Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Perceptions of Internet Delivery of Hearing Aids.
J Am Acad Audiol. 2016 Jun;27(6):424
Authors: Jacobson GP
PMID: 27310401 [PubMed - as supplied by publisher]
The American Journal of Sports Medicine
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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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The Journal of Hand Surgery
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Resuscitation
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Journal of Pediatric Orthopaedics
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Journal of Pediatric Orthopaedics
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Anterior lateral thigh osteomyocutaneous free flap reconstruction in the head and neck: The anterolateral thigh osteomyocutaneous femur bone flap.
Head Neck. 2016 Jun 16;
Authors: Brody RM, Pandey NC, Bur AM, O'Malley BW, Rassekh CH, Weinstein GS, Chalian AA, Newman JG, Cannady SB
Abstract
BACKGROUND: The anterolateral thigh (ALT) free flap is one of the most commonly used donor sites in head and neck reconstruction, however, it is not typically considered when an osseous component is needed.
METHODS: Soft tissue harvests, cadaveric study, and retrospective analysis of a series of 10 patients undergoing angiography were performed to assess vascular supply to the femoral cortex. In 6 patients, corticocancellous split-femur was incorporated into the ALT to reconstruct bony defects of the head and neck.
RESULTS: There is a consistent blood supply to the femur from the lateral femoral circumflex artery both intraoperatively and on angiography. No fractures or orthopedic injuries have been seen to date. None of the patients had complications of bone harvest, such as deep vein thrombosis or pulmonary embolism.
CONCLUSION: The ALT osteomyocutaneous (ALTO) flap has consistent vascular anatomy to the femoral cortex. This flap provides additional corticocancellous bone and overlying vastus intermedius muscle for the reconstruction of complex craniofacial defects. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.
PMID: 27310816 [PubMed - as supplied by publisher]
Atypical granular cell tumor in the maxilla: The first report of primary intraosseous granular cell tumor.
Head Neck. 2016 Jun 16;
Authors: Oh KY, Kang KR, Yoon HJ, Lee JI, Hong SP, Hong SD
Abstract
BACKGROUND: Granular cell tumor (GCT) is a benign soft tissue tumor of neural origin and is characterized by eosinophilic granular cells showing positivity for neuronal markers. Herein, we report the first case of primary intraosseous GCT arising in the maxilla of an adolescent girl.
METHODS AND RESULTS: A 16-year-old female patient presented with palatal swelling. Radiographic findings revealed a well-defined radiolucent lesion centrally located in the right maxilla. Mass excision was performed, and histopathologic examination showed sheets and cords of eosinophilic granular cells with cellular pleomorphism. Tumor cells were strongly positive for vimentin, S-100 protein, and CD56, and negative for cytokeratin, desmin, smooth muscle actin, and c-kit. High expression of p53 and Ki-67 was found. The final diagnosis was atypical GCT.
CONCLUSION: When evaluating an intraosseous radiolucent lesion with histopathologic features of granular cells, clinicians and pathologists should include GCT in the differential diagnosis. © 2016 Wiley Periodicals, Inc. Head Neck, 2016.
PMID: 27310657 [PubMed - as supplied by publisher]
Progress and prospects in pharmacogenetics of antidepressant drugs.
Expert Opin Drug Metab Toxicol. 2016 Jun 16;
Authors: Fabbri C, Crisafulli C, Calabrò M, Spina E, Serretti A
Abstract
INTRODUCTION: Depression is responsible for the most part of the personal and socio-economic burden due to psychiatric disorders. Since antidepressant response clusters in families, pharmacogenetics represents a meaningful tool to provide tailored treatments and improve the prognosis of depression.
AREAS COVERED: This review aims to summarize and discuss the pharmacogenetics of antidepressant drugs in major depressive disorder, with a focus on the most replicated genes, genome-wide association studies (GWAS), but also on the findings provided by new and promising analysis methods. In particular, multimarker tests such as pathway analysis and polygenic risk scores increase the power of detecting associations compared to the analysis of individual polymorphisms. Since genetic variants are not necessarily associated with a change in protein level, gene expression studies may provide complementary information to genetic studies. Finally, the pharmacogenetic tests that have been investigated for clinical application are discussed.
EXPERT OPINION: Despite the lack of widespread clinical applications, preliminary results suggest that pharmacogenetics may be useful to guide antidepressant treatment. The US Food and Drug Administration included pharmacogenetic indications in the labeling of several antidepressants. This represented an important official recognition of the clinical relevance of genetic polymorphisms in antidepressant treatment.
PMID: 27310483 [PubMed - as supplied by publisher]
Familial Central Hypothyroidism Caused by a Novel IGSF1 Gene Mutation.
Thyroid. 2016 Jun 16;
Authors: Rakover YT, Turgeon MO, London S, Hermanns P, Pohlenz J, Bernard DJ, Bercovich D
Abstract
BACKGROUND: Congenital hypothyroidism of central origin (CH-C) is a rare disease in which thyroid hormone deficiency is caused by insufficient thyrotropin stimulation of a normal thyroid gland. A recently described syndrome of isolated CH-C and macroorchidism was attributed to loss-of-function mutations of the immunoglobulin superfamily, member 1 gene (IGSF1).
PATIENTS AND METHODS: CH-C was diagnosed in three siblings. The TRH, TRHR and TSHB genes were sequenced followed by whole-exome sequencing in the proband. A mutation identified in IGSF1 was analyzed by direct PCR sequencing in family members. The effects of the mutation were assessed by in -vitro studies in HEK293 cells.
RESULTS: The index case was negative for mutations in TRH, TRHR and TSHB. Whole-exome sequencing revealed a novel insertion mutation in IGSF1, c.2284_2285insA, p.R762QfsX7, which was confirmed by direct PCR sequencing and was identified in additional six family members. The mutation introduces a frame-shift and premature stop codon in the 7th Ig loop, thereby truncating IGSF1. In vitro studies revealed that the mutated IGSF1-R762QfsX7 migrates as a doublet at ~28 kDa, which is far smaller than the wild-type protein (130-140 kDa). Both bands were endonuclease H-sensitive, indicating immature glycosylation and failure of the protein to traffic out of the endoplasmic reticulum to the plasma membrane. Further phenotypic findings in the family included macroorchidism and infertility in the uncle and mild neurological phenotypes in the affected males, such as hypotonia, delayed psychomotor development, clumsy behavior and attention deficit disorder.
CONCLUSIONS: We identified a novel insertion mutation in the IGSF1 gene and further delineated the phenotype of IGSF1-deficiency syndrome. Our findings indicate a possible association between an IGSF1 mutation and a neurological phenotypes.
PMID: 27310681 [PubMed - as supplied by publisher]
Opioids in the treatment of restless legs syndrome: pharmacological and clinical aspects.
Expert Opin Drug Metab Toxicol. 2016 Jun 16;
Authors: de Biase S, Merlino G, Valente M, Gigli GL
Abstract
INTRODUCTION: Restless legs syndrome (RLS) is a common neurologic sensorimotor disorder that can have a negative impact on sleep, quality of life and health. In patients affected by severe RLS, pharmacological treatment is mandatory.
AREAS COVERED: The present review is based on a search using PubMed from 1993 to 2016. It is focused on pharmacological and clinical aspects of opioids used for the treatment of RLS.
EXPERT OPINION: The drugs currently available for the treatment of RLS do not always allow for optimal control of symptoms, in particular, when utilised for long-term treatment. Opioids as monotherapy or add-on treatment should be considered when alternative satisfactory regimens are unavailable and the severity of symptoms warrants it. In a phase III trial oxycodone-naloxone prolonged-release (PR) demonstrated a significant and sustained effect on patients with severe RLS inadequately controlled by previous treatment. It was recently approved for the second-line symptomatic treatment of severe to very severe idiopathic RLS, after failure of dopaminergic treatment. Further studies are needed to evaluate if oxycodone-naloxone PR is equally efficacious as a first-line treatment. Moreover, long-term comparative studies between opioids, dopaminergic drugs and α-2-δ ligands are needed.
PMID: 27310338 [PubMed - as supplied by publisher]
Acute, transitional and long-term cluster headache treatment: pharmacokinetic issues.
Expert Opin Drug Metab Toxicol. 2016 Jun 16;
Authors: de Andrés F, Lionetto L, Curto M, Capi M, Cipolla F, Negro A, Martelletti P
Abstract
INTRODUCTION: The cornerstones of cluster headache therapy are based on the tripod of acute, transitional and preventative treatments that respectively aim to the control of the bouts, the transitional suppression of the relapse and the prevention of the entire cluster period. Particularly in chronic cluster headache, where a long-term preventative therapy is necessary, multiple drug regimens increase the risk of drug-drug interactions leading to variability in the clinical efficacy and to potentially harmful adverse effects.
AREAS COVERED: We focused on how clinically significant pharmacokinetic drug-drug and food-drug interactions can be carefully managed both in cluster headache patients with a progressive frequency of bouts and in chronic cluster headache sufferers. In fact, in these cases a long-term preventive therapy is indicated, increasing the possibility of interactions both with other transitional and acute cluster headache medications and with other foods or xenobiotics.
EXPERT OPINION: Pharmacokinetic interactions for both preventive, transitional and acute drugs are significant with a number of xenobiotics and other medications. Therefore, the pharmacokinetic issues knowledge is advisable for a safe and effective cluster headache management.
PMID: 27310148 [PubMed - as supplied by publisher]
Levetiracetam Prophylaxis for Post-traumatic Brain Injury Seizures is Ineffective: A Propensity Score Analysis.
World J Surg. 2016 Jun 15;
Authors: Zangbar B, Khalil M, Gruessner A, Joseph B, Friese R, Kulvatunyou N, Wynne J, Latifi R, Rhee P, O'Keeffe T
Abstract
INTRODUCTION: Early seizures after severe traumatic brain injury (TBI) have a reported incidence of up to 15 %. Prophylaxis for early seizures using 1 week of phenytoin is considered standard of care for seizure prevention. However, many centers have substituted the anticonvulsant levetiracetam without good data on the efficacy of this approach. Our hypothesis was that the treatment with levetiracetam is not effective in preventing early post-traumatic seizures.
METHODS: All trauma patients sustaining a TBI from January 2007 to December 2009 at an urban level-one trauma center were retrospectively analyzed. Seizures were identified from a prospectively gathered morbidity database and anticonvulsant use from the pharmacy database. Statistical comparisons were made by Chi square, t tests, and logistic regression modeling. Patients who received levetiracetam prophylaxis were matched 1:1 using propensity score matching with those who did not receive the drug.
RESULTS: 5551 trauma patients suffered a TBI during the study period, with an overall seizure rate of 0.7 % (39/5551). Of the total population, 1795 were diagnosed with severe TBI (Head AIS score 3-5). Seizures were 25 times more likely in the severe TBI group than in the non-severe group [2.0 % (36/1795) vs. 0.08 % (3/3756); OR 25.6; 95 % CI 7.8-83.2; p < 0.0001]. Of the patients who had seizures after severe TBI, 25 % (9/36) received pharmacologic prophylaxis with levetiracetam, phenytoin, or fosphenytoin. In a matched cohort by propensity scores, no difference was seen in seizure rates between the levetiracetam group and no-prophylaxis group (1.9 vs. 3.4 %, p = 0.50).
CONCLUSIONS: In this propensity score-matched cohort analysis, levetiracetam prophylaxis was ineffective in preventing seizures as the rate of seizures was similar whether patients did or did not receive the drug. The incidence of post-traumatic seizures in severe TBI patients was only 2.0 % in this study; therefore we question the benefit of routine prophylactic anticonvulsant therapy in patients with TBI.
PMID: 27307089 [PubMed - as supplied by publisher]
Mid-Term Remission of Type 2 Diabetes Mellitus After Laparoscopic Roux En-Y Gastric Bypass.
World J Surg. 2016 Jun 15;
Authors: Vasas P, Al-Khyatt W, Idris I, Leeder PC, Awan AK, Awad S, Ahmed J
Abstract
BACKGROUND: Laparoscopic Roux en-Y gastric bypass (LRYGB) is an established therapeutic modality for type 2 diabetes mellitus (T2DM). However, there is paucity of data on the outcomes of LRYGB on T2DM beyond 2 years. This study aimed to examine the medium-term effects of LRYGB on T2DM and determine the predictors of T2DM resolution.
METHODS: Prospective data were collected for all consecutive LRYGB performed from September 2009 to November 2010. The American Diabetes Association guidelines were used to define complete (CR) or partial (PR) remission of diabetes. Diabetes status was considered improved when there was >50 % reduction in the dose of medications or when glycaemic control was achieved after stopping insulin. The effects of baseline characteristics, diabetes data and weight loss data at 4 years on T2DM remission were studied.
RESULTS: Forty-six patients with T2DM underwent LRYGB with mean ± SD age and body mass index (BMI) of 48.6 ± 9.6 years and 50.4 ± 6.5 kg/m(2), respectively. Median (IQR, interquartile range) duration of T2DM preoperatively was 60 (36-126) months. Median (IQR) follow-up was 52 (50-57) months. T2DM remission was achieved in 64 % of patients (44 % CR, 20 % PR), and a further 28 % of patients had improvement in their diabetes status. Multivariate analyses demonstrated significant excess weight loss (EWL) [P = 0.008] and lower BMI [P = 0.04] at 4 years to be the only independent predictors of T2DM medium-term outcomes.
CONCLUSION: The medium-term effects of LRYGB on T2DM remission/improvement were maintained in 92 % of patients. EWL and lower BMI at 4 years were independent predictors of T2DM remission.
PMID: 27307088 [PubMed - as supplied by publisher]
A case of crossed-doubled patellar tendon: an atavistic variant, simple mutation or pathologic finding?
Surg Radiol Anat. 2016 Jun 15;
Authors: Loizides A, Messina C, Glodny B, Gruber L, Brenner E, Gruber H, Henninger B
Abstract
Anatomical variants can be found throughout the whole body. Especially in the knee region, some variability has been reported concerning the osseous, tendinous, and muscular system. Beside a few cases of patellar tendon aplasia, no anatomical variations of this tendon are known. We present a rare case of a doubled patellar tendon as an anatomical variant, which to our knowledge, has not been described previously.
PMID: 27307254 [PubMed - as supplied by publisher]
The Prognostic Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Colorectal Cancer.
World J Surg. 2016 Jun 15;
Authors: Kubo H, Murayama Y, Arita T, Kuriu Y, Nakanishi M, Otsuji E
Abstract
BACKGROUND: The prognostic value of the neutrophil-to-lymphocyte ratio (NLR) has been reported in several cancers included colorectal cancer; however, it is not clear if there is an association between NLR and cancer-specific survival in colorectal cancer. And the optimal cut-off value is controversial. This study was designed to assess the prognostic value of preoperative NLR in colorectal cancer patients.
METHODS: Total 823 consecutive patients who underwent surgery for all stages of colorectal cancer in our hospital between January 2006 and December 2011 were included in the study. Preoperative NLR was calculated from their hospital records.
RESULTS: Using the receiver-operating characteristic curve, we found that the optimal preoperative NLR cut-off value that was strongly associated with cancer-specific survival was 2.1. Using this value, 505 patients were identified as having high NLR (≥2.1) and 397 patients were identified as having low NLR (<2.1). High NLR was associated with preoperative serum albumin values <4.0 g/dl (p < 0.001), positive preoperative serum C-reactive protein (CRP; p < 0.001), preoperative carcinoembryonic antigen (CEA) values ≥5.0 ng/dl (p = 0.003), and stage progression (p = 0.002). Cox proportional hazard analyses identified preoperative high NLR as an independent poor prognostic factor (p = 0.020, HR 1.66 (95 % CI: 1.08-2.63)). When comparing stage of disease, preoperative high-NLR patients with Stage III disease (p = 0.024) and Stage IV disease (p = 0.036) had significantly poorer prognoses.
CONCLUSIONS: In this study, we have demonstrated that preoperative NLR ≥2.1 was a prognostic indicator for cancer-specific survival of colorectal cancer patients.
PMID: 27307087 [PubMed - as supplied by publisher]
Applied clinical anatomy: the successful integration of anatomy into specialty-specific senior electives.
Surg Radiol Anat. 2016 Jun 15;
Authors: Morgan H, Zeller J, Hughes DT, Dooley-Hash S, Klein K, Caty R, Santen S
Abstract
PURPOSE: A strong foundation in anatomical knowledge is essential for physicians in all fields. Despite this established importance, anatomy continues to be primarily taught only during the pre-clinical years of medical school. Senior medical students have more mature clinical reasoning and analytical skills; therefore, advanced anatomy courses have great potential to integrate basic and clinical sciences to better prepare senior medical students for residency.
METHODS: At our institution, five electives have been implemented that integrate anatomical education in clinical contexts in the fields of emergency medicine, musculoskeletal medicine, radiology, surgery, and obstetrics and gynecology. These 4-week courses are all offered in the spring of the final year of medical school. The course curricula, content, and evaluation data are described for each of the courses.
RESULTS: The five electives have been extremely popular at our institution, and all have been consistently filled each year by students entering diverse disciplines. Course evaluations have been positive and students specifically note how these courses allow them the opportunity to integrate basic anatomical knowledge into clinical contexts. Students have marked improvement in anatomical knowledge after completion of these electives.
CONCLUSIONS: Advanced anatomy courses that integrate anatomical education with clinical reasoning are important curricular innovations that are popular with students and lead to important improvements in anatomical knowledge. Anatomists can lead the charge for better integration of basic sciences into senior medical school curricula.
PMID: 27307253 [PubMed - as supplied by publisher]
Ventricular metastatic dissemination of a paediatric craniopharyngioma: case report and literature review.
Br J Neurosurg. 2016 Jun 16;:1-4
Authors: Carleton-Bland N, Kilday JP, Pathmanaban ON, Stivaros S, Kelsey A, Kamaly-Asl ID
Abstract
Distant intraventricular metastasis is extremely rare in childhood craniopharyngioma. Here, we report the isolated posterior ventricular recurrence of an adamantinomatous craniopharyngioma, in a child previously treated with surgery and proton beam therapy for local progression. The importance of surveillance imaging is highlighted, while specific surgical approaches and techniques are considered.
PMID: 27310220 [PubMed - as supplied by publisher]
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Small Cell Carcinoma of the Gall Bladder.
WMJ. 2016 Apr;115(2):96-9
Authors: Haid M, Gahju B, Schulz C, Sterner D, Falconer S
Abstract
Small cell carcinoma of the gall bladder (SCCGB) is a rare condition, with only 53 prior cases reported in the world literature when our case was first diagnosed. Our patient was found to have limited stage disease and was treated with sequential laparoscopic cholecystectomy, etoposide/carboplatin chemotherapy followed by consolidating loco-regional radiation therapy. She is alive and well without evidence of disease more than 132 months since diagnosis. We describe here our experience in the diagnosis, staging workup, treatment, and surveillance of a case of SCCGB and review the published literature. Treated aggressively with currently available methods, patients with limited stage SCCGB can have an excellent prognosis. The authors' intent is to provide a reasonable plan of treatment for other physicians facing such an unusual patient.
PMID: 27197345 [PubMed - indexed for MEDLINE]
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Spinal tuberculosis with severe neurological symptoms as a complication of intravesical BCG therapy for carcinoma of the bladder.
Neurol Neurochir Pol. 2016;50(2):131-8
Authors: Białecki J, Nowak-Misiak M, Rąpała K, Marczyński W, Suchodolski G, Truszczyńska A
Abstract
INTRODUCTION: Non-invasive bladder cancer is effectively treated with intravesical BCG therapy. The administration of the BCG vaccine is to destroy the neoplastic lesion or prevent further recurrences. The activity of the vaccine involves boosting the immune system through the stimulation of the inflammation in the bladder. Adverse reactions after this immunotherapy are rare. The aim of the study was to present complications in the form of spinal tuberculosis and serious neurological symptoms that occurred during intravesical BCG immunotherapy for carcinoma of the bladder. The manuscript also describes a method for neurosurgical spinal cord decompression of the thoracic spine.
MATERIAL AND METHODS: In the first patient, aged 66, after intravesical BCG therapy for bladder carcinoma, back pain and spastic paralysis of the lower limbs were observed. The MRI and CT revealed destruction of the intervertebral disc and vertebral endplates Th11-Th12. Mycobacterium tuberculosis complex bacilli were cultured from the material obtained by puncture aspiration. In the second patient, aged 35 years, during intravesical BCG immunotherapy for carcinoma of the bladder, girdle thoracic spine pain was observed. The MRI and CT of the spine showed visible lesions characteristic of tuberculosis. Immobilization in a plaster corset and implementation of antituberculous treatment resulted in quick relief of the pain and healing of the tuberculosis focus in the spine.
CONCLUSION: The cases described in the work are the first documented reports in the Polish literature of spinal tuberculosis which occurred as a complication of intravesical administration of bacilli Calmette-Guérin. The diagnosis was based on the finding of BCG vaccine bacillus with molecular methods or PCR. Full antimycobacterial treatment was implemented.
PMID: 26969570 [PubMed - indexed for MEDLINE]
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Primary hepatic Epstein-Barr virus-associated CD30-positive peripheral T-cell lymphoma of cytotoxic phenotype.
Exp Mol Pathol. 2016 Feb;100(1):207-11
Authors: Peng Y, Cai J, Yue C, Qing X
Abstract
Primary hepatic peripheral T-cell lymphoma (PTCL) is exceedingly rare. We encountered such a case in a 58-year-old Hispanic female with a history of chronic sinusitis and hypothyroidism who presented with 4weeks of fever and weight loss. Laboratory studies showed altered liver function and mild pancytopenia. Hepatitis and HIV infection were excluded by negative serological tests. A computed tomography (CT) scan showed innumerable small low-density lesions throughout the liver without splenomegaly or lymphadenopathy. CT-guided liver core biopsy showed scattered small lymphoid aggregates located mainly in the portal tracts and periportal regions. Within the lymphoid aggregates, scattered large pleomorphic lymphoma cells were seen, admixed with smaller lymphoid cells and histiocytes. By immunohistochemistry, the lymphoma cells expressed CD2, CD3, CD8, CD30, CD43, CD45, granzyme B, TIA-1, and negative for CD4, CD5, CD7, CD56, βF1, ALK-1, and B-cell markers. In situ hybridization for Epstein-Barr virus-encoded RNA (EBER) was positive in some lymphoma cells. To our knowledge, this is the first reported case of primary hepatic Epstein-Barr virus-associated PTCL with CD30 expression.
PMID: 26778690 [PubMed - indexed for MEDLINE]
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[Diagnosis and treatment of rare malignant tumors in external auditory canal].
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015 Aug;29(16):1438-42
Authors: Wang F, Wu N, Hou Z, Liu J, Shen W, Han W, Yang S
Abstract
OBJECTIVE: To analyze the diagnosis, therapy and prognosis of the rare cases of malignant tumors in external auditory canal.
METHOD: Eight cases of rare malignant tumors in external auditory canal were collected except squamous cell carcinoma and adenoid cystic carcinoma. The clinical manifestation, staging, surgical method, secondary treatment and prognosis were analysed.
RESULT: There were 5 cases of basal cell carcinoma and 2 cases of mucoepidermoid carcinoma and 1 case of myoepithelial carcinoma. Three cases of the 5 basal cell carcinoma in external auditory canal have been misdiagnosed for a long time. After admission, 4 of the 5 basal cell carcinoma were T1 stage and cured only by a complete resection of tumor. One case of T2 stage basal cell carcinoma was found recurrence 2 years later after the first excision of tumor, and was treated with radiotherapy. Tumor was controlled. Two cases of mucoepidermoid carcinoma had been misdiagnosed as a benign tumor and received a resection. One case was found metastasis to the parapharyngeal space and nasopharynx and was treated with concurrent chemotherapy. Tumor was also controlled after 5-years follow-up. Another case was found metastasis to parotid gland and received an expanding tumor resection. No recurrence was detected after a 1-year followed up. One case of T4 stage myoepithelial carcinoma in external auditory canal was a metastasis of parotid and received a partial temporal bone resection. No-recurrence was found 1 year later.
CONCLUSION: Because the tumors above have a very low incidence in external ear canal and the location of tumors are hidden, they are often misdiagnosed and delayed in treatment. Therefore, otologists should pay more attention to avoid the misdiagnosis. To the treatment, complete surgical resection of early-stage tumor is important and for late-stage tumor, a supplemented by chemoradiotherapy may be needed.
PMID: 26665451 [PubMed - indexed for MEDLINE]
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Plasmablastic lymphoma presenting as a large intracardiac mass and bilateral pleural effusions.
Exp Mol Pathol. 2016 Feb;100(1):79-81
Authors: Qing X, Enbom E, Qing A, French S, Cai J
Abstract
Plasmablastic lymphoma (PBL) is a rare aggressive lymphoma arising most frequently in the oral cavity of HIV-infected patients. Rare cases of PBL have been reported in extra-oral sites, as well as in HIV-negative patients. Cardiac involvement by lymphoma is very rare. The most common primary cardiac lymphoma is diffuse large B-cell lymphoma. We report an unusual case of PBL in a 49-year-old, HIV-positive man presenting with a large intracardiac mass and bilateral pleural effusions. Histological examination of the cardiac mass biopsy and cytological evaluation of the pleural fluid demonstrated large lymphoma cells with plasmablastic differentiation. By immunohistochemistry, the large lymphoma cells expressed CD30, CD45, CD138, MUM1, and kappa light chain, were weakly positive for EMA, and were negative for T-cell and B-cell markers, lambda light chain, and human herpes virus 8 (HHV8). In situ hybridization for Epstein Barr Virus-encoded RNA (EBER) was negative in large lymphoma cells. To our knowledge, in the English literature, this is the second reported case of PBL with cardiac origin and the first reported case of PBL that presents as a combination of intracardiac mass and pleural effusions.
PMID: 26607603 [PubMed - indexed for MEDLINE]
Epileptic seizures result from aberrant cellular and/or synaptic properties that can alter the capacity of neurons to integrate and relay information. During absence seizures, spike-and-wave discharges (SWDs) interfere with incoming sensory inputs and preclude conscious experience. The Genetic Absence Epilepsy Rats from Strasbourg (GAERS), a well-established animal model of absence epilepsy, allows exploring the cellular basis of this impaired information processing. Here, by combining in vivo electrocorticographic and intracellular recordings from GAERS and control animals, we investigated how the pro-ictogenic properties of seizure-initiating cortical neurons modify their integrative properties and input-output operation during inter-ictal periods and during the spike (S-) and wave (W-) cortical patterns alternating during seizures. In addition to a sustained depolarization and an excessive firing rate in between seizures, ictogenic neurons exhibited a pronounced hyperpolarization-activated depolarization compared to homotypic control neurons. Firing frequency versus injected current relations indicated an increased sensitivity of GAERS cells to weak excitatory inputs, without modifications in the trial-to-trial variability of current-induced firing. During SWDs, the W-component resulted in paradoxical effects in ictogenic neurons, associating an increased membrane input resistance with a reduction in the current-evoked firing responses. Conversely, the collapse of cell membrane resistance during the S-component was accompanied by an elevated current-evoked firing relative to W-sequences, which remained however lower compared to inter-ictal periods. These findings show a dynamic modulation of ictogenic neurons intrinsic properties that may alter inter-seizure cortical function and participate to compromise information processing in cortical networks during absences.
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Often characterised as 'unstructured' (Hoppe 2011), 'post-normal' (e.g. Funtowicz & Ravetz 1993) or 'wicked' (e.g. Pryshlakivsky & Searcy 2013) problems, complex sustainability issues such as climate change, loss of biodiversity, resource depletion, gentrification, etc. prove difficult to solve. Their consequences are far-reaching yet unpredictable. Expert knowledge is incomplete, fragmented, and uncertain, giving rise to scientific controversies. Furthermore, social and political controversy arises because of a lack of agreement on norms and values at stake and on the acceptability of goals and solutions. Neither the existing institutions, frameworks and routines for decision-making nor the application of the available expertise appear capable of democratically tackling such problems. All the same, the sense of urgency surrounding these issues that drastically affect our planet and its inhabitants continues to grow. The pursuit of a more sustainable world is one of the most important societal challenges today and – given its wicked character – a challenge that requires a trans-disciplinary engagement with the issues at stake. In this context, policy-makers as well as scholars repeatedly argue for 'learning our way out' of unsustainability (Finger & Asún 2001) and explicitly call on educational institutions to contribute to this endeavour. Yet, also for education such wicked socio-ecological problems bring about major challenges. When the required and available knowledge is uncertain and the desirability of proposed solutions is contested, education cannot be reduced to a matter of teaching and learning the 'proper' attitudes, knowledge, behaviour, skills, etc. Environmental and sustainability education (ESE) researchers have emphasised the absence of a universal ethical foundation for sustainable development as well as of an absolute conception of scientific truth. Questions and challenges emerging, then, are e.g. how to deal with unstable knowledge and controversy in educational processes (Ashley 2000)? How to move beyond moralising instruction without falling into undue anything-goes-relativism (Sund & Öhman 2014; Van Poeck et al. 2015)? How to foster creativity (Garrison et al. 2015) and encourage 'thinking and doing things that have not been done before' (Jickling & Wals 2012)? Etc. Highlighting different aspects of such educational challenges and bringing together varied national perspectives, the contributors to this symposium will address this topic from theoretical, methodological as well as empirical points of view. In this second part of the symposium, we focus on empirical ESE research contributions about teaching and learning in the face of wicked socio-ecological problems. McKenzie and Reid draw on large scale comparative study of sustainability in formal education to address the question how sustainability issues are conceptualized, practiced, resisted, and addressed within and across places, and why that matters for educational research, policy, and pedagogy. Lee examined children's perceptions and articulations of changing climates in primary schools in the UK, Mongolia, Mexico and Alaska and describes the uncovered distinctions in the way that children in different countries talk about the wicked socio-ecological problem, climate change. Læssøe, Rahbek and Lysgaard investigate and describe how future wicked problems influence Folk High school teacher thinking on their teaching and how new approaches and methods emerge through spaces for knowledge sharing, self-reflection, experimentation and evaluation.
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Often characterised as 'unstructured' (Hoppe 2011), 'post-normal' (e.g. Funtowicz & Ravetz 1993) or 'wicked' (e.g. Pryshlakivsky & Searcy 2013) problems, complex sustainability issues such as climate change, loss of biodiversity, resource depletion, gentrification, etc. prove difficult to solve. Their consequences are far-reaching yet unpredictable. Expert knowledge is incomplete, fragmented, and uncertain, giving rise to scientific controversies. Furthermore, social and political controversy arises because of a lack of agreement on norms and values at stake and on the acceptability of goals and solutions. Neither the existing institutions, frameworks and routines for decision-making nor the application of the available expertise appear capable of democratically tackling such problems. All the same, the sense of urgency surrounding these issues that drastically affect our planet and its inhabitants continues to grow. The pursuit of a more sustainable world is one of the most important societal challenges today and – given its wicked character – a challenge that requires a trans-disciplinary engagement with the issues at stake. In this context, policy-makers as well as scholars repeatedly argue for 'learning our way out' of unsustainability (Finger & Asún 2001) and explicitly call on educational institutions to contribute to this endeavour. Yet, also for education such wicked socio-ecological problems bring about major challenges. When the required and available knowledge is uncertain and the desirability of proposed solutions is contested, education cannot be reduced to a matter of teaching and learning the 'proper' attitudes, knowledge, behaviour, skills, etc. Environmental and sustainability education (ESE) researchers have emphasised the absence of a universal ethical foundation for sustainable development as well as of an absolute conception of scientific truth. Questions and challenges emerging, then, are e.g. how to deal with unstable knowledge and controversy in educational processes (Ashley 2000)? How to move beyond moralising instruction without falling into undue anything-goes-relativism (Sund & Öhman 2014; Van Poeck et al. 2015)? How to foster creativity (Garrison et al. 2015) and encourage 'thinking and doing things that have not been done before' (Jickling & Wals 2012)? Etc. Highlighting different aspects of such educational challenges and bringing together varied national perspectives, the contributors to this symposium will address this topic from theoretical, methodological as well as empirical points of view. In this first part of the symposium, we focus on exploring promising theoretical frameworks for ESE research on teaching and learning in the face of wicked socio-ecological problems. Van Poeck, Block and Östman develop a conceptual framework for understanding and investigating urban sustainability transition initiatives as spaces for experiential learning drawing on Dewey's theory of experience. Drawing on ecofeminism and environmental ethics, Bengtsson and Kronlid argue that it is impossible to fulfil the ethical demand to include and acknowledge that which is excluded (e.g. women, nonhuman nature) and explore the consequences thereof for environmental education and social progress. Lysgaard and Van Poeck draw inspiration from theoretical, epistemological work in the fields of Speculative Realism and Actor Network Theory to examine whether and how the entanglement of social, political, human aspects on the one hand and material, technical, natural elements on the other is reflected in the way in which ESE practices present and approach the subject matter of wicked socio-ecological problems.
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Sleep quality is a construct often measured, employed as an outcome criterion for therapeutic success, but never defined. In two studies we examined appraised good and poor sleep quality in three groups: a control group, individuals with obstructive sleep apnea, and those with insomnia disorder. In Study 1 we used qualitative methodology to examine good and poor sleep quality in 121 individuals. In Study 2 we examined sleep quality in 171 individuals who had not participated in Study 1 and evaluated correlates and predictors of sleep quality. Across all six samples and both qualitative and quantitative methodologies, the daytime experience of feeling refreshed (nonrefreshed) in the morning and the nighttime experience of good (impaired) sleep continuity characterized perceived good and poor sleep. Our results clarify sleep quality as a construct and identify refreshing sleep and sleep continuity as potential clinical and research outcome measures.
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Today, towns and cities, all over the world, are engaged in so-called 'sustainability transitions' and develop projects and activities to move towards more social justice and sustainable development (Evans 2005). Loorbach (2009) defines urban sustainability transitions as long-term structural transformation processes in complex urban socio-technical systems. Because there are no suited institutions available with the power to provide a solution, a way out of unsustainability is often sought in ambiguous 'urban governance' networks (Block and Paredis 2013), in 'new political spaces' that emerge in an 'institutional void': 'there are no generally accepted rules and norms according to which policy making and politics is to be conducted' (Hajer 2003: 175). Facing the impotence of existing decision-making institutions to realise adequate sustainability transitions, appeals have been made to 'learning' as a leverage to decisive action. We want to explore and understand how new political spaces, emerging in the context of urban sustainability initiatives and characterised by institutional voids, can also function as 'educative spaces'. Indeed, sustainability transitions are often framed as a matter of 'learning by doing' and 'doing by learning' (Loorbach 2007), i.e. as an outcome of experiential and experimental learning. Yet, as Dewey (1938/2015: 25) argues, 'experience and experiment are not self-explanatory ideas'. Their meaning and educative value should be explored theoretically as well as empirically. Questions emerging then are, e.g.: Under which conditions do such settings serve as a space where people learn to find ways to open-up new possibilities for a sustainable future? Under which conditions can an institutional void give rise to spaces that can be considered 'educative' instead of 'non-educative' or even 'mis-educative'? Which kind of experiences can be regarded educative in the face of unstructured, wicked sustainability problems? Etc. In this contribution, we draw on Dewey's (1938/2015) theory of experience, framed by the principles of continuity and transaction, to develop a conceptual framework for understanding urban sustainability transition initiatives as spaces for experiential learning. The aim is to theoretically define design parameters (regarding content, method, material equipment, social organisation, etc.) for adequate practice which will be empirically tested in confrontation with what actually happens in urban sustainability transition initiatives.
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The present study examined how support providers' empathic dispositions (dispositional perspective taking, empathic concern, and personal distress) as well as their situational empathic reactions (interaction-based perspective taking, empathic concern, and personal distress) relate to the provision of spousal support during observed support interactions. Forty-five committed couples provided questionnaire data and participated in two ten-minute social support interactions designed to assess behaviors when partners are offering and soliciting social support. A video-review task was used to assess situational forms of perspective taking (e.g., empathic accuracy), empathic concern and personal distress. Data were analyzed by means of the multi-level Actor-Partner Interdependence Model. Results revealed that providers scoring higher on affective empathy (i.e., dispositional empathic concern), provided lower levels of negative support. In addition, for male partners, scoring higher on cognitive empathy (i.e., situational perspective taking) was related to lower levels of negative support provision. For both partners, higher scores on cognitive empathy (i.e., situational perspective taking) correlated with more instrumental support provision. Male providers scoring higher on affective empathy (i.e., situational personal distress) provided higher levels of instrumental support. Dispositional perspective taking was related to higher scores on emotional support provision for male providers. The current study furthers our insight into the empathy-support link, by revealing differential effects (a) for men and women, (b) of both cognitive and affective empathy, and (c) of dispositional as well as situational empathy, on different types of support provision.
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We demonstrate that feature-specific attention allocation influences the way in which repeated exposure modulates implicit and explicit evaluations toward fear-related stimuli. During an exposure procedure, participants were encouraged to assign selective attention either to the evaluative meaning (i.e., Evaluative Condition) or a non-evaluative, semantic feature (i.e., Semantic Condition) of fear-related stimuli. The influence of the exposure procedure was captured by means of a measure of implicit evaluation, explicit evaluative ratings, and a measure of automatic approach/avoidance tendencies. As predicted, the implicit measure of evaluation revealed a reduced expression of evaluations in the Semantic Condition as compared to the Evaluative Condition. Moreover, this effect generalized toward novel objects that were never presented during the exposure procedure. The explicit measure of evaluation mimicked this effect, although it failed to reach conventional levels of statistical significance. No effects were found in terms of automatic approach/avoidance tendencies. Potential implications for the treatment of anxiety disorders are discussed.
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Within the academic literature, a growing awareness is surfacing with regard to wicked socio-ecological problems' resistance to resolution by existing institutions and available expertise being linked to their specific 'hybrid' nature. It is argued that our dominant and deeply rooted Western worldview, with its strict division between, on the one hand, the world of nonhuman objects, science, nature, materiality, etc. and, on the other, the world of human subjects, society, politics, ethics, discourse etc., runs counter to the 'hybridity' of such issues (Goeminne 2011) as they are characterised by an inextricable entanglement of social, political, human aspects and material, technical, natural elements (Latour 2010). ESE researchers have critically described the risks involved in both a Modern, objectivist and a postmodern, subjectivist approach to teaching and learning in the face of such hybrid sustainability issues (e.g. Ashley 2000; Garrison et al. 2015; Van Poeck et al. 2014; Lysgaard and Fjelsted 2015; Van Poeck and Lysgaard 2015) and argue for developing theoretical, methodological as well as didactical frameworks that neither exclusively rely on language, discourse, and notions like social constructivism, nor solely focus on materiality and scientific 'matters of fact'. Instead, an 'other than modern' (Garrison et al. 2015) approach to ESE simultaneously takes into account discourse and materiality. The researchers that collaborate on this symposium contribution are interested in investigating how ESE practices (can) deal with the hybrid character of sustainability issues and how an 'other than modern' educational practice can possibly contribute to satisfactorily tackling wicked, unstructured sustainability issues. In this paper, they develop a conceptual framework in view of this ambition. Drawing on theoretical, epistemological work in the fields of Speculative Realism (Meillasoux, 2007; Bryant, 2013) and Actor Network Theory (Latour 2005), the presented framework should enable ESE researchers to empirically examine didactics and pedagogy in ESE practices as to whether – and, if so, how – the intimate entanglement of social, political, human aspects on the one hand and material, technical, natural elements on the other is reflected in the content of ESE, that is, in the way in which educational practices present and approach the subject matter. Then, they critically discuss the conceptual framework by distinguishing descriptive and prescriptive ways of applying it and illustrate their argument with examples of how topics such as the ecological footprint and the Anthropocene are/can be addresses in ESE.
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Genome-wide association studies (GWAS) of psychiatric disorders have identified multiple genetic associations with such disorders, but better methods are needed to derive the underlying biological mechanisms that these signals indicate. We sought to identify biological pathways in GWAS data from over 60,000 participants from the Psychiatric Genomics Consortium. We developed an analysis framework to rank pathways that requires only summary statistics. We combined this score across disorders to find common pathways across three adult psychiatric disorders: schizophrenia, major depression and bipolar disorder. Histone methylation processes showed the strongest association, and we also found statistically significant evidence for associations with multiple immune and neuronal signaling pathways and with the postsynaptic density. Our study indicates that risk variants for psychiatric disorders aggregate in particular biological pathways and that these pathways are frequently shared between disorders. Our results confirm known mechanisms and suggest several novel insights into the etiology of psychiatric disorders.
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IntroductionThe present study measured the daily correlates of sexual behavior in an ecologically valid context by relying on a daily diary approach. AimExamining the dyadic and multicomponent nature of sexual behavior is essential to create valid models of sexual responding that are better aligned with the day-to-day context of having sex in a relationship. Methods and Main Outcome MeasuresDuring 3 weeks, heterosexual couples completed, two times a day, an electronic diary to report on mood, own and perceived partner behavior, relational feelings (in the evening), sexual activity, physical intimacy, and masturbation (in the morning). This design allowed testing bidirectional temporal associations between daily context and different types of sexual behavior. ResultsPositive mood, displays of positive partner behavior, perceived positive partner behavior, and positive relational feelings predicted more sexual activity and intimacy in men, which then further increased their positive mood, perceived positive partner behavior, and positive feelings about the relationship on the following day. Women showed a similar pattern of predictors regarding sexual activity as men, though the effect of sexual behavior on next-day feelings and behavior was more relationship-oriented rather than affecting personal mood. Intimacy was related to almost all daily variables in women, but related only to own and perceived positive partner behavior and positive relational feelings the next day. Several partner effects also reached significance, and these were more influential in predicting male than female intimacy. Solitary sexual activity showed a different pattern of results than dyadic sexual activity, with men experiencing masturbation as negatively in the context of their relationship. ConclusionThese results confirm the regulatory function of sex and intimacy in maintaining a positive relational climate and indicate that the quality of the everyday relational context is important to get partners in the mood to act in a sexual way. Dewitte M, Van Lankveld J, Vandenberghe S, and Loeys T. Sex in its daily relational context. J Sex Med 2015;12:2436-2450.
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Renal cell carcinoma (RCC) accounts for 90% of all kidney cancers. Due to poor diagnosis, high resistance to the systemic therapies and the fact that most RCC cases occur sporadically, current research switched its focus on studying the molecular mechanisms underlying RCC. The aim is the discovery of new effective and less toxic anti-cancer drugs and novel diagnostic markers. Besides the PI3K/Akt/mTOR, HGF/Met and VHL/hypoxia cellular signaling pathways, the involvement of the Wnt/β-catenin pathway in RCC is commonly studied. Wnt signaling and its targeted genes are known to actively participate in different biological processes during embryonic development and renal cancer. Recently, studies have shown that targeting this pathway by alternating/inhibiting its intracellular signal transduction can reduce cancer cells viability and inhibit their growth. The targets and drugs identified show promising potential to serve as novel RCC therapeutics and prognostic markers. This review aims to summarize the current status quo regarding recent research on RCC focusing on the involvement of the Wnt/β-catenin pathway and how its understanding could facilitate the identification of potential therapeutic targets, new drugs and diagnostic biomarkers.
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The non-Langerhans cell histiocytosis juvenile xanthogranulomatosis (JXG) is usually a benign disease limited to the skin. Only few cases of systemic disease with ≥2 affected organs and lethal outcome have been reported yet. Treatment is controversial and no standard protocol is available. We report the rare case of a 22-month-old boy presenting multiple erythematous-brownish papules of head, trunk and legs which had developed starting from his sixth′ month of life. Additional symptoms were delayed psychomotoric development, hydrocephalus and hepatosplenomegaly. Further diagnostics revealed a systemic JXG with involvement of skin, central nervous system, liver and spleen. The patient did not respond to initial therapy with prednisone and vinblastin according to protocol III for Langerhans cell histiocytosis. However, further therapy with cytarabine and 2-chlorodeoxyadenosine followed by a consolidation phase with 2-chlorodeoxyadenosine alone was successful and the patient is in his 4th year in remission. We provide a comprehensive review of the reported cases with systemic JXG to date.
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Genome-wide identification of transcription factor binding sites with the ChIP-seq method is an extremely important scientific endeavor − one that should ideally be performed for every transcription factor in as many cell types as possible. A major hurdle on the way to this goal is the necessity for a specific, ChIP-grade antibody for each transcription factor of interest, which is often not available. Here, we describe CETCh-seq, a recently published method utilizing genome engineering with the CRISPR/Cas9 system to circumvent the need for a specific antibody. Using the CETCh-seq method, targeted genomic editing results in an epitope-tagged transcription factor, which is recognized by a well-characterized, standard antibody, efficacious for ChIP-seq. We have used CETCh-seq in human cancer cell lines as well as mouse embryonic stem cells. We find that roughly 60% of transcription factors tagged using CETCh-seq produce a high quality ChIP-seq map, a significant improvement over traditional antibody-based methods.
Transcription factors binding to precise locations in the human genome controls cell identity. Over 1,800 genes in humans encode transcription factors, yet only a minority have been assayed for where they bind. We describe CETCh-seq, a method combining CRISPR/Cas9 and epitope tagging to assay a large fraction of factors with ChIP-seq.
RGB-D data collected from Microsoft Kinect are an easily available media providing the additional depth information besides RGB, which has great potentials in improving the performance of the facial analysis applications. In this paper, we focus on facial descriptor extraction from depth channel. First, we design a facial shape descriptor based on local binary patterns encoding from surface normal. The novelty lies in that it considers local structures involved in both inner component and inter-components of surface normal. Second, we propose a tensor representation for histogram arrays embedded in multidimensional space and further use multilinear principal component analysis to obtain an optimal trade-off between efficacy and efficiency. The experiments conducted on two publicly available databases, named CurtinFaces and Eurecom, have demonstrated the promising results achieved by proposed schemes on identity and ethnicity classification.
Time-of-flight (TOF) cameras are sensors that can measure the depths of scene points, by illuminating the scene with a controlled laser or LED source and then analyzing the reflected light. In this paper, we will first describe the underlying measurement principles of time-of-flight cameras, including: (1) pulsed-light cameras, which measure directly the time taken for a light pulse to travel from the device to the object and back again, and (2) continuous-wave-modulated light cameras, which measure the phase difference between the emitted and received signals, and hence obtain the travel time indirectly. We review the main existing designs, including prototypes as well as commercially available devices. We also review the relevant camera calibration principles, and how they are applied to TOF devices. Finally, we discuss the benefits and challenges of combined TOF and color camera systems.
