Effect of cinnamon (Cinnamomum verum) bark essential oil on the halitosis-associated bacterium Solobacterium moorei and in vitro cytotoxicity

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Geneviève LeBel, Bruno Haas, Andrée-Ann Adam, Marie-Pier Veilleux, Amel Ben Lagha, Daniel Grenier
ObjectivesHalitosis, also known as bad breath or oral malodour, is a condition affecting a large proportion of the population. Solobacterium moorei is a Gram-positive anaerobic bacterium that has been specifically associated with halitosis. In this study, we investigated the effects of essential oils, more particularly cinnamon bark oil, on growth, biofilm formation, eradication and killing, as well as hydrogen sulfide (H2S) production by S. moorei.MethodsA broth microdilution assay was used to determine the antibacterial activity of essential oils. Biofilm formation was assessed by a crystal violet staining assay and scanning electron microscopy. The biofilm of S. moorei was characterized by enzymatic treatments. Biofilm killing was determined by a luminescence assay monitoring ATP production. H2S production was quantified with a colorimetric assay. The biocompatibility of cinnamon oil was investigated using a gingival keratinocyte cell line.ResultsAmong the ten essential oils tested, cinnamon oil was found to be the most powerful against S. moorei with MIC and MBC values of 0.039% and 0.156%, respectively. The biofilm formed by S. moorei was then characterized. The fact that DNase I and to a lesser extent proteinase K significantly reduced biofilm formation by S. moorei and induced its eradication suggests that the extracellular matrix of S. moorei biofilm may be mainly containing a DNA backbone associated with proteins. At concentrations below the MIC, cinnamon oil reduced S. moorei biofilm formation that resulted from an attenuation of bacterial growth. It was also found that treatment of a pre-formed biofilm of S. moorei with cinnamon oil significantly decreased its viability although it did not cause its eradication. Cinnamon oil had an inhibitory effect on the production of H2S by S. moorei. Lastly, it was found that at concentrations effective against S. moorei, no significant loss of viability in gingival keratinocytes occurred after a 1-h exposure.ConclusionsOur study brought evidence that cinnamon oil may be a promising substance to incorporate into oral hygiene products for controlling bad breath by inhibiting growth, killing biofilm, and reducing H2S production by S. moorei. Moreover, at the effective concentrations, cinnamon oil was found to have no toxic effects on oral keratinocytes.



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The treatment and outcome analysis of primary squamous cell carcinoma of the thyroid

Publication date: Available online 22 July 2017
Source:Auris Nasus Larynx
Author(s): Ryuji Yasumatsu, Masanobu Sato, Ryutaro Uchi, Takafumi Nakano, Kazuki Hashimoto, Ryunosuke Kogo, Masahiko Taura, Mioko Matsuo, Torahiko Nakashima, Takashi Nakagawa
ObjectivesPrimary squamous cell carcinoma (SCC) of the thyroid is a rare disease. It usually presents with locally advanced disease and has an overall poor prognosis. In this study, we investigated the characteristics and outcomes of patients with SCC of the thyroid, and reported our experience with chemotherapy with lenvatinib in the treatment of SCC of the thyroid.MethodsThe management outcome of 10 patients who had SCC of the thyroid between January 2000 and 2015 at Kyushu University Hospital or associated facilities was reviewed.ResultsThere were 3 males and 7 females, ranging in age from 53 to 77 years. Extent of disease was staged as follows: stage IVA, 3 cases; stage IVB, 3 cases; stage IVC, 4 cases. Only tracheostomy was applied for 2 cases, surgical resection, such as total thyroidectomy and neck dissection, for the other 8 cases. Radiotherapy following surgical treatment was applied for 9 cases. Four patients started on oral lenvatinib due to recurrent or progressive SCC of the thyroid. The one year actuarial survival rate of patients was 22.7%. There was no 2-year survivor of all patients.ConclusionsTreatment should primarily be targeted at surgical resection with negative margins in patients with resectable disease. Lenvatinib may show promise to potentially extend survival.



http://ift.tt/2uU6nNg

Sesame allergy in adults

Sesame (Sesamum indicum) allergy is the most common seed allergy and has been increasingly reported worldwide.1 The variation in prevalence between populations is likely due to different food habits and awareness. Similar to peanut, immunoglobulin E (IgE)-mediated sesame allergy begins early in life (usually before 2 years of age) and persists in 80% of patients.2 Clinical manifestations range from mucocutaneous, respiratory, and gastrointestinal manifestations to life-threatening systemic anaphylaxis.

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Identifying the relationship between beliefs and medication adherence in asthma

Many individuals with asthma choose not to take their medication in the way it was prescribed despite strong evidence recommending regular use of inhaled corticosteroids (ICSs).1 Medication nonadherence in asthma is associated with the majority of asthma-related morbidity, mortality, and excess health care use.2,3

http://ift.tt/2uUh6aD

Utility of minor determinants for skin testing in inpatient penicillin allergy evaluation

Most patients with a history of penicillin allergy can tolerate penicillin. Skin testing can identify tolerant patients, but not all known allergenic determinants are commercially available. Protocols exist that use only available reagents, but the sensitivity and safety of these protocols, particularly for hospitalized patients, are controversial.

http://ift.tt/2vwEU1i

Blood eosinophil-to-basophil ratio in patients with sinonasal polyps

In a recent preliminary study, eosinophil and basophil counts were calculated in chronic rhinosinusitis with nasal polyps (CRSwNP) using conventional histologic and immunohistochemical methods. The tissue eosinophil-to-basophil ratio differed in the CRSwNP endotypes considered.

http://ift.tt/2uTKhKI

Otorhinolaryngology and Neurosurgery Team Up to Maximize the Outcome for a Patient with Pituitary Tumor

After an unexplained "brain glitch" led to the discovery of a large pituitary tumor, retired corrosion engineer Niell Strickland joined... Read the full article...

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UT Physicians Otorhinolaryngology Holds Annual Free Cancer Screening Clinic

UT Physicians Otorhinolaryngology – Texas Medical Center, which is staffed by faculty members in the Department of Otorhinolaryngology—Head & Neck... Read the full article...

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Audiology Open House

The Audiology team at UT Physicians Otorhinolaryngology – Texas Medical Center held a well-attended, daylong open house January 12, 2017,... Read the full article...

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Clinico-radiological Co-relation of Carcinoma Larynx and Hypopharynx: A Prospective Study

Abstract

The successful management of laryngeal and hypopharyngeal cancers requires accurate diagnosis, staging, assessment of patient wishes, and the selection of the most appropriate treatment for the individual patient. Imaging plays an important complementary role to clinical examination and endoscopy in the evaluation of laryngeal and hypopharyngeal cancers. The combined information allows the disease to be staged accurately. To correlate carcinoma larynx and hypopharynx clinically and radiologically and to know the accurate pre-therapeutic stage of the disease. A total of 50 cases were included in this study. After clinical TNM staging, CT scan was done to know the real extent of tumor, volume and nodal status. After that, TNM staging was revised based on radiological findings. The number of people who had been upstaged and downstaged after CT evaluation was measured. There were total of 50 cases of carcinoma larynx and hypopharynx in this study. There were 26 (52%) cases of carcinoma larynx and 24 (48%) cases of carcinoma hypopharynx. There were significant changes in T stage after radiological evaluation. Major changes were observed in T2 and T3 stages. Majority of cases (17) were having N1 disease after radiological evaluation. On comparing clinical and radiological staging of neck nodes, it was observed that upstaging occurred mainly in N0. Overall after radiological evaluation, 48% of our cases were upstaged, 48% remained in same stage and 4% were downstaged. By combining both clinical and radiological evaluation in laryngeal and hypopharyngeal cancers, a correct pre therapeutic staging can be obtained and thereby prompt treatment can be given.

http://ift.tt/2uLIjLC

Clinico-radiological Co-relation of Carcinoma Larynx and Hypopharynx: A Prospective Study

Abstract

The successful management of laryngeal and hypopharyngeal cancers requires accurate diagnosis, staging, assessment of patient wishes, and the selection of the most appropriate treatment for the individual patient. Imaging plays an important complementary role to clinical examination and endoscopy in the evaluation of laryngeal and hypopharyngeal cancers. The combined information allows the disease to be staged accurately. To correlate carcinoma larynx and hypopharynx clinically and radiologically and to know the accurate pre-therapeutic stage of the disease. A total of 50 cases were included in this study. After clinical TNM staging, CT scan was done to know the real extent of tumor, volume and nodal status. After that, TNM staging was revised based on radiological findings. The number of people who had been upstaged and downstaged after CT evaluation was measured. There were total of 50 cases of carcinoma larynx and hypopharynx in this study. There were 26 (52%) cases of carcinoma larynx and 24 (48%) cases of carcinoma hypopharynx. There were significant changes in T stage after radiological evaluation. Major changes were observed in T2 and T3 stages. Majority of cases (17) were having N1 disease after radiological evaluation. On comparing clinical and radiological staging of neck nodes, it was observed that upstaging occurred mainly in N0. Overall after radiological evaluation, 48% of our cases were upstaged, 48% remained in same stage and 4% were downstaged. By combining both clinical and radiological evaluation in laryngeal and hypopharyngeal cancers, a correct pre therapeutic staging can be obtained and thereby prompt treatment can be given.

http://ift.tt/2uLIjLC

Thyroid Education & Awareness Blooms with July Donations – Earn a Sunflower!

Please help us reach "31 Donations in 31 Days" during the month of July to support thyroid education and awareness in 2017.

• Your donation of just $25-$100 allows us to send patient information through the mail weekly to those who do not have a computer to access information online.
• Donations of $150-$200 helps us to manage printing and website costs for our thyroid patient information brochures.
• Support of $250 – $500 helps us to accomplish collaboration with thyroid experts in developing vital ATA thyroid treatment guidelines as well as, the processes necessary to carry out our research efforts.

Your support is valuable and keeps our work in motion!

The post Thyroid Education & Awareness Blooms with July Donations – Earn a Sunflower! appeared first on American Thyroid Association.

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The Cost of Oropharyngeal Cancer in England: a Retrospective Hospital Data Analysis

Abstract

Objectives

To estimate the total costs of treating head and neck cancers, specifically oropharyngeal, laryngeal and oral cavity cancer, in secondary care facilities in England during the period 2006/2007 to 2010/2011.

Design

Patient records were extracted from an English hospital database to estimate the number of patients treated for oropharyngeal, laryngeal and oral cavity cancer in England. Identified resource use was linked to published United Kingdom cost estimates to quantify the reimbursement of treatment through the Payment by Results system.

Setting

Retrospective hospital data analysis.

Participants

From the hospital data, patient records of patients treated for oropharyngeal, laryngeal and oral cavity cancer were selected.

Main outcome measures

Annual total costs of treatment, stratified by inpatient and outpatient setting and by male and female patients.

Results

From 2006/2007 to 2010/2011, total costs of treatment across the three head and neck cancer sites were estimated to be approximately £309 million, with 90% attributable to inpatient care (bundled costs). Oropharyngeal cancer accounted for 37% of total costs. Costs and patient numbers increased over time, largely due to a rise in oropharyngeal cancer, where total costs increased from £17.21 million to £30.32 million, with over 1400 (52%) more inpatients treated in 2010/11 compared to 2006/07.

Conclusions

In four years the number of patients with oropharyngeal cancer receiving some form of inpatient care increased by more than half, and associated costs increased by three quarters. This reinforces the case for prevention and early detection strategies to help contain this epidemiological and economic burden.

This article is protected by copyright. All rights reserved.

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How to choose the best journal for your case report

Since the establishment of the Journal of Medical Case Reports in 2006, the number of journals that publish case reports has increased rapidly, and most of these journals are open access. Open access publishing u...

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Clinical Thyroidology High-Impact Articles

FREE ACCESS through August 4, 2017.
Read Now:

Teprotumumab, an Antibody that Blocks the IGF-I Receptor, Causes Dramatic Improvement in Graves' Orbitopathy
Jerome M. Hershman

For Papillary Thyroid Cancer Discovered During Pregnancy, Delayed Thyroid Surgery with Active Surveillance Is Appropriate
Jacques Orgiazzi

Can Imaging with FDG-PET Help Exclude Malignancy in Cytologically Indeterminate Thyroid Nodules?
Martin Biermann

 

The post Clinical Thyroidology High-Impact Articles appeared first on American Thyroid Association.

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Clinical Thyroidology for the Public – Highlighted Article

From Clinical Thyroidology for the Public:  Bariatric surgery for weight loss is becoming very common in the US. Obesity and hypothyroidism often occur in the same patient and ~18% of bariatric surgery patients require thyroid hormone therapy. Read More….

We welcome your feedback and suggestions. Let us know what you want to see in this publication.

Feedback & Suggestions

The post Clinical Thyroidology for the Public – Highlighted Article appeared first on American Thyroid Association.

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Cerebrospinal Fluid Leakage During Temporal Bone Surgery: Selecting Intra-operative Dural Closure with a Dumbbell-Shaped Muscle Graft as a Surgical Approach

Abstract

Cerebrospinal fluid (CSF) leakages of the temporal bone may arise during mastoid surgery. The leakages can have multiple potential etiologies, for instance, using a cutting burr near the bony tegmen or monopolar electrocautery on the surface of the dura mater. In this paper, we introduced an effective and simple technique for the management of CSF leakages of the temporal bone. In a prospective case series, 36 patients (16 males and 20 females) who have had an experience of incidental or inevitable CSF otorrhea or otorhinorrhea during temporal bone surgery were selected. All patients were treated using a muscle graft in a dumbbell-shaped design through the dura defect at the Amir-Alam University Hospital between April 2005 and November 2008. The mean size of the defects was 5 mm (a range of 2–10 mm). A dumbbell-shaped autologous muscle graft was immediately successful in sealing the leakage in all patients. Only five patients (13.8%) had some evidence of leakage remaining on the day after the operation, which was subsequently resolved by conservative management in four of them (11.1%). Only one patient (2.7%) was subjected to a second operation for a new defect. Recurrence of CSF leakage or other related complications were not observed during about 7 years of follow up. A free autologous muscle graft, using the dumbbell technique through a small to moderate dura defect is an effective, easily performed, and safe method to seal iatrogenic leakages of the temporal bone.

http://ift.tt/2ulk7h6

Cerebrospinal Fluid Leakage During Temporal Bone Surgery: Selecting Intra-operative Dural Closure with a Dumbbell-Shaped Muscle Graft as a Surgical Approach

Abstract

Cerebrospinal fluid (CSF) leakages of the temporal bone may arise during mastoid surgery. The leakages can have multiple potential etiologies, for instance, using a cutting burr near the bony tegmen or monopolar electrocautery on the surface of the dura mater. In this paper, we introduced an effective and simple technique for the management of CSF leakages of the temporal bone. In a prospective case series, 36 patients (16 males and 20 females) who have had an experience of incidental or inevitable CSF otorrhea or otorhinorrhea during temporal bone surgery were selected. All patients were treated using a muscle graft in a dumbbell-shaped design through the dura defect at the Amir-Alam University Hospital between April 2005 and November 2008. The mean size of the defects was 5 mm (a range of 2–10 mm). A dumbbell-shaped autologous muscle graft was immediately successful in sealing the leakage in all patients. Only five patients (13.8%) had some evidence of leakage remaining on the day after the operation, which was subsequently resolved by conservative management in four of them (11.1%). Only one patient (2.7%) was subjected to a second operation for a new defect. Recurrence of CSF leakage or other related complications were not observed during about 7 years of follow up. A free autologous muscle graft, using the dumbbell technique through a small to moderate dura defect is an effective, easily performed, and safe method to seal iatrogenic leakages of the temporal bone.

http://ift.tt/2ulk7h6

Expression of Concern: Schietroma M, Cecilia EM, Carlei F, Sista F, De Santis G, Lancione L, Amicucci G. Dexamethasone for the Prevention of Recurrent Laryngeal Nerve Palsy and Other Complications After Thyroid Surgery: A Randomized Double-blind Placebo-Controlled Trial. JAMA Otolaryngol Head Neck Surg. 2013;139(5):471-478. doi:10.1001/jamaoto.2013.2821.

Expression of Concern: Schietroma M, Cecilia EM, Carlei F, Sista F, De Santis G, Lancione L, Amicucci G. Dexamethasone for the Prevention of Recurrent Laryngeal Nerve Palsy and Other Complications After Thyroid Surgery: A Randomized Double-blind Placebo-Controlled Trial. JAMA Otolaryngol Head Neck Surg. 2013;139(5):471-478. doi:10.1001/jamaoto.2013.2821.

JAMA Otolaryngol Head Neck Surg. 2017 Jul 21;:

Authors: Piccirillo JF, Bauchner H

PMID: 28732099 [PubMed - as supplied by publisher]

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Case of mycotic cyst caused by Scedosporium apiospermum developed liver dysfunction following administration of voriconazole

http://ift.tt/2vKrwFV

Rapidly developed BRAF inhibitor-induced verrucous keratosis

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Dermoscopy in facilitating the recognition of acrodermatitis continua of Hallopeau

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A Silent Killer: Insights Into Venous Thromboembolism Formation and Prevention

No abstract available

http://ift.tt/2gRDBGZ

Perioperative Venous Thromboembolism: A Review

Venous thromboembolism (VTE) is a significant problem in the perioperative period, increasing patient morbidity, mortality, and health care costs. It is also considered the most preventable of the major postoperative complications. Despite widespread adoption of prophylaxis guidelines, it appears that morbidity from the disease has not substantially changed within the past 2 decades. It is becoming clear that current prophylaxis efforts are not sufficient. Using more potent anticoagulants may decrease the incidence of VTE, but increase the risk for bleeding and infection. Much has been learned about the pathophysiology of venous thrombogenesis in recent years. Beyond the "traditional coagulation cascade," which anticoagulants modulate, there is a growing appreciation for the roles of tissue factor, monocytes, neutrophils, neutrophil extracellular traps, microvesicles, and platelets in thrombus initiation and propagation. These recent studies explain to some degree why aspirin appears to be remarkably effective in preventing thrombus propagation. Endothelial dysfunction, traditionally thought of as a risk factor for arterial thrombosis, plays an important role within the cusps of venous valves, a unique environment where the majority of venous thrombi originate. This suggests a role for newer treatment modalities such as statins. Not all patients have an equal likelihood of experiencing a VTE, even when undergoing high-risk procedures, and better tools are required to accurately predict VTE risk. Only then will we be able to effectively individualize prophylaxis by balancing the risks for VTE against the risks associated with treatment. Given the different cell types and pathways involved in thrombogenesis, it is likely that multimodal treatment regimens will be more effective, enabling the use of lower and safer doses of hemostatic modulating therapies such as anticoagulants, antithrombotics, and antiplatelet medications.

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Ischemic Leg, Perfused Lung: A Trial of Remote Ischemic Preconditioning

No abstract available

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Remote Ischemic Preconditioning Decreases Oxidative Lung Damage After Pulmonary Lobectomy: A Single-Center Randomized, Double-Blind, Controlled Trial

BACKGROUND: During lobectomy in patients with lung cancer, the operated lung is often collapsed and hypoperfused. Ischemia/reperfusion injury may then occur when the lung is re-expanded. We hypothesized that remote ischemic preconditioning (RIPC) would decrease oxidative lung damage and improve gas exchange in the postoperative period. METHODS: We conducted a single-center, randomized, double-blind trial in patients with nonsmall cell lung cancer undergoing elective lung lobectomy. Fifty-three patients were randomized to receive limb RIPC immediately after anesthesia induction (3 cycles: 5 minutes ischemia/5 minutes reperfusion induced by an ischemia cuff applied on the thigh) and/or control therapy without RIPC. Oxidative stress markers were measured in exhaled breath condensate (EBC) and arterial blood immediately after anesthesia induction and before RIPC and surgery (T0, baseline); during operated lung collapse, immediately before resuming two-lung ventilation (TLV) (T1); immediately after resuming TLV (T2); and 120 minutes after resuming TLV (T3). The primary outcome was 8-isoprostane levels in EBC at T1, T2, and T3. Secondary outcomes included the following: NO2−+NO3−, H2O2 levels, and pH in EBC and in blood (8-isoprostane, NO2−+NO3−) and pulmonary gas exchange variables (PaO2/FiO2, A-aDO2, a/A ratio, and respiratory index). RESULTS: Patients subjected to RIPC had lower EBC 8-isoprostane levels when compared with controls at T1, T2, and T3 (differences between means and 95% confidence intervals): −15.3 (5.8–24.8), P = .002; −20.0 (5.5–34.5), P = .008; and −10.4 (2.5–18.3), P = .011, respectively. In the RIPC group, EBC NO2−+NO3− and H2O2 levels were also lower than in controls at T2 and T1–T3, respectively (all P

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NUDT15 polymorphism and severe azathioprine-induced myelosuppression in a Chinese man with pemphigus vulgaris

Abstract

Pemphigus vulgaris (PV) is a life-threatening autoimmune muco-cutaneous disease with formidable treatment challenges. Following the first report of successful treatment of PV in 1969 with azathioprine (AZA),¹ which was originally used to treat cancers, and prevent rejection in organ transplantation recipients, AZA has been often used concomitantly with steroids in the treatment of PV. Although generally well tolerated by most patients, AZA can induce severe myelosuppression, especially leucopenia, in some susceptible individuals, thus resulting in serious microbial infections.

This article is protected by copyright. All rights reserved.

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Molecular Classification of Tumor Cells in a Patient with Intravascular Large B-Cell Lymphoma

Abstract

Background

Intravascular large B-cell lymphoma (IVLBCL) is a rare type of extranodal large B-cell lymphoma. It is characterized by the proliferation of tumour cells exclusively intraluminally in small blood vessels of different organs. The clinical manifestation depends on the type of organ affected, additionally, a haemophagocytic syndrome can be observed in some patients.

Objective

Due to the rarity of this lymphoma and in spite of detailed immunohistochemical investigations the exact nosology of this cancer is only incompletely understood.

Methods

We used microarray-based analysis of gene expression of tumour cells isolated from a patient with primary manifestation of the lymphoma in the skin and compared it to various other diffuse large B-cell lymphomas (DLBCLs) as well as a previously published DLBCL classifier.

Results

In unsupervised analyses, the tumour cells cluster together with non-GCB DLBCL samples but are clearly distinct from GCB-DLBCL. Analogous to non-GCB DLBCL, molecular cell-of-origin classification revealed similarity to bone-marrow derived plasma cells.

Conclusion

The IVLBCL of this patient shows molecular similarity to non-GCB DLBCL. Due to the prognostic, and increasingly also therapeutic relevance of molecular subtyping in DLBCL, this method, in addition to immunohistochemistry, should also be considered for the diagnosis of IVLBCL in the future.

This article is protected by copyright. All rights reserved.

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A pilot study of fatigue in patients with Hidradenitis suppurativa

Abstract

Patients suffering from Hidradenitis Suppurativa often complain of fatigue or tiredness, a common symptom in other chronic systemic inflammatory conditions.¹ Fatigue has been reported as a prodromal symptom in 32% of HS patients¹, indicating that it is an important symptom in HS.

This article is protected by copyright. All rights reserved.

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Dimethyl fumarate modulates neutrophil extracellular trap formation in a glutathione and superoxide-dependent manner

Abstract

Background

Neutrophil (polymorphonuclear) granulocytes (PMN) were shown to contribute to the pathogenesis of psoriasis by releasing IL-17 and LL-37/ DNA complexes via neutrophil extracellular traps (NET), webs of chromatin strands decorated with antimicrobial peptides, in psoriatic skin. Fumaderm^®, a fumaric acid ester (FAE) formulation consisting of different FAE salts has been successfully used to treat psoriasis for decades. Most recently, FAE treatment was reported to inhibit NET formation in murine epidermolysis bullosa acquisita.

Objective

To elucidate the effect of FAE treatment on human psoriasis and healthy donor NET formation.

Results

Among the compounds present in the FAE formulation, dimethyl fumarate (DMF) pre-treatment of human psoriasis and healthy donor PMN resulted in a consistent inhibitory effect on NET formation to phorbol 12-myristate 13-acetate (PMA), but not to platelet activating factor and ionomycin. This effect was L-Glutathione dependent and involved the reduction of reactive oxygen species (ROS) production, a key event in NET formation. In contrast, G protein-coupled signaling and protein synthesis were not involved. Monomethyl fumarate (MMF) was found to slightly reduce ROS production without affecting NET formation.

Conclusions

We report DMF as a potent, stimulus-specific, L-Glutathione, and ROS-dependent modulator of NET formation. Our results support the notion that modulation of NET formation contributes to the beneficial effects of fumaric acid esters in a variety of inflammatory conditions.

This article is protected by copyright. All rights reserved.

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Incidence, Prevalence, Mortality and Causes of Death in Systemic Sclerosis in Korea: A Nationwide Population-Based Study

Abstract

While the epidemiology of systemic sclerosis (SSc) is known to vary by geographical region and race, studies from the national level as well as reports from Asian countries are scarce and the majority of existing studies were limited to cases from small geographic areas.^1-3

This article is protected by copyright. All rights reserved.

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Dysregulation of inflammatory gene expression in lesional and non-lesional skin of patients with pyoderma gangrenosum

Abstract

Pyoderma gangrenosum (PG) is an inflammatory skin condition that often presents as chronic ulcers. It is often idiopathic but can be associated with systemic conditions¹. Our recent publications^1,2 highlight the need for better characterization of the molecular understanding of PG to improve diagnostic accuracy and targeted therapy. Recent reviews suggest that innate immunity may have a causative and consequential role in PG. In support of this idea, we reported a possible role for Pattern Recognition Receptors (PRRs) in the pathogenesis of PG ². To test this hypothesis, paired skin biopsies were collected from lesional and non-lesional (>5 cm from affected area on ipsilateral limb) skin in five patients with PG with clinically active disease.

This article is protected by copyright. All rights reserved.

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Novel clinical and molecular findings in Spanish patients with Nevoid Basal Cell Carcinoma Syndrome

Abstract

Background

Nevoid Basal Cell Carcinoma Syndrome (NBCCS) is an autosomal dominant disorder characterised by developmental alterations and multiple basal cell carcinomas. Mutations in PTCH1, a membrane receptor for Sonic Hedgehog, are associated with the development of the disease. Most of them produce a truncated protein which is unable to supress Smoothened protein and continuously activates the downstream pathway

Objectives

We aimed to characterize 22 unrelated Spanish subjects with NBCCS, the largest cohort of Gorlin syndrome reported to date in Spain

Methods and results

We reported for the first time two young patients with uterus didelphys and ganglioneuroma, within the context of NBCCS. One patient showing a severe phenotype of the disease developed basal cell carcinomas since the childhood. Sanger sequencing of PTCH1 gene in this cohort identified 17 novel truncating mutations (11 frameshift, 5 nonsense and one mutation affecting an exon-intron splicing site) and 2 novel missense mutations that were predicted to be pathogenic. Patients showed a great clinical variability and inconsistent genotype-phenotype correlation, as seen in relatives carrying similar mutations

Conclusion

This study contributes to increase the pool of clinical manifestations of the NBCCS, as well as increasing the number of pathogenic mutations identified in PTCH1 predisposing to the condition. The inconsistencies found between phenotype and genotype suggest the involvement of other modifying genetic/epigenetic or environmental.

This article is protected by copyright. All rights reserved.

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Appearance of anti-desmocollin 1 autoantibodies leading to a vegetative lesion in a pemphigus vulgaris patient

Abstract

Pemphigus is a group of autoimmune bullous diseases that is mainly classified into pemphigus vulgaris (PV) and pemphigus foliaceus.¹ PV is further subcategorized into a mucocutaneous type (with autoantibodies against desmoglein (Dsg) 3 and Dsg1) and a mucosal type (with autoantibodies against Dsg3 but not Dsg1) based on autoantibody profile and clinical features. Pemphigus vegetans (PVeg), a rare variant of PV, is characterized by vegetating lesions. However, the mechanism behind the occurrence of these elevated lesions remains unclear.² Recently, it was reported that anti-desmocollin (Dsc) 1 and Dsc3 autoantibodies were frequently detected and potentially pathogenic in PVeg.³ Here we report a case of PV in which a vegetative plaque occurred during treatment accompanied by the elevation of anti-Dsc1 autoantibodies.

This article is protected by copyright. All rights reserved.

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KIT Mutations and CD117 Overexpression Are Markers of Better Progression-Free Survival in Vulvar Melanomas

Abstract

Background

Few studies have addressed prognostic markers and none has correlated molecular status and prognosis in vulvar melanomas.

Objectives and Methods

We evaluated the clinicopathologic features of 95 cases. p53, CD117, Ki-67, neurofibromin, brafv600e, and nrasq61r immunostains; and molecular analyses by either targeted next generation or direct sequencing were performed on available archival materials.

Results

Molecular testing detected mutations in KIT (44%), BRAF (25%), NF1 (22%), TP53 (17%), NRAS (9%), and TERT promoter (9%). Co-mutation of KIT and NF1 and of KIT and NRAS were identified in two and one case, respectively. KIT mutations significantly associated with better progression-free survival in univariate analyses. In multivariate analyses CD117 expression was significantly associated with better progression-free survival. Tumor thickness was significantly associated with worse progression-free and overall survival, and perineural invasion significantly correlated with reduced melanoma-specific survival and with reduced overall survival.

Limitation

Cases were from multiple centers and only a subset of samples was available for molecular testing.

Conclusion

KIT mutations and CD117 overexpression are markers of better progression-free survival. In addition to its prognostic value, molecular testing may identify cases that might respond to targeted agents or immunotherapeutic approaches.

This article is protected by copyright. All rights reserved.

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Diagnosing subtle palatal anomalies: Validation of video-analysis and assessment protocol for diagnosing occult submucous cleft palate

Publication date: September 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 100
Author(s): Ryan Rourke, Seth M. Weinberg, Mary L. Marazita, Noel Jabbour
IntroductionSubmucous cleft palate (SMCP) classically involves bifid uvula, zona pellucida, and notched hard palate. However, patients may present with more subtle anatomic abnormalities. The ability to detect these abnormalities is important for surgeons managing velopharyngeal dysfunction (VPD) or considering adenoidectomy.ObjectivesValidate an assessment protocol for diagnosis of occult submucous cleft palate (OSMCP) and identify physical examination features present in patients with OSMCP in the relaxed and activated palate positions.MethodsStudy participants included patients referred to a pediatric VPD clinic with concern for hypernasality or SMCP. Using an appropriately encrypted iPod touch, transoral video was obtained for each patient with the palate in the relaxed and activated positions. The videos were reviewed by two otolaryngologists in normal speed and slow-motion, as needed, and a questionnaire was completed by each reviewer pertaining to the anatomy and function of the palate.Results47 patients, with an average age of 4.6 years, were included in the study over a one-year period. Four videos were unusable due to incomplete view of the palate. The most common palatal abnormality noted was OSMCP, diagnosed by each reviewer in 26/43 and 30/43 patients respectively. Using the assessment protocol, agreement on palatal diagnosis was 83.7% (kappa = 0.68), indicating substantial agreement, with the most prevalent anatomic features being vaulted palate elevation (96%) and visible notching of hard palate (75%).ConclusionThe diagnosis of subtle palatal anomalies is difficult and can be subjective. Using the proposed video-analysis method and assessment protocol may improve reliability of diagnosis of OSMCP.



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Severe subcutaneous hematoma in a patient with psoriatic arthritis: Changes of platelet count in psoriatic patients with biologic agents

Abstract

The effectiveness of biologics has changed therapeutic strategies for psoriasis dramatically, but biologics are known to have various adverse effects. We report a 63-year-old woman with psoriatic arthritis who suddenly developed a subcutaneous hematoma after being successfully treated with adalimumab. As she had also suffered from alcoholic cirrhosis, we speculated that she had developed thrombocytopenia severe enough to cause a subcutaneous hematoma. Furthermore, we investigated the changes of platelet counts in 65 psoriatic patients treated with biologics at a single institute from 2010 to 2016. Platelet counts were found to have decreased by 17.4 ± 2.8% during adalimumab therapy (n = 16), 18.5 ± 3.8% during infliximab therapy (n = 17), 14.8 ± 2.1% during ustekinumab therapy (n = 20) and 18.5 ± 5.1% during secukinumab therapy (n = 12). Platelet counts decrease after the administration of biologics in accordance with disease activity, and there is the potential risk of subcutaneous hematoma and other adverse effects. When administrating biologics to psoriatic patients, especially to those with chronic liver disease, dermatologists should carefully monitor for thrombocytopenia.

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Novel heterozygous mutation of protoporphyrinogen oxidase gene in a Chinese patient with variegate porphyria

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Successful treatment by negative-pressure wound therapy for ulcer located on diffuse plexiform neurofibroma

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Recommendations for Procedural Sedation Clinical Trials

No abstract available

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Induction

No abstract available

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Ischemic Leg, Perfused Lung: A Trial of Remote Ischemic Preconditioning

No abstract available

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Electric Nerve Stimulation Does Not Correctly Predict Needle-Nerve Distance and Potential Local Anesthetic Spread for Interscalene Brachial Plexus Blockade

This study evaluated electric nerve stimulation as a nerve location tool. After eliciting motor response in 43 patients undergoing shoulder surgery, the needle tip's position, distance from the closest nerve, and spread of saline were evaluated using ultrasound imaging. The needle's tip resided 1 to 4 mm from the closest nerve in 21, in direct contact with it in 7, and 6 to 18 mm away in 15 patients. In 21 patients, subsequent saline dissection did not reach the brachial plexus. Thus, the success rate of electric nerve stimulation for correct needle-nerve distance identification was 48.8%, with correct fluid spread reached in only 51.2% of patients.

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Fasting Before Anesthesia: An Unsettled Dilemma

No abstract available

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In Response

No abstract available

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Time Is Money

No abstract available

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In Response

No abstract available

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Inhaled Pulmonary Vasodilators in Cardiac Surgery Patients: Correct Answer Is “NO”

No abstract available

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Role of Sigma-1 Receptor/p38 MAPK Inhibition in Acupoint Catgut Embedding–Mediated Analgesic Effects in Complete Freund’s Adjuvant-Induced Inflammatory Pain

BACKGROUND: The endoplasmic reticulum chaperone protein Sigma-1 receptor (Sig-1 R) and mitogen-activated protein kinases (MAPKs) are involved in the mechanism of pain. Acupoint stimulation exerts an exact antihyperalgesic effect in inflammatory pain. However, whether Sig-1 R and MAPKs are associated with the acupoint stimulation-induced analgesic effects is not clear. This study investigated the analgesic effect of acupoint catgut embedding (ACE) and the inhibition of Sig-1 R and MAPKs in ACE analgesia. METHODS: Rats were prepared with intrathecal catheter implantation. ACE was applied to bilateral "Kunlun" (BL60), "Zusanli" (ST36), and "Sanyinjiao" (SP6) acupoints in the rat model of inflammatory pain (complete Freund's adjuvant [CFA] intraplantar injection). Then, Sig-1R agonist PRE084 or saline was intrathecally given daily. The paw withdrawal thresholds and paw edema were measured before CFA injection and at 1, 3, and 5 day after CFA injection. Western bolt was used to evaluate the protein expression of spinal Sig-1R, p38MAPK, and extracellular signal-regulated kinase (ERK), and immunohistochemistry of Sig-1R was detected at 1, 3, and 5 days after CFA injection. RESULTS: ACE exhibited specific analgesic effects. ACE increased paw withdrawal thresholds and markedly decreased CFA-induced paw edema at 1, 3, and 5 days. ACE downregulated the protein expression of Sig-1R, which was increased significantly at 1, 3, and 5 days after CFA injection. ACE decreased the expression of p38 MAPK and ERK at 1 and 3 days but not at 5 days. However, an injection of Sig-1R agonist PRE084 markedly reversed these alterations, except ERK expression. CONCLUSIONS: The present study demonstrated that ACE exhibited antihyperalgesic effects via the inhibition of the Sig-1R that modulated p38 MAPK, but not ERK, expression in the CFA-induced inflammatory pain model in rats.

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Professionalism: The “Forgotten” Core Competency

No abstract available

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An Institution-Wide Rule-Based Protocol for Early Detection of Esophageal Intubation

No abstract available

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Two Minutes to Improve Cardiac Surgery Outcomes

No abstract available

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In Response

No abstract available

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The Consensus Bundle on Hypertension in Pregnancy and the Anesthesiologist: Doing All the Right Things for All the Patients All of the Time

No abstract available

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In Response

No abstract available

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Surveying the Literature: Synopsis of Recent Key Publications

No abstract available

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A Silent Killer: Insights Into Venous Thromboembolism Formation and Prevention

No abstract available

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Aerosolized Vasodilators for the Treatment of Pulmonary Hypertension in Cardiac Surgical Patients: A Systematic Review and Meta-analysis

BACKGROUND: In cardiac surgery, pulmonary hypertension is an important prognostic factor for which several treatments have been suggested over time. In this systematic review and meta-analysis, we compared the efficacy of inhaled aerosolized vasodilators to intravenously administered agents and to placebo in the treatment of pulmonary hypertension during cardiac surgery. We searched MEDLINE, CENTRAL, EMBASE, Web of Science, and clinicaltrials.gov databases from inception to October 2015. The incidence of mortality was assessed as the primary outcome. Secondary outcomes included length of stay in hospital and in the intensive care unit, and evaluation of the hemodynamic profile. METHODS: Of the 2897 citations identified, 10 studies were included comprising a total of 434 patients. RESULTS: Inhaled aerosolized agents were associated with a significant decrease in pulmonary vascular resistance (−41.36 dyne·s/cm5, P= .03) and a significant increase in mean arterial pressure (8.24 mm Hg, P= .02) and right ventricular ejection fraction (7.29%, P

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Interventions for Neuropathic Pain: An Overview of Systematic Reviews

Numerous interventions for neuropathic pain (NeuP) are available, but its treatment remains unsatisfactory. We systematically summarized evidence from systematic reviews (SRs) of randomized controlled trials on interventions for NeuP. Five electronic databases were searched up to March 2015. Study quality was analyzed using A Measurement Tool to Assess Systematic Reviews. The most common interventions in 97 included SRs were pharmacologic (59%) and surgical (15%). The majority of analyzed SRs were of medium quality. More than 50% of conclusions from abstracts on efficacy and approximately 80% on safety were inconclusive. Effective interventions were described for painful diabetic neuropathy (pregabalin, gabapentin, certain tricyclic antidepressants [TCAs], opioids, antidepressants, and anticonvulsants), postherpetic neuralgia (gabapentin, pregabalin, certain TCAs, antidepressants and anticonvulsants, opioids, sodium valproate, topical capsaicin, and lidocaine), lumbar radicular pain (epidural corticosteroids, repetitive transcranial magnetic stimulation [rTMS], and discectomy), cervical radicular pain (rTMS), carpal tunnel syndrome (carpal tunnel release), cubital tunnel syndrome (simple decompression and ulnar nerve transposition), trigeminal neuralgia (carbamazepine, lamotrigine, and pimozide for refractory cases, rTMS), HIV-related neuropathy (topical capsaicin), and central NeuP (certain TCAs, pregabalin, cannabinoids, and rTMS). Evidence about interventions for NeuP is frequently inconclusive or completely lacking. New randomized controlled trials about interventions for NeuP are necessary; they should address safety and use clear diagnostic criteria.

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Head-Jolting Nystagmus Occlusion of the Horizontal Semicircular Canal Induced by Vigorous Head Shaking

Bronstein, AM; Kaski, D; Cutfield, N; Buckwell, D; Banga, R; Ray, J; Chavda, S; Bronstein, AM; Kaski, D; Cutfield, N; Buckwell, D; Banga, R; Ray, J; Chavda, S; Irving, R; - view fewer (2015) Head-Jolting Nystagmus Occlusion of the Horizontal Semicircular Canal Induced by Vigorous Head Shaking. JAMA Otolaryngology: Head & Neck Surgery , 141 (8) pp. 757-760. 10.1001/jamaoto.2015.0711 .

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Spike output and synaptic plasticity in a feed-forward inhibitory microcircuit in the cerebellar cortex

Mittmann, WMO; (2006) Spike output and synaptic plasticity in a feed-forward inhibitory microcircuit in the cerebellar cortex. Doctoral thesis, UCL (University College London). Green open access

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Causal explanations of miscarriage amongst Qataris

Kilshaw, S; Major, S; Omar, N; Miller, D; Mohsen, M; Sole, K; El-Taher, F; Kilshaw, S; Major, S; Omar, N; Miller, D; Mohsen, M; Sole, K; El-Taher, F; Al-Tamimi, H; - view fewer (2017) Causal explanations of miscarriage amongst Qataris. BMC Pregnancy and Childbirth (In press). Green open access

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Spectroscopic analysis of the winds and atmospheres of galactic B supergiant stars

Searle, SC; (2006) Spectroscopic analysis of the winds and atmospheres of galactic B supergiant stars. Doctoral thesis, UCL (University College London). Green open access

http://ift.tt/2eDfAT3

The Human Remains Collections at the UCL Institute of Archaeology: Recent Acquisitions from Eastgate Square, Chichester, Sussex

Rando, C; (2016) The Human Remains Collections at the UCL Institute of Archaeology: Recent Acquisitions from Eastgate Square, Chichester, Sussex. Archaeology International , 19 pp. 79-83. 10.5334/ai.1914 . Green open access

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Archaeology in the Átures Rapids of the Middle Orinoco, Venezuela

Lozada Mendieta, N; Oliver, J; Riris, P; (2016) Archaeology in the Átures Rapids of the Middle Orinoco, Venezuela. Archaeology International , 19 pp. 73-78. 10.5334/ai.1913 . Green open access

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Inequalities in the provision of cardiovascular screening to people with severe mental illnesses in primary care Cohort study in the United Kingdom THIN Primary Care Database 2000-2007

Osborn, DPJ; Baio, G; Walters, K; Petersen, I; Limburg, H; Raine, R; Nazareth, I; (2011) Inequalities in the provision of cardiovascular screening to people with severe mental illnesses in primary care Cohort study in the United Kingdom THIN Primary Care Database 2000-2007. Schizophrenia Research , 129 (2-3) pp. 104-110. 10.1016/j.schres.2011.04.003 .

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Class and global citizenship: perspectives from non-elite young people’s participation in volunteer tourism

Cheung Judge, R; (2017) Class and global citizenship: perspectives from non-elite young people's participation in volunteer tourism. Tourism Recreation Research , 42 (2) pp. 164-175. 10.1080/02508281.2017.1303894 . Green open access

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