Melanoma and mastocytosis: is really only a coincidence?

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2NchJoK

Melanoma and mastocytosis: is really only a coincidence?

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2NchJoK

Management of Nasoorbitoethmoidal Fracture: An Institutional Experience

Abstract

The nasoorbitoethmoidal fractures remain the most complex of all facial fractures to diagnose and treat mainly because of the intricate anatomy and difficulty in fracture fixation. The number of such fractures are increasing with the more incidence of high-speed, high-force accidents. The nasoorbitoethmoidal fractures rarely occur as an isolated event. Associated injuries often include central nervous system injuries, cribriform plate fracture, cerebrospinal fluid rhinorrhea, and fractures of the frontal bone, orbital floor, and middle third of the face as well as injury to the lacrimal system. The appropriate management of these injuries require an understanding of the anatomic features of the region, the degree of severity of damage. The purpose of this article is to provide a general overview of the topic, with a more specific focus on the pearls of managing these fractures. Twenty-four patients who suffered The nasoorbitoethmoidal fractures with/without associated multiple midfacial injuries were included in the study. Postoperatively, results show stable symmetrical fixation of the canthus in three dimensions with good apposition of the eyelids against the ocular globe along with acceptable nasofrontal angle and nasal prominence. Prompt and proper management of these injuries can achieve both adequate functional and aesthetic outcomes.

https://ift.tt/2wCaAoc

Bacteriological Profile in Attico-antral type of Chronic Suppurative Otitis Media

Abstract

Chronic suppurative otitis media is defined as a chronic inflammation of the middle ear cleft, which presents with recurrent ear discharge through a tympanic membrane perforation. The purpose of this study was to find pattern of bacteriology in patients of atticoantral type of chronic suppurative otitis media as it will help the clinician to decide the effective antibiotics to be prescribed. This prospective and observational study was conducted in the Department of ENT in collaboration with Department of Microbiology, Government Medical College and Hospital, Chandigarh. The ear discharge specimen of all patients meeting the inclusion criteria were collected and sent for microbial examination. Culture positive samples were subjected to antibiotic sensitivity. A total of one hundred ears (mean age 27.33 years) clinically diagnosed with chronic suppurative otitis media, atticoantral type were included in this study based on the preset inclusion and exclusion. The male: female ratio in our patients was 0.94:1. Ninety-seven (96.9%) patients had unilateral disease, while 3 (3.1%) patients had bilateral disease. Twenty-eight percent of the total samples were sterile. The most common bacteria isolated were Pseudomonas aeruginosa (27.1%), Methicillin sensitive Staphylococcus aureus (23.3%) and Proteur mirabilis (6.5%). was sensitive to polymyxin B (100%) followed by ciprofloxacin (46.4%), neomycin (42.9%) and gentamicin (42.9%). Polymyxin B is the most effective antibiotic against the cultured bacteria followed by gentamicin, ciprofloxacin and neomycin.

https://ift.tt/2Cex7wl

Use of vismodegib for the treatment of multiple basal cell carcinomas in a patient with xeroderma pigmentosum

Pediatric Dermatology, EarlyView.


https://ift.tt/2NO4szP

Management of Nasoorbitoethmoidal Fracture: An Institutional Experience

Abstract

The nasoorbitoethmoidal fractures remain the most complex of all facial fractures to diagnose and treat mainly because of the intricate anatomy and difficulty in fracture fixation. The number of such fractures are increasing with the more incidence of high-speed, high-force accidents. The nasoorbitoethmoidal fractures rarely occur as an isolated event. Associated injuries often include central nervous system injuries, cribriform plate fracture, cerebrospinal fluid rhinorrhea, and fractures of the frontal bone, orbital floor, and middle third of the face as well as injury to the lacrimal system. The appropriate management of these injuries require an understanding of the anatomic features of the region, the degree of severity of damage. The purpose of this article is to provide a general overview of the topic, with a more specific focus on the pearls of managing these fractures. Twenty-four patients who suffered The nasoorbitoethmoidal fractures with/without associated multiple midfacial injuries were included in the study. Postoperatively, results show stable symmetrical fixation of the canthus in three dimensions with good apposition of the eyelids against the ocular globe along with acceptable nasofrontal angle and nasal prominence. Prompt and proper management of these injuries can achieve both adequate functional and aesthetic outcomes.

https://ift.tt/2wCaAoc

Bacteriological Profile in Attico-antral type of Chronic Suppurative Otitis Media

Abstract

Chronic suppurative otitis media is defined as a chronic inflammation of the middle ear cleft, which presents with recurrent ear discharge through a tympanic membrane perforation. The purpose of this study was to find pattern of bacteriology in patients of atticoantral type of chronic suppurative otitis media as it will help the clinician to decide the effective antibiotics to be prescribed. This prospective and observational study was conducted in the Department of ENT in collaboration with Department of Microbiology, Government Medical College and Hospital, Chandigarh. The ear discharge specimen of all patients meeting the inclusion criteria were collected and sent for microbial examination. Culture positive samples were subjected to antibiotic sensitivity. A total of one hundred ears (mean age 27.33 years) clinically diagnosed with chronic suppurative otitis media, atticoantral type were included in this study based on the preset inclusion and exclusion. The male: female ratio in our patients was 0.94:1. Ninety-seven (96.9%) patients had unilateral disease, while 3 (3.1%) patients had bilateral disease. Twenty-eight percent of the total samples were sterile. The most common bacteria isolated were Pseudomonas aeruginosa (27.1%), Methicillin sensitive Staphylococcus aureus (23.3%) and Proteur mirabilis (6.5%). was sensitive to polymyxin B (100%) followed by ciprofloxacin (46.4%), neomycin (42.9%) and gentamicin (42.9%). Polymyxin B is the most effective antibiotic against the cultured bacteria followed by gentamicin, ciprofloxacin and neomycin.

https://ift.tt/2Cex7wl

Yellowish‐orange plaques and slack skin in a Chinese boy

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2CbUtCI

Allergic contact dermatitis caused by propolis‐enriched honey: A case of severe penile oedema

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2MHtkMZ

Yellowish‐orange plaques and slack skin in a Chinese boy

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2CbUtCI

Allergic contact dermatitis caused by propolis‐enriched honey: A case of severe penile oedema

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2MHtkMZ

Inverted nipples correction with glandular retropapillar flap: demonstration of a technique

Abstract

Inverted nipples constitutes functional and esthetic problems, generating frustration in women regarding breastfeeding and reduced self-esteem and self-efficacy in appearance. Many techniques for surgical correction have already been described. Most use dermal patches of the areola alone or associated with sutures that fit in the base of the papilla. Description of technique for correction of inverted nipple through a series of bilateral or unilateral cases. The surgery presents adequate projection of the nipple, sensitivity and functionality is preserved, and satisfaction with the postoperative result. This study demonstrates an easily reproduced technique that spares local tissue, using a small incision and mobilizes sufficient volume to project the papilla, without deforming the areola.

Level of Evidence: Level IV, therapeutic study

https://ift.tt/2Ch0heu

An unsuspected complication with immune checkpoint blockade: a case report

Immunotherapy treatment with immune-checkpoint blockade has become a new paradigm in cancer treatment. Despite its efficacy, it has also given rise to a new class of adverse events, immune-related adverse even...

https://ift.tt/2Q2geru

Huge chronic expanding hematoma of the iliac bone following multiple hip surgeries: a case report

Chronic expanding hematoma is a rare entity resulting from trauma or surgery. This condition usually occurs in soft tissue, such as the trunk or extremities, while chronic expanding hematoma arising from bone ...

https://ift.tt/2wAb3WQ

A neonate with marked prolonged mixed apneas and CHARGE syndrome: a case report

Upper airway abnormalities in the newborn are associated with obstructive breathing but not with mixed apneas. A tracheostomy is necessary to treat severe obstructive apneas but will not have an effect on the ...

https://ift.tt/2Q2mGPi

Placebos mit Heilkraft? Placeboeffekt und -einsatz in der (Schmerz-)Therapie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 574-578
DOI: 10.1055/a-0636-1776

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2LZElUQ

Knieendoprothetik: Adduktorenkanalblockade oder lokale Infiltrationsanalgesie?

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 567-568
DOI: 10.1055/a-0668-3904

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2oE9iEG

Grundlagen und Praxis der Neuroanästhesie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 618-630
DOI: 10.1055/s-0043-111004

Zentrale Aspekte der Anästhesieführung bei neurochirurgischen Operationen sind das Aufrechterhalten der zerebralen Homöostase sowie die Vermeidung sekundärer Hirnschäden. Die wichtigsten Variablen sind zerebraler Metabolismus, zerebraler Blutfluss, zerebraler Perfusionsdruck, zerebrales Blutvolumen und ihr Einfluss auf den intrakraniellen Druck. Die Ausgewogenheit dieser Faktoren ist Ziel bei jeder neurochirurgischen Operation oder Intervention.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NHM0sw

Musikermedizin

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 568-569
DOI: 10.1055/a-0668-3886

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2MLDiNu

Placebo-Nocebo-Ethik für die Patientenkommunikation

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 592-604
DOI: 10.1055/s-0043-121685

Die Patientenaufklärung ist „täglich Brot" des klinisch tätigen Anästhesisten und gleichzeitig ein zentrales Rechtfertigungselement medizinischer Behandlungsmaßnahmen. Durch Auslösen von Placebo- und Noceboeffekten kann sie den Behandlungserfolg aber auch selbst maßgeblich beeinflussen. Einem daraus drohenden Konflikt verschiedener medizinethischer Prinzipien kann mit entsprechenden praktischen Strategien wirksam begegnet werden.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2LZDX8Q

Tiefe Relaxierung kann laparoskopische Eingriffe erleichtern

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 568-568
DOI: 10.1055/a-0668-3958

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2MKHkWf

Weiterbildung in der Anästhesie nach Novellierung der Musterweiterbildungsordnung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 635-638
DOI: 10.1055/a-0591-1169

Schlichtungsstellen für Arzthaftpflichtfragen bieten Patienten, Ärzten und Versicherern eine Möglichkeit, Arzthaftungsstreitigkeiten außergerichtlich zu klären. In der Rubrik „Fälle der Schlichtungsstelle" stellen wir abgeschlossene Fälle aus der Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern vor.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NKBoJ8

Critical-Illness-Polyneuromyopathie verschlechtert Outcomes auf Intensivstation

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 569-570
DOI: 10.1055/a-0668-3750

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2MKHexR

Placeboeffekte in der Akutschmerztherapie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 579-590
DOI: 10.1055/s-0043-121684

Placebo- und Noceboeffekte stehen aktuell sehr im Fokus der klinischen und experimentellen Schmerzforschung. Neuro- sowie psychophysiologische Prozesse scheinen eine wichtige Rolle bei der Entstehung sowie Vermittlung zu spielen. So werden Placebo- und Noceboeffekte im Wesentlichen über das Netzwerk des opioidergen, absteigenden, schmerzmodulierenden Systems vermittelt. Für das Zustandekommen eines Placeboeffektes wiederum werden 3 psychologische Mechanismen verantwortlich gemacht: klassische Konditionierung, soziales Lernen sowie die Schmerzerwartung. Eine offene Analgetikagabe, eine ausführliche Aufklärung über Wirkung und Nebenwirkung (ohne diese zu sehr in den Fokus zu stellen) der im perioperativen Bereich eingesetzten Medikamente und Interventionen sowie eine Einbindung des Patienten in die Therapie (z. B. durch patientenkontrollierte Systeme) können zu einer additiven Verbesserung der Akutschmerztherapie (bis zu 30%) führen.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NNa8d1

50 Jahre Plastische Chirurgie und 25 Jahre Facharzt für Plastische Chirurgie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 572-572
DOI: 10.1055/a-0667-9094

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2oB2E23

Placeboeffekte bei chronischen Schmerzen: Forschungsstand und klinische Anwendung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 605-617
DOI: 10.1055/s-0043-121683

Spielte der Placeboeffekt ehemals vorwiegend eine (eher unliebsame) Rolle bei randomisierten kontrollierten Studien, so treten nun vermehrt die mit dem Placeboeffekt verbundenen Chancen in den Vordergrund. Dieser Beitrag bespricht bisherige Forschungserkenntnisse zum Placeboeffekt bei chronischen Schmerzen und zeigt, wie durch eine gezielte Beeinflussung des therapeutischen Kontexts die Wirksamkeit pharmakologisch aktiver Schmerzmedikamente gesteigert werden kann.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NFo2xU

Warnhinweis auf rezeptfreien Schmerzmitteln soll künftig Risiken verringern

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 572-573
DOI: 10.1055/a-0667-9117

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2oE8M9I

Kinderanästhesie: Risikopatienten profitieren von intravenöser Einleitung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 566-567
DOI: 10.1055/a-0668-3940

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2LQvjt6

Rapid Sequence Induction

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 631-634
DOI: 10.1055/a-0628-3122

Die „Rapid Sequence Induction and Intubation" (RSI oder RSII) ist bei Patienten mit erhaltener Kreislauffunktion die Standardmethode, um schnellstmöglich eine Atemwegssicherung im Rahmen einer Notfallsituation bzw. Narkose durchzuführen. Ziel einer RSI ist es, eine Aspiration durch die schnelle endotracheale Intubation und den Verzicht auf eine Zwischenbeatmung zu verhindern.Auch heute besitzen nur wenige europäische Länder eine explizite Handlungsempfehlung zur Durchführung einer RSI. In der täglichen klinischen Routine hat sich die Kopfhochlagerung etabliert, die gegenüber den anderen Lagerungsarten gewisse Vorteile bietet. Eine liegende Magensonde sollte i. d. R. während der RSI belassen werden und muss nicht zwingend in den Ösophagus zurückgezogen werden. Wenn keine Magensonde gelegt wurde bzw. bereits lag, ist die Einlage einer Magensonde nach Intubation sinnvoll. Vor der RSI sollte im Normalfall ein Opioid appliziert werden, da die Dosis kreislaufwirksamer Hypnotika und die hämodynamische Stimulation bei der Intubation reduziert werden können.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2MKGSav

Placebos mit Heilkraft? Placeboeffekt und -einsatz in der (Schmerz-)Therapie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 574-578
DOI: 10.1055/a-0636-1776

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2LZElUQ

Knieendoprothetik: Adduktorenkanalblockade oder lokale Infiltrationsanalgesie?

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 567-568
DOI: 10.1055/a-0668-3904

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2oE9iEG

Grundlagen und Praxis der Neuroanästhesie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 618-630
DOI: 10.1055/s-0043-111004

Zentrale Aspekte der Anästhesieführung bei neurochirurgischen Operationen sind das Aufrechterhalten der zerebralen Homöostase sowie die Vermeidung sekundärer Hirnschäden. Die wichtigsten Variablen sind zerebraler Metabolismus, zerebraler Blutfluss, zerebraler Perfusionsdruck, zerebrales Blutvolumen und ihr Einfluss auf den intrakraniellen Druck. Die Ausgewogenheit dieser Faktoren ist Ziel bei jeder neurochirurgischen Operation oder Intervention.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NHM0sw

Musikermedizin

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 568-569
DOI: 10.1055/a-0668-3886

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2MLDiNu

Placebo-Nocebo-Ethik für die Patientenkommunikation

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 592-604
DOI: 10.1055/s-0043-121685

Die Patientenaufklärung ist „täglich Brot" des klinisch tätigen Anästhesisten und gleichzeitig ein zentrales Rechtfertigungselement medizinischer Behandlungsmaßnahmen. Durch Auslösen von Placebo- und Noceboeffekten kann sie den Behandlungserfolg aber auch selbst maßgeblich beeinflussen. Einem daraus drohenden Konflikt verschiedener medizinethischer Prinzipien kann mit entsprechenden praktischen Strategien wirksam begegnet werden.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2LZDX8Q

Tiefe Relaxierung kann laparoskopische Eingriffe erleichtern

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 568-568
DOI: 10.1055/a-0668-3958

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2MKHkWf

Weiterbildung in der Anästhesie nach Novellierung der Musterweiterbildungsordnung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 635-638
DOI: 10.1055/a-0591-1169

Schlichtungsstellen für Arzthaftpflichtfragen bieten Patienten, Ärzten und Versicherern eine Möglichkeit, Arzthaftungsstreitigkeiten außergerichtlich zu klären. In der Rubrik „Fälle der Schlichtungsstelle" stellen wir abgeschlossene Fälle aus der Schlichtungsstelle für Arzthaftpflichtfragen der norddeutschen Ärztekammern vor.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NKBoJ8

Critical-Illness-Polyneuromyopathie verschlechtert Outcomes auf Intensivstation

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 569-570
DOI: 10.1055/a-0668-3750

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2MKHexR

Placeboeffekte in der Akutschmerztherapie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 579-590
DOI: 10.1055/s-0043-121684

Placebo- und Noceboeffekte stehen aktuell sehr im Fokus der klinischen und experimentellen Schmerzforschung. Neuro- sowie psychophysiologische Prozesse scheinen eine wichtige Rolle bei der Entstehung sowie Vermittlung zu spielen. So werden Placebo- und Noceboeffekte im Wesentlichen über das Netzwerk des opioidergen, absteigenden, schmerzmodulierenden Systems vermittelt. Für das Zustandekommen eines Placeboeffektes wiederum werden 3 psychologische Mechanismen verantwortlich gemacht: klassische Konditionierung, soziales Lernen sowie die Schmerzerwartung. Eine offene Analgetikagabe, eine ausführliche Aufklärung über Wirkung und Nebenwirkung (ohne diese zu sehr in den Fokus zu stellen) der im perioperativen Bereich eingesetzten Medikamente und Interventionen sowie eine Einbindung des Patienten in die Therapie (z. B. durch patientenkontrollierte Systeme) können zu einer additiven Verbesserung der Akutschmerztherapie (bis zu 30%) führen.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NNa8d1

50 Jahre Plastische Chirurgie und 25 Jahre Facharzt für Plastische Chirurgie

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 572-572
DOI: 10.1055/a-0667-9094

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2oB2E23

Placeboeffekte bei chronischen Schmerzen: Forschungsstand und klinische Anwendung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 605-617
DOI: 10.1055/s-0043-121683

Spielte der Placeboeffekt ehemals vorwiegend eine (eher unliebsame) Rolle bei randomisierten kontrollierten Studien, so treten nun vermehrt die mit dem Placeboeffekt verbundenen Chancen in den Vordergrund. Dieser Beitrag bespricht bisherige Forschungserkenntnisse zum Placeboeffekt bei chronischen Schmerzen und zeigt, wie durch eine gezielte Beeinflussung des therapeutischen Kontexts die Wirksamkeit pharmakologisch aktiver Schmerzmedikamente gesteigert werden kann.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2NFo2xU

Warnhinweis auf rezeptfreien Schmerzmitteln soll künftig Risiken verringern

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 572-573
DOI: 10.1055/a-0667-9117

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2oE8M9I

Kinderanästhesie: Risikopatienten profitieren von intravenöser Einleitung

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 566-567
DOI: 10.1055/a-0668-3940

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Full text

https://ift.tt/2LQvjt6

Rapid Sequence Induction

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 631-634
DOI: 10.1055/a-0628-3122

Die „Rapid Sequence Induction and Intubation" (RSI oder RSII) ist bei Patienten mit erhaltener Kreislauffunktion die Standardmethode, um schnellstmöglich eine Atemwegssicherung im Rahmen einer Notfallsituation bzw. Narkose durchzuführen. Ziel einer RSI ist es, eine Aspiration durch die schnelle endotracheale Intubation und den Verzicht auf eine Zwischenbeatmung zu verhindern.Auch heute besitzen nur wenige europäische Länder eine explizite Handlungsempfehlung zur Durchführung einer RSI. In der täglichen klinischen Routine hat sich die Kopfhochlagerung etabliert, die gegenüber den anderen Lagerungsarten gewisse Vorteile bietet. Eine liegende Magensonde sollte i. d. R. während der RSI belassen werden und muss nicht zwingend in den Ösophagus zurückgezogen werden. Wenn keine Magensonde gelegt wurde bzw. bereits lag, ist die Einlage einer Magensonde nach Intubation sinnvoll. Vor der RSI sollte im Normalfall ein Opioid appliziert werden, da die Dosis kreislaufwirksamer Hypnotika und die hämodynamische Stimulation bei der Intubation reduziert werden können.
[...]

Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2MKGSav

Airborne foliar transfer of particular metals in Lactuca sativa L.: translocation, phytotoxicity, and bioaccessibility

Abstract

The uptake, translocation, and human bioaccessibility of metals originating from atmospheric fine particulate matters (PM) after foliar exposure is not well understood. Lettuce (Lactuca sativa L.) plants were exposed to micronic PbO, CuO, and CdO particulate matters (PMs) by the foliar pathway and mature plants (6 weeks old) were analyzed in terms of: (1) metal accumulation and localization on plant leaf surface, and metal translocation factor (TF) and global enrichment factor (GEF) in the plants; (2) shoot growth, plant dry weight (DW), net photosynthesis (Pn), stomatal conductance (Gs), and fatty acid ratio; (3) metal bioaccessibility in the plants and soil; and (4) the hazard quotient (HQ) associated with consumption of contaminated plants. Substantial levels of metals were observed in the directly exposed edible leaves and newly formed leaves of lettuce, highlighting both the possible metal transfers throughout the plant and the potential for human exposure after plant ingestion. No significant changes were observed in plant biomass after exposure to PbO, CuO, and CdO-PMs. The Gs and fatty acid ratio were increased in leaves after metal exposure. A dilution effect after foliar uptake was suggested which could alleviate metal phytotoxicity to some degree. However, plant shoot growth and Pn were inhibited when the plants are exposed to PbO, and necrosis enriched with Cd was observed on the leaf surface. Gastric bioaccessibility of plant leaves is ranked: Cd > Cu > Pb. Our results highlight a serious health risk of PbO, CuO, and CdO-PMs associated with consumption of vegetables exposed to these metals, even in newly formed leaves in the case of PbO and CdO exposure. Finally, the study highlights the fate and toxicity of metal rich-PMs, especially in the highly populated urban areas which are increasingly cultivated to promote local food.

https://ift.tt/2LQlcVa

Zn(II), Pb(II), and Cd(II) adsorption from aqueous solution by magnetic silica gel: preparation, characterization, and adsorption

Abstract

A novel magnetic silica gel adsorbent (Fe₃O₄-Si-COOH) was successfully prepared by introducing carboxyl group in situ to improve the performance for Pb(II), Zn(II), and Cd(II) adsorption. Infrared spectroscopy (IR), scanning electron microscope (SEM), transmission electron microscope (TEM), thermo-gravimetric analyzer (TGA), the Brunauer-Emmett-Teller (BET) surface area, X-ray diffraction (XRD), and vibrating sample magnetometer (VSM) characterizations suggested that Fe₃O₄-Si-COOH has been successfully prepared. The adsorption performance was evaluated by batch experiments with different initial concentrations, ionic strength, contact time, and pH. The adsorption kinetics data followed pseudo-second-order model and exhibited a three-stage intraparticle diffusion mode. Isothermal adsorption equilibrium data were best fitted by the Freundlich model and the adsorption capacity were 155, 110, and 93 mg/g (initial concentration 210 mg/L) for Pb(II), Zn(II), and Cd(II), respectively. The result of X-ray photoelectron spectroscopy (XPS) survey spectrum suggested that the main adsorption mechanism is that the H⁺ of carboxyl groups exchanged with heavy metal ions in the adsorption processes. In addition, the adsorbed Fe₃O₄-Si-COOH could be regenerated and the adsorption capacity of reused Fe₃O₄-Si-COOH could maintain 80.3% after five cycles. Hence, the Fe₃O₄-Si-COOH could be a kind of potential material for removing Pb(II), Zn(II), and Cd(II) from wastewater.

Graphical abstract

https://ift.tt/2Q1UQ5G

Cadmium accumulation and subcellular distribution in populations of Hylotelephium spectabile (Boreau) H. Ohba

Abstract

A pot experiment was conducted among six populations of Hylotelephium spectabile (Boreau) H. Ohba: four from Jiangsu province, one from Shandong province, and one from Shanxi province, China, to investigate the variation of Cd accumulation and subcellular distribution of this species (a newly reported Cd high accumulator). Under five different real Cd-contaminated soils (Cd: 0.93–97.97 mg/kg), results showed considerable differences in Cd concentration in (a) leaf (1.09–50.7 mg/kg), (b) stem (0.61–13.0 mg/kg), and (c) root (1.55–24.5 mg/kg) among the populations. Analysis of subcellular Cd distribution indicated that Cd accumulated in the leaves of H. spectabile was mainly in the cellular debris (44.1 to 53.5%), followed by heat-stable protein (HSP, 20.9 to 29.0%), Cd-rich granules (MRG, 9.9 to 19.5%), heat-denatured protein (6.0 to 8.5%), and organelle fractions (3.1 to 7.4%). The populations of H. spectabile with more Cd partitioned to cellular debris and biological detoxified metal (HSP + MRG) fractions have greater capacity to accumulate Cd, indicating the probable intrinsic mechanism to accumulate Cd. Therefore, H. spectabile has the considerable potential of phytoremediation for Cd-contaminated soils, but screening suitable populations according to soil Cd concentrations is necessary before used for phytoremediation of Cd-contaminated soils.

https://ift.tt/2NKtZJQ

Plant uptake and translocation of perfluoroalkyl acids in a wheat–soil system

Abstract

Application of per- and polyfluoroalkyl substances (PFASs) is shifting to short-chain analogs (C ≤ 6) that raises concerns for their potential ecotoxicological risks. In the present study, pot experiments were carried out to study the effects of perfluoroalkyl acids (PFAAs), including perfluoroalkyl carboxylic acids (PFCAs) and perfluoroalkyl sulfonic acids (PFSAs), with different carbon chain lengths (C4, C6, and C8) on the growth of wheat seedlings and their plant uptake and transfer at two spiking levels (200 and 2000 μg/kg soil). Exposure to C4 PFAAs slightly inhibited chlorophyll activity, whereas exposure to C8 PFAAs showed enhancement. The bioaccumulation factors (BAFs) for C4 PFAAs in wheat were over 10, while BAFs for C8 PFAAs were all below 1. Rhizospheric and root to shoot transfer factors for PFAAs were both negatively correlated with their log K_ow (p < 0.05). PFCAs exhibited both higher rhizospheric mobility and accumulation potentials than PFSAs of the same chain lengths. Hence, perfluoroalkyl chain governs the mobility of PFAAs in a soil–plant system besides interactions of their head groups, and the substitution with shorter chain PFASs raises concerns for their higher plant accumulation potential that brings higher ecotoxicological and human exposure risks via food chains.

https://ift.tt/2Q1UIDe

The concentration of heavy metals in noodle samples from Iran’s market: probabilistic health risk assessment

Abstract

In the current study, the concentration of heavy metals including lead (Pb), chromium (Cr), cadmium (Cd), and aluminum (Al) in commonly instant noodles consumed in Iran (either imported from other countries or produced in Iran) was investigated by acid digestion method followed by an inductively coupled plasma optical emission spectrometry system (ICP-OES). Also, the associated non-carcinogenic risk due to ingestion of heavy metals for adults and children was estimated by calculating percentile 95% target hazard quotient (THQ) in the Monte Carlo simulation (MCS) method. The average concentrations of Pb, Cr, Cd, and Al in Iranian instant noodle samples were measured as 1.21 ± 0.81, 0.08 ± 0.10, 0.03 ± 0.06, and 9.15 ± 4.82 (mg/kg) and in imported instant noodle samples were 1.00 ± 0.61, 0.07 ± 0.07, 0.04 ± 0.03, and 15.90 ± 0.93 (mg/kg), respectively. A significant difference (p value < 0.05) in the mean concentration of Pb, Cr, Cd, and Al of Iranian instant noodle and imported instant noodle samples was observed. Also, the concentration of Pb, Cr, Cd, and Al in all brands of instant noodle (0.025 mg/kg, 0.050 mg/kg, 0.003 mg/kg, and 0.237 mg/kg, respectively) surpassed the WHO-permitted limits for Pb, Cr, Cd, and Al. Percentile 95% of THQ of Pb, Cr, Cd, and Al for the adult consumers was calculated as 0.012, 0.000007, 0.010, and 1.789; while in the case of children, percentile 95% of THQ of Pb, Cr, Cd, and Al was defined as 0.044, 0.00023, 0.035, and 6.167, respectively. Health risk assessment indicated that both adults and children are at considerable non-carcinogenic health risk for Al (THQ > 1). Therefore, approaching the required strategies in order to reduce the concentration of heavy metals particularly Al in the instant noodle is recommended.

https://ift.tt/2NJlYVI

Clinical Thyroidology®High-Impact Articles

FREE ACCESS through September 14, 2018.
Read Now:

Hypothyroidism Is Associated with Increased Mortality Risk in Individuals 65 Years of Age or Older
Elizabeth N. Pearce  

Alemtuzumab, a Monoclonal Antibody to CD52, Frequently Causes Graves' Disease
Jerome M. Hershman 

Patients with Differentiated Thyroid Cancer Who Undergo Reoperation for Recurrence Have Increased Mortality
Masha J. Livhits, Michael W. Yeh 

Serum TSH Remains Normal in Those without Significant Risk Factors for Thyroid Dysfunction
Angela M. Leung 

The post Clinical Thyroidology^®High-Impact Articles appeared first on American Thyroid Association.

https://ift.tt/2CaCOvg

Shared decision making and decisional conflict in the Management of Vestibular Schwannoma: a prospective cohort study

Abstract

Background

Patients with vestibular schwannomas (VS) are faced with complex management decisions. Watchful waiting, surgical resection, and radiation are all viable options with associated risks and benefits. We sought to determine if patients with VS experience decisional conflict when deciding between surgery or non-surgical management, and factors influencing the degree of decisional conflict.

Methods

A prospective cohort study in two tertiary ambulatory skull-base clinics was performed. Patients with newly diagnosed or newly growing vestibular schwannomas were recruited. Patients were given a demographic form and the decisional conflict scale (DCS), a validated measure to assess the degree of uncertainty when making medical decisions. The degree of shared decision making (SDM) experienced by the patient and physician were assessed via the SDM-Q-10 and SDM-Q-Doc questionnaires, respectively. Non-parametric statistics were used. Questionnaires and demographic information were correlated with DCS using Spearman correlation coefficient and Mann-Whitney U. Logistic regression was performed to determine factors independently associated with DCS scores.

Results

Seventy-seven patients participated (55% female, aged 37–81 years); VS ranged in size from 2 mm–50 mm. Significant decisional conflict (DCS score 25 or greater) was experienced by 17 (22%) patients. Patients reported an average SDM-Q-10 score of 86, indicating highly perceived level of SDM. Physician and patient SDM scores were weakly correlated (p = 0.045, Spearman correlation coefficient 0.234). DCS scores were significantly negatively correlated with a decision to pursue surgery, presence of a trainee, and higher SDM-Q-10 score. DCS was higher with female gender. Using logistic regression, the SDM-Q-10 score was the only variable associated with significantly reduced DCS.

Conclusions

About one fifth of patients deciding how to manage their vestibular schwannoma experienced a significant degree of decisional conflict. Involving the patients in the process through shared decision-making significantly reduced the degree of uncertainty patients experienced.

https://ift.tt/2MKggXa

Re-visiting the ATA 2015 sonographic guidelines - who are we missing?: A retrospective review

Abstract

Background

The American Thyroid Association published revised guidelines in 2015 on the management of differentiated thyroid cancer in adults. One of the key changes introduced in the revision proposes that diagnostic biopsy be based on ultrasound findings (i.e. size and nodule characteristics). The overall effect of these changes results in fewer nodules requiring biopsy. This study was conducted to determine if the changes to the guidelines will result in overlooked thyroid cancers, specifically malignancies with aggressive characteristics measuring between 1 and 1.49 cm.

Methods

Patients (n = 2083) with thyroid nodules who underwent total or subtotal/hemi thyroidectomy with or without neck dissection by a single surgeon between 2006 and 2016 were retrospectively enrolled. Demographic information and nodule characteristics were collected for all patients. Ultrasonography and final pathology reports were reviewed for patients with thyroid nodules between the sizes of 1–1.49 cm (n = 155).

Results

45% (n = 70) of patients with nodules between 1 and 1.49 cm were "low suspicion" nodules according to ultrasound. 47 of these nodules contained malignancies on final histopathological examination, 100% of which were of the papillary subtype. 21% (n = 10) of these malignant nodules demonstrated extrathyroidal extension and 34% (n = 16) were associated with regional metastases.

Conclusions

Reliance on sonographic patterns alone could result in missed cancer diagnoses in patients with thyroid nodules measuring between 1 and 1.49 cm. Moreover, a portion of these malignancies may be associated with aggressive features. The effect of this finding on long-term outcomes is unclear.

https://ift.tt/2NPOqVK

Effectiveness of skull X-RAY to determine cochlear implant insertion depth

Abstract

Background

Cochlear implant (CI) insertion depth can affect residual hearing preservation, tonotopic range coverage, and Mapping. Therefore, determining insertion depth has the potential to maximize CI performance. A post-op skull X-RAY is commonly used to assess insertion depth, however its effectiveness has not been well established. Our primary objective was to assess the accuracy of post-op skull X-RAYs to determine insertion depth, compared to CT as the gold standard. Secondary objectives were to compare experience level of raters and different skull X-RAY views.

Methods

Thirteen patients with Advanced Bionic HiRes 90 K implants, and post-operative temporal bone CT scans were selected from the CI database at Sunnybrook Health Sciences Centre. Medical students, otology fellows, and CI surgeons evaluated insertion depths on post-op skull X-RAYs, while neuroradiologists evaluated CT scans. Descriptive statistics, regression analysis, and paired t-tests were used to compare the two types of imaging.

Results

X-RAYs and CTs provided an equivalent mean insertion depth of 337 degrees (p = 0.93), a mean difference of − 0.9 degrees and a standard deviation of paired differences of 43 degrees. Although means were similar across rater groups, CI surgeons (45 degrees) had the lowest standard deviation of paired differences. Comparing X-RAY views, Caldwell (29 degrees) had less variation than Towne (59 degrees) for standard deviation of paired differences.

Conclusions

Skull X-RAYs provide accurate and reliable measurements for CI insertion depth. The Caldwell view alone may be sufficient for evaluations of insertion depth, and experience has a minor impact on the variability of estimates.

https://ift.tt/2MKBYKD

Clinical Thyroidology®High-Impact Articles

FREE ACCESS through September 14, 2018.
Read Now:

Hypothyroidism Is Associated with Increased Mortality Risk in Individuals 65 Years of Age or Older
Elizabeth N. Pearce  

Alemtuzumab, a Monoclonal Antibody to CD52, Frequently Causes Graves' Disease
Jerome M. Hershman 

Patients with Differentiated Thyroid Cancer Who Undergo Reoperation for Recurrence Have Increased Mortality
Masha J. Livhits, Michael W. Yeh 

Serum TSH Remains Normal in Those without Significant Risk Factors for Thyroid Dysfunction
Angela M. Leung 

The post Clinical Thyroidology^®High-Impact Articles appeared first on American Thyroid Association.

https://ift.tt/2CaCOvg

Efficacy of breast reconstruction with fat grafting: A systematic review and meta-analysis

Breast reconstruction with fat grafting is a new alternative to prosthetic implants and flaps for women with breast cancer. In this study, we investigate the efficacy of fat grafting for breast reconstruction in a meta-analysis.

https://ift.tt/2PyIFMF

Cartilage sparing surgery for melanoma of the external ear

The excision of melanoma of the external ear poses a challenge to surgeons, who must achieve adequate oncological control while minimising impact on form and function. Cartilage preserving surgery is an attractive option as it leaves behind a scaffold for immediate reconstruction with a variety of techniques including full thickness skin grafts (FTSGs) and local flaps. This manuscript will review the literature comparing cartilage sparing surgery with composite excision of skin and cartilage for the treatment of auricular melanoma.

https://ift.tt/2oBKBIU

Readability and quality of breast reduction on-line resources

Many patients are now using the Internet as a resource for health-related information. It is recommended that the readability of patient education materials should be equal to or less than an 11-13-year-old reading level.The aim of this study was to evaluate the readability and quality of websites related to breast reduction.The largest internet search engine was queried for 'breast reduction'. 112 articles from the ten most popular websites were downloaded for analysis. Results from the private cosmetic industry were excluded.

https://ift.tt/2LVM5H4

Comparison of piezosurgery, percutaneous and endonasal continuous osteotomy techniques on a caprine skull model

Osteotomy is a crucial step in rhinoplasty which can have a significant impact on the outcome. In addition to previous percutaneous (external perforating) and endonasal (internal) approaches, piezosurgery has been used in rhinoplasty practice since 2007. This experimental model was planned to compare the three osteotomy techniques.

https://ift.tt/2oBSZbB

Utilization of Installation Wound Vacuum Device for Breast Implant Salvage: Approach and Results

Negative pressure wound therapy allow for an increase in fibroblast migration, a decrease in cell death and stimulation of angiogenesis, all to allow for more rapid wound healing. With irrigating vacs, wounds can be continually washed without painful dressing changes, while concurrently providing the benefit of intermittent negative pressure.

https://ift.tt/2LUHPaP

Shear wave elastography in the diagnosis of the ulnar tunnel syndrome.

An interesting alternative to traditional diagnostic techniques of the upper extremity nerve entrapments might be provided by an ultrasound elastography that started to gain attention in recent research. The aim of this preliminary study was to verify if quantitative analysis of ulnar nerve stiffness with shear-wave elastography can be used to diagnose the ulnar tunnel syndrome, an ulnar nerve neuropathy at the Guyon's canal. The study included 46 patients (39 women) and 39 healthy controls (34 women).

https://ift.tt/2oAUBSD

A SIMPLE METHOD FOR LYMPHEDEMA SELF-MEASUREMENT USING THE ZOZOSUIT BODYSUIT

Dear Editor,

https://ift.tt/2LU6UD4

Obstructive Sleep Apnea and the Metabolic Syndrome: The Road to Clinically-Meaningful Phenotyping, Improved Prognosis, and Personalized Treatment

Obstructive sleep apnea (OSA) is an increasingly prevalent sleep disorder characterized by upper airway obstruction during sleep, resulting in breathing pauses, intermittent hypoxia, and fragmented sleep. In parallel, the constellation of adverse health outcomes associated with prolonged obesity, such as insulin resistance, elevated blood pressure, triglycerides, and reduced high-density lipoprotein cholesterol – termed metabolic syndrome –raises the risk of cardiovascular morbidity and mortality, type 2 diabetes, and all-cause mortality.

https://ift.tt/2MImKFY

Risk Factors for Recurrent Anaphylaxis-Related ED Visits in the United States

Anaphylaxis is an acute systemic allergic reaction that may be life-threatening1. Patients with a history of anaphylaxis live with a chronic risk of relapse with the subsequent event being unpredictable. In one of the earliest studies examining anaphylaxis recurrence, Mullins2 reported that one in twelve patients with anaphylaxis will experience recurrence and one in fifty will require adrenaline or hospital attention.

https://ift.tt/2oIt4z3

Survival, disease progression and prognostic factors in elderly patients with mycosis fungoides and Sézary syndrome: a retrospective analysis of 174 patients

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


https://ift.tt/2MJ6yEC

Management of patients with hereditary angioedema in Germany: comparison to other countries in the Icatibant Outcome Survey

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


https://ift.tt/2NKARHi

Secukinumab survival and long‐term efficacy in patients with plaque psoriasis: real‐life data from a tertiary hospital in Greece

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


https://ift.tt/2MOcagU

Comparison of clinical and ultrasound scores in patients with hidradenitis suppurativa: results from an Italian ultrasound working group

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


https://ift.tt/2NIU8sK

Hidradenitis suppurativa/acne inversa: A practical framework for treatment optimization – systematic review and recommendations from the HS ALLIANCE working group

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


https://ift.tt/2MNjqt4

Probabilistic risk assessment (Monte Carlo simulation method) of Pb and Cd in the onion bulb (Allium cepa) and soil of Iran

Abstract

Recently, the exposure to heavy metals through the consumption of vegetables has become a global concern. In this regard, the current study was aimed to measure the concentrations of lead (Pb) and cadmium (Cd) in the collected onion bulb samples as well as the surrounded soil using a flame atomic absorption spectrometer (FAAS). Additionally, the target hazard quotient (THQ) for males and females in all age groups of consumers were estimated by using Monte Carlo Simulation (MCS) method. Furthermore, the soil threshold values (STVs) were evaluated to investigate the heavy metal contents in the soil based on the established standard limits. In this context, 45 onion bulbs (HashtBandi region, 25 and Ravang region, 20) and 41 soil (HashtBandi region, 21 and Ravang region, 20) samples were collected (March–May of 2016). The average concentrations of Pb in the onions from HashtBandi and Ravang regions were determined as 0.0052 ± 0.0011 and 0.0061 ± 0.0022 mg/kg, and for Cd were 0.0095 ± 0.0024 and 0.0011 ± 0.0035 mg/kg, respectively. The average concentration of Pb in the soil from HashtBandi and Ravang regions were measured as 3.99 ± 3.77 and 2.03 ± 0.69 mg/kg, and for Cd, the corresponding values were determined as 2.21 ± 3.17 and 2.22 ± 0.92 mg/kg, respectively. The average concentration of Pb and Cd in both investigated onion bulb and soil were lower than Iranian national (onion bulb: Pb = 0.1 mg/kg, Cd = 0.05 mg/kg) and FAO/WHO (onion bulb: Pb = 0.3 mg/kg, Cd = 0.1 mg/kg; soil: Pb = 50 mg/kg, Cd = 0.3 mg/kg) standard limits. Moreover, the THQ and total target hazard quotient (TTHQ) for males and females in all age groups were less than 1 value. Therefore, no risk of the exposure to Pb and Cd as result of onion bulb consumption was reported. STVs for Pb and Cd in the HashtBandi region were calculated as 3.99 and 2.21 mg/kg, and Ravang as 2.03 and 2.22 mg/kg, respectively. Due to the higher calculated STVs for Cd while compared with the established standard limit for the soil, the further revisions regarding the heavy metal standard limits in the soil were recommended.

https://ift.tt/2oCLBwx

The effect of ICT, financial development, growth, and trade openness on CO 2 emissions: an empirical analysis

Abstract

This study investigates the impact of Internet use, financial development, economic growth, and trade openness on carbon dioxide (CO₂) emissions in selected European Union (EU) countries. To this end, pooled mean group (PMG) estimator is utilized for panel data from 2001 to 2014. Empirical findings suggest that Internet use has long-run relationship with CO₂ emissions and lowering the environmental quality in EU countries. Also, the electricity consumption has a positive and significant effect on CO₂ emissions. Moreover, interestingly, economic growth and financial development have a diminishing negative impact on CO₂ emission. Heterogeneous panel Granger causality results suggest unidirectional causality running from Internet use to CO₂ emissions. The finding implies that the European Union countries did not achieve the level of green information and telecommunication (ICTs) consumption. Overall, the innovative findings indicate that Internet use is raising the threat to the sustainable development. Thus, to curb and mitigate CO₂ emissions from Internet use and electricity consumption is the need of time to maintain the sustainable development in EU countries.

https://ift.tt/2oCtve5

Effects of Microcystis aeruginosa on the life history traits and SOD activity of Daphnia similoides sinensis

Abstract

With water eutrophication and global warming, cyanobacteria blooms have occurred frequently, and the interaction between M. aeruginosa and Daphnia has been widely paid attention by researchers. However, the effects of toxic M. aeruginosa on the SOD activity of Daphnia are poorly known. Six D. similoides sinensis clones collected from Lake Junshan and the offspring of two clones were employed. The effects of toxic M. aeruginosa on the life history traits and SOD activities of D. similoides sinensis in the mother and their offspring were studied. Toxic M. aeruginosa could significantly inhibit the life history traits (e.g., body lengths, offspring numbers at first reproduction, cumulative offspring numbers, and the intrinsic rate of population) and induce higher SOD activities of D. similoides sinensis. Compared with the mother, the effects of toxic M. aeruginosa on the life history traits and SOD activities of D. similoides sinensis in the offspring showed obvious differences. Moreover, the adaptability of the offspring to M. aeruginosa indicated also the differences between two clones. Our results suggested that the mother exposed to toxic M. aeruginosa could enhance the fitness of their offspring to Microcystis by maternal effect and was also affected by the D. similoides sinensis genotypes.

https://ift.tt/2wFWD8w

Bowel perforation in chronic idiopathic megarectum and megacolon

Chukwuebuka Anyaegbuna<br />Aug 20, 2018; 2018:bcr-2018-225406-bcr-2018-225406<br />Images in...

https://ift.tt/2Nhejki

Penile fracture after priapism due to sildenafil ingestion: out of frying pan into the fire

Deepanshu Sharma<br />Aug 14, 2018; 2018:bcr-2018-226562-bcr-2018-226562<br />Images in...

https://ift.tt/2PAsf6N

Unexpected cause for eyelid swelling and ptosis: rigid gas permeable contact lens migration following a 28-year-old trauma

Sirjhun Patel<br />Aug 10, 2018; 2018:bcr-2018-225767-bcr-2018-225767<br />Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

https://ift.tt/2Na1EQh

Follow-up of water-only fasting and an exclusively plant food diet in the management of stage IIIa, low-grade follicular lymphoma

Toshia R Myers<br />Aug 9, 2018; 2018:bcr-2018-225520-bcr-2018-225520<br />Images in...

https://ift.tt/2NJFCkg

Auto-amputation of penis due to advanced carcinoma penis

Gaurav Garg<br />Aug 9, 2018; 2018:bcr-2018-226505-bcr-2018-226505<br />Images in...

https://ift.tt/2NatUSJ

Rarasaponin-bentonite-activated biochar from durian shells composite for removal of crystal violet and Cr(VI) from aqueous solution

Abstract

This paper presents the preparation of composite material and its application for the adsorption of crystal violet and Cr(VI) from aqueous solution onto acid-activated bentonite (AAB) and rarasaponin–bentonite-activated biochar from durian shells composite (RBAB). The influence of initial pH of the solution and the temperature of adsorption on the adsorbents adsorption performance was also studied. Langmuir and Freundlich models could represent the adsorption equilibria equally well. Thermodynamic parameters such as ∆G°, ∆H°, and ∆S° were evaluated based on the adsorption isotherms. The values of ∆G°, ∆H°, and ∆S° for crystal violet adsorption system demonstrate behavior contrary to the Cr(VI) adsorption system. Where crystal violet adsorption is preferred at high temperatures with q_max, value is 518.64 mg/L; while adsorption Cr(VI) is better at low temperature with q_max, value is 106.30 mg/L. Pseudo-first-order and pseudo-second-order kinetic models could represent the kinetic data well.

https://ift.tt/2LRIXfA

A new molecular multiplex IgE assay for the diagnosis of pollen allergy in Mediterranean countries: a validation study

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


https://ift.tt/2NIe7b0

Development of Central Serous Chorioretinopathy following Chalazion Removal with Intralesional Triamcinolone Injection: A Case Report

We report a case of central serous chorioretinopathy (CSC) that developed 1 month after an intralesional injection of triamcinolone acetonide that was administered during removal of a chalazion. The subretinal fluid and ipsilateral visual acuity (VA) worsened with initial observation. The edema resolved with verteporfin photodynamic therapy (PDT) 1 month after diagnosis, but VA did not improve during short-term follow-up. We conclude that CSC can occur as a complication of low-dose intrapalpebral corticosteroid administration and provide another example of the therapeutic role of PDT in the management of this disease.
Case Rep Ophthalmol 2018;9:416–420

https://ift.tt/2NLEmx4

A global consensus statement on ashy dermatosis, erythema dyschromicum perstans, lichen planus pigmentosus, idiopathic eruptive macular pigmentation, and Riehl's melanosis

International Journal of Dermatology, EarlyView.


https://ift.tt/2NIjAyu

Tonsillenchirurgie: Einfluss des Tonsillenspatels auf den Pharynxdurchmesser

Zusammenfassung

Hintergrund

Die Selektivverträge der Krankenkassen mit den Leistungserbringern sehen eine Fotodokumentation vor, um die Indikationsstellung der Tonsillotomie adäquat rechtfertigen zu können. Im Jahr 2017 führte die HNO-Klinik Mönchengladbach eine standardisierte Fotodokumentation bei diesem Eingriff ein.

Ziel der Arbeit

Anhand der archivierten Fotodokumente sollte überprüft werden, ob sich die Abstände der medialen Tonsillenflächen durch das Aufspannen des Tonsillenspatels signifikant verändern.

Material und Methoden

Fotos wurden durch das Operationsmikroskop unmittelbar nach Einsetzen und Öffnen des Spatels angefertigt, ohne ihn aufzuspannen (D1), dann nach zusätzlichem Einhängen vor (D2) und nach der Tonsillotomie (D3). Es wurde jeweils ein 10-mm-Ausschnitt eines Einmal-Papierlineals in den Situs gebracht, um die Abstände genau messen zu können. Die Fotos wurden aus der digitalen Patientenakte in eine Powerpoint-Datei kopiert, um über ein eingefügtes, variabel gestaltbares Rechteck die Distanzbestimmungen vorzunehmen.

Ergebnisse

Die Dokumentation von 149 Patienten in einem 6‑Monats-Zeitraum wurde analysiert. Es handelte sich um etwa gleich viele männliche wie weibliche Patienten, der jüngste Patient war 16 Monate, der älteste 48 Jahre alt (Durchschnitt: 6,95; Median: 5 Jahre). Bei allen Patienten fand sich eine signifikante Weitung des Pharynxdurchmessers (p < 0,001) mit scheinbarer Verkleinerung der Tonsillengröße.

Schlussfolgerung

Das Aufspannen des Tonsillenspatels führt zu einer Weitung des Pharynxdurchmessers, in Relation dazu erscheinen die Tonsillen kleiner, als sie sind. Dies sollte berücksichtigt werden, um eventuellen Diskussionen mit Krankenkassen vorzubeugen. Inwieweit das Aufspannen des Spatels auch zu einer Annäherung der umgebenden Arterien führt, sollten weitere Studien klären.

https://ift.tt/2LSYaNw

Alterations in levels of intermediate-chained acylcarnitines associate with weight-gain following reestablishment of euthyroidism in Graves’ disease

https://ift.tt/2oAV7jB

Visual analogue scale for sino-nasal symptoms severity correlates with sino-nasal outcome test 22: paving the way for a simple outcome tool of CRS burden

A visual analogue scale (VAS) is a psychometric instrument widely used in the Rhinology field to subjectively quantify patient's symptoms severity. In allergic rhinitis, VAS has been found to correlate well wi...

https://ift.tt/2Pzzufa

A dense mapping study of six European AITD susceptibility regions in a large Chinese Han Cohort of Graves’ disease

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


https://ift.tt/2CdUWnZ

Thyrotoxicosis after iodine fortification. A 21 year Danish population based study

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


https://ift.tt/2wCt2wE

Four compartment method as an efficacious and simplified technique for autologous non‐cultured epidermal cell suspension preparation in vitiligo surgery: A randomized, active‐controlled study

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


https://ift.tt/2CeoaDk

Role of cytochrome c in modulating chromium-induced oxidative stress in Oryza sativa

Abstract

Cytochrome c (CYTc) is one of the redox-active molecules responsible for electron transport in plant mitochondria. It is important in the interaction of metal ions with mitochondrial proteome, it is also essential for insights into electron transport during oxidative stress. This study focused on the clarification of interactions of CYTc with metal accumulation and associated modulation of CYTc with reactive oxygen species (ROS) generation in rice seedlings exposed to chromium either hexavalent Cr(VI) or trivalent Cr(III). The result indicates that exposures to both Cr species resulted in significant accumulation of Cr in rice tissues. ROS-dependent growth inhibition of rice seedlings was also evident from both Cr treatments. Changes of CYTc content in roots and shoots maintained almost the same pattern after both Cr exposures. However, dynamically transcriptional levels of rice CYTc genes conducted by real-time quantitative RT-PCR were inconsistent in rice tissues. The results presented here demonstrate that oxidative stresses induced by ROS accumulation do not equally and/or detrimentally influence the perturbations of CYTc content and expression patterns of CYTc genes in rice tissues after Cr exposure, suggesting that the decrease of CYTc levels in roots did not originate ROS accumulation, it may be due to metal-binding properties, while enhancement of CYTc content in shoots was probably a signal of severe growth inhibition owing to ROS accumulation.

https://ift.tt/2Na8Njr

Skin type differences in solar simulated radiation‐induced oxidative stress

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


https://ift.tt/2oHiPLn

Skin type differences in solar simulated radiation‐induced oxidative stress

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


https://ift.tt/2oHiPLn

Alterations in levels of intermediate-chained acylcarnitines associate with weight-gain following reestablishment of euthyroidism in Graves’ disease

https://ift.tt/2oAV7jB

Cadmium-accumulator straw application alleviates cadmium stress of lettuce ( Lactuca sativa ) by promoting photosynthetic activity and antioxidative enzyme activities

Abstract

The effects of application of straw derived from cadmium (Cd) accumulator plants (Siegesbeckia orientalis, Conyza canadensis, Eclipta prostrata, and Solanum photeinocarpum) on growth and Cd accumulation of lettuce plants grown under Cd exposure were studied. Treatment with straw of the four Cd-accumulator species promoted growth, photosynthesis, and soluble protein contents and enhanced the activities of peroxidase in leaves of lettuce seedlings. The biomass of shoot of lettuce from high to low in turn is the treatment of C. canadensis straw > S. photeinocarpum straw > S. orientalis > E. prostrata > Control. The Cd content in edible parts (shoots) of the lettuce plants was significantly decreased in the presence of straw from the Cd-accumulator species, except the presence of the straw of E. prostrata. And, the greatest reduction in Cd content in shoots was 27.09% in the S. photeinocarpum straw treatment compared with that of the control. Therefore, application of straw of S. orientalis, C. canadensis, and S. photeinocarpum can promote the growth of lettuce seedlings, and decrease their Cd accumulation, when grown in Cd-contaminated soil, which is beneficial for production of lettuce safe for human consumption.

https://ift.tt/2oztxTP

Impact of marine and continental sources on aerosol characteristics using an on-board SPAMS over southeast sea, China

Abstract

The chemical composition of atmospheric aerosols was characterized using an on-board single particle aerosol mass spectrometer (SPAMS) over the Southeast China Sea. High-time-resolution observation of marine aerosols was carried out to clarify the source of aerosols and the interaction of marine and continental aerosols. Atmospheric aerosols were determined by the interaction of continental and marine sources over coastal area. Aerosols from continental sources flux into sea surfaces through deposition or diffusion, which results in the rapid decrease of continental aerosols. Five main subtypes of carbonaceous particles are identified as C_Al-Si, C_V-Ni, C_S, C_K, and C_secondary to clarify the impact of marine and continental sources on atmospheric aerosols. High fraction of C_Al-Si and C_secondary is present over XA (Xiamen anchorage), accounting for 23.8% and 18.6% of total carbonaceous particles. Contrarily, the relative percentage of C_S increases as the distance from land to sea increases. The influence of continental aerosols declines, while the contribution of marine aerosols increases as the distance from land to sea increases. Air masses in XA, LSA (land to sea area), SLA (sea to land area), and SA (sea area) were all from ocean during the observation period, resulting in low relative fraction of continental aerosols in SLA, SA, and LSA. High-time-resolution measurement is useful to understand aerosol source types and the impact of marine and continental sources on marine atmosphere aerosols.

https://ift.tt/2MLnL03

Multifocal Warthin’s Tumor: An Uncommon Presentation of Bilateral Cervical Lymphadenopathy

Warthin's tumor is the second most common benign lesion of the parotid gland. It is most commonly encountered in male smokers in the fifth to seventh decades of life. Uniquely, among benign lesions of the parotid gland, it can be seen bilaterally in 7–10% of cases. Very rarely, Warthin's tumor can also mimic malignant or metastatic disease by presenting within cervical lymph nodes. We present a rare case of a 71-year old male smoker with bilateral parotid lesions in addition to progressively enlarging cervical and mediastinal lymphadenopathy. Excisional biopsy of a cervical lymph node ultimately revealed Warthin's tumor.

https://ift.tt/2CezLSY

Efficacy of high-intensity laser therapy in comparison with conventional physiotherapy and exercise therapy on pain and function of patients with knee osteoarthritis: a randomized controlled trial with 12-week follow up

Abstract

Knee osteoarthritis (KOA) is one of the most common musculoskeletal disorders causing pain and functional impairment. The purpose of the study is to compare the effects of high-intensity laser therapy (HILT), conventional physical therapy (CPT), and exercise therapy (ET) on pain and function in patients with KOA. The study was designed as an assessor-blind randomized controlled trial. Ninety-three patients (aged between 50 and 75 years) with proved KOA were included and randomly allocated into three groups, and received 12 sessions of HILT, CPT, or ET. The outcomes were pain intensity measured by visual analog scale (VAS), knee flexion range of motion (FROM), timed up and go test (TUG), 6-min walk test (6MWT), and functionality of knee measured by the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) questionnaire. Statistical analyses were done to compare the amounts at the baseline, immediately after treatment and after 12 weeks. HILT was significantly more effective than the other groups in decreasing the VAS, increasing FROM and improving the scores of WOMAC (total and function subscale) both after treatment and after 12 weeks. The effect of HILT and CPT on the TUG, 6MWT, and WOMAC pain subscale was not significantly different after treatment, and both were better than ET. HILT was significantly better than the others after follow-up, particularly more effective on the stiffness subscale of WOMAC. HILT combined with exercise therapy, as a useful therapeutic approach, could have positive influences on KOA patients.

https://ift.tt/2CfddS6

Anaphylaxis to xylitol diagnosed by skin prick test and basophil activation test

Publication date: Available online 3 September 2018

Source: Allergology International

Author(s): Kaoru Okamoto, Michiko Kagami, Manabu Kawai, Yuji Mori, Kazuo Yamawaki, Yoichi Nakajima, Yasuto Kondo, Ikuya Tsuge

https://ift.tt/2oH5vXn

The role of nutrition in inflammatory pilosebaceous disorders: Implication of the skin‐gut axis

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2ClAaDg

Setting sun pattern in dermoscopy of a scalp nodule

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2wBSwKG

The role of nutrition in inflammatory pilosebaceous disorders: Implication of the skin‐gut axis

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2ClAaDg

Setting sun pattern in dermoscopy of a scalp nodule

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2wBSwKG

A framework for quality measurement in the presurgical care of chronic rhinosinusitis: a review from the Quality Improvement Committee of the American Rhinologic Society

International Forum of Allergy &Rhinology, EarlyView.


https://ift.tt/2oxM0jL

Combination of submandibular salivary gland transfer and intensity‐modulated radiotherapy to reduce dryness of mouth (xerostomia) in patients with head and neck cancer

Head &Neck, EarlyView.


https://ift.tt/2PzWOcL

Effectiveness of small monitoring skin paddle in free muscle flap for scalp reconstruction

Head &Neck, EarlyView.


https://ift.tt/2Ne31gK

Tattoos and Penalty Success at the FIFA World Cup 2018

Dermatology

https://ift.tt/2NDN94a

Decreased Systemic Levels of Endocan-1 and CXCL16 in Psoriasis Are Restored following Narrowband UVB Treatment

Background: In psoriasis, a common immune-mediated disease affecting 2–3% of the population worldwide, there is an increased prevalence of extracutaneous diseases including obesity, the metabolic syndrome, and cardiovascular disease. This is believed to be linked to systemic inflammation. In previous studies, we have explored various markers in plasma and serum to characterize the ongoing systemic inflammation in psoriasis patients compared to controls. We have identified several markers that were altered in psoriasis patients, but which all were unresponsive to narrowband UVB (NB-UVB) treatment. Objective: The objective of the study was to evaluate the effect of NB-UVB treatment on markers of cardiovascular risk and systemic inflammation in psoriasis. Methods: The levels of 17 potential biomarkers with an association with cardiovascular risk were quantitated in plasma from 37 age- and gender-matched psoriasis patients and controls at baseline and in 21 psoriasis patients after 12 weeks of NB-UVB treatment to identify a systemic treatment response. Results: We identified the mediators endocan-1, CXCL16, and sVEGFR1, which were systemically decreased in psoriasis at baseline, as well as FABP3, FABP4, and sIL-1R1, which showed normal baseline levels. After 10–12 weeks of NB-UVB treatment, endocan-1 and CXCL16 were restored to normal levels, while sVEGFR1, FABP3, FABP4, and sIL-1R1 showed a significant reduction. Conclusion: The current study expands the number of potential biomarkers in psoriasis by including a greater number and variety of mediators, approaching the systemic inflammation from additional vantage points, including soluble immune receptors and adipocyte contribution, to provide a more complete picture of the systemic inflammatory state in psoriasis.
Dermatology

https://ift.tt/2ozkYs7

An investigator‐blinded, randomized, prospective, comparative study of efficacy of four anti‐inflammatory and barrier hand moisturizers in patients with chronic hand dermatitis

Dermatologic Therapy, EarlyView.


https://ift.tt/2PwFQvA

The use of etanercept for treatment of toxic epidermal necrolysis when toxic shock syndrome is in the differential

Dermatologic Therapy, EarlyView.


https://ift.tt/2oAPSjU

Values of body mass index (BMI) and body surface area (BSA) in patients with psoriatic arthritis treated with adalimumab: Preliminary report

Dermatologic Therapy, EarlyView.


https://ift.tt/2PzPaiz

“SENECA” Sinecatechins 10% ointment: A green tea extract for the treatment of actinic keratosis. Case series

Dermatologic Therapy, EarlyView.


https://ift.tt/2oAik5J

Cytokine targets in lupus nephritis: Current and future prospects

Publication date: Available online 2 September 2018

Source: Clinical Immunology

Author(s): Christina Adamichou, Spyros Georgakis, George Bertsias

Abstract

Despite advancements in the care of lupus nephritis, a considerable proportion of patients may respond poorly or flare while on conventional immunosuppressive agents. Studies in murine and human lupus have illustrated a pathogenic role for several cytokines by enhancing T- and B-cell activation, autoantibodies production and affecting the function of kidney resident cells, therefore supporting their potential therapeutic targeting. To this end, there is limited post-hoc randomized evidence to suggest beneficial effect of belimumab, administered on top of standard-of-care, during maintenance therapy in lupus nephritis. Type I interferon receptor blockade has yielded promising results in preliminary SLE trials yet data on renal activity are unavailable. Conversely, targeting interleukin-6 and interferon-γ both failed to demonstrate a significant renal effect. For several other targets, preclinical data are encouraging but will require confirmation. We envision that high-throughput technologies will enable accurate patient stratification, thus offering the opportunity for personalized implementation of cytokine-targeting therapies.

https://ift.tt/2Q0p5tO

Adipose tissue, fillers, and skin tightening

Dermatologic Therapy, EarlyView.


https://ift.tt/2PxHGMH

An investigator‐blinded, randomized, prospective, comparative study of efficacy of four anti‐inflammatory and barrier hand moisturizers in patients with chronic hand dermatitis

Dermatologic Therapy, EarlyView.


https://ift.tt/2PwFQvA

The use of etanercept for treatment of toxic epidermal necrolysis when toxic shock syndrome is in the differential

Dermatologic Therapy, EarlyView.


https://ift.tt/2oAPSjU

Values of body mass index (BMI) and body surface area (BSA) in patients with psoriatic arthritis treated with adalimumab: Preliminary report

Dermatologic Therapy, EarlyView.


https://ift.tt/2PzPaiz

“SENECA” Sinecatechins 10% ointment: A green tea extract for the treatment of actinic keratosis. Case series

Dermatologic Therapy, EarlyView.


https://ift.tt/2oAik5J

Adipose tissue, fillers, and skin tightening

Dermatologic Therapy, EarlyView.


https://ift.tt/2PxHGMH

Risk Factors for Recurrent Anaphylaxis-Related ED Visits in the United States

Publication date: Available online 3 September 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Megan S. Motosue, M. Fernanda Bellolio, Holly K. Van Houten, Nilay D. Shah, Ronna L. Campbell

https://ift.tt/2wE2fjT

Parasitoids of the eucalyptus gall wasp Leptocybe spp.: a global review

Abstract

The genus Leptocybe Fisher & La Salle (Hymenoptera: Eulophidae) and its type species L. invasa were first described in 2004. Leptocybe spp. are global pests of eucalyptus plantations, and parasitoids play an important role in their control. In this review, we describe the species, distribution, biology, ecology and parasitism levels of Leptocybe spp. parasitoids and the problems associated with biological control programmes against Leptocybe spp. Additionally, prospects for the use of conservation or augmentative biological control programmes against Leptocybe spp. are discussed. Worldwide, approximately 23 species of parasitoids of Leptocybe spp. in 7 families and 10 genera have been found to date. Comparing the parasitism levels of the parasitoids showed that Quadrastichus mendeli, Selitrichodes neseri and several (approximately 4) native Megastigmus spp. could be exploited to manage Leptocybe spp. Available information on the Leptocybe spp. parasitoids is expected to improve our understanding related to ongoing studies of biological control programmes against Leptocybe spp.

https://ift.tt/2Q17LEZ

Electrode Penetration of the Caudate Nucleus in Deep Brain Stimulation Surgery for Parkinson’s Disease

Objective: To evaluate the possible influence of electrode trajectories penetrating the caudate nucleus (CN) on cognitive outcomes in deep brain stimulation (DBS) surgery for Parkinson's disease (PD). Background: It is currently unclear how mandatory CN avoidance during trajectory planning is. Design/Methods: Electrode trajectories were determined to be inside, outside, or in border region of the CN. Pre- and postoperative neuropsychological tests of each trajectory group were compared in order to evaluate possible differences in cognitive outcomes 12 months after bilateral STN DBS. Results: One hundred six electrode tracks in 53 patients were evaluated. Bilateral penetration of the CN occurred in 15 (28%) patients, while unilateral penetration occurred in 28 (53%). In 19 (36%) patients tracks were located in the border region of the CN. There was no electrode penetration of the CN in 10 (19%) patients. No difference in cognitive outcomes was found between the different groups. Conclusion: Cognitive outcome was not influenced by DBS electrode tracks penetrating the CN. It is both feasible and sensible to avoid electrode tracks through the CN when possible, considering its function and anatomical position. However, penetration of the CN can be considered without major concerns regarding cognitive decline when this facilitates optimal trajectory planning due to specific individual anatomical variations.
Stereotact Funct Neurosurg

https://ift.tt/2C9mI4Y

Feasibility of 5-fluorouracil pharmacokinetic monitoring using the My-5FU PCM™ system in a quaternary oncology centre

Abstract

Purpose

5-Fluorouracil (5FU) drug exposure correlates with treatment response and toxicity in cancer patients. Dosing is based upon body surface area which does not correlate with 5FU pharmacokinetics (PK)/pharmacodynamics. Therapeutic drug monitoring has enabled real-time 5FU dose adjustments: reducing toxicity with increased efficacy. The aim of this study was to assess feasibility of a 5FU monitoring service utilising a commercial kit in a quaternary cancer centre and to compare PK parameters to previously published studies.

Methods

Cancer patients receiving continuous infusional (CI) 5FU with ECOG PS 0–2, and adequate organ function, were eligible. Patients had blood samples taken at t = 0, mid infusion (if feasible) then 2 h pre infusion end. 5FU levels were measured using a commercial kit (My-5FU PCM™). A feasibility questionnaire was completed by trial nurses and toxicity data were recorded at baseline and at the commencement of the next cycle. 5FU pharmacokinetic exposure parameters were calculated.

Results

Twenty patients (12 male; 8 female), median age 62, (range 37–71) had samples taken. Twenty (100%) feasibility forms were available for assessment. Blood samples were taken at 51/69 (74%) specified time points. Ease of sample processing was recorded as easy in all 20 patients. Patient compliance with scheduled visits was 18/20 (90%). One form noted other difficulties with predicting end of infusion time. 19/20 patients had blood samples analysed. Mean measured 5FU AUC (0-Tlast) for 5FU 1 g/m² with platinum: 35.8 h mg/L (range 28.56–44.26), mean Css 372.2 µg/L (range 297.5–461.0); 5FU 600 mg/m² with platinum: 12.42 h mg/L (range 6.91–18.29), mean Css 111.0 µg/L (72.0–190.5) and 5FU 2400 mg/m² as part of FOLFOX ± bevacizumab: 14.75 h mg/L (range 6.74–22.93), mean Css 320.70 µg/L (range 146.5–498.5). One patient had grade 4 neutropenia and one patient without PK parameters experienced febrile neutropenia (grade 4 neutropenia). Mucositis was observed in two patients: [5FU/platinum (1), grade 1, FOXFOX ± bevacizumab (1) grade 1]. Diarrhoea was reported in three patients [5FU/platinum (2) grade 1–2, FOXFOX ± bevacizumab (1) grade 1].

Conclusion

Therapeutic 5FU drug monitoring was feasible using commercial kits and analysers and hence warrants development as a routine standard of care in cancer patients. The variability in the 5FU exposure parameters is consistent with other studies using the My 5FU PCM kit.

https://ift.tt/2LSJVIj

Primary adrenal insufficiency due to bilateral infiltrative disease

Abstract

Purpose

Evidence on clinical presentation, evaluation, and management of patients with primary adrenal insufficiency (PAI) due to bilateral adrenal infiltrative disease is scarce. Our objective was to review the clinical presentation, biochemical work-up, imaging findings, and management of patients with PAI due to infiltrative adrenal disease in order to determine the best diagnostic and management approach.

Methods

Retrospective study of patients with PAI due to bilateral infiltrative adrenal disease referred for adrenal biopsy during 2000–2014 at Mayo Clinic, Rochester, Minnesota. Two additional patients evaluated after 2014 were included.

Results

Seven patients (six males and one female) were diagnosed with PAI caused by bilateral adrenal infiltrative disease at a median age of 54 (range 36–80) years. Duration of symptoms prior to the diagnosis of PAI and initiating treatment was 6 months (range 3 months–4 years). All patients demonstrated bilateral adrenal masses on adrenal imaging. The underlying diagnosis was confirmed by histopathology and included: bilateral adrenal metastases (lung and breast adenocarcinoma), diffuse large B-cell lymphoma, tuberculosis, cryptococcus, histoplasmosis, and, Erdheim-Chester disease.

Conclusion

In patients with newly diagnosed PAI, the differential diagnosis should include bilateral infiltrative adrenal disease, especially when testing for autoimmune adrenalitis is negative, or if there is clinical history suggesting another etiology. Patients who present with known bilateral adrenal infiltrative disease should be counseled and tested for PAI periodically, particularly if presenting with suggestive signs or symptoms.

https://ift.tt/2oA644X

Primary adrenal insufficiency due to bilateral infiltrative disease

Abstract

Purpose

Evidence on clinical presentation, evaluation, and management of patients with primary adrenal insufficiency (PAI) due to bilateral adrenal infiltrative disease is scarce. Our objective was to review the clinical presentation, biochemical work-up, imaging findings, and management of patients with PAI due to infiltrative adrenal disease in order to determine the best diagnostic and management approach.

Methods

Retrospective study of patients with PAI due to bilateral infiltrative adrenal disease referred for adrenal biopsy during 2000–2014 at Mayo Clinic, Rochester, Minnesota. Two additional patients evaluated after 2014 were included.

Results

Seven patients (six males and one female) were diagnosed with PAI caused by bilateral adrenal infiltrative disease at a median age of 54 (range 36–80) years. Duration of symptoms prior to the diagnosis of PAI and initiating treatment was 6 months (range 3 months–4 years). All patients demonstrated bilateral adrenal masses on adrenal imaging. The underlying diagnosis was confirmed by histopathology and included: bilateral adrenal metastases (lung and breast adenocarcinoma), diffuse large B-cell lymphoma, tuberculosis, cryptococcus, histoplasmosis, and, Erdheim-Chester disease.

Conclusion

In patients with newly diagnosed PAI, the differential diagnosis should include bilateral infiltrative adrenal disease, especially when testing for autoimmune adrenalitis is negative, or if there is clinical history suggesting another etiology. Patients who present with known bilateral adrenal infiltrative disease should be counseled and tested for PAI periodically, particularly if presenting with suggestive signs or symptoms.

https://ift.tt/2oA644X

Toxicity potential of particles caused by particle-bound polycyclic aromatic hydrocarbons (PPAHs) at two roadside locations and relationship with traffic

Abstract

This study assessed exposure by the roadside to highly toxic particle-bound polycyclic aromatic hydrocarbons (PPAHs) that are known to adsorb preferentially on fine particles, aerodynamic diameter (d_p ≤ 1 μm). The real-time air quality measurements were conducted in March, April, and May 2015 in Kanpur at two busy roadside locations: one outside IIT Kanpur main gate, IG, and another by a residential area, M3. The locations show varying land use type and traffic density. Higher averaged daily concentrations of PM₁₀, PM_2.5, and PM₁ were observed at IG (PM₁₀ 700–800 μg/m³) owing to nature and high density of traffic, and occurrence of biomass burning nearby. Statistically significant relation (R² > 90%, p < 0.05) between PM₁ and PM_2.5 highlights the influence of mobile sources on particle load at IG. IG, the busier location, had higher daily averaged concentration of aggregate PPAHs (104 ng/m³) than M3 which is located near a residential area (38 ng/m³). In contrast, the higher average daily value of PC/DC ratio (mass per unit surface area of PPAHs on nanoparticles) at M3 (4.87 ng/mm²) than at IG (4.08 ng/mm²) suggests that PAHs of greater mass occur on particles at M3. Finer particles are known to adsorb pollutants of a larger mass that are likely to be more toxic in case of PAHs suggest that ambient air at M3 has more toxicity potential. However, this inference is not based on chemical analyses, and chemical characteristics must also be taken into account for the detailed assessment of health risk. The multiple path dosimetry model (MPPD-v3.04) reveals that the 99.02% of PM₁₀ inhaled, 77.01% of PM_2.5 and 34.54% of PM₁ are deposited in the outermost (head) region of the human respiratory tract.

https://ift.tt/2oATnGY

Economic valuation of noise pollution control policy: does the type of noise matter?

Abstract

As the average noise level and number of noise sources have increased, governments have taken various measures to make soundscapes sustainable. Wise policy decisions require information about the monetary value of noise-control policies. This study elicited people's willingness to pay (WTP) for noise policies, separating traffic noise from residential noise to compare the value of controlling different types of noise. The contingent valuation method was used for the empirical analysis, with data from South Korea. The results show that the monthly mean WTP of respondents was KRW 3392.3 for residential noise reduction and KRW 3507.1 for transport noise reduction; thus, the WTP for the latter is slightly higher than that for the former. Moreover, about 80% of people are unwilling to pay for a noise policy at all, and that high ratio of people with zero WTP must be taken into consideration in the process of policy formulation and implementation. Respondents' experiential and psychological factors were found to be more important than their demographics in explaining their WTP for a noise policy. Potential policy implications based on the analysis results are provided.

https://ift.tt/2Px7UPt

Empirics on linkages among industrialization, urbanization, energy consumption, CO2 emissions and economic growth: a heterogeneous panel study of China

Abstract

This is the first attempt to explore linkages among industrialization, urbanization, energy consumption, CO2 emissions, and economic growth based on estimations in simultaneous equations framework. An economic growth model is extended to incorporate industrialization as shift factor and pollutant emissions as determinant of total factor productivity. A country panel of 30 Chinese provinces/cities and three regional panels, for periods 2000–2016, are estimated employing Augmented Mean Group (AMG) estimator as well as Common Correlated Effects Mean Group (CCEMG) estimator that are robust to both cross-sectional dependence and cointegration. The empirical findings are as follows: (i) the impact of urbanization on economic growth varied from negative to neutral to positive for western-, intermediate-, and eastern-economic zone, respectively, and is known as "urbanization ladder effect," (ii) moving from western to eastern economic zone, as regions develop, industry expansion has more powerful impact on economic growth, and thus, we define it as "industry expansion effect," (iii) industrialization promotes rapid urbanization in less developed and less employment saturated regions; hence, we name it as "employment saturation effect," (iv) economic growth in more developed regions pulled the CO2 emissions downward, while pushed it upward in case of less developed regions; therefore, we call it "growth pull/push effect," and (v) in bidirectional causality between energy consumption and economic growth, the "feedback effect" of economic growth remained dominant for all four panels. Based on empirical findings, policies are suggested for Chinese economy. Further, these policies have potential to extract implications for the rest of the world.

https://ift.tt/2NcKSjr

Correction to: Nematicidal potential of Taraxacum officinale

The original publication of this paper contains a mistake. Data on Table 1 under TR and TL column have been interchanged: that is compounds 1-12 and their amounts refer to TL; compounds 1-8 and related amounts refer to TR (see Fig. 1).

https://ift.tt/2PqW5u4

Tri-dimensional model for ventilation tube permeability

Abstract

Purpose

Ventilation tubes (VT) in the tympanic membrane expose the middle ear (ME) to the external auditory canal and its content. It carries the risk of penetration of contaminated material and could provide a pathway for the delivery of drugs into the ME. The aim of this study was to use a printed 3D-model of the external auditory canal (EAC) and ME to assess the permeability of various VTs to different fluids.

Methods

CT scan of the external and ME was 3D-reconstructed and printed. Five different types of VT were inserted in the model's tympanic membrane and the minimal pressure for penetration to the ME was measured. Liquids with different viscosities, including commonly used ear drops, were tested.

Results

Water passed through the standard 1.14 mm diameter VTs after filling the EAC with a volume of 2 ml and through a narrower grommet or a T-tube after filling the canal with 2.5 ml. Soapy-water had the highest penetration in all VTs (1–2 ml). The initial volume of dexamethasone needed for penetration was 2.5 ml in the standard tubes. It did not pass at any volume through the narrow grommet or the T-tube.

Conclusion

In the printed 3D-model, the volume of most solutions, including water, required to provide enough pressure in order to pass through the VTs was as high as the EAC volume or exceeded it. Soapy water had the highest penetrance while Dexamethasone needed volume of 2.5 ml to pass through the VT, questioning its reliability as a passive drug delivery channel to the ME.

https://ift.tt/2wDiT30

Ultrasonographic features associated with false-negative and false-positive results of extrathyroidal extensions in papillary thyroid microcarcinoma

Abstract

Purpose

To assess the ultrasonographic features affect accuracy of extrathyroid extension (ETE) evaluation on preoperative ultrasonography (US) in papillary thyroid microcarcinoma (PTMC).

Methods

Of the total patients who underwent thyroid surgery, 516 patients with a tumor measuring less than 1 cm on preoperative US were enrolled in this study. One blinded head and neck radiologist reviewed the preoperative US images to evaluate the US features of PTMC, and the pathologic reports were reviewed. The diagnostic accuracy rates, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, were calculated, and the factors associated with false-negative and false-positive results for ETE were analyzed.

Results

The sensitivity, specificity, PPV, NPV, and accuracy for predicting ETE according to sonographic criteria were 32.8%, 87.5%, 51.0%, 76.6%, and 71.7%, respectively. Non-adjacent to the trachea and unilateral lesion on US were significant factors associated with false-negative results.

Conclusion

Size, shape, and location of PTMC on US are important factors that affect the US results in ETE evaluation.

https://ift.tt/2Pybzge

DFT/TDDFT insights into effects of dissociation and metal complexation on photochemical behavior of enrofloxacin in water

Abstract

Elucidation of the mechanisms underlying the effects of different dissociated forms and metal ion complexation on the photochemical behavior of antibiotics in aqueous media is a key problem and requires further research. We examined the mechanism of the direct photolysis of enrofloxacin (ENRO) in different dissociated forms in water and the impact of metal ions (Mg²⁺) on the photolysis of ENRO using density functional theory and time-dependent density functional theory. The results showed that different dissociated forms of ENRO exhibited diverse maximum electronic absorbance wavelengths (ENRO³⁺ (264 nm) < ENRO⁻ (278 nm) < ENRO⁰ (280 nm) < ENRO²⁺ (282 nm) < ENRO⁺ (306 nm)). The calculations of the reaction pathways and activation energies (E_a) in the photolysis of ENRO⁰/ENRO⁺/ENRO⁻ showed that defluorination was the main reaction pathway. The removal of cyclopropane was the main reaction pathway for the direct photolysis of ENRO²⁺/ENRO³⁺. Furthermore, the presence of Mg²⁺ was observed to change the order of the maximum electronic absorbance wavelengths and increases the intensities of the ENRO absorbance peaks. Calculations of the photolysis reaction pathways showed that the presence of Mg²⁺ increased the E_a for the most direct photolysis pathways of ENRO, while its presence decreased the E_a for several partial direct photolysis pathways such as the pathway in which the piperazine ring moiety of ENRO⁰/ENRO³⁺ is damaged and the pathway in which cyclopropane is released from ENRO³⁺. The findings on the photolysis behavior of ENRO in water system have provided useful information on the risk assessment of antibiotics.

https://ift.tt/2wySFO4

Analysis of key genes and signaling pathways involved in Helicobacter pylori‐associated gastric cancer based on The Cancer Genome Atlas database and RNA sequencing data

Helicobacter, EarlyView.


https://ift.tt/2CdlBBs

Analysis of key genes and signaling pathways involved in Helicobacter pylori‐associated gastric cancer based on The Cancer Genome Atlas database and RNA sequencing data

Helicobacter, EarlyView.


https://ift.tt/2CdlBBs

Herpes Zoster Optic Neuropathy: Comment

No abstract available

https://ift.tt/2PvJje0

Anterior Ischemic Optic Neuropathy After Dental Extraction

Background: While often idiopathic, anterior ischemic optic neuropathy occasionally may occur from an identifiable cause. Methods: Observational case report. Results: A 19-year-old woman with unremarkable medical and ophthalmic histories developed visual loss from nonarteritic anterior ischemic optic neuropathy in her right eye after otherwise uneventful dental extraction of the inferior third molars. Conclusions: Anterior ischemic optic neuropathy may rarely occur after dental extraction. Potential pathophysiologic mechanisms of this rare occurrence are discussed. Address correspondence to Rod Foroozan, MD, Baylor College of Medicine, 1977 Butler Boulevard, Houston, TX 77030; E-mail: foroozan@bcm.edu From the Baylor College of Medicine (EK, RF), Houston, Texas. The authors report no conflicts of interest. © 2018 by North American Neuro-Ophthalmology Society

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