Nevus azul subungueal

Publication date: Available online 7 October 2017
Source:Actas Dermo-Sifiliográficas
Author(s): C. Fachal, L.C. Pérez-Pérez, F. Allegue, S. Calviño

Incidence and Predictors of Venous Thromboembolism in Abdominoplasty

Abstract

Background

The prevention of venous thromboembolism (VTE) is a high priority in aesthetic surgery. Abdominoplasty is the aesthetic procedure most commonly associated with VTE, yet the mechanisms for the development of VTE associated with this procedure are unclear.

Objectives

The purpose of this study was to analyze the incidence and predictors of VTE in patients undergoing abdominoplasty procedures in outpatient surgery centers using data from the Internet Based Quality Assurance Program (IBQAP).

Methods

IBQAP data from 2001 to 2011 were queried retrospectively to identify abdominoplasty cases and VTE cases. Patient- and procedure-specific variables were analyzed to identify potential predictors of VTE in abdominoplasty.

Results

Among all outpatient aesthetic surgery cases entered from 2001 to 2011, 414 resulted in VTE, representing a VTE incidence of 0.02%. Of these, 240 (58%) occurred in abdominoplasty cases. Predictors of VTE were age greater than 40 years and BMI greater than 25 kg/m². Patient sex, duration of anesthesia and surgery, type of anesthesia, type of additional procedure, and number of procedures did not appear to influence the risk of VTE. Importantly, 95.5% of the VTEs identified for this study occurred in patients whose Caprini risk assessment model score was between 2 and 8, which would not be an indication for chemoprophylaxis according to current recommendations.

Conclusions

Many factors must be considered when determining the true incidence of VTE in abdominoplasty. Research is needed to discover the reason abdominoplasty carries a greater risk compared with other aesthetic surgery procedures so that appropriate steps can be taken to prevent its occurrence and improve the safety of the procedure.

Level of Evidence: 2

The Balcony Technique of Breast Augmentation and Inverted-T Mastopexy With an Inferior Dermoglandular Flap

Abstract

Background

Optimal breast augmentation-mastopexy involves a reliable technique, fast recovery, minimal complications, and aesthetic results that are excellent and enduring.

Objectives

The authors sought to determine whether the balcony technique of augmentation-mastopexy was safe and yielded satisfactory long-term outcomes in patients with breast ptosis and hypoplasia.

Methods

The authors conducted a retrospective review of 207 patients who underwent subglandular augmentation and inverted-T mastopexy with a customized Wise keyhole resection pattern and an inferior flap. Patient satisfaction was assessed anonymously on a visual analog scale via a questionnaire administered 4 years postoperatively.

Results

A total of 182 women received follow-up for 48 months and were included in statistical analyses. High levels of satisfaction were determined using Fischer exact test for breast shape, size, and symmetry, but not for other items, such as scar appearance, body perception, or self-esteem. The most common complications were Baker II capsular contracture and wound dehiscence. No patient experienced nipple loss or skin flap necrosis.

Conclusions

The results of this long-term analysis demonstrate that the balcony technique of augmentation-mastopexy is suitable for patients with breast ptosis and hypoplasia.

Level of Evidence: 4

Soil aggregate and organic carbon distribution at dry land soil and paddy soil: the role of different straws returning

Abstract

Agriculture wastes returning to soil is one of common ways to reuse crop straws in China. The returned straws are expected to improve the fertility and structural stability of soil during the degradation of straw it selves. The in situ effect of different straw (wheat, rice, maize, rape, and broad bean) applications for soil aggregate stability and soil organic carbon (SOC) distribution were studied at both dry land soil and paddy soil in this study. Wet sieving procedures were used to separate soil aggregate sizes. Aggregate stability indicators including mean weight diameter, geometric mean diameter, mean weight of specific surface area, and the fractal dimension were used to evaluate soil aggregate stability after the incubation of straws returning. Meanwhile, the variation and distribution of SOC in different-sized aggregates were further studied. Results showed that the application of straws, especially rape straw at dry land soil and rice straw at paddy soil, increased the fractions of macro-aggregate (> 0.25 mm) and micro-aggregate (0.25–0.053 mm). Suggesting the nutrients released from straw degradation promotes the growing of soil aggregates directly and indirectly. The application of different straws increased the SOC content at both soils and the SOC mainly distributed at < 0.53 mm aggregates. However, the contribution of SOC in macro- and micro-aggregates increased. Straw-applied paddy soil have a higher total SOC content but lower SOC contents at > 0.25 and 0.25–0.053 mm aggregates with dry land soil. Rape straw in dry land and rice straw in paddy field could stabilize soil aggregates and increasing SOC contents best.

Responses of growth, malformation, and thyroid hormone-dependent genes expression in Bufo gargarizans embryos following chronic exposure to Pb 2+

Abstract

The aim of this study was to examine the adverse effects of lead (Pb) exposure on Bufo gargarizans embryos. The 96 h-LC₅₀ of Pb²⁺ for B. gargarizans embryos was determined to be 26.6 mg L⁻¹ after an acute test. In the chronic test, B. gargarizans embryos at Gosner stage 3 were exposed to 10~2000 μg Pb²⁺ L⁻¹ during embryogenesis. Total length, weight, developmental stage, and malformation were monitored. In addition, the transcript levels of type II and type III iodothyronine deiodinase (Dio2 and Dio3) and thyroid hormone receptors (TRα and TRβ) were determined to assess the thyroid-disrupting effects of Pb²⁺. Slightly increased growth and development of B. gargarizans embryos were observed at low concentrations of Pb²⁺ (10, 50, and 100 μg L⁻¹), while retarded growth and development were found at high concentrations of Pb²⁺ (1000 and 2000 μg L⁻¹). In addition, Pb²⁺ exposure induced morphological abnormalities, which were characterized by edema at tail, wavy fin, abdominal edema, stunted growth, hyperplasia, and axial flexures in B. gargarizans embryos. Furthermore, our results showed that exposure to 2000 μg Pb²⁺ L⁻¹ decreased the transcript levels of Dio2, TRα, and TRβ, but it increased Dio3 mRNA level. In contrast, exposure to 50 μg Pb²⁺ L⁻¹ increased TRα mRNA level and decreased Dio3 mRNA level. These results suggested that Pb²⁺ might have thyroid-disrupting effects, leading to the disruption of growth and development in B. gargarizans embryos.

Human biomonitoring of eight trace elements in urine of residents living in rural areas along the Yangtze River, China

Abstract

The rapid economic development and industrialization have made heavy metal contamination a great public concern, especially in China. However, the levels of heavy metals in human body, especially those susceptible to the effect of industrial progression, are rarely explored. In this study, eight elements in 2643 urinary samples of individuals living in rural areas along the Yangtze River were determined through inductively coupled plasma optical emission spectrometry (As, Cr, Cu, Fe, Mn, Pb, and Zn) and TAS-990 atomic absorption spectrophotometry (Cd). Two-level regression model was applied to explore the potential factors associated with the level of the eight trace elements. After adjusting for urinary creatinine, the geometric means were 77.5, 10.98, 14.39, 13.00, 0.59, 1.51, 489.62, and 1.80 μg/g for As, Cr, Cu, Fe, Mn, Pb, Zn, and Cd, respectively. The level of eight elements varied among individual and familial characteristics. Compared with domestic and international results, the rural residents living in riverside areas had higher level of As, Cd, Cr, Fe, and Zn. Therefore, industrial progression followed by economic development has resulted in high body burden of heavy metals. Targeted public health policies should be made to improve the local environment and the recognition of potential risk factors.

Genetics and Evolution of Infectious Diseases

Genetics and Evolution of Infectious Diseases (Second Edition) Edited by ElsevierMichel Tibayrenc, 2017; 686 pages; Hardcover: $190 ISBN: 9780127999425

Cardiovascular disease prevention policy in HIV: recommendations from a modelling study

Abstract

Background

Cardiovascular disease (CVD) is expected to contribute a large non-communicable disease burden amongst HIV-positive people. We quantify the impact of prevention interventions on annual CVD burden and costs amongst HIV-positive people in The Netherlands.

Methods

We constructed an individual-based model of CVD in HIV-positive people using national ATHENA cohort data on 8,791 patients on combination antiretroviral therapy (cART). The model follows patients as they age, develop CVD (by incorporating a CVD risk equation) and start cardiovascular medication. Four prevention interventions were evaluated: (1) increasing the rate of earlier HIV diagnosis and treatment; (2) avoiding use of cART with increased CVD risk; (3) smoking cessation; (4) intensified monitoring and drug treatment of hypertension and dyslipidaemia, quantifying annual number of averted CVDs and costs.

Results

The model predicts that annual CVD incidence and costs will increase by 55% and 36% between 2015-2030. Traditional prevention interventions, i.e. smoking cessation and intensified monitoring and treatment of hypertension and dyslipidaemia, will avert the largest number of annual CVD cases (13.1% and 20.0%) compared to HIV-related interventions, i.e. earlier HIV diagnosis and treatment and avoiding cART with increased CVD risk (0.8% and 3.7%, respectively), as well as reduce cumulative CVD-related costs. Targeting high risk patients could avert the majority of events and costs.

Conclusions

Traditional CVD prevention interventions can maximize cardiovascular health and defray future costs, particularly if targeting high risk patients. Quantifying additional public health benefits, beyond CVD, is likely to provide further evidence for policy development.

Infrequent testing of women for rectal chlamydia and gonorrhea in the United States

Abstract

Background

Anal sex is a common sexual behavior among women that increases their risk of acquiring rectal infection with Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC).

Methods

We estimated the frequency and positivity of rectal CT and GC tests for women aged 15-60 years performed by a large U.S. commercial laboratory between November 2012 and September 2015. We also estimated the frequency and positivity of pharyngeal and genital specimens also performed on the same date. Among women with a positive CT or GC result, we estimated the frequency and positivity of recommended repeat testing within 12 months.

Results

Of 5,499 women who had rectal CT and GC tests, positivity was 10.8%. On the same date, approximately 80% also had genital CT tests, genital GC tests, and pharyngeal GC tests, while 40% had pharyngeal CT tests. Rectal CT or GC infection was associated with genital CT or GC infection, but 46.5% of rectal CT and GC infections would not have been identified with genital testing alone. Among women with a rectal CT or GC infection, only 20.0% had a recommended repeat rectal test. Of those who had a repeat test, 17.7% were positive.

Conclusions

Testing women for rectal CT and GC was infrequent but positive tests were often found in women with negative genital tests. Most women with positive rectal tests were not retested. Interventions are needed to increase extragenital CT and GC testing of at-risk women.

Clinical Features of Acute Flaccid Myelitis Temporally Associated with an Enterovirus D68 Outbreak: Results of a Nationwide Survey of Acute Flaccid Paralysis in Japan, August–December 2015

Abstract

Backgroud

Acute flaccid myelitis (AFM) is an acute flaccid paralysis (AFP) syndrome with spinal motor neuron involvement of unknown etiology. We investigated the characteristics and prognostic factors of AFM clusters coincident with an enterovirus D68 (EV-D68) outbreak in Japan during autumn 2015.

Methods

An AFM case series study was conducted following a nationwide survey from August to December 2015. Radiographic and neurophysiologic data were subjected to centralized review, and virology studies were conducted for available specimens.

Results

Fifty-nine AFM cases (58 definite, one probable) were identified, including 55 children and four adults (median age, 4.4 years). The AFM epidemic curve showed strong temporal correlation with EV-D68 detection from pathogen surveillance, but not with other pathogens. EV-D68 was detected in nine patients: five in nasopharyngeal, two in stool, one in cerebrospinal fluid (adult case), and one in tracheal aspiration, nasopharyngeal, and serum samples (a pediatric case with preceding steroid usage). Cases exhibited heterogeneous paralysis patterns from one- to four-limb involvement, but all definite cases had longitudinal spinal gray matter lesions on MRI (median 20 spinal segments). Cerebrospinal fluid pleocytosis was observed in 50/59 cases (85%), and 8/29 (28%) were positive for anti-ganglioside antibodies, as frequently observed in Guillain-Barré syndrome. Fifty-two patients showed variable residual weakness at follow-up. Good prognostic factors included a pretreatment manual muscle strength test unit score >3, normal F-wave persistence, and EV-D68-negative status.

Conclusions

EV-D68 may be one of the causative agents for AFM, while host susceptibility factors such as immune response could contribute to AFM development.

Cross-reactivity in β-Lactam Allergy

Publication date: Available online 7 October 2017
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Robert J. Zagursky, Michael E. Pichichero
β-Lactam drugs (penicillins, amoxicillin, and cephalosporins) account for 42.6% of all severe drug-induced anaphylaxis. In this review, we focus on clinically significant immunologic cross-reactivity in patients with confirmed penicillin allergy to cephalosporins, and the structural involvement of the R1 and R2 chemical side chains of the cephalosporins causing IgE-mediated cross-reactivity with penicillin and other cephalosporins. Skin tests predict IgE-mediated reactions and showed cross-reactivity between penicillins and early generation cephalosporins that shared side chains, but confirmatory challenge data are lacking. Later-generation cephalosporins, which have distinct side chains, do not have any skin test cross-reactivity with penicillin/amoxicillin. There is debate as to the involvement of R2 side chains as the antigenic determinants that cause IgE-mediated hypersensitivity with various cephalosporins. Avoidance of cephalosporins, when they are the drug of choice in a penicillin-allergic individual, results in significant morbidity that outweighs the low risk of anaphylaxis. We conclude that there is ample evidence to allow the safe use of cephalosporins in patients with isolated confirmed penicillin or amoxicillin allergy.

Impact of Rhinitis on Work Productivity: A Systematic Review

Publication date: Available online 7 October 2017
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Olivier Vandenplas, Denis Vinnikov, Paul D. Blanc, Ioana Agache, Claus Bachert, Michael Bewick, Lars-Olaf Cardell, Paul Cullinan, Pascal Demoly, Alexis Descatha, Joao Fonseca, Tari Haahtela, Peter W. Hellings, Jacques Jamart, Juha Jantunen, Ömer Kalayci, David Price, Boleslaw Samolinski, Joaquin Sastre, Longxiu Tian, Antonio L. Valero, Xinyi Zhang, Jean Bousquet
BackgroundAllergic rhinitis (AR) is increasingly acknowledged as having a substantial socioeconomic impact associated with impaired work productivity, although available information remains fragmented.ObjectiveThis systematic review summarizes recently available information to provide a quantitative estimate of the burden of AR on work productivity including lost work time (ie, absenteeism) and reduced performance while working (ie, presenteeism).MethodsA Medline search retrieved original studies from 2005 to 2015 pertaining to the impact of AR on work productivity. A pooled analysis of results was carried out with studies reporting data collected through the validated Work Productivity and Activity Impairment (WPAI) questionnaire.ResultsThe search identified 19 observational surveys and 9 interventional studies. Six studies reported economic evaluations. Pooled analysis of WPAI-based studies found an estimated 3.6% (95% confidence interval [CI], 2.4; 4.8%) missed work time and 35.9% (95% CI, 29.7; 42.1%) had impairment in at-work performance due to AR. Economic evaluations indicated that indirect costs associated with lost work productivity are the principal contributor to the total AR costs and result mainly from impaired presenteeism. The severity of AR symptoms was the most consistent disease-related factor associated with a greater impact of AR on work productivity, although ocular symptoms and sleep disturbances may independently affect work productivity. Overall, the pharmacologic treatment of AR showed a beneficial effect on work productivity.ConclusionsThis systematic review provides summary estimates of the magnitude of work productivity impairment due to AR and identifies its main determinant factors. This information may help guide both clinicians and health policy makers.

The effects of diosmin on aflatoxin-induced liver and kidney damage

Abstract

Aflatoxin is among the natural toxins that cause serious side effects on living things. Diosmin is also one of the compounds with broad pharmacological effects. In this study, the effects on the oxidant/antioxidant system of 50 mg/kg body weight/day dose of diosmin, aflatoxin (500 μg/kg body weight/day), and combined aflatoxin (500 μg/kg body weight/day) plus diosmin (50 mg/kg body weight/day) given to the stomach via catheter female adult Wistar Albino rats is examined. Forty rats were used in the experiment, and these animals were randomly allocated to four equal groups. The test phase lasted 21 days, and blood samples and tissue (liver and kidney) samples were taken after this period was over. Some biochemical parameters (glucose, triglyceride, cholesterol, blood urea nitrogen, creatinine, uric acid, lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total protein, albumin) and levels of malondialdehyde, nitric oxide, and 4-hydroxynonenal and activities of superoxide dismutase, catalase, and glutathione peroxidase were analyzed in the samples. The aflatoxin administered over the period indicated a significant increase in levels of malondialdehyde (MDA), nitric oxide (NO), and 4-hydroxynonenal (4-HNE) in all tissues and blood samples. Therewithal, the activity of antioxidant enzymes showed a change in the decreasing direction. Biochemical parameters of the group in which aflatoxin were administered alone changed unfavorably. Parallel effects were also observed in the histopathological findings of this group. The results showed that aflatoxin changed antioxidant/oxidant balance in favor of oxidant and eventually led to lipid peroxidation. Diosmin administration to aflatoxin-treated animals resulted in positive changes in antioxidant enzyme activities while the levels of MDA, NO, and 4-HNE were reduced in all tissues and blood samples examined. Diosmin alleviates the oxidative stress caused by aflatoxin. Similar improvement was observed in biochemical parameters of this group as well as in liver and kidney histopathology. No significant change was observed in the group treated with diosmin alone in terms of the parameters examined and histologic findings. As a result, diosmin may be included in compounds that can be used as a therapeutic and prophylactic agent in the event of the formation of aflatoxin exposure and poisoning in animals.

Short-term reasons for withdrawal and adverse events associated with apremilast therapy for psoriasis in real-world practice compared to clinical trials: a multicenter retrospective study

Focal Atrichia: A Diagnostic Clue in Female Pattern Hair Loss

Focal atrichia is a common clinical finding in female pattern hair loss whose specificity and histologic findings need further clarification.

QTc prolongation during phenol-croton oil peels

The Frisbee Maneuver: A Novel Method to Abort Acute Attacks of Raynaud’s Phenomenon

Alternating histopathological pattern in blaschkoid dermatoses with epidermal changes: A retrospective series of 61 cases

The burden of atopic dermatitis in US adults: Health care resource utilization data from the 2013 National Health and Wellness Survey

There is a lack of data on the burden of atopic dermatitis (AD) in adults relative to the general population.

Nanoscale wide-band semiconductors for photocatalytic remediation of aquatic pollution

Abstract

Water pollution is a serious challenge to the public health. Among different forms of aquatic pollutants, chemical and biological agents create paramount threat to water quality when the safety standards are surpassed. There are many conventional remediatory strategies that are practiced such as resin-based exchanger and activated charcoal/carbon andreverse osmosis. Newer technologies using plants, microorganisms, genetic engineering, and enzyme-based approaches are also proposed for aquatic pollution management. However, the conventional technologies have shown impending inadequacies. On the other hand, new bio-based techniques have failed to exhibit reproducibility, wide specificity, and fidelity in field conditions. Hence, to solve these shortcomings, nanotechnology ushered a ray of hope by applying nanoscale zinc oxide (ZnO), titanium dioxide (TiO₂), and tungsten oxide (WO₃) particles for the remediation of water pollution. These nanophotocatalysts are active, cost-effective, quicker in action, and can be implemented at a larger scale. These nanoparticles are climate-independent, assist in complete mineralization of pollutants, and can act non-specifically against chemically and biologically based aquatic pollutants. Photocatalysis for environmental remediation depends on the availability of solar light. The mechanism of photocatalysis involves the formation of electron-hole pairs upon light irradiations at intensities higher than their band gap energies. In the present review, different methods of synthesis of nanoscale ZnO, TiO₂, and WO₃ as well as their structural characterizations have been discussed. Photodegradation of organic pollutants through mentioned nanoparticles has been reviewed with recent advancements. Enhancing the efficacy of photocatalysis through doping of TiO₂ and ZnO nanoparticles with non-metals, metals, and metal ions has also been documented in this report.

Ultrasonography and return to play of the different clinical grading of quadriceps contusions: a case series

Abstract

Prognostication of quadriceps contusion is based on the patient's active knee flexion after the injury. Unlike ultrasonography, clinical grading does not define the extent of soft tissue injury and may provide inaccurate time for return to play. The purposes of this report are to describe the ultrasound findings of the different clinical grading of quadriceps contusion and document the return to play of each case. Seven patients were evaluated in this series. Results showed discrepancies in the disability time between clinical grading and ultrasound findings. Clinical grading did not consistently estimate the return to play as described in previously published literature. Contusions with hyperechoic lesions had earlier return to play compared to patients with hypoechoic findings. Contusions with hypoechoic lesions might require aggressive monitoring and therapy to decrease disability time and avoid complications such as myositis ossificans.

A Selfie of Mohs Micrographic Surgery in Spain

Publication date: Available online 7 October 2017
Source:Actas Dermo-Sifiliográficas (English Edition)
Author(s): M. de Troya-Martín

A comprehensive analysis of direct and photosensitized attenuation of Toxoplasma gondii tachyzoites

Publication date: Available online 7 October 2017
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Juan G. Yañuk, M. Lis Alomar, M. Micaela Gonzalez, Andrés M. Alonso, Sergio O. Angel, Verónica M. Coceres, Franco M. Cabrerizo
In the present work, we have evaluated the effect of three different types of radiation: UVC (254±5nm), UVA (365±20nm) and visible (420±20nm) on different morphological and biological functions of Toxoplasma gondii tachyzoites. Briefly, UVC and UVA showed an inhibitory effect on parasite invasion in a dose-dependent manner. UVC showed the strongest effect inducing both structural damage (antigens) and functional inhibition (i.e., invasion and replication). On its own, visible light induces a quite distinctive and selective pattern of parasite-attenuation. This type of incident radiation inhibits the replication of the parasite affecting neither the capability of invasion/attachment nor the native structure of proteins (antigens) on parasites. Such effects are a consequence of photosensitized processes where phenol red might act as the active photosensitizer. The potential uses of the methodologies investigated herein are discussed.

Graphical abstract

Enhanced biological properties of biomimetic apatite fabricated polycaprolactone/chitosan nanofibrous bio-composite for tendon and ligament regeneration

Publication date: Available online 7 October 2017
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Geng Wu, Xuefeng Deng, Jinqi Song, Feiqiang Chen
The development of tailored nanofibrous scaffolds for tendon and ligament tissue engineering has been a goal of clinical research for current researchers. Here, we establish a formation of novel nanofibrous matrix with significant mechanical and biological properties by electro-spinning process. The fine fibrous morphology of the nanostructured hydroxyapatite (HAp) dispersed in the polycaprolactone/chitosan (HAp-PCL/CS) nanofibrous matrix was exhibited by microscopic (SEM and TEM) techniques. The favorable mechanical properties (load and modulus) were achieved. The load and modulus of the HAp-PCL/CS composite fibers was 250.1N and 215.5MPa, which is very similar to that of standard value of the human tendon and ligament tissues. The cellular responses and biocompatibility of HAp-PCL/CS nanofibrous scaffolds were investigated with human osteoblast (HOS) cells for tendon regeneration and examined the primary osteoblast mechanism by in vitro method. The morphological (FE-SEM and fluorescence) microscopic images clearly exhibited that HOS cells are well attached and flatted on the nanofibrous composites. The HAp dispersed PCL/CS nanofibrous scaffolds promoted higher adhesion and proliferation of HOS cells comparable to the nanofibrous scaffolds without HAp nanoparticles. The physic-chemical and biological properties of the synthesized nanofibrous scaffold were very close to that of normal ligament and tendon in human body. Over all, these studied results confirmed that the prepared nanofibrous scaffolds will be effective biomaterial of tendon ligament regeneration applications.

Graphical abstract

Non-cytotoxic effect of green synthesized silver nanoparticles and its antibacterial activity

Publication date: Available online 7 October 2017
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): B. Senthil, T. Devasena, B. Prakash, A. Rajasekar
Silver nanoparticles (AgNPs) were green synthesized using ethanolic extract of fenugreek leaves and characterized using UV–Vis spectroscopy, Fourier transform infra-red spectroscopy (FTIR), X-ray diffraction (XRD), high resolution transmission electron microscopy HRTEM and energy dispersive X-ray analysis (EDX) techniques. The HRTEM results revealed the formation of highly stable, mono dispersed, spherical shaped AgNPs with the size ranging from 20 to 30nm. The presence of flavonoids and their interaction with the AgNPs were confirmed using FTIR. Antibacterial activities of the AgNPs were studied against pathogenic gram-positive Staphylococcus aureus (S. aureus) and gram negative Escherichia coli (E. coli) bacteria. The synthesized AgNPs displayed the enhancement of antibacterial activity against E. coli. The morphological changes in the bacterial cell membrane was observed using SEM analysis. Leakage of protein from the bacterial cells increased at every time intervals (2 and 4h). MTT assay was carried out for the AgNPs against human skin cell line (HaCaT). Interestingly, cytotoxicity of the synthesized AgNPs was less toxic to HaCaT cells as compared to bacteria cells, which suggests that the synthesized AgNPs by this method is eco-friendly in nature.

Micro-autologous fat transplantation for rejuvenation of the dorsal surface of the ageing hand

Publication date: Available online 6 October 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Yun-Nan Lin, Shu-Hung Huang, Tsung-Ying Lin, Chih-Kang Chou, Yu-Hao Huang, Hidenobu Takahashi, Chung-Sheng Lai, Sin-Daw Lin, Tsai-Ming Lin
BackgroundRejuvenation of the dorsal surface of the hand for various conditions, such as cutaneous dyschromia, fine wrinkling, skin laxity, visible extensor tendons, and varicosities appear vital to prevent wrist and digit flexion resulting from hiding of the aged appearance of the hand. Numerous fillers have been applied to re-contour the ageing dorsal surface of the hand; the results were variable. The micro-autologous fat transplantation (MAFT) technique, proposed by Lin et al. in 2006, has demonstrated its feasibility in facial rejuvenation. In this study, we applied the MAFT technique for the rejuvenation of the dorsal portion of the hand.MethodsMAFT was performed in 68 female patients. Fat was harvested by performing liposuction, processed, and refined by centrifugation. Purified fat was micro-transplanted to the dorsal surface of the hand in parcels of small volume.ResultsThe mean age of the patients was 56 years (range, 38-70 years). MAFT was completed in 72 min, on average. The average amount of delivered fat was 13.9 and 13.8 mL for the right and left hands, respectively. The mean follow-up period was 32 months (range, 10-64 months). The 5-point Likert scale revealed that 58.8% of patients were very satisfied and 39.7% were satisfied about their outcome.ConclusionsMAFT has changed the concept of fat grafting, from an operation with unpredictable clinical results to an easy and reliable procedure. MAFT demonstrated high patient satisfaction with long-term results and is an effective approach to rejuvenate the dorsal surface of the hand.

Pre-culture in endothelial growth medium enhances the angiogenic properties of adipose-derived stem/stromal cells

Abstract

Considerable progress has been made on the development of adipose-derived stem/stromal cells (ASCs) as pro-angiogenic therapeutic tools. However, variable clinical results highlight the need for devising strategies to enhance their therapeutic efficacy. Since ASCs proliferate and stabilize newly formed vessels during the angiogenic phase of adipose tissue formation, we hypothesized that mimicking an angiogenic milieu during culture of ASCs would enhance their capacity to support endothelial cell survival and angiogenesis. To test this, we compared the effect of an endothelial growth medium (EGM-2) and conventional media (αMEM) on the progenitor and angiogenic properties of ASCs. ASCs cultured in EGM-2 (ASC-EGM) displayed the highest clonogenic efficiency, proliferative potential and multilineage potential. After co-culture under growth factor starvation, only ASC-EGM attenuated luciferase-expressing human umbilical vein endothelial cells (HUVEC^luc) apoptosis and supported the formation of endothelial cords in a dose-dependent manner. These effects were recapitulated by the conditioned medium of ASC-EGM, which displayed a 100-fold higher expression of hepatocyte growth factor in comparison with ASC-αMEM. Next, HUVEC^luc and ASCs were co-transplanted subcutaneously into immunodeficient mice, and the survival of HUVEC^luc was monitored by bioluminescent imaging. After 60 days, the survival of HUVEC^luc transplanted alone was equivalent to that of HUVEC^luc co-transplanted with ASC-αMEM (15.0 ± 0.7 vs. 13.0 ± 0.5%). Strikingly, co-transplantation with ASC-EGM increased HUVEC^luc survival to 105.0 ± 3.5%, and the resulting organoids displayed functional vasculature with the highest human-derived vascular area. These findings demonstrate that pre-conditioning of ASCs in endothelial growth medium augment their pro-angiogenic properties and could enhance their therapeutic efficacy against ischemic diseases.

Technology and the Virtues: a Response to My Critics

Factors influencing streambed hydraulic conductivity and their implications on stream–aquifer interaction: a conceptual review

Abstract

The estimation and modeling of streambed hydraulic conductivity (K) is an emerging interest due to its connection to water quality, aquatic habitat, and groundwater recharge. Existing research has found ways to sample and measure K at specific sites and with laboratory tests. The challenge undertaken was to review progress, relevance, complexity in understanding and modeling via statistical and geostatistical approaches, literature gaps, and suggestions toward future needs. This article provides an overview of factors and processes influencing streambed hydraulic conductivity (K) and its role in the stream–aquifer interaction. During our synthesis, we discuss the influence of geological, hydrological, biological, and anthropogenic factors that lead to variability of streambed substrates. Literature examples document findings to specific sites that help to portray the role of streambed K and other interrelated factors in the modeling of hyporheic and groundwater flow systems. However, studies utilizing an integrated, comprehensive database are limited, restricting the ability of broader application and understanding. Examples of in situ and laboratory methods of estimating hydraulic conductivity suggest challenges in acquiring representative samples and comparing results, considering the anisotropy and heterogeneity of fluvial bed materials and geohydrological conditions. Arriving at realistic statistical and spatial inference based on field and lab data collected is challenging, considering the possible sediment sources, processes, and complexity. Recognizing that the K for a given particle size group includes several to many orders of magnitude, modeling of streambed K and groundwater interaction remain conceptual and experimental. Advanced geostatistical techniques offer a wide range of univariate or multi-variate interpolation procedures such as kriging and variogram analysis that can be applied to these complex systems. Research available from various studies has been instrumental in developing sampling options, recognizing the significance of fluvial dynamics, the potential for filtration, transfer, and storage of high-quality groundwater, and importance to aquatic habitat and refuge during extreme conditions. Efforts in the characterization of natural and anthropogenic conditions, substrate materials, sediment loading, colmation, and other details highlight the great complexity and perhaps need for a database to compile relevant data. The effects on streambed hydraulic conductivity due to anthropogenic disturbances (in-stream gravel mining, contaminant release, benthic activity, etc.) are the areas that still need focus. An interdisciplinary (hydro-geo-biological) approach may be necessary to characterize the magnitude and variability of streambed K and fluxes at local, regional scales.

RNA-seq analysis of Lgr6+ stem cells and identification of an Lgr6 isoform

Abstract

We studied Lgr6⁺ stem cells in experimental UV carcinogenesis in hairless mice. For further characterisation through RNA-seq, these stem cells were isolated by FACS from transgenic hairless mice bearing an EGFP-Ires-CreERT2 reporter cassette inserted into exon-1 of the Lgr6 gene (purity confirmed by human ERT2 expression). Between Lgr6/EGFP⁺ and Lgr6/EGFP^– basal cells (Tg/wt) 682 RNAs were differentially expressed, indicating stemness and expression of cancer-related pathways in Lgr6/EGFP⁺ cells. We discovered that suspected 'Lgr6 null' mice (Tg/Tg) expressed RNA of an Lgr6 isoform (delta-Lgr6, lacking 74 N-terminal aa) which could be functional and explain the lack of a phenotype.

This article is protected by copyright. All rights reserved.

Abstract: Facelift Technique for the Management of Soft Tissue Drooping after Facial Bone Contouring Surgery in Asian Patients

No abstract available

Sensitivity of aspiration as a safety test before injection of soft tissue fillers

Summary

Background

Embolism due to accidental intra-arterial injection of a soft tissue filler (STF) can lead to serious complications. Physicians practice aspiration as a safety test before injection to rule out intra-arterial placement of the needle tip. The value of aspiration as a safety test is evaluated in this study, which also considered the rheological properties of different STFs and their needle dimensions.

Methods

Aspiration with eleven different needle sizes and 24 different STFs was performed using Ringer's lactate (RL) colored with blue skin marking ink and secondly an empty saline bag containing anticoagulated blood, both pressurized to 150 mm Hg to mimic arterial blood pressure. Time between the start of aspiration and liquid in the needle hub was recorded.

Results

A total of 340 individual aspiration tests with different STFs and needles were performed, of which 112 yielded true-positive results within 1-s and 128 yielded false-negative results after 10 s. Positive results between one and ten seconds were seen in 101 aspiration tests.

Conclusions

True-positive results were seen in 33% of the tests performed with STFs within 1 s of aspiration. Aspiration test results are influenced by needle diameter, needle length, and rheological properties of STFs. Additional safety measures are necessary to further reduce risk of inadvertent intravascular injection of STFs.

Efficacy and safety of a novel, soluble microneedle patch for the improvement of facial wrinkle

Summary

Background

Various kinds of functional cosmetics are on the market, although there are a variety of opinions concerning the actual effect. Transdermal microneedle patch has been introduced as a newly developed device for drug delivery through the skin.

Objective

This study was conducted to verify the face skin improvement effect and safety of a novel cosmetic microneedle patch.

Methods

A total of 84 Korean females finished this prospective clinical trial. The subjects were divided into 3 groups: (1) soluble hyaluronic acid (HA) microneedle patch alone, (2) soluble HA microneedle patch plus adenosine wrinkle cream, and (3) adenosine wrinkle cream alone. The treatments were applied to the crow's feet and nasolabial fold wrinkle for 12 weeks. The test areas were measured before treatment and at 4, 8, and 12 weeks after use of the test product. At the completion of the testing period of the trial, the global assessment of efficacy and product preferences were surveyed from the subjects.

Results

Combination treatment with wrinkle cream and microneedle patch significantly improved Merz scale for crow's feet and nasolabial folds, compared to the sole application of wrinkle cream or patch. Measurement on the crow's feet showed an overall improvement in all 3 groups, yielding no significant differences among the groups. No serious adverse effects were observed during the follow-up period.

Conclusion

Combination application of a soluble microneedle patch and wrinkle cream was an effective treatment in improving facial wrinkles, thus enhancing skin rejuvenation.

Hamilton’s Principle and Dispositional Essentialism: Friends or Foes?

Abstract

Most recently Smart and Thébault revived an almost forgotten debate between Katzav and Ellis on the compatibility of Hamilton's Principle (HP) with Dispositional Essentialism (DE). Katzav's arguments inter alia aim to show that HP (a) presupposes a kind of metaphysical contingency which is at odds with the basic tenets of DE, and (b) offers explanations of a different type and direction from those given by DE. In this paper I argue that though dispositional essentialists might adequately respond to these arguments, the question about the compatibility of HP with DE has not been answered yet; therefore, dispositional essentialists have not yet provided an illuminating DE-friendly metaphysical account of HP.

Short-term reasons for withdrawal and adverse events associated with apremilast therapy for psoriasis in real-world practice compared to clinical trials: a multicenter retrospective study

Publication date: Available online 7 October 2017
Source:Journal of the American Academy of Dermatology
Author(s): Arvin Ighani, Jorge R. Georgakopoulos, Neil H. Shear, Scott Walsh, Jensen Yeung

Epidemiology of Hyperhidrosis in Two Population-Based Healthcare Databases

Publication date: Available online 6 October 2017
Source:Journal of the American Academy of Dermatology
Author(s): Kristen Ricchetti-Masterson, J. Morel Symons, Molly Aldridge, Ayush Patel, Joe Maskell, John Logie, Yuji Yamaguchi, Suzanne F. Cook
BackgroundPopulation-based and clinical case reports of hyperhidrosis (HH) provide prevalence estimates that vary widely across reported studies due to differences in case ascertainment.ObjectiveIn this study, we specify diagnosis, symptom, and prescription codes for HH in order to estimate incidence and prevalence for the United Kingdom and the United States.MethodsData from U.K. and U.S. healthcare databases were analyzed to ascertain HH cases and estimate incidence and prevalence from healthcare records during calendar years 2011 through 2013.ResultsBased on 2013 data for the U.S. and U.K., between 1.0% and 1.6% of these populations have healthcare records indicating diagnosis or treatment of HH. Women accounted for approximately 60% of incident and prevalent cases in both databases.LimitationsSince the case ascertainment methods rely on available data for those seeking healthcare, we may have underestimated the number of HH cases in both countries.ConclusionFindings represent a plausible estimate for incidence and prevalence of HH among persons seeking medical care for excessive sweating. Improved practices for identifying HH in clinical settings may increase the sensitivity and specificity of future studies and improve characterization and quantification of the population burden of this significant disease.

Teaser

Hyperhidrosis has a range of reported prevalence estimates with the most often cited equal to 2.8%.We describe methods using a combination of diagnosis, symptom, and prescription codes from healthcare databases to ascertain hyperhidrosis cases.This study estimates population prevalences of 1% - 1.6% for patients seeking healthcare for hyperhidrosis.

The Wood’s Lamp as a Tool in the Evaluation of Morphea

Publication date: Available online 7 October 2017
Source:Journal of the American Academy of Dermatology
Author(s): Paul Curtiss, Gaurav Singh, Kristen Lo Sicco, Andrew G. Franks

MicroRNA-126 deficiency enhanced the activation and function of CD4+T cells by elevating IRS-1 pathway

Summary

Recent evidence showed that microRNA-126 (miR-126) has been involved in the development and function of immune cells, which contributed to the pathogenesis of related clinical diseases. However, the potential role of miR-126 in the development and function of CD4⁺T cells remains largely unknown. Here we firstly found that the activation and proliferation, as well as the expression of IFN-γ, of CD4⁺T cells from miR-126 knockdown (KD) mice using miRNA-Sponge technique were enhanced significantly in vitro, compared with those in CD4⁺T cells from wild type (WT) mice. To further monitor the possible effect of miR-126 deficiency on the function of CD4⁺T cells in vivo, we used dextran sulfate sodium (DSS)-induced murine model of acute autoimmune colitis and found that miR-126 deficiency could elevate the pathology of colitis. Importantly, the proportion of CD4⁺T cells in splenocytes increased significantly in miR-126KD mice. Moreover, the expression levels of CD69 and CD44 on CD4⁺T cells increased obviously and CD62L expression decreased significantly. Of note, adoptive cell transfer assay showed that the pathology of colitis was more serious in CFSE-labeled miR-126KD CD4⁺T cells transferred group, compared with that in CFSE-labeled WT CD4⁺T cells transferred group. Consistently, the expression levels of CD69 and CD44 on CFSE⁺ cells increased significantly. Furthermore, both the proliferation and IFN-γ secretion of CFSE⁺ cells also increased significantly in CFSE-labeled miR-126KD CD4⁺T cells transferred group. Mechanistic evidence showed that the expression of insulin receptor substrate 1 (IRS-1), as a functional target of miR-126, was elevated in CD4⁺T cells from miR-126KD mice, accompanied by altered transduction of ERK, AKT and NF-κB pathway. Our data revealed a novel role in which miR-126 was an intrinsic regulator in the function of CD4⁺T cells, which provided preliminary basis for further exploring on the role of miR-126 in the development, function of CD4⁺T cells and related clinical diseases. This article is protected by copyright. All rights reserved.

Occurrence, ecological risk assessment, and spatio-temporal variation of polychlorinated biphenyls (PCBs) in water and sediments along River Ravi and its northern tributaries, Pakistan

Abstract

Ecological risk assessment, spatio-temporal variation, and source apportionment of polychlorinated biphenyls (PCBs) were studied in surface sediments and water from River Ravi and its three northern tributaries (Nullah Deg, Nullah Basantar, and Nullah Bein) in Pakistan. In total, 35 PCB congeners were analyzed along 27 sampling stations in pre-monsoon and post-monsoon seasons. The ∑₃₅PCB concentration ranged from 1.06 to 95.76 ng/g (dw) in sediments and 1.94 to 11.66 ng/L in water samples, with hexa-CBs and tetra-CBs as most dominant homologs in sediments and water matrixes, respectively. The ∑₈DL-PCB levels were 0.33–22.13 ng/g (dw) and 0.16–1.95 ng/L in sediments and water samples, respectively. The WHO-toxic equivalent values were ranged from 1.18 × 10⁻⁶ to 0.012 ng/L and 1.8 × 10⁻⁶ to 0.031 ng/g in water and sediments matrixes, respectively. The ecological risk assessment indicates considerable potential ecological risk during pre-monsoon season ( \( {E}_r^i \)  = 95.17) and moderate potential ecological risk during post-monsoon season ( \( {E}_r^i \)  = 49.11). The industrial and urban releases were recognized as key ongoing sources for high PCB levels in environment. Therefore, we recommend more freshwater ecological studies to be conducted in the study area and firm regulatory initiatives are required to be taken in debt to the Stockholm Convention, 2001 to cop up with PCB contamination on emergency basis.

Education, In Spite of it All

Abstract

This special issue of Studies in Philosophy and Education neither rejects, nor offers outright alternatives to the dominant contemporary model of education, but instead explores its margins and the possibilities they might offer for administrators, teachers and students within institutions and broader social contexts. The intention of the editors and contributors has been to tweak the focus from a critique of an oppressive system to a mapping of that system and the opportunities that exist within it–or on its margins–in spite of itself.

Occupational Exposure to Manganese and Fine Motor Skills in Elderly Men: Results from the Heinz Nixdorf Recall Study

Abstract

Objectives

Exposure to manganese (Mn) may cause movement disorders, but less is known whether the effects persist after the termination of exposure. This study investigated the association between former exposure to Mn and fine motor deficits in elderly men from an industrial area with steel production.

Methods

Data on the occupational history and fine motor tests were obtained from the second follow-up of the prospective Heinz Nixdorf Recall Study (2011–2014). The study population included 1232 men (median age 68 years). Mn in blood (MnB) was determined in archived samples (2000–2003). The association between Mn exposure (working as welder or in other at-risk occupations, cumulative exposure to inhalable Mn, MnB) with various motor functions (errors in line tracing, steadiness, or aiming and tapping hits) was investigated with Poisson and logistic regression, adjusted for iron status and other covariates. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated for substantially impaired dexterity (errors >90th percentile, tapping hits <10th percentile).

Results

The median of cumulative exposure to inhalable Mn was 58 µg m^–3 years in 322 men who ever worked in at-risk occupations. Although we observed a partly better motor performance of exposed workers at group level, we found fewer tapping hits in men with cumulative Mn exposure >184.8 µg m^–3 years (OR 2.15, 95% CI 1.17–3.94). MnB ≥ 15 µg l^–1, serum ferritin ≥ 400 µg l^–1, and gamma-glutamyl transferase ≥74 U l^–1 were associated with a greater number of errors in line tracing.

Conclusions

We found evidence that exposure to inhalable Mn may carry a risk for dexterity deficits. Whether these deficits can be exclusively attributed to Mn remains to be elucidated, as airborne Mn is strongly correlated with iron in metal fumes, and high ferritin was also associated with errors in line tracing. Furthermore, hand training effects must be taken into account when testing for fine motor skills.

Uncovering the diagnostic dermoscopic features of flat melanomas located on the lower limbs

Abstract

Lower limbs represent the second most common site of all melanomas and the first one in females (1,2). Few studies have explored the diagnostic clues helping in the early diagnosis for melanoma on lower limbs (3).

This article is protected by copyright. All rights reserved.

Development of an international core outcome set for peripheral vascular malformations (OVAMA project)

Summary

Background

An important limitation in vascular malformation research is the heterogeneity in outcome measures used for the evaluation of treatment outcome.

Objective

The Outcome measures for VAscular MAlformations (OVAMA) project aimed to reach international consensus on a core outcome set (COS) for clinical research on peripheral vascular malformations: lymphatic (LM), venous (VM) and arteriovenous malformations (AVM). In this consensus study, we determined what domains should constitute the COS.

Methods

Thirty-six possibly relevant outcome domains were proposed to an international group of physicians, patients and the parents of patients. In a 3-round e-Delphi process using online surveys, participants repeatedly rated the importance of these domains on a 5-point Likert scale. Participants could also propose other relevant domains. This process was performed for LM, VM and AVM separately. Consensus was pre-defined as 80% agreement on the importance of a domain amongst both the physician group and the patient/parent group. Outcomes were then reevaluated in an online consensus meeting.

Results

167 physicians and 134 patients and parents of patients with LM (n=50), VM (n=71) and AVM (n=29) participated in the study. After three rounds and a consensus meeting, consensus was reached for all three types of vascular malformations on the core domains of radiological assessment, physician-reported location-specific signs, patient-reported severity of symptoms, pain, quality of life, satisfaction and adverse events. Vascular malformation type-specific signs and symptoms were included for LM, VM and AVM, separately.

Conclusion

It is recommended to measure at least these core outcome domains in therapeutic-efficacy studies on peripheral vascular malformations.

This article is protected by copyright. All rights reserved.

Genetic Risk Factors for Development of Atopic Dermatitis: a Systematic Review

Abstract

Purpose of Review

The purpose of this study is to systematically review studies conducted between April 2015 and April 2017 for the genetic risks for the development of atopic dermatitis (AD). We sought to identify (1) specific loci and genes associated with AD, (2) the proportion of studies for each gene, and (3) genetic risks that need further investigation.

Recent Findings

Studies have found that genetic predisposition and environmental triggers are involved in the pathogenesis of AD. Thirty-four loci and 46 genes have been identified as genetic risk factors, of which filaggrin gene null mutations and genes in the type 2 T-helper lymphocyte (Th2) signaling pathway have been the most extensively studied.

Summary

Our systematic review found that in the last 2 years, 46 loci and 53 genes have been studied in the development of AD. Genes involved in epidermal barrier, immune regulation, and intracellular functions were identified. We suggest that future research should investigate the intricate interaction of these genes as well as the complex interplay of genetic and environmental factors in the development of AD.

Interrelationships among trace metals and metallothionein in digestive glands and gills for field samples of Merceneria merceneria

Abstract

More widespread use of metallothionein (MT) as a biomarker for trace metal pollution continues to be partly dependent on obtaining reliable baseline concentrations and identifying increased induction of the enzyme with only modest increases in metal concentrations. In this study, new data on metals and MT levels in whole clams tissue, gills, and digestive glands from field samples and in sediments are presented. Concentrations of Cd, Cu, Fe, and Zn in depurated (24 h) clam samples of digestive glands, gills, and the whole clam Merceneria merceneria from the Indian River Lagoon, Florida, varied with location and showed moderate to strong correlations among Zn, Cu, and Fe. Concentrations of metallothionein (dry wt.) ranged from 34─270 μg/g in gills and 150–440 μg/g in digestive glands and showed moderate to strong correlations between organs and with metal concentrations in those organs. Observed trends support increased synthesis of metallothionein with only moderate increases in metal values and in response to statistically higher sediment metal concentrations.

Morphological and morphometrical changes on adult Wistar rat testis caused by chronic sodium arsenite exposure

Abstract

Arsenic is a contaminant that occurs naturally in the environment, and it is related to several diseases, such as cancer and severe metabolic diseases. Sodium arsenite effects on testes rats are not fully understood regarding morphology and stereology; thus, it becomes necessary to evaluate possible changes in these parameters under low concentrations and simulating occupational exposure. Therefore, the aim of this study was to analyze the morphometrical and stereological changes on rat testis treated with sodium arsenite. The treatment was accomplished using 5 mg/kg of sodium arsenite by gastric gavage in Wistar rats, which experiment lasted 8 weeks. Organs were weighed and gonadosomatic index (GSI) was calculated. Using the software Image Pro Plus, seminiferous tubule diameter was measured, and the volume densities of testicular parenchymal components were obtained. It was counted 200 hundred spermatozoa and classified as normal or abnormal. The parameters means of control (N = 5) and treated (N = 7) groups were compared by U Mann-Whitney's test, and the results were considered significant for P < 0.05. We observed a decrease in seminiferous tubule diameter, as well as testis weight. These finds may be related with disorders of testosterone metabolism due to activation of immunological responses of macrophage, which inhibit the steroidogenesis. Thus, we conclude that sodium arsenic does not impair the animal's general health, but its exposure induces biochemical and tissue changes.

Treatment-Free Remission: a New Therapeutic Goal in Chronic Myelogenous Leukemia

Abstract

Purpose of Review

Chronic myelogenous leukemia (CML) is a chronic myeloproliferative neoplasm characterized by the presence of Philadelphia chromosome [t(9:22)] leading to the presence of pathognomonic fusion gene product, BCR-ABL1. This leads to constitutive activation of ABL1 kinase. CML was a difficult-to-treat illness until the advent of small molecule tyrosine kinase inhibitor (TKI), imatinib which revolutionized therapy of CML. Since then, multiple second- and third-generation TKIs have been formulated which have proven effective and has led to marked improvement in survival. In this article, we review currently available data on possibility of holding TKI therapy in patients in deep remission [treatment-free remission (TFR)] and safety of this approach.

Recent Findings

As CML treatment has become more effective, new questions have emerged, most important being whether the treatment with TKIs can ever be stopped. This is especially relevant in patient experiencing side effects from therapy or who may be subject to increased health risks due to treatment. There is now evidence that some CML patients who have achieved stable deep molecular response can safely stop TKI. Furthermore, patients can safely re-establish remission after restarting their TKI therapy in the situation of relapse.

Summary

CML is highly treatable disease, but the treatment has untoward physical and socioeconomic consequences. The idea of TFR is hence attractive. There is a growing body of evidence that some CML patients who have achieved stable deep molecular response can safely stop TKI.

Acacetin attenuates mice endotoxin-induced acute lung injury via augmentation of heme oxygenase-1 activity

Abstract

Acacetin, a natural product, has a wide spectrum of biological activities such as antioxidant properties. In the present study, we examined whether Acacetin has any beneficial role on lipopolysaccharide (LPS)-induced acute lung injury (ALI) and, if so, whether its effect is mediated via heme oxygenase-1 (HO-1), an antioxidant enzyme playing an important role in ALI. Male BALB/c mice were stimulated with LPS intratracheal instillation to induce ALI. Acacetin was administrated 2 h after LPS challenge. Samples were harvested 10 h after LPS administration. We demonstrated that LPS challenge significantly induced lung histological alterations such as inflammation and edema. Acacetin administration notably attenuated these changes and reduced tumor necrosis factor-α and interleukin-1β in lung tissues. The LPS-induced reactive oxygen species generation was markedly suppressed by Acacetin. Furthermore, Acacetin treatment significantly elevated pulmonary HO-1 and nuclear factor erythroid-2-related factor 2 (Nrf2) activities. However, the beneficial action of Acacetin was markedly abolished when pretreated with zinc protoporphyrin, an inhibitor of HO-1. In in vitro studies, Acacetin notably increased the HO-1 expression in pulmonary microvascular endothelial cells. During knockdown of Nrf2 by siRNA, the effect of Acacetin on HO-1 expression was significantly reversed. Acacetin attenuates LPS-induced ALI in mice. This protective effect of Acacetin may be mediated, in part, through an HO-1-dependent pathway.

Caffeic acid combined with autoclaved Leishmania major boosted the protection of infected BALB/c mice by enhancing IgG2 production, IFN-γ/TGF-β and iNO synthase/arginase1 ratios, and the death of infected phagocytes

Abstract

Background

Immunization with killed Leishmania promastigotes without adjuvant was considered as safe, but gave variable rates of protection. Taking advantage of the immuno-modulatory effect of caffeic acid (CA), a natural polyphenolic antioxidant, we investigated its potentiating effect in autoclaved Leishmania major (ALM)-induced protection of Leishmania major-infected BALB/c.

Methods

First, BALB/c mice were sensitized for 6 weeks either with CA, or ALM alone or combined with caffeic acid (ALM–CA) or Freund's adjuvant (ALM–FA), and subsequently infected with L. major promastigotes. Second, to test the curative effect, CA was given daily for 5 weeks to susceptible mice, starting on week 4 post-infection. Sera, footpads and lymph nodes (LNs) were collected at week 9 post-infection and submitted to biochemical or histological analyses.

Results

Compared to the respective controls, our results showed that CA directly healed footpad lesions and reduced the hallmarks of cutaneous leishmaniasis including oxidative inflammation, parasite load, and phagocytes influx and infestation. In sensitized mice, the protection enhanced gradually from ALM–FA, CA, ALM to ALM–CA in parallel to decreased seric IgGt levels. In contrast to ALM–FA, the combined effect of ALM and CA increased specific isotype IgG2, and decreased IL-17 and MCP-1, and phagocyte influx, as attested by the concomitant reduction in myeloperoxidase (MPO) and α-naphthyl acetate esterase (ANAE) activities. ALM–CA shifted IFN-γ/TGF-β and iNO synthase/arginase1 (iNOS/Arg1) balances in a Th1 immune response that control efficiently cutaneous lesions and LNs hypertrophy, and reactivate the death of infected phagocytes.

Conclusions

Therefore, CA combined with ALM synergizes with L. major antigens for priming innate cells, through early polarization to optimal Th1 response that leads to IFN-γ and iNOS-dependent leishmanicidal activity of neutrophils and macrophages.

Graphical Abstract

Iron and iron oxide nanoparticles are highly toxic to Culex quinquefasciatus with little non-target effects on larvivorous fishes

Abstract

The control of filariasis vectors has been enhanced in several areas, but there are main challenges, including increasing resistance to insecticides and lack of cheap and eco-friendly products. The toxicity of iron (Fe⁰) and iron oxide (Fe₂O₃) nanoparticles has been scarcely investigated yet. We studied the larvicidal and pupicidal activity of Fe⁰ and Fe₂O₃ nanoparticles against Culex quinquefasciatus. Fe⁰ and Fe₂O₃ nanoparticles produced by green (using a Ficus natalensis aqueous extract) and chemical nanosynthesis, respectively, were analyzed by UV–Vis spectrophotometry, FT-IR spectroscopy, XRD analysis, SEM, and EDX assays. In larvicidal and pupicidal experiments on Cx. quinquefasciatus, LC₅₀ of Fe⁰ nanoparticles ranged from 20.9 (I instar larvae) to 43.7 ppm (pupae) and from 4.5 (I) to 22.1 ppm (pupae) for Fe₂O₃ nanoparticles synthesized chemically. Furthermore, the predation efficiency of the guppy fish, Poecilia reticulata, after a single treatment with sub-lethal doses of Fe⁰ and Fe₂O₃ nanoparticles was magnified. Overall, this work provides new insights about the toxicity of Fe⁰ and Fe₂O₃ nanoparticles against mosquito vectors; we suggested that green and chemical fabricated nano-iron may be considered to develop novel and effective pesticides.

Sorption and desorption of organophosphate esters with different hydrophobicity by soils

Abstract

Organophosphate esters (OPEs) are ubiquitous contaminants with potentially hazardous effects on both the environment and human health. Knowledge about the soil sorption-desorption process of organic chemicals is important in order to understand their fate, mobility, and bioavailability, enabling an estimation to be made of possible risks to the environment and biota. The aim of this study was to use the batch equilibrium technique to evaluate the sorption-desorption behavior of seven OPEs (TCEP, TCPP, TBEP, TDCP, TBP, TPhP, and EHDP) in soils with distinctive characteristics (two unamended soils and a soil amended with sewage sludge). The equilibrium concentrations of the OPEs were determined by high performance liquid chromatography coupled to a triple quadrupole mass spectrometer (HPLC-MS/MS). All the compounds were sorbed by the soils, and soil organic carbon (OC) played an important role in this process. The sorption of the most soluble OPEs (TCEP, TCPP, and TBEP) depended on soil OC content, although desorption was ≥ 58.1%. The less water-soluble OPEs (TDCP, TBP, TPhP, and EHDP) recorded total sorption (100% for TPhP and EHDP) or very high sorption (≥ 34.9%) by all the soils and were not desorbed, which could be explained by their highly hydrophobic nature, as indicated by the logarithmic octanol/water partition coefficient (K_ow) values higher than 3.8, resulting in a high affinity for soil OC. The results of the sorption-desorption of the OPEs by soils with different characteristics highlighted the influence of these compounds' physicochemical properties and the content and nature of soil OC in this process.

Nanoscale zero-valent iron functionalized Posidonia oceanica marine biomass for heavy metal removal from water

Abstract

Because of the excellent reducing capacity of nanoscale zero-valent iron (NZVI), it can be used as alternative materials for the removal of a variety of reducible water contaminants including toxic metals. The current paper reports the research results obtained for self-prepared biosorbent, Posidonia oceanica biomass, activated in alkaline medium and functionalized with NZVI particles. The structural characteristics, surface morphology, and binding properties of the resulting nanobiosorbent are presented. Batch comparative adsorption trials including adsorption kinetics and isothermals onto raw Posidonia, Posidonia–OH and Posidonia–OH–NZVI were investigated on three heavy metal ions: Cd(II), Pb(II), and Cu(II). The nanobiosorbent showed better properties, such as high reactivity and high uptake rate through the sorption process. The toxic metal removal has been monitored in terms of pseudo-first- and pseudo-second-order kinetics, and both Langmuir- and Freundlich-type isotherm models have been used to describe the sorption mechanism. The experimental data of all studied systems showed that the uptake kinetics follow the pseudo-second-order kinetic model and the equilibrium uptake can adopt the Langmuir-type isotherm model which assumes a monolayer coverage as the adsorption saturates and no further adsorption occurs. The thermodynamic results confirm that all sorption processes were feasible, spontaneous and thermodynamically favorable. Zeta potential data displayed that Cd(II), Pb(II), and Cu(II) tend to be reduced after exposure on the Posidonia–OH–NZVI surface. Furthermore, sorption competitions of the metals from binary and ternary systems were carried out onto Posidonia–OH–NZVI in order to gain further insight into the sorption efficiency of this material. Therefore, as a result, the proposed new nanobiosorbent could offer potential benefits in remediation of heavy metal-contaminated water as a green and environmentally friendly bionanocomposite.

David Wong’s Interpretation of Confucian Moral Psychology

Addition of large amount of municipal sewage sludge as raw material in cement clinker production

Abstract

Two addition modes were used to explore the maximum addition of municipal sewage sludge as a raw material in cement clinker production. The clinker and cement product quality were determined by chemical analysis, cement quality testing, characterization of the clinker crystalline phases, and leaching tests. Municipal sewage sludge addition in the raw mix could be up to 30% based on the cement clinker moduli, and the cement quality met the P.O 42.5 cement standard (GB 175-2007). The amount of municipal sewage sludge added based on the direct addition mode should be less than 15% because of an insufficient early-term cement strength (third day). The leaching concentrations of heavy metals in all cements were below the threshold (GB 30760-2014) using the latest leaching procedure (GB 30810-2014). The municipal sewage sludge could be used with a high addition (30%) in the raw mix as a raw material in cement clinker production.

Endoscopic Features of Varices Involving Lacrimal Sac and Nasolacrimal Duct.

No abstract available

Orbital Inflammation as a Presenting Sign for CREST Syndrome.

A 61-year-old male was referred with a week's history of a painful and swollen left eye. Examination revealed normal visual acuities, left proptosis and global restriction of ocular ductions, and subretinal fluid at the macula. CT imaging confirmed thickening of the posterior scleral coat, with an associated choroidal effusion. Serology revealed positive antinuclear antibodies with a centromere staining pattern; subsequent rheumatology review revealed extensive telangiectasia with digital ulceration in both hands, and a diagnosis of limited cutaneous systemic sclerosis was made. Orbital inflammatory disease is often the initial presentation of systemic diseases such as sarcoidosis, granulomatosis with polyangiitis, and IgG4 disease. Limited cutaneous systemic sclerosis is rarely encountered in the context of orbital inflammation, but is a further systemic association, reminding the clinician of the diagnostic importance of peripheral symptoms and serological markers in patients presenting with orbital inflammation and scleritis. (C) 2017 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

An Eye for an Eye and a Tooth for a Tooth!

No abstract available

Tratamiento de las neoplasias anexiales cutáneas malignas

Publication date: Available online 6 October 2017
Source:Actas Dermo-Sifiliográficas
Author(s): C. Bernárdez, L. Requena
Las neoplasias anexiales cutáneas malignas constituyen un grupo de carcinomas poco frecuentes, habitualmente de bajo grado de malignidad, que muestran diferenciación folicular, sebácea, apocrina o ecrina o una combinación de las 3 primeras. Clínicamente suelen ser neoplasias con características poco distintivas, siendo necesaria una biopsia que permitirá establecer el tipo de diferenciación y el diagnóstico definitivo. Al tratarse de una enfermedad poco frecuente, no existe un claro consenso sobre el tratamiento más eficaz. En la mayoría de casos se considera la microcirugía de Mohs como la opción más efectiva para prevenir recidivas. La radioterapia y quimioterapia han sido escasamente estudiadas y solo se han mostrado eficaces en escasas ocasiones.Malignant cutaneous adnexal neoplasms form a group of rare, typically low-grade-malignancy carcinomas with follicular, sebaceous, apocrine, or eccrine differentiation or a combination of the first 3 subtypes. Their clinical presentation is usually unremarkable, and biopsy is required to establish the differentiation subtype and the definitive diagnosis. Due to their rarity, no clear consensus has been reached on which treatment is most effective. Mohs micrographic surgery is considered to be the best option to prevent recurrence in the majority of patients. Radiotherapy and chemotherapy have been studied in very few cases and have rarely been shown to be effective.

Graphical abstract