Medicine by Alexandros G. Sfakianakis

Es wird ein Überblick über die Inzidenz‑, Mortalitäts- und Überlebensraten bei hepatozellulärem Karzinom (HCC) in Deutschland, beruhend auf den Daten der epidemiologischen Krebsregister sowie der amtlichen Todesursachsenstatistik, gegeben.

Inzidenz‑, Mortalitäts- und Überlebensraten

Insgesamt wurden im Jahr 2014 in Deutschland 5710 Fälle des hepatozellulären Karzinoms diagnostiziert, davon 4520 bei Männern und 1190 bei Frauen. Das mittlere Erkrankungsalter betrug für Frauen 74, für Männer 71 Jahre. Männer sind etwa 4‑mal häufiger betroffen als Frauen. Zudem ist bei ihnen seit Anfang des Jahrtausends ein deutlicher Anstieg der Inzidenz und Mortalität zu erkennen. In den letzten Jahren scheinen sich diese Zahlen jedoch zu stabilisieren. Bei Frauen ist dagegen kein deutlicher Trend zu verzeichnen. Die Prognose beim HCC verbesserte sich zwar leicht, ist aber nach wie vor ungünstig: Die 5‑Jahres-Überlebensraten betrugen zuletzt um 16 %. Im Jahr 2015 verstarben 4416 Menschen in Deutschland an einem hepatozellulären Karzinom, davon 1089 Frauen.

Candidate long‐range regulatory sites acting on the IL17‐pathway genes TRAF3IP2 and IL17RA are associated with psoriasis

Experimental Dermatology, Volume 0, Issue ja, -Not available-.

The effects of vitamin K1 and vitamin K2 on the proliferation, cytokine production and regulatory T‐cell frequency in peripheral blood mononuclear cells of paediatric atopic dermatitis patients

Experimental Dermatology, EarlyView.

Nail Abnormalities Identified in an Aging Study of 30 Inbred Mouse Strains

Experimental Dermatology, Volume 0, Issue ja, -Not available-.

Vascular morphology in normal skin studied with dynamic optical coherence tomography

Experimental Dermatology, EarlyView.

Regulation of 25‐hydroxyvitamin D‐1‐hydroxylase and 24‐hydroxylase in keratinocytes by PTH and FGF23

Experimental Dermatology, Volume 0, Issue ja, -Not available-.

Correction to: FDG-PET/MRI in patients with pelvic recurrence of rectal cancer: first clinical experiences

The original version of this article, published on 6 July 2018, unfortunately contained a mistake.

Environmental surveillance for Vibrio cholerae in selected households’ water storage systems in Accra Metropolitan Area (AMA) prior to the 2014 cholera outbreak in Accra, Ghana

Abstract

Cholera is a global public health problem with high endemicity in many developing countries in Africa. In 2014, Ghana experienced its largest epidemic with more than 20,000 cases and 200 deaths; most of it occurred in the Accra Metropolitan Area (AMA). Ghana's disease surveillance system is mainly clinically based and focused on case detection and management. Environmental exploration for the etiological agents is missing from the surveillance strategy. This study therefore assessed the occurrence of toxigenic Vibrio cholerae in water storage systems in selected high risk areas in the AMA area prior to the 2014 outbreak. Three hundred twenty water samples from 80 households' water storage systems were analyzed for toxigenic Vibrio cholerae using the bacterial culture method. Presumptive V. cholerae was isolated from 83.8% of households' water storage systems. The viable cells ranged from 1 to 1400 CFU/100 ml. Vibrio cholerae O1 serotype was isolated from five households in Old Fadama, one household in Shiabu, and one household in Bukom in the month of May and a similar trend was observed for the months of June and July. The presence of Vibro cholerae in the water storage vessels used for drinking confirms the need to consider environmental surveillance for toxigenic Vibro cholerae particularly in high-risk areas to strengthen the existing surveillance system.

Effects of nitrification inhibitors on gross N nitrification rate, ammonia oxidizers, and N 2 O production under different temperatures in two pasture soils

Abstract

Australian pasture soil for cattle and sheep industries constitutes the principal land use with considerable N fertilizer consumption, which is one of the causes of local environmental problems. Nitrification plays a key role in regulating soil inorganic N concentration and its environmental diffusion. The effects of different nitrification inhibitors (NIs) on gross N nitrification (n_gross) rate and N₂O production under different temperatures in pasture soils remain unclear. A laboratory incubation experiment was conducted to determine the effect of NIs (dicyandiamide [DCD], 3,4-dimethylpyrazole phosphate [DMPP], and 3-methylpyrazol and 1H-1,2,4-triazol [3MP + TZ]) on N₂O emissions, n_gross and net N nitrification (n_net) rates, and the abundance of ammonia oxidizers, namely, ammonia-oxidizing archaea (AOA) and ammonia-oxidizing bacteria (AOB), in two Australian pasture soils incubated at temperatures of 15, 25, and 35 °C. All NIs reduced both n_gross and n_net rates and N₂O production rate from the two pasture soils but to different extents. The inhibitory rates of NIs on n_gross and n_net reached 6.80–63.8 and 5.91–62.3%, respectively, whereas that on N₂O production rate totaled 4.5–41.4% in the tested soils. NIs reduced nitrification and N₂O production by inhibiting the growth of AOB rather than AOA. The inhibitory effects of NIs were temperature-dependent, that is, decreasing with increasing temperature from 15 to 35 °C. In general, DMPP performed better than DCD and 3MP + TZ at 15 and 35 °C, whereas DCD performed more effectively than the other two NIs at 25 °C. Our results suggest that the utilization of NIs will depend on the conditions present, especially soil temperature. Additionally, AOB is the target of inhibition when mitigating nitrification and N₂O emission by applying NIs in pasture soils.

Ten‐year trends in contact allergy to formaldehyde and formaldehyde‐releasers

Contact Dermatitis, EarlyView.

Quantitative contribution of Cd 2+ adsorption mechanisms by chicken-manure-derived biochars

Abstract

This study investigated the efficiency and mechanisms of Cd²⁺ removal by chicken-manure biochar produced at different temperatures. Adsorption kinetics, isotherms, thermodynamic, and desorption were examined, and the biochars before and after adsorption were analyzed by SEM-EDS, FTIR, Boehm titration, and XRD. Kinetics of adsorption were better described by pseudo-second-order kinetic model than pseudo-first-order kinetic and intraparticle diffusion model under different initial Cd²⁺ concentrations of 20, 50, and 100 mg L⁻¹. Equilibrium adsorption was better modeled by Freundlich and Temkin isotherm equations than Langmuir equation at different temperatures of 25, 35, and 45 °C. Thermodynamic parameters confirmed the spontaneous and endothermic nature of the adsorption of Cd²⁺ at all of temperatures. Moreover, functional group complexation, precipitation, and cation exchange jointly contributed to Cd²⁺ adsorption on the biochars, whose relationship with the properties of biochar were also analyzed. The new precipitate as Cd₅(PO₄)₃OH was found during the adsorption. Complexation and precipitation were predominant mechanisms for all biochars (together accounting for 92.4–98.8%), while cation exchange made a relatively minor contribution to total Cd²⁺ removal (accounting for 1.2–7.6%). The relative distribution of each mechanism on the biochars was determined, which deepen our understanding of the Cd²⁺ adsorption process. These results are useful for future practical applications of biochar to removal heavy metals from water.

Κυριακή 5 Αυγούστου 2018

Epithelial–Myoepithelial Carcinoma Presenting as a Pseudo Veno-Lymphatic Malformation

A 41-year-old woman presented with several days of right eye pain and blurred vision. Examination and radiologic workup were consistent with a veno-lymphatic malformation, including demonstration of cystic fluid–fluid levels on imaging. Histopathology supported the presence of cystic spaces but revealed the final diagnosis of lacrimal epithelial–myoepithelial carcinoma, a rare neoplasm typically associated with the salivary gland. This represents the first reported case of lacrimal epithelial–myoepithelial carcinoma presenting with pain and evidence of intralesional cysts on radiographic and histopathologic evaluation. Better characterization will enable recognition, complete surgical excision, and potential adjuvant radiation therapy. Accepted for publication June 5, 2018. The authors have no financial or conflicts of interest to disclose. Supported by the National Institutes of Health Research Grant CA 16359 from the National Cancer Institute. Presented at the New York Orbital Society Spring Meeting, New York, NY on April 18, 2018. Address correspondence and reprint requests to Emily Li, M.D., 40 Temple Street, Suite 3D, New Haven, CT 06510. E-mail: emily.li@yale.edu © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

Age-Related Changes in Globe Position

Purpose: To longitudinally evaluate for changes in globe position as part of the natural aging process. Methods: A Cleveland Clinic Foundation imaging database of all head imaging scans performed from 1995 to 2017 was used to identify adults with normal orbits undergoing imaging studies at least 20 years apart. A total of 100 patients (200 globes) who had CT or MRI scans were studied. Globe position was determined by measuring the distance from the anterior aspect of the cornea to the zygomaticofrontal processes baseline. Clinically significant changes in globe position were defined as changes of ≥2 mm posteriorly (enophthalmos) or anteriorly (exophthalmos). Results: On average, globe projection decreased by 0.25 ± 2.3 and 0.26 ± 2.2 mm in the right and left eyes, respectively. Clinically significant enophthalmos with age was measured in 55 (27.5%) globes in 35 (35%) individuals, while clinically significant exophthalmos with age was measured in 43 (21.5%) globes in 26 (26%) individuals. The proportion of cases that developed enophthalmos, exophthalmos, or experienced no change were not significantly different from each other (p = 0.26). No patients developed clinically significant enophthalmos in one eye and exophthalmos in the other. Conclusions: Adults may develop clinically significant enophthalmos, exophthalmos, or no change in globe position over a 20-year period. This lack of uniform change in globe position with age impacts surgical considerations for treatment of the aging periocular region. Accepted for publication June 22, 2018. The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Julian D. Perry, M.D., Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH 44195. E-mail: perryj1@ccf.org © 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.

In situ phytoremediation characterization of heavy metals promoted by Hydrocotyle ranunculoides at Santa Bárbara stream, an anthropogenic polluted site in southern of Brazil

Abstract

Aquatic environments are widely affected by anthropogenic activities and efficient remediation of these areas requires detailed studies for each natural ecosystem. This research aimed to evaluate the natural phytoremediation potential of Hydrocotyle ranunculoides L., a floating aquatic macrophyte located in a polluted aquatic environment in South of the Rio Grande do Sul, Brazil. Nutrients such as P, K, Ca, Mg, and S and heavy metals such as Cu, Zn, Fe, Mn, Na, Cd, Cr, Ni, Pb, Al, As, Co, and V content in the roots and shoots of the plants were evaluated through nitric perchloric acid digestion (HNO₃-HClO₄) methods and quantified by ICP-OES. Bioconcentration factor (BCF), translocation factor (TF), plant effective number (PEN), and potential phytoremoval (mg m⁻²) were carried out. H. ranunculoides showed a substantial ability for phytoextracting P, Na, and As, since showed ability of uptake these elements from the water and translocate them to the shoots of the plants. H. ranunculoides also showed potential for application in rhizofiltration of Mg, S, Cu, Zn, Fe, Mn, Cd, Cr, Ni, Pb, Al, and V, since exhibited high potential to uptake higher levels in the roots. The highest potential for bioremoval (mg m⁻²) of the H. ranunculoides was detected for K, Ca, P (recommending thus the use for phytoextraction), Fe, and Al (highly recommended for rhizofiltration). Therefore, this species under study showed high potential for in situ phytoremediation at Santa Bárbara stream, and as a widespread species, it might be tested for phytoremediation in other sites.

The way forward confronting eco-environmental challenges during land-use practices: a bibliometric analysis

Abstract

With rapid urbanisation and industrialisation, land-use practice, while satisfying the ever-increasing desires of our material civilisation in the short term, may undermine natural ecosystems on a local, regional and global scale in the long run. Innovative and sustainable land-use practices should be developed in response, so that eco-environmental problems can assessed and dealt with during the whole process of land-use planning, construction, operation, maintenance and management. Using a bibliometric analysis, this study has traced global trends in land-use research from 1992 to 2016, as indexed in the Science Citation Index EXPANDED (SCI-EXPANDED) and the Social Sciences Citation Index (SSCI). A novel method called 'word cluster analysis' has revealed that hotspot analysis is one of the emerging techniques, tools and strategies used to respond to, improve, and protect deteriorating ecosystems during land use. Based on involving various elements, the emerging analytical techniques and tools, including geographical information systems (GIS) and remote sensing, have attracted attention for their ability to assess and solve increasingly serious eco-environmental problems, such as climate change, deforestation, soil erosion, greenhouse gas (GHG) emissions and eutrophication. Ecosystem services, biodiversity conservation, protected areas, and sustainable development are also potential resilience strategies used to confront eco-environmental destruction. The maximum benefits that can be derived from natural ecosystems should be pursued to achieve environmentally sustainable land-use development, strengthening the socio-economy and eco-environment, as well as enhancing the well-being of people and nature.

A yeast for all seasons – Is Pichia pastoris a suitable chassis organism for future bioproduction?

Abstract

The methylotrophic yeast Pichia pastoris (Komagataella spp.) is well established as a host for recombinant protein production. Since a few years it has also been subject to metabolic engineering to produce a diversity of biochemicals. Based on these developments we discuss here why P. pastoris is a suitable future chassis organism for synthetic biology, and we provide a roadmap for a community effort towards this aim.

Relationship of diversity and the secondary structure in 16S-23S rDNA internal transcribed spacer: a case in Vibrio parahaemolyticus

Abstract

The 16S-23S rDNA internal transcribed spacer (ITS) sequence, located in the rrn operon, has been analyzed and evaluated for use in phylogenetic analysis and the detection target of bacteria. The ITS region displays a high level of diversity, being present in multiple copies and displaying variability in both length and sequence, and it carries more phylogenetic information than 16S rDNA. However, appropriately identifying ITS regions to use in analyses is challenging. To solve this problem, we analyzed the ITS regions in Vibrio parahaemolyticus and predicted the secondary structure of each analogous rrn transcript. The genomic DNA of V. parahaemolyticus contains approximately 8-14 rrns, making it more complex than the sequences of most other bacterial species. We analyzed 216 ITSs, of which 206 ITSs come from 18 complete genomes, and 10 ITSs were identified in the present study. The subunits of each ITS were distinguished by their predicted secondary structures. We propose a refined backbone model of the V. parahaemolyticus ITS that can be applied to the sequences of other bacteria. The backbone includes C, V, tDNA and linker blocks. These blocks, which may represent true functional units, may be used as potential targets for phylogenetic analysis or molecular detection.

Σάββατο 4 Αυγούστου 2018

Removal of metronidazole by TiO 2 and ZnO photocatalysis: a comprehensive comparison of process optimization and transformation products

Abstract

The photodegradation of antibiotic metronidazole (MNZ) was systematically studied and compared by using aqueous suspensions of TiO₂ and ZnO catalysts under 100-W UV irradiation. The degradation conditions were optimized using the central composite design and response surface methodology. The optimal photodegradation conditions obtained were at pH 6.0 with 1.5 g L⁻¹ of TiO₂ (86.10% removal for 50 mg L⁻¹ MNZ) and at pH 9.5 with 0.5 g L⁻¹ of ZnO (60.32% removal for 30 mg L⁻¹ MNZ) after 60-min irradiation at 20 °C. The degradation efficiency in the presence of TiO₂ was higher than that of ZnO. The participation of active species such as hydroxyl radicals (OH·), holes (h⁺), and superoxide radicals (O₂⁻·) during MNZ photodegradation over TiO₂ and ZnO catalysts was also examined. Experimental results showed that MNZ oxidation was mainly driven by the presence of holes and superoxide radicals. Totally, 10 major intermediates were detected in UV/TiO₂ and UV/ZnO photocatalysis of MNZ using LC-QTof/MS system, in which 5 same intermediates were found. The remaining different intermediates led to the variations of degradation pathways of both processes. Moreover, some bigger transformation products than the parent MNZ were detected.

Proton therapy patterns of care among pediatric and adult patients with CNS tumors

Given the lack of exit radiation dose, proton therapy (PT) has been used for primary CNS tumors to minimize dose to adjacent, radiosensitive brain structures. For example, exposure of the hippocampus to even a low radiation dose has been associated with neurocognitive impairment.^1,2 While PT efficacy and toxicity for CNS tumors is being studied, data on the patterns of care for PT use is limited and based on only pediatric patients.^3–5 We used a multicenter registry to identify which CNS patients receive PT and whether differences exist between adult and pediatric CNS PT patients.

Physiological responses and metal uptake of Miscanthus under cadmium/arsenic stress

Abstract

The aim of this study is to explore the impact of cadmium (Cd) and arsenic (As) stress on physiological indexes and Cd/As uptake ability of Miscanthus, including Miscanthus sacchariflorus A0104, Miscanthus sinensis C0424 and C0640. Cd and As concentration showed significant hormesis effects on some physiological indexes, such as chlorophyll content, net photosynthetic rate, and MDA content. Compared with control group, Cd uptake can be most greatly enhanced by above fourfold with 150 mg/kg Cd treatment. As uptake of A0104 was increased by 3 ~ 33 folds with 200 mg/kg As treatment, C0424 was increased by 7–12 folds with 100 mg/kg As treatment, while C0640 was increased 1 ~ 6 folds with 250 mg/kg As treatment. The results also showed that C0640 was relatively better for the Cd remediation in the high Cd concentration (150 mg/kg) contaminated soil, while A0104 and C0424 were relatively better for the As remediation in the high As concentration (100 ~ 200 mg/kg) contaminated soil. Additionally, significantly (p < 0.05) close correlations were found among physiological indexes (except MDA content), while physiological indexes showed no significant relationship with the heavy metal contents in root, stem, and leaf.

The missclassification of obesity affects the course of migraine

Measuring the frequency of consumer hair combing and magnitude of combing forces on individual hairs in a tress and the implications for product evaluation and claims substantiation

International Journal of Cosmetic Science, Volume 0, Issue ja, -Not available-.

Melanoma subungueal: estudio descriptivo de 34 pacientes

Publication date: Available online 3 August 2018

Source: Actas Dermo-Sifiliográficas

Author(s): A. Talavera-Belmonte, M. Bonfill-Ortí, L. Martínez-Molina, R. Fornons-Servent, A. Bauer-Alonso, J.R. Ferreres-Riera, J. Marcoval

Resumen

Introducción y objetivos

El melanoma subungueal constituye un reto diagnóstico por su presentación clínica frecuentemente atípica. El objetivo del estudio fue revisar las características clínico-patológicas de los pacientes con melanoma subungueal diagnosticados en un hospital universitario de tercer nivel y analizar los factores posiblemente asociados al retraso del diagnóstico.

Material y métodos

Fueron analizados los datos de 34 pacientes diagnosticados de melanoma subungueal durante 20 años en nuestro centro.

Resultados

Del total de pacientes, 18 eran mujeres y 16 eran varones, con una edad mediana al diagnóstico de 66 años. Únicamente 5 de los pacientes presentaron melanoniquia longitudinal al ser visitados en nuestro Servicio de Dermatología. De los 34 pacientes, 19 presentaron melanoma invasivo al diagnóstico, con una mediana de índice de Breslow de 3,70 mm; 16 presentaron ulceración y 8 invasión ganglionar regional al diagnóstico. Cinco pacientes fueron diagnosticados en fase de melanoma in situ. La mediana del tiempo de evolución de las lesiones desde su aparición hasta la consulta al Centro de Asistencia Primaria fue de 15 meses, y desde la consulta al Centro de Asistencia Primaria hasta el diagnóstico en nuestro hospital fue de 5,5 meses. Las lesiones localizadas en los dedos de los pies presentaron con mayor frecuencia ulceración (p = 0,017) y una mayor probabilidad de invasión ganglionar regional al diagnóstico (p = 0,012).

Conclusiones

Los factores que en nuestro estudio se asociaron a un mayor retraso del diagnóstico del melanoma subungueal fueron la ausencia de melanoniquia como presentación clínica inicial y la localización de las lesiones en los dedos de los pies.

Abstract

Introduction and objectives

Subungual melanoma constitutes a diagnostic challenge because it often has an atypical clinical presentation. The aims of this study were to revise the clinical and pathologic characteristics of patients with subungual melanoma diagnosed at a tertiary care university hospital and analyze the factors potentially associated with a delayed diagnosis.

Material and methods

We analyzed data for 34 patients diagnosed with subungual melanoma at our hospital over a period of 20 years.

Results

The study population comprised 18 women and 16 men with a median age at diagnosis of 66 years. Only 5 of the patients had longitudinal melanonychia when examined at the dermatology department. At the time of diagnosis, 19 of the 34 patients had invasive melanoma (median Breslow thickness, 3.70 mm); 16 had ulceration and 8 had regional lymph node involvement. Five patients had subungual melanoma in situ at diagnosis. The median time from appearance of the lesions to consultation at a primary care center was 15 months; the corresponding time from primary care consultation to diagnosis at our hospital was 5.5 months. Lesions located on the toes were more likely to be ulcerated (P = .017) and to be accompanied by regional lymph node involvement at diagnosis (P = .012).

Conclusions

The factors associated with a longer diagnostic delay in patients with subungual melanoma were absence of melanonychia as a presenting feature and involvement of the toes.

Graphical abstract

Graphical abstract for this article

Παρασκευή 3 Αυγούστου 2018

A Review of Workplace Risk Management Measures for Nanomaterials to Mitigate Inhalation and Dermal Exposure

Abstract

This review describes an evaluation of the effectiveness of Risk Management Measures (RMM) for nanomaterials in the workplace. Our aim was to review the effectiveness of workplace RMM for nanomaterials and to determine whether established effectiveness values of conventional chemical substances applied for modelling purposes should be adopted or revised based on available evidence. A literature review was conducted to collate nano-specific data on workplace RMM. Besides the quantitative efficacy values, the library was populated with important covariables such as the study design, measurement type, size of particles or agglomerates/aggregates, and metrics applied. In total 770 records were retrieved from 41 studies for three general types of RMM (engineering controls, respiratory equipment and skin protective equipment: gloves and clothing). Records were found for various sub-categories of the different types of RMM although the number of records for each was generally limited. Significant variation in efficacy values was observed within RMM categories while also considering the respective covariables. Based on a comparative evaluation with efficacy values applied for conventional substances, adapted efficacy values are proposed for various RMM sub-categories (e.g. containment, fume cupboards, FFP2 respirators). It is concluded that RMM efficacy data for nanomaterials are limited and often inconclusive to propose effectiveness values. This review also shed some light on the current knowledge gaps for nanomaterials related to RMM effectiveness (e.g. ventilated walk-in enclosures and clean rooms) and the challenges foreseen to derive reliable RMM efficacy values from aggregated data in the future.

Photo-mediated Biosynthesis of Silver Nanoparticles Using the Non-edible Accrescent Fruiting Calyx of Physalis peruviana L. Fruits and Investigation of its Radical Scavenging Potential and Cytotoxicity Activities

Publication date: Available online 4 August 2018

Source: Journal of Photochemistry and Photobiology B: Biology

Author(s): Jayanta Kumar Patra, Gitishree Das, Anuj Kumar, AbuZar Ansari, Hojun Kim, Han-Seung Shin

Abstract

Silver nanoparticles (AgNPs) have been synthesized by various ways but the green technology methods using food waste materials has been accepted now a days for their cost effectiveness, environmental friendly and effective biomedical application. In the present study an attempt has been made to synthesize AgNPs by using the outer accrescent fruiting calyx of Physalis peruviana fruits, a food waste material under different light source condition, and to investigate their cytotoxic activity against the HepG₂ cells as well as their antibacterial and radical scavenging potential. The surface morphology and elemental composition of the biosynthesized AgNPs were evaluated by scanning electron microscopy, energy-dispersive X-ray analysis, and X-ray powder diffraction analysis. Fourier transform infrared spectroscopy of the sample extract and AgNPs was performed to determine the involvement of functional groups in the synthesis, capping, and stabilization process. The AgNPs showed promising cytotoxic activity against the HepG2 cells in a dose-dependent manner. The biosynthesized AgNPs also exhibited moderate antibacterial activity (8.14–10.22 mm inhibition zones) against two Gram-negative pathogenic bacteria with promising radical scavenging potential. Overall, the results highlight the effectiveness of the AgNPs for use in antibacterial wound dressing materials and other biomedical applications for the treatment of critical diseases such as cancer.

Synthesis, X-ray structure, DFT and antimicrobial studies of Ag(I) complexes with nicotinic acid derivatives

Publication date: Available online 4 August 2018

Source: Journal of Photochemistry and Photobiology B: Biology

Author(s): Saied M. Soliman, Sobhy E. Elsilk

Abstract

The [Ag(Menic)₂(ClO₄)]₂, (1) and [Ag(NA)₂]ClO₄, (2) complexes, where Menic; methylnicotinate and NA; nicotinamide, were synthesized and characterized using elemental analysis, FTIR, NMR and single crystal X-ray diffraction combined with DFT calculations. The Ag(I) is coordinated with two organic ligand molecules in both complexes. In 1, the coordination sphere is completed by one ClO₄¯ anion as a monodentate ligand while in 2, the ClO₄¯ anion is in the outer sphere. Both complexes showed some argentophilic interactions where the Ag sbnd Ag distance is shorter in 1 (3.152(6) Å) than 2 (3.303(9) Å). The organic ligands showed no antimicrobial activity up to 15 mmole/L while both silver(I) complexes are biologically active against different bacterial strains and the fungus Candida albicans. The minimal inhibition concentrations (MICs) of the Ag(I) complexes are in the range of 4–8 mmol/L depending on the nature of microorganism. Complex 2 showed slightly better antifungal action than 1. In contrast, complex 1 showed higher antibacterial potency against P. aeruginosa, C. perfringens, Sh. sonnei and Str. pneumonia compared to 2. The antibacterial action of 2 is slightly higher or equal against the rest of microorganisms compared to 1. The strength and nature of the Ag sbnd Ag, Ag sbnd N and Ag…O interactions were analyzed using atoms in molecules and natural bond orbital calculations.

Graphical Abstract

Unlabelled Image

Reconstruction of columellar defects: which surgical technique to choose ? A retrospective study of 18 patients

Publication date: Available online 4 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Claire Bergel, Abdullah Alshukry, Nathalie Kerfant, Cecile Philandrianos, Jacques Bardot, Dominique Casanova, Baptiste Bertrand

Abstract

The reconstruction of the columella is challenging and poorly evaluated in the literature. Our study aimed to evaluate retrospectively the different techniques used in our center and to propose an algorithm of reconstruction adapted to each patient. We report a retrospective cohort study included 18 patients (9 men and 9 women; 53 years-old in average) with columellar reconstruction treated from 1999 through 2014. Six different techniques were used: chondrocutaneous graft, nasolabial flap, paramedian forehead flap and scalping flap according to the Converse technique or the Raulo technique. Four independent plastic surgeons evaluated the aesthetic result on a 10cm visual analogue scale comparing the patients' photographs before and after the reconstruction. Furthermore, we asked the patients to perform the same evaluation, and to evaluate their level of satisfaction. The mean follow-up was 4 years. Three chondrocutaneous grafts were performed to reconstruct partial defects (Surgical Evaluation (SE): 7.9, Patient Evaluation (PE): 8.3).Three bilateral nasolabial flaps (SE: 6.1, PE: 6.7), 5 paramedian forehead flap (SE: 6.9, PE: 7.3) 6 Converse scalping flap (SE: 4.9, PE: 5.4) and 1 Raulo scalping flap (SE: 6,1, PE: 6,3) were performed to reconstruct total defects exceeding the columella. The use of composite graft was the most satisfactory procedure for partial defects. Paramedian forehead flaps and Raulo scalping flap were the most satisfactory procedures for extended defects. Nasolabial flap was the most adapted procedure for patients with general anesthesia contraindication or for defects extended to the lip.

Sensory and functional morbidity following sural nerve harvest in paediatric patients

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Joseph Catapano, Mark Shafarenko, Emily S. Ho, Ronald M. Zuker, Gregory H. Borschel

Summary

Background

The sural nerve is a common donor site for nerve reconstruction. The only study describing outcomes in paediatric patients was following bilateral sural nerve harvest prior to the age of one. Bilateral nerve harvest at such a young age may limit patients' ability to perceive a sensory difference. The objective of this study was to understand the sensory and functional deficit after unilateral sural nerve harvest in paediatric patients.

Methods

A prospective case series was performed in children (age 6 to 18) following unilateral sural nerve harvest. The contralateral foot was used as a control. Sensory Threshold Evaluation was performed using Weinstein Enhanced Sensory Test (WEST) – Foot and a Functional Sensory and Pain Questionnaire was administered. Sural nerve harvest was performed using a minimally invasive technique using a nerve stripper.

Results

Twenty-eight feet of fourteen patients that underwent unilateral sural nerve harvest were assessed. As a group, the fourteen feet with sural nerve harvest demonstrated significantly higher thresholds in the four areas tested (p < 0.05), identifying objective sensory loss at each location. The location of sensory loss in each patient was variable with heavier sensory thresholds detected in 69.6 % of areas tested in comparison to the corresponding location in the contralateral foot. Greater sensory loss was detected at the proximal lateral foot in comparison to the distal lateral foot. Responses to the questionnaire revealed that only one patient perceived a sensory loss that affected their function.

Conclusions

Unilateral sural nerve harvest in paediatric patients results in measurable sensory loss. Despite loss of innervation, only two patients reported intermittent dysesthesia or cold-sensitivity and the majority of patients report no functional deficit.

Post oncological lacrimal duct reconstruction; a practical classification system for reconstructive planning and short-term results of a case series.

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): M.V. van Burink, H.A. Rakhorst, G.M. van Couwelaar, U. Schmidbauer

Summary / Abstract

Background

: Surgical resection of skin tumors in the medial canthal area may damage the lacrimal duct and can result in chronic ephiphora. Post oncologic reconstruction of the lacrimal duct has not been studied extensively. The current study discusses the anatomical and functional features of the lacrimal duct. It describes short-term functional outcomes after monocanalicular reconstruction of the lacrimal duct in a case series of 10 patients.

Methods

: From February 2015 until October 2017 all patients with a post oncological lacrimal duct defect were analyzed to make an anatomical classification. The functional outcomes of patients, after monocanalicular reconstruction was measured with the Munk scale up to three months after stent removal.

Results

: Twelve patients had lacrimal duct defects after mohs resection. Anatomical characteristics were used to create a clinical classification for lacrimal duct defects. This classification divides the upper (U) and lower (L) proximal lacrimal duct in two sections which can be damaged. The punctum and pars verticalis (1), the canaliculus horizontalis (2) or combined (3). The Common lacrimal duct (C) is the distal part of the lacrimal duct and can also be affected. Ten patients where analyzed after lacrimal duct reconstruction. Three months after stent removal none of the patients suffered from ephiphora.

Conclusions

: This article proposes an anatomical classification for lacrimal duct defects in the proximal lacrimal drainage system. The classification can be applied in comparing cases and determining reconstructive strategies after oncologic skin tumor resection. Short-term results are promising for future efforts to reconstruct the lacrimal duct.

Negative-Pressure Wound Therapy: An Effective Adjunctive Treatment to Assist Flap Survival and Wound Closure

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Minliang Wu, Mengyan Sun, Haiying Dai, Jianguo Xu, Rui Guo, Yuchong Wang, Chunyu Xue

Multiple granular cell tumors associated with joint hypermobility, facial dysmorphism, and asymptomatic neurologic findings: A rare syndrome

Background: The granular cell tumor (GCT), also known as Abrikossoff tumor, is a rare, benign tumor. Its supposed origin is related to Schwann cells. It generally presents with a solitary nodule, but multiple tumors may be found in up to 25% of patients, less frequently in children. Bakos and Muscardin have reported multiple GCT associated with malformations in cardiovascular, neurologic and musculoskeletal systems in addition to a dysmorphic face, which could be features of a rare syndrome.

Multiple eruptive myxoid dermatofibroma in a man with chronic hepatitis B infection

We report the first known case of multiple eruptive myxoid dermatofibromas (MEMDF) in a male with chronic hepatitis B infection presenting with eruptive lesions showing marked deposits of dermal mucin. Tumor cells were positive for CD68 and vimentin and negative for S-100 and SMA. CD34 stained regular endothelial cells. Work-up showed asymptomatic chronic hepatitis B infection without cirrhosis. This case highlights an extremely rare histologic variant and the importance of screening for altered immunity in patients with eruptive dermatofibromas.

Psychologic health status and health-related quality of life in adults with atopic dermatitis

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder which is characterized by recurrent pruritic eczematous skin lesions. Patients with AD often suffer from a lot of psychologic distress and poor health-related quality of life (HRQoL) because of the irritating and disfiguring nature of the disease. However, psychologic burden of the AD patients has been underestimated and often considered to be of little importance even in clinics.

Classic Sweet sydrome: A case report

Sweet syndrome, or acute febrile neutrophilic dermatosis, is the most common of the neutrophilic dermatoses. We present a 54-year-old man who began 11 days before consultation with an upper respiratory tract infection, fever, and painful blisters on the face and arms, receiving treatment with antivirals and antibiotics unsuccessfully. Clinically he had bilateral conjunctivitis, vesicles, blisters, some with purulent exudate, flattened and necrotic center, plaques with erythematous and raised edges affecting face, neck, ears, chest, and upper limbs.

Clear cell variant of eccrine porocarcinoma of the hand: A case report

Introduction: Eccrine porocarcinoma (EP) is a rare malignant neoplasm of the acrosyringium with metastatic potential that most commonly presents on the acral skin in older adults. The primary lesions present as verrucous or polypoid nodules or plaques, often with spontaneous bleeding and ulceration, and arise either from a preexisting eccrine poroma or de novo. Only 8% of porocarcinomas occur in the upper extremity and only 3% are on the hand. The histologic characteristics of EP vary a lot so more than one consultation is often needed to establish the diagnosis.

Clinical analysis of linear focal elastosis

Background: Linear focal elastosis (LFE) is an uncommon disease of elastic tissue. There have been 31 cases of LFE in the English-language literature.

Clinical and dermoscopic features of 135 cases of small-diameter melanomas

Introduction: Early diagnosis of melanoma reduces morbidity, mortality, and costs. As a result of the increasingly early diagnosis, the percentage of melanomas removed when their diameter does not exceed 6 mm is rising and about 50% of the cases are already invasive. These lesions represent a diagnostic challenge both clinically and dermatoscopically.

Clinical and economic implications of a noninvasive molecular pathology assay for early detection of melanoma

Background: More than 90% of ∼2.5 million surgical biopsies performed to rule out melanoma in the U.S. alone are benign and classified as neither invasive melanomas nor melanomas in situ by histopathology. A recently described adhesive patch skin biopsy based noninvasive gene expression test (pigmented lesion assay; PLA) demonstrated utility and differentiated benign from malignant pigmented skin lesions with a test performance that exceeded visual inspection (VI) and a sensitivity that matching the criterion standard of dermatopathology.

Clinical and erythema-directed instrumental evaluation of papulopustular rosacea treated with topical ivermectin

Background: Ivermectin 1% cream is a new therapeutic topical option able to control mild/moderate papulopustular rosacea (PPR). Nontransient erythema from inflammatory lesions represents an important component of PPR often leading to patient emotional suffering, and digital photography equipped with RBX system enabling separation of red/brown skin color signatures is a useful tool for evaluation of erythema in patients affected by inflammatory dermatoses including rosacea. Colorimetry is also a sensitive technique for skin color analysis.

Clinical and instrumental characterization of hair and scalp aging in nonbalding Caucasian women

Introduction: Aging affecting the body doesn't spare scalp and hair, leading to changes in the physiology of scalp and the physical properties of the hair, with potential psychologic repercussions. Most of the time, it is difficult to isolate the aging effects alone because they can be superimposed to a preexisting alopecic phenomenon.

Secukinumab demonstrates significantly lower immunogenicity potential compared with ixekizumab and adalimumab

Background: Secukinumab (SEC), a fully human monoclonal antibody (mAb) that selectively neutralizes IL-17A, has significant efficacy in the treatment of moderate to severe plaque psoriasis (Pso) and psoriatic arthritis (PsA), demonstrating a rapid onset of action and sustained responses up to 5 years with a favorable safety profile and 0.4% immunogenicity in the Pso phase 3 program. SEC has previously demonstrated lower potential for immunogenicity compared with other mAbs used to treat Pso and PsA in in vitro assays.

The menace of persistent dermatophytosis: What is the cause?

'Background: Many patients with tinea corporis and or cruris are showing incomplete response to treatment or relapse soon after stopping treatment. The present study was carried out to determine the minimum inhibitory concentration (MIC) of the commonly used antifungal drugs in such cases and to identify predisposing factors.

Unilateral mucocutaneous lymphangioma circumscriptum: A rare case successfully treated with simple sclerotherapy and laser ablation

A 15-year-old boy presented with growth in the right buccal mucosa extending to chin skin since childhood. These were complaints for pain, bleeding, cosmetic looks. He has a linear multivesicular swellings with hemorrhagic, crusted hard swellings extending up to angle of mouth. These tumors were nontender, nonpulsatile with an irregular warty surface, and firm in consistency. Right side of the chin skin showed grouped vesicles with flash colored to dark red and black colored. A clinical suspesion of lymphangioma was made due to frog spawn picture and then biopsy from mucosa was taken.

Successful treatment of severe plaque psoriasis with secukinumab in a patient with myasthenia gravis: Case report

The treatment of severe psoriasis is often tailored around patients needs, weighting the potential benefits and side-effects. Patients' comorbidities can often make the effective treatment challenging. In the herein report, we present our experience of a patient in whom the treatment of severe psoriasis didn't aggravate myasthenia gravis (MG) symptomatology. A 60-year-old Caucasian man was first admitted to our institution suffering from severe plaque psoriasis in 2014. His medical history included MG for which was treated with neostigmine for the past 30 years.

Rate of regional nodal metastases of cutaneous squamous cell carcinoma in the immunosuppressed patient: An update

Background: The immunosuppressed patient has both an increased incidence of cutaneous squamous cell carcinoma (SCC) and a worse prognosis due to the propensity for metastatic spread. The single most important prognostic indicator for mortality in patients with SCC is the presence or development of regional lymph node metastasis. Previous studies have sought to determine the rate of regional lymph node metastases in solid organ transplant recipients (SOTRs). However, reported rates appear surprisingly low and are limited to only SOTRs.

Topical glycerol improved psoriasiform lesions and inhibited epidermal hyperplasia in an in vivo mouse model of psoriasis

Psoriasis is a chronic incurable skin disease that has been extensively studied. Although multiple treatments have been introduced, emollients are still used as a topical treatment to control several aspects of the disease. Glycerol, an emollient, has been shown to restore barrier function and accelerate wound healing. Glycerol is transported into epidermal keratinocytes via aquaporin-3 (AQP3), which is associated with the lipid-metabolizing enzyme phospholipase D2 (PLD2). PLD2 can convert glycerol to phosphatidylglycerol, which has been shown to inhibit proliferation and promote differentiation in keratinocytes in vitro.

TH17 pathway assessment in the inflammatory infiltrate of psoriasis and geographic tongue

Psoriasis is an immune-mediated disease with a genetic basis, associated with an inappropriate immune activation, mediated by T cells. There is predominance of the TH1 response and, more recently, was confirmed the participation of TH17 cells. Some studies have shown a direct relationship between psoriasis (Ps) and geographic tongue (GT), both with etiologic, histopathologic and genetic similarities. The aim of this study was to demonstrate that the histologic pattern and immunoreactivity to anti–IL-6, –IL-17, and –IL-23 antibodies, in the inflammatory response of geographic tongue are similar to psoriasis.

Sociodemographics, comorbidities, and management in a pediatric cohort of chronic spontaneous urticaria

Rationale: Chronic urticaria (CU) is defined when itchy hives and/or angioedema develop for at least 6 weeks. Although not life threatening, CU is reported to be associated with recurrent visits to the emergency room, stress and missing days of school and work due to severe itchiness. In 80% of CU cases, hives occur spontaneously and are not attributable to a physical stimulus or an identifiable cause (CSU). The objective of our study is to assess sociodemographics, comorbidities, and management of CSU in a pediatric cohort.

Risk of rhegmatogenous retinal detachment in atopic dermatitis: A 12-year nationwide cohort study

Background: Atopic dermatitis (AD) causes various ophthalmic complications, of which rhegmatogenous retinal detachment (RRD) is the most serious.

Validation of scratching severity as an objective assessment for itch

Background: Itch is a very bothersome symptom that is associated with many medical and dermatologic conditions. Itch is typically assessed subjectively, e.g., numeric rating scale (NRS). Yet, there are currently no simple, standardized, objective assessments of itch for clinical trials and practice.

Cross-section investigation and analysis of anxiety and depression in preoperative patients in outpatient department of aesthetic plastic surgery in a general hospital in China

Objective: This study was designed to evaluate the anxiety and depression disorders and investigate the prevalence and risk factors in preoperative patients who came to cosmetic plastic surgery clinic. Methods: Using the field survey method, the estimate of anxiety and depression in preoperative patients was made by the Hospital Anxiety and Depression Scale from July 2016 to July 2017 in the outpatient department of plastic surgery in a general hospital. The demographic information was collected.

Reconstruction of columellar defects: which surgical technique to choose ? A retrospective study of 18 patients

Nipple-sparing mastectomy with different approaches: surgical incisions, complications and cosmetic results. Preliminary results of 100 consecutive patients at a single center

Nipple areola sparing mastectomy is a novel surgical approach that preserves the nipple areola complex. Patients with moderate and/or severe breast ptosis are usually not eligible for this surgical approach. In this study we are aimed to demonstrate the feasibility of non-conventional surgical approaches for nipple sparing mastectomy.One hundred consecutive patients were enrolled for this study, with diagnosed primary breast cancer. Clinical and pathological data, such as body mass index, smoking status, breast ptosis, complications and aesthetic satisfaction (Breast-Q test) were considered.

Sensory and functional morbidity following sural nerve harvest in paediatric patients

Negative-Pressure Wound Therapy: An Effective Adjunctive Treatment to Assist Flap Survival and Wound Closure

Dear Sir,

The impact of orthognathic surgery on velopharyngeal function by evaluating speech and cephalometric radiographs

: Maxillary retrognathia is a well-known consequence of abnormal facial growth in patients with cleft lip and palate. Orthognathic surgery improves facial appearance and occlusion, but may induce velopharyngeal insufficiency. The aim of the study was to evaluate the effect of orthognathic surgery on velopharyngeal function using speech analysis and lateral cephalometric radiographs.

Autologous fat grafting for enhancement of breast reconstruction with a transverse myocutaneous gracilis flap: A cohort study

The transverse myocutaneous gracilis (TMG) flap is a viable option for reconstruction of small to moderate breasts. The purpose of this series was to examine outcomes of fat grafting to breast and donor site secondary to breast reconstruction with a TMG flap.

Post oncological lacrimal duct reconstruction; a practical classification system for reconstructive planning and short-term results of a case series.

Use of coliphages to investigate norovirus contamination in a shellfish growing area in Republic of Korea

Abstract

A number of severe norovirus outbreaks due to the consumption of contaminated shellfish have been reported recently. In this study, we evaluated the distribution of coliphage densities to determine their efficacy as fecal indicators of enteric viruses, including noroviruses, in water samples collected from a shellfish growing area in Republic of Korea over a period of approximately 1 year. Male-specific and somatic coliphages in water samples were analyzed using the single agar layer method, and norovirus genogroups I and II, which infect mainly humans, were analyzed using duplex reverse transcription quantitative PCR. Male-specific and somatic coliphages were detected widely throughout the study area. Several environmental parameters, including salinity, precipitation, temperature, and wind speed were significantly correlated with coliphage concentrations (P < 0.05). Moreover, the concentrations of male-specific coliphages were positively correlated with the presence of human noroviruses (r = 0.443; P < 0.01). The geospatial analysis with coliphage concentrations using a geographic information system revealed that densely populated residential areas were the major source of fecal contamination. Our results indicate that coliphage monitoring in water could be a useful approach to prevent norovirus contamination in shellfish.

Effect of tetramethyl thiuram disulfide (thiram) in relation to tibial dyschondroplasia in chickens

Abstract

Tetramethyl thiuram disulfide (thiram) is one of the important pesticides, which is extensively used in agriculture, but if it is combined with the cell membrane, then it causes membrane damage, bone morphogenic inactivation, and inhibited angiogenesis. Thiram has been considered a common cause of tibial dyschondrolplasia (TD) in various avian species, because it becomes the part of feed due to environmental contamination and its overuse in agriculture as pesticides or fungicide. However, there is no systematic study on the changes of the correlation indexes with toxic effect of the thiram in chickens. Therefore, we evaluated the toxic effects of thiram on growth performance of chickens, viscera organ index, pathological changes in tissue, and gene expression associated with osteoblast differentiation, vascularization, and tibial bone development. For this study, 1-day chickens (n = 300) were randomly distributed into two equal groups, control group (normal basal diet) and thiram group (adding thiram 40 mg/kg in basal diet). The result presented that thiram group chickens were looking unhealthy, lazy, and showing clinical symptoms like lameness. Thiram treatment significantly reduced the performance of chickens, liver index, and tibial length compared with control group. The toxic effect of thiram increased the visceral organ index (spleen and cardiac), tibia index, and TD severity considerably. It also increased serum Ca²⁺ and P³⁺ concentration and decreased tibial density compared to control chickens but the difference was not significant. Histopathology of tibia and liver showed that there were severe lesions due to toxic effect of thiram. Furthermore, HIF-1α and VEGF antibody localizations were increased and WNT4 localization was reduced significantly in immunohistochemical analysis. This systemic study of toxic effects of thiram in chicken concluded that thiram reduced the growth performance of chickens through decreasing liver index, whereas increasing kidney, cardiac, and spleen index, and induced TD by changing the expressions of VEGF, HIF-1α, and WNT4.

Brain Health and the Batterer

Violence and Gender, Ahead of Print.

The therapeutic potential of targeting the endothelial-to-mesenchymal transition

Abstract

Endothelial cells (ECs) have been found to be capable of acquiring a mesenchymal phenotype through a process known as endothelial-to-mesenchymal transition (EndMT). First seen in the developing embryo, EndMT can be triggered postnatally under certain pathological conditions. During this process, ECs dedifferentiate into mesenchymal stem-like cells (MSCs) and subsequently give rise to cell types belonging to the mesoderm lineage. As EndMT contributes to a multitude of diseases, pharmacological modulation of the signaling pathways underlying EndMT may prove to be effective as a therapeutic treatment. Additionally, EndMT in ECs could also be exploited to acquire multipotent MSCs, which can be readily re-differentiated into various distinct cell types. In this review, we will consider current models of EndMT, how manipulation of this process might improve treatment of clinically important pathologies and how it could be harnessed to advance regenerative medicine and tissue engineering.

Split-Face, Randomized, Placebo-Controlled, Double-Blind Study to Investigate Passive Versus Active Dermal Filler Administration

Abstract

Background

QueryHyaluronic acid (HA) is a large polymer increasingly used as dermal filler. HA does not permeate through healthy skin and is administered using various injection techniques. As HA procedures become more popular, the number of complications in facial rejuvenation procedures is likely to increase. Alternative methods may be necessary to satisfy the increasing demand for HA procedures. High-frequency high-intensity ultrasound is a painless and noninvasive method to deliver large molecules to the skin that is expected to deliver HA with visible results.

Objective

Assess facial rejuvenation with HA delivered with high-frequency high-intensity ultrasound.

Methods

Fifteen women (mean age 55) willing to participate in a randomized, double-blind, face-split trial with HA and placebo formulations in different sides of the face, were subject to five treatment sessions with high-frequency high-intensity ultrasound. Photographs taken before the procedure and after the last procedure were evaluated by a panel of five experts, blind to which side was treated with the HA or with the placebo.

Results

The expert panel identified a noticeable facial rejuvenation in the HA side relative to the placebo with a very statistically significant difference between the two sides (p < 0.0001).

Conclusions

Administration of HA with high-frequency high-intensity ultrasound is safe and leads to unambiguous facial rejuvenation.

Level of Evidence I

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Best Before Date Necessity: A Reply to Psillos

Abstract

This discussion paper is a reply to Stathis Psillos' paper "Induction and Natural Necessities" (J Gen Philos Sci 48(3):327–340, 2017. https://ift.tt/2OaCrSJ), published in this journal. In that paper, he attempts to refute David Armstrong's solution to the problem of induction. To accomplish this desideratum, he proposes that the best explanation for our observed regularities is a sort of "best before date" necessity. That is, necessary connections may break down and are not by default timeless. He develops arguments against my (Castro, Teorema 33(3):67–82, 2014) defence of the necessitarian solution regarding a previous paper by Beebee (Noûs 45(3):504–527, 2011. https://ift.tt/2vfiTFH). He alleges that (a) best before date necessity is no worse than timeless necessity; (b) his proposal does not imply any further inductive generalisation to timeless necessity; and (c) inductive inferences are justified. In this discussion paper, I provide arguments against these three claims.

Antibiotic-induced alterations in taurocholic acid levels promote gastrointestinal colonization of Candida albicans

Abstract

Candida albicans is a fungal pathogen that poses a significant public health risk due to high incidence and mortality rates among immunocompromised patients. C. albicans infections begin with successful gastrointestinal (GI) colonization; however, the mechanisms behind this colonization remain to be elucidated. In this study, we investigated the role of taurocholic acid (TCA) on growth and GI colonization of C. albicans. Our results indicate that cefoperazone-treated mice susceptible to C. albicans infection had significantly increased levels of TCA in the gut contents. In addition, an increase in TCA levels directly correlates with higher C. albicans load in the fecal and gut contents of antibiotic-treated infected mice. Using in vitro assays, we also demonstrated that TCA enhances the growth of C. albicans and its ability to develop filamentous hyphae. Furthermore, TCA significantly increased the ability of C. albicans to attach to mammalian cells. These results demonstrate that antibiotic treatment alters TCA levels in the gut and potentially enhances GI colonization of C. albicans.

Inactivation of feline calicivirus using ultraviolet light-emitting diodes

Abstract

Ultraviolet light-emitting diodes (UV-LEDs) with peak emission wavelengths of 265, 280 and 300 nm were applied for the inactivation of feline calicivirus (FCV) in water, and the results were compared to those derived with a common viral surrogate coliphage MS2. The fluence response profiles indicated that the log₁₀-based inactivation rate constant of FCV was 0.113, 0.101 and 0.007 cm² mJ⁻¹ for the 265, 280 and 300 nm UV-LEDs, respectively, while that of MS2 was 0.034, 0.033 and 0.003 cm² mJ⁻¹ for the 265, 280 and 300 nm UV-LEDs, respectively. Namely, FCV was about 2 to 3 times more sensitive than MS2 to germicidal UV emissions adopted in this study, and the 265 nm and 280 nm UV-LEDs were particularly effective to inactivate FCV. Results of this study are to be a part of knowledge base on fluence response profiles of various microorganisms, which would foster the development of disinfection apparatuses equipped with UV-LEDs.

The impacts of seawater physicochemical parameters and sediment metal contents on trace metal concentrations in mussels—a chemometric approach

Abstract

The concentrations of Al, Ba, Cd, Co, Cr, Cu, Fe, Li, Mn, Ni, Pb, Sr, Zn, and Hg were studied in Mytilus galloprovincialis collected from the coastal area of Montenegro. The impact of seawater temperature, salinity, dissolved oxygen, total organic carbon (TOC), and metal content in sediment samples on the metal contents in mussels collected from three locations in four different seasons was analyzed by a Pearson correlation coefficient (r), principal component analysis (PCA), and cluster analysis (CA). These analyses were used to discriminate groups of samples, elements, and seawater parameters, according to similarity of samples chemical composition in different seasons, as well as the impact of seawater parameters and surface sediment composition on the mussels' element concentrations. Synergistic interactions occurred between seawater TOC, Fe, and Al concentrations in mussels. Compared with other studies, which are usually performed under constant laboratory conditions where mussels undergo only one stress at a time, this study was performed in nature. The analyses showed the importance of considering simultaneously acting environmental parameters that make determining of separate impacts of each factor selected very difficult and complex.

Cross-section investigation and analysis of anxiety and depression in preoperative patients in outpatient department of aesthetic plastic surgery in a general hospital in China

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Liyuan Wei, Chaoyi Ge, Wei Xiao, Xiaochen Zhang, Jinghong Xu

Summary

Objective: This study was designed to evaluate the anxiety and depression disorders and investigate the prevalence and risk factors in preoperative patients who came to cosmetic plastic surgery clinic. Methods: Using the field survey method, the estimate of anxiety and depression in preoperative patients was made by the Hospital Anxiety and Depression Scale from July 2016 to July 2017 in the outpatient department of plastic surgery in a general hospital. The demographic information was collected. All data were analyzed by SPSS statistical package. Results: A total of 315 patients were enrolled, including 15 males and 300 females, with an average age of 30 ± 8.4 years. The mean HADS score was 8.2 ± 5.13, HADS-A was 4.7±3.04, and HADS-D was 3.5±2.72. The HADS-A score was significantly higher than the HADS-D score (p=0.000). There were 34 cases (10.8%) with anxiety, 15 cases (4.8%) with depression and 6 cases (1.9%) with both anxiety and depression. We found that education level of these patients (p=0.001) and the development level of their residence places (p=0.040) have a negative correlation with the score of anxiety. There was a negative correlation between education level (p=0.000) and depression score. The education level was associated with the diagnosis of anxiety (p=0.034). The education level (p=0.001) and occupations (p=0.015) were associated with the diagnosis of depression. Conclusion: In the patients seeking cosmetic plastic surgery, the preoperative anxiety is more obvious than depression. There is a negative correlation between education level and anxiety and depressive symptoms.

Nipple-sparing mastectomy with different approaches: surgical incisions, complications and cosmetic results. Preliminary results of 100 consecutive patients at a single center

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): G. Corso, F. De Lorenzi, E. Vicini, G. Pagani, P. Veronesi, M. Sargenti, F. Magnoni, P. Naninato, P. Maisonneuve, C. Sangalli, M. Rietjens, Viviana Galimberti

Abstract

One hundred consecutive patients were enrolled for this study, with diagnosed primary breast cancer. Clinical and pathological data, such as body mass index, smoking status, breast ptosis, complications and aesthetic satisfaction (Breast-Q test) were considered. In accord with the different type of breast ptosis, surgical procedures were classified as a) hemi-periareolar, b) round block, c) vertical pattern, and d) wise pattern skin incisions. We considered statistical analysis to assess the correlation with complications, degree of ptosis, and breast-Q scores.

Among the 117 surgical procedures performed in 100 breast cancer patients, no significant associations are verified considering clinical and pathological data, complications, pre- and post-surgery satisfactions, such as other parameters.

Different surgical approaches represent the evolution of "classic" nipple sparing mastectomy, meeting the cosmetic and oncological results. These procedures are safety and indicated also in cases conventionally considered not eligible for nipple areola preservation.

Autologous fat grafting for enhancement of breast reconstruction with a transverse myocutaneous gracilis flap: A cohort study

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): Elisabeth Russe, Hassan Kholosy, Laurenz Weitgasser, Michael Brandstetter, Heike Traintinger, Jennifer Neureiter, Gottfried Wechselberger, Thomas Schoeller

Summary

Background

Methods

A cohort study was undertaken to identify all patients who underwent autologous fat grafting after breast reconstruction with a TMG flap at two institutions between 1/2009 and 10/2013. Data was collected regarding patient demographics, body mass index and medical history as well as surgical details regarding TMG flap surgery and fat grafting.

Results

A total of 145 fat graftings were performed in 83 patients following TMG flap breast reconstruction for improvement of contour, shape and volume of breasts (98%, n=142), donor site (9%, n=13) or both (7%, n=10), mainly after breast cancer surgery (83%). On average 1.8 fat grafting sessions were performed with an average of 30cc fat per breast and 56.4cc fat per thigh. In 72% fat injection was performed with other pending reconstructive procedures. Fat was harvested in tumescent technique, using a filter syringe system and injected without any further processing in multiple layers.

Conclusions

Autologous fat grafting as a secondary procedure represents a powerful adjunct to enhance the aesthetic outcome of the reconstructed breast and donor site. It can be easily combined with other pending reconstructive procedures. With additional fat grafting it may be possible to expand indications and offer autologous reconstruction with a TMG flap even in very lean patients.

The impact of orthognathic surgery on velopharyngeal function by evaluating speech and cephalometric radiographs

Publication date: Available online 3 August 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): D. Impieri, K.A. Tønseth, Ø. Hide, E.L. Brinck, H.E. Høgevold, C. Filip

Abstract

Background

Patients and Methods

: A retrospective study of 47 patients who underwent maxillary advancement ± mandibular setback between 2006 and 2016. Pre- and 1-year postoperative audio recordings were blinded for scoring by three trained speech therapists. Pre- and 1-year postoperative lateral cephalometric radiographs were used to obtain information about skeletal movement and its relationship with the velopharyngeal area. Correlations between the speech outcomes and cephalometric radiographs were calculated.

Results

: Hyponasality improved significantly after surgery (p<0.05), while hypernasality deteriorated significantly only in the patients who underwent maxillary advancement alone (p<0.05). No difference in speech parameters was found between patients with hypernasality or patients who had a pharyngoplasty preoperatively and the rest of the group. No correlation was found between amount of maxillary advancement and hypernasality. Significant correlation (r< -0.49, p<0.05) was found between preoperative velar length and hypernasality postoperatively.

Conclusions

: Maxillary advancement has a negative impact on velopharyngeal function, while bimaxillary surgery seems to protect from deterioration. No difference was found in the amount of maxillary advancement or in velopharyngeal measurements between the Le Fort I and the bimaxillary group. A short soft palate is a predictor of hypernasality after orthognathic surgery.

Robot-assisted mediastinoscopic esophagectomy for esophageal cancer: the first clinical series

Abstract

Background

Radical esophagectomy for esophageal cancer is associated with high morbidity, especially with pulmonary complications. Mediastinoscopic esophagectomy via a small left neck incision combined with the esophageal hiatus, without using transthoracic approach, has been reported to reduce pulmonary complication; however, from technical point of view, this approach using non-articulating, straight, long forceps is extremely challenging, especially in the middle mediastinal area. Its technical difficulties may be attenuated using da Vinci Surgical System. The aim of this study was to evaluate the feasibility and safety of robot-assisted mediastinoscopic esophagectomy.

Methods

Robot-assisted mediastinoscopic esophagectomy was performed in six patients between October 2016 and May 2017. Robotic esophageal mobilization with upper and middle mediastinal lymphadenectomy was performed via the three da Vinci Xi (Intuitive Surgical, Inc. Sunnyvale, CA) trocars placed on the 5-cm left cervical incision. Thereafter, the remaining part of radical esophagectomy was completed via a transhiatal approach.

Results

Upper and middle mediastinal lymphadenectomy was robotically completed via the transcervical approach in all cases without conversion to transthoracic approach. No postoperative complications (Clavien–Dindo classification grade ≥ III) were observed.

Conclusions

Robot-assisted mediastinoscopic esophagectomy was technically feasible and safe. Use of da Vinci Surgical System may help attenuate technical difficulties in transcervical middle mediastinal lymph node dissection.

ESMO Consensus Conference on testicular germ cell cancer: diagnosis, treatment and follow-up

Abstract

The European Society for Medical Oncology (ESMO) consensus conference on testicular cancer was held on 3–5 November 2016 in Paris, France. The conference included a multidisciplinary panel of 36 leading experts in the diagnosis and treatment of testicular cancer (34 panel members attended the conference; an additional two panel members [CB and K-PD] participated in all preparatory work and subsequent manuscript development). The aim of the conference was to develop detailed recommendations on topics relating to testicular cancer that are not covered in detail in the current ESMO Clinical Practice Guidelines (CPGs) and where the available level of evidence is insufficient. The main topics identified for discussion related to: (1) diagnostic work-up and patient assessment; (2) stage I disease; (3) stage II-III disease; (4) post-chemotherapy surgery, salvage chemotherapy, salvage and desperation surgery and special topics; and (5) survivorship and follow-up schemes. The experts addressed questions relating to one of the five topics within five working groups. Relevant scientific literature was reviewed in advance. Recommendations were developed by the working groups and then presented to the entire panel. A consensus vote was obtained following whole-panel discussions, and the consensus recommendations were then further developed in post-meeting discussions in written form. This manuscript presents the results of the expert panel discussions, including the consensus recommendations and a summary of evidence supporting each recommendation. All participants approved the final manuscript.

Targeting gamma secretase: has progress moved up a notch?

It only takes two to tango: against grounding morality in interaction

Abstract

Most Kantian constructivists try to ground universal duties of interpersonal morality in certain interactions between individuals, such as communication, argumentation, shared action or the second-person standpoint. The goal of this paper is to present these, which I refer to as arguments from the second-person perspective, with a dilemma: either the specific kind of interaction that is taken as a starting point of these arguments is inescapable, but in that case the argument does not justify a universal principle of interpersonal morality. Or interaction does have a principle of interpersonal morality among its necessary conditions of possibility, but such forms of interactions are merely optional. I argue that proponents of arguments from the second-person perspective have failed to provide a convincing response to this dilemma and that this failure is systematic. This suggests that the success of Kantian constructivism depends on the success of arguments from the first person.

Πέμπτη 2 Αυγούστου 2018

Variability and Determinants of Occupational Noise Exposure Among Iron and Steel Factory Workers in Tanzania

Abstract

Background

Machines, processes, and tasks in the iron and steel factories may produce noise levels that are harmful to hearing if not properly controlled. Studies documenting noise exposure levels and related determinants in sub-Saharan Africa, including Tanzania are lacking. The aim of this study was to document noise exposure and to identify determinants of noise exposure with a view to establishing an effective hearing conservation programme.

Methods

A walk-through survey was conducted to describe the working environment in terms of noise sources in four metal factories (A–D) in Tanzania. Noise measurements were conducted by both personal, full-shift noise measurements (8 h) using dosimeters and area measurements (10-s measurements) using a sound level meter. A total of 163 participants had repeated personal noise measurements (Factory A: 46 participants, B: 43, C: 34, and D: 40). Workers were randomly selected and categorized into 13 exposure groups according to their job. Linear mixed effects models were used to identify significant determinants of noise exposure in the furnace section and the rolling mill section.

Results

The average personal noise exposure in the four factories was 92.0 dB(A) (range of job group means; 85.4–96.2 dB(A)) (n = 326). Personal exposure was significantly higher in the rolling mill section (93.0 dB(A)) than in the furnace section (89.6 dB(A)). Among the job groups, the cutters located in the rolling mill section had the highest noise exposure (96.2 dB(A)). In the furnace section, furnace installation (below the ground floor), manual handling of raw materials/billets/crowbars, and billet weighing/transfer were significant determinants explaining 40% of the total variance in personal noise exposure. In the rolling mill section, the size of the cutting machine, steel billet weight and feeding re-heating furnace explained 46% of the total variance in personal noise exposure. The mean noise level of the area measurements was 90.5 dB(A) (n = 376).

Conclusion

Workers in the four iron and steel factories in Tanzania were exposed to average noise of 92.0 dB(A), without using hearing protection, implying a high risk of developing hearing loss. Task and factory level determinants were identified in the furnace and the rolling mill sections of the plant, which can inform noise control in factories with similar characteristics.

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Δευτέρα 6 Αυγούστου 2018

Zusammenfassung

Hintergrund

Inzidenz‑, Mortalitäts- und Überlebensraten

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Κυριακή 5 Αυγούστου 2018

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Σάββατο 4 Αυγούστου 2018

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Introduction and objectives

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Graphical abstract

Παρασκευή 3 Αυγούστου 2018

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Graphical Abstract

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Summary / Abstract

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Objective

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Level of Evidence I

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