Αναζήτηση αυτού του ιστολογίου

Κυριακή 11 Αυγούστου 2019

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,


Laparoscopic Hyperthermic Intraperitoneal Chemotherapy is Safe for Patients with Peritoneal Metastases...
Laparoscopic Hyperthermic Intraperitoneal Chemotherapy is Safe for Patients with Peritoneal Metastases from Gastric Cancer and May Lead to Gastrectomy"Author's Response to Reflexion on Consensus Statement on Oncoplastic Surgery, by Zucca-Matthes, Gustavo, et al.Bridging the Gap: Making Sense of the Diverging Evidence for Self-Expandable Metallic Stents in Malignant Colonic ObstructionsLaparoscopic Isolated Total Caudate Lobectomy for Hepatocellular Carcinoma Located in the Paracaval Portion of the...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
08:04
Facial Rejuvenation Using a Mixture of Calcium Hydroxylapatite Filler and Hyaluronic Acid Filler Calcium...
Facial Rejuvenation Using a Mixture of Calcium Hydroxylapatite Filler and Hyaluronic Acid FillerCalcium hydroxylapatite filler is a popular dermal filler, as it provides long-lasting results. However, it sometimes undergoes unexpected early volume loss, due to rapid gel absorption before neocollagenesis. To compensate for this phenomenon, hyaluronic acid filler was added to calcium hydroxylapatite filler for injection as a mixture. Twenty-five patients who scored 1 or 2 on the Merz 5-point scale...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
08:04
Review of Børge Bakken, Crime and the Chinese Dream Examining the Links Between General Strain and...
Review of Børge Bakken, Crime and the Chinese DreamExamining the Links Between General Strain and Control Theories: an Investigation of Delinquency in South KoreaAbstractIn modifying general strain theory (GST), Agnew has accepted the control-related variables as conditioning variables to moderate or mediate the casual process through strain into delinquency. In this regard, this study aims to empirically and theoretically address the void of connecting traditional and redefined self-control variables...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
08:04
Smartphone Addiction and Its Relationship with Indices of Social-Emotional Distress and Personality...
Smartphone Addiction and Its Relationship with Indices of Social-Emotional Distress and PersonalityAbstractWe examined the relationships among smartphone addiction, social-emotional distress (e.g., anxiety, depression, sleep quality, and loneliness), and personality traits among 150 undergraduate college students. Participants completed the Smartphone Addiction Scale, the Outcome Questionnaire-45.2, the Pittsburgh Sleep Quality Index, the UCLA Loneliness Scale-3, and the Neuroticism-Extraversion-Openness...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
08:03
Ten Years of Response to Intervention: Trends in the School Psychology Literature Abstract With the...
Ten Years of Response to Intervention: Trends in the School Psychology LiteratureAbstractWith the reauthorization of the Individuals with Disabilities Education (Improvement) Act (IDEA) in 2004, local education agencies (LEAs) were no longer required to employ an IQ-achievement discrepancy model in the identification of a specific learning disability (SLD). Rather, districts were permitted to use data from a Response to Intervention (RTI) framework in determining a student's eligibility for special...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
08:02
Clinical Behaviours and Prognoses of High and Low Risk Parotid Malignancies Based on Histology" Letter...
Clinical Behaviours and Prognoses of High and Low Risk Parotid Malignancies Based on Histology"Letter to the Editor regarding "Clinical behaviors and prognoses of high- and low-risk parotid malignancies based on histology" by Tao L. et al.Comparison of superelastic nitinol stapes prostheses and platin teflon stapes prosthesesAbstractIntroductionStapes plasty is an established procedure to improve hearing in case of otosclerosis. By reinforcing the prostheses, an optimization of the prosthesis could...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
08:02
Adalimumab-Biosimilar in Dosierung für junge Patienten Nachsorge mit Maß Probiotika wirksam bei Darmerkrankungen...
Adalimumab-Biosimilar in Dosierung für junge PatientenNachsorge mit MaßProbiotika wirksam bei DarmerkrankungenHeilerde kann Lebensqualität und Symptomatik verbessernLiebesbriefe von KollegenAlginat als wirksame Alternative zur PPI-EinnahmeThem2 als Zielstruktur für die NAFLD-TherapieKomplementärmedizin in der Onkologie: Nicht verteufeln, sondern integrieren!Reduzierung der Therapiedauer auf acht WochenProphylaxe der HE nicht vernachlässigen
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
08:02
Complex Semblance and Its Application Abstract Semblance, a measure of multi-trace coherence, has been...
Complex Semblance and Its ApplicationAbstractSemblance, a measure of multi-trace coherence, has been used extensively in seismic data processing and interpretation such as velocity analysis and fault detection. The traditional algorithm has a difficulty at zero-crossings of seismic recordings. This problem is alleviated by applying a smoothing window at the cost of losing vertical resolutions. In this paper, we improve the algorithm by computing semblance from complex traces. Our initial results...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:59
Resuscitative endovascular balloon occlusion of the inferior vena cava is made hemodynamically possible...
Resuscitative endovascular balloon occlusion of the inferior vena cava is made hemodynamically possible by concomitant endovascular balloon occlusion of the aorta – a porcine studyBackground Resuscitative endovascular balloon occlusion of the vena cava inferior (REBOVC) may provide a minimal invasive alternative for hepatic vascular and inferior vena cava isolation in severe retrohepatic bleeding. However, circulatory stability may be compromised by the obstruction of venous return. The aim was to...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:59
A novel truncating mutation in MYD88 in a patient with BCG adenitis, neutropenia and delayed umbilical...
A novel truncating mutation in MYD88 in a patient with BCG adenitis, neutropenia and delayed umbilical cord separationPublication date: October 2019Source: Clinical Immunology, Volume 207Author(s): Craig D. Platt, Fatima Zaman, Jacqueline G. Wallace, Michael Seleman, Janet Chou, Nashat Al Sukaiti, Raif S. GehaAbstractMutations in MYD88 cause susceptibility to invasive bacterial infections through impaired signaling downstream of toll-like receptors (TLRs) and IL-1 receptors. We studied a patient...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:59
Special issue of the "International Conference on Computational and Experimental Science and Engineering...
Special issue of the "International Conference on Computational and Experimental Science and Engineering (ICCESEN)"Correction to: Determination of genetic diversity of natural sage populations in Muğla region of TurkeyThe article "Determination of genetic diversity of natural sage populations in Muğla region of Turkey", written by D. Altindal, was originally published electronically on the publisher's internet portal (currently SpringerLink) on 05 January 2019 with open access.Flow field analysis...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:58
Machine Learning Models in Type 2 Diabetes Risk Prediction: Results from a Cross-sectional Retrospective...
Machine Learning Models in Type 2 Diabetes Risk Prediction: Results from a Cross-sectional Retrospective Study in Chinese AdultsSummaryType 2 diabetes mellitus (T2DM) has become a prevalent health problem in China, especially in urban areas. Early prevention strategies are needed to reduce the associated mortality and morbidity. We applied the combination of rules and different machine learning techniques to assess the risk of development of T2DM in an urban Chinese adult population. A retrospective...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:58
The need to disclose the composition of medical devices at the European levelAnne Herman, An Goossens...
The need to disclose the composition of medical devices at the European levelAnne Herman, An GoossensPages: 159-160 | First Published: 15 July 2019ORIGINAL ARTICLESAllergic contact dermatitis caused by glucose sensors in type 1 diabetes patientsHeli S. I. Hyry, Jussi P. Liippo, Hannele M. VirtanenPages: 161-166 | First Published: 17 June 2019Allergic contact dermatitis caused by synthetic rubber gloves in healthcare workers: Sensitization to 1,3‐diphenylguanidine is commonGuillaume Dejonckheere, Anne...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:57
Operating Room Fires: Comment Jan Ehrenwerth, M.D. Anesthesiology Published online August 09, 2019....
Operating Room Fires: CommentJan Ehrenwerth, M.D.Anesthesiology Published online August 09, 2019. doi:10.1097/ALN.0000000000002922Operating Room Fires: ReplyTeresa S. Jones, M.D.; Edward L. Jones, M.D.Anesthesiology Published online August 09, 2019. doi:10.1097/ALN.0000000000002923
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:56
Etiology and Pathomechanics of Femoroacetabular Impingement AbstractPurpose of review Femoroacetabular...
Etiology and Pathomechanics of Femoroacetabular ImpingementAbstractPurpose of reviewFemoroacetabular impingement is a common cause of hip pain in young patients and has been shown to progress to osteoarthritis. The purpose of this review is to better understand the development of femoroacetabular impingement.Recent findingsRecent literature shows little genetic transmission of FAI. However, molecular studies show strong similarities with the cartilage in osteoarthritis. The development of cam lesions...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:53
 "Biological Background of Block Periodized Endurance Training: A Review" Reply to Kiely et al.: Comment...
 "Biological Background of Block Periodized Endurance Training: A Review"Reply to Kiely et al.: Comment on: "Biological Background of Block Periodized Endurance Training: A Review"Causal Mediation Analysis Could Resolve Whether Training-Induced Increases in Muscle Strength are Mediated by Muscle HypertrophyAbstractResistance training increases muscle size (i.e., causes hypertrophy) and muscle strength, particularly in untrained individuals. Hypertrophy is widely believed to be one of the mechanisms...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:52
Wondering About Rapunzel: Reading and Responding to Feminist Fairy Tales with Seventh Graders Abstract...
Wondering About Rapunzel: Reading and Responding to Feminist Fairy Tales with Seventh GradersAbstractShannon Hale, Dean Hale, and Nathan Hale's graphic novel set Rapunzel's Revenge (2008) and Calamity Jack (2010) features fractured fairy tales that take up the issue of 'the damsel in distress,' questioning and complicating traditional gender roles in fairy tales. Throughout both graphic novels Rapunzel's character challenges traditional representations of being feminine within the heterosexual matrix...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:52
A Combination of Variational Mode Decomposition and Histogram Equalization for Image Enhancement Abstract...
A Combination of Variational Mode Decomposition and Histogram Equalization for Image EnhancementAbstractA new technique for image contrast enhancement is proposed in this paper. The technique is based on the variational mode decomposition (VMD) of image and various histogram equalization approaches. The original image is decomposed into different sub-images or modes using VMD. The histogram equalization approaches such as the conventional histogram equalization, the contrast limited adaptive histogram...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:51
Prothrombin Complex Concentrates are Superior to Fresh Frozen Plasma for Emergency Reversal of Vitamin...
Prothrombin Complex Concentrates are Superior to Fresh Frozen Plasma for Emergency Reversal of Vitamin K Antagonists: A Meta-Analysis in 2606 SubjectsAbstractBackgroundUrgent reversal of vitamin K antagonists (VKAs) is required for major bleeding or urgent surgery by intravenous vitamin K with either prothrombin complex concentrates (PCCs) or fresh frozen plasma (FFP). However, there is lack of consensus regarding the superiority of either reversal agent. We sought to compare the performance of PCC...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:51
Daily Changes in The Expression of Clock Genes in Sepsis and Their Relation with Sepsis Outcome and...
Daily Changes in The Expression of Clock Genes in Sepsis and Their Relation with Sepsis Outcome and Urinary Excretion of 6-SulfatoximelatoninBackground: Whereas the circadian system controls the daily production of melatonin and the daily activity of the immune system, increasing evidences support the association between circadian misalignment with the alterations in the immune response and melatonin rhythm during sepsis. The aim of this study was to analyze the daily changes in clock genes expression...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:50
Publisher Correction to: The KOF Globalisation Index – revisited The article listed above was initially...
Publisher Correction to: The KOF Globalisation Index – revisitedThe article listed above was initially published with incorrect copyright information. Upon publication of this Correction, the copyright of this article changed to "The Author(s)". The original article has been corrected.Paul Poast and Johannes Urpelainen. 2018 . Organizing Democracy: How International Organizations Assist New Democracies (Chicago, IL:  University of Chicago Press)When do authoritarian rulers educate: Trade competition...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:49
Kenneth A. Forde, MD, 1934–2019 EAES/SAGES consensus conference on acute diverticulitis: a paradigm...
Kenneth A. Forde, MD, 1934–2019EAES/SAGES consensus conference on acute diverticulitis: a paradigm shift in the management of acute diverticulitisClinical prediction model for tumor progression in Barrett's esophagusAbstractBackgroundIndividuals with Barrett's esophagus (BE) are at increased risk of high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC), but the cost-effectiveness of general surveillance of BE is low. This study aimed to identify a risk prediction model for tumor progression...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:48
Besondere Situationen und Komplikationsmanagement in der Wirbelsäulenchirurgie Techniken zur Steigerung...
Besondere Situationen und Komplikationsmanagement in der WirbelsäulenchirurgieTechniken zur Steigerung der Pedikelschraubenstabilität im osteoporotischen KnochenZusammenfassungOperationszielOperative Stabilisation osteoporotischer Wirbelkörperfrakturen.IndikationenOsteoporotische Frakturen der Brust- und Lendenwirbelsäule.KontraindikationenKeine.OperationstechnikPräoperative Detektion der zu erwartenden Knochendichte. Einbringen von Pedikelschrauben in speziellen Trajektorien, Augmentation des Schraubenlagers...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:48
IgG4-Related Disease of the Thyroid Gland Requiring Emergent Total Thyroidectomy: A Case Report Abstract...
IgG4-Related Disease of the Thyroid Gland Requiring Emergent Total Thyroidectomy: A Case ReportAbstractIgG4-related disease of the thyroid gland is a recently recognized subtype of thyroiditis, often with rapid progression requiring surgical treatment. It is considered as a spectrum of disease varying from early IgG4-related Hashimoto's thyroiditis (HT) pattern to late fibrosing HT or Riedel's thyroiditis patterns. Here, we report a 47-year-old Malay woman presenting with progressively painless neck...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:47
Differences in prothrombotic response between the uninterrupted and interrupted apixaban therapies in...
Differences in prothrombotic response between the uninterrupted and interrupted apixaban therapies in patients undergoing cryoballoon ablation for paroxysmal atrial fibrillation: a randomized controlled studyIn the original publication of the article, the table 2 was published incorrectly.Effects of deep inspiration on QRS axis, T-wave axis and frontal QRS-T angle in the routine electrocardiogramAbstractThe frontal QRS-T angle on the electrocardiogram has been described as a variable of ventricular...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:46
Delayed graft function in simultaneous liver kidney transplantation Background: Delayed graft function...
Delayed graft function in simultaneous liver kidney transplantationBackground: Delayed graft function (DGF) is associated with inferior posttransplant outcomes in kidney transplantation. Given these adverse outcomes, we sought to determine the incidence, unique risk factors, and posttransplant outcomes for simultaneous liver kidney (SLK) transplant recipients developing DGF. Methods: We studied 6214 adult SLK recipients from March 2002 to February 2017 using the Scientific Registry of Transplant...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:45
Very Late Recurrence of Hepatocellular Carcinoma After Orthotopic Liver Transplantation: Presentation...
Very Late Recurrence of Hepatocellular Carcinoma After Orthotopic Liver Transplantation: Presentation and ManagementNo abstract availableStaged Biliary Reconstruction After Orthotopic Liver Transplantation: A Practical Surgical Strategy for High-Acuity Adult RecipientsBackground. Biliary complications (BC) following orthotopic liver transplantation (OLT) is strongly associated with inferior patient outcomes and increased healthcare cost. BC in high-acuity patients can be lethal. While the utility...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:45
Analgesia in Major Abdominal Surgery No abstract available The Clinical Use of Cricoid Pressure: First,...
Analgesia in Major Abdominal SurgeryNo abstract availableThe Clinical Use of Cricoid Pressure: First, Do No HarmApplication of cricoid pressure (CP) during rapid sequence induction and intubation sequence has been a "standard" of care for many decades, despite limited scientific proof of its efficacy in preventing pulmonary aspiration of gastric contents. While some of the current rapid sequence induction and intubation guidelines recommend its use, other international guidelines do not, and many...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:44
Digestibility and Acceptability of Wheat Flour Cookies Partially Substituted with High Amylose Maize...
Digestibility and Acceptability of Wheat Flour Cookies Partially Substituted with High Amylose Maize StarchAbstractCookies are one of the most consumed bakery products and the formulation could be modified to consider them as a functional food. The high amylose maize starch (HAMS) is considered as resistant starch (RS) type 2. The objective of this work was to assess the starch fractions, texture, sensory properties and acceptability of wheat flour cookies added with HAMS at different percentages....
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:44
Epidermal Growth Factor Receptor (EGFR)–Tyrosine Kinase Inhibitors (TKIs) Combined with Chemotherapy...
Epidermal Growth Factor Receptor (EGFR)–Tyrosine Kinase Inhibitors (TKIs) Combined with Chemotherapy Delay Brain Metastasis in Patients with EGFR‑Mutant Lung AdenocarcinomaThe article Epidermal Growth Factor Receptor (EGFR)–Tyrosine Kinase Inhibitors (TKIs) Combined with Chemotherapy Delay Brain Metastasis in Patients with EGFR-Mutant Lung Adenocarcinom, written by Changhui Li, Bo Zhang, Jindong Guo, Fang Hu, Wei Nie, Xiaoxuan Zheng, Lixin Wang, Yuqing Lou, Yinchen Shen, Baohui Han, Xueyan Zhang,...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:43
Suture Catheter for Rescue Perineural Catheter Placement When Unable to Position a Conventional Through-the-Needle...
Suture Catheter for Rescue Perineural Catheter Placement When Unable to Position a Conventional Through-the-Needle Catheter: A Case ReportThe main purported benefit of suture-style catheters is the ability to secure the catheter at 2 sites, thereby decreasing the likelihood of catheter dislodgement. An additional benefit is the ability to precisely control the placement of the orifice to infuse local anesthetic. Here we present the case of a patient undergoing open ankle surgery for whom placement...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:43
Correction to: An Anti-hyperventilation Instruction Decreases the Drop in End-tidal CO 2 and Symptoms...
Correction to: An Anti-hyperventilation Instruction Decreases the Drop in End-tidal CO 2 and Symptoms of Hyperventilation During Breathing at 0.1 HzThe original version of this article unfortunately contained an error in abstract section. The number of participants should be "Forty-six participants" instead of "Thirty-six participants". The correct sentence is as follows: Forty-six participants were randomly assigned to one of two groups: a group given an anti-hyperventilation instruction and a control...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:42
Clampless aortic punch system for making a large-diameter access route without side-biting clamp: a...
Clampless aortic punch system for making a large-diameter access route without side-biting clamp: a preliminary studyAbstractAlthough thoracic endovascular aneurysm repair (TEVAR) has been getting popularity as a less-invasive procedure, the treatment of thoracic aortic aneurysm with atherosclerotic aortic disease is still challenging. In hybrid TEVAR through the median sternotomy approach, side-biting clamp of the ascending aorta is often necessary for making an access route; however, it could cause...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:41
Objectification in Heterosexual Romantic Relationships: Examining Relationship Satisfaction of Female...
Objectification in Heterosexual Romantic Relationships: Examining Relationship Satisfaction of Female Objectification Recipients and Male Objectifying PerpetratorsAbstractSexual objectification is one of most the common manifestations of discrimination against women in Western societies; however, few studies have examined objectification in the context of romantic relationships. The primary aim of the present research was to bring the study of objectification phenomena into the setting of heterosexual...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:40
Prevalence of contact dermatitis in the Greek population: A retrospective observational studyAnna...
Prevalence of contact dermatitis in the Greek population: A retrospective observational studyAnna Tagka, Alexandros Stratigos, George I. Lambrou, Electra Nicolaidou, Alexandra Katsarou, Argyro ChatziioannouVersion of Record online: 08 August 2019ORIGINAL ARTICLESClinical features, culprit drugs, and allergology workup in 41 cases of fixed drug eruptionNajah Ben Fadhel, Amel Chaabane, Helmi Ammar, Haifa Ben Romdhane, Yosra Soua, Zohra Chadli, Jameleddine Zili, Naceur A. Boughattas, Nadia Ben Fredj, Karim...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:40
A peculiar case of sensitization to Candelilla Cera and sucrose (di)stearate in a toddlerAnne‐Sophie...
A peculiar case of sensitization to Candelilla Cera and sucrose (di)stearate in a toddlerAnne‐Sophie Darrigade, Ella Dendooven, Evelyne Mangodt, Evert Vermander, Margo Hagendorens, Olivier AertsFirst Published: 10 August 2019CONTACT POINTSFixed drug eruption caused by allylisopropylacetylurea mimicking contact dermatitis of the faceRikako Deno, Yukinobu Nakagawa, Saori Itoi‐Ochi, Yorihisa Kotobuki, Eiji Kiyohara, Mari Wataya‐Kaneda, Manabu FujimotoFirst Published: 10 August 2019ORIGINAL ARTICLESOccupational...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:40
Gibt es eine Magic Bullet für Sarkome? ZusammenfassungHintergrund Personalisierte Therapien von Tumorerkrankungen...
Gibt es eine Magic Bullet für Sarkome?ZusammenfassungHintergrundPersonalisierte Therapien von Tumorerkrankungen zielen darauf ab, spezifische überlebenswichtige Mechanismen eines Tumors medikamentös zu unterbinden.Ziel der Arbeit und MethodeDer Beitrag soll einen Überblick über relevante genetische Veränderungen und potenzielle therapeutische Zielstrukturen von Knochen- und Weichteilsarkomen vermitteln und aktuelle Ansätze in der personalisierten Behandlung maligner Tumoren des Stütz- und Bewegungsapparates...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:39
Study of the mechanical properties of fresh and cryopreserved individual human oocytes Abstract In assisted...
Study of the mechanical properties of fresh and cryopreserved individual human oocytesAbstractIn assisted reproduction technologies, the cryopreservation of oocytes is a common procedure used to circumvent female infertility. However, some morphological and functional alterations of oocytes have been observed depending on the protocol applied. In this work, the mechanical response of individual human oocytes before and after a freeze-thawing procedure was characterised. Oocytes, immediately after...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:39
Michelangelo il Giovane, Ecuba , ed. Claudia Cuzzotti. Lucca: Maria Pacini Fazzi editore, 2017. Pp....
Michelangelo il Giovane, Ecuba , ed. Claudia Cuzzotti. Lucca: Maria Pacini Fazzi editore, 2017. Pp. 280. Softcover. €15. ISBN: 978-88-6550-571-7The Classical Tradition in the Baltic Region: Perceptions and Adaptations of Greece and Rome , ed. Arne Jönsson and Gregor Vogt-Spira. Spudasmata, 171Newly Recovered English Classical Translations, 1600 – 1800 , ed. Stuart GillespieHellenomania , ed. Katherine Harloe, Nicoletta Momigliano and Alexandre Faroux. British School at Athens – Modern Greek and Byzantine...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:38

Chirurgische Versorgung ösophagotrachealer und -bronchialer Fisteln ZusammenfassungHintergrund Ösophagotracheale...
Chirurgische Versorgung ösophagotrachealer und -bronchialer FistelnZusammenfassungHintergrundÖsophagotracheale bzw. -bronchiale Fisteln sind pathologische Verbindungen zwischen dem Verdauungstrakt und dem Atemwegssystem. Aufgrund häufiger pulmonaler Komplikationen gehen sie mit einer erheblichen Mortalität einher. Therapeutisch steht zunächst die Endoskopie im Vordergrund, bei Versagen ist eine chirurgische Sanierung obligat.MethodenRetrospektiv wurden Patienten mit ösophagotrachealer bzw. -bronchialer...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:38
D-Optimal Optimization and Data-Analysis Comparison Between a DoE Software and Artificial Neural Networks...
D-Optimal Optimization and Data-Analysis Comparison Between a DoE Software and Artificial Neural Networks of a Chitosan Coating Process onto PLGA Nanoparticles for Lung and Cervical Cancer TreatmentAbstractPurposeA common approach to "Quality-by-Design" is to employ quality software(s) to characterize the impacts of input parameters on output-critical quality attributes. In this study, paclitaxel (PTX), a common chemotherapeutic agent, was loaded into poly-lactic-co-glycolic acid (PLGA) nanoparticles...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:37
Diabetes
Frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes presenting at a tertiary care hospitalAbstractObjectiveTo evaluate frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes.MethodologyThis prospective observational study was conducted from January 2017 to June 2017 at the outpatient department of Baqai Institute of Diabetology and Endocrinology (BIDE) and Baqai Medical University a tertiary care diabetes hospital of Karachi, Pakistan....
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:36
Das AltersTraumaRegister DGU® – aktueller Stand, Methodik und Publikationsrichtlinie Primäre (idiopathische)...
Das AltersTraumaRegister DGU® – aktueller Stand, Methodik und PublikationsrichtliniePrimäre (idiopathische) SchultersteifeZusammenfassungDas charakteristische Merkmal der Schultersteife ist die Einschränkung der aktiven und passiven Beweglichkeit des Glenohumeralgelenks. Ursächlich sind letztendlich eine Fibrosierung und die daraus resultierende Kontraktur der glenohumeralen Gelenkkapselstrukturen. Der Begriff „Schultersteife" ist jedoch nur ein beschreibender Überbegriff, der zwingend weiterführend...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:36
Frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes presenting at a...
Frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes presenting at a tertiary care hospitalAbstractObjectiveTo evaluate frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes.MethodologyThis prospective observational study was conducted from January 2017 to June 2017 at the outpatient department of Baqai Institute of Diabetology and Endocrinology (BIDE) and Baqai Medical University a tertiary care diabetes hospital of Karachi, Pakistan....
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:36
Oral Radiology
Abnormal positioning of the common carotid artery clinically diagnosed as a submandibular massAbstractThe common carotid artery (CCA) usually runs along the long axis of the neck, although it is occasionally found in an abnormal position or is displaced. We report a case of an 86-year-old woman in whom the CCA was identified in the submandibular area. The patient visited our clinic and reported soft tissue swelling in the right submandibular area. It resembled a tumor mass or a swollen lymph node....
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:35
Current Treatment Options in Gastroenterology
Indications for Single-Operator Cholangioscopy and Pancreatoscopy: an Expert ReviewAbstractPurpose of reviewDirect endoscopic visualization of the biliary and pancreatic ducts by single-operator cholangioscopy (SOC) and pancreatoscopy (SOP) is an expanding technique with an increasing number of indications. This review provides technical tips and tricks and a literature update on the usefulness of SOC and SOP in clinical practice.Recent findingsSOC has shown a 91.3% and 87.3% diagnostic procedural...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:34
Indications for Single-Operator Cholangioscopy and Pancreatoscopy: an Expert Review AbstractPurpose...
Indications for Single-Operator Cholangioscopy and Pancreatoscopy: an Expert ReviewAbstractPurpose of reviewDirect endoscopic visualization of the biliary and pancreatic ducts by single-operator cholangioscopy (SOC) and pancreatoscopy (SOP) is an expanding technique with an increasing number of indications. This review provides technical tips and tricks and a literature update on the usefulness of SOC and SOP in clinical practice.Recent findingsSOC has shown a 91.3% and 87.3% diagnostic procedural...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:34
Abnormal positioning of the common carotid artery clinically diagnosed as a submandibular mass Abstract...
Abnormal positioning of the common carotid artery clinically diagnosed as a submandibular massAbstractThe common carotid artery (CCA) usually runs along the long axis of the neck, although it is occasionally found in an abnormal position or is displaced. We report a case of an 86-year-old woman in whom the CCA was identified in the submandibular area. The patient visited our clinic and reported soft tissue swelling in the right submandibular area. It resembled a tumor mass or a swollen lymph node....
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:33
Causes & Control
Cost-effectiveness of patient navigation for breast cancer screening in the National Breast and Cervical Cancer Early Detection ProgramAbstractObjectivesPatient navigation (PN) services have been shown to improve cancer screening in disparate populations. This study estimates the cost-effectiveness of implementing PN services within the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).MethodsWe adapted a breast cancer simulation model to estimate a population cohort of women...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:33
Cost-effectiveness of patient navigation for breast cancer screening in the National Breast and Cervical...
Cost-effectiveness of patient navigation for breast cancer screening in the National Breast and Cervical Cancer Early Detection ProgramAbstractObjectivesPatient navigation (PN) services have been shown to improve cancer screening in disparate populations. This study estimates the cost-effectiveness of implementing PN services within the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).MethodsWe adapted a breast cancer simulation model to estimate a population cohort of women...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:32
Ossetian Surnames as a Genetic Marker Abstract This paper carries out a comparative analysis of standard...
Ossetian Surnames as a Genetic MarkerAbstractThis paper carries out a comparative analysis of standard population-genetic parameters based on the distribution of surnames and marriage migrations in the Digorsky and Ardonsky districts. The positive and significant correlation of all the considered parameters allowed concluding that it is possible to use Ossetian surnames (of both Irons and Digors) as a biological marker in population-genetic studies.Causes of the Excess of Frequency of SCH34 Mitotype...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:31
A new species of Metadelphis Travassos, 1944 (Digenea: Dicrocoeliidae) from the gall-bladder of Molossus...
A new species of Metadelphis Travassos, 1944 (Digenea: Dicrocoeliidae) from the gall-bladder of Molossus molossus (Pallas) (Chiroptera: Molossidae) in the Brazilian eastern AmazonAbstractMetadelphis tkachi n. sp. is described based on material from the gall-bladder of Molossus molossus (Pallas) (Chiroptera: Molossidae) in the Brazilian eastern Amazon. The main differentiating characters of the new species include lobed, tandem testes and elongated clusters of vitelline follicles commencing at the...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:31
Incidence of and mortality from epidermal necrolysis (Stevens‐Johnson syndrome/toxic epidermal necrolysis)...
Incidence of and mortality from epidermal necrolysis (Stevens‐Johnson syndrome/toxic epidermal necrolysis) in France during 2003‐2016: a four‐source capture–recapture estimateG. Chaby, C. Maldini, C. Haddad, B. Lebrun‐Vignes, F. Hemery, S. Ingen‐Housz‐Oro, S. Gonzalez‐Chiappe, P. Wolkenstein, O. Chosidow, A. Mahr, L. FardetFirst Published: 09 August 2019Research LettersRemission of severe hidradenitis suppurativa following chemotherapy for Hodgkin's lymphomaN. Byrne, R. Hughes, L.A. Murphy, B. KirbyFirst...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:30
Paediatric DermatologyDoes the gene matter? Genotype–phenotype and genotype–outcome associations in...
Paediatric DermatologyDoes the gene matter? Genotype–phenotype and genotype–outcome associations in congenital melanocytic naeviS. Polubothu, N. McGuire, L. Al‐Olabi, W. Baird, N. Bulstrode, J. Chalker, D. Josifova, D. Lomas, J. O'Hara, J. Ong, D. Rampling, P. Stadnik, A. Thomas, E. Wedgeworth, N.J. Sebire, V.A. KinslerVersion of Record online: 09 August 2019What's already known about this topic?Multiple congenital melanocytic naevi (CMN) have been shown to be caused by NRAS mosaic mutations in 70–80%...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:29
Vector-Borne and Zoonotic Diseases  Volume: 19, Number: 8 (August 2019) View this Issue OnlineReviewStreptococcus...
Vector-Borne and Zoonotic Diseases Volume: 19, Number: 8 (August 2019)View this Issue OnlineReviewStreptococcus suis Meningitis: Epidemiology, Clinical Presentation and TreatmentMaria Hlebowicz, Paweł Jakubowski, and Tomasz SmiataczVector-Borne and Zoonotic Diseases, Vol. 19, No. 8, August 2019: 557-562.Abstract | Full Text | PDF (127 KB) | PDF Plus (218 KB)Original ArticlesHuman Seroprevalence to 11 Zoonotic Pathogens in the U.S. Arctic, AlaskaKaren M. Miernyk, Dana Bruden, Alan J. Parkinson, Debby...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:29
Building a bridge between ecology and Chinese herbal medicines Publication date: Available online 9...
Building a bridge between ecology and Chinese herbal medicinesPublication date: Available online 9 July 2019Source: Chinese Herbal MedicinesAuthor(s): Rui Fang, George HeAn important mechanism of herb-induced hepatotoxicity: To produce RMs based on active functional groups-containing ingredients from phytomedicine by binding CYP450sPublication date: Available online 9 July 2019Source: Chinese Herbal MedicinesAuthor(s): Xin He, Zi-jun Wu, Li-li Wang, Xue Gao, Yue Hai, Wen-li Liu, Le-mei Du, Lei Zhang,...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:28
Zoonotic Pathogens in the American Mink in Its Southernmost Distribution  Francisco Ramírez-Pizarro,...
Zoonotic Pathogens in the American Mink in Its Southernmost Distribution Francisco Ramírez-Pizarro, Carolina Silva-de la Fuente, Claudio Hernández-Orellana, Juana López, Verónica Madrid, Ítalo Fernández, Nicolás Martín, Daniel González-Acuña, Daniel Sandoval, René Ortega, and Carlos Landaeta-AquevequeVector-Borne and Zoonotic Diseases, Ahead of PrintAbstract | Full Text | PDF (260 KB) | PDF Plus (248 KB)The American mink, Neovison vison, is an invasive species in Chile. Its impact on native fauna...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
07:26
The Full Moon on August 15th falls in the sign of Aquarius and is going be shedding a light on what...
The Full Moon on August 15th falls in the sign of Aquarius and is going be shedding a light on what we can do to serve each other. Aquarius is the sign of the humanitarian and is represented by a woman carrying a jug of water. The woman symbolizes the healer in us all and the water symbolizes the heavy emotions, the pain, and the suffering of the world. As the water bearer, Aquarius has the natural gift and ability to take these heavy emotions and transform them into something lighter. She doesn't...
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,
Sat Aug 10, 2019 11:48

Diabetes

Frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes presenting at a tertiary care hospital

Abstract

Objective

To evaluate frequency and risk factors of diabetic retinopathy in patients with type 2 diabetes.

Methodology

This prospective observational study was conducted from January 2017 to June 2017 at the outpatient department of Baqai Institute of Diabetology and Endocrinology (BIDE) and Baqai Medical University a tertiary care diabetes hospital of Karachi, Pakistan. Convenience sampling was done. Demographic, anthropometric, clinical, and biochemical data were collected, and ophthalmic screening was performed by funduscopy at a slit lamp biomicroscopy with the help 90 D fundus lens. Grading of diabetic retinopathy was done according to the modified Early Treatment Diabetic Retinopathy Disease Severity Scale (ETDRS) criteria.

Result

Retinopathy was present in 17.5% of patients. Non-sight-threatening retinopathy was found in 15.2% and sight-threatening retinopathy was found in 17.6%. In table 4, logistic regression analysis determined the relationship between retinopathy and its possible risk factors. In univariate logistic regression model, Age, poor glycemic control and longer duration of diabetes were found to be significant risk factors for developing retinopathy. In multivariate logistic regression model, duration of diabetes remained significantly associated with the development of retinopathy. Additionally, gender was not significantly associated in univariate analysis but it became significant after adjustment in multivariate model.

Conclusion

An early screening program reduces the risk of incidence of diabetic retinopathy. Hence, screening of retinopathy should be done once in a year.



The tear VEGF and IGFBP3 in healthy and diabetic retinopathy

Abstract

Background/ purpose

Diabetic retinopathy is an important problem worldwide. The purposes of this study were to measure and analyze VEGF and IGFBP3 level changes in tears of type 2 diabetics with and without retinopathy.

Methods

In a case–control study, tear samples of 30 diabetes patients without diabetic retinopathy (DNR) were collected, as well as tears of 30 patients with diabetes retinopathy (DR), and 30 healthy subjects without diabetes as the control group by Schirmer's standard strip, who were matched in terms of age and sex with the other groups. VEGF and IGFBP3 concentration was measured by ELISA method. HbA1c, VEGF, and IGFBP3 were measured in all 3 groups and statistically analyzed.

Results

The percentage of HbA1C in the DNR group was clearly higher than the control group. Also, there was a significant difference in the percentage of HbA1C between DR and DNR groups. The concentration of VEGF in tears statistically increased in comparison with control (P < 0.05) but the IGFBP3 level did not change.

Discussion

The VEGF level in tears is clearly linked with the process of DR; however, there wasn't any significant relationship between the level of IGFBP3 in tears and diabetic retinopathy. It is concluded that VEGF can be used as a noninvasive method for the diagnosis of diabetic retinopathy.



Knowledge, attitude, and practices of fasts in patients with type 2 diabetes among different religions in North India

Abstract

Background and objectives

There is no data regarding knowledge, attitude, and practices (KAP) of fasts in subjects with type 2 diabetes (T2DM) among different religions in India. Study was done to assess KAP regarding fasts among subjects with T2DM from various religions.

Material and methods

A total of 300 consecutive participants with T2DM (age ≥ 25 years) from 3 diabetes clinics in North India after consent were subjected to predesigned study pro forma.

Result

A total of 300 subjects participated in the study with 76.3% being Hindus, 11% Muslims, 4.3% Sikhs, and 5.7% from other religions (Christians and Buddhists). Knowledge and attitude regarding fasts in context of diabetes were poor in majority of subjects. 59.7% participants agreed that diabetic patients can fast. 36.3% participants believed that people with poor glycemic control (HbA1c ≥ 10%) can also observe fast. 40.7% believed medicines/insulins are not allowed during fasts because of religious reasons. 46.7% participants were aware of hypoglycemic symptoms. Among Hindus 2 most common fasts were Navratri (observed by 53%) and Karva Chauth (observed by 47.6%). Overall, 66.7% of Muslims observed Ramadan. Only 1.3% of participants discussed with their doctors before observing fast. 51.7% of participants who observed fasts had symptoms suggestive of hypoglycemia during fasts. 60.4% of subjects missed their medications during fasting. 28.8% altered their drug regimen by themselves without doctors' consultation. 78.5% of participants observed fasts because of social obligations. Hindus were more likely to consult doctors during fasts and experienced comparatively lesser hypoglycemia and hyperglycemia as compared with Muslims and other religions. Women had greater inhibition to disclose about diabetes during fasts, were more likely to consult doctor during fasts, and perceived greater changes in body weight, hypoglycemia, and hyperglycemia during fasts.

Conclusion

The study showed significant gaps in knowledge and attitude regarding fasts among subjects with T2DM, in spite of fasting being common among all religions. The different nature and duration of different fasts and associated religious practices may contribute to these differences.



Factors associated with silent myocardial ischemia, autonomic or peripheral neuropathies, and survival in diabetes mellitus type 2 patients without cardiovascular symptoms

Abstract

Introduction

Complications from diabetes mellitus (DM) include cardiovascular system, peripheral neuropathy (PN), and autonomic dysfunction (AD). Goal: Assess the association of silent myocardial ischemia, AD, and PN in cardiovascular asymptomatic type 2 diabetics.

Methods

As part of a multicenter project, 40 patients with type 2 DM were studied, with > 5 years of known disease and a baseline electrocardiogram non suggestive of coronary artery disease. Myocardial SPECT was performed with exercise stress test measuring corrected QT interval (QTc) and heart rate recovery (HRR) post-exercise (abnormal QTc ≥ 450 ms at rest and HRR < 14 beats at the first minute in maximum exercise). After 3 years, it was possible to re-study 32 cases. PN was evaluated with Michigan Neuropathy Screening Instrument (MNSI). Logistic regression analysis was performed to determine associated factors for AD, PN, SI, and survival analysis.

Results

Thirty-four percent of the group had ischemia in SPECT; QTc was prolonged in 23.3%; 31% fulfilled criteria of PN; and 25% of AD due to HRR alteration. With bivariate and multivariate analyses, associations were observed between lipid, glycemic parameters, ischemia, PN, and AD. The follow-up (mean 119 months) consigned 4 cardiac-related deaths; ischemia, glycemic control parameters, and microalbuminuria had significant value in bivariate analysis.

Conclusion

In our small sample of asymptomatic cardiovascular type 2 DM patients, myocardial ischemia, glycemic control, and microalbuminuria have influence on survival, requiring a more intensive global therapeutic approach.



Association of Helicobacter pylori infection with metabolic and inflammatory profile in type 2 diabetes mellitus

Abstract

Objective

To evaluate the effect of Helicobacter pylori (H. pylori) infection upon metabolic and inflammatory parameters in type 2 diabetes mellitus (T2DM).

Methods

A total of 72 patients with T2DM were included in the study. These patients were divided into two groups as H. pylori infection positive or negative. For each patient, the following data were collected: age, gender, duration of diabetics, anti-diabetic treatment, the body mass index (BMI), and laboratory parameters (lipid profile, GLU, HbA1c, HCY, HsCRP, ghrelin, leptin, leukocyte, and platelet counts).

Results

Totally 47 patients (65.28%) were H. pylori positive and 25 patients (34.72%) were H. pylori negative. Diabetic patients infected by H. pylori showed significantly increased Lpa (297.83 ± 299.51 vs 154.24 ± 83.63, p < 0.05), higher HbA1c (9.21 ± 2.15 vs 8.00 ± 1.77, p < 0.05), and decreased leptin (4.59 ± 7.55 vs 9.82 ± 10.76, p < 0.05) than non-infected patients. Additionally, 72.2% of the patients with HbA1c > 7% were found to be H. pylori positive and 44.4% of the patients with HbA1c ≤ 7% were H. pylori positive. The levels of other parameters were not significantly different between two groups (p > 0.05), although CRP levels determined by high-sensitivity assay showed mild and variable increases in H. pylori infection.

Conclusion

H. pylori affects glycemic control in T2DM and might promote the development of diabetes.



The use of ABI in screening for diabetes-related lower limb peripheral arterial disease in IDF middle- and low-income countries: a scoping review

Abstract

Background

The burden of disease from diabetic foot ulcers linked to peripheral arterial disease (PAD) is complicated by limited resources in low- to middle-income countries (LMIC). This precludes the widespread use of sophisticated imaging methods. Screening for PAD can include the use of low-cost tests such as the ankle brachial index (ABI). A scoping review was performed to identify what is known about the use of ABI in screening for diabetes-related PAD in LMIC.

Methods

LMIC were defined as per the International Diabetes Federation Atlas. The following databases were searched using a comprehensive search term: Cochrane Library, EbscoHost, PubMed, Web of Science, Science Direct, Scopus, and Google Scholar. A total of 400 records were gleaned. The publication abstracts were screened through several rounds to select only those in which ABI was used in the context of screening for PAD to prevent diabetic foot disease.

Results

Twenty publications were included, from MLIC countries such as Brazil, Nigeria, Kenya, Uganda, South Africa, India, China, Singapore, Korea, Taiwan, Hong Kong, Indonesia, Thailand, and the Philippines. Ten ancilliary publications were identified.

Conclusions

The widespread reporting and large scale use of ABI in PAD screening in Asia are evident, compared to fewer reports from Africa and South America. Many Asian publications report using faster, automated ABI equipment in conjunction with handheld Doppler evaluation of flow signals. Despite concerns regarding the potential for false elevations secondary to vessel calcification and non-compressibility, ABI remains a useful first encounter test in screening for PAD. Asian publications endorse and report the use of ABI firmly within the core clinical examination and consideration of other risk factors for PAD. No publications were found on large-scale use of automated ABI in the South African or greater African context of diabetic foot screening.



The clinical relevance of lipohypertrophy


Impact of calorie restriction on glycemic control in overweight patients with type 2 diabetes mellitus

Abstract

Introduction

Calorie restriction is emerging as a tool to achieve remission in type 2 diabetes mellitus. We conducted a clinical trial to assess its effectiveness and durability in our setting.

Methods

This was a single-arm clinical trial (CTRI/2017/05/008711) conducted at JIPMER hospital, Pondicherry. Nine adult patients with type 2 diabetes mellitus and with a BMI of more than 23 kg/m2 were included into the study from December 2016. They were admitted to the hospital and given a 700 kcal per day balanced diet for 1 week following which either weight maintaining or weight reducing diet was advised. Patients were followed up monthly for the initial 3 months and were reassessed later after 12 months.

Results

One patient was lost to follow-up and hence results have been provided for eight patients. The mean age was 50.5 years. All patients were males. The duration of diabetes was a median of 2.5 years. All patients tolerated the low calorie diet. The mean weight loss was 4.2 kg after a median of 12 months. The average HbA1c declined from a baseline value of 7.98% to 7.13% after a median of 12 months (p = 0.27). Four patients were off any antidiabetic medication at 12 months of follow-up.

Conclusion

The intervention of a short duration of calorie restriction may be effective in reducing HbA1C in overweight patients with diabetes and the effect can last for a year.



Importance of the Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) for mass screening of type 2 diabetes and its complications at primary health care centers of North India

Abstract

Diabetes in combination with abdominal obesity and hypertension is the leading cause of cardiovascular diseases (CVD) and death. Type 2 diabetes (T2DM) increases CVD risk in two- to fourfold. The prevalence of CVD is constantly rising in India and is higher in urban areas. In addition, more than 50% of diabetic patients are still undiagnosed in the general population. The Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) is a cost-effective and very simple tool, which can be used at a primary health care center routinely. It is observed that people with increasing age, sedentary lifestyle, greater abdominal obesity, and family history of diabetes are at a high risk for diabetes and its complications. MDRF-IDRS is helpful for mass screening of diabetes and its complications in North Indian population to prevent the incidence of diabetes and with lifestyle interventions, knowledge, and awareness, it helps to reduce and revert the complications of diabetes. It is suggested that regular practice of MDRF-IDRS-based screening at primary health care center may also reduce the burden at the critical care center in North India.



Lower quality of life, lower limb pain with neuropathic characteristics, female sex, and ineffective metabolic control are predictors of depressive symptoms in patients with type 2 diabetes mellitus treated in primary care

Abstract

The primary objective of this study was to identify if lower limb pain with neuropathic characteristics is predictive of depressive symptoms in patients with type 2 diabetes mellitus (T2DM) treated in primary care in Brazil. It was investigated if diabetic and non-diabetic related variables could influence depressive symptoms. A quantitative and cross-sectional study was carried out in two Basic Health Units with users of the Brazilian Public Healthcare System, who were evaluated for depressive symptoms (BDI), quality of life (QoL, SF6D), pain intensity, neuropathy (loss of plantar sensitivity—LOPPS), body composition (DEXA), biochemical tests, sociodemographic variables, and comorbidities. The patients were stratified into four groups: N+P+, N+P, NP+, and NP (N = neuropathy and P = pain). One hundred twenty-one diabetics were selected by random sampling between August 2016 and June 2017. Neuropathy affected 53.8% of these individuals, and 59.5% reported intense pain. Overall depressive symptoms scores showed a positive correlation with pain intensity and a negative correlation with QoL. Depressive symptoms were reported by 66.9% of the sample, mostly female, with better levels of cholesterol, HDL and LDL; comorbidities; worse QoL; greater intensity of pain; impaired sleep; and painful neuropathy (N+P+). The predictive factors for depressive symptoms were lower QoL, pain with neuropathic characteristics, female sex, obesity, and ineffective glycemic control. These data may contribute to the understanding of the complexity of patients with T2DM who are treated in primary care and to public policies planning of care directed at the needs of this population.



Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Oral Radiology

Abnormal positioning of the common carotid artery clinically diagnosed as a submandibular mass

Abstract

The common carotid artery (CCA) usually runs along the long axis of the neck, although it is occasionally found in an abnormal position or is displaced. We report a case of an 86-year-old woman in whom the CCA was identified in the submandibular area. The patient visited our clinic and reported soft tissue swelling in the right submandibular area. It resembled a tumor mass or a swollen lymph node. Computed tomography showed that it was the right CCA that had been bent forward and was running along the submandibular subcutaneous area. Ultrasonography verified the diagnosis. No other lesions were found on the diagnostic images. Consequently, the patient was diagnosed as having abnormal CCA positioning. Although this condition generally requires no treatment, it is important to follow-up the abnormality with diagnostic imaging because of the risk of cerebrovascular disorders.



Buccal bifurcation cyst (paradental cyst) defined by ultrasonography and cone-beam computed tomography

Abstract

Buccal bifurcation cyst (BBC) is an uncommon inflammatory odontogenic cyst that generally occurs at the buccal region of the permanent mandibular first molars in children aged 6–8 years. The diagnosis of BBC cannot be made from the histopathologic features; therefore, diagnosis is primarily based on specific clinical and radiographic findings. In this case report, we present the clinical and radiological findings, including ultrasonography (USG) and cone-beam computed tomography (CBCT) images, of a 10-year-old boy who was referred with a complaint of swelling on the lower right jaw. According to the radiographic and clinical findings, the differential diagnosis of this lesion included lateral radicular cyst, lateral periodontal cyst, dentigerous cyst, eruption cyst, and others. Recently, in addition to classical radiographies and CBCT, USG has been considered important for diagnosis. In particular, if a cyst produces a perforation in the cortical bone, it is helpful to make a pre-diagnosis with USG.



Diagnostic usefulness of panoramic imaging of the pterygopalatine fossa: case of a schwannoma causing pterygopalatine fossa expansion

Abstract

The pterygopalatine fossa is a small area between the posterior wall of the maxillary sinus and the anterior surface of the pterygoid process of the sphenoid bone. The pterygopalatine fossa can be seen clearly on panoramic imaging. We present the case of a 57-year-old man who exhibited right pterygopalatine fossa expansion on panoramic imaging. Computed tomography (CT), magnetic resonance imaging (MRI), and panoramic imaging all showed a tumor at the right pterygopalatine fossa in this patient. CT indicated that the tumor replaced right retromaxillary fat and displaced the posterior wall of the maxillary sinus. On MRI, the tumor showed intermediate signal intensity at the paranasal area on T1-weighted images, and variable intermediate and high signal intensities on fat-suppressed T2-weighted images. It was eventually diagnosed as a schwannoma. Thus, panoramic imaging can be used for disease screening at the posterior border of the maxilla. Our conclusion is based on this report of a patient with a schwannoma at the posterior wall of the maxillary sinus, which panoramic imaging revealed to have pterygopalatine fossa expansion.



Radiculomegaly of canines in oculofaciocardiodental syndrome

Abstract

Oculofaciocardiodental (OFCD) syndrome is a rare genetic disease, first reported by Hayward in 1980. This syndrome presents with various ocular, facial, cardiac, and dental symptoms, including congenital cataract, dysmorphic facial features, congenital heart disease, and enlarged roots, respectively. The most important criteria for the diagnosis of OFCD syndrome are dental abnormalities, especially extreme elongation of canine roots. Here, we report detailed analysis of the dentofacial region, as well as ocular, facial, cardiac, and dental findings in a female with OFCD syndrome. To the best of our knowledge, the patient in this case is the first such patient reported in South Korea.



Protection evaluation of non-lead radiation-shielding fabric: preliminary exposure-dose study

Abstract

Objectives

The aim of this study was to evaluate the effectiveness and shielding performance of a novel recently developed non-lead radiation-shielding fabric containing bismuth oxide (BO-fabric).

Methods

BO-fabric was fabricated using urethane resin and bismuth nanopowder. A dose-measurement method was employed to evaluate the radiation-attenuation characteristics of the shielding fabric in accordance with the Korean Standards standard. The shielding performances (%) were calculated by measuring the radiation doses after lamination with increasing layers of fabric (1–10 layers). The physical performance of the fabric in terms of flexural and abrasion resistances was evaluated by the Korea Apparel Testing and Research Institute (KATRI).

Results

The radiation-attenuation capabilities of one layer of BO-fabric were 58.5, 49.9, and 43.0% at tube voltages of 60, 80, and 100 kVp, respectively. The radiation-shielding performance upon lamination of BO-fabric gradually increased as the number of layers increased. Excellent flexural and abrasion resistances were observed in the KATRI evaluation.

Conclusions

A non-lead radiation-shielding fabric based on urethane resin and bismuth was fabricated and examined, revealing an excellent shielding performance. Owing to the flexibility and simple operation of the fabric, it can be employed for various designs of clothing and protective apparel with many purposes.



Characteristic imaging findings of acantholytic squamous cell carcinoma: a case report

Abstract

Acantholytic squamous cell carcinoma (ASCC) is an uncommon, histopathologically distinct variant of squamous cell carcinoma. ASCC commonly occurs in areas of skin exposed to sunlight and has only rarely been seen on mucosal surfaces such as the oral cavity. Although the World Health Organization has defined ASCC as an original entity, the imaging findings of ASCC have not been adequately described. We herein report a case of ASCC occurring in the oral mucosa with emphasis on the findings of several imaging studies: panoramic radiography, intraoral radiography, contrast-enhanced computed tomography, magnetic resonance imaging, and fluorine-18 fluorodeoxyglucose positron emission tomography-computed tomography.



Environmental temperature and air humidity and prevalence of maxillary sinus retention cysts: possible relationships (preliminary study)

Abstract

Objectives

The aims of this study were to determine the prevalence of maxillary sinus retention cysts (MSRCs) and to evaluate the effects of mean temperature and mean air humidity on the prevalence of MSRCs in two cities in Turkey.

Methods

This retrospective study was conducted in Antalya and Erzurum, two cities with different air humidities and temperatures in Turkey. Panoramic images of patients who visited the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University and Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ataturk University for diagnostic purposes were evaluated. A total of 4800 panoramic images were included in the study. The mean age of the patients was 27.03 ± 6.48 years. The prevalence of MSRCs was analyzed according to sex, mean temperature, and mean air humidity. Values of p < 0.05 were considered statistically significant.

Results

Among the 4800 panoramic images evaluated, 228 indicated the presence of MSRCs. MSRCs were found significantly more frequently in males than in females. The prevalence was 3% in Antalya and 6.5% in Erzurum, with a total prevalence of 4.8%. While there was a significant correlation between the total amount of cysts and monthly mean air humidity in Erzurum, the correlation effect size was very low.

Conclusions

The total prevalence of MSRCs was 4.8%. There were no correlations between the frequency of MSRCs and the mean air humidity or mean temperature.



Relationship between sella turcica bridging and cephalometric parameters in adolescents and young adults

Abstract

Objectives

Sella turcica bridging occurs with fusion or calcification of the anterior and posterior clinoid processes in the middle cranial region. This study aimed to compare the cephalometric parameters among normal shape, partial bridge, and total bridge of the sella turcica in adolescent and young adult subjects.

Methods

This retrospective study was performed on the lateral cephalometric radiographs of 410 Turkish adolescent and young adult subjects. The subjects were divided into three groups: normal sella turcica shape (128 females, 32 males; mean age: 17.7 ± 1.54 years), partial sella turcica bridge (129 females, 32 males; mean age: 17.8 ± 2.15 years), and total sella turcica bridge (66 females, 23 males; mean age: 18.2 ± 1.82 years). Thirteen angular and eight linear cephalometric measurements were performed using a cephalometric software program. The data were analyzed by one-way analysis of variance, and the Kruskal–Wallis test with the Bonferroni correction.

Results

Significant differences were found for Nperp–A distance, Nperp–Pg distance, and palatal plane-to-anterior cranial base angle among the groups (p < 0.016). There were no significant differences in the cephalometric parameters between the partial and total sella turcica bridging groups (p > 0.05).

Conclusions

This study evaluated a large amount of data for cephalometric measurements focusing on the degree of calcification of the sella turcica in adolescent and young adult subjects. The maxilla and mandible were located in a sagittally retrusive position in the partial and total sella turcica bridge subjects compared with the normal sella turcica shape subjects.



Deep-learning classification using convolutional neural network for evaluation of maxillary sinusitis on panoramic radiography

Abstract

Objectives

To apply a deep-learning system for diagnosis of maxillary sinusitis on panoramic radiography, and to clarify its diagnostic performance.

Methods

Training data for 400 healthy and 400 inflamed maxillary sinuses were enhanced to 6000 samples in each category by data augmentation. Image patches were input into a deep-learning system, the learning process was repeated for 200 epochs, and a learning model was created. Newly-prepared testing image patches from 60 healthy and 60 inflamed sinuses were input into the learning model, and the diagnostic performance was calculated. Receiver-operating characteristic (ROC) curves were drawn, and the area under the curve (AUC) values were obtained. The results were compared with those of two experienced radiologists and two dental residents.

Results

The diagnostic performance of the deep-learning system for maxillary sinusitis on panoramic radiographs was high, with accuracy of 87.5%, sensitivity of 86.7%, specificity of 88.3%, and AUC of 0.875. These values showed no significant differences compared with those of the radiologists and were higher than those of the dental residents.

Conclusions

The diagnostic performance of the deep-learning system for maxillary sinusitis on panoramic radiographs was sufficiently high. Results from the deep-learning system are expected to provide diagnostic support for inexperienced dentists.



Oropharyngeal adenoid cystic carcinoma invading the mandibular bone through the mandibular foramen

Abstract

Adenoid cystic carcinoma (ACC) is a rare epithelial tumor of the head and neck region, and one of the most common malignant tumors of the salivary glands. ACC is a slow-growing tumor characterized by perineural invasion and often has a high-recurrence rate. We describe a case of oropharyngeal ACC invading the mandibular bone through the mandibular foramen that showed a rare pattern of origin and invasion. A 70-year-old woman complained of noise and pain around the right temporomandibular joint. Osteomyelitis was suspected on the initial imaging examinations, although the findings were slightly atypical. However, a mass was observed in the right oropharyngeal wall on subsequent imaging examinations, and mandibular bone invasion, rather than osteomyelitis, was additionally suspected. The mass in the right oropharyngeal wall and right mandible was surgically excised. On postoperative histopathological examination, the mass was finally diagnosed as ACC. As tumor cells were also observed around the inferior alveolar nerve, mandibular bone invasion through the mandibular foramen was suspected. An oropharyngeal ACC invading the mandibular bone through the mandibular foramen is extremely rare. The present case suggests that bone invasion should be considered carefully with several imaging examinations when a malignant tumor such as ACC is observed around the jaw bone.



Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Current Treatment Options in Gastroenterology

Indications for Single-Operator Cholangioscopy and Pancreatoscopy: an Expert Review

Abstract

Purpose of review

Direct endoscopic visualization of the biliary and pancreatic ducts by single-operator cholangioscopy (SOC) and pancreatoscopy (SOP) is an expanding technique with an increasing number of indications. This review provides technical tips and tricks and a literature update on the usefulness of SOC and SOP in clinical practice.

Recent findings

SOC has shown a 91.3% and 87.3% diagnostic procedural success in indeterminate strictures and difficult stones respectively, with a 9.4%–16.4% complication rate. Although the interpretation of the images suspected for malignancy can be challenging, new classifications based in mucosal and vascular patterns as well as better devices are in development. A higher sensitivity has been associated to targeted biopsies, compared to brushing and blinded biopsies. Indeed, SOC has recently demonstrated a decrease in the number of procedures and costs when compared with endoscopic retrograde cholangiopancreatography. This technique has also been reported for many other diagnostic and therapeutic indications, such as cholangiocarcinoma staging and foreign body extraction. Similarly, diagnostic and therapeutic SOP in indeterminate strictures or pancreatic stones, and intraductal papillary mucinous neoplasms, has been successfully reported.

Summary

Research to date supports the use of cholangioscopy as a complementary examination in patients with indeterminate strictures, difficult stones and specific situations. In a near future, there will probably be new established indications, a better understanding of the imaging findings and a place of SOC/SOP as first line in selected scenarios.



The Evolving Role of Thiopurines in Inflammatory Bowel Disease

Abstract

Purpose of review

With the advent of biologic therapies for the treatment of inflammatory bowel disease, the roles of thiopurines have continued to evolve. This review will focus on recent advances in pharmacology and the safety and efficacy of thiopurines as maintenance therapies for steroid-induced remissions and post-surgical maintenance of remission and as combination therapies to reduce immunogenicities of biologic agents.

Recent findings

Due to pharmacogenetics of thiopurine S-methyltransferase, thiopurine dosing is more effectively based on monitoring of thiopurine metabolites rather than weight-based dosing. Thiopurines continue to have a role as maintenance therapy after steroid-induced remissions and in combination with biologics to induce and maintain remission. Safety monitoring includes measurements of blood counts, liver chemistries, and dermatologic evaluations and protection from sun exposure.

Summary

Thiopurines appear to be safe during pregnancies and while very uncommon, lymphomas (including hepatosplenic T cell lymphomas) remain a recognized risk, particularly in younger and older males.



The Role of Behind Folds Visualizing Techniques and Technologies in Improving Adenoma Detection Rate

Abstract

Purpose of review

Colorectal cancer is one of the most common malignancies in the Western world and is thought to develop from premalignant polyps. Over the past decade, several behind folds visualizing techniques (BFTs) have become available to improve polyp detection. This systematic review and meta-analysis aims to compare BFTs with conventional colonoscopy (CC).

Recent findings

In the past five years, 14 randomized controlled trials (RCTs) including 8384 patients comparing different BFTs with CC were published. The overall relative risks for adenoma detection rate, polyp detection rate, and adenoma miss rate comparing BFTs with CC were 1.04 (95% confidence interval [CI] 0.98–1.10; P = 0.15), 1.03 (95% CI 0.98–1.09; P = 0.28), and 0.70 (95% CI 0.46–1.05; P = 0.08), respectively. Other quality metrics for colonoscopy were not significantly different between BFT-assisted colonoscopy and CC either.

Summary

This meta-analysis of RCTs published in the past five years does not show a significant benefit of BFTs on any of the important quality metrics of colonoscopy. The lack of additional effect of BFTs might be due to improved awareness of colonoscopy quality metrics and colonoscopy skills among endoscopists combined with improvements of conventional colonoscope technology.



Current Status and Future Perspective in Cholangiopancreatoscopy

Abstract

Purpose of review

With the rapid growth of cholangiopancreatoscopy, several platforms of cholangiopancreatoscopy have been currently available. Since the introduction of digital single-operator cholangiopancreatoscopy, there have been several reports describing its efficacy for long-standing and novel applications. The purpose of this review is to show the current status and future perspective of cholangiopancreatoscopy.

Recent findings

Meta-analysis of cholangiopancreatoscopy have demonstrated good diagnostic yield for visual impression; however, it should be noted that there is no standardized classification system used for distinguishing benign from malignant lesions. In contrast, utility of tissue sampling under direct vision for cholangiopancreatic disorders is inconclusive. This could be explained by the fact that available devices (e.g., biopsy forceps) are limited by the small diameter of accessory channel. Regarding therapeutic applications, several studies demonstrated efficacy and feasibility of electrohydraulic lithotripsy or laser lithotripsy for difficult bile duct stone and pancreatic duct stone under cholangiopancreatoscopic guidance. Additionally, ablation of tumors, selective guidewire placement, retrieval of migrated stents, and anterograde cholangioscopy-guided procedure by using cholangiopancreatoscopy have been reported.

Summary

The recent development of digital single-operator cholangiopancreatoscopy enables easy access to the bile duct and pancreatic duct, contributing to expanding indications for cholangiopancreatoscopy. Improvement of devices or development of innovative devices is required to overcome the remaining problems of cholangiopancreatoscopy.



Hepatitis C elimination: a Public Health Perspective

Abstract

Purpose of review

Hepatitis C virus (HCV) infection is a principal cause of morbidity, mortality, and economic burden, and the global elimination of HCV is now considered a public health objective. Globally, an estimated 71 million have chronic HCV infection with an estimated annual mortality of 3,99,000.

Recent findings

The 69th World health Assembly has endorsed the global HCV elimination strategy by 2030, which is made possible because of all oral, cost-effective, efficacious, generic direct-acting antivirals. The public health strategy targets not only diagnosed chronic hepatitis C patients but also asymptomatic undiagnosed HCV-infected individuals, persons living with human immunodeficiency virus (HIV), post-transplant, thallasemia, persons who inject drugs, and the pediatric population.

Summary

Mobilization of state-sponsored HCV elimination programs in a global coalition against HCV has taken root in Egypt, India, Georgia, Mongolia, China, Australia, and Brazil. This review summarizes current HCV elimination initiatives in terms of medical progress, barriers to HCV elimination, and current gaps in knowledge and social outreach from the public health perspective.



Endoscopic Methods for Gallbladder Drainage

Abstract

Purpose of review

Acute cholecystitis is conventionally managed with cholecystectomy; however, when this occurs in the non-operative patient, it requires consideration for alternative means of gallbladder drainage (GBD).

Recent findings

Suitable endoscopic methods for GBD include transpapillary cystic duct stent or endoscopic ultrasound (EUS)-guided transmural stent placement. Importantly, patients who undergo endoscopic GBD have comparable outcomes to those who undergo placement of percutaneous transhepatic catheters by interventional radiology (IR).

Summary

There is evolving evidence to support endoscopic gallbladder drainage by EUS or ERCP with transpapillary stenting for patients who are non-operative candidates. There appear to be advantages over percutaneous drainage in terms of lower rates of recurrent cholecystitis, faster clinical resolution of symptoms, and omission of external drain-related complications. However, careful consideration of individual characteristics is warranted in the care of these complicated patients. The technical and clinical considerations for endoscopic methods of GB drainage are discussed in this review article.



Epigenetic Mechanisms of Pancreatobiliary Fibrosis

Abstract

Purpose of review

The goal of this manuscript is to review the current literature related to fibrogenesis in the pancreatobiliary system and how this process contributes to pancreatic and biliary diseases. In particular, we seek to define the current state of knowledge regarding the epigenetic mechanisms that govern and regulate tissue fibrosis in these organs. A better understanding of these underlying molecular events will set the stage for future epigenetic therapeutics.

Recent findings

We highlight the significant advances that have been made in defining the pathogenesis of pancreatobiliary fibrosis as it relates to chronic pancreatitis, pancreatic cancer, and the fibro-obliterative cholangiopathies. We also review the cell types involved as well as concepts related to epithelial-mesenchymal crosstalk. Furthermore, we outline important signaling pathways (e.g., TGFβ) and diverse epigenetic processes (i.e., DNA methylation, non-coding RNAs, histone modifications, and 3D chromatin remodeling) that regulate fibrogenic gene networks in these conditions.

Summary

We review a growing body of scientific evidence linking epigenetic regulatory events to fibrotic disease states in the pancreas and biliary system. Advances in this understudied area will be critical toward developing epigenetic pharmacological approaches that may lead to more effective treatments for these devastating and difficult to treat disorders.



Interplay of Liver Disease and Gut Microbiota in the Development of Colorectal Neoplasia

Abstract

Purpose of the review

Liver disease, colon cancer, and the gut microbiome are intimately interrelated; however, the connections linking liver disease and colorectal neoplasia via the gut microbiota remain poorly understood and rarely addressed in a single space. The goal of this review is to take a broad perspective on the clinical problem of colorectal neoplasia in the liver disease population, recognize the significance of the clinical study findings, and delve into the evidence supporting putative molecular mechanisms connecting dysbiosis in the progression of liver disease to the development of colorectal neoplasia.

Recent findings

Clinical studies have recently reported increased risk of colorectal neoplasia in patients with fatty liver disease, and risk increases with liver disease severity. Concurrently, the evolution of -omics technology has shown dysregulation of the gut microbial community, termed dysbiosis, in the progression of liver disease. Specific microbes enriched in the gut flora of liver disease patients have been linked to colon cancer and adenomatous precursor lesions.

Summary

The gut microbiome of liver disease patients generates a pro-neoplastic environment, mediated via altered bile acid signaling and a dysregulated inflammatory response that suppresses immune surveillance. Research focused on the mechanisms linking liver disease to colorectal neoplasia via the gut microbiome is needed to help us prepare for the rising tide of colon cancer in young patients with an increasing prevalence of liver disease.



Endoscopic Bariatric Therapies: Intragastric Balloons, Tissue Apposition, and Aspiration Therapy

Abstract

Purpose of review

Endoscopic bariatric therapies (EBTs) have been identified as a group of procedures that can bridge the treatment gap between bariatric surgical procedures and non-procedural treatments such as pharmacotherapy and lifestyle therapy. We will review the recent progress that has been made in this important area in the past several years.

Recent findings

Traditional intragastric balloons (IGB) that are both placed and removed endoscopically have been the fixture of IGB therapy. They have been shown to be safe and effective, when kept in place for 6 months. Newer IGBs, both currently FDA approved and those in clinical trials, have unique features. The Obalon gastric balloon system is gas filled and does not require endoscopy for placement. The Elipse balloon system that is in clinical trials neither requires endoscopy for placement nor removal. The Spatz3 balloon is in clinical trials and can be adjusted endoscopically by adding or subtracting volume to titrate balloon volume to symptoms and weight loss. In addition to IGBs, several other promising therapies have continued to evolve. Endoscopic sleeve gastroplasty (ESG) is a promising gastric restriction technique that has efficacy and durability. POSE is a gastric plication technique that is available in Europe and in clinical trials in the USA. Aspiration therapy is a novel approach to weight loss that requires patient compliance but can be very effective and used long term.

Summary

EBTs are an evolving effective and safe approach for patients who do not qualify for or do not want bariatric surgery. There are multiple EBTs currently FDA approved as well as prospective endoscopic therapies in clinical trials that appear promising.



Contemporary Epidemiology of Cirrhosis

Abstract

Purpose of Review

We sought to review the contemporary epidemiology of cirrhosis, focusing on the relative burden of the most common chronic liver diseases.

Recent Findings

The key findings in the review highlight the increasing prevalence and impact of alcohol-related liver disease, particularly among young people, and the epidemic of nonalcoholic fatty liver commensurate with rising rates of obesity. We also contrast recent advances in the care of persons with hepatitis C with the lamentable rise in new infections associated with intravenous drug use. Finally, we highlight the impact of both conventional complications of cirrhosis (namely hepatic encephalopathy) but also the host of patient-reported outcomes adversely impacted by the symptoms of cirrhosis.

Summary

Cirrhosis is associated with an expanding footprint in contemporary public health. In order to improve global outcomes, we must not only focus on the identifying and treating persons with viral hepatitis but also preventing the rise of alcohol-related liver disease and nonalcoholic fatty liver disease while attending to the urgent patient-centered needs posed by the symptoms of cirrhosis.



Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Causes & Control

Cost-effectiveness of patient navigation for breast cancer screening in the National Breast and Cervical Cancer Early Detection Program

Abstract

Objectives

Patient navigation (PN) services have been shown to improve cancer screening in disparate populations. This study estimates the cost-effectiveness of implementing PN services within the National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

Methods

We adapted a breast cancer simulation model to estimate a population cohort of women aged 40–64 years from the NBCCEDP through their lifetime. We incorporated their screening frequency and screening and diagnostic costs.

Results

Within the NBCCEDP, Program with PN (vs. No PN) resulted in a greater number of mammograms per woman (4.23 vs. 4.14), lower lifetime mortality from breast cancer (3.53% vs. 3.61%), and fewer missed diagnostic resolution per woman (0.017 vs. 0.025). The estimated incremental cost-effectiveness ratios for a Program with PN was $32,531 per quality-adjusted life-years relative to Program with No PN.

Conclusions

Incorporating PN services within the NBCCEDP may be a cost-effective way of improving adherence to screening and diagnostic resolution for women who have abnormal results from screening mammography. Our study highlights the value of supportive services such as PN in improving the quality of care offered within the NBCCEDP.



Dose–risk relationships between cigarette smoking and ovarian cancer histotypes: a comprehensive meta-analysis

Abstract

Purpose

Although smoking has not been associated with overall ovarian cancer risk, a different impact on various histotypes has been reported. Our aim is to provide an accurate, up-to-date estimate of the dose–risk relationships between cigarette smoking and epithelial ovarian cancer, overall and by histotypes.

Methods

Using an innovative approach for the identification of original study publications, we conducted a systematic review and meta-analysis of epidemiological studies published on the topic until September 2018. Summary relative risks (RR) for cigarette smoking were estimated using random-effects models; dose–risk relationships were evaluated using one-stage random-effects models with restricted cubic splines.

Results

Thirty-seven studies were considered in the meta-analysis. The summary RRs for current versus never smokers were 1.05 (95% confidence interval CI 0.95–1.16) for overall ovarian cancer, 1.78 (95% CI 1.52–2.07) for mucinous, 0.77 (95% CI 0.65–0.93) for clear cell, 0.81 (95% CI 0.73–0.91) for endometrioid, and 1.05 (95% CI 0.94; 1.17) for serous cancer. The risk of borderline mucinous (RR 2.09) and serous (RR 1.16) tumors was higher than for invasive cancers (RR 1.44 and 0.95, respectively). For mucinous cancer, risk was noticeably higher with smoking intensity and duration (RR 2.35 for 20 cigarettes/day, and 2.11 for 20 years of smoking). A non-significant linear relation was found with smoking intensity, duration, and time since quitting for overall ovarian cancer and other histotypes.

Conclusions

This uniquely large and comprehensive meta-analysis confirms that although cigarette smoking does not appear to be a risk factor for ovarian cancer, and it is even slightly protective for some rare histotypes, there is a strong dose–risk relationship with mucinous ovarian cancer.



The association between colorectal sessile serrated adenomas/polyps and subsequent advanced colorectal neoplasia

Abstract

Purpose

Colorectal cancer (CRC) screening guidelines recommend increased surveillance of individuals with sessile serrated adenomas/polyps (SSA/Ps), but there is uncertainty about the risk associated with SSA/Ps. We aimed to determine the association between SSA/Ps and subsequent advanced colorectal neoplasia.

Methods

This case–control study included Kaiser Permanente Washington (KPWA) members who received an index colonoscopy between 1/1/1998 and 12/31/2007, and had hyperplastic polyps (HPs) or SSA/Ps but no conventional adenomas according to study pathologist histologic review. Subsequent pathology reports and biopsies through 1/1/2013 were reviewed for advanced colorectal neoplasia. We linked to the Seattle-Puget Sound Surveillance Epidemiology and End Results (SEER) registry to identify additional CRC cases. We used generalized estimating equations with a logit link to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for advanced colorectal neoplasia, comparing those with SSA/Ps to those with HPs.

Results

There were 161 individuals with index SSA/Ps, 548 with HPs, and 918 subsequent endoscopies included in analyses. Of those with index SSA/Ps, 19 had subsequent advanced colorectal neoplasia; 39 with HPs had subsequent advanced colorectal neoplasia. Compared to those with HPs, those with SSA/Ps were not statistically significantly more likely to have subsequent advanced colorectal neoplasia (adjusted OR 1.79; CI 0.98–3.28). Polyp size ≥ 10 mm, right colon location, and the presence of multiple serrated polyps were also not associated with advanced colorectal neoplasia.

Conclusions

Our results suggest that there is not a strong association between SSA/Ps and subsequent advanced colorectal neoplasia during the 5 years following SSA/P removal.



Socioenvironmental adversity and risk of prostate cancer in non-Hispanic black and white men

Abstract

Non-Hispanic black (NHB) men experience higher risk of prostate cancer than other racial/ethnic groups, and it is possible that socioenvironmental (SE) adversity and resulting stress may contribute to this disparity. Data from the Southern Community Cohort Study were used to evaluate associations between SE adversity and perceived stress in relation to prostate cancer risk, overall and by race/ethnicity and grade. Between 2002 and 2009, 26,741 men completed a questionnaire, from which an 8-item SE adversity composite was created (covering socioeconomic status, residential environment, and social support/buffers). Two items from the Perceived Stress Scale were assessed. With follow-up through 2011, 527 prostate cancer cases were diagnosed. In multivariable models, each one-unit increase in the SE adversity composite was associated with increased prostate cancer risk among non-Hispanic white (NHW) men (HR 1.23; 95% CI 1.02–1.48) and reduced risk among NHB men (HR 0.89; 95% CI 0.82–0.95) (p interaction: 0.001). This pattern held for low grade, but not high grade, cancers although power was limited for the latter. Perceived stress variables were associated with increased risk of prostate cancer among NHW men, but not among NHB men. Results do not support the hypothesis that SE adversity my underlay the racial disparity in prostate cancer, over and above that of covariates, including healthcare utilization.



Patterns of comorbidities in women with breast cancer: a Canadian population-based study

Abstract

Purpose

Improving the understanding of co-existing chronic diseases prior to and after the diagnosis of cancer may help to facilitate therapeutic decision making in clinical practice. This study aims to examine patterns of comorbidities in Canadian women with breast cancer.

Methods

We conducted a retrospective cohort study using provincial linked administrative health datasets from British Columbia, Canada, between 2000 and 2013. Women diagnosed with breast cancer between 2005 and 2009 were identified. The index date was defined as the date of diagnosis of breast cancer. Subsets of the breast cancer cohort were identified based on the absence of individual type of comorbidity of interest within 5 years prior to breast cancer diagnosis. For each subset, cases were then individually matched by year of birth at 1:2 ratios with controls without a history of cancer and the individual type of comorbidity of interest within 5 years prior to the assigned index year, matching with the year of breast cancer diagnosis of the corresponding case. Baseline comorbidities were measured over a 1-year period prior to the index date using two comorbidity indices, Rx-Risk-V and Aggregated Diagnosis Groups (ADG). Cox regression model was used to assess the development of seven specific comorbidities after the index date between women with breast cancer and non-cancer women.

Results

The most prevalent baseline comorbidity in the breast cancer cohort measured using the Rx-Risk-V model was cardiovascular conditions (39.0%), followed by pain/pain-inflammation (34.8%). The most prevalent category measured using the ADG model was major signs or symptoms (71.8%), followed by stable chronic medical conditions (52.2%). The risks of developing ischemic heart disease, heart failure, depression, diabetes, osteoporosis, and hypothyroidism were higher in women with breast cancer compared to women without cancer, with the hazard ratios ranging from 1.09 (95 CI% 1.03–1.16) for ischemic heart disease to 2.10 (95% CI 1.99–2.21) for osteoporosis in the model adjusted for baseline comorbidity measured using Rx-Risk-V score.

Conclusion

Women with breast cancer had a higher risk of developing new comorbidities than women without cancer. Development of coordinated care models to manage multiple chronic diseases among breast cancer patients is warranted.



Circulating lipids, mammographic density, and risk of breast cancer in the Nurses' Health Study and Nurses' Health Study II

Abstract

Purpose

Epidemiologic evidence supports an association between high mammographic density and increased breast cancer risk yet etiologic mechanisms remain largely unknown. Mixed evidence exists as to whether circulating lipid levels influence mammographic density and breast cancer risk. Therefore, we examined these associations in the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII), two large prospective cohorts with information on PMD and circulating lipid measures, long follow-up, and breast cancer risk factor and outcome data.

Methods

We conducted a nested case–control study among women in the NHS and NHSII. Percent mammographic density (PMD) was measured using Cumulus software, a computer-assisted method, on digitized film mammograms. Cross-sectional associations between circulating lipids [total cholesterol (n = 1,502), high-density lipoprotein (HDL-C; n = 579), and triglycerides (n = 655)] and PMD were evaluated among controls. All analyses were stratified by menopausal status at time of mammogram. Relative risks for breast cancer by lipid and PMD measures were estimated among postmenopausal women in the full nested case–control study (cases/controls for cholesterol, HDL-C, and triglycerides were 937/975, 416/449, and 506/537, respectively).

Results

There were no significant associations between circulating lipid levels and PMD among healthy women, irrespective of menopausal status. The association between PMD and breast cancer risk among postmenopausal women was not modified by circulating lipid levels (p interaction = 0.83, 0.80, and 0.34 for total cholesterol, HDL-C, and triglycerides, respectively).

Conclusion

Overall, no association was observed between lipid levels and PMD, and there was no evidence that lipid levels modified the association between PMD and breast cancer risk.



Ovarian Cancer in Women of African Ancestry (OCWAA) consortium: a resource of harmonized data from eight epidemiologic studies of African American and white women

Abstract

Purpose

Although the incidence rate of epithelial ovarian cancer (EOC) is somewhat lower in African American (AA) than white women, survival is worse. The Ovarian Cancer in Women of African Ancestry (OCWAA) consortium will overcome small, study-specific sample sizes to better understand racial differences in EOC risk and outcomes.

Methods

We harmonized risk factors and prognostic characteristics from eight U.S. studies: the North Carolina Ovarian Cancer Study (NCOCS), the Los Angeles County Ovarian Cancer Study (LACOCS), the African American Cancer Epidemiology Study (AACES), the Cook County Case–Control Study (CCCCS), the Black Women's Health Study (BWHS), the Women's Health Initiative (WHI), the Multiethnic Cohort Study (MEC), and the Southern Community Cohort Study (SCCS).

Results

Determinants of disparities for risk and survival in 1,146 AA EOC cases and 2,922 AA controls will be compared to 3,368 white EOC cases and 10,270 white controls. Analyses include estimation of population-attributable risk percent (PAR%) by race.

Conclusion

OCWAA is uniquely positioned to study the epidemiology of EOC in AA women compared with white women to address disparities. Studies of EOC have been underpowered to address factors that may explain AA-white differences in the incidence and survival. OCWAA promises to provide novel insight into disparities in ovarian cancer.



Influence of physical activity on active surveillance discontinuation in men with low-risk prostate cancer

Abstract

Purpose

Epidemiologic data suggest that high levels of physical activity (PA) may reduce the risk of disease progression in men with prostate cancer (PCa), but it is unknown whether PA can delay the requirement for definitive treatment for those on active surveillance (AS). We investigated the influence of PA post-diagnosis on AS discontinuation in men with low-risk disease.

Methods

The effect of PA on the time to AS discontinuation was assessed in 421 patients, of whom 107 underwent additional PCa treatment over a median of 2.5 years.

Results

Using Cox regression models, we found that PA was not significantly associated with time to curative treatment initiation. Prostate-specific antigen (PSA) most proximal to AS initiation (HR, 1.11; 95% CI 1.03 to 1.21) and the number of positive cores (HR, 1.34; 95% CI 1.12 to 1.61) at diagnosis were associated with a significantly increased risk of discontinuing AS.

Conclusion

Our findings suggest that PA during AS for PCa does not significantly influence time to curative treatment.



Trajectories of body mass index, from adolescence to older adulthood, and pancreatic cancer risk; a population-based case–control study in Ontario, Canada

Abstract

Purpose

Pancreatic cancer has the highest fatality rate of all cancers. Adulthood obesity is an established risk factor for pancreatic cancer; however, life-course obesity is not well understood. The aim of this study was to evaluate the association between body mass index (BMI) trajectories throughout the life-course and pancreatic cancer risk.

Methods

A population-based case–control study was conducted (2011–2013) in Ontario, Canada. Cases were recruited from the Ontario pancreas cancer study (n = 310) and controls from the Ontario cancer risk factor study (n = 1258). Questionnaires captured self-reported height and weight at four timepoints (adolescence, 20 s, 30–40 s, 50–60 s). BMI trajectories were identified using latent class growth mixture modeling. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from multivariable logistic regression.

Results

Five BMI trajectories were identified: stable-normal weight (38.9%), progressively overweight (42.2%), persistent overweight (12.6%), progressive obesity (4.2%), and persistent obesity (2.1%). The persistent overweight (OR = 1.55; 95% CI 1.02, 2.39) and progressive obesity trajectories (OR = 1.49; 95% CI 0.77, 2.87) compared to stable-normal weight were associated with increased odds of pancreatic cancer. When BMI was evaluated separately the strongest associations with pancreatic cancer emerged in young and mid-adulthood.

Conclusion

BMI trajectories characterized by overweight in early adulthood were associated with increased pancreatic cancer risk suggesting a life-course approach to disease risk.



Clinical characteristics and survival patterns of subsequent sarcoma, breast cancer, and melanoma after childhood cancer in the DCOG-LATER cohort

Abstract

Purpose

Childhood cancer survivors are at increased risk of developing subsequent malignant neoplasms (SMNs). We compared survival and clinical characteristics of survivors with SMNs (sarcoma, breast cancer, or melanoma) and a population-based sample of similar first malignant neoplasm (FMN) patients.

Methods

We assembled three case series of solid SMNs observed in a cohort of 5-year Dutch childhood cancer survivors diagnosed 1963–2001 and followed until 2014: sarcoma (n = 45), female breast cancer (n = 41), and melanoma (n = 17). Each SMN patient was sex-, age-, and calendar year-matched to 10 FMN patients in the population-based Netherlands Cancer Registry. We compared clinical and histopathological characteristics by Fisher's exact tests and survival by multivariable Cox regression and competing risk regression analyses.

Results

Among sarcoma-SMN patients, overall survival [hazard ratio (HR) 1.88, 95% confidence interval (CI) 1.23–2.87] and sarcoma-specific mortality (HR 1.91, 95% CI 1.16–3.13) were significantly worse compared to sarcoma-FMN patients (foremost for soft-tissue sarcoma), with 15-year survival rates of 30.8% and 61.6%, respectively. Overall survival did not significantly differ for breast-SMN versus breast-FMN patients (HR 1.14, 95% CI 0.54–2.37), nor for melanoma-SMN versus melanoma-FMN patients (HR 0.71, 95% CI 0.10–5.00). No significant differences in tumor characteristics were observed between breast-SMN and breast-FMN patients. Breast-SMN patients were treated more often with mastectomy without radiotherapy/chemotherapy compared to breast-FMN patients (17.1% vs. 5.6%).

Conclusions

Survival of sarcoma-SMN patients is worse than sarcoma-FMN patients. Although survival and tumor characteristics appear similar for breast-SMN and breast-FMN patients, treatment differs; breast-SMN patients less often receive breast-conserving therapy. Larger studies are necessary to substantiate these exploratory findings.



Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480