Myotoxicity of local anesthetics is equivalent in individuals with and without predisposition to malignant hyperthermia

Abstract

Purpose

Malignant hyperthermia (MH) is an inherited muscle disorder caused by abnormal elevations of intracellular calcium (Ca²⁺) in skeletal muscle. There are several reports of myotoxicity caused by local anesthetics, and the increased intracellular Ca²⁺ is considered to be an important cause. However, there is insufficient evidence regarding myotoxicity in MH-susceptible individuals when large doses of local anesthetics are administered. This study investigated the effect of MH predisposition on myotoxicity.

Methods

Human skeletal muscle samples were obtained from 22 individuals to determine susceptibility to MH, and were evaluated according to whether their Ca²⁺-induced Ca²⁺ release (CICR) rates were accelerated or not. This study was performed using surplus muscle that remained after the CICR rate test. We calculated the 50% effective concentration (EC₅₀) values of three local anesthetics, namely lidocaine, levobupivacaine, and ropivacaine using the ratiometric dye Fura-2 AM. Significance was tested using the unpaired t test.

Results

In the accelerated and unaccelerated groups, respectively, the mean ± SD of the EC₅₀ values were 1.52 ± 0.72 and 1.75 ± 0.37 mM for lidocaine (p = 0.42), 0.72 ± 0.36 and 0.79 ± 0.46 mM for levobupivacaine (p = 0.68), and 1.21 ± 0.35 and 1.62 ± 0.57 mM for ropivacaine (p = 0.06). These values were similar in individuals with and without MH predisposition.

Conclusion

The myotoxicity of local anesthetics was equivalent in individuals with and without predisposition to MH.

https://ift.tt/2KhUZPo

Rapid onset of action and reduced nasal hyperreactivity: new targets in allergic rhinitis management

This article summarizes a EUFOREA symposium, presented during the European Rhinology Research Forum in Brussels (9–10 November 2017; https://ift.tt/2IquVj9

https://ift.tt/2KkMOFg

Critical analysis and mapping of research trends and impact assessment of polyaromatic hydrocarbon accumulation in leaves: let history tell the future

Abstract

The article is basically an attempt to provide a consolidated report on impact assessment and trends in research pertaining to accumulation and curbing the menace of polyaromatic hydrocarbon (PAH) accumulation in leaves. Emphasis is given to understand the consequences of the fact that edible/medicinal plants cultivated in PAH contaminated soil or close to such places which are potential liberators of PAHs can virtually act as transporters for direct PAH entry into biological systems. An attempt has been made to predict the future by digging out golden facts from history. Extensive Scopus-based data mining has been done to dig out research data since last 10 years (2006–2016) pertaining to the said area. Critical analysis of statistical data on research trends highlighting the different aspects of evaluation of PAH accumulation in leaves has been described. The concentrate of all researches for the said period have been presented as few golden principles which shall serve as important facts for researchers and policy makers for curbing the menace of PAH-induced oxidative stress in plants and shall also provide start-up ideas for researchers new to the area. Critical analysis of trends in phytoremediation aspect has also been duly highlighted to measure the intensity of restoration steps taken by researchers and government to safeguard the future generations.

https://ift.tt/2yA3XWG

Mitigation of NOx and smoke emissions in a diesel engine using novel emulsified lemon peel oil biofuel

Abstract

Lemon peel oil (LPO) is considered to be a viable alternative fuel for diesel engine applications due to its wider availability, renewable nature, easy extraction process, almost equivalent calorific value as neat diesel, and low viscosity. The present work aims to investigate the effect of novel emulsified LPO in a diesel engine in order to reduce the NOx emission without compromising the engine performance. A new ionic surfactant is introduced in the present study, namely methyl-dihydroxy propyl imidazolium chloride due to its higher hydrophilic-lipophilic balance value which helps to prepare stable water in oil emulsion. Also, Span 80 has been selected as another suitable surfactant for water in oil emulsion. Four emulsified fuel samples have been prepared using LPO, water, and different concentrations of surfactants. All the fuel samples are tested for their stability through gravitational technique for 7 days. Among the emulsified samples, 92% LPO + 5% water + 2% Span 80 + 1% methyl-dihydroxy propyl imidazolium chloride by volume (LPOE2) and 93.5% LPO + 5% water + 1.5% surfactant Span 80 by volume (LPOE4) have showed better stability when compared to other emulsion fuel samples. It is also revealed that the stability of LPO emulsion is improved by the addition of two emulsions. The experimental results showed that the brake thermal efficiency of LPO emulsion is reduced to 29.87 from 34.58% of pure LPO at full load condition. Oxides of nitrogen emission and smoke emission are reduced by 21–32 and 6–15% for the LPO emulsion samples compared to pure LPO. Moreover, the diesel engine operation with emulsified form of LPO increases the HC emission about 0.1 g/kWh for LPOE4 and 0.15 g/kWh for LPOE2 fuels from 0.053 g/kW for pure LPO at maximum power output condition. The reformulation of LPO into emulsified form increases the CO emission by 25–53% compared to pure LPO. Moreover, the reformulation of LPO into emulsions has resulted in lower cylinder pressure and heat release rate compared to pure LPO and diesel fuels.

https://ift.tt/2lAEMtD

Omalizumab chronic spontaneous urticaria: efficacy, safety, predictors of treatment outcome and time to response

Publication date: Available online 24 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): E. Nettis, L. Cegolon, E. Di Leo, F. Lodi Rizzini, A. Detoraki, W.G. Canonica




https://ift.tt/2Mkv6ik

Cephalic vein transposition in autologous breast reconstruction salvage: a review of outcomes and implications for patient care

Abstract

Background

Success in microsurgical autologous breast reconstruction is reliant on establishing an effective circulation. Cephalic vein transposition (CVT) is a technique for augmentation, supercharging or replacement of problematic venous anastomoses for free flap salvage. Little is known about the consequences of using this valuable surgical lifeboat for patients. We investigated our experience of CVTs, focusing on the development of lymphedema in the cephalic vein donor limb.

Method

A retrospective review was undertaken of consecutive patients undergoing autologous microsurgical breast reconstruction between 2009 and 2015. Patients requiring CVTs were identified and notes reviewed. Outcome measures included further surgery, flap survival, and complications.

Results

Between 2009 and 2015, 1208 autologous free tissue transfers for breast reconstruction were performed at our institution. Twelve patients required CVTs for flap salvage. Eleven notes were available for review. Mean age at reconstruction was 51 (43–74). All patients had previous axillary surgery, with post-mastectomy lymphedema noted in four patients. Reconstructions were seven MS-TRAM and four DIEP flaps. Indications for CVT were venous insufficiency in all but one patient, who had scarred internal mammary vessels. No anastomoses required revision and all flaps survived. No wound healing or scar problems were encountered. Lymphedema worsened in two patients and arose de novo in another two patients.

Conclusions

The cephalic vein is an excellent local option for free flap salvage in breast reconstruction. Lymphedema, however, developed or worsened in one third of our patients. All patients undergoing microsurgical breast reconstruction are now counseled about the potential need for CVT and the risk of lymphedema.

Level of Evidence: Level IV, therapeutic study.

https://ift.tt/2K4bthO

A wide-range solid state potentiometric pH sensor based on poly-dopamine coated carbon nano-onion electrodes

Publication date: Available online 24 June 2018
Source:Sensors and Actuators B: Chemical
Author(s): Julio C. Zuaznabar-Gardona, Alex Fragoso
A novel potentiometric pH sensor based on polydopamine films coated on a carbon nano-onion conductive surface is introduced. Glassy carbon electrodes containing a carbon nano-onion layer were modified by electropolymerization and self-polymerization of dopamine. The modified surfaces were characterized by ESEM, RAMAN spectroscopy and cyclic voltammetry. The modified electrodes displayed an almost Nernstian potentiometric response over the pH range 2-10. Furthermore, the pH sensors exhibit a fast and reversible behavior toward variations of pH and negligible interference effects from monovalent cations. The sensors showed an excellent correspondence between the pH values obtained using the GCE/CNO/PDA electrodes and those measured with glass electrodes and were applied to the analysis of real samples covering a wide pH range from 2.2 to 8.3. The analytical performance is comparable to other reported devices based on electropolymerized amines over graphite and noble metal electrodes. Their reproducible and stable response and their ease of fabrication is very promising for the miniaturization and integration of pH sensors in (bio)analytical devices.



https://ift.tt/2tyMcBy

The role of Scalpel‐bougie cricothyroidotomy in managing emergency Front of Neck Airway access. A review and technical update for ENT surgeons

https://ift.tt/2tyxCK8

Presenting symptoms and long‐term survival in head and neck cancer

https://ift.tt/2lv3YSl

Diagnostic accuracy of high‐resolution T2‐weighted MRI vs contrast‐enhanced T1‐weighted MRI to screen for cerebellopontine angle lesions in symptomatic patients

https://ift.tt/2tzYeKF

A systematic review of validated sinus surgery simulators

https://ift.tt/2lxFRCy

Hypopharyngeal evaluation in obstructive sleep apnea with awake flexible laryngoscopy: Validation and updates to Cormack‐Lehane and Modified Cormack‐Lehane scoring systems

https://ift.tt/2tzY7Pf

Psychosocial health of cochlear implant users compared to that of adults with and without hearing aids: Results of a nationwide cohort study

https://ift.tt/2lwmCcL

The effect of flurbiprofen oral spray and ibuprofen vs ibuprofen alone on postoperative tonsillectomy pain: An open, randomised, controlled trial

https://ift.tt/2tzY0TP

A novel succinate dehydrogenase subunit B germline variant associated with head and neck paraganglioma in a Dutch kindred: A family‐based study

https://ift.tt/2lvwymI

Socioeconomic deprivation and the burden of head and neck cancer—Regional variations of incidence and mortality in Merseyside and Cheshire, North West, England

https://ift.tt/2tzLLqF

A prospective cohort study of 122 adult patients presenting to an otolaryngologist's office with globus pharyngeus

https://ift.tt/2luIZiB

Deprivation in relation to urgent suspicion of head and neck cancer referrals in Glasgow

https://ift.tt/2tBlDeM

Predicting the hearing outcome in sudden sensorineural hearing loss via machine learning models

https://ift.tt/2lv3Kut

Clinical value of 18FDG PET/CT in screening for distant metastases in head and neck squamous cell carcinoma

https://ift.tt/2yAyX9e

Voice quality outcomes of idiopathic Parkinson's disease medical treatment: A systematic review

https://ift.tt/2lAjEUl

Assessment of narrative writing by Persian‐speaking students with hearing impairments

https://ift.tt/2tu1Bmu

Have reducing tonsillectomy rates in England led to increasing incidence of invasive Group A Streptococcus infections in children?

https://ift.tt/2lv3Bap

Signs of electrocochleography on endolymphatic sac decompression for patients with Ménière's Disease: Our experience in 12 patients

https://ift.tt/2tvUqtS

Indications for transnasal flexible laryngooesophagoscopy in a head and neck clinic, our experience in one hundred and ninety‐four patients

https://ift.tt/2luNIRt

A differential diagnosis of a head and neck bony lesion: Review of a case series with 18 patients with extraintestinal features of familial adenomatous polyposis

https://ift.tt/2yEjswT

Accuracy of FDG PET‐CT response assessment following radiotherapy alone for head and neck squamous cell carcinoma: Retrospective analysis of 45 patients

https://ift.tt/2lwjfSY

Omalizumab chronic spontaneous urticaria: efficacy, safety, predictors of treatment outcome and time to response

Chronic spontaneous urticaria (CSU) is the most common subtype of urticaria, and is characterized by recurrent episodes of spontaneous wheals and/or angioedema with unknown triggers, lasting for more than six weeks.1 CSU generally affects 0.5–1.0% of people 20–40 years of age, with a disease duration of 1–5 years.2 Patients with CSU often experience sleep deprivation and psychiatric comorbidities like anxiety and depression, which compromise the health-related and overall quality of life of the affected individuals.

https://ift.tt/2yzvPdw

Effect of statin use on oncologic outcomes in head and neck squamous cell carcinoma

Head &Neck, EarlyView.


https://ift.tt/2Miot06

Association between diffuse lymphocytic infiltration and papillary thyroid cancer aggressiveness according to the presence of thyroid peroxidase antibody and BRAFV600E mutation

Head &Neck, EarlyView.


https://ift.tt/2KjadXv

Cervical necrotizing fasciitis: Systematic review and analysis of 1235 reported cases from the literature

Head &Neck, EarlyView.


https://ift.tt/2MnqTe2

Transoral robotic‐assisted supracricoid partial laryngectomy with cricohyoidoepiglottopexy: Procedure development and outcomes of initial cases

Head &Neck, EarlyView.


https://ift.tt/2K3SqUQ

Systematic review of sentinel lymph node biopsy in Merkel cell carcinoma of the head and neck

Head &Neck, EarlyView.


https://ift.tt/2Irq41q

Accuracy of the HPV status site‐specific factor 10 (SSF‐10) variable for patients with oropharyngeal cancers in the Iowa Cancer Registry, 2010‐2014

Head &Neck, EarlyView.


https://ift.tt/2K3ShAM

Comparison of volatile compounds released by entomopathogenic fungi

Publication date: Available online 24 June 2018
Source:Microbiological Research
Author(s): Aleksandra Bojke, Cezary Tkaczuk, Piotr Stepnowski, Marek Gołębiowski
Entomopathogenic fungi are fungal species which are used as a potential source of biopesticides. These fungi produce secondary metabolites which in insects can cause disruption in the normal functioning of their bodies, disease or even death. In order to fully characterize the physiology of entomopathogenic fungi we should identify the volatile organic compounds which are involved in this process. Therefore, we conducted a qualitative and quantitative analysis of volatile compounds produced by entomopathogenic fungi. Seven different species of fungi were analyzed: Metarhizium anisopliae, Metarhizium flavoviride, Pandora sp., Isaria fumosorosea, Hirsutella danubiensis, Batkoa sp. and Beauveria bassiana. The analyses were performed using the HS-SPME/GC-MS technique. In the analyzed fungi, 63 volatile compounds were identified and classified into the following groups: aldehydes, ketones, alcohols, esters, acids, terpenes and others. The results show that entomopathogenic fungi produce a wide profile of secondary metabolites. Principal Components Analysis was used to determine whether separate classes of fungi can be distinguished from one another based on their metabolite profiles.



https://ift.tt/2tsHTID

Does the Angle of Rigid Endoscope Makes a Difference in Videolaryngoscopy

Abstract

Authors describe the technique of office based rigid video laryngoscopy with 0° endoscope and compare with technique of 70° 4 mm videolaryngoscopy. (1) To compare and assess the efficacy of techniques of 0° and 70° office based video laryngoscopy for examining laryngopharyngeal disorders at Ear Nose Throat (ENT) Out Patient Department level. (2) To assess whether the degree of angle of the rigid endoscope makes any difference in the visualisation in videolaryngoscopy. Prospective non randomised double blinded study of direct videolaryngoscopies using 0° and 70° 4 mm rigid endoscope (Karl Storz, Germany) done at M.I.M.E.R. Medical College and Sushrut ENT Hospital, Talegaon-D, Pune, India, during the period of October 2016 to February 2017. Patients with predominant complaints of change of voice and foreign body sensation in throat were subjected for Videolaryngoscopy by 0° and 70° 4 mm Endoscope. 375 patients were examined with both the techniques. After the end of the procedure, the patient preference or discomfort with any of the techniques was enquired. The unlabelled endoscopic recording of both techniques was visualised by the second author to compare and evaluate the 0° videolaryngoscopy with 70° in terms of extent of visualisation. The time taken for each technique was recorded. The data of all patients has been analysed in terms of patient and surgeon grading. On statistical analysis, both the techniques with 0° as well as 70° rigid endoscope videolaryngoscopy were found to be comparable. Our study concludes that both the endoscopes are equally efficient in comparable laryngeal visualization. Hence, the degree of angulation of the rigid endoscope makes no difference in videolaryngoscopy. With little practice, 0° videolaryngoscopy may be extended for routine use in laryngological examination.

Level of Evidence Level 4.

https://ift.tt/2txhGYL

Long Term Outcomes of Intratympanic Dexamethasone in Intractable Unilateral Meniere’s Disease

Abstract

To evaluate the long term effect of Intratympanic dexamethasone in intractable Meniere's disease. 30 patients with refractory Meniere's disease which did not respond to the standard medical management, were treated with Intratympanic dexamethasone injections. Post treatment hearing outcome and dizziness scores were compared with the pretreatment values respectively. The mean dizziness handicap inventory (DHI) score was reduced from 91.58 (range 80–100) to be 31.00 (p = 0.00) at 3 months of treatment. With the successive follow-up periods, the mean DHI scores were reduced to 51.50, 46.6, and 50.90 at the end of, 6, 12, and 24 months (p = 0.04, 0.35, and 0.49 respectively). Again at the end of 24 months, 23.80% of patients were free of vertigo (p = 0.01). No patient had improvement in the hearing (> 10 dB) in any of the follow-up periods and 6.6% demonstrated deterioration in hearing. There were no major intraoperative or postoperative complications detected. Intratympanic injection of steroid is a safe and effective method for treating intractable Meniere's disease. Although short term improvement in the vertigo is well documented, still in 23% of the patients were found to be free of vertigo at even the end of 24 months. There was no significant improvement in hearing noticed, either in short term or in long term.

https://ift.tt/2MTYr4s

Differential Diagnosis of Post Auricular Swelling with Mastoid Bone Involvement

Abstract

Post auricular swelling with mastoid bone involvement most commonly occurs as a cranial complication of chronic or acute suppurative otitis media. Aim of this study, to detect etiology of postauricular swelling with mastoid bone involvement. This is a retrospective study which was done on all patients whom underwent mastoidectomy for post auricular swelling with mastoid bone involved in El Minia University Hospital from January 2014 to June 2017. A total of 49 patients were identified in this study, 23 males and 26 females, their ages ranged 5–28 years old with a mean of 25.8 years old. Group A: these were 45 patients with a history of otorrhea (chronic suppurative otitis media), of 3 months to 4 years duration. Group B: these were four patients without any history of otorrhea. Two patients diagnosed as acute otitis media, one patient diagnosed as Langerhans cell histiocytosis and one patient diagnosed as fungal mastoiditis. Chronic suppurative otitis media is the most common causes of postauricular swelling. Langerhans cell histiocytosis of the temporal bone and fungal mastoiditis are considered a rare presentation of postauricular swelling.

https://ift.tt/2yG1gTG

Incidence of vulval squamous cell carcinoma in women with vulval lichen sclerosus in an Australian tertiary referral centre

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2Kkgnqu

Leishmania tropica successfully treated with photodynamic therapy

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2KjFFSq

Treating melanoma in situ and lentigo maligna with Mohs micrographic surgery in Australia

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2Kl16ph

Incidence of vulval squamous cell carcinoma in women with vulval lichen sclerosus in an Australian tertiary referral centre

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2Kkgnqu

Leishmania tropica successfully treated with photodynamic therapy

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2KjFFSq

Treating melanoma in situ and lentigo maligna with Mohs micrographic surgery in Australia

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2Kl16ph

Clinical characteristics and prognostic factors of sinonasal undifferentiated carcinoma: a multicenter study

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2MiinNg

Cosensitization to profilin is associated with less severe reactions to foods in nsLTPs and storage proteins reactors and with less severe respiratory allergy

Allergy, EarlyView.


https://ift.tt/2In6yTE

A cortical substrate for the long-term memory of saccadic eye movements calibration

Publication date: 1 October 2018
Source:NeuroImage, Volume 179
Author(s): Denis Pélisson, Ouazna Habchi, Muriel T.N. Panouillères, Charles Hernoux, Alessandro Farnè
How movements are continuously adapted to physiological and environmental changes is a fundamental question in systems neuroscience. While many studies have elucidated the mechanisms which underlie short-term sensorimotor adaptation (∼10–30 min), how these motor memories are maintained over longer-term (>3–5 days) -and thanks to which neural systems-is virtually unknown. Here, we examine in healthy human participants whether the temporo-parietal junction (TPJ) is causally involved in the induction and/or the retention of saccadic eye movements' adaptation. Single-pulse transcranial magnetic stimulation (spTMS) was applied while subjects performed a ∼15min size-decrease adaptation task of leftward reactive saccades. A TMS pulse was delivered over the TPJ in the right hemisphere (rTPJ) in each trial either 30, 60, 90 or 120 msec (in 4 separate adaptation sessions) after the saccade onset. In two control groups of subjects, the same adaptation procedure was achieved either alone (No-TMS) or combined with spTMS applied over the vertex (SHAM-TMS). While the timing of spTMS over the rTPJ did not significantly affect the speed and immediate after-effect of adaptation, we found that the amount of adaptation retention measured 10 days later was markedly larger (42%) than in both the No-TMS (21%) and the SHAM-TMS (11%) control groups. These results demonstrate for the first time that the cerebral cortex is causally involved in maintaining long-term oculomotor memories.



https://ift.tt/2KenqAS

Part 1. Current prescribing trends of antibiotics by dentists in Australia from 2013 to 2016

Australian Dental Journal, EarlyView.


https://ift.tt/2KfyRIt

Cowpox virus infection in two brothers with possible human‐to‐human transmission

Journal of the European Academy of Dermatology and Venereology, EarlyView.


https://ift.tt/2yD6yPA

Transposition cutaneous flap and split skin mesh graft as combined optimal treatment approach for giant neglected multicentric BCC of the shoulder

Journal of the European Academy of Dermatology and Venereology, EarlyView.


https://ift.tt/2lu4LTy

Expanding the differential diagnosis of raccoon eyes: sweet syndrome

Journal of the European Academy of Dermatology and Venereology, EarlyView.


https://ift.tt/2yDYE8V

Atypical maculopapular cutaneous mastocytosis showing a nevus spilus‐like lesion

Pediatric Dermatology, EarlyView.


https://ift.tt/2Ikj9XH

Childhood atopic dermatitis—An Indian perspective

Pediatric Dermatology, EarlyView.


https://ift.tt/2Kk6PvE

Divided or kissing nevus of the penis: A new case with dermoscopic findings

Pediatric Dermatology, EarlyView.


https://ift.tt/2KlQ540

Impact of naevus association on survival for nodular and superficial spreading melanomas

British Journal of Dermatology, EarlyView.


https://ift.tt/2Mi9Nhw

Issue Information

Clinical and Experimental Dermatology, Volume 43, Issue 5, Page i,511-512, July 2018.


https://ift.tt/2yzhD4e

Impact of naevus association on survival for nodular and superficial spreading melanomas

British Journal of Dermatology, EarlyView.


https://ift.tt/2Mi9Nhw

Issue Information

Clinical and Experimental Dermatology, Volume 43, Issue 5, Page i,511-512, July 2018.


https://ift.tt/2yzhD4e

NDRG1 and FOXO1 regulate endothelial cell proliferation in infantile haemangioma

Experimental Dermatology, Volume 27, Issue 6, Page 690-693, June 2018.


https://ift.tt/2tAiImL

Corrigendum

Experimental Dermatology, Volume 27, Issue 6, Page 697-697, June 2018.


https://ift.tt/2MTzrtS

No evidence for follicular keratinocyte hyperproliferation in acne lesions as compared to autologous healthy hair follicles

Experimental Dermatology, Volume 27, Issue 6, Page 668-671, June 2018.


https://ift.tt/2yAwdIR

A guide to studying human dermal adipocytes in situ

Experimental Dermatology, Volume 27, Issue 6, Page 589-602, June 2018.


https://ift.tt/2tt8HIE

Clinical Snippets

Experimental Dermatology, Volume 27, Issue 6, Page i-i, June 2018.


https://ift.tt/2yAw7kt

Issue Information

Experimental Dermatology, Volume 27, Issue 6, Page 587-588, June 2018.


https://ift.tt/2tqao9Z

Methadone—Not a magic bullet in melanoma therapy

Experimental Dermatology, Volume 27, Issue 6, Page 694-696, June 2018.


https://ift.tt/2yDRGAN

Digital analysis yields more reliable and accurate measures of dermal and epidermal thickness in histologically processed specimens compared to traditional methods

Experimental Dermatology, Volume 27, Issue 6, Page 687-690, June 2018.


https://ift.tt/2tt8oxu

Generalized morphea in the setting of pembrolizumab

International Journal of Dermatology, EarlyView.


https://ift.tt/2ltfQV8

Trigeminal trophic syndrome: an updated review

International Journal of Dermatology, EarlyView.


https://ift.tt/2yJP9om

A giant mass on the scalp: an unusual presentation of lupus vulgaris

International Journal of Dermatology, EarlyView.


https://ift.tt/2luLAJj

Complementary and compensatory dietary changes associated with consumption or omission of plain water by US adults

Publication date: 1 September 2018
Source:Appetite, Volume 128
Author(s): Ashima K. Kant, Barry I. Graubard
We examined within-person and between-person differences in self-selected diets of free-living individuals when they choose to consume or not to consume plain water. We used 2-days of dietary data from the NHANES 2005–2012 for this study. For within-person analyses, we compared recalls of respondents who reported water in one of the two available recalls (n = 1875 men and 1479 women). For between-person analysis, we compared dietary recalls of respondents who reported water in two, one of two, or zero of two recalls (n = 8632 men and 8907 women). The outcomes examined included reported intakes of 24-h energy from foods, beverages, and dietary and eating pattern attributes. We used covariate-adjusted regression methods for both types of analyses. For within-person analyses, the regression models included separate person-level fixed effects. Relative to the water day, on the no-water day, amount of beverages and energy contribution of beverages were significantly higher in both men (106 kcal) and women (43 kcal) (P ≤ 0.002). However, the water and the no-water days did not differ in 24-h energy intake, or the amount and energy from reported foods (P > 0.05). Energy density of foods, servings of fruits or vegetables and eating patterns did not differ between the water and the no-water day in both men and women (P > 0.05). For between-person analysis, however, intakes of energy and energy density of foods were higher, but density of sodium, potassium, and magnesium were lower among those who reported no water in both recalls. Overall, beverages partially substituted for plain water on the no-water day but qualitative dietary characteristics and eating patterns, which may relate to habitual food intake and personal preferences, were not appreciably different within individuals.



https://ift.tt/2KjX28A

Patterns of treatment failure in salivary gland cancers

Publication date: July–August 2018
Source:Reports of Practical Oncology & Radiotherapy, Volume 23, Issue 4
Author(s): Mateusz Szewczyk, Paweł Golusiński, Jakub Pazdrowski, Piotr Pieńkowski, Sławomir Marszałek, Jacek Sygut, Wojciech Golusiński
AimThe purpose of the study was to publish our experience of salivary gland cancer treatment with large number of patients treated at a single institution.BackgroundSalivary gland cancers are rare tumors of the head and neck representing about 5% of cancers in that region and about 0.5% of all malignancies. Due to the rarity of the disease, most of the studies regarding treatment outcome consist of low number of patients, thus making it difficult to draw conclusions.Material and methods115 patients with primary salivary gland cancer were included in a retrospective study. The subsites of tumor were the parotid gland (58% patients), submandibular gland (19%) and minor salivary glands (23%). All patients underwent primary surgical resection. The following were collected: age, stage of the disease, T status, N status, grade of tumor, perineurial invasion, lymphovascular invasion, extracapsular spread, final histological margin status and postoperative treatment. Details of local, regional or distant recurrence, disease free survival and overall survival were included.ResultsThe majority (65%) of patients presented in early stage, T1 and T2 tumors. 81% of patients were N0. Free surgical margins were achieved in 18% of patients, close in 28% patients and positive surgical margins in 54% (62) patients. Factors that significantly increased the risk of recurrence: T stage (p=0.0006); N-positive status (p<0.0001); advanced stage of the disease (p<0.0001); high grade of tumor (p=0.0007); PNI (p=0.0061); LVI (p=0.0022); ECS (p=0.0136); positive surgical margins (p=0.0022). On multivariate analysis, high grade of tumor and positive surgical margins remained significant independent adverse factors for recurrence formation.ConclusionsThis report shows a single institution results of oncological treatment in patients with malignant salivary gland tumors, where positive surgical margins strongly correlate with patients' worse outcome. Whether to extend the procedure, which very often requires sacrificing the nerve is still a question of debate.



https://ift.tt/2MlUsfE

Infantile Hemangioma Presenting as Colocolic Intussusception in an Infant Case Report with Review of Pathologic Lead Points

Infantile hemangioma (IH) is one of the most common vascular anomalies of early childhood and is usually recognized in the first few weeks to months of life as a solitary cutaneous lesion. This report documents our experience with a GLUT-1 positive IH presenting as the pathologic lead point in a colocolic intussusception in a 10-week-old infant who had no skin lesions. Literature suggests approximately 2% of all children presenting with an intussusception require surgical intervention; however, an IH as the pathologic lead point is unique.

https://ift.tt/2ImhYa8

Needs Assessment for an American College of Surgeons Certificate in Applied Surgical Education Leadership (CASEL)

Publication date: Available online 23 June 2018
Source:Journal of Surgical Education
Author(s): Hilary Sanfey, Kimberly Schenarts, David A. Rogers, Alisa Nagler, Patrice Gabler Blair, Susan Newman, Ajit K. Sachdeva
OBJECTIVESurgeon educators in departments of surgery play key roles in leading and advancing surgical education. Their activities include ensuring sound curricula and evaluation systems, monitoring education resources, overseeing faculty development, and providing mentorship. For more than 25years, the American College of Surgeons (ACS) has offered a comprehensive "Surgeons as Educators" (SAE) course to address fundamental topics in surgical education. This study aims to identify future career needs of SAE graduates to inform the development of an American College of Surgeons Certificate in Applied Surgical Education Leadership program.DESIGNAn IRB exempt, anonymous electronic survey was developed to determine educational roles, career aspirations, and needs of SAE Graduates.SETTING AND PARTICIPANTSParticipants included all 763 1993-2016 SAE graduates.RESULTSOne hundred and thirty-five responses were received from 600 (22.5%) graduates with valid email addresses. Sixty (45%) respondents completed the SAE Course > 5years prior to the study (M5YRS) and 75 (55%) within the last 5years (L5YRS). L5YRS respondents were less likely to be full professors (8% vs. 44%) or to serve as program directors (32% vs. 57%), and more likely to be associate program directors (25% vs. 17%) or clerkship directors (40% vs. 18%). High percentages of both L5YRS and M5YRS reported not pursuing additional educational opportunities post-SAE due to time and fiscal constraints. One-fifth of respondents were unaware of additional opportunities and 19% of M5YRS versus 6% of L5YRS stated that existing programs did not meet their needs. Overall improving skills as educational leaders, developing faculty development programs, and conducting educational research were noted as priorities for future development. Differences were observed between the L5YRS and M5YRS groups. The dominant preferences for course format were full-time face-to-face (41%) or a combination of full-time face-to-face with online modules (24%). The most important considerations in deciding to pursue a certificate course were course content, and interest in advancing career and time constraints.CONCLUSIONSAn SAE graduate survey has confirmed the need for additional formal training in surgical education leadership in order to permit surgeon educators meet the demands of the changing landscape of surgical education. The needs of early career faculty may differ from those of more senior surgeon educators.



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Should adhesive debonding be simulated for intra-radicular post stress analyses?

Publication date: Available online 23 June 2018
Source:Dental Materials
Author(s): Ricardo A. Caldas, Atais Bacchi, Valentim A.R. Barão, Antheunis Versluis
ObjectiveElucidate the influence of debonding on stress distribution and maximum stresses for intra-radicular restorations.MethodsFive intra-radicular restorations were analyzed by finite element analysis (FEA): MP=metallic cast post core; GP=glass fiber post core; PP=pre-fabricated metallic post core; RE=resin endocrowns; CE=single piece ceramic endocrown. Two cervical preparations were considered: no ferule (f0) and 2mm ferule (f1). The simulation was conducted in three steps: (1) intact bonds at all contacts; (2) bond failure between crown and tooth; (3) bond failure among tooth, post and crown interfaces. Contact friction and separation between interfaces was modeled where bond failure occurred. Mohr–Coulomb stress ratios (σMC ratio) and fatigue safety factors (SF) for dentin structure were compared with published strength values, fatigue life, and fracture patterns of teeth with intra-radicular restorations.ResultsThe σMC ratio showed no differences among models at first step. The second step increased σMC ratio at the ferule compared to step 1. At the third step, the σMC ratio and SF for f0 models were highly influenced by post material. CE and RE models had the highest values for σMC ratio and lower SF. MP had the lowest σMC ratio and higher SF. The f1 models showed no relevant differences among them at the third step.SignificanceFEA most closely predicted failure performance of intra-radicular posts when frictional contact was modeled. Results of analyses where all interfaces are assumed to be perfectly bonded should be considered with caution.

Graphical abstract

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Impact of crystallization firing process on the microstructure and flexural strength of zirconia-reinforced lithium silicate glass-ceramics

Publication date: Available online 23 June 2018
Source:Dental Materials
Author(s): Hilton Riquieri, Jaiane Bandoli Monteiro, Diogo Cabecinha Viegas, Tiago Moreira Bastos Campos, Renata Marques de Melo, Guilherme de Siqueira Ferreira Anzaloni Saavedra
ObjectivesThe aim of this study was to characterize the microstructure of two zirconia-reinforced lithium silicate (ZLS) glass-ceramics and evaluate their mechanical properties before and after the crystallization firing process (CFP).MethodsField emission-scanning electron microscope (FE-SEM) and energy-dispersive X-ray spectroscopy (EDS) analyses were performed for microstructural characterization. To evaluate the pattern of crystallization and the molecular composition of ZLS glass-ceramics, was used X-ray diffraction (XRD). Vickers hardness, fracture toughness by the indentation method, and biaxial flexural strength were also measured. One hundred and forty ceramic discs were produced (diameter=12mm; thickness=1.2mm) and allocated among four groups (n=30): Sfir, Sunf-ZLS Vita Suprinity; and Cfir and Cunf-ZLS Celtra Duo; fired and unfired, respectively. Statistical analysis was performed and Weibull failure probabilities were calculated.ResultsCfir showed the highest characteristic strength (251.25MPa) and hardness (693.333±10.85GPa). Conversely, Sunf presented the lowest characteristic strength (106.95MPa) and significantly lowest hardness (597.533±33.97GPa). According to Weibull analysis, Sunf had the highest structural reliability (m=7.07), while Sfir presented the lowest (m=5.38). The CFP was necessary to crystallize zirconia in the partially crystallized ZLS glass-ceramics. Sfir had a lower percentage of crystallized zirconia than did Cfir. Fractographic analyses showed that all failures initiated from an inherent critical defect in Sunf and from processing defects in the remaining groups.SignificanceThe CFP had a direct influence on the flexural strength and microstructural characteristics of both ZLS materials.



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Évaluation de l’IRM cardiaque dans le suivi des patients ayant une hypertension artérielle pulmonaire (EVITA). IRM cardiaque dans le suivi de l’hypertension artérielle pulmonaire

Publication date: Available online 23 June 2018
Source:Revue des Maladies Respiratoires
Author(s): A. Chaouat, A. Cherifi, O. Sitbon, N. Girerd, M. Zysman, M. Faure, D. Mandry, M. Mercy, A. Guillaumot, R. Fay, P.-Y. Marie, F. Chabot
Le suivi hémodynamique dans l'hypertension artérielle pulmonaire (HTAP) est actuellement principalement basé sur les résultats du cathétérisme cardiaque droit (CCD). L'objectif principal de l'étude EVITA est de comparer l'imagerie par résonance magnétique cardiaque (IRMc) au CCD afin d'établir un diagnostic d'état hémodynamique défavorable. Les objectifs secondaires permettront de préciser le rôle de l'IRMc dans une stratégie de suivi. L'ensemble des patients réaliseront lors du diagnostic et du suivi une IRMc et un CCD. Les patients seront suivis et traités selon les recommandations actuelles. Le critère principal d'évaluation sera un état hémodynamique défavorable défini par un index cardiaque<2,5L/min/m² ou une pression auriculaire droite≥8mm Hg par CCD en comparaison à un index cardiaque<2,5L/min/m² ou une fraction d'éjection ventriculaire droite (FEVD)<35 % ou une diminution en valeur absolue de 10 % de la FEVD par rapport à la précédente mesure effectuée par IRMc. Les valeurs exactes de sensibilité, de spécificité et les intervalles de confiance à 95 % seront calculés. Un effectif de 180 patients permettra d'avoir une puissance de 90 % à un risque α de 5 %. Les analyses de Cox univariées et multivariées permettront de répondre aux objectifs secondaires. Nous espérons démontrer que l'IRMc peut en partie se substituer au CCD lors du suivi des patients ayant une HTAP.Haemodynamic follow up in pulmonary arterial hypertension (PAH) is currently based on right heart catheterisation (RHC). The primary objective of the EVITA study is to compare the use of cardiac magnetic resonance imaging (cMRI) with RHC in the identification of an unfavourable hemodynamic status. The secondary objectives are to determine the role of cMRI in the follow up process. Patients will undergo at diagnosis and at follow up visits both RHC and cMRI. Patients will be followed and treated according to the current guidelines. The primary endpoint will be an unfavourable haemodynamic status defined by cardiac index<2.5L/min/m² or a right atrial pressure≥8mm Hg measured with RHC compared with a cardiac index<2.5L/min/m² or right ventricle ejection fraction<35% or an absolute decrease of 10% from the previous measurement with cMRI. Exact values of sensitivity, specificity and 95% confidence intervals will be computed. A population of 180 subjects will have a power of 90% with an α risk of 5%. Univariate and multivariate Cox analysis will allow answering to the secondary objectives. We expect to demonstrate that cMRI could be partly used instead of RHC in the follow up of patients with PAH.



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Trachéobronchopathie ostéochondroplastique : à propos de 3 cas

Publication date: Available online 23 June 2018
Source:Revue des Maladies Respiratoires
Author(s): M. Ferreira, H. Morel, A. Dixmier, F. Arbion, S. Marchand-Adam
IntroductionLa trachéobronchopathie ostéochondroplastique (TOCP) est une pathologie rare de cause inconnue qui affecte l'arbre trachéobronchique. Elle se caractérise par de multiples formations cartilagineuses ou nodules osseux se projetant dans la lumière trachéale ou bronchique proximale. Cette atteinte reste le plus souvent asymptomatique du fait d'une progression lente des nodules. Cependant, peuvent être rapportées une toux chronique, des hémoptysies récidivantes ou des infections respiratoires récurrentes.ObservationsNous rapportons les cas de trois patients atteint de TOCP symptomatique : deux hommes et une femme consultant pour des surinfections bronchiques ou pneumonies avec difficultés d'expectorations (2 cas) ou simplement pour toux chronique (1 cas). Dans les trois cas, le diagnostic était suspecté devant des irrégularités de la paroi trachéale ou bronchique avec des calcifications sur l'imagerie et confirmé par l'endoscopie bronchique avec prélèvements biopsiques. Aucune prise en charge thérapeutique spécifique n'a été initiée chez ces patients en dehors du traitement des complications ou comorbidités associées.ConclusionLa TOCP, pathologie bénigne, peut conduire à une symptomatologie bronchique allant de la simple toux à des obstructions sévères des voies aériennes résultant de sténoses trachéobronchiques. La clé du diagnostic afin d'éviter des examens et biopsies non indispensables serait de savoir évoquer la TOCP sur le scanner ou la fibroscopie bronchique devant des irrégularités de la paroi trachéale ou bronchique avec des calcifications.IntroductionOsteochondroplastic tracheobronchopathy (OCTB) is a rare disorder of unknown cause that affects the tracheobronchial tree. It is characterized by multiple cartilaginous formations or bone nodules projecting into the tracheal or proximal bronchial lumen. It is usually asymptomatic because of the slow progression of the nodules. However, chronic cough, recurrent hemoptysis or recurrent respiratory infections have been reported.ObservationsWe describe the cases of three patients with symptomatic OCTB: two men and one woman consulting for bronchial infections or pneumonia with sputum difficulties (2 cases) or simply for chronic cough (1 case). In all three cases, the diagnosis was suspected because of irregularities of the tracheal or bronchial wall with calcification seen on imaging and confirmed at bronchoscopy with biopsy specimens. No specific therapy was initiated in these patients except for the treatment of associated complications or comorbidities.ConclusionOCTB is a benign pathology which can lead to bronchial symptoms ranging from mild cough to severe airway obstruction due to tracheobronchial stenosis. A key to diagnosis, limiting non-essential examinations and biopsies, is to consider OCTB based on CT scan or bronchoscopy based on irregularities of the tracheal or bronchial wall with calcification.



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Consommation de tabac et usage de cigarette électronique en France

Publication date: Available online 23 June 2018
Source:Revue des Maladies Respiratoires
Author(s): R. Andler, R. Guignard, S. Spilka, O. Le Nézet, A. Pasquereau, J.-B. Richard, V. Nguyen-Thanh
IntroductionL'objectif de cet article est de synthétiser les connaissances concernant la consommation de tabac en France issues d'enquêtes représentatives de la population.État des connaissancesLe tabagisme est très répandu en France puisque plus du quart des 15–75 ans déclare fumer quotidiennement en 2016 (28,7 %). Ce taux est élevé dès 15 ans (14,6 %) et la moitié des adolescents de cet âge ont déjà fumé une cigarette (51,8 %). Depuis les années 1970, les différences de comportement tabagique selon le sexe s'amenuisent. Plus récemment, la prévalence tabagique tend à diminuer parmi les populations les plus favorisées mais à augmenter parmi les populations de plus faible niveau socio-économique. Ces inégalités sociales, de plus en plus marquées, s'observent dès l'initiation au tabagisme, souvent avant 18 ans. Les utilisateurs quotidiens de cigarette électronique représentent 2,5 % des 15–75 ans et sont fumeurs de tabac (58,8 %) ou ex-fumeurs (41,2 %).PerspectivesLa prise en compte des inégalités sociales de santé est un enjeu central dans la lutte contre le tabagisme.ConclusionsIl est primordial d'accentuer les efforts engagés pour faire diminuer la proportion de fumeurs en France. Les enquêtes Baromètre santé et Escapad 2017 permettront d'évaluer si les politiques mises en place en 2016 ont eu un impact sur l'image du tabagisme et sur le niveau de prévalence tabagique.IntroductionThe aim of the article is to present a summary of current knowledge on tobacco smoking in France available through representative population surveys.State of artSmoking is very common in France as more than a quarter (28.7%) of 15–75years old individuals reported daily smoking in 2016. The rate is also high among 15-year-old (14.6%) and half of them (51.8%) have already smoked one cigarette. Since the 1970s, sex differences in smoking behaviour are narrowing. More recently, since 2000, smoking prevalence has tended to decrease among the most advantaged individuals but to increase among less advantaged ones. These social inequalities, which are becoming more and more pronounced, are being observed from smoking initiation, often before the age of 18. Daily users of E-cigarettes represent 2.5% of individuals from 15–75 years in France. They are also tobacco smokers (58.8%) or former smokers (41.2%).PerspectivesTaking social inequalities in health into consideration, notably regarding smoking initiation, is a key challenge in the fight against smoking.ConclusionsIt is essential to strengthen efforts to decrease the rate of smoking in France. The 2017 Health Barometer and Escapad surveys will allow evaluation of the public policies implemented in 2016 and determine whether they have had an impact on the image of smoking and on smoking rates.



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Physiopathologie hémodynamique du ventricule droit

Publication date: Available online 23 June 2018
Source:Revue des Maladies Respiratoires
Author(s): D. Chemla, E. Berthelot, P. Assayag, P. Attal, P. Hervé
Le ventricule droit (VD) joue un rôle majeur dans le maintien d'un débit cardiaque adapté en toutes circonstances et donc dans l'optimisation du rapport ventilation/perfusion. Le VD a une paroi mince et il peut tamponner des variations importantes de retour veineux sans augmentation de la pression auriculaire droite (POD) : le VD est une chambre de capacitance. Au cours de l'éjection, il fournit un travail volumique au sein d'un système à basse pression. La fonction systolique du VD joue un rôle modeste au repos car la contraction ventriculaire gauche et la respiration ont un grand rôle dans la performance cardiaque droite. La fonction systolique du VD devient importante à l'exercice ou face à une augmentation anormale de la pression artérielle pulmonaire. Le VD s'adapte mieux à un changement progressif qu'à un changement aigu de la charge artérielle. La « désadaptation à la postcharge » témoigne d'un couplage VD–artère pulmonaire altéré, impliqué dans la physiopathologie des maladies cardiaques et vasculaires pulmonaires, et dans les effets hémodynamiques délétères de la ventilation mécanique. L'apparition d'une hypertension pulmonaire, puis d'une dysfonction du VD avec inadaptation du débit cardiaque et augmentation de la POD est associée à une majoration de l'atteinte fonctionnelle et à un moins bon pronostic.The right ventricle (RV) plays a key role in the maintenance of an adequate cardiac output whatever the demand, and thus contributes to the optimization of the ventilation/perfusion ratio. The RV has a thin wall and it buffers the physiological increases in systemic venous return without causing a deleterious rise in right atrial pressure (RAP). The RV is coupled to the pulmonary circulation which is a low pressure, low resistance, high compliance system. In the healthy subject at rest, the contribution of the RV to right heart systolic function is surpassed by the contribution of both left ventricular contraction and the respiratory pump. RV systolic function plays a contributory role during exercise and in patients with pulmonary hypertension. The RV compensates better for volume overload than for pressure overload and is more capable of sustaining chronic increases in load than acute ones. An impaired RV–pulmonary artery coupling leads to a major mismatch between RV function and arterial load ("afterload mismatch") and is associated progressively with a low cardiac output and a high RAP. Right ventricular dysfunction is involved in the pathophysiology of both cardiovascular and pulmonary diseases, and may partly explain the deleterious haemodynamic consequences of mechanical ventilation.



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Illuminating GPCR Signaling by Cryo-EM

Publication date: Available online 23 June 2018
Source:Trends in Cell Biology
Author(s): Haaris Ahsan Safdari, Shubhi Pandey, Arun K. Shukla, Somnath Dutta
The wave of resolution revolution in cryo-EM has touched, and made a significant impact on, the structural biology of GPCRs. High-resolution structures of several GPCR-G-protein complexes are now determined by cryo-EM and they illuminate fine structural details of this central macromolecular complex involved in cellular signaling.



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Yeast and Human Nuclear Pore Complexes: Not So Similar After All

Publication date: Available online 22 June 2018
Source:Trends in Cell Biology
Author(s): Yaron Shav-Tal, Timir Tripathi
Nucleoporin subunits that generate the nuclear pore complex (NPC) are highly conserved in evolution. High-resolution structures of the NPC are available, but the actual NPC composition in yeast has only been quantified recently. Two studies reveal major differences between species, suggesting high flexibility in NPC structures during evolution.



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Towards Intelligent Robust Detection of Anatomical Structures in Incomplete Volumetric Data

Publication date: Available online 23 June 2018
Source:Medical Image Analysis
Author(s): Florin C. Ghesu, Bogdan Georgescu, Sasa Grbic, Andreas Maier, Joachim Hornegger, Dorin Comaniciu
Robust and fast detection of anatomical structures represents an important component of medical image analysis technologies. Current solutions for anatomy detection are based on machine learning, and are generally driven by suboptimal and exhaustive search strategies. In particular, these techniques do not effectively address cases of incomplete data, i.e., scans acquired with a partial field-of-view. We address these challenges by following a new paradigm, which reformulates the detection task to teaching an intelligent artificial agent how to actively search for an anatomical structure. Using the principles of deep reinforcement learning with multi-scale image analysis, artificial agents are taught optimal navigation paths in the scale-space representation of an image, while accounting for structures that are missing from the field-of-view. The spatial coherence of the observed anatomical landmarks is ensured using elements from statistical shape modeling and robust estimation theory. Experiments show that our solution outperforms marginal space deep learning, a powerful deep learning method, at detecting different anatomical structures without any failure. The dataset contains 5043 3D-CT volumes from over 2000 patients, totaling over 2,500,000 image slices. In particular, our solution achieves 0% false-positive and 0% false-negative rates at detecting whether the landmarks are captured in the field-of-view of the scan (excluding all border cases), with an average detection accuracy of 2.78 millimeters. In terms of runtime, we reduce the detection-time of the marginal space deep learning method by 20-30 times to under 40 milliseconds, an unmatched performance for high resolution incomplete 3D-CT data.

Graphical abstract

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Can we spread the risk? A demand-share perspective to sustained hamstring health

Publication date: Available online 23 June 2018
Source:Journal of Bodywork and Movement Therapies
Author(s): Lincoln Blandford, Warrick McNeill, Ingrid Charvet




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Efficient decellularization of rabbit trachea to generate a tissue engineering scaffold biomatrix

Publication date: September 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 112
Author(s): Paul Hong, Michael Bezuhly, M. Elise Graham, Paul F. Gratzer
ObjectivesMost tracheal decellularization protocols are lengthy and can lead to reduced biomechanical stability. The objectives of this study were: 1) to generate a tracheal extracellular matrix scaffold using an efficient decellularization process and 2) to characterize the decellularized scaffold to assess its suitability for tissue engineering applications.MethodsTwelve rabbit tracheae underwent a decellularization process that involved enzymatic-detergent treatments. For characterization, fresh (control) and decellularized tissues underwent histological, immunohistochemical, and biochemical analyses. Tensile testing, scanning electron microscopy, and biocompatibility assay were also conducted.ResultsPost-decellularization, the tracheal tissue had significantly less genetic material while the structural integrity was maintained. Specifically, the deoxyribonucleic acid content was significantly reduced and the glycosaminoglycan content was unchanged. Cell and cellular components were largely removed; at the same time the tensile properties and surface ultrastructural characteristics were unaltered. Biocompatibility was confirmed by contact cytotoxicity assay.ConclusionsOverall, an efficient decellularization process was used to treat rabbit tracheal tissue. The effectiveness of the decellularization process was demonstrated and at the same time there was preservation of the underlying extracellular matrix structure. This decellularized material may serve as a potential scaffold for tracheal tissue engineering.



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Monitoring metal pollution in soils using portable-XRF and conventional laboratory-based techniques: Evaluation of the performance and limitations according to metal properties and sources

Publication date: 1 December 2018
Source:Science of The Total Environment, Volume 643
Author(s): Antonio G. Caporale, Paola Adamo, Fiore Capozzi, Giuliano Langella, Fabio Terribile, Simona Vingiani
Large variability in the spatial distribution and content of metals is generally recognised in anthropogenically-polluted soils, hence, a detailed site investigation implying the collection and analysis of a large number of soil samples is often necessary. To this regard, the selection of a rapid, cost-effective and accurate analytical technique to assess the concentration of metals in soil is of paramount importance. The overall objective of this work was to evaluate the possibility of assessing the aqua regia-extractable (AR) content of metals in soil from the multi-element profile of the soil obtained by a portable X-ray fluorescence analyser (pXRF). To this objective, we attempted: (i) to establish, by simple linear regressions, the relations occurring between the metal contents measured by pXRF and AR in laboratory setting on air-dried and 2 mm-sieved soil samples from two case studies (A-agricultural and B-industrial sites); (ii) to define metal-based linear models predicting metal AR contents from pXRF measurements; (iii) to assess the influence of metal properties and sources on relations found between the two analytical methods. Very satisfying correlations (R² > 0.90) were observed between the AR and pXRF contents of Ca, Cu, Cr, Ni, Pb and Zn in the site A, and of Cd, Cu, Pb and Zn in the site B. For the majority of metals, lower AR than pXRF contents were measured, as result of the AR incomplete dissolution of metal-bearing silicates. This was not observed when metals - of anthropogenic origin - occurred in soil in very high concentrations (i.e., Cr for A and Pb for B). In both sites, the comparison among different regression parameters revealed a strong metal-dependence. Moreover, for most of the metals, the parameters of each metal-regression line significantly differed between the two case studies, indicating site-dependence of regression fits.

Graphical abstract

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Quantification of the relationship between multiple metal(loid) distribution and integrated effect of internal-external factors in riverbed sediments across Xijiang River basin, South China

Publication date: 1 December 2018
Source:Science of The Total Environment, Volume 643
Author(s): Xuan Ru, Jianbo Liao, Likun Liang, Zewei Wen, Jingyue Wei, Chaohai Wei, Fusheng Li
Understanding the integrated effect of external factors (e.g., human activities) and internal factors (e.g., hydrodynamics, sediment properties) on metal(loid) distributions is necessary for relevant decision-makers to develop river basin management strategies. In attempts to understand the possible causes of the distribution of nine target metal(loid)s in riverbed sediments across Xijiang River basin in China, we grouped and portrayed the multiple metal(loid) distributions by calculating metal(loid)'s normalised-and-weighted average concentrations, and then canonical correlation analysis combined with a series of statistical operations, collectively called optimized CCA analysis, was applied to quantify the strength of relationship between multiple metal(loid) distribution and integrated effect of internal-external factors. Results showed that the target metal(loid)s can be divided into three groups according to their distribution patterns: Group A (including Zn, As, Cd, Sb and Pb), Group B (including Cr, Ni and Cu) and Group C (including Tl). Among them, metal(loid)s in Group A was significantly enriched in comparison with the reference values of Chinese sediments, and the wide-ranging accumulation of Cd and Sb in the whole study area needs paying great attention to. For those metals in natural states (e.g., metals in Group B), the affinity of sediment (e.g., Fe and Mn oxides) is responsible for their distributions. By contrast, when metal(loid)s (e.g., metal(loid)s in Group A and Group C) had obvious anthropogenic sources, the interferences of anthropogenic inputs (e.g., non-ferrous metal enterprises' waste-discharging activities) and the specific sedimentary characteristics (e.g. karst topography and low-energy hydrodynamic depositional conditions) in study area can weaken the correlation between the binding affinity of sediment and the contents of metal(loid)s. The optimized CCA analysis can be an alternative and advantageous statistical operation for determining the main types of causes of multiple metal(loid) distribution in the case of observations with relatively low case-per-variable ratios.

Graphical abstract

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Intrinsically disordered N-terminal domain of the Helicoverpa armigera Ultraspiracle stabilizes the dimeric form via a scorpion-like structure

Publication date: Available online 23 June 2018
Source:The Journal of Steroid Biochemistry and Molecular Biology
Author(s): Krzysztof Wycisk, Aneta Tarczewska, Magdalena Kaus-Drobek, Michał Dadlez, Rafał Hołubowicz, Zbigniew Pietras, Andrzej Dziembowski, Michał Taube, Maciej Kozak, Marek Orłowski, Andrzej Ożyhar
Nuclear receptors (NRs) are a family of ligand-dependent transcription factors activated by lipophilic compounds. NRs share a common structure comprising three domains: a variable N-terminal domain (NTD), a highly conserved globular DNA-binding domain and a ligand-binding domain. There are numerous papers describing the molecular details of the latter two globular domains. However, very little is known about the structure-function relationship of the NTD, especially as an intrinsically disordered fragment of NRs that may influence the molecular properties and, in turn, the function of globular domains. Here, we investigated whether and how an intrinsically disordered NTD consisting of 58 amino acid residues affects the functions of the globular domains of the Ultraspiracle protein from Helicoverpa armigera (HaUsp). The role of the NTD was examined for two well-known and easily testable NR functions, i.e., interactions with specific DNA sequences and dimerization. Electrophoretic mobility shift assays showed that the intrinsically disordered NTD influences the interaction of HaUsp with specific DNA sequences, apparently by destabilization of HaUsp-DNA complexes. On the other hand, multi-angle light scattering and sedimentation velocity analytical ultracentrifugation revealed that the NTD acts as a structural element that stabilizes HaUsp homodimers. Molecular models based on small-angle X-ray scattering indicate that the intrinsically disordered NTD may exert its effects on the tested HaUsp functions by forming an unexpected scorpion-like structure, in which the NTD bends towards the ligand-binding domain in each subunit of the HaUsp homodimer. This structure may be crucial for specific NTD-dependent regulation of the functions of globular domains in NRs.



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Median preoptic nucleus excitatory neurotransmitters in the maintenance of hypertensive state

Publication date: Available online 23 June 2018
Source:Brain Research Bulletin
Author(s): Aline A. Mourão, Aryanne B. Soares de Mello, Marina C. Dos Santos Moreira, Karla L. Rodrigues, Carlos H. Xavier, Rodrigo M. Gomes, André H. Freiria-Oliveira, Graziela T. Blanch, Gustavo R. Pedrino
The crucial role of the median preoptic nucleus (MnPO) in the maintenance of hydroelectrolytic balance and autonomic regulation have been highlighted. Recently, the participation of the MnPO in the control of sympathetic nerve activity was demonstrated in essential hypertension model. However, peculiarities on the neurochemical changes underlying the differential role of MnPO during hypertension remain to be clarified. Therefore, this study aimed to investigate the main excitatory pathways that modulate MnPO neurons in hypertensive rats. Spontaneously hypertensive rats (SHR) and rats submitted previously to the Goldblatt protocol (two kidneys; one clip; 2K1C) were used. Rats of both groups (250 to 350 g, n = 6) were anesthetized with urethane (1.2 g/kg,i.v.) and instrumented to record mean arterial pressure (MAP), heart rate (HR) and renal sympathetic nerve activity (RSNA). Nanoinjection (100 nl) of saline (NaCl, 150 mM), losartan (AT1 receptor antagonist; 10 mM) and kynurenic acid (glutamate receptor antagonist; 50 mM) into the MnPO were performed. In 2K1C rats, glutamatergic blockade promoted decreases in MAP and RSNA (-19.1 ± 0.9 mmHg, -21.6 ± 2.8%, p < 0.05) when compared to saline (-0.4 ± 0.6 mmHg, 0.2 ± 0.7%, p < 0.05). Angiotensinergic inhibition also reduced these parameters (-11.5 ± 1.2 mmHg, -10.5 ± 1.0%, p < 0.05) in 2K1C. In SHR, Kynurenic acid nanoinjections produced hypotension and sympathoinhibition (-21.0 ± 2.5 mmHg, -24.7 ± 2.4%, p < 0.05), as well losartan nanoinjections (-9.7 ± 1.2 mmHg; p < 0.05) and RSNA (-12.0 ± 2.4%, p < 0.05). These findings support the conclusion that a tonic excitatory neurotransmission exerted by angiotensin II, and mostly by glutamate in the MnPO could participate in the modulation of blood pressure and RSNA that independent on whether hypertension is primarily neurogenic or is secondary to stenosis in renal artery.



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CONCURRENT EXPOSURE TO HEAVY METALS AND COGNITION IN SCHOOL-AGE CHILDREN IN CONGO-KINSHASA: A COMPLEX OVERDUE RESEARCH AGENDA

Publication date: Available online 23 June 2018
Source:Brain Research Bulletin
Author(s): Béatrice Koba Bora, Ana Luiza Ramos-Crawford, Alla Sikorskii, Michael Joseph Boivin, Didier Malamba Lez, Dieudonné Mumba Ngoyi, Abdon Mukalay Wa Mukalay, Daniel Okitundu Luwa, Desiré Tshala-Katumbay
The impact of concurrent exposure to neurotoxic metals is a significant threat to brain function, mostly in contexts of multiple exposures as seen in the developing world. Ninety-five children (46 boys and 49 girls, 6 to 11-year old) from Congo-Kinshasa were assessed for cognition using the Kaufman Assessment Battery for Children (2nd edition) and exposure to Cr, Cu, Zn, Co, Mn, As, Cd, Se, Hg, Fe, and Pb by inductively coupled plasma mass spectrometry (ICPMS) in serum and urine collections. Concentrations of elements were all above normal ranges except for Cd, Se and Hg. General linear mixed effects models were used to predict neurocognitive outcomes with variable selection methods including backward elimination, elastic net, or subsets identified based on subject matter expertise. After adjusting for sex, age, and SES, urinary Co > 5 µg/l was associated with poor simultaneous processing (memory)(p = 0.0237). Higher excretion but normal concentration of Cd in serum was associated with better memory (p = 0.03), planning (p = 0.05), and overall performance scores (p < 0.01); thus appeared to be neuroprotective. However, higher excretion of Zn had negative influence on the overall performance scores (p = 0.02). Predictive neurotoxicology is a challenging task in contexts of multiple and concurrent exposures. Urinary Co > 5 µg/l is a risk factor for poor neurodevelopmental outcomes in such contexts. The impact of heavy metals on cognition is dependent on concentrations of and interactions between toxic and essential elements.



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Antifungal Photodynamic Inactivation against Dermatophyte Trichophyton rubrum Using Nanoparticle-Based Hybrid Photosensitizers

Publication date: Available online 23 June 2018
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Niranga Wijesiri, Zhao Yu, Hong Tang, Peng Zhang
Trichophyton rubrum is one of the most common dermatophytes, which can cause fungal nail and ringworm infections. Infections associated with T. rubrum have become a global phenomenon. Herein, we report the antifungal photodynamic inactivation of T. rubrum (ATCC 28188) using the mesoporous silica-coated silver nanoparticle-based hybrid photosensitizers without involving antifungal drugs. Results show that the hybrid photosensitizers display low cytotoxicity under the experimental conditions where significant killing (~3 orders of magnitude) against T. rubrum is observed. These results demonstrate the potential applications of the nanoparticle-based hybrid photosensitizers in antifungal photodynamic therapy against T. rubrum.



https://ift.tt/2MV0BAM

Erratum to “Severe Drug-Induced Agranulocytosis Successfully Treated with Recombinant Human Granulocyte Colony-Stimulating Factor”

https://ift.tt/2MlzrSB

Can MRI-only replace MRI-CT planning with a titanium tandem and ovoid applicator?

Publication date: Available online 23 June 2018
Source:Brachytherapy
Author(s): Matthew M. Harkenrider, Rakesh Patel, Murat Surucu, Bonnie Chinsky, Michael L. Mysz, Abbie Wood, Kelly Ryan, Steven M. Shea, William Small, John C. Roeske
Purpose/Objective(s)To evaluate dosimetric differences between MRI-only and MRI-CT planning with a titanium tandem and ovoid applicator to determine if all imaging and planning goals can be achieved with MRI only.Materials/MethodsWe evaluated 10 patients who underwent MRI-CT-based cervical brachytherapy with a titanium tandem and ovoid applicator. High-risk clinical target volume and organs at risk were contoured on the 3D T2 MRI, which were transferred to the co-registered CT, where the applicator was identified. Retrospectively, three planners independently delineated the applicator on the axial 3D T2 MRI while blinded to the CT. Identical dwell position times in the delivered plan were loaded. Dose-volume histogram parameters were compared to the previously delivered MRI-CT plan.ResultsThere were no significant differences in dose to D90 or D98 of the high-risk clinical target volume with MRI vs. MRI-CT planning. MRI vs. MRI-CT planning resulted in mean D0.1cc bladder of 8.8 ± 3.4 Gy vs. 8.5 ± 3.2 Gy (p = 0.29) and D2cc bladder of 6.2 ± 1.4 Gy vs. 6.0 ± 1.4 Gy (p = 0.33), respectively. Mean D0.1cc rectum was 5.7 ± 1.2 Gy vs. 5.3 ± 1.2 Gy (p = 0.03) and D2cc rectum 4.0 ± 0.8 Gy vs. 4.2 ± 1.0 Gy (p = 0.18), respectively. Mean D0.1cc sigmoid was 5.2 ± 1.3 Gy vs. 5.4 ± 1.6 Gy (p = 0.23) and D2cc sigmoid 3.9 ± 1.0 Gy vs. 4.0 ± 1.1 Gy (p = 0.18), respectively.ConclusionThere were no clinically significant dosimetric differences between the MRI and MRI-CT plans. This study demonstrates that cervical brachytherapy with a titanium applicator can be planned with MRI alone, which is now our clinical standard.



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A global Unified Dosimetry Index (gUDI) to evaluate simultaneous integrated boost radiotherapy plans in prostate cancer

Publication date: Available online 23 June 2018
Source:Radiotherapy and Oncology
Author(s): Maddalena Mambretti, Chiara Romanò, Giulia Marvaso, Stefania Comi, Raffaella Cambria, Delia Ciardo, Francesca Emiro, Cristiana Fodor, Dario Zerini, Giulia Riva, Giuseppe Petralia, Ottavio De Cobelli, R. Orecchia, Federica Cattani, Barbara Alicja Jereczek-Fossa
PurposeFormulation of a global Unified Dosimetry Index (gUDI) for the evaluation of prostate simultaneous integrated boost Volumetric Modulated Arc Therapy (VMAT by RapidArc) radiotherapy plans.Methods and materialsDose coverage, conformity, homogeneity and dose gradient index could be included in the Unified Dosimetry Index (UDI). We developed a global UDI to evaluate treatment plans containing volumes irradiated with different dose prescriptions: Intensity Modulated Radiation Therapy with simultaneous integrated boost (IMRT-SIB) with 2 dose levels (36.25 Gy/5 fz for the whole prostate gland and 37.5 Gy/5 fz for Dominant Intraprostatic Lesion (DIL)).To validate gUDI scoring system, 65 prostate cancer patients were evaluated. Mean (µ) and standard deviations (σ) were calculated for all dosimetry indices and gUDI. Furthermore, gUDI µ and σ were analyzed to compare and classify treatment plans: plans can be ranked as "excellent", "good", "average" or "poor".ResultsProstate Dose Gradient, Prostate Conformity and DIL Conformity indices had highlighted a major deviation from ideal scores. gUDI index classification showed most of the plans scored as "average" and "good".ConclusiongUDI score can be a useful tool to quantify treatment plans quality also when volumes with different dose-prescription are treated.



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Validation and assessment of discordance of the 8th edition AJCC (American Joint Committee on Cancer) clinical and pathologic staging systems in patients with p16+ oropharyngeal cancer treated with surgery and adjuvant radiation at a single institution

Publication date: August 2018
Source:Oral Oncology, Volume 83
Author(s): Piyush Gupta, Jocelyn C. Migliacci, Ashley Hay, Matthew Rosenthal, Ximena Mimica, Nancy Lee, Richard J. Wong, Jatin Shah, Snehal Patel, Ian Ganly




https://ift.tt/2yAwc7R

Signification of protein p-53 isoforms and immune therapeutic success in chronic lymphocytic leukemia

Publication date: October 2018
Source:Biomedicine & Pharmacotherapy, Volume 106
Author(s): Aurelian Udristioiu, Delia Nica-Badea
In the past few years has used thetechnique for analyzing deletions of genes, its rearrangements, cross-reactivity or multiplications in human genome affected of genetic diseases. Was proved that, the best techniques in the investigation of malignant lymphocytes are the Flow Cytometry, Elisa, ICT and Fluorescence in situ hybridization (FISH). Last method, FISH is used as an alternative to chromosomal banding, a conventional application in molecular medicine and can detect the chromosomal rearrangements and complexes of different genes in malignant diseases, like chronic lymphocytic leukemia (CLL), acute lymphocytic leukemia, (ALL), or multiple myeloma (MM). Identification of P53 gene deletions and mutations in regions of chromosome 17 in hematological malignancies is important because these mutations have an impact on the clinical management of patients.

Graphical abstract

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The down-regulation of microRNA-137 contributes to the up-regulation of retinoblastoma cell proliferation and invasion by regulating COX-2/PGE2 signaling

Publication date: October 2018
Source:Biomedicine & Pharmacotherapy, Volume 106
Author(s): Jian Zhang, Jing He, Le Zhang
MicroRNA-137 (miR-137) plays an important role in the development and progression of many types of human cancers; however, the role of miR-137 in retinoblastoma (RB) remains unclear. In this study, we aimed to investigate the functional significance and molecular mechanisms of miR-137 in RB. We reported that miR-137 was frequently down-regulated in RB tissues and cell lines. The overexpression of miR-137 inhibited RB cell proliferation and invasion, while the suppression of miR-137 promoted RB cell proliferation and invasion. Bioinformatic analysis predicted that cyclooxygenase-2 (COX-2) was a potential target gene of miR-137, which was validated by a dual-luciferase reporter assay. Moreover, our results showed that miR-137 negatively regulated the expression of COX-2 and the production of prostaglandin E2 (PGE2) in RB cells. The knockdown of COX-2 suppressed the proliferation and invasion of RB cells as well as the production of PGE2. The overexpression of COX-2 significantly reversed the inhibitory effect of miR-137 overexpression on RB cell proliferation and invasion. Taken together, these results suggest that miR-137 suppresses the proliferation and invasion of RB cells by targeting COX-2/PGE2. Our study reveals a tumor suppressive role of miR-137 in the progression of RB and suggests miR-137 as a potentially effective therapeutic target for the treatment of RB.

Graphical abstract

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Antitumor and immune-modulatory efficacy of dual-treatment based on levamisole and/or taurine in Ehrlich ascites carcinoma-bearing mice

Publication date: October 2018
Source:Biomedicine & Pharmacotherapy, Volume 106
Author(s): Hany M. Ibrahim, Faten R. Abdel Ghaffar, Ibrahim A. El-Elaimy, Mona S. Gouida, Heba M. Abd El latif
Many alternative and complementary therapies for cancer have been reported. The objective of the present work is to examine antitumor and immune-modulatory properties of dual-treatment based on levamisole (Lms) and/or taurine (Tau) in Ehrlich ascites carcinoma-bearing mice. In the current study, Lms (10 mg/kg; subcutaneously) and Tau (640 mg/kg; intragastrically) was administered alone or as a dual-treatment. Lms or Tau was administered in combination with cyclophosphamide (CTX) (100 mg/kg; intraperitoneal) in mice bearing Ehrlich ascites carcinoma. Treatment with CTX or (Lms plus Tau) significantly reduced the ascitic tumor cell count, percentage of tumor cell viability while elevated the tumor inhibition rate and apoptosis percentage compared to non-treated animals. Dual-treatment (Lms and CTX) or (Tau and CTX) significantly potentiated the reduction of the ascitic tumor cell count, viability and augmented the tumor inhibition rate and apoptosis percentage compared to CTX-treated mice. Dual-treatment of (Lms plus Tau), (Lms plus CTX) or (Tau plus CTX) altered splenocytes immunological profile of CD3⁺CD4⁺, CD3⁺CD8⁺, CD4⁺CD25⁺ and CD11b⁺Ly6G⁺ cells in order to achieve better immune surveillance against tumor cells. In conclusion, dual-treatments based on Lms and/or Tau are promising therapies for cancer, not only due to its abilities to induce apoptosis in the tumor cells and modulate the immune response against them, but also due to its capabilities to potentiate the chemotherapy anticancer efficacy and minimize its adverse effects.

Graphical abstract

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The intervention effect of zuogui pill on chronic kidney disease-mineral and bone disorder regulatory factor

Publication date: October 2018
Source:Biomedicine & Pharmacotherapy, Volume 106
Author(s): Xiaohong Ma, Liqun He
Chronic kidney disease-mineral and bone disorder (CKD-MBD) play a critical role in the pathogenesis of cardiovascular complications in patients with chronic kidney disease (CKD). Zuogui pill as a traditional Chinese herbal drug has been used for nourish kidney essence improve bone malnutrition of renal bone disease by regulating the metabolism of calcium and phosphorus and participating in osteoblast metabolism. In the present study, 5/6 nephrectomy rat model was used to reveal the mechanism of zuogui pill in treatment of CKD-MBD. Compared with sham rats, the levels of serum phosphorus, PTH, iPTH and creatinine were significantly decreased, while the serum calcium level was significantly increased, and the Cbfa1 protein level was significantly decreased and FGF23 protein level was significantly increased by Zuogui pill treatment. Compared with model rats, the BMD of rat was significantly increased by Zuogui pill treatment. Histological analysis revealed that the kidney injury of rats with CKD was significantly reduced by zuogui pill treatment. Compared with model rats, the CYP27B1 mRNA level was significantly increased, and the PTH mRNA level and NaPiIIa protein level were significantly decreased in the kidney by zuogui pill treatment. We inferred that zuogui pill exhibited potential therapeutic effects on CKD-MBD in the rats by regulating bone metabolism and nourish kidney.

Graphical abstract

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Material distributions and functional structures in probiotic microcapsules

Publication date: 15 September 2018
Source:European Journal of Pharmaceutical Sciences, Volume 122
Author(s): Li Wu, Wei Qin, Yuanzhi He, Weifeng Zhu, Xiaohong Ren, Peter York, Tiqiao Xiao, Xianzhen Yin, Jiwen Zhang
Smart microstructure design of dosage forms such as microcapsules that protect the microorganism, can improve probiotics survival from gastric pH challenges and prolong their shelf life. In this study, synchrotron radiation X-ray microcomputed tomography (SR-μCT) was applied to quantitatively reveal the material distributions and functional structures of bifidobacterium and lactobacillus microcapsules. The shell layer, middle protective layer, and the microorganisms as particles in the center layer were extracted and visualized. All the microorganisms were encapsulated by the shell completely, which prevents them from being destroyed by external environments. However, the non-uniform thickness of the shell and typical defects in the microcapsules were observed. The quantitative analysis and characterization of internal microstructures provide evidence of the need for further improvement in formulations and processing technologies for the structured system to deliver living microorganisms.

Graphical abstract

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Nasal vaccination with pneumococcal surface protein A in combination with cationic liposomes consisting of DOTAP and DC-chol confers antigen-mediated protective immunity against Streptococcus pneumoniae infections in mice

Publication date: August 2018
Source:International Immunopharmacology, Volume 61
Author(s): Rui Tada, Hidehiko Suzuki, Saeko Takahashi, Yoichi Negishi, Hiroshi Kiyono, Jun Kunisawa, Yukihiko Aramaki
Infectious diseases are the second leading cause of death worldwide, suggesting that there is still a need for the development of new and improved strategies for combating pathogens effectively. Streptococcus pneumoniae is the most virulent bacteria causing pneumonia with high mortality, especially in children and the elderly. Because of the emergence of antibiotic resistance in S. pneumoniae, employing a serotype-independent mucosal vaccine would be the best approach to prevent and treat the diseases caused by S. pneumoniae. In this study, we have developed a pneumococcal nasal vaccine, consisting of pneumococcal surface protein A (PspA) and cationic liposomes composed of 1,2-dioleoyl-3-trimethylammonium-propane (DOTAP) and cholesteryl 3β-N-(dimethylaminoethyl)­carbamate (DC-chol) (DOTAP/DC-chol liposome). The efficiency of this cationic liposome-based PspA nasal vaccine was examined in a murine model of S. pneumoniae infection. Intranasal vaccination with PspA and DOTAP/DC-chol liposomes conferred protective immunity against lethal inhalation of S. pneumoniae, improving the survival rate of infected mice. Moreover, intranasal immunization with PspA and DOTAP/DC-chol liposomes not only induced the production of PspA-specific IgA and IgG by both mucosal and systemic compartments but also elicited PspA-specific Th17 responses, which play a pivotal role in controlling S. pneumoniae infection by host innate immune response. We further demonstrated that DOTAP/DC-chol liposomes enhanced PspA uptake by nasal dendritic cells (DCs), which might be a mechanism for the induction of protective immune responses to S. pneumoniae infection. These results show that DOTAP/DC-chol liposome would be an efficient mucosal vaccine system for a serotype-independent universal nasal vaccine against pneumococcal infection.

Graphical abstract

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A Case of Sirenomelia Associated with Hypoplastic Left Heart with a Healthy Co-Twin: A Rare Entity

Sirenomelia is a rare developmental malformation and is incompatible to life. The incidence of sirenomelia, as recorded in the literature, is estimated to be approximately between 1.5 and 4.2 per 1,00,000 births. Around 15% of sirenomelia cases are associated with twin pregnancy, most often in monozygotic cases with an incidence of 7%. In monozygotic twins, the risk of sirenomelia is nearly 100–150 times higher as compared to dizygotic twins or singleton pregnancies. Until now, only two cases of sirenomelia associated with hypoplastic left heart have been reported in the literature. Here, we present a monozygotic twin pregnancy, where one fetus was diagnosed with sirenomelia associated with hypoplastic left heart syndrome and the co-twin was absolutely healthy.

https://ift.tt/2K2wYQ4

Successful Treatment of Severe Atopic Dermatitis with Calcitriol and Paricalcitol in an 8-Year-Old Girl

Atopic dermatitis (AD) is a chronic inflammatory disease affecting children and adolescence. The traditional therapeutic options for AD, including emollients topically and immune modulatory agents systemically focusing on reducing skin inflammation and restoring the function of the epidermal barrier, are proven ineffective in many cases. Several studies have linked vitamin D supplementation with either a decreased risk to develop AD or a clinical improvement of the symptoms of AD patients. In this report, we present a girl with severe AD who under adequate supplementation with cholecalciferol was treated with calcitriol and subsequently with paricalcitol. She had significant improvement—almost healing of her skin lesions within 2 months, a result sustained for more than 3 years now. Because of hypercalciuria as a side effect from calcitriol therapy, treatment was continued with paricalcitol, a vitamin D analogue used in secondary hyperparathyroidism in chronic kidney disease. Calcitriol therapy may be considered as a safe and efficacious treatment option for patients with severe AD, particularly for those with refractory AD, under monitoring for possible side effects. Treatment with paricalcitol resolves hypercalciuria, is safe, and should be further investigated as an alternative treatment of atopic dermatitis and possibly other diseases of autoimmune origin.

https://ift.tt/2ImoU7k

X-Linked Chronic Granulomatous Disease: Initial Presentation with Intracranial Hemorrhage from Vitamin K Deficiency in Infant

Vitamin K deficiency bleeding (VKDB) is a life-threatening condition and can be found in children as early as neonatal period with early onset intracranial hemorrhage (ICH). Here, we reported a 1-year-old boy who initially presented with intracranial hemorrhage secondary to vitamin K deficiency since 3 months of age and later found to have XL-CGD which was complicated by malabsorption due to severe vaccine-associated mycobacterial disease.

https://ift.tt/2K6tqwn

Mechanically cartilage-mimicking poly(PCL-PTHF urethane)/collagen nanofibers induce chondrogenesis by blocking NF–kappa B signaling pathway

Publication date: September 2018
Source:Biomaterials, Volume 178
Author(s): Tongmeng Jiang, Dan Kai, Sijia Liu, Xianyuan Huang, Shujun Heng, Jinmin Zhao, Benjamin Qi Yu Chan, Xian Jun Loh, Ye Zhu, Chuanbin Mao, Li Zheng
Cartilage cannot self-repair and thus regeneration is a promising approach to its repair. Here we developed new electrospun nanofibers, made of poly (ε-caprolactone)/polytetrahydrofuran (PCL-PTHF urethane) and collagen I from calf skin (termed PC), to trigger the chondrogenic differentiation of mesenchymal stem cells (MSCs) and the cartilage regeneration in vivo. We found that the PC nanofibers had a modulus (4.3 Mpa) lower than the PCL-PTHF urethane nanofibers without collagen I from calf skin (termed P) (6.8 Mpa) although both values are within the range of the modulus of natural cartilage (1–10 MPa). Both P and PC nanofibers did not show obvious difference in the morphology and size. Surprisingly, in the absence of the additional chondrogenesis inducers, the softer PC nanofibers could induce the chondrogenic differentiation in vitro and cartilage regeneration in vivo more efficiently than the stiffer P nanofibers. Using mRNA-sequence analysis, we found that the PC nanofibers outperformed P nanofibers in inducing chondrogenesis by specifically blocking the NF–kappa B signaling pathway to suppress inflammation. Our work shows that the PC nanofibers can serve as building blocks of new scaffolds for cartilage regeneration and provides new insights on the effect of the mechanical properties of the nanofibers on the cartilage regeneration.



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Poly(2-oxazoline)s based biomaterials: A comprehensive and critical update

Publication date: September 2018
Source:Biomaterials, Volume 178
Author(s): Thomas Lorson, Michael M. Lübtow, Erik Wegener, Malik S. Haider, Solomiia Borova, Daniel Nahm, Rainer Jordan, Marina Sokolski-Papkov, Alexander V. Kabanov, Robert Luxenhofer
Poly(2-oxazoline)s have been investigated for decades as biomaterials. Pioneering early work suggested that hydrophilic poly(2-oxazoline)s are comparable to poly(ethylene glycol) regarding their potential as biomaterials, but the ready commercial availability of the latter has led to its meteoric rise to become the gold standard of hydrophilic synthetic biomaterials. In contrast, poly(2-oxazoline)s almost fell into oblivion. However, in the last decade, this family of polymers has gained much more interest in general and as biomaterials in particular. The rich chemistry and comparably straightforward synthesis of poly(2-oxazoline)s gives many opportunities for tailoring the properties of the resulting biomaterials, allowing the chemist to explore new conjugation chemistry, and to fine-tune the molar mass, hydrophilic-lipophilic balance as well as architecture. Thus, the wide range of demands for various applications of biomaterials can be suitably addressed.This review aims to give a comprehensive and critical update of the development of poly(2-oxazoline) based biomaterials, focusing on the last 5 years, which have seen an explosive increase of interest. We believe that the research regarding this diverse family of polymers will remain strong and will keep growing, in particular after the promising first-in-human studies of a poly(2-oxazoline) drug conjugate. This review aims at researchers and students new to this polymer family and seasoned poly(2-oxazoline) experts alike and attempts to showcase how the chemical diversity of poly(2-oxazoline)s allows a relatively facile and broad access to biomaterials of all kinds.



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Practice Roles and Characteristics of Integrative and Functional Nutrition Registered Dietitian Nutritionists

Publication date: Available online 23 June 2018
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Emily M. Goodman, Jessica Redmond, Dana Elia, Stephanie R. Harris, Mary Beth Augustine, Rosa K. Hand




https://ift.tt/2MUgqb4

A Cluster-Randomized Trial of a Mobile Produce Market Program in 12 Communities in North Carolina: Program Development, Methods, and Baseline Characteristics

Publication date: Available online 23 June 2018
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Lucia A. Leone, Gina L. Tripicchio, Lindsey Haynes-Maslow, Jared McGuirt, Jaqueline S. Grady Smith, Janelle Armstrong-Brown, Sarah D. Kowitt, Ziya Gizlice, Alice S. Ammerman
BackgroundMobile markets are an increasingly popular method for providing access to fresh fruits and vegetables (F/V) in underserved communities; however, evaluation of these programs is limited, as are descriptions of their development, study designs, and needs of the populations they serve.ObjectiveOur aim was to describe the development and theoretical basis for Veggie Van (VV), a mobile produce market intervention, the study design for the VV evaluation, and baseline characteristics of the study population.DesignThe protocol and sample for a cluster-randomized controlled trial with 12 sites are described.Participants/settingCommunity partner organizations in the Triangle region of North Carolina that primarily served lower-income families or were located in areas that had limited access to fresh produce were recruited. Eligible individuals at each site (older than 18 years of age, self-identified as the main shoppers for their household, and expressed interest in using a mobile market) were targeted for enrollment. A total of 201 participants at 12 sites participated in the VV program and evaluation, which was implemented from November 2013 to March 2016.Main outcome measuresChange in F/V intake (cups/day), derived from self-reported responses to the National Cancer Institute F/V screener, was the main outcome measure.Statistical analyses performedWe performed a descriptive analysis of baseline sample characteristics.ResultsMean reported F/V intake was 3.4 cups/day. Participants reported generally having some access to fresh F/V, and 57.7% agreed they could afford enough F/V to feed their family. The most frequently cited barriers were cost (55.7%) and time to prepare F/V (20.4%). Self-efficacy was lowest for buying more F/V than usual and trying new vegetables.ConclusionsBy addressing cost and convenience and building skills for purchasing and preparing F/V, the VV has the potential to improve F/V consumption in underserved communities.



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Assessing Clinical Judgment and Critical Thinking Skills in a Group of Experienced Integrative and Functional Nutrition Registered Dietitian Nutritionists

Publication date: Available online 23 June 2018
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Emily M. Goodman, Jessica Redmond, Dana Elia, Stephanie R. Harris, Mary Beth Augustine, Rosa K. Hand




https://ift.tt/2tqesH3

Latino Fathers’ Perspectives and Parenting Practices Regarding Eating, Physical Activity, and Screen Time Behaviors of Early Adolescent Children: Focus Group Findings

Publication date: Available online 23 June 2018
Source:Journal of the Academy of Nutrition and Dietetics
Author(s): Youjie Zhang, Ghaffar Ali Hurtado, Rafael Flores, Antonio Alba-Meraz, Marla Reicks
BackgroundInvolvement of Latino fathers in food and activity parenting practices has implications for child obesity prevention yet remains largely unknown.ObjectiveTo explore Latino fathers' perspectives and parenting experiences regarding early adolescents' eating, physical activity, and screen-time behaviors using the focus group method.DesignTwenty-six fathers (primarily Mexican-American men) of 10- to 14-year-old children participated in one of four focus groups between March and October 2016. Focus groups were conducted in Spanish by male moderators.Participants/settingsA convenience sample was recruited from three community centers and one charter school in Minneapolis/St Paul, MN.AnalysisAudiotaped focus groups were transcribed verbatim in Spanish and translated to English; transcripts were coded and analyzed for themes based on the grounded theory approach.ResultsThree themes emerged including 1) paternal beliefs and concerns about early adolescents' diet, physical activity, and screen time; 2) paternal food and activity parenting practices; and 3) factors that may influence paternal involvement in promoting healthy lifestyle behaviors. Father-reported food and activity parenting practices included setting expectations and limits, role modeling, managing availability and accessibility, teaching and reasoning, monitoring, motivating, and doing things together. Factors influencing paternal involvement were identified at intrapersonal, interpersonal, and social-environmental levels, which included paternal dietary and activity behaviors, self-efficacy, time and financial constraints, parental congruency, child resistance, perceived gender role, and environmental challenges.ConclusionsFathers identified eight major food and activity parenting practices they use to promote a healthy lifestyle for their adolescent children and factors that influence their involvement. Health care professionals can use this information to provide culturally appropriate and specific interventions for Latino American fathers of young adolescents.



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Potentially toxic elements in fly ash dependently of applied technology of hard coal combustion

Abstract

Coal combustion is one of the most significant anthropogenic sources of thallium in the environment. This study presents the results of determination of thallium and some toxic elements (Pb, Cd, As, Ni, Zn, and Cu) concentration in fly ash produced in the coal combustion in conventional furnaces (pulverized coal furnace and grate furnace), in a fluidized-bed furnace with circulation bed, and in a home furnace. The high content of thallium was determined in ash produced in the grate furnace (on average 10.7 mg/kg) and fluidized-bed furnace with circulation bed (6.6 mg/kg). The average content of Tl in the fly ash of the pulverized coal furnace and in the home furnace is 1.7 and 2.4 mg/kg, respectively. There was a strong relationship between the occurrence of Tl and As, Cd, Pb, Cu, and Zn in ash from grate and pulverized coal furnace.

https://ift.tt/2ltvsb3

Triage for selection to colonoscopy?

Publication date: Available online 23 June 2018
Source:European Journal of Surgical Oncology
Author(s): Mathias Mertz-Petersen, Thomas B. Piper, Jakob Kleif, Linnea Ferm, Ib Jarle Christensen, Hans J. Nielsen
Implementation of population screening for colorectal cancer by direct colonoscopy or follow-up colonoscopy after a positive fecal blood test has challenged the overall capacity of bowel examinations. Certain countries are facing serious colonoscopy capacity constraints, which have led to waiting lists and long-time latency of follow-up examinations. Various options for improvement are considered, including increased cut-off values of the fecal blood tests. Results from major clinical studies of blood-based, cancer-associated biomarkers have led to focus, however, on a triage concept for improved selection to colonoscopy. The triage test may include subject age, concentration of hemoglobin in a feces test and a combination of certain blood-based cancer associated biomarkers. Recent results have indicated that triage may reduce the requirements for colonoscopy by around 30%. Such results may be advantageous for the capacity, the heath budgets and in particular, the subjects, who do not need an unnecessary, unpleasant and risk-associated bowel examination.



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Prognostic impact of residual disease in simultaneous additional excision specimens after one-step breast conserving therapy with negative final margin status in primary breast cancer

Publication date: Available online 23 June 2018
Source:European Journal of Surgical Oncology
Author(s): Steffen Kahlert, M. Kolben Theresa, Elisa Schmoeckel, Bastian Czogalla, Anna Hester, Tom Degenhardt, Cordula Kempf, Sven Mahner, Nadia Harbeck, Thomas Kolben
PurposeThe purpose of this study was the evaluation of risk factors for local recurrence after breast conserving surgery (BCS) with special focus on the impact of residual disease in specimens of simultaneous additional excisions (AE) from the tumor cavity on patients´ outcome in patients with negative final margin status after one-step BCS.MethodsThis study was designed as a single center retrospective cohort study. Patients with primary non-metastatic breast cancer treated by one-step BCS with pathologically confirmed negative resection status between 1990 and 2006 were included. Ipsilateral breast tumor recurrence (IBTR) and overall survival (OS) were evaluated by Kaplan-Meier-estimates. A multivariate Cox proportional hazards regression model was used to identify potential independent prognostic factors associated with the risk of IBTR.ResultsA total of 1081 patients were included in this analysis. Simultaneous additional excisions were performed in 79.4% of patients (tumor positive: 12.2%). Median follow-up after primary diagnosis was 124 months. The IBTR rate after 15 years was significantly higher in the group with tumor positive AE (no AE (10.2%) vs. AE tumor positive (27.5%) p=0.002; AE tumor negative (14.0%) vs. AE tumor positive (27.5%) p=0.008). The OS rate did not differ significantly between groups. Multivariate analysis revealed residual cancer in AE being associated with a significantly increased relative risk of IBTR of 2.0 (p=0.014).ConclusionIn the current analysis residual disease in simultaneous additional excisions was associated with an increased risk for IBTR despite negative final margin status. This should be considered in the overall therapeutic concept.



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Survival Outcomes and Interval Between Lymphoscintigraphy and SLNB in Cutaneous Melanoma- Findings of a Large Prospective Cohort Study

Publication date: Available online 23 June 2018
Source:European Journal of Surgical Oncology
Author(s): Fionnuala M. O'Leary, Clare J. Beadsmoore, Davina Pawaroo, John Skrypniuk, Martin J. Heaton, Marc D. Moncrieff




https://ift.tt/2yCSndp

A systematic analysis highlighting deficiencies in reported outcomes for patients with stage IV colorectal cancer undergoing palliative resection of the primary tumour

Publication date: Available online 23 June 2018
Source:European Journal of Surgical Oncology
Author(s): Deena P. Harji, Abigail Vallance, Jenny Selgimann, Simon Bach, Faheez Mohammed, Julia Brown, Nicola Fearnhead
BackgroundManagement of the primary tumour in the presence of unresectable metastatic colorectal cancer (mCRC) is controversial. The role of primary tumour resection (PTR) has been investigated by a number of retrospective cohort studies, with a number on going randomised controlled trials. The aim of this study was to identify the clinical and patient-reported outcomes currently reported in studies that evaluate the role of PTR in mCRC.MethodsLiterature searches were performed in MEDLINE (via OvidSP) (1966– June 2017), EMBASE (via OvidSP) and the Cochrane Library using terms related to colorectal cancer and primary tumour resection. All studies documenting outcomes following palliative PTR were included. Eligible articles were assessed using the Risk of Bias In Non-Randomised Studies of Intervention (ROBINS-I) tool.ResultsOf 11,209 studies screened, 59 non-randomised studies reporting outcomes on 331,157 patients were included. Patient characteristics regarding performance status and co-morbidity were recorded in 26 (44.1%) and 17 (28.8%) studies. The chemotherapy regime used was reported in 27 (45.8%) studies. The operative setting and the operative approach was reported in 42 (71%) and 14 (23.7%) studies. Post-operative mortality and morbidity were reported in 33 (55.9%) and 35 (59.3%) of studies. Overall survival was reported in 49 (83.1%) of studies, with 5 different definitions identified. Quality of life was only reported in 1 (1.7%) study.ConclusionThis study demonstrates significant heterogeneity in the selection and definition of outcomes reported following PTR in mCRC. There is significant heterogeneity with a significant under-reporting of important outcomes such as treatment related adverse events and patient reported outcomes.



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30-day and long-term outcome following salvage surgery for squamous cell carcinoma of the anus

Publication date: Available online 23 June 2018
Source:European Journal of Surgical Oncology
Author(s): T.B. Pedersen, P. Gocht-Jensen, M.F. Klein
IntroductionSquamous cell carcinoma of the anus (SCCA) is a rare condition. First line treatment is combined chemo-radio therapy. As many as a third of patients undergoing CRT will experience recurrence. These patients often undergo salvage surgery with an extended abdominoperineal excision. The aims of this study were 1) to assess and evaluate 30-day postoperative morbidity and mortality after salvage surgery for recurrent SCCA, and furthermore, 2) to examine secondary recurrence and long-term mortality after salvage surgery for recurrent SCCA.Material and MethodsRetrospective evaluation of all patients undergoing salvage surgery for SCCA at Copenhagen University Hospital Herlev between 1st of January 2011 and 31th December 2016.ResultsForty-seven patients were identified. 30-day postoperative mortality was 4%. The most common postoperative complication was perineal wound defects. Within the follow-up period of median 20(1-80) months, secondary recurrence occurred in 30% of patients. Median disease free survival was 32 months. Secondary recurrence was significantly more frequent in patients with R1 resection and pN≥1. Within the follow-up period of median 25(0-80) months, mortality was 40%. Overall median survival was 39 months. Secondary recurrence was associated with a significantly higher risk of death within the follow-up period.ConclusionSalvage surgery for relapse of squamous cell carcinoma of the anus is a safe procedure with a good short-term outcome. Secondary recurrence was more frequent in patients with R1-resection and pN≥1. More than one third of the patients died within the follow-up period, and mortality was significantly higher in the group of patients with secondary recurrence.



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