Association between Breslow Thickness and Dermoscopic Findings in Acral Melanoma

Publication date: Available online 13 June 2018
Source:Journal of the American Academy of Dermatology
Author(s): Je-Ho Mun, Gwanghyun Jo, Claudia C. Darmawan, Jin Park, Jung Min Bae, HyunJu Jin, Woo-Il Kim, Hoon-Soo Kim, Hyun-Chang Ko, Byung-Soo Kim, Moon-Bum Kim
BackgroundDermoscopy is a useful tool for the diagnosis of acral melanomas (AM). However, little is known about the influence of tumor thickness on the dermoscopic findings of AM.ObjectiveTo investigate the impact of Breslow thickness (BT) on the dermoscopic patterns of AM.MethodsData on cases of AM on the glabrous skin were collected from four university hospitals. We investigated the frequency of each dermoscopic feature of AM according to the BT. Statistical analysis was performed to investigate the association between the specific dermoscopic patterns and BT.ResultsMultivariable analysis revealed that red (odds ratio [OR] 16.482, 95% confidence interval [CI] 3.605-99.016), blue (OR 7.092; 95% CI 1.707-37.435), and white colors (OR 5.048, 95% CI 1.152-22.897) were more common in AM with BT >2 mm. Regarding patterns, atypical vascular patterns (OR 34.589, 95% CI 6.458-305.852), blue-white veil (OR 9.605, 95% CI 1.971-72.062), and ulcers (OR 5.084, 95% CI 1.145-24.152) were more frequently detected in cases with BT >2 mm.LimitationsA retrospective study design and small sample sizeConclusionThis study showed an association between dermoscopic patterns and tumor thickness among patients with AM. Dermoscopy can be a useful adjuvant tool in predicting BT in AM.



https://ift.tt/2HJT3NB

Incontinentia Pigmenti Misdiagnosed as Neonatal Herpes Simplex Virus Infection

Incontinentia pigmenti (IP) is an X-linked dominant neurocutaneous syndrome with ophthalmologic, neurologic, cutaneous, and dental manifestations and in most cases antenatally lethal in boys. Occasionally, typical IP may occur in boys due to Klinefelter syndrome or a genomic mosaicism. Skin lesions are observed in 4 stages: blistering, verrucous linear plaques, swirling macular hyperpigmentation, followed by linear hypopigmentation that develop during adolescence and early adulthood. Neonatal herpes simplex virus (HSV) infection can be manifested in 3 forms: localized, disseminated, and central nervous system (CNS) involvement. Timely diagnosis and treatment of neonatal HSV infection is critical. In this case report, we present a 12-day female newborn with a history of maternal genital HSV in second trimester and vesicular lesions on the upper and lower limbs that was appeared at first hours of life. She was admitted in the maternity hospital that was born and was treated by antibiotic and acyclovir for 11 days. Then, she readmitted for her distributed vesicular lesions. The results of blood and CSF for HSV PCR were negative. Eventually the diagnosis for incontinentia pigmenti was made by consultation with a dermatologist, and skin biopsy confirmed the diagnosis.

https://ift.tt/2JHK29w

Developmental assessment of preterm infants: Chronological or corrected age?

Publication date: September 2018
Source:Research in Developmental Disabilities, Volume 80
Author(s): Ayelet Harel-Gadassi, Edwa Friedlander, Maya Yaari, Benjamin Bar-Oz, Smadar Eventov-Friedman, David Mankuta, Nurit Yirmiya
The aim of this study is to examine the effect of age correction on the developmental assessment scores of preterm infants, using for the first time, the Mullen scales of early learning (MSEL) test. Participants included 110 preterm infants (born at a gestational age of ≤ 34 weeks) at ages 1, 4, 8, 12, 18, 24 and 36 months. The corrected age-based MSEL composite score and each of the five MSEL scale scores were significantly higher than chronological age-based scores at all ages. These corrected scores were significantly higher than the chronological scores regardless of gestational age whether weight was, or adequate or small for gestational age. Larger differences between corrected and chronological age-based scores significantly correlated with earlier gestational age and with lower birth weight between 1 and 24 months but not at 36 months. Using chronological age-based scores yielded significantly more infants identified with developmental delays than using corrected age-based scores. The findings indicate that clinicians and researchers, as well as family members, should be aware of and acknowledge the distinction between corrected and chronological ages when evaluating preterm infants in research and clinical practices.



https://ift.tt/2t223bq

Health-related quality of life of children with Developmental Coordination Disorder

Publication date: Available online 12 June 2018
Source:Research in Developmental Disabilities
Author(s): Heather C. Karras, Danita N. Morin, Kamaldeep Gill, Sara Izadi-Najafabadi, Jill G. Zwicker
BackgroundAlthough Developmental Coordination Disorder (DCD) is primarily a motor disorder, it can also impact emotional and psychosocial functioning of children with this condition. Evidence suggests that children with DCD experience lower quality of life than their peers, but few studies have explicitly examined the health-related quality of life (HRQOL) of these children.AimsTo: (1) describe HRQOL of children with DCD compared to typically-developing children; (2) compare HRQOL from the perspectives of children with DCD and their parents; and (3) explore predictors of HRQOL for children with DCD.MethodsData from the KidScreen-52 and Strength and Difficulties Questionnaire were collected from 50 children with DCD [Mean(SD) age: 9.8 (1.2) years] and their parents and compared to normative data.ResultsChildren with DCD and their parents report significantly lower HRQOL compared to published norms. Caregivers have a significantly lower perception of their child's HRQOL than their child's self-report in many domains. Parents of children with DCD report that their children experience significantly more emotional and behavioral disturbances compared to norms. Poor motor function and attentional difficulties predict HRQOL.Conclusion and implicationsDCD appears to contribute to lower perceived HRQOL. Findings inform therapeutic targets for children with DCD, beyond motor skill intervention.



https://ift.tt/2sV8Vbf

Adenotonsillectomy in children with sickle cell disease and obstructive sleep apnea

Publication date: August 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 111
Author(s): Annie N. Farrell, Steven L. Goudy, Marianne E. Yee, Roberta M. Leu, April M. Landry
IntroductionObstructive sleep apnea (OSA) is prevalent and may be more severe in children with Sickle Cell Disease (SCD) compared to the general pediatric population.ObjectivesThe objective of this study was to describe the therapeutic effects and complications of tonsillectomy and adenoidectomy (T&A) for treatment of OSA in children with SCD.MethodsA comprehensive database of pediatric SCD patients was reviewed to identify all patients who underwent T&A between 2010 and 2016. An IRB-approved, retrospective review of laboratory values, perioperative course, pre- and post-T&A hospital utilization, and polysomnography was conducted.ResultsThere were 132 SCD children (108 HbSS) who underwent T&A. Mean age was 7.6 ± 4.6 years. The mean baseline hemoglobin of these patients was 9.3 ± 1.4 g/dL; 72.7% of patients had pre-operative transfusion, such that the mean Hb at time of T&A was 11.4 ± 1.0 g/dL. The average admission length surrounding T&A was 3.5 ± 1.2 days. Complications were documented in 11.4% of operative cases. Polysomnography was available in 104 pre-T&A and 45 post-T&A. The Apnea-Hypopnea Index decreased on post-T&A polysomnogram (7.6 ± 8.7 vs. 1.3 ± 1.9, p = 0.0001). The O2 nadir improved on post-T&A polysomnogram (81.2 ± 10.8 vs. 89.3 ± 7, p = 0.0003). Emergency room visits (mean events per year) decreased post-operatively (2.6 ± 2.8 vs. 1.8 ± 2.2, p = 0.0002).ConclusionsT&A can be a safe and effective option to treat OSA in pediatric patients with SCD and was significantly associated with reduced AHI and fewer ER visits post-operatively.



https://ift.tt/2sU59iz

Substrate micropatterns produced by polymer demixing regulate focal adhesions, actin anisotropy, and lineage differentiation of stem cells

Publication date: Available online 12 June 2018
Source:Acta Biomaterialia
Author(s): Sebastián L. Vega, Varun Arvind, Prakhar Mishra, Joachim Kohn, N. Sanjeeva Murthy, Prabhas V. Moghe
Stem cells are adherent cells whose multipotency and differentiation can be regulated by numerous microenvironmental signals including soluble growth factors and surface topography. This study describes a simple method for creating distinct micropatterns via microphase separation resulting from polymer demixing of poly(desaminotyrosyl-tyrosine carbonate) (PDTEC) and polystyrene (PS). Substrates with co-continuous (ribbons) or discontinuous (islands and pits) PDTEC regions were obtained by varying the ratio of PDTEC and sacrificial PS. Human mesenchymal stem cells (MSCs) cultured on co-continuous PDTEC substrates for 3 days in bipotential adipogenic/osteogenic (AD/OS) induction medium showed no change in cell morphology but exhibited increased anisotropic cytoskeletal organization and larger focal adhesions when compared to MSCs cultured on discontinuous micropatterns. After 14 days in bipotential AD/OS induction medium, MSCs cultured on co-continuous micropatterns exhibited increased expression of osteogenic markers, whereas MSCs on discontinuous PDTEC substrates showed a low expression of adipogenic and osteogenic differentiation markers. Substrates with graded micropatterns were able to reproduce the influence of local underlying topography on MSC differentiation, thus demonstrating their potential for high throughput analysis. This work presents polymer demixing as a simple, non-lithographic technique to produce a wide range of micropatterns on surfaces with complex geometries to influence cellular and tissue regenerative responses.Statement of SignificanceGaining a better understanding of how engineered microenvironments influence stem cell differentiation is integral to increasing the use of stem cells and materials in a wide range of tissue engineering applications. In this study, we show the range of topography obtained by polymer demixing is sufficient for investigating how surface topography affects stem cell morphology and differentiation. Our findings show that co-continuous topographies favor early (3-day) cytoskeletal anisotropy and focal adhesion maturation as well as long-term (14-day) expression of osteogenic differentiation markers. Taken together, this study presents a simple approach to pattern topographies that induce divergent responses in stem cell morphology and differentiation.

Graphical abstract

https://ift.tt/2sU9LFm

CytID Analysis of Oral Lesions

Conditions:   Oral Cavity Cancer;   Oropharyngeal Cancer
Interventions:   Other: Oral examination with incandescent light;   Other: Oral examination with OralID;   Diagnostic Test: Biopsy;   Diagnostic Test: CytID;   Diagnostic Test: hpvID
Sponsors:   The University of Texas Health Science Center, Houston;   M.D. Anderson Cancer Center
Recruiting

https://ift.tt/2JUDY0R