Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Τρίτη 23 Μαΐου 2017
The pathogenesis of dermatomyositis
Summary
This review looks at the many different factors thought to play a role in idiopathic inflammatory myopathies (IIM), concentrating mainly on the dermatomyositis (DM) subtype. Subject areas addressed include looking at the different clinical features of IIM, paying particular attention to the skin manifestations. There is a discussion around investigations needed with their perceived value, followed by a description of the immunohistochemical findings of DM. This review goes on to address other attributing factors such as genetic associations with the different subtypes of IIM, and environmental factors including infections, ultraviolet radiation and vitamin D deficiency and drugs. Finally, the potential immunopathogenesis of DM is summarized, looking at T cells, B cells, autoantibodies, dendritic cells, cytokines and nonimmune-mediated endoplasmic reticulum stress.
http://ift.tt/2rPpnrl
Immunohistochemical localization of cannabinoid receptor 1 (CB1) in the submandibular gland of mice under normal conditions and when stimulated by isoproterenol or carbachol
Source:Archives of Oral Biology, Volume 81
Author(s): Wipawee Thoungseabyoun, Apussara Tachow, Sawetree Pakkarato, Atsara Rawangwong, Suthankamon Krongyut, Waraporn Sakaew, Hisatake Kondo, Wiphawi Hipkaeo
ObjectiveWe wished to investigate the subcellular localization of CB1, a receptor for the endocannabinoids in mouse submandibular glands (SMGs) under normal conditions and when stimulated by adrenergic or cholinergic agonists.Materials and methodsSMGs of both male and female adult mice were utilized for immunoblotting and immuno-light and –electron microscopic analyses. Isoproterenol and carbachol were used as adrenergic and cholinergic stimulants, respectively. SMGs were examined at 15, 30, 60 and 120min after intraperitoneal injection of these agents.ResultsSelective localization of intense immunoreactivity for CB1 in the granular convoluted ductal cells was confirmed by immunoblotting and the antigen absorption test. In SMGs of control male mice, CB1-immunoreactivity was evident on the basolateral plasma membranes, including the basal infoldings, but was absent on the apical membranes in the ductal cells. Localization and intensity of CB1-immunoreactivity were essentially the same in SMGs of female mice. The immunoreactivity was transiently localized in the apical plasmalemma of some acinar and granular ductal cells of male SMGs shortly after stimulation by isoproterenol, but not by carbachol.ConclusionThe present finding suggests that CB1 functions primarily in the basolateral membranes of the granular convoluted ductal cells of SMGs under normal conditions, and that the CB1 can function additionally in the apical membrane of acinar and granular ductal cells for modulation of the saliva secretory condition via adrenoceptors.
http://ift.tt/2qfai16
Purinergic 2X7 receptor activation regulates WNT signaling in human mandibular-derived osteoblasts
Source:Archives of Oral Biology, Volume 81
Author(s): Pimrumpai Rochanakit Sindhavajiva, Panunn Sastravaha, Mansuang Arksornnukit, Prasit Pavasant
ObjectivePurinergic 2X7 receptor (P2X7R) activation modulates in vitro mineralization by primary rat and human osteoblasts. However, the detailed mechanism of how P2X7R activation affects primary human osteoblasts remains unclear. The aim of this study was to investigate the effect of P2X7R activation on human mandibular-derived osteoblast (hMOB) differentiation.DesignPrimary human osteoblasts were obtained from non-pathologic mandibular bone from healthy patients. The hMOBs were cultured in osteogenic medium with or without 0.5–5μM 2′(3′)-O-(4-benzoyl) benzoyl-ATP (BzATP), a selective P2X7R agonist. The mRNA expression of osteogenic differentiation markers and WNT-signaling molecules was investigated by quantitative real time polymerase chain reaction. In vitro mineral deposition was determined by Alizarin Red S staining. Transfection of small interfering RNA was performed to confirm the effect of P2X7R activation. WNT/β-catenin signaling was detected by immunofluorescence staining for β-catenin.ResultsBzATP inhibited osteogenic medium-induced RUNX2 and OSX mRNA expression in hMOBs. Moreover, BzATP significantly retarded in vitro mineralization. These findings indicated that BzATP/P2X7R activation inhibited hMOB differentiation. Interestingly, reduced WNT3A mRNA expression and blockage of osteogenic medium-induced β-catenin nuclear translocation were also found. These data suggested that WNT signaling might be a target of P2X7R-regulated osteogenic differentiation. Furthermore, when recombinant human WNT3A was added to the BzATP-treated group, it rescued the reduced RUNX2 and OSX expression, and in vitro mineralization.ConclusionOur results demonstrate that P2X7R activation by BzATP inhibits hMOB differentiation. This inhibitory effect was associated with inhibition of the WNT/β-catenin signaling pathway.
http://ift.tt/2ryzeEI
Identification of oral cavity biofilm forming bacteria and determination of their growth inhibition by Acacia arabica, Tamarix aphylla L. and Melia azedarach L. medicinal plants
Source:Archives of Oral Biology, Volume 81
Author(s): Muhammad Khalid, Danial Hassani, Muhammad Bilal, Zahid Ali Butt, Muhammad Hamayun, Ayaz Ahmad, Danfeng Huang, Anwar Hussain
ObjectiveBiofilms are complex, multi-species bacterial communities that colonize the oral cavity in the form of plaque and are known to cause dental caries and periodontal disease. Present study demonstrated the potential of three selected medicinal plants against isolated and identified dental biofilm forming strains.MethodsPathogenic bacteria from dental biofilms were isolated, cultured, identified by phylogenetic analysis using PCR-based 16S ribosomal RNA (or 16S rRNA) nucleotide sequences and were analyzed for their biofilm forming capability. The antimicrobial activity of the three important medicinal plant extracts (Acacia arabica, Tamarix aphylla L. and Melia azadirachta L.) was determined against the highest biofilm forming bacteria.ResultsPhylogenetic analysis revealed that the 19 strains belonged to Proteobacteria, Firmicutes and Actinobacteria. Among the 19 isolates, eleven strains were found to possess high biofilm formation capability comparatively and antimicrobial activity assay showed that the selected plants considerably inhibited their growth. Extract from A. arabica stem had strong effect on the ability of bacteria isolated from dental carries as evident by up to 73% reduction in biofilm formation on surface pre-treated with extract from this plant. The same extract also showed tremendous biofilm cleaning potential up to 87% of the biofilm.ConclusionThe results suggested that the extracts of selected medicinal plants could be used for protection against pathogenic dental biofilm causing bacteria and attempts should be taken by pharmaceutical industries to utilize it in dental caring products.
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Surgical orthodontics.
Purpose of review: The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Recent findings: Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. Summary: A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2qTf73A
http://ift.tt/2qTf73A
Airway management during induction of anaesthesia, spontaneous ventilation (SV) and controlled mechanical ventilation (CMV), using an endotracheal tube (ETT), laryngeal mask (LM), rabbit-specific supraglottic airway device (v-gel) or facemask (FM).
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
http://ift.tt/2q9QEaK
Airway management during induction of anaesthesia, spontaneous ventilation (SV) and controlled mechanical ventilation (CMV), using an endotracheal tube (ETT), laryngeal mask (LM), rabbit-specific supraglottic airway device (v-gel) or facemask (FM).
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
Curcumin attenuates lipopolysaccharide/d-galactosamine-induced acute liver injury
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
http://ift.tt/2q9DFWG
Curcumin attenuates lipopolysaccharide/d-galactosamine-induced acute liver injury
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
Quality indicators for the acute and long-term management of anaphylaxis: a systematic review
The quality of acute and long-term anaphylaxis management is variable and this contributes to the poor outcomes experienced by many patients. Clinical practice guidelines have the potential to improve outcomes...
http://ift.tt/2qNohhw
Williams-Beuren Syndrome and Congenital Lobar Emphysema: Uncommon Association with Common Pathology?
Introduction. Congenital lobar emphysema (CLE) and Williams-Beuren Syndrome are two rare conditions that have only been reported together in a single case study. Case Presentation. We report another case of a male Caucasian newborn with nonspecific initial respiratory distress, with detection of CLE on repeat chest X-ray on Day 25 of life and concurrent ventricular septal defect, supravalvular aortic stenosis, and branch pulmonary stenosis, in whom a 7q11.23 deletion consistent with Williams-Beuren Syndrome was made. Conclusion. A diagnosis of congenital lobar emphysema should prompt further screening for congenital heart disease and genetic deletion, and further research is needed to investigate the role of elastin gene mutation in the development of the neonatal lung.
http://ift.tt/2rRMpxb
Impact of Obesity on Serum Levels of Thyroid Hormones among Euthyroid Saudi Adults
Aim of Study. To assess serum thyroid hormones levels among Saudi adults and to correlate participants' serum levels with their grades of body mass index (BMI). Methodology. A total of 278 adult subjects were recruited. Participants were categorized according to their BMI grades into normal weight (BMI
http://ift.tt/2rOL0HA
Hypersensitivity reactions to gadolinium-based contrast agents.
Purpose of review: Gadolinium-based contrast agents (GBCAs) have been utilized since the late 1980s to enhance the diagnostic value of MRI studies. They are known to have excellent safety profile and serious adverse reactions are uncommon despite widespread global use. However, immediate hypersensitivity reactions are well described in the literature, with urticaria the most common manifestation. Anaphylaxis can occur, though fatality is extremely rare. This review explores the incidence of GBCA-related hypersensitivity reactions and highlights potential risk factors. Recent findings: Emerging evidence suggests that at least some immediate hypersensitivity reactions are IgE-mediated. Skin testing may be informative in confirmation of causality and revealing cross-reactivity patterns. Summary: GBCA hypersensitivity is infrequent but can be serious. Familiarity with management of acute hypersensitivity reactions may be lifesaving. Appropriate use of diagnostic testing can be used to guide future management of patients who have suffered from such reactions. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2rO7zwM
http://ift.tt/2rO7zwM
Alternative treatments for chronic spontaneous urticaria beyond the guideline algorithm.
Purpose of review: The international EAACI/GA2LEN/EDF/WAO guideline suggests a stepwise approach for the therapeutic management of chronic spontaneous urticaria (CSU), outlined in an algorithm. The aim of this article is to summarize and review the evidence available on alternative treatment options for CSU outside of this algorithm. Recent findings: Although CSU is a common disease, there are a limited number of high-quality studies, and only antihistamines and omalizumab are licensed for its treatment. Most studies regarding alternative therapies for CSU show methodological limitations and a high risk of bias. For many therapies, only case reports and uncontrolled studies exist. Recent publications on alternative treatments for chronic urticaria/CSU include reports on the use of adalimumab, rituximab, vitamin D, probiotics, histaglobulin, injection of autologous whole blood or serum, and phototherapy. Summary: Numerous treatments beyond the guideline algorithm have been evaluated in patients with refractory CSU. The global level of evidence to support their efficacy in CSU is low or very low. Further research is needed to assess the efficacy and safety of alternative therapies of CSU to manage adequately those patients who do not respond to the treatments included in the algorithm. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2rRx0Ni
http://ift.tt/2rRx0Ni
Hypersensitivity reactions to gadolinium-based contrast agents.
Purpose of review: Gadolinium-based contrast agents (GBCAs) have been utilized since the late 1980s to enhance the diagnostic value of MRI studies. They are known to have excellent safety profile and serious adverse reactions are uncommon despite widespread global use. However, immediate hypersensitivity reactions are well described in the literature, with urticaria the most common manifestation. Anaphylaxis can occur, though fatality is extremely rare. This review explores the incidence of GBCA-related hypersensitivity reactions and highlights potential risk factors. Recent findings: Emerging evidence suggests that at least some immediate hypersensitivity reactions are IgE-mediated. Skin testing may be informative in confirmation of causality and revealing cross-reactivity patterns. Summary: GBCA hypersensitivity is infrequent but can be serious. Familiarity with management of acute hypersensitivity reactions may be lifesaving. Appropriate use of diagnostic testing can be used to guide future management of patients who have suffered from such reactions. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2rO7zwM
http://ift.tt/2rO7zwM
Alternative treatments for chronic spontaneous urticaria beyond the guideline algorithm.
Purpose of review: The international EAACI/GA2LEN/EDF/WAO guideline suggests a stepwise approach for the therapeutic management of chronic spontaneous urticaria (CSU), outlined in an algorithm. The aim of this article is to summarize and review the evidence available on alternative treatment options for CSU outside of this algorithm. Recent findings: Although CSU is a common disease, there are a limited number of high-quality studies, and only antihistamines and omalizumab are licensed for its treatment. Most studies regarding alternative therapies for CSU show methodological limitations and a high risk of bias. For many therapies, only case reports and uncontrolled studies exist. Recent publications on alternative treatments for chronic urticaria/CSU include reports on the use of adalimumab, rituximab, vitamin D, probiotics, histaglobulin, injection of autologous whole blood or serum, and phototherapy. Summary: Numerous treatments beyond the guideline algorithm have been evaluated in patients with refractory CSU. The global level of evidence to support their efficacy in CSU is low or very low. Further research is needed to assess the efficacy and safety of alternative therapies of CSU to manage adequately those patients who do not respond to the treatments included in the algorithm. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2rRx0Ni
http://ift.tt/2rRx0Ni
Surgical orthodontics.
Purpose of review: The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Recent findings: Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. Summary: A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
http://ift.tt/2qTf73A
http://ift.tt/2qTf73A
Picking a Pediatrician
Tune in to this episode of Belly to Baby to talk about how you go about picking a pediatrician. Abby is joined by Dr. Kristen Bruno with Purely Pediatrics at the Children's Speciality Care Center to answer your questions.
The post Picking a Pediatrician appeared first on ChildrensMD.
http://ift.tt/2q8q8Pn
World Thyroid Day Recognized Globally on May 25th
World Thyroid Day Recognized Globally
American Thyroid Association collaborates with International Thyroid Societies
May 25, 2017
On May 25th the American Thyroid Association (ATA) (www.thyroid.org), in cooperation with the European Thyroid Association (www.eurothyroid.com), will be making an extraordinary effort to promote its year-round goals —focus attention on that small butterfly-shaped gland at the base of the neck that causes approximately 20 million Americans to experience thyroid disease. In addition to the millions who have some form of thyroid disease, it is estimated that more than 12 percent of the U.S. population will develop a thyroid condition during their lifetime.
The important goal of the ATA and our sister thyroid organizations is to get the word out about Thyroid! Perhaps the most stunning statistics are that up to 60 percent of those with thyroid disease are unaware of their condition and that women are five to eight times more likely than men to have thyroid problems. Almost everyone knows someone affected by thyroid disease or thyroid cancer and the ATA is proud to promote international awareness on World Thyroid Day so that symptoms, diagnosis, and treatment of conditions are available around the globe. If you or someone you know are experiencing thyroid symptoms, make an appointment to see a thyroid specialist – you can find one in your area (in the US and internationally) by using the ATA Physician Referral Tool and you can read up on the thyroid educational materials in the ATA Thyroid Information Library.
The ATA is the leading organization devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education, and public health. Our mission assures that we communicate the importance of the thyroid gland, which produces hormones that influence every cell, tissue, and organ in the body. Thyroid hormones regulate the body's metabolism—the rate at which the body produces energy from nutrients and oxygen—and affects critical body functions, such as energy level and heart rate. Through its mission, the ATA supports the clinicians and researchers who are at the frontlines of thyroid treatments and research. We also work with the public, patients, and their families to educate and increase awareness of thyroid diseases.
ATA member of 29 years, Dr. Gregory Brent – Chair, Department of Medicine from the University of California-Los Angeles says that, "The ATA has been my professional home since my fellowship and it has been a privilege to serve with my many valued colleagues and with such a committed and talented staff. I am most grateful to my mentors, who have encouraged and guided me. The professional and personal growths I have experienced from my involvement with the ATA are immeasurable."
The ATA Patient Thyroid Information library is just a few clicks away on the ATA website – http://ift.tt/25XAFbU and we encourage you to check back regularly for updates and new materials. We are also pleased to offer many of our brochures in Spanish – http://ift.tt/2q8V7uD and provide a translator on the website for most languages. The ATA website provides easy-to-access, patient-friendly information on topics such as:
Hypothyroidism: One of the most common thyroid conditions that occurs when the thyroid gland does not produce enough thyroid hormone. Symptoms include fatigue, depression, forgetfulness, irregular menses and weight gain. Treatment of hypothyroidism is usually with a synthetic form of thyroid hormone called "levothyroxine." Hashimoto's Thyroiditis is an autoimmune disease affecting the thyroid is the most common cause of hypothyroidism in the US, affecting mostly women. Diagnosis is usually confirmed by symptoms suggesting thyroid underactivity, positive anti-thyroid antibodies, and small goiter (thyroid enlargement) on physical examination. Patients with an elevated blood level of TSH and/or goiter are treated with thyroxine (T4).
On the opposite side of the spectrum is Hyperthyroidism and this occurs when the thyroid gland produces too much thyroid hormone. Symptoms include irritability, nervousness, muscle weakness, unexplained weight loss, sleep disturbances, vision problems and eye irritation. One type of hyperthyroidism, Graves' disease, is an autoimmune disorder that is partly genetic.
In addition to these common thyroid conditions, we also know that Thyroid Cancer is the most rapidly increasing form of cancer in the United States. The American Cancer Society estimates 58,670 new cases of thyroid cancer will be diagnosed in 2017 resulting in approximately 2,000 deaths. When thyroid cancer is identified and treated early, the majority of patients can be completely cured.
Mary Catherine Petermann whose father was diagnosed with Anaplastic Thyroid Cancer in 2006 describes how the ATA impacted her search for help, "The ATA was a valuable resource for our family when my dad was diagnosed with Anaplastic Thyroid Cancer. When you are faced with a detrimental diagnosis where even a few days can make the difference in life or death, understanding your options quickly is critical. The ATA website offers a one-stop shop for patients and caregivers to find specialists, current clinical trials, general thyroid cancer information, and links to other patient support groups and information" Mary Catherine's father was treated by ATA member physicians at Mayo Clinic and has clean scans as of October 2016.
For thyroid cancer, Endocrinologists can sometimes employ minimally invasive procedures to distinguish thyroid cancer from benign thyroid nodules, which are common in the population. The ATA produces management guidelines for thyroid diseases and thyroid cancer, which, are open to the public and can accessed on the ATA website here: http://ift.tt/2qTzJ9R
We invite and encourage you to take a moment on the 25th of May, World Thyroid Day, to help ATA continue to serve patients, families, and the physicians to treat them by making a donation on the ATA World Thyroid Day Donation Page: http://ift.tt/2q8Rjt0
Your donation will help ATA continue the important work of education, research, and awareness on this most important disease. No donation is too small and if you would like to make a recurring donation throughout the year, please visit this page: http://ift.tt/2q8GFCx and select frequency that is good for you.
Your interest and support help make a positive impact on the lives of so many who struggle with thyroid conditions and thyroid cancer every day and we thank you for joining us and helping carry-out the ATA mission!
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The American Thyroid Association (ATA) is the leading worldwide organization dedicated to the advancement, understanding, prevention, diagnosis and treatment of thyroid disorders and thyroid cancer. ATA is an international individual membership organization for over 1,700 clinicians and researchers from 43 countries around the world, representing a broad diversity of medical disciplines. It also serves the public, patients and their family through education and awareness efforts
Celebrating its 94th anniversary, ATA delivers its mission through several key endeavors: the publication of highly regarded monthly journals, THYROID, Clinical Thyroidology, VideoEndocrinology and Clinical Thyroidology for the Public; annual scientific meetings; biennial clinical and research symposia; research grant programs for young investigators, support of online professional, public and patient educational programs; and the development of guidelines for clinical management of thyroid disease.
More information about ATA is found at www.thyroid.org.
The post World Thyroid Day Recognized Globally on May 25th appeared first on American Thyroid Association.
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Exclusion of alternative exon 33 of CaV1.2 calcium channels in heart is proarrhythmogenic [Physiology]
Alternative splicing changes the CaV1.2 calcium channel electrophysiological property, but the in vivo significance of such altered channel function is lacking. Structure–function studies of heterologously expressed CaV1.2 channels could not recapitulate channel function in the native milieu of the cardiomyocyte. To address this gap in knowledge, we investigated the role...
http://ift.tt/2rQGtof
Reply to Piperno et al.: It is too soon to argue for localized, short-term human impacts in interfluvial Amazonia [Social Sciences]
We welcome the debate opened by Piperno et al. (1) in response to our recent article (2), and thank the editors of PNAS for the opportunity to reply. Although acknowledging that we detected localized human impacts in our study area, Piperno et al. (1) downplay the increases in palms observed...
http://ift.tt/2qSNeZ5
Reply to Candel et al.: Evidence for evolutionary conservation of folding kinetics in the thioredoxin protein family [Biological Sciences]
The letter by Candel et al. (1) does not address a potential problem with their own experimental set-up. In particular, the use of guanidinium hydrochloride (GdnHCl) is not the best choice of denaturant for studying a folding reaction. There is an ample amount of evidence to suggest that the variations...
http://ift.tt/2qSSprY
Further evidence for localized, short-term anthropogenic forest alterations across pre-Columbian Amazonia [Social Sciences]
By generating soil phytolith and charcoal data from a region of geoglyph construction in southwest Amazonia, Watling et al. (1) provide important evidence on a current debate over the scale and intensity of pre-Columbian modification of Amazonia (e.g., refs. 2–6). The clear evidence for human activity in their study region...
http://ift.tt/2rQBUu0
Fast folding and slow unfolding of a resurrected Precambrian protein [Biological Sciences]
Tzul et al. (1) report different unfolding rates and similar folding rates for a number of thioredoxins. The authors interpret this result as evidence of the principle of minimal frustration. Their study includes several resurrected Precambrian thioredoxins that we have previously prepared and characterized (2–5). We agree that the principle...
http://ift.tt/2rQPqh3
The wisdom of crowds for visual search [Psychological and Cognitive Sciences]
Decision-making accuracy typically increases through collective integration of people's judgments into group decisions, a phenomenon known as the wisdom of crowds. For simple perceptual laboratory tasks, classic signal detection theory specifies the upper limit for collective integration benefits obtained by weighted averaging of people's confidences, and simple majority voting can...
http://ift.tt/2rR77wS
Biological origins of color categorization [Psychological and Cognitive Sciences]
The biological basis of the commonality in color lexicons across languages has been hotly debated for decades. Prior evidence that infants categorize color could provide support for the hypothesis that color categorization systems are not purely constructed by communication and culture. Here, we investigate the relationship between infants' categorization of...
http://ift.tt/2rejRBA
Identifying the landscape drivers of agricultural insecticide use leveraging evidence from 100,000 fields [Sustainability Science]
Agricultural landscape intensification has enabled food production to meet growing demand. However, there are concerns that more simplified cropland with lower crop diversity, less noncrop habitat, and larger fields results in increased use of pesticides due to a lack of natural pest control and more homogeneous crop resources. Here, we...
http://ift.tt/2repvUk
Coronavirus nonstructural protein 15 mediates evasion of dsRNA sensors and limits apoptosis in macrophages [Microbiology]
Coronaviruses are positive-sense RNA viruses that generate double-stranded RNA (dsRNA) intermediates during replication, yet evade detection by host innate immune sensors. Here we report that coronavirus nonstructural protein 15 (nsp15), an endoribonuclease, is required for evasion of dsRNA sensors. We evaluated two independent nsp15 mutant mouse coronaviruses, designated N15m1 and...
http://ift.tt/2rQVBSp
Ab initio dynamics and photoionization mass spectrometry reveal ion-molecule pathways from ionized acetylene clusters to benzene cation [Chemistry]
The growth mechanism of hydrocarbons in ionizing environments, such as the interstellar medium (ISM), and some combustion conditions remains incompletely understood. Ab initio molecular dynamics (AIMD) simulations and molecular beam vacuum-UV (VUV) photoionization mass spectrometry experiments were performed to understand the ion–molecule growth mechanism of small acetylene clusters (up to...
http://ift.tt/2qSQJ23
Aggregation of thrombin-derived C-terminal fragments as a previously undisclosed host defense mechanism [Immunology and Inflammation]
Effective control of endotoxins and bacteria is crucial for normal wound healing. During injury, the key enzyme thrombin is formed, leading to generation of fibrin. Here, we show that human neutrophil elastase cleaves thrombin, generating 11-kDa thrombin-derived C-terminal peptides (TCPs), which bind to and form amorphous amyloid-like aggregates with both...
http://ift.tt/2rQQQbt
Body sway reflects leadership in joint music performance [Psychological and Cognitive Sciences]
The cultural and technological achievements of the human species depend on complex social interactions. Nonverbal interpersonal coordination, or joint action, is a crucial element of social interaction, but the dynamics of nonverbal information flow among people are not well understood. We used joint music making in string quartets, a complex,...
http://ift.tt/2rQGqJ5
Polyketide mimetics yield structural and mechanistic insights into product template domain function in nonreducing polyketide synthases [Biochemistry]
Product template (PT) domains from fungal nonreducing polyketide synthases (NR-PKSs) are responsible for controlling the aldol cyclizations of poly-β-ketone intermediates assembled during the catalytic cycle. Our ability to understand the high regioselective control that PT domains exert is hindered by the inaccessibility of intrinsically unstable poly-β-ketones for in vitro studies....
http://ift.tt/2qSHXRu
Erythritol is a pentose-phosphate pathway metabolite and associated with adiposity gain in young adults [Medical Sciences]
Metabolomic markers associated with incident central adiposity gain were investigated in young adults. In a 9-mo prospective study of university freshmen (n = 264). Blood samples and anthropometry measurements were collected in the first 3 d on campus and at the end of the year. Plasma from individuals was pooled...
http://ift.tt/2rQU6Um
Fold-change detection and scale invariance of cell-cell signaling in social amoeba [Biophysics and Computational Biology]
Cell–cell signaling is subject to variability in the extracellular volume, cell number, and dilution that potentially increase uncertainty in the absolute concentrations of the extracellular signaling molecules. To direct cell aggregation, the social amoebae Dictyostelium discoideum collectively give rise to oscillations and waves of cyclic adenosine 3′,5′-monophosphate (cAMP) under a...
http://ift.tt/2rQQhyi
Maturation arrest in early postnatal sensory receptors by deletion of the miR-183/96/182 cluster in mouse [Neuroscience]
The polycistronic miR-183/96/182 cluster is preferentially and abundantly expressed in terminally differentiating sensory epithelia. To clarify its roles in the terminal differentiation of sensory receptors in vivo, we deleted the entire gene cluster in mouse germline through homologous recombination. The miR-183/96/182 null mice display impairment of the visual, auditory, vestibular,...
http://ift.tt/2rQPduv
String method solution of the gating pathways for a pentameric ligand-gated ion channel [Biophysics and Computational Biology]
Pentameric ligand-gated ion channels control synaptic neurotransmission by converting chemical signals into electrical signals. Agonist binding leads to rapid signal transduction via an allosteric mechanism, where global protein conformational changes open a pore across the nerve cell membrane. We use all-atom molecular dynamics with a swarm-based string method to solve...
http://ift.tt/2qSF0jW
Functional genomics in Brugia malayi reveal diverse muscle nAChRs and differences between cholinergic anthelmintics [Pharmacology]
Many techniques for studying functional genomics of important target sites of anthelmintics have been restricted to Caenorhabditis elegans because they have failed when applied to animal parasites. To overcome these limitations, we have focused our research on the human nematode parasite Brugia malayi, which causes elephantiasis. Here, we combine single-cell...
http://ift.tt/2reREdQ
Atypical interactions of integrin {alpha}V{beta}8 with pro-TGF-{beta}1 [Biophysics and Computational Biology]
Integrins αVβ6 and αVβ8 are specialized for recognizing pro-TGF-β and activating its growth factor by releasing it from the latency imposed by its surrounding prodomain. The integrin αVβ8 is atypical among integrins in lacking sites in its cytoplasmic domain for binding to actin cytoskeleton adaptors. Here, we examine αVβ8 for...
http://ift.tt/2rR78kq
Structural basis for cancer immunotherapy by the first-in-class checkpoint inhibitor ipilimumab [Immunology and Inflammation]
Rational modulation of the immune response with biologics represents one of the most promising and active areas for the realization of new therapeutic strategies. In particular, the use of function blocking monoclonal antibodies targeting checkpoint inhibitors such as CTLA-4 and PD-1 have proven to be highly effective for the systemic...
http://ift.tt/2qSWSej
Media Advisory: Experts Available to Discuss Historic Cancer Drug Approval
Today, for the first time, a drug has been FDA-approved for cancer based on disease genetics rather than type. Developed from 30 years of basic research at Johns Hopkins and its Bloomberg~Kimmel Institute, pembroluzimab now can be used for colon, pancreatic, stomach, ovarian and other cancers if genetic testing reveals defects in so-called mismatch repair genes.
http://ift.tt/2rNAEZg
The association between microsatellite instability and lymph node count in colorectal cancer
Abstract
The number of lymph nodes retrieved from colorectal cancer (CRC) resection specimens is crucial for adequate diagnosis and therapy. Previous studies indicate that in addition to the extent of surgical resection and the quality of pathological lymph node examination, non-modifiable tumour parameters like microsatellite instability (MSI) are associated with higher lymph node count. In order to study the potential influence of MSI on lymph node count, we analysed a previously MSI-typed population of CRC patients (n = 1196) to determine the relationship between MSI and the frequency with which at least 12 lymph nodes were retrieved, as well as the mean and median number of retrieved lymph nodes. MSI was associated with an increased frequency of 12-node retrieval, as well as a higher mean and median lymph node count in the overall analysis (p 0.004 and 0.001 for 12-node retrieval and lymph node count, respectively). However, when the analysis was restricted to cancers of the proximal colon, the main location of microsatellite unstable tumours (84% in our study), no association between MSI and 12-node retrieval was found. Subcategorisation by UICC stage of proximally located cancers showed a statistically significant increase in the lymph node count only in microsatellite unstable stage I tumours (p 0.010). In conclusion, our data shows that previously reported associations between MSI and higher lymph node count are mainly a consequence of the increased incidence of microsatellite unstable cancer in the proximal colon. Our finding that MSI is related to a significantly higher mean lymph node count in proximal stage I cancers may indicate that the immunogenicity of this molecular tumour type induces earlier lymph node activation.
http://ift.tt/2qM0ezr
Current insights in noise-induced hearing loss: a literature review of the underlying mechanism, pathophysiology, asymmetry, and management options
Abstract
Background
Noise-induced hearing loss is one of the most common forms of sensorineural hearing loss, is a major health problem, is largely preventable and is probably more widespread than revealed by conventional pure tone threshold testing. Noise-induced damage to the cochlea is traditionally considered to be associated with symmetrical mild to moderate hearing loss with associated tinnitus; however, there is a significant number of patients with asymmetrical thresholds and, depending on the exposure, severe to profound hearing loss as well.
Main body
Recent epidemiology and animal studies have provided further insight into the pathophysiology, clinical findings, social and economic impacts of noise-induced hearing loss. Furthermore, it is recently shown that acoustic trauma is associated with vestibular dysfunction, with associated dizziness that is not always measurable with current techniques. Deliberation of the prevalence, treatment and prevention of noise-induced hearing loss is important and timely. Currently, prevention and protection are the first lines of defence, although promising protective effects are emerging from multiple different pharmaceutical agents, such as steroids, antioxidants and neurotrophins.
Conclusion
This review provides a comprehensive update on the pathophysiology, investigations, prevalence of asymmetry, associated symptoms, and current strategies on the prevention and treatment of noise-induced hearing loss.
http://ift.tt/2q7Wrhk
Intranasal distribution and clearance of thermoreversible gel in an animal model
Background
Poloxamer 407 (P407) has been investigated for an intranasal drug delivery system. However, there is little known about the distribution and clearance of intranasally applied P407. The purpose of this study was to evaluate the distribution and clearance time of P407 in an animal model.
Methods
Five male pigs were administered the experimental solution (18% of P407 with 0.01% of fluorescein) and the control solution (normal saline with 0.01% of fluorescein) into their right and left nasal cavity, respectively. For quantitative analysis, endoscopic images of each nasal cavity were taken immediately and at 10, 20, 30, and 60 minutes after intranasal administration.
Results
The experimental group showed a significantly wider distribution of fluorescein than the control group at 10, 20, and 30 minutes. The experimental group also showed a significantly higher mean intensity of fluorescein than the control group at 10, 20, and 30 minutes. The mean intensity in the control group was significantly decreased during 30 minutes but the mean intensity in the experimental group was significantly decreased during 60 minutes.
Conclusion
A substantial amount of P407 remained in the nasal cavity for at least 30 minutes post-application.
http://ift.tt/2qLWyh5
Acute impact of continuous positive airway pressure on nasal patency
Background
Continuous airflow in the upper airway can cause discomfort, leading to nasopharyngeal complaints. The aim of the present study is to evaluate the acute effects of continuous positive upper-airway pressure on nasal patency in awake normal subjects.
Methods
Twenty-seven adults (17 men; 10 women; age range, 18 to 43 years) were exposed to continuous airway pressure (20 cmH2O) in the nasal cavity, delivered by a continuous positive airway pressure (CPAP) device through a nasal mask for 2 hours. Visual analogue scale (VAS) of nasal obstruction, Nasal Obstruction Symptom Evaluation (NOSE) modified scale, acoustic rhinometry (AR), and peak nasal inspiratory flow (PF) were measured before and after the use of CPAP.
Results
There was an increase in nasal obstruction scores both on the VAS (p < 0.05) and on the NOSE scale (p < 0.05), as well as a reduction in nasal cavity volume on AR (p < 0.05) and a decline in PF (p < 0.05). Subjects were stratified into 2 groups: with and without symptoms of allergic rhinitis. Nasal parameters were significantly worse in the rhinitis group, with higher nasal obstruction scores on the VAS (p = 0.001) and NOSE scale (p < 0.001) and decreased PF (p < 0.001).
Conclusion
Acute exposure to positive pressure via CPAP is associated with subjective and objective reductions in nasal patency. In individuals with allergic nasal symptoms, deterioration is even more severe than in patients without these symptoms.
http://ift.tt/2qgRnlF
Current insights in noise-induced hearing loss: a literature review of the underlying mechanism, pathophysiology, asymmetry, and management options
Noise-induced hearing loss is one of the most common forms of sensorineural hearing loss, is a major health problem, is largely preventable and is probably more widespread than revealed by conventional pure to...
http://ift.tt/2rdO2c6
Reirradiation for Small Inoperable Head and Neck Tumors
Condition: Head and Neck Cancer
Interventions: Radiation: SBRT; Radiation: IMRT/IMPT; Behavioral: Questionnaires
Sponsor: M.D. Anderson Cancer Center
Not yet recruiting - verified May 2017
http://ift.tt/2qS0nSe
Interventions: Radiation: SBRT; Radiation: IMRT/IMPT; Behavioral: Questionnaires
Sponsor: M.D. Anderson Cancer Center
Not yet recruiting - verified May 2017
http://ift.tt/2qS0nSe
G-CSF Administration in IVF in a Preferable Preceptive Endometrium Score
Condition: Women Infertility
Interventions: Procedure: Endometrial scratch; Drug: G-CSF administration; Drug: Saline Solution
Sponsors: Istishari Arab Hospital; Salem Abu Khyzaran; Nizam Najeeb
Not yet recruiting - verified May 2017
http://ift.tt/2rQ2D9Q
Interventions: Procedure: Endometrial scratch; Drug: G-CSF administration; Drug: Saline Solution
Sponsors: Istishari Arab Hospital; Salem Abu Khyzaran; Nizam Najeeb
Not yet recruiting - verified May 2017
http://ift.tt/2rQ2D9Q
PET/MRI in Oropharyngeal Squamous Cell Carcinoma Evaluation
Condition: Head and Neck Cancer
Intervention: Diagnostic Test: PET/MRI for evaluation
Sponsors: Chang Gung Memorial Hospital; Ministry of Science and Technology, Taiwan
Recruiting - verified April 2017
http://ift.tt/2qS8PRK
Intervention: Diagnostic Test: PET/MRI for evaluation
Sponsors: Chang Gung Memorial Hospital; Ministry of Science and Technology, Taiwan
Recruiting - verified April 2017
http://ift.tt/2qS8PRK
De gedeelde baksteen in de maag? Meerwaarde realiseren door gemeenschappelijk wonen en collectief bouwen.
De Vlaamse bevolking groeit, vergrijst en wordt meer en meer divers. Het aantal gezinnen stijgt, de grootte ervan daalt, nieuwe gezinsvormen - zoals eenoudergezinnen of nieuw samengestelde gezinnen komen vaker voor. Het bestaande woonpatrimonium, met veelal klassieke ééngezinswoningen, is hier niet op aangepast. Er is nood aan meer betaalbare kleine woningen, maar ook de vraag naar flexibele woontypes en innovatieve woonvormen stijgt. Ondernemende burgers nemen initiatief om die veranderende woonwensen in te vullen. Via collectief bouwen en gemeenschappelijk wonen gaan ze op zoek naar winst op ruimtelijk, financieel maar ook op sociaal vlak. Ook het Vlaams ruimtelijk beleid ziet potenties in het stimuleren van gemeenschappelijk wonen zoals bijvoorbeeld cohousing, om het ruimtelijk rendement op een kwaliteitsvolle manier te verhogen, de buurten leefbaar te houden en de sociale cohesie te verhogen. Ondanks de stijgende interesse voor cohousing, werden er de voorbije jaren maar weinig projecten gerealiseerd. Het is als initiatiefgroep echt niet evident om een project van de grond te krijgen. Maar ook voor overheden is het niet zo makkelijk om gemeenschappelijk wonen en innoverende projectontwikkeling door burgercollectieven actief te ondersteunen. De paper bespreekt knelpunten voor het realiseren van gemeenschappelijk wonen via collectief bouwen, vanuit het standpunt van een initiatiefgroep voor cohousing. Hieruit worden algemene aanbevelingen gedaan om deze nieuwe woon- en bouwcultuur in Vlaanderen beter te ondersteunen. Bovendien worden er ook specifieke sleutels aangereikt voor ruimtelijk beleid om dergelijke innovatieve initiatieven ook te laten renderen voor een ruimere omgeving.
http://ift.tt/2qLOkWk
Ruimtelijke transformaties in verstedelijkte gebieden gedurende de afgelopen 50 jaar De case van het stadsgewest Gent.
Dit artikel onderzoekt de dynamiek van ruimtelijke transformaties in sterk verstedelijkte gebieden en in het bijzonder de stedelijke agglommeratie van Gent (België). Daartoe wordt teruggegaan tot 50 jaar in de tijd (1963-2013). Als hypothese wordt ervan uitgegaan dat in die periode zich drie grote ruimtelijke transformaties voltrekken: de bevolkingstoename leidt tot de jaren 1980 tot suburbanisatie of het uitspreiden van functies rondom de stadskern en wordt gevolgd door een periode van verdichtingsprocessen waarbij resterende open gebieden worden ingevuld binnen de suburbane nevel. Het gaat vooral over nieuwbouw. Deze verdichte nevel -die zich voordoet als een stadsrand- transformeert, tot slot, samen met de stadskern zowel in aard als in gebruik van het bestaand bebouwd weefsel. Het gaat dan vooral over renovatie en hergebruik. De dynamiek van deze processen kan gerecontrueerd worden aan de hand van bouw- en verkavelingsaanvragen. Op basis hiervan kunnen buurten onderscheiden worden met een lage of hoge dynamiek inzake transformaties. Tot slot wordt onderzocht waar tranformaties zich in de toekomst zullen voordoen. Sociaal-economische kenmerken van starters op de woonmarkt kunnen een indicatie zijn voor te verwachten transformaties in de toekomst in andere buurten. Het artikel introduceert het concept van Napoleon-percelen om de statistische en ruimtelijke analyse uit te voeren. Dynamieken en patronen worden in kaart gebracht.
http://ift.tt/2qgulM2
Management of Kounis syndrome: two case reports
Kounis syndrome corresponds to the occurrence of myocardial injury following an allergic insult. This syndrome is infrequent, and is not well known. In consequence, it is usually misdiagnosed leading to inappr...
http://ift.tt/2qSEqR2
Contribution of chronic conditions to the disability burden across smoking categories in middle-aged adults, Belgium
Introduction : Smoking is considered the single most important preventable cause of morbidity and mortality worldwide, contributing to increased incidence and severity of disabling conditions. The aim of this study was to assess the contribution of chronic conditions to the disability burden across smoking categories in middle-aged adults in Belgium. Methods : Data from 10,224 individuals aged 40 to 60 years who participated in the 1997, 2001, 2004, or 2008 Health Interview Surveys in Belgium were used. Smoking status was defined as never, former (cessation >= 2 years), former (cessation <2 years), occasional light (<20 cigarettes/day), daily light, and daily heavy (>= 20 cigarettes/day). To attribute disability to chronic conditions, binomial additive hazards models were fitted separately for each smoking category adjusted for gender, except for former (cessation <2 years) and occasional light smokers due to the small sample size. Results : An increasing trend in the disability prevalence was observed across smoking categories in men (never = 4.8%, former (cessation >= 2 years) = 5.8%, daily light = 7.8%, daily heavy = 10.7%) and women (never = 7.6%, former (cessation >= 2 years) = 8.0%, daily light = 10.2%, daily heavy = 12.0%). Musculoskeletal conditions showed a substantial contribution to the disability burden in men and women across all smoking categories. Other important contributors were depression and cardiovascular diseases in never smokers; depression, chronic respiratory diseases, and diabetes in former smokers (cessation >= 2 years); chronic respiratory diseases, cancer, and cardiovascular diseases in daily light smokers; cardiovascular diseases and chronic respiratory diseases in men and depression and diabetes in women daily heavy smokers. Conclusions : Beyond the well-known effect of smoking on mortality, our findings showed an increasing trend of the disability prevalence and different contributors to the disability burden across smoking categories. This information can be useful from a public health perspective to define strategies to reduce disability in Belgium.
http://ift.tt/2qLpQN1
Contribution of chronic diseases to the mild and severe disability burden in Belgium
Background: Population aging accompanied by an increased longevity with disability has raised international concern, especially due to its costs to the health care systems. Chronic diseases are the main causes of physical disability and their simultaneous occurrence in the population can impact the disablement process, resulting in different severity levels. In this study, the contribution of chronic diseases to both mild and severe disability burden in Belgium was investigated. Methods: Data on 21 chronic diseases and disability from 35,799 individuals aged 15 years or older who participated in the 1997, 2001, 2004, or 2008 Belgian Health Interview Surveys were analysed. Mild and severe disability were defined based on questions related to six activities of daily living and/or mobility limitations. To attribute disability by severity level to selected chronic diseases, multiple additive hazard models were fitted to each disability outcome, separately for men and women. Results: A stable prevalence of mild (5 %) and severe (2–3 %) disability was observed for the Belgian population aged 15 years or older between 1997 and 2008. Arthritis was the most important contributor in women with mild and severe disability. In men, low back pain and chronic respiratory diseases contributed most to the mild and severe disability burden, respectively. The contribution also differed by age: for mild disability, depression and chronic respiratory diseases were important contributors among young individuals, while heart attack had a large contribution for older individuals. For severe disability, neurological diseases and stroke presented a large contribution in young and elderly individuals, respectively. Conclusions: Our results indicate that the assessment of the contribution of chronic diseases on disability is more informative if different levels of disability are taken into consideration. The identification of diseases which are related to different levels of disability – mild and severe – can assist policymakers in the definition and prioritisation of strategies to tackle disability, involving prevention, rehabilitation programs, support services, and training for disabled individuals.
http://ift.tt/2qL2ZRy
BMP and Hedgehog regulate distinct AGM hematopoietic stem cells ex vivo
Hematopoietic stem cells (HSC), the self-renewing cells of the adult blood differentiation hierarchy, are generated during embryonic stages. The first HSCs are produced in the aorta-gonad-mesonephros (AGM) region of the embryo through endothelial to a hematopoietic transition. BMP4 and Hedgehog affect their production and expansion, but it is unknown whether they act to affect the same HSCs. In this study using the BRE GFP reporter mouse strain that identifies BMP/Smad-activated cells, we find that the AGM harbors two types of adult-repopulating HSCs upon explant culture: One type is BMP-activated and the other is a non-BMP-activated HSC type that is indirectly controlled by Hedgehog signaling through the VEGF pathway. Transcriptomic analyses demonstrate that the two HSC types express distinct but overlapping genetic programs. These results revealing the bifurcation in HSC types at early embryonic stages in the AGM explant model suggest that their development is dependent upon the signaling molecules in the microenvironment.
http://ift.tt/2qg7vUG
Early phrenic motor neuron loss and transient respiratory abnormalities following unilateral cervical spinal cord contusion
Contusion-type cervical spinal cord injury (SCI) is one of the most common forms of SCI observed in patients. In particular, injuries targeting the C3-C5 region affect the pool of phrenic motor neurons (PhMNs) that innervates the diaphragm, resulting in significant and often chronic respiratory dysfunction. Using a previously described rat model of unilateral midcervical C4 contusion with the Infinite Horizon Impactor, we have characterized the early time course of PhMN degeneration and consequent respiratory deficits following injury, as this knowledge is important for designing relevant treatment strategies targeting protection and plasticity of PhMN circuitry. PhMN loss (48% of the ipsilateral pool) occurred almost entirely during the first 24 h post-injury, resulting in persistent phrenic nerve axonal degeneration and denervation at the diaphragm neuromuscular junction (NMJ). Reduced diaphragm compound muscle action potential amplitudes following phrenic nerve stimulation were observed as early as the first day post-injury (30% of pre-injury maximum amplitude), with slow functional improvement over time that was associated with partial reinnervation at the diaphragm NMJ. Consistent with ipsilateral diaphragmatic compromise, the injury resulted in rapid, yet only transient, changes in overall ventilatory parameters measured via whole-body plethysmography, including increased respiratory rate, decreased tidal volume, and decreased peak inspiratory flow. Despite significant ipsilateral PhMN loss, the respiratory system has the capacity to quickly compensate for partially impaired hemidiaphragm function, suggesting that C4 hemicontusion in rats is a model of SCI that manifests subacute respiratory abnormalities. Collectively, these findings demonstrate significant and persistent diaphragm compromise in a clinically relevant model of midcervical contusion SCI; however, the therapeutic window for PhMN protection is restricted to early time points post-injury. On the contrary, preventing loss of innervation by PhMNs and/or inducing plasticity in spared PhMN axons at the diaphragm NMJ are relevant long-term targets.
http://ift.tt/2qL2YwY
In vitro 2-deoxy-2-[18F]fluoro-D-glucose uptake: practical considerations
In oncology 2-deoxy-2-[F-18]fluoro-D-glucose ([F-18]-FDG), a glucose analogue, is the most used positron emission tomography (PET) tracer. There are however some limitations due to low metabolic activity or high surrounding physiological uptake in several tumors or regions. Investigating new tracers or methods is expensive and elaborative when animal experiments or phase I clinical trials are used. In vitro experiments can overcome these limitations. We analyzed the influence of incubation time, cell medium conditions, administered activity, and cell density on [F-18]-FDG uptake in six different cell cultures. Glucose transporter 1 (GLUT1)- and hexokinase 2 (HK2)-expression at high and low cell density was analyzed using immunocytochemistry. FDG-uptake increases over time and absence of glucose in the incubation medium increases uptake. By increasing the administered activity, uptake per protein also increases and tracer uptake per protein is lower at higher cell densities. Immunocytochemical analysis reveals a lower expression of both GLUT1 and HK2 at higher cell concentrations. All investigated parameters influenced FDG uptake and therefore we can conclude it is of utmost importance to keep administered activity, incubation medium, and time constant and to correct uptake when cell density changes due to environmental conditions, such as therapy.
http://ift.tt/2qfZ8IP
A multilocus sequence typing scheme implies population structure and reveals several putative novel Achromobacter species
The genus Achromobacter currently is comprised of seven species, including Achromobacter xylosoxidans, an opportunistic and nosocomial pathogen that displays broad-spectrum antimicrobial resistance and is recognized as causing chronic respiratory tract infection in persons with cystic fibrosis (CF). To enable strain typing for global epidemiologic investigations, to clarify the taxonomy of "Achromobacter-like" strains, and to elucidate the population structure of this genus, we developed a genus-level multilocus sequence typing (MLST) scheme. We employed in silico analyses of whole-genome sequences of several phylogenetically related genera, including Bordetella, Burkholderia, Cupriavidus, Herminiimonas, Janthinobacterium, Methylibium, and Ralstonia, for selecting loci and designing PCR primers. Using this MLST scheme, we analyzed 107 genetically diverse Achromobacter isolates cultured from biologic specimens from CF and non-CF patients, 1 isolate recovered from sludge, and an additional 39 strains obtained from culture collections. Sequence data from these 147 strains, plus three recently genome-sequenced Achromobacter strains, were assigned to 129 sequence types based on seven loci. Calculation of the nucleotide divergence of concatenated locus sequences within and between MLST clusters confirmed the seven previously named Achromobacter species and revealed 14 additional genogroups. Indices of association showed significant linkage disequilibrium in all of the species/genogroups able to be tested, indicating that each group has a clonal population structure. No clear segregation of species/genogroups between CF and non-CF sources was found.
http://ift.tt/2qL2Ygs
Lymph node metastasis of squamous cell carcinoma from an unknown primary in the upper and middle neck: impact of 18F-fluorodeoxyglucose positron emission tomography/computed tomography
Purpose: The purpose of this study was to assess the potential of F-18-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) imaging for detection of the primary tumor and its impact on treatment planning in patients presenting with cancer of unknown primary and squamous cell carcinoma (SCC)-positive cervical lymph nodes of the upper and middle neck. Methods: The study population consisted of 18 consecutive patients with biopsy-proven SCC involving lymph nodes of the upper and middle neck region and negative conventional diagnostic procedures with regard to the location of the primary. All patients underwent FDG-PET/CT according to a standard procedure in search for the primary, unidentified tumor. Results: In none of the patients FDG-PET/CT was able to indicate a primary tumor localization. Although FDGPET/CT did identify all sites of known lymph node involvement, neither additional sites of lymph node involvement nor sites of distant metastases were identified. Accordingly, FDG-PET/CT did not impact patient treatment planning. Conclusions: In this series, including patients suffering from lymph node metastases by an SCC of unknown primary in the upper and middle neck, FDG-PET/CT was unable to identify a primary tumor. In addition, FDGPET/CT did not modify the treatment planning in any of the patients studied.
http://ift.tt/2qfSEd2
Giant orf tumor in an immunocompromised patient
Abstract
Herein, we report the efficacy and the safety of open-spray cryotherapy in an immunocompromised woman presenting with tumor-like orf lesion. A 58-year-old woman was referred with a 4-month history of an undiagnosed, painful, ulcerated, tumor-like lesion on the last phalanx of the fifth digit of her left hand. Six months earlier, the woman had received a cadaveric kidney transplant for an indication of focal segmental glomerulosclerosis.
This article is protected by copyright. All rights reserved.
http://ift.tt/2rdhjUx
A novel nonframeshift deletion in MVK gene responsible for disseminated superficial actinic porokeratosis in one Chinese family
Abstract
Disseminated superficial actinic porokeratosis (DSAP), a genodermatosis transmitted as an autosomal dominant trait featuring disorder of keratinization, is characterized clinically by annular plaques with an atropic center and hyperkeratotic edges.1-4 Recently, Zhang et al. 2 reported MVK mutations in 33% familiar and 16% sporadic patients with DSAP by exome sequencing. Here, we report a single novel mutation of MVK, p.Cys161_Arg176del, in a Chinese family suffering from DSAP.
This article is protected by copyright. All rights reserved.
http://ift.tt/2rModNo
Central nervous system involvement of primary cutaneous diffuse large B-cell lymphoma, leg type: 13 cases
Abstract
Primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT) is an aggressive primary cutaneous B-cell lymphoma affecting older people.1 Rituximab (RTX) combined with polychemotherapy (RTX-PCT) has improved survival but relapses are frequent.2 Central nervous system (CNS) involvement is rare and poorly described.
This article is protected by copyright. All rights reserved.
http://ift.tt/2rdw0qz
The cutaneous disease of Saint Ubald of Gubbio (1084–1160)
Abstract
Ubald was a Catholic Church Saint (1084 – 1160), born in Gubbio (Umbria, Italy) and died after two years of painful illness; his mummy is now guarded in a glass sarcophagus at Sant'Ubald Cathedral in Gubbio. Informations about Ubald are derived by his two main biographers: Iordanus (Giordano) of Città di Castello1 and Theobaldus (Teobaldo), his successor in the episcopal seat2.
This article is protected by copyright. All rights reserved.
http://ift.tt/2rwbW2s
Can universities save us from disaster?
Maxwell, N; (2017) Can universities save us from disaster? On the Horizon , 25 (2) pp. 115-130. 10.1108/OTH-04-2016-0019 .
http://ift.tt/2qS7at8
Surfactant Assemblies on Selected Nano-Structured Surfaces: Evidence, Driving Forces, and Applications
Striolo, A; Grady, BP; (2017) Surfactant Assemblies on Selected Nano-Structured Surfaces: Evidence, Driving Forces, and Applications. Langmuir 10.1021/acs.langmuir.7b00756 . (In press).
http://ift.tt/2qSAtMo
Visibilia ex invisibilibus: seeing at the nanoscale for improved preservation of parchment
Bartoletti, A; Odlyha, M; Hudziak, S; Axelsson, KM; de Groot, J; Bozec, L; (2017) Visibilia ex invisibilibus: seeing at the nanoscale for improved preservation of parchment. Insight - Non-Destructive Testing and Condition Monitoring , 59 (5) pp. 265-272. 10.1784/insi.2017.59.5.265 .
http://ift.tt/2q7dCPU
Progressive approach to eruption at Campi Flegrei caldera in southern Italy
Kilburn, CRJ; De Natale, G; Carlino, S; (2017) Progressive approach to eruption at Campi Flegrei caldera in southern Italy. Nature Communications , 8 , Article 15312. 10.1038/ncomms15312 . Green open access
http://ift.tt/2qSo8I6
Treatment of Fabry’s Disease with the Pharmacologic Chaperone Migalastat
Germain, DP; Hughes, DA; Nicholls, K; Bichet, DG; Giugliani, R; Wilcox, WR; Feliciani, C; Germain, DP; Hughes, DA; Nicholls, K; Bichet, DG; Giugliani, R; Wilcox, WR; Feliciani, C; Shankar, SP; Ezgu, F; Amartino, H; Bratkovic, D; Feldt-Rasmussen, U; Nedd, K; Sharaf El Din, U; Lourenco, CM; Banikazemi, M; Charrow, J; Dasouki, M; Finegold, D; Giraldo, P; Goker-Alpan, O; Longo, N; Scott, CR; Torra, R; Tuffaha, A; Jovanovic, A; Waldek, S; Packman, S; Ludington, E; Viereck, C; Kirk, J; Yu, J; Benjamin, ER; Johnson, F; Lockhart, DJ; Skuban, N; Castelli, J; Barth, J; Barlow, C; Schiffmann, R; - view fewer (2016) Treatment of Fabry's Disease with the Pharmacologic Chaperone Migalastat. New England Journal of Medicine , 375 (6) pp. 545-555. 10.1056/NEJMoa1510198 . Green open access
http://ift.tt/2q7uFBw
Decentralized Time-Synchronized Channel Swapping for Ad Hoc Wireless Networks
Smart, G; Deligiannis, N; Surace, R; Loscri, V; Fortino, G; Andreopoulos, Y; (2016) Decentralized Time-Synchronized Channel Swapping for Ad Hoc Wireless Networks. IEEE Transactions on Vehicular Technology , 65 (10) pp. 8538-8553. 10.1109/TVT.2015.2509861 . Green open access
http://ift.tt/2qS78l0
Effect of stirring rate on the morphology of FDU-12 mesoporous silica particles
Meoto, S; Kent, N; Nigra, MM; Coppens, MO; (2017) Effect of stirring rate on the morphology of FDU-12 mesoporous silica particles. Microporous and Mesoporous Materials , 249 pp. 61-66. 10.1016/j.micromeso.2017.04.045 . Green open access
http://ift.tt/2q7egNb
Late Anthracycline-Related Cardiotoxicity in Low-Risk Breast Cancer Patients
Maestrini, V; Cheang, MH; Kotwinski, P; Rosmini, S; Lloyd, G; Kellman, P; Pennell, DJ; Maestrini, V; Cheang, MH; Kotwinski, P; Rosmini, S; Lloyd, G; Kellman, P; Pennell, DJ; Montgomery, H; Moon, JC; Manisty, C; - view fewer (2017) Late Anthracycline-Related Cardiotoxicity in Low-Risk Breast Cancer Patients. Journal of the American College of Cardiology , 69 (20) pp. 2573-2575. 10.1016/j.jacc.2017.03.560 .
http://ift.tt/2q7rYzP
Multiparametric prostate MRI: technical conduct, standardized report and clinical use. A narrative review
Manfredi, M; Mele, F; Garrou, D; Walz, J; Fütterer, JJ; Russo, F; Vassallo, L; Manfredi, M; Mele, F; Garrou, D; Walz, J; Fütterer, JJ; Russo, F; Vassallo, L; Villers, A; Emberton, M; Valerio, M; - view fewer (2017) Multiparametric prostate MRI: technical conduct, standardized report and clinical use. A narrative review. Minerva Urologica E Nefrologica , 69 10.23736/S0393-2249.17.02846-6 .
http://ift.tt/2qScyg2
The Relationship between 25-hydroxyvitamin D Levels, Insulin Sensitivity and Insulin Secretion in Women 3 Years after Delivery
Tänczer, T; Magenheim, R; Fürst, Á; Domján, B; Janicsek, Z; Szabó, E; Ferencz, V; Tänczer, T; Magenheim, R; Fürst, Á; Domján, B; Janicsek, Z; Szabó, E; Ferencz, V; Tabák, ÁG; - view fewer (2017) The Relationship between 25-hydroxyvitamin D Levels, Insulin Sensitivity and Insulin Secretion in Women 3 Years after Delivery. Canadian Journal of Diabetes 10.1016/j.jcjd.2017.01.003 . (In press).
http://ift.tt/2q7iIeQ
Decreased body mass index in the preclinical stage of autosomal dominant Alzheimer's disease
Mueller, S; Preische, O; Sohrabi, HR; Graeber, S; Jucker, M; Dietzsch, J; Ringman, JM; Mueller, S; Preische, O; Sohrabi, HR; Graeber, S; Jucker, M; Dietzsch, J; Ringman, JM; Martins, RN; McDade, E; Schofield, PR; Ghetti, B; Rossor, M; Graff-Radford, NR; Levin, J; Galasko, D; Quaid, KA; Salloway, S; Xiong, C; Benzinger, T; Buckles, V; Masters, CL; Sperling, R; Bateman, RJ; Morris, JC; Laske, C; - view fewer (2017) Decreased body mass index in the preclinical stage of autosomal dominant Alzheimer's disease. Scientific Reports , 7 , Article 1225. 10.1038/s41598-017-01327-w . Green open access
http://ift.tt/2qSfzg9
Anthony King In Memoriam
Weale, A; (2017) Anthony King In Memoriam. PS: Political Science & Politics , 50 (2) pp. 590-592. 10.1017/S1049096517000063 . Green open access
http://ift.tt/2q7swpx
Prolonged denervation induces remodeling of nasal mucosa in rat model of posterior nasal neurectomy
Background
The posterior nasal nerve is the dominant source of the parasympathetic, sympathetic, and sensory fibers that innervate the nasal respiratory mucosa. Therefore, a posterior nasal neurectomy (PNN) induces denervation of the nasal mucosa and relieves the nasal symptoms of intractable rhinitis. PNN depletes nerve fibers, choline acetyltransferase, and neuropeptides in nasal respiratory mucosa, and reduces nasal secretion. However, the histological and symptomatic changes over an extended period after PNN remain unknown.
Methods
Using a rat model of PNN via the transorbital approach, we investigated chronological changes of nasal morphology, innervation, and secretion over a 48-week postoperative period after PNN.
Results
The respiratory nasal mucosa exhibited squamous metaplasia, lymphocyte and plasma cell infiltration, basement membrane thickening, loss of cilia, and hyperplasia of the mucus gland in thickened epithelium with increased connective tissue from 24 weeks after PNN. These changes resemble the characteristics of remodeling in chronic rhinosinusitis. DNA microarray and quantitative polymerase chain reaction analysis revealed that mucin 5ac, interleukin 13, and brain-derived neurotrophic factor messenger RNA (mRNA) were upregulated in PNN-treated mucosa compared to untreated mucosa. During this period, nerve fibers including sensory, sympathetic, and parasympathetic fibers gradually reinnervated the mucosa from 12 weeks after PNN. However, nasal secretion was decreased even at 48 weeks after PNN probably due to the prolonged absence of choline acetyltransferase.
Conclusion
Prolonged denervation induces remodeling of the nasal mucosa. Although the depleted nerves were partially reinnervated a few months after PNN, nasal secretion was still suppressed, partly due to a sustained deficiency of acetylcholine synthesis.
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Effects of ophthalmologic solutions on sinonasal ciliated epithelium
Background
Off-label use of topical ophthalmologic formulations for treatment of rhinologic disease is cited in recent literature and is anecdotally prevalent among practicing otolaryngologists. Steroids, antibiotics, and other drugs designed for ocular use have subjective clinical efficacy in the nose and sinuses, but their specific effects on the ciliated epithelium are less well defined. This study examines 9 commercially available ophthalmologic drug formulations for effects on ciliary motility in sinonasal cultures, in an effort to characterize their utility as topical therapies for sinonasal diseases.
Methods
Ophthalmologic solutions were tested on human sinonasal cultures grown at an air-liquid interface. Baseline ciliary beat frequency (CBF) was recorded and compared with CBF changes in the 20 minutes after drug addition. Substances were categorized by degree of ciliostimulation or cilioinhibition.
Results
All ophthalmologic solutions tested had only moderate effects on CBF during the 20-minute experimental period, with no solutions causing overt ciliostasis. Azithromycin, neomycin, and olopatadine were slightly ciliostimulatory, whereas levofloxacin, tobramycin, dexamethasone, azelastine, and prednisolone acetate were cilioinhibitory. Ciprofloxacin elicited moderate cilioinhibition that progressed to ciliostimulation.
Conclusion
All solutions tested appear to have moderate effects on ciliated cell surfaces for a period of time typical of mucociliary clearance (10 to 20 minutes). Both active drugs and excipients can play a role in ciliary modulation, and specific formulations can show unique or unexpected properties. Any other individual ophthalmologic solutions to be used in a nasal drug delivery system should be tested in this manner to evaluate potential ciliary effects before clinical use.
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Clinical practice guideline on management of older patients with chronic kidney disease stage 3b or higher (eGFR < 45 mL/min/1.73 m²) : a summary document from the European Renal Best Practice Group
The population of patients with moderate and severe CKD is growing. Frail and older patients comprise an increasing proportion. Many studies still exclude this group, so the evidence base is limited. In 2013 the advisory board of ERBP initiated, in collaboration with European Union of Geriatric Medicine Societies (EUGMS), the development of a guideline on the management of older patients with CKD stage 3b or higher (eGFR > 45 mL/min/1.73 m(2)). The full guideline has recently been published and is freely available online and on the website of ERBP (http://ift.tt/2rP3xn9). This paper summarises main recommendations of the guideline and their underlying rationales.
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Con: Cautionary tales and reservations about the adoption of new technologies and biomarkers for the management of acute kidney injury
Acute kidney injury (AKI) is an important health-care problem. Over the last decades, many innovative therapies and diagnostic approaches have been tried; however, none of these has been able to confirm consistently that they lead to improved outcomes. Much focus has been placed on intensive care unit (ICU)-associated AKI, whereas the bulk of AKI still concerns patients not in the ICU. Involvement of nephrologists in the care of AKI patients is necessary to further improve outcomes. It is unclear whether new technologies, such as biomarkers, are helpful and could replace nephrology consultation.
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Punishment at home: offenders' experiences with electronic monitoring
As an increasingly popular alternative to prison sentences, electronic monitoring is assumed to generate fewer side effects and to be more humane than imprisonment. While most research on electronic monitoring focuses on its financial or technical implications for penal policy, or on numbers and recidivism, this article analyses the experiences of 27 Belgian convicted offenders with electronic monitoring. Overall, most preferred electronic monitoring to prison, but this was not the case for all the offenders and every circumstance. These findings show that electronic monitoring cannot necessarily be considered a 'softer' alternative to imprisonment. The results imply that, as well as reducing over-population in prisons, electronic monitoring may contribute to a decrease in risks for society and the positive empowerment of offenders. Such empowerment can increase their chances of living a crime-free life, which means electronic monitoring can be considered an important step forward for offenders in regaining control over their own lives.
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Clinically amyopathic dermatomyositis with rapidly progressive interstitial pneumonia: The relation between the disease activity and the serum interleukin-6 level
Abstract
A 67-year-old woman exhibited chilblain-like erythema on the bilateral auricles, erythema with hyperkeratosis on the sides of fingers and the bilateral elbows, and erythema on the extensor/flexor sides of the finger joints and the iliac regions. Fine crackles were audible on the dorsal side of the bilateral lower lung regions. We diagnosed clinically amyopathic dermatomyositis accompanied by rapidly progressive interstitial pneumonia. While we initiated immunosuppressive therapy, the respiratory failure showed no responses. We performed endotoxin adsorption therapy using polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP). After the first PMX-DHP session, the respiratory condition was slightly improved but it soon deteriorated. At the second PMX-DHP session, subcutaneous and mediastinal emphysema was noted. The patient died, showing no improvement in the respiratory condition. We measured the levels of serum interleukin (IL)-6, tumor necrosis factor (TNF)-α and IL-10 before and after PMX-DHP and compared them with previously reported levels. The levels of TNF-α and IL-10 showed no or slight changes, but those of IL-6 at the beginning of the treatment were higher compared with previous reports. After the first PMX-DHP, the IL-6 level decreased with slight improvement in respiratory condition. However, after the second PMX-DHP, it increased markedly with exacerbation of the respiratory failure. The serum IL-6 level is considered to be effective for the evaluation of the disease activity and prognosis under the treatment by PMX-DHP.
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Secukinumab improves psoriasis symptoms in patients with inadequate response to cyclosporine A: A prospective study to evaluate direct switch
Abstract
There are limited data on the safety and efficacy of switching to secukinumab from cyclosporine A (CyA) in patients with psoriasis. The purpose of the present study was to assess the efficacy and safety of secukinumab for 16 weeks after direct switching from CyA in patients with moderate-to-severe psoriasis. In this multicenter, open-label, phase IV study, 34 patients with moderate-to-severe psoriasis and inadequate response to CyA received secukinumab 300 mg s.c. at baseline and weeks 1, 2, 3, 4, 8 and 12. The primary end-point was ≥75% improvement from baseline in Psoriasis Area and Severity Index score (PASI 75) at week 16. The efficacy of secukinumab treatment was evaluated up to week 16, and adverse events (AE) were monitored during the study. The primary end-point of the PASI 75 response at week 16 was achieved by 82.4% (n = 28) of patients receiving secukinumab. Early improvements were observed with secukinumab, with PASI 50 response of 41.2% at week 2 and PASI 75 response of 44.1% at week 4. AE were observed in 70.6% (n = 24) of patients, and there were no serious AE or deaths reported in the entire study period. Secukinumab showed a favorable safety profile consistent with previous data with no new or unexpected safety signals. The results of the present study show that secukinumab is effective in patients with psoriasis enabling a smooth and safe direct switch from CyA to biological therapy.
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Renal biopsy in patients with diabetes : a pooled meta-analysis of 48 studies
Background. The utility of renal biopsy in patients with diabetes is highly debated. Diabetics with rapidly worsening renal disease are often 'clinically' labelled as having diabetic nephropathy (DN), whereas, in many cases, they are rather developing a nondiabetic renal disease (NDRD) or mixed forms (DN + NDRD). Methods. We performed a systematic search for studies on patients with diabetes with data on the frequency of DN, NDRD and mixed forms, and assessed the positive predictive values (PPVs) and odds ratios (ORs) for such diagnoses by meta-analysing single-study prevalence. Possible factors explaining heterogeneity among the different diagnoses were explored by meta-regression. Results. In the 48 included studies (n = 4876), the prevalence of DN, NDRD and mixed forms ranged from 6.5 to 94%, 3 to 82.9% and 4 to 45.5% of the overall diagnoses, respectively. IgA nephropathy was the most common NDRD (3-59%). PPVs for DN, NDRD and mixed forms were 50.1% [95% confidence interval (CI): 44.7-55.2], 36.9% (95% CI: 32.3-41.8) and 19.7% (95% CI: 16.3-23.6), respectively. The PPV when combining NDRD and mixed forms was 49.2% (95% CI: 43.8-54.5). Meta-regression identified systolic pressure, HbA1c, diabetes duration and retinopathy as factors explaining heterogeneity for NDRD, creatinine and glomerular filtration rate for mixed forms and only serum creatinine for DN. ORs of DN versus NDRD and mixed forms were 1.71 (95% CI: 1.54-1.91) and 4.1 (95% CI: 3.43-4.80), respectively. Conclusions. NDRD are highly prevalent in patients with diabetes. Clinical judgment alone can lead to wrong diagnoses and delay the establishment of adequate therapies. Risk stratification according to individual factors is needed for selecting patients who might benefit from biopsy.
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Cum grano salis
So, do we now need to set up a randomised clinical trial to determine whether correcting chronic hyponatraemia will result in a reduction in the number of hip fractures?
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Antiphospholipid Syndrome: Multiple Manifestations in a Single Patient—A High Suspicion Is Still Needed
Antiphospholipid Syndrome (APS) is an autoimmune disorder with clinical and laboratory features of vascular thrombosis, pregnancy loss, and persistent antiphospholipid antibodies (aPLs). The pathophysiology is thought to involve the activation of endothelial cells, monocytes, platelets, and complement by aPLs. Disease can range from asymptomatic to rapidly fatal catastrophic APS. We present a case of a 34-year-old male referred for pancytopenia and splenomegaly. On examination, he had decreased sensation and 4/5 power in the left upper extremity. A lacy, purplish rash was noted on the trunk and upper extremity. MRI of brain showed acute/subacute lacunar infarctions. Laboratory studies revealed an elevated lactate dehydrogenase level, bilirubin and ferritin, decreased haptoglobin, and positive Coombs test. Antinuclear antibody test was negative and antiphospholipid antibody panel revealed positivity for anti-cardiolipin IgG and IgM, antiphosphatidylserine IgG, and anti-β2-glycoprotein IgG. The patient was diagnosed with primary APS. Pancytopenia is relatively rare in primary APS and is more often seen in secondary APS. Our patient demonstrated involvement of multiple organ systems as well as livedo reticularis and autoimmune-related findings such as Raynaud phenomenon and Coombs positive hemolytic anemia. We discuss the various clinical and laboratory findings in patients with APS that aid in diagnosis, as well as important management considerations.
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A Novel Surgical Technique for Fixation of Recurrent Acromioclavicular Dislocations: AC Dog Bone Technique in Combination with Autogenous Semitendinosus Tendon Graft
Various surgical techniques have been described for the fixation of acromioclavicular (AC) dislocations. However, recurrent dislocation is one of the main complications associated with the majority of these techniques. We report a case of postoperative AC joint redislocation. In order to overcome recurrent dislocation after revision surgery, a reconstruction of the conoid and trapezoid ligament with the use of a free tendon graft in combination with a FiberTape was provided within a novel surgical technique. After 12 months, the patient was very satisfied with the functional outcome. The patient achieved excellent results in the Constant (98 points), SPADI (0 points), and QuickDASH score (0 points). The described technique results in an anatomic reconstruction of the AC joint. The nonrigid nature of the intervention seems to restore the normal arthrokinematics by reconstructing the coracoclavicular ligaments with an autograft which is then protected by the AC Dog Bone artificial ligaments during the healing period. The arthroscopic approach to the AC joint with minimal exposure reduces the risks and complications of the intervention. This is the first case in literature that utilizes the artificial dog bone ligament securing the autograft in an anatomic AC reconstruction.
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Benign atrophic papulosis (Köhlmeier-Degos disease): The wedge-shaped dermal necrosis can resolve with time
Abstract
Background
Atrophic papulosis is a rare thrombo-occlusive disease, characterized by the appearance of multiple atrophic porcelain-white skin papules, with a surrounding erythematous rim, which are histologically consisting of wedge-shaped necrosis of the dermis.
Objective
It consists of two variants: a) the benign atrophic papulosis (BAP) only involving the skin and b) the malignant atrophic papulosis (MAP) also involving several internal organs with a cumulative 5-year survival rate of approx. 55%. While the probability of only having a BAP at onset is approximately 70%, increasing to 97% after 7 years of monosymptomatic cutaneous course, no close long-term follow-up of the development of the skin lesions has been reported.
Methods
We present a precise visual documentation of the evolution of the disseminated skin lesions in a female patient with BAP spanning over two decades.
Results
A considerable improvement and/or clinical resolution of the majority of the lesions disputing the scarring character of the atrophic porcelain-white skin papules has been detected.
Conclusion
BAP not only exhibits an excellent prognosis but resolution of lesions can also occur after a considerable period of time.
This article is protected by copyright. All rights reserved.
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Pustular erythema multiforme major associated with atypical pneumonia
Abstract
A 52-year-old male patient presented to the hospital with severe difficulties swallowing, sore eyes and an asymptomatic skin rash. The patient was fully oriented, vital signs were normal. Two days before admission to the hospital, the referring physician had suspected an upper respiratory tract infection and had started treatment with oral cefuroxime while also prescribing ibuprofen for sore throat.
This article is protected by copyright. All rights reserved.
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The molluscum pendulum necklace sign in tuberous sclerosis complex: a case series.A pathognomonic finding?
Abstract
Molluscum pendulum (MP) are a very common finding in the general population. They can be a marker of abnormal glucose metabolism(1,2) or a classical sign of tuberous sclerosis complex (TSC) (3). Here we reported the occurrence of multiple MP located in the posterior neck with a peculiar arrangement in a series of patients with TSC.
This article is protected by copyright. All rights reserved.
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Bottom of an iceberg: undiagnosed aortic aneurysm masquerading as vocal cord palsy
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από Rao, V. U. S., Chatterjee, S., Swamy, S. S. στο BMJ Case Reports Last 6 Issues Μετάφραση άρθρου Description A previously healthy woman aged 60 years was referred to a tertiary referral cancer centre with change of voice for 1 week suspecting neoplastic aetiology on account of her tobacco chewing habit of more than 20 years. No history of voice abuse, fever or cough was there preceding the onset of the change of voice. She did not have any previous history of hospitalisation or diagnosed comorbidities. On clinical examination, her pulse rate was 82 bpm; blood pressure was 130/90 mm Hg and respiratory rate was 12/min. Video laryngoscopy examination revealed left vocal cord palsy with no obvious lesion. A whole-body F18 FDG PET–CT scan revealed the presence of 6.6x4.8x6.7 cm lobulated sacullar aneurysm arising from the aortic arch between the origins of the left common carotid and subclavian arteries (figures 1 and 2). The likely mycotic aneurysm caused significant surrounding metabolically active inflammatory changes (figure 3).
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480
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Excessive chest compression rate is associated with insufficient compression depth in out-of-hospital cardic arrest
Background and goal of study: In the latest Consensus on Science and Treatment Recommendations on Cardiopulmonary Resuscitation (ref), the relationship between compression rate and compression depth is considered to be a knowledge gap. In order to characterize this relationship, we performed an observational study in pre-hospital cardiac arrest patients. Materials and methods : In patients undergoing out-of-hospital cardiopulmonary resuscitation by health care professionals, chest compression rate and depth were recorded using an accelerometer (E-series monitor-defibrillator, Zoll, USA). The monitor provided real-time corrective feedback for compression rates <80/min and for depth <4 cm. Compression depth was analyzed for rates <80/min, 80-120/min and >120/min. A difference in compression depth ≥5 mm was considered potentially clinically significant. Results and discussion : Thirty-one consecutive patients were analyzed (50375 compressions, on average 1625 per patient). Of all compressions 2% were <80/min, 63% between 80-120/min and 35% >120/min. Mean compression depth for rates 80-120/min was 4.5 cm (SD=1) compared to 3.5 cm (SD=1) for compressions >120/min (P<0.001; see Figure). In 20 out of 31 (64%) patients a statistically significant lower depth was observed for rates >120/min compared to rates 80-120/min, in 10 out of 31 (32%) this difference was also clinically significant. There was no difference between the mean depth of compressions <80/min and the mean depth of compressions 80-120/min. Conclusions : Compression rates >120/min were associated with a lower compression depth. The observation that compression depth is lower with increased compression rates underscores the importance of feedback on rate during CPR. Reference Nolan JP, Hazinski MF, Billi JE, Boettiger BW, et al. Executive Summary 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation 2010; 81S: e1-e25.
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