Αναζήτηση αυτού του ιστολογίου

Πέμπτη 6 Σεπτεμβρίου 2018

Swedish translation and validation of the international skin tear advisory panel skin tear classification system

International Wound Journal, EarlyView.


Correction to: Facile synthesis of carbon-coated layered double hydroxide and its comparative characterisation with Zn–Al LDH: application on crystal violet and malachite green dye adsorption—isotherm, kinetics and Box-Behnken design

The original publication of this paper contains an error. The correct Figure 8 is shown in this paper.



Synthesis of mesoporous core-shell TiO 2 microstructures with coexposed {001}/{101} facets: enhanced intrinsic photocatalytic performance

Abstract

TiO2 microstructures were synthesized via a facile one-step route for enhanced intrinsic photocatalytic performance. The prepared TiO2 microstructures are featured by both mesoporous core-shell structures and coexposed {001}/{101} facets. Their intrinsic photocatalytic performance were remarkably enhanced due to their high specific surface area, coexposed {001}/{101} facets, and promoted separation of photogenerated carriers. Furthermore, the origin and detailed mechanism for diethylenetriamine (DETA) that served as a high efficient stabilizer of TiO2 {001} facet have been theoretically investigated. Finally, a new DETA-modified Ostwald ripening mechanism was originally proposed when studying the growth mechanism of the mesoporous core-shell TiO2 spherical microstructures with coexposed {001}/{101} facets.



Predicting Genotype and Survival in Glioma Using Standard Clinical MR Imaging Apparent Diffusion Coefficient Images: A Pilot Study from The Cancer Genome Atlas [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Few studies have shown MR imaging features and ADC correlating with molecular markers and survival in patients with glioma. Our purpose was to correlate MR imaging features and ADC with molecular subtyping and survival in adult diffuse gliomas.

MATERIALS AND METHODS:

Presurgical MRIs and ADC maps of 131 patients with diffuse gliomas and available molecular and survival data from The Cancer Genome Atlas were reviewed. MR imaging features, ADC (obtained by ROIs within the lowest ADC area), and mean relative ADC values were evaluated to predict isocitrate dehydrogenase (IDH) mutation, 1p/19q codeletion status, MGMT promoter methylation, and overall survival.

RESULTS:

IDH wild-type gliomas tended to exhibit enhancement, necrosis, and edema; >50% enhancing area (P < .001); absence of a cystic area (P = .013); and lower mean relative ADC (median, 1.1 versus 1.6; P < .001) than IDH-mutant gliomas. By means of a cutoff value of 1.08 for mean relative ADC, IDH-mutant and IDH wild-type gliomas with lower mean relative ADC (<1.08) had poorer survival than those with higher mean relative ADC (median survival time, 24.2 months; 95% CI, 0.0–54.9 months versus 62.0 months; P = .003; and median survival time, 10.4 months; 95% CI, 4.4–16.4 months versus 17.7 months; 95% CI, 11.6–23.7 months; P = .041, respectively), regardless of World Health Organization grade. Median survival of those with IDH-mutant glioma with low mean relative ADC was not significantly different from that in those with IDH wild-type glioma. Other MR imaging features were not statistically significant predictors of survival.

CONCLUSIONS:

IDH wild-type glioma showed lower ADC values, which also correlated with poor survival in both IDH-mutant and IDH wild-type gliomas, irrespective of histologic grade. A subgroup with IDH-mutant gliomas with lower ADC had dismal survival similar to that of those with IDH wild-type gliomas.



Reply: [LETTERS]



Comment on "Blood Flow Mimicking Aneurysmal Wall Enhancement: A Diagnostic Pitfall of Vessel Wall MRI Using the Postcontrast 3D Turbo Spin-Echo MR Imaging Sequence" [LETTERS]



Near-Term Decrease in Brain Volume following Mild Traumatic Injury Is Detectible in the Context of Preinjury Volumetric Stability: Neurobiologic Insights from Analysis of Historical Imaging Examinations [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Neurodegeneration after mild traumatic brain injury may manifest as decreasing regional brain volume that evolves from months to years following mild traumatic brain injury and is associated with worse clinical outcomes. We hypothesized that quantitative brain volume derived from CT of the head, performed for clinical indications during routine care, would change with time and provide insights into the putative neuroinflammatory response to mild traumatic brain injury.

MATERIALS AND METHODS:

We searched the electronic medical record of our institution for NCCTs of the head performed in patients with mild traumatic brain injury and included those who also underwent NCCTs of the head 1 month to 1 year before and after mild traumatic brain injury for an indication unrelated to trauma. Controls underwent 3 sequential NCCTs of the head with indications unrelated to trauma. The whole-brain and intracranial volume groups were computed using ITK-SNAP. Brain volumes normalized to intracranial volumes were compared across time points using the Wilcoxon signed-rank test.

RESULTS:

We identified 48 patients from 2005 to 2015 who underwent NCCTs of the head in the emergency department for mild traumatic brain injury and had NCCTs of the head performed both before and after mild traumatic brain injury. Median normalized brain volumes significantly decreased on the follow-up study post-mild traumatic brain injury (0.86 versus 0.84, P < .001) and were similar compared with pre-mild traumatic brain injury studies (0.87 versus 0.86, P = .927). There was no significant difference between normalized brain volumes in the 48 controls.

CONCLUSIONS:

A decrease in brain volume following mild traumatic brain injury is detectable on CT and is not seen in similar patients with non-mild traumatic brain injury during a similar timeframe. Given the stability of brain volume before mild traumatic brain injury, CT volume loss may represent the subtle effects of neurodegeneration.



Apparent Diffusion Coefficient Levels and Neurodevelopmental Outcome in Fetuses with Brain MR Imaging White Matter Hyperintense Signal [PEDIATRICS]

BACKGROUND AND PURPOSE:

One of the perplexing findings of fetal brain MR imaging is white matter T2 hyperintense signal. The aims of our study were initially to determine the main etiologies associated with white matter T2 hyperintense signal, then to examine whether the different etiologies have different ADC values, and, last, to assess the association of white matter T2 hyperintense signal with developmental outcome.

MATERIALS AND METHODS:

This was a prospective cohort study of 44 MR imaging scans of fetal brains obtained for suspected brain pathologies at a tertiary medical center during 2011–2015. Clinical data were collected from electronic medical charts. ADC values were measured and averaged in the frontal, parietal, occipital, and temporal lobes. Neurodevelopmental assessments were performed with the Vineland Adaptive Behavior Scales II.

RESULTS:

Half of the cases of MRI hyperintense T2 signal of the fetal brain were associated with congenital cytomegalovirus infection. The other half were mainly idiopathic. Thus, the study group was divided to subgroups positive and negative for cytomegalovirus. Both groups had hyperintense signal in the temporal lobe. The group positive for cytomegalovirus had involvement of the parietal lobe. Only this group had increased ADC values in the temporal and parietal lobes. There was no association between the neurodevelopment outcome and the etiologies or ADC values.

CONCLUSIONS:

T2 hyperintense signal in fetal brain MRI associated with positive cytomegalovirus infection has increased ADC values in the temporal and parietal lobes, suggestive of brain edema in these areas. However, the association between this finding and neurodevelopment outcome requires further evaluation.



“The validity of the EQ-5D-5L in measuring quality of life benefits of breast reconstruction”

The EuroQol EQ-5D-5L instrument is the most widely-used quality of life measure in health economic evaluations. It is unclear whether such a generic instrument is valid enough to estimate the benefits of breast reconstruction (BR), given the specific changes observed in quality of life after BR. Hence, we aimed to evaluate the validity of EQ-5D-5L in patients who had undergone postmastectomy BR.

Tofacitinib for the Treatment of Alopecia Areata in Preadolescent Children



Reply to MS#JAAD-D-18-01527



Ruxolitinib for the treatment of severe alopecia areata



Lightening Becker’s nevus: Role of topical therapies



Trichloroacetic acid as a treatment for persistent oral mucosal lesions in pemphigus vulgaris



Previously undiagnosed Darier disease complicated by bilateral ecthyma gangrenosum masquerading as a vasculopathy with retiform eschar formation

We present the case of a 57-year-old incarcerated man with a history of hepatitis C and life-long presumed atopic dermatitis who presented with a two month history of painful, progressive, ulcerations with overlying eschars on his bilateral lower extremities. He had been treated unsuccessfully with oral trimethoprim-sulfamethoxazole and clindamycin before admission. Upon admission, he was found to have leukocytosis but was otherwise hemodynamically stable and afebrile. On exam, he had erythematous hyperkeratotic papules coalescing into plaques on the neck, chest, abdomen, back, and extremities, with a flexural predominance, and retiform ulcerations with overlying eschars on the bilateral lower legs.

Onychogryphosis: A case report and review of the literature

Patient history: A 67-year-old man presented with a 30-year history of severe thickening, curving, and yellow discoloration of his left great toenail. He stated that the nail broke off midway and regrew every six months. It had become more painful recently and was impinging on his second toe, making it difficult to walk and put on socks. There is no history of trauma, tinea pedis or family history of onychomycosis. Physical examination was notable for thickening and lateral deviation of the left first toenail.

Peristomal pyoderma gangrenosum in a patient with chronic ulcerative colitis: Case report

Introduction: Peristomal pyoderma gangrenosum (PPG) is a rare subtype of pyoderma gangrenosum that could be difficult to diagnose and treat. A painful necrotic ulcer surrounding an area of abdominal stoma with rapidly progression is the clinical hallmark. It is almost exclusively associated with inflammatory bowel disease (IBD). In this report, we present a 63-year-old man previously diagnosed of chronic ulcerative colitis (CUC) that develop a peristomal pyoderma gangrenosum 2 years after surgery.

Necrotisans erythema nodosum leprosum with systemic manifestations

Introduction: Erythema nodosum leprosum (ENL) is an acute reaction that generally occurs during the treatment of multibacillary leprosy. Severe cases can lead to necrotic ulcers and cause extra cutaneous manifestations. One case of necrotisans erythema nodosum leprosum (NENL) is reported to show that leprosy late diagnosis and treatment can cause severe cutaneous and systemic manifestations.

Pruritus in patients under targeted anticancer therapy: Multidimensional analysis using the 5-D itch scale

Background: Pruritus is very common symptom in patients under anticancer therapy. However, the characteristics of pruritus according to anticancer agents have not been known well.

Platelet-rich plasma for skin rejuvenation: A systematic review of the clinical evidence

Background: Recently, platelet-rich plasma (PRP) has been used as an off-label treatment for a variety of clinical conditions including skin rejuvenation (SR). The effectiveness of PRP for SR is unclear due to lack of standardization for PRP administration. We aimed to assess the level of evidence (LOE) for safety and efficacy of PRP for SR.

Patient experience of the “two-week wait” cancer referral pathway in a large secondary care department in England

Background: The 2-week wait (2WW) system has been implemented across the NHS in England to enable rapid referral of patients with squamous cell carcinoma and malignant melanoma from primary to secondary care. Patients are told that the referral is to exclude skin cancer. In our secondary care dermatology department, a 2-week lag between referral and dermatology consultation represents a 19-week reduction in wait time (WT) from a standard referral. Little is currently known about the patients' perception of this streamlining, how WT impacts patient quality of life, and how appropriate patients consider this WT when being referred for suspected malignancy.

Nonmelanoma skin cancer in HIV-positive patients: A six-year single-institution retrospective review

Background: HIV-positive (HIV+) patients have been demonstrated to have an increased incidence of nonmelanoma skin cancer (NMSC) at 2.1-2.8 times the rate found in HIV negative (HIV-) populations. Rates of NMSC with aggressive subclinical extension (ASE), defined as extensive subclinical tumor spread revealed during Mohs micrographic surgery (MMS), have not been found to be significantly different in HIV+ and HIV− populations in a previous study. However, HIV disease progression (CD4 and CD8 levels and viral load) and NMSC characteristics and their relationship to presence of NMSC with ASE within the HIV+ population remain unclear.

Process of standardized postoperative telephone follow-up implementation for Mohs micrographic surgery

Mohs micrographic surgery (MMS) is an effective outpatient procedure for skin cancer removal with low reported complication rates. Identifying both major and minor postoperative complications is necessary to improve the quality of Mohs-based surgical care. There are currently no established standards for regular patient follow-up after MMS. Therefore, there exists a need to determine standardized, cost-effective, and reproducible follow-up strategies. The objective of this study was to determine whether routine telephone follow-up is an effective tool to capture postoperative complications and other patient-reported concerns.

Predicting therapy outcome by HLA-Cw6 genotyping in psoriasis patients treated with secukinumab

Introduction: A possible correlation of genetic markers and response to treatment has been proclaimed. The strongest association has been shown between HLA-Cw6 and ustekinumab. So far it is unclear whether this effect can be also found in IL-17.

Pigmented eccrine poroma: A clinical dermoscopy challenge

Eccrine poroma is a benign neoplasia originated from the intraepidermal portion of the sweat gland duct. It is characterized by a papule, plaque or nodule, normochromic or erythematous, exophytic or hyperkeratotic. Although its pathogenesis is still unknown, it seems to be related to radiation, trauma or scars. The pigmented variant, more frequent in blacks and affecting mainly nonacral areas, is responsible for 17% of the cases. Various clinical-dermatoscopic features have been described, directing its differential diagnosis to other benign and malignant neoplasia, such as seborrheic keratosis, epithelized pyogenic granuloma, basal-cell and squamous-cell carcinoma, angiofibroma, and melanoma.

Pediatric melanoma immunotherapy: A retrospective examination of a decade of clinical experience at a tertiary care center

Background: Pediatric or adolescent melanoma, defined as melanoma in patients below age 20, is an infrequent occurrence that represents 0.4% of the approximately 87,110 new cases of melanoma diagnosed in the United States annually. As a result, few data exist to guide therapy that prolong survival, in particular with more recently developed immune therapies, such as immune checkpoint inhibitors. This lack of data is especially important as there is growing evidence that pediatric melanoma differs in its presentation, gene expression, and behavior from adult melanoma, and that response to therapy may vary by age.

Painful subcutaneous lesions in a patient with metastatic melanoma

Introduction: We present the case of a patient with metastatic melanoma (MM) treated with combined therapy (vemurafenib + cobimetinib), who develops painful subcutaneous lesions compatible with secondary panniculitis.

Old is gold—Revisiting the efficacy of topical psoralen–ultraviolet A phototherapy for palmoplantar dermatoses

Palmoplantar involvement of dermatoses such as atopic dermatitis and psoriasis has significant impact on quality of life. While systemic treatment options have increased in recent years, topical psoralen ultraviolet A (tPUVA) therapy remains a viable option when topical treatments have failed and potential systemic adverse events outweigh benefits. Literature on tPUVA efficacy is sparse. Our objectives were to report the efficacy of tPUVA after an initial treatment course and to identify associated clinical factors.

Nicolau syndrome appears after filling hyaluronic acid with the use of blanching technique

A 34-year-old woman was treated in our clinic for mild acne and scars. Two years before, oral isotretinoin was given to the patient with a complete healing of the acne but numerous 2–3-mm scars remained in both cheeks. Two sessions of a nonablative CO2 laser was performed one year after the termination of the isotretinoin treatment with partial improvement of the scars. After that, a blanching technique with hyaluronic acid was offered to the patient. She was injected with a low reticulated hyaluronic acid with lidocaine using a 30 Gy needle doing a blanching technique to fill the scars presented in her cheeks.

Aggregation, sedimentation, and dissolution of CuO and ZnO nanoparticles in five waters

Abstract

With the accelerated application of copper oxide (CuO) and zinc oxide (ZnO) nanoparticles (NPs) in commercial products, concerns about the potential impacts on the environment have been growing. Environmental behaviors of NPs are expected to significantly influence their fate and ecological risk in the aquatic environment. In this study, the environmental behaviors of two metallic NPs (CuO and ZnO NPs), including aggregation, sedimentation, and dissolution, were systematically evaluated in five representative waters (pool water, lake water, rainwater, tap water, and wastewater) with varying properties. Remarkable aggregation, sedimentation, and dissolution were observed for both metallic NPs, among which ZnO NPs exhibited greater influence. CuO (ZnO) NPs aggregated to 400 (500) nm, 500 (900) nm, and 800 (1500) nm in lake water, wastewater, and tap water, respectively. The sedimentation rates of CuO and ZnO NPs in the five waters were ranked as tap water > wastewater > lake water > pool water > rainwater. The dissolution of CuO and ZnO NPs in waters follows a first-order reaction rate model and is affected by ionic type, ionic strength (IS), and NOM (natural organic matter) concentrations. Redundancy analysis (RDA) indicated that the aggregation and sedimentation of NPs have a strong correlation, insofar as the sedimentation rates increase with increasing aggregation rates. The aggregation and dissolution of NPs have a negative correlation, insofar as the dissolution rates reduce with increasing aggregation rates. The aggregation, sedimentation, and dissolution of NPs can be influenced by ionic types, IS, and TOC in waters, among which, TOC may the dominant factor.



Transcriptome analysis to identify the Ras and Rap1 signal pathway genes involved in the response of TM3 Leydig cells exposed to zearalenone

Abstract

The mechanism of action of zearalenone (ZEA) in inducing germ cell tumors is unclear, and little is known about the change in the transcriptome of germ cells after ZEA exposure. To explore the molecular basis of the ZEA oncogene, we examined the median lethal concentration (50 μmol/L) and pro-apoptotic effect of ZEA on TM3 Leydig cells by MTT and TUNEL assay. Subsequently, we investigated the genetic changes in the transcriptome of TM3 Leydig cells exposed to 50 μmol/L ZEA. The transcriptome sequencing results show that 772 genes are significantly down-regulated, while 204 genes are significantly up-regulated. Gene ontology (GO) enrichment analysis shows that ZEA has a major effect on the connective function, cell composition, cell cycle, and energy metabolism of the TM3 Leydig cells. Using the results of the GO and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses, we select the Ras and Rap1 signaling pathways that are closely related to the occurrence of cancer. The differentially expressed genes visualized in the KEGG pathway were selected for RT-qPCR differential gene expression validation. The results show that the gene expression results are consistent with the transcriptome sequencing results. This study thus provides a theoretical molecular basis for the mechanism of ZEA carcinogenesis.



Orbicularis-Tarsus Fixation Approach in Double-Eyelid Blepharoplasty: A Modification of Park’s Technique

Abstract

Background

Incisional double-eyelid blepharoplasty is widely applied because of its extensive indications and robust results. The orbicularis-levator fixation method is an incisional approach that provides stronger adhesion than traditional techniques. However, there remains the risk of postoperative relapse or suture spitting out.

Methods

The authors introduced a modified technique for supratarsal crease formation. When necessary soft tissue removal was completed, the orbicularis oculi muscle was anchored on the tarsus. Then the muscle edges near canthus were reattached to prevent muscle retraction. For skin closure, the skin-pretarsal fascia-skin maneuver was adopted to enhance cicatricial adhesion.

Results

Six hundred and fifty-nine patients underwent double eyelidplasty by the same surgeon using this modified technique. Patients were followed up from 2 to 38 months, with a mean period of 15 months. Short-term complications included mild edema, bruising or reddish change of the upper eyelid, yet all gradually relieved in 6–8 weeks. Fourteen cases of palpebral fold asymmetry and nine cases of unsatisfactory fold formation near the inner canthus were encountered, and all the defects had been well improved by revision surgeries. Ninety-five percent of the patients were satisfied with the long-term outcomes, which showed as natural and well-defined palpebral folds without scar hypertrophy, suture spitting out or crease depression. Besides, no supratarsal crease drooping or disappearing was observed 3 years postoperatively.

Conclusions

The authors introduced an orbicularis-tarsus fixation method for upper eyelid blepharoplasty. It is a reliable technique that enables high feasibility and long-lasting result, and with lower risk of suture spitting out.

Level of Evidence IV

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.



Opinions on the “Trick” Technique to Reposition the NAC in Female-to-Male Transsexuals



Clinical Impact of Highly Condensed Stromal Vascular Fraction Injection in Surgical Management of Depressed and Contracted Scars

Abstract

Background

Recent research on stromal vascular fraction (SVF) has demonstrated the presence of numerous growth factors that aid in tissue regeneration and suggest the potential for scar treatment. This study was conducted to clinically show that adding stem cells can improve the surgical outcomes of scar formation.

Methods

Between March 2014 and February 2016, 17 patients underwent injections of fat and highly condensed SVF simultaneously with scar reduction surgeries and 15 patients received scar revision with or without simultaneous application of highly condensed SVF (4.90 × 107 stem cells/ml) at our institution. Clinical photographs were taken before and after surgery, and the scars were graded using the following standard scales: the Observer Scar Assessment Scale (OSAS), Stony Brook Scar Evaluation Scale (SBSES), Vancouver Scar Scale (VSS), and Visual Analog Scale (VAS).

Results

All patients showed improvement, registering significant increases in scar tissue scores (P < 0.05 in all four scoring systems). Patients in the SVF group showed more improved outcomes than patients in the non-SVF group for all scar tissue scores except the SBSES (OSAS, P = 0.029; SBSES, P = 0.281; VSS, P = 0.001; VAS, P = 0.021). Subcategories of these scales reflected more favorable outcomes in terms of height and pliability; however, there was no significant change in vascularity.

Conclusions

SVF injections enhance tissue regeneration by contributing stem cells and growth factors to improve outcomes in scar revisions or tissue grafts. Harvesting the SVF through liposuction also provides a cosmetic benefit. Significant SVF-related gains in the scoring of scars indicate the merit of SVF as an aspect of conventional scar management.

Level of Evidence IV

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.



Reputation and Group Dispositions

Abstract

In many contexts, such as business, science and law, it is essential to determine whether a company, a product or a person in fact has the reputation attributed to it, regardless of whether that reputation has been rightly earned. In this paper I offer two necessary and jointly sufficient conditions for the attribution of a reputation to a subject within a social group. The first one concerns the way in which reputational information is spread among the members of the relevant social group; the second is the existence, in most members of the group, of a disposition to interpret and evaluate a reputational object in a manner molded by reputational information. Reputational claims generate expectations that are tested every time a member of the group comes in contact with the reputational object. In many cases, the preferential search for behavioral evidence consistent with those expectations will result in a distorted evaluation of the reputational object.



Reconciling Omissions and Causalism

Abstract

If causalism is a complete theory of what it is to behave intentionally, it also has to account for intentional omissions. Carolina Sartorio (Noûs 43 (3), 513–530, 2009) has developed a powerful argument, the Causal Exclusion for Omissions, showing that intentional omissions cannot be explained by causalism. A crucial claim in the argument is that there is a causal competition between a mental omission and the mental action performed instead. In this paper I reject the argument by demonstrating that there is no causal competition ever between an omission and the action performed instead. I propose what I call the Realisationist Conception of Omissions, which consists in considering omissions as multiply realisable absences whose realisers are specific positive actions. I further argue in favour of the Determinationist Conception of Omissions, according to which the relation between omissions and their realisers is a determinable/determinate relation. Since there can be no causal preemption between a determinable and its determinates, there can be no causal preemption between omissions and the actions performed instead, and causalism is safe. I also show that this view of omissions has some other independent advantages – like for example that of solving the problem of the spatio-temporal localisation of omissions.



How to Measure Moral Realism

Abstract

In recent years an increasing number of psychologists have begun to explore the prevalence, causes and effects of ordinary people's intuitions about moral realism. Many of these studies have lacked in construct validity, i.e., they have failed to (fully or exclusively) measure moral realism. My aim in this paper accordingly is to motivate and guide methodological improvements. In analysis of prominent existing measures, I develop general recommendations for overcoming ten prima facie serious worries about research on folk moral realism. G1 and G2 require studies' answer choices to be as metaethically comprehensive as methodologically feasible. G3 and G4 prevent fallacious inferences from intuitions about related debates. G5 and G6 limit first-order moral and epistemic influences. G7 address studies' instructions. And G8 and G9 suggest tests of important psychological presuppositions.



Consciousness, Self-Consciousness, Selfhood: a Reply to some Critics

Abstract

Review of Philosophy and Psychology has lately published a number of papers that in various ways take issue with and criticize my work on the link between consciousness, self-consciousness and selfhood. In the following contribution, I reply directly to this new set of objections and argue that while some of them highlight ambiguities in my (earlier) work that ought to be clarified, others can only be characterized as misreadings.



Evaluation of Safety and Efficacy for an Intranasal Airway Device in Nasal Surgery

This review of medical records and survey study evaluates the safety and efficacy of a silicone intranasal airway device for maintaining airway patency in patients after rhinoplasty and nasal surgery.

Opioid Prescription Patterns After Rhinoplasty

This data analysis examines electronic medical records and a state prescription registry to investigate the prescription patterns for opioids in patients who have undergone rhinoplasty to manage pain in the 3 weeks after surgery.

Trichloroacetic acid as a treatment for persistent oral mucosal lesions in pemphigus vulgaris

Publication date: Available online 6 September 2018

Source: Journal of the American Academy of Dermatology

Author(s): Hamidreza Mahmoudi, Kamran Balighi, Soheil Tavakolpour, Maryam Daneshpazhooh, Cheyda Chams-Davatchi



Lightening Becker’s nevus: Role of topical therapies

Publication date: Available online 6 September 2018

Source: Journal of the American Academy of Dermatology

Author(s): Naveen Kumar Kansal



Reply to MS#JAAD-D-18-01527

Publication date: Available online 6 September 2018

Source: Journal of the American Academy of Dermatology

Author(s): Mao-Qiang Man



Ruxolitinib for the treatment of severe alopecia areata

Publication date: Available online 6 September 2018

Source: Journal of the American Academy of Dermatology

Author(s): Lucy Y. Liu, Brett A. King



Inflammation cutanée de contiguïté : situations diverses et contours flous

Publication date: Available online 5 September 2018

Source: Annales de Dermatologie et de Vénéréologie

Author(s): P. del Giudice



Brachial Plexus Ultrasound and MRI in Children with Brachial Plexus Birth Injury [PEDIATRICS]

BACKGROUND AND PURPOSE:

Brachial plexus birth injury is caused by traction on the neck during delivery and results in flaccid palsy of an upper extremity commonly involving C5–C6 nerve roots. MR imaging and MR myelography help to assess the anatomic location, extent, and severity of brachial plexus injuries which influence the long-term prognosis along with the surgical decision making. Recently, sonography has been increasingly used as the imaging modality of choice for brachial plexus injuries. The aim of this study was to assess the degree of correlation among brachial plexus sonography, MR imaging, and surgical findings in children with brachial plexus birth injury.

MATERIALS AND METHODS:

This prospective study included 55 consecutive patients (girls/boys = 32:23; mean age, 2.1 ± 0.8 months) with brachial plexus birth injury between May 2014 and April 2017. The patients were classified according to the Narakas classification and were followed up at 4- to 6-week intervals for recovery by the Modified Mallet system and sonography without specific preparation for evaluation. All patients had MR imaging under general anesthesia. Nerve root avulsion-retraction, pseudomeningocele, and periscalene soft tissue were accepted brachial plexus injury findings on imaging. Interobserver agreement for MR imaging and the agreement between imaging and surgical findings were estimated using the statistic. The diagnostic accuracy of sonography and MR imaging was calculated on the basis of the standard reference, which was the surgical findings.

RESULTS:

Forty-three patients had pre- and postganglionic injury, 12 had only postganglionic injury findings, and 47% of patients underwent an operation. On sonography, no patients had preganglionic injury, but all patients had postganglionic injury findings. For postganglionic injury, the concordance rates between imaging and the surgical findings ranged from 84% to 100%, and the diagnostic accuracy of sonography and MR imaging was 89% and 100%, respectively. For preganglionic injury, the diagnostic accuracy of MR imaging was 92%. Interobserver agreement and the agreement between imaging and the surgical findings were almost perfect for postganglionic injury ( = 0.81–1, P < .001).

CONCLUSIONS:

High-resolution sonography can identify and locate the postganglionic injury associated with the upper and middle trunks. The ability of sonography to evaluate pre- and the postganglionic injury associated with the lower trunk was quite limited. Sonography can be used as a complement to MR imaging; thus, the duration of the MR imaging examination and the need for sedation can be reduced by sonography.



Adjunctive Efficacy of Intra-Arterial Conebeam CT Angiography Relative to DSA in the Diagnosis and Surgical Planning of Micro-Arteriovenous Malformations [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

Micro-arteriovenous malformations are an underrecognized etiology of intracranial hemorrhage. Our study aimed to assess the adjunctive efficacy of intra-arterial conebeam CTA relative to DSA in the diagnosis and surgical planning of intracranial micro-AVMs.

MATERIALS AND METHODS:

We performed a retrospective study of all micro-AVMs (≤1-cm nidus) at our institution. Blinded neuroradiologists qualitatively graded DSA and intra-arterial conebeam CTA images for the detection of specific micro-AVM anatomic parameters (arterial feeder, micronidus, and venous drainer) and defined an overall diagnostic value. Statistical and absolute differences in the overall diagnostic values defined the relative intra-arterial conebeam CTA diagnostic values, respectively. Blinded neurosurgeons reported their treatment approach after DSA and graded the adjunctive value of intra-arterial conebeam CTA to improve or modify treatment. Intra-arterial conebeam CTA efficacy was defined as interobserver agreement in the relative intra-arterial conebeam CTA diagnostic and/or treatment-planning value scores.

RESULTS:

Ten patients with micro-AVMs presented with neurologic deficits and/or intracranial hemorrhages. Both neuroradiologists assigned a higher overall intra-arterial conebeam CTA diagnostic value (P < .05), secondary to improved evaluation of both arterial feeders and the micronidus, with good interobserver agreement ( = 0.66, P = .018) in the relative intra-arterial conebeam CTA diagnostic value. Both neurosurgeons reported that integrating the intra-arterial conebeam CTA data into their treatment plan would allow more confident localization for surgical/radiation treatment (8/10; altering the treatment plan in 1 patient), with good interobserver agreement in the relative intra-arterial conebeam CTA treatment planning value ( = 0.73, P = .025).

CONCLUSIONS:

Adjunctive intra-arterial conebeam CTA techniques are more effective in the diagnostic identification and anatomic delineation of micro-AVMs, relative to DSA alone, with the potential to improve microsurgical or radiosurgery treatment planning.



MR Imaging Features of Adult-Onset Neuronal Intranuclear Inclusion Disease May Be Indistinguishable from Fragile X-Associated Tremor/Ataxia Syndrome [letter]



Intracranial Serpentine Aneurysms: Spontaneous Changes of Angiographic Filling Pattern [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

Serpentine aneurysms are partially thrombosed aneurysms with an eccentrically located tortuous intra-aneurysmal vascular channel. The large size, distinctive neck anatomy, and supply of the brain parenchyma by the outflow tract pose technical challenges in treatment. The aim of this study was to discuss the endovascular treatment results and illustrate the dynamic nature of serpentine aneurysms. Spontaneous transformation of saccular and fusiform aneurysms into serpentine morphology, along with a case of serpentine-into-fusiform aneurysm transformation during follow-up, is presented.

MATERIALS AND METHODS:

A retrospective analysis from 3 institutions revealed 15 patients with serpentine aneurysms who underwent diagnostic evaluation and endovascular treatment. Nine of the 15 patients underwent endovascular occlusion of the parent vessel with detachable balloon or coils. Six of the 15 patients underwent aneurysm and parent artery occlusion with coiling.

RESULTS:

In 11 patients, improvement or resolution of symptoms was achieved by an endovascular approach without any treatment-related morbidity. Morbidity related to treatment in the immediate postoperative period was seen in 3 patients, with resolution of the deficits at long-term follow-up in 2 patients and persistence of a mild deficit in 1 patient. Endovascular treatment failed to achieve resolution of symptoms in a case with a basilar tip aneurysm treated by aneurysm coiling.

CONCLUSIONS:

Serpentine aneurysms are dynamic structures with spontaneous transformation possible from a saccular or fusiform shape into a serpentine configuration. An endovascular approach by parent vessel occlusion or intra-aneurysmal occlusion is a successful treatment technique for serpentine aneurysms.



Reply: [reply]



Breath-Hold Blood Oxygen Level-Dependent MRI: A Tool for the Assessment of Cerebrovascular Reserve in Children with Moyamoya Disease [FUNCTIONAL]

BACKGROUND AND PURPOSE:

There is a critical need for a reliable and clinically feasible imaging technique that can enable prognostication and selection for revascularization surgery in children with Moyamoya disease. Blood oxygen level–dependent MR imaging assessment of cerebrovascular reactivity, using voluntary breath-hold hypercapnic challenge, is one such simple technique. However, its repeatability and reliability in children with Moyamoya disease are unknown. The current study sought to address this limitation.

MATERIALS AND METHODS:

Children with Moyamoya disease underwent dual breath-hold hypercapnic challenge blood oxygen level–dependent MR imaging of cerebrovascular reactivity in the same MR imaging session. Within-day, within-subject repeatability of cerebrovascular reactivity estimates, derived from the blood oxygen level–dependent signal, was computed. Estimates were associated with demographics and intellectual function. Interrater reliability of a qualitative and clinically applicable scoring scheme was assessed.

RESULTS:

Twenty children (11 males; 12.1 ± 3.3 years) with 30 MR imaging sessions (60 MR imaging scans) were included. Repeatability was "good" on the basis of the intraclass correlation coefficient (0.70 ± 0.19). Agreement of qualitative scores was "substantial" ( = 0.711), and intrarater reliability of scores was "almost perfect" ( = 0.83 and 1). Younger participants exhibited lower repeatability (P = .027). Repeatability was not associated with cognitive function (P > .05). However, abnormal cerebrovascular reactivity was associated with slower processing speed (P = .015).

CONCLUSIONS:

Breath-hold hypercapnic challenge blood oxygen level–dependent MR imaging is a repeatable technique for the assessment of cerebrovascular reactivity in children with Moyamoya disease and is reliably interpretable for use in clinical practice. Standardization of such protocols will allow further research into its application for the assessment of ischemic risk in childhood cerebrovascular disease.



Blunt Cerebrovascular Injuries: Advances in Screening, Imaging, and Management Trends [letter]



Simultaneous Bipedicular Radiofrequency Ablation Combined with Vertebral Augmentation for Local Tumor Control of Spinal Metastases [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

Percutaneous radiofrequency ablation combined with vertebral augmentation has emerged as a minimally invasive treatment for patients with vertebral metastases who do not respond to or have contraindications to radiation therapy. The prevalence of posterior vertebral body metastases presents access and treatment challenges in the unique anatomy of the spine. The purpose of this study was to evaluate the safety and efficacy of simultaneous bipedicular radiofrequency ablation using articulating bipolar electrodes combined with vertebral augmentation for local tumor control of spinal metastases.

MATERIALS AND METHODS:

Imaging-guided simultaneous bipedicular radiofrequency ablation combined with vertebral augmentation was performed in 27 patients (33 tumors) with vertebral metastases selected following multidisciplinary consultations, to achieve local tumor control in this retrospective study. Tumor characteristics, procedural details, and complications were documented. Pre- and postprocedural cross-sectional imaging was evaluated to assess local tumor control rates.

RESULTS:

Thirty-three tumors were successfully ablated in 27 patients. Posterior vertebral body or pedicle involvement or both were present in 94% (31/33) of cases. Sixty-seven percent (22/33) of the tumors involved ≥75% of the vertebral body volume. Posttreatment imaging was available for 79% (26/33) of the treated tumors. Local tumor control was achieved in 96% (25/26) of tumors median imaging follow up of 16 weeks. No complications were reported, and no patients had clinical evidence of metastatic spinal cord compression at the treated levels.

CONCLUSIONS:

Simultaneous bipedicular radiofrequency ablation combined with vertebral augmentation is safe and effective for local tumor control of vertebral metastases. Articulating bipolar electrodes enable the placement and proximity necessary for optimal confluence of the ablation zones. Local tumor control may lead to more durable pain palliation, prevent disease progression, and reduce skeletal-related events of the spine.



Reply: [reply]



Feasibility, Safety, and Periprocedural Complications Associated with Endovascular Treatment of Ruptured Intracranial Aneurysms according to the Depth of Anesthesia [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

The aim of the present study was to report the feasibility, safety, and periprocedural complications associated with EVT of ruptured intracranial aneurysms according to the depth of anesthesia. In most centers, endovascular treatment of intracranial aneurysm is performed under general anesthesia.

MATERIALS AND METHODS:

Between March 2011 and December 2016, a total of 183 consecutive patients with 183 aneurysms were treated endovascularly at the authors' center. The data about the depth of anesthesia (local anesthesia, conscious sedation, deep sedation, and general anesthesia), procedural details, and clinical and radiologic outcomes were reviewed.

RESULTS:

A total of 183 consecutive patients with 183 aneurysms (mean age, 60.2 ± 14.8 years; 54 men and 129 women) were successfully treated. Of these, 70 (38.3%) patients underwent endovascular treatment under local anesthesia, 33 (18.0%) patients underwent endovascular treatment under conscious sedation, 78 (42.6%) patients underwent endovascular treatment under deep sedation, and only 2 (1.1%) patients underwent endovascular treatment under general anesthesia. For patients who presented with Hunt and Hess grades 1, 2, 3, 4, and 5, 75%, 59.6%, 59.1%, 53.3%, and 35.3% were treated under local anesthesia or conscious sedation, respectively. The procedure-related complication rates amounted to 8.7% (16/183, with 11 thromboembolic complications and 5 intraprocedural ruptures) overall, and 7.7% (14/183) of complications were symptomatic events. In the patients with good clinical grade (Hunt and Hess 1 or 2), the procedure-related complication rate was 4.1% (4/97), and all complications were symptomatic events under local anesthesia or conscious sedation.

CONCLUSIONS:

In the authors' experience, local anesthesia or conscious sedation seemed safe and feasible for the patients with good clinical grade SAH.



[other]



Five-Year Longitudinal Study of Neck Vessel Cross-Sectional Area in Multiple Sclerosis [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Alterations of neck vessel cross-sectional area in multiple sclerosis have been reported. Our aim was to investigate the evolution of the neck vessel cross-sectional area in patients with MS and healthy controls during 5 years.

MATERIALS AND METHODS:

Sixty-nine patients with MS (44 relapsing-remitting MS, 25 progressive MS) and 22 age- and sex-matched healthy controls were examined twice, 5 years apart, on a 3T MR imaging scanner using 2D neck MR angiography. Cross-sectional areas were computed for the common carotid/internal carotid arteries, vertebral arteries, and internal jugular veins for all slices between the C3 and C7 cervical levels. Longitudinal cross-sectional area differences at each cervical level and the whole-vessel course were tested within study groups and between patients with MS with and without cardiovascular disease using mixed-model analysis and the related-samples Wilcoxon singed rank test. The Benjamini-Hochberg procedure was performed to correct for multiple comparisons.

RESULTS:

No significant cross-sectional area differences were seen between patients with MS and healthy controls at baseline or at follow-up. During the follow-up, significant cross-sectional area decrease was found in patients with MS for the common carotid artery–ICAs (C4: P = .048; C7: P = .005; whole vessel: P = .012), for vertebral arteries (C3: P = .028; C4: P = .028; C7: P = .028; whole vessel: P = .012), and for the internal jugular veins (C3: P = .014; C4: P = .008; C5: P = .010; C6: P = .010; C7: P = .008; whole vessel: P = .002). Patients with MS without cardiovascular disease had significantly greater change than patients with MS with cardiovascular disease for internal jugular veins at all levels.

CONCLUSIONS:

For 5 years, patients with MS showed significant cross-sectional area decrease of all major neck vessels, regardless of the disease course and cardiovascular status.



Review of the Imaging Features of Benign Osteoporotic and Malignant Vertebral Compression Fractures [SPINE]

SUMMARY:

Vertebral compression fractures are very common, especially in the elderly. Benign osteoporotic and malignant vertebral compression fractures have extremely different management and prognostic implications. Although there is an overlap in appearances, characteristic imaging features can aid in the distinction between these 2 types of compression fractures. The aim of this review is to characterize the imaging features of benign and malignant vertebral compression fractures seen with CT, PET, SPECT, and MR imaging.



Comparison of a Photon-Counting-Detector CT with an Energy-Integrating-Detector CT for Temporal Bone Imaging: A Cadaveric Study [HEAD & NECK]

BACKGROUND AND PURPOSE:

Evaluating abnormalities of the temporal bone requires high-spatial-resolution CT imaging. Our aim was to assess the performance of photon-counting-detector ultra-high-resolution acquisitions for temporal bone imaging and compare the results with those of energy-integrating-detector ultra-high-resolution acquisitions.

MATERIALS AND METHODS:

Phantom studies were conducted to quantify spatial resolution of the ultra-high-resolution mode on a prototype photon-counting-detector CT scanner and an energy-integrating-detector CT scanner that uses a comb filter. Ten cadaveric temporal bones were scanned on both systems with the radiation dose matched to that of the clinical examinations. Images were reconstructed using a sharp kernel, 0.6-mm (minimum) thickness for energy-integrating-detector CT, and 0.6- and 0.25-mm (minimum) thicknesses for photon-counting-detector CT. Image noise was measured and compared using adjusted 1-way ANOVA. Images were reviewed blindly by 3 neuroradiologists to assess the incudomallear joint, stapes footplate, modiolus, and overall image quality. The ranking results for each specimen and protocol were compared using the Friedman test. The Krippendorff α was used for interreader agreement.

RESULTS:

Photon-counting-detector CT showed an increase of in-plane resolution compared with energy-integrating-detector CT. At the same thickness (0.6 mm), images from photon-counting-detector CT had significantly lower (P < .001) image noise compared with energy-integrating-detector CT. Readers preferred the photon-counting-detector CT images to the energy-integrating-detector images for all 3 temporal bone structures. A moderate interreader agreement was observed with the Krippendorff α = 0.50. For overall image quality, photon-counting-detector CT image sets were ranked significantly higher than images from energy-integrating-detector CT (P < .001).

CONCLUSIONS:

This study demonstrated substantially better delineation of fine anatomy for the temporal bones scanned with the ultra-high-resolution mode of photon-counting-detector CT compared with the ultra-high-resolution mode of a commercial energy-integrating-detector CT scanner.



MR Thermography-Guided Head and Neck Lesion Laser Ablation [HEAD & NECK]

SUMMARY:

Interstitial laser ablation has been successfully used as a minimally invasive treatment option for tumors in many parts of the body, including the head and neck. In this article, we describe the use of MR imaging guidance and mapping sequences for accurate localization of the target lesion, percutaneous interstitial laser ablation methods, and the use of MR thermography for temperature monitoring during laser ablation, with a focus on applications in the head and neck region.



Feasibility of a Synthetic MR Imaging Sequence for Spine Imaging [SPINE]

BACKGROUND AND PURPOSE:

Synthetic MR imaging is a method that can produce multiple contrasts from a single sequence, as well as quantitative maps. Our aim was to determine the feasibility of a synthetic MR image for spine imaging.

MATERIALS AND METHODS:

Thirty-eight patients with clinical indications of infectious, degenerative, and neoplastic disease underwent an MR imaging of the spine (11 cervical, 8 dorsal, and 19 lumbosacral MR imaging studies). The SyntAc sequence, with an acquisition time of 5 minutes 40 seconds, was added to the usual imaging protocol consisting of conventional sagittal T1 TSE, T2 TSE, and STIR TSE.

RESULTS:

Synthetic T1-weighted, T2-weighted, and STIR images were of adequate quality, and the acquisition time was 53% less than with conventional MR imaging. The image quality was rated as "good" for both synthetic and conventional images. Interreader agreement concerning lesion conspicuity was good with a Cohen of 0.737. Artifacts consisting of white pixels/spike noise across contrast views, as well as flow artifacts, were more common in the synthetic sequences, particularly in synthetic STIR. There were no statistically significant differences between readers concerning the scores assigned for image quality or lesion conspicuity.

CONCLUSIONS:

Our study shows that synthetic MR imaging is feasible in spine imaging and produces, in general, good image quality and diagnostic confidence. Furthermore, the non-negligible time savings and the ability to obtain quantitative measurements as well as to generate several contrasts with a single acquisition should promise a bright future for synthetic MR imaging in clinical routine.



Gadolinium Deposition in Deep Brain Structures: Relationship with Dose and Ionization of Linear Gadolinium-Based Contrast Agents [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Dose-dependent association between hyperintensity in deep brain structures on unenhanced T1WIs and gadolinium-based contrast agent administrations has been demonstrated with subsequent histopathological confirmation of gadolinium deposition. Our aim was to determine whether greater exposure to linear gadolinium-based contrast agent administration is associated with higher signal intensity in deep brain structures on unenhanced T1-weighted MR imaging. Secondary objective was to compare signal intensity differences between ionic and nonionic linear gadolinium-based contrast agents.

MATERIALS AND METHODS:

Subjects with secondary-progressive MS originally enrolled in a multicenter clinical trial were studied retrospectively. Eighty subjects (high-exposure cohort) received 9 linear gadolinium-based contrast agent administrations (30 nonionic/50 ionic) between week –4 and year 1 and a tenth administration by year 2. One hundred fifteen subjects (low-exposure cohort) received 2 administrations (40 nonionic/75 ionic) between week –4 and year 1 and a third administration by year 2. Signal intensities were measured on unenhanced T1WIs by placing sample-points on the dentate nucleus, globus pallidus, caudate, thalamus, pons, and white matter, and they were normalized using the following ratios: dentate/pons, globus pallidus/white matter, caudate/white matter, and thalamus/white matter.

RESULTS:

Between week –4 and year 1, subjects in the high-exposure cohort showed increased signal intensity ratios in all regions (P < .01), while the low-exposure cohort showed only an increase in the dentate nucleus (P = .003). Between years 1 and 2, when both cohorts received only 1 additional gadolinium-based contrast agent, no significant changes were observed. In the high-exposure cohort, significantly higher changes in signal intensity ratios were observed in subjects receiving linear nonionic than in those receiving linear ionic gadolinium-based contrast agents.

CONCLUSIONS:

Hyperintensity in deep brain structures from gadolinium deposition is related to the number of doses and the type of linear gadolinium-based contrast agent (nonionic greater than ionic) administration.



Memorial: Galdino Valvassori, MD, FACR [letter]



Gadolinium Deposition within the Pediatric Brain: No Increased Intrinsic T1-Weighted Signal Intensity within the Dentate Nucleus following the Administration of a Minimum of 4 Doses of the Macrocyclic Agent Gadoteridol [PEDIATRICS]

BACKGROUND AND PURPOSE:

Our aim was to evaluate whether serial administration of the macrocyclic gadolinium-based contrast agent gadoteridol in children is associated with T1-weighted hyperintensity within the dentate nucleus, an imaging surrogate for gadolinium deposition.

MATERIALS AND METHODS:

We identified a retrospective cohort of 10 patients younger than 18 years of age who underwent between 4 and 8 gadoteridol-enhanced MR imaging examinations of the brain from 2016 to 2017. For comparison, we identified a retrospective cohort of 9 pediatric patients who each underwent 6 gadodiamide-enhanced MR imaging examinations. For each examination, both dentate nuclei were contoured on unenhanced images and the mean dentate-to-pons signal intensity ratio was calculated. Dentate-to-pons signal intensity ratios from the first and last scans were compared using paired t tests.

RESULTS:

In the gadoteridol group, there was no significant change in the mean dentate-to-pons signal intensity ratio from the first to the last scan (0.99 versus 0.99, P = .59). In the gadodiamide group, there was a significant increase in the mean dentate-to-pons signal intensity ratio from the first to the last scan (0.99 versus 1.10, P = .001).

CONCLUSIONS:

Repeat administration of the macrocyclic gadolinium-based contrast agent gadoteridol in children was not associated with T1-weighted dentate hyperintensity, while the repeat administration of the linear gadolinium-based contrast agent gadodiamide was associated with T1-weighted dentate hyperintensity, presumably due to gadolinium deposition.



Invisible Empire of Hate: Gender Differences in the Ku Klux Klan's Online Justifications for Violence

Violence and Gender, Ahead of Print.


Updated Guidelines on Complex Regional Pain Syndrome in Adults

Publication date: Available online 6 September 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): James Henderson

Abstract

A multidisciplinary team representing 28 professional bodies has updated the guidelines for the management of Complex regional Pain Syndrome (CRPS), published by the Royal College of Physicians of England (RCP) 2018. The author represented the British Association of Plastic, Reconstructive and Aesthetic Surgeons in this process and is an author of the guidelines. This article summarises the updated guidelines and highlights aspects relevant to Plastic and Reconstructive Surgery.



Determining Post-Operative Outcomes After Cleft Palate Repair: A Systematic Review and Meta Analysis

Publication date: Available online 5 September 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Michael J. Stein, Zach Zhang, Matthew Fell, Nigel Mercer, Claudia Malic

Abstract
Background

A lack of high level evidence exists on the outcomes of different cleft palate repair techniques. A critical appreciation for the complication rates of common repair techniques is paramount to optimize cleft palate care.

Methods

A literature search was conducted for articles measuring fistula and VPI rates following cleft palate repair. Study quality was determined using validated scales. The heterogeneity between studies was evaluated using I2. Random effect model analysis and forest plots were used to report pooled relative risks (RR) with 95% confidence intervals for treatment effect. P-values of 0.05 were considered statistically significant.

Results

Of 2386 studies retrieved, 852 underwent screening and 227 met inclusion criteria (130 studies (57%) on fistulas and 122 studies (54%) on VPI). Meta-analyses were performed using 32 studies. The Furlow technique is associated with less post-operative fistulae than the von Langenbeck and Veau/Kilner/Wardill techniques (RR=0.56[0.39–0.79],p<0.01 and RR=0.25[0.12–0.52],p<0.01 respectively). One-stage repair is associated with less fistulae compared to two-stage repair (RR=0.42[0.19–0.96],p=0.04). The Furlow repair was also associated with a less VPI than the Bardach palatoplasty (RR=0.41[0.23, 0.71],p<0.01) and the one-stage repair is associated with a reduction in VPI rates compared to two-stage repairs (RR=0.55[0.32, 0.95],p=0.03).

Conclusion

The Furlow repair is associated with less risk of fistula formation than the von Langenbach and Veau/Kilner/Wardill techniques and less VPI compared to the Bardach repair. One-stage repair is associated with less risk of fistula formation and VPI than two-stage repairs.



Comments on “Long-term outcome of patients with or without osseointegrated implants after resection of mandibular ameloblastoma and reconstruction with vascularized bone graft: Functional assessment and quality of life”

Publication date: Available online 5 September 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Meng Wang, Yubin Cao, Xuedong Zhou



Septocutaneous thoracodorsal artery perforator flaps: a retrospective cohort study

Publication date: Available online 5 September 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Shimpei Miyamoto, Masaki Arikawa, Yu Kagaya, Yutaka Fukunaga

Abstract
Background

This study aimed to investigate the versatility of septocutaneous thoracodorsal artery perforator flaps in various areas in the body and the running pattern of septocutaneous perforators.

Methods

This retrospective cohort study included 20 consecutive patients who underwent reconstruction of an oncology-related defect with a septocutaneous thoracodorsal artery perforator flap from May 2014 to January 2018. Fifteen flaps were free and the other five were pedicled. Surgical details and postoperative complications were investigated.

Results

The flap size ranged from 13 × 6.5 to 22 × 15 cms. The defect location was the upper extremity in eight patients, the head and neck in six, the lower extremity in four, and the trunk in two. The septocutaneous perforator arose from the thoracodorsal vessels proximal to the serratus anterior branch in 10 (50.0%) patients, from the thoracodorsal vessels distal to the serratus anterior branch in six (30.0%), and from the serratus anterior branch in four (20.0%). All flaps completely survived, except for one with partial necrosis. The scapula was simultaneously harvested based on the angular branch in three patients who underwent mandibular reconstruction.

Conclusions

The septocutaneous thoracodorsal artery perforator flap can be a versatile option for various types of reconstruction if the dominant septocutaneous perforator is present. Prevalence of the dominant septocutaneous thoracodorsal artery perforator is estimated at approximately 50%. However, this flap can be harvested without tedious intramuscular dissection and the two-team approach is possible during tumor resection. The presence of the dominant septocutaneous perforator can expand indication of the thoracodorsal artery perforator flap.



Adsorption behavior of chloroform, carbon disulfide, and acetone on coconut shell-derived carbon: experimental investigation, simulation, and model study

Abstract

The adsorption performances of chloroform (TCM), carbon disulfide (CDS), and acetone (CP) were investigated and compared over self-prepared coconut shell-derived carbon (CDC) to study the adsorption behavior and mechanism of heteroatom (Cl, S, O)-containing volatile organic compounds (VOCs). The result indicates that the adsorption capacity of three typical VOCs obeys the sequence: TCM (361 mg/g) > CDS (194 mg/g) > CP (37 mg/g). However, desorption experiments show that adsorption intensity follows the order: CDS (165 °C) > TCM (147 °C) > CP (130 °C). The influence of surface oxygen-containing functional groups over CDC on adsorption performance was also studied by temperature programmed desorption (TPD) and in situ DRIFT spectra. It is implied that carbonyl in lactone and benzoquinonyl of CDC could affect VOC adsorption intensity by conjugation effect. Furthermore, adsorption isotherms of three VOCs were obtained through Grand Canonical Monte Carlo (GCMC) simulation and then fitted by classical isothermal models. Furthermore, the total adsorption potentials are calculated by potential theory, and the result follows the order: TCM (− 2.18 kJ/mol) > CDS (− 2.1 kJ/mol) > CP (− 1.5 kJ/mol). It is believed that the effect of magnetic susceptibility (χ) is more crucial than polarizability () and the distance r between the interacting molecules for the potential difference.



Remediation potential of caffeine, oxybenzone, and triclosan by the salt marsh plants Spartina maritima and Halimione portulacoides

Abstract

Pharmaceuticals and personal care products (PPCPs) have attracted increasing concern during the last decade because of their widespread uses and continuous release to the aquatic environment. This work aimed to study the distribution of caffeine (CAF), oxybenzone (MBPh), and triclosan (TCS) when they arrive in salt marsh areas and to assess their remediation potential by two different species of salt marsh plants: Spartina maritima and Halimione portulacoides. Experiments were carried out in the laboratory either in hydroponics (sediment elutriate) or in sediment soaked in elutriate, for 10 days. Controls without plants were also carried out. CAF, MBPh, and TCS were added to the media. In unvegetated sediment soaked in elutriate, CAF was mainly in the liquid phase (83%), whereas MBPh and TCS were in the solid phase (90% and 56%, respectively); the highest remediation was achieved for TCS (40%) and mainly attributed to bioremediation. The presence of plants in sediment soaked in elutriate-enhanced PPCPs remediation, decreasing CAF and TCS levels between approximately 20-30% and MBPh by 40%.. Plant uptake, adsorption to plant roots/sediments, and bio/rhizoremediation are strong hypothesis to explain the decrease of contaminants either in water or sediment fractions, according to PPCPs characteristics.



Recall urticaria - a new clinical sign in the diagnosis of alpha-gal syndrome

Publication date: Available online 5 September 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Paul Schmidle, Klara Reidenbach, Claudia Kugler, Bernadette Eberlein, Tilo Biedermann, Ulf Darsow



The use of medical alert jewelry to communicate allergy information

Publication date: Available online 5 September 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Thanh-Thao (Adriana) Le, Caroline Foreman, William Smith



CME Exam: Eosinophilic Esophagitis

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s):



Eosinophilic Esophagitis

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Benjamin L. Wright, Jonathan M. Spergel



Disseminated abscesses due to Mycoplasma faucium in a patient with activated PI3Kδ syndrome type 2

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Nerea Dominguez-Pinilla, Luis M. Allende, Jérémie Rosain, Maria del Carmen Gallego, Fernando Chaves, Caroline Deswarte, Esther Viedma, Jaime de Inocencio Arocena, Jesús Ruiz-Contreras, Jacinta Bustamante, Luis Ignacio Gonzalez-Granado



A survey of caregiver perspectives on emergency epinephrine autoinjector sharing

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Marcus Shaker, Tsuzumi Kanaoka, Robert G.P. Murray, Dana Toy, Susan Shaker, Aurora Drew



The B antigen protects against the development of red meat allergy

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Jonathan R. Brestoff, Merih T. Tesfazghi, Mark A. Zaydman, Ronald Jackups, Brian S. Kim, Mitchell G. Scott, Ann M. Gronowski, Brenda J. Grossman



Coca-Cola allergy identified as fructose-induced anaphylaxis

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Chang-Gyu Jung, Eun-Mi Yang, Ji-Ho Lee, Seung-Hyun Kim, Hae-Sim Park, Yoo Seob Shin



Implementation of guidelines for early peanut introduction at a pediatric academic center

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): David R. Stukus, Ben T. Prince, Irene Mikhail



Allergic myocardial infarction (Kounis syndrome) after cefuroxime with side-chain cross-reactivity

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Magdalena Absmaier, Tilo Biedermann, Knut Brockow



Conjunctivitis occurring in atopic dermatitis patients treated with dupilumab–clinical characteristics and treatment

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Andreas Wollenberg, Lieneke Ariens, Stephan Thurau, Chantal van Luijk, Marlene Seegräber, Marjolein de Bruin-Weller



Male X-chromosome mosaicism leading to carrier phenotype and inheritance of chronic granulomatous disease

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Stephanie Harris, Helen Braggins, Karin van Leeuwen, Kimberly Gilmour, Matthew S. Buckland, Dirk Roos, David M. Lowe



Ara h 2 basophil activation test does not predict clinical reactivity to peanut

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Alexandra Chapuis, Jonathan Thevenot, Frédéric Coutant, Khaled Messaoudi, Elodie Michaud, Bruno Pereira, Emmanuelle Rochette, Nelly Gourdon-Dubois, Etienne Merlin, Jean-Luc Fauquert, Bertrand Evrard, Paul Rouzaire



Partial RAG deficiency in a patient with varicella infection, autoimmune cytopenia, and anticytokine antibodies

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Vera Goda, Aniko Malik, Tibor Kalmar, Zoltan Maroti, Bhumika Patel, Boglarka Ujhazi, Krisztian Csomos, Jaime E. Hale, Karin Chen, Jacob Bleesing, Paolo Palma, Caterina Cancrini, Anne M. Comeau, Gergely Krivan, Jolan E. Walter



DRESS Syndrome due to benzylpenicillin with cross-reactivity to amoxicillin

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Timothy J. Watts, Philip H. Li, Rubaiyat Haque



Liver disturbances in activated phosphoinositide 3-kinase δ syndrome

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Gil Ben-Yakov, Devika Kapuria, Jamie Marko, Min Ho Cho, Stefania Pittaluga, David Erwin Kleiner, Christopher Koh, Steven Holland, Gulbu Uzel, Theo Heller



Successful subcutaneous desensitization in a patient with allergy to ixekizumab

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Ruth Barranco Jimenez, Daiana Guillen Vera, Raquel Rivera-Díaz, Susana Cortijo-Cascajares, Ruth Mielgo Ballesteros, María del Carmen Diéguez Pastor



Treatment with the SQ house dust mite sublingual immunotherapy tablet may be initiated year-round

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Hendrik Nolte, David I. Bernstein, Jörg Kleine-Tebbe, Peter A. Fejerskov, Qing Li, Susan Lu, Harrold S. Nelson



A penicillin skin testing initiative in an outpatient allergy office

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Allison Ramsey, S. Shahzad Mustafa



Smell loss is associated with severe and uncontrolled disease in children and adolescents with persistent allergic rhinitis

Publication date: September–October 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 6, Issue 5

Author(s): Franklin Mariño-Sanchez, Meritxell Valls-Mateus, Oliver Haag, Isam Alobid, Jean Bousquet, Joaquim Mullol



Advanced Imaging of the Left Atrium with Cardiac Magnetic Resonance: A Review of Current and Emerging Methods and Clinical Applications

Abstract

Purpose of Review

The thin wall of the left atrium (LA) is difficult to visualize. The high spatial and temporal resolution of cardiac magnetic resonance (CMR) allows for the most accurate assessment of left atrial structure, function, and tissue characterization. This review will describe emerging methods used to image the LA with CMR, and will discuss associated clinical applications.

Recent Findings

LA function can now be described in a dynamic fashion with feature-tracking algorithms. Novel methods have been created to augment visualization of late gadolinium enhancement (LGE) in the LA, and left atrial fibrosis can be further quantified with T1 mapping algorithms. The advancement in how we image the LA with CMR has implications in atrial fibrillation (AF) and cardiomyopathic processes.

Summary

A nuanced understanding of left atrial pathology is emerging with the rapid advancement of CMR technology, which has implications in the risk stratification and treatment of several cardiovascular disease states.



Analysis of the results of empirical research and surveys of perceived indoor temperature depending on gender and seasons

Abstract

The indoor thermal condition tests were conducted as real and declared by the respondents. The tests were carried out in the laboratory room in Bialystok. The object is a detached, two-storey building with a cellar. The tests were carried out from February to May 2015. In 1 week, on average, ten measurement series were carried out. During one experiment series, there were between 10 and 15 students present in the room. The aim of the publication is to analyze the results of declared perceived temperature tests in the room depending on the gender, the season and indoor and outdoor temperature conditions. On the basis of statistical analysis of the test results, it was found that in the analyzed age group, the perceived temperature declared in the room is not affected by the respondent's gender. The conclusion is that the temperature sensations of young (and probably healthy) people who do not do physical work are similar, regardless of gender. Differences between the average perceived temperature in the room, declared by all respondents in winter and declared in spring are statistically significant. The indoor perceived temperature declared in the winter is almost constant and does not depend on the temperature of the perceived temperature of outdoor air.



Water quality modeling of a prairie river-lake system

Abstract

Eutrophication of an under-ice river-lake system in Canada has been modeled using the Water Quality Analysis Simulation Program (WASP7). The model was used to assess the potential effect on water quality of increasing inter-basin transfer of water from an upstream reservoir into the Qu'Appelle River system. Although water is currently transferred, the need for increased transfer is a possibility under future water management scenarios to meet water demands in the region. Output from the model indicated that flow augmentation could decrease total ammonia and orthophosphate concentrations especially at Buffalo Pound Lake throughout the year. This is because the water being transferred has lower concentrations of these nutrients than the Qu'Appelle River system, although there is complex interplay between the more dilute chemistry, and the potential to increase loads by increasing flows. A global sensitivity analysis indicated that the model output for the lake component was more sensitive to input parameters than was the model output of the river component. Sensitive parameters included dissolved organic nitrogen mineralization rate, phytoplankton nitrogen to carbon ratio, phosphorus-to-carbon ratio, maximum phytoplankton growth rate, and phytoplankton death rate. Parameter sensitivities on output variables for the lake component were similar for both summer (open water) and winter (ice-covered), whereas those for the river component were different. The complex interplay of water quality, ice behaviors, and hydrodynamics of the chained river-lake system was all coupled in WASP7. Mean absolute error varied from 0.03–0.08 NH4-N/L for ammonium to 0.5 to1.7 mg/L for oxygen, and 0.04–0.13 NO3-N/L for nitrate.



PREHISTORIC BODY THEATER: bringing paleontology narratives to global contemporary performance audiences

narrativestorytellingperformanceoutreachdance-theaterpaleontology

Pazopanib may reduce bleeding in hereditary hemorrhagic telangiectasia

Abstract

Pazopanib (Votrient) is an orally administered tyrosine kinase inhibitor that blocks VEGF receptors potentially serving as anti-angiogenic treatment for hereditary hemorrhagic telangiectasia (HHT). We report a prospective, multi-center, open-label, dose-escalating study [50 mg, 100 mg, 200 mg, and 400 mg], designed as a proof-of-concept study to demonstrate efficacy of pazopanib on HHT-related bleeding, and to measure safety. Patients, recruited at 5 HHT Centers, required ≥ 2 Curacao criteria AND [anemia OR severe epistaxis with iron deficiency]. Co-primary outcomes, hemoglobin (Hgb) and epistaxis severity, were measured during and after treatment, and compared to baseline. Safety monitoring occurred every 1.5 weeks. Seven patients were treated with 50 mg pazopanib daily. Six/seven showed at least 50% decrease in epistaxis duration relative to baseline at some point during study; 3 showed at least 50% decrease in duration during Weeks 11 and 12. Six patients showed a decrease in ESS of > 0.71 (MID) relative to baseline at some point during study; 3/6 showed a sustained improvement. Four patients showed > 2 gm improvement in Hgb relative to baseline at one or more points during study. Health-related QOL scores improved on all SF-36 domains at Week 6 and/or Week 12, except general health (unchanged). There were 19 adverse events (AE) including one severe AE (elevated LFTs, withdrawn from dosing at 43 days); with no serious AE. In conclusion, we observed an improvement in Hgb and/or epistaxis in all treated patients. This occurred at a dose much lower than typically used for oncologic indications, with no serious AE. Further studies of pazopanib efficacy are warranted.



Solar Ultraviolet Radiation Exposure and Sun Protection Behaviours and Knowledge Among a High Risk and Overlooked Group of Outdoor Workers in South Africa

Photochemistry and Photobiology, Volume 0, Issue ja, -Not available-.


Adverse effects of fillers

Dermatologic Therapy, EarlyView.


Commentary on adverse effects of isotretinoin article by Brezenski et al.

Dermatologic Therapy, EarlyView.


Commentary on article on clinical efficacy of oral finasteride by Won, Lew, and Sim

Dermatologic Therapy, EarlyView.


Loose Ends in the Epidemiology of the 1918 Pandemic: Explaining the Extreme Mortality Risk in Young Adults

Abstract
In the century since the 1918 influenza pandemic, insights have been sought to explain the pandemic's signature pattern of high death rates in young adults and low death rates in the elderly and infants. Our understanding of the origin and evolution of the pandemic has shifted considerably. We review evidence of the characteristic age-related pattern of death during the 1918 pandemic relative to the "original antigenic sin" hypothesis. We analyze age-stratified mortality data from Copenhagen around 1918 to identify break points associated with unusual death risk. Whereas infants had no meaningful risk elevation, death risk gradually increased, peaking for young adults 20–34 years of age before dropping sharply for adults ages 35–44 years, suggesting break points for birth cohorts around 1908 and 1878. Taken together with data from previous studies, there is strong evidence that those born before 1878 or after 1908 were not at increased risk of dying of 1918 pandemic influenza. Although the peak death risk coincided with the 1889–1892 pandemic, the 1908 and 1878 break points do not correspond with known pandemics. An increasing number of interdisciplinary studies covering fields such as virology, phylogenetics, death, and serology offer exciting insights into patterns and reasons for the unusual extreme 1918 pandemic mortality risk in young adults.

Addressing Extreme Propensity Scores via the Overlap Weights

Abstract
The popular inverse probability weighting method in causal inference is often hampered by extreme propensity scores, resulting in biased estimates and excessive variance. A common remedy is to trim patients with extreme scores. However, such methods are often sensitive to the choice of cutoff points and discard a large proportion of the sample. The implications to bias and precision of the treatment effect estimate are unclear. These problems are mitigated by the newly developed overlap weighting method. Overlap weights emphasize the target population with the most overlap in observed characteristics between treatments, by continuously down-weighting the units in the tails of the propensity score distribution. We use simulations to compare overlap weights to standard inverse probability weighting with trimming, in terms of bias, variance and confidence interval coverage. A range of propensity score distributions are considered, including settings with substantial non-overlap and extreme values. To facilitate practical implementation, we further provide a consistent estimator for standard error of the treatment effect estimated using overlap weighting.

Fluconazole resistance is not a predictor of poor outcome in patients with cryptococcosis

Mycoses, Volume 0, Issue ja, -Not available-.


Cyberlindnera fabianii Fungemia Outbreak in Preterm Neonates in Kuwait and Literature Review

Mycoses, Volume 0, Issue ja, -Not available-.


Increased risk of depression in patients with cutaneous lupus erythematosus and systemic lupus erythematosus: a Danish nationwide cohort study

British Journal of Dermatology, EarlyView.


Impact of a rare chronic genodermatosis on family daily life: the example of epidermolysis bullosa

British Journal of Dermatology, EarlyView.


Eighth American Joint Committee on Cancer (AJCC) melanoma classification: what about stage IIC?

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Cutaneous Mucormycosis caused by Mucor irregularis in a patient with CARD9 deficiency

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Etanercept biosimilar SB4 in the treatment of chronic plaque psoriasis. Data from the Psobiosimilars registry

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Fingernail involvement in pemphigus and its correlation with disease severity and other clinico‐demographic parameters

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


The Adverse Effects of Topical Photodynamic Therapy: a consensus review and approach to management

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Psychosocial impact of skin biopsies in the setting of melanoma screening – A cross‐sectional survey

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Acute Exacerbation of Carpal Tunnel Syndrome After Radiesse® Injection for Hand Rejuvenation

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Skin involvement by chronic lymphocytic leukemia is frequently associated with unrelated neoplastic or inflammatory cutaneous disease and is not indicative of general disease progression

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


Increase in preventive behaviour by organ transplant recipients after sun protection information in a skin cancer surveillance clinic

British Journal of Dermatology, EarlyView.


Joint recommendations for retinal screening in long‐term users of hydroxychloroquine and chloroquine in the United Kingdom, 2018

British Journal of Dermatology, EarlyView.


Temperature and humidity affect the incidence of hand, foot, and mouth disease: a systematic review of the literature – a report from the International Society of Dermatology Climate Change Committee

International Journal of Dermatology, EarlyView.


A case of bullous eruptive disseminated porokeratosis

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


Langerhans Cell Histiocytosis with Prominent Nail Involvement

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


Solid carcinoma is a variant of microcystic adnexal carcinoma: A 14‐Case series

Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.


Multimodal Skin Lesion Classification using Deep Learning

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


Com-Posting Experimental Futures: Pragmatists Making (Odd)Kin with New Materialists

Abstract

Here I craft a case for recognizing the roots and patterns that ground the possibility of contemporary com-posting—as outlined in Donna Haraway's Staying with the Trouble—by New Materialists and critical pragmatists, especially those who are affected by the social injustices and ill-advised practices of today's formal education. I explore both Spinozan Ethics and American pragmatism (and the ways each seems to be and mean more in their juxtaposition and interaction) in order to fashion a pattern that affects educational thought and action. That pattern of affect/affecting is one Haraway calls "attunement" (via Vinciane Despret), a state of co-relation that makes "unexpected feats possible." My goal is to encourage those educational theorists who dwell in a critical pragmatist archive and those who dwell in a New Materialist archive to "make kin," to learn to play string figures with a companion species, as they com-post educational possibility in a world(view) where agency is both more limited and more widely-distributed.



Long‐term outcomes following sweat gland excision for axillary hyperhidrosis

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.


Cryopyrin‐associated periodic syndrome (CAPS) in a patient with NLRP3 T348M mutation

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.


Kongresskalender 2018

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, September 2018.


Robert Pfleger‐Forschungspreises 2018 an Prof. Dr Karin Scharffetter‐Kochanek

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1176-1176, September 2018.


Journal‐Club

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1171-1171, September 2018.


Bläulich‐graue Pigmentierung

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1149-1151, September 2018.


Phototherapy

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1120-1129, September 2018.


Autoimmunität gegen heterogenes nukleäres Ribonukleoprotein A1 bei Psoriasispatienten und Korrelation mit dem Schweregrad der Erkrankung

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1103-1108, September 2018.


Prof. Dr. med. Heinz Langhof (1918–1965) – Leben und Werk eines bedeutenden aber fast vergessenen Dermatologen Deutschlands und sein Beitrag zur Erstbeschreibung der erythropoetischen Protoporphyrie sowie für den Beginn der Zytokinforschung

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1172-1175, September 2018.


Adjuvante Behandlung des schweren/refraktären bullösen Pemphigoids mit Protein‐A‐Immunadsorption

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1109-1119, September 2018.


Geschickte Positionierung Burowscher Dreiecke lokaler Lappenplastiken zum ästhetisch ansprechenden Verschluss multipler Defekte nach Tumorexzisionen

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1166-1169, September 2018.


Adjuvant treatment of severe/refractory bullous pemphigoid with protein A immunoadsorption

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1109-1118, September 2018.


Autoimmunity to heterogeneous nuclear ribonucleoprotein A1 in psoriatic patients and correlation with disease severity

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1103-1107, September 2018.


Phototherapie

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1120-1131, September 2018.


Rezidivierende ulzeronekrotische Plaques und Knoten mit spontaner Remission

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1155-1158, September 2018.


Informationssuche und Nutzung von Informationsquellen durch Melanompatienten deutscher Hautkrebszentren

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1093-1102, September 2018.


Paradoxe Reaktion auf Infliximab: Uveitis und Pyoderma gangraenosum bei einer Patientin mit Psoriasisarthritis

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1139-1141, September 2018.


Erratum

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1170-1170, September 2018.


Diagnostik blasenbildender Autoimmundermatosen

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue 9, Page 1077-1092, September 2018.