Water decontamination containing nitrate using biosorption with Moringa oleifera in dynamic mode

Abstract

This study was conducted to assess the feasibility of using Moringa oleifera Lam. (MO) seeds in the biosorption of nitrate present in aqueous solutions by means of batch and fixed-bed column biosorption processes. The batch assays showed that nitrate biosorption is enhanced under experimental conditions of pH 3 and a biosorbent mass of 0.05 g. For the experiments in dynamic mode, the results obtained from the statistical parameters showed that lesser pH, lesser feed flow rate, and higher initial concentration will result in an increase of the maximum capacity of the bed. These conditions were confirmed by experimental analysis. The best experimental conditions, according to the values for percentage removal (91.09%) and maximum capacity (7.69 mg g⁻¹) of the bed, were those used in assay 1, which utilized pH 3, feed flow rate of 1 mL min⁻¹, and initial nitrate concentration of 100 mg L⁻¹.

Effects of physical and chemical aspects on membrane fouling and cleaning using interfacial free energy analysis in forward osmosis

Abstract

Natural organic matter (NOM) in micro-polluted water purification using membranes is a critical issue to handle. Understanding the fouling mechanism in the forward osmosis (FO) process, particularly identifying the predominant factor that controls membrane fouling, could have significant effects on exerting the advantages of FO technique. Cellulose triacetate no-woven (CTA-NW) membrane is applied to experiments with a high removal efficiency (> 99%) for the model foulant. Tannic acid (TA) is used as a surrogate foulant for NOM in the membrane fouling process, thus enabling the analysis of the effects of physical and chemical aspects of water flux, retention, and adsorption. The membrane fouling behavior is affected mainly by the combined effects of the osmotic dragging force and the interaction of the pH in the working solution, foulants, and calcium ions, as demonstrated by the water flux loss and the changes of membrane retention and adsorption. The fouled CTA-NW membrane (in PRO mode) could be flux-recovered by > 85% through physical cleaning methods. The interfacial free energy analysis theory was used to analyze the membrane fouling behavior with calculating the interfacial cohesion and adhesion free energies. The cohesion free energy refers to the deposition of foulants (TA or TA combined with calcium ions) on a fouled membrane. In addition, the adhesion free energy could be used to evaluate the interaction between foulants and a clean membrane.

Mesotherapy with Botulinum toxin for the treatment of refractory vascular and papulopustular rosacea

Cutaneous Features and Diagnosis of Primary Sjogren’s Syndrome: An Update and Review

SS is diagnostically challenging due to clinical and immunologic features which overlap with other connective tissue diseases, SS patients with cutaneous vasculitis, especially cryoglobulinemic vasculitis, have worse prognosis with increased risk of systemic vasculitis and lymphoma. SS patients with photosensitive annular erythema tend to have milder systemic and glandular involvement, Characteristic cutaneous features of SS are early diagnostic signs correlating with prognosis.

Increased Severity and Epidermal Alterations in Persistent versus Evanescent Skin lesions in Adult Onset Still’s disease

Adalimumab Alleviates Skin Pain in Patients with Moderate to Severe Hidradenitis Suppurativa: Secondary Efficacy Results from the PIONEER I and PIONEER II Randomized Controlled Trials

Teaching pediatric dermoscopy in a resource limited setting

In response to Stiegel et al, “Prognostic value of sentinel lymph node biopsy according to Breslow thickness for cutaneous melanoma”

Reply to MS#JAAD-D-18-00555

Optimal Surgical Modality for Early Merkel Cell Carcinoma—Results from the National Cancer Data Base

Relative survival analysis in patients with stage I-II Merkel cell carcinoma treated with Mohs micrographic surgery or wide local excision

Undifferentiated Pleomorphic Sarcoma: Factors Predictive of Adverse Outcomes

Undifferentiated pleomorphic sarcoma (UPS) embodies various spindle cell tumors; we sought to identify those with aggressive behavior, Invasion beyond subcutaneous fat and tumor size >2 cm predicted more aggressive behavior, We propose subcategorization to superficial and deep UPS

Sirolimus Gel vs Placebo for Facial Angiofibromas in Patients With Tuberous Sclerosis Complex

This randomized clinical trial assesses the efficacy and safety of sirolimus gel, 0.2% vs placebo for treatment of angiofibromas and skin lesions in adult and pediatric patients with tuberous sclerosis complex.

Intralesional laser treatment for dermal fillers complications

Background: For complications due to filler treatments, in general two treatment regimens are advised: systemic drugs or surgical removal of the material. Another possible treatment option would be removal of the material by intralesional laser treatment (ILT) Methods: 242 patients with complications due to fillers were treated with intralesional laser treatment. Results: In the majority of patients an improvement was achieved (92%), in 9% the complication was resolved and in 3% it was not improved (rest unknown). Conclusion: Considering the large number of patients treated up to date, the efficacy and good safety profile of this treatment, we plead that ILT may be considered as a treatment option before surgery. Financial Disclosure Statement: Dr. Velthuis is trainer for Allergan (hyaluronic acid and botulin toxin), the other authors have nothing to disclose. No funding was received for this article. Corresponding author: L.W. Schelke, MD, Department of Dermatology, Erasmus MC, Postbus 2040, 3000 CA ROTTERDAM, The Netherlands. Lschelke@outlook.com ©2018American Society of Plastic Surgeons

The Role of Anastomotic Vessels in Controlling Tissue Viability and Defining Tissue Necrosis with Special Reference to Complications Following Injection of Hyaluronic Acid Fillers

BACKGROUND: Most target areas for facial volumization procedures relate to the anatomical location of the facial or ophthalmic artery. Occasionally, inadvertent injection of hyaluronic acid (HA) filler into the arterial circulation occurs, and unrecognised, is irreparably associated with disastrous vascular complications. Of note, the site of complications, irrespective of the injection site, is similar, and falls into only 5 areas of the face, all within the functional angiosome of the facial or ophthalmic artery. MATERIAL AND METHODS: Retrospective and prospective studies were made to assess the site and behaviour of anastomotic vessels connecting the angiosomes of the face and their possible involvement in the pathogenesis of tissue necrosis. In-vivo studies of pig and rabbit, and archival human total body and prospective selective lead oxide injections of the head and neck were analysed. Results were compared with documented patterns of necrosis following inadvertent HA intra-arterial injection. RESULTS: Studies showed the location of TRUE and CHOKE anastomoses connecting the facial artery with neighbouring angiosomes predicted the tissue at risk of necrosis following inadvertent intra-arterial HA injection. CONCLUSION: Complications related to HA injections are intimately associated with: (i) the anatomical distribution of TRUE and CHOKE anastomoses connecting the facial artery to neighbouring ophthalmic and maxillary angiosomes where CHOKE vessels define the boundary of necrosis of an involved artery but TRUE anastomoses allow free passage to a remote site; or possibly (ii) retrograde perfusion of HA into avalvular facial veins, especially in the periorbital region, and thereby the ophthalmic vein, cavernous sinus and brain. ** Joint first authors * Presented at 50 Years of Aesthetics, American Society of Aesthetic Plastic Surgeons (ASAPS ), San Diego California Meeting, 27 April – 2 May 2017. Financial Disclosure: The authors have no financial interest to declare in relation to the content of this article. Acknowledgments: We would like to thank Mrs Prue Dodwell for her help with preparing the manuscript and images. Thanks also to Dr Adam Gascoigne for assistance with the dissections and Dr Louie Ye for his time with the Literature Review. The work would not have been possible without support from Mr Jim Carroll and The Donald Ratcliffe and Phyllis Macleod Trust. Corresponding Author: Professor Ian Taylor, Taylor-Lab, Department of Anatomy and Neurosciences, University of Melbourne, Parkville, Victoria 3052, Email: g.taylor@unimelb.edu.au ©2018American Society of Plastic Surgeons

Quality of Surgical Outcomes Reporting in Plastic Surgery: A 15 Year Analysis of Complication Data

Background: Postoperative complication data are integral to assessing patient outcomes and identifying areas to improve quality in surgical care. Accurate appraisal of surgical techniques requires consistency and reliability in complication data reporting. The purpose of this study was to analyze the quality of complication reporting in plastic surgery. Methods: The authors critically reviewed the literature from January 1st, 2000 to December 31st, 2014 to identify articles reporting surgical outcomes after 3 index procedures (autologous breast reconstruction, prosthetic breast reconstruction and reduction mammaplasty). Studies were extracted from the journals Plastic and Reconstructive Surgery and Annals of Plastic Surgery. Two authors independently analyzed data using a modification of established criteria for complication reporting that incorporates 10 critical elements. Results: 296 articles reporting outcomes for 299,819 procedures in 249,942 patients were analyzed. Of the 10 reporting criteria, no articles met all criteria,

Immediate two-stage prosthetic breast reconstruction failure: radiation is not the only culprit

Background: Immediate prosthetic breast reconstruction produces a satisfactory aesthetic result with high levels of patient satisfaction. However, with the broader indication for post-mastectomy adjuvant radiation, many patients are advised against immediate breast reconstruction because of concerns of implant loss and infection particularly as most patients also require chemotherapy. This retrospective cohort study examines outcomes for patients who underwent immediate two-stage prosthetic breast reconstruction after mastectomy with or without adjuvant chemotherapy or radiotherapy (RT). Methods: Between 1998 and 2010, 452 patients undergoing two-stage prosthetic immediate breast reconstruction involving a total of 562 breasts were included in this study. Stage one was defined as insertion of the temporary expander and stage two insertion of the final silicone implant. Post-operative adjuvant radiotherapy was recommended with tissue expander in-situ for 114 patients. Complications, including loss of prosthesis, seroma and infection were recorded and analysed. Cosmetic result was assessed using a 4-point scale. Results: Post-operative prosthesis loss was 2.7%, 5.3% for patients undergoing adjuvant chemotherapy increasing to 11.3% for patients receiving chemotherapy+RT. Chemotherapy and radiotherapy independently were the main, statistically significant, risk factors for expander or implant loss; IRR: 13.85 (p=0.012) and 2.23 (p=0.027), respectively. Prosthesis loss for patients undergoing combination chemotherapy+RT was also significant; IRR: 4.791 (p

Prospective, Randomized, Controlled Comparison of Local Anesthetic Infusion Pump versus DepoFoam Bupivacaine For Pain Management After Unilateral Delayed Deep Inferior Epigastric Perforator Free Flap Reconstruction.

Background: Effective postsurgical analgesia is a critical aspect of patient recovery. The goal of this prospective, randomized, controlled, blinded study was to examine the effect that liposomal bupivacaine delivered via a transversus abdominis plane (TAP) block has on pain control in women undergoing unilateral deep inferior epigastic perforator reconstruction. Methods: IRB approval was granted for this prospective study. Patients were eligible if they were undergoing unilateral, delayed DIEP reconstruction. Patients were randomized to one of three groups; liposomal bupivacaine or bupivacaine TAP block or bupivacaine pain pump. Charts were reviewed for demographics, length of stay, and post-operative narcotic utilization. Results: There were eight patients in the liposomal bupivacaine and bupivacaine groups and 5 patients in the pain pump group. A retrospective cohort of six patients who did not receive any intervention was included. Patients who received a liposomal bupivacaine TAP block used statistically significantly less intravenous and total post-operative narcotics in mg and mg/kg/day compared to all other cohorts. They were able to get out of bed earlier time point. Overall hospital costs were similar amongst the groups. Conclusion: This is the first study to investigate liposomal bupivacaine delivered as a TAP block in a prospective, randomized, blinded study in women undergoing unilateral, delayed abdominally-based autologous breast reconstruction. We were able to demonstrate a significant reduction in intravenous and total narcotic utilization when a liposomal bupivacaine TAP block was utilized. Future studies are needed to prospectively investigate the effect that liposomal bupivacaine would have on immediate and bilateral reconstructions. There are no financial disclosures Corresponding Author: Risal Djohan, MD, Crile Building, Mail Code A60, 2049 East 100th Street, Cleveland, OH 44195, Email: Djohanr@ccf.org, Phone: 216-445-2433 ©2018American Society of Plastic Surgeons

“Toradol® following breast surgery: Is there an increased risk of hematoma?”

Background: Ketorolac tromethamine (Toradol®), a nonsteroidal antiinflammatory drug, is used with increased frequency given its success in postoperative pain control and the subsequent decreased need for narcotics. Its use has been limited in plastic surgery for fear of postoperative bleeding and hematoma formation. In this study of breast surgery patients, we investigated whether ketorolac increased the risk of postoperative hematoma formation. Methods: After obtaining institutional review board approval, we retrospectively reviewed the records of patients undergoing breast surgery (breast reduction and autologous or implant based reconstruction) from January 2012 through December 2014. Excluded were patients who underwent the first stage of breast reconstruction before January 2012. We compared the incidence of postoperative hematomas in patients who did, versus those who did not, receive ketorolac postoperatively. In addition, we documented other risk factors, such as chronic anticoagulation, aspirin use, or coagulopathies. Results: For our entire cohort, the overall hematoma rate was 2.8%. Of the patients who received ketorolac, the rate was 3.5% of those who did not, 2.5%. Of the breast reduction patients, the rate was 4% in those who received ketorolac vs. 3.2% in those who did not. Of the breast reconstruction patients, the rate was 4% in those who received ketorolac vs. 3.2% in those who did not. Conclusion: In recent years, the high rates of prescribing postoperative narcotics have received increased attention. Aside from the risk of increased availability of narcotics in the community, the side effects of nausea, pruritus, and constipation can delay patient recovery. Ketorolac is controversial for postoperative pain control because of the potential risk of bleeding, but in our 3-year retrospective study, it was not associated with an increased risk of hematoma formation. Financial Disclosure Statement: The authors have nothing to disclose. Presented at: Aesthetica Super Symposium 2017 in New Orleans, LA, Minnesota Surgical Society 2017 in Minneapolis, MN Corresponding Author: Brittany Nguyen, BS, 420 Delaware ST SE, Minneapolis, MN 55455 nguy446@umn.edu, 651-492-3098 ©2018American Society of Plastic Surgeons

The Functional Anatomy of the Superficial Fat Compartments of the Face – A Detailed Imaging Study

Background: The superficial (subcutaneous) facial fat compartments contribute to the signs of facial aging, but a comprehensive anatomic description of their location and their functional behavior during the application of soft tissue fillers still remains elusive. Methods: We investigated 30 fresh frozen cephalic specimens from 13 male and 17 female Caucasian body donors (age: 78.3 ± 14.2 years, body mass index: 23.1 ± 5.3 kg/m2). Upright positioned contrast enhanced CT scans and additional MR imaging was performed. 3D reconstruction based measures were conducted to evaluate the position of the applied contrast agent in each compartment separately. Successive anatomical dissections were performed to confirm the imaging findings. Results: Positive correlations were detected between the amounts of injected material and the inferior displacement for the superficial nasolabial (rp = 0.92, p = 0.003), middle cheek (rp = 0.70, p = 0.05) and jowl (rp = 0.92, p = 0.03) compartments but not for the medial cheek (rp = 0.20, p = 0.75), lateral cheek (rp = 0.15, p = 0.75), the superior superficial temporal compartments superior: rp = -0.32, p = 0.41; or the inferior superficial temporal compartment: rp = -0.52, p = 0.29. Conclusion: This study confirms the presence of distinct subcutaneous fat compartments and provides evidence for an individual behavior when soft tissue fillers are applied: inferior displacement of the superficial nasolabial, middle cheek and jowl compartments, in contrast to an increase in volume without displacement, i.e. an increase in projection of the medial cheek, lateral cheek and both superficial temporal compartments. Author disclosure: None of the other authors listed have commercial associations or financial disclosures that might pose or create a conflict of interest with the methods applied or the results presented in this article. Funding: The imaging part of this study received funding from Q-Med AB, Sweden (Grant Nr: 15092016). Acknowledgements: We would like to thank Markus Schlager for his support in the imaging parts of this study and Robert H. Gotkin, MD for his guidance during the writing process. Corresponding author: Sebastian Cotofana, MD, PhD, Associate Professor, Albany Medical College, 47 New Scotland Avenue MC-135, Albany, NY 12208, Phone: 518-262-5667, Email: ©2018American Society of Plastic Surgeons

“Relationship Between Tamoxifen And The Absorption Of Subfascial Autologous Fat Grafts”

Introduction: In the lipofilling procedures used in breast reconstruction, there is an unpredictability in the rate of reabsorption of the grafted fat. The objective of this study was to analyze the effect of Tamoxifen, a medication commonly prescribed for patients with breast cancer, as a possible alternative to reduce the rate of autologous fat graft resorption. Materials and methods: The fatty cushion of the inguinal region of 20 female adult Wistar rats was removed and then autografted, using a standard volume of 0.2 mL in the subfascial plane of the dorsal region. The subject animals were randomized into two groups, control and study. The study group animals were administed 20 mg/kg/day of Tamoxifen citrate over a period of 21 days, via gavage. At the end of the experiment, the animals were euthanized and the grafts underwent morphological and histopathological analysis, with emphasis on the predominant inflammatory response pattern and collagen maturation. Results: The rats undergoing treatment with Tamoxifen (study group) presented higher values in relation to the weight and the volume of fat grafts when compared to the initial values and to the control group. Histological analysis using Hematoxylin-Eosin staining showed that resolution of the inflammatory process was faster in the control group. Analysis using the Picrosirius method demonstrated higher percentages of immature collagen vs. mature collagen. Conclusion: The use of the drug Tamoxifen reduced the rates of resorption and fibrosis of the injected fat, resulting in a better integration of the autologous fat graft. Financial Disclosure Statement: Dr. Alfredo Silva, Mr. Felipe Haupenthal, Mr. André D. Morais, Dr. Adriana Sayuri, Dr. Ana Paula, Dr. Manoel Cavalcanti and Dr. Renato Freitas have nothing to disclose. No funding was received for this article. Ethical conduct of experimental studies with animals: All procedures performed involving animals were in accordance with the ethical standards of the institucional and national research committee or comparable ethical standards. Presented at: Congresso Paulista de Cirurgia 2016 in Sao Paulo, Brazil. Corresponding author: Adriana Sayuri Kurogi Ascenço, Plastic Surgeon, Rua Solimões, 1175, Curitiba, Paraná, Brazil. e-mail address: sayurikurogi@hotmail.com ©2018American Society of Plastic Surgeons

Risk Factors for Delays in Adjuvant Chemotherapy Following Immediate Breast Reconstruction

Background: Concerns exist that immediate breast reconstruction may delay adjuvant chemotherapy initiation, impacting oncologic outcomes. Here, we determine how post-operative complications impact chemotherapy timing, and identify factors associated with greater risk for delays. Methods: Retrospective chart review identified patients undergoing immediate breast reconstruction and adjuvant chemotherapy at a single institution from 2010 to 2015. Patients were analyzed based on occurrence of post-operative complications and time to chemotherapy. Results: A total of 182 patients (244 breast reconstructions) were included in the study; 210 (86%) reconstructions did not experience post-operative complications, 34 (13.9%) did. Patients who experienced post-operative complications had a higher mean age (53.6 vs. 48.1 years, p=0.002), and higher rates of diabetes (23.5% vs. 3.8%, p48.5 days were of higher mean age (55.9 vs. 50.7 years, p=0.074), had increased rates of diabetes (36.8% vs. 6.7%, p=0.053), and immediate autologous reconstruction (31.6% vs. 0%, p=0.027). A predictive model based on these findings determined that patients with at least 1 of these 3 risk factors have a 74% chance of experiencing prolonged times to chemotherapy initiation vs. 18% without risk factors (p=0.003). Conclusions: Risk factors for delayed chemotherapy in the context of post-operative complications are age >51.7 years, diabetes, and autologous reconstruction. Reconstructive candidates who fit this profile are at highest risk and merit extra consideration and counseling. * Authors contributed equally to preparation of this manuscript FINANCIAL DISCLOSURES: None of the authors of this manuscript have commercial associations or financial disclosures to report that create a conflict of interest with information presented in this manuscript. Corresponding Author: Nolan Karp, M.D. 307 East 33rd Street, New York, NY 10016, (212) 263-5834, Nolan.Karp@nyumc.org ©2018American Society of Plastic Surgeons

Development of a large‐volume human‐derived adipose acellular allogenic flap by perfusion decellularization

Wound Repair and Regeneration, EarlyView.

Chromomycose cutanée étendue : efficacité de l’association terbinafine et cryothérapie

Publication date: Available online 17 May 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): Y. Elkhachine, J. Elbenaye, M. Er-Rami, A. Sakkah, A. Jakar, M. Elhaouri
IntroductionLa chromomycose est une infection cutanée fongique chronique touchant principalement les membres. Rarement décrite au Maroc, elle est responsable d'une morbidité lourde et son traitement est long et souvent décevant. Nous en rapportons un nouveau cas, remarquable par son évolution rapidement favorable sous un traitement de courte durée combinant terbinafine et cryothérapie.ObservationUn homme de 56 ans, immunocompétent, présentait sur le dos des deux avant-bras des placards érythémateux pustuleux et croûteux évoluant depuis une année. Le prélèvement mycologique objectivait des corps fumagoïdes et la biopsie cutanée des granulomes épithéloïdes avec cellules géantes et sans nécrose. Le diagnostic de chromomycose à Fonsecaea pedrosoi était confirmé par PCR. La sérologie VIH était négative. La terbinafine orale à la posologie de 250mg/j pendant 6 mois, associée à des séances de cryothérapie, permettait d'obtenir un début d'amélioration clinique après seulement 3 semaines et une rémission complète au terme du traitement.DiscussionLa survenue d'une chromomycose dans les régions non tropicales est de plus en plus souvent rapportée. Si les moyens diagnostiques deviennent plus performants dans l'identification des espèces en cause, la prise en charge reste difficile et mal codifiée. L'association terbinafine-cryothérapie s'est révélée chez notre patient très efficace et bien tolérée.ConclusionLe traitement combinant terbinafine et cryothérapie pourrait constituer une excellente alternative thérapeutique pour les chromomycoses cutanées à F. pedrosoi, du fait de son efficacité, sa faisabilité, son faible coût, son mode d'administration et son résultat esthétique.BackgroundChromomycosis is a chronic fungal skin infection, mainly affecting the limbs. It is responsible for severe morbidity and its treatment remains long and disappointing. Rarely described in Morocco, we report a new observation that has evolved very well under treatment combining terbinafine and cryotherapy over a short duration.Case reportA 56-year-old patient, immunocompetent, had a pustular and crusty placard on both forearms that had evolved for a year. Mycological examination showed fumagoid bodies and cutaneous biopsy showed epithelioid granulomas and giant cells without necrosis. The PCR confirmed a chromomycosis at Fonsecaea pedrosoi. HIV serology was negative. Treatment with terbinafine 250mg/d for 6months combined to cryotherapy resulted in complete remission with initial clinical improvement after only 3 weeks.DiscussionChromomycosis occurs increasingly in non-tropical areas. If diagnostic methods become more effective, management remains difficult and poorly codified. Terbinafine-cryotherapy combination would bring a lot of benefits with a little risk to bothpractitioner and patient.ConclusionThis combined treatment would constitute an excellent therapeutic alternative because of its efficiency, feasibility, low cost, method of administration and aesthetic result.

Carcinome épidermoïde de croissance rapide après traitement par mébutate d’ingénol

Publication date: Available online 17 May 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): M. Ehret, C. Velter, M. Tebacher, C. Bruant-Rodier, B. Cribier
IntroductionLe mébutate d'ingénol est un traitement médical des kératoses actiniques (KA) qui agit par un double mécanisme : induction rapide de mort cellulaire et réaction inflammatoire intense.ObservationNous rapportons le cas d'un patient de 75 ans qui a développé une tumeur de croissance rapide 5 semaines après l'application de mébutate d'ingénol sur des KA. L'analyse histologique après exérèse chirurgicale révélait un carcinome épidermoïde (CE) invasif avec des signes d'agressivité (infiltration péri-nerveuse et perméation vasculaire).DiscussionLes effets secondaires constants du mébutate d'ingénol sont bénins et régressifs spontanément en 2 à 4 semaines : érythème, œdème, croûtes, ulcérations/érosions, pustules. La survenue d'un CE est rare. Nous avons cherché d'autres cas dans la littérature et dans les centres de pharmacovigilance français et européens. Trois observations ont été rapportées dans la littérature, 21 cas ont été signalés à l'agence européenne du médicament et l'interrogation des centres de pharmacovigilance français a permis de trouver cinq cas de CE après application de mébutate d'ingénol. Le rôle du mébutate d'ingénol dans le développement de CE n'est pas connu. L'inflammation induite par la molécule pourrait jouer un rôle dans le développement de ces tumeurs, par analogie à d'autres événements, de type traumatisme cutané (prise de greffe cutanée, incision chirurgicale). Le suivi au long cours de patients traités permettra de mieux connaître la fréquence des cas.IntroductionIngenol mebutate is an actinic keratosis treatment, which has a dual action mechanism. It allows a rapid cellular death and a severe inflammation.ObservationWe report the case of a 75 years old patient with a rapidly growing tumor 5 weeks after application of ingenol mebutate on typical actinic keratosis. Histological analysis after surgical excision showed an invasive squamous cell carcinoma (SCC); with aggressiveness signs: perineural infiltration and vascular permeation.DiscussionIngenol mebutate's common side effects are benign and regressive within 2 to 4 weeks. There are erythema, edema, crusts, and ulcerations/erosions. Squamous cell carcinoma development was rarely reported. We have tried to collect other cases in the literature and in pharmacovigilance centres: three similar cases were recently published in the literature, 21 cases were notified to the European Medicines Agency and we asked French pharmacovigilance centres and found 5 cases of SCC after ingenol mebutate application. The role of the molecule in SCC development is currently unknown. Induced inflammation could take part in the development of these tumors. We compare this case with other situations of inflammation, such skin graft donor site or surgical incision, complicated of rapidly growing SCC. Our case, literature's and pharmacovigilance's cases encourage us to follow ingenol mebutate's side effects. Careful follow-up and registration of such cases are important to gain further insight on this topic.

Sensitization to Cor a 9 or Cor a 14 has a strong impact on the distribution of thresholds to hazelnut

Publication date: Available online 18 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Laury J.N. Masthoff, W.Marty Blom, Carina M. Rubingh, Rob J.B. Klemans, Ben C. Remington, Carla A.F.M. Bruijnzeel-Koomen, Els van Hoffen, Geert F. Houben, Yolanda Meyer, Suzanne G.M.A. Pasmans, André C. Knulst

Health Disparities among Children with Asthma in the U.S. by Place of Residence

Publication date: Available online 18 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Patrick W. Sullivan, Vahram Ghushchyan, Abhishek Kavati, Prakash Navaratnam, Howard S. Friedman, B. Ortiz
BackgroundChildren residing in poor-urban areas may have greater asthma morbidity. It is unclear if this is due to individual characteristics like race and ethnicity or place of residence.ObjectiveAssess indicators of control and treatment by residence.MethodsThis was a cross-sectional analysis of children (aged 1-17) in the 2000-2014 Medical Expenditure Panel Survey (MEPS). Indicators of poor control included use of > 3 canisters of short-acting beta agonist (SABA) in 3 months, asthma attack, and Emergency Department (ED) or inpatient (IP) visit during the year. Treatment measures included use of controller medications and a ratio of controller-to-total prescriptions ≥ 0.7.ResultsThere were 15,052 children with asthma in the MEPS 2000-14 data, reflecting 8.4 million children in 2014. After controlling for covariates, children with asthma residing in poor-urban areas had lower odds of using controller medications (OR = 0.77), having a controller-to-total ratio ≥ 0.7 (OR = 0.75) and reporting an asthma attack (OR = 0.75); and higher odds of having an ED/IP visit (OR = 1.3) compared to those living elsewhere. Black race and Hispanic ethnicity were associated with greater odds of excessive SABA use (OR = 2.11) and ED/IP visits (OR=2.03); and lower odds of controller-to-total ratio≥0.07 (OR=0.50).ConclusionPoor-urban residence may be independently associated with asthma control and treatment even after controlling for individual characteristics like race and ethnicity. Future research is needed to understand the sources of these geographic health disparities in order to more successfully target public health interventions.

Effects of elevated pressure on Pseudanabaena galeata Böcher in varying light and dark environments

Abstract

To understand the effect of the hydrostatic pressure on Pseudanabaena galeata Böcher cells in both stratified and frequently mixed lakes, separate laboratory-scale models were developed. The pressure conditions in the stratified and mixed lakes were simulated in those models, and the variations of the cell and chlorophyll-a (Chl-a) concentration were analyzed. It was observed that an increase in pressure and darkness significantly reduced the cell concentration and pigmentation in P. galeata (p < 0.01, n = 3). After 10 days, the cell concentrations of P. galeata that were grown under conditions of a water depth of 30 m were reduced by 7.0%, per day, while the cell concentration rate after 10 days in atmospheric conditions was increased by 2.53% per day. During the experiment, cells were subjected to the prolonged darkness under 0.3 MPa pressure for 10 days and then exposed to the white light under atmospheric pressure for 5 days. Even after running this cycle for 60 days, 19.5% of the initial cells could survive. This rate exceeded the cell concentration-increasing rate in the control. These findings indicate that P. galeata has an adequate tolerance to pressure and fluctuating light irradiance and that the cells are able to propagate after escaping from those stress conditions.

Preparation and adsorption characteristics for heavy metals of active silicon adsorbent from leaching residue of lead-zinc tailings

Abstract

To comprehensively reuse the leaching residue obtained from lead-zinc tailings, an active silicon adsorbent (ASA) was prepared from leaching residue and studied as an adsorbent for copper(II), lead(II), zinc(II), and cadmium(II) in this paper. The ASA was prepared by roasting the leaching residue with either a Na₂CO₃/residue ratio of 0.6:1 at 700 °C for 1 h or a CaCO₃/residue ratio of 0.8:1 at 800 °C for 1 h. Under these conditions, the available SiO₂ content of the ASA was more than 20%. The adsorption behaviors of the metal ions onto the ASA were investigated and the Langmuir, Freundlich, and Dubinin-Radushkevich isotherm models were used to analyze the adsorption isotherm. The result showed that the maximum adsorption capacities of copper(II), lead(II), cadmium(II), and zinc(II) calculated by the Langmuir model were 3.40, 2.83, 0.66, and 0.62 mmol g⁻¹, respectively. The FT-IR spectra of the ASA and the mean free adsorption energies indicated that ion exchange was the mechanism of copper(II), lead(II), and cadmium(II) adsorption and that chemical reaction was the mechanism of zinc(II) adsorption. These results provide a method for reusing the leaching residue obtained from lead-zinc tailings and show that the ASA is an effective adsorbent for heavy metal pollution remediation.

Invited Response to the Comment by Caruso and Heimberger on "Trivalent CAR T cells overcome interpatient antigenic variability in glioblastoma" by Bielamowicz et al