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Παρασκευή 3 Αυγούστου 2018

A Review of Workplace Risk Management Measures for Nanomaterials to Mitigate Inhalation and Dermal Exposure

Abstract
This review describes an evaluation of the effectiveness of Risk Management Measures (RMM) for nanomaterials in the workplace. Our aim was to review the effectiveness of workplace RMM for nanomaterials and to determine whether established effectiveness values of conventional chemical substances applied for modelling purposes should be adopted or revised based on available evidence. A literature review was conducted to collate nano-specific data on workplace RMM. Besides the quantitative efficacy values, the library was populated with important covariables such as the study design, measurement type, size of particles or agglomerates/aggregates, and metrics applied. In total 770 records were retrieved from 41 studies for three general types of RMM (engineering controls, respiratory equipment and skin protective equipment: gloves and clothing). Records were found for various sub-categories of the different types of RMM although the number of records for each was generally limited. Significant variation in efficacy values was observed within RMM categories while also considering the respective covariables. Based on a comparative evaluation with efficacy values applied for conventional substances, adapted efficacy values are proposed for various RMM sub-categories (e.g. containment, fume cupboards, FFP2 respirators). It is concluded that RMM efficacy data for nanomaterials are limited and often inconclusive to propose effectiveness values. This review also shed some light on the current knowledge gaps for nanomaterials related to RMM effectiveness (e.g. ventilated walk-in enclosures and clean rooms) and the challenges foreseen to derive reliable RMM efficacy values from aggregated data in the future.

Photo-mediated Biosynthesis of Silver Nanoparticles Using the Non-edible Accrescent Fruiting Calyx of Physalis peruviana L. Fruits and Investigation of its Radical Scavenging Potential and Cytotoxicity Activities

Publication date: Available online 4 August 2018

Source: Journal of Photochemistry and Photobiology B: Biology

Author(s): Jayanta Kumar Patra, Gitishree Das, Anuj Kumar, AbuZar Ansari, Hojun Kim, Han-Seung Shin

Abstract

Silver nanoparticles (AgNPs) have been synthesized by various ways but the green technology methods using food waste materials has been accepted now a days for their cost effectiveness, environmental friendly and effective biomedical application. In the present study an attempt has been made to synthesize AgNPs by using the outer accrescent fruiting calyx of Physalis peruviana fruits, a food waste material under different light source condition, and to investigate their cytotoxic activity against the HepG2 cells as well as their antibacterial and radical scavenging potential. The surface morphology and elemental composition of the biosynthesized AgNPs were evaluated by scanning electron microscopy, energy-dispersive X-ray analysis, and X-ray powder diffraction analysis. Fourier transform infrared spectroscopy of the sample extract and AgNPs was performed to determine the involvement of functional groups in the synthesis, capping, and stabilization process. The AgNPs showed promising cytotoxic activity against the HepG2 cells in a dose-dependent manner. The biosynthesized AgNPs also exhibited moderate antibacterial activity (8.14–10.22 mm inhibition zones) against two Gram-negative pathogenic bacteria with promising radical scavenging potential. Overall, the results highlight the effectiveness of the AgNPs for use in antibacterial wound dressing materials and other biomedical applications for the treatment of critical diseases such as cancer.



Synthesis, X-ray structure, DFT and antimicrobial studies of Ag(I) complexes with nicotinic acid derivatives

Publication date: Available online 4 August 2018

Source: Journal of Photochemistry and Photobiology B: Biology

Author(s): Saied M. Soliman, Sobhy E. Elsilk

Abstract

The [Ag(Menic)2(ClO4)]2, (1) and [Ag(NA)2]ClO4, (2) complexes, where Menic; methylnicotinate and NA; nicotinamide, were synthesized and characterized using elemental analysis, FTIR, NMR and single crystal X-ray diffraction combined with DFT calculations. The Ag(I) is coordinated with two organic ligand molecules in both complexes. In 1, the coordination sphere is completed by one ClO4¯ anion as a monodentate ligand while in 2, the ClO4¯ anion is in the outer sphere. Both complexes showed some argentophilic interactions where the AgsbndAg distance is shorter in 1 (3.152(6) Å) than 2 (3.303(9) Å). The organic ligands showed no antimicrobial activity up to 15 mmole/L while both silver(I) complexes are biologically active against different bacterial strains and the fungus Candida albicans. The minimal inhibition concentrations (MICs) of the Ag(I) complexes are in the range of 4–8 mmol/L depending on the nature of microorganism. Complex 2 showed slightly better antifungal action than 1. In contrast, complex 1 showed higher antibacterial potency against P. aeruginosa, C. perfringens, Sh. sonnei and Str. pneumonia compared to 2. The antibacterial action of 2 is slightly higher or equal against the rest of microorganisms compared to 1. The strength and nature of the AgsbndAg, AgsbndN and Ag…O interactions were analyzed using atoms in molecules and natural bond orbital calculations.

Graphical Abstract

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Reconstruction of columellar defects: which surgical technique to choose ? A retrospective study of 18 patients

Publication date: Available online 4 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Claire Bergel, Abdullah Alshukry, Nathalie Kerfant, Cecile Philandrianos, Jacques Bardot, Dominique Casanova, Baptiste Bertrand

Abstract

The reconstruction of the columella is challenging and poorly evaluated in the literature. Our study aimed to evaluate retrospectively the different techniques used in our center and to propose an algorithm of reconstruction adapted to each patient. We report a retrospective cohort study included 18 patients (9 men and 9 women; 53 years-old in average) with columellar reconstruction treated from 1999 through 2014. Six different techniques were used: chondrocutaneous graft, nasolabial flap, paramedian forehead flap and scalping flap according to the Converse technique or the Raulo technique. Four independent plastic surgeons evaluated the aesthetic result on a 10cm visual analogue scale comparing the patients' photographs before and after the reconstruction. Furthermore, we asked the patients to perform the same evaluation, and to evaluate their level of satisfaction. The mean follow-up was 4 years. Three chondrocutaneous grafts were performed to reconstruct partial defects (Surgical Evaluation (SE): 7.9, Patient Evaluation (PE): 8.3).Three bilateral nasolabial flaps (SE: 6.1, PE: 6.7), 5 paramedian forehead flap (SE: 6.9, PE: 7.3) 6 Converse scalping flap (SE: 4.9, PE: 5.4) and 1 Raulo scalping flap (SE: 6,1, PE: 6,3) were performed to reconstruct total defects exceeding the columella. The use of composite graft was the most satisfactory procedure for partial defects. Paramedian forehead flaps and Raulo scalping flap were the most satisfactory procedures for extended defects. Nasolabial flap was the most adapted procedure for patients with general anesthesia contraindication or for defects extended to the lip.



Sensory and functional morbidity following sural nerve harvest in paediatric patients

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Joseph Catapano, Mark Shafarenko, Emily S. Ho, Ronald M. Zuker, Gregory H. Borschel

Summary
Background

The sural nerve is a common donor site for nerve reconstruction. The only study describing outcomes in paediatric patients was following bilateral sural nerve harvest prior to the age of one. Bilateral nerve harvest at such a young age may limit patients' ability to perceive a sensory difference. The objective of this study was to understand the sensory and functional deficit after unilateral sural nerve harvest in paediatric patients.

Methods

A prospective case series was performed in children (age 6 to 18) following unilateral sural nerve harvest. The contralateral foot was used as a control. Sensory Threshold Evaluation was performed using Weinstein Enhanced Sensory Test (WEST) – Foot and a Functional Sensory and Pain Questionnaire was administered. Sural nerve harvest was performed using a minimally invasive technique using a nerve stripper.

Results

Twenty-eight feet of fourteen patients that underwent unilateral sural nerve harvest were assessed. As a group, the fourteen feet with sural nerve harvest demonstrated significantly higher thresholds in the four areas tested (p < 0.05), identifying objective sensory loss at each location. The location of sensory loss in each patient was variable with heavier sensory thresholds detected in 69.6 % of areas tested in comparison to the corresponding location in the contralateral foot. Greater sensory loss was detected at the proximal lateral foot in comparison to the distal lateral foot. Responses to the questionnaire revealed that only one patient perceived a sensory loss that affected their function.

Conclusions

Unilateral sural nerve harvest in paediatric patients results in measurable sensory loss. Despite loss of innervation, only two patients reported intermittent dysesthesia or cold-sensitivity and the majority of patients report no functional deficit.



Post oncological lacrimal duct reconstruction; a practical classification system for reconstructive planning and short-term results of a case series.

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): M.V. van Burink, H.A. Rakhorst, G.M. van Couwelaar, U. Schmidbauer

Summary / Abstract
Background

: Surgical resection of skin tumors in the medial canthal area may damage the lacrimal duct and can result in chronic ephiphora. Post oncologic reconstruction of the lacrimal duct has not been studied extensively. The current study discusses the anatomical and functional features of the lacrimal duct. It describes short-term functional outcomes after monocanalicular reconstruction of the lacrimal duct in a case series of 10 patients.

Methods

: From February 2015 until October 2017 all patients with a post oncological lacrimal duct defect were analyzed to make an anatomical classification. The functional outcomes of patients, after monocanalicular reconstruction was measured with the Munk scale up to three months after stent removal.

Results

: Twelve patients had lacrimal duct defects after mohs resection. Anatomical characteristics were used to create a clinical classification for lacrimal duct defects. This classification divides the upper (U) and lower (L) proximal lacrimal duct in two sections which can be damaged. The punctum and pars verticalis (1), the canaliculus horizontalis (2) or combined (3). The Common lacrimal duct (C) is the distal part of the lacrimal duct and can also be affected. Ten patients where analyzed after lacrimal duct reconstruction. Three months after stent removal none of the patients suffered from ephiphora.

Conclusions

: This article proposes an anatomical classification for lacrimal duct defects in the proximal lacrimal drainage system. The classification can be applied in comparing cases and determining reconstructive strategies after oncologic skin tumor resection. Short-term results are promising for future efforts to reconstruct the lacrimal duct.



Negative-Pressure Wound Therapy: An Effective Adjunctive Treatment to Assist Flap Survival and Wound Closure

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Minliang Wu, Mengyan Sun, Haiying Dai, Jianguo Xu, Rui Guo, Yuchong Wang, Chunyu Xue



Multiple granular cell tumors associated with joint hypermobility, facial dysmorphism, and asymptomatic neurologic findings: A rare syndrome

Background: The granular cell tumor (GCT), also known as Abrikossoff tumor, is a rare, benign tumor. Its supposed origin is related to Schwann cells. It generally presents with a solitary nodule, but multiple tumors may be found in up to 25% of patients, less frequently in children. Bakos and Muscardin have reported multiple GCT associated with malformations in cardiovascular, neurologic and musculoskeletal systems in addition to a dysmorphic face, which could be features of a rare syndrome.

Multiple eruptive myxoid dermatofibroma in a man with chronic hepatitis B infection

We report the first known case of multiple eruptive myxoid dermatofibromas (MEMDF) in a male with chronic hepatitis B infection presenting with eruptive lesions showing marked deposits of dermal mucin. Tumor cells were positive for CD68 and vimentin and negative for S-100 and SMA. CD34 stained regular endothelial cells. Work-up showed asymptomatic chronic hepatitis B infection without cirrhosis. This case highlights an extremely rare histologic variant and the importance of screening for altered immunity in patients with eruptive dermatofibromas.

Psychologic health status and health-related quality of life in adults with atopic dermatitis

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder which is characterized by recurrent pruritic eczematous skin lesions. Patients with AD often suffer from a lot of psychologic distress and poor health-related quality of life (HRQoL) because of the irritating and disfiguring nature of the disease. However, psychologic burden of the AD patients has been underestimated and often considered to be of little importance even in clinics.

Classic Sweet sydrome: A case report

Sweet syndrome, or acute febrile neutrophilic dermatosis, is the most common of the neutrophilic dermatoses. We present a 54-year-old man who began 11 days before consultation with an upper respiratory tract infection, fever, and painful blisters on the face and arms, receiving treatment with antivirals and antibiotics unsuccessfully. Clinically he had bilateral conjunctivitis, vesicles, blisters, some with purulent exudate, flattened and necrotic center, plaques with erythematous and raised edges affecting face, neck, ears, chest, and upper limbs.

Clear cell variant of eccrine porocarcinoma of the hand: A case report

Introduction: Eccrine porocarcinoma (EP) is a rare malignant neoplasm of the acrosyringium with metastatic potential that most commonly presents on the acral skin in older adults. The primary lesions present as verrucous or polypoid nodules or plaques, often with spontaneous bleeding and ulceration, and arise either from a preexisting eccrine poroma or de novo. Only 8% of porocarcinomas occur in the upper extremity and only 3% are on the hand. The histologic characteristics of EP vary a lot so more than one consultation is often needed to establish the diagnosis.

Clinical analysis of linear focal elastosis

Background: Linear focal elastosis (LFE) is an uncommon disease of elastic tissue. There have been 31 cases of LFE in the English-language literature.

Clinical and dermoscopic features of 135 cases of small-diameter melanomas

Introduction: Early diagnosis of melanoma reduces morbidity, mortality, and costs. As a result of the increasingly early diagnosis, the percentage of melanomas removed when their diameter does not exceed 6 mm is rising and about 50% of the cases are already invasive. These lesions represent a diagnostic challenge both clinically and dermatoscopically.

Clinical and economic implications of a noninvasive molecular pathology assay for early detection of melanoma

Background: More than 90% of ∼2.5 million surgical biopsies performed to rule out melanoma in the U.S. alone are benign and classified as neither invasive melanomas nor melanomas in situ by histopathology. A recently described adhesive patch skin biopsy based noninvasive gene expression test (pigmented lesion assay; PLA) demonstrated utility and differentiated benign from malignant pigmented skin lesions with a test performance that exceeded visual inspection (VI) and a sensitivity that matching the criterion standard of dermatopathology.

Clinical and erythema-directed instrumental evaluation of papulopustular rosacea treated with topical ivermectin

Background: Ivermectin 1% cream is a new therapeutic topical option able to control mild/moderate papulopustular rosacea (PPR). Nontransient erythema from inflammatory lesions represents an important component of PPR often leading to patient emotional suffering, and digital photography equipped with RBX system enabling separation of red/brown skin color signatures is a useful tool for evaluation of erythema in patients affected by inflammatory dermatoses including rosacea. Colorimetry is also a sensitive technique for skin color analysis.

Clinical and instrumental characterization of hair and scalp aging in nonbalding Caucasian women

Introduction: Aging affecting the body doesn't spare scalp and hair, leading to changes in the physiology of scalp and the physical properties of the hair, with potential psychologic repercussions. Most of the time, it is difficult to isolate the aging effects alone because they can be superimposed to a preexisting alopecic phenomenon.

Secukinumab demonstrates significantly lower immunogenicity potential compared with ixekizumab and adalimumab

Background: Secukinumab (SEC), a fully human monoclonal antibody (mAb) that selectively neutralizes IL-17A, has significant efficacy in the treatment of moderate to severe plaque psoriasis (Pso) and psoriatic arthritis (PsA), demonstrating a rapid onset of action and sustained responses up to 5 years with a favorable safety profile and 0.4% immunogenicity in the Pso phase 3 program. SEC has previously demonstrated lower potential for immunogenicity compared with other mAbs used to treat Pso and PsA in in vitro assays.

The menace of persistent dermatophytosis: What is the cause?

'Background: Many patients with tinea corporis and or cruris are showing incomplete response to treatment or relapse soon after stopping treatment. The present study was carried out to determine the minimum inhibitory concentration (MIC) of the commonly used antifungal drugs in such cases and to identify predisposing factors.

Unilateral mucocutaneous lymphangioma circumscriptum: A rare case successfully treated with simple sclerotherapy and laser ablation

A 15-year-old boy presented with growth in the right buccal mucosa extending to chin skin since childhood. These were complaints for pain, bleeding, cosmetic looks. He has a linear multivesicular swellings with hemorrhagic, crusted hard swellings extending up to angle of mouth. These tumors were nontender, nonpulsatile with an irregular warty surface, and firm in consistency. Right side of the chin skin showed grouped vesicles with flash colored to dark red and black colored. A clinical suspesion of lymphangioma was made due to frog spawn picture and then biopsy from mucosa was taken.

Successful treatment of severe plaque psoriasis with secukinumab in a patient with myasthenia gravis: Case report

The treatment of severe psoriasis is often tailored around patients needs, weighting the potential benefits and side-effects. Patients' comorbidities can often make the effective treatment challenging. In the herein report, we present our experience of a patient in whom the treatment of severe psoriasis didn't aggravate myasthenia gravis (MG) symptomatology. A 60-year-old Caucasian man was first admitted to our institution suffering from severe plaque psoriasis in 2014. His medical history included MG for which was treated with neostigmine for the past 30 years.

Rate of regional nodal metastases of cutaneous squamous cell carcinoma in the immunosuppressed patient: An update

Background: The immunosuppressed patient has both an increased incidence of cutaneous squamous cell carcinoma (SCC) and a worse prognosis due to the propensity for metastatic spread. The single most important prognostic indicator for mortality in patients with SCC is the presence or development of regional lymph node metastasis. Previous studies have sought to determine the rate of regional lymph node metastases in solid organ transplant recipients (SOTRs). However, reported rates appear surprisingly low and are limited to only SOTRs.

Topical glycerol improved psoriasiform lesions and inhibited epidermal hyperplasia in an in vivo mouse model of psoriasis

Psoriasis is a chronic incurable skin disease that has been extensively studied. Although multiple treatments have been introduced, emollients are still used as a topical treatment to control several aspects of the disease. Glycerol, an emollient, has been shown to restore barrier function and accelerate wound healing. Glycerol is transported into epidermal keratinocytes via aquaporin-3 (AQP3), which is associated with the lipid-metabolizing enzyme phospholipase D2 (PLD2). PLD2 can convert glycerol to phosphatidylglycerol, which has been shown to inhibit proliferation and promote differentiation in keratinocytes in vitro.

TH17 pathway assessment in the inflammatory infiltrate of psoriasis and geographic tongue

Psoriasis is an immune-mediated disease with a genetic basis, associated with an inappropriate immune activation, mediated by T cells. There is predominance of the TH1 response and, more recently, was confirmed the participation of TH17 cells. Some studies have shown a direct relationship between psoriasis (Ps) and geographic tongue (GT), both with etiologic, histopathologic and genetic similarities. The aim of this study was to demonstrate that the histologic pattern and immunoreactivity to anti–IL-6, –IL-17, and –IL-23 antibodies, in the inflammatory response of geographic tongue are similar to psoriasis.

Sociodemographics, comorbidities, and management in a pediatric cohort of chronic spontaneous urticaria

Rationale: Chronic urticaria (CU) is defined when itchy hives and/or angioedema develop for at least 6 weeks. Although not life threatening, CU is reported to be associated with recurrent visits to the emergency room, stress and missing days of school and work due to severe itchiness. In 80% of CU cases, hives occur spontaneously and are not attributable to a physical stimulus or an identifiable cause (CSU). The objective of our study is to assess sociodemographics, comorbidities, and management of CSU in a pediatric cohort.

Risk of rhegmatogenous retinal detachment in atopic dermatitis: A 12-year nationwide cohort study

Background: Atopic dermatitis (AD) causes various ophthalmic complications, of which rhegmatogenous retinal detachment (RRD) is the most serious.

Validation of scratching severity as an objective assessment for itch

Background: Itch is a very bothersome symptom that is associated with many medical and dermatologic conditions. Itch is typically assessed subjectively, e.g., numeric rating scale (NRS). Yet, there are currently no simple, standardized, objective assessments of itch for clinical trials and practice.

Cross-section investigation and analysis of anxiety and depression in preoperative patients in outpatient department of aesthetic plastic surgery in a general hospital in China

Objective: This study was designed to evaluate the anxiety and depression disorders and investigate the prevalence and risk factors in preoperative patients who came to cosmetic plastic surgery clinic. Methods: Using the field survey method, the estimate of anxiety and depression in preoperative patients was made by the Hospital Anxiety and Depression Scale from July 2016 to July 2017 in the outpatient department of plastic surgery in a general hospital. The demographic information was collected.

Reconstruction of columellar defects: which surgical technique to choose ? A retrospective study of 18 patients

The reconstruction of the columella is challenging and poorly evaluated in the literature. Our study aimed to evaluate retrospectively the different techniques used in our center and to propose an algorithm of reconstruction adapted to each patient. We report a retrospective cohort study included 18 patients (9 men and 9 women; 53 years-old in average) with columellar reconstruction treated from 1999 through 2014. Six different techniques were used: chondrocutaneous graft, nasolabial flap, paramedian forehead flap and scalping flap according to the Converse technique or the Raulo technique.

Nipple-sparing mastectomy with different approaches: surgical incisions, complications and cosmetic results. Preliminary results of 100 consecutive patients at a single center

Nipple areola sparing mastectomy is a novel surgical approach that preserves the nipple areola complex. Patients with moderate and/or severe breast ptosis are usually not eligible for this surgical approach. In this study we are aimed to demonstrate the feasibility of non-conventional surgical approaches for nipple sparing mastectomy.One hundred consecutive patients were enrolled for this study, with diagnosed primary breast cancer. Clinical and pathological data, such as body mass index, smoking status, breast ptosis, complications and aesthetic satisfaction (Breast-Q test) were considered.

Sensory and functional morbidity following sural nerve harvest in paediatric patients

The sural nerve is a common donor site for nerve reconstruction. The only study describing outcomes in paediatric patients was following bilateral sural nerve harvest prior to the age of one. Bilateral nerve harvest at such a young age may limit patients' ability to perceive a sensory difference. The objective of this study was to understand the sensory and functional deficit after unilateral sural nerve harvest in paediatric patients.

Negative-Pressure Wound Therapy: An Effective Adjunctive Treatment to Assist Flap Survival and Wound Closure

Dear Sir,

The impact of orthognathic surgery on velopharyngeal function by evaluating speech and cephalometric radiographs

: Maxillary retrognathia is a well-known consequence of abnormal facial growth in patients with cleft lip and palate. Orthognathic surgery improves facial appearance and occlusion, but may induce velopharyngeal insufficiency. The aim of the study was to evaluate the effect of orthognathic surgery on velopharyngeal function using speech analysis and lateral cephalometric radiographs.

Autologous fat grafting for enhancement of breast reconstruction with a transverse myocutaneous gracilis flap: A cohort study

The transverse myocutaneous gracilis (TMG) flap is a viable option for reconstruction of small to moderate breasts. The purpose of this series was to examine outcomes of fat grafting to breast and donor site secondary to breast reconstruction with a TMG flap.

Post oncological lacrimal duct reconstruction; a practical classification system for reconstructive planning and short-term results of a case series.

: Surgical resection of skin tumors in the medial canthal area may damage the lacrimal duct and can result in chronic ephiphora. Post oncologic reconstruction of the lacrimal duct has not been studied extensively. The current study discusses the anatomical and functional features of the lacrimal duct. It describes short-term functional outcomes after monocanalicular reconstruction of the lacrimal duct in a case series of 10 patients.

Use of coliphages to investigate norovirus contamination in a shellfish growing area in Republic of Korea

Abstract

A number of severe norovirus outbreaks due to the consumption of contaminated shellfish have been reported recently. In this study, we evaluated the distribution of coliphage densities to determine their efficacy as fecal indicators of enteric viruses, including noroviruses, in water samples collected from a shellfish growing area in Republic of Korea over a period of approximately 1 year. Male-specific and somatic coliphages in water samples were analyzed using the single agar layer method, and norovirus genogroups I and II, which infect mainly humans, were analyzed using duplex reverse transcription quantitative PCR. Male-specific and somatic coliphages were detected widely throughout the study area. Several environmental parameters, including salinity, precipitation, temperature, and wind speed were significantly correlated with coliphage concentrations (P < 0.05). Moreover, the concentrations of male-specific coliphages were positively correlated with the presence of human noroviruses (r = 0.443; P < 0.01). The geospatial analysis with coliphage concentrations using a geographic information system revealed that densely populated residential areas were the major source of fecal contamination. Our results indicate that coliphage monitoring in water could be a useful approach to prevent norovirus contamination in shellfish.



Effect of tetramethyl thiuram disulfide (thiram) in relation to tibial dyschondroplasia in chickens

Abstract

Tetramethyl thiuram disulfide (thiram) is one of the important pesticides, which is extensively used in agriculture, but if it is combined with the cell membrane, then it causes membrane damage, bone morphogenic inactivation, and inhibited angiogenesis. Thiram has been considered a common cause of tibial dyschondrolplasia (TD) in various avian species, because it becomes the part of feed due to environmental contamination and its overuse in agriculture as pesticides or fungicide. However, there is no systematic study on the changes of the correlation indexes with toxic effect of the thiram in chickens. Therefore, we evaluated the toxic effects of thiram on growth performance of chickens, viscera organ index, pathological changes in tissue, and gene expression associated with osteoblast differentiation, vascularization, and tibial bone development. For this study, 1-day chickens (n = 300) were randomly distributed into two equal groups, control group (normal basal diet) and thiram group (adding thiram 40 mg/kg in basal diet). The result presented that thiram group chickens were looking unhealthy, lazy, and showing clinical symptoms like lameness. Thiram treatment significantly reduced the performance of chickens, liver index, and tibial length compared with control group. The toxic effect of thiram increased the visceral organ index (spleen and cardiac), tibia index, and TD severity considerably. It also increased serum Ca2+ and P3+ concentration and decreased tibial density compared to control chickens but the difference was not significant. Histopathology of tibia and liver showed that there were severe lesions due to toxic effect of thiram. Furthermore, HIF-1α and VEGF antibody localizations were increased and WNT4 localization was reduced significantly in immunohistochemical analysis. This systemic study of toxic effects of thiram in chicken concluded that thiram reduced the growth performance of chickens through decreasing liver index, whereas increasing kidney, cardiac, and spleen index, and induced TD by changing the expressions of VEGF, HIF-1α, and WNT4.



Brain Health and the Batterer

Violence and Gender, Ahead of Print.


The therapeutic potential of targeting the endothelial-to-mesenchymal transition

Abstract

Endothelial cells (ECs) have been found to be capable of acquiring a mesenchymal phenotype through a process known as endothelial-to-mesenchymal transition (EndMT). First seen in the developing embryo, EndMT can be triggered postnatally under certain pathological conditions. During this process, ECs dedifferentiate into mesenchymal stem-like cells (MSCs) and subsequently give rise to cell types belonging to the mesoderm lineage. As EndMT contributes to a multitude of diseases, pharmacological modulation of the signaling pathways underlying EndMT may prove to be effective as a therapeutic treatment. Additionally, EndMT in ECs could also be exploited to acquire multipotent MSCs, which can be readily re-differentiated into various distinct cell types. In this review, we will consider current models of EndMT, how manipulation of this process might improve treatment of clinically important pathologies and how it could be harnessed to advance regenerative medicine and tissue engineering.



Split-Face, Randomized, Placebo-Controlled, Double-Blind Study to Investigate Passive Versus Active Dermal Filler Administration

Abstract

Background

QueryHyaluronic acid (HA) is a large polymer increasingly used as dermal filler. HA does not permeate through healthy skin and is administered using various injection techniques. As HA procedures become more popular, the number of complications in facial rejuvenation procedures is likely to increase. Alternative methods may be necessary to satisfy the increasing demand for HA procedures. High-frequency high-intensity ultrasound is a painless and noninvasive method to deliver large molecules to the skin that is expected to deliver HA with visible results.

Objective

Assess facial rejuvenation with HA delivered with high-frequency high-intensity ultrasound.

Methods

Fifteen women (mean age 55) willing to participate in a randomized, double-blind, face-split trial with HA and placebo formulations in different sides of the face, were subject to five treatment sessions with high-frequency high-intensity ultrasound. Photographs taken before the procedure and after the last procedure were evaluated by a panel of five experts, blind to which side was treated with the HA or with the placebo.

Results

The expert panel identified a noticeable facial rejuvenation in the HA side relative to the placebo with a very statistically significant difference between the two sides (p < 0.0001).

Conclusions

Administration of HA with high-frequency high-intensity ultrasound is safe and leads to unambiguous facial rejuvenation.

Level of Evidence I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.



Best Before Date Necessity: A Reply to Psillos

Abstract

This discussion paper is a reply to Stathis Psillos' paper "Induction and Natural Necessities" (J Gen Philos Sci 48(3):327–340, 2017. https://ift.tt/2OaCrSJ), published in this journal. In that paper, he attempts to refute David Armstrong's solution to the problem of induction. To accomplish this desideratum, he proposes that the best explanation for our observed regularities is a sort of "best before date" necessity. That is, necessary connections may break down and are not by default timeless. He develops arguments against my (Castro, Teorema 33(3):67–82, 2014) defence of the necessitarian solution regarding a previous paper by Beebee (Noûs 45(3):504–527, 2011. https://ift.tt/2vfiTFH). He alleges that (a) best before date necessity is no worse than timeless necessity; (b) his proposal does not imply any further inductive generalisation to timeless necessity; and (c) inductive inferences are justified. In this discussion paper, I provide arguments against these three claims.



Antibiotic-induced alterations in taurocholic acid levels promote gastrointestinal colonization of Candida albicans

Abstract
Candida albicans is a fungal pathogen that poses a significant public health risk due to high incidence and mortality rates among immunocompromised patients. C. albicans infections begin with successful gastrointestinal (GI) colonization; however, the mechanisms behind this colonization remain to be elucidated. In this study, we investigated the role of taurocholic acid (TCA) on growth and GI colonization of C. albicans. Our results indicate that cefoperazone-treated mice susceptible to C. albicans infection had significantly increased levels of TCA in the gut contents. In addition, an increase in TCA levels directly correlates with higher C. albicans load in the fecal and gut contents of antibiotic-treated infected mice. Using in vitro assays, we also demonstrated that TCA enhances the growth of C. albicans and its ability to develop filamentous hyphae. Furthermore, TCA significantly increased the ability of C. albicans to attach to mammalian cells. These results demonstrate that antibiotic treatment alters TCA levels in the gut and potentially enhances GI colonization of C. albicans.

Inactivation of feline calicivirus using ultraviolet light-emitting diodes

Abstract
Ultraviolet light-emitting diodes (UV-LEDs) with peak emission wavelengths of 265, 280 and 300 nm were applied for the inactivation of feline calicivirus (FCV) in water, and the results were compared to those derived with a common viral surrogate coliphage MS2. The fluence response profiles indicated that the log10-based inactivation rate constant of FCV was 0.113, 0.101 and 0.007 cm2 mJ−1 for the 265, 280 and 300 nm UV-LEDs, respectively, while that of MS2 was 0.034, 0.033 and 0.003 cm2 mJ−1 for the 265, 280 and 300 nm UV-LEDs, respectively. Namely, FCV was about 2 to 3 times more sensitive than MS2 to germicidal UV emissions adopted in this study, and the 265 nm and 280 nm UV-LEDs were particularly effective to inactivate FCV. Results of this study are to be a part of knowledge base on fluence response profiles of various microorganisms, which would foster the development of disinfection apparatuses equipped with UV-LEDs.

The impacts of seawater physicochemical parameters and sediment metal contents on trace metal concentrations in mussels—a chemometric approach

Abstract

The concentrations of Al, Ba, Cd, Co, Cr, Cu, Fe, Li, Mn, Ni, Pb, Sr, Zn, and Hg were studied in Mytilus galloprovincialis collected from the coastal area of Montenegro. The impact of seawater temperature, salinity, dissolved oxygen, total organic carbon (TOC), and metal content in sediment samples on the metal contents in mussels collected from three locations in four different seasons was analyzed by a Pearson correlation coefficient (r), principal component analysis (PCA), and cluster analysis (CA). These analyses were used to discriminate groups of samples, elements, and seawater parameters, according to similarity of samples chemical composition in different seasons, as well as the impact of seawater parameters and surface sediment composition on the mussels' element concentrations. Synergistic interactions occurred between seawater TOC, Fe, and Al concentrations in mussels. Compared with other studies, which are usually performed under constant laboratory conditions where mussels undergo only one stress at a time, this study was performed in nature. The analyses showed the importance of considering simultaneously acting environmental parameters that make determining of separate impacts of each factor selected very difficult and complex.



Cross-section investigation and analysis of anxiety and depression in preoperative patients in outpatient department of aesthetic plastic surgery in a general hospital in China

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Liyuan Wei, Chaoyi Ge, Wei Xiao, Xiaochen Zhang, Jinghong Xu

Summary

Objective: This study was designed to evaluate the anxiety and depression disorders and investigate the prevalence and risk factors in preoperative patients who came to cosmetic plastic surgery clinic. Methods: Using the field survey method, the estimate of anxiety and depression in preoperative patients was made by the Hospital Anxiety and Depression Scale from July 2016 to July 2017 in the outpatient department of plastic surgery in a general hospital. The demographic information was collected. All data were analyzed by SPSS statistical package. Results: A total of 315 patients were enrolled, including 15 males and 300 females, with an average age of 30 ± 8.4 years. The mean HADS score was 8.2 ± 5.13, HADS-A was 4.7±3.04, and HADS-D was 3.5±2.72. The HADS-A score was significantly higher than the HADS-D score (p=0.000). There were 34 cases (10.8%) with anxiety, 15 cases (4.8%) with depression and 6 cases (1.9%) with both anxiety and depression. We found that education level of these patients (p=0.001) and the development level of their residence places (p=0.040) have a negative correlation with the score of anxiety. There was a negative correlation between education level (p=0.000) and depression score. The education level was associated with the diagnosis of anxiety (p=0.034). The education level (p=0.001) and occupations (p=0.015) were associated with the diagnosis of depression. Conclusion: In the patients seeking cosmetic plastic surgery, the preoperative anxiety is more obvious than depression. There is a negative correlation between education level and anxiety and depressive symptoms.



Nipple-sparing mastectomy with different approaches: surgical incisions, complications and cosmetic results. Preliminary results of 100 consecutive patients at a single center

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): G. Corso, F. De Lorenzi, E. Vicini, G. Pagani, P. Veronesi, M. Sargenti, F. Magnoni, P. Naninato, P. Maisonneuve, C. Sangalli, M. Rietjens, Viviana Galimberti

Abstract

Nipple areola sparing mastectomy is a novel surgical approach that preserves the nipple areola complex. Patients with moderate and/or severe breast ptosis are usually not eligible for this surgical approach. In this study we are aimed to demonstrate the feasibility of non-conventional surgical approaches for nipple sparing mastectomy.

One hundred consecutive patients were enrolled for this study, with diagnosed primary breast cancer. Clinical and pathological data, such as body mass index, smoking status, breast ptosis, complications and aesthetic satisfaction (Breast-Q test) were considered. In accord with the different type of breast ptosis, surgical procedures were classified as a) hemi-periareolar, b) round block, c) vertical pattern, and d) wise pattern skin incisions. We considered statistical analysis to assess the correlation with complications, degree of ptosis, and breast-Q scores.

Among the 117 surgical procedures performed in 100 breast cancer patients, no significant associations are verified considering clinical and pathological data, complications, pre- and post-surgery satisfactions, such as other parameters.

Different surgical approaches represent the evolution of "classic" nipple sparing mastectomy, meeting the cosmetic and oncological results. These procedures are safety and indicated also in cases conventionally considered not eligible for nipple areola preservation.



Autologous fat grafting for enhancement of breast reconstruction with a transverse myocutaneous gracilis flap: A cohort study

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Elisabeth Russe, Hassan Kholosy, Laurenz Weitgasser, Michael Brandstetter, Heike Traintinger, Jennifer Neureiter, Gottfried Wechselberger, Thomas Schoeller

Summary
Background

The transverse myocutaneous gracilis (TMG) flap is a viable option for reconstruction of small to moderate breasts. The purpose of this series was to examine outcomes of fat grafting to breast and donor site secondary to breast reconstruction with a TMG flap.

Methods

A cohort study was undertaken to identify all patients who underwent autologous fat grafting after breast reconstruction with a TMG flap at two institutions between 1/2009 and 10/2013. Data was collected regarding patient demographics, body mass index and medical history as well as surgical details regarding TMG flap surgery and fat grafting.

Results

A total of 145 fat graftings were performed in 83 patients following TMG flap breast reconstruction for improvement of contour, shape and volume of breasts (98%, n=142), donor site (9%, n=13) or both (7%, n=10), mainly after breast cancer surgery (83%). On average 1.8 fat grafting sessions were performed with an average of 30cc fat per breast and 56.4cc fat per thigh. In 72% fat injection was performed with other pending reconstructive procedures. Fat was harvested in tumescent technique, using a filter syringe system and injected without any further processing in multiple layers.

Conclusions

Autologous fat grafting as a secondary procedure represents a powerful adjunct to enhance the aesthetic outcome of the reconstructed breast and donor site. It can be easily combined with other pending reconstructive procedures. With additional fat grafting it may be possible to expand indications and offer autologous reconstruction with a TMG flap even in very lean patients.



The impact of orthognathic surgery on velopharyngeal function by evaluating speech and cephalometric radiographs

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): D. Impieri, K.A. Tønseth, Ø. Hide, E.L. Brinck, H.E. Høgevold, C. Filip

Abstract
Background

: Maxillary retrognathia is a well-known consequence of abnormal facial growth in patients with cleft lip and palate. Orthognathic surgery improves facial appearance and occlusion, but may induce velopharyngeal insufficiency. The aim of the study was to evaluate the effect of orthognathic surgery on velopharyngeal function using speech analysis and lateral cephalometric radiographs.

Patients and Methods

: A retrospective study of 47 patients who underwent maxillary advancement ± mandibular setback between 2006 and 2016. Pre- and 1-year postoperative audio recordings were blinded for scoring by three trained speech therapists. Pre- and 1-year postoperative lateral cephalometric radiographs were used to obtain information about skeletal movement and its relationship with the velopharyngeal area. Correlations between the speech outcomes and cephalometric radiographs were calculated.

Results

: Hyponasality improved significantly after surgery (p<0.05), while hypernasality deteriorated significantly only in the patients who underwent maxillary advancement alone (p<0.05). No difference in speech parameters was found between patients with hypernasality or patients who had a pharyngoplasty preoperatively and the rest of the group. No correlation was found between amount of maxillary advancement and hypernasality. Significant correlation (r< -0.49, p<0.05) was found between preoperative velar length and hypernasality postoperatively.

Conclusions

: Maxillary advancement has a negative impact on velopharyngeal function, while bimaxillary surgery seems to protect from deterioration. No difference was found in the amount of maxillary advancement or in velopharyngeal measurements between the Le Fort I and the bimaxillary group. A short soft palate is a predictor of hypernasality after orthognathic surgery.



Robot-assisted mediastinoscopic esophagectomy for esophageal cancer: the first clinical series

Abstract

Background

Radical esophagectomy for esophageal cancer is associated with high morbidity, especially with pulmonary complications. Mediastinoscopic esophagectomy via a small left neck incision combined with the esophageal hiatus, without using transthoracic approach, has been reported to reduce pulmonary complication; however, from technical point of view, this approach using non-articulating, straight, long forceps is extremely challenging, especially in the middle mediastinal area. Its technical difficulties may be attenuated using da Vinci Surgical System. The aim of this study was to evaluate the feasibility and safety of robot-assisted mediastinoscopic esophagectomy.

Methods

Robot-assisted mediastinoscopic esophagectomy was performed in six patients between October 2016 and May 2017. Robotic esophageal mobilization with upper and middle mediastinal lymphadenectomy was performed via the three da Vinci Xi (Intuitive Surgical, Inc. Sunnyvale, CA) trocars placed on the 5-cm left cervical incision. Thereafter, the remaining part of radical esophagectomy was completed via a transhiatal approach.

Results

Upper and middle mediastinal lymphadenectomy was robotically completed via the transcervical approach in all cases without conversion to transthoracic approach. No postoperative complications (Clavien–Dindo classification grade ≥ III) were observed.

Conclusions

Robot-assisted mediastinoscopic esophagectomy was technically feasible and safe. Use of da Vinci Surgical System may help attenuate technical difficulties in transcervical middle mediastinal lymph node dissection.



ESMO Consensus Conference on testicular germ cell cancer: diagnosis, treatment and follow-up

Abstract
The European Society for Medical Oncology (ESMO) consensus conference on testicular cancer was held on 3–5 November 2016 in Paris, France. The conference included a multidisciplinary panel of 36 leading experts in the diagnosis and treatment of testicular cancer (34 panel members attended the conference; an additional two panel members [CB and K-PD] participated in all preparatory work and subsequent manuscript development). The aim of the conference was to develop detailed recommendations on topics relating to testicular cancer that are not covered in detail in the current ESMO Clinical Practice Guidelines (CPGs) and where the available level of evidence is insufficient. The main topics identified for discussion related to: (1) diagnostic work-up and patient assessment; (2) stage I disease; (3) stage II-III disease; (4) post-chemotherapy surgery, salvage chemotherapy, salvage and desperation surgery and special topics; and (5) survivorship and follow-up schemes. The experts addressed questions relating to one of the five topics within five working groups. Relevant scientific literature was reviewed in advance. Recommendations were developed by the working groups and then presented to the entire panel. A consensus vote was obtained following whole-panel discussions, and the consensus recommendations were then further developed in post-meeting discussions in written form. This manuscript presents the results of the expert panel discussions, including the consensus recommendations and a summary of evidence supporting each recommendation. All participants approved the final manuscript.

Targeting gamma secretase: has progress moved up a notch?



It only takes two to tango: against grounding morality in interaction

Abstract

Most Kantian constructivists try to ground universal duties of interpersonal morality in certain interactions between individuals, such as communication, argumentation, shared action or the second-person standpoint. The goal of this paper is to present these, which I refer to as arguments from the second-person perspective, with a dilemma: either the specific kind of interaction that is taken as a starting point of these arguments is inescapable, but in that case the argument does not justify a universal principle of interpersonal morality. Or interaction does have a principle of interpersonal morality among its necessary conditions of possibility, but such forms of interactions are merely optional. I argue that proponents of arguments from the second-person perspective have failed to provide a convincing response to this dilemma and that this failure is systematic. This suggests that the success of Kantian constructivism depends on the success of arguments from the first person.