Platelets: the holy grail in cancer blood biomarker research?

Abstract

We would like to promote the fact that platelets are increasingly emerging as a rich source of potential biomarkers for cancer. Blood platelets contain vast amounts of bioactive proteins, such as growth factors, chemokines, and cytokines. These proteins are either synthesized by the megakaryocytes that produce the platelets or are sequestered by the circulating platelets from the blood, in which case these proteins may originate from the tumor. Recent studies in patients have demonstrated that the presence of cancer influences multiple platelet characteristics (e.g., platelet count, volume, activation status, proteins, and RNA content). Interestingly, these changes happened already in early stages of the disease before metastasis had occurred. Additionally, exploiting these platelet alterations enabled discrimination of patients with early-stage cancer from healthy sex- and age-matched individuals. Therefore, we challenge clinicians and researchers to look beyond traditional fluid sources such as plasma or serum, and to take platelets and their content into account as they may become the holy grail in cancer blood biomarker research.

Esthetic and functional result of crooked nose treatment; internal microperforating osteotomy and subtotal septal reconstruction

Abstract

Crooked nose is mostly characterized by a deviation of both the bone and the cartilaginous parts of the nose. In order to obtain proper functional and improved esthetic results, both of these parts have to be corrected. The objective of this study is to evaluate the esthetical and the functional outcomes following correction procedures of the bone pyramid through internal microperforating technique and the cartilaginous part through subtotal septal reconstruction. The medical records of 158 patients who have undergone through primary septorhinoplasty for crooked nose treatment during the period of 21 June 2016 and 31 July 2017 have been reviewed. Functional results have been evaluated using the Nasal Obstruction Symptom Evaluation (NOSE) scores and the esthetical results through Rhinoplasty Outcome Evaluation (ROE) scores. The observation times have been arranged preoperatively as 6 months–1 year (group 1) and 1–2 years (group 2). Septorhinoplasty procedure has been performed on 158 patients with crooked noses. Out of this number, 104 of the patients (65.8%) were women and 54 were men (34.2%). The average age of the patients was 31.59 (9.3%), all of who have undergone this procedure. There was a significant improvement (P < 0.001) in the NOSE and the ROE scores of group 1 and group 2, which was statistically significant. There was no difference between group 1 and group 2. In crooked nose treatment, correction of the deviated bone pyramid using internal microperforating osteotomy and correction of the severely deviated septum using subtotal septal reconstruction yield improved functional and esthetic results.

Level of Evidence: Level V, therapeutic study.

Coffee May Reduce Rosacea Risk

Caffeinated coffee was associated with a significant reduction in risk of rosacea but other sources of caffeine, such as soda and tea, did not appear protective.
Medscape Medical News

Practical and clinical utility of non-invasive vagus nerve stimulation (nVNS) for the acute treatment of migraine: a post hoc analysis of the randomized, sham-controlled, double-blind PRESTO trial

The PRESTO study of non-invasive vagus nerve stimulation (nVNS; gammaCore®) featured key primary and secondary end points recommended by the International Headache Society to provide Class I evidence that for ...

Spray Drift from a Conventional Axial Fan Airblast Sprayer in a Modern Orchard Work Environment

Abstract

Pesticide spray drift represents an important cause of crop damage and farmworker illness, especially among orchard workers. We drew upon exposure characteristics from known human illness cases to design a series of six spray trials that measured drift from a conventional axial fan airblast sprayer operating in a modern orchard work environment. Polyester line drift samples (n = 270; 45 per trial) were suspended on 15 vertical masts downwind of foliar applications of zinc, molybdenum, and copper micronutrient tracers. Samples were analyzed using inductively coupled plasma mass spectrometry and resulting masses were normalized by sprayer tank mix concentration to create tracer-based drift volume levels. Mixed-effects modeling described these levels in the context of spatial variability and buffers designed to protect workers from drift exposure. Field-based measurements showed evidence of drift up to 52 m downwind, which is approximately 1.7 times greater than the 30 m (100 ft) 'Application Exclusion Zone' defined for airblast sprayers by the United States Environmental Protection Agency Worker Protection Standard. When stratified by near (5 m), mid (26 m), and far (52 m) distances, geometric means and standard deviations for drift levels were 257 (1.8), 52 (2.0), and 20 (2.3) µl, respectively. Fixed effect model coefficients showed that higher wind speed [0.53; 95% confidence interval (CI): 0.35, 0.70] and sampling height (0.16; 95% CI: 0.11, 0.20) were positively associated with drift; increasing downwind distance (−0.05; 95% CI: −0.06, −0.04) was negatively associated with drift. Random effects showed large within-location variability, but relatively few systematic changes for individual locations across spray trials after accounting for wind speed, height, and distance. Our study findings demonstrate that buffers may offer drift exposure protection to orchard workers from airblast spraying. Variables such as orchard architecture, sampling height, and wind speed should be included in the evaluation and mitigation of risks from drift exposure. Data from our study may prove useful for estimating potential exposure and validating orchard-based bystander exposure models.

Response to Dobie et al. Letter, ‘Exchange Rate and Risk of Noise-induced Hearing Loss in Construction Workers’

We thank Dobie et al. for their letter and the additional discussion around this important issue. However, we believe that Dobie et al. have mischaracterized or misrepresented multiple aspects of our study. We hope this response will help clarify these issues for Dobie et al. and other readers.

A Slow Trip To A Hot Planet: Spacecraft Poised For Mission To Mercury

The European Space Agency's BepiColombo will take seven years to reach the innermost planet in our solar system, where temperatures at the surface can reach 800 degrees Fahrenheit.

(Image credit: NASA, Johns Hopkins University Applied Physics Laboratory, Carnegie Institution of Washington via AP)

One-year outcomes in children with eosinophilic esophagitis

Abstract

Background and aims

Despite rising incidence of eosinophilic esophagitis (EoE), data on the follow-up and treatment outcomes in pediatric patients are scarce. Therefore, the aim of this study was to present data on the treatment outcomes in children diagnosed with EoE who were treated in a tertiary medical center.

Patients and methods

A retrospective study involving patients younger than 18 years who were diagnosed with EoE in our center between January 2011 and June 2017.

Results

Thirty-two patients met inclusion criteria and were followed up for a mean of 3 years (range 0.5–6.8). Six months after the diagnosis, 28 (87.5%) children were still followed up; 21 (75%) were in clinical remission, including 10 (36%) who were in histological remission. After 12 months, 27 patients were still followed up; 21 (78%) achieved clinical remission, including 10 (37%) with histological remission. During follow-up, three patients developed gastroesophageal reflux disease (GERD). There was no difference in body mass index (BMI) Z score between baseline and 12 months follow-up (median − 0.3 vs − 0.3 SD, p = 0.862).

Conclusions

Absence of symptoms does not indicate mucosal healing; therefore, patients should be followed up endoscopically. Additionally, despite restricted diet, nutritional status remains unaffected. Finally, patients with EoE can develop significant GERD even years after the EoE diagnosis.

Grounding the normative: a problem for structured non-naturalism

Abstract

Many non-naturalists about the normative want to endorse the view that some normative facts hold in virtue of both non-normative facts and normative principles. In this paper, I argue that non-naturalism is inconsistent with this thesis, due to the nature of normative principles and their grounds. I then consider two ways in which the nonnaturalist position could be modified or expanded to solve this problem. No solution, it turns out, is without its problems. I end by considering how the non-naturalist can deny that normative facts obtain partially in virtue of principles.

Bio-synthesis of Barleria gibsoni leaf extract mediated zinc oxide nanoparticles and their formulation gel for wound therapy in nursing care of infants and children

Publication date: Available online 18 October 2018

Source: Journal of Photochemistry and Photobiology B: Biology

Author(s): Feng Shao, AiJun Yang, Dong Mei Yu, Juan Wang, Xue Gong, Hong Xiao Tian

Abstract

Bio-synthesis of nano-metal oxide particles is gaining lot of significance and recommended as promising substitute not only physical methods but also chemical methods. Here in, we demonstrate the nano-zinc oxide (nano-ZnO) particles were successfully prepared by an eco-friendly process using plant Barleria gibsoni (B. gibsoni) aqueous leaf extract. The water leaf extract of B. gibsoni responsible for not only reducing source but also protective agent. The prepared nano-ZnO particles were studied by UV–Vis diffuse reflectance (UV-DRS), Photoluminescence (PL), Fourier transform (FT-IR) infrared spectroscopy, X-ray diffraction spectroscopy (X-RD), transmission electron microscopy (TEM), thermal stability was studied by thermogravimetric and differential thermal (TG-DTA) analysis and particle size by zeta sizer, dynamic light scattering (DLS). UV-DRS spectrum of nano-ZnO particles showed below at wave length 400 nm. FT-IR spectra showed that plant metabolites like polyphenols, flavonoids and amino acids etc., are act as reducing and protective agent. X-RD studies revealed the formed nano-ZnO particles have hexagonal (wurtzite) structure. TEM analysis confirmed the range of nanoparticles between 30 and 80 nm, which is supported by DLS analysis. The antibacterial property of synthesized nano-ZnO particles was tested with bacterial pathogens showed good results. The developed nano-ZnO gel act as an efficient and superior another tropical antimicrobial formulations for healing of burn infections. Moreover, the formulated nano-ZnO gel exhibited a remarkable wound healing potential in rats.

Graphical abstract

Evaluating Patient Responses to Omalizumab in Solar Urticaria

Photodermatology, Photoimmunology &Photomedicine, Volume 0, Issue ja, -Not available-.

Enhanced Production of Hypocrellin A in Submerged Cultures of Shiraia bambusicola by Red Light

Photochemistry and Photobiology, Volume 0, Issue ja, -Not available-.

Skin hydration is significantly increased by a cream formulated to mimic the skin’s own natural moisturizing systems

Platelet‐rich plasma: Potential role in combined therapy for vitiligo

Dermatologic Therapy, Volume 0, Issue ja, -Not available-.

Vulvar Cancer Association with Groin Hidradenitis Suppurativa: A Large, Urban, Midwestern U.S. Patient Population Study

Publication date: Available online 18 October 2018

Source: Journal of the American Academy of Dermatology

Author(s): Supriya Rastogi, Kevin R. Patel, Vivek Singam, Yasmeen Ali, Jing Gao, Ahmad Amin, Bethanee J. Schlosser, Dennis P. West, Beatrice Nardone

Tumor necrosis factor-alpha inhibitors for the treatment of pyoderma gangrenosum not associated with inflammatory bowel diseases: a multicenter retrospective study

Publication date: Available online 18 October 2018

Source: Journal of the American Academy of Dermatology

Author(s): Laurie Rousset, Adèle de Masson, Edouard Begon, Axel Villani, Maxime Battistella, Michel Rybojad, Marie Jachiet, Martine Bagot, Jean-David Bouaziz, Clémence Lepelletier

Epidemiology of Nickel Sensitivity: Retrospective Cross-Sectional Analysis of North American Contact Dermatitis Group (NACDG) Data 1994-2014

Publication date: Available online 18 October 2018

Source: Journal of the American Academy of Dermatology

Author(s): Erin M. Warshaw, Amy J. Zhang, Joel G. DeKoven, Howard I. Maibach, Donald V. Belsito, Denis Sasseville, Joseph F. Fowler, Anthony F. Fransway, Toby Mathias, Melanie D. Pratt, James G. Marks, Kathryn A. Zug, Matthew J. Zirwas, James S. Taylor, Vincent A. DeLeo

Abstract

Background

Nickel is a common allergen.

Objective

To examine the epidemiology of nickel sensitivity in North America.

Methods

Retrospective, cross-sectional analysis of 44,097 patients patch tested by the North American Contact Dermatitis Group from 1994-2014. Nickel sensitivity was defined as a positive patch test to nickel. We evaluated frequency of nickel sensitivity and patient demographics. For each positive nickel reaction, we tabulated clinical relevance, occupational relatedness, and exposure sources.

Results

Average frequency of nickel sensitivity was 17.5% (1994-2014). Nickel sensitivity significantly increased over time (14.3% 1994-1996 to 20.1% 2013-2014, p<0.0001). Nickel sensitive patients were significantly more likely to be female, young, non-Caucasian, atopic (eczema and asthma), and/or have dermatitis affecting the face, scalp, ears, neck, arm, or trunk (p values ≤0.0474). Overall, 55.5% of reactions were currently clinically relevant; this frequency significantly increased over time (44.1% 1994-1996 to 51.6% 2013-2014, p<0.0001). Occupational relatedness was 3.7% overall with a significant decrease over time (7.9% 1994-1996 to 1.9% 2013-2014, p<0.0001). Jewelry was the most common source.

Limitations

Tertiary referral population.

Conclusions

Nickel allergy is of significant public health importance in North America. The frequency of nickel sensitivity in patients referred for patch testing has significantly increased over a 20-year period.

Hydrocolloid Dressing Application for the Treatment of Pediatric Onychodystrophies

Publication date: Available online 18 October 2018

Source: Journal of the American Academy of Dermatology

Author(s): Solomon Geizhals, Christine T. Lauren, Shari R. Lipner

Antioxidant supplements in combination with phototherapy for vitiligo: A systematic review and meta-analysis of randomized controlled trials

Publication date: Available online 18 October 2018

Source: Journal of the American Academy of Dermatology

Author(s): Han Mi Jung, Yu Seok Jung, Ji Hae Lee, Gyong Moon Kim, Jung Min Bae

Effect of Physical and Chemical Hair Removal Methods on Skin Barrier Function in vitro: Consequences for a Hydrophilic Model Permeant

Background: Although very common in our society, the effect of hair removal on physiological skin parameters and on the ingress of applied chemicals has not been systematically investigated. Thus, as a first step, the aim of the present study was to elucidate the effect of hair removal through epilation (electric epilation, waxing) and depilation (dry and wet shaving, depilatory cream) on skin properties in vitro using the porcine ear model. Methods: Attenuated total reflection Fourier transform infrared spectroscopy, measurement of the transepidermal water loss (TEWL), visualization by capacitance-based contact imaging, confocal Raman spectroscopy (CRS), diffusion cell studies and tape stripping experiments were employed. Results: Increased TEWL and altered skin permittivity maps were observed. Decreased stratum corneum thickness was observed after waxing. Diffusion cell studies showed increased skin permeation especially in case of dry shaving, electric epilation and waxing. Conclusion: Considering CRS and diffusion cell data, a moderate if significant decrease in skin barrier function was found after hair removal by dry shaving (physical skin/material interaction) and epilation methods (plucking out the entire hair, for example, by electrical epilation and waxing). Subsequent experiments will include testing of different permeants covering a broad range of physicochemical properties in vitro and confirming our findings in vivo.
Skin Pharmacol Physiol 2019;32:8–21

Issue Information

Clinical &Experimental Immunology, Volume 194, Issue 2, November 2018.

Research Techniques Made Simple: Transepidermal Water Loss Measurement as a Research Tool

Transepidermal water loss (TEWL) is the most widely used objective measurement for assessing the barrier function of skin in healthy individuals but also patients with skin diseases that are associated with skin barrier dysfunction, such as atopic dermatitis. TEWL is the quantity of condensed water that diffuses across a fixed area of stratum corneum to the skin surface per unit time. The water evaporating from the skin is measured using a probe that is placed in contact with the skin surface and contains sensors that detect changes in water vapor density.

Clinical Snippets

The opportunistic skin bacterium Propionibacterium acnes has been linked to acne vulgaris, a condition that affects more than 40 million people in the United States and has mostly inadequate or intolerable therapies. Following prior studies indicating that the P. acnes secretory virulence factor Christie-Atkins-Munch-Peterson (CAMP) factor is the main source of inflammation in acne vulgaris, Wang and colleagues demonstrated that a vaccination strategy targeting CAMP factor reduced the growth of P. acnes, diminished associated erythema, and limited production of proinflammatory cytokines in mice.

Editors’ Picks

Cutaneous squamous cell carcinoma (SCC) has the clinical and molecular features of a tumor that is likely to respond to systemic immunotherapy, as this tumor harbors a high mutational load and incidence is increased in immunocompromised patients. While nearly all cases are cured with surgery, in the remaining 5%, the tumor becomes metastatic or locally advanced, requiring palliative systemic therapy due to a lack of efficacious approved systemic therapies. In early phase I trials, the human monoclonal antibody to programmed death-1 (PD-1), cemiplimab, elicited a durable response in patients with advanced disease.

Editorial Board

SnapshotDx Quiz: November 2018

Editorial note: Welcome to the Journal of Investigative Dermatology (JID) SnapshotDx Quiz. In this monthly online-only quiz, the first question ("What is your diagnosis?") relates to the clinical images above, while additional questions concern the findings reported in the JID article by Rahbar et al. (https://ift.tt/2PG6iDx).

Subscription Information

Cells to Surgery Quiz: November 2018

Editorial note: Welcome to the Journal of Investigative Dermatology (JID) Cells to Surgery Quiz. In this monthly online-only quiz, the first question ("What is your diagnosis?") relates to the clinical image above, while additional questions concern the findings reported in a JID article by Tucker et al (https://ift.tt/2PbjraL).

Table of Contents

Zebrafish Models of Ectopic Mineralization—The Paradigm of Pseudoxanthoma Elasticum

Zebrafish represent a powerful model system with which to study human biology and pathology. Recently developed CRISPR/Cas9 technology enables genetic manipulation with precision. Using CRISPR/Cas9 methodology, van Gils et al. generated knockout zebrafish for abcc6a, the orthologue of human ABCC6 that is mutated in pseudoxanthoma elasticum. Although similarities exist between this and other abcc6a zebrafish models, none fully recapitulate phenotypes of human pseudoxanthoma elasticum.

General Relative Rate Models for the Analysis of Case-Cohort Designs

Abstract

A standard approach to analysis of case-cohort data involves fitting log-linear models. We describe how standard statistical software can be used to fit a broad class of general relative rate models to case-cohort data and derive confidence intervals. We focus on a case-cohort design in which a roster has been assembled and events ascertained, but additional information needs to be collected on explanatory variables. The additional information is ascertained just for individuals who experience the event of interest and for a sample of the cohort members enumerated at study entry. One appeal of such a case-cohort design is that this sample of the cohort may be used to support analyses of several outcomes. The ability to fit general relative rate models to case cohort data may allow an investigator to reduce model misspecification in exposure-response analyses, fit models in which some factors have effects that are additive and others multiplicative, and facilitate estimation of relative excess risk due to interaction. We address model fitting for simple random sampling designs as well as stratified designs. Data on lung cancer among radon exposed men are used to illustrate these methods.

Invasive mucormycosis in children with cance r: a retrospective study from the infection working group of Italian Pediatric Hematology Oncology Association

Mycoses, Volume 0, Issue ja, -Not available-.

A human subcutaneous infection by Microascus ennothomasiorum sp. nov

Mycoses, Volume 0, Issue ja, -Not available-.

Usefulness of the skin biopsy as a tool in the diagnosis of silvery hair syndrome

Pediatric Dermatology, EarlyView.

Long‐term off‐label dupilumab in pediatric atopic dermatitis: A case series

Pediatric Dermatology, EarlyView.

Pitfalls in the diagnosis and management of Kawasaki disease: An update for the pediatric dermatologist

Pediatric Dermatology, EarlyView.

Response to ustekinumab in three pediatric patients with alopecia areata

Pediatric Dermatology, EarlyView.

Corticosteroid phobia (corticophobia) in parents of young children with atopic dermatitis and their health care providers

Pediatric Dermatology, EarlyView.

Infective dermatitis associated with HTLV‐1 infection in a girl from Trinidad: Case report and review of literature

Pediatric Dermatology, EarlyView.

In utero development of epidermolysis bullosa acquisita

Pediatric Dermatology, EarlyView.

Treatment of pediatric alopecia areata with anthralin: A retrospective study of 37 patients

Pediatric Dermatology, EarlyView.

Prospective Multicenter Study of Changes in MTT after Aneurysmal SAH and Relationship to Delayed Cerebral Ischemia in Patients with Good- and Poor-Grade Admission Status [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Patients with aneurysmal SAH and good clinical status at admission are considered at a lower risk for delayed cerebral ischemia. Prolonged MTT may be associated with an increased risk. It is unclear whether this is dependent on clinical status. Our purpose was to determine whether increased MTT within 3 days of aneurysmal SAH compared with baseline is associated with a higher risk of delayed cerebral ischemia in patients with good (World Federation of Neurosurgical Societies I–III) versus poor (World Federation of Neurosurgical Societies IV–V) admission status.

MATERIALS AND METHODS:

This prolonged MTT was a multicenter, prospective cohort investigation of 87 patients with aneurysmal SAH. MTT was measured at admission before aneurysm treatment (MTT1) and following repair (MTT2) within 3 days of admission; MTT_diff was calculated as the difference between MTT2 and MTT1. Changes in MTT across time were assessed with repeated measures analyses. Risk of delayed cerebral ischemia or death was determined with multivariate logistic regression analysis.

RESULTS:

In patients with a good grade (n = 49), MTT was prolonged in patients who developed delayed cerebral ischemia, with MTT_diff significantly greater (0.82 ± 1.5) compared with those who did not develop delayed cerebral ischemia (–0.14 ± 0.98) (P = .03). Prolonged MTT was associated with a significantly higher risk of delayed cerebral ischemia or death (OR = 3.1; 95% CI, 1.3–7.4; P = .014) on multivariate analysis. In patients with poor grades (n = 38), MTT_diff was not greater in patients who developed delayed cerebral ischemia; MTT1 was significantly prolonged compared with patients with a good grade.

CONCLUSIONS:

Patients in good clinical condition following aneurysmal SAH but with increasing MTT in the first few days after aneurysmal SAH are at high risk of delayed cerebral ischemia and warrant close clinical monitoring.

The Central Vein: FLAIR Signal Abnormalities Associated with Developmental Venous Anomalies in Patients with Multiple Sclerosis [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Demyelination is a recently recognized cause of FLAIR hyperintensities associated with developmental venous anomalies. Our purpose was to quantify the prevalence of white matter signal abnormalities associated with developmental venous anomalies in patients with multiple sclerosis compared with controls.

MATERIALS AND METHODS:

A retrospective, blinded, multireader study compared the prevalence of FLAIR hyperintense signal abnormalities adjacent to developmental venous anomalies in patients with MS compared with controls (patients with developmental venous anomalies without MS). Study findings were positive if a central vein was demonstrated using FLAIR and contrast-enhanced fat-saturated T1 sequences. Imaging parameters also included developmental venous anomaly location, developmental venous anomaly drainage, white matter lesion size, and depth of white matter lesions. Clinical parameters included age, sex, and the presence of confounding variables (hypertension, diabetes, migraines, and/or vasculopathy).

RESULTS:

FLAIR signal abnormality was present around 47.3% (35/74) of developmental venous anomalies in patients with MS, and 13.5% (10/74) of developmental venous anomalies in the control group (P < .001). The multivariate logistic regression model controlling for covariates (including migraines, hypertension, diabetes mellitus, vasculopathy, age, sex, and drainage direction of developmental venous anomalies) showed that the odds of FLAIR hyperintensity around developmental venous anomalies was 6.7-fold higher in patients with MS (relative risk MS = 6.68; 95% CI, 2.79–15.97; P < .001).

CONCLUSIONS:

The association of developmental venous anomalies and FLAIR hyperintensities was more common in patients with MS, which suggests that the underlying demyelinating pathologic process of MS may be the cause of this propensity in patients with MS. Impaired venous drainage in the territory of developmental venous anomalies may predispose to development of these lesions, and an associated central vein is helpful in understanding an atypical location of MS plaques.

Outcomes of Stent Retriever versus Aspiration-First Thrombectomy in Ischemic Stroke: A Systematic Review and Meta-Analysis [INTERVENTIONAL]

BACKGROUND:

There is ongoing debate regarding the optimal first-line thrombectomy technique for large-vessel occlusion.

PURPOSE:

We performed a systematic review and meta-analysis of comparative studies on stent retriever–first and aspiration-first thrombectomy.

DATA SOURCES:

We searched Ovid MEDLINE, PubMed, and EMBASE from 2009 to February 2018.

STUDY SELECTION:

Two reviewers independently selected the studies. The primary end point was successful reperfusion (TICI 2b/3).

DATA ANALYSIS:

Random-effects meta-analysis was used for analysis.

DATA SYNTHESIS:

Eighteen studies including 2893 patients were included. There was no significant difference in the rate of final successful reperfusion (83.9% versus 83.3%; OR = 0.87; 95% CI, 0.62%–1.27%) or good functional outcome (mRS 0–2) at 90 days (OR = 1.07; 95% CI, 0.80–1.44) between the stent-retriever thrombectomy and aspiration groups. The stent-retriever thrombectomy–first group achieved a statistically significant higher TICI 2b/3 rate after the first-line device than the aspiration-first group (74.9% versus 66.4%; OR = 1.53; 95% CI, 1.14%–2.05%) and resulted in lower use of a rescue device (19.9% versus 32.5%; OR = 0.36; 95% CI, 0.14%–0.90%). The aspiration-first approach resulted in a statistically shorter groin-to-reperfusion time (weighted mean difference, 7.15 minutes; 95% CI, 1.63–12.67 minutes). There was no difference in the number of passes, symptomatic intracerebral hemorrhage, vessel dissection or perforation, and mortality between groups.

LIMITATIONS:

Most of the included studies were nonrandomized. There was significant heterogeneity in some of the outcome variables.

CONCLUSIONS:

Stent-retriever thrombectomy–first and aspiration-first thrombectomy were associated with comparable final reperfusion rates and functional outcome. Stent-retriever thrombectomy was superior in achieving reperfusion as a stand-alone first-line technique, with lower use of rescue devices but a longer groin-to-reperfusion time.

Aberrant Structural Brain Connectivity in Adolescents with Attentional Problems Who Were Born Prematurely [PEDIATRICS]

BACKGROUND AND PURPOSE:

Differences in structural brain connectivity that underlie inattention have been previously investigated in adolescents with attention deficit/hyperactivity disorder, but not in the context of premature birth, which is often associated with attentional problems. The purpose of this study was to identify the neural correlates of attentional problems in adolescents born prematurely and determine neonatal predictors of those neural correlates and attention problems.

MATERIALS AND METHODS:

The study included 24 adolescents (12.5 ± 1.8 years of age; 12 girls, 12 boys) who were born prematurely and underwent MR imaging of the brain and cognitive assessment, both shortly after birth and as adolescents. Structural connectivity was assessed at adolescence using diffusion tensor imaging and tractography.

RESULTS:

Of the 24 subjects, 12 had attention deficits. A set of axonal pathways connecting the frontal, parietal, temporal, and occipital lobes had significantly lower fractional anisotropy in subjects with attentional problems. The temporoparietal connection between the left precuneus and left middle temporal gyrus was the most significantly underconnected interlobar axonal pathway. Low birth weight and ventriculomegaly, but not white matter injury or intraventricular hemorrhage on neonatal MR imaging, predicted temporoparietal hypoconnectivity in adolescence. However, neither birth weight nor other neonatal characteristics were associated with attention deficits directly.

CONCLUSIONS:

We identified an aberrant structural brain connectivity pattern, involving temporoparietal hypoconnectivity, in prematurely born adolescents with attentional problems. We also identified birth weight as a potential neonatal predictor of the temporoparietal hypoconnectivity. These findings add to our understanding of the neural basis and etiology of inattention in adolescents after premature birth.

Systematic Assessment of Multispectral Voxel-Based Morphometry in Previously MRI-Negative Focal Epilepsy [ADULT BRAIN]

BACKGROUND AND PURPOSE:

Voxel-based morphometry is widely used for detecting gray matter abnormalities in epilepsy. However, its performance with changing parameters, smoothing and statistical threshold, is debatable. More important, the potential yield of combining multiple MR imaging contrasts (multispectral voxel-based morphometry) is still unclear. Our aim was to objectify smoothing and statistical cutoffs and systematically compare the performance of multispectral voxel-based morphometry with existing T1 voxel-based morphometry in patients with focal epilepsy and previously negative MRI.

MATERIALS AND METHODS:

3D T1-, T2-, and T2-weighted FLAIR scans were acquired for 62 healthy volunteers and 13 patients with MR imaging negative for focal epilepsy on a Magnetom Skyra 3T scanner with an isotropic resolution of 0.9 mm³. We systematically optimized the main voxel-based morphometry parameters, smoothing level and statistical cutoff, with T1 voxel-based morphometry as a reference. As a next step, the performance of multispectral voxel-based morphometry models, T1+T2, T1+FLAIR, and T1+T2+FLAIR, was compared with that of T1 voxel-based morphometry using gray matter concentration and gray matter volume analysis.

RESULTS:

We found the best performance of T1 at 12 mm and a T-threshold (statistical cutoff) of 3.7 for gray matter concentration analysis. When we incorporated these parameters, after expert visual interpretation of concordant and discordant findings, we identified T1+FLAIR as the best model with a concordant rate of 46.2% and a concordant rate/discordant rate of 1.20 compared with T1 with 30.8% and 0.67, respectively. Visual interpretation of voxel-based morphometry findings decreased concordant rates from 38.5%–46.2% to 15.4%–46.2% and discordant rates from 53.8%–84.6% to 30.8%–46.2% and increased specificity across models from 33.9%–40.3% to 46.8%–54.8%.

CONCLUSIONS:

Multispectral voxel-based morphometry, especially T1+FLAIR, can yield superior results over single-channel T1 in focal epilepsy patients with a negative conventional MR imaging.

MR Imaging in Meniere Disease: Is the Contact between the Vestibular Endolymphatic Space and the Oval Window a Reliable Biomarker? [HEAD & NECK]

BACKGROUND AND PURPOSE:

No reliable MR imaging marker for the diagnosis of Menière disease has been reported. Our aim was to investigate whether the obliteration of the inferior portion of the vestibule and the contact with the stapes footplate by the vestibular endolymphatic space are reliable MR imaging markers in the diagnosis of Menière disease.

MATERIALS AND METHODS:

We retrospectively enrolled 49 patients, 24 affected by unilateral sudden hearing loss and 25 affected by definite Menière disease, who had undergone a 4-hour delayed 3D-FLAIR sequence. Two readers analyzed the MR images investigating whether the vestibular endolymphatic space bulged in the third inferior portion of the vestibule contacting the stapes footplate. This sign was defined as the vestibular endolymphatic space contacting the oval window.

RESULTS:

We analyzed 98 ears: 27 affected by Menière disease, 24 affected by sudden sensorineural hearing loss, and 47 that were healthy. The vestibular endolymphatic space contacting the oval window showed an almost perfect interobserver agreement (Cohen = 0.87; 95% CI, 0.69–1). The vestibular endolymphatic space contacting oval window showed the following: sensitivity = 81%, specificity = 96%, positive predictive value = 88%, and negative predictive value = 93% in differentiating Menière disease ears from other ears. The vestibular endolymphatic space contacting the oval window showed the following: sensitivity = 81%, specificity = 96%, positive predictive value = 96%, negative predictive value = 82% in differentiating Menière disease ears from sudden sensorineural hearing loss ears.

CONCLUSIONS:

The vestibular endolymphatic space contacting the oval window has high specificity and positive predictive value in differentiating Menière disease ears from other ears, thus resulting in a valid tool for ruling in Menière disease in patients with mimicking symptoms.

Spinal Epidural Arteriovenous Fistula with Perimedullary Venous Reflux: Clinical and Neuroradiologic Features of an Underestimated Vascular Disorder [SPINE]

BACKGROUND AND PURPOSE:

The purpose of this study was to discuss the clinical and radiologic characteristics of spinal epidural arteriovenous fistulas (SEAVF) and demonstrate their specific angiomorphology in a single-center series.

MATERIALS AND METHODS:

Thirteen consecutive patients were diagnosed with SEAVF at RWTH Aachen University Hospital between 2006 and 2018 and were included in this study. All patients had MR imaging and DSA before treatment; 10 of these 13 patients received contrast-enhanced MRA (CE-MRA).

RESULTS:

The mean patient age was 72 ± 8 years. Paraparesis was present in 12 (92%) patients. Sphincter dysfunction and sensory symptoms were observed in 7 (54%) and 6 (46%) patients, respectively. The mean duration of symptoms was 6 ± 8 months. Congestive myelopathy on MR imaging was present in all patients. Prominent arterialized perimedullary veins were demonstrated in only 3 cases. CE-MRA revealed arterialized perimedullary veins and an arterialized epidural pouch in 9/10 (90%) patients, mostly located ventrolaterally. DSA demonstrated a multisegmental extension of the arterialized ventrolateral epidural pouch in 6 (46%) cases. An intradural radicular drainage vein was localized distant from the original fistula point in 3 (23%) patients.

CONCLUSIONS:

Congestive myelopathy with an acute/subacute clinical course was the dominant finding in spinal epidural arteriovenous fistulas. CE-MRA is a powerful diagnostic tool for identifying arterialized perimedullary veins as well as an arterialized epidural pouch. While arterialized perimedullary veins frequently present with only mild enlargement and elongation in spinal epidural arteriovenous fistulas, the arterialized epidural pouch is frequently located ventrolaterally and may extend over several vertebral levels. DSA remains the criterion standard to precisely visualize a spinal epidural arteriovenous fistula and its intradural radicular drainage vein, which may be located distant from the fistulous point.

EGR3 is a late epidermal differentiation regulator that establishes the skin-specific gene network

Late epidermal differentiation is a key step of skin barrier formation; however, the specific genetic factors that distinguish late differentiation from early differentiation remain unknown. Here, we demonstrated that early growth response factor 3 (EGR3) is highly expressed in the stratum granulosum, and that it contributes to late epidermal differentiation. However, its expression is lost under poorly differentiated conditions such as the parakeratosis-lesional skin. EGR3 mediated the regulation of genes located in the epidermal differentiation complex (EDC) through activation of enhancers and induction of enhancer RNAs.

A Technique to Provide Enhanced Visualization For Suture Cutting In Dermatologic Surgery

Patient Requests to Alter the Medical Record

Scientists Learn To Hear The 'Songs' Of Ice Shelves

Scientists have found a new way to analyze the structural integrity of ice shelves at the end of the world, through the songs the winds sing on top of them.

(Image credit: De Agostini Picture Library/De Agostini/Getty Images)

SOP – Fatigue

Standards für die Palliativmedizin

Association of Vaping and Smoking With Decreased Flap Viability in Rats

This study investigates whether exposure to electronic cigarette vapor is less likely than exposure to cigarette smoke to lower the viability of random pattern flaps in laboratory rats.

Is e-Cigarette Vaping a New Clinical Challenge to Wound Healing?

Traditional cigarette smoking has been implicated by indisputable physiologic and clinical evidence to have substantial wound healing problems in surgical procedures. Physiologically, nicotine and the thousands of chemicals (ie, tar) in cigarette smoke induce not only peripheral vasoconstriction but also oxidative stress that weakens neutrophil function and subsequently wound healing through a variety of mechanisms. But what about electronic or e-cigarettes, otherwise known as vaping?

Association of Smoking Tobacco With Complications in Head and Neck Microvascular Reconstructive Surgery

This population database study uses 2005-2014 National Surgical Quality Improvement Program data to assess the risks associated with smoking among patients undergoing free flap reconstruction surgery of the head and neck.

SOP – Umgang mit und Versorgung von Verstorbenen

SOP – Aufnahmekriterien auf die Palliativstation

SOP – Atemnot bei erwachsenen Palliativpatienten

SOP – Depression und Angst in der Palliativmedizin

SOP – Übelkeit und Erbrechen bei Palliativpatienten

SOP – Inappetenz und Kachexie

SOP – Schmerztherapie bei Palliativpatienten

SOP – Akuter Verwirrtheitszustand

SOP – Subkutane Medikamentengabe und Infusionen in der erwachsenen Palliativmedizin

SOP – Behandlung und Betreuung in der Sterbephase

SOP – Darmpassagestörung in der Palliativmedizin

SOP – Palliative Sedierung

SOP – Umgang mit multiresistenten Erregern auf der Palliativstation

Issue Information

Pigment Cell &Melanoma Research, Volume 31, Issue 6, Page 653-657, November 2018.

Couvent des jacobins rennes, france 24th – 27th september 2018

Pigment Cell &Melanoma Research, Volume 31, Issue 6, Page 736-777, November 2018.

Grandma Was Right: Sunshine Helps Kill Germs Indoors

All kinds of bacteria live with us indoors, and some can make us sick. A new study shows that rooms exposed to light had about half the live bacteria found in rooms that were kept in darkness.

(Image credit: Dave G Kelly/Getty Images)

Moisturizers versus Current and Next-Generation Barrier Repair Therapy for the Management of Atopic Dermatitis

We compare here the principal characteristics of over-the-counter moisturizers with physiologic lipid-based barrier repair therapy. Moisturizers are standard ancillary therapy for anti-inflammatory skin disorders, like atopic dermatitis (AD), and can attenuate the emergence of AD, the initial step in the "atopic march." But not all moisturizers are beneficial; some can make skin function worse, and can even induce inflammation, possibly accounting for the frequent occurrence of "sensitive skin" in women. In contrast, physiologic lipid-based barrier repair therapy, if comprised of the 3 key stratum corneum lipids, in sufficient quantities and at an appropriate molar ratio, can correct the barrier abnormality and reduce inflammation in AD, and perhaps in other inflammatory dermatoses.
Skin Pharmacol Physiol 2019;32:1–7

Rheology of hyaluronic acid and dynamic facial rejuvenation: Topographical specificities

Journal of Cosmetic Dermatology, Volume 17, Issue 5, Page 736-743, October 2018.

JCD Commentary for September 2018

Journal of Cosmetic Dermatology, Volume 17, Issue 5, Page 649-649, October 2018.

Issue Information

Journal of Cosmetic Dermatology, Volume 17, Issue 5, Page 643-644, October 2018.

Issue Information

International Journal of Cosmetic Science, Volume 40, Issue 5, Page i-iv, October 2018.

Therapeutic management of vitiligo

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.

Pengtala flap for reconstructing nasal tip defects

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.

Segmental Darier’s disease of unusually late onset

JDDG: Journal der Deutschen Dermatologischen Gesellschaft, EarlyView.

Bye, Bye, Beer? Brewers Say They've Got A Plan On Climate Change

A scientific paper published this week predicts climate change will send beer prices skyrocketing and drastically reduce the barley crop. It got tons of media attention. But is beer really doomed?

(Image credit: Dean Hutton/Bloomberg via Getty Images)

Geological Teams Try To Determine The Future Of Storm-Affected Communities

Researchers from the U.S. Geological Survey are on the ground in Florida looking for the high water marks of Hurricane Michael. FEMA uses these maps to determine who is eligible for what kind of aid.

What Do You Get A Nobel Prize Winner? It's Hard To Find A Perfect Gift

The University of Missouri was deciding how to honor George Smith, who shared the 2018 Nobel in chemistry. Some schools designate parking spots but Smith bikes. He now has his own spot in a bike rack.

Use of multifilament nylon floss in onychocryptosis

Publication date: Available online 17 October 2018

Source: Journal of the American Academy of Dermatology

Author(s): Anuradha Bishnoi, Keshavamurthy Vinay, Sunil Dogra

What do Patients Undergoing Mohs Micrographic Surgery Value? Results of a Patient Values Survey based on OAS-CAHPS

Publication date: Available online 17 October 2018

Source: Journal of the American Academy of Dermatology

Author(s): Paul R. Massey, Ruibin Wang, Simi D. Cadmus, Katherine R. Sebastian, Matthew C. Fox

Ameliorative effect of berberine coated bio-active nanoparticles in acetaminophen induced hepato-renal damage in diabetic rats

Publication date: Available online 17 October 2018

Source: Journal of Photochemistry and Photobiology B: Biology

Author(s): Yueyue Wu, Xinmei Huang, Min Yang, Jiong Xu, Zaoping Chen, Zhiyan Yu, Jun Liu

Abstract

The current investigation was performed for the detailed analysis of protective effect of biofabricate berberine coated nano‑silver ameliorate (BBR-AgNPs) on acetaminophen (APAP) induced hepato-renal damages in diabetic rats by blood biochemistry, tissue biochemistry, histopathological and immunohistochemical analysis. The spherical shaped BBR-AgNPs were synthesized by the Biofabrication technique and its physico-chemical characterizations done by different spectroscopic (UV–vis spectrophotometer, XRD spectroscopy, FTIR spectroscopy EDAX & DLS analyses) and microscopic (FE-SEM) techniques. The diabetic developed rats were administrated with APAP (2.0 g/5 ml/kg) and scrutinize its hepato-renal injuries. The synthesized BBR-AgNPs (75 mg/kg p.o) was administrated orally to the APAP-induced diabetic rats. The result of biochemical markers and lipid peroxidation were significantly (P ˂ 0.05) increased in APAP-induced diabetic rats but decreased the level of antioxidants (P ˂ 0.05), which results obtained in liver and kidney compared to the control group. Immunohistochemical studies result showed that the APAP-induced diabetic rats expressed a high immunoreactivity of nuclear transcription factor (NF-kB). Whereas, the acetaminophen-induced diabetic rats were treated with BBR-AgNPs renovated the changes in the above parameters analyzed. The results of the study clearly indicated that the BBR-AgNPs possess the antioxidant properties as well as anti-diabetic effects, furthermore, the acetaminophen-induced liver and kidney damage was probably inhibited by the inhibition of proinflammatory factor & NF-kB factors.

Graphical abstract

EPA Boasts Of Reduced Greenhouse Gases, Even As Trump Questions Climate Science

U.S. production of heat-trapping greenhouse gases fell 2.7 percent last year. But larger cuts will be needed to address climate change.

(Image credit: Branden Camp/AP)

Recall dermatitis at patch test sites in an atopic dermatitis patient treated with dupilumab

Contact Dermatitis, EarlyView.

Occupational airborne allergic contact dermatitis caused by N‐(4‐hydroxyphenyl)benzenesulfonamide

Contact Dermatitis, EarlyView.

A case of yellow chromonychia and yellow skin induced by topical ascorbic acid

Australasian Journal of Dermatology, EarlyView.

Combining topical tretinoin with mometasone furoate in the treatment of vulvar lichen sclerosus: Results of dermoscopic assessment

Dermatologic Therapy, EarlyView.

Evaluation of the scars’ vascularization using computer processing of the digital images

Skin Research and Technology, EarlyView.

CCN proteins as potential actionable targets in scleroderma

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

Vitiligo surgery: a journey from tissues via cells to the stems!

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

The role of phosphodiesterase 4 in the pathophysiology of atopic dermatitis and the perspective for its inhibition

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

Diagnostic workout to assess early response indicators in invasive pulmonary aspergillosis in adult patients with hematologic malignancies

Mycoses, Volume 0, Issue ja, -Not available-.

Definition of psoriasis severity in routine clinical care: current guidelines fail to capture the complexity of long‐term psoriasis management

British Journal of Dermatology, EarlyView.

Efficacy and safety of brodalumab in patients with psoriasis who had inadequate responses to ustekinumab: subgroup analysis of two randomized phase 3 trials

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.

5‐aminolevulinic acid nanoemulsion (BF‐200 ALA) is more effective than methyl‐5‐aminolevulinate (MAL) in daylight photodynamic therapy for actinic keratosis: A non‐sponsored randomized double‐blind multicentre trial

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.