This large cohort study of participants in the Nurses' Health Study II evaluates the association between risk of incident rosacea in women and caffeine intake, including caffeinated coffee consumption.
Τετάρτη 17 Οκτωβρίου 2018
One More Reason to Continue Drinking Coffee—It May Be Good for Your Skin
Who does not love a study that validates one of life's habitual pleasures? Whether it is an iced latte, a double espresso, or simply a hot cup of brown liquid in the hospital cafeteria, many of us in medicine have an emotional attachment as well as a physiologic dependence on coffee.
Utility of Test Result Monitoring in Patients Taking Terbinafine or Griseofulvin for Dermatophyte Infections
This study assesses the rate and utility of monitoring laboratory test result abnormalities in adults and children taking terbinafine and griseofulvin for treatment of dermatophyte infections.
Cicatrizing Blepharoconjunctivitis During Dupilumab Treatment and an Algorithm for Its Management
This case report describes a patient who developed cicatrizing blepharoconjunctivitis while undergoing dupilumab treatment and proposes an algorithm for the management of dupilumab-associated conjunctivitis.
Analyzing Vaccine Trials in Epidemics with Mild and Asymptomatic Infection
Abstract
Vaccine efficacy against susceptibility to infection (VES), regardless of symptoms, is an important endpoint of vaccine trials for pathogens with a high proportion of asymptomatic infection, as such infections may contribute to onward transmission and long-term sequelae such as Congenital Zika Syndrome. However, estimating VES is resource-intensive. We aim to identify approaches to accurately estimate VES when limited information is available and resources are constrained. We model an individually randomized vaccine trial by generating a network of individuals and simulating an epidemic. The disease natural history follows a Susceptible, Exposed, Infectious/Symptomatic or Infectious/Asymptomatic, Recovered model. We then use seven approaches to estimate VES, and we also estimate vaccine efficacy against progression to symptoms (VEP). A corrected relative risk and an interval censored Cox model accurately estimate VES and only require serologic testing of participants once, while a Cox model using only symptomatic infections returns biased estimates. Only acquiring serological endpoints in a 10% sample and imputing the remaining infection statuses yields unbiased VES estimates across values of R0 and accurate estimates of VEP for higher R0 values. Identifying resource-preserving methods for accurately estimating VES and VEP is important in designing trials for diseases with a high proportion of asymptomatic infection.A Dynamic Model for Evaluation of the Bias of Influenza Vaccine Effectiveness Estimates from Observational Studies
Abstract
As influenza vaccination is now widely recommended in the United States, observational studies based on patients with acute respiratory illness (ARI) remain the only option to estimate influenza vaccine effectiveness (VE). We developed a dynamic probability model to evaluate bias of VE estimates from passive surveillance cohort, test-negative, and traditional case-control studies. The model includes two covariates (health status and health awareness), which may affect the probabilities of vaccination, developing ARI, and seeking medical care. Our results suggest that test-negative studies produce unbiased estimates of VE against medically-attended influenza when (1) vaccination does not affect the probability of non-influenza ARI and (2) health status has the same effect on the probability of influenza and non-influenza ARIs. The same estimate may be severely biased (i.e., estimated VE – true VE ≥ 0.20) for estimating VE against symptomatic influenza if the vaccine affects the probability of seeking care against influenza ARI. VE estimates from test-negative studies may also be severely biased for both outcomes of interest when vaccination affects the probability of non-influenza ARI, but estimates from passive surveillance cohort studies are unbiased in this case. Finally, VE estimates from traditional case-control studies suffer from bias regardless of the source of bias.Social Isolation and Mortality in US Black and White Men and Women
Abstract
Social isolation is associated with higher mortality in studies of mostly white adults, yet associations among black adults is unclear. This prospective cohort study evaluated whether associations of social isolation with all-cause, cardiovascular disease and cancer mortality differ by race and sex. Adults enrolled into Cancer Prevention Study-II in 1982/1983 were followed for mortality through 2012 (n = 580,182). Sex- and race-specific multivariable-adjusted hazard ratios and 95% confidence intervals were estimated for associations of a five-point social isolation score with risk of death. Social isolation was associated with all-cause mortality in all subgroups (P-trend ≤ 0.005); for the most versus the least isolated, the hazard ratios (95% confidence intervals) were 2.34 (1.58, 3.46) and 1.60 (1.41, 1.82) among black and white men, respectively (P-interaction = 0.40), and 2.13 (1.44, 3.15) and 1.84 (1.68, 2.01) among black and white women, respectively (P-interaction = 0.89). The association did not differ between black men and women (P-interaction = 0.33) but was slightly stronger in white women than white men (P-interaction = 0.01). Social isolation was associated with cardiovascular disease mortality in each subgroup (P-trend < 0.03) but with cancer mortality only among whites (P-trend < 0.0001). Subgroup differences in the influence of specific social isolation components were identified. Identifying and intervening with socially isolated adults could improve health outcomes.Patient reported outcome measures for soft tissue facial reconstruction: a systematic review and evaluation of the quality of their measurement properties
Background: A patient's health-related quality of life (HRQoL) can be significantly impacted by facial scarring and disfigurement. Facial soft tissue reconstruction should aim to improve HRQoL, with outcomes measured from the patient's perspective using patient-reported outcome measures (PROMs). This systematic review identifies PROMs for soft tissue facial reconstruction and appraises their methodological and psychometric properties using up-to-date methods. Methods: A systematic search of MEDLINE, EMBASE, PsychINFO and Cochrane was performed in line with the PRISMA guidelines. Identified PROMs were assessed using the updated COnsensus-based Standards for the Selection of Health Measurement INstruments (COSMIN) checklist. Psychometric properties were also assessed and a modified GRADE analysis was performed to aid in recommendations for future PROM use. Results: Thirty-four studies covering 9 PROMs were included. Methodological quality and psychometric evidence was variable. FACE-Q, Skin Cancer Index (SCI), Patient Outcome of Surgery – Head/Neck (POS-Head/Neck) and the Derriford Appearance Scale 59/24 all demonstrated high enough evidence to be recommended as having potential for inclusion in future studies. Conclusion: This is the first systematic review to identify and critically appraise PROMs for soft tissue facial reconstruction using internationally accepted criteria. Four PROMs were deemed to have adequate levels of methodological and psychometric evidence, although further studies should be conducted before their routine use in patients undergoing facial reconstruction. Through the use of psychometrically well-validated PROMs it is hoped that patients' concerns can be truly appreciated, level of care improved, and the quality of reconstructive options offered progressed. Meetings: This work has not yet been presented at any meetings. Acknowledgements: We would like to acknowledge the help of Anne Powell, retired librarian at Abertawe Bro Morgannwg University Health Board. Conflicts of Interest and Funding: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. This work has received no specific funding. Mr Thomas Dobbs is funded by the Welsh Clinical Academic Training Fellowship. Author role: TD, HH and ISW developed the idea for this systematic review. TD, JG, AT, BP performed the literature review and data extraction. TD and SH assessed all included papers according to the methodology. TD produced the first draft of the manuscript and all authors were then involved in editing to reach the final, submitted version. Corresponding Author: Mr Thomas Dobbs, The Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea. SA6 6NL, e: tomdobbs@doctors.org.uk ©2018American Society of Plastic Surgeons
Secukinumab is Superior to Ustekinumab in Clearing Skin in Patients with Moderate to Severe Plaque Psoriasis (16-Week CLARITY Results)
Abstract
Introduction
Secukinumab, a fully human anti-interleukin-17A monoclonal antibody, has demonstrated superior efficacy to ustekinumab in the phase 3b CLEAR study of moderate to severe plaque psoriasis. Here, we report 16-week results from CLARITY, a second head-to-head trial comparing secukinumab with ustekinumab.
Methods
In the phase 3b CLARITY study, patients were randomized 1:1 to receive subcutaneous secukinumab 300 mg or ustekinumab per label. The co-primary objectives were to demonstrate the superiority of secukinumab over ustekinumab at Week 12 in relation to the proportion of patients with (1) 90% or more improvement from baseline Psoriasis Area and Severity Index (PASI 90) and (2) a score of 0/1 (clear/almost clear) on the modified Investigator's Global Assessment (IGA mod 2011 0/1). Key secondary objectives were also assessed, as was Dermatology Life Quality Index (DLQI) 0/1 (no impact of skin disease on patients' quality of life) response. Missing values were handled by multiple imputation except for DLQI 0/1, where last observation carried forward techniques were utilized.
Results
Both co-primary objectives were met: secukinumab was superior to ustekinumab for the proportion of patients achieving a PASI 90 (66.5% vs. 47.9%) and IGA mod 2011 0/1 response (72.3% vs. 55.4%) at Week 12 (p < 0.0001). PASI 90 responses were greater with secukinumab compared to ustekinumab from as early as Week 4 (16.7% vs. 4.0%) and out to Week 16 (76.6% vs. 54.2%). Similarly, IGA mod 2011 0/1 findings were greater with secukinumab at Week 4 (26.9% vs. 7.8%) and at Week 16 (78.6% vs. 59.1%). DLQI 0/1 response rates were also greater with secukinumab compared to ustekinumab at Week 4 (33.9% vs. 18.0%), Week 12 (64.0% vs. 51.7%), and Week 16 (68.4% vs. 55.9%).
Conclusion
The results of this study confirm the superior efficacy of secukinumab over ustekinumab in treating patients with moderate to severe psoriasis.
Trial Registration
Clinicaltrials.gov Identifier, NCT02826603.
Funding
Novartis Pharma AG, Basel, Switzerland.
Les toxidermies graves sont-elles évitables ?
Publication date: Available online 16 October 2018
Source: Annales de Dermatologie et de Vénéréologie
Author(s): J.-L. Schmutz
-Asthma Prevalence Among Medicaid-Enrolled Children
Publication date: Available online 17 October 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Anna Smith, Nicoleta Serban, Anne Fitzpatrick
Abstract
Background
Small-area asthma prevalence measures, which are crucial for targeting interventions, are currently sparsely available for children.
Objective
This study aims to provide measures of in-contact asthma prevalence for the 2012 Medicaid child population, to highlight areas in need of targeted asthma interventions.
Methods
Using the 2012 Medicaid Analytic eXtract (MAX) claims files, we develop two prevalence metrics differentiated by persistent or diagnosed asthma. We develop prevalence measures at the state, county, and census tract levels, with statistical inferences to highlight areas of high-prevalence where intervention should be focused. We compare the measures to asthma prevalence estimates derived from a sample of the child population who have self-reported whether they have been diagnosed with asthma regardless whether in-contact.
Results
1.98 million (8.1%) and 1.71 million (6.9%) Medicaid-enrolled children are identified with in-contact asthma diagnosis and persistent asthma, respectively. Among 40 states, 17 have lower prevalence estimates for the Medicaid-enrolled children than similar Centers for Disease Control and Prevention (CDC) child asthma self-reported prevalence estimates. High prevalence regions span primarily in the southern Midwest region, from Texas to West Virginia and Illinois to north Florida.
Conclusions
There are large variations in the differences between CDC self-reported estimates for the general population and the in-contact estimates for the Medicaid-enrolled children, highlighting potential asthma misdiagnosis in the Medicaid population in many states. Small area estimates point to areas of high prevalence, consistently throughout the south and southeast.
Oral direct-acting antiviral therapy for hepatitis C virus (HCV) infection in X-linked agammaglobulinemia
Publication date: Available online 17 October 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Hermann M. . Wolf, Martha M. Eibl, Christian J. Müller
Atopic Dermatitis is associated with increased prevalence of multiple ocular comorbidities
Publication date: Available online 17 October 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Kishan Govind, Katherine Whang, Raveena Khanna, Adrienne W. Scott, Shawn G. Kwatra
Nitrate allergy and desensitization in a patient with refractory angina
Publication date: Available online 16 October 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Sarah G. Kessler, Amanda R. Gillion, Debendra Pattanaik, Kelly C. Rogers
Inhaled corticosteroid-related tuberculosis in the real world among patients with asthma and COPD: A 10-year nationwide population-based study
Publication date: Available online 16 October 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Chang-Min Lee, Jeongwon Heo, Seon-Sook Han, Ki Won Moon, Seung-Hwan Lee, Young-Ju Kim, Seung-Joon Lee, Jae-Woo Kwon
Abstract
Background
There have been concerns about the risk of ICS-related tuberculosis (TB) development.
Objective
We investigated the occurrence of TB among ICS users according to underlying respiratory diseases and type of ICS.
Methods
A 12-year population cohort comprising about 1 million subjects collected from the Korean claims database were used. Adult ICS users (budesonide or fluticasone) were enrolled. The temporal relationship between TB development and the last ICS prescription before TB development was evaluated. A nested case-control study was performed with 1:4 matching for age, sex, and the initiation date of the ICS.
Results
There were 17,991 ICS users, and 175 developed TB during the study period. About 80% (140/175) of patients who developed TB were diagnosed within 3 years after the last ICS prescription. In the nested case-control study, the occurrence of TB was not related to the type of ICS, but was related to a higher annual admission rate and a higher comorbidity score. The risk of TB was higher in patients with chronic obstructive pulmonary disease (COPD) than in those with asthma (OR: 2.31, CI 95%: 1.39-3.38, p= 0.0011) after adjusting for covariates. The subgroup analysis revealed no difference between budesonide and fluticasone with respect to the risk of developing TB in patients with asthma, COPD, or asthma-COPD overlap syndrome.
Conclusion
An increased risk of TB development may persist for 3 years after stopping the ICS and the risk is higher in patients with COPD regardless of the type of ICS used.
National ENT workforce planning in the United Kingdom; An increasing cause for concern?
Clinical Otolaryngology, Volume 0, Issue ja, -Not available-.
Generalized Fixed Drug Eruption Mimicking CD8+ Cutaneous T‐cell Lymphoma in HIV
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Utility of CD30, Ki67 and p53 in assisting with the diagnosis Mycosis Fungoides with Large Cell Transformation
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Novel immune signatures associated with dysplastic nevi and primary cutaneous melanoma in human skin
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
Photodynamic Therapy with a 5‐ALA‐Patch Does Not Increase the Risk of Conversion of Actinic Keratoses into Squamous Cell Carcinoma
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
Transcranial magnetic stimulation over contralateral primary somatosensory cortex disrupts perception of itch intensity
Experimental Dermatology, Volume 0, Issue ja, -Not available-.
Multiple yellowish white papules on the trunk and upper arms
International Journal of Dermatology, EarlyView.
Atypical presentation of immunoglobulin A vasculitis in disseminated tuberculosis
International Journal of Dermatology, EarlyView.
Noninvasive diagnosis of liquefied gouty tophus: Reflectance confocal microscopy as an alternative to polarizing light microscopy analysis
Skin Research and Technology, EarlyView.
Th17 responses to pneumococcus in blood and adenoidal cells in children
Clinical &Experimental Immunology, Volume 0, Issue ja, -Not available-.
Use of Absolute Risk Measurements in Dermatologic Observational Studies: Important Information For Decision Making Is Frequently Absent
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
A case of Incontinentia Pigmenti associated with congenital absence of portal vein system and nodular regenerative hyperplasia
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
Association of auto‐immunity and long‐term complete remission in Sezary patients treated with mogamulizumab
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
The burden of cutaneous adnexal carcinomas and the risk of associated squamous cell carcinoma: a population‐based study
British Journal of Dermatology, Volume 0, Issue ja, -Not available-.
The good, the bad and the malignant
British Journal of Dermatology, Volume 179, Issue 4, Page 809-810, October 2018.
隐性 XLI: 神经系统疾病的高患病率
British Journal of Dermatology, Volume 179, Issue 4, Page e192-e192, October 2018.
An Oral Disease Severity Score for pemphigus vulgaris
British Journal of Dermatology, Volume 179, Issue 4, Page e169-e169, October 2018.
Revealing the mysteries of X‐linked recessive ichthyosis
British Journal of Dermatology, Volume 179, Issue 4, Page 821-822, October 2018.
Image Gallery: Granulomatous dermatitis due to infection with the chlorophyllic green alga Desmodesmus
British Journal of Dermatology, Volume 179, Issue 4, Page e167-e167, October 2018.
The utility of understanding atrophic acne scar formation for prevention and treatment
British Journal of Dermatology, Volume 179, Issue 4, Page 819-819, October 2018.
A promising new treatment for SAPHO syndrome that deserves further studies
British Journal of Dermatology, Volume 179, Issue 4, Page 823-823, October 2018.
Can antibiotics be harmful in atopic dermatitis?
British Journal of Dermatology, Volume 179, Issue 4, Page 807-808, October 2018.
Assessing benefits and risks of holiday sun exposure in children
British Journal of Dermatology, Volume 179, Issue 4, Page 822-823, October 2018.
Generating new evidence for old medications: the TREAT trial in paediatric atopic dermatitis
British Journal of Dermatology, Volume 179, Issue 4, Page 813-814, October 2018.
Is the Oral Disease Severity Score going to be useful for dermatologists when assessing pemphigus?
British Journal of Dermatology, Volume 179, Issue 4, Page 816-817, October 2018.
来自 AD 患者的金黄色葡萄球菌的局部抗生素耐药性
British Journal of Dermatology, Volume 179, Issue 4, Page e188-e188, October 2018.
A Prospective Randomized Blinded Trial Comparing Digital Simulation to Textbook for Cleft Surgery Education
Background: Simulation is progressively being integrated into surgical training, yet its utility in plastic surgery has not been well described. We present a prospective, randomized, blinded trial comparing digital simulation to a surgical textbook for conceptualization of cleft-lip repair. Methods: Thirty-five medical students were randomized to learning cleft repair using a simulator or textbook. Participants outlined markings for a standard cleft-lip repair before (pre-intervention) and after (post-intervention) 20 minutes of studying their respective resource. Two expert reviewers blindly graded markings according to a 10-point scale, on two separate occasions. Intra-rater and inter-rater reliability were calculated using intra-class correlation coefficients. Paired and independent t-tests were performed to compare scoring between study groups. A validated student satisfaction survey was administered to assess the two resources separately. Results: Intra-rater grading reliability was excellent among both raters for pre-intervention and post-intervention grading (rater 1 ICC=0.94 and 0.95, respectively; rater 2 ICC=0.60 and 0.92, respectively; p
“Flap Preconditioning with the Cyclic Mode (Triangular Waveform) of Pressure-Controlled Cupping in a Rat Model: An Alternative Mode to the Continuous System”
Background: Improving flap survival is essential for successful soft-tissue reconstruction. Although many methods have been attempted to increase the survival of the distal flap portion, there has been no widely adopted procedure. We evaluated the effect of flap preconditioning with two different modes (continuous and cyclic) of external volume expansion (pressure-controlled cupping) in a rat dorsal flap model. Methods: Thirty rats were randomly assigned to the control group and two experimental groups (n=10/group). The continuous group underwent 30 min of preconditioning with -25 mmHg pressure once daily for 5 days. The cyclic group received 0 to -25 mmHg pressure for 30 min with the cyclic mode once daily for 5 days. On the day after the final preconditioning, caudally based 2x8-cm dorsal random-pattern flaps were raised and replaced in the native position. On postoperative day 9, the surviving flap area was evaluated. Results: The cyclic group showed the highest flap survival rate (76.02%), followed by the continuous and control groups (64.96% and 51.53%, respectively). All inter-group differences were statistically significant. Tissue perfusion of the entire flap showed similar results (cyclic, 87.13%; continuous, 66.64%; control, 49.32%). Histologic analysis with hematoxylin and eosin, Masson trichrome, and CD31 staining showed the most increased and organized collagen production with hypertrophy of the attached muscle and vascular density in the cyclic group, followed by the continuous and control groups. Conclusions: Flap preconditioning with the cyclic mode of external volume expansion is more effective than the continuous mode in an experimental rat model. Further studies will be necessary for clinical application. Financial Disclosure Statement: None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript Authors' Contributions: K.S.K. came up with the main idea and its concept of hypothesis in this experiment. He led the process of this study. Y.G.H. mainly conducted the animal experiment and further organized and analyzed histologic results. He wrote the article. S.C.K. supervised and advised the experimental process and participated in the laboratory meeting with the team and gave several opinions during discussion. Ethics Statement: All procedures were conducted in accordance with the Guide for the Care and Use of Laboratory Animals of the Asan Life Science Research Center animal review board (document no. 2017-13-113). Corresponding author: Kyung S. Koh, MD, PhD, Professor, Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Sonpa-gu, Seoul 05505, Korea. Tel.: +82-2-3010-3600, Fax: +2-476-7471, E-mail: kskoh@amc.seoul.kr, kyungskoh@gmail.com ©2018American Society of Plastic Surgeons
Outcomes of Elbow Flexion Reconstruction in Patients Over 50 with Traumatic Brachial Plexus Injury
Background: There is controversy regarding the effectiveness of brachial plexus (BP) reconstruction for elbow function in older patients as reported outcomes are generally poor. The purpose of this study is to evaluate elbow function outcomes in patients over 50. Methods: Fifty-eight patients over the age of 50 underwent nerve grafting, transfers or free functioning muscle transfer (FFMT) to improve elbow function after traumatic BP injury. Patients were evaluated pre- and post-operatively for elbow flexion strength and range of motion (ROM), Disability of the Arm, Shoulder, and Hand (DASH) scores, pain, delay from injury to operation, concomitant trauma, severity of trauma, and type of reconstruction. Results: The average age was 57.8 years (range 50-72) with an average follow-up of 24.0 months. The average modified BMRC (British Medical Research Council) elbow flexion grade improved significantly from 0.26 to 2.63. Thirty-three patients (60%) achieved functional flexion ≥M3 post-operatively, compared to zero patients pre-operatively. There was no correlation between age and modified BMRC grade. Active elbow ROM improved significantly post-operatively, with no effect of age on flexion motion. More patients achieved ≥M3 flexion with nerve transfers (69%) compared to FFMT (43%). Patients had worse outcomes with high energy injuries. The mean DASH score decreased from 51.5 to 49.6 post-operatively and the average pain score decreased from 5.0 to 4.3. Conclusion: BP reconstruction for elbow function in patients over the age of 50 can yield useful flexion. Conflicts of Interest: We have no conflicts of interest or financial interest to disclose. Corresponding author: Alexander Shin, MD, shin.alexander@mayo.edu, Division of Orthopedic Surgery, Mayo Clinic, 200 First Street, SW, 55905 Rochester, MN ©2018American Society of Plastic Surgeons
Wide-awake flexor pollicis longus tendon reconstruction with evaluation of the active voluntary contraction of the ruptured muscle-tendon
Background: The purpose of this study was to investigate the clinical outcome of the wide-awake tendon reconstruction for chronic rupture of the flexor pollicis longus (FPL) tendon with evaluation of the voluntary active contraction distance (ACD) of the ruptured musculotendinous unit. Methods: Eleven consecutive patients underwent tendon reconstruction under wide-awake surgery for chronic tendon rupture of the FPL. If the total of the passive distraction distance (PDD) and the ACD of the ruptured FPL musculotendinous unit was greater than 30 mm, tendon grafting was performed. If not, tendon transfer was performed using the 4th flexor digitorum superficialis (FDS). Patients were evaluated with total active motion (TAM) before surgery, during surgery, and in final follow-up and subjectively surveyed with quick Disability of the Arm, Shoulder, and Hand (q-DASH) scores. The final outcomes of tendon grafting and of tendon transfer were compared. Results: Tendon grafting was performed in 4 patients, and tendon transfer was performed in 7 patients while maintaining finger active motion during surgery. The final follow-up %TAM was 84.3%±12.7% in the tendon transfer group and 80.7%±10.2% in the tendon grafting group. There were no significant differences between tendon transfer and tendon grafting in the final follow-up %TAM and q-DASH scores. Conclusions: The functional outcomes of both tendon grafting and tendon transfer were acceptable based on evaluating the ACD and PDD of the ruptured musculotendinous unit during wide-awake surgery. Evaluating the ACD and PDD may be a useful index to assess the ruptured musculotendinous unit. The greatest advantage of the wide-awake tendon reconstruction is that surgeons can evaluate the ruptured musculotendinous unit and measure TAM during surgery while adjusting suture tension. Financial Disclosure: none Acknowledgements: none This report was approved by the Ethics Comitee, University of Toyama (Toyama, Japan) and clinical reaserch number "21-22" was granted. Corresponding auther: Mineyuki Zukawa. MD ©2018American Society of Plastic Surgeons
“Delayed Post-conditioning with External Volume Expansion (EVE) Improves Survival of Adipose Tissue Grafts in a Murine Model”
Background: External volume expansion (EVE) improves the survival of adipose tissue grafts by pre-operatively conditioning ('pre-conditioning') tissues that will receive the graft. EVE's mechanisms of action (induction of angiogenesis and of adipogenesis) could improve graft survival also when applied post-operatively (post-conditioning). We tested this hypothesis and optimized the parameters of post-operative application of EVE in a murine model. Methods: Fifty-six 8-week-old athymic (nu/nu) mice received dorsal subcutaneous grafts of human lipoaspirate (0.3 ml each) bilaterally before undergoing EVE (left dorsum) or no treatment (right dorsum, controls). EVE was started either on the same day of (Immediate group), two days after (Early group), or one week after surgery (Delayed group). At follow-up, grafts were analyzed for tissue survival, remodeling, adipogenesis, and angiogenesis using histology. Volume retention was assessed by MRI. We subsequently assessed the effects of the Delayed application of EVE adopting a foam-shaped interface (F-EVE) to deliver the treatment. Results: At 28 days follow-up delayed post-conditioning with EVE significantly improved the survival of grafts (+18%) compared to controls (viable graft thickness ratio: 58 ±15% vs 49 ±13%) and increased the density of blood vessels within the graft (+63%: blood vessels/ 10x magnification field: 44 ±12 vs 27 ±11). Other groups did not lead to significant changes. Adoption of F-EVE similarly improved outcomes while further reducing fibrosis within the grafts. Conclusions: Post-operative delayed application of EVE modestly improves the survival of adipose tissue grafts by inducing adipogenesis and angiogenesis. Use of a foam-shaped interface decreases the fibrosis induced in the grafts. # co-first authors Acknowledgments, conflict of interest and role of funding sources disclosure statement: Dr. Orgill receives research funding through grants from Acelity L.P. to Brigham and Women's Hospital and is a consultant for Acelity L.P. All other authors declare no actual or potential conflict of interests: in addition, they disclose no commercial or financial associations, personal or other relationships with other people or organizations that could inappropriately influence the reported manuscript or create a conflict of interest with the information presented. This study was funded by a research grant from Acelity L.P. Inc. to Brigham and Women's Hospital and a research grant by the Gillian Reny Stepping Strong Foundation to Brigham and Women's Hospital. Authorship: All authors had full access to the data and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors have seen and agreed to the submitted version of the manuscript and bear responsibility for it. Ethics: The study was carried out under high ethical standards. All the studies have been approved, when required, by the appropriate ethics committee and have been performed in accordance and in conformity to the World Medical Association Declaration of Helsinki (June 1964) and subsequent amendments. Meetings at which the paper has been presented: None. Corresponding authors: Dennis P. Orgill (* corresponding author), Tissue Engineering and Wound Healing Laboratory, Department of Surgery, Division of Plastic Surgery, Brigham and Women's Hospital - Harvard Medical School, 75 Francis St., Boston MA 02115 (USA). T: 617-732-5456F: 617-730-2855E:dorgill@partners.org ©2018American Society of Plastic Surgeons
“Craniometric Analysis of Endoscopic Suturectomy for Bilateral Coronal Craniosynostosis.”
Background: Endoscopic suturectomy and helmeting represents a successful first-line surgical treatment for bilateral coronal craniosynostosis. Its effect on cranial morphology has not been previously described. Methods: Patients were identified who had bilateral coronal craniosynostosis treated with endoscopic suturectomy and postoperative helmeting at Boston Children's Hospital between 2005 and 2013 and who received pre- and post-operative CT scans. Two normative patient populations were identified from our trauma registry with CT scans completed at the same age as our pre- and post-treatment scans. Craniometric indices were utilized to quantify the effect of treatment. Results: Twenty-seven patients were identified who underwent bilateral coronal suturectomy. Twelve patients had preoperative and postoperative CT studies. Eight patients (66.7%) were syndromic. The average ages for preoperative and postoperative CT scan was 1.1 months (0.03–2.6) and 19.6 months (10.8–37.5). Thirteen patients with an average age of 1.1 months (0.5–1.6) were identified as a preoperative control group. Fourteen patients with an average age of 18.5 months (15.5–22.9) were identified as a postoperative control group. The anterior cranial height (ACH) stabilized with treatment and the anterior cranial base length increased (ACBL). The ACH:ACBL ratio significantly decreased with treatment (p=0.128). Frontal bossing normalized with endoscopic suturectomy (CS vs control; pre-op: p=0.001, post-op (p=0.8). Cephalic indices also normalized with treatment (CS vs control; pre-op: p=0.02, post-op, p=0.13). No cases of hydrocephalus were observed. Conclusion: Endoscopic suturectomy and helmeting improves anterior turricephaly and corrects frontal bossing and brachycephaly in patients with bilateral coronal craniosynostosis. FD - None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding author: S. Alex Rottgers MD, Assistant Professor of Plastic Reconstructive Surgery, John Hopkins All Children's Hospital, Division of Plastic and Reconstructive Surgery, 601 Fifth Street South, Suite 306, St. Petersburg, FL. srottge1@jhmi.edu ©2018American Society of Plastic Surgeons
Evaluation of Donor Morbidity Following Single-Stage Latissimus Dorsi Neuromuscular Transfer for Facial Reanimation
Background: Single-stage latissimus dorsi (LD) neuromuscular transfer has been a valuable option for dynamic smile reanimation. However, there is a paucity of studies evaluating the potential donor morbidity in such cases. The present study aimed to comprehensively analyze the donor morbidity following functional LD muscle transfer. Methods: Patients who underwent single-stage functional LD muscle transfer for smile reanimation between 2002 and 2016 were reviewed. Postoperative complications and functional impairments at the donor sites were evaluated. The Quick-Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used for assessing postoperative donor-site function. Results: Sixty patients including 12 pediatric (≤ 18 years) were analyzed. Mean length of a harvested thoracodorsal nerve was 14.9 cm. Fourteen patients were treated with dual innervation technique, in which both a descending and transverse branch of the thoracodorsal nerve were harvested. Donor complications were observed in seven cases; all of them were seroma and resolved by simple aspiration. No other complications including scoliosis and sensory and/or motor disturbances in the upper extremities were encountered. Fifty patients responded to the Quick-DASH questionnaire at a median follow-up period of 51 months. The average score was 2.64 and all but three patients scored less than 10. No variables, including patient age (pediatric versus adult) and the use of dual innervation technique, affected the donor morbidities including the functional deficits. Conclusions: Single-stage LD neuromuscular transfer for facial reanimation might be associated with a low rate of complications and minimal functional morbidity at the donor site. Financial Disclosure:None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Presented at:13thInternational Facial Nerve Symposium, August 3-6, 2017, Los Angeles, CA (Podium) Corresponding Author Contact Information: Dr. Goo-Hyun Mun, MD, Ph D., Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong 50, Gangnam-gu, Seoul, S. Korea. 135-710.,Tel.: 82-2-3410-2233, Fax: 82-2-3410-0036, E-mail: supramicro@gmail.com ©2018American Society of Plastic Surgeons
Τρίτη 16 Οκτωβρίου 2018
The colors of biotechnology: general overview and developments of white, green and blue areas
Abstract
Biotechnology is responsible for the manipulation of living organisms or their components for the production of products that are of benefit to human kind. Due to the wide range of applications, colors have been used to differentiate the main areas of research, such as white (industrial), green (agricultural) and blue (marine and fresh-water), among others. Thus, this review outlines the impacts of these areas of biotechnology, emphasizing their impact and potential to replace carbon-based technologies with more sustainable technologies.The Smallest Intestine (TSI)—a low volume in vitro model of the small intestine with increased throughput
Abstract
There is a growing interest in understanding the fate and behaviour of probiotic microorganisms and bioactive compounds during passage of the human gastrointestinal tract (GIT). Here, we report the development of a small volume in vitro model called The smallest Intestine (TSI) with increased throughput focusing on simulating passage through the stomach and small intestine (SI). The basic TSI module consists of five reactors, with a working volume of 12 ml each. During the simulated passage through the SI, bile is absorbed and pH is adjusted to physiologically relevant values for duodenum, jejunum and ileum. A consortium of seven representative bacterial members of the ileum microbiota is included in the ileal stage of the model. The behaviour of three putative probiotic Lactobacillus strains during in vitro simulated upper GIT passage was tested in the model and results were compared to previous studies describing probiotic survival. It was found, that probiotic persistence is strongly related to whether food was ingested, but also to presence of the ileal microbiota, which significantly impacted probiotic survival. In conclusion, TSI allows testing a substantial number of samples, at low cost and short time, and is thus suitable as an in vitro screening platform.Assessment of community pharmacy professionals’ knowledge and counseling skills achievement towards headache management: a cross-sectional and simulated-client based mixed study
Headache is one of the most common disabling medical condition affecting over 40% of adults globally. Many patients with headache prefer to alleviate their symptom with a range of over-the-counter analgesics t...
Determinants of Fasting Hyperglucagonemia in Patients with Type 2 Diabetes and Nondiabetic Control Subjects
Metabolic Syndrome and Related Disorders, Ahead of Print.
Acute Physical Effort Increases Sympathovagal Balance Responses to Autonomic Stimulation in Metabolic Syndrome
Metabolic Syndrome and Related Disorders, Ahead of Print.
Continuous Negative Pressure Drain is Associated with Better Outcome: A Randomized Prospective Trial in Plastic Surgery Patients
Abstract
Background
A randomized prospective trial to compare the effects on minimizing complications using continuous negative pressure drain and intermittent suction mode in plastic surgeries.
Methods
There were 174 cases of stage II post-auricular flap expansion and ear reconstruction, 76 cases of skin expansion flap repair, 56 cases of breast augmentation surgery, 58 cases of abdominoplasty, and 76 cases with free skin grafts. Patients were randomized to intermittent suction mode group (control group) and continuous negative pressure external drain group (intervention group) stratified by surgery types. In the intervention group, different pressure levels were applied according to the surgery types. The drainage volume, the length of time of external drainage, incidence of seroma, flap necrosis, the first intending healing rate and drain-associated bleeding were recorded and compared.
Results
Generally, fewer complications and better healing were observed in the intervention group. In patients with stage II post-auricular flap expansion and ear reconstruction, lower incidence of flap necrosis and seroma, higher first intention healing rate, greater drain volume but shorter time of drainage were observed in the intervention group (p < 0.05 for all). Similar results were shown in patients with skin expansion flap repair, breast augmentation, abdominoplasty, and free skin grafts. In patients who underwent free skin grafts, a higher graft success rate and lower graft infection rate were also observed (p < 0.01 for both). No drain-associated bleeding was observed.
Conclusions
A continuous negative pressure drain was associated with better outcomes in patients underwent various plastic surgeries and is a powerful technique in the postoperative management of plastic surgery.
Level of Evidence II
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.
Synkinesis Between Orbicularis Oculi and Procerus Muscles: Video Presentation of an Unusual Type of Aberrant Innervation after Cosmetic Rhinoplasty
Abstract
Background
Synkinesis is a recognized complication following peripheral facial nerve paralysis. Different types of synkinesis have been described, with oral–ocular and ocular–oral synkinesis being the most common. Ocular–nasal synkinesis has been reported in two patients following cosmetic rhinoplasty. However, synkinesis between the orbicularis oculi and procerus muscles has not been reported by now.
Methods
This is an interventional case report.
Results
Two women, aged 42 and 37 years, presented with unilateral contraction of the medial eyebrow muscles (procerus) with spontaneous or voluntary blinking, 4 and 5 months after cosmetic rhinoplasty, respectively. Both were successfully treated with injection of botulinum toxin A.
Conclusions
Surgical trauma is inevitable during every procedure, including rhinoplasty, and may damage the fine structures including branches of the facial nerve innervating the muscles. Gentle tissue handling may minimize iatrogenic injury to the fine motor branches of the facial nerve and prevent subsequent aberrant innervation and synkinesis. Botulinum toxin A injection can effectively, yet temporarily, resolve the unintentional contractions and provide significant patient comfort.
Level of Evidence V
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.
Problems and Solutions for Platelet-Rich Plasma in Facial Rejuvenation: A Systematic Review
Abstract
Background
In recent years, platelet-rich plasma (PRP) has been widely applied in orthopedics, maxillofacial surgery, burns, and plastic surgery, especially in facial rejuvenation. Research is ongoing into new indications and mechanisms of PRP to promote its wider, safer, and more effective use in the clinic. This article reviews the possible mechanisms of PRP in facial rejuvenation and related research. It is expected that the application of PRP in this field will increase.
Methods
The use of PRP in facial rejuvenation was screened using inclusion and exclusion criteria. The relevant articles were searched through Pubmed digest database, SCI full-text database, ScienceDirect full-text database, and the CNKI full-text database. The different effects and limitations of PRP were extracted.
Results
A total of 108 articles were obtained, including 18 articles researching PRP in cells, 10 articles on animal research using PRP, 16 articles on the clinical study of PRP, 24 articles involving signs of skin aging, and four articles on the limitations of PRP. The remaining articles were related to the preparation of PRP, the introduction of PRP, and other aspects.
Conclusion
Based on in vitro and in vivo research, PRP may play a role in promoting tissue regeneration, oxidative stress and revascularization, which form the theoretical basis for the use of PRP in the clinical treatment of facial rejuvenation.
Level of Evidence III
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.
Barrett’s esophagus is negatively associated with eosinophilic esophagitis in Japanese subjects
Abstract
Background
Although both eosinophilic esophagitis (EoE) and Barrett's esophagus (BE) are considered to be associated with T helper (Th) 2-mediated immune responses, the association between EoE and BE is unclear. We investigated the clinical relationship between EoE and BE.
Methods
We conducted a single-center retrospective observational study. The study included 95 patients with EoE and randomly selected age- and sex-matched controls who underwent esophagogastroduodenoscopy during a medical health check-up at Osaka City University in a ratio of 1:2 for comparison. We compared the clinical characteristics and the prevalence rate of BE, reflux esophagitis (RE), hiatal hernia, and atrophic gastritis between EoE patients and controls by univariate analysis. Furthermore, we performed multivariate logistic regression analysis to investigate the association of these factors with EoE.
Results
On univariate analysis, the prevalence rate of BE was significantly lower in patients with EoE than in controls (2.1% vs. 13.2%; p = 0.00528). In contrast, the prevalence rate of RE was higher in EoE patients than in controls, but it was not statistically significant (absence and Grades A, B, and C: 74.7%, 18.9%, 5.3%, and 1.1% vs. 83.7%, 12.6%, 3.7%, and 0%; p = 0.193, respectively). Multivariate analysis showed that BE was negatively associated with EoE (odds ratio: 0.132; 95% confidence interval: 0.0302–0.573; p = 0.00686).
Conclusions
BE is negatively associated with EoE in Japanese subjects. The mechanism behind the inverse relationship between EoE and BE should be examined.
The effects of melatonin supplementation in adjunct with non-surgical periodontal therapy on periodontal status, serum melatonin and inflammatory markers in type 2 diabetes mellitus patients with chronic periodontitis: a double-blind, placebo-controlled trial
Abstract
Background
Diabetes mellitus (DM) and periodontitis are two common chronic diseases with bidirectional relationship. Oxidative stress plays a key role in the pathogenesis of these two diseases. The aim of this study was to investigate the effects of melatonin supplementation in adjunct with non-surgical periodontal therapy on periodontal status, serum melatonin and inflammatory markers in type 2 DM patients with chronic periodontitis (CP).
Materials and methods
In this double-blind clinical trial study, 50 type 2 DM patients with CP were randomly allocated to the intervention and control groups. The intervention and control groups received either 6 mg melatonin or placebo (2 tablets) once a day. Serum levels of melatonin, tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), hs-C-reactive protein (hs-CRP), clinical attachment loss (CAL), pocket depth (PD), bleeding on probing (BOP) and plaque index were evaluated in all subjects pre- and post-intervention.
Results
Melatonin supplementation significantly increased the mean serum levels of melatonin after intervention. The mean changes of melatonin were significantly higher in intervention group compared with control group. IL-6 and hs-CRP levels were significantly (p = 0.008 and p = 0.017, respectively) reduced in the intervention group. The mean changes of IL-6 were significantly lower in the intervention group compared with the control group (p = 0.04). In the intervention group, PD and CAL were significantly decreased after intervention (p < 0.001). There were significant differences in the mean change of PD and CAL between the intervention and control groups after intervention (p < 0.001).
Conclusions
Melatonin supplementation in adjunct with non-surgical periodontal therapy might improve inflammatory and periodontal status in T2DM with CP.
Association of hereditary angioedema type 1 with developmental anomalies due to a large and unusual de novo pericentromeric rearrangement of chromosome 11 spanning the entire C1 inhibitor gene (SERPING1)
Publication date: Available online 16 October 2018
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Ebo Didier G, Blaumeiser Bettina, Kooy R. Frank, Beckers Sigri, Van Gasse Athina L, Saerens Michael, Spinhoven Maarten, Sabato Vito, Poirel Hélène A
Identification of the Fraction of Indolent Tumors and Associated Overdiagnosis in Breast Cancer Screening Trials
Abstract
It is generally accepted that some screen-detected breast cancers are overdiagnosed and would not progress to symptomatic cancer if left untreated. However, precise estimates of the fraction of non-progressive cancers remain elusive. In recognition of the weaknesses of overdiagnosis estimation methods based on excess incidence, there is a need for model-based approaches that accommodate non-progressive lesions. Here, we present an in-depth analysis of a generalized breast cancer natural history model that allows for a mixture of progressive and indolent lesions. We provide a formal proof of global structural identifiability of the model and use simulation to identify conditions that allow for parameter estimates that are sufficiently precise and practically actionable. We show that clinical follow-up after the last screen can play a critical role in ensuring adequately precise identification of the fraction of indolent cancers in a stop-screen trial design, and we demonstrate that model misspecification can lead to substantially biased mean sojourn time estimates. Finally, we illustrate our findings on the example of the Canadian National Breast Screening Study-2 and show that the fraction of indolent cancers is not precisely identifiable. Our findings provide the foundation for extended models that account for both in situ and invasive lesions.Myocardial Imaging with CMR Parametric Mapping: Clinical Applications
Abstract
Purpose of Review
Cardiovascular magnetic resonance (CMR) parametric mapping techniques enable the direct visualization and quantification of changes in myocardial T1, T2, T2* relaxation times and extracellular volume fraction. Recent updates on clinical applications of CMR parametric mapping techniques are reviewed in this article.
Recent Findings
CMR parametric mapping techniques are useful in the evaluation of multiple conditions, including iron overload, amyloid infiltration, glycosphingolipid accumulation, myocardial edema, and fibrosis. An advantage of parametric mapping over conventional tissue characterization sequences is that these techniques are quantitative, allowing for standardization of measurements and assessment of longitudinal changes over time. Parametric mapping techniques are useful in clinical practice, including aiding in establishing a diagnosis, monitoring disease progression, evaluating response to therapy, and informing prognosis.
Summary
This article provides a summary of the existing evidence for the clinical application of cardiac parametric mapping techniques.
Increasing Frequency and Share of Dermatologic Procedures Billed by Non-Physician Clinicians from 2012-2016
Publication date: Available online 15 October 2018
Source: Journal of the American Academy of Dermatology
Author(s): Andrew T. Rogers, Ge Bai, Manisha J. Loss, Gerard F. Anderson
Carcinoma en escroto de células escamosas gigantes productor de factor estimulante de colonias de granulocitos (G-CSF)
Publication date: Available online 15 October 2018
Source: Actas Dermo-Sifiliográficas
Author(s): M. Takako, K. Yasunobu, Y. Toshiyuki
The importance of ethics in dermatopathology: a fellow’s perspective
Journal of Cutaneous Pathology, Volume 0, Issue ja, -Not available-.
Allergic contact dermatitis to slime: The epidemic of isothiazolinone allergy encompasses school glue
Pediatric Dermatology, EarlyView.
Multifocal congenital pyogenic granuloma successfully treated with oral propranolol
Pediatric Dermatology, EarlyView.
Infantile hemangiomas with minimal or arrested growth: A retrospective case series
Pediatric Dermatology, EarlyView.
Prescribing isotretinoin for transgender youth: A pledge for more inclusive care
Pediatric Dermatology, EarlyView.
The readability, suitability, and content features of eczema action plans in the United States
Pediatric Dermatology, EarlyView.
Congenital tufted angioma: A multicenter retrospective study of 30 cases
Pediatric Dermatology, EarlyView.
Recalcitrant alopecia areata responsive to leflunomide and anthralin—Potentially undiscovered JAK/STAT inhibitors?
Pediatric Dermatology, EarlyView.
Does laser therapy improve the wound healing process after tooth extraction? ‐ A systematic review
Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.
Electrical stimulation disrupts biofilms in a human wound model and reveals the potential for monitoring treatment response with volatile biomarkers
Wound Repair and Regeneration, Volume 0, Issue ja, -Not available-.
Incidence and death rate of pemphigus vulgaris and pemphigus foliaceus in Korea: A nationwide, population‐based study (2006–2015)
The Journal of Dermatology, EarlyView.
Scabies herpeticum, an emerging clinical form of crusted scabies in AIDS patient: case report and literature review
International Journal of Dermatology, EarlyView.
Interactive thermal tissue reactions of 7‐MHz intense focused ultrasound and 1‐MHz and 6‐MHz radiofrequency on cadaveric skin
Skin Research and Technology, EarlyView.
Δευτέρα 15 Οκτωβρίου 2018
Decoupling between sulfate reduction and the anaerobic oxidation of methane in the shallow methane seep of the Black sea
ABSTRACT
Methane seepages are widespread in the Black Sea. However, microbiological research has been carried out only at the continental shelf seeps. The present work dealt with coastal gas seepages of the Kalamit Bay (Black Sea). High-throughput 16S rRNA gene sequencing and radiotracer analysis (14С and 35S) were used to determine the composition of the microbial community and the rates of microbial sulfate reduction and methane oxidation. The phylum Proteobacteria, represented mainly by sulfate reducers of the class Deltaproteobacteria, was the predominant in sequence dataset. Bacteroidetes and Planctomycetes were other numerous phyla. Among archaea, the phylum Woesearchaeota and Marine Benthic Group B were predominant in the upper horizons. Relative abundance of Euryarchaeota of the families Methanomicrobiaceae and Methanosarcinaceae (including ANME-3 archaea) increased in deeper sediment layers. Sulfate reduction rate (up to 2.9 mmol/L × day) was considerably higher than the rate of anaerobic methane oxidation (up to 43.4 μmol/L × day), which indicated insignificant contribution of anaerobic methane oxidation to the total sulfide production.Volatile phenols are produced by strains of Dekkera bruxellensis under Brazilian fuel ethanol industry-like conditions
ABSTRACT
Dekkera bruxellensis is a spoilage yeast in wine and fuel ethanol fermentations able to produce volatile phenols from hydroxycinnamic acids by the action of the enzymes cinnamate decarboxylase (CD) and vinyphenol reductase (VR) in wine. However, there is no information about this ability in the bioethanol industry. This work evaluated CD and VR activities and 4-ethylphenol production from p-coumaric acid by three strains of D. bruxellensis and PE-2, an industrial Saccharomyces cerevisiae strain. Single and multiple-cycle batch fermentations in molasses and sugarcane juice were carried out. Dekkera bruxellensis strains showed similar CD activity but differences in VR activity. No production of 4-ethylphenol by S. cerevisiae in any fermentation system or media was observed. The concentrations of 4-ethylphenol peaked during active growth of D. bruxellensis in single-cycle fermentation but they were lower than in multiple-cycle fermentation. Higher concentrations were observed in molasses with molar conversion (p-coumaric acid to 4-ethylphenol) ranging from 45% to 85%. As the first report on 4-ethylphenol production in sugarcane musts by D. bruxellensis in industry-like conditions, it opens up a new avenue to investigate its effect on the viability and fermentative capacity of S. cerevisiae as well as to understand the interaction between the yeasts in the bioethanol industry.Late Onset Complications Secondary to Polyacrylamide Hydrogel-Based Filler for Rehabilitation of HIV-Related Facial Lipoatropy
In 2015 we reported our experience of a 5-year follow-up study regarding the utilization of polyacrylamide hydrogel-based filler for rehabilitation of HIV-related facial lipoatropy.1 The outcomes of this study confirmed the safety and efficacy of this noninvasive treatment as already stated in an earlier report of 18-month follow-up period for that study population.2
The Launch of ASJ Open Forum Brings Changes to ASJ
I am pleased to announce that Aesthetic Surgery Journal Open Forum will launch in early 2019 and I am taking the opportunity to explain the effect this will have on the Aesthetic Surgery Journal (ASJ).
Congenital Oculonasal Synkinesis: Botulinum Toxin A in the Treatment of a Pure Facial Synkinesis
Oculonasal synkinesis (ONS) refers to involuntary contractions of the orbicularis oculi and the compressor narium minor muscles (CNMM). In this phenomenon, blinking triggers simultaneous depression of alar complex. The etiology of congenital type ONS is unknown and has not been investigated in depth. Anomalous connections between zygomatic and buccal branches of the facial nerve are attributed to the etiology.1,2
Filler Rhinoplasty: Evidence, Outcomes, and Complications
Rhinoplasty is one of the most popular facial aesthetic procedures but also one of the most technically challenging, with revision rates after surgical rhinoplasty ranging from 5% to 20%.1 The popularity of nonsurgical alternatives has been steadily increasing, especially that of injectable filler rhinoplasty using hyaluronic acid (HA), which offers reduced financial and anaesthetic impact, immediate aesthetic results, and rapid recovery.2 This is often demonstrated on video posts on social media platforms, which show immediate postprocedure results but often no further follow-up.3 Although fillers are predominantly used for aesthetic rhinoplasty, the technique has also been utilized to address functional issues including internal valve collapse.4
Tele-Interview in the Aesthetic Fellowship Selection Process
Aesthetic surgery fellowships traditionally select applicants for an in-person interview in the facility where the fellowship will occur. Most fellowship applicants are preselected by evaluation of the application package, which includes medical school and residency records, a personal statement, and letters of recommendation.
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