Antimicrobial use and antimicrobial resistance in food animals

Abstract

Antimicrobials have been widely used in food animals for growth promotion since the 1950s. Antimicrobial resistance emerges in animal production settings and frequently spreads to humans through the food chain and direct contact. There have been international efforts to restrict or ban antimicrobials used for both humans and animals. Denmark has taken positive strides in the development of a comprehensive database DANMAP to track antimicrobial usage and resistance. Although food animals are sources of antimicrobial resistance, there is little evidence that antimicrobial resistance originates from food animals. This review comprehensively introduces the history and trends of antimicrobial use, the emergence and spread of antimicrobial resistance in food animals provides suggestions to tackle the problems of the spread of antimicrobial resistance.

A prospective, randomized, within‐subject study of ALA‐PDT for actinic keratoses using different irradiation regimes

Photodermatology, Photoimmunology &Photomedicine, EarlyView.

Trace element contaminants in mineral fertilizers used in Iran

Abstract

The application of mineral fertilizers which have contaminants of trace elements may impose concern regarding the entry and toxic accumulation of these elements in agro-ecosystems. In this study, 57 mineral fertilizers (nitrogen, potassium, phosphate, and compound fertilizers) distributed in Iran were analyzed for their contents of Cd, Co, Cr, Cu, Mn, Ni, Pb, Zn, and Fe. The results revealed that the contents of these trace elements varied considerably depending on the type of the element and the fertilizer. Among these elements, Fe displayed the highest average content, whereas Cd showed the lowest. Generally, the trace element contents in P-containing fertilizers were higher than those in nitrogen and potassium fertilizers. The mean values of trace elements (mg kg⁻¹) in P-containing fertilizers were 4.0 (Cd), 5.5 (Co), 35.7 (Cr), 24.4 (Cu), 272 (Mn), 14.3 (Ni), 6.0 (Pb), 226 (Zn), and 2532 (Fe). Comparing trace element contents to limit values set by the German Fertilizer Ordinance showed that the mean contents of potentially toxic trace elements, such as Cd and Pb, were lower than their limit values in all groups of fertilizers. On the other hand, while a number of fertilizers contained a high content of some essential trace elements, particularly Fe, they were not labeled as such.

A retrospective study on titanium sensitivity: Patch test materials and manifestations

Contact Dermatitis, EarlyView.

Pretreated animal and human waste as a substantial nutrient source for cultivation of microalgae for biodiesel production

Abstract

The use of human and animal wastes for fertilization of aquaculture ponds has been practiced for thousands of years. In the present work, we have used the excreta (human urine, poultry waste, cow dung, and urine) as a nutrient source for the cultivation of Chlorella singularis, Micractinium pusillum, and Chlorella sorokiniana strains of microalgae. Different solid wastes were treated with 60 mM H₂SO₄ for the extraction of nutrients. After treatment, the supernatant of different solid wastes and liquid waste were diluted 5, 10, 15, and 20% to be used as a media for the cultivation of microalgae. Chlorella sorokiniana was able to grow in all concentration of excreta media. The maximum growth rate 140 ± 3.1 mg/L/day and lipid production (45.5 ± 2.3 mg/L/day) was obtained in 20% poultry. Among the different excreta media used for cultivation of microalgae, poultry media displayed the best results and thus, should be used for large scale cultivation of microalgae.

Multisite Concordance of DSC-MRI Analysis for Brain Tumors: Results of a National Cancer Institute Quantitative Imaging Network Collaborative Project [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Standard assessment criteria for brain tumors that only include anatomic imaging continue to be insufficient. While numerous studies have demonstrated the value of DSC-MR imaging perfusion metrics for this purpose, they have not been incorporated due to a lack of confidence in the consistency of DSC-MR imaging metrics across sites and platforms. This study addresses this limitation with a comparison of multisite/multiplatform analyses of shared DSC-MR imaging datasets of patients with brain tumors.

MATERIALS AND METHODS:

DSC-MR imaging data were collected after a preload and during a bolus injection of gadolinium contrast agent using a gradient recalled-echo–EPI sequence (TE/TR = 30/1200 ms; flip angle = 72°). Forty-nine low-grade (n = 13) and high-grade (n = 36) glioma datasets were uploaded to The Cancer Imaging Archive. Datasets included a predetermined arterial input function, enhancing tumor ROIs, and ROIs necessary to create normalized relative CBV and CBF maps. Seven sites computed 20 different perfusion metrics. Pair-wise agreement among sites was assessed with the Lin concordance correlation coefficient. Distinction of low- from high-grade tumors was evaluated with the Wilcoxon rank sum test followed by receiver operating characteristic analysis to identify the optimal thresholds based on sensitivity and specificity.

RESULTS:

For normalized relative CBV and normalized CBF, 93% and 94% of entries showed good or excellent cross-site agreement (0.8 ≤ Lin concordance correlation coefficient ≤ 1.0). All metrics could distinguish low- from high-grade tumors. Optimum thresholds were determined for pooled data (normalized relative CBV = 1.4, sensitivity/specificity = 90%:77%; normalized CBF = 1.58, sensitivity/specificity = 86%:77%).

CONCLUSIONS:

By means of DSC-MR imaging data obtained after a preload of contrast agent, substantial consistency resulted across sites for brain tumor perfusion metrics with a common threshold discoverable for distinguishing low- from high-grade tumors.

Efficacy and Safety of Percutaneous Microwave Ablation and Cementoplasty in the Treatment of Painful Spinal Metastases and Myeloma [SPINE]

BACKGROUND AND PURPOSE:

Painful spinal metastases are a common cause of cancer-related morbidity. Percutaneous ablation presents an attractive minimally invasive alternative to conventional therapies. We performed a retrospective review of 69 patients with 102 painful spinal metastases undergoing microwave ablation and cementoplasty to determine the efficacy and safety of this treatment.

MATERIALS AND METHODS:

Procedures were performed between January 2015 and October 2016 with the patient under general anesthesia using image guidance for 102 spinal metastases in 69 patients in the following areas: cervical (n = 2), thoracic (n = 50), lumbar (n = 34), and sacral (n = 16) spine. Tumor pathologies included the following: multiple myeloma (n = 10), breast (n = 27), lung (n = 12), thyroid (n = 6), prostate (n = 5), colon (n = 4), renal cell (n = 3), oral squamous cell (n = 1), and adenocarcinoma of unknown origin (n = 1). Procedural efficacy was determined using the visual analog scale measured preprocedurally and at 2–4 weeks and 20–24 weeks postprocedure. Tumor locoregional control was assessed on follow-up cross-sectional imaging. Procedural complications were recorded to establish the safety profile.

RESULTS:

The median ablation time was 4 minutes 30 seconds ± 7 seconds, and energy dose, 4.1 ± 1.6 kJ. Median visual analog scale scores were the following: 7.0 ± 1.8 preprocedurally, 2 ± 1.6 at 2–4 weeks, and 2 ± 2.1 at 20–24 weeks. Eight patients died within 6 months following the procedure. Follow-up imaging in the surviving patients at 20–24 weeks demonstrated no locoregional progression in 59/61 patients. Two complications were documented (S1 nerve thermal injury and skin burn).

CONCLUSIONS:

Microwave ablation is an effective and safe treatment technique for painful spinal metastases. Further studies may be helpful in determining the role of microwave ablation in locoregional control of metastases.

Clinical Significance of Intraplaque Hemorrhage in Low- and High-Grade Basilar Artery Stenosis on High-Resolution MRI [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

Intraplaque hemorrhage within intracranial atherosclerotic plaques identified by high-resolution MR imaging has been studied as a potential marker of stroke risk. However, previous studies only examined intracranial arteries with high-grade stenosis (degree of stenosis, >50%). This study aimed to ascertain the clinical relevance of intraplaque hemorrhage in patients with low- and high-grade stenotic basilar artery plaques.

MATERIALS AND METHODS:

Patients with basilar artery stenosis (n = 126; mean age, 62 ± 10 years; 66 symptomatic and 60 asymptomatic) underwent high-resolution MR imaging. The relationship between imaging findings (intraplaque hemorrhage, contrast enhancement, degree of stenosis, minimal lumen area, and plaque burden) and symptoms was analyzed.

RESULTS:

Intraplaque hemorrhage was identified in 22 patients (17.5%), including 21 (31.8%) symptomatic patients and 1 (1.7%) asymptomatic patient. Multivariate analysis showed that intraplaque hemorrhage was the strongest independent marker of symptomatic status (odds ratio, 27.5; 95% CI, 3.4–221.5; P = .002). Contrast enhancement was also independently associated with symptomatic status (odds ratio, 9.9; 95% CI, 1.5–23.6; P = .016). Stenosis, minimal lumen area, and plaque burden were not correlated with symptoms (P > .05). Intraplaque hemorrhage was present in both low- and high-grade stenotic basilar arteries (11.3% versus 16.3%, P = .63). Diagnostic performance values of intraplaque hemorrhage for patients with acute/subacute symptomatic stroke were the following: specificity, 98.3%; sensitivity, 31.8%; positive predictive value, 95.5%; and negative predictive value, 56.7%.

CONCLUSIONS:

Intraplaque hemorrhage is present in both low- and high-grade stenotic basilar artery plaques and is independently associated with symptomatic stroke status. Intraplaque hemorrhage may identify high-risk plaque and provide new insight into the management of patient with stroke without significant stenosis.

Prevalence of Cerebral Microhemorrhage following Chronic Blast-Related Mild Traumatic Brain Injury in Military Service Members Using Susceptibility-Weighted MRI [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Cerebral microhemorrhages are a known marker of mild traumatic brain injury. Blast-related mild traumatic brain injury relates to a propagating pressure wave, and there is evidence that the mechanism of injury in blast-related mild traumatic brain injury may be different from that in blunt head trauma. Two recent reports in mixed cohorts of blunt and blast-related traumatic brain injury in military personnel suggest that the prevalence of cerebral microhemorrhages is lower than in civilian head injury. In this study, we aimed to characterize the prevalence of cerebral microhemorrhages in military service members specifically with chronic blast-related mild traumatic brain injury.

MATERIALS AND METHODS:

Participants were prospectively recruited and underwent 3T MR imaging. Susceptibility-weighted images were assessed by 2 neuroradiologists independently for the presence of cerebral microhemorrhages.

RESULTS:

Our cohort included 146 veterans (132 men) who experienced remote blast-related mild traumatic brain injury (mean, 9.4 years; median, 9 years after injury). Twenty-one (14.4%) reported loss of consciousness for <30 minutes. Seventy-seven subjects (52.7%) had 1 episode of blast-related mild traumatic brain injury; 41 (28.1%) had 2 episodes; and 28 (19.2%) had >2 episodes. No cerebral microhemorrhages were identified in any subject, as opposed to the frequency of SWI-detectable cerebral microhemorrhages following blunt-related mild traumatic brain injury in the civilian population, which has been reported to be as high as 28% in the acute and subacute stages.

CONCLUSIONS:

Our results may reflect differences in pathophysiology and the mechanism of injury between blast- and blunt-related mild traumatic brain injury. Additionally, the chronicity of injury may play a role in the detection of cerebral microhemorrhages.

Abnormal Blood Oxygen Level-Dependent Fluctuations in Focal Cortical Dysplasia and the Perilesional Zone: Initial Findings [FUNCTIONAL]

BACKGROUND AND PURPOSE:

Focal cortical dysplasia is a common cause of intractable epilepsy for which neurosurgery is an option. Delineations of a focal cortical dysplasia lesion on structural brain images may not necessarily reflect the functional borders of normal tissue. Our objective was to determine whether abnormalities in spontaneous blood oxygen level–dependent fluctuations arise in focal cortical dysplasia lesions and proximal regions.

MATERIALS AND METHODS:

Fourteen patients with focal cortical dysplasia–related epilepsy and 16 healthy controls underwent structural and resting-state functional MR imaging. Three known blood oxygen level–dependent measures were determined, including the fractional amplitude of low-frequency fluctuations, regional homogeneity, and wavelet entropy. These measures were evaluated in the lesion and perilesional zone and normalized to the contralateral cortex of patients with focal cortical dysplasia and healthy controls.

RESULTS:

Patients showed significantly decreased fractional amplitude of low-frequency fluctuations and increased wavelet entropy in the focal cortical dysplasia lesion and the perilesional zone (≤2 cm) relative to the contralateral homotopic cortex and the same regions in healthy controls. Regional homogeneity was significantly increased in the focal cortical dysplasia lesion compared with the contralateral homotopic cortex and healthy controls.

CONCLUSIONS:

Abnormalities in spontaneous blood oxygen level–dependent fluctuations were seen up to 2 cm distant from the radiologically visible boundary. It was demonstrated that functional boundaries go beyond structural boundaries of focal cortical dysplasia lesions. Validation is required to reveal whether this information is valuable for surgical planning and outcome evaluation of focal cortical dysplasia lesions and comparing current results with electrophysiologic analysis.

Hematocrit Measurement with R2* and Quantitative Susceptibility Mapping in Postmortem Brain [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Noninvasive venous oxygenation quantification with MR imaging will improve the neurophysiologic investigation and the understanding of the pathophysiology in neurologic diseases. Available MR imaging methods are limited by sensitivity to flow and often require assumptions of the hematocrit level. In situ postmortem imaging enables evaluation of methods in a fully deoxygenated environment without flow artifacts, allowing direct calculation of hematocrit. This study compares 2 venous oxygenation quantification methods in in situ postmortem subjects.

MATERIALS AND METHODS:

Transverse relaxation (R2*) mapping and quantitative susceptibility mapping were performed on a whole-body 4.7T MR imaging system. Intravenous measurements in major draining intracranial veins were compared between the 2 methods in 3 postmortem subjects. The quantitative susceptibility mapping technique was also applied in 10 healthy control subjects and compared with reference venous oxygenation values.

RESULTS:

In 2 early postmortem subjects, R2* mapping and quantitative susceptibility mapping measurements within intracranial veins had a significant and strong correlation (R² = 0.805, P = .004 and R² = 0.836, P = .02). Higher R2* and susceptibility values were consistently demonstrated within gravitationally dependent venous segments during the early postmortem period. Hematocrit ranged from 0.102 to 0.580 in postmortem subjects, with R2* and susceptibility as large as 291 seconds^–1 and 1.75 ppm, respectively.

CONCLUSIONS:

Measurements of R2* and quantitative susceptibility mapping within large intracranial draining veins have a high correlation in early postmortem subjects. This study supports the use of quantitative susceptibility mapping for evaluation of in vivo venous oxygenation and postmortem hematocrit concentrations.

MSVAT-SPACE-STIR and SEMAC-STIR for Reduction of Metallic Artifacts in 3T Head and Neck MRI [HEAD & NECK]

BACKGROUND AND PURPOSE:

The incidence of metallic dental restorations and implants is increasing, and head and neck MR imaging is becoming challenging regarding artifacts. Our aim was to evaluate whether multiple-slab acquisition with view angle tilting gradient based on a sampling perfection with application-optimized contrasts by using different flip angle evolution (MSVAT-SPACE)-STIR and slice-encoding for metal artifact correction (SEMAC)-STIR are beneficial regarding artifact suppression compared with the SPACE-STIR and TSE-STIR in vitro and in vivo.

MATERIALS AND METHODS:

At 3T, 3D artifacts of 2 dental implants, supporting different single crowns, were evaluated. Image quality was evaluated quantitatively (normalized signal-to-noise ratio) and qualitatively (2 reads by 2 blinded radiologists). Feasibility was tested in vivo in 5 volunteers and 5 patients, respectively.

RESULTS:

Maximum achievable resolution and the normalized signal-to-noise ratio of MSVAT-SPACE-STIR were higher compared with SEMAC-STIR. Performance in terms of artifact correction was dependent on the material composition. For highly paramagnetic materials, SEMAC-STIR was superior to MSVAT-SPACE-STIR (27.8% smaller artifact volume) and TSE-STIR (93.2% less slice distortion). However, MSVAT-SPACE-STIR reduced the artifact size compared with SPACE-STIR by 71.5%. For low-paramagnetic materials, MSVAT-SPACE-STIR performed as well as SEMAC-STIR. Furthermore, MSVAT-SPACE-STIR decreased artifact volume by 69.5% compared with SPACE-STIR. The image quality of all sequences did not differ systematically. In vivo results were comparable with in vitro results.

CONCLUSIONS:

Regarding susceptibility artifacts and acquisition time, MSVAT-SPACE-STIR might be advantageous over SPACE-STIR for high-resolution and isotropic head and neck imaging. Only for materials with high-susceptibility differences to soft tissue, the use of SEMAC-STIR might be beneficial. Within limited acquisition times, SEMAC-STIR cannot exploit its full advantage over TSE-STIR regarding artifact suppression.

Experimental analysis of performance and emission on DI diesel engine fueled with diesel-palm kernel methyl ester-triacetin blends: a Taguchi fuzzy-based optimization

Abstract

The energy situation and the concerns about global warming nowadays have ignited research interest in non-conventional and alternative fuel resources to decrease the emission and the continuous dependency on fossil fuels, particularly for various sectors like power generation, transportation, and agriculture. In the present work, the research is focused on evaluating the performance, emission characteristics, and combustion of biodiesel such as palm kernel methyl ester with the addition of diesel additive "triacetin" in it. A timed manifold injection (TMI) system was taken up to examine the influence of durations of several blends induced on the emission and performance characteristics as compared to normal diesel operation. This experimental study shows better performance and releases less emission as compared with mineral diesel and in turn, indicates that high performance and low emission is promising in PKME-triacetin fuel operation. This analysis also attempts to describe the application of the fuzzy logic-based Taguchi analysis to optimize the emission and performance parameters.

Total sediment transport from an urbanizing watershed in the upper Yellow River, China

Abstract

For many event-based, high-sediment yield rivers draining arid zones, where erosion activities in the watershed and fluvial erosion in the stream channel are nearly equally important in sediment transport, determination of fluvial sediment dynamics are of great importance in establishing reliable strategies to manage environmental changes in watershed scale. Wash load rating curve indicating watershed characteristic changes and Ackers and White's bed load function (wash load excluded) used for determining bed load transport dynamics are distinguished for the first time to recognize the true sediment transport mode in the lower Huangshui River, which is the largest tributary of the upper Yellow River, contributing a lot to the wash load of the Inner Mongolia desert reach of the Yellow River and causing complicated water-sediment response. Based on the continuous and detailed hydrological data monitored at the Minhe gauge station, our results indicated that the sediment transport regime has altered since the 1980s in response to the eco-environmental changes mainly due to urbanization, with suspended sediment concentration (SSC) decreased by 50% on average compared with the natural state (1950–1980). The combined use of wash load rating curve and theoretical bed load function derived an estimate of total sediment transport due to comprehensive ecological management since the 2000s to be 3.43 × 107 t for the lower Huangshui River, among which the total bed load is 1.40 × 107 t, and the wash load is 2.03 × 107 t. The transport ratio of wash load to total bed load is 1.45:1.

Global development of the studies focused on antibiotics in aquatic systems from 1945 to 2017

Abstract

Antibiotics are used to fight diseases in humans and farm animals. Their residues, however, can enter aquatic environments and affect the resistance of non-target microbial strains, and the prevalence of antibiotic resistance genes (ARGs) potentially poses negative impacts on human health. In order to better understand how the studies of antibiotics have been conducted, we analyzed the publications on antibiotics in aquatic systems for the period of 1945–2017. We applied a bibliometric analysis method by coupling cluster analysis and network analysis. Results indicated that early research on antibiotics in water was mostly performed in America and Europe, while, in recent years, publications for the same subject were dominated by China and the USA. The majority of the articles were published in journal Chemosphere and the most representative subject categories of the seven sections were "Environmental science and ecology," "Chemistry," "Engineering," "Biochemistry and molecular biology," "Water resources," "Agriculture," and "Pharmacology and pharmacy." The most studied class of antibiotics was tetracyclines in wastewater. Antibiotic resistance, ARGs, Escherichia coli, and some mechanistic studies such as adsorption, toxicity, degradation, and kinetics were common topics in this field. ARGs present a major public health concern and much attention should be directed at the problems with antibiotics in the future studies of water.

Intragenic copy number variation within human epiplakin 1 (EPPK1) generates variation of molecular size of epiplakin

Epiplakin is a versatile cytolinker protein that is expressed in the epithelium, including the epidermis, several glands, and digestive organs [1]. Human epiplakin consists of 13 B domains that are homologous to the B domain found in the carboxy-terminal region of desmoplakin; the last five B domains at the carboxy-terminal end, together with their associated linker regions, are highly conserved [1] (Fig. 1A). The mRNA of epiplakin is transcribed from the third exon of the epiplakin gene (EPPK1) [2,3] (Fig.

Patterns of medicinal cannabis use, strain analysis, and substitution effect among patients with migraine, headache, arthritis, and chronic pain in a medicinal cannabis cohort

Medicinal cannabis registries typically report pain as the most common reason for use. It would be clinically useful to identify patterns of cannabis treatment in migraine and headache, as compared to arthriti...

Factors associated with acute medication overuse in people with migraine: results from the 2017 migraine in America symptoms and treatment (MAST) study

The MAST Study is a longitudinal, cross-sectional survey study of US adults with migraine. These analyses were conducted to estimate rates of acute medication overuse (AMO) and determine associations of AMO wi...

Host characteristics and dynamics of Staphylococcus aureus colonization in patients with moderate-to-severe psoriasis before and after treatment: A prospective cohort study

Maintenance of Skin Clearance With Ixekizumab Treatment of Psoriasis: Three-Year Results From the UNCOVER-3 Study

Ixekizumab treatment is associated with a high level of skin clearance in patients with psoriasis., After 3 years of ixekizumab treatment, a majority of patients sustained a PASI 90 response, with no new safety signals.. Ixekizumab is a reasonable long-term treatment option for patients with moderate-to-severe plaque psoriasis.

Phosphorous-doped TiO 2 nanoparticles: synthesis, characterization, and visible photocatalytic evaluation on sulfamethazine degradation

Abstract

Mesoporous phosphorous-doped TiO₂ (TP) with different wt% of P (0.5, 1.0, and 1.5) was synthetized by microwave-assisted sol–gel method. The obtained materials were characterized by XRD with cell parameters refinement approach, Raman, BET-specific surface area analysis, SEM, ICP-OES, UV–Vis with diffuse reflectance, photoluminescence, FTIR, and XPS. The photocatalytic activity under visible light was evaluated on the degradation of sulfamethazine (SMTZ) at pH 8. The characterization of the phosphorous materials (TP) showed that incorporation of P in the lattice of TiO₂ stabilizes the anatase crystalline phase, even increasing the annealing temperature. The mesoporous P-doped materials showed higher surface area and lower average crystallite size, band gap, and particle size; besides, more intense bands attributed to O–H bond were observed by FTIR analysis compared with bare TiO₂. The P was substitutionally incorporated in the TiO₂ lattice network as P⁵⁺ replacing Ti⁴⁺ to form Ti–O–P bonds and additionally present as PO₄³⁻ on the TiO₂ surface. All these characteristics explain the observed superior photocatalytic activity on degradation (100%) and mineralization (32%) of SMTZ under visible radiation by TP catalysts, especially for P-doped TiO₂ 1.0 wt% calcined at 450 °C (TP1.0-450). Ammonium, nitrate, and sulfate ions released during the photocatalytic degradation were quantified by ion chromatography; the nitrogen and sulfur mass balance evidenced the partial mineralization of this recalcitrant molecule.

The invisible hand and EKC hypothesis: what are the drivers of environmental degradation and pollution in Africa?

Abstract

This study examined the drivers of environmental degradation and pollution in 17 countries in Africa from 1971 to 2013. The empirical study was analyzed with Westerlund error-correction model and panel cointegration tests with 1000 bootstrapping samples, U-shape test, fixed and random effect estimators, and panel causality test. The investigation of the nexus between environmental pollution economic growth in Africa confirms the validity of the EKC hypothesis in Africa at a turning point of US$ 5702 GDP per capita. However, the nexus between environmental degradation and economic growth reveals a U shape at a lower bound GDP of US$ 101/capita and upper bound GDP of US$ 8050/capita, at a turning point of US$ 7958 GDP per capita, confirming the scale effect hypothesis. The empirical findings revealed that energy consumption, food production, economic growth, permanent crop, agricultural land, birth rate, and fertility rate play a major role in environmental degradation and pollution in Africa, thus supporting the global indicators for achieving the sustainable development goals by 2030.

Removal of Cs + from aqueous solutions by perlite

Abstract

Perlite is an abundant mineral that requires minimum processing before use either as raw or expanded perlite, resulting in a low-cost, natural porous material. The application of materials for the removal of radioactive cesium from liquid effluents and contaminated waters is currently of great interest. Perlite has been evaluated in the last years for the sorption of a variety of metals, but it had not been investigated before for removal of Cs⁺ from contaminated waters. The present work examines the use of perlites from a deposit in Salta, Argentina, for removal of Cs⁺ from aqueous solutions. The mineral was characterized by means of powder X-ray diffraction, thermal analysis, analysis of specific area, and scanning electron microscopy. The effect of solution pH, presence of concomitant ions, contact time, Cs⁺ initial concentration, perlite dose, and basic or acidic treatment of the sorbent were studied by batch experiments. Removal increased at high pHs and after treatment with NaOH. Sorption of Cs⁺ by perlite presented a rapid rise in the first 80 min of contact. The selected material (from Pava mine) yielded removal efficiencies of 84 and 89% before and after treatment with NaOH, respectively, for a dose of 30 g perlite/L and initial cation concentration of 10 mg/L. Our results demonstrate that perlite is a material capable of removing Cs⁺ from aqueous solutions, even when applied at low doses. These findings are relevant in the context of removal of radioactive Cs isotopes from nuclear effluents and in case of contamination of environmental waters.

Analysis of Craniofacial Remodeling in the Aging Midface Using Reconstructed Three-Dimensional Models in Paired Individuals

No abstract available

The Impact of Mastectomy Weight on Reconstructive Trends and Outcomes in Nipple-Sparing Mastectomy: Progressively Greater Complications with Larger Breast Size

Background: Reconstructive trends and outcomes for nipple-sparing mastectomy continue to be defined. The graduated impact of breast size and mastectomy weight remains incompletely evaluated. Methods: All patients undergoing nipple-sparing mastectomy from 2006 to June of 2016 were identified. Demographics and outcomes were analyzed and stratified by mastectomy weight of 800 g or higher (large group), between 799 and 400 g (intermediate group), and less than 400 g (small group). Results: Of 809 nipple-sparing mastectomies, 66 (8.2 percent) had mastectomy weights of 800 g or higher, 328 (40.5 percent) had mastectomy weights between 799 and 400 g, and 415 nipple-sparing mastectomies (51.3 percent) had mastectomy weights less than 400 g. Nipple-sparing mastectomies in the large group were significantly more likely to be associated with major mastectomy flap necrosis (p = 0.0005), complete nipple-areola complex necrosis (p

The Accuracy of Conflict-of-Interest Disclosures Reported by Plastic Surgeons and Industry

Background: The purpose of this study was to analyze the frequency and nature of self-reported conflict-of-interest disclosures in the plastic surgery literature and to compare these findings to the Physician Payments Sunshine Act database. Methods: All articles published from August of 2013 through December of 2013 in four major plastic surgery journals were analyzed. For every publication, the conflict-of-interest disclosure statement for each investigator was reviewed. These statements were then compared to transactions of value for each investigator as reported by biomedical companies in the Sunshine Act database. An analysis was performed to identify and characterize specific factors associated with conflict-of-interest disclosures. Results: A total of 1002 independent investigators/authors were identified. Of these, 90 investigators (9 percent) self-reported a conflict of interest. In contrast, a total of 428 authors (42.7 percent) were found to have received transactions of value from a biomedical company according to the Sunshine Act database. Conversely, a total of 22 authors (2.2 percent) self-reported a conflict of interest but were not found to have received transactions of value in the Sunshine Act database. Our analysis found that (1) academic investigators, (2) transactions of value in excess of $500, and (3) publishing articles related to the sponsoring biomedical company were all statistically associated with reporting conflicts of interest (p

Does Hormone Therapy Use Increase Perioperative Complications in Abdominally Based Microsurgical Breast Reconstruction?

Background: The use of hormone therapy (tamoxifen and aromatase inhibitors) has been shown to increase venous thromboembolism. As breast cancer patients undergoing microsurgical breast reconstruction are often receiving hormone therapy, it is unclear whether this increased thrombotic risk is associated with increased flap loss. Methods: A retrospective review was performed on patients undergoing abdominally based microsurgical breast reconstruction at an academic institution from 2004 to 2015. Patients were divided by use of hormone therapy at the time of surgery. Complication rates, including complete or partial flap loss and overall complications, were compared and analyzed using univariate and logistic regression models. Results: Among a total of 853 patients (1253 flaps), 193 patients (269 flaps) were receiving hormone therapy and 660 patients (984 flaps) were not. Patients on hormone therapy had higher rates of previous breast surgery, advanced cancer stage, chemoradiation before reconstruction, and delayed and unilateral reconstruction. There were no statistically significant differences between hormone therapy patients and nontherapy patients in complete flap loss (1.0 percent versus 1.1 percent) and partial flap loss (2.2 percent versus 1.5 percent). Hypertension and previous breast surgery were the only independent risk factors for minor complications (adjusted OR, 2.1; 95 percent CI, 1.3 to 3.6; p = 0.005; and adjusted OR, 1.8; 95 percent CI, 1.2 to 2.7; p = 0.009, respectively) and overall complications (adjusted OR, 2.2; 95 percent CI, 1.3 to 3.7; p = 0.004; and adjusted OR, 1.9; 95 percent CI, 1.3 to 3.0; p = 0.003, respectively). Conclusions: Hormone therapy was not associated with a higher incidence of complete or partial flap loss or overall complications. The authors propose an individualized approach to the preoperative cessation of tamoxifen or aromatase inhibitors. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Discussion: Predictors of Patient Satisfaction and Postoperative Complications in Penile Inversion Vaginoplasty

No abstract available

Prospective, Randomized, Controlled Comparison of Bupivacaine versus Liposomal Bupivacaine for Pain Management after Unilateral Delayed Deep Inferior Epigastric Perforator Free Flap Reconstruction

Summary: 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 by means of a transversus abdominis plane block has on pain control in women undergoing unilateral deep inferior epigastric perforator flap reconstruction. Institutional review board approval was granted for this prospective study. Patients were eligible if they were undergoing unilateral, delayed deep inferior epigastric perforator flap reconstruction. Patients were randomized to one of three groups: liposomal bupivacaine transversus abdominis plane block, or bupivacaine pain pump. Charts were reviewed for demographics, length of stay, and postoperative narcotic use. There were eight patients in the liposomal bupivacaine and bupivacaine transversus abdominis plane block groups and five 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 transversus abdominis plane block used statistically significantly less intravenous and total postoperative narcotics in milligrams and milligrams per kilogram per day compared with all other cohorts. They were able to get out of bed at an earlier time point. Overall hospital costs were similar among the groups. This is the first study to investigate liposomal bupivacaine delivered as a transversus abdominis plane block in a prospective, randomized, blinded study in women undergoing unilateral, delayed, abdominally based autologous breast reconstruction. The authors were able to demonstrate a significant reduction in intravenous and total narcotic use when a liposomal bupivacaine transversus abdominis plane block was used. Future studies are needed to prospectively investigate the effect that liposomal bupivacaine would have on immediate and bilateral reconstructions.

Five Steps to Internal Mammary Vessel Preparation in Less than 15 Minutes

No abstract available

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, the authors investigated whether ketorolac increased the risk of postoperative hematoma formation. Methods: After obtaining institutional review board approval, the authors retrospectively reviewed the records of patients undergoing breast surgery from January of 2012 through December of 2014. The authors compared the incidence of postoperative hematomas in patients who did, versus those who did not, receive ketorolac postoperatively. Results: For the entire cohort, the overall hematoma rate was 2.8 percent. Of the patients who received ketorolac, the rate was 3.5 percent; of those who did not, the rate was 2.5 percent. Of the breast reduction patients, the rate was 4 percent in those who received ketorolac versus 3.2 percent in those who did not. Of the breast reconstruction patients, the rate was 4 percent in those who received ketorolac versus 3.2 percent in those who did not. Conclusions: Recently, 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 can delay patient recovery. Ketorolac is controversial for postoperative pain control because of the potential risk of bleeding, but in the authors' 3-year retrospective study, it was not associated with an increased risk of hematoma formation. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Successful Noninvasive Treatment of Festoons

No abstract available

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 for improving 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 1, 2000, to December 31, 2014, to identify articles reporting surgical outcomes after three 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: Two hundred ninety-six articles reporting outcomes for 299,819 procedures in 249,942 patients were analyzed. Of the 10 reporting criteria, no articles met all criteria, fewer than 1 percent met nine, 16 percent met seven to eight, 43 percent met five to six, 35 percent met three to four, and 6 percent met one to two (mean, five criteria met). Commonly underreported criteria included complication definitions (37 percent of articles reported), aesthetic or patient-reported outcome (28 percent), and complication severity (16 percent). Only 46 studies (16 percent) reported complication severity, with 15 different definitions of what constituted a "major" complication. Risk factors for complications were absent in 37 percent of articles. Conclusions: Inconsistency in reporting complications in the plastic surgery literature confounds the comparison of surgical outcomes. The use of standard guidelines to accurately, efficiently, and reproducibly report complication data is essential for quality assurance and improvement.

Gender Inequality for Women in Plastic Surgery: A Systematic Scoping Review

Background: Previous research has highlighted the gender-based disparities present throughout the field of surgery. This study aims to evaluate the breadth of the issues facing women in plastic surgery, worldwide. Methods: A systematic scoping review was undertaken from October of 2016 to January of 2017, with no restrictions on date or language. A narrative synthesis of the literature according to themed issues was developed, together with a summary of relevant numeric data. Results: From the 2247 articles identified, 55 articles were included in the analysis. The majority of articles were published from the United States. Eight themes were identified, as follows: (1) workforce figures; (2) gender bias and discrimination; (3) leadership and academia; (4) mentorship and role models; (5) pregnancy, parenting, and childcare; (6) relationships, work-life balance, and professional satisfaction; (7) patient/public preference; and (8) retirement and financial planning. Despite improvement in numbers over time, women plastic surgeons continue to be underrepresented in the United States, Canada, and Europe, with prevalence ranging from 14 to 25.7 percent. Academic plastic surgeons are less frequently female than male, and women academic plastic surgeons score less favorably when outcomes of academic success are evaluated. Finally, there has been a shift away from overt discrimination toward a more ingrained, implicit bias, and most published cases of bias and discrimination are in association with pregnancy. Conclusions: The first step toward addressing the issues facing women plastic surgeons is recognition and articulation of the issues. Further research may focus on analyzing geographic variation in the issues and developing appropriate interventions.

BRCA Mutations in the Young, High-Risk Female Population: Genetic Testing, Management of Prophylactic Therapies, and Implications for Plastic Surgeons

Summary: Growing public awareness of hereditary breast cancers, notably BRCA1 and BRCA2, and increasing popularity of personalized medicine have led to a greater number of young adult patients presenting for risk-reduction mastectomies and breast reconstruction. Plastic surgeons must be familiar with treatment guidelines, necessary referral patterns, and particular needs of these patients to appropriately manage their care. Genetic testing for BRCA1 and BRCA2 is most often reserved for patients older than the age of consent, and can be performed in the young adult population (aged 18 to 25 years) with the appropriate preemptive genetic counseling. Subsequent risk-reduction procedures are usually delayed until at least the latter end of the young adult age range, and must be considered on an individualized basis with regard for a patient's level of maturity and autonomy. Prophylactic mastectomies in young adults also can serve to aid the unique psychosocial needs of this population, although the long-term psychological and physical ramifications must be considered carefully. With the development of nipple-sparing mastectomy and improvement in reconstructive techniques, risk-reducing surgery has become more accepted in the younger population. Immediate, implant-based reconstruction is a common reconstructive technique in these patients but requires extensive discussion regarding reconstructive goals, the risk of possible complications, and long-term implications of these procedures. Comprehensive, continuous support with multispecialty counseling is necessary throughout the spectrum of care for the high-risk, young adult patient.

Mastering Medical Photography of the Head and Neck

No abstract available

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 anatomical description of their location and their functional behavior during the application of soft-tissue fillers remains elusive. Methods: The authors 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-position, contrast-enhanced computed tomographic scanning, and additional magnetic resonance imaging were performed. Three-dimensional 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), or the superior (rp = −0.32, p = 0.41) or 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.

Treating Breast Conservation Therapy Defects with Brava and Fat Grafting: Technique, Outcomes, and Safety Profile

No abstract available

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 filler into the arterial circulation occurs and, unrecognized, is irreparably associated with disastrous vascular complications. Of note, the site of complications, irrespective of the injection site, is similar, and falls into only five areas of the face, all within the functional angiosome of the facial or ophthalmic artery. Methods: Retrospective and prospective studies were performed to assess the site and behavior 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 analyzed. Results were compared with documented patterns of necrosis following inadvertent hyaluronic acid intraarterial or intravenous injection. Results: Studies showed that the location of true and choke anastomoses connecting the facial artery with neighboring angiosomes predicted the tissue at risk of necrosis following inadvertent intraarterial hyaluronic acid injection. Conclusion: Complications related to hyaluronic acid injections are intimately associated with (1) the anatomical distribution of true and choke anastomoses connecting the facial artery to neighboring 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 (2) retrograde perfusion of hyaluronic acid into avalvular facial veins, especially in the periorbital region, and thereby the ophthalmic vein, cavernous sinus, and brain.

A New Microtia Reconstruction Method Using Delayed Postauricular Skin Flap

No abstract available

Intralesional Laser Treatment for Dermal Filler Complications

Background: For complications caused by filler treatments, in general, two treatment regimens are advised: systemic drugs and surgical removal of the material. Another possible treatment option would be removal of the material by intralesional laser treatment. Methods: Two hundred forty-two patients with complications caused by fillers were treated with intralesional laser treatment. Results: In the majority of patients, an improvement was achieved (92 percent), in 9 percent the complication was resolved, and in 3 percent it was not improved (unknown in the rest). Conclusion: Considering the large number of patients treated until now and the efficacy and good safety profile of this treatment, the authors plead that intralesional laser treatment may be considered as a treatment option before surgery. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

ASPS/PSF Sponsored Symposia and Workshops

No abstract available

Motiva Ergonomix Round SilkSurface Silicone Breast Implants: Outcome Analysis of 100 Primary Breast Augmentations over 3 Years and Technical Considerations

Background: Macrotextured anatomical implants are frequently used in aesthetic breast surgery; however, several safety concerns linked to this implant type have been raised recently. In an attempt to address these shortcomings, Motiva Ergonomix implants have been introduced. Here, the authors describe the current world's largest experience with these novel devices in aesthetic breast surgery and evaluate the postoperative outcome of 100 primary breast augmentations. Methods: A retrospective assessment of 100 consecutive primary breast augmentation patients over a period of 3 years was conducted. Patients were followed for a minimum of 6 months postoperatively. Demographics, surgical data, and complications were recorded. In addition, a survey regarding the breast augmentation outcome was performed. Results: The reasons for surgery were mainly hypoplasia (52 percent) and ptosis (28 percent). All implants were placed by means of an inframammary approach in a submuscular pocket, and the average implant volume was 370 cc (range, 150 to 700 cc) with mostly full projection (65 percent). The revision rate was 7 percent. The authors observed four cases of implant malpositioning, one implant rupture, one implant exchange for aesthetic reasons, and one hematoma evacuation. Nevertheless, the authors achieved a 100 percent satisfaction rate with the postsurgical outcome among both patients and surgeons. Conclusions: Motiva Ergonomix implants provide reliable and satisfying results for both patients and surgeons. They can be used safely and effectively for aesthetic breast surgery. However, like all breast prostheses, Motiva Ergonomix implants are not completely free of complications and should be used only with advanced technique to achieve optimal results. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Optimization of Type 3 protein secretion in enteropathogenic E.coli

Abstract

The type 3 secretion system (T3SS) is a protein export pathway common to Gram-negative pathogens. It comprises a trans-envelope syringe, the injectisome, with a cytoplasm-facing translocase channel. In enteropathogenic E.coli, exported substrates are chaperone-delivered to the major translocase component, EscV and cross the membrane in strict hierarchical manner, e.g. first 'translocators', then 'effectors'. The in vitro dissection of T3SS and the determination of its structure are hampered by the low numbers of the injectisomes per cell. We have now defined an optimal M9 minimal medium and established that the per transcriptional regulator enhances the number of filamented cells, the number of injectisomes per cell and the secretion of T3S substrates. Our findings provide a valuable tool for further biochemical and biophysical analysis of the T3SS and suggest that additional improvement to maximize injectisome production is possible in future efforts.

Photoirradiated caffeic acid as an antimicrobial treatment for fresh produce

Abstract

The antimicrobial efficacy of 400 nm photoirradiated caffeic acid (CA, 5 mM) was evaluated against Escherichia coli O157:H7 and Listeria innocua. A stronger antimicrobial effect was observed on E. coli than on L. innocua where the combined treatment resulted in 4 and 1 log(CFU/mL) reductions, respectively. The treatment's effects on cellular metabolism (resazurin assay), uptake of caffeic acid (fluorescence technique) and membrane damage (propidium iodide assay) were studied in both species. Caffeic acid uptake increased in both species, but membrane damage was only observed in E. coli O157:H7. The treatment had minimal impact on metabolic activity in both species. The treatment applied to the surface of spinach leaves was found to be effective against E. coli O157:H7. The novel treatment proposed in this study has the potential to improve the microbial food safety of fresh produce.

The content of essential and toxic elements in the hair of the mane of the trotter horses depending on their speed

Abstract

A study on the Russian trotting breeds was conducted to assess the impact of horses' sporting results and the degree of accumulation of chemical elements in the hair. In the first phase of the research, the elemental composition of the mane hair of trotter horses (n = 215) was studied. Based on these studies, percentile intervals for the distribution of concentrations of chemical elements in the hair have been established, and the values of 25 and 75 percentile adopted as a "physiological standard" have been defined. In the second stage of the research into clinically healthy Russian trotting breeds (n = 56), it was estimated that the sporting results were dependent on the elemental status defined by the hair. The elemental composition of the hair was defined by 25 chemical elements using atomic emission and mass spectrometry. It is established that the mane hair is closely related to the sporting results of trotter horses. Thus, in animal wool with the highest sporting achievements, there were reliably less I, Cr, Co, Li, V, Al, Pb, and Cd, and reliably more Si than the low ones. Differences in individual elements exceeded 200%. As sporting performance diminished, the number of elements within the standard increased. For example, for mares with average speed, there were deviations from the physiological standard by 6 elements (P, Fe, Mn, I, Co, Si), with the low one by 13 elements (P, Fe, Cu, Mn, I, Co, Si, K, Cr, Ni, V, Al, Pb). A comparative estimate of the mineralization of the horses' mane measured by the sum of the amount of substances showed that there was a negative correlation between the accumulation of toxic elements and the speed (r = − 0.59). On the basis of the above, a conclusion is reached on the future use of the mane hair to assess the speed qualities of trotter horses.

Optimization of operating conditions for the valorization of olive mill wastewater using membrane processes

Abstract

The main goal of this work was to assess the performance of an integrated membrane system for the treatment and valorization of wastewater generated from an olive mill (OMW) coming from a traditional extraction press. Two different lots of this effluent were firstly processed in an ultrafiltration (UF) pilot unit after a pretreatment by screening. The effect of transmembrane pressure (TMP) and temperature on the chemical oxygen demand (COD) reduction and removal of total phenolic (TPh) content was investigated. Under optimal conditions (TMP = 1.5 bar and T = 20 °C), 20.6 and 26.8% for COD and TPh removal were achieved, respectively. The permeate from UF was then treated by nanofiltration (NF) in order to obtain a retentate enriched in phenolic compounds. The influence of pressure drop (ΔP), temperature, and pH on the removal of COD, TPh, and permeate flow was examined using a 2³ full-factorial experimental design. The effect of the independent variables and their interactions on the process performance was analyzed with Pareto charts. Multivariable regression models allowed to built 3D surface plots. The best conditions that maximize the COD abatement (83.3%) and TPh removal (93.1%) were ΔP = 18 bar, T = 20 °C, and a pH 2.7. It can be concluded that the integration of UF and NF processes investigated in this work is a promising strategy for the treatment and valorization of OMW.

Adsorptive removal of phenolic compounds from aqueous solutions using pine cone biomass: kinetics and equilibrium studies

Abstract

In this study, a novel inexpensive biosorbent of pine cone powder was used for the treatment of wastewater contaminated with phenol and chlorophenols (CPhs). The biosorbent was thoroughly characterized by using CHN and BET measurements, as well as FTIR, SEM, and XRD analyses. Kinetic and equilibrium biosorption experiments showed that the uptake was more than 80% within the first 30 min of contact time at pH 5.0. The biosorption of 4-CPh onto pine cone powder was higher than those of phenol and 2-CPh. The kinetic data were consistent with the pseudo-first-order kinetic model, and the Langmuir isotherm model best represented the equilibrium data. The maximum biosorption capacities of phenol, 2-CPh, and 4-CPh were 164.51, 189.44, and 220.12 mg/g, respectively, at 30 ± 1 °C. Therefore, the pine cone powder is an effective low-cost adsorbent for the removal of phenol and CPhs from the contaminated water.

Missing Video and Citation

In the Original Investigation titled "Association of Nasal Tip Rotation Outcome Estimation With the New Domes Technique in Primary Rhinoplasty," published online February 22, 2018, the video and citation to the video were missing. This article has been corrected online.

Risk of Venous Thromboembolism in Patients With Keratinocyte Carcinoma

This population-based analysis uses data from a US nationwide insurance claims database to assess the risk of venous thromboembolism associated with keratinocyte carcinoma within 1 year following the date of diagnosis and compares rates of venous thromboembolism among patients with or without cancer.

Multiples Myelom und seine Vorstufen

Zusammenfassung

Hintergrund

Das multiple Myelom (MM) ist mit einer Inzidenz von etwa 7 Neuerkrankungen pro 100.000 Einwohner die zweithäufigste maligne hämatologische Erkrankung, die bei der weit überwiegenden Zahl von Patienten unheilbar bleibt. Vor diesem Hintergrund gewinnt die Erfassung der körperlichen und mentalen gesundheitsbezogenen Lebensqualität zunehmend an Bedeutung. Dem Vollbild des symptomatischen MM gehen prämaligne Stadien voraus. Die monoklonale Gammopathie unbestimmter Signifikanz (MGUS) kann mit einer Prävalenz von 1–3 %/Jahr in ein MM übergehen. Für das sog. „smoldering" MM (SMM) beträgt die Wahrscheinlichkeit eines Übergangs zum symptomatischen MM durchschnittlich 10 %/Jahr.

Fragestellung

Die Befunde zur gesundheitsbezogenen Lebensqualität und psychischen Belastung bei MM sollten gesichtet und eingeordnet und die psychischen Belastungen („distress") von Patienten mit MM und von Menschen mit dessen prämalignen Stadien (MM/SMM) verglichen werden.

Material und Methode

Es wurden eine Literaturrecherche durchgeführt und eigene Versorgungsdaten ausgewertet.

Ergebnisse

Während zur Lebensqualität und psychischen Belastung bei MM einige Untersuchungen vorliegen, gibt es bisher kaum Erhebungen dieser Aspekte bei Patienten mit SMM oder MGUS. Vergleiche hinsichtlich der psychischen Belastung zeigten (im Vergleich zum MM) ähnlich hohe Ausprägungsgrade bei Patienten mit MGUS und SMM.

Schlussfolgerungen

In Zukunft sollten weitere Untersuchungen zur gesundheitsbezogenen Lebensqualität und psychischen Belastung bei MGUS, SMM und MM durchgeführt werden. In einem weiteren Schritt könnte es sinnvoll sein, longitudinale Erhebungen mit wiederholten Messungen durchzuführen, um mehr über Prädiktoren und den Verlauf erfahren und entsprechende Unterstützungsangebote unterbreiten zu können.

Food dependent exercise induced anaphylaxis to soybean

Publication date: Available online 23 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Neema Izadi, Rabinovitch Nathan

Limited ability of recombinant Hymenoptera venom allergens to resolve IgE double sensitization

Publication date: Available online 23 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Julij Šelb, Urška Bidovec Stojković, Nissera Bajrović, Peter Kopač, Renato Eržen, Mihaela Zidarn, Mitja Košnik, Peter Korošec

Sesame: an unrecognized trigger of food protein-induced enterocolitis syndrome

Publication date: Available online 23 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Adi Ovadia, Amit Nahum, Diana Tasher, Shirli Abiri, Larisa Epov, Aharon Kessel, Ilan Dalal

Use of omalizumab in uncontrolled chronic spontaneous urticaria also improved latex induced contact urticaria

Publication date: Available online 23 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Elisabetta Di Leo, Gianfranco Calogiuri, Luigi Macchia, Eustachio Nettis

Safety and Outcomes of Oral Graded Challenges to Amoxicillin without Prior Skin Testing

Publication date: Available online 23 May 2018
Source:The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Melissa Iammatteo, Santiago Alvarez Arango, Denisa Ferastraoaru, Nadeem Akbar, Andrew Y. Lee, Hillel W. Cohen, Elina Jerschow
BackgroundUnconfirmed penicillin allergy poses substantial public health consequences. The most widely accepted protocol to evaluate penicillin allergy is skin testing followed by amoxicillin challenge.ObjectiveTo evaluate the safety of direct oral graded challenges to amoxicillin.MethodsProspective single-blind clinical trial with historical controls of patients ≥ 7 years old with historical non-life-threatening reactions to penicillin. Patients received placebo followed by a 2-step graded challenge to amoxicillin. The allergic reaction rate was compared to the rate observed in our previous study that included skin testing and to the currently reported penicillin allergy prevalence in the US population.ResultsOf the 155 participants who completed an amoxicillin challenge, 120 patients (77.4%) experienced no reaction while 31 patients (20%) experienced non-allergic reactions to either placebo (n=16) or amoxicillin (n=15). Four patients (2.6%) developed mild allergic reactions. Significantly (p=0.03) fewer patients [4/155, 2.6%, 95% CI (1.0%, 6.5%)] were determined to be allergic compared to 14/170 subjects [(8.2%, 95% CI (5.0%, 13.4%)] in our previous study where patients were determined to be allergic based on either positive skin tests (n=11) or allergic challenge reactions after negative skin tests (n=3). This 2.6% reaction rate was also significantly less than the 10% reported US prevalence of penicillin allergy (p=0.003).ConclusionsPlacebo-controlled oral graded challenges to amoxicillin without prior skin testing may be safe for patients ≥ 7 years old with non-life-threatening historical reactions to penicillin. Amoxicillin can be tolerated by the majority of patients with self-reported penicillin allergy.

Raman spectroscopy quantification of eumelanin subunits in natural unaltered pigments

Pigment Cell &Melanoma Research, EarlyView.

In This Issue

Mincle: 20 years of a versatile sensor of insults

Abstract

Macrophage-inducible C-type lectin, better known as Mincle, is a member of the C-type lectin receptor family and is encoded by Clec4e. Mincle was an orphan receptor for a long time after having been discovered as a lipopolysaccharide-induced protein, yet later an adjuvant glycolipid in mycobacteria—trehalose dimycolate—was identified as a ligand. Ligands for Mincle were also found existing in bacteria, fungi and even mammals. When confronted with foreign elements, Mincle can recognize characteristic pathogen-associated molecular patterns, mostly glycolipids, from Mycobacterium tuberculosis and other pathogens, and thus induce immune responses against infection. To maintain self-homeostasis, Mincle can recognize lipid-based damage-associated molecular patterns, thereby monitoring the internal environment. The mechanism by which Mincle functions in the immune system is also becoming more clear along with the identification of its ligands. Being expressed widely on antigen-presenting cells, Mincle activation leads to the production of cytokines and chemokines, neutrophil infiltration and other inflammatory responses. Besides, Mincle can induce acquired immunity such as antigen-specific T-cell responses and antibody production as an adjuvant receptor. In this review, we will retrospectively sketch the discovery and study of Mincle, and outline some current work on this receptor.

Nodules péniens artificiels

Publication date: Available online 23 May 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): A. Kervyn, A. Le Guern, A. Thieffry, A. Greliak, P. Modiano

Nuevas perspectivas en el tratamiento de la alopecia androgenética

Publication date: Available online 23 May 2018
Source:Actas Dermo-Sifiliográficas
Author(s): J. Ferrando

Case of xeroderma pigmentosum group A with West syndrome

The Journal of Dermatology, EarlyView.

The challenge of diagnosing seborrheic keratosis by reflectance confocal microscopy

Skin Research and Technology, EarlyView.

Effects of humidity on skin friction against medical textiles as related to prevention of pressure injuries

International Wound Journal, EarlyView.

Use of split‐thickness plantar skin grafts in the management of leg and foot skin defects

International Wound Journal, EarlyView.

The Ghent Global IAD Monitoring Tool (GLOBIAD‐M) to monitor the healing of incontinence‐associated dermatitis (IAD): Design and reliability study

International Wound Journal, EarlyView.

Paraneoplastic pemphigus in Russian patients: a single center case series

International Journal of Dermatology, EarlyView.

Complex regional pain syndrome of the face in a child

International Journal of Dermatology, EarlyView.

Unravelling motor behaviour hallmarks in intoxicated adolescents: methylmercury subtoxic-dose exposure and binge ethanol intake paradigm in rats

Abstract

Methylmercury (MeHg) is a hazardous environmental pollutant, affecting Amazon basin communities by anthropogenic activities. The exact safe level of MeHg exposure is unclear, despite the efforts of health international societies to avoid mercury (Hg) poisoning. Central nervous system is severely impacted by Hg intoxication, reflecting on motor impairment. In addition, alcohol has been associated to an overall brain damage. According to lifestyle of Amazon riverside communities, alcohol intake occurs frequently. Thus, we investigated if continuous MeHg exposure at low doses during adolescence displays motor deficits (experiment 1). In the experiment 2, we examine if the co-intoxication (i.e. MeHg plus ethanol exposure) during adolescence intensify motor damage. In the experiment 1, Wistar adolescent rats (31 days old) received chronic exposure to low dose (CELD) of MeHg (40 μg/kg/day) for 35 days. For the experiment 2, five sessions of alcohol binge drinking paradigm (3ON-4OFF; 3.0 g/kg/day) were employed associated to MeHg intoxication. Motor behaviour was evaluated by the open field, pole test, beam walking and rotarod paradigms. CELDS of MeHg display motor function damage, related to hypoactivity, bradykinesia-like behaviour, coordination deficits and motor learning impairment. Co-intoxication of MeHg plus ethanol reduced cerebellar Hg content, however also resulted in motor behavioural impairment, as well as additive effects on bradykinesia and fine motor evaluation.

The Role of Dynamic m6A RNA Methylation in Photobiology

Photochemistry and Photobiology, EarlyView.

Erythrocyte acetylcholinesterase as biomarker of pesticide exposure: new and forgotten insights

Abstract

Acetylcholinesterase (AChE) acts on the hydrolysis of acetylcholine, rapidly removing this neurotransmitter at cholinergic synapses and neuromuscular junctions as well as in neuronal growth and differentiation, modulation of cell adhesion ("electrotactins") and aryl-acylamidase activity (AAA). This enzyme is also found in erythrocyte, as 160 kDa dimer that anchors to the plasma membrane via glycophosphatidylinositol. The function of this enzyme in erythrocytes has not yet been elucidated; however, it is suspected to participate in cell-to-cell interactions. Here, a review on erythrocyte AChE characteristics and use as biomarker for organophosphorus and carbamate insecticides is presented since it is the first specific target/barrier of the action of these pesticides, besides plasma butyrylcholinesterase (BChE). However, some past and current methods have disadvantages: (a) not discriminating the activities of AChE and BChE; (b) low accuracy due to interference of hemoglobin in whole blood samples. On the other hand, extraction methods of hemoglobin-free erythrocyte AChE allows: (a) the freezing and transporting of samples; (b) samples free of colorimetric interference; (c) data from only erythrocyte AChE activity; (d) erythrocyte AChE specific activity presents higher correlation with the central nervous system AChE than other peripheral ChEs; (e) slow spontaneous regeneration against anti-ChEs agents of AChE in comparison to BChE, thus increasing the chances of detecting such compounds following longer interval after exposure. As monitoring perspectives, hemoglobin-free methodologies may be promising alternatives to assess the degree of exposure since they are not influenced by this interfering agent.

Atypical presentation of Dowling–Degos disease with novel and recurrent mutations in POFUT1

Clinical and Experimental Dermatology, EarlyView.

Associations between maternal exposure to air pollution and birth outcomes: a retrospective cohort study in Taizhou, China

Abstract

Previous studies from Western country settings had shown correlation between maternal exposure to air pollution and pregnancy outcomes; however, the evidence is difficult to clearly interpret. We aimed to investigate the association of maternal exposure to air pollution expressed as particulate matter (PM_2.5, PM₁₀) and nitrogen dioxide (NO₂). The exposure was assessed for the 1st, 2nd, and 3rd trimester and related to the birth outcomes. During each trimester of gestation, the effect of PM_2.5, PM₁₀, and NO₂ exposure as well as the entire pregnancy on the preterm birth, low birth weight, and term babies' birth weight was explored. The dataset of 26,998 delivered live births between January 1, 2013 and May 31, 2016, were collected from the Taizhou Maternal and Child Care Service Center. Air monitoring data were collected from the Taizhou Municipal Environmental Monitoring Center for the same period. We used multi-variable logistic and linear regression analyses to investigate the correlation of air pollution to maternal and outcomes of birth. In models of adjusted single pollutant for second trimester, NO₂ concentration was positively correlated with term low birth weight and preterm birth [aRR for an interquartile range increase: 1.59 (1.44, 1.75); 1.27 (1.12, 1.44)]; likewise, a 1 μg/m³ increase in NO₂ was correlated with a reduction in birth weight 2.94 g (P < 0.001) in linear models. Each of PM_2.5 and PM₁₀ concentration was also associated with preterm birth [aRR for an interquartile range increase 1.30 (1.21, 1.38); 1.39 (1.27, 1.52)]. In co-pollutant models, the results were similar. Maternal exposure to air pollutant in Taizhou was associated with an increased risk of preterm birth and reduction in birth weight. We reported a potential link between maternal exposure to air pollution and negative outcomes of birth in Taizhou, China.