Reuters Health Information
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Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Τετάρτη 23 Νοεμβρίου 2016
Sirolimus Gel for Tuberous Sclerosis Facial Angiofibromas
Reuters Health Information
http://ift.tt/2ghNs7a
Botulinum toxin treatment for essential palatal tremors presenting with nasal clicks instead of pulsatile tinnitus: a case report
Abstract
Background
In this study, we report a rare case of an adult patient with essential palatal tremors (EPT) presenting as nasal clicks, instead of otic clicks or objective pulsatile tinnitus in common EPT.
Case presentation
Nasal endoscopic examination and EMG recordings of the soft palate muscles were performed to confirm the source of the clicks. Initial treatment with lidocaine provided symptomatic relief for four hours. The patient was then treated with four simultaneous injections of 12.5 U of botulinum toxin in four different sites of the soft palate. Palatal tremors and clicks completely disappeared within three months of treatment.
Conclusions
To our knowledge, this is the first case of EPT that presented with nasal clicks. We recommend that otolaryngologists should expect this rare occurrence in the clinical setting, and handle patients presenting with such symptoms with care and compassion in order not to worsen their psychological status.
http://ift.tt/2g4mpJW
Interactions of GST Polymorphisms in Air Pollution Exposure and Respiratory Diseases and Allergies
Abstract
Purpose of Review
The purpose of this review is to summarize the evidence from recently published original studies investigating how glutathione S-transferase (GST) gene polymorphisms modify the impact of air pollution on asthma, allergic diseases, and lung function.
Recent Findings
Current studies in epidemiological and controlled human experiments found evidence to suggest that GSTs modify the impact of air pollution exposure on respiratory diseases and allergies. Of the nine articles included in this review, all except one identified at least one significant interaction with at least one of glutathione S-transferase pi 1 (GSTP1), glutathione S-transferase mu 1 (GSTM1), or glutathione S-transferase theta 1 (GSTT1) genes and air pollution exposure. The findings of these studies, however, are markedly different. This difference can be partially explained by regional variation in the exposure levels and oxidative potential of different pollutants and by other interactions involving a number of unaccounted environment exposures and multiple genes.
Summary
Although there is evidence of an interaction between GST genes and air pollution exposure for the risk of respiratory disease and allergies, results are not concordant. Further investigations are needed to explore the reasons behind the discordancy.
http://ift.tt/2fqtYMt
Osseointegrated implants into a variety of composite free flaps: A comparative analysis
Abstract
Background
Significant oral function is often lost after surgical therapy for head and neck cancer. The use of osseointegrated implants for reconstruction in patients with head and neck surgery has shown to significantly improve the quality of life for these patients. Variable success rates range from 99% to 70%.
Methods
A retrospective audit of patient records was performed looking at cumulative survival of implants. Inclusion criteria were patients who were treated at 1 of 2 designated Australian Head and Neck Units and received oral osseointegrated implants.
Results
Fifty-nine patients were included for analysis. One hundred ninety-nine implants were placed into vascularized bone grafts (VBGs). There were 11 implant failures with an overall success rate of 94.5%. There was 1 significant adverse outcome with a pathological fracture of a flap after implant placement. Implant success in scapula and iliac crest flaps was comparable to fibula flaps.
Conclusion
Implants placed into VBGs have a reasonable success rate in well-selected patients. © 2016 Wiley Periodicals, Inc. Head Neck, 2016
http://ift.tt/2gKR2Zk
Head and neck surgical subspecialty training in Africa: Sustainable models to improve cancer care in developing countries
Abstract
Background
Cancer poses a health crisis in the developing world where surgery is the mainstay of treatment for head and neck cancers. However, a shortage of surgeons with appropriate skills exists. How do we train head and neck surgeons in developing countries and avoid a brain drain? The ideal model provides appropriate affordable training leading to establishment of head and neck cancer centers that teach and train others.
Methods
Different head and neck surgery training models are presented based on the personal experiences of the authors. Surgical exposure of head and neck fellows in Cape Town and (potentially) in Nairobi is benchmarked against programs in the United States.
Results
Surgical exposure in Cape Town is equivalent to that in the United States, but more appropriate to a developing world setting.
Conclusion
Training can be achieved in a number of ways, which may be complimentary. Fellowship training is possible in developing countries. © 2016 Wiley Periodicals, Inc. Head Neck, 2016
http://ift.tt/2glKUmn
Inhibition of epithelial–mesenchymal transition by cetuximab via the EGFR-GEP100-Arf6-AMAP1 pathway in head and neck cancer
Abstract
Background
Despite improved survival by the addition of a monoclonal antibody against epidermal growth factor receptor (EGFR), cetuximab, to chemotherapy or radiotherapy for squamous cell carcinoma of the head and neck (SCCHN), cetuximab by itself is not a potent antiproliferative agent against SCCHN. We aimed to elucidate working mechanism of cetuximab in SCCHN.
Methods
The effect of cetuximab on the proliferation, migration, invasion, epithelial-mesenchymal transition, and signaling events downstream of the EGFR were investigated in 4 SCCHN cell lines. The in vivo efficacy of cetuximab was evaluated in a xenotransplant model.
Results
Cetuximab inhibited migration, invasion, epithelial-mesenchymal transition, and lymph node metastasis by suppressing EGFR-GEP100-Arf6-AMAP1 pathway, but it did not inhibit cancer cell proliferation.
Conclusion
The improved survival by the addition of cetuximab is likely to be attributable to the antiepithelial-mesenchymal transition action of cetuximab via inhibiting EGFR-GEP100-Arf6-AMAP1 pathway. © 2016 Wiley Periodicals, Inc. Head Neck, 2016
http://ift.tt/2gKShHR
Vγ1+γδT, early cardiac infiltrated innate population dominantly producing IL-4, protect mice against CVB3 myocarditis by modulating IFNγ+ T response
Source:Molecular Immunology, Volume 81
Author(s): Fangfang Wan, Kepeng Yan, Dan Xu, Qian Qian, Hui Liu, Min Li, Wei Xu
Viral myocarditis (VMC) is an inflammation of the myocardium closely associated with Coxsackievirus B3 (CVB3) infection. Vγ1+γδT cells, one of early cardiac infiltrated innate population, were reported to protect CVB3 myocarditis while the precise mechanism not fully addressed. To explore cytokine profiles and kinetics of Vγ1+γδT and mechanism of protection against VMC, flow cytometry was conducted on cardiac Vγ1 cells in C57BL/6 mice following CVB3 infection. The level of cardiac inflammation, transthoracic echocardiography and viral replication were evaluated after monoclonal antibody depletion of Vγ1γδT. We found that Vγ1+γδT cells infiltration peaked in the heart at day3 post CVB3 infection and constituted a minor source of IFN-γ but major producers for early IL-4. Vγ1γδT cells were activated earlier holding a higher IL-4-producing efficiency than CD4+Th cells in the heart. Depletion of Vγ1+γδT resulted in a significantly exacerbated cardiac infiltration, increased T, macrophage and neutrophil population in heart homogenates and worse cardiomyopathy; which was accompanied by a significant expansion of peripheral IFNγ+CD4+ and CD8+T cells. Neutralization of IL-4 in mice resulted in an exacerbated acute myocarditis confirming the IL-4-mediated protective mechanism of Vγ1. Our findings identify a unique property of Vγ1+γδT cells as one dominant early producers of IL-4 upon CVB3 acute infection which is a key mediator to protect mice against acute myocarditis by modulating IFNγ-secreting T response.
http://ift.tt/2g3CJdX
The role of the pharmacy in the management of bronchial asthma
Source:Annals of Allergy, Asthma & Immunology
Author(s): Gianenrico Senna, Marco Caminati, Clara Bovo, Giorgio Walter Canonica, Giovanni Passalacqua
ObjectivePharmacists play a relevant role in the real-life management of asthma because they are a first-line referral for patients. In fact, the role of pharmacies has been underlined and evidenced also in guidelines. Nonetheless, the true effect of pharmacy-based management of asthma has been assessed in only a few studies. We review the available literature on asthma management in a territorial pharmacy setting.Data SourcesThe literature was searched for the keywords pharmacy, bronchial asthma, control, and management.Study SelectionThe available studies were subdivided into observational and interventional and described.ResultsSeven observational studies and 14 interventional trials were found, involving approximately 20,000 individuals. Most of those studies were performed in Europe and Australia. A high proportion of patients had poorly controlled asthma in the observational studies. The active involvement of pharmacists, in the interventional trials, consistently led to an improvement of the quality of life, a better inhalation technique, and a reduction of exacerbations.ConclusionThe literature analysis confirms the relevance of the role of pharmacists in the real-life management of bronchial asthma and underlines the need for a more specific training for those health care professionals.
http://ift.tt/2gLeNQS
Reproducibility and validity of an FFQ to assess usual intake of methyl-group donors
Objective: To develop and validate a novel FFQ to assess the daily intake of four methyl-group donors (methionine, choline, betaine and folate). Design: The relative validity of the FFQ was assessed by comparison with 7 d estimated diet records (n 80) and its reproducibility was evaluated by repeated administrations 6 weeks apart (n 92). Paired Student t tests were used to compare group means and de-attenuated intra-class correlations to investigate the ability of the FFQ to rank individuals according to their methyl-group donor intake. De-attenuated intra-class correlation coefficients were calculated between the test and reference method for methionine, choline, betaine, folate and the sum of methyl-group donors. The weighted kappa (kappa(w)) was calculated as a measure of tertile agreement. Setting: Flanders, Belgium. Subjects: The FFQ was validated among Flemish women of reproductive age (18-35 years). Results: The questionnaire had an acceptable ranking ability (r=0.32-0.68; kappa(w)=0.10-0.35), but overestimated the daily intake of folate (280.6 g v. 212.0 g) and betaine (179.1 mg v. 147.0 mg) compared with the 7 d estimated diet record. Cross-classification analysis indicated that 20 % (choline) of the participants were grossly misclassified in the validation study. The correlation between repeated administrations was good (r=0.62-0.83) with a maximal misclassification of 7 % for betaine (kappa(w)=0.44-0.66). Conclusions: These results indicate that this newly developed FFQ is a reliable instrument with acceptable validity for ranking individuals according to methyl-group donor intake (except for a poor agreement for choline (kappa(w)=0.10) and a fair ranking ability for betaine (r=0.32)) in Flemish women of reproductive age.
http://ift.tt/2f6J5w3
An Unusual Laryngeal Foreign Body in Adult
The accidental aspiration of a foreign body is a frequent domestic accident among children but a rare occurrence in adults. The laryngeal impaction of a coin is an unusual accident; only a few cases have been reported in the literature. Diagnosis is mostly achieved by clinicoradiological examinations. The authors report an uncommon case of laryngeal impaction of a coin in a 21-year-old patient, presenting with dysphonia without dyspnea or stridor. The extraction was performed by endoscopy.
http://ift.tt/2gkbXia
Communication difficulties and the experience of loneliness in patients with cancer dealing with fertility issues: a qualitative study
Purpose/Objectives: To explore communication difficulties and the experience of loneliness among patients with cancer dealing with fertility issues. Design: Qualitative study based on grounded theory principles. Setting: One university hospital and two general hospitals in Flanders, Belgium. Sample: 21 female and 7 male patients with cancer with potential fertility problems as a result of treatment. Methods: Grounded theory approach using the constant comparison method; data collection (semistructured face-to-face interviews) and analysis occurred simultaneously. Findings: Loneliness was a central theme in the experience of potential fertility loss among patients with cancer. Feelings of loneliness resulted from communication difficulties between the patient and members of his or her social environment or healthcare professionals because of several underlying processes and influencing factors. Conclusions: Loneliness was a strong and common feeling among patients with cancer. Patients, members of their social environment, and healthcare professionals experienced difficulties in communicating about fertility in the context of cancer, leading to patients' feelings of loneliness. Implications for Nursing: Healthcare professionals must be attentive to signs indicating loneliness regarding fertility concerns, and they should provide adequate information and appropriate guidance to support patients. Professionals need further training to improve knowledge and skills.
http://ift.tt/2gkpvtW
Plasma elaidic acid level as biomarker of industrial trans fatty acids and risk of weight change: report from the EPIC study
Background : Few epidemiological studies have examined the association between dietary trans fatty acids and weight gain, and the evidence remains inconsistent. The main objective of the study was to investigate the prospective association between biomarker of industrial trans fatty acids and change in weight within the large study European Prospective Investigation into Cancer and Nutrition ( EPIC) cohort. Methods : Baseline plasma fatty acid concentrations were determined in a representative EPIC sample from the 23 participating EPIC centers. A total of 1,945 individuals were followed for a median of 4.9 years to monitor weight change. The association between elaidic acid level and percent change of weight was investigated using a multinomial logistic regression model, adjusted by length of follow- up, age, energy, alcohol, smoking status, physical activity, and region. Results : In women, doubling elaidic acid was associated with a decreased risk of weight loss ( odds ratio ( OR) = 0.69, 95% confidence interval ( CI) = 0.55- 0.88, p = 0.002) and a trend was observed with an increased risk of weight gain during the 5- year follow- up ( OR = 1.23, 95% CI = 0.97- 1.56, p = 0.082) ( p- trend<. 0001). In men, a trend was observed for doubling elaidic acid level and risk of weight loss ( OR = 0.82, 95% CI = 0.66- 1.01, p = 0.062) while no significant association was found with risk of weight gain during the 5- year follow- up ( OR = 1.08, 95% CI = 0.88- 1.33, p = 0.454). No association was found for saturated and cismonounsaturated fatty acids. Conclusions : These data suggest that a high intake of industrial trans fatty acids may decrease the risk of weight loss, particularly in women. Prevention of obesity should consider limiting the consumption of highly processed foods, the main source of industrially- produced trans fatty acids.
http://ift.tt/2froFwj
Reply to: A Phase 2 Randomised Controlled Trial of Nicotinamide for Skin Cancer Chemoprevention in Renal Transplant Recipients
Abstract
We have read with interest the paper by Chen et al. in which oral nicotinamide is used to prevent keratinocyte carcinomas (KC; basal and squamous cell carcinomas of the skin) in renal transplant patients.1 The current study suggests nicotinamide is safe and effective to prevent the development of KC in this high-risk group, similarly to a study by the same group in non-transplant patients (ONTRAC study, Oral Nicotinamide To Reduce Actinic Cancer).
This article is protected by copyright. All rights reserved.
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Systematic review of some prosthetic risk factors for periimplantitis
STATEMENT OF PROBLEM: The recent literature underlines a correlation between plaque and the development of periimplantitis but neglects the importance of the prosthetic factors. PURPOSE: The purpose of this systematic review was to appraise the available literature to evaluate the role played by cement excess and misfitting components on the development of periimplantitis. MATERIAL AND METHODS: An electronic search restricted to the English language was performed in PubMed, Embase, and the Cochrane Register up to September 1, 2014, based on a selected search algorithm. Only cohort studies and case-control studies were included without additional restrictions. The presence of periimplantitis and implant failure were considered primary and secondary outcome variables. RESULTS: The search produced 275 potentially relevant titles, of which only 2 were found eligible. They showed a correlation in cemented implant prostheses between cement excess and the presence of periimplant disease, especially in patients with a history of periodontal disease. After cement excess removal by means of debridement, disease symptoms disappeared around most of the implants. CONCLUSIONS: Scientific articles on prosthetic risk factors for periimplantitis are scarce. Although the studies found on cement remnants have a high risk for bias, cement excess seems to be associated with mucositis and possibly with periimplantitis, especially in patients with a history of periodontal disease.
http://ift.tt/2glNbOg
Using clinical cases to stimulate active learning in a short periodontal continuing professional development course
A case-based approach was used in a two-day periodontal continuing professional development course as a strategy to stimulate active learning. The present study investigates the outcome of this course format in terms of feasibility, perceived efficiency as a learning approach and reported individual learning goals. The study was performed in five identical courses entitled 'risk analysis and treatment in periodontal patients' at Malmö University between 2011-2014. Before the course, clinical cases were used to activate participants' prior knowledge and to attune their focus on the course content. During the course, cases were discussed to synchronise theory with practical application. A pre- and end-course questionnaire were developed to evaluate participants' characteristics (age, clinical expertise, experience and expectations), perceptions on feasibility and instructiveness and emerged individual learning goals. The participants (39 dentists and 78 dental hygienists) reported an average preparation time of 62 minutes (range 2-190) and had positive perceptions on the accessibility, instructiveness and difficulty of cases. Expectations ranged between refreshing, acquiring new knowledge and mastering of the course subject. Most reported learning goals were related to daily clinical practice including the development of a treatment plan, when to continue non-surgical treatment or to extract teeth/perform surgery, the approach to periodontitis, how to motivate non-compliant patients and when to refer. Conclusion: The use of clinical cases to stimulate active learning in a short-term continuing professional development periodontal course was positively perceived by the dentists and dental hygienists in terms of feasibility and learning potential.
http://ift.tt/2gL0PhR
Simplified Impulse Response Characterization for Mode Division Multiplexed Systems
Shi, K; Gomez, A; Jin, X; Jung, Y; Quintana, C; O'Brien, D; Payne, FP; Shi, K; Gomez, A; Jin, X; Jung, Y; Quintana, C; O'Brien, D; Payne, FP; Barua, P; Sahu, J; Kang, Q; Alam, S-U; Richardson, DJ; Thomsen, BC; - view fewer (2016) Simplified Impulse Response Characterization for Mode Division Multiplexed Systems. In: Optical Fiber Communications Conference and Exhibition (OFC), 2016. Institute of Electrical and Electronics Engineers (IEEE) Green open access
http://ift.tt/2glQBk9
Use of Digital Technologies in Education
Male, T; (2016) Use of Digital Technologies in Education. [Editorial comment]. EDucationalFutures , 7 (3) pp. 1-4. Gold open access
http://ift.tt/2gKTJKb
Amine bridges grafted mesoporous silica, as a prolonged/controlled drug release system for the enhanced therapeutic effect of short life drugs
Rehman, F; Ahmed, K; Airoldi, C; Gaisford, S; Buanz, A; Rahim, A; Muhammad, N; Rehman, F; Ahmed, K; Airoldi, C; Gaisford, S; Buanz, A; Rahim, A; Muhammad, N; Volpe, PLO; - view fewer (2017) Amine bridges grafted mesoporous silica, as a prolonged/controlled drug release system for the enhanced therapeutic effect of short life drugs. Materials Science and Engineering: C , 72 pp. 34-41. 10.1016/j.msec.2016.11.040 . (In press).
http://ift.tt/2glKVqi
The design and implementation of a CBT-based intervention for sensory processing difficulties in adolescents on the autism spectrum
Edgington, L; Hill, V; Pellicano, E; (2016) The design and implementation of a CBT-based intervention for sensory processing difficulties in adolescents on the autism spectrum. Research in Developmental Disabilities , 59 pp. 221-233. 10.1016/j.ridd.2016.09.004 .
http://ift.tt/2gL1vDI
European Paediatric Surgeons' Association Survey on the Management of Hirschsprung Disease
Zani, A; Eaton, SJ; Morini, F; Puri, P; Rintala, R; van Heurn, E; Lukac, M; Zani, A; Eaton, SJ; Morini, F; Puri, P; Rintala, R; van Heurn, E; Lukac, M; Bagolan, P; Kuebler, JF; Friedmacher, F; Wijnen, R; Tovar, J; Hoellwarth, M; Pierro, A; - view fewer (2016) European Paediatric Surgeons' Association Survey on the Management of Hirschsprung Disease. European Journal of Pediatric Surgery 10.1055/s-0036-1593991 . (In press).
http://ift.tt/2glHu35
Effectiveness of 1:1 speech and language therapy for older children with (developmental) language disorder
Ebbels, SH; Wright, L; Brockbank, S; Godfrey, C; Harris, C; Leniston, H; Neary, K; Ebbels, SH; Wright, L; Brockbank, S; Godfrey, C; Harris, C; Leniston, H; Neary, K; Nicoll, H; Nicoll, L; Scott, J; Marić, N; - view fewer (2016) Effectiveness of 1:1 speech and language therapy for older children with (developmental) language disorder. International Journal of Language & Communication Disorders 10.1111/1460-6984.12297 . (In press).
http://ift.tt/2gL1vnc
Influence of combusting methane-hydrogen mixtures on compression–ignition engine exhaust emissions and in-cylinder gas composition
Talibi, M; Balachandran, R; Ladommatos, N; (2016) Influence of combusting methane-hydrogen mixtures on compression–ignition engine exhaust emissions and in-cylinder gas composition. International Journal of Hydrogen Energy 10.1016/j.ijhydene.2016.10.049 . (In press).
http://ift.tt/2glP9OD
Mentalization in the Development of Psychotic Disorders
Debbane, M; Salaminios, G; Badoud, D; Fonagy, P; Luyten, P; (2016) Mentalization in the Development of Psychotic Disorders. Early Intervention in Psychiatry , 10 (S1) p. 63. 10.1111/eip.12396 .
http://ift.tt/2gKWv1X
Between Political Emancipation and Creole Hegemony: Viscardo's Letter to the Spanish Americans (c. 1791)
Nunez-Faraco, HR; (2017) Between Political Emancipation and Creole Hegemony: Viscardo's Letter to the Spanish Americans (c. 1791). History of European Ideas 10.1080/01916599.2016.1261256 . (In press).
http://ift.tt/2glLZKH
mTORC1 and mTORC2 regulate skin morphogenesis and epidermal barrier formation
Ding, X; Bloch, W; Iden, S; Rüegg, MA; Hall, MN; Leptin, M; Partridge, L; Ding, X; Bloch, W; Iden, S; Rüegg, MA; Hall, MN; Leptin, M; Partridge, L; Eming, SA; - view fewer (2016) mTORC1 and mTORC2 regulate skin morphogenesis and epidermal barrier formation. Nature Communications , 7 , Article 13226. 10.1038/ncomms13226 . Green open access
http://ift.tt/2gKSjzo
A new mechanism for spatial pattern formation via lateral and protrusion-mediated lateral signalling
Hadjivasiliou, Z; Hunter, GL; Baum, B; (2016) A new mechanism for spatial pattern formation via lateral and protrusion-mediated lateral signalling. Journal of the Royal Society Interface , 13 (124) , Article 20160484. 10.1098/rsif.2016.0484 . Green open access
http://ift.tt/2glQAg5
Identification of priorities for improvement of medication safety in primary care: a PRIORITIZE study
Tudor Car, L; Papachristou, N; Gallagher, J; Samra, R; Wazny, K; El-Khatib, M; Bull, A; Tudor Car, L; Papachristou, N; Gallagher, J; Samra, R; Wazny, K; El-Khatib, M; Bull, A; Majeed, A; Aylin, P; Atun, R; Rudan, I; Car, J; Bell, H; Vincent, C; Franklin, BD; - view fewer (2016) Identification of priorities for improvement of medication safety in primary care: a PRIORITIZE study. BMC Family Practice , 17 , Article 160. 10.1186/s12875-016-0552-6 . Green open access
http://ift.tt/2gKXaAN
The application of ATR-FTIR spectroscopy and multivariate data analysis to study drug crystallisation in the stratum corneum
Goh, CF; Craig, DQ; Hadgraft, J; Lane, ME; (2017) The application of ATR-FTIR spectroscopy and multivariate data analysis to study drug crystallisation in the stratum corneum. European Journal of Pharmaceutics and Biopharmaceutics , 111 pp. 16-25. 10.1016/j.ejpb.2016.10.025 .
http://ift.tt/2glOltj
Shale Gas Flowback Water Desalination: Single vs Multiple-effect evaporation with Vapor Recompression Cycle and Thermal Integration
Onishi, VC; Carrero-Parreño, A; Reyes-Labarta, JA; Ruiz-Femenia, R; Salcedo-Díaz, R; Fraga, ES; Caballero, JA; (2017) Shale Gas Flowback Water Desalination: Single vs Multiple-effect evaporation with Vapor Recompression Cycle and Thermal Integration. Desalination , 404 pp. 230-248. 10.1016/j.desal.2016.11.003 . (In press). Green open access
http://ift.tt/2gKQbrA
The psychotropic education and knowledge test for nurses in nursing homes: striving for PEAK performance
Objectives: The psychotropic education and knowledge test for nurses in acute geriatric care (PEAK-AC) measures knowledge of psychotropic indications, doses and adverse drug reactions in older inpatients. Given the low internal consistency and poor discrimination of certain items, this study aims to adapt the PEAK-AC, validate it in the nursing home setting and identify factors related to nurses' knowledge of psychotropics. Method: This study included nurses and nurse assistants employed by nursing homes (n = 13) and nursing students at educational institutions (n = 5) in Belgium. A Delphi technique was used to establish content validity, the known groups technique for construct validity (n respondents = 550) and the test-retest procedure for reliability (n respondents = 42). Internal consistency and item analysis were determined. Results: The psychotropic education and knowledge test for nurses in nursing homes (PEAK-NH) (n items = 19) demonstrated reliability (k = 0.641) and internal consistency (Cronbach's alpha = 0.773). Significant differences between group median scores were observed by function (p < 0.001), gender (p = 0.019), educational background (p < 0.001), work experience (p = 0.008) and continuing education (p < 0.001) for depression, delirium and pharmacotherapy topics. Items were acceptably difficult (n items = 15) and well-functioning discriminators (n items = 17). Median PEAK-NH score was 9/19 points (interquartile range 6-11 points). Respondents' own estimated knowledge was related to their PEAK-NH performance (p < 0.001). Conclusion: The PEAK-NH is a valid and reliable instrument to measure nurses' knowledge of psychotropics. These results suggest that nurses have limited knowledge of psychotropic use in nursing homes and are aware of their knowledge deficits. The PEAK-NH enables educational initiatives to be targeted and their impact on nurses' knowledge to be tracked.
http://ift.tt/2gfzKON
A Phase II Study of Pembrolizumab in Refractory Advanced Esophageal Cancer
Conditions: Esophageal Cancer; Squamous Cell Esophagus Cancer; Adenocarcinoma Esophagus
Intervention: Drug: Pembrolizumab
Sponsors: Dana-Farber Cancer Institute; Merck Sharp & Dohme Corp.
Not yet recruiting - verified November 2016
http://ift.tt/2f6pvjC
Intervention: Drug: Pembrolizumab
Sponsors: Dana-Farber Cancer Institute; Merck Sharp & Dohme Corp.
Not yet recruiting - verified November 2016
http://ift.tt/2f6pvjC
Cognitive Style and Mobile Technology in E-learning in Undergraduate Medical Education
Condition: Medical Education
Intervention: Other: mobile technology of e-learning (M-TEL)
Sponsors: Chang Gung Memorial Hospital; Ministry of Science and Technology, Taiwan
Not yet recruiting - verified November 2016
http://ift.tt/2foFULK
Intervention: Other: mobile technology of e-learning (M-TEL)
Sponsors: Chang Gung Memorial Hospital; Ministry of Science and Technology, Taiwan
Not yet recruiting - verified November 2016
http://ift.tt/2foFULK
Chemoradiation Versus Esophagectomy for Locally Advanced Esophageal Cancer
Condition: Esophagus Cancer
Interventions: Procedure: CRT; Procedure: surgery
Sponsors: The First Affiliated Hospital of Henan University of Science and Technology; Jiangsu HengRui Medicine Co., Ltd.; Anyang Tumor Hospital; 150th Hospital of PLA
Not yet recruiting - verified November 2016
http://ift.tt/2f6rTa3
Interventions: Procedure: CRT; Procedure: surgery
Sponsors: The First Affiliated Hospital of Henan University of Science and Technology; Jiangsu HengRui Medicine Co., Ltd.; Anyang Tumor Hospital; 150th Hospital of PLA
Not yet recruiting - verified November 2016
http://ift.tt/2f6rTa3
Seborrheic Keratoses as the First Sign of Bladder Carcinoma: Case Report of Leser-Trélat Sign in a Rare Association with Urinary Tract Cancer
Introduction. Skin disorders can be the first manifestation of occult diseases. The recognition of typical paraneoplastic dermatoses may anticipate the cancer diagnosis and improve its prognosis. Although rarely observed, the sudden appearance and/or rapid increase in number and size of seborrheic keratoses can be associated with malignant neoplasms, known as the sign of Leser-Trélat. The aim of this report is to unveil a case of a patient whose recently erupted seborrheic keratoses led to investigation and consequent diagnosis of bladder cancer. Case Presentation. A 67-year-old man was admitted to the intensive care unit due to an exacerbation of chronic obstructive pulmonary disease (COPD). On physical examination, multiple seborrheic keratoses on the back of the hands, elbows, and trunk were observed; the patient had a 4-month history of these lesions yet was asymptomatic. The possibility of Leser-Trélat syndrome justified the investigation for neoplasia, and a bladder carcinoma was detected by CT-scan. The patient denied previous hematuria or any other related symptoms. Many of the lesions regressed during oncologic treatment. Conclusion. Despite the critics on the validity of the sign of Leser-Trélat, our patient fulfills the description of the disease, though urinary malignancy is a rare association. That corroborates the need of further investigation when there is a possibility of paraneoplastic manifestation.
http://ift.tt/2gkezg6
Traumatic Pseudoaneurysm of the Internal Maxillary Artery: A Rare Life-Threatening Hemorrhage as a Complication of Maxillofacial Fractures
Pseudoaneurysm of the internal maxillary artery due to a traumatic event is a rare condition. Pseudoaneurysms are usually directly produced by arteries break with extravasation of blood. The compressed perivascular tissue forms the wall of aneurysmal sac. Then, this sac gradually expands and can be damaged. It is rare to see pseudoaneurysms of IMA. They are usually associated with fracture of the neck of the mandible. To the best of our knowledge the pseudoaneurysm of the internal maxillary artery related to maxillofacial trauma is an event extremely rare in the literature and if not quickly managed can lead to the patient's death. This case underlines how the close cooperation between surgeons and radiologists results in a quick diagnosis and management of such pathological events.
http://ift.tt/2fr6o2l
Evidence of microbiota dysbiosis in chronic rhinosinusitis
Background
Despite considerable research, the pathogenesis of chronic rhinosinusitis (CRS) remains poorly understood. Potential microbial roles in the etiology or progression of CRS have long been hypothesized, yet few specific associations have been identified. In this study we investigate associations between patterns in resident bacterial communities and clinical variants of CRS.
Methods
Bacterial communities were assessed in 94 patients with extensive bilateral CRS undergoing endoscopic sinus surgery (ESS) and 29 controls undergoing ESS for indications other than CRS. Patients were grouped on the basis of phenotypic variants (with or without polyposis) and clinical parameters, including asthma and cystic fibrosis. Bacterial communities were characterized via 16S rRNA gene amplicon sequencing, and quantified by quantitative polymerase chain reaction.
Results
Controls and idiopathic CRS subjects tended to be dominated by members of the genera Corynebacterium and Staphylococcus, together with lower abundances of several other genera, including Streptococcus, Moraxella, and Haemophilus. Aberrant (dysbiotic) bacterial assemblages (with changes in community membership and structure, reduced diversity, and increased bacterial load) and increased inter- and intrasubject variability were more common in subjects with comorbidities such as asthma and cystic fibrosis. Dysbiotic communities were variably dominated by members of the genera Staphylococcus, Streptococcus, Haemophilus, Pseudomonas, Moraxella, or Fusobacterium.
Conclusion
Bacterial community dysbiosis was more apparent than specific associations with examined phenotypes or endotypes, and may play a role in the pathogenesis or influence the severity of CRS. Reductions in several common core bacterial taxa, increased inter- and intrasubject variability, reduced bacterial diversity, and increased bacterial load characterized aberrant bacterial communities in CRS.
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Sinus surgery can improve quality of life, lung infections, and lung function in patients with primary ciliary dyskinesia
Background
Chronic rhinosinusitis (CRS) and bacterial sinusitis are ubiquitous in patients with primary ciliary dyskinesia (PCD). From the sinuses, Pseudomonas aeruginosa can infect the lungs.
Methods
We studied the effect of endoscopic sinus surgery (ESS) on symptoms of CRS and lower airway infections in PCD patients in a prospective single-arm intervention study of ESS with adjuvant therapy using nasal irrigation with saline, topical nasal steroids, and 2 weeks of systemic antibiotics. Additional treatment with local colistin for 6 months was instigated when P. aeruginosa was cultured at ESS.
Results
Twenty-four PCD patients underwent ESS to search for an infectious focus (n = 10), due to severe symptoms of CRS (n = 8), or both (n = 6). Bacteria were cultured from sinus samples in 21 patients (88%), and simultaneous sinus and lung colonization with identical pathogens were observed in 13 patients (62%). Four patients with preoperative P. aeruginosa lung colonization (25%) had no regrowth during follow-up; 2 of these had P. aeruginosa sinusitis. Sinonasal symptoms were improved 12 months after ESS and we observed a trend toward better lung function after ESS.
Conclusion
We demonstrated an improvement in CRS-related symptoms after ESS and adjuvant therapy. In selected PCD patients, the suggested regimen may postpone chronic lung infection with P. aeruginosa and stabilize lung function.
http://ift.tt/2ggNOLx
Effect of resveratrol and orchidectomy on the vasorelaxing influence of perivascular adipose tissue
Perivascular adipose tissue (PVAT) releases several adipo(cyto)kines. Some are vasoactive substances that elicit a net beneficial anticontractile effect. Resveratrol and testosterone are known to modulate adipo(cyto)kine release from adipose tissue and could therefore influence the anticontractile effect of PVAT. In vitro tension measurements were performed using thoracic aorta segments with and without adipose tissue from sham-operated or orchidectomized male Swiss mice. Concentration-response curves to norepinephrine (NOR) were constructed in the presence and absence of resveratrol (10 mu M, 15 min) or the relaxant effect of resveratrol (10-100 mu M) was investigated after inducing tone with NOR (5 mu M). Aortas with PVAT displayed significantly attenuated contractions to NOR compared with aortas without PVAT. In aortas without PVAT, resveratrol (10 mu M) significantly decreased NOR responses and elicited concentration-dependent (10-100 A mu M) relaxations. However, in aortas with adherent PVAT, resveratrol (10 mu M) neither decreased NOR responses, nor did resveratrol (10-100 A mu M) induce arterial relaxations. The anticontractile effect of PVAT was less pronounced in the presence of resveratrol and unaltered by orchidectomy. Orchidectomy did not influence contractions induced by NOR. Orchidectomy does not modulate the anticontractile capacity of PVAT, while resveratrol decreases the vasorelaxing influence of PVAT. The positive effects associated with resveratrol addition are neutralized by the presence of PVAT. This is thought to result from a dual effect of resveratrol: (1) inhibition of the influence of vasodilatory adipo(cyto)kines and (2) a direct relaxant effect on the vascular smooth muscle. Overall, the beneficial relaxing effect of resveratrol is lost in mice thoracic aorta surrounded by PVAT.
http://ift.tt/2g3bpfx
An empirical study of the effectiveness of telepresence as a business meeting mode
Telepresence is a technology that has emerged as a promising mode for conducting business meetings with distributed participants, since it enables an immersive lifelike experience. However, telepresence meetings are substantially more expensive than audio- and video-conferencing meetings. This paper examines the justification of using telepresence for meetings. Based on an extensive literature review, two research questions about the effectiveness of telepresence for achieving meeting objectives are formulated. These are then addressed in an empirical study consisting of two phases, conducted in a large multinational corporation in which telepresence is widely used. In Phase 1, a list of meeting objectives is compiled. In Phase 2, the effectiveness of telepresence is analyzed relative to audio-conferencing, video-conferencing, and face-to-face for these objectives, based on input from 392 meeting organizers. The results of the analysis indicate that although the effectiveness of telepresence is higher than the effectiveness of audio- and video-conferencing for several meeting objectives, it is not significantly different from the effectiveness of face-to-face for any objective.
http://ift.tt/2fRa9Pf
Accurate quantification of episomal HIV-1 two-long terminal repeat circles by use of optimized DNA isolation and droplet digital PCR
Episomal HIV-1 two-long terminal repeat (2-LTR) circles are considered markers for ongoing viral replication. Two sample processing procedures were compared to accurately quantify 2-LTR in patients by using droplet digital PCR (ddPCR). Here, we show that plasmid isolation with a spiked non-HIV plasmid for normalization enables more accurate 2-LTR quantification than genomic DNA isolation.
http://ift.tt/2fRa4ed
Crusted impetigo-like lesion on the face: A case of IgG/IgA pemphigus
In recent years, cases of IgG/IgA pemphigus, a rare subtype of pemphigus characterized by circulating IgG and IgA autoantibodies against the keratinocyte cell surface have been reported.1-6 The cutaneous manifestations of IgG/IgA pemphigus were reported to resemble those of IgA pemphigus in form, including the presence of pustules and annular lesions.1 However, no consensus on what eruptions are typical of IgG/IgA pemphigus has been established, due to the rarity of this disease. In this report, we describe a case of IgG/IgA pemphigus who developed severe crusted lesions on the seborrheic area that closely resembled facial crusted impetigo.
This article is protected by copyright. All rights reserved.
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Quality of Life Measurement in Atopic Dermatitis. Position Paper of the European Academy of Dermatology and Venereology (EADV) Task Force on Quality of Life
Abstract
There is a need for researchers to have easy reference to the wide spectrum of different types of quality of life (QoL) instruments that can be used in atopic dermatitis (AD). Previous reviews on QoL in AD do not cover the full spectrum of QoL measures used in studies on AD. This paper, on behalf of the European Academy of Dermatology and Venereology (EADV) Task Force on QoL contains information on instruments available for health-related QoL and family QoL assessment in AD including information on validation, experience of QoL assessment in AD for different purposes, peculiarities of QoL assessment in different age groups, expert analysis of available instruments including data on limitations of their use and recommendations of the Task Force.
This article is protected by copyright. All rights reserved.
http://ift.tt/2gKFDbU
Epidemiological, dermoscopical and pathological evaluation of melanocytic lesions of the buttock in a 5-year period: a female prevalence
A self-assessment of the skin plays a pivotal role in the early diagnosis of melanoma. However, when pigmented lesions are located on hidden areas or on locations that are difficult to self-examine, their assessment becomes more difficult.
This article is protected by copyright. All rights reserved.
http://ift.tt/2glBHue
Do employer preferences contribute to sticky floors?
We investigate the importance of employer preferences in explaining Sticky Floors, the pattern that women are, compared to men, less likely to start to climb the job ladder. To this end we perform a randomised field experiment in the Belgian labour market and test whether hiring discrimination based on gender is heterogeneous by whether or not jobs imply a promotion (in comparison with employees' current position). We find that women get 33% less interview invitations when they apply for jobs implying a first promotion in functional level. On the other hand, their hiring chances are not significantly affected by the job authority level of the job.
http://ift.tt/1S0Sw8k
Anti-CD81 but not anti-SR-BI blocks Plasmodium falciparum liver infection in a humanized mouse model
Objectives: Plasmodium falciparum sporozoites, deposited in the skin by infected Anopheles mosquitoes taking a blood meal, cross the endothelium of skin capillaries and travel to the liver where they traverse Kupffer cells and hepatocytes to finally invade a small number of the latter. In hepatocytes, sporozoites replicate, differentiate and give rise to large numbers of merozoites that are released into the bloodstream where they invade red blood cells, thus initiating the symptomatic blood stage. Using in vitro systems and rodent models, it has been shown that the hepatocyte receptors CD81 and scavenger receptor type B class I (SR-BI) play a pivotal role during sporozoite invasion. We wanted to evaluate whether these two entry factors are genuine drug targets for the prevention of P. falciparum infection in humans. Methods: Immunodeficient mice of which the liver is largely repopulated by human hepatocytes were treated with monoclonal antibodies blocking either CD81 or SR-BI 1 day prior to challenge with infected mosquitoes. P. falciparum infection of the liver was demonstrated using a qPCR assay. Results: In human liver chimeric mice, an antibody directed against CD81 completely blocked P. falciparum sporozoite invasion while SR-BI-specific monoclonal antibodies did not influence in vivo infection. Conclusions: These observations confirm the role of CD81 in liver-stage malaria and question that of SR-BI. CD81 might be a valuable drug target for the prevention of malaria.
http://ift.tt/2fR679z
Mixing studies in lupus anticoagulant testing are required at least in some type of samples
BackgroundAccording to the ISTH guidelines for lupus anticoagulant (LAC) testing, the second step in the three-step procedure (screening, mixing, and confirmation) is the mixing test, which improves the discrimination between the presence of an inhibitor and coagulation factor deficiencies such as those occurring in patients receiving vitamin K antagonists (VKAs). ObjectivesFrom a retrospective analysis of dilute Russell viper venom (dRVVT) results, we evaluated the impact of the mixing test result on the interpretation of LAC positivity. MethodsWe interpreted the dRVVT clotting times with and without taking into account the results of the mixing test in a patient population with prolonged screening test (n=267) with special attention to the patients receiving VKAs. Results and conclusionsThe number of samples classified as LAC positive' differed substantially depending on the method of interpretation; 170 and 235 of 267 samples were classified as LAC positive with the three- and two-step procedure, respectively. Discrepancy between the two-step (without mixing step) and the three-step procedure was due to not including a mixing test and was more pronounced in the VKA patient population. Screen/confirm ratios carried out on a 1:1 mix of patient and normal pooled plasma (NPP) gave a lower incidence of 59 of 267. We advise continuing to perform mixing test to avoid false-positives. In patients with discrepant results between the two- and three-step dRVVT interpretation, mainly observed in VKA-treated patients, we advise retesting of the patients preferable beyond the period of anticoagulant therapy and additional testing for anti-beta2GPI and/or anti-cardiolipin antibodies.
http://ift.tt/2g39oQQ
Evaluation of Copan FLOQSwab for the molecular detection of Chlamydia trachomatis by Abbott RealTime CT PCR
Objectives: We evaluated Copan FLOQSwabs next to Abbott swabs for the detection of Chlamydia trachomatis (CT) by Abbott RealTime PCR. Methods: We collected 1062 paired swabs from female sex workers. The study was divided in two arms, according to the order of swab collection. Results: If the Abbott swab was collected first, 501 couples were concordant and two discordant (Abbott negative and Copan positive). If the Copan swab was collected first, 537 couples were concordant and 10 discordant (eight Abbott negative and Copan positive and two Abbott positive and Copan negative). All discordant samples contained low levels of C. trachomatis. Technical issues lead to retesting of 64 Copan and 21 Abbott swabs. Conclusion: Our results show that Copan FLOQSwabs can be used interchangeably with Abbott swabs. While appearing to have an advantage in detecting more positive samples, the use of Copan swabs led to a higher retesting rate due to technical errors.
http://ift.tt/2fR6Ojc
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