En bloc corpectomy for late gastrointestinal stromal tumor metastasis: a case report and review of the literature

Spinal metastases of gastrointestinal stromal tumors are rare; however, the incidence has been increasing since the introduction of tyrosine kinase inhibitors, which have improved overall survival. Due to the ...

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Testicular adrenal rest tumour in an adult patient with congenital adrenal hyperplasia: a case report and review of literature

Abstract

Late presentations of testicular adrenal rest tumours (TART) are rarely seen in males with congenital adrenal hyperplasia, and are often misdiagnosed as primary testicular germ cell tumours. We report a case of bilateral TART in an adult patient with congenital adrenal hyperplasia who had defaulted treatment. He presented with a gradually increasing swelling of the left testis and genital examination revealed a large hard indurated swelling of both epididymes more prominent on the left side. As imaging was inconclusive, a biopsy was performed which showed features in favour of TART rather than Leydig cell neoplasm and he had good response to steroids. Histopathological evaluation is helpful in cases where there is a strong need for excluding a malignancy. Optimal steroid replacement is the treatment of choice and leads to regression of the lesion in the majority.

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Cholecystocolonic fistula with a giant colonic gallstone: the mainstay of treatment in an acute setting

Abstract

A cholecystoenteric fistula (CEF) is a rare complication of cholelithiasis with cholecystitis. Cholecystocolonic fistulas (CCFs) account for 8–26.5% of all CEFs. CCFs can cause colonic bleeding, obstruction or perforation, with such complications being mainly reported in the narrower sigmoid colon. Colonic biliary ileus, or obstruction due to the colonic gallstone impaction, is extremely rare in the proximal colon and its best management is yet to be elucidated. We present the case of a 73-year-old male patient with multiple comorbidities and previous abdominal surgeries who presented with hematochezia and intestinal obstructive symptoms. Imaging revealed a giant 5 × 7 cm² gallstone in the proximal transverse colon. Laparotomy and stone extraction via colotomy were performed. Complicated proximal colonic gallstones are exceedingly rare with several operative and non-operative treatments already described. A time-saving surgery in a patient with serious comorbidities is reasonable when compared to a more extensive procedure including enterolithotomy, cholecystecomy and fistula closure.

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Tracheopleural fistula after thoracoscopic esophagectomy: novel therapeutic approach with pericardial and intercostal muscle flaps

Abstract

Tracheal rupture following thoracoscopic esophagectomy is a dangerous event requiring primary repair with flap reinforcement. If the injury is not diagnosed during the surgery, morbidity and mortality increase significantly. Meanwhile, primary repair in such cases is not feasible due to the inflammation and difficulty in approximating the defect. Here, we report a case of tracheal injury during thoracoscopic esophagectomy with primary repair failure. We successfully repaired the injury by covering the defect first by a pericardial flap, then reinforcing it with an intercostal muscle flap. To our knowledge, there are few reports of such novel surgical techniques.

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A giant duodenal diverticulum causing Lemmel syndrome

Abstract

An 80-year-old female, with a known periampullary giant duodenal diverticulum, presented to the emergency department with general deterioration. While not clinically icteric, her laboratory investigations revealed an obstructive jaundice. MRCP demonstrated mild distension of the gallbladder with several calculi. There was intra- and extra-hepatic biliary dilatation to the level of the ampulla. A giant fluid and air filled periampullary duodenal diverticulum measuring ~8 cm in the long axis was noted. The CBD was dilated to the level of this diverticulum and the cause of the patient's biliary dilatation and obstruction. A rare pancreaticobiliary complication of duodenal diverticula is Lemmel syndrome. Lemmel syndrome is defined as an obstructive jaundice caused by a periampullary duodenal diverticulum compressing the intra-pancreatic portion of the common bile duct with resultant dilatation of the extra- and intra-hepatic bile ducts. Recognition of this condition is important, as delayed diagnosis can result in unnecessary further investigations.

https://ift.tt/2NJNL7D

Oral immunotherapy with the ingestion of house dust mite extract in a murine model of allergic asthma

Allergen-specific immunotherapy (ASIT) has the potential to modify allergic diseases, and it is also considered a potential therapy for allergic asthma. House dust mite (HDM) allergens, a common source of airb...

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A Novel Grading System for Salpingopharyngeal Fold Hypertrophy in Obstructive Sleep Apnoea

Abstract

The present study aimed at reporting the incidence of Salpingopharyngeal Fold (SPF) hypertrophy on Drug Induced Sleep Endoscopy (DISE) in patients with Obstructive Sleep Apnoea (OSA, validate a grading system and analyse the impact of various grades on the clinical presentation while ascertaining its relation with Apnoea-Hypopnoea Index (AHI). A retrospective analysis of 169 patients with polysomnographic confirmation of obstructive sleep apnoea has been done in the study. The DISE video data of 169 patients was evaluated by two ENT surgeons individually and they graded the hypertrophy of the fold as Grade 0 being normal anatomy, Grade 1 being hypertrophy causing partial obstruction and Grade 2 being hypertrophy causing complete obstruction of lateral pharyngeal wall. It was found that the presence of SPF hypertrophy independently adds considerably to the severity of the obstruction, attributing to lateral collapse at the upper retropalatal level and also significantly increases AHI. It is thus advised to consider the grade of SPF hypertrophy while surgically planning the management of patients with OSA.

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The relationship between seizure in electroconvulsive therapy and pupillary response using an automated pupilometer

Abstract

Objectives

Seizure duration and morphology, postictal suppression, and sympathetic nervous system activation are all recommended as assessments of adequate seizure in electroconvulsive therapy (ECT). However, blood pressure and heart rate are not typically assessed as part of sympathetic nervous system activation because of the administration of anesthetic or cardiovascular agents during ECT. Although the pupils are known to reflect to the activity of autonomic nervous system and the degree of brain damage, previous studies have not examined the relationship between seizure of electroconvulsive therapy and pupillary response.

Methods

We conducted 98 sessions of ECT with 13 patients, divided into two groups according to seizure quality: (1) adequate or (2) inadequate. Pupillary light reflex [% constriction = (maximum resting pupil size {MAX} − minimum pupil size after light stimulation)/MAX × 100] was measured using a portable infrared quantitative pupilometer before anesthesia induction and immediately after electrical stimulation.

Results

The number regarded as adequate was 67 times and as inadequate was 31 times. Maximum pupil size at the control and immediately after electrical stimulation was similar between the adequate and inadequate groups. Pupillary light reflex was similar at the control between both groups, but significantly smaller immediately after stimulation in the adequate group (2.5 ± 3.6%) compared with the inadequate group (10.6 ± 11.5%). Receiver operating characteristic curve analysis revealed that pupillary light reflex (> 5.5%) predicted adequate seizure.

Conclusions

The current findings suggest that pupillary constriction immediately after ECT could provide a helpful method for assessing the efficacy of ECT.

https://ift.tt/2NISd6o

A Novel Grading System for Salpingopharyngeal Fold Hypertrophy in Obstructive Sleep Apnoea

Abstract

The present study aimed at reporting the incidence of Salpingopharyngeal Fold (SPF) hypertrophy on Drug Induced Sleep Endoscopy (DISE) in patients with Obstructive Sleep Apnoea (OSA, validate a grading system and analyse the impact of various grades on the clinical presentation while ascertaining its relation with Apnoea-Hypopnoea Index (AHI). A retrospective analysis of 169 patients with polysomnographic confirmation of obstructive sleep apnoea has been done in the study. The DISE video data of 169 patients was evaluated by two ENT surgeons individually and they graded the hypertrophy of the fold as Grade 0 being normal anatomy, Grade 1 being hypertrophy causing partial obstruction and Grade 2 being hypertrophy causing complete obstruction of lateral pharyngeal wall. It was found that the presence of SPF hypertrophy independently adds considerably to the severity of the obstruction, attributing to lateral collapse at the upper retropalatal level and also significantly increases AHI. It is thus advised to consider the grade of SPF hypertrophy while surgically planning the management of patients with OSA.

https://ift.tt/2Acgm23

Circulating Epithelial Cell Characterization and Correlation with Remission and Survival in Patients with Thyroid Cancer

Thyroid, Ahead of Print.


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Do High Levels of Antibodies to the IGF-1 Receptor Ameliorate Orbitopathy in Some Patients with Graves’ Disease?

Clinical Thyroidology, Volume 30, Issue 10, Page 464-467, October 2018.


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Thyroid Cancers with Nodules of Indeterminate Cytology Have a Specific Distribution of Histologic Types

Clinical Thyroidology, Volume 30, Issue 10, Page 480-484, October 2018.


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Persistent Disease is 3.5-Fold More Common Than Recurrent Disease After Initial Therapy for Differentiated Thyroid Cancer

Clinical Thyroidology, Volume 30, Issue 10, Page 447-449, October 2018.


https://ift.tt/2J124Uz

Integrated Cervical Ultrasound by the Same Specialist Who Performed Parathyroid Scintigraphy Improves Parathyroid Adenoma Detection

Clinical Thyroidology, Volume 30, Issue 10, Page 471-475, October 2018.


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Male Sex Is Associated with Increased Mortality from Papillary Thyroid Cancers with BRAF V600E Mutation

Clinical Thyroidology, Volume 30, Issue 10, Page 450-452, October 2018.


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Radioactive Iodine Therapy Is Associated with Clonal Hematopoiesis, a Precursor for Hematologic Malignancies

Clinical Thyroidology, Volume 30, Issue 10, Page 443-446, October 2018.


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Varying Levothyroxine Doses Within or Near the Reference Range Does Not Affect Energy Expenditure or Body Composition

Clinical Thyroidology, Volume 30, Issue 10, Page 453-455, October 2018.


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Thermal Inkjet Printing of Combination Synthetic LT3+LT4 May Be a Novel Method for Personalizing the Treatment of Hypothyroidism in the Future

Clinical Thyroidology, Volume 30, Issue 10, Page 468-470, October 2018.


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Levothyroxine Replacement for Primary Hypothyroidism Can Be Given Between Meals with Similar Effectiveness at Various Times of the Day

Clinical Thyroidology, Volume 30, Issue 10, Page 456-459, October 2018.


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Benign Nodules Show Little Change in Sonographic Appearance over Time

Clinical Thyroidology, Volume 30, Issue 10, Page 476-479, October 2018.


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Low Maternal Iodine Availability During Pregnancy Is Associated with Poorer Child Language Development

Clinical Thyroidology, Volume 30, Issue 10, Page 460-463, October 2018.


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Paul Walfish—In Memoriam

Clinical Thyroidology, Volume 30, Issue 10, Page 485-485, October 2018.


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Activity of Meropenem-Vaborbactam Against Pseudomonas aeruginosa and Acinetobacter baumannii in a Neutropenic Mouse Thigh Infection Model [Experimental Therapeutics]

We have evaluated the activity of meropenem-vaborbactam against clinical isolates of Pseudomonas aeruginosa and Acinetobacter baumannii in a neutropenic mouse thigh infection model. Data show that meropenem-vaborbactam regimens equivalent to 3-hour infusions every 8 hours with 2g meropenem-2g vaborbactam produced bacterial killing against strains with MICs of 2 – 16 mg/L and suggests that this combination may have utility in the treatment of infections caused by P. aeruginosa and A. baumannii.

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ARGONAUT-I: Activity of cefiderocol (S-649266), a siderophore cephalosporin, against Gram-negative bacteria including carbapenem resistant nonfermenters and Enterobacteriaceae with defined extended-spectrum {beta}-lactamases and carbapenemases [Susceptibility]

Activity of the siderophore cephalosporin cefiderocol, targeted for activity against carbapenem resistant Gram-negatives, was determined by microdilution in iron-depleted Mueller Hinton broth against characterized carbapenem resistant Acinetobacter baumannii complex, Stenotrophomonas maltophilia, Pseudomonas aeruginosa and Enterobacteriaceae. MIC₉₀s against A. baumannii, S. maltophilia and P. aeruginosa were 1, 0.25 and 0.5 mg/L, respectively. Against Enterobacteriaceae, MIC₉₀ was 1 mg/L for OXA-48-like group, 2 mg/L for KPC-3 group, and 8 mg/L for TEM/SHV ESBL, NDM and KPC-2 groups.

https://ift.tt/2PCanIS

OXA-48-like-producing Klebsiella pneumoniae in southern Spain in 2014-2015. [Epidemiology and Surveillance]

The aim of this study was to characterize the population structure of 56 OXA-48-like-producing K. pneumoniae isolates, as well as ESBLs and carbapenemases genes, recovered in 2014 and 2015 from 16 hospitals in southern Spain. XbaI PFGE and MLST were performed to assess clonal relatedness. Representative isolates belonging to OXA-48-like-producing and CTX-M-15-co-producing pulsotypes were selected for characterization of bla_OXA-48-like- and bla_CTX-M-15-carrying plasmids by PCR-based replicon typing, IncF subtyping, WGS analysis and typing of Tn1999 structures. Forty-three (77%) OXA-48-producing isolates were recovered from clinical samples and 13 from rectal swabs. All isolates showed ertapenem MIC values ≥ 1 mg/L, although 70% remained susceptible to imipenem and meropenem. Forty-nine isolates (88%) produced OXA-48, 5 produced OXA-245, and 2 produced OXA-181. Twenty-eight different pulsotypes (5 detected in more than one hospital) and 16 sequencetypes were found. The most prevalent clones were ST15 (29 isolates, 52%) and ST11 (7 isolates, 13%). Forty-five (80%) isolates were also bla_CTX-M-15 carriers. The bla_CTX-M-15 gene was mostly (82%) located on IncR plasmids, although ST15 and ST11 isolates also carried this gene on IncF plasmids. The composite transposon variant Tn1999.2-like was the most frequent. Among ST15 and ST11 isolates, different transposon variants were observed. The bla_OXA-48 gene was mainly located on IncL plasmids, although IncM plasmids were also observed. The spread of OXA-48-like-producing K. pneumoniae in southern Spain is mainly due to ST15 and ST11 clones. Variation within clonal lineages could indicate different acquisition events for both ESBL and carbapenemase traits.

https://ift.tt/2OXnUhj

Loss of C-5 sterol desaturase activity in Candida albicans - azole resistance or merely trailing growth? [Susceptibility]

Increased expression of drug efflux pumps and changes in the target enzyme, Erg11p, are known to contribute to azole resistance in Candida albicans, one of the most prevalent fungal pathogens. Mutations that inactivate ERG3, which encodes sterol ^5,6-desaturase also confer in vitro azole resistance. However, it is unclear if loss of Erg3p activity is sufficient to confer resistance within the mammalian host, and relatively few erg3 deficient mutants have been reported among azole-resistant clinical isolates. 'Trailing growth' (residual growth in the presence of the azoles) is a phenotype observed with many C. albicans isolates, and in its extreme form can be mistaken for resistance. The purpose of this study was to determine if growth of Erg3p-deficient C. albicans mutants in the presence of the azoles possesses the characteristics of azole resistance, or of an exaggerated form of trailing growth. Our results demonstrate that similar to trailing isolates, the capacity of an erg3/ mutant to endure the consequences of azole exposure is at least partly dependent upon both temperature and pH. This contrasts with true azole resistance that results from enhanced drug efflux and/or changes in the target enzyme. The erg3/ mutant and trailing isolates also appear to sustain significant membrane damage upon azole treatment, further distinguishing them from resistant isolates. However, the erg3/ mutant's insensitivity to the azoles is unaffected by the calcineurin inhibitor cyclosporin A, distinguishing it from trailing isolates. In conclusion, the erg3 mutant phenotype is qualitatively and quantitatively distinct from both azole resistance and trailing growth.

https://ift.tt/2PBEKzk

The Utility of Urine Cultures in Predicting Blood Culture Susceptibilities in Patients with Bacteremic Urinary Tract Infection [Susceptibility]

In a review of 428 patients with bacteremic urinary tract infection, urine culture susceptibility results accurately predicted blood culture results when the same organism was isolated from both cultures. Early targeted therapy using urine culture results can potentially reduce broad-spectrum antibiotic exposure, its associated adverse effects, and length of hospitalization.

https://ift.tt/2OWtZun

Comparison of Pharmacist-Directed Management of Multiplex PCR Blood Culture Results with Conventional Microbiology Methods on Effective and Optimal Therapy within a Community Hospital [Clinical Therapeutics]

Multiplex PCR combined with a pharmacist-driven reporting protocol was compared to standard-of-care within a community hospital to evaluate initial changes after notification of a positive blood culture. The intervention group demonstrated decreased time-to-change in antimicrobial therapy (p=0.0081), increased change to optimal antimicrobial therapy (p=0.013) and decreased vancomycin use for coagulase negative staphylococci contaminants (p<0.01) with multiplex PCR implementation and pharmacist intervention.

https://ift.tt/2PvWkEB

Acquisition of extended-spectrum ss-lactamase GES-6 leading to resistance to ceftolozane-tazobactam combination in Pseudomonas aeruginosa [Mechanisms of Resistance]

A clinical Pseudomonas aeruginosa isolate resistant to all β-lactams including ceftolozane-tazobactam and carbapenems was recovered. It belonged to the Sequence Type ST235 and produced the extended-spectrum β-lactamase (ESBL) GES-6 differing from GES-1 by two amino-acid substitutions (E104K and G170S). GES-6 possessed an increased hydrolytic activity toward carbapenems and to ceftolozane, and a decreased susceptibility to β-lactamase inhibitors as compared to GES-1, except for avibactam. We showed here that resistance to ceftolozane-tazobactam may occur through acquisition of a specific ESBL in P. aeruginosa, but that ceftazidime-avibactam combination remained an effective alternative.

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Effects of ivermectin and oxantel pamoate on tribendimidine: in vitro and in vivo drug-drug interaction study [Experimental Therapeutics]

Soil-transmitted helminth (STH) infections still remain a major health problem in poor rural settings. The lack of efficacious drugs against all STH species raises the interest in drug combinations. Drug-drug interactions are, however, of major concern so that careful in vitro and in vivo characterization is needed. The combination of tribendimidine with either ivermectin or oxantel pamoate targets a broad range of STH and thus, represents a promising treatment alternative. Drug-drug interactions, however, have not yet been investigated. Therefore, the effect of combinations of ivermectin, oxantel pamoate and tribendimidine's active metabolite deacylated amidantel (dADT) on the CYP450 metabolism was evaluated followed by a pharmacokinetic analysis of tribendimidine and ivermectin alone and in combination in healthy rats. Oxantel pamoate is only poorly absorbed and was therefore excluded from pharmacokinetic analysis. No evident effect was observed for tribendimidine-oxantel pamoate at CYP450 metabolism level, whereas a combination of tribendimidine and ivermectin led to a moderately increased CYP2D6 inhibition as compared to ivermectin or tribendimidine alone. Co-administration of tribendimidine with ivermectin altered neither the T_max nor elimination half-lives of dADT, adADT and ivermectin. While the AUCs and C_max of dADT, adADT and ivermectin are reduced by co-administration, the change is insufficient to declare that a DDI has been detected. Further studies are necessary to understand the observed interaction of tribendimidine and ivermectin, which is not related to P450 metabolism, and its significance for the situation in human.

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A Novel Actin Binding Drug with In Vivo Efficacy [Mechanisms of Action]

Occidiofungin is produced by the soil bacterium Burkholderia contaminans MS14 likely as an antifungal agent. This study identified the primary cellular target of occidiofungin, which was determined to be actin. Occidiofungin modified with a functional alkyne group enabled affinity purification assays and localization studies in yeast. Occidiofungin has a subtle effect on actin dynamics that triggers an apoptotic cell death. We demonstrate highly specific localization of occidiofungin to cellular regions rich in actin in yeast and binding of occidiofungin to purified actin in vitro. Further, disruption of actin mediated cellular processes such as endocytosis, nuclear segregation, and hyphae formation were observed. All these processes require the formation of stable actin cables, which are disrupted following the addition of a subinhibitory concentration of occidiofungin. We were also able to demonstrate the effectiveness of occidiofungin in treating a vulvovaginal yeast infection in a murine model. The results of this study are important for the development of an efficacious novel class of actin binding drugs that could fill the existing gap in treatment options for fungal infections or in the treatment of different types of cancer.

https://ift.tt/2OZmjaE

Daptomycin pore formation and stoichiometry depends on membrane potential of target membrane [Mechanisms of Action]

Daptomycin is a calcium-dependent lipodepsipeptide antibiotic clinically used to treat serious infections caused by Gram-positive pathogens. Its precise mode of action is somewhat controversial; the biggest issue is daptomycin pore formation, which we directly investigated here. We first performed a screening experiment using propidium iodide (PI) entry to Bacillus subtilis cells and chose the optimum and therapeutically relevant conditions (10 µg/mL daptomycin and 1.25 mM CaCl₂) for the subsequent analyses. Using conductance measurements on planar lipid bilayers, we show that daptomycin forms non-uniform oligomeric pores with conductance ranging from 120 pS up to 14 nS. The smallest conductance unit is probably a dimer, however tetramers and pentamers occur in the membrane most frequently. Moreover, daptomycin pore-forming activity is exponentially dependent on the applied membrane voltage. We further analyzed the membrane permeabilizing activity in B. subtilis cells using fluorescence methods (PI, DiSC₃(5)). Daptomycin most rapidly permeabilizes cells with high initial membrane potential and dissipates it within a few minutes. Low initial membrane potential hinders daptomycin pore formation.

https://ift.tt/2PBHoou

Efficacy of antifungal monotherapies and combinations against Aspergillus calidoustus [Susceptibility]

Invasive fungal infections due to Aspergillus calidoustus with decreased azole susceptibility are emerging in the setting of azole prophylaxis and are associated with poor outcomes. We assessed the in vitro activity of antifungal drugs used alone or in combinations against A. calidoustus and found a synergistic effect between voriconazole and terbinafine at concentrations within the therapeutic range. An invertebrate Galleria mellonella model of A. calidoustus infection tended to support the potential benefit of this combination.

https://ift.tt/2OXnV4R

Comparison of the Superpolymyxin™ and CHROMID(R) Colistin R screening media for the detection of colistin-resistant Enterobacteriaceae from spiked rectal swabs [Analytical Procedures]

The dissemination of carbapenemase-producing Enterobacteriaceae (CPE), has led to the increased use of colistin, which resulted in the emergence of colistin-resistant Enterobacteriaceae worldwide. One of the most threatening scenarios is the dissemination of colistin-resistance in CPE, particularly the plasmid-encoded resistance MCR. Thus, it becomes now mandatory to possess reliable media to screen for colistin-resistant Gram-negative isolates, especially Enterobacteriaceae. In this study we evaluated the performances of the Superpolymyxin™medium (ELITechGroup) and the CHROMID® Colistin R (bioMérieux) to screen for colistin-resistant Enterobacteriaceae from spiked rectal swabs. Stools were spiked with a total of 94 enterobacterial isolates (Escherichia coli, Klebsiella pneumoniae, Salmonella enterica, Enterobacter cloacae), including 53 colistin-resistant isolates. ESwabs™(Copan Diagnostics) were then inoculated with those spiked fecal suspensions and proceed as recommended by both manufacturers. The sensitivity of detection colistin-resistant Enterobacteriaceae were of 86.8% [95% confidence interval (CI95) 74.0 – 94.0] using both the Superpolymyxin™medium and the CHROMID® Colistin R plates. Surprisingly, the isolates that were not detected were not the same for both media. The specificities were high for both media, at 97.9% [CI95 = 87.3% - 99.9%] for Superpolymyxin™medium and 100% [CI95 = 90.4% - 100%] for the CHROMID® Colistin R medium. Both commercially-available media, CHROMID® Colistin R and Superpolymyxin™, provide a useful tool to screen for colistin-resistant Enterobacteriaceae from patient samples (rectal swabs) regardless of the level and mechanism of colistin resistance.

https://ift.tt/2Pz2rbm

Pse-T2, an antimicrobial peptide with High-Level, Broad-Spectrum Antimicrobial Potency and Skin Biocompatibility against Multidrug-resistant Pseudomonas aeruginosa infection [Experimental Therapeutics]

Pseudin-2, isolated from the frog Pseudis paradoxa, exhibits potent antibacterial activity but also cytotoxicity. In an effort to develop clinically applicable AMPs, we designed pseudin-2 analogs with Lys substitutions, resulting in elevated amphipathic α-helical structure and cationicity. In addition, truncated analogs of pseudin-2 and Lys-substituted peptides were synthesized to produce linear 18-residue amphipathic α-helices, which were further investigated for their mechanism and functions. These truncated analogs exhibited higher antimicrobial activity and lower cytotoxicity than pseudin-2. In particular, Pse-T2 showed marked pore formation, permeabilization of the outer/inner bacterial membranes, and DNA binding. Fluorescence spectroscopy and scanning electron microscopy showed that Pse-T2 kills bacterial cells by disrupting membrane integrity. In vivo, wounds infected with MDR Pseudomonas aeruginosa healed significantly faster when treated Pse-T2 than did untreated wounds or wounds treated with ciprofloxacin. Moreover, Pse-T2 facilitated infected wound closure by reducing inflammation through suppression of IL-1β, IL-6, and TNF-α. These data suggest the small antimicrobial peptide Pse-T2 could be useful for future development of therapeutic agents effective against MDR bacterial strains.

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A pathway-directed screen for inhibitors of the bacterial cell elongation machinery [Mechanisms of Action]

New antibiotics are needed to combat the growing problem of resistant bacterial infections. An attractive avenue towards the discovery of such next generation therapies is to identify novel inhibitors of clinically validated targets like cell wall biogenesis. We have therefore developed a pathway-directed, whole-cell screen for small molecules that block the activity of the Rod system of Escherichia coli. This conserved multi-protein complex is required for cell elongation and the morphogenesis of rod-shaped bacteria. It is composed of cell wall synthases and membrane proteins of unknown function that are organized by filaments of the actin-like MreB protein. Our screen takes advantage of the conditional essentiality of the Rod system and the ability of the beta-lactam mecillinam to cause a toxic malfunctioning of the machinery. Rod system inhibitors can therefore be identified as molecules that promote growth in the presence of mecillinam under conditions permissive for the growth of Rod^– cells. A screen of ~690,000 identified 1,300 compounds active against E. coli. Pathway-directed screening of a majority of this subset of compounds for Rod inhibitors successfully identified eight analogs of the MreB-antagonist A22. Further characterization of the A22 analogs identified showed that their antibiotic activity under conditions where the Rod system is essential was strongly correlated with their ability to suppress mecillinam toxicity. This result combined with additional biological studies reinforce the notion that A22-like molecules are relatively specific for MreB and suggest that the lipoprotein transport factor LolA is unlikely to be a physiologically relevant target as previously proposed.

https://ift.tt/2PCBN1w

Method-dependent epidemiological cutoff values (ECVs) for detection of triazole resistance in Candida and Aspergillus species for the SYO colorimetric broth and Etest agar diffusion methods [Susceptibility]

Although the Sensitrite Yeast-One (SYO) and Etest methods are widely utilized, interpretive criteria are not available for triazole susceptibility testing of Candida or Aspergillus species. We collected fluconazole, itraconazole, posaconazole and voriconazole SYO and Etest MICs from 39 laboratories representing all continents for (method-agent-dependent): 11,171 Candida albicans, 215 C. dubliniensis, 4,418 C. glabrata species complex (SC), 157 C. (Meyerozyma) guilliermondii, 676 C. krusei (Pichia kudriavzevii), 298 C. (Clavispora) lusitaniae, 911 and 3,691 C. parapsilosis sensu stricto (SS) and C. parapsilosis SC, respectively, 36 C. metapsilosis, 110 C. orthopsilosis, 1,854 C. tropicalis, 244 Saccharomyces cerevisiae, 1,409 Aspergillus fumigatus, 389 A. flavus, 130 A. nidulans, 233 A. niger, and 302 A. terreus complexes. SYO/Etest MICs for 282 confirmed non-WT isolates were included: ERG11 (C. albicans), ERG11 and MRR1 (C. parapsilosis), cyp51A (A. fumigatus), and CDR2, CDR1 overexpression (C. albicans and C. glabrata, respectively). Interlaboratory modal agreement was superior by SYO for yeast spp., and by the Etest for Aspergillus spp. Distributions fulfilling CLSI criteria for ECV definition were pooled and we proposed SYO ECVs for S. cerevisiae, 9 yeast and 3 Aspergillus species, and Etest ECVs for 5 yeast and 4 Aspergillus species. The posaconazole SYO ECV of 0.06 µg/ml for C. albicans and the Etest itraconazole ECV of 2 µg/ml for A. fumigatus were the best predictors of non-WT isolates. These findings support the need for method-dependent ECVs, as overall, the SYO appears to perform better for susceptibility testing of yeast spp. and the Etest for Aspergillus spp. Further evaluations should be conducted with more Candida mutants.

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Genomic Characterization of Carbapenemase-producing Klebsiella pneumoniae with Chromosomally Encoded blaNDM-1 [Epidemiology and Surveillance]

We report here the K. pneumoniae strains carrying chromosomal bla_NDM-1 in Thailand. The genomes of these two isolates include a 160-kbp insertion containing bla_NDM-1, which is almost identical to that in the IncHI1B-like plasmid. Further analysis indicated that IS5-mediated intermolecular transposition and Tn3-transposase-mediated homologous recombination resulted in the integration of bla_NDM-1 into the chromosome from an IncHI1B-like plasmid. The spread of this type of carbapenem-resistant Enterobacteriaceae may threaten public health and warrants further monitoring.

https://ift.tt/2PF7Iyp

Mutations in the MAB_2299c TetR regulator confer cross-resistance to clofazimine and bedaquiline in Mycobacterium abscessus [Mechanisms of Resistance]

New therapeutic approaches are needed against Mycobacterium abscessus, a respiratory mycobacterial pathogen that evades efforts to successfully treat infected patients. Clofazimine and bedaquiline, two drugs used for the treatment of multi-drug resistant tuberculosis, are being considered as alternatives for the treatment in lung diseases caused by M. abscessus. With the aim to understand the mechanism of action of these agents in M. abscessus, we sought herein to determine the means by which M. abscessus can develop resistance. Spontaneous resistant strains selected on clofazimine, followed by whole-genome sequencing, identified mutations in MAB_2299c, encoding a putative TetR transcriptional regulator. Unexpectedly, these mutants were also cross-resistant to bedaquiline. MAB_2299c was found to bind to its target DNA located upstream of the divergently orientated MAB_2300/MAB_2301 gene cluster, encoding MmpS/MmpL membrane proteins. Point mutations or deletion of MAB_2299c were associated with concomitant up-regulation of the mmpS/mmpL transcripts and accounted for this cross-resistance. Strikingly, deletion of MAB_2300/MAB_2301 in the MAB_2299c mutant strain restored susceptibility to bedaquiline and clofazimine. Overall, these results expand our knowledge with respect to the regulatory mechanisms of the MmpL family of proteins and on a novel mechanism of drug resistance in this difficult-to-treat respiratory mycobacterial pathogen. Therefore, MAB_2299c may represent an important marker of resistance to be considered for the treatment of M. abscessus diseases with clofazimine and bedaquiline in clinical settings.

https://ift.tt/2OV8Vo7

Activation of 2,4-diaminoquinazoline in Mycobacterium tuberculosis by Rv3161c, a putative dioxygenase [Mechanisms of Resistance]

The diaminoquinazoline series has good potency against Mycobacterium tuberculosis. Resistant isolates have mutations in Rv3161c, a putative dioxygenase. We carried out metabolite analysis on wild-type and an Rv3161c mutant strain after exposure to a diaminoquinazoline. The parental compound was found in intracellular extracts from the mutant, but not the wild-type. A metabolite consistent with a mono-hydroxylated form was identified in the wild-type. These data support the hypothesis that Rv3161c metabolizes diaminoquinazolines in M. tuberculosis.

https://ift.tt/2PBUySs

New Treatment Options Against Carbapenem-Resistant Acinetobacter baumannii Infections [Minireviews]

Carbapenem-resistant Acinetobacter baumannii (CRAB) is a perilous nosocomial pathogen causing substantial morbidity and mortality. Current treatment options for CRAB are limited and suffer from pharmacokinetic limitations such as high toxicity and low plasma levels. As a result, CRAB is declared as the top priority pathogen by the World Health Organization for investment in new drugs. This urgent need for new therapies, in combination with faster FDA approval process accelerated new drug development and placed several drug candidates in the pipeline. This article reviews available information about the new drugs and other therapeutic options focusing on agents in clinical or late stage pre-clinical studies for the treatment of CRAB and evaluates their expected benefits and potential shortcomings.

https://ift.tt/2OV8R7R

No evidence for acquired mutations associated with cytochrome bc1-inhibitor resistance in 13,559 clinical Mycobacterium tuberculosis complex isolates [Letters]

In 2016, tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb) was responsible for an estimated 1.7 million deaths (1)....

https://ift.tt/2PzmOoP

The connection of pollen concentrations and crowd-sourced symptom data: new insights from daily and seasonal symptom load index data from 2013 to 2017 in Vienna

Online pollen diaries and mobile applications nowadays allow easy and fast documentation of pollen allergy symptoms. Such crowd-sourced symptom data provides insights into the development and the onset of a po...

https://ift.tt/2PCFrby

Adenocarcinoma de Saco Endolinfático

Adenocarcinoma de saco endolinfático

 

https://ift.tt/2Abtm83

Increasing Frequency and Share of Dermatologic Procedures Billed by Non-Physician Clinicians from 2012-2016

https://ift.tt/2RRW0ld

Trefoil factor family 2 protein: a potential immunohistochemical marker for aiding diagnosis of lobular endocervical glandular hyperplasia and gastric-type adenocarcinoma of the uterine cervix

Abstract

Gastric-type adenocarcinoma (GA) is an aggressive subtype of cancer of the uterine cervix. Several immunohistochemical markers for gastric mucins, such as mucin 6 (MUC6) and N-acetylglucosamine α1 → 4galactose → R (αGlcNAc-R), which is recognized by HIK1083 antibody, have been introduced for diagnosis of GA and lobular endocervical glandular hyperplasia (LEGH). However, MUC6 is also expressed in normal endocervical glands and HIK1083 antibody has limited availability. Trefoil factor family 2 protein (TFF2) is secreted by gastric, but not normal endocervical glands. Here, we evaluated TFF2 immunostaining for detection of a gastric immunophenotype in endocervical glandular lesions. We compared TFF2, αGlcNAc-R, and MUC6 expression in 103 endocervical glandular lesions: LEGH (n = 23), adenocarcinoma in situ/microinvasive adenocarcinoma (AIS–MIA) (n = 29), and invasive adenocarcinoma (usual type [UA], n = 26; GA, n = 11; intestinal type [IA], n = 2; signet ring cell type [Sig], n = 2; and mucinous adenocarcinoma not otherwise specified [NOS], n = 10). TFF2 and αGlcNAc-R expression was completely concordant in each subtype: LEGH (100%), AIS–MIA (44.8%), UA (26.9%), GA (90.9%), IA (100%), Sig (0%), and NOS (20%). TFF2 staining scores were significantly correlated with those of αGlcNAc-R in these lesions. TFF2 and αGlcNAc-R immunoreactivity was present in cytoplasmic mucins and luminal secretions. TFF2 and αGlcNAc-R were not expressed in the normal endocervical glands. MUC6 was frequently expressed in normal endocervical glands and endocervical glandular lesions. Endocervical adenocarcinomas sometimes stained only for MUC6. TFF2 is a promising immunohistochemical marker and its identification in uterine cervical secretion is a potentially useful diagnostic test for endocervical glandular lesions with gastric differentiation.

https://ift.tt/2EnNxnk

Chirurgische Therapie im Stadium I und II des nichtkleinzelligen Lungenkarzinoms

Zusammenfassung

Hintergrund

In den vergangenen Jahrzehnten hat sich die Prognose des Lungenkarzinoms trotz moderner Diagnostik und multimodaler Therapiestrategien kaum verbessert. Ein großer Anteil der Patienten mit einem nichtkleinzelligen Lungenkarzinom (NSCLC; 57 %) haben zum Zeitpunkt der Diagnose Fernmetastasen und nur etwa 40 % der Patienten sind in einem potenziell operablen Tumorstadium.

Material und Methoden

Diese Arbeit basiert auf einer selektiven Literaturrecherche in der Datenbank PubMed sowie eigenen Erfahrungen zum Thema des Artikels.

Ergebnisse

Für Patienten in einem frühen Tumorstadium, Stadium I und II nach der Klassifikation der Tumorstadien in der 8. Ausgabe der Union for International Cancer Control (UICC), ist die chirurgische anatomische Tumorresektion in Kombination mit einer systematischen mediastinalen und hilären Lymphknotendissektion das Therapieverfahren der Wahl. Mit dem klassischen Resektionsverfahren der Lobektomie (Bilobektomie, Pneumonektomie) in Verbindung mit einer systematischen Lymphadenektomie lassen sich Fünfjahresüberlebensraten von über 80 % im Frühstadium IA bzw. 48 % im Stadium II erzielen. Neben der offenen chirurgischen Resektion konnten weltweit minimal-invasive, videoassistierte thorakoskopische Resektionsverfahren (VATS, „video-assisted thoracic surgery") im Stadium I und II erfolgreich etabliert werden. Im Stadium II kann eine adjuvante Chemotherapie das Überleben positiv beeinflussen.

Diskussion

Ob zielgerichtete Krebstherapien (sog. „targeted therapies") oder eine Immuntherapie im neoadjuvanten oder adjuvanten Therapiekonzept beim NSCLC im Frühstadium das Überleben der Patienten verbessern, wird momentan in Studien untersucht.

https://ift.tt/2AcKHxg

Lebensqualität und Depression bei Hörminderung

Zusammenfassung

Hintergrund

Hörbehinderungen können zu einer verminderten Lebensqualität führen und somit einen Vulnerabilitätsfaktor für psychische Störungen darstellen.

Ziel der Arbeit

Diese Studie stellt die erste grundlegende Analyse subjektiver Lebensqualität und depressiver Symptome bei Hörbehinderung in Deutschland aus psychiatrischer Perspektive dar.

Material und Methoden

Die Patientengruppe umfasste 30 hörbehinderte Probanden (27 Frauen, 3 Männer), die eine aktuelle oder vergangene psychische Erkrankung und/oder eine psychiatrisch-psychotherapeutische Behandlung vorwiesen (Alter: Mittelwert [M] = 49,67 Jahre, Standardabweichung [SD] = 13,54). Die Kontrollgruppe bestand aus 22 hörbehinderten Probanden (16 Frauen, 6 Männer), die weder eine psychische Störung noch eine dementsprechende Behandlung angaben (Alter M = 52,41 Jahre, SD = 17,30). Neben soziodemografischen Daten wurden der Beginn/Grad der Hörbehinderung sowie die Versorgung mit Hörsystemen erfasst. Testdiagnostisch wurden die subjektiv wahrgenommene Funktionsbeeinträchtigung (Sheehan Disability Scale [SDS]) und die gesundheitsbezogene Lebensqualität (Fragebogen zum Gesundheitszustand, SF-36) ermittelt. Zudem erfolgte eine Erhebung depressiver Symptome (Beck-Depressions-Inventar, BDI-II).

Ergebnisse

Die Gruppen unterschieden sich nicht signifikant bzgl. Alter, Geschlecht und Intelligenz. Teilnehmer der Patientengruppe wiesen eine signifikant höhere subjektive Beeinträchtigung, niedrigere Lebensqualität und stärkere depressive Symptome auf. Als potenzielle Vulnerabilitätsfaktoren auf seelische Gesundheit innerhalb dieser Gruppe erscheinen insbesondere das Ausmaß der Invasivität der Hörhilfe (d. h. Cochlea-Implantat) sowie Entwicklungszeitpunkt der Hörminderung (postlingual) plausibel.

Schlussfolgerung

Die Ergebnisse dieser Studie bedeuten für den Behandler, dass dieser neben einer qualitativ hochwertigen akustischen Versorgung die psychosoziale Behandlungsbedürftigkeit der psychischen Folgen, bedingt durch den Verlust der Lebensqualität, kontinuierlich prüfen sollte. Die Entwicklung eines spezifischen psychotherapeutischen Angebots für Menschen mit einer Hörminderung bedarf zusätzlicher Erforschung von Schutz- und Vulnerabilitätsfaktoren, die für die Entwicklung psychischer Störungen bei Hörminderung von Bedeutung sein können.

https://ift.tt/2OWX5d2

Recovery of positional nystagmus after benign paroxysmal positional vertigo fatigue

Abstract

Purpose

In benign paroxysmal positional vertigo (BPPV), positional nystagmus is generally weaker when the Dix–Hallpike test is repeated. This phenomenon is known as BPPV fatigue. The positional nystagmus induced by the Dix–Hallpike test can be observed again when time has passed. There has been no study regarding the length of time required to recover the positional nystagmus. The purpose of this study was to examine whether positional nystagmus recovers within 30 min after the disappearance of the nystagmus by BPPV fatigue.

Methods

This was a prospective observational study. Twenty patients with posterior canal type of BPPV (canalolithiasis of the posterior canal) were included. Dix–Hallpike tests were performed three times for each patient. A second Dix–Hallpike test was performed immediately after the first Dix–Hallpike test. A third Dix–Hallpike test was performed 30 min after the second Dix–Hallpike test. We recorded positional nystagmus induced by the Dix–Hallpike tests and analyzed maximum slow-phase eye velocity (SPEV) of the positional nystagmus.

Results

The average maximum SPEV of positional nystagmus induced by the second Dix–Hallpike test (4.8°/s) was statistically lower than that induced by the first Dix–Hallpike test (48.0°/s); this decrease was caused by BPPV fatigue. There was no statistical difference between average maximum SPEV of positional nystagmus induced by the first Dix–Hallpike test and that induced by the third Dix–Hallpike test (41.6°/s); this indicates that the effect of BPPV fatigue disappeared. The effect of BPPV fatigue disappears within 30 min.

Conclusions

A second Dix–Hallpike test should be performed at least 30 min after the first.

https://ift.tt/2ChtQuG

Prevention of Dermatitis in Epoxy Exposed Workers

Conditions:   Contact Dermatitis;   Sensitization Dermatitis
Intervention:   Device: Fluorescence visualization (feedback)
Sponsors:   Aarhus University Hospital;   Arbejdsmiljøforskningsfonden;   Vestas Wind Power;   Siemens Gamesa Renewable Energy;   Skane University Hospital;   Herning Hospital;   National Research Centre for the Working Environment, Denmark;   Aalborg Universitetshospital
Not yet recruiting

https://ift.tt/2yeM8Kc

Effects of Mobilization and Perceptive Rehabilitation on Patients With Fibromyalgia Syndrome

Condition:   Fibromyalgia
Interventions:   Other: Perceptive Rehabilitation;   Other: Mobilisation Techniques
Sponsor:   European University of Lefke
Not yet recruiting

https://ift.tt/2yHtLNg

A Comparative Analysis of Global Datasets and Initiatives for Urban Health and Sustainability

Taylor, JG; Haines, A; Milner, J; Davies, M; Wilkinson, P; (2018) A Comparative Analysis of Global Datasets and Initiatives for Urban Health and Sustainability. Sustainability , 10 (10) , Article 3636. 10.3390/su10103636 . Green open access

https://ift.tt/2QQ8Wa4

Causes of stillbirths and neonatal deaths in Dhanusha district, Nepal: A verbal autopsy study

Manandhar, SR; Ojha, A; Manandhar, DS; Shrestha, B; Shrestha, D; Saville, N; Costello, AM; Manandhar, SR; Ojha, A; Manandhar, DS; Shrestha, B; Shrestha, D; Saville, N; Costello, AM; Osrin, D; - view fewer (2010) Causes of stillbirths and neonatal deaths in Dhanusha district, Nepal: A verbal autopsy study. Kathmandu University Medical Journal , 8 (29) pp. 62-72.

https://ift.tt/2Aa1np1

Role of Proton Diffusion in the Nonexponential Kinetics of Proton-Coupled Electron Transfer from Photoreduced ZnO Nanocrystals

Ghosh, S; Soudackov, AV; Hammes-Schiffer, S; (2017) Role of Proton Diffusion in the Nonexponential Kinetics of Proton-Coupled Electron Transfer from Photoreduced ZnO Nanocrystals. ACS Nano , 11 (10) pp. 10295-10302. 10.1021/acsnano.7b05009 . Green open access

https://ift.tt/2QTjghI

The Relationship Between Microfracture Damage and the Physical Properties of Fault-Related Rocks: The Gole Larghe Fault Zone, Italian Southern Alps

Rempe, M; Mitchell, TM; Renner, J; Smith, SAF; Bistacchi, A; Di Toro, G; (2018) The Relationship Between Microfracture Damage and the Physical Properties of Fault-Related Rocks: The Gole Larghe Fault Zone, Italian Southern Alps. Journal of Geophysical Research: Solid Earth 10.1029/2018JB015900 . (In press). Green open access

https://ift.tt/2Aa1cKn

Theoretical Insights into Proton-Coupled Electron Transfer from a Photoreduced ZnO Nanocrystal to an Organic Radical

Ghosh, S; Castillo-Lora, J; Soudackov, AV; Mayer, JM; Hammes-Schiffer, S; (2017) Theoretical Insights into Proton-Coupled Electron Transfer from a Photoreduced ZnO Nanocrystal to an Organic Radical. Nano Letters , 17 (9) pp. 5762-5767. 10.1021/acs.nanolett.7b02642 . Green open access

https://ift.tt/2QTiGQY

Tele-monitoring in paediatric neuromuscular patients requiring home mechanical ventilation, multicentric study

Trucco, F; Pedemonte, M; Racca, F; Falsaperla, R; Romano, C; Wenzel, A; Tacchetti, P; ... Minetti, C; + view all Trucco, F; Pedemonte, M; Racca, F; Falsaperla, R; Romano, C; Wenzel, A; Tacchetti, P; Bella, C; Bruno, C; Minetti, C; - view fewer (2017) Tele-monitoring in paediatric neuromuscular patients requiring home mechanical ventilation, multicentric study. Presented at: European-Respiratory-Society (ERS) International Congress, Milan, Italy.

https://ift.tt/2Aa151p

Investigating the growing trend of non-drinking among young people; analysis of repeated cross-sectional surveys in England 2005–2015

Ng Fat, L; Shelton, N; Cable, N; (2018) Investigating the growing trend of non-drinking among young people; analysis of repeated cross-sectional surveys in England 2005–2015. BMC Public Health , 18 (1) , Article 1090. 10.1186/s12889-018-5995-3 . Green open access

https://ift.tt/2QUuLW7

Case Studies in Neuroscience: Evidence of motor thalamus reorganization following bilateral forearm amputations

Whatley, BP; Chopek, JW; Hill, R; Brownstone, RM; (2018) Case Studies in Neuroscience: Evidence of motor thalamus reorganization following bilateral forearm amputations. Journal of Neurophysiology , 120 (4) pp. 1776-1780. 10.1152/jn.00120.2018 .

https://ift.tt/2AaZNDz

Molecular aspects of eye development and regeneration in the Australian redclaw crayfish, Cherax quadricarinatus

Ventura, T; Stewart, MJ; Chandler, JC; Rotgans, B; Elizur, A; Hewitt, AW; (2018) Molecular aspects of eye development and regeneration in the Australian redclaw crayfish, Cherax quadricarinatus. Aquaculture and Fisheries 10.1016/j.aaf.2018.04.001 . (In press). Green open access

https://ift.tt/2QUuC51

‘Best friends forever’? Friendship stability across school transition and associations with mental health and educational attainment

Ng-Knight, T; Shelton, KH; Riglin, L; Frederickson, N; McManus, IC; Rice, F; (2018) 'Best friends forever'? Friendship stability across school transition and associations with mental health and educational attainment. British Journal of Educational Psychology 10.1111/bjep.12246 . (In press).

https://ift.tt/2AbB5mo

Hydrodynamic predictions for mixed harmonic correlations in 200 GeV Au+ Au collisions

Gardim, FG; Grassi, F; Luzum, M; Noronha-Hostler, J; (2017) Hydrodynamic predictions for mixed harmonic correlations in 200 GeV Au+ Au collisions. Physical Review C , 95 (3) , Article 034901. 10.1103/PhysRevC.95.034901 . Green open access

https://ift.tt/2QRwtHD

Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016

Griswold, MG; Fullman, N; Hawley, C; Arian, N; Zimsen, SRM; Tymeson, HD; Venkateswaran, V; ... Gakidou, E; + view all Griswold, MG; Fullman, N; Hawley, C; Arian, N; Zimsen, SRM; Tymeson, HD; Venkateswaran, V; Tapp, AD; Forouzanfar, MH; Salama, JS; Abate, KH; Abate, D; Abay, SM; Abbafati, C; Abdulkader, RS; Abebe, Z; Aboyans, V; Abrar, MM; Acharya, P; Adetokunboh, OO; Adhikari, TB; Adsuar, JC; Afarideh, M; Agardh, EE; Agarwal, G; Aghayan, SA; Agrawal, S; Ahmed, MB; Akibu, M; Akinyemiju, T; Akseer, N; Al Asfoor, DH; Al-Aly, Z; Alahdab, F; Alam, K; Albujeer, A; Alene, KA; Ali, R; Ali, SD; Alijanzadeh, M; Aljunid, SM; Alkerwi, A; Allebeck, P; Alvis-Guzman, N; Amare, AT; Aminde, LN; Ammar, W; Amoako, YA; Amul, GGH; Andrei, CL; Angus, C; Ansha, MG; Antonio, CAT; Aremu, O; Arnlov, J; Artaman, A; Aryal, KK; Assadi, R; Ausloos, M; Avila-Burgos, L; Avokpaho, EFGA; Awasthi, A; Ayele, HT; Ayer, R; Ayuk, TB; Azzopardi, PS; Badali, H; Badawi, A; Banach, M; Barker-Collo, SL; Barrero, LH; Basaleem, H; Baye, E; Bazargan-Hejazi, S; Bedi, N; Bejot, Y; Belachew, AB; Belay, SA; Bennett, DA; Bensenor, IM; Bernabe, E; Bernstein, RS; Beyene, AS; Beyranvand, T; Bhaumik, S; Bhutta, ZA; Biadgo, B; Bijani, A; Bililign, N; Birlik, SM; Birungi, C; Bizuneh, H; Bjerregaard, P; Bjorge, T; Borges, G; Bosetti, C; Boufous, S; Bragazzi, NL; Brenner, H; Butt, ZA; Cahuana-Hurtado, L; Calabria, B; Campos-Nonato, IR; Campuzano Rincon, JC; Carreras, G; Carrero, JJ; Carvalho, F; Castaneda-Orjuela, CA; Castillo Rivas, J; Catala-Lopez, F; Chang, J-C; Charlson, FJ; Chattopadhyay, A; Chaturvedi, P; Chowdhury, R; Christopher, DJ; Chung, S-C; Ciobanu, LG; Claro, RM; Conti, S; Cousin, E; Criqui, MH; Dachew, BA; Dargan, P; Daryani, A; Das Neves, J; Davletov, K; De Castro, F; De Courten, B; De Neve, J-W; Degenhardt, L; Demoz, GT; Des Jarlais, DC; Dey, S; Dhaliwal, RS; Dharmaratne, SD; Dhimal, M; Doku, DT; Doyle, KE; Dubey, M; Dubljanin, E; Duncan, BB; Ebrahimi, H; Edessa, D; Zaki, MES; Ermakov, SP; Erskine, HE; Esteghamati, A; Faramarzi, M; Farioli, A; Faro, A; Farvid, MS; Farzadfar, F; Feigin, VL; Felisbino-Mendes, MS; Fernandes, E; Ferrari, AJ; Ferri, CP; Fijabi, DO; Filip, I; Finger, JD; Fischer, F; Flaxman, AD; Franklin, RC; Futran, ND; Gallus, S; Ganji, M; Gankpe, FG; Gebregergs, GB; Gebrehiwot, TT; Geleijnse, JM; Ghadimi, R; Ghandour, LA; Ghimire, M; Gill, PS; Ginawi, IA; Giref, AZZ; Gona, PN; Gopalani, SV; Gotay, CC; Goulart, AC; Greaves, F; Grosso, G; Guo, Y; Gupta, R; Gupta, R; Gupta, V; Alma Gutierrez, R; Gvs, M; Hafezi-Nejad, N; Hagos, TB; Hailu, GB; Hamadeh, RR; Hamidi, S; Hankey, GJ; Harb, HL; Harikrishnan, S; Maria Haro, J; Hassen, HY; Havmoeller, R; Hay, S; Heibati, B; Henok, A; Heredia-Pi, I; Francisco Hernandez-Llanes, N; Herteliu, C; Hibstu, DTT; Hoogar, P; Horita, N; Hosgood, HD; Hosseini, M; Hostiuc, M; Hu, G; Huang, H; Husseini, A; Idrisov, B; Ileanu, BV; Ilesanmi, OS; Irvani, SSN; Islam, SMS; Jackson, MD; Jakovljevic, M; Jayatilleke, AU; Jha, RP; Jonas, JB; Jozwiak, JJ; Kabir, Z; Kadel, R; Kahsay, A; Kapil, U; Kasaeian, A; Kassa, TDD; Katikireddi, SV; Kawakami, N; Kebede, S; Kefale, AT; Keiyoro, PN; Kengne, AP; Khader, Y; Khafaie, MA; Khalil, IA; Khan, MN; Khang, Y-H; Khater, MM; Khubchandani, J; Kim, C-I; Kim, D; Kim, YJ; Kimokoti, RW; Kisa, A; Kivimaki, M; Kochhar, S; Kosen, S; Koul, PA; Koyanagi, A; Krishan, K; Defo, BK; Bicer, BK; Kulkarni, VS; Kumar, P; Lafranconi, A; Balaji, AL; Lalloo, R; Lallukka, T; Lam, H; Lami, FH; Lan, Q; Lang, JJ; Lansky, S; Larsson, AO; Latifi, A; Leasher, JL; Lee, PH; Leigh, J; Leinsalu, M; Leung, J; Levi, M; Li, Y; Lim, L-L; Linn, S; Liu, S; Lobato-Cordero, A; Lotufo, PA; King Macarayan, ER; Machado, IE; Madotto, F; Abd El Razek, HM; Abd El Razek, MM; Majdan, M; Majdzadeh, R; Majeed, A; Malekzadeh, R; Malta, DC; Mapoma, CC; Martinez-Raga, J; Maulik, PK; Mazidi, M; Mckee, M; Mehta, V; Meier, T; Mekonen, T; Meles, KG; Melese, A; Memiah, PTN; Mendoza, W; Mengistu, DT; Mensah, GA; Meretoja, TJ; Mezgebe, HB; Miazgowski, T; Miller, TR; Mini, GK; Mirica, A; Mirrakhimov, EM; Moazen, B; Mohammad, KA; Mohammadifard, N; Mohammed, S; Monasta, L; Moraga, P; Morawska, L; Jalu, MT; Mousavi, SM; Mukhopadhyay, S; Musa, KI; Naheed, A; Naik, G; Najafi, F; Nangia, V; Nansseu, JR; Nayak, MSDP; Nejjari, C; Neupane, S; Neupane, SP; Ngunjiri, JW; Cuong, TN; Long, HN; Trang, HN; Ningrum, DNA; Nirayo, YL; Noubiap, JJ; Ofori-Asenso, R; Ogbo, FA; Oh, I-H; Oladimeji, O; Olagunju, AT; Olivares, PR; Olusanya, BO; Olusanya, JO; Oommen, AM; Oren, E; Orpana, HM; Ortega-Altamirano, DD; Ortiz, JR; Ota, E; Owolabi, MO; Oyekale, AS; Mahesh, PA; Pana, A; Park, E-K; Parry, CDH; Parsian, H; Patle, A; Patton, GC; Paudel, D; Petzold, M; Phillips, MR; Pillay, JD; Postma, MJ; Pourmalek, F; Prabhakaran, D; Qorbani, M; Radfar, A; Rafay, A; Rafiei, A; Rahim, F; Rahimi-Movaghar, A; Rahman, M; Rahman, MA; Rai, RK; Rajsic, S; Raju, SB; Ram, U; Rana, SM; Ranabhat, CL; Rawaf, DL; Rawaf, S; Reiner, RC; Reis, C; Renzaho, AMN; Rezai, MS; Roever, L; Ronfani, L; Room, R; Roshandel, G; Rostami, A; Roth, GA; Roy, A; Sabde, YD; Saddik, B; Safiri, S; Sahebkar, A; Saleem, Z; Salomon, JA; Salvi, SS; Sanabria, J; Dolores Sanchez-Nino, M; Santomauro, DF; Santos, IS; Milicevic, MMMS; Sarker, AR; Sarmiento-Suarez, R; Sarrafzadegan, N; Sartorius, B; Satpathy, M; Sawhney, M; Saxena, S; Saylan, M; Schaub, MP; Schmidt, MI; Schneider, IJC; Schoettker, B; Schutte, AE; Schwendicke, F; Sepanlou, SG; Shaikh, MAA; Sharif, M; She, J; Sheikh, A; Shen, J; Shiferaw, MS; Shigematsu, M; Shiri, R; Shishani, K; Shiue, I; Shukla, SR; Sigfusdottir, ID; Santos Silva, DA; Da Silva, NT; Alves Silveira, DG; Sinha, DNN; Sitas, F; Soares Filho, AM; Soofi, M; Sorensen, RJD; Soriano, JB; Sreeramareddy, CT; Steckling, N; Stein, DJ; Sufiyan, MB; Sur, PJ; Sykes, BL; Tabares-Seisdedos, R; Tabuchi, T; Tavakkoli, M; Tehrani-Banihashemi, A; Tekle, MG; Thapa, S; Thomas, N; Topor-Madry, R; Topouzis, F; Tran, BX; Troeger, CE; Truelsen, TC; Tsilimparis, N; Tyrovolas, S; Ukwaja, KN; Ullah, I; Uthman, OA; Valdez, PR; Van Boven, JFM; Vasankari, TJ; Venketasubramanian, N; Violante, FS; Vladimirov, SK; Vlassov, V; Vollset, SE; Vos, T; Wagnew, FWS; Waheed, Y; Wang, Y-P; Weiderpass, E; Weldegebreal, F; Weldegwergs, KG; Werdecker, A; Westerman, R; Whiteford, HA; Widecka, J; Wijeratne, T; Wyper, GMA; Xu, G; Yamada, T; Yano, Y; Ye, P; Yimer, EM; Yip, P; Yirsaw, BD; Yisma, E; Yonemoto, N; Yoon, S-J; Yotebieng, M; Younis, MZ; Zachariah, G; Zaidi, Z; Zamani, M; Zhang, X; Zodpey, S; Mokdad, AH; Naghavi, M; Murray, CJL; Gakidou, E; - view fewer (2018) Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet , 392 (10152) pp. 1015-1035. 10.1016/S0140-6736(18)31310-2 . Green open access

https://ift.tt/2AaZfgW

Cognitive Development Respiratory Tract Illness and Effects of Exposure (Cortex) Project: Combining High Spatial Resolution Pollution Measurements With Individual Level Data, a Methodological Approach

Rodgers, SE; Lyons, J; Mizen, A; Berridge, D; Akbari, A; Carruthers, D; Davies, G; ... Wilkinson, P; + view all Rodgers, SE; Lyons, J; Mizen, A; Berridge, D; Akbari, A; Carruthers, D; Davies, G; Dearden, L; Doherty, R; Lake, I; Mavrogianni, A; Milojevic, A; Strickland, S; Wilkinson, P; - view fewer (2018) Cognitive Development Respiratory Tract Illness and Effects of Exposure (Cortex) Project: Combining High Spatial Resolution Pollution Measurements With Individual Level Data, a Methodological Approach. Presented at: International Population Data Linkage Conference, Banff, Canada. Green open access

https://ift.tt/2QOFH7B

Are Children Who Are Treated for Asthma and Seasonal Allergic Rhinitis Disadvantaged in Their Educational Attainment When Acutely Exposed to Air Pollution and Pollen? A Feasibility Study

Mizen, A; Lyons, J; Rodgers, S; Berridge, D; Akbari, A; Wilkinson, P; Milojevic, A; ... Davies, G; + view all Mizen, A; Lyons, J; Rodgers, S; Berridge, D; Akbari, A; Wilkinson, P; Milojevic, A; Doherty, R; Dearden, L; Lake, I; Carruthers, D; Strickland, S; Mavrogianni, A; Davies, G; - view fewer (2018) Are Children Who Are Treated for Asthma and Seasonal Allergic Rhinitis Disadvantaged in Their Educational Attainment When Acutely Exposed to Air Pollution and Pollen? A Feasibility Study. Presented at: International Conference for Administrative Data Research, Belfast, Northern Ireland, UK. Green open access

https://ift.tt/2AbiczS

The Future of Cross-Linking and Immunoprecipitation (CLIP)

Ule, J; Hwang, H-W; Darnell, RB; (2018) The Future of Cross-Linking and Immunoprecipitation (CLIP). Cold Spring Harbor Perspectives in Biology , 10 (8) , Article a032243. 10.1101/cshperspect.a032243 . Green open access

https://ift.tt/2QQPeuL

From the Editor’s desk....: September 2018

Moreau, R; Bataller, R; Berg, T; Lotersztajn, S; Zucman-Rossi, J; Jalan, R; (2018) From the Editor's desk....: September 2018. [Editorial comment]. Journal of Hepatology , 69 (3) pp. 559-561. 10.1016/j.jhep.2018.06.006 .

https://ift.tt/2AbkfnO

Two New Species of Feroperis Lafer (Carabidae: Pterostichus) From China, With a Key to All Known Chinese Species in This Subgenus

Sun, X; Shi, H; Sang, W; Axmacher, JC; (2018) Two New Species of Feroperis Lafer (Carabidae: Pterostichus) From China, With a Key to All Known Chinese Species in This Subgenus. ZooKeys (In press).

https://ift.tt/2QLYD6W

Identification of differentially methylated cell-types in Epigenome-Wide Association Studies

Teschendorff, AE; Zheng, S; Breeze, C; Beck, S; (2019) Identification of differentially methylated cell-types in Epigenome-Wide Association Studies. Nature Methods (In press).

https://ift.tt/2Abx7Kz

Ethnic group differences in impacts of free bus passes in England: A national study

Patterson, R; Webb, E; Mindell, JS; Millett, C; Laverty, AA; (2018) Ethnic group differences in impacts of free bus passes in England: A national study. Journal of Transport and Health , 11 pp. 1-14. 10.1016/j.jth.2018.09.005 . (In press).

https://ift.tt/2QOqaVh

Analysis of the India-myanmar Timber Trade

Maria-Sube, E; Woodgate, GR; (2018) Analysis of the India-myanmar Timber Trade. Asian Journal of Forestry , 3 (1) (In press). Green open access

https://ift.tt/2Aa0RHB

Supracellular contraction at the rear of cell groups drives collective chemotaxis

Mayor, R; (2018) Supracellular contraction at the rear of cell groups drives collective chemotaxis. Science (In press).

https://ift.tt/2CgSgV2

Pharmacogenetic analyses of 2183 patients with advanced colorectal cancer; potential role for common dihydropyrimidine dehydrogenase variants in toxicity to chemotherapy

Madi, A; Fisher, D; Maughan, TS; Colley, JP; Meade, AM; Maynard, J; Humphreys, V; ... Cheadle, JP; + view all Madi, A; Fisher, D; Maughan, TS; Colley, JP; Meade, AM; Maynard, J; Humphreys, V; Wasan, H; Adams, RA; Idziaszczyk, S; Harris, R; Kaplan, RS; Cheadle, JP; - view fewer (2018) Pharmacogenetic analyses of 2183 patients with advanced colorectal cancer; potential role for common dihydropyrimidine dehydrogenase variants in toxicity to chemotherapy. European Journal of Cancer , 102 pp. 31-39. 10.1016/j.ejca.2018.07.009 .

https://ift.tt/2CLj3dq

Multimodal technologies in LEGO House: A social semiotic perspective

Cowan, K; (2018) Multimodal technologies in LEGO House: A social semiotic perspective. Multimodal Technologies and Interaction , 2 (4) , Article 70. 10.3390/mti2040070 . Green open access

https://ift.tt/2CgOSJK

Structural properties of Silicon-Germanium and Germanium-Silicon Core-Shell Nanowires

O'Rourke, C; Mujahed, S; Kumarasinghe, C; Miyazaki, T; Bowler, DR; (2018) Structural properties of Silicon-Germanium and Germanium-Silicon Core-Shell Nanowires. Journal of Physics: Condensed Matter 10.1088/1361-648X/aae617 . (In press). Green open access

https://ift.tt/2CKP98S

The Formation of Organizational Reputation

Ravasi, D; Rindova, V; Etter, M; Cornelissen, J; (2018) The Formation of Organizational Reputation. Academy of Management Annals , 12 (2) pp. 574-599. 10.5465/annals.2016.0124 . Green open access

https://ift.tt/2CifoTl

When Handicraft Experts Face Novelty: Effects of Shape and Wheel Familiarity on Individual and Community Standardization of Ceramic Vessels

Gandon, E; Coyle, T; Bootsma, RJ; (2014) When Handicraft Experts Face Novelty: Effects of Shape and Wheel Familiarity on Individual and Community Standardization of Ceramic Vessels. Journal of Anthropological Archaeology , 35 pp. 289-296. 10.1016/j.jaa.2014.06.008 . Green open access

https://ift.tt/2ChpjID

The role of SLC34A2 in intestinal phosphate absorption and phosphate homeostasis

Marks, J; (2019) The role of SLC34A2 in intestinal phosphate absorption and phosphate homeostasis. Pflügers Archiv European Journal of Physiology (In press).

https://ift.tt/2CLTqZX

Influence of Bubble Size, Diffuser Width, and Flow Rate on the Integral Behavior of Bubble Plumes

Fraga, B; Stoesser, T; (2016) Influence of Bubble Size, Diffuser Width, and Flow Rate on the Integral Behavior of Bubble Plumes. Journal of Geophysical Research: Oceans , 121 (6) pp. 3887-3904. 10.1002/2015JC011381 . Green open access

https://ift.tt/2CJYVbr

Are European HIV cohort data within EuroCoord representative of the diagnosed HIV population?

Vourli, G; Pharris, A; Cazein, F; Costagliola, D; Dabis, F; Del Amo, J; Delpech, V; ... Touloumi, G; + view all Vourli, G; Pharris, A; Cazein, F; Costagliola, D; Dabis, F; Del Amo, J; Delpech, V; Díaz, A; Girardi, E; Gourlay, A; Gunsenheimer-Bartmeyer, B; Hernando, V; Nikolopoulos, G; Porter, K; Rosińska, M; Sabin, C; Suligoi, B; Supervie, V; Wit, F; Touloumi, G; - view fewer (2018) Are European HIV cohort data within EuroCoord representative of the diagnosed HIV population? AIDS 10.1097/QAD.0000000000002034 . (In press).

https://ift.tt/2CLiBMg

Novel usage of microfocus computed tomography (micro-CT) for visualisation of human embryonic development-Implications for future non-invasive post-mortem investigation

Shelmerdine, SC; Hutchinson, JC; Kang, X; Suich, JD; Ashworth, M; Cannie, MM; Segers, V; ... Arthurs, OJ; + view all Shelmerdine, SC; Hutchinson, JC; Kang, X; Suich, JD; Ashworth, M; Cannie, MM; Segers, V; Sebire, NJ; Jani, JC; Arthurs, OJ; - view fewer (2018) Novel usage of microfocus computed tomography (micro-CT) for visualisation of human embryonic development-Implications for future non-invasive post-mortem investigation. Prenatal Diagnosis , 38 (7) pp. 538-542. 10.1002/pd.5281 .

https://ift.tt/2Cif9aT

A First Time in Human, Microdose, Positron Emission Tomography Study of the Safety, Immunogenicity, Biodistribution and Radiation Dosimetry of [18F]FB-A20FMDV2 for Imaging the Integrin αvβ6

Keat, N; Kenny, J; Chen, K; Onega, M; Garman, N; Slack, R; Parker, C; ... Lukey, P; + view all Keat, N; Kenny, J; Chen, K; Onega, M; Garman, N; Slack, R; Parker, C; Lumbers, RT; Hallett, W; Saleem, A; Passchier, J; Lukey, P; - view fewer (2018) A First Time in Human, Microdose, Positron Emission Tomography Study of the Safety, Immunogenicity, Biodistribution and Radiation Dosimetry of [18F]FB-A20FMDV2 for Imaging the Integrin αvβ6. Journal of Nuclear Medicine Technology , 40 (2) pp. 136-143. 10.2967/jnmt.117.203547 . Green open access

https://ift.tt/2Cif4nB

Frailty Defined by FRAIL Scale as a Predictor of Mortality: A Systematic Review and Meta-analysis

Kojima, G; (2018) Frailty Defined by FRAIL Scale as a Predictor of Mortality: A Systematic Review and Meta-analysis. Journal of the American Medical Directors Association , 19 (6) pp. 480-483. 10.1016/j.jamda.2018.04.006 .

https://ift.tt/2CJYXQB

Holographic Second Laws of Black Hole Thermodynamics

Bernamonti, A; Galli, F; Myers, RC; Oppenheim, J; (2018) Holographic Second Laws of Black Hole Thermodynamics. Journal of High Energy Physics , 2018 (111) 10.1007/JHEP07(2018)111 . Green open access

https://ift.tt/2Ce1gKN

Mechanistic Evaluation of Panretinal Photocoagulation Versus Aflibercept in Proliferative Diabetic Retinopathy: CLARITY Substudy

Nicholson, L; Crosby-Nwaobi, R; Vasconcelos, JC; Prevost, AT; Ramu, J; Riddell, A; Bainbridge, JW; ... Sivaprasad, S; + view all Nicholson, L; Crosby-Nwaobi, R; Vasconcelos, JC; Prevost, AT; Ramu, J; Riddell, A; Bainbridge, JW; Hykin, PG; Sivaprasad, S; - view fewer (2018) Mechanistic Evaluation of Panretinal Photocoagulation Versus Aflibercept in Proliferative Diabetic Retinopathy: CLARITY Substudy. Investigative Ophthalmology & Visual Science , 59 (10) pp. 4277-4284. 10.1167/iovs.17-23509 .

https://ift.tt/2CeTnEG

Stress correlates and vowel targets in Tongan

Garellek, M; White, J; (2012) Stress correlates and vowel targets in Tongan. UCLA: Department of Linguistics: Los Angeles, USA. Green open access

https://ift.tt/2CHMf53

Seeing is believing, or is it? An assessment of the influence of interior finish characteristics on thermal comfort perception at a University campus in a temperate climate

Foo, J; Mavrogianni, A; (2018) Seeing is believing, or is it? An assessment of the influence of interior finish characteristics on thermal comfort perception at a University campus in a temperate climate. In: Brotas, J and Roaf, S and Nicol, F and Humphreys, M, (eds.) Proceedings of 10th Windsor Conference Rethinking Comfort. (pp. pp. 275-295). NCEUB: Windsor, Berkshire, UK.

https://ift.tt/2CKP7hg

Nonmicrocephalic Infants with Congenital Zika Syndrome Suspected Only after Neuroimaging Evaluation Compared with Those with Microcephaly at Birth and Postnatally: How Large Is the Zika Virus “Iceberg”?

Aragao, MFVV; Holanda, AC; Brainer-Lima, AM; Petribu, NCL; Castillo, M; van der Linden, V; Serpa, SC; ... Costello, A; + view all Aragao, MFVV; Holanda, AC; Brainer-Lima, AM; Petribu, NCL; Castillo, M; van der Linden, V; Serpa, SC; Tenório, AG; Travassos, PTC; Cordeiro, MT; Sarteschi, C; Valenca, MM; Costello, A; - view fewer (2017) Nonmicrocephalic Infants with Congenital Zika Syndrome Suspected Only after Neuroimaging Evaluation Compared with Those with Microcephaly at Birth and Postnatally: How Large Is the Zika Virus "Iceberg"? American Journal of Neuroradiology , 38 (7) pp. 1427-1434. 10.3174/ajnr.A5216 .

https://ift.tt/2Cf5MbT

Radial vibrations of BPS skyrmions

Adam, C; Haberichter, M; Romanczukiewicz, T; Wereszczynski, A; (2016) Radial vibrations of BPS skyrmions. Physical Review D , 94 (9) , Article 096013. 10.1103/PhysRevD.94.096013 . Green open access

https://ift.tt/2CeTlN4

An eco-approach to optimise efficiency and productivity of a hydraulic excavator

Ng, F; Harding, JA; Glass, J; (2016) An eco-approach to optimise efficiency and productivity of a hydraulic excavator. Journal of Cleaner Production , 112 (5) pp. 3966-3976. 10.1016/j.jclepro.2015.06.110 . Green open access

https://ift.tt/2CL60bK

Inferring Thermal Turbulent Structures Properties in the Wake of an Array Cylindrical Obstacles

Mulahasan, S; Stoesser, T; (2018) Inferring Thermal Turbulent Structures Properties in the Wake of an Array Cylindrical Obstacles. In: Proceedings of the River Flow 2018 : 9th International Conference on Fluvial Hydraulics. (pp. pp. 1-8). E3S Web of Conferences: Lyon, France. Green open access

https://ift.tt/2CLToRP

Japanese familial anetoderma: A report of two cases and review of the published work

The Journal of Dermatology, EarlyView.


https://ift.tt/2OqEoix

Extracellular proteoglycan decorin maintains human hair follicle stem cells

The Journal of Dermatology, EarlyView.


https://ift.tt/2yICMFU

Cutaneous phaeohyphomycosis caused by Microsphaeropsis arundinis in a Japanese patient with cardiac sarcoidosis

The Journal of Dermatology, EarlyView.


https://ift.tt/2OqEtCR

Indeterminate dendritic cell neoplasm accompanied by eosinophilic pneumonia successfully treated by systemic steroid therapy: Report of the first case with muscular and parotid involvement and review of published work

The Journal of Dermatology, EarlyView.


https://ift.tt/2yICOO2

Sexuell übertragbare Infektionen in den Tropen

Zusammenfassung

Sexuell übertragbare Infektionen (STI) sind weltweit häufig; allein die Inzidenz für Chlamydien-Infektionen, Gonorrhö, Syphilis und Trichomoniasis wird auf 500 Mio. Fälle/Jahr geschätzt. Drei Viertel dieser Infektionen entfallen auf tropische Länder in Lateinamerika, Subsahara-Afrika sowie Süd- bzw. Südostasien. Unter „tropischen Geschlechtskrankheiten" werden die bakteriellen Infektionen Ulcus molle, Lymphogranuloma venereum und Granuloma inguinale zusammengefasst. Diese treten vornehmlich in den Ländern zwischen den Wendekreisen auf – Regionen, die zum einen durch ein feucht-heißes Klima, zum anderen vielfach durch Armut und Unterentwicklung gekennzeichnet sind. Die 3 Erkrankungen gehen primär mit Ulzera einher; ihr Vorliegen stellt daher ein erhöhtes Risiko für die Übertragung von HIV und anderen STI dar. Wie bei allen STI gilt auch für die Tropeninfektionen, dass Risikominimierung durch Verzicht auf riskante Sexualpraktiken und Kondombenutzung essenziell sind.

https://ift.tt/2PAiplu

Monitoring treatment response in patients affected by actinic keratosis: dermoscopic assessment and metalloproteinases evaluation after piroxicam 0.8% and sunfilter cream

Dermatologic Therapy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2OqCVJ2

Recent advances in the histological and molecular classification of endometrial stromal neoplasms

Abstract

This review addresses known features and recent developments in the histological, immunohistochemical, and molecular characterization of endometrial stromal neoplasms. We discuss the spectrum of these tumors, from the benign endometrial stromal nodule to low-grade endometrial stromal sarcoma to uterine undifferentiated sarcomas with a special emphasis on the expanding group of high-grade stromal sarcomas, recently added to the 2014 WHO classification, not only discussing the well-established YWHAE-FAM22 tumors but also two new groups, presenting with BCOR alterations including those with BCOR tandem internal duplications or NTRK fusions. It is likely that this high-grade category of endometrial stromal tumors will expand as increasing molecular data is available.

https://ift.tt/2Ck0dsu

Heated humidified high-flow nasal oxygen prevents intraoperative body temperature decrease in non-intubated thoracoscopy

Abstract

Purpose

In patients receiving non-intubated video-assisted thoracic surgery (NIVATS), transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) has been applied instead of oxygen mask for better oxygenation. However, the THRIVE effects on intraoperative temperature decrease have not been investigated.

Methods

Pre- and postoperative temperatures, measured by an infrared tympanic ear thermometer, taken before sending patients to the operation room and immediately upon their arrival in the postoperative anesthesia unit, were collected from medical records of patients who received NIVATS either with oxygen mask or THRIVE. Intraoperative temperature decrease, calculated by preoperative temperature minus postoperative temperature, was compared between different groups. Multiple linear regression analysis was performed to determine factors associated with intraoperative temperature decrease.

Results

Records of 256 adult patients with forced-air warming were retrospectively analyzed. 172 patients of them received THRIVE and 84 patients received oxygen mask. Preoperative temperatures were comparable between groups (THRIVE: 36.25 ± 0.46 °C; mask: 36.30 ± 0.39 °C, p = 0.43). Postoperative temperatures were significantly higher in patients using THRIVE than those using oxygen masks (36.05 ± 0.59 vs 35.87 ± 0.62 °C, p = 0.025). Significantly less intraoperative temperature decrease was shown in THRIVE group (THRIVE: 0.20 ± 0.69 °C; mask: 0.43 ± 0.69 °C, p = 0.04). According to the multiple linear regression analysis, significant temperature decrease was associated with the advanced age (β_age = 0.01) but not the anesthetic duration. Using THRIVE was correlated with significantly less body temperature decrease (β_TRIVE = − 0.24).

Conclusions

THRIVE effectively prevents intraoperative temperature decrease during NIVATS, especially in old patients.

https://ift.tt/2Py60yt

Fuzzy Logic Tool to Forecast Soil Fertility in Nigeria

The soil is composed of several nutrients which are important for the effective growth of plants. Nitrogen, phosphorus, and potassium are micronutrients which are very important for plant growth. There have been several methods and soil tests developed to test the compositions of these nutrients in the soil. Interpreting the results gotten from such tests has been a herculean task for farmers. Employing the use of a soft computing method to interpret such result would be a noble idea. In this paper, we describe the use of fuzzy logic to interpret the values of nitrogen, phosphorus, and potassium (NPK) gotten from conventional soil test to know their levels in the soil and predict possible NPK inputs.

https://ift.tt/2NEbTbO

Clinical Use of the Pictorial Baxter Retching Faces Scale for the Measurement of Postoperative Nausea in Children

BACKGROUND: Because nausea is difficult to evaluate in children, vomiting is used as the objective clinical end point in managing pediatric postoperative nausea and vomiting and postdischarge nausea and vomiting (PDNV). The recently developed pictorial Baxter Retching Faces (BARF) scale has content, construct, and convergent validity in quantifying pediatric nausea intensity. We determined its clinical usefulness in assessing pediatric postoperative nausea and vomiting and PDNV, establishing the lowest age associated with consistently reliable use, the score at which patients identify a need for therapy, and the minimum clinically relevant change in scores, and examined its test–retest reliability. METHODS: We obtained subject ratings of the severity of their nausea using the BARF and visual analog scales in the preoperative, postanesthesia care unit and postdischarge phases. Changes in nausea were rated on a 5-point Likert scale, along with responses to queries of a need for rescue antiemetics at these time points. RESULTS: Children ≥6 years of age had a consistently reliable ability to use the BARF scale (132/132 [100%] vs 59/76 [77.6%] for children ≥6 and 6) in 13 (6.7%). Emesis occurred in 8 (4.1%). Rescue antiemetics were administered to 16 (8.3%), including 2 with severe emesis (≥3 episodes) but in only 2 of 11 (18.2%) with severe nausea without vomiting. PDNV was reported in 39 of the 99 who returned diaries (39.4%), with nausea in 34 (34.3%), severe nausea in 15 (15.2 %), and emesis in 16 (16.2%). CONCLUSIONS: The pictorial BARF scale is easy to use in the clinical setting by children ≥6 years of age, has a minimum clinically relevant difference of 1.47, with scores of 4 or higher associated with a patient-identified need for rescue antiemetics. Assessment of postoperative nausea by the BARF scale has shown that clinically significant nausea occurs frequently in children but is not always treated unless accompanied by vomiting. Accepted for publication September 5, 2018. Funding: This work was supported by internal funding from the Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, Houston, TX, and Baylor College of Medicine, Houston, TX. The authors declare no conflicts of interest. Clinical trials registration: The trial was registered before patient enrollment at clinicaltrials.gov (NCT 02421952, principal investigator: S.A.B.; date of registration: April 21, 2015). Reprints will not be available from the authors. Address correspondence to Mehernoor F. Watcha, MD, Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, 6621 Fannin St, Suite A 3300, Houston, TX 77030. Address e-mail to mwatcha@gmail.com. © 2018 International Anesthesia Research Society

https://ift.tt/2CKr5Do

Anesthesia in Enhanced Recovery Pathways for Hip and Knee Arthroplasty: Where Is the Evidence?

No abstract available

https://ift.tt/2CM8l6v

Rapid Titration of Intravenous Treprostinil to Treat Severe Pulmonary Arterial Hypertension Postpartum: A Retrospective Observational Case Series Study

BACKGROUND: Pulmonary hypertension during pregnancy carries high mortality rate. The relatively long-acting, specific pulmonary vasodilator treprostinil has been used to improve survival in these parturients. Slow uptitration is performed in most cases, and rapid titration has not been reported in the postpartum period. METHODS: We retrospectively reviewed 17 pregnant patients with severe pulmonary arterial hypertension who were treated with intravenous treprostinil in our institution between 2014 and 2016. Patients' demographic characteristics, etiology, functional status, mode of delivery, anesthetic administration, medical therapy, echocardiographic and hemodynamic measurements, subsequent clinical course, and maternal–fetal outcomes were assessed. The a priori primary outcome is maternal mortality in this study. RESULTS: Rapid titration of intravenous treprostinil was initiated at 1.25 ng/kg/min and increased to effective dose of 10 ng/kg/min by 1.25–2.5 ng/kg/min every 3 hours. In the next 24 hours, we adjusted the dosage to a median maximum dose of 15 ng/kg/min (interquartile range, 15–20 ng/kg/min) over a median uptitration period of 34 hours (interquartile range, 24–41 hours) for 17 parturients with severe pulmonary hypertension. Treprostinil was weaned off by 0.50–1.25 ng/kg/min every 3 hours in 94.3 ± 42.4 hours. Fifteen patients survived to discharge, and only 2 patients died of pulmonary hypertensive crisis (maternal mortality rate, 11.7%). No treprostinil infusion-related postpartum complication was observed. CONCLUSIONS: Our experience suggested that rapid uptitration of intravenous treprostinil combined with oral sildenafil in the postpartum period may be a safe and effective approach for these very sick parturients with severe pulmonary hypertension. Accepted for publication August 23, 2018. Funding: None. The authors declare no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (https://ift.tt/KegmMq). T. Wang and J. Lu contributed equally and share first authorship. Reprints will not be available from the authors. Address correspondence to Jiapeng Huang, MD, PhD, Department of Anesthesiology and Perioperative Medicine, University of Louisville, 200 Abraham Flexner Way, Louisville, KY 40202. Address e-mail to jiapenghuang@yahoo.com; and Jinglan Zhang, MD, Department of Surgical Intensive Care Medicine, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing AnZhen Hospital, Capital Medical University, No. 2 AnZhen Rd, Chaoyang District, Beijing 100029, People's Republic of China. Address e-mail to jinglanzhang2006@163.com. © 2018 International Anesthesia Research Society

https://ift.tt/2QSPZUm

In Response

No abstract available

https://ift.tt/2QRf6Xs

Electronic Audit and Feedback With Positive Rewards Improve Anesthesia Provider Compliance With a Barcode-Based Drug Safety System

BACKGROUND: We implemented a previously described barcode-based drug safety system in all of our anesthetizing locations. Providers were instructed to scan the barcode on syringes using our Anesthesia Information Management System before drug administration, but the rate of provider adherence was low. We studied an implementation intervention intended to increase the rate of scanning. METHODS: Using our Anesthesia Information Management System and Smart Anesthesia Manager software, we quantified syringe drug administrations by anesthesia providers with and without barcode scanning. We use an anesthesia team model in which an attending anesthesiologist is paired with a certified registered nurse anesthetist (CRNA) or a resident. Our system identified the pair of providers associated with a particular drug administration, but did not distinguish which providers actually administered the drug. Therefore, the rate of barcode scanning for a particular case was assigned to both providers equally. A baseline rate of scanning was established over a period of 17 months. An audit and feedback intervention was then performed that consisted of monthly performance reports sent by email to individual providers along with coffee gift card awards for top performers. The coffee gift cards were awarded in only the first 2 months of the intervention, while the email performance reports continued on a monthly basis. The coffee card awards were made public. The monthly emails reported the individual provider's rank order of performance relative to other providers, but was otherwise anonymous. The baseline rate of scanning was compared to the rate of scanning after the intervention for a period of 7 months. RESULTS: From November 2014 to March 2017, we accumulated 60,197 cases performed by 88 attending anesthesiologists, 65 CRNAs, and 148 residents. The total number of syringe drug administrations was 653,355. Average scanning performance improved from 8.7% of syringe barcodes scanned during the baseline period from November 2014 to February 2016 to 64.4% scanned during the period September 2016 to March 2017 (P

https://ift.tt/2CgdORS

In Response

No abstract available

https://ift.tt/2Cf0hK9

Hepatic Critical Care

No abstract available

https://ift.tt/2CKNvEa

Improving outcomes in ambulatory anesthesia by identifying high risk patients

Purpose of review Currently, outcome data in ambulatory anesthesia are somewhat limited though results are quite good with low reported rates of mortality and major morbidity. As patient comorbidities and surgical invasiveness increase, identifying those patients at higher risk will help to focus quality improvement energy and research where most effective. Better data collection and analysis will refine patient and procedure selection and improve outcomes going forward. Recent findings Complications after ambulatory surgery are associated with age, higher American Society of Anesthesiologists physical status, obstructive sleep apnea, and obesity. Frailty has recently been linked to increased complications in ambulatory surgery as well. Newer ambulatory procedures such as spine and total joint arthroplasty require careful patient selection. Summary Identifying high-risk ambulatory patients can help facilitate development of a strategy to triage these patients, optimize their conditions prior to surgery, and manage their care and disposition postoperatively. Inpatient surgery or admission should be considered for higher risk patients having high invasive surgery. Correspondence to Michael T. Walsh, MD, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Tel: +507 284 9700; fax: +507 284 0120; e-mail: walsh.michael1@mayo.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2IXRde2

Prospective, Randomized Comparison of the i-gel and the Self-Pressurized air-Q Intubating Laryngeal Airway in Elderly Anesthetized Patients

BACKGROUND: Age-related changes in upper airway anatomy may affect the overall performance of supraglottic airways significantly. The clinical performance of the i-gel and the self-pressurized air-Q intubating laryngeal airways with noninflatable cuffs for elderly populations remains unknown, unlike in children. Thus, we performed a prospective, randomized comparison of these 2 supraglottic airways in elderly patients undergoing general anesthesia. METHODS: We recruited 100 patients, 65–90 years of age, who were scheduled for elective surgery under general anesthesia with muscle relaxation. The enrolled patients were allocated to the i-gel or self-pressurized air-Q group. We assessed oropharyngeal leak pressure as the primary outcome and fiberoptic view after placement and fixation of the airway and at 10 minutes after the initial assessment. The fiberoptic view was scored using a 5-point scale as follows: vocal cords not visible; vocal cords and anterior epiglottis visible, >50% visual obstruction of epiglottis to vocal cords; vocal cords and anterior epiglottis visible,

https://ift.tt/2CgwfFV

Attenuation of Unevoked Mechanical and Cold Pain Hypersensitivities Associated With Experimental Neuropathy in Mice by Angiotensin II Type-2 Receptor Antagonism

Recent findings from a phase II clinical trial showed analgesic effects of an angiotensin II type-2 receptor (AT2R) antagonist in postherpetic neuralgia patients. This study aimed to investigate whether AT2R antagonism could provide effective analgesia in voluntary measures of unevoked/ongoing pain-like behaviors in mice with experimental neuropathy. Mice were subjected to spared nerve injury to induce neuropathy and tested in 2 operant behavioral tests to measure ongoing mechanical and cold pain hypersensitivities. Systemic administration of an AT2R antagonist provided effective analgesia in these behavioral measures of mechanical and cold pain in spared nerve injury mice, suggesting its effectiveness in neuropathic pain. Accepted for publication September 6, 2018. Funding: This study was supported by a pilot and feasibility grant from the Washington University Nutrition Obesity Research Center National Institutes of Health grant P30DK056341 (to A.J.S.) and by start-up funds from the Department of Anesthesiology, Washington University Pain Center and Washington University School of Medicine (to D.P.M.). The authors declare no conflicts of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (https://ift.tt/KegmMq). Reprints will not be available from the authors. Address correspondence to Andrew J. Shepherd, PhD, Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine in St Louis, St Louis, MO 63110. Address e-mail to a.shepherd@wustl.edu; and Durga P. Mohapatra, PhD, Department of Anesthesiology and Washington University Pain Center, Washington University School of Medicine in St Louis, St Louis, MO 63110. Address e-mail to d.p.mohapatra@wustl.edu. © 2018 International Anesthesia Research Society

https://ift.tt/2Cg7Yjj

Initial results of ixekizumab efficacy and safety in real‐world plaque psoriasis patients: A multicenter retrospective study

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2CfZ05C

Picosecond laser for atrophic surgical scars treatment: in vivo monitoring of results by means of reflectance confocal microscopy

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Aa5660

Long‐term efficacy and safety of ixekizumab in Japanese patients with erythrodermic or generalized pustular psoriasis: Subgroup analyses of an open‐label, phase 3 study (UNCOVER‐J)

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2AaLNcV

Systemic corticosteroid use in psoriasis: a national survey of board‐certified dermatologists

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Ab66qA

Association between psoriasis, psoriatic arthritis and gout: A nationwide population‐based study

Journal of the European Academy of Dermatology and Venereology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2Ci1RLz

Response to critical appraisal of LIBERTY AD CHRONOS

British Journal of Dermatology, EarlyView.


https://ift.tt/2OnCzCS

Response to Critical appraisal of LIBERTY AD CHRONOS: reply from authors

British Journal of Dermatology, EarlyView.


https://ift.tt/2IXQCcn

Noncaseating suppurative granulomatous lymphadenitis in adult onset Still’s disease – a diagnostic dilemma in a tuberculosis-endemic region: a case report

Lymphadenopathy is not an uncommon presentation of adult onset Still's disease: it is present in up to two thirds of patients with adult onset Still's disease. The characteristic appearance of lymphadenopathy ...

https://ift.tt/2EiXVgc

The effectiveness of hyperbaric oxygen in patients with idiopathic sudden sensorineural hearing loss: a systematic review

Abstract

Objective

To evaluate the effectiveness of hyperbaric oxygen in the treatment of patients with idiopathic sudden sensorineural hearing loss (ISSHL).

Data sources

An Embase, MEDLINE and Cochrane search were utilised to identify various clinical trials on the treatment of ISSHL. Studies that were published between 2002 and 2018 and written in the English, Dutch or German language were included. Search terms included synonyms for idiopathic sudden hearing loss.

Data synthesis

A total of 16 articles were identified regarding hyperbaric oxygen therapy. All patients were evaluated with pure-tone audiometry. A major part of the cases presented with unilateral hearing loss(bilateral hearing loss less than 5%). In several studies, the average of the mean hearing gain at five contiguous frequencies was significantly higher in the hyperbaric oxygen (HBO) therapy and systemic steroid (SS) group in patients with severe or profound hearing impairment. They recorded a significant treatment effect (p = 0.005) of HBO + SS therapy on patients with an initial hearing loss of ≥ 81 dB.

Conclusions

On the whole group of ISSHL patients, no significant difference was demonstrated between the intervention and control group. However, in severe or profound hearing-impaired ISSHL patients, significant benefit was observed in the intervention group. These results likely indicate that adding HBO to steroid therapies might be of benefit in cases of severe and profound hearing impairment.

https://ift.tt/2AaCcTe