Role of simvastatin in tumor lymphangiogenesis and lymph node metastasis

Abstract

Lymphangiogenesis plays a crucial role in promoting cancer metastasis to sentinel lymph nodes (LNs) and beyond. Increasing data have shown that simvastatin, a cholesterol-lowering medication for the prevention of cardiovascular diseases, is involved in tumor growth and dissemination, and endothelial functions. This study aimed to investigate the potential effect of simvastatin on lymphatic formation and LN metastasis. Tumor models were established by subcutaneous injection of B16-F10 melanoma cells into mouse hind footpads. Simvastatin was administered (0.2 µg/g, intraperitoneal injection, IP) every other day for a total of eight times. Tissue samples were removed and examined by immunohistochemical staining and reverse transcription-polymerase chain reaction (RT-PCR) techniques. The lymphatics of LN, skin, liver, and lung exhibited morphological changes, and LN weight and metastatic area of the tumor group treated with simvastatin was lower than that of the untreated tumor group. Analysis of lymphatic size, area fraction, and lymphatic vessel density showed tissue specificity and variation to melanoma carcinogenesis in the simvastatin-treated group compared with the untreated group. In addition, LNs and cutaneous tissues showed altered expression of lymphangiogenic factors and inflammatory cytokines such as VEGF-A/-C/-D and TNF-α. These findings indicated that simvastatin may modify lymphangiogenesis and tumor progression in malignant melanoma.

https://ift.tt/2OdR8YC

Novel in-frame deletion in MFSD8 gene revealed by trio whole exome sequencing in an Iranian affected with neuronal ceroid lipofuscinosis type 7: a case report

The neuronal ceroid lipofuscinoses are a group of neurodegenerative, lysosomal storage disorders. They are inherited as an autosomal recessive pattern with the exception of adult neuronal ceroid lipofuscinosis...

https://ift.tt/2xBuQ9Q

The differential diagnosis of Helicobacter pylori negative gastritis

Abstract

Gastric biopsies are often submitted with as clinical question Helicobacter pylori (HP) infection. Regularly, the morphology suggests a HP infection but the organism is not detected in special stains. This review presents a practical approach to deal with such biopsies. The first step is to exclude a false negative result of the search for HP, by ensuring that both antral and oxyntic mucosa are present, by the use of sensitive stains, identification of marked reactive changes, such as intestinal, pseudo-pyloric, pancreatic metaplasia that may suggest a diagnosis of (HP associated or autoimmune) atrophic gastritis, and finally identification of signs of the use of proton pump inhibitors (PPI) as in such biopsies, HP may sometimes be found only within parietal cells. The differential diagnosis should include lymphocytic gastritis, other diseases affecting the stomach, such as inflammatory bowel disease (IBD), vasculitis, granulomatous disease, viral infection, such as cytomegalovirus (CMV) or more rarely Epstein-Barr virus (EBV) infection, or other bacterial infections, such as Enterococcus and Treponema pallidum. Clinical input may be required to ensure the patient is not taking medication that may cause gastritis, such as antibiotics used for HP eradication or common medications that cause a form of gastropathy. When these have been excluded, a known cause has not been found and in such a case, the term idiopathic focal/diffuse gastritis can be used.

https://ift.tt/2Q5e9ul

Association Between Type 2 Diabetes Mellitus and Hearing Loss Among Patients in a Coastal City of South India

Abstract

Diabetes mellitus (DM) is a metabolic culprit known to perpetuate several disease processes. The relationship between hearing loss (HL) and type 2 DM (T2DM) remains unclear despite the vast volume of research devoted to this topic. We conducted this study with the aim to evaluate HL among T2DM patients and to assess the relationship between severity of HL, glycosylated hemoglobin (HbA1c) levels and duration of T2DM. Design: a time bound descriptive crosssectional study. Setting: tertiary care hospital of South India. Subjects: subjects with T2DM, aged from 40 to 60 years (excluding hypertension, chronic noise exposure and history of smoking or ototoxicity) were included. Methods: Non-random convenience sampling. Details were gathered using a self-administered, semistructured questionnaire and the hearing was assessed by pure tone audiometry. Data was analysed using SPSS. A large proportion of the sampled population had audiological assessments suggestive of SensoriNeural HL (SNHL). 90.2% had a bilateral distribution of HL; however, only 39% of patients reported having any associated ear complaints. No statistically significant associations were obtained between severity of HL, glycaemic control, duration of diabetes or gender. Bilateral SNHL is a complication associated with T2DM. Duration and glycaemic control are independent variables and do not statistically influence the severity of HL. However, this study demonstrated that many patients with SNHL had no symptoms and also lacked awareness of HL in DM. Therefore routine assessment of hearing should be considered in the diabetic population.

https://ift.tt/2Q2RZbT

Association Between Type 2 Diabetes Mellitus and Hearing Loss Among Patients in a Coastal City of South India

Abstract

Diabetes mellitus (DM) is a metabolic culprit known to perpetuate several disease processes. The relationship between hearing loss (HL) and type 2 DM (T2DM) remains unclear despite the vast volume of research devoted to this topic. We conducted this study with the aim to evaluate HL among T2DM patients and to assess the relationship between severity of HL, glycosylated hemoglobin (HbA1c) levels and duration of T2DM. Design: a time bound descriptive crosssectional study. Setting: tertiary care hospital of South India. Subjects: subjects with T2DM, aged from 40 to 60 years (excluding hypertension, chronic noise exposure and history of smoking or ototoxicity) were included. Methods: Non-random convenience sampling. Details were gathered using a self-administered, semistructured questionnaire and the hearing was assessed by pure tone audiometry. Data was analysed using SPSS. A large proportion of the sampled population had audiological assessments suggestive of SensoriNeural HL (SNHL). 90.2% had a bilateral distribution of HL; however, only 39% of patients reported having any associated ear complaints. No statistically significant associations were obtained between severity of HL, glycaemic control, duration of diabetes or gender. Bilateral SNHL is a complication associated with T2DM. Duration and glycaemic control are independent variables and do not statistically influence the severity of HL. However, this study demonstrated that many patients with SNHL had no symptoms and also lacked awareness of HL in DM. Therefore routine assessment of hearing should be considered in the diabetic population.

https://ift.tt/2Q2RZbT

Carrie Owen Benefits from a New Minimally Invasive In-office Treatment for Nasal Polyposis

By the time she arrived in the office of rhinologist Martin J. Citardi, MD, Carrie Owen had lost her senses...

https://ift.tt/2DqVt6T

Breathing Better After Surgery and a Novel Implant

Former Houstonian Kelly Krohn was among the first to benefit from a relatively new solution for nasal airway obstruction symptoms...

https://ift.tt/2NEI3ss

Six ORL Specialists Named Houstonia Top Doctors for 2018

Six members of the Department of Otorhinolaryngology-Head and Neck Surgery have been selected as Houstonia Top Doctors by physicians, physician...

https://ift.tt/2DrS9YZ

Dr. Amber Luong Selected Faculty Member of the Year by ORL Residents

Each year, otorhinolaryngology residents of the Department of Otorhinolaryngology-Head and Neck Surgery at McGovern Medical School at UTHealth have the...

https://ift.tt/2NzflJA

TEKT4 Promotes Papillary Thyroid Cancer Cell Proliferation, Colony Formation, and Metastasis through Activating PI3K/Akt Pathway

Abstract

Thyroid carcinoma is the most common malignancy of the endocrine system worldwide, but its molecular mechanisms remain unclear. Some diseases are associated with TEKT4 gene. However, its role in thyroid carcinoma has yet to be fully examined. This study was designed to investigate the function of TEKT4 in papillary thyroid cancer (PTC). The effect of TEKT4 on aggressive behavior of PTC cell lines, namely, TPC1 and BCPAP, transfected with small interfering RNA was identified through cell proliferation, colony formation, migration, and invasion. Our previous study revealed that TEKT4 may be vital in PTC. In in vitro experiments, TEKT4 downregulation suppressed cell proliferation, colony formation, cell migration, and invasion. Our data also indicated that tumor-suppressing role of TEKT4 knockdown in PTC cell lines was associated with the silence of the PI3K/Akt pathway. Our study revealed that TEKT4 shows important biological implications and is worthy of further study.

https://ift.tt/2O6hBHB

How to integrate physical activity and exercise approaches into inpatient treatment for eating disorders: fifteen years of clinical experience and research

Abstract

Background

The importance of physical activity and exercise among patients with eating disorders (EDs) is acknowledged among clinicians and researchers. The lack of clinical guidelines, the differing attitudes towards exercise approaches in treatment, and the lack of specialized competence all influence the management of ED symptoms in specialist ED treatment units. The purpose of the study was to examine 15 years of clinical experience with exercise approaches as an integrated part our inpatients treatment program.

Methods

From January 2003 to December 2017, 244 patients were admitted to a specialist ED unit in Norway. The treatment program at the ED unit is multidisciplinary. It is based on psychodynamic theory, and designed to enhance patients' recovery and to enable them to adopt a lifestyle that is as healthy as possible. The authors describe the clinical management of patients with reference to practical examples and a case example.

Recommendations and experience

The treatment for exercise is not manualized, but adjusted to the specific symptoms and needs of individual ED patients. The treatment approaches to exercise are part of the body-oriented treatment at the Specialist eating disorder unit (Regionalt kompetansesenter for spiseforstyrrelser (RKSF)), and the therapy addresses the entire body and the relation between the body, emotions, and the patient's social situation. It covers a chain of approaches from admission to discharge, from rest and relaxation to regular exercise groups.

Conclusions

Our experience and recommendations support earlier proposals for treatment approaches to exercise and exercise-related issues as a beneficial supplement to the treatment of ED inpatients. We have not experienced any adverse influences on patients' recovery processes, such as their rate of weight gain. Our intention is that this paper will be a contribution to the field of ED, the integration of exercise approaches in the inpatient treatment of ED and development of clinical guidelines.

https://ift.tt/2QViS2M

Human Vestibulo-Ocular Reflex Adaptation Training: Time Beats Quantity

Abstract

The vestibulo-ocular reflex (VOR) is the main gaze stabilising system during rapid head movements. The VOR is highly plastic and its gain (eye/head velocity) can be increased via training that induces an incrementally increasing retinal image slip error signal to drive VOR adaptation. Using the unilateral incremental VOR adaptation technique and horizontal active head impulses as the vestibular stimulus, we sought to determine the factors important for VOR adaptation including: the total training time, ratio and number of head impulses to each side (adapting and non-adapting sides; the adapting side was pseudo-randomised left or right) and exposure time to the visual target during each head impulse. We tested 11 normal subjects, each over 5 separate sessions and training protocols. The basic training protocol (protocol one) consisted of unilateral incremental VOR adaptation training lasting 15 min with the ratio of head impulses to each side 1:1. Each protocol varied from the basic. For protocol two, the ratio of impulses were in favour of the adapting side by 2:1. For protocol three, all head impulses were towards the adapting side and the training only lasted 7.5 min. For protocol four, all impulses were towards the adapting side and lasted 15 min. For protocol five, all head impulses were to the adapting side and the exposure time to the visual target during each impulse was doubled. We measured the active and passive VOR gains before and after the training. Albeit with small sample size, our data suggest that the total training time and the visual target exposure time for each head impulse affected adaptation, whereas the total number and repetition rate of head impulses did not. These data have implications for vestibular rehabilitation, suggesting that quality and duration of VOR adaptation exercises are more important than rapid repetition of exercises.

https://ift.tt/2NCnPPZ

Effect of atrazine on growth and production of AFB 1 in Aspergillus section Flavi strains isolated from maize soils

Abstract

Atrazine is one of the most frequently used herbicides in Argentina for controlling broadleaf weeds and annual grasses. Currently, there is limited information on the impact of triazine herbicides on mycotoxin production and growth parameters of toxigenic fungi in maize. The objective of this study was to evaluate the effect of different concentrations of atrazine on the lag phase prior to growth, the growth rate, and on production of aflatoxin B₁ (AFB₁) of Aspergillus flavus and Aspergillus parasiticus strains, on maize meal extract agar (MMEA) under different water activities (a_W) and temperatures. A commercial formulation of atrazine was added to MMEA medium at 0, 5, 10, 50, or 100 mmol/l, adjusted to 0.98, 0.95, and 0.93 a_W, and incubated at 28 °C and 37 °C for 21 days. AFB₁ was determined by HPLC after 7, 14, and 21 days of incubation. In the control treatments, a significant increase in the time prior to growth was observed and as the a_W decreased, at both temperatures, the growth rate of the strains also decreased. A significant increase in growth rate was observed as the concentration of atrazine in the medium increased, for all a_W levels tested. The optimal conditions for the accumulation of AFB₁ in the control treatments were 0.98 a_W and 28 °C, after 7 days of incubation. As the concentration of herbicide increased, AFB₁ production also increased (P < 0.05). These results add to the knowledge about consequences with regard to aflatoxin production of the use of excessive atrazine doses in extensive maize culture.

https://ift.tt/2xzS40e

A Systematic Review of Evidence-Based Treatments for Prurigo Nodularis

This review provides evidence supporting some efficacy of topical agents and phototherapy in treatment of prurigo nodularis, while highlighting emerging therapeutic potential from modulation of neurokinin-1 receptor, interleukin-31 receptor, and κ-opioid receptor signaling. Higher-powered studies for prurigo nodularis treatments are needed.

https://ift.tt/2OPl6zc

Efficacy and safety assessment of expiratory positive airway pressure (EPAP) mask for OSAHS therapy

We have designed the expiratory positive airway pressure (EPAP) mask to provide a new sort of therapeutic strategies for Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS). And this study aims to assess the safety, efficacy and compliance of the EPAP therapy.

https://ift.tt/2O8GuT9

Prediction of tongue obstruction observed from drug induced sleep computed tomography by cephalometric parameters

To elucidate potential role of cephalometric measurements to predict tongue base obstruction as observed on drug Induced Sleep Computed Tomography (DIS-CT).

https://ift.tt/2Q312d0

Human Vestibulo-Ocular Reflex Adaptation Training: Time Beats Quantity

Abstract

The vestibulo-ocular reflex (VOR) is the main gaze stabilising system during rapid head movements. The VOR is highly plastic and its gain (eye/head velocity) can be increased via training that induces an incrementally increasing retinal image slip error signal to drive VOR adaptation. Using the unilateral incremental VOR adaptation technique and horizontal active head impulses as the vestibular stimulus, we sought to determine the factors important for VOR adaptation including: the total training time, ratio and number of head impulses to each side (adapting and non-adapting sides; the adapting side was pseudo-randomised left or right) and exposure time to the visual target during each head impulse. We tested 11 normal subjects, each over 5 separate sessions and training protocols. The basic training protocol (protocol one) consisted of unilateral incremental VOR adaptation training lasting 15 min with the ratio of head impulses to each side 1:1. Each protocol varied from the basic. For protocol two, the ratio of impulses were in favour of the adapting side by 2:1. For protocol three, all head impulses were towards the adapting side and the training only lasted 7.5 min. For protocol four, all impulses were towards the adapting side and lasted 15 min. For protocol five, all head impulses were to the adapting side and the exposure time to the visual target during each impulse was doubled. We measured the active and passive VOR gains before and after the training. Albeit with small sample size, our data suggest that the total training time and the visual target exposure time for each head impulse affected adaptation, whereas the total number and repetition rate of head impulses did not. These data have implications for vestibular rehabilitation, suggesting that quality and duration of VOR adaptation exercises are more important than rapid repetition of exercises.

https://ift.tt/2NCnPPZ

Short-term evaluation of photobiomodulation therapy on the proliferation and undifferentiated status of dental pulp stem cells

Abstract

The aim of this in vitro study was to analyze the effect of photobiomodulation therapy (PBMT) on the proliferation and undifferentiating status of stem cell from human exfoliated deciduous teeth (SHEDs). PBMT was carried out with an aluminum gallium indium phosphide (InGaAlP) diode laser in contact and punctual mode (continuous wave, 660 nm, 20 mW, 0.028 cm², and average energy densities of 1 (1 s), 3 (4 s), 5 (7 s), 10 (14 s), 15 (21 s), or 20 (28 s) J/cm² per point). The immunoprofile of the SHEDs was analyzed using flow cytometry. Cell proliferation was assessed by the MTT reduction assay. Gene expressions of mesenchymal stem cell markers (OCT4, Nestin, CD90, and CD105) were assessed by RT-qPCR 48 h after PBMT. Data were compared by analysis of variance (ANOVA) and Tukey's test (p ≤ 0.05). Cells cultured under nutritional deficit and treated with PBMT at 5 J/cm² presented similar cell growth than those of positive control group. Cell growth was significantly higher than those of other groups. Mesenchymal stem cell gene markers were still expressed after PBMT at 5 J/cm². In a short-term analysis, PBMT increases the number of stem cells with no interference in the undifferentiated state of the irradiated cells, which opens wide possibilities for application in tissue regeneration.

https://ift.tt/2xEV2jT

Sleep and the human impacts of climate change

In this issue of Sleep Medicine Reviews, Rifkin and colleagues (referred subsequently as RLP) [1] report on a systematic review of the literature – and present a conceptual framework for – the potential impacts of climate change on human sleep. Their review spans literature from 1980-2017 and results in 16 studies matching the authors' selection criteria. Across these studies, RLP report a tendency of exposure to warmer temperatures, extreme weather events, floods, or wildfires to associate with diminished total sleep times as well as incidences of sleep disruption.

https://ift.tt/2NC7ZVJ

Management of Long-Standing Flaccid Facial Palsy

Chronic flaccid facial paralysis (FFP>2 years) may be approached with static and dynamic techniques. An horizontal zonal assessment evaluates the upper, middle, and lower thirds of the face. Surgery is tailored to an individual's deficits, goals, and health status. While dynamic reanimation is the gold standard for rehabilitation, there are cases in which static approaches are more appropriate or may be used as an adjunct to dynamic techniques. This article focuses on the surgical management of FFP primarily using static approaches to the individual zones of the face to create resting symmetry.

https://ift.tt/2zrToTU

Facial Rehabilitation

This article describes the most widely used clinician-graded and patient-reported outcome measures, and describes facial rehabilitation strategies for acute and chronic facial palsy, and rehabilitation following dynamic facial reanimation surgery. The multimodality rehabilitation of the facial palsy patient is determined by the extent of facial nerve injury, specific functional deficits, the presence of synkinesis, and the patient's individual goals. Appropriate intervention, including patient education, soft tissue mobilization, neuromuscular reeducation, and chemodenervation, decreases facial tension and improves facial muscle motor control, physical function, facial expression, and quality of life.

https://ift.tt/2N2fXCe

Leadership Driving Safety and Quality

Leaders in health care play a large role in successful achievement of quality and safety goals through an overt commitment to both quality and safety, fostering a culture of quality improvement and clear and consistent communication of goals and plans. Specific training for frontline providers, managers, and staff is critical in developing skilled leaders with a quality and safety orientation. Many models exist for organizational leadership development, and exemplars of quality and safety leadership have openly shared the keys to their successes for others to raise the bar.

https://ift.tt/2zsePEz

Reprocessing Standards for Medical Devices and Equipment in Otolaryngology

Stringent regulatory standards for reprocessing medical devices and equipment have proliferated in response to patient safety incidents in which improperly disinfected or contaminated endoscopes lead to large-scale disease transmission or outbreaks. This article details best practices in reprocessing reusable and single-use devices in otolaryngology, with particular attention to flexible fiberoptic endoscopes/nasophyarngoscopes, nasal speculums, and other clinic and operating room instruments. High-risk devices require sterilization, whereas lower risk devices may be reprocessed using various disinfection procedures. Reprocessing practices have implications for adequacy, efficiency, and cost. Nuanced understanding of procedures and their rationale ensures delivery of safe, ethical, and quality patient care.

https://ift.tt/2MZOoJN

Glucose intolerance in children with cystic fibrosis: a developing country’s perspective

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


https://ift.tt/2NDAPVw

TRPM2 modulates neutrophil attraction to murine tumor cells by regulating CXCL2 expression

Abstract

In recent years, immune cells were shown to play critical roles in tumor growth and metastatic progression. In this context, neutrophils were shown to possess both pro- and anti-tumor properties. To exert their anti-tumor effect, neutrophils need to migrate towards, and form physical contact with tumor cells. Neutrophils secrete H₂O₂ in a contact-dependent mechanism, thereby inducing a lethal Ca²⁺ influx via the activation of the H₂O₂-dependent TRPM2 Ca²⁺ channel. Here, we explored the mechanism regulating neutrophil chemoattraction to tumor cells. Interestingly, we found that TRPM2 plays a role in this context as well, since it regulates the expression of potent neutrophil chemoattractants. Consequently, cells expressing reduced levels of TRPM2 are not approached by neutrophils. Together, these observations demonstrate how tumor cells expressing reduced levels of TRPM2 evade neutrophil cytotoxicity in two interrelated mechanisms—downregulation of neutrophil chemoattractants and blocking of the apoptotic Ca²⁺-dependent cascade. These observations demonstrate a critical role for TRPM2 in neutrophil-mediated immunosurveillance and identify cells expressing low levels of TRPM2, as a potential target for cancer therapy.

https://ift.tt/2PX8Ixk

Molecular Expression of Mg2+ regulator TRPM7 and CNNM4 in rat odontoblasts

Publication date: Available online 23 September 2018

Source: Archives of Oral Biology

Author(s): Jonghwa Won, Ji Hyun Kim, Seog Bae Oh

Abstract

Objective

Magnesium, the second most abundant cation in cellular fluid, is critical for mineralization of hard tissues. Among the molecules involved in cellular Mg²⁺ homeostasis, functional impairment of Mg²⁺ permeable ion channel TRPM7 or Mg²⁺ transporter CNNM4 have been found to result in severe hypomineralization of the enamel and dentin. However, molecular expressions of TRPM7, CNNM4 and their respective homologues have not been fully investigated in adult odontoblasts.

Design

Expressions of TRPM6, TRPM7, CNNM1, CNNM2, CNNM3, CNNM4 were screened in acutely dissociated rat odontoblasts by single cell RT-PCR. Among these candidates, expression levels of TRPM7 and CNNM4 were compared along the odontoblast layer by immunohistochemical analysis. Finally, the coexpression pattern of TRPM7 and CNNM4 in subcellular regions was examined by immunocytochemical analysis.

Results

ScRT-PCR revealed high expression rate of TRPM7 and CNNM4 in odontoblasts, with CNNM4 detected almost exclusively in TRPM7-positive odontoblasts. However, CNNM2 and CNNM3 were detected in only a small population of odontoblasts, and TRPM6 and CNNM1 were not detected even in the pulp tissue. Immunohistochemical analysis revealed higher CNNM4 expression in the apical odontoblast layer than the coronal area, in contrast to the ubiquitous expression of TRPM7. Lastly, immunocytochemical analysis revealed colocalization of CNNM4 with TRPM7 in the odontoblastic process.

Conclusions

CNNM4 and TRPM7 may serve as main Mg²⁺ regulators in odontoblasts, possibly with selective involvement of CNNM4 in apical dentin formation or mineralization. Colocalization of TRPM7 and CNNM4 in the odontoblastic process suggest functional coupling of these two molecules to maintain Mg²⁺ homeostasis.

https://ift.tt/2zr6tNy

Null Cell Adenoma of the Pituitary: Pseudo-rosettes Say It Best When Immunohistochemistry Says Nothing At All!

Abstract

Null cell adenoma is composed of adenohypophyseal cells that show no evidence of any specific cell type differentiation by immunohistochemistry or transcription factors like pituitary-specific positive transcription factor 1 and steroidogenic factor 1. Though rare, pituitary ependymoma and germinoma are also known to occur at sellar region and in such instances, it is challenging to differentiate them from a pituitary null cell adenoma featuring papillary architecture and perivascular pseudo-rosettes. We describe a case of an elderly diabetic lady presenting with headache and blurring of vision for past 3 months due to a sellar tumour. The histology was diagnostically challenging with notable presence of numerous perivascular pseudo-rosettes and negative immunoreactivity for all pituitary hormones. The differential diagnosis and importance of ancillary techniques is discussed.

https://ift.tt/2PWwiu6

Analytic and clinical validity of thyroid nodule mutational profiling using droplet digital polymerase chain reaction

Abstract

Background

Recent guidelines for the management of thyroid nodules incorporate mutation testing as an adjunct for surgical decision-making, however current tests are costly with limited accuracy. Droplet digital PCR (ddPCR) is an ultrasensitive method of nucleic acid detection that is particularly useful for identifying gene mutations. This study aimed to assess the analytic and clinical validity of RAS and BRAF ddPCR mutational testing as a diagnostic tool for thyroid fine needle aspirate biopsy (FNAB).

Methods

Patients with thyroid nodules meeting indication for FNAB were prospectively enrolled from March 2015 to September 2017. In addition to clinical protocol, an additional FNAB was obtained for ddPCR. Optimized ddPCR probes were used to detect mutations including HRASG12 V, HRASQ61K, HRASQ61R, NRASQ61R, NRASQ61K and BRAFV600E. The diagnostic performance of BRAF and RAS mutations was assessed individually or in combination with Bethesda classification against final surgical pathology.

Results

A total of 208 patients underwent FNAB and mutational testing with the following Bethesda cytologic classification: 26.9% non-diagnostic, 55.2% benign, 5.3% FLUS/AUS, 2.9% FN/SPN, 2.4% SFM and 7.2% malignant. Adequate RNA was obtained from 91.3% (190) FNABs from which mutations were identified in 21.1% of HRAS, 11.5% of NRAS and 7.4% of BRAF. Malignant cytology or BRAFV600E was 100% specific for malignancy. Combining cytology with ddPCR BRAF600E mutations testing increased the sensitivity of Bethesda classification from 41.7 to 75%. Combined BRAFV600E and Bethesda results had a positive predictive value (PPV) of 100% and negative predictive value (NPV) of 89.7% for thyroid malignancy in our cohort.

Conclusions

DdPCR offers a novel and ultrasensitive method of detecting RAS and BRAF mutations from thyroid FNABs. BRAFV600E mutation testing by ddPCR may serve as a useful adjunct to increase sensitivity and specificity of thyroid FNAB.

https://ift.tt/2pvCwWG

Opioid Use After Open Resection or VATS for Early-Stage Lung Cancer

This population-based study compares opioid use in patients with non–small cell lung cancer who underwent open resection vs video-assisted thoracoscopic surgery.

https://ift.tt/2QU6pMQ

Quality of occlusal outcome following space closure in cases of lower second premolar aplasia using lingual orthodontic molar mesialization without maxillary counterbalancing extraction

Abstract

Background

Controlled space closure in cases of isolated lower second premolar aplasia (ILSPA) without maxillary counterbalancing extraction is challenging. Anterior anchorage loss may occur during space closure resulting in compromised occlusal results in terms of an absence of proper canine guidance during laterotrusive mandible movements.

In order to evaluate the effectiveness of Herbst telescope anchorage in combination with double-cable, pull mechanics and a completely customized lingual appliance for orthodontic space management in cases of ILSPA, we tested the null hypothesis that there is a significant deterioration in the sagittal canine relationship towards an Angle-Class-II occlusion expressed as a loss of anterior anchorage following space closure with molar mesialization.

Methods

Twenty-five consecutively de-bonded subjects (female / male 17 / 8; aged at T0 (start of MB Tx) 12.3 to 20.6 years; mean age 15.0 / SD 1.7 years) were included in this retrospective analysis using the inclusion criteria of least of one lower second premolar aplasia; completed treatment with a totally customized lingual appliance (CCLA) in combination with Herbst telescopes. Exclusion criteria were the absence of counterbalancing maxillary extractions, as well as additional tooth aplasia other than lower second premolars. A total of 33 single, lower premolar aplasia space closures (right / left sided 17 / 16) were assessed using plaster casts and intra-oral photographs scaled to the plaster casts, at bonding (T0), Herbst insertion (T1), following gap closure (T2) and de-bonding (T3). Parallelism of roots was controlled by panoramic x-rays at T3.

Results

The mean aplasia space at T0 was 7.5 mm (SD 2.6). Complete space closure was achieved in all 33 situations. The null hypothesis was rejected. There was a significant improvement in the initial canine relationships (mean 3.5 mm distal occlusion at T0) to a mean 0.1 mm at T3. When evaluated against the individual treatment plan, the following amounts of planned improvements were achieved: space closure 100%, canine relationship 97.5%, overjet 93.9%, overbite 96.4%, parallel roots in space closure site 93.9%.

Conclusion

Herbst telescope anchorage in combination with double-cable pull mechanics and a CCLA for orthodontic space closure can deliver predictable, high-quality treatment results.

https://ift.tt/2MX7hwZ

Phase 1-2a Study of EBNA1 Inhibitor, VK-2019, in Patients With Epstein-Barr Virus-positive Nasopharyngeal Cancer

Conditions:   Nasopharyngeal Carcinoma;   Nasopharyngeal Cancer
Intervention:   Drug: VK-2019
Sponsors:   Troy Messick;   Stanford University;   National Cancer Institute (NCI)
Not yet recruiting

https://ift.tt/2xM299D

Diagnostic Accuracy of Salivary DNA Integrity Index in Oral Malignant and Premalignant Lesions

Conditions:   Oral Cancer;   Oral Lichen Planus;   Oral Leukoplakia
Intervention:   Diagnostic Test: DNA Integrity Index
Sponsor:   Cairo University
Not yet recruiting

https://ift.tt/2QUM3De

Interventions for Patients With Alzheimer's Disease and Dysphagia

Conditions:   Dementia;   Dysphagia
Interventions:   Device: Isometric tongue strengthening;   Drug: Biotene
Sponsor:   University of Wisconsin, Madison
Recruiting

https://ift.tt/2xKeknm

Perioperative Analgesia Using Gabapentin in Head and Neck Cancer Surgery: A Randomized Controlled Trial

Conditions:   Cancer of Head and Neck;   Narcotic Use
Interventions:   Drug: Gabapentin;   Drug: Placebo - Concentrate
Sponsor:   University of California, Davis
Not yet recruiting

https://ift.tt/2QULQ2U

Phase 1-2a Study of EBNA1 Inhibitor, VK-2019, in Patients With Epstein-Barr Virus-positive Nasopharyngeal Cancer

Conditions:   Nasopharyngeal Carcinoma;   Nasopharyngeal Cancer
Intervention:   Drug: VK-2019
Sponsors:   Troy Messick;   Stanford University;   National Cancer Institute (NCI)
Not yet recruiting

https://ift.tt/2xM299D

Diagnostic Accuracy of Salivary DNA Integrity Index in Oral Malignant and Premalignant Lesions

Conditions:   Oral Cancer;   Oral Lichen Planus;   Oral Leukoplakia
Intervention:   Diagnostic Test: DNA Integrity Index
Sponsor:   Cairo University
Not yet recruiting

https://ift.tt/2QUM3De

Interventions for Patients With Alzheimer's Disease and Dysphagia

Conditions:   Dementia;   Dysphagia
Interventions:   Device: Isometric tongue strengthening;   Drug: Biotene
Sponsor:   University of Wisconsin, Madison
Recruiting

https://ift.tt/2xKeknm

Perioperative Analgesia Using Gabapentin in Head and Neck Cancer Surgery: A Randomized Controlled Trial

Conditions:   Cancer of Head and Neck;   Narcotic Use
Interventions:   Drug: Gabapentin;   Drug: Placebo - Concentrate
Sponsor:   University of California, Davis
Not yet recruiting

https://ift.tt/2QULQ2U

Null Cell Adenoma of the Pituitary: Pseudo-rosettes Say It Best When Immunohistochemistry Says Nothing At All!

Abstract

Null cell adenoma is composed of adenohypophyseal cells that show no evidence of any specific cell type differentiation by immunohistochemistry or transcription factors like pituitary-specific positive transcription factor 1 and steroidogenic factor 1. Though rare, pituitary ependymoma and germinoma are also known to occur at sellar region and in such instances, it is challenging to differentiate them from a pituitary null cell adenoma featuring papillary architecture and perivascular pseudo-rosettes. We describe a case of an elderly diabetic lady presenting with headache and blurring of vision for past 3 months due to a sellar tumour. The histology was diagnostically challenging with notable presence of numerous perivascular pseudo-rosettes and negative immunoreactivity for all pituitary hormones. The differential diagnosis and importance of ancillary techniques is discussed.

https://ift.tt/2PWwiu6

Null Cell Adenoma of the Pituitary: Pseudo-rosettes Say It Best When Immunohistochemistry Says Nothing At All!

Abstract

Null cell adenoma is composed of adenohypophyseal cells that show no evidence of any specific cell type differentiation by immunohistochemistry or transcription factors like pituitary-specific positive transcription factor 1 and steroidogenic factor 1. Though rare, pituitary ependymoma and germinoma are also known to occur at sellar region and in such instances, it is challenging to differentiate them from a pituitary null cell adenoma featuring papillary architecture and perivascular pseudo-rosettes. We describe a case of an elderly diabetic lady presenting with headache and blurring of vision for past 3 months due to a sellar tumour. The histology was diagnostically challenging with notable presence of numerous perivascular pseudo-rosettes and negative immunoreactivity for all pituitary hormones. The differential diagnosis and importance of ancillary techniques is discussed.

https://ift.tt/2PWwiu6

Immediate Negative Pressure Wound Therapy After Free Flap Transfer for Head and Neck Cancer Surgery

The Laryngoscope, EarlyView.


https://ift.tt/2O4oJEs

Effects of topical applications of porcine acellular urinary bladder matrix and Centella asiatica extract on oral wound healing in a rat model

Abstract

Objectives

To evaluate the effects of topical applications of porcine acellular urinary bladder matrix (AUBM) and Centella asiatica extract (CAE) on the healing of tongue wounds in a rat model.

Materials and methods

Wounds were made in the tongue using a punch tool in 64 male Sprague-Dawley rats, randomized into four groups (n = 16 per group): group 1 (control), group 2 (CAE), group 3 (AUBM mixed with orabase), and group 4 (orabase). No product was applied in group 1 and groups 2–4 received three daily topical applications. The animals were weighed on day 0 and at the time of euthanasia. Four rats in each group were euthanized at days 2, 7, 14, and 21 and the tongues were processed for: macroscopic morphometric analysis, myeloperoxidase (MPO) and malondialdehyde (MDA) levels, histological wound repair (degree of reepithelialization and inflammation), and CD31 positivity.

Results

The animals' weight gain, histological wound repair, and CD31 positivity from greatest to least were: AUBM > CAE > orabase > control. Percentage of tongue occupied by wound, MPO, and MPA levels from least to greatest were: AUBM < CAE < orabase < control, whereby the AUBM group showed significant differences (p ≤ 0.05) in comparison with the other groups on days 2, 7, 14, and 21 for percentage of tongue occupied by wound and MDA and on days 7, 14, and 21 for MPO.

Conclusions

CAE is effective for oral tissue regeneration, while AUBM is an even more potent means of oral mucosa regeneration.

Clinical relevance

AUBM may be beneficial to patients with oral wounds; this finding requires further clinical and laboratory investigation.

https://ift.tt/2IaSVs3

Case series of oral minoxidil for androgenetic and traction alopecia: Tolerability & the five C's of oral therapy

Dermatologic Therapy, EarlyView.


https://ift.tt/2IbDHTU

Case series of oral minoxidil for androgenetic and traction alopecia: Tolerability & the five C's of oral therapy

Dermatologic Therapy, EarlyView.


https://ift.tt/2IbDHTU

Primary Laryngeal Tuberculosis: A Series of 15 Cases

Abstract

Tuberculosis usually involves the lungs, but can also involve various other organs. Extra pulmonary tuberculosis is very rarely confined to the larynx in the absence of an associated pulmonary lesion. In this retrospective study, clinicopathological characteristics of patients with final diagnosis of laryngeal tuberculosis (LTB) were reviewed. The diagnosis of LTB was based on: (1) the existence of chronic granulomatous inflammation with caseous necrosis in the histopathology of laryngeal lesions or (2) the presence of laryngeal lesions with atypical histopathology (chronic granulomatous inflammation) which had a complete response to anti-tuberculosis therapy. Fifteen cases with a diagnosis of LTB were collected. The patients' age ranged between 24 and 75 years with a mean of 49 years. On laryngoscopy, 66.6% of cases (10/15) had an ulceroproliferative lesion while the remaining 33.3% of cases (5/15) had an exophytic growth. The pathology of laryngeal lesions revealed chronic granulomatous inflammation with caseous necrosis in nine cases and chronic granulomatous inflammation without necrosis in six cases. Nine out of 15 cases (60%) showed presence of acid-fast bacilli on Ziehl–Neelsen stain. Any evidence of pulmonary tuberculosis was ruled out by chest X-ray findings. The response to anti-tuberculosis therapy was desirable in all patients. Since the introduction of anti-tuberculous therapy, the incidence of LTB has declined. However, with the incidence of TB increasing, the overall incidence of laryngeal involvement may be on the rise. This study highlights the importance to consider the rare possibility of LTB in the presence of non-specific clinical and laryngoscopic signs and to confirm this by histological examination.

https://ift.tt/2xLeAm5

Helicobacter pylori‐associated peptic ulcer disease: A retrospective analysis of post‐treatment testing practices

Helicobacter, EarlyView.


https://ift.tt/2xCTqqR

Helicobacter pylori and non‐alcoholic fatty liver disease: A new enigma?

Helicobacter, EarlyView.


https://ift.tt/2MXbcKc

Helicobacter pylori‐associated peptic ulcer disease: A retrospective analysis of post‐treatment testing practices

Helicobacter, EarlyView.


https://ift.tt/2xCTqqR

Helicobacter pylori and non‐alcoholic fatty liver disease: A new enigma?

Helicobacter, EarlyView.


https://ift.tt/2MXbcKc

The effect of the volume of supra-inguinal injected solution on the spread of the injectate under the fascia iliaca: a preliminary study

Abstract

The fascia iliaca compartment is the compartment confined by the fascia iliaca (FI) and a muscular layer formed by the iliac- and psoas muscle. This compartment creates a virtual tunnel that contains the femoral nerve (FN), the obturator nerve (ON), and the lateral femoral cutaneous nerve (LFCN) of the lumbar plexus. In this pilot study, we aimed to determine the suggested volume needed to reach the three target nerves of the lumbar plexus (FN, ON, and LFCN) with a single-injection ultrasound-guided supra-inguinal fascia iliaca compartment (S-FICB). A computer tomography (CT scan)-guided step-up/step-down sequence was used to determine the suggested injection volume to target all three nerves. Subsequently, an anatomist blinded for the injected volume and CT findings, dissected the cadavers, and evaluated the spread of dye underneath the fascia iliaca. In total, seven pelvic areas of four cadavers were evaluated on CT scan and dissected. Distribution of dye underneath the FI in relation to the FN, ON, and the LFCN was recorded in all dissected cadavers. Combining CT and dissection findings, the suggested volume to reach the FN, ON, and LFCN with an S-FICB was 40 mL.

https://ift.tt/2NwGdtL

Expression of Transcripts Selective for GABA Neuron Subpopulations across the Cortical Visuospatial Working Memory Network in the Healthy State and Schizophrenia

Abstract

Visuospatial working memory (WM), which is impaired in schizophrenia, depends on a distributed network including visual, posterior parietal, and dorsolateral prefrontal cortical regions. Within each region, information processing is differentially regulated by subsets of γ-aminobutyric acid (GABA) neurons that express parvalbumin (PV), somatostatin (SST), or vasoactive intestinal peptide (VIP). In schizophrenia, WM impairments have been associated with alterations of PV and SST neurons in the dorsolateral prefrontal cortex. Here, we quantified transcripts selectively expressed in GABA neuron subsets across four cortical regions in the WM network from comparison and schizophrenia subjects. In comparison subjects, PV mRNA levels declined and SST mRNA levels increased from posterior to anterior regions, whereas VIP mRNA levels were comparable across regions except for the primary visual cortex (V1). In schizophrenia subjects, each transcript in PV and SST neurons exhibited similar alterations across all regions, whereas transcripts in VIP neurons were unaltered in any region except for V1. These findings suggest that the contribution of each GABA neuron subset to inhibitory regulation of local circuitry normally differs across cortical regions of the visuospatial WM network and that in schizophrenia alterations of PV and SST neurons are a shared feature across these regions, whereas VIP neurons are affected only in V1.

https://ift.tt/2Q0E1av

Role of Concha Bullosa in Chronic Rhinosinusitis

Abstract

Concha bullosa is one of the most common anatomical variant found in the patients of chronic rhinosinusitis. To study the role of concha bullosa in patients of chronic rhinosinusitis a prospective cross sectional study was done comprising of 60 patients who were having symptoms of sinusitis for more than 12 weeks. These were evaluated with the help of nasal endoscope and CT scan. DNS and concha bullosa are the most common anatomical variant seen in the patients of chronic rhinosinusitis with percentage being 88.3% and 76.6% respectively. Patients with deviated nasal septum and large concha bullosa (bulbous and extensive) were associated with higher incidence of ostiomeatal complex obstruction. There seems a strong relationship between unilateral concha bullosa and contralateral deviated nasal septum in development of chronic rhinosinusitis. (1) To find out the percentage and role of concha bullosa in patients of chronic rhinosinusitis. (2) To screen the patients of chronic rhinosinusitis for concha bullosa. (3) To do the nasal endoscopy and CT scan of the screened patients. Study design: cross sectional study. Sample size: 60. Inclusion criteria: all patients of chronic rhinosinusitis. Exclusion criteria: patients with previous sinus surgeries, malignancy and acute cases of chronic rhinosinusitis.

https://ift.tt/2xCLINr

Role of Concha Bullosa in Chronic Rhinosinusitis

Abstract

Concha bullosa is one of the most common anatomical variant found in the patients of chronic rhinosinusitis. To study the role of concha bullosa in patients of chronic rhinosinusitis a prospective cross sectional study was done comprising of 60 patients who were having symptoms of sinusitis for more than 12 weeks. These were evaluated with the help of nasal endoscope and CT scan. DNS and concha bullosa are the most common anatomical variant seen in the patients of chronic rhinosinusitis with percentage being 88.3% and 76.6% respectively. Patients with deviated nasal septum and large concha bullosa (bulbous and extensive) were associated with higher incidence of ostiomeatal complex obstruction. There seems a strong relationship between unilateral concha bullosa and contralateral deviated nasal septum in development of chronic rhinosinusitis. (1) To find out the percentage and role of concha bullosa in patients of chronic rhinosinusitis. (2) To screen the patients of chronic rhinosinusitis for concha bullosa. (3) To do the nasal endoscopy and CT scan of the screened patients. Study design: cross sectional study. Sample size: 60. Inclusion criteria: all patients of chronic rhinosinusitis. Exclusion criteria: patients with previous sinus surgeries, malignancy and acute cases of chronic rhinosinusitis.

https://ift.tt/2xCLINr

Anesthesiologists should bring in their expertise during the early postoperative period to improve surgical outcome

No abstract available

https://ift.tt/2Dp95zp

Ambulatory anesthesia: what's new in 2018

No abstract available

https://ift.tt/2NDXpO8

Niedrig dosierte prophylaktische orale Therapie mit Isotretinoin über 18 Jahre bei einer Patientin mit Epidermodysplasia verruciformis und zahlreichen Plattenepithelkarzinomen

Zusammenfassung

Epidermodysplasia verruciformis (auch Lewandowsky-Lutz-Dysplasie) ist eine extrem seltene autosomal-rezessive Genodermatose, bei der eine ungewöhnlich hohe Empfindlichkeit der Haut gegenüber humanen Papillomviren vorliegt. Die Erkrankung ist mit einem hohen Risiko für die Entwicklung von nichtmelanozytären Hauttumoren verbunden. Eine Behandlung mittels keratolytischen Retinoiden gilt derzeit als die effektivste Therapie. Retinoide haben ein breites Wirkungsspektrum und hemmen das Wachstum von Plattenepithelkarzinomen und anderen bösartigen Tumoren. Wir berichten über eine 81-jährige Patientin, die aufgrund einer Epidermodysplasia verruciformis (Nachweis von HPV 9 und HPV 57) mit der raschen Entwicklung zahlreicher kutaner Karzinome seit ca. 18 Jahren eine prophylaktische orale Therapie mit Isotretinoin in einer Dosis von 1,0–0,33 mg/kg Körpergewicht täglich erhält. Im Verlauf zeigte sich eine starke Reduktion der Inzidenz, des Größenwachstums und der Invasionsneigung von weiteren Karzinomen der Haut, sodass wir im vorliegenden Fall einen protektiven Effekt der Retinoidgabe auf die Aktivität der Hautkrebserkrankung postulieren.

https://ift.tt/2Q0t6Oi

Role of serum 25‐hydroxyvitamin D levels and vitamin D receptor gene polymorphisms in patients with rosacea: a case–control study

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2NzIRyQ

Topical dapsone gel is a new treatment option for acne agminata

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2DrWICD

Role of serum 25‐hydroxyvitamin D levels and vitamin D receptor gene polymorphisms in patients with rosacea: a case–control study

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2NzIRyQ

Topical dapsone gel is a new treatment option for acne agminata

Clinical and Experimental Dermatology, EarlyView.


https://ift.tt/2DrWICD

Primary Laryngeal Tuberculosis: A Series of 15 Cases

Abstract

Tuberculosis usually involves the lungs, but can also involve various other organs. Extra pulmonary tuberculosis is very rarely confined to the larynx in the absence of an associated pulmonary lesion. In this retrospective study, clinicopathological characteristics of patients with final diagnosis of laryngeal tuberculosis (LTB) were reviewed. The diagnosis of LTB was based on: (1) the existence of chronic granulomatous inflammation with caseous necrosis in the histopathology of laryngeal lesions or (2) the presence of laryngeal lesions with atypical histopathology (chronic granulomatous inflammation) which had a complete response to anti-tuberculosis therapy. Fifteen cases with a diagnosis of LTB were collected. The patients' age ranged between 24 and 75 years with a mean of 49 years. On laryngoscopy, 66.6% of cases (10/15) had an ulceroproliferative lesion while the remaining 33.3% of cases (5/15) had an exophytic growth. The pathology of laryngeal lesions revealed chronic granulomatous inflammation with caseous necrosis in nine cases and chronic granulomatous inflammation without necrosis in six cases. Nine out of 15 cases (60%) showed presence of acid-fast bacilli on Ziehl–Neelsen stain. Any evidence of pulmonary tuberculosis was ruled out by chest X-ray findings. The response to anti-tuberculosis therapy was desirable in all patients. Since the introduction of anti-tuberculous therapy, the incidence of LTB has declined. However, with the incidence of TB increasing, the overall incidence of laryngeal involvement may be on the rise. This study highlights the importance to consider the rare possibility of LTB in the presence of non-specific clinical and laryngoscopic signs and to confirm this by histological examination.

https://ift.tt/2xLeAm5

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

International Journal of Dermatology, EarlyView.


https://ift.tt/2OJdtuo

Filaggrin gene polymorphisms in Iranian ichthyosis vulgaris and atopic dermatitis patients

International Journal of Dermatology, EarlyView.


https://ift.tt/2zpB8dT

Evaluation of structural damage and pH of nail plates of hands after applying different methods of decorating

International Journal of Dermatology, EarlyView.


https://ift.tt/2OH33Lv

Letter to the Editor regarding “Ertapenem – a potent treatment for clinical and quality of life improvement in patients with hidradenitis suppurativa”

International Journal of Dermatology, EarlyView.


https://ift.tt/2zqOnev

Transient symptomatic zinc deficiency in a breast‐fed African infant: case report and literature review

International Journal of Dermatology, EarlyView.


https://ift.tt/2OSYJsE

Allogeneic skin donors from a tissue bank in Southern Brazil: clinical and epidemiological profiles and microbial colonization of skin

International Journal of Dermatology, EarlyView.


https://ift.tt/2zpKJ4C

Diagnostic values of KOH examination, histological examination, and culture for onychomycosis: a latent class analysis

International Journal of Dermatology, EarlyView.


https://ift.tt/2ONSmqC

An extremely rare association of multiple familial trichoepitheliomas and hereditary multiple osteochondromas

International Journal of Dermatology, EarlyView.


https://ift.tt/2zpp9wU

Ankle‐brachial index in psoriasis: a population‐based study

International Journal of Dermatology, EarlyView.


https://ift.tt/2OH316l

Review of safety and efficacy of approved systemic psoriasis therapies

International Journal of Dermatology, EarlyView.


https://ift.tt/2zqhazQ

Amelanotic melanoma arising in an area of SLURP‐1 mutated Mal de Meleda

International Journal of Dermatology, EarlyView.


https://ift.tt/2ONPzhe

Measurement properties of three assessments of burden used in atopic dermatitis in adults

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


https://ift.tt/2OSWV2Q

Differential Diagnosis in Dermatology, 2nd edn. Klaus F. Helm, Galen T. Foulke and James G. Marks Jr. London: JP Medical Ltd, 2017; 312 pp. ISBN: 978‐1909836198. Price £110·00.

British Journal of Dermatology, EarlyView.


https://ift.tt/2zpebHZ

Persistence of treatment with biologics for patients with psoriasis: a real‐world analysis of 16 545 biologic‐naïve patients from the French National Health Insurance database (SNIIRAM)

British Journal of Dermatology, EarlyView.


https://ift.tt/2OJokEr

Handbook of Dermatology Treatments. Michael Ardern‐Jones, Philip Hampton and Ruth Ann Vleugels (eds). London: JP Medical Ltd, 2017; 176pp. ISBN: 978‐1909836211. Price £65·00.

British Journal of Dermatology, EarlyView.


https://ift.tt/2zpIwpQ

Measurement properties of three assessments of burden used in atopic dermatitis in adults

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


https://ift.tt/2OSWV2Q

Differential Diagnosis in Dermatology, 2nd edn. Klaus F. Helm, Galen T. Foulke and James G. Marks Jr. London: JP Medical Ltd, 2017; 312 pp. ISBN: 978‐1909836198. Price £110·00.

British Journal of Dermatology, EarlyView.


https://ift.tt/2zpebHZ

Persistence of treatment with biologics for patients with psoriasis: a real‐world analysis of 16 545 biologic‐naïve patients from the French National Health Insurance database (SNIIRAM)

British Journal of Dermatology, EarlyView.


https://ift.tt/2OJokEr

Handbook of Dermatology Treatments. Michael Ardern‐Jones, Philip Hampton and Ruth Ann Vleugels (eds). London: JP Medical Ltd, 2017; 176pp. ISBN: 978‐1909836211. Price £65·00.

British Journal of Dermatology, EarlyView.


https://ift.tt/2zpIwpQ

Primary Laryngeal Tuberculosis: A Series of 15 Cases

Abstract

Tuberculosis usually involves the lungs, but can also involve various other organs. Extra pulmonary tuberculosis is very rarely confined to the larynx in the absence of an associated pulmonary lesion. In this retrospective study, clinicopathological characteristics of patients with final diagnosis of laryngeal tuberculosis (LTB) were reviewed. The diagnosis of LTB was based on: (1) the existence of chronic granulomatous inflammation with caseous necrosis in the histopathology of laryngeal lesions or (2) the presence of laryngeal lesions with atypical histopathology (chronic granulomatous inflammation) which had a complete response to anti-tuberculosis therapy. Fifteen cases with a diagnosis of LTB were collected. The patients' age ranged between 24 and 75 years with a mean of 49 years. On laryngoscopy, 66.6% of cases (10/15) had an ulceroproliferative lesion while the remaining 33.3% of cases (5/15) had an exophytic growth. The pathology of laryngeal lesions revealed chronic granulomatous inflammation with caseous necrosis in nine cases and chronic granulomatous inflammation without necrosis in six cases. Nine out of 15 cases (60%) showed presence of acid-fast bacilli on Ziehl–Neelsen stain. Any evidence of pulmonary tuberculosis was ruled out by chest X-ray findings. The response to anti-tuberculosis therapy was desirable in all patients. Since the introduction of anti-tuberculous therapy, the incidence of LTB has declined. However, with the incidence of TB increasing, the overall incidence of laryngeal involvement may be on the rise. This study highlights the importance to consider the rare possibility of LTB in the presence of non-specific clinical and laryngoscopic signs and to confirm this by histological examination.

https://ift.tt/2xLeAm5

Equivalent Outcomes with Retransplantation and Primary Liver Transplantation in the Direct Acting Antiviral Era

Background The present multicenter study investigated whether equivalent outcomes to primary LT could be achieved with reLT and whether improvements in outcomes have taken place over time, particularly in the Direct Acting Antiviral (DAA) Era. Methods All reLT performed at Mayo Clinic-Florida, Mayo Clinic-Rochester and Mayo Clinic-Arizona were divided into Era 1 (2002-2007), Era 2 (2008-2012) and Era 3 (2013-2017) based on the date of reLT. Results Improvement in graft survival (GS) following reLT was seen over the 3 eras (p

https://ift.tt/2zqL8nl

A Randomized Study of Quantiferon-CMV-Directed Versus Fixed Duration Valganciclovir Prophylaxis to Reduce Late CMV Following Lung Transplantation

Background We provide the results of the first interventional study of CMV-specific immune monitoring to direct the length of antiviral prophylaxis in lung transplantation (LTx). Methods Patients (n = 118) at risk of CMV infection were randomized 1:2 to either 5 months or variable length valganciclovir prophylaxis (5-11 months post-LTx), as determined by the QuantiFERON (QFN)-CMV assay. Patients with a negative QFN-CMV assay ( 600 copies/ml) within the blood was significantly reduced in patients with a positive QFN-CMV assay compared to those without protective immunity (13% vs 67%, p = 0.0003), as was the incidence of severe viremia (>10,000 copies/ml) (3% vs 50%, p

https://ift.tt/2OHjnMq

Waitlisted Patients and Serious Fall: May Have Implications After All!

No abstract available

https://ift.tt/2zpS0RW

Effect of the Selective NLRP3 Inflammasome Inhibitor mcc950 on Transplantation Outcome in a Pig Liver Transplantation Model with Organs from Donors after Cardiac Death Preserved by Hypothermic Machine Perfusion

Background We investigated whether the outcome of organs from donors after cardiac death (DCD) can be improved by the addition of mcc950 to the perfusate of the hypothermia machine perfusion (HMP) system and intravenous mcc950 injection after transplantation in a pig liver transplantation model. Methods Thirty-six healthy Bama mini pigs randomized into 3 groups. All the DCD livers were preserved in an HMP system after 2 h of simple cold storage (SCS).In HMP-Postop group, mcc950 was added to the perfusate; in the control group and Postop group, the perfusate was normal LPS. After transplantation, the pigs in the Postop group and HMP-Postop group were intravenously administered 3 mg/kg mcc950, at the time of reperfusion and on day 2 and day 3 after transplantation. During the 3-day follow-up period, general operative characteristics, and serological markers and histological features related to ischemia reperfusion injury were examined. Results The HMP-Postop group suffer the lightest ischemia reperfusion injury(IRI),and functioned best after transplantation. Model for the Early Allograft Function Score (MEAF, predictor of long-term survival), degree of injury in the hepatocytes and rate of apoptosis was lowest in the HMP-Postop group. Further, in the HMP-Postop group, the NLRP3 inflammasome pathway activation was lowest, and the level of IL-1β was lowest. Postop group functioned better than control group, but not comparable with HMP-Postop group. Conclusions The outcome of DCD organs can be improved by the addition of mcc950 to the perfusate of the HMP system and intravenous injection of mcc950 after transplantation. *Corresponding Author: Dr. Yong-Feng Liu, MD, First Affiliated Hospital, China Medical University, 155 Nanjing Street, Shenyang , Liaoning Province 110000, The People's Republic of China. E-mail: gdwkkyxx@sina.com AUTHORSHIP: Author's specific contributions: Yang Yu, Ying Cheng and Yong-Feng Liu designed the study, analyzed the data, interpreted the data and wrote the manuscript. Yang Yu, Qi Pan, Yi-Jie Zhang and De-Gong Jia, Ya performed the experiments, analyzed the data and participated in drafting the manuscript. Yang Yu and Qi Pan interpreted the data. Ying Cheng and Yong-Feng Liu contributed to the conception of the study, interpreted the data and revised the article critically. Disclosures: The authors have no conflicts of interest to declare. Funding: This study is funded by National natural science foundation of China (grant number :02046) and Basic Research on Key Laboratory of Liaoning Provincial Department of Education(grant number :LS201603) Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2OMbyVG

Recent History of Serious Fall Injuries and Posttransplant Outcomes among U.S. Kidney Transplant Recipients

Background Serious fall injuries are associated with poor outcomes among dialysis patients, but whether these associations hold in patients with a history of serious fall injury before kidney transplantation is unknown. Methods In national administrative data, 22 474 U.S. adults receiving a first kidney transplant in 2011-2014 with at least 1 year of follow-up prior to transplant were identified. Serious fall injuries in the year prior to transplant were identified using diagnostic codes for falls and simultaneous fractures, dislocations, or head trauma in inpatient or outpatient claims. We used multivariable Cox proportional hazards models to estimate associations of incident posttransplant outcomes with serious fall injury in the year prior to transplant. Results A total of 620 recipients (2.8%) had serious fall injuries prior to transplant and were more likely to be white, female, and have more comorbid conditions than those without a fall injury. While posttransplant recipient survival did not differ by recent serious fall injuries (HR=1.03; 95% CI 0.78-1.36), these injuries were associated with 33% higher rates of graft failure (HR=1.33; 95% CI 1.03-1.72). Patients with serious fall injuries spent 12.1% of posttransplant follow-up hospitalized, a 3.3-fold higher rate than those without a fall, and had nearly 2-fold higher rates of skilled nursing facility utilization (HR=1.98; 95% CI 1.52-2.57). Conclusions Serious fall injuries are independently associated with significantly greater resource requirements and lower graft survival. Further study is needed to delineate the relationship between falls and adverse outcomes in transplant and reduce the incidence and deleterious effects of these events. Corresponding Author: Laura Plantinga, Division of Renal Medicine, Department of Medicine, Emory University, 101 Woodruff Circle, 5105 Woodruff Memorial Building, Atlanta, GA 30322. Phone: 404-727-3460; Fax: 404-727-3425; e-mail: laura.plantinga@emory.edu. Authorship statement: R.J.L. interpreted results and cowrote the manuscript. R.E.P., S.O.P., and C.B.B. revised the manuscript and provided important intellectual content. L.C.P. performed the data analysis, interpreted results, and cowrote the manuscript. Disclosure: The authors declare no conflicts of interest. Funding: Support was provided through a Career Development Award from the US Department of Veterans Affairs (IK2CX000856) to C.B.B. and an award from the Extramural Grant Program (EGP) by Satellite Healthcare, a not-for-profit renal care provider, to L.P. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2zqyzsd

Novel Therapeutic Approaches to Allosensitization and Antibody-Medicated Rejection

Modification of pathogenic antibodies for autoimmune diseases illuminated the biologic relevance of B cells, plasma cells and pathogenic antibodies in autoimmunity. They have also rejuvenated interest in how B cells mediate multiple effector functions that include antibody production, antigen presentation to T cells, costimulation and the production of immune stimulating and immune modulatory cytokines. Repurposing these drugs from autoimmunity and cancer immunotherapy has yielded important advancements in the care of ABMR patients and novel drug development aimed at HLA desensitization have recently emerged. We now stand on an important threshold that promises many advances in the care of our allosensitized patients. We hope these initial advances will encourage basic scientist, clinical investigators, industry, National Institutes of Health (NIH), our academic societies and the FDA to continue support of these important objectives. These advances clearly have implications for sensitized patients receiving solid organ transplants and ABMR treatment. Modification of alloimmunity and alloantibodies will also have relevance to xenotransplantation where the xenoantibodies present a formidable obstacle to advancement of this important therapy. Working together, we can advance transplant therapeutics where biologic agents are likely to play novel and important roles. Here we discuss novel drugs emerging in this area. Refer Correspondence to: Stanley C. Jordan, M.D.,FASN, FAST, Director, Nephrology & Transplant Immunology, Medical Director, Kidney Transplant Program, Cedars-Sinai Medical Center, 8900 Beverly Blvd., West Hollywood, CA. 90048, Professor of Pediatrics & Medicine, David Geffen School of Medicine at UCLA. Email: sjordan@cshs.org. Fax: 310-423-6369 Competing interest S.C.J. received grant support from Hansa Medical, CSL-Behring, Vitaeris, and Genentech and is a consultant for Hansa Medical, CSLBehring, and Genentech. E.H., A.V, J.C., A.P., S.S., R.N, M.T., K.L, S.L, N.A. have no disclosures to report. Authors Contributions S.C.J. participated in the conception, design, and supervision of work, acquisition and analysis of data, preparation of draft, critical revisions to, and final approval of the manuscript. N.A. conducted the literature evaluation, preparation of draft and revisions to the manuscript. M.T. participated in the conception, design and performance of work, acquisition and analysis of data, and contribution to the preparation of the manuscript. E.H., A.V, J.C., A.P., S.S., R.N, K.L, S.L. participated in the conception, design and performance of work, and contribution to the preparation of the manuscript. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2OLTsTY

Building Kidney Exchange Programmes in Europe – An Overview of Exchange Practice and Activities

Background Considerable differences exist among the living donor Kidney Exchange Programmes (KEPs) that are in use and being built in Europe, contributing to a variation in the number of living donor transplants [6]. Efforts of European KEPs to exchange (best) practices and share approaches to address challenges have, however, been limited. Methods Experts from 23 European countries, collaborating on the ENCKEP COST Action, developed a questionnaire to collect detailed information on the functioning of all existing KEPs in Europe, as well as their opportunities and challenges. Following a comparative analysis, results were synthesised and interpreted by the same experts. Results The practices, opportunities and challenges reported by 17 European countries reveal that some of the 10 operating programmes are mature, while others are in earlier stages of development. Over 1300 transplants were performed through existing KEPs up to the end of 2016, providing approximately 8% of their countries' living kidney donations in 2015. All countries report challenges to either initiating KEPs or increasing volumes. Some challenges are shared, whilst others differ because of differences in context (eg, country size, effectiveness of deceased donor programme) and ethical and legal considerations (eg, regarding living donation as such, nonrelated donors, and altruistic donation). Transnational initiatives have started in Central Europe, Scandinavia, and Southern Europe. Conclusions Exchange of best practices and shared advancement of national programmes to address existing challenges, aided by transnational exchanges, may substantially improve access to the most (cost) effective treatment for the increasing number of patients suffering from kidney disease. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. *contributed equally Authorship PB, BH and JvK organised the survey and research. The 2 first authors have contributed equally as regards design, analyses of the study and writing the manuscript as the chair and vice-chair of Working Group 1 of the ENCKEP COST Action. DM, JvK contributed significantly in writing the paper while JvK was chair of the COST Action. LB and RJ contributed to the questionnaire design. All the remaining authors have provided information in the questionnaires on their countries of origin, also including LB, BH, AH and RJ. Finally, TA, CB, GB, KC, PDC, JF, BH, KH, RJ, RK, RL, M-AM, GM, BS and MV gave presentations about their national KEPs, and everyone participated in the discussions at the ENCKEP workshops. Disclosure The authors declare no conflicts of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Prognostic impact of pre‐treatment neutrophil‐to‐lymphocyte ratio (NLR) in nasopharyngeal carcinoma: A retrospective study of 180 Taiwanese patients

Clinical Otolaryngology, EarlyView.


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Estradiol and leptin have separate but additive anorexigenic effects and differentially target fat mass in rats

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


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