Cosmetics, Vol. 6, Pages 7: Bioactive Metabolites of the Stem Bark of Strychnosaff. darienensisand Evaluation of Their Antioxidant and UV Protection Activity in Human Skin Cell Cultures

Cosmetics, Vol. 6, Pages 7: Bioactive Metabolites of the Stem Bark of Strychnosaff. darienensisand Evaluation of Their Antioxidant and UV Protection Activity in Human Skin Cell Cultures

Cosmetics doi: 10.3390/cosmetics6010007

Authors: Aikaterini Travasarou Maria T. Angelopoulou Konstantina Vougogiannopoulou Adamantia Papadopoulou Nektarios Aligiannis Charles L. Cantrell Dimitris Kletsas Nikolas Fokialakis Harris Pratsinis

The genus Strychnos (Loganiaceae) is well-known as a rich source of various bioactive metabolites. In continuation of our phytochemical studies on plants from Amazonia, we examined Strychnosaff. darienensis, collected in Peru. This species has been traditionally used in South America and is still presently used as a drug by the Yanesha tribe in Peru. Phytochemical investigation of this plant led to the isolation and structure elucidation by ΝuclearΜagnetic Resonance and High Resolution Mass Spectroscopy of 14 compounds that belong to the categories of phenolic acids [p-hydroxybenzoic acid (1) and vanillic acid (2)], flavonoids [luteolin, (3),3-O-methyl quercetin (4), strychnobiflavone (5), minaxin (6) and 3’,4’,7-trihydroxy-flavone (7)], lignans [syringaresinol-β-D-glucoside (8), balanophonin (9) and ficusal (10)] and alkaloids [venoterpine (11), 11-methoxyhenningsamine (12), diaboline (13) and 11-methoxy diaboline (14)]. The isolated flavonoids—a class known for its anti-aging activities—were further evaluated for their biological activities on normal human skin fibroblasts. Among them, only (6), and to a lesser extent (7), exhibited cytotoxicity at 100 µg/ml. All five flavonoids suppressed intracellularreactive oxygen species (ROS) levels, either basal or following stimulation with hydrogen peroxide or both. Moreover, luteolin and strychnobiflavone protected skin fibroblasts against ultraviolet (UV)-irradiation-induced cell death. The isolated flavonoids could prove useful bioactive ingredients in the cosmetic industry.

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Influence of Spirulina platensis and ascorbic acid on amikacin-induced nephrotoxicity in rabbits

Abstract

The current study was performed to investigate the nephroprotective efficacy of Spirulina platensis (SP) and the possible benefits of combining SP and ascorbic acid (AA) in protecting against amikacin (AMK)-induced nephrotoxicity in rabbits. Forty-two male New Zealand rabbits were allocated to seven equal groups, receiving (I) normal saline as negative controls, (II) oral SP (500 mg/kg body weight), (III) oral AA (20 mg/kg bw), (IV) intramuscular AMK injection (100 mg/kg bw), (V) AMK plus SP, (VI) AMK plus AA, or (VII) AMK plus SP and AA at the aforementioned doses. The treatments were given once/day for 7 days. Data analysis showed that in comparison to the control group, AMK-intoxicated rabbits showed significant increases (p ≤ 0.05) in serum concentrations of creatinine, uric acid, and urea, as well as renal tissue concentrations of tumor necrosis factor-α [TNF-α], malondialdehyde [MDA], and nitric oxide [NO]. Moreover, significant (p ≤ 0.05) reductions in renal glutathione concentration, antioxidant enzymatic activities (catalase, glutathione peroxidase, and superoxide dismutase), and total antioxidant capacity were noted following AMK intoxication. Treatment by SP ameliorated most of the aforementioned AMK-induced alterations. Although treatment with AA significantly reduced the renal tissue MDA, NO, and TNF-α concentrations, it was not associated with significant ameliorations of AMK-induced changes in the serum concentrations of renal function markers or renal tissue antioxidant parameters. The nephroprotective effects of SP-AA combination were more potent than SP alone in several parameters. In conclusion, SP alone or in combination with AA minimized the nephrotoxic effects of AMK through their antioxidant and anti-inflammatory activities.

http://bit.ly/2Scktok

Thyroid Hormone Receptor Alpha Mutations Lead to Epithelial Defects in the Adult Intestine in a Mouse Model of Resistance to Thyroid Hormone

Thyroid, Ahead of Print.


http://bit.ly/2RSGFVe

Trends, Determinants, and Associations of Treated Hypothyroidism in the United Kingdom, 2005–2014

Thyroid, Ahead of Print.


http://bit.ly/2CJ3zUO

Randomized Trial of a Tailored Cognitive‐Behavioral Therapy Mobile Application for Anxiety in Patients with Incurable Cancer

AbstractBackground.The aim of this study was to test the efficacy of a tailored cognitive‐behavioral therapy (CBT) mobile application (app) to treat anxiety in patients with incurable cancer.Materials and Methods.Patients with incurable cancers (n = 145) who reported elevated anxiety symptoms at two cancer centers were randomized to receive either the CBT mobile app for anxiety or a mobile health education program (control) delivered via tablet computers, which patients self‐administered over 12 weeks. To assess anxiety, depression symptoms, and quality of life (QOL), we used the Hamilton Anxiety Rating Scale (HAM‐A, primary outcome), Clinical Global Impression Scale, Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire‐9, and Functional Assessment of Cancer Therapy‐General at baseline and 12 weeks. Analysis of covariance models were calculated to assess intervention effects on patient outcomes.Results.Patients (73.8% female; 91.0% white; mean age = 56.45 years, SD = 11.30) in both study groups reported improvements in anxiety, depression symptoms, and QOL from baseline to postassessment, with no significant differences in any outcome measure between groups. Secondary analyses showed that, among the subgroup of patients with severe baseline anxiety, those randomized to the CBT app had greater improvements on the HAM‐A (Mean Difference = 7.44, standard error [SE] = 3.35, p = .037) and HADS‐Anxiety Subscale (Mean Difference = 4.44, SE = 1.60, p = .010) compared with the control group.Conclusion.Both the tailored CBT app for anxiety and the health education program were associated with improvements in anxiety, mood, and QOL, but these outcomes did not differ between study groups. The CBT app was more beneficial than health education for patients with severe baseline anxiety.Implications for Practice.A cognitive‐behavioral therapy mobile application tailored to treat anxiety in patients with advanced cancer helps improve access to evidence‐based supportive care in a convenient, private, and timely manner.

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Hybrid Capture‐Based Genomic Profiling Identifies BRAF V600 and Non‐V600 Alterations in Melanoma Samples Negative by Prior Testing

AbstractBackground.BRAF and MEK inhibitors are approved for BRAF V600‐mutated advanced melanoma, with response rates of up to 70%. Responses to targeted therapies have also been observed for diverse non‐V600 BRAF alterations. Thus, sensitive, accurate, and broad detection of BRAF alterations is critical to match patients with available targeted therapies.Materials and Methods.Pathology reports were reviewed for 385 consecutive melanoma cases with BRAF mutations or rearrangements identified using a hybrid capture‐based next‐generation sequencing comprehensive genomic profiling (CGP) assay during the course of clinical care.Results.Records of prior BRAF molecular testing were available for 79 (21%) cases. Of cases with BRAF V600 mutations, 11/57 (19%) with available data were negative by prior BRAF testing. Prior negative BRAF results were also identified in 16/20 (80%) cases with non‐V600 mutations, 2 of which harbored multiple BRAF alterations, and in 2/2 (100%) cases with activating BRAF fusions. Clinical outcomes for a subset of patients are presented.Conclusion.CGP identifies diverse activating BRAF alterations in a significant fraction of cases with prior negative testing. Given the proven clinical benefit of BRAF/MEK inhibitors in BRAF‐mutated melanoma, CGP should be considered for patients with metastatic melanoma, particularly if other testing is negative.Implications for Practice.Published guidelines for melanoma treatment recommend BRAF mutational analysis, but little guidance is provided as to selection criteria for testing methodologies, or as to clinical implications for non‐V600 alterations. This study found that hybrid capture‐based next‐generation sequencing can detect BRAF alterations in samples from a significant fraction of patients with advanced melanoma with prior negative BRAF results. This study highlights the need for oncologists and pathologists to be critically aware of coverage and sensitivity limitations of various assays, particularly regarding non‐V600E alterations, of which many are potentially targetable.

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Suspected Hereditary Cancer Syndromes in Young Patients: Heterogeneous Clinical and Genetic Presentation of Colorectal Cancers

AbstractColorectal cancer (CRC) is rare in young patients without a confirmed family history of cancer. Reports of an increased prevalence of POLD1/POLE mutations in young patients with colorectal cancer have raised awareness and support routine genetic testing for patients with early‐onset tumors. In cases of CRC without proven MMR‐germline mutation, molecular analyses are warranted to confirm or rule out other familial CRC syndromes. This article describes the cases of two young male patients, who presented with locally advanced and metastatic CRC, and reports the results of the germline mutational analyses done for both patients. These cases demonstrate the importance of special care and molecular diagnostic procedures for young patients with CRC.Key Points. Patients with colorectal cancer who are younger than 50 years at initial diagnosis (early onset) should routinely undergo genetic testing.Early‐ and very‐early‐onset patients (younger than 40 years) with absence of microsatellite instability should be considered for tumor mutation burden testing and/or DNA polymerase proofreading mutation.The mutational signature of HSP110 within mismatch repair deficiency‐related tumors may help to identify patients likely to benefit from 5‐fluorouracil‐based chemotherapy.Intensified, maintained, and specific surveillance may help to reduce secondary tumor progression.

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Topical pimecrolimus versus betamethasone for oral lichen planus: a randomized clinical trial

Abstract

Objectives

Oral lichen plans (OLP) is a potentially malignant inflammatory mucocutaneous disease. CD133 is an investigated surface marker for cancer stem-like cells (CSCs) that may be involved in tumor initiation in head and neck carcinomas. We compared short-term clinical effectiveness of topical pimecrolimus as selective inflammatory cytokine release inhibitor with betamethasone cream for erosive/atrophic OLP and investigated the influence of this therapy on CD133 expression.

Material and methods

Thirty patients were randomly assigned into two equal groups to receive topical pimecrolimus (group I) or betamethasone (group II) four times daily for 4 weeks. A marker lesion in each patient were assessed at baseline using clinical score (CS) and visual analog scale (VAS) then at 1, 2, and 4 weeks and after 4 weeks of treatment-free period. CD133 expression was detected in pre- and post-treatment immunostained sections.

Results

Both drugs showed a reduction in CS, VAS, and CD133 expressions after treatment termination (p < 0.001). Pimecrolimus-treated lesions showed significant higher 1st week reduction in severity (33.1% (22.2)), pain score (57.53% (14.27)), less recurrence in follow-up period and less CD133 expression by the end of the 1st 4 weeks compared with betamethasone.

Conclusion

Pimecrolimus showed earlier clinical response and less recurrence rate compared with standard topical corticosteroid in symptomatic OLP lesions, and both treatment reduced CD133-positive CSC population.

Clinical relevance

The study proved the benefits of topical pimecrolimus in early management of painful lesions of OLP and its ability to inhibit CSCs, suggesting a possible role in reducing risk of malignant transformation.

http://bit.ly/2RbPjZT

Remineralization capacity of carious and non-carious white spot lesions: clinical evaluation using ICDAS and SS-OCT

Abstract

Objectives

To assess the remineralization capacity of carious, non-carious, and combined white spot lesions (WSLs) using the ICDAS and SS-OCT.

Materials and methods

This clinical trial was based on a quasi-experimental design. Forty-two healthy subjects (median age 26.6 years), who visited university hospital and had at least one WSL with an ICDAS score of 2 or 1, were recruited. The subjects chewed a non-blind sugar-free gum containing bioavailable calcium and fluoride for 3 months. The remineralization capacities of carious and non-carious 121 WSLs were assessed using ICDAS by two calibrated non-blind examiners and optical boundary depth (BD) by SS-OCT at a monthly recall. The outcome variables, transitions of ICDAS score, mean BD, and mean BD recovery rate (RR%), were statistically analyzed using the chi-square test, two way-repeated measures ANOVA, and Wilcoxon rank sum test, respectively (alpha = 0.05).

Results

Based on the visual inspection, OCT images at the baseline, 72 WSLs were purely carious, 20 were non-carious (developmental) lesions, while 29 were combined (carious-developmental). The responses of WSLs over time showed to be highly variable. There was a significant difference in transitions of ICDAS scores after 3 months between carious and non-carious WSLs (p < 0.05) and non-carious and combined WSLs (p < 0.05). Carious and combined WSLs underwent significant changes in the mean BD between baseline (161.8 ± 56.8 μm) and 2 months (130.7 ± 57.4 μm) or 3 months (119.1 ± 57.5 μm) (p < 0.05), while there was no significant difference between baseline (132.2 ± 26.2 μm) and 2 months (122.8 ± 24.1 μm) or 3 months (119.8 ± 22.6 μm) in non-carious WSLs (p > 0.05). There was a significant difference in mean RR% after 2 and 3 months between carious and non-carious WSLs (p < 0.05).

Conclusions

The remineralization capacity of WSL was variable among the cases and subjects, and depended on the WSLs history, etiology (carious, non-carious, or combined lesion) and structure (histological pattern).

Clinical relevance

Carious WSLs showed the highest remineralization potential.

http://bit.ly/2Wjn5QB

Relationship between erosive tooth wear and beverage consumption among a group of schoolchildren in Mexico City

Abstract

Objective

To assess the association between erosive tooth wear (ETW) and consumption of different kinds of beverages in a group of schoolchildren 11–14 years old in Mexico City.

Methods

Cross-sectional study in a sample of students (n = 512) in Mexico City. The Basic Erosive Wear Examination (BEWE) was used to quantify ETW. Beverage consumption (BC) was determined using a frequency questionnaire; beverages included pure water, natural fruit juices, milk, hot beverages, and soft drinks. Ordinal logistic regression model was used to evaluate the association between the presence of ETW and BC.

Results

In total, 45.7% of the schoolchildren showed an initial loss of surface texture (BEWE = 1) and 18.2% a distinct defect involving loss of dental tissue (BEWE ≥ 2) in at least one tooth. For each glass (350 ml) of milk/week, the odds of not having erosive wear (BEWE = 0) versus having an initial loss of surface texture (BEWE = 1) or of having an initial loss of surface texture versus the presence of a defect involving the loss of dental tissue (BEWE ≥ 2) decreased 4% (OR = 0.96, 95% CI 0.93–0.99, p = 0.008); for each portion of sweet carbonated beverage consumed (350 ml), the odds increased 3% (OR = 1.03, 95% CI 1.001–1.07, p = 0.046).

Conclusion

The intake of milk and milk-based products could be a dietary means of helping prevent ETW, especially if their consumption could replace sweet carbonated drink consumption.

Clinical relevance

Knowing the impact of beverage consumption on ETW helps to provide suitable recommendations for the prevention and control of ETW in order to promote tooth longevity.

http://bit.ly/2RgVSKt

Both operator and heat treatment determine the centring ability of Reciproc® files in vitro

Abstract

Objectives

To determine the shaping ability of reciprocating files without/with post-manufacturing heat treatment (Reciproc®/Reciproc blue®, VDW) when used by six operators of similar level of experience.

Materials and methods

Plastic training blocs with curved root canals (5 mm radius, 55° angle) were mounted in a dental manikin. Each operator prepared six specimens with each instrument system using the file sizes R25, R40 and R50 consecutively. Specimens were photographed, and deviations from the centre of the canal were measured at intervals of 0.5 mm and averaged for the apical, middle and coronal part of the canal. Data were tested for significance using the Mann-Whitney U test and two-way ANOVA with instrument systems and operators serving as factors.

Results

Deviations were observed towards the outer curvature in the apical and coronal and to the inner curvature in the middle segment of the canal. They were larger after using larger size instruments and were smaller when using Reciproc blue® compared to Reciproc®. Significant differences among operators were observed in the middle (all sizes) and coronal part of the canals (only sizes R25 und R40). Coronally, interaction between the main factors was significant as well.

Conclusions

Post-manufacturing heat treatment significantly improved shaping ability of the reciprocating file system Reciproc®. The observed differences among operators suggest the possibility of further improvement by providing specific training for prospective users.

Clinical relevance

Maintenance of root canal curvature may be improved by using post-manufacturing heat-treated instruments, but specific training should be recommended as well.

http://bit.ly/2WjvfbS

One-year clinical evaluation of bulk-fill flowable vs. regular nanofilled composite in non-carious cervical lesions

Abstract

Objective

The aim of this double-blind, randomized trial was to evaluate the 1-year clinical performance of a bulk-fill flowable and a regular nanofilled composite in non-carious cervical lesions (NCCLs).

Methods

Twenty-two subjects with at least two NCCLs were enrolled in the study. A total of 89 restorations were performed by a single operator using Filtek Supreme (FS) Ultra Universal or Filtek Bulk (FB) Fill Flowable. A universal adhesive (Scotchbond™ Universal Adhesive) was used with a self-etching approach in dentin. The restorations were evaluated by two independent and previously calibrated examiners at baseline (7 days), 6 months and 1 year, according to the USPHS modified criteria. Mann–Whitney U test was used to analyze the differences between composites and Wilcoxon signed rank test for comparisons between the baseline and follow-ups (α = 5%).

Results

One restoration was considered clinically unacceptable due to loss of retention after 6 months in the FS group. FS presented statistically high scores for surface roughness when compared to FB after 1 year (p < 0.05), but both were considered clinically acceptable. After 1 year, the frequency of clinically unacceptable rates was 3.3% for anatomical form in the FB group, 1.1% for retention in the FS group, and 2.2% for marginal adaptation in both groups. All restorations, in both groups, presented score 0 over the 1-year period for marginal staining, postoperative sensitivity, and secondary caries.

Conclusion

Both composite resins showed acceptable clinical performances for the restoration of NCCLs after 1 year.

Clinical relevance

Both bulk-fill flowable and regular nanofilled composites showed good clinical performances for the restoration of NCCLs after 1 year.

http://bit.ly/2RgADZm

2-Methacryloyloxyethyl phosphorylcholine (MPC)-polymer suppresses an increase of oral bacteria: a single-blind, crossover clinical trial

Abstract

Objectives

The biocompatible 2-methacryloyloxyethyl phosphorylcholine (MPC)-polymers, which mimic a biomembrane, reduce protein adsorption and bacterial adhesion and inhibit cell attachment. The aim of this study is to clarify whether MPC-polymer can suppress the bacterial adherence in oral cavity by a crossover design. We also investigated the number of Fusobacterium nucleatum, which is the key bacterium forming dental plaque, in clinical samples.

Materials and methods

This study was a randomized, placebo-controlled, single-blind, crossover study, with two treatment periods separated by a 2-week washout period. We conducted clinical trial with 20 healthy subjects to evaluate the effect of 5% MPC-polymer mouthwash after 5 h on oral microflora. PBS was used as a control. The bacterial number in the gargling sample before and after intervention was counted by an electronic bacterial counter and a culture method. DNA amounts of total bacteria and F. nucleatum were examined by q-PCR.

Results

The numbers of total bacteria and oral streptcocci after 5 h of 5% MPC-polymer treatment significantly decreased, compared to the control group. Moreover, the DNA amounts of total bacteria and F. nucleatum significantly decreased by 5% MPC-polymer mouthwash.

Conclusions

We suggest that MPC-polymer coating in the oral cavity may suppress the oral bacterial adherence.

Clinical relevance

MPC-polymer can be a potent compound for the control of oral microflora to prevent oral infection.

http://bit.ly/2WiYlb4

Molecular imaging assessment of periodontitis lesions in an experimental mouse model

Abstract

Objective

We aimed to evaluate molecular imaging as a novel diagnostic tool for mice periodontitis model induced by ligature and Porphyromonas gingivalis (Pg) inoculation.

Materials and methods

Twelve female mice were assigned to the following groups: no treatment as control group (n = 4); periodontitis group induced by ligature and Pg as Pg group (n = 4); and Pg group treated with glycyrrhizinic acid (GA) as Pg + GA group (n = 4). All mice were administered a myeloperoxidase (MPO) activity-specific luminescent probe and observed using a charge-coupled device camera on day 14. Image analysis on all mice was conducted using software to determine the signal intensity of inflammation. Additionally, histological and radiographic evaluation for periodontal inflammation and bone resorption at the site of periodontitis, and quantitative enzyme-linked immunosorbent assay (ELISA) were conducted on three mice for each group. Each experiment was performed three times.

Results

Levels of serum IgG antibody against P. gingivalis were significantly higher in the Pg than in the Pg + GA group. Histological analyses indicated that the number of osteoclasts and neutrophils were significantly lower in the Pg + GA than in the Pg group. Micro-CT image analysis indicated no difference in bone resorption between the Pg and Pg + GA groups. The signal intensity of MPO activity was detected on the complete craniofacial image; moreover, strong signal intensity was localized specifically at the periodontitis site in the ex vivo palate, with group-wise differences.

Conclusions

Molecular imaging analysis based on MPO activity showed high sensitivity of detection of periodontal inflammation in mice.

Clinical relevance

Molecular imaging analysis based on MPO activity has potential as a diagnostic tool for periodontitis.

http://bit.ly/2RbPaFP

The effect of intraosseous local anesthesia of 4% articaine with 1:100,000 epinephrine on pulpal blood flow and pulpal anesthesia of mandibular molars and canines

Abstract

Objectives

The aim of this study was to determine the effect of intraosseous (IO) anesthesia with 4% articaine and 1:100,000 epinephrine on pulpal blood flow (PBF) and pulpal anesthesia of mandibular first molars and canines in human subjects.

Materials and methods

Ten healthy volunteers with intact mandibular first molar and canine were given an osteocentral technique of IO injection using the Quick Sleeper 5 system and 4% articaine with 1:100,000 epinephrine at distal site of mandibular first molar. The PBF was monitored by a laser Doppler flowmeter (LDF). Pulpal anesthesia was assessed with an electric pulp tester (EPT).

Results

IO injection caused a decrease in PBF in molars from 6.31 ± 3.85 perfusion units (P.U.) before injection to 2.51 ± 2.53 P.U. 1 min after injection (P < 0.001). The percentage reduction in PBF was 60% after 1 min and PBF returned back to the baseline after 45 min. No significant reduction in PBF was observed in the canines (P = 0.212). For pulpal anesthesia in the molars, the mean onset was 2.40 ± 0.84 min and the mean duration was 38 ± 16.19 min. In the canines, there was a decrease in the sensitivity to EPT but complete pulpal anesthesia was not achieved.

Conclusions

IO injection distal to mandibular first molar caused a decrease in PBF and successful pulpal anesthesia in first molar, but not in canine. Both PBF and EPT readings returned to normal, suggesting that pulpal ischemia may not occur.

Clinical relevance

IO anesthesia is safe to use as a primary technique in teeth with normal pulp.

http://bit.ly/2WkmTRe

Clinical antibacterial effectiveness and biocompatibility of gaseous ozone after incomplete caries removal

Abstract

Objectives

To evaluate local effect of gaseous ozone on bacteria in deep carious lesions after incomplete caries removal, using chlorhexidine as control, and to investigate its effect on pulp vascular endothelial growth factor (VEGF), neuronal nitric oxide synthase (nNOS), and superoxide dismutase (SOD).

Materials and methods

Antibacterial effect was evaluated in 48 teeth with diagnosed deep carious lesion. After incomplete caries removal, teeth were randomly allocated into two groups regarding the cavity disinfectant used: ozone (open system) or 2% chlorhexidine. Dentin samples were analyzed for the presence of total bacteria and Lactobacillus spp. by real-time quantitative polymerase chain reaction. For evaluation of ozone effect on dental pulp, 38 intact permanent teeth indicated for pulp removal/tooth extraction were included. After cavity preparation, teeth were randomly allocated into two groups: ozone group and control group. VEGF/nNOS level and SOD activity in dental pulp were determined by enzyme-linked immunosorbent assay and spectrophotometric method, respectively.

Results

Ozone application decreased number of total bacteria (p = 0.001) and Lactobacillus spp. (p < 0.001), similarly to chlorhexidine. The VEGF (p < 0.001) and nNOS (p = 0.012) levels in dental pulp after ozone application were higher, while SOD activity was lower (p = 0.001) comparing to those in control pulp.

Conclusions

Antibacterial effect of ozone on residual bacteria after incomplete caries removal was similar to that of 2% chlorhexidine. Effect of ozone on pulp VEGF, nNOS, and SOD indicated its biocompatibility.

Clinical relevance

Ozone appears as effective and biocompatible cavity disinfectant in treatment of deep carious lesions by incomplete caries removal technique.

http://bit.ly/2RgADIQ

The impact of premature birth on dental maturation in the permanent dentition

Abstract

Objectives

To evaluate tooth development and calculate dental maturity score in prematurely born children and to compare the findings with full-term born children.

Material and methods

Nine-year-old preterm children were selected from the Swedish Medical Birth Register. One group consisted of 36 extremely preterm children (born before week 29), and the other included 38 very preterm children (born during weeks 29 to 32). Panoramic radiography was performed on each child and the preterm children were compared with 42 full-term born children. Five observers independently assessed the tooth development stages for all teeth in the left mandible (31–37) on the panoramic radiographs according to the method described by Demirjian et al. (Hum Biol 45:211–227, 1973). Data from tooth development stages were compiled and converted into a dental maturity score for each group. Kappa values were calculated for intra- and inter-observer agreement.

Results

When the different development stages for each individual tooth were compared, all observers presented a significant delay in the maturity of tooth 37 for the extremely preterm group (p ≤ 0.002). The extremely preterm group had a significantly lower dental maturity score than the full-term group, as assessed by each observer (p ≤ 0.006). Kappa values for inter-observer agreement varied between 0.31 and 0.71 depending on tooth and intra-observer agreement was between 0.16 and 1.0.

Conclusions

At age 9, the extremely preterm children had a general delay in tooth development.

Clinical relevance

The increased survival rate of extremely preterm babies adds a new group of children to society. Dental clinicians should be aware that the delay in tooth development could impact the timing of orthodontic diagnostics and potential treatment.

http://bit.ly/2WhoqaA

Structural and histological differences between connective tissue grafts harvested from the lateral palatal mucosa or from the tuberosity area

Abstract

Summary

Tuberosity grafts had a greater percentage of lamina propria and lower percentage of submucosa when compared to lateral palate grafts.

Objective

The study aims to understand the differences in the structural composition of soft tissue autografts harvested from the lateral palate or the tuberosity.

Material and methods

Patients were randomly allocated to receive autografts harvested either from palatal or tuberosity sites to augment horizontal volume deficiencies around single-tooth implants. Tissue biopsies were analyzed for histological and histo-morphometric analysis. Picro-sirius red stain was used to evaluate collagen 1 and 3. Also, immuno-histochemical analysis was performed against MMP1, MMP2, cytokeratin-10, cytokeratin-13, and lysine hydroxylase-2.

Results

Twenty specimens were harvested from 9 subjects in the lateral palate group (PG) and 11 subjects in the tuberosity group (TG). The percentage of lamina propria represented 51.08% in the PG group and 72.79% in the TG group, while the area of submucosa was minimal in the TG group representing 4.89% of the total sample vs 25.75% in the PG. The total area of COL-1 and 3 in the TG was 1.19 ± 0.57 and 0.72 ± 0.44 mm², respectively, while in the PG, the corresponding values were 1.4 ± 0.7 and 1.04 ± 0.5 mm². The immuno-histochemical analysis generally showed a higher expression of LLH-2, MMP2, CYT-10, and CYT-13 in the TG when compared with the PG.

Conclusion

Tuberosity grafts had a greater percentage of lamina propria and lower percentage of submucosa. The collagen content in the lamina propria was similar for both groups while the immuno-histochemical profile showed differences in the antibody expression of the epithelial cells.

Clinical relevance

Tuberosity grafts had more lamina propria and less submocusa, which may be beneficial for volume augmentation.

http://bit.ly/2Rd8dj2

Does enamel matrix derivative application improve clinical outcomes after semilunar flap surgery? A randomized clinical trial

Abstract

Objectives

To evaluate the treatment of gingival recessions by semilunar coronally positioned flap plus enamel matrix derivative (SCPF + EMD).

Materials and methods

Thirty patients with class I localized gingival recession were included. They were randomly allocated in two groups: SCPF + EMD and SCPF. Recession height (RH), recession width (RW), width of keratinized tissue (WKT), thickness of keratinized tissue (TKT), probing depth (PD), and clinical attachment level (CAL) were measured at baseline, 6 and 12 months post-surgery. Patient/professional evaluation of esthetics and root sensitivity was performed.

Results

After 12 months, mean root coverage was 1.98 ± 0.33 mm for SCPF + EMD (90.86 ± 14.69%) and 1.85 ± 0.41 mm (79.76 ± 17.44%) for SCPF (p > 0.05). The esthetic evaluation by the patient showed preference for SCPF + EMD. According to the professional evaluation (QCE), the use of EMD decreases the appearance of postoperative scar tissue line. There was a significant reduction in root hypersensitivity with no further complaints by the patients.

Conclusions

The addition of EMD provides significantly better esthetics to SCPF, according to patient and professional assessments. SCPF + EMD is effective but not superior to SCPF for root coverage, after 12 months.

Clinical relevance

Previous clinical trials showed that the combination of EMD with coronally advanced flaps may enhance the outcome of root coverage. There is a lack of studies testing the combination of EMD with SCPF. The combination SCPF + EMD provides better esthetics when compared to the SCPF and is effective, but not superior, to SCPF for root coverage, after 12 months.

Trial registration: NCT02459704

http://bit.ly/2WiYbjY

In vitro evaluation by quantitative real-time PCR and culturing of the effectiveness of disinfection of multispecies biofilms in root canals by two irrigation systems

Abstract

Objectives

The purpose of this in vitro study was by using quantitative real-time PCR and culturing to determine the effectiveness of two irrigation and cleaning systems in removing multispecies oral biofilms from root canals.

Material and methods

Twenty extracted human molars were instrumented to size #15/.02 and then cleaned with the GentleWave (GW) System. The teeth were autoclaved to provide the same sterile baseline. The molars were filled with mixed plaque suspended in BHI and centrifuged to inoculate the biofilms. After 2 weeks of incubation, the teeth were randomly divided into two treatment groups. In GW group (26 canals), the teeth were further instrumented to size #15/04, and in PiezoFlow (PF) group (30 canals) to #35/.04. The teeth were then cleaned either with GW System or ProUltra PiezoFlow Active Ultrasonic System using 3% sodium hypochlorite NaOCl, 8% EDTA, and sterile water as irrigants. Samples (S1, S2, and S3) for bacterial cultures were taken from 13 canals before and after instrumentation and after final cleaning. Quantitative real-time PCR was performed from all 56 canals, and universal bacterial, one genus, and one species-specific primers were used to determine the presence of microorganisms in samples from root canals before and after instrumentation and after final cleaning. Statistical analyses were performed using the Mann-Whitney U test with the significance level set at P < 0.05.

Results

Bacterial culturing from the canal samples revealed strong reduction of bacteria from S1 to S2 in both groups after instrumentation and irrigation with water only. No growth was detected in any of the S3 samples after cleaning in either group. A highly significant reduction in bacterial DNA was recorded by qPCR for both groups (P < 0.001). GW System showed more constant and a significantly higher reduction of total microbial DNA (P = 0.007), Enterococcus faecalis DNA (P = 0.011) and Streptococcus spp. DNA (P = 0.029) than the Ultrasonic System. The amount of residual microbial DNA calculated as an average of residual DNA in each individual canal in PF group was 1.99% and in GW group 0.09%.

Conclusions

While both systems demonstrated a highly effective reduction of intracanal bacterial DNA, the final total amount and variation in the number of residual bacterial DNA was significantly smaller in the GW group.

Clinical relevance

Elimination of microbes from the infected root canal system is regarded as the key for long-term clinical success. While both GentleWave and Ultrasonic Systems used with NaOCl and EDTA demonstrated a highly effective reduction of intracanal bacterial DNA; GW produced higher reduction and better predictability.

http://bit.ly/2Riba1E

PEKK-made indirect temporary crowns and bridges: a clinical pilot study

Abstract

Objectives

The aim of the present study was to find out whether the high-performance polymer PEKK is an equivalent alternative compared to cobalt chrome (CoCr)-made restorations, regarding to biocompatibility, stability, and comfort.

Materials and methods

Twenty-two patients (m, 10; f, 12) who were indicated for a long-term temporary-fixed restoration were included. They were randomized through a lottery procedure into two groups: the first group was restored with veneered PEKK-made crowns and bridges (Pekkton ivory), while the second group was restored with veneered CoCr crowns. Clinical parameters (plaque index (PI), probing depth (PD), fracture, and chipping) were documented in a period of 3–5 months from the insertion of restoration. Furthermore, every patient completed the OHIP-14 questionnaire. An exchange of the restorations from the first to the alternative material was performed after a period of 3–5 months.

Results

All patients showed an improvement of the oral hygiene and probing depth after insertion of the temporary restorations. However, there were no significant differences between PEKK and CoCr-made restorations (P > 0.05). There was no chipping after 5 months for both kinds of materials. There was a noticeable reduction of pain and discomfort of patients after insertion of temporary restorations. However, there were no significant differences between the two materials (P > 0.05).

Conclusions

PEKK-made temporary restorations offer a good and stable alternative to CoCr-made restorations. They have a high aesthetical advantage over CoCr restoration.

Clinical relevance

Esthetic and price-efficient temporary crowns can be offered for the patient during periodontal therapy to improve its success, in particular by improving the oral hygiene.

http://bit.ly/2WiY7Rg

Combustion, performance, and emissions of a compression ignition engine using Pongamia biodiesel and bioethanol

Abstract

Concerns over the depletion of conventional fuels have increased interest in new renewable energy sources like alcohol- and vegetable-based oils. Major drawbacks of using esters of vegetable oils, known as biodiesel, include reduced engine performance and increased emissions of oxides of nitrogen. In the present study, the effects of ethanol on biodiesel and mineral diesel blends in a diesel engine are experimentally investigated. The ethanol is produced from cashew apple juice by fermentation. Experiments are conducted using B20 Pongamia biodiesel with ethanol in proportions of 5, 7.5, and 10% by volume at varying load conditions. The results indicate that a B20 biodiesel blend with 7.5% ethanol yields a higher brake thermal efficiency and lower brake-specific energy consumption than pure B20 (20% biodiesel + 80% diesel), as well as significantly reduced emissions such as oxides of nitrogen, carbon monoxide, hydrocarbons, and smoke.

http://bit.ly/2UjnRve

Setal-epidermal, muscular and enzymatic anomalies induced by certain agrochemicals in the earthworm Eudrilus eugeniae (Kinberg)

Abstract

Eudrilus eugeniae, the vermicomposing worm, is found in considerable numbers in agricultural fields in India due to their eventual transfer through vermimanure. These worms are very often exposed to pesticides, herbicides, chemical fertilisers and other soil amendments. This paper reports the effects of variable concentrations of urea, phosphogypsum (PG), paper mill sludge (PMS) and two organophosphorus agrochemicals, monocrotophos and glyphosate, on certain morphological, histological and biochemical parameters of E. eugeniae. Results indicated setal anomalies, epidermal lesions, clitellar swelling and constriction of the body. Disintegration of connective tissue, vacuolation of dermis and significant alterations in protein, lipid peroxidation levels and activities of lactate dehydrogenase, acetylcholinesterase and catalase have also been observed in the treated worms. It is proposed that setae, connective tissue, protein and enzymes in E. eugeniae could be useful markers to evaluate toxicity due to the test chemicals.

http://bit.ly/2TbmbU9

Modified Kunlin's Technique for Microsurgical End-to-End Anastomoses: A Series of 100 Flaps

J reconstr Microsurg
DOI: 10.1055/s-0039-1677797

Background In 1949, a French vascular surgeon, Jean Kunlin, first described a venous end-to-side anastomotic technique to address large vessel size mismatches. It was later modified by Dr. Robert Linton for end-to-end (ETE) anastomoses on the "macrovascular" scale. While multiple procedures exist for addressing moderate caliber discrepancies, few safely and reliably compensate for marked diameter differences at the microvascular level. In this study, we present the first large series adapting a modified geometric Kunlin's technique for arterial and venous ETE anastomoses in reconstructive microsurgery. Methods We reviewed 100 consecutive cases of free flap reconstructions from 2006 to 2015 utilizing a modified geometric Kunlin's technique for arterial and venous ETE anastomoses. Patient demographics and flap outcomes were analyzed. Overall flap survival rates and postoperative complications were analyzed and compared with standard values in the microsurgical literature. Results A total of 146 ETE anastomoses from 100 free flaps were analyzed. The average patient age was 51 ± 3.1 years (range: 10–84 years). Free flaps in this study were used for gender confirmation phalloplasties (20%) and reconstructing defects of the head and neck (63%), extremities (16%), and trunk (1%). There was a total of 17 takebacks including 5 for hematoma, 8 for anastomotic thromboses (6 venous), and 4 without any identifiable complication. Of these takebacks, two partial and two complete flap losses occurred. There was an 88% salvage rate for flaps requiring takebacks during the postoperative period. Overall, flap survival rate was 98% including those with complications or takebacks. Conclusions The modified Kunlin's technique is a reliable, facile, and versatile method of performing ETE anastomoses for arterial and venous vessels, especially with vessel diameter mismatches of 3:1 or greater, as well as for challenging orientations. Notably, it provides equivalent flap survival and complication rates as compared with other techniques in the microsurgical literature.
[...]

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Article in Thieme eJournals:
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http://bit.ly/2FQpSeW

Long-term spatiotemporal variations of aerosol optical depth over Yellow and Bohai Sea

Abstract

In this study, MODerate resolution Imaging Spectroradiometer (MODIS) Collection 6.1 (C6.1) level-2 Dark Target (DT) Aerosol Optical Depth (AOD) observations at 550 nm (AOD₅₅₀) for the highest quality flag assurance (QA = 3) were obtained to analyze spatiotemporal variations of aerosol optical properties over the Yellow and the Bohai Sea from 2002 to 2017. Spectral AOD observations at 470 nm (AOD₄₇₀) and 660 nm (AOD₆₆₀) were obtained to calculate Angstrom Exponent (AE_470–660) and classify the aerosol types including clean continental (CC), clean maritime (CM) biomass and urban industrial (BUI), dust (D), and mixed (MXD) aerosol types. Results showed a very distinct spatial pattern of AOD distribution over the Bohai Sea which looks suspicious, i.e., high aerosol loadings (AOD > 0.8) throughout the entire time period, whereas relative low AOD distribution was observed over the adjacent land pixels especially in autumn and winter, which suggested that the DT algorithm might be influenced by a large number of sediments located in the Bohai Sea. Significant differences in spatial distributions were found in different seasons in terms of area coverage as a maximum number of pixels were available during autumn, and regional high and low aerosol loadings were observed during autumn and summer, respectively. Trend analysis from 2002 to 2017 showed that AOD was increased up to 0.04 over the Bohai Sea and decreased up to 0.04 over the Yellow Sea, and this trend varies from month to month. Aerosol classification showed significant contributions of BUI and CC over the region, and contributions of CM, DUST, and MXD aerosols over the Yellow Sea were relatively high compared to the Bohai Sea.

http://bit.ly/2HwGWZb

Elemental distribution including toxic elements in edible and inedible wild growing mushrooms from South Africa

Abstract

Macro-elements (Ca, Fe, K, Mg and Na) and trace elements including some toxic (As, Be, Cd, Co, Cu, Mn, Ni, Pb, Se and Zn) were determined in edible and inedible wild-growing mushrooms (Amanita rubescens, Auricularia polytricha, Boletus edulis, Boletus mirabilis, Clavulina cristata, Helvella crispa, Lactarius deliciosus, Suillus luteus, Termitomyces microcarpus, Termitomyces reticulatus, Termitomyces clypeatus, Termitomyces umkowaanii, Amanita foetidissima, Amanita muscaria, Amanita pantherina, Aseroe rubra, Chlorophyllum molybdites, Ganoderma lucidum, Gymnopilus junonius, Hypholoma fasciculare, Lentinus villosus, Lepista caffrorum, Pycnoporus sanguineus, Panaeolus papilionaceus, Pisolithus tinctorius, Pleurotus ostreatus, Podaxis pistillaris, Russula sardonia, Scleroderma citrinum, Scleroderma michiganense). Analyses of samples were carried out using inductively coupled plasma-optical emission spectrometry. The elemental content in both edible and inedible mushrooms, in decreasing order, was found to be K >> Na > Ca > Mg > Fe > Mn > Zn > Cu > Se > Co > Ni > Be > Pb ≥ Cd > As. Our study revealed that the accumulation of metals from the soil is independent of whether mushrooms are edible or inedible as uptake is dependent on the soil quality and its environment. Edible mushroom species studied were found to be rich in Se (145–836% towards the RDA) with B. edulis being rich in it, C. cristata in Cu, S. luteus in Fe and H. crispa in Zn, and all contained low concentrations of toxic metals making them suitable for human consumption.

http://bit.ly/2SeEMSp

Financial development and environment in South Asia: the role of institutional quality

Abstract

The paper investigates the effect of financial development and institutional quality on the environment in South Asia. Other determinants of environmental quality included are economic growth, energy consumption, FDI, trade openness and institutional quality. For empirical analysis, panel data is used for the period 1984 to 2015. The estimated results indicate that Environmental Kuznet Curve (EKC) hypothesis holds in South Asia, i.e., environment first deteriorates with economic development and then it starts improving. Empirical results reveal that 1% increase in economic growth worsens environment by 1.709%. However, further increase in economic growth improves environment by 0.104%. Energy consumption has deteriorating effect on environment. Financial development has degraded the environment in the region, which indicates that South Asian countries have used financial development for capitalization and not to improve technology. The estimated results show that 1% increase in financial development deteriorates environment by 0.147%. FDI, which is a measure of financial openness, has mitigating effect on pollution. In turn, trade openness has worsened the environmental quality in the region. Institutional quality has significant negative effect on carbon emissions. It also has significant negative moderating effects on carbon emissions. The findings show that 1% improvement in institutional quality will decrease pollution by 0.114%. The study suggests that South Asian countries should focus more on technology effect and not on scale effect of financial development.

http://bit.ly/2HsTSPM

A Comparison of the Efficacy of Ablative Fractional Laser Assisted Photodynamic Therapy according to Ablative Depth for Actinic Keratosis: A Single-blinded, Randomized, Comparative, Prospective Study

http://bit.ly/2CN24EO

Real-world drug survival of ixekizumab for psoriasis

http://bit.ly/2HzEzos

Pharmacy Costs of Medications for the Treatment of Onychomycosis in the United States

http://bit.ly/2RMqpVP

Causal correlation between energy use and carbon emissions in selected emerging economies—panel model approach

Abstract

Fossil fuels used in energy mix continues to dictate world heat usage. Demand for heat is considered as substantial contributor to carbon emissions and energy-related emissions equivalent to 12.5 Gt of carbon emissions. Data on heat is limited and therefore, a study on the causal correlation between energy use and emissions would provide policy guidance on how to decarbonize the heat sector to achieve Paris's Greenhouse Effect Treaty. Most empirical works aggregated energy consumption and ignore spatial dependence and heterogeneity in a panel dataset. Our study, however, disaggregated energy into renewable and non-renewable to find their distinct influence on emissions, which were tested for spatial dependence and heterogeneity and applied potential emissions as environmental impact. Using FGLS and PCSE estimators for the period 1971–2013, our findings revealed that the increase in renewable energy use and industrialization improves the ecological structure of emerging economies while the increase in population, economic expansion, and non-renewable energy use increases the carbon stock. We accordingly, investigated causation direction with pooled mean group estimator. Rising economic power states therefore encourage to ensure energy efficiency and replace fuel use with renewable source for heating to reduce carbon stock.

http://bit.ly/2SdvZA8

Toxicological impact of oxyfluorfen 24% herbicide on the reproductive system, antioxidant enzymes, and endocrine disruption of Biomphalaria alexandrina (Ehrenberg, 1831) snails

Abstract

Oxyfluorfen (Goal 24%EC) herbicide is widely used in agriculture for weed control. Biomphalaria alexandrina snails can be used as bioindicator of the chemical pollution in the aquatic environment. The objective of this study was to evaluate the molluscicidal activity of this herbicide on Biomphalaria alexandrina snails and how it affected its biological system. The present study revealed a molluscicidal effect of oxyfluorfen 24%EC on these snails at LC₅₀ 5.9 mg/l. After exposure of snails to the sub-lethal concentrations (LC₀, LC₁₀, or LC₂₅) of this herbicide, the survival rates, reproductive rate (R₀), and fecundity (M_x) of adult B. alexandrina snails were significantly decreased in comparison with the control group. Also, levels of testosterone and estradiol were decreased significantly. It caused alterations in the antioxidant system, where exposure to sub-lethal concentration of this herbicide caused significant increases in levels of lipid peroxide malondialdehyde (MDA), catalase (CAT), and superoxide dismutase (SOD), while it significantly decreased glutathione transferase (GST). Histopathological changes in the digestive gland included severe damage in the digestive cells, where, they lost their tips and some were degenerated, while the secretory cells increased in number. Regarding the hermaphrodite gland, there were losses of the connective tissues, irregular sperms, and the eggs degenerated. These findings concluded that B. alexandrina snails can be used as a bioindicator for pollution with pesticide in the aquatic environment.

http://bit.ly/2Hzjn1X

Relationship among pollution concerns, attitudes toward social problems, and environmental perceptions in abandoned sites using Bayesian inferential analysis

Abstract

How do local community perceive pollution risk and social problems in abandoned areas? Which factors affect these risk perceptions? Among several factors affecting environmental perceptions, familiarity to places has long been known to positively affect landscape perception, but is this also true for abandoned area with scruffy vegetation and industrial remnants? Will long-term residents eventually adapt to and accept these neglected landscapes? In the past, efforts have largely been devoted to the cleanup of large, highly polluted areas. This left many smaller, less polluted sites, often in urban or suburban areas, relatively neglected. These areas, which typically consist of small abandoned industrial and commercial sites and vacant lots in neighborhoods, are problematic since people living nearby continue to suffer from urban blight. Recently, there has been a shift in the focus of brownfield programs from highly polluted post-industrial cleanup to local brownfield reuse. In this new environment, a participatory planning process that engages the community seems to have become more important. In order to better understand factors affecting community people's risk perception and effectively engage community support for the better management of derelict sites, this study investigated the factors on local community perceptions of abandoned landscapes including the effect of familiarity (the length of residency) and other sociodemographic (gender and age). For the study, the 200 study participants in eight neighborhoods along the Rail Corridor Revitalization Project in the city of Roanoke, VA, were asked to participate in survey and evaluate scenes of three types of abandoned landscapes focusing on two aspects, preference and pollution concerns. The results of scene ratings showed that lower scene preferences were associated with scene concerns related to higher pollution. However, although age and gender were associated with participants' preference ratings and attitudes toward social problems and pollution, there was no significant effect for the length of residency.

http://bit.ly/2S34Rne

Health damage assessment of particulate matter pollution in Jing-Jin-Ji region of China

Abstract

Jing-Jin-Ji is the largest and most dynamic economic region in northern China, and its air pollution has attracted much public attention. Scientific evaluation of health losses caused by air pollution can provide decision-making basis for formulation and improvement of pollution reduction policies in the Jing-Jin-Ji region. This paper estimated the adverse effects of particulate matter pollution on health in the Jing-Jin-Ji region in 2016 by using logarithmic linear exposure-response function, and monetized the health effects by adjusting human capital method and disease cost method. The results show non-ignorable health hazards and economic impacts caused by atmospheric particulate pollution. The economic losses relevant to health hazards by PM2.5 in the Jing-Jin-Ji region are 122.40 billion yuan, and those relevant to PM10 are 118.34 billion yuan, accounting for 1.62% and 1.56% of the region's GDP, respectively. Similar evaluations previously conducted in other countries yielded figures within the same order of magnitude. Considering the difference in economic losses per unit among disease types, the economic losses caused by air pollution in the Jing-Jin-Ji region mainly come from premature deaths. Infants and elderly people are the main victims of particulate matter. Affected by population, pollutant concentration, industrial structure, and other factors, the economic losses of particulate matter pollution in Beijing, Tianjin, Shijiazhuang, Tangshan, and Baoding are large. In order to reduce health hazards and economic impacts caused by particulate matter pollution, this paper put forward to guide the urban population diversion, reduce the outgoing frequency of susceptible groups such as infants and the elderly in haze weather, adopt high-efficiency particulate matter air purifier indoors, and develop public transportation to reduce motor vehicle exhaust emissions. In Tianjin and Hebei, promoting cleaner production in industries such as steel and cement and reducing coal use in the power industry are also suggested.

http://bit.ly/2HzjmLr

Nongreen revolution: a case study of wild-grown edible mushroom

Abstract

Mushroom's biological content has a positive effect on human welfare which is called "nongreen revolution". It has an economic and social component that provides long-term food nutrition, environmental conservation, and regeneration of valuable resources. This article provides evidence that mushrooms can be a healthy food alternative to meat. In this study, analyzed data was collected from Marmara region of Turkey using a survey method. A survey questionnaire was prepared and distributed to a total sample size of 408 participants. Linear regression model y = α + β1×1+β2×2 was administered to determine the relationship of the variables. Secondary data were also used for the literature of the study. The study revealed that the consumption of mushroom accounts for 13.2% of the consumption of meat at the time of mushroom collection period. Consequently, it showed also that for every 1% increase in consumption of two species of mushrooms (Lactarius semisanguifluus and Macrolepiota procera var.) meat consumption decreases (−4.39, −2.97%).

http://bit.ly/2S7yiEC

Treatment and prevention of spider veins

Spider veins are smaller and thinner than varicose veins and usually appear on the face or legs. They are generally painless and do not cause any health problems. However, some people may wish to treat them for cosmetic reasons. Learn more about the causes, treatment, and prevention of spider veins here.

http://bit.ly/2RcAvtL

Biological effects of acid-eroded MTA Repair HP and ProRoot MTA on human periodontal ligament stem cells

Abstract

Objective

The aim of this study was to analyze the biological effects of MTA Repair HP and ProRoot MTA on human periodontal ligament stem cells (hPDLSCs) after exposure to acidic and neutral environments.

Materials and methods

Discs of each material (n = 30) were exposed to phosphate buffered saline (pH = 7.4) or butyric acid (pH = 5.2) for 7 days, and biological testing was carried out in vitro on hPDLSCs. Cell viability and apoptosis assays were performed using eluates of each root-end filling material. To evaluate cell attachment to the different materials, hPDLSCs were directly seeded onto the material surfaces and analyzed by scanning electron microscopy. The chemical composition of the root-end filling materials was determined by energy-dispersive x-ray and eluates were analyzed by inductively coupled plasma-mass spectrometry. Statistical differences were assessed by ANOVA and Tukey test (p < 0.05).

Results

Under an acidic environment, both materials displayed similar ion release abilities, with the increased release of Si and Ca ions. Substantial changes in microstructure were observed for both materials after exposure to acidic pH. In addition, material exposure to an acidic environment showed a similar degree of cell adherence, and, surprisingly, MTA Repair HP exhibited higher cell viability rates at pH 5.2 than ProRoot MTA.

Conclusions

Exposure to an acidic environment promoted Si and Ca ion release from ProRoot MTA and MTA Repair HP. Moreover, we observed optimal biological properties of ProRoot MTA and MTA Repair HP in terms of cell viability, cell death, and cell attachment in both environments.

Clinical relevance

These results may suggest that MTA Repair HP and ProRoot exhibited optimal biological properties in terms of cell viability, cell death and cell attachment in acidic environment, being considered as materials for root-end filling and perforations.

http://bit.ly/2Rg8GRi

Treatment and prevention of spider veins

Spider veins are smaller and thinner than varicose veins and usually appear on the face or legs. They are generally painless and do not cause any health problems. However, some people may wish to treat them for cosmetic reasons. Learn more about the causes, treatment, and prevention of spider veins here.

http://bit.ly/2RcAvtL

Limno-ecological assessment of Aras River surface waters in Turkey: application of diatom indices

Abstract

This study is the first attempt to evaluate the limno-ecological status of freshwater ecosystems in Aras River system (Turkey) using diatom metrics and multivariate analyses according to the European Union Water Framework Directive requirements. Samples were collected using the standard protocols from 17 sampling stations in August and October of 2014, and June of 2015. Deterioration of water quality in the Aras River catchment was remarked from the downstream of Karakoyunlu, Sarısu, and Bozkuş creeks, which showed higher values of trophic index Turkey (TIT), trophic index (TI), and eutrophication and/or pollution index-diatom (EPI-D). These sites were also characterized by pollution tolerant taxa e.g., Cocconeis placentula, Gomphonema parvulum, Navicula cryptocephala, Navicula trivialis, and Tryblionella angustata. Sites S14–S17 had high ecological status according to TIT, supported by the score of EPI-D which indicated a good ecological condition for S14. The occurrence of pollution-sensitive species (e.g., Hannaea arcus, Cymbella affinis, Didymosphenia geminata, Meridion circulare, and Encyonema silesiacum) and the low nutrients like total phosphorus, orthophosphate and nitrate, conductivity, and BOD₅ supported the high ecological status of S14–S17. The relationships between diatom assemblages and environmental variables were also illustrated by multivariate analyses. Spearman correlation analysis revealed that TIT had positive important correlations with total phosphorus (p < 0.01, r = 0.768). Trophic index and EPI-D had also significant correlations with environmental variables, but they had lower correlation coefficient than that of TIT. It seems that TIT could be a suitable diatom metric for assessing the ecological status of sampling stations in Aras River system and Mediterranean region. Our findings showed also that ecological statuses of surface waters should be evaluated due to the indices developed in their ecoregions.

http://bit.ly/2RfZ7lu

68 Ga-DOTANOC and 18 F-FDG PET/CT in metastatic medullary thyroid carcinoma: novel correlations with tumoral biomarkers

Abstract

Objective

Metastatic disease is common in medullary thyroid carcinoma (MTC) and it is usually detected by raising calcitonin and carcinoembryonic antigen (CEA) levels. Nuclear medicine imaging has an important role in lesion identification/characterisation. We aim to compare ⁶⁸Ga-DOTANOC PET/CT and ¹⁸F-FDG PET/CT performance and to explore the correlations between tumoral markers and functional imaging.

Methods

This a retrospective cross-sectional study including 13 patients with MTC and high calcitonin/CEA levels that underwent both ⁶⁸Ga-DOTANOC PET/CT and ¹⁸F-FDG PET/CT.

Results

⁶⁸Ga-DOTANOC PET/CT identified MTC metastases in 2twopatients that were ¹⁸F-FDG-negative (sensitivity of 69.2% vs. 53.9%, respectively). ⁶⁸Ga-DOTANOC PET/CT also detected a higher number of lesions than ¹⁸F-FDG PET/CT in seven patients, with only one patient showing the opposite pattern. Both differences lacked statistical significance (p = 0.50 and p = 0.86, respectively) but ⁶⁸Ga-DOTANOC PET/CT better performance allowed changes in patients' management. ⁶⁸Ga-positive/¹⁸F-FDG-negative patients were the ones with the lowest calcitonin doubling time and presented a CEA doubling time >24 months, while the patient with more ¹⁸F-FDG-positive lesions was the one with the highest CEA/calcitonin ratio. The number of lesions found in ⁶⁸Ga-DOTANOC PET/CT were correlated with calcitonin levels (r = 0.73; p < 0.01) but not with CEA ones (r = 0.42; p = 0.15). The number of ¹⁸F-FDG hypermetabolic focus were correlated with CEA levels (r = 0.60; p < 0.05) but not with calcitonin (r = 0.48; p = 0.09).

Conclusions

This is the first study to describe a positive correlation between ⁶⁸Ga-positive lesions and calcitonin levels and between ¹⁸F-FDG-positivity and CEA levels. Tumoral markers pattern in metastatic MTC could help clinicians to decide which exam to perform first.

http://bit.ly/2sKzxeN

The effectiveness of high-resolution ultrasound in the assessment of the carotid intima–media thickness for postirradiated neck

Abstract

Objective

The carotid intimal–medial thickness (CIMT) is a strong predictor of future cardiovascular events. We assessed the mean CIMT and evaluated associated factors in head and neck cancer (HNC) patients.

Materials and methods

Between January 2016 and March 2018, 70 volunteers underwent automatic ultrasound measurement of the common carotid artery CIMT. A mean CIMT ≥ 1.0 mm was regarded as an elevated risk for cardiovascular disease (CVD). We aimed to investigate the risk factors for an increased mean CIMT.

Results

We recruited 20 HNC survivors and 50 noncancer control individuals. Multiple linear regression analysis showed that old age (β = 0.006, 95% confidence interval, CI 0.004–0.008), increased weight (β = 0.003, 95% CI 0.001–0.005), hypertension (β = 0.10, 95% CI 0.03–0.17), and prior irradiation (β = 0.13, 95% CI 0.08–0.19) were positively correlated with the mean CIMT. From logistic regression analysis, it was shown that patients who underwent radiotherapy (OR 13.5, 95% CI 1.48–122.8) and who had higher bodyweight (OR 1.09, 95% CI 1.01–1.18) had a significantly higher risk of developing CVD.

Conclusion

Measurement of the mean CIMT using ultrasound could be useful for assessing CVD risk in HNC survivors after neck irradiation.

http://bit.ly/2FZfxgb

Benign osteoblastoma of the palate: a rare clinical presentation

Abstract

Osteoblastoma is a rare, benign type of osteoblastic tumor. It constitutes approximately 1% of all primary bone tumors. Osteoblastoma most commonly affects the long bones; it very rarely affects the jaw bones. Because of its clinical and histological similarity with other bony tumors, such as osteoid osteoma and fibro-osseous lesions, osteoblastoma is a diagnostic challenge. Very few cases of osteoblastoma involving the maxillofacial region have been reported to date. We herein describe a 15-year-old female patient with osteoblastoma that presented as a palatal swelling of 6 months' duration.

http://bit.ly/2UiXmpM

Headache deteriorates the quality of life in children with chronic spontaneous urticaria

Publication date: Available online 25 January 2019

Source: Allergologia et Immunopathologia

Author(s): S. Filiz, M.G. Kutluk, D.F.K. Uygun

Abstract

Background

Quality of life, which is impaired in patients with chronic spontaneous urticaria (CSU), is influenced by comorbid mental disorders. Headaches could be another comorbid mental disorder that affects quality of life in children with CSU.

Objectives

To investigate the effect of headaches on urticaria symptoms, disease activity and quality of life in children with CSU.

Methods

A total of 83 patients with CSU were enrolled in the study and were separated into two groups as those with or without headache. Demographic and clinical characteristics were studied with the Urticaria Activity Score (UAS7), Urticaria Control test (UCT) and Chronic Urticaria Quality of Life Questionnaire (CU-Q2QoL). The headache questionnaire designed according to the Department of International Classification of Headache Disorders, second edition (ICHD-II) was used and VAS (Visual Analogue Scale) and NRS (Numerical Rating Scale) were used to assess the pain measurement. In patients diagnosed with migraine, the paediatric Migraine Disability Assessment Scale (PedMIDAS) was applied.

Results

CU-QoL total scores were significantly higher in patients with CSU with headache than in those without headache (p = 0.015). In the five domains of CU-QoL, impact of daily life activities domain and sleep problems domain had higher scores in CSU with headache (p = 0.008, 0.028, respectively). There was no significant relationship between UCT, UAS and CU-QoL and headache severity (p < 0.05). No differences were found between the groups in respect of duration of urticaria, UAS7 and UCT.

Conclusion

Headache may be an important factor that affects and impairs quality of life in children with chronic urticaria.

http://bit.ly/2UkCdeV

Editorial board

Publication date: January 2019

Source: Annales de Dermatologie et de Vénéréologie, Volume 146, Issue 1

Author(s):

http://bit.ly/2UmQKXx

Remerciements aux experts

Publication date: January 2019

Source: Annales de Dermatologie et de Vénéréologie, Volume 146, Issue 1

Author(s):

http://bit.ly/2DwLgUb

Deciphering myeloid-derived suppressor cells: isolation and markers in humans, mice and non-human primates

Abstract

In cancer, infection and inflammation, the immune system's function can be dysregulated. Instead of fighting disease, immune cells may increase pathology and suppress host-protective immune responses. Myeloid cells show high plasticity and adapt to changing conditions and pathological challenges. Despite their relevance in disease pathophysiology, the identity, heterogeneity and biology of myeloid cells is still poorly understood. We will focus on phenotypical and functional markers of one of the key myeloid regulatory subtypes, the myeloid derived suppressor cells (MDSC), in humans, mice and non-human primates. Technical issues regarding the isolation of the cells from tissues and blood, timing and sample handling of MDSC will be detailed. Localization of MDSC in a tissue context is of crucial importance and immunohistochemistry approaches for this purpose are discussed. A minimal antibody panel for MDSC research is provided as part of the Mye-EUNITER COST action. Strategies for the identification of additional markers applying state of the art technologies such as mass cytometry will be highlighted. Such marker sets can be used to study MDSC phenotypes across tissues, diseases as well as species and will be crucial to accelerate MDSC research in health and disease.

http://bit.ly/2UfOhOw

West Nile virus encephalitis in GATA2 deficiency

We report a male with longstanding warts who presented with severe West Nile virus encephalitis (WNVE) and recovered after interferon alfa-2b and intravenous immunoglobulin. He was later found to have GATA2 de...

http://bit.ly/2Re7VIP

From the pages of AllergyWatch

Publication date: Available online 25 January 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): John J. Oppenheimer, David Michael Lang, Stanley M. Fineman

http://bit.ly/2MwzqMO

Chronic Itch Management: Therapies Beyond Those Targeting the Immune System

Publication date: Available online 25 January 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Emilie Fowler, Gil Yosipovitch

http://bit.ly/2sLkCAR

Pattern of Medication Use in Children with Very Poorly Controlled Asthma

Publication date: Available online 25 January 2019

Source: Annals of Allergy, Asthma & Immunology

Author(s): Arlene M. Butz, Tricia Morphew, Melissa Bellin, Mary Elizabeth Bollinger, Mona Tsoukleris

http://bit.ly/2MyTo9A

Editorial Board

Publication date: February 2019

Source: Auris Nasus Larynx, Volume 46, Issue 1

Author(s):

http://bit.ly/2S5nK97

SERPING1 exon 3 splicing variants using alternative acceptor splice sites

Publication date: March 2019

Source: Molecular Immunology, Volume 107

Author(s): Tereza Grymová, Lucie Grodecká, Přemysl Souček, Tomáš Freiberger

Abstract

Mutations in the C1 inhibitor (C1INH) encoding gene, SERPING1, are associated with hereditary angioedema (HAE) which manifests as recurrent submucosal and subcutaneous edema episodes. The major C1INH function is the complement system inhibition, preventing its spontaneous activation. The presented study is focused on SERPING1 exon 3, an alternative and extraordinarily long exon (499 bp). Endogenous expression analysis performed in the HepG2, human liver, and human peripheral blood cells revealed several exon 3 splicing variants alongside exon inclusion: a highly prevalent exon skipping variant and less frequent +38 and -15 variants with alternative 3′ splice sites (ss) located 38 and 15 nucleotides downstream and upstream from the authentic 3′ ss, respectively. An exon skipping variant introducing a premature stop codon, represented nearly one third of all splicing variants and surprisingly appeared not to be degraded by NMD. The alternative -15 3′ ss was used to a small extent, although predicted to be extremely weak. Its use was shown to be independent of its strength and highly sensitive to any changes in the surrounding sequence. -15 3′ ss seems to be co-regulated with the authentic 3′ ss, whose use is dependent mainly on its strength and less on the presence of intronic regulatory motifs. Subtle SERPING1 exon 3 splicing regulation can contribute to overall C1INH plasma levels and HAE pathogenesis.

http://bit.ly/2RMQ94z

Remodelling the attentional system after left hemispheric stroke: effect of leftward prismatic adaptation

Publication date: Available online 24 January 2019

Source: Cortex

Author(s): Sonia Crottaz-Herbette, Isabel Tissieres, Eleonora Fornari, Pierre-André Rapin, Stephanie Clarke

Abstract

Left hemispheric stroke is known to be associated with right neglect and/or not lateralized attentional deficits. The former appears to respond favourably to leftward prismatic adaptation (L-PA), as reported in a case of a large left stroke. In normal subjects, brief exposure to L-PA was shown to enhance the representation of the right visual field within the right inferior parietal lobule, emphasizing thus right hemispheric dominance within the ventral attentional system. We have investigated whether L-PA does the same in left hemispheric stroke by comparing neural responses to left, central and right stimuli before and after a brief exposure to L-PA. Neural responses to visual stimuli were significantly modulated within a large part of the occipito-temporal cortex and in smaller clusters in the angular gyrus, the anterior temporal lobe and the insula, corresponding to decrease in activity. Within the occipito-temporal region the decrease concerned predominantly neural activity elicited by left stimuli, downregulating thus the representation of the contralateral visual field, which is characteristic of the higher-order visual areas in this region.

http://bit.ly/2sNS4qA

Prediabetes in children and adolescents in the United States: prevalence estimates and comorbidities – a population analysis

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


http://bit.ly/2sMipW4

Challenging diagnosis of thyroid hormone resistance initially as Hashimoto’s thyroiditis

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


http://bit.ly/2Myzv2q

Maternal allergen-specific IgG may protect the child against allergic sensitization

Publication date: Available online 25 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Christian Lupinek, Heidrun Hochwallner, Catharina Johansson, Axel Mie, Eva Rigler, Annika Scheynius, Johan Alm, Rudolf Valenta

Abstract

Background

The analysis of allergen-specific IgE responses in birth cohorts with micro-arrayed allergens has provided detailed information regarding the evolution of specific IgE responses in children. High resolution data regarding early development of allergen-specific IgG are needed.

Objective

To analyze IgG reactivity to micro-arrayed allergens in mothers during pregnancy, in cord blood samples, breast milk and in infants in the first years of life with the aim to investigate if maternal allergen-specific IgG may protect against IgE sensitization in the offspring.

Methods

Plasma samples from mothers during third trimester, cord blood, breast milk collected at 2 months after delivery, and plasma samples from children at 6, 12 and 60 months of age were analyzed for IgG reactivity to 164 micro-arrayed allergens (ImmunoCAP ISAC technology) in 99 families in the Swedish birth cohort ALADDIN. IgE sensitizations to micro-arrayed allergens were determined at 5 years of age in the children.

Results

Allergen-specific IgG reactivity profiles in mothers, cord blood and breast milk were highly correlated. Maternal allergen-specific IgG persisted in some children at 6 months. Children´s allergen-specific IgG production occurred at 6 months and reflected allergen exposure. Children who were IgE-sensitized against an allergen at 5 years of age had significantly higher allergen-specific IgG levels than non-sensitized children. For all 164 tested allergens, children from mothers with elevated (>30 ISU) specific plasma IgG against an allergen had no IgE sensitizations against that allergen at 5 years of age.

Conclusion

This is the first detailed analysis of the molecular IgG recognition profile in mothers and their children in early life. High allergen-specific IgG reactivity in mother´s plasma and breast milk and in cord blood seemed to protect against allergic sensitization at 5 years of age.

Clinical implication

High levels of allergen-specific IgG in mothers during third trimester and in cord blood seem to protect against allergic sensitization in the offsprings. This finding has implications for the prevention of allergy.

Graphical abstract

http://bit.ly/2Tf87Jo

Age-specific changes in the molecular phenotype of patients with moderate-to-severe atopic dermatitis

Publication date: Available online 24 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Lisa Zhou, Alexandra Leonard, Ana B. Pavel, Kunal Malik, Aishwarya Raja, Jacob Glickman, Yeriel D. Estrada, Xiangyu Peng, Ester del Duca, Juan Sanz-Cabanillas, Juan Ruano, Hui Xu, Ning Zhang, Huei-Chi Wen, Juana Gonzalez, Sandra Garcet, James G. Krueger, Emma Guttman-Yassky

Abstract

Background

Atopic dermatitis/AD shows differential clinical presentation in older compared to younger patients. Nevertheless, changes in the AD molecular profile with age are unknown.

Objective

To characterize age-related changes in the AD profile.

Methods

We evaluated age-specific changes in lesional and non-lesional tissues and blood from moderate-to-severe AD patients (n=246) and age-matched controls (n=72) using immunohistochemistry, qRT-PCR, and Singulex in a cross-sectional study. Patients were analyzed using age-groups (18-40, 41-60, and 61+ years old).

Results

While disease severity/SCORAD was similar across AD age-groups (mean:∼60; P=0.873), dendritic cell infiltrates (CD1b⁺, FcεRI⁺; P<0.05) decreased with age. T_H2 measures (IL-5, IL-13, CCL13, CCL18, CCL26) significantly decreased with age in AD, despite increasing with age in controls. Consistent with T_H2 axis decreases, serum IgE and eosinophils negatively correlated with age in AD (r=-0.24, r=-0.23, P<0.05). T_H22-secreted IL-22 also decreased with age uniquely in AD (P<0.05). T_H1- (IFN-γ, IL-12/23p40, STAT1, CXCL9; P<0.05 for CXCL9) and T_H17-related markers (IL-17A, IL-20; P<0.05 for IL-20) increased with age in both AD and controls. Terminal differentiation measures significantly increased in older AD patients (LOR, FLG; P<0.05), while S100As (S100A8; P<0.01) and hyperplasia markers (epidermal thickness/ET, K16, Ki67; P<0.05 for K16) decreased. Serum trends in AD mimicked skin findings, with T_H2 downregulation (CCL26; r=-0.32, P<0.1) and T_H1 upregulation (IFN-γ; r=0.48, P<0.01) with age.

Conclusion

The adult AD profile varies with age. While T_H1/T_H17-skewing decreases in both AD and controls, AD shows unique decreases in T_H2/T_H22 polarization, and normalization of epithelial abnormalities. Thus, age-specific treatment approaches may be beneficial for AD.

http://bit.ly/2B2Z9YK

The Impact of Testosterone on the Chests and Abdomens of Transgender Men

Publication date: Available online 24 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Catherine C. Motosko, George A. Zakhem, Miriam Keltz Pomeranz, Rhonda Pomerantz, Pierre B. Saadeh, M David Gothard, Alexes Hazen

http://bit.ly/2HyRqr1

Impact of the Patient Protection and Affordable Care Act on Dermatologic Healthcare Utilization

Publication date: Available online 24 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Raghav Tripathi, Konrad D. Knusel, Harib H. Ezaldein, Jeremy S. Bordeaux, Jeffrey F. Scott

http://bit.ly/2S5isKN

REPLY to MS#JAAD-D-19-00075

Publication date: Available online 24 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): L.C. Strowd

http://bit.ly/2HykmiV

Examining Cutaneous Disease Activity As An Outcome Measure For Clinical Trials In Dermatomyositis

Publication date: Available online 24 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): R.G. Gaffney, M. Tarazi, R. Feng, D. Pearson, V.P. Werth

http://bit.ly/2S5PBpC

Comments on: Abnormal erythrocyte morphology in drug reaction with eosinophilia and systemic symptoms

Publication date: Available online 24 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Yung-Tsu Cho, Chia-Yu Chu

http://bit.ly/2HxdVMW

Inpatient consultative dermatology: Where are we now? Assessing the value and evolution of this sub-specialty over the past decade

Publication date: Available online 24 January 2019

Source: Journal of the American Academy of Dermatology

Author(s): Lauren M. Madigan, Lindy P. Fox

Abstract

The importance of inpatient consultative dermatology is often under recognized and undervalued. A significant need exists as the burden of skin disease in the hospital is great and expertise regarding the recognition and management of uncommon and severe skin disorders is limited outside of the field. In response to this need the concept of a "dermatology hospitalist" was defined and the Society for Dermatology Hospitalists was created in 2009. Over the past decade, the sub-specialty has developed and fostered both research and education. Data now exist demonstrating the value of inpatient dermatology services not only to patients, but also to payors and health care systems. Future needs include strategies to improve access to expertise and additional efforts to establish our field as an indispensable and enduring component of hospital-based care.

http://bit.ly/2S5UfDX

Otolaryngologists adhere to evidence-based guidelines for chronic rhinosinusitis

Abstract

Purpose

To assess awareness of, opinion about and adherence to evidence-based guidelines on chronic rhinosinusitis among Dutch Otolaryngologists.

Methods

We assessed implementation of two guidelines, one Dutch and one European, that are both intended for diagnosis and treatment of patients with chronic rhinosinusitis. We invited 485 Otolaryngologists to fill out a questionnaire and report on their opinion on and adherence to the guidelines. The adherence was further tested by 4 clinical case scenarios, derived from guideline recommendations.

Results

166 (34%) completed the questionnaire. 99% of the respondents was aware of one or both guidelines. Most respondents (90%) consider the guidelines as directing or supportive for their clinical practice based on the clinical case scenarios, between 62 and 99% of the respondents act according to guidelines. Concerning diagnosis, CT-imaging is performed more and allergy testing less than recommended. Where multiple treatment options are recommended, the responses are more heterogeneous as a result of this. Nonetheless, high recommended treatment was chosen more often. Otolaryngologists were reluctant in surgical treatment as a first option, which is according to the guidelines.

Conclusions

Overall, both the EPOS and CBO guideline are well known among Dutch Otolaryngologists and 90% indicates that the guideline is important in their daily practice. Adherence to the guidelines is sufficient to high. If multiple treatment or diagnostic options are recommended this leads to a more heterogeneous response pattern. Recommendations with a high grade of recommendation were followed up most often.

http://bit.ly/2RhYhoA

Simultaneous transient global amnesia and Takotsubo syndrome after death of a relative: a case report

Simultaneous occurrence of transient global amnesia and Takotsubo syndrome has been only rarely reported. Here we report another patient with a transient global amnesia and concomitant Takotsubo syndrome.

http://bit.ly/2Mtw6Sw

Importancia de la cuantificación del desplazamiento hioideo en la valoración del estadio y evolución de la disfagia orofaríngea

Publication date: Available online 24 January 2019

Source: Acta Otorrinolaringológica Española

Author(s): Gemma Garmendia Merino, Helena Bascuñana Ambrós

Resumen

Introducción y objetivos

El objetivo de este trabajo es mostrar nuestra experiencia y consideraciones al cuantificar el desplazamiento hioideo, así como observar su correlación con las escalas cualitativas de valoración de la disfagia.

Métodos

Se mide el desplazamiento hioideo mediante el método descrito por el grupo de Molfenter y Steele 2014 en una serie de 14 pacientes con disfagia orofaríngea antes y después del tratamiento, y se valora su correlación con la Escala de penetración y aspiración de Rosenbek de 1996, y con la Functional Oral Intake Scale de Crary de 2005.

Resultados

Todos los pacientes variaron el desplazamiento total del hioides tras el tratamiento aplicado. Esta variación se correlacionó con las variaciones de la Escala de penetración y aspiración en todos los pacientes que presentaban aspiración o penetración. Sin embargo, las modificaciones del desplazamiento total hioideo no se correlacionaron con las variaciones de la Functional Oral Intake Scale.

Conclusiones

La mejora en el desplazamiento total del hioides es un indicador clínico de la mejora en la aspiración del paciente con disfagia orofaríngea, y puede ser utilizado en su diagnóstico y seguimiento. Sin embargo, no lo es como indicador de la tolerancia de la dieta oral.

Abstract

Introduction and objectives

The objective of this paper was to show our experience and considerations when quantifying hyoid bone displacement and to observe its correlation with the qualitative scales that evaluate dysphagia.

Methods

Hyoid displacement was assessed using the method described by Molfenter and Steele's group in 2014 in a series of 14 patients affected by oropharyngeal dysphagia. The degree of dysphagia was also qualitatively assessed with the Rosenbek Penetration and Aspiration Scale (PAS) of 1996 and with the Functional Oral Intake Scale (FOIS) of Crary of 2005. All assessments were done before and after treatment.

Results

All patients increased their hyoid bone total displacement after the treatment. These variations were highly correlated with the variations in the PAS scale with aspiration or penetration. However, the variations of hyoid bone displacement did not correlate with the FOIS scale.

Conclusions

The improvement in total hyoid bone displacement is a clinical indicator of improved aspiration of patients suffering dysphagia. However, the improvement of this displacement is not related to the oral intake tolerance of the patients.

http://bit.ly/2FPWwNO

Systematic review and meta‐analysis of the impact of dosimetry to dysphagia and aspiration related structures

Abstract

Background

Technological advances in radiotherapy have allowed investigations into new methods to spare healthy tissue in those treated for head and neck cancer. This systematic review with meta‐analysis demonstrates the effect that radiation has on swallowing.

Methods

Selection and analysis of studies examining the effect of radiation to swallowing structures. A fixed effects meta‐analysis calculated the pooled proportions for select outcomes of dysphagia, common across many studies.

Results

The majority of the papers found a correlation between radiation dose to the swallowing structures and dysphagia, however a meta‐analysis found the studies carried a significant degree of heterogeneity. The appraisal demonstrates the need for large‐scale studies using a randomized design and instrumental dysphagia assessments.

Conclusions

Radiation dose to dysphagia and aspiration structures is correlated with incidence of dysphagia and aspiration. The variables in this population contribute to the heterogeneity within and cross studies and future studies should consider controlling for this.

http://bit.ly/2CKh32l

Rationale and budget impact of bimonthly use of Cetuximab in patients with recurrent and/or metastatic head and neck cancer

Abstract

Background

In recurrent and/or metastatic head and neck squamous cell cancer, Cetuximab is administered once a week, followed by weekly doses. We present the clinical rationale of a different schedule of maintenance Cetuximab and we estimate the potential economic benefits on the health care budget from a societal perspective in Italy.

Methods

A budget impact (BI) excel‐based model was developed comparing a base case scenario of 100% weekly administration with a dose of 250 mg/m² to an every‐other‐week (EOW) administration at 50% or 100% with a dose of 500 mg/m².

Results

In the EOW, 50% scenario it was calculated a cost reduction of €347 000 of which 70% attributable to indirect costs, increasing to €694 000 after 4 months.

Conclusions

In our analysis, we showed that this simplified schedule could also reduce the costs of treatments both for the health system (direct costs) and for the society (indirect costs).

http://bit.ly/2RNL37T

Response to Letter to the Editor regarding follow‐up for NIFTP

http://bit.ly/2CFWmVo

Interventions for erythema multiforme: a systematic review

Abstract

Treatment of erythema multiforme (EM) is not codified. We performed a systematic review of the effect of any topical or systemic treatment on time to healing and frequency of episodes with acute and chronic forms of EM in adults. Four databases (MEDLINE, CENTRAL, EMBASE and LILACS) and other sources were searched for articles published up to March20, 2018. Randomized control trials (RCTs), observational studies and case‐series (n≥10) were considered. From 1558 references, we included 1 RCT and 6 case series. The RCT (n=20) showed a significant difference in complete remission of EM with continuous acyclovir versus placebo over 6 months. One case series found a mean reduction in flare duration with thalidomide for recurrent EM (5.1vs16.2 days) (n=20). Adverse events were poorly or not reported in included studies. Quality of life was never assessed. One limitation of our study is that we excluded the cases of isolated mucosal EM in order to prevent inclusion of Stevens‐Johnson syndrome cases. In conclusion, there is low‐level evidence for continuous acyclovir treatment for recurrent EM (one RCT). Evidence for other treatments is only based on retrospective case series. Results for thalidomide in particular encourage further research. Data concerning safety are insufficient.

PROSPERO registration no. CRD42016053175.

This article is protected by copyright. All rights reserved.

http://bit.ly/2sH4JeS

Endoplasmic reticulum aminopeptidase 1 polymorphism Ile276Met is associated with atopic dermatitis and affects the generation of an HLA‐C associated antigenic epitope in vitro

Abstract

Background

Atopic dermatitis (AD) is a common inflammatory skin disease of complex etiology, with interactions between susceptibility genes and environmental factors. We have previously described a protective effect of the KIR2DS1 gene encoding the NK cell receptor, whose ligands are HLA‐C molecules. Here, we found an association of HLA‐C*05:01 allele with AD. KIR‐HLA‐C interactions are affected by peptides presented by HLA‐C. The generation of these peptides is strongly influenced by endoplasmic reticulum aminopeptidases 1 and 2 (ERAP1 and ERAP2). Expression and activity of ERAP molecules depend on the polymorphisms of their genes.

Objective

Possible associations of several single nucleotide polymorphisms (SNPs) in the ERAP1 and ERAP2 genes with susceptibility to AD.

Methods

Peripheral blood DNA isolation from 318 patients and 549 controls. PCR‐SSO or PCR‐SSP for HLA‐C typing; TaqMan Genotyping Assay for ERAP typing.

Results

Only one SNP in the ERAP1 gene, rs26618T>C, causing the amino acid change Ile276Met, had an association with AD. To gain insight on the functional role of this SNP we produced recombinant variants differing only at position 276 (Ile or Met) and tested their aminopeptidase activity against a N‐terminally extended precursor LIVDRPVTLV of the HLA‐C*05:01 epitope IVDRPVTLV. Both ERAP1 variants were able to efficiently generate the epitope, although the 276Ile allotype was able to do this about 50% faster. Furthermore, both variants were quite inefficient in further degradation of the mature epitope. Finally, we found that the effect of 276Met on susceptibility to AD was seen only in KIR2DS1‐negative individuals, not protected by this KIR.

Conclusion

Associations of HLA‐C*05:01 allele and rs26618T>C (Ile276Met) ERAP1 polymorphism with AD, and a significant difference between these two ERAP1 variants in their ability to generate an epitope for the HLA‐C*05:01 molecule were found.

This article is protected by copyright. All rights reserved.

http://bit.ly/2MvbMQW

Itch: An Under‐recognized Problem in Psoriasis

Abstract

Psoriasis has historically been considered a nonpruritic dermatosis, in contrast with atopic dermatitis. Thus, itch has often been underappreciated and overlooked in psoriasis. However, increasing evidence over the past decade has shown that itch can be one of the most prevalent and burdensome symptoms associated with psoriasis, affecting almost every patient to some degree; it can involve the entire body, although it predominantly affects the legs, hands, back, body, and especially the scalp. Uncontrolled itch can significantly impact all aspects of the well‐being and quality of life of the patient. While there has been some progress in trying to better understand the pathophysiology of itch in psoriasis, more research effort and interest are needed. This under‐recognition of itch in psoriasis is clearly reflected in the dearth of treatment options targeting itch despite significant advancement in treating the lesions themselves. Recently, however, clinical studies have begun to include itch as a study outcome. The resulting data have demonstrated concomitant antipruritic benefits and improved Psoriasis Area and Severity Index (PASI) scores with mainstay treatments for psoriasis, such as topical corticosteroids and vitamin D analogs, phototherapies, and various systemics and biologics. This article takes a closer look at this debilitating symptom, reviewing the available epidemiology data for psoriatic itch, presenting the current understanding of psoriatic itch pathophysiology, and highlighting important clinical data for various treatment options for itch. Practical considerations for increasing the recognition of itch as well as improving its management in psoriasis are also provided.

This article is protected by copyright. All rights reserved.

http://bit.ly/2sMHVdv

Fumaric acid ester‐induced T cell lymphopenia in the real‐life treatment of psoriasis

Abstract

Background

Fumaric acid esters (FAEs) are used to treat psoriasis and are known to cause lymphopenia in roughly 60% of the patients. Much remains to be elucidated about the biological effects of FAEs on lymphocytes.

Objective

To evaluate the influence of long‐term FAE (Fumaderm^®) treatment on peripheral blood CD4⁺ and CD8⁺ T cells, CD19⁺ B cells and CD56⁺ natural killer (NK) cells in psoriasis.

Methods

In this single‐centre retrospective observational subcohort study, we obtained leucocyte and lymphocyte subset counts before initiating FAE therapy in 371 psoriasis patients (mean age, 47.8 years; 63.3% males) and monitored them during treatment (mean treatment duration, 2.9 years). Multiparametric flow cytometry was used for immunophenotyping.

Results

FAEs significantly reduced the numbers of CD4⁺ T, CD8⁺ T, CD19⁺ B, and CD56⁺ NK cells. Among lymphocyte subsets, the mean percentage reduction from baseline was always highest for CD8⁺ T cells, with a peak of 55.7% after 2 years of therapy. The risk of T cell lymphopenia increased significantly with the age of the psoriasis patients at the time that FAE therapy was initiated. It was significantly decreased for the combination therapy with methotrexate and folic acid (vitamin B9) supplementation. Supporting evidence was found suggesting that T cell lymphopenia enhances the effectiveness of FAE therapy.

Conclusions

Monitoring distinct T cell subsets rather than just absolute lymphocyte counts may provide more meaningful insights into both the FAE treatment safety and efficacy. We therefore suggest optimising pharmacovigilance by additionally monitoring CD4⁺ and CD8⁺ T cell counts at regular intervals, especially in patients of middle to older age. Thus, further prospective studies are needed to establish evidence‐based recommendations to guide dermatologists in the management of psoriasis patients who are taking FAEs and who develop low absolute T cell counts.

This article is protected by copyright. All rights reserved.

http://bit.ly/2MtrETO

Phenotypic and Genotypic Analysis of Amelanotic and Hypomelanotic Melanoma Patients

Abstract

Background

Amelanotic/hypomelanotic melanoma is associated with poorer outcomes due to a more advanced disease stage at diagnosis.

Objective

To determine phenotypic risks and genotypic associations with amelanotic/hypomelanotic melanoma to develop a clinical and genetic profile that could assist in identifying high‐risk individuals.

Methods

The Brisbane Naevus Morphology Study conducted from 2009‐2016 has recruited a core of 1254 participants. Participants were drawn from a combination of volunteers from dermatology outpatient clinics, private dermatology clinics, the Brisbane Longitudinal Twin Study and QSkin study. Case participants had a personal history of melanoma and control participants no personal history of melanoma. We specifically examined seven known candidate pigmentation and melanoma genes and pigmentary phenotypic characteristics in participants with amelanotic/hypomelanotic melanoma compared to pigmented melanomas. This assayed single nucleotide polymorphisms (SNPs) in MC1R, TYR, HERC/OCA2, IRF4, MTAP, PLA2G6 and MITF.

Results

47 participants had at least one amelanotic/hypomelanotic melanoma and 389 had pigmented melanomas, with amelanotic/hypomelanotic melanoma patients significantly older than pigmented melanoma participants (63.3 ± 13.0 vs 54.6 ± 15.3 years; P<0.001). Amelanotic/hypomelanotic melanoma patients were more likely than pigmented melanoma patients to have red hair (34% vs 15%; P=0.01), severe hand freckling (13% vs 5%; P=0.01) and propensity to sunburn (63% vs 44%; P=0.01). MC1R R/R genotype was much more frequent in our amelanotic/hypomelanotic melanoma population (31.1% vs 11%; P<0.001; OR 26.4 vs 5.9; control 1.0). Amelanotic/hypomelanotic melanoma was associated with TYR rs1126809*A/A (OR[CI95%] 2.7 [1.1‐6.8] vs 1.2 [0.8‐1.9]) and PLA2G6 rs11570734*A/A (OR[CI95%] 3.7 [1.0‐13.6] vs 1.3[0.9‐2.0]). The MTAP melanoma risk SNP genotype, associated with darker pigmentation, (rs4636294*A/A) was less common in amelanotic/hypomelanotic melanoma patients (OR[CI95%] 0.8 [0.3‐2.1] vs 2.0 [1.3‐3.1]).

Conclusions

Knowledge of phenotypic and genotypic associations of amelanotic/hypomelanotic melanoma can help predict risks and associations of this difficult to diagnose melanoma, which may ultimately assist clinical management and patient skin self‐examination.

This article is protected by copyright. All rights reserved.

http://bit.ly/2sMHNL3