Characterization of a Monoclonal Antibody Specific for the Growth Hormone Secretagogue Receptor

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy , Vol. 0, No. 0.


http://ift.tt/2owofaV

Monoclonal Antibody Against Premembrane Viral Protein of Avian Tembusu Virus

Monoclonal Antibodies in Immunodiagnosis and Immunotherapy , Vol. 0, No. 0.


http://ift.tt/2ph4aIE

IL17A Polymorphism Is Not Associated with Human T-Lymphotropic Virus 1-Associated Myelopathy/Tropical Spastic Paraparesis

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2oJjUU1

Notch Signaling Regulates Circulating T Helper 22 Cells in Patients with Chronic Hepatitis C

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2ogNXP2

Advances in Innate Antiviral Immunity

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2oJlaXn

Transcriptomic Analysis of Host Immune Response in the Skin of Chickens Infected with Marek's Disease Virus

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2ogVwoJ

The Relationship Between Caffeine Intake and Immunological and Virological Markers of HIV Disease Progression in Miami Adult Studies on HIV Cohort

Viral Immunology , Vol. 0, No. 0.


http://ift.tt/2oJeCIc

Re: “Iodine Content in Milk Alternatives” by Ma et al. (Thyroid 2016;26:1308–1310)

Thyroid , Vol. 0, No. 0.


http://ift.tt/2ogEVBx

Qualitative analysis of the impact of Oral Potentially Malignant Disorders on daily life activities

by Jyothi Tadakamadla, Santhosh Kumar, Ratilal Lalloo, Newell W. Johnson

Objective

To evaluate the impact of Oral Potentially Malignant Disorders (OPMD) on daily life activities.

Materials and methods

Patients diagnosed with Oral Leukoplakia, Oral submucous fibrosis and Oral Lichen Planus attending the Oral Medicine clinic of Panineeya Institute of Dental Sciences & Research Centre, Hyderabad, India were invited to participate. Eighteen interviews and three focus groups were conducted in a non-clinical setting. Voice recordings were transcribed and translated from Telugu to English. Data coding was performed using the NVivo software.

Results

Sample size for this qualitative study comprised 32 patients. Four main themes emerged: (1) difficulties with diagnosis and knowledge about the condition, (2) physical impairment and functional limitations, (3) psychological and social wellbeing and (4) effects of treatment on daily life. In a majority of the patients, most of the interview time was spent discussing physical impairment and functional limitations. Patients also reported their mouth condition having a debilitating effect on their psychological well-being and social interactions.

Conclusions

'Physical impairment and functional limitations' was the most important theme for many of the patients. However, the impacts of OPMD also extended beyond physical impairment and functional limitations to aspects of daily living, notably psychological and social wellbeing.

http://ift.tt/2piZ6Ar

Exercise Training Reverses Extrapulmonary Impairments in Smoke-exposed Mice

Purpose: Cigarette smoking is the main risk factor for chronic obstructive pulmonary disease and emphysema. However, evidence on the extrapulmonary effects of smoke exposure that precede lung impairments remains unclear at present, as are data on nonpharmacological treatments such as exercise training. Methods: Three groups of mice, including control (n = 10), smoking (n = 10), and smoking with 6 wk of high-intensity interval treadmill running (n = 11), were exposed to 20 wk of fresh air or whole-body cigarette smoke. Exercise capacity (peak oxygen uptake) and lung destruction (histology) were subsequently measured, whereas the heart, peripheral endothelium (aorta), and respiratory (diaphragm) and limb (extensor digitorum longus and soleus) skeletal muscles were assessed for in vivo and in vitro function, in situ mitochondrial respiration, and molecular alterations. Results: Smoking reduced body weight by 26% (P 0.05). Smoking impaired exercise capacity by 15% while inducing right ventricular dysfunction by ~20%, endothelial dysfunction by ~20%, and diaphragm muscle weakness by ~15% (all P

http://ift.tt/2oIuavG

Etiology and Recovery of Neuromuscular Fatigue after Simulated Soccer Match Play

Purpose: We profiled the etiology and recovery of neuromuscular fatigue after simulated soccer match play. Methods: Fifteen semiprofessional players completed a 90-min simulated soccer match. Before, immediately after, and at 24, 48, and 72 h, participants completed a battery of neuromuscular, physical, and perceptual tests. Perceived fatigue and muscle soreness were assessed via visual analog scales. Maximum voluntary contraction (MVC) and twitch responses to electrical (femoral nerve) and magnetic (motor cortex) stimulation during isometric knee extensor contractions and at rest were measured to assess central (voluntary activation) and peripheral (quadriceps potentiated twitch force, Qtw,pot) fatigue, and responses to single and paired magnetic stimuli were assessed to quantify corticospinal excitability and short intracortical inhibition, respectively. Countermovement jump, reactive strength index, and sprint performance were assessed to profile the recovery of physical function. Results: Simulated match play elicited decrements in MVC that remained unresolved at 72 h (P = 0.01). Central fatigue was prominent immediately postexercise (−9% reduction in voluntary activation) and remained depressed at 48 h (−2%, P = 0.03). Qtw,pot declined by 14% postexercise, remained similarly depressed at 24 h, and had not fully recovered 72 h after (−5%, P = 0.01). Corticospinal excitability was reduced at 24 h (P = 0.047) only, and no change in short intracortical inhibition was observed. Measures of jump performance and self-reported fatigue followed a similar time course recovery to neuromuscular fatigue. Conclusion: Central processes contribute significantly to the neuromuscular fatigue experienced in the days after soccer match play, but the magnitude and slower recovery of peripheral fatigue indicates that it is the resolution of muscle function that primarily explains the recovery of neuromuscular fatigue after soccer match play.

http://ift.tt/2pkhwRz

Prevalence of Exercise-Induced Arterial Hypoxemia in Distance Runners at Sea Level

Purpose: It has been reported that ~50% of endurance-trained men demonstrate exercise-induced arterial hypoxemia (EIAH) during heavy exercise. However, this often-cited prevalence rate comes from a single study using a cohort of 25 highly trained men who completed maximal cycle ergometry. As arterial oxyhemoglobin saturation (SpO2) during maximal exercise is reported to be significantly lower during treadmill versus cycle ergometry in the same subjects, we hypothesized that the prevalence of EIAH would be greater than previously reported (and commonly referenced) in a larger cohort of highly endurance-trained men during maximal treadmill running. Methods: Data from 124 highly trained male distance runners (V˙O2max range = 60.3–84.7 mL·kg−1·min−1) were retrospectively examined from previously published studies completed in the Indiana University Human Performance Laboratory. Subjects completed a constant speed, progressive-grade treadmill exercise test to volitional exhaustion, and arterial oxyhemoglobin saturation (SaO2ear) in all subjects was estimated using the same oximeter (Hewlett Packard 47201A). Results: Using similar inclusion criteria as previously published for highly trained (V˙O2max > 68 mL·kg−1·min−1) and for EIAH (SaO2ear ≤ 91%), 55 of 79 subjects (70%) exhibited exercise-induced arterial desaturation. Across all 124 subjects, 104 (84%) demonstrated at least moderate EIAH (SaO2ear ≤ 93%) during maximal treadmill exercise. SaO2ear was significantly yet weakly correlated with V˙E/V˙O2 (P

http://ift.tt/2oIULbV

Branchial cleft cyst: An unusual site for the cervical metastasis of nasopharyngeal carcinoma

Publication date: Available online 14 April 2017
Source:Auris Nasus Larynx
Author(s): Yu-Chang Liao, Mohamad Adel, Li-Yu Lee, Kai-Ping Chang
ObjectiveCancers found in the resected branchial cleft cyst are rare clinically but usually impose substantive diagnostic and treatment challenges for clinicians.MethodsA 31-year-old man presented with a lateral neck mass that was suspected to be an inflammatory branchial cleft cyst. After excision, the pathologic specimen revealed a benign cystic appearance with a focus of undifferentiated carcinoma. Serologic tests for Epstein–Barr virus were negative. A positron emission tomography scan and upper aerodigestive tract endoscopies were negative for any other suspicious lesion.ResultsThe patient underwent random biopsies of the nasopharynx, tongue base, and hypopharynx and bil tonsillectomy. Pathologic examination of the nasopharyngeal biopsies showed the presence of undifferentiated carcinoma. The cancerous part of the branchial cleft cyst and this nasopharyngeal specimen were positive for the latent membrane protein-1 and EBV-encoded RNAs of Epstein–Barr virus (EBV) and confirmed our diagnosis.ConclusionThis is the first report of a NPC metastasizing to a branchial cleft cyst. Molecular diagnostic techniques facilitate the definite diagnosis that enabled us to refine treatment plans and offered the patient a favorable outcome.



http://ift.tt/2pkF48F

Prophylactic dissection of level V in primary mucosal SCC in the clinically N positive neck: A systematic review

Objective

To review the evidence for level V dissection in the management of previously untreated mucosal squamous cell carcinoma (SCC) of the head and neck presenting with nodal metastasis when level V is clinically uninvolved.

Data Source

The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) were used to conduct a systematic review of the current literature, including all English language articles published after 1990. A literature search was performed on November 29, 2015, of Medline, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and the Cochrane Library.

Review Methods

The search yielded a total of 270 papers. Strict inclusion and exclusion criteria were applied, leaving 20 eligible papers. Overall prevalence was calculated using random effect meta-analysis.

Results

The overall prevalence of level V occult disease in the node (N)-positive neck, irrespective of subsite, was 2.56% (95% confidence interval 1.29–3.84) (2,368 patients and 2,533 necks). The prevalence of occult level V metastasis was up to 7.7% for oral cavity and 8.3% for oropharyngeal tumors. Five studies reported regional recurrence rates over variable time periods. There is exceedingly limited data on outcomes, such as spinal accessory nerve function, quality of life, and perioperative complications.

Conclusion

Mucosal head and neck SCC presenting with nodal metastasis but with level V clinically uninvolved has a low prevalence of occult level V disease. Routine dissection of level V does not appear to be warranted; however, a definitive conclusion is unable to be drawn due to limited data on morbidity and oncological outcomes. Laryngoscope, 2017

http://ift.tt/2ow995o

25-Hydroxyvitamin-D3 serum modulation after use of sunbeds compliant with European Union standards: A randomized open observational controlled trial

Regular use of sunbed exposure has been reported to increase 25-hydroxyvitamin-D3 [25(OH)D] serum levels. However, the influence of sunbeds compliant with the recent European Union standard EN-60335-2-27 on 25(OH)D serum levels is unknown.

http://ift.tt/2oIY7f3

Pigmented epithelioid melanocytoma (animal type melanoma): An institutional experience

Pigmented epithelioid melanocytoma (PEM) is an uncommon, recently described entity with unknown biologic behavior. There is a high rate of regional metastases, but limited evidence of distant metastases or disease-related death.

http://ift.tt/2oIP1il

Long-term safety and tolerability of apremilast in patients with psoriasis: Pooled safety analysis for ≥156 weeks from 2 phase 3, randomized, controlled trials (ESTEEM 1 and 2)

Randomized, controlled trials demonstrated efficacy and safety of apremilast for moderate-to-severe plaque psoriasis and psoriatic arthritis.

http://ift.tt/2pgtoH7

The role of cannabinoids in dermatology

Twenty-eight states currently allow for comprehensive public medical cannabis programs, and this number continues to grow.1 Approximately 1 in 10 adult cannabis users in the United States use it for medical purposes.2 Numerous studies have investigated its uses for chronic pain, spasticity, anorexia, and nausea. In recent years, researchers have also investigated its use for the treatment of dermatologic conditions including pruritus, inflammatory skin disease, and skin cancer.

http://ift.tt/2ogkLrq

Inflammatory myopathy associated with myasthenia gravis with and without thymic pathology: Report of four cases and literature review

Publication date: Available online 13 April 2017
Source:Autoimmunity Reviews
Author(s): Ernestina Santos, Ester Coutinho, Ana Martins da Silva, António Marinho, Carlos Vasconcelos, Ricardo Taipa, Manuel Melo Pires, Guilherme Gonçalves, Carlos Lopes, Maria Isabel Leite
Introductionthe association of myasthenia gravis (MG) and inflammatory myopathy is rare and often only one of the diseases is diagnosed. Thymus pathology may be in the origin of such disease association.Methodswe described four patients with both MG and inflammatory myopathy.Resultsthese cases correspond to 2.3% of our MG cohort. Case 1: MG, polymyositis and thymolipoma; case 2: MG and necrotizing myopathy without thymic pathology on a background of scleroderma, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia (CREST); case 3: MG and dermatomyositis without thymic pathology; case 4: MG and dermatomyositis with type C thymoma.Discussionthe recognition of these neuromuscular co-morbidities contributes to (i) understanding their pathogenic mechanisms, (ii) developing better management approaches and (iii) further improving disease outcomes.



http://ift.tt/2pjXx5k

Rituximab for immunologic renal disease: What the nephrologist needs to know

Publication date: Available online 13 April 2017
Source:Autoimmunity Reviews
Author(s): Andreas Kronbichler, Martin Windpessl, Herwig Pieringer, David R.W. Jayne
Rituximab (RTX), a chimeric, monoclonal anti-CD20 antibody, is increasingly used in immune-mediated renal diseases. While licensed in the induction treatment of ANCA-associated vasculitis, it represents one of the most commonly prescribed off-label drugs. Much of the information regarding its safety has been drawn from experience in hematology and rheumatology. Ample evidence illustrates the safety of RTX, however, rare but serious adverse events have emerged that include progressive multifocal leucoencephalopathy and hepatitis B reactivation. Moderate to severe hypogammaglobulinemia and late-onset neutropenia following RTX therapy confer an increased infectious risk and factors predicting these side effects (i.e. a genetic basis) need to be identified. Nephrologists initiating RTX need to bear in mind that long-term risks and optimal dosing for many renal indications remain unclear. Special considerations must be given when RTX is used in women of childbearing age. We summarize practical aspects concerning the use of RTX. This review will provide nephrologists with information to guide their use of RTX alerting them to safety risks and the need for patient counselling.



http://ift.tt/2pglaP8

Targeting synovial neoangiogenesis in rheumatoid arthritis

Publication date: Available online 14 April 2017
Source:Autoimmunity Reviews
Author(s): Agathe Leblond, Yannick Allanore, Jérôme Avouac
In Rheumatoid arthritis (RA), neoangiogenesis is an early and crucial event to promote the development of the hyperplasic proliferative pathologic synovium. Endothelial cells are critical for the formation of new blood vessels since they highly contribute to angiogenesis and vasculogenesis. Current therapies in RA target the inflammatory consequences of autoimmune activation and despite major improvements these last years still refractory patients or incomplete responders may be seen raising the point of the need to identify complementary additive and innovative therapies. This review resumes the mechanisms of synovial neoangiogenesis in RA, including recent insights on the implication of vasculogenesis, and the regulation of synovial neoangiogenesis by angiogenic and inflammatory mediators. In line with the recent development of vascular-targeted therapies used in cancer and beyond, we also discuss possible therapeutic implications in RA, in particular the combination of targeted immunotherapies with anti-angiogenic molecules.



http://ift.tt/2pkf0e1

Laryngeal function-preserving operation for T4a laryngeal cancer with vocal cord paralysis — A case report

For locally advanced laryngeal cancers, the standard treatment of choice is chemoradiotherapy if organ function needs to be conserved. Surgical treatment with larynx preservation is conducted only for limited cases. For locally advanced laryngeal cancers such as those with vocal cord fixation and/or cricoid cartilage destruction, there is no apparent standardized organ-preserving surgery keeping the essential laryngeal functions, viz. the airway, deglutition and articulation, uncompromized.Recently, our surgical team saw a patient with T4a advanced laryngeal cancer with vocal cord fixation who aspired to maintain his laryngeal function.

http://ift.tt/2pk8fbV

Bilateral spontaneous symptomatic temporomandibular joint herniation into the external auditory canal: A case report and literature review

Spontaneous temporomandibular joint (TMJ) herniation is the entity of protrusion of the retrodiscal contents of the TMJ into the external auditory canal (EAC) through a persistent Huschke's foramen. There have been a number of reports of spontaneous TMJ herniation, but there are no reports of bilateral symptomatic TMJ herniation. We report a case of a 70-year-old man who complained of a crunching sound in both ears during mastication. Examination showed bulging from the anterosuperior wall of the EAC on each side when the patient opened his mouth, which pushed the tympanic membrane medially.

http://ift.tt/2pgwpHm

Clinical experiences of Ultrasound-guided transversus thoracic muscle plane block for children

The transversus thoracic muscle plane (TTP) block has been reported to be able to block multiple anterior branches of intercostal nerves (Th2-6) in the internal mammary region [1]. Therefore, there were some publications for clinical setting [2,3,4]. However, there were no papers of TTP block for children. We reported two cases using the TTP block for children. Case 1 was a 7-year-old girl (120cm, 27kg) with no complications who underwent a funnel chest. To provide good perioperative pain management, we recommended her to receive an epidural anesthesia before a general anesthesia.

http://ift.tt/2pggrNu

Internal image anti-idiotypic antibody: A new strategy for the development a new category of prolactin receptor (PRLR) antagonist

Publication date: July 2017
Source:Molecular Immunology, Volume 87
Author(s): Hainan Lan, Pan Hong, Ruonan Li, Suo L, Shan Anshan, Steven Li, Xin Zheng
Over the past decades, a number of prolactin receptor (PRLR) antagonists have been developed, which can be divided into two categories, PRLR analogue and anti-PRLR antibody. However, until now, there have been no commercially available PRLR antagonists. Here, we described a new approach for the preparation of PRLR antagonist, namely internal image anti-idiotypic antibody strategy. The hybridoma technique was used to generate anti-idiotypic antibodies to PRL. Competitive ELISA, competitive receptor-binding analysis and immunofluorescence assay (IFA) were then used to screen and characterize anti-idiotypic antibodies to PRL. One internal image anti-idiotypic antibody, termed MG7, was obtained. A series of experiments demonstrated that MG7 behaved as a typical internal image anti-idiotypic antibody (Ab2β). MG7 exhibited effective antagonistic activity, which not only inhibited PRL binding to PRLR in a dose-dependent manner but also inhibited PRLR-mediated intracellular signalling. Furthermore, MG7 also blocked Nb2 cell proliferation induced by PRL. The current study suggests that MG7 has the potential application in the PRL/PRLR-related studies in future. In addition, this work also suggests that the internal image anti-idiotypic antibody may represent a novel strategy for the development of PRLR antagonist.



http://ift.tt/2pfT6LI

Thyroid Top-Read Articles

FREE ACCESS through April 28, 2017.
Read now:

Latest Impact Factor: 3.784
The Official Journal of: American Thyroid Association

Subclinical Hypothyroidism in Pregnancy: A Systematic Review and Meta-Analysis
Spyridoula Maraka, Naykky M. Singh Ospina, Derek T. O'Keeffe, Ana E. Espinosa De Ycaza, Michael R. Gionfriddo, Patricia J. Erwin, Charles C. Coddington III, Marius N. Stan, M. Hassan Murad, Victor M. Montor

Long-Term Outcomes of Patients with Papillary Thyroid Cancer Undergoing Remnant Ablation with 30 milliCuries Radioiodine
Muhammad Mujammami, Michael P. Hier, Richard J. Payne, Louise Rochon, Michael Tamilia

Follicular Variant of Papillary Thyroid Carcinoma: Hybrid or Mixture?
Gilbert H. Daniels

Thyroid Ultrasound Features and Risk of Carcinoma: A Systematic Review and Meta-Analysis of Observational Studies
Luciana Reck Remonti, Caroline Kaercher Kramer, Cristiane Bauermann Leitão, Lana Catani F. Pinto, Jorge Luiz Gross

Incidences of Unfavorable Events in the Management of Low-Risk Papillary Microcarcinoma of the Thyroid by Active Surveillance Versus Immediate Surgery
Hitomi Oda, Akira Miyauchi, Yasuhiro Ito, Kana Yoshioka, Ayako Nakayama, Hisanori Sasai, Hiroo Masuoka, Tomonori Yabuta, Mitsuhiro Fukushima, Takuya Higashiyama, Minoru Kihara, Kaoru Kobayashi, Akihiro Miya

 

The post Thyroid Top-Read Articles appeared first on American Thyroid Association.

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Pharmacologic Properties of Novel Local Anesthetic Agents in Anesthesia Practice

Publication date: Available online 14 April 2017
Source:Anesthesiology Clinics
Author(s): Chih H. King, Sascha S. Beutler, Alan D. Kaye, Richard D. Urman

Teaser

Therapeutic duration of traditional local anesthetics when used in peripheral nerve blocks is normally limited. This article describes novel approaches to extend the duration of peripheral nerve blocks currently available or in development. Three newer approaches on extending the duration of peripheral nerve blocks include site-1 sodium channel blockers, novel local anesthetics delivery systems, and novel adjuvants of local anesthetics. Compared with plain amide-based and ester-based local anesthetics, alternative approaches show significant promise in decreasing postoperative pain, rescue opioid requirement, hospital length-of-stay, and overall health care cost, without compromising the established safety profile of traditional local anesthetics.


http://ift.tt/2ozb9v3

Ketorolac, Oxymorphone, Tapentadol, and Tramadol

Publication date: Available online 14 April 2017
Source:Anesthesiology Clinics
Author(s): Nalini Vadivelu, Daniel Chang, Erik M. Helander, Gregory J. Bordelon, Alice Kai, Alan D. Kaye, Dora Hsu, Daniel Bang, Inderjeet Julka

Teaser

Pain remains a tremendous burden on patients and for the health care system, with uncontrolled pain being the leading cause of disability in this country. There are a variety of medications that can be used in the treatment of pain, including ketorolac, oxymorphone, tapentadol, and tramadol. Depending on the clinical situation, these drugs can be used as monotherapy or in conjunction with other types of medications in a multimodal approach. A strong appreciation of pharmacologic properties of these agents and potential side effects is warranted for clinicians.


http://ift.tt/2ouP9jn

Pulmonary Vasodilators and Anesthesia Considerations

Publication date: Available online 14 April 2017
Source:Anesthesiology Clinics
Author(s): Jeremy B. Green, Brendon M. Hart, Elyse M. Cornett, Alan D. Kaye, Ali Salehi, Charles J. Fox

Teaser

Pulmonary hypertension (PH) is a complex disease process of the pulmonary vasculature system characterized by elevated pulmonary arterial pressures. Patients with PH are at increased risk for morbidity and mortality, including intraoperatively and postoperatively. Appreciation by the clinical anesthesiologist of the pathophysiology of PH is warranted. Careful and meticulous strategy using appropriate anesthetic medications, pulmonary vasodilator and inotropic agents, and careful fluid management all increase the likelihood of the best possible outcome in this challenging patient population.


http://ift.tt/2ozkHGr

Cardiovascular Pharmacology

Publication date: Available online 14 April 2017
Source:Anesthesiology Clinics
Author(s): Camellia Asgarian, Henry Liu, Alan D. Kaye

Teaser

Cardiovascular disease remains a leading cause of morbidity and mortality worldwide. The development of therapeutic agents for the treatment of cardiovascular diseases has always been a priority because of the huge potential market for these drugs. These medications should be part of the anesthesiologist's armamentarium because the typical surgical patient is older and has more comorbidities than in the past. This article reviews commonly used cardiovascular medications that are important in managing patients with unstable hemodynamics.


http://ift.tt/2ouXMdG

Total Parenteral and Enteral Nutrition in the ICU

Publication date: Available online 14 April 2017
Source:Anesthesiology Clinics
Author(s): Amir O. Elhassan, Lien B. Tran, Richard C. Clarke, Sumit Singh, Alan David Kaye

Teaser

Appropriate nutrition in the hospital setting, particularly in critically ill patients, has long been tied to improving clinical outcomes. During critical illness, inflammatory mediators and cytokines lead to the creation of a catabolic state to facilitate the use of endogenous energy sources to meet increased energy demands. This process results in increasing the likelihood of overfeeding. The literature has revealed exponential advances in understanding the molecular basis of nutritional support and evolution of clinical protocols aimed at treating artificial nutritional support as a therapeutic intervention, preventing loss of lean body mass and metabolic deterioration to improve clinical outcomes in the critically ill.


http://ift.tt/2oz8NwA

New Hypnotic Drug Development and Pharmacologic Considerations for Clinical Anesthesia

Publication date: Available online 14 April 2017
Source:Anesthesiology Clinics
Author(s): Mariah Kincaid Tanious, Sascha S. Beutler, Alan D. Kaye, Richard D. Urman

Teaser

Since the public demonstration of ether as a novel, viable anesthetic for surgery in 1846, the field of anesthesia has continually sought the ideal anesthetic—rapid onset, potent sedation-hypnosis with a high therapeutic ratio of toxic dose to minimally effective dose, predictable clearance to inactive metabolites, and minimal side effects. This article aims to review current progress of novel induction agent development and provide an update on the most promising drugs poised to enter clinical practice. In addition, the authors describe trends in novel agent development, implications for health care costs, and implications for perioperative care.


http://ift.tt/2ouYKa2

Pharmacologic Considerations of Anesthetic Agents in Pediatric Patients

Publication date: Available online 14 April 2017
Source:Anesthesiology Clinics
Author(s): Alan D. Kaye, Charles J. Fox, Ira W. Padnos, Kenny P. Ehrhardt, James H. Diaz, Elyse Cornett, Debbie Chandler, Sudipta Sen, Shilpadevi Patil

Teaser

Acute pain in the pediatric population has important differences in terms of biology, intrapopulation variation, and epidemiology. Discussion as to the pharmacologic considerations of anesthetic agents, such as induction agents, neuromuscular blockers, opioids, local anesthetics, and adjuvant agents, is presented in this article. Special considerations and concerns, such as risk for propofol infusion syndrome and adverse potential side effects of anesthesia agents, are discussed. Anesthesiologists managing pediatric patients need to have a firm understanding of physiologic and pharmacologic differences compared with the adult population. Future studies to improve the understanding of pharmacokinetics in the pediatric population are needed.


http://ift.tt/2oz0pNg

Qualitative analysis of the impact of Oral Potentially Malignant Disorders on daily life activities

by Jyothi Tadakamadla, Santhosh Kumar, Ratilal Lalloo, Newell W. Johnson

Objective

To evaluate the impact of Oral Potentially Malignant Disorders (OPMD) on daily life activities.

Materials and methods

Patients diagnosed with Oral Leukoplakia, Oral submucous fibrosis and Oral Lichen Planus attending the Oral Medicine clinic of Panineeya Institute of Dental Sciences & Research Centre, Hyderabad, India were invited to participate. Eighteen interviews and three focus groups were conducted in a non-clinical setting. Voice recordings were transcribed and translated from Telugu to English. Data coding was performed using the NVivo software.

Results

Sample size for this qualitative study comprised 32 patients. Four main themes emerged: (1) difficulties with diagnosis and knowledge about the condition, (2) physical impairment and functional limitations, (3) psychological and social wellbeing and (4) effects of treatment on daily life. In a majority of the patients, most of the interview time was spent discussing physical impairment and functional limitations. Patients also reported their mouth condition having a debilitating effect on their psychological well-being and social interactions.

Conclusions

'Physical impairment and functional limitations' was the most important theme for many of the patients. However, the impacts of OPMD also extended beyond physical impairment and functional limitations to aspects of daily living, notably psychological and social wellbeing.

http://ift.tt/2piZ6Ar

GC-CI-MS/MS analysis of anabolic androgenic steroids

http://ift.tt/2pB7pHg

Modelling, Analysis and Comparison of Heat Sink Designs with Improved Natural Convection

The paper presents a finite element modeling based study of various heat sink designs. The main aim of the study is to determine and evaluate solutions with improved heat dissipation by utilization of natural convection. Seventeen different cases both classical and proposed by the authors are studied, where each case is examined under three different heat source (in the case with the proposed study a transistor) powers. Results for temperature of the power source and velocity magnitudes in the studied volume are presented and compared. Experimental verification of the modeling is presented for a number of selected cases.

http://ift.tt/2p3uJRE

Comparison of Multiple Stage Braking Circuits for Wind Driven Generators

This paper presents multiple stage braking circuits for wind turbines with a permanent magnet synchronous generator. The system combines both passive converter circuit coupled to a resistive braking circuit. The second one is an over voltage protection when an emergency situation of no load is detected. The power converter control and braking are simulated and the output power/frequency graphics are derived. Three braking circuits are analyzed and compared. Design recommendations are formulated regarding the application of different topologies depending of the wind speed and the input assignments

http://ift.tt/2pBnyfK

Comparison and design of power electronics transformers in 25 kHz–400 kHz range

The paper presents comparison and design considerations of power electronics transformers in 25 kHz - 400 kHz range. Improved design algorithm consisting of 15 steps is applied. Five designs of power transformers under the same input parameters are realized based on different frequencies: 25kHz, 50kHz, 100kHz, 200kHz and 400kHz. The material used is ferrite (N87). The design is aimed at minimizing losses and volume of the component. A set of parameters is defined to compare the obtained design results including operating and construction parameters. The obtained design results are verified by carried out simulations using FEM. Design conclusions and guidelines are derived based on the comparison of the carried out designs regarding the influence of operating frequency on the total parameters of the power transformers.

http://ift.tt/2pi984W

Het grote rode verhaal: Geschiedenis van de socialistische beweging in Sint-Niklaas

http://ift.tt/2phKAZG

Self-oscillating gate driver used for gallium nitride transistors in high frequency applications

A design of a self-oscillating gate driver that is used for gallium nitride transistors and MOSFETs operating at high frequencies up to few megahertz has been made. A capability of driving one or two transistors is provided. The oscillating mode is obtained using the input capacitance of the power transistors as a part from a resonant circuit. The gate driver is suitable for resonant power stage and soft switching. The proposed gate driver circuit is analyzed and experimentally tested.

http://ift.tt/2peFMY1

SPEED SENSOR-LESS AND ROBUST POWER CONTROL OF GRID-CONNECTED WIND TURBINE DRIVEN DOUBLY FED INDUCTION GENERATORS BASED ON FLUX ORIENTATION

The aim of this paper is to propose a power control method for Wind Energy Conversion System (WECS) using Double Fed Induction Generator (DFIG). This control strategy, based on stator flux orientation, tracks the maximum power for different wind speeds and regulates separately the active and reactive powers exchanged between the generator and the grid. The control algorithm uses Sliding Mode Control technique (SMC). The suitability of the proposed control strategy is proved in terms of efficiency maximization by including external disturbances (grid fault condition) with respect to bounded parameter variations affecting the electrical system. The estimation of the speed is based on Model Reference Adaptive System (MRAS) method. Some results of simulation are presented, discussed to prove efficiency and robustness of the DFIG control policy for WECS against external and internal perturbations with MPPT responses.

http://ift.tt/2phMSbx

Dyadic Yoga Intervention for Patient With Head and Neck Cancer Undergoing Radiotherapy and Their Family Caregivers

Conditions:   Malignant Neoplasms of Lip Oral Cavity and Pharynx;   Head and Neck Cancer
Interventions:   Behavioral: Yoga;   Behavioral: Yoga Questionnaire;   Behavioral: Symptom Questionnaires
Sponsor:   M.D. Anderson Cancer Center
Recruiting - verified April 2017

http://ift.tt/2oytgBr

Trial of Stereotactic HYpofractionateD RadioAblative (HYDRA) Treatment of Laryngeal Cancer

Conditions:   Malignant Neoplasms of Respiratory and Intrathoracic Organs;   Squamous Cell Carcinoma of the Larynx
Interventions:   Radiation: Stereotactic Hypofractionated Radioablation;   Behavioral: Questionnaires
Sponsors:   M.D. Anderson Cancer Center;   Cancer Prevention Research Institute of Texas
Not yet recruiting - verified April 2017

http://ift.tt/2peEpIH

Observational Study of Nivolumab in Patients in Germany With Squamous Cell Carcinoma of the Head and Neck Progressing on or After Platinum-Based Therapy

Condition:   Head and Neck Cancer
Intervention:   Other: Non-Interventional
Sponsor:   Bristol-Myers Squibb
Not yet recruiting - verified April 2017

http://ift.tt/2ouhk26

Pembrolizumab and Induction Chemotherapy in Head and Neck Squamous Cell Carcinoma (PICH Study)

Condition:   Head and Neck Squamous Cell Carcinoma (HNSCC)
Interventions:   Drug: TPF2;   Other: Radiotherapy with carboplatin
Sponsor:   Centre Antoine Lacassagne
Not yet recruiting - verified April 2017

http://ift.tt/2pexL5k

A Simple Walking Program to Enhance Concurrent Chemoradiotherapy Delivery

Conditions:   Brain Cancer;   Head and Neck Cancer;   Lung Cancer;   Gastrointestinal Cancer;   Cervical Cancer
Intervention:   Behavioral: Pedometer-based Walking Program
Sponsor:   Albert Einstein College of Medicine, Inc.
Recruiting - verified April 2017

http://ift.tt/2of9Eiy

Effects of Nutritional Counseling on Nutritional Status and Quality of Life of Head and Neck Cancer Patients

Condition:   Head and Neck Neoplasms
Interventions:   Other: intensive nutritional counseling;   Other: Standard care
Sponsor:   University of Sao Paulo General Hospital
Not yet recruiting - verified March 2017

http://ift.tt/2oyuMDR

Evaluate Efficacy and Safety of IBI308 and Paclitaxel/Irinotecan in Patients With Advanced/Metastatic Esophageal Squamous Cell Carcinoma

Condition:   Efficacy and Safety
Interventions:   Biological: IBI308;   Biological: paclitaxel/ irinotecan
Sponsor:   Innovent Biologics (Suzhou) Co. Ltd.
Not yet recruiting - verified April 2017

http://ift.tt/2ou7LA6

Incidence of Venous Thromboembolism in Patients Undergoing Major Esophageal Resection

Conditions:   Venous Thromboembolism;   Thoracic Surgery;   Esophageal Cancer
Intervention:  
Sponsor:   McMaster University
Not yet recruiting - verified April 2017

http://ift.tt/2of3m2j

The Value of EMDR in the Treatment of Tinnitus

Condition:   Tinnitus
Interventions:   Other: TRT / EMDR;   Behavioral: TRT / CBT
Sponsors:   University Hospital, Antwerp;   Agentschap voor Innovatie door Wetenschap en Technologie
Recruiting - verified April 2017

http://ift.tt/2oytcSd

Het documentaire geheugen van een middeleeuwse grootstad: ontwikkeling en betekenis van de Gentse archieven. Te vindene tghuent dat men gheerne ghevonden hadde

http://ift.tt/2oH3j32

Relational information moderates approach-avoidance instruction effects on implicit evaluation.

http://ift.tt/2phrovp

Noncontact Infrared-Mediated Heat Transfer During Continuous Freeze-Drying of Unit Doses

Recently, an innovative continuous freeze-drying concept for unit doses was proposed, based on spinning the vials during freezing. An efficient heat transfer during drying is essential to continuously process these spin frozen vials. Therefore, the applicability of noncontact infrared (IR) radiation was examined. The impact of several process and formulation variables on the mass of sublimed ice after 15 min of primary drying (i.e., sublimation rate) and the total drying time was examined. Two experimental designs were performed in which electrical power to the IR heaters, distance between the IR heaters and the spin frozen vial, chamber pressure, product layer thickness, and 5 model formulations were included as factors. A near-infrared spectroscopy method was developed to determine the end point of primary and secondary drying. The sublimation rate was mainly influenced by the electrical power to the IR heaters and the distance between the IR heaters and the vial. The layer thickness had the largest effect on total drying time. The chamber pressure and the 5 model formulations had no significant impact on sublimation rate and total drying time, respectively. This study shows that IR radiation is suitable to provide the energy during the continuous processing of spin frozen vials. (C) 2016 American Pharmacists Association r.

http://ift.tt/2oGZKtY

Exploring Racial Bias in a European Country with a Recent History of Immigration of Black Africans

http://ift.tt/2phEj0q

Comparison and design of power electronics transformers in 25 kHz–400 kHz range

The paper presents a finite element modeling based study of various heat sink designs. The main aim of the study is to determine and evaluate solutions with improved heat dissipation by utilization of natural convection. Seventeen different cases both classical and proposed by the authors are studied, where each case is examined under three different heat source (in the case with the proposed study a transistor) powers. Results for temperature of the power source and velocity magnitudes in the studied volume are presented and compared. Experimental verification of the modeling is presented for a number of selected cases.

http://ift.tt/2oGY7fB

The contextual malleability of approach-avoidance training effects: approaching or avoiding fear conditioned stimuli modulates effects of approach-avoidance training

http://ift.tt/2pehHRd

Spontaneous thought and goal pursuit: From functions such as planning to dysfunctions such as rumination.

http://ift.tt/2of1kz4

Vaginal colonization by Group B Streptococcus in different populations of African women: risk factors and relation with the vaginal microbiome and the cervicovaginal immune system

http://ift.tt/2oGHjFL

A Systematic Review of Pliance, Tracking, and Augmenting

http://ift.tt/2obA8Cg

Language discordance and technological mediation in healthcare service encounters: A contrastive experiment.

This chapter reports on the design and implementation of a multilingual, mobile app to facilitate the communication in language discordant service encounters (SE). It describes the results of a two-group between-subjects experiment, in which respondents (N=20) were randomly assigned to either a SE with app (N=11), or a SE without app (N=9). The research builds on the hypothesis that technological mediation facilitates the transfer of information. To verify this hypothesis, it relies on qualitative and quantitative research data: (i) SERVQUAL satisfaction questionnaires and (ii) interaction analysis of video-recorded SEs. The findings address concerns of lengthened visit time, reduced eye contact and additional training needs. The chapter closes with brief guidelines for unlocking the potential of mHealth in language discordant SEs.

http://ift.tt/2oGHSPy

Body dissatisfaction revisited: On the importance of implicit beliefs about actual and ideal body image.

http://ift.tt/2obNH4z

Vulnerability for new episodes in recurrent major depressive disorder: protocol for the longitudinal DELTA-neuroimaging cohort study

http://ift.tt/2oGQRAD

Implicit and Explicit Self-Esteem in Current, Remitted, Recovered, and Comorbid Depression and Anxiety Disorders: The NESDA Study

http://ift.tt/2obzFjD

Guided Act and Feel Indonesia (GAF-ID) – Internet-based behavioral activation intervention for depression in Indonesia: study protocol for a randomized controlled trial

http://ift.tt/2oGJFnO

De vrolijke wijsheid: zoeken, denken en leven met Michel de Montaigne

Hoe moet je leven en denken? Rusteloos zocht Michel de Montaigne (1533-1592), door velen beschouwd als de eerste echt moderne mens, naar een antwoord op deze vraag. Alexander Roose beschrijft op meeslepende wijze hoe Montaigne tegenslag en ontgoochelingen overwon, en wat wij van hem kunnen leren. Michel de Montaigne schreef niet voor ons. Hij begon zijn gedachten te noteren om greep te krijgen op zichzelf. Zijn Essays behoren tot de boeiendste filosofische teksten ooit. Montaigne leefde in een tijdperk van wetenschappelijke omwentelingen, godsdienstoorlogen en politieke instabiliteit. Zijn 'probeersels' zijn een therapie, een zelfportret en een publieke bekentenis. De gentleman-filosoof denkt na over het goede leven en probeert koortsachtig inzicht te krijgen in zijn eigen bestaan. Hij dialogeert daarom met filosofen uit de oudheid – stoïcijnen, sceptici, epicuristen – voor wie filosofie altijd meer was dan een theorie. Want moedig en waarachtig leven, dat wil Montaigne.

http://ift.tt/2obA71a

The role of avoidant and obsessive-compulsive personality disorder traits in matching patients with major depression to cognitive behavioral and psychodynamic therapy: A replication study

http://ift.tt/2oGPguu

The potential of low-intensity and online interventions for depression in low- and middle-income countries

http://ift.tt/2obKjXn

Employment status, difficulties at work and quality of life in inflammatory bowel disease patients

http://ift.tt/2oGQQg3

Imagery Rescripting: The Impact of Conceptual and Perceptual Changes on Aversive Autobiographical Memories

http://ift.tt/2obzG7b

Stop or go? Preventive cognitive therapy with guided tapering of antidepressants during pregnancy: study protocol of a pragmatic multicentre non-inferiority randomized controlled trial

http://ift.tt/2oGASCz

Non-fatal disease burden for subtypes of depressive disorder: population-based epidemiological study

http://ift.tt/2oc12K2

Emotion regulation mediates the effect of childhood trauma on depression

http://ift.tt/2oGDzUz

Treatment of post-anesthesia dementia with perispinal etanercept injection and hyperbaric oxygen therapy: a case report

We report on the first case of successful treatment for post-anesthesia dementia with perispinal etanercept injection combined with hyperbaric oxygen therapy.

http://ift.tt/2pdW1EK

Acute symptomatic peri-lead edema 33 hours after deep brain stimulation surgery: a case report

Symptomatic peri-lead edema is a rare complication of deep brain stimulation that has been reported to develop 4 to 120 days postoperatively.

http://ift.tt/2pgCuRb

Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants

http://ift.tt/2pgPGWf

Disrupting the rhythm of depression using Mobile Cognitive Therapy for recurrent depression: randomized controlled trial design and protocol

http://ift.tt/2pgTWoO

REFLEX, a social-cognitive group treatment to improve insight in schizophrenia: study protocol of a multi-center RCT

http://ift.tt/2pebPqX

PRegnancy Outcomes after a Maternity Intervention for Stressful EmotionS (PROMISES): study protocol for a randomised controlled trial

http://ift.tt/2pdWR4j

Branchial cleft cyst: An unusual site for the cervical metastasis of nasopharyngeal carcinoma

Cancers found in the resected branchial cleft cyst are rare clinically but usually impose substantive diagnostic and treatment challenges for clinicians.

http://ift.tt/2pgtM5r

The use of partially hydrolysed polyvinyl alcohol for the production of high drug-loaded sustained release pellets via extrusion-spheronisation and coating: In vitro and in vivo evaluation

Partially hydrolysed polyvinyl alcohol (PVA) was evaluated as a pelletisation aid for the production of pellets with a high acetaminophen and metformin hydrochloride concentration (>70%, w/w). Mixtures with varying drug concentration and PVA/microcrystalline cellulose (MCC) ratios were processed via extrusion-spheronisation, either after addition of PVA as a dry powder or as an aqueous solution. Finally, high drug-loaded metformin pellets were coated with a methacrylic acid copolymer (Eudragit (TM) NM 30D) and evaluated for their sustained release potency in vitro and in vivo. The plasticity index of the wet mass increased by the addition of PVA to the formulation, which resulted in enhanced extrusion-spheronisation properties, even at a high drug load. Although the MCC concentration was successfully lowered by adding PVA, the inclusion of MCC in the formulation was essential to overcome problems related to the tackiness effect of PVA during extrusion. Overall, wet addition of PVA was superior to dry addition, as pellets with a higher mechanical strength and narrower particle size distribution were obtained. Pellets containing 87% (w/w) metformin hydrochloride were successfully layered with 20% (w/w) coating material, yielding sustained release pellets with a final drug load of 70% (w/w). In addition, the sustained release characteristics of the PVA-based pellets with a high drug content were confirmed in vivo as no difference with the Glucophage (TM) SR reference formulation was observed.

http://ift.tt/2oeKZut

Functional screening of Alzheimer risk loci identifies PTK2B as an in vivo modulator and early marker of Tau pathology

http://ift.tt/2p2w1wm

Involvement of GATOR complex genes in familial focal epilepsies and focal cortical dysplasia

http://ift.tt/2oeNnB8

ADAM30 Downregulates APP-Linked Defects Through Cathepsin D Activation in Alzheimer's Disease

http://ift.tt/2p2JpAL

TBK1 Mutation Spectrum in an Extended European Patient Cohort with Frontotemporal Dementia and Amyotrophic Lateral Sclerosis

http://ift.tt/2oeM4lW

Statistical Methodological Issues in Handling of Fatty Acid Data: Percentage or Concentration, Imputation and Indices

http://ift.tt/2p2BqU9

Longitudinal hypothalamic–pituitary–adrenal axis trait and state effects in recurrent depression

http://ift.tt/2oexElI

Developmental Expression of 4-Repeat-Tau Induces Neuronal Aneuploidy in Drosophila Tauopathy Models

http://ift.tt/2oGnHS8

The Actual and Ideal Sexual Self Concept in the Context of Genital Pain Using Implicit and Explicit Measures

http://ift.tt/2otBPMg

Decor

http://ift.tt/2pgAUir

Assessment of Implicit Self-Esteem in Older Adults

http://ift.tt/2ot1fcJ

Exhibits that matter: material gestures with theoretical stakes

Rotor's 2013 exhibition Behind the Green Door and the 2014 exhibition 1:1 Period Rooms by Andreas Angelidakis expound theoretical arguments about sustainability and about changing museological conventions through material exhibits and material-discursive gestures. In the first exhibition these gestures correspond to a Latourian Dingpolitik, while in the second they are informed by institutional critique. The two exhibitions defy any simple opposition between engaging with the materiality of architecture and theoretically informed criticality. They illustrate an expansion of architectural practice into research exhibition making as well as an expansion of architecture's models and theory.

http://ift.tt/2nLTK3z

Development of Laminar Burning Velocity Correlation for the Simulation of Methanol Fueled SI Engines Operated with Onboard Fuel Reformer

Methanol fueled spark ignition (SI) engines have the potential for very high efficiency using an advanced heat recovery system for fuel reforming. In order to allow simulation of such an engine system, several sub-models are needed. This paper reports the development of two laminar burning velocity correlations, corresponding to two reforming concepts, one in which the reformer uses water from an extra tank to produce hydrogen rich gas (syngas) and another that employs the water vapor in the exhaust gas recirculation (EGR) stream to produce reformed-EGR (R-EGR). This work uses a one-dimensional (1D) flame simulation tool with a comprehensive chemical kinetic mechanism to predict the laminar burning velocities of methanol/syngas blends and correlate it. The syngas is a mixture of H2/CO/CO2 with a CO selectivity of 6.5% to simulate the methanol steam reforming products over a Cu-Mn/Al catalyst. The simulation was exercised over syngas contents in the blend, fuel-air equivalence ratios, pressures, unburned gas temperatures and EGR ratios ranging respectively from 0% to 50%, 0.5 to 1.5, 10 to 85 bar, 550 to 800 K and 0% to 30% (by mass). The developed correlations are ready to be implemented into engine simulation tools as well as computational fluid dynamic codes. Based on the developed correlations, optimal control strategies and dilution methods have been studied. The engine is able to work with the same mass burning rate at leaner mixtures or lower intake charge temperatures with an onboard fuel reformer. If the engine is operated at stoichiometric condition, at the same mass fraction of methanol to the catalyst and the same EGR, the R-EGR concept is recommended because it provides a faster laminar burning velocity and does not require an extra tank of water for fuel reforming.

http://ift.tt/2oG2Uhg

Offline en digitale vormen van relationeel geweld bij tieners

http://ift.tt/2pAvzSf

Veel inmenging van buitenaf in België

http://ift.tt/2osP8wn

Reduced measuring strategies to assess ventilation rates in naturally ventilated animal houses

http://ift.tt/2pdnrL5

Novel PIK3CD mutations affecting N-terminal residues of p110δ cause APDS1 in humans

Publication date: Available online 13 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Andrew J. Takeda, Yu Zhang, Gillian L. Dornan, Braden D. Siempelkamp, Meredith L. Jenkins, Helen F. Matthews, Joshua J. McElwee, Weimin Bi, Filiz O. Seeborg, Helen C. Su, John E. Burke, Carrie L. Lucas
APDS is a newly described and prevalent primary immunodeficiency disease, and we now expand the list of mutation sites to include E81K and G124D of p110δ and uncover an intramolecular mechanism of activation that is inhibited by clinically relevant targeting of p110δ.



http://ift.tt/2nLOgG4

Mechanistic Correlates of Clinical Responses to Omalizumab in the Setting of Oral Immunotherapy for Milk Allergy

Publication date: Available online 13 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Pamela A. Frischmeyer-Guerrerio, Madhan Masilamani, Wenjuan Gu, Erica Brittain, Robert Wood, Jennifer Kim, Kari Nadeau, Kirsi M. Jarvinen, Alexander Grishin, Robert Lindblad, Hugh A. Sampson
Background: In our recent clinical trial, the addition of omalizumab to oral immunotherapy (OIT) for milk allergy improved safety but no significant clinical benefit was detected.Objective: To investigate mechanisms by which omalizumab modulates immunity in the context of OIT, and to identify baseline biomarkers that predict subgroups of patients most likely to benefit from omalizumab.Methods: Blood was obtained at baseline and multiple time-points during a placebo-controlled trial of OIT for milk allergy where subjects were randomized to receive omalizumab or placebo. Immunologic outcomes included measurement of basophil CD63 expression and histamine release (HR), and casein-specific CD4⁺ T regulatory (Treg) cell proliferation. Biomarkers were analyzed in relationship to measurements of safety and efficacy.Results: Milk-induced basophil CD63 expression was transiently reduced in whole blood samples from both omalizumab and placebo subjects. However, IgE-dependent HR increased in washed cell preparations from omalizumab but not placebo subjects. No increase in Treg frequency was evident in either group. Subjects with lower rates of adverse reactions, regardless of arm, experienced better clinical outcomes. Pre-OIT basophil reactivity positively associated with occurrence of symptoms during OIT, while the baseline milk IgE/total IgE ratio correlated with the likelihood of achieving sustained unresponsiveness (SU). A combination of baseline basophil and serologic biomarkers defined a subset of patients where adjunctive therapy with omalizumab was associated with attainment of SU and a reduction in adverse reactions.Conclusions: Combining omalizumab therapy with milk OIT led to distinct alterations in basophil reactivity but not T cell responses. Baseline biomarkers may identify subjects most likely to benefit from adjunctive therapy with omalizumab.

Teaser

Omalizumab distinctly altered IgE-dependent basophil activation but not Treg development during OIT. Baseline biomarkers may identify subjects likely to experience the greatest benefit from this adjunctive therapy in terms of both safety and efficacy.


http://ift.tt/2pAlMvn

Hypersensitivity transfusion reactions due to IgA deficiency are rare according to French hemovigilance data

Publication date: Available online 13 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Charles Tacquard, Karim Boudjedir, Monique Carlier, Jean-Yves Muller, Philippe Gomis, Paul Michel Mertes
In an analysis of a large French hemovigilance database (2004-2014), hypersensitivity transfusion reactions (HTRs) due to IgA deficiency were extremely rare with an frequency far lower than reported so far. In depth investigation of HTRs for IgA deficiency should be limited to moderate to severe recurrent reactions.



http://ift.tt/2nLDtvs

Systems Approach to Uncover Signaling Networks in Primary Immunodeficiency Diseases

Publication date: Available online 13 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Jeff Choi, Rosemary Fernandez, Holden T. Maecker, Manish J. Butte

Teaser

Capsule Summary: This broad, unbiased approach of studying signaling across all circulating immune cells in healthy subjects allowed identification of disrupted signaling networks in patients with primary immunodeficiencies.


http://ift.tt/2pA5PFN

Moving towards endotypes in atopic dermatitis: identification of patient clusters based on serum biomarker analysis

Publication date: Available online 13 April 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Judith Lydia Thijs, Ian Strickland, Catharina Ansfrieda Francisca Maria Bruijnzeel-Koomen, Stefan Nierkens, Barbara Giovannone, Eszter Csomor, Bret Richard Sellman, Tomas Mustelin, Matthew Alexander Sleeman, Marjolein Saskia de Bruin-Weller, Athula Herath, Julia Drylewicz, Richard David May, DirkJan Hijnen
BackgroundAtopic dermatitis (AD) is a complex, chronic, inflammatory skin disease with a diverse clinical presentation. It is however unclear whether this diversity exists at a biological level.ObjectiveTo test the hypothesis that AD is heterogeneous at the biological level of individual inflammatory mediators.MethodsSerum from 193 moderate to severe adult AD patients (geomean (95%CI) SASSAD of 22.3 (21.3, 23.3) and 39.1 (37.5, 40.9) respectively) and 30 non-AD healthy controls was analysed for 147 serum mediators, total IgE and 130 allergen specific IgEs. Population heterogeneity was assessed by principal component analysis (PCA) followed by unsupervised k-means cluster analysis of the principal components.ResultsAD patients showed pronounced evidence of inflammation compared to healthy controls. PCA of AD serum data revealed the presence of four potential AD patient clusters. Fifty-seven principal components (PCs) described approximately 90% of the variance. Unsupervised k-means cluster analysis of the 57 largest PCs delivered 4 distinct clusters of AD patients. Cluster 1 had high SASSAD and BSA with the highest levels of PARC, TIMP-1 and sCD14. Cluster 2 had low SASSAD with the lowest levels of IFN-α, TIMP-1 and VEGF. Cluster 3 had high SASSAD with the lowest levels of IFN-β, IL-1 and epithelial cytokines. Cluster 4 had low SASSAD but highest levels of inflammatory markers: IL-1, IL-4, IL-13 and TSLP.ConclusionAD is a heterogeneous disease both clinically and biologically. Four distinct AD patient clusters have been identified that could represent endotypes with unique biological mechanisms. Elucidation of these endotypes warrants further investigation and will require future intervention trials with specific agents such as biologics.



http://ift.tt/2nLFyrA