A systematic review of immunomodulatory strategies used in skin-containing preclinical vascularized composite allotransplant models

xlomafota13 shared this article with you from Inoreader A systematic review of immunomodulatory strategies used in skin-containing preclinical vascularized composite allotransplant models Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 13:S1748-6815(21)00548-9. doi: 10.1016/j.bjps.2021.11.003. Online ahead of print. ABSTRACT BACKGROUND: Acute rejection remains a vexing problem in vascularized composite allotransplantation (VCA). Available immunosuppressive regimens are successful at minimizing alloimmune response and allowing VCA in humans. However, repeated rejection episodes are common, and systemic side effects of the current standard regimen (Tacrolimus, MMF, Prednisone) are dose limiting. Novel immunomodulatory approaches to improve allograft acceptance and minimize systemic toxicity are continuously explored in preclinical models. We aimed to systematically summarize past and current approaches to help guide future research in this complex field. METHODS: We conducted a systematic review of manuscripts listed in the MEDLINE and PubMed databases. For inclusion, articles had to primarily investigate the effect of a th erapeutic approach on prolonging the survival of a skin-containing preclinical VCA model. Non-VCA studies, human trials, anatomical and feasibility studies, and articles written in a language other than English were excluded. We followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. RESULTS: The search retrieved 980 articles of which 112 articles were ultimately included. The majority of investigations used a rat model. An orthotopic hind limb VCA model was used in 53% of the studies. Cell and drug-based approaches were investigated 58 and 52 times, respectively. We provide a comprehensive review of immunomodulatory strategies used in VCA preclinical research over a timeframe of 44 years. CONCLUSION: We identify a transition from anatomically non-specific to anatomical models mimicking clinical needs. As limb transplants have been most frequently performed, preclinical research focused on using the hind limb model. We also id entify a transition from drug-based suppression therapies to cell-based immunomodulation strategies. PMID:34895853 | DOI:10.1016/j.bjps.2021.11.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

'Identification of Essential Assessment Criteria in Facial Botulinum Toxin Injections'

xlomafota13 shared this article with you from Inoreader "Identification of Essential Assessment Criteria in Facial Botulinum Toxin Injections" Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Nov 15:S1748-6815(21)00584-2. doi: 10.1016/j.bjps.2021.11.040. Online ahead of print. ABSTRACT INTRODUCTION: Facial botulinum toxin injections represent the most commonly performed aesthetic non-surgical procedures by plastic surgeons; however, post-graduate programs remain devoid of objective tools to adequately assess competence in trainees. In this study, the authors employ the Delphi methodology to establish a list of essential assessment criteria in facial botulinum toxin injections. METHODS: A list of 10 suggested criteria was generated through a literature search and in consultation with an expert plastic surgeon. A panel of content experts was selected to which an online survey was administered; skills were ranked for their relevance using a 1-10 Likert scale. Recommendations for additional skills were solicited and survey rounds were repeated until consensus was achieved. The latter wa s a measure of panelist reliability and assessed using Cronbach α (≥0.8); skills with a rating of 7 or above were taken to be essential. RESULTS: The survey process was successful at achieving consensus following two rounds of survey administration. Twenty-one participants completed the first round representing a response rate of 38%. Percent agreement among the panel was 83% and Cronbach α was computed as 0.78, necessitating further rounds. The response rate in the second round was 90%; one additional skill was added; percent agreement and Cronbach α improved to 88% and 0.87, respectively. CONCLUSION: Nine assessment criteria were identified as essential in facial botulinum toxin injections; these findings provide the groundwork necessary for the development of an objective assessment tool for the more appropriate training of marginalized aesthetic procedures in plastic surgery. PMID:34896042 | DOI:10.1016/j.bjps.2021.11.040 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A double-blind, placebo-controlled randomised trial of intraparenchymal administration of local anaesthetic in elective breast augmentation

xlomafota13 shared this article with you from Inoreader A double-blind, placebo-controlled randomised trial of intraparenchymal administration of local anaesthetic in elective breast augmentation Via Journal of plastic, reconstructive & aesthetic surgery : JPRAS J Plast Reconstr Aesthet Surg. 2021 Oct 7:S1748-6815(21)00442-3. doi: 10.1016/j.bjps.2021.09.003. Online ahead of print. ABSTRACT INTRODUCTION: Several methods of controlling pain post-bilateral breast augmentation (BBA) have been described. BBA is frequently performed as a day case procedure; therefore, a simple effective method of controlling pain in the immediate post-operative period is desired. METHODS: We conducted a prospective, double-blinded, placebo-controlled randomised study of 20 women undergoing BBA. Women were randomly assigned to receive intraparenchymal infiltration intra-operatively prior to implant placement with either local anaesthetic (LA) (chirocaine) or normal saline. The primary outcome was post-operative pain scores immediately, and at 6 h. Our secondary endpoint was post-operative narcotic consumption. RESULTS: Twenty patients were included in this study. The average pain score in the immediate po st-operative period was 3.4 in the control group versus 0.7 in the treatment group (p = 0.013). In 6 h post-operatively, the average pain score was 2.4 in the control group versus 0.9 in the treatment group (p = 0.03). Sixty-six percentage of patients in the control arm required post-operative opiates compared with 27% in the treatment group (p = 0.17) CONCLUSION: This randomised controlled trial demonstrates a technique of intraparenchymal infiltration of LA that significantly reduces post-operative pain scores after BBA. PMID:34895854 | DOI:10.1016/j.bjps.2021.09.003 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical risk prediction for nasolacrimal duct obstruction in radioactive iodine treated thyroid cancer: A nationwide cohort study

xlomafota13 shared this article with you from Inoreader Surgical risk prediction for nasolacrimal duct obstruction in radioactive iodine treated thyroid cancer: A nationwide cohort study Via radioactive iodine Thyroid. 2021 Dec 12. doi: 10.1089/thy.2021.0418. Online ahead of print. ABSTRACT BACKGROUND: To estimate the incident risk of surgical intervention for nasolacrimal duct obstruction after radioactive iodine (RAI) treatment and elucidate the high-risk group of patients with thyroid cancer (TC). METHODS: This is a nationwide, population-based, cohort study using data from the Korean National Health Claims database. Among the entire South Korean population aged between 20 and 8 0 years from 2007 to 2019, all patients with TC were included. Among all TC patients, a cohort was established by classifying it into the RAI and non-RAI groups according to whether RAI treatment was performed during the recruitment period. A log-rank analysis was used to evaluate the risk of nasolacrimal duct obstruction surgery in the RAI group compared to that in the non-RAI group. The cox proportional hazards regression analysis was performed to calculate the adjusted hazard ratio (HR). The analysis was performed stratified by the age group, sex, frequency of RAI treatment, and cumulative dose of I131. RESULTS: Among 55371 TC patients, who received RAI treatment, 515 (0.93%) underwent NLDO surgeries, and among 56950 TC patients, who did not receive RAI treatment, 72 (0.13%) underwent the surgeries. The average timing of incident nasolacrimal duct obstruction surgery was 3.8 ± 2.1 years after the first exposure to RAI. The incidence rate of nasolacrimal duct obstruction su rgery was 104.04/100000 person-years in the RAI group. There was a significantly higher risk of nasolacrimal duct obstruction surgery (HR 7.50, 95% confidence interval [CI]: 5.86-9.60, p < 0.001) in the RAI group than in the non-RAI group. The risks significantly increased in the high-dose group (HR 14.15, 95% CI: 10.88-18.39) and those younger than 50 years (HR 15.54, 95% CI: 9.76-24.72). CONCLUSION: We quantified the risk of RAI-induced nasolacrimal duct obstruction surgery through a long-term follow-up of 9 years, which may contribute to estimating the general health care burden related to RAI treatment for TC patients in a practical setting. Great attention should be paid to its risk in patients younger than 50 years, especially in those treated with high doses. PMID:34894720 | DOI:10.1089/thy.2021.0418 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Botulinumtoxin-Behandlung der großen Speicheldrüsen bei chronischer Sialorrhö

xlomafota13 shared this article with you from Inoreader Botulinumtoxin-Behandlung der großen Speicheldrüsen bei chronischer Sialorrhö Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1556-0949 Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Differentialdiagnostik intraorbitaler Raumforderungen – eine Übersicht

xlomafota13 shared this article with you from Inoreader Differentialdiagnostik intraorbitaler Raumforderungen – eine Übersicht Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1580-7371 Hintergrund Aufgrund der unmittelbaren Nähe zum visuellen System stellen intraorbitale Raumforderungen eine Bedrohung für den Patienten und eine besondere Herausforderung für jede in Diagnostik und Therapie involvierte Fachdisziplin dar. Material/Methoden Narratives Review mit Diskussion von relevanten Originalarbeiten und Expertenempfehlungen. Zur Veranschaulichung beschreiben wir den Fall eines 71-jährigen Patienten, der 3 Monate nach einer Nasennebenhöhlenoperation in unserer Abteilung aufgenommen wurde. Ein postoperatives intraorbitales Hämatom der rechten Orbita war extern konservativ mit Antibiotika/Kortikosteroiden behandelt worden, was zu einem nahezu vollständigen einseitigen Sehverlust geführt hatte. Die folglich durchgeführte Orbita- und Optikusdekompression verhinderte nicht die Bildung eines intraorbitalen Lipogranuloms. Gegenwärtig werden die damit verbundenen rezidivierenden Entzündungsphasen erfolgreich konservativ auf der Grundlage multidisziplinärer Empfehlungen behandelt. Ergebnisse In dem berichteten Fall mündete eine verzögerte Orbita- und Optikusdekompression bei retrobulbärem Hämatom nach Nasennebenhöhlenoperation in der Bildung eines intraorbitalen Lipogranuloms. Die Literatur unterstützt unsere Empfehlung einer sofortigen chirurgischen Intervention im Falle eines akuten retrobulbären Hämatoms. Neben akuten Zuständen können intraorbitale Raumforderungen Zeichen systemischer Erkrankungen sein. In jedem Fall ist ein multidisziplinärer Therapieansatz für ein adäquates Management erforderlich. Schlussfolgerung Intraorbitale Raumforderungen können u.a. als akute Komplikation nach Nasennebenhöhlenoperationen auftreten oder Zeichen maligner Entartung und chronischer Erkrankungen sein. Differenzialdiagnostische Kenntnisse zu intraorbitalen Raumforderungen sind daher für jede im Kopf-Hals-Bereich tätige Fachdisziplin unerlässlich. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

PD-1 Inhibitor Maintenance Therapy Combined Iodine-125 Seed Implantation Successfully Salvage Recurrent Cervical Cancer after CCRT: A Case Report

xlomafota13 shared this article with you from Inoreader PD-1 Inhibitor Maintenance Therapy Combined Iodine-125 Seed Implantation Successfully Salvage Recurrent Cervical Cancer after CCRT: A Case Report Via radioactive iodine Curr Oncol. 2021 Nov 9;28(6):4577-4586. doi: 10.3390/curroncol28060387. ABSTRACT Cervical cancer is the fourth most common cancer in females worldwide. Patients with stage III and IV cervical cancer based on the Federation of Gynecology and Obstetrics (FIGO) classification have higher recurrence rates. Because of organs at risk (OAR) protection and the low indication rate of salvage surgery, the choice of treatment is always challenging. Systemic chemotherapy is palliative and can be performed in conjunction with surgery or radiotherapy; however, it has no significant benefit to survival. Brachytherapy and stereotactic body radiotherapy (SBRT) are characterized by extremely high radiation doses applied to tumor cells while sparing the normal tissues. Several studies have investigated the efficacy of these technologies in recurrent cervical cancer and showed promising results. The immune checkpoint inhibitors approach was also investigated and showed promising results too. Herein, we report a case of a patient with cervical cancer that recurred five months after adjuvant chemotherapy and concurrent chemoradiotherapy. The disease prognosis after interstitial implantation brachytherapy (IIB) was determined. Then, the patient underwent radioactive 125I-seed implantation combined with PD-1 inhibitor treatment. The patient exhibited a partial response after seed implantation, and up to now, the duration of this partial response was 24 months. PMID:34898560 | DOI:10.3390/curroncol28060387 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Vascular thrombosis and vasculitis in the gastrointestinal tract are associated with poor prognosis in patients with COVID-19

xlomafota13 shared this article with you from Inoreader Vascular thrombosis and vasculitis in the gastrointestinal tract are associated with poor prognosis in patients with COVID-19 Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Nov 15;14(11):1069-1079. eCollection 2021. ABSTRACT AIM: To report pathologic findings in the gastrointestinal (GI) tract of coronavirus disease 2019 (COVID-19) patients. MATERIAL AND METHODS: we evaluated clinical and GI tract histologic findings in six COVID-19 patients that presented with GI symptoms like diarrhea, and abdominal pain. This study includes surgical resection specimens from five patients and two sets of biopsy specimens from one patient. RESULTS: Idiopathic inflammatory bowel disease was considered in three of six cases based on clinical, radiologic, and endoscopic presentation. Histologically, the enteric mucosa had a spectrum of histologic changes, including active enteritis, chronic active enteritis, and transmural necrosis. Extensive thrombi in vessels and/or vasculitis were identified in three out of the six cases. The presence of extensive vascular thrombi is associated wit h poor prognosis, and the three patients deceased in a short period of time (ranges from 7-67 days, median 14 days) after admission for GI symptoms. Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) RNA was detected in bowel tissue of one case. The other three patients recovered and were discharged and free of GI symptoms (follow-up period ranges from 235 days to 270 days, median 237 days). CONCLUSION: COVID-19 associated enteritis may mimic Crohn's disease clinically, radiologically and endoscopically, and these two entities can be differentiated by pathologic findings. COVID-19 patients with GI symptoms may warrant a workup to evaluate for pathologic changes, as the presence of vasculitis and microthrombi may predict poor clinical outcome. PMID:34900075 | PMC:PMC8661070 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Double primary germ cell tumor

xlomafota13 shared this article with you from Inoreader Double primary germ cell tumor in a 45 year old woman: one case report and literature review Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Nov 15;14(11):1090-1094. eCollection 2021. ABSTRACT We report a rare case of double primary germ cell tumor: right ovarian yolk sac tumor and left ovarian dysgerminoma. A 45 year-old woman was admitted to our hospital due to irregular bleeding for 2 days and extended menstrual period. Right ovarian mass was discovered on transvaginal ultrasound. The pathology results revealed that right ovarian yolk sac tumor and left ovarian dysgerminoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy with debulking with pelvic lymphadenectomy was performed. The patient underwent adjuvant chemotherapy with BEP six courses in four months and AFP dropped from 8490 ng/ml to nearly 10 ng/ml. Conclusion: Total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by combination chemotherapy must be the treatment of first choice of germ cell tumor. PMID:34900077 | PMC:PMC8661071 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of MIF gene polymorphisms with pemphigus vulgaris: a case-control study with comprehensive review of the literature

xlomafota13 shared this article with you from Inoreader Association of <em>MIF</em> gene polymorphisms with pemphigus vulgaris: a case-control study with comprehensive review of the literature Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Nov 15;14(11):1080-1089. eCollection 2021. ABSTRACT BACKGROUND: Functional macrophage migration inhibitory factor (MIF) gene polymorphisms are associated with elevated serum levels of MIF and increased susceptibility to various autoimmune diseases. MIF levels in the sera of pemphigus vulgaris (PV) patients are increased; however, no definite association has been demonstrated between PV and MIF gene polymorphisms. The present study was conducted to ascertain any association between MIF-173*G-C and MIF-794*CATT5-8 polymorphisms and PV. METHODS: Seventy-five patients with PV and 252 healthy, unrelated, voluntary controls were enrolled randomly in the study. MIF-173*G-C polymorphism (rs755622) was genotyped using polymerase chain reaction (PCR) followed by restriction fragment length analysis, and MIF-794*CATT5-8 (rs5844572) was genotyp ed using PCR followed by capillary gel electrophoresis. Subsequently, the allelic, genotype, and haplotype frequencies were determined and compared for both groups. Data were also analyzed with respect to sex, age at onset, type of disease, and duration of disease. RESULTS: No significant association was observed in terms of allelic, genotype, and haplotype frequencies of MIF gene polymorphisms in PV patients. However, a significantly lower prevalence of the C allele (P=0.02) and CATT7 allele (P=0.03) was seen in our patient population compared to healthy controls. Analysis of the effect of various factors such as gender, age at onset, type of disease, and disease duration revealed no significant association with the genetic variants. CONCLUSIONS: MIF-173*G-C and -794*CATT5-8 polymorphisms are not associated with PV. PMID:34900076 | PMC:PMC8661066 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chromophobe renal cell carcinoma-like thyroid carcinoma: possible misdiagnosis as metastatic renal cell carcinoma

xlomafota13 shared this article with you from Inoreader Chromophobe renal cell carcinoma-like thyroid carcinoma: possible misdiagnosis as metastatic renal cell carcinoma Via International Journal of Clinical and Experimental Pathology Int J Clin Exp Pathol. 2021 Nov 15;14(11):1095-1101. eCollection 2021. ABSTRACT To date, multiple thyroid cancer variants have been reported. Herein, we report a rare case of chromophobe renal cell carcinoma-like thyroid carcinoma (CRETHCA) in a 60-year-old woman, for which the morphologic findings resembled those of chromophobe renal cell carcinoma (ChRCC). ChRCC of the kidney is characterized by large polygonal tumor cells with distinct cell borders, perinuclear clearing, multiple binucleate cells, and strongly positive immunostaining for paired box gene 8 (PAX8) and carbonic anhydrase IX (CA IX). In our case, the thyroid gland tumor was incidentally detected by routine medical screening without sufficient medical information; it showed similar histology and immunohistochemical features to ChRCC and was initially misdiagnosed as metastatic ChRCC. Additional tests, including kidney computed tomography and positron emission tomography, revealed no abnormalities in the patient's kidney; therefore, we diagnosed the tumor as CRETHCA. Focal weak staining for thyroid transcription factor 1 (TTF-1) was the only supporting evidence that it was a primary thyroid neoplasm. To the best of our knowledge, this is the second report of CRETHCA in literature. This novel variant is very difficult to distinguish from metastatic ChRCC and can be a diagnostic challenge for pathologists. Further studies of similar cases should be done to define this new entity. PMID:34900078 | PMC:PMC8661068 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.