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Great progress has recently been made in the treatment of metastatic renal cell carcinoma, including the introduction of nivolumab, an immune checkpoint inhibitor. Despite promising results, this treatment bri...
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Moderne Therapeutika haben das Leben von Melanompatienten verlängert. Ob und in welchem Ausmaß das auch für Patienten mit Hirnmetastasen zutrifft, wurde nun anhand von Beobachtungsdaten analysiert.
Eine Biopsie der Sentinellymphknoten ist neben der Beurteilung der Tumordicke nach Breslow eine zweite gängige Methode, bei Melanomen Informationen zu Stadium und Prognose zu sammeln. Ob der Befund tatsächlich zusätzliche prognostische Informationen liefert, wurde nunin einer retrospektiven Studie untersucht.
Bei der Bewertung der Dignität von Pigmentmalen der Haut gilt die ABC-Regel mit den drei Hauptmerkmalen Asymmetrie, (unregelmäßige) Begrenzung und (uneinheitliches) Colorit. Wie Experten die Regel anwenden, und ob sie in ihren Einschätzungen übereinstimmen, wurde nun getestet.
In New York hat sich eine geheime Parallelgesellschaft etabliert: Wichtige Positionen in der Kunst- und Kulturszene, aber auch in der Politik sind von Vampiren besetzt. Sie und ihre Familien verbindet nicht nur ein äußerlich sichtbares Mal, sondern auch ein gemeinsamer Feind, den die meisten längst besiegt glaubten.
Mit einer therapiebegleitenden Kostumstellung kann der Schweregrad einer Psoriasis beziehungsweise Psoriasisarthritis reduziert werden. Die National Psoriasis Foundation hat jetzt Ernährungsempfehlungen für diese Patientengruppe veröffentlicht.
Psoriasis gilt als eigenständiger Risikofaktor für kardiovaskuläre Ereignisse. Eine Schlüsselrolle wird dem Tumornekrose-Faktor α zugeschrieben — von der Behandlung mit dessen Inhibitioren könnten Patienten mehrfach profitieren.
Beim Modellprojekt „mSkin" in Mecklenburg-Vorpommern können Hausärzte bei Hautveränderungen ihrer Patienten per App einen Dermatologen konsultieren.
Bei androgenetischer Alopezie ist Laserlicht möglicherweise am wirksamsten. Ein indirekter Vergleich per Netzwerkmetaanalyse findet für dieses Verfahren die stärksten Therapieeffekte.
Aknepatienten suchen oft nach nichtmedikamentösen Optionen. Deren Wirksamkeit ist aber nur wenig verlässlich belegt.
Die konventionelle photodynamische Therapie aktinischer Keratosen ist sehr effektiv, bringt aber einige Unannehmlichkeiten mit sich: Die Durchführung nimmt viel Zeit in Anspruch und kann für den Patienten schmerzhaft sein. Seit einiger Zeit gibt es mit der photodynamischen Therapie mit Tageslicht eine in der Anwendung einfachere Alternative.
Die Menschen wüssten heutzutage mehr über Medizin, meinen die Gesundheitsminister — die Ärzteschaft sollte dies in der Kommunikation mit ihren Patienten berücksichtigen.
Das Münchner Kindl auf der Spitze des Rathausturms breitete seine Arme aus und hieß vom 24. bis 28. Juli 2018 die Teilnehmer der zweijährlichen Fortbildungswoche für praktische Dermatologie und Venerologie im Internationalen Congress Center in München willkommen. Trotz verdichtetem Kernprogramm auf vier Tage war die Auswahl dermatologischer Themen wieder einmal breit gefächert.
Facial plast Surg
DOI: 10.1055/s-0038-1670647
A key concept in successful rhinoplasty surgery is maintaining or increasing tip support, and addressing tip projection and rotation. The tongue-in-groove (TIG) technique is a method to achieve this goal using sutures to create a strong connection between the septum and medial crura to change tip rotation and projection. Criticisms of this method include that it may cause stiffness of the nasal tip and columellar retraction. TIG is routinely used by the authors during anterior septal reconstructions (a modified extracorporeal septoplasty technique), as well as in primary and revision aesthetic and functional rhinoplasties. Through this review, technical aspects of the TIG technique are discussed, as well as how pitfalls of the technique can be avoided, as illustrated by several rhinoplasty patient examples.
[...]
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Article in Thieme eJournals:
Table of contents | Abstract | Full text
Previous studies on asthma phenotypes were often conducted in selected clinical populations and overlooked changes over the life course.
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Eosinophilic esophagitis (EoE) is a chronic allergic, immune-mediated disease associated with increased risk of comorbid atopic conditions.
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To investigate the success rates and hearing outcomes of temporalis fascia and tragal cartilage grafts used for type-1 tympanoplasty in the elderly (³65 years)
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Allergy, Volume 0, Issue ja, -Not available-.
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International Forum of Allergy &Rhinology, EarlyView.
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The Journal of Dermatology, EarlyView.
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Pediatric Dermatology, Volume 35, Issue 5, Page 683-684, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 671-672, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 685-687, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 673-675, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 700-700, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 676-677, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 681-682, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 669-670, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 732-735, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 678-680, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 698-699, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 667-668, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 701-701, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 541-546, September/October 2018.
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Pediatric Dermatology, Volume 35, Issue 5, Page 702-731, September/October 2018.
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Australasian Journal of Dermatology, EarlyView.
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Australasian Journal of Dermatology, EarlyView.
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Australasian Journal of Dermatology, EarlyView.
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Description
A 4-year-old girl with a history of chromosome 22q11.2 deletion syndrome presented to the emergency department with 2–3 weeks of worsening emesis. CT of the head revealed a large pineal region calcified tumour with associated hydrocephalus. Contrast-enhanced MRI of the brain and spine status postexternal ventricular drain placement confirmed a pineal tumour with diffuse metastatic leptomeningeal spinal spread (figure 1A,B). The child had a normal MRI of the brain 2 years prior (figure 1C) as work-up for her developmental delay. The diagnosis of 22q11.2 deletion syndrome was made by chromosomal microarray testing, which revealed a 2.5 MB deletion of 22q11.2 that included the TBX1 gene. Neuropathology on a subtotal resection showed clusters and sheets of tightly packed, small, blue cells with oval or slightly angulated nuclei and scant cytoplasm, consistent with a primitive neuroectodermal tumour. The tumour showed no loss of expression of INI...
Coronary artery ectasia (CAE) is defined as a localised or diffuse dilatation of coronary artery lumen more than 1.5 times that of an adjacent normal segment. CAE may present with or without functionally significant stenosis. Such patients may manifest with stable angina or with acute coronary syndrome. Ectasia may serve as a nidus for thrombus formation with likelihood of distal embolisation or it may lead to dissection or spasm. This condition presents a challenge for an interventionist. Should we intervene or manage it medically. We describe a case of CAE where all the vessels were diffusely ectatic with variable degree of stenosis. In brief we discuss the causes and management issues in ectasia.
An 84-year-old woman with previous spinal operations including vertebroplasty and lumbar decompressions was admitted electively under the spinal team for right-sided L4/5 decompression for worsening back pain which she undergoes using a posterior approach. Postoperatively, she develops stabbing upper central chest pain and given unremarkable chest X-ray, ECG and cardiac troponin, she undergoes a CT pulmonary angiogram which shows a fracture of the upper part of sternum but no pulmonary embolism. There is no history of recent trauma and this is deemed to be secondary to prolonged spinal surgery in the prone position in a patient with osteopenic bones. To date, we have not come across a case of spontaneous sternal fracture as a complication of spinal surgery at our regional spinal unit. Most cases of sternal fractures are secondary to blunt anterior chest wall trauma with spontaneous fractures and stress fractures being rare.
Description
A 25-year-old man from a rural background and suffering from psychiatric illness had complaints of acute urinary retention 1 year ago for which trocar-guided suprapubic cystostomy (SPC) Foley catheter placement was done elsewhere after failed attempt of per-urethral catheterisation.
There was no history of haematuria, lithuria, catheterisation and endourological intervention in the past. On further eliciting the history, there was a retrograde urethrogram film taken 1 year back which revealed a short segment (1.0 cm) bulbar urethral stricture. He had undergone optical internal urethrotomy with Foley catheter placement (14F) under regional anaesthesia for his urethral stricture. Per-urethral catheter was removed after 7 days and he voided well with good urinary stream. He was sent back home and instructed to follow-up after 3 days for removal of SPC catheter and need of de-clamping SPC catheter in case of urinary retention again.
However, a thorough counselling about catheter's care and related complications was not...
Cellular angiofibroma (CAF) is a rare, site-specific, benign mesenchymal tumour affecting both women and men in the genitourinary region. The tumour usually presents as a small, asymptomatic lesion involving the vulvovaginal regions in women and inguinoscrotal regions in men. We report the case of a 38-year-old woman presenting with a painless mass in the vulval region, especially on the right side of urethral meatus for 8 years with progressively increasing lower abdominal discomfort. A simple excision was performed. The diagnosis of CAF was confirmed histopathologically.
Description
A 94-year-old man presented with complaints of increasing fatigue and generalised weakness for 1 month's duration. On admission, the patient had tachycardia of 112 bpm and fever of 101.1 °F. His initial physical examination was otherwise normal. Lactic acid was elevated (4.13 pg/mL), but other laboratory markers were within normal limits. No apparent source of infection was identified by initial urinalysis, chest radiography or CT of the abdomen without contrast. The lactic acidosis resolved after administration of normal saline, but he continued to have fever, which prompted more thorough physical examination that revealed a painless right-sided neck mass. CT of the neck without contrast confirmed a low-density neck mass in the right posterior cervical region measuring 7 cm in the maximum diameter (figures 1 and 2), suspicious for necrotic tumour or an abscess. Ultrasound-guided drainage of the mass recovered 50 mL of purulent material that was submitted for...
Febrile neutropenia (FN) is a common complication in patients with cancer during treatment with antineoplastic drugs. The initial cause is usually bacterial, and treatment of FN follows well-defined algorithms. We report a case of a 62-year-old patient with chronic lymphocytic leukaemia (CLL), who developed FN, which was unresponsive to both empirical antibacterial and empirical antifungal therapy. Surprisingly, a diagnosis of the life-threatening condition haemophagocytic lymphohistiocytosis (HLH) associated with cytomegalovirus (CMV) infection was made and treated successfully. CMV-associated HLH has not previously been described in patients with CLL treated with rituximab and bendamustine. It is concluded that HLH should be considered in patients with cancer with FN not responding to conventional antibiotic therapy.
We describe the case of a 15-year-old girl who presented to the Accident and Emergency Department with right knee pain and a tense effusion following a twist and fall directly onto her right knee. An MRI scan demonstrated that she had an incarcerated dislocated patella with an associated patella avulsion fracture. This required open reduction. Open reduction and fixation was performed using suture anchors. We feel that this case is particularly pertinent since nearly all previous case reports describe an incarcerated patella with an associated femur fracture. Furthermore, no previous case reports have been published in a child.
Description
A 2-year-old male child was referred to the paediatric rheumatology clinic with history of limping, swelling of right knee and low-grade fevers for 6 weeks. About 2 months prior to this presentation, he had an episode of upper respiratory infection which was followed by swelling of the right knee. He was initially treated with oral analgesics by his primary physician. After 6 weeks when there was no improvement, he was referred for evaluation of possible juvenile idiopathic arthritis.
On examination, there was visible swelling of his right knee compared with his left and he was refusing to bear weight on his right lower limb (figure 1). On closer observation, a diffuse swelling was noted over the right calf region with fullness of the popliteal fossa (figure 1). The swelling was not warm or tender. There was no contact history with tuberculosis. The patient...
We present an interesting case of an intramucosal carcinoma (IMC) in the setting of Barrett's oesophagus in a 66-year-old woman. Her clinical course highlights the shifting paradigm in the approach to management of Barrett's oesophagus and IMC. With innovation in imaging and endoscopic treatment modalities, patients are detected earlier and managed prior to development of malignancy. The patient was treated with endoscopic modalities, and after 3 years' follow-up, she remains recurrence free.
As your ER visit progresses and your child begins to feel a little better, you're both probably anxiously waiting to be discharged. But, what happens at the end of your visit? Who discharges you? Will you have follow up appointments? Dr. Jamie Kondis breaks down the end-of-visit procedures for all patients.
The post Emergency Room Discharge | What's Next? appeared first on ChildrensMD.
Guillery, Daniel; (2018) States and the limits of feasibility: enforcement, morality and possibility. Doctoral thesis (Ph.D), UCL (University College London). Green open access
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Bucknall, R; Suarez De La Fuente, S; Szymko, S; Bowers, W; Sim, A; (2018) Evaluation of Electric-Turbo-Charging applied to Marine Diesel-Engines. In: (Proceedings) 14th International Naval Engineering Conference and Exhibition. Institute of Marine Engineering, Science and Technology (In press).
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Gualdi, Davide; (2018) Cosmology from compressed high-order statistics in galaxy surveys. Doctoral thesis (Ph.D), UCL (University College London).
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Haider, S; (2018) Computational Methods to Study G-Quadruplex-Ligand Complexes. Journal of the Indian Institute of Science , 98 (3) pp. 325-339. 10.1007/s41745-018-0083-3 . Green open access
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Friberg, P; Berry, D; Savini, G; Bintley, D; Dempsey, J; Graves, S; Parsons, H; (2018) Characterizing and reducing the POL-2 instrumental polarization. In: Proceedings of SPIE 10708, Millimeter, Submillimeter, and Far-Infrared Detectors and Instrumentation for Astronomy IX, 107083M. SPIE: Austin, Texas, United States. Green open access
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Govender, Roganie; (2018) Development and feasibility testing of a pre-treatment swallowing intervention package for patients with head and neck cancer. Doctoral thesis (Ph.D), UCL (University College London).
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Horne, R; Chapman, S; Glendinning, E; Date, HL; Guitart, J; Cooper, V; (2018) Mind Matters: Treatment Concerns Predict the Emergence of Antiretroviral Therapy Side Effects in People with HIV. AIDS and Behavior 10.1007/s10461-018-2239-6 . (In press). Green open access
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Cooper, C; Booth, A; Varley-Campbell, J; Britten, N; Garside, R; (2018) Defining the process to literature searching in systematic reviews: A literature review of guidance and supporting studies. [Review]. BMC Medical Research Methodology , 18 , Article 85. 10.1186/s12874-018-0545-3 . Green open access
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Suarez De La Fuente, S; Larsen, U; Bucknall, R; Greig, A; (2018) Cooling Fluids and Ambient Temperature: Sensitivity Performance of a Container Ship Organic Rankine Cycle Unit. In: Proceedings of Transport Research Arena 2018. Transport Research Arena: Vienna, Austria.
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Warner, M; Gutmann, A; Sasse, MA; Blandford, A; (2018) Privacy Unraveling Around Explicit HIV Status Disclosure Fields in the Online Geosocial Hookup App Grindr. In: 21st ACM Conference on Computer-Supported Cooperative Work and Social Computing. (pp. p. 181). ACM (In press). Green open access
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Groves, PD; (2016) Assured PNT Through Multiple Diverse Technologies. Presented at: 29th International Technical Meeting of The-Satellite-Division-of-the-Institute-of-Navigation (ION GNSS+), Portland, OR. Green open access
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Groves, PD; (2016) Solving the Urban Positioning Problem using 3D-Mapping-Aided GNSS. Presented at: 29th International Technical Meeting of The-Satellite-Division-of-the-Institute-of-Navigation (ION GNSS+), Portland, OR. Green open access
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Ciurtin, C; Roussou, E; (2010) The Overlap Between Fibromyalgia Points and Enthesitis Sites in Patients With Inflammatory Back Pain and Widespread Body Pains: Results From an Audit. Presented at: Annual Conference of the British Society for Rheumatology/Spring Meeting of British-Health-Professional-in-Rheumatology, Birmingham, England.
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Rashid, A; Danezis, G; Chivers, H; Lupu, E; Martin, A; Lewis, M; Peersman, C; (2018) Scoping the Cyber Security Body of Knowledge. IEEE Security & Privacy , 16 (3) pp. 96-102. 10.1109/MSP.2018.2701150 . Green open access
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Chan, E; MacPherson, SE; Bozzali, M; Shallice, T; Cipolotti, L; (2018) The Influence of Fluid Intelligence, Executive Functions and Premorbid Intelligence on Memory in Frontal Patients. Frontiers in Psychology , 9 , Article 926. 10.3389/fpsyg.2018.00926 . Green open access
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North, S; (2000) Significant decisions: supporting social housing clients through procession's artificially intelligent 3d information visualisation. In: Timmermans, H and de Vries, B, (eds.) Proceedings of the 5th international conference on design & decision support systems in urban planning. (pp. pp. 215-228). : Eindhoven University of Technology, Netherlands.
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Pencheva, I; Esteve, M; Mikhaylov, SJ; (2018) Big Data and AI – A transformational shift for government: So, what next for research? Public Policy and Administration 10.1177/0952076718780537 . (In press). Green open access
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Russell, N; Wright, KI; Carter, T; Ketchum, S; Ryan, P; Yalman, N; Regan, R; ... Milic, M; + view all Russell, N; Wright, KI; Carter, T; Ketchum, S; Ryan, P; Yalman, N; Regan, R; Stevanovic, M; Milic, M; - view fewer (2014) Bringing down the house: house closing deposits at Çatalhöyük. In: Hodder, I, (ed.) Integrating Çatalhöyük. (pp. 109-121). Cotsen Institute of Archaeology Press: Los Angeles, USA.
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Khaw, PT; (2018) Noel Stephen Cracroft Rice OBITUARY. The BMJ , 362 , Article k3579. 10.1136/bmj.k3579 . Green open access
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Brookes, KJ; McConnell, G; Williams, K; Chaudhury, S; Madhan, G; Patel, T; Turley, C; ... Morgan, K; + view all Brookes, KJ; McConnell, G; Williams, K; Chaudhury, S; Madhan, G; Patel, T; Turley, C; Guetta-Baranes, T; Bras, J; Guerreiro, R; Hardy, J; Francis, PT; Morgan, K; - view fewer (2018) Genotyping of the Alzheimer's Disease Genome-Wide Association Study Index Single Nucleotide Polymorphisms in the Brains for Dementia Research Cohort. Journal of Alzheimer's Disease , 64 (2) pp. 355-362. 10.3233/JAD-180191 . Green open access
https://ift.tt/2CU3oZS
IgA nephropathy (IgAN) is associated predominantly IgA deposition in the affected glomeruli and has been shown to be the most common glomerular disorder among young people in the world. Although the exact pathogenic mechanism underlying IgAN remains largely unknown, circulating IgA-containing immune complexes (IgA ICs) is considered to play a major role in initiating the development and evolution of the renal disorder. In this review article, we discuss the fundamental mechanisms of clearance kinetics of IgA ICs and related issues, covering the following: (1) role of circulating IgA ICs in the pathogenesis of IgAN and (2) elimination of IgA ICs from the body, with emphasis of the role of the liver and Fc receptors in immune cells.
Publication date: Available online 13 September 2018
Source: European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): E. Guyader, J. Savéan, C. Clodic, P. Letellier, P. Meriot, R. Marianowski
To evaluate the accuracy of three-dimensional (3D) Cone Beam Computed Tomography (CBCT) and Computed Tomography (CT) reconstructions of human temporal bones compared with in situ measurements.
Experimental anatomical study of 10 human temporal bones. Wilcoxon's test was used to compare 8 distances on each temporal bone measured in situ and then on 3D CT and CBCT reconstructions. Six landmarks were used: external auditory canal (EAC), tip of the mastoid process, tip of the occiput, zygoma, a point situated 1 cm above the tip of the mastoid process (T0) (open technique: lower limit of the mastoidectomy), head of stapes.
No significant difference was observed between the 3 measuring techniques for any of the distances studied (P > 0.05).
This study demonstrates the equivalence of CBCT and CT for temporal bone measurements.
CBCT is a new imaging modality providing 3D reconstructions of the temporal bone that are as reliable as those obtained by CT. As a result of better spatial resolution compared to CT, CBCT is associated with a significantly lower radiation dose. This technique constitutes a morphological progress, as CBCT is comparable to CT, allowing investigation of pathological ears with a lower radiation dose.
Publication date: Available online 13 September 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Elisabeth Cole, Alexandra Dreyzin, Amber D. Shaffer, Allison B.J. Tobey, David H. Chi, Tony Tarchichi
To improve the recognition of differences in presentation amongst patients with type 1 laryngeal clefts of various ages and better understand the age dependent outcomes of injection laryngoplasty. A second aim was to analyze the discrepancies between swallow assessment modalities in various age groups with type I laryngeal clefts undergoing injection laryngoplasty.
A retrospective review of electronic medical records of patients who underwent injection laryngoplasty from 2009 through 2015 at a tertiary care children's hospital. Data extracted included: Demographics, histories and physical exam findings, diagnostic studies, and medical and surgical treatments.
Most (72/102, 70.6%) patients were male with a median gestational age at birth of 37 weeks (range 24–41 weeks). Formula thickening and GERD medications were used in 94/102 (92.2%) and 97/102 (95.1%) patients, respectively. Comorbid GERD, laryngomalacia, tracheomalacia, and subglottic stenosis were present in 98/102 (96.1%), 40/102 (39.2%), 9/102 (8.8%), and 14/102 (13.7%) patients, respectively. There was no significant difference in demographics, comorbidities or medical therapy between age groups. Symptoms at presentation differed between age groups with stridor (χ2(1) =11.6, p=0.002) and cyanosis (χ2(1) =8.13, p=0.012) being more common in the 0–3-month group compared to the 12-36 month group. Symptom resolution and the odds of undergoing additional surgery (second injection or suture repair) over time, however, did not differ. There was a significant reduction in aspiration with thins during FEES (McNemar χ2(1) =10.7, p=0.002) and aspiration with nectar during MBS (McNemar χ2(1) =5.26, p=0.035) post-injection. After injection, there was significant agreement in aspiration with thins between FEES and MBS (kappa=0.308 ± SE 0.170, p=0.035). However, finding aspiration with thins was more common during MBS than during FEES (McNemar χ2(1) =7.00, p=0.016). There were no differences in swallow evaluation findings between the age groups.
Symptoms of type I laryngeal clefts may differ by age. However, there was no impact of age on the safety and efficacy of surgical intervention.
Publication date: Available online 13 September 2018
Source: International Journal of Pediatric Otorhinolaryngology
Author(s): Elizabeth J. Kerris, Jason T. Patregnani, Matthew Sharron, Anthony A. Sochet
To assess the frequency of post-procedural complications, medical interventions, and hospital costs associated with microlaryngobronchoscopy (MLB) in children prophylactically admitted for pediatric intensive care unit (PICU) monitoring for age ≤ 2 years.
We performed a single-center, retrospective, descriptive study within a 44-bed PICU in a stand-alone, tertiary, pediatric referral center. Inclusion criteria were age ≤ 2 years and pre-procedural selection of prophylactic PICU monitoring after MLB between January 2010 and December 2015. Children were excluded for existing tracheostomy, if undergoing concurrent non-otolaryngeal procedures, or if intubated at the time of PICU admission. Primary outcomes were the development of major and minor procedural complications and medical rescue interventions. Secondary outcomes were hospital cost and length of stay (LOS).
One hundred and eight subjects met inclusion criteria with a median age of 5.3 (IQR: 2.6-10.9) months. A majority (86%) underwent therapeutic instrumentation in addition to diagnostic MLB. There were no observed major complications or rescue interventions. Minor complications were noted within 5 hours of monitoring and included isolated stridor (24%), desaturation <90% (10%), and nausea/emesis (8%). Minor interventions included supplemental oxygen via regular nasal cannula (39%), single-dose inhaled racemic epinephrine (19%), single-dose systemic corticosteroids (19%), or high flow nasal cannula (HFNC) therapy (4%). Save for two cases of HFNC, interventions were completed or discontinued within 5 hours. Median PICU LOS was 1.1 days and median cost was $9,650 (IQR: $8,235- $14,861) per encounter. Estimated cost of same day observation in our post anesthesia care unit (PACU) following MLB without PICU admission is $1,921 per encounter.
In children ≤ 2 years of age prophylactically admitted for PICU observation, we did not observe severe complications or major interventions after MLB. Minor interventions and complications were noted early during post-procedural monitoring. PICU monitoring was substantially more expensive than same-day PACU observation. Young age as the sole criteria for prophylactic PICU monitoring after diagnostic or therapeutic MLB may be unjustified when comparable, cost-conscious care can be achieved in a PACU setting. Prior to pre-procedural selection of PICU monitoring, we recommend a broad contextual risk assessment including a review of comorbidities, operative plan, and intended anesthetic exposure.
Publication date: November 2018
Source: Molecular Immunology, Volume 103
Author(s): Zhehao Shi, Wen Ye, Jiecheng Zhang, Fan Zhang, Dinglai Yu, Huajun Yu, Bicheng Chen, Mengtao Zhou, Hongwei Sun
An essential component of acute pancreatitis(AP)-induced acute lung injury(ALI) is the inflammation that is part of the body's systemic inflammatory response to a variety of systemic stimuli. Lipoxins(LXs) are considered important endogenous lipids that mediate the resolution of inflammation. In previous studies, we found that Lipoxin A4 (LXA4) reduced AP-induced pulmonary oedema and TNF-α production in lung. However, the underlying mechanism remains unclear. Due to the above studies, we investigated the aquaporin, matrix metalloprotein, apoptosis and PKC/SSeCKS signal pathway in cellular and animal models of AP-associated lung injury following LXA4 intervention. In this study, we first proved LXA4 could effectively promote F-actin reconstruction and regulate its expression in pulmonary microvascular endothelial cells both in vivo and vitro via suppressing PKC/SSeCKS signalling pathway. Next, we found that LXA4 attenuated cell growth inhibition and apoptosis in lung tissues of AP-ALI mice and HPMECs. Additionally, we demonstrated that LXA4 could regulate the expression of AQP-5 and MMP-9 to stabilize the permeability of pulmonary microvascular endothelial cell. In summary, our results suggest that the anti-inflammatory eff ;ects of LXA4 may be due to the inhibition of both the PKC/SSeCKS pathway and apoptosis to reduce alveolar fluid exudation and to the regulation of AQP-5 and MMP-9 expression to maintain the clearance of alveolar fluid. Thus, LXA4 is capable of exerting protective eff ;ects on AP-induced ALI.
Publication date: Available online 13 September 2018
Source: Clinical Immunology
Author(s): Delphine Turpin, Adeline Furudoi, Marie Parrens, Patrick Blanco, Jean-François Viallard, Dorothée Duluc
Common variable immunodeficiency (CVID) is characterized by low levels of circulating immunoglobulins and defects in B cell maturation leading to an increased susceptibility to infections. Some patients develop complications such as autoimmune diseases, enteropathy, and lymphoproliferation, resulting in higher morbidity and mortality. Follicular helper T (Tfh) cells are specialized in helping B cell differentiation into Ig-producing cells. Three subsets have been described, namely non B-cell helper Tfh1 and the two B-helper cell subsets Tfh2 and Tfh17. We determined that circulating Tfh cells were elevated in CVID patients and skewed toward a Tfh1 profile. Interestingly, elevated levels of Tfh1 cells were significant only in patients harboring non-infectious complications regardless of the type of complication and inversely correlated with switched memory B cells. Moreover, CXCR3+ cells are increased in splenic CVID germinal centers. Our observations suggest that the altered balance in Tfh subsets in CVID is linked to a more severe disease.
The relationship between preoperative hyperglycemia and postoperative acute kidney injury (AKI) occurrence in non-cardiac surgery including laparoscopic surgery remains unclear. This study aimed to assess the relationship between preoperative chronic hyperglycemia and postoperative AKI occurrence after a major laparoscopic abdominal surgery.
We retrospectively reviewed medical records of diabetic patients (≥ 20 years old) who underwent elective major laparoscopic abdominal surgery procedures between 2010 and 2016. Patients were divided into two groups based on a cut-off value of hemoglobin A1c (HbA1c) at 6%. Serum creatinine value was used for the diagnosis of AKI, and all assessments and diagnoses of postoperative AKI were performed on 0–3 postoperative days (POD) using the criteria of Kidney Disease: Improving Global Outcomes.
In all, 1885 patients were included in the final analysis, and patients were divided into the following groups: < 6.0% group with 1257 patients (66.7%), and ≥ 6.0% group with 628 patients (33.3%). Sixty-nine patients (3.7%) were diagnosed with postoperative AKI within 3 POD. Multivariable logistic regression analysis showed no significant difference in the incidence rate of postoperative AKI between the HbA1c ≥ 6.0% group and the < 6.0% group (odds ratio 1.10, 95% confidence interval 0.57–2.15; P = 0.770). In addition, there was no significant interaction between preoperative HbA1c group and exposure to acute hyperglycemia (serum glucose > 200 mg/dL) for incidence of AKI on POD 0–3 (P = 0.181).
In diabetic patients, preoperative chronic hyperglycemia is not associated with postoperative AKI occurrence within 3 POD after a major laparoscopic abdominal surgery.
Meng, X; Grote, RR; Jin, W; Dadap, JI; Panoiu, NC; Osgood, RM; (2016) Rigorous theoretical analysis of a surface-plasmon nanolaser with monolayer MoS2 gain medium. Optics Letters , 41 (11) pp. 2636-2639. 10.1364/OL.41.002636 . Green open access
https://ift.tt/2xima78
Clark-Wilson, A; Oldknow, A; (2007) Innovative multimedia approaches to mathematics education. In: Proceedings of the International Conference on Technology in Mathematics Teaching – ICTMT 07. : Hradec Králové, Czech Republic.
https://ift.tt/2xeJRxb
Deng, H; Chen, X; Panoiu, NC; Ye, F; (2016) Topological surface plasmons in superlattices with changing sign of the average permittivity. Optics Letters , 41 (18) pp. 4281-4284. 10.1364/OL.41.004281 . Green open access
https://ift.tt/2xbZTst
You, JW; Panoiu, NC; (2017) A New Scheme to Enhance the Third-Harmonic Generation in Graphene. In: 2017 Conference on Lasers and Electro-Optics Pacific Rim (CLEO-PR). IEEE Green open access
https://ift.tt/2xbZHtf
You, JW; Panoiu, NC; (2017) Tunable Enhancement of Second-Harmonic Generation in Dual Graphene Optical Gratings. In: 11th International Congress on Engineered Material Platforms for Novel Wave Phenomena. (pp. pp. 382-384). IEEE Green open access
https://ift.tt/2xilX3Q
Adhitya, SA; (2018) Musical Cities. UCL Press: London, UK. Green open access
https://ift.tt/2x9Mod2
Publication date: November 2018
Source: Oral Oncology, Volume 86
Author(s): Zuzana Saidak, Florian Clatot, Denis Chatelain, Antoine Galmiche
Perineural invasion (PNI) is a common histopathological finding in head and neck squamous cell carcinoma (HNSCC). We aimed to explore the molecular mechanisms involved in PNI and the role of PNI as an aggressive pathological feature.
We used data from The Cancer Genome Atlas (TCGA) to relate the histological presentation of 528 HNSCC tumours to clinical, whole genome expression and proteomic data.
We identified a specific gene expression profile highly enriched in genes related to muscle differentiation/function and associated with PNI in HNSCC. We explored the clinical significance of this profile in three groups of HNSCC tumours stratified according to their low, intermediate or high risk of post-surgical recurrence. In the "low-risk" group, defined as tumours indicated for surgery without adjuvant radiotherapy (n = 51), the PNI gene expression profile identified a subset of HNSCC with a higher rate of tumour recurrence, decreased Disease Free Survival (DFS) and Overall Survival (OS) (p < 0.0001 and p = 0.0064, respectively). Comparable results were observed in "intermediate risk" tumours (n = 112), but not in "high risk" tumours (n = 147), whose prognosis was driven by the presence of lymph node extracapsular spread. Finally, we found that tumours with histological PNI had increased activation levels of the Akt/PKB and mTOR (mammalian Target Of Rapamycin) kinases.
PNI is characterised by a specific gene expression profile and distinct biological characteristics. Analysing the PNI gene expression profile holds potential for therapeutic stratification of HNSCC and identification of a subset of tumours with a higher risk of recurrence.
Publication date: October 2018
Source: Oral Oncology, Volume 85
Author(s):
African Americans/(AA) are disproportionately impacted by atopic dermatitis/(AD) with increased prevalence and therapeutic challenges unique to this population. Molecular profiling data informing development of targeted therapeutics for AD are derived primarily from European American/(EA) patients. These studies are absent in AA, hindering development of effective treatments for this population.
https://ift.tt/2p68GYA
Die Hyperhidrose tritt meist als primäre, selten als sekundäre symptomatische Hyperhidrose auf. Die primäre Hyperhidrose wird als komplexe neuropathische Dysregulation mit genetischer Disposition verstanden, die ein pathologisches Schwitzverhalten mit vermehrter Schweißsekretion über mindestens 6 Monate bedingt und mindestens 4 der folgenden Diagnosekriterien erfüllt: Betroffenheit der Axillae und/oder der Handinnenflächen und/oder der Fußsohlen und/oder des Stirnbereiches, symmetrisches Auftreten, kein nächtliches Schwitzen, Häufigkeit des Auftretens mindestens wöchentlich, Beginn der Erkrankung vor dem 25. Lebensjahr, positive Familienanamnese sowie Beeinträchtigung der täglichen Aktivitäten. Zur Therapie der primären Hyperhidrose werden v. a. topisch Aluminiumsalze und Anticholinergika, Leitungswasseriontophorese sowie intrakutan Botulinumtoxin angewendet. In der systemischen Therapie kommen ebenfalls verschiedene Anticholinergika zum Einsatz. Meist als Ultima-Ratio-Therapie werden chirurgische Verfahren angewendet. Außerdem sind Verfahren zur Thermolyse entwickelt worden.
Increasing numbers of trials employing anti-PD-1 immunotherapy emphasize the requirement for predictive biomarkers of clinical response. Many studies examine the cell surface expression of PD-1 and other key regulators of T-cell activation and inhibition. Here, we compared common commercially available anti-PD-1 diagnostic antibodies and tested whether they can bind the PD-1 receptor in the presence of the therapeutic antagonists pembrolizumab and nivolumab. We observed that currently no antibodies are available that can reliably stain all PD-1 receptors on T-cells from patients treated with anti-PD-1 antibodies. Furthermore, none of the diagnostic antibodies detected the entire population of PD-1+ T-cells relative to indirect staining using the therapeutic antibodies themselves. To overcome this problem, here we present a reliable method for quantifying PD-1 expression on immune cells from treated patients which can be included in any conventional flow or mass cytometry antibody panel used for patient monitoring.
Cummings, BB; Marshall, JL; Tukiainen, T; Lek, M; Donkervoort, S; Foley, AR; Bolduc, V; ... MacArthur, DG; + view all Cummings, BB; Marshall, JL; Tukiainen, T; Lek, M; Donkervoort, S; Foley, AR; Bolduc, V; Waddell, LB; Sandaradura, SA; O'Grady, GL; Estrella, E; Reddy, HM; Zhao, F; Weisburd, B; Karczewski, KJ; O'Donnell-Luria, AH; Birnbaum, D; Sarkozy, A; Hu, Y; Gonorazky, H; Claeys, K; Joshi, H; Bournazos, A; Oates, EC; Ghaoui, R; Davis, MR; Laing, NG; Topf, A; Kang, PB; Beggs, AH; North, KN; Straub, V; Dowling, JJ; Muntoni, F; Clarke, NF; Cooper, ST; Bonnemann, CG; MacArthur, DG; - view fewer (2017) Improving genetic diagnosis in Mendelian disease with transcriptome sequencing. Science Translational Medicine , 9 (386) 10.1126/scitranslmed.aa15209 . Green open access
https://ift.tt/2NeK4LJ
Duncan, L; Yilmaz, Z; Gaspar, H; Walters, R; Goldstein, J; Anttila, V; Bulik-Sullivan, B; ... Bulik, CM; + view all Duncan, L; Yilmaz, Z; Gaspar, H; Walters, R; Goldstein, J; Anttila, V; Bulik-Sullivan, B; Ripke, S; Eating Disorders Working Group of the Psychiatric Genomics Conso, ; Thornton, L; Hinney, A; Daly, M; Sullivan, PF; Zeggini, E; Breen, G; Bulik, CM; - view fewer (2017) Significant Locus and Metabolic Genetic Correlations Revealed in Genome-Wide Association Study of Anorexia Nervosa. American Journal of Psychiatry , 174 (9) pp. 850-858. 10.1176/appi.ajp.2017.16121402 . Green open access
https://ift.tt/2xeD46M
Chase, M; Meiklejohn, S; (2016) Transparency Overlays and Applications. Cryptology ePrint Archive Green open access
https://ift.tt/2Na7stL
Wilson, TE; Weedon, J; Cohen, MH; Golub, ET; Milam, J; Young, MA; Adedimeji, AA; ... Fredrickson, BL; + view all Wilson, TE; Weedon, J; Cohen, MH; Golub, ET; Milam, J; Young, MA; Adedimeji, AA; Cohen, J; Fredrickson, BL; - view fewer (2016) Positive affect and its association with viral control among women with HIV infection. Health Psychology , 36 (1) pp. 91-100. 10.1037/hea0000382 . Green open access
https://ift.tt/2xeCHJq
Braso-Maristany, F; Filosto, S; Catchpole, S; Marlow, R; Quist, J; Francesch-Domenech, E; Plumb, DA; ... Tutt, AN; + view all Braso-Maristany, F; Filosto, S; Catchpole, S; Marlow, R; Quist, J; Francesch-Domenech, E; Plumb, DA; Zakka, L; Gazinska, P; Liccardi, G; Meier, P; Gris-Oliver, A; Cheang, MCU; Perdrix-Rosell, A; Shafat, M; Noel, E; Patel, N; McEachern, K; Scaltriti, M; Castel, P; Noor, F; Buus, R; Mathew, S; Watkins, J; Serra, V; Marra, P; Grigoriadis, A; Tutt, AN; - view fewer (2016) PIM1 kinase regulates cell death, tumor growth and chemotherapy response in triple-negative breast cancer. Nature Medicine , 22 (11) pp. 1303-1313. 10.1038/nm.4198 . Green open access
https://ift.tt/2NgnlPG
Lavan, N; Rankin, G; Lorking, N; Scott, S; McGettigan, C; (2016) Neural correlates of the affective properties of spontaneous and volitional laughter types. Neuropsychologia , 95 pp. 30-39. 10.1016/j.neuropsychologia.2016.12.012 . Green open access
https://ift.tt/2xf2otz
Aydi, E; Orio, M; Beardmore, AP; Ness, J-U; Page, KL; Kuin, NPM; Walter, FM; ... Woodward, CE; + view all Aydi, E; Orio, M; Beardmore, AP; Ness, J-U; Page, KL; Kuin, NPM; Walter, FM; Buckley, DAH; Mohamed, S; Whitelock, P; Osborne, JP; Strader, J; Chomiuk, L; Darnley, MJ; Dobrotka, A; Kniazev, A; Miszalski, B; Myers, G; Ospina, N; Henze, M; Starrfield, S; Woodward, CE; - view fewer (2018) Multiwavelength observations of V407 Lupi (ASASSN-16kt) - a very fast nova erupting in an intermediate polar. Monthly Notices of the Royal Astronomical Society , 480 (1) pp. 572-609. 10.1093/mnras/sty1759 . Green open access
https://ift.tt/2NeXWFZ
Simic, G; Leko, MB; Wray, S; Harrington, CR; Delalle, I; Jovanov-Milosevic, N; Bazadona, D; ... Hof, PR; + view all Simic, G; Leko, MB; Wray, S; Harrington, CR; Delalle, I; Jovanov-Milosevic, N; Bazadona, D; Buee, L; de Silva, R; Di Giovanni, G; Wischik, CM; Hof, PR; - view fewer (2016) Monoaminergic neuropathology in Alzheimer's disease. Progress in Neurobiology , 151 pp. 101-138. 10.1016/j.pneurobio.2016.04.001 . Green open access
https://ift.tt/2xaulSY
Hewer, S; Varley, S; Boxer, AL; Paul, E; Williams, DR; AL-108-231 Investigators, ; (2016) Minimal clinically important worsening on the progressive supranuclear Palsy Rating Scale. Movement Disorders , 31 (10) pp. 1574-1577. 10.1002/mds.26694 .
https://ift.tt/2NcOOlc
Warren-Jeanpiere, L; Dillaway, H; Hamilton, P; Young, M; Goparaju, L; (2017) Life begins at 60: Identifying the social support needs of African American women aging with HIV. Journal of Health Care for the Poor and Underserved , 28 (1) pp. 389-405. 10.1353/hpu.2017.0030 . Green open access
https://ift.tt/2xgj6IH
Skeen, S; Sherr, L; Tomlinson, M; Croome, N; Ghandi, N; Roberts, JK; Macedo, A; (2017) Interventions to improve psychosocial well-being for children affected by HIV and AIDS: a systematic review. Vulnerable Child Youth Studies , 12 (2) pp. 91-116. 10.1080/17450128.2016.1276656 . Green open access
https://ift.tt/2NbzTaQ
Deming, Y; Li, Z; Kapoor, M; Harari, O; Del-Aguila, JL; Black, K; Carrell, D; ... Cruchaga, C; + view all Deming, Y; Li, Z; Kapoor, M; Harari, O; Del-Aguila, JL; Black, K; Carrell, D; Cai, Y; Fernandez, MV; Budde, J; Ma, S; Saef, B; Howells, B; Huang, K-L; Bertelsen, S; Fagan, AM; Holtzman, DM; Morris, JC; Kim, S; Saykin, AJ; De Jager, PL; Albert, M; Moghekar, A; O'Brien, R; Riemenschneider, M; Petersen, RC; Blennow, K; Zetterberg, H; Minthon, L; Van Deerlin, VM; Lee, VM-Y; Shaw, LM; Trojanowski, JQ; Schellenberg, G; Haines, JL; Mayeux, R; Pericak-Vance, MA; Farrer, LA; Peskind, ER; Li, G; Di Narzo, AF; Kauwe, JSK; Goate, AM; Cruchaga, C; - view fewer (2017) Genome-wide association study identifies four novel loci associated with Alzheimer's endophenotypes and disease modifiers. Acta Neuropathologica , 133 (5) pp. 839-856. 10.1007/s00401-017-1685-y . Green open access
https://ift.tt/2xe6WA5
Zou, J; Song, B; Simmerling, C; Raleigh, D; (2016) Experimental and Computational Analysis of Protein Stabilization by Gly-to-D-Ala Substitution: A Convolution of Native State and Unfolded State Effects. Journal of the American Chemical Society , 138 (48) pp. 15682-15689. 10.1021/jacs.6b09511 . Green open access
https://ift.tt/2NcpThG
French, JA; Koepp, M; Naegelin, Y; Vigevano, F; Auvin, S; Rho, JM; Rosenberg, E; ... Dichter, MA; + view all French, JA; Koepp, M; Naegelin, Y; Vigevano, F; Auvin, S; Rho, JM; Rosenberg, E; Devinsky, O; Olofsson, PS; Dichter, MA; - view fewer (2017) Clinical studies and anti-inflammatory mechanisms of treatments. Epilepsia , 58 pp. 69-82. 10.1111/epi.13779 . Green open access
https://ift.tt/2xnizFh
Groth, J; Kohlweiss, M; Maller, M; Meiklejohn, S; Miers, I; (2018) Updatable and universal common reference strings with applications to zk-SNARKs. In: Shacham, H and Boldyreva, A, (eds.) Advances in Cryptology – CRYPTO 2018. CRYPTO 2018. Lecture Notes in Computer Science, vol 10993. (pp. pp. 698-728). Springer: Cham.
https://ift.tt/2NepdIA
Tsai, RM; Lobach, I; Bang, J; Whitwell, JL; Senjem, ML; Jack, CR; Rosen, H; ... AL-108-231 Investigators, ; + view all Tsai, RM; Lobach, I; Bang, J; Whitwell, JL; Senjem, ML; Jack, CR; Rosen, H; Miller, B; Boxer, AL; AL-108-231 Investigators, ; - view fewer (2016) Clinical correlates of longitudinal brain atrophy in progressive supranuclear palsy. Parkinsonism & Related Disorders , 28 pp. 29-35. 10.1016/j.parkreldis.2016.04.006 . Green open access
https://ift.tt/2xatykY
McCorry, P; Hicks, A; Meiklejohn, S; (2018) Smart contracts for bribing miners. (In press). Green open access
https://ift.tt/2N8hbRr
Liu, C; Goparaju, L; Barnett, A; Wang, C; Poppen, P; Young, M; Zea, MC; (2017) Change in patterns of HIV status disclosure in the HAART era and association of HIV status disclosure with depression level among women. AIDS Care , 29 (9) pp. 1112-1118. 10.1080/09540121.2017.1307916 . Green open access
https://ift.tt/2xgKlmJ
Bandelow, B; Baldwin, D; Abelli, M; Bolea-Alamanac, B; Bourin, M; Chamberlain, SR; Cinosi, E; ... Riederer, P; + view all Bandelow, B; Baldwin, D; Abelli, M; Bolea-Alamanac, B; Bourin, M; Chamberlain, SR; Cinosi, E; Davies, S; Domschke, K; Fineberg, N; Grünblatt, E; Jarema, M; Kim, Y-K; Maron, E; Masdrakis, V; Mikova, O; Nutt, D; Pallanti, S; Pini, S; Ströhle, A; Thibaut, F; Vaghi, MM; Won, E; Wedekind, D; Wichniak, A; Woolley, J; Zwanzger, P; Riederer, P; - view fewer (2016) Biological markers for anxiety disorders, OCD and PTSD: A consensus statement. Part II: Neurochemistry, neurophysiology and neurocognition. The World Journal of Biological Psychiatry , 18 (3) pp. 162-214. 10.1080/15622975.2016.1190867 . Green open access
https://ift.tt/2xatyS0
Singh, G; Marshall, IJ; Thomas, J; Shawe-Taylor, J; Wallace, BC; (2017) A Neural Candidate-Selector Architecture for Automatic Structured Clinical Text Annotation. In: (Proceedings) ACM Conference on Information and Knowledge Management (CIKM). (pp. pp. 1519-1528). ACM Green open access
https://ift.tt/2NcmcIR