X chromosome gain is related to increased androgen receptor expression in male breast cancer

Abstract

X chromosome gain has been previously described in male breast cancer (MBC). Androgen receptor (AR) gene is located on X chromosome. The aim of this study was to investigate the role of the X chromosome gain in the development of MBC and its relation with AR gene copy number and expression.

The X chromosome status was assessed in 66 cases of male invasive and in situ duct breast carcinoma, in 34 cases of gynecomastia associated with cancer, and in 11 cases of tumor-free gynecomastia. Cases were tested by fluorescence in situ hybridization (FISH) to assess the X chromosome status and AR amplification. AR expression was studied by immunohistochemistry (IHC). In addition, AR methylation status was assessed.

X chromosome gain was observed in 74.7% of invasive duct carcinoma, in 20.6% of in situ duct carcinoma, and in 14.6% of gynecomastia when associated with cancer, while all cases of tumor-free gynecomastia showed wild X chromosome asset. AR gene copy number when increased paralleled the number of X chromosomes. AR IHC expression was observed in 100% of MBC tested. AR gene methylation status revealed low level or absence of methylation.

These data suggest that X chromosome can play a role in the neoplastic transformation of male breast epithelium. X chromosome gain is paralleled by AR gene polysomy. Polysomic AR genes show low methylation levels and high AR protein expression on IHC. These data should be taken into consideration for MBC treatment planning.

https://ift.tt/2xabsCZ

Improved synaptic and cognitive function in aged 3 × Tg-AD mice with reduced amyloid-β after immunotherapy with a novel recombinant 6Aβ15-TF chimeric vaccine

Publication date: Available online 24 May 2018
Source:Clinical Immunology
Author(s): Yun-Zhou Yu, Qing-Li Li, Hai-Chao Wang, Si Liu, Xiao-Bin Pang, Qing Xu, Xiao-Wei Zhou, Pei-Tang Huang
Alzheimer's disease (AD) is the most common progressive neurodegenerative disorder impairing memory and cognition. In this study, we describe the immunogenicity and protective efficacy of the novel recombinant 6Aβ15-TF chimeric antigen as a subunit protein vaccine for AD. Recombinant 6Aβ15-TF chimeric vaccine induced strong Aβ-specific humoral immune responses without Aβ-specific T cell immunity in C57/BL6 and 3 × Tg-AD mice at different ages. As an early immunotherapy model for AD, this vaccine induced high titers of long-lasting anti-Aβ42 antibodies in aged 3 × Tg-AD mice, which led to improve behavioral performance and markedly reduced the levels of insoluble and soluble Aβ and Aβ oligomers. In agreement with these findings, immunotherapy with 6Aβ15-TF prevented the Aβ-induced decrease of presynaptic and postsynaptic proteins in aged 3 × Tg-AD mice. Our results suggest that this novel and highly immunogenic recombinant 6Aβ15-TF chimeric vaccine provides neuroprotection in AD mice and can be considered an effective AD candidate vaccine.

Graphical abstract

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From fish embryos to human patients: lymphangiogenesis in development and disease

Cristina Mauri | Guangxia Wang | Stefan Schulte-Merker

https://ift.tt/2LrREhq

The potential role of pharmacogenomics and biotransformation in hypersensitivity reactions to paracetamol

Purpose of review The aim of the present review is to discuss recent advances supporting a role of paracetamol metabolism in hypersensitivity reactions to this drug. Recent findings Recent developments in the identification of novel paracetamol metabolites, as well as in allele frequencies and functional effects of genetic variation leading to the bioavailablity of reactive paracetamol metabolites, have led to the identification of potential pharmacogenomic and metabolomic targets in studies seeking mechanisms involved in hypersensitivity reactions caused by this drug. Particularly relevant are identification of araquidonate metabolites, identification of specific-binding sequences for reactive paracetamol metabolite-protein adducts, and studies on the frequencies and the functional impact of duplication or multiduplication of genes involved in the formation of reactive metabolites, as well as complete gene deletion or deleterious mutations in genes involved in the detoxification of paracetamol reactive metabolites. In addition, recent evidence points to sex, ethnic origin and age as relevant factors in the production of reactive paracetamol metabolites. Summary High inter-individual variability in the production of reactive paracetamol metabolites exists, and factors leading to increased bioavailability of reactive paracetamol metabolites are being uncovered. Additional research is required to link these factors to paracetamol-induced hypersensitivity reactions. Correspondence to José A.G. Agúndez, University Institute of Molecular Pathology Biomarkers, UEx. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain. E-mail: jagundez@unex.es Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2knGn5J

Isolation and antimicrobial drug susceptibility pattern of bacterial pathogens from pediatric patients with otitis media in selected health institutions, Addis Ababa, Ethiopia: a prospective cross-sectional study

Otitis media is inflammation of the middle ear and tympanic membrane, which often occurs after an acute upper respiratory tract infection. It is the most common episode of infection in children and the second ...

https://ift.tt/2J6BTOG

The potential role of pharmacogenomics and biotransformation in hypersensitivity reactions to paracetamol

Purpose of review The aim of the present review is to discuss recent advances supporting a role of paracetamol metabolism in hypersensitivity reactions to this drug. Recent findings Recent developments in the identification of novel paracetamol metabolites, as well as in allele frequencies and functional effects of genetic variation leading to the bioavailablity of reactive paracetamol metabolites, have led to the identification of potential pharmacogenomic and metabolomic targets in studies seeking mechanisms involved in hypersensitivity reactions caused by this drug. Particularly relevant are identification of araquidonate metabolites, identification of specific-binding sequences for reactive paracetamol metabolite-protein adducts, and studies on the frequencies and the functional impact of duplication or multiduplication of genes involved in the formation of reactive metabolites, as well as complete gene deletion or deleterious mutations in genes involved in the detoxification of paracetamol reactive metabolites. In addition, recent evidence points to sex, ethnic origin and age as relevant factors in the production of reactive paracetamol metabolites. Summary High inter-individual variability in the production of reactive paracetamol metabolites exists, and factors leading to increased bioavailability of reactive paracetamol metabolites are being uncovered. Additional research is required to link these factors to paracetamol-induced hypersensitivity reactions. Correspondence to José A.G. Agúndez, University Institute of Molecular Pathology Biomarkers, UEx. ARADyAL Instituto de Salud Carlos III, Cáceres, Spain. E-mail: jagundez@unex.es Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2knGn5J

The role of gastrointestinal permeability in food allergy

The contribution of a dysfunctional intestinal barrier to the onset and progression of a variety of intestinal and extra-intestinal inflammatory diseases is well established. However, the role of the intestinal barrier function in food allergy is less evident.

https://ift.tt/2IKUzQy

High-risk drug rashes

Provide a brief overview of the clinical presentation, common offending agents, management, prognosis, and mortality of selected six high-risk drug rashes, namely Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), drug reaction with eosinophilia and systemic symptoms (DRESS), multiple drug hypersensitivity syndrome (MDH), acute generalized exanthematous pustulosis (AGEP), and drug-induced bullous pemphigoid (DIBP).

https://ift.tt/2LtSqLa

Subcutaneous allergen immunotherapy may be a suitable treatment for exacerbator allergic asthma

Asthma is a heterogeneous disease which is mainly linked with allergy. Allergen immunotherapy (AIT) is the only specific treatment for allergic diseases with evidence of a disease-modifying effect. Nevertheless, the safety of subcutaneous AIT (SCIT) in asthma has been of some concern since the 1980s, especially in uncontrolled asthma. In this context, our objectives were to assess the safety and efficacy of a Dermatophagoides pteronyssinus (D. pteronyssinus) cluster SCIT protocol in children with moderate to severe allergic asthma.

https://ift.tt/2xd2SU8

The Efficacy of add-on Sublingual Immunotherapy for Adult Asthma patients: A Meta-analysis and Systematic Review

Allergen specific immunotherapy (SIT) is a immunomodulatory treatment for several types of allergic disease.1,2 It is complementary to traditional pharmacotherapy because as a biological response modifier, SIT treats not only the symptoms but also targets the causes of the disease, thus altering disease progression. Meta-analyses have found that injections of allergens under the skin (subcutaneous immunotherapy, SCIT) are effective for treating allergic rhinitis and asthma in children .3 The benefits may last for years after treatment is stopped.

https://ift.tt/2IIpD7K

Dose counting and use of short-acting beta-agonist inhalers in emergency department patients with asthma exacerbation

Medication non-adherence in asthma is a well-recognized problem.1 Non-adherence includes asthma patients using run-out (empty) inhalers and incorrect inhaler techniques.2 These lead to suboptimal disease control and asthma-related emergency department (ED) visits that are potentially preventable.2 Indeed, studies have shown that patients with asthma commonly overestimate the remaining doses of their short-acting beta-agonist (SABA) in metered-dose inhalers (MDIs).3,4 Overestimating the remaining doses of SABA can cause patients to use inhalers beyond the labeled number of actuations, when the drug delivered per actuation can range from 20% to 80% of the therapeutic dose.

https://ift.tt/2xaenvH

Allergy and atopy from infancy to adulthood: Messages from the German birth cohort MAS,

Allergic diseases in early and late childhood have become a common health problem across the globe as documented by the first cross-sectional phase of the International Study on Asthma and Allergies in Childhood [ISAAC] in the mid-1990s.1,2 In many industrialized and developing countries the prevalence of asthma, allergic rhinitis and eczema has increased since then or remained at a high plateau as shown by another global ISAAC assessment a decade later.3

https://ift.tt/2Lq269k

Hypereosinophilic Syndrome in the Differential Diagnosis of Pulmonary Infiltrates with Eosinophilia

The finding of pulmonary eosinophilia elicits a broad differential diagnosis (Table 1).1–3 Attention to key differentiating histologic features combined with clinical and laboratory findings and pertinent radiologic findings are important for distinguishing among the most common entities in the differential diagnosis that include eosinophilic pneumonia, eosinophilic granulomatosis with polyangiitis (EGPA, formerly Churg-Strauss syndrome), allergic bronchopulmonary aspergillosis (ABPA) or more generally allergic bronchopulmonary fungal disease (ABPFD) and isolated asthma.

https://ift.tt/2x8XtNP

Hypereosinophilic Syndrome in the Differential Diagnosis of Pulmonary Infiltrates with Eosinophilia

Publication date: Available online 24 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Nives Zimmermann, Kathryn A. Wikenheiser-Brokamp




https://ift.tt/2GLPB4z

The Amish have Decreased Asthma and Allergic Diseases Compared to Old Order Mennonites

Publication date: Available online 23 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Jamee C. Tantoco, Jordan Elliott Bontrager, Qianqian Zhao, James DeLine, Christine M. Seroogy




https://ift.tt/2IFrUjY

Nonpharmacologic Considerations in the Management of Allergies and Asthma

Publication date: Available online 23 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Gailen D. Marshall




https://ift.tt/2GLPwOj

Provider Practices in Screening for Mental Health Concerns in Caregivers of Patients with Primary Immunodeficiency

Publication date: Available online 23 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Amanda Page, Marni B. Jacobs, Nicole A. Herrera, Tiffany S. Henderson, Christopher Scalchunes, Michael D. Keller, Linda J. Herbert




https://ift.tt/2kpjW02

Written by Kristen A. Feemster. Vaccines—What Everyone Needs to Know, Oxford University Press, 198 Madison Avenue, New York, NY 10016, First Edition, 2018. Softcover, 186 pages, $16.95. ISBN: 978-0-19-027791-8.

Publication date: Available online 24 May 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Peter Capucilli, Jonathan M. Spergel




https://ift.tt/2s8GXYz

Vertigo and Dizziness

Vertigo and dizziness are common conditions among older adults. They are closely associated with fall risk and portend major implications for geriatric injury and disability. Management can be particularly challenging, because symptoms are often nonspecific and may reflect multiple etiologies. Chronic dizziness can reflect dysfunction in the vestibular, somatosensory, or visual systems or in their central integration. Systemic processes, such as postural hypotension, arrhythmias, heart failure, medication use, and lower extremity weakness or frailty, also contribute. Management of acute vestibular syndrome requires ruling out dangerous causes, such as stroke. This article reviews relevant definitions, epidemiology, pathophysiology, diagnosis, and clinical management.

https://ift.tt/2IMXtbW

Host characteristics and dynamics of Staphylococcus aureus colonization in patients with moderate-to-severe psoriasis before and after treatment: A prospective cohort study

https://ift.tt/2GQuGxi

Maintenance of Skin Clearance With Ixekizumab Treatment of Psoriasis: Three-Year Results From the UNCOVER-3 Study

Ixekizumab treatment is associated with a high level of skin clearance in patients with psoriasis., After 3 years of ixekizumab treatment, a majority of patients sustained a PASI 90 response, with no new safety signals.. Ixekizumab is a reasonable long-term treatment option for patients with moderate-to-severe plaque psoriasis.

https://ift.tt/2kmfXRK

What is Jaundice in Newborns?

It is not uncommon for newborn babies to be jaundiced when they are first born. However, it can leave many questions for new parents. What is jaundice? Is it normal? How do I tell if my child is improving? Here are answers to some of the questions you may have if your newborn has jaundice.

The post What is Jaundice in Newborns? appeared first on ChildrensMD.

https://ift.tt/2s9eK3G

Sudden cardiac arrest under spinal anesthesia in a mission hospital: a case report and review of the literature

Sudden cardiac arrest following spinal anesthesia is relatively uncommon and a matter of grave concern for any anesthesiologist as well as clinicians in general. There have been, however, several reports of su...

https://ift.tt/2koZlsI

T-lymphocyte profiles differ between keratoacanthomas and invasive squamous cell carcinomas of the human skin

Abstract

Background

T-lymphocytes are involved in tumor progression and regression. Actinic keratoses (AK) are atypical proliferations of keratinocytes of the skin. Some AK progress into invasive cutaneous squamous cell carcinomas (cSCC). Keratoacanthomas (KA) are either classified as a cSCC subtype or a benign tumor with histologic resemblance to well-differentiated cSCC as it is supposed to regress spontaneously. In contrast, cSCC represent malignant tumors that may metastasize.

Objectives

To compare the T-lymphocyte profiles of AK, KA and cSCC in relation to PD-L1 expression.

Methods

Tissue micro-arrays of 103 cases of AK, 43 cases of KA and 106 cases of cSCC were stained by immunohistochemistry for E-cadherin, CD3, CD4, CD8, FOXp3, and the receptor–ligand pair PD-1/PD-L1. Immunohistological scores were computationally determined to assess PD-L1 expression as well as the expression profiles of T-lymphocytes.

Results

AK had lower numbers of CD3+ and PD-1+ cells compared to KA and lower numbers of CD3+, CD8+ and PD-1+ cells in comparison with cSCC. KA showed significantly higher numbers of CD4+ and FOXp3+ cells as well as lower numbers of CD8+ cells in comparison with invasive cSCC. cSCC expressed significantly more PD-L1 in comparison with AK and KA. Among cSCC PD-L1 expression was higher in moderately and poorly-differentiated cSCC than in well-differentiated cSCC. Increased PD-L1 expression also correlated with increased numbers of CD4+, CD8+ and FOXp3+ cells in cSCC.

Conclusions

Tumor-associated T-lymphocyte infiltrates showed significant differences between AK, KA and invasive cSCC. PD-L1 expression correlated with invasion of T-cell infiltrates in invasive cSCC.

https://ift.tt/2J2ytwx

NCI study finds gut microbiome can control antitumor immune function in liver

An NCI study in mice that found a connection between gut bacteria and antitumor immune responses in the liver has implications for understanding mechanisms that lead to liver cancer and for potential treatments. The study was published in Science.

https://ift.tt/2IKOXWN

Big Drop in Malignant Melanoma Rate After Bariatric Surgery

Weight loss surgery for obesity appears to result in a huge reduction in the risk of malignant melanoma that persists for up to 20 years, according to a new analysis of long-term data from the SOS study.
Medscape Medical News

https://ift.tt/2IKwdGL

25-Hydroxyvitamin D3 and 1,25 Dihydroxyvitamin D3 as an Antiviral and Immunomodulator Against Herpes Simplex Virus-1 Infection in HeLa Cells

Viral Immunology, Ahead of Print.


https://ift.tt/2LtXpLM

A Man With a Midline Lesion Within the Oral Tongue

A man presented with tongue swelling; he denied any history of trauma, foreign body, or piercing. He returned several days later with worsening tongue swelling, voice change, and subjective fever. Computed tomography demonstrated a midline lesion within the oral tongue. What is your diagnosis?

https://ift.tt/2IKwxJC

Standardized Tracheostomy Care and Life-Threatening Respiratory Events

This cohort study examines the medical records of adults patients who had a tracheostomy placed before and after implementation of a standardized tracheostomy care protocol and assesses the occurrence of acute life-threatening respiratory events before and after protocol implementation.

https://ift.tt/2se4qro

Association of CPAP Use With Sexual Quality of Life in Patients With Sleep Apnea

This cohort study evaluates the association of sexual quality of life in patients with newly diagnosed obstructive sleep apnea who used continuous positive airway pressure (CPAP) for 12 months vs those who did not use CPAP.

https://ift.tt/2IEK6u2

Identification of Pure-Tone Audiologic Thresholds for Pediatric Cochlear Implant Candidacy

This systematic review describes studies that have evaluated audiologic thresholds as a criterion for cochlear implantation in children with severe and profound hearing impairment.

https://ift.tt/2GOAt6e

Novel terms for laser-assisted surgery of the upper aero-digestive tract providing more specificity to surgical interventions

A consensus statement of the European Laryngological Society

TLM is the most used acronym for endoscopic transoral pharynx surgery using the CO2 laser and microscope. TLM is not limited to a rigid approach. ELS adopted nomenclature to categorize additional approaches including flexible endoscopy and robotics.

 

https://ift.tt/2KOZpgu

Homozygous Mutation in Human Serum Albumin and Its Implication on Thyroid Tests

Thyroid, Ahead of Print.


https://ift.tt/2ILxnBU

Retained Herrick Plug

A 79-year-old female with a history of keratoconjunctivitis sicca presented with several years of epiphora of both eyes. Thirteen years earlier, intracanalicular Herrick lacrimal plugs (Lacrimedics, Eastsound, WA, USA) had been placed in both eyes to treat her dry eye syndrome. After 13 years the patient felt the epiphora was intolerable and underwent endoscopic dacryocystorhinostomy (DCR) of the left, then the right side. Intraoperatively, during the right endoscopic DCR, a Herrick lacrimal plug was found in the common canaliculus into the lacrimal sac. Postoperatively, the patient did well with improved epiphora. The Herrick plug is designed to be intracanalicular, and this case illustrates that the plug can migrate and be retained for many years. Collared punctal plugs have a lower risk of this type of complication.
Case Rep Ophthalmol 2018;9:283–286

https://ift.tt/2Lrcyxe

Periocular Necrotizing Fasciitis with Toxic Shock Syndrome

Purpose: To report a case of periocular necrotizing fasciitis with toxic shock syndrome. Methods: This is a case report of a previously healthy 69-year-old woman with left preseptal eyelid infection that spread rapidly and deteriorated into necrosis of the eyelid with toxic shock syndrome. She was admitted to intensive care unit for hemodynamic stabilization. Results: Intravenous antibiotic and high-dose immunoglobulin were administered followed by surgical debridement. Rehabilitative eyelid reconstruction was performed after acute episode, resulting in patient satisfaction in relation to periocular function and appearance. Conclusion: We reported a case of periocular necrotizing fasciitis with toxic shock syndrome that necessitated early aggressive medical treatment and adequate surgical intervention to decrease morbidity and mortality. A high level of suspicion of periocular necrotizing fasciitis is necessary to make a prompt diagnosis.
Case Rep Ophthalmol 2018;9:299–303

https://ift.tt/2ILhSxN

Use of Ozone-Based Eye Drops: A Series of Cases in Veterinary and Human Spontaneous Ocular Pathologies

Conjunctivitis, keratoconjunctivitis, and corneal ulcers are common eye disorders frequently diagnosed in both humans and animals, and are currently treated by topical administration of eye drops containing anti-inflammatory and antibacterial agents. The current molecules often lack efficacy because infections in hypoxic tissue contain methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa; thus, new products for the treatment of ocular pain and inflammation are needed. The use of ozone, a molecule stabilized for topical use as an ozonide, could be providential due to its anti-inflammatory and bactericidal activity in certain anterior segment pathologies, in addition to promoting tissue repair properties. Ozonated oils have the same properties as gaseous ozone and are well tolerated by tissues. In the present study the repair and regeneration effect of ozonated oil in liposomes plus hypromellose (Ozodrop®, FB Vision, Ascoli Piceno, Italy) instilled 3–4 times a day in external ocular spontaneous pathologies both in animals and humans are reported.
Case Rep Ophthalmol 2018;9:287–298

https://ift.tt/2IJCdQ0

Clinicopathologic Correlation of a Subretinal Proliferative Vitreoretinopathy Band in a Patient with Chronic Recurrent Retinal Detachment

Purpose: Proliferative vitreoretinopathy is a well-known cause of failure of retinal detachment surgery. The purpose of this case report is to illustrate the clinical occurrence and histopathology of a horizontal subretinal band ("clothesline" configuration) creating recurrent and persistent retinal detachment. Observations: A 67-year-old Hispanic female with diabetes type 2 and a history of retinal detachment surgery in the left eye (OS) presented with decreased vision OS. Best corrected visual acuity at this recent presentation was 20/80 OS. Clinical examination disclosed a recurrent inferior retinal detachment and a subretinal "clothesline" fibrotic band. Surgical removal of the subretinal band was performed. Histopathological evaluation of longitudinal and transverse sections of the band revealed a cable-like configuration composed predominantly of glial differentiation, RPE differentiation, and collagen, based on morphology and immunohistochemical staining. There was focal smooth muscle and neuroendocrine cell differentiation, as detected with smooth muscle actin (SMA) and S100 staining, respectively. Cross-sections demonstrated pigmented fibrocellular tissue with foci of cells staining positive for S100 and keratin peripherally around the tissue, suggestive of RPE differentiation. Scattered foci of SMA-positive cells suggested mild myoblastic differentiation. Conclusions and Importance: This case report presents further information on the structure and orientation of the cellular components of subretinal band proliferative vitreoretinopathy. Cells suggestive of Müller cell differentiation compose the central aspect of the band, alongside collagen fibers. RPE differentiation is variably present peripherally in the band, likely reflective of proliferating RPE encircling the subretinal fibrous tissue. A mild amount of myofibroblastic differentiation was present within the band of tissue, correlating with the clinical findings of subretinal tissue contraction and localized retinal detachment.
Case Rep Ophthalmol 2018;9:279–282

https://ift.tt/2IN5Xvv

Cerebral Functional Magnetic Resonance Imaging and Multifocal Visual Evoked Potentials in a Patient with Unexplained Impairment of Visual Function: A Case Report

We present a case of a young female with a slowly progressing visual impairment who was examined with multifocal visual evoked potentials and functional magnetic resonance imaging (fMRI) for underlying neuronal abnormality. The fMRI examination consisted of presenting black-and-white checkerboard stimuli, and her activation patterns were compared to the patterns from 4 normal-sighted subjects. The results showed clear differences in neuronal activation between the patient and the controls in the occipital and parietal lobes. Although we have shown neuronal correlates in a case of unexplained visual loss, it is still an open question as to whether this has an organic or functional cause, which should be the subject for future research.
Case Rep Ophthalmol 2018;9:269–278

https://ift.tt/2LpVtnq

Cataract Surgery following Sequential Myopic and Hyperopic LASIK

We report a case of patient dissatisfaction after sequential myopic and hyperopic LASIK in the same eye. We discuss the course of management for this patient involving eventual cataract extraction and intraocular lens (IOL) implantation with attention to the IOL power calculation method used.
Case Rep Ophthalmol 2018;9:264–268

https://ift.tt/2x6PII4

The central role of the pathologist in the management of patients with cervical cancer: ESGO/ESTRO/ESP guidelines

Abstract

The European Society of Gynaecological Oncology (ESGO), the European Society for Radiotherapy & Oncology (ESTRO) and the European Society of Pathology (ESP) nominated an international multidisciplinary development group consisting of practicing clinicians who have demonstrated leadership and expertise in cervical cancer to produce evidence-based guidelines regarding all aspects of the management of patients with this disease. Herein, we provide a detailed analysis of the pathological reporting of cervical carcinoma specimens, focusing on practical aspects of specimen sampling and on the core pathological data which are critical for patient management.

https://ift.tt/2s6enHT

Changes in Albuminuria and the Risk of Major Clinical Outcomes in Diabetes: Results From ADVANCE-ON

Jun, M; Ohkuma, T; Zoungas, S; Colagiuri, S; Mancia, G; Marre, M; Matthews, D; ... Woodward, M; + view all Jun, M; Ohkuma, T; Zoungas, S; Colagiuri, S; Mancia, G; Marre, M; Matthews, D; Poulter, N; Williams, B; Rodgers, A; Perkovic, V; Chalmers, J; Woodward, M; - view fewer (2018) Changes in Albuminuria and the Risk of Major Clinical Outcomes in Diabetes: Results From ADVANCE-ON. DIABETES CARE , 41 (1) pp. 163-170. 10.2337/dc17-1467 .

https://ift.tt/2klDPVB

Volcan de Colima dome collapse of July, 2015 and associated pyroclastic density currents

Reyes-Davila, GA; Arambula-Mendoza, R; Espinasa-Perena, R; Pankhurst, MJ; Navarro-Ochoa, C; Savov, I; Vargas-Bracamontes, DM; ... Lee, PD; + view all Reyes-Davila, GA; Arambula-Mendoza, R; Espinasa-Perena, R; Pankhurst, MJ; Navarro-Ochoa, C; Savov, I; Vargas-Bracamontes, DM; Cortes-Cortes, A; Gutierrez-Martinez, C; Valdes-Gonzalez, C; Dominguez-Reyes, T; Gonzalez-Amezcua, M; Martinez-Fierros, A; Ariel Ramirez-Vazquez, C; Cardenas-Gonzalez, L; Castaneda-Bastida, E; Vazquez Espinoza de los Monteros, DM; Nieto-Torres, A; Campion, R; Courtois, L; Lee, PD; - view fewer (2016) Volcan de Colima dome collapse of July, 2015 and associated pyroclastic density currents. Journal of Volcanology and Geothermal Research , 320 pp. 100-106. 10.1016/j.jvolgeores.2016.04.015 . Green open access

https://ift.tt/2GKyoIL

CD36 palmitoylation disrupts free fatty acid metabolism and promotes tissue inflammation in non-alcoholic steatohepatitis

Zhao, L; Zhang, C; Luo, X; Wang, P; Zhou, W; Zhong, S; Xie, Y; ... Ruan, XZ; + view all Zhao, L; Zhang, C; Luo, X; Wang, P; Zhou, W; Zhong, S; Xie, Y; Jiang, Y; Yang, P; Tang, R; Pan, Q; Hall, AR; Luong, TV; Fan, J; Varghese, Z; Moorhead, JF; Pinzani, M; Chen, Y; Ruan, XZ; - view fewer (2018) CD36 palmitoylation disrupts free fatty acid metabolism and promotes tissue inflammation in non-alcoholic steatohepatitis. Journal of Hepatology 10.1016/j.jhep.2018.04.006 . (In press).

https://ift.tt/2kqkvq5

Synchrotron quantification of ultrasound cavitation and bubble dynamics in Al-10Cu melts

Xu, WW; Tzanakis, I; Srirangam, P; Mirihanage, WU; Eskin, DG; Bodey, AJ; Lee, PD; (2016) Synchrotron quantification of ultrasound cavitation and bubble dynamics in Al-10Cu melts. Ultrasonics Sonochemistry , 31 pp. 355-361. 10.1016/j.ultsonch.2016.01.017 . Green open access

https://ift.tt/2s7fHJT

Enhanced liver fibrosis test predicts transplant-free survival in primary sclerosing cholangitis, a multi-centre study

de Vries, EMG; Farkkila, M; Milkiewicz, P; Hov, JR; Eksteen, B; Thorburn, D; Chazouilleres, O; ... Vesterhus, M; + view all de Vries, EMG; Farkkila, M; Milkiewicz, P; Hov, JR; Eksteen, B; Thorburn, D; Chazouilleres, O; Pares, A; Nygard, S; Gilja, OH; Wunsch, E; Invernizzi, P; Carbone, M; Bernuzzi, F; Boberg, KM; Rosjo, H; Rosenberg, W; Beuers, UH; Ponsioen, CY; Karlsen, TH; Vesterhus, M; - view fewer (2017) Enhanced liver fibrosis test predicts transplant-free survival in primary sclerosing cholangitis, a multi-centre study. Liver International , 37 (10) pp. 1554-1561. 10.1111/liv.13402 . Green open access

https://ift.tt/2kqkqmh

Body mass index and age at natural menopause: an international pooled analysis of 11 prospective studies

Zhu, D; Chung, H-F; Pandeya, N; Dobson, AJ; Kuh, D; Crawford, SL; Gold, EB; ... Mishra, GD; + view all Zhu, D; Chung, H-F; Pandeya, N; Dobson, AJ; Kuh, D; Crawford, SL; Gold, EB; Avis, NE; Giles, GG; Bruinsma, F; Adami, H-O; Weiderpass, E; Greenwood, DC; Cade, JE; Mitchell, ES; Woods, NF; Brunner, EJ; Simonsen, MK; Mishra, GD; - view fewer (2018) Body mass index and age at natural menopause: an international pooled analysis of 11 prospective studies. European Journal of Epidemiology 10.1007/s10654-018-0367-y . (In press).

https://ift.tt/2GLu4J3

Sparsity seeking total generalized variation for undersampled tomographic reconstruction

Kazantsev, D; Ovtchinnikov, E; Withers, PJ; Lionheart, WRB; Lee, PD; (2016) Sparsity seeking total generalized variation for undersampled tomographic reconstruction. In: (Proceedings) IEEE 13th International Symposium on Biomedical Imaging (ISBI). (pp. pp. 731-734). IEEE Green open access

https://ift.tt/2kqkhzf

Insights into Ferric Leaching of Low Grade Metal Sulfide-Containing Ores in an Unsaturated Ore Bed Using X-ray Computed Tomography

Dobson, KJ; Harrison, STL; Lin, Q; Bhreasail, AN; Fagan-Endres, MA; Neethling, SJ; Lee, PD; Dobson, KJ; Harrison, STL; Lin, Q; Bhreasail, AN; Fagan-Endres, MA; Neethling, SJ; Lee, PD; Cilliers, JJ; - view fewer (2017) Insights into Ferric Leaching of Low Grade Metal Sulfide-Containing Ores in an Unsaturated Ore Bed Using X-ray Computed Tomography. Minerals , 7 (5) , Article 85. 10.3390/min7050085 . Green open access

https://ift.tt/2s9fHcb

Structure and Transport in Coatings from Multiscale Computed Tomography of Coatings-New Perspectives for Eelectrochemical Impedance Spectroscopy Modeling?

Hughes, AE; Trinchi, A; Chen, FF; Yang, YS; Sellaiyan, S; Carr, J; Lee, PD; ... Xiao, TQ; + view all Hughes, AE; Trinchi, A; Chen, FF; Yang, YS; Sellaiyan, S; Carr, J; Lee, PD; Thompson, GE; Xiao, TQ; - view fewer (2015) Structure and Transport in Coatings from Multiscale Computed Tomography of Coatings-New Perspectives for Eelectrochemical Impedance Spectroscopy Modeling? Electrochimica Acta , 202 pp. 243-252. 10.1016/j.electacta.2015.10.183 . Green open access

https://ift.tt/2IGvURn

The effects of cytokine and progenitor cell therapy on clinical and biochemical status in patients with non-ischaemic dilated cardiomyopathy

Arnous, Samer; (2018) The effects of cytokine and progenitor cell therapy on clinical and biochemical status in patients with non-ischaemic dilated cardiomyopathy. Doctoral thesis (Ph.D), UCL (University College London). Green open access

https://ift.tt/2GKDeWg

Modelling particle scale leach kinetics based on X-ray computed micro-tomography images

Lin, Q; Barker, DJ; Dobson, KJ; Lee, PD; Neethling, SJ; (2016) Modelling particle scale leach kinetics based on X-ray computed micro-tomography images. Hydrometallurgy , 162 pp. 25-36. 10.1016/j.hydromet.2016.02.008 . Green open access

https://ift.tt/2klRo7q

Refinement and growth enhancement of Al2Cu phase during magnetic field assisting directional solidification of hypereutectic Al-Cu alloy

Wang, J; Yue, S; Fautrelle, Y; Lee, PD; Li, X; Zhong, Y; Ren, Z; (2016) Refinement and growth enhancement of Al2Cu phase during magnetic field assisting directional solidification of hypereutectic Al-Cu alloy. Scientific Reports , 6 , Article 24585. 10.1038/srep24585 . Green open access

https://ift.tt/2GNj4eh

Multi-scale 3D characterisation of porosity and organic matter in shales with variable TOC content and thermal maturity: Examples from the Lublin and Baltic Basins, Poland and Lithuania

Ma, L; Taylor, KG; Dowey, PJ; Courtois, L; Gholinia, A; Lee, PD; (2017) Multi-scale 3D characterisation of porosity and organic matter in shales with variable TOC content and thermal maturity: Examples from the Lublin and Baltic Basins, Poland and Lithuania. International Journal of Coal Geology , 180 pp. 100-112. 10.1016/j.coal.2017.08.002 . Green open access

https://ift.tt/2klR6xm

The rise of South-South trade and its effect on global CO2 emissions

Meng, J; Mi, Z; Guan, D; Li, J; Tao, S; Li, Y; Feng, K; ... Davis, SJ; + view all Meng, J; Mi, Z; Guan, D; Li, J; Tao, S; Li, Y; Feng, K; Liu, J; Liu, Z; Wang, X; Zhang, Q; Davis, SJ; - view fewer (2018) The rise of South-South trade and its effect on global CO2 emissions. Nature Communications , 9 , Article 1871. 10.1038/s41467-018-04337-y . Green open access

https://ift.tt/2GLtX05

Application of Machine Learning to Arterial Spin Labeling in Mild Cognitive Impairment and Alzheimer Disease

Collij, LE; Heeman, F; Kuijer, JPA; Ossenkoppele, R; Benedictus, MR; Moller, C; Verfaillie, SCJ; ... Wink, AM; + view all Collij, LE; Heeman, F; Kuijer, JPA; Ossenkoppele, R; Benedictus, MR; Moller, C; Verfaillie, SCJ; Sanz-Arigita, EJ; van Berckel, BNM; van der Flier, WM; Scheltens, P; Barkhof, F; Wink, AM; - view fewer (2016) Application of Machine Learning to Arterial Spin Labeling in Mild Cognitive Impairment and Alzheimer Disease. Radiology , 281 (3) pp. 865-875. 10.1148/radiol.2016152703 . Green open access

https://ift.tt/2IIKLLc

Dosimetric investigation of image-guided radiotherapy for prostate cancer using cone-beam computed tomography

Ariyaratne, Hemal; (2018) Dosimetric investigation of image-guided radiotherapy for prostate cancer using cone-beam computed tomography. Doctoral thesis (M.D(Res)), UCL (University College London). Green open access

https://ift.tt/2GM2ATN

Impacts of climate change on hydropower generation in China

Fan, JL; Hu, JW; Zhang, X; Kong, LS; Li, F; Mi, Z; (2018) Impacts of climate change on hydropower generation in China. Mathematics and Computers in Simulation 10.1016/j.matcom.2018.01.002 . (In press).

https://ift.tt/2IHWDNp

Unacknowledged distinctions: Corporeality versus embodiment in later life

Gilleard, C; Higgs, P; (2018) Unacknowledged distinctions: Corporeality versus embodiment in later life. Journal of Aging Studies , 45 pp. 5-10. 10.1016/j.jaging.2018.01.001 .

https://ift.tt/2GM2yv9

Multi-scale quantification of leaching performance using X-ray tomography

Lin, Q; Neethling, SJ; Courtois, L; Dobson, KJ; Lee, PD; (2016) Multi-scale quantification of leaching performance using X-ray tomography. Hydrometallurgy , 164 pp. 265-277. 10.1016/j.hydromet.2016.06.020 . Green open access

https://ift.tt/2IJRaFW

Which wets TiB2 inoculant particles: Al or Al3Ti?

Wearing, D; Horsfield, AP; Xu, W; Lee, PD; (2016) Which wets TiB2 inoculant particles: Al or Al3Ti? Journal of Alloys and Compounds , 664 pp. 460-468. 10.1016/j.jallcom.2015.12.203 . Green open access

https://ift.tt/2GP9bgk

Failure rate in pediatric cochlear implantation and hearing results following revision surgery

Publication date: August 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 111
Author(s): Philip A. Gardner, Robyn Shanley, Brian P. Perry
IntroductionIn a discussion of the risks and benefits of pediatric cochlear implantation, device failure and the need for revision surgery is often overlooked. The failure rate has not been investigated extensively for this population of patients. Hearing results are under-reported following revision surgery as well. We will review our experience with cochlear implant failure, revision, and hearing results when available to better guide the preoperative counseling of families considering cochlear implantation.MethodsRetrospective chart review of all children undergoing cochlear implantation from 2004 to 2014.ResultsIn this review of 579 cases of pediatric cochlear implantation, a 4.7% device failure rate was identified. Additionally, there was a 0.3% device infection rate, as well as a 0.3% electrode extrusion rate. 10 patients had audiometric data prior to and following revision surgery. These data demonstrate similar pre-failure and post revision surgery pure tone average.ConclusionCochlear implant device failure is the most common long-term complication of surgery; fortunately, hearing outcomes following revision surgery, evaluated with pure tone average, revealed no decline in auditory performance.



https://ift.tt/2GNfS2h

Congenital complete absence of tracheal rings with trifurcate carina: Case report of a rare clinical and endoscopic presentation

Publication date: August 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 111
Author(s): Isaac E. Schwartz, Edward R. Utz, Philip A. Gaudreau
We describe the case of a child with isolated absence of cartilaginous tracheal rings and a trifurcate carina. At 6 months of age, the patient presented to our multidisciplinary airway clinic with stridor and recurrent severe respiratory infections requiring hospitalization. Radiographs showed airway narrowing. Exam demonstrated biphasic stridor. Flexible fiberoptic laryngoscopy demonstrated only mild laryngomalacia. Operative bronchoscopy demonstrated severe tracheomalacia with absence of any visible tracheal rings and a trifurcate carina. Subsequent CT imaging corroborated these findings and did not demonstrate any other major abnormality. The patient did not require operative intervention and his subsequent course was uncomplicated.



https://ift.tt/2kndA1e

Screening for hearing loss among school going children

Publication date: August 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 111
Author(s): Abraham Owusu Osei, Phillips Atsu Larnyo, Anthony Azaglo, Theresa M. Sedzro, Eric Lawer Torgbenu
Hearing loss results from a deviation in the perception of sounds in one's environment. A child may have hearing loss at a hearing threshold of ≥16 dB. Hearing loss is among the frequent disorders and affects lots of people globally. Hearing loss negatively affects many areas needed for classroom learning, language development, academic performance, and social development. These consequences can be reduced by early detection with appropriate audiological and speech therapy interventions. In developing countries like Ghana, there is no such laid down formal hearing screening programs for early detection of any signs of impairments. The present study was aimed at identifying the prevalence and causes of hearing loss among basic school children aged between 5 and 17 years at Freetown Basic School, Ho. The study sought to determine the causes and prevalence of hearing loss. Out of the 210 participants, 44 (21%) failed the audiometric screening test. Out of the 44 students who failed the audiometric screening test, 25 (11.9%) had hearing loss across all the test frequencies. Prevalence of hearing loss among basic school children was found to be 11.9%. This shows that hearing loss is not uncommon among school going children in the Ho Municipality. It was determined from the study that the prevailing causes of the hearing impairments may be attributable to abused use of ototoxic drugs and ear-aches and infections with majority of participants recording mild hearing loss. It can be concluded that hearing loss among school going children is preventable if appropriate measures are put in place.



https://ift.tt/2s98vNo

Multiples Myelom und seine Vorstufen

Zusammenfassung

Hintergrund

Das multiple Myelom (MM) ist mit einer Inzidenz von etwa 7 Neuerkrankungen pro 100.000 Einwohner die zweithäufigste maligne hämatologische Erkrankung, die bei der weit überwiegenden Zahl von Patienten unheilbar bleibt. Vor diesem Hintergrund gewinnt die Erfassung der körperlichen und mentalen gesundheitsbezogenen Lebensqualität zunehmend an Bedeutung. Dem Vollbild des symptomatischen MM gehen prämaligne Stadien voraus. Die monoklonale Gammopathie unbestimmter Signifikanz (MGUS) kann mit einer Prävalenz von 1–3 %/Jahr in ein MM übergehen. Für das sog. „smoldering" MM (SMM) beträgt die Wahrscheinlichkeit eines Übergangs zum symptomatischen MM durchschnittlich 10 %/Jahr.

Fragestellung

Die Befunde zur gesundheitsbezogenen Lebensqualität und psychischen Belastung bei MM sollten gesichtet und eingeordnet und die psychischen Belastungen („distress") von Patienten mit MM und von Menschen mit dessen prämalignen Stadien (MM/SMM) verglichen werden.

Material und Methode

Es wurden eine Literaturrecherche durchgeführt und eigene Versorgungsdaten ausgewertet.

Ergebnisse

Während zur Lebensqualität und psychischen Belastung bei MM einige Untersuchungen vorliegen, gibt es bisher kaum Erhebungen dieser Aspekte bei Patienten mit SMM oder MGUS. Vergleiche hinsichtlich der psychischen Belastung zeigten (im Vergleich zum MM) ähnlich hohe Ausprägungsgrade bei Patienten mit MGUS und SMM.

Schlussfolgerungen

In Zukunft sollten weitere Untersuchungen zur gesundheitsbezogenen Lebensqualität und psychischen Belastung bei MGUS, SMM und MM durchgeführt werden. In einem weiteren Schritt könnte es sinnvoll sein, longitudinale Erhebungen mit wiederholten Messungen durchzuführen, um mehr über Prädiktoren und den Verlauf erfahren und entsprechende Unterstützungsangebote unterbreiten zu können.

https://ift.tt/2KPkO99

Isolation and antimicrobial drug susceptibility pattern of bacterial pathogens from pediatric patients with otitis media in selected health institutions, Addis Ababa, Ethiopia: a prospective cross-sectional study

Abstract

Background

Otitis media is inflammation of the middle ear and tympanic membrane, which often occurs after an acute upper respiratory tract infection. It is the most common episode of infection in children and the second most important cause of hearing loss affecting 1.23 billion people, thus ranked fifth global burden of disease with a higher incidence in sub-Saharan Africa. Thus, the aim of this study was to determine the isolation rate of bacterial pathogens from pediatric patients with otitis media.

Methodology

Institutional based cross-sectional study was conducted from January 2013–June 2014 in Addis Ababa among 210 pediatrics patients. Demographic, clinical and associated factors data was obtained in face to face interview with guardians/parents by 5 trained nurse data collectors using structured questionnaire. Middle ear drainage swab was collected following all aseptic procedures and transported to the microbiology laboratory. Culture and Antimicrobial sensitivity test were performed according to the standards. The data quality was assured by questionnaire translation, retranslation and pretesting. Reference strains were used as a positive and negative control for biochemical tests, and culture results were cross checked. Data was checked for completeness, consistency and then entered into Epi Info v3.5.1 and analyzed by SPSS v20. Data interpretation was made using graphs, tables, and result statements.

Result

A total of 196 middle ear drainage swab samples were analyzed from pediatric patients and of those 95 (48.5%) samples were positive for pathogenic organisms. The major isolate was S. aureus (15.8%) followed by P. aeruginosa (10.9%), Viridians streptococcus (9.9%), S. pneumoniae (8.9%) and S. pyogenes (7.9%). Upper respiratory tract infection history and living in the rural area have shown significant association with the isolation of pathogenic organism, (p-value = 0.035) and (p-value = 0.003) respectively. Most of the isolates show a high level of resistance to Trimethoprim-Sulfamethoxazole, Penicillin G, Ampicillin, Amoxicillin, and Chloramphenicol.

Conclusion

S. aureus and P. aeruginosa are the most common pathogens that contribute to otitis media as well most of the isolates show a high level of resistance to commonly used drugs to treat otitis media. Therefore, culture and susceptibility testes have paramount importance for the better management of otitis media and drug-resistant infections.

https://ift.tt/2xbAuSk

High-dose Intensity Modulatd Radiotherapy and Concurrent Chemotherapy in Esophageal Cancer

Condition:   Esophageal Cancer
Interventions:   Radiation: standard chemoradiotherapy;   Radiation: experimental chemoradiotherapy
Sponsor:   Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine
Recruiting

https://ift.tt/2x9vs90

Efficacy of a Spirulina Supplement for Amelioration of Benign ThYroid Nodules

Condition:   Benign Thyroid Nodule
Interventions:   Dietary Supplement: Preparation with Spirulina;   Dietary Supplement: Placebo
Sponsor:   Fundatia Bio-Forum
Recruiting

https://ift.tt/2LpELok

RIPC During Free Flap With Preoperative Radiotherapy

Conditions:   Ischemic Reperfusion Injury;   Other Reconstructive Surgery;   Radiotherapy
Interventions:   Other: remote ischemic preconditioning (RIPC);   Other: Sham-RIPC
Sponsor:   Seoul National University Hospital
Recruiting

https://ift.tt/2x8DH5f

Vaccination-Induced Herd Immunity: Successes and Challenges

Publication date: Available online 24 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Michael L. Mallory, Lisa C. Lindesmith, Ralph S. Baric




https://ift.tt/2II6Vc9

New Developments in Eosinophilic Gastrointestinal Diseases Presented at the CEGIR/TIGERS Symposium at the 2018 AAAAI Meeting

Publication date: Available online 24 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Jonathan M. Spergel, Seema S. Aceves, Kara Kliewer, Nimi Gonsalves, Mirna Chehade, Joshua B. Wechsler, Marion Groetch, Joshua Friedlander, Evan S. Dellon, Wendy Book, Ikuo Hirano, Amanda B. Muir, Antonella Cianferoni, Lisa Spencer, Chris A. Liacouras, Edaire Cheng, Leah Kottyan, Ting Wen, Thomas Platts-Mills, Marc E. Rothenberg




https://ift.tt/2s3lf90

Severe combined immunodeficiency in Sting V154M/WT mice

Publication date: Available online 23 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Delphine Bouis, Peggy Kirstetter, Florent Arbogast, Delphine Lamon, Virginia Delgado, Sophie Jung, Claudine Ebel, Hugues Jacobs, Anne-Marie Knapp, Nadia Jeremiah, Alexandre Belot, Thierry Martin, Yanick J. Crow, Isabelle André-Schmutz, Anne-Sophie Korganow, Frédéric Rieux-Laucat, Pauline Soulas-Sprauel
BackgroundAutosomal dominant gain-of-function (GOF) mutations in human STING (Stimulator of Interferon Genes) lead to a severe autoinflammatory disease called SAVI (STING Associated Vasculopathy with onset in Infancy), associated with enhanced expression of interferon (IFN) stimulated gene (ISG) transcripts.ObjectiveThe goal of this study was to analyze the phenotype of a new mouse model of Sting hyperactivation, and the role of type I IFN in this system.MethodsWe generated a knock-in model carrying an amino acid substitution (V154M) in mouse Sting, corresponding to a recurrent mutation seen in human patients with SAVI. Hematopoietic development and tissue histology were analyzed. Lymphocyte activation and proliferation were assessed in vitro. Sting V154M/WT mice were crossed to IFNAR (IFNα/β Receptor) knock-out mice in order to evaluate the type I IFN-dependence of the mutant Sting phenotype recorded.ResultsIn Sting V154M/WT mice we detected variable expression of inflammatory infiltrates in the lungs and kidneys. These mice showed a marked decrease in survival and developed a severe combined immunodeficiency disease (SCID) affecting B, T and NK cells, with an almost complete lack of antibodies and a significant expansion of monocytes and granulocytes. The blockade in B and T cell development was present from early immature stages in bone marrow and thymus. In addition, in vitro experiments revealed an intrinsic proliferative defect of mature T cells. Whilst the V154M/WT mutant demonstrated increased expression of ISGs, the SCID phenotype was not reversed in Sting V154M/WT IFNAR knock-out mice. However, the anti-proliferative defect in T cells was partially rescued by IFNAR deficiency.ConclusionsSting GOF mice developed an IFN-independent SCID phenotype with a T, B and NK cell developmental defect and hypogammaglobulinemia, associated with signs of inflammation in lungs and kidneys. Only the intrinsic proliferative defect of T cells was, partially, IFN-dependent.

Teaser

Sting V154M/WT mice develop an IFN-independent severe combined immunodeficiency with hypogammaglobulinemia, a partially IFN-dependent T cell proliferation defect, and variable lung and kidney inflammation, providing new clues in the understanding of STING gain-of-function pathophysiology.


https://ift.tt/2IKbO4B

Microbiome in Upper Airway Disease: Moving from taxonomic findings to mechanisms and causality

Publication date: Available online 24 May 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Vijay R. Ramakrishnan, Daniel N. Frank




https://ift.tt/2s3ERtt

Vast Majority of Poor, Urban Women Don’t Use Prenatal Vitamins Before Pregnancy, Study Shows

A study of more than 7,000 low-income, urban mothers enrolled in the Boston Birth Cohort found that fewer than 5 percent of them started folic acid supplementation and used it almost daily before pregnancy, a widely recommended public health measure designed to prevent potentially crippling birth defects.

https://ift.tt/2J6zaF1

In This Issue

https://ift.tt/2IKMlfi

Mincle: 20 years of a versatile sensor of insults

Abstract

Macrophage-inducible C-type lectin, better known as Mincle, is a member of the C-type lectin receptor family and is encoded by Clec4e. Mincle was an orphan receptor for a long time after having been discovered as a lipopolysaccharide-induced protein, yet later an adjuvant glycolipid in mycobacteria—trehalose dimycolate—was identified as a ligand. Ligands for Mincle were also found existing in bacteria, fungi and even mammals. When confronted with foreign elements, Mincle can recognize characteristic pathogen-associated molecular patterns, mostly glycolipids, from Mycobacterium tuberculosis and other pathogens, and thus induce immune responses against infection. To maintain self-homeostasis, Mincle can recognize lipid-based damage-associated molecular patterns, thereby monitoring the internal environment. The mechanism by which Mincle functions in the immune system is also becoming more clear along with the identification of its ligands. Being expressed widely on antigen-presenting cells, Mincle activation leads to the production of cytokines and chemokines, neutrophil infiltration and other inflammatory responses. Besides, Mincle can induce acquired immunity such as antigen-specific T-cell responses and antibody production as an adjuvant receptor. In this review, we will retrospectively sketch the discovery and study of Mincle, and outline some current work on this receptor.

https://ift.tt/2saJJMC

Nodules péniens artificiels

Publication date: Available online 23 May 2018
Source:Annales de Dermatologie et de Vénéréologie
Author(s): A. Kervyn, A. Le Guern, A. Thieffry, A. Greliak, P. Modiano




https://ift.tt/2LqtELN

Management und Komplikationen von Mittelgesichtstumorresektionen

Zusammenfassung

Nur etwa 8 % der Kopf-Hals-Tumoren betreffen das Mittelgesicht. Das Resektionsgebiet zeichnet sich durch eine Vielzahl funktionell bedeutsamer Strukturen bei häufig nur geringem erreichbarem Sicherheitsabstand aus. Zur Vermeidung von Komplikationen, aber auch unerwünschten Verläufen ist daher die individuelle Vorbereitung von Operateur und Patient von besonderer Bedeutung. Im vorliegenden Übersichtsartikel werden anhand des klinischen Ablaufs Impulse für die dezidierte Fort- und Weiterbildung interessierter HNO-Fachärzte für die Resektion dieser Tumoren gegeben. Außerdem werden anhand der aktuellen Literatur die wesentlichen Erkenntnisse zur Komplikationsvermeidung aufgeführt.

https://ift.tt/2GK5UyP

Towards development of a platform process for novel Lantiobic production

Khan, Haroon Dawood Sadullah; (2018) Towards development of a platform process for novel Lantiobic production. Doctoral thesis (Eng.D), UCL (University College London). Green open access

https://ift.tt/2sf6RKj

Border as Refuge: Demarcating Safe Spaces in Times of Conflict

Yagod, M.; (2018) Border as Refuge: Demarcating Safe Spaces in Times of Conflict. Architecture_MPS , 13 (4) pp. 1-23. 10.14324/111.444.amps.2018v13i4.001 . Green open access

https://ift.tt/2kouTPk

Learning in megaprojects: Constructing identities and imporving performance

Sergeeva, N; (2018) Learning in megaprojects: Constructing identities and imporving performance. In: (Proceedings) Engineering Project Organization Conference. (In press).

https://ift.tt/2sf6MGv

Decisional tools for cost-effective bioprocess design for cell therapies and patient-specific drug discovery tools

Jenkins, Michael Joseph; (2018) Decisional tools for cost-effective bioprocess design for cell therapies and patient-specific drug discovery tools. Doctoral thesis (Eng.D), UCL (University College London). Green open access

https://ift.tt/2J7yob3

Progressive brain rich-club network disruption from clinically isolated syndrome towards multiple sclerosis

Shu, N; Duan, Y; Huang, J; Ren, Z; Liu, Z; Dong, H; Barkhof, F; ... Liu, Y; + view all Shu, N; Duan, Y; Huang, J; Ren, Z; Liu, Z; Dong, H; Barkhof, F; Li, K; Liu, Y; - view fewer (2018) Progressive brain rich-club network disruption from clinically isolated syndrome towards multiple sclerosis. NeuroImage: Clinical , 19 pp. 232-239. 10.1016/j.nicl.2018.03.034 . Green open access

https://ift.tt/2sf6IXh

Effective silencing of ENaC by siRNA delivered with epithelial-targeted nanocomplexes in human cystic fibrosis cells and in mouse lung

Tagalakis, AD; Munye, MM; Ivanova, R; Chen, H; Smith, CM; Aldossary, AM; Rosa, LZ; ... Hart, SL; + view all Tagalakis, AD; Munye, MM; Ivanova, R; Chen, H; Smith, CM; Aldossary, AM; Rosa, LZ; Moulding, D; Barnes, JL; Kafetzis, KN; Jones, SA; Baines, DL; Moss, GWJ; O'Callaghan, C; McAnulty, RJ; Hart, SL; - view fewer (2018) Effective silencing of ENaC by siRNA delivered with epithelial-targeted nanocomplexes in human cystic fibrosis cells and in mouse lung. Thorax 10.1136/thoraxjnl-2017-210670 . (In press). Green open access

https://ift.tt/2J7yi3b

Review of Elizaveta Gaufman, Security Threats and Public Perception

Kurylo, B; (2018) Review of Elizaveta Gaufman, Security Threats and Public Perception. Security Dialogue (In press).

https://ift.tt/2s7iYZG

Editing Fluid Simulations with Jet Particles

Hodgson, Julian; (2018) Editing Fluid Simulations with Jet Particles. Doctoral thesis (Ph.D), UCL (University College London).

https://ift.tt/2klgBPp

Molecularly defined diffuse leptomeningeal glioneuronal tumor (DLGNT) comprises two subgroups with distinct clinical and genetic features

Deng, MY; Sill, M; Chiang, J; Schittenhelm, J; Ebinger, M; Schuhmann, MU; Monoranu, C-M; ... Jones, DTW; + view all Deng, MY; Sill, M; Chiang, J; Schittenhelm, J; Ebinger, M; Schuhmann, MU; Monoranu, C-M; Milde, T; Wittmann, A; Hartmann, C; Sommer, C; Paulus, W; Gärtner, J; Brück, W; Rüdiger, T; Leipold, A; Jaunmuktane, Z; Brandner, S; Giangaspero, F; Nozza, P; Mora, J; Morales la Madrid, A; Cruz Martinez, O; Hansford, JR; Pietsch, T; Tietze, A; Hernáiz-Driever, P; Stoler, I; Capper, D; Korshunov, A; Ellison, DW; von Deimling, A; Pfister, SM; Sahm, F; Jones, DTW; - view fewer (2018) Molecularly defined diffuse leptomeningeal glioneuronal tumor (DLGNT) comprises two subgroups with distinct clinical and genetic features. Acta Neuropathologica 10.1007/s00401-018-1865-4 . (In press).

https://ift.tt/2sf6xez

Assistive visual content creation tools via multimodal correlation analysis

Hennessey, James W.; (2018) Assistive visual content creation tools via multimodal correlation analysis. Doctoral thesis (Eng.D), UCL (University College London). Green open access

https://ift.tt/2J6YYB6

High cell density purification strategies for application to antibody and virus-vectored biopharmaceutical products

De Villiers, Ann-Marie; (2018) High cell density purification strategies for application to antibody and virus-vectored biopharmaceutical products. Doctoral thesis (Ph.D), UCL (University College London).

https://ift.tt/2sf6pvB

Why Separation Logic Works

Pym, D; Spring, J; O'Hearn, P; (2018) Why Separation Logic Works. Philosophy and Technology (In press).

https://ift.tt/2knPfs1

Local injections of tacrolimus-loaded hydrogel reduce systemic immunosuppression-related toxicity in vascularized composite allotransplantation

Background Routine application of vascularized composite allotransplantation (VCA) is hampered by immunosuppression-related health comorbidities. To mitigate these we developed an inflammation-responsive hydrogel for local immunosuppression. Here we report on its long-term effect on graft survival, immunological and toxicological impact. Methods Brown Norway-to-Lewis rat hind limb transplantations were treated either systemically with daily injections of 1 mg/kg tacrolimus or with subcutaneous intragraft injections of hydrogel containing 7 mg tacrolimus, every 70 days. Animals were monitored for rejection or other pathology for 280 days. Systemic and graft tacrolimus levels, regulatory T cells, and donor cell chimerism were measured periodically. At endpoint, markers for kidney, liver and metabolic state were compared to naïve age-matched rats. Results Both daily systemic tacrolimus and subcutaneous intragraft tacrolimus hydrogel at 70 day intervals were able to sustain graft survival for >280 days in 5 out of 6 recipients. In the hydrogel group, 1 graft progressed to grade 3 rejection at postoperative day (POD) 149. In systemic tacrolimus group, 1 animal was euthanized due to lymphoma on POD 275. Hydrogel treatment provided stable graft– and reduced systemic tacrolimus levels, and a 4 times smaller total tacrolimus dose compared with systemic immunosuppression. Hydrogel-treated animals showed preserved kidney function, absence of malignancies or opportunistic infections and increased hematopoietic chimerism compared to systemic immunosuppression. Conclusions Our findings demonstrate that localized immunosuppression with tacrolimus hydrogel is a long-term safe and reliable treatment. It may reduce the burden of systemic immunosuppression in VCA, potentially boosting the clinical application of this surgical intervention. Corresponding authors: Adriano Taddeo, Ph.D., Department for BioMedical Research, University of Bern, Murtenstrasse 50, 3008, Bern, Switzerland. Telephone: +41 31 632 02 99. Fax: +41 31 632 75 94. E-Mail: adriano.taddeo@dbmr.unibe.ch; Robert Rieben, Ph.D., Department for BioMedical Research, University of Bern, Murtenstrasse 50, 3008, Bern, Switzerland. Telephone: +41 31 632 96 69. Fax: +41 31 632 75 94. E-Mail: robert.rieben@dbmr.unibe.ch Authorship: D.V.D. performed and analyzed the in vivo experiments, flow cytometry, TGMS-TAC hydrogel preparation, DSA analyses. R.O. and J.L. designed and performed the hind limb transplantations. Y.B. performed and analyzed the histopathological evaluations. J.-C.P. performed the tissue TAC analyses. A.D. and P.K.V. designed and developed the TGMS-TAC hydrogel. D.V.D., A.T. and R.R. wrote the manuscript. E.V., P.K.V., A.T. and R.R. designed and supervised the studies, and reviewed the manuscript. Disclosure: The authors declare no conflicts of interest. Funding: This work was supported by Indo-Swiss Joint Research Program of the Swiss National Science Foundation (SNF, grant 156773) and the Department of Science and Technology, Govt. of India (grant INT/SWISS/SNSFP-51/2015) to R.R., E.V. and P.K.V., respectively. A.D. thanks the University Grant Commission for the senior research fellowship. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2IH8dIv

Engineering Confined and Prevascularized Sites for Islet Transplantation

No abstract available

https://ift.tt/2INoN5q

Predictive Performance of Postoperative Neutrophil Gelatinase Associated Lipocalin for Development of Chronic Kidney Disease Following Liver Transplantation

No abstract available

https://ift.tt/2IIsgGL

Endovascular thrombectomy in acute ischemic stroke: new treatment guide

Purpose of review Recent randomized clinical trials (RCTs) have demonstrated strong efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) from large vessel occlusions (LVO). SIESTA, AnSTROKE, GOLIATH showed no deleterious effects of general anesthesia on patient outcome after EVT compared with conscious sedation. DAWN and DEFUSE 3 are extending the time window for EVT up to 24 h in carefully selected patients. This review discusses the current literature on the rapidly expanding subject of endovascular stroke therapy and optimal anesthetic management. Recent findings Recent retrospective studies of RCT data sets show that general anesthesia is associated with negative clinical outcome in AIS patients undergoing EVT when compared with sedation. Two of the possible mechanisms of this finding are systolic hypotension and hypocapnia. SIESTA, AnSTROKE, GOLIATH showed no difference in short-term clinical outcome between EVT patients treated with general anesthesia versus conscious sedation. DAWN and DEFUSE 3 demonstrated improved functional outcomes after EVT in those treated up to 24 h after selection with perfusion imaging, increasing the number of patients eligible for EVT. Summary Effective reperfusion with stent retriever technology, careful patient selection using perfusion imaging, and careful use of anesthetic technique affect outcome. Correspondence to Apolonia E. Abramowicz, MD, Department of Anesthesiology, Westchester Medical Center, New York Medical College, 100 Woods Road, Macy Pavilion Room 2391, Valhalla, NY 10595, USA. Tel: +1 914 493 7692; e-mail: elisabeth.abramowicz@gmail.com Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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Emerging evidence for antidepressant actions of anesthetic agents

Purpose of review After decades without substantial advances, multiple novel antidepressants show promise against treatment-resistant depression. Interestingly, many of these are anesthetics. The purpose of this review is to discuss the evidence for the antidepressant effects of ketamine, nitrous oxide, isoflurane and propofol and to consider potential clinical, administrative and research implications for anesthesiologists. Recent findings Ketamine has acute, transient antidepressant and antisuicidal effects. Nitrous oxide has also shown antidepressant efficacy. There are converging preclinical and clinical data that isoflurane (and perhaps propofol), dosed to burst suppression, has relatively rapid, robust and durable antidepressant effects and lacks the adverse effects associated with electroconvulsive therapy (ECT). Summary Several anesthetics show promise as novel antidepressants. Ketamine is the most well studied. Anesthetic-induced burst-suppression may provide an alternative to ECT that lacks adverse cognitive effects. Further study is necessary to better understand how these drugs work and how they might be used as effective antidepressant therapy. Correspondence to Scott C. Tadler, Associate Professor, Department of Anesthesiology, Adjunct Associate Professor, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT 84132, USA. Tel: +801 581 6393; e-mail: scott.tadler@hsc.utah.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2GKQ7Qb

Advances in pharmacokinetic modeling: target controlled infusions in the obese

Purpose of review The use of conventional pharmacokinetic parameters sets 'models' derived from nonobese patients has proven inadequate to administer intravenous anesthetics in the obese population and is commonly associated with higher than anticipated plasma propofol concentrations when used with target (plasma or effect site) controlled infusion pumps. In this review we will describe recent modeling strategies to characterize the disposition of intravenous anesthetics in the obese patient and will show clinically relevant aspects of new model's performance in the obese population. Recent findings Because clearance of a drug increases in a nonlinear manner with weight, nonlinear relationships better scale infusion rates between lean and obese individuals. Allometric concepts have been successfully used to describe size-related nonlinear changes in clearances. Other nonlinear scaling options include the use of descriptors such as body surface area, lean body weight, fat-free mass, and normal fat mass. Newer pharmacokinetic models, determined from obese patient data, have been developed for propofol and remifentanil using allometric concepts and comprehensive size descriptors. Summary Pharmacokinetic models to perform target-controlled infusion in the obese population should incorporate descriptors that reflect with greater precision the influence of body composition in volumes and clearances of each drug. It is our hope that commercially available pumps will soon incorporate these new models to improve the performance of this technique in the obese population. Correspondence to Luis I. Cortínez, Associate Professor, Pontificia Universidad Católica de Chile Santiago, Chile. Tel: +56(2)6382933; fax: +56(2)6327620; e-mail: licorti@med.puc.cl Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2J1mTBM

An overview of the cannabinoid type 2 receptor system and its therapeutic potential

Purpose of review This narrative review summarizes recent insights into the role of the cannabinoid type 2 (CB2) receptor as potential therapeutic target in neuropathic pain and neurodegenerative conditions. Recent findings The cannabinoid system continues to receive attention as a therapeutic target. The CB2 receptor is primarily expressed on glial cells only when there is active inflammation and appears to be devoid of undesired psychotropic effects or addiction liability. The CB2 receptor has been shown to have potential as a therapeutic target in models of diseases with limited or no currently approved therapies, such as neuropathic pain and neurodegenerative conditions such as Alzheimer's disease. Summary The functional involvement of CB2 receptor in neuropathic pain and other neuroinflammatory diseases highlights the potential therapeutic role of drugs acting at the CB2 receptor. Correspondence to Mohamed Naguib, MB, BCh, MSc, FCARCSI, MD, Department of General Anesthesia, Anesthesiology Institute, Cleveland Clinic, 9500 Euclid Ave. - NE6–306, Cleveland, OH 44195, USA. Tel: +1 216 444 6328; fax: +1 216 636-2043; e-mail: naguibm@ccf.org Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2KR90TM

New horizons in anesthetic clinical pharmacology, patient outcomes and perioperative neuromonitoring

No abstract available

https://ift.tt/2J985AW

Case of xeroderma pigmentosum group A with West syndrome

The Journal of Dermatology, EarlyView.


https://ift.tt/2IJaj6C

Pinna granular cell tumor in a child

Guhan Kumarasamy, Philip Rajan, Mazura Mohamed Zahidi, Irfan Mohamad

Indian Journal of Otology 2018 24(1):63-65

Granular cell tumor (GCT) is a rare soft-tissue neoplasm that has a predilection to occur in the head and neck region, especially in the tongue. It tends to affect the females in their 3rd to 4th decade of age. Due to its insidious nature, tendency to recur, and possibility of the lesion to be malignant, it is prudent to always GCT as a differential diagnosis when encountering a painless nodule. GCT in a child is exceedingly uncommon. Although half the cases occur in the head and neck region, a GCT in the pinna has never been reported.

https://ift.tt/2x8HEGU

Audio-vestibular dysfunction in rheumatoid arthritis: An undervalued extra-articular feature

Reem Elbeltagy, Dalia Galhom, Marwa Hammad, Ghada A Dawa

Indian Journal of Otology 2018 24(1):47-52

Objective: The study objective was to assess vestibular system either peripherally or centrally in patients with rheumatoid arthritis (RA) using video-nystagmography (VNG) and cervical vestibular-evoked myogenic potentials (cVEMP) in an Egyptian group of RA patients and to study whether there is a correlation between hearing levels, VNG, and cVEMP test results. Materials and Methods: This study was a comparative cross-sectional study. A total of forty individuals (twenty apparently healthy controls [40 ears] and twenty RA patients previously diagnosed by a rheumatologist [40 ears]) were included in the study. RA patients were recruited from the Rheumatology and Internal Medicine Departments of Zagazig University Hospitals. All participants gave their written consent before participation in the study. All participants in the study were subjected to basic audiological evaluation and vestibular evaluation (cVEMP-VNG). Results: There was a highly significant difference in VEMP latencies between RA patients and controls (P < 0.001) and nonsignificant difference as regards amplitude (P > 0.05). There was no statistically significant difference in VEMP latencies and amplitude between males and females of the study group (P > 0.05). There was a nonsignificant difference between VEMP latencies and amplitudes among subgroups A and B. All RA patients showed absence of spontaneous gaze-evoked positional and positioning nystagmus, normal oculomotor test, and unilateral caloric weakness in 12 ears. Conclusion: The findings of the current study add more evidence to the cochlea–vestibular involvement in patients with RA. Audio-vestibular function assessment is highly recommended for all RA patients as a routine examination.

https://ift.tt/2IHmULX

Effect of smoke from medicinal herbs on the nosocomial infections in ENT outpatient department

TU Samanth, Sushil G Jha, Vikas Sinha, Shirishkumar Patel, Kairavi J Desai

Indian Journal of Otology 2018 24(1):9-12

Introduction: From time immemorial, human beings have used smoke of medicinal plants for curing disorders. Smoke produced from natural substances has been used extensively in many cultures, and famous ancient physicians have described and recommended such use. Aim and Objective: To reduce the nosocomial infections at the ENT outpatient department. Materials and Methods: Air sampling is done by set plate method. Air sampling of the medicinal smoke arising after burning a mixture of wood of mango or pipal tree andmedicinal herbs (obtained from shantikunj haridwar ) with rituals in an indoor environment. Results: Medicinal smoke caused over 95% reduction of aerial bacterial counts by 60 min. Conclusion: We have observed that 1 h treatment of medicinal smoke emanated by burning wood and a mixture of odoriferous and medicinal herbs (havan sámagri = material used in oblation to fire all over India) on aerial bacterial population caused over 95% reduction of bacterial counts by 60 min.

https://ift.tt/2x8OBrt

Systematic review and meta-analysis of otitis media in Iran: Prevalence, etiology, antibiotic susceptibility, and complications

Safar-Ali Amiri-Andy, Diana Sarokhani, Milad Azami, Hossein Vazini, Mostafa Rezaei-Tavirani, Ali Hasanpour Dehkordi

Indian Journal of Otology 2018 24(1):1-8

Otitis media (OM) is a relatively common infectious disease, and its chronic form may lead to complications such as hearing impairment. This study aims to determine the prevalence, etiology, antibiotic susceptibility, and complications of OM in Iran through meta-analysis. English language databases, including Science Direct, PubMed, Scopus, Web of Science, and Persian language databases, including SID, Magiran, Iranmedex, Medlib, as well as the Google Scholar search engine, were searched from 1994 to 2017, using the Mesh keywords: Otitis media, Middle ear, Causality, Etiology, and Iran. The heterogeneity assessment of the studies was done using Q-Cochran test and I2 index. Considering the high heterogeneity of the studies, the random effects model was used to estimate the point prevalence with 95% confidence interval. Data were analyzed using STATA version 11.1 software. Fifty-one articles with a sample size of 10,675 were reviewed in this study, the most common types of OM involvement were right otitis (51% [95% confidence interval (CI): 33–68]), left otitis (44% [95% CI: 36–52]), and bilateral otitis (33% [95% CI: 7–59]). The most common bacterial etiologies involved in OM were Pseudomonas aeruginosa (26% [CI 95%: 17–35]), Proteus (21% [95% CI: 0%–45%]), and Staphylococcus (20% [95% CI: 0–42]). The fungal etiology of OM was estimated to be 22% (95% CI: 4–40). The most common OM pathologies were ossicular changes (56%[95% CI, 27–85]), granulation (49% [95% CI: 18–80]), cholesteatoma (32% [95% CI: 13–51]), tympanosclerosis (17% [95% CI: 10–23]), and cholesterol granuloma (11% [95% CI: 0–26]). The results of this meta-analysis provide useful information on the epidemiology of OM in Iran to otorhinologists and health policymakers.

https://ift.tt/2LpOz1m

Effect of postural restrictions on the outcome of benign paroxysmal positional vertigo, postcanalith repositioning maneuver

D Anand Karthikeyan, PK Purushothaman, R Ramakrishnan, K Banumathi

Indian Journal of Otology 2018 24(1):13-15

Introduction: Postural Restrictions of Head are advised by some physicians after BPPV is treated by canalith repositioning maneuvers. Aim: To find out if these postural restrictions are beneficial. Methodology: A total of 682 patients were studied over a period of 2 years. They were separated into 2 groups where one observed postural restrictions and the other didn't. Both the groups were compared. Results: The group which observed postural restrictions had better symptom relief after the first repositioning maneuver itself and recurrences were less. An odds ratio of 1.7862 was obtained upon statistical analysis. Conclusion: BPPV patients who observed postural restrictions after canalith repositioning maneuver had a better outcome than those who didn't.

https://ift.tt/2x8Oufx

Glomus tympanicum: Clinical presentation, management and outcomes

Priyanka Misale, Anjali Lepcha, Amit Kumar Tyagi

Indian Journal of Otology 2018 24(1):56-59

Objective: The objective of the study is to describe the clinical presentation, management, and outcomes of glomus tympanicum (GT) Grade 1–3 (based on Glasscock Jackson staging). Materials and Methods: This is a retrospective chart review of five patients who presented with GT (Grade 1–3) over a period of 4 years to a tertiary hospital. All of them had undergone tumor excision without preoperative embolization. Details of clinical features, diagnostic protocol, surgical approach based on grade of tumor, tumor control, treatment complications, and follow-up results were noted and analyzed. Results: All five patients presented with unilateral hearing loss and tinnitus. Imaging done was magnetic resonance imaging with gadolinium of the brain and high-resolution temporal bone computed tomography. Three patients had transmastoid facial recess approach and one had transcanal approach for tumor removal. One patient had canal wall down mastoidectomy. The average follow-up was 34.8 months. Symptomatic improvement in pulsatile tinnitus was observed in all patients. Hearing remained the same in 1 patient and improved in 4 patients. One patient presented with cholesteatoma 1 year postsurgery. None of the patients had recurrence/residual tumor. Conclusions: GT Grades 1–3 can be managed successfully without preoperative embolization. This gives satisfactory results with respect to hearing improvement and recurrence rates.

https://ift.tt/2Ln2XaJ

Otoscopic, radiological, and audiological status of the contralateral ears in patients with unilateral chronic suppurative otitis media

Mohammed Radef Dawood

Indian Journal of Otology 2018 24(1):16-19

Context and Aims: Since unilateral chronic suppurative otitis media (CSOM) does not look to be an isolated entity, but rather a series of constitutional events that affecting both ears, so this study aimed to evaluate the otoscopic, radiological, and audiological status of the contralateral ears (CLEs) in patients with unilateral CSOM. Patients and Methods: A prospective, observational study recruited 96 consecutive patients with unilateral CSOM with or without cholesteatoma, in whom their CLEs revealed an intact tympanic membrane (TM) were categorized as "Group 1" and "Group 2" respectively, they were evaluated with otomicroscopy, computed tomography (CT) scanning of temporal bones, pure tone audiometry and tympanometry. All above-mentioned observations were recorded and analyzed. Results: The incidence of otoscopic CLEs structural abnormalities was 47.91% in both groups; being 45.83% in "Group 1" mostly 25% of TM retraction, and 50% in "Group 2" mainly (20.84%) of thinning TM. Mastoid CT scan showed (35.41%) air cell abnormalities in both groups; being 37.5% in "Group 1" and 33.33% in "Group 2," while tympanic cavity mucosal thickening was 33.33% "in Group 1" and 25% in "Group 2." Conductive hearing loss was found (39.58%) in both groups; being 45.83% in "Group 1" and 33.33% in "Group 2," while C-curve tympanometry curve was 63.63% and 36.36% in both groups, respectively. Conclusions: The incidence of otoscopic structural abnormalities of CLEs was mainly in the form of TM retraction in squamous type and thinning TM in mucosal type; also, the radiological and audiological abnormalities of the CLEs were shown more event in squamous than in mucosal type of CSOM.

https://ift.tt/2IJLhoa

Congenital sensorineural hearing loss with anomalous vestibular nerve complex: A rare radiological finding

Asma Binti Abdullah, Faizah Binti Mohd Zaki, Luqman Bin Rosla

Indian Journal of Otology 2018 24(1):71-73

Radiological assessment is an essential tool for preoperative assessment of cochlear implant (CI) candidates with congenital sensorineural hearing loss (SNHL). It gives crucial information of the inner ear, vestibulocochlear nerve, and brain. Hypoplasia of the cochlear nerve bony canal is commonly associated with profound SNHL, whereby 88% of this abnormality was found in 95% of CI candidates. This finding may be associated with internal auditory canal hypoplasia or other cranial nerve abnormalities. We describe a rare case of a patient diagnosed with congenital SNHL exhibiting an interesting radiological finding of an anomalous vestibular nerve course alongside hypoplasia of the cochlear bony canal which could be postulated by the complex embryological development of the inner ear.

https://ift.tt/2IHx536

A novel modality of treatment for pseudocyst of auricle

Yogesh Dabholkar, Shreyas Chawathey, Haritosh Velankar

Indian Journal of Otology 2018 24(1):20-22

Introduction: Pseudocyst of auricle is benign painless idiopathic cystic swelling on anterior surface of auricular cartilage with no definitive treatment and with a tendency to recur. We describe a novel modality of treatment for this condition. Methods: 14 patients treated by aspiration followed by pressure dressing with a silicone-based impression material used for hearing aid fitting. These patients were followed up over a six month period. Results: 13 patients had a successful outcome with complete resolution of swelling and without any recurrence. Only 1 patient (7.14%) showed recurrence after 2 weeks of treatment due to ineffective compression which was subsequently managed successfully by the same procedure. Conclusion: Complete aspiration and compression dressing using a silicone-based material (used to make hearing aid moulds) in our experience is a safe, inexpensive, non-invasive and effective method for management of the pseudocyst of the auricle.

https://ift.tt/2INlivO

Targeted screening for hearing impairment in neonates: A prospective observational study

Jehangir Allam Bhat, Rajesh Kurmi, Santosh Kumar, Roshan Ara, Amit Kumar Mittal

Indian Journal of Otology 2018 24(1):42-46

Background: The aim of this study is to estimate the incidence and determine the risk factors predictive of hearing impairment in newborn by targeted hearing screening. Methods: This was a prospective, observational study conducted over a period of 1 year. We screened high-risk neonates for hearing impairment admitted to the Neonatal Intensive Care Unit using evoked otoacoustic emissions (EOAEs) and brainstem auditory evoked response (BAER). Babies who tested refer on EOAE were subjected to BAER urgently. Babies having an abnormality on BAER where confirmed as hearing impaired for this study. Results: A total of 195 high-risk babies comprising males (95 = 48.7%) and females (100 = 51.3%) were screened. Fifteen neonates (7.69%) tested refer in the initial screening procedure, i.e., EOAE, who then underwent BAER and out of these 15 (7.69%) neonates, 12 (6.15%) had abnormal BAER, i.e., hearing impairment. The significant individual risk factors in neonates with hearing impairment were stigmata and/syndrome associated with hearing loss, craniofacial anomalies, and hyperbilirubinemia and Apgar score <4 at 1 min and <6 at 5 min. Hearing impairment increased from 0.917% for one risk factor, 6.66% for two risk factors, 10.52% with three risk factors, 28.57% with four risk factors, and 25% with five risk factors. Conclusions: In this study, the incidence of hearing impairment was 7.69%. Stigmata and/syndrome associated with hearing loss, craniofacial anomalies, and hyperbilirubinemia and Apgar score <4 at 1 min and <6 at 5 min are significant risk factors for hearing loss, hearing loss increased as risk factors increase.

https://ift.tt/2Lqu2tC

Temporalis fascia graft versus composite graft in chronic suppurative otitis media with subtotal and total perforations

Manas Ranjan Rout, Deeganta Mohanty, Chintagunta Pakeer Das, P Vittal Prasad

Indian Journal of Otology 2018 24(1):23-27

Introduction: Temporalis fascia graft is the most commonly used graft material for reconstruction of the tympanic membrane in chronic suppurative otitis media. However, the success rate is low in case of subtotal and total perforations. We have used both cartilage and the temporalis fascia for the repair with greater success. Aims and Objectives: The aim and objective of the study was to compare the result of temporalis fascia graft and composite graft (temporalis fascia and cartilage) in the repair of subtotal and total perforation of tympanic membrane with respect to graft take-up rate and hearing improvement. Materials and Methods: A total of 300 patients were selected for the study. One hundred and fifty cases we used only temporalis fascia (tympanoplasty with temporalis fascia graft [TTG] group) and another 150 cases both temporalis fascia and cartilage (Composite graft, tympanoplasty with composite graft [TCG] group) were used. The result was assessed after 6 months of surgery. Results: Graft take-up rate in TTG group is 82.67% and in TCG group is 95.34%. More remnant and re-perforations were found in TTG group. It was found that, in TTG group out of 124 patients, hearings improved in 104 patients (83.87%), remain same in 15 patients (12.09%), and deteriorated in 5 patients (4.032%). In TCG group out of 143 patients, hearings improved in 116 patients (81.118%), remain same in 19 patients (15.322%), and deteriorated in 8 patients (6.451%). Discussion and Conclusion: Composite graft is a better graft in comparison to temporalis fascia graft for the repair of the subtotal and total perforation.

https://ift.tt/2x8HjE8

The elusive eustachian tube and its role in chronic otitis media

Maitri Rahul Kaushik, Aishwarya Shukla, Arun Yashwant Dehadaray, Prasun Mishra, Jency Johnson

Indian Journal of Otology 2018 24(1):53-55

Aims: To evaluate ET function using impedance audiometry, to visualise its orifices in the nasopharynx and the protympanum of the middle ear, to correlate the findings seen. Setting and design: Prospective study conducted in a tertiary care hospital from September 2015 to August 2017. Materials and Methods: In all cases of COM posted for surgery, nasopharyngoscopy was done to visualise the pharyngeal end of the ET. Impedance audiometry was done for assessing physiological function. Intra operative visualisation of the ET opening in the protympanum was done. Findings were correlated. Statistical Analysis Used: Sensitivity, specificity, positive predictive value and negative predictive value was calculated. Results: On comparison of findings of the pharyngeal orifice of the ET and the ET opening at the protympanum of the middle ear, strong statistical co relation is seen. On comparing mucosal and squamosal COM intra operatively, almost double the cases of obstruction were seen in squamosal type. Conclusion: Nasopharyngoscopy and intra operative findings of patients suffering from COM are important indicators of ETD. Patients of COM with abnormal Eustachian tube opening in the nasopharynx are more likely to have an abnormal opening in the protympanum of the middle ear.

https://ift.tt/2IIwRbI

Delivering an audiology outreach clinic in Gujarat: Clinical observations and challenges

Jeff Davies

Indian Journal of Otology 2018 24(1):28-32

Introduction: Audiology staff and students from De Montfort University delivered an audiology outreach clinic in Wankaner, Gujarat, with the aim of providing free audiological examination, hearing tests, and hearing aids to local residents with hearing loss. In addition, the project also presented a valuable opportunity to evaluate the spectrum of hearing-related symptoms in this rural region of India. Subjects and Methods: This was a prospective, observational clinical study. Participants aged 5+ were invited for a consultation at the Devdaya Diagnostic Centre. The consultation comprised of an audiological history, otoscopy, and a hearing test. Middle ear evaluation through tympanometry was also available. Digital receiver-in-ear hearing aids were fitted to participants deemed clinically suitable. Red flag otological symptoms were referred onward to an ENT consultant. Clinical consultations were translated into Gujarati by the local hospital staff. Results: Over 2 days, 170 participants (aged 6–94 years) were screened; 116 males and 54 females. A wide range of otological symptoms and conditions was observed including tinnitus in 70 participants (41%), perforated eardrums (22%), active ear discharge (15%), occluding wax (12%), otalgia (8%), and a history of noise exposure (5%). Average hearing threshold configuration showed a bilateral moderate-to-severe sensorineural hearing loss which was worse in males. Twelve participants had normal or mild hearing loss. Hearing aids were offered to 97 (57%) participants, 88 of which reported listener benefit and agreed to wear the aids on a daily basis. The remaining 44 participants were not considered suitable for hearing aids. Conclusions: A new partnership between De Montfort University and the Devdaya Diagnostic Centre has provided the local community of Wankaner with access to free audiological healthcare. While there were a number of environmental and technological challenges to overcome, this maiden visit proved to be successful, laying the foundation for future clinics.

https://ift.tt/2x7qgSO

Mucormycosis of middle ear in a diabetic patient

Farzin Khorvash, Seyed Hamid Reza Abtahi, Atousa Hakamifard, Maryam Derakhshan, Leila Zarghami

Indian Journal of Otology 2018 24(1):60-62

Mucormycosis is an infection caused by fungi belonging to class zygomycetes, with high mortality and morbidity rate. Acquisition of mucormycosis is inhalation of spores or cutaneous route. The common risk factors for invasive mucormycosis consist of diabetes mellitus, high-dose glucocorticoid therapy, and neutropenia. The most clinical manifestation of mucormycosis is rhinocerebral lesions. Other manifestations are pulmonary, cutaneous, disseminated, and gastrointestinal. Ear involvement is extremely rare. The authors describe a case of mucormycosis cholesteatoma with concomitant central nervous system lesion in a patient with diabetes mellitus that responded to therapy.

https://ift.tt/2IGDaN8

Treatment of cisplatin-induced ototoxicity by intra-tympanic corticosteroid injection

Wail Fayez Nasr, Mohammad Abdelhady, Mohammad El-Sayed Abd Elbary, Ebtessam Nada

Indian Journal of Otology 2018 24(1):33-37

Background: Cisplatin is a common chemotherapeutic drug often causes ototoxicity attributed to the formation of reactive oxygen and nitrogen species damaging critical inner ear structures. Steroids have been shown to reduce the formation of reactive oxygen species, and thus, may reduce ototoxicity. In this study, intratympanic corticosteroid injection is proved to help the recovery of cisplatin ototoxicity. Objectives: The objective of this study was to assess the efficacy of intratympanic corticosteroid injection in the treatment of cisplatin ototoxicity. Patients and Methods: This study was applied on 20 patients that have sensorineural hearing loss caused by cisplatin, which was used as a chemotherapeutic agent for the treatment of their malignancies. All cases were subjected to intratympanic corticosteroid injection. All patients were exposed to pure-tone audiometry before and after the procedure. Results: Significant increases in the average pure-tone thresholds (PTTs) at 8000 Hz were found in both the study and control groups after the cumulative dose: 43.15 ± 15.557 dBHL and 55.7 ± 13.2589 dBHL, a value of P = 0.0004 and <0.001, respectively. Significant increases in the average PTTs at 6000 Hz were found in both the study and control groups after the cumulative dose: 39.7 ± 11.885 dBHL and 52.6 ± 7.456 dBHL, a value of P = <0.001 and <0.001, respectively. Conclusion: Intratympanic corticosteroid injection appears to have the only minimal therapeutic effect to cisplatin-induced hearing loss, especially for 6000 and 8000 HZ.

https://ift.tt/2xaEl1Y

Duplicated internal auditory canal and dolichoectasia causing bilateral profound deafness in an adult

Vishwaroop Bhattacharyya, Sandeep Kumar, Subhendu Parida, T Mandapal

Indian Journal of Otology 2018 24(1):66-70

Inner ear malformations contributing to bilateral profound hearing loss in adulthood are extremely rare. High-resolution computed tomography of the temporal bones and magnetic resonance imaging revealed unilateral duplicated internal auditory canal (IAC) and bilateral semicircular canal aplasia in such an adult. This is only the fourth reported case in literature known to us of duplicated IAC in adults and first in which there is a description of isolated bilateral lateral semicircular canal aplasia as the sole labyrinthine abnormality. Dolichoectasia of the vertebrobasilar artery was also present in the contralateral ear causing compression of the cochlear nerve and profound deafness in the other ear for which cochlear implantation was done.

https://ift.tt/2IGD34a

Comparative retrospective evaluation of outcomes of tympanoplasty according to graft support materials

Bilge Türk, Seçil Arslanoğlu, Mustafa Zafer Uğuz

Indian Journal of Otology 2018 24(1):38-41

Objective: The aim of this study is to evaluate and compare the surgical outcomes and hearing results in tympanoplasty surgeries according to graft support material. The results of patients with hyaluronate-carboxymethylcellulose membrane and spongostan and the results of patients with only spongostan were compared. Materials and Methods: This was a retrospective comparative study of 118 tympanoplasty operations of 118 patients who underwent tympanoplasty in the Department of Otorhinolaryngology at a tertiary medical center from September 2000 to December 2005. The subjects were classified into two groups; Group 1 (n = 38) in whom both sodium hyaluronate-carboxymethylcellulose membrane and spongostan had been applied and Group 2 (n = 80) in whom only spongostan had been applied as graft support material. The rate of graft success and pure tone audiometric results were evaluated and compared between the groups. Chi-square test and Mann–Whitney U-test were used for the analysis. Results: Pre- and post-operative audiometric results including air-bone gaps were not significantly different between the groups. In all groups, the postoperative air-bone gap was significantly improved compared to the preoperative air-bone gap. Graft success rate in Group 1 and Group 2 were 89% and 71%, respectively. The rate of tympanic membrane perforation closure was significantly higher in Group 1 (P < 0.05). Conclusion: Depending on these results, we suggest sodium hyaluronate-carboxymethylcellulose membrane as an additional option as graft support material in tympanoplasties. The positive effect on graft success rate is documented in the present study. Further investigations are needed to evaluate the benefits and clinical outcomes of hyaluronate carboxymethylcellulose membrane.

https://ift.tt/2IKIsDe

Pseudomonas Aeruginosa in chronic suppurative otitis media

Beuy Joob, Viroj Wiwanitkit

Indian Journal of Otology 2018 24(1):74-74



https://ift.tt/2IGCNCe

Paraneoplastic pemphigus in Russian patients: a single center case series

International Journal of Dermatology, EarlyView.


https://ift.tt/2IXKEL9

Complex regional pain syndrome of the face in a child

International Journal of Dermatology, EarlyView.


https://ift.tt/2GJaxJb

New insights into the phenotypes of atopic dermatitis linked with allergies and asthma in children: An overview

Clinical &Experimental Allergy, EarlyView.


https://ift.tt/2Lr1YGt

Extensive Craniocervical Abscess after Transoral Ganglionic Local Opioid Analgesia at the Superior Cervical Ganglion for Atypical Trigeminal Neuralgia: Report of a Severely Complicated Case

Ganglionic local opioid analgesia (GLOA) describes the application of low-dose opioids close to sympathetic as, for example, to the superior cervical ganglion. GLOA can be effective in different pain syndromes affecting the head and face region and has been considered to be a safe technique with few complications reported so far. We present the case of a patient who received a single, transoral GLOA for a refractory trigeminal neuralgia. The patient subsequently developed an extensive epidural abscess at the craniocervical junction, requiring ultimately transoral odontoid resection and dorsal stabilisation. This severe complication challenges the role of transoral infiltration therapies in analgetic medicine.

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Erector Spinae Plane Block Versus Retrolaminar Block: A Magnetic Resonance Imaging and Anatomical Study

Background and Objectives The erector spinae plane (ESP) and retrolaminar blocks are ultrasound-guided techniques for thoracoabdominal wall analgesia involving injection into the musculofascial plane between the paraspinal back muscles and underlying thoracic vertebrae. The ESP block targets the tips of the transverse processes, whereas the retrolaminar block targets the laminae. We investigated if there were differences in injectate spread between the 2 techniques that would have implications for their clinical effect. Methods The blocks were performed in 3 fresh cadavers. The ESP and retrolaminar blocks were performed on opposite sides of each cadaver at the T5 vertebral level. Twenty milliliters of a radiocontrast dye mixture was injected in each block, and injectate spread was assessed by magnetic resonance imaging and anatomical dissection. Results Both blocks exhibited spread to the epidural and neural foraminal spaces over 2 to 5 levels. The ESP block produced additional spread to intercostal spaces over 5 to 9 levels and was associated with a greater extent of craniocaudal spread along the paraspinal muscles. Conclusions The clinical effect of ESP and retrolaminar blocks can be explained by epidural and neural foraminal spread of local anesthetic. The ESP block produces additional intercostal spread, which may contribute to more extensive analgesia. The implications of these cadaveric observations require confirmation in clinical studies. Accepted for publication January 28, 2018. Address correspondence to: Ki Jinn Chin, FRCPC, Department of Anesthesia, Toronto Western Hospital, McL 2-405, 399 Bathurst St, Toronto, Ontario, Canada M5T 2S8 (e-mail: gasgenie@gmail.com). The authors have no sources of funding to declare for this article. The authors declare no conflict of interest. Copyright © 2018 by American Society of Regional Anesthesia and Pain Medicine.

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Use of Serratus Plane Block for Repair of Coarctation of Aorta: A Report of 3 Cases

Objectives The practice of regional anesthesia techniques (thoracic, epidural, paravertebral) in pediatric cardiac surgery enhances perioperative outcomes such as improved perioperative analgesia, decreased stress response, early extubation, and shortened hospital stay. However, these blocks can be technically challenging and can be associated with unacceptable failure rate and complications in infants. For these reasons, regional anesthesia is sometimes avoided in pediatric cardiac surgery. We describe the simple and effective serratus plane block for thoracotomy analgesia in 2 neonates and a child. Case Report We present 3 pediatric patients, each of whom was having coarctation repair and received an ultrasound-guided serratus plane block for thoracotomy analgesia. The patients were 3 days, 14 days, and 4 years old, weighing from 1.9 to 16 kg. The serratus plane block was performed prior to surgical incision. The block was technically simple compared with thoracic epidural or paravertebral block. All patients were extubated immediately after completion of surgery. Apart from the induction dose of fentanyl (2 μg/kg), no further opioids were required intraoperatively. Postoperative opioid requirements as well as duration of intensive care and hospital stay were lower than recent averages (for the same demographic and procedure) in our hospital. Conclusions We propose that the serratus plane block is a simple procedure that provides good perioperative analgesia for infant thoracotomy, potentially facilitating early extubation and a shorter hospital stay. Accepted for publication January 15, 2018. Address correspondence to: Abhijit Biswas, MBBS, MSc, FCARCSI, EDRA, Department of Anesthesia and Perioperative Medicine, London Health Science Centre, 339 Windermere Rd, London, Ontario, Canada N6A 5A5 (e-mail: avijitbsws@yahoo.com). This work is attributed to the Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada. Funding was provided by the Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada. The authors declare no conflict of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.rapm.org). Copyright © 2018 by American Society of Regional Anesthesia and Pain Medicine.

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