Αρχειοθήκη ιστολογίου

Πέμπτη 11 Οκτωβρίου 2018

Donor-specific Cell-Free DNA as a Biomarker in Solid Organ Transplantation. A Systematic Review

Background There is increasing interest in the use of noninvasive biomarkers to reduce the risks posed by invasive biopsy for monitoring of solid organ transplants (SOT). One such promising marker is the presence of donor-derived cell-free DNA (dd-cfDNA) in the urine or blood of transplant recipients. Methods We systematically reviewed the published literature investigating the use of cfDNA in monitoring of graft health following SOT. Electronic databases were searched for studies relating cfDNA fraction or levels to clinical outcomes, and data including measures of diagnostic test accuracy (DTA) were extracted. Narrative analysis was performed. Results 95 manuscripts from 47 studies met the inclusion criteria (18 kidney, 7 liver, 11 heart, 1 kidney-pancreas, 5 lung, and 5 multiorgan). The majority were retrospective and prospective cohort studies, with 19 reporting DTA data. Multiple techniques for measuring dd-cfDNA were reported, including many not requiring a donor sample. dd-cfDNA falls rapidly within 2 weeks, with baseline levels varying by organ type. Levels are elevated in the presence of allograft injury, including acute rejection (AR) and infection, and return to baseline following successful treatment. Elevation of cfDNA levels are seen in advance of clinically apparent organ injury. Discriminatory power was greatest for higher grades of T cell mediated and antibody-mediated AR, with high negative predictive values. Conclusions cfDNA is a promising biomarker for monitoring the health of solid-organ transplants. Future studies will need to define how it can be used in routine clinical practice and determine clinical benefit with routine prospective monitoring. Corresponding Author: Simon R Knight, Oxford Transplant Centre, Nuffield Department of Surgical Sciences, Churchill Hospital, Old Road, Headington, OX3 7LE, United Kingdom. Tel: +44 (0) 1865 227131. E-mail: simon.knight@nds.ox.ac.uk Authorship SK conceived the study, authored the study protocol, developed and performed literature searches, screened references, analysed the data and wrote the manuscript. AT participated in study design, screened references, analysed the data and participated in the writing of the manuscript. MLF participated in study design and participated in the writing of the manuscript. Disclosures The authors declare no conflicts of interest relating to the content of this article. Funding This study received no external sources of funding. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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A worldwide survey of Live liver donor selection policies at 24 centers with a combined experience of 19 009 adult living donor liver transplants

Background While surgical technique in LDLT has evolved with a focus on donor safety and recipient challenges, the donor selection criteria remain considerably disparate. Methods A questionnaire on donor selection was sent to 41 centers worldwide. 24 centers with a combined experience of 19009 LDLTs responded. Results Centers were categorized into predominantly LDLT (18) or DDLT (6), and high (10) or low volume (14) centers. At the majority of centers, the minimum acceptable GRWR was 1 features of metabolic syndrome. On biopsy, all considered macrovesicular and 50% considered microvesicular steatosis important. Nearly all (92%) rejected donors for early fibrosis, and minority for nonspecific granuloma or mild inflammation. Most anatomical anomalies except portal vein type D/E were acceptable at high volume centers. There was no standard policy for pre or peroperative cholangiogram. Conclusions This first large live liver donor survey provides insight into donor selection practices that may aid standardization between centers, with potential expansion of the donor pool without compromising safety. Corresponding author: Dr. AS Soin, Chairman, Chief Liver Transplant and Hepatobiliary Surgeon, Medanta Institute of Liver Transplantation and Regenerative Medicine, Medanta-The Medicity, Gurgaon, Haryana 122001, India. e-mail IDs: absoin@gmail.com, arvinder.soin@medanta.org Authorship Page 1 Dr. Arvinder Singh Soin. FRCS. Chairman, Medanta Institute of Liver Transplantation and Regenerative Medicine, Medanta-The Medicity, Gurgaon, Haryana 122001, India. e-mail ID: absoin@gmail.com. 2. Dr. Rohan Jagat Chaudhary. MS. Associate Consultant, Medanta Institute of Liver Transplantation and Regenerative Medicine, Medanta-The Medicity, Gurgaon, Haryana 122001, India. e-mail ID: rohanjc1@gmail.com. 3. Dr. Hirak Pahari. MS. Fellow, Medanta Institute of Liver Transplantation and Regenerative Medicine, Medanta-The Medicity, Gurgaon, Haryana 122001, India. e-mail ID: hirak.pahari@gmail.com. 4. Dr. Elizabeth Pomfret. MD. Division of Transplant Surgery, University of Colorado School of Medicine, 1635 Aurora Court, Aurora, CO, 80045, USA. E-mail ID: elizabeth.pomfret@ucdenver.edu Contributions: AS Soin: Conception of the work; data analysis and interpretation. Drafting the work, critical revision for important intellectual content and final approval of the version to be published. R J Chaudhary: Data acquisition, analysis and interpretation, drafting and final approval. H Pahari: Data acquisition, analysis and interpretation, drafting and final approval. E A Pomfret: Conception, critical revision and final approval of the version to be published. Disclosures: None. No conflict of interest. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

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High-flow oxygen via tracheostomy facilitates weaning from prolonged mechanical ventilation in patients with restrictive pulmonary dysfunction: two case reports

Weaning from prolonged mechanical ventilation is extremely difficult in tracheostomized patients with restrictive pulmonary dysfunction. High-flow oxygen via tracheostomy supplies heated and humidified oxygen ...

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Facets of Innate Immunity to Viral Infection

Viral Immunology, Ahead of Print.


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Understanding the Role of Antiviral Cytokines and Chemokines on Neural Stem/Progenitor Cell Activity and Survival

Viral Immunology, Ahead of Print.


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October iotaderma (#296)



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November Iotaderma (#297)



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Seasonal patterns in alopecia areata, totalis, and universalis

To the Editor: Although seasonal patterns of pediatric alopecia areata (AA), totalis (AT), and universalis (AU) have been suspected clinically, there is limited research about whether disease flares follow a temporal pattern.1-3 Patients and families report increased hair loss during the winter, with cycles of regrowth in summer months. Through retrospective review of medical records, we sought to identify whether AA, AT, and AU flares show seasonal variation in pediatric patients and to characterize temporal patterns.

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Answers to CME examination



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Editorial Board



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CME examination



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Table of Contents



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CME examination



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Information for Readers



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Answers to CME examination



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JAAD Case Reports Article List



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Lichen planus and lichenoid dermatoses

Having reviewed the diverse clinical subtypes of lichenoid disease and the postulated molecular basis thereof in the first article in this 2-part continuing medical education series, we discuss herein the existing and emerging treatment strategies in the most common clinical forms of lichenoid inflammation and provide an overview of their pharmacodynamics and evidence base. The scope of this review is not to exhaustively discuss treatment modalities for all lichenoid variants discussed in the previous article of this series.

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Journal Based CME Instructions and Information



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Announcement: A New Section Entitled Technology Pearls



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Dermatology Calendar



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Lichen planus and lichenoid dermatoses

Deriving from the Greek word λειχήν for "tree moss" and the Latin word planus for "planar," lichen planus is a relatively uncommon and heterogeneous cutaneous disorder that typically develops in middle-aged adults. Despite the significant clinical burden associated with the disorder, little well-conducted molecular research has been undertaken, possibly because of heterogeneity impeding consistent and confident phenotyping. The multiple variants of lichenoid disease bear overlapping clinical and pathologic features despite manifesting as distinct clinical disorders.

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What is a Pediatric Dentist?

Taking your child to their first dentist appointment is an exciting milestone. However, it may also bring about many questions. Should you see a pediatric dentist or a general dentist? Is there a difference? Dr. Emily Hahn answers all of the common questions parents ask about pediatric dentistry.

The post What is a Pediatric Dentist? appeared first on ChildrensMD.



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Occurrence of aflatoxins in rice and in cassava ( Manihot esculenta ) products (meal, bread) produced in Guyana

Abstract

A survey was conducted on Guyana's main staple foods, rice, cassava meal and cassava bread to determine the presence and concentration of aflatoxins (AFs) using enzyme-linked immunosorbent assay (ELISA) and high-performance liquid chromatography (HPLC) with fluorescence detection for concurrence. Aflatoxins are secondary metabolites of the fungus Aspergillus and can be a health risk to humans and animals. Results were compared with European Union Commission (EUC) maximum levels of total aflatoxins of 10 μg/kg. Various types of rice (paddy, steamed paddy, cargo rice, white rice and parboiled rice) were randomly collected either directly from the field and rice mills in Guyana during the November 2015/March 2016 season. Of the total 186 composite samples of rice fractions collected from field and mills, 10% (19) had AF concentrations greater than the maximum EUC level of 10 μg/kg. Fifteen samples had aflatoxin concentrations ranging from 10 to 171 μg/kg, mean 54.4 μg/kg; four samples were outliers. Since Guyanese consume mainly white and parboiled rice, composite samples were taken along the marketing chain at points of sale to determine the presence of AFs. Of the sixty samples of white rice collected, 6.7% (4) had AF concentrations greater than the EUC regulatory limits ranging from 31.9 to 131 μg/kg, mean 80.8 μg/kg. For the 57 samples of parboiled rice, 3.5% (2) samples exceeded the limit with values of 72.6 and 407 μg/kg. Forty (40) samples each of cassava meal and cassava bread were analysed fresh and after 2 months of storage, and no sample exceeded the ELISA detection limit of 0.5 μg/kg.



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Soluble CTLA-4 as a favorable predictive biomarker in metastatic melanoma patients treated with ipilimumab: an Italian melanoma intergroup study

Abstract

CTLA-4 blockade by means of ipilimumab (IPI) potentiates the immune response and improves overall survival (OS) in a minority of metastatic melanoma (MM) patients. We investigated the role of soluble CTLA-4 (sCTLA-4) as a possible biomarker for identifying this subset of patients. sCTLA-4 levels were analyzed at baseline in sera from 113 IPI-treated MM patients by ELISA, and the median value (200 pg/ml) was used to create two equally sized subgroups. Associations of sCTLA-4 with best overall response (BOR) to IPI and immune-related adverse events (irAEs) were evaluated through logistic regression. Kaplan–Meier and Cox regression methods were used to analyze OS. A remarkable association between sCTLA-4 levels and BOR was found. Specifically, the proportion of patients with sCTLA-4 > 200 pg/ml in irSD or irPD (immune-related stable or progressive disease) was, respectively, 80% (OR = 0.23; 95%CL = 0.03–1.88) and 89% (OR = 0.11; 95%CL = 0.02–0.71) and was lower than that observed among patients in irCR/irPR (immune-related complete/partial response). sCTLA-4 levels increased during IPI treatment, since the proportion of patients showing sCTLA > 200 pg/ml after 3 cycles was 4 times higher (OR = 4.41, 95%CL = 1.02–19.1) than that after 1 cycle. Moreover, a significantly lower death rate was estimated for patients with sCTLA-4 > 200 pg/ml (HR = 0.61, 95%CL = 0.39–0.98). Higher baseline sCTLA-4 levels were also associated with the onset of any irAE (p value = 0.029), in particular irAEs of the digestive tract (p value = 0.041). In conclusion, our results suggest that high sCTLA-4 serum levels might predict favorable clinical outcome and higher risk of irAEs in IPI-treated MM patients.



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Duration of Antibiotic Therapy and Major Surgical Site Infection in Cochlear Implantation

This cohort study describes the rates of major surgical site infection for patients undergoing cochlear implantation who receive prolonged antibiotic treatment compared with those who receive a single perioperative dose of antibiotic prophylaxis.

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Limitations to Association of Airway Disease Risk With Removal of Adenoids and Tonsils in Children

To the Editor Byars et al recently published a large case-control study based on data from Danish health registries. We believe that several important limitations in the study need to be addressed.

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Association of Proton Pump Inhibitors With Hospitalization Risk in Children With Oropharyngeal Dysphagia

This retrospective cohort study of 293 children with oropharyngeal dysphagia examines hospitalization risk for those treated with proton pump inhibitors compared with those who were not.

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Limitations to Association of Airway Disease Risk With Removal of Adenoids and Tonsils in Children—Reply

In Reply Four main issues were raised by Kitipornchai and Mackay and Lüscher et al. All of them appear invalid as challenges of our main results.

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Empirical Proton Pump Inhibitor Therapy

For over a decade, publications in medical literature have raised several concerns regarding the use of proton pump inhibitors (PPIs). More recently, the pace of publication has quickened. This class of medications has been associated with pulmonary and gastrointestinal negative effects both in adults and children. For children, concern exists regarding elevated rates of viral and bacterial infections of the gastrointestinal tract, including Clostridium difficile, as well as increases in bacterial pneumonia. Changes in the microbiome may be related to these negative effects, and the length of PPI use may not matter. Although these concerns have been raised through studies that demonstrate correlation rather than cause and effect, word is getting out in gastroenterology, pediatrics, and neonatology. These findings have spread more slowly to those closely related fields of pulmonology and otolaryngology. These are fields in which physicians may be very comfortable and familiar with prescribing this class of medications to their pediatric patients, yet may be less aware of possible adverse effects than gastroenterologists and pediatricians.

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Notice of Retraction for Schietroma et al

This Notice of Retraction is to retract an article by Schietroma et al.

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Limitations to Association of Airway Disease Risk With Removal of Adenoids and Tonsils in Children

To the Editor The conclusion by Byars et al that the children who have had adenoidectomy and/or tonsillectomy are at a greater lifetime risk of airway disease may be supported by their data; however, their implication that surgery is causally related to this incidence is unfounded.

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Comparison of Objective Outcomes in Dynamic Lower Facial Surgical Reanimation

This case series describes the use of temporalis tendon transfer or gracilis free muscle transfer to adjust the vector of smile and commissure position in patients with facial paralysis.

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The clinical value of assays detecting antibodies against domain I of β2-glycoprotein I in the antiphospholipid syndrome

Publication date: Available online 11 October 2018

Source: Autoimmunity Reviews

Author(s): Dongmei Yin, Bas de Laat, Katrien M.J. Devreese, Hilde Kelchtermans

Abstract

As the clinical symptoms of the antiphospholipid syndrome (APS) frequently occur irrespective of the syndrome, diagnosis predominantly depends on the laboratory assays measuring the level or function of antiphospholipid antibodies (aPLs). β2-glycoprotein I (β2GPI) is increasingly accepted as the most important target of aPLs. Anti-β2GPI antibodies constitute a heterogeneous population, but current in vivo and in vitro evidence show that especially the first domain (DI) of β2GPI contains an important pathogenic epitope. This epitope containing Glycine40-Arginine43 (G40-R43) has proven to be cryptic and only exposed when β2GPI is in its open conformation. A previous study demonstrated a highly variable exposure of the cryptic epitope in commercial anti-β2GPI assays, with implications on correct patient classification. Unexpectedly, recent unpublished data revealed impaired exposure of the pathogenic epitope in the commercially available anti-DI chemiluminescence immunoassay (CIA) assay detecting specific antibodies directed to DI.

In this review we summarize the laboratory and clinical performance characteristics of the different anti-DI assays in published data and conclude with inconsistent results for both the correlation of anti-DI antibodies with clinical symptoms and the added value of anti-DI antibodies in the classification criteria of APS. Additionally, we hypothesize on possible explanations for the observed discrepancies. Finally, we highly advise manufacturers to use normal pooled plasma spiked with the monoclonal anti-DI antibodies to verify correct exposure of the cryptic epitope.



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Conditioned fear stress increases bone resorption in apical periodontitislesions in Wistar male rats

Publication date: Available online 10 October 2018

Source: Archives of Oral Biology

Author(s): Emisael Stênio Batista Gomes, Lucyana Conceição Farias, Luiz Henrique Silveira, Carlos Ícaro de Jesus, Rogério Gonçalves da Rocha, Guilherme Veloso Ramos, Hanna Thaynara Alves Teixeira Magalhães, Manoel Brito-Júnior, Sérgio Henrique Sousa Santos, Bruno Correia Jham, Alfredo Maurício Batista de Paula, André Luiz Sena Guimarães

Abstract
Objective

Because the impact of conditioned fear stress on apical bone resorption is unknown, the aim of the current studywas to use a rat model to evaluate the impact of conditioned fear stress on the bone resorption of inflammatory apical periodontitis lesions.

Methods

Twenty-five animals were divided into two groups. They underwent a surgical procedure in the first left lower molar tooth to expose the dental pulp and induce inflammatory apical periodontitis lesions through the retention of contamination (bacterial infection) during a 56-day period. The animals in the case group were stressed daily by using electrical stimuli (1.10 mA), whereas the animals in the control group were absent from the stressful stimuli (shocks). The open field test was performed to validate the stress methodology. The jaws were removed and collected for histological and radiographic analyses.

Results

Stressed animals presented increased levels of bone loss and inflammatory cells in the root apex in comparison with the control group (P = 0.0001). However, no radiographic differences were observed between the groups (P > 0.05).

Conclusions

Our results demonstrated that conditioned fear stress could modify a periapical lesion by increasing the size of bone loss there. Conditioned fear stress also increased the total number of inflammatory cells compared with the control group. Studies evaluating the impact of conditioned fear stress on human periapical inflammatory lesions should be encouraged.



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Compensatory interactions between developing maxillary anterior teeth in a sample of twins

Publication date: Available online 10 October 2018

Source: Archives of Oral Biology

Author(s): Marianne Tadros, Alan H Brook, Sarbin Ranjitkar, Grant C Townsend

Abstract
Objectives

The objective of this study was to revisit the topic of compensatory interactions between maxillary anterior teeth during development advanced by Sofaer et al. (1971). We addressed the hypotheses listed by Sofaer and colleagues using data derived from our Australian twin sample to investigate whether final tooth size in permanent maxillary central incisors and canines showed evidence of developmental compensation for adjacent missing or microdont lateral incisors. Such compensation is one factor interacting in the complex system of dental development.

Materials and methods

A 2D image analysis system was used to measure crown height from the labial view, labiopalatal crown width from the incisal view, and mesiodistal crown width from both the labial (MDl) and incisal (MDi) views of the permanent maxillary central incisors and canines on the dental study model of twins enrolled in a longitudinal study of dental development.

Results

Developmental variations of maxillary lateral incisors influence the morphogenesis of the adjacent teeth. For example, individuals with one missing lateral incisor and one lateral incisor of average dimensions, had significantly larger central incisors than the control group for the MDl and MDi dimensions (p < 0.05). Of the 7 monozygotic twin pairs, 6 were discordant in maxillary anterior hypodontia and microdontia, and 13 out of 14 dizygotic twin pairs were discordant.

Conclusions

This study provides further evidence of developmental interactions in the maxillary anterior region, partially supporting Sofaer and colleagues' hypotheses. These interactions are part of a complex adaptive system involving genetic, epigenetic and environmental factors.



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microRNA-199a may be involved in the pathogenesis of lupus nephritis via modulating the activation of NF-κB by targeting Klotho

Publication date: November 2018

Source: Molecular Immunology, Volume 103

Author(s): Hong Ye, Bofeng Su, Haizhen Ni, Linlin Li, Xuduan Chen, Xiaohan You, Huidi Zhang

Abstract

Klotho is considered to have renal protective effect by prohibiting the activation of the nuclear factor (NF)-κB pathway, while the role of microRNA-199a (miR-199a)/Klotho in lupus nephritis (LN) is still unknown. A single dose of pristane (0.5 ml) was intraperitoneally injected into 8 weeks-old female mice to establish the LN model. MiR-199a mimic or miR-199a inhibitor, Klotho plasmid or Klotho siRNA, and miR-199a inhibitor plus si-Klotho were transfected into lipopolysaccharides (LPS) stimulated human embryonic kidney 293 T (HEK293 T) cells. Western Blot was adopted to measure p-P65 expression. Tumor necrosis factor (TNF)-α and interleukin (IL)-1β in the supernatant were determined by enzyme-linked immunosorbent assay (ELISA). The expression of Klotho was suppressed by miR-199a through direct binding to the three prime untranslated regions (3'-UTR). The high miR-199a level was accompanied by low Klotho expression in the LN kidney. MiR-199a promoted LPS-induced NF-κB activation and improved the secretion of TNF-α and IL-1β by regulation of Klotho in HEK293 T cells. If miR-199a antagomir was administrated after 48 h of pristane administration, the expression of p-P65 and the secretion of TNF-α and IL-1β were significantly down-regulated in LN kidney. Although the direct involvement and detailed mechanism of miR-199a in LN still need further investigation, our data show that MiR-199a could regulate the activation of NF-κB by directly targeting Klotho.



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Donor white blood cell survival and cytokine profiles following red blood cell transfusion in Australian major trauma patients

Publication date: November 2018

Source: Molecular Immunology, Volume 103

Author(s): Rena Hirani, Melinda M. Dean, Zsolt J. Balogh, Natalie J. Lott, Julie Seggie, Jeremy M. Hsu, Susan Taggart, Peter Maitz, Lesley Survela, Anthony Joseph, Mark Gillett, David O. Irving

Abstract
Background

The potential for the co-existence of genetically disparate cells (microchimerism) and associated cytokine profiles following red blood cell (RBC) transfusion in trauma patients has not been well characterized to date. This study investigated the incidence of surviving donor white blood cells (known as transfused-associated microchimerism (TAM)) and cytokine changes following blood transfusion in trauma patients.

Study design and methods

Trauma patients with an injury severity score (ISS) >12 who had been transfused between 2012–2016 with at least 5 units of RBC units over a 4 h period were recruited. Trauma patients with ISS > 12 who did not require blood transfusion were recruited as controls. The incidence of TAM was determined using a panel of insertion/deletion (InDel) bi-allelic polymorphisms. Selected pro- and anti-inflammatory cytokine profiles were analyzed using cytometric bead array.

Results

The transfused cohort (n = 40) had median ISS of 28 [12–66], received a median of 11 RBC units [4–114] and had median hospital length of stay of 35 days [1–152]. Only 11 (27.5%) patients returned for follow-up blood sampling after discharge. Of these, one patient showed an InDel pattern indicating the presence of TAM. No patients in the control cohort (n = 49) showed TAM. Cytokines IL-10 and IL-6 were found to be elevated in the transfused trauma patients.

Conclusion

In this cohort, TAM was found to occur in one patient of the 11 who received a blood transfusion. Elevated IL-6 and IL-10 cytokines were detected in those patients who were transfused. However, the incidence of TAM could not be correlated with the elevated cytokine profiles for this cohort.



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Lesion of the thyroid cartilage

Publication date: Available online 10 October 2018

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): Z. Cavallier, J. Sarini, V. Maisongrosse, A. Dupret-Bories



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Safety profile after prolonged C3 inhibition

Publication date: December 2018

Source: Clinical Immunology, Volume 197

Author(s): Edimara S. Reis, Nadja Berger, Xin Wang, Sophia Koutsogiannaki, Robert K. Doot, Justin T. Gumas, Periklis G. Foukas, Ranillo R.G. Resuello, Joel V. Tuplano, David Kukis, Alice F. Tarantal, Anthony J. Young, Tetsuhiro Kajikawa, Athena M. Soulika, Dimitrios C. Mastellos, Despina Yancopoulou, Ali-Reza Biglarnia, Markus Huber-Lang, George Hajishengallis, Bo Nilsson

Abstract

The central component of the complement cascade, C3, is involved in various biological functions, including opsonization of foreign bodies, clearance of waste material, activation of immune cells, and triggering of pathways controlling development. Given its broad role in immune responses, particularly in phagocytosis and the clearance of microbes, a deficiency in complement C3 in humans is often associated with multiple bacterial infections. Interestingly, an increased susceptibility to infections appears to occur mainly in the first two years of life and then wanes throughout adulthood. In view of the well-established connection between C3 deficiency and infections, therapeutic inhibition of complement at the level of C3 is often considered with caution or disregarded. We therefore set out to investigate the immune and biochemical profile of non-human primates under prolonged treatment with the C3 inhibitor compstatin (Cp40 analog). Cynomolgus monkeys were dosed subcutaneously with Cp40, resulting in systemic inhibition of C3, for 1 week, 2 weeks, or 3 months. Plasma concentrations of both C3 and Cp40 were measured periodically and complete saturation of plasma C3 was confirmed. No differences in hematological, biochemical, or immunological parameters were identified in the blood or tissues of animals treated with Cp40 when compared to those injected with vehicle alone. Further, skin wounds showed no signs of infection in those treated with Cp40. In fact, Cp40 treatment was associated with a trend toward accelerated wound healing when compared with the control group. In addition, a biodistribution study in a rhesus monkey indicated that the distribution of Cp40 in the body is associated with the presence of C3, concentrating in organs that accumulate blood and produce C3. Overall, our data suggest that systemic C3 inhibition in healthy adult non-human primates is not associated with a weakened immune system or susceptibility to infections.



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Significance of IgG4-positive cells in severe eosinophilic chronic rhinosinusitis

Publication date: Available online 11 October 2018

Source: Allergology International

Author(s): Takahisa Koyama, Shin Kariya, Yasuharu Sato, Yuka Gion, Takaya Higaki, Takenori Haruna, Tazuko Fujiwara, Akira Minoura, Soshi Takao, Yorihisa Orita, Kengo Kanai, Masami Taniguchi, Kazunori Nishizaki, Mitsuhiro Okano

Abstract
Background

IgG4 production is regulated by type 2 (IL-4 and IL-13) and regulatory (IL-10) cytokines involved in the pathophysiology of chronic rhinosinusitis (CRS). We sought to determine the pathophysiological characteristics of IgG4-positive cells in sinonasal tissues in CRS, especially eosinophilic CRS (ECRS).

Methods

IgG4-positive cells in uncinate tissues (UT) and nasal polyps (NP) were examined by immunohistochemistry. Associations between the number of IgG4-positive cells and clinicopathological factors were analyzed. Receiver operating characteristics (ROC) analysis was performed to determine the cut-off value of IgG4-positive cells in tissue that can predict the post-operative course.

Results

IgG4 was mainly expressed in infiltrating plasma and plasmacytoid cells, and the number of IgG4-positive cells was significantly higher in NP, especially those from severe ECRS patients, than in UT. In CRS patients, the number of IgG4-positive cells significantly and positively correlated with blood and tissue eosinophilia, radiological severity, and serum level of total IgE. The number of infiltrating IgG4-positive cells was significantly higher in patients with a poor post-operative course (sustained sinus shadow 6 months after surgery) than in those with a good one. The number of IgG4-positive cells in NP could discriminate patients with a good or a poor post-operative course (area under the curve: 0.769). Also, 73.3% sensitivity and 82.5% specificity were achieved when the cut-off value was set at 17 cells/high-power field.

Conclusions

Our results suggest that the local expression of IgG4 on cells may be used as a biomarker that reflects the pathophysiology of CRS, including the post-operative course.



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A successful microsurgical approach to treating penile amputation following genital self mutilation

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Abstract
We present the case of a 33-year-old male who presented to the Emergency Department having amputated his penis as a result of auditory hallucinations triggered by cannabis use. A successful microsurgical technique involving anastomosing the individual structures of the penile shaft enabled a successful cosmetic and functional outcome including restoration of erectile function.

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Complete unilateral ureteral duplication encountered during intersphincteric resection for low rectal cancer

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Abstract
Complete duplication of ureters is a very rare clinical entity that may either be asymptomatic or present with a variety of clinical findings. In the presented case a 51-year-old Caucasian female underwent an intersphincteric resection for low rectal cancer. Intraoperatively, during the standard bilateral recognition and mobilization of the ureters, complete unilateral duplication of the left ureter was incidentally detected, deriving from a single renal parenchyma. Such a congenital abnormality though constitutes a major risk-factor of accidental ureteral injury during operations including pelvis. Conclusively, meticulous exposure of both ureters combined with surgeons' unceasing awareness constitute the cornerstone of a safe operation.

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High-grade angiosarcoma presenting with cytology-negative hemorrhagic ascites

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Abstract
Angiosarcomas are a rare subtype of soft-tissue sarcomas originating from the vascular endothelium. Both retroperitoneal and omental angiosarcomas tend to be aggressive and rapidly fatal if not amenable to early intervention. In this report, we describe an unusual case of high-grade angiosarcoma with cytology-negative hemorrhagic ascites and diffuse omental invasion. Multiple investigations into the origin of the hemorrhagic ascites, including cytological analysis, tumor marker measurements, serum-ascites albumin gradient calculation and frozen section pathological examination, failed to reveal a diagnosis. We conclude that malignancy should be considered in the differential diagnosis in the presence of suspicious cytology-negative hemorrhagic ascites and concomitant retroperitoneal and abdominal findings.

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Distraction osteogenesis for brachymetatarsia using initial circular fixator and early trans-fixation metatarsal K—wires—a series of three cases†

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Abstract
Brachymetatarsia is a rare forefoot deformity predominantly affecting the fourth metatarsal. Current treatment include gradual lengthening by distraction osteogenesis using an external fixator or single-stage lengthening with bone grafting or a combination of the above two procedures. Our aim was to assess outcomes and complications of a novel technique for gradual metatarsal lengthening using a circular fixator. The procedure was performed on three female patients with unilateral congenital shortening of the fourth ray. All participants reported aesthetic dissatisfaction as well as pressure related complications of the deformity and opted for lengthening and distraction osteogenesis using a frame. Mean duration of the treatment was 122 days and average length gained was 12 mm. The desired metatarsal length was achieved in all three patients with no significant complications. This method of treatment of brachymetatarsia is effective and reproducible. This a promising technique, owing to its low complication rates and efficacy in lengthening.

https://ift.tt/2QHHcVa

The Microbiome and Radiation Induced-Bowel Injury: Evidence for Potential Mechanistic Role in Disease Pathogenesis

Kumagai, T; Rahman, F; Smith, AM; (2018) The Microbiome and Radiation Induced-Bowel Injury: Evidence for Potential Mechanistic Role in Disease Pathogenesis. Nutrients , 10 (10) , Article 1405. 10.3390/nu10101405 . Green open access

https://ift.tt/2Eam9ZM

The Impact of Exposure to Media Coverage of the 2012 Paralympic Games on Mixed Physical Ability Interactions

Carew, MT; Noor, M; Burns, J; (2018) The Impact of Exposure to Media Coverage of the 2012 Paralympic Games on Mixed Physical Ability Interactions. Journal of Community and Applied Social Psychology (In press).

https://ift.tt/2RIAAXS

Country-level welfare-state measures and change in wellbeing following work exit in early old age: evidence from 16 European countries

Richardson, S; Carr, E; Netuveli, G; Sacker, A; (2018) Country-level welfare-state measures and change in wellbeing following work exit in early old age: evidence from 16 European countries. International Journal of Epidemiology 10.1093/ije/dyy205 . (In press). Green open access

https://ift.tt/2EalSGe

Genome-wide association studies and CRISPR/Cas9-mediated gene editing identify regulatory variants influencing eyebrow thickness in humans

Wu, S; Zhang, M; Yang, X; Peng, F; Zhang, J; Tan, J; Yang, Y; ... Wang, S; + view all Wu, S; Zhang, M; Yang, X; Peng, F; Zhang, J; Tan, J; Yang, Y; Wang, L; Hu, Y; Peng, Q; Li, J; Liu, Y; Guan, Y; Chen, C; Hamer, MA; Nijsten, T; Zeng, C; Adhikari, K; Gallo, C; Poletti, G; Schuler-Faccini, L; Bortolini, M-C; Canizales-Quinteros, S; Rothhammer, F; Bedoya, G; González-José, R; Li, H; Krutmann, J; Liu, F; Kayser, M; Ruiz-Linares, A; Tang, K; Xu, S; Zhang, L; Jin, L; Wang, S; - view fewer (2018) Genome-wide association studies and CRISPR/Cas9-mediated gene editing identify regulatory variants influencing eyebrow thickness in humans. PLoS Genetics , 14 (9) , Article e1007640. 10.1371/journal.pgen.1007640 . (In press). Green open access

https://ift.tt/2RJCqrA

Stillbirth: understand, standardise, educate - time to end preventable harm

Siassakos, D; Silver, R; Dudley, D; Flenady, V; Erwich, JJ; Joseph, KS; (2018) Stillbirth: understand, standardise, educate - time to end preventable harm. BJOG: An International Journal of Obstetrics and Gynaecology , 125 (2) p. 99. 10.1111/1471-0528.15028 .

https://ift.tt/2Edcbqx

Encoding of locomotion kinematics in the mouse cerebellum

Muzzu, T; Mitolo, S; Gava, GP; Schultz, SR; (2018) Encoding of locomotion kinematics in the mouse cerebellum. PLoS One , 13 (9) 10.1371/journal.pone.0203900 . Green open access

https://ift.tt/2RJCkjI

A multicenter comparison of quantification methods for antisense oligonucleotide-induced DMD exon 51 skipping in Duchenne muscular dystrophy cell cultures

Hiller, M; Falzarano, MS; Garcia-Jimenez, I; Sardone, V; Verheul, RC; Popplewell, L; Anthony, K; ... Spitali, P; + view all Hiller, M; Falzarano, MS; Garcia-Jimenez, I; Sardone, V; Verheul, RC; Popplewell, L; Anthony, K; Ruiz-Del-Yerro, E; Osman, H; Goeman, JJ; Mamchaoui, K; Dickson, G; Ferlini, A; Muntoni, F; Aartsma-Rus, A; Arechavala-Gomeza, V; Datson, NA; Spitali, P; - view fewer (2018) A multicenter comparison of quantification methods for antisense oligonucleotide-induced DMD exon 51 skipping in Duchenne muscular dystrophy cell cultures. PLoS One , 13 (10) , Article e0204485. 10.1371/journal.pone.0204485 . Green open access

https://ift.tt/2Eccl1i

Living with spina bifida: the view of people aged between 18 and 33

Alderson, P; (1998) Living with spina bifida: the view of people aged between 18 and 33. Links (178) pp. 18-20.

https://ift.tt/2RJgqNb

Making stillbirths visible: a systematic review of globally reported causes of stillbirth

Reinebrant, HE; Leisher, SH; Coory, M; Henry, S; Wojcieszek, AM; Gardener, G; Lourie, R; ... Flenady, V; + view all Reinebrant, HE; Leisher, SH; Coory, M; Henry, S; Wojcieszek, AM; Gardener, G; Lourie, R; Ellwood, D; Teoh, Z; Allanson, E; Blencowe, H; Draper, ES; Erwich, JJ; Froen, JF; Gardosi, J; Gold, K; Gordijn, S; Gordon, A; Heazell, AEP; Khong, TY; Korteweg, F; Lawn, JE; McClure, EM; Oats, J; Pattinson, R; Pettersson, K; Siassakos, D; Silver, RM; Smith, GCS; Tuncalp, OE; Flenady, V; - view fewer (2018) Making stillbirths visible: a systematic review of globally reported causes of stillbirth. BJOG: An International Journal of Obstetrics and Gynaecology , 125 (2) pp. 212-224. 10.1111/1471-0528.14971 .

https://ift.tt/2EfY8AB

Decomposing sensorimotor variability changes in ageing and their connection to falls in older people

Lin, C-H; Faisal, AA; (2018) Decomposing sensorimotor variability changes in ageing and their connection to falls in older people. Scientific Reports , 8 , Article 14546. 10.1038/s41598-018-32648-z . Green open access

https://ift.tt/2RIAy2c

Bioprocessing strategies to enhance the challenging isolation of neuro-regenerative cells from olfactory mucosa

Georgiou, M; Reis, JND; Wood, R; Esteban, PP; Roberton, V; Mason, C; Li, D; ... Wall, I; + view all Georgiou, M; Reis, JND; Wood, R; Esteban, PP; Roberton, V; Mason, C; Li, D; Li, Y; Choi, D; Wall, I; - view fewer (2018) Bioprocessing strategies to enhance the challenging isolation of neuro-regenerative cells from olfactory mucosa. Scientific Reportsvolume , 8 , Article 14440. 10.1038/s41598-018-32748-w . Green open access

https://ift.tt/2EdpcR1

Digital technologies: Implications for educational organisations and settings in the twenty-first century

Male, T; (2016) Digital technologies: Implications for educational organisations and settings in the twenty-first century. EducationalFutures , 7 (3) pp. 5-25. Green open access

https://ift.tt/2RIniuc

Vps34/PI3KC3 deletion in kidney proximal tubules impairs apical trafficking and blocks autophagic flux, causing a Fanconi-like syndrome and renal insufficiency

Grieco, G; Janssens, V; Chevronnay, HPG; N'Kuli, F; Van Der Smissen, P; Wang, T; Shan, J; ... Courtoy, PJ; + view all Grieco, G; Janssens, V; Chevronnay, HPG; N'Kuli, F; Van Der Smissen, P; Wang, T; Shan, J; Vainio, S; Bilanges, B; Jouret, F; Vanhaesebroeck, B; Pierreux, CE; Courtoy, PJ; - view fewer (2018) Vps34/PI3KC3 deletion in kidney proximal tubules impairs apical trafficking and blocks autophagic flux, causing a Fanconi-like syndrome and renal insufficiency. Scientific Reports , 8 , Article 14133. 10.1038/s41598-018-32389-z . Green open access

https://ift.tt/2EfY5Vr

Genome-wide association study identifies glutamate ionotropic receptor GRIA4 as a risk gene for comorbid nicotine dependence and major depression

Zhou, H; Cheng, Z; Bass, N; Krystal, JH; Farrer, LA; Kranzler, HR; Gelernter, J; (2018) Genome-wide association study identifies glutamate ionotropic receptor GRIA4 as a risk gene for comorbid nicotine dependence and major depression. Translational Psychiatryvolume , 8 (1) , Article 208. 10.1038/s41398-018-0258-8 . Green open access

https://ift.tt/2RIn5ao

Screening for potential susceptibility to rubella in an antenatal population: A multivariate analysis

Snell, LB; Smith, C; Chaytor, S; McRae, K; Patel, M; Griffiths, P; (2017) Screening for potential susceptibility to rubella in an antenatal population: A multivariate analysis. Journal of Medical Virology , 89 (9) pp. 1532-1538. 10.1002/jmv.24818 . Green open access

https://ift.tt/2Ed4AIH

Stability of periodic travelling flexural-gravity waves in two dimensions

Vanden-Broeck, J; Trichtchenko, O; Milewski, P; Parau, E; (2018) Stability of periodic travelling flexural-gravity waves in two dimensions. Studies in Applied Mathematics (In press).

https://ift.tt/2RIrvyk

Positive reinforcement targeting abstinence in substance misuse (PRAISe): Study protocol for a Cluster RCT & process evaluation of contingency management

Metrebian, N; Weaver, T; Pilling, S; Hellier, J; Byford, S; Shearer, J; Mitcheson, L; ... Strang, J; + view all Metrebian, N; Weaver, T; Pilling, S; Hellier, J; Byford, S; Shearer, J; Mitcheson, L; Astbury, M; Bijral, P; Bogdan, N; Bowden-Jones, O; Day, E; Dunn, J; Finch, E; Forshall, S; Glasper, A; Morse, G; Akhtar, S; Bajaria, J; Bennett, C; Bishop, E; Charles, V; Davey, C; Desai, R; Goodfellow, C; Hague, F; Little, N; McKechnie, H; Morris, J; Mosler, F; Mutz, J; Pauli, R; Poovendran, D; Slater, E; Strang, J; - view fewer (2018) Positive reinforcement targeting abstinence in substance misuse (PRAISe): Study protocol for a Cluster RCT & process evaluation of contingency management. Contemporary Clinical Trials , 71 pp. 124-132. 10.1016/j.cct.2018.06.008 .

https://ift.tt/2Ed4CQP

The Sentiment Cocoon: A Case Study of Media Architectural Interfaces

Behrens, M; Mavromichalis, K; Fatah gen. Schieck, A; (2018) The Sentiment Cocoon: A Case Study of Media Architectural Interfaces. In: (Proceedings) Media Architecture Biennale. ACM (In press). Green open access

https://ift.tt/2RH0ZoM

Better Conversations with Aphasia: What are the interactional challenges of Wernicke’s aphasia and how do people deal with them?

Beeke, SL; Maxim, J; Bruns, C; Johnson, F; Beckley, F; Sirman, N; Edwards, S; Beeke, SL; Maxim, J; Bruns, C; Johnson, F; Beckley, F; Sirman, N; Edwards, S; Best, W; - view fewer (2018) Better Conversations with Aphasia: What are the interactional challenges of Wernicke's aphasia and how do people deal with them? Presented at: International Aphasia Rehabilitation Conference (IARC), Aveiro, Portugal.

https://ift.tt/2Enh6Fk

Financial crises as herds: overturning the critiques

Chari, VV; Kehoe, PJ; (2004) Financial crises as herds: overturning the critiques. Journal of Economic Theory , 119 (1) pp. 128-150. 10.1016/S0022-0531(03)00225-4 . Green open access

https://ift.tt/2RIG1pt

Pachyonychia congenita: A case report of a successful treatment with rosuvastatin in a patient with a KRT6A mutation

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


https://ift.tt/2EfFEA8

Advances in mechanisms of allergic disease 2017

Publication date: Available online 11 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Chrysanthi Skevaki, Harald Renz

Abstract

This review highlights advances in mechanisms of allergic disease, particularly type 2 innate lymphoid cells; TH2 lymphocytes; B cells; dendritic cells: microbiome and barrier function; eosinophils, mast cells. During the last year, considerable progress has been made in the further characterization of type 2 inflammation controlled by both adaptive (TH2) as well as innate (ILC2) effector cells. New pathways of lymphocyte activation, trafficking and recruitment, and effector cell mechanisms have been discovered. The plasticity of lymphocyte effector cell responses is another area where major progress has been achieved. Accumulating evidence will influence both our understanding of allergic disease but also our efforts for allergy prevention and treatment.



https://ift.tt/2IS0aW4

The specificity and definition of blood eosinophil

Publication date: Available online 10 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Yan-Fang Xing, Yan-Hong Zhou, Ting Liu, Ding-Yun Feng, Jian-Hua Ren, Cong Wang, Si-Lu Tan, Wen-Hui Jiang



https://ift.tt/2pOKTww

Neuroplastic changes in the olfactory bulb associated with nasal inflammation in mice

Publication date: Available online 10 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Sanae Hasegawa-Ishii, Atsuyoshi Shimada, Fumiaki Imamura

Abstract
Background

Rhinitis and rhinosinusitis are olfactory disorders caused by inflammation of the nasal passage and paranasal sinuses. Although chronic rhinosinusitis patients have smaller olfactory bulbs (OBs), there is limited knowledge regarding the influence of chronic nasal inflammation on OB neurons.

Objective

Repeated intranasal administration of lipopolysaccharide (LPS) that induced persistent nasal inflammation in mice caused a loss of olfactory sensory neurons (OSNs) and gliosis and synaptic loss in the OB within three weeks. The present study aimed to clarify the effects of long-term LPS treatment on the OB neurocircuit.

Methods

LPS was repeatedly administered into a mouse nostril for up to 24 weeks. For the recovery analyses, the mice received LPS for 10 weeks and were subsequently maintained without additional treatment for another 10 weeks. The effects of these treatments on the OB were histologically examined. Three or more mice were analyzed per group.

Results

Long-term repeated LPS administration caused OB atrophy, particularly in the layers along which OSN axons travel and in the superficial external plexiform layer (sEPL), in which tufted cells form synapses with interneurons. Interestingly, the OB recovered from atrophy following the cessation of LPS administration: the OB volume and sEPL thickness returned to the pretreatment level after the nontreatment period. In contrast, the regeneration of OSN was incomplete.

Conclusion

These results suggest that chronic nasal inflammation induces structural changes in a specific OB circuit related to tufted cells, while tufted cells retain a high degree of plasticity that enables recovery from structural damages after inflammation subsides.

Graphical abstract

Graphical abstract for this article



https://ift.tt/2QMbF4r

Identification of bee venom Api m 1 IgE epitopes and characterization of corresponding mimotopes

Publication date: Available online 10 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Abida Zahirović, Ana Koren, Peter Kopač, Borut Štrukelj, Peter Korošec, Mojca Lunder



https://ift.tt/2A4KJHv

Epithelial acid imbalance in eosinophilic esophagitis

Publication date: Available online 10 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): David A. Hill, Jonathan M. Spergel



https://ift.tt/2QIypC6

Reply

Publication date: Available online 10 October 2018

Source: Journal of Allergy and Clinical Immunology

Author(s): Jeong H. Yun, Craig P. Hersh



https://ift.tt/2A4qOIQ

Multivariable model for predicting acute oral mucositis during combined IMRT and chemotherapy for locally advanced nasopharyngeal cancer patients

Publication date: November 2018

Source: Oral Oncology, Volume 86

Author(s): Ester Orlandi, Nicola Alessandro Iacovelli, Tiziana Rancati, Alessandro Cicchetti, Paolo Bossi, Emanuele Pignoli, Cristiana Bergamini, Lisa Licitra, Carlo Fallai, Riccardo Valdagni, Anna Cavallo

Abstract
Introduction/objective

Oral and oropharyngeal mucositis (OM) represents a multifactorial and complex interplay of patient-, tumor-, and treatment-related factors. We aimed to build a predictive model for acute OM for locally advanced nasopharyngeal carcinoma (NPC) patients by combining clinical and dosimetric factors.

Materials/methods

A series of consecutive NPC patients treated curatively with IMRT/VMAT + chemotherapy at 70 Gy (2–2.12 Gy/fr) was considered. For each patient, clinical- tumor- and treatment-related data were retrospectively collected. oral cavity (OC) and parotid glands (PG, considered as a single organ) were selected as organs-at-risk (OARs). Acute OM was assessed according to CTCAE v4.0 at baseline and weekly during RT. Two endpoints were considered: grade ≥3 and mean grade ≥1.5. DVHs were reduced to Equivalent Uniform Dose (EUD). Dosimetric and clinical/treatment features selected via LASSO were inserted into a multivariable logistic model. Goodness of fit was evaluated through Hosmer-Lemeshow test and calibration plot.

Results

Data were collected for 132 patients. G ≥ 3 and mean G ≥ 1.5 OM were reported in 40 patients (30%). Analyses resulted in a 3-variables model for G ≥ 3 OM, including OC EUD with n = 0.05 (OR = 1.02), PG EUD with n = 1 (OR = 1.06), BMI ≥ 30 (OR = 3.8, for obese patients), and a single variable model for mean G ≥ 1.5 OM, i.e. OC EUD with n = 1 (mean dose) (OR = 1.07). Calibration was good in both cases.

Conclusion

OC mean dose was found to impact most on OM duration (mean G ≥ 1.5), while G ≥ 3 OM was associated to a synergic effect between PG mean dose and high dose received by small OC volumes, with BMI acting as a dose-modifying factor.



https://ift.tt/2A4h0hG

A novel scoring model to predict benefit of additional induction chemotherapy to concurrent chemoradiotherapy in stage II–IVa nasopharyngeal carcinoma

Publication date: November 2018

Source: Oral Oncology, Volume 86

Author(s): Liang Peng, Yu-Pei Chen, Cheng Xu, Ling-Long Tang, Lei Chen, Ai-Hua Lin, Xu Liu, Ying Sun, Jun Ma

Abstract
Objectives

Induction chemotherapy (IC) is gaining recognition for the treatment of nasopharyngeal carcinoma (NPC). We aimed to develop a model to predict benefit from additional IC to concurrent chemoradiotherapy (CCRT).

Materials and methods

From an NPC-specific database, 7413 patients with stage II–IVa disease who received CCRT with or without IC were included. Distant metastasis-free survival (DMFS) was the primary outcome and benefit from IC was evaluated by adjusted hazard ratio. Interaction terms between IC and other prognostic factors were identified in multivariate Cox model, and IC benefit score (ICBS) was calculated based on β coefficients from the Cox model.

Results

Nodal category, overall stage, and pre-treatment plasma Epstein–Barr virus DNA (log transformed as continuous variable) interacted with IC and determined ICBS. ICBS could discriminate patients who benefited differently from IC in terms of DMFS well, especially for patients with high and low ICBS. As for patients with medium ICBS, predictive performance of ICBS seemed reduced.

Conclusions

Based on the ICBS model, we proposed a decision-making process to help in clinical practice. Multi-institutional and prospective studies are warranted to further validate our findings.



https://ift.tt/2QJCsyi

Changing sexual practices: A possible link to oral cancer

Publication date: Available online 11 October 2018

Source: Oral Oncology

Author(s): Sameep S. Shetty, U.S. Vishal Rao



https://ift.tt/2CbllkY

Pooled Analysis of Clinical Data From Six GSK Studies to Investigate the Efficacy of a Dentifrice Containing 67% Weight by Weight (w/w) Sodium Bicarbonate on Gingivitis and Plaque Accumulation

Conditions:   Gingivitis;   Plaque Accumulation
Interventions:   Other: Sodium bicarbonate;   Other: Control Dentifrice
Sponsor:   GlaxoSmithKline
Not yet recruiting

https://ift.tt/2NzrU2B

Liquid Biopsy Evaluation and Repository Development at Princess Margaret

Conditions:   Cancer;   Breast Cancer;   Lung Cancer;   Colon Cancer;   Ovarian Cancer;   Melanoma;   Lymphoma;   Leukemia;   Mutation;   Lynch Syndrome;   Cowden Syndrome;   BRCA1 Mutation;   BRCA2 Mutation;   Uterine Cancer;   Myeloma;   Kidney Cancer;   Head and Neck Cancer;   Meningioma
Intervention:  
Sponsor:   University Health Network, Toronto
Recruiting

https://ift.tt/2OQW71S

This is what scientific societies are for. The CIBAL consensus

Publication date: November–December 2018

Source: Allergologia et Immunopathologia, Volume 46, Issue 6

Author(s): L. Garcia-Marcos



https://ift.tt/2NBtO2H

Cooking influence in tolerance acquisition in egg-induced acute food protein enterocolitis syndrome

Publication date: Available online 11 October 2018

Source: Allergologia et Immunopathologia

Author(s): S. Miceli Sopo, A. Romano, G. Bersani, C. Fantacci, L. Badina, G. Longo, G. Monti, S. Viola, S. Tripodi, G. Barilaro, I.D. Iacono, C. Caffarelli, C. Mastrorilli, S. Barni, F. Mori, L. Liotti, B. Cuomo, F. Franceschini, D. Viggiano, S. Monaco

Abstract
Background

Few studies on the age of resolution of Food Protein Induced Enterocolitis Syndrome (FPIES) induced by solid foods are available. In particular, for FPIES induced by egg, the mean age of tolerance acquisition reported in the literature ranges from 42 to 63 months.

Objective

We have assessed whether the age of tolerance acquisition in acute egg FPIES varies depending on whether the egg is cooked or raw.

Methods

We conducted a retrospective and multicentric study of children with diagnosis of acute egg FPIES seen in 10 Italian allergy units between July 2003 and October 2017. The collected data regarded sex, presence of other allergic diseases, age of onset of symptoms, kind and severity of symptoms, cooking technique of the ingested egg, outcome of the allergy test, age of tolerance acquisition.

Results

Sixty-one children with acute egg FPIES were enrolled, 34 (56%) males and 27 (44%) females. Tolerance to cooked egg has been demonstrated by 47/61 (77%) children at a mean age of 30.2 months. For 32 of them, tolerance to raw egg has been demonstrated at a mean age of 43.9 months. No episodes of severe adverse reaction after baked egg ingestion have been recorded.

Conclusions

It is possible to perform an OFC with baked egg, to verify the possible acquisition of tolerance, at about 30 months of life in children with acute egg FPIES.



https://ift.tt/2OQVNQI

Focus group parental opinions regarding treatment with topical corticosteroids on children with atopic dermatitis

Publication date: Available online 10 October 2018

Source: Allergologia et Immunopathologia

Author(s): S. Veenje, H. Osinga, I. Antonescu, B. Bos, T.W. de Vries

Abstract
Introduction and objectives

Atopic dermatitis is common among children of 0–5 years old. Treatment consists of emollients and topical corticosteroids. Due to corticophobia, however, adherence to topical corticosteroids is low. Our aim was to find factors that influence opinions about topical corticosteroids among parents of children with atopic dermatitis.

Methods

A qualitative focus group study in secondary care with parents of children with atopic dermatitis. Questions concerned opinions, attitude, sources of information, and the use of topical corticosteroids.

Results

The parents indicated that they lack knowledge about the working mechanism and side effects of topical corticosteroids. Dermatologists and paediatricians emphasise the beneficial effects, whereas other healthcare workers and lay people often express a negative attitude.

Conclusions

This study gives a complete overview of factors influencing adherence. Treatment with topical corticosteroids can be improved by better informing parents about the working mechanisms, the use, and how to reduce the dose. Healthcare professionals need to be aware of the consequences of their negative attitude concerning topical corticosteroids.



https://ift.tt/2Ny5K0M

Development of a Donor Tissue Holding Technique for Descemet’s Membrane Endothelial Keratoplasty Using a 25-Gauge Graft Manipulator

Purpose: To report a modified surgical technique called the "donor tissue holding technique for Descemet's membrane endothelial keratoplasty (DMEK)" using a newly developed 25-gauge graft manipulator. Methods: Six consecutive patients exhibiting endothelial dysfunction were enrolled and treated by DMEK. In brief, after insertion of a DMEK donor into the anterior chamber, the edge of the roll was grasped using a graft manipulator and this grasp was maintained throughout the centering and opening of the roll (holding technique). The following parameters were evaluated in comparison to the previous 10 consecutive DMEK cases in which the no touch technique was used: time of graft unfolding, incidence of intra-/postoperative complications, and best spectacle-corrected visual acuity (BCVA) and endothelial cell density (ECD) 6 months after the procedure. Results: In both technique groups, neither intra- nor postoperative complications were noted in any case. No differences were observed between the two groups in postoperative BCVA (p = 0.88). Also, no differences were observed between the two groups in postoperative ECD (holding technique group: 2,108.3 cells/mm2, no touch technique group: 1,491.7 cells/mm2) (p = 0.08) Most notably, the time of graft unfolding prior to filling with air was significantly reduced in the holding technique group (305.5 s) compared to that of the no touch technique group (1,310.0 s; p = 0.01). Conclusions: This donor tissue holding technique enabled rapid and safe DMEK in a reproducible manner, even in Asian eyes with shallow anterior chambers with high vitreous pressure.
Case Rep Ophthalmol 2018;9:431–438

https://ift.tt/2PABdkw

Nasal Symptom Questionnaire: Our Proposed Scoring System and Prognostic Factors in Chronic Rhinosinusitis

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Objectives: We aimed to verify the usefulness of our proposed nasal symptom questionnaire (NSQ) scoring system and to determine predictors linked to the improvement in nasal symptoms in chronic rhinosinusitis (CRS) patients undergoing endoscopic sinus surgery (ESS). Patients and Methods: Ninety-one CRS patients undergoing ESS and 144 volunteers with results of NSQ available were enrolled. The NSQ consists of 10 items. Receiver-operating-characteristic (ROC) curve, area under the ROC curve (AUC), internal consistency, and test-retest reproducibility of the NSQ were analyzed. The relationship of the NSQ score with the visual analogue scale (VAS) was examined. After classifying into two groups, i.e., (i) "improvement group" and (ii) "no-improvement group," factors linked to the improvement in NSQ after ESS were investigated. Results: ROC-AUC (0.9318), the Cronbach α coefficient (0.8696), and the test-retest coefficient (0.8131) showed high reliability. NSQ score significantly correlated with VAS in both pre- (p #x3c; 0.0001, rs = 0.6007) and postoperative stages (p #x3c; 0.0001, rs = 0.5975). The postoperative NSQ scores significantly decreased compared with baseline levels (p #x3c; 0.0001). In multivariate analysis, the computed tomography (CT) score by the Lund-Mackay scoring system revealed to be significant (p = 0.0481). Conclusion: Our proposed NSQ scoring system was well verified. The CT score can be helpful for predicting the improvement in nasal symptoms after ESS in CRS patients.
ORL

https://ift.tt/2QH0cCY

Increased IL17‐expressing γδ T Cells in Seborrheic Dermatitis‐like Lesions of the Mpzl3 Knockout Mice

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2yewVsN

Sequential cyclic changes of hair roots revealed by dermoscopy demonstrate a progressive mechanism of diffuse alopecia areata over time

Experimental Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Pst41P

CIC fusion-positive sarcoma of the spermatic cord

Abstract

In addition to germ cell tumors and tumors of the sex cord stroma, the WHO classification of testis and paratesticular tumors also contains malignant soft tissue tumors. Among them, liposarcomas of the spermatic cord are the most common entities. Other mesenchymal tumors with smooth muscle, skeletal muscle, fibroblastic/myofibroblastic, or nerve sheath differentiation are rare. Ewing sarcoma is composed of uniform small round cells and typically characterized by translocations of the EWSR1 gene. In rare cases, Ewing sarcoma-like tumors lack an EWSR1 gene fusion. Some of these tumors harbor a specific CIC translocation. However, Ewing-like sarcoma has up to now never been described in the testis or spermatic cord. The present case describes the first EWSR1-negative, undifferentiated round cell sarcoma with CIC translocation of the spermatic cord. Potential differential diagnoses are discussed.



https://ift.tt/2OgunnX

Suspiciousness in young minds: Convergent evidence from non-clinical, clinical and community twin samples

Zhou, HY; Wong, KKY; Shi, LJ; Cui, XL; Qian, Y; Jiang, WQ; Du, YS; ... Chan, RCK; + view all Zhou, HY; Wong, KKY; Shi, LJ; Cui, XL; Qian, Y; Jiang, WQ; Du, YS; Lui, SSY; Luo, XR; Yi, ZH; Cheung, EFC; Docherty, AR; Chan, RCK; - view fewer (2018) Suspiciousness in young minds: Convergent evidence from non-clinical, clinical and community twin samples. Schizophrenia Research , 199 pp. 135-141. 10.1016/j.schres.2018.03.027 .

https://ift.tt/2IN2DRL

Nonataxia symptoms in Friedreich Ataxia: Report from the Registry of the European Friedreich's Ataxia Consortium for Translational Studies (EFACTS)

Reetz, K; Dogan, I; Hohenfeld, C; Didszun, C; Giunti, P; Mariotti, C; Durr, A; ... EFACTS Study Group, ; + view all Reetz, K; Dogan, I; Hohenfeld, C; Didszun, C; Giunti, P; Mariotti, C; Durr, A; Boesch, S; Klopstock, T; Rodríguez de Rivera Garrido, FJ; Schöls, L; Giordano, I; Bürk, K; Pandolfo, M; Schulz, JB; EFACTS Study Group, ; - view fewer (2018) Nonataxia symptoms in Friedreich Ataxia: Report from the Registry of the European Friedreich's Ataxia Consortium for Translational Studies (EFACTS). Neurology , 91 (10) e917-e930. 10.1212/WNL.0000000000006121 .

https://ift.tt/2pP2LYm

Functional and phenotypic heterogeneity of Th17 cells in health and disease

Bystrom, J; Clanchy, FI; Taher, TE; Al-Bogami, M; Ong, VH; Abraham, DJ; Williams, RO; Bystrom, J; Clanchy, FI; Taher, TE; Al-Bogami, M; Ong, VH; Abraham, DJ; Williams, RO; Mageed, RA; - view fewer (2018) Functional and phenotypic heterogeneity of Th17 cells in health and disease. European Journal of Clinical Investigation , Article e13032. 10.1111/eci.13032 . (In press).

https://ift.tt/2IQDl5t

Hacking the Label: Hacktivism, Race, and Gender

Tanczer, LM; (2015) Hacking the Label: Hacktivism, Race, and Gender. Ada: A Journal of Gender, New Media, and Technology , 6 10.7264/N37S7M22 . Green open access

https://ift.tt/2pQndb7

Über diese Feminismus-Sache hinaus“: Eine Diskursanalyse des Post-Gender Begriffs in der Piratenpartei Österreich (PPÖ)

Tanczer, LM; (2014) Über diese Feminismus-Sache hinaus": Eine Diskursanalyse des Post-Gender Begriffs in der Piratenpartei Österreich (PPÖ). Femina Politica - Zeitschrift für feministische Politikwissenschaft , 23 (1) pp. 116-124. 10.3224/feminapolitica.v23i1.16022 . Green open access

https://ift.tt/2IQfqmA

The Impact of Environmental Regulation on Firm and Country Competitiveness: A Meta-analysis of the Porter Hypothesis

Cohen, MA; Tubb, A; (2018) The Impact of Environmental Regulation on Firm and Country Competitiveness: A Meta-analysis of the Porter Hypothesis. Journal of the Association of Environmental and Resource Economists , 5 (2) pp. 371-399. 10.1086/695613 .

https://ift.tt/2pL7fPG

Über die Herstellung und Zusammensetzung der ersten Platinmünzen in Russland

Auer, E; Rehren, THH; von Bohlen, A; Kirchner, D; Klockenkamper, R; (1998) Über die Herstellung und Zusammensetzung der ersten Platinmünzen in Russland. Metalla , 5 (2) pp. 71-90. Green open access

https://ift.tt/2IOna8G

... ut oleum aquis Vom Schwimmen des Silbers auf Bleiglätte

Rehren, T; Klappauf, L; (1995) ... ut oleum aquis Vom Schwimmen des Silbers auf Bleiglätte. Metalla , 2 (1) pp. 19-28. Green open access

https://ift.tt/2pL7cU0

A Head-Mounted Camera System Integrates Detailed Behavioral Monitoring with Multichannel Electrophysiology in Freely Moving Mice

Meyer, AF; Poort, J; O'Keefe, J; Sahani, M; Linden, JF; (2018) A Head-Mounted Camera System Integrates Detailed Behavioral Monitoring with Multichannel Electrophysiology in Freely Moving Mice. Neuron , 100 (1) pp. 46-60. 10.1016/j.neuron.2018.09.020 . Green open access

https://ift.tt/2IOi8Jj

Towards a new digital data infrastructure for urban analysis and modelling

Longley, PA; Harris, RJ; (1999) Towards a new digital data infrastructure for urban analysis and modelling. Environment and Planning B: Planning and Design , 26 (6) pp. 855-878. 10.1068/b260855 . Green open access

https://ift.tt/2pP2Mvg

Book review: Factory and community in Stalin's Russia: The making of an industrial working class

Koenker, DP; (1999) Book review: Factory and community in Stalin's Russia: The making of an industrial working class. Europe-Asia Studies , 51 (3) pp. 533-535. 10.1080/09668139998976 . Green open access

https://ift.tt/2ISzHIk

Modeling and measuring organization capital

Atkeson, A; Kehoe, PJ; (2005) Modeling and measuring organization capital. Journal of Political Economy , 113 (5) pp. 1026-1053. 10.1086/431289 . Green open access

https://ift.tt/2pN5IbO

Sticky price models of the business cycle: Can the contract multiplier solve the persistence problem?

Chari, VV; Kehoe, PJ; McGrattan, ER; (2000) Sticky price models of the business cycle: Can the contract multiplier solve the persistence problem? Econometrica , 68 (5) pp. 1151-1179. 10.1111/1468-0262.00154 . Green open access

https://ift.tt/2IPnKTn

Modern macroeconomics in practice: How theory is shaping policy

Chari, VV; Kehoe, PJ; (2006) Modern macroeconomics in practice: How theory is shaping policy. Journal of Economic Perspectives , 20 (4) pp. 3-28. 10.1257/jep.20.4.3 . Green open access

https://ift.tt/2pJPtfM

Modeling the transition to a new economy: Lessons from two technological revolutions

Atkeson, A; Kehoe, PJ; (2007) Modeling the transition to a new economy: Lessons from two technological revolutions. American Economic Review , 97 (1) pp. 64-88. 10.1257/aer.97.1.64 . Green open access

https://ift.tt/2IPxwF9

Business cycle accounting

Chari, VV; Kehoe, PJ; McGrattan, ER; (2007) Business cycle accounting. Econometrica , 75 (3) pp. 781-836. 10.1111/j.1468-0262.2007.00768.x . Green open access

https://ift.tt/2pMYcxD

Models of energy use: Putty-putty versus putty-clay

Atkeson, A; Kehoe, PJ; (1999) Models of energy use: Putty-putty versus putty-clay. American Economic Review , 89 (4) pp. 1028-1043. 10.1257/aer.89.4.1028 . Green open access

https://ift.tt/2IPxqNN

If exchange rates are random walks, then almost everything we say about monetary policy is wrong

Alvarez, F; Atkeson, A; Kehoe, PJ; (2007) If exchange rates are random walks, then almost everything we say about monetary policy is wrong. American Economic Review , 97 (2) pp. 339-345. 10.1257/aer.97.2.339 . Green open access

https://ift.tt/2pOQuDo

Research with disabled pupils: how useful is a child-centred ethics?

Alderson, P; Goodey, C; (1996) Research with disabled pupils: how useful is a child-centred ethics? Children and Society , 10 (2) pp. 106-116. 10.1111/chso.1996.10.2.106 . Green open access

https://ift.tt/2IPxfSD

Time inconsistency and free-riding in a monetary union

Chari, VV; Kehoe, PJ; (2008) Time inconsistency and free-riding in a monetary union. Journal of Money, Credit and Banking , 40 (7) pp. 1329-1355. 10.1111/j.1538-4616.2008.00162.x . Green open access

https://ift.tt/2pOOCuk

Bilateral suprazygomatic maxillary nerve blocks vs. infraorbital and palatine nerve blocks in cleft lip and palate repair: A double-blind prospective, randomised study

BACKGROUND Cleft defects are common craniofacial malformations which require early surgical repair. These patients are at high risk of postoperative airway obstruction and respiratory failure. Cleft surgery may require high doses of opioids which may contribute to these complications. OBJECTIVES To compare the effectiveness of proximal and distal approaches to blocking the maxillary nerve in patients undergoing cleft lip or cleft palate surgery. DESIGN Randomised, controlled and double-blind study. SETTING The current study was carried out in Guwahati (Assam, India) between April 2014 and June 2014. PATIENTS A total of 114 patients older than 6 months who underwent cleft lip or cleft palate surgery were included. Exclusion criteria included coagulation disorders, peripheral neuropathy or chronic pain syndrome, infection in the puncture site, allergy to local anaesthetics, lack of consent and language problems or other barriers that could impede the assessment of postoperative pain. INTERVENTIONS Patients were randomly assigned to one of two groups: proximal group (bilateral suprazygomatic maxillary nerve blocks) and distal group (bilateral infraorbital nerve blocks for cleft lip repair and bilateral greater and lesser palatine nerve blocks and nasopalatine nerve block for cleft palate surgery). MAIN OUTCOME MEASURE The primary endpoint was the percentage of patients requiring extra doses of opioids. Secondary endpoints included pain scores, respiratory and nerve block-related complications during the first 24 h. RESULTS In the intra-operative period, there was a significant reduction of nalbuphine consumption in the proximal group (9.1 vs. 25.4%, P = 0.02). The percentage of patients requiring intra-operative fentanyl was lower in the proximal group (16.4 vs. 30.5%, P = 0.07). There were no differences in either postoperative pain scores or in postoperative complications. No technical failure or block-related complications were reported. CONCLUSION Bilateral suprazygomatic maxillary nerve block is an effective and safe alternative to the traditional peripheral nerve blocks for cleft lip and cleft palate surgery, in a mixed paediatric and adult population. Correspondence to Gaston Echaniz, Department of Anesthesiology, Vall d'Hebron Hospital, Department of Surgery, Universitat Autònoma de Barcelona, Passeig de Vall d'Hebron, 119-129, Barcelona 08035, Spain. E-mail: grcechaniz@vhebron.net Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (https://ift.tt/2ylyqmW). © 2018 European Society of Anaesthesiology

https://ift.tt/2QHkxZ6

Measurement of forces applied using a Macintosh direct laryngoscope compared with a Glidescope video laryngoscope in patients with predictors of difficult laryngoscopy: A randomised controlled trial

BACKGROUND In patients with predictive features associated with easy direct laryngoscopy, videolaryngoscoy with the GlideScope has been shown to require less force when compared with Macintosh direct laryngoscopy. OBJECTIVE The aim of this study was to compare forces applied with Glidescope vs. Macintosh laryngoscopes in patients with predictive features associated with difficult direct laryngoscopy. DESIGN A prospective randomised study. SETTING Toronto General Hospital, a university tertiary centre in Canada. PATIENTS Forty-four patients aged over 18 years, with one or more features of difficult intubation, undergoing elective surgery requiring single-lumen tracheal intubation. INTERVENTION We measured the force applied to oropharyngeal tissues by attaching three FlexiForce Sensors (A201-25) to the concave surface of Macintosh and GlideScope laryngoscope blades. Anaesthetists or experienced anaesthesia residents performed laryngoscopies with both devices in a randomised sequence. MAIN OUTCOME MEASURES The primary outcome was peak force. The secondary outcomes were average force and impulse force. The latter is the integral of the force over the time during which the force acted. RESULTS Complete data were available for 40 individuals. Peak and average forces decreased with GlideScope (17 vs. 21 N, P = 0.03, and 6 vs. 11 N, P 

https://ift.tt/2A4QCoh

Modified ROTEM for the detection of rivaroxaban and apixaban anticoagulant activity in whole blood

BACKGROUND Rapid detection of the anticoagulant effect of oral factor Xa (FXa) inhibitors may be essential in several emergency clinical situations. Specific assays quantifying the drugs are performed in plasma and require a turnaround time that is too long to be useful in emergency situations. Rotational thromboelastometry (ROTEM) is a whole blood coagulation assay of blood viscoelasticity and could be of interest for FXa inhibitor detection in emergency. However, conventional ROTEM reagents only detect high amounts of inhibitors. OBJECTIVE The aim of this study was first to assess the effect of whole blood components on the viscoelastic measurement of the effects of FXa inhibitors, an second to evaluate whether a modified ROTEM, triggered with a low amount of tissue factor and a saturating amount of phospholipid vesicles, can reliably detect low levels of FXa inhibitor activity in whole blood. DESIGN Diagnostic test study. SETTINGS A university research laboratory. From November 2014 to April 2016. PATIENTS Sixty-six patients: 30 treated with rivaroxaban, 17 with apixaban and 19 without treatment. INTERVENTION ROTEM was triggered with 2.5 pmol l−1 of tissue factor and 10 μmol l−1 of phospholipid vesicles. MAIN OUTCOME MEASURES Modified ROTEM parameters were measured in different experimental conditions: platelet-poor plasma (PPP), platelet-rich plasma, PPP supplemented with fibrinogen and reconstituted whole blood with various haematocrit levels adjusted between 30 and 60%. Modified ROTEM was further validated using whole blood from patients who were either treated or not treated with FXa inhibitors. RESULTS Modified ROTEM allowed detection of as little as 25 ng ml−1 FXa inhibitors in PPP, with at least a 1.4-fold increase of the clotting time (P ≤ 0.02). Neither changes of fibrinogen concentration nor variations of platelet count or haematocrit precluded FXa inhibitor detection. A lengthened modified ROTEM clotting time of more than 197 s allowed detection of FXa inhibitor concentrations above 30 ng ml−1 in whole blood with 90% sensitivity and 85% specificity. CONCLUSION Modified ROTEM may be applicable in emergency situations for the detection of FXa inhibitors in whole blood. Correspondence to Charles M. Samama, MD, PhD, FCCP, Department of Anaesthesia and Intensive Care Medicine, Cochin University Hospital, 27 rue du Faubourg St Jacques, 75014 Paris, France Tel: +33 1 42 34 85 51/+33 6 62 14 86 64; fax: +33 1 58 41 14 15; e-mail: marc.samama@aphp.fr Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (https://ift.tt/2ylyqmW). © 2018 European Society of Anaesthesiology

https://ift.tt/2QHkoF2

Rational targeting Cdc42 restrains Th2 cell differentiation and prevents allergic airway inflammation

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


https://ift.tt/2RFukQt

Dermatologic findings of vitamin B12 deficiency in infants

Pediatric Dermatology, EarlyView.


https://ift.tt/2ye37fL

A scavenging system against internal pathogens promoted by the circulating protein apoptosis inhibitor of macrophage (AIM)

Abstract

An internal system designed to ward off and remove unnecessary or hazardous materials is intrinsic to animals. In addition to exogenous pathogens, a number of self-molecules, such as apoptotic or necrotic dead cells, their debris, and the oxides or peroxides of their cellular components, are recognized as extraneous substances. It is essential to eliminate these internal pathogens as quickly as possible because their accumulation can cause chronic inflammation as well as autoimmune responses, possibly leading to onset or progression of certain diseases. Apoptosis inhibitor of macrophage (AIM, also called CD5L) is a circulating protein that is a member of the scavenger receptor cysteine-rich superfamily, and we recently found that during acute kidney injury, AIM associates with intraluminal dead cell debris accumulated in renal proximal tubules and enhances clearance of luminal obstructions, thereby facilitating repair. Thus, AIM acts as a marker for phagocytes so that they can efficiently recognize and engulf the debris as their targets. In this chapter, we give an overview of the professional and non-professional phagocytes, and how soluble scavenging molecules such as AIM contribute to improvement of diseases by stimulating phagocytic activity.



https://ift.tt/2NCTvjH

Recurrent grade 4 panuveitis with serous retinal detachment related to nivolumab treatment in a patient with metastatic renal cell carcinoma

Abstract

Blockade of programmed cell death-1 (PD-1) has become one of the most promising immunotherapies for many human cancers. However, immune-related adverse events can be produced by anti-PD-1 therapy. Uveitis is a rare but potentially devastating side effect of anti-PD-1 therapy. Delay in diagnosis or improper treatment may eventually lead to irreversible blindness. Therefore, it is important for the oncologist and the ophthalmologist to recognize and manage this adverse event properly in patients receiving anti-PD-1 therapy in a timely manner. Here we present a grade 4 panuveitis with bilateral serous retinal detachment following treatment with nivolumab for metastatic renal cell carcinoma. Oral prednisone, topical steroid eye drops, periorbital injection of steroid and finally intravitreal injection of steroid implant were administered in our patient. We observed that intravitreal injection of dexamethasone implant, but not the periorbital injection of steroid or the steroid eye drops, was effective to control the posterior uveitis and serous retinal detachment. Oral prednisone was also effective, but it might affect the efficacy of anti-PD-1 therapy and promote tumor growth. We also summarize 15 cases of uveitis reported to date related to nivolumab or pembrolizumab therapy in the present study. The symptoms, signs, potential underlying mechanisms and treatment options regarding this adverse event are discussed.



https://ift.tt/2A46tTP

Radiotherapy modality as a predictor of survival in hypopharyngeal cancer

Head &Neck, EarlyView.


https://ift.tt/2NB1sph

Advanced colorectal carcinoma with testicular metastasis in an adolescent: a case report

Colorectal carcinoma in the pediatric age group is rare and tends to be very aggressive and present late, due to which it has a very poor prognosis. It may present with distant metastasis; however, metastasis ...

https://ift.tt/2ydwGhn

Comparison of the Impact of Ga-68-DOTATATE and F-18-FDG PET/CT on Clinical Management in Patients with Neuroendocrine Tumors

Panagiotidis, E; Alshammari, A; Miehopoulou, S; Skoura, E; Naik, K; Maragkoudakis, E; Mohmaduvesh, M; ... Bomanji, J; + view all Panagiotidis, E; Alshammari, A; Miehopoulou, S; Skoura, E; Naik, K; Maragkoudakis, E; Mohmaduvesh, M; Al-Harbi, M; Belda, M; Caplin, ME; Toumpanakis, C; Bomanji, J; - view fewer (2017) Comparison of the Impact of Ga-68-DOTATATE and F-18-FDG PET/CT on Clinical Management in Patients with Neuroendocrine Tumors. Journal of Nuclear Medicine , 58 (1) pp. 91-96. 10.2967/jnumed.116.178095 . Green open access

https://ift.tt/2ycqINX

Book review: Dollinger, Roland, Wulf Koepke, and Heidi Thomann Tewarson, eds. A Companion to the Works of Alfred Döblin

Zusi, PA; (2007) Book review: Dollinger, Roland, Wulf Koepke, and Heidi Thomann Tewarson, eds. A Companion to the Works of Alfred Döblin. [Review]. The German Quarterly , 80 (1) pp. 122-123. 10.1111/j.1756-1183.2007.tb00065.x . Green open access

https://ift.tt/2PseRSl

Policy options for the sustainable development of Zambia’s electricity sector

Tembo, B; Merven, B; (2013) Policy options for the sustainable development of Zambia's electricity sector. Journal of Energy in Southern Africa , 24 (2) pp. 16-27. 10.17159/2413-3051/2013/v24i2a3126 . Green open access

https://ift.tt/2ye7BTL

Cerebrospinal fluid neurofilament light levels in neurodegenerative dementia: Evaluation of diagnostic accuracy in the differential diagnosis of prion diseases

Zerr, I; Schmitz, M; Karch, A; Villar-Pique, A; Kanata, E; Golanska, E; Diaz-Lucena, D; ... Llorens, F; + view all Zerr, I; Schmitz, M; Karch, A; Villar-Pique, A; Kanata, E; Golanska, E; Diaz-Lucena, D; Karsanidou, A; Hermann, P; Knipper, T; Goebel, S; Varges, D; Sklaviadis, T; Sikorska, B; Liberski, PP; Santana, I; Ferrer, I; Zetterberg, H; Blennow, K; Calero, O; Calero, M; Ladogana, A; Sanchez-Valle, R; Baldeiras, I; Llorens, F; - view fewer (2018) Cerebrospinal fluid neurofilament light levels in neurodegenerative dementia: Evaluation of diagnostic accuracy in the differential diagnosis of prion diseases. Alzheimer's & Dementia , 14 (6) pp. 751-763. 10.1016/j.jalz.2017.12.008 .

https://ift.tt/2Prv7Dd

Abnormal Effective Connectivity in the Brain is Involved in Auditory Verbal Hallucinations in Schizophrenia

Li, B; Cui, L-B; Xi, Y-B; Friston, KJ; Guo, F; Wang, H-N; Zhang, L-C; ... Lu, H; + view all Li, B; Cui, L-B; Xi, Y-B; Friston, KJ; Guo, F; Wang, H-N; Zhang, L-C; Bai, Y-H; Tan, Q-R; Yin, H; Lu, H; - view fewer (2017) Abnormal Effective Connectivity in the Brain is Involved in Auditory Verbal Hallucinations in Schizophrenia. Neuroscience Bulletin , 33 (3) pp. 281-291. 10.1007/s12264-017-0101-x . Green open access

https://ift.tt/2yfN1Cf

Cognitive Impairment in Glucocerebrosidase (GBA)-Associated PD: Not Primarily Associated With Cerebrospinal Fluid Abeta and Tau Profiles

Lerche, S; Schulte, C; Srulijes, K; Pilotto, A; Rattay, TW; Hauser, A-K; Stransky, E; ... Brockmann, K; + view all Lerche, S; Schulte, C; Srulijes, K; Pilotto, A; Rattay, TW; Hauser, A-K; Stransky, E; Deuschle, C; Csoti, I; Lachmann, I; Zetterberg, H; Liepelt-Scarfone, I; Gasser, T; Maetzler, W; Berg, D; Brockmann, K; - view fewer (2017) Cognitive Impairment in Glucocerebrosidase (GBA)-Associated PD: Not Primarily Associated With Cerebrospinal Fluid Abeta and Tau Profiles. Movement Disorders , 32 (12) pp. 1780-1783. 10.1002/mds.27199 .

https://ift.tt/2Pstvcm

Deep temporal models and active inference

Friston, KJ; Rosch, R; Parr, T; Price, C; Bowman, H; (2018) Deep temporal models and active inference. [Corrigendum]. Neuroscience & Biobehavioral Reviews , 90 pp. 486-501. 10.1016/j.neubiorev.2018.04.004 . Green open access

https://ift.tt/2yeJc0b

Fe-57 Mossbauer study of NiFe2O4 nanoparticles produced by the levitation-jet aerosol technique

Bogart, LK; Morozov, IG; Parkin, IP; Kuznetcov, MV; (2018) Fe-57 Mossbauer study of NiFe2O4 nanoparticles produced by the levitation-jet aerosol technique. Journal of Materials Science: Materials in Electronics , 29 (16) pp. 14347-14352. 10.1007/s10854-018-9569-z .

https://ift.tt/2PtmtnR

Concordance Between Different Amyloid Immunoassays and Visual Amyloid Positron Emission Tomographic Assessment

Janelidze, S; Pannee, J; Mikulskis, A; Chiao, P; Zetterberg, H; Blennow, K; Hansson, O; (2017) Concordance Between Different Amyloid Immunoassays and Visual Amyloid Positron Emission Tomographic Assessment. JAMA Neurology , 74 (12) pp. 1492-1501. 10.1001/jamaneurol.2017.2814 .

https://ift.tt/2ycek0e

Estimation of the prevalence of cholesteryl ester storage disorder in a cohort of patients with clinical features of familial hypercholesterolaemia

Ashfield-Watt, P; Haralambos, K; Edwards, R; Townsend, D; Gingell, R; Wa Li, K; Humphries, SE; Ashfield-Watt, P; Haralambos, K; Edwards, R; Townsend, D; Gingell, R; Wa Li, K; Humphries, SE; McDowell, I; - view fewer (2018) Estimation of the prevalence of cholesteryl ester storage disorder in a cohort of patients with clinical features of familial hypercholesterolaemia. Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 10.1177/0004563218793165 . (In press). Green open access

https://ift.tt/2PsttBg

CSF A beta(1-42) - an excellent but complicated Alzheimer's biomarker - a route to standardisation

Kuhlmann, J; Andreasson, U; Pannee, J; Bjerke, M; Portelius, E; Leinenbach, A; Bittner, T; ... Blennow, K; + view all Kuhlmann, J; Andreasson, U; Pannee, J; Bjerke, M; Portelius, E; Leinenbach, A; Bittner, T; Korecka, M; Jenkins, RG; Vanderstichele, H; Stoops, E; Lewczuk, P; Shaw, LM; Zegers, I; Schimmel, H; Zetterberg, H; Blennow, K; - view fewer (2017) CSF A beta(1-42) - an excellent but complicated Alzheimer's biomarker - a route to standardisation. Clinica Chimica Acta , 467 pp. 27-33. 10.1016/j.cca.2016.05.014 . Green open access

https://ift.tt/2yfzGd6

Meta‐analysis of non‐linear exposure‐outcome relationships using individual participant data: A comparison of two methods

White, IR; Kaptoge, S; Royston, P; Sauerbrei, W; (2018) Meta‐analysis of non‐linear exposure‐outcome relationships using individual participant data: A comparison of two methods. Statistics in Medicine 10.1002/sim.7974 . (In press). Green open access

https://ift.tt/2Pstq8y

Diagnostic accuracy of CSF neurofilament light chain protein in the biomarker-guided classification system for Alzheimer's disease

Lista, S; Toschi, N; Baldacci, F; Zetterberg, H; Blennow, K; Kilimann, I; Teipel, SJ; ... Hampel, H; + view all Lista, S; Toschi, N; Baldacci, F; Zetterberg, H; Blennow, K; Kilimann, I; Teipel, SJ; Cavedo, E; dos Santos, AM; Epelbaum, S; Lamari, F; Dubois, B; Floris, R; Garaci, F; Hampel, H; - view fewer (2017) Diagnostic accuracy of CSF neurofilament light chain protein in the biomarker-guided classification system for Alzheimer's disease. Neurochemistry International , 108 pp. 355-360. 10.1016/j.neuint.2017.05.010 . Green open access

https://ift.tt/2yeJbt9

Electroconvulsive therapy does not alter the synaptic protein neurogranin in the cerebrospinal fluid of patients with major depression

Kranaster, L; Blennow, K; Zetterberg, H; Sartorius, A; (2017) Electroconvulsive therapy does not alter the synaptic protein neurogranin in the cerebrospinal fluid of patients with major depression. Journal of Neural Transmission , 124 (12) pp. 1641-1645. 10.1007/s00702-017-1802-z .

https://ift.tt/2Pp76Na

Evolution of cerebrospinal fluid total alpha-synuclein in Parkinson's disease

Forland, MG; Ohrfelt, A; Dalen, I; Tysnes, O-B; Blennow, K; Zetterberg, H; Pedersen, KF; ... Lange, J; + view all Forland, MG; Ohrfelt, A; Dalen, I; Tysnes, O-B; Blennow, K; Zetterberg, H; Pedersen, KF; Alves, G; Lange, J; - view fewer (2018) Evolution of cerebrospinal fluid total alpha-synuclein in Parkinson's disease. Parkinsonism & Related Disorders , 49 pp. 4-8. 10.1016/j.parkreldis.2018.01.018 .

https://ift.tt/2yfN019

CityNet - Deep Learning Tools for Urban Ecoacoustic Assessment

Fairbrass, A; Firman, M; Williams, C; Brostow, G; Titheridge, H; Jones, KE; (2018) CityNet - Deep Learning Tools for Urban Ecoacoustic Assessment. Methods in Ecology and Evolution (In press).

https://ift.tt/2PqZ7ip

Modification of the human genome: Human rights challenges raised by scientific and technological developments

Montgomery, JR; (2018) Modification of the human genome: Human rights challenges raised by scientific and technological developments. In: (Proceedings) 20th Anniversary of the Oviedo Convention: relevance and challenges. Council of Europe: Strasbourg, France. Green open access

https://ift.tt/2yd20gb

A Bayesian multivariate approach to estimating the prevalence of a superordinate category of disorders

Fawcett, JM; Fairbrother, N; Fawcett, EJ; White, IR; (2018) A Bayesian multivariate approach to estimating the prevalence of a superordinate category of disorders. International Journal of Methods in Psychiatric Research 10.1002/mpr.1742 . (In press). Green open access

https://ift.tt/2PstncS

How Voters Assess Elite-Educated Politicians: A Survey Experiment

Gift, TC; Lastra-Anadón, CX; (2018) How Voters Assess Elite-Educated Politicians: A Survey Experiment. Electoral Studies 10.1016/j.electstud.2018.09.004 . (In press).

https://ift.tt/2ydagwE

Variation at the TRIM11 Locus Modifies Progressive Supranuclear Palsy Phenotype

Jabbari, E; Woodside, J; Tan, MMX; Shoai, M; Pittman, A; Ferrari, R; Mok, KY; ... Morris, HR; + view all Jabbari, E; Woodside, J; Tan, MMX; Shoai, M; Pittman, A; Ferrari, R; Mok, KY; Zhang, D; Reynolds, RH; de Silva, R; Grimm, M-J; Respondek, G; Müller, U; Al-Sarraj, S; Gentleman, SM; Lees, AJ; Warner, TT; Hardy, J; Revesz, T; Höglinger, GU; Holton, JL; Ryten, M; Morris, HR; - view fewer (2018) Variation at the TRIM11 Locus Modifies Progressive Supranuclear Palsy Phenotype. Annals of Neurology 10.1002/ana.25308 . (In press). Green open access

https://ift.tt/2PtmqbF