JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.
Παρασκευή 30 Μαρτίου 2018
The retroauricular subcutaneously pedicled island flap for reconstruction of auricular conchal defects
Occupational subacute cutaneous lupus erythematosus caused by outdoor work
JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.
Immune privilege disruption in folliculotropic mycosis fungoides: investigation of major histocompatibility complex antigen expression
International Journal of Dermatology, EarlyView.
Paederus dermatitis – touched by champion flies – three clinical manifestations of pederin toxin‐inflicted dermatitis
International Journal of Dermatology, EarlyView.
Can the epoxides of cinnamyl alcohol and cinnamal show new cases of contact allergy?
Contact Dermatitis, EarlyView.
Reactive glia promote development of CD103+CD69+ CD8+ T‐cells through programmed cell death‐ligand 1 (PD‐L1)
Immunity, Inflammation and Disease, EarlyView.
Biologics for pityriasis rubra pilaris treatment: a review of the literature
Pityriasis rubra pilaris (PRP) is a rare inflammatory papulosquamous skin disease, often refractory to conventional therapies. The off-label use of biologics, such as anti-TNF, -IL-12/IL-23, -IL-17 agents, has been proven successful, in the last two decades, in PRP treatment.Our aim was to analyse the literature for the use of biologics in PRP treatment. We conducted a review by "Pubmed" and "clinicaltrial.gov" searches. 68 articles met our selection criteria and were herein discussed. Out of 86 PRP patients, the vast majority of which treated with anti-TNF, -IL-12/IL-23, and -IL-17 biologics, either alone or in combination therapy, a marked-to-complete response (50-78%), a partial response (11-25%) or no/poor response (11-25%) was observed.
Dual neutralization of both IL-17A and IL-17F with bimekizumab in patients with psoriasis: results from BE ABLE 1, a 12-week randomized, double-blinded placebo-controlled phase 2b trial
Neutralizing interleukin (IL)-17F in addition to IL-17A may provide a more complete and specific approach to inhibiting inflammation.
Epinephrine in Severe Allergic Reactions: The European Anaphylaxis Register
Publication date: Available online 30 March 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Linus B. Grabenhenrich, Sabine Dölle, Franziska Ruëff, Jean-Marie Renaudin, Kathrin Scherer, Claudia Pföhler, Regina Treudler, Alice Koehli, Vera Mahler, Thomas Spindler, Lars Lange, Maria Beatrice Bilò, Nikolaos G. Papadopoulos, Jonathan O.B. Hourihane, Roland Lang, Montserrat Fernández-Rivas, George Christoff, Ewa Cichocka-Jarosz, Margitta Worm
BackgroundCurrent guidelines recommend intramuscular administration of epinephrine as the first-line drug for the emergency treatment of severe allergic reactions (anaphylaxis), but no randomized trial evidence supports this consensus.ObjectiveWe aimed to assess anaphylaxis treatment practices over 10 years, covering several European regions, all allergen sources, and all age groups.MethodsThe European Anaphylaxis Register tracks elicitors, symptoms, emergency treatment, diagnostic workups, and long-term counseling for anaphylaxis incidents through web-based data entry from tertiary allergy specialists, covering information from the emergency respondent, patient, tertiary referral, and laboratory/clinical test results.ResultsWe analyzed 10,184 anaphylaxis incidents. In total, 27.1% of patients treated by a health professional received epinephrine and, in total, 10.5% received a second dose. Successful administration was less frequent in German-speaking countries (minimum 19.6%) than in Greece, France, and Spain (maximum 66.7%). Over the last decade, epinephrine administration from a health professional almost doubled to reach 30.6% in 2015-2017, half of which was applied intramuscularly. A total of 14.7% of lay- or self-treated cases were treated with an autoinjector. Of those without treatment, 22.4% carried a device for administration. No change in successful administration by lay emergency respondents was found over the last 10 years. Of the reaction and patient characteristics analyzed, only clinical severity considerably influenced the likelihood of receiving epinephrine, with 66.9% of successful administrations in near-fatal (grade IV) reactions.ConclusionsDespite clear recommendations, only a small proportion of anaphylaxis incidents are treated with epinephrine. We demonstrated a slight increase in treated patients when handled by professionals, but stagnation in lay- or self-treated anaphylaxis. The reaction circumstances, the respondent's professional background, and patient characteristics did not explain which reactions were treated.
A threshold dose distribution approach for the study of PDT resistance development
Publication date: Available online 30 March 2018
Source:Journal of Photochemistry and Photobiology B: Biology
Author(s): Clara Maria Gonçalves de Faria, Natalia Mayumi Inada, José Dirceu Vollet-Filho, Vanderlei Salvador Bagnato
Cerebra: “All-Human”, “All-Too-Human”, “All-Too-Transhuman”
Abstract
In thinking the passage from the "all-human cerebrum" (H.G. Wells) to what one might call the contemporary "all-too-human" cerebrum in neo-liberal societies and beyond to the "all-too-transhuman" cerebrum in the cybernetic society, in contrasting Wells's idea of a new world order with the dystopia of the disordering un-world (Nancy in The creation of the world or globalization, State University of New York Press, Albany, 2002/2007), in considering the prospects of a "world brain" faced with the realities of the "global mnemotechnical system" (Bernard Stiegler), in highlighting the differences between the global and authoritarian instrument of "control" in Wells and the descriptions of the control society by Deleuze, and finally, in critiquing the "unifying of the general intelligence services of the world" in Wells (World brain, Methuen & Co., Ltd., London, 1938, pp. 3–4) and the capturing of the "general intellect" (Wark in General intellects: twenty-one thinkers for the twenty-first century. Verso Books, London, 2017), this paper maps the contemporary prospects of the "world brain" against the backdrop of the worldweariness of the present.
An electrical plasma dissection tool for surgical treatment of chronic ulcers: Results of a prospective randomised trial
International Wound Journal, EarlyView.
An unusual presentation of a common condition: Allergic contact dermatitis
International Wound Journal, EarlyView.
Fast 5DOF needle tracking in iOCT
Abstract
Purpose
Intraoperative optical coherence tomography (iOCT) is an increasingly available imaging technique for ophthalmic microsurgery that provides high-resolution cross-sectional information of the surgical scene. We propose to build on its desirable qualities and present a method for tracking the orientation and location of a surgical needle. Thereby, we enable the direct analysis of instrument–tissue interaction directly in OCT space without complex multimodal calibration that would be required with traditional instrument tracking methods.
Method
The intersection of the needle with the iOCT scan is detected by a peculiar multistep ellipse fitting that takes advantage of the directionality of the modality. The geometric modeling allows us to use the ellipse parameters and provide them into a latency-aware estimator to infer the 5DOF pose during needle movement.
Results
Experiments on phantom data and ex vivo porcine eyes indicate that the algorithm retains angular precision especially during lateral needle movement and provides a more robust and consistent estimation than baseline methods.
Conclusion
Using solely cross-sectional iOCT information, we are able to successfully and robustly estimate a 5DOF pose of the instrument in less than 5.4 ms on a CPU.
Viewing Others as Equals: the Non-cognitive Roots of Shared Intentionality
Abstract
We propose two adjustments to the classic view of shared intentionality (our capacity to share mental states of various sorts) as based on conceptual-level cognitive skills. The first one takes into account that infants and young children display this capacity, but lack conceptual-level cognitive skills. The second one seeks to integrate cognitive and non-cognitive skills into that capacity. This second adjustment is motivated by two facts. First, there is an enormous difference between human infants and our closest living primate relatives with respect to the range and scale of goal sharing and cooperation. Second, recent evidence suggests that there are hardly any differences in their mental-state attribution capacities. We argue therefore that our distinctively human capacity for shared intentionality is due to the effect on our cognitive skills of a (probably inborn) practical attitude. Accordingly, we propose that cognitive and practical skills, working together, produce our capacity for shared intentionality, and review evidence suggesting that the practical skill in question consists in the ability to adopt an attitude of equality.
In vivo evaluation of EGFRvIII mutation in primary glioblastoma patients via complex multiparametric MRI signature
Abstract
Background
Epidermal growth factor receptor variant III (EGFRvIII) is a driver mutation and potential therapeutic target in glioblastoma. Non-invasive in vivo EGFRvIII determination, using clinically acquired multiparametric MRI sequences, could assist in assessing spatial heterogeneity related to EGFRvIII, currently not captured via single-specimen analyses. We hypothesize that integration of subtle, yet distinctive, quantitative imaging/radiomic patterns using machine learning may lead to non-invasively determining molecular characteristics, and particularly the EGFRvIII mutation. Methods
We integrated diverse imaging features, including the tumor's spatial distribution pattern, via support vector machines, to construct an imaging signature of EGFRvIII. This signature was evaluated in independent discovery (n = 75) and replication (n = 54) cohorts of de novo glioblastoma, and compared with the EGFRvIII status obtained through an assay based on next-generation sequencing. Results
The cross-validated accuracy of the EGFRvIII signature in classifying the mutation status in individual patients of the independent discovery and replication cohorts was 85.3% (specificity = 86.3%, sensitivity = 83.3%, area under the curve [AUC] = 0.85) and 87% (specificity = 90%, sensitivity = 78.6%, AUC = 0.86), respectively. The signature was consistent with EGFRvIII+ tumors having increased neovascularization and cell density, as well as a distinctive spatial pattern involving relatively more frontal and parietal regions compared with EGFRvIII− tumors. Conclusions
An imaging signature of EGFRvIII was found, revealing a complex, yet distinct macroscopic glioblastoma phenotype. By non-invasively capturing the tumor in its entirety, the proposed methodology can assist in evaluating the tumor's spatial heterogeneity, hence overcoming common spatial sampling limitations of tissue-based analyses. This signature can preoperatively stratify patients for EGFRvIII-targeted therapies, and potentially monitor dynamic mutational changes during treatment.Insect community composition and functional roles along a tropical agricultural production gradient
Abstract
High intensity agricultural production systems are problematic not only for human health and the surrounding environment, but can threaten the provision of ecosystem services on which farm productivity depends. This research investigates the effects of management practices in Costa Rica on on-farm insect diversity, using three different types of banana farm management systems: high-input conventional system, low-input conventional system, and organic system. Insect sampling was done using pitfall and yellow bowl traps, left for a 24-h period at two locations inside the banana farm, at the edge of the farm, and in adjacent forest. All 39,091 individual insects were classified to family level and then morphospecies. Insect species community composition and diversity were compared using multivariate statistics with ordination analysis and Monte Carlo permutation testing, and revealed that each of the management systems were significantly different from each other for both trap types. Insect diversity decreased as management intensity increased. Reduced insect diversity resulted in fewer functional groups and fewer insect families assuming different functions essential to ecosystem health. Organic farms had similar species composition on the farm compared to adjacent forest sites, whereas species composition increasingly differed between farm and forest sites as management intensity increased. We conclude that while organic production has minimal impact on insect biodiversity, even small reductions in management intensity can have a significantly positive impact on on-farm insect biodiversity and functional roles supported.
Metal accumulation in Raphanus sativus and Brassica rapa : an assessment of potential health risk for inhabitants in Punjab, Pakistan
Abstract
Pakistan is an agricultural country and due to the shortage of clean water, most of the irrigated area (32,500 ha) of Pakistan was supplied with wastewater (0.876 × 109 m3/year). Concentrations of heavy metals in radish (Raphanus sativus) and turnip (Brassica rapa) taken from vegetable fields in Sargodha, Pakistan, were measured. Untreated wastewater was used persistently for a long time to irrigate these vegetable fields. A control site was selected that had a history of fresh groundwater irrigation. Mean metal concentrations were found for irrigation water, soil, and vegetables. In irrigation water, concentrations of Mo and Pb at three sites and Se at sites II and III were higher than the recommended limits. In vegetables, concentrations of Mo and Pb were above the maximum permissible limits. High bioconcentration factor was observed for Zn (12.61 in R. sativus and 11.72 in B. rapa) at site I and high pollution load index was found for Pb (3.89 in R. sativus and 3.87 in B. rapa) at site II. The differences in metal concentrations found in samples depended upon different soil nature and assimilation capacities of vegetables at different sites which in turn depended upon different environmental cues. The entrance of metal and metalloids to human body may happen through different pathways; however, the food chain is the chief route through which metals are transferred from vegetables to individuals. Health risk index observed for metals, (Mo, As, Ni, Cu, and Pb) higher than 1 indicated high risk through consumption of these vegetables at three sites.
Modelling equilibrium adsorption of single, binary, and ternary combinations of Cu, Pb, and Zn onto granular activated carbon
Abstract
Elevated concentrations of heavy metals in water can be toxic to humans, animals, and aquatic organisms. A study was conducted on the removal of Cu, Pb, and Zn by a commonly used water treatment adsorbent, granular activated carbon (GAC), from three single, three binary (Cu-Pb, Cu-Zn, Pb-Zn), and one ternary (Cu-Pb-Zn) combination of metals. It also investigated seven mathematical models on their suitability to predict the metals adsorption capacities. Adsorption of Cu, Pb, and Zn increased with pH with an abrupt increase in adsorption at around pH 5.5, 4.5, and 6.0, respectively. At all pHs tested (2.5–7.0), the adsorption capacity followed the order Pb > Cu > Zn. The Langmuir and Sips models fitted better than the Freundlich model to the data in the single-metal system at pH 5. The Langmuir maximum adsorption capacities of Pb, Cu, and Zn (mmol/g) obtained from the model's fits were 0.142, 0.094, and 0.058, respectively. The adsorption capacities (mmol/g) for these metals at 0.01 mmol/L equilibrium liquid concentration were 0.130, 0.085, and 0.040, respectively. Ideal Adsorbed Solution (IAS)-Langmuir and IAS-Sips models fitted well to the binary and ternary metals adsorption data, whereas the Extended Langmuir and Extended Sips models' fits to the data were poor. The selectivity of adsorption followed the same order as the metals' capacities and affinities of adsorption in the single-metal systems.
Cortical Bone Graft and GTR Membrane as “Ceiling Effect” in Alveolar Bone Grafting
Abstract
Background
In orofacial cleft deformity cases, bone grafting is a very essential step in reconstruction of the residual alveolar cleft defect.
Material and Methods
Though various authors have put forth different techniques and graft sources for alveolar bone grafting, at our center, we have used iliac crest as the graft source and cortical bone graft with GTR membrane as "ceiling effect".
Results
We have evaluated a series of cases of secondary alveolar bone grafting done with this technique by same surgeon at our center and have found great success.
Conclusion
In this clinical paper, we describe our surgical technique and also the key points from surgeons experience to ensure a better result.
Techniques to Improve Reliability and Predictability of the Dorsal Pedicled Tongue Flap in Closure of Palatal Defects and Oronasal Fistulae
Abstract
Introduction
Despite the improvement in surgical techniques in cleft palate surgery, oronasal fistulas continue to remain a challenge, usually the result of residual palatal and alveolar clefts and post-palatoplasty defects. The tongue flap is an extremely versatile, sturdy, reliable and efficient means of closure of anterior as well as posterior, unilateral and bilateral palatal defects, effectively functionally obliterating the oronasal communication, owing much of its success to its highly vascular structure, good mobility, texture match, central location and low donor site morbidity. However, it has a few drawbacks. Flap dehiscence and detachment during the early postoperative period is a troublesome complication owing to tongue movements during normal activities such as speaking, swallowing, yawning and coughing.
Aim
This article describes some of the methods which can be used to effectively alleviate these shortcomings.
Methods
A protocol of immobilizing the tongue by tethering it to the maxillary teeth for the 3-week postoperative period, and also maintaining the patient on nasogastric feeding, until the patient is taken up for surgical separation the pedicle, was employed in all patients in this case series.
Results
There was a successful and predictable take of the tongue flap at the donor site, namely the palatal/oronasal fistula with its successful closure, in all the patients.
Conclusion
Treatment of the oronasal fistula using a two-layer closure using the nasal mucoperiosteum together with an anteriorly based dorsal tongue flap is an easy and efficient method, whose reliability can be further increased by avoiding a common complication, namely tongue flap detachment in the postoperative period brought on by movements of the tongue, by immobilizing the tongue by tethering it to the maxillary teeth and also maintaining the patient on nasogastric feeding for the 3-week postoperative period.
Infection, Alveolar Osteitis, and Adverse Effects Using Metronidazole in Healthy Patients Undergoing Third Molar Surgery: A Meta-analysis
Abstract
Purpose
The aim of this systematic review and meta-analysis was to evaluate the risk of surgical infection, alveolar osteitis, and adverse effects using systemic metronidazole in comparison with placebo in healthy patients undergoing third molar surgery.
Materials and Methods
The eligible reports were identified from diverse science sources. Clinical trials meeting the inclusion and exclusion criteria and an acceptable Oxford Quality Score were included in this study. The evaluation of risk was done using the Risk Reduction Calculator and Review Manager 5.3., from the Cochrane Library. A significant risk reduction was assumed when the upper limit of the 95% confidence intervals was <1 and the lower limit did not cross zero (negative number) alongside a p value of <0.05 for the overall test. Data of 667 patients from five clinical trials were used for the assessment of risk.
Results
Our analysis showed no reduction of the risk of infection or dry socket in patients receiving metronidazole compared to whom took placebo. Meanwhile, the adverse effects did not exhibit a difference between the studied groups.
Conclusion
The routine use of systemic metronidazole to prevent surgical site infection and/or dry socket in healthy patients undergoing third molar surgery is not recommended.
Teaching is Oppositional: On the Importance of Supporting Experimental Teaching During Student Teaching
Abstract
This paper has two interrelated goals. The first is to introduce a framework: oppositional democracy. The second is to use this framework to address what I see as a central problem that occurs when learning to teach: the moment when someone with power tells an aspiring teacher that something she hopes to accomplish is unrealistic. The framework of oppositional democracy helps us understand this problem while also suggesting responses that free an aspiring teacher to experiment in responsible ways, thereby empowering her to work against practices she does not want to be complicit in perpetuating.
A comparative evaluation of spectrophotometric intracutaneous analysis and laser doppler imaging in the assessment of adult and paediatric burn injuries
Publication date: Available online 29 March 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): S. Charuvila, M. Singh, D. Collins, I. Jones
IntroductionClinical assessment of mid dermal burns can be challenging. Currently, Laser Doppler Imaging is the gold standard adjunct in the assessment of burn injuries. Whilst Laser Doppler Imaging has demonstrated reliable accuracy, it poses various limitations in everyday use including cost and ease of use. In comparison, Spectrophotometric Intracutaneous Analysis is a relatively cheaper technique which can be carried out using a modified digital camera which enables easy image acquisition. We aim to compare the accuracy of the two modalities in the assessment of mid-dermal burn injuries.MethodsWe recruited 29 patients with mid-dermal burns presenting within two to five days post burn. 45 burn regions of interest were identified and underwent imaging using both the modalities. Subsequent clinical outcome was followed and treatment remained unaffected by participation. Two clinicians then independently predicted the healing potential of each burn region retrospectively as per images from either modality.ResultsMcNemar's test indicated that there is no significant difference between the accuracy of the two modalities (p=0.61).ConclusionThe results suggest that the accuracy of Spectrophotometric Intracutaneous Analysis is comparable to that of Laser Doppler Imaging. Our experience with Spectrophotometric Intracutaneous Analysis indicates its potential as a cost effective and user friendly adjunct in decision making.
Tissue expansion in cranioplasty - a collaborative approach for all involved for improved outcomes?
Publication date: Available online 29 March 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Sarah Williams, Norbert Kang
The use of tissue expanders is well established in plastic surgery. However, there are currently no clear indications for tissue expansion as an adjunct to cranioplasty. We present a series of nine patients who underwent tissue expansion prior to cranioplasty after removal of an infected bone flap and/or radiotherapy. Family members of 8 patients were taught how to undertake expansion at home. Two patients experienced exposure and infection of the expander. Post-operatively two patients developed an infection of their cranioplasty implant which was removed. We recommend using tissue expansion for patients who have experienced a long interval (>6 months) after removal of their bone flap to reconstruction. Early involvement of plastic surgeons may be helpful in reducing the risk of re-operation in these complex cases. Tissue expansion done at home appears to be safe.
Screening of seaweeds in the East China Sea as potential bio-monitors of heavy metals
Abstract
Seaweeds are good bio-monitors of heavy metal pollution and have been included in European coastal monitoring programs. However, data for seaweed species in China are scarce or missing. In this study, we explored the potential of seaweeds as bio-monitor by screening the natural occurring seaweeds in the "Kingdom of seaweed and shellfish" at Dongtou Islands, the East China Sea. Totally, 12 seaweed species were collected from six sites, with richness following the sequence of Rhodophyta > Phaeophyta > Chlorophyta. The concentration of heavy metals (Cu, Cr, Ni, Zn, Pb, Cd, As) in the seaweeds was determined, and the bioaccumulation coefficient was calculated. A combination of four seaweeds, Pachydictyon coriaceum, Gelidium divaricatum, Sargassum thunbergii, and Pterocladiella capillacea, were proposed as bio-monitors due to their high bioaccumulation capabilities of specific heavy metals in the East China Sea and hence hinted the importance of using seaweed community for monitoring of pollution rather than single species. Our results provide first-hand data for the selection of bio-monitor species for heavy metals in the East China Sea and contribute to selection of cosmopolitan bio-monitor communities over geographical large area, which will benefit the establishment of monitoring programs for coastal heavy metal contamination.
Soil surface Hg emission flux in coalfield in Wuda, Inner Mongolia, China
Abstract
Hg emission flux from various land covers, such as forests, wetlands, and urban areas, have been investigated. China has the largest area of coalfield in the world, but data of Hg flux of coalfields, especially, those with coal fires, are seriously limited. In this study, Hg fluxes of a coalfield were measured using the dynamic flux chamber (DFC) method, coupled with a Lumex multifunctional Hg analyzer RA-915+ (Lumex Ltd., Russia). The results show that the Hg flux in Wuda coalfield ranged from 4 to 318 ng m−2 h−1, and the average value for different areas varied, e.g., coal-fire area 99 and 177 ng m−2 h−1; no coal-fire area 19 and 32 ng m−2 h−1; and backfilling area 53 ng m−2 h−1. Hg continued to be emitted from an underground coal seam, even if there were no phenomena, such as vents, cracks, and smog, of coal fire on the soil surface. This phenomenon occurred in all area types, i.e., coal-fire area, no coal-fire area, and backfilling area, which is universal in Wuda coalfield. Considering that many coalfields in northern China are similar to Wuda coalfield, they may be large sources of atmospheric Hg. The correlations of Hg emission flux with influence factors, such as sunlight intensity, soil surface temperature, and atmospheric Hg content, were also investigated for Wuda coalfield.
Graphical abstract
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Hyper‐immunoglobulin D syndrome with novel mutations in an afebrile infant
Pediatric Dermatology, EarlyView.
Cloning and characterization of UePrf1 gene in Ustilago esculenta
Abstract
Ustilago esculenta, an obligate parasite of Zizania latifolia, is a typical dimorphic fungus, which induces host stem swelling and inhibits host inflorescence development, but is not found in host leaves. Previous studies have shown that dimorphic switching is essential for fungal pathogenicity and is regulated by PKA and mitogen-activated protein kinase (MAPK) signaling pathways that are integrated by Prf1 in Ustilago maydis. In this study, we identified a Prf1 homolog in U. esculenta, designated UePrf1, encoding 830 amino acids, with a conserved high mobility group (HMG) domain located between amino acids 124 and 195. UePrf1 was upregulated during the mating process, which induces dimorphism in U. esculenta. In vitro, UePrf1 mutants showed defects in the mating process, including cell fusion and hyphal growth. UePrf1 mutants also show reduced expression of a genes, even during the cell fusion process. Additionally, the defect in hyphal growth of the UeKpp2 and UeKpp6 mutants (MAPK signaling pathway mutant) was partially counteracted by UePrf1 overexpression, along with induced b gene expression. These results provide evidence that UePrf1 is a key factor coordinating dimorphism in U. esculenta and suggest a conserved role for UePrf1 in the regulation of the a and b genes.Negative association of antibiotics on clinical activity of immune checkpoint inhibitors in patients with advanced renal cell and non-small cell lung cancer
Abstract
Background
The composition of gut microbiota affects anti-tumor immune responses, preclinical and clinical outcome following immune checkpoint inhibitors (ICI) in cancer. Antibiotics (ATB) alter gut microbiota diversity and composition leading to dysbiosis, which may affect effectiveness of ICI. Patients and Methods
We examined patients with advanced renal cell carcinoma (RCC) and non-small cell lung cancer (NSCLC) treated with anti-PD-(L)1 mAb monotherapy or combination at two academic institutions. Those receiving ATB within 30 days of beginning ICI were compared to those who did not. Objective response, progression-free survival (PFS) determined by RECIST1.1 and overall survival (OS) were assessed. Results
Sixteen of 121 (13%) RCC patients and 48 of 239 (20%) NSCLC patients received ATB. The most common ATB were β-lactam or quinolones for pneumonia or urinary tract infections. In RCC patients, ATB compared to no ATB was associated with increased risk of primary progressive disease (PD) (75% vs 22%, p < 0.01), shorter PFS (median 1.9 vs 7.4 months, hazard ratio (HR) 3.1, 95% confidence interval (CI) 1.4-6.9, p < 0.01), and shorter OS (median 17.3 vs 30.6 months, HR 3.5, 95% CI 1.1-10.8, p = 0.03). In NSCLC patients, ATB was associated with similar rates of primary PD (52% vs 43%, p = 0.26) but decreased PFS (median 1.9 vs 3.8 months, HR 1.5, 95% CI 1.0-2.2, p = 0.03) and OS (median 7.9 vs 24.6 months, HR 4.4, 95% CI 2.6-7.7, p < 0.01). In multivariate analyses, the impact of ATB remained significant for PFS in RCC and for OS in NSCLC. Conclusion
ATB were associated with reduced clinical benefit from ICI in RCC and NSCLC. Modulatation of ATB-related dysbiosis and gut microbiota composition may be a strategy to improve clinical outcomes with ICI.Bevacizumab may improve quality of life, but not overall survival in glioblastoma: an epidemiological study
Abstract
Background
The vascular endothelial growth factor antibody bevacizumab (Avastin®), received approval for the treatment of recurrent glioblastoma in many countries including the US and Switzerland, but not the European Union, in 2009. Here we explored the hypothesis that the approval of bevacizumab improved outcome with glioblastoma on a population level. Patients and methods
The prognostic significance of epidemiological, molecular genetic, and clinical data including treatment for glioblastoma patients diagnosed from 2010-2014 in the Canton of Zurich, Switzerland, was retrospectively analyzed using log rank test and Cox proportional hazards models. Data were compared to data for the years 2005-2009. Results
310 glioblastoma patients were identified in the years 2010-2014. Median overall survival (OS) was 13.5 months for patients with known isocitrate dehydrogenase (IDH) wildtype (wt) (IDH1R132H-non-mutant) tumors (N=248), compared with 11.3 months for IDH wt patients (P=0.761) before (2005-2009). In the IDH wt cohort bevacizumab use at any time increased from 19% in 2005-2009 to 49% in 2010-2014. Multivariate analysis did not identify bevacizumab exposure at any time to be associated with survival. Yet, upon second-line treatment, baseline doses of corticosteroids were reduced by more than half in 83% of patients on bevacizumab compared with 48% of the patients treated with bevacizumab-free regimens (P=0.007). Conclusion
This epidemiological study of a small, but clinically well annotated patient cohort fails to support the assumption that the strong increase of bevacizumab use since 2010 improved survival in glioblastoma, although clinical benefit associated with decreased steroid use may have been achieved.Strategies to support pressure injury best practices by the inter‐professional team: A systematic review
International Wound Journal, EarlyView.
Contact sensitivity in patients with venous leg ulcer: A multi‐centric Indian study
International Wound Journal, EarlyView.
Serum level of endostatin and digital ulcers in systemic sclerosis patients
International Wound Journal, EarlyView.
Statistical analysis of factors affecting re‐operative times in paediatric patients with scar deformity after deep second‐degree burn injury
International Wound Journal, EarlyView.
LV function validation of computer-assisted interventional system for cardiac resyncronisation therapy
Abstract
Purpose
Cardiac resynchronisation therapy (CRT) is an established treatment for symptomatic patients with heart failure, a prolonged QRS duration, and impaired left ventricular (LV) function; however, non-response rates remain high. Recently proposed computer-assisted interventional platforms for CRT provide new routes to improving outcomes. Interventional systems must process information in an accurate, fast and highly automated way that is easy for the interventional cardiologists to use. In this paper, an interventional CRT platform is validated against two offline diagnostic tools to demonstrate that accurate information processing is possible in the time critical interventional setting.
Methods
The study consisted of 3 healthy volunteers and 16 patients with heart failure and conventional criteria for CRT. Data analysis included the calculation of end-diastolic volume, end-systolic volume, stroke volume and ejection fraction; computation of global volume over the cardiac cycle as well as time to maximal contraction expressed as a percentage of the total cardiac cycle.
Results
The results showed excellent correlation ( \(R^{2}\) values of \(>\,0.99\) and Pearson correlation coefficient of \(>\,0.98\) ) with comparable offline diagnostic tools.
Conclusion
Results confirm that our interventional system has good accuracy in everyday clinical practice and can be of clinical utility in identification of CRT responders and LV function assessment.
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Publication date: Available online 25 July 2018 Source: Journal of Photochemistry and Photobiology B: Biology Author(s): Marco Ballestr...
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Editorial AJR Reviewers: Heartfelt Thanks From the Editors and Staff Thomas H. Berquist 1 Share + Affiliation: Citation: American Journal...
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Publication date: Available online 28 September 2017 Source: Actas Dermo-Sifiliográficas Author(s): F.J. Navarro-Triviño
