Hyponatremia in patients with esophageal cancer treated with chemotherapy including cisplatin

Abstract

Background

Little is known about hyponatremia in patients with esophageal cancer treated with cisplatin-based chemotherapy. The aim of this study was to analyze the risk factors for hyponatremia and its effect on outcomes in patients with esophageal cancer treated with chemotherapy including cisplatin.

Methods

We retrospectively analyzed the records of 137 patients with esophageal cancer who received chemotherapy including cisplatin for the first time between January 2011 and December 2014.

Results

Hyponatremia (Na < 135 mEq/L) was seen in 77 patients (59%), of whom 29 had Grade 3 (120 ≤ Na < 130 mEq/L) or Grade 4 (Na < 120 mEq/L) hyponatremia. We divided patients into the hyponatremia group (patients with Na < 130 mEq/L) and the control group (patients with Na ≥ 130 mEq/L), and compared the results between the two groups. Three patients (2%) were diagnosed with the syndrome of inappropriate secretion of antidiuretic hormone. The serum sodium level before starting chemotherapy was significantly lower and white blood cell count was significantly higher in the hyponatremia group. Appetite loss was seen significantly more often in the hyponatremia group as the chemotherapy-related adverse effect. There was no significant difference in overall survival between the two groups.

Conclusions

Hyponatremia is a common adverse effect induced by cisplatin. Caution should be exercised with patients with a low sodium level before starting chemotherapy. Hyponatremia can be associated with other chemotherapy-related adverse effects, and it should therefore be treated correctly.

Editorial: Synthesizing the Evidence on Prisoner Health—Taking Stock and Moving Forward

Biochemical responses of the Protaetia brevitarsis Lewis larvae to subchronic copper exposure

Abstract

Copper (Cu) is one of the most commonly detected heavy metals in livestock manure pollution. Protaetia brevitarsis Lewis larvae are widely used in the decomposition of livestock manure. During decomposition, heavy metals in livestock manure can accumulate in P. brevitarsis larvae and affect normal growth and reproduction. Therefore, this research focused on characterizing the toxic effects of Cu to P. brevitarsis Lewis larvae. Larvae were exposed to Cu concentrations of 0, 100, 200, 400, and 800 mg kg⁻¹ in edible fungi residue for 7, 14, 21, and 28 days. Results showed that the soluble protein content was markedly increased in 200 and 400 mg kg⁻¹ treatment groups on day 28. Compared to the control group, superoxide dismutase (SOD) and glutathione S-transferase (GST) activities were significantly stimulated on day 7 and then decreased as exposure length was increased (e.g., after 14, 21, and 28 days). Catalase (CAT) activity was also significantly increased after 7 days of exposure. Malondialdehyde (MDA) levels were markedly increased in the 100, 200, and 400 mg kg⁻¹ treatment groups on day 7. However, as time and Cu concentration were increased, MDA levels gradually decreased. These results indicate that Cu has biochemical effects on P. brevitarsis Lewis larvae, and both time and dose affect this biochemical response.

Quantification of Carbon Nanotubes by Raman Analysis

Abstract

The increasing prevalence of carbon nanotubes (CNTs) in manufacturing and research environments, together with the potential exposure risks, necessitates development of reliable and accurate monitoring methods for these materials. We examined quantification of CNTs by two distinct methods based on Raman spectroscopy. First, as measured by the Raman peak intensity of aqueous CNT suspensions, and second, by Raman mapping of air filter surfaces onto which CNTs were collected as aerosols or applied as small-area (0.05 cm²) deposits. Correlation (R² = 0.97) between CNT concentration and Raman scattering intensity for suspensions in cuvettes was found over a concentration range from about 2 to 10 µg/ml, but measurement variance precludes practical determination of a calibration curve. Raman mapping of aerosol sample filter surfaces shows correlation with CNT mass when the surface density is relatively high (R² = 0.83 and 0.95 above about 5 µg total mass on filter), while heterogeneity of CNT deposition makes obtaining representative maps of lower density samples difficult. This difficulty can be mitigated by increasing the area mapped relative to the total sample area, improving both precision and the limit of detection (LOD). For small-area deposits, detection of low masses relevant to occupational monitoring can be achieved, with an estimated LOD of about 50 ng.

Development of Fe/Nb-based solar photocatalysts for water treatment: impact of different synthesis routes on materials properties

Abstract

Semiconductors based on Fe/Nb oxides can present both solar sensitivity and high catalytic activity. However, there is still a lack regarding the comparison between different routes to produce Fe/Nb-based solar photocatalysts and the evaluation of the impact of the synthesis operating conditions on the material properties. In this work, Fe/Nb₂O₅ ratio, type of precipitating agent, presence/absence of washing stage, and temperature of calcination were verified to be the most relevant parameters in the synthesis by the co-precipitation method. These factors led to remarkable differences in the properties and performance of the photocatalysts produced by each distinct synthesis route. Composition, iron species present in the materials, crystallinity characteristics, and pH of the catalysts were affected, leading to different photocatalytic activities under UV-Vis light. Due to their characteristics, the synthesized materials are potential photocatalysts for application in solar processes.

Graphical abstract

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A case series: Association of anaphylaxis with a significant decrease in platelet levels and possible secondary risk of thrombosis

Immunity, Inflammation and Disease, EarlyView.

Cluster analysis of microclimate data to optimize the number of sensors for the assessment of indoor environment within museums

Abstract

For the first time, the cluster analysis (k-means) has been applied on long time series of temperature and relative humidity measurements to identify the thermo-hygrometric features in a museum. Based on ASHRAE (2011) classification, 84% of time all rooms in the Napoleonic Museum in Rome (case study) were found in the class of control B. This result was obtained by analyzing all recorded data in 10 rooms of the museum as well as using the cluster aggregation. The use of objective-oriented methodology allows to achieve an acceptable knowledge of the microclimate in case of multi-room buildings, reducing computations with large amounts of collected data and time-consuming in redundant elaborations. The cluster analysis enables to reduce the number of the sensors in microclimate monitoring programs within museums, provided that the representativeness of the instrument location is known, and professional conservators have assessed that the artifacts are well preserved.

Is Gd-DTPA Necessary in Clinical Practice for Peripheral Nerve Injury? [LETTERS]

REPLY: [LETTERS]

Common Origin of Brachiocephalic and Left Common Carotid Arteries: Proposal of New Terminology [LETTERS]

Multicentric Experience in Distal-to-Proximal Revascularization of Tandem Occlusion Stroke Related to Internal Carotid Artery Dissection [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

Internal carotid dissection is a frequent cause of ischemic stroke in young adults. It may cause tandem occlusions in which cervical carotid obstruction is associated with intracranial proximal vessel occlusion. To date, no consensus has emerged concerning endovascular treatment strategy. Our aim was to evaluate our endovascular "distal-to-proximal" strategy in the treatment of this stroke subtype in the first large multicentric cohort.

MATERIALS AND METHODS:

Prospectively managed stroke data bases from 2 separate centers were retrospectively studied between 2009 and 2014 for records of tandem occlusions related to internal carotid dissection. Atheromatous tandem occlusions were excluded. The first step in the revascularization procedure was intracranial thrombectomy. Then, cervical carotid stent placement was performed depending on the functionality of the circle of Willis and the persistence of residual cervical ICA occlusion, severe stenosis, or thrombus apposition. Efficiency, complications, and radiologic and clinical outcomes were recorded.

RESULTS:

Thirty-four patients presenting with tandem occlusion stroke secondary to internal carotid dissection were treated during the study period. The mean age was 52.5 years, the mean initial NIHSS score was 17.29 ± 6.23, and the mean delay between onset and groin puncture was 3.58 ± 1.1 hours. Recanalization TICI 2b/3 was obtained in 21 cases (62%). Fifteen patients underwent cervical carotid stent placement. There was no recurrence of ipsilateral stroke in the nonstented subgroup. Twenty-one patients (67.65%) had a favorable clinical outcome after 3 months.

CONCLUSIONS:

Endovascular treatment of internal carotid dissection–related tandem occlusion stroke using the distal-to-proximal recanalization strategy appears to be feasible, with low complication rates and considerable rates of successful recanalization.

Diffusion-Weighted Zonal Oblique Multislice-EPI Enhances the Detection of Small Lesions with Diffusion Restriction in the Brain Stem and Hippocampus: A Clinical Report of Selected Cases [ADULT BRAIN]

SUMMARY:

Diffusion restriction is the morphologic hallmark of acute ischemic infarcts and excitotoxic brain injury in various cerebral pathologies. Diffusion restriction is visible as hyperintensity on DWI and as hypointensity on ADC maps. Due to the vicinity of multiple anatomic structures in the brain stem and hippocampus, very small lesions with diffusion restriction may result in severe clinical symptomatology, but these small lesions easily go undetected on standard cerebral DWI due to insufficient spatial resolution, T2* blurring, and image artifacts caused by susceptibility-related image distortions. Diffusion-weighted zonal oblique multislice–EPI with reduced FOV acquisition permits a considerable increase in spatial resolution and enhances the visualization of very small pathologic lesions in the brain stem and hippocampus. Improved performance in the depiction of different pathologic lesions with diffusion restriction in the brain stem and hippocampus using this sequence compared with standard DWI in selected cases is presented.

Segmentation of the Globus Pallidus Internus Using Probabilistic Diffusion Tractography for Deep Brain Stimulation Targeting in Parkinson Disease [FUNCTIONAL]

BACKGROUND AND PURPOSE:

Although globus pallidus internus deep brain stimulation is a widely accepted treatment for Parkinson disease, there is persistent variability in outcomes that is not yet fully understood. In this pilot study, we aimed to investigate the potential role of globus pallidus internus segmentation using probabilistic tractography as a supplement to traditional targeting methods.

MATERIALS AND METHODS:

Eleven patients undergoing globus pallidus internus deep brain stimulation were included in this retrospective analysis. Using multidirection diffusion-weighted MR imaging, we performed probabilistic tractography at all individual globus pallidus internus voxels. Each globus pallidus internus voxel was then assigned to the 1 ROI with the greatest number of propagated paths. On the basis of deep brain stimulation programming settings, the volume of tissue activated was generated for each patient using a finite element method solution. For each patient, the volume of tissue activated within each of the 10 segmented globus pallidus internus regions was calculated and examined for association with a change in the Unified Parkinson Disease Rating Scale, Part III score before and after treatment.

RESULTS:

Increasing volume of tissue activated was most strongly correlated with a change in the Unified Parkinson Disease Rating Scale, Part III score for the primary motor region (Spearman r = 0.74, P = .010), followed by the supplementary motor area/premotor cortex (Spearman r = 0.47, P = .15).

CONCLUSIONS:

In this pilot study, we assessed a novel method of segmentation of the globus pallidus internus based on probabilistic tractography as a supplement to traditional targeting methods. Our results suggest that our method may be an independent predictor of deep brain stimulation outcome, and evaluation of a larger cohort or prospective study is warranted to validate these findings.

Consensus Needed for Noncontrast CT Markers in Intracerebral Hemorrhage [LETTERS]

Dark Rims: Novel Sequence Enhances Diagnostic Specificity in Multiple Sclerosis [ADULT BRAIN]

BACKGROUND AND PURPOSE:

The 2010 McDonald criteria are designed to sensitively detect MS; however, the low specificity of these criteria can occasionally lead to the misdiagnosis of MS. The purpose of this study was to determine whether a novel double inversion recovery MR imaging technique has the potential to increase the specificity of diagnostic criteria distinguishing MS from non-MS white matter lesions.

MATERIALS AND METHODS:

This was a cross-sectional observational study. MR imaging data were acquired between 2011 and 2016. A novel double inversion recovery sequence that suppresses CSF and GM signal was used (GM-double inversion recovery). We compared WM lesions in a group of patients with multiple sclerosis and in a second group of positive controls with white matter lesions who did not have a diagnosis of MS. The presence of a rim on the GM-double inversion recovery MR imaging sequence was combined with the 2001 and 2010 McDonald disseminated-in-space criteria. Multiple MR imaging markers, including lesion location, size, and the presence of a rim, were compared between groups as well as a quantitative measure of lesion T1 hypointensity.

RESULTS:

MR images from 107 patients with relapsing-remitting MS (median age, 32 years) and 36 positive control (median age, 39 years) subjects were analyzed. No significant differences were found in age and sex. In patients with MS, 1120/3211 lesions (35%) had a rim on GM-double inversion recovery; the positive control group had only 9/893 rim lesions (1%). Rims were associated with a decrease in the lesion T1 ratio. Using the 2010 MR imaging criteria plus the presence of rims on GM-double inversion recovery, we achieved 78% and 97% specificity in subjects with ≥1 and ≥2 rim lesions, respectively.

CONCLUSIONS:

The addition of a novel GM-double inversion recovery technique enhanced specificity for diagnosing MS compared with established MR imaging criteria.

Antituberculosis drug isoniazid degraded by electro-Fenton and photoelectro-Fenton processes using a boron-doped diamond anode and a carbon-PTFE air-diffusion cathode

Abstract

Solutions with 0.65 mM of the antituberculosis drug isoniazid (INH) in 0.050 M Na₂SO₄ at pH 3.0 were treated by electro-Fenton (EF) and UVA photoelectro-Fenton (PEF) processes using a cell with a BDD anode and a carbon-PTFE air-diffusion cathode. The influence of current density on degradation, mineralization rate, and current efficiency has been thoroughly evaluated in EF. The effect of the metallic catalyst (Fe²⁺ or Fe³⁺) and the formation of products like short-chain linear aliphatic carboxylic acids were assessed in PEF. Two consecutive pseudo-first-order kinetic regions were found using Fe²⁺ as catalyst. In the first region, at short time, the drug was rapidly oxidized by ^●OH, whereas in the second region, at longer time, a resulting Fe(III)-INH complex was much more slowly removed by oxidants. INH disappeared completely at 300 min by EF, attaining 88 and 94% mineralization at 66.6 and 100 mA cm⁻², respectively. Isonicotinamide and its hydroxylated derivative were identified as aromatic products of INH by GC-MS and oxalic, oxamic, and formic acids were quantified by ion-exclusion HPLC. The PEF treatment of a real wastewater polluted with the drug led to slower INH and TOC abatements because of the parallel destruction of its natural organic matter content.

Modeling the oxygen transport process under preferential flow effect in landfill

Abstract

Evaluation of oxygen distribution during aeration in landfill is significantly important to determine the design parameters of an injection well. A coupling model describing gas preferential transport in a landfill was developed, which linked the effect of advection–diffusion and oxidation reaction and mass exchange between the fracture and the matrix system. The quantitative simulation of the variation in gas distribution during vertical well aeration in short term was presented, combined with the typical cases in field site. The parameter sensitivity in the coupling model to gas transport was addressed. Simulation result of the oxygen and methane concentrations by using the dual advective–diffusive (DAD) model, which considered the immobile zone effect, was closer to the monitoring data than that by using single advective–diffusive model. The variation of the AR under aeration was presented with the key parameters to provide the theory evidence for gas well design in landfill. This study provided reference for the design of the gas injection well distribution in aerobic landfill.

Glycyrrhiza flavonoids and its major component, licochalcone A, inhibit melanogenesis through MAPK/ERK pathway by activating ERK phosphorylation

Melanin is synthesized mainly by melanocytes that are located in the basal layer of the epidermis and its formation is associated with tyrosinase and dopachrome tautomerase activities [1]. And tyrosinase plays an important role in melanogenesis which can catalyze the hydroxylation of tyrosine to 3, 4-L-dihydroxyphenylalanine (DOPA) and further oxidation of DOPA to dopaquinone [2]. Microphthalmia-associated transcription factor (MITF) is a basic helix-loop-helix leucine zipper transcription factor, which can control the expression of various genes for normal melanin synthesis in melanocytes [3].

Leveraging organismal biology to forecast the effects of climate change

Abstract

Despite the pressing need for accurate forecasts of ecological and evolutionary responses to environmental change, commonly used modelling approaches exhibit mixed performance because they omit many important aspects of how organisms respond to spatially and temporally variable environments. Integrating models based on organismal phenotypes at the physiological, performance and fitness levels can improve model performance. We summarize current limitations of environmental data and models and discuss potential remedies. The paper reviews emerging techniques for sensing environments at fine spatial and temporal scales, accounting for environmental extremes, and capturing how organisms experience the environment. Intertidal mussel data illustrate biologically important aspects of environmental variability. We then discuss key challenges in translating environmental conditions into organismal performance including accounting for the varied timescales of physiological processes, for responses to environmental fluctuations including the onset of stress and other thresholds, and for how environmental sensitivities vary across lifecycles. We call for the creation of phenotypic databases to parameterize forecasting models and advocate for improved sharing of model code and data for model testing. We conclude with challenges in organismal biology that must be solved to improve forecasts over the next decade.acclimation, biophysical models, ecological forecasting, extremes, microclimate, spatial and temporal variability

Mitochondrial adaptations to variable environments and their role in animals’ stress tolerance

Abstract

Mitochondria are the key organelles involved in energy and redox homeostasis, cellular signaling and survival. Animal mitochondria are exquisitely sensitive to environmental stress, and stress-induced changes in the mitochondrial integrity and function have major consequences for the organismal performance and fitness. Studies in the model organisms such as terrestrial mammals and insects showed that mitochondrial dysfunction is a major cause of injury during pathological conditions and environmental insults such as hypoxia, ischemia-reperfusion and exposure to toxins. However, animals from highly stressful environments (such as the intertidal zone of the ocean) can maintain mitochondrial integrity and function despite intense and rapid fluctuations in abiotic conditions of their habitats and associated changes in the intracellular milieu. Recent studies demonstrate that mitochondria of intertidal organisms (including mollusks, crustaceans and fish) are capable of maintaining activity of mitochondrial electron transport system (ETS), ATP synthesis and mitochondrial coupling in a broad range of temperature, osmolarity and ion content. Mitochondria of intertidal organisms such as mollusks are also resistant to hypoxia-reoxygenation injury and show stability or even upregulation of the mitochondrial ETS activity and ATP synthesis capacity during intermittent hypoxia. In contrast, pH optima for mitochondrial ATP synthesis and respiration are relatively narrow in intertidal mollusks and may reflect adaptation to suppress metabolic rate during pH shifts caused by extreme stress. Sensitivity to anthropogenic pollutants (such as trace metals) in intertidal mollusks appears similar to that of other organisms (including mammals) and may reflect the lack of adaptation to these evolutionarily novel stressors. The mechanisms of the exceptional mitochondrial resilience to temperature, salinity and hypoxic stress are not yet fully understood in intertidal organisms, yet recent studies demonstrate that they may involve rapid modulation of the ETS capacity (possibly due to post-translation modification of mitochondrial proteins), upregulation of antioxidant defenses in anticipation of oxidative stress and high activity of mitochondrial proteases involved in degradation of damaged mitochondrial proteins. With rapidly developing molecular tools for non-model organisms, future studies of mitochondrial adaptations should pinpoint the molecular sites associated with the passive tolerance and/or active regulation of mitochondrial activity during stress exposures in intertidal organisms, investigate the roles of mitochondria in transduction of stress signals and explore the interplay between bioenergetics and mitochondrial signaling in facilitating survival in these highly stressful environments.

Selenium and silicon reduce cadmium uptake and mitigate cadmium toxicity in Pfaffia glomerata (Spreng.) Pedersen plants by activation antioxidant enzyme system

Abstract

Cadmium (Cd) is toxic to plants and animals, making it necessary to develop strategies that seek to reduce its introduction into food chains. Thus, the aim of this study was to investigate whether silicon (Si) and selenium (Se) reduce Cd concentrations in Pfaffia glomerata medicinal plant and attenuate the oxidative stress promoted by this metal. These plants were cultivated in hydroponics under the following treatments: control (nutrient solution), 2.5 μM Se, 2.5 mM Si, 50 μM Cd, 50 μM Cd + 2.5 μM Se, 50 μM Cd + 2.5 mM Si. After 14 days of exposure to treatments, leaves and roots were collected for the determination of dry weight of shoot and roots, Cd concentrations, chlorophyll and carotenoids content, and biochemical parameters (lipid peroxidation and guaiacol peroxidase and superoxide dismutase activities). The data were submitted to analysis of variance and means were compared with Scott-Knott test at 5% error probability. Roots of P. glomerata plants showed a significant reduction on dry weight accumulation when exposed to Cd. However, both Se and Si promoted a significant reduction of deleterious effects of Cd. The Cd concentrations in the tissues were reduced in the presence of Se or Si. Plants treated with Cd together with Se or Si presented higher pigment content than those with only Cd, thus showing a reduction in the negative effects caused by this element. In the treatments in which Se and Si were added in the growth medium together with Cd, an activation of superoxide dismutase and guaiacol peroxidase enzymes was observed in the roots and shoot, which may have contributed to lower lipid peroxidation. Thus, Se and Si reduce Cd concentrations and have potential to ameliorate Cd toxicity in P. glomerata plants, which can be used to increase productivity and quality of medicinal plants.

Changes in the nutritional composition of maize flour due to Tribolium castaneum infestation and application of carbon dioxide to manage this pest

Abstract

Maize flour was infested with fresh emerged Tribolium castaneum adults, and its nutritional composition was evaluated after 0, 45, and 90 days of the infestation. Furthermore, 99% carbon dioxide was applied to different developmental stages of T. castaneum for its management. There were six treatments and five replicates; for each replicate, maize flour (150 g) was taken in a 250-ml plastic jar container, insects were released in the flour, and jars were placed into the incubator at a temperature of 28 ± 1 °C, 60 ± 5% RH. Similarly, the application of 99% CO₂ was done with four exposure times of 12, 24, 48, and 72 h, at 35 °C 65 ± 5% RH. Present results showed major fluctuations in the nutritive composition of maize flour. Increase in the moisture, fat, fiber, protein, and ash contents was directly proportional to the increase in infestation level and time, contrary to the depletion of carbohydrates and total weight loss. The results of CO₂ treatment indicated that pupa was the most resilient stage as compared with larvae and adult stage. The observed susceptibility order was as follows: adult > larvae > pupae. The maximum mortality of adult, larval, and pupal stages was recorded after 24, 48, and 72 h of CO₂ application, respectively. These findings might be helpful to develop an ecofriendly technique to manage this crucial pest.

Effective sorption of atrazine by biochar colloids and residues derived from different pyrolysis temperatures

Abstract

Biochar has attracted much attention, which owns many environmental and agronomic benefits, including carbon sequestration, improvement of soil quality, and immobilization of environmental contaminants. Biochar has been also investigated as an effective sorbent in recent publications. Generally, biochar particles can be divided into colloids and residues according to particle sizes, while understanding of adsorption capacities towards organic pollutants in each section is largely unknown, representing a critical knowledge gap in evaluations on the effectiveness of biochar for water treatment application. Scanning electron microscopy (SEM) images, X-ray diffraction (XRD), Raman spectra, Fourier-transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), and Brunauer-Emmett-Teller (BET) method are used to examine the structures and surface properties of biochar colloids and residues derived from corn straws prepared at different pyrolysis temperatures. Also, their roles in atrazine (a typical organic pollutant) removal are investigated by batch adsorption experiments and fitted by different kinetic and thermodynamic models, respectively. The adsorption capacities of biochar colloids are much more than those of residues, resulting from the colloids containing abundant oxygen functional groups and mineral substances, and the adsorption capacities of biochar colloids and residues increase with the increase of pyrolysis temperatures. The highest adsorption performance of 139.33 mg g⁻¹ can be obtained in biochar colloids prepared at 700 °C, suggesting the important functions of biochar colloids in the application of atrazine removal by biochar.

Towards saving freshwater: halophytes as unconventional feedstuffs in livestock feed: a review

Abstract

Water represents 71% of all earth area and about 97% of this water is salty water. So, only 3% of the overall world water quantity is freshwater. Human can benefit only from 1% of this water and the remaining 2% freeze at both poles of earth. Therefore, it is important to preserve the freshwater through increasing the plants consuming salty water. The future prosperity of feed resources in arid and semi-arid countries depends on economic use of alternative resources that have been marginalized for long periods of time, such as halophytic plants, which are one such potential future resource. Halophyte plants can grow in high salinity water and soil and to some extent during drought. The growth of these plants depends on the contact of the salted water with plant roots as in semi-desert saline water, mangrove swamps, marshes, and seashores. Halophyte plants need high levels of sodium chloride in the soil water for growth, and the soil water must also contain high levels of salts, as sodium hydroxide or magnesium sulfate. There are many uses for halophyte plants, including feed for animals, vegetables, drugs, sand dune stabilizers, wind shelter, soil cover, wetland cultivation, laundry detergents, and paper production. This paper will focus on the use of halophytes as a feed additive for animals. In spite of the good nutritional value of halophytes, some anti-nutritional factors as nitrates, nitrite complexes, tannins, glycosides, phenolic compounds, saponins, oxalates, and alkaloids may be present in some of them. The presence of such anti-nutritional agents makes halophytes unpalatable to animals, which tends to reduce feed intake and nutrient use. Therefore, the negative effects of these plants on animal performance are the only objection against using halophytes in animal feed diets. This review article highlights the beneficial impact of considering halophytes in animal feeding on saving freshwater and illustrates its nutritive value for livestock from different aspects.

PR‐957 mediates neuroprotection by inhibiting Th17 differentiation and modulating cytokine production in a mouse model of ischaemic stroke

Clinical &Experimental Immunology, EarlyView.

Placental inflammation in pre‐eclampsia by Nod‐like receptor protein (NLRP)3 inflammasome activation in trophoblasts

Clinical &Experimental Immunology, EarlyView.

Preoperative Photographing and Morphing for Predictable Profiles in Rhinoplasty

This Surgical Pearl discusses preoperative photographing and morphing for predictable profiles in rhinoplasty.

A Closer Look at the Analgesic Regimen After Rhinoplasty—Reply

In Reply We thank Kendall and Castro-Alves for taking the time to read and critically analyze our article. Their commentary was very insightful and thought provoking. First, to directly answer their inquiries, we did not use a consistent standardized intraoperative or perioperative pain regimen, although that would have been desirable. In large medical center and academic medical center hospitals, and especially now with large anesthesia groups, the ability to have the same anesthesia team even throughout a single case is difficult because different anesthesiologists and certified registered nurse anesthetists continually come in and out of the operating room to spell one another for breaks and leave at shift changes so that the person who started the anesthesia portion is often not the same as who ends the case and extubates the patient. We agree that pain management should be discussed and coordinated with the anesthesiology team, and this should be a proactive venture that is highly dependent on the ability of local anesthesia to quell the need for intravenous medications during the case.

A Closer Look at the Analgesic Regimen After Rhinoplasty

To the Editor We read with great interest the article of Patel and colleagues in a recent issue of the JAMA Facial Plastic Surgery. The authors performed a retrospective study of 62 patients who underwent rhinoplasty, and they proposed a multifaceted pain control program to manage postoperative pain and ascertain the balance between controlling pain and avoiding overprescribing narcotics. The authors should be commended for performing a study in an important topic (eg, opioid consumption) in patients undergoing outpatient surgery. The current emphasis on the need to improve postoperative pain using multimodal analgesic strategies makes the topic very relevant in perioperative medicine.

A 3-Dimensional–Printed Short-Segment Template Prototype for Mandibular Fracture Repair

This feasibility study explores the potential application of a 3-dimensional–printed short-segment mandibular template in the management of complex mandibular fractures.

Reply: Postoperative Patient- and Parent-Reported Outcomes for Children with Congenital Hand Differences A Systematic Review

No abstract available

Discussion: Evaluating the July Phenomenon in Plastic Surgery A National Surgical Quality Improvement Program Analysis

No abstract available

Aseptic Freeze-Dried versus Sterile Wet-Packaged Human Cadaveric Acellular Dermal Matrix in Immediate Tissue Expander Breast Reconstruction: A Propensity Score Analysis

Background: Although multiple acellular dermal matrix sources exist, it is unclear how its processing impacts complication rates. The authors compared complications between two preparations of human cadaveric acellular dermal matrix (freeze dried and ready-to-use) in immediate tissue expander breast reconstruction to analyze the effect of processing on complications. Methods: The authors retrospectively reviewed all alloplastic breast reconstructions with freeze-dried or ready-to-use human acellular dermal matrices between 2006 and 2016. The primary outcome measure was surgical-site occurrence defined as seroma, skin dehiscence, surgical-site infection, or reconstruction failure. The two groups were compared before and after propensity score matching. Results: The authors included 988 reconstructions (freeze-dried, 53.8 percent; ready-to-use, 46.2 percent). Analysis of 384 propensity score–matched pairs demonstrated a slightly higher rate of surgical-site occurrence (21.4 percent versus 16.7 percent; p = 0.10) and surgical-site infection (9.6 percent versus 7.8 percent; p = 0.13) in the freeze-dried group than in the ready-to-use group, but the difference was not significant. However, failure was significantly higher for the freeze-dried versus ready-to-use group (7.8 percent versus 4.4 percent; p = 0.050). Conclusions: This is the largest study comparing the outcomes of alloplastic breast reconstruction using human acellular dermal matrix materials prepared by different methods. The authors demonstrated higher early complications with aseptic, freeze-dried matrix than with sterile ready-to-use matrix; reconstructive failure was the only outcome to achieve statistical significance. The authors conclude that acellular dermal matrix preparation has an independent impact on patient outcomes in their comparison of one company's product. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Preoperative and Postoperative Assessment of Rectus Abdominis Muscle Size and Function following DIEP Flap Surgery

Background: Prospective evaluation of rectus abdominis muscle function after deep inferior epigastric artery perforator (DIEP) flap breast reconstruction is limited. Elimination of muscle harvest with this procedure is theoretically associated with preservation of rectus abdominis function and minimization of abdominal wall morbidity. In this study, the authors evaluate the change in rectus abdominis muscle size and function after DIEP flap surgery. Methods: Patients undergoing unilateral DIEP flap surgery were recruited prospectively. Using computed tomography, the change in preoperative to postoperative rectus abdominis muscle size was compared between the operative side rectus abdominis muscle and the contralateral, nonoperative control rectus abdominis. Postoperative muscle integrity and contractility were evaluated using ultrasound by comparing the change in rectus abdominis muscle dimensions between contractile and relaxed states. The BREAST-Q was used to score patients' subjective satisfaction. Clinical and radiographic hernia rates were also calculated. Results: Analysis of 26 paired rectus abdominis muscles revealed no significant change in muscle size from preoperative to postoperative values. Furthermore, dimensional change from contractile to relaxed states postoperatively was similar for paired operative and nonoperative rectus abdominis muscles. BREAST-Q scores indicated a high degree of satisfaction in abdominal well-being, breast satisfaction, and surgical experience domains. There were no clinical or radiographic abdominal wall hernias noted. Conclusions: The DIEP flap is an effective surgical procedure with minimal abdominal wall morbidity that is associated with no measurable loss in rectus abdominis size and contractile function postoperatively. Patients are highly satisfied with their abdominal function postoperatively using this technique. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Evolution in Monitoring of Free Flap Autologous Breast Reconstruction after Nipple-Sparing Mastectomy: Is There a Best Way?

Background: Free flap monitoring in autologous reconstruction after nipple-sparing mastectomy remains controversial. The authors therefore examined outcomes in nipple-sparing mastectomy with buried free flap reconstruction versus free flap reconstruction incorporating a monitoring skin paddle. Methods: Autologous free flap reconstructions with nipple-sparing mastectomy performed from 2006 to 2015 were identified. Demographics and operative results were analyzed and compared between buried flaps and those with a skin paddle for monitoring. Results: Two hundred twenty-one free flaps for nipple-sparing mastectomy reconstruction were identified: 50 buried flaps and 171 flaps incorporating a skin paddle. The most common flaps used were deep inferior epigastric perforator (64 percent), profunda artery perforator (12.1 percent), and muscle-sparing transverse rectus abdominis myocutaneous flaps (10.4 percent). Patients undergoing autologous reconstructions with a skin paddle had a significantly greater body mass index (p = 0.006). Mastectomy weight (p = 0.017) and flap weight (p

Medial Row Perforators Are Associated with Higher Rates of Fat Necrosis in Bilateral DIEP Flap Breast Reconstruction

No abstract available

The Cost of Contralateral Prophylactic Mastectomy in Women with Unilateral Breast Cancer

Background: Contralateral prophylactic mastectomy may be unnecessary from an oncologic perspective; therefore, the debate persists about the value of contralateral prophylactic mastectomy in women with early-stage unilateral breast cancer. Given finite health care resources, this study aims to evaluate the cost of contralateral prophylactic mastectomy and breast reconstruction. Methods: Women with unilateral breast cancer undergoing either unilateral mastectomy or unilateral mastectomy with contralateral prophylactic mastectomy and immediate breast reconstruction were selected from the Truven MarketScan databases between 2009 and 2013. Demographic and treatment data were recorded, and over an 18-month follow-up period, the treatment cost was tallied. A log-transformed linear model was used to compare cost between the groups. Results: A total of 2343 women were identified who met our inclusion criteria, with 1295 undergoing unilateral mastectomy and 1048 undergoing contralateral prophylactic mastectomy. Complication rates within 18 months were similar for women undergoing unilateral mastectomy and contralateral prophylactic mastectomy (39 percent versus 42 percent; p = 0.17). Management with unilateral mastectomy with reconstruction required an adjusted cumulative mean cost of $33,557. Contralateral prophylactic mastectomy with reconstruction was an additional $11,872 in expenditure (p

ASPS/PSF Sponsored Symposia and Workshops

No abstract available

Discussion: The Cost of Contralateral Prophylactic Mastectomy in Women with Unilateral Breast Cancer

No abstract available

Photoacoustic Tomography Shows the Branching Pattern of Anterolateral Thigh Perforators In Vivo

Summary: The distal branching pattern of perforators is associated with thin anterolateral thigh flap failure. The purpose of this study was to investigate the feasibility of using photoacoustic tomography as a diagnostic imaging modality to identify anterolateral thigh perforators and their branching patterns in the subcutaneous layer. Ten thighs in five healthy men were studied. The anterolateral aspect of the midthigh was examined using photoacoustic tomography. The correlation between photoacoustic tomography and ultrasound findings was evaluated. To determine the detectability of photoacoustic tomography by depth, the depth of vessels in the stem portion was compared to the depth of the deep fascia measured by ultrasound. Branching patterns of vessels in the adipose and suprafascial layers were evaluated by three-dimensional observation. A total of 18 perforators were visualized by photoacoustic tomography. Photoacoustic tomography and ultrasound had comparable diagnostic potential for the detection of perforators. Photoacoustic tomography visualized microvessels in the subcutaneous layer, especially those in oblique or horizontal orientations. The estimated mean depth of visualized vessels was 9 mm; the maximum depth was 13 mm. There was a strong correlation between the depth of visualized vessels in the stem portion and the depth of the deep fascia. Three-dimensional observation of photoacoustic tomographic images showed the branching morphology of perforators. This study showed the applicability of photoacoustic tomography to identification of the branching patterns of anterolateral thigh perforators in vivo, although limited visualization of subfascial vessels is a technical issue. The authors believe that photoacoustic tomography has the potential to be a new imaging modality for thin anterolateral thigh flap surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE: Diagnostic, IV.

Validated Outcomes in the Grafting of Autologous Fat to the Breast: The VOGUE Study. Development of a Core Outcome Set for Research and Audit

Background: Autologous fat grafting is an important part of the reconstructive surgeon's toolbox when treating women affected by breast cancer and subsequent tumor extirpation. The debate over safety and efficacy of autologous fat grafting continues within the literature. However, work performed by the authors' group has shown significant heterogeneity in outcome reporting. Core outcome sets have been shown to reduce heterogeneity in outcome reporting. The authors' goal was to develop a core outcome set for autologous fat grafting in breast reconstruction. Methods: The authors published their protocol a priori. A Delphi consensus exercise among key stakeholders was conducted using a list of outcomes generated from their previous work. These outcomes were divided into six domains: oncologic, clinical, aesthetic and functional, patient-reported, process, and radiologic. Results: In the first round, 55 of 78 participants (71 percent) completed the Delphi consensus exercise. Consensus was reached on nine of the 13 outcomes. The clarity of the results and lack of additional suggested outcomes deemed further rounds to be unnecessary. Conclusions: The VOGUE Study has led to the development of a much-needed core outcome set in the active research front and clinical area of autologous fat grafting. The authors hope that clinicians will use this core outcome set to audit their practice, and that researchers will implement these outcomes in their study design and reporting of autologous fat grafting outcomes. The authors encourage journals and surgical societies to endorse and encourage use of this core outcome set to help refine the scientific quality of the debate, the discourse, and the literature. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Peak: How to Master Almost Anything

No abstract available

Facebook Facts: Breast Reconstruction Patient-Reported Outcomes Using Social Media

Background: Social media are used for information sharing among patients with similar health conditions, and analysis of social media activity could inform clinical decision-making. The aim of this study was to use Facebook to evaluate a cohort of individuals' perceptions of and satisfaction with breast reconstruction. Methods: In this observational study, the authors collected and analyzed posts pertaining to autologous and implant-based breast reconstruction from active Facebook groups. Patient satisfaction data were categorized, and a thematic analysis of posts was conducted. Qualitative posts were grouped based on common themes and quantitatively compared using frequency and chi-square analysis. Results: The authors evaluated 500 posts from two Facebook groups. Two hundred sixty-four posts referenced deep inferior epigastric perforator (DIEP) flap reconstruction and 117 were related to implant-based reconstruction. Among individuals referencing DIEP flap reconstruction, 52 percent were satisfied, compared with 20 percent of individuals who referenced satisfaction with implant-based reconstruction (p

Reply: Smaller Diameter Anastomotic Coupling Devices Have Higher Rates of Venous Thrombosis in Microvascular Free Tissue Transfer

No abstract available

Evaluating Platelet-Rich Therapy for Facial Aesthetics and Alopecia: A Critical Review of the Literature

Background: Despite the growing popularity of platelet-rich plasma, existing evidence supporting its efficacy remains controversial due to the lack of large-scale studies and standardized protocols for preparation and application. This article reviews its use in facial rejuvenation, fat grafting, acne scarring, and androgenic alopecia. Emphasis is placed on comparing methods of platelet-rich plasma preparation and application across studies. Methods: A systematic review was performed for articles published between 2006 and 2015. All clinical studies and case reports that addressed platelet-rich plasma alone and/or in combination with fat grafting for facial rejuvenation, acne scarring, or androgenic alopecia were included. Results: Of the 22 articles included in the analysis, seven studies used platelet-rich plasma alone for facial rejuvenation, seven in combination with fat grafting, two for treatment of acne scarring, and six for treatment of androgenic alopecia. Individual study procedures, means of evaluation, and significant results are summarized. Although the majority of studies in this review report positive results, significant variation exists in preparation protocols and in the number and frequency of clinical treatments. Conclusions: The majority of studies report positive results for all indications evaluated in this review, but the procedure is limited by the lack of a standardized method for preparation and application of platelet-rich plasma. The extent to which significant variability in platelet-rich plasma preparation and/or application methods may affect clinical outcomes is not completely clear. In the interim, we present a consolidation of platelet-rich plasma treatment techniques and outcomes currently in use to help guide physicians in their clinical practice.

Reply: Vectra 3D Imaging for Quantitative Volumetric Analysis of the Upper Limb A Feasibility Study for Tracking Outcomes of Lymphedema Treatment

No abstract available

Cheek Volumization and the Nasolabial Fold

Background: The impression that cheek filling results in longitudinal shortening ("lift") of the skin and elevation of the nasolabial crease or nasolabial fold has become common within the facial injection community but remains unsubstantiated. Methods: In this study, 77 patients were evaluated before and after injection of the cheeks with a hyaluronic acid filler using a three-dimensional camera system. Results: A constant pattern of skin expansion away from the center of the injection and perpendicular to the surface of the skin was observed. A subgroup of 37 patients without differences in their preinjection and postinjection facial expression were analyzed by direct comparison and failed to demonstrate lateral traction (or "pull") on the intervening skin from the cheek injection site to the nasolabial crease. Furthermore, there was no photographic difference in the nasolabial fold or nasolabial crease. The only patients who demonstrated photographic improvement of the medial face were those who had filler placed directly in the transition between the lateral nasolabial fold and cheek (nasojugal crease). Conclusions: Filling the cheek with 3 cc of volume does not create traction forces or move the skin between the site of injection and the nasolabial crease. It is likely that expanding the nasojugal crease is the direct visual cue that leads to perceived improvement in the nasolabial fold.

Accessory Nerves of the Forehead: A Newly Discovered Frontotemporal Neurovascular Bundle and Its Implications in the Treatment of Migraine Headache, Migraine Surgery, and Cosmetic Temple Filler Injection

Background: Surgical decompression of peripheral cranial and spinal nerves at several anatomically studied trigger sites has demonstrated significant efficacy in bringing permanent relief to migraine sufferers. In their experience performing frontal nerve decompression on migraine patients, the authors noticed a previously undescribed accessory nerve and vessel in the frontotemporal area, and report its implication in migraine surgery and cosmetic filler injection. Methods: A retrospective review of 113 patients who underwent frontal migraine decompression surgery at the University of Texas Southwestern Medical Center from July of 2011 to May of 2016 was performed. For the included 76 patients, measurements of this nerve had been taken intraoperatively using high-definition endoscopic assistance, and topographic measurements were correlated with endoscopic location of the nerve. Results: This frontotemporal nerve was present in 55 percent, and the bilateral incidence was 57 percent of those. An accompanying vessel was also present in 81 percent of nerve complexes. Both nerve and vessel varied in size. A large vessel was present in 8 percent of all patients, and a medium vessel was present in 20 percent. Consistently, the nerve exited a foramen in the frontal bone on average 3.4 ± 0.47 cm superior to the lateral canthus. Conclusions: The identification and proper avulsion neurectomy of this newly described sensory frontotemporal nerve may lead to better surgical response rate during migraine surgery. In addition, this nerve should be considered during nerve block and botulinum toxin injections in migraine treatment. The existence of the accompanying vessel could have significant implications in the safety of filler and fat injections to this area.

Expansion Vibration Lipofilling: A New Technique in Large-Volume Fat Transplantation

Background: Despite rapid growth, gluteal fat transplantation is an operation in search of science and a teachable technique. Long operating times, tedious syringe transfers, inability to shape the recipient site, and the risk of fat embolism all headline as impediments to clinical adoption of the procedure. Expansion vibration lipofilling is a syringe-free surgical strategy that is a logical extension of Separation, Aspiration, and Fat Equalization (SAFELipo). In expansion vibration lipofilling, there is simultaneous disruption of recipient-site connective tissue, internal expansion using exploded-tip cannulas, and backfilling of these spaces with roller pump–propelled fat. Methods: Two thousand four hundred nineteen consecutive cases of expansion vibration lipofilling fat transplantation to the buttocks were reviewed. Average follow-up was 12 months. The technique of expansion vibration lipofilling is dependent on the use of larger caliber cannulas attached to a roller pump and to an oscillatory power-assisted liposuction device, which is less labor-intensive, potentially allowing for better knowledge of cannula-tip location at all times during the procedure. Results: Operating times averaged 1 hour 40 minutes. The average volume of fat inserted was 1003 cc. Complications included donor-site seroma, infection, and one pulmonary embolism treated with anticoagulation. There were no cases of fat embolism or death. Conclusions: Expansion vibration lipofilling is a new method for large-volume fat transplantation. Avoidance of fatal fat emboli demands a surgeon's complete knowledge of cannula tip location at all times during the procedure. Syringe-free, larger caliber, and less flexible cannulas, combined with techniques requiring less operator upper extremity effort resulting in less fatigue, may contribute to avoidance of this dreadful complication. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Mechanical versus Hand-Sewn Venous Anastomoses in Free Flap Reconstruction: A Systematic Review and Meta-Analysis

Background: Venous complications are the primary reason for flap loss in massive defect reconstructions; therefore, the quality and reliability of microvascular anastomoses are significant. The aim of this systematic review was to evaluate venous anastomotic time, the venous complication rate, and the flap failure rate with the mechanical anastomotic coupling device versus the hand-sewn technique in venous anastomoses of microvascular free flap operations. Methods: Chinese and English databases were searched for eligible articles published between their inception and July of 2017. The pooled relative risk was calculated for dichotomous variables, and the weighted mean difference was calculated for continuous data. Whether to use the fixed effects or random effects model depended on the heterogeneity evaluation among the studies. Results: Twelve studies were selected, including 3788 flaps (mechanical anastomotic coupling device, n = 1667; hand-sewn, n = 2121). Using the mechanical anastomotic coupling device significantly decreased venous anastomotic time (weighted mean difference, −13.50; 95 percent CI, −17.09 to −9.91; p

Freie Vorträge • 26. Jahrestagung ADH 2018

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue S2, Page 1-2, April 2018.

Poster • 26. Jahrestagung ADH 2018

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, Volume 16, Issue S2, Page 3-10, April 2018.

A case of photodistributed multicentric reticulohistiocytosis: correlation with multiphoton microscopy imaging

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.

Short‐term efficacy of adalimumab in a patient with pyrin‐associated autoinflammation with neutrophilic dermatosis

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.

Influence of uvrA, recJ and recN gene mutations on nucleoid reorganization in UV-treated Escherichia coli cells

Abstract

Exposure to ultraviolet (UV) radiation blocks DNA replication and arrests cellular division in Escherichia coli. Restoration of chromosome replication involves nucleoid reorganization, which involves the participation of the recombination-catalysing proteins RecA, RecO, RecR and RecN. In the present work, we evaluated the influence of recN, uvrA and recJ gene mutations on post-irradiation nucleoid reorganization. We used isogenic E. coli strains that are defective for these genes to study post-irradiation kinetics of the nucleoid shape fractions using fluorescence microscopy. The results showed that in the wild-type strain, post-irradiation nucleoid reorganization occurs, which restores the nucleoid shape fractions in the cells to those observed prior to irradiation. First, the nucleoid condenses into the central area of the irradiated cell. Second, the nucleoid disperses along the cell. Third, the cell enters the chromosome replicative phase and cytokinesis. E. coli cells with a recN mutation did not exhibit increased nucleoid condensation, but chromosome replication and cytokinesis occurred. In the uvrA and recJ strains, the condensation step was delayed compared to the wild-type strain, and chromosome replication and cytokinesis did not occur. The results are discussed with an emphasis on the functions of RecN, UvrA and RecJ in nucleoid reorganization in UV-irradiated E. coli cells.

The use of gamification in the teaching of disease epidemics and pandemics

E-Health-Angebote in der Onkologie

Zusammenfassung

Hintergrund

Die krankheits- und behandlungsbedingten Belastungen von Krebserkrankungen gehen in der Regel mit deutlichen Beeinträchtigungen der Lebensqualität der Betroffenen einher. Durch die starke Verbreitung des Internets in deutschen Haushalten stellen onkologische E‑Health-Angebote eine schnelle und einfach zugängliche mögliche Quelle der Unterstützung für Patienten und Angehörige dar. Angebote für Behandler umfassen z. B. Informationsportale, die Behandler auf die Bedürfnisse von Krebspatienten vorbereiten. Die Zukunft von onkologischen E‑Health Angeboten scheint in der Entwicklung von Angeboten für das Smartphone zu liegen.

Ziel

Die Autoren beschreiben E‑Health-Angebote in der Onkologie, v. a. hinsichtlich Form und Inhalt, Inanspruchnahme und Wirksamkeit.

Diskussion/Schlussfolgerung

In der Literatur ist eine große Anzahl von Studien zu finden, die Prozess und Outcome von E‑Health-Interventionen evaluieren. Jedoch wird weiterhin ein Bedarf für gut designte höherwertige RCTs (randomisierte kontrollierte Studien) konstatiert, unter anderem um genauere Aussagen zur Wirksamkeit der Angebote treffen zu können. Häufig berichtete Probleme der E‑Health-Angebote sind hohe Dropout-Raten und ein Nachhohlbedarf bei der bisher weitgehend fehlenden Implementierung der in Studien erprobten Ansätze in die Versorgungspraxis. Das Einbeziehen von potenziellen Zielgruppen in den Entwicklungsprozess der Angebote könnte hilfreich sein, um das Auftreten von hohen Dropout-Raten und Usability-Problemen zu vermindern und sicherzustellen, dass die Angebote dem Bedarf der Patienten entsprechen.

Data Literacy in der Medizin

Zusammenfassung

Hintergrund

Die digitale Transformation des Gesundheitssystems verändert den Beruf des Arztes. Data Literacy wird hierbei als eine der führenden Zukunftskompetenzen erachtet, findet jedoch derzeit weder in den implementierten Curricula des Medizinstudiums noch in den aktuell laufenden Reformprozessen (Masterplan Medizinstudium 2020 und Nationaler Kompetenzbasierter Lernzielkatalog) Beachtung.

Ziel

Der Beitrag möchte zum einen die Aspekte beleuchten, die im Begriff der Data Literacy im medizinischen Kontext gebündelt werden. Zum andern wird ein Lehrkonzept vorgestellt, das Data Literacy im Zeichen der digitalen Transformation erstmals im Medizinstudium abbildet.

Material und Methoden

Das Blended-Learning-Curriculum „Medizin im digitalen Zeitalter" adressiert in 5 Modulen den diversen Transformationsprozess der Medizin von digitaler Kommunikation über Smart Devices und medizinische Apps, Telemedizin, virtuelle/augmentierte und robotische Chirurgie bis hin zu individualisierter Medizin und Big Data. Diese Arbeit stellt Konzept und Erfahrungen der erstmaligen Implementierung des 5. Moduls dar, welches transdisziplinär und integrativ den Aspekt Data Literacy erläutert.

Ergebnisse

Die Evaluation des Kurskonzepts erfolgte sowohl qualitativ als auch quantitativ und demonstriert einen Kompetenzgewinn in den Bereichen Wissen und Fertigkeiten sowie eine differenziertere Haltung nach Kursabschluss.

Schlussfolgerungen

Die curriculare Integration von Data Literacy ist eine transdisziplinäre und longitudinale Aufgabe. Bei der Entwicklung dieser Curricula sollten die hohe Geschwindigkeit des Veränderungsprozesses der digitalen Transformation beachtet und die curriculare Anpassung im Sinne eines Agility by Design bereits bei der Konzeption adressiert werden.

The Influence of Reactive Oxygen Species and Glucocorticoids on Dry Skin in a Mouse Model of Arthritis

Background: Dry skin induced by rheumatoid arthritis (RA) causes itching, which negatively influences a patient's quality of life. We previously reported that mast cells are related to dry skin in arthritic mice. However, the mechanism of mast cell activation is unclear. In this study, we examined the mechanism underlying the formation of dry skin induced by mast cells in arthritis that involves thymic stromal lymphopoietin (TSLP), neutrophils, reactive oxygen species (ROS), and glucocorticoids. Methods: Mice with DBA/1JJmsSlc collagen-induced arthritis were treated with inhibitors or neutralizing antibodies. We measured transepidermal water loss (TEWL) to examine the modulating signal of mast cells. Results: TEWL, the number of mast cells, and the plasma levels of TSLP, ROS, and corticosterone in the arthritic mice were increased when compared with the control mice. However, the mice treated with TSLP- and neutrophil-neutralizing antibodies and ROS and glucocorticoid receptor inhibitors (N-acetyl-L-cysteine [NAC] and RU-486, respectively) experienced an improvement. The ameliorating effect was most remarkable following treatment with NAC + RU-486. Conclusion: This study suggested that inhibiting ROS and glucocorticoids is important to ameliorate dry skin in arthritis, which may provide a novel treatment option for dry skin in RA patients.
Skin Pharmacol Physiol 2018;31:188–197

Exploring an in situ LED-illuminated isothermal micro-calorimetric method to investigating the thermodynamic behavior of Chlorella vulgaris during CO 2 bio-fixation

Abstract

Much endeavor has been dispensed recently to evaluate the potential of CO₂ mitigation by microalgae. We introduce an alternative, novel, LED-illumination isothermal microcalorimetric method to assess the thermodynamic behaviors of microalgae for better understanding of their carbon sequestration capacity. Microalgae thermodynamic behaviors were recorded as power-time curves, and their indices such as total heat evolution (Q_T ), maximum power output (P_max) and heat generated by per algae cell (J_N/Q ) were obtained. The values for highest (74.80 g L⁻¹) and control sample (0.00 g L⁻¹) of Q_T , P_max and J_N/Q were 20.85 and 2.32 J; 252.17 and 57.67 μW; 7.91 × ⁻⁰⁶ and 8.80 × ⁻⁰⁷ J cell⁻¹, respectively. According to the values of Q_T , a general order to promote the CO₂ sequestration was found at 74.8 g L⁻¹ > 29.92 g L⁻¹ > 14.96 g L⁻¹ > 7.48 g L⁻¹ > 0 g L⁻¹ of C sources, which directly corresponded to carbon availability in the growth medium. Chlorella vulgaris GIEC-179 showed the highest peak P_max at 74.8 g L⁻¹ concentration which was directly transformed to their biomass during bio-fixation of CO₂ process. This study is applicable for better understanding of CO₂ fixation performance of algae.

PIK3CA mutations are associated with reduced pathological complete response rates in primary HER2-positive breast cancer: pooled analysis of 967 patients from five prospective trials investigating lapatinib and trastuzumab

Ann Oncol 2016; 27: 1519–1525 (doi: 10.1093/annonc/mdw197)

Pathway level alterations rather than mutations in single genes predict response to HER2-targeted therapies in the neo-ALTTO trial

Ann Oncol 2017; 28: 128–135 (doi: 10.1093/annonc/mdw434)

Errance médicale des patients atteints d’hidradénite suppurée : un problème majeur et persistant. Étude « R-ENS Verneuil »

Publication date: Available online 26 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): J. Loget, C. Saint-Martin, P. Guillem, L. Kanagaratnam, P.-A. Becherel, A. Nassif, A.-C. Fougerousse, M. Siham, C. Girard, H. Barthelemy, G. Chaby, G. Gabison, J.-L. Perrot, V. Pallure, N. Beneton, T. Boye, C. Jacobzone, E. Begon, P. Bernard, Z. Reguiai
ObjectifL'objectif principal de cette étude était d'analyser les facteurs associés à l'existence d'un délai diagnostique significatif chez les patients atteints d'hidradénite suppurée (HS) en France.Malades et méthodesCette étude nationale prospective multicentrique réalisée d'octobre 2015 à mars 2016 incluait tous les patients consultant pour une HS. Les données concernant les patients étaient recueillies à l'aide d'un questionnaire standardisé. Des analyses univariée et multivariée ont été effectuées afin de recueillir les facteurs associés à un délai diagnostique significatif, défini comme un délai d'au moins 5,5 ans entre les premiers signes de la maladie et son diagnostic formel.RésultatsLes 16 centres ont inclus 312 patients (62 % de femmes) d'âge moyen 35 ans. L'âge moyen de début de l'HS était de 22 ans. Respectivement 170 (54 %), 114 (37 %) et 45 (15 %) patients avaient consulté au moins 3, 5 et 10 médecins avant le diagnostic formel, qui était posé par un dermatologue dans 64 % des cas. Les premiers signes d'HS étaient apparus en moyenne 6,2 ans avant la première consultation de dermatologie et 8,4 ans avant le diagnostic. Un tabagisme actif (Odd Ratio (OR) ajusté 1,85; p=0,027) et un début des signes à un âge plus précoce (OR ajusté 0,92; p<0,001) étaient associés à un délai diagnostique significatif.ConclusionCes résultats soulignent l'errance médicale des patients atteints d'HS, mais ne montrent pas d'association entre les caractéristiques sociodémographiques ou économiques des patients et l'existence d'un délai diagnostique significatif.ObjectiveTo provide physicians with an understanding of the factors behind significant delays in the diagnosis of hidradenitis suppurativa (HS) in France.Patients and methodsThis prospective multicentre national study conducted from October 2015 to March 2016 included all patients consulting for HS. Patient data were collected by means of a standardized questionnaire. Univariate and multivariate analyses were conducted to collect factors associated with a significant time to diagnosis of at least 5.5years, defined as the period between the onset of initial clinical signs and the time of formal diagnosis.ResultsThe 16 participating centres enrolled 312 patients (62% women), of average age 35years. The average age at onset of HS was 22years. Before formal diagnosis by a dermatologist (64% of cases), 170 (54%), 114 (37%) and 45 (15%) patients had previously consulted at least 3, 5 and 10 general physicians, respectively. The average time between the initial clinical signs of HS, the first dermatology visit and the definitive diagnosis was 6.2 and 8.4 years, respectively. Active smoking (OR adjusted 1.85; P=0.027) and disease onset at a younger age (adjusted OR 0.92; P<0.001) were both associated with significant delays in diagnosis.ConclusionThese results emphasized misdiagnosis among HS patients but did not evidence any association between either sociodemographic or economic characteristics and the existence of significant times to diagnosis.

Measurement of Current Substance Use in a Cohort of HIV-infected Persons in Continuity HIV Care, 2007-2015

Abstract

Accurate, routine measurement of recent illicit substance use is challenging. The Johns Hopkins Human Immunodeficiency Virus Clinical Cohort (Baltimore, MD) collects two imperfect but routine measurements of recent substance use: medical record review and self-interview. We used Bayesian latent class modeling to estimate sensitivity and specificity of each measurement, and prevalence of substance use among 2,064 patients engaged in care from 2007 to 2015. Sensitivity of medical record review was higher than sensitivity of self-interview for cocaine and heroin use; posterior estimates ranged from 44% to 76% for cocaine use and from 39% to 67% for heroin use, depending on model assumptions and priors. In contrast, sensitivity of self-interview was higher than sensitivity of medical record review for any alcohol use, hazardous alcohol use, and cigarette smoking. Posterior estimates of sensitivity of self-interview were generally above 80%, 85% and 87% for each substance, respectively. Specificity was high for all measurements. From one model, we estimated prevalence of substance use in the cohort to be 12.5% for cocaine; 9.3% for heroin; 48.5% for alcohol; 21.4% for hazardous alcohol; and 55.4% for cigarettes. Prevalence estimates from other models were generally comparable. Measurement error of substance use is non-trivial and should be accounted for in subsequent analyses.

Medical History, Medication Use, and Risk of Nasopharyngeal Carcinoma

Abstract

Because persistent inflammation may render the nasopharyngeal mucosa susceptible to carcinogenesis, chronic ear/nose/throat (ENT) disease and its treatment might influence the risk of nasopharyngeal carcinoma (NPC). Existing evidence is, however, inconclusive and often based on methodologically suboptimal epidemiologic studies. In a population-based case-control study in southern China, we enrolled 2532 NPC cases and 2597 controls aged 20–74 years from 2010 to 2014. Odds ratios were estimated for associations between NPC risk and history of ENT and related medications. Any history of chronic ENT disease was associated with a 34% increased risk of NPC. Similarly, use of nasal drops or aspirin was associated with approximately doubled risk of NPC. However, in secondary analyses restricted to chronic ENT diseases and related medication use at least 5 years prior to diagnosis/interview, most results were statistically non-significant, except a history of uncured ENT diseases, untreated nasal polyps, and earlier age at first diagnosis of ENT disease and first or most recent aspirin use. Overall, these findings suggest that ENT disease and related drug use are most likely early indications rather than causes of NPC, although the possibility of a modestly increased NPC risk associated with these diseases and related drugs cannot be excluded.

Histologic characterization of cellular infiltration in autoimmune subepidermal bullous diseases in a tertiary hospital in Saudi Arabia

Characterizing the correlation between dephosphorization and solution pH in a calcined water treatment plant sludge

Abstract

This study focused on characterizing the correlation between the dephosphorization process of calcined water treatment plant sludge (C-WTPS) and the solution initial pH in batch experiments. The specific aim was to illustrate the effect of different initial pH on the adsorption and desorption of phosphorous in C-WTPS. In addition, the effects of solution initial pH on the release of ammonia nitrogen and total organic carbon (TOC) from C-WTPS and the change of pH after adsorption were also investigated. The results demonstrated that the initial pH significantly influenced the adsorption of phosphorus on C-WTPS. When initial pH was increased from 3 to 10, the phosphorous absorption capacity reduced by 76.5%. Especially, when the initial pH reached to 11, the phosphorus adsorption capacity became a negative value, indicating that C-WTPS released phosphorus into the solution. The addition of C-WTPS to the solution had little impact on the initial pH of the solution. The absorbed phosphorous on C-WTPS was relatively stable in the pH range of 3 to 10. Nevertheless, when the solution pH was higher than 11, it can be easily released into the solution. Furthermore, by comparison with WTPS, C-WTPS released less ammonia nitrogen and TOC into the solution and adsorbed more phosphorus from the solution in the experimental pH range. Therefore, C-WTPS is more suitable to serve as a cost-effective sorbent for phosphorus removal.

Antifungal treatment in haematological and oncological patients: Need for quality assessment in routine care

Mycoses, EarlyView.

A case of acrodermatitis continua of Hallopeau (ACH) successfully treated with sulfasalazine

Dermatologic Therapy, EarlyView.