Incidence of simultaneous renal cyst with calyceal diverticula in contralateral kidney is rare in children. A minimally invasive procedure in different sittings is often recommended.
https://ift.tt/2NUSecs
Δευτέρα 1 Οκτωβρίου 2018
Robotic renal cyst decortication with calyceal diverticulectomy in a toddler – technical practicalities: a case report
Correction to: Neural therapy of an athlete’s chronic plantar fasciitis: a case report and review of the literature
In the publication of this article [1], there are reference errors in four positions the respective references are missing since reference Fischer [26] was omitted.
https://ift.tt/2y6UPWb
Characterization of pyrolysis bio-oil derived from intermediate pyrolysis of Aegle marmelos de-oiled cake: study on performance and emission characteristics of C.I. engine fueled with Aegle marmelos pyrolysis oil-blends
Abstract
The present research focuses on the analyzing the characteristics of bio-oil derived from intermediate pyrolysis of Aegle marmelos (AM) seed cake and its suitability for C.I. engine adaptation. Owing to the high volatile matter content of 73.69%, Aegle marmelos biomass was selected as the feedstock for this research. The intermediate pyrolysis was carried out at 600 °C in a 2-kg fixed bed type pyrolysis reactor at a heating rate of 10 °C/min and the obtained bio-oil was characterized by different analytical methods. As per American Society for Testing and Materials (ASTM) standards, physicochemical properties of the bio-oil were tested and it was observed that bio-oil is a highly viscous fluid with low calorific value. Analysis of bio-oil through FT-IR and GC-MS examination confirmed the presence of phenol, esters, alkyl, and oxygenated compounds. The performance and emission testing of direct injection diesel engine were conducted with various bio-oil blends and the results were compared with baseline diesel fuel. The experimental results showed that the addition of bio-oil decreased BTE (%) while increasing the BSEC (MJ/kW-h). At the same time, increasing the bio-oil ratio with diesel decreases dangerous emissions such as carbon monoxide and oxides of nitrogen emissions in the engine exhaust. According to engine test result, it was suggested that up to 20% of AM bio-oil (F20) can be employed as engine fuel for better engine operating characteristics.
https://ift.tt/2DNYz50
Metals in a northern Nile Delta lake: water, suspended particulates, sediments, and biota
Abstract
Lake Edku is one of the important fishing areas in the Nile Delta. It is exposed to different quantities of serious pollutants in particular metals. To overall appraise the risk and status of metals in the lake, a comprehensive study of total concentrations of cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), and zinc (Zn) in sediments and spatial-temporal variations of these metals in the dissolved and suspended particulates, and some tissues of Tilapias niloticus, was conducted from ten sampling sites during 2016. Results showed that none of the investigated metals exceeded the limits considered as hazardous for aquatic life in water. The highest concentrations of Cd, Cu, Ni, and Zn were observed in suspended particulate matter, which may precipitate on the surface of the sediments. Potential ecological risk analysis of the majority of the investigated metals in the sediment indicated that Lake Edku posed a low ecological risk. The estimated values of all metals in tissues of Tilapia niloticus were below the international permissible limits. Moreover, the potential risk of metals to human via the consumption of Tilapia niloticus was estimated using the weekly intake levels, which was lower than the WHO's safe provisional tolerant weekly intake levels. These results prove the importance of performing measurements of contaminants in various compartments of Lake Ecosystem including sediment, biota, and suspended particulate matter for proper management.
https://ift.tt/2zLiLAy
Accumulation of heavy metals in native Andean plants: potential tools for soil phytoremediation in Ancash (Peru)
Abstract
Metal contamination is a recurring problem in Peru, caused mainly by mine tailings from a past active mining activity. The Ancash region has the largest number of environmental liabilities, which mobilizes high levels of metals and acid drainages into soils and freshwater sources, posing a standing risk on human and environmental health. Native plant species spontaneously growing on naturally acidified soils and acid mine tailings show a unique tolerance to high metal concentrations and are thus potential candidates for soil phytoremediation. However, little is known about their propagation capacity and metal accumulation under controlled conditions. In this study, we aimed at characterizing nine native plant species, previously identified as potential hyperaccumulators, from areas impacted by mine tailings in the Ancash region. Plants were grown on mine soils under greenhouse conditions during 5 months, after which the concentration of Cd, Cu, Ni, Pb, and Zn was analyzed in roots, shoots, and soils. The bioaccumulation (BAF) and translocation factor (TF) were calculated to determine the amount of each metal accumulated in the roots and shoots and to identify which species could be better suited for phytoremediation purposes. Soil samples contained high Cd (6.50–49.80 mg/kg), Cu (159.50–1187.00 mg/kg), Ni (3.50–8.70 mg/kg), Pb (1707.00–4243.00 mg/kg), and Zn (909.00–7100.00 mg/kg) concentrations exceeding national environmental quality standards. After exposure to mine tailings, concentrations of metals in shoots were highest in Werneria nubigena (Cd, 16.68 mg/kg; Cu, 41.36 mg/kg; Ni, 26.85 mg/kg; Zn, 1691.03 mg/kg), Pennisetum clandestinum (Pb, 236.86 mg/kg), and Medicago lupulina (Zn, 1078.10 mg/kg). Metal concentrations in the roots were highest in Juncus bufonius (Cd, 34.34 mg/kg; Cu, 251.07 mg/kg; Ni, 6.60 mg/kg; Pb, 718.44 mg/kg) and M. lupulina (Zn, 2415.73 mg/kg). The greatest BAF was calculated for W. nubigena (Cd, 1.92; Cu, 1.20; Ni, 6.50; Zn, 3.50) and J. bufonius (Ni, 3.02; Zn, 1.30); BCF for Calamagrostis recta (Cd, 1.09; Cu, 1.80; Ni, 1.09), J. bufonius (Cd, 3.91; Cu, 1.79; Ni, 18.36), and Achyrocline alata (Ni, 137; Zn, 1.85); and TF for W. nubigena (Cd, 2.36; Cu, 1.70; Ni, 2.42; Pb, 1.17; Zn, 1.43), A. alata (Cd, 1.14; Pb, 1.94), J. bufonius (Ni, 2.72; Zn, 1.63), and P. clandestinum (Zn, 1.14). Our results suggest that these plant species have a great potential for soil phytoremediation, given their capability to accumulate and transfer metals and their tolerance to highly metal-polluted environments in the Andean region.
https://ift.tt/2DKOmX6
Microflora of normal maxillary sinuses: does it justify perioperative antibiotic treatment in sinus augmentation procedures
Abstract
Objectives
To investigate bacterial flora of normal maxillary sinuses in order to facilitate perioperative antibiotic management in sinus augmentation procedures.
Materials and methods
Specimens of maxillary sinus mucosa were harvested during planned orthognatic surgery in 18 patients with no evidence of rhinosinusitis. The samples were processed according to hospital routine for aerobic and anaerobic cultures.
Results
Ten maxillary sinuses were found sterile. Twenty-six (72%) maxillary mucosa specimens were culture-positive. Aerobes were recovered in 21 sinus samples (58%), predominantly as polymicrobial flora (18 cultures, 50% of all specimens), S. aureus in 2 sinuses of the same patient (6% of the samples), and Bacillus sp. in 1 sinus (3%). Anaerobes were isolated in 20 of 26 culture-positive specimens (56% of all sinus samples). They were recovered alone in 5 samples. Fifteen anaerobic cultures were polymicrobial (42% of all samples). Propionibacterium acnes was isolated from another 5 sinuses (14%) of 3 patients.
Conclusions
Our data support the policy of perioperative antibiotic prophylaxis in sinus augmentation procedures where Schneiderian membrane is perforated.
Clinical relevance
Evaluating the need of a perioperative antibiotic therapy in sinus augmentation procedures.
https://ift.tt/2NTHxqN
Evaluation of the genotoxic potential of different delivery methods of at-home bleaching gels: a single-blind, randomized clinical trial
Abstract
Objective
This single-blind, parallel, randomized clinical trial evaluated the genotoxic potential and effectiveness of 10% hydrogen peroxide (HP) in patients submitted to at-home bleaching.
Materials and methods
Sixty young volunteers with maxillary incisors equal to or darker than M1.5 were included in the study. Patients were submitted to bleaching for 14 days (30 min/day) with one of the three 10% HP treatments: the bleaching agent was delivered in a bleaching tray (White Class, FGM), whitening strips (White Strips, Oral-b), or in prefilled disposable trays (Opalescence Go, Ultradent). The color change was evaluated with the Vita Bleachedguide, and the micronucleus test of exfoliative oral mucosa was carried out, starting from a count of 1000 cells, at the baseline, immediately after and 30 days after the end of the treatment. The micronucleus data were evaluated with the Kruskal-Wallis and Wilcoxon tests and color change with the two-way ANOVA test and the Tukey test (α = 0.05).
Results
Significant whitening was observed for all groups after 14 days (p = 0.001) and was maintained after 30 days, with no difference between groups (p = 0.42). The micronucleus count did not indicate genotoxic potential in any of the groups studied (p = 0.32), irrespective of the time intervals (p = 0.62).
Conclusion
No genotoxic effects of 10% HP were observed in patients submitted to at-home bleaching systems (30 min/day for 14 days), even 30 days after the end of treatment.
Clinical significance
It is safe to use different systems to deliver 10% HP during at-home bleaching according to the manufacturers' recommendations, with no risk of genotoxic effects applied.
https://ift.tt/2y3c1Mc
Why Shouldn’t We Forget About the Role of Clinical Psychologists in the Treatment of Patients with Psoriasis?
Epidermal Nevi and Related Syndromes — Part 1: Keratinocytic Nevi
Epidermal Nevi and Related Syndromes —Part 2: Nevi Derived from Adnexal Structures
Cutaneous Adverse Drug Reactions: How to Identify the Trigger
The Library of the Spanish Academy of Dermatology and Venereology (AEDV)
Functional Surgery for Malignant Subungual Tumors: A Case Series and Literature Review
Systemic Treatment of Moderate to Severe Psoriasis in Pediatric Patients in Galicia, Spain: A Descriptive Study
A. Batalla, R. Fernández-Torres, L. Rodríguez-Pazos, B. Monteagudo, R. Pardavila-Riveiro, R. Rodríguez-Lojo, Á. Zulaica, M. Cabanillas, E. Fonseca, Á. León, L. Fernández-Díaz, T. Abalde, L. Salgado-Boquete, F. Valdés, M.J. Seoane-Pose, H. Vázquez-Veiga, I. Suárez-Conde, J. Álvarez-López, Á. Flórez
Actas Dermosifiliogr.2018;109:722-32
Abstract - Full Text - PDF
https://ift.tt/2NXg879
Measurement of the Psychological Impact of Psoriasis on Patients Receiving Systemic Treatment
Blisters Induced by PUVA: A Report of 5 Cases
Diffuse Erythema and Acral Hyperkeratosis in a Newborn
Multiple Acquired Hypopigmented Nodules on the Anterior Chest
Panniculitis Due to Atypical Mycobacteria After Mesotherapy
Inflammation of Actinic Keratosis During Panitumumab Therapy
Sulfate supply enhances cadmium tolerance in Vicia faba L. plants
Abstract
Sulfur deficiency and cadmium (Cd) pollution are two ubiquitous constraints affecting plant growth in agricultural soils. However, facing the situation of sulfur deficiency, whether surplus sulfate supply can affect Cd toxicity in plants is still unclear. Therefore, in the present study, experiments with deficient, sufficient, and excess sulfate levels under Cd stress were conducted in faba bean plants hydroponically. We found that sulfate supply significantly increased biomass of Cd-stressed plants when compared with deficient sulfate treatment. Intriguingly, sulfate application also increased Cd concentrations in leaves. Based on increased Cd concentrations without retarding plant growth, we conclude that sulfate supply enhances Cd tolerance in faba bean plants. Sulfate application increased CdSO40 proportion in the growth medium which is partially related to the increase of Cd in plants because the diffusion of CdSO40 is faster than Cd2+ in plants. Further study on Cd localization showed that this heavy metal was prone to accumulate in the epidermis of leaves as affected by sulfate which might contribute to enhancement of Cd tolerance. Oxidative stress induced by Cd toxicity was alleviated by surplus sulfate supply compared with deficient sulfate. Although capacities of total antioxidants were increased by sulfate in Cd-stressed plants, phenolic compounds as one kind of important antioxidants were unchanged, suggesting that sulfate has no effect on phenolic compounds for scavenging ROS under Cd stress. Taken together, sulfate accelerates Cd accumulation in the epidermis of leaves in faba bean giving rise to higher Cd tolerance.
https://ift.tt/2NfNUPR
Effects of Radioactive Iodine Therapy on Ovarian Reserve: A Prospective Pilot Study
Thyroid, Ahead of Print.
https://ift.tt/2DMntlt
Surgical treatments for a case of superior canal dehiscence syndrome associated with patulous Eustachian tube
The patulous Eustachian tube (PET) and superior semicircular canal dehiscence syndrome (SCDS) have similarity in their symptoms and similar effects caused by positional changes, causing difficulty in the differentiation between the two disorders. This report describes a case of both SCDS and PET that was eventually successfully treated.
https://ift.tt/2QmCKe8
Simultaneous bilateral butterfly tympanoplasty using tragal cartilage from one ear
To evaluate the outcomes of simultaneous bilateral inlay butterfly cartilage tympanoplasties (BIBCT) using tragal cartilage from one ear in patients with bilateral chronic otitis media (BCOM).
https://ift.tt/2NYYC2A
Thyroid Nodules and Goiters Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these regards thyroid nodules and goiters.
- Dr. Trevor Engell of the Division of Endocrinology, Diabetes, and Hypertension at Brigham and Women's Hospital and Harvard Medical School, in Boston, Massachusetts, will present a study called "Xpression Atlas Findings in the Genomic Sequencing Classifier (GSC) Clinical Validation Cohort."
The GSC used in this study classifies cytologically indeterminate thyroid nodules as either benign (B) or suspicious (S). The ability to detect genomic variants and fusions was recently expanded by the Xpression Atlas (XA), which identifies 761 nucleotide variants and 130 fusion gene pairs in 511 genes. In this study, researchers used XA to analyze the mutational spectrum of 190 nodules classified with standard histologic diagnoses (using microscopic studies of the tissues) as belonging to categories III and IV in the Bethesda System for Reporting Thyroid Cytopathology (BSRTC). The conclusion was that GSC is better than XA for ruling out cancers, while the two used together may provide additional insights into pathway activation and potential cancer treatment targets.
Another study involving XA will be presented by Dr. Allan C. Golding of the Memorial Center for Integrative Endocrine Surgery in Hollywood, Florida. Titled "Xpression Atlas Variants and Fusions Found Among 4,742 Thyroid Nodules," the study involved reanalyzing all clinical samples with complete XA profiles from July 2017 to April 3, 2018.
Overall, fusions were detected less frequently than variants across all BSRTC categories. This analysis supported excluding XA reporting among GSC-benign nodules. However, markedly different genomic insights were found between cohorts at increased risk of cancer, specifically, those in categories III through VI of the BSRTC. Together, the GSC and XA contribute substantial genomic content to advance preoperative risk stratification.
In a presentation by Dr. Christine Cherella of Boston Children's Hospital (BCH), attendees will learn how "Malignancy Rates of Thyroid Nodules Differ Between Children and Adults Within Indeterminate Cytopathological Categories." Thyroid nodules are more common in older individuals but are more likely to be malignant in younger ones. Although the BSRTC is widely used to interpret fine-needle aspiration (FNA) cytology, it is unclear whether BSRTC diagnostic categories suggest the same risk of malignancy in younger versus older patients.
Researchers evaluated all consecutive patients who underwent FNA of a thyroid nodule ≥1 cm in diameter, at the BCH and the Brigham and Women's Hospital between 1998 and 2016. They found that, in children and adults with clinically relevant thyroid nodules, malignancy rates differ within indeterminate BSRTC categories defined by similar morphologic features. This finding likely reflects true differences in nodule biology rather than variations in cytological classification.
Dr. Yu-kun Luo of the Ultrasound Department, General Hospital of Chinese PLA, Beijing, China, will present a study titled "Artificial Intelligence-Assisted Ultrasound Diagnosis for Thyroid Nodules." Due to uneven development of medical resources, diagnostic accuracy for thyroid nodules varies greatly. The aim of this study was to explore a novel AI-assisted ultrasound diagnostic system to improve the efficiency and accuracy of thyroid nodule diagnosis.
To test the accuracy of the new system, 500 pathologically confirmed thyroid nodules were selected, including 208 benign and 292 malignant ones. The images of all nodules, acquired from 10 different types of ultrasound equipment, were dynamically stored in the form of consecutively longitudinal and transverse sections. The AI-assisted diagnostic system recognized and analyzed the features of the images and offered recommendations for diagnosis. The diagnostic accuracy of the system was then compared with that of junior and senior physicians. Results showed the diagnostic accuracy of the AI system alone was higher than that of junior physicians (77.6% vs. 70.5%); however, accuracy could reach 92.4% when junior physicians were assisted by the new AI system—higher than the accuracy of senior physicians (85.6%) unassisted by the system. For nodules of different sizes, testing showed no significant difference in diagnostic accuracy among the three groups.
Another presentation will be given by Dr. Mingbo Zhang of the same department in Beijing's General Hospital. Dr. Mingbo will describe a "Randomized controlled clinical trial of ethanol-sensitized radiofrequency ablation (RFA) for benign solid thyroid nodules" that took place between June 2016 and February 2018. While solid thyroid nodules are good candidates for RFA surgery, they often require high power and energy, which increase the incidence of complications. This study used ethanol as a sensitizer before RFA to explore whether that could achieve a safer, faster, and more effective result.
Seventy-two patients with 84 nodules among them were enrolled in the study group and in a conventional RFA group, respectively, each with 42 nodules. The researchers concluded that ethanol can significantly improve the efficiency of RFA, reduce the time and energy of the ablation, and reduce the occurrence of complications.
In a presentation titled "Efficacy and Safety of Thermal Ablation of 200 Benign Thyroid Nodules: Comparison of Three Techniques (Radiofrequency, Laser, High Intensity Focused Ultrasound)," Dr. Adrien Ben Hamou of the Endocrinology Department at the University Hospital in Lille, France, will describe a bicentric retrospective study conducted between October 2013 and January 2018.
The aim was to compare the three ablation methods for treating benign thyroid nodules. Two hundred nodules were treated in 176 patients with benign histology or cytology, all of whom refused surgery. Clinical, biological, and ultrasound evaluation was performed before treatment. Researchers compared variations in volume and symptoms as well as side effects at 6 weeks and 12 months after treatment. Volume reduction between radiofrequency (RFA) and laser (LA) ablation was significantly different at 6 weeks but not at 12 months. After adjustments, no significant difference was observed at either 6 weeks or 12 months between RFA and high-intensity focused ultrasound (HIFU) or between LA and HIFU. Clinical symptoms were reduced in all three groups. Very few transient but potentially serious side effects were reported, the causes of which should be analyzed.
###
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Thyroid Nodules and Goiters Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
https://ift.tt/2NUEuhX
Disorders of Thyroid Function Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these concerns disorders of thyroid function.
- Dr. Maia Banige will give a presentation titled "Prediction of fetal and neonatal dysthyroidism," showing how imperfect development and function of the thyroid in fetuses (FD) and newborns (ND) can be predicted from perinatal variables. Dr. Banige is from the Department of Pediatrics-Neonatology and Pediatric Emergency of the French-British Hospital Institute, Levallois-Perret, Ile-de-France.
She and her colleagues conducted a retrospective, multicenter study using data from the medical records of all patients monitored for pregnancy from 2007 to 2014 in 10 obstetric centers of the Assistance Publique des Hôpitaux de Paris. Women with Graves' disease who were positive for thyrotropin receptor antibodies (TRAb) at least once during pregnancy were included. Among 280,000 births, 2,288 medical records of women with thyroid dysfunction were selected and screened, and 417 women with Graves' disease who were positive for TRAb during pregnancy (0.15%) were finally included in the study.
Analysis revealed that the TRAb level in the mother and child was the strongest independent predictor of thyroid dysfunction. The risk of FD and ND increases with maternal hormonal imbalance and is also greater in the patients receiving antithyroid drugs (ATDs) during pregnancy. In pregnant women with TRAb levels ≥2.5 IU/L, fetal ultrasound monitoring is essential until delivery. All newborns with TRAb levels ≥6.8 IU/L should be examined by a pediatrician with special attention for thyroid dysfunction.
A presentation titled "Pre-conception thyroid stimulating hormone level and risk of preterm birth in over 4.3 million rural Chinese women aged 20-49 years: a population-based cohort study" will be given by Dr. Ying Yang of the National Research Institute for Health and Family Planning and the National Human Genetic Resources Center. Dr. Ying and his colleagues studied the association between the pre-conception thyroid stimulating hormone (TSH) levels of women planning for pregnancy and the risk of preterm births (PTB).
Researchers conducted a historical cohort study of 4,320,584 rural reproductive-age women who had participated in free National Free Pre-pregnancy Checkups (NFPC) in 2013-2016 in China. Data on preconception TSH, history of pregnancy and diseases, and other variables were obtained from the physical examination record in NFPC. Successful conception and pregnancy outcomes were documented during the follow-up period, June 2013 to December 2017. PTB is defined as any birth within 28 to 37 weeks of gestational age. Participants who failed to become pregnant within 6 months, suffered from fetal death or stillbirth, or had multiple gestations during the period of study were excluded from the analysis. The data documented 283,854 PTB events (6.57%).
The study identified a V-shaped relationship between maternal pre-conception TSH levels and PTB risk. Either decreasing or increasing pre-conception TSH levels can significantly increase the risk of preterm birth.
Dr. George Kahaly of the Department of Medicine at Johannes Gutenberg University Medical Center in Mainz, Germany, and colleagues have undertaken a three-phase clinical trial of the drug teprotumumab. Results from the first phase—a 24-week randomized, double-masked, placebo-controlled treatment trial of the drug, which is an insulin-like growth-factor-1 receptor inhibitory antibody—were reported in the New England Journal of Medicine (NEJM 2017; 376:1748). Compared with a placebo (69% versus 20%), teprotumumab reduced protopsis (protrusion of the eyeballs) significantly beginning at week 6 and continuing over the 24 weeks of the trial. This second-phase report is an assessment of clinical status at weeks 28 and 72.
At week 28 (4 weeks after the treatment period), proptosis response was 73.8% in the teprotumumab group versus 13.3% in controls. At week 72 (48 weeks after treatment), 53% of week 24 teprotumumab proptosis responders maintained ≧ 2 mm improvement relative to baseline. Compared to baseline and placebo, clinical activity also decreased at week 28 and was relatively unchanged in the teprotumumab group at week 72. These results indicate no acute rebound of disease following the 24-week treatment.
Dr. Kahaly's group conclude that teprotumumab may represent a disease-modifying therapy in TAO by reducing proptosis and clinical activity, with sustained effects seen in most patients 48 weeks after treatment. In phase 3 of the trial, the research group will investigate whether patients would benefit from longer treatment or retreatment with teprotumumab.
Dr. Mats Holmberg of Institute of Medicine, Sahlgrenska Academy, and the Karolinska University Hospital, ANOVA, both in Stockholm, Sweden, will present a study titled "Structural brain changes in Graves' hyperthyroidism may be of autoimmune origin." During the hyperthyroid state of Graves' disease (GD), the volumes of medial temporal lobe (MTL) structures, e.g., the hippocampi, are reduced. This has been attributed to high thyroid hormone levels, but Dr. Holmberg and his colleagues hypothesized that the structural changes and mental symptoms may be due to autoimmunity per se. The aim of their study was to determine the relationship between nonthyroid autoimmunity and MTL volumes during hyperthyroidism in GD.
Dr. Holmberg's project is a longitudinal, observational, prospective case-controlled study in which 65 premenopausal women were evaluated within 2 weeks after a diagnosis of GD and again after 15 months of antithyroid treatment. Thyroid-stimulating hormone receptor antibodies, thyroid-stimulating immunoglobulins, and several additional antibodies were measured in the hyperthyroid state. MTL structures were scanned to determine hippocampal and amygdala volumes. This presentation reports preliminary data on the nonthyroid antibodies at baseline. Data on the thyroid antibodies will be reported separately.
The data so far support the hypothesis that autoimmunity that is not directly connected to the thyroid may be involved in the impairment of brain function in GD, introducing a new concept that needs further study.
###
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Disorders of Thyroid Function Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
https://ift.tt/2y42u7t
Thyroid Nodules and Goiters Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these regards thyroid nodules and goiters.
- Dr. Trevor Engell of the Division of Endocrinology, Diabetes, and Hypertension at Brigham and Women's Hospital and Harvard Medical School, in Boston, Massachusetts, will present a study called "Xpression Atlas Findings in the Genomic Sequencing Classifier (GSC) Clinical Validation Cohort."
The GSC used in this study classifies cytologically indeterminate thyroid nodules as either benign (B) or suspicious (S). The ability to detect genomic variants and fusions was recently expanded by the Xpression Atlas (XA), which identifies 761 nucleotide variants and 130 fusion gene pairs in 511 genes. In this study, researchers used XA to analyze the mutational spectrum of 190 nodules classified with standard histologic diagnoses (using microscopic studies of the tissues) as belonging to categories III and IV in the Bethesda System for Reporting Thyroid Cytopathology (BSRTC). The conclusion was that GSC is better than XA for ruling out cancers, while the two used together may provide additional insights into pathway activation and potential cancer treatment targets.
Another study involving XA will be presented by Dr. Allan C. Golding of the Memorial Center for Integrative Endocrine Surgery in Hollywood, Florida. Titled "Xpression Atlas Variants and Fusions Found Among 4,742 Thyroid Nodules," the study involved reanalyzing all clinical samples with complete XA profiles from July 2017 to April 3, 2018.
Overall, fusions were detected less frequently than variants across all BSRTC categories. This analysis supported excluding XA reporting among GSC-benign nodules. However, markedly different genomic insights were found between cohorts at increased risk of cancer, specifically, those in categories III through VI of the BSRTC. Together, the GSC and XA contribute substantial genomic content to advance preoperative risk stratification.
In a presentation by Dr. Christine Cherella of Boston Children's Hospital (BCH), attendees will learn how "Malignancy Rates of Thyroid Nodules Differ Between Children and Adults Within Indeterminate Cytopathological Categories." Thyroid nodules are more common in older individuals but are more likely to be malignant in younger ones. Although the BSRTC is widely used to interpret fine-needle aspiration (FNA) cytology, it is unclear whether BSRTC diagnostic categories suggest the same risk of malignancy in younger versus older patients.
Researchers evaluated all consecutive patients who underwent FNA of a thyroid nodule ≥1 cm in diameter, at the BCH and the Brigham and Women's Hospital between 1998 and 2016. They found that, in children and adults with clinically relevant thyroid nodules, malignancy rates differ within indeterminate BSRTC categories defined by similar morphologic features. This finding likely reflects true differences in nodule biology rather than variations in cytological classification.
Dr. Yu-kun Luo of the Ultrasound Department, General Hospital of Chinese PLA, Beijing, China, will present a study titled "Artificial Intelligence-Assisted Ultrasound Diagnosis for Thyroid Nodules." Due to uneven development of medical resources, diagnostic accuracy for thyroid nodules varies greatly. The aim of this study was to explore a novel AI-assisted ultrasound diagnostic system to improve the efficiency and accuracy of thyroid nodule diagnosis.
To test the accuracy of the new system, 500 pathologically confirmed thyroid nodules were selected, including 208 benign and 292 malignant ones. The images of all nodules, acquired from 10 different types of ultrasound equipment, were dynamically stored in the form of consecutively longitudinal and transverse sections. The AI-assisted diagnostic system recognized and analyzed the features of the images and offered recommendations for diagnosis. The diagnostic accuracy of the system was then compared with that of junior and senior physicians. Results showed the diagnostic accuracy of the AI system alone was higher than that of junior physicians (77.6% vs. 70.5%); however, accuracy could reach 92.4% when junior physicians were assisted by the new AI system—higher than the accuracy of senior physicians (85.6%) unassisted by the system. For nodules of different sizes, testing showed no significant difference in diagnostic accuracy among the three groups.
Another presentation will be given by Dr. Mingbo Zhang of the same department in Beijing's General Hospital. Dr. Mingbo will describe a "Randomized controlled clinical trial of ethanol-sensitized radiofrequency ablation (RFA) for benign solid thyroid nodules" that took place between June 2016 and February 2018. While solid thyroid nodules are good candidates for RFA surgery, they often require high power and energy, which increase the incidence of complications. This study used ethanol as a sensitizer before RFA to explore whether that could achieve a safer, faster, and more effective result.
Seventy-two patients with 84 nodules among them were enrolled in the study group and in a conventional RFA group, respectively, each with 42 nodules. The researchers concluded that ethanol can significantly improve the efficiency of RFA, reduce the time and energy of the ablation, and reduce the occurrence of complications.
In a presentation titled "Efficacy and Safety of Thermal Ablation of 200 Benign Thyroid Nodules: Comparison of Three Techniques (Radiofrequency, Laser, High Intensity Focused Ultrasound)," Dr. Adrien Ben Hamou of the Endocrinology Department at the University Hospital in Lille, France, will describe a bicentric retrospective study conducted between October 2013 and January 2018.
The aim was to compare the three ablation methods for treating benign thyroid nodules. Two hundred nodules were treated in 176 patients with benign histology or cytology, all of whom refused surgery. Clinical, biological, and ultrasound evaluation was performed before treatment. Researchers compared variations in volume and symptoms as well as side effects at 6 weeks and 12 months after treatment. Volume reduction between radiofrequency (RFA) and laser (LA) ablation was significantly different at 6 weeks but not at 12 months. After adjustments, no significant difference was observed at either 6 weeks or 12 months between RFA and high-intensity focused ultrasound (HIFU) or between LA and HIFU. Clinical symptoms were reduced in all three groups. Very few transient but potentially serious side effects were reported, the causes of which should be analyzed.
###
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Thyroid Nodules and Goiters Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
https://ift.tt/2NUEuhX
Disorders of Thyroid Function Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these concerns disorders of thyroid function.
- Dr. Maia Banige will give a presentation titled "Prediction of fetal and neonatal dysthyroidism," showing how imperfect development and function of the thyroid in fetuses (FD) and newborns (ND) can be predicted from perinatal variables. Dr. Banige is from the Department of Pediatrics-Neonatology and Pediatric Emergency of the French-British Hospital Institute, Levallois-Perret, Ile-de-France.
She and her colleagues conducted a retrospective, multicenter study using data from the medical records of all patients monitored for pregnancy from 2007 to 2014 in 10 obstetric centers of the Assistance Publique des Hôpitaux de Paris. Women with Graves' disease who were positive for thyrotropin receptor antibodies (TRAb) at least once during pregnancy were included. Among 280,000 births, 2,288 medical records of women with thyroid dysfunction were selected and screened, and 417 women with Graves' disease who were positive for TRAb during pregnancy (0.15%) were finally included in the study.
Analysis revealed that the TRAb level in the mother and child was the strongest independent predictor of thyroid dysfunction. The risk of FD and ND increases with maternal hormonal imbalance and is also greater in the patients receiving antithyroid drugs (ATDs) during pregnancy. In pregnant women with TRAb levels ≥2.5 IU/L, fetal ultrasound monitoring is essential until delivery. All newborns with TRAb levels ≥6.8 IU/L should be examined by a pediatrician with special attention for thyroid dysfunction.
A presentation titled "Pre-conception thyroid stimulating hormone level and risk of preterm birth in over 4.3 million rural Chinese women aged 20-49 years: a population-based cohort study" will be given by Dr. Ying Yang of the National Research Institute for Health and Family Planning and the National Human Genetic Resources Center. Dr. Ying and his colleagues studied the association between the pre-conception thyroid stimulating hormone (TSH) levels of women planning for pregnancy and the risk of preterm births (PTB).
Researchers conducted a historical cohort study of 4,320,584 rural reproductive-age women who had participated in free National Free Pre-pregnancy Checkups (NFPC) in 2013-2016 in China. Data on preconception TSH, history of pregnancy and diseases, and other variables were obtained from the physical examination record in NFPC. Successful conception and pregnancy outcomes were documented during the follow-up period, June 2013 to December 2017. PTB is defined as any birth within 28 to 37 weeks of gestational age. Participants who failed to become pregnant within 6 months, suffered from fetal death or stillbirth, or had multiple gestations during the period of study were excluded from the analysis. The data documented 283,854 PTB events (6.57%).
The study identified a V-shaped relationship between maternal pre-conception TSH levels and PTB risk. Either decreasing or increasing pre-conception TSH levels can significantly increase the risk of preterm birth.
Dr. George Kahaly of the Department of Medicine at Johannes Gutenberg University Medical Center in Mainz, Germany, and colleagues have undertaken a three-phase clinical trial of the drug teprotumumab. Results from the first phase—a 24-week randomized, double-masked, placebo-controlled treatment trial of the drug, which is an insulin-like growth-factor-1 receptor inhibitory antibody—were reported in the New England Journal of Medicine (NEJM 2017; 376:1748). Compared with a placebo (69% versus 20%), teprotumumab reduced protopsis (protrusion of the eyeballs) significantly beginning at week 6 and continuing over the 24 weeks of the trial. This second-phase report is an assessment of clinical status at weeks 28 and 72.
At week 28 (4 weeks after the treatment period), proptosis response was 73.8% in the teprotumumab group versus 13.3% in controls. At week 72 (48 weeks after treatment), 53% of week 24 teprotumumab proptosis responders maintained ≧ 2 mm improvement relative to baseline. Compared to baseline and placebo, clinical activity also decreased at week 28 and was relatively unchanged in the teprotumumab group at week 72. These results indicate no acute rebound of disease following the 24-week treatment.
Dr. Kahaly's group conclude that teprotumumab may represent a disease-modifying therapy in TAO by reducing proptosis and clinical activity, with sustained effects seen in most patients 48 weeks after treatment. In phase 3 of the trial, the research group will investigate whether patients would benefit from longer treatment or retreatment with teprotumumab.
Dr. Mats Holmberg of Institute of Medicine, Sahlgrenska Academy, and the Karolinska University Hospital, ANOVA, both in Stockholm, Sweden, will present a study titled "Structural brain changes in Graves' hyperthyroidism may be of autoimmune origin." During the hyperthyroid state of Graves' disease (GD), the volumes of medial temporal lobe (MTL) structures, e.g., the hippocampi, are reduced. This has been attributed to high thyroid hormone levels, but Dr. Holmberg and his colleagues hypothesized that the structural changes and mental symptoms may be due to autoimmunity per se. The aim of their study was to determine the relationship between nonthyroid autoimmunity and MTL volumes during hyperthyroidism in GD.
Dr. Holmberg's project is a longitudinal, observational, prospective case-controlled study in which 65 premenopausal women were evaluated within 2 weeks after a diagnosis of GD and again after 15 months of antithyroid treatment. Thyroid-stimulating hormone receptor antibodies, thyroid-stimulating immunoglobulins, and several additional antibodies were measured in the hyperthyroid state. MTL structures were scanned to determine hippocampal and amygdala volumes. This presentation reports preliminary data on the nonthyroid antibodies at baseline. Data on the thyroid antibodies will be reported separately.
The data so far support the hypothesis that autoimmunity that is not directly connected to the thyroid may be involved in the impairment of brain function in GD, introducing a new concept that needs further study.
###
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Disorders of Thyroid Function Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
https://ift.tt/2y42u7t
Clinical efficacy of sublingual immunotherapy is associated with restoration of steady-state serum lipocalin 2 after SLIT: a pilot study
So far, only a few biomarkers in allergen immunotherapy exist that are associated with a clinical benefit. We thus investigated in a pilot study whether innate molecules such as the molecule lipocalin-2 (LCN2)...
https://ift.tt/2y9uuqi
Oral symptoms and oral health-related quality of life in patients with chronic kidney disease from predialysis to posttransplantation
Abstract
Objective
This prospective follow-up cohort study analyzed chronic kidney disease (CKD) patients' oral symptoms, health habits, and oral health-related quality of life (OHRQoL), from predialysis to posttransplantation. A simplified questionnaire method (Oral Health Quality Score, OHQS), based on these and clinical findings, was constructed and tested for identifying patients in need for referral to a dentist.
Material and methods
Fifty-three CKD patients were followed up for a mean of 10.3 years. Clinical oral, radiological, and salivary examination was performed at baseline and posttransplantation. Total Dental Index (TDI) indicating inflammation was calculated. The patients filled out a questionnaire on symptoms, oral hygiene and health care habits, smoking, alcohol use, and medication. General health-related quality of life was assessed with the 15-dimensional (15D) instrument at posttransplantation. Descriptive and analytical methods were used in statistics.
Results
OHQS significantly correlated with high TDI (p = 0.017), number of teeth (p = 0.031), and unstimulated salivary flow rate (p = 0.001) in transplanted patients. Number of daily medications showed a negative correlation with the OHQS (r = − 0.30; p = 0.028). The prevalence of oral symptoms was slightly, but not significantly, more common posttransplantation compared with predialysis stage.
Conclusion
OHQS identified patients with high oral inflammatory score thus confirming our study hypothesis.
Clinical relevance
Use of OHQS and measuring salivary flow indicate patients at risk for oral diseases. These markers might be easy to use chair-side also by auxiliary personnel.
https://ift.tt/2Iub4Bm
Characteristics and source apportionment of winter black carbon aerosols in two Chinese megacities of Xi’an and Hong Kong
Abstract
Black carbon (BC) aerosols were observed over Xi'an (XA) and Hong Kong (HK) to better compare its properties and sources in two geographically separate regions in China. High-BC (7.9 ± 3.3 μg·m−3) and -PM2.5 (182 ± 80.5 μg·m−3) concentrations were observed in XA, and these were much higher than those in HK (BC, 3.2 ± 0.9 μg·m−3; PM2.5, 34.5 ± 9.3 μg·m−3). The contribution of BC to PM2.5 in HK reached 10.7%, which was ~ 1.5 times than that in XA (7.6%). The results emphasized that BC played an important role in HK PM2.5. The diurnal distribution of HK BC was highly correlated with vehicle emissions during the daytime; it peaked during heavy traffic times. Whereas XA BC exhibited flat distribution owing to stable BC sources. It is not markedly driven by traffic patterns. Additionally, the potential source contribution function (PSCF) analysis showed that XA BC mainly originated from local emissions while nearly half of the HK BC originated from distant sources, such as industrial emissions from northeastern regions and ship emissions from marine regions. These anthropogenic BC sources were found to be regional in nature based on multilinear engine (ME-2) analysis. Specifically, the XA BC sources were dominated by three factors: 22.5% from coal burning, 19.6% from biomass burning, and 32.9% from vehicle emissions. In HK, the majority of BC contributions originated from vehicle and ship emissions (78.9%), while only 14.5% and 1.5% originated from coal and biomass burning from residential combustion, as well as industrial and power plants in inland China.
https://ift.tt/2Ng5BPs
Patient Safety in Audiology
There is a need to educate audiologists, physicians, and other clinicians about patient safety in audiology. This article addresses the many aspects of patient safety and the applicability to the practice of audiology in health care. Clinical examples of strategies to build a culture of patient safety are provided.
https://ift.tt/2RjPELt
More than keratitis, ichthyosis, and deafness: multisystem effects of lethal GJB2 mutations
Infant death in KID syndrome is recognized; its association with specific genotypes and pathophysiology is inadequately understood.
https://ift.tt/2P4NVb4
Infertility and Teratogenicity after Paternal Exposure to Systemic Dermatologic Medications: A Systematic Review
Many systemic dermatologic medications can cause teratogenicity after maternal exposure. Some of these medications can cause infertility and may have teratogenic effects after paternal exposure; however, teratogenicity is understudied. Information on fertility effects or teratogenicity risk should guide discussions with male patients using these medications and looking to conceive.
https://ift.tt/2O0cEkF
Lower Socioeconomic Status is Associated with Delayed Access to Care for Infantile Hemangioma, a Cohort Study
What is already known on this topic: Children with Medicaid face greater barriers of access-to-care. Delayed management of complicated infantile hemangiomas compromises outcomes. What this article adds to our knowledge. Lower socioeconomic status is associated with delayed care for infantile hemangioma, but not among children with institutional care-management services. How this information impacts clinical practice and/or changes patient care. Institution-facilitated managed-care programs may moderate socioeconomic disparities in accessing timely specialty care and improve outcomes.
https://ift.tt/2NWRmEb
Overall and Subgroup Prevalence of Acne Vulgaris Among Patients with Hidradenitis Suppurativa
This analysis augments the significantly literature establishing the link between acne vulgaris and hidradenitis suppurativa. Understanding the burden of acne vulgaris among patients with hidradenitis suppurativa may support evaluation and optimization of management for both conditions.
https://ift.tt/2P10NPt
Association between atopic dermatitis and autoimmune disorders in US adults and children: A cross-sectional study
•The present study found increased risk of autoimmune disorders of the skin, endocrine, gastrointestinal, hematologic and musculoskeletal systems in both adults and children, with a predilection for females, young age, Asian race/ethnicity and those without asthma.•Clinicians should consider increased screening for autoimmune disorders in atopic dermatitis patients.
https://ift.tt/2NWRmUT
Cost Analysis of a Store and Forward Teledermatology Consult System in Philadelphia
When conducted appropriately, store and forward teledermatology can be cost saving by reducing unnecessary office-based dermatology clinic and emergency room visits. With engagement of stakeholders and proper planning, patients can obtain improved access to high-quality sustainable dermatologic care, in the setting of teledermatology reimbursement.
https://ift.tt/2NUQu2Z
Guideline-Based Medicine Grading based upon the Guidelines of Care for Ambulatory Atopic Dermatitis Treatment in the United States
Although atopic dermatitis practice guidelines are published, how doctors adhere to these guidelines is unknown. Using a grading system analogous to the United States A to F system, healthcare providers receive a grade of B or C in their atopic dermatitis management, suggesting that physicians may benefit from reviewing guidelines of care
https://ift.tt/2P0jYsN
A systematic review and meta-analysis of the regional and age-related differences of atopic dermatitis clinical characteristics
•This study identified considerable heterogeneity of atopic dermatitis, with seventy eight different signs and symptoms identified, and notable differences by study region and age-group.•These phenotypical differences should be incorporated into the diagnosis and severity assessment of atopic dermatitis patients.
https://ift.tt/2NUQmR3
"Treatment of male pattern alopecia with platelet-rich plasma: a double blind controlled study with analysis of platelet number and growth factor levels"
Platelet rich plasma (PRP) has shown promise for androgenetic alopecia. We found PRP injections significantly increased hair growth compared to placebo, but response was not correlated with platelet or the measured growth factors in PRP
https://ift.tt/2NVQGyR
Dr. Kimishige Ishizaka 1926-2018 The discovery of IgE and the revolution in the study of allergic disease
Dr. Ishizaka completed his medical qualifications and PhD at Tokyo University in 1948, and in 1953 he became head of the immune-serology division at the Japanese Institute of Health. In 1957-59 he spent two years at Cal Tech as a fellow with Dan Campbell (see Fig. 1) This period made a major impact on Kimi's subsequent career because Dr. Campbell already had an interest in both reagins and the source of allergens in house dust1, 2. In addition Kimi developed a further understanding of immunochemistry because Dan Campbell was one of the recognized authorities3.
https://ift.tt/2NWbeHG
Opioid Prescribing for Acute Postoperative Pain After Cutaneous Surgery
Nonopioid interventions should be used for patients in pain; patients who need opioids should also receive nonopioid therapy. Among patients requiring opioids, 36-hour supply is generally adequate. Requests for refill beyond expected duration of need should require return visit.
https://ift.tt/2P10LqP
Concordance of skin prick test and serum specific-IgE to locally produced-component-resolved diagnostics for cockroach allergy
Cockroaches (CR) are ubiquitous insects of public health concern as they are not only a potential source of pathogens, but also produce potent allergens that are hazardous to human health. It has been estimated that there are 4,000 extant species of CR. Whereas most species dwell in tropical and subtropical forests, about 50 species have adapted to life as domiciliary pests within the human environment.1 In Thailand, the American cockroach Periplaneta americana is predominant species.2 Exposure to cockroach (CR) allergens represents a high risk for IgE sensitization3,4 and allergic symptoms, particularly allergic rhinitis and atopic asthma after allergen reexposure.
https://ift.tt/2DK2Jeg
The role of TERT promoter mutations in differentiating recurrent nevi from recurrent melanomas: a retrospective, case-control study
Repigmentation at previous biopsy sites pose a significant diagnostic dilemma given clinical and histologic similarities between recurrent nevi and locally recurrent melanoma. While common in melanoma, the role of TERT promoter mutations (TPMs) in recurrent nevi is unknown.
https://ift.tt/2P4cq8e
Feasibility of multi-parametric PET and MRI for prediction of tumour recurrence in patients with glioblastoma
Abstract
Background
Recurrence in glioblastoma patients often occur close to the original tumour and indicates that the current treatment is inadequate for local tumour control. In this study, we explored the feasibility of using multi-modality imaging at the time of radiotherapy planning. Specifically, we aimed to identify parameters from pre-treatment PET and MRI with potential to predict tumour recurrence.
Materials and methods
Sixteen patients were prospectively recruited and treated according to established guidelines. Multi-parametric imaging with 18F-FET PET/CT and 18F-FDG PET/MR including diffusion and dynamic contrast enhanced perfusion MRI were performed before radiotherapy. Correlations between imaging parameters were calculated. Imaging was related to the voxel-wise outcome at the time of tumour recurrence. Within the radiotherapy target, median differences of imaging parameters in recurring and non-recurring voxels were calculated for contrast-enhancing lesion (CEL), non-enhancing lesion (NEL), and normal appearing grey and white matter. Logistic regression models were created to predict the patient-specific probability of recurrence. The most important parameters were identified using standardized model coefficients.
Results
Significant median differences between recurring and non-recurring voxels were observed for FDG, FET, fractional anisotropy, mean diffusivity, mean transit time, extra-vascular, extra-cellular blood volume and permeability derived from scans prior to chemo-radiotherapy. Tissue-specific patterns of voxel-wise correlations were observed. The most pronounced correlations were observed for 18F-FDG- and 18F-FET-uptake in CEL and NEL. Voxel-wise modelling of recurrence probability resulted in area under the receiver operating characteristic curve of 0.77 from scans prior to therapy. Overall, FET proved to be the most important parameter for recurrence prediction.
Conclusion
Multi-parametric imaging before radiotherapy is feasible and significant differences in imaging parameters between recurring and non-recurring voxels were observed. Combining parameters in a logistic regression model enabled patient-specific maps of recurrence probability, where 18F-FET proved to be most important. This strategy could enable risk-adapted radiotherapy planning.
https://ift.tt/2P1jdj6
Dynamics of phosphorus content and the activity of phosphatase in forest soil in the sustained nitrogen compounds emissions zone
Abstract
This paper summarizes research work on the seasonal and profile dynamics of phosphorus content and the activity of phosphatase in soil next to the nitrogen industry. The results are presented of the total phosphorus (TP) and available phosphorus (AP) content and the alkaline phosphatase (AlP) and acid phosphatase (AcP) against the basic physicochemical properties (clay, pH, total organic carbon, total nitrogen). Three soil profiles were sampled from Brunic Arenosols 0.8, 2.0, and 2.5 km away from the nitrogen plant. The control profile was taken from the Tuchola Forest. The soil was collected in both spring and autumn. The results showed that the total phosphorus content was higher in spring than in autumn (the value of index of changes in time TI < 0) contrary to available phosphorus (TI > 0) and in both seasons in surface soils, the lowest, in profile I. Both total and available phosphorus decreased with depth along the soil profiles. The distribution index (DI) calculated for total phosphorus in surface soils demonstrated a rather moderate accumulation, while DI value for available phosphorus for profile III, a considerable accumulation. The availability factor (AF) for all the soil samples was above the threshold of phosphorus load (2%) in the two seasons in this study (from 2.00 to 10.13% for spring and from 3.92 to 21.19% for autumn), suggesting that the transformation rate from TP to AP was high, and AP supply for plant growth was sufficient. The correlation analysis showed a significant and positive correlation of available phosphorus with soil properties such as total organic carbon (r = 0.577), total nitrogen (r = 0.512), and clay (r = 0.493); however, there was no correlation with the activity of phosphatases.
https://ift.tt/2P48BzU
Prognostic role of baseline 18F-FDG PET/CT metabolic parameters in Burkitt lymphoma
Abstract
Purpose
Burkitt's lymphoma (BL) is an aggressive lymphoma subtype with high 18F-FDG avidity at 18F-FDG-PET/CT, but no validated criteria for PET/CT in treatment evaluation or prediction of outcome in BL are available. The aim of our study was to investigate whether the metabolic baseline PET/CT parameters can predict treatment response and prognosis in BL.
Materials and methods
We retrospectively enrolled 65 patients who underwent baseline 18F-FDG-PET/CT, interim and end of treatment PET/CT. The PET images were analyzed visually and semi-quantitatively by measuring the maximum standardized uptake value body weight (SUVbw), the maximum standardized uptake value lean body mass (SUVlbm), the maximum standardized uptake value body surface area (SUVbsa), lesion to liver SUVmax ratio (L-L SUV R), lesion to blood-pool SUVmax ratio (L-BP SUV R), total metabolic tumor volume (tMTV) and total lesion glycolysis (TLG). Survival curves were plotted according to the Kaplan–Meier method.
Results
At a median follow-up of 40 months, the median PFS and OS were 34 and 39 months. MTV and TLG were significantly higher in patients with partial response compared to complete response group at end of treatment, while no significant differences were found at interim. Other metabolic PET/CT parameters were not related to treatment response. MTV and TLG were demonstrated to be independent prognostic factors for both PFS and OS; instead SUVbw, SUVlbm, SUVbsa, L-L SUV R and L-BP SUV R were not related to outcome survival.
Conclusions
Metabolic tumour features (MTV and TLG) were significantly correlated with response to treatment and long-term outcome.
https://ift.tt/2zJMOZl
Microbial diversity in infections of patients with medication-related osteonecrosis of the jaw
Abstract
Objectives
A central role of infections in the treatment of MRONJ patients is widely accepted. An investigation of the MRONJ lesions' biofilms as potential pathogens seems logical.
Materials and methods
We investigated the clinical data of our MRONJ patients who received surgery in advanced stage of the disease. Special attention was granted to the local colonizers harvested from osseous MRONJ specimens and submucosal putrid infections.
Results
Eleven out of 71 patients presented a spontaneous onset of the disease and for 60 out of 71 patients a trigger was detected. Breast cancer (29.6%) and prostate cancer (22.5%) were the most frequent underlying disease for prescription of an antiresorptive therapy, mostly zoledronate. Submucosal soft tissue biofilms significantly differed from biofilms harvested from the MRONJ lesions bottom, yet the most frequent bacteria were equally present in both groups: Streptococcus species (spp.), Prevotella spp., Actinomyces spp., Veillonella spp., and Parvimonas micra. The cephalosporins, cefuroxime and cefotaxime, and ß-lactam antibiotics with ß-lactamase inhibitor revealed the greatest susceptibility for the detected bacteria.
Conclusion
The bacteria from the submucosal areas and the bottom of the infected bone presented comparable susceptibility to the common antibiotics regimes. Streptococcus spp., Prevotella spp., and Veillonella spp. present a high abundance in MRONJ lesions beside Actinomyces spp. The MRONJ lesions bottom is in many cases not infected by Actinomyces spp.
Clinical relevance
The removal of the necrotic bone reduces the variety of bacteria found in MRONJ lesions, in particular at the bottom of the lesion.
https://ift.tt/2DJYcYY
Thyroid Cancer Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these regards thyroid cancer.
- Dr. Marcia Brose of the Department of Otorhinolaryngology at the Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA, will present a study on the "Activity of Larotrectinib in Patients With Advanced TRK Fusion Thyroid Cancer." Tropomyosin receptor kinases (TRKs) are encoded by neurotrophic tyrosine receptor kinase (NTRK) genes. Fusion proteins involving NTRK genes are oncogenic and have been reported in a wide variety of malignancies, including nonmedullary thyroid cancer.
Larotrectinib is a potent and highly selective oral TRK inhibitor. The researchers studied the activity and safety of larotrectinib, using seven patients who had undergone thyroidectomies but were diagnosed with advanced TRK-fusion thyroid cancer.Larotrectinib is highly active and was very well tolerated, with treatment-related adverse events being predominantly grade 1. All patients continued to receive larotrectinib treatment after the end of the study. These results strongly support the inclusion of NTRK gene fusions as part of routine molecular testing for patients with advanced thyroid cancer. - Dr. Gary Clayman of the Thyroid and Parathyroid Institute of Tampa General Hospital in Florida will describe his group's analysis of 217 patients with thyroid nodules and lymph nodes of concern for malignancy. His presentation is titled "A National Epidemic of Inadequate Preoperative Neck Ultrasound in the Evaluation of Suspicious or Malignant Thyroid Nodules and Cervical Lymph Nodes." High-resolution ultrasound evaluation of the central and lateral neck is considered the gold standard in the evaluation of thyroid cancer. Dr. Clayman's group hypothesized that comprehensive ultrasound evaluation of the neck would be commonplace throughout the United States, because it is an accurate predictor of complete surgical resection and long-term, disease-free regional control.
The 217 consecutive patients all provided preoperative ultrasound CDs to the Institute, prior to having additional high-resolution ultrasound evaluation and management of their primary thyroid malignancy at a tertiary referral center during 2017. Information from the evaluation included sonographic status of the thyroid and central and lateral neck lymph nodes, demographics, histopathologic variables, and cancer staging. Of the 66 males and 151 females with a median age of 41 years (range 14-87), 68 (31%) of the previous ultrasound studies were from the southwest region and 149 (69%) from the rest of the United States. The images and reports revealed that only 4 (2%) of the previous ultrasound studies found any lateral neck lymph nodes. However, the high-resolution preoperative ultrasound carried out by Dr. Clayman's group found 101 patients (46%) with T1, 39 (18%) with T2, and 77 (35%) with T3 or T4 thyroid malignancies.
The researchers concluded that preoperative analysis of suspicious and malignant thyroid nodules is inadequate in imaging centers throughout the United States and likely contributes to persistent thyroid malignancy, increased health care costs, and patient morbidity. - In a study titled "Recombinant human thyrotropin [rhTSH] vs. thyroid hormone withdrawal [THW] in radioactive iodine therapy of thyroid cancer patients with nodal metastatic disease: Influence of prognostic factors on follow-up clinical status," Dr. David Taieb of the Nuclear Medicine Department at La Timone Hospital in Marseille, France, and colleagues asked whether patients with well-differentiated thyroid cancers (DTC) would respond differently to radioiodine therapy (RIT) when they were prepared with rhTSH, as opposed to those prepared with THW.While DTC has an excellent prognosis, patients' responses after thyroidectomy and RIT can be influenced by various factors, including age, number of nodes, location of nodes' invasion at diagnosis, and tumor stage. Researchers wanted to discover whether any of these factors effected the response to RIT. The 404 patients, with lymph node metastases and no evidence of distant metastasis at the time of RIT, were prepared with either rhTSH (205 patients) or THW (199). Patients and tumor characteristics were similar between the two groups for up to three years. None of the prognostic factors was found to be associated with different RIT outcomes after preparation with rhTSH versus THW.
###
The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Thyroid Cancer Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
https://ift.tt/2ReSxgp
Thyroid Cancer Presentations at American Thyroid Association: 88th Annual Meeting
October 2, 2018—The American Thyroid Association (ATA) will hold its 88th Annual Meeting on October 3‒7, 2018, at the Marriott Marquis in Washington, DC. In addition to the major speeches and awards, a variety of smaller presentations will be accessible to attendees in the form of posters and oral abstracts. One group of these regards thyroid cancer.
- Dr. Marcia Brose of the Department of Otorhinolaryngology at the Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA, will present a study on the "Activity of Larotrectinib in Patients With Advanced TRK Fusion Thyroid Cancer." Tropomyosin receptor kinases (TRKs) are encoded by neurotrophic tyrosine receptor kinase (NTRK) genes. Fusion proteins involving NTRK genes are oncogenic and have been reported in a wide variety of malignancies, including nonmedullary thyroid cancer.
Larotrectinib is a potent and highly selective oral TRK inhibitor. The researchers studied the activity and safety of larotrectinib, using seven patients who had undergone thyroidectomies but were diagnosed with advanced TRK-fusion thyroid cancer.Larotrectinib is highly active and was very well tolerated, with treatment-related adverse events being predominantly grade 1. All patients continued to receive larotrectinib treatment after the end of the study. These results strongly support the inclusion of NTRK gene fusions as part of routine molecular testing for patients with advanced thyroid cancer. - Dr. Gary Clayman of the Thyroid and Parathyroid Institute of Tampa General Hospital in Florida will describe his group's analysis of 217 patients with thyroid nodules and lymph nodes of concern for malignancy. His presentation is titled "A National Epidemic of Inadequate Preoperative Neck Ultrasound in the Evaluation of Suspicious or Malignant Thyroid Nodules and Cervical Lymph Nodes." High-resolution ultrasound evaluation of the central and lateral neck is considered the gold standard in the evaluation of thyroid cancer. Dr. Clayman's group hypothesized that comprehensive ultrasound evaluation of the neck would be commonplace throughout the United States, because it is an accurate predictor of complete surgical resection and long-term, disease-free regional control.
The 217 consecutive patients all provided preoperative ultrasound CDs to the Institute, prior to having additional high-resolution ultrasound evaluation and management of their primary thyroid malignancy at a tertiary referral center during 2017. Information from the evaluation included sonographic status of the thyroid and central and lateral neck lymph nodes, demographics, histopathologic variables, and cancer staging. Of the 66 males and 151 females with a median age of 41 years (range 14-87), 68 (31%) of the previous ultrasound studies were from the southwest region and 149 (69%) from the rest of the United States. The images and reports revealed that only 4 (2%) of the previous ultrasound studies found any lateral neck lymph nodes. However, the high-resolution preoperative ultrasound carried out by Dr. Clayman's group found 101 patients (46%) with T1, 39 (18%) with T2, and 77 (35%) with T3 or T4 thyroid malignancies.
The researchers concluded that preoperative analysis of suspicious and malignant thyroid nodules is inadequate in imaging centers throughout the United States and likely contributes to persistent thyroid malignancy, increased health care costs, and patient morbidity. - In a study titled "Recombinant human thyrotropin [rhTSH] vs. thyroid hormone withdrawal [THW] in radioactive iodine therapy of thyroid cancer patients with nodal metastatic disease: Influence of prognostic factors on follow-up clinical status," Dr. David Taieb of the Nuclear Medicine Department at La Timone Hospital in Marseille, France, and colleagues asked whether patients with well-differentiated thyroid cancers (DTC) would respond differently to radioiodine therapy (RIT) when they were prepared with rhTSH, as opposed to those prepared with THW.While DTC has an excellent prognosis, patients' responses after thyroidectomy and RIT can be influenced by various factors, including age, number of nodes, location of nodes' invasion at diagnosis, and tumor stage. Researchers wanted to discover whether any of these factors effected the response to RIT. The 404 patients, with lymph node metastases and no evidence of distant metastasis at the time of RIT, were prepared with either rhTSH (205 patients) or THW (199). Patients and tumor characteristics were similar between the two groups for up to three years. None of the prognostic factors was found to be associated with different RIT outcomes after preparation with rhTSH versus THW.
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The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis, and treatment of thyroid disorders and thyroid cancer. ATA is an international membership medical society with over 1,700 members from 43 countries around the world. Celebrating its 95th anniversary, the ATA continues to deliver its mission of being devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. These efforts are carried out via several key endeavors:
- The publication of the highly regarded professional journals Thyroid, Clinical Thyroidology, and VideoEndocrinology
- Annual scientific meetings
- Biennial clinical and research symposia
- Research grant programs for young investigators
- Support of online professional, public, and patient educational programs
- Development of guidelines for clinical management of thyroid disease and thyroid cancer
The ATA promotes thyroid awareness and information online through Clinical Thyroidology for the Public and extensive, authoritative explanations of thyroid disease and thyroid cancer in both English and Spanish. The ATA website serves as the clinical resource for patients and the public who look for reliable information on the Internet. Every fifth year, the American Thyroid Association joins with the Latin American Thyroid Society, the European Thyroid Association, and the Asia and Oceania Thyroid Association to cosponsor the International Thyroid Congress (ITC).
The post Thyroid Cancer Presentations at American Thyroid Association: 88th Annual Meeting appeared first on American Thyroid Association.
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A Survey On Fever Monitoring and Management in Patients With Acute Brain Injury: The SUMMA Study
Background: Fever is common in patients with acute brain injury and worsens secondary brain injury and clinical outcomes. Currently, there is a lack of consensus on the definition of fever and its management. The aims of the survey were to explore: (a) fever definitions, (b) thresholds to trigger temperature management, and (c) therapeutic strategies to control fever. Materials and Methods: A questionnaire (26 items) was made available to members of the European Society of Intensive Care Medicine via its website between July 2016 and December 2016. Results: Among 231 respondents, 193 provided complete responses to the questionnaire (84%); mostly intensivists (n=124, [54%]). Body temperature was most frequently measured using a bladder probe (n=93, [43%]). A large proportion of respondents considered fever as a body temperature >38.3°C (n=71, [33%]). The main thresholds for antipyretic therapy were 37.5°C (n=74, [34%]) and 38.0°C (n=86, [40%]); however, lower thresholds (37.0 to 37.5°C) were targeted in cases of intracranial hypertension and cerebral ischemia. Among first-line methods to treat fever, ice packs were the most frequently utilized physical method (n=90, [47%]), external nonautomated system was the most frequent utilized device (n=49, [25%]), and paracetamol was the most frequently utilized drug (n=135, [70%]). Among second-line methods, intravenous infusion of cold fluids was the most frequently utilized physical method (n=68, [35%]), external computerized automated system was the most frequently utilized device (n=75, [39%]), and diclofenac was the most frequently utilized drug (n=62, [32%]). Protocols for fever control and shivering management were available to 83 (43%) and 54 (28%) of respondents, respectively. Conclusions: In this survey we identified substantial variability in fever definition and application of temperature management in acute brain injury patients. These findings may be helpful in promoting educational interventions and in designing future studies on this topic. E.P. and F.S.T. were involved in the study design, acquisition of data, analysis and interpretation of data, drafting of manuscript, and critical revision. M.O. was involved in study design, analysis and interpretation of data, drafting of manuscript, and critical revision. L.P. and R.H. were involved in study design, drafting of manuscript, and critical revision. F.S.T. is a lecturer for BARD. F.S.T. is the Chair of the Neuro-Intensive Care (NIC) section of the European Society of Intensive Care Medicine (ESICM). R.H. is a lecturer and received congress support from Bard and Zoll. R.H. is a steering committee member for the INTREPID study supported by Bard. L.P. is the Deputy Chair of the NIC section of the ESICM. The remaining authors have no funding or conflicts of interest to disclose. Address correspondence to: Edoardo Picetti, MD, Department of Anesthesia and Intensive Care, Parma University Hospital, Via Gramsci 14, 43100 Parma, Italy (e-mail: edoardopicetti@hotmail.com). Received March 9, 2018 Accepted August 16, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved
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The Effect of Ultra–low-dose Intrathecal Naloxone on Pain Intensity After Lumbar Laminectomy With Spinal Fusion: A Randomized Controlled Trial
Background: Despite advances in pain management, several patients continue to experience severe acute pain after lumbar spine surgery. The aim of this study was to assess the safety and effectiveness of single ultra–low-dose intrathecal (IT) naloxone in combination with IT morphine for reducing pain intensity, pruritus, nausea, and vomiting in patients undergoing lumbar laminectomy with spinal fusion. Materials and Methods: In this double-blind trial, patients scheduled for lumbar laminectomy with spinal fusion were randomly assigned to receive single ultra–low-dose IT naloxone (20 μg) and IT morphine (0.2 mg) (group M+N) or IT morphine (0.2 mg) alone (group M). The severity of postoperative pain, pruritus and nausea, and frequency of vomiting were assessed at recovery from anesthesia and, subsequently, at 1, 3, 6, 12, and 24 hours postoperatively using an 11-point (0-10) visual analogue scale. Results: A total of 77 patients completed the study, and there were significant differences in postoperative pain, pruritus, and nausea visual analogue scale between the groups (P
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Q-switched 1064 nm Nd-Yag nanosecond laser effects on skin barrier function and on molecular rejuvenation markers in keratinocyte-fibroblasts interaction
Abstract
Skin represents an interface between internal and external environment; it protects human body by regulating the water loss and the maintenance of body temperature, defending against irritant and pathogen agents, and against physical, chemical, and UV damage. It provides to essential physiological functions, such as the important antioxidant defense capacity; its protective/defensive function is performed by a high number of proteins, and shows important functions in maintenance of skin barrier homeostasis. Keratinocytes and fibroblasts play a pivotal role to determine or prevent skin aging in response to intrinsic or extrinsic stimuli, modulating cytokines and several biochemical factors. Non-ablative technologies are playing an increasing role in the management of skin aging, inducing a dermal remodeling without a visible epidermal damage. The objective of this study was to evaluate the effect of Q-switched 1064 Nd-YAG laser (Medlite Conbio C6 Nd-YAG laser, Cynosure USA) in skin barrier function, analyzing the constituents which are strongly altered in aging skin. Particularly, we evaluated the expression of filaggrin, TGase, HSP70, and aquaporins, on HaCaT cells. The expression of proinflammatory cytokines has been investigated too.
As a second step of the study, we analyzed the modulation of the rejuvenation molecular markers on human skin fibroblasts (HDFs) stimulated with keratinocytes conditioned medium (KCM).
Our results demonstrated that Q-switched 1064 nm Nd:YAG laser acts on the skin barrier function, increasing the expression of aquaporins, filaggrin, TGase, and HSP70, modulating the proinflammatory cytokines. In fibroblasts stimulated with keratinocytes conditioned medium (KCM) and irradiated with Q-switched 1064 nm Nd:YAG laser, we can observe a reduction of MMP-1 and an increase in procollagen, collagen type I, and elastin. Our results highlight that Q-switched 1064 nm Nd:YAG laser treatment could represent an effective weapon to fight skin aging.
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Detection of KK-LC-1 Protein, a Cancer/Testis Antigen, in Patients with Breast Cancer
Background: Kita-Kyushu lung cancer antigen-1 (KK-LC-1) is a cancer/testis antigen and predominant target for cancer immunotherapy. Its detection is only established based on gene expression. In this study, we established a monoclonal antibody against KK-LC-1 to detect its protein expression in formalin-fixed samples. Materials and Methods: The monoclonal antibody against KK-LC-1 was evaluated and the detection of KK-LC-1 between gene expression and protein expression was compared in patients with breast cancer. The monoclonal antibody clone 34B3, which we established, stained testicular germ cells positively. Results: The rates of detection of KK-LC-1 gene and protein expression were 11.8% and 52.9%, respectively. Protein expression was detected in all triple-negative breast cancer cases studied (n=8). Furthermore, KK-LC-1 was detected in all tumours without oestrogen receptor expression. Conclusion: This study indicated that KK-LC-1 expression was detected in breast cancer, especially in oestrogen receptor-negative subtypes.
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Surgical Endoscopic Vacuum-assisted Closure Therapy (EVAC) in Treating Anastomotic Leakages After Major Resective Surgery of Esophageal and Gastric Cancer
Background/Aim: Endoscopic vacuum-assisted closure therapy (EVAC) is a promising new technique for repairing upper gastrointestinal defects of different etiologies. As of 2018, however, no standardized recommendation exists. This article reviewed EVAC in treating anastomotic leakage following major resective surgery of esophageal (EC) and gastric cancer (GC). Materials and Methods: Only English-language literature was investigated. Only studies or data on EC and GC were included. Seven popular search engines (PubMed, Web of Science, ScienceDirect, Scopus, Google Scholar, ResearchGate, PubFacts) were utilized. Results: A total of 29 studies (17 retrospective, six prospective and six case reports) with a total of 209 patients. Range of anastomotic leakage closure was 66.7-100%. Anastomotic stricture was the most frequent long-term related complication (18 cases). Conclusion: EVAC appears to be an extremely useful treatment for postsurgical anastomotic leakage in patients with EC/GC. Almost all kinds of anastomotic leakage (silent to symptomatic, small to large) seem to be amenable to this technique.
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Current and Future Use of Radiological Images in the Management of Gynecological Malignancies - A Survey of Practice in the UK
Background/Aim: Radiology provides increasingly accurate and complex information. Understanding the clinicians' interpretation of scans could improve surgical planning, decision-making; informed training and development of augmented imaging. This was a survey exploring the interpretation of imaging by clinicians and its use in operative preparation and prediction. Materials and Methods: The survey was open for two-months and circulated online to British Gynaecological Cancer society members. Results: Seventy-three (19%) members completed the survey. Respondents had a confidence level of 51% in their ability to interpret computed tomography (CT) and/or magnetic resonance imaging (MRI) images independently. Preoperative imaging was commonly used to plan operations, predict complications and complete resection. Images were reviewed for primary (96.3%)/interval (92.6%) ovarian debulking, but less so for vulvectomy (45%). Scan (79.6%) and multidisciplinary team meeting (MDT) (66.6%) reports were used more often than scan images (50%) for operative planning. Amount and pattern of disease on scan were the most important factors predicting operating time. Conclusion: Imaging influences the surgeon's planning, however respondents lack confidence. Training of clinicians in radiological interpretation needs to improve. Augmented image interfaces could facilitate this.
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Spinal Ewing Sarcoma Debuting with Cord Compression: Have We Discovered the Thread of Ariadne?
Ewing's sarcoma (ES) of the spine with cord or radicular compression as an initial sign is infrequent. It is unclear, in alleviating a neurological deficit, whether decompressive laminectomy is preferred over chemotherapy. Herein, a literature review of the treatment approaches to the primary or metastatic ES of the spine has been performed. Collected data included clinical features of the patients, treatment, and outcome. There are reported 69 cases with initial presentation of cord or radicular compression of spinal cord, arising from primary or metastatic ES, treated either with initial chemotherapy and/or radiotherapy (RT) (33.33%, n=23), or decompressive surgery (66.66%, n=46). The median age at diagnosis was 17.95 years old (range=0.06-60), and 38 patients (55.07%) were male. Eighteen (78.26%) were initially treated with chemotherapy combined with RT, whereas 3 (13.04%) were managed with RT alone. One patient (4.35%) received only corticosteroids, while there are not available data for the treatment of another one (4.35%). The remaining 46 patients (66.66%) were initially treated with decompressive surgery. Among them, 40 (57.97%) received postoperative chemotherapy, RT or combined modality therapy, whereas 6 patients (8.69%) were not treated adjuvantly. Sixteen out of 23 patients (69.6%) treated with systemic therapy, and 37 from 46 (80.43%) of those managed with decompressive laminectomy were still alive at a mean follow-up period of 2.11 years (range=0.16-6) and 3.45 years (range=0.16-26.08), respectively. To summarize, spinal resection and reconstruction followed by adjuvant treatment reduce the risk of local recurrence, and improve long-term survival. However, ES of the spine is not a distinct clinical entity and can be either managed with chemotherapy and/or RT, similarly to other localization.
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