No abstract available
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Πέμπτη 27 Σεπτεμβρίου 2018
Short Call Abstracts
Thyroid, Volume 28, Issue S1, Page A-169-A-198, October 2018.
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Short Call Author Abstract Index
Thyroid, Volume 28, Issue S1, Page A-199-A-202, October 2018.
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Chronic Viral Neuroinflammation: Speculation on Underlying Mechanisms
Viral Immunology, Ahead of Print.
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Diabetic Pulmopathy: A New Clinical Challenge for Diabetology
Exp Clin Endocrinol Diabetes 2018; 126: 590-591
DOI: 10.1055/a-0715-2743
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
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Reduced Anterolateral Thigh Flap Donor-Site Morbidity Using Incisional Negative Pressure Therapy
J reconstr Microsurg
DOI: 10.1055/s-0038-1672126
Background Primary closure of the donor-site after harvest of a large anterolateral thigh flap (ALT) is associated with significant morbidity. Incisional negative pressure therapy (INPT) may decrease complications in high-risk incisions. This study assessed if the incidence of complications after primary closure of the ALT flap donor-site decreases with INPT. Methods Retrospective cohort study of a prospectively maintained database including patients who underwent upper and lower limb reconstruction, using an ALT free flap with primary closure of the donor-site. Two groups were defined: primary closure and INPT (study group) and primary closure with traditional dressings (control group). Nonparametric statistics were employed to identify prognostic factors, p < 0,05. Results Fifty-eight free ALT flaps in 58 patients (study group n = 28; control group n = 30) were included. Median flap width and length were 9 cm (range: 5–14) and 25 cm (range: 10–48), respectively. Median follow-up was 19 months (range: 3–78 months). No significant differences in age or flap size were identified in both groups (p > 0.05). The global complication rate was 7.14% (n = 2) in the INPT group, and 37% (n = 11) in the control group (p = 0.007). The study group had a lower dehiscence and skin necrosis rate (p < 0.05). Multivariate logistic regression analysis showed IPNT was associated with a significant reduction of donor-site complications (p = 0.006), especially in patients with defects > 8 cm (p = 0.003). Conclusions In this cohort study the use of INPT significantly reduced the donor-site morbidity after ALT flap harvest.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
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The Psychological Wellbeing Outcomes of Nonpharmacological Interventions for Older Persons with Insomnia Symptoms: A Systematic Review and Meta-Analysis
Nonpharmacological treatment of insomnia in older persons has been associated with reduced insomnia symptoms and increased psychological wellbeing. This systematic review and meta-analysis examined whether nonpharmacological interventions can promote wellbeing indicators in older persons who experience insomnia symptoms and investigated the components of these interventions. Twenty studies met inclusion criteria. Psychological wellbeing outcomes included symptoms of depression, anxiety, mental health-related quality of life, and fatigue.
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Renal cell carcinoma metastatic to the sinonasal cavity: A review and report of 8 cases
Pierre-Louis Bastier, MD; Dorothee Dunion, MD; Guillaume de Bonnecaze, MD; Elie Serrano, MD, PhD; Ludovic de Gabory, MD, PhD
Abstract
Renal cell carcinoma (RCC) metastatic in the sinonasal cavity is rare. In many cases, it represents the initial presentation of RCC. We conducted a retrospective chart review to report the clinical presentation, imaging, and treatment of RCC metastases in the sinonasal cavity at two tertiary care referral centers. Our population was made up of 8 patients-6 men and 2 women, aged 55 to 86 years (mean: 66.9; median: 63.5)-who had been diagnosed with cancer in the sinonasal cavity. The most common complaints were epistaxis, nasal obstruction, and diplopia. Cancers were located in the ethmoid sinus (n = 3), nasal cavity (n = 2), sphenoid sinus (n = 2), and maxillary sinus (n = 1). Local treatment involved resection and adjuvant radiotherapy in 4 patients, surgery alone in 2 patients, and radiotherapy alone in the other 2. The lesion was embolized before surgery in 4 cases. We also performed a critical review of similar published cases. Our literature review covered 53 cases of RCC metastatic to the sinonasal cavity, including ours. Metastases were the first presentation of RCC in 24 of these cases (45.3%); in our series, the metastases led to the diagnosis of the primary RCC in 3 cases (37.5%). In the 53 reported cases, metastatic resection was performed on 35 patients (66.0%). Survival data were available for 22 of these operated patients, and 17 of them achieved a complete local response. Adjunctive radiotherapy was not associated with a better local response. Overall survival was significantly better in patients who had an isolated metastasis rather than multiple metastases (p = 0.013). There was no difference in overall survival between patients whose metastasis represented the initial presentation of RCC and those whose metastasis did not (p = 0.95). We recommend that sinonasal metastasis be suspected in the event of unilateral nasal bleeding or nasal obstruction in patients diagnosed with RCC. Embolization may prevent abundant bleeding during removal. Surgery may improve the quality of life of these patients while decreasing nasal obstruction and bleeding.
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Positivity rates of in vitro inhalant/respiratory and food allergy tests in the northern midwestern United States
Michael S. Benninger, MD; Thomas Daly, MD; Kevin Graffmiller, MD
Abstract
Rates of allergy-test positivity vary by country and by regions within countries. Several studies have looked at allergy test results to determine the most common allergens. Many of these studies have been based on surveys or on studies of small numbers of tests. Positivity rates for allergy tests are poorly defined in the northern midwestern region of the United States. We conducted a study to identify the rates of positive allergy tests for both inhalant/respiratory allergens and food allergens in the upper Midwest. We extracted from our laboratory database the results of all test samples sent for one of eight allergen panels that had been analyzed between Sept. 1, 2014, and Sept. 1, 2015. All testing was performed at The Cleveland Clinic with the Phadia ImmunoCAP system. The percentage of positive tests, the distribution of the most frequently positive tests, and the class of in vitro responses were identified. A total of 148,628 test results for 63 different allergens were identified. Of the 125,190 tests for inhalant/respiratory allergens, the most frequently positive were dog dander (24% of tests), cat dander (23%), dust mites (23% for both Dermatophagoides pteronyssinus and Dermatophagoides farinae), and June grass (21%). Of the 23,438 food tests, the most frequently positive test results were for milk (18%), peanut (17%), wheat (16%), and egg white (15%). Most of the results fell into classes 1 through 3, although there was still a notable number of very high responses (class 5 and 6). These findings suggest that there is wide variability in the positivity of in vitro allergy tests and that the likelihood of a positive result in screening panels can be estimated. Evaluating such rates will help identify the most and least common allergens and will help to cost-effectively refine allergy screening panels.
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Audiologic profile in patients with ankylosing spondylitis: A controlled study of 30 patients
Lumy Yagueshita, MD; Lucas Resende Lucinda, MD; Valderilio Azevedo, PhD; Gislaine Richter Minhoto Wiemes, PhD; Nicole Richter Minhoto Wiemes, MD; Jose Fernando Polanski, PhD
Abstract
Recent studies have identified sensorineural hearing loss as a possible manifestation of ankylosing spondylitis. We conducted a study of 30 patients with ankylosing spondylitis to characterize their audiologic profile and to correlate their disease activity and functional indices with their hearing thresholds. The study group was made up of 18 men and 12 women, aged 25 to 58 years (mean: 46.5), who were diagnosed with ankylosing spondylitis. We compared their findings with a socially and demographically matched group of 30 healthy controls. All 60 participants underwent an audiologic assessment, consisting of pure-tone audiometry, speech audiometry, and tympanometry. We used validated indices to assess disease activity and functional status, and we compiled information on the time of diagnosis and the types of medications used to treat the ankylosing spondylitis. We found that the average of the mean air-conduction thresholds at 0.5, 1, 2, and 4 kHz in the ankylosing spondylitis group was significantly worse than that of the controls (p = 0.004). A statistically significant difference was observed at frequencies greater than 3 kHz (p < 0.05). A subgroup of case patients who used only a tumor necrosis factor-alpha inhibitor exhibited better hearing thresholds than patients who used other drugs (p = 0.01). Differences in functional and disease activity scores between case patients with and without hearing loss were not statistically significant. We found that patients with ankylosing spondylitis did indeed have a greater prevalence of sensorineural hearing loss but that it was not correlated with either disease activity or functional status.
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Button battery insertion in nose manifested as infraorbital cellulitis
Sheng-Yao Cheng, MD; Cheng-Ping Shih, MD
Infraorbital cellulitis developing from a nasal foreign body is relatively rare and should be considered when diagnosing a child with a presentation similar to the one described in this article.
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Histoplasmosis of the head and neck in the immunocompetent patient: Report of 2 cases
Ashley P. O'Connell Ferster, MD; Aaron Jaworek, MD; Amanda Hu, MD, FRCSC
Abstract
Histoplasmosis of the head and neck is rarely seen in immunocompetent patients. We report 2 new cases of histoplasmosis of the head and neck in immunocompetent patients, one an 80-year-old man and the other a 57-year-old man. The older man presented with oral cavity histoplasmosis; his symptoms included pain, dysphagia, and ulcerative lesions. The younger man had laryngeal histoplasmosis, which resulted in hoarseness and dyspnea. We discuss the methods of diagnosis and the classic findings in histoplasmosis, including the microscopic appearance of caseating granulomas, the results of periodic acid-Schiff staining and Gomori staining, and antibody detection of histoplasmosis. We also review the treatment options with antifungals, including amphotericin B and the oral conazole drugs. With an accurate diagnosis and proper treatment, both of our patients recovered well and their symptoms resolved. Because their symptoms overlapped with those of other, more common disease processes, an accurate diagnosis of these patients was essential to treating their infection.
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Primary pleomorphic adenoma of the middle ear and mastoid
Asnake Bitew, MD; Tsion Sahle, MD; Miriam Redleaf, MD FACS
Unlike metastatic cases, primary pleomorphic adenomas tend to recur and tend to be aggressive.
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Nonarytenoid laryngeal granulomas
Marissa Evarts, DO; Jonathan Romak, MD; Robert T. Sataloff, MD, DMA, FACS
Contact and postintubation granulomas rarely are located on the middle third or anterior portion of the vocal folds, with few reported in the literature.
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The anatomy of the superficial temporal artery in patients with unilateral microtia.
This is a retrospective study that evaluated the anatomical distribution of the superficial temporal artery (STA) in supply of the temporoparietal fascial (TPF) flap for use in unilateral microtia patients undergoing reconstruction. We aimed to determine if embryologic arrest of pharyngeal arch development would lead to aberrant STA which impedes reliable harvest of the TPF flap in patients requiring microtia repair.
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Nondisseminated rhinosporidiosis with multisite involvement in the head and neck
K Devaraja, MS; Prem Sagar, MS; Chirom Amit Singh, MS; Rajeev Kumar, MS
Abstract
Rhinosporidiosis is a communicable disease prevalent in tropical countries that affects one or more mucocutaneous sites such as the nasal cavity, pharynx, skin, bronchus, genitals, and bone, in isolation or together. We report a case of multicentric rhinosporidiosis involving the nasal cavity, oropharynx, larynx, and cheek skin without disseminated disease outside the head and neck. Although the appearance of mucocutaneous lesions in our patient was similar to that of papilloma or neoplasm, the distinct clinicopathologic characteristics of the rhinosporidiosis guided us in managing the case successfully. In our own experience with 11 patients with rhinosporidiosis on whom we operated over the past 5 years, the nasal cavity and pharynx were the most commonly involved sites in the head and neck. Surgical excision of all lesions along with cauterization of the base and long-term dapsone therapy is the current standard of care for multicentric rhinosporidiosis.
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Endoscopic view of the carotid artery in the sphenoid sinus
Eiji Yanagisawa, MD, FACS; Dewey A. Christmas, MD; Joseph P. Mirante, MD, MBA, FACS
The sphenoid sinus has been described as the most variable, in shape and size, of any bilateral cavity or organ in the human body.
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Mucocele development after endoscopic sinus surgery for nasal polyposis: A long-term analysis
Hakim Benkhatar, MD; Idir Khettab, MD; Philippe Sultanik, MD, PhD; Ollivier Laccourreye, MD; Pierre Bonfils, MD, PhD
Abstract
The aim of the present study was to determine the prevalence of long-term mucocele development after functional endoscopic sinus surgery (FESS) for nasal polyposis, to search for a statistical relationship with preoperative variables and to analyze the management of this complication. A retrospective analysis of 153 patients who underwent FESS for nasal polyposis, with a minimum of 7 years of follow-up, was performed. Mucocele diagnosis was based on regular clinical and radiologic evaluation. Univariate and multivariate statistical analysis was performed. The postoperative mucocele rate was 13.1% (20 patients). The mean delay between surgery and mucocele diagnosis was 6.25 years. A high preoperative Lund-Mackay score (>19) was a risk factor for postoperative mucocele (p = 0.04). Asthma and aspirin intolerance did not increase the risk of this complication. Endoscopic marsupialization of mucoceles was successful in 19 patients, with only one recurrent frontal mucocele. One patient required external approaches for two frontal mucoceles. In conclusion, mucocele risk after FESS for nasal polyposis is significant, especially in case of a high preoperative Lund-Mackay score (>19). Long-term clinical follow-up is recommended, imaging being prescribed based on symptoms or abnormal findings on clinical examination. Endoscopic marsupialization is very effective, but frontal mucoceles are more likely to recur.
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Photobiomodulation therapy before futsal matches improves the staying time of athletes in the court and accelerates post-exercise recovery
Abstract
This study aimed to analyze PBMT effects on futsal player's performance and recovery in a non-controlled field environment. It is a randomized, triple-blinded, placebo-controlled, crossover clinical trial. The research included six professional athletes and in each match phototherapy treatments were performed before matches (40 minutes), blood samples were collected before treatments, and samples immediately after the end of the matches and 48 h after. Furthermore, videos were analyzed to quantify the time athletes spent on the pitch and the distance they covered. PBMT was performed at 17 sites of each lower limb (40 mins before matches), employing a cluster with 12 diodes (4 laser diodes of 905 nm, 4 LEDs of 875 nm, and 4 LEDs of 640 nm, 30 J per site). The performance of the athlete could be quantified considering the time on the pitch and the distance covered; the biochemical markers evaluated were creatine kinase, lactate dehydrogenase, blood lactate, and oxidative damage to lipids and proteins. PBMT significantly increased the time of staying in the pitch and a significant improvement in all the biochemical markers evaluated. No statistically significant difference was found for the distance covered. Pre-exercise PBMT can enhance performance and accelerate recovery of high-level futsal players.
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Surface electromyography after lower level laser therapy application on skeletal muscles in individuals with heart failure
Abstract
The purpose of this study was to investigate the effects of low-level laser therapy (LLLT) applied before a fatigue protocol through the effects on the electrical activation in the quadriceps muscle in patients with HF. Fourteen patients with the diagnosis of heart failure (HF) were selected for this double-blind, crossover type clinical trial. These participants have attended to a familiarization, LLLT, and placebo sessions, totaling three visits. The LLLT was applied in the quadriceps muscle (850 nm, 5 J per diode). The fatigue protocol consisted of concentric and eccentric isokinetic contractions (cc/ec) until exhaustion or up to 50 cc/ec. The muscular fatigue was evaluated with surface electromyography, by the analysis of integral, median frequency, and entropy. Only one application of LLLT is not able to decrease skeletal muscle activation in patients with HF. There was no reduction of muscle fatigue among the proposed protocols. Single LLLT session has no effect on the reduction of skeletal muscle fatigue in patients with HF.
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Interaural Time Difference Perception with a Cochlear Implant and a Normal Ear
Abstract
Currently there is a growing population of cochlear-implant (CI) users with (near) normal hearing in the non-implanted ear. This configuration is often called SSD (single-sided deafness) CI. The goal of the CI is often to improve spatial perception, so the question raises to what extent SSD CI listeners are sensitive to interaural time differences (ITDs). In a controlled lab setup, sensitivity to ITDs was investigated in 11 SSD CI listeners. The stimuli were 100-pps pulse trains on the CI side and band-limited click trains on the acoustic side. After determining level balance and the delay needed to achieve synchronous stimulation of the two ears, the just noticeable difference in ITD was measured using an adaptive procedure. Seven out of 11 listeners were sensitive to ITDs, with a median just noticeable difference of 438 μs. Out of the four listeners who were not sensitive to ITD, one listener reported binaural fusion, and three listeners reported no binaural fusion. To enable ITD sensitivity, a frequency-dependent delay of the electrical stimulus was required to synchronize the electric and acoustic signals at the level of the auditory nerve. Using subjective fusion measures and refined by ITD sensitivity, it was possible to match a CI electrode to an acoustic frequency range. This shows the feasibility of these measures for the allocation of acoustic frequency ranges to electrodes when fitting a CI to a subject with (near) normal hearing in the contralateral ear.
https://ift.tt/2N6Jvid
Risk Factors Associated With Unplanned Reoperation in Major Head and Neck Surgery
This cohort study uses the American College of Surgeons National Surgical Quality Improvement Program 2005-2014 database to identify risk factors associated with unplanned reoperation following major head and neck surgical procedures.
https://ift.tt/2xE1p72
https://ift.tt/2xE1p72
Rapidly Enlarging Parapharyngeal Mass
A man in his 40s with Poland syndrome presented with 6-month history of left throat pain and enlarging oropharyngeal mass. What is your diagnosis?
https://ift.tt/2OUrs0u
https://ift.tt/2OUrs0u
Patient Concerns About Nasal Reconstruction and Implications for Shared Decision Making
This study examines the concerns of patients with nonmelanoma skin cancer regarding nasal reconstruction after Mohs surgery to develop an intervention to improve the shared decision-making process of patients and practitioners.
https://ift.tt/2xE1oQw
https://ift.tt/2xE1oQw
Hyperbaric Oxygen Therapy vs Medical Therapy Alone for Idiopathic Sudden Sensorineural Hearing Loss
This systematic review and meta-analysis of 19 studies evaluates the benefit of the addition of hyperbaric oxygen therapy for patients with sudden sensorineural hearing loss.
https://ift.tt/2OUKhR8
https://ift.tt/2OUKhR8
Standard Clinical Method vs Patient-Centered Tinnitus Likeness Rating
This case series assessed individual test-retest reliability of the 2-alternative forced-choice and tinnitus likeness rating approaches in patients undergoing evaluation for tinnitus.
https://ift.tt/2xGIQ2f
https://ift.tt/2xGIQ2f
Suppressed descending pain modulatory and enhanced sensorimotor networks in patients with chronic low back pain
Abstract
Purpose
Although cerebral structural and functional changes were uncovered by neuroimaging in patients with chronic low back pain (CLBP), their associations remain to be clarified. We co-analyzed anatomical and functional magnetic resonance imaging data in those patients and tested whether cortical gray matter volume changes are associated with altered pain modulatory networks underlying chronification of pain.
Methods
In 16 patients with CLBP and 16 heathy controls, we performed functional magnetic resonance imaging during mechanical pain stimulation on the lower back followed by anatomical imaging. We performed voxel-based morphometry and functional connectivity analysis from the seeds with altered gray matter volume, and examined correlations between imaging and psychophysical parameters.
Results
Patients showed decreases in gray matter volume at the right dorsolateral prefrontal cortex, middle occipital gyrus, and cerebellum, and showed increases at the bilateral primary sensorimotor cortices, left fusiform gyrus, and right cerebellum compared with controls (P < 0.001). Dorsolateral prefrontal and fusiform volumes showed negative associations with affective comorbidity, whereas motor cortex volume with impaired daily activity (P < 0.05). Connectivity was decreased between the cerebellar and limbic, and increased between the bilateral sensorimotor regions (PFDR < 0.05). Higher pain intensity and unpleasantness correlated with enhanced bilateral sensorimotor and dorsolateral–medial prefrontal networks, respectively (P < 0.05).
Conclusion
Patients showed a decreased volume of cortical center for descending pain modulation and an increased volume of sensorimotor network, in association with suppressed descending pain modulatory and cerebellum–limbic networks and enhanced sensorimotor network during pain. Such structural and functional alterations might be part of cerebral pathophysiology of CLBP.
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Interaural Time Difference Perception with a Cochlear Implant and a Normal Ear
Abstract
Currently there is a growing population of cochlear-implant (CI) users with (near) normal hearing in the non-implanted ear. This configuration is often called SSD (single-sided deafness) CI. The goal of the CI is often to improve spatial perception, so the question raises to what extent SSD CI listeners are sensitive to interaural time differences (ITDs). In a controlled lab setup, sensitivity to ITDs was investigated in 11 SSD CI listeners. The stimuli were 100-pps pulse trains on the CI side and band-limited click trains on the acoustic side. After determining level balance and the delay needed to achieve synchronous stimulation of the two ears, the just noticeable difference in ITD was measured using an adaptive procedure. Seven out of 11 listeners were sensitive to ITDs, with a median just noticeable difference of 438 μs. Out of the four listeners who were not sensitive to ITD, one listener reported binaural fusion, and three listeners reported no binaural fusion. To enable ITD sensitivity, a frequency-dependent delay of the electrical stimulus was required to synchronize the electric and acoustic signals at the level of the auditory nerve. Using subjective fusion measures and refined by ITD sensitivity, it was possible to match a CI electrode to an acoustic frequency range. This shows the feasibility of these measures for the allocation of acoustic frequency ranges to electrodes when fitting a CI to a subject with (near) normal hearing in the contralateral ear.
https://ift.tt/2N6Jvid
Risk of Hepatocellular Carcinoma After Treatment With Entecavir vs Tenofovir for Chronic Hepatitis B
This cohort study uses data from the Korean National Health Insurance Service database to compare the risk of hepatocellular cancer associated with entecavir vs tenofovir disoproxil fumarate in patients receiving long-term treatment for chronic hepatitis B infection.
https://ift.tt/2R5oo3a
https://ift.tt/2R5oo3a
Clinical Benefit of Cancer Drugs With FDA Approval Based on Single-Arm Trials
This study uses the European Society of Medical Oncology Magnitude of Clinical Benefit Scale to evaluate the clinical benefit of anticancer drugs that gained approval by the US Food and Drug Administration based on single-arm rather than randomized clinical trials.
https://ift.tt/2N7mBXQ
https://ift.tt/2N7mBXQ
Tenofovir vs Entecavir for Hepatocellular Carcinoma Prevention in Patients With Chronic Hepatitis B
Current guidelines for the treatment of chronic hepatitis B (CHB) recommend as first-line line therapy entecavir (ETV), tenofovir disoproxil fumarate (TDF), or tenofovir alafenamide fumarate. Both ETV and TDF achieve similar rates of hepatitis B virus (HBV) DNA suppression and alanine aminotransferase normalization over time and have an excellent safety record. However, ETV and TDF have not been directly compared except in patients with decompensated cirrhosis; to our knowledge, no other head-to-head randomized trials exist. Yet, there is strong interest in understanding if one drug might be superior to the other in specific clinical settings or subpopulations. In the absence of randomized comparator trials, high-quality "real world" cohorts can be quite informative. In this issue of JAMA Oncology, Choi and colleagues report the results of 2 retrospective cohort studies of patients with CHB from Korea that evaluated the association between the type of nucleoside or nucleotide analogue and the development of hepatocellular carcinoma (HCC). Using both a large administrative data set (24 156 patients with CHB and 984 with HCC) and a tertiary hospital-based cohort (2701 patients with CHB and 154 with HCC), the authors found that the risk of HCC was consistently about 35% lower in those treated with TDF than in those treated with ETV. This association persisted even when stratified by cirrhosis status and after very thorough adjustment for available confounders. These striking findings raise the question of whether the current CHB guidelines should be updated to reflect this observed superior anticancer benefit of TDF over ETV.
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Immune Checkpoint Blockade and Tumor-Specific Vaccine for Patients With Incurable HPV-16 Cancer
This phase 2 clinical trial examines whether the efficacy of nivolumab is amplified through treatment with ISA 101, a synthetic long-peptide human papillomavirus 16 vaccine, in patients with incurable human papillomavirus 16–positive cancer.
https://ift.tt/2N4oaWE
https://ift.tt/2N4oaWE
Paediatric ocular super glue injuries: assessment of two cases
In this report, we elaborate the clinical findings and the optimal management of two cases with ocular glue injuries in two paediatric patients. Both the patients were presented to the ocular emergency with completely closed eyelid and periocular erythema. The eyelids were completely closed due to matting of the eyelashes with glue retention up to lash roots. Thus, in both cases, after the application of local anaesthetic agent, immediate lash trimming was performed along with the removal of crystallised glue particles. However, the ocular surface showed only congestion in absence of any added corneal complications. Patients were followed up with standard treatment protocol as per chemical injuries. Until the end of 5 months, the clinical course was uneventful.
https://ift.tt/2QbJE64
Comorbid presentation of syringomyelia and Guillain-Barre syndrome, attributed to mycoplasma, in a 6-year-old female patient
Syringomyelia is the development of a fluid-filled cavity or syrinx within the spinal cord that can cause loss of sensation and muscle spasticity. Guillain-Barre syndrome (GBS) is a postinfection autoimmune disease, classified as an acute polyneuropathy. This report describes the emergency admission of a 6-year-old girl presenting with sudden pallor and pain in both lower limbs. The patient's reflexes were normal, as were the results of her sonography, radiography and biochemical tests; however, spinal MRI revealed extensive compartmentalised syringomyelia extending from C2 to T3. A sensory and motor nerve conduction study revealed a demyelinating type motor polyneuropathy which, along with positive Mycoplasma pneumoniae test, was suggestive of GBS. Intravenous immunoglobulin infusion showed excellent results. In conclusion, we report a rare paediatric case of syringomyelia coexisting with GBS. It is important to bear in mind the possibility of other coexisting diseases even if MRI reveals definitive characteristics of another condition.
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Diagnosis of a tick-borne coinfection in a patient with persistent symptoms following treatment for Lyme disease
A 67-year-old woman presented with 5 days of myalgias and fevers on completion of a 21-day course of amoxicillin for Lyme disease (Borrelia burgdorferi infection). She was found to have profound thrombocytopenia, as well as new anaemia and leucopenia. Workup revealed Babesia microti as the causative agent of her symptoms. The patient quickly improved after appropriate antimicrobial therapy directed against babesiosis was started. This case illustrates the importance of basic microbiology, including epidemiology and common vectors, when creating a differential diagnosis. Because the Ixodes scapularis tick can harbour and transmit multiple parasites simultaneously, the possibility of coinfection should be considered in any patient not responding to appropriate initial medical therapy.
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Desire for lasting long in bed led to contact allergic dermatitis and subsequent superficial penile gangrene: a dreadful complication of benzocaine-containing extended-pleasure condom
Description
A 30-year-old non-atopic, non-diabetic man presented with complaints of swelling, pain and patchy blackening of penile skin for the last 3 days. He stated that for improving the duration of sexual intercourse and for better sexual performance, he recently used a new brand of condom, which contained 5% benzocaine. He, however, denied about the use of any lubricants or topical substance at the time of sexual act. There was no history of fever, inguinal or scrotal swelling, genital trauma, insect bite, known drug allergy, substance abuse or similar complaints in the past. In the past, he was using non-medicated natural rubber latex condom for contraception without any adverse effects. Local examination revealed vesicle eruption, sloughing and patchy blackening of penile skin extending from prepuce to base of penis with a clear demarcation line with non-palpable inguinal lymph nodes suggestive of allergic contact dermatitis as shown in figure 1. The underlying...
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Knotted electric wire in urinary bladder: Can such complex foreign body be retrieved endoscopically!
Various types of foreign bodies have been recovered from the urinary bladder and urethra including telephone cables, pocket battery, little fish, pen tips and so on. Management of such cases include either endoscopic removal or open surgery. We report the case of an 18-year-old boy who inserted an electric wire in the urethra for eroticism and was managed by endoscopic removal following fragmentation of wire under local anaesthesia using holmium laser.
https://ift.tt/2QdFESt
Recurrent aseptic meningitis with PIGT mutations: a novel pathogenesis of recurrent meningitis successfully treated by eculizumab
We report the case of a patient with PIGT mutations who experienced recurrent aseptic meningitis 121 times over 16 years before developing paroxysmal nocturnal haemoglobinuria (PNH). Each episode was preceded by urticaria and arthralgia. After developing PNH, haemolysis occurred prior to meningitis. Flow cytometry revealed deficiency of the glycophosphatidylinositol (GPI)-anchored complement regulatory proteins, CD59 and CD55, and he was diagnosed with PNH. All the symptoms disappeared on administering eculizumab, an anti-C5 antibody. We did not detect mutation in PIGA, which is regarded as the cause of PNH. However, we detected a germ-line mutation and a somatic microdeletion in chromosome 20q including PIGT; PIGT is essential for transferring GPI anchor to the precursors of CD59 and CD55, which play important roles in complement regulation. Loss of these proteins leads to complement overactivation, causing inflammatory symptoms, including recurrent meningitis. PIGT mutations should be considered a novel pathogenesis of recurrent meningitis of unknown aetiology.
https://ift.tt/2zAyO45
Obstructive urosepsis secondary to ureteric herniation into the sciatic foramen
A 65-year-old female patient presented with a 2-day history of worsening right-sided abdominal pain and clinical signs of sepsis, on the background of a recent admission for pancolitis. Imaging revealed right ureteric herniation through the sciatic foramen with subsequent hydroureteronephrosis and radiological signs of severe pyelonephritis. The patient underwent emergency decompression with a percutaneous nephrostomy, followed by insertion of an antegrade stent to correct the ureteric hernia once the sepsis was appropriately treated. We describe the presentation and management of this unusual case of herniation of the right ureter into the sciatic foramen.
https://ift.tt/2QfcMtc
Acromioclavicular joint cyst formation in a patient with rotator cuff-tear arthropathy: a rare cause of shoulder discomfort
We report a case of a 77-year-old man who presented to our shoulder department with a soft tissue mass on his right acromioclavicular (AC) joint. Previously attempted puncture aspiration had revealed serous fluid retention which recurred after each of several drainage attempts. Conventional radiography and MRI of the affected shoulder joint demonstrated a progressed cuff-tear arthropathy with an irreparable tear of the supraspinatus tendon, static superior migration of the humeral head, opening of the AC joint capsule and a superior joint-fluid 'eruption' and accumulation called 'Geyser sign'. Given that the patient's cuff-tear arthropathy was very well compensated, arthroscopic rotator cuff debridement and open cyst excision were performed. Closure of the superior aspect of the AC joint capsule was performed by the aid of a collagen matrix with additional closure of the deltotrapezial fascia. One year postoperatively, no cyst recurrence was noted.
https://ift.tt/2zAvNAC
Atypical presentation of molar pregnancy
The classic features of molar pregnancy are irregular vaginal bleeding, hyperemesis, enlarged uterus for gestational age and early failed pregnancy. Less common presentations include hyperthyroidism, early onset pre-eclampsia or abdominal distension due to theca lutein cysts. Here, we present a case of molar pregnancy where a woman presented to the emergency department with symptoms of acute abdomen and was treated as ruptured ectopic pregnancy. The woman underwent laparoscopy and evacuation of retained products of conception. Histological examination of uterine curettage confirmed the diagnosis of a complete hydatidiform mole. The woman was discharged home in good general condition with a plan for serial beta-human chorionic gonadotropin (beta-hCG) follow-up. Complete follow-up includes use of contraception and follow-up after beta-hCG is negative for a year.
https://ift.tt/2QbFTx8
Lupus causing small bowel obstruction
A 20-year-old female patient was admitted to hospital in 2015 with 1 year history of recurrent abdominal pain, distension, borborygmi and nausea. The patient had a background of systemic lupus erythematous (SLE) diagnosed 4 years before, with skin, joint and renal involvement. The initial investigations have shown a long segment of ileal inflammation with upstream obstruction. Differential diagnoses were mainly SLE enteritis or concomitant Crohn's. Patient failed the initial conservative management and had a laparotomy with small bowel (SB) resection and ileostomy. The histology was suggestive of autoimmune enteritis. Although bowel involvement is a frequent feature of SLE, surgery for obstruction is extremely rare. Postoperatively, she had an emergency admission and was diagnosed with SB volvulus with perforation. She underwent further resection and stoma refashioning in 2016. As a consequence, she developed short gut syndrome. Eventually, the stoma was reversed and parenteral nutrition was stopped and weight became stable.
https://ift.tt/2zzfbcw
Idiopathic macrocheilia
A 13-year-boy presented with painless swelling of upper and lower lips accompanied with gingival enlargement. The aetiology for these symptoms included vast pathological varieties but none of them could fit in. Clinical features were similar to orofacial graulomatosis but histopathological examination revealed chronic non-specific infection. Therefore, the final diagnosis was made as idiopathic macrocheilia through exclusion criteria. Management with intralesional triamcinolone acetonide 40 mg, twice a week for 3 weeks, resulted in significant remission in lip swelling without recurrence after a 6-month follow-up.
https://ift.tt/2QbT3ug
Massive gastric dilatation leading to acute respiratory distress 1 year after a Nissen fundoplication
Acute massive gastric dilatation (AMGD) is a recognised complication after Nissen fundoplication.1 A 63-year-old man recently presented to our emergency department in acute respiratory distress, acute abdominal pain and distension, having had an elective umbilical port incisional hernia repair a day prior. In the year preceding his presentation, the patient had undergone a laparoscopic paraoesophageal hiatus hernia repair and excision of sac, posterior cruropexy, dual mesh reinforcement of repair and 360° fundoplication, as a day case. In between these two events, the patient was asymptomatic, and had a free diet with no further medical or surgical intervention. We hereby present successful management and discuss implications of this exceptional yet potentially life-threatening complication.
https://ift.tt/2zA92gp
Diabetic ketoacidosis and thyroid storm: coexistence of a double trouble
Diabetic ketoacidosis (DKA) and thyrotoxic crisis are both endocrine emergencies. Here, we present a case of a patient who presented with DKA and on further evaluation was found to also have a thyrotoxic crisis. The coexistence of both of these endocrine emergencies simultaneously is extremely rare and heralds grave prognosis unless identified and treated promptly.
https://ift.tt/2QaNWdG
Bilateral submandibular gland nodular oncocytic hyperplasia with papillary cystadenoma-like areas
A 57-year-old man presented in 2016 with a 4-month history of a right submandibular mass, having undergone left submandibular gland (SMG) excision in 2003. Imaging suggested a benign tumour and subsequent core biopsy findings suggested a nodular oncocytic hyperplasia, similar to the tumour removed from the contralateral side. This was confirmed on histological analysis following right submandibular gland excision which showed characteristic features of nodular oncocytic hyperplasia along with an unusual diffuse papillary cystadenoma-like ductal proliferation, similar to that seen in the 2003 specimen. A diagnosis of multinodular adenomatous oncocytic hyperplasia (MAOH) was rendered in order to communicate the unique histological features that have otherwise not been described in the literature. We believe that this is the first reported case of non-synchronous multinodular oncocytic hyperplasia and the first case affecting the submandibular glands.
https://ift.tt/2zzPVTw
Gossypiboma masquerading as nephrocutaneous fistula
Nephrocutaneous fistula is a rare complication of surgical procedures involving the kidney. Fistula formation is also a complication seen in gossypiboma. We present the case of a patient who was initially suspected to have nephrocutaneous fistula after open pyelolithotomy. Later while undergoing open resection of fistula, he was found to have a retained surgical sponge (gossypiboma) near the lower pole of kidney. Gossypiboma is a term used for mass formed around a surgical sponge accidentally left in the body. It is most of the times not diagnosed by radiological imaging and thus results in unnecessary investigations to rule out other causes for the patient's symptoms. Having a high index of suspicion may lead to an earlier diagnosis. But the prevention of gossypiboma is of the utmost importance. A meticulous approach while operating by the surgeon and operating rooms staff is very important in doing so.
https://ift.tt/2Qde4Vl
Chronic urinary retention due to diabetic cystopathy masquedering as mesenteric cyst
Description
A 55-year-old previously diabetic man presented with progressive abdominal distension for the last three months. He denied any bowel/bladder complaints. His medical/surgical history was unremarkable. On examination his vitals were stable and a huge abdominal mass (10x11 cm) was palpable. The mass was having side-to-side mobility. There was no hepatosplenomegaly or clinically significant lymphadenoapathy. On evaluation with ultrasonography of abdomen and CT scan, there was evidence of huge, cystic and homogenous mass (13x11 cm) with clear margins occupying almost entire abdominal cavity (figure 1). There was no evidence of calcification, septations or nodules in the mass, and it appeared to be separate from both the kidneys and bowel. A provisional diagnosis of mesenteric cyst was made, and the patient was taken for laparotomy. A per-urethral catheter was placed intraoperatively and surgery was started. During laparotomy it came as an element of surprise that the swelling was actually chronically distended bladder...
https://ift.tt/2zA9taa
Fetishism in ADHD: an impulsive behaviour or a paraphilic disorder?
A boy with attention deficit and hyperactivity disorder (ADHD) presented with a fetish for and the subsequent stealing of female undergarments. He was predominantly inattentive and had been a slow learner. Psychological tests showed that he had significant cognitive and inattention problems without significant hyperactivity, and was at risk of dyslexia as well as conduct disorder.
https://ift.tt/2QddTJF
Pneumonia and bacteraemia caused by Gemella morbillorum in a previously healthy infant: first reported case in literature
A 5-month-old baby presented with a low-grade fever and tachypnoea and was found to have right upper lobe consolidation on chest radiograph. He was admitted with the diagnosis of bronchopneumonia and the treatment protocol for pneumonia was initiated. Blood culture samples were collected, and he was started on a course of intravenous amoxicillin–clavulanate. Blood culture results displayed pansensitive Gemella morbillorum bacteraemia and he was continued on intravenous antibiotic to which he responded in a short period and was discharged in good condition on the fourth day.
https://ift.tt/2zzCnXW
Gastric emphysema secondary to severe vomiting: a comparative review of 14 cases
Gastric emphysema is characterised by the presence of air within the wall of the stomach. The radiographic finding of gastric emphysema with hepatic portal venous gas is classically an ominous sign, associated with a high mortality rate. We report one case from our clinical experience and undertake a review of the previously reported cases of vomiting-induced gastric emphysema retrieved from the PubMed. A total of 14 cases were found to date. The mean age at the time of diagnosis was 45.6 years (range, 9 months to 81 years). Computed tomography abdomen was the frequently used diagnostic modality. Interestingly, conservative treatment led to a clinical cure and resolution of gastric emphysema as well as the associated hepatic portal venous gas in most of the patients. This review illustrates that vomiting-related gastric emphysema entails a more benign course and surgical intervention can be avoided with a prompt aetiology establishment in these patients.
https://ift.tt/2Q9X2Yj
Aneurysmal dilation of the vein of Galen and straight sinus with resultant obstructive hydrocephalus
Description
A 20-year-old woman was admitted to the emergency department on a previous occasion with tonic-clonic seizures. Her medical history was significant for headaches and hypertension. The headaches were associated with nausea and vomiting. She had no history of developmental delay or epilepsy. CT scan of the brain showed signs of obstructive hydrocephalus due to venous hypertension as a result of vein of Galen malformation, and hence a ventriculoperitoneal shunt was placed. Now on follow-up, her MRI brain demonstrates a round flow void in the suprapineal cisterns with engorged straight sinus, compatible with vein of Galen arteriovenous fistulous communication and shunting (figure 1). The resultant venous hypertension leads to mild to moderate compensated hydrocephalus.
Figure 1
(A) Axial T2, (B) axial T1 and (C) sagittal T2 MRI brain. MRI brain demonstrates a round flow void in the suprapineal cisterns with engorged straight sinus (green arrow),...
https://ift.tt/2zyNwsj
Effect of DACH1 on proliferation and invasion of laryngeal squamous cell carcinoma
Abstract
Background
To investigate the effect of DACH1 over-expression on proliferation and invasion of laryngeal squamous cell carcinoma (LSCC).
Methods
The 120 cases of LSCC tumors and 114 adjacent non-neoplastic tissues were collected to detect the expression of DACH1 by immunohistochemistry. The changes of DACH1 expression from each group were assessed and correlated to the clinical parameters of the patients. Plasmid-DACH1 was transfected into Hep-2 cells to up-regulate the expression of DACH1C. Real-time PCR, Western blot, CCK8 and transwell assay were used to verify the cell proliferation and invasion after plasmid-DACH1 transfection.
Results
The results indicated that DACH1 was downregulated in LSCC tissues as compared to corresponding adjacent non-neoplastic tissues. Decreased expression of DACH1 was found in the tumors upraglottic tumor, lymph node metastases, T3–4 stage and advanced clinical stage. In Hep-2 cells, transfection with plasmid-DACH1 could suppress cell proliferation, invasion and induce G1 phase extension in cell cycle.
Conclusions
DACH1 may act as a tumor suppressor gene and could be a potential target for therapeutic intervention of LSCC.
https://ift.tt/2xJXndl
Photobiomodulation with single and combination laser wavelengths on bone marrow mesenchymal stem cells: proliferation and differentiation to bone or cartilage
Abstract
Tissue engineering aims to take advantage of the ability of undifferentiated stem cells to differentiate into multiple cell types to repair damaged tissue. Photobiomodulation uses either lasers or light-emitting diodes to promote stem cell proliferation and differentiation. The present study aimed to investigate single and dual combinations of laser wavelengths on mesenchymal stem cells (MSCs). MSCs were derived from rabbit iliac bone marrow. One control and eight laser irradiated groups were designated as Infrared (IR, 810 nm), Red (R, 660 nm), Green (G, 532 nm), Blue (B, 485 nm), IR–R, IR–B, R–G, and B–G. Irradiation was repeated daily for 21 days and cell proliferation, osseous, or cartilaginous differentiation was then measured. RT-PCR biomarkers were SOX9, aggrecan, COL 2, and COL 10 expression for cartilage and ALP, COL 1, and osteocalcin expression for bone. Cellular proliferation was increased in all irradiated groups except G. All cartilage markers were significantly increased by IR and IR–B except COL 10 which was suppressed by IR–B combination. ALP expression was highest in R and IR groups during osseous differentiation. ALP was decreased by combinations of IR with B and with R, and also by G alone. R and B–G groups showed stimulated COL 1 expression; however, COL 1 was suppressed in IR–B, IR–R, and G groups. IR significantly increased osteocalcin expression, but in B, B–G, and G groups it was reduced. Cartilage differentiation was stimulated by IR and IR–B laser irradiation. The effects of single or combined laser irradiation were not clear-cut on osseous differentiation. Stimulatory effects on osteogenesis were seen for R and IR lasers, while G laser had inhibitory effects.
https://ift.tt/2QcEjet
Heterogeneity of Astrocytic and Neuronal GLT-1 at Cortical Excitatory Synapses, as Revealed by its Colocalization With Na+/K+-ATPase α Isoforms
Abstract
GLT-1, the major glutamate transporter, is expressed at perisynaptic astrocytic processes (PAP) and axon terminals (AxT). GLT-1 is coupled to Na+/K+-ATPase (NKA) α1–3 isoforms, whose subcellular distribution and spatial organization in relationship to GLT-1 are largely unknown. Using several microscopy techniques, we showed that at excitatory synapses α1 and α3 are exclusively neuronal (mainly in dendrites and in some AxT), while α2 is predominantly astrocytic. GLT-1 displayed a differential colocalization with α1–3. GLT-1/α2 and GLT-1/α3 colocalization was higher in GLT-1 positive puncta partially (for GLT-1/α2) or almost totally (for GLT-1/α3) overlapping with VGLUT1 positive terminals than in nonoverlapping ones. GLT-1 colocalized with α2 at PAP, and with α1 and α3 at AxT. GLT-1 and α2 gold particles were ∼1.5–2 times closer than GLT-1/α1 and GLT-1/α3 particles. GLT-1/α2 complexes (edge to edge interdistance of gold particles ≤50 nm) concentrated at the perisynaptic region of PAP membranes, whereas neuronal GLT-1/α1 and GLT-1/α3 complexes were fewer and more uniformly distributed in AxT. These data unveil different composition of GLT-1 and α subunits complexes in the glial and neuronal domains of excitatory synapses. The spatial organization of GLT-1/α1–3 complexes suggests that GLT-1/NKA interaction is more efficient in astrocytes than in neurons, further supporting the dominant role of astrocytic GLT-1 in glutamate homeostasis.https://ift.tt/2IkcrCH
TAS 102 in Combination With Ramucirumab in Advanced, Refractory Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma
Conditions: Gastric Adenocarcinoma; Gastroesophageal Junction Adenocarcinoma; Gastric Cancer
Interventions: Drug: TAS 102; Drug: Ramucirumab 10 MG/ML Intravenous Solution [CYRAMZA]
Sponsor: H. Lee Moffitt Cancer Center and Research Institute
Not yet recruiting
https://ift.tt/2N6PKT1
Interventions: Drug: TAS 102; Drug: Ramucirumab 10 MG/ML Intravenous Solution [CYRAMZA]
Sponsor: H. Lee Moffitt Cancer Center and Research Institute
Not yet recruiting
https://ift.tt/2N6PKT1
Diagnostic Accuracy of Human Transcriptional Activator(MYB) Expression by ELISA Technique Versus Immmunohistochemistry in Detecting Salivary Gland Carcinomas
Conditions: Malignant Neoplasm of Salivary Gland; Benign Neoplasm of Salivary Gland
Intervention: Device: enzyme linked immunosorbent assay (ELISA)
Sponsor: Cairo University
Not yet recruiting
https://ift.tt/2R1Qe05
Intervention: Device: enzyme linked immunosorbent assay (ELISA)
Sponsor: Cairo University
Not yet recruiting
https://ift.tt/2R1Qe05
TAS 102 in Combination With Ramucirumab in Advanced, Refractory Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma
Conditions: Gastric Adenocarcinoma; Gastroesophageal Junction Adenocarcinoma; Gastric Cancer
Interventions: Drug: TAS 102; Drug: Ramucirumab 10 MG/ML Intravenous Solution [CYRAMZA]
Sponsor: H. Lee Moffitt Cancer Center and Research Institute
Not yet recruiting
https://ift.tt/2N6PKT1
Interventions: Drug: TAS 102; Drug: Ramucirumab 10 MG/ML Intravenous Solution [CYRAMZA]
Sponsor: H. Lee Moffitt Cancer Center and Research Institute
Not yet recruiting
https://ift.tt/2N6PKT1
Diagnostic Accuracy of Human Transcriptional Activator(MYB) Expression by ELISA Technique Versus Immmunohistochemistry in Detecting Salivary Gland Carcinomas
Conditions: Malignant Neoplasm of Salivary Gland; Benign Neoplasm of Salivary Gland
Intervention: Device: enzyme linked immunosorbent assay (ELISA)
Sponsor: Cairo University
Not yet recruiting
https://ift.tt/2R1Qe05
Intervention: Device: enzyme linked immunosorbent assay (ELISA)
Sponsor: Cairo University
Not yet recruiting
https://ift.tt/2R1Qe05
Interferon Gamma and Interleukin 8 Gene Polymorphisms in Patients with Hepatitis C virus related Oral Lichen Planus
Publication date: Available online 26 September 2018
Source: Archives of Oral Biology
Author(s): Noha A. Azab, Lobna Abd El Salam, Enji Ahmed, Marwa El Sharkawy, Aisha ElSharkawy, Shahira G. El Asheiry
Abstract
Objectives
This study aimed to determine the association of rs2430561 and rs4073 polymorphisms in the Interferon gamma (IFN-ɤ) and Interleukin 8 (IL-8) genes, respectively, with hepatitis C virus-related oral lichen planus and disease severity.
Design
This is a case-control study. 60 subjects were equally divided into patients with and without oral lichen planus. They were further subdivided into hepatitis C virus seropositive and seronegative patients. All patients were genotyped for IFN-γ rs2430561 thymine to adenine (T > A) and IL-8 rs4073 adenine to thymine (A > T) polymorphisms. All patients with oral lichen planus had their lesions measured and documented using the Escudier scoring system.
Results
Disease activity was significantly higher in the "oral lichen planus/hepatitis C virus-positive" patients than in the "oral lichen planus/hepatitis C virus-negative" patients (P = 0.003). IFN-γ rs2430561 T > A and IL-8 rs4073 A > T genotypes and allele frequencies were not associated with the oral lichen planus group or the normal group. Stratification of the two groups into HCV and non-HCV-infected patients or into erosive and non-erosive types revealed no significant associations. The "A-allele-containing" genotypes of IL-8 rs4073 A > T were significantly more prevalent in the patients with oral lichen planus than in those without.
Conclusion
Hepatitis C virus infection is associated with the development of erosive oral lichen planus. The A-allele of IL-8 rs4073 A > T may have a role in the development and progression of oral lichen planus.
https://ift.tt/2OTAGdr
Evaluation of immunophenotyping, proliferation and osteogenic differentiation potential of SSEA-4 positive stem cells derived from pulp of deciduous teeth
Publication date: Available online 26 September 2018
Source: Archives of Oral Biology
Author(s): Farzaneh Aghajani, Somaieh Kazemnejad, Tabassom Hooshmand, Zahra Ghaempanah, Amir-Hassan Zarnani
Abstract
Objectives
Despite the increased interest in stem cells isolated from remnant pulp of deciduous teeth, no specific marker has been yet established for them. The present study aimed to investigate whether SSEA-4 (stage-specific embryonic antigen) would be a suitable marker to isolate stem cells from Human Exfoliated Deciduous teeth (SHEDs) in order to increase its differentiation potential toward osseous tissue.
Design
The SHEDs were isolated and the expression patterns of mesenchymal, hematopoietic and embryonic stem cell markers were assessed. The cells were then divided into two groups of SSEA-4(+) and unsorted SHEDs and the cell proliferation rate and population-doubling-time (PDT) were calculated. Subsequently, the differentiation potentials were examined through alizarin-red staining and Quantitative real time-PCR (qRT-PCR).
Results
Isolated cells were spindle-shaped with a high expression of mesenchymal stem cell markers and weak expression of hematopoietic markers. The mean expression of Oct-4 was 68.77%±1.28. Despite similar proliferation rates between SSEA-4(+) and unsorted SHEDs, because of differences in the shape of the growth curves, PDT was lower in unsorted SHEDs (P = 0.2 × 10-4). Alizarin-red staining showed similar calcium deposition in both groups. Upon differentiation, the expression of osteocalcin was higher in unsorted SHEDs (P = 0.043), while, the expression of alkaline phosphatase was lower (P<0.001). The parathyroid hormone receptor (PTHR) expression was not significantly different (P = 0.0625).
Conclusions
The results of the present study revealed that SHEDs have high differentiation potentials even in the unsorted cells. Although, the SSEA-4-positive SHEDs showed slightly better osteogenic potential, the differences were not abundant to link SSEA-4 expression with superior differentiation potency.
https://ift.tt/2zzTJUU
Management of spontaneous temporal bone cerebrospinal fluid leak: A 30-year experience
Publication date: Available online 26 September 2018
Source: American Journal of Otolaryngology
Author(s): Esther Cheng, David Grande, John Leonetti
Abstract
Purpose
The goal of this study was to describe the incidence of and our long-term results in the management of spontaneous temporal bone CSF leak and to determine if there is any association with an increase in body mass index (BMI).
Methods
This was an Institutional Review Board (IRB) approved retrospective review of 58 patients who underwent repair of spontaneous temporal bone CSF leaks by a single surgeon at a tertiary care academic medical center between 1988 and 2017. Patients with CSF leaks due to trauma, iatrogenic injury, or chronic infection were excluded. Surgical approaches included middle cranial fossa, transmastoid, or a combination of both. Cases were divided into three decades. Patient demographics, clinical features, audiologic results, imaging studies, operative findings, complications, and long-term results were reviewed with a specific emphasis on the potential correlation with BMI.
Results
The average BMI was 32. There was a statistically significant increase in BMI between the two most recent decades (p = 0.044). The middle cranial fossa was the most commonly utilized approach. Multiple tegmen defects were often noted on imaging and intraoperatively.
Conclusion
There is an increase in the incidence of spontaneous CSF leaks possibly associated with an increase in BMI in the United States over the last 30 years.
https://ift.tt/2DzYL7E
Audiological outcomes in sudden sensorineural hearing loss with presumed inner ear hemorrhage
Publication date: Available online 26 September 2018
Source: American Journal of Otolaryngology
Author(s): Kaitian Chen, Lanying Wen, Ling Zong, Min Liu, Jincangjian Sun, Xuan Wu
Abstract
Objective
To explore the hearing outcomes and prognostic factors in patients with sudden sensorineural hearing loss resulting from inner ear hemorrhage.
Methods
42 patients (22 male and 20 female) were recruited from January 2016 to December 2017. Intravenous methylprednisolone and/or intratympanic corticosteroid were used as salvage therapy. The main measures included systemic risk factors and audiometric outcomes as proposed by American Academy of Otolaryngology-Head and Neck Surgery Hearing Loss Scale. All individuals were assessed at baseline, discharge (2 weeks post-treatment) and at 1, 3 and 6 months.
Results
The mean ages of patients were 39.3 ± 14.8 yrs. Cardiovascular disorders were seen in 19.0–33.3% of cases. Restoration of hearing and speech discrimination abilities were assessed at the first month post-treatment versus initial levels (95.5 ± 15.5 vs. 109.2 ± 9.6 dB, p = 0.000; and 17.6 ± 24.4 vs. 1.3 ± 4.0%, p = 0.003, respectively). Word recognition scores continued to recover at month 6 (38.7 ± 35.4%, p = 0.000), whereas puretone ceased to change (90.8 ± 16.2 dB, p = 0.139). The final percentages of complete, partial and no recovery were 0%, 57.1% and 42.9% respectively. The prognosis was independent of accompanying systemic risk factors as analyzed in this study. Intratympanic intervention was associated with improved word recognition scores, although intravenous corticosteroid was not.
Conclusions
Profound sudden sensorineural hearing loss caused by inner ear hemorrhage often has an unsatisfactory prognosis. However, this cohort did experience partial audiological recovery with delayed onset. Immediate and effective intratympanic corticosteroid may have therapeutic potential for this intractable disease.
https://ift.tt/2R0ZQIl
CD8+iTregs attenuate glomerular endothelial cell injury in lupus-prone mice through blocking the activation of p38 MAPK and NF-κB
Publication date: November 2018
Source: Molecular Immunology, Volume 103
Author(s): Ya Liu, Weijuan Deng, Qiaoyun Meng, Xiaonan Qiu, Dong Sun, Chun Dai
Abstract
Systemic lupus erythematosus (SLE) is a chronic inflammatory disease. Endothelial cell injury plays an important role in the inflammatory processes associated with SLE. CD4+Foxp3+regulatory T cells (Tregs) reduce the injury to endothelial cells induced by inflammatory factors. As a newly identified regulatory T cell, we previously reported that CD8+CD103+iTregs had similar effects to those of CD4+iTregs in the process of immunoregulation. In this paper, we further explored the effect and mechanism of CD8+iTregs on endothelial cell injury. The expressions of vascular cellular adhesion molecule-1 (VCAM-1), intracellular adhesion molecule-1 (ICAM-1), interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1) in MRL/lpr mouse glomerular endothelial cells (lupus-MGECs) were estimated by quantitative real-time polymerase chain reaction, enzyme-linked immunosorbent assay and Western blotting. The lupus-MGEC apoptosis rate was detected by flow cytometry and the adhesion of monocyte-like cells to lupus-MGECs exposed to lipopolysaccharide (LPS) was determined by the adhesion assay. Additionally, the expressions of P-p38, P-NF-κB and P-IκBα were detected by Western blotting. The results showed that LPS increased the expressions of VCAM-1, ICAM-1, IFN-γ, TNF-α, IL-6 and MCP-1 in lupus-MGECs, while CD8+iTregs significantly decreased the levels of these adhesion molecules and inflammatory mediators. Furthermore, CD8+iTregs alleviated lupus-MGEC apoptosis and inhibited the adhesion of monocyte-like cells to lupus-MGECs. Both nuclear factor-κB (NF-κB) and p38 mitogen-activated protein kinase (MAPK), activated by LPS, were suppressed by CD8+iTregs. These findings suggest that CD8+iTregs attenuate LPS-induced glomerular endothelial cell injury through blocking the activation of p38 MAPK and NF-κB in lupus-MGECs. The protective effect of CD8+iTregs indicates their possible therapeutic application in Lupus nephritis.
https://ift.tt/2DBh2Si
Evaluation of interleukin-12 receptor β1 and interferon gamma receptor 1 deficiency in patients with disseminated BCG infection
Publication date: Available online 27 September 2018
Source: Allergologia et Immunopathologia
Author(s): B. Pourakbari, R. Hosseinpour Sadeghi, S. Mahmoudi, N. Parvaneh, S. Keshavarz Valian, S. Mamishi
Abstract
Introduction
Disseminated BCG infections among other complications of Bacillus Calmette–Guérin (BCG) vaccine are rare and have occurred in children with immunodeficiency disorders such as mendelian susceptibility to mycobacterial disease (MSMD) which could be due to defects in some elements of IL-12/IFN-γ axis. MSMD-causing mutations have been identified in 10 genes during the last two decades. Among them, mutations in the IL12Rβ1 and IFNγR1 genes constitute about 80% of recorded cases of MSMD syndrome. The aim of this study was to investigate IL-12Rβ1 and IFN-γR1 deficiencies in patients with disseminated BCG infection.
Methods
This study was performed on 31 children with disseminated BCG infections who referred to children's medical center. Whole blood cell culture was performed in presence of BCG, IL-12 and IFN-γ stimulators. The supernatants were assayed for IFN-γ and IL-12p70 by ELISA method. In order to evaluate IL12Rβ1 and IFN-γR1 receptors expression, flow cytometry staining was performed on the patients' T-cells stimulated with PHA.
Results
Flow cytometry staining of 31 Iranian patients with disseminated BCG infections with the average age of 43 months showed lack of the expression of IL-12Rβ1 and IFN-γR1 genes in PHA-T-cells of the nine and one patients, respectively in whom the incomplete production of IFN-γ and IL-12 was reported by ELISA. Among these 10 patients, eight cases had related parents (80%).
Conclusion
It is recommended that to avoid BCG complications, screening be performed for MSMD before BCG inoculation in individuals with positive family history of primary immunodeficiency diseases and inhabitants of areas with high frequency of consanguinity.
https://ift.tt/2NIQR0H
Association of M470V polymorphism of CFTR gene with variability of clinical expression of asthma: Case-report study
Publication date: Available online 27 September 2018
Source: Allergologia et Immunopathologia
Author(s): Imen Wahabi, Sondess Hadj Fredj, Malek Nefzi, Rym Dabboubi, Hajer Siala, Fatma Khalsi, Khedija Bousetta, Taieb Messaoud
Abstract
Introduction and Objectives
Asthma is a complex genetic disorder. Several genes have been found associated with asthma. The cystic fibrosis transmembrane conductance regulator (CFTR) gene is one of them. The aim of this study was to perform a comparative analysis of the genotype and allele frequency distributions of the biallelic marker M470V within the CFTR gene on mutant and wide chromosomes.
Patients and methods
The molecular approach consists in the genotyping of the M470V marker by the PCR-RFLP technique in 105 asthmatic patients, aged between four months and 17 years, and 105 healthy subjects.
Results
We found a significant difference in the genotype frequencies between the two studied groups (χ2 = 9.855, P = 0.007). The V/V genotype was over represented in the asthmatic group as compared to the controls (32.38% vs. 16.19%). Whereas, the M/V genotype is more frequent in healthy subjects (40.95% vs. 28.71%). We also noted a significant difference in allelic distribution of M470V with associated diseases (χ2 = 9.610, P = 0.022).
Conclusions
The present study is the first report on the distribution of the M470V polymorphism in asthmatic Tunisian patients. We noticed that the M470V variant could modulate the clinical phenotype of asthmatic patients. This preliminary study will establish the molecular basis of this disease in Tunisia.
https://ift.tt/2IpXMpH
Current therapeutic paradigm in pediatric atopic dermatitis: Practical guidance from a national expert panel
Publication date: Available online 26 September 2018
Source: Allergologia et Immunopathologia
Author(s): A. Chiricozzi, A. Belloni Fortina, E. Galli, G. Girolomoni, I. Neri, G. Ricci, M. Romanelli, D. Peroni
Abstract
Introduction and Objectives
Atopic dermatitis (AD) is the most common cutaneous inflammatory disease in both adults and children. Although emerging therapeutic approaches are being investigated for the management of pediatric AD, it still needs to be managed with conventional treatments. This consensus document is aimed at providing an update on general management and therapies of pediatric AD, defining practical recommendations for using both topical and systemic agents.
Material and Methods
A panel of experts consisting of dermatologists and pediatricians were convened in order to define statements, through a Delphi process, standardizing the management of AD in pediatric subjects in a real-world setting.
Results
A set of practical recommendations obtaining an at least 75% agreement was presented.
Conclusions
This set of practical recommendations represents a simple and fast snapshot on the pediatric use of common anti-AD therapeutics.
https://ift.tt/2NMpLFK
Laser-assisted photodynamic therapy for actinic keratosis: A systematic review and meta-analysis
Publication date: Available online 27 September 2018
Source: Journal of the American Academy of Dermatology
Author(s): Theresa Steeb, Justin Gabriel Schlager, Christoph Kohl, Thomas Ruzicka, Markus V. Heppt, Carola Berking
Abstract
Background
Photodynamic therapy (PDT) is an effective intervention for actinic keratosis (AK) and field-cancerization. Ablative fractional laser may facilitate the delivery of photosensitizers and thereby improve the effects of PDT.
Objective
To summarize the current evidence on the efficacy and safety of laser-assisted PDT.
Methods
We performed a systematic literature research in Medline, Embase, and CENTRAL and hand-searched pertinent trial registers for eligible randomized controlled trials (RCTs). Results from individual studies were pooled using a random-effects model. The risk of bias was estimated with the Cochrane Risk of Bias Tool and the quality of evidence of the outcomes with the GRADE approach.
Results
Out of 817 records initially identified, 7 RCTs were included in the qualitative analysis and 4 in the meta-analysis. Laser-assisted PDT showed significantly higher clearance rates compared to PDT monotherapy (risk ratio 1.33, 95% CI 1.24 to 1.42, I2=25%, p<0.01). There was no difference in pain intensity between laser-assisted PDT and other interventions (mean difference 0.31, 95% CI to 0.12 to 0.74, I2=0%, p=0.16). The included studies showed a high risk of bias.
Limitations
The clinical heterogeneity of included studies.
Conclusion
Laser-assisted PDT is more efficient but not more painful than PDT or laser treatment only.
https://ift.tt/2OTOWCV
Results of a nationwide epidemiologic survey of autosomal recessive congenital ichthyosis and ichthyosis syndromes in Japan
Publication date: Available online 26 September 2018
Source: Journal of the American Academy of Dermatology
Author(s): Michiko Kurosawa, Ritei Uehara, Atsushi Takagi, Yumi Aoyama, Keiji Iwatsuki, Masayuki Amagai, Masaki Nagai, Yosikazu Nakamura, Yutaka Inaba, Kazuhito Yokoyama, Shigaku Ikeda
Background
Autosomal recessive congenital ichthyosis (ARCI) and ichthyosis syndrome (IS) are rare genetic skin disorders.
Objective
To estimate the number of patients with ARCI and IS in Japan and clarify the clinicoepidemiologic features of these diseases.
Methods
We performed a nationwide survey of patients treated for ARCI or IS during January 2005-December 2009. We developed diagnostic criteria and conducted a primary survey in a stratified random sample of Japanese hospitals to quantify the number of outpatients and inpatients with ARCI or IS. We performed a secondary survey of clinicoepidemiologic features in positive cases.
Results
The estimated number of patients receiving treatment for ARCI and IS during 2005-2009 was 220 (95% confidence interval [CI] 180-260). The estimated disease distribution was as follows: 95 (95% CI 80-110) patients with nonbullous congenital ichthyosiform erythroderma, 30 (95% CI 20-40) with lamellar ichthyosis, 15 (95% CI 10-20) with harlequin ichthyosis, and 85 (95% CI 50-120) with IS.
Limitations
Patients with a mild case of the disease might not have visited a dermatology department, potentially causing underestimation of affected patients.
Conclusion
We report the estimated number of patients with ARCI and IS in Japan and sex differences in the age distribution.
https://ift.tt/2OfqlLH
Attenuating anger and aggression with neuromodulation of the vmPFC: a simultaneous tDCS-fMRI study
Publication date: Available online 27 September 2018
Source: Cortex
Author(s): Gadi Gilam, Rany Abend, Guy Gurevitch, Alon Erdman, Halen Baker, Ziv Ben-Zion, Talma Hendler
Abstract
Angry outbursts during interpersonal provocations may lead to violence and prevails in numerous pathological conditions. In the anger-infused Ultimatum Game (aiUG), unfair monetary offers accompanied by written provocations induce anger. Rejection of such offers relates to aggression, whereas acceptance to anger regulation. We previously demonstrated the involvement of the ventro-medial prefrontal cortex (vmPFC) in accepting unfair offers and attenuating anger during an aiUG, suggestive of its role in anger regulation. Here, we aimed to enhance anger regulation by facilitating vmPFC activity during anger induction, using anodal transcranial direct current stimulation (tDCS) and simultaneously with functional Magnetic Resonance Imaging to validate modulation of vmPFC activity. In a cross-over, sham-controlled, double-blind study, participants (N=25) were each scanned twice, counterbalancing sham and active tDCS applied during administration of the aiUG. Outcome measures included the effect of active vs. sham stimulation on vmPFC activity, unfair offers' acceptance rates, self-reported anger, and aggressive behavior in a subsequent reactive aggression paradigm. Results indicate that active stimulation led to increased vmPFC activity during the processing of unfair offers, increased acceptance rates of these offers, and mitigated the increase in self-reported anger following the aiUG. We also noted a decrease in subsequent aggressive behavior following active stimulation, but only when active stimulation was conducted in the first experimental session. Finally, an exploratory finding indicated that participants with a stronger habitual tendency to use suppression as an emotion regulation strategy, reported less anger following the aiUG in the active compared to sham stimulation conditions. Findings support a potential causal link between vmPFC functionality and the experience and expression of anger, supporting vmPFC's role in anger regulation, and providing a promising avenue for reducing angry and aggressive outbursts during interpersonal provocations in various psychiatric and medical conditions.
https://ift.tt/2xGgq8w
Rest on it: Awake quiescence facilities insight
Publication date: Available online 27 September 2018
Source: Cortex
Author(s): Michael Craig, Georgina Ottaway, Michaela Dewar
Abstract
Many scientific discoveries have been explained by a sudden gaining of insight with regards to an ongoing problem. Insight is characterised by a mental restructuring of acquired information, from which new explicit knowledge can be drawn, leading to qualitative changes in behaviour. Extended sleep facilitates the gaining of insight, possibly because it is conducive to the stabilisation and restructuring of new memory representations via consolidation. Research shows that a brief period of awake quiescence (quiet resting), too, can support consolidation: people remember more new memories if they quietly rest for several minutes after encoding than if they engage in a task involving ongoing sensory input after encoding. However, it remains unknown whether awake quiescence inspires insight. Using a number-based problem-solving task (the Number Reduction Task – 'NRT'), we reveal that, like sleep, awake quiescence facilitates the rapid gaining of insight: young adults were more than twice as likely to demonstrate new explicit knowledge of a hidden solution to the NRT if initial exposure to this task was followed by 10 minutes of awake quiescence than an unrelated perceptual task. These findings indicate that, at least for the NRT, the development of insight is not restricted to sleep but can be achieved via a brief period of awake quiescence. Thus, contrary to conventional wisdom and theories, when faced with a novel problem we may not always need to 'sleep on it' to find a novel solution, simply 'resting on it' may be enough.
https://ift.tt/2ORMxIM
Regeneration of Pancreatic β-Islet Cells in a Type-II Diabetic.
| Related Articles |
Regeneration of Pancreatic β-Islet Cells in a Type-II Diabetic.
Case Rep Endocrinol. 2018;2018:6147349
Authors: Jones EC, Rylands JC, Jardet CL
Abstract
A case report is presented in which a type-II diabetic patient significantly improved his dysfunctional β-islet cells using a combination of a strenuous exercise program, cyclical ketogenic diet, and oral GABA/probiotic supplementation. The patient was diagnosed with type-II diabetes at the age of 41 which then progressed through a typical series of treatment changes over 14 years. Treatment periods consisted of metformin therapy alone for 4 years followed by a metformin/glyburide combination therapy for 6 years, and eventually an insulin/metformin combination therapy for 4 years. One year after the initiation of insulin, the patient increased the level of strenuous physical activity (hiking and weight lifting) and adopted a ketogenic diet. Oral GABA and probiotic supplementation were also initiated at the age of 52.7. By the age of 55, the patient no longer required any insulin and is currently being managed with metformin alone. C-peptide values indicate a functional improvement of the β-islet cells during the time of insulin/GABA/probiotic treatment.
PMID: 30254769 [PubMed]
https://ift.tt/2P0DdlO
Lateral Proboscis (Elephant Tusk) with Orofacial Clefts: A Report of a Rare Case
Lateral proboscis is a rare congenital anomaly. Lateral proboscis is a rare craniofacial malformation characterized by a rudimentary tubular, nose-like structure occurring in association with a wide spectrum of other anomalies. We presented a seven-month-old girl's lateral proboscis, cleft lip, and palate. Proboscis was excised by an elliptical incision, and the cleft was repaired at the same surgery.
https://ift.tt/2xS4nUH
Coexistence of mucous membrane pemphigoid, vitiligo, and hypothyroidism: A second report of a new multiple autoimmune syndrome
Dermatologic Therapy, EarlyView.
https://ift.tt/2N5nrEO
Coexistence of mucous membrane pemphigoid, vitiligo, and hypothyroidism: A second report of a new multiple autoimmune syndrome
Dermatologic Therapy, EarlyView.
https://ift.tt/2N5nrEO
Silicone breast implant associated fibromatosis
Abstract
Extra-abdominal desmoid tumors, also known as aggressive or deep fibromatosis, are uncommon soft tissue tumors that rarely involve the breast. Although the exact etiology is unknown, the development of these tumors has been correlated with sites of previous trauma, surgery or in association with familial adenomatous polyposis. Clinically, breast fibromatosis is often mistaken for carcinoma but lacks metastatic potential. It is locally aggressive with high rates of recurrence. The treatment is primarily wide local excision with negative margins. Adjuvant treatments have been suggested and include radiotherapy, chemotherapy and hormonal therapy, however, there are no evidence-based treatment protocols to support their use. Here, we describe a case of fibromatosis that developed within the capsule around a silicone breast implant treated with surgical excision alone. The patient remains recurrence free at 3 months post-operative magnetic resonance imaging.https://ift.tt/2OY3qBS
Nomograms for incident risk of postpartum type 2 diabetes in Chinese women with prior gestational diabetes mellitus
Clinical Endocrinology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2R2k8kP
Serum testosterone, sex hormone‐binding globulin and sex‐specific risk of incident type 2 diabetes in a retrospective primary care cohort
Clinical Endocrinology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2xTU8zo
Neuroendocrine Regulation of Reproduction, Stress, Inflammation and energy Homeostasis
Journal of Neuroendocrinology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2xWEm70
Nagashima‐type palmoplantar keratoderma and malignant melanoma in Japanese patients
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2zxgE39
Physicochemical, morphological, and biological analyses of Ti-15Mo alloy surface modified by laser beam irradiation
Abstract
Perform a physicochemical and morphological characterization of a Ti-15Mo alloy surface modified by laser beam irradiation and to evaluate in vitro the morphological response and proliferation of osteoblastic cells seeded onto this alloy. Disks were made of two different metals, Ti-15Mo alloy and cpTi, used as control. A total of four groups were evaluated: polished cpTi (cpTi-pol), laser-irradiated cpTi (cpTi-L), polished Ti-15Mo alloy (Ti-15Mo-pol), and laser-irradiated Ti-15Mo alloy (Ti-15Mo-L). Before and after laser irradiation of the surfaces, physicochemical and morphological analyses were performed: scanning electron microscopy (FEG-SEM), energy-dispersive spectroscopy (EDX), and X-ray diffraction (XRD). The wettability of the samples was evaluated by contact angle measurement. Murine preosteoblastic cells MC3T3-E1 were cultured onto the experimental disks for cell proliferation, morphology, and spreading analyses. Laser groups presented irregular-shaped cavities on its surface and a typical microstructured surface with large depressions (FEG-SEM). The contact angle for both laser groups was 0°, whereas for the polished groups was ≈ 77 and ≈ 78 for cpTi-pol and Ti-15Mo-pol, respectively. Cell proliferation analysis demonstrated a higher metabolic activity in the laser groups (p < 0.05). From the fluorescence microscopy, Ti-15Mo-L surface seems to induce greater cellular differentiation compared to the cpTi-L surface. The preliminary biological in vitro analyses suggested possible advantages of laser surface treatment in the Ti-15Mo alloy regarding cell proliferation and maturation.
https://ift.tt/2IjFuGt
Nagashima‐type palmoplantar keratoderma and malignant melanoma in Japanese patients
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
https://ift.tt/2zxgE39
Enamel matrix derivative for the treatment of partially contained intrabony defects: 12‐month results
Australian Dental Journal, Volume 0, Issue ja, -Not available-.
https://ift.tt/2QeBUQL
Emerging Insights into the Occupational Mycobiome
Abstract
Purpose of Review
The evolution of molecular-based methods over the last two decades has provided new approaches to identify and characterize fungal communities or "mycobiomes" at resolutions previously not possible using traditional hazard identification methods. The recent focus on fungal community assemblages within indoor environments has provided renewed insight into overlooked sources of fungal exposure. In occupational studies, internal transcribed spacer (ITS) region sequencing has recently been utilized in a variety of environments ranging from indoor office buildings to agricultural commodity and harvesting operations.
Recent Findings
Fungal communities identified in occupational environments have been primarily placed in the phylum Ascomycota and included classes typically identified using traditional fungal exposure methods such as the Eurotiomycetes, Dothideomycetes, Sordariomycetes, and Saccharomycetes. The phylum Basidiomycota has also been reported to be more prevalent than previously estimated and ITS region sequences have been primarily derived from the classes Agaricomycetes and Ustilaginomycetes. These studies have also resolved sequences placed in the Basidiomycota classes Tremellomycetes and Exobasidiomycetes that include environmental and endogenous yeast species.
Summary
These collective datasets have shown that occupational fungal exposures include a much broader diversity of fungi than once thought. Although the clinical implications for occupational allergy are an emerging field of research, establishing the mycobiome in occupational environments will be critical for future studies to determine the complete spectrum of worker exposures to fungal bioaerosols and their impact on worker health.
https://ift.tt/2xSCfky
Beware what lies beneath: a case of a gigantic cutaneous squamous cell carcinoma
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2zxfWTx
Herpes vegetans in a human immunodeficiency virus‐negative kidney transplant patient
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2Qas2aw
Widespread vegetating ulcers
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2zxxgrj
Risk factors associated with frontal fibrosing alopecia: a multicentre case–control study
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2QarRfm
Diabetic scleroedema successfully treated by topical hyaluronidase injection: efficacy of magnetic resonance imaging
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2zyGmEg
Successful treatment of PAPA syndrome with minocycline, dapsone, deflazacort and methotrexate: a cost‐effective therapy with a 2‐year follow‐up
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2OfpJFH
Beware what lies beneath: a case of a gigantic cutaneous squamous cell carcinoma
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2zxfWTx
Herpes vegetans in a human immunodeficiency virus‐negative kidney transplant patient
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2Qas2aw
Widespread vegetating ulcers
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2zxxgrj
Risk factors associated with frontal fibrosing alopecia: a multicentre case–control study
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2QarRfm
Diabetic scleroedema successfully treated by topical hyaluronidase injection: efficacy of magnetic resonance imaging
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2zyGmEg
Successful treatment of PAPA syndrome with minocycline, dapsone, deflazacort and methotrexate: a cost‐effective therapy with a 2‐year follow‐up
Clinical and Experimental Dermatology, EarlyView.
https://ift.tt/2OfpJFH
Emerging Insights into the Occupational Mycobiome
Abstract
Purpose of Review
The evolution of molecular-based methods over the last two decades has provided new approaches to identify and characterize fungal communities or "mycobiomes" at resolutions previously not possible using traditional hazard identification methods. The recent focus on fungal community assemblages within indoor environments has provided renewed insight into overlooked sources of fungal exposure. In occupational studies, internal transcribed spacer (ITS) region sequencing has recently been utilized in a variety of environments ranging from indoor office buildings to agricultural commodity and harvesting operations.
Recent Findings
Fungal communities identified in occupational environments have been primarily placed in the phylum Ascomycota and included classes typically identified using traditional fungal exposure methods such as the Eurotiomycetes, Dothideomycetes, Sordariomycetes, and Saccharomycetes. The phylum Basidiomycota has also been reported to be more prevalent than previously estimated and ITS region sequences have been primarily derived from the classes Agaricomycetes and Ustilaginomycetes. These studies have also resolved sequences placed in the Basidiomycota classes Tremellomycetes and Exobasidiomycetes that include environmental and endogenous yeast species.
Summary
These collective datasets have shown that occupational fungal exposures include a much broader diversity of fungi than once thought. Although the clinical implications for occupational allergy are an emerging field of research, establishing the mycobiome in occupational environments will be critical for future studies to determine the complete spectrum of worker exposures to fungal bioaerosols and their impact on worker health.
https://ift.tt/2xSCfky
WhatsApp platforms in tropical public health resource‐poor settings
International Journal of Dermatology, EarlyView.
https://ift.tt/2xQxE2d
Periodontal Disease in Women and Men
Abstract
Purpose of Review
This manuscript will present a narrative review of the distribution of periodontitis in women and men based on recent epidemiological studies.
Recent Findings
Large, global, population-based surveys provide continued evidence that a sexual dimorphism in prevalence of periodontitis exists between women and men. Based on included studies, the prevalence of severe periodontitis is greater in men compared to women by between 4.6 to 12.7%. Environmental or behavioral factors that exhibit a sex differential between women and men do not adequately account for the aforementioned observation. A sex dimorphism in host immune response remains a plausible explanation and requires further investigation.
Summary
There is a sexual dimorphism in susceptibility to periodontitis, reflecting a higher prevalence of destructive periodontal disease in men than women.
https://ift.tt/2R23jqb
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