Chronic laryngopharyngeal vagal neuropathy

Michael S. Benninger, Andrea Campagnolo
Braz J Otorhinolaryngol.2018;84:401-3

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https://ift.tt/2uITvXV

Comparison of the recovery rate of otomycosis using betadine and clotrimazole topical treatment

Mohammad Reza Mofatteh, Zahra Naseripour Yazdi, Masoud Yousefi, Mohammad Hasan Namaei
Braz J Otorhinolaryngol.2018;84:404-9

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Body mass index and acoustic voice parameters: is there a relationship?

Lourdes Bernadete Rocha de Souza, Marquiony Marques dos Santos
Braz J Otorhinolaryngol.2018;84:410-5

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Free tissue flaps in head and neck reconstruction: clinical application and analysis of 93 patients of a single institution

Jiwang Liang, Tao Yu, Xu Wang, Yuejiao Zhao, Fengqin Fang, Wei Zeng, Zhendong Li
Braz J Otorhinolaryngol.2018;84:416-25

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Outcomes of external septorhinoplasty in a Turkish male population

Gamze Didem Kilci, Engin Başer, Ayşegül Verim, Ömer Faruk Çalim, Bayram Veyseller, Orhan Özturan, Ahmet Altintaş, Mustafa Çelik
Braz J Otorhinolaryngol.2018;84:426-34

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Turkish validity and reliability of Eustachian tube dysfunction questionnaire‐7

Erdoğan Özgür, Cem Bilgen, Beyhan Cengiz Özyurt
Braz J Otorhinolaryngol.2018;84:435-40

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Evaluating the ototoxicity of an anti‐MRSA peptide KR‐12‐a2

Chung Man Sung, Hong Chan Kim, Yong Beom Cho, Song Yub Shin, Chul Ho Jang
Braz J Otorhinolaryngol.2018;84:441-7

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Influence of chronic lymphocytic thyroiditis on the risk of persistent and recurrent disease in patients with papillary thyroid carcinoma and elevated antithyroglobulin antibodies after initial therapy

Marina Carvalho S. Côrtes, Pedro Weslley Rosario, Gabriela Franco Mourão, Maria Regina Calsolari
Braz J Otorhinolaryngol.2018;84:448-52

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25 (OH) D3 levels, incidence and recurrence of different clinical forms of benign paroxysmal positional vertigo

Sinisa Maslovara, Silva Butkovic Soldo, Anamarija Sestak, Katarina Milinkovic, Jasna Rogic‐Namacinski, Anamarija Soldo
Braz J Otorhinolaryngol.2018;84:453-9

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Performance of the phonatory deviation diagram in the evaluation of rough and breathy synthesized voices

Leonardo Wanderley Lopes, Jonas Almeida de Freitas, Anna Alice Almeida, Priscila Oliveira Costa Silva, Giorvan Ânderson dos Santos Alves
Braz J Otorhinolaryngol.2018;84:460-72

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IRF6 rs2235375 single nucleotide polymorphism is associated with isolated non‐syndromic cleft palate but not with cleft lip with or without palate in South Indian population

Venkatesh Babu Gurramkonda, Altaf Hussain Syed, Jyotsna Murthy, Bhaskar V.K.S. Lakkakula
Braz J Otorhinolaryngol.2018;84:473-7

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https://ift.tt/2zQYKuh

Short‐term evaluation of tegumentary changes of the nose in oral breathers undergoing rapid maxillary expansion

Fauze Ramez Badreddine, Reginaldo Raimundo Fujita, Mario Cappellette
Braz J Otorhinolaryngol.2018;84:478-85

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Anthropometric study of the caucasian nose in the city of Curitiba: relevance of population evaluation

Annelyse Cristine Ballin, Bettina Carvalho, José Eduardo Lutaif Dolci, Renata Becker, Cezar Berger, Marcos Mocellin
Braz J Otorhinolaryngol.2018;84:486-93

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Quality of life and cochlear implant: results in adults with postlingual hearing loss

Aline Faria de Sousa, Maria Inês Vieira Couto, Ana Claudia Martinho‐Carvalho
Braz J Otorhinolaryngol.2018;84:494-9

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Water protection after tympanostomy (Shepard) tubes does not decrease otorrhea incidence ‐ retrospective cohort study

João Subtil, Ana Jardim, André Peralta Santos, João Araújo, José Saraiva, João Paço
Braz J Otorhinolaryngol.2018;84:500-5

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Factors associated with voice disorders among the elderly: a systematic review

Amanda Cibelly Brito Gois, Leandro de Araújo Pernambuco, Kenio Costa de Lima
Braz J Otorhinolaryngol.2018;84:506-13

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Degree of tinnitus improvement with stapes surgery – a review

Aliciane Mota G. Cavalcante, Isabella Monteiro de Castro Silva, Bianca Jessica Neves, Carlos Augusto Oliveira, Fayez Bahmad Jr
Braz J Otorhinolaryngol.2018;84:514-8

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A rare laryngeal tumor in a patient with thyroid papillary cancer: granular cell tumor

Sheng‐Yao Cheng, Li‐Hsiang Cheng, Yi‐Shu Liao, Wen‐Sen Lai
Braz J Otorhinolaryngol.2018;84:519-22

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Parotid Masson's tumor: case report

Filippo Carta, Sara Sionis, Valeria Ledda, Clara Gerosa, Roberto Puxeddu
Braz J Otorhinolaryngol.2018;84:523-5

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A case of bilateral inferior concha bullosa connecting to maxillary sinus

Soo Kweon Koo, Ji Seung Moon, Sung Hoon Jung, Mi Jin Mun
Braz J Otorhinolaryngol.2018;84:526-8

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A murine model of wheat versus potato allergy: Patatin and 53kDa protein are the potential allergen from potato

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Ibtessam Tahir Ansari, Taihua Mu

Abstract

Wheat allergy is the most common around the world as gluten is the potential allergen. People diagnosed with wheat allergy were mainly substitute with other novel food such as potato though it is also being reported for allergenic manifestations. Thus there is an increasing demand for developing a BALB/c mice model to empathize the allergic properties of potato protein and its fractions. Purified potato protein showed lower IgE-binding capacity (474.39 ± 0.6 ng/mL) even in higher concentration (30 mg/mL) compared to wheat gluten (1418.28 ± 0.17 ng/mL, 5mg/mL). Immediate active cutaneous hypersensitivity reaction, vascular leakage, intestinal permeability and lung's inflammatory cell infiltration was also ascertained comparatively lower in potato protein than wheat gluten. Furthermore, patatin (43 kDa) and protease inhibitors (∼21 kDa) were purified and separated, and patatin exhibited higher hypersensitivity score than that of protease inhibitors. Immuno-detection assays indicated that patatin and 53 kDa protein in potato protein showed specific Ig-E binding capacity, and 53 kDa was adenosyl homocysteinase identified by LC–MS/MS.

Graphical abstract

https://ift.tt/2mrzj99

VAX1 Gene Associated Non-syndromic Cleft lip with or without Palate in Western Han Chinese

Publication date: Available online 18 July 2018

Source: Archives of Oral Biology

Author(s): Bi-He Zhang, Jia-Yu Shi, Yan-Song Lin, Bing Shi, Zhong-Lin Jia

ABSTRACT

Objective

Non-syndromic cleft lip with or without palate (NSCL/P) is one of the most common human birth defects, it results from multiple genetic and environmental risk factors. Recently, GWA studies identified associations between NSCL/P and two genetic risk loci, rs7078160 and rs4752028, at VAX1.

Design

Currently, we tried to investigate the roles of the two loci among 302 NSCL/P trios (129 non-syndromic cleft lip only (NSCLO) trios and 173 non-syndromic cleft lip and cleft palate (NSCLP) trios) from Western Han Chinese. The two SNPs were genotyped by SNPscan method; Hardy–Weinberg equilibrium test, allelic TDT and parent-of-origin effect were performed by PLINK software, and genotypic TDT and haplotype by FBAT software.

Results

Allelic TDT analysis revealed allele A at rs7078160 was over-transmitted among NSCL/P group (P = 0.0086, OR_transmission = 1.36, 95%CI: 1.08-1.72). Parent-of-origin effect analysis revealed a paternal special over-transmission of allele A at rs708260 in NSCL/P group (P = 0.0079). Haplotype AC of rs7078160-rs4752028 was significant over-transmitted in the NSCL/P group.

Conclusions

Our study firstly confirmed that allele A at rs7078160 at VAX1 gene was a risk factor for NSCL/P in Western Han Chinese population.

https://ift.tt/2zNyVLu

Effect of Metformin on Dental Pulp Stem Cells Attachment, Proliferation and Differentiation Cultured on Biphasic Bone Substitutes

Publication date: Available online 18 July 2018

Source: Archives of Oral Biology

Author(s): Behzad Houshmand, Zohreh Tabibzadeh, Saeed Reza Motamedian, Farnaz Kouhestani

Abstract

Objective

To evaluate to the effect of metformin on attachment of human dental pulp stem cells (hDPSCs) and their proliferation and osteogenic differentiation on biphasic hydroxyapatite/beta-tricalcium phosphate granules of macro-porous biphasic calcium phosphate (MBCP).

Materials and methods

This in vitro study included four groups: A:hDPSCs + MBCP + Metfromin, B:hDPSCs + MBCP, C:hDPSCs + Metformin and D:hDPSCs (control). Attachment of hDPSCs to bone granules in groups A and B was observed by scanning electron microscopy on days 1 and 7 of cultivation. Cell viability was assessed by MTT assay on days 1, 3, and 7 after cell seeding. Differentiation of the hDPSCs was assessed by measurement of alkaline phosphatase activity on days 3, 7, 14 and 21 after cell culturing in standard and osteogenic media. The data was analyzed by two-way ANOVA at a significance level of p = 0.05.

Results

The hDPSCs had firmly attached to the surface of MBCP granules, especially in group A. The MTT values increased in all groups from day 1 to day 7 (p < 0.001). The highest MTT values were observed in group C followed by the control group and groups A and B (p < 0.001). Alkaline phosphatase activity also increased in all groups between days 3 to 21 (p < 0.001) except between days 7 and 14 in standard media (p = 0.094). In standard media, groups with MBCP granules (A and B) showed higher activity (p < 0.05). In osteogenic media, the groups with metformin (A and C) showed higher alkaline phosphatase activity (p < 0.05).

Conclusion

This in vitro study showed that 100 Mol/L metformin increased attachment and proliferation of hDPSCs on biphasic granules. Osteogenic differentiation of hDPSCs also increased in the presence of metformin.

https://ift.tt/2uxHrt4

Effect of palm oil alone or associated to stannous solution on enamel erosive-abrasive wear: a randomized in situ/ex vivo study

Publication date: Available online 18 July 2018

Source: Archives of Oral Biology

Author(s): Franciny Querobim Ionta, Catarina Ribeiro Barros de Alencar, Natália Mello dos Santos, Bianca Tozi Portaluppe Bergantin, Poliana Pacifico Val, Heitor Marques Honório, Thais Marchini de Oliveira, Daniela Rios

Abstract

Objective

Palm oil has demonstrated preventive potential against initial erosive demineralization in vitro. This in situ study evaluated the effect of palm oil alone or associated with stannous-containing (Sn) solution on preventing enamel loss from an erosive/abrasive challenge.

Design

This single-blind, randomized, crossover in situ/ex vivo study was developed in four phases (one per group of five days) with sixteen volunteers. Enamel blocks (n = 256) were allocated to groups according to the treatment: Palm oil; Palm oil plus Sn solution; Sn solution – positive control; and Deionized water - negative control. Half of the enamel blocks of each group was subjected to erosion and the other half to erosion + abrasion. The daily ex vivo protocol consisted of four citric acid immersions (2 minutes). Before the first and third acid exposure, the blocks were treated with the test solutions (1 drop/block) for 1 minute followed by acid immersion and abrasive challenge (toothpaste was applied on all blocks and half were brushed for 15 seconds/block). Enamel loss was quantified profilometrically and data were analyzed by two-way ANOVA and Tukey's test (p < 0.05).

Results

A significant difference was found for type of treatment (p < 0.001); wear condition (p = 0.38) and the treatment x condition interaction (p = 0.33) was non-significant. Palm oil associated or not to Sn solution significantly reduced enamel wear in comparison with the negative control but did not differ from the positive control (p > 0.05).

Conclusions

Palm oil was able to prevent enamel loss under erosive and erosive + abrasive challenges in a similar extend to stannous-containing commercial solution.

https://ift.tt/2zQ7XDj

Buccal space tumours

Publication date: Available online 18 July 2018

Source: Auris Nasus Larynx

Author(s): Zubair Hasan, Darius Tan, Malcolm Buchanan, Carsten Palme, Faruque Riffat

Abstract

Objective

To review the available literature as it pertains to the buccal space with a specific focus on the pathologies encountered within this space. Clinical presentation, investigations, and surgical approaches to the region are also reviewed.

Methods

A systematic review of the available literature was performed on buccal space tumours from 1980 to 2017. Data was extracted on clinical presentation, investigations and surgical approaches to the buccal space. The pathologies encountered in the buccal space were reviewed and presented.

Results

Forty-nine unique articles were reviewed, with a total 217 patients. The age of the patients ranged from 0 to 83 with a mean age of 45.8. A total of 51 pathologies were reported. The majority of these were vascular and salivary gland pathologies. The majority of salivary gland neoplasms were malignant. However a wide variety of benign and malignant soft tissue tumours were also reported to occur in this region.

Conclusions

The buccal space is a small and complex region with a variety of pathologies occurring within it. This review clarifies the differential diagnosis of a mass which presents in this area and the pathologies which occur within it.

https://ift.tt/2zY9AyS

Electrophysiological Monitoring During Percutaneous Trigeminal Nerve Ganglion Block

No abstract available

https://ift.tt/2uxBLPX

Antiviral RNA interference in mammals

Shou-Wei Ding | Qingxia Han | Jinyan Wang | Wan-Xiang Li

https://ift.tt/2NsCR6A

Gutartige Parotistumore: moderne Therapiekonzepte

Laryngo-Rhino-Otol
DOI: 10.1055/a-0633-0820

Bei gutartigen Parotistumoren ist es ein vorrangiges Behandlungsziel, die Morbidität des operativen Eingriffs zu senken. Standardisiertes intraoperatives Vorgehen und Verfahren zur Minimierung des Operationsumfangs konnten das Risiko einer bleibenden Fazialisparese deutlich senken. Aktuelle evidenzbasierte Therapieverfahren und mögliche Komplikationen nach Parotidektomie werden in diesem Beitrag näher erläutert.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2uMcVLd

Transorale videoendoskopische Resektion von Kopf-Hals-Tumoren in 4-Hand-Technik

Laryngo-Rhino-Otol
DOI: 10.1055/a-0654-5376

Einleitung Videoendoskopische Operationsverfahren in 4-Hand-Technik sind bereits in der Visceralchirurgie bei laparoskopischen Eingriffen sowie bei der Hypophysenchirurgie etabliert. Auch in der Tumorchirurgie im Kopf-Hals-Bereich gewinnt die transorale videoendoskopische Resektion von Tumoren in 4-Hand-Technik (TOVR) zunehmend an Bedeutung. Material und Methoden Seit März 2013 wurden erfolgreich 28 transorale videoendoskopische Tumorresektionen von Oropharynx (n = 5) –, Hypopharynx (n = 12) – und Larynxkarzinomen (n = 11) in 4-Hand-Technik durchgeführt. Ergebnisse In allen 28 Fällen wurde transoral eine R0-Resektion ohne Erweiterung des Eingriffs durch einen Zugang von transcervikal erreicht. Auch bei Patienten mit schlechter Beweglichkeit im HWS-Bereich (n = 9) gelang durch den Einsatz von Winkeloptiken über ein Kleinsasser- oder Weerda-Rohr per TOVR eine transorale R0-Tumorresektion. Schlußfolgerungen Die TOVR ist ein effektives, preisgünstiges und minimalinvasives Operationsverfahren bei Tumoren im Kopf-Hals-Bereich mit zahlreichen Vorteilen im Vergleich zur CO2-Laserresektion und stellt eine echte Alternative zu den herkömmlichen Resektionsverfahren dar.
[...]

© Georg Thieme Verlag KG Stuttgart · New York

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

https://ift.tt/2LkHKRO

Successful Percutaneous Coronary Intervention for Atherosclerotic Coronary Lesion with Anomalous Origin of the Right Coronary Artery

Congenital coronary artery anomalies, including anomalous origin of a coronary artery, can manifest as life-threatening conditions, such as myocardial infarction or arrhythmia, and may even lead to sudden death associated with specific congenital anatomical features. Such arteries can also develop atherosclerotic lesions. This report describes the case of a 75-year-old man who was admitted to our hospital due to exertional dyspnea. The right coronary artery was found to originate from the left coronary sinus and exhibit tight stenosis due to atherosclerosis, causing effort angina pectoris. This case highlights the fact that coronary artery anomalies can cause angina pectoris via both atherosclerotic and nonatherosclerotic effects, and successful revascularization was achieved noninvasively via percutaneous coronary angioplasty.

https://ift.tt/2LjxLMu

Pearls for the middle fossa approach in acoustic neuroma surgery

Purpose of review To discuss the use of the middle fossa craniotomy for resection of vestibular schwannomas; to present pearls of and modifications to the approach. Recent findings The middle fossa craniotomy allows for hearing preservation in the resection of intracanalicular vestibular schwannomas. Over recent years, the approach has been modified to address larger tumors with a limited cerebellopontine angle component. Positive identification of the superior semicircular canal allows for rapid exposure of the internal auditory canal (IAC). Removal of cerebrospinal fluid from the posterior fossa during exposure of the IAC allows for removal of the middle fossa retractor; reinforced silicone sheeting is used to protect the middle fossa dura during further drilling. The use of the endoscope has allowed for more complete dissection at the fundus of the IAC, including tumors lateral to the transverse crest. Summary Technical modifications to the middle fossa craniotomy have allowed for a shorter duration of temporal lobe retraction intraoperatively and more complete resection of tumors with fundal involvement. Correspondence to Eric P. Wilkinson, MD, House Clinic, 2100 W 3rd St, Ste 111, Los Angeles, CA 90057, USA. Tel: +1 213 483 9930; e-mail: ewilkinson@houseclinic.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uzmLkv

Functional considerations in oral cavity reconstruction

Purpose of review The treatment of oral cavity cancer may impair speech and swallowing function. Optimizing posttreatment function may lead to significant improvement of quality of life. Recent findings Although oncologic control remains the main goal of treatment for oral cavity cancer, posttreatment function for surviving patients has over the last decades been recognized as an important secondary outcome. Reconstruction of oral cavity defects range from primary closure to advanced microvascular reconstruction, including multiple tissue types. Free flap reconstruction has greatly enhanced the ability to tailor transferred tissue to specific defects. In this review, we describe recent findings in reconstruction of tongue defects, including data from perforator flaps. We also summarize recent evidence regarding reinnervated flaps. Summary When vascularized tissue is needed, it remains unclear how the reconstructive choice impacts postoperative outcome, although in many situations it appears to be dominated by the donor site morbidity rather than the reconstructive technique. Despite numerous case series, the functional impact of motor and sensory reinnervation in vascularized tissue remains unknown. Although perforator flaps have emerged as a promising flap option, with favorable donor site morbidity, their ultimate impact on functional outcomes remains unclear, whereas the success rate appears to be lower than traditional flaps. Correspondence to Patrik Pipkorn, MD, Department of Otolaryngology, Head and Neck Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8057, St. Louis, MO 63110, USA. Tel: +1 314 362 6599; fax: +1 314 362 7522; e-mail: ppipkorn@wustl.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2zRx8VL

Conjunctival provocation tests: prediction of seasonal allergy

Purpose of review The conjunctival provocation test (CPT) is often used to clearly identify the specific allergen causing the symptoms of allergic rhinoconjunctivitis but also to assess the clinical efficacy of an allergen immunotherapy (AIT). As there is no consensus about its predictive value, the aim of this publication is to evaluate under which conditions the CPT can predict the symptom severity during the allergy season after previous AIT. Recent findings Three out of four randomized controlled trials (RCTs) showed a correlation between CPT reactivity and symptoms occurring under natural allergen exposure after previous AIT. Furthermore, one RCT found that performing the CPT 4 weeks after initiating AIT can identify early responders who also show a benefit during the season. Another RCT suggested that conducting the CPT prior to starting AIT can be used to identify patients who may benefit more from treatment than others. Summary The assessment of the reviewed literature led us to the conclusion that the CPT has a predictive value and can consequently be used to assess the efficacy of an administered AIT if performed according to a standardized challenge protocol with high-quality allergen extracts. Correspondence to Ralph Mösges, Institute of Medical Statistics and Computational Biology (IMSB), Faculty of Medicine, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany. Tel: +49 172 2056230; e-mail: ralph@moesges.de Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2zNz9lR

Globalization and anaphylaxis

Purpose of review To understand the impact of globalization in the management of anaphylaxis and identify potential strategies to improve patients' care and prevention. Recent findings Developments in the field of anaphylaxis have been consistently following these globalization trends offering possibilities of collaborations of the allergy community and integrated international initiatives to reach quality care of allergic patients worldwide. Summary Globalization is the process of interaction and integration between people, companies, and governments worldwide. Developments in the field of anaphylaxis have been following these globalization trends offering possibilities of collaborations and integrated international initiatives to reach quality care of allergic patients worldwide. Complex disorders, such as anaphylaxis, have called for complex integrative strategies, leading to a new acceptance of outside traditions. Allergy is encouraging us to accept holistic and integrative medical practices as viable options. With the dissolution of multinational boundaries and the universal free access to information, the notion of holistic and global-based care is emerging as the new reality of the medicine. We strongly believe that the integrated action plan to the management and prevention of anaphylaxis, just possible through the globalization, is a key health, political and economical move that advocates for the best practice of allergology. Correspondence to Luciana Kase Tanno, MD, PhD, Division of Allergy, Department of Pulmonology, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, 371, av. du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France. Tel: +33 467336107; fax: +33 467633645; e-mail: luciana.tanno@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uxxR9v

Seasonal ocular allergy and pollen counts

Purpose of review The purpose of the article is to provide a historical overview of literature regarding pollen sensitization and ocular allergy with an emphasis on developments that have occurred over the past 5 years. Recent findings Currently, pollen studies have examined the molecular and cellular pathways involved in initiating allergic conjunctivitis to find targets for therapeutics. Studies have also documented the threshold, linear increase and plateau point in the relationship between pollen levels and allergic conjunctivitis symptoms. Summary Traditionally, intact pollen grains are counted as a means of correlating patient symptoms to allergen exposure. However, establishing a dose–response relationship between pollen grain exposure and allergic conjunctivitis has proven to be difficult. It has been observed that ocular allergies induce a two-fold response including early-phase and late-phase IgE-mediated reactions. Sensitization itself is a combination of pollen exposure over time in genetically predisposed individual. However, symptoms appear to reach an asymptotic point at which clinical severity plateaus. More studies are needed to clearly define differences in pollen sensitization by plant species. Correspondence to Leonard Bielory, MD, University Asthma and Allergy Associates, 400 Mountain Ave, Springfield, NJ 07081, USA. Tel: +1 973 912 9817; e-mail: drlbielory@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2zPdnhz

Cosmetics and ocular allergy

Purpose of review The purpose of this review was to explore recent developments in the study of ocular cosmetics, as they pertain to adverse reactions that can be attributed to them. Recent findings Immunologically mediated adverse reactions to cosmetics are most commonly the result of sensitization to preservatives, fragrances and dyes used in these products. Metals such as nickel, cobalt, chromium and lead are used in products such as eye shadows and eye liners as well as toy makeup sets in amounts greater than the recommended amount of 1 ppm. Cosmetics make up the majority of fragrance-induced contact dermatitis. Recently, a free smartphone app was developed by American Contact Dermatitis Society that holds promise in better enabling patients to utilize their patch test data while shopping for cosmetics. Summary Both immediate and delayed hypersensitivity reactions linked to cosmetics are often the result of sensitization to preservatives, fragrances and additives in the products themselves. Despite significant advances in our understanding of these reactions, further research will be necessary to elucidate the mechanisms behind these reactions and bring this knowledge to the bedside as to improve patient care with potential cosmetic-based related allergic disorders. Correspondence to Leonard Bielory, MD, University Asthma and Allergy Associates, 400 Mountain Ave, Springfield, NJ 07081, USA. Tel: +1 973 912 9817; e-mail: drlbielory@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uvpKdT

Topical antihistamines, mast cell stabilizers, and dual-action agents in ocular allergy: current trends

Purpose of review To address the current trends of therapeutic mechanisms for treatment of allergic conjunctivitis (AC), based on topical antihistamines and mast cell stabilizers (MCS). Recent findings The antihistamine drug alcaftadine has H4 receptor inverse agonism, anti-inflammatory and MCS activities. The antihistamines levocabastine and azelastine are more effective than placebo in treatment of AC symptoms in randomized controlled trials (RCTs). The topical dual-action antihistamines/MCS olopatadine, azelastine, ketotifen, and epinastine are commonly used in Europe and in the United States for mild subtypes of AC. For the main symptoms of AC, ocular itch and conjunctival hyperemia, epinastine 0.05% was superior to placebo, but equal or more effective than olopatadine 0.1%, while the later was more effective than ketotifen. High concentration olopatadine 0.77% had longer duration of action, better efficacy on ocular itch, and a similar safety profile to low-concentration olopatadine 0.2%. The new formulas of topical dual-action agents present longer duration of action, leading to a decreased frequency of use. Summary The topical dual-action agents are the most effective agents treating signs and symptoms of mild forms of AC. There is superiority to the high-concentration olopatadine drug over other agents on ocular itch, with prolonged effect when used once-daily. Correspondence to Prof. Abraham Solomon, Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Kiryat Hadassah, Ein-Kerem, POB 1200, Jerusalem 91120, Israel. Tel: +972 50 7874664; e-mail: dr.avi.solomon@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2zUYYRk

Adults and children with anaphylaxis in the emergency room: why it is not recognized?

Purpose of review Despite many international guidelines have been published in the last 10 years, anaphylaxis continues to be underdiagnosed, undernotified, and undertreated. Anaphylactic reactions in adults and children in emergency departments are frequently not recognized, leading to underutilization of epinephrine, and a higher risk of death. Recent findings A few studies have been recently published showing that educational intervention for both physicians and other healthcare professionals improve diagnosis and treatment of anaphylaxis. Moreover, the new International Classification of Diseases, 11th edition improved classification of anaphylaxis, making it easier to be notified. Summary Anaphylaxis is a life-threatening hypersensitivity reaction that is most frequently seen by emergency physicians and nurses than allergists or immunologists. Education seems to be best strategy to improve management of this severe condition. Correspondence to Marcelo V. Aun, MD, PhD, Faculdade Israelita de Ciências da Saúde (FICS) Albert Einstein, Avenida Brigadeiro Luis Antonio 4267, 01401-002 São Paulo, SP, Brazil. Tel: +55 11 983080404; e-mail: marcelovivoloaun@gmail.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uw1bxp

Pearls for the middle fossa approach in acoustic neuroma surgery

Purpose of review To discuss the use of the middle fossa craniotomy for resection of vestibular schwannomas; to present pearls of and modifications to the approach. Recent findings The middle fossa craniotomy allows for hearing preservation in the resection of intracanalicular vestibular schwannomas. Over recent years, the approach has been modified to address larger tumors with a limited cerebellopontine angle component. Positive identification of the superior semicircular canal allows for rapid exposure of the internal auditory canal (IAC). Removal of cerebrospinal fluid from the posterior fossa during exposure of the IAC allows for removal of the middle fossa retractor; reinforced silicone sheeting is used to protect the middle fossa dura during further drilling. The use of the endoscope has allowed for more complete dissection at the fundus of the IAC, including tumors lateral to the transverse crest. Summary Technical modifications to the middle fossa craniotomy have allowed for a shorter duration of temporal lobe retraction intraoperatively and more complete resection of tumors with fundal involvement. Correspondence to Eric P. Wilkinson, MD, House Clinic, 2100 W 3rd St, Ste 111, Los Angeles, CA 90057, USA. Tel: +1 213 483 9930; e-mail: ewilkinson@houseclinic.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2uzmLkv

Functional considerations in oral cavity reconstruction

Purpose of review The treatment of oral cavity cancer may impair speech and swallowing function. Optimizing posttreatment function may lead to significant improvement of quality of life. Recent findings Although oncologic control remains the main goal of treatment for oral cavity cancer, posttreatment function for surviving patients has over the last decades been recognized as an important secondary outcome. Reconstruction of oral cavity defects range from primary closure to advanced microvascular reconstruction, including multiple tissue types. Free flap reconstruction has greatly enhanced the ability to tailor transferred tissue to specific defects. In this review, we describe recent findings in reconstruction of tongue defects, including data from perforator flaps. We also summarize recent evidence regarding reinnervated flaps. Summary When vascularized tissue is needed, it remains unclear how the reconstructive choice impacts postoperative outcome, although in many situations it appears to be dominated by the donor site morbidity rather than the reconstructive technique. Despite numerous case series, the functional impact of motor and sensory reinnervation in vascularized tissue remains unknown. Although perforator flaps have emerged as a promising flap option, with favorable donor site morbidity, their ultimate impact on functional outcomes remains unclear, whereas the success rate appears to be lower than traditional flaps. Correspondence to Patrik Pipkorn, MD, Department of Otolaryngology, Head and Neck Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8057, St. Louis, MO 63110, USA. Tel: +1 314 362 6599; fax: +1 314 362 7522; e-mail: ppipkorn@wustl.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2zRx8VL

Interplay between acute phase response and coagulation/fibrinolysis in chronic spontaneous urticaria

Chronic spontaneous urticaria (CSU) is associated with activation of systemic inflammatory response and coagulation/fibrinolysis.

https://ift.tt/2O49Y1I

Summary of the updated international consensus diagnostic criteria for eosinophilic esophagitis: AGREE conference,

EoE is a global health condition that has steady increased over the last few decades and is now reported on all continents, with an estimated incidence of 4 per 100,000. Diagnostic Guidelines on eosinophilic esophagitis (EoE) were published in 2007 and updated in 2011.1,2 EoE is defined as a clinicopathological condition that is likely immune or antigen driven, and characterized clinically by symptoms of esophageal dysfunction and histologically by ≥15 eosinophils per high power field (eos/hpf).

https://ift.tt/2NpDDBa

Long-term sheltering mustaches reduce incidence of lower lip actinic keratosis

https://ift.tt/2LmvpfL

Journal of the American Academy of Dermatology: Original article Comorbidities in alopecia areata: A systematic review and meta-analysis

Alopecia areata (AA) may be associated with various systemic diseases according to several studies.

https://ift.tt/2Jz8kSb

Blunt trauma to the antecubital fossa causing brachial artery injury and minor fractures around the elbow joint, an easily missed diagnosis with potential devastating consequences: a case report

Blunt trauma causing brachial artery injury in a young patient is very rare. Cases of brachial artery injury may be associated with closed elbow dislocation or instability. Elbow dislocation may not be evident...

https://ift.tt/2JzboOj

Buccal space tumours

To review the available literature as it pertains to the buccal space with a specific focus on the pathologies encountered within this space. Clinical presentation, investigations, and surgical approaches to the region are also reviewed.

https://ift.tt/2LtL7mc

Pediatric Nasal Obstruction

Nasal obstruction is one of the most common problems seen by pediatric otolaryngologists. Prompt treatment of nasal obstruction can be critical in newborns and infants because of their obligatory nasal breathing. Older children will typically have more inflammatory, infectious, or traumatic causes of nasal obstruction. Nasal obstruction can lead to a significant decrease in the quality of life in children along with an increase health care expenditures.

https://ift.tt/2utNb7h

Efficacy & Safety of OPN-375 Adults With Bilateral Nasal Polyps Using Nasoendoscopic Video

Condition:   Bilateral Nasal Polyposis
Intervention:   Drug: OPN-375
Sponsor:   Optinose US Inc.
Recruiting

https://ift.tt/2zO4vZR

A Phase 1b Dose Escalation/Expansion Study of Abexinostat in Combination With Pembrolizumab in Patients With Advanced Solid Tumor Malignancies

Conditions:   Stage III Cutaneous Melanoma;   Stage IV Cutaneous Melanoma;   Locally Advanced Melanoma;   Locally Advanced Solid Neoplasm;   Metastatic Head and Neck Squamous Cell Carcinoma;   Metastatic Malignant Solid Neoplasm;   Metastatic Melanoma;   Metastatic Urothelial Carcinoma;   Non-Small Cell Lung Carcinoma;   Stage IB Lung Cancer AJCC v7;   Stage III Cutaneous Squamous Cell Carcinoma of the Head and Neck AJCC v8;   Stage III Lung Cancer AJCC v8;   Stage III Ureter Cancer AJCC v8;   Stage IIIA Lung Cancer AJCC v8;   Stage IIIB Lung Cancer AJCC v8;   Stage IIIC Lung Cancer AJCC v8;   Stage IV Cutaneous Squamous Cell Carcinoma of the Head and Neck AJCC v8;   Stage IV Lung Cancer AJCC v8;   Stage IV Ureter Cancer AJCC v8;   Stage IVA Lung Cancer AJCC v8;   Stage IVB Lung Cancer AJCC v8
Interventions:   Drug: Abexinostat;   Biological: Pembrolizumab
Sponsors:   Rahul Aggarwal;   Xynomic Pharmaceuticals, Inc.
Not yet recruiting

https://ift.tt/2mswQLL

Papuloerythroderma of Ofuji successfully treated with methotrexate

Dermatologic Therapy, EarlyView.


https://ift.tt/2uLplD7

Hyaluronic acid filler for skin rejuvenation: The role of diet on outcomes. A pilot study

Dermatologic Therapy, EarlyView.


https://ift.tt/2LhqLQ5

Efficacy and safety of rupatadine in Japanese adult and adolescent patients with chronic spontaneous urticaria: A double-blind, randomized, multicenter, placebo-controlled clinical trial

Publication date: Available online 18 July 2018

Source: Allergology International

Author(s): Michihiro Hide, Takamasa Suzuki, Ayaka Tanaka, Hiroshi Aoki

Abstract

Background

Rupatadine, a novel nonsedating second-generation H1-antihistamine with antiplatelet-activating factor activity, has been used in the treatment of allergic rhinitis and urticaria in European countries since 2003. However, its efficacy and safety in Japanese patients with chronic spontaneous urticaria (CSU) are unknown.

Methods

We conducted a prospective, multicenter, randomized, placebo-controlled, double-blind study in adolescent and adult CSU outpatients aged 12 to < 65 years (JAPIC-CTI No. 152786). Overall, 94, 91, and 92 eligible patients orally received placebo, rupatadine 10 mg, and 20 mg once daily for 2 weeks, respectively. The primary endpoint was change from baseline to the second week of treatment in total pruritus score (TPS, sum of daytime and nighttime pruritus scores).

Results

The results yielded a least squares mean TPS difference of −1.956 between rupatadine 10 mg versus placebo, and −2.121 between rupatadine 20 mg versus placebo (analysis of covariance, both P < 0.001). The incidence of adverse events was 8.5% for placebo, 20.9% for rupatadine 10 mg, and 17.4% for rupatadine 20 mg. Somnolence was the only adverse drug reaction to rupatadine reported in 2 or more subjects. No serious or clinically significant adverse events were observed.

Conclusions

The primary and secondary efficacy endpoints consistently favored rupatadine 10 and 20 mg doses over the placebo. No noteworthy dose-related increase in the incidence of adverse drug reactions was observed. Rupatadine is safe and effective at a dose of 10 mg once daily, and can be safely increased to 20 mg once daily, as necessary.

https://ift.tt/2JxY5xz

Human Th9 differentiation is dependent upon STAT3 to restrain STAT1-mediated inhibition

Publication date: Available online 18 July 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Yuan Zhang, Andrea M. Siegel, Guangping Sun, Tom Dimaggio, Alexandra F. Freeman, Joshua D. Milner

Abstract

Background

Patients with loss of function (LOF) signal transducer and activator of transcription 3 (STAT3) mutations have dermatitis, enhanced IgE production despite a relative lack of immediate hypersensitivity, recurrent infection, and an increased rate of lymphoma, in addition to a number of skeletal and connective tissue abnormalities. Gain of function (GOF) STAT1 mutant patients also have susceptibility to candidiasis and sinopulmonary infection, as well as autoimmunity and squamous cell carcinoma, in addition to even more broad phenotypes.

Objective

Because of the link between Th9 cells and allergic inflammation, autoimmunity and anti-tumor surveillance, and because evidence shows either the role for STAT3 or STAT1 in Th9 differentiation conflicts, we wished to determine the status on this lineage of STAT1GOF and STAT3LOF in humans.

Methods

We detected IL-9 levels and Th9 differentiation of STAT3LOF and STAT1GOF patients, together with Th9 transcript factors, and partially rescued their deficiency in vitro by adding cytokines they lacked or transfecting key molecules.

Results

We found that PBMCs or sorted naïve CD4+ T cells from STAT3LOF and STAT1GOF patients had impaired Th9 generation/differentiation. STAT3 inhibition in normal Th9 cultures diminished early IL-21 induction and late IL-9 production, while exogenous IL-21 enhanced Th9 differentiation even with STAT3 inhibition, by restoring SOCS3 expression and thus inhibiting excessive p-STAT1 activation. Furthermore, exogenous expression of SOCS3 or either T-bet or STAT1 RNAi in STAT3 LOF cells partially rescued IL-9 differentiation.

Conclusion

Collectively, these results suggest that human Th9 differentiation depends on normal p-STAT3 and IL-21 production to suppress p-STAT1 activation and T-bet transcription.

Graphical abstract

https://ift.tt/2Noip6U

Immunomodulatory effect of thymoquinone on atopic dermatitis

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Hina Aslam, Muhammad Shahzad, Arham Shabbir, Sabeen Irshad

Abstract

Background

Atopic dermatitis (AD) or atopic eczema is a skin disease characterized with itching, increased serum level of immunoglobulin E, and peripheral eosinophilia. Thymoquinone (TQ) is an important ingredient of Nigella sativa seeds having antioxidant and anti-inflammatory effects.

Objective

Present study investigates the immunomodulatory effects of Thymoquinone (TQ) in mice model of atopic dermatitis.

Methods

Ear pinnas of mice were sensitized and challenged with DNCB (2–4 di nitro chloro benzene) to induce AD-like lesions. The mice were then treated with TQ and tacrolimus, both orally and topically. Ear thickness and weight were measured along with gross changes. Total and differential leukocyte counts were measured in blood. Total serum IgE levels were measured by enzyme linked immunosorbent assay (ELISA). The mRNA expression levels of IL-4, IL-5, and IFN-γ in ear tissue were measured using reverse transcription polymerase chain reaction (RT-PCR).

Results

Both oral and topical thymoquinone showed the potential to improve atopic dermatitis by significantly reducing the inflammatory cells infiltration in the blood (p <  0.001) and improving the dermatitis score (p < 0.001). Significant reduction in ear thickness (p < 0.001) and IgE levels (p < 0.001) were also observed. TQ and tacrolimus also significantly attenuated mRNA expression levels of IL-4, IL-5 and IFN-γ (p <  0.001).

Conclusions & clinical relevance

Taken together, our results showed that oral and topical application of thymoquinone exerts immunomodulatory effects in animal model of atopic dermatitis, suggesting further studies and clinical trials to establish it as a candidate nutraceutical for the treatment of AD.

https://ift.tt/2zQ6woi

Molecular identification and gene expression profiles of the T cell receptors and co-receptors in developing red-tailed phascogale (Phascogale calura) pouch young

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Casey R. Borthwick, Lauren J. Young, Julie M. Old

Abstract

Expressed coding sequences were identified for the T cell receptors TCRα, TCRβ, TCRγ, TCRδ, TCRμ, and co-receptors CD3ε, CD4, and CD8α in the red-tailed phascogale (Phascogale calura). Expression of these genes was examined in the developing thymus and spleen of pouch young and juvenile individuals to detect any changes in expressionrelative to developmental stages. Transcripts of CD3ε, CD4, TCRδ and TCRμ were first detected in the thorax at 1 day postpartum (dpp), and transcripts of all target genes were detected in the thymus from 3 dpp, and the spleen from 17 dpp. The relative expression of all target genes changed significantly over the course of pouch life and was associated with histological milestones of both the thymus and the spleen. Peak gene expression was observed early in pouch life in the thymus, with a decrease in expression associated with timing of thymic involution, while expression peaked later in the spleen and was associated with the initial differentiation of the red and white pulp and a population of T cells forming the periarterial lymphatic sheath (PALS). Active expression of these target genes within the thymus and spleen indicates that the young marsupials are actively developing immunocompetence during pouch life.

https://ift.tt/2mqpdp1

A novel Aβ epitope vaccine based on bacterium-like particle against Alzheimer’s disease

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Lu Fu, Yongqing Guo, Yao Sun, Yue Dong, Jiaxin Wu, Bin Yu, Haihong Zhang, Xianghui Yu, Hui Wu, Wei Kong

Abstract

Amyloid-beta (Aβ) plaque accumulation in the brain is one of the hallmarks of Alzheimer's disease (AD). Immunotherapy against Aβ was considered a potential strategy for reducing the Aβ load in the brain. However, none of the Aβ immunotherapies have produced clinically meaningful results to date, due to poor safety or lack of efficacy. Thus, we aimed to design a safe and effective vaccine against AD. In this study, we used bacterium-like particles (BLPs) as carriers and different copy numbers of the Aβ 1-6 peptide as epitopes to design four Aβ active immunization vaccines. The epitopes containing different copy numbers of the Aβ 1-6 peptide were specifically loaded on the surface of BLPs via fusion with a peptidoglycan anchoring domain. These four BLP-based Aβ vaccines successfully induced high levels of Aβ42-specific antibodies in mice. However, none of the vaccines induced a T-cell-mediated immune response. Importantly, the antibodies induced by these four vaccines were effective in blocking Aβ42 oligomer toxicity at the cellular level. Among the four vaccines, 6copy-Aβ 1-6 -PA-BLP was the most effective in inducing Aβ-specific antibodies, indicating that a suitable epitope copy number is critical for high immunogenicity of the BLP-based vaccine. Furthermore, high levels of serum Aβ-specific antibodies could still be detected 3 months after the final administration of 6copy-Aβ 1-6 -PA-BLP. Thus, 6copy-Aβ 1-6 -PA-BLP may be a potential therapeutic treatment for AD.

https://ift.tt/2uMch0n

Myeloid-derived suppressor cells exacerbate Sjögren’s syndrome by inhibiting Th2 immune responses

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Jingjing Qi, Dan Li, Guoping Shi, Xuefang Zhang, Yuchen Pan, Huan Dou, Genhong Yao, Yayi Hou

Abstract

Myeloid-derived suppressor cells (MDSCs) can regulate various aspects of immune responses based on their potent immune-suppressive activity. Studies reported that MDSCs participated in many autoimmune diseases. However, the role of MDSCs in Sjögren's syndrome (SS) is unknown. In this study, we determined the frequencies and function of MDSCs in non-obese diabetic (NOD) mice and SS patients. The NOD mice were adoptively transferred with MDSCs or treated with anti-Gr1 antibody. Results showed that peripheral MDSCs increased significantly with the development of SS-like syndrome in NOD mice and the percentage of MDSCs was higher in SS patients than healthy controls. The SS-like syndrome aggravated after transfer of MDSCs in NOD mice. The deletion of MDSCs in NOD mice alleviated SS-like syndrome. Mechanistically, MDSCs down-regulated the percentages of Th2 cells in NOD mice and SS patients. In summary, our findings suggested that MDSCs exacerbated Sjögren's syndrome by inhibiting Th2 cells.

https://ift.tt/2mqwkO4

Humanin prevents high glucose-induced monocyte adhesion to endothelial cells by targeting KLF2

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Xiaohui Wang, Ziheng Wu, Yangyan He, Hongkun Zhang, Lu Tian, Chengfei Zheng, Tao Shang, Qianqian Zhu, Donglin Li, Yunjun He

Abstract

Endothelial dysfunction and vascular complications induced by hyperglycemia play an important role in the pathological development of atherosclerosis in diabetes. Humanin, a 24-amino acid mitochondria-derived polypeptide, has displayed its cytoprotective effects in diverse cell types and tissues. In the current study, we aimed to characterize the effects of humanin on high glucose-induced endothelial dysfunction. Firstly, we found that humanin treatment induced the expression of Krüppel-like factor 2 (KLF2), an essential transcriptional regulator of endothelial function, at the transcriptional level in human umbilical vein endothelial cells (HUVECs). Additionally, our results indicate that humanin treatment regulated the expression of KLF2 target genes such as endothelial nitric oxide synthase (eNOS) and endothelin-1 (ET-1). Evidence demonstrated that the effects of humanin on KLF2 expression was mediated by the phosphorylation of extracellular signal regulated kinase 5 (ERK5). Furthermore, humanin restored high glucose-induced reduction of KLF2 expression. We also showed that humanin significantly reduced the expression of vascular cell adhesion molecule 1 (VCAM-1) and E-selectin. Notably, humanin treatment markedly prevented high glucose-induced attachment of the monocyte THP-1 cells to HUVECs. However, knockdown of KLF2 abolished these effects. Lastly, we report that humanin treatment inhibited high glucose-induced secretion of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β). These findings suggest that humanin may have therapeutic potential for the treatment of hyperglycemia-associated endothelial dysfunction.

https://ift.tt/2uMcaSv

Summary of the updated international consensus diagnostic criteria for eosinophilic esophagitis: AGREE conference,

Publication date: Available online 18 July 2018

Source: Annals of Allergy, Asthma & Immunology

Author(s): Jonathan M. Spergel, Evan S. Dellon, Chris A. Liacouras, Ikuo Hirano, Javier Molina-Infante, Albert J. Bredenoord, Glenn T. Furuta, On behalf of the participants of AGREE

https://ift.tt/2L6uAZm

Delayed Adverse Skin Effects After PD-1-Inhibitor Therapy

Eczema, psoriasis, and lupuslike reactions can occur even months after starting or stopping these drugs, so patients need to be monitored on an ongoing basis.
Medscape Medical News

https://ift.tt/2NoaBC2

Sunscreen Use and Melanoma Risk Among Young Australian Adults

This population-based, case-control family study of data collected for the Australian Melanoma Family Study assesses the association of sunscreen use in childhood and early adulthood with the risk of cutaneous melanoma before age 40 years.

https://ift.tt/2mqvmSb

Spiky Skin in a Renal Transplant Recipient

A woman in her 70s with a cadaveric renal transplant presented with a 1-year history of a facial cutaneous eruption and mildly pruritic lesions, initially affecting malar cheeks and eyebrows and subsequently spreading to involve the nose, chin, upper trunk, and extremities. What is your diagnosis?

https://ift.tt/2uFGJsU

Timing of Onset of Adverse Cutaneous Reactions Associated With PD-1 Inhibitor Therapy

This observational study assesses the timing of onset of cutaneous reactions after initiation of programmed cell death protein 1 therapy in patients with metastatic melanoma or carcinoma.

https://ift.tt/2mwXNxX

A Comparison of Tanning Habits Among Gym Tanners and Other Tanners

This survey study evaluates the incidence of tanning in adults who use indoor gyms.

https://ift.tt/2uIrdwI

Effect of Stress Ball Use or Hand-holding on Anxiety During Skin Cancer Excision

This randomized clinical trial examines the effects of hand-holding vs stress ball use compared with usual care on anxiety in patients undergoing excisional removal of nonmelanoma skin cancer of the head or neck with local anesthesia.

https://ift.tt/2moXlBs

Scabies—An Ancient Disease With Unanswered Questions in Modern Times

This Viewpoint discusses the global disease burden of scabies, as well as its diagnosis and treatment.

https://ift.tt/2uIr2S4

Venous air embolism in a patient with a massive upper gastrointestinal bleeding

Description 

Emergency medical responders (EMS) were called in for a subject who developed multiple generalised tonic-clonic seizures attributed to hydrocodone-acetaminophen overdose and possible upper gastrointestinal (GI) bleeding. His medical history was significant for peptic ulcer disease status post partial gastrectomy, chronic alcoholism, polysubstance abuse, factor V Leiden mutation with recurrent deep venous thrombosis and pulmonary embolism on warfarin treatment. On his way to the hospital, EMS had difficulty obtaining an intravenous access, and was only successful after three attempts, and the patient was started on intravenous fluids and naloxone. In the emergency room he had an episode of massive bleeding per rectum and was haemodynamically unstable. Fluid resuscitation was started, second intravenous access was obtained and nasogastric tube was placed. CT of the chest, abdomen and pelvis without contrast (figure 1) demonstrated a small amount of air in the right atrium, main pulmonary artery, and right lower lobe segmental and...

https://ift.tt/2Jva4Mh

Splenic torsion: a rare cause of abdominal pain

Splenic torsion is an exceedingly rare but clinically important disease process that should be recognised promptly by the treating physician. In this condition, there is twisting of the spleen along its vascular pedicle, subsequently leading to abdominal pain in the setting of organ ischaemia. Vascular thrombosis and splenic infarction may ensue. Torsion has been described in cases of a known wandering spleen. Abnormal development of the splenic suspensory ligaments may predispose a patient to a wandering spleen. Treatment of splenic torsion is typically surgical, with goals of preservation of the spleen if possible.

We present a case of a young woman who presented with left-sided chest and abdominal pain and was found to have splenic torsion with complete splenic infarction. Surgical intervention was required, and splenectomy was performed. In this case presentation, we outline the multidisciplinary approach needed to care for the patient with this rare condition.

https://ift.tt/2L5nPqr

Aggressive myxoinflammatory fibroblastic sarcoma with multiple site metastases

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare soft tissue sarcoma which was initially observed in acral sites and characterised by spindle cells, pleomorphic bizarre cells and distinctive large Reed-Sternberg–like cells admixed with an intense inflammatory cell infiltrates. MIFS manifests as a slow growing often superficial lesion which can be mistaken as infectious or chronic inflammatory process or benign tumours such as nodular fasciitis, giant cell tumour of tendon sheath or synovial pseudocyst. We report a rare presentation of a MIFS in a 38-year-old man with extensive local spread from subcutaneous tissue to the ankle joint and bones as well as multiple synchronous metastases to lung, sixth rib and vertebra. Our case is peculiar for its aggressive clinical behaviour with short duration, fast growth and extensive metastases, a feature infrequent in MIFS.

https://ift.tt/2Jzlyy7

Rare cause for a common presentation: isolated pulmonary valve endocarditis yet another mimicker

Isolated pulmonary valve endocarditis (PVE) is a rare condition. Known risk factors in previous case reports were intravenous drug abuse and congenital heart disease. Epidemiology of PVE has been changing. It is now being reported specially following invasive healthcare-related procedures even in patients with structurally normal heart. Vast majority of patients present with respiratory symptoms and diagnosis of endocarditis may be challenging unless there is high index of suspicion. Various microorganisms had been isolated as aetiological agents; however, Enterococcus faecalis is being increasingly isolated. PVE mostly managed conservatively with intravenous antibiotics with option for surgical intervention in specific situations. We present a patient with isolated PVE due to E. faecalis following colonoscopy and polypectomy with predisposing risk factor of alcohol excess, mimicking clinically as pneumonia and radiologically as a neoplastic lesion.

https://ift.tt/2L79xWg

Metastasis of malignant myoepithelial carcinoma to the brain

Myoepithelial tumours are a rare form of salivary gland neoplasm and intracranial metastases have rarely been described. The authors present the case of a 61-year-old patient with a history of primary myoepithelial carcinoma of the right foot. Metastases were found in the third ventricle, left temporal lobe and right frontal lobe. The third ventricular and left temporal lobe tumours were resected in a two-stage operation. Pathology of the third ventricular lesion was most consistent with metastasis. MRI of the spine 2 weeks after his operation revealed an intradural mass with several lesions in the lumbar thecal space suggesting further metastases. The patient succumbed to his disease 2 months after his two-stage operation and 5 years after his initial diagnosis. This appears to be the first case in the literature of multiple primary myoepithelial carcinoma metastases to the brain. Further information is needed to provide diagnostic and therapeutic recommendations.

https://ift.tt/2Jy3qVF

The successful treatment of a multidrug-resistant Achromobacter xylosoxidans corneal ulcer with topical meropenem

Microbial keratitis is a common corneal condition, with many known risk factors. We present a case of an 88-year-old female patient with a multidrug-resistant Achromobacter xylosoxidans corneal ulcer in a previously failed second penetrating keratoplasty, successfully managed with topical meropenem drops administered hourly around the clock, for five days preceding and then hourly day only, for five days following a repeat third penetrating keratoplasty. Topical meropenem 50 mg/mL was prepared by mixing a 500 mg vial of meropenem with 10 mL of sterile water with pharmacy advice that administration should be within an hour. To the best of our knowledge, this is the first report of the use of topical meropenem in the management of A.xylosoxidans keratitis. This case highlights the importance of the mean inhibitory concentrations for antibiotics when considering sensitivities. Topical meropenem may be a useful treatment option for multidrug-resistant bacterial corneal ulcers that are resistant to conventional therapy.

https://ift.tt/2L40oy3

Caseous calcification of the mitral valve annulus: a rare cause of bilateral cerebral and ocular embolisation

A 65-year-old woman presented with sudden bilateral visual loss of recent onset. She was recently diagnosed with multiple acute stroke syndrome for which she was commenced on antiplatelet therapy. Funduscopic examination revealed bilateral inferotemporal retinal artery occlusions. The recent history of multiple cerebral infarcts combined with the current ocular findings prompted a transoesophageal echocardiogram which successfully revealed caseous calcification of the mitral valve annulus as the source of the numerous sequential emboli, a finding which the conventional transthoracic echocardiogram had failed to disclose as a result of suboptimal image quality. Transoesophageal echocardiography should always be considered as part of the diagnostic workup of retinal arterial occlusive disease, particularly in bilateral lesions, due to its higher yield in identifying posteriorly located cardiac valvular and aortic lesions.

https://ift.tt/2Lppovx

Cryptococcus neoformans empyema in a patient receiving ibrutinib for diffuse large B-cell lymphoma and a review of the literature

We report a case of Cryptococcus neoformans pulmonary infection complicated by empyema in a 79-year-old man with diffuse large B-cell lymphoma treated with R-CHOP and ibrutinib. A literature review identified 25 cases of cryptococcal pleural disease published since 1980. Most cases were caused by the C. neoformans species in immunocompromised hosts with an exudative pleural effusion and lymphocyte-predominant infiltrate. The cryptococcal antigen test was often positive when pleural fluid and serum were tested. The outcome was favourable in most cases with antifungal therapy and either thoracocentesis or surgical resection. We also identified 40 cases of opportunistic infections, most commonly aspergillosis, cryptococcosis and Pneumocystis jirovecii pneumonia, in patients treated with ibrutinib. In vitro studies indicate Bruton tyrosine kinase inhibition impairs phagocyte function and offer a mechanism for the apparent association between ibrutinib and invasive fungal infections.

https://ift.tt/2L7aTQS

Transformation of jejunoileal follicular lymphoma into diffuse large B-cell lymphoma detected using double-balloon enteroscopy

Jejunoileal follicular lymphomas (FLs) are rare and have been reported to undergo histological transformation (HT). We report a case of jejunoileal FL transformation into diffuse large B-cell lymphoma (DLBCL). An 82-year-old woman presented with a 5.5 cm ulcerated jejunal mass, identified through double-balloon enteroscopy. The histopathology report revealed diffuse atypical lymphoid cells, which confirmed the presence of DLBCL. Neoplastic follicles confirmed the presence of FL. Genetic analysis revealed a match between the FL and DLBCL. Following a segmentectomy and chemotherapy, the patient is in remission. Based on this case, we should consider the possibility of jejunoileal FLs transforming into DLBCL.

https://ift.tt/2JwIqyw

Aortocaval fistula: an unusual complication of ruptured abdominal aortic aneurysm

Aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysm, which erodes into the wall of the inferior vena cava, resulting in the formation of a fistula. ACF presents with various inconsistent symptoms and signs. ACF can be a diagnostic dilemma if not suspected and it is lethal if left untreated.

A 60-year-old man presented with abdominal and lower back pain of sudden onset. Renal and liver functions were impaired, without signs of cardiac failure. CT angiography revealed an abdominal aneurysm rupture into the inferior vena cava. Patient underwent a successful open repair: ACF ligation from within the aneurysmal sac and an aorto-bi-iliac bypass using a Dacron graft. Renal and liver functions improved and the patient was discharged on the eighth postoperative day. A month later, the patient was fit and well with normal liver and renal functions.

Despite progress made in the endovascular treatment of ACF, complications still persist with a reported endoleak rate of 50%. Open repair is still a valid method for ACF repair in patients fit to undergo laparotomy and general anaesthesia. In this case, the patient was fit and along the lack of a suitable stent graft, the vascular team performed an open repair with good results.

Open repair of an ACF is a valid treatment method for patients who are fit enough to undergo laparotomy and general anaesthesia, and avoids complications related to endovascular repair, such as endoleaks.

https://ift.tt/2L3Cmmx

Laryngoceles with airway compromise complicating mucous membrane pemphigoid

Mucous membrane pemphigoid (MMP) encompasses a group of autoantibody-mediated, subepithelial blistering diseases, which primarily affect mucosal surfaces including oral, ocular, skin, genital, nasopharyngeal and oesophageal sites. We present a first description of laryngoceles as a manifestation of mucous membrane pemphigoid resulting in dynamic airway closure. Mucosal injury at other sites had previously resulted in pathergy and localised cicatrisation. We discuss successful combined medical and transcutaneous surgical intervention designed to avoid tracheostomy and minimise iatrogenic laryngeal cicatrisation.

https://ift.tt/2LtI8tO

Primary bladder amyloidosis as a cause of haematuria

We report the case of a 46-year-old man who initially presented with macroscopic haematuria. Although initially concerning for a malignancy in the bladder, histology demonstrated a primary bladder amyloidosis that has remained stable for 6 years since the initial diagnosis. Primary bladder amyloidosis is an important clinical entity that can mimic bladder malignancy on clinical history, radiological investigation and cystoscopic evaluation. Although uncommon, it should not be neglected as a possible diagnosis in patients presenting with haematuria.

https://ift.tt/2L4Ni3q

Polypoidal lesions associated to choroidal naevus: spectrum of pachychoroid disease?

A 78-year-old woman was referred by an optician for an incidental finding of peripapillary naevus in the absence of visual symptoms. On examination, the right eye showed a choroidal naevus of around 1.5 disc diameter, adjacent to the optic disc. Optical coherence tomography detected the presence of pigment epithelium detachment and subretinal fluid within the context of the naevus. Fundus fluorescein angiography and indocyanine green showed multiple polypoidal lesions (Polypoidal Choroidal Vasculopathy, PCV) in the choroid within the spectrum of a pachychoroid, without any sign of malignancy related to neovascularisation. The patient underwent a follow-up of 6 months, showing stability of the lesions over this timeframe. No treatment has been required since the polypoidal lesions were outside the fovea and visual acuity remained stable. The association between choroidal naevi and polypoidal lesions is rare¹; however, this seems to confirm that these findings are part of the spectrum of pachychoroid disease.

https://ift.tt/2JwI3UE

Acute infection-related glomerulonephritis with disseminated gonococcal infection in a 13-year-old girl

Infection-related glomerulonephritis results from glomerular immune complex deposition due to a variety of potential pathogens. Poststreptococcal glomerulonephritis is the best known example. We present a case of acute infection-related glomerulonephritis associated with disseminated gonococcal infection in a sexually active 13-year-old girl, the first report of such an association in the absence of endocarditis. The patient presented with features of acute disseminated gonococcal infection including fever, hypotension, tenosynovitis, polyarthralgias and petechiae. She developed hypocomplementemic glomerulonephritis synchronous with the acute infection. The renal biopsy revealed a diffuse endocapillary proliferative and exudative glomerulonephritis with subepithelial electron-dense humps and granular glomerular capillary wall staining for C3 and IgG, typical of acute postinfectious glomerulonephritis. After treatment and resolution of the gonococcal infection, the serum creatinine, complement levels and urine sediment normalised. The only residual renal damage 16 months later was low-grade proteinuria.

https://ift.tt/2L6BjlV

Two for the price of one: emerging carbapenemases in a returning traveller to New York City

We report a case of a complex orthopaedic infection in a patient returning to New York City from Bangladesh where he was involved in a serious motor vehicle accident. He developed extensive osteomyelitis with a carbapenem-resistant Klebsiella pneumoniae. The isolate was unique due to the coexistence of New Delhi metallo-β-lactamase-1 and Oxacillinase type-181 carbapenemases, which are relatively uncommon in North America and were presumably acquired in Bangladesh. Herein, we explore challenges associated with management of carbapenem-resistant Enterobacteriaceae infections, including limited available data on effective antimicrobial therapy. We also highlight the added value of rapid diagnostic technology in guiding clinical management. Ultimately, the patient required both aggressive surgical management and combination therapy with aztreonam and ceftazidime-avibactam for true source control and favourable clinical outcome.

https://ift.tt/2Lv3XcK

Efficacy of 4-year treatment of icon infiltration resin on postorthodontic white spot lesions

White spot lesions are defined as enamel surface and sub surface demineralisation, although these lesions can be reversed and do not form cavities. Infiltration using fluid resin proved to be a valid micro-invasive alternative compared with traditional conservative therapy. This has allowed treatment without any trauma (no use of local anaesthesia and cavity preparation) of numerous lesions in only one session with stable clinical (mechanical stability, enamel hardness, conservation of sound tissue) and aesthetic results (disappearance of lesions) over the time. The present report evaluates the effectiveness of Icon infiltration resin on postorthodontic white spots at 6 months, 1 and 4 years.

https://ift.tt/2L9b9iE

Unruptured giant left ventricular pseudoaneurysm after silent myocardial infarction

Description 

An 88-year-old woman presented with complaints of class 2 dyspnoea for the last 6 months with episodes of paroxysmal nocturnal dyspnoea. Except for her age, she had no other risk factor for coronary artery disease. On cardiovascular examination, she had double apical impulse with a pan-systolic murmur at the apex and her ECG showed Q waves in inferior leads. She had one episode of resting typical chest pain 2 years back for which she did not seek medical consultation; afterwards, she never experienced angina pain.

Transthoracic echocardiography revealed giant aneurysm involving the lateral wall of the left ventricle (figure 1, videos 1 and 2). The ratio of the maximum diameter of the orifice to the maximum internal dimensions of the aneurysmal cavity was less than 0.5 (figure 2). There was large clot in the aneurysm involving the posterior wall of the left ventricle (

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Hypophosphataemia: an important cause of collapse

We present a case of a 44-year-old man, civil servant, who presented to the emergency department (ED) following an episode of collapse. He was usually fit and well and while at work he had developed a headache with pins and needles over his face and subsequently collapsed. On arrival to ED, he had a Glasgow Coma Scale (GCS) of 4/15. There was no history of note apart from being prescribed citalopram for depression. Laboratory investigations revealed severe hypophosphataemia (phosphate 0.19 mmol/L) and no other electrolyte abnormality. He was commenced on intravenous phosphate and his GCS improved to 15 within 4 hours. Further investigations revealed no cause for his severe hypophosphataemia and repeat bloods in clinic follow-up showed a normal phosphate level.

https://ift.tt/2L3xJsO

Extravasation of contrast beneath the preputial skin due to improper technique of retrograde urethrogram

Description 

A 22-year-old uncircumcised male patient had a thin stream of urine and had to exert pressure while voiding. He had a history of some instrumentation in his penis during childhood, but no records were available. He was first seen by a primary care physician, who made a provisional diagnosis of stricture urethra and advised for a retrograde urethrogram (RUG). His RUG had a contrast shadow, which was thought to be possible dilated distal urethra due to proximal obstruction (stricture), and the patient was referred to us for further management (figure 1). When we examined the patient, he was found to have phimosis. A dorsal slit was done and the meatus was examined, which was normal. A gentle calibration was done with a 14F Foley catheter that was normal. He voided with a good stream after surgery. The radio-opaque shadow that was seen on the RUG...

https://ift.tt/2LpCAAF

Purple urinary bag syndrome: what every primary healthcare provider should know

Description 

A 70-year-old man with bladder outlet obstruction due to benign prostatic hyperplasia who was on urethral (Foley) catheter presented to us with complaint of purple discoloration of his urine collection bag (figure 1). He had history of multiple failed trials of voiding without catheter. Along with this he had constipation for which he was already taking laxatives. He was on Foley catheter for 6 months (which was changed every 3 weeks) and now was planned for transurethral resection of prostate (TURP). He was alarmed by this discolouration. His urine was clear but the urine collection bag had a purple discolouration. On microscopic examination, his urine had plenty of leucocytes and his urinary pH was 8. His urine culture was positive for Escherichia coli (>10⁵ colony forming units/mL). His serum creatinine was 0.9 mg/dL. A diagnosis of purple urinary bag syndrome (PUBS) was made. His catheter was replaced...

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Influence of hearing on vestibulospinal control in healthy subjects

Abstract

Background

Balance control is based on multisensory interaction. In addition to vestibular, proprioceptive and visual information, it seems that auditory input also plays an important role.

Objectives

The aim of the study was to investigate the effect of hearing on vestibulospinal coordination and to obtain deeper knowledge about mechanisms of audiovestibular interaction.

Materials and methods

In normal hearing, healthy subjects who performed the Unterberger (Fukuda) stepping test with and without frontal presentation of noise, the distance of displacement, the angle of displacement and the angle of rotation were measured by means of ultrasound based cranio-corpo-graphy (CCG). Additionally, subjective estimation of the effect of auditory input was compared to objective test results.

Results

In the noise condition, there was a significant improvement in the distance of displacement (mean with noise 66.9 cm± 33.5 standard deviation, SD, mean without noise 77.0 cm±32.7 SD, p< 0.001) and in the angle of rotation (mean with noise 14.2°± 10.1 SD, mean without noise 28.3°± 20.2 SD, p< 0.001), while no difference was found within the conditions regarding the angle of displacement (mean with noise 29.1°± 33.5 SD, mean without noise 30.0°± 34.0 SD, p= 0.641). Side-specific analysis revealed a positive correlation between angle of displacement and angle of rotation in the condition without noise (Spearman r = 0.441, p< 0.001). The rate of agreement between subjective estimation of noise influence and objective test results ranged between only 43% and 63%, depending on the question and endpoint.

Conclusion

Hearing had a clearly beneficial effect of auditory inputs on vestibulospinal coordination, especially for distance of displacement and angle of rotation.

https://ift.tt/2JDaMHc

Pilotstudie: Bestimmung der subjektiven Rumpfvertikalen in lotrechter Kopfposition

Zusammenfassung

Hintergrund

Übereinstimmende Annahme ist, dass die subjektive Vertikale (SV) aus einer multimodalen Sensorintegration resultiert. Um die zervikalvestibuläre Sensorkompetenz für die SV besser einschätzen zu können, war es Ziel der Pilotstudie, unter lotrechter Kopffixierung eine isolierte subjektive Rumpfvertikale (SRV) zu bestimmen.

Material und Methoden

Unter lotrechter Kopffixierung wurde eine SRV im Altersvergleich und nach monophasischer zervikaler transkutaner elektrischer Nervenstimulation (C-TENS) exploriert. Auf einem dreidimensional auslenkbaren (Kippung, Torsion, Flexion) Rumpfexkursionsstuhl (3-D-RES) wurden junge gesunde Probanden untersucht (n = 49) und mit älteren gesunden Probanden (n = 50) verglichen. Eine weitere junge gesunde Gruppe wurde in Placebo- (n = 27) und C‑TENS-Gruppe (n = 22) unterschieden und in ihrer Vertikalitätswahrnehmung verglichen.

Ergebnisse

In der SRV nach Rumpfflexion zeigte sich das Alter als signifikante Variable (p = 0,021). Die ältere Probandengruppe verfehlte im Mittel um 1,8° die physikalische Vertikale mehr als die jüngere. Im Durchgangsvergleich zeigte nur die Placebogruppe eine Verbesserung der SRV im Durchschnitt von 4,3° nach Rumpftorsion.

Schlussfolgerung

Bei der Erhebung einer Vertikalitätsbestimmung sind nicht nur die Makulaorgane beteiligt, sondern ebenfalls zervikovestibuläre Sensorafferenzen. Ein Altersunterschied zuungunsten der älteren gesunden Probanden sowie ein ausbleibender Lernerfolg nach angewandter C‑TENS wurden festgestellt. In der Pilotstudie zeigten sich in lotrechter Kopfposition Hinweise auf eine korrekte Empfindung der Rumpfvertikalen, hervorgerufen durch zervikalvestibuläre Sensorafferenz.

https://ift.tt/2L3vi9v

Effects of built environment morphology on wind turbine noise exposure at building facades

Qu, F; Kang, J; (2017) Effects of built environment morphology on wind turbine noise exposure at building facades. Renewable Energy , 107 pp. 629-638. 10.1016/j.renene.2017.02.037 . Green open access

https://ift.tt/2NZorf3

Disaggregated optical data center in a box network using parallel OCS topologies

Yuan, H; Saljoghei, A; Peters, A; Zervas, G; (2018) Disaggregated optical data center in a box network using parallel OCS topologies. In: (Proceedings) Optical Fiber Communication Conference 2018. The Optical Society of America (OSA)

https://ift.tt/2NogVcE

Angular Independence of Break Position for Magnetic Power Spectra Density in Solar Wind Turbulence and Its Relation with the Breakdown of the Frozen-in Condition in the Wavenumber Space

Duan, D; He, J; Pei, Z; Huang, S; Wu, H; Verscharen, D; Wang, L; (2018) Angular Independence of Break Position for Magnetic Power Spectra Density in Solar Wind Turbulence and Its Relation with the Breakdown of the Frozen-in Condition in the Wavenumber Space. The Astrophysical Journal (In press).

https://ift.tt/2O08hSX

Quantum arithmetics via computation with minimized external control: The half-adder

Eloie, L; Banchi, L; Bose, S; (2018) Quantum arithmetics via computation with minimized external control: The half-adder. Physical Review A , 97 (6) , Article 062321. 10.1103/PhysRevA.97.062321 . Green open access

https://ift.tt/2NmydXJ

Demonstration of NFV for mobile edge computing on an optically disaggregated datacentre in a box

Enrico, M; Mishra, V; Saljoghei, A; Bielski, M; Pap, E; Syrigos, I; de Dios, OG; ... Katrinis, K; + view all Enrico, M; Mishra, V; Saljoghei, A; Bielski, M; Pap, E; Syrigos, I; de Dios, OG; Theodoropoulos, D; Pnevmatikatos, DN; Reale, A; Syrivelis, D; Zervas, G; Parsons, N; Katrinis, K; - view fewer (2018) Demonstration of NFV for mobile edge computing on an optically disaggregated datacentre in a box. In: (Proceedings) Optical Fiber Communication Conference 2018. The Optical Society of America (OSA)

https://ift.tt/2NWxT2R

Fathers against sons/sons against fathers: The problem of generations in the early Soviet workplace

Koenker, DP; (2001) Fathers against sons/sons against fathers: The problem of generations in the early Soviet workplace. Journal of Modern History , 73 (4) pp. 781-810. 10.1086/340146 . Green open access

https://ift.tt/2Nr3Zms

Accessing new 2D semiconductors with optical band gap: synthesis of iron-intercalated titanium diselenide thin films via LPCVD

Sanchez-Perez, C; Knapp, CE; Colman, RH; Sotelo-Vazquez, C; Oilunkaniemi, R; Laitinen, RS; Carmalt, CJ; (2018) Accessing new 2D semiconductors with optical band gap: synthesis of iron-intercalated titanium diselenide thin films via LPCVD. RSC Advances , 8 (40) pp. 22552-22558. 10.1039/c8ra03174f . Green open access

https://ift.tt/2NYkF5K

ECEL1 gene related contractural syndrome: long-term follow-up and update on clinical and pathological aspects

Ullmann, U; D'Argenzio, L; Mathur, S; Whyte, T; Quinlivan, R; Longman, C; Farrugia, ME; ... Muntoni, F; + view all Ullmann, U; D'Argenzio, L; Mathur, S; Whyte, T; Quinlivan, R; Longman, C; Farrugia, ME; Manzur, A; Willis, T; Jungbluth, H; Pitt, M; Cirak, S; UK10K consortium, .; Feng, L; Stewart, W; Mein, R; Phadke, R; Sewry, C; Sarkozy, A; Muntoni, F; - view fewer (2018) ECEL1 gene related contractural syndrome: long-term follow-up and update on clinical and pathological aspects. Neuromuscular Disorders (In press).

https://ift.tt/2Nq35GF

A note on exponential-Möbius sums over F_{q}[t]

Porritt, SM; (2018) A note on exponential-Möbius sums over F_{q}[t]. Finite Fields and Their Applications , 51 pp. 298-305. 10.1016/j.ffa.2018.02.005 . Green open access

https://ift.tt/2O08fuj

Comparison of SDM-WDM based Data Center Networks with equal/unequal core pitch Multi-Core Fibers

Yuan, H; Saljoghei, A; Peters, A; Zervas, G; (2018) Comparison of SDM-WDM based Data Center Networks with equal/unequal core pitch Multi-Core Fibers. In: (Proceedings) Optical Fiber Communication Conference 2018. The Optical Society of America (OSA)

https://ift.tt/2NnILG8

dReDBox: Materializing a Full-stack Rack-scale System Prototype of a Next-Generation Disaggregated Datacenter

Bielski, M; Syrigos, L; Katrinis, K; Syrivelis, D; Reale, A; Theodoropoulos, D; Alachiotis, N; ... Gonzalez de Dios, O; + view all Bielski, M; Syrigos, L; Katrinis, K; Syrivelis, D; Reale, A; Theodoropoulos, D; Alachiotis, N; Pnevmatikatos, D; Pap, EH; Zervas, G; Mishra, V; Saljoghei, A; Rigo, A; Fernando Zazo, J; Lopez-Buedo, S; Torrents, M; Zyulkyarov, F; Enrico, M; Gonzalez de Dios, O; - view fewer (2018) dReDBox: Materializing a Full-stack Rack-scale System Prototype of a Next-Generation Disaggregated Datacenter. In: Proceedings of 2018 Design, Automation & Test in Europe Conference & Exhibition (DATE). (pp. pp. 1093-1098). IEEE: Dresden, Germany. Green open access

https://ift.tt/2O0JHRZ

Synchronizing reconfiguration of coherent functions on disaggregated FPGA resources

Chen, Q; Mishra, V; Nunez-Yanez, J; Zervas, G; (2017) Synchronizing reconfiguration of coherent functions on disaggregated FPGA resources. In: Athanas, P and Cumplido, R and Feregrino, C and Sass, R, (eds.) Proceedings of the International Conference on Reconfigurable Computing and FPGAs 2017. IEEE: Cancun, Mexico. Green open access

https://ift.tt/2Nq2wN3

SLC25A46 Mutations Underlie Progressive Myoclonic Ataxia With Optic Atrophy and Neuropathy

Charlesworth, G; Balint, B; Mencacci, NE; Carr, L; Wood, NW; Bhatia, KP; (2016) SLC25A46 Mutations Underlie Progressive Myoclonic Ataxia With Optic Atrophy and Neuropathy. Movement Disorders , 31 (8) pp. 1249-1251. 10.1002/mds.26716 .

https://ift.tt/2NWVeS6

Copper deficiency and myelopathy after bariatric surgery - Authors' reply

Oben, J; Cordero, P; (2018) Copper deficiency and myelopathy after bariatric surgery - Authors' reply. [Letter]. The Journal of the Royal College of Physicians of Edinburgh , 48 (1) p. 92. 10.4997/JRCPE.2018.120 . Green open access

https://ift.tt/2NssqQz

Cows, Cabins and Tweets: Posthuman Intra-acting Affect and Feminist Fires in Secondary School

Ringrose, JL; Renold, E; (2016) Cows, Cabins and Tweets: Posthuman Intra-acting Affect and Feminist Fires in Secondary School. In: Taylor, C and Hughes, C, (eds.) Posthuman Research Practices in Education. Springer

https://ift.tt/2O0jXoG

SiP-enabled FPGA network interface for programmable access to disaggregated data centre resources

Chen, Q; Mishra, V; De Dobbelaere, P; Enrico, M; Parsons, N; Nunez-Yanez, J; Zervas, G; (2017) SiP-enabled FPGA network interface for programmable access to disaggregated data centre resources. In: Proceedings of the Asia Communications and Photonics Conference. (pp. Su2A.78). OSA Publishing: Guangzhou, Guangdong China.

https://ift.tt/2NqDcGZ

A quasi-experimental study of impacts of Tanzania's wildlife management areas on rural livelihoods and wealth

Bluwstein, J; Homewood, K; Lund, JF; Nielsen, MR; Burgess, N; Msuha, M; Olila, J; ... Keane, A; + view all Bluwstein, J; Homewood, K; Lund, JF; Nielsen, MR; Burgess, N; Msuha, M; Olila, J; Sankeni, SS; Millia, SK; Laizer, H; Elisante, F; Keane, A; - view fewer (2018) A quasi-experimental study of impacts of Tanzania's wildlife management areas on rural livelihoods and wealth. Scientific Data , 5 , Article 180087. 10.1038/sdata.2018.87 . Green open access

https://ift.tt/2NVc2sC

The contribution of cool and hot executive function to academic achievement, learning-related behaviours, and classroom behaviour

O'Toole, S; Monks, CP; Tsermentseli, S; Rix, K; (2018) The contribution of cool and hot executive function to academic achievement, learning-related behaviours, and classroom behaviour. Early Child Development and Care 10.1080/03004430.2018.1494595 . (In press).

https://ift.tt/2No1n8S

Crystal structure prediction of flexible pharmaceutical-like molecules: Density functional tight-binding as an intermediate optimization method and for free energy estimation

Iuzzolino, L; McCabe, P; Price, SL; Brandenburg, JG; (2018) Crystal structure prediction of flexible pharmaceutical-like molecules: Density functional tight-binding as an intermediate optimization method and for free energy estimation. Faraday Discussions 10.1039/C8FD00010G . (In press). Green open access

https://ift.tt/2NVbRxs

Cool and hot executive functions at 5-years-old as predictors of physical and relational aggression between 5- and 6-years-old

O'Toole, S; Tsermentseli, S; Humayun, S; Monks, CP; (2018) Cool and hot executive functions at 5-years-old as predictors of physical and relational aggression between 5- and 6-years-old. International Journal of Behavioral Development (In press).

https://ift.tt/2NpsaS4

Gender differences in first-year students' expectations towards a new engineering multidisciplinary curriculum

Direito, I; Tilley, E; Mitchell, JE; (2018) Gender differences in first-year students' expectations towards a new engineering multidisciplinary curriculum. In: (Proceedings) CISPEE 2018, Third International Conference of the Portuguese Society for Engineering Education, 27-29 June, 2018, Aveiro, Portugal. (In press).

https://ift.tt/2uyscQy

Evaluating the effectiveness of a multi-component intervention on early childhood development in paediatric HIV care and treatment programmes: a randomised controlled trial

Chingono, R; Mebrahtu, H; Mupambireyi, Z; Simms, V; Weiss, HA; Ndlovu, P; Charasika, F; ... Sherr, L; + view all Chingono, R; Mebrahtu, H; Mupambireyi, Z; Simms, V; Weiss, HA; Ndlovu, P; Charasika, F; Tomlinson, M; Cluver, LD; Cowan, FM; Sherr, L; - view fewer (2018) Evaluating the effectiveness of a multi-component intervention on early childhood development in paediatric HIV care and treatment programmes: a randomised controlled trial. BMC Pediatrics , 18 , Article 222. 10.1186/s12887-018-1201-0 . Green open access

https://ift.tt/2Lv4jjk

In Compute/Memory Dynamic Packet/Circuit Switch Placement for Optically Disaggregated Data Centers

Peters, A; Oikonomou, G; Zervas, G; (2018) In Compute/Memory Dynamic Packet/Circuit Switch Placement for Optically Disaggregated Data Centers. Journal of Optical Communications and Networking , 10 (7) B164-B178. 10.1364/JOCN.10.00B164 .

https://ift.tt/2uwTGpT

Sharing data from the Ecosystem Services for Poverty Alleviation programme

Homewood, K; Schreckenberg, K; (2018) Sharing data from the Ecosystem Services for Poverty Alleviation programme. Scientific Data , 5 , Article 180137. 10.1038/sdata.2018.137 . Green open access

https://ift.tt/2zQ0VOH

Band gap temperature-dependence and exciton-like state in copper antimony sulphide, CuSbS2

Birkett, M; Savory, CN; Rajpalke, MK; Linhart, WM; Whittles, TJ; Gibbon, JT; Welch, AW; ... Veal, TD; + view all Birkett, M; Savory, CN; Rajpalke, MK; Linhart, WM; Whittles, TJ; Gibbon, JT; Welch, AW; Mitrovic, IZ; Zakutayev, A; Scanlon, DO; Veal, TD; - view fewer (2018) Band gap temperature-dependence and exciton-like state in copper antimony sulphide, CuSbS2. APL Materials , 6 (8) , Article 084904. 10.1063/1.5030207 . Green open access

https://ift.tt/2uuWjZi

Investment Strategy and Selection Bias: An Equilibrium Perspective on Overoptimism

Jehiel, P; (2018) Investment Strategy and Selection Bias: An Equilibrium Perspective on Overoptimism. American Economic Review , 108 (6) pp. 1582-1597. 10.1257/aer.20161696 . Green open access

https://ift.tt/2LqeIwB

Mediterranean diet and physical functioning trajectories in Eastern Europe: Findings from the HAPIEE study

Stefler, D; Hu, Y; Malyutina, S; Pajak, A; Kubinova, R; Peasey, A; Pikhart, H; ... Bobak, M; + view all Stefler, D; Hu, Y; Malyutina, S; Pajak, A; Kubinova, R; Peasey, A; Pikhart, H; Rodriguez-Artalejo, F; Bobak, M; - view fewer (2018) Mediterranean diet and physical functioning trajectories in Eastern Europe: Findings from the HAPIEE study. PLoS One , 13 (7) , Article e0200460. 10.1371/journal.pone.0200460 . Green open access

https://ift.tt/2uy1wiR

Quasi-markets, school diversity and social selection: Analysing the case of free schools in England, five years on

Allen, R; Higham, R; (2018) Quasi-markets, school diversity and social selection: Analysing the case of free schools in England, five years on. London Review of Education , 16 (2) 10.18546/LRE.16.2.02 . Green open access

https://ift.tt/2Lv3NSq

Is the national professional qualification for headship making a difference

Male, T; (2001) Is the national professional qualification for headship making a difference. School Leadership and Management , 21 (4) pp. 463-477. 10.1080/13632430120108961 . Green open access

https://ift.tt/2utyCke

Dynamic Changes in Schlemm Canal and Iridocorneal Angle Morphology During Accommodation in Children With Healthy Eyes: A Cross-Sectional Cohort Study

Moritz, CD; Dubis, AM; Quartilho, A; Al-Hayouti, H; Khaw, PT; Theodorou, M; Dahlmann-Noor, A; (2018) Dynamic Changes in Schlemm Canal and Iridocorneal Angle Morphology During Accommodation in Children With Healthy Eyes: A Cross-Sectional Cohort Study. Investigative Ophthalmology and Visual Science , 59 (8) pp. 3497-3502. 10.1167/iovs.17-23189 . Green open access

https://ift.tt/2Lv3B5E

Micro-imaging of buried layers and interfaces in ultrathin films by X-ray reflectivity

Jiang, J; Hirano, K; Sakurai, K; (2016) Micro-imaging of buried layers and interfaces in ultrathin films by X-ray reflectivity. Journal of Applied Physics , 120 (11) , Article 115301. 10.1063/1.4962311 . Green open access

https://ift.tt/2utFcHq

The Impact on Disaster Governance of the Intersection of Environmental Hazards, Border Conflict and Disaster Responses in Ladakh, India

Field, J; Kelman, I; (2018) The Impact on Disaster Governance of the Intersection of Environmental Hazards, Border Conflict and Disaster Responses in Ladakh, India. International Journal of Disaster Risk Reduction 10.1016/j.ijdrr.2018.07.001 . (In press).

https://ift.tt/2zPpawv

High-throughput analysis of sulfatides in cerebrospinal fluid using automated extraction and UPLC-MS/MS

Blomqvist, M; Boren, J; Zetterberg, H; Blennow, K; Mansson, J-E; Stahlman, M; (2017) High-throughput analysis of sulfatides in cerebrospinal fluid using automated extraction and UPLC-MS/MS. Journal of Lipid Research , 58 (7) pp. 1482-1489. 10.1194/jlr.D076588 . Green open access

https://ift.tt/2utEY32

Cardiac fibrosis can be attenuated by blocking the activity of transglutaminase 2 using a selective small-molecule inhibitor

Wang, Z; Stuckey, DJ; Murdoch, CE; Camelliti, P; Lip, GYH; Griffin, M; (2018) Cardiac fibrosis can be attenuated by blocking the activity of transglutaminase 2 using a selective small-molecule inhibitor. Cell Death and Disease , 9 (6) , Article 613. 10.1038/s41419-018-0573-2 . Green open access

https://ift.tt/2Lqnk6t

Medicare Will Likely Face Pushback on Physician Pay Changes

CMS has unveiled a proposed overhaul of evaluation and management billing that may create 'winners and losers' among specialties, while leaving the 2018 MIPS reporting period unchanged.
Medscape Medical News

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Comparison of a novel clinical score to estimate the risk of REsidual neuromuscular block Prediction Score and the last train-of-four count documented in the electronic anaesthesia record: A retrospective cohort study of electronic data on file

BACKGROUND Residual neuromuscular block (rNMB) after surgery is not difficult to identify if proper neuromuscular monitoring is used, but many clinicians do not use quantitative neuromuscular monitoring. OBJECTIVE The aim of this study was to develop a REsidual neuromuscular block Prediction Score (REPS) to predict postoperative rNMB and compare the predictive accuracy of the prediction score with train-of-four count (TOFC) measurement at the end of a surgical case. DESIGN Retrospective cohort study of data on file. DATA SOURCE Electronic patient data and peri-operative data on vital signs, administered medications, and train-of-four ratio (TOFR) obtained in the postoperative recovery rooms [postanaesthesia care unit (PACU)] at Massachusetts General Hospital in Boston, Massachusetts, USA. PATIENTS Quantitative TOFR measurements obtained on admission to the PACU were available from 2144 adult noncardiac surgical patients. MAIN OUTCOME MEASURE Presence of rNMB at PACU admission, defined as a TOFR of less than 0.9. RESULTS In the score development cohort (n=2144), rNMB occurred in 432 cases (20.2%). Ten independent predictors for residual paralysis were identified and used for the score development. The final model included: hepatic failure, neurological disease, high-neostigmine dose, metastatic tumour, female sex, short time between neuromuscular blocking agent administration and extubation, aminosteroidal neuromuscular blocking agent, BMI more than 35, absence of nurse anaesthetist and having an experienced surgeon. The model discrimination by C statistics was 0.63, 95% confidence interval (0.60 to 0.66), and risk categories derived from the REPS had a higher accuracy than the last documented intra-operative TOFC for predicting rNMB (net reclassification improvement score 0.26, standard error 0.03, P 

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Near-infrared spectroscopy in vegetables and humans: An observational study

BACKGROUND Cerebral near-infrared spectroscopy (NIRS) of tissue oxygen saturation is claimed to be a surrogate marker for global cerebral perfusion. Increasingly, NIRS target-based therapy has been used during cardiac surgery in the hope of decreasing the incidence of adverse neurological outcome. OBJECTIVES We report NIRS values for some common vegetables and faculty at a world-class medical institution. DESIGN Observational nonblinded study. SETTING Single tertiary care institution and local urban vegetable market. PARTICIPANTS Five yams (Dioscorea cayenensis), five courgettes (Cucurbita pepo) and five butternut squashes (Cucurbita moschata) were studied. Five cardiothoracic surgeons and anaesthesiologists were the control group. INTERVENTIONS None. MAIN OUTCOME MEASURES NIRS value of each species. RESULTS Mean NIRS value for the control group was 71% [95% confidence interval (CI) 68 to 74] and was similar to that of the yellow squashes [75% (95% CI 74 to 76)]. These values were significantly greater than the NIRS measurements of both the butternut squash and yam [63% (95% CI 62 to 64) and 64% (95% CI 63 to 65), respectively, P 

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Superior sealing effect of a three-dimensional printed modified supraglottic airway compared with the i-gel in a three-dimensional printed airway model

Abstract

Purpose

The aim of this study was to compare the force exerted by a three-dimensional (3D) printed modified supraglottic airway (mSGA) vs. that exerted by the i-gel on a 3D printed airway model.

Methods

After a preliminary experiment in Thiel embalmed cadavers, we created a 3D printed mSGA and five 3D printed airway models based on computed tomography data from five female Japanese patients. We compared the force exerted by the i-gel and mSGA on the larynx of the 3D printed airway models. In addition, tidal volumes with insertion of the airway devices into the 3D printed airway model and administration of different levels of pressure-controlled ventilation (PCV) were compared.

Results

The values below indicate mean values ± SD (p value, 95% confidence interval) for the mSGA and i-gel, respectively. The forces exerted by the cuff parts were as follows: ventral: 12.5 ± 5.4 vs. 20.7 ± 3.7 N (p = 0.0001, − 10.0 to − 6.5), proximal: 1.9 ± 1.4 vs. 1.7 ± 1.3 N (p = 0.322, − 0.26 to 0.74), and dorsal parts: 6.9 ± 2.2 vs. 12.5 ± 4.8 N (p = 0.0001, − 7.9 to − 3.4), respectively. We also found significantly higher tidal volumes with the mSGA under PCV of 10, 15, and 20 cmH₂O.

Conclusions

The method of creating the mSGA that we proposed in this study can be applied to development of novel SGAs that is anatomically more suitable for pharyngolaryngeal structure.

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Successful Treatment of Methampyrone-Induced Toxic Epidermal Necrolysis with Therapeutic Plasma Exchange

The toxic epidermal necrolysis (TEN) is a severe cutaneous adverse reaction frequently caused by drug exposure. A 58-year-old male was admitted to the hospital after administration of methampyrone. He developed sloughing of the total epidermis which rapidly extended over the trunk and limbs. The presumptive diagnosis was drug-induced TEN. Despite the treatment with pulsed glucocorticoid and cyclosporine, the skin lesions extended over the entire body. Strikingly, the progression of blistering was stopped by therapeutic plasma exchange (TPE). TPE was discontinued after the signs of skin inflammation had been overcome. He recovered in 8 days of hospitalization. We present here a case of a methampyrone-induced TEN which was successfully treated with TPE.

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