Publication date: Available online 31 October 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Isabela de Oliveira Amui, José Vicente Tagliarini, Emanuel C. Castilho, Mariângela de Alencar Marques, Yoshio Kiy, José Eduardo Corrente, Gláucia M.F.S. Mazeto
IntroductionEndogenous thyroid-stimulating hormone-stimulated thyroglobulin collected after total thyroidectomy is a useful predictor of better prognosis in patients with differentiated thyroid carcinomas in general, but studies with microcarcinomas are scarce.ObjectiveTo assess whether the first postoperative stimulated thyroglobulin measurement is a prognostic factor in patients with microcarcinoma.MethodsThe medical data of 150 differentiated thyroid carcinoma patients were studied retrospectively, and 54 (36%) cases with microcarcinoma were selected. The first postoperative stimulated thyroglobulin (1st stimulated thyroglobulin), measured after thyroidectomy, initial presentation data, and microcarcinomas treatment were assessed regarding outcome. Worse prognosis was defined as neoplasm persistence/recurrence.ResultsPersistence/recurrence occurred in 27.6% of the cases. These patients were identified according to the following parameters: receiving more than one 131iodine dose (100% vs. 0%; p<0.0001); accumulated 131iodine dose (232.14±99.09 vs. 144±33.61mCi; p<0.0001); presented active disease in the last assessment (53.3% vs. 0%; p<0.0001); follow-up time (103.07±61.27 vs. 66.85±70.14 months; p=0.019); and 1st stimulated thyroglobulin (19.01±44.18 vs. 2.19±2.54ng/dL; p<0.0001). After multivariate logistic regression, only the 1stSTg [odds ratio=1.242; 95% confidence interval: 1.022–1.509; p=0.029] and follow-up time (odds ratio=1.027; 95% confidence interval: 1.007–1.048; p=0.007) were independent predictors of risk of persistence/recurrence. The cutoff point of 1.6ng/dL for the 1st stimulated thyroglobulin was significantly associated with disease persistence/recurrence [area under the curve=0.713 (p=0.019)].ConclusionThe first stimulated thyroglobulin predicted disease persistence/recurrence in patients with microcarcinoma.
http://ift.tt/2z2gb9A
Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Τρίτη 31 Οκτωβρίου 2017
The first postoperative-stimulated serum thyroglobulin is a prognostic factor for thyroid microcarcinomas
Downregulation of Notch4 – a prognostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma
Publication date: Available online 31 October 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): M.K. Harishankar, A. Mathan Mohan, A. Vinod Krishnan, Devi Arikketh
IntroductionOral verrucous carcinoma is a special form of well-differentiated squamous cell carcinoma which possesses specific clinical, morphologic and cytokinetic features that differ from other types of oral cancers and hence diagnosis requires immense experience in histopathology. Hence it is certainly important to distinguish such a lesion from other oral tumors as treatment strategies vary widely between them.ObjectiveIn search of a critical diagnostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma, Notch4 receptor, one of the key regulatory molecules of the Notch signaling family has been aberrantly activated in the progression of several types of tumors. However its function in oral verrucous carcinoma remains unexplored. Thus the present study aims in determining the differential expression pattern of Notch4 in oral verrucous carcinoma and oral squamous cell carcinoma.MethodsTen patients reported positive for oral cancer (5 patients with oral verrucous carcinoma and 5 patients with oral squamous cell carcinoma). Five normal tissue samples were also obtained and evaluated for clinicopathological parameters and immunohistochemistry, western blotting and RT-PCR for Notch4 expression.ResultsOur results reveal that the expression of Notch4 was considerably high in oral squamous cell carcinoma lesions compared to normal tissue, whereas in oral verrucous carcinoma, irrespective of the clinicopathological features, complete regulação descendente of Notch4 was observed.ConclusionsThese preliminary findings strongly support the fact that Notch4 is downregulated in oral verrucous carcinoma and could be considered as a suitable prognostic marker in distinguishing oral verrucous carcinoma from oral squamous cell carcinoma. This distinguishing marker can help in improving therapeutic options in patients diagnosed with oral verrucous carcinoma.
http://ift.tt/2h1ZbJx
Clinicopathologic characteristics of early-onset Becker's nevus in Korean children and adolescents
Abstract
Background
Becker's nevus (BN) presents as a hairy patch or plaque with or without proliferation of the dermal smooth muscles. BN has been described as acquired as found in a similar entity, congenital smooth muscle hamartoma (CSMH). This study was aimed at evaluating the clinicopathological aspects of BN in Korean cases in differential diagnosis with CSMH.
Methods
We performed a retrospective study of 103 patients histopathologically diagnosed as having BN or CSMH. The cases included 40 cases diagnosed with BN or CSMH before the age of 10 years who had clinical monitoring and a second skin biopsy after puberty to determine the disease course.
Results
Among cases of children to adolescents (<18 years), we observed a slight male predominance. Among children aged <14 years, sex ratio converged at 1:1. Early-onset BN showed a female predominance and hyperpigmented skin lesions. All BN cases showed hyperpigmentation, and face and neck involvement tended to make severe cosmetic concerns. In contrast, hypertrichosis was more frequent in CSMH. Either skin-colored lesion or pseudo-Darier's sign was not seen in early-onset BN. BN showed less dermal smooth muscle than CSMH.
Conclusions
Androgens themselves do not seem to be related to the development of BN but play only an aggravating role especially in male patients. Considering high occurrence in exposed areas, BN may distress patients severely. As early laser treatment may be helpful in some patients with BN, early-onset BN in comparison to CSMH should be diagnosed appropriately.
http://ift.tt/2A6Luhg
Furuncular myiasis for the Western dermatologist: treatment in outpatient consultation
Abstract
Background
Furuncular myiasis is likely to be seen by Western dermatologists because of the increasing number of international travelers but remains unfamiliar to most of them, who tend to refer these patients to hospitals. Different treatments have been proposed, but many of them are not achievable in outpatient consultation.
Methods
We reported three typical cases of furuncular myiasis, according to each species involved, and proposed diagnostic and therapeutic guidelines for dermatologists in outpatient consultation.
Results
One patient, complaining of an inflammatory nodule of the leg with a central punctum, was diagnosed with Dermatobia hominis infection, after a forest walk in French Guiana. One woman returned from Senegal with a nodule of the left buttock. She had been infected by a Cordylobia anthropophaga larva after drying her underwear under a mango tree. One woman living in Cameroon presented with scalp nodules, pain, fatigue, and facial edema. She had been infected by more than 40 larvae of Cordylobia rodhaini after drying her sheets under a mango tree. Manual extraction ensured complete healing in the three patients. We used neither doppler ultrasound nor occlusive dressing. Diagnosis was immediately made thanks to the typical clinical stories.
Conclusions
The diagnosis of furuncular myiasis requires only clinical skills and basic knowledge of life cycles. The treatment varies slightly depending on the species involved but is achievable in outpatient consultation and does not require occlusive dressing.
http://ift.tt/2A63Vmn
Multiple epidermolytic acanthomas mimicking condyloma: a retrospective study of 8 cases
Abstract
Background
Epidermolytic acanthoma (EA) is an uncommon benign cutaneous lesion. Multiple epidermolytic acanthomas (multiple EAs) are rarely reported.
Methods
We retrospectively identified patients diagnosed with multiple EAs between 2005 and 2017 from our dermatopathology database and analyzed their clinical, pathological, and immunohistochemical features. We also evaluated the association of multiple EAs with human papillomavirus (HPV) infection.
Results
In total, eight patients (average age 51 years; 3 : 1 male predominance) with multiple EAs were found. All patients had lesions on the genitocrural area. The two most common clinical diagnoses were condyloma (5/8) and soft fibroma (3/8), which were predominantly skin-colored (5/8) or whitish (2/8). The lesions were less than 1 cm in diameter, and most (6/8) appeared to have a smooth surface. No molecular evidence suggesting HPV infection was found. Immunohistochemical staining showed low mitotic activity. The lesions were removed in one of two patients via cryotherapy, and one patient was treated with electrocauterization. The other five patients were followed without treatment.
Conclusion
The genital area was the most common location for multiple EAs, which was commonly misdiagnosed clinically as condyloma. Patients presenting with uniformly small-sized, skin-colored to whitish, smooth papular lesions in the genitalia should be carefully evaluated. The specific pathological features of epidermolytic hyperkeratosis are diagnostic, and the lesions can be observed without aggressive treatment after confirmed diagnosis.
http://ift.tt/2xIA4Pc
A narrative review of dermatologic protocols for primary care medical service trips in Latin America and the Caribbean
Abstract
Background
Skin disorders are prevalent on primary care medical service trips in Latin America and the Caribbean and commonly include scabies, superficial mycoses, and pyoderma. There have been no previous attempts to describe protocols that international volunteer clinicians use in managing these patients. The purpose of this study was to collect North American clinical protocols used by sending organizations in their volunteer operations in Latin America and the Caribbean, summarize the most common pharmacologic and nonpharmacologic management strategies, and compare these to published international practice recommendations.
Methods
A systematic web search was used to identify North American medical service trip-sending organizations. Clinical protocols were downloaded from their websites, and organizations were directly contacted to request protocols that were not published online. The protocols obtained were summarized, analyzed thematically, and compared to existing international guidelines.
Results
Of 225 organizations contacted, 112 (49.8%) responded, and 31 of these (27.7%) claimed to possess protocols for their trips, of which 20 were obtained and analyzed. Ten (50%) protocols discussed scabies, eight (40%) discussed superficial mycoses, and five (25%) discussed pyoderma. The protocols discussed clinical assessment, pharmacologic and nonpharmacologic management with variable degrees of accuracy and thoroughness, and with important omissions when compared to international guidelines. None were the product of systematic literature searches, and most were not referenced.
Conclusions
To avoid ineffective treatment and related harms, context-specific clinical guidelines are needed for volunteer clinicians practicing in remote international settings, and such guidelines should be based on best evidence and stakeholder consensus.
http://ift.tt/2A6LptY
Ethnic variations in the epidemiology of bullous pemphigoid in Israel
Abstract
Background
No ethnic or geographic predisposition to bullous pemphigoid (BP) was reported so far.
Objective
To evaluate trends in the incidence of BP in northern Israel, shedding light on differences between two distinct ethnic populations who inhabit the same region, namely Jews and Arabs.
Methods
Bullous pemphigoid incidence was retrospectively estimated from January 2000–December 2015 in two Israeli regions with a total population of 1.56 million inhabitants.
Results
A total of 287 new-onset BP patients (mean age: 77.6 ± 12.1) were identified. The incidence rate was 11.4 per million inhabitants per year (95% CI, 10.2–12.9). The crude incidence rate in Jews was 4.8-fold higher than that in Arabs (16.4 vs. 3.4 cases per million per year, respectively [P < 0.0001]). After adjusting for age, the discrepancy between the two populations diminished (11.7 vs. 8.9 cases per million per year, respectively) but remained statistically significant (P = 0.032). The incidence increased consistently from 7.6 cases per million per year in the calendar period 2000–2005 to 12.6 and 14.3 cases in 2006–2010 and 2011–2015, respectively (P < 0.0001). Bullous pemphigoid patients of Arab ancestry presented with the disease significantly earlier than Jews (69.5 ± 15.3 vs. 78.7 ± 11.1 years, respectively, P = 0.002).
Conclusions
The incidence of BP in northern Israel has increased in the last 16 years and is significantly higher among Jews compared to Arabs. The age of presentation is remarkably different between patients belonging to the two populations.
http://ift.tt/2xKpKpT
Cross-sectional study of Treponema pallidum PCR in diagnosis of primary and secondary syphilis
Abstract
Background
Syphilis remains a major challenge and a complex diagnosis. We aim to evaluate the role of polymerase chain reaction (PCR) in Treponema pallidum (Tp) detection in various types of biological samples in the diagnosis of early syphilis.
Methods
We conducted a cross-sectional study including all attendees of the STI clinic with clinical suspicion of early syphilis. One or more specimens for the detection of Tp by PCR testing were collected.
Results
The overall sensitivity of Tp PCR test was 82.61% (95% CI: 68.6–92.2%). Tp PCR test had sensitivity of 84.6% (95% CI: 54.6–98.1%) in primary syphilis cases and 81.8% (95% CI: 64.5–93%) in secondary syphilis cases. PCR test performance was independent of HIV status.
Conclusion
Tp PCR test is a fast and reliable method for the detection of Tp in skin lesions of early syphilis, and it is a powerful tool in clinical settings.
http://ift.tt/2A63SqH
Prospective, pilot evaluation of the performance of nanofractional radiofrequency for improvement of skin texture via skin resurfacing
Summary
Background
The latest generation of radiofrequency, nanofractional radiofrequency, allows the heat energy to be delivered through the use of pins or needles as electrodes, facilitating increased efficacy and reduced pain, downtime, and side effects.
Objective
The objective of this prospective pilot clinical study was to evaluate the efficacy of nanofractional radiofrequency in skin resurfacing.
Methods and materials
Seventeen subjects were enrolled in the study, and each received three nanofractional radiofrequency (160-pin tip) treatments in the facial area at 3-week intervals. Follow-up visits were scheduled at 1 and 2 months after the final treatment. Clinical photography, patient, and investigator assessments were conducted during the treatment visits and follow-up.
Results
All subjects completed the study. At the 1- and 2-month follow-up, there was a moderate to significant improvement (2.6 and 3.5, respectively, P = .01) according to the investigator global esthetic improvement scale rating. Most subjects reported that they were satisfied or very satisfied with the outcome and level of comfort.
Conclusion
Nanofractional radiofrequency is a safe and effective strategy for improving texture, tone, and skin laxity with high patient satisfaction and tolerable safety profile.
http://ift.tt/2zXRnMG
Selected highlights in clinical anesthesia research
To review research highlights of manuscripts published in 2016 that pertain to all aspects of the clinical practice of anesthesiology.
http://ift.tt/2xGm6gx
Oncocytic carcinoma of the salivary glands: A Danish national study
To present a Danish national series of oncocytic carcinoma (OC) patients, including data on treatment, recurrence and survival.
http://ift.tt/2yk7N5W
Factors affecting the effect of physical rehabilitation therapy for synkinesis as a sequela to facial nerve palsy
To investigate factors affecting the effect of physical rehabilitation therapy for synkinesis as a sequela to facial nerve palsy.
http://ift.tt/2lAze5j
Visually augmented targeted combination light therapy for acne vulgaris: a case report
Acne vulgaris is a common skin disease. Pharmacological modalities for treatment are proven to be efficacious but have limitations. Light therapy for acne vulgaris has shown promise in previous studies. This c...
http://ift.tt/2yhVGpH
Paraganglioma in the bladder: a case report
Paraganglioma is an extra site of pheochromocytoma. Paraganglioma in the bladder is a very rare disease accounting for 0.06% of all bladder tumors.
http://ift.tt/2lB4XmT
Adjuvant BRAF and MEK Inhibition for Melanoma: 'Impressive'
New at ESMO 2017, adjuvant dabrafenib/trametinib in stage III melanoma shows 'impressive' results in relapse-free survival.
Medscape Oncology
http://ift.tt/2hseok0
Cross-talk between TNF-α and IFN-γ signaling in induction of B7-H1 expression in hepatocellular carcinoma cells
Abstract
Clinical benefit from immunotherapy of B7-H1/PD-1 checkpoint blockade indicates that it is important to understand the regulatory mechanism of B7-H1 expression in cancer cells. As an adaptive response to the endogenous antitumor immunity, B7-H1 expression is up-regulated in HCC cells. B7-H1 expression is induced mainly by IFN-γ released from tumor-infiltrating T cells in HCC. In addition, HCC is a prototype of inflammation-related cancer and TNF-α is a critical component of inflammatory microenvironment of HCC. In the present study, we asked whether TNF-α can promote the expression of B7-H1 induced by IFN-γ in HCC cells. We found that JAK/STAT1/IRF1 was the primary pathway responsible for induction of B7-H1 expression by IFN-γ in human HCC cell lines. TNF-α and IFN-γ synergistically induced the expression of B7-H1 in the HCC cells. Moreover, the mechanism of the synergy was that TNF-α enhanced IFN-γ signaling by upregulating the expression of IFN-γ receptors. Furthermore, B7-H1 expression induced synergistically by TNF-α and IFN-γ in murine HCC cells facilitated tumor growth in vivo. Our findings suggest that TNF-α may enhance the adaptive immune resistance mediated by IFN-γ-induced B7-H1 in HCC cells.
http://ift.tt/2ijmTO4
Bioactive glass obliteration of the mastoid significantly improves surgical outcome in non-cholesteatomatous chronic otitis media patients
Abstract
This retrospective follow-up study evaluates the efficacy and safety of bioactive glass (BAG) S53P4 when applied as filler material in mastoid obliteration surgery performed on non-cholesteatomatous chronic otitis media (NC-COM) patients with chronically discharging ears despite conservative therapy. 94 Patients (96 ears) were included. Patients underwent either intact canal wall (ICW) or canal wall down (CWD) mastoid surgery between 2005 and 2015. The intervention group comprised 23 patients (23 ears) who were treated with additional mastoid obliteration using BAG S53P4; the remaining 71 patients (73 ears) were considered controls. All patients underwent preoperative CT scanning of the mastoid. Primary functional outcome, as defined by control of suppuration, was assessed using Merchant's scale. Hearing results as measured by air–bone gap and the incidence of adverse events were assessed as secondary outcomes. Thirty-two ears (44%) in the control group (n = 73) achieved complete control of infection at the most recent postoperative clinic visit vs 17 (74%) in the S53P4 obliteration group (n = 23). Comparing these outcomes yielded an odds ratio (OR) of 3.6 (p = 0.012, 95% CI 1.3–10.3). Complete failure to manage infection significantly differed (p = 0.048) between the control group (11 ears; 15%) and the S53P4 obliteration group (0 ears). No adverse events were observed in either group. Pre- and postoperative ABG results did not differ significantly between groups. Obliteration of the mastoid cavity using BAG S53P4 along with mastoidectomy in patients with chronically discharging NC-COM significantly improves the achievement of a dry and safe ear as compared to mastoidectomy alone. Importantly, no adverse events were observed with S53P4 BAG obliteration.
http://ift.tt/2gRHk4x
Anaplastic thyroid cancer and hyperfractionated accelerated radiotherapy (HART) with and without surgery
Abstract
Anaplastic carcinoma of the thyroid gland (ATC) is one of the most aggressive cancers in humans. With insufficient treatment, the disease most often leads to death in suffocation. From 2002, our treatment strategy has been hyperfractionated accelerated radiotherapy (HART) with high doses (64 Gy) to the neck, followed by surgery 4–8 weeks later if feasible, with the aim to gain control in the neck. After a pathology review, 51 patients were diagnosed with ATC in the period 2002–2014 in the south-east of Norway. Thirty-one received HART, and we present a study of these patients, with death in suffocation as the primary endpoint and survival as the second. No patients treated with HART died in suffocation. Six had a tracheostomy during their course of disease, of whom four were dependent on a tracheal cannula when they died. The best median survival, 19 months, was obtained in the 13 patients where both radiotherapy and surgery were possible as primary treatments. Only surgery came out as a prognostic factor for survival in multivariate analysis. Patients surviving more than 2 years were characterised by having surgery with R0 resection and no or small residual foci of ATC in the specimens. Stage 4C patients survived 3 months only.
http://ift.tt/2iiQpDM
Endoscopic management of petrous apex cholesteatoma
Abstract
We describe a technique for approaching petrous apex cholesteatoma using combined lateral microscopic/endoscopic approaches, and discuss the utility of endoscopy in managing matrix inside the petrous apex. In our two cases, total view inside the petrous apex was achieved under endoscopy without mobilizing the internal carotid artery, and the matrix was successfully removed. Neither patient has presented with postoperative recurrence thanks to the wide-angle endoscopic view inside the petrous apex. Since the number of patients was small, comparisons with microscopic treatments are not yet valid, but endoscopes could offer a helpful tool for operating inside the petrous apex.
http://ift.tt/2gP8RDv
Transoral robotic surgery for squamous cell carcinomas of the posterior pharyngeal wall
Abstract
Posterior pharyngeal wall squamous cell carcinomas (SCCs) are rare and have an associated poor prognosis. Progress in transoral resection techniques, in particular, transoral robotic surgery (TORS), have renewed the role of surgery in their treatment. This article presents the oncological and functional results obtained by the French Group of Head and Neck Robotic Surgery for TORS for posterior pharyngeal wall SCC-curative surgery. This retrospective, multicentre study presents data collected between September 2009 and November 2013 for patients treated with TORS for posterior pharyngeal wall SCCs. Analysis of patient characteristics, tumour and treatment details were completed. Kaplan–Meier analysis was used to calculate overall survival rates and recurrence-free survival rates. Student's t test and Chi2 test were also calculated. 23 patients were included (mean age of 62 years). 12 patients had a prior HNSCC. Ten patients had pT1 cancers. The overall two-year survival rate was 59%, but 89% for pT1 compared to 28% for pT2-T3 (p = 0.01). It was noted that TORS was simple to perform, but generated significant post-operative dysphagia. Two cases of spondylodiscitis were reported as specific post-operative complications of TORS. In conclusion, TORS is a treatment solution for selected posterior pharyngeal wall SCCs. It provides a possible alternative to medical treatment for early pT1 lesions and is often the only remaining curative solution in patients previously treated with radiotherapy. In cases of bulky resection, or when there is a past medical history of radiotherapy, a tissue reconstruction by forearm free-flap may be indicated.
http://ift.tt/2iiTwLH
The role of subtotal petrosectomy in cochlear implant recipients
Abstract
Describe the indications and outcome of subtotal petrosectomy for cochlear implant recipients. Tertiary care referral center. This is a retrospective study of all subtotal petrosectomies and cochlear implants performed between January 2012 and December 2014. We review the charts of these patients collecting the following data: age, gender, otologic history, audiologic tests, indication of subtotal petrosectomy, data of surgery, surgical and immediate complications, late complications and follow-up of for at least 2.5 years. 12 cases of subtotal petrosectomies with cochlear implantation in 11 patients were performed during this period; 2 children and 10 adults. The indication for a cochlear implant was in 10 cases bilateral severe to profound sensorineural hearing loss and in the remaining 2 cases was asymmetric hearing loss or unilateral hearing loss. The reason for performing a subtotal petrosectomy was chronic otitis media with or without cholesteatoma, radical cavities from previous surgeries or electrode extrusion of previously implanted devices. All cases were performed in one stage. One patient had an infectious complication that required revision surgery and finally an explantation. No other complications are described. Subtotal petrosectomy combined with cochlear implantation is a procedure required in certain situations. It is an effective and safe procedure for managing middle ear problems and creating a safe cavity to receive a cochlear implant either in adults and children.
http://ift.tt/2gS9YT6
Palatal ancient schwannoma: optical, immunohistochemical and ultrastructural study with literature review
Abstract
Schwannoma or neurilemmoma is a benign encapsulated slow-growing tumor that originates from a Schwann cell of a nerve, and is rare at intraoral locations. Different histological variants of schwannomas have been described, of these degenerative or ancient schwannoma is probably one of the least common in the oral cavity with only 16 previously reported cases, of which only one has been described in palatal location. Although ancient schwannoma shows particular characteristics, it is difficult to diagnose based on clinical and imaging appearance alone; as a result, morphological examination assisted by ancillary techniques is necessary to establish a definite diagnosis. We present a clinicopathological description of this rare variant of schwannoma, located in an unusual intraoral site, of a 26-year-old female. We illustrate the optical, immunohistochemical and ultrastructural characterization that aid diagnosis, as well as providing a review of the relevant published data of this unusual tumor.
http://ift.tt/2fNNVjr
Surgical management of primary hyperparathyroidism
Abstract
We reviewed the surgical management of primary hyperparathyroidism through a retrospective chart review of 200 parathyroidectomy procedures performed over a 12 year period. Epidemiological data and accuracy of radiological investigations used in identifying pathological parathyroid tissue location were assessed. We determined how often simultaneous removal of thyroid tissue was required during parathyroidectomy and the associated pathology. Radiology reports were screened to determine if confirmed thyroid pathology from histological specimens were referenced pre-operatively. Open parathyroid surgery was performed in 71%, the remainder endoscopically. 95% of parathyroid specimens were confirmed as benign adenomas, with eight cases of hyperplasia and two parathyroid carcinomas. Pre-operative ultrasound and SPECT-CT imaging demonstrated sensitivity of 55% and 73% respectively with regards correct adenoma localisation. Forty-nine patients (25%) underwent simultaneous partial thyroidectomy, 45 (92%) with dual pathology confirmed. Malignant thyroid lesions were identified in 18% (n = 8), Graves' disease 2% (n = 1), thyroiditis 9% (n = 4), multinodular goitre 56% (n = 25), unilateral nodule 4% (n = 2), hyperplasia 7% (n = 3) and intra-thyroid adenoma 4% (n = 2). Reference to these thyroid lesions was made in only 36% of preoperative imaging reports. In conclusion, synchronous thyroid surgery was carried out in a quarter of all parathyroidectomy procedures performed for treatment of primary hyperparathyroidism. Coincidental thyroid pathology was common. The limitations of pre-operative imaging in reliably locating involved parathyroid tissue are demonstrated and the importance of considering the potential need to perform thyroid surgery during parathyroidectomy and obtaining appropriate informed consent.
http://ift.tt/2gS9Tig
Are the Epworth Sleepiness Scale and Stop-Bang model effective at predicting the severity of obstructive sleep apnoea (OSA); in particular OSA requiring treatment?
Abstract
Obstructive sleep apnoea (OSA) is a condition characterised by repetitive upper airway collapse during sleep. The condition carries a range of health sequelae that can prove fatal in cases with co-existing risk factors for the condition, such as obesity and hypertension. Utilisation of a high-performance screening tool for OSA is thus important. A retrospective audit using the ESS and Stop-Bang scores, alongside Apnoea–Hypopnea Index values, for patients who underwent polysomnography over 1 year. Multinomial logistic regression was used to compare the predictive abilities of ESS, SBM, and body mass index (BMI) for the patient outcome groups, "None" (No OSA), "Notreat" (OSA not requiring treatment) and "treat" (OSA requiring treatment). The influences of age, gender and BMI on outcome group were also assessed. 126 bariatric and 66 non-bariatric patients were included. Multinomial logistic regression failed to demonstrate predictive ability of ESS. A higher Stop-Bang score significantly increases the risk being in the "treat" group. In addition, male gender, greater age and a higher BMI each individually increase the risk of OSA requiring treatment. Stop-Bang failed to demonstrate predictive significance when age and gender were controlled for. ESS is not an appropriate screening tool for OSA. Stop-Bang, however, remains a useful screening tool, with the ability to detect patient with OSA in need of treatment. Further study may benefit the development and implementation of a concise and more specific screening tool that considers high evidence-based risk factors for OSA, including male gender, greater age and raised BMI.
http://ift.tt/2gS9Gvu
CO 2 laser stapedotomy safety: influence of laser energy and time on bone-conduction hearing levels
Abstract
Total laser energy in CO2 stapedotomy depends on the laser settings and the amount of applications. It is unclear if the amount of total laser energy affects bone-conduction hearing thresholds and if possible effects are temporary or permanent. Alterations of bone-conduction hearing thresholds after single or multiple-shot CO2 laser stapedotomy were analyzed between 1 and 3 weeks and 1.5–6 months after primary (n = 501) or revision surgeries (n = 153) and correlated to time, laser energy, frequency, surgical technique, and pathology encountered in revision stapedotomy. In both time periods, most patients showed a lower bone-conduction threshold in the four-tone puretone average (PTA) at frequencies of 0.5, 1, 2, and 3 kHz that further improved over time. Between 1 and 3 weeks, the improvement was significant in subgroups with cumulative energies lower 1 J and successful one-shot technique or in revisions without laser application. The remaining subgroups with higher total energies showed significant improvements between 1.5 and 6 months. At 4 and 8 kHz, significant improvements were found during 1.5–6 months after primary and revision surgery independent of the used energy. Repeated CO2 laser applications showed no impairment in bone-conduction thresholds and can thus be considered as safe. In most patients, significant, yet unexplained, improvements in bone-conduction hearing thresholds were noticed in a time- and energy-related pattern.
http://ift.tt/2gS9AE8
Objective assessment of the reliability of the House–Brackmann and Fisch grading of synkinesis
Abstract
The objective of this paper is to assess synkinesis associated with post paretic voluntary facial movements using the objective OSCAR method and to investigate the correlation between synkinesis and paresis to compare the objective results with the subjective scaling systems of Fisch and House–Brackmann. The development of an objective assessment of synkinesis with the OSCAR method is focused on the clinically most relevant eye-mouth and forehead-mouth synkinetic movements. Thirteen patients with unilateral facial paralysis and synkinesis of the University Hospital Zurich were examined. Two types of clinically relevant facial synkinesis were found: a maximal synkinesis and a relative synkinesis. Neither Synkinesis-Index correlates well with the underlying degree of global facial palsy. The relative Synkinesis-Index (rSI) correlates well with the subjective evaluation of synkinesis according to the Fisch Grading, but shows a poor correlation with the traditional House–Brackmann grading. Therefore a single scaling index combining the degree of facial nerve palsy and synkinesis is inappropriate and we propose the use of two independent scaling systems for the evaluation of facial palsy: one for the voluntary facial movements, the other for the involuntary synkinetic movements. The adequate evaluation of the post paretic face should include the results of both scaling systems.
http://ift.tt/2iiEsxO
Reply to Letter to the Editor in reference to “The transotic approach for vestibular schwannoma: indications and results”
Abstract
This communication is the response to letter to the editor in reference to "The transotic approach for vestibular schwannoma: indications and results".
http://ift.tt/2iivSPs
Reply to Bruggeman: Learning is robust to noise in decentralized networks [Social Sciences]
Our study (1) presents a theoretical model and experimental test of how social influence affects the wisdom of crowds. Our theoretical simulations (SI appendix of ref. 1) show that the accuracy of the group mean can improve in decentralized networks when the weight that individuals place on their own estimates...
http://ift.tt/2gS8yrP
Reply to Jern et al.: On asking the right questions [Biological Sciences]
We are delighted that Jern et al. (1) share our interest in the psychopharmacological underpinnings of social behavior (2). It is a topic of growing interest and major significance. It is, however, important to correct some misunderstandings. First, we fully appreciate the concern about type I errors in multiple comparisons;...
http://ift.tt/2hr0Jd9
Solving problems in social groups [Social Sciences]
Humans live and work in groups where they face similar, and often shared, problems, ranging from finding resources to avoiding external threats. To solve a problem at hand, they have to make sense of it and develop an accurate idea of a solution. The wisdom of crowds means that the...
http://ift.tt/2hr0QW7
Reported associations between receptor genes and human sociality are explained by methodological errors and do not replicate [Biological Sciences]
Using a sample of 757 British individuals, Pearce et al. (1) tested 24 single-nucleotide polymorphisms (SNPs) in six candidate genes for association with eight social behavior traits. For each SNP for each trait, five genotypic model tests were reported (except the androgen receptor gene, for which two model tests were...
http://ift.tt/2hr0MWn
Correction to Supporting Information for Abel et al., Functional network inference of the suprachiasmatic nucleus [SI Correction]
NEUROSCIENCE Correction to Supporting Information for "Functional network inference of the suprachiasmatic nucleus," by John H. Abel, Kirsten Meeker, Daniel Granados-Fuentes, Peter C. St. John, Thomas J. Wang, Benjamin B. Bales, Francis J. Doyle III, Erik D. Herzog, and Linda R. Petzold, which was first published April 4, 2016; 10.1073/pnas.1521178113...
http://ift.tt/2xGJFWG
Structural basis for regulation of the nucleo-cytoplasmic distribution of Bag6 by TRC35 [Biochemistry]
The metazoan protein BCL2-associated athanogene cochaperone 6 (Bag6) forms a hetero-trimeric complex with ubiquitin-like 4A and transmembrane domain recognition complex 35 (TRC35). This Bag6 complex is involved in tail-anchored protein targeting and various protein quality-control pathways in the cytosol as well as regulating transcription and histone methylation in the nucleus....
http://ift.tt/2gQAjkb
Meta-mass shift chemical profiling of metabolomes from coral reefs [Biochemistry]
Untargeted metabolomics of environmental samples routinely detects thousands of small molecules, the vast majority of which cannot be identified. Meta-mass shift chemical (MeMSChem) profiling was developed to identify mass differences between related molecules using molecular networks. This approach illuminates metabolome-wide relationships between molecules and the putative chemical groups that differentiate...
http://ift.tt/2gQNbXK
Correction for Pereira et al., Dorsolateral prefrontal cortex GABA deficit in older adults with sleep-disordered breathing [Correction]
NEUROSCIENCE Correction for "Dorsolateral prefrontal cortex GABA deficit in older adults with sleep-disordered breathing," by Ana C. Pereira, Xiangling Mao, Caroline S. Jiang, Guoxin Kang, Sara Milrad, Bruce S. McEwen, Ana C. Krieger, and Dikoma C. Shungu, which was first published September 5, 2017; 10.1073/pnas.1700177114 (Proc Natl Acad Sci USA...
http://ift.tt/2A2uE30
Correction for Louf et al., Universal poroelastic mechanism for hydraulic signals in biomimetic and natural branches [Correction]
APPLIED PHYSICAL SCIENCES, PLANT BIOLOGY Correction for "Universal poroelastic mechanism for hydraulic signals in biomimetic and natural branches," by J.-F. Louf, G. Guéna, E. Badel, and Y. Forterre, which was first published October 2, 2017; 10.1073/pnas.1707675114 (Proc Natl Acad Sci USA 114:11034–11039). The authors note that, due to a printer's...
http://ift.tt/2xGvUqV
WD40-repeat 47, a microtubule-associated protein, is essential for brain development and autophagy [Genetics]
The family of WD40-repeat (WDR) proteins is one of the largest in eukaryotes, but little is known about their function in brain development. Among 26 WDR genes assessed, we found 7 displaying a major impact in neuronal morphology when inactivated in mice. Remarkably, all seven genes showed corpus callosum defects,...
http://ift.tt/2lzTAMa
Hedgehog signaling regulates ciliary localization of mouse odorant receptors [Neuroscience]
The ciliary localization of odorant receptors (ORs) is evolutionary conserved and essential for olfactory transduction. However, how the transport of ORs is regulated in mammalian olfactory sensory neurons is poorly understood. Here we demonstrate that odorant responsiveness and OR transport is regulated by the Hedgehog pathway. OR transport is inhibited...
http://ift.tt/2ijrqQG
Properties of real metallic surfaces: Effects of density functional semilocality and van der Waals nonlocality [Applied Physical Sciences]
We have computed the surface energies, work functions, and interlayer surface relaxations of clean (111), (100), and (110) surfaces of Al, Cu, Ru, Rh, Pd, Ag, Pt, and Au. We interpret the surface energy from liquid metal measurements as the mean of the solid-state surface energies over these three lowest-index...
http://ift.tt/2zUU4yN
Identification of a tumor-promoter cholesterol metabolite in human breast cancers acting through the glucocorticoid receptor [Medical Sciences]
Breast cancer (BC) remains the primary cause of death from cancer among women worldwide. Cholesterol-5,6-epoxide (5,6-EC) metabolism is deregulated in BC but the molecular origin of this is unknown. Here, we have identified an oncometabolism downstream of 5,6-EC that promotes BC progression independently of estrogen receptor α expression. We show...
http://ift.tt/2gQB5O7
In silico evidence for sequence-dependent nucleosome sliding [Biophysics and Computational Biology]
Nucleosomes represent the basic building block of chromatin and provide an important mechanism by which cellular processes are controlled. The locations of nucleosomes across the genome are not random but instead depend on both the underlying DNA sequence and the dynamic action of other proteins within the nucleus. These processes...
http://ift.tt/2zVcYp8
Cliff-edge model predicts intergenerational predisposition to dystocia and Caesarean delivery [Anthropology]
Recently, we presented the cliff-edge model to explain the evolutionary persistence of relatively high incidences of fetopelvic disproportion (FPD) in human childbirth. According to this model, the regular application of Caesarean sections since the mid-20th century has triggered an evolutionary increase of fetal size relative to the dimensions of the...
http://ift.tt/2gRJHnR
Methyl-compound use and slow growth characterize microbial life in 2-km-deep subseafloor coal and shale beds [Environmental Sciences]
The past decade of scientific ocean drilling has revealed seemingly ubiquitous, slow-growing microbial life within a range of deep biosphere habitats. Integrated Ocean Drilling Program Expedition 337 expanded these studies by successfully coring Miocene-aged coal beds 2 km below the seafloor hypothesized to be "hot spots" for microbial life. To...
http://ift.tt/2gQazoj
PTIP chromatin regulator controls development and activation of B cell subsets to license humoral immunity in mice [Immunology and Inflammation]
B cell receptor signaling and downstream NF-κB activity are crucial for the maturation and functionality of all major B cell subsets, yet the molecular players in these signaling events are not fully understood. Here we use several genetically modified mouse models to demonstrate that expression of the multifunctional BRCT (BRCA1...
http://ift.tt/2gQrXcl
The misleading narrative of the canonical faculty productivity trajectory [Social Sciences]
A scientist may publish tens or hundreds of papers over a career, but these contributions are not evenly spaced in time. Sixty years of studies on career productivity patterns in a variety of fields suggest an intuitive and universal pattern: Productivity tends to rise rapidly to an early peak and...
http://ift.tt/2zWKsDo
Balanced excitation and inhibition are required for high-capacity, noise-robust neuronal selectivity [Neuroscience]
Neurons and networks in the cerebral cortex must operate reliably despite multiple sources of noise. To evaluate the impact of both input and output noise, we determine the robustness of single-neuron stimulus selective responses, as well as the robustness of attractor states of networks of neurons performing memory tasks. We...
http://ift.tt/2iinNuk
PAF1 complex component Leo1 helps recruit Drosophila Myc to promoters [Biochemistry]
The Myc oncogene is a transcription factor with a powerful grip on cellular growth and proliferation. The physical interaction of Myc with the E-box DNA motif has been extensively characterized, but it is less clear whether this sequence-specific interaction is sufficient for Myc's binding to its transcriptional targets. Here we...
http://ift.tt/2htdkwB
Sclerotherapy for Reticular Veins in the Lower Limbs
http://ift.tt/2xHRBHf
Prior Authorizations for Diagnostic Skin Biopsies
http://ift.tt/2A2b6eZ
Use of a Physician Extender and Dermatology Appointment Wait Times
http://ift.tt/2xFW796
Descriptive Error in the Text
http://ift.tt/2A3PbUY
Nonhealing Leg Ulcer in a Middle-aged Indian Man
http://ift.tt/2xFSlg5
Factors Associated With Chronic Urticaria in Children
http://ift.tt/2A3pfsm
Chronic Urticaria in Children
http://ift.tt/2xEm0Gd
Thyroid Function in Children With Alopecia Areata
http://ift.tt/2xEMzel
Do Dogs Help Prevent Eczema and Asthma?
Animals are a common trigger for eczema and asthma symptoms but two new US studies show dogs may not be the enemy they are often thought to be.
WebMD Health News
http://ift.tt/2ygMIck
Universities and Primary Care Organisations working together to recruit GPs- the Enfield clinical teaching fellow programme
Jones, MM; Bashir, N; Purushotham, N; Friel, R; Rosenthal, J; (2017) Universities and Primary Care Organisations working together to recruit GPs- the Enfield clinical teaching fellow programme. BJGPopen (In press).
http://ift.tt/2zlEhg7
Consistency, breakdown robustness, and algorithms for robust improper maximum likelihood clustering
Coretto, P; Hennig, CM; (2018) Consistency, breakdown robustness, and algorithms for robust improper maximum likelihood clustering. Journal of Machine Learning Research (In press).
http://ift.tt/2iPi036
Analysis of syngas methanation for bio-SNG production from wastes: kinetic model development and pilot scale validation
Materazzi, M; Grimaldi, F; Foscolo, PU; Cozens, P; Taylor, R; Chapman, C; (2017) Analysis of syngas methanation for bio-SNG production from wastes: kinetic model development and pilot scale validation. Fuel Processing Technology , 167 pp. 292-305. 10.1016/j.fuproc.2017.07.009 .
http://ift.tt/2zmhRLS
Sliding Mode Control for Nonlinear Manipulator Systems
Zhang, B; Yang, X; Zhao, D; Spurgeon, SK; Yan, X; (2017) Sliding Mode Control for Nonlinear Manipulator Systems. IFAC-PapersOnLine , 50 (1) pp. 5127-5132. 10.1016/j.ifacol.2017.08.781 . Green open access
http://ift.tt/2iPhQZy
The (W)hole in the Archive
Ring, A; (2014) The (W)hole in the Archive. Paragraph , 37 (3) pp. 387-402. 10.3366/para.2014.0136 .
http://ift.tt/2zmv734
Biotransformation of β-Hydroxypyruvate and Glycolaldehyde to L-Erythrulose by Pichia pastoris strain GS115 overexpressing native Transketolase
Wei, Y-C; Braun-Galleani, S; Henriquez, M-J; Bandara, S; Nesbeth, DN; (2017) Biotransformation of β-Hydroxypyruvate and Glycolaldehyde to L-Erythrulose by Pichia pastoris strain GS115 overexpressing native Transketolase. Biotechnology Progress (In press).
http://ift.tt/2iPhGBq
The role of technology diffusion in a decarbonizing world to limit global warming to well below 2 °C: An assessment with application of Global TIMES model
Huang, W; Chen, W; Anandarajah, G; (2017) The role of technology diffusion in a decarbonizing world to limit global warming to well below 2 °C: An assessment with application of Global TIMES model. Applied Energy 10.1016/j.apenergy.2017.10.040 . (In press).
http://ift.tt/2zjGoAY
Time-Varying Sliding Mode Control for ABS Control of an Electric Car
Rajendran, S; Spurgeon, S; Tsampardoukas, G; Hampson, R; (2017) Time-Varying Sliding Mode Control for ABS Control of an Electric Car. IFAC-PapersOnLine , 50 (1) pp. 8490-8495. 10.1016/j.ifacol.2017.08.823 . Green open access
http://ift.tt/2iNwPU1
The Desire of the Whole in Classical German Philosophy
Gardner, S; (2017) The Desire of the Whole in Classical German Philosophy. International Yearbook of German Idealism (In press).
http://ift.tt/2zlLxbQ
On the redistributive power of pensions
Laroque, G; Choné, P; (2018) On the redistributive power of pensions. Social Choice and Welfare (In press).
http://ift.tt/2iQdAZT
Colonic dysmotility in children
Stanton, Michael; (2005) Colonic dysmotility in children. Doctoral thesis (Ph.D), UCL (University College London). Green open access
http://ift.tt/2zlLqNs
Flexible Causal Inference for Political Science
Braumoeller, BF; Marra, G; Radice, R; Bradshaw, A; (2017) Flexible Causal Inference for Political Science. Political Analysis (In press).
http://ift.tt/2iRPWwl
Impacts of undetected and inadequately treated hypertension on incident stroke in China
Han, TS; Wang, HHX; Wei, L; Pan, Y; Ma, Y; Wang, Y; Wang, J; ... Chen, R; + view all Han, TS; Wang, HHX; Wei, L; Pan, Y; Ma, Y; Wang, Y; Wang, J; Hu, Z; Sharma, P; Chen, R; - view fewer (2017) Impacts of undetected and inadequately treated hypertension on incident stroke in China. BMJ Open , 7 (10) , Article e016581. 10.1136/bmjopen-2017-016581 . Green open access
http://ift.tt/2zjOFot
“We just follow the patients’ lead”: Healthcare professional perspectives on the involvement of teenagers with cancer in decision-making
Stone, PC; Day, E; Jones, L; Langner, R; Stirling, L; Hough, R; Bluebond-Langner, M; (2017) "We just follow the patients' lead": Healthcare professional perspectives on the involvement of teenagers with cancer in decision-making. Pediatric Blood and Cancer (In press).
http://ift.tt/2iRPPkp
The continuing challenge of familial hypercholesterolaemia.
Patel, RS; (2017) The continuing challenge of familial hypercholesterolaemia. Eur Heart J Qual Care Clin Outcomes , 3 (4) pp. 253-255. 10.1093/ehjqcco/qcx029 .
http://ift.tt/2zmhMb2
An unusual anatomic and geographic location of primary germinoma of the fourth ventricle
Khan, AA; Kirkman, MA; Anderson, C; Jaunmuktane, Z; Morris, RC; Kitchen, ND; (2013) An unusual anatomic and geographic location of primary germinoma of the fourth ventricle. Journal of Clinical Neuroscience , 20 (11) pp. 1620-1622. 10.1016/j.jocn.2012.11.025 . Green open access
http://ift.tt/2iMVLea
Cryptic disease-induced mortality may cause host extinction in an apparently stable host- parasite system
Valenzuela-Sánchez, A; Schmidt, BR; Uribe-Rivera, DE; Costas, F; Cunningham, AA; Soto-Azat, C; (2017) Cryptic disease-induced mortality may cause host extinction in an apparently stable host- parasite system. Proceedings of the Royal Society B: Biological Sciences , 284 (1863) , Article 20171176. 10.1098/rspb.2017.1176 . Green open access
http://ift.tt/2zlAyPG
Future of keeping pet reptiles and amphibians: towards integrating animal welfare, human health and environmental sustainability
Pasmans, F; Bogaerts, S; Cunningham, AA; Braeckman, J; Hellebuyck, T; Griffiths, RA; Sparreboom, M; ... Martel, A; + view all Pasmans, F; Bogaerts, S; Cunningham, AA; Braeckman, J; Hellebuyck, T; Griffiths, RA; Sparreboom, M; Schmidt, BR; Martel, A; - view fewer (2017) Future of keeping pet reptiles and amphibians: towards integrating animal welfare, human health and environmental sustainability. Veterinary Record , 181 (7) , Article 450. 10.1136/vr.104296 . Gold open access
http://ift.tt/2iRPCh7
A Trial Comparing USG-HIFU vs AS in Management of Low-risk PTMC
Intervention: Device: Echopulse
Sponsor: The University of Hong Kong
Not yet recruiting
http://ift.tt/2gZmWlC
Membrane Sweeping Versus Transcervical Foley Catheter for Induction of Labour in Women With Previous Caesarean Delivery
Intervention: Procedure: Membrane Sweeping versus Transcervical Foley Catheter for Induction of Labour in Women with Previous Caesarean Delivery
Sponsor: Ministry of Health, Malaysia
Not yet recruiting
http://ift.tt/2z0YOG8
Community-based Intervention Effects on Older Adults' Physical Activity
Interventions: Behavioral: Otago Exercise Program; Device: PAM; Behavioral: Interpersonal Behavior Change Strategies; Behavioral: Intrapersonal Behavior Change Strategies; Other: Information about Health and Wellness
Sponsors: University of Minnesota - Clinical and Translational Science Institute; National Institute of Nursing Research (NINR)
Recruiting
http://ift.tt/2gYvHwr
THE NON-NEURONAL AND NON-MUSCULAR EFFECTS OF BOTULINUM TOXIN: A Graceful Opportunity for a Deadly Molecule to Treat a Human Disease in the Skin and Beyond
Abstract
There is growing evidence that botulinum neurotoxins (BoNTs) exhibit biological effects on various human cell types with a host of associated clinical implications. The BoNT receptors and intracellular targets are not unique for neurotransmission. They have been found in both neuronal and non-neuronal cells, but there are differences in the way BoNT binds to, and acts on neuronal vs. non-neuronal cells. The non-neuronal cells expressing one or more BoNT/A-binding proteins and/or cleavage target SNAP-25 include epidermal keratinocytes, mesenchymal stem cells from subcutaneous adipose, nasal mucosal cells, urothelial cells, intestinal epithelial cells, neutrophils, macrophages, and prostate, breast and alveolar epithelial cells, BoNT/A can also elicit specific biological effects in dermal fibroblasts, sebocytes and vascular endothelial cells. The reported non-traditional applications of BoNT in dermatologic conditions include hyperhidrosis, Hailey-Hailey disease, Darier disease, inversed psoriasis, aquagenic palmoplantar keratoderma, pachyonychia congenita, multiple eccrine hydrocystomas, eccrine angiomatous hamartoma, eccrine sweat gland nevi, congenital eccrine nevus, Raynaud phenomenon and cutaneous leiomyomas. Experimental studies demonstrated BoNT/A ability to protect skin flaps, facilitate wound healing, decrease thicknesses of hypertrophic scars, produce an anti-aging effect, and improve a mouse model of psoriasiform dermatitis. Furthermore, experimental studies also have revealed extracutaneous effects of BoNT arising from its anti-inflammatory and anti-cancer properties. Therefore, it is clear that BoNTs have a much wider zone of influence than originally understood, and that these ubiquitous events are based on individual cellular responses to the cholinergic impacts of BoNTs, which represents fertile grounds for future studies that are highly likely to result in impactful discoveries.
This article is protected by copyright. All rights reserved.
http://ift.tt/2gZaXEG
Widespread covariation of early environmental exposures and trait-associated polygenic variation
Krapohl, E; Hannigan, LJ; Pingault, JMR; Patel, H; Curtis, C; Newhouse, SJ; Eley, TC; ... Plomin, R; + view all Krapohl, E; Hannigan, LJ; Pingault, JMR; Patel, H; Curtis, C; Newhouse, SJ; Eley, TC; O'Reilly, PF; Plomin, R; - view fewer (2017) Widespread covariation of early environmental exposures and trait-associated polygenic variation. Proceedings of the National Academy of Sciences 10.1073/pnas.1707178114 . (In press).
http://ift.tt/2z0InHD
IP3-4 kinase Arg1 regulates cell wall homeostasis and surface architecture to promote clearance of Cryptococcus neoformans infection in a mouse model
Li, C; Lev, S; Desmarini, D; Kaufman-Francis, K; Saiardi, A; Silva, APG; Mackay, JP; ... Djordjevic, JT; + view all Li, C; Lev, S; Desmarini, D; Kaufman-Francis, K; Saiardi, A; Silva, APG; Mackay, JP; Thompson, PE; Sorrell, TC; Djordjevic, JT; - view fewer (2017) IP3-4 kinase Arg1 regulates cell wall homeostasis and surface architecture to promote clearance of Cryptococcus neoformans infection in a mouse model. Virulence 10.1080/21505594.2017.1385692 . (In press).
http://ift.tt/2z7mQyP
The relationship between schizotypal facets and conspiracist beliefs via cognitive processes
Barron, D; Furnham, A; Weis, L; Morgan, KD; Towell, T; Swami, V; (2018) The relationship between schizotypal facets and conspiracist beliefs via cognitive processes. Psychiatry Research , 259 pp. 15-20. 10.1016/j.psychres.2017.10.001 . (In press).
http://ift.tt/2z1plkh
High calcium enhances the expression of double-stranded RNA sensors and antiviral activity in epidermal keratinocytes
Abstract
Double-stranded RNA (dsRNA) sensors including TLR3, MDA5, and RIG-I are expressed in epidermal keratinocytes, and play an important immunological role by enhancing various innate and adaptive immune responses. Although the role of elevated extracellular calcium concentration in keratinocyte differentiation is well understood, the effect of high calcium on dsRNA sensors is not well studied.
We investigated alterations in dsRNA sensor expression and antiviral activity induced by a high extracellular concentration of calcium in epidermal keratinocytes. Normal human epidermal keratinocytes (NHEKs) were stimulated with high calcium and/or synthetic dsRNA, poly (I:C). TLR3, IFIH1 (MDA5), and DDX58 (RIG-I) expression were measured via qPCR, and IFN-β and human beta defensin 2 (HBD2) levels were measured using ELISA. TLR3 localization was evaluated with immunocytofluorescence. Antiviral activity was quantified with virus plaque assays using herpes simplex virus type-1 (HSV-1). High calcium significantly upregulated mRNA expression of TLR3, IFIH1, and DDX58 in NHEKs. In addition, high calcium significantly enhanced poly (I:C)-induced anti-HSV-1 activity in NHEKs. The anti-viral molecule, HBD2 but not IFN-β induction by poly (I:C) was enhanced by high calcium.
Our findings indicate that high levels of extracellular calcium enhance the expression of dsRNA sensors and augment antiviral activity in epidermal keratinocytes.
This article is protected by copyright. All rights reserved.
http://ift.tt/2ygGdq9
Microvascular reactivity, assessed by near-infrared spectroscopy and a vascular occlusion test, is associated with patient outcomes following cardiac surgery: A prospective observational study.
http://ift.tt/2A3MgLR
Odontogenic sinusitis: developments in diagnosis, microbiology, and treatment.
http://ift.tt/2zjxSlL
Delayed complications from expanded endonasal surgery for intracranial tumors.
http://ift.tt/2zjQZw2
Review and update on postoperative opioid use after nasal and sinus surgery.
http://ift.tt/2zlKQiA
Grading system for migrated lumbar disc herniation on sagittal magnetic resonance imaging: an agreement study
Abstract
Purpose
Migrated lumbar disc herniations (LDHs) in the sagittal plane are common. Disc migration grading can be applied as a useful measurement tool in the diagnosis, treatment, and outcome evaluation of migrated LDH. No study has evaluated the reliability of migrated LDH grading. We evaluated the reliability and functionality of the current magnetic resonance imaging (MRI) grading system for migrated LDH.
Methods
We assessed a six-level grading system developed based on sagittal MRI and graded according to the direction (rostral and caudal) and degree (low, high, and very high) of disc migration. One-hundred and one migrated LDHs treated with minimally invasive endoscopic discectomy were analyzed independently by two experienced radiologists. Intraobserver and interobserver agreements were assessed by kappa statistics.
Results
The most common migrated LDH grade was grade 4 (30.94%; caudal, low-grade migration). Rostral and caudal migrations were more common in the upper and lower lumbar levels, respectively. Interobserver agreement in the grading of migrated LDH was good at both the first (kappa = 0.737) and second assessment (kappa = 0.657). The intraobserver agreement for reader 1 was very good (kappa = 0.827) and for reader 2 was good (kappa = 0.620).
Conclusions
The current grading system for migrated LDH was found to be reliable and functional with good interobserver and intraobserver agreement. It may be useful in the interpretation of disc migration patterns and outcomes of various minimally invasive surgical procedures.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2gXQDDz
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CXCL13 expression is prognostic and predictive for postoperative adjuvant chemotherapy benefit in patients with gastric cancer
Abstract
Background
Chemokine (C-X-C motif) ligand 13 (CXCL13/BLC/BCA-1) is a cytokine from C-X-C chemokine family, which is selectively chemotactic for B cells. Previous research has demonstrated that high CXCL13 expression is correlated to poor prognosis in various cancers. However, the association between CXCL13 expression and gastric cancer is still unclear.
Methods
Intratumoral CXCL13 expression was evaluated by immunohistochemistry using a semi-quantitative method (modified H-score) in a testing set of 214 and a validation set of 227 randomly selected gastric cancer patients resected in 2008 in one institution. The median value was used as the cut-off point. We performed correlative analysis of CXCL-13 expression with clinicopathological variables, Kaplan–Meier analysis for association with overall survival (OS), and multivariate modeling.
Results
High CXCL13 expression was associated with larger tumor diameter and shorter OS. By multivariate analysis, CXCL13 expression was associated with OS independently from clinicopathological factors. Within the T2–4 stage patients group, low CXCL13 expression was associated with longer survival, especially in the subgroup of patients (57.6%) who received adjuvant chemotherapy.
Conclusions
Intratumoral CXCL13 expression appears as an independent prognostic marker for patients after gastric cancer resection. In addition, CXCL13 expression may serve as a predictive biomarker of response to postoperative adjuvant chemotherapy in these patients.
http://ift.tt/2gP0mZ3
Hierarchically Nanostructured 1D Conductive Bundle Yarn-Based Triboelectric Nanogenerators
Abstract
Wearable 2D textile platforms are the subject of intense focus to promote the creation of outstanding added value for textile-based applications in consumer electronics, energy harvesting, and storage. In particular, 2D textile-based energy harvesters from the living environment of human motions exhibit insufficient geometry deformation and low current density, thereby providing low power generation. Therefore, a unique starting point in this work is the use of 1D conductive bundle yarn (1D CBY) as a generic step for the development of 1D CBY-based energy harvesters through a weaving technology. The performance of 1D CBY-based triboelectric nanogenerators (1D CBY-TENGs) is addressed through contact electrification between the arrays of nanostructured 1D CBYs and 2D conductive fabric serving as tribomaterials. The manipulation of hierarchically nanostructured surfaces on the 1D CBYs by the hydrothermal process represents one of the crucial approaches of enhancing power generation through a large contact surface area. The 1D CBY-TENGs with a variation in the number of 1D CBY and stack configurations are also tested as a simple integration scheme, confirming the expected 1D CBY number and stack dependency in the output performance.
1D conductive bundle yarn-based triboelectric nanogenerators (1D CBY-TENGs) are designed to build a new class of wearable energy harvester operated by human motions. Hierarchically nanostructured 1D CBY-TENGs would lead to a breakthrough in wearable textile electronics and open up the field for a much broader range of free-form factor by weaving 1D yarn onto various 2D/3D textile networks.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2gYsZqm
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A successful case of locally advanced pancreatic cancer undergoing curative distal pancreatectomy with en bloc celiac axis resection after combination chemotherapy of nab-paclitaxel with gemcitabine
Abstract
Pancreatic cancer patients have a poor prognosis because of a low rate of resection that results from distant metastases or local advancement. We report a successful case of unresectable locally advanced pancreatic cancer in a patient who was curatively resected after combination therapy with nab-paclitaxel (nab-PTX) and gemcitabine (GEM). A 61-year-old man was referred for treatment of a 45-mm pancreatic tail tumor involving the celiac axis, common hepatic artery, and splenic artery that appeared as an abnormal soft-density mass on imaging. This patient's tumor was defined as unresectable due to local advancement, and, therefore, the powerful combined chemotherapy regimen of nab-PTX with GEM was initiated to allow for possible resection later. After three cycles of chemotherapy, a CT scan revealed that the soft-density mass around the celiac axis and common hepatic artery had dramatically disappeared, and the tumor was then determined to be a resectable lesion. Thus, distal pancreatectomy with en bloc celiac axis resection was performed and curability was achieved. There has been no tumor recurrence or distant metastasis at more than 12 months after surgery, and the patient remains alive at 17 months after initial chemotherapy.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2z0Bo3L
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Can gray values derived from CT and cone beam CT estimate new bone formation? An in vivo study
Abstract
Objectives
The main aim of this study was to investigate whether Hounsfield unit derived from computed tomography (HU/CT) and gray value derived from cone beam computed tomography (GV/CBCT) can predict the amount of new bone formation (NBF) in the defects after bone reconstruction surgeries.
Materials and methods
Thirty calvaria defects created in 5 rabbits and grafted with both radiolucent (RL, n = 15) and radiopaque (RO, n = 15) bone substitute materials were evaluated, 8 weeks postoperatively. The defects were scanned by multislice computed tomography (Somatom®, Siemens Healthineers, Erlangen, Germany) and CBCT (NewTom VG®, Qualitative Radiology, Verona, Italy). MSCT and CBCT scans were matched to select the exact region of interest (ROI, diameter = 5 mm and height = 1 mm). HU/CT and GV/CBCT of each ROI were obtained. Mean amount of NBF in whole of the defects was measured using serial histomorphometric assessment. We investigated the correlation between HU/CT and GV/CBCT, HU/CT and NBF, and GV/CBCT and NBF generally, and separately among the RL or RO grafted defects, by linear generalized estimating equation modeling. Receiver operation characteristic analysis was performed to check the accuracy of HU/CT and GV/CBCT in diagnosing more than 10% NBF in the samples.
Results
There were linear correlations between HU/CT and GV/CBCT, HU/CT and NBF, and GV/CBCT and NBF.
Conclusion
According to the results, both HU/CT and GV/CBCT can be considered as fairly good predictors for assessment of the amount of NBF following bone reconstruction surgeries.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2z1LcIu
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Grading system for migrated lumbar disc herniation on sagittal magnetic resonance imaging: an agreement study
Abstract
Purpose
Migrated lumbar disc herniations (LDHs) in the sagittal plane are common. Disc migration grading can be applied as a useful measurement tool in the diagnosis, treatment, and outcome evaluation of migrated LDH. No study has evaluated the reliability of migrated LDH grading. We evaluated the reliability and functionality of the current magnetic resonance imaging (MRI) grading system for migrated LDH.
Methods
We assessed a six-level grading system developed based on sagittal MRI and graded according to the direction (rostral and caudal) and degree (low, high, and very high) of disc migration. One-hundred and one migrated LDHs treated with minimally invasive endoscopic discectomy were analyzed independently by two experienced radiologists. Intraobserver and interobserver agreements were assessed by kappa statistics.
Results
The most common migrated LDH grade was grade 4 (30.94%; caudal, low-grade migration). Rostral and caudal migrations were more common in the upper and lower lumbar levels, respectively. Interobserver agreement in the grading of migrated LDH was good at both the first (kappa = 0.737) and second assessment (kappa = 0.657). The intraobserver agreement for reader 1 was very good (kappa = 0.827) and for reader 2 was good (kappa = 0.620).
Conclusions
The current grading system for migrated LDH was found to be reliable and functional with good interobserver and intraobserver agreement. It may be useful in the interpretation of disc migration patterns and outcomes of various minimally invasive surgical procedures.
from #MedicinebyAlexandrosSfakianakis via xlomafota13 on Inoreader http://ift.tt/2gXQDDz
via IFTTT
Seven years of clinical experience with the Yeast Traffic Light PNA FISH: assay performance and possible implications on antifungal therapy
Abstract
We evaluated the performance of Yeast Traffic Light PNA FISH (YTL PNA FISH) in identification of Candida spp. from blood cultures. A total of 200 new episodes of candidemia were analysed prospectively. The YTL PNA FISH results were reported to the clinicians and data on antifungal therapy was documented. In total, there were 164/200 (82%) positive blood culture bottles with monomicrobial growth. Coverage of monomicrobial yeasts was 150/164 (91.5%). YTL PNA FISH could identify 23/24 (95.8%) Candida spp. in bottles with concomitant growth of bacteria and one yeast. Growth of two or more different yeasts was observed in 12/200 (6%) blood culture bottles and the method could identify all yeasts in 8/12 (66.7%). Data on antifungal treatment was available for 181/200 patients (90.5%). In 132/137 (96.4%) samples from patients without antifungal treatment, YTL PNA FISH could identify the Candida spp. or gave a negative result for yeasts not included in panel, and based on the result guide appropriate antifungal therapy the same day when the blood culture bottle signaled positive. The present study shows that YTL PNA FISH is a rapid, reliable diagnostic method which significantly reduces time delay for choice of appropriate antifungal therapy for critically ill patients.
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Approaches to modeling the development of physiological stress responsivity
Abstract
Influential biopsychosocial theories have proposed that some developmental periods in the lifespan are potential pivot points or opportunities for recalibration of stress response systems. To date, however, there have been few longitudinal studies of physiological stress responsivity and no studies comparing change in physiological stress responsivity across developmental periods. Our goals were to (a) address conceptual and methodological issues in studying the development of physiological stress responsivity within and between individuals, and (b) provide an exemplar for evaluating development of responsivity to stress in the parasympathetic nervous system, comparing respiratory sinus arrhythmia (RSA) responsivity from middle to late childhood with middle to late adolescence. We propose the use of latent growth modeling of stress responsivity that includes time-varying covariates to account for conceptual and methodological issues in the measurement of physiological stress responsivity. Such models allow researchers to address key aspects of developmental sensitivity including within-individual variability, mean level change over time, and between-individual variability over time. In an empirical example, we found significant between-individual variability over time in RSA responsivity to stress during middle to late childhood but not during middle to late adolescence, suggesting that childhood may be a period of greater developmental sensitivity at the between-individual level.
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Circulating Interferon-λ3, Responsiveness to HBV Vaccination, and HBV/HCV Infections in Haemodialysis Patients
The IFN-λ3 gene (IFNL3) plays a role in HCV clearance. We investigated circulating IFN-λ3 and IFNL3 SNPs in haemodialysis patients who differed in their response to HBV vaccination and their HBV/HCV infection status. In 201 patients, plasma IFN-λ3 was determined using ELISA. IFNL3 SNPs (rs12979860, rs8099917) were genotyped using HRM analysis. Differences in IFN-λ3 levels were shown between responders and nonresponders to HBV vaccination and between HBsAg-positive patients and those who developed anti-HBs after infection and became HBsAg negative. HBV vaccine responders without HCV resolution revealed lower IFN-λ3 than noninfected responders. HBsAg/HCV RNA-positive subjects showed lower IFN-λ3 than patients positive only for HCV RNA or subjects who resolved both infections. Circulating IFN-λ3 correlated positively with anti-HBs and negatively with positive HCV RNA testing in the adjusted regression analyses. HBV vaccine nonresponders, HBsAg-positive patients, and subjects with replicating HCV composed a group with unfavourable outcomes. Responders to HBV vaccination, subjects who became HBsAg negative, and those who cleared HCV were analysed as having favourable outcomes. The latter showed higher IFN-λ3 but did not differ in distribution of IFNL3 SNPs compared with subjects with unfavourable outcomes. Higher IFN-λ3 concentrations are associated with response to HBV vaccination, self-limited HBV infection, and HCV resolution.
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Antifungal Activity of Aqueous Extracts of Some Dominant Algerian Medicinal Plants
Aim. This study investigated the antifungal properties of aqueous extracts obtained from indigenous plants that grow spontaneously in the Northern Sahara of Algeria. The activities of these plants in controlling two fungal species that belong to Fusarium genus were evaluated in an in vitro assay. Materials and Methods. Fresh aerial parts of four plant species (Artemisia herba alba, Cotula cinerea, Asphodelus tenuifolius, and Euphorbia guyoniana) were collected for the preparation of aqueous extracts. Two levels of dilution (10% and 20%) of the pure extracts were evaluated against Fusarium graminearum and Fusarium sporotrichioides. Results. The results of this study revealed that the A. herba alba, C. cinerea, A. tenuifolius, and E. guyoniana aqueous extracts are effective at both concentrations of 10% and 20% for the Fusarium mycelia growth inhibition. In particular, A. tenuifolius extract is effective against F. graminearum, whereas F. sporotrichioides mycelium growth is strongly affected by the E. guyoniana 20% extract. The phytochemical characterization of the compositions of the aqueous extracts has revealed that the presence of some chemical compounds (tannins, flavonoids, saponins, steroids, and alkaloids) is likely to be responsible for the antifungal activities sought. Conclusion. The antifungal properties of A. herba alba, C. cinerea, A. tenuifolius, and E. guyoniana make these plants of potential interest for the control of fungi affecting both wheat yield and safety.
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Comparative Phytochemical Profiling and In Vitro Antioxidant Activity of Extracts from Raw Materials, Tissue-Cultured Plants, and Callus of Oroxylum indicum (L.) Vent.
Extracts from raw materials from different plant parts, tissue-cultured plants, and callus cultures of Oroxylum indicum were analyzed for in vitro antioxidant activities determined by DPPH radical scavenging assay and evaluated for phytochemical profiles by TLC and LC-MS methods. The results were analyzed by principal component analysis (PCA) to evaluate the similarity. Stalk, pedicel, flower, seed, and whole fruit and callus extracts promoted strong antioxidant activity with high total phenolic and total flavonoid contents. The main phytochemicals found in extracts were baicalin, baicalein, and chrysin. Baicalein and baicalin promoted strong antioxidant effects and existed in most extracts while chrysin, which promoted very low antioxidant activity, was a major flavonoid in the leaves and tissue-cultured plants. From PCA analysis by total phenolic and total flavonoid contents, four main clusters including callus and tissue-cultured plant groups from different growth stages, flower group, and whole fruit and leaf group could be organized. When the results were analyzed by PCA using antioxidant activity with total phenolic or total flavonoid contents, all O. indicum samples could be grouped together except the extracts from the root of tissue-cultured plants which separated from the rest due to their low phytochemical contents and weak antioxidant activities.
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Hemothorax due to Ruptured Mycotic Aneurysm of Intercostal Arteries Associated with Infective Endocarditis
We present a case of hemothorax due to ruptured mycotic aneurysm in three intercostal arteries in a 40-year-old male with methicillin-resistant Staphylococcus aureus infective endocarditis (IE) due to intravenous drug use. Microcoil embolization and thoracotomy successfully achieved hemostasis. Mycotic aneurysm is a rare complication of IE and is usually found in the intracranial vessels. Ruptured mycotic aneurysm in the intercostal arteries can be associated with IE and can present as acute hemothorax.
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Hemothorax due to Ruptured Mycotic Aneurysm of Intercostal Arteries Associated with Infective Endocarditis
We present a case of hemothorax due to ruptured mycotic aneurysm in three intercostal arteries in a 40-year-old male with methicillin-resistant Staphylococcus aureus infective endocarditis (IE) due to intravenous drug use. Microcoil embolization and thoracotomy successfully achieved hemostasis. Mycotic aneurysm is a rare complication of IE and is usually found in the intracranial vessels. Ruptured mycotic aneurysm in the intercostal arteries can be associated with IE and can present as acute hemothorax.
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CXCL13 expression is prognostic and predictive for postoperative adjuvant chemotherapy benefit in patients with gastric cancer
Abstract
Background
Chemokine (C-X-C motif) ligand 13 (CXCL13/BLC/BCA-1) is a cytokine from C-X-C chemokine family, which is selectively chemotactic for B cells. Previous research has demonstrated that high CXCL13 expression is correlated to poor prognosis in various cancers. However, the association between CXCL13 expression and gastric cancer is still unclear.
Methods
Intratumoral CXCL13 expression was evaluated by immunohistochemistry using a semi-quantitative method (modified H-score) in a testing set of 214 and a validation set of 227 randomly selected gastric cancer patients resected in 2008 in one institution. The median value was used as the cut-off point. We performed correlative analysis of CXCL-13 expression with clinicopathological variables, Kaplan–Meier analysis for association with overall survival (OS), and multivariate modeling.
Results
High CXCL13 expression was associated with larger tumor diameter and shorter OS. By multivariate analysis, CXCL13 expression was associated with OS independently from clinicopathological factors. Within the T2–4 stage patients group, low CXCL13 expression was associated with longer survival, especially in the subgroup of patients (57.6%) who received adjuvant chemotherapy.
Conclusions
Intratumoral CXCL13 expression appears as an independent prognostic marker for patients after gastric cancer resection. In addition, CXCL13 expression may serve as a predictive biomarker of response to postoperative adjuvant chemotherapy in these patients.
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CXCL13 expression is prognostic and predictive for postoperative adjuvant chemotherapy benefit in patients with gastric cancer
Abstract
Background
Chemokine (C-X-C motif) ligand 13 (CXCL13/BLC/BCA-1) is a cytokine from C-X-C chemokine family, which is selectively chemotactic for B cells. Previous research has demonstrated that high CXCL13 expression is correlated to poor prognosis in various cancers. However, the association between CXCL13 expression and gastric cancer is still unclear.
Methods
Intratumoral CXCL13 expression was evaluated by immunohistochemistry using a semi-quantitative method (modified H-score) in a testing set of 214 and a validation set of 227 randomly selected gastric cancer patients resected in 2008 in one institution. The median value was used as the cut-off point. We performed correlative analysis of CXCL-13 expression with clinicopathological variables, Kaplan–Meier analysis for association with overall survival (OS), and multivariate modeling.
Results
High CXCL13 expression was associated with larger tumor diameter and shorter OS. By multivariate analysis, CXCL13 expression was associated with OS independently from clinicopathological factors. Within the T2–4 stage patients group, low CXCL13 expression was associated with longer survival, especially in the subgroup of patients (57.6%) who received adjuvant chemotherapy.
Conclusions
Intratumoral CXCL13 expression appears as an independent prognostic marker for patients after gastric cancer resection. In addition, CXCL13 expression may serve as a predictive biomarker of response to postoperative adjuvant chemotherapy in these patients.
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Patient-Centered Structured Interdisciplinary Bedside Rounds in the Medical ICU
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NLRP3 Inflammasome Activation Contributes to Mechanical Stretch–Induced Endothelial-Mesenchymal Transition and Pulmonary Fibrosis
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Informed Consent Documents Used in Critical Care Trials Often Do Not Implement Recommendations
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Renal Replacement Therapy Modality in the ICU and Renal Recovery at Hospital Discharge
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Urinary Oxygenation as a Surrogate Measure of Medullary Oxygenation During Angiotensin II Therapy in Septic Acute Kidney Injury
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