Medicine by Sfakianakis Alexandros: 02/27/18

Although uveitis is reported as a rare adverse event (AE) associated with dabrafenib/trametinib therapy or nivolumab, the occurrence of severe uveitis is extremely rare. We describe two cases of Vogt–Koyanagi–Harada (VKH)-like uveitis developing after the sequential administration of nivolumab and dabrafenib/trametinib therapy. Interestingly, both cases had HLA-DRB1*04:05, which is strongly associated with VKH disease, and achieved biologically complete remission after the treatment for uveitis. Our cases suggest a possible correlation between VKH-like uveitis as an AE and the clinical outcomes of sequential administration of nivolumab and dabrafenib/trametinib therapy for the treatment of advanced melanoma.

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Unusual association between digital mucous cyst and acquired ungual fibrokeratoma: A case report

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Case of pyoderma gangrenosum-like sporotrichosis caused by Sporothrix globosa in a patient with ulcerative colitis

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Landiolol hydrochloride to successfully treat refractory ventricular arrhythmia during weaning from cardiopulmonary bypass

We effectively treated refractory ventricular arrhythmia (RVA) at the time of weaning from the cardiopulmonary bypass (CPB) during aortic valve replacement with landiolol for three patients who failed to respond to electrical defibrillation. Demographic data, comorbid factors, and preoperative finding were noted [Table 1].

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Human factors study in untrained adolescents comparing an epinephrine prefilled syringe (symjepi™) with EpiPen® autoinjector

Self- or caregiver administration of epinephrine is considered the treatment of choice for acute anaphylaxis (1). In June 2017, US FDA approved Symjepi™, a prefilled syringe used for the administration of epinephrine (2).

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Uses of biologics in allergic diseases: what to choose and when

Choosing a biologic therapy for asthma, urticaria, atopic dermatitis, or nasal polyps should be based on disease phenotype, relevant biomarkers, comorbid allergic conditions, and FDA approval status.

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The Eosinophil: for better or worse, in sickness and in health

Key messages

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Epinephrine auto-injector needle lengths can both subcutaneous and periosteal/intraosseous injection be avoided?

Administration of epinephrine should be intramuscularly in the anterolateral aspect of the thigh. The length of the epinephrine autoinjector, EAI, needle should assure intramuscular injection.

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Surgical Care and Otolaryngology in Global Health

Surgical access is inadequate for most people. The Lancet Commission on Global Surgery established 6 indicators to measure surgical access: geographic accessibility, density of surgical providers, number of procedures performed, perioperative mortality, impoverishing expenditure, and catastrophic expenditure. Otolaryngology surgical, training, and research efforts use these 6 indicators to maximize impact and coordination of worldwide efforts in surgery. Research must be rigorous and consider the counterfactual. For otolaryngologists who want to contribute, focusing on 1 of the 6 indicators may be most impactful.

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Workforce Considerations, Training, and Diseases in Africa

Surgeons in sub-Saharan Africa face different challenges than those in developed countries: extreme shortages of otolaryngologists, speech pathologists, and audiologists; lack of training opportunities; and a paucity of otolaryngology services aggravated by population growth and aging. In addition to common Western diseases, patients have otolaryngology complications related to the human immunodeficiency virus, tuberculosis, malaria, and trauma. Less than 5% of the population has access to timely, safe, affordable surgery; 29 out of 52 African countries have no radiotherapy services. Discussion focuses on education and training, which can be achieved in several ways, some complimentary.

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Melanoma risk prediction using a multi-locus genetic risk score in the Women’s Health Initiative cohort

Single-nucleotide polymorphisms (SNPs) associated with melanoma have been identified though genome-wide association studies (GWASs). However, the combined impact of these SNPs on melanoma development remains unclear, particularly in post-menopausal women who carry lower melanoma risk.

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The Risk of Cardiovascular Events in Psoriasis Patients Treated with Tumor Necrosis Factor-alpha Inhibitors versus Phototherapy: An Observational Cohort Study

Psoriasis is a risk factor for cardiovascular events.

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Dermatologists are the primary treating physicians of skin cancer in the United States Medicare population

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Dermatology and climate change

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Title: Opioid, Alcohol, and Cannabis Misuse Among Patients with Hidradenitis Suppurativa: a population-based analysis in the United States

Patients with hidradenitis suppurativa (HS) experience chronic pain and have significant physical, emotional and psychological disease impact. These patients may be at risk for substance abuse.

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Surgical Pearl: Video chat to prevent wrong site surgery

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Similar survival of patients with multiple vs. single primary melanomas based on Utah SEER data (1973-2011)

Survival data are mixed comparing patients with multiple primary melanomas (MPM) to those with single primary melanomas (SPM).

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Correction for Woelders et al., Melanopsin- and L-cone-induced pupil constriction is inhibited by S- and M-cones in humans [Correction]

NEUROSCIENCE Correction for "Melanopsin- and L-cone–induced pupil constriction is inhibited by S- and M-cones in humans," by Tom Woelders, Thomas Leenheers, Marijke C. M. Gordijn, Roelof A. Hut, Domien G. M. Beersma, and Emma J. Wams, which was first published January 8, 2018; 10.1073/pnas.1716281115 (Proc Natl Acad Sci USA 115:792–797)....

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Correction for Goncalves et al., Fenofibrate prevents skeletal muscle loss in mice with lung cancer [Correction]

MEDICAL SCIENCES Correction for "Fenofibrate prevents skeletal muscle loss in mice with lung cancer," by Marcus D. Goncalves, Seo-Kyoung Hwang, Chantal Pauli, Charles J. Murphy, Zhe Cheng, Benjamin D. Hopkins, David Wu, Ryan M. Loughran, Brooke M. Emerling, Guoan Zhang, Douglas T. Fearon, and Lewis C. Cantley, which was first...

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Correction for Conforti et al., Faulty neuronal determination and cell polarization are reverted by modulating HD early phenotypes [Correction]

NEUROSCIENCE Correction for "Faulty neuronal determination and cell polarization are reverted by modulating HD early phenotypes," by P. Conforti, D. Besusso, V. D. Bocchi, A. Faedo, E. Cesana, G. Rossetti, V. Ranzani, C. N. Svendsen, L. M. Thompson, M. Toselli, G. Biella, M. Pagani, and E. Cattaneo, which was first...

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Temporal-prefrontal cortical network for discrimination of valuable obȷects in long-term memory [Psychological and Cognitive Sciences]

Remembering and discriminating objects based on their previously learned values are essential for goal-directed behaviors. While the cerebral cortex is known to contribute to object recognition, surprisingly little is known about its role in retaining long-term object–value associations. To address this question, we trained macaques to arbitrarily associate small or...

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Targeted DNA demethylation of the Arabidopsis genome using the human TET1 catalytic domain [Plant Biology]

DNA methylation is an important epigenetic modification involved in gene regulation and transposable element silencing. Changes in DNA methylation can be heritable and, thus, can lead to the formation of stable epialleles. A well-characterized example of a stable epiallele in plants is fwa, which consists of the loss of DNA...

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GABAergic inhibition of leg motoneurons is required for normal walking behavior in freely moving Drosophila [Neuroscience]

Walking is a complex rhythmic locomotor behavior generated by sequential and periodical contraction of muscles essential for coordinated control of movements of legs and leg joints. Studies of walking in vertebrates and invertebrates have revealed that premotor neural circuitry generates a basic rhythmic pattern that is sculpted by sensory feedback...

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Ridding fMRI data of motion-related influences: Removal of signals with distinct spatial and physical bases in multiecho data [Neuroscience]

"Functional connectivity" techniques are commonplace tools for studying brain organization. A critical element of these analyses is to distinguish variance due to neurobiological signals from variance due to nonneurobiological signals. Multiecho fMRI techniques are a promising means for making such distinctions based on signal decay properties. Here, we report that...

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Compartmentalization of antagonistic Ca2+ signals in developing cochlear hair cells [Neuroscience]

During a critical developmental period, cochlear inner hair cells (IHCs) exhibit sensory-independent activity, featuring action potentials in which Ca2+ ions play a fundamental role in driving both spiking and glutamate release onto synapses with afferent auditory neurons. This spontaneous activity is controlled by a cholinergic input to the IHC, activating...

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Suppression of RGSz1 function optimizes the actions of opioid analgesics by mechanisms that involve the Wnt/{beta}-catenin pathway [Neuroscience]

Regulator of G protein signaling z1 (RGSz1), a member of the RGS family of proteins, is present in several networks expressing mu opioid receptors (MOPRs). By using genetic mouse models for global or brain region-targeted manipulations of RGSz1 expression, we demonstrated that the suppression of RGSz1 function increases the analgesic...

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Targeting the cMET pathway augments radiation response without adverse effect on hearing in NF2 schwannoma models [Medical Sciences]

Neurofibromatosis type II (NF2) is a disease that needs new solutions. Vestibular schwannoma (VS) growth causes progressive hearing loss, and the standard treatment, including surgery and radiotherapy, can further damage the nerve. There is an urgent need to identify an adjunct therapy that, by enhancing the efficacy of radiation, can...

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Chimeric antigen receptor T cells form nonclassical and potent immune synapses driving rapid cytotoxicity [Immunology and Inflammation]

Chimeric antigen receptor T (CAR-T) cells are effective serial killers with a faster off-rate from dying tumor cells than CAR-T cells binding target cells through their T cell receptor (TCR). Here we explored the functional consequences of CAR-mediated signaling using a dual-specific CAR-T cell, where the same cell was triggered...

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Correction for Kleist et al., Chronic anthropogenic noise disrupts glucocorticoid signaling and has multiple effects on fitness in an avian community [Correction]

ECOLOGY Correction for "Chronic anthropogenic noise disrupts glucocorticoid signaling and has multiple effects on fitness in an avian community," by Nathan J. Kleist, Robert P. Guralnick, Alexander Cruz, Christopher A. Lowry, and Clinton D. Francis, which was first published January 8, 2018; 10.1073/pnas.1709200115 (Proc Natl Acad Sci USA 115:E648–E657). The...

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STING-dependent translation inhibition restricts RNA virus replication [Immunology and Inflammation]

In mammalian cells, IFN responses that occur during RNA and DNA virus infections are activated by distinct signaling pathways. The RIG-I–like-receptors (RLRs) bind viral RNA and engage the adaptor MAVS (mitochondrial antiviral signaling) to promote IFN expression, whereas cGAS (cGMP–AMP synthase) binds viral DNA and activates an analogous pathway via...

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The ZBED6-IGF2 axis has a maȷor effect on growth of skeletal muscle and internal organs in placental mammals [Genetics]

A single nucleotide substitution in the third intron of insulin-like growth factor 2 (IGF2) is associated with increased muscle mass and reduced subcutaneous fat in domestic pigs. This mutation disrupts the binding of the ZBED6 transcription factor and leads to a threefold up-regulation of IGF2 expression in pig skeletal muscle....

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CRISPR/Cas9 cleavages in budding yeast reveal templated insertions and strand-specific insertion/deletion profiles [Genetics]

Harnessing CRISPR-Cas9 technology provides an unprecedented ability to modify genomic loci via DNA double-strand break (DSB) induction and repair. We analyzed nonhomologous end-joining (NHEJ) repair induced by Cas9 in budding yeast and found that the orientation of binding of Cas9 and its guide RNA (gRNA) profoundly influences the pattern of...

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Pivotal roles of PCNA loading and unloading in heterochromatin function [Genetics]

In Saccharomyces cerevisiae, heterochromatin structures required for transcriptional silencing of the HML and HMR loci are duplicated in coordination with passing DNA replication forks. Despite major reorganization of chromatin structure, the heterochromatic, transcriptionally silent states of HML and HMR are successfully maintained throughout S-phase. Mutations of specific components of the...

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Long-term value memory in primates [Psychological and Cognitive Sciences]

Every year around Christmas we receive a visitor from the Nordic countries. A hawk keeps returning to a particular branch of a single tree throughout the entire winter, knowing that he will obtain daily treats with little effort. With the advent of spring, he happily returns to his breeding grounds,...

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Antibiotic killing through oxidized nucleotides [Microbiology]

The alarming global rise of antibiotic resistance among bacterial pathogens necessitates not only urgent discovery of new antibiotics but also practical strategies to preserve those that are currently used (1, 2). A system-level understanding of the killing mechanisms of bactericidal antibiotics holds the promise of shortening treatment time courses and...

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Interacting-heads motif has been conserved as a mechanism of myosin II inhibition since before the origin of animals [Cell Biology]

Electron microscope studies have shown that the switched-off state of myosin II in muscle involves intramolecular interaction between the two heads of myosin and between one head and the tail. The interaction, seen in both myosin filaments and isolated molecules, inhibits activity by blocking actin-binding and ATPase sites on myosin....

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Liprin-{alpha}3 controls vesicle docking and exocytosis at the active zone of hippocampal synapses [Neuroscience]

The presynaptic active zone provides sites for vesicle docking and release at central nervous synapses and is essential for speed and accuracy of synaptic transmission. Liprin-α binds to several active zone proteins, and loss-of-function studies in invertebrates established important roles for Liprin-α in neurodevelopment and active zone assembly. However, Liprin-α...

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Number of Obese Years — Not Just Obesity — a Distinct Risk Factor for Heart Damage

In an analysis of clinical data collected on more than 9,000 people, Johns Hopkins researchers have shown that the number of years spent overweight or obese appear to "add up" to a distinct risk factor that makes those with a longer history of heaviness more likely to test positive for a chemical marker of so-called "silent" heart damage than those with a shorter history

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Drugs With a REMS: Benefit/Risk Counseling to Patients

Do you know what to do when counseling a patient on a drug with a REMS designation? Learn more with new guidance from the FDA.
FDA Expert Commentaries and Interviews

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Diagnosis and endoscopic endonasal management of nontraumatic pseudoaneurysms of the cranial base

Background

Nontraumatic pseudoaneurysms of the cranial base are rare and present unique diagnostic and treatment dilemmas compared with both true aneurysms and pseudoaneurysms outside of the cranial base. There is a dearth of knowledge regarding the management of these complicated lesions.

Methods

Nontraumatic pseudoaneurysms of the cranial base internal carotid artery (ICA) were retrospectively identified at the University of Pittsburgh Medical Center through a key word search of cranial base cases from 2010 to 2017.

Results

Three cases were identified, demonstrating pseudoaneurysms of the cavernous and petrous ICA. Each patient underwent diagnostic work-up with computed tomography, magnetic resonance imaging, and angiography, followed by endovascular occlusion and endoscopic endonasal surgery, which resulted in relief of presenting complaints and ablation of the pseudoaneurysm.

Conclusion

Symptomatic cranial base pseudoaneurysms should undergo treatment to obliterate the aneurysm and relieve the mass effect. First, formal angiography is necessary for accurate diagnosis and treatment planning. Next, endovascular occlusion is performed, with a preference for coiling or endoluminal reconstruction with a flow diverter. Last, endoscopic intervention follows in cases where: (1) decompression of vital structures is indicated; (2) diagnosis of the pseudoaneurysm cannot be definitively confirmed with angiography; or (3) the etiology of the confirmed pseudoaneurysm requires further investigation.

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Management of long-lasting phantosmia: a systematic review

Background

Interest in the pathophysiology and management of phantom smells has increased rapidly over the last decade. A PubMed search for the term "phantosmia" demonstrated a near-doubling of articles published on phantosmia within the past 7 years. We aimed to systematically review the literature on the management of phantosmia.

Methods

The PubMed, EMBASE, and Cochrane databases were searched for articles published since January 1990, using terms combined with pertinent Boolean search operators. We included articles evaluating management of phantosmia written in the English language, with original data and a minimum of 6 months of follow-up, on at least 2 patients and with well-defined and measurable outcomes.

Results

A total of 2151 unique titles were returned upon the initial search. Of these, 146 abstracts were examined, yielding 7 articles meeting the inclusion criteria. All articles were predominantly level 4 evidence. One prospective level 3 study was included. The studies included a total of 96 patients, with follow-up ranging from 6 months to 11 years. Endpoints were primarily based on subjective patient responses. Management options included observation and medical and surgical therapy. Olfactory mucosa excision was the only surgical intervention studied, with short-term symptomatic improvement in 10 of 11 patients. Forty-one patients were treated medically, which included antipsychotic, antimigraine, and antiseizure medications, transcranial stimulation, and topical cocaine application.

Conclusion

Despite increasing interest in the treatment of phantosmia and reports of successful therapies, there remains a paucity of data and lack of consensus regarding optimal management of this difficult condition.

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A challenge-response endoscopic sinus surgery specific checklist as an add-on to standard surgical checklist: an evaluation of potential safety and quality improvement issues

Background

The goal of this study was to develop and evaluate the impact of an aviation-style challenge and response sinus surgery–specific checklist on potential safety and equipment issues during sinus surgery at a tertiary academic health center. The secondary goal was to assess the potential impact of use of the checklist on surgical times during, before, and after surgery. This initiative is designed to be utilized in conjunction with the "standard" World Health Organization (WHO) surgical checklist. Although endoscopic sinus surgery is generally considered a safe procedure, avoidable complications and potential safety concerns continue to occur. The WHO surgical checklist does not directly address certain surgery-specific issues, which may be of particular relevance for endoscopic sinus surgery.

Methods

This prospective observational pilot study monitored compliance with and compared the occurrence of safety and equipment issues before and after implementation of the checklist. Forty-seven consecutive endoscopic surgeries were audited; the first 8 without the checklist and the following 39 with the checklist. The checklist was compiled by evaluating the patient journey, utilizing the available literature, expert consensus, and finally reevaluation with audit type cases. The final checklist was developed with all relevant stakeholders involved in a Delphi method.

Results

Implementing this specific surgical checklist in 39 cases at our institution, allowed us to identify and rectify 35 separate instances of potentially unsafe, improper or inefficient preoperative setup. These incidents included issues with labeling of topical vasoconstrictor or injectable anesthetics (3, 7.7%) and availability, function and/or position of video monitors (2, 5.1%), endoscope (6, 15.4%), microdebrider (6, 15.4%), bipolar cautery (6, 15.4%), and suctions (12, 30.8%).

Conclusion

The design and integration of this checklist for endoscopic sinus surgery, has helped improve efficiency and patient safety in the operating room setting.

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Do you know your guidelines? Diagnosis and management of cutaneous head and neck melanoma

Abstract

The following article is the next installment of the series "Do You Know Your Guidelines?" presented by the Education Committee of the American Head and Neck Society. Guidelines for the prevention, diagnosis, workup, and management of cutaneous melanoma are reviewed in an evidence-based fashion.

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Change in alcohol and tobacco consumption after a diagnosis of head and neck cancer: Findings from head and neck 5000

Abstract

Background

Tobacco and alcohol consumption are risk factors for developing head and neck cancer, and continuation postdiagnosis can adversely affect prognosis. We explored changes to these behaviors after a head and neck cancer diagnosis.

Methods

Demographic and clinical data were collected from 973 people newly diagnosed with oral cavity, oropharyngeal, or laryngeal cancer. Tobacco and alcohol consumption were additionally collected 4 and 12 months later.

Results

The prevalence of high alcohol consumption reduced from 54.3% at diagnosis to 41.4% at 12 months, and smoking reduced from 21.0% to 11.7%. Changes in behavior were dynamic, for example, 44% of smokers at 12 months were not smoking at diagnosis or 4 months. Several factors were associated with alcohol consumption, whereas only tumor site and comorbidities were associated with smoking.

Conclusion

A diagnosis of head and neck cancer can result in important changes in alcohol consumption and smoking prevalence. However, these changes are dynamic in the first year after diagnosis.

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Supine positioning for the subscapular system of flaps: A pictorial essay

Abstract

Background

This pictorial essay demonstrates a modification to the positioning, prepping, and draping technique for the subscapular system of flaps allowing the patient to be placed supine and without the need for a second assistant during the harvest or closure.

Methods and Results

We performed a literature review focusing on the positioning of the patient during the harvest of the subscapular system of flaps. A supine modification harvest prepping, draping, and position is then described in pictorial essay format. The technique is made possible with the use of a Mayo stand to position the arm.

Discussion

A literature review demonstrates limited description of nonlateral decubitus position harvest of the scapular flap. A novel positioning technique is described in pictorial essay format to demonstrate the ease and feasibility without the need for a second assistant during the case, an important goal in the era of limited resident duty hours.

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Improved labelling for consumers with food allergy

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Issue Information

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Forthcoming Meetings

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Cover Image

The cover image, by Y. J. Jeon et al., is based on the Original Article Type III interferons are critical host factors that determine susceptibility to Influenza A viral infection in allergic nasal mucosa, DOI: 10.1111/cea.13082.

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Sunscreen habits and skin cancer rates in patients with vitiligo in Australia

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In reply

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Ultrasound versus fiberscope-guided tracheal intubation

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Probing resonant energy transfer in collisions of ammonia with Rydberg helium atoms by microwave spectroscopy

Zhelyazkova, V; Hogan, SD; (2017) Probing resonant energy transfer in collisions of ammonia with Rydberg helium atoms by microwave spectroscopy. The Journal of Chemical Physics , 147 (24) , Article 244302. 10.1063/1.5011406 .

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The UK Paediatric Familial Hypercholesterolaemia Register: Statin-related safety and 1-year growth data

Humphries, SE; Cooper, J; Dale, P; Ramaswami, U; FH Paediatric Register Steering Group, .; (2018) The UK Paediatric Familial Hypercholesterolaemia Register: Statin-related safety and 1-year growth data. Journal of Clinical Lipidology , 12 (1) pp. 25-32. 10.1016/j.jacl.2017.11.005 . Green open access

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Listening effort during sentence processing is increased for non-native listeners: a pupillometry study

Borghini, G; Hazan, VL; (2018) Listening effort during sentence processing is increased for non-native listeners: a pupillometry study. Frontiers in Neuroscience (In press).

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From “transitions in cities“ to “transitions of cities“: The diffusion and adoption of solar hot water systems in urban China

Huang, P; Castán Broto, V; Liu, Y; (2017) From "transitions in cities" to "transitions of cities": The diffusion and adoption of solar hot water systems in urban China. Energy Research and Social Science , 36 pp. 156-164. 10.1016/j.erss.2017.10.028 . Green open access

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Creative interventions for symptoms of postnatal depression: A process evaluation of implementation

Fancourt, D; Perkins, R; (2018) Creative interventions for symptoms of postnatal depression: A process evaluation of implementation. Arts & Health 10.1080/17533015.2017.1413398 . (In press).

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The Beaker phenomenon and the genomic transformation of northwest Europe

Olalde, I; Brace, S; Allentoft, ME; Armit, I; Kristiansen, K; Booth, T; Rohland, N; ... Reich, D; + view all Olalde, I; Brace, S; Allentoft, ME; Armit, I; Kristiansen, K; Booth, T; Rohland, N; Mallick, S; Szécsényi-Nagy, A; Mittnik, A; Altena, E; Lipson, M; Lazaridis, I; Harper, TK; Patterson, N; Broomandkhoshbacht, N; Diekmann, Y; Faltyskova, Z; Fernandes, D; Ferry, M; Harney, E; de Knijff, P; Michel, M; Oppenheimer, J; Stewardson, K; Barclay, A; Alt, KW; Liesau, C; Ríos, P; Blasco, C; Miguel, JV; García, RM; Fernández, AA; Bánffy, E; Bernabò-Brea, M; Billoin, D; Bonsall, C; Bonsall, L; Allen, T; Büster, L; Carver, S; Navarro, LC; Craig, OE; Cook, GT; Cunliffe, B; Denaire, A; Dinwiddy, KE; Dodwell, N; Ernée, M; Evans, C; Kuchařík, M; Farré, JF; Fowler, C; Gazenbeek, M; Pena, RG; Haber-Uriarte, M; Haduch, E; Hey, G; Jowett, N; Knowles, T; Massy, K; Pfrengle, S; Lefranc, P; Lemercier, O; Lefebvre, A; Martínez, CH; Olmo, VG; Ramírez, AB; Maurandi, JL; Majó, T; McKinley, JI; McSweeney, K; Mende, BG; Mod, A; Kulcsár, G; Kiss, V; Czene, A; Patay, R; Endrődi, A; Köhler, K; Hajdu, T; Szeniczey, T; Dani, J; Bernert, Z; Hoole, M; Cheronet, O; Keating, D; Velemínský, P; Dobeš, M; Candilio, F; Brown, F; Fernández, RF; Herrero-Corral, A-M; Tusa, S; Carnieri, E; Lentini, L; Valenti, A; Zanini, A; Waddington, C; Delibes, G; Guerra-Doce, E; Neil, B; Brittain, M; Luke, M; Mortimer, R; Desideri, J; Besse, M; Brücken, G; Furmanek, M; Hałuszko, A; Mackiewicz, M; Rapiński, A; Leach, S; Soriano, I; Lillios, KT; Cardoso, JL; Pearson, MP; Włodarczak, P; Price, TD; Prieto, P; Rey, P-J; Risch, R; Rojo Guerra, MA; Schmitt, A; Serralongue, J; Silva, AM; Smrčka, V; Vergnaud, L; Zilhão, J; Caramelli, D; Higham, T; Thomas, MG; Kennett, DJ; Fokkens, H; Heyd, V; Sheridan, A; Sjögren, K-G; Stockhammer, PW; Krause, J; Pinhasi, R; Haak, W; Barnes, I; Lalueza-Fox, C; Reich, D; - view fewer (2018) The Beaker phenomenon and the genomic transformation of northwest Europe. Nature 10.1038/nature25738 . (In press).

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Cleaning up after Gropius: an ethnography of dirt

Drazin, AM; Bredenbroeker, I; Knowles, R; Bloch, A; (2016) Cleaning up after Gropius: an ethnography of dirt. In: Bittner, R and Krasny, E, (eds.) On housekeeping and budgeting after Modernity. (pp. 160-167). Edition Bauhaus: Dessau, Germany.

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Automatic Multi-organ Segmentation on Abdominal CT with Dense V-networks

Gibson, E; Giganti, F; Hu, Y; Bonmati, E; Bandula, S; Gurusamy, K; Davidson, B; ... Barratt, DC; + view all Gibson, E; Giganti, F; Hu, Y; Bonmati, E; Bandula, S; Gurusamy, K; Davidson, B; Pereira, SP; Clarkson, MJ; Barratt, DC; - view fewer (2018) Automatic Multi-organ Segmentation on Abdominal CT with Dense V-networks. IEEE Transactions on Medical Imaging 10.1109/TMI.2018.2806309 . (In press). Green open access

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The cost of cooking a meal. The case of Nyeri County, Kenya

Fuso Nerini, F; Ray, C; Boulkaid, Y; (2017) The cost of cooking a meal. The case of Nyeri County, Kenya. Environmental Research Letters , 12 (6) , Article 065007. 10.1088/1748-9326/aa6fd0 . Green open access

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Very delayed lupus nephritis: a report of three cases and literature review

Alexandre, AR; Carreira, PL; Isenberg, DA; (2018) Very delayed lupus nephritis: a report of three cases and literature review. Lupus Sci Med , 5 (1) , Article e000241. 10.1136/lupus-2017-000241 . Green open access

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Posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as per ICD-11 proposals: A population study in Israel

Ben-Ezra, M; Karatzias, T; Hyland, P; Brewin, CR; Cloitre, M; Bisson, JI; Roberts, NP; ... Shevlin, M; + view all Ben-Ezra, M; Karatzias, T; Hyland, P; Brewin, CR; Cloitre, M; Bisson, JI; Roberts, NP; Lueger-Schuster, B; Shevlin, M; - view fewer (2018) Posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as per ICD-11 proposals: A population study in Israel. Depression and Anxiety 10.1002/da.22723 . (In press).

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Unexplained chronic liver disease in Ethiopia: a cross-sectional study

Orlien, SMS; Ismael, NY; Ahmed, TA; Berhe, N; Lauritzen, T; Roald, B; Goldin, RD; ... Johannessen, A; + view all Orlien, SMS; Ismael, NY; Ahmed, TA; Berhe, N; Lauritzen, T; Roald, B; Goldin, RD; Stene-Johansen, K; Dyrhol-Riise, AM; Gundersen, SG; Morgan, MY; Johannessen, A; - view fewer (2018) Unexplained chronic liver disease in Ethiopia: a cross-sectional study. BMC Gastroenterology , 18 , Article 27. 10.1186/s12876-018-0755-5 . Green open access

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Neutrinoless double beta decay in left-right symmetric models with a universal seesaw mechanism

Deppisch, FF; Hati, C; Patra, S; Pritimita, P; Sarkar, U; (2018) Neutrinoless double beta decay in left-right symmetric models with a universal seesaw mechanism. Physical Review D , 97 (3) , Article 035005. 10.1103/PhysRevD.97.035005 . Green open access

http://ift.tt/2FANeTb

Fluid shear stress modulation of hepatocyte-like cell function

Rashidi, H; Alhaque, S; Szkolnicka, D; Flint, O; Hay, DC; (2016) Fluid shear stress modulation of hepatocyte-like cell function. Archives of Toxicology , 90 (7) pp. 1757-1761. 10.1007/s00204-016-1689-8 . Green open access

http://ift.tt/2EYVqvn

Tracing transcontinental sand transport: From anatolia-zagros to the rub' al khali sand sea

Garzanti, E; Vermeesch, P; Al-Ramadan, KA; Ando, S; Limonta, M; Rittner, M; Vezzoli, G; (2017) Tracing transcontinental sand transport: From anatolia-zagros to the rub' al khali sand sea. Journal of Sedimentary Research , 87 (11) pp. 1196-1213. 10.2110/jsr.2017.65 .

http://ift.tt/2FAgnhh

Theoretical modeling of charge trapping in crystalline and amorphous Al2O3

Dicks, OA; Shluger, AL; (2017) Theoretical modeling of charge trapping in crystalline and amorphous Al2O3. Journal of Physics: Condensed Matter , 29 (31) , Article 314005. 10.1088/1361-648X/aa7767 . Green open access

http://ift.tt/2F0B3hh

Early life cognitive function and health behaviours in late childhood: testing the neuroselection hypothesis

Aggio, D; Smith, L; Hamer, M; (2018) Early life cognitive function and health behaviours in late childhood: testing the neuroselection hypothesis. JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH , 72 (1) pp. 41-46. 10.1136/jech-2017-208896 . Green open access

http://ift.tt/2FBRnGu

Reply to Comment on "Thermal history modelling: HeFTy vs. QTQt" by K. Gallagher and RA Ketcham

Vermeesch, P; Tian, Y; (2018) Reply to Comment on "Thermal history modelling: HeFTy vs. QTQt" by K. Gallagher and RA Ketcham. Earth-Science Reviews , 176 pp. 395-396. 10.1016/j.earscirev.2017.11.015 .

http://ift.tt/2EYVpHP

"Forget the 'Health and Care' and just call them Education Plans": SENCOs' perspectives on Education, Health and Care (EHC) plans

Boesley, L; Crane, LM; (2018) "Forget the 'Health and Care' and just call them Education Plans": SENCOs' perspectives on Education, Health and Care (EHC) plans. Journal of Research in Special Educational Needs (In press).

http://ift.tt/2FCe1OE

Playing Beowulf: Bridging computational thinking, arts and literature through game-making

De Paula, BH; Burn, A; Noss, R; Armando Valente, J; (2017) Playing Beowulf: Bridging computational thinking, arts and literature through game-making. International Journal of Child-Computer Interaction 10.1016/j.ijcci.2017.11.003 . (In press). Green open access

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The multi-receptor inhibitor axitinib reverses tumor-induced immunosuppression and potentiates treatment with immune-modulatory antibodies in preclinical murine models

Abstract

Cancer immunotherapies have significantly improved the prognosis of cancer patients. Despite the clinical success of targeting inhibitory checkpoint receptors, including PD-1 and/or CTLA-4 on T cells, only a minority of patients derive benefit from these therapies. New strategies to improve cancer immunotherapy are therefore needed. Combination therapy of checkpoint inhibitors with targeted agents has promisingly shown to increase the efficacy of immunotherapy. Here, we analyzed the immunomodulatory effects of the multi-receptor tyrosine kinase inhibitor axitinib and its efficacy in combination with immunotherapies. In different syngeneic murine tumor models, axitinib showed therapeutic efficacy that was not only mediated by VEGF–VEGFR inhibition, but also through the induction of anti-cancer immunity. Mechanistically, a significant reduction of immune-suppressive cells, including a decrease of tumor-promoting mast cells and tumor-associated macrophages was observed upon axitinib treatment. Inhibition of mast cells by axitinib as well as their experimental depletion led to reduced tumor growth. Of note, treatment with axitinib led to an improved T cell response, while the latter was pivotal for the therapeutic efficacy. Combination with immune checkpoint inhibitors anti-PD-1 and anti-TIM-3 and/or agonistic engagement of the activating receptor CD137 resulted in a synergistic therapeutic efficacy. This demonstrates non-redundant immune activation induced by axitinib via modulation of myeloid and mast cells. These findings provide important mechanistic insights into axitinib-mediated anti-cancer immunity and provide rationale for clinical combinations of axitinib with different immunotherapeutic modalities.

http://ift.tt/2FyshrP

Defective HLA class I antigen processing machinery in cancer

Abstract

Malignant transformation of cells is frequently associated with defective HLA class I antigen processing machinery (APM) component expression. This abnormality may have functional relevance, since it may have a negative impact on tumor cell recognition by cognate T cells. Furthermore, HLA class I APM abnormalities appear to have clinical significance, since they are associated with poor prognosis in several malignant diseases and may play a role in the resistance to immune checkpoint inhibitor-based immunotherapy. In this paper, we have reviewed the literature describing abnormalities in HLA class I APM component expression in many types of cancer. These abnormalities have been reported in all types of cancer analyzed with a frequency ranging between a minimum of 35.8% in renal cancer and a maximum of 87.9% in thyroid cancer for HLA class I heavy chains. In addition, we have described the molecular mechanisms underlying defects in HLA class I APM component expression and function by malignant cells. Lastly, we have discussed the clinical significance of HLA class I APM component abnormalities in malignant tumors.

http://ift.tt/2FBe0KS

Ipilimumab in metastatic melanoma patients with pre-existing autoimmune disorders

Abstract

Background

Ipilimumab and programmed death (PD) 1-antibodies are effective treatment options in metastatic melanoma. The safety and efficacy of ipilimumab in patients with pre-existing autoimmune disorders (AD) has only been evaluated in a selected number of patients.

Methods

We performed a retrospective analysis in 14 German skin cancer centers for patients with metastatic melanoma and pre-existing AD treated with ipilimumab.

Results

41 patients with 44 pre-existing AD were treated with ipilimumab (thyroiditis n = 15, rheumatoid n = 11, dermatologic n = 10, Crohn's disease/ulcerative colitis n = 3, neurological n = 2, sarcoidosis n = 2, pancreatitis n = 1). 3 out of 41 patients had two AD, 11 patients required immunosuppressants at the time of induction of ipilimumab. 12 patients (29.2%) experienced a flare of their pre-existing AD, mainly patients with rheumatoid or dermatologic diseases. Additional immune-related adverse events (irAEs) occurred in 12 patients (29.2%). In 23 patients (56%) neither a change of their AD nor additional irAEs were observed. Objective responses were seen in five patients (one complete remission, four partial remissions, 12.1%).

Conclusion

This is the largest series of patients with pre-existing AD and treatment with ipilimumab reported. Flares of pre-existing AD were observed but manageable. Response rates and occurrence of new irAEs were comparable to previous trials. Thus, in this patient subgroup, ipilimumab can be a treatment option after a thorough discussion of pros and cons and taking severity and activity of the preexisting AD into account.

http://ift.tt/2EZEcxG

Should catheter-directed thrombolysis be the standard of care for pregnancy-related iliofemoral deep vein thrombosis?

A 33-year-old, 8-week pregnant woman presented with mottling, pain and swelling of her left leg. Ultrasound Doppler scan revealed a large left iliofemoral deep vein thrombosis and the patient was diagnosed with phlegmasia cerulea dolens. After 24 hours of treatment with unfractionated heparin, there were minimal improvements in her symptoms. Catheter-directed thrombolysis was performed, following multidisciplinary consultation with the patient. An underlying May-Thurner lesion was identified and successfully stented. Radiation exposure to the fetus was minimised with the use of intravenous ultrasound and very low-dose fluoroscopy. Total radiation exposure to the fetus is 1.38 mGy, which is equivalent to 8 months of background radiation exposure. No immediate complication occurred and patient's symptoms completely resolved. On further follow-up, her iliofemoral veins remained patent with good flow and there were no recurrence of symptoms. A healthy infant was successfully delivered at 40 weeks gestation.

http://ift.tt/2sX7w6B

Primary spontaneous pneumothorax in conjunction with Marfan syndrome

A 25-year-old man with a history of Marfan syndrome, asthma and smoking presented with worsening dyspnoea and right-sided chest pain worsened with deep breathing after a fall 2 days prior. Diagnostic imaging revealed a spontaneous right-sided pneumothorax due to ruptured subpleural bullae in the apex of the right lung. Smaller subpleural bullae were also noted in the apex of the left lung. A chest tube was placed to reduce the right pneumothorax successfully.

http://ift.tt/2ozKmgZ

Persistent wrist monarthritis: down to the bone

A minority of osteoid osteomas are found to be juxta-articular and within the small bones of the wrist. We present a 30-year-old man diagnosed with an osteoid osteoma of the lunate bone, presenting with 3 years of left wrist pain, swelling and reduced range of motion. Given the patient's background and laboratory testing, consideration was given to both inflammatory and infectious causes and the diagnosis was delayed, requiring repeat interval imaging and assisted by multiple imaging modalities. Management by surgical excision led to resolution of pain and swelling. In cases of a prolonged isolated monarthritis, juxta-articular osteoid osteoma should be considered in the differential.

http://ift.tt/2ou1Dch

Ruptured hepatocellular carcinoma disguising as heterotopic pregnancy

The incidence of hepatocellular carcinoma (HCC) in pregnancy is rare but is typically aggressive, with a 1-year survival rate of 23%. One of the complications of HCC is spontaneous rupture, resulting in haemoperitoneum. A 36-year-old pregnant Chinese immigrant who was positive for hepatitis B virus and in her first trimester presented to the emergency department of Wyong Hospital, Hamlyn Terrace, New South Wales, Australia, with severe epigastric and right upper quadrant pain and haemodynamic instability. Spontaneous rupture of a heterotopic pregnancy was initially suspected. However, histopathological staining of the lesions excised during surgery revealed HCC. To our knowledge, this is the first case of spontaneous rupture of HCC with haemoperitoneum during pregnancy in Australia. As developed countries receive global migrants, similar cases may be seen in the future. Epidemiological studies suggest that immigrants from China and Vietnam have the highest incidence of chronic hepatitis B virus carrier status.

http://ift.tt/2oEv2Qy

'Barely a scratch: Capnocytophaga canimorsus causing prosthetic hip joint infection following a dog scratch

Capnocytophaga canimorsus is a commensal organism commonly found in the oral cavity of cats and dogs. Infections with this organism are rare and can affect both immunocompetent and immunocompromised individuals. The authors present a case of C. canimorsus causing indolent prosthetic hip joint infection in a healthy 66-year-old woman following a history of being scratched by her pet dog. The patient had an atypical history of chronic, low-grade infection which is unusual, as this organism is more frequently associated with acute presentations and fulminant sepsis. This patient was treated successfully with a two-stage exchange of her hip prosthesis and broad-spectrum antibiotics.

C. canimorsus is a very rare cause of prosthetic joint infection but an important pathogen to consider, particularly in culture-negative joint infections and a history of animal exposure.

http://ift.tt/2otIiYS

Obstructive uropathy from complete bladder and bilateral ureteral incarceration within an inguinal hernia

A 59-year-old man with a medical history of hypertension, gout and obesity presented to the hospital with a chief complaint of worsening scrotal oedema. The patient endorsed associated symptoms of decreased force of stream on urination, stranguria and hesitancy with slight dysuria. Physical exam showed an effaced umbilicus and phallus with a hidden scrotum estimated to be 30x20x30 cm in size. Imaging and lab findings led to a diagnosis of total bladder herniation within an incarcerated right inguinal hernia. Surgical repair of the inguinal hernia and replacement of the bladder and ureters led to a resolution of urinary symptoms with no evidence of vesicoureteral reflux or urinary retention.

http://ift.tt/2oBKLQ7

Teriparatide-induced atrial tachycardia

We present the case of a patient who presented with worsening chest pain and tachycardia. We were able to monitor her remotely through her pacemaker. She had been started on the injectable medication teriparatide (Forteo) and since then she had an increase in her symptoms. She was found to have intermittent atrial tachycardia with 1:1 conduction and occasional atrioventricular block transiently, coinciding with her injection of teriparatide. This specific-associated arrhythmia has yet to be described.

http://ift.tt/2CoklKV

The man that lost (part of) his mind

An 84-year-old man presented to the emergency department following recurrent falls over several weeks and onset of new left-sided weakness. CT of the brain revealed a large air cavity (pneumatocoele) in the right frontal lobe thought to be secondary to an ethmoidal osteoma communicating through the cribriform plate allowing air to be forced into the skull under pressure. Subsequent MRI confirmed these findings and also revealed a small focal area of acute infarction in the adjacent corpus callosum. The patient had a prolonged hospital stay, declined neurosurgical intervention and was discharged home on secondary stroke prevention.

http://ift.tt/2oBgDEt

Use of oral immunosuppressive drugs in the treatment of atopic dermatitis in the Netherlands

Abstract

Background

Although atopic dermatitis (AD) is a very common skin disease, data on the percentage of patients with really difficult to treat AD are scarce. From socio-economic perspective it is important to have more insight in these numbers, as new very effective, but expensive, treatment options will be available in the near future for difficult to treat AD. Estimating the number of AD patients using oral immunosuppressive drugs can give an impression of the percentage of difficult to treat patients in the total AD population.

Objective

To give an overview of the use of oral immunosuppressive drugs in patients with AD in the Netherlands.

Methods

Prescription data of oral immunosuppressive drugs in the Netherlands were extracted from a pharmaceutical database (NControl) containing data of 557 million prescriptions and 7.2 million patients. An algorithm, based on the WHO Anatomical Therapeutic Chemical (ATC) codes, was used to identify patients with AD. The prescription of oral immunosuppressive drugs in patients with AD between January 1^st 2012 and January 1^st 2017 was evaluated.

Results

Based on the algorithm, 65 943 patients with AD were selected. 943 AD patients (1.4%) used cyclosporine A, methotrexate, azathioprine or mycophenolic acid. Methotrexate was most commonly used, followed by azathioprine and cyclosporine A. A switch in medication was rarely seen. In the evaluation period a decrease in the prescription of cyclosporine A was seen, together with an increase of the prescription of methotrexate. In 31% of the patients who stopped treatment, the discontinuation took place within the first months of treatment.

Conclusion

In this study population, 1.4% of the AD patients used oral immunosuppressive drugs for their eczema in a five year period. Methotrexate was the most commonly used systemic drug in the Netherlands for the treatment of AD.

http://ift.tt/2oA2840

Surgical treatment of hidradenitis suppurativa: an analysis of postoperative outcome, cosmetic results and quality of life in 255 patients

Abstract

Background

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease with increasing incidence. Severe disease stages are seen as a therapeutic challenge and pose the threat of significant restrictions in patients' life quality.

Objectives

We evaluated postoperative outcome after wide local excision for HS as well as postoperative course, cosmetic results, disease recurrence and quality of life.

Methods

All patients receiving radical surgical treatment for HS (Hurley III) between 2006-2015 were identified and received a letter-based survey. They were asked about postoperative course, cosmetic results, recurrence and life quality.

Results

255 patients (103 men, 152 women) answered the questionnaire. 95% of patients reported disease-specific restrictions in everyday life. 72% of patients did not experience any postoperative adverse events, however, postoperative pain with need for analgesics was reported in 38%. The majority of patients (80%) were very satisfied or satisfied after surgery, 85% of patients would recommend surgery to other affected persons.

Limitations

The retrospective design of the study was a limitation.

Conclusions

The well-known negative psychological and social effects are a relevant part of HS and emphasize the importance of immediate therapy. Since long-lasting local disease-control can be achieved, surgery should be considered as first-line therapy.

http://ift.tt/2EZ32Sk

Thumb necrotic ulcers caused by weeverfish. Case report and review of the literature

Abstract

a 59-year-old Caucasian man presented to our department with a three weeks history of erythema and edema of the left hand, and a necrotic ulcer of the left thumb, after a holiday in Greece, associated with extreme pain. No other skin or mucosal lesions were present. Systemic symptoms such as nausea, vomiting, hypotension, seizures, cardiac arrhythmias, or paralysis were denied. The local erythematous reaction started after fishing, during which the patient was attacked by a weeverfish (Fig. 1A); the wound was treated with topical antiseptics and antibioticum ointments, and seemed to granulate, but in the following week massive edema of the left hand developed (Fig. 1B), together with a rapidly progressive necrotic ulceration of the left thumb (Fig. 1C).

http://ift.tt/2BTBkUu

Imiquimod anal tampons treatment of anal intraepithelial neoplasia

Abstract

The prevalence of Human Papillomavirus (HPV) in men who have sex with men (MSM) is high, reaching 85-93% prevalence in HIV-positive men. High-risk HPV are strongly associated with development of high degrees of anal intraepithelial neoplasia (AIN) which, later on, can develop in anal squamous carcinoma. The growing incidence of anal cancer during last years is particularly important in MSM and HIV-positive patients, in which the coexistence of multiple serotypes of HPV reduces the probability of eliminating the AIN. The treatments for anal dysplasia have shown limited effectiveness. Imiquimod (1-[2-methylpropyl]-1H-imidazo-[4,5-c]-quinolin-4-amine) has been successfully used for different neoplasia.

http://ift.tt/2osAHtw

Insulin resistance in hidradenitis suppurativa: a case-control study

Abstract

Background

The association between chronic inflammatory diseases, such as rheumatoid arthritis and psoriasis, and insulin resistance (IR) has been well established. Hidradenitis suppurativa (HS) is a chronic inflammatory cutaneous disease that affects the apocrine gland-bearing areas of the body.

Objective

We aimed to determine the prevalence of IR in patients with HS.

Methods

This cross-sectional, case-control study enrolled 137 subjects, 76 patients with HS and 61 age- and gender-matched controls. Demographic data, clinical examination of HS patients, anthropometric measures, cardiovascular risk factors and laboratory studies were recorded. The homeostasis model assessment of IR (HOMA-IR) was calculated in all participants by measuring fasting plasma glucose and insulin levels.

Results

The median (IQR) HOMA-IR value in HS patients was significantly higher [2.0 (1.0-3.6)] than in controls [1.5(0.9-2.3)] (p=0.01). The prevalence of IR was significantly higher in cases (43.4%) compared with controls (16.4%) (p=0.001). In the linear regression multivariable analysis after adjusting for age, sex and body mass index (BMI), HS remained as a significant factor for a higher HOMA-IR [2.51(0.18) vs 1.92(0.21); p=0.04]. The HOMA-IR value and the prevalence of IR did not differ significantly among HS patients grouped by severity of the disease.

Conclusion

Our results show an increased frequency of IR in HS. Thus, we suggest HS patients to be evaluated for IR and managed accordingly.

http://ift.tt/2BWqnlg

Effect of atopic skin stressors on natural moisturizing factors and cytokines in healthy adult epidermis

Abstract

Background

Epidermal deficiency of filaggrin, and the derived natural moisturizing factors (NMF), is associated with increased risk of atopic dermatitis (AD). While filaggrin gene mutations cause filaggrin deficiency, there is limited insight in causative environmental factors.

Objective

To explore the effect of selected exogenous skin stressors on NMF and skin cytokines levels in healthy adult epidermis.

Material and methods

40 healthy volunteers (18-49 years) were exposed to hard, soft, and chlorinated water, 0.5% SLS, house dust mite, cat allergen, staphylococcal enterotoxin B (SEB), cooling and histamine. Participants were tape-stripped and biophysiological measurements were performed. NMF was determined after 24 and 48 hours, while skin cytokines were measured after 24 hours for selected exposures.

Results

At 24 hours, a significant decrease in NMF was observed for soft (0.51±0.19) and hard water (0.61±0.32) compared to occlusion alone (0.71±0.18). Hard water led to increased levels of IL-4, IFN-ɣ and IL-10. Exposure to house dust mite and SEB led to a significant decrease in NMF after 24 hours (0.77 ±0.28 and 0.80±0.28, respectively) compared to occlusion alone (1.00±0.42). House dust mite led to an increase in IFN-ɣ, IL-2 and IL-4, as compared to the non-occluded control site.

Conclusion

Based on experimental exposure to selected atopic skin stressors such as different water types, allergens and SEB, we conclude that NMF levels are decreased along with increased secretion of various skin cytokines in healthy individuals. Our data highlight environmental factors that might play a role in AD pathophysiology, but needs confirmation in AD patients.

http://ift.tt/2GO6ege

Globular adiponectin acts as a melanogenic signal in human epidermal melanocytes

Summary

Background

Adiponectin is an adipocyte-derived cytokine which circulates as a full-length protein and a fragment containing the globular domain of adiponectin (gAd). A recent study has reported the anti-melanogenic effects of full-length adiponectin.

Objectives

To examine the involvement of gAd in melanogenesis and its action mechanisms.

Methods

The effects of gAd on melanogenesis and its mechanism of action were investigated in human epidermal melanocytes and reconstructed epidermis, and they included the levels of melanin content, cellular tyrosinase activity, cAMP production and protein kinase A (PKA) activity, expression and phosphorylation of signaling molecules.

Results

Exogenous gAd increased the melanin content, and the mRNA levels of microphthalmia-associated transcription factor (MITF) and its downstream genes tyrosinase and tyrosinase-related protein (TRP)-1, but not TRP-2, were increased by gAd. However, cAMP production and PKA activity were not affected by gAd. Moreover, attempts to elucidate the underlying mechanism behind the gAd-mediated effect revealed that gAd could regulate melanogenesis by upregulating MITF through phosphorylation of the cAMP response element-binding protein (CREB). In addition, upregulation of MITF was mediated through activation of adenosine monophosphate-activated protein kinase (AMPK)-p38MAPK signaling. Taken together, these findings indicate that promotion of melanogenesis by gAd occurs through increased expression of the MITF gene, which is mediated by activation of the AMPK-p38MAPK-CREB pathway.

Conclusions

These findings suggest that gAd contributes to epidermal homeostasis via its effect on melanocyte biology, and products of adipose tissue could affect epidermal biology.

http://ift.tt/2HPhDOd

Tracheal injury detected immediately after median sternotomy by inexperienced surgeons: two case reports

Although median sternotomy is standard during cardiac surgery, the procedure is associated with a risk of injury to mediastinal organs. Here, we discuss two cases of tracheal injury following median sternotomy...

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Purpura induced by laser hair removal: a case report

Laser hair removal is an effective and safe method for the permanent reduction of unwanted hair. Common side effects include temporary pain, transient erythema, and perifollicular edema. Purpuric eruption is a...

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Does local factors alter discharge times after surgery?

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Evaluation of eczema, asthma, allergic rhinitis and allergies among the Grade-1 children of Iqaluit

Little is known about the prevalence of asthma, allergic rhinitis, eczema and allergies among Canadian Inuit children, especially those living in the arctic and subarctic areas.

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Quantity Over Quality: Metrics in Solid Organ Transplantation

No abstract available

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Management of severe portopulmonary hypertension with dual oral therapy prior to liver transplantation

No abstract available

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Small-for-size syndrome does not occur in intestinal transplantation without liver containing grafts

ABSTRACTBackgroundThe ideal donor in intestinal transplantation is generally considered to be 50 – 70% of recipient body weight. This may be due to concerns for "small for size" syndrome as seen in liver transplantation. We report our experience using smaller donors (donor-recipient weight ratio, DRWR 50%. We examined patient and graft survival and enteral autonomy from parenteral nutrition as surrogate markers for safety of using smaller donors and ease of abdominal wall closure between groups to determine the value.ResultsThere was no difference in overall patient and graft survival, time to enteral autonomy from parenteral nutrition and weight gain after ITX over time between groups. Need for complicated abdominal closure techniques were significantly more frequent in the control group than in the study group (34.6% versus 6.9%, p = 0.01). Secondary abdominal closure occurred more frequently in the control group (15.4% versus 0%, p = 0.014). Wound revisions also occurred more frequently in the control group (15.4% versus 0%, p = 0.028).ConclusionsOur data suggest that ITX using smaller donors (DRWR ≤ 50%) seems to be an acceptable practice without adverse impact on surgical complications, nutritional autonomy, and patient and graft survival. Abdominal wall closure seems easier in recipients of smaller donors and 'small for size' syndrome as described in liver transplantation does not occur with intestinal allografts. Background The ideal donor in intestinal transplantation is generally considered to be 50 – 70% of recipient body weight. This may be due to concerns for "small for size" syndrome as seen in liver transplantation. We report our experience using smaller donors (donor-recipient weight ratio, DRWR 50%. We examined patient and graft survival and enteral autonomy from parenteral nutrition as surrogate markers for safety of using smaller donors and ease of abdominal wall closure between groups to determine the value. Results There was no difference in overall patient and graft survival, time to enteral autonomy from parenteral nutrition and weight gain after ITX over time between groups. Need for complicated abdominal closure techniques were significantly more frequent in the control group than in the study group (34.6% versus 6.9%, p = 0.01). Secondary abdominal closure occurred more frequently in the control group (15.4% versus 0%, p = 0.014). Wound revisions also occurred more frequently in the control group (15.4% versus 0%, p = 0.028). Conclusions Our data suggest that ITX using smaller donors (DRWR ≤ 50%) seems to be an acceptable practice without adverse impact on surgical complications, nutritional autonomy, and patient and graft survival. Abdominal wall closure seems easier in recipients of smaller donors and 'small for size' syndrome as described in liver transplantation does not occur with intestinal allografts. CORRESPONDENCE: Jang I Moon, One Gustave L. Levy Place, Box 1104. New York, NY 10029–6574. jang.moon@mountsinai.org AUTHORSHIP Jang Moon: Participated in research design, data collection, statistical analysis and composing manuscript. Thomas D Schiano: Participated in research design and reviewing data. Alyssa Burnham: Participated in data collection. Kwai Lam: Participated in data collection. Kishore R Iyer: Participated in research design, reviewing data and composing manuscript. DISCLOSURE The authors declare no conflicts of interests. FUNDING This study does not have funding support. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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Survival and quality of life impact of a risk-based allocation algorithm for deceased donor kidney transplantation

Background To determine the incremental gains in graft and patient survival under a risk-based, deceased donor kidney allocation compared to the current Australian algorithm. Methods Risk-based matching algorithms were applied to first graft, kidney only recipients (n=7513) transplanted in Australia between 1994 and 2013. Probabilistic models were used to compare the waiting time, life and quality-adjusted life years and graft years between the 8 risk-based allocation strategies against current practice. Results Compared to current practice, KDRI-EPTS matching of the lowest 20% of scores reduced median waiting time by 0.64 years (95% CI: 0.52–0.73) for recipients aged ≤ 30 years, but increased waiting time by 0.94 years (95% CI: 0.79 – 1.09) for recipients aged > 60 years. Among all age groups, the greatest gains occurred if KDRI-EPTS matching of the lowest 30% of scores was used, incurring a median overall gain of 0.63 (95% CI: 0.03–1.25) life years and 0.78 (95% CI: 0.30 – 1.26) graft years compared to current practice. A median gain in survival of 1.91 years for younger recipients (aged 30–45 years) was offset by a median reduction in survival (by 0.95 life years) among the older recipients. Prioritisation of lower quality donor kidneys for older candidates reduced the waiting time for recipients aged > 45 years, but no changes in graft and patient survivals were observed. Conclusions Risk-based matching engendered a moderate, overall increase in graft and patient survival, accrued through benefits for recipients aged ≤ 45 years but disadvantage to recipients aged > 60 years. Corresponding author: Germaine Wong, Sydney School of Public Health, The University of Sydney, Camperdown, 2006 Australia. Email: germaine.wong@health.nsw.gov.au Acknowledgments We would like to thank all clinicians, nurses, patients and clinical research staff who have contributed data to the Australia and New Zealand Dialysis and Transplant Registry. Funding: The study is funded by the BEAT-CKD Program Grant (APP1092579). Contributors: VC and GW had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analyses. VC and GW conceived and designed the study. All authors acquired and interpreted the data, revised the manuscript, and gave final approval of the manuscript. VC and GW drafted the manuscript. VC and GW and JY were responsible for the statistical analyses and the figures. Disclosure: No authors have any financial relationships with any organisations that might have any interests in the submitted work, and no other relationships or activities that may have influenced the conduct of the submitted work. Ethical approval: Only de-identified data were used. Ethics approval for this study was not required. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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The Changing Epidemiology of Posttransplant Lymphoproliferative Disorder in Adult Solid Organ Transplant Recipients Over 30 Years: A Single Center Experience

AbstractBackgroundPosttransplant lymphoproliferative disorders (PTLD) are a complication of solid organ transplantation (SOT) associated with Epstein-Barr virus (EBV).MethodsWe analyzed the incidence of and risk factors for PTLD among adult SOT recipients at our center over 30 years (1984–2013). We also compared PTLD incidence before and after a prevention strategy of EBV viral load monitoring in EBV serology mismatched patients was adopted in 2001 (ie transplant era 1 (1983–2001) vs era 2 (2002–13)).ResultsAmong 4171 SOT patients, 109 developed PTLD. Cumulative incidence at 1, 10 and 20 years posttransplant was 0.95, 2.3 and 3.5 per 100 person-years, respectively. Beyond the first year peak of almost exclusively EBV positive PTLD, a lower incidence of PTLD, predominantly EBV negative, persisted for 20 years. Thoracic transplant (hazard ratio (HR) 2.1, p=0.007) and negative EBV serology (HR 7.7, p

http://ift.tt/2F9Bfy8

Predicting Liver Allograft Discard: The Discard Risk Index

AbstractBackgroundAn index that predicts liver allograft discard can effectively grade allografts and can be used to preferentially allocate marginal allografts to aggressive centers. Aim: to devise an index to predict liver allograft discard using only risk factors available at the time of initial DonorNet offer.MethodsUsing univariate and multivariate analyses on a training set of 72,297 deceased donors, we identified independent risk factors for liver allograft discard. Multiple imputation was used to account for missing variables.ResultsWe identified 15 factors as significant predictors of liver allograft discard; the most significant risk factors were: total bilirubin > 10 mg/dl (OR 25.23, CI 17.32-36.77), donation after cardiac death (OR 14.13, CI 13.30-15.01), and total bilirubin 5 – 10 mg/dl (OR 7.57, CI 6.32-9.05). The resulting Discard Risk Index (DSRI) accurately predicted the risk of liver discard with a C-statistic of 0.80. We internally validated the model with a validation set of 37,243 deceased donors and also achieved a 0.80 C-statistic. At a DSRI at the 90th percentile, the discard rate was 50% (OR 32.34 CI 28.63-36.53), while at a DSRI at the 10th percentile only 3% of livers were discarded.ConclusionsThe use of the DSRI can help predict liver allograft discard. The DSRI can be used to effectively grade allografts and preferentially allocate marginal allografts to aggressive centers in order to maximize the donor yield and expedite allocation. Background An index that predicts liver allograft discard can effectively grade allografts and can be used to preferentially allocate marginal allografts to aggressive centers. Aim: to devise an index to predict liver allograft discard using only risk factors available at the time of initial DonorNet offer. Methods Using univariate and multivariate analyses on a training set of 72,297 deceased donors, we identified independent risk factors for liver allograft discard. Multiple imputation was used to account for missing variables. Results We identified 15 factors as significant predictors of liver allograft discard; the most significant risk factors were: total bilirubin > 10 mg/dl (OR 25.23, CI 17.32-36.77), donation after cardiac death (OR 14.13, CI 13.30-15.01), and total bilirubin 5 – 10 mg/dl (OR 7.57, CI 6.32-9.05). The resulting Discard Risk Index (DSRI) accurately predicted the risk of liver discard with a C-statistic of 0.80. We internally validated the model with a validation set of 37,243 deceased donors and also achieved a 0.80 C-statistic. At a DSRI at the 90th percentile, the discard rate was 50% (OR 32.34 CI 28.63-36.53), while at a DSRI at the 10th percentile only 3% of livers were discarded. Conclusions The use of the DSRI can help predict liver allograft discard. The DSRI can be used to effectively grade allografts and preferentially allocate marginal allografts to aggressive centers in order to maximize the donor yield and expedite allocation. Corresponding Author: Abbas Rana, MD, Michael E. DeBakey Department of Surgery, Division of Abdominal Transplantation and Division of Hepatobiliary Surgery, Baylor College of Medicine, 6620 Main Street, Suite 1425, Houston, Texas 77030, USA. Telephone: (713) 321–8423. Fax: (713) 610–2479. abbas.rana@bcm.edu Authorship Page Abbas Rana MD: Study concept and design, acquisition of data, analysis and interpretation of data, drafting of manuscript Rohini R. Sigireddi BA: Drafting of manuscript Karim J. Halazun MD: Critical revision of manuscript Aishwarya Kothare: Critical revision of manuscript Meng-Fen Wu MS: Critical revision of manuscript Hao Liu PhD: Critical revision of manuscript Michael L. Kueht MD: Critical revision of manuscript John M. Vierling MD: Drafting of manuscript Norman L. Sussman MD: Critical revision of manuscript Ayse L. Mindikoglu MD: Critical revision of manuscript Tamir Miloh MD: Critical revision of manuscript N. Thao N. Galvan MD: Critical revision of manuscript Ronald T. Cotton MD: Critical revision of manuscript Christine A. O'Mahony MD: Critical revision of manuscript John A. Goss MD: Drafting of manuscript Disclosures: None Funding: None Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

http://ift.tt/2sX1T8z

International Liver Transplant Society Consensus Statement on IMMUNOSUPPRESSION IN LIVER TRANSPLANT RECIPIENTS

No abstract available

http://ift.tt/2CmRbfd

BRITE-Constellation high-precision time-dependent photometry of the early O-type supergiant zeta Puppis unveils the photospheric drivers of its small- and large-scale wind structures

Ramiaramanantsoa, T; Moffat, AFJ; Harmon, R; Ignace, R; St-Louis, N; Vanbeveren, D; Shenar, T; ... Bohm, T; + view all Ramiaramanantsoa, T; Moffat, AFJ; Harmon, R; Ignace, R; St-Louis, N; Vanbeveren, D; Shenar, T; Pablo, H; Richardson, ND; Howarth, ID; Stevens, IR; Piaulet, C; St-Jean, L; Eversberg, T; Pigulski, A; Popowicz, A; Kuschnig, R; Zoclonska, E; Buysschaert, B; Handler, G; Weiss, WW; Wade, GA; Rucinski, SM; Zwintz, K; Luckas, P; Heathcote, B; Cacella, P; Powles, J; Locke, M; Bohlsen, T; Chene, A-N; Miszalski, B; Waldron, WL; Kotze, MM; Kotze, EJ; Bohm, T; - view fewer (2017) BRITE-Constellation high-precision time-dependent photometry of the early O-type supergiant zeta Puppis unveils the photospheric drivers of its small- and large-scale wind structures. Monthly Notices of the Royal Astronomical Society (MNRAS) , 473 (4) pp. 5532-5569. 10.1093/mnras/stx2671 . Green open access

http://ift.tt/2ozQSEM

Teaching A-level in early career: induction, support and professional learning

Smith, C; Golding, J; (2018) Teaching A-level in early career: induction, support and professional learning. Teaching Mathematics and its Applications (In press).

http://ift.tt/2ou0tO1

Viron ulkomaandelegaatio ja Suomi – Estlands utrikesdelegation och Finland

Kuldkepp, M; (2017) Viron ulkomaandelegaatio ja Suomi – Estlands utrikesdelegation och Finland. In: Happonen, P and Nuorteva, J and Strömberg, J, (eds.) Pro Finlandia. Suomen tie itsenäisyyteen 4. Näkökulma: Venäjä, Puola, Viro, Latvia ja Liettua. (pp. 669-678). Edita Publishing: Helsinki, Finland.

http://ift.tt/2owNjPw

CSF in the differential diagnosis of Alzheimer's disease: clinical utility of an extended panel of biomarkers

Paterson, R; (2018) CSF in the differential diagnosis of Alzheimer's disease: clinical utility of an extended panel of biomarkers. Alzheimer's Research and Therapy (In press).

http://ift.tt/2ou0mlz

Sleep Quality, Fatigue and Quality of Life among Teenage and Young Adult Cancer Survivors

Fortmann, J; Fisher, A; Hough, R; Gregory, A; Pugh, G; (2018) Sleep Quality, Fatigue and Quality of Life among Teenage and Young Adult Cancer Survivors. Journal of Adolescent and Young Adult Oncology (In press).

http://ift.tt/2oAVBG1

Tandem androgenic and psychological shifts in male reproductive effort following a manipulated "win" or "loss" in a sporting competition

Wells, JCK; Longman, DP; Surbey, MK; Stock, JT; (2018) Tandem androgenic and psychological shifts in male reproductive effort following a manipulated "win" or "loss" in a sporting competition. Human Nature (In press).

http://ift.tt/2CpbDfx

Exploring Social Interaction With a Tangible Music Interface

Xambo, A; Hornecker, E; Marshall, P; Jorda, S; Dobbyn, C; Laney, R; (2017) Exploring Social Interaction With a Tangible Music Interface. Interacting with Computers , 29 (2) pp. 248-270. 10.1093/iwc/iww019 . Green open access

http://ift.tt/2ozrRJz

Habitual exercise levels are associated with cerebral amyloid load in presymptomatic autosomal dominant Alzheimer's disease

Brown, BM; Sohrabi, HR; Taddei, K; Gardener, SL; Rainey-Smith, SR; Peiffer, JJ; Xiong, C; ... Martins, RN; + view all Brown, BM; Sohrabi, HR; Taddei, K; Gardener, SL; Rainey-Smith, SR; Peiffer, JJ; Xiong, C; Fagan, AM; Benzinger, T; Buckles, V; Erickson, KI; Clarnette, R; Shah, T; Masters, CL; Weiner, M; Cairns, N; Rossor, M; Graff-Radford, NR; Salloway, S; Voeglein, J; Laske, C; Noble, J; Schofield, PR; Bateman, RJ; Morris, JC; Martins, RN; - view fewer (2017) Habitual exercise levels are associated with cerebral amyloid load in presymptomatic autosomal dominant Alzheimer's disease. Alzheimer's & Dementia , 13 (11) pp. 1197-1206. 10.1016/j.jalz.2017.03.008 .

http://ift.tt/2CphIZx

Semi-interpenetrating network hyaluronic acid microgel delivery systems in micro-flow

Song, W; Chen, Q; Passos, A; Balabani, S; Chivu, A; Zhao, S; Azevedo, H; Song, W; Chen, Q; Passos, A; Balabani, S; Chivu, A; Zhao, S; Azevedo, H; Butler, P; - view fewer (2018) Semi-interpenetrating network hyaluronic acid microgel delivery systems in micro-flow. Journal of Colloid And Interface Science , 519 pp. 174-185. 10.1016/j.jcis.2018.02.049 .

http://ift.tt/2oAjfCH

Pressure passivity of cerebral mitochondrial metabolism is associated with poor outcome following perinatal hypoxic ischemic brain injury

Mitra, S; Bale, G; Highton, D; Gunny, R; Uria-Avellanal, C; Bainbridge, A; Sokolska, M; ... Robertson, NJ; + view all Mitra, S; Bale, G; Highton, D; Gunny, R; Uria-Avellanal, C; Bainbridge, A; Sokolska, M; Price, D; Huertas-Ceballos, A; Kendall, GS; Meek, J; Tachtsidis, I; Robertson, NJ; - view fewer (2017) Pressure passivity of cerebral mitochondrial metabolism is associated with poor outcome following perinatal hypoxic ischemic brain injury. Journal of Cerebral Blood Flow & Metabolism 10.1177/0271678X17733639 . (In press). Green open access

http://ift.tt/2otJVFL

Legalisation, Diplomacy, and Development: Do Investment Treaties De-Politicize Investment Disputes?

Gertz, G; Poulsen, L; Jandhyala, S; (2018) Legalisation, Diplomacy, and Development: Do Investment Treaties De-Politicize Investment Disputes? World Development (In press).

http://ift.tt/2oyyUSM

Community group membership and multidimensional subjective well-being in older age

Fancourt, D; Steptoe, A; (2018) Community group membership and multidimensional subjective well-being in older age. Journal of Epidemiology and Community Health 10.1136/jech-2017-210260 . (In press). Green open access

http://ift.tt/2otvXUj

Communication: Evaluating non-empirical double hybrid functionals for spin-state energetics in transition-metal complexes

Wilbraham, L; Adamo, C; Ciofini, I; (2018) Communication: Evaluating non-empirical double hybrid functionals for spin-state energetics in transition-metal complexes. The Journal of Chemical Physics , 148 (4) , Article 041103. 10.1063/1.5019641 .

http://ift.tt/2oyyLic

Effects of surface and interface traps on exciton and multi-exciton dynamics in core/shell quantum dots

Bozio, R; Righetto, M; Minotto, A; (2017) Effects of surface and interface traps on exciton and multi-exciton dynamics in core/shell quantum dots. In: Bronstein, HA and Deschler, F and Bakulin, AA, (eds.) Proceedings of SPIE Physical Chemistry of Semiconductor Materials and Interfaces XVI;. SPIE: San Diego, CA, United States.

http://ift.tt/2CoV2IC

Bronchiectasis in severe asthma: clinical features and outcomes

Publication date: Available online 27 February 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Isabel Coman, Beatriz Pola-Bibián, Pilar Barranco, Gemma Vila-Nadal, Javier Dominguez-Ortega, David Romero, Carlos Villasante, Santiago Quirce
BackgroundBronchiectasis are increasingly identified in subjects with severe asthma and could contribute to disease severity.ObjectiveWe aimed to determine the prevalence of bronchiectasis in our population of subjects with severe asthma and to better characterize the clinical features of these patients and their outcomes.MethodsWe retrospectively reviewed the medical files of 184 subjects with confirmed severe asthma who had undergone a high resolution thoracic computed tomography and compared the characteristics and outcomes of subjects with and without bronchiectasis.ResultsBronchiectasis were identified in 86 (47%) patients. These patients had concomitant hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (OR 2.24, 95% CI 1.00-5.03) and gastroesophageal reflux disease (GERD) (OR 1.89, 95% CI 1.05-3.41) more frequently than subjects without bronchiectasis, but less atopic dermatitis (OR 0.188, 95% CI 0.04-0.88). Subjects with bronchiectasis were more frequently hospitalized for asthma exacerbations (OR 2.09, 95% CI 1.08-4.05) and had higher blood eosinophil levels (464 vs 338, p 0.005) than subjects without bronchiectasis.ConclusionOur study suggests that in subjects with severe asthma, the presence of bronchiectasis is associated with more frequent hospitalizations, concomitant GERD, hypersensitivity to NSAIDs and higher blood eosinophilia. Bronchiectasis could represent an additional phenotypic feature of severe eosinophilic asthma.

http://ift.tt/2FDzF5q

Treatment of hypereosinophilic syndrome and eosinophilic dermatitis with reslizumab

Publication date: Available online 26 February 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Merin Kuruvilla
Hypereosinophilic syndrome (HES) is a rare disease defined by organ damage directly attributable to hypereosinophilia that is either primary (neoplastic), secondary (reactive) or idiopathic. The mainstay of therapy in idiopathic HES centers around systemic steroids, and cytoreduction with hydroxyurea and interferon-alfa in steroid refractory cases. We describe the successful treatment of recalcitrant, idiopathic cutaneous HES with reslizumab, a humanized interleukin-5 blocker.

http://ift.tt/2EV10P9

Human factors study in untrained adolescents comparing an epinephrine prefilled syringe (symjepi™) with EpiPen® autoinjector

Publication date: Available online 27 February 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Ronald B. Moss, Karen Daniels, Thomas Moll, Dennis J. Carlo

http://ift.tt/2FzoZVc

Developmental characteristics of secondary cartilage in the mandibular condyle and sphenoid bone in mice

Publication date: May 2018
Source:Archives of Oral Biology, Volume 89
Author(s): Hidetomo Hirouchi, Kei Kitamura, Masahito Yamamoto, Kento Odaka, Satoru Matsunaga, Koji Sakiyama, Shinichi Abe
ObjectiveSecondary cartilage develops from osteochondral progenitor cells. Hypertrophic chondrocytes in secondary cartilage increase within a very short time and then ossify rapidly. In the present study, we investigated the sequential development process of osteochondral progenitor cells, and the morphology and size of hypertrophic chondrocytes in secondary cartilage.DesignICR mice at embryonic days (E) 14.5–17.5 were used. The mandibular condyle and the medial pterygoid process of the sphenoid bone were observed as secondary cartilage, and the cranial base and the lateral pterygoid process of the sphenoid bone, which is primary cartilage, were observed as a control. Thin sections were subjected to immunostaining and alkaline phosphatase (ALP) staining. Using a confocal laser microscope, 3D stereoscopic reconstruction of hypertrophic cells was performed. To evaluate the size of hypertrophic chondrocytes objectively, the cell size was measured in each cartilage.ResultsHypertrophic chondrocytes of secondary cartilage first expressed type X collagen (Col X) at E15.5. SRY-box 9 (Sox 9) and ALP were co-expressed in the fibroblastic/polymorphic tissue layer of secondary cartilage. This layer was very thick at E15.5, and then rapidly became thin. Hypertrophic cells in secondary cartilage were markedly smaller than those in primary cartilage.ConclusionsThe small hypertrophic cells present in secondary cartilage may have been a characteristic acquired in order for the cartilage to smoothly promote a marked increase in hypertrophic cells and rapid calcification.

http://ift.tt/2t1NyYg

Corrigendum to “Tooth damage in captive orcas (Orcinus orca)” [Arch. Oral Biol. 84 (2017) 151–160]

Publication date: May 2018
Source:Archives of Oral Biology, Volume 89
Author(s): John Jett, Ingrid N. Visser, Jeffrey Ventre, Jordan Waltz, Carolina Loch

http://ift.tt/2CpG8SP

Positive end-expiratory pressure-induced increase in external jugular venous pressure does not predict fluid responsiveness in laparoscopic prostatectomy

Abstract

Background

Dynamic change in central venous pressure (CVP) was associated with fluid responsiveness. External jugular venous pressure (EJVP) may reliably estimate CVP and have the advantages of being less invasive. We investigated whether increase in EJVP induced by positive end-expiratory pressure (PEEP) could be a reliable predictor of fluid responsiveness in patients undergoing robot-assisted laparoscopic prostatectomy (RALP).

Methods

Fifty patients who underwent RALP with steep Trendelenburg position were enrolled. PEEP of 10 cmH₂O was applied for 5 min and then 300 ml of colloid was administered. EJVP, stroke volume variation (SVV), and cardiac index calculated by pulse contour method were measured before and after the PEEP challenge and colloid administration. Increase in cardiac index > 10% was used to define the fluid responsiveness.

Results

Twenty-six patients were fluid responders. Neither the increase in EJVP after the initial PEEP nor SVV was significantly different between responders and non-responders. They were not significantly correlated with an increase in cardiac index. The areas under the receiver operating characteristic curve (AUC) of these two variables were not significantly greater than 0.5. However, a post hoc analysis revealed that AUC of a decrease in EJVP after removal of PEEP was significantly greater than 0.50.

Conclusion

Our study results suggested that SVV and increase in EJVP after applying PEEP were not accurate predictors of fluid responsiveness during RALP. Further studies are required to find an adequate preload index in robot-assisted urologic surgery with steep Trendelenburg position.

http://ift.tt/2HOAJ75

Necrobiotic xanthogranuloma associated with chronic lymphocytic leukemia

http://ift.tt/2FaQAyq

Two cases of seborrheic keratosis of the external ear canal: involvement of PIK3CA and FGFR3 genes

Abstract

Background

Seborrheic keratosis (SK) of the outer ear canal is rarely described in literature. Etiological risk factors involved in SK such as exposure to human papillomavirus (HPV) and ultraviolet (UV) light are established but must still be confirmed. In recent years, new insights into the pathogenesis of SKs occurred in the area of molecular pathogenesis. Fibroblast growth factor receptor 3 (FGFR3) gene and p110α subunit of phosphoinositide 3-kinase (PIK3CA) oncogene mutations are known to be involved.

Methods

We describe two cases of SK of the outer ear canal. We conducted a review of literature and examined the role of etiological risk factors involved in our cases. The lesions were primarily treated with surgical resection. Postoperatively, in both patients, the lesions recurred after a considerably long disease-free interval. We tested both FGFR3 and PIK3CA genes for mutations, in the primary and recurrent lesions.

Results

We did not find any mutations in both genes in all samples.

Conclusion

Additional research is needed to further establish possible etiological risk factors and to clarify the involvement of PIK3CA and FGFR3 genes in the pathogenesis of seborrheic keratosis of the outer ear canal. These cases underscore the need for meticulous diagnosis, treatment, and sufficient long-term follow-up.

http://ift.tt/2t3n5K4

Fixed Effect Estimation of Large T Panel Data Models

Fernandez-Val, I; Weidner, M; (2018) Fixed Effect Estimation of Large T Panel Data Models. The Annual Review of Economics (In press).

http://ift.tt/2GN1CH3

Flexible and Mindful Self-Tracking: Design Implications from Paper Bullet Journals

Ayobi, A; Sonne, T; Marshall, P; Cox, AL; (2018) Flexible and Mindful Self-Tracking: Design Implications from Paper Bullet Journals. In: Proceedings of the 2018 CHI Conference on Human Factors in Computing Systems (CHI '18). ACM: Montreal, Canada. (In press). Green open access

http://ift.tt/2HPbZLO

Discontinuous Galerkin Finite Element Approximation of Hamilton--Jacobi--Bellman Equations with Cordes Coefficients

Smears, I; Sueli, E; (2014) Discontinuous Galerkin Finite Element Approximation of Hamilton--Jacobi--Bellman Equations with Cordes Coefficients. SIAM Journal on Numerical Analysis , 52 (2) pp. 993-1016. 10.1137/130909536 . Green open access

http://ift.tt/2GL3cti

Health Professionals as Rights Advisers: Rights Advice and Primary Healthcare Services

Pleasence, P; Balmer, NJ; Buck, A; (2007) Health Professionals as Rights Advisers: Rights Advice and Primary Healthcare Services. (LSRC Research Briefings Series , pp. pp. 1-18 ). Legal Services Commission: London, UK.

http://ift.tt/2HPbNfy

Prague Palimpsest: Writing, Memory, and the City by Alfred Thomas

Zusi, PA; (2012) Prague Palimpsest: Writing, Memory, and the City by Alfred Thomas. The Modern Language Review , 107 (1) pp. 263-265. 10.5699/modelangrevi.107.1.0263 . Green open access

http://ift.tt/2GMgPbs

Civil Justice in England and Wales: Report of the 2007 English and Welsh Civil and Social Justice Survey

Pleasence, P; Balmer, NJ; Tam, T; Buck, A; Smith, M; Patel, A; Legal Services Research Centre, .; (2008) Civil Justice in England and Wales: Report of the 2007 English and Welsh Civil and Social Justice Survey. (LSRC Research Paper 22 , pp. pp. 1-84 ). Legal Services Commission: London, UK.

http://ift.tt/2HPbxgA

Civil Justice in England and Wales: Report of the 2006 English and Welsh Civil and Social Justice Survey

Pleasence, P; Balmer, NJ; Tam, T; (2007) Civil Justice in England and Wales: Report of the 2006 English and Welsh Civil and Social Justice Survey. (LSRC Research Paper 19 , pp. pp. 1-85 ). Legal Services Commission: London, UK.

http://ift.tt/2GMgKoa

Civil Justice in England and Wales, 2009: Report of the 2006-2009 English and Welsh Civil and Social Justice Survey

Pleasence, P; Balmer, NJ; Patel, A; Denvir, C; (2010) Civil Justice in England and Wales, 2009: Report of the 2006-2009 English and Welsh Civil and Social Justice Survey. Legal Services Commission: London, UK.

http://ift.tt/2HOBWvb

Unmanageable Debt and Financial Difficulty in the English and Welsh Civil and Social Justice Survey: Report for the Money Advice Trust

Balmer, NJ; Patel, A; Denvir, C; Pleasence, P; (2010) Unmanageable Debt and Financial Difficulty in the English and Welsh Civil and Social Justice Survey: Report for the Money Advice Trust. Legal Services Commission: London, UK.

http://ift.tt/2GPFXhp

The Legal Problems of Renters: Findings from How People Understand and Interact with the Law

Pleasence, P; Balmer, NJ; (2015) The Legal Problems of Renters: Findings from How People Understand and Interact with the Law. (TLEF Research Findings ). Legal Education Foundation: London, UK.

http://ift.tt/2HR2Our

Does the implementation of a novel intensive care discharge risk score and nurse-led inpatient review tool improve outcome? A prospective cohort study in two intensive care units in the UK.

Fabes, J; Seligman, W; Barrett, C; McKechnie, S; Griffiths, J; Does the implementation of a novel intensive care discharge risk score and nurse-led inpatient review tool improve outcome? A prospective cohort study in two intensive care units in the UK. BMJ Open , 7 (12) , Article e018322. 10.1136/bmjopen-2017-018322 . Green open access

http://ift.tt/2GQetbD

Some Thoughts on the Relationship Between the Pauline Action and the Désastre Regime in Jersey

Agnew, SC; (2012) Some Thoughts on the Relationship Between the Pauline Action and the Désastre Regime in Jersey. Jersey and Guernsey Law Review , 2012 (1) pp. 63-68.

http://ift.tt/2HQB618

How much do smart appliances reduce CO2 emissions? Assessing the environmental impact of domestic demand response technologies

McKenna, E; Darby, S; (2017) How much do smart appliances reduce CO2 emissions? Assessing the environmental impact of domestic demand response technologies. In: (Proceedings) ECEEE 2017 Summer Study on energy efficiency: consumption, efficiency and limits. European Council for an Energy Efficient Economy (In press). Green open access

http://ift.tt/2GMEgS0

Criminal Defence Services: Users' Perspectives [Interim Report]

Kemp, V; Balmer, NJ; (2008) Criminal Defence Services: Users' Perspectives [Interim Report]. (LSRC Research Paper 21 , pp. pp. 1-56 ). Legal Services Commission: London, UK.

http://ift.tt/2HOIwSd

Antibacterial Effect of Hypochlorous Acid Solution on Nasal Discharge from Patients with Chronic Rhinosinusitis

Purpose. The antibacterial effect of hypochlorous acid (HOCl) solution on nasal secretion of patients with chronic rhinosinusitis (CRS) was investigated. Materials and Methods. Five swab specimens were collected from the middle meatus of CRS patients. The first one was placed directly in a Thanswab tube while all of the others were placed randomly into 4 glass tubes containing either HOCl solution, normal saline (NS), 75% alcohol, or povidone-iodine (PVPI) solution for one minute in the first part and for 5 minutes in the second part of the study before transfer to a Thanswab tube. Results. Bacteria were cultured from 27 of 50 specimens when they were put directly in a Thanswab tube and from 26 after soaking in HOCl solution, 27 in NS, 13 in 75% alcohol, and 25 in PVPI solution for one minute. In the second part of the study, bacteria were cultured from 14 of 32 specimens when they were put directly in a Thanswab tube and from 14 after soaking in HOCl solution, 13 in NS, 3 in 75% alcohol, and 11 in PVPI solution for 5 minutes. Conclusions. This study showed that HOCL solution did not exert an antibacterial effect on nasal secretion from CRS patients within 5 minutes.

http://ift.tt/2HQtRGc

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Τρίτη 27 Φεβρουαρίου 2018

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