Head and Neck Diseases by Alexandros G.Sfakianakis: 11/07/18

Τετάρτη 7 Νοεμβρίου 2018

Prostaglandin D2 Levels Regulate CD103+ Conventional Dendritic Cell Activation in Neonates During Respiratory Viral Infection

Viral Immunology, Ahead of Print.

https://ift.tt/2qBuhsS

Three-dimensional force analysis of surgical manipulations at the long process of the incus

Abstract

Purpose

Surgical manipulation with application of inappropriate force may damage middle ear structures leading to hearing loss. This work analyzes the forces applied in simulated otosurgical exercises in a laboratory set-up by measuring the spatial components of applied forces with objective assessment criteria. With these criteria, the individual force characteristics applied by the surgeon can be quantified and an objective feedback can be given about their surgical maneuvers.

Methods

A natural size model of the human incus was mounted on a load cell to measure the spatial forces in all three directions during different manipulation tasks performed under the microscope by ten surgeons from our department having different levels of experience in otosurgery. The motions of the incus model and the instrument tip were recorded simultaneously with a video camera.

Results

Independent of surgical experience, a three-dimensional force pattern could be detected with components transverse to the desired force directions. The measured forces applied by trainees showed larger variations in magnitude, in spatial distribution and in temporal course than those applied by experienced surgeons. A better repeatability of identical tasks, constancy of force patterns and low peak force values could be seen in the group of experienced surgeons.

Conclusions

The laboratory system presented in this study using simultaneous video and 3-D force registration allows the objective assessment of surgical manipulations, e.g., at the long process of the incus. Training with video and force feedback provides information about surgical techniques and skill development of surgeons and has the potential to shorten the learning curve and to diminish intra-operative risks to patients.

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Methicillin-resistant Staphylococcus aureus in health-care workers with cystic fibrosis in Sydney.

Methicillin-resistant Staphylococcus aureus in health-care workers with cystic fibrosis in Sydney.

Respirol Case Rep. 2018 Dec;6(9):e00378

Authors: Song Y, Keatley LR, Middleton PG

Abstract
Cystic Fibrosis (CF), the most common lethal inherited disorder in Australia, is associated with increased respiratory tract colonization/infection. Given that many adults with CF work as health-care workers (HCW), which has been associated with an increased risk of methicillin-resistant Staphylococcus aureus (MRSA) colonization/infection, we examined these risks in 252 adults with CF at our centre between 2001-2015. Demographic and clinical characteristics, including pathogens, were compared for HCW and non-HCW groups. MRSA colonization/infection was found in 20 subjects, comprising 2/19 HCW, and 18/233 non-HCW (p = 0.66). Sixteen of these 20 subjects undertook eradication therapy, with success in 2/2 HCW and 5/14 non-HCW. This study showed that the rate of MRSA colonization/infection did not differ between adults with CF who work in the health-care setting versus other areas. This suggests that choosing a health-care profession does not necessarily result in an increased risk of MRSA colonization/infection for an adult with CF.

PMID: 30397479 [PubMed]

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The unsolved problem of otitis media in indigenous populations: a systematic review of upper respiratory and middle ear microbiology in indigenous children with otitis media.

The unsolved problem of otitis media in indigenous populations: a systematic review of upper respiratory and middle ear microbiology in indigenous children with otitis media.

Microbiome. 2018 Nov 05;6(1):199

Authors: Coleman A, Wood A, Bialasiewicz S, Ware RS, Marsh RL, Cervin A

Abstract
BACKGROUND: Otitis media (OM) imposes a great burden of disease in indigenous populations around the world, despite a variety of treatment and prevention programs. Improved understanding of the pathogenesis of OM in indigenous populations is required to advance treatment and reduce prevalence. We conducted a systematic review of the literature exploring the upper airway and middle ear microbiota in relation to OM in indigenous children.
METHODS: Papers targeting microbiota in relation to OM in children < 18 years indigenous to Australia, New Zealand, North America, and Greenland were sought. MEDLINE, CINAHL, EMBASE, Cochrane Library, and Informit databases were searched using key words. Two independent reviewers screened titles, abstracts, and then full-text papers against inclusion criteria according to PRISMA guidelines.
RESULTS: Twenty-five papers considering indigenous Australian, Alaskan, and Greenlandic children were included. There were high rates of nasopharyngeal colonization with the three main otopathogens (Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis) in indigenous children with OM. Middle ear samples had lower rates of otopathogen detection, although detection rates increased when molecular methods were used. Pseudomonas aeruginosa and Staphylococcus aureus were commonly detected in middle ear discharge of children with chronic suppurative OM. There was a significant heterogeneity between studies, particularly in microbiological methods, which were largely limited to culture-based detection of the main otopathogens.
CONCLUSIONS: There are high rates of otopathogen colonization in indigenous children with OM. Chronic suppurative OM appears to be associated with a different microbial profile. Beyond the main otopathogens, the data are limited. Further research is required to explore the entire upper respiratory tract/middle ear microbiota in relation to OM, with the inclusion of healthy indigenous peers as controls.

PMID: 30396360 [PubMed - in process]

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A Hybrid Approach Towards Successful Resection of a Huge Carotid Body Paraganglioma Using Coil Embolization and Traditional Surgical Techniques

Abstract

Carotid Body Paraganglioma (CBPGL), is a type of neuroendocrine tumor that should be managed promptly due to their malignant potential and locally aggressive nature making resection at a later stage difficult. The objective of this case report is to explore the benefit of coil embolization and describe the surgical techniques employed in successful resection of a huge CBPGL.

https://ift.tt/2PO0B9X

Evaluation of the Predictive and Prognostic Values of Stromal Tumor-Infiltrating Lymphocytes in HER2-Positive Breast Cancers treated with neoadjuvant chemotherapy

Abstract

Background

Stromal tumor-infiltrating lymphocytes (sTILs) have been identified as a predictive biomarker for response to neoadjuvant chemotherapy (NAC) and prognosis in human epidermal growth factor receptor 2 (HER2)-positive breast cancers. However, standardized scoring methods for use in clinical practice need to be established, and the optimal threshold of sTILs to predict pathological complete response (pCR) and prognosis in HER2+ breast cancers has not yet been defined.

Objective

The predictive and prognostic values of sTILs in patients with HER2-positive breast cancer treated with NAC were evaluated, with the aim to explore the optimal thresholds of sTILs and to investigate the feasibility of scoring methods in clinical practice.

Patients and Methods

A total of 143 core needle biopsy specimens of HER2-positive invasive breast cancers obtained from Chinese patients who had been treated with trastuzumab-based NAC followed by surgery between 2009 and 2015 were extracted from the pathology database of Fudan University Shanghai Cancer Center. sTIL levels in the pre-NAC core needle biopsy specimens were scored using methods recommended by the International TILs Working Group 2014. The associations between sTILs and pCR, disease-free survival (DFS), and overall survival (OS) were evaluated, and the optimal thresholds for predictive and prognostic values of sTILs were analyzed.

Results

First, sTILs were associated with a higher pCR rate in HER2-positive breast cancers. Univariate (per 10% sTILs: odds ratio [OR] 1.05, 95% confidence interval [CI] 1.02–1.08, p = 0.001) and multivariate regression analyses (per 10% sTILs: OR 1.04, 95% CI 1.00–1.07, p = 0.034) indicated that sTILs as a continuous variable were a significant predictor of pCR in HER2-positive breast cancers. Receiver operating characteristics (ROC) curve analysis showed that a 20% threshold best distinguished the pCR subgroup from the non-pCR subgroup. The dichotomized sTILs with a threshold set at 20% was a strong predictor of pCR in the univariate (OR 0.25, 95% CI 0.12–0.52, p < 0.001) and multivariate analyses (OR 0.35, 95% CI 0.14–0.87, p = 0.024). Second, sTILs were associated with better prognosis in HER2-positive breast cancers. Univariate (DFS: hazard ratio [HR] 0.91, 95% CI 0.88–0.95, p < 0.001; OS: HR 0.88, 95% CI 0.83–0.94, p < 0.001), and multivariate analyses (DFS: HR 0.93, 95% CI 0.90–0.97, p < 0.001; OS: HR 0.92, 95% CI 0.86–0.98, p = 0.009) suggested that sTILs as a continuous variable had a strong predictive value for improved DFS and OS. As a binary variable with a threshold of 20%, univariate (DFS: HR 6.60, 95% CI 2.91–14.95, p < 0.001; OS: HR 10.29, 95% CI 2.37–44.66, p = 0.002) and multivariate analyses (DFS: HR 3.87, 95% CI 1.65–9.12, p = 0.002; OS: HR 4.74, 95% CI 1.02–22.01, p = 0.047) indicated that patients with ≥ 20% sTILs had a significantly better prognosis than the patients with < 20% sTILs.

Conclusions

Our study indicates that baseline sTILs scored by methods recommended by the International TILs Working Group in pre-NAC core needle biopsy specimens are significantly correlated with pCR and prognosis in HER2-positive breast cancers. A 20% threshold for sTILs may be a feasible diagnostic marker to predict pCR to NAC and prognosis in patients with HER2-positive breast cancers.

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Acknowledgment of Reviewers 2016 and 2017

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Acknowledgment of Reviewers 2016 and 2017

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A Hybrid Approach Towards Successful Resection of a Huge Carotid Body Paraganglioma Using Coil Embolization and Traditional Surgical Techniques

Abstract

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Paralytic Lagophthalmos: Comprehensive Approach to Management

Abstract

Purpose of Review

Facial paralysis can lead to lagophthalmos, loss of corneal protection, and devastating ocular consequences like corneal ulcers or even blindness. The purpose of this review is to discuss the importance of comprehensive and early eye care.

Recent Findings

Treatment of paralytic lagophthalmos should be individualized to each patient's situation; depending on the severity of the problem and the prognosis for recovery, treatment modalities are broad and include lubrication, selective chemodenervation, filler injection, fat augmentation, and surgical procedures like canthopexy and tarsorrhaphy.

Summary

This paper serves to highlight the importance of treating paralytic lagophthalmos and provides an overview of the optimal management algorithm of the compromised periocular complex to help improve function and quality of life. Prospective studies and long-term comparisons of surgical techniques for repair of paralytic lagophthalmos will help improve our understanding of this complex problem and perhaps introduce novel treatment strategies.

https://ift.tt/2Peir6F

Meilensteine der Schilddrüsenchirurgie

Laryngo-Rhino-Otol 2018; 97: 762-771
DOI: 10.1055/a-0664-8953

In der hier vorgelegten Darstellung der Entwicklung der Schilddrüsenchirurgie hin zu einer sicheren Chirurgie, die auf dem aktuellen chirurgischen und medizinhistorischen Forschungsstand und der verfügbaren einschlägigen Literatur basiert, wird die Entwicklungskontinuität hin zu den minimalinvasiven Operationsverfahren, die den dank der historischen Entwicklung erreichten hohen Sicherheitsstandards mindestens genügen müssen, erstmals im medizingeschichtlichen Kontext interpretiert. Das zunehmende Verständnis der Erkrankungen der Schilddrüse und der perioperativen Folgen und Komplikationen, die zu neuen medizinischen und therapeutischen Erkenntnissen führten, wird somit erstmals auch in diesem Kontext interpretiert.Zur Verbesserung des Patientenkomforts im Hinblick auf die Operationswunde und spätere Narbenbildung werden seit Beginn des 21. Jahrhunderts immer wieder neue minimalinvasive Operationsmethoden beschrieben, die sich durch die Zugangsmodalitäten und -wege unterscheiden. Zukünftige Weiterentwicklungen der operativen Zugangswege und Methoden müssen dem heutigen hohen Stand der chirurgischen und nuklearmedizinischen Therapie und ihren Qualitäts- und Sicherheitsstandards mindestens genügen.
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Unterkieferprotrusionsschiene bei obstruktivem Schlafapnoesyndrom getestet

Laryngo-Rhino-Otol 2018; 97: 752-753
DOI: 10.1055/a-0677-5541

Marco Pitarch R et al. Effectiveness of a mandibular advancement device in obstructive sleep apnea patients: a prospective clinical trial. Eur Arch Otorhinolaryngol 2018; 275: 1903–1911 In einer prospektiven Studie wurde die Effektivität einer Unterkieferprotrusionsschiene (mandibular advancement device, MAD) bei Patienten mit obstruktivem Schlafapnoesyndrom getestet. Evaluiert wurden dabei verschiedene Merkmale der Patienten und der MAD als Prädiktoren des Behandlungsergebnisses.
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Fragen für die Facharztprüfung

Laryngo-Rhino-Otol 2018; 97: 812-813
DOI: 10.1055/a-0652-6802

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Fixationsoptionen des Receivers/Stimulators bei Cochlea-Implantation begutachtet

Laryngo-Rhino-Otol 2018; 97: 753-754
DOI: 10.1055/a-0651-4028

Pamuk AE et al. The effect of cochlear implant bed preparation and fixation technique on the revision cochlear implantation rate. J Laryngol Otol 2018; 11:1–6 Zur Prävention einer Migration des Receivers/Stimulators bei der Cochlea-Implantation ist seine Einbettung entscheidend. Türkische Ärzte der Klinik für Hals-, Nasen- und Ohrenheilkunde der Universität von Istanbul verglichen zwei Techniken der Einbettung.
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Schwieriger magnetresonanztomografischer Nachweis eines Hämangioms des N. facialis – Ein Fallbericht

Laryngo-Rhino-Otol 2018; 97: 793-795
DOI: 10.1055/a-0747-6990

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Oropharynx-Karzinom-CT: prognostische Bedeutung der extranodalen Ausbreitung

Laryngo-Rhino-Otol 2018; 97: 754-755
DOI: 10.1055/a-0677-5308

Patel MR et al. Radiographic Imaging Does Not Reliably Predict Macroscopic Extranodal Extension in Human Papilloma Virus-Associated Oropharyngeal Cancer. ORL 2018; 80: 85–95 Amerikanische Radiologen und Fachärzte für Otorhinolaryngologie evaluierten bei Patienten mit Oropharynx-Plattenepithelkarzinomen (OPSCC) die Genauigkeit der präoperativen kontrastmittelverstärkten Computertomographie (CECT), um die extranodale Ausdehnung (ENE) (> 2 mm) zu prognostizieren.
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Reinke-Ödem

Laryngo-Rhino-Otol 2018; 97: 760-761
DOI: 10.1055/a-0652-6769

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Funktionell-ästhetische Rhinochirurgie unter besonderer Berücksichtigung physiologischer Aspekte

Laryngo-Rhino-Otol 2018; 97: 756-756
DOI: 10.1055/a-0719-7383

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Stimm- und Kehlkopfveränderungen im Alter (Presbyphonie und Presbylarynx)

Laryngo-Rhino-Otol 2018; 97: 772-776
DOI: 10.1055/a-0652-6758

Etwa 20 % der über 60-Jährigen weisen eine Altersstimmstörung (Presbyphonie) auf, die oftmals von Presbyakusis (Altersschwerhörigkeit), Presbyphagie (Schluckstörungen im Alter), Presbyvertigo (Altersschwindel) und/oder Presbyopie (Alterssichtigkeit) begleitet wird.Presbyphonie betrifft die Singstimme häufiger, früher und deutlicher als die Sprechstimme. Aber nicht nur Qualität und Belastbarkeit von Sing- und Sprechstimme werden beeinträchtigt, auch der Atemantrieb wird durch die eingeschränkte Lungenfunktion schwächer. Durch das Absenken des Kehlkopfes verändern sich bei Senioren zudem die Resonanzverhältnisse im Ansatzrohr, und das Aspirationsrisiko steigt.Die stimmlichen Einbußen beruhen auf morphologischen Altersveränderungen des Kehlkopfes (Prebylarynx), die sowohl das ektolaryngeale Kehlkopfskelett als auch die endolaryngealen Weichteile (insbesondere die Stimmlippen) betreffen.Der Vokalismuskel atrophiert und wird hypoton, was zu einer spindelförmig-ovalären Glottisschlussinsuffizienz mit Luftverlust bei Phonation führt. Die Schleimhäute trocknen aus im Sinne einer Laryngitis sicca.Bei der Stimmrehabilitation im Alter müssen allgemeine und speziell auf die Stimme bezogene Behandlungsoptionen unterschieden werden: Zu den allgemeinen Therapieansätzen gehört die Mitbehandlung internistischer und neurologischer Grunderkrankungen (z. B. Reflux, neurodegenerative oder zerebrovaskuläre Erkrankungen) – auch Nebenwirkungen von Medikamenten müssen beachtet werden. Ein gesunder Lebensstil ohne Noxen begünstigt den Funktionserhalt von Phonations- und Atemorganen. Stimmtherapeutisch kommen sowohl Tonisierungsübungen zur Verbesserung des phonatorischen Glottisschlusses als auch detonisierende Entspannungsübungen zum Abbau supraglottischer hyperfunktioneller Pressmechanismen in Betracht. In Einzelfällen mit großem Glottisspalt bei Phonation kann eine phonochirurgische Stimmlippenaugmentation den Glottisschluss verbessern und somit die Stimme kräftigen. Stimmhygienische Maßnahmen (z. B. regelmäßiges Befeuchten der Atemwege) ergänzen das Stimmtraining.Singen im Alter hat sowohl psychosozial (Steigerung des Wohlbefindens und der sozialen Teilhabe) als auch immunologisch (Anstieg des IgA im Speichel) positive Effekte.
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Nachruf Prof. Dr. med. Joachim Heermann

Laryngo-Rhino-Otol 2018; 97: 758-759
DOI: 10.1055/a-0734-4304

Am 20.07.2018 ist Herr Prof. Dr. med. Joachim Heermann nach langer Krankheit im Kreise seiner großen Familie in Essen verstorben. Mit Joachim Heermann verliert die HNO-Gesellschaft eine außergewöhnliche Persönlichkeit, einen Pionier der Mikrochirurgie des Ohres und der Nase und einen menschlichen innovativen Geist.
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Aus der Gutachtenpraxis: Die Bedeutung der Bulbusvolumometrie für die Begutachtung von Riechstörungen

Laryngo-Rhino-Otol 2018; 97: 796-798
DOI: 10.1055/a-0652-6791

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Fehlbildungschirurgie von Nase und Lippe

Laryngo-Rhino-Otol 2018; 97: 814-816
DOI: 10.1055/a-0652-6846

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Kommentar der Schriftleitung

Laryngo-Rhino-Otol 2018; 97: 748-749
DOI: 10.1055/a-0652-6736

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Antibiotics in hospital effluents: occurrence, contribution to urban wastewater, removal in a wastewater treatment plant, and environmental risk assessment

Abstract

The study presented the occurrence of antibiotics in 16 different hospital effluents, the removal of antibiotics in urban wastewater treatment plant (WWTP), and the potential ecotoxicological risks of the effluent discharge on the aquatic ecosystem. The total concentration of antibiotics in hospital effluents was ranged from 21.2 ± 0.13 to 4886 ± 3.80 ng/L in summer and from 497 ± 3.66 to 322,735 ± 4.58 ng/L in winter. Azithromycin, clarithromycin, and ciprofloxacin were detected the highest concentrations among the investigated antibiotics. The total antibiotic load to the influent of the WWTP from hospitals was 3.46 g/day in summer and 303.2 g/day in winter. The total antibiotic contribution of hospitals to the influent of the WWTP was determined as 13% in summer and 28% in winter. The remaining 87% in summer and 72% in winter stems from the households. The total antibiotic removal by conventional physical and biological treatment processes was determined as 79% in summer, whereas it decreased to 36% in winter. When the environmental risk assessment was performed, azithromycin and clarithromycin in the effluent from the treatment plant in winter posed a high risk (RQ > 10) for the aquatic organisms (algae and fish) in the receiving environment. According to these results, the removal efficiency of antibiotics at the WWTP is inadequate and plant should be improved to remove antibiotics by advanced treatment processes.

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Improving of the Mg-Co nanoferrites efficiency for crude oil adsorption from aqueous solution by blending them with chitosan hydrogel

Abstract

The efficiency of the as-prepared Mg_0.25Co_0.75Fe₂O₄ spinel nanoparticles for adsorption of crude oil from aqueous solution was improved by blending them with chitosan hydrogel (CH) prepared using epichlorohydrin as cross-linker resulting (CH/Mg_0.25Co_0.75Fe₂O₄) nanocomposites. Mg_0.25Co_0.75Fe₂O₄ nanocrystals was prepared by the chemical co-precipitation method and characterized by using X-ray diffraction (XRD), infrared spectroscopy (FT-IR), scanning electron microscope (SEM), transmission electron microscope (TEM), and differential thermal analysis (DTA)/thermogravimetric analysis (TGA). DTA/TGA results showed that the net weight loss of the samples heated from room temperature up to 1000 °C lies in the range 2.2–26.5% weight, where the maximum weight loss appeared at 100 °C and 614 °C. The blending nanocomposites prepared, were characterized by FT-IR and SEM micrographs. The effect of the nanoparticles ratio on the water uptake of nanocomposites and their capability to adsorb the crude oil was estimated by the gravimetric method. TEM results showed that the average nanoparticle size (Z) of Mg_0.25Co_0.75Fe₂O₄ is 30.06 nm and the SEM illustrated the presence of a very clear and rough layer of pores which are homogenously arranged structures that could play an important role in the adsorption and stability of crude oil on polymers. The adsorption ability of crude oil from waste water on the CH/Mg_0.25Co_0.75Fe₂O₄ nanocomposites hydrogel was reported and it was found that the CH/Mg_0.25Co_0.75Fe₂O₄ with 95/5% ratio showed the improvement in the oil adsorption (72.5%) than the 0/100% one (50.2%). As a consequence, it is highly suggested that the potential of blending CH with Mg_0.25Co_0.75Fe₂O₄ to obtain CH/Mg_0.25Co_0.75Fe2O₄ for enhancing crude oil adsorption in oily waste water treatment with a low cost.

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Production, characterization and effectiveness of cellulose acetate functionalized ZnO nanocomposite adsorbent for the removal of Se (VI) ions from aqueous media

Abstract

In this study, ZnO functionalized cellulose acetate nanocomposite (ZnO/CA NC) was synthesized using a simple chemical approach found to have a high surface area of 657.34 m²/g and utilized as adsorbents for the removal of Se (VI) from aqueous solutions. Investigations on X-ray diffraction (XRD) revealed that ZnO nanocomposite has a smaller crystallite size compared to ZnO nanoparticles which facilitated for reduced agglomeration confirmed by scanning electron microscopy (SEM). The ensuing properties of ZnO/CA NC displayed high maximum adsorption capacity of 160.5 mg/g for Se (VI) ions. Inner-sphere surface complexes on ZnO/CA NC under prevailing conditions for Se (VI) were discussed using FTIR spectroscopical results. In order to evaluate the removal efficiency, the effects of adsorbent dosage, pH, and temperature were thoroughly investigated. The amount of Se (VI) ions adsorbed on ZnO/CA NC was also determined by zeta potential. The fractional removal of pollutants (Se (VI)) was done using mass transfer model. In addition, prominent adsorption capacity was also tested utilizing concurrent anions (SO₄²⁻, Cl⁻, and F⁻) with reference to Se (VI) and cost prudent regenerability of adsorbent by NaOH solution was ascertained with anti-interference and recovery steps. ZnO/CA NC was obtained by simple chemical methodology and high surface adsorption capacities supply an encouraging technique for Se (VI) removal in water treatment applications.

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Influence of salinity cycles in bioreactor performance and microbial community structure of membrane-based tidal-like variable salinity wastewater treatment systems

Abstract

A membrane bioreactor and two hybrid moving bed bioreactor-membrane bioreactors were operated for the treatment of variable salinity wastewater, changing in cycles of 6-h wastewater base salinity and 6-h maximum salinity (4.5 and 8.5 mS cm⁻¹ electric conductivity, which relate to 2.4 and 4.8 g L⁻¹ NaCl, respectively), under different hydraulic retention times (6, 9.5, and 12 h) and total solids concentrations (2500 and 3500 mg L⁻¹). The evaluation of the performance of the systems showed that COD removal performance was unaffected by salinity conditions, while BOD₅ and TN removals were significantly higher in the low-salinity scenario. The microbial community structure showed differences with respect to salinity conditions for Eukarya, suggesting their higher sensitivity for salinity with respect to Prokarya, which were similar at both salinity scenarios. Nevertheless, the intra-OTU distribution of consistently represented OTUs of Eukarya and Prokarya was affected by the different salinity maximums. Multivariate redundancy analyses showed that several genera such as Amphiplicatus (0.01–5.90%), Parvibaculum (0.27–1.19%), Thiothrix (0.30–1.19%), Rhodanobacter (2.81–5.85%), Blastocatella (0.21–2.01%), and Nitrobacter (0.80–0.99%) were positively correlated with BOD₅ and TN removal, and the ecological roles of these were proposed. All these genera were substantially more represented under low-salinity conditions (10–500% higher relative abundance), demonstrating that they might be of importance for the treatment of variable salinity wastewater. Evaluation of Eukarya OTUs showed that many of them lack a consistent taxonomic classification, which highlights the lack of knowledge of the diversity and ecological role of Eukaryotes in saline wastewater treatment processes. The results obtained will be of interest for future design and operation of salinity wastewater treatment systems particularly because little is known on the effect of variable salinity conditions in wastewater treatment.

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What works for jetlag? A systematic review of non-pharmacological interventions

Jetlag is a combination of travel fatigue and circadian misalignment resulting from air travel across time zones. Routinely recommended interventions based on circadian science include timely exposure to light and darkness (scheduled sleep), but the real-world effectiveness of these and other non-circadian strategies is unknown. We systematically reviewed the evidence for non-pharmacological interventions for jetlag. PubMed, EMBASE, Scopus, and Web of Science were searched. Studies reviewed (i) involved human participants undergoing air travel with a corresponding shift in the external light-dark cycle; (ii) administered a non-pharmacological intervention; (iii) had a control or comparison group; and (iv) examined outcomes such as jetlag symptoms, sleep, cognitive/physical performance, mood, fatigue, or circadian markers.

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Immunology of the Ancestral Differences in Eosinophilic Esophagitis

Eosinophilic Esophagitis (EoE) is an allergen driven disease characterized by eosinophilic inflammation in the esophagus1. Like other atopic disorders such as atopic dermatitis (AD), food allergy (FA), allergic rhinitis (AR), and asthma, EoE has complex etiology with genetic predisposition and environmental factors playing a major role in disease development2. The genetic predisposition has been suggested as an important factor by familial and twin studies. Additionally, numerous genetic risk loci have been now described linked to EoE risk confirming that inheritability is associated with genetic predisposition3.

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Review of 400 Consecutive Oral Food Challenges to Almond

Diagnosis of almond allergy is complicated by a high rate of false positive test results. Accurate diagnosis of almond allergy is critical as almond is a source of nutrition and milk products for children with other food allergies.

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Pleiotropic Effects of French Maritime Pine Bark Extract to Promote Healthy Aging

Rejuvenation Research, Ahead of Print.

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Developing air exchange rate models by evaluating vehicle in-cabin air pollutant exposures in a highway and tunnel setting: case study of Tehran, Iran

Abstract

The passengers inside vehicles could be exposed to high levels of air pollutants particularly while driving on highly polluted and congested traffic roadways. In order to study such exposure levels and its relation to the cabin ventilation condition, a monitoring campaign was conducted to measure the levels inside the three most common types of vehicles in Tehran, Iran (a highly air polluted megacity). In this regard, carbon monoxide (CO) and particulate matter (PM) were measured for various ventilation settings, window positions, and vehicle speeds while driving on the Resalat Highway and through the Resalat Tunnel. Results showed on average in-cabin exposure to particle number and PM₁₀ for the open windows condition was seven times greater when compared to closed windows and air conditioning on. When the vehicle was passing through the tunnel, in-cabin CO and particle number increased 100 and 30%, respectively, compared to driving on highway. Air exchange rate (AER) is a significant factor when evaluating in-cabin air pollutants level. AER was measured and simulated by a model developed through a Monte Carlo analysis of uncertainty and considering two main affecting variables, vehicle speed and fan speed. The lowest AER was 7 h⁻¹ for the closed window and AC on conditions, whereas the highest AER was measured 70 h⁻¹ for an open window condition and speed of 90 km h⁻¹. The results of our study can assist policy makers in controlling in-cabin pollutant exposure and in planning effective strategies for the protection of public health.

https://ift.tt/2JMFcbK

Unraveling the enigma: elucidating the relationship between the physicochemical properties of aluminium-based adjuvants and their immunological mechanisms of action

Aluminium salts are by far the most commonly used adjuvants in vaccines. There are only two aluminium salts which are used in clinically-approved vaccines, Alhydrogel® and AdjuPhos®, while the novel aluminium adj...

https://ift.tt/2JOeijN

Process development of silica extraction from RHA: a cradle to gate environmental impact approach

Abstract

India is one of the major rice-producing countries. Rice husk is a major agricultural by-product from rice production, which is used as a fuel in boilers. Its use as fuel produces huge amounts of silica-rich rice husk ash (RHA). This paper aims at providing an overall assessment of environmental impacts associated with the extraction of silica from RHA—a process developed by our study group. The functional unit used in this study is production of 100 kg of silica. The analysis included the extraction and transportation of other raw materials; RHA was assumed to be processed at the site. The study was conducted in accordance with the international ISO 14040 procedural framework. LCA is performed using GaBi Education software, and five midpoint indicators are chosen to assess the environmental impacts of silica extraction. The overall climate change (CC) of the extraction process is 7.26 kg CO₂ equivalent per kg of silica produced. A high contribution of calcination to CC is attributed to the use of electricity. The comprehensive environmental impacts of silica-rich RHA resulting from processing of RHA and improvement options to achieve sustainable production are presented. The negative impacts that can be avoided during silica extraction are also discussed. It is observed that calcination is a major contributor to the overall environmental indicators. The work also stresses on the use of renewable energy for electricity generation, which would help in decreasing the overall greenhouse gas emissions during extraction while ensuring waste utilization.

https://ift.tt/2ARvIsT

Developing an electric vehicle urban driving cycle to study differences in energy consumption

Abstract

This paper develops a methodology for constructing a representative electric vehicle (EV) urban driving cycle as a basis for studying the differences in estimated energy consumption, taking Xi'an as an example. The test route is designed in accordance with the overall topological structure of the urban roads in the study region and the results of a traffic flow survey. Wavelet decomposition and reconstruction are utilized to preprocess the original data. Principal component analysis (PCA) is used to reduce the number of the kinetic parameters. The fuzzy C-means (FCM) clustering algorithm is used to cluster the driving segments. A representative EV urban driving cycle is constructed in accordance with the time proportions of three classes of driving segments and the correlation coefficients of the characteristic parameters. Finally, the differences in energy consumption estimates obtained using the constructed Xi'an EV urban driving cycle (XA-EV-UDC) and the international driving cycles are studied. The comparison shows that when international driving cycles are used to estimate the energy consumption and driving range of EVs, large relative errors will result, with energy consumption errors of 9.65 to 21.17% and driving range errors of 20.10 to 38.14%. Therefore, to accurately estimate energy consumption and driving range of EVs under real-world driving conditions, representative EV driving cycles for each typical city and region should be constructed.

https://ift.tt/2JMDZ45

Evaluation of mercury phytoavailability in Oxisols

Abstract

Mercury is a metal which is potentially toxic for the environment. Many factors control its retention in the soil, such as cation exchange capacity, pH, clay content, organic matter, and redox potential. It is important to know the phytotoxic effects of soil Hg to prevent environmental contamination and its entry into the food chain. Several analytical methods are used to measure metal phytoavailability in soils, but none has been reported for Hg in Oxisols, the most common soil class in Brazil and a very important soil class throughout the tropics. The aim of this study was to select the chemical extractor that best correlated the Hg levels in plants and the Oxisols. The soils used were classified as Dystrophic Red-Yellow Oxisol (LVAd) and Dystroferric Red Oxisol (LVdf), which were collected in the 0–0.2-m soil layer. The species selected for cultivation were a monocotyledon, oat (Avena sativa L. cv. São Carlos) and a eudicotyledon, common bean (Phaseolus vulgaris L. cv. Madrepérola). Each test plot was composed of a 500 cm³ pot filled with soil samples contaminated with HgCl₂. Treatments were arranged in a completely randomized design, with four replications. The experiment was conducted for 30 days. Mercury contents were separately extracted with the following extractors: USEPA 3051A, Mehlich-1, Mehlich-3, DTPA, and water. Mercury was determined by hydride generation atomic absorption spectroscopy. The extracted contents were correlated with the contents in the tissues of the plants' aerial part by the Pearson correlation. Although it is not considered a standard procedure to evaluate metal phytoavailable contents, the method that presented the best correlations between soil Hg and plant Hg was USEPA 3051A (r = 0.75*). As expected, the worst correlation was with water (r = 0.57* for common bean and r = 0,05^ns for oat).

https://ift.tt/2DrUa6J

Are egg white face masks good for your skin?

Many people use egg white face masks as a way to boost the health of both oily and dry skin. However, there is little to no evidence to support the suggested benefits of these masks. We take a closer look at these alleged benefits and explain how to make an egg white face mask.

https://ift.tt/2DqQkuv

Blue light-emitting diode in healthy vaginal mucosa—a new therapeutic possibility

Abstract

A healthy female genital mucosa has an ecosystem that remains in balance through interactions between endogenous and exogenous factors. The light-emitting diode (LED) is a device that emits light at different wavelengths, with varying color and effects. Blue light in humans is most commonly used for antimicrobial purposes and has been already applied to treat facial acne and gastric bacteria. Although blue LED therapy in humans has been reported, its properties against vaginal infections have not yet been investigated. This study aims to test the safety and effects of 401 ± 5 nm blue LED on healthy vaginal mucosa. Phase I clinical trial involving 10 women between 18 and 45 years old with healthy vaginal mucosa. The participants were illuminated by 401 ± 5 nm blue LED for 30 min and anamnesis, oncotic cytology, and pH measurement were made again after 21/28 days of treatment. In the re-evaluation, adverse effects were investigated. The mean age was 27 ± 5.4 years and one of the women was excluded due to interruption of use of oral contraceptives. Oncotic cytology done before and after therapy showed that the composition of the microflora remained normal in all participants. Vaginal pH remained unchanged in eight of the women and had a reduction in one woman (5.0–4.0). No adverse effects were observed during or after illumination. 401 ± 5 nm blue LED did not generate any adverse effects or pathogenic changes in the microflora and vaginal pH. The effects of 401 ± 5 nm blue LED still need to be tested in vulvovaginal pathogens. Trial registration number: NCT03075046

https://ift.tt/2QvIC5v

Are egg white face masks good for your skin?

Modified Ramped Position for Endotracheal Intubation of Obese Patients

Conditions: Obesity; Anesthesia
Interventions: Other: Modified ramped position; Other: Ramped position
Sponsor: Cairo University
Not yet recruiting

https://ift.tt/2JK2oHD

Panitumumab-IRDye800 and 89Zr-Panitumumab in Identifying Metastatic Lymph Nodes in Patients With Squamous Cell Head and Neck Cancer

Condition: Cutaneous Squamous Cell Carcinoma of the Head and Neck
Interventions: Drug: Panitumumab-IRDye800; Drug: Zirconium Zr-89 Panitumumab; Device: Pinpoint IR IR9000 flourescence imaging system (FIS); Device: SPY-PHI IR9000 flourescence imaging system (FIS); Device: Explorer Air camera; Device: PDE-NEO II camera; Device: FIS-00 fluorescence imaging system (FIS); Device: Da Vinci Firefly Imaging System; Device: IGP-ELVIS-v4 Macroscopic Specimen Imager; Device: Vevo 3100 LAZR-X; Device: Pearl Triology Imaging System; Device: Odyssey CLx Imaging System; Device: Leica fluorescence microscope
Sponsors: Stanford University; National Institutes of Health (NIH); National Cancer Institute (NCI)
Not yet recruiting

https://ift.tt/2ASTV2h

Removal of particulate matter and trace elements from ambient air by urban greenery in the winter season

Abstract

Particulate matter (PM) is one of the most harmful inhaled pollutants. When PM is emitted into the atmosphere, the only possible method for cleaning ambient air is through vegetation acting as biological filters for pollutants. However, in winter periods when the concentration of PM is usually the highest, the efficiency of plants is very low. The aim of this work was therefore to examine the accumulation of PM and selected trace elements (TE) by three species, evergreen coniferous Taxus baccata L. and Pinus nigra Arn., and deciduous Carpinus betulus L. during the winter season. The highest amounts of PM accumulated on the foliage of P. nigra, while TE on the leaves of C. betulus. Most of the PM accumulated on plant foliage belonged to the large fraction size (10–100 μm) and was deposited on the surface of foliage (_SPM). The concentration of four TE (Ni, Pb, Cd, and Sb) was higher in PM accumulated on foliage, while in the case of three other TE (Zn, Cr and Mg), their concentration was higher in plant tissue. The TE were recorded in all PM size fractions and were rather equally distributed between surface PM (_SPM) and in-wax PM (_WPM). These findings have implications for urban plantings in countries with short vegetative season, where tolerant conifer species and deciduous species which keep foliage through winter should be included in urban forest plantings due to their efficiency in the removal of pollutants from the air.

https://ift.tt/2DsdG3c

Modified Ramped Position for Endotracheal Intubation of Obese Patients

Conditions: Obesity; Anesthesia
Interventions: Other: Modified ramped position; Other: Ramped position
Sponsor: Cairo University
Not yet recruiting

https://ift.tt/2JK2oHD

Panitumumab-IRDye800 and 89Zr-Panitumumab in Identifying Metastatic Lymph Nodes in Patients With Squamous Cell Head and Neck Cancer

Disseminated Vegetating Plaques and Pustules

A teenaged male in Kenya presented with painful vegetating, bleeding plaques and pustules on his face, scalp, trunk, and extremities. He continued to develop new lesions despite prescribed daily medications. He was HIV negative. What is your diagnosis?

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Staging Systems to Predict Metastatic Cutaneous Squamous Cell Carcinoma

Disease staging systems play 2 critical roles in oncology. In the first instance, these systems summarize the extent of a patient's cancer at the time of diagnosis and disease progression, by including information on the tumor characteristics at the primary site (eg, location, size, histologic features, etc) as well as locoregional (lymph node involvement) and distant metastatic state. Second, clinicians use these systems to evaluate treatment options, assess prognosis, and plan their patients' care. Ideally, staging systems should have strong prognostic value so that clinicians can inform patients, with a reasonable degree of certainty, about the course of their disease and eligibility for adjuvant and therapeutic interventions.

https://ift.tt/2PMVHdl

Effect of Platelet-Rich Plasma Injection for Rejuvenation of Photoaged Facial Skin

This randomized clinical trial investigates whether platelet-rich plasma injection improves the visual appearance, including texture and color, of photodamaged facial skin in adults with bilateral cheek rhytids of Glogau class II or greater.

https://ift.tt/2D8IYLl

Effectiveness of Tacrolimus Swish-and-Spit Treatment in Patients With Geographic Tongue

This study evaluates the effectiveness of a twice daily tacrolimus swish-and-spit treatment regimen for geographic tongue.

https://ift.tt/2PIA5ih

Incomplete Data in Cutaneous Squamous Cell Carcinoma Staging System Analysis—Reply

In Reply On behalf of our coauthors, we thank Jambusaria-Pahlajani and colleagues for their interest in and comments to our study and appreciate the opportunity to respond to their concerns.

https://ift.tt/2D7wCTI

Incomplete Data in Cutaneous Squamous Cell Carcinoma Staging System Analysis

To the Editor We read with interest the article by Roscher et al on validation of 4 staging systems for cutaneous squamous cell carcinoma published in the April issue of JAMA Dermatology. We believe that such a population-based case-control comparison of staging systems is highly valuable in helping to refine subsequent staging. However, we have some concerns with the report's analysis and conclusions.

https://ift.tt/2PIzZap

Notice of Retraction and Replacement

This is a notice of the retraction and replacement for an article by Roscher et al. to correct errors detected throughout the text.

https://ift.tt/2DbT4uK

Cutaneous Sensitization to Peanut in Children With Atopic Dermatitis

This Viewpoint discusses recent findings associating atopic dermatitis in infants with increased sensitization to peanut protein and how those findings are informing new guidelines and efforts to prevent peanut allergy.

https://ift.tt/2PIa4jg

Perspektiven für die Praxis

https://ift.tt/2RFYcvd

The nature of the human T cell response to the cancer antigen 5T4 is determined by the balance of regulatory and inflammatory T cells of the same antigen-specificity: implications for vaccine design

Abstract

The oncofoetal antigen 5T4 is a promising T cell target in the context of colorectal cancer, as demonstrated by a recent clinical study where 5T4-specific T cell responses, induced by vaccination or cyclophosphamide, were associated with a significantly prolonged survival of patients with metastatic disease. Whilst Th1-type (IFN-γ⁺) responses specific to 5T4, and other oncofoetal antigens, are often readily detectable in early stage CRC patients and healthy donors, their activity is suppressed as the cancer progresses by CD4⁺CD25^hiFoxp3⁺ regulatory T cells (Treg) which contribute to the immunosuppressive environment conducive to tumour growth. This study mapped the fine specificity of Th1 and Treg cell responses to the 5T4 protein. Surprisingly, both immunogenic peptides and those recognised by Tregs clustered in the same HLA-DR transcending epitope-rich hotspots within the 5T4 protein. Similarly, regions of low Th1-cell immunogenicity also did not contain peptides capable of stimulating Tregs, further supporting the notion that Treg and Th1 cells recognise the same peptides. Understanding the rules which govern the balance of Th1 and Treg cells responding to a given peptide specificity is, therefore, of fundamental importance to designing strategies for manipulating the balance in favour of Th1 cells, and thus the most effective anti-cancer T cell responses.

https://ift.tt/2PIuhFv

Evaluating the effects of mobile health intervention on weight management, glycemic control and pregnancy outcomes in patients with gestational diabetes mellitus

Abstract

Purpose

To explore the effects of mobile health (mHealth) intervention on pregnancy weight management, blood glucose control and pregnancy outcomes.

Methods

A total of 124 patients with gestational diabetes mellitus (GDM) were selected. Patients were randomly divided into two groups. The 60 patients in the control group received standard outpatient treatment, while the remaining 64 patients received a nurse's online guidance both through a mobile medical App installed on their phone and through regular offline clinical treatment in the mHealth group. Patients were treated for an average of 13 weeks and general conditions, compliance, blood glucose, glycosylated hemoglobin, weight gain, pregnancy, and neonatal outcomes were monitored in both groups longitudinally.

Results

The mHealth group demonstrated higher levels of compliance (83.3 ± 12.5% vs. 70.4 ± 10.1%, t = − 6.293, df = 122, p < 0.001), lower frequency of outpatient service (8.1 ± 1.3 vs. 11.2 ± 1.1, t = 14.285, df = 122, p < 0.001), lower hemoglobin A1C before delivery (4.7 ± 0.2 vs. 5.3 ± 0.3, t = 13.216, df = 122, p < 0.001) as well as the rates of off-target measurements both fasting (4.6 ± 0.4% vs. 8.3 ± 0.6%, t = 40.659, df = 122, p < 0.001) and 2 h post-prandial (7.9 ± 0.7% vs. 14.7 ± 0.8%, t = 50.746, df = 122, p < 0.001). Weight gain in the mHealth group was less than control group (3.2 ± 0.8 vs. 4.8 ± 0.7, t = 11.851, df = 122 p < 0.001).

Conclusion

Mobile health intervention management of gestational diabetes mellitus improves patients' compliance and blood glucose control, and reduces weight gain, thereby reducing the rates of complications in both pregnant women and fetuses during delivery during pregnancy.

https://ift.tt/2JRXs3L

Adding dextran to local anesthetic enhances analgesia

https://ift.tt/2PJotvj

Patient- versus physician-reported outcomes in prostate cancer patients receiving hypofractionated radiotherapy within a randomized controlled trial

Abstract

Purpose

The risk of developing acute radiotherapy(RT)-induced side effects may increase with hypofractionated RT. To detect treatment-related side effects, patient-reported outcomes (PROs) might be more reliable than physician-reported outcomes. Therefore, we tried to evaluate the rate of agreement between urinary and gastrointestinal (GI) side effects and the prevalence of side effects reported by patients and by physicians.

Methods

Data from a randomized controlled trial (RCT) comparing two hypofractionated RT schedules were used. Urinary (nocturia, incontinence, frequency, dysuria, and urgency) and GI (obstruction, diarrhea, vomiting, nausea, bloating, hemorragia, and incontinence) symptoms measured by the EORTC QLQ-C30 and PR-25 were used for PROs. The same symptoms were scored by the physician using the Common Terminology Criteria Adverse Events v4.0. Outcomes were reported at baseline, end of treatment, month 1, and month 3. PROs and physician-reported outcomes were converted in two categories (0 = no symptoms; 1 = symptoms of any severity) and were correlated using the kappa (κ) correlation statistics. Values below 0.40 were considered low agreement. In addition, the prevalence of symptoms was calculated.

Results

Data from 160 patients were used. The mean value for Cohen's κ was 0.31 (ranging between 0.04 and 0.55) and 0.23 (ranging between 0.04 and 0.47) for urinary and GI symptoms, respectively. Except for three symptoms at baseline, all symptoms reported by patients were higher than those reported by physicians.

Conclusion

There is low agreement between symptoms reported by patients and physicians, with high rates of underreporting by the physician.

https://ift.tt/2RJmtkj

Assessment of a guideline-based heart substructures delineation in left-sided breast cancer patients undergoing adjuvant radiotherapy

Abstract

Background and purpose

In our institute, breast cancer patients undergoing adjuvant treatment are included in a protocol aimed to reduce cardiovascular morbidity (SAFE-2014, NCT2236806), assessing preclinical heart damage with heart speckle-tracking ultrasound. To develop a dose constraint related to subclinical heart damage, a reliable delineation of heart substructures based on a pre-existing guideline was made.

Patients and methods

Heart substructures of 16 left-sided breast cancer patients included in the SAFE protocol were delineated by five operators. For each substructure, a multi-contour delineation based on a majority vote algorithm (MCD) was created. A consensus-based delineation (CBD) was developed by an independent team of two blinded operators. Dice similarity coefficients (DSC) between volumes delineated by different operators and the MCD were collected and reported, as well as DSC between CBD and MCD.

Results

Mean DSCs between heart chambers delineated by each operator and the corresponding MCDs ranged between 0.78 and 0.96. Mean DSC between substructures delineated by all single operators and the corresponding MCD ranged between 0.84 and 0.94. Mean DSC between CBD and the corresponding MCD ranged from 0.89 to 0.97.

Conclusion

Results showed low inter-observer variability of heart substructure delineation. This constitutes an external validation of the contouring atlas used, allowing a reliable dosimetric assessment of these volumes within the SAFE-2014 trial.

https://ift.tt/2PSdmR7

Decreasing farm number benefits the mitigation of agricultural non-point source pollution in China

Abstract

Agricultural non-point source pollution causes global warming and the deterioration of air and water quality. It is difficult to identify and monitor the emission sources of agricultural pollution due to the large number of farms in China. Many studies focus on the technological aspect of achieving agricultural sustainability, but its socioeconomic aspect is poorly understood. Here, we report how group size (number of farms in a certain region) affects agricultural pollution governance through conducting a social science experiment. We found that when communication was allowed among group members, a small group size facilitated cooperation. Although deviations from the cooperation equilibrium occurred with time in all groups, the smaller the group size, the slower the cooperation equilibrium became frangible. These findings suggest that reducing number of farms and extending the length of farm property rights can benefit the mitigation of agricultural non-point pollution in China. Social science experiments can be a useful tool to understand the socioeconomic aspect of agricultural sustainability.

https://ift.tt/2Pf7W2N

β -Pinene moderates Cr(VI) phytotoxicity by quenching reactive oxygen species and altering antioxidant machinery in maize

Abstract

We examined the possible role of monoterpene β-pinene in providing protection against Cr(VI) toxicity in maize (Zea mays). Treatment with β-pinene (10 μM) significantly alleviated Cr(VI) accumulation and recuperated Cr(VI) caused decline in root and coleoptile growth in maize. β-Pinene addition caused a decline in Cr(VI)-induced accumulation of superoxide anion, hydroxyl ion, hydrogen peroxide and confirmed by in-situ detection of ROS using histochemical localization. It suggested that the β-pinene quenches/neutralizes enhanced ROS generated under Cr(VI) exposure. β-Pinene also reduced Cr(VI)-induced electrolyte leakage, thereby suggesting its role in membrane stabilization. Further, β-pinene regulated the activity of scavenging enzymes, thereby suggesting a role in modulating Cr(VI)-induced oxidative damage. In conclusion, our results suggest that the addition of β-pinene has a protective role against Cr(VI) stress and provides resistance to maize against Cr(VI) toxicity.

https://ift.tt/2QmRgD7

BRAF mutation testing in melanoma: results from a German observational multicenter study

Abstract

Quality control of BRAF mutation testing methods used in routine practice is crucial for optimal treatment selection. In this prospective study, we assessed the impact of patient/sample characteristics on BRAF mutation testing results in patients with melanoma, during clinical practice. Data were collected on routine testing practices and documented mutation status in patients with melanoma stages IIIB, IIIC, or IV across 28 diagnostic pathology centers in Germany. Patient/sample data collected included: patient age, location of primary melanoma and metastases, origin of sample, melanoma subtype, and quality of tissue. Statistical influence of patient/sample characteristics on BRAF mutation rate was assessed using multiple logistic regression analyses and statistical models developed to predict the probability of BRAF mutations for individual patient cohorts. Data/samples from 642 patients with melanoma were analyzed. BRAF mutations were documented in 241/642 patients (37.5%). The primary statistical model to predict BRAF mutation rates included: age (continuous), origin of sample, method of mutation analysis, and quality of tissue. Analyses of post hoc collected data identified major deviations between documented mutation rates included in this study vs. routinely recorded mutation rates for three centers. When samples from these centers were excluded, the influence of testing method was no longer statistically significant. The final model included patient age, origin of sample (including metastasis location), and quality of tissue. Once validated in an independent population, this type of model could allow pathology centers to compare the performance of their testing methods with what would be expected based on patient, tumor, and sample characteristics.

https://ift.tt/2F8ws0S

Outcome of Internal Neurolysis for Trigeminal Neuralgia without Neurovascular Compression and Its Relationship with Intraoperative Trigeminocardiac Reflex

Background: Internal neurolysis (IN) is an effective surgical treatment for trigeminal neuralgia (TN) without neurovascular compression (NVC) or postoperative recurrence. However, the trigeminal nerve is directly manipulated during the procedure, and there is a high incidence of trigeminocardiac reflex (TCR). The aim of this study was to retrospectively analyze the outcome of IN and to explore its relationship with the occurrence of intraoperative TCR. Methods: Surgical and anesthesia records of 27 TN patients who underwent surgical treatment with IN at our department between March 2010 and September 2016 were retrospectively analyzed. Patients were divided into 2 groups on the basis of the occurrence of TCR during surgery, and clinical characteristics were compared. Pain intensity was assessed by the Barrow Neurological Institute (BNI) pain intensity score and BNI facial numbness score. Results: TCR was observed in 23 of 27 patients (85.2%); it manifested as obvious changes in mean arterial pressure and heart rate by at least 20% of the baseline values. Trigeminal nerve atrophy was found in 9 patients (33.3%). The immediate pain-free rate was 96.3%, and the "excellent" rate was 72.1% for follow-up, with a rate of numbness or hypesthesia of 97.1%. These outcomes were retrospectively compared between the TCR and non-TCR groups, and there was a nonsignificantly higher "excellent" rate in the TCR group than in the non-TCR group. Conclusions: This study demonstrated that IN is an effective treatment for TN without NVC and has a close relationship with intraoperative TCR. To our knowledge, this is the first research describing TCR during IN.
Stereotact Funct Neurosurg

https://ift.tt/2RG1COF

Re-Irradiation with Stereotactic Radiosurgery/Radiotherapy for Recurrent High-Grade Gliomas: Improved Survival in the Modern Era

Objective: The aim of this study was to evaluate the efficacy of stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT) as salvage therapy for recurrent high-grade glioma and to look at the overall efficacy of treatment with linear accelerator (LINAC)-based radiosurgery and fractionated radiotherapy. Methods: From 2010 to 2017, a total of 25 patients aged 23–74 years were re-irradiated with LINAC-based SRS and fSRT. Patients were treated to a median dose of 25 Gy in 5 fractions. Results: The median overall survival (OS) after (initial) diagnosis was 39 months with an actuarial 1-, 3-, and 5-year OS rate of 88, 56, and 30%, respectively. After treatment with SRS or fSRT, the median OS was 9 months with an actuarial 1-year OS rate of 29%. Local control, assessed for 28 tumors, after 6 months was 57%, while local control after 1 year was 39%. Three patients experienced local failure. There was no evidence of toxicity noted after SRS or fSRT throughout the follow-up period. Conclusion: SRS and fSRT remain a safe, reasonable, effective treatment option for re-irradiation following recurrent glioblastoma. Additionally, treatment volume may predict local control in the salvage setting.
Stereotact Funct Neurosurg

https://ift.tt/2DtiuFr

Optimising sampling patterns for bi-exponentially decaying signals

Publication date: Available online 6 November 2018

Source: Magnetic Resonance Imaging

Author(s): A. Reci, M.I. Ainte, A.J. Sederman, M.D. Mantle, L.F. Gladden

Abstract

A recently reported method, based on the Cramér-Rao Lower Bound theory, for optimising sampling patterns for a wide range of nuclear magnetic resonance (NMR) experiments is applied to the problem of optimising sampling patterns for bi-exponentially decaying signals. Sampling patterns are optimised by minimizing the percentage error in estimating the most difficult to estimate parameter of the bi-exponential model, termed the objective function. The predictions of the method are demonstrated in application to pulsed field gradient NMR data recorded for the two-component diffusion of a binary mixture of methane/ethane in a zeolite. It is shown that the proposed method identifies an optimal sampling pattern with the predicted objective function being within 10% of that calculated from the experiment dataset. The method is used to advise on the number of sampled points and the noise level needed to resolve two-component systems characterised by a range of ratios of populations and diffusion coefficients. It is subsequently illustrated how the method can be used to reduce the experiment acquisition time while still being able to resolve a given two-component system.

https://ift.tt/2PMMlyd

Les Annales de dermatologie ont 150 ans !

Publication date: Available online 7 November 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): B. Cribier

https://ift.tt/2OsgEpi

Programme des Posters

Publication date: Available online 6 November 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s):

https://ift.tt/2yVC1dK

Next-Generation Robotic Head and Neck Surgery

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Following the inception of transoral robotic surgery (TORS) in 2005, the field of robotic head and neck surgery has undergone refinement and innovation. Optimizing patient outcome, preserving function, and limiting morbidity are the key drivers. The next leap forward is another generation of flexible robotic surgical systems. Several such systems are under clinical and preclinical evaluation. A new single-port (Sp) robotic surgical architecture is now available integrating three fully articulating instruments and a flexible three-dimensional high-definition camera delivered through a 25-mm cannula. Preclinical feasibility studies of the Sp in human cadaver and porcine models suggest improved application compared to existing platforms for oropharyngeal and nasopharyngeal resection. With 3-handed manipulation of tissue, traction and countertraction may be used to deliver a more precise surgical dissection of head and neck anatomy than is currently possible. The single-port design permits greater access and maneuverability for the bedside surgical assistant. An alternative currently available in clinical use includes the Flex® system using a robotic camera and manually controlled endoscopic instruments. The Cambridge Medical Robotics Versius system is undergoing preclinical evaluation for TORS and may offer a novel modular approach. All of these systems allow the head and neck surgeon to reach further beyond the upper aerodigestive tract with greater agility and precision, expanding the boundaries of minimal access head and neck surgery.
ORL 2018;80:213–219

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Editorial Board/Aims & Scope

Publication date: November 2018

Source: Oral Oncology, Volume 86

Author(s):

https://ift.tt/2PMGedf

Apoptosis of tumor-infiltrating T lymphocytes: a new immune checkpoint mechanism

Abstract

Immunotherapy based on checkpoint inhibitors is providing substantial clinical benefit, but only to a minority of cancer patients. The current priority is to understand why the majority of patients fail to respond. Besides T-cell dysfunction, T-cell apoptosis was reported in several recent studies as a relevant mechanism of tumoral immune resistance. Several death receptors (Fas, DR3, DR4, DR5, TNFR1) can trigger apoptosis when activated by their respective ligands. In this review, we discuss the immunomodulatory role of the main death receptors and how these are shaping the tumor microenvironment, with a focus on Fas and its ligand. Fas-mediated apoptosis of T cells has long been known as a mechanism allowing the contraction of T-cell responses to prevent immunopathology, a phenomenon known as activation-induced cell death, which is triggered by induction of Fas ligand (FasL) expression on T cells themselves and qualifies as an immune checkpoint mechanism. Recent evidence indicates that other cells in the tumor microenvironment can express FasL and trigger apoptosis of tumor-infiltrating lymphocytes (TIL), including endothelial cells and myeloid-derived suppressor cells. The resulting disappearance of TIL prevents anti-tumor immunity and may in fact contribute to the absence of TIL that is typical of "cold" tumors that fail to respond to immunotherapy. Interfering with the Fas–FasL pathway in the tumor microenvironment has the potential to increase the efficacy of cancer immunotherapy.

https://ift.tt/2yX5d41

Application of indocyanine green in the parathyroid detection and protection: Report of 3 cases

Publication date: Available online 7 November 2018

Source: American Journal of Otolaryngology

Author(s): Jinrui Fan, Hao Jin, Jun Yang, Kun Liao, Zhuocheng He, Min Cui

Abstract

Background

It was thought that identifying the parathyroid gland during surgery was difficult for surgeons. It may be critical to locate the parathyroid for surgeons during thyroidectomy or parathyroidectomy due to the significant function of the parathyroid in calcium balance. According to recent reports, intrinsic fluorescence of the parathyroid has been found. There is some evidence to suggest that new equipment can detect the intrinsic fluorescence via imaging technology. In this case reports, a newly-invented intraoperative fluorescence imaging system and indocyanine green dye were applied to detect the parathyroid gland and evaluate the vascularization of parathyroid.

Case presentation

From July 1st to August 8st, 2018, 3 patients underwent total thyroidectomy in Zhuhai People's Hospital. The 3 subjects were recruited into our research. Indocyanine green angiography was performed on all the three participants. By ICG angiography, parathyroid glands were identified and protected. In the 3 patients, postoperative PTH levels were in the normal range. No one of them developed transient hypoparathyroidism.

Conclusions

This study has identified that the fluorescence imaging system applied with indocyanine green is a safe, easy and effective method to protect the parathyroid and predict postoperative parathyroidism.

https://ift.tt/2OwHvk7

Expression of T‐cell immunoglobulin and immunoreceptor tyrosine‐based inhibitory motif domain on CD4+ T cells in patients with atopic dermatitis

Abstract

The T‐cell immunoglobulin and immunoreceptor tyrosine‐based inhibitory motif domain (TIGIT) is a co‐inhibitory receptor mainly expressed on T cells. Although TIGIT plays an important role in various autoimmune diseases, its role in atopic dermatitis (AD) remains unclear. In this study, we examined the expression levels of TIGIT and their association with clinical features in patients with AD. TIGIT expression on CD4⁺ T cells, central memory T cells, effector memory T cells and regulatory T cells was determined by flow cytometry. CD4⁺ T cells exhibited enhanced TIGIT expression in patients with AD compared with healthy individuals. In particular, effector memory T cells and regulatory T cells, but not central memory T cells, exhibited higher TIGIT expression in patients with AD than in healthy individuals. The frequency of TIGIT⁺ cells among CD4⁺ T cells was significantly increased in patients with mild AD compared with healthy individuals, while decreased in patients with severe AD. Consistently, the frequency of TIGIT⁺ cells among CD4⁺ T cells was negatively correlated with both serum thymus and activation‐regulated chemokine levels and immunoglobulin E levels in patients with AD. Furthermore, TIGIT expression on CD4⁺ T cells inhibited cell proliferation in patients with AD. These results suggest that TIGIT expression on CD4⁺ T cells in patients with AD may be increased to suppress chronic cutaneous inflammation. Moreover, TIGIT expression may be impaired in a subset of patients with AD, leading to a deterioration of skin inflammation. Our study may provide new insight into a TIGIT pathway‐based therapeutic approach for AD.

https://ift.tt/2PMyvMh

Redesigning Skin Cancer Early Detection and Care Using a New Mobile Health Application: Protocol of the SKIN Research Project, a Randomised Controlled Trial

Patients often detect melanoma themselves; therefore, regular skin self-examinations (SSEs) play an important role in the early detection and prompt treatment of melanoma. Mobile teledermoscopy is a technology that may facilitate consumer SSEs and rapid communication with a dermatologist. This paper describes the planned randomised controlled trial of an intervention to determine whether mobile technologies can help improve the precision of SSE in consumers. A randomised controlled trial will be conducted to evaluate mobile teledermoscopy-enhanced SSE versus naked-eye SSE. Participants in each group will conduct three home whole-body SSEs at baseline, 1 and 2 months, then present for a clinical skin examination (CSE) by a doctor after the 2-month SSE. Specifically, participants will identify skin lesions that meet the AC (asymmetry and colour) rule for detecting a suspicious skin spot. The primary outcomes are sensitivity and specificity of the skin lesions selected by the participants as needing attention by a doctor, compared to the clinical diagnosis by the dermatologist that will serve as the reference standard for this analysis. For the mobile teledermoscopy-enhanced SSE group, researchers will assess the number, location and type of lesions (1) sent by the participant via mobile teledermoscopy, (2) found at CSE or (3) missed by the participant. For the naked-eye SSE group, researchers will assess the number, location and type of lesions (1) recorded on their body chart by the participant, (2) found at CSE or (3) missed by the participant. Secondary outcomes are based on participants' self-reported data via online questionnaires.
Dermatology

https://ift.tt/2PdnKmE

Consumer Acceptance and Expectations of a Mobile Health Application to Photograph Skin Lesions for Early Detection of Melanoma

Background: Mobile teledermoscopy may facilitate skin self-examinations (SSEs) and further improve monitoring and detection of melanoma. Objective: To assess consumer acceptability and expectations of a mobile health app used to: (i) instruct SSE and (ii) conduct consumer-performed mobile teledermoscopy. Methods: People aged 18 years and above were invited to participate in either (i) an online survey or (ii) focus group in Brisbane, Australia. Participants were asked about their SSE practices, mobile teledermoscopy acceptance, and app design and functionality. The online survey responses and focus group discussions were coded by two researchers who conducted thematic analysis. Results: Four focus groups were held with a total of 28 participants; 88 participants completed the online survey. The mean ages of participants in the focus group and online survey were 46 and 38 years, respectively. There were more males in the focus groups (61%, 17/28) compared to the online survey (19%, 17/88). Regular SSEs were conducted by 56 (64%) of the online survey participants. Barriers to SSE were forgetfulness (44%), low self-perceived risk of melanoma (25%) and low confidence in conducting SSEs (25%). The large majority of online survey participants (95%) would consider sending photos of their skin lesions to a medical practitioner via an app. Focus group participants reported that they would accept using mobile teledermoscopy; however, they would prefer to use it to monitor lesions between face-to-face consultations. Conclusions: Overall, participants had positive views on using mobile teledermoscopy to send images of skin lesions to a dermatologist or other medical practitioner.
Dermatology

https://ift.tt/2OtEkcZ

Body Piercing: A National Survey in France

Background: There are no recent data available in France regarding body piercing (BP). Objective: We examined the demographics, motivations, quality of life, cutaneous conditions, and cutaneous side effects after BP within the French population. Methods: A representative sample of 5,000 individuals (aged 15 and over) from the general population responded to a survey online between April and August 2017. Data regarding demographics, BP characteristics (location, age at first piercing, hesitation, regrets, motivations, cutaneous side effects), tobacco, skin conditions (acne, contact eczema, atopic eczema, rosacea, psoriasis, vitiligo), and tattoos were collected. Respondents also filled an SF-12 quality of life questionnaire. Results: Overall, 12% of the respondents reported at least one BP (women: 19.4%, men: 8.4%, p #x3c; 0.01). The prevalence was highest among those aged between 25 and 34 years (25.8%). Individuals with BP were more likely to smoke (p #x3c; 0.01). The most common body parts for piercings were the external part of the ear (42%), the navel (24%), the tongue (15%), and the nose (11%). Gender differences included localization (belly button and nose for women, eyebrows for men) and motivations (embellishment of the body for women, individuality and sexuality for men). A total of 33.6% of the study participants reported having skin problems after BP, primarily infection (44%). Individuals with BPs were more likely to report having contact eczema, atopic dermatitis, and acne. BP was associated with a lower mental quality of life score. Conclusion: This is the largest epidemiological study on BP in France to date. It allows us to draw a precise current snapshot of French indi viduals with BP.
Dermatology

https://ift.tt/2PdnLHe

Lesions Mimicking Melanoma at Dermoscopy Confirmed Basal Cell Carcinoma: Evaluation with Reflectance Confocal Microscopy

Background: Atypical basal cell carcinoma (BCC), characterized by equivocal dermoscopic features typical of malignant melanoma (MM), can be difficult to diagnose. Reflectance confocal microscopy (RCM) enables in vivo imaging at nearly histological resolution. Objectives: To evaluate with RCM atypical melanocytic lesions identified in dermoscopy, according to common RCM criteria for the differential diagnosis of BCC, and to identify representative RCM parameters for superficial (sBCCs) and nonsuperficial (nsBCCs) basal cell carcinomas (BCCs). Methods: A retrospective analysis of consecutive patients evaluated with RCM, selecting excised lesions classified at dermoscopy with ≥1 score from the re visited 7-point checklist, mimicking melanoma, registered between 2010 and 2016. Cluster analysis identified BCC subclassifications. Results: Of 178 atypical lesions, 34 lesions were diagnosed as BCCs with RCM. Lesions were confirmed BCCs with histopathology. Dermoscopic features included atypical network (55.9%) and regression structures (35.5%) associated with sBCCs, and an atypical vascular pattern (58.8%) and irregular blotches (58.8%) with nsBCCs. Hierarchical cluster analysis identified 2 clusters: cluster 1 (100% sBCCs) was characterized by the presence of cords connected to the epidermis (90%, p #x3c; 0.001), tumor islands located in the epidermis (100%, p #x3c; 0.001), smaller vascular diameter (100%, p #x3c; 0.001) and solar elastosis (90%, p = 0.017), and cluster 2 (nsBCCs 85%) was defined by the dermic location of tumor islands (87.5%, p #x3c; 0.001) with branch-like structures (70.8%, p = 0.007) and surrounding collagen (83.3%, p = 0.012), peripheral palisading (83.3%, p = 0.012) and coiled vascular morphology (79.2%, p #x3c; 0.001) with a larger vascular diameter (50%, p #x3c; 0.001). Conclusions: RCM is able to diagnose BCCs mimicking melanoma at dermoscopy and seems able to identify sBCCs and nsBCCs.
Dermatology

https://ift.tt/2Ov5hgc

Gender difference and correlation between sexuality, thyroid hormones, cognitive, and physical functions in elderly fit

Abstract

Purpose

Sexuality in the elderly is related to psycho-physical well-being. Aim of this study was to analyze the correlation between sexual health, thyroid hormones, cognitive functions, and physical fitness in elderly population.

Methods

Fifty-one fit adults were recruited (age: 71.9 ± 5.3 years, 26 females and 25 males). Sexuality was evaluated using the Changes in Sexual Functioning Questionnaire-short form (CSFQ-14) and the Sexual Attitude Scale (SAS). Thyroid function was assessed by measuring serum TSH, FT3, and FT4. Cognitive functions and depressive symptoms were evaluated by the Mini Mental State Examination (MMSE) test and Geriatric Depression Scale (GDS) scores. Subjects' physical fitness was evaluated using the following tests: Short Physical Performance Battery (SPPB), Handgrip test (HG), Timed Up and Go test (TUG), and 2-Minute step test (ST).

Results

CSFQ-14 positively correlated with MMSE (p < 0.05) and negatively with GDS (p < 0.05), while thyroid function was not correlated with sexuality, in both genders. A negative relationship between FT4 vs. weight, FT3 vs. HG and FT3/FT4 ratio vs. ST were found (p = 0.05) in females, while in males, it occurred for TSH vs. TUG (p < 0.05); a positive relationship existed in females between FT4 vs. ST (p < 0.05). Finally, CSFQ-14 was significantly correlated with SPPB (p < 0.05), CST, TUG, and ST (p < 0.01), in both genders.

Conclusion

We demonstrated a strict relationship between active sexuality, preserved cognitive function and appropriate physical fitness in elderly subjects, independently from gender. Our preliminary data suggest that in elderly fit population, peripheral thyroxin deiodination may be a useful predictor of better physical performance and more successful aging.

https://ift.tt/2JLShSS

Interleukin-4/interleukin-13 versus interleukin-5: a comparison of molecular targets in biologic therapy for the treatment of severe asthma

Purpose of review Asthma is a chronic, inflammatory disorder of the airways caused by a complex interplay of various biologic mechanisms. Several monoclonal antibody therapies targeting interleukin (IL)-4/IL-13 and IL-5 cytokine pathways have been developed for the treatment of severe eosinophilic asthma. As individuals can display biomarkers and clinical features characteristic of several asthma phenotypes, selection of anoptimal biologic can be difficult. Recent findings Dupilumab, a monoclonal antibody that binds to the α subunit of the IL-4 receptor (IL-4Rα) and has been approved for the treatment of adults with severe atopic dermatitis, has been shown in recent phase 3 trials to also have significant clinical benefits in the asthmatic population irrespective of baseline eosinophil counts. Summary As monoclonal antibodies targeting either IL-4 or IL-13 cytokines individually have failed to demonstrate significant clinical benefits, biologics that target cytokine receptors may be more efficacious compared to those that target cytokines. Furthermore, inhibition of the IL-4/IL-13 signaling cascades may disrupt a broader Th2 inflammatory response compared to a more selective impairment of eosinophil proliferation and activity via blockage of the IL-5 pathway. Future research with independently funded, head-to-head trials of approved biologics is needed to elucidate a favorable therapeutic option. Correspondence to Julia W. Tripple, MD, Allergy and Immunology Division, University of Texas Medical Branch, Galveston, TX 77555, USA. E-mail: jgwoodar@utmb.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2PJkejl

Strategies to reduce corticosteroid-related adverse events in asthma

Purpose of review Severe asthmatics, despite the chronic use of high inhaled corticosteroids (ICS) doses and frequent intake of systemic corticosteroids, remains clinically and/or functionally uncontrolled. These patients are also often affected by rhinitis or chronic rhinosinusitis requiring frequent use of intranasal corticosteroids. Therefore, severe asthmatics are exposed to an overload of corticosteroids that is frequently associated with relevant and costly adverse events. This clinical problem and the strategies to overcome it are here summarized. Recent findings Different therapeutic options may help in reducing the corticosteroid load in asthmatics, ranging from allergy immunotherapy (nonsuitable for severe uncontrolled patients), immunosuppressant agents like methotrexate or cyclosporine, novel biologic drugs (mainly anti-IgE, anti-IL5 and anti-IL4-receptor-alpha), and aspirin desensitization (for patients with anti-inflammatory drugs exacerbated respiratory disease). Summary The evidence of even serious corticosteroid-related adverse events associated with consistent health-care costs, should prompt the entire scientific community and health regulatory authorities to promote actions to increase the use of well tolerated and effective strategies to reduce the corticosteroid need in asthmatics; the most promising option seems to be the add-on use of biologic agents. Correspondence to Professor Enrico Heffler, Personalized Medicine, Asthma and Allergy Unit, Istituto Clinico Humanitas, Humanitas Research Hospital, Via Alessandro Manzoni 56, Rozzano MI, Italy. Tel: +39 282247013; fax: +39 282246484; e-mail: enrico.heffler@hunimed.eu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2Dbg4KL

Performances of Pichia kudriavzevii in decolorization, biodegradation, and detoxification of C.I. Basic Blue 41 under optimized cultural conditions

Abstract

The aim of this study was to evaluate the performances of Pichia kudriavzevii CR-Y103 yeast strain for the decolorization, biodegradation, and detoxification of cationic dye C.I. Basic Blue 41, a toxic compound to aquatic life with long-lasting effects. Under optimized cultural conditions (10.0-g L⁻¹ glucose, 0.2-g L⁻¹ yeast extract, and 1.0-g L⁻¹ (NH₄)₂SO₄), the yeast strain was able to decolorize 97.86% of BB41 (50 mg L⁻¹) at pH 6 within 4 h of incubation at 30 °C under shaken conditions (12,238.00-μg h⁻¹ average decolorization rate) and 100% within 12 h. The UV-Vis spectral analysis, high-performance liquid chromatography (HPLC), and Fourier-transform infrared spectroscopy (FTIR) analysis confirmed the complete decolorization and degradation of the BB41 dye by P. kudriavzevii CR-Y103. Also, other seven yeast strains, isolated from soil, as P. kudriavzevii (CR-Y108, CR-Y119, and CR-Y112), Candida tropicalis CR-Y128, Cyberlindnera saturnus CR-Y125, and Candida solani CR-Y124 have shown a promising decolorizing potential of azo-dye BB41 (99.89–76.09% decolorization). Phytotoxicity, cytotoxicity, and genotoxicity assays on Trifolium pratense and Triticum aestivum seedlings confirmed the high toxicity of BB41 dye (500 ppm), with inhibition on germination rate (%), root and shoot elongation, decreasing of mitoxic index value (with 34.03% in T. pratense and 40.25% in T. aestivum), and increasing the frequency of chromosomal aberrations (6.87 times in T. pratense and 6.25 times in T. aestivum), compared to control. The same biomarkers indicated the nontoxic nature of the BB41 degraded metabolite (500 ppm) obtained after P. kudriavzevii CR-Y103 treatment. Moreover, the healthy monkey kidney cells (Vero cells) had a low sensitivity to BB41 biodegraded products (250 μg mL⁻¹) (MTT cell viability assay) and revealed minor DNA damage (comet assay) compared to BB41 dye treatment. These findings show that P. kudriavzevii could be used in eco-friendly bioremediation technologies, applicable for reducing the toxicity of basic azo-dyes containing wastewaters.

https://ift.tt/2Dr2tQg

Effects of different composting strategies on methane, nitrous oxide, and carbon dioxide emissions and nutrient loss during small-scale anaerobic composting

Abstract

Composting is considered as one of the main sustainable methods for the treatment of livestock manure. In this study we investigated the effects of additives (urea and rice straw) on methane (CH₄), nitrous oxide (N₂O), and carbon dioxide (CO₂) emissions using a traditional Chinese pig slurry composting method over an 81-day period, as well as examining total organic carbon and total nitrogen loss. Four common treatment strategies were examined in this study: a control (MC), urea nitrogen addition (MN), composting using rice straw cover (MS_cover), and compost mixed with rice straw (MS_mix). Our results indicate that the addition of urea resulted in the lowest total CH₄ emissions and the highest N₂O emissions. MS_cover treatment had the highest and most significant effect on CH₄ emissions, while MS_mix treatment had the lowest CO₂ emissions. Carbon lost through CH₄ and CO₂ released during the experiment was 0.1–0.9 and 2.4–3.9% of total carbon loss, respectively, and nitrogen lost through N₂O release was 11.1–17.9% of total nitrogen. In general, although MS_mix, MS_cover, and MN treatments increased global warming potential by 21.4, 41.6, and 50.9% per kg of pig slurry, respectively, no statistical differences between the four treatments were recorded. By considering carbon and nitrogen conservation, as well as the improvement of the quality of compost and the mitigation of greenhouse gases (GHGs), the small-scale composting method of pig slurry alone is an acceptable environmentally friendly strategy for use in China.

https://ift.tt/2JKImwI

“Normal‐appearing” scalp areas are also affected in lichen planopilaris and frontal fibrosing alopecia: an observational histopathologic study of 40 patients

Abstract

Lichen planopilaris (LPP) and frontal fibrosing alopecia (FFA) are lymphocyte‐mediated scarring alopecias which clinically affect primarily the anterior and mid scalp. However, unaffected scalp areas have not yet been investigated in a systemic manner. In this study we assessed histopathologic changes in affected and unaffected scalp in both diseases and healthy control subjects and compared these findings with clinical signs and scalp symptoms. We have demonstrated that "normal‐appearing" scalp that is devoid of clinical lesions of LPP and FFA showed lymphocytic perifollicular inflammation around the isthmus/infundibulum areas in 65% of biopsy specimens, perifollicular fibrosis in 15% and mucin deposits in 7.5% of the cases. None of these findings were found in control samples. No direct correlation was found between the degree of histopathological inflammation, scalp symptoms and clinical lesions in the corresponding affected scalp areas. This preliminary study suggests that both diseases may be more generalized processes which affect the scalp and therefore, need systemic or total scalp therapy.

https://ift.tt/2RGIBf0

Interleukin-4/interleukin-13 versus interleukin-5: a comparison of molecular targets in biologic therapy for the treatment of severe asthma

Strategies to reduce corticosteroid-related adverse events in asthma

Active vaccination against Interleukin‐5 as long‐term treatment for insect bite hypersensitivity in horses

Abstract

Background

Insect‐bite hypersensitivity (IBH) in horses is a chronic allergic dermatitis caused by insect bites. Horses suffer from pruritic skin lesions, caused by type‐I/type‐IV allergic reactions accompanied by prominent eosinophil infiltration into the skin. Interleukin‐5 (IL‐5) is the key cytokine for eosinophils and we have previously shown that targeting IL‐5 by vaccination reduces disease symptoms in horses.

Objective

Here we analyzed the potential for long‐term therapy by assessing a second follow‐up year of the previously published study.

Methods

The vaccine consisted of equine IL‐5 (eIL‐5) covalently linked to a cucumber mosaic virus‐like particle (VLP) containing a universal T cell epitope (CuMV_TT) using a semi‐cross over design to follow vaccinated horses during a second treatment season. Thirty Icelandic horses were immunized with 300 μg of eIL‐5‐CuMV_TT without adjuvant.

Results

The vaccine was well tolerated and did not reveal any safety concerns throughout the study. Upon vaccination all horses developed reversible anti‐eIL‐5 auto‐antibody titers. The mean course of eosinophil levels was reduced compared to placebo treatment leading to significant reduction of clinical lesion scores. Horses in their second vaccination year showed a more pronounced improvement of disease symptoms when compared to first treatment year, most likely due to more stable antibody titers induced by a single booster injection. Hence, responses could be maintained over two seasons and the horses remained protected against disease symptoms.

Conclusion

Yearly vaccination against IL‐5 may be a long‐term solution for the treatment of IBH and other eosinophil‐mediated diseases in horses and other species including humans.

https://ift.tt/2RH23bz

Effect of bisphosphonate treatment on the jawbone: an exploratory study using periapical and panoramic radiographic evaluation

Abstract

Objective

This cross-sectional study aimed to explore potential jawbone changes secondary to bisphosphonate (BP) treatment of osteoporosis using digital panoramic and periapical radiography.

Methods

Thirty-nine women, previously examined with dual-energy X-ray absorptiometry, were radiographed by digital panoramic and/or periapical radiography. On periapical radiographs, trabecular bone structure and fractal dimension analyses of the mandibular first molar and edentulous regions were performed. On panoramic radiographs, the mandibular cortical width (MCW) was calculated, and trabecular bone structure and fractal dimension analyses of the trabecular bone in the alveolar and basal bones were performed. The results were compared between patients treated or not treated with BP using linear regression analysis to adjust for potential confounding factors.

Results

The analyses of periapical and panoramic radiological images showed no statistical differences in the jawbones between groups after bisphosphonate use for mean intervals of 4.3 and 5 years; respectively. Although the mandibular cortical width on panoramic radiography was correlated with BP use, it was not noted to be statistically significant.

Conclusions

The trabecular parts of the alveolar and basal bones and the MCW were not significantly altered by BP treatment in patients with osteoporosis over 4.3–5 years, as detected by digital periapical and panoramic radiography. The low dosages of bisphosphonates used in the treatment of osteoporosis may explain this lack of change in MCW. Dental radiographs should not be considered as a method to monitor BP-induced jaw bone alterations among osteoporotic patients.

https://ift.tt/2Oxu0Au

Αρχειοθήκη ιστολογίου

! # Ola via Alexandros G.Sfakianakis on Inoreader

Η λίστα ιστολογίων μου

Τετάρτη 7 Νοεμβρίου 2018

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