Mutations in the BRAF serine/threonine kinase are found in 50-70% of human cutaneous melanomas. The most common alteration is V600E, a change which induces constitutive activity. Two groups have independently developed transgenic mice to express BrafV600E at physiological levels from the endogenous Braf locus after recombination mediated by cre recombinase.
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Wound antisepsis has undergone a renaissance due to the introduction of highly effective wound-compatible antimicrobial agents and the spread of multidrug-resistant organisms (MDROs). However, a strict indication must be set for the application of these agents. An infected or critically colonized wound must be treated antiseptically. In addition, systemic antibiotic therapy is required in case the infection spreads. If applied preventively, the Wounds-at-Risk Score allows an assessment of the risk for infection and thus appropriateness of the indication. The content of this updated consensus recommendation still largely consists of discussing properties of octenidine dihydrochloride (OCT), polihexanide, and iodophores. The evaluations of hypochlorite, taurolidine, and silver ions have been updated. For critically colonized and infected chronic wounds as well as for burns, polihexanide is classified as the active agent of choice. The combination 0.1% OCT/phenoxyethanol (PE) solution is suitable for acute, contaminated, and traumatic wounds, including MRSA-colonized wounds due to its deep action. For chronic wounds, preparations with 0.05% OCT are preferable. For bite, stab/puncture, and gunshot wounds, polyvinylpyrrolidone (PVP)-iodine is the first choice, while polihexanide and hypochlorite are superior to PVP-iodine for the treatment of contaminated acute and chronic wounds. For the decolonization of wounds colonized or infected with MDROs, the combination of OCT/PE is preferred. For peritoneal rinsing or rinsing of other cavities with a lack of drainage potential as well as the risk of central nervous system exposure, hypochlorite is the superior active agent. Silver-sulfadiazine is classified as dispensable, while dyes, organic mercury compounds, and hydrogen peroxide alone are classified as obsolete. As promising prospects, acetic acid, the combination of negative pressure wound therapy with the instillation of antiseptics (NPWTi), and cold atmospheric plasma are also subjects of this assessment.
Skin Pharmacol Physiol 2018;31:28-58
Erythropoietic protoporphyria is a genetic disease characterized by sensitivity to sunlight caused by the accumulation of protoporphyrin IX. Photoprotection against ultraviolet A and visible light is necessary for erythropoietic porphyria patients because the absorption spectrum of protoporphyrin IX lies in both ultraviolet A and visible light region. We developed a novel index, in vitro porphyrin protection factor, based on the protoporphyrin IX absorbance spectrum. We also selected appropriate photoprotective products designed according to protoporphyrin IX absorbance. The porphyrin protection factors of a combination of make-up base with a powder as well as with a liquid foundation were significantly higher than those of a conventional sunscreen product, even at a small application dose. An in-use test carried out for 6 months showed that the efficacy of these products was 78.3%, and no adverse reactions were observed. Male subjects preferred liquid foundation, whereas all female subjects used powder foundation. The preference of the subjects could lead to the long-term use of the tested products. In conclusion, this study provided a new approach to improve photoprotection in erythropoietic protoporphyria patients.
Centrifugal lipodystrophy (CLD), characterized by a depressed lesion in the abdominal skin, is a chronic disease occurring more often among younger patients of East Asian descent. We present an extremely unusual case of CLD of the scalp associated with reversible hair loss. The patient demonstrated alopecia in the frontal, temporal and occipital areas of the scalp, which connected to form a ring-shaped area of hair loss. Curiously, the area of hair loss gradually expanded outwards while the central region showed normal hair regrowth. Immunohistochemical analysis demonstrated reduced expression of leptin, an adipokine capable of inducing the anagen phase of the hair cycle, in the adipose tissue, associated with active inflammation. By contrast, recovery of leptin expression was observed at sites of healed inflammatory lesions, suggesting that reversible hair loss might be caused by a change in leptin expression in adipose tissue.
Increasing levels of physical activity among people with venous leg ulcers (VLUs) can potentially reduce the health cost burden, improve functional aspects of patients' lives and increase ulcer healing rates. The aim of this study was to investigate factors associated with physical activity levels in patients with VLUs. Data from 2016 to 2017 Aspirin for Venous Leg Ulcer cohort study were analysed for the present study. Ninety participants were recruited from 5 outpatient specialist wound clinics across Victoria, Australia between August 2016 and April 2017. There was a statistically significant association between diabetes and physical activity, with a higher proportion of people with type 2 diabetes in the sedentary category. Further, there was a statistically significant association between patient-reported VLU education and physical activity levels. An indirect advantage of relevant, easy-to-understand education about VLUs may increase physical activity levels, which may facilitate improved time to healing of VLUs.
Drug related cutaneous lupus erythematous is characterised by clinical and immunopathological findings similar to lupus but which is temporarily related to drug exposure. Multiple drugs have been described in association with drug induced lupus.(1) To date there have been no documented cases of pirfenidone induced lupus erythematous.
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The effect of nanotitanium dioxide (TiO2-NP) in human monocytes is still unknown. Therefore, an understanding of probable cytotoxicity of TiO2-NP on human monocytes and underlining the mechanisms involved is of significant interest. The aim of this study was to assess the cytotoxicity of TiO2-NP on human monocytes. Using biochemical and flow cytometry assessments, we demonstrated that addition of TiO2-NP at 10 μg/ml concentration to monocytes induced cytotoxicity following 12 h. The TiO2-NP-induced cytotoxicity on monocytes was associated with intracellular reactive oxygen species (ROS) generation, mitochondrial membrane potential (MMP) collapse, lysosomal membrane injury, lipid peroxidation, and depletion of glutathione. According to our results, TiO2-NP triggers oxidative stress and organelles damages in monocytes which are important cells in defense against foreign agents. Finally, our findings suggest that use of antioxidants and mitochondrial/lysosomal protective agents could be of benefit for the people in the exposure with TiO2-NP.
Vascular complications after hyaluronic acid (HA) filling of the chin have rarely been reported. In this report, two cases of vascular occlusion after HA augmentation of the mentum are presented. The first case involved local skin necrosis that resulted from a massive microcirculatory embolism and/or external compression of the chin skin microvasculature. The second case involved vascular compromise in the tongue that resulted from HA injection in the chin. The diagnosis was established on the basis of interventional angiography findings. Concerning the pathogenesis, we hypothesized that the filler embolus flowed into the branches of the deep lingual artery through the rich vascular anastomoses among the submental, sublingual, and deep lingual arteries, after being accidentally injected into the submental artery (or its branches).
Level of Evidence V 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 http://ift.tt/18t7xNj.
The mandibular contour plays a significant role in the beautiful and youthful look but the reconstruction remains a challenging problem. The objective of this study was to evaluate the use of individualized high-density porous polyethylene (Medpor®) implants for comprehensive reconstruction of mandibular contour with the aid of computer-aided design/computer-aided manufacturing (CAD/CAM).
From 2010 to 2014, 12 patients with mandibular contour deformities were enrolled in our retrospective study. Mandible models and individualized surgical templates were fabricated by three-dimensional (3D) printing and Medpor® implants were made according to the surgical templates. The Medpor® implants were used for both unilateral and bilateral mandibular contour deformities. In four cases, simultaneous mandibular orthognathic surgery was performed with unilateral mandibular contour reconstruction.
Eleven patients had a reposeful postoperative recovery with no complication. Delayed infection was shown in one patient and the Medpor® implant was removed. All the 11 patients had the mandibular contour reconstructed satisfactorily.
The technique and cases presented demonstrate the utility of Medpor® implants with CAD/CAM in comprehensive mandibular contour reconstruction.
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 http://ift.tt/18t7xNj.
The molecular imprinting technique combined with photocatalysis was used in the removal of fluoroquinolones. In this study, we prepared molecular imprinted polymers (MIPs) and investigated the adsorption and photocatalytic regeneration performance, followed by the effect of different environmental factors and photoproduct identification. Compared with non-imprinted polymers (NIPs) and P25, MIPs had a better adsorption performance towards norfloxacin with the removal efficiency of 77.1% in 1 h. pH, humic acid, and high valence ions had significant effects on the adsorption performance. Under neutral condition, the adsorption effect of MIPs was better than that of acidic and alkaline condition. The removal efficiency declined to 25.9% when pH reached 11. The removal efficiency gradually improved with the concentration of humic acid increasing. The adsorption efficiency of MIPs in surface water was only 12.6% lower than that of ultrapure water, which indicated that molecular imprinting process improved the anti-interference property. The photodegradation rate was 0.114 min−1 when the concentration of norfloxacin was 1 mg L−1. Norfloxacin was oxidized with aldehyde group or hydroxyl. The adsorption removal efficiency of MIPs did not decline apparently after 11 adsorption-photocatalytic regeneration cycles, which suggested that the in-situ regeneration and sustainable use of MIPs were achievable in organic pollutant control.
In psoriasis, a chronic inflammatory skin disease with a complex pathophysiology, multiple epidermal differentiation and immune-related genes interact with environmental factors [1]. Despite recent findings on pathogenic related-immune cellular subsets and cytokines (e.g. Th17 and Th22 pathways), the ultimate factors that trigger and preserve inflammation remain unknown. TLRs are germ line-encoded pattern-recognition receptors that recognize pathogen-associated and molecular patterns (PAMPs) and tissue damage-associated molecular patterns (DAMPs) such as self-nucleic acids.
Dermatologic conditions cause morbidity and mortality among hospitalized cancer patients. An improved understanding is critical for implementing clinical and research programs in inpatient oncodermatology.
Alpha gal syndrome has been reported after Amblyomma tick bites. Patients who had ≥ 2 tick bites had higher levels of anti-alpha-gal IgE antibody than those with 0-1 tick bites. Patients with multiple Amblyomma tick bites may be at higher risk of developing allergy to red meat.
The stable isotopic compositions (δD and δ18O) of precipitation were firstly investigated from May 2012 to November 2013 in the Jinshui River basin of the South Qinling Mts., China. The local meteoric water lines (LMWLs) based on all daily and monthly precipitation-weighted data were defined as δD = 8.32 δ18O + 12.57 (r 2 = 0.957, n = 47, p < 0.001) and δD = 8.11 δ18O + 11.59 (r 2 = 0.946, n = 15, p < 0.001), respectively. The fluctuations of daily deuterium excess (d-excess) values indicated the mixing moisture sources from the monsoon circulation during the rainy season and the local moisture recycling during the dry season in the river basin. The monthly precipitation-weighted values of d-excess confirmed the moisture sources and determined the temporal variations in moisture supply for the river basin. The precipitation amount and temperature effects were found to be significant, with amount gradient of − 0.06‰/mm for daily δ18O variability and temperature gradients of − 1.51 and − 0.44‰/°C for daily δD and d-excess variability, respectively. However, the isotopes of local precipitation during precipitation events were almost unaffected by relative humidity due to overwhelming recycled moisture at relative humidity > 85%. The results of this research provide an effective method for tracing the local water hydrologic cycle in the South Qinling Mts., China.
Interactions between pesticides (paraquat, glyphosate, 2,4-D, atrazine, and metsulfuron methyl) and soil organic and inorganic components have been studied in batch experiments by performing adsorption, dissolution, and chemical and photochemical degradation under different conditions. The obtained results confirm that the affinity of a pesticide to the solid surface depends on the nature of both and shows that each reactant strongly affects the mobility of the other one, e.g., anionic pesticides promote the dissolution of the solid humic acid but if this last is retained into the inorganic matrix enhances the adsorption of a cationic pesticide. Adsorption also seems to protect the bonded specie to be chemical degraded, such as shown in two pesticide/clay systems at constant pH. The use of mesoporous silicas could result in a good alternative for pesticide remediation. In fact, the solid shows high adsorption capacity towards paraquat and its modification with TiO2 nanoparticles increases not only the pesticide adsorption but also seems to catalyze its degradation under UV light to less-toxic metabolites. UV-VIS spectroscopy was relevant and novel in such sense. Electrostatic interactions, hydrogen and coordinative bonds formations, surface complexations and hydrophobic associations play a key role in the fate of mentioned pesticides on soil and ground/surface water environments.
The Sacca di Goro and Sacca di Scardovari are two coastal lagoons of the Po River delta facing the northern Adriatic Sea. They are sensitive ecosystems both from the naturalistic and socio-economic point of view, since they are included in a natural park and are high productivity shellfish sites. Bottom sediments from the two lagoons have been analysed for their textural and geochemical (major and trace elements by XRF) composition in order to identify natural backgrounds and anthropogenic inputs. OC, N and δ13COC data have been also carried out by EA-IRMS to highlight the association of heavy metals with inorganic or organic sedimentary components. Results show that abundances of siderophile (Cr, Ni, Co) heavy metals in samples from the two lagoons are generally in the range of those recorded in alluvial sediments from the neighbours and are associated with the finest (clayey) fraction. Among chalcophile heavy metals, Pb and Zn display significant enrichments relative to the local geochemical backgrounds suggesting anthropogenic sources. They appear to be preferentially associated with the sedimentary organic matter that, according to the isotopic composition, is mainly formed by the incorporation of different proportions of macroalgae and macrophytes that have a significant bioaccumulation capacity. Taking into consideration that the extent of the algal biomass is sensitive to anthropogenic pressure and climatic changes, the trace element budget of sediments from these lagoons has to be monitored in the future, also to assess the impact of heavy metals on shellfish production.
Publication date: Available online 19 December 2017
Source:Dermatologic Clinics
Author(s): Leah A. Cardwell, Timothy Nyckowski, Laura N. Uwakwe, Steven R. Feldman
Publication date: Available online 19 December 2017
Source:Journal de Mycologie Médicale
Author(s): E. Gonçalves Silva, S. Marilia de Souza Silva, C. Rodrigues Paula, L. da Silva Ruiz, A. Latercia Tranches Dias
Cryptococcosis is a subacute or chronic disease. For many years, amphotericin B has been used in severe fungal infections. Voriconazole is a triazole with high bioavailability, a large distribution volume, and excellent penetration of the central nervous system (CNS). The objective of this study was to evaluate the production of pro-inflammatory cytokines in the lungs during an experimental infection caused by C. neoformans in murine model (SCID) that was treated with amphotericin B and voriconazole. After intravenous inoculation with 3.0×105 viable yeast cells, the animals were treated with amphotericin B and voriconazole. The daily treatments began 24hours after inoculation and lasted 15 days. We evaluated the survival curve and we measured the levels of TNF-α, IL-6 and IL-10. For all treatments, there was a significant increase in survival compared to the untreated group of animals and the group treated with voriconazole (maximum concentration). The levels of pro-inflammatory cytokines were significantly lower in the groups treated with voriconazole (maximum concentration) and amphotericin B (minimum concentration). Under the conditions studied, we can suggest by that the production of pro-inflammatory cytokines mediated by amphotericin B and voriconazole is dependent on the concentration administered.
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By Jamshed Arslan Pharm.D.
Muscle atrophy is a common feature of many tumors. Cancer-induced muscle wasting, or cancer cachexia, results from pro-inflammatory cytokines (TNFα and IL-6) and/or agonists of type IIB activin receptors (ActRIIB), but the key humoral factors have remained elusive. Animal studies have implicated systemic inflammation-induced activation of p38β MAPK-C/EBPβ signaling, but the etiology of cancer cachexia was unclear until recently. A team led by researchers at the University of Texas Health Science Center (UTHealth), Texas, found that conditioned medium of Lewis lung carcinoma (LLC) cells has catabolic activity related to high levels of two heat shock proteins, Hsp70 and Hsp90. By neutralizing these two proteins and silencing their genes, the team was also able to treat cancer cachexia in mice.[1]
Cachectic cancers release high amounts of EV-associated Hsp70/90
The team compared the conditioned media of cachexic cancer cells with the conditioned media of non-cachexic cancer and non-tumorigenic cells, in order to investigate if all cachexic cancers release Hsp70/90. ELISA showed that cachexic cancer cells, such as LLC (lung) and C26 (colon), release about ten-fold higher levels of Hsp70 and Hsp90α. Moreover, increased Hsp70 and Hsp90α in the sera of mice models led investigators to think that tumor cells release these two proteins extracellularly through extracellular vesicles (EVs). Western blotting and immunoprecipitation of isolated EVs revealed that the release of Hsp70/90 was associated with CD9/TSG101/acetylcholinesterase-positive EVs.
However, investigators made the important observation that "elevated serum Hsp70 has been reported in patients with CHF and COPD.[2,3] These conditions are known to induce muscle atrophy, too."
Professor Yi-Ping Li, PhD., Department of Integrative Biology and Pharmacology, UTHealth
Cancer cachexia depends on Hsp70/90
In order to know if elevated levels of circulating Hsp70/90 induce muscle catabolism, the team exposed primary rat and C2C12 myotubes to the conditioned media of LLC and C26 cells in the presence/absence of antibodies against Hsp70 and/or Hsp90. Only blocking of both Hsp70 and Hsp90 led to complete abolishment of the upregulation of E3 ligases atrogin1 and UBR2, suppression of p38 MAPK activation, and prevention of myotube atrophy and myosin heavy chain loss. The results in mice cancer models validated the cachexia-inducing impact of Hsp70/90.
The team then used small interfering RNAs and short hairpin RNAs against Hsp70/90 in LLC cells to answer the next logical question: is the cachexia-inducing ability of tumors dependent on Hsp70/90? As expected, Hsp70/90-deficient tumors did not lead to muscle catabolism and Hsp70/90-deficient mice did not exhibit increased serum Hsp70/90 levels. Intriguingly, blocking the GTPases that control EV release (Rab27a and Rab27b) in LLC and C26 cells stalled the release of EVs, and consequently blocked Hsp70/90 and muscle catabolism. Furthermore, exposing myotubes to cancer-generated EVs revealed that catabolic response to Hsp70/90 was dependent on TLR4, but not on TLR2.
Significance
The findings from these UTHealth investigators and their collaborators let us appreciate the nuances in some widely held notions. For example, they did not find any abnormal PTHrP release in serum or from cancer cells, and IL-1β was found to be not associated with tumor cachexia. They are the first ones to associate serum Hsp70/90 to cachexia in an in vivo (mice) model, and demonstrate that Hsp70/90 drive inflammation and cachexia in cancer. They found that increase in cytokines (TNF-α and IL-6) in cachectic tumor-bearing mice was an immune response to TLR4 activation by Hsp70/90, indicating that effective therapeutic strategies should target upstream activation of TLR4, not the cytokines per se. Likewise, now we know the major humoral factors (Hsp70/90) that initiate cancer cachexia, and hope that targeting them will improve patients' quality of life.
University of Alabama at Birmingham, School of Medicine
Dr. Arslan studies cell signaling in mitochondrial defects in C. elegans and transgenic mice.
References
Das epitheloide Sarkom vom klassischen, „distalen" Typ wurde 1970 erstmals beschrieben. Es handelt sich um einen äußerst seltenen, malignen, subkutan gelegenen, langsam wachsenden aggressiven Weichteiltumor, der sowohl epitheliale wie auch mesenchymale Marker stark exprimiert. Er tritt v. a. bei jungen männlichen Erwachsenen auf und manifestiert sich klinisch als derbe meist schmerzhafte, kutan bis subkutan gelegene knotige Induration, die im Verlauf häufig exulzeriert. Eine Assoziation mit einem Trauma wird häufig berichtet und lenkt von der korrekten Diagnose ab. Prädilektionsstellen sind v. a. die Beugeseiten der Finger, Handrücken, Fußsohlen sowie Streckseiten der Unterarme und Unterschenkel. Ein Spezifikum des Tumors ist die Ausbreitung entlang von Nerven, Sehnen und Faszien. Die Therapie der Wahl ist die großzügige Exzision des Tumors, eine Sentinelnodebiopsie und ggf. die prä- oder postoperative Bestrahlungstherapie. Das epitheloide Sarkom zeigt eine ausgeprägte Rezidivneigung in den ersten Jahren, die häufig mit Lungen- und/oder Lymphknotenmetastasen vergesellschaftet ist und dann eine infauste Prognose aufweist.
Scientifically evaluating the level of low-carbon development in terms of theoretical and practical significance is extremely important to coal enterprise groups for implementing national energy-related systems. This assessment can assist in building institutional mechanisms that are conducive for the economic development of coal business cycle and energy conservation as well as promoting the healthy development of coal enterprises to realize coal scientific development and resource utilization. First, by adopting systematic analysis method, this study builds low-carbon development evaluation index system for coal enterprise groups. Second, to determine the weight serving as guideline and criteria of the index, analytic hierarchy process (AHP) is applied using integrated linear weighted sum method to evaluate the level of low-carbon development of coal enterprise groups. Evaluation is also performed by coal enterprise groups, and the process comprises field analysis and evaluation. Finally, industrial policies are proposed regarding the development of low-carbon coal conglomerate strategies and measures. This study aims mainly to guide the low-carbon development of coal enterprise groups, solve the problem of coal mining and the destruction of ecological environment, support the conservation of raw materials and various resources, and achieve the sustainable development of the coal industry.
Accurate estimation of extinction depth of shallow groundwater (EDSG) and identification of its influence factors are important for sustainable management of groundwater resources, ecological protection, and human health in intensively irrigated region. In this study, the ratio of actual groundwater depth and EDSG (RAE) method was used to understand the spatial variability of EDSG in the Sanjiang Plain, one of China's largest grain production bases and China's largest inland freshwater wetland region. The study showed a large spatial variation of EDSG in the region. Spatially, the sites, which were in the northeast and center had the deepest and the shallowest EDSG, whereby, indicate that it has higher and lower pumping potential capacity. Many factors including climate, soil parameters, vegetation and topography affected the EDSG. We also identified an area of 3.86 × 1010 m2, which accounting for 35.3% of the entire Sanjiang Plain, has exceeded the ESGD by over exploited for years. Knowledge of the variation and influence factors of EDSG for a certain plant system and the current shallow groundwater condition in the higher latitude region can be a key to the development of preventive actions for large quantity pumping groundwater and protection regional and sustainable development of irrigated agriculture.
Sweet syndrome (SS), also known as acute febrile neutrophilic dermatosis, is a distinct clinical-pathologic entity characterized by an abrupt eruption of tender or painful erythematous or violaceous plaques or nodules, with histopathologic features of a predominantly neutrophilic infiltrate in the dermis without leukocytoclastic vasculitis, constituting the major criteria for the diagnosis (1, 2). Clinically, these present as acutely eruptive juicy, erythematous papules and plaques. SS may be associated with a variety of systemic disorders, including malignancy, medications, and pregnancy.
Health impact of exposure to air pollution is a public health concern. The aim of this study was to investigate an extended parallel process model (EPPM)-based mobile phone text message intervention for improving protective behaviors against air pollution among pregnant women. In this randomized controlled trial (IRCT2016102810804N8), 130 pregnant women were randomly assigned into either experimental or control groups. A valid and reliable questionnaire was used to collect data. Experimental group received mobile phone intervention on a daily basis for 2 months. Control group received usual care, only. Data were analyzed using SPSS 15 applying t test, chi-square, and Wilcoxon and Mann-Whitney U test. Although before intervention, there were no significant differences between different structures of EPPM (P > 0.05), after intervention, there were statistically significant differences between perceived severity, response efficacy, self-efficacy, and protective behaviors between two groups (P < 0.05). Implementing EPPM based-mobile phone intervention could promote protective behaviors against air pollution among pregnant women. The present study might be used as a framework for evidence-based health promotion regarding air pollution risk communication and self-care behaviors. Trial registration: IRCT2016102810804N8
Biochar is a product of the thermal decomposition of biomass under a limited supply of oxygen and can be deriving from pyrolysis or gasification. As the product is rich in highly recalcitrant carbon, it has been proposed as a soil amendment to improve soil fertility and to stock carbon in soils. However, the contaminant compounds present in biochar could represent potential environmental threats. The gasification biochar is a promising by-product, but its effects on soil microarthropods are still nearly unknown. The aim of this study was to assess, using a prognosis approach, any ecotoxicological consequences of four biochars (conifer, poplar, grape marc, and wheat straw) on the springtail Folsomia candida. This was assessed through a series of tests: an avoidance behavior test, a survival and reproduction test, and a test based on the hatching of eggs. Biochars were tested at different concentrations (pulverized and diluted w/w with an artificial standard soil). The results showed that the springtails did not tend to avoid the biochars' substrates up to the rate of 2–5%, but any higher levels of concentration caused the animals to keep away from it. While mortality was negatively affected only in the grape marc biochar, reproduction was significantly reduced in all biochars considered. The hatching of the eggs was anticipated at even the lowest concentrations of herbaceous biochars, while a severe delay was observed in both concentrations tested of the conifer biochar. The endpoints considered were negatively affected by pH, polycyclic aromatic hydrocarbons, and heavy metals (in order of importance). The findings confirmed the potential adverse effects that gasification biochars could have on soil microarthropods and demonstrated the necessity of introducing these tests into biochar characterization protocols.
Exposure to volatile organic compounds (VOCs) can cause cancers in human. This study aimed to measure the concentration of four VOCs including benzene, styrene, ethylbenzene, and phenol in ambient air of a petrochemical complex in Iran. Also, their urinary metabolites including phenol, mandelic acid (MA), and phenylglyoxylic acid (PGA) in the workers were monitored. Urine samples were collected before and after the 8-h workshift according to the NIOSH methods. They were analyzed by a gas chromatograph coupled with a flame ionization detector (GC-FID). High levels of the ambient VOCs were detected in the units of recovery and olefin. The levels of ethylbenzene and phenol were less than the guidelines suggested by NIOSH and ACGIH. However, in some cases, the amounts of benzene and styrene were higher than the guidelines. Excellent positive correlations were observed between VOCs exposure and their urinary metabolites (r 2 > 0.90), except for benzene (r 2 = 0.26). Our finding verified that urinary biomarkers can be applied as bioindicators for ambient exposure to VOCs. There is a risk of exposure to high levels of the pollutants in some of the sites, and it is necessary to adopt some preventive measures to reduce health risk.
Humans are exposed to heavy metals through ingestion, inhalation, and dermal absorption. Exposure to these chemicals may be possible during lactation. Although breastfeeding has import benefits of physical growth and development of breastfed infants, it may be a source of exposure to toxicants. The present study was conducted to determine infant exposure to the arsenic via breastfeeding. The milk samples were collected from the 150 volunteering mothers three times during the first month of lactation after delivery. The average arsenic concentration in breast milk samples was measured by atomic absorption spectrometer (AAS). The demographic parameters of lactating mothers were collected by a questionnaire and were analyzed using SPSS 18 software. Arsenic was not detectable in 71 of 150 samples (47.3%). The highest arsenic concentration was 3.73 μg/L, and overall mean of arsenic concentration was 0.87 ± 0.66 μg/L. The daily infant intake of arsenic ranged in the 0.01–0.17 μg/kg of body weight, which is below the limit of daily permissible intake for adults. Our results showed the need to strengthen national food safety programs and to further promote avoidance of unhealthy foods consuming during pregnancy. Most of the study samples had detectable levels of arsenic indicate that there was maternal exposure prior to pregnancy, nevertheless, it is recommended that the toxic metal levels should be regularly monitored in biological environments.
The paper specifically looks at the rural-urban interaction and contribution of various entities or agents to the total employment in China, rural China, and urban China. The study concentrated on the total employment after 1978 reforms. The paper looked at the 1978–2004 reform and after 2004 reform. It was revealed that 1978–2004 reform hindered the flow of labor from rural to urban but after 2004 reform promoted the flow of labor force from rural to urban China the development, which resulted in a drastic reduction in the rural labor force. Before the reforms, state- and collective-owned units were the only entities that were employing people in China. Even though private enterprises were allowed after the reforms, the leading role of the state- and collective-owned units persist. State-owned units contribute immensely to the total employment in China and urban employment, but its contribution to employment in rural China is negative. Collective-owned and cooperative units show a positive contribution to employment in rural areas but its contribution to the total employment in China is negative. Units with funds from Hong Kong, Macao, and Taiwan and rural private enterprises also contribute positively to total employment in China. Cooperative units, joint holding corporations Ltd., foreign-funded units, and rural self-employed individuals contribute negatively to the total employment in China. Collective-owned and cooperative units contribute negatively to employment in the urban areas. Urban and rural private enterprises and rural self-employed individuals contribute positively to urban employment.
Erythrodermic psoriasis (EP) is a rare but severe variant of psoriasis. Evidence-based treatment of EP is limited due to its rarity and lack of controlled studies. Secukinumab is an anti-IL17A monoclonal antibody approved for the treatment of moderate to severe psoriasis with superior efficacy compared to etanercept and ustekinumab. Since 2015 it has been approved by FDA in the United States and gained increasing popularity for the treatment of plaque psoriasis. However, there are very few reports showing secukinumab as an option for treating EP.
This article is protected by copyright. All rights reserved.
In Führungspositionen spielen neben den fachlichen Kompetenzen auch die „soft skills" eine entscheidende Rolle für den Erfolg. Persönlichkeitseigenschaften, Kommunikation und Führungsstil sind wichtige Einflussfaktoren, wenn es um das eigene Fortkommen oder die Arbeitszufriedenheit der Mitarbeiter geht. Der Beitrag gibt einen Überblick über die Definition der Soft skills (soziale Kompetenz), die Instrumente für die Messung solcher Kompetenzen und die Möglichkeiten der Förderung eventueller Entwicklungsfelder.
Respiratory syncytial virus (RSV) infection remains one of the major reasons of re-hospitalization among children with congenital heart disease (CHD). This study estimated the cost-effectiveness of palivizumab...
An increasing incidence of contact allergy to methylisothiazolinone (MI) has been seen, caused, in particular, by cosmetic products and paints. A study from 2015 showed that 93.0% of paints bought in five European countries contained MI. New regulations have been discussed for paints in the EU, which may have influenced this market.
To re-evaluate the use and concentrations of MI and four other isothiazolinones in water-based wall paints.
Water-based white wall paints (n = 60) were purchased in retail stores in five European countries: Denmark, France, Germany, Sweden, and the United Kingdom. The paints were analysed for isothiazolione content by the use of high-performance liquid chromatography coupled to ultraviolet detection, and the results were confirmed with high-performance liquid chromatography–tandem mass spectrometry.
MI was identified in 55 (91.7%) of the paints, with concentrations ranging from 1.1 to 142.7 ppm. The other isothiazolinones were identified in 20.0% [methylchloroisothiazolinone (MCI)] to 88.3% [benzisothiazolinone (BIT)] of the paints. BIT concentrations varied significantly between countries, whereas MI and MCI concentrations did not. There were no statistically significant differences in MI, MCI and BIT concentrations between the current study and the 2015 study.
MI and other isothiazolinones are widely used in paints available in Europe. Their use does not seem to be decreasing.
Tropical rainforest soils harbor a considerable diversity of soil fauna that contributes to emissions of N2O. Despite their ecological dominance, there is limited information available about the contribution of epigeal ant mounds to N2O emissions in these tropical soils. This study aimed to determine whether ant mounds contribute to local soil N emissions in the tropical humid rainforest. N2O emission was determined in vitro from individual live ants, ant-processed mound soils, and surrounding reference soils for two trophically distinct and abundant ant species: the leaf-cutting Atta mexicana and omnivorous Solenopsis geminata. The abundance of total bacteria, nitrifiers (AOA and AOB), and denitrifiers (nirK, nirS, and nosZ) was estimated in these soils using quantitative PCR, and their respective mineral N contents determined. There was negligible N2O emission detected from live ant individuals. However, the mound soils of both species emitted significantly greater (3-fold) amount of N2O than their respective surrounding reference soils. This emission increased significantly up to 6-fold in the presence of acetylene, indicating that, in addition to N2O, dinitrogen (N2) is also produced from these mound soils at an equivalent rate (N2O/N2 = 0.57). Functional gene abundance (nitrifiers and denitrifiers) and mineral N pools (ammonium and nitrate) were significantly greater in mound soils than in their respective reference soils. Furthermore, in the light of the measured parameters and their correlation trends, nitrification and denitrification appeared to represent the major N2O-producing microbial processes in ant mound soils. The ant mounds were estimated to contribute from 0.1 to 3.7% of the total N2O emissions of tropical rainforest soils.
Summary: Negative-pressure wound therapy (NPWT) is a well-established therapeutic approach for various complex wound classes. There is currently limited information on the use of NPWT for the scope of head and neck wounds. However, NPWT has been used successfully in some cases, including malignancy, infection, and trauma. In West Virginia, the incidence of dental-related infections leading to Ludwig's Angina is high due to lack of access to dental care. Our case series describes the application of vacuum-based therapy in conjunction with antibiotic therapy for quick, effective closure of deep tissue infections before definitive complex wound repair via graft and flap reconstructions. Over a period of 3 months, 2 patients with submental infections extending to the lateral neck demonstrated clean, efficient wound closure with NPWT for less than 14 days while hospitalized at West Virginia University Medicine. Outpatient follow-up with these patients demonstrated excellent cosmetic outcomes with minimal contracture or hypertrophy of healing tissue. NPWT promotes wound healing through decreased edema, improved perfusion, and increased granulation of tissue based on our findings. Our series encourages the use of NPWT for initial closure of complex wounds secondary to deep neck infections.Reflectance confocal microscopy (RCM) imaging can be used to diagnose and subtype basal cell carcinoma (BCC) but relies on individual morphologic pattern recognition that might vary among users.
We assessed the inter-rater and intra-rater agreement of RCM in correctly diagnosing and subtyping BCC.
In this prospective study we evaluated the inter-rater and intra-rater agreement of RCM on BCC presence and subtype among three raters with varying experience who independently assessed static images of 48 RCM cases twice with four weeks interval (T1 and T2). Histopathologic confirmation of presence and subtype of BCC from surgical excision specimen was defined as the reference standard.
The inter-rater agreement of RCM for BCC presence showed an agreement of 82% at T1 and 84% at T2. The agreements for subtyping BCC were lower (52% for T1 and 47% for T2). The intra-rater agreement of RCM for BCC presence showed an observed agreement that varied from 79% to 92%. The observed agreements for subtyping varied from 56% to 71%.
In conclusion, our results show that RCM is reliable in correctly diagnosing BCC based on the assessment of static RCM images. RCM could potentially play an important role in BCC management if accurate subtyping will be achieved. Therefore future clinical studies on reliability and specific RCM features for BCC subtypes are required.
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Surgery is an important treatment modality for hidradenitis suppurativa (HS). Various methods of HS surgery have been described. Even though wide excision is a common surgical procedure for HS, data on the recurrence rate and patient satisfaction are scarce.
To determine the recurrence rate and patient satisfaction of HS lesional wide excision (complete excision) with secondary intention healing.
A single center retrospective study. Hundred twenty eligible patients were identified from our medical files and an individualized questionnaire was sent.
Eighty-six patents responded to our questionnaire (71.7%). Of whom 84 patients underwent in total 253 procedures. The mean follow-up time per procedure was 36.2 months. In 37.6% of the procedures, recurrence occurred within a mean follow-up period of 3 years (after a median of 6.0 months). Total remission of an anatomical area was achieved in 49% of the procedures, whereas natural disease progression occurred in 13%. The genital region was the most prone to recurrence.
The majority of the patients were glad that they had undergone the procedure and would recommend the surgical procedure to other HS patients.
Lesional wide excision (complete excision) with secondary intention healing yields a meaningful local cure rate for HS and is well tolerated.
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Merkel cell carcinoma (MCC) is a rare, aggressive, polyomavirus associated tumor with neuroendocrine and epithelial differentiation. The status of somatostatin receptors (SSTRs) are well characterized in neuroendocrine tumors [1, 2]. The levels of expression of SSTRs differ considerably in different tumors, immunohistochemistry (IHC) to identify the features of their key parameters allow us to assign a reasonable therapy with somatostatin analogues. The cases of successful treatment and diagnostics of metastatic MCC using radiolabelled somatostatin analogues [3, 4, 5] described in the literature. But the role of SSTRs expression in behavior of disease is not available for MCC.
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Psoriasis vulgaris (PV) is widely considered as a chronic inflammatory skin disease which is characterized hyperplasia with incomplete differentiation and decreased apoptosis of epidermal keratinocytes(1). The patients with PV suffer severe physical and psychological discomfort, and often have decreased life quality. However, traditional treatments of PV cannot meet the needs of patients(2). So it is crucial and urgent to explore the underlying molecular mechanism of PV and develop new target therapy to PV.
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Skin cancer prevalence is well-characterized for white solid organ transplant recipients. Although the prevalence of skin cancer in non-white (Black, Asian, Hispanic) kidney transplant recipients (KTRs) has been assessed, no study has reported the prevalence of skin cancer in Native American (NA) KTRs. The aim of this study is to determine if the prevalence of skin cancer in NAKTRs is the same as in white KTRs.
We conducted a case-controlled retrospective review from a single transplant center. One hundred thirteen NAKTRs who received a transplant between 2001 and 2011 were age- and transplant-year matched with 113 white controls.
The 226 KTRs consisted of 141 (62.4%) men and 85 (37.6%) women, with a mean age of 50.2 ± 10.8 years. There was no skin cancer found in NAKTRs prior to or post transplantation, while seven (6.2%) white KTRs had eight skin cancers prior to transplantation, and 28 (24.8%) white KTRs developed 66 skin cancers post transplantation. Twenty-two (19.5%) NAKTRs did not follow-up with dermatology at this institution. The median follow-up in NAKTRs was 3.3 years compared to 3.0 years in white KTRs.
NAKTRs have a decreased prevalence of skin cancer compared to their white counterparts.
Plantar fibromatosis or Ledderhose disease is characterized by a benign fibroblastic proliferation of the plantar fascia. It is an illness with unknown etiology and a complex treatment in its most intense manifestation.
The authors describe a surgical option for extensive cases where conservative treatments are not successful. Surgical techniques may vary according to the site and extent of the lesions.
Surgical treatment with wide resection of the lesion and second intention healing using a hydrocolloid dressing.
After a 3-year follow-up with no recurrence, the authors demonstrated an excellent result, which led to an important improvement in the patient's quality of life.
Surgical treatment can be a good option for plantar fibromatosis. Giant lesions can be treated with wide excisions and second intention healing, with low risk of aesthetic and functional complications.
Ectodermal dysplasias (EDs) are a group of hereditary disorders defined by alterations in two or more ectodermal structures. One recently described rare entity is the autosomal recessive inherited ectodermal dysplasia-syndactyly syndrome 1 (EDSS1). Homozygous and compound heterozygous missense and nonsense mutations in the poliovirus receptor related-4 (PVRL4) gene, encoding cell adhesion molecule nectin-4, have been identified as causal for EDSS1. We here report a consanguineous family with a 2-year-old girl featuring EDSS1, including slowly progressive alopecia on the head, pili torti-like twisted hairs in trichoscopy, widely spaced, peg-shaped and conical teeth, proximal syndactyly with fusion of the 2nd to 4th toes, and generalized dry skin. There was no palmoplantar hyperkeratosis and sweating appeared normal to slightly enhanced, especially on the head. Using exome sequencing, we identified the novel homozygous nonsense mutation c.229C>T (p.Gln77Ter) in PVRL4.
This paper tells the story of G-protein coupled receptors (GPCRs), one of the most important scientific objects in contemporary biochemistry and molecular biology. By looking at how cell membrane receptors turned from a speculative concept into a central element in modern biochemistry over the past 40 years, we revisit the role of manipulability as a criterion for entity realism in wet-lab research. The central argument is that manipulability as a condition for reality becomes meaningful only once scientists have decided how to conceptually coordinate measurable effects distinctly to a specific object. We show that a scientific entity, such as GPCRs, is assigned varying degrees of reality throughout different stages of its discovery. The criteria of its reality, we further claim, cannot be made independently of the question about how this object becomes a standard by which the reality of neighbouring elements of enquiry is evaluated.
Schilddrüsenkarzinome sind die häufigsten endokrinen Tumore.
Mit diesem Artikel möchten die Autoren eine Übersicht über die aktuellen Therapieempfehlungen bei metastasierten Schilddrüsenkarzinomen geben.
Diese Arbeit basiert auf einer selektiven Literaturrecherche (PubMed) zur Therapie des Schilddrüsenkarzinoms sowie der aktuellen europäischen und amerikanischen Leitlinien.
Die Therapie der differenzierten Schilddrüsenkarzinome ist multimodal und besteht in der Regel aus Operation, ggf. Radiojodtherapie und risikoadaptierter TSH-Suppression (TSH „thyroid-stimulating hormone"). Die Radiojodtherapie wird auch bei radiojodspeichernden Metastasen eingesetzt. Bei radiojodrefraktären, entdifferenzierten sowie den medullären Schilddrüsenkarzinomen stellen Tyrosinkinaseinhibitoren eine neue Therapieoption mit signifikanter Verlängerung des progressionsfreien Überlebens dar. Die Behandlung mit Tyrosinkinaseinhibitoren ist jedoch mit teils erheblichen Nebenwirkungen verbunden. Eine sorgfältige Indikationsstellung mit Nachweis einer Tumorprogression und die Berücksichtigung des jeweiligen Nebenwirkungsprofils werden daher gefordert. Die Chemotherapie kommt aufgrund der vergleichsweise höheren Toxizität und schlechteren Ansprechrate kaum mehr zum Einsatz. Zur Behandlung des hoch aggressiven anaplastischen Schilddrüsenkarzinoms steht zurzeit keine kurative Therapie zur Verfügung. Sowohl Tyrosinkinaseinhibitoren als auch Checkpointinhibitoren scheinen im Rahmen einer Off-label-Therapie vielversprechend.
Aufgrund ihrer Komplexität sowie den verschiedenen neuen Therapieoptionen einschließlich neuer Leitlinien sollten Patienten mit Schilddrüsenkarzinomen in spezialisierten endokrinen Zentren behandelt werden.
The term "parrot beak nail" describes a morphologic change of the nail plate characterized by excessive forward curvature. It may be associated with systemic disease or, most commonly, occurs as an idiopathic finding complicated by delayed nail plate trimming. The characteristics of parrot beak nails in ten men are described, and the features of this acquired nail deformity are reviewed. Of the ten patients, six presented with concurrent neuropathies that resulted in frequent foot injuries or falls. While the true incidence of parrot beak nails is unknown, this nail deformity occurred in 2.1 % of patients seen by a single physician during a 3-month period. In conclusion, parrot beak nails secondary to poor nail care may lead to functional impairment, tissue injury, and subsequent infections. Therefore, it is important for clinicians to look for these nail lesions on cutaneous examination and recommend frequent nail trimmings to individuals with parrot beak nails.
Individuals play a prominent role in many metaphysical theories. According to an individualistic metaphysics, reality is determined (at least in part) by the pattern of properties and relations that hold between individuals. A number of philosophers have recently brought to attention alternative views in which individuals do not play such a prominent role; in this paper I will investigate one of these alternatives.
The aim of this study was to evaluate the differences in upper gastrointestinal symptoms between generations and genders in relatively healthy Japanese subjects.
Altogether, 4086 healthy Japanese male and female (M/F) adults (M/F: 2244/1842) were analyzed. Among them, 3505 subjects (M/F: 1922/1583) were underwent a routine medical checkup at one of five hospitals in Saga, Japan from January 2013 to December 2013. The others were 581 (M/F: 322/259) healthy young volunteers at the Saga Medical School from April 2007 to March 2013. The participants were asked to complete the frequency scale for the symptoms of gastroesophageal reflex disease (FSSG) questionnaire, undergo upper gastrointestinal endoscopy, and submit to a rapid urease test to diagnose Helicobacter pylori infection. Among the 4086 subjects, the 2414 who had no H. pylori infection and no positive endoscopic findings were enrolled in the study.
Subjects' average age was 46.9 ± 12.2 years, with males' and females' ages being almost equivalent. The total FSSG score were high in females compared to males (P < 0.01) and decreased significantly with aging (P < 0.05). Among the generations, FSSG scores were the highest for those 20–29 years old, and they were significantly decreased with ageing in both males and females (P < 0.05).
The FSSG score was significantly higher in healthy Japanese females than in males, and the scores decreased with aging.
Protection of common natural goods is one of the greatest challenges man faces every day. Extracting and processing natural resources such as mineral deposits contributes to the transformation of the natural environment. The number of activities designed to keep balance are undertaken in accordance with the concept of integrated order. One of them is the use of comprehensive systems of tailings storage facility monitoring. Despite the monitoring, system failures still occur. The quantitative aspect of the failures illustrates both the scale of the problem and the quantitative aspect of the consequences of tailings storage facility failures. The paper presents vast possibilities provided by the global monitoring in the effective prevention of these failures. Particular attention is drawn to the potential of using multidirectional monitoring, including technical and environmental monitoring by the example of one of the world's biggest hydrotechnical constructions—Żelazny Most Tailings Storage Facility (TSF), Poland. Analysis of monitoring data allows to take preventive action against construction failures of facility dams, which can have devastating effects on human life and the natural environment.
Cadmium is an important environmental contaminant. High consumption of chemical fertilizers and industrial activities in recent decades has caused people to be worried about exposure to cadmium. There is no policy for environmental and biological monitoring of exposure to cadmium in the general population in Iran. This study was aimed to review cadmium content in consuming foods and biological samples in Iran, systematically. We developed a comprehensive search strategy and used it to search on Web of Science, Scopus, Science Direct, and Scientific Information Database until 28 December 2016. The totals of 285 articles were identified and finally 31 original papers were selected. Cadmium contamination was found in Iranian food groups such as rice, cereal and legumes, canned tuna fish, vegetables, fruit juice, and egg. This study showed that cadmium amount in 75% of the consumed rice samples (domestic and imported) was higher than the maximum limits approved by institute of standards and industrial research of Iran. Lettuce samples in Yazd were recorded the highest concentration of cadmium compared to other studies. In addition, high amount of cadmium was observed in the blood of the general population. Regarding the cadmium contamination in food and blood samples in Iran, policies must be adopted to reduce exposure to cadmium through different matrices as much as possible.
Cadmium (Cd) and lead (Pb) are ubiquitous environmental pollutants. There is a dearth of information on the mutual interaction between the antemortem metal intoxication and the postmortem changes of the eye. Thus, this study aimed to follow the morphological, biochemical, histopathological ocular perturbations and the retinal DNA damage up to 8 h postmortem (PM) in Cd and/or Pb intoxicated rabbits. The animals orally received 5 mg Cd Cl2/kg bw and/or 12.5 mg lead acetate/kg bw for 30 consecutive days. At time of death, eye pupil of different groups had a normal diameter except Pb-intoxicated group had marked myosis. After 8 h of death, different rabbit's eye corneas appeared wrinkled and covered with thin white cloud while the pupils were in the mydriatic stage. Up to 8 h PM, the individual exposure to Cd or Pb resulted in a significant elevation in GGT, urea, K, DNA damage and obvious retinal lesions. However, their co-exposure evoked an antagonistic outcome. The eye of Cd and/or Pb intoxicated rabbit showed mildly degenerated tissue of cornea and sclera and the presence of irregular eosinophilic droplets of variably size in the lens with a gradual degeneration and vacuolization in the different cell layers of retina especially ganglion up to 8 h PM. Also, by increasing post mortem interval (PMI), retinal DNA damage in Cd and/or Pb intoxicated group significantly decreased. It is concluded that Cd and/or Pb intoxication induced ocular alterations which retain the same trend in correlation with PMI as natural deaths except for the retinal DNA damage. Also, the simultaneous exposure to Cd and Pb evoked an antagonistic outcome in the eye. The findings of the current study should be taken into consideration when estimating PMI in areas with high Cd and/or Pb contamination.
To better understand the complex transformation mechanisms of pollutants in different phases in sluice-controlled river reaches (SCRRs), a multi-phase transformation model of water quality is proposed. This model mainly describes the interactions of the water body, suspended matter, deposited sediments, and organisms. Mathematical expressions were first derived to describe the mass transportation processes in different phases of the river system. The multi-phase transformation model in SCRRs was then established with defined physical mechanisms. Monitored data from the operation of Huaidian sluice were used to identify and validate the parameters of the transformation model and to simulate the spatial and temporal changes of pollutants in different phases. Four findings were made from the results. Firstly, the concentration values of pollutants in each phase in the upper and lower river reaches of the sluice are affected by flow, mode of sluice operation, and algal growth and enrichment. Secondly, the reaction processes in the upper and lower river reaches of the sluice indicate different dominant mechanisms according to the change in sluice operation. Thirdly, sluice operation leads to stronger exchanges between the water body and external materials because of the increased water disturbance. Fourthly, in the early period of the experiment, changes in the alga concentrations were mainly affected by water movement. In the later period, changes in the alga concentrations were mainly affected by the obstruction of the sluice in the upstream section, while these were affected by flow velocity, flow volume, and changes in nutrient concentration in the downstream section.
