Clinical Correlation of Cytomegalovirus Infection with CMV-Specific CD8+ T Cell Immune Competence Score and Lymphocyte Subsets in Solid Organ Transplant Recipients

Introduction Control of cytomegalovirus (CMV) infection after solid organ transplantation (SOT) requires a functional immune system. We assessed the association between quantitation and function of CMV-specific CD8+ T cells and CMV infection in SOT recipients. Methods During a 10-year period, selected kidney, heart, lung, pancreas, liver and composite tissue recipients were tested for CMV-specific CD8+ T cells immune competence (CMV-CD8+), as measured by enumeration, interferon-gamma production and CD107a/b degranulation. Quantitative and functional data were used to assemble T cell immune competence (TIC) score. CMV infection was diagnosed by PCR in blood and other samples, or histopathology. Results Of 130 patients tested, 59 had CMV infection or disease. The median onset to CMV infection was 10.5 months (IQR 5.5-18.7). Gastrointestinal disease (28.8%), pneumonia (20.3%), and CMV syndrome (17%) were most common presentation. An impaired nonspecific or CMV-CD8+ TIC score was associated with tissue-invasive disease (HR 2.84, 95% CI 1.03-11.81; p=.04). Patients with impaired CMV-CD8+ TIC score had longer viremia duration (42.4 vs. 18.8 days, p<.001 patients with impaired nonspecific or cmv-cd8 tic score had higher risk of relapse vs. hr ci p="0.03)." cmv infection disease lower median absolute lymphocyte count cells and cd4 t cell conclusion cmv-specific cd8 function correlated the course after sot measuring these has potential to assist in its clinical management. correspondence: roshini s. abraham ph.d. department laboratory medicine pathology mayo clinic rochester mn abraham.rochini raymund r. razonable m.d. division infectious diseases razonable.raymund authorship page atibordee meesing: participation performance research data collection analysis writing manuscript abraham: reviewing razonable: design approving disclosures: none funding: copyright wolters kluwer health inc. all rights reserved.>

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Role of 18F-FDG PET/CT in Restrictive Allograft Syndrome after lung transplantation

Background Differential diagnosis of phenotypes of chronic lung allograft dysfunction (CLAD) remains troublesome. We hypothesized that 18F-FDG PET/CT may help in differential diagnosis of CLAD phenotypes, as it showed promising results regarding diagnosis and prognosis in interstitial lung diseases. Methods A monocentric, retrospective study was performed including all lung transplant recipients suffering from bronchiolitis obliterans syndrome (BOS) or restrictive allograft syndrome (RAS) who underwent 18F-FDG PET/CT scan, in comparison with stable lung transplant recipients. Maximum standardized uptake value (SUVmax) was associated with pulmonary function and survival. Proof-of-concept microCT and glucose transporter-1 (GLUT1) staining served as morphologic validation for regions with different SUVmax. Results SUVmax was higher in RAS (median 2.6, n=29) compared to BOS (median 1.0, n=15) and stable patients (median 0.59, n=8) (p

https://ift.tt/2OOugMO

Patient Functional Status at Transplant and Its Impact on Posttransplant Survival of Adult Deceased-Donor Kidney Recipients

Background Recorded at the time of transplant and reported to the Organ Procurement and Transplantation Network (OPTN), patient's functional status is measured using the Karnofsky Performance Score (KPS), ranging 0-100. Functional status analysis may provide insights on candidate listing and posttransplant survival outcomes for deceased-donor kidney transplants (DDKT). Methods The cohort consisted of adult DDKT recipients transplanted beginning January 2007. One-year and 3-year Cox models for posttransplant survival were fitted with current Scientific Registry of Transplant Recipients (SRTR) variables and KPS. Comparative analyses were performed between the SRTR model without KPS and the augmented model with it. Using the augmented model, we examined the impact of Kidney Donor Profile Index (KDPI) on posttransplant survivals for 5 different KPS strata: 10-30, 40-50, 60-70, 80-90, and 100. Results Comparative analyses showed that KPS was a statistically significant predictor for posttransplant survival: it improved model calibration, discrimination, and predictive accuracy. From the augmented model, the survival curves illustrated that recipients with KPS 40-50 and kidneys with KDPI as high as 99 have expected survival probabilities of above 90% in 1 year and above 80% in 3 years. The expected survival probabilities improve as KPS increases. Recipients with KPS 10-30 have the worst survival probability, even if they received high-quality kidneys. Conclusions Insights from the survival analyses recommend possible inclusion of functional status into SRTR's risk-adjusted models. Moreover, they invite further examination of its use in order to improve current listing and transplantation strategies at transplant centers and potentially reduce deceased-donor kidney discard rate. Corresponding Author: Sanjay Mehrotra, PhD, Professor of Industrial Engineering and Management Sciences, 2145 Sheridan Road, Tech C246, Evanston, IL 60208, Phone: 847-491-3155, Fax: 847-491-8005, E-mail: mehrotra@northwestern.edu Authorship Information Kevin Bui1 MS, Vikram Kilambi2 PhD, James R. Rodrigue3 PhD, Sanjay Mehrotra4 PhD, 1Developed research design, conducted data analysis, and drafted the article; 2Reviewed research design and edited article; 3Reviewed and edited article; 4Developed research design, supervised data analysis, and edited the article; Authors have no conflicts of interest to disclose. This work is funded by National Institutes for Health award 1R21DK108104-01. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2AQOh2y

Living Donors: Caring for the Trailblazers of Progress in Transplantation

No abstract available

https://ift.tt/2vyJq11

Submandibular Gland-preserving Technique for Heterotopic Cervical Heart Transplantation in Mice

No abstract available

https://ift.tt/2ARW0xf

DONOR HYPOTHERMIA AND ORGAN TRANSPLANTATION

No abstract available

https://ift.tt/2OPKdlX

Changes in Simultaneous Liver Kidney Transplant Allocation Policy May Impact Post Liver Transplant Outcomes

Background Previous simultaneous liver-kidney transplant (SLK) allocation was based on serum creatinine, a metric that disadvantaged women relative to men. A recent SLK policy change utilizes eGFR, which accounts for sex-based differences in creatinine. Methods To understand the impact of this new policy, we analyzed nonstatus 1 adults listed for liver transplantation (LT) from 5/2007-7/2014, excluding those with exceptions. We defined patients who met the new SLK policy as having an eGFR

https://ift.tt/2AZjQr8

Reducing proinflammatory signalling and enhancing insulin secretion with the application of oxygen persufflation in human pancreata

No abstract available

https://ift.tt/2vtWGUr

EFFECT OF DONOR AGE ON OUTCOME OF LUNG TRANSPLANTATION STRATIFIED BY RECIPIENT DIAGNOSIS: A NORDIC MULTICENTER STUDY

Background Organs from older donors are increasingly used in lung transplantation, and studies have demonstrated that this could be safe in selected recipients. However, which recipient groups that have the largest benefit of older organs are unclear. This multicenter study reviews all bilateral lung transplantations (BLTx) from donors ≥55 years stratified by recipient diagnosis, and compares outcomes with transplantations from younger donors. Methods All BLTx recipients (excluding ReTx) at 5 Scandiatransplant centers between 2000 and 2013 were included (n=913). Recipients were stratified to diagnosis groups including cystic fibrosis (CF), Chronic Obstructive Pulmonary Disease (COPD), interstitial lung disease (ILD) and "Other". Intensive care unit (ICU) length of stay (LOS) and survival were assessed. Results Overall, there was no difference in survival among patients transplanted from donors ≥ 55 years compared to younger donors. However, in CF-recipients, donor age ≥55 years was associated with inferior survival (p=0.014), and this remained significant in a multivariate model (HR 5.0, CI 1.8 – 14.1, p=0.002). There was no significant effect of donor age on survival in recipients with COPD, ILD or in the "Other"-group in multivariate models. Utilization of older donors was associated with increased ICU LOS for recipients with CF and ILD, but not in the COPD or "Other"-group. Conclusions BLTx recipients with CF had inferior survival and longer ICU LOS when receiving organs from donors ≥55 years. Recipients with COPD, ILD or in the "Other"-group did not have inferior survival in multivariate models. Authorship information Author-Areas of participation Auråen H-Research design, writing, performance of research, data analysis Durheim MT-Research design, writing, performance of research, data analysis Dellgren G-Writing, performance of research Hämmäinen P-Writing, performance of research Larsson H-Writing, performance of research Geiran O-Writing, performance of research Lawaetz Schultz HH-Writing, performance of research Leuckfeld I-Writing, performance of research Iversen M-Writing, performance of research Fiane AE-Writing, performance of research Holm AM-Research design, writing, performance of research, data analysis Conflict of interest statement: The authors declare no conflicts of interest. Funding: First author Auråen H received funding from The Norwegian Respiratory Society to conduct this research. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2APhTND

Effect of institutional case volume on in-hospital mortality after living donor liver transplantation: Analysis of 7073 cases between 2007 and 2016 in Korea

Background The relationship between institutional case volume and clinical outcomes after living donor liver transplantation is not clarified. Methods We conducted a nationwide retrospective cohort study using the database of Korean National Healthcare Insurance Service. Between January 2007 and December 2016, 7073 adult living donor liver transplantations were performed at 50 centers in Korea. Centers were categorized according to the average annual number of liver transplantations: >50, 10 to 50, and 50 liver transplantations/year) had better outcomes after living donor liver transplantation, including in-hospital mortality and long-term mortality, compared to centers with lower case volume (≤50 liver transplantations/year). Seokha Yoo and Eun Jin Jang contributed equally to this work and are co-first authors. Corresponding author: Ho Geol Ryu, MD, PhD, Seoul National University Hospital, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul, 03080, Republic of Korea, E-mail: hogeol@gmail.com Authorship S.Y.: Study design, Data analysis, First draft of manuscript E.J.J.: Data acquisition, Data analysis, First draft of manuscript N.J.Y.: Revision of manuscript G.H.K.: Data acquisition, Data analysis D.H.K.: Data acquisition, Data analysis H.L.: Study conception, Revision of manuscript C.W.J.: Study design, Revision of manuscript H.G.R.: Study conception, Study design, Revision of manuscript Disclosure The authors declare no conflicts of interest. Funding None. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2vpd88C

Teaching a Tracheotomy Handoff Tool to Pediatric First Responders

Publication date: Available online 7 August 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Nicole Murray, Tulio A. Valdez, Amy L. Hughes, Katherine R. Kavanagh

Abstract

Introduction

The Critical Airway Risk Evaluation (CARE) system is an airway classification system we designed to improve handoffs between caregivers by describing the risk of a patient's airway above the tracheotomy tube, and therefore the correct resuscitation maneuvers in the event of an airway emergency. It is designed to quickly communicate 3 categories: 1-easily intubatable; 2-intubatable with specialized techniques or equipment; or 3-not intubatable. We have demonstrated previously that the system is easily taught to and used by pediatric otolaryngologists. For this system to be useful, it must be usable by a broader group, including first responders to a tracheostomy related airway emergency. The objective of this study is to analyze the reliability of teaching and ease of learning the CARE system among practicing otolaryngologists, otolaryngology residents, and pediatric residents.

Methods

A brief tutorial was designed to introduce the scale and was presented to practicing otolaryngologists, otolaryngology residents, and pediatrics residents. A 30-point questionnaire was administered in which patient's airways and airway management techniques were described. Participants were asked to classify each example according to the CARE system. Statistical analysis was performed using Student's t test and Fleiss' kappa reliability.

Results

A total of 66 physicians participated in the study. The pediatric residents correctly identified the patients' airway class 89% of the time (26.6/30 +/- SD=2.9). Otolaryngology attendings and residents answered correctly 92% of the time (27.7/30 +/- SD=2.9), which was not statistically different (p=0.23). Inter-rater reliability was also substantial among all groups, with a Fleiss' kappa greater than 0.7 for all groups.

Conclusions

This study demonstrates that the system can be taught to pediatrics residents as effectively as it can be taught to otolaryngology residents and practicing otolaryngologists and, therefore, can be effectively utilized in inter-disciplinary handoffs to facilitate information transfer to potential first responders.

https://ift.tt/2ORoQRe

Rural and Urban Food Allergy Prevalence from the South African Food Allergy Study (Saffa)

Publication date: Available online 7 August 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Maresa Botha, Wisdom Basera, Heidi E. Facey-Thomas, Ben Gaunt, Claudia L. Gray, Jordache Ramjith, Alexandra Watkins, Michael E. Levin

Abstract

Background

Food sensitization and challenge proven food allergy has not been compared in urban and rural settings.

Objective

To determine and compare the prevalence of food sensitization and challenge-proven IgE-mediated food allergy in urban and rural South African toddlers aged 12-36 months.

Methods

This cross-sectional study of unselected children included 1185 participants in urban Cape Town and 398 in the rural Eastern Cape. All participants completed a questionnaire and underwent skin prick tests to egg, peanut, cow's milk, fish, soya, wheat, and hazelnut. Participants with SPT≥ 1mm to one or more foods and not tolerant on history underwent an open oral food challenge.

Result

The prevalence of food allergy was 2.5% (CI 1.6-3.3) in urban children - most commonly to raw egg white (1.9%), followed by cooked egg (0.8%), peanut (0.8%), cow's milk (0.1%) and fish (0.1%). Urban sensitization (≥1mm SPT) to any food was 11.4% (CI 9.6%-13.3%) and 9.0% (CI 7.5%-10.8%) at ≥3mm SPT. Sensitization in the rural cohorts was significantly lower than the urban cohort (1mm SPT 4.5%, CI 2.5-6.6; 3mm SPT 2.8%, CI 1.4-4.9: p<0.01).

In the rural black African cohort 0.5% (CI 0.1%-1.8%) of children were food allergic - all to egg. This is significantly lower than the prevalence of urban cohort overall (2.5%) and urban black African participants (2.9%; CI 1.5%-4.3%)(p=0.006).

Conclusion

Food allergy prevalence in Cape Town is comparable to rates in industrialised middle-income countries and is significantly higher than in rural areas. Further analysis will describe and compare environmental exposures and other risk factors in this cohort.

https://ift.tt/2AR7Tnj

Education-dependent activation of glycolysis promotes the cytolytic potency of licensed human natural killer cells

Publication date: Available online 7 August 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Jolie R. Schafer, Travis C. Salzillo, Nitin Chakravarti, Meisam Naeimi Kararoudi, Prashant Trikha, Jennifer A. Foltz, Ruoning Wang, Shulin Li, Dean A. Lee

Abstract

The mechanism by which natural killer (NK) cell education results in licensed NK cells with heightened effector function against missing-self targets is not known. We found that licensed human NK cells are higher in number in peripheral blood and proliferate more in vitro than unlicensed NK cells. Using high-throughput protein analysis, we found that unstimulated licensed NK cells have increased expression of the glycolytic enzyme PKM2, and after KIR crosslinking have increased phosphorylation of the metabolic modulators p38-α and AMPKα. Following cytokine expansion and activation, unlicensed NK cells solely depended on mitochondrial respiration for cytolytic function, whereas licensed NK cells demonstrated metabolic reprogramming toward glycolysis and mitochondrial-dependent glutaminolysis, leading to accumulation of glycolytic metabolites and depletion of glutamate. As such, blocking both glycolysis and mitochondrial-dependent respiration was required to suppress cytotoxicity of licensed NK cells. Collectively, our data support an arming model of education in which enhanced glycolysis in licensed NK cells supports proliferative and cytotoxic capacity.

https://ift.tt/2OShq0k

Blimp-1 controls Th9 cell development, IL-9 production and allergic inflammation

Publication date: Available online 7 August 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Luciana Benevides, Renata Sesti Costa, Lucas Alves Tavares, Momtchilo Russo, Gislâine A. Martins, Luis Lamberti P. da Silva, Luiza Karla de P. Arruda, Fernando Q. Cunha, Vanessa Carregaro, João Santana Silva

Abstract

Background

The transcriptional repressor Blimp-1 has a key role in terminal differentiation in various T cell subtypes. However, whether Blimp-1 regulates Th9 differentiation and its role in allergic inflammation are unknown.

Objective

We aimed to investigate the role of Blimp-1 in Th9 differentiation and in the pathogenesis of allergic airway inflammation.

Methods

In vitro Th9 differentiation, flow cytometry, ELISA and real-time PCR were used to investigate the effects of Blimp-1 on Th9 polarization. T cell-specific Blimp-1-deficient mice (CKO), a model of allergic airway inflammation, and T cell adoptive transfer to Rag-1^-/- mice were used to address the role of Blimp-1 in the pathogenesis of allergic inflammation.

Results

We found that Blimp-1 regulates Th9 differentiation, as deleting Blimp-1 increased IL-9 production in CD4⁺ T cells in vitro. In addition, we showed that in CKO mice, deletion of Blimp-1 in T cells worsened airway disease, and this worsening was inhibited by the neutralization of IL-9. In asthmatic patients, CD4⁺ T cells in response to TGF-β plus IL-4 increased IL-9 expression and down-regulated Blimp-1 expression compared to those of healthy controls. Blimp-1 overexpression in human Th9 cells inhibited IL-9 expression. Conclusion: Blimp-1 is a pivotal negative regulator of Th9 differentiation and controls allergic inflammation.

Graphical abstract

https://ift.tt/2ARCCR7

Tertiary lymphoid organs: A novel target in chronic rhinosinusitis

Publication date: Available online 7 August 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Sathish Paramasivan, Susan Lester, Aden Lau, Judy Ou, Alkis Psaltis, Peter-John Wormald, Sarah Vreugde

https://ift.tt/2ORL9WV

Investigating innate immune mechanisms in the early-life development and outcomes of food allergy

Publication date: Available online 7 August 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Andrew Dang, Stephanie Logsdon, Simon P. Hogan

https://ift.tt/2AORdwq

Advancing synoptic cancer reports beyond English: the University of Bern/PathoLink approach

https://ift.tt/2M4qBw7

Real-world use of secukinumab for the treatment of plaque psoriasis and psoriatic arthritis: Experience of four dermatology units in Spain

Introduction: Worldwide, there is an increasing trend to use real-world data to inform decision making in health care. The data regarding appropriate drug use, effectiveness, and cost-effectiveness in real-world clinical practice is intended to complement the findings from clinical trials, and to evaluate a drug's real-world value. Secukinumab is a fully humanized anti–interleukin (IL) 17A antibody that specifically binds to IL-17A receptors. In recent years, IL-17A has been recognized to play an important role in the disease pathology.

https://ift.tt/2M8PeYy

Comorbid conditions in lichen planopilaris: A retrospective data analysis of 334 patients

Background: Lichen planopilaris (LPP) is a rare cicatricial, lymphocyte mediated alopecia. It is thought to have an autoimmune pathogenesis, and possibly related to other autoimmune diseases; however, data are limited. In addition, studies examining comorbid conditions are lacking.

https://ift.tt/2MrsXSA

Small molecule inhibitor of the Wnt pathway (SM04755) as a potential topical treatment for psoriasis

Background: Psoriasis (PSO) is an autoimmune disease causing patches of thick, inflamed, scaly skin due to excessive proliferation of skin cells. Wnt signaling plays an important role in PSO, regulating inflammation and keratinocyte proliferation. SM04755, a novel, topical small-molecule Wnt pathway inhibitor was previously shown to inhibit inflammation and keratinocyte proliferation in vitro and in an IMQ-induced mouse PSO model. In this study, the effects of SM04755 on inflammation and skin health were evaluated in a model using reconstitution of ICR scid mice with minor histocompatibility mismatched naive CD4+ T lymphocytes, which more closely resembles human PSO pathophysiology.

https://ift.tt/2M9AM2p

Time to tumor response and planned subgroup analyses from the BOLT trial for sonidegib in advanced basal cell carcinoma

Background: Sonidegib 200 mg once daily (qd) was approved in the United States for patients with locally advanced basal cell carcinoma (laBCC) not amenable to curative surgery or radiotherapy based on results of the phase 2 BOLT study (NCT01327053). Here we report time to tumor response and planned subgroup analyses from the 30-month efficacy data from BOLT.

https://ift.tt/2MscNrW

Teledermatology in rural and remote British Columbia: A survey of primary care providers

Teledermatology, defined as the delivery of dermatology care at a distance through telecommunication technologies, has been proposed as a strategy to improve dermatology access to underserved populations. One such population is in rural and remote British Columbia, an area where there are currently no regularly practicing dermatologists. To gain an understanding of teledermatology utilization, attitudes and experiences in this area, we distributed a 14-question survey containing 10 questions related to the study objective.

https://ift.tt/2KxrHLW

Retrospective comparison of the clinical effects of programmed death protein 1 inhibitors to treat melanoma versus nonmelanoma skin cancer

Background: Programmed death protein (PD) 1 inhibitors have revolutionized treatment for cancers such as melanoma. However, clinical benefits and risks of PD-1 inhibitors among nonmelanoma skin cancers (NMSCs) are less well known, although off-label usage has been reported in the medical literature.

https://ift.tt/2OOlvmd

Two cases of cutaneous endometriosis

Cutaneous endometriosis (CEM) is a rare cutaneous manifestation of a common gynecological disease. More than 70% of CEM lesions are seen at sites of previous surgical scars, however primary lesions can arise de-novo in previously normal epithelium. The clinical presentation can vary and mimic other common dermatologic conditions. We present 1 primary and 1 secondary case of young healthy African American women with umbilical CEM. A 30-year-old woman presented with 2 umbilical lesions present for 1 year, associated with intermittent pain, swelling, and bleeding with menstrual cycles.

https://ift.tt/2MscLjO

The importance of early implementation of laser treatment in facial scars: A single-institution retrospective study

Background: Interest in minimizing scars especially on face has been rising recently.

https://ift.tt/2OTmDFc

Subject satisfaction demonstrated for two on-label injection volumes of abobotulinumtoxinA when used to treat moderate to severe glabellar lines

Introduction: In the U.S., glabellar lines (GLs) are most often treated with botulinum toxin type A (BoNT-A) and satisfaction with treatment is typically measured using patient-reported outcomes. Dysport (abobotulinumtoxinA [ABO]) is approved in the U.S. for the treatment of GLs and can be injected at 2 different injection volumes, 0.05 mL and 0.08 mL. In this study, we evaluated both on-label injection volumes in subjects with moderate to severe GLs at maximum frown and asked them to complete questionnaires before and after treatment to assess treatment satisfaction and health-related quality of life subject-reported outcomes, which is the focus of this report.

https://ift.tt/2MobGtl

Secondary localized cutaneous amyloidosis in mycosis fungoides

Secondary localized cutaneous amyloidosis is often not clinically apparent, but may be seen histologically. It is associated with several skin tumors, and has been reported with PUVA use. To date, there are three reported cases of secondary localized cutaneous amyloidosis associated with mycosis fungoides before any treatment. We present a case of a 39-year-old woman who presented to the dermatology clinic for evaluation of facial acne. During the exam, several 5-10 mm hypopigmented patches were noted on the bilateral ventral forearms.

https://ift.tt/2OOlizr

Ustekinumab an alternative therapeutic option for refractory erytroderma pytiriasis rubra pilaris disease

Introduction: Pityriasis rubra pilaris (PRP) is a rare, chronic erythematous squamous disorder. PRP is divided into six subtypes, type 1 being the most common and classic form in adults. PRP erytroderma may be a therapeutic challenge because standard therapies are lacking due to its unclear pathogenesis. Ustekinumab is a monoclonal antibody that is approved for the treatment of psoriasis, but has been shown to be effective as an off-label use treatment for PRP. We report a case of refractory erythroderma type 1 PRP with complete resolution with ustekinumab therapy.

https://ift.tt/2KxrisU

Treating to target: Exploration of Investigator Global Assessment and body surface area (IGA×BSA) as a practical minimal disease activity goal

Objective: Psoriasis Area Severity Index (PASI) is typically used in clinical trials, but may not be pragmatic for use in clinical practice. The Investigator Global Assessment (IGA) and percentage of affected body surface area (BSA) are measures of psoriasis disease activity that are easily performed in routine clinical practice. This retrospective pooled analysis explored cutoff values of the product of IGA and BSA (IGA×BSA) that correlate with minimal disease activity (MDA) and would allow for a treat-to-target approach that may be feasible in clinical practice.

https://ift.tt/2Mc9dWe

The sun and your health: Targeting teenagers and adolescents in British Columbia

Introduction: Skin cancer is one of the most preventable forms of cancer. Approximately 85% of skin cancer cases could be avoided by reducing ultraviolet (UV) exposure, especially during childhood and adolescence. We conducted a pilot study to evaluate UV exposure and sun safety behaviors in this age group. In addition, the effectiveness in changing sun protection knowledge, attitudes, and behaviors using an innovative intervention was compared with the strategy of using education alone.

https://ift.tt/2Kxr7he

The effect of topical sunscreen plus antioxidant against the visible light biologic effects

Background: Visible light (VL) has been shown to induce erythema, pigmentation, and photodamage. Sunscreens effective against VL contain inorganic filters, but are often cosmetically unacceptable in darker skin tones. Antioxidants possess photoprotective properties and may serve as an alternative.

https://ift.tt/2Mc984S

Sparing the use of steroids in the treatment of Sweet syndrome: A case report

Sweet syndrome is an acute febrile neutrophilic dermatosis first decribed in 1964. It is an uncommon disease, with no racial predisposition, that affects mostly women 30-60 years of age. Its physiopathology is unknown and 20% of the cases are linked to malignant tumors. It can also be associated with autoimmune diseases, drug intake, pregnancy and 60% are idiopathic. It can present with papules, nodules, and erythematous plaques, most of the times painful. Edema is associated, and can lead to vesicules, bullae, and/or pustules.

https://ift.tt/2MsoC1B

Spontaneous regression of Merkel cell carcinoma is associated with clonal T-cell expansion

Merkel cell carcinoma (MCC) is a rare and aggressive neuroendocrine skin tumor. MCC is immunogenic and highly responsive to immune checkpoint inhibitors. There are at least 45 reported cases of spontaneous regression of both local and metastatic MCC following biopsies, excisions, fine needle aspirations, and in 1 case after allergic contact dermatitis. Spontaneous tumor regression has also been observed in other tumor types, however the mechanism is poorly understood. There has been speculation that trauma-induced antigen shedding and subsequent recruitment of a host immune response drives tumor regression.

https://ift.tt/2Mc9U1A

Serratia pyoderma mimicking acne vulgaris

A 17-year-old woman with no significant medical history presented complaining of acne. She reported that three days before her "acne" started she applied tea tree oil (TTO) for a few pimples. Photos on the patient's phone before TTO application revealed completely clear facial skin. Within a few days of TTO use she developed a facial eruption. She was evaluated by her pediatrician who prescribed minocycline for 10 days along with adapalene and benzoyl peroxide. She did not improve and was referred to dermatology.

https://ift.tt/2KzM1fK

Safety and efficacy of microfocused ultrasound with visualization for the correction of moderate-to-severe atrophic acne scars

Background and objective: Microfocused ultrasound with visualization (MFU-V; Ulthera) has been shown to induce collagen production and remodeling of tissue layers in the skin. The purpose of this study was to assess the efficacy and safety of MFU-V for improving the appearance of atrophic acne scars.

https://ift.tt/2OSUy0m

Mast cell activation syndrome: High frequency of skin manifestations and anaphylactic shock

Publication date: Available online 7 August 2018

Source: Allergology International

Author(s): Eline A. Casassa, Claire Mailhol, Emilie Tournier, Camille Laurent, Yannick Degboe, Marine Eischen, Natalia Kirsten, Jacques Moreau, Solène M. Evrard, Véronique Mansat-De Mas, Laurence Lamant, Patrice Dubreuil, Pol André Apoil, Olivier Hermine, Carle Paul, Cristinai Bulai Livideanu

https://ift.tt/2AN26PB

Putative neuromycotoxicoses in an adult male following ingestion of moldy walnuts

Abstract

A tremorgenic syndrome occurs in dogs following ingestion of moldy walnuts, and Penicillium crustosum has been implicated as the offending fungus. This is the first report of suspected moldy walnut toxicosis in man. An adult male ingested approximately eight fungal-infected walnut kernels and after 12 h experienced tremors, generalized pain, incoordination, confusion, anxiety, and diaphoresis. Following symptomatic and supportive treatment at a local hospital, the man made an uneventful recovery. A batch of walnuts (approximately 20) was submitted for mycological culturing and identification as well as for mycotoxin analysis. Penicillium crustosum Thom was the most abundant fungus present on walnut samples, often occurring as monocultures on isolation plates. Identifications were confirmed with DNA sequences. The kernels and shells of the moldy walnuts as well as P. crustosum isolates plated on yeast extract sucrose (YES) and Czapek yeast autolysate (CYA) agars and incubated in the dark at 25 °C for 7 days were screened for tremorgenic mycotoxins and known P. crustosum metabolites using a liquid chromatography-tandem mass spectrometric (LC-MS/MS) method. A relatively low penitrem A concentration of only 1.9 ng/g was detected on the walnut kernels when compared to roquefortine C concentrations of 21.7 μg/g. A similar result was obtained from P. crustosum isolates cultured on YES and CYA, with penitrem A concentrations much lower (0.6–6.4 μg per g mycelium/agar) compared to roquefortine C concentrations (172–1225 μg/g). The authors surmised that besides penitrem A, roquefortine C might also play an additive or synergistic role in intoxication of man.

https://ift.tt/2vobMe4

An integrated deep sequencing analysis of microRNAs in transplanted corneas

Publication date: September 2018

Source: Molecular Immunology, Volume 101

Author(s): Xiaoli Lu, Jing Wu, Ming Ma, Xiaosong Wu, Jing Wen, Jian Yu

Abstract

Illumina Hiseq 2500 deep sequencing was used to screen for differentially expressed genes (DEGs) in matched pairs of isograft corneas and normal corneas, allograft corneas and isograft corneas. Our results showed that 22 miRNAs were significantly upregulated and 4 were significantly downregulated in the isograft group when compared with the control group (P < 0.01), while 17 miRNAs were significantly upregulated and 3 were significantly downregulated in the allograft group when compared with the isograft group (P < 0.01). Among the miRNAs with altered expression levels, miR-155-5p, miR-142-3p, miR-142-5p, and miR-223-3p displayed simultaneous changes in the above two comparisons. Potential target genes among the DEGs were predicted using target prediction software (TargetScan, Miranda, miRDB, and CLIP), and the overlay portion was analyzed using the Gene Ontology (GO) database and the Kyoto Encyclopedia of Genes and Genomes (KEGG). GO and KEGG analyses showed that the DEGs were mainly involved in metabolic pathways, cytokine secretion, and tumor immunity functions. An analysis of the interactions between DEG proteins (PPI analysis) and a MetaCore software analysis of 4 key DEGs revealed that the genes regulated by miR-155-5p played important roles in the miRNA-mRNA regulatory network. Furthermore, the MetaCore analysis identified C/EBP beta, p53, and sp1 as key transcription factors in that network. Our study identified transplanted corneas-specific miRNA in matched pairs of isograft corneas and normal corneas, allograft corneas and isograft corneas. Furthermore, bioinformatics analysis of the key miRNA regulatory network revealed the molecular mechanisms, which suggests miRNAs may as new molecular targets for treating corneal injuries and corneal transplant rejection.

https://ift.tt/2APOdQv

The effectiveness of eugenol against cisplatin-induced ototoxicity

Publication date: Available online 7 August 2018

Source: Brazilian Journal of Otorhinolaryngology

Author(s): Muhammed Sedat Sakat, Korhan Kilic, Fazile Nur Ekinci Akdemir, Serkan Yildirim, Gizem Eser, Ahmet Kiziltunc

Abstract

Introduction

Ototoxicity refers to cellular damage or function impairment developing in the inner ear in association with any therapeutic agent or chemical substance, and still represents the principal side-effect restricting the use of cisplatin.

Objective

The aim of this study was to perform a biochemical, functional and histopathological investigation of the potential protective effect of eugenol against cisplatin-induced ototoxicity.

Methods

The study was performed with 24 female Sprague Dawley rats. Distortion product otoacoustic emissions tests were performed on all animals, which were randomized into four equal groups. A single intraperitoneal dose of 15 mg/kg cisplatin was administered to cisplatin group, while the eugenol group received 100 mg/kg eugenol intraperitoneal for five consecutive days. 100 mg/kg eugenol was administered to cisplatin + eugenol group for 5 days. On the third day, these rats were received a single dose of 15 mg/kg cisplatin. The control group was given 8 mL/kg/day intraperitoneal saline solution for five days. The distortion product otoacoustic emissions test was repeated 24 h after the final drug administration. All animals were sacrificed, and the cochleas were subsequently used for biochemical and histopathological examinations.

Results

Cisplatin caused oxidative stress in the cochlea, impaired the cochlear structure and significantly reduced signal noise ratio levels. Administration of eugenol together with cisplatin reversed these effects and provided functional, biochemical and histopathological protection.

Conclusion

The study findings represent the first indication in the literature that eugenol may protect against ototoxicity by raising levels of antioxidant enzymes and lowering those of oxidant parameters.

Resumo

Introdução

A ototoxicidade refere-se ao dano celular ou comprometimento da função da orelha interna interna associado a qualquer agente terapêutico ou substância química, e ainda representa o principal efeito colateral que restringe o uso da cisplatina.

Objetivo

O objetivo deste estudo foi realizar uma investigação bioquímica, funcional e histopatológica do potencial efeito protetor do eugenol contra a ototoxicidade induzida pela cisplatina.

Método

O estudo foi realizado com 24 ratos fêmeas Sprague Dawley. Testes de emissões otoacústicas por produto de distorção foram realizados em todos os animais, os quais foram randomizados em quatro grupos iguais. Uma única dose intraperitoneal de 15 mg/kg de cisplatina foi administrada ao grupo cisplatina, enquanto o grupo eugenol recebeu 100 mg/kg de eugenol intraperitoneal por cinco dias consecutivos. Foram administrados 100 mg/kg de eugenol ao grupo cisplatina + eugenol durante 5 dias. No terceiro dia, estes ratos receberam uma dose única de 15 mg/kg de cisplatina. O grupo controle recebeu 8 mL/kg/dia de solução salina intraperitoneal por cinco dias. O teste de emissões otoacústicas por produto de distorção foi repetido 24 horas após a administração final do medicamento. Todos os animais foram sacrificados e as cócleas foram posteriormente utilizadas para exames bioquímicos e histopatológicos.

Resultados

A cisplatina causou estresse oxidativo na cóclea, prejudicou a estrutura coclear e reduziu significativamente os níveis da relação sinal/ruído. A administração de eugenol juntamente com a cisplatina reverteu esses efeitos e forneceu proteção funcional, bioquímica e histopatológica.

Conclusão

Os achados do estudo representam a primeira indicação na literatura de que o eugenol pode proteger contra a ototoxicidade, elevando os níveis de enzimas antioxidantes e diminuindo os níveis dos parâmetros oxidantes.

https://ift.tt/2ORmrWP

Foam-driven fracture [Applied Physical Sciences]

In hydraulic fracturing, water is injected at high pressure to crack shale formations. More sustainable techniques use aqueous foams as injection fluids to reduce the water use and wastewater treatment of conventional hydrofractures. However, the physical mechanism of foam fracturing remains poorly understood, and this lack of understanding extends to...

https://ift.tt/2KAww7d

Opinion: Risk to study nonparticipants: A procedural approach [Medical Sciences]

Current ethical guidance for research on human subjects is primarily concerned with protecting study participants.* They are, after all, the "human subjects" whose interests are the focus of oversight. But research—whether on human subjects or not—may also strongly affect individuals who are not study participants. US law defines study participants...

https://ift.tt/2OLh4bL

Different opinion on the reported role of Poldip2 and ACSM1 in a mammalian lipoic acid salvage pathway controlling HIF-1 activation [Biological Sciences]

Paredes et al. (1) describe polymerase-δ interacting protein 2 (Poldip2) as a novel regulator of mitochondrial lipoylation through stabilization of Ac-CoA synthetase medium-chain family member 1 (ACSM1). We have several concerns with their proposed model based on the following reasons. Prior mammalian and yeast biochemical studies are not consistent with...

https://ift.tt/2KCEGvP

Tractable near-optimal policies for crawling [Computer Sciences]

The problem of maintaining a local cache of n constantly changing pages arises in multiple mechanisms such as web crawlers and proxy servers. In these, the resources for polling pages for possible updates are typically limited. The goal is to devise a polling and fetching policy that maximizes the utility...

https://ift.tt/2OQDOa8

Reply to Bailey et al.: New perspectives on the novel role of the Poldip2/ACSM1 axis in a functional mammalian lipoylation salvage pathway [Biological Sciences]

We appreciate Bailey et al.'s (1) interest in our publication (2), in which we define a role for polymerase-δ interacting protein 2 (Poldip2) in controlling a salvage pathway of lipoylation. Our study builds on a substantial body of evidence, indicating that the mammalian mitochondrial lipoyltransferase LIPT1 lipoylates using lipoyl-AMP. While...

https://ift.tt/2niABUj

Neural tracking of the musical beat is enhanced by low-frequency sounds [Psychological and Cognitive Sciences]

Music makes us move, and using bass instruments to build the rhythmic foundations of music is especially effective at inducing people to dance to periodic pulse-like beats. Here, we show that this culturally widespread practice may exploit a neurophysiological mechanism whereby low-frequency sounds shape the neural representations of rhythmic input...

https://ift.tt/2M6ybpL

Profile of Myles Brown [Profiles]

Ever since oncologist Myles Brown used tamoxifen to treat a patient with metastatic breast cancer during his fellowship, he has wanted to understand how cancer cells can sometimes become resistant to this therapy after months of success. That quest led him to his life's work on estrogen receptor (ER) biology....

https://ift.tt/2KFxwXA

Cytoskeletal tension regulates mesodermal spatial organization and subsequent vascular fate [Biophysics and Computational Biology]

Morphogenesis during human development relies on the interplay between physiochemical cues that are mediated in part by cellular density and cytoskeletal tension. Here, we interrogated these factors on vascular lineage specification during human-induced pluripotent stem-cell (hiPSC) fate decision. We found that independent of chemical cues, spatially presented physical cues induce...

https://ift.tt/2KB0Luz

Understanding when people will report crimes to the police [Social Sciences]

In a recent PNAS article, Hagan et al. (1) use administrative records of 911 calls to study how people in urban neighborhoods decide whether to report crimes to the police. The authors argue that an important factor in the decision is what researchers have called "legal cynicism," or a general...

https://ift.tt/2njECrL

Indigenous impacts on North American Great Plains fire regimes of the past millennium [Environmental Sciences]

Fire use has played an important role in human evolution and subsequent dispersals across the globe, yet the relative importance of human activity and climate on fire regimes is controversial. This is particularly true for historical fire regimes of the Americas, where indigenous groups used fire for myriad reasons but...

https://ift.tt/2M3ZlOj

Zooming in on a small multidrug transporter reveals details of asymmetric protonation [Commentary]

Drug resistance poses a major threat to human health. A principal mechanism of multidrug resistance is the active transport of chemically unrelated compounds out of the cell by integral membrane proteins known as multidrug transporters (1). Multidrug transporters are represented by four superfamilies: ABC (ATP-binding cassette), MFS (major facilitator superfamily),...

https://ift.tt/2KzZzYH

Endoplasmic reticulum stress leads to accumulation of wild-type SOD1 aggregates associated with sporadic amyotrophic lateral sclerosis [Neuroscience]

Abnormal modifications to mutant superoxide dismutase 1 (SOD1) are linked to familial amyotrophic lateral sclerosis (fALS). Misfolding of wild-type SOD1 (SOD1WT) is also observed in postmortem tissue of a subset of sporadic ALS (sALS) cases, but cellular and molecular mechanisms generating abnormal SOD1WT species are unknown. We analyzed aberrant human...

https://ift.tt/2MvClVr

Simple scaling law predicts peak efficiency in oscillatory propulsion [Engineering]

Oscillatory propulsion is ubiquitous among swimming and flying animals, and may some day be practical as a replacement for rotary propulsion in watercraft and small air vehicles. The strength and efficiency of flapping thrust production closely depend on a dimensionless parameter called the Strouhal number (St), representing the ratio of...

https://ift.tt/2niAwQr

In This Issue [This Week in PNAS]

Exploring curcumin's anticancer effects Turmeric. Image courtesy of Pixabay/cgdsro. The anticancer properties of turmeric are attributed to its active ingredient curcumin, a polyphenol extracted from the rhizomes of the medicinal plant Curcuma longa. Curcumin is thought to block the action of proteasomes, which are cellular organelles that recycle damaged proteins,...

https://ift.tt/2niAyb1

How adaptive immunity constrains the composition and fate of large bacterial populations [Physics]

Features of the CRISPR-Cas system, in which bacteria integrate small segments of phage genome (spacers) into their DNA to neutralize future attacks, suggest that its effect is not limited to individual bacteria but may control the fate and structure of whole populations. Emphasizing the population-level impact of the CRISPR-Cas system,...

https://ift.tt/2KzFLVh

Elesclomol restores mitochondrial function in genetic models of copper deficiency [Biochemistry]

Copper is an essential cofactor of cytochrome c oxidase (CcO), the terminal enzyme of the mitochondrial respiratory chain. Inherited loss-of-function mutations in several genes encoding proteins required for copper delivery to CcO result in diminished CcO activity and severe pathologic conditions in affected infants. Copper supplementation restores CcO function in...

https://ift.tt/2KBZvrr

Selection of an ASIC1a-blocking combinatorial antibody that protects cells from ischemic death [Applied Biological Sciences]

Acid-sensing ion channels (ASICs) have emerged as important, albeit challenging therapeutic targets for pain, stroke, etc. One approach to developing therapeutic agents could involve the generation of functional antibodies against these channels. To select such antibodies, we used channels assembled in nanodiscs, such that the target ASIC1a has a configuration...

https://ift.tt/2nl7YGc

Computational discovery of chemically patterned surfaces that effect unique hydration water dynamics [Chemistry]

The interactions of water with solid surfaces govern their apparent hydrophobicity/hydrophilicity, influenced at the molecular scale by surface coverage of chemical groups of varied nonpolar/polar character. Recently, it has become clear that the precise patterning of surface groups, and not simply average surface coverage, has a significant impact on the...

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Switching of the folding-energy landscape governs the allosteric activation of protein kinase A [Biochemistry]

Protein kinases are dynamic molecular switches that sample multiple conformational states. The regulatory subunit of PKA harbors two cAMP-binding domains [cyclic nucleotide-binding (CNB) domains] that oscillate between inactive and active conformations dependent on cAMP binding. The cooperative binding of cAMP to the CNB domains activates an allosteric interaction network that...

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Chemical feedbacks weaken the wintertime response of particulate sulfate and nitrate to emissions reductions over the eastern United States [Earth, Atmospheric, and Planetary Sciences]

Sulfate (SO42-) and nitrate (NO3-) account for half of the fine particulate matter mass over the eastern United States. Their wintertime concentrations have changed little in the past decade despite considerable precursor emissions reductions. The reasons for this have remained unclear because detailed observations to constrain the wintertime gas–particle chemical...

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Diagnosis by Comprehensive Cardiovascular Imaging for Stroke and TIA

Conditions:   Stroke;   Transient Ischaemic Attack
Intervention:   Diagnostic Test: CCI scanning (CTA, cardiac CT), and MRI scanning
Sponsors:   NHS Greater Glasgow and Clyde;   University of Glasgow
Not yet recruiting

https://ift.tt/2KCLnhs

Stereotactic Body Radiation Therapy and Durvalumab With or Without Tremelimumab Before Surgery in Treating Participants With Human Papillomavirus Positive Oropharyngeal Squamous Cell Caner

Conditions:   Clinical Stage I HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC (American Joint Committee on Cancer) v8;   Clinical Stage II HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8;   Clinical Stage III HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8;   Human Papillomavirus Positive;   Oropharyngeal Squamous Cell Carcinoma;   p16 Positive Neoplastic Cells Present;   Pathologic Stage I HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8;   Pathologic Stage II HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8;   Pathologic Stage III HPV-Mediated (p16-Positive) Oropharyngeal Carcinoma AJCC v8
Interventions:   Biological: Durvalumab;   Procedure: Modified Radical Neck Dissection;   Other: Quality-of-Life Assessment;   Other: Questionnaire Administration;   Radiation: Stereotactic Body Radiation Therapy;   Procedure: Transoral Robotic Surgery;   Biological: Tremelimumab
Sponsors:   Jonsson Comprehensive Cancer Center;   National Cancer Institute (NCI)
Not yet recruiting

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Impact of Cancer Therapy on Myocardial Function in Patients With Esophagus Cancer

Condition:   Cancer of Esophagus
Intervention:  
Sponsors:   Aarhus University Hospital Skejby;   Danish Cancer Society
Recruiting

https://ift.tt/2KzVmUw

Durvalumab With or Without Metformin in Treating Participants With Head and Neck Squamous Cell Carcinoma

Conditions:   Larynx;   Lip, Oral Cavity and Pharynx
Interventions:   Drug: Metformin;   Biological: Durvalumab
Sponsor:   Sidney Kimmel Cancer Center at Thomas Jefferson University
Not yet recruiting

https://ift.tt/2M1ZmmE

Soil exposure modifies the gut microbiota and supports immune tolerance in a mouse model

Publication date: Available online 7 August 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Noora Ottman, Lasse Ruokolainen, Alina Suomalainen, Hanna Sinkko, Piia Karisola, Jenni Lehtimäki, Maili Lehto, Ilkka Hanski, Harri Alenius, Nanna Fyhrquist

Background

Sufficient exposure to natural environments, in particular soil and its microbes, has been suggested to be protective against allergies.

Objective

We aim at gaining more direct evidence of the environment-microbiota-health axis by studying the colonization of gut microbiota in mice after exposure to soil and by examining immune status in both a steady-state situation and during allergic inflammation.

Methods

The gastrointestinal microbiota of mice housed on clean bedding or in contact with soil was analyzed by using 16S rRNA gene sequencing, and the data were combined with immune parameters measured in the gut mucosa, lung tissue, and serum samples.

Results

We observed marked differences in the small intestinal and fecal microbiota composition between mice housed on clean bedding or in contact with soil, with a higher proportion of Bacteroidetes relative to Firmicutes in the soil group. The housing environment also influenced mouse intestinal gene expression, as shown by upregulated expression of the immunoregulatory markers IL-10, forkhead box P3, and cytotoxic T lymphocyte–associated protein 4 in the soil group. Importantly, using the murine asthma model, we found that exposure to soil polarizes the immune system toward T_H1 and a higher level of anti-inflammatory signaling, alleviating T_H2-type allergic responses. The inflammatory status of the mice had a marked influence on the composition of the gut microbiota, suggesting bidirectional communication along the gut-lung axis.

Conclusion

Our results provide evidence of the role of environmentally acquired microbes in alleviating against T_H2-driven inflammation, which relates to allergic diseases.

Graphical abstract

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Caracterización de la enfermedad por reflujo faringolaríngeo en pacientes de edad avanzada y ancianos

Publication date: Available online 7 August 2018

Source: Acta Otorrinolaringológica Española

Author(s): Francisco J. Cervera-Paz, Marta Jordano-Cabrera

Resumen

Objetivos

Caracterizar la enfermedad por reflujo faringolaríngeo en pacientes de edad avanzada y ancianos.

Métodos

Estudio retrospectivo de pacientes mayores de 60 años, con sintomatología sugestiva de enfermedad por reflujo faringolaríngeo, vistos entre 2005 y 2014 en el Departamento de Otorrinolaringología de un hospital universitario. Se seleccionaron 85 pacientes (54 mujeres y 31 hombres) sometidos a una pH-metría de 24 h con doble sensor («gold standard» en el diagnóstico del reflujo).

Se calculó el índice de masa corporal. Se revisó la información clínica y evaluaron las pH-metrías según los criterios de DeMeester y Johnson. Se revisó el cuestionario «Reflux Symptoms Index» (RSI), considerado patológico cuando fue ≥13. Se evaluaron los hallazgos endoscópicos faringolaríngeos del «Reflux Finding Score» (RFS), considerado patológico cuando fue ≥7.

Resultados

La edad media fue 67 años. En 70 pacientes (82%) la pH-metría fue patológica. El índice de masa corporal fue patológico en 50 pacientes (59%), de los que casi el 90% tenían pH-metría patológica. El RSI medio fue 9,8, con resultados anormales en 24 pacientes (28%). En 20 pacientes (23%) con RSI anormal tenían una pH-metría positiva. El hallazgo endoscópico más común (90%) fue la hipertrofia de comisura posterior. El RFS medio fue 9,07, con resultados anormales en 69 pacientes (70%). En 61 pacientes (70%) con RFS anormal tenían una pH-metría patológica. Solo 18 pacientes con RSI y RFS patológicos tenían una pH-metría patológica.

Conclusiones

En pacientes mayores, los valores patológicos de índice de masa corporal se asocian altamente con pH-metrías patológicas. El RSI es un indicador de poco valor, mientras que el RFS es de valor moderado.

Abstract

Objectives

To characterize laryngo-pharyngeal reflux (LPR) in patients over 60 years of age.

Methods

Retrospective review of patients over 60 years of age with symptoms suspicious of LPR, seen from 2005 to 2014 at an ENT Department of an academic hospital. Eighty-five consecutive patients (54 females, 31 males) who had completed a dual-sensor 24-hour pH-metry were included (considered "gold-standard" in LPR diagnosis).

Body mass index, and reflux information and interventions were revised. pH-metries were evaluated according to DeMeester & Johnson's criteria. Symptoms were assessed according to the Reflux Symptom Index (RSI) and classified as abnormal if score was ≥13. A naso-fibro-laryngoscopy enabled findings to be documented according to the Reflux Finding Score (RFS), and they were classified as abnormal if the score was ≥7.

Results

The patients' mean age was 67 years. A positive pH-metry was present in 70 patients (82.5%). Fifty patients (59%) had abnormal body mass index, and almost 90% of them had an abnormal pH-metry. Mean RSI score was 9.8, with abnormal results in 24 patients (28%). Only 20 patients (23%) with abnormal RSI had a positive pH-metry. Posterior commissure hypertrophy was the most common finding (90% of patients). Mean RFS score was 9.07, with abnormal results in 69 patients (81%). Sixty-one patients (70%) with abnormal RFS had a positive pH-metry. Only 18 patients (20%) had coincidental abnormal pH-metry, RSI, and RFS.

Conclusions

In ageing patients, abnormal body mass index is strongly associated with abnormal pH-metry. RSI is a weak indicator of LPR, whereas RFS has a moderate value.

https://ift.tt/2nkILLK

Validez de las medidas del pico cepstral para la valoración objetiva de la disfonía en sujetos de habla hispana

Publication date: Available online 7 August 2018

Source: Acta Otorrinolaringológica Española

Author(s): Faustino Núñez-Batalla, Noelia Cartón-Corona, Gabriela Vasile, Patricia García-Cabo, Laura Fernández-Vañes, José Luis Llorente-Pendás

Resumen

Introducción y objetivos

La fiabilidad de las calificaciones perceptuales de la calidad global de la voz y sus dimensiones específicas es difícil de alcanzar, por cuanto estos juicios dependen de la subjetividad del examinador. De este modo, la búsqueda de unas medidas clínicas que sean objetivas, válidas y accesibles es una prioridad para incluirlas en los protocolos de evaluación de la voz.

El propósito del presente estudio fue: 1) determinar la exactitud diagnóstica de un único parámetro acústico, la prominencia del pico cepstral suavizado (CPPS), para predecir la presencia y severidad de una disfonía en vocales sostenidas y habla conectada utilizando el programa Praat; 2) determinar la relación entre las medidas del CPPS y las calificaciones perceptuales de la calidad vocal; y 3) describir los valores normativos del CPPS.

Método

Se obtuvo el valor del CPPS de muestras vocales sostenidas y de habla conectada de 72 sujetos hispanohablantes con trastornos vocales y de 52 sujetos hispanohablantes sanos utilizando el programa Praat. Se llevó a cabo un estudio estadístico completo utilizando el programa SPSS de IBM versión 23.

Resultados

Se encontró una sensibilidad de un 70% y una especificidad de un 85%. La severidad estimada de la voz, tanto en vocal sostenida como en habla conectada, se correlacionó de forma importante con las calificaciones perceptuales de severidad global de la disfonía.

Conclusiones

Un parámetro acústico único, el CPPS calculado mediante el programa Praat, predice de forma importante el estatus de un trastorno vocal. Se considera la incorporación del CPPS para complementar la valoración clínica de la voz.

Abstract

Introduction and objectives

Perceptual rating of overall voice quality and other more specific perceptual dimensions is difficult, as such judgments depend on the listener's subjectivity. Thus, finding objective, valid, and accessible clinical measures to include in comprehensive voice evaluation protocols is a priority.

The purposes of this study were to 1) determine the diagnostic accuracy of a single acoustic measure, smoothed cepstral peak prominence (CPPS), to predict voice disorder status from sustained vowels and connected speech samples using the software Praat; 2) to determine the relationship between measures of CPPS and perceptual ratings of vocal quality; and 3) describe the normative values of CPPS.

Method

Measures of CPPS were obtained from connected speech and sustained vowel recordings of 72 Spanish-speaking subjects with voice disorders and 52 nondysphonic Spanish-speaking subjects with no vocal disorders using freely downloadable Praat software. IBM SPSS Statistics software version 23 was used to complete the statistical analyses.

Results

results revealed a 70% sensitivity rate, a specificity rate of 85%. Estimated severity for sustained vowels and connected speech were strongly correlated and significantly associated with listener ratings of dysphonia severity.

Conclusions

A single acoustic measure of CPPS was highly predictive of voice disorder status using Praat software. Clinicians may consider using CPPS to complement clinical voice evaluation and screening protocols.

https://ift.tt/2vMeIAN

What do Vitiligo Impact Scale (VIS)‐22 scores mean? Studying the clinical interpretation of scores using an anchor‐based approach

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2APL7w5

Comparison of the effect of the lidocaine, tetracaine, and articaine application into nasal packs on pain and hemorrhage after septoplasty

Abstract

Objective

We purposed to compare the effects of certain local anesthetics soaked Merocel nasal packs on hemorrhage and pain after septoplasty.

Materials and methods

This study is a prospective double-blind study that was done in patients undergoing septoplasty. The study was created with 90 patients. All patients were divided into four groups. The each group was applied 2% lidocaine plus adrenaline, 2% tetracaine, 4% articaine plus adrenaline as study groups or 0.9% sodium chloride (NaCl) as control group in their Merocel packs after septoplasty. Verbal analog scale (VAS) was applied to all patients and the amount of postoperative hemorrhage was noted during postoperative period. The statistical analysis was performed using Student's t test and Chi-square test on each patient group at each time point.

Results

The study groups (2% lidocaine plus adrenaline, 2% tetracaine and 4% articaine plus adrenaline groups) had significantly better pain scores versus control group in the 1st, 4th, 8th, 16th and 24th postoperative hours (p < 0.05). The articaine plus adrenaline group had better pain scores than the lidocaine plus adrenaline group, and the lidocaine plus adrenaline group had better pain scores than the tetracaine group in the postoperative first day. Also articaine plus adrenaline group had less postoperative bleeding rate than the lidocaine plus adrenaline, tetracaine and control groups (p < 0.05). There was no statistically significant difference between the lidocaine plus adrenaline, tetracaine and control groups in terms of postoperative hemorrhage (p > 0.05).

Conclusion

Topical articaine plus adrenaline application in the nasal packs can be safely used for less pain and bleeding following septoplasty.

https://ift.tt/2AOgI14

Engage in Imaginative Play with Your Kids

Kids are hard-wired to play. Even in this age of screens and scheduled activities galore, kids are still finding time to play. Recent research has shown that kids today are just as good at pretend play as they were 20 years ago!

Benefits of Pretend Play

Pretend play happens when children playfully treat something as if it were something else. For example, a block may become a car or a TV. When children pretend, they use imagination and emotion. Pretend play is linked to skills in creativity, emotional control and awareness, and even academic achievement.

Tips to Bond with Your Child through Play

Because kids are naturally drawn to play, it can be a great tool for parents to connect with our kids and to help them develop new skills. Here are some ways for creating a great bonding and growing experience with your child:

• Be intentional about setting aside time to play together, one-on-one. Plan for about 20 minutes if you can, with minimal distractions.
• Choose toys that allow for good pretend play. Pretend play is non-electronic in nature and does not apply to structured games such as board games or puzzles. Good toys for pretend play might include dolls, animals, cars or Legos. It can also be fun to empty the junk drawer and see what your child can re-imagine!
• If you and your child need help getting started, you can use a story stem. For example:
  • "A story about a boy who lives in a castle."
  • "A story about a girl who has magic powers."
  • "A story about a boy who can talk to animals."

• If you remember nothing else, FOLLOW YOUR CHILD'S LEAD. They are the experts, after all. As a rule of thumb, try not to say anything that changes the course of the story or adds a plot point. Here are some examples of great ways to participate:
  • "Who should I be?"
  • "I wonder what will happen next."
  • Summarize the story at various points.
  • Model pretend (e.g., "We could use this block as the birthday present.")

• Praise, praise, praise! Kids absolutely soak up every bit of praise they receive. Find as many moments as possible to tell your child what great ideas they have and how funny and creative they are.
  • "What a creative idea!"
  • "That was cool how you used ___ to be something else."
  • "It is so much fun playing with you."
• Avoid asking lots of questions. Questions can show you are engaged, but they can also shut down natural creativity. We also tend to shift into teaching mode as parents (e.g., "What sound does a tiger make?" or, "What color is this?"), which is much less fun than what our kids have in mind for playtime.

Take an extra second to reflect on what you notice about your child during your time together. Kids are often entertaining and almost always surprising, so enjoy what you see and hear when they are in their element.

The post Engage in Imaginative Play with Your Kids appeared first on ChildrensMD.

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Antenatal vitamin D exposure and childhood eczema, food allergy, asthma and allergic rhinitis at 2 and 5 years of age in the atopic disease‐specific Cork BASELINE Birth Cohort Study

Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2M0cusb

Tsunami design procedures for engineered buildings: a critical review

Macabuag, JLD; Raby, A; Pomonis, A; Nistor, I; Wilkinson, S; Rossetto, T; (2018) Tsunami design procedures for engineered buildings: a critical review. Proceedings of the Institution of Civil Engineers: Civil Engineering 10.1680/jcien.17.00043 . (In press). Green open access

https://ift.tt/2nkJWeu

A Mobile Application for Multi-Hazard Physical Vulnerability Prioritization of Schools

Nassirpour, A; Galasso, C; D'Ayala, D; (2018) A Mobile Application for Multi-Hazard Physical Vulnerability Prioritization of Schools. In: Proceedings of the 16th Conference on European Association of Earthquake Engineering (EAEE) 2018. European Association of Earthquake Engineering (EAEE): Thessaloniki, Greece. (In press).

https://ift.tt/2OiGLiD

Chronic exposure to tumor necrosis factor alpha induces retinal pigment epithelium cell dedifferentiation

Touhami, S; Beguier, F; Augustin, S; Charles-Messance, H; Vignaud, L; Nandrot, EF; Reichman, S; ... Sennlaub, F; + view all Touhami, S; Beguier, F; Augustin, S; Charles-Messance, H; Vignaud, L; Nandrot, EF; Reichman, S; Forster, V; Mathis, T; Sahel, JA; Bodaghi, B; Guillonneau, X; Sennlaub, F; - view fewer (2018) Chronic exposure to tumor necrosis factor alpha induces retinal pigment epithelium cell dedifferentiation. Journal of Neuroinflammation , 15 , Article 85. 10.1186/s12974-018-1106-8 . Green open access

https://ift.tt/2nhNspF

Cone degeneration is triggered by the absence of USH1 proteins but prevented by antioxidant treatments

Trouillet, A; Dubus, E; Dégardin, J; Estivalet, A; Ivkovic, I; Godefroy, D; García-Ayuso, D; ... Picaud, S; + view all Trouillet, A; Dubus, E; Dégardin, J; Estivalet, A; Ivkovic, I; Godefroy, D; García-Ayuso, D; Simonutti, M; Sahly, I; Sahel, JA; El-Amraoui, A; Petit, C; Picaud, S; - view fewer (2018) Cone degeneration is triggered by the absence of USH1 proteins but prevented by antioxidant treatments. Scientific Reports , 8 , Article 1968. 10.1038/s41598-018-20171-0 . Green open access

https://ift.tt/2Kw9BKg

Dietary, environmental, and genetic risk factors of Extensive Macular Atrophy with Pseudodrusen, a severe bilateral macular atrophy of middle-aged patients

Douillard, A; Picot, MC; Delcourt, C; Defoort-Dhellemmes, S; Marzouka, NAD; Lacroux, A; Zanlonghi, X; ... Meunier, I; + view all Douillard, A; Picot, MC; Delcourt, C; Defoort-Dhellemmes, S; Marzouka, NAD; Lacroux, A; Zanlonghi, X; Drumare, I; Jozefowicz, E; Bocquet, B; Baudoin, C; Perez-Roustit, S; Arsène, S; Gissot, V; Devin, F; Arndt, C; Wolff, B; Mauget-Faÿsse, M; Quaranta, M; Mura, T; Deplanque, D; Oubraham, H; Cohen, SY; Gastaud, P; Zambrowski, O; Creuzot-Garcher, C; Saïd, SM; Sahel, JA; Souied, E; Milazzo, S; Garavito, RB; Kalatzis, V; Puech, B; Hamel, C; Audo, I; Meunier, I; - view fewer (2018) Dietary, environmental, and genetic risk factors of Extensive Macular Atrophy with Pseudodrusen, a severe bilateral macular atrophy of middle-aged patients. Scientific Reports , 8 , Article 6840. 10.1038/s41598-018-25003-9 . Green open access

https://ift.tt/2M1ifWQ

Intrinsic electron trapping in amorphous oxide

Strand, JW; Kaviani, M; Afanas'ev, VV; Lisoni, JG; Shluger, AL; (2018) Intrinsic electron trapping in amorphous oxide. Nanotechnology , 29 (12) , Article 125703. 10.1088/1361-6528/aaa77a . Green open access

https://ift.tt/2OjVl9x

Thermodynamic Nonequilibrium Features in Binary Diffusion

Lin, C-D; Luo, KH; Gan, Y-B; Lai, H-L; (2018) Thermodynamic Nonequilibrium Features in Binary Diffusion. Communications in Theoretical Physics , 69 (6) pp. 722-726. 10.1088/0253-6102/69/6/722 .

https://ift.tt/2M3LPeo

Study of mechanisms for electric field effects on ethanol oxidation via reactive force field molecular dynamics

Jiang, XZ; Feng, M; Zeng, W; Luo, KH; (2018) Study of mechanisms for electric field effects on ethanol oxidation via reactive force field molecular dynamics. Proceedings of the Combustion Institute 10.1016/j.proci.2018.07.053 . (In press). Green open access

https://ift.tt/2OkSAoO

Direct numerical simulation of H2 effect on autoignition of DME/Air mixture under HCCI engine conditions

Jin, T; Wang, X; Luo, KH; Luo, K; Fan, J; (2017) Direct numerical simulation of H2 effect on autoignition of DME/Air mixture under HCCI engine conditions. In: Proceedings of the 11th Asia-Pacific Conference on Combustion - 2017. Combustion Institute, The University of Sydney: Sydney, Australia. (In press).

https://ift.tt/2M1Th9B

Does the Circular Economy Grow the Pie? The Case of Rebound Effects From Smartphone Reuse

Makov, T; Font Vivanco, D; (2018) Does the Circular Economy Grow the Pie? The Case of Rebound Effects From Smartphone Reuse. Frontiers in Energy Research , 6 , Article 39. 10.3389/fenrg.2018.00039 . Green open access

https://ift.tt/2KB2foC

Novel allosteric mechanism of p53 activation by small molecules for targeted anticancer therapy

Okorokov, A; Zawacka-Pankau, J; Grinkevich, V; Burmakin, M; Ridderstråle, K; Issaeva, N; Andreotti, V; ... Selivanova, G; + view all Okorokov, A; Zawacka-Pankau, J; Grinkevich, V; Burmakin, M; Ridderstråle, K; Issaeva, N; Andreotti, V; Vema, A; Dickinson, E; Hedström, E; Spinnler, C; Inga, A; Larsson, L-G; Karlén, A; Tarasova, O; Poroikov, V; Lavrenov, S; Preobrazhenskaya, M; Wilhelm, M; Barran, P; Selivanova, G; - view fewer (2018) Novel allosteric mechanism of p53 activation by small molecules for targeted anticancer therapy. BioRxiv: Cold Spring Harbor, NY, USA. Green open access

https://ift.tt/2nkKL6Y

Wave diffraction and radiation by a vertical circular cylinder standing in a three-dimensional polynya

Ren, K; Wu, GX; Ji, C; (2018) Wave diffraction and radiation by a vertical circular cylinder standing in a three-dimensional polynya. Journal of Fluids and Structures , 82 pp. 287-307. 10.1016/j.jfluidstructs.2018.07.008 .

https://ift.tt/2KAhvCj

Lead isotope and metal source of Shang bronzes: A response to Sun et al.'s comments

Liu, SR; Chen, KL; Rehren, T; Mei, JJ; Chen, JL; Liu, Y; Killick, D; (2018) Lead isotope and metal source of Shang bronzes: A response to Sun et al.'s comments. Archaeometry 10.1111/arcm.12411 . (In press).

https://ift.tt/2M1SOEn

The Retranslation Phenomenon: A Sociological Approach to the English Translations of Dickens' Great Expectations into Arabic

Al-Shaye, Shatha Abdullah Abdulrahman; (2018) The Retranslation Phenomenon: A Sociological Approach to the English Translations of Dickens' Great Expectations into Arabic. Doctoral thesis (Ph.D), UCL (University College London).

https://ift.tt/2KB1OL0

The Making of a Liberal Education: Political Economy of the Austrian School Reform, 1865 – 1880

Cvrcek, TT; Zajicek, M; (2018) The Making of a Liberal Education: Political Economy of the Austrian School Reform, 1865 – 1880. Explorations in Economic History 10.1016/j.eeh.2018.07.003 . (In press).

https://ift.tt/2M3KAfe

Effect of different surgical weight-loss interventions and ethnicity on GLP-1 secretion

AlRasheid, Noora; (2018) Effect of different surgical weight-loss interventions and ethnicity on GLP-1 secretion. Doctoral thesis (Ph.D), UCL (University College London). Green open access

https://ift.tt/2KB1Dzk

Kastro Palaia settlement, Volos, Greece: a diachronical technological approach to bronze metalwork

Rehren, THH; Asderaki, E; Skafida, E; Vaxenavopoulos, M; Connolly, P; (2018) Kastro Palaia settlement, Volos, Greece: a diachronical technological approach to bronze metalwork. STAR: Science & Technology of Archaeological Research, , 3 (2) pp. 179-193. 10.1080/20548923.2018.1427182 . Green open access

http://discovery.ucl.ac.uk/10053922/

Parasites, Power, and Photography

Iskander, D; (2016) Parasites, Power, and Photography. Trends in Parasitology , 32 (1) pp. 2-3. 10.1016/j.pt.2015.11.002 . Green open access

https://ift.tt/2KB1fkm

Glass Coloring Technologies of Late Roman Cage Cups: Two Examples from Bulgaria

Rehren, THH; Cholakova, A; Gratuze, B; Lankton, J; (2017) Glass Coloring Technologies of Late Roman Cage Cups: Two Examples from Bulgaria. Journal of Glass Studies , 59 pp. 117-133.

https://ift.tt/2nkJpJw

Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery

Akhtar, MM; Bhan, A; Lim, ZY; Akhtar, MA; Sekhri, N; Bharadwaj, P; Mullen, M; (2018) Percutaneous extraction of an embolized progesterone contraceptive implant from the pulmonary artery. Open Access Journal of Contraception , 9 pp. 57-61. 10.2147/OAJC.S165827 . Green open access

https://ift.tt/2OkROIq

Serum Leukotriene B4 Levels, Tonsillar Hypertrophy and Sleep-Disordered Breathing in Childhood

Publication date: Available online 7 August 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Emmanouel Ι. Alexopoulos, George Haritos, Christina Befani, Georgia Malakasioti, Vassilis A. Lachanas, Panagiotis Liakos, Konstantinos Gourgoulianis, Athanasios G. Kaditis

Abstract

Objectives

In children with snoring, increased production of leukotriene B₄ (LTB₄) may promote tonsillar hypertrophy and sleep-disordered breathing (SDB) or conversely SDB may enhance LTB₄ synthesis. We explored whether: i) high LTB₄ serum levels predict tonsillar hypertrophy; and ii) SDB severity correlates with LTB₄ serum concentration.

Methods

Normal-weight children with SDB or controls underwent polysomnography and measurement of LTB₄ serum concentration. Tonsillar hypertrophy was the main outcome measure and high LTB₄ serum level (>75 t h percentile value in controls) was the primary explanatory variable. Odds ratio (OR) and the corresponding 95% confidence intervals (CI) for tonsillar hypertrophy in children with versus without high LTB₄ level were calculated. The control subgroup and subgroups of subjects with increasing SDB severity were compared regarding LTB₄ concentration by Kruskal-Wallis test. Spearman's correlation co-efficient was applied to assess the association of LTB₄ concentration with SDB severity.

Results

A total of 104 children with SDB and mean obstructive apnea-hypopnea index-AHI of 4.8 ± 5.3 episodes/h (primary snoring: n=19; mild SDB: n=49; moderate/severe SDB: n=36) and 13 controls (no snoring; AHI: 0.4 ± 0.2 episodes/h) were recruited. The four study subgroups were similar regarding LTB₄ serum concentration (P=0.64). High LTB₄ (>170.3 pg/mL) was a significant predictor of tonsillar hypertrophy after adjustment for age and gender (OR 3.0 [1.2-7.2]; P=0.01). There was no association between AHI or desaturation index and LTB₄ serum concentration (r=-0.08; P=0.37 and r=-0.1; P=0.30, respectively).

Conclusion

No association was identified between SDB severity and LTB₄ levels, but high LTB₄ concentration predicted tonsillar hypertrophy.

https://ift.tt/2vIzBN7

Prevalence of ear disease and associated hearing loss among primary school students in the Solomon Islands: otitis media still a major public health issue

Publication date: Available online 7 August 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Annette Kaspar, Obiga Newton, Joseph Kei, Carlie Driscoll, De Wet Swanepoel, Helen Goulios

https://ift.tt/2M05I5J

Submental flap donor site morbidity in pediatric patients

Publication date: Available online 7 August 2018

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Amin Rahpeyma, Saeedeh khajehahmadi

https://ift.tt/2vGk2W0

Researchers Uncover Potential New Drug Targets in the Fight Against HIV

Johns Hopkins scientists report they have identified two potential new drug targets for the treatment of HIV. The finding is from results of a small, preliminary study of 19 people infected with both HIV—the virus that causes AIDS—and the hepatitis C virus. The study revealed that two genes—CMPK2 and BCLG, are selectively activated in the presence of type 1 interferon, a drug once used as the first line of treatment against hepatitis C.

https://ift.tt/2vHB5qU

Melasma in a transgender woman

Publication date: Available online 7 August 2018

Source: American Journal of Otolaryngology

Author(s): Laura Garcia-Rodriguez, Jeffrey Spiegel

https://ift.tt/2vt4mGo

Know Your Heart: Rationale, design and conduct of a cross-sectional study of cardiovascular structure, function and risk factors in 4500 men and women aged 35-69 years from two Russian cities, 2015-18 [version 2; referees: 3 approved]

Cook, S; Malyutina, S; Kudryavtsev, A; Averina, M; Bobrova, N; Boytsov, S; Brage, S; ... Leon, D; + view all Cook, S; Malyutina, S; Kudryavtsev, A; Averina, M; Bobrova, N; Boytsov, S; Brage, S; Clark, T; Diez Benavente, E; Eggen, AE; Hopstock, L; Hughes, A; Johansen, H; Kholmatova, K; Kichigina, A; Kontsevaya, A; Kornev, M; Leong, D; Magnus, P; Mathiesen, E; McKee, M; Morgan, K; Nilssen, O; Plakhov, I; Quint, J; Rapala, A; Ryabikov, A; Saburova, L; Schirmer, H; Shapkina, M; Shiekh, S; Shkolnikov, V; Stylidis, M; Voevoda, M; Westgate, K; Leon, D; - view fewer (2018) Know Your Heart: Rationale, design and conduct of a cross-sectional study of cardiovascular structure, function and risk factors in 4500 men and women aged 35-69 years from two Russian cities, 2015-18 [version 2; referees: 3 approved]. Wellcome Open Research , 3 , Article 67. 10.12688/wellcomeopenres.14619.2 . Green open access

https://ift.tt/2Ky64Lz

PolNet: A Tool to Quantify Network-Level Cell Polarity and Blood Flow in Vascular Remodeling

Bernabeu, MO; Jones, ML; Nash, RW; Pezzarossa, A; Coveney, PV; Gerhardt, H; Franco, CA; (2018) PolNet: A Tool to Quantify Network-Level Cell Polarity and Blood Flow in Vascular Remodeling. Biophysical Journal , 114 (9) pp. 2052-2058. 10.1016/j.bpj.2018.03.032 . Green open access

https://ift.tt/2LX6pwK

Phosphodiesterase-type 3 inhibitor potentiates cAMP generation and antiproliferative effects of treprostinil in pulmonary arterial smooth muscle cells from patients with pulmonary hypertension

Patel, J; Orie, N; Clapp, LH; (2010) Phosphodiesterase-type 3 inhibitor potentiates cAMP generation and antiproliferative effects of treprostinil in pulmonary arterial smooth muscle cells from patients with pulmonary hypertension. Presented at: ERS Annual Congress 2010, Barcelona, Spain.

https://ift.tt/2Ky6oKh

Reversible Kleene Lattices

Brunet, P; (2017) Reversible Kleene Lattices. In: Larsen, KG and Bodlaender, HL and Raskin, J-F, (eds.) Proceedings of the 42nd International Symposium on Mathematical Foundations of Computer Science (MFCS 2017). (pp. 66:1-66:14). LIPICS: Dagstuhl, Germany. Green open access

https://ift.tt/2njuDCJ

'The first steps rightly directed in the track of legislation': Jeremy Bentham on Cesare Beccaria’s Essay on Crimes and Punishments

Schofield, P; (2019) 'The first steps rightly directed in the track of legislation': Jeremy Bentham on Cesare Beccaria's Essay on Crimes and Punishments. Diciottesimo secolo (In press).

https://ift.tt/2KyHkmc

Pharmacy Interweaving Safety Within Hospital Health Information Technology

Lichtner, V; Westbrook, JI; Franklin, BD; (2018) Pharmacy Interweaving Safety Within Hospital Health Information Technology. Studies in Health Technology and Informatics , 252 pp. 105-111. 10.3233/978-1-61499-890-7-105 . Green open access

https://ift.tt/2LX6jFo

Uncertainty, Risk, and Information Value in Software Requirements and Architecture

Letier, E; Stefan, D; Barr, ET; (2014) Uncertainty, Risk, and Information Value in Software Requirements and Architecture. In: Jalote, P and Briand, L and VanderHoek, A, (eds.) Proceedings of the 36th International Conference on Software Engineering ICSE 2014. (pp. pp. 883-894). ACM: Hyderabad, India. Green open access

https://ift.tt/2Ky5L3n

Revisiting Models for Spheroidal Graphite Growth

Bjerre, MK; Azeem, M; Lee, PD; Hattel, JH; Tiedje, NS; (2018) Revisiting Models for Spheroidal Graphite Growth. Materials Science Forum , 925 pp. 118-124. 10.4028/https://ift.tt/2KylkYQ . Green open access

https://ift.tt/2M1BMGr

Rivaroxaban for Preventing Venous Thromboembolism in High-Risk Ambulatory Patients with Cancer: Rationale and Design of the CASSINI Trial

Khorana, AA; Vadhan-Raj, S; Kuderer, NM; Wun, T; Liebman, H; Soff, G; Belani, C; ... Lyman, GH; + view all Khorana, AA; Vadhan-Raj, S; Kuderer, NM; Wun, T; Liebman, H; Soff, G; Belani, C; O'Reilly, EM; McBane, R; Eikelboom, J; Damaraju, CV; Beyersl, K; Dietrichl, F; Kakkar, AK; Riess, H; Peixoto, RD; Lyman, GH; - view fewer (2017) Rivaroxaban for Preventing Venous Thromboembolism in High-Risk Ambulatory Patients with Cancer: Rationale and Design of the CASSINI Trial. Thrombosis and Haemostasis , 117 (11) pp. 2135-2145. 10.1160/TH17-03-0171 . Green open access

https://ift.tt/2nfQiM6

Safety of rAAV2/2-ND4 Gene Therapy for Leber Hereditary Optic Neuropathy

Vignal, C; Uretsky, S; Fitoussi, S; Galy, A; Blouin, L; Girmens, JF; Bidot, S; ... Sahel, JA; + view all Vignal, C; Uretsky, S; Fitoussi, S; Galy, A; Blouin, L; Girmens, JF; Bidot, S; Thomasson, N; Bouquet, C; Valero, S; Meunier, S; Combal, JP; Gilly, B; Katz, B; Sahel, JA; - view fewer (2018) Safety of rAAV2/2-ND4 Gene Therapy for Leber Hereditary Optic Neuropathy. Ophthalmology , 125 (6) pp. 945-947. 10.1016/j.ophtha.2017.12.036 . Green open access

https://ift.tt/2OjP3qI

Evaluating Evidence of Mechanisms in Medicine: Principles and Procedures

Parkkinen, V-P; Wallmann, C; Wilde, M; Clarke, B; Illari, P; Kelly, MP; Norell, C; ... Williamson, J; + view all Parkkinen, V-P; Wallmann, C; Wilde, M; Clarke, B; Illari, P; Kelly, MP; Norell, C; Russo, F; Shaw, B; Williamson, J; - view fewer (2018) Evaluating Evidence of Mechanisms in Medicine: Principles and Procedures. [Book]. Springer: Cham, Switzerland. Green open access

https://ift.tt/2nk6sEk

Racial Cities: Governance and the segregation of Romani people in urban Europe, by Giovanni Picker, London and New York, Routledge, 2017, 174 pp., £110.00 (hardcover), ISBN 978-1-138-80878-2

Tomicic, A; (2018) Racial Cities: Governance and the segregation of Romani people in urban Europe, by Giovanni Picker, London and New York, Routledge, 2017, 174 pp., £110.00 (hardcover), ISBN 978-1-138-80878-2. [Review]. Transnational Social Review 10.1080/21931674.2018.1502927 . (In press).

https://ift.tt/2OjvAWT

Design and engineering of electrospun fibres for oil spill clean-up

Akanbi, Muftau Jide; (2018) Design and engineering of electrospun fibres for oil spill clean-up. Doctoral thesis (Ph.D), UCL (University College London).

https://ift.tt/2LWUtLn

Probabilistic models of contextual effects in Auditory Pitch Perception

Adam, Vincent; (2018) Probabilistic models of contextual effects in Auditory Pitch Perception. Doctoral thesis (Ph.D), UCL (University College London).

https://ift.tt/2Ky5iy9

Soluble CD14 concentration in human breast milk and its potential role in child atopic dermatitis: results of the Ulm Birth Cohort Studies

Clinical &Experimental Allergy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2KvQAHS

Cholesteatoma vs granulation tissue: a differential diagnosis by DWI-MRI apparent diffusion coefficient

Abstract

Purpose

To diagnose cholesteatoma when it is not visible through tympanic perforation, imaging techniques are necessary. Recently, the combination of computed tomography and magnetic resonance imaging has proven effective to diagnose middle ear cholesteatoma. In particular, diffusion weighted images have integrated the conventional imaging for the qualitative assessment of cholesteatoma. Accordingly, the aim of this study was to obtain a quantitative analysis of cholesteatoma calculating the apparent diffusion coefficient value. So, we investigated whether it could differentiate cholesteatoma from other inflammatory tissues both in a preoperative and in a postoperative study.

Methods

This study included 109 patients with clinical suspicion of primary or residual/recurrent cholesteatoma. All patients underwent preoperative computed tomography and magnetic resonance imaging with diffusion sequences before primary or second-look surgery to calculate the apparent diffusion coefficient value.

Results

We found that the apparent diffusion coefficient values of cholesteatoma were significantly lower than those of non cholesteatoma. In particular, the apparent diffusion coefficient median value of the cholesteatoma group (0.84 × 10^− 3 mm²/s) differed from the inflammatory granulation tissue (2.21 × 10^− 3 mm²/s) group (p < 2.2 × 10^− 16). Furthermore, we modeled the probability of cholesteatoma by means of a logistic regression and we determined an optimal cut-off probability value of ~ 0.86 (specificity = 1.0, sensitivity = 0.97), corresponding to an apparent diffusion coefficient cut-off value of 1.37 × 10^− 3 mm²/s.

Conclusions

Our study has demonstrated that apparent diffusion coefficient values constitute a valuable quantitative parameter for preoperative differentiation of cholesteatomas from other middle ear inflammatory diseases and for postoperative diagnosis of recurrent/residual cholesteatomas.

https://ift.tt/2AO5OZ6

Saline irrigation for allergic rhinitis

Head, K; Snidvongs, K; Glew, S; Scadding, G; Schilder, AGM; Philpott, C; Hopkins, C; (2018) Saline irrigation for allergic rhinitis. [Review]. Cochrane Database of Systematic Reviews (6) , Article CD012597. 10.1002/14651858.CD012597.pub2 .

https://ift.tt/2MqhAdv

Screening heteroatom distributions in zeotype materials using an effective Hamiltonian approach: the case of aluminogermanate PKU-9

Arce-Molina, J; Grau-Crespo, R; Lewis, DW; Rabdel Ruiz-Salvador, A; (2018) Screening heteroatom distributions in zeotype materials using an effective Hamiltonian approach: the case of aluminogermanate PKU-9. Physical Chemistry Chemical Physics , 20 (26) pp. 18047-18055. 10.1039/c8cp01369a . Green open access

https://ift.tt/2vmskmI

In-depth Physiological Analysis of Defined Cell Populations in Acute Tissue Slices of the Mouse Vomeronasal Organ

Ackels, T; Drose, DR; Spehr, M; (2016) In-depth Physiological Analysis of Defined Cell Populations in Acute Tissue Slices of the Mouse Vomeronasal Organ. Journal of Visualized Experiments (115) , Article e54517. 10.3791/54517 . Green open access

https://ift.tt/2MmtuVW

Wood [née Chick], Frances

Cole, TJ; (2018) Wood [née Chick], Frances. In: Oxford Dictionary of National Biography. OUP: Oxford, UK.

https://ift.tt/2vm3ZO4

Frequency dependent characterisation of impedance changes during epileptiform activity in a rat model of epilepsy

Hannan, S; Faulkner, M; Aristovich, KY; Avery, J; Holder, DS; (2018) Frequency dependent characterisation of impedance changes during epileptiform activity in a rat model of epilepsy. Physiological Measurement 10.1088/1361-6579/aad5f4 . (In press). Green open access

https://ift.tt/2Mpwxwx

Hacking + Aktivismus = Männlich?

Tanczer, LM; (2014) Hacking + Aktivismus = Männlich? FIfF-Kommunikation , 3/2014 Green open access

https://ift.tt/2M9TeI0

Hidden magnetic order in plutonium dioxide nuclear fuel

Pegg, JT; Shields, AE; Storr, MT; Wills, AS; Scanlon, DO; de Leeuw, NH; (2018) Hidden magnetic order in plutonium dioxide nuclear fuel. Physical Chemistry Chemical Physics 10.1039/c8cp03583k . (In press). Green open access

https://ift.tt/2OiLiSi

Is zeroth order crystal structure prediction (CSP_0) coming to maturity? What should we aim for in an ideal crystal structure prediction code?

Price, SL; (2018) Is zeroth order crystal structure prediction (CSP_0) coming to maturity? What should we aim for in an ideal crystal structure prediction code? Faraday Discussion 10.1039/c8fd00121a . (In press). Green open access

https://ift.tt/2M5SjZf

'The Ten Percent’: Young people’s access to publicly-funded instrumental music tuition in England: findings from an idiographic geographical case study

Purves, RM; (2016) 'The Ten Percent': Young people's access to publicly-funded instrumental music tuition in England: findings from an idiographic geographical case study. In: Boal-Palheiros, G, (ed.) Proceedings of the 26th International Seminar of the ISME Commission on Research. (pp. pp. 243-254). International Music Education Research Centre (iMerc) Press: London, UK.

https://ift.tt/2MlTIHV

Microstructural Control of Physical Properties During Deformation of Porous Limestone

Brantut, N; Baker, M; Hansen, LN; Baud, P; (2018) Microstructural Control of Physical Properties During Deformation of Porous Limestone. Journal of Geophysical Research: Solid Earth , 123 (6) pp. 4751-4764. 10.1029/2018JB015636 . Green open access

https://ift.tt/2vpfx2Z

Residential facilities for psychosocial rehabilitation: planning permit regulations and social inclusion

Chrysikou, E; (2018) Residential facilities for psychosocial rehabilitation: planning permit regulations and social inclusion. In: AMPS Proceedings Series - Architecture_MPS 2018. AMPS (In press).

https://ift.tt/2OgAi7S

Validation of 3D Model-Based Maximum-Likelihood Estimation of Normalisation Factors for Partial Ring Positron Emission Tomography

Niknejad, T; Tavernier, S; Varela, J; Thielemans, K; (2016) Validation of 3D Model-Based Maximum-Likelihood Estimation of Normalisation Factors for Partial Ring Positron Emission Tomography. In: Proceedings of 2016 IEEE Nuclear Science Symposium, Medical Imaging Conference and Room-Temperature Semiconductor Detector Workshop (NSS/MIC/RTSD). IEEE: Strasbourg, France. Green open access

https://ift.tt/2M51hWI

The murine lung as a factory to produce secreted intrapulmonary and circulatory proteins

Paul-Smith, MC; Pytel, KM; Gelinas, J-F; McIntosh, J; Pringle, I; Davies, L; Chan, M; ... Griesenbach, U; + view all Paul-Smith, MC; Pytel, KM; Gelinas, J-F; McIntosh, J; Pringle, I; Davies, L; Chan, M; Meng, C; Bell, R; Cammack, L; Moran, C; Cameron, L; Inoue, M; Tsugumine, S; Hironaka, T; Gill, DR; Hyde, SC; Nathwani, A; Alton, EWFW; Griesenbach, U; - view fewer (2018) The murine lung as a factory to produce secreted intrapulmonary and circulatory proteins. Gene Therapy 10.1038/s41434-018-0025-8 . (In press). Green open access

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The ecopsychosocial complexities of acute psychiatric wards

Chrysikou, E; (2018) The ecopsychosocial complexities of acute psychiatric wards. In: Christer,, Kirsty and Craig, Claire and Wolstenholme, Dan, (eds.) Proceedings of the 5th European Conference on Design4Health. Sheffield Hallam University: Sheffield, UK. (In press).

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Learning abstract words and concepts: insights from developmental language disorder

Ponari, M; Norbury, CF; Rotaru, A; Lenci, A; Vigliocco, G; (2018) Learning abstract words and concepts: insights from developmental language disorder. Philosophical Transactions B: Biological Sciences , 373 (1752) 10.1098/rstb.2017.0140 . Green open access

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Mind Perception of Robots Varies With Their Economic Versus Social Function

Wang, X; Krumhuber, EG; (2018) Mind Perception of Robots Varies With Their Economic Versus Social Function. Frontiers in Psychology , 9 , Article 1230. 10.3389/fpsyg.2018.01230 . Green open access

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The left inferior frontal gyrus: A neural crossroads between abstract and concrete knowledge

Della Rosa, PA; Catricala, E; Canini, M; Vigliocco, G; Cappa, SF; (2018) The left inferior frontal gyrus: A neural crossroads between abstract and concrete knowledge. NeuroImage , 175 pp. 449-459. 10.1016/j.neuroimage.2018.04.021 .

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Homozygous OB-fold variants in telomere protein TPP1 are associated with dyskeratosis congenita like phenotypes

Tummala, H; Collopy, LC; Walne, AJ; Ellison, A; Cardoso, S; Aksu, T; Yarali, N; ... Dokal, I; + view all Tummala, H; Collopy, LC; Walne, AJ; Ellison, A; Cardoso, S; Aksu, T; Yarali, N; Aslan, D; Akata, RF; Teo, J; Songyang, Z; Pontikos, N; Fitzgibbon, J; Tomita, K; Vulliamy, T; Dokal, I; - view fewer (2018) Homozygous OB-fold variants in telomere protein TPP1 are associated with dyskeratosis congenita like phenotypes. Blood 10.1182/blood-2018-03-837799 . (In press).

https://ift.tt/2MdRJc9

Electoral volatility and political finance regulation in Colombia

Castañeda, N; (2018) Electoral volatility and political finance regulation in Colombia. Colombia Internacional , 95 pp. 3-24. 10.7440/colombiaint95.2018.01 . Green open access

https://ift.tt/2Oe2kRB

Short Report: Object Personification in Autism (this paper will be very sad if you don’t read it)

White, R; Remington, AM; (2018) Short Report: Object Personification in Autism (this paper will be very sad if you don't read it). Autism (In press). Green open access

https://ift.tt/2MabW2e

Leserbrief

https://ift.tt/2vpnpBs

E-Services von Ärzten erwartet

Das Thema Fernbehandlung spaltet die Ärzteschaft. Die Mehrheit der Patienten hingegen scheint sich Onlinekontakt zu Ärzten zu wünschen. Das geht aus einer Patientenbefragung der apoBank hervor.

https://ift.tt/2OiXa6D

Tuberkulose nicht unterschätzen

https://ift.tt/2vmpLB6

Was taugt Medizin nach Noten?

Glaubt man den einschlägigen Statistiken, schauen sich die weitaus meisten Patienten, die nach einem Arzt suchen, im Internet um. An Portalen, in denen Ärzte gelistet und auch bewertet werden, herrscht dort kein Mangel. Eher schon fehlt es an einer Antwort auf die Frage, was die dort verzeichneten Informationen tatsächlich wert sind.

https://ift.tt/2MoXFMa

Zystadenolymphome schonender operieren

https://ift.tt/2Ma9EQG

Probiotika unterstützen Toleranzinduktion

Die Entwicklung weiterer Allergien bei primär kuhmilchallergischen Kindern beruht wahrscheinlich auch auf einer intestinalen Dysbiose. Was bringt die Zugabe von Probiotika zu einem Casein-Hydrolysat in der Prävention atopischer Sekundärmanifestationen?

https://ift.tt/2MoXAIm

Biofeedback bei chronischer Fazialisparese

https://ift.tt/2M2RKPZ

Bescheinigungen: Viele Ärzte verschenken hier Geld

Oft werden Ärzte im Praxisalltag gebeten, zwischen Tür und Angel „schnell mal" ein Formular auszufüllen oder ein Attest auszustellen. Dabei übersehen Arzt und Praxisteam häufig, dass solche vermeintlichen Bagatellen durchaus auch relevant für die Abrechnung sind.

https://ift.tt/2MqsCzB

Oftmals von Dauer: Schluckbeschwerden nach Thyreoidektomie

Anders als bislang angenommen, beschränken sich Schluckbeschwerden nach einer Thyreoidektomie nicht auf die unmittelbar postoperative Phase. Selbst ein halbes Jahr später fühlt sich ein Teil der Patienten beim Schlucken noch beeinträchtigt, wobei ein objektivierbares Korrelat meist fehlt.

https://ift.tt/2M5QMT0

Haben Sie auch eine fachliche Frage?

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Umfassendes Werk zur rekonstruktiven Chirurgie

https://ift.tt/2vq4Ey1

M. Menière: Otolin-1 als möglicher Biomarker

https://ift.tt/2OiM0yT

Inhaltsverzeichnis

https://ift.tt/2M8w5pr

Forschung heute — Zukunft morgen

Die 89. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie fand dieses Jahr vom 9. bis. 12 Mai in Lübeck statt. Der Kongress mit rund 2.500 Teilnehmern aus 40 Nationen stand unter dem Motto „Forschung heute — Zukunft morgen".

https://ift.tt/2MpZYOQ

Big Data — der neue Heilsbringer?

https://ift.tt/2M2XRnr

Therapie einer superinfizierten Radikalhöhle bei perforiertem Trommelfell

https://ift.tt/2OgxRlK

Impfempfehlungen nicht vernachlässigen

https://ift.tt/2vq4err

Mundmikrobiom kann Risiko für Kopf-Hals-Tumoren beeinflussen

Das Risiko, an einem Plattenepithelkarzinom im Kopf-Hals-Bereich zu erkranken, scheint auch von der bakteriellen Besiedlung der Mundhöhle abzuhängen. Bestimmte Bakteriengattungen könnten protektiv wirken.

https://ift.tt/2OjgaSM

Auch an eine HIV-Infektion denken

https://ift.tt/2vqQSLn

Wann Datenschutzbeauftragte in Arztpraxen jetzt Pflicht sind

Am 25. Mai 2018 ist die neue EU-Datenschutz-Grundverordnung in Kraft getreten. Damit gelten nun in allen Staaten der Europäischen Union grundsätzlich die gleichen Standards für den Datenschutz. Ziel des Europäischen Rats und des Europäischen Parlaments war es dabei, die schon bestehenden Prinzipien des grundrechtsorientierten Datenschutzrechts mit einer stärkeren Harmonisierung und einer maßvollen Modernisierung zu verknüpfen.

https://ift.tt/2MprPyR

Effect of preoperative pregabalin versus gabapentin on postoperative pain control after laparoscopic gastric bypass surgery

Khalid G Abd El-Maksoud, Mokhtar M Younes, Sherif A Elokda

Ain-Shams Journal of Anaesthesiology 2017 10(1):195-200

Background Perioperative gabapentin helps produce a significant opioid-sparing effect and probably also improves postoperative pain scores. Pregabalin is a novel drug with a heightened research interest in the analgesic, sedative, anxiolytic, and opioid-sparing effects, in various pain settings, including postoperative pain. We investigated pregabalin analgesic efficacy in morbid obese patients experiencing acute pain after laparoscopic gastric bypass surgery and compared it with gabapentin and placebo. Patients and methods A randomized, placebo-controlled study was conducted on 90 morbidly obese patients undergoing laparoscopic gastric bypass surgery. Patients were allocated into one of the three groups; the pregabalin group in which the patients received 300 mg pregabalin, the gabapentin group in which the patients received 1200 mg gabapentin, or the control group in which the patients received placebo 2 h prior to surgery. Postoperative pain was controlled with intravenous fentanyl via patient controlled analgesia (PCA). Fentanyl consumption over 24 h and pain intensity measured by visual analogue score at rest (static) and during cough (dynamic) at recovery time, 1, 2, 6, 12, and 24 h were recorded. Also sedation status, somnolence, dizziness, headache, nausea, and vomiting were monitored. Results Postoperative 24 h fentanyl consumption was significantly higher in the control group compared with both pregabalin and gabapentin groups (P<0.001). Pain intensity on visual analogue score (static and dynamic) was significantly higher in the control group compared with both pregabalin and gabapentin groups at time of recovery, 1, 2, 6, 12, and 24 h postoperatively. Numeric sedation score was significantly lower in the control group compared with pregabalin and gabapentin groups at time of recovery, 1, 2, and 6 h postoperatively. No significant differences were found among the three groups as regards somnolence, dizziness, headache, nausea, and vomiting. Conclusion A single dose of 300 mg pregabalin or 1200 mg gabapentin given 2 h before surgery is better than placebo for postoperative pain control for laparoscopic gastric bypass surgery without significant side effects.

https://ift.tt/2vGaOcw

Optimum target in percutaneous upper thoracic thermocoagulation in primary hyperhidrosis

Osama Yehia A Khalifa, Ahmed Sobhi M.E Hegab

Ain-Shams Journal of Anaesthesiology 2017 10(1):293-296

Introduction Primary palmar hyperhidrosis is a disabling problem that affects young age groups and usually continues for years without an effective treatment. It is usually accompanied by plantar hyperhidrosis and to a lesser extent by axillary affection. We have tried to improve the efficacy of percutaneous radiofrequency ablation of upper thoracic sympathetic ganglia via imitating what thoracoscopic surgeons do in endoscopic thoracic sympathectomy. Patients and methods A total of 40 patients with primary hyperhidrosis were randomly classified into two groups. Group Tb (n=20) underwent thermocoagulation of sympathetic chain on vertebral body. Group Th (n=20) underwent thermocoagulation of sympathetic chain on the head and neck of ribs. Hand temperature and dryness were followed up during the procedure and on the following intervals: 1 week, 1 month, 3 months, 6 months, 9 months, and 12 months after the procedure. Results During the procedure, the hands of 50% of patients became warm and dry in group Tb and only 40% remained so till 12 months, whereas in group Th, the hands of 100% of the patients became warm and dry during the procedure till 12 months. Conclusion Thermocoagulation of upper thoracic sympathetic chain on the head and neck of the second and third ribs is more effective than attacking the chain on vertebral bodies in patients with primary hyperhidrosis with no recorded complications.

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Effectiveness of minimal acute normovolemic hemodilution to minimize allogenic blood transfusion and re-exploration in elective adult coronary artery bypass graft surgery using colloid as a replacement solution

Mohammed S Shorbagy, Dina Salah

Ain-Shams Journal of Anaesthesiology 2017 10(1):3-9

Background and aim Various studies have questioned the efficacy of intraoperative acute normovolemic hemodilution (ANH) in reducing bleeding, the need for allogenic transfusion, and the incidence of re-exploration in cardiac surgery. The aim of the present study was to evaluate the effectiveness of the use of minimal ANH for blood transfusion requirements and re-opening in elective adult coronary artery bypass graft surgery using cardiopulmonary bypass. Patients and methods This prospective, randomized controlled study was conducted on 100 consecutive adult patients who underwent elective coronary artery bypass graft. Patients were randomly divided into two equal groups: the ANH group (n=50) and the control group (n=50). In the ANH group, 5–8 ml/kg of autologous blood was withdrawn after administering anesthesia and before systemic heparinization. Simultaneously, colloid solution (6% hydroxyethyl starch 130/0.4; Voluven) was infused in a ratio of 1:1, and then the blood was re-infused after bypass. Hemodilation was not carried out for the control group. Total amount of allogenic-packed red blood cell, fresh frozen plasma, platelet concentrate transfusion, and the number of patients undergoing re-opening because of excessive bleeding were calculated for the two groups. Results A significant decrease was observed in the number of red blood cell units and fresh frozen plasma transfusion per patient in the ANH group compared with the control group. Conversely, chest tube output, representing postoperative bleeding and platelet count, did not differ between the two groups. Conclusion In this study, the use of the minimal ANH technique reduced the consumption of allogenic red blood cells and fresh frozen plasma in adult cardiac surgery patients. However, this technique had no effect on postoperative bleeding, incidence of re-exploration, and platelet count.

https://ift.tt/2vEnGQm