Introduction Control of cytomegalovirus (CMV) infection after solid organ transplantation (SOT) requires a functional immune system. We assessed the association between quantitation and function of CMV-specific CD8+ T cells and CMV infection in SOT recipients. Methods During a 10-year period, selected kidney, heart, lung, pancreas, liver and composite tissue recipients were tested for CMV-specific CD8+ T cells immune competence (CMV-CD8+), as measured by enumeration, interferon-gamma production and CD107a/b degranulation. Quantitative and functional data were used to assemble T cell immune competence (TIC) score. CMV infection was diagnosed by PCR in blood and other samples, or histopathology. Results Of 130 patients tested, 59 had CMV infection or disease. The median onset to CMV infection was 10.5 months (IQR 5.5-18.7). Gastrointestinal disease (28.8%), pneumonia (20.3%), and CMV syndrome (17%) were most common presentation. An impaired nonspecific or CMV-CD8+ TIC score was associated with tissue-invasive disease (HR 2.84, 95% CI 1.03-11.81; p=.04). Patients with impaired CMV-CD8+ TIC score had longer viremia duration (42.4 vs. 18.8 days, p<.001 patients with impaired nonspecific or cmv-cd8 tic score had higher risk of relapse vs. hr ci p="0.03)." cmv infection disease lower median absolute lymphocyte count cells and cd4 t cell conclusion cmv-specific cd8 function correlated the course after sot measuring these has potential to assist in its clinical management. correspondence: roshini s. abraham ph.d. department laboratory medicine pathology mayo clinic rochester mn abraham.rochini raymund r. razonable m.d. division infectious diseases razonable.raymund authorship page atibordee meesing: participation performance research data collection analysis writing manuscript abraham: reviewing razonable: design approving disclosures: none funding: copyright wolters kluwer health inc. all rights reserved.>
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Τρίτη 7 Αυγούστου 2018
Role of 18F-FDG PET/CT in Restrictive Allograft Syndrome after lung transplantation
Background Differential diagnosis of phenotypes of chronic lung allograft dysfunction (CLAD) remains troublesome. We hypothesized that 18F-FDG PET/CT may help in differential diagnosis of CLAD phenotypes, as it showed promising results regarding diagnosis and prognosis in interstitial lung diseases. Methods A monocentric, retrospective study was performed including all lung transplant recipients suffering from bronchiolitis obliterans syndrome (BOS) or restrictive allograft syndrome (RAS) who underwent 18F-FDG PET/CT scan, in comparison with stable lung transplant recipients. Maximum standardized uptake value (SUVmax) was associated with pulmonary function and survival. Proof-of-concept microCT and glucose transporter-1 (GLUT1) staining served as morphologic validation for regions with different SUVmax. Results SUVmax was higher in RAS (median 2.6, n=29) compared to BOS (median 1.0, n=15) and stable patients (median 0.59, n=8) (p
https://ift.tt/2OOugMO
https://ift.tt/2OOugMO
Patient Functional Status at Transplant and Its Impact on Posttransplant Survival of Adult Deceased-Donor Kidney Recipients
Background Recorded at the time of transplant and reported to the Organ Procurement and Transplantation Network (OPTN), patient's functional status is measured using the Karnofsky Performance Score (KPS), ranging 0-100. Functional status analysis may provide insights on candidate listing and posttransplant survival outcomes for deceased-donor kidney transplants (DDKT). Methods The cohort consisted of adult DDKT recipients transplanted beginning January 2007. One-year and 3-year Cox models for posttransplant survival were fitted with current Scientific Registry of Transplant Recipients (SRTR) variables and KPS. Comparative analyses were performed between the SRTR model without KPS and the augmented model with it. Using the augmented model, we examined the impact of Kidney Donor Profile Index (KDPI) on posttransplant survivals for 5 different KPS strata: 10-30, 40-50, 60-70, 80-90, and 100. Results Comparative analyses showed that KPS was a statistically significant predictor for posttransplant survival: it improved model calibration, discrimination, and predictive accuracy. From the augmented model, the survival curves illustrated that recipients with KPS 40-50 and kidneys with KDPI as high as 99 have expected survival probabilities of above 90% in 1 year and above 80% in 3 years. The expected survival probabilities improve as KPS increases. Recipients with KPS 10-30 have the worst survival probability, even if they received high-quality kidneys. Conclusions Insights from the survival analyses recommend possible inclusion of functional status into SRTR's risk-adjusted models. Moreover, they invite further examination of its use in order to improve current listing and transplantation strategies at transplant centers and potentially reduce deceased-donor kidney discard rate. Corresponding Author: Sanjay Mehrotra, PhD, Professor of Industrial Engineering and Management Sciences, 2145 Sheridan Road, Tech C246, Evanston, IL 60208, Phone: 847-491-3155, Fax: 847-491-8005, E-mail: mehrotra@northwestern.edu Authorship Information Kevin Bui1 MS, Vikram Kilambi2 PhD, James R. Rodrigue3 PhD, Sanjay Mehrotra4 PhD, 1Developed research design, conducted data analysis, and drafted the article; 2Reviewed research design and edited article; 3Reviewed and edited article; 4Developed research design, supervised data analysis, and edited the article; Authors have no conflicts of interest to disclose. This work is funded by National Institutes for Health award 1R21DK108104-01. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
https://ift.tt/2AQOh2y
https://ift.tt/2AQOh2y
Changes in Simultaneous Liver Kidney Transplant Allocation Policy May Impact Post Liver Transplant Outcomes
Background Previous simultaneous liver-kidney transplant (SLK) allocation was based on serum creatinine, a metric that disadvantaged women relative to men. A recent SLK policy change utilizes eGFR, which accounts for sex-based differences in creatinine. Methods To understand the impact of this new policy, we analyzed nonstatus 1 adults listed for liver transplantation (LT) from 5/2007-7/2014, excluding those with exceptions. We defined patients who met the new SLK policy as having an eGFR
https://ift.tt/2AZjQr8
https://ift.tt/2AZjQr8
EFFECT OF DONOR AGE ON OUTCOME OF LUNG TRANSPLANTATION STRATIFIED BY RECIPIENT DIAGNOSIS: A NORDIC MULTICENTER STUDY
Background Organs from older donors are increasingly used in lung transplantation, and studies have demonstrated that this could be safe in selected recipients. However, which recipient groups that have the largest benefit of older organs are unclear. This multicenter study reviews all bilateral lung transplantations (BLTx) from donors ≥55 years stratified by recipient diagnosis, and compares outcomes with transplantations from younger donors. Methods All BLTx recipients (excluding ReTx) at 5 Scandiatransplant centers between 2000 and 2013 were included (n=913). Recipients were stratified to diagnosis groups including cystic fibrosis (CF), Chronic Obstructive Pulmonary Disease (COPD), interstitial lung disease (ILD) and "Other". Intensive care unit (ICU) length of stay (LOS) and survival were assessed. Results Overall, there was no difference in survival among patients transplanted from donors ≥ 55 years compared to younger donors. However, in CF-recipients, donor age ≥55 years was associated with inferior survival (p=0.014), and this remained significant in a multivariate model (HR 5.0, CI 1.8 – 14.1, p=0.002). There was no significant effect of donor age on survival in recipients with COPD, ILD or in the "Other"-group in multivariate models. Utilization of older donors was associated with increased ICU LOS for recipients with CF and ILD, but not in the COPD or "Other"-group. Conclusions BLTx recipients with CF had inferior survival and longer ICU LOS when receiving organs from donors ≥55 years. Recipients with COPD, ILD or in the "Other"-group did not have inferior survival in multivariate models. Authorship information Author-Areas of participation Auråen H-Research design, writing, performance of research, data analysis Durheim MT-Research design, writing, performance of research, data analysis Dellgren G-Writing, performance of research Hämmäinen P-Writing, performance of research Larsson H-Writing, performance of research Geiran O-Writing, performance of research Lawaetz Schultz HH-Writing, performance of research Leuckfeld I-Writing, performance of research Iversen M-Writing, performance of research Fiane AE-Writing, performance of research Holm AM-Research design, writing, performance of research, data analysis Conflict of interest statement: The authors declare no conflicts of interest. Funding: First author Auråen H received funding from The Norwegian Respiratory Society to conduct this research. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
https://ift.tt/2APhTND
https://ift.tt/2APhTND
Effect of institutional case volume on in-hospital mortality after living donor liver transplantation: Analysis of 7073 cases between 2007 and 2016 in Korea
Background The relationship between institutional case volume and clinical outcomes after living donor liver transplantation is not clarified. Methods We conducted a nationwide retrospective cohort study using the database of Korean National Healthcare Insurance Service. Between January 2007 and December 2016, 7073 adult living donor liver transplantations were performed at 50 centers in Korea. Centers were categorized according to the average annual number of liver transplantations: >50, 10 to 50, and 50 liver transplantations/year) had better outcomes after living donor liver transplantation, including in-hospital mortality and long-term mortality, compared to centers with lower case volume (≤50 liver transplantations/year). Seokha Yoo and Eun Jin Jang contributed equally to this work and are co-first authors. Corresponding author: Ho Geol Ryu, MD, PhD, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea, E-mail: hogeol@gmail.com Authorship S.Y.: Study design, Data analysis, First draft of manuscript E.J.J.: Data acquisition, Data analysis, First draft of manuscript N.J.Y.: Revision of manuscript G.H.K.: Data acquisition, Data analysis D.H.K.: Data acquisition, Data analysis H.L.: Study conception, Revision of manuscript C.W.J.: Study design, Revision of manuscript H.G.R.: Study conception, Study design, Revision of manuscript Disclosure The authors declare no conflicts of interest. Funding None. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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https://ift.tt/2vpd88C
Teaching a Tracheotomy Handoff Tool to Pediatric First Responders
Publication date: Available online 7 August 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Nicole Murray, Tulio A. Valdez, Amy L. Hughes, Katherine R. Kavanagh
Abstract
Introduction
The Critical Airway Risk Evaluation (CARE) system is an airway classification system we designed to improve handoffs between caregivers by describing the risk of a patient's airway above the tracheotomy tube, and therefore the correct resuscitation maneuvers in the event of an airway emergency. It is designed to quickly communicate 3 categories: 1-easily intubatable; 2-intubatable with specialized techniques or equipment; or 3-not intubatable. We have demonstrated previously that the system is easily taught to and used by pediatric otolaryngologists. For this system to be useful, it must be usable by a broader group, including first responders to a tracheostomy related airway emergency. The objective of this study is to analyze the reliability of teaching and ease of learning the CARE system among practicing otolaryngologists, otolaryngology residents, and pediatric residents.
Methods
A brief tutorial was designed to introduce the scale and was presented to practicing otolaryngologists, otolaryngology residents, and pediatrics residents. A 30-point questionnaire was administered in which patient's airways and airway management techniques were described. Participants were asked to classify each example according to the CARE system. Statistical analysis was performed using Student's t test and Fleiss' kappa reliability.
Results
A total of 66 physicians participated in the study. The pediatric residents correctly identified the patients' airway class 89% of the time (26.6/30 +/- SD=2.9). Otolaryngology attendings and residents answered correctly 92% of the time (27.7/30 +/- SD=2.9), which was not statistically different (p=0.23). Inter-rater reliability was also substantial among all groups, with a Fleiss' kappa greater than 0.7 for all groups.
Conclusions
This study demonstrates that the system can be taught to pediatrics residents as effectively as it can be taught to otolaryngology residents and practicing otolaryngologists and, therefore, can be effectively utilized in inter-disciplinary handoffs to facilitate information transfer to potential first responders.
https://ift.tt/2ORoQRe
Mechanistic and pharmacological assessment of murine IL-23 mediated psoriasiform dermatitis; implications for drug discovery
Publication date: Available online 7 August 2018
Source: Journal of Dermatological Science
Author(s): Stephen B. Gauld, Donna Gauvin, Lauren Olson, Laura Leys, Stephanie Paulsboe, Zheng Liu, Rebecca M. Edelmayer, Joseph Wetter, Katherine Salte, Yibing Wang, Susan Huang, Prisca Honore, Steven McGaraughty
Abstract
Background
Animal models of Psoriasis (PsO) are important for our understanding of the pathophysiology of human disease but rarely manifest all features of the disease. In order to facilitate greater understanding of the underlying biology of PsO it is key that we understand the strengths and limitations of models used.
Objective
While humanized mouse models are available for PsO they remain technically challenging, expensive, require prolonged timelines and require a continued source of human tissue. Another approach is to focus on developing mechanistic models which recapitulate key features of human PsO. The role of the IL-23/IL-17 pathway as a key driver of human PsO is both well characterized and clinically validated. The goal of this manuscript is to provide a comprehensive disease and pharmacological assessment of IL-23 driven skin inflammation and its similarity to human psoriatic skin.
Methods
Intradermal injection of IL-23 has been used to study the IL-23 pathway in rodents, and this current study further characterizes pathology, cellular infiltrate, and gene signature kinetics, as well as the modulation of disease features by clinically relevant agents.
Results
Our results indicate that IL-23 triggers an early and robust activation of the immune system resulting in accumulation of T cell and monocyte/macrophage populations. It also supports changes in gene expression that parallel those observed in human psoriasis samples and is responsive to biologics commonly used to treat PsO in the clinic.
Conclusions
Collectively, our studies indicate that a 5 day model of IL-23 psoriasiform dermatitis can be used to assess the pharmacology of novel small molecules/biologics in the treatment of PsO.
https://ift.tt/2vsubGO
Rural and Urban Food Allergy Prevalence from the South African Food Allergy Study (Saffa)
Publication date: Available online 7 August 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Maresa Botha, Wisdom Basera, Heidi E. Facey-Thomas, Ben Gaunt, Claudia L. Gray, Jordache Ramjith, Alexandra Watkins, Michael E. Levin
Abstract
Background
Food sensitization and challenge proven food allergy has not been compared in urban and rural settings.
Objective
To determine and compare the prevalence of food sensitization and challenge-proven IgE-mediated food allergy in urban and rural South African toddlers aged 12-36 months.
Methods
This cross-sectional study of unselected children included 1185 participants in urban Cape Town and 398 in the rural Eastern Cape. All participants completed a questionnaire and underwent skin prick tests to egg, peanut, cow's milk, fish, soya, wheat, and hazelnut. Participants with SPT≥ 1mm to one or more foods and not tolerant on history underwent an open oral food challenge.
Result
The prevalence of food allergy was 2.5% (CI 1.6-3.3) in urban children - most commonly to raw egg white (1.9%), followed by cooked egg (0.8%), peanut (0.8%), cow's milk (0.1%) and fish (0.1%). Urban sensitization (≥1mm SPT) to any food was 11.4% (CI 9.6%-13.3%) and 9.0% (CI 7.5%-10.8%) at ≥3mm SPT. Sensitization in the rural cohorts was significantly lower than the urban cohort (1mm SPT 4.5%, CI 2.5-6.6; 3mm SPT 2.8%, CI 1.4-4.9: p<0.01).
In the rural black African cohort 0.5% (CI 0.1%-1.8%) of children were food allergic - all to egg. This is significantly lower than the prevalence of urban cohort overall (2.5%) and urban black African participants (2.9%; CI 1.5%-4.3%)(p=0.006).
Conclusion
Food allergy prevalence in Cape Town is comparable to rates in industrialised middle-income countries and is significantly higher than in rural areas. Further analysis will describe and compare environmental exposures and other risk factors in this cohort.
https://ift.tt/2AR7Tnj
Education-dependent activation of glycolysis promotes the cytolytic potency of licensed human natural killer cells
Publication date: Available online 7 August 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Jolie R. Schafer, Travis C. Salzillo, Nitin Chakravarti, Meisam Naeimi Kararoudi, Prashant Trikha, Jennifer A. Foltz, Ruoning Wang, Shulin Li, Dean A. Lee
Abstract
The mechanism by which natural killer (NK) cell education results in licensed NK cells with heightened effector function against missing-self targets is not known. We found that licensed human NK cells are higher in number in peripheral blood and proliferate more in vitro than unlicensed NK cells. Using high-throughput protein analysis, we found that unstimulated licensed NK cells have increased expression of the glycolytic enzyme PKM2, and after KIR crosslinking have increased phosphorylation of the metabolic modulators p38-α and AMPKα. Following cytokine expansion and activation, unlicensed NK cells solely depended on mitochondrial respiration for cytolytic function, whereas licensed NK cells demonstrated metabolic reprogramming toward glycolysis and mitochondrial-dependent glutaminolysis, leading to accumulation of glycolytic metabolites and depletion of glutamate. As such, blocking both glycolysis and mitochondrial-dependent respiration was required to suppress cytotoxicity of licensed NK cells. Collectively, our data support an arming model of education in which enhanced glycolysis in licensed NK cells supports proliferative and cytotoxic capacity.
https://ift.tt/2OShq0k
Blimp-1 controls Th9 cell development, IL-9 production and allergic inflammation
Publication date: Available online 7 August 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Luciana Benevides, Renata Sesti Costa, Lucas Alves Tavares, Momtchilo Russo, Gislâine A. Martins, Luis Lamberti P. da Silva, Luiza Karla de P. Arruda, Fernando Q. Cunha, Vanessa Carregaro, João Santana Silva
Abstract
Background
The transcriptional repressor Blimp-1 has a key role in terminal differentiation in various T cell subtypes. However, whether Blimp-1 regulates Th9 differentiation and its role in allergic inflammation are unknown.
Objective
We aimed to investigate the role of Blimp-1 in Th9 differentiation and in the pathogenesis of allergic airway inflammation.
Methods
In vitro Th9 differentiation, flow cytometry, ELISA and real-time PCR were used to investigate the effects of Blimp-1 on Th9 polarization. T cell-specific Blimp-1-deficient mice (CKO), a model of allergic airway inflammation, and T cell adoptive transfer to Rag-1-/- mice were used to address the role of Blimp-1 in the pathogenesis of allergic inflammation.
Results
We found that Blimp-1 regulates Th9 differentiation, as deleting Blimp-1 increased IL-9 production in CD4+ T cells in vitro. In addition, we showed that in CKO mice, deletion of Blimp-1 in T cells worsened airway disease, and this worsening was inhibited by the neutralization of IL-9. In asthmatic patients, CD4+ T cells in response to TGF-β plus IL-4 increased IL-9 expression and down-regulated Blimp-1 expression compared to those of healthy controls. Blimp-1 overexpression in human Th9 cells inhibited IL-9 expression. Conclusion: Blimp-1 is a pivotal negative regulator of Th9 differentiation and controls allergic inflammation.
Graphical abstract
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Tertiary lymphoid organs: A novel target in chronic rhinosinusitis
Publication date: Available online 7 August 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Sathish Paramasivan, Susan Lester, Aden Lau, Judy Ou, Alkis Psaltis, Peter-John Wormald, Sarah Vreugde
https://ift.tt/2ORL9WV
Investigating innate immune mechanisms in the early-life development and outcomes of food allergy
Publication date: Available online 7 August 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Andrew Dang, Stephanie Logsdon, Simon P. Hogan
https://ift.tt/2AORdwq
The association between ambient air pollution exposure and mental health status in Chinese female college students: a cross-sectional study
Abstract
The association between exposure to air pollution and mental health has not been adequately studied. Accordingly, this study aimed to explore the association between exposure to ambient air pollution and mental health status among female college students. We performed a cross-sectional study involving female students attending college located in Anshan, a heavy industry city in Northeast China. The investigation was performed using electronic questionnaires including the Symptom Checklist-90 (SCL-90), Pittsburgh Sleep Quality Index (PSQI), Cornell Medical Index (CMI), and general well-being (GWB) scale between March and April 2017. The individual daily average of time spent outdoors in each season was used as an indicator of exposure to ambient air pollution. The association between mental health status and exposure to ambient air pollution was analyzed using general linear regression. Of the 412 female participants, 346 (83.98%) submitted valid questionnaires. Multivariate linear regression indicated that GWB was negatively associated with the SCL-90 score, and annual average daily outdoor time and sleep quality were positively associated with the SCL-90 score. This study demonstrated that exposure to ambient air pollution may be a risk factor for mental health problems among female college students.
https://ift.tt/2Mw0FXe
Lactobacillus rhamnosus LRB mediated inhibition of oral streptococci
Molecular Oral Microbiology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2OSkrxt
Mycosis fungoides in Puerto Rico
Mycosis fungoides (MF) and Sezary syndrome compromise about 53% of cutaneous lymphomas. Disease stage depends on involved body surface area, clinical presentation and the presence or absence systemic involvement, which will determine treatment. MF is generally diagnosed at early stages and carries a chronic and indolent disease course. In 2007, 30 MF cases in Puerto Rico were described from 1983 to 2002. We performed a retrospective chart review of MF cases (1999-2016) to compare these populations and identify any changes in disease prognosis and treatment response given different and new treatment modalities are now available.
https://ift.tt/2Mrt40s
Real-world use of secukinumab for the treatment of plaque psoriasis and psoriatic arthritis: Experience of four dermatology units in Spain
Introduction: Worldwide, there is an increasing trend to use real-world data to inform decision making in health care. The data regarding appropriate drug use, effectiveness, and cost-effectiveness in real-world clinical practice is intended to complement the findings from clinical trials, and to evaluate a drug's real-world value. Secukinumab is a fully humanized anti–interleukin (IL) 17A antibody that specifically binds to IL-17A receptors. In recent years, IL-17A has been recognized to play an important role in the disease pathology.
https://ift.tt/2M8PeYy
Time to tumor response and planned subgroup analyses from the BOLT trial for sonidegib in advanced basal cell carcinoma
Background: Sonidegib 200 mg once daily (qd) was approved in the United States for patients with locally advanced basal cell carcinoma (laBCC) not amenable to curative surgery or radiotherapy based on results of the phase 2 BOLT study (NCT01327053). Here we report time to tumor response and planned subgroup analyses from the 30-month efficacy data from BOLT.
https://ift.tt/2MscNrW
Teledermatology in rural and remote British Columbia: A survey of primary care providers
Teledermatology, defined as the delivery of dermatology care at a distance through telecommunication technologies, has been proposed as a strategy to improve dermatology access to underserved populations. One such population is in rural and remote British Columbia, an area where there are currently no regularly practicing dermatologists. To gain an understanding of teledermatology utilization, attitudes and experiences in this area, we distributed a 14-question survey containing 10 questions related to the study objective.
https://ift.tt/2KxrHLW
Retrospective comparison of the clinical effects of programmed death protein 1 inhibitors to treat melanoma versus nonmelanoma skin cancer
Background: Programmed death protein (PD) 1 inhibitors have revolutionized treatment for cancers such as melanoma. However, clinical benefits and risks of PD-1 inhibitors among nonmelanoma skin cancers (NMSCs) are less well known, although off-label usage has been reported in the medical literature.
https://ift.tt/2OOlvmd
Two cases of cutaneous endometriosis
Cutaneous endometriosis (CEM) is a rare cutaneous manifestation of a common gynecological disease. More than 70% of CEM lesions are seen at sites of previous surgical scars, however primary lesions can arise de-novo in previously normal epithelium. The clinical presentation can vary and mimic other common dermatologic conditions. We present 1 primary and 1 secondary case of young healthy African American women with umbilical CEM. A 30-year-old woman presented with 2 umbilical lesions present for 1 year, associated with intermittent pain, swelling, and bleeding with menstrual cycles.
https://ift.tt/2MscLjO
The importance of early implementation of laser treatment in facial scars: A single-institution retrospective study
Background: Interest in minimizing scars especially on face has been rising recently.
https://ift.tt/2OTmDFc
Subject satisfaction demonstrated for two on-label injection volumes of abobotulinumtoxinA when used to treat moderate to severe glabellar lines
Introduction: In the U.S., glabellar lines (GLs) are most often treated with botulinum toxin type A (BoNT-A) and satisfaction with treatment is typically measured using patient-reported outcomes. Dysport (abobotulinumtoxinA [ABO]) is approved in the U.S. for the treatment of GLs and can be injected at 2 different injection volumes, 0.05 mL and 0.08 mL. In this study, we evaluated both on-label injection volumes in subjects with moderate to severe GLs at maximum frown and asked them to complete questionnaires before and after treatment to assess treatment satisfaction and health-related quality of life subject-reported outcomes, which is the focus of this report.
https://ift.tt/2MobGtl
Ustekinumab an alternative therapeutic option for refractory erytroderma pytiriasis rubra pilaris disease
Introduction: Pityriasis rubra pilaris (PRP) is a rare, chronic erythematous squamous disorder. PRP is divided into six subtypes, type 1 being the most common and classic form in adults. PRP erytroderma may be a therapeutic challenge because standard therapies are lacking due to its unclear pathogenesis. Ustekinumab is a monoclonal antibody that is approved for the treatment of psoriasis, but has been shown to be effective as an off-label use treatment for PRP. We report a case of refractory erythroderma type 1 PRP with complete resolution with ustekinumab therapy.
https://ift.tt/2KxrisU
Treating to target: Exploration of Investigator Global Assessment and body surface area (IGA×BSA) as a practical minimal disease activity goal
Objective: Psoriasis Area Severity Index (PASI) is typically used in clinical trials, but may not be pragmatic for use in clinical practice. The Investigator Global Assessment (IGA) and percentage of affected body surface area (BSA) are measures of psoriasis disease activity that are easily performed in routine clinical practice. This retrospective pooled analysis explored cutoff values of the product of IGA and BSA (IGA×BSA) that correlate with minimal disease activity (MDA) and would allow for a treat-to-target approach that may be feasible in clinical practice.
https://ift.tt/2Mc9dWe
The sun and your health: Targeting teenagers and adolescents in British Columbia
Introduction: Skin cancer is one of the most preventable forms of cancer. Approximately 85% of skin cancer cases could be avoided by reducing ultraviolet (UV) exposure, especially during childhood and adolescence. We conducted a pilot study to evaluate UV exposure and sun safety behaviors in this age group. In addition, the effectiveness in changing sun protection knowledge, attitudes, and behaviors using an innovative intervention was compared with the strategy of using education alone.
https://ift.tt/2Kxr7he
The effect of topical sunscreen plus antioxidant against the visible light biologic effects
Background: Visible light (VL) has been shown to induce erythema, pigmentation, and photodamage. Sunscreens effective against VL contain inorganic filters, but are often cosmetically unacceptable in darker skin tones. Antioxidants possess photoprotective properties and may serve as an alternative.
https://ift.tt/2Mc984S
Sparing the use of steroids in the treatment of Sweet syndrome: A case report
Sweet syndrome is an acute febrile neutrophilic dermatosis first decribed in 1964. It is an uncommon disease, with no racial predisposition, that affects mostly women 30-60 years of age. Its physiopathology is unknown and 20% of the cases are linked to malignant tumors. It can also be associated with autoimmune diseases, drug intake, pregnancy and 60% are idiopathic. It can present with papules, nodules, and erythematous plaques, most of the times painful. Edema is associated, and can lead to vesicules, bullae, and/or pustules.
https://ift.tt/2MsoC1B
Spontaneous regression of Merkel cell carcinoma is associated with clonal T-cell expansion
Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin tumor. MCC is immunogenic and highly responsive to immune checkpoint inhibitors. There are at least 45 reported cases of spontaneous regression of both local and metastatic MCC following biopsies, excisions, fine needle aspirations, and in 1 case after allergic contact dermatitis. Spontaneous tumor regression has also been observed in other tumor types, however the mechanism is poorly understood. There has been speculation that trauma-induced antigen shedding and subsequent recruitment of a host immune response drives tumor regression.
https://ift.tt/2Mc9U1A
Serratia pyoderma mimicking acne vulgaris
A 17-year-old woman with no significant medical history presented complaining of acne. She reported that three days before her "acne" started she applied tea tree oil (TTO) for a few pimples. Photos on the patient's phone before TTO application revealed completely clear facial skin. Within a few days of TTO use she developed a facial eruption. She was evaluated by her pediatrician who prescribed minocycline for 10 days along with adapalene and benzoyl peroxide. She did not improve and was referred to dermatology.
https://ift.tt/2KzM1fK
Safety and efficacy of microfocused ultrasound with visualization for the correction of moderate-to-severe atrophic acne scars
Background and objective: Microfocused ultrasound with visualization (MFU-V; Ulthera) has been shown to induce collagen production and remodeling of tissue layers in the skin. The purpose of this study was to assess the efficacy and safety of MFU-V for improving the appearance of atrophic acne scars.
https://ift.tt/2OSUy0m
Mast cell activation syndrome: High frequency of skin manifestations and anaphylactic shock
Publication date: Available online 7 August 2018
Source: Allergology International
Author(s): Eline A. Casassa, Claire Mailhol, Emilie Tournier, Camille Laurent, Yannick Degboe, Marine Eischen, Natalia Kirsten, Jacques Moreau, Solène M. Evrard, Véronique Mansat-De Mas, Laurence Lamant, Patrice Dubreuil, Pol André Apoil, Olivier Hermine, Carle Paul, Cristinai Bulai Livideanu
https://ift.tt/2AN26PB
Putative neuromycotoxicoses in an adult male following ingestion of moldy walnuts
Abstract
A tremorgenic syndrome occurs in dogs following ingestion of moldy walnuts, and Penicillium crustosum has been implicated as the offending fungus. This is the first report of suspected moldy walnut toxicosis in man. An adult male ingested approximately eight fungal-infected walnut kernels and after 12 h experienced tremors, generalized pain, incoordination, confusion, anxiety, and diaphoresis. Following symptomatic and supportive treatment at a local hospital, the man made an uneventful recovery. A batch of walnuts (approximately 20) was submitted for mycological culturing and identification as well as for mycotoxin analysis. Penicillium crustosum Thom was the most abundant fungus present on walnut samples, often occurring as monocultures on isolation plates. Identifications were confirmed with DNA sequences. The kernels and shells of the moldy walnuts as well as P. crustosum isolates plated on yeast extract sucrose (YES) and Czapek yeast autolysate (CYA) agars and incubated in the dark at 25 °C for 7 days were screened for tremorgenic mycotoxins and known P. crustosum metabolites using a liquid chromatography-tandem mass spectrometric (LC-MS/MS) method. A relatively low penitrem A concentration of only 1.9 ng/g was detected on the walnut kernels when compared to roquefortine C concentrations of 21.7 μg/g. A similar result was obtained from P. crustosum isolates cultured on YES and CYA, with penitrem A concentrations much lower (0.6–6.4 μg per g mycelium/agar) compared to roquefortine C concentrations (172–1225 μg/g). The authors surmised that besides penitrem A, roquefortine C might also play an additive or synergistic role in intoxication of man.
https://ift.tt/2vobMe4
An integrated deep sequencing analysis of microRNAs in transplanted corneas
Publication date: September 2018
Source: Molecular Immunology, Volume 101
Author(s): Xiaoli Lu, Jing Wu, Ming Ma, Xiaosong Wu, Jing Wen, Jian Yu
Abstract
Illumina Hiseq 2500 deep sequencing was used to screen for differentially expressed genes (DEGs) in matched pairs of isograft corneas and normal corneas, allograft corneas and isograft corneas. Our results showed that 22 miRNAs were significantly upregulated and 4 were significantly downregulated in the isograft group when compared with the control group (P < 0.01), while 17 miRNAs were significantly upregulated and 3 were significantly downregulated in the allograft group when compared with the isograft group (P < 0.01). Among the miRNAs with altered expression levels, miR-155-5p, miR-142-3p, miR-142-5p, and miR-223-3p displayed simultaneous changes in the above two comparisons. Potential target genes among the DEGs were predicted using target prediction software (TargetScan, Miranda, miRDB, and CLIP), and the overlay portion was analyzed using the Gene Ontology (GO) database and the Kyoto Encyclopedia of Genes and Genomes (KEGG). GO and KEGG analyses showed that the DEGs were mainly involved in metabolic pathways, cytokine secretion, and tumor immunity functions. An analysis of the interactions between DEG proteins (PPI analysis) and a MetaCore software analysis of 4 key DEGs revealed that the genes regulated by miR-155-5p played important roles in the miRNA-mRNA regulatory network. Furthermore, the MetaCore analysis identified C/EBP beta, p53, and sp1 as key transcription factors in that network. Our study identified transplanted corneas-specific miRNA in matched pairs of isograft corneas and normal corneas, allograft corneas and isograft corneas. Furthermore, bioinformatics analysis of the key miRNA regulatory network revealed the molecular mechanisms, which suggests miRNAs may as new molecular targets for treating corneal injuries and corneal transplant rejection.
https://ift.tt/2APOdQv
The effectiveness of eugenol against cisplatin-induced ototoxicity
Publication date: Available online 7 August 2018
Source: Brazilian Journal of Otorhinolaryngology
Author(s): Muhammed Sedat Sakat, Korhan Kilic, Fazile Nur Ekinci Akdemir, Serkan Yildirim, Gizem Eser, Ahmet Kiziltunc
Abstract
Introduction
Ototoxicity refers to cellular damage or function impairment developing in the inner ear in association with any therapeutic agent or chemical substance, and still represents the principal side-effect restricting the use of cisplatin.
Objective
The aim of this study was to perform a biochemical, functional and histopathological investigation of the potential protective effect of eugenol against cisplatin-induced ototoxicity.
Methods
The study was performed with 24 female Sprague Dawley rats. Distortion product otoacoustic emissions tests were performed on all animals, which were randomized into four equal groups. A single intraperitoneal dose of 15 mg/kg cisplatin was administered to cisplatin group, while the eugenol group received 100 mg/kg eugenol intraperitoneal for five consecutive days. 100 mg/kg eugenol was administered to cisplatin + eugenol group for 5 days. On the third day, these rats were received a single dose of 15 mg/kg cisplatin. The control group was given 8 mL/kg/day intraperitoneal saline solution for five days. The distortion product otoacoustic emissions test was repeated 24 h after the final drug administration. All animals were sacrificed, and the cochleas were subsequently used for biochemical and histopathological examinations.
Results
Cisplatin caused oxidative stress in the cochlea, impaired the cochlear structure and significantly reduced signal noise ratio levels. Administration of eugenol together with cisplatin reversed these effects and provided functional, biochemical and histopathological protection.
Conclusion
The study findings represent the first indication in the literature that eugenol may protect against ototoxicity by raising levels of antioxidant enzymes and lowering those of oxidant parameters.
Resumo
Introdução
A ototoxicidade refere-se ao dano celular ou comprometimento da função da orelha interna interna associado a qualquer agente terapêutico ou substância química, e ainda representa o principal efeito colateral que restringe o uso da cisplatina.
Objetivo
O objetivo deste estudo foi realizar uma investigação bioquímica, funcional e histopatológica do potencial efeito protetor do eugenol contra a ototoxicidade induzida pela cisplatina.
Método
O estudo foi realizado com 24 ratos fêmeas Sprague Dawley. Testes de emissões otoacústicas por produto de distorção foram realizados em todos os animais, os quais foram randomizados em quatro grupos iguais. Uma única dose intraperitoneal de 15 mg/kg de cisplatina foi administrada ao grupo cisplatina, enquanto o grupo eugenol recebeu 100 mg/kg de eugenol intraperitoneal por cinco dias consecutivos. Foram administrados 100 mg/kg de eugenol ao grupo cisplatina + eugenol durante 5 dias. No terceiro dia, estes ratos receberam uma dose única de 15 mg/kg de cisplatina. O grupo controle recebeu 8 mL/kg/dia de solução salina intraperitoneal por cinco dias. O teste de emissões otoacústicas por produto de distorção foi repetido 24 horas após a administração final do medicamento. Todos os animais foram sacrificados e as cócleas foram posteriormente utilizadas para exames bioquímicos e histopatológicos.
Resultados
A cisplatina causou estresse oxidativo na cóclea, prejudicou a estrutura coclear e reduziu significativamente os níveis da relação sinal/ruído. A administração de eugenol juntamente com a cisplatina reverteu esses efeitos e forneceu proteção funcional, bioquímica e histopatológica.
Conclusão
Os achados do estudo representam a primeira indicação na literatura de que o eugenol pode proteger contra a ototoxicidade, elevando os níveis de enzimas antioxidantes e diminuindo os níveis dos parâmetros oxidantes.
https://ift.tt/2ORmrWP
Mitigation of NOx emission using aromatic and phenolic antioxidant-treated biodiesel blends in a multi-cylinder diesel engine
Abstract
The present work analyzes the effect of antioxidants on engine combustion performance of a multi-cylinder diesel engine fueled with PB30 and PB50 (30 and 50 vol.% palm biodiesel (PB)). Four antioxidants namely N,N′-diphenyl-1,4-phenylenediamine (DPPD), N-phenyl-1,4-phenylenediamine (NPPD), 2(3)-tert-Butyl-4-methoxyphenol (BHA), and 2-tert-butylbenzene-1,4-diol (TBHQ) were added at concentrations of 1000 and 2000 ppm to PB30 and PB50. TBHQ showed the highest activity in increasing oxidation stability in both PB30 and PB50 followed by BHA, DPPD, and NPPD respectively, without any negative effect on physical properties. Compared to diesel fuel, PB blends showed 4.61–6.45% lower brake power (BP), 5.90–8.69% higher brake specific fuel consumption (BSFC), 9.64–11.43% higher maximum in cylinder pressure, and 7.76–12.51% higher NO emissions. Carbon monoxide (CO), hydrocarbon (HC), and smoke opacity were reduced by 36.78–43.56%, 44.12–58.21%, and 42.59–63.94%, respectively, than diesel fuel. The start of combustion angles (SOC) of PB blends was − 13.2 to − 15.6 °CA BTDC, but the combustion delays were 5.4–7.8 °CA short compared to diesel fuel which were − 10 °CA BTDC and 11°CA respectively. Antioxidant fuels of PB showed higher BP (1.81–5.32%), CO (8.41–24.60%), and HC (13.51–37.35%) with lower BSFC (1.67–7.68%), NO (4.32–11.53%), maximum in cylinder pressure (2.33–4.91%) and peak heat release rates (HRR) (3.25–11.41%) than baseline fuel of PB. Similar SOC of − 13 to − 14 °CA BTDC was observed for PB blended fuels and antioxidants. It can be concluded that antioxidants' addition is effective in increasing the oxidation stability and in controlling the NOx emissions of palm biodiesel fuelled diesel engine.
https://ift.tt/2KzYgbS
Diagnosis by Comprehensive Cardiovascular Imaging for Stroke and TIA
Conditions: Stroke; Transient Ischaemic Attack
Intervention: Diagnostic Test: CCI scanning (CTA, cardiac CT), and MRI scanning
Sponsors: NHS Greater Glasgow and Clyde; University of Glasgow
Not yet recruiting
https://ift.tt/2KCLnhs
Intervention: Diagnostic Test: CCI scanning (CTA, cardiac CT), and MRI scanning
Sponsors: NHS Greater Glasgow and Clyde; University of Glasgow
Not yet recruiting
https://ift.tt/2KCLnhs
Stereotactic Body Radiation Therapy and Durvalumab With or Without Tremelimumab Before Surgery in Treating Participants With Human Papillomavirus Positive Oropharyngeal Squamous Cell Caner
Conditions: Clinical Stage I HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC (American Joint Committee on Cancer) v8; Clinical Stage II HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8; Clinical Stage III HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8; Human Papillomavirus Positive; Oropharyngeal Squamous Cell Carcinoma; p16 Positive Neoplastic Cells Present; Pathologic Stage I HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8; Pathologic Stage II HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8; Pathologic Stage III HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8
Interventions: Biological: Durvalumab; Procedure: Modified Radical Neck Dissection; Other: Quality-of-Life Assessment; Other: Questionnaire Administration; Radiation: Stereotactic Body Radiation Therapy; Procedure: Transoral Robotic Surgery; Biological: Tremelimumab
Sponsors: Jonsson Comprehensive Cancer Center; National Cancer Institute (NCI)
Not yet recruiting
https://ift.tt/2LZmKBg
Interventions: Biological: Durvalumab; Procedure: Modified Radical Neck Dissection; Other: Quality-of-Life Assessment; Other: Questionnaire Administration; Radiation: Stereotactic Body Radiation Therapy; Procedure: Transoral Robotic Surgery; Biological: Tremelimumab
Sponsors: Jonsson Comprehensive Cancer Center; National Cancer Institute (NCI)
Not yet recruiting
https://ift.tt/2LZmKBg
Impact of Cancer Therapy on Myocardial Function in Patients With Esophagus Cancer
Condition: Cancer of Esophagus
Intervention:
Sponsors: Aarhus University Hospital Skejby; Danish Cancer Society
Recruiting
https://ift.tt/2KzVmUw
Intervention:
Sponsors: Aarhus University Hospital Skejby; Danish Cancer Society
Recruiting
https://ift.tt/2KzVmUw
Durvalumab With or Without Metformin in Treating Participants With Head and Neck Squamous Cell Carcinoma
Conditions: Larynx; Lip, Oral Cavity and Pharynx
Interventions: Drug: Metformin; Biological: Durvalumab
Sponsor: Sidney Kimmel Cancer Center at Thomas Jefferson University
Not yet recruiting
https://ift.tt/2M1ZmmE
Interventions: Drug: Metformin; Biological: Durvalumab
Sponsor: Sidney Kimmel Cancer Center at Thomas Jefferson University
Not yet recruiting
https://ift.tt/2M1ZmmE
Diagnosis by Comprehensive Cardiovascular Imaging for Stroke and TIA
Conditions: Stroke; Transient Ischaemic Attack
Intervention: Diagnostic Test: CCI scanning (CTA, cardiac CT), and MRI scanning
Sponsors: NHS Greater Glasgow and Clyde; University of Glasgow
Not yet recruiting
https://ift.tt/2KCLnhs
Intervention: Diagnostic Test: CCI scanning (CTA, cardiac CT), and MRI scanning
Sponsors: NHS Greater Glasgow and Clyde; University of Glasgow
Not yet recruiting
https://ift.tt/2KCLnhs
Stereotactic Body Radiation Therapy and Durvalumab With or Without Tremelimumab Before Surgery in Treating Participants With Human Papillomavirus Positive Oropharyngeal Squamous Cell Caner
Conditions: Clinical Stage I HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC (American Joint Committee on Cancer) v8; Clinical Stage II HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8; Clinical Stage III HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8; Human Papillomavirus Positive; Oropharyngeal Squamous Cell Carcinoma; p16 Positive Neoplastic Cells Present; Pathologic Stage I HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8; Pathologic Stage II HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8; Pathologic Stage III HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8
Interventions: Biological: Durvalumab; Procedure: Modified Radical Neck Dissection; Other: Quality-of-Life Assessment; Other: Questionnaire Administration; Radiation: Stereotactic Body Radiation Therapy; Procedure: Transoral Robotic Surgery; Biological: Tremelimumab
Sponsors: Jonsson Comprehensive Cancer Center; National Cancer Institute (NCI)
Not yet recruiting
https://ift.tt/2LZmKBg
Interventions: Biological: Durvalumab; Procedure: Modified Radical Neck Dissection; Other: Quality-of-Life Assessment; Other: Questionnaire Administration; Radiation: Stereotactic Body Radiation Therapy; Procedure: Transoral Robotic Surgery; Biological: Tremelimumab
Sponsors: Jonsson Comprehensive Cancer Center; National Cancer Institute (NCI)
Not yet recruiting
https://ift.tt/2LZmKBg
Impact of Cancer Therapy on Myocardial Function in Patients With Esophagus Cancer
Condition: Cancer of Esophagus
Intervention:
Sponsors: Aarhus University Hospital Skejby; Danish Cancer Society
Recruiting
https://ift.tt/2KzVmUw
Intervention:
Sponsors: Aarhus University Hospital Skejby; Danish Cancer Society
Recruiting
https://ift.tt/2KzVmUw
Durvalumab With or Without Metformin in Treating Participants With Head and Neck Squamous Cell Carcinoma
Conditions: Larynx; Lip, Oral Cavity and Pharynx
Interventions: Drug: Metformin; Biological: Durvalumab
Sponsor: Sidney Kimmel Cancer Center at Thomas Jefferson University
Not yet recruiting
https://ift.tt/2M1ZmmE
Interventions: Drug: Metformin; Biological: Durvalumab
Sponsor: Sidney Kimmel Cancer Center at Thomas Jefferson University
Not yet recruiting
https://ift.tt/2M1ZmmE
Soil exposure modifies the gut microbiota and supports immune tolerance in a mouse model
Publication date: Available online 7 August 2018
Source: Journal of Allergy and Clinical Immunology
Author(s): Noora Ottman, Lasse Ruokolainen, Alina Suomalainen, Hanna Sinkko, Piia Karisola, Jenni Lehtimäki, Maili Lehto, Ilkka Hanski, Harri Alenius, Nanna Fyhrquist
Background
Sufficient exposure to natural environments, in particular soil and its microbes, has been suggested to be protective against allergies.
Objective
We aim at gaining more direct evidence of the environment-microbiota-health axis by studying the colonization of gut microbiota in mice after exposure to soil and by examining immune status in both a steady-state situation and during allergic inflammation.
Methods
The gastrointestinal microbiota of mice housed on clean bedding or in contact with soil was analyzed by using 16S rRNA gene sequencing, and the data were combined with immune parameters measured in the gut mucosa, lung tissue, and serum samples.
Results
We observed marked differences in the small intestinal and fecal microbiota composition between mice housed on clean bedding or in contact with soil, with a higher proportion of Bacteroidetes relative to Firmicutes in the soil group. The housing environment also influenced mouse intestinal gene expression, as shown by upregulated expression of the immunoregulatory markers IL-10, forkhead box P3, and cytotoxic T lymphocyte–associated protein 4 in the soil group. Importantly, using the murine asthma model, we found that exposure to soil polarizes the immune system toward TH1 and a higher level of anti-inflammatory signaling, alleviating TH2-type allergic responses. The inflammatory status of the mice had a marked influence on the composition of the gut microbiota, suggesting bidirectional communication along the gut-lung axis.
Conclusion
Our results provide evidence of the role of environmentally acquired microbes in alleviating against TH2-driven inflammation, which relates to allergic diseases.
Graphical abstract
https://ift.tt/2vT7Y4b
Variations in the management of acute illness in children with congenital adrenal hyperplasia: An audit of three paediatric hospitals
Clinical Endocrinology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2KFnHJc
Gestational diabetes mellitus: different management strategies should be adopted for different subsets of patients diagnosed by oral glucose tolerance test
Abstract
Purpose
To compare women diagnosed with gestational diabetes mellitus (GDM) according to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria based on the number of OGTT diagnostic criteria, which OGTT parameters are altered and the glycemic deviation from proposed diagnostic cutoffs.
Methods
Cross-sectional, multicentric study of women diagnosed with GDM between 24–28 weeks of pregnancy according to the IADPSG criteria, in Portugal, between 2012–2014. Primary outcomes: large for gestational age (LGA) and maternal glucose metabolism status after delivery. Secondary outcome: small for gestational age (SGA).
Results
Three-thousand three-hundred fourteen patients were included; 67% had 1 OGTT altered value; 3.6% had LGA and 13% had SGA newborns; 7% had prediabetes/diabetes after delivery. Three diagnostic criteria in OGTT (OR 3.02; p < 0.001), a diagnostic value at 0 min (OR 2.09; p = 0.002) and 60 min (OR 1.70; p = 0.022) and glucose deviation at 0 min (OR 1.02; p = 0.014) were predictors of LGA. Having 2 (OR 1.94; p < 0.001) or 3 (OR 3.93; p < 0.001) diagnostic criteria in OGTT, a diagnostic value at 0 min (OR 1.76; p = 0.002), at 60 min (OR 1.57; p = 0.007) and at 120 min (OR 3.11; p < 0.001), the glucose deviation at 0 (OR 1.02; p = 0.017) and 120 min (OR 1.02; p < 0.001) were predictors of prediabetes/diabetes after delivery. Insufficient weight gain in pregnancy (OR 1.49; p < 0.001) and lower maternal BMI (OR 0.97; p = 0.024) were associated with SGA.
Conclusion
IADPSG diagnostic criteria include a heterogeneous group of women, for whom different management strategies should be adopted to obtain ideal pregnancy outcomes.
https://ift.tt/2vtLozq
Gestational diabetes mellitus: different management strategies should be adopted for different subsets of patients diagnosed by oral glucose tolerance test
Abstract
Purpose
To compare women diagnosed with gestational diabetes mellitus (GDM) according to the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria based on the number of OGTT diagnostic criteria, which OGTT parameters are altered and the glycemic deviation from proposed diagnostic cutoffs.
Methods
Cross-sectional, multicentric study of women diagnosed with GDM between 24–28 weeks of pregnancy according to the IADPSG criteria, in Portugal, between 2012–2014. Primary outcomes: large for gestational age (LGA) and maternal glucose metabolism status after delivery. Secondary outcome: small for gestational age (SGA).
Results
Three-thousand three-hundred fourteen patients were included; 67% had 1 OGTT altered value; 3.6% had LGA and 13% had SGA newborns; 7% had prediabetes/diabetes after delivery. Three diagnostic criteria in OGTT (OR 3.02; p < 0.001), a diagnostic value at 0 min (OR 2.09; p = 0.002) and 60 min (OR 1.70; p = 0.022) and glucose deviation at 0 min (OR 1.02; p = 0.014) were predictors of LGA. Having 2 (OR 1.94; p < 0.001) or 3 (OR 3.93; p < 0.001) diagnostic criteria in OGTT, a diagnostic value at 0 min (OR 1.76; p = 0.002), at 60 min (OR 1.57; p = 0.007) and at 120 min (OR 3.11; p < 0.001), the glucose deviation at 0 (OR 1.02; p = 0.017) and 120 min (OR 1.02; p < 0.001) were predictors of prediabetes/diabetes after delivery. Insufficient weight gain in pregnancy (OR 1.49; p < 0.001) and lower maternal BMI (OR 0.97; p = 0.024) were associated with SGA.
Conclusion
IADPSG diagnostic criteria include a heterogeneous group of women, for whom different management strategies should be adopted to obtain ideal pregnancy outcomes.
https://ift.tt/2vtLozq
Differences in Rate of Complete Excision of Basal Cell Carcinoma by Dermatologists, Plastic Surgeons and General Practitioners: A Large Cross-Sectional Study
Background: Due to the increasing incidence of basal cell carcinoma (BCC) and rising health care costs, health care insurance companies seek ways to shift skin surgery for BCC from secondary to primary care. Objectives: To study the differences in complete excision of BCC by general practitioners (GPs), dermatologists, and plastic surgeons. Methods: A retrospective cross-sectional study of pathology records of 2,986 standard excisions of primary BCCs performed by a GP, dermatologist, or plastic surgeon in the area of Southwest Netherlands between 2008 and 2014. To compare the risk of an incomplete BCC excision between the specialties, the odds ratio (OR) was used adjusted for patient age, sex, tumor site, size, and histological subtype. Results: BCCs were completely excised by GPs in 70%, which was lower than the 93% by dermatologists and 83% by plastic surgeons (p #x3c; 0.001). Compared to the dermatologist, BCCs which were excised by a GP were 6 times higher at risk of an incomplete excision (adjusted OR 6, 95% CI 5–8) and 2 times higher at risk when excised by a plastic surgeon (adjusted OR 2, 95% CI 2–3). Conclusion: BCCs were more often completely excised by dermatologists than by GPs and plastic surgeons. Dermatologists probably perform better because of their extensive training and high experience in BCC care. To minimize incomplete BCC excision, GPs should receive specific training before the shift of BCC care from secondary to primary care is justifiable.
Dermatology
https://ift.tt/2MrGsll
Dermatology
https://ift.tt/2MrGsll
Hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) reduction by granular zero-valent iron in continuous flow reactor
Abstract
Wastewater streams containing hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) are subject to regulatory discharge regulations that require processing through industrial waste treatment. Thus, the development of easy-to-apply technologies for the treatment of RDX-laden wastewater streams is imperative. In the present study, the reduction of RDX by granular zero valent iron (GZVI) in batch and column experiments was investigated. Preliminary batch tests conducted under both oxic and anoxic conditions showed that after 3.0 h of reaction with GZVI, RDX was mainly converted to formaldehyde (CH2O), nitrate (NO3−), and ammonium (NH4+). Column filtration tests showed that pretreatment of the GZVI media with acid wash and low influent pH (4.0 ± 0.1) achieved 99% removal of RDX up to 5000 bed volume. BOD tests carried out on the post-treatment streams showed increased biodegradability of the treated wastewater, leading to a lower environmental impact for the final waste.
https://ift.tt/2OlVABf
Decentralization, national context and environmental policy performance: a fuzzy set qualitative comparative analysis
Abstract
This study examines the complex relationship between decentralization, national context and environment policy performance with the cross-sectional data from 118 countries. Decentralization is decomposed into three dimensions: political, fiscal and administrative. Both multiple regression analysis and fuzzy set qualitative comparative analysis are adopted. Results show that: (1) political, fiscal and administrative decentralization differ in their impacts on environmental policy performance. (2) There are multiple pathways, constituted by specific configurations of decentralization and context conditions, to high (or low) environmental policy performance. (3) High environmental policy performance occurs most often when a country is fiscally and administratively decentralized and its context is favorable, i.e. advanced economy, good governance and stringent environmental regulations. In this situation, political decentralization seems to be irrelevant to the outcome. (4) Low environmental policy performance occurs most often when a country, without the favorable context mentioned above, become fiscally centralized, regardless of whether political and administrative decentralization is present or not. This study suggests policy makers should keep in mind the contextual fit of decentralization and adopt a configurational thinking in environmental governance.
https://ift.tt/2ORzUhh
Caracterización de la enfermedad por reflujo faringolaríngeo en pacientes de edad avanzada y ancianos
Publication date: Available online 7 August 2018
Source: Acta Otorrinolaringológica Española
Author(s): Francisco J. Cervera-Paz, Marta Jordano-Cabrera
Resumen
Objetivos
Caracterizar la enfermedad por reflujo faringolaríngeo en pacientes de edad avanzada y ancianos.
Métodos
Estudio retrospectivo de pacientes mayores de 60 años, con sintomatología sugestiva de enfermedad por reflujo faringolaríngeo, vistos entre 2005 y 2014 en el Departamento de Otorrinolaringología de un hospital universitario. Se seleccionaron 85 pacientes (54 mujeres y 31 hombres) sometidos a una pH-metría de 24 h con doble sensor («gold standard» en el diagnóstico del reflujo).
Se calculó el índice de masa corporal. Se revisó la información clínica y evaluaron las pH-metrías según los criterios de DeMeester y Johnson. Se revisó el cuestionario «Reflux Symptoms Index» (RSI), considerado patológico cuando fue ≥13. Se evaluaron los hallazgos endoscópicos faringolaríngeos del «Reflux Finding Score» (RFS), considerado patológico cuando fue ≥7.
Resultados
La edad media fue 67 años. En 70 pacientes (82%) la pH-metría fue patológica. El índice de masa corporal fue patológico en 50 pacientes (59%), de los que casi el 90% tenían pH-metría patológica. El RSI medio fue 9,8, con resultados anormales en 24 pacientes (28%). En 20 pacientes (23%) con RSI anormal tenían una pH-metría positiva. El hallazgo endoscópico más común (90%) fue la hipertrofia de comisura posterior. El RFS medio fue 9,07, con resultados anormales en 69 pacientes (70%). En 61 pacientes (70%) con RFS anormal tenían una pH-metría patológica. Solo 18 pacientes con RSI y RFS patológicos tenían una pH-metría patológica.
Conclusiones
En pacientes mayores, los valores patológicos de índice de masa corporal se asocian altamente con pH-metrías patológicas. El RSI es un indicador de poco valor, mientras que el RFS es de valor moderado.
Abstract
Objectives
To characterize laryngo-pharyngeal reflux (LPR) in patients over 60 years of age.
Methods
Retrospective review of patients over 60 years of age with symptoms suspicious of LPR, seen from 2005 to 2014 at an ENT Department of an academic hospital. Eighty-five consecutive patients (54 females, 31 males) who had completed a dual-sensor 24-hour pH-metry were included (considered "gold-standard" in LPR diagnosis).
Body mass index, and reflux information and interventions were revised. pH-metries were evaluated according to DeMeester & Johnson's criteria. Symptoms were assessed according to the Reflux Symptom Index (RSI) and classified as abnormal if score was ≥13. A naso-fibro-laryngoscopy enabled findings to be documented according to the Reflux Finding Score (RFS), and they were classified as abnormal if the score was ≥7.
Results
The patients' mean age was 67 years. A positive pH-metry was present in 70 patients (82.5%). Fifty patients (59%) had abnormal body mass index, and almost 90% of them had an abnormal pH-metry. Mean RSI score was 9.8, with abnormal results in 24 patients (28%). Only 20 patients (23%) with abnormal RSI had a positive pH-metry. Posterior commissure hypertrophy was the most common finding (90% of patients). Mean RFS score was 9.07, with abnormal results in 69 patients (81%). Sixty-one patients (70%) with abnormal RFS had a positive pH-metry. Only 18 patients (20%) had coincidental abnormal pH-metry, RSI, and RFS.
Conclusions
In ageing patients, abnormal body mass index is strongly associated with abnormal pH-metry. RSI is a weak indicator of LPR, whereas RFS has a moderate value.
https://ift.tt/2nkILLK
Validez de las medidas del pico cepstral para la valoración objetiva de la disfonía en sujetos de habla hispana
Publication date: Available online 7 August 2018
Source: Acta Otorrinolaringológica Española
Author(s): Faustino Núñez-Batalla, Noelia Cartón-Corona, Gabriela Vasile, Patricia García-Cabo, Laura Fernández-Vañes, José Luis Llorente-Pendás
Resumen
Introducción y objetivos
La fiabilidad de las calificaciones perceptuales de la calidad global de la voz y sus dimensiones específicas es difícil de alcanzar, por cuanto estos juicios dependen de la subjetividad del examinador. De este modo, la búsqueda de unas medidas clínicas que sean objetivas, válidas y accesibles es una prioridad para incluirlas en los protocolos de evaluación de la voz.
El propósito del presente estudio fue: 1) determinar la exactitud diagnóstica de un único parámetro acústico, la prominencia del pico cepstral suavizado (CPPS), para predecir la presencia y severidad de una disfonía en vocales sostenidas y habla conectada utilizando el programa Praat; 2) determinar la relación entre las medidas del CPPS y las calificaciones perceptuales de la calidad vocal; y 3) describir los valores normativos del CPPS.
Método
Se obtuvo el valor del CPPS de muestras vocales sostenidas y de habla conectada de 72 sujetos hispanohablantes con trastornos vocales y de 52 sujetos hispanohablantes sanos utilizando el programa Praat. Se llevó a cabo un estudio estadístico completo utilizando el programa SPSS de IBM versión 23.
Resultados
Se encontró una sensibilidad de un 70% y una especificidad de un 85%. La severidad estimada de la voz, tanto en vocal sostenida como en habla conectada, se correlacionó de forma importante con las calificaciones perceptuales de severidad global de la disfonía.
Conclusiones
Un parámetro acústico único, el CPPS calculado mediante el programa Praat, predice de forma importante el estatus de un trastorno vocal. Se considera la incorporación del CPPS para complementar la valoración clínica de la voz.
Abstract
Introduction and objectives
Perceptual rating of overall voice quality and other more specific perceptual dimensions is difficult, as such judgments depend on the listener's subjectivity. Thus, finding objective, valid, and accessible clinical measures to include in comprehensive voice evaluation protocols is a priority.
The purposes of this study were to 1) determine the diagnostic accuracy of a single acoustic measure, smoothed cepstral peak prominence (CPPS), to predict voice disorder status from sustained vowels and connected speech samples using the software Praat; 2) to determine the relationship between measures of CPPS and perceptual ratings of vocal quality; and 3) describe the normative values of CPPS.
Method
Measures of CPPS were obtained from connected speech and sustained vowel recordings of 72 Spanish-speaking subjects with voice disorders and 52 nondysphonic Spanish-speaking subjects with no vocal disorders using freely downloadable Praat software. IBM SPSS Statistics software version 23 was used to complete the statistical analyses.
Results
results revealed a 70% sensitivity rate, a specificity rate of 85%. Estimated severity for sustained vowels and connected speech were strongly correlated and significantly associated with listener ratings of dysphonia severity.
Conclusions
A single acoustic measure of CPPS was highly predictive of voice disorder status using Praat software. Clinicians may consider using CPPS to complement clinical voice evaluation and screening protocols.
https://ift.tt/2vMeIAN
What do Vitiligo Impact Scale (VIS)‐22 scores mean? Studying the clinical interpretation of scores using an anchor‐based approach
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2APL7w5
What do Vitiligo Impact Scale (VIS)‐22 scores mean? Studying the clinical interpretation of scores using an anchor‐based approach
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2APL7w5
Comparison of the effect of the lidocaine, tetracaine, and articaine application into nasal packs on pain and hemorrhage after septoplasty
Abstract
Objective
We purposed to compare the effects of certain local anesthetics soaked Merocel nasal packs on hemorrhage and pain after septoplasty.
Materials and methods
This study is a prospective double-blind study that was done in patients undergoing septoplasty. The study was created with 90 patients. All patients were divided into four groups. The each group was applied 2% lidocaine plus adrenaline, 2% tetracaine, 4% articaine plus adrenaline as study groups or 0.9% sodium chloride (NaCl) as control group in their Merocel packs after septoplasty. Verbal analog scale (VAS) was applied to all patients and the amount of postoperative hemorrhage was noted during postoperative period. The statistical analysis was performed using Student's t test and Chi-square test on each patient group at each time point.
Results
The study groups (2% lidocaine plus adrenaline, 2% tetracaine and 4% articaine plus adrenaline groups) had significantly better pain scores versus control group in the 1st, 4th, 8th, 16th and 24th postoperative hours (p < 0.05). The articaine plus adrenaline group had better pain scores than the lidocaine plus adrenaline group, and the lidocaine plus adrenaline group had better pain scores than the tetracaine group in the postoperative first day. Also articaine plus adrenaline group had less postoperative bleeding rate than the lidocaine plus adrenaline, tetracaine and control groups (p < 0.05). There was no statistically significant difference between the lidocaine plus adrenaline, tetracaine and control groups in terms of postoperative hemorrhage (p > 0.05).
Conclusion
Topical articaine plus adrenaline application in the nasal packs can be safely used for less pain and bleeding following septoplasty.
https://ift.tt/2AOgI14
Macroprolactinomas: longitudinal assessment of biochemical and imaging therapeutic responses
Abstract
Purpose
To assess biochemical and imaging therapeutic response rates, when these occur and their predictive factors in patients with macroprolactinomas treated with dopamine agonists (DA).
Methods
Retrospective, longitudinal study of patients with macroprolactinomas treated with DA for ≥12 months. Outcomes: prolactin normalization, reduction in maximum tumor diameter ≥50% and time until therapeutic responses.
Results
We included 67 patients; 49.3% females, with median age at diagnosis of 43 years, 61.2% only treated with bromocriptine, 10.4% only with cabergoline, and 28.4% with both DA. Median follow-up time was 73 months. Prolactin levels normalized in 87%, mostly during the first 2 years. Prolactin levels after 6 months (HR 0.994, p = 0.012), 1 year (HR 0.970, p = 0.003), and 2 years (HR 0.970, p = 0.015) predicted its normalization time. Only 62% of the patients achieved a ≥50% reduction in maximum tumor diameter. Percent tumor diameter reduction after 1 year (OR 1.098, p = 0.022) and 2 years (OR 1.102, p = 0.008) predicted a ≥50% size reduction. Size reduction occurred later than prolactin normalization. Initial tumor diameter (HR 1.050, p = 0.032) and its percent reduction at 6 months (HR 1.110, p = 0.002), 1 (HR 1.060, p < 0.001), 2 (HR 1.045, p < 0.001), 3 (HR 1.048, p = 0.002), and 4 years (HR 1.074, p = 0.042) predicted the time until imaging response.
Conclusion
A significant number of patients did not obtain an imaging response. Biochemical and imaging responses were asynchronous and occurred mainly in the first 4 years of treatment. This may allow an earlier identification of partially resistant and resistant macroprolactinomas, with consequent change in the therapeutic approach.
https://ift.tt/2AR11pS
Macroprolactinomas: longitudinal assessment of biochemical and imaging therapeutic responses
Abstract
Purpose
To assess biochemical and imaging therapeutic response rates, when these occur and their predictive factors in patients with macroprolactinomas treated with dopamine agonists (DA).
Methods
Retrospective, longitudinal study of patients with macroprolactinomas treated with DA for ≥12 months. Outcomes: prolactin normalization, reduction in maximum tumor diameter ≥50% and time until therapeutic responses.
Results
We included 67 patients; 49.3% females, with median age at diagnosis of 43 years, 61.2% only treated with bromocriptine, 10.4% only with cabergoline, and 28.4% with both DA. Median follow-up time was 73 months. Prolactin levels normalized in 87%, mostly during the first 2 years. Prolactin levels after 6 months (HR 0.994, p = 0.012), 1 year (HR 0.970, p = 0.003), and 2 years (HR 0.970, p = 0.015) predicted its normalization time. Only 62% of the patients achieved a ≥50% reduction in maximum tumor diameter. Percent tumor diameter reduction after 1 year (OR 1.098, p = 0.022) and 2 years (OR 1.102, p = 0.008) predicted a ≥50% size reduction. Size reduction occurred later than prolactin normalization. Initial tumor diameter (HR 1.050, p = 0.032) and its percent reduction at 6 months (HR 1.110, p = 0.002), 1 (HR 1.060, p < 0.001), 2 (HR 1.045, p < 0.001), 3 (HR 1.048, p = 0.002), and 4 years (HR 1.074, p = 0.042) predicted the time until imaging response.
Conclusion
A significant number of patients did not obtain an imaging response. Biochemical and imaging responses were asynchronous and occurred mainly in the first 4 years of treatment. This may allow an earlier identification of partially resistant and resistant macroprolactinomas, with consequent change in the therapeutic approach.
https://ift.tt/2AR11pS
Advective pore-water transport of hydrocarbons in North East Scotland coastal sands
Abstract
Oil spills in the marine environment can cause ecosystem-level impacts. Dispersant application as an oil spill response measure leads to the widespread distribution of hydrocarbons in the water column and marine sediments. The North Sea is an area of intense hydrocarbon production and is at risk of oil spills, which are of concern to its benthic ecosystem due to its sediments' high permeability. Here, entrainment of hydrocarbons via pore-water advection into permeable North Sea sands and the associated effect of Superdispersant-25, a commercial oil dispersant, were evaluated in a laboratory. Centrally stirred chambers that induce advective pore-water fluxes in sediments were filled with sediment, seawater and mixtures of oil and Superdispersant-25. Dispersant application had contrasting effects on hydrocarbon interactions with sediment: (1) it reduced accumulation of hydrocarbons in surface sediments and (2) facilitated the entrainment of hydrocarbons up to 8 cm deep into sediments by increasing hydrocarbon solubility in seawater and its subsequent washout or pumping into sediment by pore-water movement. Results here show that dispersant application can have counter-intuitive effects on hydrocarbon interactions with marine sediments and highlight the need for further research in this area to make better informed decision in an oil spill response scenario.
https://ift.tt/2vl8ZCv
Relationship between phytoplankton community and environmental factors in landscape water with high salinity in a coastal city of China
Abstract
Relationship between phytoplankton community and environmental variables was explored in three landscape water bodies (namely Jiyun River Oxbow (JRO), Qingjing Lake (QL), and Jiyun River (JR)) with high salinity, located in Sino-Singapore Tianjin Eco-city of China, using redundancy analysis (RDA). A total of 48 species of phytoplankton were identified during the study period, in which Chlorophyta and Bacillariophyta accounted for 35.42 and 31.25%, respectively. The most dominant species of the studied water bodies were Cyclotella meneghiniana (Bacillariophyta) and Aphanocapsa elachista (Cyanophyta). The diversity index ranged from 0.56 to 1.42, with an average of 1.11, reflecting low biodiversity in the phytoplankton community. Moreover, the average density of phytoplankton was 42.39 × 106 cells/L, indicating that those landscape water bodies belonged to moderate eutrophication. The results of RDA revealed that the most significant environmental factors influencing phytoplankton community were water temperature (WT), dissolved total phosphorus (DTP), salinity, and total nitrogen (TN) (p < 0.05, Monte Carlo permutation test). Meanwhile, Aphanocapsa elachista was positively correlated with WT, TN, and salinity, while Cyclotella meneghiniana was positively related to salinity and negatively related to TP. The results suggested that salinity was a non-negligible key factor affecting the phytoplankton community of the water body with high salinity.
https://ift.tt/2MqRcjC
Serum Leukotriene B4 Levels, Tonsillar Hypertrophy and Sleep-Disordered Breathing in Childhood
Publication date: Available online 7 August 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Emmanouel Ι. Alexopoulos, George Haritos, Christina Befani, Georgia Malakasioti, Vassilis A. Lachanas, Panagiotis Liakos, Konstantinos Gourgoulianis, Athanasios G. Kaditis
Abstract
Objectives
In children with snoring, increased production of leukotriene B4 (LTB4) may promote tonsillar hypertrophy and sleep-disordered breathing (SDB) or conversely SDB may enhance LTB4 synthesis. We explored whether: i) high LTB4 serum levels predict tonsillar hypertrophy; and ii) SDB severity correlates with LTB4 serum concentration.
Methods
Normal-weight children with SDB or controls underwent polysomnography and measurement of LTB4 serum concentration. Tonsillar hypertrophy was the main outcome measure and high LTB4 serum level (>75 t h percentile value in controls) was the primary explanatory variable. Odds ratio (OR) and the corresponding 95% confidence intervals (CI) for tonsillar hypertrophy in children with versus without high LTB4 level were calculated. The control subgroup and subgroups of subjects with increasing SDB severity were compared regarding LTB4 concentration by Kruskal-Wallis test. Spearman's correlation co-efficient was applied to assess the association of LTB4 concentration with SDB severity.
Results
A total of 104 children with SDB and mean obstructive apnea-hypopnea index-AHI of 4.8 ± 5.3 episodes/h (primary snoring: n=19; mild SDB: n=49; moderate/severe SDB: n=36) and 13 controls (no snoring; AHI: 0.4 ± 0.2 episodes/h) were recruited. The four study subgroups were similar regarding LTB4 serum concentration (P=0.64). High LTB4 (>170.3 pg/mL) was a significant predictor of tonsillar hypertrophy after adjustment for age and gender (OR 3.0 [1.2-7.2]; P=0.01). There was no association between AHI or desaturation index and LTB4 serum concentration (r=-0.08; P=0.37 and r=-0.1; P=0.30, respectively).
Conclusion
No association was identified between SDB severity and LTB4 levels, but high LTB4 concentration predicted tonsillar hypertrophy.
https://ift.tt/2vIzBN7
Prevalence of ear disease and associated hearing loss among primary school students in the Solomon Islands: otitis media still a major public health issue
Publication date: Available online 7 August 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Annette Kaspar, Obiga Newton, Joseph Kei, Carlie Driscoll, De Wet Swanepoel, Helen Goulios
https://ift.tt/2M05I5J
Submental flap donor site morbidity in pediatric patients
Publication date: Available online 7 August 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Amin Rahpeyma, Saeedeh khajehahmadi
https://ift.tt/2vGk2W0
Melasma in a transgender woman
Publication date: Available online 7 August 2018
Source: American Journal of Otolaryngology
Author(s): Laura Garcia-Rodriguez, Jeffrey Spiegel
https://ift.tt/2vt4mGo
Cell and molecular mechanisms behind diet‐induced hypothalamic inflammation and obesity
Journal of Neuroendocrinology, EarlyView.
https://ift.tt/2AOcCWD
Stress, alcohol and infection during early development: A brief review of common outcomes and mechanisms
Journal of Neuroendocrinology, EarlyView.
https://ift.tt/2OPtqzq
Neuropeptide and steroid hormone mediators of neuroendocrine regulation
Journal of Neuroendocrinology, EarlyView.
https://ift.tt/2AUjXns
Retraction Note to: Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features: Historical Context, Diagnosis, and Future Challenges
This article [1] has been retracted by the authors as it substantially overlaps with the following article [2]. All authors agree to the retraction.
https://ift.tt/2Mqi8jF
Interplay between base excision repair protein XRCC1 and ALDH2 predicts overall survival in lung and liver cancer patients
Abstract
Background
To deliver efficacious personalised cancer treatment, it is essential to characterise the cellular metabolism as well as the genetic stability of individual tumours. In this study, we describe a new axis between DNA repair and detoxification of aldehyde derivatives with important implications for patient prognosis and treatment.
Methods
Western blot and qPCR analyses were performed in relevant non-transformed and cancer cell lines from lung and liver tissue origin in combination with bioinformatics data mining of The Cancer Genome Atlas database from lung and hepatocellular cancer patients.
Results
Using both biochemical and bioinformatics approaches, we revealed an association between the levels of expression of the aldehyde detoxifying enzyme aldehyde dehydrogenase 2 (ALDH2) and the key DNA base excision repair protein XRCC1. Across cancer types, we found that if one of the corresponding genes exhibits a low expression level, the level of the other gene is increased. Surprisingly, we found that low ALDH2 expression levels associated with high XRCC1 expression levels are indicative for a poor overall survival, particularly in lung and liver cancer patients. In addition, we found that Mithramycin A, a XRCC1 expression inhibitor, efficiently kills cancer cells expressing low levels of ALDH2.
Conclusions
Our data suggest that lung and liver cancers require efficient single-strand break repair for their growth in order to benefit from a low aldehyde detoxification metabolism. We also propose that the ratio of XRCC1 and ALDH2 levels may serve as a useful prognostic tool in these cancer types.
https://ift.tt/2ninz9j
Metformin inhibits human breast cancer cell growth by promoting apoptosis via a ROS-independent pathway involving mitochondrial dysfunction: pivotal role of superoxide dismutase (SOD)
Abstract
Purpose
Despite a growing body of evidence indicating a potential efficacy of the anti-diabetic metformin as anti-cancer agent, the exact mechanism underlying this efficacy has remained largely unknown. Here, we aimed at assessing putative mechanisms associated with the ability of metformin to reduce the proliferation and migration of breast cancer cells.
Methods
A battery of in vitro assays including MTT, colony formation, NBT and scratch wound healing assays were performed to assess the viability, proliferation, anti-oxidative potential and migration of breast cancer-derived MCF-7, MDA-MB-231 and T47D cells, respectively. Reactive oxygen species (ROS) assays along with fluorescence microscopy were used to assess apoptotic parameters. Quantification of SOD, Bcl-2, Bax, MMPs, miR-21 and miR-155 expression was performed using qRT-PCR.
Results
We found that metformin inhibited the growth, proliferation and clonogenic potential of the breast cancer-derived cells tested. ROS levels were found to be significantly reduced by metformin and, concomitantly, superoxide dismutase (SOD) isoforms were found to be upregulated. Mitochondrial dysfunction was observed in metformin treated cells, indicating apoptosis. In metastatic MDA-MB-231 cells, migration was found to be suppressed by metformin through deregulation of the matrix metalloproteinases MMP-2 and MMP-9. The oncogenic microRNAs miR-21 and miR-155 were found to be downregulated by metformin, which may be correlated with the suppression of cell proliferation and/or migration.
Conclusions
Our data indicate that metformin may play a pivotal role in modulating the anti-oxidant system, including the SOD machinery, in breast cancer-derived cells. Our observations were validated by in silico analyses, indicating a close interaction between SOD and metformin. We also found that metformin may inhibit breast cancer-derived cell proliferation through apoptosis induction via the mitochondrial pathway. Finally, we found that metformin may modulate the pro-apoptotic Bax, anti-apoptotic Bcl-2, MMP-2, MMP-9, miR-21 and miR-155 expression levels. These findings may be instrumental for the clinical management and/or (targeted) treatment of breast cancer.
https://ift.tt/2vS4C1l
Induction of apoptosis via proteasome inhibition in leukemia/lymphoma cells by two potent piperidones
Abstract
Purpose
Previously, compounds containing a piperidone structure have been shown to be highly cytotoxic to cancer cells. Recently, we found that the piperidone compound P2 exhibits a potent anti-neoplastic activity against human breast cancer-derived cells. Here, we aimed to evaluate two piperidone compounds, P1 and P2, for their potential anti-neoplastic activity against human leukemia/lymphoma-derived cells.
Methods
Cytotoxicity and apoptosis induction were evaluated using MTS, annexin V-FITC/PI and mitochondrial membrane potential polychromatic assays to confirm the mode of action of the piperidone compounds. The effects of compound P1 and P2 treatment on gene expression were assessed using AmpliSeq analysis and, subsequently, confirmed by RT-qPCR and Western blotting.
Results
We found that the two related piperidone compounds P1 and P2 selectively killed the leukemia/lymphoma cells tested at nanomolar concentrations through induction of the intrinsic apoptotic pathway, as demonstrated by mitochondrial depolarization and caspase-3 activation. AmpliSeq-based transcriptome analyses of the effects of compounds P1 and P2 on HL-60 acute leukemia cells revealed a differential expression of hundreds of genes, 358 of which were found to be affected by both. Additional pathway analyses revealed that a significant number of the common genes were related to the unfolded protein response, implying a possible role of the two compounds in the induction of proteotoxic stress. Subsequent analyses of the transcriptome data revealed that P1 and P2 induced similar gene expression alterations as other well-known proteasome inhibitors. Finally, we found that Noxa, an important mediator of the activity of proteasome inhibitors, was significantly upregulated at both the mRNA and protein levels, indicating a possible role in the cytotoxic mechanism induced by P1 and P2.
Conclusions
Our data indicate that the cytotoxic activity of P1 and P2 on leukemia/lymphoma cells is mediated by proteasome inhibition, leading to activation of pro-apoptotic pathways.
https://ift.tt/2M1hFbi
Correction to: β-Catenin gene promoter hypermethylation by reactive oxygen species correlates with the migratory and invasive potentials of colon cancer cells
In the original version of above mentioned article an error occurred in Fig. 2. Panel g and panel h are included in the figure legend, but have not been published in the figure.
https://ift.tt/2vS4z5F
Soluble CD14 concentration in human breast milk and its potential role in child atopic dermatitis: results of the Ulm Birth Cohort Studies
Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.
https://ift.tt/2KvQAHS
Neck Ultrasound in Patients with Follicular Thyroid Carcinoma
Abstract
There are limited data on the role of neck ultrasound (US) in the surveillance of patients with follicular thyroid cancer (FTC). Here, we analyze the likelihood of US to find structural disease in patients with FTC and evaluate if initial American Thyroid Association (ATA) risk stratification and the response to therapy categories [the latter based on thyroglobulin (Tg) levels] modify that likelihood. We conducted a retrospective cohort study of 32 patients with FTC in our institution. We included all patients with well-differentiated FTC who underwent total thyroidectomy and radioactive iodine (RAI) treatment without neck structural disease at the time of RAI and with Tg and US at least 6 months after RAI. After a median follow-up of 4.3 years, two patients (6.3%) had structural disease by US. None of the 18 patients with initial ATA low-risk disease had structural disease by US in contrast to higher, but not significant, frequency of 18.2% (2/11) in patients with initial ATA high-risk disease (p = 0.14). Based on Tg levels, 24/32 patients had excellent response to therapy and 8/32 had biochemical incomplete/indeterminate response. None of the patients with excellent response had structural disease by US versus 2/8 (25%) patients with biochemical incomplete/indeterminate response all of whom had other sites of structural disease (p = 0.054). Our findings suggest that neck US in FTC is unlikely to find structural disease with initial low-risk ATA or excellent response to therapy but can detect structural disease in some patients with initial ATA high-risk or incomplete/indeterminate responses to therapy.
https://ift.tt/2M85WHb
A phase I study to assess afatinib in combination with carboplatin or with carboplatin plus paclitaxel in patients with advanced solid tumors
Abstract
Purpose
Afatinib, an irreversible ErbB family blocker, has demonstrated preclinical antitumor activity with chemotherapy.
Methods
As part of a phase I trial in patients with advanced solid tumors (NCT00809133; 3 + 3 dose-escalation design), we determined the maximum tolerated dose (MTD) of afatinib with carboplatin (A/C) or with carboplatin plus paclitaxel (A/C/P). Starting doses: afatinib 20 mg/day, carboplatin AUC6 (A/C) with paclitaxel 175 mg/m2 (A/C/P) (chemotherapy: Day 1 of 21-day cycles). The primary objective was to determine the MTDs; safety, pharmacokinetics and antitumor activity were also evaluated.
Results
Thirty-eight patients received A/C (n = 12) or A/C/P (n = 26). No dose-limiting toxicities (DLTs) were reported with A(20 mg)/C(AUC6). One patient experienced DLT in the A(40 mg)/C(AUC6) cohort (grade 3 acneiform rash); A(40 mg)/C(AUC6) was determined as the recommended phase II dose (RP2D) for A/C. Two patients each had DLTs with A(20 mg/day)/C(AUC6)/P(175 mg/m2): fatigue, infection, diarrhea, small intestine hemorrhage, dehydration, renal impairment, neutropenic sepsis (n = 1), mucositis (n = 1); A(40 mg)/C(AUC5)/P(175 mg/m2): febrile neutropenia (n = 1), mucositis, fatigue (n = 1); and A(30 mg)/C(AUC5)/P(175 mg/m2): stomatitis (n = 1), mucositis (n = 1). No DLT was observed with A(20 mg)/C(AUC5)/P(175 mg/m2), determined as the RP2D for A/C/P. The most frequent drug-related adverse events were (A/C; A/C/P): rash (75%; 73%), fatigue (67%; 69%), and diarrhea (58%; 88%). Drug plasma concentrations were similar between cycles, suggesting no drug–drug interactions. Objective response rates in these heavily pretreated patients were A/C, 3/12 (25%); A/C/P, 5/26 (19%).
Conclusions
Afatinib 40 mg/day (approved monotherapy dose) with carboplatin AUC6, and afatinib 20 mg/day with carboplatin AUC5 and paclitaxel 175 mg/m2 demonstrated manageable safety and antitumor activity. Afatinib > 20 mg/day in the triple combination was not well tolerated.
https://ift.tt/2vpuTV1
Cholesteatoma vs granulation tissue: a differential diagnosis by DWI-MRI apparent diffusion coefficient
Abstract
Purpose
To diagnose cholesteatoma when it is not visible through tympanic perforation, imaging techniques are necessary. Recently, the combination of computed tomography and magnetic resonance imaging has proven effective to diagnose middle ear cholesteatoma. In particular, diffusion weighted images have integrated the conventional imaging for the qualitative assessment of cholesteatoma. Accordingly, the aim of this study was to obtain a quantitative analysis of cholesteatoma calculating the apparent diffusion coefficient value. So, we investigated whether it could differentiate cholesteatoma from other inflammatory tissues both in a preoperative and in a postoperative study.
Methods
This study included 109 patients with clinical suspicion of primary or residual/recurrent cholesteatoma. All patients underwent preoperative computed tomography and magnetic resonance imaging with diffusion sequences before primary or second-look surgery to calculate the apparent diffusion coefficient value.
Results
We found that the apparent diffusion coefficient values of cholesteatoma were significantly lower than those of non cholesteatoma. In particular, the apparent diffusion coefficient median value of the cholesteatoma group (0.84 × 10− 3 mm2/s) differed from the inflammatory granulation tissue (2.21 × 10− 3 mm2/s) group (p < 2.2 × 10− 16). Furthermore, we modeled the probability of cholesteatoma by means of a logistic regression and we determined an optimal cut-off probability value of ~ 0.86 (specificity = 1.0, sensitivity = 0.97), corresponding to an apparent diffusion coefficient cut-off value of 1.37 × 10− 3 mm2/s.
Conclusions
Our study has demonstrated that apparent diffusion coefficient values constitute a valuable quantitative parameter for preoperative differentiation of cholesteatomas from other middle ear inflammatory diseases and for postoperative diagnosis of recurrent/residual cholesteatomas.
https://ift.tt/2AO5OZ6
Alopecia in Association with Malignancy: A Review
Abstract
The interaction between hair and malignancy is complicated. Various hair abnormalities can manifest in oncology patients as a clinical manifestation, the result of cancer therapy, or due to a paraneoplastic condition. The mechanisms of these changes remain unclear. Alopecia is one of the common clinical presentations occurring in oncology patients that affects their quality of life. The condition can concomitantly develop during the course of malignancy or when patients undergo cancer treatment. It is important for physicians to understand alopecia in association with malignancy as it may be an important associated finding or provide the clues to aid diagnosis. The aim of this review is to summarize the clinical characteristics of alopecia that occur in cancer patients and their relationship with the type of malignancy and its treatment.
https://ift.tt/2OcosLW
E-Services von Ärzten erwartet
Das Thema Fernbehandlung spaltet die Ärzteschaft. Die Mehrheit der Patienten hingegen scheint sich Onlinekontakt zu Ärzten zu wünschen. Das geht aus einer Patientenbefragung der apoBank hervor.
https://ift.tt/2OiXa6D
Was taugt Medizin nach Noten?
Glaubt man den einschlägigen Statistiken, schauen sich die weitaus meisten Patienten, die nach einem Arzt suchen, im Internet um. An Portalen, in denen Ärzte gelistet und auch bewertet werden, herrscht dort kein Mangel. Eher schon fehlt es an einer Antwort auf die Frage, was die dort verzeichneten Informationen tatsächlich wert sind.
https://ift.tt/2MoXFMa
Probiotika unterstützen Toleranzinduktion
Die Entwicklung weiterer Allergien bei primär kuhmilchallergischen Kindern beruht wahrscheinlich auch auf einer intestinalen Dysbiose. Was bringt die Zugabe von Probiotika zu einem Casein-Hydrolysat in der Prävention atopischer Sekundärmanifestationen?
https://ift.tt/2MoXAIm
Bescheinigungen: Viele Ärzte verschenken hier Geld
Oft werden Ärzte im Praxisalltag gebeten, zwischen Tür und Angel „schnell mal" ein Formular auszufüllen oder ein Attest auszustellen. Dabei übersehen Arzt und Praxisteam häufig, dass solche vermeintlichen Bagatellen durchaus auch relevant für die Abrechnung sind.
https://ift.tt/2MqsCzB
Oftmals von Dauer: Schluckbeschwerden nach Thyreoidektomie
Anders als bislang angenommen, beschränken sich Schluckbeschwerden nach einer Thyreoidektomie nicht auf die unmittelbar postoperative Phase. Selbst ein halbes Jahr später fühlt sich ein Teil der Patienten beim Schlucken noch beeinträchtigt, wobei ein objektivierbares Korrelat meist fehlt.
https://ift.tt/2M5QMT0
Forschung heute — Zukunft morgen
Die 89. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie fand dieses Jahr vom 9. bis. 12 Mai in Lübeck statt. Der Kongress mit rund 2.500 Teilnehmern aus 40 Nationen stand unter dem Motto „Forschung heute — Zukunft morgen".
https://ift.tt/2MpZYOQ
Mundmikrobiom kann Risiko für Kopf-Hals-Tumoren beeinflussen
Das Risiko, an einem Plattenepithelkarzinom im Kopf-Hals-Bereich zu erkranken, scheint auch von der bakteriellen Besiedlung der Mundhöhle abzuhängen. Bestimmte Bakteriengattungen könnten protektiv wirken.
https://ift.tt/2OjgaSM
Wann Datenschutzbeauftragte in Arztpraxen jetzt Pflicht sind
Am 25. Mai 2018 ist die neue EU-Datenschutz-Grundverordnung in Kraft getreten. Damit gelten nun in allen Staaten der Europäischen Union grundsätzlich die gleichen Standards für den Datenschutz. Ziel des Europäischen Rats und des Europäischen Parlaments war es dabei, die schon bestehenden Prinzipien des grundrechtsorientierten Datenschutzrechts mit einer stärkeren Harmonisierung und einer maßvollen Modernisierung zu verknüpfen.
https://ift.tt/2MprPyR
Effect of preoperative pregabalin versus gabapentin on postoperative pain control after laparoscopic gastric bypass surgery
Ain-Shams Journal of Anaesthesiology 2017 10(1):195-200
Background Perioperative gabapentin helps produce a significant opioid-sparing effect and probably also improves postoperative pain scores. Pregabalin is a novel drug with a heightened research interest in the analgesic, sedative, anxiolytic, and opioid-sparing effects, in various pain settings, including postoperative pain. We investigated pregabalin analgesic efficacy in morbid obese patients experiencing acute pain after laparoscopic gastric bypass surgery and compared it with gabapentin and placebo. Patients and methods A randomized, placebo-controlled study was conducted on 90 morbidly obese patients undergoing laparoscopic gastric bypass surgery. Patients were allocated into one of the three groups; the pregabalin group in which the patients received 300 mg pregabalin, the gabapentin group in which the patients received 1200 mg gabapentin, or the control group in which the patients received placebo 2 h prior to surgery. Postoperative pain was controlled with intravenous fentanyl via patient controlled analgesia (PCA). Fentanyl consumption over 24 h and pain intensity measured by visual analogue score at rest (static) and during cough (dynamic) at recovery time, 1, 2, 6, 12, and 24 h were recorded. Also sedation status, somnolence, dizziness, headache, nausea, and vomiting were monitored. Results Postoperative 24 h fentanyl consumption was significantly higher in the control group compared with both pregabalin and gabapentin groups (P<0.001). Pain intensity on visual analogue score (static and dynamic) was significantly higher in the control group compared with both pregabalin and gabapentin groups at time of recovery, 1, 2, 6, 12, and 24 h postoperatively. Numeric sedation score was significantly lower in the control group compared with pregabalin and gabapentin groups at time of recovery, 1, 2, and 6 h postoperatively. No significant differences were found among the three groups as regards somnolence, dizziness, headache, nausea, and vomiting. Conclusion A single dose of 300 mg pregabalin or 1200 mg gabapentin given 2 h before surgery is better than placebo for postoperative pain control for laparoscopic gastric bypass surgery without significant side effects.
https://ift.tt/2vGaOcw
Optimum target in percutaneous upper thoracic thermocoagulation in primary hyperhidrosis
Ain-Shams Journal of Anaesthesiology 2017 10(1):293-296
Introduction Primary palmar hyperhidrosis is a disabling problem that affects young age groups and usually continues for years without an effective treatment. It is usually accompanied by plantar hyperhidrosis and to a lesser extent by axillary affection. We have tried to improve the efficacy of percutaneous radiofrequency ablation of upper thoracic sympathetic ganglia via imitating what thoracoscopic surgeons do in endoscopic thoracic sympathectomy. Patients and methods A total of 40 patients with primary hyperhidrosis were randomly classified into two groups. Group Tb (n=20) underwent thermocoagulation of sympathetic chain on vertebral body. Group Th (n=20) underwent thermocoagulation of sympathetic chain on the head and neck of ribs. Hand temperature and dryness were followed up during the procedure and on the following intervals: 1 week, 1 month, 3 months, 6 months, 9 months, and 12 months after the procedure. Results During the procedure, the hands of 50% of patients became warm and dry in group Tb and only 40% remained so till 12 months, whereas in group Th, the hands of 100% of the patients became warm and dry during the procedure till 12 months. Conclusion Thermocoagulation of upper thoracic sympathetic chain on the head and neck of the second and third ribs is more effective than attacking the chain on vertebral bodies in patients with primary hyperhidrosis with no recorded complications.
https://ift.tt/2ngN2QD
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