Comparative effect of photobiomodulation associated with dexamethasone after sciatic nerve injury model

Abstract

To analyze the effect of photobiomodulation and dexamethasone on nerve regeneration after a sciatic nerve crushing model. Twenty-six Swiss mice were divided into the following groups: naive; sham; injured, low-level laser therapy (LLLT) (660 nm, 10 J/cm², 0.6 J, 16.8 J total energy emitted during the 28 days of radiation, 20 s, for 28 days); dexamethasone (Dex) (local injection of 2 mg/kg for 10 consecutive days); and LLLT group associated with Dex (LLLT/Dex), with the same parameters of the other groups. For nerve injury, a portable adjustable pinch was used. The animals were evaluated using the Sciatic Functional Index (SFI) and Sciatic Static Index (SSI). The results obtained were evaluated with Image J™ and Kinovea™. Data and images were obtained at baseline and after 7, 14, 21, and 28 days after surgery. The evaluation of hyperalgesia, using Hargreaves, and behavior through the open field was also performed. In functional and static analysis, all groups presented significant differences when compared to the injured group. In the analysis of the SSI results, the group treated with both LLLT and dexamethasone was more effective in improving the values of this parameter, and in the SFI, the laser-treated group obtained better results. In the evaluation through the open field and the Hargreaves, there was no difference. The application of LLLT and dexamethasone was effective in nerve regeneration according to the results and was more effective when LLLT was associated with dexamethasone than in LLLT alone for the SSI.

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Physical properties of hydrogel wound dressing and its use in low-level laser therapy (LLLT)

Abstract

Hydrogel dressings are routinely used in the treatment of superficial skin wounds. Due to their excellent transparency, we decided to evaluate their usefulness in laser-based medical procedures. We focused on assessing selected physical properties of HydroAid hydrogel wound dressing, used for low-level laser therapy (LLLT) aka laser biostimulation procedures. For the two wavelengths of 660 and 808 nm used in the biostimulation laser POLARIS 2, a dressing transmittance of 92 and 98%, respectively, was determined. Using a FLIR i7 thermal imaging camera, the changes in temperature distribution across the surface of the dressing were assessed, during a 3-h period following its unpacking and placing on the skin of a patient or leaving it at the ambient temperature. The results of the thermal imaging, as well as temperature measurements using a digital thermometer, showed that the cooling properties of a hydrogel dressing were maintained throughout the entire experiment and that it was capable to keep the temperature at least 5° below the skin/ambient (room) temperature. During the 6-h observation using the holographic microscope, which provided indirect insight into the processes occurring within the hydrogel, only minimum topographical changes (observable at a micrometre scale) were recorded, although dressing thickness and its flexibility decreased significantly with time. Additionally, the possibility to regenerate the hydrogel dressing by treating it with distilled water or a physiological salt solution was tested.

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ROS-induced autophagy reduces B16F10 melanoma cell proliferative activity

Abstract

Cancer is a pathology characterized by increased cell progression and/or reduced programmed cell death. Melanoma shows a rapid increase in cell progression and its resistance to chemotherapy is associated with uncontrolled apoptosis and to mechanisms that increase the flow of the drug out of the cell. The objective of this study was to evaluate the effects of photodynamic therapy (PDT) on the cell proliferation and cellular alterations in B16F10 murine melanoma. For that, four experimental groups were evaluated: the control group; laser group (ʎ = 660 ηm, 40 mW, 2.4 J/cm²); photosensitizer group (solution containing methylene blue and toluidine blue 1:1–12.5 μg/mL); PDT group. The incubation time was 30 min. Fluorescence microscopy assays were performed without fixation with the DAPI, monodansylcadaverine (MDC), and dihydroethidium (DHE) probes. Cell proliferation was also determined at 24-h time. The tests were performed in triplicate and the statistical test used was ANOVA with Tukey post-test. The results demonstrate that the plasma membrane of the cells of all the experimental groups remained intact, ROS production and autophagy significantly increased (p < 0.0005 and p < 0.0071, respectively) only in the PDT group. The cell proliferation essay showed a reduction of 74.2% on the PDT group in relation to the control group. The present study demonstrated that oxidative stress promoted by photodynamic therapy may induce autophagy and consequently reduce cell proliferation in B16F10 melanoma.

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Two cases of unidentified acute compartment syndrome

Acute compartment syndrome (ACS) is a surgical emergency that requires urgent fasciotomy to prevent irreversible sequelae. We report two cases of unidentified ACS, which did not result from traumatic injuries such as fractures or crush injury, iatrogenic injury or diseases such as haematological malignancies. Both patients complained of severe pain and swelling of their extremity. No bite marks, blisters or skin necrosis was noted. They also complained of marked symptoms of third cranial nerve injury, including divergent squint and diplopia. The diagnosis of ACS was made following continuous intracompartmental pressure measurement, and both patients underwent urgent fasciotomy with partial incision. Considering the season and location of the injuries, together with the rapid progression of signs and symptoms that included thrombocytopaenia, acute renal failure, rhabdomyolysis and especially that of third cranial nerve injury, we postulate that these two cases may have developed following mamushi (Gloydiusblomhoffii) bites.

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Limited incision harvest of the rectus abdominis muscle flap

Abstract

Background

Rectus abdominis muscle harvest typically uses a long and continuous paramedian approach. To limit donor site morbidity, the senior author performs a limited incision approach particularly useful in medically vulnerable patients, including patients with sternal wound infections.

Methods

All patients of a single surgeon from 2000 to 2014 who underwent rectus harvest by one or two transverse incisions and use of lighted retractor were identified. Patients were categorized by indication, for "sternal wound coverage" or "non-sternal wound coverage." Co-morbidities, operative notes, and post-operative courses were evaluated. Comparisons were made to patients undergoing harvest by paramedian approach.

Results

Seventeen patients with a mean age of 61 underwent limited-incision rectus harvest. Nine patients had indication for "sternal wound coverage." Three patients had single transverse incision and six patients had double transverse incisions. One patient expired post-reconstruction day 3. One patient had complete abdominal and partial sternal wound dehiscence. No other donor site complications were observed. Eight patients had indication for "non-sternal wound coverage," including seven patients requiring free rectus for lower extremity defects and one a pedicled rectus abominis for pelvic osteomyelitis. No post-operative complications were observed in these non-sternal wound coverage patients. There was a trend toward improved wound healing and hospitalization time using the transverse compared to paramedian technique, although this was not significant.

Conclusions

The morbidity of the traditional paramedian incision for rectus harvest may be avoided using a limited skin incision approach. This is useful in patients with attenuated healing capacity and offers a lower risk approach to a traditionally risky donor site.

Level of Evidence: Level IV, therapeutic study.

https://ift.tt/2GMiLEA

Label-free sensitive luminescence biosensor for immunoglobulin G based on Ag6Au6 ethisterone cluster-estrogen receptor α aggregation and graphene

Publication date: 1 August 2018
Source:Talanta, Volume 185
Author(s): Nannan Chen, Wenjing Guo, Zhixiang Lin, Qiaohua Wei, Guonan Chen
A specific and label-free "on-off-on" luminescence biosensor based on a novel heterometallic cluster [Ag6Au6(ethisterone)12]-estrogen receptor α (Ag6Au6Eth-ERα) aggregation utilizing graphene oxide (GO) as a quencher to lead a small background signal was firstly constructed to detect immunoglobulin G (IgG) with a simple process and high selectivity. The efficient photoluminescent (PL) Ag6Au6Eth-ERα aggregation is strongly quenched by GO. In the presence of IgG, the PL of this system will be restored, and perceivable by human eyes under UV lamp excitation (365 nm). The quenching mechanism of GO on Ag6Au6Eth-ERα and enhancement mechanism of IgG on Ag6Au6Eth-ERα-GO were investigated in detail. Under the optimum conditions, the biosensor for high sensitive IgG detection expressed a wider linear range of 0.0078–10 ng/mL and a lower detection limit of 0.65 pg/mL with good stability and repeatability, which provided a new approach for label-free IgG detection.

Graphical abstract

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RE: “Deployment And Preterm Birth Among US Army Soldiers”

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2017 Articles of the Year, Reviewers of the Year, and Figure of the Year

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Plasticity and biological diversity of myeloid derived suppressor cells

Kerem Ben-Meir | Nira Twaik | Michal Baniyash

https://ift.tt/2IixYKQ

How to cope with food allergy symptoms?

Purpose of review Food allergy symptoms may involve a wide variety of organs (skin, gastrointestinal tract, and eyes) and systems (respiratory, circulatory, and neurological). They are often associated. Their severity ranges from mild to potentially life-threatening reactions and the presentation from acute to chronic. Recent findings Food allergies have been the focus of multiple studies, position papers, and guidelines in recent years. They have defined an approach in classifying symptoms as mild to anaphylactic, distinguishing objective from subjective symptoms, and describing their heterogeneity, specific phenotypes or syndromes (e.g., lipid transfer protein syndrome or pollen food syndrome). Cofactors can also influence food allergy reactions. Symptoms of non-IgE-gastrointestinal food allergies, illustrated by eosinophilic esophagitis and food-protein-induced enterocolitis syndrome, are also now better understood and defined. Improvement in the knowledge of food allergy symptoms is crucial for correct diagnosis and a personalized treatment approach. Summary Through a better description and understanding of symptoms, the diversity of food allergies is now better known. The next step is to harmonize symptom assessment not only for clinicians but also for patients, researchers, and public health stakeholders, to describe food allergy phenotypes and their underlying mechanisms and endotypes, to develop targeted management. Correspondence to Antoine Deschildre, Pneumologie et Allergologie Pédiatriques, Hôpital Jeanne de Flandre, CHRU de Lille, Avenue Avinée, 59037 Lille Cedex, France. Tel: +33 320445072; e-mail: antoine.deschildre@chru-lille.fr Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Oral food challenge using different target doses and time intervals between doses

Purpose of review The oral food challenge (OFC) is a specific and vital tool used in clinical practice to identify the level of tolerance a person exhibits toward certain foods while diagnosing food-related allergies. OFC methods differ among countries. The aim of this review is to evaluate different target doses and determine the time interval between doses used for OFC. Recent findings We analyzed recent articles on target doses and time between doses, and noted that some papers reported low target doses and less time between doses. A low-dose OFC appears to be a useful strategy; a time interval of 15 min between doses is short and that of at least 1 h is appropriate. Summary Low-dose OFCs appear to be well tolerated and effective to avoid complete elimination of the consumption of foods causing allergies. For the safety of the OFC method, the time interval between doses should be more than 30 min. Correspondence to Noriyuki Yanagida, Department of Pediatrics, Sagamihara National Hospital, 18-1, Sakuradai, Minami-ku, Sagamihara, Kanagawa 252-0392, Japan. Tel: +81 42 742 8311; fax: +81 42 742 5314; e-mail: n-yanagida@sagamihara-hosp.gr.jp Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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3D cell printing of in vitro stabilized skin model and in vivo pre-vascularized skin patch using tissue-specific extracellular matrix bioink: A step towards advanced skin tissue engineering

Publication date: June 2018
Source:Biomaterials, Volume 168
Author(s): Byoung Soo Kim, Yang Woo Kwon, Jeong-Sik Kong, Gyu Tae Park, Ge Gao, Wonil Han, Moon-Bum Kim, Hyungseok Lee, Jae Ho Kim, Dong-Woo Cho
3D cell-printing technique has been under spotlight as an appealing biofabrication platform due to its ability to precisely pattern living cells in pre-defined spatial locations. In skin tissue engineering, a major remaining challenge is to seek for a suitable source of bioink capable of supporting and stimulating printed cells for tissue development. However, current bioinks for skin printing rely on homogeneous biomaterials, which has several shortcomings such as insufficient mechanical properties and recapitulation of microenvironment. In this study, we investigated the capability of skin-derived extracellular matrix (S-dECM) bioink for 3D cell printing-based skin tissue engineering. S-dECM was for the first time formulated as a printable material and retained the major ECM compositions of skin as well as favorable growth factors and cytokines. This bioink was used to print a full thickness 3D human skin model. The matured 3D cell-printed skin tissue using S-dECM bioink was stabilized with minimal shrinkage, whereas the collagen-based skin tissue was significantly contracted during in vitro tissue culture. This physical stabilization and the tissue-specific microenvironment from our bioink improved epidermal organization, dermal ECM secretion, and barrier function. We further used this bioink to print 3D pre-vascularized skin patch able to promote in vivo wound healing. In vivo results revealed that endothelial progenitor cells (EPCs)-laden 3D-printed skin patch together with adipose-derived stem cells (ASCs) accelerates wound closure, re-epithelization, and neovascularization as well as blood flow. We envision that the results of this paper can provide an insightful step towards the next generation source for bioink manufacturing.



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Alternative Choices for Anterolateral Thigh Flaps Lacking Suitable Perforators: A Systematic Review

J reconstr Microsurg
DOI: 10.1055/s-0038-1639366

Background The anterolateral thigh (ALT) flap has become a predominant option in the field of reconstruction. However, some difficulties in harvesting flap exist due to the anatomical variability of the perforators. Reports have provided solutions for unreliable perforators. Although numerous cases that showed successful conversion to tensor fasciae latae (TFL) flap or anteromedial thigh (AMT) flap have been reported in the literature, none fully addresses the reliability of the perforators that have been described to date. Therefore, we conducted a systematic literature review to compare the reliability of the TFL flap with that of the AMT flap when an ALT flap perforator is not suitable. Methods A systematic review of the MEDLINE, PubMed, and Cochrane Library electronic databases was performed to compare the characteristics of TFL and AMT flap perforators. Results A total of 13 articles were included for review. The mean number of TFL perforators varied from 1.41 to 3.17 per thigh. The mean number of AMT perforators was between 0.59 and 1.3 per thigh. The cumulative assessment of the clinical and anatomical studies showed 456 perforators in 180 TFL flaps (mean, 2.53) and 145 perforators in 162 AMT flaps (mean, 0.90). The mean pedicle length of the TFL and AMT flaps ranged from 7.0 to 9.59 cm and from 7.4 to 11.0 cm, respectively. The mean perforator diameter was similar in both flaps. Conclusion Currently available literature suggests that the TFL flap may be a more reliable alternative when adequate perforators are not found for ALT flap harvest.
[...]

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Development of Targeted Muscle Reinnervation Model in Hind Limb Amputated Rats

J reconstr Microsurg
DOI: 10.1055/s-0038-1639602

Background Targeted muscle reinnervation (TMR) is a novel approach to postamputation neuroma pain; however, this has not been explicitly studied. The purpose of this study was to develop a TMR model in hind limb amputated rats. Methods Ten hind limbs from 5 Sprague Dawley cadaver rats were used. Sciatic nerve, main branches of the sciatic nerve (common peroneal, tibial, sural), motor branches from the sciatic nerve to the biceps femoris and cauda femoris, gluteal nerve and its motor branches to the semimembranosus, and biceps femoris and femoral nerve were dissected to look for consistent nerve anatomy that can be used for TMR in the rat hind limb amputation model. Transfemoral amputation was performed and two types of coaptations were made: common peroneal nerve to motor branch to biceps femoris and tibial nerve to motor branch to semimembranosus. Results The total surgical time for the dissection, amputation, and coaptation of nerves was ∼90 minutes. A total of 100 nerves were dissected in 10 rat hind limbs. Anatomical dissections were straightforward to perform. Anatomy of the dissected nerves was consistent. Hind limb amputations were performed without damaging the target muscles and nerves. Nerve lengths were sufficient for coaptation without any tension. Conclusions To the best of our knowledge, this is the first report on TMR model in hind limb amputated rats. This model will allow for mechanical, electromyography (EMG), and histological analysis for future assessment of neuroma prevention.
[...]

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Future Perspectives in the Management of Nerve Injuries

J reconstr Microsurg
DOI: 10.1055/s-0038-1639353

Aim The author presents a solicited "white paper" outlining her perspective on the role of nerve transfers in the management of nerve injuries. Methods PubMed/MEDLINE and EMBASE databases were evaluated to compare nerve graft and nerve transfer. An evaluation of the scientific literature by review of index articles was also performed to compare the number of overall clinical publications of nerve repair, nerve graft, and nerve transfer. Finally, a survey regarding the prevalence of nerve transfer surgery was administrated to the World Society of Reconstructive Microsurgery (WSRM) results. Results Both nerve graft and transfer can generate functional results and the relative success of graft versus transfer depended on the function to be restored and the specific transfers used. Beginning in the early 1990s, there has been a rapid increase from baseline of nerve transfer publications such that clinical nerve transfer publication now exceeds those of nerve repair or nerve graft. Sixty-two responses were received from WSRM membership. These surgeons reported their frequency of "usually or always using nerve transfers for repairing brachial plexus injuries as 68%, radial nerves as 27%, median as 25%, and ulnar as 33%. They reported using nerve transfers" sometimes for brachial plexus 18%, radial nerve 30%, median nerve 34%, ulnar nerve 35%. Conclusion Taken together this evidence suggests that nerve transfers do offer an alternative technique along with tendon transfers, nerve repair, and nerve grafts.
[...]

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Distal Nerve Transfer: Perspective of Reconstructive Microsurgery

J reconstr Microsurg
DOI: 10.1055/s-0038-1639369

Recent articles have strongly emphasized the superiority of distal nerve transfers despite indefinite assessment. I would like to introduce the problems associated with functional evaluation following nerve transfers.
[...]

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Is the Oblique Branch a Preferable Vascular Pedicle for Anterolateral Thigh Free Flaps?

J reconstr Microsurg
DOI: 10.1055/s-0038-1639370

Background The oblique branch of the lateral circumflex femoral artery is considered an alternative vascular pedicle of the anterolateral thigh (ALT) flap. However, the oblique branch has several advantages over the descending branch. Methods A total of 61 consecutive ALT free flaps were harvested according to Yu's ABC system. Vascular pedicle dimensions and length, artery course, perforator origins, and flap harvest time with the oblique branch or the descending branch were recorded. We classified the ALT flaps with oblique branches into three types according to the origin of perforator B. Type I flaps were those where perforator B originated from the descending branch. Type II flaps were those without perforator B. Type III flaps were those where perforator B originated from the oblique branch. Results The mean ± standard deviation (SD) diameter of the oblique branch at its origin was 1.68 ± 0.51 mm, with an average ± SD pedicle length of 12.92 ± 3.7 cm, while that of the descending branch was 2.27 ± 0.49 mm and 18.73 ± 5.14 cm, respectively. The percentage of septocutaneous perforators from the oblique branch was 35.59%, while that from the descending branch was 15.38%. The flap harvest time with the oblique branch was 33.73 ± 11.68 minutes, while that of the descending branch was 52.27 ± 7.21 minutes. Based on the origin of perforator B, 7 cases had type I ALT flaps, 4 had type II ALT flaps, and 10 had type III ALT flaps. Various ALT flaps based on the oblique branch were harvested, and good clinical results were achieved. Conclusion The oblique branch is sufficiently large and can be reliably used as the flap pedicle. It may be the preferred vascular pedicle for ALT free flaps.
[...]

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Dynamic Quantitative Assessment of Motor Axon Sprouting after Direct Facial–Hypoglossal End-To-Side Neurorrhaphy in Rats

J reconstr Microsurg
DOI: 10.1055/s-0038-1636539

Background End-to-side (ETS) neurorrhaphy is a promising procedure for peripheral nerve repair, yet controversies regarding the efficacy of this repair in facial nerve anastomosis for facial paralysis still exist. Methods Thirty rats were divided into three groups: intact control group, direct facial–hypoglossal ETS neurorrhaphy, and end-to-end (ETE) neurorrhaphy. Nerve regeneration was assessed with vibrissae motor performance, electrophysiological tests, retrograde labeling, and histomorphological analysis at 4 and 8 months postoperatively. Results Both ETS and ETE neurorrhaphies resulted in axonal regeneration and functional recovery of the recipient nerve but did not reach the level of intact controls. Significantly higher numbers of myelinated axons and labeled neurons giving regenerating fibers were found in group ETE compared with group ETS at both time points, consistent with the functional and electrophysiological recovery. Group ETS showed significantly smaller fiber diameter and thinner myelin thickness than group ETE at 4 months, but the difference became nonsignificant at 8 months. ETS neurorrhaphy had a very slight effect on the donor nerve, as determined electrophysiologically and histomorphologically. Sparsely distributed double-labeled neurons and relatively large amounts of single-labeled neurons contributing to reinnervation were found through double retrograde neuronal labeling in group ETS. Further quantitative analysis of the percentage of double-labeled neurons showed a pronounced tendency to decline from 19.8% at 4 months to 6.0% at 8 months postoperatively. Conclusion Successful reinnervation after ETS neurorrhaphy could be achieved through both collateral sprouting and terminal sprouting, with the latter seeming to be the principal origin of motor nerve sprouting.
[...]

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Does Cigarette Smoking Harm Microsurgical Free Flap Reconstruction?

J reconstr Microsurg
DOI: 10.1055/s-0038-1639377

Background Free tissue transfers can successfully address a wide range of reconstructive requirements. While the negative influence of cigarette smoking is well documented, its effects in the setting of microsurgical free flap reconstruction remain debated. This study evaluates the impact of cigarette smoking on microsurgical reconstructions. Methods Over a 7-year period, 897 patients underwent 969 microvascular free flap reconstructions at a single surgical center. The cases were divided into "smoker" (S) and "nonsmoker" (NS) groups according to their cigarette smoking status. The data were retrospectively screened for patients' demographics, perioperative details, surgical complications, free flap types, recipient sites, flap survival, and overall outcomes. Results Both groups were comparable regarding comorbidities including hypertension, peripheral artery disease, diabetes, American Society of Anesthesiologists scores, types of performed free flaps, and recipient sites. While patients in the NS group were significantly older and had a higher prevalence of obesity (p < 0.05), there were no significant differences regarding the rate of major or minor complications during our 3-month follow-up period (p > 0.05). Conclusion While minor and major complications were increased regarding virtually all examined parameters, cigarette smoking did not have significant effects on the overall outcomes of microsurgical free flap reconstructions.
[...]

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Check the Record: Remote CT Scans for Breast Flap Perforator Mapping

J reconstr Microsurg
DOI: 10.1055/s-0038-1639578

Background Perforator mapping with computed tomography angiography (CTA) prior to autologous breast reconstruction reduces donor-site morbidity and operative time, but is costly. The aim of this study was to evaluate whether pre-existing CT scans could be used for dominant perforator identification before autologous reconstruction. Methods We identified all female patients who underwent mastectomy with immediate or delayed breast reconstruction with abdominal free flaps at a single institution between 2006 and 2016. Medical records were reviewed to identify patients with pre-existing CT scans of the abdomen/pelvis. CT images were reviewed by the senior surgeon and ranked on a 1 to 3 scale to indicate utility for preoperative planning. An analysis was performed to assess financial savings and radiation avoidance associated with the use of pre-existing scans. Results Of 301 identified patients, 44.9% (n = 135) had an available pre-existing CT. A dominant perforator was identified on 92.6% of scans. A higher proportion of dominant perforators was identified using positron emission tomography (PET)/CT scans compared with CT scans with intravenous (IV) contrast and noncontrast CTs (p < 0.0001). Compared with PET/CTs and CTs with IV contrast, the average utility score for noncontrast CTs was lower (p = 0.0001). Dominant perforators were clearly identified in patients who had both a remote CT scan and a preoperative CTA. Perforator mapping using remote CT scans yielded a projected radiation reduction of 13.2 mGy per patient and yielded a projected annual U.S. health care savings of $28,459,638. Conclusion Our study suggests that pre-existing CT scans represent a viable and economical alternative for perforator mapping before abdominal-based free flap breast reconstruction.
[...]

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3D cell printing of in vitro stabilized skin model and in vivo pre-vascularized skin patch using tissue-specific extracellular matrix bioink: A step towards advanced skin tissue engineering

Publication date: June 2018
Source:Biomaterials, Volume 168
Author(s): Byoung Soo Kim, Yang Woo Kwon, Jeong-Sik Kong, Gyu Tae Park, Ge Gao, Wonil Han, Moon-Bum Kim, Hyungseok Lee, Jae Ho Kim, Dong-Woo Cho
3D cell-printing technique has been under spotlight as an appealing biofabrication platform due to its ability to precisely pattern living cells in pre-defined spatial locations. In skin tissue engineering, a major remaining challenge is to seek for a suitable source of bioink capable of supporting and stimulating printed cells for tissue development. However, current bioinks for skin printing rely on homogeneous biomaterials, which has several shortcomings such as insufficient mechanical properties and recapitulation of microenvironment. In this study, we investigated the capability of skin-derived extracellular matrix (S-dECM) bioink for 3D cell printing-based skin tissue engineering. S-dECM was for the first time formulated as a printable material and retained the major ECM compositions of skin as well as favorable growth factors and cytokines. This bioink was used to print a full thickness 3D human skin model. The matured 3D cell-printed skin tissue using S-dECM bioink was stabilized with minimal shrinkage, whereas the collagen-based skin tissue was significantly contracted during in vitro tissue culture. This physical stabilization and the tissue-specific microenvironment from our bioink improved epidermal organization, dermal ECM secretion, and barrier function. We further used this bioink to print 3D pre-vascularized skin patch able to promote in vivo wound healing. In vivo results revealed that endothelial progenitor cells (EPCs)-laden 3D-printed skin patch together with adipose-derived stem cells (ASCs) accelerates wound closure, re-epithelization, and neovascularization as well as blood flow. We envision that the results of this paper can provide an insightful step towards the next generation source for bioink manufacturing.



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Gender comparisons of young adults’ eating behavior regulation: Re-examination of the Regulation of Eating Behavior Scale (REBS)

Publication date: 1 July 2018
Source:Appetite, Volume 126
Author(s): Tessa Hamilton, Jessica Hoffman, Dilbur Arsiwalla, Robert Volpe, Ellyn Schmidt, Sareen Gropper
The aim of this study was to evaluate the psychometric properties of the Regulation of Eating Behavior Scale (REBS) in mixed-gender, American samples and to evaluate how responses differed across male and female respondents. Responses were examined in a sample of 535 undergraduate students in the Southeastern United States. A confirmatory factor analysis was used to confirm the predicted factor structure; male and female participants were analyzed in a multi-group, unconstrained configural model, with male and female participants analyzed simultaneously to allow for multi-group comparisons within the same model. Additional analyses evaluated measurement invariance, reliability of the measure in the new sample, gender differences in subscale scores, and correlations across factors. Results of confirmatory factor analysis, multi-group by gender comparisons suggested that the factor structure did not vary across genders. In addition, factor structure was consistent with the findings of the original studies examining the psychometric property of the REBS, with the exception of the 'introjected regulation' subscale, which measures regulation of eating behaviors to avoid self-enforced consequences. Consistent with expectations, female participants' ratings were higher, on average, on more autonomous forms of eating regulation; however, contrary to expectations, scores did not differ significantly between males and females on more external forms of eating regulation. Conclusions, limitations, and implications are discussed.



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“Successful non-invasive treatment of festoons.”

No abstract available

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Reply: Commetary on Primary Septal Cartilage Graft for the Unilateral Cleft Rhinoplasty

No abstract available

https://ift.tt/2H1uXyS

A Hidden legacy of Dr.Ralph Millard, Jr.

No abstract available

https://ift.tt/2Ilj2LI

The use of fat grafting as antiestrogen vehicle for the treatment of capsular contracture

No abstract available

https://ift.tt/2H3UUOn

Muscle versus Fasciocutaneous Free Flaps in Lower Extremity Traumatic Reconstruction: A Multicenter Outcomes Analysis.

No abstract available

https://ift.tt/2Imbus2

Digital Natives Plastic Surgeons

No abstract available

https://ift.tt/2H27IEW

“Is There Value to Seeing a Transgender Fellowship Trained Surgeon?”

We are presently at a unique crossroad in medicine, where the healthcare field has the opportunity to recognize and treat transgender patients on a scale that was previously unattainable. As more professionals join the effort to treat this increasingly visible population, we have a duty to set standards for training residents and credentialing our colleagues to protect the wellbeing of this already vulnerable group. Fellowship training may be the fundamental answer to surmounting the significant medical, legal, and social complexities entailed with treating this deserving population. Financial Disclosure Statement: We have no financial disclosures. Presented at (if applicable): 2016 Philadelphia Trans Health Conference, 9/8/17 Corresponding Author: Christopher J. Salgado, 1321 NW 14th St, Ste 200, West Bldg, Miami, FL 33125, Csalgado2@med.miami.edu ©2018American Society of Plastic Surgeons

https://ift.tt/2EbwAqA

Does Orthognathic Surgery have a Significant Impact on Patients’ Perceived Attractiveness, Personality Traits, and Emotional Expressions?

No abstract available

https://ift.tt/2H3OkYe

“Treating Breast Conservation Therapy Defects with Brava and Fat Grafting: Technique, Outcomes, and Safety Profile”

No abstract available

https://ift.tt/2Ecj71S

Reply to Letter: Muscle versus fasciocutaneous free flaps in lower extremity traumatic reconstruction A multicenter outcomes analysis

No abstract available

https://ift.tt/2H7mwCt

“Reply: Orthognathic Surgery Has a Significant Effect on Perceived Personality Traits and Emotional Expressions”

No abstract available

https://ift.tt/2EbKA3W

“Analysis of Craniofacial Remodeling in the Aging Midface Using Reconstructed Three-Dimensional Models in Paired Individuals”

No abstract available

https://ift.tt/2H2qYC5

“A New Microtia Reconstruction Method Using Delayed Postauricular Skin Flap”

No abstract available

https://ift.tt/2E9Edy0

“Analysis of Craniofacial Remodeling in the Aging Midface Using Reconstructed Three-Dimensional Models in Paired Individuals”

No abstract available

https://ift.tt/2GLKWDC

“Pursuing Mirror Image Reconstruction in Unilateral Microtia: Customizing Auricular Framework by Application of Three-Dimensional Imaging and Three-Dimensional Printing”.

No abstract available

https://ift.tt/2IhAdOc

Book Review: Mastering Medical Photography of the Head and Neck

No abstract available

https://ift.tt/2H4u0pq

Optimal Use of Surgical Drains: Evidence-Based Strategies

Background: Closed-suction drains are a widely-used tool to reduce the incidence of seroma whenever potential spaces are surgically created. However, few studies have examined the parameters that affect drain efficacy. Methods: An in vitro model was created to assess the effects of tubing length, tubing size, tubing type, fluid viscosity, fluid clotting, evacuator type, evacuator squeeze method, evacuator fill and evacuator pressure on the performance of closed-suction drains. Results: Fluid flow rate through the drain increases with increasing intracavitary tubing length, decreasing extracavitary tubing length, increasing tubing diameter, increasing negative pressure, decreasing fluid viscosity, and the use of perforated rather than fluted drains. Bulbs generate more effective suction when squeezed "side-to-side" than when squeezed "bottom-up", and evacuators were only able to generate half the maximal negative pressure when 25% full or greater. Stripping the drain tubing helped relieve obstruction due to clotting. Conclusions: Our findings have practical clinical implications for surgeons hoping to maximize the efficacy of closed-suction drains. Through this comprehensive review of the literature and in vitro analysis of relevant variables that affect drain function, the performance of closed-suction drains can be optimized by increasing intracavitary tubing length, decreasing extracavitary tubing length, increasing tubing diameter, increasing the pressure differential, using perforated drains, squeezing bulbs "side-to-side", stripping drain tubing frequently, and evacuating containers whenever they are 25% full. Disclosures: Dr. Janis is a consultant for LifeCell, Bard and Daiichi Sankyo, has received prior honoraria from Pacira and KCI, and receives royalties from Thieme Publishing. Drs. Khansa, Khansa and Meyerson have no relevant financial disclosures. Corresponding author: Jeffrey E. Janis, MD, FACS, Professor and Executive Vice Chairman, Department of Plastic Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Rd, Columbus, OH 43212, Phone: (614) 293-8566, Fax: (614) 293-9024, Email: jeffrey.janis@osumc.edu ©2018American Society of Plastic Surgeons

https://ift.tt/2IjzeNC

“Pathways to academic leadership in plastic surgery – a nationwide survey of program directors, division chiefs, and department chairs of plastic surgery”

Background: While plastic surgeons and plastic surgery residents aspire to leadership in academic plastic surgery, there is no well-established pathway. Methods: Plastic surgery residencies and program directors(PDs) were obtained from the AMA's FREIDA database. The division chief or department chair (academic head) of every academic plastic surgery program was identified. One internet-based survey was distributed to academic heads, another to PDs. Results: 90 academic heads were identified, 35 of whom also serve as PD. 67 unique PDs were identified. There was a 51% academic head response rate and a 65% PD response rate. Academic plastic surgery is overwhelmingly administered by mid-career males. The average PD was appointed at age 45 and has served for 7 years. S/he was trained via the independent track, completed additional training in hand surgery, and is a full professor. S/he publishes 2-3 peer reviewed manuscripts per year and spends 9 hours-per-week in administration. The average academic head was appointed at age 45 and has held his/her position for 12 years. S/he was trained in the independent model, completed fellowship training, and is a full professor. S/he publishes 5 peer reviewed manuscripts per year and spends 12 hours-per-week involved in administration. Conclusion: PDs and academic heads serve non-overlapping roles. Few PDs will advance to the role of academic head. Successful applicants to the PD position often serve as an associate program director and are seen as motivated resident educators. In contrast, those faculty members selected for the academic head role are academically accomplished administrators with business acumen. Financial Disclosure Statement: Drs. Fishman, Pang, and Nguyen have nothing to disclose. Dr. Losee receives book royalties from CRC press and Elsevier. Dr. Rubin receives book royalties from Elsevier, consulting fees from a medical device company, and has ownership interest in a number of plastic surgery related ventures. No funding was received for this article. Corresponding Author: Vu T. Nguyen MD1, University of Pittsburgh, Department of Plastic Surgery, 3550 Terrace Street, 6B – Sciafe Hall, Pittsburgh, PA 15261, fishmanje@upmc.edu ©2018American Society of Plastic Surgeons

https://ift.tt/2H1htDm

Wound Surface Area as a Risk Factor for Flap Complications Among Patients with Open Fractures

Background: Soft tissue complications often dictate the success of limb salvage and the overall outcome of open fractures. Based on prior work at our institution, we hypothesize that wounds greater than 200cm2 are associated with a greater likelihood of both flap-related reoperation and wound complications among patients requiring soft tissue reconstruction with a rotational flap or free tissue transfer. Methods: We performed a secondary analysis of FLOW trial data that included all patients who received a rotational or free tissue flap transfer for an open fracture. Our primary outcome was flap-related reoperation within 12 months of injury. Our secondary outcome was wound complication, which included events treated operatively or non-operatively. Multivariable logistic regression was used to assess the association between wound size and the outcomes, adjusting for confounders. Results: 17.0% of the 112 patients required a flap-related reoperation. A wound size of greater than 200cm2 was not associated with reoperation in an unadjusted model (p=0.64) or adjusting for Gustilo type (p=0.70). The sample had an overall wound complication rate of 47.3%. Patients with a wound size of greater than 200 cm2 were three times more likely to experience wound complications (Odds Ratio: 3.05, 95% CI 1.08- 8.62, p=0.04) when adjusting for moderate-severe wound contamination and wound closure in the operating room. Conclusion: The findings of this study demonstrate that wound surface area is an integral determinant for wound complication following soft tissue flap treatment, but found no association between wound surface area and flap-related reoperation rates. * list of trial authors is listed in the Appendix Financial disclosure statement: The study was funded by the Canadian Institutes of Health Research (MCT-93173), the U.S. Army Institute of Surgical Research Orthopedic Trauma Research Program (W81XWH-08-1-0473), U.S. Army Institute of Surgical Research Peer Reviewed Orthopedic Research Program (W81XWH-12-1-0530), and Association Internationale pour l'Ostéosynthèse Dynamique. Dr. Bhandari reports receiving consulting fees from Stryker, Smith & Nephew, Amgen, Eli Lilly, DJO Global, Zimmer, and Ferring Pharmaceuticals, and grant support from Stryker, Amgen, DePuy Synthes, Eli Lilly, and DJO Global; Dr. Jeray, receiving consulting fees from Zimmer and Eli Lilly and lecture fees from Zimmer and AO North America; Dr. Petrisor reports consulting fees from Stryker and Pfizer, and research support from Stryker and Zimmer; Dr. Sprague, being an employee of Global Research Solutions; Dr. Pensy reports consulting fees from Globus Medical; and Dr. Slobogean reports being a paid presenter for Zimmer Biomet. No other potential conflict of interest relevant to this article was reported. Statement of institutional review board approval: The study was approved by the ethics committees at McMaster University, Greenville Health System, and each participating center. All the patients provided written informed consent. Clinical trial registration:ClinicalTrial.gov Identifier: NCT1069315 Corresponding Author: Raymond A. Pensy, MD, R. Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, 22 Greene St., Baltimore, MD 21201, Email: rpensy@umoa.umm.edu ©2018American Society of Plastic Surgeons

https://ift.tt/2EbzoV3

Evolution and Revolution of Perforator Flaps

No abstract available

https://ift.tt/2H1hnvu

A retentive memory of tetrachloroethene respiration in Sulfurospirillum halorespirans - involved proteins and a possible link to acetylation of a two-component regulatory system

Publication date: Available online 1 April 2018
Source:Journal of Proteomics
Author(s): Dominique Türkowsky, Jens Esken, Tobias Goris, Torsten Schubert, Gabriele Diekert, Nico Jehmlich, Martin von Bergen
Organohalide respiration (OHR), comprising the reductive dehalogenation of halogenated organic compounds, is subject to a unique memory effect and long-term transcriptional downregulation of the involved genes in Sulfurospirillum multivorans. Gene expression ceases slowly over approximately 100 generations in the absence of tetrachloroethene (PCE). However, the molecular mechanisms of this regulation process are not understood. We show here that Sulfurospirillum halorespirans undergoes the same type of regulation when cultivated without chlorinated ethenes for a long period of time. In addition, we compared the proteomes of S. halorespirans cells cultivated in the presence of PCE with those of cells long- and short-term cultivated with nitrate as sole electron acceptor. Important OHR-related proteins previously unidentified in S. multivorans include a histidine kinase, a putative quinol dehydrogenase membrane protein, and a PCE-induced porin. Since for some regulatory proteins a posttranslational regulation of activity by lysine acetylations is known, we also analyzed the acetylome of S. halorespirans, revealing that 32% of the proteome was acetylated in at least one condition. The data indicate that the response regulator and the histidine kinase of a two-component system most probably involved in induction of PCE respiration are highly acetylated during short-term cultivation with nitrate in the absence of PCE.SignificanceThe so far unique long-term downregulation of organohalide respiration is now identified in a second species suggesting a broader distribution of this regulatory phenomenon. An improved protein extraction method allowed the identification of proteins most probably involved in transcriptional regulation of OHR in Sulfurospirillum spp. Our data indicate that acetylations of regulatory proteins are involved in this extreme, sustained standby-mode of metabolic enzymes in the absence of substrate. This first published acetylome of Epsilonproteobacteria might help to study other ecologically or medically important species of this clade.

Graphical abstract

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Dermal Fillers: The Risks to Eliminating Wrinkles

In 2016, more than 2.4 million filler procedures were done with one type alone, hyaluronic acid (Juvederm, Restylane), in the U.S. That's a 56% increase over the last decade.
WebMD Health News

https://ift.tt/2GDCLcw

Corrigendum to “Genetically defined variants of toll-like receptors 3, 7 and 9 as phenotype and risk modifier factors for psoriasis” [89 (March (3)) (2018) 301–304]

Publication date: Available online 1 April 2018
Source:Journal of Dermatological Science
Author(s): M. Julià, M. Consuegra-Fernández, A. Guilabert, C. Muñoz, A. Esteve, N. Armiger-Borràs, F. Santiago, M.T. Arias, J. Romaní, C. Ferrándiz, J.M. Carrascosa, E. Pedrosa, M. Alsina-Gibert, F. Lozano, J.M. Mascaró-Galy




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Serine protease inhibitors containing a Kunitz domain: their role in modulation of host inflammatory responses and parasite survival

Publication date: Available online 1 April 2018
Source:Microbes and Infection
Author(s): Mariana T.Q. de Magalhães, Fábio S. Mambelli, Bruno P.O. Santos, Suellen B. Morais, Sergio C. Oliveira
Proteins containing a Kunitz domain have the typical serine protease inhibition function ranging from sea anemone to man. Protease inhibitors play major roles in infection, inflammation disorders and cancer. This review discusses the role of serine proteases containing a Kunitz domain in immunomodulation induced by helminth parasites. Helminth parasites are associated with protection from inflammatory conditions. Therefore, interest has raised whether worm parasites or their products hold potential as drugs for treatment of immunological disorders. Finally, we also propose the use of recombinant SmKI-1 from Schistosoma mansoni as a potential therapeutic molecule to treat inflammatory diseases.



https://ift.tt/2GKJUrq

Passive sentence comprehension difficulties and its related factors in children with cochlear implants

Publication date: June 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 109
Author(s): Youngmee Lee, Jee Eun Sung, Hyunsub Sim
ObjectivesThe purposes of this study were to investigate which syntactic structures, from active and passive sentences, sensitively differentiate children with cochlear implants (CIs) from children with normal hearing (NH), to explore the correlations among working memory (WM) and other factors for each group, and to examine predictors of the active and passive sentence scores for both groups.MethodsTwenty deaf children with CIs and 20 children with NH, aged 8–14 years, were included in this study. Sentence comprehension skills were measured using the picture-pointing comprehension task, which consisted of active and passive sentences. The WM capacity was tested by the digit forward, digit backward, word forward, and word backward span tasks.ResultsPassive sentence type was a significant predictor to differentiate between the two groups (p < .05). In the CI group, passive sentence scores were significantly correlated with age, duration of an implant use, receptive vocabulary scores, and WM scores (all p values < .05). In the stepwise regression analysis, WM capacity was a significant factor in predicting the passive sentence scores of children with CIs (p < .05).ConclusionPassive sentence type was a significant factor in distinguishing the CI group from the NH group. The WM capacity was an important predictor accounting for individual differences in processing complex sentence types for children with CIs. The results indicate that a complex syntactic form may serve as a clinically critical index in detecting higher-level cognitive and linguistic processing difficulties in good performers after implantation.



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Effect of electronic cigarettes on human middle ear

Publication date: June 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 109
Author(s): Jae-Jun Song, Yoon Young Go, Ji Yoen Mun, Sehee Lee, Gi Jung Im, Yoo yon Kim, Jun Ho Lee, Jiwon Chang
ObjectiveElectronic cigarettes (e-cigarettes) are the most commonly used electronic nicotine delivery systems and are a relatively new product designed for smoking cessation. The market scale of electronic cigarettes is growing rapidly, but the potential impact of e-cigarettes on public health has not yet been verified. In this study, we examined the effect of e-liquids on a human middle ear epithelial cell (HMEEC) line.Material and methodsThe main components of e-liquids are propylene glycol, vegetable glycerin and flavoring agents with or without nicotine. We analyzed 73 bottles of e-liquids from 12 different manufacturers, evaluated the trace elements in e-liquids, and identified the cytotoxicity of e-liquids on HMEECs in the presence or absence of nicotine.ResultsIn the trace elements analysis, nickel, arsenic, cadmium, and lead were detected in the e-liquids. E-liquids without nicotine decreased cell viability, and the average IC 50 value of total e-liquids (n = 73) was 2.48 ± 0.93%. Among the different flavors, menthol-flavored e-liquids significantly reduced cell viability, and their average IC 50 value (n = 28) was 1.85 ± 0.80%. The average IC 50 values were distinct among manufacturers and the proportion of the solvents.ConclusionThe present study provides evidence that e-cigarettes influence and reduce human middle ear cell viability even without the application of nicotine. Additionally, the cytotoxicity of e-liquids was affected by the flavoring agents.



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Acoustic Structure Quantification Versus Point Shear Wave Speed Measurement for the Assessment of Liver Fibrosis in Viral Hepatitis B

Publication date: Available online 30 March 2018
Source:Ultrasound in Medicine & Biology
Author(s): Jianxue Liu, Wei Ren, Hong Ai, Guoliang Dun, Yonghao Ji, Yaoren Zhang, Qinyun Wan, Shumei Lin
This study was conducted to evaluate the value of acoustic structure quantification (ASQ) technology versus that of point shear wave speed measurement (PSWSM) imaging technology for the assessment of liver fibrosis stage. A total of 104 patients with chronic hepatitis B (CHB) and 30 healthy control patients underwent ASQ and PSWSM examinations. Seven quantitative parameters were obtained from ASQ, and a principal component analysis was used to establish the integrative indicators. A quantitative parameter, known as the shear wave speed (SWS, m/s), was obtained from the PSWSM. The METAVIR scores for the assessment of pathologic liver fibrosis were used as a benchmark. Liver fibrosis stages exhibited a good correlation with the integrative indicators and SWS (r = 0.682, p < 0.001; r = 0.651, p < 0.001). The areas under the receiver operating characteristic curves for ASQ and PSWSM were 0.705 and 0.854 for mild liver fibrosis (F ≥ 1, p = 0.045), 0.813 and 0.743 for significant liver fibrosis (F ≥ 2, p = 0.115), 0.839 and 0.857 for severe liver fibrosis (F ≥ 3, p = 0.417) and 0.874 and 0.971 for liver cirrhosis (F = 4, p = 0.016), respectively. In conclusion, both ASQ and PSWSM were promising ultrasonic methods for assessing liver fibrosis in patients with CHB; however, PSWSM was more valuable for identifying mild liver fibrosis (F ≥ 1) and cirrhosis (F = 4) than ASQ, and the combination of PSWSM and ASQ improved the accuracy of diagnosing severe liver fibrosis (F ≥ 3).



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Consistency and Generalizability of Dietary Patterns in a Multiethnic Working Population

Publication date: Available online 1 April 2018
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Jui-Yee Eng, Foong-Ming Moy, Awang Bulgiba, Sanjay Rampal
BackgroundDietary pattern analysis is a complementary method to nutrient analysis in evaluating overall diet–disease hypotheses. Although studies have been conducted to derive dietary patterns among Malaysians, their consistency across subgroups has not been examined.ObjectiveThe study aimed to derive dietary patterns empirically and to examine the consistency and generalizability of patterns across sex, ethnicity, and urban status in a working population.DesignThis was a cross-sectional study using data from the Clustering of Lifestyle Risk Factors and Understanding its Association with Stress on Health and Well-Being among School Teachers in Malaysia study collected between August 2014 and November 2015. Dietary intake was assessed using a food frequency questionnaire, and dietary patterns were derived using factor analysis.Participants/settingParticipants were teachers from selected public schools from three states in Peninsular Malaysia (n=4,618).Main outcome measuresDietary patterns derived using factor analysis.Statistical analyses performedSeparate factor analysis was conducted by sex, ethnicity, and urban status to identify dietary patterns. Eigenvalue >2, scree plot, Velicer's minimum average partial analysis, and Horn's parallel analysis were used to determine the number of factors to retain. The interpretability of each dietary pattern was evaluated. The consistency and generalizability of dietary patterns across subgroups were assessed using the Tucker congruence coefficient.ResultsThere was no subgroup-specific dietary pattern found. Thus, dietary patterns were derived using the pooled sample in the final model. Two dietary patterns (Western and Prudent) were derived. The Western dietary pattern explained 15.4% of total variance, characterized by high intakes of refined grains, animal-based foods, added fat, and sugar-sweetened beverages as well as fast food. The Prudent dietary pattern explained 11.1% of total variance and was loaded with pulses, legumes, vegetables, and fruits.ConclusionsThe derived Western and Prudent dietary patterns were consistent and generalizable across subgroups of sex, ethnicity, and urban status. Further research is needed to explore associations between these dietary patterns and chronic diseases.



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Exercise after Aortic Dissection: to Run or Not to Run

Publication date: Available online 31 March 2018
Source:European Journal of Vascular and Endovascular Surgery
Author(s): Konstantinos Spanos, Nikolaos Tsilimparis, Tilo Kölbel




https://ift.tt/2GK4zf9

An intramural uterine fibroid became submucosal in the puerperium – proposed probable mechanism: a case report

Vaginal prolapse of a large uterine fibroid is a rare phenomenon in a woman who delivered vaginally recently, given that this fibroid might have obstructed labor. The author presents a case report of a vaginal...

https://ift.tt/2GL2MXm

Cosmetics, Vol. 5, Pages 26: Rice Water: A Traditional Ingredient with Anti-Aging Efficacy

Cosmetics, Vol. 5, Pages 26: Rice Water: A Traditional Ingredient with Anti-Aging Efficacy

Cosmetics doi: 10.3390/cosmetics5020026

Authors: Joana Marto Ângela Neves Lídia Gonçalves Pedro Pinto Cristina Almeida Sandra Simões

The skin healing benefits of rice have been known for centuries. Rice (Oryza sativa) water is a food processing waste that can potentially be incorporated into cosmetic formulations. However, no scientific evidence supports their role in skincare products. The aim of this project is to design and develop a topical gel formulation containing rice water and to evaluate its biological properties, namely, the anti-aging and antioxidant rice water properties. Rice water was evaluated in terms of physico-chemical composition and in terms of in vitro biological antioxidant activity and elastase inhibitory effect. Rice water was incorporated into a hydrogel and the developed formulation was subjected to pharmacotechnical tests such as pH and viscosity. Biological and sensory effects were evaluated on a panel of 12 volunteers for 28 days. The safety evaluation study was performed on rice water gel, using the Human Repeat Insult Patch test protocol. Rice water presented in vitro biological antioxidant activity and elastase inhibitory effect. The gel formulation containing 96% rice water was biocompatible with the human skin and presented suitable cosmetic properties. Rice water should be thus considered as an anti-aging ingredient to be used as raw material for skincare applications.

https://ift.tt/2pUTQ7t

Elavl3 regulates neuronal polarity through the alternative splicing of an embryo-specific exon in AnkyrinG

Publication date: Available online 31 March 2018
Source:Neuroscience Research
Author(s): Yuki Ogawa, Junji Yamaguchi, Masato Yano, Yasuo Uchiyama, Hirotaka James Okano
Alternative splicing of RNAs diversifies the functionalities of proteins, and it is optimized for each cell type and each developmental stage. nElavl (composed of Elavl2, Elavl3, and Elavl4) proteins are the RNA-binding proteins that is specifically expressed in neurons, regulate the alternative splicing of target RNAs, and promote neuronal differentiation and maturation. Recent studies revealed that Elavl3 knockout (Elavl3^−/−) mice completely lost the expression of nElavl proteins in the Purkinje cells and exhibited cerebellar dysfunction. Here, we found that the alternative splicing of AnkyrinG exon 34 was misregulated in the cerebella of Elavl3^−/− mice. AnkyrinG is an essential factor for the formation of neuronal polarity and is required for normal neuronal functions. We revealed that exon 34 of AnkyrinG was normally included in immature neurons and was mostly excluded in mature neurons; however, it was included in the cerebella of Elavl3^−/− mice even in adulthood. In the Purkinje cells of adult Elavl3^−/− mice, the length of the AnkyrinG-positive region shortened and somatic organelles leaked into the axons. These results suggested that exon 34 of AnkyrinG is an embryonic-stage-preferential exon that should be excluded from mature neurons and that Elavl3 regulates neuronal polarity through alternative splicing of this exon.



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3-Tesla MRI-assisted detection of compression points in ulnar neuropathy at the elbow in correlation with intraoperative findings.

Related Articles

3-Tesla MRI-assisted detection of compression points in ulnar neuropathy at the elbow in correlation with intraoperative findings.

J Plast Reconstr Aesthet Surg. 2018 Mar 06;:

Authors: Hold A, Mayr-Riedler MS, Rath T, Pona I, Nierlich P, Breitenseher J, Kasprian G

Abstract
INTRODUCTION: Releasing the ulnar nerve from all entrapments is the primary objective of every surgical method in ulnar neuropathy at the elbow (UNE). The aim of this retrospective diagnostic study was to validate preoperative 3-Tesla MRI results by comparing the MRI findings with the intraoperative aspects during endoscopic-assisted or open surgery.
METHODS: Preoperative MRI studies were assessed by a radiologist not informed about intraoperative findings in request for the exact site of nerve compression. The localizations of compression were then correlated with the intraoperative findings obtained from the operative records. Percent agreement and Cohen's kappa (κ) values were calculated.
RESULTS: From a total of 41 elbows, there was a complete agreement in 27 (65.8%) cases and a partial agreement in another 12 (29.3%) cases. Cohen's kappa showed fair-to-moderate agreement.
CONCLUSION: High-resolution MRI cannot replace thorough intraoperative visualization of the ulnar nerve and its surrounding structures but may provide valuable information in ambiguous cases or relapses.

PMID: 29602661 [PubMed - as supplied by publisher]

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Editorial Board

Publication date: May 2018
Source:Research in Developmental Disabilities, Volume 76





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EGFR is not amplified in ameloblastoma.

Related Articles

EGFR is not amplified in ameloblastoma.

Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Mar 06;:

Authors: Costa V, Fregnani ER, Fonseca FP, Abreu Alves F, Pinto CAL, Kaminagakura E

Abstract
OBJECTIVE: The aim of this study was to investigate alterations in the EGFR gene and its protein expression for a better understanding of the biologic behavior of ameloblastoma.
STUDY DESIGN: Twenty-five samples of ameloblastoma were selected, and dual-color fluorescence in situ hybridization assay was performed. The results of the assay and immunohistochemistry reaction for EGFR and Ki67 were associated with clinicopathologic features and recurrence.
RESULTS: All analyzed cases presented disomy without any gene polysomy or amplification. With regard to EGFR immunoexpression, 3 cases (12%) were considered negative, and 22 (88%) were positive, of which 13 (52%) were weak and 9 (36%) were strong. All samples presented low positivity for Ki67. There was no association between EGFR expression and clinicopathologic features or recurrence (P > .05). In some cases, EGFR immunoexpression was observed without gene amplification.
CONCLUSIONS: Ameloblastoma development, progression, or recurrence does not appear to be related to EGFR amplification or polysomy.

PMID: 29602688 [PubMed - as supplied by publisher]

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Thyroid disorders and breast cancer risk in Asian population: a nationwide population-based case-control study in Taiwan.

Related Articles

Thyroid disorders and breast cancer risk in Asian population: a nationwide population-based case-control study in Taiwan.

BMJ Open. 2018 Mar 30;8(3):e020194

Authors: Weng CH, Chen YH, Lin CH, Luo X, Lin TH

Abstract
OBJECTIVE: To evaluate whether hyperthyroidism or hypothyroidism increases the risk of subsequent breast cancer in an Asian population.
DESIGN: Nationwide population-based case-control study.
SETTING: All healthcare facilities in Taiwan.
PARTICIPANTS: A total of 103 466 women (mean age 53.3 years) were enrolled.
METHODS: 51 733 adult women with newly diagnosed primary breast cancer without a previous cancer history between 2006 and 2011 were identified and included in our study. 51 733 women with no cancer diagnosis prior to the index date were age matched as controls. Diagnosis of hyperthyroidism or hypothyroidism prior to the diagnosis of breast cancer or the same index date was identified, age, histories of thyroid disease treatment, oestrogen use and radioactive iodine treatment were adjusted.
MAIN OUTCOME MEASURES: To identify risk differences in developing breast cancer among patients with a medical history of hyperthyroidism or hypothyroidism.
RESULTS: There was a significantly increased risk of breast cancer in women with hyperthyroidism under the age of 55 years (age <45: OR 1.16, P=0.049; age 45-55: OR 1.15, P=0.019). Patients with hypothyroidism also showed an increased risk of breast cancer (OR 1.19, P=0.029) without statistical significance after stratification by age group (age <45, 45-55, >55 years). Treatment for thyroid disorders did not alter the association in subgroup analyses (P=0.857; 0.262, respectively).
CONCLUSIONS: Asian women under 55 years of age with history of hyperthyroidism have a significantly increased risk of breast cancer regardless of treatment. Women with history of hypothyroidism may also have an increased risk.

PMID: 29602850 [PubMed - in process]

https://ift.tt/2GrnNqQ

Evaluation of superior concha bullosa by computed tomography.

Related Articles

Evaluation of superior concha bullosa by computed tomography.

Surg Radiol Anat. 2018 Mar 30;:

Authors: İla K, Yilmaz N, Öner S, Başaran E, Öner Z

Abstract
OBJECTIVE: Concha bullosa is generally regarded as pneumatisation of the middle turbinate in the nose. However, pneumatisation may also be seen in the superior and inferior turbinate. Computed tomography (CT) of paranasal sinuses is extremely helpful for the examination of this inaccessible area. Coronal CT sections of paranasal sinuses are particularly useful for surgical anatomy, as these images show nearly the same regions as the endoscopic examinations. The aim of this retrospective study was to evaluate the presence, incidence and unilaterality-bilaterality of superior turbinate pneumatisation and concomitant nasal pathologies.
METHODS: A total of 1000 patients who underwent CT of the paranasal sinuses because of headaches, nasal obstructions, anosmia, facial pain or facial trauma were evaluated retrospectively.
RESULTS: Among the 1000 patients, superior pneumatized turbinate was seen on CT images of the paranasal sinuses in 149 (14.9%) cases. Of these patients, 84 were female, 65 were male, and the mean age was 38.14 years. Among 149 patients, 58 patients had bilateral superior pneumatized turbinate and the remaining 91 patients had unilateral superior pneumatized turbinate. 60.4% of the patients with superior pneumatized turbinate also had middle pneumatized turbinate.
CONCLUSION: The superior pneumatized turbinate is an anatomical variation with an incidence ranging from 12.2 to 50%. The present study revealed that there is no relationship between volume size of the superior pneumatized turbinates and sinusitis, nasal septum deviation and paradoxical middle concha. It is very important to define anatomical variations in the preoperative CT evaluation of the paranasal sinuses.

PMID: 29602963 [PubMed - as supplied by publisher]

https://ift.tt/2Ebi6XL

Preoperative radiologic patent blue localization for intracorporeal laparoscopic resection of a terminal ileal submucosal lipoma: A case report.

Preoperative radiologic patent blue localization for intracorporeal laparoscopic resection of a terminal ileal submucosal lipoma: A case report.

Int J Surg Case Rep. 2018 Mar 15;45:91-95

Authors: Wu HY, Huang SF, Pan KT, Yu MC

Abstract
BACKGROUND: Ileal submucosal lipomas are rare cases and surgical intervention was necessary in case of abdominal pain and intussusception. Laparoscopic resection may be difficult for the intraluminal submucosal lesion. Herein, we report a case of terminal ileal submucosal lipoma resected by radiologic-assisted laparoscopic surgery.
CASE PRESENTATION: The 31-year-old female was admitted for intermittent abdominal pain. The colonoscopy showed a 1.5 cm diameter subepithelial lesion in terminal ileum and computed tomography showed a hypodense lesion in distal ileum. The diagnosis of terminal ileal submucosal lipoma without obstruction was impressed and surgical strategy of minimal invasive surgery was taken. Preoperative CT-guided patent blue dye injection near the terminal ileal submucosal lipoma for localization was performed by Radiologist. Then laparoscopic resection with intracorporeal suture was done smoothly without complications. The pathology proved lipoma and she had good recovery within one week.
CONCLUSIONS: There are many kinds of intervention methods to treat the small bowel lipoma. Our experience supports that laparoscopic surgery with radiologic localization assistance is feasible for terminal ileal nonintussusceptive submucosal lipoma resection.

PMID: 29604532 [PubMed - as supplied by publisher]

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The successful salvage of a thrombosed pancreatic graft at the early postoperative period of a simultaneous pancreas and kidney transplantation.

The successful salvage of a thrombosed pancreatic graft at the early postoperative period of a simultaneous pancreas and kidney transplantation.

Int J Surg Case Rep. 2018 Mar 16;45:116-120

Authors: Shahbazov R, Azari F, Whan PA, Wei L, Agarwal A, Brayman KL

Abstract
INTRODUCTION: Simultaneous kidney and pancreas transplant is the preferred treatment option for end-stage renal disease due to type 1 diabetic nephropathy. Vascular complications are detrimental to graft survival and can lead to graft loss in the early postoperative phase of transplantation. Generally, duplex Doppler ultrasound is used for vascular patency monitoring and pancreatectomy followed by re-transplantation is required in the majority of cases. Recently, pancreatic graft salvage with non-operative management, including medical anticoagulation and endovascular thrombectomy, in the early postoperative period has been described with success.
PRESENTATION OF CASE: We report a case of early detection of pancreas venous graft thrombosis via clinical suspicion and radiological methods, and early intervention with endovascular thrombolysis. As a result, the pancreatic graft was successfully salvaged.
DISCUSSION: A limited number of studies had showed successful graft salvage in only 30-45% of thrombosed pancreatic graft with surgical thrombectomy. Our patient also had bleeding from the vascular access site and ultimately required blood transfusion, however she recovered well after procedure.
CONCLUSION: Given the complexity and significance of PVGT, urgent and prompt treatment is necessary. Interpreting outcomes from our case and other small studies, it appears that endovascular pharmacomechanical thrombectomy can be a vital tool to salvage graft organs in those receiving SPK.

PMID: 29604531 [PubMed - as supplied by publisher]

https://ift.tt/2Ijl6nE

Double cross finger flaps from the middle to the index or ring finger: A case series of 4 patients with an emphasis on donor finger morbidity.

Double cross finger flaps from the middle to the index or ring finger: A case series of 4 patients with an emphasis on donor finger morbidity.

Int J Surg Case Rep. 2018 Mar 26;45:107-111

Authors: Al-Qattan OM, Almobarak AA, Al-Qattan MM

Abstract
INTRODUCTION: The use of two cross finger flaps from one digit has not been previously reported and the technique raises concerns regarding donor finger morbidity. In this paper, the authors report on a case series of double cross fingers flaps harvested from the middle finger to reconstruct large defects in the adjacent index or ring finger; with an emphasis on documenting morbidity in the donor middle finger.
METHODS: A total of four cases of double cross finger flaps were retrospectively reviewed. Demographic data, surgery, and postoperative complications were documented. Donor middle finger morbidity (stiffness, painful neuromas, skin graft instability, cold intolerance and cosmetic concerns) were also documented.
RESULTS: All patients were young male industrial workers. Two patients underwent reconstruction with de-epithelialized cross finger flaps and the other two patients had classic cross finger flaps. No postoperative complications were noted. Mild stiffness at the distal interphalangeal joints were noted in all patients. There were no painful neuromas and one donor site had occasional blistering at the site of the skin graft. Mild cold intolerance was seen in the two patients with electric burns. Hyperpigmentation of the skin grafts was noted in all patients.
CONCLUSIONS: Our paper introduces to the literature the technique of utilizing two cross finger flaps from the middle finger to reconstruct large dorsal or volar defects of the adjacent index or ring finger. The study shows that the technique is feasible and is easily executed. The results document an acceptable donor finger morbidity.

PMID: 29604530 [PubMed - as supplied by publisher]

https://ift.tt/2H0xoBM

Renal cell metastasis to the thyroid gland: An emerging phenomenon.

Renal cell metastasis to the thyroid gland: An emerging phenomenon.

Int J Surg Case Rep. 2018 Mar 26;45:104-106

Authors: Connolly CE

Abstract
INTRODUCTION: Suspected thyroid malignancies are usually assumed to be primary in origin. Rarely, in 1-3% of cases, the tumour arises from a secondary source such as a melanoma or breast carcinoma. There is a growing body of research concerning metastatic spread of renal cell carcinoma to the thyroid gland.
PRESENTATION OF CASE: This case report describes the presentation and diagnostic work-up of an 84yr male presenting with a goitre and hoarse voice. Histopathological examination of the excised 95 × 65 × 55 mm tissue mass revealed metastatic clear cell renal cell carcinoma.
DISCUSSION: This disease pattern has become increasingly apparent in recent literature. A literature review of 150 documented cases worldwide showed that the mean interval for this spread to occur is 9 years.
CONCLUSION: There is a need for further investigation into the underlying pathophysiology of this phenomenon and increased awareness from clinicians of its existence.

PMID: 29604529 [PubMed - as supplied by publisher]

https://ift.tt/2Ebs9Mu

Intraabdominal actinomycosis resulting in a difficult to diagnose intraperitoneal mass: A case report.

Intraabdominal actinomycosis resulting in a difficult to diagnose intraperitoneal mass: A case report.

Int J Surg Case Rep. 2018 Mar 21;45:101-103

Authors: Tsujimura N, Takemoto H, Nakahara Y, Wakasugi M, Matsumoto T, Nishioka K, Takachi K, Oshima S, Yoshida K

Abstract
INTRODUCTION: Actinomycosis is a chronic suppurative granulomatous disease caused by Actinomyces israelii. Preoperative confirmed diagnosis is very difficult, so most cases are diagnosed preoperatively as malignant tumors. We report a case of intraabdominal actinomycosis which was difficult to diagnose preoperatively.
PRESENTATION OF THE CASE: A woman, 60 years old, experienced discomfort in her lower right abdomen. She complained of nausea and anorexia and visited our hospital. Laboratory blood tests, abdominal CT, and abdominal MRI led to a diagnosis of a uterine sarcoma or primary intestinal mass, and she underwent surgery. Her histopathological diagnosis was intraabdominal actinomycosis.
DISCUSSION: Actinomycosis is a chronic purulent granulomatous inflammation caused by Actinomyces israelii. No clinical symptoms or laboratory findings are characteristic of abdominal actinomycosis, so this disorder is very difficult to diagnose preoperatively. Therefore, many cases are diagnosed as malignant tumors and undergo surgery. After surgery, long-term antibiotic treatment (penicillin) is usually administered.
CONCLUSIONS: We reported a case of intraabdominal actinomycosis that resulted in a difficult to diagnose intraperitoneal mass. When a large intraperitoneal mass is found, actinomycosis needs to be included as one of differential diagnoses.

PMID: 29604528 [PubMed - as supplied by publisher]

https://ift.tt/2GJS5nS

Trend in otolaryngological surgeries in an era of super-aging: Descriptive statistics using a Japanese inpatient database.

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Trend in otolaryngological surgeries in an era of super-aging: Descriptive statistics using a Japanese inpatient database.

Auris Nasus Larynx. 2018 Mar 27;:

Authors: Suzuki S, Yasunaga H, Matsui H, Fushimi K, Yamasoba T

Abstract
OBJECTIVE: To reveal the age distribution and capture the longitudinal trend in otolaryngological surgeries performed in Japan, where society is rapidly aging.
METHODS: Using the Diagnosis Procedure Combination database, we extracted data on patients who were hospitalized and underwent any type of otolaryngological surgery in departments of otolaryngology or head and neck surgery from fiscal year 2007 to fiscal year 2013. Type of surgery, patient's age, and fiscal year were compared. We categorized >200 types of surgeries into eight specialties: ear surgery, functional endoscopic sinus surgery (FESS), other types of paranasal surgery (except for malignancy), head and neck cancer surgery, benign tumor surgery, upper airway surgery (including pharynx and larynx), removal of foreign body, and other.
RESULTS: In total, 558,732 patients were included. The proportions of patients in each age category formed two peaks in middle age and in children aged ≤9years. The proportion of all surgeries made up by FESS, other paranasal surgery, benign tumor surgery, and head and neck cancer surgery gradually increased with age, forming a peak in patients in their 60s. The proportion of ear surgery was highest in patients aged ≤9years (34.0% of all surgeries, mostly myringotomy and transtympanic ventilation tube insertion) and formed a gradual peak in patients in their 60s (mostly tympanoplasty). The proportion of upper airway surgery (tonsillectomy and adenoidectomy) was highest in patients aged ≤9years (25.3% of all surgeries). The proportion of foreign body removal was highest in patients aged ≤9years (52.2% of all surgeries) and increased slightly with age. In 2013, compared with 2007, those aged 65-74 years and ≥75years made up a larger percentage of patients undergoing each specific surgery, including tympanoplasty, stapedectomy/stapedotomy, FESS, head and neck cancer surgery, pharyngolaryngectomy, total/subtotal glossectomy, thyroid lobectomy, parotidectomy (for a benign tumor), submandibular gland resection, tonsillectomy, and vocal fold polypectomy.
CONCLUSION: The age distribution of otolaryngological surgeries varied by specialty. We found an increased proportion of patients aged 65-74 and ≥75years in most specific surgeries.

PMID: 29602585 [PubMed - as supplied by publisher]

https://ift.tt/2uG0MuG

Subcortical sources dominate the neuroelectric auditory frequency-following response to speech.

Subcortical sources dominate the neuroelectric auditory frequency-following response to speech.

Neuroimage. 2018 Mar 28;:

Authors: Bidelman GM

Abstract
Frequency-following responses (FFRs) are neurophonic potentials that provide a window into the encoding of complex sounds (e.g., speech/music), auditory disorders, and neuroplasticity. While the neural origins of the FFR remain debated, renewed controversy has reemerged after demonstration that FFRs recorded via magnetoencephalography (MEG) are dominated by cortical rather than brainstem structures as previously assumed. Here, we recorded high-density (64 ch) FFRs via EEG and applied state-of-the art source imaging techniques to multichannel data (discrete dipole modeling, distributed imaging, independent component analysis, computational simulations). Our data confirm a mixture of generators localized to bilateral auditory nerve (AN), brainstem inferior colliculus (BS), and bilateral primary auditory cortex (PAC). However, frequency-specific scrutiny of source waveforms showed the relative contribution of these nuclei to the aggregate FFR varied across stimulus frequencies. Whereas AN and BS sources produced robust FFRs up to ∼700 Hz, PAC showed weak phase-locking with little FFR energy above the speech fundamental (100 Hz). Notably, CLARA imaging further showed PAC activation was eradicated for FFRs >150 Hz, above which only subcortical sources remained active. Our results show (i) the site of FFR generation varies critically with stimulus frequency; and (ii) opposite the pattern observed in MEG, subcortical structures make the largest contribution to electrically recorded FFRs (AN ≥ BS > PAC). We infer that cortical dominance observed in previous neuromagnetic data is likely due to the bias of MEG to superficial brain tissue, underestimating subcortical structures that drive most of the speech-FFR. Cleanly separating subcortical from cortical FFRs can be achieved by ensuring stimulus frequencies are >150-200 Hz, above the phase-locking limit of cortical neurons.

PMID: 29604459 [PubMed - as supplied by publisher]

https://ift.tt/2H3Bg5i

Pharyngocutaneous and tracheoesophageal fistula closure using supraclavicular artery island flap.

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Pharyngocutaneous and tracheoesophageal fistula closure using supraclavicular artery island flap.

Eur Arch Otorhinolaryngol. 2018 Mar 30;:

Authors: Teixeira S, Costa J, Monteiro D, Bartosch I, Ínsua-Pereira I, Correia B, Silva Á

Abstract
BACKGROUND: Pharyngocutaneous fistula is a common complication of laryngopharyngeal surgery, being associated with increased morbidity and mortality. Classical regional and free flaps, frequently used in the treatment of this complication, have several limitations, including bulking, donor site morbidity and long operative time. The supraclavicular artery island flap (SCAIF) is a fasciocutaneous flap and presents as an alternative option with good results and without the previously stated limitations. We describe our experience with SCAIF in pharyngocutaneous and tracheoesophageal fistula closure.
METHODS: Between April and December 2017, four patients with pharyngocutaneous and two patients with tracheoesophageal fistula underwent fistula closure with SCAIF. Clinical records were retrospectively reviewed.
RESULTS: Pharyngocutaneous fistulae were associated with anterior esophageal wall defects ranging from 4 to 13.5 cm2. Tracheoesophageal fistulae defects were smaller (approximately 2 cm2). Fistula closure was achieved in all patients, oral diet was started on the 14th day post-operative and there were no signs of recurrence during follow-up. The donor area was complicated with the formation of hematoma in two patients.
CONCLUSIONS: The SCAIF has unique features that makes it an ideal option for pharyngocutaneous and tracheoesophageal fistula closure, namely, reliable perfusion, quick and simple dissection, pliability and minor donor site morbidity. Local complications do not significantly affect long term morbidity of the donor area and can be avoided with simple measures.

PMID: 29602967 [PubMed - as supplied by publisher]

https://ift.tt/2JcWkH8

Parent understanding of the risk of future limitations secondary to pediatric cancer treatment.

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Parent understanding of the risk of future limitations secondary to pediatric cancer treatment.

Pediatr Blood Cancer. 2018 Mar 30;:e27020

Authors: Greenzang KA, Cronin AM, Kang T, Mack JW

Abstract
BACKGROUND: Parents and physicians may have different understandings of a child's risk of future limitations due to cancer or cancer treatment. We evaluated alignment between parent- and physician-estimated risk of late effects.
METHODS: We surveyed 352 parents of children with cancer within 12 weeks of diagnosis, and the children's oncologists, at Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Children's Hospital of Philadelphia. We assessed parent and physician estimations of the child's risk of future limitations in physical abilities, intelligence, or quality of life (QOL) due to cancer treatment. Physician-estimated risk of limitations ≥50% was considered high risk.
RESULTS: Physicians considered 22% of children at high risk of physical impairments, 9% at high risk for impaired intelligence, and 6% at high risk for impaired QOL. Among high-risk children, 38% of parents recognized this risk in physical abilities, 21% in intelligence, and 5% in QOL. In multivariable analysis, parental understanding of risk, defined as concordant parent and physician estimates, was greater among parents of children at lower risk of future limitations (odds ratio 2.59; 95% confidence interval 1.35-4.96). Regardless of risk, 92% of parents considered it very/extremely important to receive information about potential health implications of cancer treatment.
CONCLUSIONS: Although most parents want information about life after cancer, most parents of children at high risk of future impairment do not recognize this risk. Strategies to improve communication about late effects throughout pediatric cancer treatment should prioritize meeting information needs and improving parent understanding of the risk of impairment.

PMID: 29603610 [PubMed - as supplied by publisher]

https://ift.tt/2H1ptnH

Hemoptysis After CardioMEMS Implantation: Case Report and Review.

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Hemoptysis After CardioMEMS Implantation: Case Report and Review.

Am J Case Rep. 2018 Mar 31;19:382-385

Authors: Rali AS, Shah Z, Sauer AJ, Gupta K

Abstract
BACKGROUND The CardioMEMS heart failure system is a small sensor that is placed in a branch pulmonary artery for ambulatory monitoring of pulmonary artery pressures. CardioMEMS has been approved for use in the United States in patients with New York Heart Association (NYHA) class III heart failure and frequent hospitalizations. In this report we describe a patient who had hemoptysis after CardioMEMS implantation. Further, we discuss possible etiologies for the occurrence of hemoptysis and suggest strategies to minimize this risk. CASE REPORT The patient was a 79-year-old female with NYHA class III heart failure with non-ischemic cardiomyopathy (LVEF 40%) and chronic atrial fibrillation who was referred for CardioMEMS implantation. The procedure was completed uneventfully. The patient was transferred out of the procedure suite to the recovery area where she developed a slight cough approximately 20 minutes after the implantation. Within a few coughs the patient started having hemoptysis. She was transferred to the cardiac intensive care unit for observation. She was kept off warfarin and aspirin and her hemoptysis resolved 3 days later. While the exact etiology of hemoptysis in this patient was unclear, we felt that it may have been precipitated by a minor wire-induced distal branch pulmonary artery injury. CONCLUSIONS Our report discusses hemoptysis as a potential life-threatening complication of CardioMEMS sensor implantation while suggesting possible etiologies and avoidance strategies. As the utilization of this technology expands in the years to come, a more comprehensive national registry for surveillance of device related complications will be crucial.

PMID: 29602943 [PubMed - in process]

https://ift.tt/2pVihS2

Procalcitonin monitoring as a guide for antimicrobial therapy: a review of current literature.

Procalcitonin monitoring as a guide for antimicrobial therapy: a review of current literature.

Pharmacotherapy. 2018 Mar 31;:

Authors: Covington EW, Roberts MZ, Dong J

Abstract
Effective antimicrobial stewardship practices are increasingly essential to best utilize the current arsenal of antimicrobials for the shortest necessary duration to minimize the development of antimicrobial resistance, secondary infections, and health care costs. Monitoring of serum procalcitonin (PCT) levels represents an effective antimicrobial stewardship strategy to differentiate bacterial infections from viral infections and noninfectious inflammatory conditions. Current literature illustrates the merits of PCT monitoring in reducing duration of antibiotic therapy without detrimental effects on mortality or infection relapses. However, the interpretation of PCT levels can be challenging, especially in light of comorbid disease states that can elevate PCT levels. This review will shed light on the utility of PCT monitoring, as well as provide insight into the practical interpretation of PCT levels. Much of the current literature surrounding PCT monitoring consists of use among patients with lower respiratory tract infections or in the critically ill. Overall, studies have demonstrated shorter antibiotic therapy durations when PCT monitoring is utilized. No studies to date have found increased rates of mortality or infection relapses, suggesting that PCT monitoring is not only effective, but also safe when used as a guide for antimicrobial therapy. Nonetheless, many conditions have been shown to elevate PCT serum concentrations, even in the absence of bacterial infections, which can make interpretation of PCT concentrations challenging. Two common conditions that affect the accurate interpretation of PCT levels are renal dysfunction and congestive heart failure. Limited studies have been performed in these populations, but current available data proposes the need for higher PCT thresholds in those with renal dysfunction or congestive heart failure and supports utilizing PCT trends to monitor clinical improvement from bacterial infections. Evidence also suggests that PCT monitoring is cost effective, as long as the test is ordered judiciously. In summary, PCT monitoring represents a promising antimicrobial stewardship strategy to limit exposure to unnecessary antimicrobial therapy. This article is protected by copyright. All rights reserved.

PMID: 29604109 [PubMed - as supplied by publisher]

https://ift.tt/2Eeg61i

Reductions in otitis and other respiratory tract infections following childhood pneumococcal vaccination.

Reductions in otitis and other respiratory tract infections following childhood pneumococcal vaccination.

Acta Paediatr. 2018 Mar 30;:

Authors: Johansson Kostenniemi U, Palm J, Silfverdal SA

Abstract
AIM: Streptococcus pneumoniae commonly causes respiratory tract infections including acute otitis media and pneumonia. In this study, we evaluated the impact of general infant pneumococcal vaccination, introduced in Sweden in 2009, on respiratory tract infections.
METHODS: We studied the incidence of respiratory tract infections and antibiotic consumption in Västerbotten County, Sweden, during 2005-2014 by using the County Council's diagnosis register.
RESULTS: Comparing the pre-vaccination period of 2005-2008 to 2014, the incidences of all-cause acute otitis media decreased significantly in children aged 0-4 and 5-17 years, by 41.5% and 20.9% respectively. In addition, we also noted significant reductions for sinusitis and other upper respiratory tract infections, and some reductions in adults. Antibiotic consumption for upper respiratory tract infections decreased by 37.1%, with the largest decrease occurring in children aged 0-4 years. For pneumonia, the incidence significantly decreased by 28.6% for children aged 0-4 years, with no significant changes in older children or adults.
CONCLUSION: Pneumococcal vaccination was followed by reduced incidence of upper respiratory tract infections and antibiotic consumption in vaccinated children, with some indications of possible herd immunity. For pneumonia a major reduction was noted limited to the youngest children. This article is protected by copyright. All rights reserved.

PMID: 29603797 [PubMed - as supplied by publisher]

https://ift.tt/2H2K0bI

Apigenin enhances the antitumor effects of cetuximab in nasopharyngeal carcinoma by inhibiting EGFR signaling.

Apigenin enhances the antitumor effects of cetuximab in nasopharyngeal carcinoma by inhibiting EGFR signaling.

Biomed Pharmacother. 2018 Mar 28;102:681-688

Authors: Hu WJ, Liu J, Zhong LK, Wang J

Abstract
Nasopharyngeal carcinoma (NPC) is a type of head and neck cancers with poor prognosis. Despite that platinum-based chemotherapy concurrent with radiotherapy have made great achievements for the treatment of NPC, the therapeutic reaction and toxicity varies dramatically among individuals. Apigenin (API), a naturally occurring plant flavone, is considered to have anti-cancer effect. Cetuximab (CET), a well known epidermal growth factor receptor (EGFR) inhibitor, is widely used in various cancers, especially head and neck cancers. The aim of our study was to measure the combination of API and CET for the treatment of NPC in vitro and in vivo. Results demonstrated that combining API and CET could better suppress the viability of the human nasopharyngeal carcinoma cell lines (HONE1 and CNE2) and inhibit the growth of NPC than API or CET used alone. Besides, the combination of API with CET produced greater pro-apoptosis effect. Moreover, the increased G2/M phase arrest caused by CET could be remarkably enhanced by adding API in HONE1 and CNE2 cells. Although, both API and CET could decrease the expressions of p-EGFR, p-Akt, p-STAT3 and Cyclin D1. Combining them produced greater inhibition effect. These results suggested that the combination of API and CET may be a promising therapeutic approach for the treatment of NPC.

PMID: 29604587 [PubMed - as supplied by publisher]

https://ift.tt/2pYdDmf