Head and Neck Diseases by Alexandros G.Sfakianakis: 09/28/18

Παρασκευή 28 Σεπτεμβρίου 2018

A Retrospective Study to Assess the Role of Using Fine Needle Aspiration Cytology and Frozen Section in the Diagnosis of Thyroid Swelling

Abstract

The most cost-effective test is fine needle aspiration cytology (FNAC). Many surgeons use intraoperative frozen section to confirm the FNAC findings and to guide the extent of thyroid surgery. Though it is a valuable tool in the diagnosis of the thyroid lesion and determining the extent of thyroid surgery, still in certain cases diagnosis can be incorrect or inconclusive, so histopathology of the excised specimen remains the most reliable test. The purpose of this study will be to compare the result attained by FNAC and frozen section of the thyroid to the final histopathological diagnosis, in order to establish their role in thyroid surgery today. A retrospective study with a total of 140 patients who underwent thyroid surgery at the ENT department, of a tertiary hospital in coastal Karnataka. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for FNAC and frozen section. The sensitivity, specificity, positive predictive rate, and negative predictive rate of frozen section was found to be 66.7%, 88.4%,76.6%, 82.4% respectively for detecting malignancy. This was found to be higher than the results of FNAC for the same which were 64.4%, 77.8%, 64.4%, 77.8% respectively. As the sensitivity of FNAC is similar to frozen section in detecting malignant cases, FNAC is a good tool for screening the patient for determining malignancy in thyroid, but frozen section is more specific in confirming the malignancy.

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Two Cases of Lingual Arteriovenous Malformations with Comorbidities Treated by Glue Embolization: A Report with Review of Literature

Abstract

Arteriovenous malformations (AVMs) involving the tongue are uncommon lesions in the head and neck region. They present with bleeding that can be massive and life-threatening apart from debilitating symptoms of pain, ulcers, difficulty in phonation or swallowing. Various therapeutic approaches have been used in their management—surgery, endovascular embolization, radiation and ablation procedures like laser ablation. We report two patients—a 34 year-old man and 56 year-old female who presented with massive bleeding due to lingual AVM and had comorbidities as liver cirrhosis and chronic medical renal disease respectively, and treated with glue embolization, with a review of the literature.

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Long Term Oncological Results of Transoral Laser Microsurgery for Early and Moderately Advanced Glottic Carcinoma in Primary and Salvage Settings

Abstract

The aim of the study is to document the long term oncological results of trans-oral laser microsurgery (TLM) for early and moderately advanced glottic cancer in primary and salvage settings. In this prospective cohort study 43 consecutive patients of glottic cancer (T1–30, T2–7, and selected T3 with mobile cords-6) were recruited. TLM was performed in these 35 primary and 8 previously treated cases. In our series, the local disease control rate with TLM was 90% (27/30) for T1 disease, 71.4% (5/7) for T2 cancer and 66.6% (4/6) for T3 lesions. The overall disease control rates after subsequent treatment for locoregional recurrences were 100% (30/30), 85.7% (6/7) and 83.3% (5/6) for T1, T2, and T3 glottic cancers respectively. The 5-years disease free survival rate for primary cases was 100% and 50% for salvage cases. The 5-years local disease control rate was 96.4% and 41.67% in primary and salvage TLM settings respectively. The 5-years laryngectomy free rates were 96.3% and 18.75% for primary and salvage cases respectively. TLM offers a minimally invasive and oncologically robust treatment option for early glottic cancer with an overall disease free survival of 100% at 5 years noted for primary untreated cases in this experience. TLM for post radiation salvage cases has however been disappointing and alternate larynx preserving option of open partial laryngectomy needs to be considered in this setting.

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Rab14 overexpression regulates gemcitabine sensitivity through regulation of Bcl-2 and mitochondrial function in pancreatic cancer

Abstract

Rab family protein Rab14 has been implicated in the development of human cancers. To date, its expression pattern, biological function, and potential mechanism in pancreatic cancer have not been explored. In this study, we analyzed Rab14 expression in 103 cases of pancreatic cancer tissues using immunohistochemistry (IHC) and found that Rab14 was overexpressed in 41/103 cases (39.8%). Rab14 overexpression correlated with the advanced stage. Moreover, elevated Rab14 levels indicated poor prognosis of patients with pancreatic cancers. We used BxPC-3 and Capan-2 respectively for plasmid and siRNA transfection. MTT and colony formation assays showed that Rab14 transfection increased cell proliferation and colony formation in BxPC-3 cells. Rab14 siRNA knockdown inhibits proliferation and colony formation ability in Capan-2 cell line. Cell cycle analysis showed that Rab14 facilitated cell cycle progression. Matrigel invasion assay showed that Rab14 promoted BxPC-3 cell invasion while its depletion inhibited Capan-2 cell invasion. In addition, MTT and AnnexinV/PI analysis demonstrated that overexpression of Rab14 reduced gemcitabine sensitivity which conversely was increased by Rab14 knockdown. We also demonstrated that Rab14 upregulated mitochondrial membrane potential (MMP) while its depletion downregulated MMP during gemcitabine treatment. In addition, western blotting revealed that Rab14 overexpression upregulated cyclin D1, cyclin A, cyclin E, p-Rb, and Bcl-2 and downregulated p21. Rab14 also downregulated caspase3, PARP cleavage, and cytochrome c release. In conclusion, our data indicated that Rab14 was overexpressed in pancreatic cancer and promotes growth and gemcitabine resistance, possibly through regulation of mitochondrial function and Bcl-2.

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miR-26b Inhibits Virus Replication Through Positively Regulating Interferon Signaling

Viral Immunology, Ahead of Print.

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A Patient‐Reported Outcome Instrument to Assess Symptom Burden and Predict Survival in Patients with Advanced Cancer: Flipping the Paradigm to Improve Timing of Palliative and End‐of‐Life Discussions and Reduce Unwanted Health Care Costs

AbstractBackground.Discussions regarding palliative care and end‐of‐life care issues are frequently delayed past the time of usefulness, resulting in unwanted medical care. We sought to develop a patient‐reported outcome (PRO) instrument that allows patients to voice their symptom burdens and facilitate timing of discussions.Subjects, Materials, and Methods.A seven‐item PRO instrument (Cota Patient Assessed Symptom Score‐7 item [CPASS‐7]) covering physical performance status, pain, burden, and depression was administered (September 2015 through October 2016) with correlation to overall survival, correcting for time to complete survey since diagnosis.Results.A total of 1,191 patients completed CPASS‐7 at a median of 560 days following the diagnosis of advanced cancer. Of these patients, 49% were concerned that they could not do the things they wanted; 35% reported decreased performance status. Financial toxicity was reported by 39% of patients, with family burdens noted in 25%. Although depression was reported by 15%, 43% reported lack of pleasure. Pain was reported by 33%. The median CPASS‐7 total symptom burden score was 16 (possible 0–112). With a median follow‐up of 15 months from initial survey, 46% had died. Patients with symptom burden scores <29 and ≥29 had a 6‐month overall survival rate of 87% and 67%, respectively, and 12‐month survival rates of 72% and 50%. A one‐point score increase resulted in a 1.8% increase in expected hazard.Conclusion.Patients with advanced cancer with higher levels of symptom burden, as self‐reported on the CPASS‐7, had inferior survival. The PRO facilitates identification of patients appropriate for reassessment of treatment goals and potentially palliative and end‐of‐life care in response to symptom burden concerns.Implications for Practice.A seven‐item patient‐reported outcome (PRO) instrument was administered to 1,191 patients with advanced cancers. Patients self‐reporting higher levels of physical and psychological symptom burden had inferior overall survival rates. High individual item symptom PRO responses should serve as a useful trigger to initiate supportive interventions, but when scores indicate global problems, discussions regarding end‐of‐life care might be appropriate.

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A Randomized Phase II Trial (TAMIGA) Evaluating the Efficacy and Safety of Continuous Bevacizumab Through Multiple Lines of Treatment for Recurrent Glioblastoma

AbstractBackground.We assessed the efficacy and safety of bevacizumab (BEV) through multiple lines in patients with recurrent glioblastoma who had progressed after first‐line treatment with radiotherapy, temozolomide, and BEV.Patients and Methods.TAMIGA (NCT01860638) was a phase II, randomized, double‐blind, placebo‐controlled, multicenter trial in adult patients with glioblastoma. Following surgery, patients with newly diagnosed glioblastoma received first‐line treatment consisting of radiotherapy plus temozolomide and BEV, followed by six cycles of temozolomide and BEV, then BEV monotherapy until disease progression (PD1). Randomization occurred at PD1 (second line), and patients received lomustine (CCNU) plus BEV (CCNU + BEV) or CCNU plus placebo (CCNU + placebo) until further disease progression (PD2). At PD2 (third line), patients continued BEV or placebo with chemotherapy (investigator's choice). The primary endpoint was survival from randomization. Secondary endpoints were progression‐free survival in the second and third lines (PFS2 and PFS3) and safety.Results.Of the 296 patients enrolled, 123 were randomized at PD1 (CCNU + BEV, n = 61; CCNU + placebo, n = 62). The study was terminated prematurely because of the high drop‐out rate during first‐line treatment, implying underpowered inferential testing. The proportion of patients receiving corticosteroids at randomization was similar (BEV 33%, placebo 31%). For the CCNU + BEV and CCNU + placebo groups, respectively, median survival from randomization was 6.4 versus 5.5 months (stratified hazard ratio [HR], 1.04; 95% confidence interval [CI], 0.69–1.59), median PFS2 was 2.3 versus 1.8 months (stratified HR, 0.70; 95% CI, 0.48–1.00), median PFS3 was 2.0 versus 2.2 months (stratified HR, 0.70; 95% CI, 0.37–1.33), and median time from randomization to a deterioration in health‐related quality of life was 1.4 versus 1.3 months (stratified HR, 0.76; 95% CI, 0.52–1.12). The incidence of treatment‐related grade 3 to 4 adverse events was 19% (CCNU + BEV) versus 15% (CCNU + placebo).Conclusion.There was no survival benefit and no detriment observed with continuing BEV through multiple lines in patients with recurrent glioblastoma.Implications for Practice.Previous research suggested that there may be value in continuing bevacizumab (BEV) beyond progression through multiple lines of therapy. No survival benefit was observed with the use of BEV through multiple lines in patients with glioblastoma who had progressed after first‐line treatment (radiotherapy + temozolomide + BEV). No new safety concerns arose from the use of BEV through multiple lines of therapy.

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FDA Approves Cemiplimab, First Drug for Advanced CSCC

The US Food and Drug Administration today approved cemiplimab for the treatment of patients with metastatic cutaneous squamous cell carcinoma (CSCC) or locally advanced, unresectable CSCC.
FDA Approvals

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Neutrophil- and Platelet- to Lymphocyte Ratio in Patients with Euthyroid Hashimoto’s Thyroiditis

05-2018-0226-endo_10-1055-a-0723-3441-1.

Exp Clin Endocrinol Diabetes
DOI: 10.1055/a-0723-3441

Background Hashimoto's thyroiditis (HT) is the most prevalent autoimmune thyroid disorder. Both neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are reported to be increased in various inflammation-related diseases, but their clinical significance in HT remains unclear. Objectives The aim of this study was to investigate the relationship between thyroid autommunity and NLR and PLR as markers of systemic inflammation in HT. Methods In this study, we evaluated 145 women with HT and 60 age-matched healthy controls. We compared the PLR and the NLR of HT patients with controls and the correlation between the NLR, PLR, and C-reactive protein (CRP), thyroid-stimulating hormone (TSH) and thyroid antibody titers in the patient group. Also we compared the PLR and the NLR of HT patients that received levothyroxine with those who did not receive levothyroxine Results There were no significant differences between patient and control groups in terms of overall leukocyte counts, neutrophil counts, and other laboratory tests. In the patient group lymphocyte counts were lower while the platelet counts, NLR (2.29±0.65 vs1.68±0.40), PLR (164.95±55.14 vs106.88±32.19) were higher than those of the control (p<0.001 for all comparisons). Conclusion In this study we found that NLR and PLR were higher in euthyroid Hashimoto patients than in a healthy control group. NLR and PLR are likely non-specific indicators of immune disorder and their implications for HT and other conditions remain to be elucidated.
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Article in Thieme eJournals:
Table of contents | Abstract | Full text

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Coagulopathies and inflammatory diseases: ‘…glimpse of a Snark’

Silvina del Carmen | Sophie M Hapak | Sourav Ghosh | Carla V Rothlin

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Regulation of lymphocyte trafficking in central nervous system autoimmunity

Mohamed Oukka | Estelle Bettelli

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ATA 2018 Abstracts Available Online

We are pleased to provide complimentary access to the conference program and meeting abstracts for the 88^th Annual Meeting of the American Thyroid Association, October 3-7, 2018 in Washington, DC. The Abstracts are available now on the Thyroid^® website:

88^th Annual Meeting of the American Thyroid Association Abstracts
Abstract Author Index
Short Call Abstracts
Short Call Author Abstract Index

The post ATA 2018 Abstracts Available Online appeared first on American Thyroid Association.

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ATA 2018 Abstracts Available Online

88^th Annual Meeting of the American Thyroid Association Abstracts
Abstract Author Index
Short Call Abstracts
Short Call Author Abstract Index

The post ATA 2018 Abstracts Available Online appeared first on American Thyroid Association.

https://ift.tt/2OjDZgJ

CDKN2A germline mutations are not associated with poor survival in an Italian cohort of melanoma patients

Cyclin dependent kinase inhibitor 2A gene (CDKN2A) germline mutations have recently been associated with poor survival in patients with melanoma. Despite the high mutation rate in our cohort (up to 10% in patients with apparently sporadic melanoma), information on the impact of CDKN2A on survival in this cohort is lacking.

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Randomized in situ study on the efficacy of CO 2 laser irradiation in increasing enamel erosion resistance

Abstract

Objectives

The aim of this double-blind, randomized in situ study was to evaluate the erosion-preventive effect of a specific set of CO₂ laser parameters, associated or not with fluoride.

Methods

Two hundred forty bovine enamel blocks were prepared for individual palatal appliances (n = 6 samples/appliance). The study had four phases of 5 days each, with ten volunteers and the following treatments: CO₂ laser irradiation (L), fluoride treatment (F), combined fluoride and laser treatment (FL), and no treatment, control (C). Laser irradiation was performed at 0.3 J/cm² (5 μs/226 Hz/10.6 μm) and the fluoride gel contained AmF/NaF (12′500 ppm F⁻/pH = 4.8–6). For erosive demineralization, the appliances were immersed extra-orally in citric acid (0.05 M/20 min/pH = 2.3) twice daily. Analysis of enamel surface loss was done using a 3D-laser profilometer on 3 days. Additionally, fluoride uptake was quantified and scanning electron microscopies were done. Data were analyzed with repeated measures ANOVA and post hoc pairwise comparisons (α = 0.05).

Results

At all analyzing days, both laser groups caused the lowest means of enamel loss, which were also statistically significant lower than C (p < 0.05). At day 5, FL means ± SD (33.6 ± 12.6 μm) were even significantly lower than all other groups (C 67.8 ± 15.4 μm; F 57.5 ± 20.3 μm; L 46.8 ± 14.5 μm). Significantly increased enamel fluoride uptake was observed for both fluoride-containing groups (p < 0.05) at day 1.

Conclusion

Compared to the control, the CO₂ laser irradiation with a specific set of laser parameters (0.3 J/cm²/5 μs/226 Hz) either alone or in combination with a fluoride gel (AmF/NaF) could significantly decrease enamel erosive loss up to 5 days in situ.

Clinical relevance

Combined CO₂ laser-fluoride treatment has a significant anti-erosive effect.

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Deep analysis of immune response and metabolic signature in children with food protein induced enterocolitis to cow’s milk

Food Protein-Induced Enterocolitis Syndrome (FPIES) is considered to be a non-IgE mediated food allergy. However, its pathogenesis remains poorly understood and biomarkers are lacking. We aimed to perform in-d...

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Treatment of urticarial vasculitis: A systematic review

Publication date: Available online 27 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Pavel Kolkhir, Maria Grakhova, Hanna Bonnekoh, Karoline Krause, Marcus Maurer

Abstract

Urticarial vasculitis (UV) is a difficult-to-treat condition characterized by long-lasting urticarial rashes and histopathologic findings of leukocytoclastic vasculitis. Treatment is dictated by severity of skin and systemic involvement and the underlying systemic disease. This is a comprehensive systematic review of the efficacy of current UV treatment options. We searched for relevant studies in seven databases including MEDLINE, Scopus, and Web of Science. In total, 261 eligible studies and 789 unique UV patients were included in the systematic review. Most UV patients are adult females with chronic (≥6 weeks) and systemic disease. UV is mostly idiopathic, but can be associated with drugs, malignancy, autoimmunity and infections. It usually resolves with their withdrawal or cure. Corticosteroids are effective for the treatment of skin symptoms in >80% of UV patients. However, their long-term administration can lead to potentially serious adverse effects. The addition of immunomodulatory or immunosuppressive agents often allows corticosteroids tapering and improves the efficacy of therapy. Biologicals, including omalizumab, as well as corticosteroids, cyclophosphamide, dapsone, mycophenolate mofetil, plasmapheresis, colchicine, hydroxychloroquine, intravenous immunoglobulins, NSAIDs, and cyclosporine can be effective for skin as well as systemic symptoms in UV patients. H₁-antihistamines, montelukast, danazol, H₂-antihistamines, pentoxifylline, doxepin and tranexamic acid are not effective in most UV patients. As of yet, no drugs have been approved for UV, and management recommendations are based mostly on case reports and retrospective studies. Prospective studies investigating the effects of treatment on the signs and symptoms of UV are needed.

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A skewed pool of resident T cells triggers psoriasis-associated tissue responses in never-lesional psoriasis skin

Publication date: Available online 27 September 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Irène Gallais Sérézal, Elena Hoffer, Borislav Ignatov, Elisa Martini, Beatrice Zitti, Marcus Ehrström, Liv Eidsmo

Abstract

Background

Resident T cells are implicated in the maintenance and recurrence of psoriasis lesions. Whether skin that has not yet experienced psoriasis in subjects with established disease harbours pathogenic T cells is less investigated.

Objective

To analyse the composition of resident T cells and T cell driven tissue responses in skin never affected by disease from psoriasis patients.

Methods

Never-lesional skin was collected from patients with mild psoriasis. T cell profiles were assessed with confocal imaging and flow cytometry. Tissue responses to T cell stimulation were measured by multiplex and Nanostring.

Results

T cell activation ex vivo triggered psoriasiform and type-I interferon tissue responses in epidermis from never-lesional psoriasis. Accordingly, keratinocytes from never-lesional psoriasis responded to IFN-γ stimulation with MX1 expression and IFN-α release. Additionally, CCR6 expressing resident T cells poised to produce IFN-γ and IL-17 were enriched in never-lesional epidermis whereas dermal tissue responses and T cell compositions were similar to healthy skin. Finally, never-lesional keratinocytes exposed to IL-17 and skin explants exposed to common fungal antigens responded with upregulation of the CCR6-ligand CCL20.

Conclusion

Epidermal resident T cells capable of triggering psoriasiform tissue responses accumulate in never-lesional epidermis. Our global analysis of never-lesional psoriasis reveals that microbial interplay with genetically predisposed keratinocytes may shape the local pool of resident T cells.

Graphical abstract

Graphical abstract for this article

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A patient with classical galactosemia is graduated with a university degree

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

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Inositol in Polycystic Ovary Syndrome: Restoring Fertility through a Pathophysiology-Based Approach

Publication date: Available online 27 September 2018

Source: Trends in Endocrinology & Metabolism

Author(s): Antonio Simone Laganà, Simone Garzon, Jvan Casarin, Massimo Franchi, Fabio Ghezzi

Myo-inositol (MI) and D-chiro-inositol (DCI) are insulin second messengers, and MI is involved in follicular gonadotropin pathways which orchestrate ovulation. The tissue-specific MI/DCI ratio is modulated by insulin through aromatase and is altered in insulin resistance (IR), with reduced epimerization of MI to DCI in insulin-sensitive tissues. In ovaries, the MI/DCI ratio is 100:1, but is dramatically reduced by insulin-stimulated epimerase in hyperinsulinemic women with polycystic ovary syndrome (PCOS). Inositols have proved to be effective in PCOS, improving metabolic and hormonal state, and restoring spontaneous ovulation. In assisted reproductive technology, inositol improved ovarian stimulation parameters, although data concerning fertility outcomes are conflicting. Given their functions, inositols are an attractive treatment option for PCOS, although well-designed studies on spontaneous and non-spontaneous fertility are needed.

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Laryngeal reconstruction in children with recurrent respiratory papillomatosis

Publication date: Available online 28 September 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): M.L. Scatolini, A. Cocciaglia, C.G. Pérez, H.A. Rodríguez

Abstract

OBJETIVES

To describe our experience in reconstructive laryngeal surgery in patients with recurrent respiratory papillomatosis (RRP). INTRODUCTION: RRP is a rare laryngeal disease requiring multiple surgical endoscopic interventions during its course. These interventions may cause secondary lesions that may compromise airway patency. Open larynx reconstructive surgery, as tracheostomy, is a procedure considered to potentially favor extralaryngeal papilloma dissemination. In patients with RRP, the use of endoscopic posterior cricoid grafting has not been previously described.

METHODS

The clinical charts of 230 patients with RRP seen between 1996 and 2017 were reviewed. All patients who underwent airway expansion procedures either by open or endoscopic approach were included in the study. RESULTS: Four patients with RRP underwent laryngeal surgery for laryngeal stenosis were included. A doble-stage open approach was used in two patients and a single-stage endoscopic approach in the remaining two. The two tracheostomized patients were decannulated while tracheostomy was avoided in the two patients who underwent a single-stage endoscopic procedure. Two patients had active papillomatous lesions limited to the larynx at the time of surgery; no dissemination was observed during follow-up (cases 1 and 3). One patient had extralaryngeal disseminated papilomatosis; surgery did not lead to an increased lesion load compared to presurgical lesions (case 4). The patient who did not have active lesions did not have recurrence (case 2).

CONCLUSIONS

Reconstructive laryngeal surgery is a safe and effective option in the management of stenotic sequelae resulting from the surgical treatment of RRP, allowing for decannulation or avoiding tracheostomy.

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An analysis of the literature addressing tonsillectomy knowledge gaps

Publication date: Available online 27 September 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Craig M. Cooper, Jake X. Checketts, Lacy Brame, Harrison Gray, Jaye Bea Downs, Matt Vassar

Abstract

Importance

The ability of clinical practice guidelines to improve patient outcomes depends on the quality of evidence that they are built upon. Research into tonsillectomy in children is lacking, and the gaps in evidence were identified by guideline authors.

Objective

The objective of this study is to evaluate the extent that new research is addressing the gaps identified in the AAO-HNS Tonsillectomy in Children Guideline.

Design

For each recommendation in the AAO-HNS guideline Tonsillectomy In Children, we created PICO (Participants, Intervention, Comparator, Outcome) questions and search strings. PubMed was searched to locate studies undertaken after the final literature search performed by the AAO-HNS work group. These studies were then extracted and analyzed.

Setting

This study is relevant to all invested in focusing otolaryngological research on questions which currently lack strong evidence.

Participants

Trials in tonsillectomy that started after the development of the AAO-HNS clinical practice guidelines.

Main Outcome Measures

The main outcome measures of this study is the extent to which tonsillectomy research is addressing the evidence gaps listed in the clinical practice guideline.

Results

Of the 2519 studies included in our sample, 276 (11%) were relevant to the 18 recommendations made within the Tonsillectomy in Pediatric Patients clinical practice guideline. All but one of the recommendations was met by at least one study.

Conclusions

and Relevance: Our findings indicate that knowledge gaps within the guideline at publication may have since been addressed and a guideline update may thus be warranted.

Level of Evidence

NA.

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Classical paintings may trigger pain and pleasure in the gendered brain

Publication date: Available online 28 September 2018

Source: Cortex

Author(s): Beatrice de Gelder, Rebecca Watson, Minye Zhan, Matteo Diano, Marco Tamietto, Maarten J. Vaessen

Abstract

The human body is the most common object of pictorial representation in western art and its representations trigger a vast range of experiences from pain to pleasure. The goal of this study was to investigate brain activity triggered by paintings of male and female body images exemplifying conditions associated with pleasure or pain. Our findings show participant-general as well as gender specific brain activity for either the pain or the pleasure conditions. Although our participants were fully aware that they were viewing artworks, the inferior parietal lobule - known for its role in the perception of emotional body images - and the somatosensory cortex related to touch were selectively active for female body paintings in all participants in the pleasure conditions. As regards gender we observed that the sight of female bodies activates the subgenual anterior cingulate cortex in males, an area known to subserve autonomic arousal. In contrast, in females the sight of the male body activated reward and control related parts of the dorsal anterior cingulate cortex. This supports the notion that some basic evolutionary processes operate when we view body images, also when they are paintings far removed from daily experience.

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Fast and robust quantification of liquid inside thin fibrous porous materials with single-sided NMR

Publication date: Available online 27 September 2018

Source: Magnetic Resonance Imaging

Author(s): Behzad Mohebbi, Jan Claussen, Bernhard Blümich

Abstract

Single-sided NMR with the NMR-MOUSE is employed for the characterization of fluids in fibrous and open foam materials. One of the key aspects of this study is the quantification of the fluid amount. To this end critical information was provided by a relaxation study. Using 2 mM/L of a Gd³⁺ relaxation agent the repetition time could be shortened to 250 ms, improving the correlation coefficient between liquid amount and signal amplitude from R² = 0.893 to R² = 0.982. To assess reproducibility and instrument precision, calibration experiments were repeated several times and their variation investigated. The results showed that the device is highly precise and robust with a standard deviation for liquid quantification of less than 1%.

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IDO1 impairs NK cell cytotoxicity by decreasing NKG2D/NKG2DLs via promoting miR-18a

Publication date: November 2018

Source: Molecular Immunology, Volume 103

Author(s): Jiahui Zhang, Xiao Han, Xiao Hu, Fengjiao Jin, Zihe Gao, Liyong Yin, Junfang Qin, Fuzai Yin, Chen Li, Yue Wang

Abstract

Background

Indoleamine-2,3-dioxygenase 1 (IDO1) is an important enzyme for altering the tumour microenvironment and assisting tumour cells to escape the immune system.

Results

In this study, a significant reduction in NK cell cytotoxicity that was associated with a high expression of IDO1 in a reconstructed tumour microenvironment was observed. In a co-culture system of tumour cell culture supernatant (TSN) and murine NK cell, IDO1 was substantially increased, while NKG2D was markedly downregulated in NK cells. Based on computational predictions, miR-18a, which has two definite binding sites consisting of the 3′UTR of NKG2D and the 3′UTR of NKG2D ligand (Mult-1), was suspected to be a negative regulator of which its conjoined. As expected, the IDO1 could promote the expression of miR-18a and promote the downregulation effect of miR-18a on NKG2D and NKG2DL, and INCB024360 (INCB) could reverse the result. For digging the mechanism deeper, we authenticated IDO1 promoted the combination of miR-18a and AGO2 after argonaute 2 (AGO2) co-immunoprecipitation, which then degraded Mult-1 mRNA and inhibited the translation of it, further destructing NK cell cytotoxicity.

Conclusion

Our findings revealed a new regulatory axis, IDO1/miR-18a/NKG2D/NKG2DL, in the regulation of NK cell function. This may provide insight into the mechanism of the priming effect of IDO1 inhibitors and miR-18a interference, then elicit possible new methods of cancer treatment.

Graphical abstract

Graphical abstract for this article

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A Study to Evaluate the Effect of ACT-774312 in Subjects With Bilateral Nasal Polyposis

Condition: Bilateral Nasal Polyposis
Interventions: Drug: ACT-774312; Drug: Placebo
Sponsor: Idorsia Pharmaceuticals Ltd.
Not yet recruiting

https://ift.tt/2zCWdBJ

Examine the Prognostic Role of FLT PET/CT for Patients With LR-NPC Treated by Carbon Ion Therapy

Condition: Recurrent Nasopharyngeal Carcinoma
Intervention: Diagnostic Test: FLT PET/CT
Sponsor: Shanghai Proton and Heavy Ion Center
Not yet recruiting

https://ift.tt/2OTlU6s

Arginase-1 Peptide Vaccine in Patients With Metastatic Solid Tumors

Conditions: Non Small Cell Lung Cancer; Urothelial Carcinoma; Malignant Melanoma; Ovarian Cancer; Colorectal Cancer; Breast Cancer; Squamous Cell Carcinoma of the Head and Neck; Metastatic Cancer
Intervention: Biological: ARG1-18,19,20
Sponsor: Inge Marie Svane
Not yet recruiting

https://ift.tt/2zCsBVe

A Phase 3 Study of the Effects of GC4419 on Radiation Induced Oral Mucositis in Patients With Head/Neck Cancer

Conditions: Oral Mucositis; Head and Neck Cancer
Interventions: Drug: GC4419; Drug: Placebo
Sponsor: Galera Therapeutics, Inc.
Not yet recruiting

https://ift.tt/2OVyulB

A Study to Evaluate the Effect of ACT-774312 in Subjects With Bilateral Nasal Polyposis

Condition: Bilateral Nasal Polyposis
Interventions: Drug: ACT-774312; Drug: Placebo
Sponsor: Idorsia Pharmaceuticals Ltd.
Not yet recruiting

https://ift.tt/2zCWdBJ

Examine the Prognostic Role of FLT PET/CT for Patients With LR-NPC Treated by Carbon Ion Therapy

Condition: Recurrent Nasopharyngeal Carcinoma
Intervention: Diagnostic Test: FLT PET/CT
Sponsor: Shanghai Proton and Heavy Ion Center
Not yet recruiting

https://ift.tt/2OTlU6s

Arginase-1 Peptide Vaccine in Patients With Metastatic Solid Tumors

A Phase 3 Study of the Effects of GC4419 on Radiation Induced Oral Mucositis in Patients With Head/Neck Cancer

Conditions: Oral Mucositis; Head and Neck Cancer
Interventions: Drug: GC4419; Drug: Placebo
Sponsor: Galera Therapeutics, Inc.
Not yet recruiting

https://ift.tt/2OVyulB

Impact of non-invasive continuous blood pressure monitoring on maternal hypotension during cesarean delivery: a randomized-controlled study

Abstract

Purpose

This study aimed to investigate the efficacy of the ClearSight™ system (Edwards Lifesciences, Irvine, CA) for reducing the incidence of hypotension compared with the traditional oscillometric blood pressure monitoring in cesarean delivery under spinal anesthesia.

Methods

Forty patients undergoing cesarean delivery under spinal anesthesia were enrolled. The patients were randomly divided into two groups (Control and ClearSight groups). All patients received spinal anesthesia using 0.5% hyperbaric bupivacaine (11.5 mg) and fentanyl (10 µg). Blood pressure was managed with the same protocol using the ClearSight™ system (ClearSight group) and oscillometric blood pressure monitoring (Control group). Furthermore, we compared the accuracy of the ClearSight™ system with the traditional oscillometric monitoring for blood pressure measurement using Bland–Altman, four-quadrant plot, and polar plot analyses.

Results

The incidence of hypotension was significantly lower in the ClearSight group from induction to delivery (45% vs. 0%, p < 0.001) and to the end of surgery (50% vs. 20%, p = 0.049). Intraoperative nausea occurred more frequently in the Control group (45% vs. 10%, p = 0.012). The ClearSight™ system demonstrated acceptable accuracy with a bias of − 4.3 ± 11.7 mmHg throughout the procedure. Four-quadrant analysis revealed an excellent trending ability of the ClearSight™ system with a concordance rate of approximately 95%. In the polar plot analysis, the angular bias and concordance rate were − 13.5° ± 19.0° and 76.9%, respectively.

Conclusions

The accuracy and trending ability of the ClearSight™ system for blood pressure measurement was clinically acceptable in cesarean delivery under spinal anesthesia, leading to reductions in maternal hypotension and nausea.

https://ift.tt/2Qi5PYg

Taurine administration prevents the intestine from the damage induced by beta-lactoglobulin sensitization in a murine model of food allergy

Publication date: Available online 27 September 2018

Source: Allergologia et Immunopathologia

Author(s): S. Aïnad-Tabet, H. Grar, A. Haddi, H. Negaoui, A. Guermat, O. Kheroua, D. Saïdi

Abstract

Background

Allergy to cow's milk proteins has often been associated with dysfunction of the intestinal mucosa caused by chronic inflammation in infants. This study evaluated the protective effect of taurine on intestinal damage induced by beta-lactoglobulin (β-Lg) in Balb/c mice used as an animal model of allergy to cow's milk proteins.

Methods

Balb/c mice were treated with taurine administered orally by gavage (3 mmol/kg/day) or intraperitoneally (100 mg/kg/day) for two weeks, then sensitized intraperitoneally with β-Lg. The electrophysiological parameters: active ion transport of chloride (Short-circuit current: Isc) and the passive ion permeability (Conductance: G) were measured ex vivo in Ussing chamber by intestine challenge with β-Lg. Histological study was used to assess gut inflammation. Serum levels of TNF-α and IL-6 were measured. Serum IgG and IgE anti-β-Lg were determined by ELISA.

Results

Compared with sensitized mice, β-Lg challenge of intestinal epithelium of taurine-pre-treated mice in Ussing chamber did not influence the intensity of Isc, nor produce any changes in the G, reflecting a reduction in the secretory response and epithelial permeability. Histological and morphometric analysis showed that taurine reduced the intestinal damage and limited intestine retraction caused by β-Lg sensitization. No statistically significant difference in the serum levels of TNF-α or IL-6 was found after oral or intraperitoneal administration of taurine. Treatment with taurine significantly decreased the IgG (p < 0.001) and IgE anti β-Lg levels (p < 0.05).

Conclusions

These results have for the first time provided evidence that pre-treatment with taurine appears to prevent intestinal damage induced by β-Lg.

https://ift.tt/2Oi8Wlr

Effect of Age of Onset of Psoriasis on Clinical Outcomes with Systemic Treatment in the Psoriasis Longitudinal Assessment and Registry (PSOLAR)

Abstract

Objective

Our objective was to compare therapeutic response among patients with early-onset psoriasis (EOP) and late-onset psoriasis (LOP) receiving adalimumab, etanercept, infliximab, ustekinumab, or methotrexate in the Psoriasis Longitudinal Assessment and Registry (PSOLAR).

Methods

Patients were grouped by age of onset: EOP (age ≤ 40 years) or LOP (age > 40 years). Repeated-measures analysis with logistic regression was used to calculate the adjusted odds ratio (AOR; adjusted for baseline characteristics) for achieving a Physician's Global Assessment score of cleared/minimal (PGA 0/1) or a percentage of body surface area involved with psoriasis < 3% (%BSA < 3) or %BSA < 1 for all patients; similar sensitivity analyses were performed for each treatment group.

Results

Of 7511 patients, 5479 (72.9%) had EOP. The LOP group had a higher likelihood of achieving PGA 0/1 after treatment than did the EOP group in all patients (AOR 1.14 [95% confidence interval (CI) 1.05–1.25]; p = 0.0019); the same was true in subgroups of etanercept-treated (AOR 1.38 [95% CI 1.14–1.66]; p = 0.0010) and methotrexate-treated (AOR 1.62 [95% CI 1.16–2.26]; p = 0.0049) patients. No significant difference was found between the EOP and LOP groups with regard to the likelihood of achieving %BSA < 3 or %BSA < 1 among all patients. However, LOP patients were more likely than EOP patients to achieve %BSA < 3 or %BSA < 1 in subgroups treated with infliximab (AOR 1.45 [95% CI 1.09–1.93; p = 0.0103] and AOR 1.36 [95% CI 1.03–1.78; p = 0.0290], respectively) and etanercept (AOR 1.30 [95% CI 1.06–1.61; p = 0.0123] and AOR 1.34 [95% CI 1.09–1.64; p = 0.0053], respectively).

Conclusion

Our real-world data from PSOLAR indicate that there are differences in some patient characteristics between EOP and LOP and that patients with EOP are less likely than those with LOP to respond to certain systemic treatments. (ClinicalTrials.gov identifier: NCT00508547).

https://ift.tt/2N79ZQH

Danger-Associated Molecular Patterns (DAMPs): the Derivatives and Triggers of Inflammation

Abstract

Purpose of Review

Allergen is an umbrella term for irritants of diverse origin. Along with other offenders such as pathogens, mutagens, xenobiotics, and pollutants, allergens can be grouped as inflammatory agents. Danger-associated molecular patterns (DAMPs) are altered metabolism products of necrotic or stressed cells, which are deemed as alarm signals by the innate immune system. Like inflammation, DAMPs play a role in correcting the altered physiological state, but in excess, they can be lethal due to their signal transduction roles. In a vicious loop, inflammatory agents are DAMP generators and DAMPs create a pro-inflammatory state. Only a handful of DAMPs such as uric acid, mtDNA, extracellular ATP, HSPs, amyloid β, S100, HMGB1, and ECM proteins have been studied till now. A large number of DAMPs are still obscure, in need to be unveiled. The identification and functional characterization of those DAMPs in inflammation pathways can be insightful.

Recent Findings

As inflammation and immune activation have been implicated in almost all pathologies, studies on them have been intensified in recent times. Consequently, the pathologic mechanisms of various DAMPs have emerged. Following PRR ligation, the activation of inflammasome, MAPK, and NF-kB is some of the common pathways.

Summary

The limited number of recognized DAMPs are only a fraction of the vast array of other DAMPs. In fact, any misplaced or abnormal level of metabolite can be a DAMP. Sophisticated analysis studies can reveal the full profile of the DAMPs. Lowering the level of DAMPs is useful therapeutic intervention but certainly not as effective as avoiding the DAMP generators, i.e., the inflammatory agents. So, rather than mitigating DAMPs, efforts should be focused on the elimination of inflammatory agents.

https://ift.tt/2DEjrvz

Invasion of the mandible in gingivobuccal complex cancers: Histopathological analysis of routes of tumour entry and correlation with preoperative assessment

Publication date: November 2018

Source: Oral Oncology, Volume 86

Author(s): DA. Chaukar, M. Dandekar, S. Kane, S. Arya, N. Purandare, V. Rangarajan, AK. D'Cruz

Abstract

Objectives

To determine the most accurate imaging modality predicting mandibular invasion in gingivobuccal (GB) complex cancers. To determine patterns of invasion and routes of tumour entry into the mandible by detailed histopathologic analysis.

Material and methods

Prospective observational study of GB Complex cancers juxtaposed with the mandible clinically necessitating some form of mandibular resection. Orthopantomogram (OPG), Multi Detector Computed Tomography (MDCT), DENTA scan and Single Photon Emission Computed Tomography scan (SPECT) were performed after which the patient was subjected to surgery. Histopathological assessment was systematically performed with serial cuts of the mandibular segment.

Results

Of 70 patients, MDCT was the most accurate with area under curve (AUC) of 0.833. OPG, DENTA and SPECT had AUC of 0.714, 0.786 and 0.738 respectively. Mean calculated difference of involved height was −0.025 cm by MDCT (p value 0.87), −0.2 cm by OPG (p value 0.09) and 0.12 by DENTA scan (p value 0.41). Mean difference of involved length was −0.51 cm (p value 0.08) and −1.02 cm (p value 0.04) for MDCT and OPG respectively. 50% of tumour invasion was through the occlusal route while large tumours demonstrated multiple routes of entry.

Conclusion

-Gingivobuccal complex cancers are homogenous with respect to mandibular invasion, preferred route of tumour entry being the occlusal surface.

-Multidetector CT scan is fairly accurate in detecting mandibular involvement and predicting extent of involvement.

-Oncological safety can be achieved by positioning the bone cuts corresponding to the adjacent soft tissue margins in segmental mandibulectomy.

https://ift.tt/2NMaxAt

Onkologie

https://ift.tt/2xTzmQp

Oleandrin synergizes with cisplatin in human osteosarcoma cells by enhancing cell apoptosis through activation of the p38 MAPK signaling pathway

Abstract

Purpose

Our previous studies have reported the antitumor effect of oleandrin on osteosarcoma; however, its chemosensitizing effect in osteosarcoma treatment is still unknown. Therefore, we explored the sensitizing effects of oleandrin to cisplatin in osteosarcoma and investigated the potential mechanisms.

Methods

After exposure to oleandrin and/or cisplatin, CCK-8 and colony formation assays, DAPI staining and flow cytometry were performed to detect cell proliferation and apoptosis in 143B, U-2OS and MG-63 osteosarcoma cells. The median-effect analysis was applied to evaluate the combined effect. Western blot was used to determine the expression of related proteins. Osteosarcoma xenografts and histological observations were applied to confirm the combined effect in vivo.

Results

Compared with cisplatin or oleandrin alone, the combined treatment significantly inhibited cell proliferation and induced cell apoptosis. The median-effect analysis indicated a synergistic cytotoxic effect. The combined treatment downregulated Bcl-2 and upregulated Bax and cleaved caspase-3, -8 and -9. And the suppression of caspases reduced cell death. Furthermore, oleandrin alone or with cisplatin, activated the p38 MAPK/Elk-1 pathway. The inhibition of the p38 MAPK pathway increased cell viability and reduced apoptosis. In vivo, the combined treatment was also verified to significantly inhibit tumor growth, induce apoptosis and activate the p38 MAPK pathway.

Conclusions

The combination of oleandrin with cisplatin exerts a synergistic antitumor effect in osteosarcoma, which relates to the activation of the p38 MAPK pathway.

https://ift.tt/2OVR7pm

Danger-Associated Molecular Patterns (DAMPs): the Derivatives and Triggers of Inflammation

Abstract

Purpose of Review

Recent Findings

Summary

https://ift.tt/2DEjrvz

Imaging of salivary gland pathology

Publication date: Available online 28 September 2018

Source: Operative Techniques in Otolaryngology-Head and Neck Surgery

Author(s): Gopi K. Nayak, Mari Hagiwara

ABSTRACT

The major salivary glands can be affected by a variety of acute or chronic, systemic, and neoplastic conditions. Several modalities can be used for salivary gland imaging, each with its own advantages and limitations. The article reviews the optimal imaging modality for different clinical scenarios, the typical imaging appearance of commonly encountered pathologies, and seeks to provide a framework for generating an appropriate differential diagnosis. Additionally, with regard to neoplastic conditions, the goals of the review are to highlight features suggestive of benign or low-grade lesions verses high grade malignancy, while recognizing the limitations of imaging in making specific histologic diagnoses.

https://ift.tt/2N1PtRv

Concomitant 1p36 deletion and TNFRSF14 mutations in primary cutaneous follicle center lymphoma frequently expressing high levels of EZH2 protein

Abstract

Primary cutaneous follicle center lymphoma (PCFCL) is an indolent variant of follicular lymphoma (FL) with limited information available on the genetic background of the disease. The genetic hallmark of nodal FL, the t(14;18) translocation, affecting the BCL2 gene, is rare in PCFCL. Loss of 1p36, the most common secondary chromosomal abnormality in nodal FL, has been recently reported in 16.7% of PCFCL cases. In order to further characterize PCFCL, 21 cases were analyzed using interphase fluorescence in situ hybridization with BCL2 break apart and 1p36/1q25 dual color probes. Sanger sequencing was used to investigate TNFRSF14 and EZH2 mutations and immunohistochemistry to assess BCL2, EZH2 protein expressions.

1p36 deletion occurred in 22% (5/21), BCL2 gene break in 10% (2/20) of the PCFCL cases. Mutations of the candidate tumor suppressor gene of the 1p36 region, TNFRSF14 mutations were detected in 4/17 (23.5%) cases with 2 cases presenting with concurrent 1p36 deletion. EZH2 hotspot mutations at Y641, A682, and A692 were not found. High EZH2 protein expression associated with a BCL2 negative phenotype was observed in 43% (9/21) of the cases. BCL2 gene break or 1p36 deletion did not impact the prognosis; however, they showed association with advanced stages at diagnosis (p = 0.016) and a tendency with shorter event free survival (p = 0.052).

In conclusion, 1p36 deletion co-occurs with acquired TNFRSF14 mutations, suggesting a role of this tumor suppressor gene in the development of a subgroup of PCFCL. High EZH2 protein expression associated with BCL2 negative phenotype is common and might represent an ideal therapeutic target.

https://ift.tt/2xIslTi

Novel steps forward in the histopathology of non-celiac gluten sensitivity

https://ift.tt/2In8JId

Novel steps forward in the histopathology of non-celiac gluten sensitivity, authors’ reply

https://ift.tt/2xKhR5U

HLA-G expression in gastric carcinoma: clinicopathological correlations and prognostic impact

Abstract

To analyze expression of human leukocyte antigen-G (HLA-G) in gastric adenocarcinoma and correlate its expression with histological and clinical variables. A continuous series of 94 unselected patients with gastric adenocarcinoma (stage I to III) were selected. All histological and clinical variables were collected including the intensity of intra- and peri-tumor lymphocytic infiltration. HLA-G expression was investigated using immunohistochemistry. All histological samples analyzed for HLA-G expression were taken from the primary gastric lesion and included non-neoplastic mucosa. Evaluation of HLA-G expression was performed on the transition zone between tumor and non-neoplastic mucosa, and the invasive front of the tumor and assessment was performed as follows: percentage of positive (strong expression vs weak) cells. A variable amount of HLA-G-positive tumor cells was found in 24 out of 94 cases (25.5%). No significant correlation was found between HLA-G expression and other clinicopathological variables (sex, age, stage, grade, histotype). The overall median survival was worse in patients with HLA-G-positive adenocarcinoma (24.3 months, CI_95% 7.7–41.0) compared to those with HLA-G-negative tumors (66.3 months, CI_95% 53.0–79.7; p < 0.0001). Two- and 5-year survival rates of HLA-G-negative patients were 88 and 44%, respectively, while were 42 and 11% in those HLA-G-positive. This trend was observed in all stages but was more marked in stage III. HLA-G expression is associated with poor survival in stage III gastric cancer patients and represents a possible immunoescape mechanism of cancer cells.

https://ift.tt/2Isbngd

Case of bilateral elastofibroma on the tensor fasciae latae

The Journal of Dermatology, EarlyView.

https://ift.tt/2OhHGnc

Prediction of Electrode Contacts for Clinically Effective Deep Brain Stimulation in Essential Tremor

Background/Aim: Deep brain stimulation (DBS) is an established neurosurgical treatment that can be used to alleviate symptoms in essential tremor (ET) and other movement disorders. The aim was to develop a method and software tool for the prediction of effective DBS electrode contacts based on probabilistic stimulation maps (PSMs) in patients with ET treated with caudal zona incerta (cZi) DBS. Methods: A total of 33 patients (37 leads) treated with DBS were evaluated with the Essential Tremor Rating Scale (ETRS) 12 months after surgery. In addition, hand tremor and hand function (ETRS items 5/6 and 11–14) were evaluated for every contact during stimulation with best possible outcome without inducing side effects. Prediction of effective DBS electrode contacts was carried out in a retrospective leave-one-out manner based on PSMs, simulated stimulation fields, and a scoring function. Electrode contacts were ranked according to their likelihood of being included in the clinical setting. Ranked electrode contacts were compared to actual clinical settings. Results: Predictions made by the software tool showed that electrode contacts with rank 1 matched the clinically used contacts in 60% of the cases. Contacts with a rank of 1–2 and 1–3 matched the clinical contacts in 83 and 94% of the cases, respectively. Mean improvement of hand tremor and hand function was 79 ± 21% and 77 ± 22% for the clinically used and the predicted electrode contacts, respectively. Conclusions: Effective electrode contacts can be predicted based on PSMs in patients treated with cZi DBS for ET. Predictions may in the future be used to reduce the number of clinical assessments that are carried out before a satisfying stimulation setting is defined.
Stereotact Funct Neurosurg

https://ift.tt/2N4nYXj

Mechanical and hydrolytic degradation of an Ormocer®-based Bis-GMA-free resin composite

Abstract

Objectives

The aim of the study was to evaluate the mechanical stability of bisphenol A-glycidyl methacrylate (Bis-GMA) and Ormocer-based resin composites before and after water absorption and to examine water saturation.

Material and methods

Disc-shaped specimens of the Bis-GMA (Grandio SO, Voco) and the Ormocer-based (Admira Fusion, Voco) dental resin composites were produced, stored in water, and weighed after pre-determined times to measure the absorbed water. Bend bars were produced and stored for 24 h in dry conditions as well as in distilled water for 14 days or 60 days at 37 °C. The initial flexural strength (FS) under quasi-static loading and flexural fatigue strength (FFS) under cyclic loading were determined under 4-point bending. Fracture toughness (K_Ic) of both composites was measured using the single-edge-V-notch-beam (SEVNB) technique after the same storage conditions under 3-point bending.

Results

Within the first 14 days, storage conditions did not affect the initial FS of Grandio SO, while a significant drop in initial FS was observed for Admira Fusion after 2 weeks in water and most of the water was absorbed within this time. FFS for the Bis-GMA composite was not reduced before 2 months in water, whereas for the Ormocer®-based composite, there has been a significant decrease in strength after cyclic fatigue already at 2 weeks of water storage. K_Ic of Admira Fusion decreased significantly after both storage periods, while K_Ic of Grandio SO decreased only significantly after 2 weeks of water storage.

Conclusion

All mechanical properties of the Bis-GMA composite were superior to those of the Ormocer®-based material, except water sorption.

Clinical significance

Water storage seems to have a much more pronounced effect on the mechanical properties of Ormocer®-based dental composites in comparison to Bis-GMA-based composites.

https://ift.tt/2xJRblz

Tofacitinib for the treatment of lichen planopilaris: A case series

Dermatologic Therapy, EarlyView.

https://ift.tt/2DDpaS9

Tofacitinib for the treatment of lichen planopilaris: A case series

Dermatologic Therapy, EarlyView.

https://ift.tt/2DDpaS9

Treatment of Vocal Cord Paralysis by Autologous Fat Injection: Our Experience with 41 Patients

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

https://ift.tt/2zCUjkH

A 20 year observational cohort of a 5 million patient population – tonsillectomy rates in the context of two national policy changes

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

https://ift.tt/2N7oCTZ

Our Experience of Long Term Result of Tympanoplasty Using Areolar Tissue in 359 patients

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

https://ift.tt/2zC4GW2

Snoring sound energy as a potential biomarker for disease severity and surgical response in childhood obstructive sleep apnea: a pilot study

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

https://ift.tt/2N7oEez

Retrospective Analysis of 91 Kaposi’s Sarcoma Cases: A Single-Center Experience and Review of the Literature

Background: Kaposi's sarcoma (KS) is a multifocal angioproliferative tumor involving primarily the skin. Objective: The aim of this study was to describe the clinical, demographic, histopathological characteristics, treatment modalities, and outcome of 91 KS patients, and compare them with other contemporary research. Methods: Medical records of 91 KS patients followed between January 2005 and September 2017 were evaluated retrospectively. Results: Most of our patients were male (male-to-female ratio was 4.05). The median age at diagnosis was 69 years (range, 6–93 years). The duration of the lesions varied between 3 and 25 years. The lower extremities were the most commonly involved area (51.6%). Of the 91 patients, classic type KS was seen in 75 patients. Radiotherapy was used successfully in approximately half of our patients. Recurrence was observed in approximately one third of the patients. All KS patients in this study except 1 were classic KS. Conclusion: The clinical and demographic characteristics of our patients were compatible with the previous literature suggesting that KS is a tumor that tends to be limited to the skin. Close follow-up of patients is important to monitor for recurrence. This is the largest report from Turkey to date.
Dermatology

https://ift.tt/2OSw1bG

Total parenteral nutrition in the pleural space

Description

A male infant was delivered spontaneously at 29+3 weeks and transferred to the local neonatal unit for uplift in care. This included 24 hours of ventilation, 12 hours of dobutamine and placement of a peripherally inserted central catheter (PICC) for total parenteral nutrition (TPN). By 24 hours he was extubated onto Optiflow at 6 L/min and Fraction of Inspired Oxygen (FiO₂) of 0.21. Expressed breastmilk was commenced whilst awaiting PICC placement.

A 22G 80 mm Leaderflex PICC was aseptically inserted on day 2 into the right antecubital fossa. The line did not bleed but flushed easily. A 0.9% sodium chloride infusion was commenced whilst awaiting confirmation of line position. Chest X-ray showed the PICC projected over the subclavian vein with mild residual airspace shadowing in both lungs (figure 1). The PICC position was felt to be acceptable when the X-ray was reviewed prospectively and retrospectively.

Figure 1

Chest X-ray showing peripherally inserted central catheter...

https://ift.tt/2OpFR81

Retinal Nerve Fiber Layer and Peripapillary Capillary Density Reduction Detected Using Optical Coherence Tomography Enface Images and Angiography in Optic Tract Syndrome

Abstract: In a patient with an optic tract syndrome, we describe the loss of retinal nerve fiber layer and retinal microvasculature using enface and optical coherence tomography angiography image analyses. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Address correspondence to Atsushi Miki, MD, PhD, Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan; E-mail: amiki@tc5.so-net.ne.jp Supported by Japan Society for the Promotion of Science, Award Number: 17K11497: A. Miki. The authors report no conflicts of interest. © 2018 by North American Neuro-Ophthalmology Society

https://ift.tt/2OZos33

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Παρασκευή 28 Σεπτεμβρίου 2018

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