Extra-ocular movement restriction and diplopia following orbital fracture repair

Publication date: Available online 25 August 2017
Source:American Journal of Otolaryngology
Author(s): H.A. Shah, Taha Shipchandler, Dominic Vernon, Maraya Baumanis, David Chan, William R. Nunery, Hui Bae Harold Lee
PurposeTo report a series of patients with extra-ocular movement restriction and diplopia after orbital fracture repair, and determine the effect of timing of repair and the type of implant used.MethodsA chart review was conducted identifying all patients >18years of age at our institution between June 2005 and June 2008 who underwent orbital fracture repair, and presented with clinically significant diplopia and extra-ocular movement restriction persisting longer than one month after repair. Data collected included timing of repair, implant used within the orbit, and need for revision.ResultsTen patients were identified with a mean time to primary orbital fracture repair at 9days (range 1–48). Seven patients underwent revision of their orbital fracture repair with removal of the previously placed implant and replacement with non-porous 0.4mm Supramid Foil, whereas one patient underwent lateral and inferior rectus recessions without revision of primary fracture repair. Titanium mesh was the intra-orbital implant found in all patients requiring revision of orbital fracture repair. All revisions resulted in resolution of clinically significant diplopia.ConclusionsClinically significant diplopia and extra-ocular movement restriction is not an uncommon complication after orbital fracture repair. In our series, there was a strong association between these complications and the use of porous titanium mesh implants. Revision of fractures significantly improved diplopia in all but one patient. This suggests that meticulous fracture repair and the use of non-porous implants primarily or secondarily may preclude the need for strabismus surgery after orbital trauma.



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Comment on: “The outcomes of overlay myringoplasty: Endoscopic versus microscopic approach”

Publication date: Available online 25 August 2017
Source:American Journal of Otolaryngology
Author(s): Zhengcai Lou




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Well-Differentiated Thyroid Cancer Neovasculature Expresses Prostate-Specific Membrane Antigen—a Possible Novel Therapeutic Target

Abstract

Prostate-specific membrane antigen (PSMA), a type II transmembrane glycoprotein receptor, is highly expressed in prostate cancer and in the tumor neovasculature of colon, breast, and adrenocortical tumors. Here, we analyzed PSMA expression in the neovasculature of various thyroid cancer subtypes and assessed whether PSMA expression is correlated with aggressive behavior. From a prospectively maintained database, we evaluated 91 samples from 68 patients, including 37 primary differentiated thyroid cancers (DTCs) [11 classic papillary (cPTC), 9 follicular-variant (FvPTC), 11 follicular (FTC), 6 radioactive iodine-refractory (RAIR)], 5 anaplastic (ATC) carcinomas, 9 distant and 12 lymph node metastases, 21 benign thyroid nodules, and 7 normal thyroid specimens. Formalin-fixed paraffin-embedded tissue blocks were immunostained for vascular endothelial marker CD31 and PSMA with proper controls. PSMA expression was not detected in normal thyroid tissue. DTC tumors demonstrated a significantly higher PSMA expression, in regard to both intensity and percentage of vessels stained, than benign tumors (p < 0.001). Among the histologic subtypes, cPTC, FTC, and RAIR carcinomas demonstrated the highest percent of moderate to strong PSMA staining. PSMA expression was seen more frequently in specimens from distant metastases (100%) compared with specimens from only lymph node metastases (67%). PSMA is significantly overexpressed in the neovasculature of DTCs compared with normal and benign thyroid nodules specifically with increased expression in RAIR carcinomas and distant metastases. PSMA should be further explored as a novel therapeutic target for metastatic and RAIR carcinomas.

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The molecular mechanisms of sexual orientation and gender identity

Publication date: Available online 25 August 2017
Source:Molecular and Cellular Endocrinology
Author(s): Alessandra Fisher, Jiska Ristori, Girolamo Morelli, Mario Maggi
Differences between males and females are widely represented in nature. There are gender differences in phenotypes, personality traits, behaviors and interests, cognitive performance, and proneness to specific diseases. The most marked difference in humans is represented by sexual orientation and core gender identity, the origins of which are still controversial and far from being understood. Debates continue on whether sexual behavior and gender identity are a result of biological (nature) or cultural (nurture) factors, with biology possibly playing a major role. The main goal of this review is to summarize the studies available to date on the biological factors involved in the development of both sexual orientation and gender identity. A systematic search of published evidence was performed using Medline (from January 1948 to June 2017). Review of the relevant literature was based on authors' expertise. Indeed, different studies have documented the possible role and interaction of neuroanatomic, hormonal and genetic factors. The sexual dimorphic brain is considered the anatomical substrate of psychosexual development, on which genes and gonadal hormones may have a shaping effect. In particular, growing evidence shows that prenatal and pubertal sex hormones permanently affect human behavior. In addition, heritability studies have demonstrated a role of genetic components. However, a convincing candidate gene has not been identified. Future studies (e.i. genome wide studies) are needed to better clarify the complex interaction between genes, anatomy and hormonal influences on psychosexual development.



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DEVELOPING DRUGS IN CANCER-RELATED BONE PAIN

Publication date: Available online 25 August 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Maurizio Lucchesi, Gaetano Lanzetta, Andrea Antonuzzo, Antonio Rozzi, Iacopo Sardi, Claudio Favre, Carla Ida Ripamonti, Daniele Santini, Grazia Armento
IntroductionCancer-related bone pain is a frequent and important key problem for metastatic patients that may reduce quality of life, with related limitations in daily activities and morbidity. Often traditional approach to pain may fail given the complex pathophysiology of this phenomenon.MethodsThe aim of this review is to describe promising therapies for cancer-related bone pain, from the pathophysiology to the clinical trials currently ongoing. Moreover, any new evidence for better approach to cancer-related bone pain with the traditional drugs is also considered.ConclusionsIn clinical practice opioids remain the most important pharmacologic treatment for severe pain related to bone cancer. Regard developing drugs, anti-NGF and anti-TrkA are the most investigated new drug in this setting, but a future role in clinical practice is still uncertain.



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Triplet (FOLFOXIRI) versus doublet (FOLFOX or FOLFIRI) backbone chemotherapy as first-line treatment of metastatic colorectal cancer: a systematic review and meta-analysis

Publication date: Available online 25 August 2017
Source:Critical Reviews in Oncology/Hematology
Author(s): Rui Pedro Marques, Gonçalo S Duarte, Carmelo Sterrantino, Helena Luna Pais, António Quintela, Ana Paula Martins, João Costa
Uncertainty exists regarding the comparative effectiveness of triplet chemotherapy (FOLFOXIRI) as backbone first-line chemotherapy for metastatic colorectal cancer (mCRC). We conducted a systematic review and meta-analysis of randomized-controlled trials (RCTs) comparing triplet versus doublet chemotherapy (FOLFOX or FOLFIRI) as first-line therapy in mCRC. Methods and reporting followed PRISMA and SAMPL guidelines.Eight RCTs were included, comprising 1732 patients. In pooled analysis, FOLFOXIRI was associated with improvements in efficacy outcomes, notably with a 25% survival increase (95%CI: 10–37%). FOLFOXIRI was also associated with increased toxicity, with a non-significant 25% increase in the risk of patients experiencing grade ≥3 adverse events (95% CI: −3 to 61%) and with a 1.83 (95% CI: 1.62–2.07) increase in the rate ratio of grade ≥3 adverse events.Moderate quality evidence suggests that first-line FOLFOXIRI provides clinically meaningful efficacy benefits in this setting, at the expense of increased toxicity. Further research is warranted to better characterize safety and to evaluate the most beneficial combination with targeted agents.



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A rapid LC-MS/MS method for the determination of moniliformin and occurrence of this mycotoxin in maize products from the Bavarian market

Abstract

A simple LC-MS/MS method was developed for the determination of moniliformin (MON) in maize and applied for the analysis of samples within the official food surveillance. The homogenized samples were extracted with acetonitrile/water 50/50 (v/v) which proved to have the highest extraction efficiency compared to other tested solvents. The centrifuged extracts were diluted with acetonitrile and were measured after chromatographic separation by HILIC (hydrophobic interaction liquid chromatography)-HPLC without any cleanup (dilute and shoot approach). The LOD and LOQ achieved by this procedure were 2.6 and 8.8 μg/kg, respectively. Thirty-nine samples of popcorn, maize meal, and semolina were collected in 2014 and 2015 at mills, cinemas, wholesale, and retail from the Bavarian market (Germany). The rate of contamination with MON was very high (97%) with levels ranging between the LOD and 847 μg/kg. The mean level was 118 μg/kg and the median, 39 μg/kg. The maximum value was detected in maize meal. The results are discussed with respect to possible health implications for the consumer.

http://ift.tt/2wwHfN0