Doble conducto auditivo interno

Publication date: Available online 15 March 2018
Source:Acta Otorrinolaringológica Española
Author(s): María Fernanda Vargas Gamarra, Carlos de Paula Vernetta, Miguel Mazón Momparler




http://ift.tt/2FLhgTl

Predictors of locoregional recurrence in early stage buccal cancer with pathologically clear surgical margins and negative neck

Publication date: Available online 16 March 2018
Source:Acta Otorrinolaringológica Española
Author(s): Shakeel Uz Zaman, Shakil Aqil, Mohammad Ahsan Sulaiman
ObjectiveTo identify the significant predictors of locoregional recurrence in early stage squamous cell carcinoma (SCC) of buccal mucosa with pathologically clear surgical margins and negative neck.MethodSeventy-three patients who underwent per oral wide excision and supraomohyoid neck dissection for early stage buccal SCC with clear surgical margins (>5mm margins each) and negative neck (N0) were included. None of the patients received postoperative radiotherapy or chemotherapy. Univariate and multivariate analyses were used to identify independent predictors of locoregional recurrence.ResultsRecurrence was observed in 22 of 73 (30%) cases. Twelve had local, seven had regional and three developed locoregional recurrences. Both univariate and multivariate analyses demonstrated that lymphovascular invasion (LVI) and non-T4 muscular invasion (non-T4MI) were independent predictors affecting locoregional control.ConclusionLymphovascular invasion (LVI) and non-T4 muscular invasion (non-T4MI) significantly increased the locoregional recurrence rate in early stage buccal SCC with clear surgical margins and negative nodal status. Adjuvant treatment with either radiation or chemoradiation should be considered when one or both of these factors present.



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Incidental Histopathologic Finding of Sinonasal Inverted Papilloma Among Surgically Excised Polyps Increases the Risk of Tumor Recurrence

Abstract

Inverted papilloma (IP) is a benign tumor remarkable for its tendency toward recurrence. Local relapse implicates incomplete resection concerning the bone adjacent to tumor base. The high false negative rates on biopsies, mainly when nasal polyps coexist, may affect the surgical management and outcomes. Our objective was to study the impact of preoperative histologic diagnosis in IP recurrence, particularly in patients with pre-surgical diagnosis of inflammatory polyps. A retrospective analysis of 62 patients treated for IP was conducted. Demographic data and information about smoking status, alcohol intake, tumor location, histology, presence of nasal polyps, staging, malignancy, previous biopsies and surgical approach were evaluated to identify factors associated with recurrence. Prevalence of nasal polyps was higher in patients with recurrence. Smoking history, alcohol abuse, staging, histologic type, malignancy and surgical approach were not associated with recurrence. The presence of nasal polyps at endoscopy was inversely associated with the diagnosis of IP at incisional biopsy. Incidental histologic diagnosis of IP after surgery increased the risk of recurrence more than tenfold. Biopsy reporting the diagnosis of IP previous to surgery was inversely associated to recurrence. In patients with IP, coexistence of nasal polyps at initial endoscopy and lack of pathological IP diagnosis prior to surgery are strongly associated with a higher risk of recurrence. When excisional biopsy reports IP incidentally, an early revision surgery should be considered in order to avoid future aggressive surgeries because of tumor recurrence.

http://ift.tt/2DwKNhD

Incidental Histopathologic Finding of Sinonasal Inverted Papilloma Among Surgically Excised Polyps Increases the Risk of Tumor Recurrence

Abstract

Inverted papilloma (IP) is a benign tumor remarkable for its tendency toward recurrence. Local relapse implicates incomplete resection concerning the bone adjacent to tumor base. The high false negative rates on biopsies, mainly when nasal polyps coexist, may affect the surgical management and outcomes. Our objective was to study the impact of preoperative histologic diagnosis in IP recurrence, particularly in patients with pre-surgical diagnosis of inflammatory polyps. A retrospective analysis of 62 patients treated for IP was conducted. Demographic data and information about smoking status, alcohol intake, tumor location, histology, presence of nasal polyps, staging, malignancy, previous biopsies and surgical approach were evaluated to identify factors associated with recurrence. Prevalence of nasal polyps was higher in patients with recurrence. Smoking history, alcohol abuse, staging, histologic type, malignancy and surgical approach were not associated with recurrence. The presence of nasal polyps at endoscopy was inversely associated with the diagnosis of IP at incisional biopsy. Incidental histologic diagnosis of IP after surgery increased the risk of recurrence more than tenfold. Biopsy reporting the diagnosis of IP previous to surgery was inversely associated to recurrence. In patients with IP, coexistence of nasal polyps at initial endoscopy and lack of pathological IP diagnosis prior to surgery are strongly associated with a higher risk of recurrence. When excisional biopsy reports IP incidentally, an early revision surgery should be considered in order to avoid future aggressive surgeries because of tumor recurrence.

http://ift.tt/2DwKNhD

Plasticity of myeloid-derived suppressor cells in cancer

Evgenii Tcyganov | Jerome Mastio | Eric Chen | Dmitry I Gabrilovich

http://ift.tt/2pe7QbY

Systematic review of professional liability when prescribing beta-lactams for patients with a known penicillin allergy

To describe medical negligence and malpractice cases in which a patient with a known penicillin allergy received a beta-lactam and experienced an adverse reaction related to the beta-lactam.

http://ift.tt/2GxgSsX

Paediatric asthma treatment: what to do when international guidelines' recommendations don't agree?

Authors' contributions

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Sound energy absorbance characteristics of cartilage grafts used in type 1 tympanoplasty

The purpose of this prospective case-control study is to evaluate the sound energy absorbance characteristics of cartilage grafts in patients, who have undergone type 1 cartilage tympanoplasty.

http://ift.tt/2DzdavS

Treating isotretinoin-associated cheilitis with hydrocortisone-containing lip balm

http://ift.tt/2IqYMcq

A novel technique using Lidocaine 2% topical gel for peristomal dermatitis

http://ift.tt/2pl2FHs

‘Filter’ Hones GWAS Results to Help Researchers Avoid Dead Ends

A genetics research team at Johns Hopkins Medicine has solved a dilemma facing researchers who use genomewide association studies (GWAS) by developing a new approach that strategically "filters" which genes are worth further study. The researchers hope this strategy will accelerate the study of diseases such as Parkinson's, Alzheimer's, schizophrenia and even addiction by helping researchers avoid "dead-end paths." They are optimistic that this strategy will gain widespread use and will save researchers time and money.

http://ift.tt/2FW1YfB

Are surgeons overdosing patients with lidocaine?

Publication date: Available online 14 March 2018
Source:American Journal of Otolaryngology
Author(s): Laura Garcia-Rodriguez, Jeffrey Spiegel




http://ift.tt/2GvMwa4

What Parents Need to Know About Opioid Abuse

 

For many parents of teenagers, myself included, the rising use of opioids is incredibly concerning. Questions such as what can I do to prevent opioid use are very common among parents. Here are the facts and some tips to help you keep your teenager safe and opioid-free.

The post What Parents Need to Know About Opioid Abuse appeared first on ChildrensMD.

http://ift.tt/2FM29Jx

Cultural, Demographic and Environmental Dynamics of the Copper and Early Bronze Age in Iberia (3300–1500 BC): Towards an Interregional Multiproxy Comparison at the Time of the 4.2 ky BP Event

Abstract

This paper presents the first comprehensive pan-Iberian overview of one of the major episodes of cultural change in later prehistoric Iberia, the Copper to Bronze Age transition (c. 2400–1900 BC), and assesses its relationship to the 4.2 ky BP climatic event. It synthesizes available cultural, demographic and palaeoenvironmental evidence by region between 3300 and 1500 BC. Important variation can be discerned through this comparison. The demographic signatures of some regions, such as the Meseta and the southwest, diminished in the Early Bronze Age, while other regions, such as the southeast, display clear growth in human activities; the Atlantic areas in northern Iberia barely experienced any changes. This paper opens the door to climatic fluctuations and inter-regional demic movements within the Peninsula as plausible contributing drivers of particular historical dynamics.

http://ift.tt/2pgV6Bp

JAMA Otolaryngology–Head & Neck Surgery Peer Reviewers in 2017

We sincerely thank the 645 peer reviewers who completed manuscript reviews for JAMA Otolaryngology–Head Neck Surgery in 2017.

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JAMA Otolaryngology–Head & Neck Surgery Year in Review

As I complete my second year as Editor of JAMA Otolaryngology–Head & Neck Surgery, I would like to take this opportunity to thank our authors, reviewers, members of the editorial board, and staff for the many contributions to the journal and to share our accomplishments. This past year, we received 822 submissions and published 94 Original Investigations, 35 Reviews, 34 opinion articles, and 11 Research Letters. In 2017, the acceptance rate for major submissions was 19%. The publication of opinion articles provides context to the original investigations and a forum for active dialogue in our specialty.

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Risk Factors for Complication After Pediatric Tonsillectomy

This cohort study examines the association between posttonsillectomy complication rate and the age and weight of the child at the time of surgery.

http://ift.tt/2IsCOpz

Soft-Tissue Augmentation for Tracheoesophageal Puncture Enlargement

This study reports on the use of injectable soft-tissue fillers for the treatment of tracheoesophageal prosthesis enlargement and periprosthetic leakage.

http://ift.tt/2pgoYOm

Multidisciplinary Clinical Treatment of Head and Neck Cancer—Reply

In Reply to the letter from Mark et al, we wish to thank the writers for recognizing our publication as well as for their shared dedication to improving cancer care. We find their results in the field of prostate cancer to be quite interesting, particularly their findings regarding a survival benefit in patients with access to a multidisciplinary clinic (MDC) treatment model. Likewise, we plan to investigate potential survival benefits in our own head and neck cancer MDC treatment model once we have accrued sufficient patient volumes and follow-up time. Recent retrospective studies in head and neck cancer have identified survival benefits in patients with access to multidisciplinary evaluations in particular subsites. It will be valuable to see if we also find this site-specific advantage in our own MDC population. Again, we thank the writers for their supportive response and for their efforts to optimize complex cancer care.

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Multidisciplinary Clinical Treatment of Head and Neck Cancer

To the Editor We commend the authors on their adoption of a multidisciplinary clinic (MDC) for the treatment of head and neck cancers and we agree with their conclusion that the cooperative treatment of cancer patients by relevant specialties is superior to a multiappointment approach. In their study, Townsend et al were able to show a significant decrease in treatment delays for patients from both the time of referral and following their first appointment with the team. We have had the same experience in our own MDC.

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Analysis of Vocal Fold Motion Impairment in Neonates Undergoing Congenital Heart Surgery

This cross-sectional analysis evaluates the cost, postprocedure length of stay, and outcomes for neonates with vocal fold motion impairment after congenital heart surgery.

http://ift.tt/2IuiNyK

Single-Stage Mastoid Obliteration in Cholesteatoma Surgery

This systematic study analyzes the literature on recurrent and residual cholesteatoma rates after single-stage canal wall up and canal wall down tympanoplasty with mastoid obliteration.

http://ift.tt/2pgosjo

An Aggressive Sinonasal Mass With Parameningeal Extension

A woman in her 60s presented with sinus pressure progressing to dental pain; imaging revealed a mass arising from the skull base and nasopharynx and involvement of the right posterior orbit. What is your diagnosis?

http://ift.tt/2Iu0nhG

Generalized Radiopacities of the Craniofacial Skeleton

An adolescent girl presented with multiple, slowly growing masses of the face and head, significant bilateral exophthalmos, visual changes, and dental malocclusion, but no clinical signs of endocrinopathy. What is your diagnosis?

http://ift.tt/2kYbZ1o

Proposal for New Diagnosis for Cochlear Migraine

This Viewpoint examines the existence and features of cochlear migraine.

http://ift.tt/2EUaudl

Trustworthy Otolaryngology Clinical Practice Guidelines

Clinical practice guidelines (CPGs) are the cornerstone of the evidence-based practice of otolaryngology–head and neck surgery. The American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) CPGs are widely distributed, as judged by frequency of downloads, webpage views, and CPG-related sessions at national meetings. Clinical practice guidelines are developed to reduce variation in care and to improve quality. They create debate and even controversy, with concerns expressed about restraints on clinician decision making as well as the medicolegal implications of recommendations. Clinical practice guidelines must be trustworthy, and the Institute of Medicine (IOM) and the Guideline International Network have provided standards for CPGs. A major threat to the creation of trustworthy guidelines is conflict of interest (COI) among the organizations and the committee members who create CPGs.

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Immediate Effects of External Vibration Therapy vs Placebo in Singers

This randomized clinical trial evaluates the immediate effects of external vibration therapy vs placebo on vocal function in trained singers using acoustic and self-assessment parameters.

http://ift.tt/2kVh2jl

Diagnostic Accuracy of Parallel vs Perpendicular Orientation of the Tuning Fork in the Identification of Conductive Hearing Loss

This study compares patients' responses to the Rinne test when performed with the tuning fork positioned parallel vs perpendicular to the external auditory meatus.

http://ift.tt/2rYh4h9

Industry Relationships Among Authors of Otolaryngology Clinical Practice Guidelines

This cross-sectional analysis examines the nature of industry payments to physicians who author otolaryngology clinical practice guidelines.

http://ift.tt/2kVgRob

Otorhinolaryngological Fitness for Compressed Gas Scuba Diving—Part 2

This review aims to provide a comprehensive overview of existing otorhinolaryngological fitness guidelines for diving recreationally.

http://ift.tt/2Ewj7Pi

Serial In-Office Intralesional Steroid Injections in Airway Stenosis

This case-series study examines the association of serial in-office intralesional steroid injection after endoscopic dilation with surgery-free interval in adults with subglottic and proximal tracheal stenosis.

http://ift.tt/2Dln1XD

Facial Pain and Diplopia in a Young Boy

A young boy presented with left facial and eye pain with intermittent diplopia on upward and lateral gaze; imaging showed a well-circumscribed posterior-medial extraconal mass extending into the orbital apex with dorsal extension into the left cavernous sinus. What is your diagnosis?

http://ift.tt/2DjCdEq

Histopathological and Inflammatory Features of Open Mastoid Cavities

This study of tissue samples from a cohort of patients with chronically discharging open radical mastoid cavities investigates the histopathological and inflammatory features of these cavities and association of different types with treatment outcome.

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March 2018 Issue Highlights

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Status of Radiology Training in Otolaryngology Residency Programs

This survey study of program directors assesses the current state of radiology training in US otolaryngology residency programs.

http://ift.tt/2ET2eKB

Otorhinolaryngological Hazards Related to Diving—Part 1: Compressed Gas Scuba Diving

This review provides an overview of otorhinolaryngological complications during scuba diving.

http://ift.tt/2CneT6J

Angiolytic Laser With or Without Polypectomy for Vocal Fold Polyps

This cohort study examines the outcomes and incidence rates of adverse events associated with in-office angiolytic laser procedures with or without concurrent polypectomy as an alternative treatment for vocal fold polyps.

http://ift.tt/2Du5jUb

Adult-Onset Giant Cervical Mass

A man in his 40s presented with a giant, left-sided neck mass; magnetic resonance imaging revealed a homogenous ovoid bilobulated cystic mass in the left lateral region of the neck with displacement of the surrounding musculature and vascular structures but no sign of invasion. What is your diagnosis?

http://ift.tt/2kUlgb2

Prevalence of High-Risk Human Papillomavirus in Tonsil Tissue in Healthy Adults

This retrospective, cross-sectional study examines the prevalence of oropharyngeal human papillomavirus and the spatial relationship between the virus and crypt biofilm in tonsil tissue of otherwise healthy adults.

http://ift.tt/2GjfEB4

Nasopharyngeal Swelling After Sinus Surgery for Cystic Fibrosis

A woman in her 20s with cystic fibrosis underwent bilateral endoscopic sinus surgery and medial maxillectomy 4 months after bilateral lung transplantation; at 6-week follow-up, she presented with throat pain, and 2 weeks later, with nasal obstruction. What is your diagnosis?

http://ift.tt/2kVgKJh

Otolaryngologic Manifestations of Klippel-Feil Syndrome in Children

This review examines a series of children with Klippel-Feil syndrome to define the otolaryngologic diagnoses made and procedures performed in this challenging patient population.

http://ift.tt/2rKjY9l

Heart Failure and Hearing Loss Among Older Adults in the United States

This secondary analysis of the National Health and Nutrition Examination Survey examines the prevalence and correlates of hearing loss among older adults with and without heart failure in the United States.

http://ift.tt/2GinGu2

Primary Palate Trauma in Patients Presenting to US Emergency Departments

This database analysis uses the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample to measure the incidence of primary palate trauma visits to US emergency departments and to determine frequency and factors associated with head and neck imaging.

http://ift.tt/2GzQP3Q

Hereditary angioedema education in otolaryngology residencies: survey of program directors

Background

The objective of this work was to assess resident education regarding contemporary management of hereditary angioedema using a web-based survey.

Methods

An 11-item, multiple-choice, electronic questionnaire was sent to all 106 accredited otolaryngology training programs in November 2016. Questions focused on resident education, management principles, and formalized assessment.

Results

A total of 34 program directors responded, representing 32% of otolaryngology residences. Ninety-seven percent believed otolaryngology residents should be knowledgeable in the management of hereditary angioedema due to C1 inhibitor deficiency (C1-INH-HAE). Specifically, 38% and 26% of program directors felt their residents were comfortable and very comfortable in C1-INH-HAE management, respectively. Of those surveyed, 18% have educational simulation activities and a protocol in place for C1-INH-HAE management. Forty-seven percent of respondents felt their training program provided adequate education and exposure to C1-INH-HAE. Over the last 5 years, 45% felt residents were exposed to 1 to 5 cases of C1-INH-HAE. Sixty-seven percent of residents were trained in the management of C1-INH-HAE through in-person lectures. Seventy-one percent of programs had no formal assessment of resident competency in C1-INH-HAE management.

Conclusion

This study is the first to offer insight into C1-INH-HAE education and management principles in otolaryngology training programs. Surveyed program directors believe residents need a strong knowledge base in the management of C1-INH-HAE but less than half feel their trainees acquire the necessary exposure to this emergent disease process. Future research efforts in this area should aim to determine optimal educational activities as well as how to best incorporate this into otolaryngology residency curricula.

http://ift.tt/2Ipi0zn

Liposomal nanoparticle armed with bivalent bispecific single-domain antibodies, novel weapon in HER2 positive cancerous cell lines targeting

Publication date: April 2018
Source:Molecular Immunology, Volume 96
Author(s): Shahryar Khoshtinat Nikkhoi, Fatemeh Rahbarizadeh, Saeed Ranjbar, Sepideh Khaleghi, Alireza Farasat
Breast cancer is the leading cause of mortality among all cancers. HER2, human epidermal growth factor receptors type 2, a receptor tyrosine kinase that induces interminable cell proliferation, is overexpressed in 20–25 percent of breast cancers. In spite of significant progress in nanomedicine in the past decade, being subjected to genetic drift that hides many paramount epitopes has rendered targeting HER2 as a big challenge. In the present study, we developed monovalent and bivalent monospecific along with bivalent bispecific VHH targeting different epitopes on HER2, and showed that bivalent bispecific VHH has the highest affinity among other tested modalities. Then we covalently coupled VHHs to the fluorescent labeled liposomal nanoparticle to produce targeted liposomes. Based on flow cytometry results, bivalent bispecific VHH targeted liposomes showed the highest fluorescent intensity, on HER2 breast cancer cells. Liposomes conjugated to bivalent monospecific VHH exhibited enhanced affinity toward HER2 positive cell lines compared to monovalent targeted liposomes, with bivalent bispecific liposomes appearing as the most robust probe.



http://ift.tt/2tTwRPg

Molecular regulation of dendritic cell development and function in homeostasis, inflammation, and cancer

Publication date: Available online 15 March 2018
Source:Molecular Immunology
Author(s): Taylor T. Chrisikos, Yifan Zhou, Natalie Slone, Rachel Babcock, Stephanie S. Watowich, Haiyan S. Li
Dendritic cells (DCs) are the principal antigen-presenting cells of the immune system and play key roles in controlling immune tolerance and activation. As such, DCs are chief mediators of tumor immunity. DCs can regulate tolerogenic immune responses that facilitate unchecked tumor growth. Importantly, however, DCs also mediate immune-stimulatory activity that restrains tumor progression. For instance, emerging evidence indicates the cDC1 subset has important functions in delivering tumor antigens to lymph nodes and inducing antigen-specific lymphocyte responses to tumors. Moreover, DCs control specific therapeutic responses in cancer including those resulting from immune checkpoint blockade. DC generation and function is influenced profoundly by cytokines, as well as their intracellular signaling proteins including STAT transcription factors. Regardless, our understanding of DC regulation in the cytokine-rich tumor microenvironment is still developing and must be better defined to advance cancer treatment. Here, we review literature focused on the molecular control of DCs, with a particular emphasis on cytokine- and STAT-mediated DC regulation. In addition, we highlight recent studies that delineate the importance of DCs in anti-tumor immunity and immune therapy, with the overall goal of improving knowledge of tumor-associated factors and intrinsic DC signaling cascades that influence DC function in cancer.



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Primary failure of eruption (PFE): a systematic review

Abstract

Background

Primary failure of eruption (PFE) is a rare disease defined as incomplete tooth eruption despite the presence of a clear eruption pathway. Orthodontic extrusion is not feasible in this case because it results in ankylosis of teeth. To the best of our knowledge, besides the study of Ahmad et al. (Eur J Orthod 28:535-540, 2006), no study has systematically analysed the clinical features of and factors associated with PFE. Therefore, the aim of this study was to systematically evaluate the current literature (from 2006 to 2017) for new insights and developments on the aetiology, diagnosis, genetics, and treatment options of PFE.

Methods

Following the PRISMA guidelines, a systematic search was performed using the PubMed/Medline database for studies reporting on PFE. The following terms were used: "primary failure of tooth eruption", "primary failure of eruption", "tooth eruption failure", and "PFE".

Results

Overall, 17 articles reporting clinical data of 314 patients were identified. In all patients, the molars were affected. In 81 reported cases, both the molars and the premolars were affected by PFE. Further, 38 patients' primary teeth were also affected. In 27 patients, no family members were affected. Additional dental anomalies were observed in 39 patients. A total of 51 different variants of the PTH1R gene associated with PFE were recorded.

Conclusions

Infraocclusion of the posterior teeth, especially if both sides are affected, is the hallmark of PFE. If a patient is affected by PFE, all teeth distal to the most mesial tooth are also affected by PFE. Primary teeth can also be impacted; however, this may not necessarily occur. If a patient is suspected of having PFE, a genetic test for mutation in the PTH1R gene should be recommended prior to any orthodontic treatment to avoid ankylosis. Treatment options depend on the patient's age and the clinical situation, and they must be evaluated individually.

http://ift.tt/2IqBGCQ

A Multimodal Intervention Can Help Developing Nations Reduce One of the Most Common Health Care-Acquired Infections

Surgical site infections are the most frequent health care-associated infections in developing countries. According to the World Health Organization (WHO), this type of infection can affect up to one-third of surgical patients in those nations.

http://ift.tt/2pefqUS

Socio-economic rights, extraterritorially

Wilde, RG; (2018) Socio-economic rights, extraterritorially. In: Benvenisti, E and Nolte, G, (eds.) Community Obligations in Contemporary International Law. (pp. 381-395). Oxford University Press: Oxford, UK. (In press). Green open access

http://ift.tt/2DuBD5d

Situating digital interventions: mixed methods for HCI research in the home

Mitchell, V; Leder Mackley, K; Pink, S; Escobar-Tello, C; Wilson, GT; Bhamra, T; (2015) Situating digital interventions: mixed methods for HCI research in the home. Interacting with Computers , 27 (1) pp. 3-12. 10.1093/iwc/iwu034 . Green open access

http://ift.tt/2pbbT9W

The Self-Respect of Democratic People

Van Wietmarschen, JG; (2018) The Self-Respect of Democratic People. The American Journal of Jurisprudence (In press).

http://ift.tt/2DvH0B5

Preserving reproductive capacity in young boys with cancer

Gan, HW; Spoudeas, HA; (2013) Preserving reproductive capacity in young boys with cancer. Trends in Urology & Men's Health , 4 (3) pp. 8-12. 10.1002/tre.327 . Green open access

http://ift.tt/2FUgeIa

Experimental Generation of Focusing Wave Groups on Following and Adverse-Sheared Currents in a Wave-Current Flume

Stagonas, D; Buldakov, E; Simons, R; (2018) Experimental Generation of Focusing Wave Groups on Following and Adverse-Sheared Currents in a Wave-Current Flume. Journal of Hydraulic Engineering , 144 (5) , Article 04018016. 10.1061/(ASCE)HY.1943-7900.0001443 . Green open access

http://ift.tt/2DvlRXH

Walking the last mile on the long road to evidence-informed development: building capacity to use research evidence

Langer, L; Stewart, R; Erasmus, Y; de Wet, T; (2015) Walking the last mile on the long road to evidence-informed development: building capacity to use research evidence. Journal of Development Effectiveness , 7 (4) pp. 462-470. 10.1080/19439342.2015.1095783 . Green open access

http://ift.tt/2pcHfge

Mitochondrial damage and "plugging" of transport selectively in myelinated, small-diameter axons are major early events in peripheral neuroinflammation

Sajic, M; Ida, KK; Canning, R; Gregson, NA; Duchen, MR; Smith, KJ; (2018) Mitochondrial damage and "plugging" of transport selectively in myelinated, small-diameter axons are major early events in peripheral neuroinflammation. Journal of Neuroinflammation , 15 , Article 61. 10.1186/s12974-018-1094-8 . Green open access

http://ift.tt/2HC2bUM

Macro- and micro-scale mixing in a shaken bioreactor for fluids of high viscosity

Micheletti, M; Rodriguez, G; Ducci, A; (2018) Macro- and micro-scale mixing in a shaken bioreactor for fluids of high viscosity. Chemical Engineering Research and Design 10.1016/j.cherd.2018.01.018 . (In press).

http://ift.tt/2FVeUo7

Computational modelling of laminar dynamics in Human Primary Motor Cortex (M1): a dynamic causal modelling study of the healthy and post-stroke brain

Bhatt, Mrudul B.; (2018) Computational modelling of laminar dynamics in Human Primary Motor Cortex (M1): a dynamic causal modelling study of the healthy and post-stroke brain. Doctoral thesis (Ph.D), UCL (University College London).

http://ift.tt/2pjMrz9

Sunshine technology and dream biology: perceptions of regenerative medicine in Japan

Bia, Jesse; (2018) Sunshine technology and dream biology: perceptions of regenerative medicine in Japan. Doctoral thesis (Ph.D), UCL (University College London);.

http://ift.tt/2HEddZJ

Mode decomposition and Lagrangian structures of the flow dynamics in orbitally shaken bioreactors

Weheliye, HW; Cagney, N; Rodriguez, G; Micheletti, M; Ducci, A; (2018) Mode decomposition and Lagrangian structures of the flow dynamics in orbitally shaken bioreactors. Physics of Fluids , 30 , Article 033603. 10.1063/1.5016305 . Green open access

http://ift.tt/2petsG6

Agregar o no agregar valor contextual en lenguaje: un estudio de caso instrumental en dos establecimientos chilenos de educación media

Munoz Chereau, B; (2013) Agregar o no agregar valor contextual en lenguaje: un estudio de caso instrumental en dos establecimientos chilenos de educación media. Pensamiento Educativo: Revista de Investigación Educacional Latinoamericana , 50 (2) pp. 28-50. 10.7764/PEL.50.2.2013.3 . Green open access

http://ift.tt/2HAx77K

Cheetahs modify their prey handling behavior depending on risks from top predators

Hilborn, A; Pettorelli, N; Caro, T; Kelly, MJ; Laurenson, K; Durant, SM; (2018) Cheetahs modify their prey handling behavior depending on risks from top predators. Behavioral Ecology and Sociobiology (In press).

http://ift.tt/2pjMs6b

Fatigue life sensitivity of monopile-supported offshore wind turbines to damping

Rezaei, R; Fromme, P; Duffour, P; (2018) Fatigue life sensitivity of monopile-supported offshore wind turbines to damping. Renewable Energy , 123 pp. 450-459. 10.1016/j.renene.2018.02.086 .

http://ift.tt/2DvlNap

The application of bulk acoustic wave (BAW) resonators for the in-situ investigation of polymer electrolytes and high temperature media

Bharath, VJ; (2018) The application of bulk acoustic wave (BAW) resonators for the in-situ investigation of polymer electrolytes and high temperature media. Doctoral thesis (Ph.D), UCL (University College London). Green open access

http://ift.tt/2DuUNIm

Estimating the mass of the Local Group using machine learning applied to numerical simulations

McLeod, M; Libeskind, N; Lahav, O; Hoffman, Y; (2017) Estimating the mass of the Local Group using machine learning applied to numerical simulations. Journal Of Cosmology and Astroparticle Physics , 2017 (12) , Article 034. 10.1088/1475-7516/2017/12/034 .

http://ift.tt/2FVeSN1

b-Tagging and Evidence for the Standard Model H → bb Decay with the ATLAS Experiment

Bell, Andrew Stuart; (2018) b-Tagging and Evidence for the Standard Model H → bb Decay with the ATLAS Experiment. Doctoral thesis (Ph.D), UCL (University College London). Green open access

http://ift.tt/2HCTJnY

COMPARING FUNDUS FLUORESCEIN ANGIOGRAPHY AND SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN THE EVALUATION OF DIABETIC MACULAR PERFUSION

La Mantia, A; Kurt, RA; Mejor, S; Egan, CA; Tufail, A; Keane, PA; Sim, DA; (2018) COMPARING FUNDUS FLUORESCEIN ANGIOGRAPHY AND SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN THE EVALUATION OF DIABETIC MACULAR PERFUSION. Retina 10.1097/IAE.0000000000002045 . (In press).

http://ift.tt/2FY4Cny

Sign bilingualism and Arabic literacy: using PVR with deaf girls in Saudi Arabia

Basonbul, Najwa Abood; (2018) Sign bilingualism and Arabic literacy: using PVR with deaf girls in Saudi Arabia. Doctoral thesis (Ph.D), UCL (University College London).

http://ift.tt/2Dup6yU

Semi-automatic tumour volume measurements on MR-imaging using Smartbrush® in oropharyngeal carcinomas; our experience in 5 patients

Abstract

Head and neck cancer is worldwide the sixth most common cancer. Prognosis is linked to tumour (primary tumours, nodal stage and distant metastasis) and general patients' characteristics. Currently, the TNM-staging system is the most used staging system in the world. Beside this TNM-staging system, other prognostic factors are used to select the best treatment for each individual patient.

This article is protected by copyright. All rights reserved.

http://ift.tt/2Gus615

Transoral endoscopic base of tongue mucosectomy for investigation of unknown primary cancers of head and neck

Abstract

Cancer of the unknown primary (CUP) makes up 2-4% of new head and neck squamous cell carcinoma (SCC) diagnoses. This scenario is recognised as a diagnostic challenge for head and neck surgeons. For all patients with proven cervical lymph node metastatic SCC without a clinically apparent primary site, the current UK guidelines recommends PET-CT, panendoscopy with directed biopsies and bilateral tonsillectomy as a standard of care.

This article is protected by copyright. All rights reserved.

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A web-based prediction score for head and neck cancer referrals

Abstract

Objective

Following the announcement of the NHS Cancer Plan in 2000, anyone suspected of having cancer has to be seen by a specialist within two weeks of referral. Since this introduction, studies have shown that only 6.3-14.6% of 2-week referrals were diagnosed with a head and neck cancer and that majority of the cancer diagnoses were via other referral routes. These studies suggest that the referral scheme is not currently cost effective. Our aim is to develop a scoring system that determines the risk of head and neck cancer in a patient, which can then be used to aid GP referrals.

Design

Retrospective data was collected from 1075 patients with 2-week head and neck cancer referrals from general practitioners. The retrospective data collected included patients' demographics, risk factors and relevant investigations. The data was used as input into a logistic regression to arrive at our model. Our approach included data analysis, machine learning techniques, statistical inference and model validation metrics to arrive at the best performing model. The model was then tested with more data from 235 prospective patients.

Results

Using our results from the logistic regression, we created a web-based tool that GPs can use to calculate their patient's probability of cancer and use this result to assist in their decision regarding referral. Our prototype can be seen in Figure 2.

Conclusion

We have created a prototype scoring system that can be hosted online to assist GPs with their referrals with a sensitivity of 31% and specificity of 92%. While we acknowledge that there are several limitations to our model, we believe we have created a novel preliminary scoring system that has the potential to be improved dramatically with further data and be very helpful for GPs in a long run.

This article is protected by copyright. All rights reserved.

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Skin microneedling for acne scars associated with pigmentation in patients with dark skin

Summary

Background

Acne is very common skin condition. Most patients with acne will have a degree of scarring as a result of their acne. In patients with darker skin color the scarring can be further complicated by hyperpigmentation. Several treatment options can be used to improve acne scarring, however the problem of post acne hyperpigmentation is not often addressed. This study especially focus on the treatment of pigmented post acne scarring using skin microneedling.

Aims

The primary objective is to assess the improvement of pigmentation of acne scarring in patients with dark skin using microneedling. Secondary objectives include evaluation of post acne scarring improvement and the safety of microneedling in pigmented skin.

Materials & Methods

39 Patients with darker skin colors (types 3, 4 and 5) completed study. Baseline evaluation for both acne scars and pigmentation scores performed using "post acne hyperpigmentation index" (PAHPI) and Goodman-Baron scales (GB scale). Microneedling treatment done and subsequently patients reviewed at 2 weeks for initial assessment and then after at least 4 weeks from date of initial assessment using same scoring methods for both scars and pigmentation. Baseline photographs were taken and again at final assessment.

Results

Both PAHPI and Goodman-Baron scales showed statistically significant improvement from baseline following microneedling treatment. Side effects were minor and of transient nature. None of our patients showed worsening of pigmentation.

Conclusion

Microneedling is an effective treatment for both acne scars and associated pigmentation in patients with dark skin color. The treatment appears to be safe apart from transient redness, mild dryness, and small hematomas, however additional treatments may be needed in some patients to achieve more improvement in pigmentation.

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Improvement of skin barrier dysfunction by Scutellaria baicalensis GEOGI extracts through lactic acid fermentation

Summary

Background

The development of an alternative medicine to treat atopic dermatitis (AD) from natural sources is necessary.

Aims

To improve skin barrier dysfunction by enhancing the differentiation of human keratinocytes with the fermented Scutellaria baicalensis.

Methods

Scutellaria baicalensis was fermented with Lactobacillus plantarum and extracted with 70% ethanol (FE). Antioxidant activities and the regulation of the gene expression related to keratinocyte differentiation were measured as well as its proliferation.

Result

This work first proved that the FE had multiple activities, both increasing keratinocyte differentiation and proliferation: The FE greatly up-regulated expression of the genes of keratinocyte differentiation such as involucrin, keratin 10, and transglutaminase-1 (TG-1) up to 4.06-fold, which was 3 times higher than the 2 other extracts. The effect of baicalein on keratinocyte differentiation was also first found; however, its efficacy was lower than that of the fermented extract. The FE proved to effectively accelerate keratinocyte differentiation, rather than to initiate the differentiation, and also showed an ability of stimulating keratinocyte proliferation up to 2.8 × 10⁶ viable cells/mL as well as 70.24 ng/mL of collagen production in fibroblasts. High efficacy of the FE was confirmed by synergistic effects of large amounts of various bioactive substances in the extracts as baicalein alone did not show remarkable effects and even positive controls had not much better activities than the FE.

Conclusion

The fermented extract was able to improve skin barrier dysfunction, and the ointment with 1%-5% (v/v) of the extract be directly used for skin clinical trials to treat AD.

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Clinical characteristics from co-infection with avian influenza A H7N9 and Mycoplasma pneumoniae: a case report

More and more cases of human infections with avian influenza A H7N9 have been reported since it was first mentioned in 2013 in China, but concurrence of influenza A H7N9 with Mycoplasma pneumoniae, however, has n...

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Novel compound heterozygote mutations in the ATP7B gene in an Iranian family with Wilson disease: a case report

Wilson disease is an autosomal recessive disorder of copper transport and is characterized by excessive accumulation of cellular copper in the liver and other tissues because of impaired biliary copper excreti...

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He’s Too Picky… Does He Need Vitamins?

Ideal world:  An eager, hungry 6-year-old sits at his perfectly-portioned plate, with a vegetable, fruit, whole grain and protein – accompanied by a glass of milk.

Real world:  A picky, finicky 6-year-old stares at his plate on which you've hurriedly thrown a pile of pasta (you know he'll eat it), a few green beans (that he will avoid like the plague), apple slices (that he eats first) and a glass of milk that he refuses to finish.

Among us there are a few lucky parents whose children eat well-balanced meals every meal, every day.  The majority of us struggle with picky eaters, food refusals, busy schedules or a combination of all three.  We might get a well-balanced meal in a few times a week, but every day is a pipe dream!

The majority of children do manage to get most of what their bodies need to grow and thrive despite our less-than-perfect meals.  However, if your child refusals specific foods, has a restrictive diet or is  extremely picky, you may need give her vitamin or mineral supplements.  Megavitamins, large doses of vitamins, are not good for children.  Some vitamins and minerals can be harmful to children in large doses.  First, try to maximize the nutrients in the foods your child eats.  Look for fresh, whole foods and variety of different choices.

But what if your kid is one of these kids….

1. The meat-avoiding toddler. Young toddlers are notorious for avoiding meat.  Most drink a lot of milk and eat a variety of fruits, a few palatable vegetables but turn their noses up at the idea of meat.  Lean meats are an important source of B vitamins and Iron, as well as proteins.  Low iron is associate with fatigue, cognitive and behavioral problems.  Iron is especially important during periods of rapid growth and development because of its role in building muscles and healthy red blood cells.  B vitamins are essential for energy and a healthy nervous system. Symptoms of deficiency include irritability and short attention spans.  Non-meat dietary sources of Iron and B vitamins great for toddlers include:  Hummus, fortified cereals, beans, dark leafy greens and peanuts.  These same deficiencies are seen in vegetarian diets.  If you are concerned your child is not getting enough Iron and B vitamins, you could consider a daily Iron supplement or Children's multivitamin with Iron supplement.
2. The soda-drinking stubborn teen who avoids dairy. Teenagers have some of the worst diets.  Busy schedules often lead to nutrient-poor fast food meals.  Many teens eat foods high in fat and carbohydrates, and don't eat enough fruits, vegetables and dairy.  Often, teens opt for sports drinks and sodas over milk and water.  Calcium and Vitamin D are common nutrient deficiencies in children of all ages, that can get worse when they become teenagers.  Dairy is a major dietary source of calcium and vitamin D, both of which are vital for healthy bones and teeth.  Deficiencies of Vitamin D and Calcium result in brittle bones, muscle weakness, slow growth and fractures.  Children who do not have adequate dairy in their diet can find calcium and vitamin D in fortified orange juice, kale, salmon, tofu and eggs (D only).  Vitamin D and calcium should be supplemented for children at risk for low dietary intake of these important nutrients.
3. Infants. Breastmilk and formula (less than 32 ounces a day) alone no not provide enough Vitamin D for infants prior to starting fortified baby foods.  Vitamin D supplementation is recommended for all breastfed infants and formula fed infants taking less than 32 ounces of formula a day.
4. Extreme picky eater. Many children with autism are among those who may have very restrictive diets, often comprised primarily of carbohydrates and sometimes meats.  These children are at risk for deficiencies in many vitamins and minerals including Vitamin A and C.  Diets high in carbohydrates and low in fruits and vegetables do not provide adequate fiber either.  Vitamin A promotes normal growth and development and healthy skin and eyes.    Vitamin C is essential for a healthy immune system as well as healthy muscle, skin and connective tissue systems.  Low vitamin C can result in frequent infections and poor healing of wounds.  Fiber is important for heart and colon health.  Children who lack adequate fiber in their diets struggle with constipation.  Vitamin A and C are found in fruits and vegetables.  Foods high in fiber include whole fruits, beans, raisins, and some cereals.  Children who do not get enough fiber in their diets and/or who struggle with constipation can benefit from a daily fiber supplement.  Children with diets low in fruits and vegetables need a daily multivitamin.

Well-balanced, consistent nutrition is extremely important for growth and development starting from birth and continuing into adulthood.  Healthy eating patterns incorporating low fat dairy products, plenty of fresh fruits and a rainbow of vegetables, lean proteins and whole grains should start early in childhood.  Model healthy eating for your child.  Aim to get your child's nutrients through foods, but supplement nutrients when needed after talking to your pediatrician.

The post He's Too Picky… Does He Need Vitamins? appeared first on ChildrensMD.

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Assessment by the CANS Score Versus Anthropometry and Impact on Early Neonatal Morbidities

Condition:   Fetal Malnutrition
Interventions:   Diagnostic Test: Clinical assessment of nutritional status (CANS) score;   Diagnostic Test: Anthropometric indices;   Diagnostic Test: Proportionality indices
Sponsor:   Cairo University
Recruiting

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Plasmablast Detection From IgG4-Related Disease Patients

Condition:   IgG4-related Disease
Intervention:  
Sponsor:   Meir Medical Center
Not yet recruiting

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Resilience and Quality of Life Among Cancer Survivors

Condition:   Mental Health Wellness 1
Intervention:   Other: Non applicable
Sponsor:   Aga Khan University
Not yet recruiting

http://ift.tt/2FEVTHi

Management of tumour lysis syndrome during first-line palliative chemotherapy for high-volume colorectal cancer

Tumour lysis syndrome (TLS) is a rare oncological emergency in solid tumours. Because it is associated with bad short-term prognosis, early recognition and treatment are mandatory. This case refers to a middle-aged woman who presented with stage IV colon cancer, with massive hepatic involvement. After three cycles of first-line FOLFOX (folinic acid, 5-fluorouracil and oxaliplatin), she developed acute kidney injury and hyperkalaemia that did not respond to standard measures. High suspicion of TLS prompted further corroborating investigations and early intensive care unit admission. With vigorous hydration and allopurinol, TLS completely resolved and the patient was discharged. Prophylaxis of subsequent TLS recurrence was complicated by biopsy-proven neutrophilic vasculitis secondary to allopurinol. Prevention of TLS with hydration and rasburicase was performed prior to each subsequent cycle of chemotherapy. This case report is intended to highlight risk factors for TLS in solid tumours and focus on treatment and secondary prophylaxis of TLS.

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Unusual case of a rectal tumour

A 48-year-old man presented as an emergency with a 3-week history of rectal bleeding. Examination of his rectum revealed a circumferential tumour, 2 cm from the anal verge. An MRI scan reported a locally infiltrative mid-lower rectal tumour staged as T3d/T4 N2 MX. A colonoscopy revealed appearances of severe proctitis and biopsies did not show any evidence of dysplasia or malignancy. The patient was discussed at the regional colorectal cancer multidisciplinary team meeting with a management plan for neoadjuvant chemoradiotherapy following repeat biopsies, which were again negative for malignancy. He tested positive for the HIV and was referred to genitourinary medicine. A positive Chlamydia trachomatis nucleic acid test from a rectal swab was serovar L2 consistent with a diagnosis of lymphogranuloma venereum. He was treated with doxycycline and subsequent MRI scans showed reduction in tumour size with eventual resolution. This case report highlights the importance of HIV testing in patients with newly diagnosed colorectal tumours.

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Autopsy case of aortic dissection after transcatheter aortic valve implantation (TAVI)

Aortic dissection is one of the severe but rare vascular complications arising from transcatheter aortic valve implantation (TAVI). This paper presents an autopsy case of an 81-year-old male patient with delayed aortic dissection with underlying haemorrhages and acute inflammation 3 years after TAVI.

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Gastric Dieulafoy lesion: a rare cause of massive haematemesis in an elderly woman

Description

A 78-year-old woman presented to her local accident and emergency department by ambulance, having collapsed following several episodes of voluminous fresh haematemesis with melaena. The patient had extensive medical comorbidities, suffering from type 2 diabetes mellitus, ischaemic heart disease, bronchiectasis and severe pulmonary hypertension. Three weeks previously she had undergone an uncomplicated total hip replacement for osteoarthritis and had been using non-steroidal anti-inflammatory drugs (NSAIDs) for analgesia. She had no history of gastroenterological disease.

The patient responded to initial resuscitative measures sufficiently to undergo oesophagogastroduodenoscopy. The gastroenterologist struggled to achieve any useful view of either stomach or duodenum due to the volume of haemorrhage, and aborted the procedure. The patient rapidly displayed signs of haemodynamic instability and deteriorated into a state of refractory hypovolaemic shock. She was intubated and ventilated.

The patient underwent laparotomy and antrotomy with duodenotomy, which showed no focal gastric or duodenal abnormality. Attempted...

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Myelodysplastic syndrome presenting as a Behcets-like disease with aortitis

A 46-year-old Hispanic man presented with fever, genital ulcers, left eye redness and chest pain. Physical examination was notable for a healed oral ulcer and scrotal ulcers, and bilateral superficial thrombophlebitis. He was found to have new-onset pancytopenia. CT of the chest showed pericardial and pleural effusions and rapidly progressing inflammation of the aortic arch and ascending vessels. Although the patient had Behcet's disease (BD)-like symptoms, pancytopenia could not be explained by the diagnosis, prompting a bone marrow biopsy which showed myelodysplastic syndrome. This report highlights the importance of excluding alternate disorders before making a diagnosis of Behcet's disease if atypical, BD-incompatible or incomplete constellations of symptoms and findings are present.

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The 'wobbling pears in urine

Description

A 54-year-old female was admitted to the neurosurgery unit for excision of a non-functioning pituitary adenoma. Preoperative microscopic urinary examination revealed many motile pear- shaped organisms ranging in size from 17 to 23 µm (figure 1, red arrow) demonstrating characteristic wobbling to rotatory movement (video 1). These were conforming to the morphology of trophozoite form of Trichomonas vaginalis. Retrospectively, it was found that the patient had mild vaginal itching with passage of greenish discharge. Other laboratory investigations revealed that she was non-diabetic and HIV negative. Subsequently, she was given oral tinidazole 2 g single dose and was symptomatically better. She was taken up for surgery, and the follow-up urine sediment wet mount smears were negative for the parasite.

Trichomoniasis is the most common non-viral sexually transmitted infection worldwide. Vaginal/urethral/prostatic discharge and urine sediment wet mount smears offer rapid diagnosis with an excellent specificity owing to the...

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Disseminated tuberculous lymphadenitis presenting as cervical mass in patient with HIV infection, worsening after antiretroviral initiation: diagnosis and treatment challenges

Tuberculosis (TB) continues to represent an important public health challenge in the world and the USA, especially given its association with HIV infection and population migration. Cervical tuberculous lymphadenitis represents the most common extrapulmonary presentation of TB in the USA. Considerations for other causes of neck mass often contribute to delay in diagnosis. In this report, we describe the case of a 41-year-old man who presented with painful swelling of the neck and was diagnosed with tuberculous lymphadenitis, complicated by HIV therapy-associated immune reconstitution syndrome. Prior to this diagnosis, he presented with a chronic intermittent cough, repeatedly treated as bronchitis. Furthermore, TB is a recognised occupational risk for primary care physician, as they are often the first contact for patients. With the Patient Protection and Affordable Care Act in the USA, the risk is likely to increase with the influx of newly insured often poor,and/or immigrants.

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Internal jugular vein aneurysm in an adult: diagnosis on non-invasive imaging

We report the case of a 48-year-old man with a right fusiform internal jugular venous aneurysm, presenting as a unilateral painless neck swelling on coughing or laughing. This is a rare condition, more commonly seen in the paediatric population and can be diagnosed using non-invasive modalities such as Doppler ultrasound and contrast-enhanced CT. This anomaly is frequently misdiagnosed or overlooked, and our case highlights the importance of considering venous aneurysm as a differential to prevent invasive imaging and inappropriate management.

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Chronic myelogenous leukaemia with a p53 mutation demonstrated neutrophilic granulocytes with nuclear hypolobation (pseudo-Pelger-Hüet anomaly) and hypogranulation in the peripheral blood smear

A 70-year-old man visited our emergency department, whose laboratory test results revealed leucocytosis, anaemia, thrombocytopenia and high levels of serum lactate dehydrogenase. In addition, the peripheral blood smear revealed neutrophilic granulocytes with nuclear hypolobation (pseudo-Pelger-Hüet anomaly), hypogranulation and no myeloperoxidase reactivity. Genetic testing of the peripheral blood sample was as follows: G-band, 46XY,t(9;22)(q34;q11.2) (20/20); fluorescence in situ hybridisation BCR/ABL fusion signal, 97%; and analysis of exons 5–9 of the p53 gene, mutation (Pro72Arg) in exon 4 protein. On the basis of these findings, the patient was diagnosed with chronic myelogenous leukaemia (CML) in chronic phase with a p53 mutation and treated with hydroxyurea, dasatinib and nilotinib. Neutrophilic granulocytes with the anomalies were no longer observed after achieving cytogenetic remission. To the best of our knowledge, this is the first report of CML case with the anomalies, in which a p53 mutation without chromosome 17 abnormalities was identified.

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Dilated tonic pupils with tabes dorsalis in neurosyphilis as first manifestation of HIV/AIDS: a video report

Description

A previously healthy 30-year-old bisexual African man was admitted with a 3-month history of weight loss, paroxysmal shooting pains and paraesthesia of both lower limbs and difficulty in walking. He denied progression of visual symptoms such as blurred vision with reading and near work, photophobia, anisocoria or visual loss. The Mini-Mental State Examination was normal (30/30). He was alert, oriented to time, person and place with a Glasgow Coma Scale of 15/15. His body mass index was 17 kg/m². There was generalised wasting syndrome, cervical lymphadenopathy and diffuse hair loss of the scalp and eyebrows. There was no urinary incontinence.

Visual acuity without correction (20/20), visual fields, intraocular pressures (14 mm Hg) and fundoscopy were normal in both eyes. Ocular motility was full bilaterally with no nystagmus. The pupils, however, were 6.0 mm in diameter on room light bilaterally, unreactive to light or accommodation (Video 1, segment 1)....

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Unilateral retinitis pigmentosa occurring in an individual with a mutation in the CLRN1 gene

This case report depicts the clinical course of a female patient with unilateral retinitis pigmentosa, who first presented at the age of 12 years. Fundus photography at the time revealed unilateral pigmentary retinopathy, which was associated with extinguished electroretinogram (ERG) signal. At 35 years of age, fundus examination revealed deterioration of pre-existing unilateral pigmentary retinopathy with progressive visual field defect detected on Goldmann visual field testing. ERG findings remained unchanged and multifocal ERG showed unilateral decrease in amplitude in the affected eye. The patient was referred for genetic counselling. Next-generation sequencing identified a deleterious heterozygous c.118T>G (p.Cys40Gly) mutation in the CLRN1 gene.

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Endovascular recanalisation with drug coated balloon for chronic symptomatic middle cerebral artery total occlusion

The optimal treatment for patients with chronic symptomatic middle cerebral artery (MCA) total occlusion is not well established. In addition to medical therapy, vessel recanalisation with stenting has shown much promise, especially for patients with recurrent ischemic symptoms. Nevertheless, the incidence of symptomatic in-stent restenosis (ISR) is high, and is associated with an unfavorable prognosis. Drug coated balloons (DCBs) have been proven to be effective in treating and preventing ISR. However, the feasibility of DCBs for de novo intracranial atherothrombotic stenosis has not been previously described, especially for total occlusion lesions. Here we reported a patient with chronic left MCA total occlusion successfully treated with DCBs, with a good outcome at the 1 year follow-up. More studies are warranted to further compare the efficacy of DCBs and stentings for intracranial revascularisation.

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Coinfection of leprosy and tuberculosis

Leprosy and tuberculosis (TB) are endemic to India, however, their coinfection is not frequently encountered in clinical practice. Here, we report a 32-year-old female patient who presented with a history of high-grade intermittent fever, cough and painless skin lesions since a month, along with bilateral claw hand (on examination). The haematological profile was suggestive of anaemia of chronic disease, chest radiograph showed consolidation, sputum smears were positive for Mycobacterium tuberculosis, and skin slit smear confirmed leprosy. The patient was prescribed WHO recommended multidrug therapy for multibacillary leprosy with three drugs. Additionally, prednisolone was added to her regimen for 2 weeks to treat the type 2 lepra reaction. For treatment of TB, she was placed on the standard 6-month short course chemotherapy. She was lost to follow-up, and attempts were made to contact her. Later, it came to our notice that she had discontinued medications and passed away 3 months after diagnosis.

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Recurrence of eosinophilic oesophagitis with subcutaneous grass pollen immunotherapy

Case reports have described an association between oral food/aeroallergen immunotherapy with the development of eosinophilic oesophagitis (EoE). The underlying mechanism of this is poorly understood, as is the role that both food/aeroallergen sensitisation plays in the pathogenesis of EoE. Specific immunotherapy has a long-standing history of use in the management of moderate/severe seasonal allergic rhinitis (AR), caused by tree/grass pollens. Subcutaneous immunotherapy (SCIT) to grass pollen is less commonly used in children than sublingual immunotherapy (SLIT) or oral immunotherapy for practical reasons. We describe a case of a child with severe grass-pollen related AR and known, but quiescent, EoE, who developed recurrence of oesophageal symptoms on two separate occasions, coincident with the commencement of SLIT to grass pollen. He was subsequently started on SCIT to grass pollen and developed recurrence of symptoms of EoE—a phenomenon that has yet to be reported in the medical literature.

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Supraventricular tachycardia as a complication of severe diabetic ketoacidosis in an adolescent with new-onset type 1 diabetes

Diabetic ketoacidosis (DKA) is one of the most common causes of morbidity and mortality in new-onset type 1 diabetes (T1D). Supraventricular tachycardia (SVT), however, is a very rare complication of DKA. We present the case of a patient with new-onset T1D who presented with DKA. He received intravenous fluid resuscitation, insulin and potassium supplementation and subsequently developed SVT, confirmed on a 12-lead electrocardiograph despite a structurally normal heart. Vagal manoeuvres and adenosine failed to restore sinus rhythm, but flecainide was successful. We conclude that SVT can occur as a complication of DKA, including in new-onset T1D. Our case is the first of this phenomenon occurring in new-onset childhood diabetes, as the few prior documented cases had established diabetes. Furthermore, a combination of potassium derangement, hypophosphataemia and falling magnesium levels may have precipitated the event.

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More than 40 years follow-up of an unconstrained metal lunate replacement for the treatment of Kienböcks disease

Kienböck's disease is characterised by avascular necrosis of the lunate bone, and over the years it has been a challenging disease to manage, with differing opinions on the best intervention. We present an interesting case of a metallic unconstrained lunate replacement that is still functioning well in a patient 40 years after surgery. This case report represents the longest follow-up of any such prosthesis.

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Metastatic primary pulmonary melanoma successfully treated with checkpoint inhibitors

Our patient is a 69-year-old man who presented to the emergency department with left-sided hemiparesis that started 4 hours prior to presentation. Brain CT showed right basal ganglia and internal capsule haemorrhagic strokes. MRI revealed multiple brain lesions suspicious for metastases. Further workup revealed a 5 cm lung mass and a 1 cm pancreatic nodule. Biopsy of both pulmonary and pancreatic lesions was consistent with melanoma and was similar histologically. The patient underwent cyberknife stereotactic radiosurgery to the brain metastases followed by immunotherapy with pembrolizumab, and then by nivolumab and ipilimumab. The patient remains free of disease progression 2 years after treatment.

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Infected symptomatic carotid artery atheroma concurrent with bacterial endocarditis

Optimal management of patients with stroke due to symptomatic carotid artery disease coexistent with bacterial endocarditis is still not well established. We report the case of a patient who presented with multifocal left middle cerebral artery stroke in the setting of Enterococcus faecalis endocarditis and was found to have near-occlusive ipsilateral carotid artery stenosis in stroke workup. Carotid artery endarterectomy was performed, and atheroma material demonstrated complicated plaque with cultures positive for E. faecalis. This report demonstrates that patients with cardioembolic disorders such as bacterial endocarditis with vegetations who present with stroke may benefit from evaluation for extracranial vessel stenosis. Also, additional consideration should be given to the possibility of infected atheroma in patients with symptomatic carotid stenosis with recent or active endocarditis or bacteraemia.

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Methacrylate dressing on refractory venous leg ulcers

Chronic leg ulcers can have a major impact on the quality of life of patients. These wounds can be complex and hard to heal, as several factors may affect the outcome. Underlying conditions, bacterial growth and excess moisture may prevent wounds from healing. We describe the case of a patient with known chronic venous disease, who was admitted to our hospital for several complex, irregular and infected chronic venous ulcers in his lower legs. The management was frustrating for several months, until we began to use methacrylate powder dressing for his hard-to-heal wounds.

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Unusual association between erythema nodosum and autoimmune atrophic gastritis

We report a case of a 46-year-old woman with a history of autoimmune atrophic gastritis and recurrent erythema nodosum (EN). Laboratory results showed iron-deficiency anaemia, positive antiparietal cell antibodies and marginal deficiency of vitamin B12. Although EN was refractory to general measures (rest and non-steroidal anti-inflammatory drugs) and corticosteroid therapy, it was successfully treated with vitamin B12 supplementation.

http://ift.tt/2pcxRt0

Myocarditis Secondary to Mesalamine-Induced Cardiotoxicity in a Patient with Ulcerative Colitis

Development of cardiac manifestations in patients diagnosed with inflammatory bowel disease undergoing treatment with mesalamine is a rare. When this occurs, it can be difficult to tease out the primary etiology, as both IBD and mesalamine can cause cardiac manifestations independently of each other. The exact mechanism of mesalamine-induced cardiotoxicity is yet to be determined although several mechanisms have been described. We present the case of a gentleman with nonexertional chest pain in the setting of ulcerative colitis exacerbation believed to have occurred secondary to mesalamine.

http://ift.tt/2DvnBQL

Faulty Cellular Membrane “Mix” Linked To Parkinson’s Disease

Working with lab-grown human brain cells, Johns Hopkins researchers report they have uncovered a much sought-after connection between one of the most common genetic mutations in Parkinson's disease and the formation of fatty plaques in the brain thought to contribute to the destruction of motor neurons that characterize the disease.

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Digital architecture and difference: a theory of ethical transpositions towards nomadic embodiments in digital architecture

Bar, Tal; (2018) Digital architecture and difference: a theory of ethical transpositions towards nomadic embodiments in digital architecture. Doctoral thesis (Ph.D), UCL (University College London).

http://ift.tt/2pg5HML

Dynamic MRI for bowel motility imaging - how fast and how long?

de Jonge, CS; Gollifer, RM; Nederveen, AJ; Atkinson, D; Taylor, SA; Stoker, J; Menys, A; (2018) Dynamic MRI for bowel motility imaging - how fast and how long? British Journal of Radiology 10.1259/bjr.20170845 . (In press). Green open access

http://ift.tt/2IreG6P

Cosmetic outcome as rated by patients, doctors, nurses and BCCT.core software assessed over 5 years in a subset of patients in the TARGIT-A Trial

Corica, T; Nowak, A; Saunders, C; Bulsara, M; Taylor, M; Williams, N; Keshtgar, M; ... Vaidya, JS; + view all Corica, T; Nowak, A; Saunders, C; Bulsara, M; Taylor, M; Williams, N; Keshtgar, M; Joseph, D; Vaidya, JS; - view fewer (2018) Cosmetic outcome as rated by patients, doctors, nurses and BCCT.core software assessed over 5 years in a subset of patients in the TARGIT-A Trial. Radiation Oncology (In press).

http://ift.tt/2Iqz7kk

Sexual dysfunction following rectal cancer surgery

Celentano, V; Cohen, R; Warusavitarne, J; Faiz, O; Chand, M; (2017) Sexual dysfunction following rectal cancer surgery. International Journal of Colorectal Disease , 32 (11) pp. 1523-1530. 10.1007/s00384-017-2826-4 . Green open access

http://ift.tt/2InTWwB

Urban Borderlands: Spatial Change in Amman and Tel Aviv-Jaffa

Atteneder, Siegfried; (2018) Urban Borderlands: Spatial Change in Amman and Tel Aviv-Jaffa. Doctoral thesis (Ph.D), UCL (University College London).

http://ift.tt/2pixex4

Novel biopharmaceutical formulations from electrohydrodynamic atomisation

Angkawinitwong, Ukrit; (2018) Novel biopharmaceutical formulations from electrohydrodynamic atomisation. Doctoral thesis (Ph.D), UCL (University College London).

http://ift.tt/2ItYVMb

Aural education and its pedagogical conceptualisation in higher music education

Andrianopoulou, M; (2018) Aural education and its pedagogical conceptualisation in higher music education. Doctoral thesis (Ph.D), UCL (University College London).

http://ift.tt/2peaezo

Social Media: Changing the Paradigm for Surgical Education

Petrucci, AM; Chand, M; Wexner, SD; (2017) Social Media: Changing the Paradigm for Surgical Education. Clinics in Colon and Rectal Surgery , 30 (4) pp. 244-251. 10.1055/s-0037-1604252 .

http://ift.tt/2pgsOqB

Circadian Clock Synchronization of the Cell Cycle in Zebrafish Occurs through a Gating Mechanism Rather Than a Period-phase Locking Process

Laranjeiro, R; Tamai, TK; Letton, W; Hamilton, N; Whitmore, D; (2018) Circadian Clock Synchronization of the Cell Cycle in Zebrafish Occurs through a Gating Mechanism Rather Than a Period-phase Locking Process. Journal of Biological Rhythms 10.1177/0748730418755583 . (In press). Green open access

http://ift.tt/2Iqz9bW

Colorectal cancer surgery in the very elderly patient: a systematic review of laparoscopic versus open colorectal resection.

Devoto, L; Celentano, V; Cohen, R; Khan, J; Chand, M; (2017) Colorectal cancer surgery in the very elderly patient: a systematic review of laparoscopic versus open colorectal resection. International Journal of Colorectal Disease , 32 (9) pp. 1237-1242. 10.1007/s00384-017-2848-y . Green open access

http://ift.tt/2pjSHpN

Learning to innovate collaboratively with technology: exploring strategic workplace skill webs in a telecom services firm in Tehran

Alyani, Náder; (2018) Learning to innovate collaboratively with technology: exploring strategic workplace skill webs in a telecom services firm in Tehran. Doctoral thesis (Ph.D), UCL (University College London).

http://ift.tt/2Isaeoh

Preschool Obesity in the United Arab Emirates: Determinants and Effectiveness of the Ten Step Healthy Lifestyle Tool for Toddlers: Eat Right Emirates Study

Altarrah, Danah Khalid; (2018) Preschool Obesity in the United Arab Emirates: Determinants and Effectiveness of the Ten Step Healthy Lifestyle Tool for Toddlers: Eat Right Emirates Study. Doctoral thesis (Ph.D), UCL (University College London).

http://ift.tt/2pdXOYo

A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases

Siddiqui, MRS; Simillis, C; Hunter, C; Chand, M; Bhoday, J; Garant, A; Vuong, T; ... Brown, G; + view all Siddiqui, MRS; Simillis, C; Hunter, C; Chand, M; Bhoday, J; Garant, A; Vuong, T; Artho, G; Rasheed, S; Tekkis, P; Abulafi, A-M; Brown, G; - view fewer (2017) A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases. British Journal of Cancer , 116 (12) pp. 1513-1519. 10.1038/bjc.2017.99 . Green open access

http://ift.tt/2pe02H2

Indocyanine green fluorescence imaging in colorectal surgery: overview, applications, and future directions

Keller, DS; Ishizawa, T; Cohen, R; Chand, M; (2017) Indocyanine green fluorescence imaging in colorectal surgery: overview, applications, and future directions. The Lancet Gastroenterology & Hepatology , 2 (10) pp. 757-766. 10.1016/S2468-1253(17)30216-9 . Green open access

http://ift.tt/2Iq9xfa

Variation in health beliefs across different types of cervical screening non-participant

Marlow, L; Ferrer, R; Chorley, A; Haddrell, J; Waller, J; (2018) Variation in health beliefs across different types of cervical screening non-participant. Preventive Medicine (In press).

http://ift.tt/2pdXKI8

Barriers to cervical screening and interest in self-sampling among women who actively decline screening

Bennett, K; Waller, J; Chorley, A; Ferrer, R; Haddrell, J; Marlow, L; (2018) Barriers to cervical screening and interest in self-sampling among women who actively decline screening. Journal of Medical Screening (In press).

http://ift.tt/2IsQYqW

Interobserver agreement of radiologists assessing the response of rectal cancers to preoperative chemoradiation using the MRI tumour regression grading (mrTRG)

Siddiqui, MRS; Gormly, KL; Bhoday, J; Balyansikova, S; Battersby, NJ; Chand, M; Rao, S; ... Brown, G; + view all Siddiqui, MRS; Gormly, KL; Bhoday, J; Balyansikova, S; Battersby, NJ; Chand, M; Rao, S; Tekkis, P; Abulafi, AM; Brown, G; - view fewer (2016) Interobserver agreement of radiologists assessing the response of rectal cancers to preoperative chemoradiation using the MRI tumour regression grading (mrTRG). Clinical Radiology , 71 (9) pp. 854-862. 10.1016/j.crad.2016.05.005 . Green open access

http://ift.tt/2pgmIXp

Psychosocial work environment and oral health in the English Longitudinal Study of Ageing

Aldalooj, Esraa; (2018) Psychosocial work environment and oral health in the English Longitudinal Study of Ageing. Doctoral thesis (Ph.D), UCL (University College London).

http://ift.tt/2IrLAEl

Application of Energy Dispersive X-Ray Diffraction (EDXRD) in the detection of fat nodules in liver disease and plaques in the blood vessels of the heart

Abuchi, Chukwuneke Sid; (2018) Application of Energy Dispersive X-Ray Diffraction (EDXRD) in the detection of fat nodules in liver disease and plaques in the blood vessels of the heart. Doctoral thesis (Ph.D), UCl (University College London).

http://ift.tt/2pdXKb6

Acute Parotitis after Lower Limb Amputation: A Case Report of a Rare Complication

Background. Postoperative parotitis is a rare complication that occurs usually after abdominal surgery. Parotitis has never been described as a complication of vascular operations, in literature. In the present article, we describe a case of a postamputation parotitis along with its management and its possible pathogenesis. Case Report. An 83-year-old diabetic man was emergently admitted to hospital because of gangrene below the right ankle and sepsis. The patient underwent a lower limb amputation above the knee. On the 5th postoperative day, he was diagnosed with right parotitis probably because of dehydration, general anesthesia, and immunocompromisation. A CT scan confirmed the diagnosis. He received treatment with antibiotics and fluids. His condition gradually improved, and he was finally discharged on 15th postoperative day. Conclusions. Postoperative parotitis can possibly occur after any type of surgery including vascular. Clinicians should be aware of this complication although it is rare. Several risk factors such as dehydration, general anesthesia, drugs, immunocompromisation, head tilt during surgery, and stones in Stensen's duct may predispose to postoperative parotitis. Treatment consists of antibiotics and hydration.

http://ift.tt/2perZQ9

Molecular defects in BRAF wild-type ameloblastomas and craniopharyngiomas—differences in mutation profiles in epithelial-derived oropharyngeal neoplasms

Abstract

The aim of this study was to evaluate the mutation profile of BRAF wild-type craniopharyngiomas and ameloblastomas. Pre-screening by immunohistochemistry and pyrosequencing for identifying BRAF wild-type tumors was performed on archived specimens of ameloblastic tumors (n = 20) and craniopharyngiomas (n = 62). Subsequently, 19 BRAF wild-type tumors (nine ameloblastic tumors and ten craniopharyngiomas) were analyzed further using next-generation sequencing (NGS) targeting hot spot mutations of 22 cancer-related genes. Thereby, we found craniopharyngiomas mainly CTNNB1 mutated (8/10), including two FGFR3/CTNNB1-double mutated tumors. Ameloblastic tumors were often FGFR2 mutated (4/9; including one FGFR2/TP53/PTEN-triple mutated case) and rarely CTNNB1/TP53-double mutated (1/9) and KRAS-mutated (1/9). In the remaining samples, no mutation could be detected in the 22 genes under investigation. In conclusion, mutation profiles of BRAF wild-type craniopharyngiomas and ameloblastomas share mutations of FGFR genes and have additional mutations with potential for targeted therapy.

http://ift.tt/2GsAL48

Enhanced expression of PD-1 and other activation markers by CD4+ T cells of young but not old patients with metastatic melanoma

Abstract

The biological behavior of melanoma is unfavorable in the elderly when compared to young subjects. We hypothesized that differences in T-cell responses might underlie the distinct behavior of melanoma in young and old melanoma patients. Therefore, we investigated the circulating T-cell compartment of 34 patients with metastatic melanoma and 42 controls, which were classified as either young or old. Absolute numbers of CD4+ T cells were decreased in young and old melanoma patients when compared to the age-matched control groups. Percentages of naive and memory CD4+ T cells were not different when comparing old melanoma patients to age-matched controls. Percentages of memory CD4+ T cells tended to be increased in young melanoma patients compared to young controls. Proportions of naive CD4+ T cells were lower in young patients than in age-matched controls, and actually comparable to those in old patients and controls. This was accompanied with increased percentages of memory CD4+ T cells expressing HLA-DR, Ki-67, and PD-1 in young melanoma patients in comparison to the age-matched controls, but not in old patients. Proportions of CD45RA−FOXP3^high memory regulatory T cells were increased in young and old melanoma patients when compared to their age-matched controls, whereas those of CD45RA+FOXP3^low naive regulatory T cells were similar. We observed no clear modulation of the circulating CD8+ T-cell repertoire in melanoma patients. In conclusion, we show that CD4+ T cells of young melanoma patients show signs of activation, whereas these signs are less clear in CD4+ T cells of old patients.

http://ift.tt/2tTHFwC

Case 8-2018: A 55-Year-Old Woman with Shock and Labile Blood Pressure

Presentation of Case. Dr. Nathalie Roy: A 55-year-old woman was transferred to this hospital for evaluation and treatment of cardiogenic shock. Approximately 4 months before presentation, the patient was admitted to a hospital in her home state for "pounding" in her chest, nausea, and diaphoresis…

http://ift.tt/2pbE6gS

A tale of seven narrow spikes and a long trough: constraining the timing of the percolation of H II bubbles at the tail end of reionization with ULAS J1120+0641

Chardin, J; Haehnelt, MG; Bosman, SEI; Puchwein, E; (2018) A tale of seven narrow spikes and a long trough: constraining the timing of the percolation of H II bubbles at the tail end of reionization with ULAS J1120+0641. Monthly Notices of the Royal Astronomical Society , 473 (1) pp. 765-775. 10.1093/mnras/stx2362 . Green open access

http://ift.tt/2FCZp58

Distribution of Field-Aligned Electron Events in the High-Altitude Polar Region: Cluster Observations

Shi, J; Zhang, Z; Torkar, K; Cheng, Z; Fazakeley, A; Dunlop, M; Carr, C; (2017) Distribution of Field-Aligned Electron Events in the High-Altitude Polar Region: Cluster Observations. Journal of Geophysical Research: Space Physics , 122 (11) pp. 11245-11255. 10.1002/2017JA024360 .

http://ift.tt/2HzOHIV

Rethinking non-inferiority: a practical trial design for optimising treatment duration

Quartagno, M; Walker, AS; Carpenter, J; Phillips, P; Parmar, M; (2018) Rethinking non-inferiority: a practical trial design for optimising treatment duration. Clinical Trials (In press).

http://ift.tt/2FF5r55

Mild Cognitive Impairment in Parkinson's Disease - What Is It?

Weil, RS; Costantini, A; Schrag, A; (2018) Mild Cognitive Impairment in Parkinson's Disease - What Is It? Current Neurology and Neuroscience Reports , 18 , Article 17. 10.1007/s11910-018-0823-9 . Green open access

http://ift.tt/2HB768j

A variational reconstruction method for undersampled dynamic x-ray tomography based on physical motion models

Burger, M; Dirks, H; Frerking, L; Hauptmann, A; Helin, T; Siltanen, S; (2017) A variational reconstruction method for undersampled dynamic x-ray tomography based on physical motion models. Inverse Problems , 33 (12) , Article 124008. 10.1088/1361-6420/aa99cf .

http://ift.tt/2FF4QAn

Approximation of full-boundary data from partial-boundary electrode measurements

Hauptmann, A; (2017) Approximation of full-boundary data from partial-boundary electrode measurements. Inverse Problems , 33 (12) , Article 125017. 10.1088/1361-6420/aa8410 .

http://ift.tt/2FKqFuz

VUV-absorption cross section of carbon dioxide from 150 to 800 K and applications to warm exoplanetary atmospheres

Venot, O; Benilan, Y; Fray, N; Gazeau, M-C; Lefevre, F; Es-sebbar, E; Hebrard, E; ... Waldmann, IP; + view all Venot, O; Benilan, Y; Fray, N; Gazeau, M-C; Lefevre, F; Es-sebbar, E; Hebrard, E; Schwell, M; Bahrini, C; Montmessin, F; Lefevre, M; Waldmann, IP; - view fewer (2018) VUV-absorption cross section of carbon dioxide from 150 to 800 K and applications to warm exoplanetary atmospheres. Astronomy & Astrophysics , 609 , Article A34. 10.1051/0004-6361/201731295 . Green open access

http://ift.tt/2pfLaZJ

Ethnicity and sexual risk in heterosexual people attending sexual health clinics in England: a crosssectional, self-administered questionnaire study

Sherr, L; Coyle, RM; Miltz, AR; Lampe, FC; Sewell, J; Phillips, AN; Speakman, A; ... A U R A H Study Group, ; + view all Sherr, L; Coyle, RM; Miltz, AR; Lampe, FC; Sewell, J; Phillips, AN; Speakman, A; Dhar, J; Sherr, L; Sadiq, ST; Taylor, S; Ivens, DR; Collins, S; Elford, J; Anderson, J; Rodger, A; A U R A H Study Group, ; - view fewer (2018) Ethnicity and sexual risk in heterosexual people attending sexual health clinics in England: a crosssectional, self-administered questionnaire study. Sexually Transmitted Infections 10.1136/sextrans-2017-053308 . (In press). Green open access

http://ift.tt/2FIvuEA

Does integrated academic and health education prevent substance use? Systematic review and meta-analyses

Melendez-Torres, GJ; Tancred, T; Fletcher, A; Thomas, J; Campbell, R; Bonell, C; (2018) Does integrated academic and health education prevent substance use? Systematic review and meta-analyses. Child: Care, Health and Development 10.1111/cch.12558 . (In press). Green open access

http://ift.tt/2FBRXXU

Mitochondria at the neuronal presynapse in health and disease

Devine, MJ; Kittler, JT; (2018) Mitochondria at the neuronal presynapse in health and disease. [Review]. Nature Reviews Neuroscience , 19 (2) pp. 63-80. 10.1038/nrn.2017.170 .

http://ift.tt/2FM4lQX

Thalamic atrophy in frontotemporal dementia - not just a C9orf72 problem

Bocchetta, M; Gordon, E; Cardoso, MJ; Modat, M; Ourselin, S; Warren, J; Rohrer, J; (2018) Thalamic atrophy in frontotemporal dementia - not just a C9orf72 problem. NeuroImage: Clinical 10.1016/j.nicl.2018.02.019 . (In press). Green open access

http://ift.tt/2p9SSof

Automated trajectory planning for laser interstitial thermal therapy in mesial temporal lobe epilepsy

Vakharia, VN; Sparks, R; Li, K; O'Keeffe, AG; Miserocchi, A; McEvoy, AW; Sperling, MR; ... Wu, C; + view all Vakharia, VN; Sparks, R; Li, K; O'Keeffe, AG; Miserocchi, A; McEvoy, AW; Sperling, MR; Sharan, A; Ourselin, S; Duncan, JS; Wu, C; - view fewer (2018) Automated trajectory planning for laser interstitial thermal therapy in mesial temporal lobe epilepsy. Epilepsia 10.1111/epi.14034 . (In press). Green open access

http://ift.tt/2HBzYNZ

Building Student Engagement in Teaching and Learning: Areas for Enhancement

Krouglov, A; (2017) Building Student Engagement in Teaching and Learning: Areas for Enhancement. In: Lubkina, V and Baranauskienė, I and Mārtinsone, K, (eds.) Society. Integration. Education.: Proceedings of the International Scientific Conference. Volume I. (pp. pp. 238-248). Rezekne Academy of Technologies: Rēzekne, Latvia.

http://ift.tt/2FCjV5Z

A new model for a drying droplet

Sazhin, SS; Rybdylova, O; Pannala, AS; Somavarapu, S; Zaripov, SK; (2018) A new model for a drying droplet. International Journal of Heat and Mass Transfer , 122 pp. 451-458. 10.1016/j.ijheatmasstransfer.2018.01.094 . (In press).

http://ift.tt/2FKdl9s

Are we seeing any better? A comprehensive comparison of myelin biomarkers in the healthy and multiple sclerosis post mortem spinal cord

Battiston, M; Schneider, T; Grussu, F; Schenk, GJ; Wergeland, S; Tachrount, M; Yiannakas, M; ... Samson, R; + view all Battiston, M; Schneider, T; Grussu, F; Schenk, GJ; Wergeland, S; Tachrount, M; Yiannakas, M; Tur Gomez, C; Geurts, JJG; Wheeler-Kingshott, CAM; Samson, R; - view fewer (2018) Are we seeing any better? A comprehensive comparison of myelin biomarkers in the healthy and multiple sclerosis post mortem spinal cord. In: (Proceedings) ISMRM 2018, International Society for Magnetic Resonance in Medicine, 16-21 June 2018, Paris, France. (In press).

http://ift.tt/2pfLpE7

In Quest of Significance: Identifying Types of Twitter Sentiment Events that Predict Spikes in Sales

Kolchyna, O; Souza, TTP; Aste, T; Treleaven, PC; (2015) In Quest of Significance: Identifying Types of Twitter Sentiment Events that Predict Spikes in Sales. Cornell University Library: Ithaca, NY, USA. Green open access

http://ift.tt/2FIvC72

Linking macrostructural and microstructural damage in early MS: a geostatistical and diffusion MRI study

Tur, C; Marschallinger, R; Prados, F; Collorone, S; Altmann, DR; Ourselin, S; Wheeler-Kingshott, CAM; Tur, C; Marschallinger, R; Prados, F; Collorone, S; Altmann, DR; Ourselin, S; Wheeler-Kingshott, CAM; Ciccarelli, O; - view fewer (2018) Linking macrostructural and microstructural damage in early MS: a geostatistical and diffusion MRI study. In: (Proceedings) ISMRM 2018, International Society for Magnetic Resonance in Medicine, 16-21 June 2018, Paris, France. (In press).

http://ift.tt/2pdDlUp

Clustering and hierarchy of financial markets data: advantages of the DBHT

Musmeci, N; Aste, T; Matteo, TD; (2014) Clustering and hierarchy of financial markets data: advantages of the DBHT. Cornell University Library: Ithaca, NY, USA. Green open access

http://ift.tt/2FKdk5o

A multi-center study on fast full-brain quantitative multi-parameter mapping of R1, MT, and R2*: scan-rescan repeatability and inter-site reproducibility

Seif, M; Leutritz, T; Samson, R; Curt, A; Wheeler-Kingshott, CAM; Freund, P; Weiskopf, N; (2018) A multi-center study on fast full-brain quantitative multi-parameter mapping of R1, MT, and R2*: scan-rescan repeatability and inter-site reproducibility. In: (Proceedings) ISMRM 2018, International Society for Magnetic Resonance in Medicine, 16-21 June 2018, Paris, France. (In press).

http://ift.tt/2FCLNGZ

Hubble PanCET: an isothermal day-side atmosphere for the bloated gas-giant HAT-P-32Ab

Nikolov, N; Sing, DK; Goyal, J; Henry, GW; Wakeford, HR; Evans, TM; Lopez-Morales, M; ... Williamson, MH; + view all Nikolov, N; Sing, DK; Goyal, J; Henry, GW; Wakeford, HR; Evans, TM; Lopez-Morales, M; Munoz, AG; Ben-Jaffel, L; Sanz-Forcada, J; Ballester, GE; Kataria, T; Barstow, JK; Bourrier, V; Buchhave, LA; Cohen, O; Deming, D; Ehrenreich, D; Knutson, H; Lavvas, P; Lecavelier des Etangs, A; Lewis, NK; Mandell, AM; Williamson, MH; - view fewer (2018) Hubble PanCET: an isothermal day-side atmosphere for the bloated gas-giant HAT-P-32Ab. Monthly Notices of the Royal Astronomical Society , 474 (2) pp. 1705-1717. 10.1093/mnras/stx2865 . Green open access

http://ift.tt/2HBzWpl

Association of overexpressed karyopherin alpha 2 with poor survival and its contribution to interleukin-1β-induced matrix metalloproteinase expression in oral cancer

Abstract

Background

The purpose of this study was to elucidate the clinicopathological associations and molecular mechanisms of karyopherin alpha 2 (KPNA2) in oral cavity squamous cell carcinoma (SCC) progression.

Methods

The KPNA2 expressions were analyzed by immunohistochemistry and enzyme-linked immunosorbent assay in 209 tissues and 181 saliva samples, respectively. The functions of KPNA2 in migration and invasion were examined in KPNA2-knowdown cells. The matrix metalloproteinase (MMP) levels were determined by real-time quantitative polymerase chain reaction (qPCR). The subcellular fraction was used to obtain the nuclear distribution of nuclear factor-kappa B (NF-κB).

Results

The KPNA2 overexpression was associated with extranodal extension (P < .05) and poor disease-specific survival in patients with oral cavity SCC (P < .05). The salivary KPNA2 levels were elevated in patients with oral cavity SCC (P < .05). The KPNA2 knockdown reduced cell migration and invasion. This knockdown also suppressed the interleukin (IL)-1β-induced nuclear import of NF-κB and MMP (MMP-1, MMP-3, and MMP-9) transcription.

Conclusion

The KPNA2 overexpression is an independent biomarker for poor prognosis of oral cavity SCC and is required for MMP-mediated metastasis.

http://ift.tt/2FV5I3m

Circulating tumor DNA as a biomarker and liquid biopsy in head and neck squamous cell carcinoma

Abstract

The use of circulating biochemical molecular markers in head and neck cancer holds the promise of improved diagnostics, treatment planning, and posttreatment surveillance. In this review, we provide an introduction for the head and neck surgeon of the basic science, current evidence, and future applications of circulating tumor DNA (ctDNA) as a biomarker and liquid biopsy to detect tumor genetic heterogeneity in patients with head and neck squamous cell carcinoma (HNSCC).

http://ift.tt/2Hzlpu4

Pilot randomized controlled trial of a comprehensive smoking cessation intervention for patients with upper aerodigestive cancer undergoing radiotherapy

Abstract

Background

Smoking among patients with cancer is associated with poor outcomes, however, smoking cessation interventions have had limited success.

Methods

This randomized controlled trial compared a novel smoking cessation intervention ("intervention") with enhanced usual care ("control"). Participants were smokers with head and neck or thoracic malignancies undergoing radiation. Controls received brief counseling. Intervention participants received intensive counseling, pharmacotherapy, text-messaging, and financial incentives. Biochemically confirmed 7-day abstinence at 8 weeks was compared using Fisher's exact t test. Smoking abstinence and intensity were also analyzed using time-series panel regression.

Results

The study population comprised 19 intervention and 10 control participants. More intervention (74%) than control (30%) participants abstained from smoking at 8 weeks (P = .05). Intervention participants were significantly more likely to abstain (adjusted odds ratio [OR] 14.70; 95% confidence interval [CI] 3.56-60.76) and smoked fewer cigarettes (adjusted incidence rate ratio [IRR], 0.16; 95% CI 0.06-0.40) during weeks 1 to 8.

Conclusion

This intervention decreased smoking among patients with upper aerodigestive cancers during radiotherapy.

http://ift.tt/2FRf5kz

Neuraxial labor analgesia: a focused narrative review of the 2017 literature

Purpose of review Neuraxial labor analgesia remains the most effective and one of the most commonly utilized methods for pain relief during labor. This narrative review article is a summary of the literature published in 2017 on neuraxial analgesia for labor. Recent findings From a total of 41 identified articles, 13 were included in the review. The topics have been structured into three categories: initiation of neuraxial analgesia, maintenance of neuraxial analgesia, and neuraxial analgesia and obstetric outcomes. Maintenance regimens, such as program intermittent epidural bolus (PIEB) techniques, remain a focus of extensive research with the potential to optimize analgesia for each individual patient. In a similar way, the dural puncture epidural technique could improve the quality of labor analgesia with fewer side effects compared with standard epidural and combined spinal epidural (CSE) techniques. Finally, the increased use of modern technology using portable ultrasound devices with automated imaging software to facilitate epidural catheter placement may offer potential advantages to the obstetric anesthesiologist, especially when dealing with technically difficult cases. Summary Recent advances, as well as refinements, of current neuraxial analgesia techniques could improve women's experience of labor. Correspondence to Mitko Kocarev, Anesthesia Department, Hamad Medical Corporation, PO Box 3050, Doha, Qatar. E-mail: mkocarev@hamad.qa Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Paediatric anaesthesia: a rapidly evolving subspecialty

No abstract available

http://ift.tt/2FEcDOU

Wellness in anaesthesia

No abstract available

http://ift.tt/2HzJZLs

Peer support in anesthesia: turning war stories into wellness

Purpose of review Peer support, a method of providing for the well being of healthcare providers following adverse or stressful events, is garnering increased attention in light of the increased prevalence and awareness of burnout, depression and suicidality in physicians. In this review, we will summarize the evolution of the 'second victim,' explore methods of support and examine how new regulatory requirements are changing the peer support landscape. Recent findings As peer support and the second victim are investigated more, themes are emerging regarding the natural history of recovery. As these are delineated, more targeted peer support models are being developed. One major change in 2017 is the institution of new Accreditation Council for Graduate Medical Education's Common Program Requirements, now including topics targeted on well being. Summary Effective and accessible peer support is developing in many departments nationwide and can only be expected to continue, given new regulatory requirements. As these programs develop, and research on their effect continues, best practices will likely emerge. Correspondence to Amy E. Vinson, MD, Boston Children's Hospital, 300 Longwood Avenue - Bader 3, Boston, MA 02115, USA. Tel: +1 401 261 4642; e-mail: amy.vinson@childrens.harvard.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Protective Effect of Punica granatum Extract in Head and Neck Cancer Patients Undergoing Radiotherapy

Abstract

In India, head and neck cancers account for 30–40% cancers of all sites. Due to lack of screening program, wide variation in the availability of infrastructures and expertise, patients present at an advanced stage. The main stay of management of the head and neck tumours is surgery and chemoradiation. Radiation dermatitis and mucositis is one of the most common side effect encountered during the radiotherapy. Aim of our study was to study protective role of pomegranate extract on radiation induced dermatitis and mucositis in head and neck cancer patients. It was a prospective, clinical, double blind, case control study. 60 patients (30 active and controls) undergoing radiotherapy for head and neck cancer were studied for 12 months. Patients in study group were given whole fruit pomegranate extract. Each capsule contained 300 mg of whole fruit extract, each capsule contains 40% polyphenols and 27% punicalagin. Each patient were given 2 capsules every day for a period of 6–7 weeks. The skin and mucosal changes was graded according to the acute radiation morbidity scoring criteria (RTOG) for skin and mucous membrane. The results were statistically significant. Pomegranate extract proved to be radioprotective. Our study is one of the first study in humans to demonstrate the effectiveness of pomegranate extract in preventing radiation dermatitis and mucositis.

http://ift.tt/2FEUGQf

Cumulative risk of skin tumours in patients with Lynch syndrome

Lynch syndrome (LS) is an autosomal-dominant disorder characterized by a predisposition to colorectal cancer and extracolonic malignancies. LS is caused by a germline mutation in one of the four DNA mismatch repair (MMR) genes (MLH1, MSH2, MSH6 and PMS2) or loss of expression of MSH2 due to deletion in the EPCAM gene. Muir-Torre syndrome (MTS) is considered a variant of LS, in which patients present with sebaceous neoplasms and/or keratoacanthomas. A few studies and case reports suggest a relation between LS and other benign and (pre)-malignant skin tumours. Currently only patients presenting with sebaceous carcinoma are advised to be referred to a dermatologist for surveillance.

This article is protected by copyright. All rights reserved.

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