Effect of the temperature of nasal lavages on mucociliary clearance: a randomised controlled trial

Abstract

Background

The respiratory epithelium is mainly constituted by caliciform (produces mucus, responsible of keeping moisture and trapping particles) and ciliated cells (transports mucus into the pharynx, by the movement of multiple cilia). For centuries, nasal lavages have been used for different rhinosinusal conditions. Some studies suggest not only a direct effect on the mobilisation of secretions, but also an improvement in mucociliary clearance rates. To our knowledge, the impact of temperature in nasal lavages has been scarcely studied.

Methodology/principal

We used the saccharin test—applying it in the inferior turbinate and timing the detection of its taste—, to estimate mucociliary clearance rates before and after nasal lavages with saline solution at room (20 °C) or body (37 °C) temperatures.

Results

78 healthy subjects were studied, with a mean saccharin test time of 13.88 min. Then, a nasal lavage was performed, half with 20 °C saline and the other with 37 °C. In both, times improved from baseline (from 13.66 to 11.59 and 14.06 to 9.4 min, respectively) with p values < 0.05.

Conclusions

Nasal lavages with saline solution improve mucociliary clearance as measured by saccharin test. Temperature seems to matter, which should be taken into account when indicating nasal lavages to our patients.

https://ift.tt/2KUxcsW

Mobility of metal(loid)s at the sediment-water interface in two tourist port areas of the Gulf of Trieste (northern Adriatic Sea)

Abstract

One of the main environmental issues affecting coastal marine environments is the accumulation of contaminants in sediments and their potential mobility. In situ benthic chamber experiments were conducted at two tourist ports (marinas) located in the Gulf of Trieste, one in Slovenia and one in Italy. The aim was to understand if and where recycling at the sediment-water interface (SWI) may affect metal(loid)s. Short sediment cores were also collected near the chamber to investigate the solid (sediments) and dissolved phases (porewaters). Both diffusive and benthic fluxes were estimated to elucidate the release of metal(loid)s at the SWI. Total element concentrations and their labile fractions were determined in sediments to quantify their potential mobility. The total element contents were found to be two orders of magnitude higher in the Italian marina than in the Slovenian one, especially for Hg (up to 1000 mg kg⁻¹), whereas the labile fraction was scarce or null. The opposite occurred in the Slovenian marina. Metal(loid)s in porewaters showed a clear diagenetic sequence and a close dependence upon the suboxic/anoxic conditions of sediments. The results suggest that although the sediments of the Italian marina exhibit the highest total metal(loid) concentration, these elements are scarcely remobilisable. Conversely, in the Slovenian marina, sediments seem to be comparatively more prone to release metal(loid)s at the SWI.

https://ift.tt/2Jj5KQ7

Role of Electronystagmography in Diagnosis of Secondary BPPV in Elderly Patients with Vertigo: A Retrospective Study

Abstract

Elderly population is frequently affected by vertigo which affects their mobility and makes them vulnerable to fall and other morbidities. Often these patient visit neurologist and are often subjected to CT scan, MRI brain etc. to rule out a central cause of vertigo; whereas majority of these patients suffer from vestibular cause of vertigo. A schematic approach by detailed history, simple tests for vestibular functions like Dix Hallpike, supine roll and head impulse test give important clue to diagnosis. Often the diagnosis is benign paroxysmal positional vertigo (BPPV) which is treated by repositioning maneuver. There are often other vestibular causes which may be diagnosed by Electronystagmography (ENG), electrocochleography and other tests. This study was undertaken to study occurrence of secondary BPPV utilizing various parameters of ENG. The study group comprised of 131 patients from the neuro-otology proforma data base at ENT centre and vertigo clinic from January 2015 to December 2017. Inclusion criterion was male and female aged 51 years and above presenting with dizziness, imbalance, rotational vertigo, unsteadiness as the chief complaint. Exclusion criterion was BPPV relieved after Epley's maneuver, Otitis externa, acute Otitis media, Suppurative Otitis media, pre existing neurological condition and history of ear surgery. Neuro-otology Data obtained and the ENG findings were tabulated in the master chart and the observations interpreted and transferred to Claussen's butterfly chart. The study group comprised of 58 male (44.27%) and 73 female (55.73%) with a male female ratio of 1:1.25. ENG exhibited 36 patients (27.49) to have recurrent BPPV, 53 (40.45%) were found to have unilateral/bilateral canal paresis. Meniere's disease was diagnosed in 39 (29.77%) patients and brain stem pathology identified in 3 (2.29%) cases.

https://ift.tt/2L6xFYs

Surgical Management of Parapharyngeal Space Tumours in a Single Tertiary Care Center

Abstract

Because of the inaccessibility and overcrowding of the vital neurovascular structures, management of the parapharyngeal space (PPS) tumour is always a challenge to the surgeons. Here we have discussed the clinical findings and management of the PPS tumours with special concern to the surgical approaches. It is a retrospective study containing 14 patients of PPS tumour from June 2015 to January 2018 in the department of Otorhinolaryngology and Head Neck Surgery in a tertiary care referral hospital. 14 consecutive patients with PPS tumours were included in the study. The retrospective clinical data, diagnostic procedures, surgical approaches and the complications were analyzed after 12 months of surgery. Of 14 patients included in the study, 10 patients were males and 4 were females. Prestyloid and poststyloid spaces were involved in 28.57% and 71.42% cases respectively. Transcervical excision of the tumours were performed in 10 patients, 2 patients had undergone transcervical-transoral approach. Transcervical transmandibular and transcervical transparotid excision of tumours were performed in one patient each. Facial nerve injury was detected in 3(21.42%) patients. Injury to the internal carotid artery and wound infection were detected in one patient each. Radiological imaging, especially the MRI helps by narrowing the spectrum of the differential diagnosis distinguishing the benign from malignant lesions, especially in cases where FNAC is contraindicated. Although the transcervical approach is commonly practiced, the combined surgical approach can be effectively applied specially for extensive PPS tumours associated with satisfactory clinical outcomes.

https://ift.tt/2JkEnVF

How molecular diagnosis may modify immunotherapy prescription in multi-sensitized pollen-allergic children

Publication date: Available online 13 July 2018

Source: Allergologia et Immunopathologia

Author(s): Genoveva Del-Río Camacho, Ana María Montes Arjona, José Fernández-Cantalejo Padial, Rodríguez Catalán Jesús

Abstract

Introduction

Specific immunotherapy (SIT) is used to treat asthma and allergic rhinitis, and a dose–response relationship has been found for SIT efficacy, creating a need to accurately select the allergen used in therapy. This need is especially pronounced in poly-sensitized children living in areas where different pollen allergen sources coexist in the same season, as this circumstance complicates diagnostic efforts. In such cases, component-resolved diagnosis (CRD) can increase diagnostic accuracy and aid in SIT prescription.

Materials and Methods

We hypothesized that CRD results would lead to modifications in classical immunotherapy prescription based on sources such as medical history, season of symptom presentation, and skin testing. We studied a sample of children indicated for immunotherapy in whom classical methods had not pointed out the most relevant allergen due to sensitization to more than two pollens. We used a small panel of recombinant allergens, analyzing the percentage of changes to prescription considering the findings of molecular studies.

Results

Of the 70 children included, CRD led to modified immunotherapy prescription in 54.3%. Indications of single-allergen therapy increased from 18% to 51% when CRD was included. The decision to prescribe immunotherapy was reversed following CRD in 9.3% of cases.

Discussion

CRD use alters the choice of specific immunotherapy in poly-sensitized children. A wide panel of recombinant allergens may not be necessary to improve immunotherapy indication using molecular techniques; rather, a smaller panel adapted to include those allergens prevalent in the geographical area in question appears to be sufficient for more effective immunotherapy, also leading to an improved cost–benefit ratio.

https://ift.tt/2NcYWFZ

Dendritic cells in sepsis: Potential immunoregulatory cells with therapeutic potential

Publication date: Available online 12 July 2018

Source: Molecular Immunology

Author(s): V. Kumar

Abstract

Sepsis is a disease of dysfunctional immune response against the pathogen causing a profound immune-mediated damage to the vital organs and death of the patient in most cases. However, when sepsis is described much attention is given to monocytes/macrophages, complement system, neutrophils, cytokine storm, and T cells. Dendritic cells (DCs) get less attention in this scenario despite comprising the major immune cell population. Therefore the present review is designed to highlight the importance of DCs in the pathogenesis of sepsis, sepsis-associated immunosuppression, and organ damage. The article starts with an introduction of sepsis as a major medical problem needing an urgent therapeutic targeting. Thereafter it provides a brief information regarding classical and plasmacytoid DCs and their role in the maintenance of immune homeostasis. The subsequent sections describe the role of DCs in the immunopathogenesis of sepsis via immunoregulation, impact of sepsis on DCs including their immunometabolic changes, and their therapeutic targeting during sepsis.

Graphical abstract

https://ift.tt/2LeWwWV

Ketamine and Electroconvulsive Therapy for Depression

No abstract available

https://ift.tt/2zyZsMu

Can Cerebral Near-infrared Spectroscopy Predict Cerebral Ischemic Events in Neurosurgical Patients? A Narrative Review of the Literature

Cerebral near-infrared spectroscopy (NIRS) is considered a valuable noninvasive modality for cerebral oxygenation monitoring during cardiovascular surgery and cardiac arrest. We assessed the capability of cerebral NIRS to predict cerebral desaturation and the related neurological outcomes in neurosurgical patients. A literature search in different electronic medical databases was performed from inception to January 2018. A total of 286 citations were found and finally 48 studies were retrieved, only 7 of these were eligible and included for review. A meta-analysis was not feasible because of high heterogeneity of patients' groups, different NIRS techniques used in the studies and different outcome criteria selected. The qualitative assessment showed controversial data on the threshold value of cerebral near-infrared spectroscopy used for detecting cerebral ischemia in neurosurgical patients. The evidence on the selected studies is not strong enough, at the moment, to recommend cerebral NIRS as a mandatory monitor to detect cerebral deoxygenation able to predict the future neurological outcome in neurosurgical patients. Further studies are needed to validate a threshold value for cerebral ischemia and the relationship between NIRS-detected cerebral desaturation and clinical outcome in the neurosurgical population. M.L. is a scientific advisor of MASIMO Corp., Irvine, CA. The remaining authors declare that they have nothing to disclose. Address correspondence to: Andrey Khozhenko, MD, DESA, Anesthesiology Institute, Cleveland Clinic Abu Dhabi, Sowwah Square, 112412, Abu Dhabi, UAE (e-mail: ahozhenko@gmail.com). Received December 25, 2017 Accepted May 30, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved

https://ift.tt/2uin6YM

Soluble antigen arrays disarm antigen-specific B cells to promote lasting immune tolerance in experimental autoimmune encephalomyelitis

Publication date: Available online 12 July 2018

Source: Journal of Autoimmunity

Author(s): Brittany L. Hartwell, Chad J. Pickens, Martin Leon, Laura Northrup, Matthew A. Christopher, J. Daniel Griffin, Francisco Martinez-Becerra, Cory Berkland

Abstract

Autoreactive lymphocytes that escape central immune tolerance may be silenced via an endogenous peripheral tolerance mechanism known as anergy. Antigen-specific therapies capable of inducing anergy may restore patients with autoimmune diseases to a healthy phenotype while avoiding deleterious side effects associated with global immunosuppression. Inducing anergy in B cells may be a particularly potent intervention, as B cells can contribute to autoimmune diseases through multiple mechanisms and offer the potential for direct antigen-specific targeting through the B cell receptor (BCR). Our previous results suggested autoreactive B cells may be silenced by multivalent 'soluble antigen arrays' (SAgAs), which are polymer conjugates displaying multiple copies of autoantigen with or without a secondary peptide that blocks intracellular cell-adhesion molecule-1 (ICAM-1). Here, key therapeutic molecular properties of SAgAs were identified and linked to the immunological mechanism through comprehensive cellular and in vivo analyses. We determined non-hydrolyzable 'cSAgAs' displaying multivalent 'click'-conjugated antigen more potently suppressed experimental autoimmune encephalomyelitis (EAE) compared to hydrolyzable SAgAs capable of releasing conjugated antigen. cSAgAs restored a healthy phenotype in disease-specific antigen presenting cells (APCs) by inducing an anergic response in B cells and a subset of B cells called autoimmune-associated B cells (ABCs) that act as potent APCs in autoimmune disease. Accompanied by a cytokine response skewed towards a Th2/regulatory phenotype, this generated an environment of autoantigenic tolerance. By identifying key therapeutic molecular properties and an immunological mechanism that drives SAgA efficacy, this work guides the design of antigen-specific immunotherapies capable of inducing anergy.

https://ift.tt/2uhNDoW

Management of retrosternal goiter: Retrospective study of 72 patients at two secondary care centers

Publication date: Available online 12 July 2018

Source: Auris Nasus Larynx

Author(s): Wai Keat Wong, Subhaschandra Shetty, Randall P. Morton, Nicholas P. McIvor, Tony Zheng

Abstract

Objective

Data pertaining to the outcomes of retrosternal goiter surgeries performed at secondary care centers, where thoracic surgery expertise is not readily available, is infrequently reported. Careful patient selection is crucial to avoid an unexpected need for a sternotomy during surgery. We sought to evaluate the surgical management of patients with retrosternal goiters treated at two secondary care centers.

Methods

Retrospective review of clinical records and computed tomographic (CT) scans of 557 patients who underwent thyroid surgery at the Departments of Otolaryngology, Head and Neck Surgery of Manukau Surgery Center and Whangarei Base Hospital. Inclusion criterion was extension of goiter below the plane of the thoracic inlet on CT scan. Clinicopathologic features and surgical outcomes were recorded.

Results

The prevalence of retrosternal goiter was 72 of 557 patients (12.9%). All patients in this series underwent thyroidectomy transcervically. Dyspnea was present in 48 patients (66.7%). On preoperative CT scans, the goiter was noted to extend beyond the aortic arch in seven patients (9.7%), tracheal bifurcation in five patients (6.9%) and posterior mediastinum in 15 patients (20.8%). Malignancy was diagnosed in eight patients (11.1%) histologically. Postoperatively, vocal cord paralysis was temporary in 5 patients (6.9%) and permanent in 1 patient (1.4%). Hypocalcaemia was transient in 10 patients (13.9%). No permanent hypocalcemia, tracheomalacia, postoperative hematoma or patient death was reported. During the study period, 4 patients were encountered in the outpatients setting whereby the evaluation of their CT imaging demonstrated features deemed to be at high risk of requiring a sternotomy: primary mediastinal goiter (n = 2) and inferior extent of goiter to the level of right atrium (n = 2). These patients were pre-emptively referred to a tertiary center where thoracic surgery service was available and their data was reported separately.

Conclusion

With careful patient selection, the majority of retrosternal goiter can be resected transcervically with minimal morbidities. Preoperative CT scan yielded useful surgical information; in the presence of primary mediastinal goiter or inferior extent of goiter to the level of the right atrium, surgery should be planned in a tertiary center where thoracic surgeon is available.

https://ift.tt/2zAsIme

Should Spinal MRI Be Routinely Performed in Patients With Clinically Isolated Optic Neuritis?

No abstract available

https://ift.tt/2zBDI2O

Surgical treatment of periocular basal cell carcinomas with whole specimen intraoperative frozen section analysis: experiences and review of literature

Abstract

Background

Periocular skin tumors are difficult to treat because of the friability of the tissue and close relationship to adjacent, functional structures. After excision, direct reconstruction with alike tissue is desirable to prevent shrinkage and deformation. We analyzed whether a quick intraoperative pathology method using whole specimen bread loaf frozen section analysis delivers a sufficiently reliable result concerning completeness of the excision in periocular basal cell carcinoma (BCC).

Methods

This is a cohort study by case note review of 132 patients undergoing excision of periocular BCC between 1996 and 2012 at the Medical Centre Leeuwarden. Whole specimen intraoperative frozen section analysis (WIFSA) was performed and compared with final paraffin-embedded tissue sections. Sensitivity and specificity of WIFSA and 5-year recurrence rate were calculated.

Results

One hundred thirty-nine periocular BCCs were excised. Paraffin sections of primary excision showed clear margins in 90 cases and tumor-positive margins in 49 cases. In 87 of 90 excisions with clear margins, WIFSA showed clear margins as well (specificity 97%). In 48 of the 49 excisions with tumor-positive margins, WIFSA showed incomplete excision as well (sensitivity 98%). Recurrence rate was 3.6% (5/139), with average follow-up of 79 months.

Conclusions

This study indicates that WIFSA is an effective method for histological examination of the margins of surgically removed periocular BCCs, with high specificity and sensitivity. Recurrence rates are low.

Level of Evidence: Level II, diagnostic study.

https://ift.tt/2NdOONt

Tracheostomy reversal years after patient lost to follow-up

Pediatric tracheostomies occur for various reasons, including prologned intubation, and require a multidisciplinary approach with routine follow-up.

https://ift.tt/2NLBfG0

Heavy metal contamination in “chemicalized’ green revolution banana fields in southern India

Abstract

The present report is a general assessment of the level of nutrient and toxic heavy metals as an impact of "chemicalized" cultivation practices for decades in banana fields in the three south Indian states, Kerala, Karnataka, and Tamilnadu. The major objective was to critically analyze the status of metallic content in green revolution fields, where chemical fertilizers or plant protective chemicals remain the major source of heavy metal contaminants. Since soil series being a soil taxonomic category that includes slightly variant soils of similar origin and common parent materials, the 286 field samples of the broad south Indian region were further grouped into composite samples representing 47 different soil series for limiting the sample analysis. The quantitative assessment of ten metals done in these soils using the Atomic Absorption Spectrophotometer included Ca, Mg, Mn, Zn, Fe, Cu, Pb, Ni, Cr, and Co. The amount of Cu observed in many fields was higher than all the previous reports of the same in the "chemicalized" fields. Similarly, the amount of Co observed in 25 fields was above its threshold levels expected for normal soils. The amount of Pb observed in all the soils appeared quite normal. The amount of Ni observed in 14 soil series was higher than its threshold levels for normal soils, except in 4 soil series, where its amount exceeded the upper limit of contamination. Cr was detected in all the samples, but found higher than its threshold level in 31 soil series. Significant positive correlations were observed between the amounts of different metals in the study. PCA results indicated that variables were correlated to four principal components, and 74.36% of the total variance was justified.

https://ift.tt/2Ldes45

Tracheostomy reversal years after patient lost to follow-up

Abstract

Background

Pediatric tracheostomies occur for various reasons, including prologned intubation, and require a multidisciplinary approach with routine follow-up.

Case presentation

This report reviews the history and clinical outcome of a 29 year old female patient who was lost to follow-up for nearly two decades after a pediatric tracheostomy. When she presented to the Otolaryngology service as an adult the original indication for tracheostomy had resolved and decannulation was initiated, but a profound psychological dependence had developed.

Conclusion

This case outlines the importance of regular follow-up for tracheostomy patients, as well as health care barriers faced in remote rural communities.

https://ift.tt/2zz6YXX

Eine seltene Raumforderung des Mittelohres – von der Parazentese zur Diagnose

Laryngo-Rhino-Otol
DOI: 10.1055/a-0648-4710

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2Lcjkql

Cyanobacteria and microcystins in Koka reservoir (Ethiopia)

Abstract

The composition and abundance of cyanobacteria and their toxins, microcystins (MCs), and cylindrospermopsins (CYN) were investigated using samples collected at monthly intervals from the Amudde side of Koka Reservoir from May 2013 to April 2014. Cyanobacteria were the most abundant and persistent phytoplankton taxa with Microcystis and Cylindrospermopsis species alternately dominating the phytoplankton community of the reservoir and accounting for up to 84.3 and 11.9% of total cyanobacterial abundance, respectively. Analyses of cyanotoxins in filtered samples by HPLC-DAD and LC-MS/MS identified and quantified five variants of MCs (MC-LR, MC-YR, MC-RR, MC-dmLR, and MC-LA) in all samples, with their total concentrations ranging from 1.86 to 28.3 μg L⁻¹ and from 1.71 to 33 μg L⁻¹, respectively. Despite the presence and occasional abundance of Cylindrospermopsis sp., cylindrospermopsin was not detected. Redundancy analysis (RDA) showed that the environmental variables explained 82.7% of the total variance in cyanobacterial abundance and microcystin concentration. The presence of considerably high levels of MCs almost throughout the year represents a serious threat to public health and life of domestic and wild animals.

https://ift.tt/2JjHLQO

Vitamin E alleviates phoxim-induced toxic effects on intestinal oxidative stress, barrier function, and morphological changes in rats

Abstract

Phoxim is an organic phosphorus pesticide that remains easily in the environment, such as human food and animal feed. The objective of this study was to explore the effect of vitamin E on phoxim-induced oxidative stress in the intestinal tissues of Sprague-Dawley (SD) rats. Forty-eight Sprague-Dawley rats were randomly assigned to a control group and three treatment groups: treatment group 1 (phoxim: 20 mg/kg·BW), treatment group 2 (phoxim: 180 mg/kg·BW), and treatment 3 (vitamin E + phoxim: 200 mg/kg·BW + 180 mg/kg·BW). Phoxim was given by gavage administration once a day for 28 days. The results showed that phoxim significantly reduced jejunum villus height in rats (P < 0.05), and decreased the mRNA expression of junction protein genes of rats, including Occlidin and Claudin-4 (P < 0.05). Phoxim reduced GSH content and T-AOC level in the intestinal mucosa (P < 0.05). The mRNA expression levels of oxidative stress-related genes (Nrf2 and GPx2) were decreased. The mRNA expression of SOD was significantly increased. In addition, phoxim increased the level of interleukin-6 (IL-6) in jejunum mucosa and significantly reduced the level of IL-8 in ileum mucosas, while significantly increased TNF-α secretion. The mRNA expression levels of IL-1β, IL-6, and IL-8 were significantly decreased, and mRNA expression of TNF-α was significantly increased (P < 0.05). Phoxim also increased the DNA expression of total cecal bacteria and Escherichia coli, inhibited the DNA expression of Lactobacillus and destroyed the intestinal barrier. Two hundred milligrams per kilogram BW vitamin E reduced the effect of phoxim on intestinal structure, alleviated the oxidative stress in intestinal tissue, and decreased the level of TNF-α. The mRNA expressions of antioxidative stress genes (SOD and GPx2) were significantly increased. The DNA expression level of Lactobacillus was significantly increased. In conclusion, vitamin E helped reduce the toxicity of organophosphate pesticides, such as phoxim on rat intestinal tissue.

https://ift.tt/2NJMvCR

Solid Cell Nests Within a Parathyroid Gland—Report of an Exceptional Case

Abstract

The ultimobranchial body (UBB) denotes the cellular mass originating from the fourth branchial pouch, which migrates from the neural crest and infolds within the middle and upper poles of the thyroid lobes, thereby establishing the presence of calcitonin-secreting parafollicular C cells. In various numbers, UBB remnants (entitled "solid cell nests", or SCNs) are found in thyroid glands examined histologically. However, despite the close embryological relation between the UBB and the superior parathyroid glands, intraparathyroidal SCNs have to our knowledge not been previously reported. Here, we describe a patient presenting with a papillary thyroid carcinoma with central and lateral lymph node metastases. Upon postoperative analysis, an unintentionally removed parathyroid gland was observed adjacent to the superior aspect of the right thyroid lobe. Within a 0.6 × 0.5-mm area of the parathyroid gland, solid nests composed of epithelial cells with oval and slightly elongated nuclei were seen. The cells were positive for p40, p63, and GATA3, but negative for PTH. The final diagnosis was a SCN entrapped within the parathyroid gland. Empirically, we have not previously observed SCNs within the parathyroid glands. To our knowledge, our finding thus constitutes a very unusual histological manifestation, and could indicate an underlying aberrancy during embryogenesis given the close anatomical relationship between the UBB and the superior parathyroid glands.

https://ift.tt/2zyfo1w

Lethal outcome of granulomatous acanthamoebic encephalitis in a man who was human immunodeficiency virus-positive: a case report

Acanthamoeba species can cause disseminating infections in immunocompromised individuals.

https://ift.tt/2NN2Iaq

Impact of ozonation and biologically enhanced activated carbon filtration on the composition of micropollutants in drinking water

Abstract

A pilot-scale drinking water treatment process for Songhua River, including conventional treatment (coagulation-settlement and rapid sand filtration), ozonation, biological enhanced activated carbon (BEAC) filtration, and chlorination disinfection, was carried out in this study. To investigate the impact of ozonation and BEAC filtration on removing the composition of micropollutants in drinking water, we detected the micropollutant composition from each stage of the treatment process by non-targeted analysis using a GC-MS technique and compared the results between effluents of single BEAC and O₃-BEAC processes. Aromatic compounds and esters could be abated efficiently during single BEAC filtration via biodegradation and adsorption; however, possible metabolic products (i.e., alkenes) were formed by biodegradation. Comparatively, O₃-BEAC process could reduce micropollutants much more significantly than single BEAC process especially for aromatic compounds including substituted benzenes and polycyclic aromatic hydrocarbons (PAHs) without the formation of metabolic products through the coupling effect of oxidation, biodegradation, and adsorption, suggesting that ozonation improved the removal potential of micropollutants in the BEAC process. In addition, conventional and novel chlorinated disinfection by-products were also measured during post-chlorination.

https://ift.tt/2L1UT21

Prevalence and incidence of clinically significant patulous Eustachian tube: A population-based study using the Korean National Health Insurance Claims Database

Publication date: Available online 12 July 2018

Source: American Journal of Otolaryngology

Author(s): Sung-Won Choi, Jinmi Kim, Hyun Min Lee, Se-Joon Oh, Il-Woo Lee, Eui-Kyung Goh, Soo-Keun Kong

Abstract

Objectives

The aim of this study is to estimate the entire population-based prevalence and incidence of Patulous Eustachian tube (PET) using the Korean National Health Insurance (NHI) claims database. The annual trends of prevalence and incidence of PET were also investigated.

Methods

Retrospective analysis of PET patients was performed between 2010 and 2016, from the NHI claims database. PET patients were defined as those who had at least one service claim with a primary diagnosis under an ICD-10-based PET code (H69.0).

Results

During the study period, there were 20,533 new PET patients in Korea. In 2016 there were 4482 incident cases, and the standardized annual incidence rate was 8.8 per 100,000 persons. The standardized annual prevalence rate increased significantly from 7.2 per 100,000 persons in 2010 to 10.3 per 100,000 persons in 2016. The prevalence increased significantly on annual basis, whereas the incidence rate fluctuated over time. Interestingly, the incidence and prevalence of PET in women was almost twice as high as that in men, and peaked in their 20s.

Conclusions

This study demonstrated the substantial annual increase of the NHI claims with PET code (H69.0) in Korea from 2010 to 2016. Statistical results based on the NHI claims, we confirmed the high prevalence and incidence rates of clinically significant PET in women than in men. This study only covered patient using the medical service for PET and missed PET sufferers not seeking medical service. However, this study can provide basic epidemiological information on clinically significant PET.

https://ift.tt/2uoJizq

Utilizing prestin as a predictive marker for the early detection of outer hair cell damage

Publication date: Available online 12 July 2018

Source: American Journal of Otolaryngology

Author(s): Murat Dogan, Mustafa Sahin, Nesibe Cetin, Mustafa Yilmaz, Buket Demirci

Abstract

Purpose

To evaluate prestin as a biomarker for the identification of early ototoxicity.

Materials and methods

Rats (n = 47) were randomly assigned to five groups: low-dose (LAG) or high-dose (HAG) amikacin (200 and 600 mg/kg/day, respectively, for 10 days), low-dose (LCIS)or high-dose (HCIS) cisplatin (single doses of 5 and 15 mg/kg, respectively, for 3 days), and control (n = 8). At the end of the experiment, measurement of distortion product-evoked otoacoustic emissions (DPOAE) were performed to evaluate hearing, then blood samples and both ear tissues were collected under anesthesia. Prestin levels were determined by ELISA. Cochlear damage was evaluated histologically using a 4-point scoring system.

Results

The mean serum prestin levels were 377.0 ± 135.3, 411.3 ± 73.1, 512.6 ± 106.0, 455.0 ± 74.2 and 555.3 ± 47.9 pg/ml for control, LCIS, HCIS, LAG and HAG groups, respectively. There was significant difference between prestin levels of Control–LCIS-HCIS groups (p = 0.031) and prestin levels of Control-LAG-HAG groups (p = 0.003). There were also significant differences in prestin levels between the low- and high-dose cisplatin and amikacin groups (p = 0.028 and p = 0.011, respectively). Each group had significantly lower DPOAE results at 4, 6 and 8 kHz than control groups (p < 0.001). The LAG, HAG, LCIS and HCIS groups had significantly higher cochlear damage scores than the control group (p < 0.05).

Conclusions

Higher doses of cisplatin and amikacin were associated with the greatest increases in serum prestin level and cochlear damage score. The results of this study suggest that prestin is a promising early indicator of cochlear damage.

https://ift.tt/2ugCHrE

Intratympanic injection of dexamethasone after failure of intravenous prednisolone in simultaneous bilateral sudden sensorineural hearing loss

Publication date: Available online 12 July 2018

Source: American Journal of Otolaryngology

Author(s): Daowen Wang, Peng Xu

Abstract

Purpose

This study aimed to analyze outcomes of intratympanic injection of dexamethasone after failure of intravenous prednisolone in simultaneous bilateral sudden sensorineural hearing loss (SSNHL).

Materials and methods

The cases of simultaneous bilateral SSNHL treated in our hospital from March 2007 to March 2018 were retrospectively analyzed. During the earlier period (March 2007 to February 2012), the cases were treated by intravenous prednisolone only, and classified into group A. During the late period (February 2012 to March 2018), intratympanic injection of dexamethasone after failure of intravenous prednisolone therapy was employed to treat simultaneous bilateral SSNHL, and these patients were enrolled in group B. Effective rates of the two treatment modalities in groups A and B were compared.

Results

In group A, 3 of 40 ears obtained complete recovery, and 4 ears achieved partial recovery after intravenous prednisolone treatment, with the effective rate of only 17.5% (7/40 ears). In contrast, 6 of 44 ears in group B achieved complete recovery, and 10 ears got partial recovery, with the effective rate of 36.4% (16/44 ears). There was significant difference in the effective rate between the two groups.

Conclusion

Intratympanic injection of dexamethasone after failure of intravenous prednisolone therapy was a better choice for simultaneous bilateral SSNHL compared to traditional intravenous prednisolone therapy.

https://ift.tt/2zwF52x

Er:YAG laser application in caries removal and cavity preparation in children: a meta-analysis

Abstract

The aim of this meta-analysis was to systematically evaluate the applications of Er:YAG lasers for the removal of caries and cavity preparation in children. The meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was conducted with data extracted from seven relevant randomized controlled trials (RCTs) published from 1997 to July 2017. The data heterogeneity of each study was assessed by a Q test. We used the heterogeneity results to calculate the standard mean difference (SMD) or relative risk (RR) and 95% confidence interval (95%CI) using STATA version 10.0. The publication bias was evaluated using Begger's test. There were seven randomized controlled trials included in this study. The analysis results indicate that compared to the conventional mechanical method, more time was needed for Er:YAG laser treatment (SMD 1.945, 95%CI 0.942 to 2.948). However, the pain reported by patients was reduced with Er:YAG laser treatment (SMD − 1.013, 95%CI − 1.892 to − 0.196). There were no significant differences between the groups in the complete retention rate (RR 1.021, 95%CI 0.963 to 1.114), the marginal discoloration (RR 1.638, 95% CI 0.240 to 11.986) and the marginal adaptation (RR 1.480, 95%CI 0.257 to 8.515). In conclusion, our data indicate that the time required for Er:YAG laser treatment was longer than that for the conventional mechanical method, but there was less pain associated with the Er:YAG laser treatment. There were no significant differences in the complete retention rate, marginal discoloration, and marginal adaptation between the two groups.

https://ift.tt/2KPPKdT

Subglottic Hemangioma: understanding the association with facial segmental hemangioma in a beard distribution

Publication date: Available online 12 July 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Andrew A. McCormick, Tony Tarchichi, Christopher Azbell, Lorelei Grunwaldt, Noel Jabbour

Abstract

Objective

A subglottic hemangioma (SGH) is a benign tumor of infancy that can cause severe obstruction of the airway. Infantile hemangiomas, in general, are the most common head and neck tumor in children, affecting 4–5% of the pediatric population. This retrospective cohort study characterizes subglottic infantile hemangiomas at a single vascular anomaly center over a 5-year period (2013 – 2017) during the era of propranolol treatment.

Methods

Queried the Vascular Anomaly Database at Children's Hospital of Pittsburgh for all infantile hemangioma(s) and then identified case of subglottic hemangiomas. Characterized key features of presentation, natural history and management for subglottic hemangiomas. A secondary differentiation focused on differences between subglottic hemangiomas associated with Beard Distribution (BD) vs not (NBD).

Results

Analysis of 761 cases of infantile hemangiomas demonstrated only 13 patients with subglottic hemangiomas (1.7%). Of those 13 patients, only 4 patients (30%) had BD while 2 patients (15%) had other cutaneous hemangiomas and 7 patients (55%) had no cutaneous hemangiomas. Secondarily, a total of 31 case of beard distribution cutaneous hemangiomas with 11 patients having oropharyngeal involvement (35%) but only 4 patients with subglottic hemangiomas (13%). Interestingly, 2 of the 4 BD patients had treatment failure on propranolol and required second line treatment with steroids or surgical excision while only 1 of 9 NBD patients failed propranolol treatment. As well the same 2 BD patients which failed propranolol also had PHACES syndrome.

Conclusion

Subglottic hemangiomas are a rare presentation of infantile hemangiomas but with significant morbidity. While the classic teaching that a segmental beard distribution hemangioma raises concern for a subglottic hemangioma, this cohort indicates subglottic hemangiomas occur in a NBD presentation (1.3%), and demonstrated only an approximate 10% incidence rate with a beard distribution. But more importantly, this study raises the question that beard distribution in setting of PHACES syndrome may herald a more recalcitrant and complicated natural history for a subglottic hemangioma. This is of significant concern as risk for CVA in setting of PHACES is highest with use of steroid treatment. None of our patients had high risk extra or intra cranial vascular arterial anomalies and no CVA were noted.

https://ift.tt/2KThwX9

Thyroid® New Open Access Article

Latest Impact Factor: 7.557
The Official Journal of: American Thyroid Association^®

No-Scar Transoral Thyroglossal Duct Cyst Excision in Children
Jin Pyeong Kim, Jung Je Park, Seung Hoon Woo

The post <i>Thyroid^®</i> New Open Access Article appeared first on American Thyroid Association.

https://ift.tt/2urIFW4

Thyroid® New Open Access Article

Latest Impact Factor: 7.557
The Official Journal of: American Thyroid Association^®

No-Scar Transoral Thyroglossal Duct Cyst Excision in Children
Jin Pyeong Kim, Jung Je Park, Seung Hoon Woo

The post <i>Thyroid^®</i> New Open Access Article appeared first on American Thyroid Association.

https://ift.tt/2urIFW4

Origins and discrimination between local and regional atmospheric pollution in Haiphong (Vietnam), based on metal(loid) concentrations and lead isotopic ratios in PM 10

Abstract

Southeast Asia is a hotspot of anthropogenic emissions where episodes of recurrent and prolonged atmospheric pollution can lead to the formation of large haze events, giving rise to wide plumes which spread over adjacent oceans and neighbouring countries. Trace metal concentrations and Pb isotopic ratios in atmospheric particulate matter < 10 μm (PM₁₀) were used to track the origins and the transport pathways of atmospheric pollutants. This approach was used for fortnightly PM₁₀ collections over a complete annual cycle in Haiphong, northern Vietnam. Distinct seasonal patterns were observed for the trace metal concentration in PM₁₀, with a maximum during the Northeast (NE) monsoon and a minimum during the Southeast (SE) monsoon. Some elements (As, Cd, Mn) were found in excess according to the World Health Organization guidelines. Coal combustion was highlighted with enrichment factors of As, Cd, Se, and Sb, but these inputs were outdistanced by other anthropogenic activities. V/Ni and Cu/Sb ratios were found to be markers of oil combustion, while Pb/Cd and Zn/Pb ratios were found to be markers of industrial activities. Pb isotopic composition in PM₁₀ revealed an important contribution of soil dusts (45–60%). In PM₁₀, the Pb fraction due to oil combustion was correlated with dominant airflow pathways (31% during the north-easterlies and 20% during the south-easterlies), and the Pb fraction resulting from industrial emissions was stable (around 28%) throughout the year. During the SE monsoon, Pb inputs were mainly attributed to resuspension of local soil dusts (about 90%), and during the NE monsoon, the increase of Pb inPM₁₀ was due to the mixing of local and regional inputs.

https://ift.tt/2N5o5lO

Design of natural elements in open spaces of cities with a Mediterranean climate, conditions for comfort and urban ecology

Abstract

More than half the world's population lives in cities that were designed with a complete disregard for nature. Then, it is vital that nature should be present in these spaces to provide ecological support for urban areas. Natural elements that are in these spaces should be designed with people's comfort in mind. This research explores the application of the PET and UTCI biometeorological comfort indices in urban microspaces, where the general environmental parameters of the city are not valid and each space must be measured individually. The research looked into the influence of the design of natural elements on improving comfort. The results show that in the children's playing spaces, the absence of thermal comfort and considerable thermal stress were detected in summer. This effect is more easily seen in the PET values. The benefits to comfort of having double layers of vegetation in the gardens have also been shown. The micro-droplets of water from the jets in the fountains are carried by the breeze and modify the human-biometeorological conditions around the fountains and reduce thermal stress. This improvement needs an appropriate design of the fountains and an awareness of the breeze patterns in these spaces.

https://ift.tt/2KOrcSF

Soil sustainable utilization technology: mechanism of flavonols in resistance process of heavy metal

Abstract

The soil ecosystem is critical for agricultural production, affecting many aspects of human health. Soil has more unknown biodiversity and edaphic parameters than any other ecosystem especially when polluted. Metagenomics and metatranscriptomics were applied to research on toxicological characteristics of Pb and resistance mechanism of flavonols. Rhizosphere microorganisms–plants system, a unified system closely related to soil environment was taken as research object. Results emphasize gene expression changes in different test groups. Gene ontology enrichment and eggNOG showed that Pb has a toxic effect on gene and protein function which concentrated on ATPase and ATP-dependent activity. Differentially expressed genes in the flavonols group indicated that flavonols regulate amino acid transport and other transportation process related to Pb stress. Kegg analysis represents that Pb interferences energy production process via not only the upstream like glycolysis and tricarboxylic acid (TCA) circle but also oxidative phosphorylation process, which can also produce reactive oxygen species and impact the eliminating process. Flavonols have shown the ability in alleviating toxic effect of Pb and improving the resistance of plants. Flavonols can recover the electronic transmission and other process in TCA and oxidative phosphorylation via ascorbic acid-glutathione metabolism. Flavonols activated antioxidative process and non-specific immunity via vitamins B₂–B₆ metabolism.

https://ift.tt/2N5nKQ4

Characteristics and Treatment Response of Older Adults With Voice Disorders in the United States

This cross-sectional study uses the 2012 National Health Interview Survey to describe sociodemographic characteristics and response to treatment among aging adults with voice disorders.

https://ift.tt/2NcaFoh

Association of Tinnitus and Other Cochlear Disorders With a History of Migraines

This cohort study used claims data from the Taiwan Longitudinal Health Insurance Database 2005 to investigate the risk of tinnitus and other cochlear disorders inr patients with a history of migraines.

https://ift.tt/2KR1Tzs

Association of Symptoms and Clinical Findings With Anticipated Outcomes in Patients With Recurrent Head and Neck Cancer

This cohort study explores whether symptoms and clinical variables are associated with anticipated outcomes in adult patients with recurrent head and neck cancer.

https://ift.tt/2NbFedE

The Role of Migraine in Hearing and Balance Symptoms

Episodic dizziness is a highly prevalent symptom that has historically been a challenge for primary care physicians, neurologists, and otolaryngologists to accurately diagnosis and properly treat. With an array of diagnoses to consider, including benign positional vertigo, vestibular migraine, Ménière disease, vertebrobasilar syndrome, and vestibular schwannoma, among others, considerable effort has been placed by otolaryngology and neurology societies to carefully examine the literature and generate clinical criteria and guidelines to aid the clinician and to standardize diagnostic algorithms and treatment protocols. In recent decades, Ménière disease has been intensely investigated in both clinical and histopathologic studies and has been among the more frequent diagnoses given to patients with episodic dizziness. Even more recently, many studies have reported substantial overlap between the symptoms of vestibular migraine and those of Ménière disease, and, consequently, distinguishing between these 2 disease entities can be difficult. To this end, the presence of sensorineural hearing loss has notably been suggested to be the primary finding to differentiate Ménière disease from vestibular migraine, highlighting the previously held and popular notion that migraine activity will seldom have a negative influence on the auditory pathways and generate cochlear symptoms, such as hearing loss and tinnitus. As Hwang and colleagues eloquently discuss in this issue of JAMA Otolaryngology–Head & Neck Surgery, there is a growing body of evidence of both the association and causal relationship between migraine and the development of cochlear symptoms.

https://ift.tt/2KOBm5E

Cyclooxygenase 1 mediates IL-33-induced extracellular signal regulated kinase activation in mast cells; Implications for aspirin sensitivity

Publication date: Available online 12 July 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Dingxin Pan, Kathleen M. Buchheit, Sachin K. Samuchiwal, Tao Liu, Haley Cirka, Hannah Raff, Joshua A. Boyce

Abstract

Background

Classical FcεRI-induced mast cell (MC) activation causes synthesis of arachidonic acid (AA)-derived eicosanoids (leukotriene (LT)C₄, prostaglandin D₂ (PGD₂), and thromboxane A₂ (TXA₂)), that mediate vascular leak, bronchoconstriction, and effector cell chemotaxis. Little is known about the significance and regulation of eicosanoid generation in response to non-classical MC activation mechanisms.

Objectives

To determine the regulation and significance of MC-derived eicosanoids synthesized in response to interleukin-33 (IL-33), a cytokine critical to innate type 2 immunity.

Methods

We employed an ex vivo model of mouse bone marrow-derived MCs (BMMCs) and an IL-33-dependent in vivo model of aspirin-exacerbated respiratory disease.

Results

IL-33 potently liberates AA and elicits LTC₄, PGD₂, and TXA₂ production by BMMCs. Unexpectedly, the constitutive function of cyclooxygenase (COX)-1 is required for IL-33 to activate group IVA cytosolic phospholipase A₂ (cPLA₂) with consequent AA release for synthesis of all eicosanoids, including cysLTs. In contrast, COX-1 was dispensable for FcεRI-driven cysLT production. Inhibition of COX-1 prevented IL-33 induced phosphorylation of extracellular signal related kinase (ERK), an upstream effector of cPLA₂, which was restored by exogenous PGH₂, implying that the effects of COX-1 required its catalytic function. The administration of a COX-1-selective antagonist to mice completely prevented the generations of both PGD₂ and LTC₄ in a model of AERD in which MC activation is IL-33-driven.

Conclusions

MC-intrinsic COX-1 amplifies IL-33-induced activation in the setting of innate type 2 immunity, and may help explain the phenomenon of therapeutic desensitization to aspirin by nonselective COX inhibitors in AERD.

https://ift.tt/2KT7jKj

Injectable platelet rich fibrin: cell content, morphological, and protein characterization

Abstract

Objectives

The aim of the present study was to evaluate the blood cell content, morphological aspects, gene expression of type I collagen, and release of growth factors on an injectable platelet rich fibrin (i-PRF).

Materials and methods

Blood samples were collected from 15 volunteers to prepare i-PRF samples. Peripheral blood was used as a control group. Blood clot and i-PRF samples were cultured for 10 days. The supernatant of the samples was collected for ELISA immunoassay quantification of PDGF and VEGF growth factors over periods of 1, 8, 24, 72, and 240 h. I-PRF and blood clot samples were biologically characterized using histological and immunohistochemistry analysis for IL-10, osteocalcin, and TGF-β. Scanning electron microscopy (SEM) was used to inspect the fibrin network and distribution of blood platelets and leukocytes. Reverse transcriptase polymerase chain reaction (RT-PCR) method was used to evaluate gene expression for type I collagen.

Results

A higher concentration of platelets and lymphocytes was recorded in i-PRF than in peripheral blood (p < 0.05). The release of VEGF was higher in blood clot samples (1933 ± 704) than that for i-PRF (852 ± 376; p < 0.001). Immunohistochemistry showed upregulation of TGF-B, IL-10, and osteocalcin in the i-PRF group. RT-PCR showed increased type I collagen gene expression in i-PRF (p < 0.05). SEM images revealed agglomeration of platelets in some regions, while a fibrin networking was noticeable in the entire i-PRF sample.

Conclusions

Injectable platelet rich fibrin becomes a good approach for soft and mineralized tissue healing considering the formation of a three-dimensional fibrin network embedding platelets, leukocytes, type I collagen, osteocalcin, and growth factors. Indeed, the injectable platelet rich fibrin can be indicated in several medical applications regarding bioactivity, simplied technique, and flowable mixing with other biomaterials.

Clinical relevance

Morphological, cell, and protein characterization of platelet rich fibrin provides a better understanding of the clinical effects and improvement of clinical guidelines for several medical applications. Once well physicochemical and biologically characterized, the use of an injectable platelet rich fibrin can be extended to other applications in the field of orthopedics, periodontics, and implant dentistry on the repairing process of both soft and mineralized tissues.

https://ift.tt/2L5hOJG

Primary Tumor Location and RAS/BRAF Mutational Status as Prognostic Factor in Stage III Colon Cancer—Reply

In Reply I read with a great interest the letter from Salvatore and collaborators commenting on our article on the prognostic value of tumor sidedness in patients with stage III colon cancer from the PETACC-8 European trial and its relationship with BRAF and RAS mutational status. We found that while patients with RAS/BRAF wild-type right-sided tumors had a worse disease-free survival, patients with RAS/BRAF-mutant right-sided tumors had a significantly better disease-free survival in comparison with those with left-sided tumors.

https://ift.tt/2Jfr49a

Assessment of Lung Cancer Risk on the Basis of a Biomarker Panel of Circulating Proteins

This validation study investigates the use of circulating protein biomarkers to improve lung cancer risk assessment and eligibility criteria for screening with low-dose computed tomography.

https://ift.tt/2L8xJH4

Delayed Adoption of Evidence-Based Surgical Practices

Management of the axilla has arguably evolved more rapidly than any other area of breast surgery over the past 20 years. Sentinel lymph node (SLN) biopsy superseded axillary lymph node dissection (ALND) for staging the clinically negative axilla and was adopted as the standard of care in the early 2000s after several single-institution and multicenter trials demonstrated test equivalence of SLN biopsy to ALND for axillary staging among patients with early-stage disease.

https://ift.tt/2LaI3Lo

Surgeon Attitudes Toward the Omission of Axillary Dissection in Early Breast Cancer

This survey study examines the propensity of surgeons to use axillary lymph node biopsy alone for axillary management in women with early-stage breast cancer undergoing breast-conserving surgery.

https://ift.tt/2L6TQO3

Management of Relapsed and Refractory Hodgkin Lymphoma in 2018

This Insights discusses management strategies for relapsed and refractory Hodgkin lymphoma using the most recent therapeutic options.

https://ift.tt/2LeXVwu

Optimal Multimodal Treatment for Desmoplastic Small Round Cell Tumors

To the Editor We read with great attention the article by Tun et al describing a case of advanced desmoplastic small round cell tumor (DSRCT) and discussing its optimal management. Although we agree with the authors on the fact that data are scarce on the clinical management of advanced DSRCT, we would like to comment on several issues regarding the current knowledge on the optimal, multimodal management of advanced DSRCT. First, we would like to point out that the benefit of hyperthermic intraperitoneal chemotherapy seems to be limited in patients with extraperitoneal disease. Second, whole abdominal radiotherapy was associated with better outcomes (and in particular peritoneal disease control rate) in large and recent series, in contrast with the authors' statement.

https://ift.tt/2L6qejW

Causes of Death and Conditional Survival Estimates of Survivors of Pancreatic Adenocarcinoma

This population-based study investigates the survival and causes of death in patients with pancreatic adenocarcinoma to 21 years after diagnosis.

https://ift.tt/2JgYc09

Optimal Multimodal Treatment for Desmoplastic Small Round Cell Tumors—Reply

In Reply We thank Mir and colleagues for their thoughtful comments and appreciate the opportunity to respond. First and foremost, our article is an overview of DSRCT in general, not intended for management of the case specifically. Management of desmoplastic small round cell tumor (DSRCT) has been challenging because of its rarity and limited prospective data. Hyperthermic intraperitoneal chemotherapy (HIPEC) has been investigated following cytoreductive surgery. We agree that the use of HIPEC is probably not indicated in patients with extraperitoneal disease. Hayes-Jordan et al conducted a phase 2 study of HIPEC in pediatric patients with sarcoma including DSRCT in which patients with the extra-abdominal extension who could not achieve complete cytoreduction at the time of enrollment were excluded. Adjuvant whole-abdominal radiation therapy (WART) combined with cytoreductive surgery and HIPEC provides adequate local control of DSRCT. And yet it is imperative to recognize the risks of severe complications due to this extensive irradiation. Osborne et al reviewed 32 patients with DSRCT treated with chemotherapy, cytoreductive surgery with HIPEC, followed by WART in which 84% of patients had grade 3 or higher toxic effects. It was concluded that WART following chemotherapy, surgical cytoreduction, and HIPEC is an aggressive treatment for patients with DSRCT and can result in severe adverse effects.

https://ift.tt/2L8Jmha

Primary Tumor Location and RAS/BRAF Mutational Status as Prognostic Factor in Stage III Colon Cancer

To the Editor The post hoc analysis from the PETACC-8 trial reported by Taieb et al showed that the association between primary tumor location cancer and disease-free survival in patients with stage III colon cancer varied on the basis of RAS and BRAF molecular status. In particular, while patients with RAS/BRAF wild-type right-sided tumors had a worse prognosis, patients with RAS- or BRAF-mutant right-sided tumors had a significantly better disease-free survival in comparison with those with left-sided tumors, which is just the opposite of what we observed in the metastatic setting. No possible explanations have been proposed by the authors because neither association between sidedness and disease-free survival according to microsatellite instability status, nor predictive effect of tumor location for cetuximab efficacy, was found.

https://ift.tt/2LcSGNO

Treatment of Relapsed AML With Second Allogeneic Hematopoietic Cell Transplant vs Donor Lymphocyte Infusion

This registry-based study compares survival in patients with acute myelogenous leukemia who have undergone a second allogeneic hematopoietic cell transplant vs donor lymphocyte infusion after relapse.

https://ift.tt/2L74F2A

Conditional Survival as a Pragmatic Resource for Cancer Survivors and Health Care Professionals

Although there are readily available population-level data from national data sets and large clinical trials regarding the likelihood that patients with a de novo diagnosis of cancer may be alive at certain times (ie, 5 years), there is a paucity of data to guide actual cancer survivors on their estimated outcome if they have already survived a certain number of years. In fact, for patients who are followed up years after being treated for a cancer, a common scenario is for the patient and caregivers to ask practitioners what the longer term prognosis may be. The question posed to practitioners may be, "Doc, am I now cured? It's been 5 years since we finished treatment." This is an everyday practical query in the clinic. In the meantime, a currently available crude outcome prediction tool is known as conditional survival. For example, the 5-year conditional (overall and cause-specific) survival can be calculated for covariates that are included in multivariable regression models. Conditional survival is the proportion surviving, for example, 5 additional years, per the following equation: when S(t) is (overall or cause-specific) survival at time t, conditional survival is S( × +5)/S( × ). In this issue of JAMA Oncology, Swords et al calculate conditional survival for pancreatic cancer survivors and demonstrate from the Surveillance, Epidemiology, and End Results data set that mortality from recurrent pancreatic cancer is not the major cause of death for patients who have survived approximately 9 years post diagnosis. In fact, consistent with other studies of survivors from treatment for primary gastrointestinal tract tumors, prognosis improves over time. There are some open-source data sets of cancer survival prediction calculators that have been developed to facilitate pragmatic discussions between patients and clinicians pertaining to conditional survival for select solid tumors. As these outcome tools are refined to include individualized patient-level "-omic" information, next-generation outcome prediction tools have the potential to be more accurate in estimating outcome for cancer survivors.

https://ift.tt/2Jih1js

Interactions among myeloid regulatory cells in cancer

Abstract

Mounting evidence has accumulated on the critical role of the different myeloid cells in the regulation of the cancerous process, and in particular in the modulation of the immune reaction to cancer. Myeloid cells are a major component of host cells infiltrating tumors, interacting with each other, with tumor cells and other stromal cells, and demonstrating a prominent plasticity. We describe here various myeloid regulatory cells (MRCs) in mice and human as well as their relevant therapeutic targets. We first address the role of the monocytes and macrophages that can contribute to angiogenesis, immunosuppression and metastatic dissemination. Next, we discuss the differential role of neutrophil subsets in tumor development, enhancing the dual and sometimes contradicting role of these cells. A heterogeneous population of immature myeloid cells, MDSCs, was shown to be generated and accumulated during tumor progression as well as to be an important player in cancer-related immune suppression. Lastly, we discuss the role of myeloid DCs, which can either contribute to effective anti-tumor responses or play a more regulatory role. We believe that MRCs play a critical role in cancer-related immune regulation and suggest that future anti-cancer therapies will focus on these abundant cells.

https://ift.tt/2NLAvAt

BRONCHOPROTECTIVE EFFECT OF VILANTEROL AGAINST METHACHOLINE-INDUCED BRONCHOCONSTRICTION IN MILD ASTHMATICS: A RANDOMIZED THREE-WAY CROSSOVER STUDY

Publication date: Available online 12 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Grace L.M. Westbury, Christianne M. Blais, Beth E. Davis, Donald W. Cockcroft

Abstract

Background

Ultra-long acting β2 agonists (uLABA) are relatively new anti-asthma medications of which there are three different formulations currently available: olodaterol, indacaterol and vilanterol. The first two formulations have been shown to exert bronchoprotective effects; they are able to prevent airway smooth muscle contraction upon exposure to constricting stimuli. However, studies have found that these two drugs produce different degrees and durations of bronchoprotection against methacholine.

Objective

The objective of this study was to investigate the degree of bronchoprotection provided by vilanterol against methacholine-induced bronchoconstriction.

Methods

Fourteen mild-to-moderate asthmatics [8 male; baseline percent predicted forced expiratory volume in 1 second (FEV1) > 65%; provocative concentration of methacholine causing a 20% reduction in FEV1 (PC20) ≤ 8mg/mL] completed this randomized, double-blind, three-way crossover study. Methacholine challenges were performed before treatment administration (placebo, 100μg fluticasone furoate, or 25μg vilanterol+100μg fluticasone furoate) and at 0.5 and 24 hours posttreatment. Each treatment arm was separated by a minimum 7-day wash-out period. A combination therapy of vilanterol+fluticasone furoate was used, as vilanterol is not available as a monotherapy.

Results

Significant bronchoprotection was evident following the combination treatment at both 0.5 and 24 hours with doubling dose shifts in methacholine PC20 of 2.0 (p=0.0004) and 1.6 (p=0.0001), respectively. Clinically significant bronchodilation was only recorded at 24 hours post-combination treatment (p<0.05).

Conclusion

These findings suggest that vilanterol (in combination with fluticasone furoate) provides significant bronchoprotection against methacholineinduced bronchoconstriction for at least 24 hours in mild-to-moderate asthmatics.

https://ift.tt/2LayVGC

Follicular Penetration of Caffeine from Topically Applied Nanoemulsion Formulations Containing Penetration Enhancers: In vitro Human Skin Studies

Background/Aims: This study aimed to investigate transfollicular delivery enhancement of caffeine from nanoemulsion formulations incorporating oleic acid (OA) and eucalyptol (EU) as chemical penetration enhancers. Methods: Caffeine permeation was evaluated from nanoemulsions containing OA or EU and an aqueous control solution through excised human full-thickness skin with hair follicles opened, blocked, or left untreated. Differential tape stripping was performed, followed by cyanoacrylate skin surface biopsies to determine the amount of caffeine in the hair follicles, and skin extraction to determine the retention of caffeine in the skin. Results: Nanoemulsions significantly increased caffeine permeation through open and untreated skin over control (untreated: 36- and 42-fold for OA and EU, respectively; open: 40- and 49-fold). The follicular route contributed 53.7% of caffeine permeation for the OA nanoemulsion and 51% for EU when follicles were opened. Nanoemulsions promoted 4- and 3.4-fold increases in caffeine retention in open follicles, for OA and EU, respectively. Retention of caffeine in the stratum corneum and skin was almost equal in all cases. Conclusions: This study demonstrated effective delivery of caffeine as a hydrophilic model drug into and through hair follicles and showed that follicles and surrounding regions may be targeted by optimised formulations for specific treatments.
Skin Pharmacol Physiol 2018;31:252–260

https://ift.tt/2KT82uI

Issue Information

Molecular Oral Microbiology, Volume 33, Issue 4, Page i-iv, August 2018.


https://ift.tt/2udZ8Og

What is a normal pharynx? A videofluoroscopic study of anatomy in older adults

Abstract

Purpose

Structural and functional pharyngeal changes occur with age. How these affect swallowing in healthy older adults is not well defined. This study presents quantitative pharyngeal anatomic features in healthy adults using videofluoroscopic study of swallowing (VFSS). This will help our understanding of the normal changes in swallowing that occur with age and illustrate what may constitute normal variation compared with abnormal swallow function.

Methods

138 mixed gender adults with no history of dysphagia were recruited and underwent a standardized VFSS protocol. Parameters including age, BMI, and gender were correlated with the presence of a cricopharyngeal bar, spinal changes and pharyngeal wall thickness at rest.

Results

46% of participants had notable spinal changes. 8% of participants demonstrated cricopharyngeal bars and 12% of subjects revealed osteophytes. Age positively correlated with the presence of a cricopharyngeal bar (r_s = 0.281, p < 0.001) and presence of osteophytes (r_s = 0.334, p < 0.001). The incidence of cricopharyngeal bars in adults over 70 years old was 16%.

Conclusions

A significant number of healthy adults with no swallowing complaints have variant pharyngeal anatomic findings such as cervical vertebral osteophytes and cricopharyngeal bars. This must be taken into account when assessing patients with dysphagia complaints to avoid misattribution of symptoms to these potentially asymptomatic variants. This ensures correct recommendations are made regarding management including diet modification, compensatory strategies, and surgical intervention.

https://ift.tt/2LepGVY

BRONCHOPROTECTIVE EFFECT OF VILANTEROL AGAINST METHACHOLINE-INDUCED BRONCHOCONSTRICTION IN MILD ASTHMATICS: A RANDOMIZED THREE-WAY CROSSOVER STUDY

Ultra-long acting β2 agonists (uLABA) are relatively new anti-asthma medications of which there are three different formulations currently available: olodaterol, indacaterol and vilanterol. The first two formulations have been shown to exert bronchoprotective effects; they are able to prevent airway smooth muscle contraction upon exposure to constricting stimuli. However, studies have found that these two drugs produce different degrees and durations of bronchoprotection against methacholine.

https://ift.tt/2ufEgGc

Molecular genetics of tetrahydrobiopterin deficiency in Chinese patients

Journal Name: Journal of Pediatric Endocrinology and Metabolism
Issue: Ahead of print


https://ift.tt/2KSWibJ

Heritability of Regional Brain Volumes in Large-Scale Neuroimaging and Genetic Studies

Abstract

Brain genetics is an active research area. The degree to which genetic variants impact variations in brain structure and function remains largely unknown. We examined the heritability of regional brain volumes (P ~ 100) captured by single-nucleotide polymorphisms (SNPs) in UK Biobank (n ~ 9000). We found that regional brain volumes are highly heritable in this study population and common genetic variants can explain up to 80% of their variabilities (median heritability 34.8%). We observed omnigenic impact across the genome and examined the enrichment of SNPs in active chromatin regions. Principal components derived from regional volume data are also highly heritable, but the amount of variance in brain volume explained by the component did not seem to be related to its heritability. Heritability estimates vary substantially across large-scale functional networks, exhibit a symmetric pattern across left and right hemispheres, and are consistent in females and males (correlation = 0.638). We repeated the main analysis in Alzheimer's Disease Neuroimaging Initiative (n ~ 1100), Philadelphia Neurodevelopmental Cohort (n ~ 600), and Pediatric Imaging, Neurocognition, and Genetics (n ~ 500) datasets, which demonstrated that more stable estimates can be obtained from the UK Biobank.

https://ift.tt/2JePsI0

Audio-Tactile and Peripersonal Space Processing Around the Trunk in Human Parietal and Temporal Cortex: An Intracranial EEG Study

Abstract

Interactions with the environment happen within one's peripersonal space (PPS)—the space surrounding the body. Studies in monkeys and humans have highlighted a multisensory distributed cortical network representing the PPS. However, knowledge about the temporal dynamics of PPS processing around the trunk is lacking. Here, we recorded intracranial electroencephalography (iEEG) in humans while administering tactile stimulation (T), approaching auditory stimuli (A), and the 2 combined (AT). To map PPS, tactile stimulation was delivered when the sound was far, intermediate, or close to the body. The 19% of the electrodes showed AT multisensory integration. Among those, 30% showed a PPS effect, a modulation of the response as a function of the distance between the sound and body. AT multisensory integration and PPS effects had similar spatiotemporal characteristics, with an early response (~50 ms) in the insular cortex, and later responses (~200 ms) in precentral and postcentral gyri. Superior temporal cortex showed a different response pattern with AT multisensory integration at ~100 ms without a PPS effect. These results, represent the first iEEG delineation of PPS processing in humans and show that PPS and multisensory integration happen at similar neural sites and time periods, suggesting that PPS representation is based on a spatial modulation of multisensory integration.

https://ift.tt/2NLryYc

Synaptic Mechanisms for Bandwidth Tuning in Awake Mouse Primary Auditory Cortex

Abstract

Spatial size tuning in the visual cortex has been considered as an important neuronal functional property for sensory perception. However, an analogous mechanism in the auditory system has remained controversial. In the present study, cell-attached recordings in the primary auditory cortex (A1) of awake mice revealed that excitatory neurons can be categorized into three types according to their bandwidth tuning profiles in response to band-passed noise (BPN) stimuli: nonmonotonic (NM), flat, and monotonic, with the latter two considered as non-tuned for bandwidth. The prevalence of bandwidth-tuned (i.e., NM) neurons increases significantly from layer 4 to layer 2/3. With sequential cell-attached and whole-cell voltage-clamp recordings from the same neurons, we found that the bandwidth preference of excitatory neurons is largely determined by the excitatory synaptic input they receive, and that the bandwidth selectivity is further enhanced by flatly tuned inhibition observed in all cells. The latter can be attributed at least partially to the flat tuning of parvalbumin inhibitory neurons. The tuning of auditory cortical neurons for bandwidth of BPN may contribute to the processing of complex sounds.

https://ift.tt/2LekUI2

Tinnitus perception in patients after vagal nerve stimulator implantation for epilepsy

Vagal nerve stimulation in conjunction with sound therapy has been proposed as a treatment for subjective tinnitus. The purpose of this study is to retrospectively review the effect of VNS on perception of tinnitus in epilepsy patients. We explore the incidence of tinnitus and its perceived reduction in patients requiring implantation of VNS for medically refractory seizures.

https://ift.tt/2L4JZZe

Intratympanic injection of dexamethasone after failure of intravenous prednisolone in simultaneous bilateral sudden sensorineural hearing loss

This study aimed to analyze outcomes of intratympanic injection of dexamethasone after failure of intravenous prednisolone in simultaneous bilateral sudden sensorineural hearing loss (SSNHL).

https://ift.tt/2L7J86L

Utilizing prestin as a predictive marker for the early detection of outer hair cell damage

To evaluate prestin as a biomarker for the identification of early ototoxicity.

https://ift.tt/2L6xU5C

Prevalence and incidence of clinically significant patulous Eustachian tube: A population-based study using the Korean National Health Insurance Claims Database

The aim of this study is to estimate the entire population-based prevalence and incidence of Patulous Eustachian tube (PET) using the Korean National Health Insurance (NHI) claims database. The annual trends of prevalence and incidence of PET were also investigated.

https://ift.tt/2L7J2Mr

Is human papillomavirus and p16 expression associated with survival outcomes in nasopharyngeal cancer?

Human papillomavirus (HPV) is a known prognostic indicator in oropharyngeal cancer. Not much is known about the prognostic role of HPV in Nasopharyngeal cancer (NPC). Here, we performed a systematic review and meta-analysis of the literature to investigate if HPV status was a prognostic factor for NPC.

https://ift.tt/2L2iPlF

Effects of Nd:YAG low-level laser irradiation on cultured human osteoblasts migration and ATP production: in vitro study

Abstract

Low-level laser therapy has become one of the fastest growing fields of medicine in recent years. Many in vivo and in vitro studies have shown that laser irradiation activates a range of cellular processes in a variety of cell types and can promote tissue repair. However, few in vitro experiments have evaluated the effects of laser irradiation on cells in real time. The purpose of this study was to examine the effects of neodymium-doped yttrium aluminum garnet (Nd:YAG) laser irradiation on the migration of cultured human osteoblasts. A dedicated 96-well plate was used, and confluent cultures of the human osteoblast-like cell line, Saos-2, were injured with a wound maker. The wounded cells were then exposed to the Nd:YAG laser (wavelength of 1064 nm) for 60 s at 0.3 W (10 pps, 30 mJ). The total energy density was about 10.34 J/cm². Images of the wounds were automatically acquired inside the CO₂ incubator by the IncuCyte ZOOM™ software. In addition, after laser irradiation, the production of adenosine triphosphate (ATP) was measured using the CellTiter-Glo™ Luminescent Cell Viability Assay. Migration of cells from the border of the original scratch zone was accelerated by laser irradiation. In addition, compared with the control group, significant enhancement of ATP production was observed in the irradiated group. The present study showed that Nd:YAG laser irradiation (wavelength of 1064 nm, 0.3 W, 10 pps, 30 mJ, 10.34 J/cm², irradiation time 60 s) may contribute to the regeneration of bone tissues owing to enhanced osteoblast cell migration.

https://ift.tt/2mf7PmR

CME Part II Psoriasis: Which Therapy for Which Patient Focus on special populations and chronic infections

Despite the availability of several new systemic agents for psoriasis treatment, it can be challenging to choose the right therapy in certain patient populations. There are few up-to-date reviews on systemic drugs for moderate to severe psoriasis in pregnant and pediatric patients and in patients with concomitant chronic infections such as hepatitis, HIV and latent tuberculosis. These groups are usually excluded from clinical trials and much of the available evidence is based on anecdotal case reports and case series.

https://ift.tt/2urj0ge

CME Part I Psoriasis: Which Therapy for Which Patient Psoriasis comorbidities and preferred systemic agents

Psoriasis is a systemic inflammatory disease associated with increased risk of comorbidities such as psoriatic arthritis, Crohn disease, malignancy, obesity and cardiovascular diseases. All these factors have a significant impact on the decision to use one therapy over another. The past decade has seen a paradigm shift in our understanding of the pathogenesis of psoriasis which has led to identification of new therapeutic targets. Several new drugs have gained FDA approval, expanding the psoriasis armamentarium but still a large number of patients continue to be untreated or undertreated.

https://ift.tt/2mdlB9E

Issue Information

Helicobacter, Volume 23, Issue 4, August 2018.


https://ift.tt/2Ji8M7c

Issue Information

Helicobacter, Volume 23, Issue 4, August 2018.


https://ift.tt/2Ji8M7c

Phase II study of accelerated Linac-based SBRT in five consecutive fractions for localized prostate cancer

Abstract

Aim

The goal was to evaluate feasibility, side effects and biochemical no evidence of disease (bNED) after stereotactic body radiation therapy (SBRT) delivered on 5 consecutive days for localized prostate cancer (PC).

Methods

The study was approved by the ethical committee and started in March 2014. Inclusion criteria were age ≤85 years, WHO performance status ≤2, histologically proven adenocarcinoma, low–intermediate risk, no previous surgery (except transurethral resection of the prostate), and a pre-SBRT International Prostatic Symptoms Score of 0–7. The radiotherapy regimen consisted of 35 Gy for low-risk and 37.5 Gy for intermediate-risk PC in 5 consecutive fractions.

Results

At the time of the analysis, 52 patients were recruited to the study (median age 73 years, range 55–83 years; median follow-up 34 months, range 12–49 months; 34 patients low-risk and 18 intermediate risk). The median initial prostate-specific antigen (PSA) was 5.9 ng/ml (range 1.8–15.7). Acute genitourinary (GU) toxicity was G0 (grade 0) 36/52 (69%), G1 11/52 (21%), G2 5/52 (10%), while acute rectal (GI) toxicity was G0 43/52 (83%), G1 8/52 (15%), G2 1/52 (2%). No acute toxicity ≥G3 was recorded. At the time of analysis late GU and GI toxicities were as follows: GU-G0 43/52 (83%), GU-G1 7/52 (13%), GU-G2 2/52 (4%); GI-G0 48/52 (92%), GI-G1 2/52 (4%), GI-G2 2/52 (4%). No late toxicities ≥G3 were recorded. bNED was 98%. One patient with intermediate PC had distant progression.

Conclusions

Accelerated SBRT for low-intermediate PC is feasible and well tolerated with comparable oncological outcome as described for other series with the same RT technique but treatment delivery on every other day. Longer follow-up is needed to the assess late toxicity profile and long-term clinical outcome.

https://ift.tt/2JgNoyZ

Expression of 15‐lipoxygenase‐1 in Merkel cell carcinoma is linked to advanced disease

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2LcQ96y

The radial forearm free flap for scalp and forehead reconstruction: a 20 year experience

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2L3IZVi

Different rhinologic diseases cause a similar multidimensional decrease in generic health‐related quality of life

Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2JgPKya

Nasal airflow resistance measured by rhinomanometry in a healthy population of China

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2KNDbQi

Trends in inferior turbinate surgery: analysis of patients using the Medicare database

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2N8EPIZ

Psoriasis and cancer. An Australian/New Zealand narrative

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2N6Rooo

Exome sequencing identifies novel compound heterozygous mutations in GJB3 gene that cause erythrokeratodermia variabilis et progressiva

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2KTvFnj

Psoriasis and cancer. An Australian/New Zealand narrative

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2N6Rooo

Exome sequencing identifies novel compound heterozygous mutations in GJB3 gene that cause erythrokeratodermia variabilis et progressiva

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2KTvFnj

Liver Biochemical Abnormalities in Turner Syndrome: a Comprehensive Characterisation of an Adult Population

Clinical Endocrinology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2N9zX6F

Inter‐related effects of insulin resistance, hyperandrogenism, sympathetic dysfunction and chronic inflammation in PCOS

Clinical Endocrinology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2KTvxEl

Hiding in a plain sight: a high prevalence of androgen deficiency due to primary hypogonadism among acute medical inpatients with anaemia

Clinical Endocrinology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2N6xMk2

Thyroid Storm and Complete Heart Block after Treatment with Radioactive Iodine.

Related Articles

Thyroid Storm and Complete Heart Block after Treatment with Radioactive Iodine.

Case Rep Endocrinol. 2018;2018:8214169

Authors: Vennard K, Gilbert MP

Abstract
Thyroid storm is a rare endocrine emergency characterized by dysfunction of multiple organ systems. Thyroid storm is more common in Graves' disease and can be precipitated by surgery, trauma, infection, metabolic abnormalities, iodine load, and parturition. We present a diagnostically challenging case of thyroid storm precipitated by radioiodine therapy and accompanied by bradycardia, a rare but life-threatening complication related to treatment for hyperthyroidism.

PMID: 29992062 [PubMed]

https://ift.tt/2NI6cuN

Role of AMPA and NMDA receptors on vasopressin and oxytocin secretion induced by hypertonic extracellular volume expansion

Journal of Neuroendocrinology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2JgG72c

ALIGNed on Adherence: subanalysis of adherence in immune‐mediated inflammatory diseases in the DACH region of the Global‐ALIGN study

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2zwuiFL

Efficacy of non‐surgical treatments for androgenetic alopecia: a systematic review and network meta‐analysis

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


https://ift.tt/2mdGOk0

Position Statement for the Management of Comorbidities in Psoriasis

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2zwtTTL

Acute generalized exanthematous pustulosis: a case‐series of 13 patients in Brazil

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2m8BePI

Factors influencing sessions’ and speakers’ evaluation: an analysis of seven consecutive EADV congress editions

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2urtY5k

EEMCO—European group on efficacy measurement and evaluation of cosmetics and other products

Skin Research and Technology, Volume 24, Issue 3, Page 349-350, August 2018.


https://ift.tt/2L3AEAY

Issue Information

Skin Research and Technology, Volume 24, Issue 3, Page i-iv, August 2018.


https://ift.tt/2Jg2ll0

The skin barrier: Epidermis versus environment

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2uqcxC4

Population pharmacokinetics of subcutaneous C1‐inhibitor for prevention of attacks in patients with hereditary angioedema

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2NJrlVa

Tropomyosins in mosquito and house dust mite cross‐react at the humoral and cellular level

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2JdgQWF

Rare clinical manifestations of leukemia cutis

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2JgEBwZ

Epithelial barrier dysfunctions in atopic dermatitis: a skin–gut–lung model linking microbiome alteration and immune dysregulation

British Journal of Dermatology, EarlyView.


https://ift.tt/2makFmr

In situ bio‐distribution and residency of a topical anti‐inflammatory using fluorescence lifetime imaging microscopy

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2urquzM

Stratum corneum analysis provide a minimal invasive tool to study immune response and skin barrier in atopic dermatitis children

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mcOYcp

Epithelial barrier dysfunctions in atopic dermatitis: a skin–gut–lung model linking microbiome alteration and immune dysregulation

British Journal of Dermatology, EarlyView.


https://ift.tt/2makFmr

In situ bio‐distribution and residency of a topical anti‐inflammatory using fluorescence lifetime imaging microscopy

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2urquzM

Stratum corneum analysis provide a minimal invasive tool to study immune response and skin barrier in atopic dermatitis children

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2mcOYcp

Quality of life in patients with acquired pigmentation: An observational study

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2L7nMqd

Nonsurgical treatment of earlobe aging in Mowlawi stages I and II earlobe ptosis with Hyaluronic acid fillers

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2NJqpAk

Quality of life in patients with acquired pigmentation: An observational study

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2L7nMqd

Nonsurgical treatment of earlobe aging in Mowlawi stages I and II earlobe ptosis with Hyaluronic acid fillers

Journal of Cosmetic Dermatology, EarlyView.


https://ift.tt/2NJqpAk

Incidentally detected pancreatic neuroendocrine microadenoma with lymph node metastasis

Abstract

Pancreatic neuroendocrine microadenomas (NEMAs) are non-functioning neuroendocrine tumors < 0.5 cm with a low proliferation rate and are considered benign. We report on a pancreatic NEMA with lymph node metastasis. A male in his 70s had pylorus-preserving pancreaticoduodenectomy for a distal bile duct carcinoma, which was a 2.1 cm well-differentiated-infiltrating adenocarcinoma with invasion limited to the bile duct wall. An incidental separate 0.4 cm well-differentiated NEMA was found in the pancreatic head with metastatic well-differentiated neuroendocrine tumor in one peripancreatic lymph node. Both neuroendocrine tumors in the pancreatic head and in the lymph node were composed of nests of uniform neoplastic cells with a fine chromatin pattern. The Ki-67 labeling index of NEMA was 0.85%. The neoplastic neuroendocrine cells in both the pancreas and node were diffusely positive for synaptophysin, chromogranin, and insulin. Therefore, this unusual case provides an exception to the current classification system which regards NEMAs as benign lesions.

https://ift.tt/2KPWAQO

Differential expression of cyclooxygenase-2 and cyclin D1 in salivary gland tumors

Abstract

Purpose

Salivary gland tumors are complex and have a great histomorphological diversity; more than 30 histological subtypes are currently described and the study of proteins that help understand and differentiate these tumors is essential. We aimed to analyze the immunoexpression of cyclooxygenase-2 (COX-2) and cyclin D1 proteins in pleomorphic adenomas (PA), mucoepidermoid carcinomas (MEC) and adenoid cystic carcinomas (AdCC) of salivary glands.

Methods

A total of 38 PA, 12 AdCC and 12 MEC underwent immunohistochemical study by the polymeric biotin-free technique. Immunopositive cells were analyzed semi-quantitatively. For statistical analysis, a significance level was set at p ≤ 0.05.

Results

Overall, these tumors were more prevalent in women (n = 37). The mean age of these patients was 58-year-old and the parotid gland was the most affected anatomic site (n = 33). All cases of AdCC and MEC showed immunopositivity to cyclin D1; however, 39.5% of the PAs were negative (p < 0.001). Regarding COX-2 immunoexpression, we observed that all cases of CME were positive, whereas 60.5% of the PA and 75% of the CAC analyzed were completely negative (p = 0.042).

Conclusions

The overexpression of COX-2, observed only in MEC, emphasizes that salivary gland tumors have different profiles. Cyclin D1 is more immunoexpressed in malignant tumors. Together, these immunohistochemical findings may be useful in differentiating the studied tumors.

https://ift.tt/2uqjWBy

TNF-alpha G/A308 polymorphism association with nasal polyposis in North part of Iran

Abstract

Nasal Polyposis (NP) is a complex multi-factorial disease; associated with several environmental, genetic and inflammatory factors. TNF-alpha is one of the major pro-inflammatory cytokines involved in NP pathogenesis. Some of the polymorphisms of this gene affect its expression. Therefore, the aim of this study was to evaluate the polymorphism of TNF-alpha G/A308 gene and its association with nasal polyposis in north part of Iran. In this case-control study, 60 patients with NP and 75 healthy individuals referred to Guilan University hospital were evaluated. After DNA extraction, RFLP-PCR was used to determine polymorphism. Chi-square test was used to compare the frequency distribution of genotype and alleles of TNF-alpha gene with NP. The frequency of genotype G/G, A/A and G/A in the NP group was 46.7, 10.0 and 43.3%, and in the control group was 65.3, 5.3 and 29.3%, respectively. There was a statistically significant difference between genotype G/G in two groups (P = 0.006, OR 2.58, CI 1.27–5.23). In addition, the frequency of allele A in patients and controls was 31.7 and 20%, respectively; and this difference was statistically significant (p = 0.02). The findings of this study demonstrated that polymorphism in TNF-alpha gene might be a risk factor for NP in north part of Iran and the minor frequency of G308A allele in the current study is slightly more than other major populations. However, more investigations with high number of population are necessary in future.

https://ift.tt/2ue1H2D

Pemphigus foliaceus associated with imatinib therapy in a patient with gastrointestinal stromal tumor

International Journal of Dermatology, EarlyView.


https://ift.tt/2zx42Ll

Eccrine hamartoma with spectrum of histologic findings associated with limb deformity

International Journal of Dermatology, EarlyView.


https://ift.tt/2mahsmX

A comparative study of various modalities in the treatment of keloids

International Journal of Dermatology, EarlyView.


https://ift.tt/2zuFuCP

Efficacy of omalizumab 150 mg/month as a maintenance dose in patients with severe chronic spontaneous urticaria showing a prompt and complete response to the drug

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2zy3PYf

Pediatric Wells syndrome (eosinophilic cellulitis) after vaccination: A case report and review of the literature

Pediatric Dermatology, EarlyView.


https://ift.tt/2N4d3NG

Exogenous silicon alters ascorbate-glutathione cycle in two salt-stressed indica rice cultivars (MTU 1010 and Nonabokra)

Abstract

Silicon is widely available in soil and is known to mitigate both biotic and abiotic stress in plants. Very low doses of silicon are becoming increasingly essential in rice for biofortification and preventing water loss. Soil salinity is a matter of grave concern in various parts of the world, and silicon is a suitable candidate to mitigate salinity-induced stress of important plants in affected areas. The present study investigates the protective capability of exogenously applied silicon in ameliorating NaCl-induced toxicity in two rice (Oryza sativa L.) cultivars, the salt-sensitive MTU 1010, and salt-tolerant Nonabokra. Rice seedlings were treated with three doses of NaCl (25, 50, and 100 mM), initially alone and subsequently in combination with 2 mM sodium silicate (Na₂SiO₃, 9H₂O). After 21 days, these plants were examined to determine levels of reduced glutathione, ascorbic acid, cysteine, and activities of different enzymes involved in the ascorbate-glutathione cycle, viz., glutathione reductase (GR), ascorbate peroxidase (APX), glutathione peroxidase (GPx), and glutathione S-transferase (GST). Though ROS levels increased in both the cultivars with increasing NaCl concentrations, cv. MTU 1010 accumulated comparatively higher amounts. A differential response of NaCl-induced toxicity on the two cultivars was observed with respect to the various enzymatic and non-enzymatic antioxidants. APX and GST activities, as well as, cysteine contents, increased concomitantly with salt concentrations, whereas GR activity declined at increasing salt concentrations, in both cultivars. Activity of GPx increased in cv. Nonabokra but declined in cv. MTU 1010, under similar NaCl concentrations. Reduced glutathione (GSH) contents decreased in both cultivars, whereas ascorbate contents declined in only the sensitive cultivar. Application of silicon, along with NaCl, in the test seedlings of both the cultivars, reduced ROS accumulation and boosted antioxidant defense mechanism, through enhancing ascorbate and GSH levels, and activities of ascorbate-glutathione cycle enzymes as well. However, amelioration of salt-induced damages in the sensitive cv. MTU 1010 was more pronounced upon silicon administration, than the tolerant cv. Nonabokra. Thus, cv. MTU 1010 was found to be more responsive to applied silicon. Hence, this study was instrumental in realizing a successful strategy in silicon-mediated amelioration of salinity stress in plants.

https://ift.tt/2ma6Ww3