Parameters of skull vibration-induced nystagmus in normal subjects

Abstract

Hypothesis

The knowledge of vibration-induced nystagmus test (SVINT) values in the normal population is highly relevant to provide a rapid orientation on the diagnosis attitude in a patient with vertigo.

Background

Although mastoid bone vibration should only induce nystagmus in the presence of vestibular asymmetry, it has also been reported in normal individuals raising doubts as to how to interpret the SVINT. To date, no population studies involving the use of the SVINT and that establish normative values have been published.

Methods

This study was carried out at two tertiary healthcare centres on a total of 122 subjects. We stimulated at three frequencies (30, 60 and 100 Hz), in increasing order, first stimulating the right mastoid and then the left mastoid, and waiting for 30 s between each stimulus. The response was recorded with a videonystagmography system. The following variables were evaluated in each subject: the mean and maximum speed of the slow phase of nystagmus, the frequency of the nystagmatic response (NR) and the component and direction of the rapid phase of nystagmus.

Results

Only 26 subjects (20.5%) of the subjects studied here (122 subjects) developed any kind of nystagmatic response and 96 subjects (79.5%) did not display any response. Stimulation at 100 Hz provoked the largest number of responses (p = 0.04), while there was no difference in the number of responses induced by 30 and 60 Hz stimulations (p = 0.85). The frequency of nystagmus was ≤ 0.7 n/s in 80.8% of the positive responses. The mean velocity of the horizontal component of the NR was 2.2°/s (SD 1.6) and that of the vertical component was 1.3°/s (SD 1.2).

Conclusions

Healthy subjects do not generally develop to NR upon vibratory stimulation and only 20% of the subjects studied here developed any kind of NR, this being a slow and inconsistent response of low frequency. The establishment of normal values contributes to improve the orientation in clinical practice in the pathological population and this opens possibilities for tackling more reliable studies in this population.

https://ift.tt/2xvUOxT

Pediatric Residents’ Assessment of Atopic Dermatitis Severity for Risk Assessment of Early Peanut Introduction,

Publication date: Available online 31 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): James Shea, Monika Martusiewicz, Lucy A Bilaver, Ozge N Aktas, Jialing Jiang, Anthony J Mancini, Ruchi S Gupta




https://ift.tt/2L73HQg

Development of Food Protein-Induced Enterocolitis Syndrome (FPIES) to egg following Immunoglobulin E (IgE)-mediated egg allergy,

Publication date: Available online 31 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Hannah Duffey, Maureen Egan




https://ift.tt/2JheLx1

Pilot study of the CAPS (Clinical extent, Area, Pruritus, Sleep) measure for atopic dermatitis severity,,✯✯✯,✯✯✯✯

Publication date: Available online 31 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Aaron M Drucker, Natalie H Matthews, Jennie Muglia, Abrar A Qureshi
Eczema; Atopic dermatitis; Outcome measures; Severity; Symptoms; ItchAbbreviations: AD, atopic dermatitis; BSA, body surface area; CAPS, Clinical extent, Area, Pruritus, Sleep; DLQI, Dermatology Life Quality Index; EASI, Eczema Area and Severity Index; IGA, Investigator Global Assessment; POEM, Patient-Oriented Eczema Measure



https://ift.tt/2Ld5rrd

Otolaryngology resident experience with supraclavicular, submental and other regional flaps in the United States

Despite the resurgence in regional flap use, otolaryngology resident regional flap experience has been incompletely studied. We sought to characterize United States (US) otolaryngology resident exposure to, and perceptions of, supraclavicular flaps (SCFs), submental flaps (SMFs), and other regional flaps.

https://ift.tt/2socB53

“Determination of the impact of melanoma surgical timing on survival using the National Cancer Database”

https://ift.tt/2J1Mrj1

Association of family structure with atopic dermatitis in United States children

The relationship between family structure and atopic dermatitis has not previously been elucidated., Children from family structures without two married, biological parents have increased odds of AD and poorer overall health outcomes., Children from family structures without two, married, biological parents may benefit from increased surveillance, closer follow-up and optimized treatment for incident AD.

https://ift.tt/2H9ApOz

Daily Oxymetazoline Cream Demonstrates High and Sustained Efficacy in Patients With Persistent Erythema of Rosacea Through 52 Weeks of Treatment

https://ift.tt/2J47CBb

Long-term adalimumab efficacy in patients with moderate-to-severe hidradenitis suppurativa/acne inversa: 3-year results of a phase 3 open-label extension study

Adalimumab is approved for moderate-to-severe hidradenitis suppurativa/acne inversa., A sustained response is seen through week 168 in 52.3% of patients treated with adalimumab 40 mg weekly, with no additional safety issues identified. Adalimumab can be considered for long term control of moderate-to-severe hidradenitis suppurativa.

https://ift.tt/2syXOnE

The readability of iPledge program patient education materials

https://ift.tt/2J43aC4

A cohort study of risk factors, clinical presentations and outcomes for dermatophyte, non-dermatophyte and mixed toenail infections

https://ift.tt/2H9sK2Q

Response to: Reply to:"Determination of the impact of melanoma surgical timing on survival using the National Cancer Database"

https://ift.tt/2kGf8DE

Changes in chronic rhinosinusitis symptoms differentially associate with improvement in general health-related quality of life

Chronic rhinosinusitis (CRS) is an inflammatory disease of the paranasal sinus mucosa.1 CRS is characterized by nasal as well as extra-nasal symptoms related to poor sleep, ear/facial discomfort and emotional disturbance.2 Due to these associated symptoms as well as other clinical manifestations—such as acute exacerbations of CRS and exacerbation of comorbid pulmonary disease—CRS causes a significant quality of life (QOL) detriment.3–5 The clinical manifestations of CRS are also associated with significant productivity losses.

https://ift.tt/2JmLCAw

Food-induced Anaphylaxis in Infants and Children

Recent recommendations to introduce peanut products to infants for peanut allergy prevention requires a focused assessment of infant anaphylaxis.

https://ift.tt/2L8MUN2

Bedroom Exposure to Airborne Allergens in the Chicago Area Using a Patient-Operated Sampling Device

Background: In current practice, allergens in vacuum collected dust are used as surrogates for inhalable allergens. We developed an airsampling device that can be used by patients themselves for direct measurement of airborne allergen concentrations in their own homes.Objective: To demonstrate the use of this device to establish allergen concentration reference ranges in a target population. To evaluate relationships of patient-reported information to measured allergen concentrations.Methods: Patients from 5 allergist's practices in the Chicagoland region were provided with instructions, questionnaire, informed consent forms and samplers to run for 5 days in their bedrooms.

https://ift.tt/2JjVqLB

Are there different subtypes of eosinophilic esophagitis?

Currently, eosinophilic esophagitis (EoE) is defined by the combination of clinical symptoms and pathologic findings. Patients should have symptoms of esophageal dysmotility as well as a defined (albeit somewhat arbitrarily so) level of esophageal eosinophilia. Thus, using this definition, the diagnosis of EoE is purely a phenotype, possibly allowing for multiple different etiologies to funnel into this diagnosis. In this manner, EoE is similar to other conditions that we treat, such as asthma, in which treatment strategies are evolving in an era of precision medicine.

https://ift.tt/2Ldda8Z

Dehiscencia de la lámina papirácea del etmoides

Publication date: Available online 30 May 2018
Source:Acta Otorrinolaringológica Española
Author(s): Gabriel Huguet Llull, Marta Mesalles Ruiz, Xavier González Compta




https://ift.tt/2xvQ0Zt

Extranodal involvement of diffuse large B-cell lymphoma in the head and neck: An indicator of good prognosis

In this study, we analyzed clinicopathological characteristics and survival outcomes according to extranodal involvement of diffuse large B-cell lymphoma (DLBCL) in the head and neck.

https://ift.tt/2xwLh9Y

Pediatric cochlear reimplantation: Decision-tree efficacy

Publication date: Available online 31 May 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): L. Distinguin, M. Blanchard, I. Rouillon, M. Parodi, N. Loundon
ObjectivesThe context leading to pediatric cochlear reimplantation (CreI) can be complex. The objectives of this study were to define initial CreI indications, analyze final diagnosis and draw up a decision-tree.MethodsA retrospective study included patients undergoing CreI between 2005 and 2015. Demographic characteristics, CreI circumstances and technical reports were collected. Circumstances indicating CreI were classified in 3 groups: performance decrement, suspected device failure, or medical. After CreI, final diagnoses were classified in 2 groups: confirmed failure (DFail) or medical (DMed).Results69 out of 734 cochlear implantation surgeries were for CreI (8%). Manufacturers' reports were available in 64 cases (93%). Two principal causes were found: trauma and infection. Initial indications were: performance decrement: 27%; device failure: 56%; and medical: 17%. Final diagnoses were: DFail: 72%; and DMed: 28%. Initial indication and final diagnosis were similar in 86% of cases. The majority of the 14% initial indication errors belonged to the "performance decrement" group. Traumatic causes correlated with risk of initial indication error (P=0.039).ConclusionApart from spontaneous device failure, the two causes of CreI were infection and trauma. Using the present decision algorithm, half of the complex cases were resolved after CreI.



https://ift.tt/2J2ljQY

Tonsillectomy in children and in adults: changes in practice following the opening of a day-surgery unit with dedicated operating room

Publication date: Available online 30 May 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): S. Bartier, I. Gharzouli, N. Kiblut, H. Bendimered, L. Cloutier, D. Salvan
ObjectivesTo study the impact of the opening of a day-surgery unit on the practice of tonsillectomy in adults and children in the light of the experience of our department, and to compare complications between day-surgery and conventional admission.Material and methodsA retrospective review was conducted of all tonsillectomies performed since the opening of a dedicated day-surgery room, using the ENT and emergency department data-bases.ResultsBetween October 2013 and December 2014, 179 tonsillectomies were performed (51 in adults, 128 in children), including 108 day-surgeries. Between 2012 and 2014, the number of tonsillectomies increased by 12.7%, with an 18.27% increase in children and stable adult rate. Within 1 year, day-surgery became predominant for children (73.19%) and equaled conventional admission for adults (47.22%). For almost all patients without same-day discharge, the reasons were organizational or due to malorientation (comorbidity, or unsuitable home environment). Day-case tonsillectomy in children showed a 30-day complications rate comparable to those reported in the literature (8.3% postoperative hemorrhage), with a higher rate in adults (35.3%). Onset of complications was at a mean 6 days in adults and 9 days in children; only 2 patients developed complications between 6 and 24hours postoperatively.ConclusionThe present study showed that opening a day-surgery unit led to changes in practice, with most tonsillectomies now performed on an outpatient basis, without increased complications, and notably immediate complications. Outpatient tonsillectomy thus seems to be a solution of choice compared to conventional admission, in terms of cost saving and of patient comfort, without sacrificing safety. The dedicated operating room facilitates scheduling and thereby increasing turnover by reducing wait time.



https://ift.tt/2Haonob

Revisiting Correlation Between Pre Operative High Resolution Computed Tomography and Operative Findings in Attico Antral Disease

Abstract

(1) To correlate the findings of high resolution computed tomography (HRCT) scans with operative findings in chronic otitis media (attico antral disease). (2) To assess the role of HRCT in chronic otitis media (attico antral disease). This prospective observational study undertaken at a tertiary level teaching hospital included 50 patients of chronic otitis media (attico antral disease) who underwent pre-operative HRCT scanning and the findings were compared with the operative findings and correlation between the two was assessed with appropriate statistical methods. HRCT findings correlated well for the status of malleus and incus, facial nerve canal, lateral semicircular canal, and sinus plate but were less accurate for stapes and tegmen plate. As for disease extent and prediction of cholesteatoma the degree of correlation was site dependent being greater in mastoid air cell system and epitympanum and lesser in mesotympanum and hypotympanum. HRCT despite of its value in management of chronic otitis media has its drawbacks and limitations. CT's accuracy of prediction in some aspects of the disease varies with the site of pathology and this point must always be kept in mind by the operating surgeon. We suggest that each health care centre should establish their own correlative indices for HRCT temporal bone imaging in COM. HRCT cannot be entirely relied upon in management of chronic otitis media patients. However against the backdrop of improved radiological skills in interpreting temporal bone ct images, improved CT machines and importantly the growing concern over medicolegal issues, the role of pre operative CT scan in COM is much more than what was thought previously. Undoubtedly, it is a very useful 'aid' to management BUT a well-trained, experienced and alert surgeon is the key for an accurate diagnosis and successful management of chronic otitis media (attico-antral disease).

https://ift.tt/2snPXd3

Parotid Gland Tumours: Our Experience

Abstract

Salivary gland tumor comprises of approximately 3 to 10% of neoplasms of the head and neck region. Parotid gland is the most commonly involved salivary gland with an incidence of 62% followed by submandibular gland and other minor salivary gland tumors. However clinical course of benign and malignant tumors resemble each other in clinical findings, we require histopatholocal or cytological diagnosis for planning of management. To analyze parotid tumors retrospectively with following objectives. (1) Demographic distribution of parotid tumors. (2) To evaluate cytological and histopathological findings of parotid tumors. (3) Correlation of cytological and histopathological findings of parotid tumors. It was a retrospective observational study involving 31 patients who presented with parotid region swelling. Pre operative FNAC (fine needle aspiration cytology) and post operative histopathology were correlated. Surgical management depended on nature of disease. Correlation of FNAC and Histopathology: among 27 cases pre operative FNAC and post operative histopathology was same and in only 3 cases reports differed. One FNAC was inconclusive. In present study, Sensitivity of FNAC is 81.81%, Specificity is 94.73% and accuracy is 90%. FNAC is usually the first investigative modality, as it is a minimally invasive, cheap, OPD procedure that can differentiate benign from malignant tumors. Knowing preoperative pathological nature of disease can help in planning of surgical process.

https://ift.tt/2supiL7

Anaplastic carcinoma of the pancreas diagnosed by endoscopic ultrasound-guided fine-needle aspiration: a case report and review of the literature

Anaplastic carcinoma of the pancreas is a rare pancreatic neoplasm with a poor prognosis. It is classified as a variant of ductal adenocarcinoma, but the clinical features and treatment of it remain unknown be...

https://ift.tt/2suIbxd

Gallbladder metastasis of renal clear cell carcinoma 15 years after primary cancer excision: a case report

Renal cell carcinoma is well-known for its propensity to metastasize to unusual sites. However, metastasis to the gallbladder has been rarely reported in the literature.

https://ift.tt/2IZg1FM

Differential regulation of human monocytes and NK cells by antibody-opsonized tumors

Abstract

The monocyte network is important for therapeutic efficacy of antibody therapies against cancer. One mechanism which monocytes/macrophages use to kill cancer cells is phagocytosis. Using trastuzumab and human breast cancer cell lines as a model, we used flow cytometry to evaluate the importance of avidity, antigen density, Fcγ receptor (FcγR) expression, and FcγR polymorphisms in human monocyte phagocytosis. By increasing avidity for the tumor through the addition of pertuzumab to trastuzumab, there was a two-to-threefold increase in phagocytosis potency against the HCC1419 cell line compared to antibodies alone, while NK cell-mediated antibody-dependent cellular cytotoxicity (ADCC) failed to increase tumor cell death. Consistent with increasing the avidity through multiple antibodies, antigen density significantly enhanced phagocytosis with breast cancer cell lines that were HER2 gene-amplified compared to non-amplified tumor cells. Confirmation that high antigen density enhanced phagocytosis was obtained when HER2 was overexpressed in HER2 non-amplified cell lines. In contrast, NK cell ADCC failed to distinguish differences in tumor cell death when comparing gene-amplified and non-amplified breast cancer cell lines. The level of phagocytosis was influenced by FcγRIIa and FcγRIIIa expression. Most monocytes are FcγRIIIa⁻, and the induction of the receptor significantly enhances antibody-dependent phagocytosis. Although both receptors are involved, when blocked FcγRIIIa had a greater influence on phagocytosis. Furthermore, the polymorphism FcγRIIIa 158V significantly enhanced phagocytosis; whereas FcγRIIa 131H polymorphism appeared to improve phagocytosis but was not statistically significant. Targeting of monocytes for enhanced phagocytosis may improve the effectiveness of therapeutic antibodies to improve clinical outcomes.

https://ift.tt/2H7tu8S

Early Labor Symptoms

As pregnancy brings many normal changes for your body, it can be challenging to identify early labor symptoms that may point to premature labor, even if you are far from your due date. So how can you know if you are experiencing preterm labor? Here are the symptoms you may be able to recognize at home.

The post Early Labor Symptoms appeared first on ChildrensMD.

https://ift.tt/2sk6leQ

Adenopharyngoplasty vs Adenotonsillectomy in Children With Severe Obstructive Sleep Apnea

This randomized clinical trial compares the outcomes of adenotonsillectomy vs adenopharyngoplasty in children with severe obstructive sleep apnea.

https://ift.tt/2J2mCva

Association of Idiopathic Sudden Sensorineural Hearing Loss With Affective Disorders

This cohort study uses a Korean nationwide database to investigate whether idiopathic sudden sensorineural hearing loss is associated with the development of affective disorders such as anxiety, depression, and bipolar disorder.

https://ift.tt/2LMmVfe

The Unrecognized Dangers of Sudden Hearing Loss

The impact of an idiopathic sudden sensorineural hearing loss (ISSNHL) on a patient can be devastating. Practitioners who treat this malady are always worried about potential life-threatening issues, such as an intracranial complication or a tumor. However, practitioners need to be aware of other life-altering consequences of a sudden hearing loss. The study by Kim et al reveals that an often-overlooked sequela is the onset of affective disorders such as depression and anxiety.

https://ift.tt/2xr7KVI

Functional Nasal Surgery and Use of CPAP in OSAS Patients: Our Experience

Abstract

The surgical correction of nasal obstruction is definitely effective and recommended in patients with poor CPAP compliance, often secondary to the high pressures that need to be given in patients with nasal sub stenosis. For this reason, the objective of this study is the evaluation of the effectiveness and effects of the functional nose surgery on adherence to CPAP- therapy in patients (with moderate to severe OSAS with indication of ventilation therapy) poorly compliant with CPAP. The study was performed on a sample of 52 patients, 40 male and 12 female, aged between 29 and 72 years followed by the Otolaryngology Unit of the University Palermo in the period between January 2015 and January 2017. All patients were subjected to the following s iter: anamnesis with Epworth Sleepiness Scale, NOSE scale, evaluation of "CPAP usage data." Upper airway optical fiber endoscopy with Müller's maneuver. We performed various type of nasal surgery (septoplasty, decongestion of the lower turbinates and FESS) 6 months after the surgery, CPAP usage was evaluated and the NOSE scale has been reapplied. All patients had a subjective degree of obstruction classified in severe or extreme by the NOSE scale before surgery. Almost all patients reported a mild degree of obstruction after the surgery. About CPAP usage, the average usage has passed by 2, 3 h at night to 6, 8 h after the surgery. The result is significant because it shows how the nasal functional surgery can make selected patients suitable to ventilation therapy. As our work shows, a better nasal function allows to reduce the CPAP pressure, Therefore, we believe that all patients with medium to severe obstructive apnea syndrome and for whom night-time ventilation therapy (CPAP) is advised should be evaluated with endoscopy and anamnesis oriented to evaluate nasal obstructive pathologies that may reduce effectiveness of CPAP.

https://ift.tt/2J7C5KA

Nrf2 pathway modulates Substance P-induced human mast cell activation and degranulation in the hair follicle

Publication date: Available online 31 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Laura Jadkauskaite, Rajia Bahri, Nilofer Farjo, Bessam Farjo, Gail Jenkins, Ranjit Bhogal, Iain Haslam, Silvia Bulfone-Paus, Ralf Paus

Teaser

Activation of Nrf2 in primary human mast cells exposed to oxidative stress induced by substance P suppresses pro-inflammatory gene transcription, activation and degranulation.


https://ift.tt/2JoZ1bg

Paradoxical psoriasis following anti-TNF therapy in ankylosing spondylitis: A population-based cohort study

Publication date: Available online 31 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Jung Min Bae, Hyuck Sun Kwon, Gyong Moon Kim, Kyung-Su Park, Ki-Jo Kim

Teaser

The risks of psoriasis and palmoplantar pustulosis were significantly increased in patients with ankylosing spondylitis (AS) treated with anti-TNF agents compared to AS patients treated without anti-TNF agents in the population-based cohort study.


https://ift.tt/2LcPYI2

Biological Therapies for Eosinophilic Gastrointestinal Diseases

Publication date: Available online 31 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Joshua B. Wechsler, Ikuo Hirano
The scientific basis and the clinical application of monoclonal antibody therapies that target specific immunologic pathways for eosinophilic gastrointestinal diseases (EGIDs) are areas of active interest. There is a growing recognition of a subset of patients with eosinophilic esophagitis, or EoE, whose disease does not respond well to topical steroids or elimination diets. In addition, long-term use of corticosteroids presents risks. Systemic therapy with a biologic agent offers potential advantages as a global approach that could limit the need for multiple, locally active medical therapies and allergen avoidance. The identification of novel biologic strategies is ongoing, and the recent validation of instruments and outcome measures to assess disease activity has proved essential in demonstrating efficacy. Studies using biologics that target IL-13 pathways in the treatment of EoE have demonstrated substantial promise.



https://ift.tt/2JiM8j7

A novel soft tissue prediction methodology for orthognathic surgery based on probabilistic finite element modelling

Knoops, PGM; Borghi, A; Ruggiero, F; Badiali, G; Bianchi, A; Marchetti, C; Rodriguez-Florez, N; ... Schievano, S; + view all Knoops, PGM; Borghi, A; Ruggiero, F; Badiali, G; Bianchi, A; Marchetti, C; Rodriguez-Florez, N; Breakey, RWF; Jeelani, O; Dunaway, DJ; Schievano, S; - view fewer (2018) A novel soft tissue prediction methodology for orthognathic surgery based on probabilistic finite element modelling. PLoS One , 13 (5) , Article e0197209. 10.1371/journal.pone.0197209 . Green open access

https://ift.tt/2sv8IKO

Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2): a multicentre observational cohort study

Wilson, D; Ambler, G; Shakeshaft, C; Brown, MM; Charidimou, A; Salman, RA-S; Lip, GYH; ... Werring, DJ; + view all Wilson, D; Ambler, G; Shakeshaft, C; Brown, MM; Charidimou, A; Salman, RA-S; Lip, GYH; Cohen, H; Banerjee, G; Houlden, H; White, MJ; Yousry, TA; Harkness, K; Flossmann, E; Smyth, N; Shaw, LJ; Warburton, E; Muir, KW; Jager, HR; Werring, DJ; - view fewer (2018) Cerebral microbleeds and intracranial haemorrhage risk in patients anticoagulated for atrial fibrillation after acute ischaemic stroke or transient ischaemic attack (CROMIS-2): a multicentre observational cohort study. The Lancet Neurology , 17 (6) pp. 539-547. 10.1016/S1474-4422(18)30145-5 . Green open access

https://ift.tt/2IYjdRT

A Structure and Durability Comparison of Membrane Electrode Assembly Fabrication Methods: Self-Assembled Versus Hot-Pressed

Hack, J; Heenan, TMM; Iacoviello, F; Mansor, N; Meyer, Q; Shearing, P; Brandon, N; Hack, J; Heenan, TMM; Iacoviello, F; Mansor, N; Meyer, Q; Shearing, P; Brandon, N; Brett, DJL; - view fewer (2018) A Structure and Durability Comparison of Membrane Electrode Assembly Fabrication Methods: Self-Assembled Versus Hot-Pressed. Journal of The Electrochemical Society , 165 (6) F3045-F3052. 10.1149/2.0051806jes . Green open access

https://ift.tt/2sv8xz8

A Stone-type Duality Theorem for Separation Logic Via its Underlying Bunched Logics

Docherty, S; Pym, D; (2018) A Stone-type Duality Theorem for Separation Logic Via its Underlying Bunched Logics. Electronic Notes in Theoretical Computer Science , 336 pp. 101-118. 10.1016/j.entcs.2018.03.018 . Green open access

https://ift.tt/2IZFqiG

A defect in myoblast fusion underlies Carey-Fineman-Ziter syndrome

Di Gioia, SA; Connors, S; Matsunami, N; Cannavino, J; Rose, MF; Gilette, NM; Artoni, P; ... Hutchinson, EB; + view all Di Gioia, SA; Connors, S; Matsunami, N; Cannavino, J; Rose, MF; Gilette, NM; Artoni, P; De Macena Sobreira, NL; Chan, WM; Webb, BD; Robson, CD; Cheng, L; Van Ryzin, C; Ramirez-Martinez, A; Mohassel, P; Leppert, M; Scholand, MB; Grunseich, C; Ferreira, CR; Hartman, T; Hayes, IM; Morgan, T; Markie, DM; Fagiolini, M; Swift, A; Chines, PS; Speck-Martins, CE; Collins, FS; Jabs, EW; Bönnemann, CG; Olson, EN; Carey, JC; Robertson, SP; Manoli, I; Engle, EC; Andrews, CV; Barry, BJ; Hunter, DG; Mackinnon, SE; Shaaban, S; Erazo, M; Frempong, T; Hao, K; Naidich, TP; Rucker, JC; Zhang, Z; Biesecker, BB; Bonnycastle, LL; Brewer, CC; Brooks, BP; Butman, JA; Chien, WW; Farrell, K; FitzGibbon, EJ; Gropman, AL; Hutchinson, EB; - view fewer (2017) A defect in myoblast fusion underlies Carey-Fineman-Ziter syndrome. Nature Communications , 8 , Article 16077. 10.1038/ncomms16077 . Green open access

https://ift.tt/2H6Wg9C

Neuroconductor: an R platform for medical imaging analysis

Muschelli, J; Gherman, A; Fortin, J-P; Avants, B; Whitcher, B; Clayden, JD; Caffo, BS; Muschelli, J; Gherman, A; Fortin, J-P; Avants, B; Whitcher, B; Clayden, JD; Caffo, BS; Crainiceanu, CM; - view fewer (2018) Neuroconductor: an R platform for medical imaging analysis. Biostatistics , Article kxx068. 10.1093/biostatistics/kxx068 .

https://ift.tt/2IZFkHQ

Sexual abuse and psychosis: The security of research findings

Bebbington, PE; (2018) Sexual abuse and psychosis: The security of research findings. Schizophrenia Research 10.1016/j.schres.2018.04.038 . (In press).

https://ift.tt/2H6UrJT

Metabolites predict lesion formation and severity in relapsing-remitting multiple sclerosis

Klauser, AM; Wiebenga, OT; Eijlers, AJ; Schoonheim, MM; Uitdehaag, BM; Barkhof, F; Pouwels, PJ; Klauser, AM; Wiebenga, OT; Eijlers, AJ; Schoonheim, MM; Uitdehaag, BM; Barkhof, F; Pouwels, PJ; Geurts, JJ; - view fewer (2018) Metabolites predict lesion formation and severity in relapsing-remitting multiple sclerosis. Multiple Sclerosis Journal , 24 (4) pp. 491-500. 10.1177/1352458517702534 . Green open access

https://ift.tt/2IZTSXN

Associations between the use of herbal medicines and adverse pregnancy outcomes in rural Malawi: a secondary analysis of randomised controlled trial data

Zamawe, C; King, C; Jennings, H; Fottrell, E; (2018) Associations between the use of herbal medicines and adverse pregnancy outcomes in rural Malawi: a secondary analysis of randomised controlled trial data. BMC Complementary and Alternative Medicine , 18 , Article 166. 10.1186/s12906-018-2203-z . Green open access

https://ift.tt/2H7uXvQ

Conservation genomics reveals possible illegal trade routes and admixture across pangolin lineages in Southeast Asia

Nash, HC; Wirdateti, ; Low, GW; Choo, SW; Chong, JL; Semiadi, G; Hari, R; ... Rheindt, FE; + view all Nash, HC; Wirdateti, ; Low, GW; Choo, SW; Chong, JL; Semiadi, G; Hari, R; Sulaiman, MH; Turvey, ST; Evans, TA; Rheindt, FE; - view fewer (2018) Conservation genomics reveals possible illegal trade routes and admixture across pangolin lineages in Southeast Asia. Conservation Genetics (In press).

https://ift.tt/2kFovn4

Dynamic behaviour in nicotinate-bridged binuclear ruthenium(IV) complexes

Tocher, DA; Steed, J; (2018) Dynamic behaviour in nicotinate-bridged binuclear ruthenium(IV) complexes. Polyhedron , 147 pp. 152-155. 10.1016/j.poly.2018.03.025 . (In press).

https://ift.tt/2sts0QN

Claiming Resources, Honoring Debts: Miners, Herders, and the Masters of the Land in Mongolia

Empson, RA; (2017) Claiming Resources, Honoring Debts: Miners, Herders, and the Masters of the Land in Mongolia. Ethnos (In press).

https://ift.tt/2IYbjYZ

Massive Silicone Oil Migration into the Subconjunctival Space: A Leakage Mechanism Dilemma

Purpose: To report a case in which an early, massive silicone oil migration into the subconjunctival space occurred in a patient after sutureless vitrectomy with the presence of a previously implanted pars plana glaucoma drainage device. Case Report: An 80-year-old man presented with neovascular glaucoma secondary to a proliferative diabetic retinopathy in his left eye. After an intracamerular bevacizumab injection and panretinal photocoagulation, a 23-gauge pars plana vitrectomy (PPV) combined with a superotemporal Ahmed pars plana glaucoma valve implantation was performed. Afterwards, the patient underwent a new 23-gauge PPV for a dense vitreous hemorrhage. Intravitreal 1,000 centistokes silicone oil was placed to prevent recurrent intraocular bleeding. No sutures were performed. In the first postoperative month, a massive migration of silicone oil into the 360° subconjunctival space was noted until no intraocular silicone oil was observed. Conclusions: We discuss the possible leakage mechanisms in this particular case.
Case Rep Ophthalmol 2018;9:310–314

https://ift.tt/2kEfqLh

Apatinib for Esophagus Cancer

Condition:   Esophagus Cancer
Intervention:   Drug: Apatinib
Sponsor:   Affiliated Hospital of North Sichuan Medical College
Not yet recruiting

https://ift.tt/2JiACnT

Prof. dr. MirkoToš: Obituary

Publication date: July 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 110
Author(s): Janez Rebol




https://ift.tt/2JlLdOM

Undifferentiated Pleomorphic Sarcoma of Pancreas: A Case Report and Review of the Literature for the Last Updates

The most prevalent type of soft tissue sarcoma is undifferentiated pleomorphic sarcoma (UPS) or previously known as malignant fibrous histiocytoma. It accounts over 20% of all soft tissue sarcomas and occurs most frequently in the extremities, trunk, and retroperitoneum. However, it has been rarely observed in the digestive system. Pancreas sarcoma represents less than 1% of all pancreatic tumors, and primary UPS of the pancreas is even rarer. It exhibits high recurrence and poor prognosis. In this case, a 72-year-old woman with a UPS tumor which was located in the pancreas head and neck without adhesion to the retroperitoneum will be discussed.

https://ift.tt/2sjrRQW

Infection Rates After Colonoscopy, Endoscopy at US Specialty Centers Are Far Higher Than Previously Thought

The rates of infection following colonoscopies and upper-GI endoscopies performed at U.S. outpatient specialty centers are far higher than previously believed, according to a Johns Hopkins study published online this month in the journal Gut.

https://ift.tt/2LNPkBB

Labeling Morphine Milligram Equivalents on Opioid Packaging: a Potential Patient Safety Intervention

Abstract

Purpose of Review

Given that the primary cause of overdose death in the USA is related to prescribed opioids, one potential strategy to improve awareness and decrease morbidity and/or mortality could include improved labeling. Specific patient populations which significantly struggle with adverse outcomes related to opioid abuse are seen in palliative care, chronic pain, and acute pain treatment settings.

Recent Findings

An unexplored option for improving the healthcare quality and safety for patients currently prescribed opioids would be to require pharmaceutical companies to provide a morphine milligram equivalent (MME) on opioid packaging. Some limitations to MME conversions include equianalgesic conversions being estimates at best and may not account for variations in genetics and pharmacokinetics. Changing opioid labeling requirements is feasible as it falls under the purview of the US Food and Drug Administration (FDA), which has been mandated to provide mechanisms to reduce or to minimize overdoses related to opioid prescriptions.

Summary

Labeling opioid packaging with MME per dose will promote clearer communication about opioid strength between patients and physicians. Labeling MME on packaging could help prevent prescriber errors.

https://ift.tt/2Lcohz4

Polypharmacy Is Associated With Higher Frailty Risk in Older People: An 8-Year Longitudinal Cohort Study

Veronese, N; Stubbs, B; Noale, M; Solmi, M; Pilotto, A; Vaona, A; Demurtas, J; ... Maggi, S; + view all Veronese, N; Stubbs, B; Noale, M; Solmi, M; Pilotto, A; Vaona, A; Demurtas, J; Mueller, C; Huntley, J; Crepaldi, G; Maggi, S; - view fewer (2017) Polypharmacy Is Associated With Higher Frailty Risk in Older People: An 8-Year Longitudinal Cohort Study. Journal of the American Medical Directors Association , 18 (7) pp. 624-628. 10.1016/j.jamda.2017.02.009 . Green open access

https://ift.tt/2J4F2LV

The role of family literacy classes in demystifying school literacies and developing closer parent–school relations

Swain, J; Cara, O; (2018) The role of family literacy classes in demystifying school literacies and developing closer parent–school relations. Cambrdige Journal of Education 10.1080/0305764X.2018.1461809 . (In press).

https://ift.tt/2LICXqt

Identification of rare nonsynonymous variants in SYNE1/CPG2 in bipolar affective disorder

Sharp, SI; Lange, J; Kandaswamy, R; Daher, M; Anjorin, A; Bass, NJ; McQuillin, A; (2017) Identification of rare nonsynonymous variants in SYNE1/CPG2 in bipolar affective disorder. Psychiatric Genetics , 27 (3) pp. 81-88. 10.1097/YPG.0000000000000166 . Green open access

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Structural white matter changes in adults and children with posttraumatic stress 3 disorder: a systematic review and meta-analysis

Siehl, S; King, JA; Burgess, N; Flor, H; Nees, F; (2018) Structural white matter changes in adults and children with posttraumatic stress 3 disorder: a systematic review and meta-analysis. NeuroImage: Clinical (In press).

https://ift.tt/2LKkYjH

How shape and internal structure affect the magnetic properties of anisometric magnetite nanoparticles

Gavilan, H; Posth, O; Bogart, LK; Steinhoff, U; Gutierrez, L; Puerto Morales, M; (2017) How shape and internal structure affect the magnetic properties of anisometric magnetite nanoparticles. Acta Materialia , 125 pp. 416-424. 10.1016/j.actamat.2016.12.016 . Green open access

https://ift.tt/2xxHN76

The additional lateralizing and localizing value of the postictal EEG in frontal lobe epilepsy

Whitehead, K; Gollwitzer, S; Millward, H; Wehner, T; Scott, C; Diehl, B; (2016) The additional lateralizing and localizing value of the postictal EEG in frontal lobe epilepsy. Clinical Neurophysiology , 127 (3) pp. 1774-1780. 10.1016/j.clinph.2015.11.050 . Green open access

https://ift.tt/2LN9k7l

Southeast Greenland Winter Precipitation Strongly Linked to the Icelandic Low Position

Berdahl, M; Rennermalm, A; Hammann, A; Mioduszweski, J; Hameed, S; Tedesco, M; Stroeve, J; ... McConnell, J; + view all Berdahl, M; Rennermalm, A; Hammann, A; Mioduszweski, J; Hameed, S; Tedesco, M; Stroeve, J; Mote, T; Koyama, T; McConnell, J; - view fewer (2018) Southeast Greenland Winter Precipitation Strongly Linked to the Icelandic Low Position. Journal of Climate , 31 (11) pp. 4483-4500. 10.1175/JCLI-D-17-0622.1 .

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Enhancing the Magnetic Heating Capacity of Iron Oxide Nanoparticles through Their Postproduction Incorporation into Iron Oxide-Gold Nanocomposites

Bell, G; Bogart, LK; Southern, P; Olivo, M; Pankhurst, QA; Parkin, IP; (2017) Enhancing the Magnetic Heating Capacity of Iron Oxide Nanoparticles through Their Postproduction Incorporation into Iron Oxide-Gold Nanocomposites. European Journal of Inorganic Chemistry (18) pp. 2386-2395. 10.1002/ejic.201601432 . Green open access

https://ift.tt/2LIBfp0

Serendipitous isolation of a disappearing conformational polymorph of succinic acid challenges computational polymorph prediction

Lucaioli, P; Nauha, E; Gimondi, I; Price, LS; Guo, R; Iuzzolino, L; Singh, I; ... Blagden, N; + view all Lucaioli, P; Nauha, E; Gimondi, I; Price, LS; Guo, R; Iuzzolino, L; Singh, I; Salvalaglio, M; Price, SL; Blagden, N; - view fewer (2018) Serendipitous isolation of a disappearing conformational polymorph of succinic acid challenges computational polymorph prediction. CrystEngComm 10.1039/C8CE00625C . (In press).

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Reference tracts and generative models for brain white matter tractography

Muñoz Maniega, S; Bastin, ME; Deary, IJ; Wardlaw, JM; Clayden, JD; (2017) Reference tracts and generative models for brain white matter tractography. Journal of Imaging , 4 (1) p. 8. 10.3390/jimaging4010008 . Green open access

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Accurate Delineation of Glioma Infiltration by Advanced PET/MR Neuro-Imaging (FRONTIER Study): A Diagnostic Study Protocol

Verburg, N; Pouwels, PJW; Boellaard, R; Barkhof, F; Hoekstra, OS; Reijneveld, JC; Vandertop, WP; ... Hamer, PCDW; + view all Verburg, N; Pouwels, PJW; Boellaard, R; Barkhof, F; Hoekstra, OS; Reijneveld, JC; Vandertop, WP; Wesseling, P; Hamer, PCDW; - view fewer (2016) Accurate Delineation of Glioma Infiltration by Advanced PET/MR Neuro-Imaging (FRONTIER Study): A Diagnostic Study Protocol. Neurosurgery , 79 (4) pp. 535-540. 10.1227/NEU.0000000000001355 . Green open access

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Neutralization and homophony avoidance in phonological learning

Yin, SH; White, JC; (2018) Neutralization and homophony avoidance in phonological learning. Cognition (In press).

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Rapid Imaging of Tumor Cell Death In Vivo Using the C2A Domain of Synaptotagmin-I

Neves, AA; Xie, B; Fawcett, S; Alam, IS; Witney, TH; de Backer, MM; Summers, J; ... Brindle, KM; + view all Neves, AA; Xie, B; Fawcett, S; Alam, IS; Witney, TH; de Backer, MM; Summers, J; Hughes, W; McGuire, S; Soloviev, D; Miller, J; Howat, WJ; Hu, D-E; Rodrigues, TB; Lewis, DY; Brindle, KM; - view fewer (2017) Rapid Imaging of Tumor Cell Death In Vivo Using the C2A Domain of Synaptotagmin-I. Journal of Nuclear Medicine , 58 (6) pp. 881-887. 10.2967/jnumed.116.183004 . Green open access

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Age constraints on intra-formational unconformities in Upper Jurassic-Lower Cretaceous carbonates in northeast Turkey; geodynamic and hydrocarbon implications

Vincent, SJ; Guo, L; Flecker, R; BouDagher-Fadel, MK; Ellam, RM; Kandemir, R; (2018) Age constraints on intra-formational unconformities in Upper Jurassic-Lower Cretaceous carbonates in northeast Turkey; geodynamic and hydrocarbon implications. Marine and Petroleum Geology , 91 pp. 639-657. 10.1016/j.marpetgeo.2018.01.011 .

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Barreras interaccionales en aulas multilingües: una aproximación crítica a la comunicación intercultural

Perez-Milans, MPM; Martin-Rojo, L; (2007) Barreras interaccionales en aulas multilingües: una aproximación crítica a la comunicación intercultural. Cultura, Lenguaje Y Representación / Culture, Language and Representation , 4 pp. 203-226. 10.6035/CLR .

https://ift.tt/2xrXdcM

Randomized controlled phase III trial of adjuvant chemoimmunotherapy with activated cytotoxic T cells and dendritic cells from regional lymph nodes of patients with lung cancer

Abstract

Randomized controlled trial of adjuvant chemoimmunotherapy for lung cancer indicated a significant advantage in patients receiving immunotherapy. Herein we report the final results and immunological analysis with a median follow-up of 59.6 months. Patients with post-surgical lung cancer were randomly designated to receive either chemoimmunotherapy (group A, immunotherapy arm) or chemotherapy (group B, control arm). The immunotherapy comprised the adoptive transfer of autologous activated killer T cells and dendritic cells (AKT–DC). The 2- and 5-year overall survival (OS) rates were 96.0 and 69.4% in group A and 64.7 and 45.1% in group B, respectively. Multivariate analysis results revealed that the hazard ratio was 0.439. The 2- and 5-year recurrence-free survival rates were 70.0 and 57.9% in group A and 43.1 and 31.4% in group B, respectively. Subgroup analysis for the OS between treatment groups indicated that younger patients (≤ 55 years: HR 0.098), males (HR 0.474), patients with adenocarcinoma (HR 0.479), patients with stage III cancer (HR 0.399), and those who did not receive preoperative chemotherapy (HR 0.483) had lower HRs than those in the other groups. Immunological analysis of cell surface markers in regional lymph nodes of subjects receiving immunotherapy indicated that the CD8⁺/CD4⁺ T-cell ratio was elevated in survivors. Patients with non-small-cell lung cancer benefited from adoptive cellular immunotherapy as an adjuvant to surgery. Patients with stage III cancer, those with adenocarcinoma, and those not receiving preoperative chemotherapy were good candidates. Lastly, cytotoxic T cells were important for a favorable chemoimmunotherapy outcome.

https://ift.tt/2su8pzU

Case 17-2018: A 40-Year-Old Woman with Leg Swelling and Abdominal Distention and Pain

Presentation of Case. Dr. Molly E. Wolf (Medicine): A 40-year-old woman was evaluated at this hospital because of progressive edema of the legs, as well as abdominal distention and pain. The patient had been in good health until approximately 10 months before this evaluation, when episodes of pain…

https://ift.tt/2H9rMUe

A measurement of CMB cluster lensing with SPT and DES year 1 data

Baxter, EJ; Raghunathan, S; Crawford, TM; Fosalba, P; Hou, Z; Holder, GP; Omori, Y; ... Zuntz, J; + view all Baxter, EJ; Raghunathan, S; Crawford, TM; Fosalba, P; Hou, Z; Holder, GP; Omori, Y; Patil, S; Rozo, E; Abbott, TMC; Annis, J; Aylor, K; Benoit-Levy, A; Benson, BA; Bertin, E; Bleem, L; Buckley-Geer, E; Burke, DL; Carlstrom, J; Rosell, AC; Kind, MC; Carretero, J; Chang, CL; Cho, H-M; Crites, AT; Crocce, M; Cunha, CE; da Costa, LN; D'Andrea, CB; Davis, C; de Haan, T; Desai, S; Dietrich, JP; Dobbs, MA; Dodelson, S; Doel, P; Drlica-Wagner, A; Estrada, J; Everett, WB; Neto, AF; Flaugher, B; Frieman, J; Garcia-Bellido, J; George, EM; Gaztanaga, E; Giannantonio, T; Gruen, D; Gruendl, RA; Gschwend, J; Gutierrez, G; Halverson, NW; Harrington, NL; Hartley, WG; Holzapfel, WL; Honscheid, K; Hrubes, JD; Jain, B; James, DJ; Jarvis, M; Jeltema, T; Knox, L; Krause, E; Kuehn, K; Kuhlmann, S; Kuropatkin, N; Lahav, O; Lee, AT; Leitch, EM; Li, TS; Lima, M; Luong-Van, D; Manzotti, A; March, M; Marrone, DP; Marshall, JL; Martini, P; McMahon, JJ; Melchior, P; Menanteau, F; Meyer, SS; Miller, CJ; Miquel, R; Mocanu, LM; Mohr, JJ; Natoli, T; Nord, B; Ogando, RLC; Padin, S; Plazas, AA; Pryke, C; Rapetti, D; Reichardt, CL; Romer, AK; Roodman, A; Ruhl, JE; Rykoff, E; Sako, M; Sanchez, E; Sayre, JT; Scarpine, V; Schaffer, KK; Schindler, R; Schubnell, M; Sevilla-Noarbe, I; Shirokoff, E; Smith, M; Smith, RC; Soares-Santos, M; Sobreira, F; Staniszewski, Z; Stark, A; Story, K; Suchyta, E; Tarle, G; Thomas, D; Troxel, MA; Vanderlinde, K; Vieira, JD; Walker, AR; Williamson, R; Zhang, Y; Zuntz, J; - view fewer (2018) A measurement of CMB cluster lensing with SPT and DES year 1 data. Monthly Notices of the Royal Astronomical Society , 476 (2) pp. 2674-2688. 10.1093/mnras/sty305 . Green open access

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Brentuximab vedotin prior to allogeneic stem cell transplantation in Hodgkin lymphoma: a report from the EBMT Lymphoma Working Party

Bazarbachi, A; Boumendil, A; Finel, H; Mohty, M; Castagna, L; Peggs, KS; Blaise, D; ... Sureda, A; + view all Bazarbachi, A; Boumendil, A; Finel, H; Mohty, M; Castagna, L; Peggs, KS; Blaise, D; Afanasyev, B; Diez-Martin, JL; Sierra, J; Bloor, A; Martinez, C; Robinson, S; Malladi, R; El-Cheikh, J; Corradini, P; Montoto, S; Dreger, P; Sureda, A; - view fewer (2018) Brentuximab vedotin prior to allogeneic stem cell transplantation in Hodgkin lymphoma: a report from the EBMT Lymphoma Working Party. British Journal of Haematology , 181 (1) pp. 86-96. 10.1111/bjh.15152 .

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Unveiling the Dynamical State of Massive Clusters through the ICL Fraction

Jimenez-Teja, Y; Dupke, R; Benitez, N; Koekemoer, AM; Zitrin, A; Umetsu, K; Ziegler, BL; ... Zheng, W; + view all Jimenez-Teja, Y; Dupke, R; Benitez, N; Koekemoer, AM; Zitrin, A; Umetsu, K; Ziegler, BL; Frye, BL; Ford, H; Bouwens, RJ; Bradley, LD; Broadhurst, T; Coe, D; Donahue, M; Graves, GJ; Grillo, C; Infante, L; Jouvel, S; Kelson, DD; Lahav, O; Lazkoz, R; Lemze, D; Maoz, D; Medezinski, E; Melchior, P; Meneghetti, M; Mercurio, A; Merten, J; Molino, A; Moustakas, LA; Nonino, M; Ogaz, S; Riess, AG; Rosati, P; Sayers, J; Seitz, S; Zheng, W; - view fewer (2018) Unveiling the Dynamical State of Massive Clusters through the ICL Fraction. The Astrophysical Journal , 857 (2) , Article 79. 10.3847/1538-4357/aab70f . Green open access

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Predicting opportunities to increase utilization of laparoscopy for rectal cancer

Keller, DS; Qiu, J; Senagore, AJ; (2017) Predicting opportunities to increase utilization of laparoscopy for rectal cancer. Surgical Endoscopy , 32 (3) pp. 1556-1563. 10.1007/s00464-017-5844-y .

https://ift.tt/2Jo7POC

Role of Emergency Laparoscopic Colectomy for Colorectal Cancer: A Population-Based Study in England

Vallance, AE; Keller, DS; Hill, J; Braun, M; Kuryba, A; van der Meulen, J; Walker, K; Vallance, AE; Keller, DS; Hill, J; Braun, M; Kuryba, A; van der Meulen, J; Walker, K; Chand, M; - view fewer (2018) Role of Emergency Laparoscopic Colectomy for Colorectal Cancer: A Population-Based Study in England. Annals of Surgery 10.1097/SLA.0000000000002752 . (In press).

https://ift.tt/2Lbtven

ERGs on the brain: the benefits of simultaneous flash retinal and cortical responses in paediatric cerebral visual impairment

Handley, SE; Thompson, DA; Prise, KL; Liasis, A; (2018) ERGs on the brain: the benefits of simultaneous flash retinal and cortical responses in paediatric cerebral visual impairment. Documenta Ophthalmologica 10.1007/s10633-018-9631-4 . (In press). Green open access

https://ift.tt/2JjQHcV

A virally encoded de-sumoylase activity is required for cytomegalovirus reactivation from latency

Poole, E; Lau, J; Kew, V; Murray, M; Stamminger, T; Sinclair, J; Reeves, M; (2018) A virally encoded de-sumoylase activity is required for cytomegalovirus reactivation from latency. Cell Reports (In press).

https://ift.tt/2L9ukV3

What's in a Name? Possible Ways Forward in the Macedonian Name Dispute

Fidanovski, K; What's in a Name? Possible Ways Forward in the Macedonian Name Dispute. Slovo , 31 (1) , Article 2. 10.14324/111.0954-6839.073 . Green open access

https://ift.tt/2JkmTNg

Multichannel visual evoked potentials in the assessment of visual pathways in children with marked brain abnormalities

Handley, SE; Liasis, AC; (2017) Multichannel visual evoked potentials in the assessment of visual pathways in children with marked brain abnormalities. Journal of American Association for Pediatric Ophthalmology and Strabismus (AAPOS) , 21 (1) pp. 52-56. 10.1016/j.jaapos.2016.10.003 . Green open access

https://ift.tt/2L9u9sR

Impaired motility in Barrett's esophagus: A study using high-resolution manometry with physiologic challenge

Sanagapalli, S; Emmanuel, A; Leong, R; Kerr, S; Lovat, L; Haidry, R; Banks, M; ... Sweis, R; + view all Sanagapalli, S; Emmanuel, A; Leong, R; Kerr, S; Lovat, L; Haidry, R; Banks, M; Graham, D; Raeburn, A; Zarate-Lopez, N; Sweis, R; - view fewer (2018) Impaired motility in Barrett's esophagus: A study using high-resolution manometry with physiologic challenge. Neurogastroenterol Motil , Article e13330. 10.1111/nmo.13330 . (In press).

https://ift.tt/2Jlc79B

Assessment of medical devices: the Emperor’s new clothes: Author reply

Sharma, RA; Fumi, L; Audisio, RA; Denys, A; Wood, BJ; Pignatti, F; (2018) Assessment of medical devices: the Emperor's new clothes: Author reply. [Letter]. British Journal of Radiology , 91 , Article 20180310. 10.1259/bjr.20180310 . (In press).

https://ift.tt/2L775Lc

Obesity is not just elevated adiposity, it is also a state of metabolic perturbation

Wells, JCK; (2017) Obesity is not just elevated adiposity, it is also a state of metabolic perturbation. Behavioral and Brain Sciences , 40 , Article e130. 10.1017/S0140525X16001552 . Green open access

https://ift.tt/2JiT0wY

Using flawed, uncertain, proximate and sparse (FUPS) data in the context of complexity: learning from the case of child mental health

Wolpert, MR; Rutter, H; (2018) Using flawed, uncertain, proximate and sparse (FUPS) data in the context of complexity: learning from the case of child mental health. BMC Medicine (In press).

https://ift.tt/2L9tRlL

Disentangling the visual, motor and representational effects of vestibular input

Abekawa, N; Ferrè, ER; Gallagher, M; Gomi, H; Haggard, P; (2018) Disentangling the visual, motor and representational effects of vestibular input. Cortex , 104 pp. 46-57. 10.1016/j.cortex.2018.04.003 .

https://ift.tt/2Jlc6Cz

Majority of adolescents with depression and anxiety not reliably improved at end of treatment: What should we tell the children?

Childs, J; Wolpert, MR; Zamperoni, V; Napoleone, E; Bear, H; (2018) Majority of adolescents with depression and anxiety not reliably improved at end of treatment: What should we tell the children? BjPsych Open (In press).

https://ift.tt/2LNT2v5

Editorial to issue 31.1

Allison, K; Editorial to issue 31.1. Slovo , 31 (1) , Article 1. 10.14324/111.0954-6839.078 . Green open access

https://ift.tt/2xruu7W

Language as description, indication, and depiction

Ferrara, L; Hodge, G; (2018) Language as description, indication, and depiction. Frontiers in Psychology , 9 , Article 716. 10.3389/fpsyg.2018.00716 . Green open access

https://ift.tt/2LKXrik

Dihydrogen: Vs. hydrogen bonding in the solvation of ammonia borane by tetrahydrofuran and liquid ammonia

Ingram, DJ; Headen, TF; Skipper, NT; Callear, SK; Billing, M; Sella, A; (2018) Dihydrogen: Vs. hydrogen bonding in the solvation of ammonia borane by tetrahydrofuran and liquid ammonia. Physical Chemistry Chemical Physics , 20 (17) pp. 12200-12209. 10.1039/c7cp08220g . Green open access

https://ift.tt/2J0jtfq

Effects of exposure to bodies of different sizes on perception of and satisfaction with own body size: Two randomized studies

Bould, H; Carnegie, R; Allward, H; Bacon, E; Lambe, E; Sapseid, M; Button, KS; ... Munafò, MR; + view all Bould, H; Carnegie, R; Allward, H; Bacon, E; Lambe, E; Sapseid, M; Button, KS; Lewis, G; Skinner, A; Broome, MR; Park, R; Harmer, CJ; Penton-Voak, IS; Munafò, MR; - view fewer (2018) Effects of exposure to bodies of different sizes on perception of and satisfaction with own body size: Two randomized studies. Royal Society Open Science , 5 (5) , Article 171387. 10.1098/rsos.171387 . Green open access

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Obturators versus flaps after maxillary oncological ablation: A systematic review and best evidence synthesis

Publication date: July 2018
Source:Oral Oncology, Volume 82
Author(s): Yubin Cao, Changhao Yu, Wei Liu, Cheng Miao, Bo Han, Jianong Yang, Longjiang Li, Chunjie Li
Maxillary defects can be resolved by prosthetic obturation, autologous tissue reconstruction, or a combination of both. However, there is still controversy in the selection of the optimal approach. Therefore, the aim of this study was to systematically review evidences comparing the performance of obturators and flaps in patients after maxillary oncological ablation. Both electronic and manual searching approaches were conducted to identify eligible evidence. Two reviewers independently assessed the risk of bias. In addition, the same reviewers independently extracted the data. Meta-analyses were performed using Revman 5.3, and best evidence synthesis was performed. Sixteen studies were included and a total of 528 participants were analyzed. All studies were assessed at low quality. Results of this meta-analysis showed weak evidence in the difference between obturators and flaps on the outcome regarding word intelligibility (P = 0.004) and masticatory efficiency (P = 0.002). However, no differences were detected regarding speech intelligibility and nasalance. All studies were compiled into the best evidence synthesis. The sum of 31 evidences was considered. Twelve evidences were evaluated at a moderate level, such as speech, mastication, pain, salivation, taste sensations, and mouth opening. Except the outcomes of word intelligibility, masticatory efficiency, and mouth pain, other moderate evidences showed no difference between obturators and flaps. In conclusion, both obturators and flaps might be effective in patients' rehabilitation functions after maxillary ablation. However, some advantages were observed when using surgical reconstruction over prosthetic rehabilitation. Additional high-quality studies are needed to provide more solid evidence before applying these results into clinical practice.



https://ift.tt/2kCpVOT

Unravelling the molecular signatures in HNSCC: Is the homogenous paradigm becoming obsolete?

Publication date: Available online 30 May 2018
Source:Oral Oncology
Author(s): Divya Gopinath, Rohit Kunnath Menon




https://ift.tt/2stBKun

Targeting myeloid-derived suppressor cells for cancer immunotherapy

Abstract

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of immature myeloid cells with an immune suppressive phenotype. They represent a critical component of the immune suppressive niche described in cancer, where they support immune escape and tumor progression through direct effects on both the innate and adaptive immune responses, largely by contributing to maintenance of a high oxidative stress environment. The number of MDSCs positively correlates with protumoral activity, and often diminishes the effectiveness of immunotherapies, which is particularly problematic with the emergence of personalized medicine. Approaches targeting MDSCs showed promising results in preclinical studies and are under active investigation in clinical trials in combination with various immune checkpoint inhibitors. In this review, we discuss MDSC targets and therapeutic approaches targeting MDSC that have the aim of enhancing the existing tumor therapies.

https://ift.tt/2Jii1Iw

An independent relation of atopic dermatitis to exercise-induced wheezing in asthmatic children

Publication date: Available online 30 May 2018
Source:Allergology International
Author(s): Satoshi Honjo, Yoko Murakami, Hiroshi Odajima, Yuichi Adachi, Koichi Yoshida, Yukihiro Ohya, Akira Akasawa
BackgroundAtopic dermatitis (AD) and exercise-induced asthma (EIA) are common in asthmatic children, and exercise is the most common trigger other than infection for acute onset asthma attack in children. We examined whether AD is related to exercise-induced wheezing (EIW), some proxy for EIA.MethodsJapanese version of the International Study of Asthma and Allergies in Childhood questionnaires were used. For 12,405 asthmatic school children, AD was defined as itchy rash coming and going for at least 6 months at any time in the last 12 months with affecting places of flexural parts of body, and severity of AD was rated according to frequency of being kept awake at night with the itch as follows: never in the past 12 months, less than one night per week and one or more nights per week.ResultsAdjusted for frequency of asthma attack, odds ratios (OR) of children with current AD as compared to those without AD for having EIW were 1.32 (95% confidence interval = 1.15–1.52), 1.35 (1.14–1.68) and 1.10 (0.92–1.31) for primary school, junior high school and high school children, respectively. EIW was more likely observed in accordance with increasing severity of AD in the primary school children with ORs of 1.12, 1.59 and 1.54 (p for trend < 0.01), and in the junior high school ones with ORs of 1.18, 1.31, 2.03 (<0.01), respectively.ConclusionsAD may be possibly related to EIW. Further studies investigating effect of AD treatment on EIW may be required.



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Interleukin 17A exacerbates ER-stress-mediated inflammation of macrophages following ICH

Publication date: September 2018
Source:Molecular Immunology, Volume 101
Author(s): Zhao Yang, Qingjun Liu, Hui Shi, Xuheng Jiang, Song Wang, Yuanlan Lu, Ji Zhang, Xiaofei Huang, Anyong Yu
IL-17A contributes to the initiation of inflammation following intracerebral hemorrhage (ICH). Endoplasmic reticulum (ER) stress acts on protein folding and contributes to inflammatory diseases. The role of IL-17A in the regulation of ER stress following ICH has not been well characterized. In this study, macrophages were stimulated with IL-17A, and then, ER stress and downstream pro-inflammatory factors were measured in vitro. In addition, brain edema and brain injury in ICH mice were assessed in vivo. We demonstrated that IL-17A induced ER stress in macrophages and thus promoted inflammation in vitro. Conversely, IL-17A inhibition attenuated ER stress and neuroinflammation. Furthermore, ERK 1/2 and p38 MAPK pathways mediated IL-17A-induced ER stress in macrophages. We also showed that IL-17A inhibition significantly attenuated ER stress and brain injury in ICH mice.In conclusion, our results demonstrate that IL 17A increases ER stress in macrophages and represents a novel mechanism in ICH.



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Seafood allergy: A comprehensive review of fish and shellfish allergens

Publication date: Available online 30 May 2018
Source:Molecular Immunology
Author(s): Thimo Ruethers, Aya C. Taki, Elecia B. Johnston, Roni Nugraha, Thu T.K. Le, Tanja Kalic, Thomas R. McLean, Sandip D. Kamath, Andreas L. Lopata
Seafood refers to several distinct groups of edible aquatic animals including fish, crustacean, and mollusc. The two invertebrate groups of crustacean and mollusc are, for culinary reasons, often combined as shellfish but belong to two very different phyla. The evolutionary and taxonomic diversity of the various consumed seafood species poses a challenge in the identification and characterisation of the major and minor allergens critical for reliable diagnostics and therapeutic treatments. Many allergenic proteins are very different between these groups; however, some pan-allergens, including parvalbumin, tropomyosin and arginine kinase, seem to induce immunological and clinical cross-reactivity.This extensive review details the advances in the bio-molecular characterisation of 20 allergenic proteins within the three distinct seafood groups; fish, crustacean and molluscs. Furthermore, the structural and biochemical properties of the major allergens are described to highlight the immunological and subsequent clinical cross-reactivities. A comprehensive list of purified and recombinant allergens is provided, and the applications of component-resolved diagnostics and current therapeutic developments are discussed.



https://ift.tt/2H4XJ08

Helminth-induced regulatory T cells and suppression of allergic responses

Jayden Logan | Severine Navarro | Alex Loukas | Paul Giacomin

https://ift.tt/2Jk7lcv

Dendritic cells, T cells and lymphatics: dialogues in migration and beyond

Marc Permanyer | Berislav Bošnjak | Reinhold Förster

https://ift.tt/2JjjSwJ

Pediatric Residents’ Assessment of Atopic Dermatitis Severity for Risk Assessment of Early Peanut Introduction,

Atopic dermatitis (AD), often referred to as eczema, is one of the most common skin disorders affecting the pediatric population.1 Although pediatricians diagnose eczema frequently, classification of severity can be challenging, as score-based indices (e.g., The Eczema and Area Severity Index (EASI), Scoring Atopic Dermatitis (SCORAD) index) are complicated and designed primarily for use in clinical trials. These instruments are used infrequently by general pediatricians and may be associated with discrepancies in AD classification between providers.

https://ift.tt/2IZFIpG

Development of Food Protein-Induced Enterocolitis Syndrome (FPIES) to egg following Immunoglobulin E (IgE)-mediated egg allergy,

Food protein-induced enterocolitis syndrome (FPIES) is a non-immunoglobulin E (IgE)-mediated condition characterized by repetitive vomiting 1-4 hours after ingestion of the particular food accompanied by additional symptoms such as lethargy, pallor or diarrhea.1 Atypical FPIES characterizes patients who are noted to have IgE-mediated sensitization to the FPIES-inducing food,2 and has been associated with an increased likelihood of persistent FPIES.3 A clinical conversion from an FPIES phenotype to an IgE-mediated phenotype to the same food has been described.

https://ift.tt/2spDFjG

Pilot study of the CAPS (Clinical extent, Area, Pruritus, Sleep) measure for atopic dermatitis severity,,✯✯✯,✯✯✯✯

Eczema; Atopic dermatitis; Outcome measures; Severity; Symptoms; ItchAbbreviations: AD, atopic dermatitis; BSA, body surface area; CAPS, Clinical extent, Area, Pruritus, Sleep; DLQI, Dermatology Life Quality Index; EASI, Eczema Area and Severity Index; IGA, Investigator Global Assessment; POEM, Patient-Oriented Eczema Measure

https://ift.tt/2kAs5Pa

Different Treatments With the TRV Reposition Chair

Condition:   Benign Paroxysmal Positional Vertigo
Intervention:   Procedure: Type of repositional maneuvre
Sponsor:   Aalborg Universitetshospital
Recruiting

https://ift.tt/2skyW3H

Audit of the Spanish EURECCA Esophagogastric Cancer Registry

Conditions:   Cancer of Stomach;   Cancer of Esophagus
Intervention:  
Sponsor:   Parc de Salut Mar
Not yet recruiting

https://ift.tt/2xu0Lvo

Thykamine Safety and Efficacy Study in Mild-to-Moderate Atopic Dermatitis

Condition:   Atopic Dermatitis Eczema
Interventions:   Drug: Administration of Placebo;   Drug: Administration of PUR0110 (Thykamine) 0.05%;   Drug: Administration of PUR0110 (Thykamine) 0.1%;   Drug: Administration of PUR0110 (Thykamine) 0.25%
Sponsor:   PurGenesis Technologies Inc.
Recruiting

https://ift.tt/2skyVNb

ctDNA as a Biomarker for Treatment Response in HNSCC

Condition:   Carcinoma, Squamous Cell of Head and Neck
Intervention:   Other: Blood draw
Sponsor:   The Netherlands Cancer Institute
Not yet recruiting

https://ift.tt/2xsYW1J

Re: “High Thyroid Cancer Mortality Rate in Japan: A Result of Non-aggressive Treatment Strategy, or Just an Aging Population?” By Magner (Thyroid [Epub ahead of print]; DOI: 10.1089/thy.2018.0121)

Thyroid, Ahead of Print.


https://ift.tt/2IWMr3U

No-Scar Transoral Thyroglossal Duct Cyst Excision in Children

Thyroid, Ahead of Print.


https://ift.tt/2H5yRoS

The impact of cold on the respiratory tract and its consequences to respiratory health

The increasing use, and sometimes the abuse, particularly in industrialized countries of air conditioning at home, in car, hotel and shopping centres has highlighted new emerging public health issues, resultin...

https://ift.tt/2Lb4MXE

Reconstrucción de defectos orofaríngeos tras cirugía transoral robótica. Revisión y recomendaciones de la Comisión de Cirugía de Cabeza y Cuello de la Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello

Publication date: Available online 30 May 2018
Source:Acta Otorrinolaringológica Española
Author(s): José Ángel González García, Carlos Pollán Guisasola, Carlos Miguel Chiesa Estomba, Constanza Viña Soria, David Virós Porcuna
La cirugía transoral de la orofaringe ha presentado una importante evolución en los últimos años, al ampliarse las opciones quirúrgicas disponibles (TORS, TOUSS, TOLS), la capacidad de resecar lesiones cada vez más extensas y el número de pacientes que se beneficia de ellas. Este hecho ha provocado una evolución en la reconstrucción de los defectos quirúrgicos tras cirugía transoral. Este artículo tiene como objetivo la revisión de las posibles técnicas reconstructivas, las indicaciones y factores que tener en cuenta previamente a la cirugía, además de proponer un protocolo para valorar la necesidad de reconstrucción transoral sobre la base de la profundidad del defecto, la estadificación y el tratamiento previamente recibido.Transoral surgery of the oropharynx has seen an important evolution in recent years, expanding the surgical options available (TORS, TOUSS, TOLS). The capacity to resect increasingly extensive lesions and the number of patients who benefit from them. This fact has led to an evolution in the reconstruction of surgical defects after transoral surgery. This article aims to review the possible reconstructive techniques, indications and factors to be taken into account prior to surgery, proposing a protocol to assess the need for transoral reconstruction based on the depth of the defect, the staging, and previous treatment.



https://ift.tt/2L4JsCX

Monophasic Synovial Sarcoma of Tongue: A Rarest of Rare Case Scenario

Abstract

Synovial sarcoma is a rare tumour of head and neck. Primary synovial sarcoma of tongue is very uncommon. Based on morphology, it can be classified as classical biphasic variant, monophasic spindle cell variant, monophasic epithelial variant and poorly differentiated variant. The authors with an index case of 74 year old lady with monophasic spindle cell synovial sarcoma of oral tongue which is one of the rarest variants (our case is the 15th case reported of synovial sarcoma of the tongue and only the 3rd case in the world which had a monophasic histopathologic pattern) studied the morphology and described the disease entity in detail. She was treated with wide local excision of sarcoma followed by adjuvant radiotherapy.

https://ift.tt/2kAYp4o

Robot Assisted Trans Axillary Thyroidectomy: A Subcontinent Experience

https://ift.tt/2spjzWM

Successful treatment of primary bone marrow Hodgkin lymphoma with brentuximab vedotin: a case report and review of the literature

Hodgkin lymphoma usually presents with sequential enlargement of peripheral lymph nodes, and bone marrow invasion rarely occurs (approximately 3–5%). However, several cases have been reported as "primary" bone...

https://ift.tt/2srgQMq

Bike Safety for the Whole Family

The sun is shining, school is out, and it is time for fun!  If your home is anything like mine, bikes, scooters, roller skates, and skateboards are being dusted off from their winter homes and are ready for daily use.  My family loves to ride bikes together, both on the camping trails and around the neighborhood.  Summer is a time for creating lasting memories – but hopefully one of them is not a trip to the emergency department!  Fortunately, taking some safety precautions can help to lessen the risk of sustaining an injury (particularly head injury) during the course of your biking adventures.

Wear a Helmet Every Time

Helmets should be worn any time your child is on a bike. Yes, even if only riding down the street.  Many accidents happen within close proximity to home – in driveways, on sidewalks – so it is important to keep your head protected whenever you ride.  Plus, wearing a helmet every time they ride will help children develop the good habit.  In fact, everyone in the family should wear a helmet when they are riding – yes, that means mom and dad too!

How Should Your Bike Helmet Fit?

Not all helmets are created equal!  A helmet must be the right type and fit properly in order to provide protection in the event of an accident.  Helmets are made differently for different activities.  For instance, a football helmet is not designed to protect the head during the types of falls typically sustained while bike riding.  Helmets should be worn level and cover the forehead.  The straps should always be fastened and tightened so that the helmet stays securely in place.

Bike Check

Riding a bike that is the right size for your child can help to keep them safe.  Your child should be able to sit on the seat of the bike, with their hands on the handlebars, and place the balls of both feet on the ground.  Before setting off on the first ride of the season you should check to make sure your child's bike is in good working order:

• Make sure the seat, handlebars, and wheels are tightly secured.
• Check and oil the chain regularly.
• Ensure the breaks are working properly (and NOT sticking).
• Check the tires to make sure the tire pressure is correct.

Wear Bright Colors

Wearing bright colors and ensuring that bikes have reflectors helps other people on the road see your children – particularly at dusk or night time!

Bike riding and being active has many benefits for both physical and mental health.  Following these safety tips can help ensure that you and your children stay safe while enjoying your time together on the road or the trails!

To learn more about bike safety, or to schedule a free helmet fitting or home safety consultation, contact Safety Stop at St. Louis Children's Hospital.

The post Bike Safety for the Whole Family appeared first on ChildrensMD.

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Trichophyton erinacei Transmitted to a Pregnant Woman From Her Pet Hedgehogs

This case report describes a pregnant woman who developed tinea manus from Trichophyton erinacei infection transmitted to her from her pet hedgehogs.

https://ift.tt/2IWzDdx

Lentigo Maligna—Challenges, Observations, Imiquimod, Confocal Microscopy, and Personalized Treatment

The word melanoma imparts considerable fear and concern in patients. Fortunately, for patients with the lentigo maligna (LM) subtype of melanoma in situ, there is overall good prognosis. The challenge of LM, however, is that it has the highest rate of local recurrence (approximately 20%) of all melanoma subtypes when treated by standard surgical excision alone, owing to frequent, unpredictable, subclinical extension. To reduce this risk, the use of Mohs surgery or staged excision has consistently demonstrated lower recurrence rates of 0.3% to 2.2% yet requires larger surgical margins for histological clearance than other in situ melanoma subtypes. Moyer et al also demonstrated that with increasing lesion size, both the surgical margin required to clear the lesion and the risk of local recurrence increased, suggesting increased subclinical spread with increasing lesion size. In addition, LM is typically located in the head and neck area, a complex zone with potential cosmetic and functional impairment owing to extensive surgery. Finally, differentiating LM from background atypical melanocytic hyperplasia can be challenging. Thus, treatments directed toward reducing the extent of surgery, minimizing morbidity, and providing a cure would enhance patient outcomes.

https://ift.tt/2H50D4K

Prevalence of Skin Cancer Examination Among Indoor Tanning Bed Users

This study uses weighted national survey data to examine the prevalence of skin cancer examinations among users of indoor tanning beds.

https://ift.tt/2IW6IGB

Lentigo Maligna Treated With Off-Label Neoadjuvant Imiquimod

This medical record review examines the rate of recurrence of lentigo maligna in patients treated with neoadjuvant topical imiquimod, 5%, cream prior to conservatively staged excisions.

https://ift.tt/2H3ShKP

Adolescents’ Perspectives on Atopic Dermatitis Treatment

This qualitative study examines the beliefs, experiences, and preferences of adolescents with atopic dermatitis toward their treatment via focus groups interviews.

https://ift.tt/2J0WQvu

Multidisciplinary management of oculo-auriculo-vertebral spectrum

Purpose of review Oculo-auriculo-vertebral spectrum (OAVS) is a complex disorder that is represented by wide variations in phenotypic presentation. Recent publications and systematic reviews of the available literature are presented here. Recent findings Treatment strategies vary among craniofacial centers across the country. Advances in presurgical planning, virtual surgical planning, and computer-aided manufacturing have been incorporated in the treatment of patients. The psychosocial effect of OAVS with longitudinal follow-up is now being studied. Summary Optimal evaluation and management of the OAVS patient requires an awareness of the phenotypic and genetic differences and involves a multidisciplinary team in order to effectively and appropriately diagnose and treat such patients. Correspondence to Jamie Funamura, MD, Assistant Professor, Department of Otolaryngology-Head and Neck Surgery, University of California Davis, 2521 Stockton Blvd, Ste 7200, Sacramento, CA 95817, USA. E-mail: jlfunamura@ucdavis.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2xtygha

Deconstructive SCNT reveals novel Treg subsets

Publication date: Available online 30 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Manching Ku, Eugene Ke, Mohsen Sabouri-Ghomi, Justin Abadejos, Brent Freeman, Amy Nham, Nathaniel Phillips, Kevin Y. Yang, Kathy O. Lui, Oktay Kirak

Teaser

Using single-cell transcriptomic and SCNT, we identify multiple distinct Treg subsets. We show that naturally occurring and agonist-induced Tregs are two of these subsets, which differ amongst in TCR strength, development, differentiation, and Ctla4 expression.


https://ift.tt/2kBOcF6

Saturated fatty acids, obesity and the NLRP3 inflammasome in asthma

Publication date: Available online 30 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Lisa G. Wood, Qian Li, Hayley A. Scott, Sandra Rutting, Bronwyn S. Berthon, Peter G. Gibson, Phil M. Hansbro, Evan Williams, Jay Horvat, Jodie L. Simpson, Paul Young, Brian G. Oliver, Katherine J. Baines
BackgroundBoth obesity and high dietary fat intake activate the NLRP3 inflammasome.ObjectiveWe aimed to examine NLRP3 inflammasome activity in the airways of obese asthmatics, following macronutrient overload and in immune cells challenged by inflammasome triggers.MethodsStudy 1: Cross-sectional, observational study of non-obese (n=51) and obese (n=76) asthmatic adults. Study 2: Randomized, crossover, acute feeding study in 23 asthmatic adults (n=12 non-obese, n=11 obese). Subjects consumed 3 isocaloric meals on 3 separate occasions: saturated fatty acid (SFA), n-6 polyunsaturated (PUFA) and carbohydrate (CHO); and were assessed at 0 and 4 hours. For Study 1 and 2, airway inflammation was measured using sputum differential cell counts, IL-1β protein (ELISA) and sputum cell gene expression (Nanostring nCounter). Study 3: Peripheral blood neutrophils and monocytes were isolated using Ficoll density gradient and magnetic bead separation, and incubated with or without palmitic acid, LPS or TNFα for 24 hours and IL-1β release measured (ELISA).ResultsStudy 1: NLRP3 and NOD1 gene expression were upregulated, and sputum IL-1β protein levels higher, in obese versus non-obese asthmatics. Study 2: The SFA meal led to increases in sputum %neutrophils and sputum cell gene expression of TLR4 and NLRP3 at 4 hours, in non-obese asthmatics. Study 3: Neutrophils and monocytes released IL-1β when challenged with a combination of palmitic acid and LPS or TNFα.ConclusionThe NLRP3 inflammasome is a potential therapeutic target in asthma. Behavioural interventions that reduce fatty acid exposure, such as weight loss and dietary saturated fat restriction warrant further exploration.Clinical implicationsBoth obesity and saturated fat intake cause NLRP3 inflammasome-mediated airway inflammation in asthma. Hence weight loss and dietary fat restriction warrant further exploration as anti-inflammatory strategies in asthma.

Graphical abstract

Teaser

The NLRP3 inflammasome is upregulated in obese asthmatics and following a high saturated fat meal in non-obese asthmatics. Both reversal of obesity and restriction of dietary saturated fat intake warrant further exploration as anti-inflammatory strategies in asthma.


https://ift.tt/2H2Tx0E

Ketamine Anesthesia Does Not Improve Depression Scores in Electroconvulsive Therapy: A Randomized Clinical Trial

Background: Although interest in ketamine use during electroconvulsive therapy (ECT) has increased, studies have been equivocal with regard to its efficacy. The aims of this clinical trial were to evaluate ketamine's antidepressive effects in ECT as a primary anesthetic, determine ketamine's tolerability when compared with standard anesthesia, and determine if plasma brain-derived neurotrophic factor (BDNF) is necessary for treatment response. Materials and Methods: Adults meeting criteria for treatment-resistant depression undergoing index course ECT received either methohexital (1 to 2 mg/kg) or ketamine (1 to 2 mg/kg) anesthesia in this dual-arm double-blinded randomized clinical trial (NCT02752724). The primary outcome of this study is change in depression questionnaire scores before and after ECT. Seizure data, depression severity using self-reported and clinician-assessed questionnaires, cognitive scoring, and plasma BDNF concentrations were obtained before and after completion of ECT. Results: There were no differences in seizure lengths, hemodynamics, or seizure stimuli between the ketamine (n=23;138 ECTs) and methohexital (n=27;159 ECTs) groups. Depression scores improved similarly after ECT in both groups. In the methohexital group, 15% of patients failed to achieve adequate seizures and were switched to ketamine and 26% were converted to bilateral ECT stimulus, whereas all ketamine patients achieved adequate seizures and only 4% required bilateral stimulus. Plasma BDNF increased after ECT only in the ketamine group. Conclusions: Our data show that ketamine does not significantly improve depression when compared with methohexital as a single induction agent for ECT, increases serum BDNF and does not increase rates of post-ECT agitation. Ketamine use in ECT may have some benefits for some patients that are not captured through standard depression assessment questionnaires alone. This work was supported in part by a Pilot Project Award #850 from the United States Department of Veterans Affairs. The content does not represent the views of the United States Department of Veterans Affairs or the United States Government. The sponsor had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The authors have no conflicts of interest to disclose. Address correspondence to: Charles William Carspecken, MD, MSc, MBA, Department of Anesthesiology and Critical Care, University of Pennsylvania, Hospital of the University of Pennsylvania, 3620 Hamilton Walk, Philadelphia, PA 19104 (e-mail: charles.carspecken@uphs.upenn.edu). Received March 2, 2018 Accepted April 23, 2018 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved

https://ift.tt/2JktHuA

Epitope mapping and kinetics of CD4 T cell immunity to pneumonia virus of mice in the C57BL/6 strain

Vandersarren, L; Bosteels, C; Vanheerswynghels, M; Moon, JJ; Easton, AJ; Van Isterdael, G; Janssens, S; ... Van Helden, MJ; + view all Vandersarren, L; Bosteels, C; Vanheerswynghels, M; Moon, JJ; Easton, AJ; Van Isterdael, G; Janssens, S; Lambrecht, BN; Van Helden, MJ; - view fewer (2017) Epitope mapping and kinetics of CD4 T cell immunity to pneumonia virus of mice in the C57BL/6 strain. Scientific Reports , 7 (1) , Article 3472. 10.1038/s41598-017-03042-y . Green open access

https://ift.tt/2xr8R85

Tear Off the Masks: Identity and Imposture in Twentieth-Century Russia. By Sheila Fitzpatrick (Princeton, Princeton University Press, 2005) 344 pp. $65.00 cloth $24.95 paper

Koenker, DP; (2008) Tear Off the Masks: Identity and Imposture in Twentieth-Century Russia. By Sheila Fitzpatrick (Princeton, Princeton University Press, 2005) 344 pp. $65.00 cloth $24.95 paper. [Review]. The Journal of Interdisciplinary History , 38 (3) pp. 465-466. 10.1162/jinh.2008.38.3.465 . Green open access

https://ift.tt/2sjPt7I

Political knowledge: Measurement, misinformation and turnout

Hudson, JA; (2017) Political knowledge: Measurement, misinformation and turnout. In: Fisher,, J and Fieldhouse, E and Franklin, M and Gibson, R and Cantijoch, M and Wlezien, C, (eds.) The Routledge Handbook of Elections, Voting Behavior and Public Opinion. (pp. 369-382). Routledge

https://ift.tt/2spwTLN

The Saga of History 492: The Transformation of Working-Class History in One Classroom

Barrett, J; Koenker, DP; (2008) The Saga of History 492: The Transformation of Working-Class History in One Classroom. Labour/ Le Travail (61) pp. 181-213.

https://ift.tt/2xs6NMU

Flexible scintillator autoradiography for tumor margin inspection using 18F-FDG

Vyas, KN; Grootendorst, M; Mertzanidou, T; MacHoll, S; Stoyanov, D; Arridge, SR; Tuch, DS; (2018) Flexible scintillator autoradiography for tumor margin inspection using 18F-FDG. In: (Proceedings) SPIE BiOS, 2018 - Molecular-Guided Surgery: Molecules, Devices, and Applications IV. SPIE Green open access

https://ift.tt/2IYV3mj

The link between interoceptive processing and anxiety in children diagnosed with autism spectrum disorder: Extending adult findings into a developmental sample

Palser, ER; Fotopoulou, A; Pellicano, E; Kilner, JM; (2018) The link between interoceptive processing and anxiety in children diagnosed with autism spectrum disorder: Extending adult findings into a developmental sample. Biological Psychology , 136 pp. 13-21. 10.1016/j.biopsycho.2018.05.003 .

https://ift.tt/2siaHD6

How effective and cost-effective are behaviour change interventions in improving the prescription and use of antibiotics in low-income and middle-income countries? A protocol for a systematic review

Batura, N; Cuevas, C; Khan, M; Wiseman, V; (2018) How effective and cost-effective are behaviour change interventions in improving the prescription and use of antibiotics in low-income and middle-income countries? A protocol for a systematic review. BMJ Open , 8 (5) , Article e021517. 10.1136/bmjopen-2018-021517 . Green open access

https://ift.tt/2xu2aBW

Sociolinguistics, translation and interpreting

Federici, FM; (2018) Sociolinguistics, translation and interpreting. In: The Routledge Handbook of Translation Studies and Linguistics. (pp. 295-309). Routledge: London; New York.

https://ift.tt/2shWENO

Changes in environmental tobacco smoke (ETS) exposure over a 20-year period: cross-sectional and longitudinal analyses

Jefferis, BJ; Thomson, AG; Lennon, LT; Feyerabend, C; Doig, M; McMeekin, L; Wannamethee, SG; ... Whincup, PH; + view all Jefferis, BJ; Thomson, AG; Lennon, LT; Feyerabend, C; Doig, M; McMeekin, L; Wannamethee, SG; Cook, DG; Whincup, PH; - view fewer (2009) Changes in environmental tobacco smoke (ETS) exposure over a 20-year period: cross-sectional and longitudinal analyses. Addiction , 104 (3) pp. 496-503. 10.1111/j.1360-0443.2008.02473.x . Green open access

https://ift.tt/2J0Lnbb

Diagnostic accuracy for the extent and activity of newly diagnosed and relapsed Crohn’s disease: a multicentre prospective comparison of magnetic resonance enterography and small bowel ultrasound –The METRIC Trial

Taylor, SA; Mallett, S; Bhatnagar, G; Baldwin-Cleland, R; Bloom, S; Gupta, A; Hamlin, P; ... Halligan, M; + view all Taylor, SA; Mallett, S; Bhatnagar, G; Baldwin-Cleland, R; Bloom, S; Gupta, A; Hamlin, P; Hart, A; Higginson, A; Jacobs, I; McCartney, S; MILES, A; Murray, C; Plumb, A; Pollok, R; Punwani, S; Quinn, L; Rodriguez-Justo, M; Shabir, Z; Slater, A; Tolan, D; Travis, S; Windsor, A; Wylie, P; Zealley, I; Halligan, M; - view fewer (2018) Diagnostic accuracy for the extent and activity of newly diagnosed and relapsed Crohn's disease: a multicentre prospective comparison of magnetic resonance enterography and small bowel ultrasound –The METRIC Trial. The Lancet Gastroenterology & Hepatology (In press).

https://ift.tt/2siaEXW

Franchising the disenfranchised? The paradoxical spaces of food banks

Livingstone, ND; (2017) Franchising the disenfranchised? The paradoxical spaces of food banks. In: Sharing Economies in Times of Crisis Practices, Politics and Possibilities. Routledge

https://ift.tt/2J0ZNrM

Sequencing of prostate cancers identifies new cancer genes, routes of progression and drug targets

Wedge, DC; Gundem, G; Mitchell, T; Woodcock, DJ; Martincorena, I; Ghori, M; Zamora, J; ... Eeles, RA; + view all Wedge, DC; Gundem, G; Mitchell, T; Woodcock, DJ; Martincorena, I; Ghori, M; Zamora, J; Butler, A; Whitaker, H; Kote-Jarai, Z; Alexandrov, LB; Van Loo, P; Massie, CE; Dentro, S; Warren, AY; Verrill, C; Berney, DM; Dennis, N; Merson, S; Hawkins, S; Howat, W; Lu, Y-J; Lambert, A; Kay, J; Kremeyer, B; Karaszi, K; Luxton, H; Camacho, N; Marsden, L; Edwards, S; Matthews, L; Bo, V; Leongamornlert, D; McLaren, S; Ng, A; Yu, Y; Zhang, H; Dadaev, T; Thomas, S; Easton, DF; Ahmed, M; Bancroft, E; Fisher, C; Livni, N; Nicol, D; Tavare, S; Gill, P; Greenman, C; Khoo, V; Van As, N; Kumar, P; Ogden, C; Cahill, D; Thompson, A; Mayer, E; Rowe, E; Dudderidge, T; Gnanapragasam, V; Shah, NC; Raine, K; Jones, D; Menzies, A; Stebbings, L; Teague, J; Hazell, S; Corbishley, C; de Bono, J; Attard, G; Isaacs, W; Visakorpi, T; Fraser, M; Boutros, PC; Bristow, RG; Workman, P; Sander, C; Hamdy, FC; Futreal, A; McDermott, U; Al-Lazikani, B; Lynch, AG; Bova, GS; Foster, CS; Brewer, DS; Neal, DE; Cooper, CS; Eeles, RA; - view fewer (2018) Sequencing of prostate cancers identifies new cancer genes, routes of progression and drug targets. Nature Genetics , 50 (5) pp. 682-692. 10.1038/s41588-018-0086-z .

https://ift.tt/2shWndK

Visual attention mechanisms in happiness vs. trustworthiness processing of facial expressions

Calvo, MG; Krumhuber, E; Fernández-Martín, A; (2018) Visual attention mechanisms in happiness vs. trustworthiness processing of facial expressions. Quarterly Journal of Experimental Psychology 10.1177/1747021818763747 . (In press). Green open access

https://ift.tt/2IZ8qmp

The behavioural variant frontotemporal dementia phenocopy syndrome is a distinct entity - evidence from a longitudinal study

Devenney, E; Swinn, T; Mioshi, E; Hornberger, M; Dawson, KE; Mead, S; Rowe, JB; Devenney, E; Swinn, T; Mioshi, E; Hornberger, M; Dawson, KE; Mead, S; Rowe, JB; Hodges, JR; - view fewer (2018) The behavioural variant frontotemporal dementia phenocopy syndrome is a distinct entity - evidence from a longitudinal study. BMC Neurology , 18 , Article 56. 10.1186/s12883-018-1060-1 . Green open access

https://ift.tt/2sjPpF5

Genome-wide association analyses identify 44 risk variants and refine the genetic architecture of major depression

Wray, NR; Ripke, S; Mattheisen, M; Trzaskowski, M; Byrne, EM; Abdellaoui, A; Adams, MJ; ... Sullivan, PF; + view all Wray, NR; Ripke, S; Mattheisen, M; Trzaskowski, M; Byrne, EM; Abdellaoui, A; Adams, MJ; Agerbo, E; Air, TM; Andlauer, TMF; Bacanu, S-A; Baekvad-Hansen, M; Beekman, AFT; Bigdeli, TB; Binder, EB; Blackwood, DRH; Bryois, J; Buttenschon, HN; Bybjerg-Grauholm, J; Cai, N; Castelao, E; Christensen, JH; Clarke, T-K; Coleman, JIR; Colodro-Conde, L; Couvy-Duchesne, B; Craddock, N; Crawford, GE; Crowley, CA; Dashti, HS; Davies, G; Deary, IJ; Degenhardt, F; Derks, EM; Direk, N; Dolan, CV; Dunn, EC; Eley, TC; Eriksson, N; Escott-Price, V; Kiadeh, FHF; Finucane, HK; Forstner, AJ; Frank, J; Gaspar, HA; Gill, M; Giusti-Rodriguez, P; Goes, FS; Gordon, SD; Grove, J; Hall, LS; Hannon, E; Hansen, CS; Hansen, TF; Herms, S; Hickie, IB; Hoffmann, P; Homuth, G; Horn, C; Hottenga, J-J; Hougaard, DM; Hu, M; Hyde, CL; Ising, M; Jansen, R; Jin, F; Jorgenson, E; Knowles, JA; Kohane, IS; Kraft, J; Kretzschmar, WW; Krogh, J; Kutalik, Z; Lane, JM; Li, Y; Li, Y; Lind, PA; Liu, X; Lu, L; MacIntyre, DJ; MacKinnon, DF; Maier, RM; Maier, W; Marchini, J; Mbarek, H; McGrath, P; McGuffin, P; Medland, SE; Mehta, D; Middeldorp, CM; Mihailov, E; Milaneschi, Y; Milani, L; Mill, J; Mondimore, FM; Montgomery, GW; Mostafavi, S; Mullins, N; Nauck, M; Ng, B; Nivard, MG; Nyholt, DR; O'Reilly, PF; Oskarsson, H; Owen, MJ; Painter, JN; Pedersen, CB; Pedersen, MG; Peterson, RE; Pettersson, E; Peyrot, WJ; Pistis, G; Posthuma, D; Purcell, SM; Quiroz, JA; Qvist, P; Rice, JP; Riley, BP; Rivera, M; Mirza, SS; Saxena, R; Schoevers, R; Schulte, EC; Shen, L; Shi, J; Shyn, SI; Sigurdsson, E; Sinnamon, GBC; Smit, JH; Smith, DJ; Stefansson, H; Steinberg, S; Stockmeier, CA; Streit, F; Strohmaier, J; Tansey, KE; Teismann, H; Teumer, A; Thompson, W; Thomson, PA; Thorgeirsson, TE; Tian, C; Traylor, M; Treutlein, J; Trubetskoy, V; Uitterlinden, AG; Umbricht, D; Van der Auwera, S; van Hemert, AM; Viktorin, A; Visscher, PM; Wang, Y; Webb, BT; Weinsheimer, SM; Wellmann, J; Willemsen, G; Witt, SH; Wu, Y; Xi, HS; Yang, J; Zhang, F; Arolt, V; Baune, BT; Berger, K; Boomsma, DI; Cichon, S; Dannlowski, U; de Geus, ECJ; DePaulo, JR; Domenici, E; Domschke, K; Esko, T; Grabe, HJ; Hamilton, SP; Hayward, C; Heath, AC; Hinds, DA; Kendler, KS; Kloiber, S; Lewis, G; Li, QS; Lucae, S; Madden, PFA; Magnusson, PK; Martin, NG; McIntosh, AM; Metspalu, A; Mors, O; Mortensen, PB; Mueller-Myhsok, B; Nordentoft, M; Noethen, MM; O'Donovan, MC; Paciga, SA; Pedersen, NL; Penninx, BWJH; Perlis, RH; Porteous, DJ; Potash, JB; Preisig, M; Rietschel, M; Schaefer, C; Schulze, TG; Smoller, JW; Stefansson, K; Tiemeier, H; Uher, R; Voelzke, H; Weissman, MM; Werge, T; Winslow, AR; Lewis, CM; Levinson, DF; Breen, G; Borglum, AD; Sullivan, PF; - view fewer (2018) Genome-wide association analyses identify 44 risk variants and refine the genetic architecture of major depression. Nature Genetics , 50 (5) pp. 668-681. 10.1038/s41588-018-0090-3 .

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Socioeconomic segregation in secondary schools: evidence from across the UK

Shure, DA; Jerrim, J; Gutierrez, G; Torres, R; (2017) Socioeconomic segregation in secondary schools: evidence from across the UK. In: Volante, L, (ed.) The PISA Effect on Global Educational Governance. Routledge

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What Does a Red Meat Allergy Have to Do With Anesthesia? Perioperative Management of Alpha-Gal Syndrome

Over the past decade, there has been a growing awareness of a new allergic syndrome known as alpha-gal allergy or alpha-gal syndrome, commonly recognized as a red meat allergy. We performed a review of the literature to identify articles that provide both background on this syndrome in general and any reports of reactions to medications or medical devices related to alpha-gal syndrome. Alpha-gal syndrome results from IgE to the oligosaccharide galactose-α-1,3-galactose, expressed in the meat and tissues of noncatarrhine mammals. It is triggered by the bite of the lone star tick and has been implicated in immediate-onset hypersensitivity to the monoclonal antibody cetuximab and delayed-onset hypersensitivity reactions after the consumption of red meat. There is growing recognition of allergic reactions in these patients to other drugs and medical devices that contain alpha-gal. Many of these reactions result from inactive substances that are part of the manufacturing or preparation process such as gelatin or stearic acid. This allergy may be documented in a variety of ways or informally reported by the patient, requiring vigilance on the part of the anesthesiologist to detect this syndrome, given its serious implications. This allergy presents a number of unique challenges to the anesthesiologist, including proper identification of a patient with alpha-gal syndrome and selection of anesthetic and adjunctive medications that will not trigger this allergy. Accepted for publication April 16, 2018. Funding: Institutional and/or departmental. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to W. Jonathan Dunkman, MD, Department of Anesthesiology, Duke University Medical Center, Box 3094, Durham, NC 27710. Address e-mail to william.dunkman@duke.edu. © 2018 International Anesthesia Research Society

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Automated Assessment of Existing Patient’s Revised Cardiac Risk Index Using Algorithmic Software

BACKGROUND: Previous work in the field of medical informatics has shown that rules-based algorithms can be created to identify patients with various medical conditions; however, these techniques have not been compared to actual clinician notes nor has the ability to predict complications been tested. We hypothesize that a rules-based algorithm can successfully identify patients with the diseases in the Revised Cardiac Risk Index (RCRI). METHODS: Patients undergoing surgery at the University of California, Los Angeles Health System between April 1, 2013 and July 1, 2016 and who had at least 2 previous office visits were included. For each disease in the RCRI except renal failure—congestive heart failure, ischemic heart disease, cerebrovascular disease, and diabetes mellitus—diagnosis algorithms were created based on diagnostic and standard clinical treatment criteria. For each disease state, the prevalence of the disease as determined by the algorithm, International Classification of Disease (ICD) code, and anesthesiologist's preoperative note were determined. Additionally, 400 American Society of Anesthesiologists classes III and IV cases were randomly chosen for manual review by an anesthesiologist. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve were determined using the manual review as a gold standard. Last, the ability of the RCRI as calculated by each of the methods to predict in-hospital mortality was determined, and the time necessary to run the algorithms was calculated. RESULTS: A total of 64,151 patients met inclusion criteria for the study. In general, the incidence of definite or likely disease determined by the algorithms was higher than that detected by the anesthesiologist. Additionally, in all disease states, the prevalence of disease was always lowest for the ICD codes, followed by the preoperative note, followed by the algorithms. In the subset of patients for whom the records were manually reviewed, the algorithms were generally the most sensitive and the ICD codes the most specific. When computing the modified RCRI using each of the methods, the modified RCRI from the algorithms predicted in-hospital mortality with an area under the receiver operating characteristic curve of 0.70 (0.67–0.73), which compared to 0.70 (0.67–0.72) for ICD codes and 0.64 (0.61–0.67) for the preoperative note. On average, the algorithms took 12.64 ± 1.20 minutes to run on 1.4 million patients. CONCLUSIONS: Rules-based algorithms for disease in the RCRI can be created that perform with a similar discriminative ability as compared to physician notes and ICD codes but with significantly increased economies of scale. Accepted for publication March 5, 2018. Funding: None. Conflicts of Interest: See Disclosures at the end of the article. I. S. Hofer and A. Mahajan are working with counsel to patent the algorithms for the diseases described in this article. Reprints will not be available from the authors. Address correspondence to Ira S. Hofer, MD, Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at University of California, Los Angeles, 757 Westwood Plaza, Los Angeles, CA 90095. Address e-mail to ihofer@mednet.ucla.edu. © 2018 International Anesthesia Research Society

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Pain Medicine Board Review

No abstract available

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Assessing the Association Between Blood Loss and Postoperative Hemoglobin After Cesarean Delivery: A Prospective Study of 4 Blood Loss Measurement Modalities

BACKGROUND: Visual estimation and gravimetric methods are commonly used to quantify the volume of blood loss during cesarean delivery (CD). However, the correlation between blood loss and post-CD hemoglobin (Hb) is poorly studied, and it is unclear whether the correlation varies according to how blood loss is measured. METHODS: After obtaining Institutional Review Board approval, we performed a prospective study of 61 women undergoing CD to assess the relations between post-CD Hb and blood loss measured using 4 modalities: gravimetric blood loss measurement (gBL), visual blood loss estimation by a blinded obstetrician (oBL) and anesthesiologist (aBL), and the Triton System (tBL). Hb was measured preoperatively and within 10 minutes after CD. gBL was quantified as blood volume in a suction canister in addition to the weight of blood-soaked sponges. tBL was measured with the Triton System by photographing blood-soaked sponges and suction canister contents. To assess the relation between blood loss and post-CD Hb, we performed correlation analyses and compared the magnitude of the correlations across the 4 measurement modalities using William t test. A Bonferroni correction was set to identify a statistically significant correlation (P

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Phentolamine Reverses Epinephrine-Enhanced Skin Antinociception of Dibucaine in Rats

BACKGROUND: The objective of the experiment was to assess the antinociceptive effect of dibucaine, bupivacaine, and epinephrine. To assess the mechanism of action of the interaction between dibucaine and epinephrine, phentolamine, a nonselective α-adrenergic antagonist, was added to the mixture. METHODS: We assessed sensory blockade with these drugs by injecting 0.6 mL of drug-in-saline in the dorsal thoracolumbar area of rats; pinprick of the "wheal" formed by the injectate was the area targeted for stimulation to elicit a cutaneous trunci muscle reflex. The sensory block of dibucaine was compared with that of bupivacaine or epinephrine. Drug–drug interactions were analyzed by isobologram. Phentolamine was added to investigate the antinociceptive effect of dibucaine coinjected with epinephrine. RESULTS: We demonstrated that dibucaine, epinephrine, and bupivacaine produced dose-dependent skin antinociception. On the median effective dose (ED50) basis, the potency was higher for epinephrine (mean, 0.011 [95% confidence interval {CI}, 0.007–0.015] μmol) than for dibucaine (mean, 0.493 [95% CI, 0.435–0.560] μmol) (P

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Intraoperative Methadone in Same-Day Ambulatory Surgery: A Randomized, Double-Blinded, Dose-Finding Pilot Study

BACKGROUND: Approximately 50 million US patients undergo ambulatory surgery annually. Postoperative opioid overprescribing is problematic, yet many patients report inadequate pain relief. In major inpatient surgery, intraoperative single-dose methadone produces better analgesia and reduces opioid use compared with conventional repeated dosing of short-duration opioids. This investigation tested the hypothesis that in same-day ambulatory surgery, intraoperative methadone, compared with short-duration opioids, reduces opioid consumption and pain, and determined an effective intraoperative induction dose of methadone for same-day ambulatory surgery. METHODS: A double-blind, dose-escalation protocol randomized 60 patients (2:1) to intraoperative single-dose intravenous methadone (initially 0.1 then 0.15 mg/kg ideal body weight) or conventional as-needed dosing of short-duration opioids (eg, fentanyl, hydromorphone; controls). Intraoperative and postoperative opioid consumption, pain, and opioid side effects were assessed before discharge. Patient home diaries recorded pain, opioid use, and opioid side effects daily for 30 days postoperatively. Primary outcome was in-hospital (intraoperative and postoperative) opioid use. Secondary outcomes were 30 days opioid consumption, pain intensity, and opioid side effects. RESULTS: Median (interquartile range) methadone doses were 6 (5–6) and 9 (8–9) mg in the 0.1 and 0.15 mg/kg methadone groups, respectively. Total opioid consumption (morphine equivalents) in the postanesthesia care unit was significantly less compared with controls (9.3 mg, 1.3–11.0) in subjects receiving 0.15 mg/kg methadone (0.1 mg, 0.1–3.3; P

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Mixing Studies in Patients With Prolonged Activated Partial Thromboplastin Time or Prothrombin Time

BACKGROUND: Patients presenting for surgery may have isolated or combined prolonged activated partial thromboplastin time (aPTT) and/or prothrombin time (PT). In patients not receiving anticoagulants or with no identifiable cause for abnormal clot formation, a mixing study is performed. The index of circulating anticoagulant (ICA) has been used to predict the presence of an inhibitor, usually a lupus anticoagulant. METHODS: We retrospectively reviewed the results of mixing studies performed at Northwestern Memorial Hospital, between January 1, 2010 and February 29, 2012. We determined the number of samples that normalized or remained prolonged, the clotting factors associated with prolonged test results, and the presence of coagulation inhibitors. We calculated the ICA in the samples with prolonged aPTT and PT to determine its ability to predict a lupus anticoagulant. The primary comparison of interest was the diagnostic utility of the ICA at cutoff values of 11% for predicting the presence of lupus anticoagulant. RESULTS: There were 269 mixing studies performed: 131 samples with prolonged aPTT; 95 with prolonged PT; and 43 with both prolonged aPTT and prolonged PT. Of the samples with a prolonged aPTT, 55 of 131 (42%) normalized, 36 of 131 (27%) partially corrected, and 40 of 131 (31%) remained prolonged. Thirty-three of 95 samples (35%) with prolonged PT normalized, while 62 of 95 (65%) remained prolonged. Eight of 43 (19%) mixing studies of patients with prolonged PT and aPTT normalized; the aPTT normalized, but the PT remained prolonged in 17 of 43 (39%); the PT normalized, but the aPTT remained prolonged in 7 of 43 (16%); and both tests remained prolonged in 11 of 43 (26%) samples. Prolongations in the aPTT were primarily associated with low activities of CF XII, while the majority of the prolongations in PT were secondary to low activities in CF VII. Combined prolongations were secondary to deficiencies in both the intrinsic and extrinsic as well as the common pathways. An ICA >11% had 100% (95% CI, 59%–100%) sensitivity, 53% (95% CI, 35%–70%) specificity, and 77% (95% CI, 62%–92%) accuracy in predicting the presence of lupus anticoagulant in patients with prolonged aPTT. CONCLUSIONS: Normalization of the aPTT and PT in a mixing study was associated with low clotting factor activity. The ICA may be helpful in predicting the presence of a lupus anticoagulant. As anesthesiologists take ownership of the perioperative surgical home, we need to understand the clinical implications of the results of mixing studies. Accepted for publication April 12, 2018. Funding: Departmental. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to Honorio T. Benzon, MD, Northwestern University Feinberg School of Medicine, 251 E Huron, Feinberg Pavilion, 5–704, Chicago, IL 60611. Address e-mail to h-benzon@northwestern.edu. © 2018 International Anesthesia Research Society

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