Head and Neck Diseases by Alexandros G.Sfakianakis: 05/07/18

Δευτέρα 7 Μαΐου 2018

Effects of long-term fertilization practices on heavy metal cadmium accumulation in the surface soil and rice plants of double-cropping rice system in Southern China

Abstract

Fertilizer regime is playing an important role in heavy metal cadmium (Cd) accumulation in paddy soils and crop plant. It is necessary to assess the Cd accumulation in soils and rice (Oryza sativa L.) plants under long-term fertilization managements, and the results which help to assess the environmental and food risk in Southern China. However, the effects of different organic manure and chemical fertilizers on Cd accumulation in soils and rice plant remain unclear under intensively cultivated rice conditions. Therefore, the objective was to explore Cd accumulation in paddy soils and rice plant at mature stage under different long-term fertilization managements in the double-cropping rice system. Cd accumulation in the surface soils (0–20 cm) and rice plant with chemical fertilizer alone (MF), rice straw residue and chemical fertilizer (RF), 30% organic matter and 70% chemical fertilizer (LOM), 60% organic matter and 40% chemical fertilizer (HOM), and without fertilizer input (CK) basis on 32 years long-term fertilization experiment were analyzed. The results showed that the soil total Cd content was increased by 0.296 and 0.351 mg kg⁻¹ and 0.261 and 0.340 mg kg⁻¹ under LOM and HOM treatments at early and late rice mature stages, respectively, compared with the CK treatment. And the soil available Cd content was increased by 0.073 and 0.137 mg kg⁻¹ and 0.102 and 0.160 mg kg⁻¹ under LOM and HOM treatments at early and late rice mature stages, respectively, compared with the CK treatment. The bioconcentration factor of Cd across different parts of rice plant was the highest in root, followed by stem and grain, and the lowest in leaves. At early and late rice mature stages, the root Cd concentration of rice plant was increased by 0.689 and 0.608 mg kg⁻¹ with HOM treatment, the stem Cd concentration of rice plant was increased by 0.666 and 0.758 mg kg⁻¹ with RF treatment, and the leaf and grain Cd concentration of rice plant was increased 0.094 and 0.082 mg kg⁻¹ and 0.086 and 0.083 mg kg⁻¹ with LOM treatment, respectively, compared with the CK treatment. The soil Cd single-factor contaminant index (P_Cd) under different fertilization treatments was as the following HOM > LOM > RF > MF > CK. Meanwhile, the P_Cd with LOM and HOM treatments was higher than that of the MF, RF, and CK treatments, but there is no significant difference between that of MF and RF treatments. Therefore, long-term application of rice straw residue and chemical fertilizer had no obvious effect on the accumulation of Cd in paddy soils and grain, and soil Cd accumulation was increased as application of organic fertilizer.

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Application of a coupled model of photosynthesis and stomatal conductance for estimating plant physiological response to pollution by fine particulate matter (PM 2.5 )

Abstract

Fine particulate matter (PM_2.5) is a current environmental issue that has an impact on the global ecology. Vegetation is a known sink for PM_2.5 deposition but the effects of these particles on plant growth, and specifically on plant photosynthesis by changing their leaf water potential, are still not well understood. This study aimed to determine and characterize possible relationships between PM_2.5 and plant photosynthesis under different PM_2.5 concentrations. Both indoor and outdoor measurements were carried out to evaluate the variation dynamics of net photosynthetic rate and stomatal conductance of four plant species with different leaf characteristics under different PM_2.5 levels. A calibrated coupled model of photosynthesis and stomatal conductance was developed to estimate the relationship between plant photosynthesis and PM_2.5 reliably. Net photosynthetic rate and stomatal conductance declined over time at elevated PM_2.5, with large variations with PM_2.5 concentrations. Using a calibrated model of photosynthesis coupled to stomatal conductance, we show that PM_2.5 can influence plant photosynthesis that primarily occurs through the stomata on leaves. Although the effect of particles on plant photosynthesis was not as high as that of photosynthetically active radiation, temperature, and CO₂ concentration around the leaf, the effect from PM_2.5 can be significant, in particular, in highly polluted atmospheres.

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The ratios of pro-inflammatory to anti-inflammatory cytokines in the serum of chronic periodontitis patients with and without type 2 diabetes and/or smoking habit

Abstract

Objective

This study assessed the impact of chronic periodontitis (CP) and CP associated with type 2 diabetes mellitus (DM) and/or smoking on the serum ratios of pro- to anti-inflammatory cytokines.

Materials and methods

Subjects were assigned into one of the following groups: control (n = 25, non-diabetic non-smokers with no history of periodontitis), CP (n = 26, non-diabetic non-smokers with CP), DMCP (n = 30, non-smokers with DM and CP), SCP (n = 27, non-diabetic smokers with CP), and SDMCP (n = 22, smokers with type 2 DM and CP). Serum levels of 18 cytokines were measured using multiplex immunoassays.

Results

Six ratios of pro-inflammatory to anti-inflammatory cytokines were significantly higher in the CP group than in the control group (p < 0.05). Eleven, seventeen and nine ratios of pro-inflammatory to anti-inflammatory cytokines were significantly higher in the DMCP, SCP and SDMCP groups than in the control group, respectively (p < 0.05). The SCP group presented higher serum ratios of tumor necrosis factor (TNF)-α/interleukin (IL)-4, TNF-α/IL-5, IL-17/IL-13 and IL-6/IL-13 (p < 0.05) than the CP group. Cluster analysis revealed a relevant cluster composed of ten cytokines (IL-17, IL-23, interferon-γ, IL-12, IL-1β, IL-2, IL-21, IL-6, IL-4 and granulocyte-macrophage colony-stimulating factor [GM-CSF]) in the serum of subjects from the DMCP group.

Conclusions

The ratios of pro- to anti-inflammatory cytokines shift to favor a pro-inflammatory status in the serum of patients with CP and even more when CP is associated with one or both risk factors.

Clinical relevance

CP and CP associated with hyperglycemia and/or smoking might contribute to a systemic inflammatory burden and increased risk of systemic complications.

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VISTA expression on tumor-infiltrating inflammatory cells in primary cutaneous melanoma correlates with poor disease-specific survival

Abstract

Adaptive immune responses contribute to the pathogenesis of melanoma by facilitating immune evasion. V-domain Ig suppressor of T-cell activation (VISTA) is a potent negative regulator of T-cell function and is expressed at high levels on monocytes, granulocytes, and macrophages, and at lower densities on T-cell populations within the tumor microenvironment. In this study, 85 primary melanoma specimens were selected from pathology tissue archives and immunohistochemically stained for CD3, PD-1, PD-L1, and VISTA. Pearson's correlation coefficients identified associations in expression between VISTA and myeloid infiltrate (r = 0.28, p = 0.009) and the density of PD-1+ inflammatory cells (r = 0.31, p = 0.005). The presence of VISTA was associated with a significantly worse disease-specific survival in univariate analysis (hazard ratio = 3.57, p = 0.005) and multivariate analysis (hazard ratio = 3.02, p = 0.02). Our findings show that VISTA expression is an independent negative prognostic factor in primary cutaneous melanoma and suggests its potential as an adjuvant immunotherapeutic intervention in the future.

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Glycosphingolipid levels and glucocerebrosidase activity are altered in normal aging of the mouse brain

Publication date: July 2018
Source:Neurobiology of Aging, Volume 67
Author(s): Penelope J. Hallett, Mylene Huebecker, Oeystein R. Brekk, Elizabeth B. Moloney, Emily M. Rocha, David A. Priestman, Frances M. Platt, Ole Isacson
Aging is the predominant risk factor for both genetic and sporadic Parkinson's disease (PD). The majority of PD cases are nonfamilial, and the connection between aging and PD-associated genes is not well understood. Haploinsufficiency of the GBA gene, leading to a reduction in glucocerebrosidase (GCase) activity, is one of the most common genetic risk factors for PD. Furthermore, GCase activity is also reduced in brain regions of sporadic PD patients, with a corresponding accumulation of its glycosphingolipid (GSL) substrates. Recent findings in PD patients and aging control cases, and in human PD patient induced pluripotent stem cell neurons, have shown an age-dependent reduction in GCase activity and an elevation of some GSLs. We therefore asked whether aging-induced changes to both lysosomal and nonlysosomal GCase activity and GSL homeostasis in the brain could also be reflected in other nonhuman mammalian systems. Increases in brain polyubiquitin and the lysosomal-associated membrane protein, LAMP2A, were found in 24-month-old wild-type mice compared to 1.5-month-old mice. A lipidomic analysis was performed on brains of wild-type mice of different strains between 1.5 and 24 months of age. Aging created GSL changes that are reminiscent of sporadic PD. Levels of glucosylceramide, glucosylsphingosine, lactosylceramide, and GM1a were elevated in the brain of aged mice, and levels of complex gangliosides, GD1a, GD1b, and GT1b, were reduced with age. Parallel biochemical analyses revealed a change in lipid metabolism probably mediated by lysosomal hydrolases, with reduced GCase and increased neuraminidase activity. Based on these data, we hypothesize that perturbation of GSL metabolism in the aging brain may precede or may be part of abnormal protein handling and may accelerate PD pathophysiological processes in vulnerable neurons in PD and other age-related neurodegenerative disorders.

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The retina as a window to early dysfunctions of Alzheimer's disease following studies with a 5xFAD mouse model

Publication date: July 2018
Source:Neurobiology of Aging, Volume 67
Author(s): Chiara Criscuolo, Elisa Cerri, Carlotta Fabiani, Simona Capsoni, Antonino Cattaneo, Luciano Domenici
Alzheimer's disease (AD) is a progressive neurodegenerative disease leading to neuronal dysfunctions with cognitive impairment. AD can affect visual pathways and visual cortex and result in various visual changes and problems. However, how early the visual dysfunctions occur in AD is still a matter of discussion. Here, we used electrophysiological techniques to show the presence of early anomalies in AD visual system. To this aim, we used a familial AD (FAD) model, the 5xFAD transgenic mouse, characterized by severe progressive amyloid pathology and cognitive deficits. We investigated the retina and primary visual cortex responsivity together with behavioral assessment of the visual acuity. Visual tests and recordings were conducted at different ages in 5xFAD mice, corresponding to different phases of neurodegeneration and beta amyloid accumulation. We showed that the visual system is impaired in 5xFAD mice. In particular, we found that the inner retina impairment precedes neuronal disorders in other brain areas and cognitive deficits. Thus, noninvasive retinal electrophysiology can provide a support for assessing early visual dysfunctions in AD.

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Bell’s Palsy-Tertiary Ischemia: An Etiological Factor in Residual Facial Palsy

Abstract

The facial nerve is unique among the motor nerves. It has long and tortuous course through the temporal bone and within the Fallopian canal. Because of this it is more prone to paralysis than any other nerve in the body. The most frequent type of facial palsy is Bell's palsy. This is an acute idiopathic lower motor neuron palsy of the facial nerve which does not normally progress and which is most usually unilateral and self limiting,: the majority of cases remit within 4–6 months and nearly always remission is complete by 1 year. In those cases that do not recover it is my contention that this is caused by Either the progression, or after effects, of secondary ischemia: tertiary ischemia. In turn this causes thickening of the facial nerve sheath with a fibrous band or bands forming with resultant strangulation and compression of the nerve, which hampers its recovery. In such cases facial nerve decompression with slitting of the sheath and cutting of any fibrous bands would be the preferred management when allied with aggressive medical therapy.

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Erythematous papular rash after gardening

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2HZ9t9w

Erythematous papular rash after gardening

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2HZ9t9w

Regional therapies for locoregionally advanced and unresectable melanoma

Abstract

Locoregionally advanced and unresectable disease can be seen in up to 10% of melanoma patients. Treatment options for these patients have been evolving most notably over the past few decades and have demonstrated efficacy through multiple intra-arterial as well as intralesional therapies. Isolated limb perfusions and isolated limb infusions have been utilized to treat locoregionally advanced melanoma of the extremity with overall response rates up to 90% in some reports. Intralesional therapies, for in transit metastatic melanoma, such as Bacille Calmette–Guerin, talimogene laherparepvec, and PV-10 (Rose Bengal) have all demonstrated efficacy in the treatment of unresectable cutaneous melanoma. The treatment effect due to intralesional injection has been identified in directly injected lesions as well as in distant uninjected "bystander lesions" with some injectables. This bystander effect is likely an immunologic reaction due to tumor antigen release, antigen-presenting cell uptake, T cell activation and subsequent bystander tumor destruction in uninjected lesions. Treatment options for unresectable melanoma metastases limited to the liver include isolated hepatic perfusion, which can now be performed through a minimally invasive approach known as percutaneous hepatic perfusion. These intra-arterial and intralesional regional therapies offer a variety of effective treatment modalities for unresectable disease and may potentially be combined with systemic treatments, such as immunotherapy, in the future treatment of locoregionally advanced melanoma.

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To Evaluate the Pre and Post Shunt Sensorineural Hearing Loss in Hydrocephalus Patients

Abstract

Hydrocephalus means watery head and defined as disturbance of formation, flow, or absorption of cerebrospinal fluid. The clinical presentation of hydrocephalus includes hearing loss especially sensorineural hearing loss (SNHL). Ventriculoperitoneal (VP) shunting is the most commonly performed procedure in these patients. Pure tone audiogram, impedence and BAEPs, were done for preoperative hearing assessment in 20 hydrocephalus patients. Out of 20 patients, 12 cases (60%) had SNHL while, rest 8 (40%) patients had mixed hearing loss. Post VP shunting hearing improvement was observed in 14 patients (70%) whereas it worsened in 30% of patients. The result is even better if shunt is placed at early age.

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PD-L1 receptor expression in vulvar carcinomas is HPV-independent

Abstract

PD-L1 (programmed cell death 1 ligand) is expressed on many cancer cells and prevents tumor cell death by blocking T cell activity. PD-L1 overexpression has been reported in squamous cell carcinomas of head and neck and lung cancer. To better understand the role of PD-L1 expression in vulvar cancer, we analyzed PD-L1 expression by immunohistochemistry in 55 well-characterized squamous cell carcinomas of vulva. PD-L1 was found in 72.7% of tumors. 27.3% of vulvar carcinomas showed moderate or strong PD-L1 expression. PD-L1 expression was correlated with low tumor stage (p < 0.05). There was no association to other clinicopathological parameters, HPV status, and overall survival of vulvar carcinoma patients. In conclusion, PD-L1 overexpression is detectable in a substantial proportion of vulvar carcinomas in all stages independent of HPV and may be a suitable therapeutic target in these cancers.

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Comparison of Therapeutic Triiodothyronine Versus Metoprolol in the Treatment of Myocardial Infarction in Rats

Thyroid, Ahead of Print.

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Organic solvent removal by pervaporation membrane technology: experimental and simulation

Abstract

This work presents purification of cyclohexane using polydimethylsiloxane (PDMS) membranes in pervaporation (PV) process. The PDMS is a rubbery polymer and appropriate as membrane material for purification of cyclohexane. PV which is a low-energy separation process was chosen for purification of cyclohexane due to its superior advantages compared to other processes. Effect of feed concentration on separation factor was investigated in order to optimize the process. It was indicated that dehydration of 80 wt% cyclohexane mixture at a temperature of 300 K and a vacuum pressure of 10 mmHg could be effectively achieved and high separation factor of 2500 was obtained. Furthermore, a two-dimensional mechanistic model was proposed for predicting mass transfer of cyclohexane in the process. The mechanistic model accounts for mass transfer of cyclohexane across the membrane, and concentration distribution of cyclohexane was determined. It was revealed that the most mass transfer flux of cyclohexane occur at the region near the inlet of feed channel, while the flux at the upper side of the module reaches zero value due to the effect of velocity distribution on the convective mass transfer of cyclohexane.

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Leachate phytotoxicity of flue gas desulfurization residues from coal-fired power plant

Abstract

Flue gas desulfurization residues (FGDR) are the main solid wastes produced in coal-fired power plants that can be reused as alternative materials for civil and agricultural applications. However, the pollutants contained in the FGDR might contaminate the local environment, hindering their material reuse. In this study, the physical-chemical characteristics, leaching, and phytotoxicity (Triticum aestivum) of the material were investigated. The FGDR samples were obtained from three pulverized coal-fired power plants in China. Multivariate statistical analyses were used to consider the contributions of the leaching components to the germination index of wheat seeds in the FGDR leachates. The FGDR contained a high percentage of amorphous mass. The ranges of selected metals and micronutrients in the FGDR are As (31.5–63.0 mg/kg), B (574–3090 mg/kg), Ba (2799–3073 mg/kg), Cr (up to 4.73 mg/kg), Cu (0.29–1.38 mg/kg), Mn (136–370 mg/kg), Ni (9.93–22.9 mg/kg), Pb (1.29–7.29 mg/kg), Sr (886–1706 mg/kg), and Zn (335–458 mg/kg). The leaching toxicity of the FGDR leachates was lower than the regulatory limit of the identification standards for hazardous waste, indicating that the FGDR are non-hazardous materials. Metals, especially Ba, Cu, Fe, and Pb, as well as As and B, in the leachate had inhibitory effects on seed germination than the other constituents. The results in this study showed that the leachate phytotoxicity resulting from FGDR could be evaluated before the utilization of FGDR, giving crucial information for the adaptation of these alternative materials.

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To Evaluate the Pre and Post Shunt Sensorineural Hearing Loss in Hydrocephalus Patients

Abstract

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A mechanism of interleukin-25 production from airway epithelial cells induced by Japanese cedar pollen

Publication date: Available online 7 May 2018
Source:Clinical Immunology
Author(s): Hideaki Kouzaki, Hirotaka Kikuoka, Koji Matsumoto, Tomohisa Kato, Ichiro Tojima, Shino Shimizu, Takeshi Shimizu
IL-25 likely has vital roles in initiating and activating type-2 immune responses in AR. We hypothesized that the molecules produced IL-25 by allergen-producing organisms such as JC is involved in the pathogenesis of AR. Participants included 13 patients with Japanese cedar pollinosis and 10 HCs. We measured the IL-25 protein concentration in nasal secretions and in culture supernatants of PNECs. NHBE cells were stimulated with pharmacological and immunological agents and JC. The IL-25 concentration in nasal secretions was significantly higher in patients with Japanese cedar pollinosis than in HCs. JC stimulated IL-25 production from PNECs. TNF-α, IL-4, and IL-13 significantly enhanced JC-induced IL-25 production; their activation by serine proteases was sufficient to enhance IL-25 production. Furthermore, the NADPH oxidase activity, including JC enhanced IL-25 production. A better understanding of JC-induced IL-25 production by epithelial cells may allow the development of novel therapeutic and preventive strategies for Japanese cedar pollinosis.

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Maternal T-cell engraftment impedes with diagnosis of a SCID-ADA patient

Publication date: Available online 7 May 2018
Source:Clinical Immunology
Author(s): Arnalda Lanfranchi, Vassilios Lougaris, Lucia Dora Notarangelo, Elena Soncini, Marta Comini, Alessandra Beghin, Federica Bolda, Alessandro Montanelli, Luisa Imberti, Fulvio Porta
We describe the case of a child affected by severe combined immunodeficiency (SCID) with adenosine deaminase (ADA) deficiency showing a maternal T-cell engraftment, a finding that has never been reported before. The presence of engrafted maternal T cells was misleading. Although ADA enzymatic levels were suggestive of ADA-SCID, the child did not present the classical signs of ADA deficiency; therefore, the initial diagnosis was of a conventional SCID. However, ADA toxic metabolites and molecular characterization confirmed this diagnosis. Polyethylene glycol-modified bovine (PEG) ADA therapy progressively decreased the number of maternal engrafted T cells. The child was grafted with full bone marrow from a matched unrelated donor, after a reduced conditioning regimen, and the result was the complete immunological reconstitution.

https://ift.tt/2I575KG

A mechanism of interleukin-25 production from airway epithelial cells induced by Japanese cedar pollen

Maternal T-cell engraftment impedes with diagnosis of a SCID-ADA patient

Oleanolic acid protects against cognitive decline and neuroinflammation-mediated neurotoxicity by blocking secretory phospholipase A2 IIA-activated calcium signals

Publication date: July 2018
Source:Molecular Immunology, Volume 99
Author(s): Leguo Zhang, Ruixue Xia, Jianpu Jia, Lixuan Wang, Kuo Li, Yanhua Li, Junling Zhang
Neuroinflammation causes neurotoxic injury and underlies the pathogenesis of neurodegenerative disorders including Alzheimer's disease (AD). Astrocytes are the predominant immunoregulatory cells in AD. Oleanolic acid (OA) is a promising anti-inflammatory therapeutic agent that can ameliorate cerebral damage in ischemic environments, but its role in AD remains poorly elucidated. Here, preconditioning with OA inhibited the transcription and secretion of inflammatory cytokines IL-6, TNF-α, and IL-1β in amyloid-beta peptide (Aβ)-activated astrocytes. Moreover, OA ameliorated primary neuron death triggered by incubation in conditioned medium from Aβ-treated astrocytes. Furthermore, OA also suppressed Aβ-induced expression and production of group IIA secretory phospholipase A2 (sPLA2-IIA) in astrocytes. Supernatants supplemented with exogenous sPLA2-IIA reversed the protective role of OA against astrocyte activation-mediated neurotoxicity by suppressing cell viability and increasing LDH release, apoptosis, the contents of neurotoxic mediator arachidonic acid, and prostaglandin D2. Simultaneously, treatment with sPLA2 inhibitor aristolochic acid also counteracted neurotoxicity induced by Aβ-activated astrocytes through increasing cell viability, inhibiting cell apoptosis, and reducing the releases of arachidonic acid and prostaglandin D2. Additionally, OA restrained Ca²⁺ influx in neurons after incubation with supernatants from Aβ-activated astrocytes, which was abrogated by adding sPLA2-IIA. Activating Ca²⁺ signaling with BayK, an L-type Ca2 + channel agonist, reversed the beneficial role of OA against neurotoxicity induced by astrocyte activation-mediated inflammatory response. OA also ameliorated cognitive deficits in an adolescent rat model of Aβ-evoked AD. These findings confirm that OA abrogates neuroinflammation and subsequent neurotoxicity induced by conditioned media from Aβ-activated astrocytes in sPLA2-IIA mediated-calcium signals. Therefore, OA may protect neurons from injury caused by neighboring astrocyte activation in AD, indicating a promising therapeutic strategy against AD.

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Immune-modulation of two BATF3 paralogues in rainbow trout Oncorhynchus mykiss

Publication date: July 2018
Source:Molecular Immunology, Volume 99
Author(s): Jun Wang, Min Liu, Yang Wu, Sohye Yoon, Abdo Alnabulsi, Fuguo Liu, Clara Fernández-Álvarez, Tiehui Wang, Jason W. Holland, Chris J. Secombes, Jun Zou
Basic leucine zipper transcription factor ATF-like (BATF) -3 is a member of the activator protein 1 (AP‑1) family of transcription factors and is known to play a vital role in regulating differentiation of antigen-presenting cells in mammals. In this study, two BATF3 homologues (termed BATF3a and BATF3b) have been identified in rainbow trout (Oncorhynchus mykiss). Both genes were constitutively expressed in tissues, with particularly high levels of BATF3a in spleen, liver, pyloric caecae and head kidney. BATF3a was also more highly induced by PAMPs and cytokines in cultured cells, with type II IFN a particularly potent inducer. In rIL-4/13 pre-stimulated cells, the viral PAMPS polyI:C and R848 had the most pronounced effect on BATF3 expression. BATF3 expression could also be modulated in vivo, following infection with Yersinia ruckeri, a bacterial pathogen causing redmouth disease in salmonids, or with the rhabdovirus IHNV. The results suggest that BATF3 may be functionally conserved in regulating the differentiation and activation of immune cells in lower vertebrates and could be explored as a potential marker for comparative investigation of leucocyte lineage commitment across the vertebrate phyla.

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Immune-modulation of two BATF3 paralogues in rainbow trout Oncorhynchus mykiss

Advanced oxidation processes on doxycycline degradation: monitoring of antimicrobial activity and toxicity

Abstract

Advanced oxidation processes (AOPs) have been highly efficient in degrading contaminants of emerging concern (CEC). This study investigated the efficiency of photolysis, peroxidation, photoperoxidation, and ozonation at different pH values to degrade doxycycline (DC) in three aqueous matrices: fountain, tap, and ultrapure water. More than 99.6% of DC degradation resulted from the UV/H₂O₂ and ozonation processes. Also, to evaluate the toxicity of the original solution and throughout the degradation time, antimicrobial activity tests were conducted using Gram-positive (Bacillus subtilis) and Gram-negative (Escherichia coli) bacteria, and acute toxicity test using the bioluminescent marine bacterium (Vibrio fischeri). Antimicrobial activity reduced as the drug degradation increased in UV/H₂O₂ and ozonation processes, wherein the first process only 6 min was required to reduce 100% of both bacteria activity. In ozonation, 27.7 mg L⁻¹ of ozone was responsible for reducing 100% of the antimicrobial activity. When applied the photoperoxidation process, an increase in the toxicity occurred as the high levels of degradation were achieved; it means that toxic intermediates were formed. The ozonated solutions did not present toxicity.

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Efficiency analysis of the electrocoagulation and electroflotation treatment of poultry slaughterhouse wastewater using aluminum and graphite anodes

Abstract

The application of electrocoagulation (EC) and electroflotation (EF) was investigated for the treatment of poultry slaughterhouse wastewater in a bench scale unit cell electrolyzer with different EC-to-EF ratios at current densities of 3, 9, and 15 mA cm⁻². The EC-to-EF ratio was controlled by current reversal using aluminum and graphite electrodes. The electrochemical treatment showed satisfactory removal efficiencies for Al coagulant loads greater than 51.8 mg L⁻¹. The 4/5 EC to EF ratio (69.1 mg L⁻¹ Al and 32.2 NmL L⁻¹ additional EF gas) and 3/5 (51.8 mg L⁻¹ Al/64 NmL L⁻¹ additional EF gas) presented the best results for the removal of COD (76–85%), color (93–99%), and turbidity (95–99%), with the additional benefit of reducing the electrode consumption and sludge disposal costs proportionally to the EC-to-EF ratio. The effects of the EC-to-EF ratio and the current density on efficiency of the electrochemical treatment for the removal of COD, apparent color, turbidity, TSS, TSD, and NH₃-N were discussed in the light of the physicochemical and electrochemical processes underlying the removal mechanism for each parameter. In particular, the blow-off mechanism seems to play an important role in the NH₃-N removal, whereas indirect electrooxidation mechanism accounts for a fraction of the soluble COD removal for the electrodes configuration used in the treatment.

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Pinna synthetic mold for otoplasty techniques application

Abstract Introduction The ear deformity Tanzer type V, also known as prominent ears, is the most common genetic defect of the pinna. The surgery designed for its correction is known as otoplasty. This esthetic surgery can be performed using different techniques, which requires great skill of its operator. Objective The purpose of this work is the development of a new tool for otoplasty techniques training, aimed on the possibility to minimize errors during the otoplasty. Methods Synthetic molds of the external ear from patients with Tanzer type V deformity were made, using silicone material and rayon. Results The main procedures of otoplasty could be performed in the molds made of silicone and rayon with a good esthetic result. Conclusion The elaborated molds had identical size and shape of a human ear and could be positioned in the same shape of the patient ears. Thus, the synthetic molds were presented as promising simulation tools for the training and surgical enhancement of otoplasty, especially for doctors beginners.

Resumo Introdução A deformidade da orelha tipo V de Tanzer, também conhecida como orelhas proeminentes, é o defeito genético mais comum da aurícula. A cirurgia criada para sua correção é conhecida como otoplastia. Essa cirurgia estética pode ser feita com diferentes técnicas, o que requer grande habilidade de seu operador. Objetivo O objetivo desse trabalho é o desenvolvimento de uma nova ferramenta para o treinamento de técnicas de otoplastia, com o objetivo de minimizar erros durante a otoplastia. Método Foram feitos moldes sintéticos da orelha externa de pacientes com deformidade tipo V de Tanzer com material de silicone e rayon. Resultados Os principais procedimentos de otoplastia foram feitos nos moldes de silicone e rayon com um bom resultado estético. Conclusão Os moldes elaborados tinham tamanho e forma idênticos aos de uma orelha humana e puderam ser posicionados no mesmo formato das orelhas dos pacientes. Assim, os moldes sintéticos foram apresentados como ferramentas de simulação promissoras para o treinamento e aperfeiçoamento cirúrgico da otoplastia, especialmente para médicos iniciantes.

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Role of preoperative air-bone gap in tinnitus outcome after tympanoplasty for chronic otitis media with tinnitus

Abstract Introduction Previous reports indicated that middle ear surgery might partially improve tinnitus after surgery. However, until now, no influencing factor has been determined for tinnitus outcome after middle ear surgery. Objective The purpose of this study was to investigate the association between preoperative air-bone gap and tinnitus outcome after tympanoplasty type I. Methods Seventy-five patients with tinnitus who had more than 6 months of symptoms of chronic otitis media on the ipsilateral side that were refractory to medical treatment were included in this study. All patients were evaluated through otoendoscopy, pure tone/speech audiometer, questionnaire survey using the visual analog scale and the tinnitus handicap inventory for tinnitus symptoms before and 6 months after tympanoplasty. The influence of preoperative bone conduction, preoperative air-bone-gap, and postoperative air-bone-gap on tinnitus outcome after the operation was investigated. Results and conclusion The patients were divided into two groups based on preoperative bone conduction of less than 25 dB (n = 50) or more than 25 dB (n = 25). The postoperative improvement of tinnitus in both groups showed statistical significance. Patients whose preoperative air-bone-gap was less than 15 dB showed no improvement in postoperative tinnitus using the visual analog scale (p = 0.889) and the tinnitus handicap inventory (p = 0.802). However, patients whose preoperative air-bone-gap was more than 15 dB showed statistically significant improvement in postoperative tinnitus using the visual analog scale (p < 0.01) and the tinnitus handicap inventory (p = 0.016). Postoperative change in tinnitus showed significance compared with preoperative tinnitus using visual analog scale (p = 0.006). However, the correlation between reduction in the visual analog scale score and air-bone-gap (p = 0.202) or between reduction in tinnitus handicap inventory score and air-bone-gap (p = 0.290) was not significant. We suggest that the preoperative air-bone-gap can be a predictor of tinnitus outcome after tympanoplasty in chronic otitis media with tinnitus.

Resumo Introdução Relatos anteriores indicaram que a cirurgia no ouvido médio pode melhorar parcialmente o zumbido após a cirurgia. No entanto, até agora, nenhum fator influenciador foi determinado para o resultado do zumbido após cirurgia de ouvido médio. Objetivo O objetivo deste estudo foi investigar a associação entre o gap aéreo-ósseo pré-operatório e o desfecho do zumbido após timpanoplastia do tipo I. Método Setenta e cinco pacientes com zumbido, com mais de 6 meses de sintomas de otite média crônica no lado ipsilateral que eram refratários ao tratamento médico foram incluídos nesse estudo. Todos os pacientes foram avaliados através de otoendoscopia, audiometria tonal/vocal, questionário utilizando a escala visual analógica e o questionário tinnitus handicap inventory para sintomas de zumbido antes e 6 meses após a timpanoplastia. A influência da condução óssea pré-operatória, gap aéreo-ósseo pré-operatório e pós-operatório sobre o desfecho do zumbido após a operação foi analisada. Resultados e conclusão Os pacientes foram divididos em dois grupos com base na condução óssea pré-operatória de menos de 25 dB (n = 50) ou mais de 25 dB (n = 25). A melhora do zumbido pós-operatória em ambos os grupos mostrou significância estatística. Pacientes com gap aéreo-ósseo pré-operatório inferior a 15 dB não apresentaram melhora no zumbido pós-operatório utilizando a escala visual analógica (p = 0,889) e o tinnitus handicap inventory (p = 0,802). Entretanto, pacientes com gap aéreo-ósseo pré-operatório maior do que 15 dB apresentaram melhoria estatisticamente significante no zumbido pós-operatório com a escala visual analógica (p < 0,01) e o tinnitus handicap inventory (p = 0,016). A mudança pós-operatória no zumbido mostrou significância em comparação com o zumbido pré-operatório usando a escala visual analógica (p = 0,006). No entanto, a correlação entre a redução no escore da escala visual analógica e gap aéreo-ósseo (p = 0,202) ou entre a redução no escore do tinnitus handicap inventory e gapaéreo-ósseo (p = 0,290) não foi significativa. Sugerimos que o gapaéreo-ósseo pré-operatório possa ser um preditor de desfecho do zumbido após timpanoplastia em otite média crônica com zumbido.

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Sleep disorders in children with moderate to severe persistent allergic rhinitis

Abstract Introduction Allergic rhinitis is associated with several complications, including sleep disorders. The Children's Sleep Habits Questionnaire has been recently translated and validated in Portuguese for the evaluation of sleep disorders in children. Objective To assess sleep disorders in children with moderate to severe persistent allergic rhinitis and to correlate the findings with disease severity markers. Methods We evaluated 167 children (4-10 years), 112 with allergic rhinitis and 55 controls. Parents/guardians of the children answered the Children's Sleep Habits Questionnaire, consisting of 33 questions divided into eight subscales, which refers to the previous week. Patients with rhinitis were also evaluated regarding the score of nasal and extra-nasal symptoms related to the previous week and the peak nasal inspiratory flow. Results There were no significant differences between groups of different age. All patients with rhinitis were being treated with nasal topical corticosteroids. The total Children's Sleep Habits Questionnaire score was significantly higher among children with rhinitis than in controls (median 48 vs. 43, p < 0.001). Significantly higher values were also observed for the parasomnia (9 vs. 8), respiratory disorders (4 vs. 3) and daytime sleepiness (14 vs. 12) subscales. Among the patients with rhinitis, no significant correlation was observed between the total Children's Sleep Habits Questionnaire score and disease activity variables, but moderate correlations were observed for the respiratory distress subscale vs. nasal symptom score (r = 0.32) and vs. extra-nasal symptom score (r = 0.32). Conclusion Children with moderate to severe persistent allergic rhinitis, even when submitted to regular treatment, have a higher frequency of sleep disorders than controls, particularly concerning nocturnal breathing disorders, daytime sleepiness, and parasomnias. The intensity of sleep disorders found in some subscales was correlated with objective markers of allergic rhinitis severity.

Resumo Introdução A rinite alérgica está associada a diversas complicações, como, por exemplo, os distúrbios do sono. O Children's Sleep Habits Questionnaire é um questionário para avaliação dos distúrbios do sono em crianças, recentemente traduzido e validado para o português. Objetivos Avaliar distúrbios do sono em crianças com rinite alérgica persistente moderada/grave e correlacionar os achados com marcadores de gravidade da doença. Método Foram avaliadas 167 crianças (4-10 anos), 112 com rinite alérgica e 55 controles. Todos os responsáveis pelas crianças responderam o questionário, composto por 33 questões dividas em oito subescalas e referentes à última semana. Os pacientes com rinite foram avaliados também pelo escore de sintomas nasais e extranasais referentes à última semana e pelo pico de fluxo inspiratório nasal. Resultados Não houve diferenças significantes entre os grupos com relação à idade. Todos os pacientes com rinite eram tratados com corticosteroide tópico nasal. O escore total do questionário foi significantemente maior entre os com rinite do que entre os controles (mediana 48 vs. 43; p < 0,001). Valores significantemente maiores também foram observados para as subescalas de parassonias (9 vs. 8), distúrbios respiratórios (4 vs. 3) e sonolência diurna (14 vs. 12). Entre os pacientes com rinite não foi observada correlação significante entre o escore total do questionário e as variáveis de atividade da doença, porém correlações moderadas foram observadas para a subescala de distúrbios respiratórios vs. escore de sintomas nasais (r = 0,32) e vs. escore de sintomas extranasais (r = 0,32). Conclusões Crianças com rinite alérgica persistente moderada-grave, mesmo em tratamento regular, apresentam maior frequência de distúrbios do sono do que controles, particularmente em relação aos distúrbios respiratórios noturnos, à sonolência diurna e às parassonias. A intensidade das alterações do sono encontradas em algumas subescalas se correlacionou com marcadores objetivos de gravidade da rinite alérgica.

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The effect of different nasal irrigation solutions following septoplasty and concha radiofrequency: a prospective randomized study

Abstract Introduction Nasal irrigation solutions are widely used following endonasal surgery. These irrigation solutions remove infective debris and crusts, reducing the probability of synechia formation, and accelerate mucosal healing. Objective The aim of the present study was to compare the effects of nasal irrigation solutions with different contents following septoplasty and concha radiofrequency. Methods The present study was a prospective, randomized, controlled simple blind study of 120 patients who underwent septoplasty and bilateral concha radiofrequency. Patients were divided into four groups according to the nasal irrigation solution used: tap water, buffered isotonic saline, saline with xylitol, and hypertonic sea water. Patients were examined on the 7th and 15th postoperative days. A saccharine test was applied to determine mucociliary activity preoperatively and on the 7th and 15th postoperative days. Patients were asked about drying and obstruction using a 10 cm visual analog scale. In addition, patients were examined to determine the crusting score. Results There was no significant difference found in the preoperative and 7th and 15th postoperative days' mucociliary clearance times among the four groups. The crusting score was found to be significantly lower in the hypertonic sea water group (p < 0.001). Drying and obstruction on the 7th and 15th postoperative days were found to be significantly more comfortable in the hypertonic sea water group (p < 0.001). Conclusion Hypertonic sea water is the recommended irrigation solution, as it is associated with less crusting, drying, and obstruction in the nose for the postoperative period following septoplasty and concha radiofrequency.

Resumo Introdução Soluções para irrigação nasal são amplamente usadas após cirurgias endonasais. Essas soluções removem os resíduos e crostas, reduzem a probabilidade de formação de sinéquias e aceleram a cicatrização da mucosa. Objetivo O objetivo do presente estudo foi comparar os efeitos das soluçoes para irrigaçao nasal com diferentes conteudos apos septoplastia e turbinoplastia com radiofrequencia. Método O presente estudo foi um estudo cego simples, randomizado, controlado e prospectivo de 120 pacientes submetidos a septoplastia e turbinoplastia bilateral com radiofrequencia. Os pacientes foram divididos em quatro grupos de acordo com a soluçao nasal utilizada: agua da torneira, soluçao salina isotonica tamponada, soluçao salina com xilitol e agua do mar hipertonica. Os pacientes foram examinados no 7° e 15° dias do pos-operatorio. O teste de sacarina foi utilizado para determinar a atividade mucociliar pre-operatoria e no 7° e 15° dias do pos-operatorio. Os pacientes foram questionados sobre a sensaçao de secura e obstruçao nasais utilizando uma escala visual analógica de 10 cm. Alem disso, os pacientes foram examinados para determinar o escore em relaçao a crostas. Resultados Não houve diferença significativa entre o pré-operatório e o sétimo e 15° dias do pós-operatório dos tempos de clearance mucociliar entre os quatro grupos. Verificou-se que o escore em relação a crostas foi significativamente menor no grupo que usou água do mar hipertônica (p < 0,001). As sensações de secura e obstrução nasais no sétimo e 15° dias do pós-operatório mostraram-se significativamente mais confortáveis no grupo água do mar hipertônica (p < 0,001). Conclusão A água de mar hipertônica é a solução de irrigação recomendada, pois está associada a menor incidência de crostas, secura e obstrução nasais no pós-operatório de cirurgia de septoplastia e das conchas nasais com radiofrequência.

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Influence of dietary and physical activity restriction on pediatric adenotonsillectomy postoperative care in Brazil: a randomized clinical trial

Abstract Introduction Although culturally food and physical activity restriction are part of the routine postoperative care of many Brazilian surgeons, current evidences from other countries support no such recommendations. Objective To determine whether dietary and physical restriction effectively lead to a decrease on postoperative complications of adenotonsillectomy in children when compared to no restriction. Methods We have designed a randomized clinical trial comparing two intervention: no specific counseling on diet or activity (Group A), and restriction recommendations on diet and physical activities (Group B). Caregivers completed a questionnaire on observed pain, diet and activity patterns, and medications administered. Parameters were compared at the 3rd and at the 7th postoperative day between intervention groups. Results We have enrolled a total of 95 patients, 50 in Group A and 45 in Group B. Fourteen patients were lost to follow up. Eventually, 41 patients in group A and 40 in Group B were available for final analysis. Mean age in months (A = 79.5; SD = 33.9/B = 81.1; SD = 32.6) and sex (A = 58% male; B = 64.4% male) were equivalent between groups. Pain, evaluated through visual analog scale in the 3rd (A = 2.0; IQR 1-6/B = 4.5; IQR 2-6; p = 0.18) and in the 7th (A = 1.0; IQR 1.0-4.5/B = 2.0; IQR 1.0-4.7; p = 0.29) postoperative days, was not different between groups, as was the amount of analgesics administered. Dietary and physical activity patterns also showed no statistically significant differences between groups. Conclusion Dietary and activity restriction after adenotonsillectomy does not seem to affect patients' recovery. Such information may impact considerably on the social aspects that involve a tonsillectomy, reducing the working days lost by parents and accelerating the return of children to school.

Resumo Introdução Embora culturalmente as restrições dietéticas e de atividade física sejam parte do cuidado pós-operatório de rotina de muitos cirurgiões brasileiros, evidências atuais de outros países não apoiam tais recomendações. Objetivo Determinar se as restrições dietéticas e físicas efetivamente levam a uma diminuição das complicações pós-operatórias da adenotonsilectomia em crianças quando comparadas com cuidados sem restrição. Método Realizamos um ensaio clínico randomizado comparando duas intervenções: nenhum aconselhamento específico sobre dieta ou atividade física (Grupo A) e recomendações de restrições dietéticas e de atividades físicas (Grupo B). Os cuidadores preencheram um questionário sobre a dor, a dieta e os padrões de atividade observados, e os medicamentos administrados. Os parâmetros foram comparados no 3° e no 7° dia do pós-operatório entre os grupos de intervenção. Resultados Avaliamos 95 pacientes, 50 no Grupo A e 45 no Grupo B; 14 foram perdidos no seguimento. Subsequentemente, 41 do grupo A e 40 do grupo B estavam disponíveis para a análise final. A média de idade em meses (A = 79,5, DP = 33,9/B = 81,1, DP = 32,6) e sexo (A = 58% do sexo masculino, B = 64,4% do sexo masculino) foram equivalentes entre os grupos. A dor, avaliada através da escala visual analógica no terceiro (A = 2,0; IIQ: 1-6/B = 4,5; IIR 2-6; p = 0,18) e no sétimo (A = 1,0; IIQ 1,0-4,5/B = 2,0; IIQR 1,0-4,7; p = 0,29) dia do pós-operatório, não foi diferente entre os grupos, assim como a quantidade de analgésicos administrados. Os padrões dietéticos e de atividade física também não mostraram diferenças estatisticamente significantes entre os grupos. Conclusão A restrição dietética e de atividade física após a adenotonsilectomia não parece afetar a recuperação dos pacientes. Tal informação pode ter um impacto considerável nos aspectos sociais que envolvem uma tonsilectomia, reduzir os dias de trabalho perdidos pelos pais e acelerar o retorno das crianças à escola.

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Rapid maxillary expansion in mouth breathers: a short-term skeletal and soft-tissue effect on the nose

Abstract Introduction Rapid maxillary expansion can change the form and function of the nose. The skeletal and soft tissue changes can influence the esthetics and the stability of the results obtained by the procedure. Objective The aim of this retrospective study was to evaluate the short-term effects of rapid maxillary expansion on the skeletal and soft tissue structures of the nose, in mouth-breathing patients, using a reliable and reproducible, but simple methodology, with the aid of computed tomography. Methods A total of 55 mouth-breathing patients with maxillary hypoplasia were assessed and were divided into an experimental group treated with rapid maxillary expansion(39 patients, 23 of which were male and 16 female, with an average age of 9.7 years and a standard deviation of 2.28, ranging from 6.5 to 14.7 years) and a control group (16 patients, 9 of which were male and 7 female, with an average age of 8.8 years, standard deviation of 2.17, ranging from 5.11 to 13.7 years). The patients of the experimental group were submitted to multislice computed tomography examinations at two different points in time: (T1) pre-rapid maxillary expansion and (T2) three months after the procedure. The control group underwent to the same exams at the same intervals of time. Four skeletal and soft tissue variables were assessed, comparing the results of T1 and T2. Results There was in the experimental group a significant increases in all the skeletal and soft tissue variables (p < 0.05) but no significant alteration was found in the control group. When comparing the experimental group and the control group, the most important change occurred in the width of the pyriform aperture (p < 0.001). Conclusion Rapid maxillary expansion is capable of altering the shape and function of the nose, promoting alterations in skeletal and soft tissue structures. This kind of study may, in the future, permit the proper planning of esthetic procedures at the tip and base of the nose and also the performance of objective measurements in early or late surgical outcomes.

Resumo Introdução A expansão rápida da maxila pode alterar a forma e a função do nariz. As alterações do esqueleto e dos tecidos moles podem influenciar a estética e a estabilidade dos resultados obtidos através deste procedimento. Objetivo Avaliar, em curto prazo, os efeitos da expansão rápida da maxila sobre as estruturas esqueléticas e tegumentares do nariz em pacientes respiradores orais por meio de uma metodologia confiável e reprodutível, porém simples, com a ajuda da tomografia computadorizada. Método Foram avaliados 55 pacientes respiradores orais com hipoplasia maxilar que foram divididos em grupo experimental tratado com expansão rápida da maxila (39, 23 do sexo masculino e 16 do feminino, com média de 9,7 anos e desvio padrão de 2,28, variação de 6,5 a 14,7 anos) e um grupo controle (16 pacientes, nove do sexo masculino e sete do feminino, com média de 8,8 anos, desvio padrão de 2,17, variação de 5,11-13,7 anos). Os pacientes do grupo experimental foram submetidos a exames de tomografia computadorizada multislice em dois tempos distintos: (T1) pré-expansão rápida da maxila e (T2) três meses após o procedimento. O grupo controle foi submetido aos mesmos exames nos mesmos intervalos de tempo. Foram avaliadas quatro variáveis esqueléticas e quatro tegumentares comparando-se os resultados de T1 e T2. Resultados O grupo experimental apresentou aumentos significativos em todas as variáveis esqueléticas e tegumentares (p < 0,05), mas não houve alterações significativas no grupo controle. Ao compararem-se o grupo experimental e o grupo controle, foi observado que a alteração mais importante ocorreu na largura da abertura piriforme (p < 0,001). Conclusão A expansão rápida da maxila é capaz de alterar a forma e a função do nariz, promove alterações nas estruturas esqueléticas e dos tecidos moles. Esse tipo de estudo pode, no futuro, permitir o planejamento adequado de procedimentos estéticos na ponta e base do nariz e também a feitura de medidas objetivas em resultados cirúrgicos iniciais ou tardios.

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Digital design of functional surgery for odontogenic cyst intruding into maxillary sinus

Abstract Introduction Traditional Caldwell-Luc approach needs modifications for odontogenic cysts intruding into the maxillary sinus, to preserve sinus mucosa and bony contour. Recently, digital technology has been widely applied to the field of maxillofacial surgery, guiding the surgical plan and improving its accuracy. Objective This study attempted to present and evaluate the functional surgery of odontogenic cysts intruding into the maxillary sinus using a computer-assisted pre-surgical design. Methods Consecutive patients with odontogenic cysts intruding into the posterior part of the maxillary sinus were enrolled. Method I "Bony wall reimplantation method" was performed for large lesions exceeding the zygomatic alveolar crest but without apparent bone destruction of the anterior wall of the sinus, while Method II "bone removal method" was more convenient for small lesions near to the zygomatic alveolar crest. The gap was filled with a pedicled buccal fat pad after lesion removal and all cases were without inferior meatal antrostomy. Results A total of 45 cases were included in the study. 22 were operated using method I while 23 were operated with method II. Operations were completed in 20 min. Pain disappeared in 3.62 days on average, and swelling 6.47 days. Nasal bleeding occurred in 8 patients lasting 1-3 days. Suppurative inflammation was observed in 1 patient, and infection occurred after bone reposition. Other repositioned free bony wall was without resorption in CT images. Conclusions Sinus mucosa and bony wall should be conserved. Preoperative digital design can guide osteotomy effectively during the surgery. Bone reposition is not suitable for suppurative inflammation. The pedicled buccal fat pad is enough for drainage and inferior meatal antrostomy is not necessary.

Resumo Introdução A abordagem tradicional de Caldwell-Luc precisa de modificações para os cistos odontogênicos que se introduzem no seio maxilar, para preservar a mucosa sinusal e o contorno ósseo. Recentemente, a tecnologia digital tem sido amplamente aplicada ao campo da cirurgia maxilofacial, orienta o plano cirúrgico e melhora sua precisão. Objetivo Esse estudo teve como objetivo apresentar e avaliar a cirurgia funcional de cistos odontogênicos intrusivos no seio maxilar utilizando um desenho pré-cirúrgico assistido por computador. Método Foram recrutados pacientes consecutivos com cistos odontogênicos intrusivos na parte posterior do seio maxilar. O método I, "método de reimplante de parede óssea", foi feito em lesões grandes que excediam a crista zigomático-alveolar, mas sem destruição óssea aparente da parede anterior do seio, enquanto o método II, "método de remoção óssea", foi mais conveniente para pequenas lesões próximas à crista zigomático-alveolar. O espaço foi preenchido com um retalho pediculado do corpo adiposo bucal após a remoção da lesão e todos os casos foram feitos sem antrostomia meatal inferior. Resultados Um total de 45 casos foram incluídos no estudo. Vinte e dois foram submetidos à cirurgia utilizando-se o método I, enquanto que 23 foram submetidos ao método II. As operações foram concluídas em 20 minutos. A dor desapareceu em média após 3,62 dias, e o edema, depois de 6,47 dias. Hemorragia nasal ocorreu em 8 pacientes com duração de 1 a 3 dias. Processo supurativa foi observado em 1 paciente ocorrendo após a reposição óssea. Outros retalhos reposicionados livres da parede óssea não mostraram reabsorção em imagens de TC. Conclusões A mucosa sinusal e a parede óssea devem ser preservadas; o desenho digital pré-operatório pode orientar a osteotomia de forma eficaz durante a cirurgia; a reposição óssea não é adequada em processos supurativos. O retalho pediculado de corpo adiposo bucal é suficiente para a drenagem e antrostomia meatal inferior não é necessária.

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Impact of body mass index on survival outcome in patients with differentiated thyroid cancer

Abstract Introduction Increased body mass index is known to be associated with the high prevalence of differentiated thyroid cancers; however data on its impact on survival outcome after thyroidectomy and adjuvant therapy is scanty. Objective We aimed to evaluate the impact of body mass index on overall survival and disease free survival rates in patients with differentiated thyroid cancers. Methods Between 2000 and 2011, 209 patients with differentiated thyroid cancers (papillary, follicular, hurthle cell) were treated with thyroidectomy followed by adjuvant radioactive iodine-131 therapy and thyroid-stimulating hormone suppression. Based on body mass index, patients were divided into five groups; (a) <18.5 kg/m2 (underweight); (b) 18.5-25 kg/m2 (normal weight); (c) 26-30 kg/m2 (overweight); (d) 31-40 kg/m2 (obese) and (e) >40 kg/m2 (morbid obese). Various demographic, clinical and treatment characteristics and related toxicity and outcomes (overall survival, and disease free survival) were analyzed and compared. Results Median follow up period was 5.2 years (0.6-10). Mean body mass index was 31.3 kg/m2 (17-72); body mass index 31-40 kg/m2 was predominant (89 patients, 42.6%) followed by 26-30 kg/m2 seen in 58 patients (27.8%). A total of 18 locoregional recurrences (8.6%) and 12 distant metastasis (5.7%) were seen. The 10 year disease free survival and overall survival rates were 83.1% and 58.0% respectively. No significant impact of body mass index on overall survival or disease free survival rates was found (p = 0.081). Similarly, multivariate analysis showed that body mass index was not an independent prognostic factor for overall survival and disease free survival. Conclusion Although body mass index can increase the risk of thyroid cancer, it has no impact on treatment outcome; however, further trials are warranted.

Resumo Introdução Sabe-se que o aumento do índice de massa corpórea está associado à alta prevalência de câncer diferenciado de tireoide; entretanto, os dados sobre seu impacto no desfecho de sobrevivência após tireoidectomia e terapia adjuvante são escassos. Objetivo Objetivou-se avaliar o impacto do índice de massa corpórea nas taxas de sobrevida global e sobrevida livre de doença em pacientes com câncer diferenciado de tireoide. Método Entre 2000 e 2011, 209 pacientes com câncer diferenciado de tireoide (papilar/folicular/de células de Hurthle) foram tratados através de tireoidectomia, seguida de tratamento com iodo radioativo-131 adjuvante e supressão de hormônio estimulante da tireoide. Com base no índice de massa corpórea, os pacientes foram divididos em cinco grupos; (a) < 18,5 kg/m2 (baixo peso); (b) 18,5-25 kg/m2 (peso normal); (c) 26-30 kg/m2 (sobrepeso); (d) 31-40 kg/m2 (obesos) e (e) > 40 kg/m2 (obesos mórbidos). Várias características demográficas, clínicas e de tratamento e toxicidade associada e desfechos (sobrevida global e sobrevida livre de doença) foram analisadas e comparadas. Resultados O período médio de acompanhamento foi de 5,2 anos (0,6-10). O índice de massa corpórea médio foi de 31,3 kg/m2 (17-72); o índice de massa corpórea de 31-40 kg/m2 foi predominante (89 pacientes, 42,6%), seguido por 26-30 kg/m2, observado em 58 pacientes (27,8%). Observaram-se 18 recidivas locorregionais (8,6%) e 12 metástases distantes (5,7%). As taxas de sobrevida livre de doença e sobrevida global de 10 anos foram de 83,1% e 58,0%, respectivamente. Não foi encontrado impacto significativo do índice de massa corpórea nas taxas de sobrevida global ou sobrevida livre de doença (p = 0,081). Da mesma forma, a análise multivariada mostrou que o índice de massa corpórea não foi um fator prognóstico independente para sobrevida global e sobrevida livre de doença. Conclusão Embora o índice de massa corpórea possa aumentar o risco de câncer de tireoide, ele não tem impacto no resultado do tratamento; contudo, outros estudos são necessários.

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Giant fronto-ethmoidal osteoma - selection of an optimal surgical procedure

Abstract Introduction Osteomas of the paranasal sinuses are benign bone tumours that produce clinical signs depending on their size and location. In most reported cases large tumours are excised by an external approach or in conjunction with an endoscopic technique. Endoscopic treatment of such tumours is a huge challenge for the operator. Objective Determine the optimal surgical approach by analysing giant osteomas of the frontal and ethmoidal sinuses in the literature. Methods Group of 37 osteomas obtained from the literature review. A group of osteomas removed only by endoscopy was compared with a group in which an external approach (lateral rhynotomy or craniotomy) or combined external and endoscopic approach was applied. Results The authors, based on the statistical analysis of the literature data, have found that the average size of osteomas excised endoscopically and those removed by external approaches does not differ statistically, when the osteomas are located in the ethmoidal cells (p = 0.2691) and the frontal sinuses (p = 0.5891). Conclusion The choice of surgical method appears to be independent of the osteoma size and the decision is likely to be taken based on the experience of the surgeon, available equipment and knowledge of different surgical techniques.

Resumo Introdução Osteomas dos seios paranasais são tumores ósseos benignos cujas manifestações clínicas ocorrem em função de seu tamanho e localização. Na maioria dos casos relatados os tumores grandes são excisados por uma abordagem externa ou associada a uma técnica endoscópica. O tratamento endoscópico destes tumores ainda é um grande desafio para o cirurgião. Objetivo Determinar a abordagem cirúrgica ideal ao analisar osteomas gigantes dos seios frontal e etmoidal na literatura. Método Um total de 38 osteomas foram avaliados a partir da revisão da literatura. Um grupo de osteomas removidos apenas por cirurgia endoscópica foi comparado com um grupo para o qual foi utilizado uma abordagem externa (rinotomia lateral ou craniotomia) ou uma abordagem combinada, externa e endoscópica. Resultados Os autores, com base na análise estatística dos dados da literatura, observaram que o tamanho médio dos osteomas excisados endoscopicamente e daqueles que foram removidos através de uma abordagem externa não diferiram estatisticamente, tanto para osteomas localizados no seio etmoidal (p = 0.2691) quanto para os localizados no seio frontal (p = 0.5891). Conclusão A escolha do método cirúrgico parece ser independente do tamanho do osteoma e a decisão provavelmente será tomada com base na experiência prévia do cirurgião, nos equipamentos disponíveis e conhecimento de diferentes técnicas cirúrgicas.

https://ift.tt/2jDVYNW

Biofeedback in dysphonia - progress and challenges

Abstract Introduction There is evidence that all the complex machinery involved in speech acts along with the auditory system, and their adjustments can be altered. Objective To present the evidence of biofeedback application for treatment of vocal disorders, emphasizing the muscle tension dysphonia. Methods A systematic review was conducted in Scielo, Lilacs, PubMed and Web of Sciences databases, using the combination of descriptors, and admitting as inclusion criteria: articles published in journals with editorial committee, reporting cases or experimental or quasi-experimental research on the use of biofeedback in real time as additional source of treatment monitoring of muscle tension dysphonia or for vocal training. Results Thirty-three articles were identified in databases, and seven were included in the qualitative synthesis. The beginning of electromyographic biofeedback studies applied to speech therapy were promising and pointed to a new method that enabled good results in muscle tension dysphonia. Nonetheless, the discussion of the results lacked physiological evidence that could serve as their basis. The search for such explanations has become a challenge for speech therapists, and determined two research lines: one dedicated to the improvement of the electromyographic biofeedback methodology for voice disorders, to reduce confounding variables, and the other dedicated to the research of neural processes involved in changing the muscle engram of normal and dysphonic patients. Conclusion There is evidence that the electromyographic biofeedback promotes changes in the neural networks responsible for speech, and can change behavior for vocal emissions with quality.

Resumo Introdução Há evidências de que o complexo aparato envolvido no ato da fala, juntamente com o sistema auditivo, e seus ajustes podem ser alterados. Objetivo Apresentar evidências da aplicação de biofeedback (biorretroalimentação) para tratamento de distúrbios vocais, enfatizar a disfonia de tensão muscular. Método Realizou-se uma revisão sistemática nas bases de dados de Scielo, Lilacs, PubMed e Web of Sciences, utilizando a combinação de descritores e admitindo como critérios de inclusão: artigos publicados em revistas com comitê editorial, relatos de casos ou pesquisas experimentais ou quase experimentais sobre o uso debiofeedbackem tempo real como fonte adicional de monitoração de tratamento de disfonia de tensão muscular ou para treinamento vocal. Resultados Trinta e três artigos foram identificados em bases de dados, e sete foram incluídos na síntese qualitativa. O início dos estudos de biofeedbackeletromiográficos aplicados à terapia fonoaudiológica foram promissores e indicaram um novo método que permitiu bons resultados na disfonia de tensão muscular. No entanto, a discussão dos resultados carecia de evidências fisiológicas que pudessem servir de base. A busca por tais explicações tornou-se um desafio para os fonoaudiólogos e determinou duas linhas de pesquisa: uma dedicada à melhoria da metodologia de biofeedbackeletromiográfico para distúrbios da voz, para reduzir as variáveis de confusão e outra dedicada à pesquisa de processos neurais envolvidos na alteração do engrama muscular de pacientes normais e disfônicos. Conclusão Há evidências de que o biofeedback eletromiográfico promove mudanças nas redes neurais responsáveis pela fala e pode mudar o comportamento para emissões vocais com qualidade.

https://ift.tt/2FSPSSR

Acquired stenosis of external auditory canal secondary to paraneoplastic manifestation of renal cancer

Chorda tympani schwannoma: one new case revealed during malignant otitis externa and review of the literature

Prevention of neck infection by endoscopic suture closure of pyriform sinus fistulae: a report of two cases

Endoscopic surgery of the frontoethmoidal osteomas

Patent Foramen Ovale Closure: The Pendulum Swings.

Author: Hankey, Graeme J. MD, FRACP, FRCP; McQuillan, Brendan M. MBBS, PhD, FRACP

Page: 1991-1993

https://ift.tt/2rsjVMG

High-Dose Versus Low-Dose Pitavastatin in Japanese Patients With Stable Coronary Artery Disease (REAL-CAD): A Randomized Superiority Trial.

Author: Taguchi, Isao MD, PhD *,; Iimuro, Satoshi MD, PhD *,; Iwata, Hiroshi MD, PhD *,; Takashima, Hiroaki MD, PhD; Abe, Mitsuru MD, PhD; Amiya, Eisuke MD, PhD; Ogawa, Takanori MD, PhD; Ozaki, Yukio MD, PhD; Sakuma, Ichiro MD, PhD; Nakagawa, Yoshihisa MD, PhD; Hibi, Kiyoshi MD, PhD; Hiro, Takafumi MD, PhD; Fukumoto, Yoshihiro MD, PhD; Hokimoto, Seiji MD, PhD; Miyauchi, Katsumi MD, PhD; Yamazaki, Tsutomu MD, PhD; Ito, Hiroshi MD, PhD; Otsuji, Yutaka MD, PhD; Kimura, Kazuo MD, PhD; Takahashi, Jun MD, PhD; Hirayama, Atsushi MD, PhD; Yokoi, Hiroyoshi MD; Kitagawa, Kazuo MD, PhD; Urabe, Takao MD, PhD; Okada, Yasushi MD, PhD; Terayama, Yasuo MD, PhD; Toyoda, Kazunori MD, PhD; Nagao, Takehiko MD, PhD; Matsumoto, Masayasu MD, PhD; Ohashi, Yasuo PhD; Kaneko, Tetsuji MS; Fujita, Retsu MS; Ohtsu, Hiroshi MSc; Ogawa, Hisao MD, PhD; Daida, Hiroyuki MD, PhD; Shimokawa, Hiroaki MD, PhD; Saito, Yasushi MD, PhD; Kimura, Takeshi MD, PhD; Inoue, Teruo MD, PhD; Matsuzaki, Masunori MD, PhD; Nagai, Ryozo MD, PhD

Page: 1997-2009

https://ift.tt/2jDEGR5

Extending the "Lower is Better" Principle to Japanese and Possibly Other Asian Populations.

Author: Teramoto, Tamio MD, PhD

Page: 2010-2012

https://ift.tt/2I50MXw

High- Versus Low-Dose Statin: Effects on Cardiovascular Events and All-Cause Death.

Author: Barter, Philip J. MBBS, PhD, FRACP

Page: 2013-2015

https://ift.tt/2rrOCBJ

Creatinine and Cystatin C: Not the Troponin of the Kidney.

Author: Costanzo, Maria Rosa MD; Barasch, Jonathan MD, PhD

Page: 2029-2031

https://ift.tt/2rsbJvL

Time to Epinephrine Administration and Survival From Nonshockable Out-of-Hospital Cardiac Arrest Among Children and Adults.

Author: Hansen, Matthew MD, MCR; Schmicker, Robert H. MS; Newgard, Craig D. MD, MPH; Grunau, Brian MD, MHSc; Scheuermeyer, Frank MD, MHSc; Cheskes, Sheldon MD; Vithalani, Veer MD; Alnaji, Fuad MD; Rea, Thomas MD, MPH; Idris, Ahamed H. MD; Herren, Heather RN, MPH; Hutchison, Jamie MD; Austin, Mike MD; Egan, Debra MPH; Daya, Mohamud MD, MS; for the Resuscitation Outcomes Consortium Investigators

Page: 2032-2040

https://ift.tt/2I1PVxn

Association Between Prompt Defibrillation and Epinephrine Treatment With Long-Term Survival After In-Hospital Cardiac Arrest.

Author: Patel, Krishna K. MD; Spertus, John A. MD, MPH; Khariton, Yevgeniy MD; Tang, Yuanyuan PhD; Curtis, Lesley H. PhD; Chan, Paul S. MD, MSc; for the American Heart Association's Get With the Guidelines-Resuscitation Investigators; Chan, Paul S. MD, MSc; Grossestreuer, Anne PhD; Moskowitz, Ari MD; Edelson, Dana P. MD, MS; Ornato, Joseph P. MD; Peberdy, Mary Ann MD, DACC; Churpek, Matthew M. MD, MPH, PhD; Kurz, Michael C. MD, MS-HES; Starks, Monique Anderson MD; Howard, Patricia Kunz PhD, RN; Girotra, Saket MBBS, SM; Perman, Sarah M. MD, MSCE; Goldberger, Zachary D. MD, MS

Page: 2041-2051

https://ift.tt/2jEFHbF

MicroRNA-195 Regulates Metabolism in Failing Myocardium Via Alterations in Sirtuin 3 Expression and Mitochondrial Protein Acetylation.

Author: Zhang, Xiaokan PhD; Ji, Ruiping MD, PhD; Liao, Xianghai PhD; Castillero, Estibaliz PhD; Kennel, Peter J. MD; Brunjes, Danielle L. PhD; Franz, Marcus MD, PhD; Mobius-Winkler, Sven MD; Drosatos, Konstantinos PhD; George, Isaac MD; Chen, Emily I. PhD; Colombo, Paolo. C. MD; Schulze, P. Christian MD, PhD

Page: 2052-2067

https://ift.tt/2wnPxYN

The Alchemist's Nightmare: Might Mesenchymal Stem Cells That Are Recruited to Repair the Injured Heart Be Transformed Into Fibroblasts Rather Than Cardiomyocytes?.

Author: Packer, Milton MD

Page: 2068-2073

https://ift.tt/2rpsd8a

From the Literature.

Author: Hampton, Tracy PhD

Page: 2074-2075

https://ift.tt/2I6A6Fx

Prevalence and Clinical Outcome of Athletes With Mitral Valve Prolapse.

Author: Caselli, Stefano MD, PhD; Mango, Federica MD; Clark, John DO; Pandian, Natesa G. MD; Corrado, Domenico MD, PhD; Autore, Camillo MD; Pelliccia, Antonio MD

Page: 2080-2082

https://ift.tt/2wlW0DD

Letter by El-Battrawy et al Regarding Article, "Sex Differences and Similarities in Atrial Fibrillation Epidemiology, Risk Factors, and Mortality in Community Cohorts: Results From the BiomarCaRE Consortium (Biomarker for Cardiovascular Risk Assessment in Europe)".

Author: El-Battrawy, Ibrahim MD; Borggrefe, Martin MD; Akin, Ibrahim MD

Page: 2083-2084

https://ift.tt/2jD7M34

Letter by Wang Regarding Article, "Sex Differences and Similarities in Atrial Fibrillation Epidemiology, Risk Factors, and Mortality in Community Cohorts: Results From the BiomarCaRE Consortium (Biomarker for Cardiovascular Risk Assessment in Europe)".

Author: Wang, Yafeng MS

Page: 2085-2086

https://ift.tt/2wlVQMx

Response by Magnussen et al to Letter Regarding Article, "Sex Differences and Similarities in Atrial Fibrillation Epidemiology, Risk Factors, and Mortality in Community Cohorts: Results From the BiomarCaRE Consortium (Biomarker for Cardiovascular Risk Assessment in Europe)".

Author: Magnussen, Christina MD; Ojeda, Francisco M. PhD; Schnabel, Renate B. MD, MSc; On behalf of the BiomarCaRE Consortium

Page: 2087-2088

https://ift.tt/2jG1m35

Letter by Yi-tong Regarding Article, "Dextrocardia: Why Significant Left-Axis Deviation?".

Author: Yi-tong, Wang MM

Page: 2089

https://ift.tt/2wkyhDw

Response by Liu and Li to Letter Regarding Article, "Dextrocardia: Why Significant Left Axis Deviation?".

Author: Liu, Renguang; Li, Yuhong PhD

Page: 2090-2091

https://ift.tt/2rr8RiR

Letter by Tang et al Regarding Article, "The Fluid Mechanics of Transcatheter Heart Valve Leaflet Thrombosis in the Neosinus".

Author: Tang, Gilbert H.L. MD, MSc, MBA; Kaneko, Tsuyoshi MD; Bapat, Vinayak MBBS, MS, DNB, FCRSEd, FRCSCTh

Page: 2092-2093

https://ift.tt/2wlSid1

A modified synthesis process of three-dimensional sulfur/graphene aerogel as binder-free cathode for lithium‑sulfur batteries

Publication date: 5 September 2018
Source:Materials & Design, Volume 153
Author(s): Buyin Li, Qi Xiao, Yuanzheng Luo
Among the existing rechargeable battery systems, lithium‑sulfur batteries exhibit ultra-high theoretical specific capacity (1672mAh/g) and specific energy (2600 Wh/kg). However, its practical applications have been limited by several problems, especially the dissolution of lithium polysulfides and shuttle effect, which will cause poor cycling stability. Herein, we synthesized a 3D porous graphene aerogel through a modified two-step hydrothermal reduction method, which has been simultaneously used as the matrix to load sulfur and the shield to constrain the dissolution of polysulfides. The graphene aerogel containing sulfur was mechanically pressed to circular disc and directly used as cathode without any additives, which shows great flexibility and excellent electrical conductivity. Since no extra conductive additives and binder are needed, this binder-free method is also more facile than conventional processes. Meanwhile, the shield was used as lithium polysulfides absorber to suppress the shuttle effect. Compared with conventional lithium‑sulfur batteries, this novel cathode with unique battery structure enables a higher areal sulfur loading of >2.5mg/cm² and initial specific capacity of >1100mAh/g. More importantly, the dissolution and shuttle effect of lithium polysulfides were suppressed effectively by the graphene aerogel matrix and shield, greatly improving the cycling stability.

Graphical abstract

https://ift.tt/2HUNEbc

The role of adenosine for IgE receptor-dependent degranulation of human peripheral basophils and skin mast cells

Publication date: Available online 25 April 2018
Source:Allergology International
Author(s): Yoshimi Matsuo, Yuhki Yanase, Reiko Irifuku, Kaori Ishii, Tomoko Kawaguchi, Shunsuke Takahagi, Izumi Hide, Michihiro Hide

https://ift.tt/2FT4DFa

Expression of Siglec-8 is regulated by interleukin-5, and serum levels of soluble Siglec-8 may predict responsiveness of severe eosinophilic asthma to mepolizumab

Publication date: Available online 24 April 2018
Source:Allergology International
Author(s): Sayaka Arakawa, Maho Suzukawa, Nobuharu Ohshima, Hiroyuki Tashimo, Isao Asari, Hirotoshi Matsui, Nobuyuki Kobayashi, Shunsuke Shoji, Takahide Nagase, Ken Ohta

https://ift.tt/2KHSjLD

Development of eosinophilic esophagitis following sublingual immunotherapy with cedar pollen extract: A case report

Publication date: Available online 24 April 2018
Source:Allergology International
Author(s): Kousaku Kawashima, Shunji Ishihara, Masaaki Masuhara, Hironobu Mikami, Eiko Okimoto, Naoki Oshima, Norihisa Ishimura, Asuka Araki, Riruke Maruyama, Yoshikazu Kinoshita

https://ift.tt/2FTTsMi

Food-induced anaphylaxis in two patients who were using soap containing foodstuffs

Publication date: Available online 16 April 2018
Source:Allergology International
Author(s): Risa Tamagawa-Mineoka, Koji Masuda, Akiko Yagami, Masashi Nakamura, Nayu Sato, Kayoko Matsunaga, Norito Katoh

https://ift.tt/2jGXy1R

Immune suppression of food allergy by maternal IgG in murine models

Publication date: Available online 30 April 2018
Source:Allergology International
Author(s): Hirotaka Yamashita, Tadamasa Hayashi, Kenichi Saneyasu, Hiroki Matsuhara, Teruaki Matsui, Hiroyuki Tanaka, Naoki Inagaki
BackgroundMost of the patients develop food allergy early in life. The factors related to parental immune condition might be one of the conceivable causes.MethodsWe reported murine models of food allergy and oral OVA tolerance. To investigate the influence of parental immune condition on infant food allergy, female and male mice with food allergy or oral tolerance were mated with each other.ResultsFood allergy was suppressed by decreased IgE production in the offspring of mice with food allergy. On the contrary, anaphylaxis for OVA was induced in the offspring of mice with oral tolerance. The suppression of food allergy being dependent on a maternal factor was revealed in the offspring after cross-mating mice with food allergy and oral tolerance. Because OVA-specific IgG, presumed to be from the allergic mother, was detected in the serum of naïve infants from mothers allergic to food, we assumed that the suppression was dependent on a specific IgG. The serum IgG purified by a G-protein column was administered before OVA sensitization in the food allergy model, and OVA-specific IgE production was found to be diminished in the administered mice. However, OVA-specific monoclonal IgG1 and IgG2a administration could not suppress food allergy. Because we detected OVA-IgG immune complex in the serum of mothers allergic to food, it might be a cause of maternal immune suppression.ConclusionsWe demonstrated that maternal specific IgG conjugated food antigen is an important factor related to the development of food allergy and acquiring tolerance.

https://ift.tt/2FTTnIu

Pazopanib: a Review in Advanced Renal Cell Carcinoma.

http:--production.springer.de-OnlineReso

Pazopanib: a Review in Advanced Renal Cell Carcinoma.

Target Oncol. 2017 Aug;12(4):543-554

Authors: Frampton JE

Abstract
Pazopanib (Votrient®), an orally administered multi-targeted tyrosine kinase inhibitor that predominantly inhibits vascular endothelial growth factor receptor-1, -2 and -3, platelet-derived growth factor receptor-α and -β, and the stem cell factor receptor c-Kit, is approved in the EU, the USA and other countries for the treatment of advanced renal cell carcinoma (RCC). In randomized controlled trials in patients with advanced, predominantly clear-cell RCC, pazopanib significantly improved progression-free survival (PFS) compared with placebo in both treatment-naïve and cytokine-pretreated patients and, as a first-line therapy, was noninferior to intermittent sunitinib with respect to PFS. However, pazopanib had a tolerability profile that was distinguishable from that of sunitinib, based on lower incidences of most adverse events, particularly those associated with discomfort, such as fatigue, hand-foot syndrome and stomatitis. Consistent with this, health-related quality of life (HR-QOL) measures evaluating fatigue, hand/foot soreness and mouth/throat soreness significantly favoured pazopanib over sunitinib. In addition, significantly more patients expressed a preference for pazopanib over sunitinib, primarily because of better overall HR-QOL and less fatigue. Efficacy and tolerability findings from these prospective clinical trials have been substantiated by evidence from a number of retrospective studies evaluating unselected real-world patients with metastatic RCC who received pazopanib (or sunitinib) as a first-line therapy. Thus, data from clinical trials supplemented with that from clinical practice support the use of pazopanib as a standard or alternative first-line treatment for advanced or metastatic RCC.

PMID: 28664385 [PubMed - indexed for MEDLINE]

https://ift.tt/2t2gzkL

Evolution of human health risk based on EPA modeling for adults and children and pollution level of potentially toxic metals in Rafsanjan road dust: a case study in a semi-arid region, Iran

Abstract

Humans can be directly exposed to potentially toxic metals in the urban environment via inhalation, ingestion, or dermal contact of dust particles. This paper focuses on human health risk assessment of urban dust contaminated with potentially toxic metals. The levels, sources, and human health risks of nine potentially toxic metals (i.e., As, Cd, Cu, Cr, Ni, Pb, Co, Mn, and Zn) in 200 road dust samples from Rafsanjan area were investigated. Pollution level was assessed using the pollution index (PI) and geoaccumulation index (I_geo), and the health risk assessment was performed following the methodology described by the US Environmental Protection Agency. The mean concentrations of As, Cu, Pb, Cd, Cr, Ni, Zn, Co, and Mn in road dust were 105.3 ± 5.7, 791.4 ± 29.8, 123.1 ± 9.7, 28.4 ± 3.3, 3.1 ± 0.6, 18.4 ± 1.6, 252.6 ± 8.3, 16.5 ± 1.4, and 525.9 ± 21.0 mg kg⁻¹, respectively. Thus, the concentrations of potentially toxic metals in road dust were higher than their corresponding natural background values, indicating that all studied potentially toxic metals were impacted by anthropogenic activities. The results of the current study are comparable to other studies conducted on road dust in other cities worldwide. Both of I_geo and PI decreased following order Cu > Mn > Pb > As > Zn > Cd > Ni > Cr > Co. Health risk assessment indicated that both of children and adults could be exposed to a potential increased risk of developing cancer over a lifetime from exposure to arsenic through ingestion of the dust samples. However, Pb ingestion can increase cancer risk in children.

https://ift.tt/2rrkiqG

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Δευτέρα 7 Μαΐου 2018

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