The etiology of scrotal pain is clinically classified in terms of the necessity for emergency surgery. Lately, color Doppler ultrasonography has reduced unnecessary surgeries, but there are still some cases that require immediate exploration because of an uncertain diagnosis. Here, we describe the case of a 14-month-old boy, who could not deliver his complaint accurately, presenting with a grumpy mood and a red swollen scrotum. Emergency surgery revealed that the cause was intense inflammation of the hydrocele wall, which typically does not cause acute scrotum. We also reviewed rare etiologies of scrotal pain for general physicians to develop the differential diagnosis.
http://ift.tt/2C3oG1M
Medicine by Alexandros G.Sfakianakis,Anapafseos 5 Agios Nikolaos,Crete 72100,Greece,tel :00302841026182 & 00306932607174
Τετάρτη 7 Φεβρουαρίου 2018
Unusual Cause of Acute Scrotal Pain-Inflammatory Noncommunicating Hydrocele: A Pediatric Case Report
Imatinib-induced diffuse hyperpigmentation of the oral mucosa, the skin, and the nails in a patient affected by chronic myeloid leukemia: report of a case and review of the literature
Abstract
Background
Imatinib mesylate is a tyrosine-kinase inhibitor used as the first-line treatment in chronic myeloid leukemia patients, but it is also indicated for other hematological diseases and solid tumors. Imatinib treatment is often associated with hypopigmentation, but only a few cases of hyperpigmentation are described in literature.
Methods
We are reporting the first case of imatinib-related hyperpigmentation involving the oral mucosa, skin, and nails in a patient affected by chronic myeloid leukemia and treated with imatinib since 2002. A review of all the available literature regarding the imatinib-related hyperpigmentation was performed, and one additional case was analyzed. Due to the possibility of a post-inflammatory hyperpigmentation, all cases of pigmentary changes previously characterized by a rash and/or pruritus in the same body areas were excluded.
Results
Thirty cases of well-documented imatinib-related hyperpigmentation were described in literature. In our case, imatinib therapy was well tolerated for several years, and it led to an excellent hematological and cytogenetic response. However, the patient gradually developed a blue-gray pigmentation that involved the nose, fingernails, toenails, pretibial regions, posterior axillary folds, and hard palate. Other causes of pigmentary changes were excluded, and histopathological examination confirmed the clinical suspicion of imatinib-related hyperpigmentation.
Conclusions
Hyperpigmentation induced by imatinib is an adverse reaction rarely described in literature. The underlying pathogenetic mechanisms are not yet completely clear, and further studies are necessary to elucidate them. Currently, no treatment is required for this condition, and there is no indication to discontinue imatinib treatment.
http://ift.tt/2nRWGZP
Treatment efficacy of probiotics on atopic dermatitis, zooming in on infants: a systematic review and meta-analysis
Abstract
Probiotic treatment of atopic dermatitis is widely studied with controversial results. The objective of this study is to review the efficacy of probiotics for the treatment of atopic dermatitis in infants. PubMed, Embase, and Cochrane Central Register of Controlled Trials databases, and reference lists were searched up to July 2017. Double-blinded randomized clinical trials were included. The primary outcome was the Scoring Atopic Dermatitis index. Subgroups analyses were conducted on probiotic species, treatment duration, participant age, and disease severity. Eight clinical trials (741 infants) were included in the quantitative synthesis. The overall pooled change in Scoring Atopic Dermatitis index (95% CI) in infants was −5.71 (−8.37, −3.04), P < 0.01. Subgroup analysis revealed that the effect was protective in moderate-to-severe patients −8.32 (−16.35, −0.28), with preparations containing Lactobacillus −5.76 (−9.21, −2.30). Probiotics for the treatment of infantile atopic dermatitis is beneficial.
http://ift.tt/2nO10Kn
Toxicity and growth inhibition potential of vetiver, cinnamon, and lavender essential oils and their blends against larvae of the sheep blowfly, Lucilia sericata
Abstract
Background
Myiasis induced by the sheep blowfly, Lucilia sericata, represents a public health problem widely distributed throughout the world. L. sericata larval stages feed on both humans and animals. L. sericata adults and larvae can play a role in spreading agents of mycobacterial infections.
Objectives
It is critical to establish new and safe alternative methods of controlling L. sericata.
Methods
The insecticidal effectiveness and growth inhibition potential of three commercially available essential oils (EOs), vetiver (Chrysopogon zizanioides), cinnamon (Cinnamomum zeylanicum), and lavender (Lavandula angustifolia), as well as their blends, were tested against the second (L2) and third (L3) larval stages of L. sericata. Sunflower (Helianthus annuus) oil was used as a carrier and tested on L2 and L3 larvae. To the best of our knowledge, all applied essential oils, except lavender, and oil blends were tested against L. sericata for the first time.
Results
All applied oils did not repel L2 from the treated liver but adversely affected their development. Contact treatments on L. sericata L3 indicated that vetiver and cinnamon oils significantly affected treated larvae. Total mortality rates were 93.33 and 95.56%, respectively. Furthermore, oil blends tested through contact assays killed larvae when used at higher concentrations; adult emergence was eliminated post-treatment with doses >30% for oil blend 1 and >10% for oil blend 2.
Conclusion
Overall, cinnamon and vetiver oils (5%) were selected as reliable and cheap biopesticides for controlling larvae of L. sericata. The tested oils are inexpensive and represent new promising botanical insecticides in the fight against blowflies causing myiasis.
http://ift.tt/2nS20w8
Postoperative chemoradiotherapy in patients with head and neck cancer aged 70 or older with positive margins or extranodal extension and the influence of nodal classification
Abstract
Background
Postoperative concomitant chemoradiotherapy (CRT) improves outcomes for younger adults with head and neck squamous cell carcinoma (HNSCC) and positive margins or extranodal extension (ENE), but its benefit for older adults is not well established.
Methods
Patients from the National Cancer Data Base (NCDB) with HNSCC undergoing curative-intent resection, neck dissection, and postoperative radiation with positive margins or ENE were identified.
Results
This analysis included 1199 patients aged ≥ 70 years with median follow-up of 42.6 months. Postoperative concurrent CRT was associated with improved overall survival (OS; hazard ratio [HR] 0.752; 95% confidence interval [CI] 0.638-0.886) compared to radiation alone in multivariable analysis. Three-year OS was 52.4% with CRT versus 43.4% with radiation (P = .012) in propensity-score matched cohorts. The survival impact of CRT varied by N classification (P = .002 for interaction), with benefit seen only in those with N2 to N3 disease.
Conclusion
Postoperative concurrent CRT may benefit older patients with HNSCC with positive margins or ENE, particularly those with higher nodal burden.
http://ift.tt/2E9tJiY
Prevalence of adverse pathological features in 1 to 4 cm low-risk differentiated thyroid carcinoma
Abstract
Background
The American Thyroid Association (ATA) recommends thyroid lobectomy for 1 to 4 cm tumors without adverse features. We studied the prevalence of adverse pathological features in patients eligible for unilateral lobectomy.
Methods
We conducted a retrospective study of patients who underwent total thyroidectomy. Patients with differentiated thyroid cancer (DTC) with tumors measuring 1 to 4 cm with no known preoperative adverse features were included in this study. Patients with nodal and distant metastasis, tumors <1 cm to > 4 cm, age < 17 years old, and gross extrathyroidal extension were excluded. Patients with bilateral nodularity on imaging were excluded from the final analysis on adverse features.
Results
There were 59.1% of patients undergoing thyroidectomy with tumors measuring 1 to 4 cm and no preoperatively known adverse features who were eligible for lobectomy under current ATA guidelines who would have needed a completion thyroidectomy after pathological analysis of the index tumor.
Conclusion
Two thirds of the patients may require a completion thyroidectomy if unilateral lobectomy is done in tumors measuring 1 to 4 cm based on adverse pathological features.
http://ift.tt/2ELgSEB
Quality of life during the first year after partial laryngectomy: Longitudinal study
Abstract
Background
This prospective study was conducted to assess changes in quality of life (QOL) of patients who undergo a partial laryngectomy.
Methods
The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaires Core and Head and Neck (EORTC-QLQ-C30, QLQ-H&N35) were used preprocedure (n = 218), 1 week (n = 159), 3 months (n = 122), and 1 year after partial laryngectomy (n = 88). Changes over time were analyzed with the Wilcoxon signed rank test and the Holm-Bonferroni method, and interpreted regarding clinical relevance.
Results
Most subscales worsened 1 week postprocedure, but many recovered to baseline level after 1 year. Dyspnea and cognitive functioning deteriorated over time, with worst scores recorded after 1 year. Financial difficulties and fatigue increased after surgery and maintained that level throughout the follow-up period; sticky saliva remained worse than at baseline, despite some improvements over time.
Conclusion
The discovered limitations of QOL should be observed more closely during follow-up treatment, and patients should be informed about these potential effects before partial laryngectomy.
http://ift.tt/2E9tCUA
Thyroidectomy in patients who have undergone gastric bypass surgery
Abstract
Background
Morbid obesity is a chronic condition that may be challenging to treat. Gastric bypass surgery is used to treat morbid obesity and its complications. Hypocalcemia, a known complication after thyroidectomy, is usually transient and treatable. There is a growing body of literature indicating that patients with previous gastric bypass surgery are at an increased risk for recalcitrant, symptomatic hypocalcemia after thyroidectomy. The management of hypocalcemia in patients with prior gastric bypass surgery may be exceedingly difficult.
Methods
Relevant articles published between 2008 and January 2017 were reviewed by topic. The review of literature was conducted using a systematic search of database resources, such as PubMed and EMBASE.
Results
Prior gastric bypass surgery may be an independent risk factor for developing profound hypocalcemia after thyroid surgery.
Conclusion
Refractory hypocalcemia in patients who have undergone gastric bypass surgery is underreported. Careful consideration should be given to performing staged thyroidectomy and, in some cases, reversal of the bariatric surgery.
http://ift.tt/2ENyi3p
Role of adjuvant chemoradiotherapy in T4N0 stage IV head and neck cancer: A National Cancer Database analysis
Abstract
Background
The purpose of this study was to evaluate the role of postoperative adjuvant radiotherapy (surgery + adjuvant RT) versus adjuvant chemoradiotherapy (surgery + adjuvant CRT) in patients with T4N0M0, stage IV head and neck squamous cell carcinoma (HNSCC).
Methods
Between 1998 and 2011, 3518 and 885 patients were treated with surgery + adjuvant RT and surgery + adjuvant CRT, respectively. Three-year overall survival (OS) rates were determined and crude and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were computed.
Results
Median follow-up was 41.8 months with 2193 reported deaths. The 3-year OS was 67.5% for surgery + adjuvant RT and 70.5% for surgery + adjuvant CRT (P = .013). For negative margins, the corresponding 3-year OS was 70.1% and 74.9% (P = .005). For positive margins, the corresponding 3-year OS was 56.0% and 60.6% (P = .079). On multivariate analysis, the beneficial effect for adjuvant CRT over adjuvant RT was not significant (HR 0.90; CI 0.79-1.03; P = .124).
Conclusion
In this cohort of patients with T4N0 HNSCC treated with surgery, there was no observed survival benefit of adjuvant CRT over adjuvant RT on multivariate analysis.
http://ift.tt/2E8JbvO
Nekrotisierende zervikale Lymphadenopathie mit unklaren Hautläsionen
Laryngo-Rhino-Otol
DOI: 10.1055/s-0044-101433
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
http://ift.tt/2C3bhqn
Hörsturz mit Surditas, Schwindel und Tinnitus - eine 12-jährige Odyssee
Laryngo-Rhino-Otol
DOI: 10.1055/s-0044-100517
© Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
http://ift.tt/2E9uSuU
Antibody response of growing German Holstein bulls to a vaccination against bovine viral diarrhea virus (BVDV) is influenced by Fusarium toxin exposure in a non-linear fashion
Abstract
The Fusarium toxin deoxynivalenol (DON) is a frequent contaminant of feedstuffs and is supposed to interfere with immune responses. As the relevance for growing bulls is less clear than for other livestock, the trial was designed according to the dose-response principal with a control group fed a diet with background contamination (CON, 0.36 mg DON per kilogram dry matter [DM]) and three groups with increasing concentrations of DON (mg/kg DM); FUS I, 3.01; FUS II, 5.66; FUS III, 8.31. Half of each treatment group was vaccinated against BVDV at days 1 and 21 of the 70 days lasting experiment. Sequential blood samples were collected for determination of antibody titers to BVDV and for hematological and clinical-chemical traits. Antibody response was strongest in group FUS II while group FUS III responded weakest. This group showed the lowest proportion of CD4+ T cells, but also the highest levels of liver lesion indicating enzyme activities in blood. BVDV-vaccination induced a pronounced decrease in red blood count indices, which occurred dose-dependently at a higher level in the FUS-fed groups. The obvious interactions between DON exposure and BVDV-vaccination require further elucidation.
http://ift.tt/2EQe5de
Prognostic significance of HPV status in the re-irradiation of recurrent and second primary cancers of the head and neck
To evaluate the prognostic significance of human papillomavirus (HPV) status among patients treated by salvage radiation therapy for local-regional recurrences and second primary cancers of the head and neck arising in a previously irradiated field.
http://ift.tt/2GZrKiX
Survival in patients with submandibular gland carcinoma — Results of a multi-institutional retrospective study
Clinical studies demonstrating the prognostic factors in submandibular gland carcinoma are limited because the tumor is relatively rare. The aim of this study was to identify clinical outcomes and prognostic factors in submandibular gland carcinoma.
http://ift.tt/2nUwCgO
A questionnaire to assess olfactory rehabilitation for laryngectomized patients (Provox voice prosthesis users) in Japan
We used a questionnaire to investigate olfactory function and the present state of olfactory rehabilitation for laryngectomized patients in Japan.
http://ift.tt/2nK5Ecf
The gray scale value of ear tissues undergoing volume-rendering high-resolution cone-beam computed tomography
When the thresholds for VR reconstruction from multi-slice CT images are changed, problems develop when assessing pathologies in the absence of standardized thresholds. The advantages of CBCT include lower radiation exposure compared with other techniques and better visualization of small ear structures. However, a disadvantage is that the scanner provides unstandardized gray scale values, thus not CT numbers (Hounsfield units, HU).
http://ift.tt/2nTNROW
Food protein-induced enterocolitis syndrome: a review of the new guidelines
Food protein-induced enterocolitis syndrome (FPIES) is a non IgE-mediated gastrointestinal food allergy that presents with delayed vomiting after ingestion primarily in infants. While the pathophysiology of FP...
http://ift.tt/2BMJe2Q
Estimating the health care costs associated with recurrent cellulitis managed in the outpatient setting
Recurrent cellulitis is diagnosed in 22% to 49% of all cellulitis cases, but little is known about the costs associated with these cases.
http://ift.tt/2nRstdf
Coexistence of frontal sinus hypoplasia with maxillary sinus hypoplasia: a radiological study
Abstract
The goal of this study was to determine whether frontal sinus hypoplasia coexists with maxillary sinus hypoplasia. Analyzing paranasal CT scans retrospectively, we included 86 patients who had a hypoplastic maxillary sinus at least on one side and 80 patients with bilateral normal maxillary sinuses (control group). We classified hypoplastic maxillary sinuses using the classification system previously defined by Bolger et al. (Otolaryngol Head Neck Surg 103(5):759–765, 1990). We classified the frontal sinuses as aplastic, hypoplastic, medium-sized, and hyperplastic; as previously defined by Guerram et al. (Am J Phys Anthropol 154(4):621–627, 2014). We compared the presence of frontal sinus hypoplasia using Chi-square test between the groups. The mean age of the maxillary sinus group was 43.2 (range 18–84) years. Of 86 patients, 33 (38.4%) had unilateral and 53 (61.6%) had bilateral maxillary sinus hypoplasia. Of 139 maxillary sinuses totally included, 73 (52.5%) were type 1, 51 (36.7%) were type 2 and 15 (10.8%) were type 3 hypoplastic maxillary sinuses. Of 332 frontal sinuses totally included, 25 (7.5%) were aplastic, 32 (9.6%) were hypoplastic, 172 (51.9%) were medium-sized, and 103 (31%) were hyperplastic. Of 86 patients with a hypoplastic maxillary sinus at least on one side, 29 (33.7%) had a hypoplastic and/or aplastic frontal sinus, while 10 (12.5%) had a hypoplastic and/or aplastic frontal sinus at least on one side in control group. Incidence of frontal sinus hypoplasia and/or aplasia was significantly higher in patients with maxillary sinus hypoplasia compared to the patients with bilaterally normal maxillary sinuses (χ2 = 10.384, P = 0.001). Maxillary sinus hypoplasia has a significantly higher coexistence with frontal sinus hypoplasia. This study may have an implication for anatomical studies about the development of the paranasal sinuses and paranasal sinus surgery as well as further morphological studies.
http://ift.tt/2nK5mSW
l-Methionine anti-biofilm activity against Pseudomonas aeruginosa is enhanced by the cystic fibrosis transmembrane conductance regulator potentiator, ivacaftor
Background
Biofilms may contribute to refractory chronic rhinosinusitis (CRS), as they lead to antibiotic resistance and failure of effective clinical treatment. l-Methionine is an amino acid with reported biofilm-inhibiting properties. Ivacaftor is a cystic fibrosis transmembrane conductance regulator (CFTR) potentiator with mild antimicrobial activity via inhibition of bacterial DNA gyrase and topoisomerase IV. The objective of this study was to evaluate whether co-treatment with ivacaftor and l-methionine can reduce the formation of Pseudomonas aeruginosa biofilms.
Methods
P aeruginosa (PAO-1 strain) biofilms were studied in the presence of l-methionine and/or ivacaftor. For static biofilm assays, PAO-1 was cultured in a 48-well plate for 72 hours with stepwise combinations of these agents. Relative biofilm inhibitions were measured according to optical density of crystal violet stain at 590 nm. Live/dead assays (BacTiter-Glo™ assay, Promega) were imaged with laser scanning confocal microscopy. An agar diffusion test was used to confirm antibacterial effects of the drugs.
Results
l-Methionine (0.5 μM) significantly reduced PAO-1 biofilm mass (32.4 ± 18.0%; n = 4; p < 0.001) compared with controls. Low doses of ivacaftor alone (4, 8, and 12 μg/mL) had no effect on biofilm formation. When combined with ivacaftor (4 μg/mL), a synergistic anti-biofilm effect was noted at 0.05 μM and 0.5 μM of l-methionine (two-way analysis of variane, p = 0.0415) compared with corresponding concentrations of l-methionine alone.
Conclusion
Ivacaftor enhanced the anti-biofilm activity of l-methionine against the PAO-1 strain of P aeruginosa. Further studies evaluating the efficacy of ivacaftor/l-methionine combinations for P aeruginosa sinusitis are planned.
http://ift.tt/2FWoy6t
Otolaryngologist adherence to the AAO-HNSF Allergic Rhinitis Clinical Practice Guideline
Background
In February 2015, the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNSF) published the Allergic Rhinitis Clinical Practice Guideline (AR-CPG). The objective of this study was to assess otolaryngologists' perception of the accuracy and adherence to the AR-CPG.
Methods
A survey was distributed to fellows of the American Academy of Otolaryngic Allergy and members of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. A total of 601 otolaryngologists responded. The survey evaluated otolaryngologists' demographic data, perception of the accuracy of the guideline, and adherence to the guideline action statements.
Results
The majority of respondents were actively practicing (544 [90.5%]), for a duration of 11–30 years (308 [51.2%]), in a private practice setting (387 [64.4%]). The cohort was largely fellowship trained (348 [57.9%]) and had reviewed the guideline (428 [71.2%]). Most respondents perceived the guideline as being correct "a great deal" (295 [69.7%]) and deviated from the guideline "only a little" (302 [71.6%]). High rates of adherence to the strong guideline recommendations were observed. Respondents "always/most of the time" recommended intranasal steroids (581 [97.6%]), and oral antihistamines (439 [74%]) as primary therapy. Otolaryngologists in practice for longer were more likely to deviate from the guideline recommendations by obtaining sinonasal imaging (p = 0.007) and recommending oral leukotriene receptor antagonists as primary therapy (p = 0.0001).
Conclusion
Overall perception of the correctness of and adherence to the AR-CPG was high in this cohort. Targeted education resources should be provided to otolaryngologists in practice for longer in efforts to reduce harmful or unnecessary variations in care.
http://ift.tt/2GXAVR2
Potential COIs in Dermatology Clinical Practice Guidelines
This Viewpoint discusses the importance of achieving balance between the practical and the ideal in clinical practice guideline development.
http://ift.tt/2E9BKV2
http://ift.tt/2E9BKV2
A New Severity Assessment for Hidradenitis Suppurativa
This study examines the accuracy and clinical relevance of a newly developed scoring system for hidradenitis suppurativa severity.
http://ift.tt/2EMSin3
http://ift.tt/2EMSin3
Evaluating Industry Payments Among Dermatology Clinical Practice Guideline Authors
To the Editor The article by Checketts et al regarding industry payments among dermatology clinical practice guideline (CPG) authors was accompanied by an editorial by Katz highlighting some of the problems with the study's methodology. We have significant additional concerns regarding its conclusions.
http://ift.tt/2E7Oxr1
http://ift.tt/2E7Oxr1
Opioid Prescribing Patterns and Complications in the Dermatology Medicare Population
This cross-sectional study characterizes the current status and potential complications of opioid prescribing practices among dermatologists for Medicare beneficiaries.
http://ift.tt/2EOm22L
http://ift.tt/2EOm22L
Evaluating Industry Payments Among Dermatology Clinical Practice Guideline Authors—Reply
In Reply We appreciate the opportunity to respond to Glazer et al regarding our recent publication on financial conflicts of interest (COIs). This issue is timely, important, and needs addressing. We will respond to their 2 primary criticisms. First, they proffer that research payments should not be considered COIs owing to the importance of physician-industry relationships in advancing medical knowledge. Second, they contend that the Open Payments Database (OPD) is "flawed," and thus our findings lack merit. We address these criticisms herein.
http://ift.tt/2E8zBZU
http://ift.tt/2E8zBZU
Erosive Patches on Bilateral Nipples
A young woman presented with painless erythematous erosive patches on both nipples 3 months after a bite during sexual intercourse. What is your diagnosis?
http://ift.tt/2EOAdVI
http://ift.tt/2EOAdVI
Efficacy and Safety of Guselkumab for Palmoplantar Pustulosis
This randomized clinical trial evaluates the safety and efficacy of guselkumab compared with placebo for the treatment of palmoplantar pustulosis.
http://ift.tt/2E9oxeK
http://ift.tt/2E9oxeK
Evaluation of treatment outcomes in patients with supraglottic laryngeal cancer in Ontario, Canada: A population-based study
Abstract
Background
Supraglottic laryngeal carcinoma has an entirely different etiology, clinical presentation, and prognosis compared to glottis cancer but the only evidence for the use of concurrent chemotherapy with radiotherapy (CRT) is the 5.4% 5-year improvement in overall survival (OS) for the combined laryngeal site.
Method
We conducted a retrospective population-based study using administrative data to compare OS, disease-specific survival (DSS), laryngectomy-free survival, and laryngoesophageal dysfunction-free survival over time and by treatment for all patients with supraglottic laryngeal carcinoma diagnosed between January 1, 1990, and December 31, 2014, in Ontario, Canada.
Results
There was no improvement over time in OS (hazard ratio [HR] 1.006; P = .90), DSS (HR 1.031; P = .65), or laryngoesophageal dysfunction-free survival (P = .39). The patients selected for CRT had similar OS (HR 1.04; P = .66), laryngectomy-free survival (HR 0.95; P = .23), and laryngoesophageal dysfunction-free survival (P = .79) compared with patients undergoing radiotherapy.
Conclusion
The addition of CRT by head and neck oncologists in Ontario, Canada, did not improve outcomes for the "real world" patients with supraglottic laryngeal carcinoma.
http://ift.tt/2C2j4om
Farm dust reduces viral load in human bronchial epithelial cells by increasing barrier function and antiviral responses
Publication date: Available online 7 February 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Luciën E.P.M. van der Vlugt, Katrien Eger, Christoph Müller, Dennis K. Ninaber, Maria C. Zarcone, Gimano D. Amatngalim, Franz Bracher, Erika von Mutius, Hermelijn H. Smits, Pieter S. Hiemstra
http://ift.tt/2E9Kj2j
Severe Asthma is Associated with Metabolic Syndrome in Brazilian Adolescents
Publication date: Available online 7 February 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Fábio Chigres Kuschnir, Mara Morelo Rocha Felix, Maria Cristina, Caetano Kuschnir, Erica Azevedo de Oliveira Costa Jordão, Dirceu Solé, Antônio José Ledo Alves da Cunha, Moyses Szklo
http://ift.tt/2ENrq6k
Germline Gain-of-Function MYD88 Mutation in a Child with Severe Arthritis
Publication date: Available online 7 February 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Keith A. Sikora, Joshua R. Bennett, Laurens Vyncke, Zuoming Deng, Wanxia Li Tsai, Ewald Pauwels, Gerlinde Layh-Schmitt, April Brundidge, Fatemeh Navid, Kristien J.M. Zaal, Eric Hanson, Massimo Gadina, Louis M. Staudt, Thomas A. Griffin, Jan Tavernier, Frank Peelman, Robert A. Colbert
http://ift.tt/2E9K5rZ
New mechanism underlying IL-31-induced atopic dermatitis
Publication date: Available online 7 February 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Jianghui Meng, Masaki Moriyama, Micha Feld, Joerg Buddenkotte, Timo Buhl, Attila Szöllösi, Jingming Zhang, Paul Miller, Andre Ghetti, Michael Fischer, Peter W. Reeh, Chunxu Shan, Jiafu Wang, Martin Steinhoff
BackgroundT helper type 2 cell-released interleukin 31 (IL-31) is a critical mediator in atopic dermatitis (AD), a prevalent and debilitating chronic skin disorder. Brain-derived natriuretic peptide (BNP) has been described as a central itch mediator. The importance of BNP in peripheral (skin-derived) itch and its functional link to IL-31 within the neuro-immune axis of the skin is unknown.ObjectiveTo investigate the function of BNP in the peripheral sensory system and skin in IL-31-induced itch and neuro-epidermal communication in AD.MethodsCa2+-imaging, immunohistochemistry, quantitative real-time PCR, RNA-Seq, knockdown, cytokine/phosphor-kinase arrays, enzyme immune assay and pharmacological inhibition were subjected to examine the cellular basis of the IL-31-stimulated, BNP-related itch signaling in human DRG neurons (hDRG) and skin cells, transgenic AD-like mouse models, and human skin of AD and healthy subjects.ResultsIn hDRG, we confirmed expression and co-occurrence of OSMRβ and IL-31 receptor A in a small subset of neuronal population. Furthermore, IL-31 activated ∼50% of endothelin-1-responsive neurons, and half of the latter also responded to histamine. In murine DRGs IL-31 upregulated Nppb and induced SNARE-dependent BNP release. In the Grhl3PAR2/+mice, house dust mite-induced severe AD-like dermatitis was associated with Nppb upregulation. Lesional IL-31Tg mice also exhibited increased Nppb transcripts in DRGs and skin; accordingly, skin BNP receptor was elevated. Importantly, expression of BNP and its receptor were increased in AD patient skin. In human skin cells, BNP stimulated a pro-inflammatory, itch-promoting phenotype.ConclusionOur findings show, for the first time, that BNP is implicated in AD and that IL-31 regulates BNP in both DRGs and skin. IL-31 enhances BNP release and synthesis, and orchestrates cytokine and chemokine release from skin cells, thereby coordinating the signaling pathways involved in itch. Inhibiting peripheral BNP function may be a novel therapeutic strategy for AD and pruritic conditions.
http://ift.tt/2ENQ0Uq
Experimental Investigation of Concrete Runway Snow Melting Utilizing Heat Pipe Technology
A full scale snow melting system with heat pipe technology is built in this work, which avoids the negative effects on concrete structure and environment caused by traditional deicing chemicals. The snow melting, ice-freezing performance and temperature distribution characteristics of heat pipe concrete runway were discussed by the outdoor experiments. The results show that the temperature of the concrete pavement is greatly improved with the heat pipe system. The environment temperature and embedded depth of heat pipe play a dominant role among the decision variables of the snow melting system. Heat pipe snow melting pavement melts the snow completely and avoids freezing at any time when the environment temperature is below freezing point, which is secure enough for planes take-off and landing. Besides, the exportation and recovery of geothermal energy indicate that this system can run for a long time. This paper will be useful for the design and application of the heat pipe used in the runway snow melting.
http://ift.tt/2FTVqNg
Complete resection of a rectus abdominis muscle invaded by desmoid tumors and subsequent management with an abdominal binder: a case report
Desmoid-type fibromatosis is characterized by desmoid tumors, which are benign soft tissue tumors that can be locally aggressive but typically do not metastasize. Desmoid tumors can manifest anywhere in the bo...
http://ift.tt/2C05FwV
Commentary on Meier et al. (2018): Smoke and mirrorsare adolescent cannabis users vulnerable to cognitive impairment?
Mokrysz, C; Freeman, TP; (2018) Commentary on Meier et al. (2018): Smoke and mirrorsare adolescent cannabis users vulnerable to cognitive impairment? Addiction , 113 (2) pp. 266-267. 10.1111/add.14055 .
http://ift.tt/2EMkgPH
Experimental design of the Cu-As-Sn ternary colour diagram
Radivojević, M; Pendić, J; Srejić, A; Korać, M; Davey, C; Benzonelli, A; Martinón-Torres, M; ... Kamberović, Z; + view all Radivojević, M; Pendić, J; Srejić, A; Korać, M; Davey, C; Benzonelli, A; Martinón-Torres, M; Jovanović, N; Kamberović, Z; - view fewer (2017) Experimental design of the Cu-As-Sn ternary colour diagram. Journal of Archaeological Science , 90 pp. 106-119. 10.1016/j.jas.2017.12.001 .
http://ift.tt/2E8eNSi
In vivo imaging reveals that pregabalin inhibits cortical spreading depression and propagation to subcortical brain structures
Cain, SM; Bohnet, B; LeDue, J; Yung, AC; Garcia, E; Tyson, JR; Alles, SRA; ... Snutch, TP; + view all Cain, SM; Bohnet, B; LeDue, J; Yung, AC; Garcia, E; Tyson, JR; Alles, SRA; Han, H; van den Maagdenberg, AMJM; Kozlowski, P; MacVicar, BA; Snutch, TP; - view fewer (2017) In vivo imaging reveals that pregabalin inhibits cortical spreading depression and propagation to subcortical brain structures. PNAS - Proceedings of the National Academy of Sciences of the United States of America , 114 (9) pp. 2401-2406. 10.1073/pnas.1614447114 .
http://ift.tt/2ELPJkW
The health benefits of secondary education in adolescents and young adults: An international analysis in 186 low-, middle- and high-income countries from 1990 to 2013
Viner, RM; Hargreaves, DS; Ward, J; Bonell, C; Mokdad, AH; Patton, G; (2017) The health benefits of secondary education in adolescents and young adults: An international analysis in 186 low-, middle- and high-income countries from 1990 to 2013. SSM Popul Health , 3 pp. 162-171. 10.1016/j.ssmph.2016.12.004 . Green open access
http://ift.tt/2E6sQYh
Motor cortex synchronization influences the rhythm of motor performance in premanifest huntington's disease
Casula, EP; Mayer, IMS; Desikan, M; Tabrizi, SJ; Rothwell, JC; Orth, M; (2018) Motor cortex synchronization influences the rhythm of motor performance in premanifest huntington's disease. Movement Disorders 10.1002/mds.27285 . (In press).
http://ift.tt/2EJzF37
The Anti-Allodynic Gabapentinoids: Myths, Paradoxes, and Acute Effects
Alles, SRA; Smith, PA; (2017) The Anti-Allodynic Gabapentinoids: Myths, Paradoxes, and Acute Effects. The Neuroscientist , 23 (1) pp. 40-55. 10.1177/1073858416628793 .
http://ift.tt/2E7WIDI
Near-field characterization of conductive micro-resonators for terahertz sensing
Khromova, I; Mitrofanov, O; (2017) Near-field characterization of conductive micro-resonators for terahertz sensing. In: Pereira, MF and Shulika, O, (eds.) Proceedings of the NATO Advanced Research Workshop on THz for CBRN and Explosives Detection and Diagnosis. (pp. pp. 23-28). Springer: Dordrecht, Netherlands.
http://ift.tt/2EPAkjO
Acute anti-allodynic action of gabapentin in dorsal horn and primary somatosensory cortex: Correlation of behavioural and physiological data
Alles, SRA; Bandet, MV; Eppler, K; Noh, M-C; Winship, IR; Baker, G; Ballanyi, K; Alles, SRA; Bandet, MV; Eppler, K; Noh, M-C; Winship, IR; Baker, G; Ballanyi, K; Smith, PA; - view fewer (2017) Acute anti-allodynic action of gabapentin in dorsal horn and primary somatosensory cortex: Correlation of behavioural and physiological data. Neuropharmacology , 113 (Part A) pp. 576-590. 10.1016/j.neuropharm.2016.11.011 .
http://ift.tt/2E8z1eD
Phenomenology and Social Agent Representation in Psychosis: A Welcome Integration
Bell, V; Mills, KL; Modinos, G; Wilkinson, S; (2017) Phenomenology and Social Agent Representation in Psychosis: A Welcome Integration. Clinical Psychological Science , 5 (5) pp. 769-770. 10.1177/2167702617709559 . Green open access
http://ift.tt/2ENGqRs
Effects of stress on the development and progression of cardiovascular disease
Kivimäki, M; Steptoe, A; (2017) Effects of stress on the development and progression of cardiovascular disease. Nature Reviews Cardiology 10.1038/nrcardio.2017.189 . (In press).
http://ift.tt/2E8ySI7
A genetically immortalized human stem cell line: a promising new tool for Alzheimer's disease therapy
Puangmalai, N; Thangnipon, W; Somani, A; Ballard, C; Broadstock, M; (2016) A genetically immortalized human stem cell line: a promising new tool for Alzheimer's disease therapy. Presented at: UNSPECIFIED.
http://ift.tt/2EP46F2
Prospective associations of social isolation and loneliness with poor sleep quality in older adults
Yu, B; Steptoe, A; Niu, K; Ku, P-W; Chen, L-J; (2017) Prospective associations of social isolation and loneliness with poor sleep quality in older adults. Quality of Life Research 10.1007/s11136-017-1752-9 . (In press).
http://ift.tt/2E8yKbB
Thirty Black male school leaders in England: Who are they? What is known about them?
Miller, PW; (2016) Thirty Black male school leaders in England: Who are they? What is known about them? Presented at: AERA, Washington DC, USA.
http://ift.tt/2ELneUs
Domestic demand-side response on district heating networks
Sweetnam, T; Spataru, C; Barrett, M; Carter, E; (2018) Domestic demand-side response on district heating networks. Building Research and Information 10.1080/09613218.2018.1426314 . (In press).
http://ift.tt/2E8yAB1
Male school leader narratives: who’s in and who’s out?
Miller, PW; (2016) Male school leader narratives: who's in and who's out? Presented at: BELMAS, Carden Park, Cheshire, UK.
http://ift.tt/2EP45ks
Social Isolation, Health Literacy, and Mortality Risk: Findings From the English Longitudinal Study of Ageing
Smith, SG; Jackson, SE; Kobayashi, LC; Steptoe, A; (2018) Social Isolation, Health Literacy, and Mortality Risk: Findings From the English Longitudinal Study of Ageing. Health Psychology , 37 (2) pp. 160-169. 10.1037/hea0000541 . Green open access
http://ift.tt/2E8ysS3
A comparison of techniques for quantifying amyloid burden on a combined pet/mr scanner
Cash, DM; Burgos, N; Modat, M; Dickson, J; Beasley, D; Markiewicz, P; Lane, CA; ... Schott, J; + view all Cash, DM; Burgos, N; Modat, M; Dickson, J; Beasley, D; Markiewicz, P; Lane, CA; Parker, T; Barnes, A; Thomas, DL; Cardoso, M; Malone, I; Veale, T; Wallon, D; Klimova, J; Erlandsson, K; Wong, A; Richards, M; Fox, N; Ourselin, S; Schott, J; - view fewer (2017) A comparison of techniques for quantifying amyloid burden on a combined pet/mr scanner. Presented at: Alzheimer's Association International Conference, London, United Kingdom. Green open access
http://ift.tt/2ELPExE
Physical activity pre- and post-dementia: English Longitudinal Study of Ageing
Soni, M; Orrell, M; Bandelow, S; Steptoe, A; Rafnsson, S; d'Orsi, E; Xavier, A; Soni, M; Orrell, M; Bandelow, S; Steptoe, A; Rafnsson, S; d'Orsi, E; Xavier, A; Hogervorst, E; - view fewer (2017) Physical activity pre- and post-dementia: English Longitudinal Study of Ageing. Aging & Mental Health 10.1080/13607863.2017.1390731 . (In press).
http://ift.tt/2E7FKVT
Alendronate-loaded PLGA/halloysite composite nanofibers
Liu, C; Welch, B; (2015) Alendronate-loaded PLGA/halloysite composite nanofibers. Presented at: COST MP1206 Workshop Textile Applications of Electrospun Nanofibers, Istanbul, Turkey.
http://ift.tt/2EM11Wq
Osteochondral tissue engineering: what we have learnt?
Liu, C; (2017) Osteochondral tissue engineering: what we have learnt? Presented at: TERMIS STEM, Porto, Portual.
http://ift.tt/2E8vf4W
Influence of peanut matrix on stability of allergens in gastric-simulated digesta: 2S albumins are main contributors to the IgE-reactivity of short digestion resistant peptides
Abstract
Background
Most food allergens sensitizing via the gastrointestinal tract are stable proteins that are resistant to pepsin digestion, in particular major peanut allergens, Ara h 2 and Ara h 6. Survival of their large fragments is essential for sensitizing capacity. However, the immunoreactive proteins/peptides to which the immune system of the gastrointestinal tract is exposed during digestion of peanut proteins is unknown. Particularly, the IgE-reactivity of short digestion-resistant peptides (<10 kDa) released by gastric digestion under standardized and physiologically relevant in vitro conditions has not been investigated.
Objective
The aim of this study was to investigate and identify digestion products of major peanut allergens and in particular to examine IgE reactivity of short digestion-resistant peptides released by pepsin digestion of whole peanut grains.
Methods
Two-dimension gel-based proteomics and shotgun peptidomics, immunoblotting with allergen-specific antibodies from peanut sensitised patients, enzyme-linked immunosorbent inhibition assay and ImmunoCAP tests, including far ultraviolet-circular dichroism spectroscopy were used to identify and characterize peanut digesta.
Results
Ara h 2 and Ara h 6 remained mostly intact, and short digestion-resistant peptides from Ara h 2 were more potent in inhibiting IgE binding than Ara h 1 and Ara 3. Ara h 1 and Ara h 3 exhibited sequential digestion into a series of digestion-resistant peptides with preserved allergenic capacity. A high number of identified short digestion-resistant peptides from Ara h 1, Ara h 2 and Ara h 3 were part of short continuous epitope sequences and possessed substantial allergenic potential.
Conclusion and Clinical Relevance
Peanut grain digestion by oral and gastric phase enzymes generates mixture of products, where the major peanut allergens remain intact and their digested peptides have preserved allergenic capacity highlighting their important roles in allergic reactions to peanut.
This article is protected by copyright. All rights reserved.
http://ift.tt/2C574Te
Advancing the management of Obstructive Airways Diseases through Translational Research
Abstract
Obstructive airways diseases (OAD) represent a huge burden of illness worldwide, and in spite of the development of effective therapies, significant morbidity and mortality related to asthma and COPD still remains. Over the past decade, our understanding of OAD has improved vastly, and novel treatments have evolved. This evolution is the result of successful translational research, which has connected clinical presentations of OAD and underlying disease mechanisms, thereby enabling the development of targeted treatments. The next challenge of translational research will be to position these novel treatments for OAD for optimal clinical use. At the same time, there is great potential in these treatments providing even better insights into disease mechanisms in OAD, by studying the effects of blocking individual immunological pathways. To optimise this potential, there is a need to ensure that translational aspects are added to randomised clinical trials, as well as Real World studies, but also to use other trial designs such as platform studies, which allow for simultaneous assessment of different interventions. Furthermore, demonstrating clinical impact, i.e. research translation, is an increasingly important component of successful translational research.
This review outlines concepts of translational research, exemplifying how translational research has moved management of Obstructive Airways Diseases into the next century, with the introduction of targeted, individualised therapy. Furthermore, the review describes how these therapies may be used as research tools, to further our understanding of disease mechanisms in OAD, through translational, mechanistic studies. We underline the current need for implementing basic immunological concepts into clinical care, in order to optimise the use of novel targeted treatments, and to further the clinical understanding of disease mechanisms. Finally, potential barriers to adoption of novel targeted therapies into routine practice are described, and how these may be overcome.
This article is protected by copyright. All rights reserved.
http://ift.tt/2C0tyVl
Tumors of the parapharyngeal space: the VU University Medical Center experience over a 20-year period
Abstract
Background
Tumors of the parapharyngeal space (PPS) are rare, accounting for 0.5–1.5% of all head and neck tumors. The anatomy of the PPS is responsible for a wide variety of tumors arising from the PPS. This series of 99 PPS tumors provides an overview of the clinical course and management of PPS tumors.
Materials and methods
This retrospective study included clinical data from patients treated for PPS tumors from 1991 to 2012 (warranting at least a 4-year follow-up) at the VU University Medical Center, Amsterdam, The Netherlands.
Results
Fifty percent were salivary gland tumors, 41% were neurogenic and 9% had a different origin. 18.2% of the PPS tumors were malignant. The most reported symptom at presentation was swelling of the neck and throat. In 14%, the PPS tumor was an accidental finding following imaging for other diagnostic reasons. Cytology showed an accuracy rate of 73.1% (19/26). The positive predictive value of a malignant cytology result was 86% (95% CI 42.1–99.6%). Surgery was performed in 55 patients (56%). The most frequently performed approach (56%) was the cervical–transparotid approach, followed by the cervical (25%), transmandibular (16%) and transoral (2%) approach. Nine patients died of the disease, of which seven patients had a malignant salivary gland tumor, one patient had a pleomorphic adenoma at first diagnosis which degenerated into carcinoma ex pleomorphic adenoma and one patient died of metastatic renal cell carcinoma.
Conclusion
This large single-centre report on PPS tumors shows that careful diagnostic work up and proper surgical planning are important in this specific and rare group of head and neck tumors. Surgery was the main treatment (56%) for parapharyngeal tumors. Management of parapharyngeal neurogenic neoplasms generally consists of active surveillance due to peri-operative risk for permanent cranial nerve damage. The histopathological diagnoses were consistent with previous reports.
http://ift.tt/2nFuOZK
Validation of the second version of the LittlEARS ® Early Speech Production Questionnaire (LEESPQ) in German-speaking children with normal hearing
Abstract
Introduction
The introduction of neonatal hearing screening and the increasingly early age at which children can receive a cochlear implant has intensified the need for a validated questionnaire to assess the speech production of children aged 0‒18. Such a questionnaire has been created, the LittlEARS® Early Speech Production Questionnaire (LEESPQ). This study aimed to validate a second, revised edition of the LEESPQ.
Methods and materials
Questionnaires were returned for 362 children with normal hearing. Completed questionnaires were analysed to determine if the LEESPQ is reliable, prognostically accurate, internally consistent, and if gender or multilingualism affects total scores.
Results
Total scores correlated positively with age. The LEESPQ is reliable, accurate, and consistent, and independent of gender or lingual status. A norm curve was created.
Discussion
This second version of the LEESPQ is a valid tool to assess the speech production development of children with normal hearing, aged 0‒18, regardless of their gender. As such, the LEESPQ may be a useful tool to monitor the development of paediatric hearing device users.
Conclusion
The second version of the LEESPQ is a valid instrument for assessing early speech production of children aged 0‒18 months.
http://ift.tt/2nQKhFh
Alternatives to Whole Liver Transplants for Children Have Become Safer, Study Finds
http://ift.tt/2BJIziG
Giant colonic diverticulum—a rare cause of acute abdomen
Abstract
Giant colonic diverticulum (GCD), defined as diverticulum larger than 4 cm, is a rare entity. It is generally a manifestation of colonic diverticular disease and can have dramatic complications such as perforation, abscess, volvulus, infarction and adenocarcinoma. This report documents the case of a 63-year-old man coming to the Emergency Department with acute abdomen due to a perforation of a GCD. In the plain abdominal X-ray the 'Balloon-sign' was revealed, computed tomography scan and Hartmann's procedure were performed. Acute abdomen can occur as a manifestation of a complication of a GCD, and this report highlights the fact that GCD should be considered for patients with a high risk of diverticular disease and abdominal pain.http://ift.tt/2ENHvZL
Medullary-like hepatocellular carcinoma
Abstract
Hepatocellular carcinoma (HCC) is the most frequent primary hepatic cancer. Pathological features can define the biological behavior and prognosis. Medullary-like HCC is a very rare variant that has been described only twice in literature. In the present study, we report the case of a non-cirrhotic 72-year-old man, who presented two HCC lesions on routine screening for hepatitis C virus liver disease. Radiological imaging and biopsy showed two different subtypes: one classic HCC, which was treated with chemoembolization, and a second PET/CT-positive carcinoma with a PET/CT-positive metastatic coeliac lymph node, which was resected laparoscopically with a left lateral sectionectomy and extended lymphadenectomy. Histopathology revealed a medullary-like HCC; lymph node analysis confirmed the metastatic nature of the PET/CT-positive coeliac node and showed an incidental B-cell lymphoma in the hepatic pedicle lymph nodes. To the best of our knowledge this is the third case of medullary-like HCC described in the literature, and the first associated to a concomitant typical HCC.http://ift.tt/2E89geq
After a punch: recurrence of compartment syndrome following minor trauma
Abstract
Acute compartment syndrome (ACS) is a diagnosis that requires high-clinical suspicion especially in cases when the initial causal event could be considered insignificant. We present a novel case presentation of ACS associated with minor trauma in a patient with a previous history of compartment syndrome in the same extremity from a motor vehicle accident 10 years prior to presentation. To the best of our knowledge, this is the first reported case of recurrent ACS. Due to the possibility of significant morbidity, including loss of limb, it is imperative to recognize the presentation quickly so proper surgical intervention can occur. This case shows compartment syndrome can occur after a low impact mechanism of injury and previous compartment syndrome may be a risk factor, lowering the threshold for a re-occurrence. Serial exams and compartment pressure measurements should be used to aid recognition in ambiguous clinical presentations.http://ift.tt/2EJRWgN
Stated Preference Design for Exploring Demand for “Mobility as a Service” Plans
Matyas, MB; Kamargianni, M; (2017) Stated Preference Design for Exploring Demand for "Mobility as a Service" Plans. Presented at: UNSPECIFIED, Cape Town, South Africa.
http://ift.tt/2Be33Pw
Generalized Multiscale Inversion for Heterogeneous Problems
Jin, B; Chung, E; Efendiev, Y; Leung, W; Vasilyeva, M; (2018) Generalized Multiscale Inversion for Heterogeneous Problems. Communications in Computational Physics (In press).
http://ift.tt/2BJkB7g
A Holistic Overview of the Mobility-as-a-Service
Matyas, MB; Kamargianni, M; (2017) A Holistic Overview of the Mobility-as-a-Service. Presented at: Hungarian Transport Research Conference, Gyor, Hungary.
http://ift.tt/2BeCGJ7
Control of brain energy supply by astrocytes
Nortley, R; Attwell, D; (2017) Control of brain energy supply by astrocytes. Current Opinion in Neurobiology , 47 pp. 80-85. 10.1016/j.conb.2017.09.012 .
http://ift.tt/2BHpduB
Astrocytes mediate neurovascular signaling to capillary pericytes but not to arterioles (vol 19, pg 1619, 2016)
Mishra, A; Reynolds, JP; Chen, Y; Gourine, AV; Rusakov, DA; Attwell, D; (2017) Astrocytes mediate neurovascular signaling to capillary pericytes but not to arterioles (vol 19, pg 1619, 2016). [Corrigendum]. Nature Neuroscience , 20 (8) p. 1189. 10.1038/nn0817-1189a .
http://ift.tt/2BgVSWT
Experimental Validation of Calculated Atomic Charges in Ionic Liquids
Fogarty, R; Matthews, R; Ashworth, C; Brandt, A; Palgrave, R; Bourne, R; Hoogerstraete, T; ... Lovelock, K; + view all Fogarty, R; Matthews, R; Ashworth, C; Brandt, A; Palgrave, R; Bourne, R; Hoogerstraete, T; Hunt, P; Lovelock, K; - view fewer (2018) Experimental Validation of Calculated Atomic Charges in Ionic Liquids. Journal of Chemical Physics (In press).
http://ift.tt/2BJkbOe
Improving the prognosis of patients with severely decreased glomerular filtration rate (CKD G4+): Conclusions from a KDIGO Controversies Conference
Wheeler, DC; Eckardt, K-U; Coresh, ME; Grams, ME; Herzog, CA; James, MT; Heerspink, HJL; (2018) Improving the prognosis of patients with severely decreased glomerular filtration rate (CKD G4+): Conclusions from a KDIGO Controversies Conference. In: (Proceedings) KDIGO Controversies Conference on HIV - Related Kidney Diseases. Kidney International (In press).
http://ift.tt/2BgVM1t
Distribution of Salivary Testosterone in Men and Women in a British General Population-Based Sample: The Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3)
Keevil, BG; Clifton, S; Tanton, C; Macdowall, W; Copas, AJ; Lee, D; Field, N; ... Wu, FCW; + view all Keevil, BG; Clifton, S; Tanton, C; Macdowall, W; Copas, AJ; Lee, D; Field, N; Mitchell, KR; Sonnenberg, P; Bancroft, J; Mercer, CH; Johnson, AM; Wellings, K; Wu, FCW; - view fewer (2017) Distribution of Salivary Testosterone in Men and Women in a British General Population-Based Sample: The Third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Journal of the Endocrine Society , 1 (1) pp. 14-25. 10.1210/js.2016-1029 . Green open access
http://ift.tt/2BKe77X
A phase IIa study of tisotumab vedotin (HuMax (R)-TF-ADC) in patients with relapsed, recurrent and/or metastatic cervical cancer
Vergote, I; Dean, E; Lassen, U; de Bono, J; Drew, Y; Machiels, J-P; Nielsen, D; ... Hong, DS; + view all Vergote, I; Dean, E; Lassen, U; de Bono, J; Drew, Y; Machiels, J-P; Nielsen, D; Arkenau, H-T; Forster, M; Jones, R; Slomovitz, B; Spicer, J; Johnson, M; Cornez, N; Gennigens, C; Fulton, B; Lisby, S; Basse, L; Coleman, R; Hong, DS; - view fewer (2017) A phase IIa study of tisotumab vedotin (HuMax (R)-TF-ADC) in patients with relapsed, recurrent and/or metastatic cervical cancer. Presented at: 42nd European-Society-for-Medical-Oncology Congress (ESMO), Madrid, Spain.
http://ift.tt/2BgVGH9
Irritable bowel syndrome diagnosis and management: A simplified algorithm for clinical practice
Moayyedi, P; Mearin, F; Azpiroz, F; Andresen, V; Barbara, G; Corsetti, M; Emmanuel, A; ... Tack, J; + view all Moayyedi, P; Mearin, F; Azpiroz, F; Andresen, V; Barbara, G; Corsetti, M; Emmanuel, A; Hungin, APS; Layer, P; Stanghellini, V; Whorwell, P; Zerbib, F; Tack, J; - view fewer (2017) Irritable bowel syndrome diagnosis and management: A simplified algorithm for clinical practice. United European Gastroenterology Journal , 5 (6) pp. 773-788. 10.1177/2050640617731968 . Green open access
http://ift.tt/2BJjYuq
The cloudUPDRS app: A medical device for the clinical assessment of Parkinson's Disease
Stamate, C; Magoulas, GD; Kueppers, S; Nomikou, E; Daskalopoulos, I; Jha, A; Pons, JS; ... Roussos, G; + view all Stamate, C; Magoulas, GD; Kueppers, S; Nomikou, E; Daskalopoulos, I; Jha, A; Pons, JS; Rothwell, J; Luchini, MU; Moussouri, T; Iannone, M; Roussos, G; - view fewer (2018) The cloudUPDRS app: A medical device for the clinical assessment of Parkinson's Disease. Pervasive and Mobile Computing , 43 pp. 146-166. 10.1016/j.pmcj.2017.12.005 .
http://ift.tt/2BgVAiL
Cortisol and subjective stress responses to acute psychosocial stress in fibromyalgia patients and control participants
Coppens, E; Kempke, S; Van Wambeke, P; Claes, S; Morlion, B; Luyten, P; Van Oudenhove, L; (2017) Cortisol and subjective stress responses to acute psychosocial stress in fibromyalgia patients and control participants. Psychosomatic Medicine 10.1097/PSY.0000000000000551 . (In press).
http://ift.tt/2BJiTTe
Parental Reflective Functioning Affects Sensitivity to Distress in Mothers with Postpartum Depression
Krink, S; Muehlhan, C; Luyten, P; Romer, G; Ramsauer, B; (2018) Parental Reflective Functioning Affects Sensitivity to Distress in Mothers with Postpartum Depression. Journal of Child and Family Studies 10.1007/s10826-017-1000-5 . (In press).
http://ift.tt/2BhpZNU
Data for "X-ray studies of magnetic and structural transitions in iridates"
Donnerer, C; (2018) Data for "X-ray studies of magnetic and structural transitions in iridates". [Dataset]. UCL Physics and Astronomy Department: London, UK. Green open access
http://ift.tt/2BJhwUu
Prevalence of Exposure to Complex Trauma and Community Violence and Their Associations With Internalizing and Externalizing Symptoms
Yearwood, K; Vliegen, N; Chau, C; Corveleyn, J; Luyten, P; (2017) Prevalence of Exposure to Complex Trauma and Community Violence and Their Associations With Internalizing and Externalizing Symptoms. Journal of Interpersonal Violence 10.1177/0886260517731788 . (In press). Green open access
http://ift.tt/2BgViIH
What Plants and Animals Do Early Childhood and Primary Students’ Name? Where Do They See Them?
Tunnicliffe, SD; Patrick, P; (2011) What Plants and Animals Do Early Childhood and Primary Students' Name? Where Do They See Them? Journal of Science Education and Technology , 20 (5) pp. 630-642. 10.1007/s10956-011-9290-7 . Green open access
http://ift.tt/2BHpayV
The implications of a diversifying workforce for higher education systems, institutions and individuals
Marini, G; Locke, W; Whitchurch, C; (2017) The implications of a diversifying workforce for higher education systems, institutions and individuals. Presented at: SRHE, Newport, Wales. (In press). Green open access
http://ift.tt/2BeC5Hj
To Hell with Aeneas: looking backwards and forwards in Aeneid 6
Mac Góráin, F; (2011) To Hell with Aeneas: looking backwards and forwards in Aeneid 6. Omnibus , 61 pp. 15-17.
http://ift.tt/2BIHO9l
Comparison of Endonasal DCR Surgery Using Cautery and Surgical Blade Technique in Cases of Chronic Dacryocystitis
Abstract
Dacryocystitis is defined as inflammation of lacrimal sac. This can be congenital or acquired. Congenital dacryocystitis is commonly chronic while acquired dacryocystitis is acute and chronic both. Endonasal DCR surgery is the most commonly used treatment in chronic DCR but recent use of cautery technique in endonasal DCR surgery rather than traditional surgical blade technique has emerged with promising results with good success rate and fewer complications.
http://ift.tt/2nKStrq
‘Early’ ‘career’ ‘researchers’ in the social sciences: Redefining the terms
Locke, W; Freeman, R; (2017) 'Early' 'career' 'researchers' in the social sciences: Redefining the terms. Presented at: Society for Research into Higher Education Annual Research Conference, Celtic Manor, Newport, Wales, United Kingdom. Green open access
http://ift.tt/2BcMjYR
Determining PhD holders’ salaries in social sciences and humanities: ‘impact’ counts
Marini, G; (2017) Determining PhD holders' salaries in social sciences and humanities: 'impact' counts. Presented at: CGHE Seminars series, London, United Kingdom.
http://ift.tt/2BLAkCI
Radiological comparison of inferior turbinate hypertrophy between allergic and non-allergic rhinitis: does allergy really augment turbinate hypertrophy?
Abstract
Background
Inferior turbinate hypertrophy could be a result of allergic rhinitis (AR) that leads to nasal congestion and nasal airway obstruction, which is the most bothersome complaint in patients with AR. However, evidence regarding whether patients with AR have a more hypertrophied inferior turbinate than do patients with non-AR is lacking.
Objective
We aimed to evaluate the degree of inferior turbinate hypertrophy according to the presence of AR using radiological measurements of the inferior turbinate.
Methods
For evaluating the inferior turbinate, which contributes to nasal obstruction in patients with AR, we enrolled 90 adult patients with septal deviation and divided them into two groups (AR group: n = 49; non-AR group: n = 41). Allergic rhinitis was diagnosed according to the presence of an allergic history, positive multiple allergen simultaneous test, and serological total immunoglobulin E level (≥ 100 kU/L). We analyzed the minimal cross-sectional area on acoustic rhinometry for both groups. The bilateral total width as well as medial mucosa and nasal cavity space in the anterior and posterior portions of the inferior turbinate were measured using computed tomography.
Results
We could not find any significant differences in the anterior and posterior dimensions of the inferior turbinate, intranasal space, and choanal spaces between the AR and non-AR groups. Instead, the anterior part of the inferior turbinate in both the groups showed significant differences between the deviated and contralateral sides. The contralateral side had a larger width than did the deviated side, but no significant difference was noted in the posterior portion of the inferior turbinate.
Conclusion
The degree of inferior turbinate hypertrophy showed no difference between patients with and without AR. Therefore, we suggest that surgical treatment for reducing the size of the inferior turbinate hypertrophy should be considered when performing septoplasty in patients with symptoms of nasal obstruction, regardless of the presence of AR.
http://ift.tt/2EaErpa
Comparison of Endonasal DCR Surgery Using Cautery and Surgical Blade Technique in Cases of Chronic Dacryocystitis
Abstract
Dacryocystitis is defined as inflammation of lacrimal sac. This can be congenital or acquired. Congenital dacryocystitis is commonly chronic while acquired dacryocystitis is acute and chronic both. Endonasal DCR surgery is the most commonly used treatment in chronic DCR but recent use of cautery technique in endonasal DCR surgery rather than traditional surgical blade technique has emerged with promising results with good success rate and fewer complications.
http://ift.tt/2nKStrq
Wide skin markings pattern - melanoma descriptor or patient-related factor?: reply from authors
We read with great interest the letter by Rishpon and Colleagues on our paper titled "Uncovering the diagnostic dermoscopic features of flat melanomas located on the lower limbs" (1). In the current letter, we investigated a series of 247 lesions, including 71 thin melanomas, located on lower limbs with the aim to identify diagnostic specific dermoscopic criteria for melanoma diagnosis. Furthermore, a new dermoscopic descriptor, namely wider skin markings was introduced.
This article is protected by copyright. All rights reserved.
http://ift.tt/2FSP68x
Posterior Nasal Pack After Transpalatal Excision of Juvenile Nasopharyngeal Angiofibroma: Can It be Avoided?
Abstract
The evolution of the packing of postnasal space following transpalatal excision of JNA in the last 7 decades is described and a modification is presented for minimizing the immediate postoperative morbidity.
http://ift.tt/2C2wAIp
Preliminary experience in transoral laryngeal surgery with a flexible robotic system for benign lesions of the vocal folds
Abstract
Purpose
This purpose of this case series is to present the first four cases utilizing micro-phonosurgical instrumentation designed specifically for use with a semi-flexible 'robotic' system—the Medrobotics Flex system and to evaluate the accessibility and feasibility of this platform in the context of transoral robotic surgery (TORS) for laryngeal surgery.
Methods
Four patients (3 female, 1 male; age range 49–79 years) were operated by the senior author at CHL—a tertiary hospital centre between 2016 and 2017. The 'robot' was deployed in all cases to assess its accessibility and ability to perform surgery in the larynx.
Results
All four patients were successfully treated using the system along with newly developed instrumentation specifically focused on phonosurgery.
Conclusion
This series has demonstrated accessibility and ability for laryngeal surgery using a novel semi-rigid operator-controlled 'robotic' system. We encountered no device failures and were able to perform all the selected cases uneventfully.
http://ift.tt/2EaqlnK
Basophils from allergic rhinitis patients show allergen-specific upregulation of thymic stromal lymphopoietin receptor
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Tomoyuki Arai, Daiju Sakurai, Tomohisa Iinuma, Takuya Nakagawa, Syuji Yonekura, Yoshitaka Okamoto
BackgroundAn allergic rhinitis (AR) diagnosis is based on typical nasal symptoms and allergen sensitization testing. However, it is sometimes difficult to distinguish AR from non-AR, and it is especially difficult to identify the causal allergen for immunotherapy of patients with AR.ObjectiveTo identify differences among patients with AR, subjects with asymptomatic sensitization (AS), and subjects without sensitization (NS) that could facilitate the diagnosis of AR.MethodsWe used RNA sequencing to examine differential gene expression in unstimulated and allergen-stimulated peripheral basophils from participants with NS, AS, and AR. We selected genes that were upregulated after allergen stimulation and showed differences in expression in patients with AR compared with subjects with AS and NS. Basophil surface expression of 1 gene product was examined by flow cytometry. The usefulness of gene expression in the diagnosis of AR was examined with receiver operating characteristic curves.ResultsExpression of cytokine receptor-like factor 2 and its product, thymic stromal lymphopoietin receptor (TSLPR), was significantly increased in basophils of patients with AR after allergen stimulation. A significantly larger percentage of TSLPR-positive cells was observed after allergen-specific stimulation of basophils from patients with AR compared with subjects with AS. Basophil TSLPR expression was as good as or better than CD203c expression in discriminating between patients with AR and subjects with AS, as judged by receiver operating characteristic curves.ConclusionOur data suggest that TSLPR expression on basophils was specifically upregulated by allergen stimulation and might be useful for the identification of the causative allergen in patients with AR.
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Patterns of electronic cigarette use in youth with asthma: Results from a nationally representative sample
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Elise Turner, David A. Fedele, Lindsay Thompson, Ramzi G. Salloum
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Author's response to ‘fractional exhaled nitric oxide: signaling lung function changes in obstructive lung diseases.’
Source:Annals of Allergy, Asthma & Immunology
Author(s): Suguru Sato, Junpei Saito
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The atopic march
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): David A. Hill, Jonathan M. Spergel
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Component-resolved diagnosis in selecting patients for yellowjacket venom immunotherapy
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Anna Kaarina Kukkonen, Anna Susanna Pelkonen, Sanna Marika Edelman, Paula Maria Kauppi, Mika Juhani Mäkelä
BackgroundVenom immunotherapy is effective in preventing systemic allergic reactions (SARs), but the diagnosis of venom allergy is problematic.ObjectiveTo compare the performance of component-resolved diagnosis and conventional tests in patients referred for venom immunotherapy.MethodsWe measured serum-specific immunoglobulin E to yellowjacket and honeybee venoms (Ves v 1 and Ves v 5 and Api m 1), cross-reactive carbohydrate determinants, serum basal tryptase (ImmunoCAP, ThermoFisher Scientific, Uppsala, Sweden), and skin prick test reactions in 84 patients referred to receive venom immunotherapy. History of SAR and its severity were evaluated.ResultsOf the 78 patients with suspected yellowjacket venom (YJV) allergy, a history of SAR was confirmed in 47 (60%) and 31 (40%) had a non-SAR reaction. The most accurate tests to confirm venom allergy after a SAR were serum-specific immunoglobulin E to yellowjacket whole-venom extract spiked with Ves v 5 (area under the curve 0.87, 95% confidence interval 0.77–0.97, P < .001) and Ves v 5 (area under the curve 0.86, 95% confidence interval 0.76–0.96, P < .001). Sensitization to Ves v 1 was infrequent and its area under the curve was low (0.62, 95% confidence interval 0.47–0.76, P = .106). Sensitivity of the YJV skin prick test was 86%, but its specificity was low at 54%. Double sensitization to yellowjacket and honeybee occurred frequently in skin prick tests. Of the patients without a SAR, 26% showed a positive reaction to YJV in any serum test and 46% showed a positive reaction in skin tests.ConclusionSpecific immunoglobulin E to the YJV spiked with Ves v 5 confirmed the allergy after a SAR. A history of SAR should be confirmed before testing, because venom sensitization is frequent in other types of reactions.
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Tribute to albert sheffer MD and sheldon spector MD
Source:Annals of Allergy, Asthma & Immunology
Author(s): Richard Nicklas
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The skin as a target for prevention of the atopic march
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Adrian J. Lowe, Donald Y.M. Leung, Mimi L.K. Tang, John C. Su, Katrina J. Allen
ObjectiveAllergic diseases have increased dramatically in the developed world during the past few decades, yet the understanding of risk factors and effective prevention approaches remain limited. In this review, we summarize the evidence supporting the hypothesis that skin-barrier impairment and early-life atopic dermatitis (AD) could play a causal role in the development of sensitization and subsequent food allergies and allergic airways disease (allergic asthma and rhinitis). We further discuss the potential to target the skin barrier as a means to lower the incidence of allergic disease.Data SourcesReview of published literature.Study SelectionsNarrative.ResultsThere is a strong link between AD and sensitization, food allergy, asthma, and allergic rhinitis, particularly AD that is severe and commences in the first 6 months of life. There also is emerging evidence that regular use of prophylactic emollients can significantly decrease the expression of AD, at least while treatment continues. Studies are exploring whether decreased AD expression might modulate the allergic response at a more fundamental level and potentially alter the association between early-life AD and subsequent development of food allergy and allergic airways disease.ConclusionAlthough at this point there is only indirect evidence that early-life emollient use might prevent AD and food allergy, early studies are encouraging. The results of high-quality prevention trials that are in progress are eagerly anticipated. If found to be effective, then neonatal emollient use could be a simple public health measure to lower the incidence of AD, food allergies, and allergic airways disease in future generations.
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Allergic asthma is associated with increased risk of infections requiring antibiotics
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Christian Woehlk, Anna von Bülow, Margit Kriegbaum, Vibeke Backer, Celeste Porsbjerg
BackgroundViral infection and allergy have been identified as major risk factors for exacerbation in asthma, especially in the presence of both. However, whether patients with allergic asthma are more susceptible to respiratory infections requiring antibiotics remains unknown.ObjectiveTo investigate allergy as a risk factor for respiratory infections requiring antibiotics based on register data from a nationwide population of patients with asthma.MethodsA register-based prospective follow-up study was performed using the Danish prescription database. In the inclusion period from 2010 through 2011, we identified patients with allergic asthma 18 to 44 years old. Patients were investigated during the follow-up period from 2012 through 2013, depending on their prescription drug use of antiallergic medication and antibiotics. Odds ratios were adjusted for age, sex, asthma severity, education, and urban vs rural residence.ResultsIn a nationwide population we identified 60,415 patients with asthma. Based on prescriptions fillings for antiallergic medication, patients were subdivided into (1) nonallergic asthma (n = 35,334, 51.5%) and (2) allergic asthma (n = 25,081, 48.5%). Allergic asthma was associated with an increased risk of filling at least 2 antibiotic prescriptions per year compared with nonallergic asthma (odds ratio 1.28, 95% confidence interval 1.24–1.33, P < .0001). Interestingly, a subgroup analysis showed a protective effect of immunotherapy against the risk of requiring antibiotics (odds ratio 0.76, 95% confidence interval 0.66–0.87, P = .0001).ConclusionPatients with allergic asthma have an increased risk of being prescribed antibiotics for respiratory infections compared with those with nonallergic asthma. Treatment with allergen immunotherapy appears to have a protective effect against this risk.
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Home-based subcutaneous immunoglobulin therapy vs hospital-based intravenous immunoglobulin therapy: A prospective economic analysis
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Lisa W. Fu, Christine Song, Wanrudee Isaranuwatchai, Stephen Betschel
BackgroundHome-based subcutaneous immunoglobulin (SCIg) administration used for immunoglobulin replacement therapy for patients with primary immunodeficiency has been demonstrated to have benefits compared with hospital-based intravenous immunoglobulin (IVIg) therapy.ObjectiveTo estimate the cost savings associated with treating eligible patients with primary immunodeficiency with home-based SCIg compared with hospital-based IVIg in a prospective study.MethodsThis study was a 12-month prospective observational study that collected information from patient charts, directly from the nurse for time spent with patients and materials used, and directly from the physicians for billing. Data were collected on case report forms at each follow-up. Data were entered in a web-based REDCap database and statistical comparisons were performed.ResultsThe average hospital (including hospital personnel such as nurses) and physician costs were significantly lower in the SCIg group ($1,836 and $84, respectively) than in the IVIg group ($4,187 and $744, respectively), which supported the findings in the number of hospital and physician visits in each group. The total cost was reported from the hospital's (only hospital-related costs) and the health system's (hospital- and physician-related costs) perspectives. For the 2 perspectives, the SCIg group reported significantly lower average total costs than the IVIg group.ConclusionThis is the first prospective analysis of the cost savings associated with home-based SCIG therapy compared with hospital-based IVIG therapy. These findings could help justify provision of home-based therapy training to suitable patients to lower health care costs or improve the capacity of care.
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Penicillin skin testing without minor determinate mixture and amoxicillin challenge in the Appalachian region
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Nicolas Mungo, Keerthi Reddy, Jan Gutierrez-Sereno, Sonia Lopez-Alvarez, Alexei Gonzalez-Estrada
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Allergic sensitization and sleep in children with asthma
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Tomoyuki Kawada
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Recent advances in asthma
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Bradley E. Chipps, Chitra Dinakar, Stanley M. Fineman, Stephen A. Tilles
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What can we learn about predictors of atopy from birth cohorts and cord blood biomarkers?
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Mallory J. Gallant, Anne K. Ellis
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Information for Readers
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
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Current insights in allergen immunotherapy
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Giovanni Passalacqua, Diego Bagnasco, Matteo Ferrando, Enrico Heffler, Francesca Puggioni, Giorgio Walter Canonica
ObjectiveAllergen-specific immunotherapy (AIT) in its subcutaneous and sublingual forms is currently a well-established and experimentally supported treatment for respiratory allergy and hymenoptera venom allergy. There have been advances in its use linked strictly to the advancement in the knowledge of the molecular mechanisms of allergy, the production of well-characterized extracts, and diagnostic techniques. The use of AIT in asthma and the application of new approaches are expanding. We briefly review the advances and concerns in the use of AIT.Data SourcesPubMed and Scopus.Study SelectionsThe most recent and clinically relevant literature was selected and reviewed.ResultsThe introduction of high-quality products supported by large dose-finding trials has yielded better defined indications, contraindications, and modalities of use. Some specific products in tablet form have recently been approved in the United States. Sublingual immunotherapy has been found to be effective in asthma, which until recently had been a matter of debate. Another promising therapy is oral and sublingual desensitization for food allergy, for which encouraging results have recently been reported. In the near future, other options will be available, including new routes of administration (intralymphatic and epicutaneous), allergoids, engineered allergens, and peptides. The use of component-resolved diagnosis techniques will further refine and target AIT prescriptions.ConclusionThis condensed and updated review shows that AIT remains a viable treatment option, especially after the introduction of standardized tablets for some allergens. Food allergy and new administration routes represent a promising expansion.
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Table of Contents
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
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Instructions for Authors
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
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Editorial Board
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
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Clinical and economic burden of hospitalizations with registration of penicillin allergy
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Bernardo Sousa-Pinto, António Cardoso-Fernandes, Luís Araújo, João Almeida Fonseca, Alberto Freitas, Luís Delgado
BackgroundPenicillin allergy is commonly reported, but only a minority of claimants has a confirmed diagnosis. Nevertheless, patients labeled as having penicillin allergy are treated with second-line antibiotics, which are more expensive and less effective, possibly increasing the risk of drug-resistant infections.ObjectiveTo compare hospitalizations with and without registration of penicillin allergy concerning their morbidity and hospital resource use.MethodsWe analyzed a national administrative database containing a registration of all Portuguese hospitalizations from 2000 to 2014. All episodes occurring in adults with a penicillin allergy registration were compared with an equal number of hospitalizations without such registration and matched for inpatients' age, sex, and main diagnosis. We compared those episodes concerning their length of stay, hospital price charges, comorbidities, and frequency of drug-resistant infections. Differences between medical and surgical hospitalizations were explored.ResultsHospitalizations with registration of penicillin allergy (n = 102,872) had a longer average length of stay than the remainder episodes (8 vs 7 days; P < .001) and higher hospital charges (3,809.0 vs 3,490.0 USD; P < .001). Inpatients with penicillin allergy registration also had a higher mean Charlson Comorbidity Index (0.91 vs 0.76; P < .001) and a significantly higher frequency of infections by several agents, including methicillin-resistant Staphylococcus aureus, Enterococcus species, and Escherichia coli. Among surgical episodes, septicemia was 1.2-fold more frequent among penicillin allergy cases.ConclusionHospitalizations with registration of penicillin allergy are associated with increased economic costs and frequency of infections by drug-resistant agents, reinforcing the need to establish a correct diagnosis of penicillin allergy.
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Is the better part of valor truly discretion?
Source:Annals of Allergy, Asthma & Immunology, Volume 120, Issue 2
Author(s): Matthew Greenhawt, John J. Oppenheimer
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Posterior Nasal Pack After Transpalatal Excision of Juvenile Nasopharyngeal Angiofibroma: Can It be Avoided?
Abstract
The evolution of the packing of postnasal space following transpalatal excision of JNA in the last 7 decades is described and a modification is presented for minimizing the immediate postoperative morbidity.
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Safety and efficacy of peri-operative administration of hydroxyethyl starch in children undergoing surgery: A systematic review and meta-analysis
BACKGROUND Hydroxyethyl starch (HES) solutions have shown their efficiency for intravascular volume expansion. However, a safety recommendation limiting their use in adult patients has recently been made. The aim of this meta-analysis was to assess the efficacy and adverse effects of HES when administered intra-operatively to paediatric patients. METHODS A search was performed for randomised controlled trials (RCTs) published before December 2016 involving paediatric patients who received 6% low molecular weight HES. Reviewers extracted valid data, including peri-operative total fluid intakes, mortality, renal function, coagulation tests, blood loss and length of hospital and ICU stay. All data were analysed using classical mean differences [and their 95% confidence intervals (CIs)] and trial sequential analysis. A Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification was performed for all outcomes. RESULTS Nine RCTs involving 530 peri-operative paediatric patients were analysed. Compared with other fluids, HES did not significantly modify the amount of peri-operative fluid administered [mean difference 0.04; 95% CI (−1.76 to 1.84) ml kg−1], urine output [mean difference −33; 95% CI (−104 to 38) ml kg−1] or blood loss [mean difference −0.09; (−0.32 to 0.15) ml kg−1]. Trial sequential analysis determined that the outcomes for peri-operative fluid and urine output were underpowered. Finally, all results were graded as very low quality of evidence. CONCLUSION Intravascular volume expansion with low molecular weight 6% HES did not appear to modify renal function, blood loss or transfusion when administered to children during the peri-operative period. However, given the lack of statistical power and the very low GRADE quality of evidence, more high-quality RCTs are needed to explore these outcomes. Correspondence to Prof. Gilles Orliaguet, MD, PhD, Service d'Anesthésie Réanimation, Hôpital Universitaire Necker-Enfants Malades, 149 rue de Sèvres, Paris 75743, France Tel: +33 144494458; fax: +33 144494170; e-mail: gilles.orliaguet@aphp.fr Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://ift.tt/2ylyqmW). © 2018 European Society of Anaesthesiology
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Patient factors and outcomes associated with the withdrawal or withholding of life-sustaining therapies in mechanically ventilated brain-injured patients: An observational multicentre study
BACKGROUND Knowledge of the factors associated with the decision to withdraw or withhold life support (WWLS) in brain-injured patients is limited. However, most deaths in these patients may involve such a decision. OBJECTIVES To identify factors associated with the decision to WWLS in brain-injured patients requiring mechanical ventilation who survive the first 24 h in the ICU, and to analyse the outcomes and time to death. DESIGN A retrospective observational multicentre study. SETTINGS Twenty French ICUs in 18 university hospitals. PATIENTS A total of 793 mechanically ventilated brain-injured adult patients. INTERVENTIONS None. MAIN OUTCOME MEASURES Decision to WWLS within 3 months of ICU admission, and death or Glasgow Outcome Scale (GOS) score at day 90. RESULTS A decision to WWLS was made in 171 patients (22%), of whom 89% were dead at day 90. Out of the 247 deaths recorded at day 90, 153 (62%) were observed after a decision to WWLS. The median time between admission and death when a decision to WWLS was made was 10 (5 to 20) days vs. 10 (5 to 26) days when no end-of-life decision was made (P
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Maternal depressive symptoms and adolescent academic attainment: Testing pathways via parenting and self-control
Ng-Knight, T; Shelton, KH; Frederickson, N; McManus, IC; Rice, F; (2018) Maternal depressive symptoms and adolescent academic attainment: Testing pathways via parenting and self-control. Journal of Adolescence , 62 pp. 61-69. 10.1016/j.adolescence.2017.11.003 .
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Dissociating Landmark Stability from Orienting Value Using Functional Magnetic Resonance Imaging
Auger, SD; Maguire, EA; (2018) Dissociating Landmark Stability from Orienting Value Using Functional Magnetic Resonance Imaging. Journal of Cognitive Neuroscience 10.1162/jocn_a_01231 . (In press).
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Self-propelled upspring jump regime in nanoscale droplet collisions: a molecular dynamics study
Zhang, YR; Jiang, X; Chen, YR; Luo, K; (2018) Self-propelled upspring jump regime in nanoscale droplet collisions: a molecular dynamics study. Communications in Computational Physics (In press).
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A Hybrid Approach to Thematic Analysis in Qualitative Research: Using a Practical Example
Swain, J; (2018) A Hybrid Approach to Thematic Analysis in Qualitative Research: Using a Practical Example. Sage research methods 10.4135/9781526435477 . Green open access
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Bioprocess microfluidics: applying microfluidic devices for bioprocessing
Marques, MPC; Szita, N; (2017) Bioprocess microfluidics: applying microfluidic devices for bioprocessing. [Review]. Current Opinion in Chemical Engineering , 18 pp. 61-68. 10.1016/j.coche.2017.09.004 . Green open access
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Simplified immobilisation method for histidine-tagged enzymes in poly(methyl methacrylate) microfluidic devices
Kulsharova, G; Dimov, N; Marques, MPC; Szita, N; Baganz, F; (2017) Simplified immobilisation method for histidine-tagged enzymes in poly(methyl methacrylate) microfluidic devices. New Biotechnology 10.1016/j.nbt.2017.12.004 . Green open access
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Arylboronate esters mediated self-healable and biocompatible dynamic G-quadruplex hydrogels as promising 3D-bioinks
Biswas, A; Malferrari, S; Kalaskar, DM; Das, AK; (2018) Arylboronate esters mediated self-healable and biocompatible dynamic G-quadruplex hydrogels as promising 3D-bioinks. Chemical Communications 10.1039/c7cc09051j . (In press).
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Use of Electroencephalography Brain-Computer Interface Systems as a Rehabilitative Approach for Upper Limb Function After a Stroke: A Systematic Review
Monge-Pereira, E; Ibanez-Pereda, J; Alguacil-Diego, IM; Serrano, JI; Spottorno-Rubio, MP; Molina-Rueda, F; (2017) Use of Electroencephalography Brain-Computer Interface Systems as a Rehabilitative Approach for Upper Limb Function After a Stroke: A Systematic Review. PM&R , 9 (9) pp. 918-932. 10.1016/j.pmrj.2017.04.016 .
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Prevention and early intervention for borderline personality disorder: a novel public health priority
Chanen, A; Sharp, C; Hoffman, P; (2017) Prevention and early intervention for borderline personality disorder: a novel public health priority. World Psychiatry , 16 (2) pp. 215-216. 10.1002/wps.20429 .
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The sensitivity of the human thirst response to changes in plasma osmolality: a systematic review.
Hughes, F; Mythen, M; Montgomery, H; (2018) The sensitivity of the human thirst response to changes in plasma osmolality: a systematic review. [Review]. Perioperative Medicine , 7 , Article 1. 10.1186/s13741-017-0081-4 . Green open access
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Photoactivity of New Octacationic Magnesium(II) and Zinc(II) Porphyrazines in a Water Solution and G-Quadruplex Binding Ability of Differently Sized Zinc(II) Porphyrazines
Sciscione, F; Manoli, F; Viola, E; Wankar, J; Ercolani, C; Donzello, MP; Manet, I; (2017) Photoactivity of New Octacationic Magnesium(II) and Zinc(II) Porphyrazines in a Water Solution and G-Quadruplex Binding Ability of Differently Sized Zinc(II) Porphyrazines. Inorganic Chemistry , 56 (21) pp. 12795-12808. 10.1021/acs.inorgchem.7b01557 .
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Income Effects and the Welfare Consequences of Tax in Differentiated Product Oligopoly
Nesheim, LP; Griffith, R; O'Connell, M; (2018) Income Effects and the Welfare Consequences of Tax in Differentiated Product Oligopoly. Quantitative Economics (In press). Green open access
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Fretting and Corrosion Between a Metal Shell and Metal Liner May Explain the High Rate of Failure of R3 Modular Metal-on-Metal Hips
Ilo, KC; Derby, EJ; Whittaker, RK; Blunn, GW; Skinner, JA; Hart, AJ; (2016) Fretting and Corrosion Between a Metal Shell and Metal Liner May Explain the High Rate of Failure of R3 Modular Metal-on-Metal Hips. The Journal of Arthroplasty , 32 (5) pp. 1679-1683. 10.1016/j.arth.2016.12.024 . Green open access
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A cluster randomised controlled trial of a staff-training intervention in residential units for people with long-term mental illness in Portugal: the PromQual trial
Cardoso, G; Papoila, A; Tome, G; Killaspy, H; King, M; Caldas-de-Almeida, JM; (2017) A cluster randomised controlled trial of a staff-training intervention in residential units for people with long-term mental illness in Portugal: the PromQual trial. Social Psychiatry and Psychiatric Epidemiology , 52 (11) pp. 1435-1445. 10.1007/s00127-017-1416-7 .
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Relationship between national mental health expenditure and quality of care in longer-term psychiatric and social care facilities in Europe: cross-sectional study
Salisbury, TT; Killaspy, H; King, M; (2017) Relationship between national mental health expenditure and quality of care in longer-term psychiatric and social care facilities in Europe: cross-sectional study. The British Journal of Psychiatry , 211 (1) pp. 45-49. 10.1192/bjp.bp.116.186213 .
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Rapid realist review of the evidence: achieving lasting change when mental health rehabilitation staff undertake recovery-oriented training
Gee, M; Bhanbhro, S; Cook, S; Killaspy, H; (2017) Rapid realist review of the evidence: achieving lasting change when mental health rehabilitation staff undertake recovery-oriented training. [Review]. Journal of Advanced Nursing , 73 (8) pp. 1775-1791. 10.1111/jan.13232 .
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601 metal-on-metal total hip replacements with 36 mm heads a 5 minimum year follow up: Levels of ARMD remain low despite a comprehensive screening program
Atrey, A; Hart, A; Hussain, N; Waite, J; Shepherd, AJ; Young, S; (2017) 601 metal-on-metal total hip replacements with 36 mm heads a 5 minimum year follow up: Levels of ARMD remain low despite a comprehensive screening program. Journal of Orthopaedics , 14 (1) pp. 108-114. 10.1016/j.jor.2016.10.023 .
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Cryptococcal meningitis in apparently immunocompetent patients: association with idiopathic CD4+ lymphopenia
Shribman, S; Noyce, A; Gnanapavan, S; Lambourne, J; Harrison, T; Schon, F; (2017) Cryptococcal meningitis in apparently immunocompetent patients: association with idiopathic CD4+ lymphopenia. Practical Neurology 10.1136/practneurol-2017-001800 . (In press). Green open access
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The relationship between deinstitutionalization and quality of care in longer-term psychiatric and social care facilities in Europe: A cross-sectional study
Salisbury, TT; Killaspy, H; King, M; (2017) The relationship between deinstitutionalization and quality of care in longer-term psychiatric and social care facilities in Europe: A cross-sectional study. European Psychiatry , 42 pp. 95-102. 10.1016/j.eurpsy.2016.11.011 .
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Stapes Surgery Teaching Tool: A Simple, Stable and Successful Technique
Abstract
Stapes surgery is a highly skilled surgery among otological procedures and needs a good dexterity. To improve the skills one may need to do procedures using temporal bone dissections. We describe a procedure that is simple, inexpensive and improves the skills and can be done using easily available materials like disposable syringe, stapler pin and a forceps.
http://ift.tt/2nHLKPe
The development of progesterone-loaded nanofibers using pressurized gyration: a novel approach to vaginal delivery for the prevention of pre-term birth
Craig, DQM; Raimi-Abraham, B; Brako, F; Edirisinghe, M; Mahalingam, S; (2018) The development of progesterone-loaded nanofibers using pressurized gyration: a novel approach to vaginal delivery for the prevention of pre-term birth. International Journal of Pharmaceutics (In press).
http://ift.tt/2sgOCqQ
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