Medicine by Sfakianakis Alexandros: 05/17/17

Τετάρτη 17 Μαΐου 2017

The role of temporal predictability for early attentional adjustments after conflict

A frequently-studied phenomenon in cognitive-control research is conflict adaptation, or the finding that congruency effects are smaller after incongruent trials. Prominent cognitive control accounts suggest that this adaptation effect can be explained by transient conflict-induced modulations of selective attention, reducing congruency effects on the next trial. In the present study, we investigated these possible attentional modulations in four experiments using the Stroop and Flanker tasks, dissociating possible enhancements of task-relevant information from suppression of task-irrelevant information by varying when this information was presented. In two experiments, the irrelevant stimulus information was randomly presented shortly before, at the same time, or briefly after the presentation of the relevant dimension. In the other two, irrelevant information was always presented first, making this aspect fully predictable. Despite the central role that attentional adjustments play in theoretical accounts of conflict adaption, we only found evidence for such processes in one of the four experiments. Specifically, we found a modulation of the attention-related posterior N1 event-related potential component that was consistent with paying less attention to the irrelevant information after incongruent trials. This was accompanied by increased inter-trial mid-frontal theta power and a theta-power conflict adaptation effect. We interpret these results as evidence for an adaptive mechanism based on relative attentional inhibition. Importantly, this mechanism only clearly seems to be implemented in a very specific context of high temporal predictability, and only in the Flanker task.

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Association of neck circumference and pulmonary function in children

Publication date: Available online 17 May 2017
Source:Annals of Allergy, Asthma & Immunology
Author(s): Onur Akın, Mutluay Arslan, Cem Haymana, Erdem Karabulut, Bulent Hacihamdioglu, Suleyman Tolga Yavuz
BackgroundChildhood obesity leads to many complications including impaired respiratory function. There are various anthropometric parameters related to obesity.ObjectiveTo investigate the correlation between anthropometric indices and pulmonary function test results in children without asthma.MethodsChildren without any respiratory disorders were enrolled in this study. Anthropometric measurements, such as height, weight, neck circumference (NC), and waist circumference, were obtained from the enrollees and body mass index was calculated. Afterward, pulmonary function tests were performed using spirometry.ResultsA total of 178 children (106 boys, 59.5%) with a mean age of 9.7 years were included the study. NC was above the 90th percentile in 65 children. Importantly, pulmonary parameters, such as forced expiratory volume during the first second (FEV1) and the ratio of FEV1 to forced vital capacity (FVC), were lower in subjects with a large NC. Similarly, waist circumference was above the 90th percentile in 67 children, and FEV1/FVC was significantly lower in children with a large waist circumference. Moreover, there was a statistically significant negative correlation among FEV1, FEV1/FVC, and body mass index SD score. Also, multivariable linear regression analysis showed that an NC above the 90th percentile was associated with lower FEV1 and FEV1/FVC values.ConclusionWe identified NC as a novel anthropometric index that is strongly correlated with respiratory functions in children. Therefore, close monitoring of respiratory symptoms, particularly in children with obesity and a large NC, could help with early and prompt determination of respiratory complications of obesity.

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Melanom: Lymphknotendissektion auch therapeutisch von Nutzen?

Eine Sentinellymphknotendissektion bei Melanompatienten könnte nicht nur einen diagnostischen, sondern auch einen therapeutischen Nutzen haben. Hinweise dafür liefert eine Studie mit fast 600 Patienten ohne Fernmetastasen.

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Infliximab wirkt rasch gegen Psoriasis

In einer Vergleichsstudie haben Patienten mit Psoriasis unter Infliximab rascher einen PASI 75 erreicht als unter Etanercept. Längerfristig war aber kein Unterschied im Therapieerfolg festzustellen.

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Schwimmbadgranulom

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Ein Glomustumor unter dem Fingernagel

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Bullöses Pemphigoid: Doxycyclin statt Prednisolon?

Bekommen Patienten mit bullösem Pemphigoid weniger schwere Nebenwirkungen unter Doxycyclin als unter der Standardtherapie mit oralem Prednisolon? Eine aktuelle Studie gibt Aufschluss.

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Kutane Nebenwirkungen der Immuntherapie

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Inhaltsverzeichnis

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Jahreshighlight der Kongresssaison

Offensichtlich kam das Konzept 2015 gut an: Auch in diesem Jahr wurde bei der Tagung der Deutschen Dermalogischen Gesellschaft (DDG) vom 26.–29. April im Berliner City Cube in über 60 Kursen, Symposien und Plenarvorträgen versucht, die Neuerungen auf dem weiten Feld der Dermatologie abzudecken. Präsentiert und diskutiert wurden unter anderem kutane Nebenwirkungen der Immuntherapie, Biosimilars bei Psoriasis und die Zukunft molekularer Diagnostik von entzündlichen Dermatosen.

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Streifen auf dem Nagel: Wann besteht Melanomverdacht?

Hochauflösende Dermatoskopie-Aufnahmen haben europäische Dermatologen retrospektiv ausgewertet, um zu prüfen, wie gut sich ein Melanom bei streifenförmiger Nagelpigmentierung dermatoskopisch diagnostizieren lässt.

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Spielt das Aquarium eine Rolle?

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Die Rente der Ärzte ist sicher – aber...

Auch die ärztlichen Versorgungswerke müssen die Gürtel in Zeiten niedriger Zinsen enger schnallen. Daher lohnt es sich für Ärzte durchaus, eine komplementäre Vorsorgestrategie zu ihrer – an sich sicheren – Rente zu verfolgen.

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Klinische Studien: Viele Patienten sind interessiert und wissbegierig

Klinische Arzneimittelstudien sind integraler Bestandteil des medizinischen Versorgungsalltags. Optimierungspotenzial gibt es laut Umfrage aber bei der Rekrutierung der Probanden.

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Histaminarme Diät gegen chronische Urtikaria

Kann man durch den Verzicht auf stark histaminhaltige Lebensmittel die Symptome einer chronisch spontanen Urtikaria bessern? In einer deutschen Studie funktionierte das Rezept.

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PDT: Wie wird die Haut optimal vorbereitet?

Um die Aufnahme von topischen Photosensibilisatoren zu erleichtern, wird eine physikalische Vorbehandlung der Haut empfohlen. Die effektivste Methode wurde nun in einer Vergleichsstudie ermittelt.

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Molekulare Diagnostik entzündlicher Dermatosen

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Sentinellymphknotenbiopsie beim malignen Melanom: ja oder nein?

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Mukosales Melanom: Kombination geprüft

Mit einer gepoolten Datenanalyse wurde erstmals die Sicherheit und Wirksamkeit von Nivolumab als Monosubstanz und in Kombination mit Ipilimumab beim seltenen, hochaggressiven Schleimhautmelanom untersucht.

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Junge Ärzte wollen sanften Einstieg in die eigene Praxis

Niederlassung als Chance? Viele junge Mediziner sehen das eher skeptisch. Dabei bietet die Selbstständigkeit tatsächlich gute Entfaltungsmöglichkeiten – wenn man es richtig anpackt.

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Narben als Schmuck und Initiation

Feine Linien überziehen die Gesichter der Bétamarribé. Die Männer der Kaningara ahmen die schuppige, raue Haut des Krokodils nach. Viele Kulturen kennen Narben als Zeichen der Schönheit und der Initiation.

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Ringförmige Läsionen auf Stirn und Händen

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Pediatric nasal surgery prior to puberty is not only safe, but may prevent facial deformity in certain patients.

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Pediatric nasal surgery: timing and technique.

από Gary, Celeste C. στο Current Opinion in Otolaryngology & Head and Neck Surgery - Published Ahead-of-Print

Μετάφραση άρθρου

Purpose of review: Timing of pediatric nasal surgery has always been a controversial topic. Concern over disrupting growing parts of the face and causing permanent facial deformity has led to a primarily conservative approach. Many surgeons feel that it is prudent to wait until the patient has completed nasal growth after puberty to pursue nasal surgery. Recent findings: Recently, this attitude has been challenged with evidence that not only is nasal surgery in the pediatric age group not a detriment to facial growth, but failure to correct significant nasal deformity may actually cause dysmorphic facial growth secondary to obligate mouth breathing. Because of this, recent studies have focused on determining safe surgical techniques for pediatric nasal surgery, including inferior turbinate reduction, septoplasty and rhinoplasty. Research focus on this topic has also been expanded to include quality-of-life measures after nasal surgery. Summary: Pediatric nasal surgery prior to puberty is not only safe, but may prevent facial deformity in certain patients. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

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Pediatric nasal surgery prior to puberty is not only safe, but may prevent facial deformity in certain patients.

http://alexandrossfa.blogspot.com/2017/05/pediatric-nasal-surgery-prior-to.html

Pediatric nasal surgery: timing and technique.

από Gary, Celeste C. στο Current Opinion in Otolaryngology & Head and Neck Surgery - Published Ahead-of-Print

Μετάφραση άρθρου

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Improve the Treatment of Thoracic Esophageal Cancer

Condition: Thoracic Esophageal Squamous Cell Carcinoma
Interventions: Drug: adjuvant chemotherapy; Procedure: standard two field Lymphadenectomy; Procedure: Total two field Lymphadenectomy; Procedure: three field Lymphadenectomy
Sponsor: Sun Yat-sen University
Recruiting - verified May 2017

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Effects of Vaccination with the C-Strain Vaccine on Immune Cells and Cytokines of Pigs Against Classical Swine Fever Virus

Viral Immunology , Vol. 0, No. 0.

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Evidence that eating baked egg or milk influences egg or milk allergy resolution: a systematic review

Summary

Background

It has been proposed that the frequent ingestion of baked hen's egg or cow's milk accelerates the resolution of hen's egg or cow's milk allergy. This practice is being introduced into clinical practice.

Objective

To systematically review the evidence to determine whether the introduction of baked hen's egg or cow's milk into the diet of children with hen's egg or cow's milk allergies respectively leads to a larger proportion of children outgrowing these allergies than expected.

Methods

A systematic review of the literature was conducted in Medline, Embase and CINAHL. The inclusion criteria were as follows: randomized control trials, case-control or cohort studies; children aged 0–18 years with hen's egg or cow's milk allergy; baked hen's egg or cow's milk intervention with or without a comparator; and resolution of the hen's egg or cow's milk allergy as determined by food challenge as the outcome. Studies were critically appraised using the quality assessment tool for quantitative studies. PROSPERO reference CRD42015026029.

Results

We identified 851 and 2816 hen's egg and cow's milk articles respectively. Only three hen's egg and three cow's milk studies fulfilled our pre-specified inclusion criteria. The studies concluded that baked products either increased the likelihood of the resolution of allergy or accelerated resolution. However, when critiqued, all studies were classified as weak because they were observational, lacking an appropriate control group; this brings into doubt the study's conclusions. There were a number of examples of severe reactions to baked products.

Conclusion

There is little evidence to address the hypothesis that the ingestion of baked hen's egg or cow's milk results in more patients outgrowing their hen's egg or cow's milk allergy respectively. Data are required from a trial comparing the resolution rates of baked-tolerant participants who are randomized to ingest or avoid baked products to assess the accuracy of this hypothesis.

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Psychoonkologische Betreuung von Patienten mit Kopf-Hals-Tumoren

Laryngo-Rhino-Otol 2017; 96: 319-331
DOI: 10.1055/s-0043-102814

Onkologische Erkrankungen und ihre Behandlungen führen zu starken Einschränkungen in der körperlichen sowie psychosozialen Lebensqualität, wobei Patienten mit Kopf-Hals-Tumoren zu den am stärksten belasteten Gruppen von Krebspatienten zählen. Der Beitrag vermittelt einen aktuellen Überblick über zentrale Aspekte der psychoonkologischen Betreuung dieser Patienten.
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Tiefer Halsabzess: Verspätete Drainage bei Erwachsenen nachteilig, bei Kindern nicht

Laryngo-Rhino-Otol 2017; 96: 275-276
DOI: 10.1055/s-0042-123653

Cramer JD et al. The Impact of Delayed Surgical Drainage of Deep Neck Abscesses in Adult and Pediatric Populations. Laryngoscope 2016; 126: 1753–1760 Bei Erwachsenen besteht die konventionelle Therapie des tiefen Halsabzesses aus Antibiotikagabe und rascher chirurgischer Drainage. Bei Kindern ist man oft zurückhaltender. Hintergrund sind Berichte über Fälle von erfolgreicher alleiniger Antibiose. Unklar ist, inwieweit der Zeitpunkt der Drainage den Therapieerfolg bei Erwachsenen und Kindern beeinflusst. US-Mediziner haben das untersucht.
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Seltene Differenzialdiagnose bei Tinnitus und Hörstörung

Laryngo-Rhino-Otol 2017; 96: 314-315
DOI: 10.1055/s-0043-105794

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Peritonsillarabszess – Schmerzfreiheit durch kraniale Tonsil-lotomie

Laryngo-Rhino-Otol 2017; 96: 276-277
DOI: 10.1055/s-0043-101049

Windfuhr JP et al. Cranial tonsillotomy for peritonsillar abscess: what a relief! Eur Arch Otorhinolaryngol 2016; 273: 4507–4513 Beim Peritonsillarabszess (PTA) hat sich u. a. die Inzisionsdrainage (ID) als wirksam erwiesen, erfordert aber immer wieder ein schmerzhaftes Nachspreizen. HNO-Ärzte der Kliniken Maria Hilf in Mönchengladbach ergänzten daher die ID um eine kraniale Tonsillotomie zur zuverlässigen Drainage von Wundsekret.
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Kommentar der Schriftleitung

Laryngo-Rhino-Otol 2017; 96: 273-273
DOI: 10.1055/s-0043-102241

Liebe Leserinnen und Leser,in den Mai starten wir mit der Diskussion, wann ein tiefer Halsabszess drainiert werden muss; eine wichtige Frage im klinischen Alltag, die selten wissenschaftlich untersucht wird. Dann wird eine Modifikation der Abszessdrainage bei Peritonsillarabszess diskutiert, die für den Patient weniger Schmerzen zu Bedeuten scheint. Hörtest per App, ein Thema, das uns sicher noch die nächsten Jahre begleiten wird, rundet die Rubrik „Referat + Kommentar" ab.
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Hörtests funktionieren mit entsprechender App auch am heimischen Tablet-Computer

Laryngo-Rhino-Otol 2017; 96: 277-278
DOI: 10.1055/s-0043-101081

Whitton PJ et al; Validation of a Self-Administered Audiometry Application: An Equivalence Study; Laryngoscope 2016; 126: 2382–2388 Die Häufigkeit von Hörverlusten wird in den nächsten Jahrzehnten noch deutlich zunehmen. Das flächendeckende Angebot entsprechender Hörtests durch speziell geschultes Personal kann somit leicht an seine Grenzen stoßen. US-amerikanische HNO-Ärzte aus Boston haben jetzt untersucht, ob sich mit einer entsprechenden Software das eigene Hörvermögen nicht auch am heimischen Computer testen lässt.
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Aus der Gutachtenpraxis: Gibt es Gehörschäden durch Vibrationen, Infraschall, Ultraschall und/oder Körperschall?

Laryngo-Rhino-Otol 2017; 96: 316-318
DOI: 10.1055/s-0043-102233

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Schluckstörungen bei tracheo(s)tomierten Patienten

Laryngo-Rhino-Otol 2017; 96: 280-292
DOI: 10.1055/s-0043-103279

Hintergrund Seit vielen Jahren sind in der Fachliteratur Hinweise zu finden, wonach bei tracheo(s)tomierten Patienten mit Schluckstörungen zu rechnen ist, deren schwerwiegendster Aspekt die Aspiration darstellt. Die vorliegende Arbeit soll einen aktuellen Beitrag zur Diskussion leisten, ob ein Tracheostoma eine Dysphagie verursacht oder verstärkt oder lediglich eine zeitliche Koinzidenz vorliegt. Material und Methoden Die Übersichtsarbeit beruht auf einer Recherche in der textbasierten Datenbank PubMed des National Center for Biotechnology Information (NCBI). Ergebnisse Es wurden die Effekte einer Tracheotomie/Tracheostomie sowie die Effekte einzelner Kanülentypen auf motorische und sensorische Aspekte des Schluckvorgangs geprüft. Die erfassten Studien fokussieren dabei in besonderer Weise die Aspirationshäufigkeit und zeigen eine insgesamt uneinheitliche Datenlage, welche keine zwingenden Beweise für eine eindeutige und kausale Beziehung zwischen dem Vorhandensein eines Tracheostomas und einer schweren Beeinträchtigung des Schluckens erkennen lassen. Schlussfolgerungen Patienten mit einem Tracheostoma bedürfen ohne Zweifel einer besonderen Aufmerksamkeit im Hinblick auf das Vorhandensein relevanter Schluckstörungen. Diese sind aber möglicherweise eher einer schweren Grunderkrankung geschuldet als dem Vorhandensein des Tracheostomas per se.
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Fragen für die Facharztprüfung

Laryngo-Rhino-Otol 2017; 96: 332-333
DOI: 10.1055/s-0043-102234

Article in Thieme eJournals:
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Korrektur einzelner Septumabschnitte

Laryngo-Rhino-Otol 2017; 96: 334-340
DOI: 10.1055/s-0043-107264

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Adaptation, validity, and reliability of the Preschool Language Scale–Fifth Edition (PLS–5) in the Turkish context: The Turkish Preschool Language Scale–5 (TPLS–5)

Publication date: July 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): A. Sanem Sahli, Erol Belgin
IntroductionSpeech and language assessment is very importantin early diagnosis of children with hearing and speech disorders. Aim of this study is to determine the validity and reliability of Preschool Language Scale (5th edition) test with its Turkish translation andadaptation.Methods and materialsOur study is conducted on 1320 children aged between 0-7 years 11 months. While 1044 of these children have normal hearing, language and speech development, 276 of them have receptive and/or expressive language disorder. After the English-Turkish and Turkish-English translations of PLS-5 made by two experts command of both languages, some of the test items are reorganized because of the grammatical features of Turkish and the cultural structure of the country. The pilot study was conducted with 378 children. The test which is reorganized in the light of data obtained in pilot application, is applied to children chosen randomly with layering technique from different regions of Turkey, then 15 days later the first test applied again to 120 children.ResultsWhile 1044 of 1320 children aged between 0 and 7 years 11 months are normal, 276 of them have receptive and/or expressive language disorder. While 98 of 103 healthy children of 120 taken under the second evaluation have normal language development, 8 of 9 who used to have language development disorder in the past still remaining (Kappa coefficient:0,468, p<0,001). Pearson correaltion coefficient for TPLS-5 standard gauge are; IA raw score:0,937, IED raw score: 0,908 and TDP: 0,887 respectively. Correlation coefficient for age equivalance is found as IA:0,871, IED: 0,896, TDP: 0,887.ConclusionsTPLS-5 is the first and only language test in our country that can evaluate receptive and/or expressive language skills of children aged between 0-7 years 11 months. Results of the study show that TPLS-5 is a valid and reliable language test for the Turkish children.

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Polysomnography results versus clinical factors to predict post-operative respiratory complications following pediatric adenotonsillectomy

Publication date: July 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 98
Author(s): John S. Saur, Scott E. Brietzke
ObjectiveSystematically review the published literature comparing the presence of clinical features (age, BMI, co-morbidities, etc.) versus polysomnogram (PSG) results in the prediction of major post-operative respiratory complications following pediatric adenotonsillectomy (T/A) for the treatment of Obstructive Sleep Apnea Syndrome (OSAS).MethodsA systematic review of the PUBMED and EMBASE databases was performed to identify studies containing both clinical and PSG data predicting major post-operative respiratory complications following T/A. Inclusion criteria included English language and extractable data. Major respiratory complications were defined as events that required significant intervention (intubation, CPAP,etc.) and/or altered patient disposition. Random effect modeling was performed and study quality was assessed using the Newcastle-Ottawa Scale.ResultsTwenty-two studies met the inclusion criteria with a median sample size of 157 (range 26–1735) and published between 1992 and 2015. The most common study design was a case series. Most studies included multiple patients at high risk for respiratory complications (Syndromic, obese, etc.). The summary estimate of the major respiratory complication rate following T/A was only 5.8% (95% CI = 4.2–7.4%, p < 0.001, I² = 99%). For studies with extractable data, 102 of 112 patients (91.1%) with a post-operative respiratory complication had a clearly identifiable clinical risk factor, the remainder (8.9%) had only moderate or severe OSAS on PSG and no other predictor.ConclusionThe major respiratory complication rate following pediatric T/A for OSAS is low even amongst series of high risk patients. The majority of the published literature report that readily identified clinical factors predict the large majority of post-operative respiratory complications following T/A.

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Association of neck circumference and pulmonary function in children

Childhood obesity leads to many complications including impaired respiratory function. There are various anthropometric parameters related to obesity.

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Advances in Radiation Oncology

Treatment of squamous cell carcinoma of the head and neck is rapidly evolving due to changing patient populations, an emphasis on quality of life–related outcomes, and advances in radiotherapy concepts and techniques to meet these new demands. This review includes recent and ongoing studies that are potentially practice changing, including improvements in intensity-modulated radiotherapy planning, the use of deintensified regimens in the human papilloma virus–related setting, and adjuvant therapy after transoral robotic surgery. Additionally, recent studies of modern proton therapy are reviewed.

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Precision Medicine

Precision medicine is the application of genotypic and Omics biomarkers to determine the most appropriate, outcome-driven therapy for individual patients. To determine the best choice of therapy, institutions use significant information technology–enabled data from imaging, electronic medical records, sensors in the clinic/hospitals, and wearable sensors to determine treatment response. With genomic profiling, targets to affect a disease course are continuing to be developed. As clonal mutational prevalence continues to be understood, information can be communicated to patients to inform them that resistance is common, requiring collection of more genetic mutations from patients with further biopsies or blood collection.

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Multicenter Patch Testing With Methylchloroisothizoline/Methylisothiazolinone in 100 and 200 ppm Within the International Contact Dermatitis Research Group

Background: The preservative methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) is a well-known contact sensitizer. Historically, there have been different opinions on the optimal patch test concentration of MCI/MI, and both 0.01% and 0.02% aqueous (aq.) have been proposed. In 2011, based on literature reviews, it was recommended that the concentration of 0.02% aq. should be used in the international baseline series. Objectives: The aim of this study was to verify the recommendation from 2011 by comparing the patch test results from consecutive patch testing with MCI/MI 0.01% and 0.02% in clinics representing countries around the world. Patients and Methods: Two thousand seven hundred three consecutive patients with dermatitis in 8 dermatology clinics representing 8 countries were patch tested with MCI/MI 0.01% aq. and, in parallel with MCI/MI 0.02% aq., provisionally included in the baseline series. Results: Contact allergy to MCI/MI at 0.01% and 0.02% was found in 3.7% and 5.6% of the patients, respectively (P

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Unreported Sources of Nickel Exposure in Community-Based Facilities Frequented by Children

No abstract available

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Preventing Occupational Skin Disease: A Review of Training Programs

Occupational contact dermatitis (OCD) is a common occupational disease that impacts a variety of worker groups. Skin protection and disease prevention training programs have shown promise for improving prevention practices and reducing the incidence of OCD. This review details the features of training programs for primary prevention of OCD and identifies gaps in the literature. Twelve studies were identified for in-depth review: many studies included wet workers employed in health care, hairdressing, cleaning, and food preparation; 1 program featured manufacturing workers. Few programs provided content on allergic contact dermatitis, and only 1 was evaluated for long-term effectiveness. Effective programs were similar in content, delivery method, and timing and were characterized by industry specificity, multimodal learning, participatory elements, skin care resource provision, repeated sessions, and management engagement. Long-term effectiveness, generalizability beyond OCD, workplace health and safety culture impact, and translation of programs in the North American context represent areas for future research.

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The Latest Occult “Hypoallergenic” Allergen: Ethylhexylglycerin

No abstract available

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Occupational Contact Dermatitis in North American Production Workers Referred for Patch Testing: Retrospective Analysis of Cross-Sectional Data From the North American Contact Dermatitis Group 1998 to 2014

Background: Little is known about the epidemiology of contact dermatitis in production workers (PWs). Objective: The aims of this study were to estimate the prevalence of contact dermatitis and characterize clinically relevant and occupationally related allergens among North American PWs undergoing patch testing. Methods: This was a retrospective cross-sectional analysis of North American Contact Dermatitis Group data from 1998 to 2014. Results: Of 39,332 patch-tested patients, 2732 (7.0%) were PWs. Among PWs, most were men (62.4%) and white (83.9%). A history of childhood eczema was uncommon (11.3%). Prevalent occupations included machine operators (27.3%); fabricators, assemblers, and hand-working occupations (16.8%); and precision metalworking occupations (16.1%). The most frequent sites of dermatitis were the hands (53.8%) and arms (29.4%), which were significantly more commonly affected compared with non-PWs (P

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SELF-ASSESSMENT

No abstract available

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Occupational Contact Dermatitis in North American Print Machine Operators Referred for Patch Testing: Retrospective Analysis of Cross-Sectional Data From the North American Contact Dermatitis Group 1998 to 2014

Background: Little is known about the epidemiology of contact dermatitis (CD) in print machine operators (PMOs). Objective: The aims of this study were to estimate the prevalence of CD and characterize clinically relevant and occupationally related allergens among PMOs undergoing patch testing. Methods: This was a retrospective cross-sectional analysis of the North American Contact Dermatitis Group data from 1998 to 2014. Results: Of 39,332 patch-tested patients, 132 (0.3%) were PMOs. Among PMOs, most were male (75.0%) and white (92.4%). The majority were printing press operators (85.6%). The most frequent sites of dermatitis were hands (63.6%), arms (29.5%), and face/scalp (24.2%). More than half had an occupationally related skin condition (56.1%). Final diagnoses were most commonly allergic CD (58.3%) and irritant CD (33.3%). Cobalt (20.8%), carba mix (12.5%), thiuram mix (8.3%), and formaldehyde (8.3%) were the most frequent occupationally related allergens. The top allergen sources included inks (22.9%), gloves (20.8%), and coatings/dye/copy/photographic chemicals (14.6%). Conclusions: Allergic CD, irritant CD, and involvement of exposed body areas were common among PMOs. Common allergens included rubber accelerators, metals, and preservatives.

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Brushing Your Way to Allergic Contact Dermatitis: Anethole Allergy

No abstract available

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Epidemic of Isothiazolinone Allergy in North America: Prevalence Data From the North American Contact Dermatitis Group, 2013–2014

Background: Preservative sensitivity patterns evolve with changing use patterns in products. During the last decade, the use of methylisothiazolinone (MI) at higher concentrations in both leave-on and rinse-off products has significantly increased. This is the first North American Contact Dermatitis Group reporting cycle that includes both methylchloroisothiazolinone (MCI)/MI and MI data. Objective: The aim of this study was to report the prevalence of isothiazolinone allergy (MCI/MI and MI) in the North American Contact Dermatitis Group patch-test population from January 1, 2013, to December 31, 2014. Methods: At 13 centers in North America, 4860 patients were patch tested in a standardized manner with a series of 70 allergens, including MCI/MI 0.01% aqueous (aq) and MI 0.2% aq. Results: Three hundred five patients (6.3%) had a positive reaction to MCI/MI; this is a significant increase from the previous cycle (5.0%, 2011–2012; P = 0.011). Five hundred twenty-one patients (10.7%) had a positive reaction to MI. These 2 isothiazolinones were among the most common preservative allergens in the 2013 to 2014 cycle; 11.9% of patch-tested individuals were allergic to 1 or both isothiazolinones. Individuals with MCI/MI and MI allergy were significantly more likely to have occupationally related skin disease (P

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Intralesional Treatment With 5-Fluorouracil and Steroid Improves Allergic Contact Dermatitis Without Causing Skin Atrophy and Rebound Lesions

No abstract available

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Multicenter Patch Testing With Methylisothiazolinone and Methylchloroisothiazolinone/Methylisothiazolinone Within the International Contact Dermatitis Research Group

Background: The preservatives methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) and MI are well-known contact sensitizers. Recently, an increase in the contact allergy frequency for MI 0.2% aqueous (aq) has been seen in many European countries paralleled with an increase in MCI/MI allergy. Many of the MI-allergic patients do not react to MCI/MI 0.01% or 0.02% because the concentration of MI in these preparations is too low (25 and 50 ppm, respectively) to elicit a positive patch test reaction. Objectives: The aims of this study were to investigate the prevalence of contact allergy to MI in the participating clinics representing various countries all over the world, to assess how many additional individuals with contact allergy are found by testing MI 0.2% aq in parallel with MCI/MI 0.02%, and to assess the clinical relevance of MI and MCI/MI allergies. Patients and Methods: In 9 dermatology clinics representing 9 countries, 3865 consecutive patients with dermatitis were patch tested with MI 0.2% aq and in parallel with MCI/MI 0.02% aq, provisionally included into the baseline series. An assessment of clinical relevance in those allergic to MI was also made. Results: Contact allergy to MI was found in 284 patients (7.3%). The frequency of contact allergy varied from 0.8% to 10.9% in different centers. Simultaneous reactivity to 200 ppm of MCI/MI was found in 67.3% of the MI-positive patients. Contact allergy to MI alone without any simultaneous contact allergy to 200 ppm of MCI/MI was diagnosed in 93 patients (32.7%; 2.4% of all tested patients). The contact allergy to MI and/or MCI/MI could explain or contribute to dermatitis in more than 60% of the MI-allergic patients. Conclusions: Methylisothiazolinone of 2000 ppm needs to be patch tested on its own to not miss contact allergy.

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Contact Allergens in Food Handlers of Kashmir Valley in North India

No abstract available

http://ift.tt/2rsrYHC

Index

Publication date: June 2017
Source:Anesthesiology Clinics, Volume 35, Issue 2

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Copyright

Publication date: June 2017
Source:Anesthesiology Clinics, Volume 35, Issue 2

http://ift.tt/2pXy2G7

Contributors

Optimized immunohistochemistry using the D5F3 antibody provides a reliable test for identification of ALK-positive lung adenocarcinomas

Abstract

We used optimized immunohistochemistry (IHC) with the D5F3 antibody for detection of tumours in a prospective study of 307 pulmonary adenocarcinomas. Cases positive by IHC (1+, 2+, 3+) were further investigated by fluorescent in situ hybridization (FISH). Of 307 cases, 22 (7.2%) were moderately intensely positive (2+/3+); 18 of these (82%) were also positive by FISH. Of the four IHC-positive/FISH-negative cases, one was unsuitable for FISH and three had abnormalities of the ALK gene. All cases with weak reactivity with D5F3 (1+) were FISH-negative. The FISH positive/IHC-positive cases with moderately intense reactivity had the typical clinicopathologic features of ALK-positive patients (younger age, p < 0.01; higher frequency in metastatic sites, p < 0.01; cribriform/mucinous/signet histology, p < 0.01; stage IV disease, p < 0.01). In conclusion, our findings indicate that optimized IHC using the D5F3 antibody provides a reliable and inexpensive test for identification of ALK-positive adenocarcinomas. Inclusion of this information in the pathology report at the time of the histological diagnosis might significantly shorten time to treatment.

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Accept or Decline? An Analytics-Based Decision Tool for Kidney Offer Evaluation.

Background: When a deceased-donor kidney is offered to a waitlisted candidate, the decision to accept or decline the organ relies primarily upon a practitioner's experience and intuition. Such decisions must achieve a delicate balance between estimating the immediate benefit of transplantation and the potential for future higher-quality offers. However, the current experience-based paradigm lacks scientific rigor and is subject to the inaccuracies that plague anecdotal decision-making. Methods: A data-driven analytics-based model was developed to predict whether a patient will receive an offer for a deceased-donor kidney at KDPI thresholds of 0.2, 0.4, and 0.6, and at time frames of 3, 6, and 12 months. The model accounted for OPO, blood group, wait time, DR antigens, and prior offer history to provide accurate and personalized predictions. Performance was evaluated on datasets spanning various lengths of time to understand the adaptability of the method. Results: Using UNOS match-run data from 03/2007 to 06/2013, out-of-sample AUC was approximately 0.87 for all KDPI thresholds and time frames considered for the 10 most populous OPOs. As more data becomes available, AUC values increase and subsequently level off. Conclusions: The development of a data-driven analytics-based model may assist transplant practitioners and candidates during the complex decision of whether to accept or forgo a current kidney offer in anticipation of a future high-quality offer. The latter holds promise to facilitate timely transplantation and optimize the efficiency of allocation. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Hepatic hemodynamics and portal flow modulation: The A2ALL experience.

Objective: A principal aim of the Adult-to-Adult Living Donor Liver Transplantation Cohort Study was to study hepatic blood flow and effect of portal flow modulation on graft outcomes in the setting of increasing use of smaller and left lobe grafts. Methods: Recipients of 274 living donor liver transplant were enrolled in A2ALL-2, including 233 (85.0%) right lobes, 40 (14.6%) left lobes, and 1 (0.5%) left lateral section. Hepatic hemodynamics were recorded after reperfusion. A total of 57 portal flow modulations were performed on 52 subjects. Results: Modulation lowered portal pressure in 68% of subjects with inconsistent effects on hepatic arterial and portal flow. A higher rate of graft dysfunction was observed in modulated vs. unmodulated subjects (31% vs. 18%; p=0.03); however, graft survival in modulated subjects was not different from unmodulated subjects at 3 years. Conclusions: These results suggest the need for a study using a prespecified portal flow modulation protocol with defined indications to better define the effects of these interventions. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.

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Heart Transplantation From DCD Donors: From the Bedside to the Bench.

No abstract available

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Die Kopfhaut im Alter

Zusammenfassung

Nichtmelanozytärer Hautkrebs und seine Frühformen sind aufgrund von steigender Inzidenz und Prävalenz häufige Diagnosen im dermatologischen Alltag. Die Diagnostik erfolgt zumeist klinisch mit konsekutiver histologischer Sicherung. Die Therapie der Wahl bei invasiven Tumoren ist die vollständige Exzision, erst bei nicht möglicher Exzision sollten andere Therapieoptionen wie Bestrahlung und Systemtherapien erwogen werden. Häufig an für ältere Menschen schlecht einsehbaren und erreichbaren Bereichen der Kopfhaut lokalisiert, stellen sie im klinischen Alltag eine besondere Herausforderung für Arzt und Patienten dar. Die Therapieoptionen sind insbesondere im Bereich der Vorstufen zahlreich und sollte individuell auf den Patienten abgestimmt werden. Der größte Risikofaktor für die Entstehung von nichtmelanozytärem Hautkrebs und seinen Frühformen ist die chronische UV-Exposition. Ein möglicher beruflicher Zusammenhang sollte immer erwogen werden. Insbesondere die Prävention durch Patientenedukation und ausreichende Sonnenschutzmaßnahmen steht im Vordergrund. Die Prognose des nichtmelanozytären Hautkrebses verbessert sich signifikant bei frühzeitiger Diagnosestellung und leitliniengerechter Therapie und Nachsorge.

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Serial Neck Ultrasonographic Evaluation of Changes in Papillary Thyroid Carcinoma During Pregnancy

Thyroid , Vol. 0, No. 0.

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Comparison of Survival Outcomes Following Postsurgical Radioactive Iodine Versus External Beam Radiation in Stage IV Differentiated Thyroid Carcinoma

Thyroid , Vol. 0, No. 0.

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Patient-Centered Outcomes in Food Allergy

Abstract

Purpose of Review

Food allergy prevalence is increasing very rapidly, causing a significant disease burden. The threat of severe allergic reactions occurring unexpectedly and in settings that are not equipped to recognize and treat anaphylaxis is a constant source of worry for individuals and families with food allergies. Inadequate knowledge and understanding in the community significantly impairs the overall quality of life of these individuals and families. Additionally, families face challenges in finding and affording appropriate allergen-free foods.

Recent Findings

Advancements have been made in understanding the impact of food allergies on patient-centered outcomes such as quality of life and economic impact, and attempts have been made to develop tools to assess patient-centered variables. Innovative national and regional initiatives are helping to spread awareness of the disease condition and to create resources, including access to allergen-free foods.