Publication date: Available online 18 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): V. Sibaud, S. Boulinguez, C. Pagès, L. Riffaud, L. Lamant, C. Chira, S. Boyrie, E. Vigarios, E. Tournier, N. Meyer
Le développement des inhibiteurs de checkpoints immunologiques (anticorps monoclonaux anti-PD-1/PD-L1, anti-CTLA-4) représente une avancée considérable dans la prise en charge de nombreux cancers. Étant donné leur mécanisme d'action particulier qui induit l'activation et la prolifération des lymphocytes T CD4+/CD8+, ils s'associent à un profil de tolérance tout à fait spécifique. Leurs effets indésirables sont avant tout d'ordre immunologique (immune-related adverse events) et peuvent concerner l'ensemble des organes. Dans ce cadre, la toxicité dermatologique est la plus fréquente, même si elle reste le plus souvent d'intensité légère à modérée et ne limite habituellement pas la poursuite de l'immunothérapie. Plus d'un tiers des patients traités peuvent développer des symptômes dermatologiques, le plus souvent sous la forme d'un exanthème maculo-papuleux, d'un prurit ou d'un vitiligo (ce dernier uniquement chez les patients traités pour mélanome). Des dermatoses beaucoup plus spécifiques peuvent cependant apparaître : réactions lichénoïdes, psoriasis induit, sarcoïdose, maladies auto-immunes (pemphigoïde bulleuse, dermatomyosite, pelade), lésions acnéiformes, xérostomie…Il est donc nécessaire de systématiquement caractériser cliniquement et histologiquement ces lésions en cas de formes atypiques, persistantes ou sévères. Cet article synthétise les principales toxicités dermatologiques rapportées avec les inhibiteurs de checkpoints immunologiques ainsi que leur incidence et décrit les principes de leur prise en charge.The development of immune checkpoint inhibitors (monoclonal antibodies targeting PD-1/PD-L1 or CTLA-4) represents a significant advance in the treatment of multiple cancers. Given their particular mechanism of action, which involves triggering CD4+/CD8+ T-cell activation and proliferation, they are associated with a specific safety profile. Their adverse events are primarily immune-related, and can affect practically all organs. In this context, dermatological toxicity is the most common, though it mostly remains mild to moderate and does not require discontinuation of treatment. More than a third of patients are faced with cutaneous adverse events, usually in the form of a maculopapular rash, pruritus or vitiligo (only in patients treated for melanoma). Much more specific dermatologic disorders, however, may occur such as lichenoid reactions, induced psoriasis, sarcoidosis, auto-immune diseases (bullous pemphigoid, dermatomyositis, alopecia areata), acne-like rash, xerostomia, etc. Rigorous dermatological evaluation is thus mandatory in the case of atypical, persistent/recurrent or severe lesions. In this article, we review the incidence and spectrum of dermatologic adverse events reported with immune checkpoint inhibitors. Finally, a management algorithm is proposed.
Παρασκευή 20 Απριλίου 2018
Toxicités dermatologiques des inhibiteurs de checkpoint immunologiques
Granulome de Lever extra-facial sur cicatrice de zona : une réaction isotopique de Wolf
Publication date: Available online 17 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): E. Melgar, J. Henry, A. Valois, M.-B. Dubois-Lacour, F. Truchetet, B. Cribier, J.-F. Cuny
IntroductionLe granulome de Lever est une affection dermatologique rare qui se localise classiquement sur le visage. Nous rapportons l'observation d'un granulome de Lever extra-facial apparu sur des cicatrices de zona du tronc, ce qui constitue une réaction isotopique particulière.ObservationUn homme de 60 ans consultait pour une lésion cutanée prurigineuse évoluant depuis deux mois. Il avait comme unique antécédent un zona lombaire gauche. À l'examen, nous constations une plaque érythémateuse infiltrée de 2,5cm de diamètre dans la région para-vertébrale lombaire gauche. Le bilan biologique était normal. L'examen histologique révélait un processus inflammatoire sans néovaisseaux, riche en éosinophiles, avec vasculite chronique et infiltrat polymorphe, permettant de retenir le diagnostic de granulome de Lever.DiscussionLe granulome de Lever est une forme localisée de vasculite des petits vaisseaux du derme. Bien qu'il touche généralement le visage, les atteintes extra-faciales existent. Le caractère original de cette présentation, hormis sa localisation, réside dans le fait que le granulome s'était développé sur une cicatrice de zona, ce qui correspond à une réaction isotopique de Wolf. Ce phénomène, décrit par R. Wolf, est l'apparition d'une nouvelle dermatose sur le lieu d'une ancienne dermatose guérie, le plus souvent herpétique. La physiopathologie est encore incertaine. Cette réaction est différente des réactions isomorphiques de type Koebner, où il s'agit de l'apparition d'une dermatose déjà connue sur le lieu d'un traumatisme, et non d'une nouvelle dermatose.ConclusionNous décrivons un cas, à notre connaissance jamais rapporté dans la littérature, de réaction isotopique de Wolf avec un granulome de Lever extra-facial.BackgroundGranuloma faciale (GF), or facial granuloma of Lever, is an uncommon dermatosis occurring classically on the face. We report a case of a GF on zoster scars located on the trunk, which is a highly particular isotopic response.Patients and methodsA 60-year-old man with a sole history of left lumbar zoster presented with a skin lesion present for two months. Clinical examination revealed a 2.5-cm papular erythematous lesion that was both infiltrated and pruritic. This lesion was situated precisely on zoster scars. Lab tests revealed no abnormalities. Histopathologic examination showed an inflammatory process without neovessels but rich in eosinophils with chronic vasculitis and polymorphic infiltrate, on which basis GF was diagnosed.DiscussionGF is a localized form of cutaneous small-vessel vasculitis. Although it usually affects the face, extra-facial locations also exist. The original character of this presentation, aside from the location, is the occurrence of this GF on a zoster scar, which corresponds to Wolf's isotopic response. This phenomenon, described by R. Wolf, comprises the occurrence of a new skin disorder at the site of another unrelated and already healed skin disease, usually herpes. The physiopathology is still unclear. This differs from isomorphic reactions such as Koebner's reaction, which consists of the appearance at an injury site of skin lesions typical of an existing dermatosis but not a new disorder.ConclusionThis is a rare case of Wolf's isotopic response with GF, of which, to our knowledge, there are no reports in the literature.
Maladie de Paget sur sein surnuméraire
Publication date: Available online 16 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): M.-H. Jegou, E. Lorier-Roy
IntroductionLa maladie de Paget mammaire est rare. Elle est exceptionnelle sur sein surnuméraire, où son diagnostic est retardé par méconnaissance de la pathologie du sein ectopique et défaut d'explorations. À partir d'un cas clinique original, nous faisons le point clinique sur le sein ectopique et ses carcinomes, dont la maladie de Paget.ObservationUne femme de 44 ans signalait depuis quelques mois une douleur dans la zone d'un sein surnuméraire. Une exploration par échographie était normale, mais la symptomatologie inexpliquée conduisait à proposer une exérèse. Celle ci était en faveur d'une maladie de Paget strictement intra-épidermique de 2 millimètres, non associée à un carcinome sous-jacent. La patiente était traitée par exérèse élargie. Une surveillance à un an ne montrait pas de récidive.DiscussionLe sein ectopique, présent dans 6 % de la population, est un « laissé pour compte », alors qu'il peut avoir les mêmes pathologies que le sein anatomique : il est à l'origine de 0,6 % des cancers mammaires. La maladie de Paget est un adénocarcinome in situ rare, représentant moins de 3 % des cancers mammaires. Elle est exceptionnelle sur sein ectopique ; nous en rapportons ici le quatrième cas publié. L'originalité de notre observation tient à l'absence de signe clinique objectif à l'inspection. Des symptômes subjectifs localisés au sein surnuméraire, tels que douleur, picotements, sensations de brûlure ou de prurit, doivent être pris en compte pour permettre un diagnostic précoce de la maladie de Paget. L'échographie et la mammographie sont souvent pris en défaut. L'imagerie en résonance magnétique (IRM) peut être une bonne indication, mais n'est pas un examen de routine. L'avenir pourrait être au dépistage par microscopie confocale sur les seins ectopiques avec plaque aréolo-mamelonnaire, car cette technique peut permettre de visualiser les cellules de Paget et leur organisation.BackgroundPaget's disease of the breast is rare, even more so when it occurs in a supernumerary breast since diagnosis is delayed due to lack of exploration and ignorance of the pathology of ectopic breast. Based on an original clinical case, we provide a clinical update concerning ectopic breast and ectopic carcinoma, including Paget's disease.Patients and methodsA 44-year-old woman had complained of pain in the area of her supernumerary breast for several months. The ultrasound examination was normal but the unexplained symptoms led to performance of an excision biopsy of the lesion. This showed strictly intra-epidermal Paget's disease measuring 2mm, without any underlying carcinoma. A wider excision was performed. Follow-up at one year showed no recurrence.DiscussionAn ectopic breast, present in 6 % of the population, is often ignored, despite being subject to the same diseases as anatomical breasts: it is at the origin of 0.6 % of breast cancers. Paget's disease is a rare in situ adenocarcinoma comprising fewer than 3 % of cases of breast cancer. It is extremely rare in ectopic breast. Ours is only the fourth reported case in the literature. This case is original because of the lack of objective clinical signs. Subjective symptoms such as pain, tingling, burning sensation and pruritus related to the supernumerary breast must be taken into consideration in order to enable early diagnosis of Paget's disease. Exploration by ultrasound and mammography generally appears flawed. Breast MRI may be useful but is not performed routinely. A promising future approach may consist of confocal microscopy screening of all ectopic breasts with areola or nipple patches, since this method enables the visualization of Paget cells and their organization.
Dermatite lichénoïde annulaire du sujet jeune : un cas et revue de la littérature
Publication date: Available online 16 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): D. Debois, J.-L. Dargent, P. Ngendahayo, P.-P. Roquet-Gravy
IntroductionNous rapportons un cas de dermatite lichénoïde annulaire du sujet jeune (DLAJ). Il s'agit d'une dermatose lichénoïde rare affectant principalement la population pédiatrique et présentant des caractéristiques histocliniques stéréotypées. C'est à notre connaissance le premier cas publié dans la littérature francophone.ObservationUne fille de 5 ans présentait une lésion abdominale isolée persistant depuis plus d'un an. Il s'agissait d'une lésion annulaire constituée d'une bordure érythémateuse légèrement surélevée et d'un centre hypopigmenté. L'utilisation de dermocorticoïdes et de pimécrolimus 1 % topique ne permettait qu'une amélioration clinique transitoire, la lésion récidivant systématiquement dès leur arrêt.DiscussionUne soixantaine de cas de dermatite lichénoïde annulaire du sujet jeune ont été décrits dans la littérature anglophone. Le diagnostic différentiel principal est le mycosis fongoïde de l'enfant, dans sa variante hypopigmentée. La biopsie est nécessaire au diagnostic et montre des signes histologiques caractéristiques. Il s'agit d'une réaction inflammatoire de type lichénoïde constituée de lymphocytes polyclonaux CD4+ et CD8+, en l'absence de lymphocytes atypiques ou d'épidermotropisme. La réaction inflammatoire prédomine au sommet des crêtes épidermiques et est associée à une nécrose des kératinocytes. De manière caractéristique, les crêtes épidermiques prennent ainsi une forme particulière, quadrangulaire.ConclusionLa DLAJ constitue une entité méconnue parmi les dermatoses lichénoïdes. La corrélation anatomoclinique est essentielle au diagnostic. L'étiologie n'est pas connue et l'évolution est chronique dans la majorité des cas.BackgroundAnnular lichenoid dermatitis of youth (ALDY) is a rare form of dermatitis mainly affecting children and young people. All cases reported show a consistent clinical and histological picture. This is the first case described in the French literature.Patients and methodsA 5-year-old girl presented an annular isolated patch of the lower abdomen with an erythematosquamous border and central hypopigmentation for one year. Topical corticosteroids and pimecrolimus proved effective but relapse occurred after treatment withdrawal.DiscussionOver sixty cases of ALDY are described in the English-language medical literature. The main differential diagnosis is childhood mycosis fungoides, particularly the hypopigmented variant. Biopsy is necessary for diagnosis since it can reveal typical histological features. Histopathology in all cases shows lichenoid reaction with CD4+ and CD8+ polyclonal lymphocytes. It is limited to the tips of rete ridges and associated with apoptosis of keratinocytes resulting in quadrangular-shaped rete ridges. Our case does not demonstrate either epidermotropism or atypical lymphocytes.ConclusionAnnular lichenoid dermatitis of youth (ALDY) is a poorly known distinctive entity within the lichenoid dermatitis family. Clinical-histological correlation is essential to diagnosis. The etiology is still unknown and the course is mostly chronic.
Drogues et peau : ce qu’il faut savoir. L’exemple du cannabis
Publication date: Available online 16 April 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): D. Tennstedt
Éditorial
Source:Annales de Dermatologie et de Vénéréologie
Author(s): C. Dangoisse
Editorial board
Source:Annales de Dermatologie et de Vénéréologie, Volume 145, Supplement 1
Pentachlorophenol dechlorination with zero valent iron: a Raman and GCMS study of the complex role of surficial iron oxides
Abstract
The dechlorination of chlorinated organic pollutants by zero valent iron (ZVI) is an important water treatment process with a complex dependence on many variables. This complexity means that there are reported inconsistencies in terms of dechlorination with ZVI and the effect of ZVI acid treatment, which are significant and are as yet unexplained. This study aims to decipher some of this complexity by combining Raman spectroscopy with gas chromatography-mass spectrometry (GC-MS) to investigate the influence of the mineralogy of the iron oxide phases on the surface of ZVI on the reductive dechlorination of pentachlorophenol (PCP). Two electrolytic iron samples (ZVI-T and ZVI-H) were found to have quite different PCP dechlorination reactivity in batch reactors under anoxic conditions. Raman analysis of the "as-received" ZVI-T indicated the iron was mainly covered with the ferrous oxide (FeO) wustite, which is non-conducting and led to a low rate of PCP dechlorination. In contrast, the dominant oxide on the "as-received" ZVI-H was magnetite which is conducting and, compared to ZVI-T, the ZVI-H rate of PCP dechlorination was four times faster. Treating the ZVI-H sample with 1 N H2SO4 made small change to the composition of the oxide layers and also minute change to the rate of PCP dechlorination. However, treating the ZVI-T sample with H2SO4 led to the loss of wustite so that magnetite became the dominant oxide and the rate of PCP dechlorination increased to that of the ZVI-H material. In conclusion, this study clearly shows that iron oxide mineralogy can be a contributing factor to apparent inconsistencies in the literature related to ZVI performance towards dechlorination and the effect of acid treatment on ZVI reactivity.
Integrated effect of nutrients from a recirculation aquaponic system and foliar nutrition on the yield of tomatoes Solanum lycopersicum L. and Solanum pimpinellifolium
Abstract
The objective of this study was to evaluate the potential of tomato plants to efficiently use the nitrogen (N) of a recirculation aquaponic system (RAS) and to evaluate the effects of foliar fertilization as a complement to the water nutrition on the growth of the two tomato cultivars. The significant effect of six macro- and seven micronutrients was evaluated on the plant growth and on the fruit yield. Two experiments were performed in a nutrient film aquaponic unit. The first experiment was designed to study the effects of foliar fertilization on the seedlings of two tomato cultivars Costoluto Genovese (CG) (Solanum lycopersicum L.) and Currant tomato (Ct) (Solanum pimpinellifolium) with 8% of weekly water exchange (WE8%-RAS). The foliar fertilizer was formulated with N restriction in the last 11 weeks (TF1). In the second experiment, two other foliar fertilization treatments (TF2 and TF3) were applied with a concentration of nutrients twice and triple that in TF1, but with a lower proportion of NPK ratio. These treatments were tested on the cultivar CG in a RAS with zero water exchange (WE0%-RAS). The data from the 1st experiment showed a positive effect of the foliar fertilization on the yield of both cultivars. The fertilization markedly influenced the dry matter weight of the CG; however, this effect was not observed in the Ct. The root length of both cultivars was positively influenced by the P content, whereas the plant height was affected by the excess of Co and S. According to the results from the 2nd experiment, the TF2 plants had the highest number of fruits with a high mean weight. The system was efficient in utilizing N from fish tank; the water K favored the yield of the CG fruit and the foliar K favored the growth of the TF2 plants. With a decrease in the foliar N, the CG plants were able to absorb 27.5% of the NO3− and 7.06% of total ammonia nitrogen from water. The absolute and relative growth rate of Nile tilapia was not affected by the rate of water exchange. Fulton's condition factor of the total length and weight curve indicated that fish from WE8%-RAS had wider bodies than the fish from WE0%-RAS at the same length range. Nitrate and P in the final effluent were lower than the maximum reference values allowed for the discharged water.
Performance and emission characteristics of a bio-lubricated two-stroke gasoline engine
Abstract
Two-stroke petrol engines find wide applications in the areas like chain saws, weed cutters, and power sprayers because of their compactness and higher power to weight ratio. In the present study, the feasibility of using vegetable-based lubricant instead of ordinary mineral 2 T oil is investigated. M15 (85% petrol + 15% methanol) and E15 (85% petrol + 15% ethanol) blend with gasoline are used as the fuel. Experiments were carried out in a two-stroke air-cooled engine equipped with a rope brake dynamometer. It is observed that the vegetable-based lubricant (sunflower oil) is miscible with the tested fuels. The frictional power for the vegetable-based lubricant was found to be less than that of mineral 2 T oil. The brake thermal efficiency improved and the brake-specific fuel consumption decreased for the sunflower oil-based lubricant. The combination of E15 + sunflower oil lubricant exhibited the greatest benefits, raising the brake thermal efficiency by 3.4% and reducing the brake-specific fuel consumption by 1.4%. Hydrocarbon and carbon monoxide emissions were lower for the vegetable-based lubricant than the 2 T mineral oil.
A new approach for the agglomeration and subsequent removal of polyethylene, polypropylene, and mixtures of both from freshwater systems – a case study
Abstract
Based on a new concept for the sustainable removal of microplastics from freshwater systems, a case study for a pH-induced agglomeration and subsequent removal of polyethylene and polypropylene particles from water is presented. The two-step-based process includes firstly a localization and secondly an aggregation of microplastic particles (250–350 μM) in a physicochemical process. The research describes a strong increase in the particle size independent of pH of the aquatic milieu induced by the addition of trichlorosilane-substituted Si derivatives. The resulting Si-based microplastic aggregates (particle size after aggregation is 2–3 cm) could be easily removed by use of, e.g., sand traps. Due to the effect that microplastic particles form agglomeration products under every kind of process conditions (e.g., various pH, various polymer concentrations), the study shows a high potential for the sustainable removal of particles from wastewater.
BRC4Env, a network of Biological Resource Centres for research in environmental and agricultural sciences
Abstract
The Biological Resource Centre for the Environment BRC4Env is a network of Biological Resource Centres (BRCs) and collections whose leading objectives are to improve the visibility of genetic and biological resources maintained by its BRCs and collections and to facilitate their use by a large research community, from agriculture research to life sciences and environmental sciences. Its added value relies on sharing skills, harmonizing practices, triggering projects in comparative biology, and ultimately proposing a single-entry portal to facilitate access to documented samples, taking into account the partnership policies of research institutions as well as the legal frame which varies with the biological nature of resources. BRC4Env currently includes three BRCs: the Centre for Soil Genetic Resources of the platform GenoSol, in partnership with the European Conservatory of Soil Samples; the Egg Parasitoids Collection (EP-Coll); and the collection of ichthyological samples, Colisa. BRC4Env is also associated to several biological collections: microbial consortia (entomopathogenic bacteria, freshwater microalgae…), terrestrial arthropods, nematodes (plant parasitic, entomopathogenic, animal parasitic...), and small mammals. The BRCs and collections of BRC4Env are involved in partnership with academic scientists, as well as private companies, in the fields of medicinal mining, biocontrol, sustainable agriculture, and additional sectors. Moreover, the staff of the BRCs is involved in many training courses for students from French licence degree to Ph.D, engineers, as well as ongoing training.
Combined acute ecotoxicity of malathion and deltamethrin to Daphnia magna (Crustacea, Cladocera): comparison of different data analysis approaches
Abstract
We studied the combined acute effect (i.e., after 48 h) of deltamethrin (a pyrethroid insecticide) and malathion (an organophosphate insecticide) on Daphnia magna. Two approaches were used to examine the potential interaction effects of eight mixtures of deltamethrin and malathion: (i) calculation of mixture toxicity index (MTI) and safety factor index (SFI) and (ii) response surface methodology coupled with isobole-based statistical model (using generalized linear model). According to the calculation of MTI and SFI, one tested mixture was found additive while the two other tested mixtures were found no additive (MTI) or antagonistic (SFI), but these differences between index responses are only due to differences in terminology related to these two indexes. Through the surface response approach and isobologram analysis, we concluded that there was a significant antagonistic effect of the binary mixtures of deltamethrin and malathion that occurs on D. magna immobilization, after 48 h of exposure. Index approaches and surface response approach with isobologram analysis are complementary. Calculation of mixture toxicity index and safety factor index allows identifying punctually the type of interaction for several tested mixtures, while the surface response approach with isobologram analysis integrates all the data providing a global outcome about the type of interactive effect. Only the surface response approach and isobologram analysis allowed the statistical assessment of the ecotoxicological interaction. Nevertheless, we recommend the use of both approaches (i) to identify the combined effects of contaminants and (ii) to improve risk assessment and environmental management.
Efficacy and safety of extracorporeal shock wave therapy for acute and chronic soft tissue wounds: A systematic review and meta‐analysis
International Wound Journal, EarlyView.
Πέμπτη 19 Απριλίου 2018
Post-chemoradiation volumetric response predicts survival in newly diagnosed glioblastoma treated with radiation, temozolomide and bevacizumab or placebo
The TNF Receptor Family Member Fn14 is Highly Expressed in Recurrent Glioblastoma (GBM) and in GBM Patient-Derived Xenografts With Acquired Temozolomide Resistance
Meningioma transcription factors link cell lineage with systemic metabolic cues
Mapping of genomic EGFRvIII deletions in glioblastoma: insight into rearrangement mechanisms and biomarker development
Representation of Obese Participants in Obesity-Related Cancer Randomized Trials
Primary Tumor Sidedness and Benefit from FOLFOXIRI plus Bevacizumab as Initial Therapy for Metastatic Colorectal Cancer
Hatchet Flap With Transposed Nasal Inset for Midfacial Reconstruction
Transconjunctival Triamcinolone Injection for Upper Lid Retraction in Thyroid Eye Disease—A New Injection Method
Registro de linfomas cutáneos primarios de la AEDV: primer año de funcionamiento
Publication date: Available online 19 April 2018
Source:Actas Dermo-Sifiliográficas
Author(s): Y. Peñate, O. Servitje, S. Machan, R. Fernández-de-Misa, M.T. Estrach, E. Acebo, J. Mitxelena, M.D. Ramón, A. Flórez, M. Blanes, M. Morillo, S. Medina, J. Bassas, A. Zayas, P. Espinosa, A. Pérez, N. Gónzalez-Romero, J.D. Domínguez, C. Muniesa, J. López Robles, A. Combalia, I. Yanguas, H. Suh, I. Polo-Rodríguez, I. Bielsa, A. Mateu, B. Ferrer, M.A. Descalzo, I. García-Doval, P.L. Ortiz-Romero
Antecedentes y objetivoLos linfomas primarios cutáneos son enfermedades poco frecuentes. Este artículo describe el Registro de linfomas cutáneos primarios de la AEDV y sus primeros resultados.Pacientes y métodosRegistro de enfermedad de pacientes con linfomas cutáneos primarios. Los centros participantes recogieron datos prospectivamente de todos los pacientes, incluyendo datos del diagnóstico, de los tratamientos, de las pruebas realizadas y del estado actual del paciente. Se realizó un análisis descriptivo.ResultadosEn diciembre del 2017 el registro tenía datos de 639 pacientes pertenecientes a 16 hospitales universitarios. Un 60% eran hombres y los diagnósticos, por orden de frecuencia, fueron: micosis fungoide/síndrome de Sézary (MF/SS) (348 casos; 55%), linfoma cutáneo primario de células B (LCCB) (184; 29%), trastorno linfoproliferativo de células T CD30+ (LTCD30+) (70; 11%) y otro tipo de linfoma T (OLT) (37; 5%). El número de casos incidentes recogidos durante el primer año fue de 105 (16,5%). En los pacientes con MF/SS, el diagnóstico más frecuente fue MF clásica (77,3%). La mitad de estos casos se diagnosticaron en estadio IA. La mayoría de los pacientes estaban en remisión parcial (32,5%) o enfermedad estable (33,1%). Los tratamientos más usados fueron los corticoides tópicos (90,8%) seguidos de fototerapia. En los pacientes con LCCB el diagnóstico más frecuente fue el linfoma de la zona marginal (50%). Casi todos los pacientes tuvieron afectación exclusivamente cutánea y casi la mitad fue T1a. La mayoría (76,1%) estaba en remisión completa. Los tratamientos más utilizados fueron la cirugía (55,4%) y la radioterapia (41,9%). En los pacientes con LTCD30+, el diagnóstico más frecuente fue la papulosis linfomatoide (68,6%). La mayoría fueron clasificados T3b (31,4%). La mitad de los casos estaban en remisión completa. Los tratamientos más frecuentes fueron los esteroides tópicos (68,6%), seguidos de la quimioterapia sistémica (32,9%).ConclusiónLas características del paciente con linfoma cutáneo primario en España no difieren de otras series descritas en la literatura. El registro facilitará al grupo de linfomas de la AEDV realizar investigación clínica.Background and objectivePrimary cutaneous lymphomas are uncommon. This article describes the Primary Cutaneous Lymphoma Registry of the Spanish Academy of Dermatology and Venereology (AEDV) and reports on the results from the first year.Patients and methodsDisease registry for patients with primary cutaneous lymphoma. The participating hospitals prospectively recorded data on diagnosis, treatment, tests, and disease stage for all patients with primary cutaneous lymphoma. A descriptive analysis was performed.ResultsIn December 2017, the registry contained data on 639 patients (60% male) from 16 university hospitals. The most common diagnoses, in order of frequency, were mycosis fungoides/Sézary syndrome (MF/SS) (348 cases, 55%), primary cutaneous B-cell lymphoma (CBCL) (184 cases, 29%), primary cutaneous CD30+ T-cell lymphoproliferative disorder (CD30+ CLPD) (70 cases, 11%), and other types of T-cell lymphoma (37 cases, 5%). In total, 105 (16.5%) of the cases recorded were incident cases. The most common diagnosis in the MF/SS group was classic MF (77.3%). Half of the patients with MF had stage IA disease when diagnosed, and the majority were either in partial remission (32.5%) or had stable disease (33.1%). The most widely used treatments were topical corticosteroids (90.8%) and phototherapy. The most common form of primary CBCL was marginal zone lymphoma (50%). Almost all of the patients had cutaneous involvement only and nearly half had stage T1a disease. Most (76.1%) were in complete remission. The main treatments were surgery (55.4%) and radiotherapy (41.9%). The most common diagnosis in patients with CD30+ CLPD was lymphomatoid papulosis (68.8%). Most of the patients (31.4%) had stage T3b disease and half were in complete remission. The most common treatments were topical corticosteroids (68.8%) and systemic chemotherapy (32.9%).ConclusionThe characteristics of patients with primary cutaneous lymphoma in Spain do not differ from those described in other series in the literature. The registry will facilitate clinical research by the AEDV's lymphoma group.
Graphical abstract
Altered White Matter Microstructure in the Corpus Callosum and Its Cerebral Interhemispheric Tracts in Adolescent Idiopathic Scoliosis: Diffusion Tensor Imaging Analysis [PEDIATRICS]
BACKGROUND AND PURPOSE:
Neural system was one of the important contributors to the etiopathogenesis of adolescent idiopathic scoliosis; additionally, the morphology of corpus callosum interconnecting both hemispheres of the brain was found to be altered morphologically. Our aim was to evaluate and compare the microstructural changes of the corpus callosum and its interhemispheric white matter fiber tracts interconnecting both cerebral hemispheres in patients with adolescent idiopathic scoliosis and matched controls using diffusion tensor imaging.
MATERIALS AND METHODS:Brain DTI was performed in 69 patients with adolescent idiopathic scoliosis (female, right thoracic/thoracolumbar curve) and 40 age-matched controls without adolescent idiopathic scoliosis (female). 2D and 3D segmentation of the corpus callosum were performed using a region-growing method, and the corpus callosum was further divided into 6 regions, including the rostrum, genu, anterior and posterior midbodies, isthmus, and splenium. The laterality index was calculated to quantify the asymmetry of the corpus callosum. Interhemispheric fiber tractography were performed using the Brodmann atlas.
RESULTS:2D ROI analysis revealed reduced fractional anisotropy in the genu and splenium (P = .075 and P = .024, respectively). Consistently reduced fractional anisotropy on the left sides of the genu and splenium was also found in 3D ROI analysis (P = .03 and P = .012, respectively). The laterality index analysis revealed a pseudo-right lateralization of the corpus callosum in adolescent idiopathic scoliosis. Interhemispheric fibers via the splenium interconnecting Brodmann 3, 1, and 2; Brodmann 17; and Brodmann 18 (corresponding to the primary somatosensory cortex and primary and secondary visual cortices) were also found to have reduced fractional anisotropy (P ≤ .05).
CONCLUSIONS:Reduced fractional anisotropy was found in the genu and splenium of the corpus callosum and corresponding interhemispheric fiber tracts interconnecting the somatosensory and visual cortices via the splenium. Our results are suggestive of altered white matter microstructure within the brain of those with adolescent idiopathic scoliosis, which could be related to abnormal brain maturation during adolescence in adolescent idiopathic scoliosis and could possibly explain the previously documented somatosensory function impairment and visuo-oculomotor dysfunction in this condition.
Value of Quantitative Collateral Scoring on CT Angiography in Patients with Acute Ischemic Stroke [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Many studies have emphasized the relevance of collateral flow in patients presenting with acute ischemic stroke. Our aim was to evaluate the relationship of the quantitative collateral score on baseline CTA with the outcome of patients with acute ischemic stroke and test whether the timing of the CTA acquisition influences this relationship.
MATERIALS AND METHODS:From the Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) data base, all baseline thin-slice CTA images of patients with acute ischemic stroke with intracranial large-vessel occlusion were retrospectively collected. The quantitative collateral score was calculated as the ratio of the vascular appearance of both hemispheres and was compared with the visual collateral score. Primary outcomes were 90-day mRS score and follow-up infarct volume. The relation with outcome and the association with treatment effect were estimated. The influence of the CTA acquisition phase on the relation of collateral scores with outcome was determined.
RESULTS:A total of 442 patients were included. The quantitative collateral score strongly correlated with the visual collateral score ( = 0.75) and was an independent predictor of mRS (adjusted odds ratio = 0.81; 95% CI, .77–.86) and follow-up infarct volume (exponent β = 0.88; P < .001) per 10% increase. The quantitative collateral score showed areas under the curve of 0.71 and 0.69 for predicting functional independence (mRS 0–2) and follow-up infarct volume of >90 mL, respectively. We found significant interaction of the quantitative collateral score with the endovascular therapy effect in unadjusted analysis on the full ordinal mRS scale (P = .048) and on functional independence (P = .049). Modification of the quantitative collateral score by acquisition phase on outcome was significant (mRS: P = .004; follow-up infarct volume: P < .001) in adjusted analysis.
CONCLUSIONS:Automated quantitative collateral scoring in patients with acute ischemic stroke is a reliable and user-independent measure of the collateral capacity on baseline CTA and has the potential to augment the triage of patients with acute stroke for endovascular therapy.
Volumetric Brain MRI Study in Fetuses with Congenital Heart Disease [PEDIATRICS]
BACKGROUND AND PURPOSE:
It is well-established that a high prevalence of infants with congenital heart defects surviving to childhood have neurodevelopmental abnormalities. The etiology is not clear. In this study, we aimed to find prenatal neuroanatomic changes in fetuses with congenital heart disease to better understand the pathophysiology behind these sequelae.
MATERIALS AND METHODS:A retrospective study of 46 fetal brain MR imaging scans was performed at a tertiary medical center during a 4-year period. Clinical data were collected from electronic medical charts. Volumes of the supratentorial brain, right hemisphere, left hemisphere, and cerebellum were measured using a semiautomated method and were compared with the normal growth percentiles.
RESULTS:We found that cerebellar volume and the cerebellar-supratentorial volume ratio were significantly lower among fetuses with congenital heart disease. Supratentorial and hemisphere volumes showed no difference between groups. This difference was not observed in fetuses with septation defects.
CONCLUSIONS:Fetuses with congenital heart disease have smaller cerebellar volumes than healthy fetuses. Additional research is needed to assess this finding as a radiologic marker for long-term outcome.
Sequential Apparent Diffusion Coefficient for Assessment of Tumor Progression in Patients with Low-Grade Glioma [ADULT BRAIN]
BACKGROUND AND PURPOSE:
Early and accurate identification of tumor progression in patients with low-grade gliomas is challenging. We aimed to assess the role of quantitative ADC analysis in the sequential follow-up of patients with low-grade gliomas as a potential imaging marker of tumor stability or progression.
MATERIALS AND METHODS:In this retrospective study, patients with a diagnosis of low-grade glioma with at least 12 months of imaging follow-up were retrospectively reviewed. Two neuroradiologists independently reviewed sequential MR imaging in each patient to determine tumor progression using the Response Assessment in Neuro-Oncology criteria. Normalized mean ADC (ADCmean) and 10th percentile ADC (ADC10) values from FLAIR hyperintense tumor volume were calculated for each MR image and compared between patients with stable disease versus tumor progression using univariate analysis. The interval change of ADC values between sequential scans was used to differentiate stable disease from progression using the Fisher exact test.
RESULTS:Twenty-eight of 69 patients who were evaluated met our inclusion criteria. Fifteen patients were classified as stable versus 13 patients as having progression based on consensus reads of MRIs and the Response Assessment in Neuro-Oncology criteria. The interval change of ADC values showed greater concordance with ultimate lesion disposition than quantitative ADC values at a single time point. The interval change in ADC10 matched the expected pattern in 12/13 patients with tumor progression (overall diagnostic accuracy of 86%, P <.001). On average, the ADC10 interval change predicted progression 8 months before conventional MR imaging.
CONCLUSIONS:The interval change of ADC10 values can be used to identify progression versus stability of low-grade gliomas with a diagnostic accuracy of 86% and before apparent radiologic progression on conventional MR imaging.
Noninvasive Assessment of Hemodynamic Stress Distribution after Indirect Revascularization for Pediatric Moyamoya Vasculopathy [PEDIATRICS]
BACKGROUND AND PURPOSE:
Indirect revascularization surgery is an effective treatment in children with Moyamoya vasculopathy. In the present study, we hypothesized that DSC-PWI may reliably assess the evolution of CBF-related parameters after revascularization surgery, monitoring the outcome of surgical pediatric patients with Moyamoya vasculopathy. Thus, we aimed to evaluate differences in DSC-PWI parameters, including the hemodynamic stress distribution, in surgical and nonsurgical children with Moyamoya vasculopathy and to correlate them with long-term postoperative outcome.
MATERIALS AND METHODS:Pre- and postoperative DSC parameters of 28 patients (16 females; mean age, 5.5 ± 4.8 years) treated with indirect revascularization were compared with those obtained at 2 time points in 10 nonsurgical patients (6 females; mean age, 6.9 ± 4.7 years). We calculated 4 normalized CBF-related parameters and their percentage variance: mean normalized CBF of the MCA territory, mean normalized CBF of the proximal MCA territory, mean normalized CBF of cortical the MCA territory, and hemodynamic stress distribution. The relationship between perfusion parameters and postoperative outcomes (poor, fair, good, excellent) was explored using 1-way analysis of covariance (P < .05).
RESULTS:A significant decrease of the mean normalized CBF of the proximal MCA territory and hemodynamic stress distribution and an increase of the mean normalized CBF of the cortical MCA territory were observed after revascularization surgery (P < .001). No variations were observed in nonsurgical children. Postoperative hemodynamic stress distribution and its percentage change were significantly different in outcome groups (P < .001).
CONCLUSIONS:DSC-PWI indices show postoperative hemodynamic changes that correlate with clinical outcome after revascularization surgery in children with Moyamoya disease.
Comparison of 3T Intracranial Vessel Wall MRI Sequences [EXTRACRANIAL VASCULAR]
BACKGROUND AND PURPOSE:
Intracranial vessel wall MR imaging plays an increasing role in diagnosing intracranial vascular diseases. For a complete assessment, pre- and postcontrast sequences are required, and including other sequences, these result in a long scan duration. Ideally, the scan time of the vessel wall sequence should be reduced. The purpose of this study was to evaluate different intracranial vessel wall sequence variants to reduce scan duration, provided an acceptable image quality can be maintained.
MATERIALS AND METHODS:Starting from the vessel wall sequence that we use clinically (6:42 minutes), 6 scan variants were tested (scan duration ranging between 4:39 and 8:24 minutes), creating various trade-offs among spatial resolution, SNR, and contrast-to-noise ratio. In total, 15 subjects were scanned on a 3T MR imaging scanner: In 5 subjects, all 7 variants were performed precontrast-only, and in 10 other subjects, the fastest variant (4:39 minutes) and our clinically used variant (6:42 minutes) were performed pre- and postcontrast.
RESULTS:The fastest variant (4:39 minutes) had higher or comparable SNRs/contrast-to-noise ratios of the intracranial vessel walls compared with the reference sequence (6:42 minutes). Qualitative assessment showed that the contrast-to-noise ratio was most suppressed in the fastest variant of 4:39 minutes and the variant of 6:42 minutes pre- and postcontrast. SNRs/contrast-to-noise ratios of the fastest variant were all, except one, higher compared with the variant of 6:42 minutes (P < .008). Furthermore, the fastest variant (4:39 minutes) detected all vessel wall lesions identified on the 6:42-minute variant.
CONCLUSIONS:A 30% faster vessel wall sequence was developed with high SNRs/contrast-to-noise ratios that resulted in good visibility of the intracranial vessel wall.
Immediate effects of yoga breathing with intermittent breath holding on response inhibition among healthy volunteers
International Journal of Yoga 2018 11(2):99-104
Background: There is very little evidence available on the effects of yoga-based breathing practices on response inhibition. The current study used stop-signal paradigm to assess the effects of yoga breathing with intermittent breath holding (YBH) on response inhibition among healthy volunteers. Materials and Methods: Thirty-six healthy volunteers (17 males + 19 females), with mean age of 20.31 ± 3.48 years from a university, were recruited in a within-subject repeated measures (RM) design. The recordings for stop signal task were performed on three different days for baseline, post-YBH, and post yogic breath awareness (YBA) sessions. Stop-signal reaction time (SSRT), mean reaction time to go stimuli (go RT), and the probability of responding on-stop signal trials (p [r/s]) were analyzed for 36 volunteers using RM analysis of variance. Results: SSRT reduced significantly in both YBH (218.33 ± 38.38) and YBA (213.15 ± 37.29) groups when compared to baseline (231.98 ± 29.54). No significant changes were observed in go RT and p (r/s). Further, the changes in SSRT were not significantly different among YBH and YBA groups. Conclusion: Both YBH and YBA groups were found to enhance response inhibition in the stop-signal paradigm. YBH could be further evaluated in clinical settings for conditions where response inhibition is altered.
Classification of electrophotonic images of yogic practice of mudra through neural networks
International Journal of Yoga 2018 11(2):152-156
Background: Mudras signify a gesture with hands, eyes, and the body. Different configurations of the joining of fingertips are also termed mudra and are used by yoga practitioners for energy manipulation and for therapeutic applications. Electrophotonic imaging (EPI) captures the coronal discharge around the fingers as a result of electron capture from the ten fingers. The coronal discharge around each fingertip is studied to understand the effect of mudra on EPI parameters. Methods: The participants were from Swami Vivekananda Yoga Anusandhana Samsthana and Sushrutha Ayurvedic Medical College, in Bengaluru, India. There were 29 volunteers in the mudra group and 32 in the control group. There were two designs: one was a pre-post design with control the other was pre-post with repeated measures with 18 individuals practicing mudra for 3 days. The duration of intervention for the pre-post design was 10 min on the 1st day, 15 min on the 2nd day, and 20 min on the 3rd day. A neural network classifier was used for classifying mudra and control samples. Results: The EPI parameters, normalized area and average intensity, passed the test of normality Shapiro–Wilk. The Cohen's d, effect size was 0.988 and 0.974 for the mudra and control groups, respectively. Neural network-based analysis showed the classification accuracy of the post-intervention samples for mudra and control varied from 85% to 100% while the classification accuracy varied from 55% to 70% for the pre-intervention samples. The result of the mudra intervention showed statistically significant changes in the mean values on the 3rd day compared to the 1st day. Conclusions: The effect size of the variations in mudra was more than that of the control group. Mudra practice of a longer duration showed statistically significant change in the EPI parameter, average intensity in comparison to the practice on the 1st day.
Yoga for heart failure: A review and future research
International Journal of Yoga 2018 11(2):91-98
Background: Complementary and alternative medicine is a rapidly growing area of biomedical inquiry. Yoga has emerged in the forefront of holistic medical care due to its long history of linking physical, mental, and spiritual well-being. Research in yoga therapy (YT) has associated improved cardiovascular and quality of life (QoL) outcomes for the special needs of heart failure (HF) patients. Aim: The aim of this study is to review yoga intervention studies on HF patients, discuss proposed mechanisms, and examine yoga's effect on physiological systems that have potential benefits for HF patients. Second, to recommend future research directions to find the most effective delivery methods of yoga to medically stable HF patients. Methods: The authors conducted a systematic review of the medical literature for RCTs involving HF patients as participants in yoga interventions and for studies utilizing mechanistic theories of stretch and new technologies. We examined physical intensity, mechanistic theories, and the use of the latest technologies. Conclusions: Based on the review, there is a need to further explore yoga mechanisms and research options for the delivery of YT. Software apps as exergames developed for use at home and community activity centers may minimize health disparities and increase QoL for HF patients.
Study to evaluate the changes in polycystic ovarian morphology after naturopathic and yogic interventions
International Journal of Yoga 2018 11(2):139-147
Background: Polycystic ovarian syndrome (PCOS) is one of the commonest endocrine disorders in women, with a prevalence ranging from 2.2% to 26% in India. Patients with PCOS face challenges including irregular menstrual cycles, hirsutism, acne, acanthosis nigricans, obesity and infertility. 9.13% of South Indian adolescent girls are estimated to suffer from PCOS. The efficacy of Yoga & Naturopathy (Y&N) in the management of polycystic ovarian syndrome requires to be investigated. Aims: The aim of the present study is to observe the morphological changes in polycystic ovaries of patients following 12 weeks of Y&N intervention. Settings and Design: The study was conducted at the Government Yoga and Naturopathy Medical College and Hospital, Chennai, India. The study was a single blinded prospective, pre-post clinical trial. Methods and Material: Fifty PCOS patients of age between 18 and 35 years who satisfied the Rotterdam criteria were recruited for the study. According to their immediate participation in the study they were either allocated to the intervention group (n=25) or in the wait listed control group (n=25). The intervention group underwent Y&N therapy for 12 weeks. Change in polycystic ovarian morphology, anthropometric measurements and frequency of menstrual cycle were studied before and after the intervention. Results: Significant improvement was observed in the ovarian morphology (P<0.001) and the anthropometric measurements (P<0.001) between the two groups. Conclusions: The findings of the study indicate that Y&N interventions are efficient in bringing about beneficial changes in polycystic ovarian morphology. We speculate that a longer intervention might be required to regulate the frequency of menstrual cycle.
Effect of yoga in the treatment of eating disorders: A single-blinded randomized controlled trial with 6-months follow-up
International Journal of Yoga 2018 11(2):166-169
Aim of the Study: The aim of this study is to examine the effect of yoga treatment of eating disorders (EDs). Methods: Adult females meeting the Diagnostic and Statistical Manual-IV criteria for bulimia nervosa or ED not otherwise specified (n = 30) were randomized to 11-week yoga intervention group (2 × 90 min/week) or a control group. Outcome measures, the Eating Disorder Examination (EDE)-Interview and Eating Disorders Inventory-2 (EDI-2) scores, were administered at baseline, posttest, and at 6-month follow-up. There was a dropout rate of 30% (posttest) and 37% (6-month follow-up). Results: The intervention group showed reductions in EDE global score (P < 0.01), the EDE subscale restraint (P < 0.05), and eating concern (P < 0.01) compared to the control group. The differences between the groups increased at 6-month follow-up. There were no differences between the groups in the EDI-2 score. Conclusion: The results indicate that yoga could be effective in the treatment of ED.
Effects of yoga training on body composition and oxidant-antioxidant status among healthy male
International Journal of Yoga 2018 11(2):105-110
Background: The stressful condition may cause oxidative stress, which is responsible for various diseases. Aims: The present study was designed to find out whether yoga has impact on the reduction of oxidative stress. Methods: For the present study, 95 (n = 95) healthy male volunteers within the age group of 18–24 years were included, 35 (n = 35) volunteers were excluded. The remaining 60 (n = 60) volunteers were randomly divided into two groups: (a) Yoga Group (n = 30) and (b) Control Group (n = 30). Yoga training was given for 60 min per day, 6 days per week for 12 weeks in the yoga group, with no yoga training in control group. Assessment of body composition and oxidant-antioxidant status were performed in both the groups at baseline, before yoga training (0 week) and after (12 weeks) of the training. Results: Significant reduction (P < 0.001) in the percentage of body fat and malondialdehyde; significant elevation (P < 0.001) in superoxide dismutase, catalase, reduced glutathione and ascorbic acid levels were noted in the yoga group after 12 weeks when compared to baseline data (0 week). However, there was no significant difference in height, weight, body mass index, body surface area and lean body mass among the yoga group after 12 weeks when compared to baseline data. These changes might be due to yoga training. Conclusions: Regular yoga practice reduces body fat and oxidative stress. Yoga training may be helpful to reduce the chance of occurrence of various diseases and helps to maintain normal healthy lifestyle.
Yoga as a therapeutic intervention for the management of type 2 diabetes mellitus
International Journal of Yoga 2018 11(2):129-138
Purpose: This study aimed to investigate the effects of 12 weeks yogic intervention on blood sugar and lipid profile in elder women with Type 2 diabetes mellitus (T2DM). Subjects and Methods: Twenty elderly (age range 55–70 years) T2DM women were divided into two groups, namely, yogic intervention group (YIG: n = 10, age 64.70 ± 4.03, body mass index [BMI] 24.26 ± 3.40) and control group (CG: n = 10, age 64.40 ± 4.79, BMI 24.28 ± 2.36). YIG underwent yoga practice (Asanas, Kriyas, Pranayamas) for 12 weeks (3 sessions/week), while the CG continued their usual routine activities. Standing height, body weight, BMI, blood sugar, and lipid profile were measured before commencement and after 6 and 12 weeks of yogic intervention in both groups. Results: There was a significant (P < 0.01) decrease in fasting plasma glucose, postprandial blood sugar, total cholesterol, triglycerides, low-density lipoprotein, and very low density lipoprotein, with a significant (P < 0.01) increase in high-density lipoprotein level from its initial value in YIG, while showing insignificant result in CG. Conclusion: It can be said that yogic intervention may have the beneficial effects on blood sugar and lipid profile in elderly women with T2DM.
Effect of yogic breathing on accommodate braille version of six-letter cancellation test in students with visual impairment
International Journal of Yoga 2018 11(2):111-115
Context: Attentional processes tend to be less well developed in the visually impaired, who require special training to develop them fully. Yogic breathing which alters the patterns of respiration has been shown to enhance attention skills. Letter cancellation tests are well-established tools to measure attention and attention span. Here, a modified Braille version of the six-letter cancellation test (SLCT) was used for students with visual impairment (VI). Aim: This study aimed to assess the immediate effects of Bhramari Pranayama (BhPr) and breath awareness (BA) on students with VI. Methods: This study was a self-as-control study held on 2 consecutive days, on 19 participants (8 males, 11 females), with a mean age of 15.89 ± 1.59 years, randomized into two groups. On the 1st day, Group 1 performed 10 min breath awareness and Group 2 performed Bhramari; on the 2nd day, practices were reversed. Assessments used a SLCT specially adapted for the visually impaired before and after each session. Results: The Braille letter cancellation test was successfully taken by 19 students. Scores significantly improved after both techniques for each student following practices on both days (P < 0.001). BhPr may have more effect on attention performance than BA as wrong scores significantly increased following BA (P < 0.05), but the increase in the score after Bhramari was not significant. Conclusions: Despite the small sample size improvement in attentional processes by both yoga breathing techniques was robust. Attentional skills were definitely enhanced. Long-term practice should be studied.
No differences in energy cost of a predetermined exercise among young overweight/obese and undernourished individuals
International Journal of Yoga 2018 11(2):148-151
Background: Physical activity is an integral part of one's daily life. Obese (Ob) and undernourished (UN) persons are known to underperform physically as compared to normal weight (N) individuals. In this study, we have measured the energy spent to perform a prefixed exercise on treadmill walking and basal heart rate and blood pressure. Body mass index (BMI) and body fat of participating individuals were assessed. Fasting blood sugar and lipid profile were also evaluated. Materials and Methods: Eighty-three young individuals (male: 41; female: 42) of medical faculty, Universiti Sultan Zainal Abidin, who volunteered for the study, were recruited. The mean age of the individuals was 19.8 ± 0 years (P < 1.08). The individuals were grouped as N, UN/underweight, and overweight (Ow)/Ob based on BMI. Results: The results of the study revealed that there were no differences in the energy spent on performing the predetermined treadmill walking of 20 min duration among the three groups (a mean of 78 and 70 calories in all male and female subgroups, respectively). The distance covered by the males was 1.6 km while the females covered 1.4 km on treadmill walking in 20 min time. Basal blood pressure and heart rate and fasting blood sugar did not reveal any significant difference among the groups. However, total cholesterol and triglyceride levels were marginally higher in the Ow/Ob groups of male and female individuals as compared to other groups. Conclusion: Since the study individuals were very young and competitive by nature and possibly had no major metabolic disturbances, the differences in physical activity performances were not obvious. Possibly, such differences would become apparent only at later stages of life as age advances or when the intensity and duration of exercise are set at higher levels.
Effect of mula bandha yoga in mild grade pelvic organ prolapse: A randomized controlled trial
International Journal of Yoga 2018 11(2):116-121
Background: Pelvic organ prolapse is the growing health issue related to women of the reproductive and postmenopausal age group in India and across the globe. Treatment option for pelvic organ prolapse includes both surgical and non-surgical intervention. The development of pelvic organ prolapse is an indication for major surgery among 20% of all women. Nevertheless, the recurrence of pelvic organ prolapse is detected among 58% of the patient after surgery. This highlights the need for preventive measures for reducing the impact of pelvic organ prolapse. Aims and Objective: To study the effect of 3 months yoga therapy in female patients suffering from mild pelvic organ prolapse. Material and Methods: 50 Participants were allocated into two groups (25 in each group) by generating Random allocation sequence. Women aged 20-60 with symptomatic mild pelvic organ prolapse in the yoga group were offered Mulabandha yoga therapy along with other conventional treatment modalities, while the control group was only on conventional treatment. All participants gave written informed consent. An assessment was done by improvement in chief complaints and Pelvic Floor Distress Inventory-20 (PFDI-20) & Pelvic floor impact Questionnaire-7 (PFIQ-7) at baseline and at the end of 4, 8 & 12 weeks. Results At the end of 12 weeks, Post-study comparison between the two groups showed a significant improvement in chief complaints like perennial pain, P/V discharge, Perineal muscle laxity and Feeling of something coming out P/V (P < 0.001). Participants in the yoga group improved by (on average) 5.7 (95% confidence interval 3.1 to 14.7) points more on the PFDI-20 than did participants in the control group (P = 0.1) and a mean score of PFIQ-7 was also improved significantly. Conclusions: Although Mulabandha (Root Lock) yoga therapy led to a significantly greater improvement in PFDI-20 & PFIQ-7 scores the difference between the groups was below the presumed level of clinical relevance (15 points). More studies are needed to identify factors related to the success of Mulabandha (Root Lock) yoga therapy and to investigate long-term effects.
Bioenergy and its implication for yoga therapy
International Journal of Yoga 2018 11(2):157-165
Electro photonic imaging (EPI) is being researched relative to its application for yoga therapy. Three parameters of interest in EPI measurements are as follows: Communication energy (C), integral or normalized area (IA), and Entropy (E). It is important to note that C indicates the total energy of communication for the organ system; IA is an indication of total amount of energy that is available for the organ system while entropy is an indication of the amount of coherence of the energy. Coherence and entropy are inversely related; this means less the entropy, more the coherence and vice versa. Illustrative cases of successful therapy with yoga practices in a wide variety of abnormal conditions are examined, and in every case, entropy is shown to decrease for the affected organ system while communication energy stays within stable range. Relative to the electromagnetic (Rubik) and living matrix (Oschman) models, it is suggested that the regulation of energy, its coherence in the biological system and interaction with life processes provide the basis for model building and design of health-promoting procedures. Further, this approach is examined relative to yoga theory, traditional medicine systems, and scientific developments in the field of gene expression and neuroplasticity and a generalized model that we call Unified System of Medicine is proposed. This model has direct implications on methods used to control the environmental factors to get robust results from EPI application for therapeutic purposes. Implications for furthering research in yoga therapy using EPI and implications of EPI as a translational technology between traditional medicine systems and modern medicine is discussed.
Effect of 6 months of meditation on blood sugar, glycosylated hemoglobin, and insulin levels in patients of coronary artery disease
International Journal of Yoga 2018 11(2):122-128
Background and Objectives: Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. It has been recognized that stress, diabetes, and hypertension are important in etiology and progression of CAD. This study is to evaluate the role of meditation in improving biochemical parameters such as blood glucose, glycosylated hemoglobin, and serum insulin levels in known CAD patients. Material and Methods: Sixty CAD patients are divided into two groups of which one group did meditation and other did not. Blood glucose, glycosylated hemoglobin, and fasting serum insulin levels were measured before and at the end of 6 months of study in both the groups. Results: At the end of the study, significant decrease was seen in patients who practiced meditation as compared to other group. Conclusion: Meditation may modulate the physiological response to stress through neurohumoral activation, which may be a novel therapeutic target for the treatment of CAD.
Effect of 1-week yoga-based residential program on cardiovascular variables of hypertensive patients: A Comparative Study
International Journal of Yoga 2018 11(2):170-174
Introduction: Hypertension (HTN) is an important public health concern and a leading cause of morbidity and mortality worldwide. Yoga is a form of mind–body medicine shown to be effective in controlling blood pressure (BP) and reduces cardiac risk factors in HTN. Integrated approach of Yoga therapy (IAYT) is a residential yoga-based lifestyle intervention proven to be beneficial in several health conditions. Aim: To study the efficacy of 1 week of residential IAYT intervention on cardiovascular parameters in hypertensive patients. Methodology: Twenty hypertensive individuals (7 females) within age range between 30 and 60 years (average; 46.62 ± 9.9 years), who underwent 1 week of IAYT treatment for HTN, were compared with age- gender-matched non-IAYT group (5 females; average age; 47.08 ± 9.69 years) in terms of systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), cardiac output (CO), stroke volume (SV), baroreflex sensitivity (BRS), and total peripheral vascular resistance (TPVR), IAYT program consisted of sessions of asanas, breathing practices, meditation and relaxation techniques, low salt, low-calorie diet, devotional session, and counseling. Individuals in non-IAYT group followed their normal routine. All the variables were assessed before and after one week. Data were analyzed using SPSS version 16. RM-ANOVA was applied to assess within group and between group changes after intervention. Results: There was a significant improvement in SBP (P = 0.004), DBP (P = 0.008), MAP (0.03), BRS (P < 0.001), and TPVR (P = 0.007) in IAYT, group whereas in control group, we did not find significant difference in any of the variables. Between-group comparison showed a significant improvement in SBP (P = 0.038), BRS (P = 0.034), and TPVR (P = 0.015) in IAYT group as compared to non-IAYT group. Conclusion: One-week IAYT intervention showed an improvement in baroreflex sensitivity, systolic BP, and total peripheral vascular resistance in hypertensive patients. However, further randomized control trials need to be performed to confirm the present findings.
C‐reactive protein is an independent prognostic marker in patients with tongue carcinoma ‐ A retrospective study
Clinical Otolaryngology, EarlyView.
Metabolic Syndrome Diagnosis: The Sooner the Better
Metabolic Syndrome and Related Disorders, Ahead of Print.
Is it worthy to treat hidradenitis suppurativa with adalimumab in patients with melanoma and other debilitating systemic diseases? A series of clinical dilemmas
Australasian Journal of Dermatology, EarlyView.
Clinicopathological, immunohistochemical and embryological aspects of cutaneous ciliated Müllerian cyst
Australasian Journal of Dermatology, EarlyView.
In vitro anti-inflammatory activity of terpenes via suppression of superoxide and nitric oxide generation and the NF-κB signalling pathway
Abstract
Background and Aims
Terpenes are considered the main components of essential oils and an important source for the identification of novel lead molecules. This study aimed to investigate the in vitro anti-inflammatory activity of l-carveol, l-carvone, and m-cimene (monoterpenes) and of valencene and guaiene (sesquiterpenes).
Methods
The influence on intracellular nitric oxide (NO) and pro- and anti-inflammatory cytokine (TNF-α, IL-1α and IL-10) production and on nuclear factor kappa B (NF-κB) activity was determined using Griess reagent, immunoenzymatic assay kits (ELISA) and chemiluminescence measurements in cell-based assays, respectively. Antioxidant activity was assayed through the protective effect against cellular oxidative damage produced by superoxide anion production (O 2·−) and hydrogen peroxide on macrophages and by the quenching activity of the NO radical.
Results and Discussion
Terpenes reduced the pro-inflammatory cytokines TNF-α and IL-1α and increased the production of IL-10. In addition, the terpenes, especially guaiene (53.3 ± 2.4%) and m-cymene (38.1 ± 0.6%), significantly inhibited NO production in a macrophage cell culture-based assay, whereas no effect was observed in the scavenging activity of this radical. l-carveol and m-cymene significantly inhibited O 2·− production with reductions of approximately 68.6 ± 2.2% and 48.2 ± 4.2%, respectively, at a concentration of 10 μM. Moreover, these terpenes were verified to suppress NF-κB activity. The results indicate that these terpenes have therapeutic potential and may be used to suppress inflammatory diseases or as a leading compounds.
Wedge‐shaped polydioxanone threads in a folded configuration (“Solid fillers”): A treatment option for deep static wrinkles on the upper face
Journal of Cosmetic Dermatology, EarlyView.
SNAI1, an endothelial–mesenchymal transition transcription factor, promotes the early phase of ocular neovascularization
Abstract
Ocular neovascularization is a comprehensive process involved in retinal vascular development and several blinding diseases such as age-related macular degeneration and retinopathy of prematurity, with vascular endothelial growth factor (VEGF) regarded as the master regulator. However, the qualified effect of anti-VEGF therapy reveals that the underlying mechanisms are still not clearly identified. To initialize angiogenesis, endothelial cells undergo a phenotype switching to generate highly migratory and invasive cells. This process shares certain similar characters observed in endothelial–mesenchymal transition (EndMT). Here, we found that SNAI1, an EndMT transcription factor, was expressed by endothelial cells in both physiological and pathological ocular neovascularization. SNAI1 overexpression triggered cell morphological change and enhanced cell motility, while loss of SNAI1 attenuated migration, invasion and sprouting. RNA sequence analysis further revealed that SNAI1 knockdown decreased the expression of genes related to cytoskeleton rearrangement and ECM remodeling. Moreover, intravitreal injection of small interfering RNA of SNAI1 suppressed new vessel formation in developing retina as well as mice model of choroidal neovascularization and oxygen-induced retinopathy. Therefore, we propose that the EndMT transcription factor SNAI1 promotes the early phase of ocular neovascularization and may provide a potential therapeutic target.
Lateral Wall Insufficiency Severity and Patient-Reported Nasal Obstruction Measures
Temporal Hollowing Augmentation by Targeted Fat-Grafting Technique in Chinese Adults
β 2 -adrenoceptor signaling reduction is involved in the inflammatory response of fibroblast-like synoviocytes from adjuvant-induced arthritic rats
Abstract
Objective
To investigate the effects of β-AR signaling on fibroblast-like synoviocytes (FLS) from adjuvant-induced arthritis (AA) rats and the partial mechanisms focused on β-AR desensitization mediated by GRK2 and β-arrestin2.
Methods
Animals were divided into a control group and an AA model group, and FLSs were cultured. Arthritis index, histopathology of joints, epinephrine (Epi) and norepinephrine (NE) were detected in vivo. The effect of the β-AR agonist isoprenaline (ISO) and the β2-AR agonist salbutamol on FLS cell viability were detected by CCK8. Cytokines TNF-α, IL-1β, OPG and RANKL were examined by ELISA. The expression of β2-AR was detected by immunofluorescence and flow cytometry. The cytomembrane expression and desensitization of β2-AR, GRK2, and β-arrestin2 were measured by flow cytometry and western blot.
Results
The concentration of NE increased to a peak on day 21, which was consistent with the arthritis index. The levels of Epi and NE in synovial tissues were decreased. ISO inhibited FLS cell viability and TNF-α, IL-1β, and RANKL secretion, and promoted OPG secretion. β2-AR mediated the effects of ISO on FLS cell viability. β2-AR signaling was weaker in AA rats compared to the controls. Elevated GRK2 and β-arrestin2 in cytomembranes promoted β2-AR desensitization and may decrease the anti-inflammatory effect of β2-AR signaling.
Conclusion
The activation of β2-AR signaling exerts its anti-inflammatory activities on FLS. β2-AR signaling decreased in the AA model, which might be related to the increased membrane expression of GRK2 and β-arrestin2, and promoted the excessive desensitization of β2-AR. Decreased β2-AR signaling may be relevant to the exacerbation of arthritis inflammation.
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The Presence of Colisitn resistance gene mcr-1 and -3 in ESBL producing Escherichia coli isolated from food in Ho Chi Minh City, Vietnam
Variation in accumulation, transport, and distribution of phthalic acid esters (PAEs) in soil columns grown with low- and high-PAE accumulating rice cultivars
Abstract
The extensive use of plasticizers containing di-n-butyl phthalate (DBP) and di-(2-ethylhexyl) phthalate (DEHP) results in high residual concentrations in agricultural soils and poses potential risks to human health through the food chain. Here, two rice cultivars with low (Fengyousimiao) and high (Peizataifeng) phthalic acid ester (PAE) accumulation were grown in leaching columns packed with DBP- and DEHP-contaminated soils to investigate their transport, fraction distribution, and accumulation in soil-rice-water system. Significant differences in soil vertical distribution of DBP and DEHP were observed among the two cultivars, sterilization and non-sterilization treatments. Both DBP and DEHP could leach to the bottom layer even though their concentrations in both soil and pore water decreased along with soil depth. DBP and DEHP concentrations in pore water were significantly correlated with those in corresponding soil layer at ripening stage. The available fractions including desorbing and non-desorbing fractions were predominant in the total concentrations of DBP and DEHP of soils. DBP and DEHP storages in coarse soil fractions (i.e., coarse and fine sands) with higher bioavailability displayed higher bioconcentration factors compared to finer soil fractions (i.e., silt and clay), and bioconcentration factors of Peizataifeng were higher than those of Fengyousimiao. The variations in vertical migration and accumulation of DBP and DEHP by the two cultivars implied different adverse effects on the security of groundwater and food.
Τετάρτη 18 Απριλίου 2018
Etiology and Treatment of Congenital Festoons
Abstract
Background
Festoons and malar bags present a particular challenge to the plastic surgeon and commonly persist after the traditional lower blepharoplasty. They are more common than we think and a trained eye will be able to recognize them. Lower blepharoplasty in these patients requires addressing the lid-cheek junction and midcheek using additional techniques such as orbicularis retaining ligament (ORL) and zygomaticocutaneous ligament (ZCL) release, midface lift, microsuction, or even direct excision (Kpodzo e al. in Aesthet Surg J 34(2):235–248, 2014; Goldberg et al. in Plast Reconstr Surg 115(5):1395–1402, 2005; Mendelson et al. in Plast Reconstr Surg 110(3):885–896, 2002). The goal in these patients is to restore a smooth contour from the lower eyelid to the cheek. The review of literature shows the need for more than one surgery for treatment of the festoons (Furnas in Plast Reconstr Surg 61(4):540–546, 1978). One of the reasons WHY these cases are so challenging is that the festoons tend to persist even after surgical treatment. As Furnas said, "Malar mounds have acquired some notoriety for their persistence in the face of surgical efforts to remove them" (Furnas in Clin Plast Surg 20(2):367–385, 1993). This could be due to different etiology between acquired and congenital festoons. There are currently no cases of congenital festoons described in the literature. In the last 10 years, we have treated a total of 59 patients with festoons or malar mounds. We used the terminology of festoon for acquired cases and malar mound for congenital ones (Kpodzo et al. 2014). We were successful with treating 56 patients who developed acquired festoons later on in life; however, three cases required an additional treatment to improve residual puffiness that they had after the first operation. From the above findings, we hypothesized that there should be something common in patients with congenital festoons or malar mounds which are different from acquired festoons. All of these three patients had one thing in common, and that was a history of puffiness of the prezygomatic space since childhood. Each of these patients expressed that these conditions have been present since a young age but became worse with aging over time. To date, there are no descriptions of the cause or treatment for congenital festoons. Here, we present the first case series of three patients with congenital festoons. We discuss the possible etiology of congenital festoons, the physical exam, and the surgical approaches.
Methods
We performed a retrospective review of 59 patients who had surgical correction of festoons in the past 10 years, three of which were presented since childhood. In this paper, we will discuss the pathophysiology and the surgical treatments for congenital festoons. Only patients with festoons present since birth were included. The first two cases were treated with a subciliary blepharoplasty with release of the orbicularis retaining and zygomaticocutaneous ligaments and midface lift with canthopexy and orbicularis muscle suspension. The third case had a subciliary lower blepharoplasty approach, skin, and muscle flap and direct excision of the fat through the orbicularis from the subcutaneous space. In addition, each patient required further treatments to address supra-orbicularis fat by various methods.
Results
All patients with acquired festoons had successful results with one operation by subciliary skin muscle flap, release of the ORL and ZCL, midface lift, and muscle suspension. All three patients with congenital festoons had residual puffiness that required surgical and non-surgical treatments. There were no complications. Our first case required three surgical treatments for complete correction. The second and third cases required Kybella injections after their initial surgical treatments. The specimen of the first patient, Fig. 10, who had direct excision, showed localized fat collection immediately under the skin and above the orbicularis oculi muscle.
Conclusions
Correction of congenital festoons or malar mounds requires a combination of subciliary lower blepharoplasty with skin muscle flap, midface lift, and orbicularis muscle suspension, as well as addressing the supra-orbicularis fat via direct excision, off-label Kybella injection or liposuction.
Level of Evidence IV
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Studies on the effects of storage stability of bio-oil obtained from pyrolysis of Calophyllum inophyllum deoiled seed cake on the performance and emission characteristics of a direct-injection diesel engine
Abstract
The highly unbalanced nature of bio-oil composition poses a serious threat in terms of storage and utilization of bio-oil as a viable fuel in engines. So it becomes inevitable to study the variations in physicochemical properties of the bio-oil during storage to value its chemical instability, for designing stabilization methodologies. The present study aims to investigate the effects of storage stability of bio-oil extracted from pyrolyzing Calophyllum inophyllum (CI) deoiled seed cake on the engine operating characteristics. The bio-oil is produced in a fixed bed reactor at 500 °C under the constant heating rate of 30 °C/min. All the stability analysis methods involve an accelerated aging procedure based on standards established by ASTM (D5304 and E2009) and European standard (EN 14112). Gas chromatography-mass spectrometry was employed to analytically characterize the unaged and aged bio-oil samples. The results clearly depict that stabilizing Calophyllum inophyllum bio-oil with 10% (w/w) methanol improved its stability than that of the unstabilized sample thereby reducing the aging rate of bio-oil to 0.04 and 0.13 cst/h for thermal and oxidative aging respectively. Engine testing of the bio-oil sample revealed that aged bio-oil samples deteriorated engine performance and increased emission levels at the exhaust. The oxidatively aged sample showed the lowest BTE (24.41%), the highest BSEC (20.14 MJ/kWh), CO (1.51%), HC (132 ppm), NOx (1098 ppm) and smoke opacity (34.8%).
Stabilization of Microtubules Restores Barrier Function after Cytokine-induced Defects in Reconstructed Human Epidermis
A variety of human skin disorders is characterized by defects in the epidermal barrier, leading to dehydration, itchiness, and rashes. Previously published literature suggests that microtubule stabilization at the cortex of differentiating keratinocytes is necessary for the formation of the epidermal barrier.
Feedstock composition influences vermicomposting performance of Dichogaster annae relative to Eudrilus eugeniae and Perionyx excavatus
Abstract
Carbon to nitrogen (C/N) ratio influences substrate combinations and earthworm performance in vermicomposting systems. To elucidate these factor effects, a comparative evaluation of species, C/N ratio combined with feed rate, was conducted on three local earthworm species: Perionyx excavatus, Eudrilus eugeniae, and Dichogaster annae. Earthworms were stocked at similar densities and fed shredded paper (SP), cattle manure (CM), and lawn clippings (LC) combined to form C/N ratios of 28, 36, and 53. Earthworms were fed at rates of 1, 1.25, and 2 g feed (dry wt.)/g worm/day for a period of 8 weeks. Percent vermiconversion, earthworm adult and juvenile biomass, and vermicast quality were measured. Vermicast production was significantly affected by the combination of C/N ratio and feed rate and varied among species. All treatment combinations resulted in > 70% conversion, except E. eugenaie fed at the medium rate. Vermiconversion increased for P. excavatus and D. annae with increasing C/N ratio but decreased with increasing the feed rate. Vermicast EC, pH, and C/N ratio was strongly affected by species, relative to other experimental factors. D. annae showed the greatest change in biomass, which peaked at the highest feed rate and lowest C/N ratio. Average adult biomass decreased for P. excavatus with increasing feed rate, while differences were nonsignificant for E. eugenaie and D. annae. Significant increases in average juvenile biomass were only evident for D. annae in response to increasing feed rates. Feed rate had a greater influence on earthworm population dynamics and vermicast quality compared to initial feedstock C/N ratio.
Chronic obstructive pulmonary diseases related to outdoor PM 10 , O 3 , SO 2 , and NO 2 in a heavily polluted megacity of Iran
Abstract
This study was conducted to quantify, by an approach proposed by the World Health Organization (WHO), the daily hospital admissions for chronic obstructive pulmonary disease (COPD) related to exposure to particulate matter (PM10) and oxidants such as ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2) in a heavily polluted city in Iran. For the health impact assessment, in terms of COPD, the current published relative risk (RR) and baseline incidence (BI) values, suggested by the WHO, and the 1-h O3 concentrations and daily PM10, NO2, and SO2 concentrations were compiled. The results showed that 5.9, 4.1, 1.2, and 1.9% of the COPD daily hospitalizations in 2011 and 6.6, 1.9, 2.3, and 2.1% in 2012 were attributed to PM10, O3, SO2, and NO2 concentrations exceeding 10 μg/m3, respectively. This study indicates that air quality and the high air pollutant levels have an effect on COPD morbidity. Air pollution is associated with visits to emergency services and hospital admissions. A lower relative risk can be achieved if some stringent control strategies for reducing air pollutants or emission precursors are implemented.
Interactions between tetrahydroisoindoline-1,3-dione derivatives and human serum albumin via multiple spectroscopy techniques
Abstract
Some tetrahydroisoindoline-1,3-dione derivatives (TDDs) possess potent herbicidal activity. To assess possible impacts of TDDs on humans, the interactions between TDDs and human serum albumin (HSA) were evaluated with steady-state and time-resolved fluorescence spectroscopy, synchronous fluorescence spectroscopy, Fourier transform-infrared spectroscopy, and circular dichroism spectroscopy. The thermodynamic data obtained at temperatures of 298, 307, and 316 K indicate that TDDs spontaneously bind to HSA and thus form a TDD-HSA complex. The conformation and secondary structure of HSA are changed, and the intrinsic fluorescence of HSA is statically quenched by TDDs. Moreover, the TDD-HSA complex is formed primarily through electrostatic interactions and has only one binding site on HSA. A competitive ligand-binding assay revealed that site II (subdomain IIIA) displays the greatest affinity for TDDs. In addition, an acute toxicity bioassay showed no zebrafish mortality upon exposure to 4000 μg L−1 of TDDs. This work is helpful for understanding interactions between TDDs and HSA.
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A Case of Diprosopus Tetraophthalmos: Ocular Findings and Surgical Treatment of Exposure KeratopathyDiprosopus is a rare variation of conjoined twinning. In this report, ophthalmic findings in an infant with diprosopus tetraophthalmos are p...
