British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Τετάρτη 31 Οκτωβρίου 2018
Glucose metabolism in patients with psoriasis
Risk factors for treatment failure in scabies: a cohort study
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Two case reports of unusual phimosis in rhesus monkeys (Macaca Mulatta)
Journal of Medical Primatology, EarlyView.
Τρίτη 30 Οκτωβρίου 2018
Prurigo pigmentosa – Response to treatment with Q‐Switched neodymium: YAG at 532 nm
Australasian Journal of Dermatology, EarlyView.
Scalp BCC's and meningioma following X‐ray epilation for tinea capitis
Australasian Journal of Dermatology, EarlyView.
REACH Worker Exposure Model for Co-formulants Used in Plant Protection Products
Abstract
Background
Substances used as co-formulants in plant protection products (PPP) may require registration under Regulation (EC) No. 1907/2006 (REACH), and additionally where an exposure assessment is required, this must take into consideration the specifics of the PPP use. Objectives
This work reports a customized screening level model developed to support human health risk assessment of operators, workers, and bystanders (OWB) for co-formulants used in PPP. The OWB model was designed to closely integrate with REACH generic exposure scenarios (GES) for PPP developed by the European Crop Protection Association (ECPA). The use of these tools in combination is expected to lead to a more standardized and hence efficient risk assessment of co-formulants. This study describes the basis for OWB exposure predictions as well as benchmarking against relevant REACH exposure models for equivalent tasks. The benchmarking was carried out to gain some insight into the initial assumption that the most commonly used tier 1 REACH model would be more conservative than the specific PPP models used for regulatory risk assessments under PPP legislation. Method
Existing exposure models with regulatory acceptance for the most common types of PPP and their professional and consumer uses were selected. The German BBA model was used to assess spray applications. Granule and seed dispersal was assessed using the US Environmental Protection Agency (EPA) Pesticide Handlers Exposure Database (PHED). ECETOC TRA was employed to assess exposure during certain tasks performed in seed treatment, not covered by these PPP models. Where the underlying models featured multiple exposure determinants, the exposure was calculated for all permutations, and the worst-case exposure selected and reported for use in risk assessment. The PPP models are based on measured data collected during actual application of PPP; hence, the worst-case exposure predicted was expected to reflect a realistic worst case for these tasks. Results
OWB was implemented as an Excel spreadsheet. Exposure models, parameters, and exposure and risk estimates are reported in a REACH-compliant output format to facilitate the registration of co-formulant uses. As would be expected, benchmarking OWB against the PPP-specific exposure models demonstrated equivalence with the worst-case prediction from these underlying PPP models. For the scenarios modelled, the tier 1 ECETOC TRA gave more conservative predictions than OWB. The reduction in conservatism is attributed to the underlying PPP models being based on measured data collected specifically during the use of PPP, compared to the data underlying ECETOC TRA, based mainly on industrial workplace uses. Conclusions
OWB provides inhalation and dermal exposure estimates for co-formulants used in PPP which are equivalent to the worst-case estimates from existing specialized PPP exposure models based on measured data. OWB has simplified information requirements in comparison to higher-tier REACH or PPP models. Use of OWB in combination with the defined ECPA GES facilitates an efficient and standardized REACH risk assessment and registration of co-formulant uses in PPP. A defined assessment framework and default inputs potentially decreases the anticipated inter-user variability compared with the use of higher-tier PPP or REACH models in this screening level context.Beyond the L-Strut: Redefining the Biomechanics of Rhinoplasty Using Topographic Optimization Modeling
Abstract
Rhinoplasty utilizes cartilage harvested from the nasal septum as autologous graft material. Traditional dogma espouses preservation the "L-strut" of dorsal and caudal septum which is as less resistant to axial loading than virgin septum. With the 90° angle between dorsal and caudal limbs the traditional L-strut also suffers from localized increases in internal stresses leading to premature septal 'cracking', structural-scale deformation or both. Deformation and failure of the L-strut leads to nasal deviation, saddle deformity, loss of tip support or restriction of the nasal valve. The balance between cartilage yield and structural integrity is a topographical optimization problem. Guided by finite element (FE) modelling, recent efforts have yielded important modifications including the chamfering of right-angled corners to reduce stress concentrations and the preservation of a minimum width along the inferior portion of the caudal strut. However, all existing FE studies make simplified assumptions to make the construct easier to model. This review article highlights advances in our understanding of septal engineering and identifies areas that require more work in order to further refine the balance between the competing interests of graft acquisition and the maintenance of nasal structural integrity.Commentary on: The Excision of the Buccal Fat Pad for Cheek Refinement: Volumetric Considerations
The authors have presented a study of 22 patients who requested buccal lipectomy, within whom they studied the anatomy and volume of the buccal fat pad (BFP) by means of transbuccal ultrasound.1 Thirteen of the patients were subsequently deemed "suitable" for surgery and underwent excision of the BFP. The author's conclusions are based on these findings.
A Global MicroRNA Profile in Fanconi Anemia: A Pilot Study
Metabolic Syndrome and Related Disorders, Ahead of Print.
RNA-Seq analysis of Polyrhachis vicina Roger and insights into the heat shock protein 90 and 70 families
Abstract
The heat shock protein 90 (Hsp90) and heat shock cognate proteins (Hsc70) have been identified as chaperones of the ecdysone receptor (EcR)/ultraspiracle protein (USP) heterocomplex. However, little is known about the status of Hsp90 and Hsc70 in Polyrhachis vicina Roger. Here, we sequenced the transcriptomes of adult ants in P. vicina for the first time. Clean reads in female, male, and worker ants were annotated into 40,147 transcripts, and 37,488, 28,300, and 33,638 unigenes were assembled in female, male, and worker ants, respectively. According to RPKM, the numbers of differentially expressed genes between female and male ants, between female and worker ants, and between male and worker ants and the common differentially expressed genes were 12,657, 21,630, 15,112 and 3704, respectively. These results reveal that caste differentiation, caste specificity formation, and social divisions of P. vicina ants may be due to gene expression differences. Moreover, PvEcR and PvUSP were also detected as differentially expressed genes in the ants; specifically, PvUSP expression was higher than PvEcR expression in all castes. We speculate that PvUSP may have a role similar to that of juvenile hormone receptor. Four identified PvHsp90 family members and 23 identified PvHsp70 family members were found in the ants, and 2 PvHsp90 genes and 8 PvHsp70 genes were analyzed by qRT-PCR. Among those genes, the expression of 2 PvHsp90 genes and 5 PvHsp70 genes coincided with the expression profiles of PvEcR and PvUSP, which suggest that the characterization of PvHsp90 and PvHsc70 may be as EcR/USP molecular chaperones in P. vicina.
Molecular diversity of “ Candidatus Phytoplasma mali” strains associated with apple proliferation disease in Bulgarian germplasm collection
Abstract
A quarantine organism, "Candidatus Phytoplasma mali," is the causal agent of apple proliferation, one of the most important apple diseases in Europe. The genetic diversity of this pathogen in Central and Southern Europe has already been reported; however, almost no data exists from Eastern Europe. In this study, "Ca. P. mali" strains, which were identified in 14 apple trees from the Bulgarian germplasm collection, were characterized by restriction fragment length polymorphism (RFLP) and sequence analysis of four genomic loci. In total, nine distinct genetic lineages were recognized based on the combination of the following detected RFLP profiles: two profiles for the 16S-23S rDNA region (16SrX-A2, -A3), four profiles for the secY gene (one previously known: secY(X)-A, and three new: secY-C, secY-D, secY-E), three profiles for the rpl22-rps3 genes (rpX-A, rpX-B, rpX-F), and one profile for the nitroreductase- and rhodanese-like gene (AT-1). Phylogenetic analysis of the Bulgarian and other European "Ca. P. mali" strains based on 16S-23S rRNA gene sequences confirmed RFLP grouping, regardless of the phytoplasma origin. In a phylogenetic tree based on the secY data, only German strains formed separate clade from the other strains. The tree based on rp genes did not correspond to RFLP profiles. Unexpectedly, when using nitroreductase and rhodanese-like gene sequences, the Bulgarian strains clustered separately from the other European strains. Apart from the identification of different "Ca. P. mali" strains, the paper also recommends the unification of the rpX-subgroup nomenclature to avoid future confusions. Both aims of this paper provide valuable tools to understand the epidemiology of this quarantine pathogen.
Analysis of sulfated glycosaminoglycan composition change in intrinsically aged and photoaged human skin using an enzymatic degradation method
Glycosaminoglycans (GAGs) are long and linear polysaccharides composed of repeating specific disaccharide units, and 6 different GAGs are known: chondroitin sulfate (CS), dermatan sulfate (DS), heparan sulfate (HS), heparin (HP), keratan sulfate (KS), and hyaluronic acid (HA) [1]. GAGs exist as alone (HA) or proteoglycan-attached forms (others) in extracellular matrix and cell surface throughout the body, and participate in diverse structural and physiological functions [1].
Pannexin-3 deficiency delays skin wound healing in mice due to defects in channel functionality
Pannexin-3 (Panx3) is a gap junction protein and is required for regulating cell cycle exit and the differentiation of osteoblasts and chondrocytes during skeletal development. However, the role of Panx3 in skin tissue regeneration remains unclear. Following dorsal skin punch biopsies, Panx3 knockout mice exhibited a significant delay in wound healing with insufficient re-epithelialization, decreased inflammatory reaction and reduced collagen remodeling. Panx3 expression coincided with inflammatory reactions both in vivo and in vitro.
When Adolescents Give Up Pot, Their Cognition Quickly Improves
When researchers convinced a group of young people to stop smoking pot, their cognition quickly improved. This adds to research warning against teen pot use, despite marijuana's growing acceptance.
(Image credit: BURGER/Canopy/Getty Images)
Aesthetic Properties, History and Perception
Abstract
If artworks and their aesthetic properties stand in constitutive relationships to historical context and circumstances, so that some understanding of relevant facts is involved in responding to a work, what becomes of the intuitive view that we see artworks and at least some of their aesthetic properties? This question is raised by arguments in both aesthetics and art history for the historical nature of works of art. The paper argues that the answer needs to take philosophy of perception into account. The principal development that has shaped philosophy of perception in the last thirty years—explaining perceptual experience in terms of contents that represent that such-and-such is the case—is directly relevant to key arguments for the historical nature of art because contents can represent complex kinds and properties. Conceptual realism is especially well-suited for explaining perception of artworks and aesthetic properties because it emphasizes that forms of understanding—in the sense of capacities, abilities and techniques—are involved in perceptual engagement with individual objects and instances of properties. To make this case, the paper examines influential arguments for the historical nature of art and aesthetic properties by Arthur C. Danto and Kendall L. Walton; and examines art-historical discussions by Michael Baxandall, Linda Nochlin and T. J. Clark. The paper argues that the aesthetic properties of an artwork depend on human intentional uses of properties, colours and contours among them, and such uses may themselves be aesthetic. The Wittgensteinian notion of use is contextual and historical, and uses are perceptible.Binding and Unbinding the Mondrian Stimulus
Abstract
This paper considers the use of the 'Mondrian Stimulus', invented by Edwin H. Land of the Polaroid Corporation, in various investigations in the visual neuropsychology, the neuroaesthetics, and the social psychology of aesthetic response to works of visual art (notably, investigations by Semir Zeki and A. Michael Noll). What difference does it make—in the set-up of these investigations and in our interpretation of their putative results—that the Mondrian Stimulus might be taken to be a 'real' painting by the actual Dutch artist Piet Mondrian? How does the existence of a set of 'real' Mondrians—more or less well known to many people, including those investigated in experiments by Land, Zeki, and Noll—affect the ways in which the Mondrian Stimulus is apprehended? The paper argues that the Mondrian Stimulus is 'bound' to the history and visual recollection of 'real Mondrians' at the same time as the 'real Mondrians'—in their historical afterlives—are bound to other creations of 'modern abstract art'. These proposals enable a revised approach to the relations between invariant visual responses (such as Land and Zeki derived for colour vision) on the one hand, and different visual cultures or visuality on the other; because of its own special history of 'binding' and 'unbinding', the Mondrian Stimulus works as an interface between—a binding of—both 'bottom-up' perceptual input and processing and 'top-down' direction of attention.Nickel induces migratory and invasive phenotype in human epithelial cells by epigenetically activating ZEB1
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By Jamshed Arslan Pharm.D.
Nickel (Ni) is a naturally abundant metallic element. It is a major component of stainless steel, coins, and many other items of daily use. Disturbingly, Ni exposure is associated with cancer and several diseases of the lung, kidney and cardiovascular system. Despite being carcinogenic, Ni's ability to cause DNA mutations and induce oxidative stress is low. To explain this paradox and investigate how the impact of carcinogen exposure may last for months or even years, researchers at the New York University and University of Virginia examined Ni-induced changes in transcription and cellular regulation in human epithelial cells from lung and urinary bladder. They found that Ni induces epithelial-mesenchymal transition (EMT) by epigenetically activating ZEB1. As a result of such irreversible activation of EMT master regulator ZEB1, the invasive mesenchymal phenotype in Ni-exposed cells persisted even after the termination of exposure.
Immunohistochemistry-Paraffin: [E-Cadherin Antibody (7H12) NBP2-19051] - Human kidney distal tubules stained with E-CAD antibody. Secondary antibody: Donkey anti-Mouse Alexa Fluor 555. Imaging with a 40x objective from Zeiss Observer microscope with Apotome2. Image from verified customer review.
Nickel induces epithelial-mesenchymal transition (EMT)
The researchers exposed non-malignant human bronchial epithelial cells to a non-cancerous dose of Ni. RNA-seq revealed that a subset of genes was persistently down- or up-regulated even two weeks after the removal of Ni from the culture medium. Functional enrichment analysis, used to determine overrepresented classes of genes, showed that the major pathway associated with these differentially expressed genes was epithelial-mesenchymal transition (EMT) regulation. The mesenchymal phenotype in Ni-exposed cells was confirmed when a downregulation of epithelial markers (CDH1 and CLDN1) was observed concomitantly with an upregulation of mesenchymal marker (FN1), at both mRNA and protein levels. Likewise, wound-healing and transwell invasion assays revealed heightened migratory and invasive abilities of these Ni-exposed cells.
Similar findings in a non-invasive human bladder cancer cell line led to the conclusion that chronic Ni exposure induces EMT. The next step was to find the mechanistic basis behind this phenomenon.
Nickel-induced EMT is ZEB1-dependent
Gene expression analysis of the EMT signaling pathway showed ZEB1, a negative regulator of CDH1, to be among the highly upregulated genes in Ni-exposed cells as compared to untreated cells. Analysis of mRNA and protein levels corroborated these findings. Knocking down ZEB1 through shRNA, recovered CDH1 protein and decreased the invasive and migratory abilities of Ni-exposed cells. These results showed the ZEB1-dependent induction of EMT by Ni.
To explore possible epigenetic basis of this observation, the team observed ZEB1 promoter by performing chromatin immunoprecipitation (ChIP)-qPCR analysis. They found that histone modifications related to gene activation (H3K4me3) at ZEB1 promoter in Ni-exposed human epithelial cells remained similar to untreated cells. However, the levels of histone modifications associated with gene repression (H3K27me3) decreased significantly. Likewise, a persistent downregulation of miRNAs that act as ZEB1 repressors (miR-200/205), which could be reversed by ZEB1 depletion, meant that ZEB1 suppresses these miRNAs in Ni-exposed cells.
In short, certain histone modifications and the suppression of ZEB1-repressing miRNAs lead to a sustained ZEB1 upregulation, which in turn promotes a highly migratory and invasive mesenchymal phenotype in Ni-exposed cells.
Significance
This study provides a plausible explanation to why environmental exposure to certain contaminants persists long after the termination of exposure. It helps understanding diseases associated with chronic exposure to a physiologically relevant dose of Ni.
Learn more about tools for epigenetic analysis
Jamshed Arslan, Pharm D.
University of Alabama at Birmingham, School of Medicine
Dr. Arslan studies cell signaling in mitochondrial defects in C. elegans
and transgenic mice.
References
Jose, Cynthia C., et al. "Nickel Exposure Induces Persistent Mesenchymal Phenotype in Human Lung Epithelial Cells through Epigenetic Activation of ZEB1." Molecular Carcinogenesis, vol. 57, no. 6, 2018, pp. 794 – 806. doi: 10.1002/mc.22802.
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Lipome péri-unguéal : une localisation inhabituelle
Publication date: Available online 30 October 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): S. Gallouj, N. Aqil, F. Zahra Mernissi
Résumé
Introduction
Les lipomes sont des tumeurs mésenchymateuses bénignes courantes composées de cellules graisseuses matures qui peuvent être ou non entourées d'une fine capsule fibreuse. Les lipomes impliquant les doigts sont extrêmement rares mais doivent être pris en compte dans le diagnostic différentiel des masses bénignes des tissus mous de localisation digitale. Nous décrivons un cas de lipome péri-unguéal.
Observation
Une femme de 65 ans se présentait en consultation avec une tuméfaction de l'index droit évoquant un lipome. Elle ne se plaignait d'aucune douleur mais avait une légère limitation des mouvements du doigt affecté. Les diagnostics différentiels qu'on pouvait envisager étaient un neurofibrome, un fibromyxome acral superficiel et une tumeur à cellules géantes des gaines synoviales des tendons. Une excision chirurgicale était effectuée. L'examen histologique confirmait le diagnostic de lipome. Il n'y avait pas d'antécédent de traumatisme de l'ongle, d'autres lipomes sur le corps ni d'antécédents familiaux de lipomatose. Il n'y a pas eu de récidive après une année de suivi.
Discussion
Les lipomes des doigts sont extrêmement rares. À notre connaissance, six cas de localisation sous-unguéale et quatre cas situés dans le bord latéral de l'ongle ont été décrits dans la littérature. Nous rapportons un autre cas de localisation inhabituelle, péri-unguéale postérieure. Des examens radiologiques peuvent être réalisés pour aider au diagnostic. Bien que les lipomes des doigts soient des entités rares, ils doivent être pris en compte dans le diagnostic différentiel des masses bénignes des tissus mous du doigt.
Summary
Background
Lipomas are common benign mesenchymal tumors composed of mature fat cells that may or may not be surrounded by a thin fibrous capsule. Lipomas involving the fingers are extremely rare but must be taken into account in the differential diagnosis of benign soft tissue masses of unusual localization. We describe a case of digital periungual lipoma.
Patients and methods
A 65-year-old Moroccan woman presented with a tumefaction of the right index finger reminiscent of a lipoma. There was no history of nail trauma, other lipomas on the body, or a family history of lipomatosis. She did not complain of any pain, but she had a slight limitation on the movement of the affected finger. Surgical excision was performed. Histological examination confirmed the diagnosis of lipoma. There was no recurrence after one year of follow-up.
Discussion
Lipomas of the fingers are extremely rare. To our knowledge, 6 cases of subungual localization and 4 cases in the lateral edge of the nail have been described in the literature. We report another case of unusual posterior periungual localization. In our case, the suspected diagnoses were either neurofibroma, superficial acral fibromyxoma, or giant cell tumor of the synovial sheaths of the tendons. Radiological examinations may be performed to aid diagnosis. Although finger lipomas are rare entities, they must be considered in the differential diagnosis of benign soft tissue masses of the finger.
Outcomes from a regional synchronous tele-allergy service
Publication date: Available online 29 October 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Kirk H. Waibel, Richard A. Bickel, Tyson Brown
Abstract
Background
While the framework and potential benefits for using telemedicine have been described, allergy-specific outcomes are often limited or have a narrow focus.
Objective
To determine the percentage of new and follow-up visits conducted via synchronous telemedicine requiring an in-person visit.
Methods
A retrospective review evaluating synchronous tele-allergy appointments in a hospital-based allergy clinic was performed.
Results
A total of 360 unique patients participated in 423 synchronous tele-allergy visits from January 2016 through December 2017; 275 (65.0%) were new consultations, 54% were male, and 118 (28%) visits were for children. Allergic rhinitis (35%), asthma (24%), and food allergy (10%) represented the top three diagnoses. New and follow-up tele-allergy visits accounted for 13.1% (275/2,097) and 10.4% (148/1,426) of all outpatient visits during the study period, respectively. Sixty-five (23.4%) new patients and 14 (9.5%) follow-up patients were recommended for an in-person appointment. (P < .001). Compared to follow-up tele-allergy visits, new visits were more likely to have medication prescribed (64.4% vs 49.0%, P < .002) and laboratory tests ordered (46.2% vs 7.4%, P <.001); there were no differences between new and follow up tele-allergy visits for mean study observation period (P = 0.68), subsequent in-person visits conducted based on provider recommendation (P = 0.12), or telephone consultations (P = 0.19). One-hundred forty (33.1%) patients completed an anonymous satisfaction survey with 98.8% of patients both recommending telehealth and reporting high satisfaction. Based on 423 visits from 13 originating sites, patients saved an average of USD $485 in travel expenses, 438 driving miles, and 2.3 days of work or school per visit.
Conclusion
Coupled with high patient satisfaction and significant time and cost savings, tele-allergy supported the majority of new and follow up visits without an in-person recommendation. While not all tele-allergy efforts incorporate a synchronous modality with a dedicated patient presenter, allergists should continue to seek opportunities to incorporate synchronous tele-allergy with a trained patient presenter into their clinical practice.
Bariatric surgery: relevant cofactor for systemic food-borne allergic reactions
Publication date: Available online 29 October 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Lisanne Janke Wolters, Marloes.Willemijn Heijstek, Pieter Weijert Holm, Hanneke Nicola Gertrude Oude Elberink, Annick Augustina Josephina Maria Van de Ven
Acquired Cold-Induced Urticaria in Pediatric Patients: a 22-year Experience in a Tertiary Care Center (1996-2017)
Publication date: Available online 29 October 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Christina S.K. Yee, Kristel El Khoury, Sultan Albuhairi, Ana Broyles, Lynda Schneider, Rima Rachid
Abstract
Background
Acquired cold urticaria (ACU) has not been well evaluated in pediatrics.
Objective
To further evaluate the presentation of ACU in children and associated risk of anaphylaxis.
Methods
A retrospective chart review was performed in children ≤18 years old diagnosed with (ACU) at Boston Children's Hospital (US, Northeast) from 1996-2017.
Results
415 patients with ACU were identified, aged 4 months-18.3 years old at time of diagnosis, with similar male:female distribution. Most patients had history of atopic disease (78.3%), and 25.8% had other urticaria. Around 2/3rd of patients experienced only localized cold-induced symptoms (grade 1), while 14.0% had diffuse cutaneous symptoms (grade 2) as the most severe reaction, and 18.6% experienced anaphylaxis (grade 3). Swimming triggered 77.6% of grade 3 reactions, while the rest were secondary to ingestion of cold food or beverages, or cold air or cold water exposure. 7.0% of subjects had more than one episode of anaphylaxis. Cold stimulation test (CST) was performed in 61.7% patients, and was positive in 69.9% of those tested. Positive CST was significantly associated with increased risk of anaphylaxis. There was a 11.7% rate of anaphylaxis amongst patients with negative CST. Disease resolution at any point in the study period was documented in 8.9% of patients and was associated with a negative history of anaphylaxis.
Conclusions
In the largest study to date on ACU, grade 3 reactions occurred in about a fifth of patients. Positive CST was associated with higher risk for anaphylaxis from ACU. Epinephrine prescription and patient/family counseling about risk factors for grade 3 reactions are recommended.
Deep Brain Stimulation (DBS) experiences: an ethnographic approach to their expression on the Internet forums
Abstract
This contribution aims at describing the experiences of Deep Brain Stimulation (DBS) as discussed on Internet forums. Since the 2000s, increasing attention has been paid to health practices associated with the use of the Internet, whether by medical professionals, public authorities or researchers in the social sciences. We know that Internet is used by patients with Parkinson's disease, in order to discuss about their lived experiences. This contribution will present how these Internet users address the specific theme of DBS. We will examine how their use and the information sharing associated to it participate in the "shaping" of the lived experience of deep cerebral stimulation. This contribution will be introduced by an analysis of the state-of-the-art in sociological and anthropological international research on the topic of "Internet health". On the basis of this analysis, it will propose a framework to describe and understand the various uses of the web that are made to give an account of the experience of stimulation. The existence of collective mobilizations in Parkinson's disease, an old Internet experience and media oppositions concerning certain antiparkinsonian drugs, are conditions which push us to question these themes concerning DBS. This paper is a description, for the first time, of roles played by the users of these Internet forums and the different online activities produced about DBS subject. In an ethnographic perspective, we had to imagine that we were an Internet user seeking patient experiences with this surgical procedure to understand these interactions about DBS. The main goal of this contribution is to describe the attention paid by users for medical information about DBS in the identity and self-help process. The interest of such an approach is to open an anthropological reflection on the place and the role of the medical representations in the testimonies of experience of the disease or the treatments.
Photodynamic therapy: Toward a systemic computational model
Publication date: Available online 30 October 2018
Source: Journal of Photochemistry and Photobiology B: Biology
Author(s): N. López-Marína, R. Mulet, R. Rodríguez
Abstract
We have designed a systemic model to understand the effect of Photodynamic Therapy (PDT) on long time scales. The model takes into account cell necrosis due to oxygen reactive species, cell apoptosis through the caspase pathway and the competition between healthy and tumor cells. We attempted to describe the system using state of the art computational techniques (necrosis and apoptosis) and simple models that allow a deeper understanding of the long time scale processes involved (healing and tumor growth). We analyzed the influence of the surface and tumor depth on the effectiveness of different treatment plans and we proposed, for the set of parameters used in this work, an optimum timing between sessions of PDT.
Irradiation by ultraviolet light-emitting diodes inactivates influenza a viruses by inhibiting replication and transcription of viral RNA in host cells
Publication date: Available online 29 October 2018
Source: Journal of Photochemistry and Photobiology B: Biology
Author(s): Risa Nishisaka, Kazuaki Mawatari, Tomomi Yamamoto, Mizuki Kojima, Takaaki Shimohata, Takashi Uebanso, Mutsumi Nakahashi, Takahiro Emoto, Masatake Akutagawa, Yohsuke Kinouchi, Takahiro Wada, Masayuki Okamoto, Hiroshi Ito, Ken-ichi Yoshida, Tomo Daidoji, Takaaki Nakaya, Akira Takahashi
Abstract
Influenza A viruses (IAVs) pose a serious global threat to humans and their livestock, especially poultry and pigs. This study aimed to investigate how to inactivate IAVs by using different ultraviolet-light-emitting diodes (UV-LEDs). We developed sterilization equipment with light-emitting diodes (LEDs) those peak wavelengths were 365 nm (UVA-LED), 310 nm (UVB-LED), and 280 nm (UVC-LED). These UV-LED irradiations decreased dose fluence-dependent plaque-forming units of IAV H1N1 subtype (A/Puerto Rico/8/1934) infected Madin-Darby canine kidney (MDCK) cells, but the inactivation efficiency of UVA-LED was significantly lower than UVB- and UVC-LED. UV-LED irradiations did not alter hemagglutination titer, but decreased accumulation of intracellular total viral RNA in infected MDCK cells was observed. Additionally, UV-LED irradiations suppressed the accumulation of intracellular mRNA (messenger RNA), vRNA (viral RNA), and cRNA (complementary RNA), as measured by strand-specific RT-PCR. These results suggest that UV-LEDs inhibit host cell replication and transcription of viral RNA. Both UVB- and UVC-LED irradiation decreased focus-forming unit (FFU) of H5N1 subtype (A/Crow/Kyoto/53/2004), a highly pathogenic avian IAV (HpaI), in infected MDCK cells, and the amount of FFU were lower than the H1N1 subtype. From these results, it appears that IAVs may have different sensitivity among the subtypes, and UVB- and UVC-LED may be suitable for HpaI virus inactivation.
Fracture patterns and causes in the craniofacial region: an 8-year review of 2076 patients.
| Related Articles |
Fracture patterns and causes in the craniofacial region: an 8-year review of 2076 patients.
Maxillofac Plast Reconstr Surg. 2018 Dec;40(1):29
Authors: Jin KS, Lee H, Sohn JB, Han YS, Jung DU, Sim HY, Kim HS
Abstract
Background: For proper recovery from craniofacial fracture, it is necessary to establish guidelines based on trends. This study aimed to analyze the patterns and causes of craniofacial fractures.
Methods: This retrospective study analyzed patients who underwent surgery for craniofacial fractures between 2010 and 2017 at a single center. Several parameters, including time of injury, region and cause of fracture, alcohol intoxication, time from injury to surgery, hospitalization period, and postoperative complications, were evaluated.
Results: This study analyzed 2708 fracture lesions of 2076 patients, among whom males aged 10 to 39 years were the most numerous. The number of patients was significantly higher in the middle of a month. The most common fractures were a nasal bone fracture. The most common causes of fracture were ground accidents and personal assault, which tended to frequently cause more nasal bone fracture than other fractures. Traffic accidents and high falls tended to cause zygomatic arch and maxillary wall fractures more frequently. Postoperative complications-observed in 126 patients-had a significant relationship with the end of a month, mandible or panfacial fracture, and traffic accidents.
Conclusions: The present findings on long-term craniofacial fracture trends should be considered by clinicians dealing with fractures and could be useful for policy decisions.
PMID: 30370262 [PubMed]
Atopic Dermatitis in America Study: a cross-sectional study examining the prevalence and disease burden of atopic dermatitis in the US adult population
Population-based estimates on the prevalence of atopic dermatitis in adults vary widely. The objectives of the present study were to determine the prevalence of atopic dermatitis in the population of the United States, distribution of disease severity, and assess its impact on health-related quality of life. Among 1,278 participating adults, the prevalence (95%CI) of atopic dermatitis was 7.3% (5.9-8.8). 60.1% (56.1-64.1%) of participants were classified as mild 28.9% (25.3-32.7%) as moderate and 11% as severe (8.6-13.7%).
Does chronic immunosuppressive therapy for autoimmune disease influence the risk of developing active tuberculosis?
Dermatologic Therapy, Volume 0, Issue ja, -Not available-.
Computer-assisted delineation of hematoma from CT volume using autoencoder and Chan Vese model
Abstract
Purpose
To reduce the inter- and intra- rater variability as well as time and effort, a method for computer-assisted delineation of hematoma is proposed. Delineation of hematoma is done for further automated analysis such as the volume of hematoma, anatomical location of hematoma, etc. for proper surgical planning.
Methods
Fuzzy-based intensifier was used as a pre-processing technique for enhancing the computed tomography (CT) volume. Autoencoder was trained to detect the CT slices with hematoma for initialization. Then active contour Chan–Vese model was used for automated delineation of hematoma from CT volume.
Results
The proposed algorithm was tested on 48 hemorrhagic patients. Two radiologists have independently segmented the hematoma manually from CT volume. The intersection of two volumes was used as ground-truth for comparison with the segmentation performed by the proposed method. The accuracy was determined by using similarity matrices. The result of sensitivity, positive predictive value, Jaccard index and Dice similarity index were calculated as 0.71 ± 0.12, 0.73 ± 0.18, 0.55 ± 0.14, and 0.70 ± 0.12 respectively.
Conclusions
A new approach for delineation of hematoma is proposed. The algorithm works well with the whole volume. Similarity indices of the proposed method are comparable with the existing state of art.
Tau PET imaging evidence in patients with cognitive impairment: preparing for clinical use
Abstract
Purpose
The development and validation of molecular imaging markers for the neuropathological hallmarks of neurodegenerative diseases associated with cognitive impairment is a reality since two decades. Amyloid PET tracers have been validated analytically and are currently tested for their clinical utility. More recently tracers targeting specifically tau deposits have been developed and are currently tested in large clinical studies. The availability of these markers opens the possibility for precision medicine in a field that was limited by a gold standard diagnosis occurring only postmortem. Aim of this review is to summarize the main findings obtained using tau-specific PET tracers in clinical cohorts of patients with cognitive impairment.
Methods and Results
We report the results of a systematic literature review. Various approaches for automated image assessment have been tested, while visual rating strategies have not been validated yet. In the AD spectrum an increase in cortical binding has been consistently observed, with a topography correlated with the profile of cognitive impairment and in agreement with the knowledge on tau pathology from neuropathological series. The evidence in non-AD diseases is more limited, with discordant findings in different cohorts and with different tracers.
Conclusion
Post-mortem validations of in vivo data in large cohorts and studies investigating the clinical added value of this biomarker in comparison with others will be required before routine clinical use of this new modality.
Ossification into the osteo‐nevus of Nanta: an interpretative insight
International Journal of Dermatology, EarlyView.
Senescent fibroblasts in melasma pathophysiology
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
Patients with Congenital Ichthyosis and TGM1 Mutations Overexpress Other ARCI Genes in the Skin: Part of a Barrier Repair Response?
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
Effects of mesenchymal stem cell therapy on alopecia areata in cellular and hair follicle organ culture models
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
Radiopharmacology and molecular imaging of PD-L1 expression in cancer
Abstract
Introduction
Immunotherapy [(specifically, antibodies blocking programmed death ligand-1 (PD-L1)] is a valuable option in cancer treatment because it leads to durable tumour regression and improves survival in several cancers. Patients with PD-L1 expressing tumours benefit from this therapy, but currently it can only be determined through biopsy, which may be inconclusive or impossible due to lesion location, associated risks, intratumoral and interlesional heterogeneity. Therefore, radio-immune-imaging with a specific radiopharmaceutical is ideally placed to play an important role when performing real-time, in vivo, whole-body and non-invasive PD-L1 expression mapping.
Purpose
To describe and summarise published scientific data on imaging PD-L1 expression using radiopharmaceuticals and discuss future directions in this research field.
Methods
A summary review of the literature was done through PubMed to search papers that described and included radiopharmaceuticals to image PD-L1 expression. Only English papers published until April 2018 that detailed laboratorial and animal procedures were selected.
Results
Eleven pre-clinical papers published between 2015 and 2018 were included. Four studies used anti-PD-L1 radiopharmaceuticals labelled with Indium-111, 4 with Copper-64, 2 with Fluoride-18 and 1 with both Copper-64 and Gallium-68. All of them had identical protocols and showed similar radiopharmaceutical biodistribution. They reported successful anti-PD-L1 labelling, with high tumour–background ratio (mainly when spleen uptake was saturated with unlabelled/cold antibody).
Conclusions
All reported radiopharmaceuticals had high sensitivity and specificity to identify tumours with PD-L1 expression in animal model. Clinical experiments appear to be now justifiable.
Δευτέρα 29 Οκτωβρίου 2018
Cavitary Pulmonary Nodules in an Immunocompromised Patient With Urothelial Carcinoma of the Bladder
A 59-year-old Moroccan man with a history of metastatic urothelial cell carcinoma presented in May 2016 with fever, shortness of breath, and chest pain. Noninvasive urothelial carcinoma had been diagnosed in 2012 and treated with mitomycin. In 2014, the patient had received intravesicular Mycobacterium bovis BCG therapy, but invasive bladder carcinoma subsequently developed, requiring 4 cycles of chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin. Nine months before the current admission, the patient underwent a radical cystoprostatectomy with creation of a neobladder. Nonetheless, brain metastases developed, for which he received dexamethasone (4 mg orally, twice daily), and underwent neurosurgical resection 3 months before presentation, followed by whole-brain irradiation. He continued receiving intermittent dexamethasone therapy until his admission to our hospital.
The role of long‐wavelength ultraviolet A1 (UVA1) in acral vitiligo
Journal of Cosmetic Dermatology, EarlyView.
Combinatorial application of dissolving microneedle patch and cream for improvement of skin wrinkles, dermal density, elasticity, and hydration
Journal of Cosmetic Dermatology, EarlyView.
The Association Between Metabolic Syndrome and Serum Concentrations of Micronutrients, Inflammation, and Oxidative Stress Outside of the Clinical Reference Ranges: A Cross-Sectional Study
Metabolic Syndrome and Related Disorders, Ahead of Print.
Surgical Correction of Unicoronal Craniosynostosis with Frontal Bone Symmetrization and Staggered Osteotomies
Background. Craniosynostosis is the premature fusion of one or more cranial sutures that produce abnormal head shape. Plagiocephaly is a general term that describes unilateral flattening of the anterior or posterior quarter of the cranium. Anterior plagiocephaly is almost always due to unilateral coronal synostosis. Early surgical treatment is the best option for these patients. The aim of this study was to investigate the surgical correction results of unicoronal craniosynostosis with frontal bone symmetrization and staggered osteotomies. Methods. All unicoronal craniosynostosis cases treated surgically from 2013 to 2016 at our hospital, with frontal bone symmetrization and staggered osteotomies and fronto-orbital advancement, were reviewed. The following variables were analyzed: sex, age, weight, hospital stay time, ICU stay time, per os (PO) starting time, anesthetic time, estimated blood loss volume (ml), estimated blood loss as percentage of total volume, surgical complication, follow-up time, and Whitaker grade. All data were analyzed with SPSS. Results. The study consisted of 33 patients (19 females, 14 males). Average age was 10.24 months, average weight was 8.97 Kg, average hospital stay time was 7.84 days, average ICU stay time was 1.69 days, average PO starting time was 1.24 days after surgery, average anesthetic time was 397.72 minutes, average estimated blood loss was 213.78 ml, and estimated blood loss as percentage of total volume was 31.69%. One case (3.03%) needed reoperation and two cases had postoperative seizure. No mortality was seen. Conclusion. It is supposed that surgical correction of unicoronal craniosynostosis with frontal bone symmetrization and staggered osteotomies results in lower blood loss, lower complication rate and reoperation, and more durable results.
Neuer Pfeil im Therapieköcher gegen Asthma von Kindern
Die Palette von Medikamenten für die Kontrolle von Asthma im Kindesalter hat Zuwachs bekommen: Der langwirksame Muskarinantagonist Tiotropium ergänzt die Optionen für die Add-on-Therapie.
Asthma hat viele Gesichter
Unter dem Begriff Asthma werden heute eine Reihe unterschiedlicher Phänotypen der entzündlichen Atemwegserkrankung zusammengefasst. Den Grundstein für diese Entwicklung legte vor 100 Jahren der Mediziner Francis M. Rackemann.
„Für eine Welt ohne Allergien“
So weit, wie das ambitionierte Motto des 13. Deutschen Allergiekonkresses erahnen lassen könnte, ist es leider noch lange nicht. Doch wie man diesem bislang noch weit entfernten Ziel ein Stück näher kommen könnte, wurde Ende September in Dresden diskutiert. Behandelte Themen waren unter anderem die personalisierte Allergieprävention, Defizite in der Anapylaxietherapie und seltene allergische Erkrankungen.
Kombiniert oder einzeln — jetzt wieder erstattungsfähig!
Nicht verschreibungspflichtige nasale Glukokortikoide mit den Wirkstoffen Beclomethason, Fluticason und Mometason können inzwischen wieder auf Kassenrezept verordnet werden. Dies gilt auch für ein Kombinationspräparat aus nasalem Glukokortikoid und Antihistaminikum, wie der Ärzteverband Deutscher Allergologen klarstellt.
Basophilenaktivierungstest zur Diagnose von Sesamallergie
Für Menschen mit einer Allergie gegen Sesam können bereits Spuren von selbigem eine schwere anaphylaktische Reaktion auslösen. Doch bislang gibt es keine ideale Methode, mit der eine Sesamallergie zuverlässig und risikofrei diagnostiziert werden kann.
Minorallergene bei Walnussallergie relevant
Untersucht man Walnussallergiker mit Walnuss-ImmunoCAP-Extrakt, reagieren nicht alle Seren. Ein Grund könnten fehlende Minorallergene wie das Jug r 4 sein. Eine Laborstudie ging der Frage nach.
Might hyperbaric oxygen therapy (HBOT) reduce renal injury in diabetic people with diabetes mellitus? From preclinical models to human metabolomics
Abstract
Diabetic kidney disease (DKD) is the leading cause of end-stage renal failure in the western world. Current treatment of diabetic kidney disease relies on nutritional management and drug therapies to achieve metabolic control. Here, we discuss the potential application of hyperbaric oxygen therapy (HBOT) for the treatment of diabetic kidney disease (DKD), a treatment which requires patients to breathe in 100% oxygen at elevated ambient pressures. HBOT has traditionally been used to diabetic foot ulcers (DFU) refractory to conventional medical treatments. Successful clinic responses seen in the DFU provide the underlying therapeutic rationale for testing HBOT in the setting of DKD. Both the DFU and DKD have microvascular endothelial disease as a common underlying pathologic feature. Supporting evidence for HBOT of DKD comes from previous animal studies and from our preliminary prospective clinical trial reported here. We report urinary metabolomic data obtained from patients undergoing HBOT for DFU, before and after exposure to 6 weeks of HBOT. The preliminary data support the concept that HBOT can reduce biomarkers of renal injury, oxidant stress, and mitochondrial dysfunction in patients receiving HBOT for DFU. Further studies are needed to confirm these initial findings and correlate them with simultaneous measures of renal function. HBOT is a safe and effective treatment for DFU and could also be for individuals with DKD.
Lipopolysaccharide induces human olfactory ensheathing glial apoptosis by promoting mitochondrial dysfunction and activating the JNK-Bnip3-Bax pathway
Abstract
Olfactory ensheathing glia (OEG) play an important role in regulating the regeneration of an injured nervous system. However, chronic inflammation damage reduces the viability of OEG via poorly understood mechanisms. We aimed to investigate the pathological responses of OEG in response to LPS-mediated inflammation stress in vitro. The results indicated that lipopolysaccharide (LPS) treatment significantly reduced the viability of OEG in a dose-dependent fashion. Mechanistically, LPS stimuli induced mitochondrial oxidative damage, mitochondrial fragmentation, mitochondrial metabolism disruption, and mitochondrial apoptosis activation. Furthermore, we verified that LPS modulated mitochondrial apoptosis by promoting Bax upregulation, and this process was regulated by the JNK-Bnip3 pathway. Inhibition of the JNK-Bnip3 pathway prevented LPS-mediated Bax activation, thus attenuating OEG apoptosis. Altogether, our data illustrated that LPS-mediated inflammation injury evoked mitochondrial abnormalities in OEG damage via the JNK-Bnip3-Bax pathway. This finding provides a potential target to protect OEG against chronic inflammation stress.
Protective effects of selenium against zearalenone-induced apoptosis in chicken spleen lymphocyte via an endoplasmic reticulum stress signaling pathway
Abstract
Selenium (Se), an antioxidant agent, provides significant protection from reactive oxygen species (ROS)-induced cell damage in vivo and in vitro. However, it is unclear whether Se can protect against zearalenone (ZEN)-induced apoptosis in chicken spleen lymphocyte. In this study, we investigated the underlying mechanism of the apoptosis induced by ZEN in chicken spleen lymphocyte and further evaluated the protective mechanism of Se on ZEN-induced apoptosis. The results show that ZEN induced an increase in ROS generation and lipid peroxidation, and a decrease in levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and glutathione (GSH). The results of apoptosis morphologically from acridine orange/ethidium bromide (AO/EB) fluorescent staining and flow cytometry analysis show apparent apoptosis in the ZEN-treated group, and was confirmed by the upregulation of caspase-3, -12 and downregulation of Bcl-2. Meanwhile, ZEN activated the endoplasmic reticulum (ER) stress by upregulating ER stress-related molecular sensors (GRP78, ATF6, ATF4, IRE). However, co-treatment with Se effectively blocked ROS generation, improved antioxdative capacity, and reversed apoptosis and ER stress-related genes and protein expression. Taken together, these data suggest that oxidative stress and ER stress play a vital role in ZEN-induced apoptosis, and Se had a significant preventive effect on ZEN-induced apoptosis in chicken spleen lymphocyte via ameliorating the ER stress signaling pathway.
Cell toxicity mechanism and biomarker
Cell toxicity may result in organ dysfunction and cause severe health problem. Recent studies revealed many toxicants may induced the over production of Nitric oxide, reactive oxygen species and the subsequent...
Actinic Lichen Planus Triggered by Drug Photosensitivity
Photodermatology, Photoimmunology &Photomedicine, Volume 0, Issue ja, -Not available-.
Introduction: Special Issue—The Origins of Macrophages and Their Roles Beyond Immunology
In the context of ontogeny and phylogeny, macrophages emerge much earlier than other hematopoietic cells, including monocytes, implying that their roles extend beyond immunology. Phagocytosis, a representative function of macrophages, has been examined since the late 19th century and such studies were the basis of characterizing innate immunity. Macrophages also make a range of cytokines important in both innate and adaptive immunity. Recently, their non-immunological homeostatic roles in organ development, angiogenesis, tissue repair/regeneration and metabolism have also become clear. This involvement in so many responses in virtually all tissues requires them to be enormously flexible but their phenotypic and functional heterogeneity have made it difficult to delineate the origins of macrophages in specific sites under different circumstances.
21‐hydroxylase autoantibodies are more prevalent in Turner syndrome but without an association to the autoimmune polyendocrine syndrome type I
Clinical &Experimental Immunology, Volume 0, Issue ja, -Not available-.
Vom Messwert zum Bemessungsniederschlag – ein Service der Hydrographie Österreichs
Zusammenfassung
Für viele Planungen in der Wasserwirtschaft werden Niederschläge benötigt, denen eine Wiederkehrzeit zugeordnet ist – ein Bemessungsniederschlag.
Zur Berechnung dieser Bemessungsgrundlage verwendet der Hydrographische Dienst in Österreich seit 2009 drei Methoden: die Extremwertstatistik, maximierte Modellniederschläge und eine Kombination dieser beiden Methoden.
In diesem Artikel werden die Methoden beschrieben und es wird auf eine Aktualisierung der Auswertungen im Jahr 2019 hingewiesen.
Cost and effectiveness of prescribing emollient therapy for atopic eczema in UK primary care in children and adults: a large retrospective analysis of the Clinical Practice Research Datalink
Abstract
Background
The Clinical Practice Research Datalink (CPRD) was used to evaluate the overall costs to the National Health Service, including healthcare utilisation, of prescribing emollients in UK primary care for dry skin and atopic eczema (DS&E).
Methods
Primary care patients in the UK were identified using the CPRD and their records were interrogated for the 2 years following first diagnosis of DS&E. Data from patients with (n = 45,218) and without emollient prescriptions (n = 9780) were evaluated. Multivariate regression models were used to compare healthcare utilisation and cost in the two matched groups (age, sex, diagnosis). Two sub-analyses of the Emollient group were performed between matched groups receiving (1) a colloidal oatmeal emollient (Aveeno-First) versus non-colloidal oatmeal emollients (Aveeno-Never) and (2) Aveeno prescribed first-line (Aveeno-First) versus prescribed Aveeno later (Aveeno-Subsequently). Logistic regression models calculated the odds of prescription with either potent / very potent topical corticosteroids (TCS) or skin-related antimicrobials.
Results
Costs per patient were £125.80 in Emollient (n = 7846) versus £128.13 in Non-Emollient (n = 7846) matched groups (p = 0.08). The Emollient group had fewer visits/patient (2.44 vs. 2.66; p < 0.0001) and lower mean per-visit costs (£104.15 vs. £113.25; p < 0.0001), compared with the Non-Emollient group. Non-Emollient patients had 18% greater odds of being prescribed TCS and 13% greater odds of being prescribed an antimicrobial than Emollient patients. In the Aveeno-First (n = 1943) versus Aveeno-Never (n = 1943) sub-analysis, costs per patient were lower in the Aveeno-First compared with the Aveeno-Never groups (£133.46 vs. £141.11; p = 0.0069). The Aveeno-Never group had ≥21% greater odds of being prescribed TCS or antimicrobial than the Aveeno-First group. In the Aveeno-First (n = 1357) versus Aveeno-Subsequently (n = 1357) sub-analysis, total costs were lower in the Aveeno-First group (£140.35 vs. £206.43; p < 0.001). Patients in the Aveeno-Subsequently group had 91% greater odds of being prescribed TCS and 75% greater odds of being prescribed an antimicrobial than the Aveeno-First group.
Conclusions
Acknowledging limitations from unknown disease severity in the CRPD, the prescription of emollients to treat DS&E was associated with fewer primary care visits, reduced healthcare utilisation and reduced cost. Prescribing emollients, especially those containing colloidal oatmeal, was associated with fewer TCS and antimicrobial prescriptions.
Trial registration
The study is registered at http://isrctn.com/ISRCTN91126037.
A cohabiting bacterium alters the spectrum of short RNAs secreted by Escherichia coli
Abstract
Recently, it has been found that bacteria secrete short RNAs able to affect gene expression in eukaryotic cells, while certain mammalian microRNAs 'shape the gut microbiome' altering bacterial transcriptome. The involvement of bacterial RNAs in communication with other bacteria is also expected, but has not been documented yet. Here, we compared the fractions of extremely short (12–22 nucleotides) RNAs secreted by Escherichia coli grown in a pure culture and jointly with bacteria of the Paenibacillus genus. Besides fragments of rRNAs and tRNAs, abundant in all samples, secreted oligonucleotides (exoRNAs) predominantly contained GC-rich fragments of messenger and antisense RNAs processed from regions with stable secondary structures. They differed in composition from oligonucleotides of intracellular fraction, where fragments of small regulatory RNAs were prevalent. Both fractions contained RNAs capable to form complementary duplexes, while for exoRNA samples a higher percentage of 3'-end modified RNAs and different endonuclease cleavage were detected. The presence of a cohabiting bacterium altered the spectrum of E. coli exoRNAs indicating a population-dependent control over their composition. Possible mechanisms of this effect are discussed.Genomewide copy number alteration screening of circulating plasma DNA: potential for the detection of incipient tumors
Abstract
Background
Early cancer diagnosis might improve survival rates. As circulating tumor(ctDNA) carries cancer-specific modifications, it has great potential as a non-invasive biomarker for detection of incipient tumors.Patients and methods. We collected cfDNA samples of 1002 elderly without a prior malignancy, performed whole genome massive parallel sequencing and scrutinized the mapped sequences for the presence of (sub)chromosomal copy number alterations (CNAs) predictive for a malignancy. When imbalances were detected, 6-monthly clinical follow-up was performed. Results
In 3% of participants chromosomal imbalances were detected. Follow-up analyses, including whole-body MRI screening, confirmed the presence of 5 hematological malignancies: 1 Hodgkin lymphoma, stage II; 3 non-Hodgkin lymphomas (type CLL, Rai I–Binet A; type SLL, stage III; type MALT, stage I) and 1 myelodysplastic syndrome with excess blasts, stage II. The CNAs detected in cfDNA were tumor-specific. Furthermore, 1 case was identified with monoclonal B-cell lymphocytosis, a potential precursor of B-cell malignancy. In 24 additional individuals CNAs were identified but no cancer diagnosis was made. For 9 of them, the aberrant cfDNA profile originated from peripheral blood cells. For 15 others the origin of aberrations in cfDNA remains undetermined. Conclusion(s)
Genomewide profiling of cfDNA in apparently healthy individuals enables the detection of incipient hematological malignancies as well as clonal mosaicism with unknown clinical significance. CNA screening of cellular DNA of peripheral blood in elderly has established that clonal mosaicism for these chromosomal anomalies predicts a 5 to 10-fold enhanced risk of a subsequent cancer. We demonstrate that cfDNA screening detects CNAs, which are not only derived from peripheral blood, but even more from other tissues. Since the clinical relevance of clonal mosaics in other tissues remains unknown, long-term follow-up is warranted. Taken together, this study demonstrates that genomewide cfDNA analysis has potential as an unbiased screening approach for hematological malignancies and premalignant conditions.An Algorithmic Approach to the Treatment of Frontal Fibrosing Alopecia-A Systematic Review
Publication date: Available online 28 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Yemisi Dina, Crystal Aguh
Present and future perspective of photodynamic therapy for cutaneous squamous cell carcinoma
Publication date: Available online 28 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Uma Keyal, Anil Kumar Bhatta, Guolong Zhang, Xiuli Wang
Abstract
Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer. Surgery remains the main stay of treatment but, some patients are not eligible for surgery and more importantly, lesions at critical site need nonsurgical approach for tissue preservation. In this context, photodynamic therapy (PDT) has been extensively studied as noninvasive or minimally invasive treatment and studies have shown promising results in terms of safety, efficacy and cosmetic outcome. Also, studies have proposed different mechanism for its efficacy. However, human studies demonstrating its efficacy are limited in terms of sample size and tumor depth of invasion. Exciting results are mainly seen in case report in microinvasive SCC, which is defined as SCC limited to papillary dermis. This inadequacy is due to inadequate penetration of topically applied photosensitizers through keratinized tumor surface. To overcome these hurdles, pretreatment with lasers or microneedles and encapsulation of photosensitizers into nanoparticles have been tried. Hence, present paper will discuss studies that have demonstrated the efficacy and safety of PDT for cSCC, studies that have postulated the mechanism of action of PDT, agents that have been used as PDT enhancers and finally, the recent use of adjuvant therapy in combination with PDT.
Gastrointestinal parasites of zoonotic importance observed in the wild, urban, and captive populations of non‐human primates in Malaysia
Journal of Medical Primatology, EarlyView.
Membrana basal: fundamentos moleculares en las enfermedades ampollosas
Publication date: Available online 28 October 2018
Source: Piel
Author(s): Andrea Ortiz Flórez, Raquel Eraso Bravo
Estudio retrospectivo del tratamiento sistémico de la dermatitis atópica grave con azatioprina. Eficacia y tolerancia en 11 pacientes pediátricos
Publication date: Available online 28 October 2018
Source: Actas Dermo-Sifiliográficas
Author(s): L. Noguera-Morel, N. Knöpfel, A. Torrelo, A. Hernández-Martín
Resumen
Antecedentes
La dermatitis atópica (DA) es una enfermedad inflamatoria crónica de la piel típicamente infantil cuyas formas graves pueden afectar intensamente la calidad de vida del paciente. Existen formas refractarias al tratamiento convencional en las que es preciso emplear inmunosupresores sistémicos como la azatioprina (AZA) para alcanzar un buen control de la enfermedad.
Objetivo
Evaluar la eficacia y la tolerancia de la AZA en niños con DA grave.
Pacientes y métodos
Se realizó una revisión retrospectiva de niños con DA grave tratados con AZA entre enero de 2007 y mayo de 2017.
Resultados
Se revisaron 11 pacientes (6 varones, 5 mujeres) con una edad promedio de 13 años (rango 8-18 años). La edad media ± DE al inicio del tratamiento fue de 10,9 ± 2,2 años (IC 95% 8,6-13,1). La media de la dosis inicial de AZA fue de 1,8 ± 0,2 mg/kg/d. Evaluamos la respuesta al tratamiento de nuestros pacientes a las 4 semanas, entre la semana 12 y la 16, y a partir de los 6 meses. La media del tratamiento fue de 10,8 ± 5,7 meses. Dos pacientes tuvieron que suspender el tratamiento por efectos adversos. Siete de los 9 pacientes restantes presentaron un aclaramiento completo o casi completo de la DA a los 6 meses de tratamiento.
Conclusión
En nuestra experiencia, la AZA es bien tolerada y puede ser considerada como una opción terapéutica en los niños con DA grave refractaria a tratamientos convencionales.
Abstract
Background
Atopic dermatitis (AD) is a chronic inflammatory skin disease that typically affects children. Severe forms may have a profound effect on patients' quality of life. Some forms are resistant to conventional treatment and require the use of systemic immunosuppressants such as azathioprine (AZA) to adequately manage the disease.
Objective
To evaluate the effectiveness and tolerance of AZA in children with severe AD.
Patients and methods
We performed a retrospective study of children with severe AD treated with AZA between January 2007 and May 2017.
Results
We reviewed the cases of 11 patients (6 boys and 5 girls) with a mean age of 13 years (range, 8-18 years). The mean (SD) age at start of treatment was 10.9 (2.2) years (95% CI 8.6-13.1). The mean initial dosage of AZA was 1.8 (0.2) mg/kg/d. We evaluated treatment response after 4 weeks, 12 to 16 weeks, and 6 months. Mean treatment duration was 10.8 (5.7) months. Treatment had to be suspended in 2 patients because of adverse effects. Seven of the 9 remaining patients presented complete or almost complete clearance of the AD after 6 months of treatment.
Conclusion
In our experience, AZA is well tolerated and may be considered as a treatment option in children with severe AD resistant to conventional treatment.
Características clínico-epidemiológicas del carcinoma de células de Merkel en una serie de 38 pacientes
Publication date: Available online 28 October 2018
Source: Actas Dermo-Sifiliográficas
Author(s): M. Dañino-García, J.J. Domínguez-Cruz, C. Pérez-Ruiz, J. Conejo-Mir, J.J. Pereyra-Rodríguez
Resumen
Introducción
El carcinoma de células de Merkel (CCM) es un tumor cutáneo muy agresivo y de mal pronóstico, aunque la incidencia es muy baja. Existen pocas series que analicen la experiencia en un mismo centro.
Metodología
Estudio observacional, descriptivo y retrospectivo de todos los pacientes diagnosticados en un hospital de tercer nivel entre 2002 y 2017. Se recogieron las características epidemiológicas, clínicas, histológicas, el tratamiento y la supervivencia, y se dividió la muestra en 2 períodos para el análisis (2002-2009 y 2010-2017). Se realizó un análisis de supervivencia mediante el modelo de Kaplan-Meier y un análisis multivariante mediante el modelo de riesgos proporcionales de Cox.
Resultados
Se incluyó a 38 pacientes, 24 hombres y 14 mujeres, con una edad media 77,76 años. El período medio de seguimiento fue de 30,11 meses. Se observó un aumento del 116% (12 vs. 26) entre los años 2002-2009 y 2010-2017, así como una edad media más avanzada (70,92 vs. 80,92; p < 0,05) y un incremento de lesiones en tronco y miembros inferiores (34,62% vs. 0%). Once pacientes fallecieron debido al CCM. La supervivencia global a los 12 meses en la serie fue del 78,2% y a los 24 meses del 69,3%. Los factores asociados a mortalidad fueron la edad mayor de 70 años y la afectación ganglionar, mientras que la localización en miembros superiores y la realización de ampliación de márgenes aumentó la supervivencia. Al realizar el análisis multivariante, solo la afectación de ganglios permaneció como factor pronóstico.
Conclusiones
Se ha observado un aumento de la frecuencia en los últimos años y un cambio en la forma de presentación a edades más avanzadas y en otras localizaciones diferentes a las clásicas.
Abstract
Background
Merkel cell carcinoma is a rare yet aggressive cutaneous tumor with a poor prognosis. Few studies have analyzed series of patients from the same hospital.
Methodology
We performed a retrospective, descriptive, observational study of all patients diagnosed with Merkel cell carcinoma at a tertiary care hospital between 2002 and 2017. We recorded epidemiological, clinical, and histologic data and information on treatments and survival. For analysis, the sample was divided into 2 groups from different periods: 2002-2009 and 2010-2017. We performed survival analysis using Kaplan-Meier curves and multivariate analysis using a Cox proportional hazards model.
Results
Thirty-eight patients (24 men and 14 women) with a mean age of 77.76 years were included. Mean follow-up time was 30.11 months. On comparing 2010-2017 with 2002-2009, we observed a 116% increase in the number of Merkel cell carcinoma cases (26 vs. 12), an older mean age at diagnosis (80.92 vs. 70.92 years, P<.05), and an increase in lesions located on the trunk and lower limbs (0% vs. 34.62%). Eleven patients died of Merkel cell carcinoma. Overall survival was 78.2% at 12 months and 69.3% at 24 months. In the univariate analysis, age over 70 years and lymph node involvement were associated with mortality, while tumor location on the upper extremities and wide surgical excision were associated with improved survival. Only lymph node involvement retained its prognostic significance in the multivariate analysis.
Conclusions
In this series, we observed that Merkel cell carcinoma has become more common in recent years and is now diagnosed at an older age and found in new anatomic locations.
Graphical abstract
Factors associated with variability in the prevention of pressure ulcers
Publication date: Available online 28 October 2018
Source: Journal of Tissue Viability
Author(s): Ana Belén Moya-Suárez, José Carlos Canca-Sánchez, Margarita Enríquez de Luna-Rodríguez, Marta Aranda-Gallardo, José Miguel Morales-Asencio
Evaluating the Risk Assessment Approach of the REACH Legislation: A Case Study
Abstract
Risk assessments based on occupational exposure to chemicals have increased since REACH (European regulation on Registration, Evaluation, Authorization, and restriction of Chemicals) came into force. The European Chemicals Agency (ECHA) recommends that chemical exposure could be calculated using exposure models and that parameters used to calculate the exposure scenario (ES) should be communicated in extended safety data sheets (e-SDS) as workplace instructions which downstream users are obligated to follow. We aimed to evaluate REACH's risk assessment approach using the Stoffenmanager® 6.1, the Advanced REACH Tool 1.5 (ART), and the European Centre for Ecotoxicology and Toxicology of Chemicals' targeted risk assessment (ECETOC TRA 3.1) exposure models. We observed 239 scenarios in three companies handling chemicals using 45 e-SDS. Risk characterization ratios (RCRs) were calculated by dividing estimated exposures by derived no-effect levels (DNELs). Observed RCRs were much lower than registered RCRs, indicating lower exposures. However, about 12% of the observed ES still had RCRs > 1, after adjustment for control measures and personal protections described in the ES, when using Stoffenmanager®. The ES with observed RCRs > 1 were the same by Stoffenmanager® and ART, but not by ECETOC TRA. Stoffenmanager and ART identified 25 adjusted scenarios with RCR > 1, while ECETOC TRA gave RCR < 1 for the same scenarios. The ES with RCR > 1 were significantly associated to chemicals with higher vapour pressure and lower DNELs than ES with RCR < 1 by Stoffenmanager®. The correlations between observed and registered RCRs were lower than those between RCRs calculated from the different models themselves; ECETOC TRA had the lowest correlation with the registered ES. These results put in question the generic ES recommended under the REACH legislation. Downstream users may get better estimates by assessing their own ES, especially for chemicals with low DNELs and high vapour pressure.Skleromyxödem
Zusammenfassung
Das Skleromyxödem ist eine sehr seltene Erkrankung, die gewöhnlich in Verbindung mit einer monoklonalen Gammopathie auftritt und systemische Symptome aufweisen kann. Die Pathogenese des Skleromyxödems ist unbekannt. Der klinische Verlauf ist chronisch und progressiv und kann zu schwerer Morbidität bzw. zum Tod führen. Der Hautbefund besteht aus multiplen wachsartigen Papeln und verhärteten Plaques. Eine fortschreitende Hautbeteiligung kann zu einer verminderten Beweglichkeit von Mund und Gelenken führen. Extrakutane Manifestationen können im Nerven-, muskuloskeletalen oder kardiovaskulären System, im Gastrointestinal- oder Atemtrakt oder an den Nieren auftreten. Eine für das Skleromyxödem zugelassene oder evidenzbasierte Therapie gibt es nicht. Als Therapie der ersten Wahl gelten hoch dosierte Immunglobuline, gefolgt von Lenalidomid (bzw. Thalidomid) und systemischen Glukokortikosteroiden, bei schweren Verläufen auch eine autologe hämatopoetische Stammzelltransplantation. In der Regel treten nach Absetzen einer erfolgreichen Therapie Rezidive auf, sodass eine engmaschige interdisziplinäre Anbindung ratsam ist.
Aktuelle pathophysiologische Entwicklungen bei fibrosierenden Erkrankungen: Ansatzpunkte für neue Konzepte in der Therapie
Zusammenfassung
Die Fibrose ist ein häufiges Symptom zahlreicher Hauterkrankungen unterschiedlicher Genese. Die Pathogenese fibrosierender Veränderungen der Haut und anderer Organsysteme ist bisher nicht ausreichend verstanden, und die derzeitigen Therapiemöglichkeiten sind unzureichend. Fibrosierende Erkrankungen der Haut führen zu einer Gewebeverhärtung und zu einem Funktionsverlust, die in der Folge mit schwerwiegenden Einschränkungen der Lebensqualität, gesteigerter Morbidität und letztlich einer erhöhten Mortalität einhergehen können. Epidemiologische Studien weisen darauf hin, dass in den westlichen Industrienationen bis zu 45 % aller Todesursachen auf Erkrankungen zurückzuführen sind, die mit einer Gewebefibrose in unterschiedlichen Organen einhergehen. Aktuell stehen nur wenige spezifisch für fibrosierende Erkrankungen zugelassene Medikamente zur Verfügung. Die Entwicklung neuer, ursachenbasierter und damit effizienter Therapieansätze ist dringend erforderlich. Dies stellt einerseits eine große Herausforderung dar, eröffnet zugleich aber auch die Möglichkeit, einen besonderen Beitrag zur Aufklärung dieses medizinisch ungelösten Problems zu leisten. Im Folgenden sind ausgewählte Erkenntnisse der letzten Jahre mit Fokus auf der Rolle der Immunantwort in der Fibrogenese dargestellt.
Wenn Sonnenschutzprodukte nicht mehr helfen: Allergisches Kontaktekzem auf UV-Filter
Zusammenfassung
UV-Filtersubstanzen können sowohl allergische als auch häufiger photoallergische Kontaktekzeme auslösen. Deshalb sollte bei Verdacht auf eine Kontaktsensibilisierung gegenüber Lichtschutzmittel immer eine Photopatchtestung durchgeführt werden. Wir berichten über eine 65-jährige Frau mit seit 11 Jahren verstärkt nach Sonnenexposition auftretender Rötung der Haut im Gesichts- und Dekolletébereich trotz Anwendung eines Lichtschutzpräparates. Anhand der (Photo‑)Patchtestung konnte die Diagnose eines allergischen Kontaktekzems auf den UV-Filter 4-tert-Butyl-4'-methoxybenzoylmethan etabliert werden. Unter der Therapie mit einem topischen Glukokortikosteroid und Meidung der kausalen UV-Filtersubstanz kam es zur raschen Abheilung.
Aktuelle Therapie der systemischen Sklerodermie
Zusammenfassung
Die systemische Sklerose (SSc, Sklerodermie) ist eine schwere chronisch entzündliche Bindegewebserkrankung der Haut, des muskuloskeletalen Systems und vieler innerer Organe. Der heterogene, langjährige Verlauf dieser Erkrankung mit dem Befall multipler Organe stellt eine besondere Herausforderung an den betreuenden Arzt dar. Die therapeutischen Möglichkeiten haben sich in den vergangenen Jahren in verschiedenen Bereichen entscheidend verbessert. Diese positiven Entwicklungen haben dazu geführt, dass in verschiedenen Arbeitsgruppen abgestimmte Empfehlungen zur Behandlung der SSc veröffentlicht wurden. Ziel dieser Übersicht ist es, die wesentlichen Empfehlungen vorzustellen und in ein Konzept einer modernen interdisziplinären Betreuung einzubetten.
Scleroedema adultorum
Zusammenfassung
Das Scleroedema adultorum (SA) ist eine seltene skleromuzinöse Erkrankung nicht geklärter Ätiologie, die charakteristischerweise zu brettharten Indurationen im Bereich des Nackens und oberen Rumpfes führt. Drei Typen des SA werden entsprechend ihrer Assoziation zu vorbestehenden bzw. zugrunde liegenden Erkrankungen unterschieden: SA bei Infektionen (v. a. Streptokokkeninfektionen der oberen Atemwege), SA bei monoklonaler Gammopathie und SA bei Diabetes mellitus. Die klinische Ausprägung, Schwere der Erkrankung und Verlauf variieren je nach Subtyp stark. Es existieren bisher keine evidenzbasierten Therapiestandards für das SA. Während spontane Remissionen häufig bei Infekt-assoziierten Formen des SA auftreten, kommt es beim SA im Rahmen von Diabetes mellitus oder monoklonaler Gammopathie in der Regel zu einem chronisch progredienten Verlauf. Zu den derzeitig empfohlenen Erstlinientherapien zählen Phototherapie und Methotrexat, eine klinische Besserung zeigt sich oftmals aber erst nach mehreren Monaten, und Therapieversagen ist häufig. Ergänzend sollte bei allen Formen des SA auch eine Physiotherapie zur Verbesserung der Beweglichkeit erfolgen.
Anaphylaxie auf Kamillentee
Zusammenfassung
Es wird über den Fall eines Patienten mit Typ-I-Allergie berichtet, die nach dem Genuss von Kamillentee auftrat. Etwa 30 min nach Konsum des Tees wurde der Patient mit Juckreiz der Handflächen, Schwellung der Augenlider, Oberlippe und der Nasenschleimhaut sowie Globusgefühl hospitalisiert. Ein hereditäres Angioödem konnte ausgeschlossen werden. Im Pricktest wurde die Diagnose einer Typ-I-Allergie auf Kamillentee bestätigt.
Sandmückenfieber – eine „vernachlässigte“ Krankheit
Zusammenfassung
Eine 45-jährige Patientin stellte sich mit Fieber, Durchfall, Gliederschmerzen, allgemeinem Krankheitsgefühl und einem juckenden papulösen Exanthem in der Ambulanz eines tropenmedizinischen Zentrums zur weiteren Diagnostik vor. Sie hatte zuvor 11 Tage Urlaub mit ihrer Familie in einem Bergdorf in Nordzypern gemacht. Dort habe es sehr viele kleine, stechende Fliegen oder Mücken gegeben. Nach der Rückkehr erkrankten sie und ihre Familie. Die körperliche Untersuchung war bis auf das Exanthem an den Beugeseiten der Extremitäten unauffällig. In der Routineblutuntersuchung fielen eine deutliche Erhöhung der Transaminasen und ein nur geringfügig erhöhtes C‑reaktives Protein (CRP) auf. Unter Berücksichtigung des Reiselandes, des Hinweises auf die „stechenden Fliegen" und der Klinik wurde in die differenzialdiagnostischen Überlegungen zur Ursache der Hepatitis auch das sog. Sandmückenfieber einbezogen. Es konnten Antikörper gegen das sizilianische Sandmückenfiebervirus (SFSV) nachgewiesen werden, die im Verlauf eine typische Dynamik zeigten, sodass die Diagnose eines Pappataci-Fiebers gestellt wurde. Die Kasuistik und eine kurze Zusammenstellung von Informationen über den Erreger, den Vektor, die Epidemiologie, Klinik, Diagnostik und Therapiemöglichkeiten sollen dazu anregen, Phlebovirusinfektionen als mögliche Differenzialdiagnose zu berücksichtigen, wenn Reisende oder Flüchtlinge nach Aufenthalt im Mittelmeerraum an schweren fieberhaften Erkrankungen mit Hepatitis und Hauterscheinungen oder aseptischen viralen Meningitiden erkranken.
Unzureichender Tetanusimpfschutz bei Psoriasis und systemischer Immunsuppression
Zusammenfassung
Hintergrund
Psoriasis gehört mit einer Prävalenz von ca. 3 % weltweit zu den häufigsten entzündlichen Dermatosen. Patienten mit mittelschwerer bis schwerer Psoriasis werden leitliniengemäß mit immunmodulatorischen bzw. -suppressiven Substanzen behandelt. Aktuelle Leitlinien weisen darauf hin, dass auf den Impfstatus immunsupprimierter Patienten geachtet werden sollte.
Ziel der Arbeit (Fragestellung)
Das Ziel unserer Untersuchung war es, den Tetanusimpfstatus von systemisch therapierten Patienten mit moderater bis schwerer Psoriasis in Deutschland serologisch zu objektivieren.
Material und Methoden
Im Rahmen der vorliegenden retrospektiven Studie wurden die Konzentrationen von Immunglobulin(Ig)G-Antikörpern gegen Clostridium tetani bei 101 Psoriasispatienten mit überwiegend systemischer Immunsuppression bestimmt.
Ergebnisse
Bei insgesamt 27,7 % der Patienten (11 Männer, 17 Frauen) wurden unzureichende IgG-Antikörper-Konzentrationen nachgewiesen, was einem fehlendem Impfschutz bezüglich einer Infektion mit C. tetani entspricht. Subgruppenanalysen zeigten bei 50 % der Patienten im Alter ≥65 Jahre einen insuffizienten Tetanusschutz.
Schlussfolgerung
Die Daten stehen im Einklang mit den Impfschutzraten in der deutschen Gesamtbevölkerung. Die Ergebnisse unterstreichen, dass Psoriasispatienten auf ihren Tetanusschutz hin untersucht werden sollten und die erforderlichen Impfungen, wenn nötig, insbesondere bei Patienten mit systemischen immunmodulierenden bzw. -supprimierenden Therapien, aufgefrischt werden müssen.
Negative remnant 99m Tc-pertechnetate uptake predicts excellent response to radioactive iodine therapy in low- to intermediate-risk differentiated thyroid cancer patients who have undergone total thyroidectomy
Abstract
Objective
Negative 99mTc-pertechnetate uptake of the thyroid bed indicates the absence or a small volume of remnant thyroid tissue (RTT) after total thyroidectomy (TT). The aim of this study is to evaluate the predictive value of negative 99mTc-pertechnetate scintigraphy for excellent response (ER) to radioactive iodine therapy (RIT) in low- to intermediate-risk differentiated thyroid cancer (DTC) patients.
Patients
One-hundred and eighty-nine low- to intermediate-risk DTC patients who underwent TT, RIT with a single dose of 30 mCi and suppressive therapy with thyroid-stimulating hormone (TSH) from July 2015 to February 2016 in our hospital were retrospectively evaluated. 99mTc-pertechnetate thyroid scintigraphy was performed just before RIT and images were reported dichotomously as negative or positive. The response of patients was assessed for 23.2 ± 3.8 months after RIT and dichotomized as excellent response (ER) or non-excellent response (NER). 99mTc-pertechnetate uptake, age at diagnosis, gender, multifocality, T stage, N stage, preablative stimulated thyroglobulin (ps-Tg), and TSH were explored as potential predictors for ER.
Results
80.68% (71/88) of patients with negative 99mTc-pertechnetate uptake achieved ER. When patients were evaluated according to different ps-Tg levels, we found that 94.83% (55/58) of patients with ps-Tg < 1 ng/ml and negative 99mTc-pertechnetate uptake achieved ER. Multivariate Cox regression analysis revealed that ps-Tg (P = 0.0001) and 99mTc-pertechnetate uptake (P = 0.0473) were independent predictors for ER.
Conclusions
In addition to ps-Tg, negative 99mTc-pertechnetate uptake is also a significant independent predictor for an excellent response in low- to intermediate-risk patients. It may be possible to omit RIT in patients with ps-Tg < 1 ng/ml and concurrent negative 99mTc-pertechnetate uptake.
Prevalence of contact allergy in the general population: A systematic review and meta‐analysis
Contact Dermatitis, EarlyView.
Patient Education in Atopic Dermatitis: Why It Is Needed and How to Improve It
Abstract
Purpose of Review
Demonstrate the need and objectives of patient education in atopic dermatitis (AD), provide an overview of the most recent studies regarding patient education, and propose new approaches to improve educational programs.
Recent Findings
Different models of patient education programs exist, and their structures depend on social and economic conditions. An active participation of patients is needed to improve new models of educational programs. Healthcare professionals who work with AD patients must have a comprehensive view of the many aspects involved in this disease, which includes psychological, environmental, social, financial, and cultural aspects.
Summary
AD is a complex disease and has a clear impact in patients' quality of life. Patients are often frustrated and confused by the information they receive. This information can often be conflicting and overwhelming. Education for patients with AD is now being proposed as an important step in major treatment guidelines. Most studies of patient education demonstrate a positive impact in patients' clinical outcomes, adherence, and quality of life.
Suprapubic catheterization is expedient for the surgical excision of female genital tumors
Dermatologic Therapy, EarlyView.
Cutaneous localization of angioimmunoblastic T‐cell lymphoma may masquerade as B cell lymphoma or classical Hodgkin lymphoma: a histologic diagnostic pitfall
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Revisiting Prepectoral Breast Augmentation: Indications and Refinements
Abstract
Background
Prepectoral breast reconstruction is receiving renewed attention as a viable alternative to retropectoral reconstruction. Prepectoral breast augmentation needs to be reappraised, as patients increasingly demand safer and less invasive procedures with a shorter recovery period. Objective
This study aimed to evaluate prepectoral breast augmentation combined with a microtextured prosthesis to determine whether it could be a useful alternative to retropectoral augmentation. Methods
This study included 76 women (152 breasts) who were indicated for primary breast augmentation. The inclusion criterion was a pinch test result of more than 3 cm at the upper pole of the breast. A total subfascial dissection was performed with endoscopic assistance. Microtextured implants were placed through an axillary approach in the subfascial space. Results
The mean follow-up period was 12 months (range, 6–23 months). The mean implant volume was 278.1 mL (range, 185–360 mL). Autologous fat grafts were applied in 12 patients. No patients developed seroma, capsular contracture or malposition during the follow-up period. Two patients expressed concerns of minor contour visibility, but no patients required revisional surgery. Conclusions
The drawbacks of prepectoral implant placement were sought to be managed by fascial coverage and microtextured prostheses. Although the follow-up duration was short, major complications were not encountered with Motiva Ergonomix SilkSurface implants. Therefore, prepectoral augmentation with microtextured prostheses should be reconsidered as a potential alternative to retropectoral methods because of the recent advances in surgical techniques and device technology.Is Histological Evaluation of Reduction Mammaplasty Specimens Worthwhile?
Abstract
Background
Reduction mammaplasty (RM) is one of the most common plastic surgery procedures. Despite its cost, the total number of RM procedures continues to increase every year. Objectives
The purpose of this study is to review the prevalence of benign and malignant breast lesions among women who live in Aegean region of Turkey, based on our university hospital's records and to compare our results with those in the literature. Methods
Seven hundred and thirty-three consecutive female patients who underwent RM between January 2003 and January 2017 in the Department of Plastic, Reconstructive, and Aesthetic Surgery were included in this study. Results
One hundred and sixty-five patients (23.4%) had preoperative breast imaging results. Most of these patients had BI-RADS-2 and BIRADS-1 findings (41.21% and 40%, respectively). Fibrocystic changes were the most common lesions (81.3%). Sixty-eight patients (9.6%) had normal breast tissue on the right side and 34 patients (4.8%) had the same on the left side. Five patients (0.71%) had atypical ductal hyperplasia and no atypical lobular carcinoma. Four patients (0.56%) had occult breast cancer and one patient (0.14%) had benign phyllodes tumor. Conclusion
RM is a good opportunity to detect proliferative lesions and occult breast cancer. While meeting the patient's aesthetic desires, the plastic surgeon should consider for histopathological evaluation. We suggest that every part of the breast tissue should be sent to pathological examination regardless of the weight of the specimen. Even if health insurance doesn't cover its cost, patients should be informed about the importance of this process.Κυριακή 28 Οκτωβρίου 2018
Pathological Features and Clinical Course in Patients With Recurrent or Malignant Orbital Solitary Fibrous Tumor/Hemangiopericytoma
Purpose: A risk assessment score for metastasis based on age, tumor size, and mitotic figures has been suggested for nonorbital solitary fibrous tumor (SFT)/hemangiopericytoma. The authors herein examine the clinicopathological features of recurrent and metastatic orbital SFT and evaluate the existing risk assessment score for orbital SFT. Methods: The American Society of Ophthalmic Plastic and Reconstructive Surgery Oncology Database was queried for patients with recurrent or malignant orbital hemangiopericytoma/SFT. The medical records were reviewed for clinical and pathologic findings, treatments, and outcomes. Results: Eight patients from 3 institutions were identified with recurrent orbital hemangiopericytoma/SFT. Median age at diagnosis was 59 years, and 4 patients were women. The mean size of tumor was 2.1 ± 1.1 cm. All patients were initially treated with surgery and experienced local recurrence after a median of 4 (range 0.5–10) years. Five patients were treated with orbital radiation. Two patients also developed distant metastases and eventually died of their disease. Median Ki-67 was 5% (range 1–65%) and 5 mitotic figures/10 high-power fields (range 2–30). The previously described risk stratification model for nonorbital SFT did not correlate with the propensity to develop metastases in this cohort; however, both patients with distant metastasis had > 4 mitotic figures /10 high-power fields. Conclusions: In this cohort of recurrent orbital hemangiopericytoma/SFT, median time to recurrence was 4 years underscoring the importance of careful continued follow-up. The current risk stratification models have limited use for orbital lesions, mostly due to the fact that orbital SFTs are smaller than even the smallest size criteria in this risk assessment model. Accepted for publication June 17, 2018. This work was supported in part by the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) Foundation through their support of the ASOPRS Oncology Database at MD Anderson Cancer Center. The authors have no conflicts of interest to disclose. Presented at the American Society of Oculoplastic and Reconstructive Surgery Fall Meeting on November 10, 2017 in New Orleans, LA. Address correspondence and reprint requests to Bita Esmaeli, M.D., F.A.C.S., Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, Unit 1488, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030. E-mail: besmaeli@mdanderson.org © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.
Clinical, endoscopic, and histologic characteristics of lymphocytic esophagitis: a systematic review
Abstract
Objective
Lymphocytic esophagitis (LyE) is a novel, yet poorly described, clinicopathologic entity. The aim of this systematic review was to characterize the demographic, clinical, endoscopic, and histologic features of LyE in observational studies of adult and pediatric patients.
Design
We searched the Embase, MEDLINE, and SCOPUS databases for relevant studies in 2018. Two authors reviewed and extracted data from studies that met the inclusion and exclusion criteria.
Results
We identified 20 studies for analysis of demographic, clinical, and endoscopic features of LyE. The mean age ranged from 9 to 67 years. When pooled, there were 231 (52.7%) patients with LyE that were female. The most common presenting symptom was dysphagia reported in 191 (48.8%) patients. On endoscopy, most patients with LyE tended to have abnormal findings (69.0%), which included erosive esophagitis, multiple esophageal rings, linear furrows, and narrow-caliber esophagus. In the 31 studies used to assess the histologic definition, the cut-off number of intraepithelial lymphocytes (IELs) was reported in 16 (51.6%) studies, peripapillary IEL specification in 18 (58.1%) studies, and presence of spongiosis in 6 (19.4%) studies.
Conclusion
We identified a spectrum of demographic, clinical, and endoscopic findings characteristic of patients with LyE. A consensus on the diagnostic criteria of LyE is required.
Vocal fold paresis as a surgical complication: our 10‐year experience with 162 incidents
Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.
A predominant Th1 polarization is present in synovial fluid of end‐stage osteoarthritic knee joints – analysis of peripheral blood, synovial fluid & synovial membrane
Clinical &Experimental Immunology, Volume 0, Issue ja, -Not available-.
Anti‐β2‐glycoprotein I antibody with DNA binding activity enters living monocytes via cell surface DNA & induces tissue factor expression
Clinical &Experimental Immunology, Volume 0, Issue ja, -Not available-.
Indications of Transnasal Humidified Rapid‐Insufflation Ventilatory Exchange (THRIVE) in laryngoscopy, a prospective study of 19 cases
Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.
Interleukin‐33 encourages scar formation in murine fetal skin wounds
Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.
Comparing the influence of two immunosuppressants (fingolimod, azathioprine) on wound healing in a rat model of primary and secondary intention wound closure
Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.
Pioneers in dermatology and venereology: an interview with Prof. Sam Shuster
Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 11, Page 1841-1844, November 2018.
The Dermatologist and psoriatic arthritis
Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 11, Page 1836-1837, November 2018.
Review of a recently delineated longitudinal lesion of the nail: onychopapilloma
Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 11, Page 1839-1840, November 2018.
Health economy in dermatology
Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 11, Page 1835-1835, November 2018.
Issue Information
Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 11, Page 1829-1834, November 2018.
Announcement
Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 11, Page 2042-2042, November 2018.
Forthcoming Events
Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 11, Page 2041-2041, November 2018.
Professional soccer and skin temperature
Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue 11, Page 1838-1838, November 2018.
Gerontodermatology: the fragility of the epidermis in older adults
Journal of the European Academy of Dermatology and Venereology, Volume 32, Issue S4, Page 1-20, November 2018.
Feathered Friends Large And Small Flock On Cornell's 'Wall Of Birds'
Artist Jane Kim was nicknamed "Michaelangela" for her work on Cornell's massive Wall of Birds mural — 40 feet high and 100 feet wide, capturing 375 million years of avian evolution in paint.
(Image credit: Courtesy of Ink Dwell)
Coastal Pacific Oxygen Levels Now Plummet Once A Year
Scientists credit the crab and oyster industries with noticing a change in oxygen levels in coastal Pacific waters.
(Image credit: Kristian Foden-Vencil/NPR)
Robust navigation support in lowest dose image setting
Abstract
Purpose
Clinical cardiac electrophysiology (EP) is concerned with diagnosis and treatment of cardiac arrhythmia describing abnormality or perturbation in the normal activation sequence of the myocardium. With the recent introduction of lowest dose X-ray imaging protocol for EP procedures, interventional image enhancement has gained crucial importance for the well-being of patients as well as medical staff.
Methods
In this paper, we introduce a novel method to detect and track different EP catheter electrodes in lowest dose fluoroscopic sequences based on \(\ell _1\) -sparse coding and online robust PCA (ORPCA). Besides being able to work on real lowest dose sequences, the underlying methodology achieves simultaneous detection and tracking of three main EP catheters used during ablation procedures.
Results
We have validated our algorithm on 16 lowest dose fluoroscopic sequences acquired during real cardiac ablation procedures. In addition to expert labels for 2 sequences, we have employed a crowdsourcing strategy to obtain ground truth labels for the remaining 14 sequences. In order to validate the effect of different training data, we have employed a leave-one-out cross-validation scheme yielding an average detection rate of \(86.9\%\) .
Conclusion
Besides these promising quantitative results, our medical partners also expressed their high satisfaction. Being based on \(\ell _1\) -sparse coding and online robust PCA (ORPCA), our method advances previous approaches by being able to detect and track electrodes attached to multiple different catheters.
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Does CBD Oil Lower Blood Pressure? This article was originally published at SundayScaries." Madeline Taylor POSTED ON January 13, 20...
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Publication date: Available online 28 September 2017 Source: Actas Dermo-Sifiliográficas Author(s): F.J. Navarro-Triviño
