABx
Matrix metalloproteinases expression in spontaneous canine histiocytic sarcomas and its xenograft model.
Matrix metalloproteinases expression in spontaneous canine histiocytic sarcomas and its xenograft model.
Vet Immunol Immunopathol. 2018 Apr;198:54-64
Authors: Fayyad A, Lapp S, Risha E, Pfankuche VM, Rohn K, Barthel Y, Schaudien D, Baumgärtner W, Puff C
Abstract
Canine histiocytic sarcoma (HS) represents a malignant neoplastic disorder often with a rapid and progressive clinical course. A better understanding of the interaction between tumor cells and the local microenvironment may provide new insights into mechanisms of tumor growth and metastasis. The influence of matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) on tumor angiogenesis, invasion and metastasis has been detailed in previous studies. In addition, inflammatory cells infiltrating neoplasms especially tumor associated macrophages (TAM) may contribute significantly to tumor progression. Due to the high variability of spontaneously occurring canine HS, standardized models are highly required to investigate tumor progression and interaction with its microenvironment. Therefore, the present study comparatively characterized the intratumoral macrophage infiltration as well as the expression of MMP-2, MMP-9, MMP-14 and TIMP-1 in spontaneous canine HS and its murine model. In spontaneous canine HS, scattered MAC 387-positive macrophages were randomly found in tumor center and periphery, whereas tumor cells were negative for this marker. Interestingly, quantitative analysis revealed that MMPs and TIMP-1 were mainly expressed at the invasive front while tumor centers exhibited significantly reduced immunoreactivity. Similar findings were obtained in xenotransplanted HS. Interestingly, murine tumor associated macrophages (TAM), characterized by Mac3 expression (CD107b/LAMP2), which was not present in xenotransplanted histiocytic sarcoma cells, strongly express MMPs and TIMP-1. In addition, MMPs are known to regulate angiogenesis and a positive correlation between MMP-14 expression and microvessel density was demonstrated in xenotransplanted histiocytic sarcomas. Summarized similar findings with respect to MMP and TIMP distribution and the role of macrophages in spontaneously-occurring and xenotransplanted HS indicate the high suitability of this murine model to further investigate HS under standardized conditions. Moreover results indicate that MMP expression contributes to tumor progression and invasion and TAMs seem to be major players in the interaction between neoplastic cells, the microenvironment and vessel formation indicating that therapeutic approaches modulating TAM associated molecules might represent promising future treatment options.
PMID: 29571518 [PubMed - in process]
https://ift.tt/2ujOkAv
A rare case of drug-induced hypersensitivity syndrome by pirfenidone for idiopathic pulmonary fibrosis
Publication date: Available online 24 March 2018
Source:Allergology International
Author(s): Kumiko Suda, Koji Kamiya, Binluen Chiang, Hirofumi Okada, Naoko Mato, Takeo Maekawa, Mayumi Komine, Satoru Murata, Mamitaro Ohtsuki
https://ift.tt/2ujIxuL
Non-invasive quantification of human swallowing using a simple motion tracking system.
Non-invasive quantification of human swallowing using a simple motion tracking system.
Sci Rep. 2018 Mar 23;8(1):5095
Authors: Hashimoto H, Hirata M, Takahashi K, Kameda S, Katsuta Y, Yoshida F, Hattori N, Yanagisawa T, Palmer J, Oshino S, Yoshimine T, Kishima H
Abstract
The number of patients with dysphagia is rapidly increasing due to the ageing of the population. Therefore, the importance of objectively assessing swallowing function has received increasing attention. Videofluoroscopy and videoendoscopy are the standard clinical examinations for dysphagia, but these techniques are not suitable for daily use because of their invasiveness. Here, we aimed to develop a novel, non-invasive method for measuring swallowing function using a motion tracking system, the Kinect v2 sensor. Five males and five females with normal swallowing function participated in this study. We defined three mouth-related parameters and two larynx-related parameters and recorded data from 2.5 seconds before to 2.5 seconds after swallowing onset. Changes in mouth-related parameters were observed before swallowing and reached peak values at the time of swallowing. In contrast, larynx-related parameters showed little change before swallowing and reached peak values immediately after swallowing. This simple swallow tracking system (SSTS) successfully quantified the swallowing process from the oral phase to the laryngeal phase. This SSTS is non-invasive, wireless, easy to set up, and simultaneously measures the dynamics of swallowing from the mouth to the larynx. We propose the SSTS for use as a novel and non-invasive swallowing assessment tool in the clinic.
PMID: 29572522 [PubMed - in process]
https://ift.tt/2G6JBI4